Human Resources
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Human Resources

Human Resources Administration Building
University of California, Davis
One Shields Avenue
Davis, CA 95616

(530) 752-0530 phone

 
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COBRA

Federal legislation (the Consolidated Omnibus Budget Reconciliation Act - COBRA) requires the University of California to allow formerly eligible employees and dependents to continue their medical, dental, and optical insurance coverage. When they lose eligibility for insurance due to certain qualifying events, employees and their dependents can continue coverage through COBRA by paying plan premiums directly to the insurance carriers. Only employees and their family members, if any, enrolled in the group insurance plans at the time of the qualifying events can elect COBRA.

If you are terminating employment or are losing eligibility:

  • You will receive a COBRA packet to elect to continue your participation in the following plans; medical, dental and vision insurance plans, Staywell and the Health Flexible Spending Account.

If your family member loses eligibility, you must submit a UPAY850 and UBEN109 form to the Benefits Office.

Once you receive the COBRA packet, you must submit the Application for COBRA Continuation form to your insurance plan's COBRA administrator by the Application Form Due date as specified in the COBRA packet. (See Mailing Addresses and Premium Information for additional information.)