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COBRA Products

As plan administrator for the COBRA process, the HCA is responsible for verifying all enrollees are notified of their COBRA and other continuation coverage rights within the specified timeframe. To satisfy this requirement, the HCA has assumed the responsibility for distributing COBRA and other continuation coverage materials. This is a monthly automated process of the PEBB Continuation of Coverage Election Notice packets.

This means agency personnel, payroll, and benefits representatives are no longer expected to provide COBRA or other continuation coverage notices to affected enrollees.

For your reference, the continuation coverage materials are provided below.

Note: These are large .pdf files and may take some time to download.

• Official notice of Changes (142.9 KB)
• Summary Plan Description of Contribution Coverage Rights is not in publication as of 12-31-2006. This has been combined with the Initial Notice (370.6 KB) (01/07).
• PEBB Initial Notice of COBRA and Continuation Rights (370.6 KB)
• Continuation of Coverage Election Notice (18-29 month qualifying events) (1.7 MB)
• Continuation of Coverage Election Notice (36 month qualifying events) (1.6 MB)

If you have questions, please contact the Outreach and Training Unit.