The following rules apply only to groups with 20 or more employees on 50 percent of the workdays in the previous calendar year.
Note: This information is only intended to be a brief overview. Federal laws and regulations regarding COBRA are publicly available online at dol.gov.
Who is eligible to receive COBRA?
A subscriber (employee) and any enrolled dependent have the right to elect up to 18 months of COBRA continuation coverage if they lose coverage under your group health plan due to:
A reduction in hours
Termination of the subscriber’s employment for any reason other than gross misconduct
A dependent has the right to elect up to 36 months of COBRA continuation coverage if he/she loses coverage under your group health plan due to:
The subscriber’s death
The subscriber’s divorce or legal separation
The subscriber becomes entitled to Medicare benefits under Part A, Part B or both
The dependent no longer qualifies as a dependent child
How do eligible participants enroll in COBRA?
The COBRA administrator must notify Sierra Health and Life of a qualifying event within 30 days.
Eligible participants (subscribers and dependents) must be sent an election notice no later than 14 days after Sierra Health and Life receives notice that a qualifying event has occurred.
The plan offered to eligible participants must be the same plan offered to other participants in similar situations. The same applies for State Continuation with the exception of vision and dental care.
Eligible participants must elect to continue coverage within 60 days of the election notice via a membership change form or enrollment form. Submit the form to your Group Services representative and be sure to include the reason for termination and what qualifies the participant to receive COBRA. If the election is not made within 60 days, the participant is not eligible to continue coverage under this plan.
Initial premiums are due within 45 days after the participant elects continuation coverage. Subsequent premiums are due on the first day of the month during which coverage is extended.
Sierra Health and Life assumes no responsibility for the COBRA administrator’s failure to provide notifications to eligible participants.
In addition, Sierra Health and Life assumes no obligation to provide COBRA continuation coverage if:
The COBRA administrator does not notify eligible participants within 44 days of the qualifying event
The eligible participants do not make a timely election
The COBRA administrator fails to notify Sierra Health and Life of the election within 30 days of the election