The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires that a group health plan offer you the opportunity to receive continued coverage you had while an active employee or dependent if you lose health coverage.
Eligibility
The following individuals qualify for coverage if they were covered under the plan at the time of one of the following events:
- An employee and his/her dependents who lose coverage due to reduction in scheduled work hours or termination of employment (including retirement, layoff, and strike) for reasons other than gross misconduct.
- An employee’s former spouse/partner (and/or children) who lose coverage due to divorce or legal separation.
- An employee’s surviving spouse/partner (and/or children) who lose coverage due to the employee’s death.
- An employee’s spouse/partner (and/or children) who lose coverage due to the employee’s entitlement to Medicare.
- An employee’s child who lose coverage due to no longer meeting the definition of dependent under the plan (i.e., attainment of maximum age).
Please note: With the exception of the first item above, it is possible that you as the employee would need to notify the Benefits Department of such a change in family status. This would require you to fill out necessary paperwork to make a change. Please contact the Benefits Department at 833-852-2210 for details and deadlines.
How Long Can I Continue?
The following are the maximum continuation periods:
- Eighteen (18) months from the qualifying event date for individuals who lose coverage due to termination of employment, retirement, layoff, strike, or reduction in work hours.
- Exception: Individuals who were disabled prior to or within the first 60 days of COBRA coverage may be eligible to continue for a maximum of 29 months (contact COBRA directly about Disability Extension)
- Thirty-six (36) months from the qualifying event date for qualified dependents who lose coverage due to divorce, legal separation, employee's death, loss of dependent status, or employee's loss of group coverage due to Medicare entitlement.
How do I elect COBRA coverage?
In order to continue coverage for yourself and your qualified dependents, you must complete a continuation election form from UPMC Benefit Management Services within 60 days of the date of the notice or 60 days from the date of termination of coverage, whichever is later. If you mail your election form after this deadline, continuation will be denied.
Your coverage will remain with the same insurance carriers. Questions regarding coverage should be directed to your insurance carrier. Claims will continue to be processed by your insurance carrier.
You may be able to continue contributing to your health care flexible spending account through COBRA. For additional information, please call Benefit Management Services at 1-888-499-6885.
Rates may differ dependent on your role and union representation status at the University.
To determine your rates, follow these instructions:
During Open Enrollment:
For the coming plan year information, visit our main Open Enrollment page.
Any other time of year:
For current year plan information, visit our Health & Welfare Benefits page.
Once on the appropriate page:
- Within the dropdowns on those pages:
- Select your role and union representation status
- Be aware of your Full Time Equivalent (FTE) status
- Click on the associated "Eligibility Chart" button to review what benefits you're eligible for.
- Review plan information based on your role/status.