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Frequently asked questions

Below are some of the most frequently asked questions. If you still have additional questions, please contact us.
 
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Can I choose to receive either COBRA or State Continuation coverage?
An employer is eligible to participate either in COBRA or a state continuation program but not both at the same time. It must be one or the other.

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How does my employer know if they participate in COBRA or State Continuation coverage?
It's based on group size - specifically, the number of full-time employees at the end of the previous tax year. For COBRA, you must be in a group of 20 or more. For State Continuation you must be in a group with fewer than 20. Ask your employer which coverage you are eligible for.

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What is a Qualifying Event?
A qualifying event is an event that changes a member or dependent eligibility status. These events can qualify a member as eligible for an enrollment addition, change, or termination. The determination of the effective date of coverage in these cases is based on the date the event occurred, and is also known as the qualifying event date.

Examples:

  • Marriage
  • Birth of a child or placement for adoption of a child
  • Legal Guardianship Dependent returning to school full time
  • Loss of prior coverage
  • Divorce
  • Death of spouse
  • Loss of dependent status
  • Change in employment status (part time to full time)

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Are there any termination reasons that prohibit my eligibility to receive this coverage?
Coverage is not available to members who have been terminated from their employer for cause, gross misconduct, or confessed to an employment related felony in which the employer was not involved.

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Who is responsible to inform me of my rights for coverage?
The Employer, by law, is required to inform all employees and their dependents to their rights of receiving this coverage.

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How do I know if I am considered a qualified employee or dependent to recieve this coverage?
Employees and their dependants are considered eligible for their continuation of coverage when a qualified event occurs.

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What plans are available to me?
You may choose from any plans your previous employer is currently offering.

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What if I want to switch my plan?
At the time of election and enrollment to either State Continuation or COBRA, the member is provided the option to elect a different plan when an employer group offers more than one benefit.

Once a member is currently active through COBRA or State Continuation the member can elect new coverage when the employer renew their policy every year at the same time and under the same plan terms as the employer.

Example: At renewal, members are able to add dental coverage, remove vision coverage, add dependents, or remove dependents, as long as it is within the employer’s new plan terms, and complies with any state mandates.

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If I originally waived COBRA coverage, can I change my mind and opt to elect it?
You have 60 days from the date of notification by the employer group to elect COBRA coverage. Any changes elected outside of this 60 day window will not be able to be submitted and honored.

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What happens if my employer changes plan options?
You may only choose from plans that your employer offers.

Example: If you currently have a PPO plan, and your employer decides not to offer it anymore, you will need to switch to a new plan that falls within your employer's offerings.

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Will my rates ever change after I've enrolled in coverage?
Yes, your rates wil change yearly, just as if you were still employed.

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Who do I make my payments to?
Payment arrangements are established between the eligible employee or dependent and the employer. The employer will provide the proper name to be included on the check.

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Can I terminate my coverage prior to exhausting the full benefit?
Yes you have the freedom to cancel your coverage benefits at any time or if you experience a Qualifying Event. Please remember that the termination date of the coverage will follow the employer’s contractual language.

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Must I only select coverage through my Employer?
State Continuation and COBRA coverage is an employee/employer relationship. Individual plans
(HumanaOne) are not administered through your employer.

State Continuation relies on the terms agreed upon by that individual state.

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What happens if I have a change in my life status (marriage, newborn birth) while being covered under State Continuation or COBRA benefits?
Plan changes or enrollment additions/terminations can be requested within 31 days of the Qualifying Event date. It is important that the life status change meets the requirements for a Qualifying Event.

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I have been contacted by Ceridian, who are they?
Humana has a partnership with Ceridian to administer some of our benefits.

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Where do I find my COBRA or State Continuation rate information?
Contact your employer for your rate information.

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Can my COBRA coverage be extended?
You may be able to extend your COBRA coverage beyond the initial 18-month coverage period if you become disabled. This would allow you to get COBRA coverage for another 11 months – for a total of 29 months. To qualify for an extension of COBRA coverage, you must:
  • Be deemed disabled by the Social Security Administration either before you go on COBRA or within the first 60 days of COBRA coverage.
  • Submit your Social Security Disability Award Notice to your previous employer within 60 days of receiving it and before your initial 18-month COBRA coverage period ends.

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Where can I find affordable dental and/or vision plans for myself or my family?
Please visit  HumanaOneDental.com  to learn more about the affordable dental insurance and vision plans available in your area.

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