Continuation of Health Coverage – COBRA

What is COBRA?

The Consolidated Omnibus Budget Reconciliation Act of 1996 (COBRA) provides your employees or their eligible family members the opportunity to continue group health benefits as provided by MIT (medical and dental) for limited periods of time, if the coverage loss was due to certain “special enrollment events” otherwise known as a COBRA qualifying events (i.e., termination of employment, reduction in hours, divorce, death, or a dependent child ceasing to meet the definition of an eligible dependent). As an MIT Participating Employer, it is imperative to notify MIT in a timely manner (MITinfo@scmedical.org) relative to any of your employee’s “special enrollment events.” MIT is responsible for notifying MIT members of their rights under COBRA should their “special enrollment event” qualify.

 

Responsibility for Informing MIT

MIT will offer COBRA continuation coverage to Qualified Beneficiaries only after MIT has been timely notified that a Special Enrollment Event has occurred.  As an MIT Participating Employer, it is imperative that MIT is notified within 31 days following the date coverage ends when the Special Enrollment Event is:

  • the end of employment with the Participating Employer;
  • reduction of hours of employment;
  • death of the employee; or
  • enrollment of the employee in any part of Medicare.

How does COBRA Work?

  • Continuation of Coverage: COBRA allows Qualified Beneficiaries to keep the same health and/or dental plan they had while employed.
  • Duration: Coverage typically lasts 18 months, but certain circumstances can extend it to 29 or 36 months.
  • Cost: Qualified Beneficiaries pay the full insurance premium—both their share and the employer’s share—plus a small administrative fee.

Who is Eligible for COBRA under MIT?

The following serve as Qualified Beneficiaries for COBRA coverage:

 

  • Any individual who, on the day before a Special Enrollment Event, is covered under the MIT benefit, by virtue of being on that day, either a covered employee, the spouse of a covered employee (as recognized under federal law), or an eligible child of a covered employee.
  • Any child who is born to or placed for adoption with a covered employee during a period of COBRA continuation coverage, and any individual who is covered by the MIT Benefit as an alternate recipient under a qualified medical support order.

When to Apply for COBRA coverage?

The Qualified Beneficiary must elect COBRA coverage during their “election period”. This period starts no later than the date coverage would end due to a qualifying event and lasts 60 days from the later of:

  • The date coverage ends, or
  • The date the Qualified Beneficiary received notice of their COBRA rights.

If the Qualified Beneficiary does not elect COBRA within this 60-day window, they will lose all rights to continue medical and/or dental coverage under COBRA.

Payment for COBRA Coverage

If you elect COBRA continuation coverage, the Qualified Beneficiary is responsible for paying:

  • 102% of the applicable premium during the standard coverage period.
  • 150% of the applicable premium during any extended coverage period due to disability.

MIT will provide the Qualified Beneficiary with the exact cost details. Payments can be made monthly or in other approved installments. The Qualified Beneficiary has 30 days after receiving notice to make their first payment.

A small shortfall in payment is acceptable if it is $50 or less or 10% of the required amount, whichever is lower. Payments are considered made on the date they are postmarked to MIT.

When COBRA Coverage May End

COBRA continuation coverage will end on the earliest of:

 

  • The last day of the Qualified Beneficiary’s maximum coverage period.
  • The first day for which timely payment is not received by MIT.
  • The date the Qualified Beneficiary’s employer stops offering any group health plan to employees.
  • The date a Qualified Beneficiary becomes covered under another group health plan that does not impose pre-existing condition exclusions.
  • The date the Qualified Beneficiary enrolls in Medicare (Part A or Part B, whichever comes first).

For those with a disability extension:

  • 29 months after the special enrollment event, or
  • The first day of the month that is more than 30 days after Social Security determines the Qualified Beneficiary is no longer disabled.
  • The end of the maximum coverage period that applies without regard to the disability extension.

Certificates of Prior Coverage

Qualified Beneficiaries may request a free Certificate of Prior Coverage by contacting MIT:

 

📞 Phone: 803-798-6207
📬 Mail: MIT, 132 Westpark Blvd, Columbia, SC 29210
📠 Fax: 803-731-4021
📧 Email: MITinfo@scmedical.org

 

For additional questions related to COBRA, please email MITinfo@scmedical.org.