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COBRA

COBRA

Consolidated Omnibus Budget Reconciliation Act (COBRA)

Congress passed the Consolidated Omnibus Budget Reconciliation Act (COBRA) in 1986. Under this law you are eligible to purchase continued medical, dental and vision coverage (or dental/vision only) under certain circumstances when your or your dependent's group health plan coverage with Seattle Housing Authority (SHA) ends.

SHA is required by law to notify you and your covered dependents of your COBRA rights, whether continuation coverage is elected or not. You must notify Human Resources department should any of the following COBRA qualifying conditions occur.

Your Medical Coverage Ends: You and your covered dependents have the right to elect COBRA continuation coverage for up to 18 months if your coverage is lost because of one of these qualifying events:

  • Your employment ends
  • Your work hours are reduced to the point where you no longer are eligible for benefits

Your Covered Family Member's Medical Coverage Ends: Covered family members have the right to choose COBRA continuation coverage for up to 36 months if coverage is lost for any of the following qualifying events:

  • Death of the employee
  • Divorce or legal separation of the employee and spouse or dissolution of the domestic partnership
  • A dependent child loses dependent child status under the City's plan

Disability Occurs: The 18-month COBRA continuation period may be extended to 29 months if you or a family member (who is a qualified beneficiary) is certified disabled according to Social Security Administration at the time of one of the previously mentioned qualifying events. This 11-month extension is available to all covered family members of the disabled for 150% of the regular premium amount.

If you do not receive your COBRA notification from City Personnel's Benefits Unit within 30 days of notifying your Human Resources Representative of the qualifying event, call 206.615.1340.

To find more detail information about COBRA, please click the links below:

COBRA FAQ [PDF]

2017 COBRA Rates [PDF]

COBRA HIPAA Initial Notices [PDF]

2017 Medical Benefits Comparisons [PDF]

COBRA Forms

Aetna Enrollment Form [PDF]

Kaiser Permanente Enrollment Form [PDF]

Delta Dental Enrollment Form [PDF]

Dental Health Services Enrollment Form [PDF]

Vision Service Plan Enrollment Form [PDF]

FSA COBRA Form [PDF]