COBRA
Due to COVID-19, I have been laid off/furloughed from my employer and no longer have health insurance. What is COBRA and how do I sign up?
The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law that provides you and your covered dependents the right to choose to continue group health benefits on a temporary basis. It’s only available when coverage would otherwise be lost due to the following events:
- Voluntary/involuntary termination of a covered employee’s employment for reasons other than gross misconduct
- Reduction in the hours worked by the covered employee
- Divorce or legal separation from a covered employee
- A covered employee becoming entitled to Medicare
- A child’s loss of dependent status and coverage under the plan
- Death of a covered employee
If your employer offers COBRA through PayFlex and you received a COBRA Qualifying Event notice, you can sign up online at www.payflex.com.
- After you log in, click Enroll Online in top right corner.
- Click on each available plan you want to enroll in by placing a check mark next to the plan.
- If you would like to decline coverage, check the box next to Decline this coverage.
- If the box to elect coverage next to the benefit is grayed out, this means it is automatically included.
- Once you elect all the benefits you want to be enrolled in, click Submit. A summary of all elected benefits will be displayed. If correct, click Confirm. Then you’ll receive a message that you have successfully completed the benefit election process.
Note: You cannot enroll online if you are electing coverage for your dependents.
Want to enroll by mail? Once you receive your COBRA Qualifying Event notice, complete and mail the election form to the address provided by the last date indicated. Include the appropriate payment amount to reinstate your coverage.
How do I make a COBRA payment?
You have two options.
1. Online
- Log in to www.payflex.com. Click Make a Payment in the top right-hand corner of the Dashboard.
- You can setup a recurring and/or one-time payment.
- If you’re a first-time user: Set up your bank account information by clicking on add a new account. Complete the required information and click Submit.
- If you already have a bank account: Select the account you want to use to pay and enter the amount you want to pay. Then click Submit.
2. Payment via mail
You can make a payment via check or money order and mail directly to:
PayFlex Systems USA, Inc.
PO Box 953374
St. Louis, MO 63195-3374
Be sure to include your name and participant number. (If you are electing COBRA coverage for the first time, mail in payment with your Qualifying Event election form)
Note: If you enroll in the recurring payment option, you won’t receive monthly payment communications from PayFlex.
Am I eligible for a COBRA extension due to COVID? If so, how do I apply for one?
To learn more about the COBRA extension and to find out if you qualify, you can email us at cobramail@payflex.com or contact your Human Resources/Benefits department.
What is the Outbreak Period and what does it mean to me?
The Outbreak Period is defined as the period of time in which we are in the COVID-19 pandemic and started on March 1, 2020. During this period, your COBRA election, premium payment, and notice deadlines are extended until the end of the Outbreak Period or until 1 year after your qualifying event, whichever happens first.
- New COBRA participants: For participants who haven’t yet elected COBRA and made their initial premium payment, delaying your COBRA election and premium payments will delay the start of your insurance coverage.
- Current COBRA participants: For participants who have already elected COBRA and made at least one premium payment, failure to pay subsequent premiums due within the standard grace period will result in the administrative termination of your coverage. Claim determinations and claim payment won’t occur if your coverage is administratively terminated.
- COBRA coverage: Participants can initiate or reinstate COBRA coverage retroactively by submitting premium payments during or upon conclusion of the Outbreak Period. Coverage will be effective through to your premium paid through date.
- COBRA statements: During the Outbreak Period, system generated billing statements and letters you receive won’t reflect the Outbreak Period deadline extension dates. Such communications will continue to show the standard grace periods and deadlines.
How do I know if I qualify for the extensions under the Outbreak Period?
If you received a notice from PayFlex outlining the extensions for certain COBRA grace period deadlines known as the “Outbreak Period” issued by the Department of Labor (DOL) and Internal Revenue Service (IRS) that was effective March 1, 2020, click here for details on the latest guidance for these extension end dates.
What happens after the Outbreak Period?
At the end of the Outbreak Period or after the one year extension period, whichever comes first, any COBRA elections not submitted and/or monthly premiums not paid during the Outbreak Period will be due. If you do not make the payments when they are due, you will be responsible for all claims after your last paid premium.
Can I enroll in COBRA online?
Yes. Online enrollment and payment capabilities are available during the standard deadlines outlined in your COBRA notice. They aren’t available if you’re delaying COBRA elections or premium payments, as permitted during the Outbreak Period.
If you’re outside the standard deadlines, you must mail in your COBRA elections and/or premium payment(s) to:
PayFlex Systems USA, Inc.
BENEFITS BILLING DEPARTMENT
P.O. BOX 953374
ST. LOUIS, MO 63195-3374