Summary: UNIVERSITY OF VIRGINIA HEALTH PLAN AND/OR DAVIS VISION
2012 COBRA ELIGIBILITY AND ENROLLMENT
Employees of the University of Virginia or its Health System covered under the University of Virginia Health Plan or the
Davis Vision Plan who: 1) terminate employment for any reason other than as the result of gross misconduct; 2) become a
part-time employee who would otherwise no longer be eligible for coverage; or 3) become a non-salaried employee no
longer eligible for coverage, may elect to continue coverage on a self-payment basis through the COBRA plan for
themselves, their spouse, and/or their dependents from the date coverage in the active employee group would otherwise
end. Covered spouses or dependents who lose coverage because they no longer qualify as a dependent or spouse under the
terms of the Plan (examples of these qualifying events are divorce and reaching age limits) may also elect to continue
coverage on a self-payment basis through the COBRA plan for themselves from the date coverage as a qualified
dependent would otherwise end.
COBRA coverage begins the day after coverage in the active employee plan ends.
Enrollment in the COBRA plan is not an opportunity to change from one program to another (for example, from
High Premium to Low Premium or vice versa); COBRA participants can choose enrollment only in the same
program in which they were enrolled on their last day of coverage in the active employee plan.
If the employee has a spouse or dependents who are covered under the Health or Vision Plans, the employee and each
covered spouse and/or dependent have independent election rights. COBRA law allows the employee and each covered
spouse and/or dependent to choose coverage that is the same as the coverage that was in effect at the time of the
Qualifying Event. If not all dependents and/or the spouse want to continue, do not include their names on the Enrollment
Form. The employee's name must be included on the Enrollment Form's list of eligible persons if the employee wants