Continuation Coverage (COBRA)

Anonymous User
Associate
House Staff
RN (NYSNA)

If healthcare coverage stops as a result of:

  • Layoff, leave of absence, disability or termination of employment for reasons other than gross misconduct
  • Retirement before age 65 if you do not qualify for retiree medical benefits
  • A reduction in your regularly scheduled hours
  • Divorce or legal separation
  • A child no longer qualifying as a family member
  • Your death

…you and/or your eligible family members can elect to continue coverage under the Montefiore healthcare options you had in effect at the time of the qualifying event. You will have the opportunity to change your options and coverage during the next fall annual election period. At that time, you will receive all the materials you need to make your elections. The decisions you make during the election period will take effect the following January 1.

If you (or your family members) elect continuation coverage, you must pay 102% of the cost of coverage, as determined by the COBRA Administrator. If a disability occurs within the first 60 days of COBRA continuation coverage, the 18 month period for medical coverage may be extended up to 29 months as a result of the disability. The premium for the family may increase to 150% of the cost of coverage for the additional 11 months.

You or your family members must notify Montefiore’s HR-Benefits Office in writing if healthcare coverage will stop due to any of the following events: you and your spouse are divorced or legally separated, or a child no longer qualifies as a dependent. You must send this written notification within 60 days after the date of the event or the date coverage would stop – whichever is later.

To elect continuation coverage, you must return the COBRA Election Form to the COBA Administrator within 60 days after:

  • You receive notice of your right to continue healthcare coverage
    or
  • The date healthcare coverage stops, if later.

If you or a family member initially waives COBRA continuation coverage, that individual may revoke that waiver during the 60-day COBRA election period. In that case, COBRA coverage will begin on the date you first became eligible provided you pay the required retroactive contributions on a timely basis.

You have 45 days after you elect COBRA coverage to pay the premium for the period beginning on the date COBRA coverage begins until the end of the month in which you return the COBRA election form. Claims under COBRA coverage will not be processed for this initial period until payment is received by the COBRA Administrator. After the initial payment, you must pay your monthly COBRA premium on the first day of the month. If not paid within 30 days of the date payment is due, coverage will automatically terminate without further notice. Claims under COBRA coverage will not be processed for any period until full payment is received by the COBRA Administrator.

If You Have Questions

For more information about your rights and obligations under the Plans and under federal law, you should contact the COBRA Administrator – HealthEquity/Wageworks – who is responsible for administering COBRA continuation coverage.

  • Mail Election forms to P.O. Box 226101, Dallas TX  75222.
  • Mail checks to PO Box 660212, Dallas TX  75266-0212.
  • Participant website:  mybenefits.wageworks.com
  • Customer Service:  888.678.4881

You may also contact the nearest Regional or District Office of the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA's website at www.dol.gov/ebsa.

Keep Your Program Informed of Address Changes

To protect your family's rights, you must notify the COBRA Administrator in writing of any changes in the addresses of family members. You should also keep a copy of any notices you send to the COBRA Administrator for your records.