How do I elect COBRA?
If you decide to enroll in COBRA coverage, there are three ways to make your health insurance election.
Elect via Member Portal: You can elect COBRA and choose a payment option online through the Vita COBRA Member portal. Your unique registration identification number is in the New Member Login Notice. If you choose to elect online, please do not complete the paper COBRA Continuation Coverage Election Form.
Elect via Mobile App: You can elect COBRA and choose a payment option through the Vita COBRA “COBRA+Bill” mobile app, which can be downloaded on the App Store or Google Play.
Elect via Paper Form: Or you can elect COBRA by completing the paper COBRA Election Form included in this mailing. The form must be returned by mail to Vita COBRA, PO Box 2167, Omaha, NE 68103-2167. Vita COBRA is not responsible for COBRA Election Forms that are not received due to being lost in the mail. We recommend securing a confirmation of delivery or checking that your form has been received.
Review the pre-filled information carefully before completing your election. If any information is incorrect or missing, please notify Vita COBRA immediately, and a revised form will be provided to you. Examples of information to double check include: ID or last-four of SSN, mailing address, missing or incorrect health plan enrollment info, or missing or incorrect dependent information.
Is there an election deadline?
Yes, and it is a FIRM deadline. You have 60 days to make your COBRA election, and, if you do not make your election within that window, your opportunity to continue COBRA coverage expires.
If you decide to elect COBRA, you must return your COBRA Election Form to Vita COBRA or complete the online election process within 60 days from the later of:
The date your coverage would terminate due to the Qualifying Event; or
The date on which the COBRA Election Notice (this packet) is provided
The “Last Day To Elect” is indicated on the COBRA Election Form. If you do not complete your election within the 60-day window, you forfeit your right to continue any COBRA coverage that you are eligible for pursuant to that Qualifying Event.
What is the payment deadline?
After you elect, you then have 45 days to pay all current and retroactive premiums to Vita COBRA. Your coverage will be retroactively reinstated once the premium(s) and all required re-enrollment forms (if applicable) are received. If you do not make timely payment, you will lose all continuation rights under the plan. You are responsible for making sure you send the correct premium amount. Thereafter, monthly premiums must be paid within 30 days of the due date.
Which health plans can I elect?
Your COBRA health insurance plan election choice(s) are indicated on the COBRA Continuation Coverage Election Form. Each Qualified Beneficiary listed on the form has an independent right to elect COBRA. In other words, there is no requirement that each person elects the same level of coverage or to elect any coverage at all. For example, if you had coverage for yourself, your spouse, and children before, each individual may elect different levels of COBRA coverage. You could elect no coverage, your spouse could elect medical, dental, and vision coverage, and your children could elect medical only, etc.
In general, you may only elect coverage under the health plan(s) in which you were enrolled immediately prior to your Qualifying Event. There are two exceptions to this rule. First, you may change plans during the regular annual open enrollment period. Second, you may change plans if you are covered under an HMO plan and move out of the HMO service area.
Who can authorize a COBRA election?
An employee or spouse who is a Qualified Beneficiary can elect COBRA on behalf of all Qualified Beneficiaries for Termination of Employment and Reduction in Work Hours events. If the election is for an adult child who has lost coverage on the plan due to age, a parent can elect on behalf of the child or children. For divorce events, only the ex‑spouse (not the employee) may authorize the election.
What if the Employee Assistance Program (EAP) is not on the election form?
If you were enrolled in an EAP plan that is not on the Election Form and you want to elect EAP through COBRA, please contact Vita COBRA to inquire about this option.
Can I elect to continue my Health FSA?
If you were previously enrolled on a health FSA plan prior to your COBRA Qualifying Event, you may elect to continue your health FSA coverage through the end of the Plan Year. However, your health FSA plan will not be listed on your COBRA Election Form. Please contact Vita COBRA directly about electing health FSA under COBRA. In addition, please refer to page 13 for more details about how health FSA plans work under COBRA.
Can I request e-mail communication?
Yes. If you prefer your written correspondence to be sent by e-mail rather than mail, you can set this preference within the Member Portal. After you elect COBRA and are logged into the Member Portal, you can click on “Preferences”, then “Communications”, and select the “Via Email” option.
What if I do not want COBRA?
If you decide you do not want to elect COBRA, you can simply take no further action. Your COBRA rights will expire after the formal election period runs out. Alternatively, you may formally indicate your waiver/declination on the paper COBRA Election Form. If you choose to make an active declination, each Qualified Beneficiary (employee, spouse, and adult dependent child age 18+), must give their consent to decline COBRA coverage. Additionally, both the employee and any spouse must give consent for an active declination of COBRA continuation on behalf of any minor dependent children.