2021-2022 COBRA RATES (SUBJECT TO CHANGE)
As of July 1, 2021
MEMBER $1,106.25 ANNUALLY
INDIVIDUAL (SPOUSE/CHILD) $1100.99 ANNUALLY
MEMBER + ONE DEPENDENT $1,610.54
+ TWO DEPENDENTS $1,239.91
ADDITIONAL DEPENDENTS $ 735.62
2021-2022 RETIREE COVERAGE RATES
RETIREE…………………………. ………………………… $510.00
RETIREE SPOUSE/ELIGIBLE DEPENDENT……. $740.00
QUALIFYING COBRA EVENTS
| QUALIFYING EVENT | PEOPLE ELIGIBLE | COVERAGE UP TO | BENEFITS COVERED |
| TERMINATION(FOR ANY REASON OTHER THAN MISCONDUCT/FMLA/MILITARY LEAVE | YOU, YOUR SPOUSE, YOUR CHILDREN | 18 MONTHS | SAME BENEFITS AS YOU RECEIVED WHEN AN ACTIVE MEMBER |
| YOUR WORKING HOURS ARE REDUCED | YOU, YOUR SPOUSE, YOUR CHILDREN | 18 MONTHS | SAME BENEFITS AS YOU RECEIVED WHEN AN ACTIVE MEMBER |
| YOU DIE | YOUR COVERED SPOUSE AND DEPENDENTS | 36 MONTHS | DENTAL,VISION, MEDICAL REIMBURSEMENT($500 MAXIMUM/FAMILY) |
| YOU DIVORCE | YOUR COVERED SPOUSE | 36 MONTHS | DENTAL,VISION, MEDICAL REIMBURSEMENT |
| YOUR DEPENDENT CHILD NO LONGER QUALIFIES AS AN ELIGIBLE DEPENDENT | YOUR COVERED DEPENDENTS | 36 MONTHS | DENTAL,VISION** |
**ACTIVE MEMBERS CAN INCLUDE CLAIMS FOR THESE COBRA COVERED DEPENDENTS ON MEDICAL REIMBURSEMENT CLAIMS