COBRA
COBRA (Consolidated Omnibus Budget Reconciliation Act) allows you or a dependent covered under medical, dental, vision and/or health care Flexible Spending Account (FSA) benefits to continue coverage when it is lost due to any of the following qualifying status changes:
- Termination of employment (for reasons other than gross misconduct)
- A reduction in the number of hours of employment that affects benefits eligibility
- Divorce
- Employee’s death (for eligible dependents)
- Child ceases to be eligible for coverage
Documents and Resources
- 2024 Faculty and Staff Health Plan Specific Plan Details Document
- 2024 Flexible Spending Account Specific Plan Details Document (applicable to current Health Care FSA participants)
COBRA Details
COBRA is administered by Luminare Health (formerly Trustmark), who can be reached at (866) 442-8257. You pay the COBRA rate. Ohio State makes no contribution. All COBRA payments are made directly to Luminare Health by you.
| Coverage | Prime Care Advantage Out-of-Area |
Prime Care Choice | Prime Care Connect |
|---|---|---|---|
| Enrollee Only | $751.19 | $728.55 | $798.29 |
| Enrollee + Spouse | $1,577.51 | $1,529.96 | $1,676.43 |
| Enrollee + Child(ren) | $1,389.71 | $1,347.83 | $1,476.86 |
| Family | $2,347.47 | $2,276.72 | $2,494.68 |
| Coverage | Dental Basic | Dental Plus |
|---|---|---|
| Enrollee Only | $35.90 | $41.39 |
| Enrollee + Spouse | $80.76 | $93.11 |
| Enrollee + Child(ren) | $66.38 | $76.52 |
| Family | $122.36 | $141.05 |
| Coverage | Vision Basic | Vision Plus |
|---|---|---|
| Enrollee Only | $6.18 | $15.48 |
| Enrollee + Spouse | $12.95 | $32.50 |
| Enrollee + Child(ren) | $10.49 | $26.32 |
| Family | $19.75 | $49.51 |
COBRA is administered by Luminare Health (formerly Trustmark), who can be reached at (866) 442-8257. You pay the COBRA rate. Ohio State makes no contribution. All COBRA payments are made directly to Luminare Health by you.
| Coverage | Prime Care Advantage Out-of-Area |
Prime Care Connect1 | Prime Care Choice |
|---|---|---|---|
| Enrollee Only | $676.06 | $721.16 | $654.72 |
| Enrollee + Spouse | $1,419.72 | $1,514.46 | $1,374.92 |
| Enrollee + Children | $1,250.70 | $1,334.16 | $1,211.23 |
| Family | $2,112.69 | $2,253.63 | $2,046.00 |
| 1 Must meet additional eligibility criteria | |||
| Coverage | Dental Basic | Dental Plus | Vision Basic | Vision Plus |
|---|---|---|---|---|
| Enrollee Only | $32.95 | $37.92 | $6.47 | $16.08 |
| Enrollee + Spouse | $74.11 | $85.29 | $13.57 | $33.76 |
| Enrollee + Children | $60.91 | $70.11 | $10.98 | $27.34 |
| Family | $112.28 | $129.23 | $20.67 | $51.45 |
| Qualifying Event | Maximum Coverage Continuation Period | Qualified Beneficiaries |
|---|---|---|
| Employee’s termination | 18 months | Employee and all covered dependents |
| Employee’s reduction in hours or type of employment that affects benefits plan eligibility | 18 months | Employee and all covered dependents |
| Employee’s divorce | 36 months | All covered dependents |
| Employee’s death | 36 months | All covered dependents |
| Loss of eligibility for a dependent child who reaches the limiting age | 36 months | Eligible covered dependent children |
COBRA coverage will cease on the last day of the month in which you:
- Reach the maximum coverage period (see Continuation Period above)
- Fail to submit a premium payment
To view other reasons that COBRA may terminate, please review the Faculty and Staff Health Plans Specific Plan Details Document.
Your health coverage termination date must be in Workday and then sent from Ohio State to Luminare before Luminare can provide a COBRA notice with an election form. Ohio State sends eligibility files to Luminare weekly.
Luminare will mail a COBRA notice with the election form within 14 days of receipt of the health coverage termination date from Ohio State.
You can also view and download the COBRA notice with the election form at myLuminareHealth.com.
You cannot be enrolled without completing a COBRA election form.
You have 60 days after the date of the notice, or qualifying event date, whichever is later, to elect COBRA. When you elect COBRA, your coverage becomes effective retroactively to the qualifying event date. This means you will not have a break in coverage. Therefore, health care expenses incurred between the qualifying event date and the date your enrollment is completed may be covered. It is important to note that claims cannot be processed until your COBRA premiums are paid through the claim’s date of service.
Completed COBRA election form(s) or any COBRA correspondence are to be mailed to the following address:
Luminare Health
PO Box 2905
Clinton, IA 52733
NOTE: DO NOT SEND PAYMENTS TO THIS ADDRESS.
Completed COBRA election form(s) can also be emailed to cobrateamhb@luminarehealth.com
Luminare will process COBRA enrollment forms within 2 to 3 business days of receipt. However, claims cannot be paid until the COBRA premiums are paid though the claim’s date of service.
You must be enrolled in COBRA by Luminare to make a COBRA premium payment.
The first payment must be received no later than 45 days after the date of your election (this is the date the Election Notice is postmarked).
All payments made after the first payment are due on the first day of the month with a 30-day grace period.
Payment options: recurring or one-time ACH, one-time credit card, check, or money order
If your COBRA enrollment has been received and processed by Luminare, you can make a COBRA premium payment online at myLuminareHealth.com by logging in and clicking “Pay COBRA and Retiree Bills” under “My Links”. You will then need to enter ACH or credit card information and select your one-time or recurring payment date.
If you prefer to mail a check or money order, send the payment to the following address:
Luminare Health
PO Box 416025
Boston, MA 02241-6025
Check and Credit/Debit card payments will post within 2 to 3 business days from receipt. ACH payments will post on the first day of the month.
To contact Luminare’s COBRA department use the following phone number, fax number, or email address:
Phone: 855-580-4838 (8AM EST to 5PM EST)
Fax: 704-527-2162
This is intended to be an overview. Refer to the Plan Document for complete information. In the event the information on these pages differs from the Plan Document, the Plan Document will govern.
