Views:

Following is a step-by-step guide to the Vita COBRA election, payment, and activation process:

1. Election

You must formally elect COBRA by either electing online (via the member portal or mobile app) or by completing the COBRA Election Form enclosed in this package. 

2. Payment

Your COBRA account must be paid in full through the current date before Vita COBRA can notify your insurance company(s) to start the process of retroactively reinstating your health coverage. 

3. Coverage Reinstatement 

Your prior health coverage with the employer was canceled the day prior to the “First Day of COBRA” indicated on your Election Form. You must elect and pay for COBRA before your coverage will be retroactively reinstated by the health insurance companies. Be aware that election and payment timing is critical to avoiding a temporary break in coverage before it is retroactively reinstated. The reinstatement process will start at different times as outlined in the following two scenarios:

  • If you elect and pay for COBRA in advance of a future COBRA effective date:
    • The reinstatement process will start when your COBRA account is paid in full; enrollment requests are generally sent to the insurance companies the day after your payment is processed.
    • If you have a 100% employer-sponsored subsidy for the first month of COBRA, the reinstatement process will begin on your COBRA effective date. However, you must still complete the COBRA election process.

  • If you elect and pay for COBRA after your COBRA effective date, the reinstatement process will begin the day after the receipt of your election form and first full payment. Coverage will be retroactively reinstated.

Coverage reinstatement typically takes 5-10 business days. In some cases, reinstatement may take less time and in some cases it may take more time. You can contact your health insurance company directly to confirm if reinstatement has been completed; contact details are on your health insurance ID card. The insurance companies generally do not notify Vita COBRA when reinstatement is complete. If reinstatement has not occurred within 10 business days from the reinstatement start date (depending on the timing scenario that applies to you, as outlined above), please contact Vita COBRA.

4. What happens if I need to see a doctor before my coverage is reinstated?

Notify your doctor’s office you are in the process of reinstatement to COBRA. Your doctor’s office will confirm next steps. You may need to reschedule your appointment. You may be able to keep your appointment and settle the accounts directly with the provider’s office. The provide may require that you pay the full cost of the claim at the time of your appointment and request reimbursement later, or they may allow you to only pay your cost-share as expected under your insurance plan. 

5. What happens if I need to pick up a prescription before my coverage is reinstated? 

For prescription drug coverage, your pharmacy will likely require you to pay for the prescription at your own expense. However, confirm with your pharmacy if they will refund you directly once your coverage is reinstated. Typically, this would occur within five business days of the date you pay the pharmacy for your prescription. 

6. Once reinstatement to COBRA is completed

Submit claims to the health insurance company for the reimbursement of any covered expenses you paid the health providers while waiting for COBRA reinstatement. As COBRA is continuation of prior coverage, you will continue the same plan year deductible and cost sharing imposed by the health plan per your employer health plan documents. 

7. Health insurance ID cards

Because COBRA is continuation of prior coverage, the insurance companies generally do not issue new enrollment ID cards. Once your coverage is reinstated through COBRA, you will continue to use your existing ID card(s). For dependent-only COBRA elections (including events where the employee was eligible to elect, but chose not to elect), new ID cards will typically be issued with the oldest dependent as the “Primary Beneficiary” name on the cards. Coverage for other family members elected to COBRA on the same account will be located under the primary beneficiary’s name. In other words, coverage will no longer be located under the employee name. Insurance claims for each family member will also need to be submitted via the new primary beneficiary’s name.