How long do I have to decide if I want to elect COBRA?top ^
Each Qualified Beneficiary has 60 days to elect COBRA Continuation Coverage. The 60-day period begins on the later of: the date of the Qualifying Event, the date of coverage termination, or the date on which the formal notice of the right to continue COBRA coverage is originally provided.
A Qualified Beneficiary who would normally have received 18 months of coverage may extend the duration of COBRA coverage to 29 months if they are determined to be disabled by the Social Security Administration within 60 days of the Qualifying Event date. Vita must be notified of the disability determination within 60 days after the date of the Social Security determination and before the end of the original 18-month period that applies to the Qualifying Event.
36 Months
Death of Employee
Divorce or Legal Separation
Dependent Child Ceases to be an Eligible Dependent Under Plan (for example, due to Age, Marital Status or Student Status)
Employer Commences a Bankruptcy Proceeding (For Covered Retirees and Their Dependents Only)
Who may elect COBRA?top ^
Each Qualified Beneficiary (an individual who has experienced a Qualifying Event) has the option to elect any combination of health coverages provided to other similarly situated employees of the employer for whom a Qualifying Event has not occurred. In some circumstances, domestic partners who were covered under the group health plan may be eligible for coverage under COBRA. However, federal COBRA law does not require such continuation coverage for domestic partners. Please contact Vita Administration Company with any questions regarding domestic partner eligibility.
How much will it cost if I elect?top ^
The premium equals 100% of the premium that your former employer pays on behalf of similarly situated non-COBRA individuals plus an administration fee of an additional 2% of the premium cost. Premiums for a COBRA extension due to the disability of a Qualified Beneficiary is 150% of premium, commencing in the 19th month. Please refer to your Monthly Premium Rate Sheet for your specific rate.
When is my payment due?top ^
The monthly premiums are due on the first of each month. (Immediate payment of all current and retroactive premiums and completion of re-enrollment materials is recommended to avoid claims suspension). Your coverage will be canceled retroactively if your payment is not postmarked within 30 days of the premium payment due date. Once COBRA coverage is canceled, there is no option for reinstatement. No claim is paid for services incurred during the premium grace period until the full premium is paid for the month in which the claim is incurred.
Who do I make the payment payable to?top ^
All payments must be made payable to Vita Administration Company. DO NOT make payments to the employer or carrier offering the continuation coverage.
When can I see a physician or pick up a prescription?top ^
Once we receive your first COBRA premium payment, the insurance carriers will typically take 7-10 business days, to reinstate your coverage. Coverage will be reinstated retroactively, but please allow for this processing time before utilizing any insurance plan services. If you are unable to wait 7-10 business days, you may be required to pay out of pocket for any expenses incurred. You may file a claim directly with the insurance carrier to be reimbursed for your out of pocket expenses after your coverage has been reinstated.
Am I eligible for an 18 month extension of coverage under Cal-COBRA?top ^
You may be eligible for this extension provided you are entitled to less than 36 months of federal COBRA, your former employer’s insurance contract is sitused in California, you are enrolled in a fully-insured medical plan, and you are not eligible for or enrolled on Medicare. The premium charged under this Cal-COBRA extension may be up to 110% of the employer cost. Please contact your medical insurance carrier directly, in writing, well in advance of the termination date of your federal COBRA coverage, to inquire about the availability of this option.
Can I add a dependent in the event of a marriage, birth or adoption?top ^
If you acquire a new dependent (due to marriage, birth or adoption) and that dependent would have qualified for group coverage if you were still covered as an employee, you may elect to add your new dependent to your COBRA Continuation Coverage. You are responsible for notifying both Vita and your insurance carrier directly within 30 days of the formal date of marriage, birth, or adoption. After 30 days, your special open enrollment option to add your new dependent expires.
Can I drop a dependent?top ^
Yes, COBRA coverage runs month to month, so you may drop coverage for a dependent in any given month as well as terminate coverage for yourself.
The date no coverage is provided for any employees.
The date a qualified beneficiary first becomes covered under any other group health plan, if this date is after the date of COBRA election. (An exception is provided if the other group health plan includes a pre-existing condition exclusion or limitation to which you are subject).
Premiums are not paid within the standard 30-day grace period after the premium due date.
The date a Qualified Beneficiary becomes entitled to Medicare (if this date is after the date of COBRA election), or
The date a similarly situated employee would be deemed ineligible per the employer master group contracts.
Group Coverage: If you are married and your spouse’s employer offers health coverage, the HIPAA law allows you to enter a spouse’s plan upon expiration of your COBRA coverage. You must request enrollment within 30 days of your COBRA coverage termination date.
Individual Policy: If you are in good health and can qualify by answering many detailed medical questions, you may apply for an individual health insurance policy through any private health insurance carrier. Please examine your options carefully before declining this coverage. You should be aware that companies selling individual health insurance typically require a review of your medical history that could result in a higher premium or you could be denied coverage entirely.
HIPAA Individual Policy: Alternatively, you may seek individual medical insurance with a carrier specializing in health insurance. The Health Insurance Portability and Accountability Act (HIPAA) states that insurance carriers must offer their two most popular individual plans on a guarantee issue basis. This coverage will be more expensive, but you cannot be denied coverage if you have exhausted your COBRA Coverage, even if you have a pre-existing health condition. To exercise this option, please contact any insurance carrier that offers individual plans in your state. Certain restrictions apply to receiving this coverage.
Conversion Coverage: You and your covered dependents may be entitled to convert your health coverage to a permanent, individual plan. This option may be available through your current medical insurance carrier and detailed information must be requested directly from the carrier. In order to qualify for conversion coverage, the carrier must receive your application and payment within the 30 days following termination of your COBRA Continuation Coverage. No exceptions will be permitted by the carriers beyond the 30-day deadline.
AB 1401 Cal-COBRA Extension (California Only): The Cal-COBRA extension provides up to 36 months of medical coverage from the date federal COBRA coverage began. You may be eligible for this extension provided you are entitled to less than 36 months of continuation coverage under federal COBRA, your former employer’s insurance contract is sitused in California, you are enrolled in a fully-insured medical plan, and you are not eligible for or enrolled on Medicare. The premium charged under this Cal-COBRA extension can be up to 110% of the total cost. Please contact (insurance carrier) directly, at (phone number) well in advance of the termination date of your federal COBRA coverage to inquire about the availability of this option.
Other State Continuation Programs: If you live outside of California, there may be other state insurance options available to you. Please contact your state insurance board to inquire about these options.
California Department of Insurance License #0581175
Securities offered through Liberty Group, L.L.C.
Member FINRA, SIPC, MSRB, Registered Investment Advisor
