COBRA

What is continued coverage or COBRA?

Consolidated Omnibus Budget Reconciliation Act (COBRA) refers to your right under federal law to make self-payments of contributions to continue your health coverage when an event such as: layoff, termination, reduction of work hours, sickness, divorce, over age dependent etc. causes loss of health coverage under TeamCare to you or a covered family member.

Who can elect to make COBRA self-payments?

Generally, you or your qualified dependents can elect to make self-payments as long as you are covered under TeamCare on the day prior to the event which causes loss of coverage.

How can I elect to continue Health coverage under COBRA?

To elect COBRA coverage, you must complete the election form sent by TeamCare. It must be returned to TeamCare within 60 calendar days from the date of the election form. You then have 45 calendar days to make your first payment for continuation coverage. If you incurred a COBRA event and you did not receive a COBRA notice, contact TeamCare

How long can I make COBRA self-payments?

For employer events such as termination of employment, reduction in hours, sick leave, and layoff, you may be eligible to make self-payments for up to 24 months.

For employee events such as divorce, member death, adult child termination, loss of dependent status and member entitlement to Medicare, your enrolled dependents may be eligible to make self-payments for up to 36 months. Review the exception for disability in the Summary Plan Description (Forms and Documents or your Participant Dashboard).

How much do COBRA self-payments cost?

The cost of COBRA self-payments vary and is determined by the specific plan you are covered under but generally it is the same premium cost being paid by your employer. The COBRA premiums and options will be outlined in the COBRA election notice you receive from TeamCare.

When and how must my first COBRA self-payments be made?

Once elected, your first payment is due within 45 days of the postmarked date you mailed in your election notice. Failure to do so results in the loss of all COBRA rights under TeamCare. You are responsible for making sure that the amount of your first payment is correct. Your first payment should be made from the initial loss of coverage date through the current week if coverage is to be maintained into the future.

When and how must ongoing COBRA self-payments be made?

Under TeamCare, ongoing COBRA payments are due on the first day of the period for which coverage will be in effect and will not be accepted after a 30 day grace period. All payments should be sent to:

TeamCare
Self-Payments Department
Dept. 10291
Palatine, IL 60055-0291

Make sure to include your Member ID and the coverage period you are self-paying on the check.

Once I start making self-payments will TeamCare bill me regularly for future coverage periods?

Only if previous bills are paid timely and in full. You are still responsible for making self-payments when due even if you do not receive a bill from TeamCare.

Can I make my COBRA payments in advance?

Yes. In fact, paying before the due date should ensure that no lapse in coverage or disruption to service occurs.

Does TeamCare accept third party payments for my COBRA continuation coverage?

Yes. A third party can pay the COBRA premiums on your behalf. However, you are still responsible for the COBRA premiums being paid when due and in full.

What forms of payment are accepted?

Personal check, cashier’s check, and money order. We do not accept credit cards.

I was recently divorced and my divorce papers say I have to maintain coverage for my ex-spouse. Will my ex-spouse remain on my active policy or do I need to make self-payments to continue coverage?

Your ex-spouse cannot stay on your active policy, but will be eligible to make COBRA self-payments due to the divorce. We will need a copy of the divorce decree and your former spouse’s address. Please contact TeamCare upon the finalization of your divorce for assistance in getting the COBRA plan set up.

I am making self-payments, but now got divorced. Can my ex–spouse make self-payments?

Yes. If you get divorced while making self-payments, your ex-spouse may be eligible to make COBRA self-payments under their own event. Please contact TeamCare upon the finalization of your divorce for assistance in getting the COBRA plan set up.

My child just turned 26 and his child coverage ended. Can he make self-payments?

Yes. Your child would be eligible to make COBRA self-payments once they turn 26. To ensure no gap in coverage, contact TeamCare for assistance in getting the COBRA plan set up.

I am covered under my spouse’s policy but still want to make self-payments with the Plan. How will you coordinate benefits?

If you have a COBRA event while also covered under your spouse’s insurance, we will coordinate benefits. We will remain your primary insurance for you and any dependents that we were primary for prior to the COBRA event. We would continue to be secondary for your spouse or any dependents we were secondary for prior to the COBRA event.

I have Medicare. Can I still make self-payments?

It depends. If your Medicare benefits started before you elected COBRA then you can make self-payments. If your Medicare benefits started after you elected COBRA then your COBRA coverage will end on the date Medicare coverage begins. COBRA ends but only for the person obtaining Medicare benefits so you can still make self-payments to cover qualified dependents.

I had Medicare coverage when I elected COBRA. Which coverage is primary and which coverage is secondary?

Medicare coverage will be primary and COBRA coverage will be secondary throughout the 24th, 29th, or 36th month period of COBRA eligibility. Review the exception for End Stage Renal Disease (ESRD) in the Summary Plan Description (Forms and Documents or your Participant Dashboard).

What happens if I become eligible for other insurance while making COBRA self-payments?

Eligibility for COBRA self-payments end the date you become eligible for coverage under another plan. 

Am I responsible for notifying TeamCare if I become covered under another group health plan or Medicare after electing COBRA?

Yes, you must immediately contact TeamCare if you or your dependents become covered under another group health plan or Medicare.

Can I make self-payments to establish eligibility?

While this differs from COBRA self-payments, once contributions made by your employer have begun, you can make self-payments to establish eligibility. Contact TeamCare for rates and assistance.

I had coverage for my whole family, but only want to make self-payments for myself. Is this an option?

Only if you are covered under one of our multi-tier plans. Your COBRA election notice from TeamCare outlines the specific options available to you.

I only had coverage for myself before I started making self-payments. I was recently married. Can I add my spouse?

Yes. As long as you notify TeamCare within 60 days of your marriage and your new spouse meets TeamCare rules for eligibility. 

Am I responsible for notifying TeamCare of certain COBRA qualifying events?

Yes. You are responsible for notifying TeamCare of employee events within 60 days. Employee events are: divorce or legal separation, death of the employee, employee’s entitlement to Medicare benefits (if under a retiree plan), and loss of dependent child eligibility. If you fail to notify TeamCare of employee events within 60 days you will not receive a COBRA election notice and you will not be eligible to make self-payments. 

Will my employer notify TeamCare if I have an employer COBRA qualifying event?

Yes. Your employer is responsible for notifying TeamCare of employer events. Employer events are: termination of employment and reduction of work hours (i.e., sick leave, quit, discharge, and layoff). Employers report COBRA qualifying events to TeamCare automatically when they submit monthly work reports.

What happens to claims I incur after my COBRA event but before I elect to continue coverage and make self-payments?

During this period eligibility will be not be updated and claims will be denied. However, when you elect COBRA and make the appropriate self-payments, your eligibility is updated retroactively and claims previously denied will automatically be reprocessed or can be resubmitted.