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Benefits

COBRA

What is COBRA?
Who is Eligible?
How Does it Work?
How Do I Elect COBRA?
Other COBRA FAQ's 
Helpful Links

What is COBRA?

COBRA is the law that requires employers to provide continuation of group health coverage to employees and their dependents that lose benefits involuntarily. It contains provisions giving certain employees, spouses, and dependent children the opportunity to choose to continue the same health care benefits they were enrolled in before certain “qualifying events” occurred (see table).

Who is Eligible for COBRA Coverage?

COBRA uses the term "Qualified Beneficiaries" to designate who is eligible for COBRA. A qualified beneficiary generally is an individual covered by a group health plan on the day before a certain qualifying event. Generally, it is the employee, the employee's spouse, or an employee's dependent child. In addition, any child born to or placed for adoption with a covered employee during the period of COBRA coverage is considered a qualified beneficiary. At BMC we also consider Same Sex Spouses, Domestic Partners and their children as qualified beneficiaries.

How Does COBRA Work?

You or one of your dependents must experience a COBRA qualifying event that results in the loss of group coverage. The type of event determines the length of coverage that will be offered (see table).


Cobra Qualifying Event



Active Coverage Ends



Length of Cobra



For Whom


You terminate employment (for reasons other than gross misconduct)

Saturday following your termination date

18 months

You and your dependents

Reduction in hours (less than  20). Change in employment status (regular to temp or per diem)

Date of hours or status change

18 months

You and your dependents

You become disabled within the first 60 days of COBRA coverage (as determined by the Social Security Administration)

N/A

11 month extension to your first COBRA event

You and your dependents

You divorce or legally separate (you must provide your spouses new address)

Date of divorce or separation

36 months

You and your dependents

You pass away

Date of death

36 months

Your dependents

Your dependent no longer meets the eligibility requirements (child turns 26, or it has been 2 years since they have been claimed as a tax dependent)

Birth date status change

36 months

Your dependent(s)


How Do I Elect COBRA?

For terminated employees or for reduction in hours, you will automatically be sent a COBRA Notification Letter within 44 days of the event. For other qualifying events (such as divorce or a child's graduation from college) you must notify Benefits within 60 days of the qualifying event, to receive a COBRA offer.

The COBRA Notification Letter states the rights to elect continuation coverage. Each qualified beneficiary has independent election rights. This means that your spouse or child may elect COBRA even if you do not.

The COBRA election period is 60 days from the later of the qualifying event or from the date on the COBRA Notification Letter. The qualified beneficiary has this time to inform the COBRA Plan Administrator, Crosby Benefits, that he or she wants to elect COBRA. If a qualified beneficiary does not elect COBRA coverage within this election period, then the right to continue their coverage will end.

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Other COBRA FAQ's?

What Plans May I Elect for Cobra coverage?

You and/or your dependents may choose to continue the same health plans you were enrolled in before the qualifying event occurred. Health plans are defined as medical, dental and vision plans as well as Medical Flexible Spending Accounts. If you have moved out of your HMO enrollment area and notify the COBRA Plan Administrator, you will have the additional option to elect the Preferred Provider Organization Plan (PPO), which can cover participants outside of Massachusetts.

Why Would I Elect to Continue my Medical FSA?

As an employee, the advantage of a Flexible Spending Account is the ability to pay for qualified medical expenses with pre tax dollars. Once you loose eligibility for the plan as an employee, the contributions are made with after tax money.

If you have contributed to the account but have not yet incurred the expenses to claim back all your contributions, you may consider electing to continue your participation in the Medical FSA so you do not forfeit your account balance.

For example, you have contributed $500, year-to-date to your account. You had a root canal for $350. By not electing COBRA, you can contribute $65 for the next month and continue your participation. During that next month you buy a new pair of eyeglasses and file a claim for the remainder $215 in your account.

How is COBRA Coverage Maintained?

When a qualified beneficiary elects COBRA coverage, he or she will receive a supply of premium payment coupons from Crosby Benefits Systems. The monthly cost of the coverage is 102% of the plan premium. The participant must send appropriate coupon and premium to Crosby benefits within 45 days from the date the participant signs the enrollment form electing to continue coverage. Checks should be made payable to Boston Medical Center. The first premium payment must cover the time frame between the date of the qualifying event and the signature date on the enrollment form. After the initial payment, each payment is due on the first day of each month. However, there is a 30 day grace period for late payments.

Until your first premium is received by the COBRA Administrator, your coverage will be in a pended status. This may prevent you from receiving medical services or filling prescriptions.

If Crosby does not receive timely payments, the COBRA coverage will be terminated on the last day of the period for which payment was received.

Helpful Links

Need Help?

Contact HR Benefits

Call: 617.638.8500
Fax: 617.638.8568
benefits@bmc.org


Boston Medical Center
HR Benefits
85 E. Concord St., 2nd Floor
Boston, MA 02118


Online Log in Problems?

Call ITS Help Desk: 617.414.4500


Claims Info on Life, Short or
Long Term Disability Insurance

Liberty Mutual Insurance
Call: 800.713.7384

FSA Accounts and COBRA Questions

Crosby Benefit Systems
Call: 800.462.2235
http://www.crosbybenefits.com/


For Health Care Coverage, Claims
or Physician Selection

BMC Select, HMO, PPO
Call: 1.888.333.4742
www.harvardpilgrim.org/bmc


BCBS Dental Blue, BU Dental Health Plan
Call: 1.800.348.7921
http://www.bcbsma.com/

Davis Vision Plan
Phone: 1.877.923.2847

For Retirement Plan Investment Info

TIAA-CREF
Call: 800.842.2776
http://www.tiaa-cref.org/bmc


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