COBRA legislation requires employers to continue group health and dental coverage for a maximum of 18 months to employees and their covered dependents who would lose their group insurance coverage at the time of termination of appointment/employment. If you elect this option, the benefits will be continued until:
- The expiration of 18 months following termination of your appointment;
- You [or your dependent(s)] become covered under any group plan;
- You [or your dependent(s)] become entitled to Medicare benefits;
- You fail to pay the monthly charge for this coverage on time;
- The health plan is no longer in force; whichever occurs first.
- If you or your dependent(s) become disabled prior to the end of the 18-month period, and are determined disabled under Title II or Title XVI of the Social Security Act, you must notify the Office of Graduate Medical Education within the first 18 months of COBRA coverage of your receiving the Social Security disability determination to continue coverage up to 29 months, and you must be determined to be disabled during the first 60 days of COBRA continuation coverage.
- Effective January 1, 2003, under the California COBRA program (Cal-COBRA) employees covered by insurance plans written in the state of California will have the option of continuing medical coverage for an additional 18 months. At the conclusion of your initial 18 months of coverage, Blue Cross will communicate with you regarding Cal-COBRA.
- If you are age 60 or older at termination, you may be eligible for an additional extension of COBRA coverage. Contact the Office of Graduate Medical Education for information.
While you are appointed full-time as an active appointee the University subsidizes your insurance premium cost. Under COBRA continuation the University will no longer subsidize your premium cost and you must pay 102% of the rate established for the active plan. These premiums or underwriters may change during a policy renewal. If you are actively covered under COBRA you will be notified at the time of any rate and/or benefit changes and you will have the right to participate in future open enrollments. The monthly costs noted below are effective 7/1/2017 - 6/30/2018:
Monthly Rates for the Academic Year 2018-2019
Anthem Blue Cross PPO:
Group # 1230CB
Anthem Blue Cross HMO:
Group # 57J13B
Anthem Blue Cross Dental PPO:
Vision Service Plan (VSP):
Group # 12-170630-0004
EE - Single Coverage (Only one person)
EE+1 - Double Coverage (Two people)
EE++ - Family Coverage (More than two people)
As an active appointee during your residency/fellowship you are covered under one or more of our available insurance plan(s) - Anthem Blue Cross PPO, Anthem Blue Cross HMO (Anthem Blue Cross), Anthem Blue Cross Dental, Vision Services Plan (VSP), Standard Life, and Standard Long Term Disability. You may elect to continue your current benefits. You may choose to drop a dependent, but you may not enroll a dependent who was not previously covered, nor are you permitted to change from one carrier to another unless you are insured under the Anthem Blue Cross HMO plan and are leaving California.
Life and Long Term Disability
If you wish to apply for Standard Life and/or Long Term Disability Insurance conversion coverage, please complete the attached Standard Life Insurance Group Conversion Packet Request form and/or the
Standard Group Conversion Request for Long Term Disability Insurance and forward it to the Standard Insurance Company. Application must be made within 31 days of the date your Group coverage terminates.
Health, Dental, and Vision Insurance
In order for you to establish eligibility for coverage, you must complete and mail the COBRA Election Agreement form (Sample) to Discovery Benefits within sixty (60) days of your receipt of this letter, or sixty (60) days from the date your coverage ends, whichever is later. Discovery Benefits will mail you the COBRA Election Agreement form to your most recent address in our system. Please confirm with the
Benefits Coordinator that your address is up to date. Your COBRA Election Agreement form will need to be mailed to Discovery Benefits at the below address:
PO Box 2079
Omaha, NE 68103-2079
Discovery Benefits is the financial administrator for our House Officer's COBRA account. They are not, however, going to be insuring you. You will be insured either by Anthem Blue Cross PPO, Anthem Blue Cross (HMO), Anthem Blue Cross Dental or VSP.
Your first payment must be received by Discovery Benefits 45 days from the date you send the COBRA Election Agreement form, and it must include premium from the time you lost group coverage under the UCSD Medical Center sponsored plan to the present.
Do not wait for Discovery Benefits to bill you for the coverage you desire. You must pay within 45 days as noted above or you will lose eligibility and will not be insured. Subsequently, your payments are due to Discovery Benefits on the first of each month. You will have a grace period of 30 days in which to submit payment before your coverage is terminated. To assure continuity of coverage and to avoid the possibility of service or claim complications, you may wish to remit payment with the enclosed form.
Send your payment with COBRA Election Agreement form to Discovery Benefits.
If you have any questions after you review the rest of this memo please contact the Office of Graduate Medical Education at
firstname.lastname@example.org or 619-543-7820.