CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT OF 1985 (COBRA)
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General COBRA Information
- General Information Regarding COBRA
http://www.dol.gov/dol/topic/health-plans/cobra.htm - US Department of Labor FAQs
http://www.dol.gov/ebsa/COBRA.html
Open Enrollment - May 7th through May 23rd, 2012
The State Employee Benefits Committee presents your 2012 Open Enrollment information. The Open Enrollment period from May7th to May 23th, 2012 is your once-a-year opportunity to review your health, dental and vision coverage and make the choices that are right for you!
During the Open Enrollment period, it's important to consider your health, dental and vision coverage. Do the plans in which you are currently enrolled still fit your personal situation? Have your dependents changed during the last year? Open Enrollment is the only time during the year you can enroll, make changes or terminate your coverage.
The 2012 Open Enrollment booklet can be accessed below. The booklet features important information about your benefit options and what you need to do to enroll in benefits. Please read it carefully and share it with your family.
We hope you will make the most of this information and choose the benefit coverage that fits your personal situation. No matter which plans you choose, remember to check the Statewide Benefits Office website at www.ben.omb.delaware.gov and the provider websites listed on the last page of the booklet for detailed information about the plans. You can use this information to understand your benefits thoroughly and be an informed health care consumer.
The benefits you elect during the Open Enrollment period will take effect July 1, 2012.
Please bookmark the link to the 2012 Open Enrollment booklet to use as a reference throughout the plan year - www.omb.delaware.gov/oe.
COBRA OE Checklist:
- Read all Open Enrollment information contained in 2012 Open Enrollment booklet
- Mark your calendar to attend one of the Statewide Benefit Health Fairs (see page 49 of the booklet for dates, times and locations).
- Review Open Enrollment Frequently Asked Questions (FAQ) located on the Statewide Benefits website at www.ben.omb.delaware.gov/oe.
- Review 2012 – 2013 COBRA Continuant Costs effective July 1, 2012 through June 30, 2013 provided below.
- If you cover your spouse in one of the State of Delaware Group Health Insurance medical plans, go to page 27 of the booklet for complete details on the Spousal Coordination of Benefits policy and required form. You MUST complete a new Spousal Coordination of Benefits form each year during Open Enrollment and anytime your spouse's employment or insurance status changes.
Failure to complete this form will result in a reduction of spousal benefits.
Please complete the form online at www.ben.omb.delaware.gov/documents/cob no later than May 23, 2012. Note: This form must be completed and submitted online.
- If you wish to enroll, or already cover, an adult dependent ages 21 to 26 in a health, dental or vision plan, go to page 28 of the booklet for complete details on the Administration of Adult Dependent to age 26 Policy and the required Adult Dependent Coordination of Benefits form. The policy and form are also located at www.ben.omb.delaware.gov/documents/cob. Note: This form must be printed and mailed to the Statewide Benefits Office with a postmark no later than May 23, 2012.
- If you are not making any changes and do not cover a spouse or adult dependent under your State of Delaware Group Health Insurance medical plan, no action is required.
- If you are enrolling in any plan or enrolling a spouse or dependent for the first time:
- Complete the appropriate enrollment applications provided below.
- If enrolling in an HMO (health or dental) plan for the FIRST TIME, make sure that before you enroll your health or dental provider participates in the plan you select and enter their provider information online when you enroll.
REMEMBER: You cannot change plans during the plan year if your provider decides to no longer participate in the plan. - If enrolling a spouse for the FIRST TIME: You MUST supply a copy of your marriage/civil union certificate to the Statewide Benefits Office.
- If enrolling a dependent for the FIRST TIME: You MUST submit a copy of the birth certificate or other legal document to the Statewide Benefits Office.
- If enrolling a spouse or children as a result of a civil union for the FIRST TIME: You MUST also submit the completed Certification of Tax Dependent Status form found at www.ben.omb.delaware.gov/cu.
- REMEMBER: As a COBRA Continuant, you can only enroll in health, dental and vision coverage that was made available to you during your eligibility in the State of Delaware Group Health Insurance Program.
RETURN ALL FORMS AND APPLICATIONS TO THE STATEWIDE BENEFITS OFFICE
Applications, Spousal Coordination of Benefits Form, Adult Dependent Coordination of Benefits Form and Certification of Tax
Dependent Status Form must be postmarked no later than Wednesday, May 23, 2012 and
received in the Statewide Benefits Office by Friday, May 25, 2012.
Send all forms and applications to:
State of Delaware
Statewide Benefits Office
Attention: Colleen Kondelis
500 W. Loockerman Street, Suite 320
Dover, DE 19904
For questions regarding your COBRA coverage, call the Statewide Benefits Office at 1-800-489-8933 or 302-739-8331 and ask for Colleen Kondelis.
REMINDER: Please do not send enrollment forms back to the Statewide Benefits Office if you and/or your Qualified Beneficiaries have not yet made an election of COBRA Continuation Coverage through Ceridian Benefits Services. Changes to your benefits will not be processed unless you or your Qualified Beneficiaries have made a COBRA election. Please contact Ceridian Benefits Services at 1-800-877-7994 if you have any questions regarding your COBRA Continuation Coverage status.
If there is any conflict in interpretation between the information contained on this website, the contents of the 2012 Open Enrollment booklet and the contract provisions and existing law pertaining to any of the benefit programs, contract provisions and existing law govern.
- 2012 Open Enrollment Booklet -- Print Friendly Version
- COBRA Rates
- BCBS of DE Application
- Aetna Application
- Delta Dental Application
- Dominon Dental Application
- EyeMed Vision Care Application
