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COBRA

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Qualifying Events

COBRA is a federally mandated program that allows you to continue your medical, dental and vision benefits based on the following qualifying events:

  • Termination or reduction in hours of employment of the covered employee (for reasons other than gross misconduct).
  • Death of the covered employee.
  • Covered employee becomes eligible for Medicare.

The covered employee or one of the qualified dependents is responsible for notifying the plan within 60 days after the qualifying event for:

  • Divorce.
  • Legal separation.
  • A child’s loss of dependent status under the plan.

Eligibility

Coverage is extended only to those individuals covered at the time of termination/loss of coverage and may only continue the coverage in effect on the day of termination/loss of coverage.

COBRA may provide for further extensions of coverage under certain circumstances up to a maximum of 36 months. See the following example for potential extensions and the eligibility section below for spouse/dependent coverage periods.

Example: An individual who is determined by the Social Security Administration to be disabled while on an 18-month COBRA policy may be eligible for an additional 11 months of coverage (for a total of 29 months). In addition, when a secondary event, such as the death of a former employee, occurs while the family is on COBRA, the 18-month original coverage period may be extended to 36 months for survivors who are on the plan.

COBRA Coverage Payments and Rates

If you elect COBRA coverage, you must pay the total monthly premium (employer and employee shares) plus an additional two percent administrative surcharge.

Monthly Rates: July 1, 2022 – June 30, 2023

Plan
Type
Plan and/or Provider Single Single Plus
Spouse
Family Minus
Spouse
Family Plus
Spouse
Medical*

Ohio Med PPO
(Includes Medical Mutual of Ohio- and Anthem-administered plans)

$786.37 N/A $2,159.49 $2,179.89
Medical* Ohio Med HDHP
(Includes Medical Mutual of Ohio- and Anthem-administered plans)
$716.09 $1,611.20 $1,253.16 $2,148.27
Medical* Ohio Med NN
(Includes Medical Mutual of Ohio- and Anthem-administered plans)
$746.00 N/A $2,048.72 $2,069.12
Dental Delta Dental PPO $34.91 N/A $101.17 $101.17
Vision EyeMed Vision Care $10.24 N/A $28.16 $28.16


Dental and Vision Coverage for Union Participants
Dental and vision COBRA coverage may be elected through the Union Benefits Trust (UBT). For information, contact UBT at (800) 228-5088.

* Medical Plan Coverage
Medical plan enrollment includes behavioral health coverage (provided by Optum Behavioral Solutions), prescription drug coverage (provided by OptumRx) and the Take Charge | Live Well wellness program (provided by Virgin Pulse).