Termination / COBRA

Service Information

Termination / COBRA

Coverage for employee health benefits ends on the last day of the month following employment termination date.  

The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows employees and/or their dependents to continue certain insurance benefits after termination of employment or when a dependent’s status changes, resulting in loss of coverage. Medical, dental and vision plans can be continued for up to 18 months under COBRA.

Payment of the full monthly cost plus an administrative fee is required. Employees have 60 days to apply for coverage retroactive to benefits termination date by submitting a completed COBRA application.

Employees are responsible for reviewing the COBRA and information regarding group benefit termination.

See the documentation below for information. 


COBRA Application


Group Benefits Termination Summary

COBRA General Notice 

COBRA Election Notice (fillable)

2022 COBRA Rates 

Credit card payments are now being accepted via phone or online for COBRA/Direct Bill invoices:

Phone payments:

Call:  888-497-8701

Provider ID# 58840

Online payments:


For payment related questions, please contact the Department of Revenue at 312-603-6961.