COBRA (Consolidated Omnibus Budget Reconciliation Act) allows eligible individuals to temporarily continue group health coverage after certain life events that would otherwise result in a loss of coverage.

To qualify for COBRA, 3 key elements must apply: the health plan must be subject to COBRA, the individual must be a qualified beneficiary, and a qualifying event must occur.

1. Plan Coverage

COBRA generally applies to group health plans maintained by employers with 20 or more employees on more than 50% of typical business days during the previous calendar year.

Both full-time and part-time employees are counted when determining whether a plan is subject to COBRA requirements. Part-time employees are counted as a fraction of a full-time employee based on hours worked.

2. Qualified Beneficiary

A qualified beneficiary is generally an individual who was covered under the group health plan on the day before a qualifying event occurred. Qualified beneficiaries may include:

• Employees
• Spouses
• Dependent children
• In certain situations, retired employees and their covered family members
• Children born to or placed for adoption with a covered employee during the COBRA coverage period

In some cases, agents, independent contractors, and directors participating in the health plan may also qualify.

3. Qualifying Events

A qualifying event is a life event that causes an individual to lose group health coverage. The type of qualifying event determines who is eligible for COBRA and how long continuation coverage may last.

Qualifying Events for Employees

• Voluntary or involuntary termination of employment (for reasons other than gross misconduct)
• Reduction in work hours resulting in loss of benefits eligibility

Qualifying Events for Spouses

• Voluntary or involuntary termination of the covered employee’s employment (for reasons other than gross misconduct)
• Reduction in the covered employee’s work hours
• Covered employee becoming entitled to Medicare
• Divorce or legal separation
• Death of the covered employee

Qualifying Events for Dependent Children

• Loss of dependent child eligibility under the plan rules
• Voluntary or involuntary termination of the covered employee’s employment (for reasons other than gross misconduct)
• Reduction in the covered employee’s work hours
• Covered employee becoming entitled to Medicare
• Divorce or legal separation
• Death of the covered employee

COBRA continuation coverage periods vary depending on the qualifying event and eligibility circumstances. In some cases, the plan may offer extended continuation coverage periods.

You can enroll online by creating your WEX account using the login credentials provided in your election notice. Alternatively, you can submit the election form by mail.

• WEX Member Portal: https://cobralogin.wexhealth.com.

You have 60 days from the date your COBRA notice is sent or from the date your coverage ended, whichever is later, to elect continuation coverage.

You may continue the same coverage in place at the time of your qualifying event, including: 

• Medical
• Dental
• Vision
• Lyra EAP
• Health Flexibile Spending Account

For full details on each benefit, please visit the corresponding page linked above.

Please Note: If you elect COBRA for the High Deductible Health Plan (HDHP), it will not include a Health Savings Account (HSA), as COBRA only continues the medical coverage, not the employer’s HSA contributions or eligibility to contribute.

You will be responsible for the full cost of the premium, plus a 2% administrative fee. Premium rates will be outlined in the election notice from WEX Health.

Premium payments should be made directly to WEX Health. Instructions for online, mail, or automatic payments will be provided in your COBRA packet and available on your member portal. Timely payment is required to maintain coverage.

COBRA coverage typically lasts:

• Up to 18 months for job loss or reduction in hours
• Up to 36 months for other events (e.g., divorce, death of employee, dependent aging out). 

Generally, you must remain on the same plan in place at the time of the qualifying event. You may be able to add or remove dependents during Open Enrollment or due to a qualifying life event (e.g., birth, marriage).

If you become entitled to Medicare or enroll in another group health plan, you must notify WEX Health. These changes may affect your COBRA eligibility or result in early termination of coverage.

• For questions regarding WEX’s benefit enrollment system, click here. 
• For questions regarding which benefit option is best for you, contact brcca@usi.com.