Under Federal law, employees and their covered dependents have the opportunity for a temporary extension of medical coverage (called COBRA continuation coverage) at group rates in instances where coverage under the plan would otherwise end. The employee or dependent is responsible for the entire premium for COBRA coverage.
Employees have a right to choose COBRA benefits when coverage is lost due to:
- a reduction in work hours, or
- termination of employment (other than for gross misconduct), including retirement.
Coverage is extended only to those individuals covered at the time of termination and may only continue the level of coverage that was in effect on the day of termination, or a lower level of coverage.
Covered dependents also have a right, independent of the employee's right, to COBRA coverage. The covered dependent may elect COBRA even if the employee does not. A spouse or dependent child covered under an employee's Indiana University medical plan has the right to elect COBRA continuation coverage if they lose coverage due to:
- the employee's death; the employee's termination (other than for gross misconduct), or reduction in work hours at IU; divorce or legal separation from the employee; the employee's entitlement to Medicare; or
- if a covered individual ceases to meet the definition of a dependent.
Indiana University must depend on notice from the employee when certain events occur that would qualify the employee or dependent for COBRA. Under COBRA regulations, the employee or family member is responsible for informing the University of such events, including: divorce, legal separation, or a child losing dependent status (e.g., due to marriage). Such notice must be within 60 days of the later of the following dates: date of the event, or date on which coverage would end under the plan because of the event. When Indiana University determines that an employee or dependent has experienced an event that qualifies the enrollee for continuation coverage, IU provides a written notice of COBRA rights and an application for the employee and dependents. The employee and/or dependents have 60 days from the date that coverage would end or date of offer letter, whichever comes later, to elect COBRA. If moving out of the health plan's medical network service area, coverage may be changed to another IU-sponsored health plan that provides benefits in the new location.
The length of COBRA coverage is between 18 and 36 months, depending on the circumstances:
- 18 months when coverage is lost due to termination or reduction in hours;
- 29 months when coverage is lost and individual becomes disabled within 60 days of termination;
- 36 months when coverage is lost due to death, divorce, legal separation, or loss of dependent child status.
An 11-month extension of coverage may be available if an individual becomes disabled (for Social Security disability purposes) within 60 days after the time of the termination, and Indiana University is notified of that determination within 60 days. The affected individual must also notify Indiana University within 30 days of any final determination that the individual is no longer disabled. In no event will COBRA continuation coverage last beyond three years from the date of the event that originally made a qualified beneficiary eligible to elect coverage.
An 18-month extension of coverage will be available to spouses and dependent children who elect continuation coverage if a second qualifying event occurs during the first 18 months of continuation coverage. The maximum amount of continuation coverage available when a second qualifying event occurs is 36 months. Such second qualifying events may include the death of a covered employee or a dependent child's ceasing to be eligible for coverage as a dependent under the Plan. These events can be a second qualifying event only if they would have caused the qualified beneficiary to lose coverage under the Plan if the first qualifying event had not occurred. You must notify Indiana University within 60 days after a second qualifying event occurs if you want to extend your coverage.
Each qualified beneficiary has a separate right to elect continuation coverage. A parent may elect to continue coverage on behalf of any dependent children. The employee or employee's spouse can elect continuation coverage on behalf of all of the qualified beneficiaries. If you elect COBRA coverage and have a newborn child placed with you for adoption, then that child will be considered a dependent for COBRA purposes.
In considering whether to elect continuation coverage, you should take into account that a failure to continue your group health coverage will affect your future rights under federal law. First, you can lose the right to avoid having pre-existing condition exclusions applied to you by other group health care plans if you have more than a 63 day gap in health coverage and election of continuation coverage may help you not have such a gap. Second, you will lose the guaranteed right to purchase individual health insurance policies that do not impose such pre-existing condition exclusions if you do not get continuation coverage for the maximum time available to you. Finally, you should take into account that you have special enrollment rights under federal law. You have the right to request special enrollment in another group health plan for which you are otherwise eligible (such as a plan sponsored by your spouse's employer) within 30 days after your group health coverage ends because of the qualifying event listed above. You will also have the same special enrollment right at the end of continuation coverage if you get continuation coverage for the maximum time available to you.
If the employee does not elect COBRA within 60 days, coverage under the IU-sponsored health plan ends. If the employee elects COBRA, coverage may also end when:
- premiums are not paid on time; the enrollee becomes covered under another group health plan which does not limit the coverage for an enrollee's preexisting condition; the enrollee becomes entitled to Medicare; IU no longer provides group health coverage to any employee;
- when the enrollee's COBRA coverage was extended due to disability and there is a final determination that the enrollee is no longer disabled.
COBRA benefits are provided subject to continued eligibility for coverage. Indiana University has the right to terminate COBRA coverage retroactive to the date on which eligibility ends.
For questions about COBRA coverage contact the University Human Resource Services ( or 812-855-7833) or a campus HR office.