Under a Federal law called the "Consolidated Omnibus Budget Reconciliation Act" (COBRA), you and your eligible covered dependents may continue your group health benefits under the Plan when your coverage is lost due to a "Qualifying Event." You and your spouse and/or dependent children must apply for coverage under COBRA following the Qualifying Event. Then, you must make monthly payments in order to keep your coverage.
Qualifying Event |
Who May Purchase Continuation Coverage |
Duration of Continuation Coverage |
Your employment terminates |
You, your spouse and your dependent children who were covered under the Plan when coverage was lost |
18 months |
Your working hours are reduced, i.e., you become a part-time Employee |
You, your spouse and your dependent children who were covered under the Plan when your status changed |
18 months |
You experience a termination or reduction in hours while you are disabled (as determined by the Social Security Administration) |
You, your spouse and your dependent children |
29 months (18 months plus an additional 11 months) |
You divorce, or your marriage is annulled |
Your spouse and your dependent children who were covered under the Plan at the time of divorce, marriage or annulment |
36 months |
Your dependent child no longer qualifies as a dependent |
Your dependent child |
36 months |
You die |
Your spouse and your dependent children who were covered under the Plan at the time of your death |
36 months |
UVA Health Plan COBRA Information
What You Need to Do
UVA Health Plan members must make a written request to continue benefits under COBRA. A written request must be received within 60 days of the date of the letter of Notification or the date of the Qualifying Event, if later. You should review the letter of Notification you receive (if any) from the COBRA Administrator regarding the amount of self-payment to be paid and when the first and subsequent self-payments will be due. No additional notices will be sent. Review the following COBRA eligibility and payment information and complete the enrollment form:
COBRA Eligibility and Enrollment (Effective 1/1/2008)
Coverage Period
UVA Health Plan members may continue your coverage and/or the coverage for your dependents for a maximum of 18 months (except as noted in the above chart under "duration of continuation coverage"). If a dependent has a second qualifying event while continuing his coverage as a result of your termination or change in employment, then the maximum period is measured from the first qualifying event that applied to the dependent.
Cost of Coverage
The amount of self-payment to be paid by the covered UVA Health Plan person shall be 102% of the applicable premium (total cost of Plan coverage for a Participant), in accordance with procedures permitted by applicable law. Coverage will not be provided if self-payments are not made, in full, when due. No claims will be paid for any medical expenses incurred by a person during any period for which self-payments have not been made. Reimbursements for covered expenses incurred will only be made when all required self-payments have been made.
UVa Health Plan Rates for COBRA: (includes 2%)
Effective January 1, 2008
High Premium Program |
|
|
Military LWOP/Active Duty Employee Rate |
Single |
$349.86 |
$38.00 |
Employee plus Child |
$693.60 |
$134.00 |
Employee plus Spouse |
$718.08 |
$156.00 |
Family |
$1,119.96 |
$299.00 |
|
|
|
| Low Premium Program |
|
|
|
Military LWOP/Active Duty Employee Rate |
Single |
$323.34 |
$12.00 |
Employee plus Child |
$604.86 |
$47.00 |
Employee plus Spouse |
$614.04 |
$54.00 |
Family |
$933.30 |
$116.00 |
| Davis Vision Plan |
|
| |
Rate |
| Single |
$5.77 |
| Employee + Child |
$10.11 |
| Employee + Spouse |
$10.40 |
| Family |
$16.18 |
Address Changes after Enrolling in COBRA
In order to protect your family's rights, you should keep the COBRA Administrator, Chard Snyder, at 1-800-982-7715, informed of any changes in addresses of family members.
Be sure to contact UVA Human Resources Benefits Divisionif you are moving away from the Southern Health network area as you may need to enroll in the National Network.
For information on COBRA rates and enrollment and to enroll in the National Network, you may contact the UVA Human Resources Benefits Division at 434-924-4392.
MAMSI /Optimum Choice Health Plan COBRA Information for Housestaff and Post-Doctoral Fellows
What You Need to Do
Housestaff Members and Post Doctoral Fellows enrolled in the MAMSI /Optimum Choice Plans must wait for your COBRA Qualifying Event Notification Letter to come to your home address from Chard Snyder before you can enroll in COBRA. If you are moving, Post docs need to notify VP for Research and Graduate Study’s office, and Housestaff should notify Medical Center Human Resources Office of your address change to ensure COBRA documents will be sent to the correct address.
Chard Snyder will send a COBRA Qualifying Event Notification, COBRA Enrollment Form, COBRA Family Member Enrollment Form, and COBRA Premium Computation Form to the MAMSI/Optimum Choice subscriber once your termination is entered by your department. You must complete these forms and return them to Chard Snyder. Enrollment in the COBRA program will not occur unless premium payment accompanies the enrollment forms. Housestaff/Post Doc Fellows have 60 days from the date of the letter of Notification or the date of the Qualifying Event, whichever is greater, to return the COBRA forms. You must pay all back premiums before any COBRA enrollment will take place.
Cost of Coverage
- 2008 COBRA premiums for Housestaff enrolled in Optimum Choice or MAMSI :
Housestaff Optimum Choice (HMO) monthly rates are:
Single $338.30
Employee+1 $707.42
Family $961.64
Housestaff MAMSI (PPO) monthly rates are:
Single $392.46
Employee+1 $821.13
Family $1114.88
- 2008 COBRA premiums for Post Doctoral Fellows enrolled in Optimum Choice or MAMSI :
Post Doc Fellow Optimum Choice (HMO) monthly rates are:
Single $296.06
Employee + 1 $618.72
Family $842.07
Post Doc Fellow MAMSI (PPO) monthly rates are:
Single $297.53
Employee +1 $621.85
Family $846.31
If you are a Housestaff or Post Doc Fellow currently enrolled in the HMO and are moving out of the Mid-Atlantic area where providers participate with the HMO (Virginia, Maryland, Washington D.C.), you will need to move from the HMO to the PPO to receive COBRA coverage from a national network of providers. You should call Chard Snyder (1-800-982-7715) when you receive your Qualifying Event Notice to let them know you must switch to the PPO.
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