How long can I keep COBRA coverage?

If you are entitled to COBRA continutation coverage, you can continue coverage for a maximum of 18 months under the following events:

• due to termination of employment,
• loss of coverage following leave without pay, or
• reduction in hours. 

An 18-month continuation period may be extended to 36 months if a secondary qualifying event occurs during the initial 18-month continuation coverage period (e.g., divorce, death or loss of dependent status). You are never entitled to more than 36 months of continuation coverage.

How much are the premiums?

When are premiums due?

The initial COBRA premium payment will be due within 105 days of the date coverage terminated or the date of notice whichever is later. Subsequent premiums are due on the first day of the coverage month.

Your monthly premium payment must be postmarked within thirty (30) days of the due date or coverage will be automatically cancelled retroactive to the last day of the month in which a full premium payment was received and was not considered delinquent. It is your responsibility to keep up with your premium payments.  If you are unsure of when your last payment was made, call ERS. If your coverage is cancelled, ERS will notify you in writing.  Cancelled COBRA coverage may not be reinstated.

 If you will receive an annuity from ERS, your monthly premium will be automatically deducted from your monthly annuity payment.

What are the differences for disabled individuals on COBRA?

If you are determined to be disabled by the Social Security Administration (SSA) under Title II or XVI before or at any time during the first 60 days of COBRA coverage, you may be eligible to extend coverage from 18 to a possible maximum of 29 months.

The premium for disability participants who extend their coverage beyond the initial 18 months of coverage will be calculated at 150% of the current group rate.

For what reasons can COBRA coverage be cancelled by ERS?

COBRA coverage may be cancelled prior to the end of the continuation coverage expiration date if:

• A timely premium payment is not received.
• The GBP ceases to provide coverage to any employee/retiree.
• The participant becomes covered under another group health and/or dental plan on or after the COBRA coverage effective date unless the participant is subject to a pre-existing condition limitation or exclusion in the other group health plan. COBRA coverage will end when the new group health plan coverage begins and there is no limitation or exclusion for pre-existing conditions in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  
• The participant begins receiving Medicare benefits on or after the COBRA coverage effective date.
• The participant extends coverage due to a disability and later begins receiving Medicare benefits or the Social Security Administration (SSA) makes a final determination that the disability no longer exists.
• A written request is received from the participant requesting cancellation of coverage. Coverage cancellations will be made effective the last day of the month in which the U.S. Postal Service postmarks the request. A full premium payment must be submitted for the month in which a request for cancellation is submitted.

May cancelled COBRA coverage be reinstated?

What happens if I become covered by another health plan or begin receiving Medicare Benefits?

You are responsible for notifying the ERS in writing when you enroll in another group health and/or dental plan or begin receiving Medicare benefits. The right to continue COBRA coverage terminates when an individual becomes covered on or after the COBRA effective date by another group health plan that does not limit or exclude coverage for pre-existing conditions OR if you begin receiving Medicare benefits. Your COBRA coverage will be cancelled retroactive to the last day of the month prior to the month in which you first became covered under the other group health and/or dental plan or began receiving Medicare benefits.

Under HIPAA a group health plan’s pre-existing condition exclusion period will be reduced month for month by the individual’s preceding period of “creditable coverage” under another health plan. The continuous coverage period in another health plan is considered “creditable coverage” provided there has been no lapse in coverage of more than 63 days. COBRA continuation coverage may be terminated if a COBRA participant becomes covered by a new group health plan with a pre-existing condition exclusion clause that is satisfied by the “creditable coverage” provision. The HIPAA rules limiting the applicability of exclusions in most employers’ health plans for pre-existing conditions became effective in plan years beginning on or after July 1, 1997.

If a participant becomes covered by another group health plan that limits or excludes coverage for pre-existing conditions on or after the COBRA effective date, COBRA coverage will not be terminated until the expiration of the pre-existing conditions exclusion period. In order to continue COBRA coverage you will be required to provide the following items regarding the other group health plan: documentation of the pre-existing conditions limitation provision, documentation of the effective date of coverage for each person that is covered by the other group health plan and documentation (e.g. medical or prescription billings) indicating that services were provided during the pre-existing period for each person that is covered by the other group health plan. COBRA coverage will be cancelled on the last day of the month in which the pre-existing condition exclusion period expires

What if I return to employment with a GBP participating agency or higher education agency?

Can I make changes to my COBRA coverage?

COBRA coverage will continue with your current health and/or dental carrier. If you are enrolled in a health maintenance organization (HMO) and move out of the service area where there is no other HMO available, you will be automatically enrolled in HealthSelect.

You may decrease your level of coverage by submitting a written request to the ERS. The decrease in coverage will be effective the first day of the month following the postmarked date of your request.

Newly acquired dependents may be added if you notify the ERS in writing within thirty (30) days of the qualifying life event.

Can COBRA coverage be converted to an individual policy?