Everything you need to know about COBRA coverage

Introduction

The Consolidated Omnibus Budget Reconciliation Act (COBRA) benefits allow Crossover W2 employees to continue their health insurance coverage after experiencing a qualifying event. COBRA enables you to extend your coverage under the same policies you were enrolled in with Crossover, though at an unsubsidized rate.

COBRA continuation coverage becomes available to you and your family members who are covered under the Plan when you would otherwise lose your group health coverage. Below is a general explanation of COBRA continuation coverage, when it may be available, and what you need to do to maintain your right to receive it.

Key Points

1. COBRA allows you to extend your current health coverage for a limited time.
2. You have 60 days to elect COBRA coverage after a qualifying event.
3. You are responsible for the full premium cost.
4. Coverage is retroactive if you elect it and make timely payments.

Crossover has delegated authority to administer COBRA continuation coverage to Flores & Associates. For questions or assistance, contact:

• Phone: 800-532-3327
• Fax: 800-726-9982
• Email: CustomerService@Flores247.com
• Website: www.flores247.com
• Mailing Address: P.O. Box 31397, Charlotte, NC 28231-1397

Eligibility and Qualifying Events

You may be eligible for COBRA if you experience one of these qualifying events:

For Employees:

• Your employment ends for any reason other than gross misconduct
• Your work hours are reduced, causing a loss of eligibility for benefits

For Spouses:

• Your spouse (the employee) dies
• Your spouse's employment ends for any reason other than his or her gross misconduct 
• Your spouse's hours of employment are reduced
• You become divorced or legally separated from your spouse
• Your spouse becomes entitled to Medicare (Part A, Part B, or both)

For Dependent Children:

• The parent-employee dies
• The parent-employee's hours of employment are reduced
• The parent-employee's employment ends for any reason other than his or her gross misconduct
• The parent-employee becomes entitled to Medicare (Part A, Part B, or both)
• The parents become divorced or legally separated
• The child loses "dependent child" status under the plan rules

Note: Domestic partners are not recognized as qualified beneficiaries under federal COBRA law, but Crossover extends COBRA-like coverage to domestic partners and their covered children, except in cases of termination of the domestic partnership. However, COBRA rights and protections do not apply to this extension of domestic partner coverage.

Notification Process:

1. For most qualifying events, Crossover will notify our COBRA administrator, Flores & Associates, within 3 business days of the event.
2. For divorce, legal separation, or loss of dependent status, you must notify Flores within 60 days of the event.
3. Flores will send you a COBRA Qualifying Event Notice with election forms within 14 days of being notified of the qualifying event.

Election Process:

1. You have 60 days from the later of (a) the date of the qualifying event or (b) the date you would lose coverage to elect COBRA coverage.
2. Complete and return the Election Form to Flores by the deadline specified in your notice.
3. You can return the form by mail, fax, or upload it to www.flores247.com.

Coverage Start Date:

1. For each qualified beneficiary who elects COBRA continuation coverage, the coverage will begin on the date that plan coverage would otherwise have been lost.
2. Your group health plan coverage through Crossover will terminate on the last day of the month in which your employment ends, regardless of the specific termination date within that month. For example, if your employment ended on June 20, 2024, your coverage will continue through until June 30, 2024.
3. COBRA continuation coverage will begin automatically on the first day of the month immediately following the termination of your group health plan coverage.
4. Note that there may be a gap between when you elect coverage and when it is activated. This is because coverage will not be activated until your first payment is received. However, once activated, coverage will be retroactive to the start date.

Coverage Duration:

• Up to 18 months for termination of employment or reduction of hours
• Up to 36 months for other qualifying events (death, divorce, etc.)

Costs and Payments:

1. You are responsible for the full premium cost.
2. Your first payment is due within 45 days of electing COBRA coverage.
3. Subsequent payments are due on the 1st of each month, with a 30-day grace period.
4. Coverage will not be activated until your first payment is received.
5. Failure to pay on time will result in termination of coverage.

Payment Methods:

• Online: Pay by credit card or e-check at www.flores247.com (fees apply)
• Mail: Send check or money order as instructed on your invoice
• Automatic Bill Pay: Set up through your bank

Important Notes:

• You can elect to continue all or only some of your current coverage options.
• You can cover all or only some of your previously covered dependents.
• If you don't elect COBRA coverage, your health insurance will end on the last day of the month in which your qualifying event occurred.
• If you find new health coverage during your COBRA period, you may cancel your COBRA coverage at any time.

Frequently Asked Questions

Why did I receive a COBRA Qualifying Event Notice?

COBRA Qualifying Event Notices are sent when you experience loss of employer-provided insurance coverage due to certain qualifying events. COBRA allows you to extend your coverage under the eligible policies you were enrolled in with the employer at an unsubsidized rate.

When will I receive the COBRA Qualifying Event Notice, and to which address will it be sent?

You will get the COBRA Qualifying Notice in the first week of the month following the month when the qualifying event happened. It will be sent to you at the address in your Paychex profile.

Where can I get the details of the plan costs that I need to pay?

The details of the plans you have enrolled in with Crossover and the cost for each plan will be in the COBRA Continuation Coverage Election Form accompanying the notice.

Who should I contact if I haven’t received the COBRA Qualifying Event Notice?

You can contact Flores. Contact details:

Flores & Associates 

P.O. Box 31397

Charlotte, NC 28231-1397

Telephone: 800-532-3327

Fax: 800-726-9982

E-Mail: CustomerService@Flores247.com

When do I have to send the completed election form?

You must complete the election form and send it to the address provided or you can upload it to the Flores247 Web Portal before the deadline stated in the COBRA Qualifying Notice. 

How do I elect COBRA coverage?

If you have experienced a loss of coverage due to a Qualifying Event, you will receive a Qualifying Event Notice letter. To elect COBRA coverage, you will return the COBRA Election Form included in the notice via mail or fax or upload it to the Flores247 Web Portal at www.flores247.com. To log in, you will use the Participant ID number included in your letter, along with the password you created when you set up your account. To set up your login for the first time or reset your password, please visit Registration | Flores247.

When do I have to send in my COBRA payment?

A 45-day window is allowed for the first payment of your COBRA continuation period. After that, payments are due on the first day of the coverage period. For example, for the May 1 - May 31 coverage period, the COBRA payment is due on 5/1. You will have 30 days from the due date to make the payment. If payment is not received within the 30-day grace period, coverage must be canceled by law.

Where do I go to make my COBRA payment online?

You can pay online by credit card (Visa or MasterCard) or e-check at www.flores247.com. There is an additional fee applied to pay using the Flores website. You can log in to the account using the Participant ID number on your invoice and the password you created when you set up your account. To set up your account for the first time or reset your password, visit Registration | Flores247. Flores can also accept automatic Bill Pay sent from your bank.

When is my COBRA paid through?

You can view your COBRA activity, including your payment status, in the Flores247 Participant Portal. After logging in, select your COBRA account to view activity, including your payment history. Enroll in e-Status updates in the Settings tab to receive email notifications when your payments are received and processed.

I made a COBRA payment, but Cigna has not reinstated my coverage. What should I do?

It can take up to 10 business days after you make a payment for COBRA for your coverage to appear as active with Cigna. Coverage will be reinstated retroactively. Providers may resubmit claims for services incurred during the waiting period.

I received a COBRA Qualifying Event Notice. I would like to continue my dental plan but not my health plan. Is this allowed?

Yes, you may elect to continue each plan separately. If you wish to continue only one plan, select only that plan on your election form. You will only be billed for the plans you select, and coverage will only be extended on the plans for which you elect and make timely payments.

Can I continue coverage for just my spouse or dependent?

If your spouse or other dependent was covered on the plan during your active employment, you may drop to an individual policy for them due to individual enrollment rights. You will be billed at the individual coverage rate on your COBRA Election Form.

I received a COBRA Qualifying Event Notice, but I don’t wish to continue the coverage. Do I need to do anything?

No, however, we recommend saving the notice for your records.

How do I cancel my COBRA coverage?

Cancel your coverage by logging into your www.flores247.com account. You may also cancel your coverage due to non-payment of premiums at no penalty.