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Consolidated Omnibus Budget Reconciliation Act (COBRA)

When no longer benefits eligible  due to reduced hours or termination of employment, an employee can buy group healthcare coverage through COBRA for one’s self and/or eligible dependents for up to 18 months, or longer in certain cases. The University’s COBRA administrator is PayFlex.

Features

  • Access to the University’s medical, dental, vision, and healthcare flexible spending account (HFSA) on an after-tax basis

Rules

  • May only elect the plan  enrolled in when benefits-eligibility ends and may change the plan  during the COBRA Annual Open Enrollment Period
  • May not add dependents  not covered when benefits-eligibility ends, except during the COBRA open enrollment period and may remove covered dependents  
  • Must pay the premium on time or coverage is discontinued with no reinstatement

Cost

Covered individuals pay the premium paid as an employee plus the premium the University paid on one’s behalf, plus a two percent administrative fee. Refer to the chart below.

Eligibility

In general, the employee and each covered dependent are eligible to elect continuation of the plan coverage in effect when no longer qualifying for Princeton benefits. Types of qualifying events are:

Qualifying Event Covered Individual(s) Length of COBRA Coverage

Employment ends

Hours are reduced

Employee

Enrolled dependents

Up to 18 months

Divorce or legal separation from spouse 

Spouse Up to 36 months
Employee’s death

Spouse

Employee’s children

Up to 36 months

Loss of dependent eligibility under the University’s health care plans

Employee’s children Up to 36 months

Deadlines & Enrollment Process

PayFlex notifies individuals of eligibility for COBRA insurance within 30 days of the date they are no longer eligible for University benefits.

Employees must return the election form to PayFlex within 60 days of receiving the election notice or within 60 days after University benefits end, whichever is later. These 60 days are called the election period. If an individual elects insurance coverage, they continue to have the right to waive or change the election through the end of the 60-day election period. 

An individual and their dependents are not covered by COBRA insurance during the election period. Once the first premium is paid, the COBRA insurance is effective retroactive to the date the coverage with the University ended. For example, if an individual goes to the doctor before COBRA coverage is effective, one may be required to pay for the service. Then, the individual would submit a claim form to the health insurance carrier to be reimbursed for the cost of the physician services.

Individuals have four choices regarding COBRA coverage at the time of initial enrollment: 

  • Continue enrollment in the plan that was in effect when either employment ended or work hours were reduced
  • Change the number of covered dependents enrolled in the plan. For example, change from “employee and family” coverage to “employee only” coverage
  • Continue coverage for one or more of covered dependents, even if an individual discontinues coverage for oneself
  • Waive continuation of coverage 

COBRA participants receive a billing statement from PayFlex and are responsible paying it on time.

To ensure continued coverage, PayFlex must receive the initial payment within 45 days of the date of the signed the COBRA Election Form. After that, monthly premiums are due the first of each month for each month of continuation coverage.

If PayFlex does not receive these payments within 31 days of the due date, coverage is terminated and cannot be reinstated.

During the COBRA continuation period, individuals receive written notification of the University's COBRA annual Benefits Open Enrollment Period (normally in November) to provide an opportunity to make allowed changes.

If a COBRA participant has a qualifying status change/event during COBRA coverage, the individual must notify PayFlex within 31 days of the event in order to adjust coverage.

Examples of status change events include:

  • Birth or adoption
  • Marriage or divorce
  • Loss of dependent status

Notify PayFlex in writing of any change in address and/or telephone number.

PayFlex Systems
Benefits Biling Department
P.O. Box 953374
St. Louis, MO 63195-3374
(800) 284-4885

For any questions, contact PayFlex at (800) 284-4885.

Monthly COBRA rates  for the period January 1, 2019, through December 31, 2019. Rates typically are adjusted annually.

Plan Employee Only Employee & Child(ren) Employee & Spouse Employee & Family
Aetna Princeton Health Plan (PHP) $862.92 $1,578.96 $1,907.40 $2,675.46

UnitedHealthcare

Princeton Health Plan (PHP)
$862.92 $1,578.96 $1,907.40 $2,675.46
Aetna HMO $660.96 $1,209.72 $1,460.64 $2,049.18
Aetna Consumer Directed Health Plan (CDHP) $294.78 $539.58 $651.78 $913.92
J–1 Visa Plan $862.92 $1,578.96 $1,907.40 $2,675.46
Metlife Vision Care Plan $15.46 $25.33 $24.87 $40.84
MetLife Basic Option PPO Dental Plan $21.10 $49.12 $45.07 $74.07
Aetna DMO $25.65 $50.03 $51.73 $71.49

MetLife High Option PPO Dental Plan

$69.15 $135.50 $139.54 $192.74