COBRA Rights

Under federal law, employees may extend medical coverage (called COBRA continuation coverage) at group rates when coverage under their plan ends. The COBRA participant pays the entire premium for coverage. The length of COBRA coverage is up to 18 months with extensions in some circumstances, e.g., disability, with a maximum of 36 months of coverage.

Employees may have a right to choose COBRA when they lose coverage due to a reduction in work hours or termination. Covered dependents also have a right, independent of the employee’s right, to COBRA. A spouse or dependent child covered under an employee’s medical plan may have the right to elect COBRA if the employee’s coverage ends or when they no longer meet the definition of a dependent.

Indiana University must depend on notice from the employee when certain events occur that would qualify the employee or dependent for COBRA. Under COBRA regulations, the employee or family member is responsible for informing the university of such events, including divorce or a child’s loss of eligible status (e.g., due to age or marriage). Generally, such notice must be within 60 days of the date on which coverage would end because of the event. When Indiana University determines that an employee or dependent has experienced a COBRA-qualifying event, IU provides a written notice of COBRA rights and an application. The employee and/or dependents then have 60 days to elect coverage.

In considering whether to elect COBRA continuation coverage, individuals should take into account that a failure to continue group health coverage will affect the future rights (listed below) under federal law.

• The right to avoid pre-existing condition exclusions applied by other group health care plans is lost when there is more than a 63-day gap in health coverage. Election of COBRA may help to avoid such a gap.
• The guaranteed right to purchase individual health insurance policies without pre-existing condition exclusions may be lost if COBRA is not maintained for the maximum time available.
• There are special enrollment rights under federal law to consider. Generally, there is a right to request special enrollment in another group health plan (such as a plan sponsored by a spouse’s employer) within 30 days after group health coverage ends because of a qualifying event. The same special enrollment right is available at the end of COBRA coverage when COBRA is maintained for the maximum time available to the participant.

Additional information is available at www.indiana.edu/~uhrs/benefits/cobra.html or by contacting the COBRA specialist at 812-855-7833.

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