COBRA (Consolidated Omnibus Budget Reconciliation Act) allows you or a dependent covered under medical, dental, vision and/or health care Flexible Spending Accounts benefits to continue coverage when it is lost due to any of the following qualifying status changes:

  • Termination of employment (for reasons other than gross misconduct)
  • A reduction in the number of hours of employment that affects benefits eligibility
  • Divorce or legal separation/termination of eligible same-sex domestic partnership
  • Employee’s death (for eligible dependents)
  • Child ceases to be eligible for coverage
 

Optum Financial is the administrator of COBRA for the State System.

Cobra.OptumFinancial.com

Customer Service available 24 hours a day, 7 days a week
 1-855-687-2021

COBRA Rates Dependent Eligibility 

 

 

COBRA Open Enrollment - May 1-19, 2023

Open Enrollment is your only opportunity outside of a life event to change your COBRA coverage. 

If you want to remain in the same medical plan and cover the same dependents, no action is required. 

To change or drop coverage, please complete the enrollment form and return to:
PassheEmployeeBenefits@passhe.edu  or:

PA State System of Higher Education
Benefit Department - COBRA OE
2300 Vartan Way, Suite 207
Harrisburg, PA 17110

7/1/23 Rates Enrollment/Change Form

 

COBRA Information
Qualifying Event Length of Coverage
Reduction in number of hours of employment 18 months
Termination of employment  18 months
Divorce, or legal separation 36 months
Death of covered employee 36 months
Loss of dependent status 36 months

 

COBRA stands for Consolidated Omnibus Budget Reconciliation Act. Under the federal law, you and your dependents may temporarily continue medical, dental, or vision benefits coverage, as a result of a qualifying event, subject to certain conditions and your continued payment of premiums. 
COBRA rights are available to qualified beneficiaries following a life event that would cause the qualified beneficiary to otherwise lose their benefit coverage. A qualified beneficiary may include the following individuals who were covered by the plans on the day the qualifying event occurred: You (Employee), your spouse, and/or your dependent child(ren).

Once you receive your packet of information from OptumFinancial, you have 60 days from the date of notice to make your COBRA benefit elections.  If electing to continue your coverage, you will be retroactively covered back to the date immediately after the termination of your loss in benefits.

Premiums are due by the first of each month. Premiums will be adjusted each July 1. Please keep in mind that there is a 2% administration fee added to the premiums.

Coverage may be terminated earlier if:

  • Premiums are not paid on time;
  • Voluntary termination
  • Coverage is obtained through another group health plan that does not have any pre-existing condition limitation or exclusion. If such coverage is obtained prior to COBRA election, the COBRA coverage may not be terminated early;
  • A qualified beneficiary ceases to be disabled during the period of extended coverage.

 

Plan Information

Plan information varies depending on what employee group you were in as an active employee.  View the pages below for the information applicable to you and your group number. 

Nonrepresented, OPEIU, SPFPA, POA
Group Numbers 025079-02, 03, 04, or 05
APSCUF Faculty and Coaches
Group Numbers 025079-00 or 06
 
 

Summary of Benefits and Coverage (SBC)

Annual Notices and Disclosures
Nonrepresented, Nurses, Security/Police