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Office of Human Resources

COBRA

Rights to Continue University of Rochester Health Care Coverage

This notice is intended to inform you of your rights and obligations under the continuation coverage provisions of the Consolidated Omnibus Budget Reconciliation Act (COBRA). The law requires that most employers sponsoring group health plans offer employees and their families the opportunity for a temporary extension of health coverage (called “continuation coverage”) at group rates in certain instances where coverage under the plan would otherwise end. Both you and your spouse should take the time to read this notice carefully.

If as a faculty or staff member you were covered by one or more of the following University of Rochester health care plans, you have a right to choose this continuation coverage if you lose your group health coverage because of a reduction in your hours of employment, change to an ineligible status, or the termination of your employment (for reasons other than gross misconduct on your part):

  • Health Care Plans
    • University High Deductible Plan
    • University Low Deductible Plan
    • University HSA-Eligible Plan
    • University Copay Plan
    • University Care Plan with Major Medical
    • University Traditional Care Plan with Major Medical
  • Dental Plans
    • Traditional Dental Assistance Plan
    • Medallion Dental Plan
  • Flexible Spending Account (FSA) - Medical/Dental

If you are the spouse of an employee covered by one or more of the University of Rochester health care plans, you have the right to choose continuation coverage for yourself if you lose group health coverage under one or more of these plans for any of the following four reasons:

  1. The death of your spouse;
  2. A termination of your spouse's employment (for reasons other than gross misconduct), change to an ineligible status, or reduction in your spouse's hours of employment with the University of Rochester;
  3. Divorce or legal separation from your spouse; or
  4. Your spouse becomes eligible for Medicare

In the case of a dependent child of an employee covered by one or more of the University of Rochester health care plans, he or she has the right to continuation coverage if group health coverage under one or more of these plans is lost for any of the following five reasons:

  1. The death of a parent;
  2. The termination of a parent's employment (for reasons other than gross misconduct), change to an ineligible status, or reduction in a parent's hours of employment with the University of Rochester;
  3. Parents' divorce or legal separation;
  4. A parent becomes eligible for Medicare; or
  5. The dependent ceases to be a "dependent child" under one or more of these plans.

Under the law, the employee or a family member has the responsibility to inform the Benefits Office of the Office of Human Resources, of a divorce, legal separation, or a child losing dependent status under one or more of the University of Rochester health care plans.

If you do not choose continuation coverage, your group health insurance coverage will end.

If you choose continuation coverage, the University of Rochester is required to give you coverage which, as of the time is being provided, is identical to the coverage provided under the plan to similarly situated employees or family members. The law requires that you have the opportunity to maintain continuation of coverage for 3 years unless you lost group health coverage because of a termination of employment, change to an ineligible status, or reduction in hours. In that case, the required continuation coverage period is 18 months. You do not have to show that you are insurable to choose continuation coverage. However, the law also provides that your continuation coverage may be cut short for any of the following five reasons:

  1. The University of Rochester no longer provides group health coverage to any of its employees;
  2. The premium for your continuation coverage is not paid;
  3. You become an employee covered under another group health plan;
  4. You become eligible for Medicare;
  5. You were divorced from a covered employee and subsequently remarry and are covered under your new spouse's group health plan.


Please note, if eligible, your Third Party Administrator (TPA) will send you the COBRA information and enrollment packet as necessary. If you choose continuation coverage,

  1. you must complete and return the enclosed election form(s) indicating the type of coverage(s) you wish to continue to the address listed below within 60 days from the date that you should lose coverage or the date of the enclosed letter, whichever is later.
  2. you also must complete and return an appropriate application within 60 days from the date that you would lose coverage or the date of the enclosed letter, whichever is later, if you choose continuation coverage in one of the University of Rochester Medical Plans.
  3. you must pay the entire cost of the premium plus an additional 2% of the premium as an administrative charge. You will be billed directly by the Insurance Company(ies). A rate schedule is attached for your information. You should note, however, that these rates are subject to change.

If you have any questions, please contact the Benefits Office of the Office of Human Resources, University of Rochester, 260 Crittenden Boulevard, PO Box 636, Rochester, NY 14642-0636, (585) 275-8382. Also, if you have changed marital status, or you or your spouse have changed addresses; please notify the Benefits Office at the above address.