Answers to Frequently Asked Questions.
What is the process of being offered and electing COBRA?
When an employee or family member experiences a COBRA qualifying event, the employer notifies us and we send a COBRA election rights notice to the qualified beneficiary (QB) (e.g., the employee and/or family member). When the QB elects to continue their coverage through COBRA (i.e. they send the enrollment election form and premium payment to us) we notify their insurance carrier to reinstate their coverage retroactive to the date that they lost coverage. We will send them a notification once this is complete. Keep in mind that each insurance carrier has different processing times, so the reinstatement can take anywhere from 14-30 days.
Oftentimes an employee uses the same insurance cards as when they were an active employee, but if the insurance carrier is going to issue new cards, they will send them directly to the employee.
When is the premium for the COBRASecure account due and how do participants make payment?
The initial COBRA premium is due no later than 45 days after electing COBRA continuation. Future premium is due on the first of the month for coverage in that month, but no later than 30 days from the due date. For example, if the payment a participant is sending is for May, the premium is due on May 1st and must be paid by May 31 to be timely.
We accept payments a few different ways:
Check or money order – our address is:
Employee Benefits Corporation
PO Box 44347
Madison, WI 53744
Certified, overnight or another traceable way, you’ll need to send it to our street address:
Employee Benefits Corporation
1350 Deming Way, Suite 300
Middleton, WI 53562-4640
Participants can have their payment debited from their financial account. Complete and send the COBRA Direct Pay Form to the mailing address listed above. We will notify you when you’re set up to have the first payment taken out of your account.
Is a voluntary drop of insurance coverage considered a Qualifying Event?
A voluntary drop of insurance coverage is not considered a Qualifying Event and does not trigger COBRA.
Claims may also be submitted online. Participants simply log into My Account Assistant at www.ebcflex.com.
What happens when coverage is dropped in anticipation of a divorce?
If an employee drops their spouse from coverage in anticipation of a divorce, the ex-spouse must still be offered COBRA when the divorce is finalized. This is the one exception to the rule that coverage must be in place the day before the Qualifying Event.
Once an employee or the ex-spouse notifies the employers that a divorce has taken place, the employer must offer COBRA to the ex-spouse. The employer is not required to cover the spouse for the time between the cessation of coverage and the Qualifying Event. COBRA would only begin at the time of the event.
In order to eliminate coverage issues with the carrier, employers should establish limits on when a participant may drop dependents from their group health plans. If the ex-spouse or ex-dependent experiences more than a 63-day break in coverage, it may be difficult to reinstate the COBRA continuation.
Can a Qualified Beneficiary change coverage levels during an open enrollment?
During an open enrollment, if active, similarly situated participants who are covered under the plan are allowed to change their coverage levels or coverage types, a Qualified Beneficiary may also make these changes.
Can a Qualified Beneficiary add coverage during an open enrollment?
During an open enrollment, if active, similarly situated participants who are covered under the plan are allowed to add coverage (e.g., dental coverage in which they had not previously enrolled), a Qualified Beneficiary may also add coverage.