After a faculty or staff member leaves the University, protection under a University healthcare plan stops at the end of the pay period during which the resignation is effective.
A federal law, commonly known as COBRA, provides Penn State employees and/or their covered dependents, who lose their health benefits as a result of certain qualifying events, the right to extend their medical, dental and vision benefits, temporarily, at group rates. Qualifying events are specific occurrences that would cause the loss of health benefits. The information provided here is intended to provide you with a summary of your rights and responsibilities under the provisions of COBRA. You and any of your adult covered dependents should take the time to read this information carefully. Further questions may be directed to the Employee Benefits Division at (814) 865-1473.
* In the case of a layoff, an employee may maintain existing coverage for the first 120 days of the layoff, by payment of the regular contribution that is charged to active employees. At the end of the 120 days, the individual has the option to continue coverage for an additional 14 months under COBRA provisions. However, continuation of coverage may not extend beyond 18 months.
Under COBRA regulations, qualifying events trigger the following requirements for notification.
Generally, COBRA benefit coverage is the same as the coverage the employee and covered dependents received just prior to the qualifying event. Any plan changes or choices applicable to employees are also applicable to COBRA qualified beneficiaries, including choices given during periods of open enrollment. If COBRA coverage is elected and a child is born or adopted by a covered employee, that child will be considered a dependent for COBRA purposes. New dependents must be added to plan coverage within 31 days of their eligibility. Claims for benefits should be submitted according to plan rules.
| Qualifying Event | Qualified Beneficiary | Coverage |
|---|---|---|
| Reduction in number of hours of employment of the covered employee affecting benefit eligibility | Employee, Spouse, Dependent Child | 18 months* (See Extension of Coverage) |
| Termination of employment (other than for gross misconduct) of the covered employee, including retirement or layoff | Employee, Spouse, Dependent Child | 18 months* (See Extension of Coverage) |
| Divorce | Spouse, Dependent Child | 36 months |
| Death of the covered employee | Spouse, Dependent Child | 36 months |
| Loss of "dependent child" status under health insurance plan rules | Dependent Child | 36 months |
If a qualified beneficiary becomes disabled under Title II or XVI of the Social Security Act during the first 60 days of COBRA coverage, then all the qualified beneficiaries may be able to extend COBRA coverage for another 11 months, increasing the coverage to a maximum of 29 months. If a qualified beneficiary becomes disabled under Title II or XVI of the Social Security Act before the first day of COBRA coverage they are considered to be disabled within the first 60 days of COBRA coverage, provided they are still disabled on the first day of COBRA coverage. This extension of coverage only applies when the initial qualifying event was reduction of hours or termination of employment. If a qualified beneficiary is eligible for and elects this extension of coverage, the additional 11 months premium will be 150% of the plan's total cost of coverage. In addition, the qualified beneficiary must notify the Plan Administrator of both the disability determination and the disability termination, if applicable, within 60 days of each determination.
If a second qualifying event occurs during the initial 18 or 29 month period, the spouse and/or dependent child may be eligible for an extension of coverage to a maximum of 36 months. This extension of coverage applies only when the initial qualifying event was reduction of hours or termination of employment. The second qualifying event must be an event that would, in the absence of the initial qualifying event, have caused the qualified beneficiary to lose health plan coverage, such as death of the employee, divorce or loss of "dependent child" status. To be eligible for the extension of COBRA coverage, the qualified beneficiary must notify the Employee Benefits Division of the second qualified event within 60 days of the event. In no instance, would coverage be granted beyond the maximum of 36 months.
COBRA coverage begins on the date that plan coverage would have been lost due to the qualifying event and ends at the end of the maximum period. However, coverage may be terminated earlier if:
Each qualified beneficiary has the right to elect COBRA coverage independently of one another. In considering whether to elect COBRA coverage, be aware that a failure to continue your group health coverage will affect your future rights under federal law.
A COBRA qualifying event may occur when an employer's obligation to provide health insurance benefits ends under FMLA, such as when an employee on FMLA leave decides not to return to work.
To view or print the COBRA Election form or rate sheets, please click on these links:
Please refer any questions or changes in status or a change of address to the Employee Benefits Division at (814) 865-1473 or by email to benefits@psu.edu
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