COBRA INITIAL NOTICE
CONTINUATION COVERAGE RIGHTS UNDER COBRA
This notice contains important information about your right to COBRA continuation coverage, which is a
temporary extension of coverage under the University of Nebraska sponsored medical, dental, vision, and health
care reimbursement account (the Plans) health care coverage. The right to COBRA continuation coverage was
created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA
continuation coverage can become available to you and to other members of your family who are covered
under the Plans when you would otherwise lose your group health coverage. This notice generally explains
COBRA continuation coverage, when it may become available to you and your family, and what you need to do
to protect the right to receive it. This notice gives only a summary of your COBRA continuation coverage rights.
For more information about your rights and obligations under the Plans and under federal law, you should review
the university’s benefits web site as well as the Plan Documents.
The COBRA Plan Administrator is responsible for administering COBRA continuation coverage. The COBRA
Plan Administrator may be contacted at the University of Nebraska, Keith Dietze, Room 217 Varner Hall, 3835
Holdrege Street, Lincoln, NE, 68583-0742.
COBRA Continuation Coverage
COBRA continuation coverage is a continuation of Plan coverage when coverage would otherwise end because of
a life event known as a "qualifying event." Specific qualifying events are listed later in this notice. COBRA
continuation coverage must be offered to each person who is a "qualified beneficiary." A qualified beneficiary is
someone who will lose coverage under the Plans because of a qualifying event. Depending on the type of
qualifying event, employees, spouses of employees, and dependent children of employees may be qualified
beneficiaries. Certain newborns, newly-adopted children and alternate recipients unde