No. Once you become covered under another group plan your COBRA coverage will end. COBRA is designed to provide “interim” or “gap” coverage until you enroll in a new health plan.

All address changes must be submitted in writing. If you move out of the service area for your health plan, you may be moved to a different health plan with a service area covering your new address. 

A new baby is NOT automatically added to your COBRA coverage. You must notify Surency in writing within 30 days of the birth or adoption of the child. Failure to do so may result in your new child NOT being covered under COBRA.

This form is designed to show you how much premium you must pay to bring your coverage “current.” Your initial payment for COBRA coverage should include all premiums due from the date your “active” coverage ends through the date you make your initial payment.

At your initial enrollment in COBRA, you may drop dependents that were previously covered but you may not change the plan in which you are participating (i.e., PPO, HMO, indemnity plan, etc.) unless you relocate to an area where your current plan is not available.

Only dependents that were covered under your “active coverage” may participate in COBRA. You are not allowed to add dependents to COBRA that were not covered when you were an “active” plan participant.

Each year during the open enrollment period, you may be able to change the plan in which you are participating.  

You are allowed to drop a plan or dependent at any time during your continuation period. To drop a plan at initial COBRA enrollment, cross through the plan description on the enrollment form and write “decline” next to the plan you have crossed out prior to mailing.

Your first premium should be submitted along with your enrollment form in order to complete the enrollment process. However, you have up to 45 days after mailing the enrollment form to mail your first premium.

After you make your initial payment, your future premiums will be due on the first of each month. COBRA law provides a 30 day grace period for these payments, but we recommend that you mail your payment well before the due date.

You have 60 days from the date of your COBRA notice (or from the date your coverage as an active plan participant ends, if later) to elect COBRA coverage. If you do not mail a completed enrollment form within this time period, all COBRA rights will end.

COBRA law requires that your payments be current before obtaining coverage. Your insurance or health plan will not re-activate your coverage until Surency has reported that we have received your payment.

If you are properly enrolled and have made a timely payment, your coverage will be “turned on” retroactive to the first day of the month for which you paid. Until then, the insurance/health plan may report you as “not covered” or “waiting for payment.”

If you need to access health care in the meantime, you may need to pay out-of-pocket for your care and then submit a claim for reimbursement to your health plan (not to Surency) after your coverage is re-activated.

After we notify your insurance or health care plan that we have received your payment, it may take a week or more for them to “turn on” your coverage again. For this reason, we recommend mailing your payment 2 weeks or more before the due date whenever possible. 

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