Human Resources

COBRA Continuation of Benefits 

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires the county to offer employees and their families the opportunity to continue current health and dental insurance enrollments where coverage would otherwise end. The continued coverage under COBRA is identical to the coverage available to active employees and retirees at group rates (plus an allowable admin fee).

The law requires that you be afforded the opportunity to maintain continuation of coverage for a designated period based on the triggering event. If you lost coverage because of termination of employment or reduction in hours, your allowable continuation coverage period is 18 months. 

A qualified beneficiary who experiences another COBRA qualifying event such as death or divorce, which occurs during the initial 18-month coverage period may extend coverage for an additional 18 months. No additional extensions of coverage are available beyond the total 36 months from the date of the event that first made a qualified beneficiary eligible to elect COBRA coverage.

The 18-month period may be extended to 29 months if a qualified beneficiary is determined to be disabled by the Social Security Administration during the first 60 days of COBRA coverage and notification is made to the Benefits Division in the Department of Human Resources within 60 days of the determination. Qualified beneficiaries who meet the criteria to extend coverage for this additional 11-month period will also see a premium increase of up to 150% of the applicable premium for coverage.

Those experiencing loss of dependent status (turning 26, death, or divorce) the allowable continuation coverage period is 36-months.

Eligibility 

Employees have the right to elect COBRA if they lose group coverage because of a reduction in hours of employment or termination of employment. Spouses have the right to choose continuation of coverage elect COBRA if they lose coverage for any of the following reasons:

• The death of spouse
• The termination of spouse's employment or reduction in hours of employment
• Divorce or legal separation.

Dependent children have the right to elect COBRA if coverage is lost for any of the following reasons:

• The death of the employee.
• The termination of the employee's employment or reduction in the employee's hours of employment.
• The employee's divorce or legal separation (from states where there is "legal" separation Note--Virginia does not have legal separation).
• The termination of coverage for a dependent child who ceases to be a "dependent” under a Fairfax County Government group plan. (Please note dependent children turning 26 will lose coverage on the last day of the month they turn 26. Dependent children who turn age 26 on the first day of the month will lose health coverage on the last day of the month prior to their 26th birthdate.)

It is the responsibility of the employee or a family member to notify the Department of Human Resources within 60-calendar days of a dependent's COBRA qualifying event (such as divorces or loss of dependent status.)  The dependents will lose their eligibility rights if the 60-calendar day deadline is not met.  

Electing to Continue Coverage under COBRA

COBRA eligible participants will receive a COBRA Notice notifying them of the opportunity to continue coverage. The COBRA Notice contains an election form, or forms, to be completed and returned to the Benefits Division in the Department of Human Resources.

COBRA Notices are generated automatically based on changes to eligibility noted in FOCUS. FOCUS events include the following:

• For events such as status changes, reduction in hours, or termination of employment, COBRA Notices are generated after this information has been updated by your Agency in FOCUS.
• For events such as loss of dependent status, divorce, or other qualifying reason, COBRA Notices are generated after this information has been updated by the Benefits Division in FOCUS. Note late notice of these events could eliminate COBRA eligibility in some cases.

New COBRA Notices are generated each week and mailed to the address of record listed in FOCUS for the eligible participant. Notices and election forms cannot be generated prior to the COBRA qualifying event, nor can enrollment be completed in advance. 

To elect to continue coverage under COBRA, you or your dependent must complete the enrollment portion of the notice and return it to the Benefits Division in the Department of Human Resources. COBRA qualified beneficiaries may elect to continue the coverages they choose but cannot change plan or elect new benefits. Plan change or coverage levels may only be changed during open enrollment. Additional enrollment details are provided in the notice.

Elections under COBRA are not made effective until receipt of the initial premium payment and arrears balances are paid in full.

When electing to continue medical plan coverage under COBRA:

• Subscribers and dependents who elect to continue coverage in the same medical plan (i.e. Cigna OAP 90% Co-insurance plan as employee, retiree, or dependent, to the Cigna OAP 90% Co-insurance plan under COBRA) any accumulated deductible (plan participant portion paid) will carryover.
• For COBRA participants who choose to elect to enroll in a different medical plan (i.e. Cigna OAP 90% Co-insurance plan as employee, retiree, or dependent, to the Cigna MyChoice CDHP plan under COBRA) deductibles will restart from $0.
• Subscribers and dependents electing to continue enrollment in the Cigna MyChoice CDHP Plan under COBRA will receive new member identification numbers. Identification numbers for subscribers and dependents electing to continue enrollment in the Cigna OAP 90% or 80% Co-insurance plan under COBRA will remain the same.

Once enrolled, participants may have the opportunity to update coverages during our Annual Open Enrollment period or due to a second qualifying event. 

Adding Dependents

A child who is born to or placed for adoption with the covered employee during a period of COBRA coverage will also be eligible to become a qualified beneficiary. These qualified beneficiaries can be added to COBRA coverage upon proper notification to the Department of Human Resources of the birth or adoption. A birth certificate or legal adoption document is required.

Premiums 

COBRA participants pay the full monthly insurance premium (the county makes no contribution) plus a two percent administrative fee.

Premiums are paid by automatic ACH withdrawal and are deducted on the first day of the month, for that month's coverage. Late and missed payments jeopardize continued enrollment. If participants fail to pay their full premium before the last day of the month, coverage is cancelled permanently with no option to re-enroll.  

COBRA participants who are declared disabled on or before their 60th day of coverage will have a premium rate of 150% for the additional 11 months of continuation coverage. Retirees do not continue their coverage under the COBRA group because the county allows them to continue coverage at the group rate through the Retirement Agency. Dependents of retirees, however, are usually eligible for COBRA coverage if they lose their eligibility to continue coverage under the retiree's plan.

Current COBRA premiums can be found in the COBRA At-A-Glance.

COBRA and Healthcare Flexible Spending Accounts

In some cases, employees may also continue to contribute to and use their Medical Flexible Spending Account. If you are participating in the Healthcare Flexible Spending Account at the time of a COBRA qualifying event (such as termination, retirement, reduction in hours, divorce, loss of dependent status, etc.), you may elect to continue contributing by completing the COBRA Election Form and submitting to the Benefits Division. Please note that COBRA enrollments will not be processed until payment is received.

Please note the following regarding access to a Healthcare Flexible Spending Account:

• Separated employees have access to the full amount elected into their Healthcare Flexible Spending Accounts (FSAs) without COBRA enrollment. To access the full balance, dates of service must be on or before the last day of the month in which you separate.

If you elect to enroll in a Healthcare Flexible Spending Account through COBRA, contributions will be post-tax and include an additional admin fee. There will be no tax-advantage to contributing to a Healthcare Flexible Spending Account through COBRA.

COBRA participants will continue to have access to their online TASC account. Current MyCash Debit Cards will provide access to any funds in your MyCash account only. Note: The debit card cannot be used at the point-of-service or to access Healthcare Flexible Spending Account funds.

COBRA is not available after the year in which the qualifying event occurs and is not available for Dependent Care Accounts.

COBRA, LiveWell and MotivateMe

Once active employment has terminated, employees and eligible dependents are no longer eligible to participate in LiveWell events and activities.

Participants who elect to continue coverage in a medical plan or flexible spending account under COBRA are not entitled to receive MotivateMe Rewards, even if eligible activities were completed during active employment. Earned rewards are forfeit upon separation of active employment unless the participant is retirement eligible and opts to continue coverage in a MotivateMe eligible medical plan as a retiree.

Termination of Coverage under COBRA

Coverage under COBRA can be voluntarily terminated, in writing, at any time. Any request to cancel coverage will be effective the first of the month following receipt. Note COBRA elections cannot be cancelled individually mid-year. If you would like to cancel one coverage, you must cancel all COBRA enrollments.

There is no option to extend enrollment in coverage under COBRA beyond the initial term unless:

• The COBRA participant experiences a second qualifying event while enrolled under COBRA.
• The COBRA participant is declared disabled on or before the 60th day of coverage.

The COBRA law provides that continuation coverage may be terminated for any of the following reasons: 

• The premium is not paid on time.
• The COBRA participant subsequently becomes covered under another group health plan that does not contain any exclusion or limitation with respect to any preexisting condition he or she may have.
• The COBRA participant subsequently becomes eligible for, or enrolled in, Medicare.
• The COBRA participant extends coverage for up to 29 months due to disability and there has been a final determination that the individual is no longer disabled.​​​​​

Continuation of coverage is subject to your eligibility for coverage. The county reserves the right to terminate your COBRA coverage retroactively if you are determined to be ineligible due to non-payment or other changes.