Health Account Solutions Resource Hub

COBRA Administration

Continue your group health insurance even after you leave the company.

The Consolidated Omnibus Budget Reconciliation (COBRA) Act of 1985 gives employees from companies with 20+ employees the right to continue participating in their group health insurance coverage after leaving (voluntarily or involuntarily) a job on a self-pay basis.
COBRA requires continuation coverage to be offered to covered employees and dependents when group health coverage would otherwise be lost due to qualified events.

What counts as a qualified event?

  • Termination of employment for any reason other than gross misconduct
  • Reduction in the number of hours of employment
  • Covered employee becomes entitled to Medicare
  • Divorce or legal separation of the spouse from the covered employee
  • Death of the covered employee
In case you become entitled to receive COBRA coverage, you must be given an election period of at least 60 days (starting on the date you receive an election notice or the date you would lose coverage) to choose whether to elect continuation coverage. You may choose to maintain your coverage for 18 or 36 months and be able to make changes to your plan during open enrollment periods. 



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If I waive COBRA coverage during the election period, can I still get coverage at a later date?

If you waive COBRA coverage during the election period, you must be permitted later to revoke your waiver of coverage and to elect continuation coverage as long as you do so during the election period. Then, the plan need only provide continuation coverage beginning on the date you revoke the waiver.

Under COBRA, what benefits must be covered?

If you elect continuation coverage, the coverage you are given must be identical to the coverage currently available under the plan to similarly situated active employees and their families (generally, this is the same coverage that you had immediately before the qualifying event). 


You will also be entitled, while receiving continuation coverage, to the same benefits, choices, and services that a similarly situated participant or beneficiary is currently receiving under the plan, such as the right during open enrollment season to choose among available coverage options. You will also be subject to the same rules and limits that would apply to a similarly situated participant or beneficiary, such as copayment requirements, deductibles, and coverage limits. The plan's rules for filing benefit claims and appealing any claims denials also apply. 

Any change made to the plan's terms that apply to similarly situated active employees and their families will also apply to qualified beneficiaries receiving COBRA continuation coverage. If a child is born to or adopted by a covered employee during a period of continuation coverage, the child is automatically considered to be a qualified beneficiary receiving continuation coverage. You should consult your plan for the rules that apply for adding your child to continuation coverage under those circumstances.

How do I file a COBRA claim for benefits?

Health plan rules must explain how to obtain benefits and must include written procedures for processing claims. You should submit a claim for benefits in accordance with these rules. Claims procedures must be described in the Summary Plan Description. Contact the plan administrator for more information on filing a claim for benefits.

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COBRA Administration offered by Voya Benefits Company, LLC (in New York, doing business as Voya BC, LLC). 

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