COBRA
Who is Eligible
Employees and dependents enrolled in the State Health Benefits Program
COBRA Events
- Termination of employment (except for gross misconduct)
- Death of the member
- Reduction in work hours
- Leave of absence
- Divorce, legal separation, dissolution of same-sex domestic partnership
- loss of a dependent child’s eligibility through independence (moving out of the household), the attainment of age 23, or marriage
- The employee elects Medicare as primary coverage. (Federal law requires active employees to terminate their employer’s health coverage if they want Medicare as their primary coverage)
Duration of COBRA Coverage
- 18 months if you or your dependent become eligible because of termination of employment, a reduction in hours, or a leave of absence
- 29 months if you have a Social Security Administration approved disability
- 36 months for a dependent in the event of the employee’s death, divorce, dissolution of a same-sex domestic partnership; or the dependent child attains age 23, or moves out of the household, or because the employee elects Medicare as the primary coverage.
How to Enroll
The Benefits Administrator will mail a COBRA enrollment application, instructions and rates
COBRA Filing Deadline
Within 60 days of the loss of coverage or date of employer notification, whichever is later
COBRA Application
The employee should mail the completed COBRA application to: NJ State Division of Pensions & Benefits, COBRA Administrator, Health Benefits Bureau, P.O. Box 299, Trenton, NJ 08626-0299. Do not send any premiums; participants are billed on a monthly basis for coverage
COBRA Premium Remittance
Upon receipt of the invoice a check or money order should be mailed to: State of New Jersey Health Benefits Program, Newark Post Office, PO Box 19519, Newark, NJ 07195-0519
COBRA Rates
www.state.nj.us/treasury/pensions/epbam/shbp/cobra.htm#2