COBRA Overview If employees and their dependents are covered by the State of Rhode Island health insurance plans and lose coverage, they may be eligible for COBRA continuation coverage for any combination of medical, dental, and vision care pursuant to the COBRA General Notice of Continuation Rights. The State’s COBRA administrator is Workterra. Key Things to Remember COBRA provides temporary coverage of up to 18 months* only. COBRA provides the same health coverage as that for active State employees but at a higher premium. You may consider obtaining health coverage on health exchanges instead. * 36 months in the case of loss of dependent status, divorce and death. Coverage Details Enrollment A COBRA packet (called a COBRA Specific Rights Notice) is mailed to you if you experience a COBRA qualifying event. The most common qualifying event is termination of employment, but there are other qualifying events as provided in the COBRA General Notice of Continuation Rights. COBRA packets include enrollment instructions and an election form. You may not receive your COBRA election notice until several weeks after your COBRA qualifying event. You have 60 days from the date of the COBRA qualifying event or the COBRA election notice, whichever is later, to make a COBRA election. Even though your COBRA Specific Rights Notice may not make it abundantly clear, you may elect two individual policies instead of a family policy if you’re electing COBRA coverage for just two people. To do so, simply write “two individual policies” onto the form where you make your COBRA elections. If you were the policy holder as an active employee, your coverage ID card(s)/number(s) will remain the same if you elect COBRA coverage. However, if a dependent becomes a new policy holder in their own right, they will get their own coverage ID card(s)/number(s) from the respective carrier(s). Furthermore, any progress you and your family have made towards satisfaction of your active employee coverage deductible and out-of-pocket maximum will carry over for the former employee, but any new dependent policy holders will get a new deductible and out-of-pocket maximum for the remainder of that calendar year. It is encouraged that you do not use snail mail when enrolling in COBRA coverage because this process is quite slow. Instead, follow the guidance in Workterra’s Alternate Enrollment and Payment Process whitepaper for a much quicker enrollment experience. Monthly Premium Rates Effective 1/1/23 - 12/31/23 Medical/Prescription Plan Name Individual Family Anchor Choice with HSA $715.70 $2,006.43 Anchor $720.90 $2,021.02 Anchor Plus $771.32 $2,162.38 Dental Plan Name Individual Family Anchor Dental $34.12 $88.36 Anchor Dental Plus $38.26 $99.13 Anchor Dental Platinum $44.15 $114.33 Vision Plan Name Individual Family Anchor Vision $5.30 $14.65 Anchor Vision Plus $7.60 $20.95 Effective 1/1/22 - 12/31/22 Medical/Prescription Plan Name Individual Family Anchor Choice with HSA $674.75 $1,891.63 Anchor $679.65 $1,905.38 Anchor Plus $727.19 $2,038.65 Dental Plan Name Individual Family Anchor Dental $34.81 $90.17 Anchor Dental Plus $39.05 $101.15 Anchor Dental Platinum $45.04 $116.67 Vision Plan Name Individual Family Anchor Vision $5.33 $14.73 Anchor Vision Plus $7.64 $21.07 Historical Rates 2021 Medical/Prescription Plan Name Individual Family Anchor Choice with HSA $642.70 $1,801.80 Anchor $647.37 $1,814.90 Anchor Plus $692.65 $1,914.84 Dental Plan Name Individual Family Anchor Dental $37.39 $96.85 Anchor Dental Plus $41.94 $108.65 Anchor Dental Platinum $48.38 $125.32 Vision Plan Name Individual Family Anchor Vision $5.47 $15.09 Anchor Vision Plus $7.82 $21.57 2020 Effective 1/1/2020 - 12/31/2020 Dental Plan Name Individual Family Anchor Dental $34.81 $90.18 Anchor Dental Plus $39.56 $101.16 Anchor Dental Platinum $45.04 $116.68 Vision Plan Name Individual Family Anchor Vision $5.13 $14.17 Anchor Vision Plus $7.34 $20.26 Medical/Prescription Plan Name Individual Family Anchor Choice with HSA $606.32 $1,699.81 Anchor $610.75 $1,712.16 Anchor Plus $653.44 $1,831.92 2019 Effective 1/1/2019–12/31/2019 Medical/Prescription Plan Name Individual Family Anchor Choice with HSA $605.06 $1,696.29 Anchor $609.47 $1,708.62 Anchor Plus $652.10 $1,828.14 (Legacy) Choice Plus with HSA $634.43 $1,778.61 (Legacy) 2014 Plan $709.28 $1,988.44 Dental Plan Name Individual Family Anchor Dental $32.63 $84.52 Anchor Dental Plus $36.61 $94.81 Anchor Dental Platinum $42.22 $109.35 (Legacy) Dental $31.31 $81.11 Vision Plan Name Individual Family Anchor Vision $4.86 $13.40 Anchor Vision Plus $6.95 $19.17 (Legacy) Vision $4.83 $13.34 Contact If you have not yet received your COBRA Specific Rights Notice and have questions about COBRA, please contact the Office of Employee Benefits. If you have received your COBRA Specific Rights Notice and have questions about COBRA, please contact Workterra: 888-611-4549 soricobra@workterra.com