Creating COBRA participants from an employee's dependent

You can create a COBRA participant from an employee's dependent. For example, the spouse that becomes the COBRA participant in a divorce and a dependent that loses a coverage due to age.

The default fields are specified automatically.

  1. Create a COBRA participant.
  2. Click the Dependents tab.
  3. Click Create.
  4. Specify the COBRA participant's personal information on the Main tab:
    1. Specify this information in the Name section:
      • Title
      • First name
      • Middle name
      • Last name
      • Suffix
      • Professional designation
      • Preferred first name
      • Preferred last name
      • Entity
    2. Optionally, select the Active check box if the dependent is active.
    3. Specify this information in the Additional section:
      Relationship
      Specify the dependent's relationship to the employee.
      Birthdate
      Specify the dependent's date of birth.
      Adoption Date
      Specify the dependent's adoption date if the is adopted.
      Placement Date
      Specify the dependent's placement date to the employee.
      Gender
      Select the dependent's gender.
      Smoker
      Select the Yes if the dependent is a smoker.

      Select No if the dependent is not a smoker.

      Student
      Select the dependent's student status:
      • Yes
      • No
      • Fulltime
      • Parttime
      Disabled
      Select Yes if the dependent is a person with disability.

      Select No if the dependent is not a person with disability.

      Consent
      Select the dependent's permission in handling personal information.
      Point of Origin
      Specify the dependent's place of origin.
      Deceased
      Select this check box if the COBRA participant is deceased.

      Leave this check box blank if the COBRA participant is not deceased.

      Date Of Death
      Specify the COBRA participant's date of death.

      If you select the Deceased check box, then specify the Date Of Death field.

    4. Specify this information in the Benefits section:
      Health Insurance Claim Number
      Specify the dependent's claim number for the health insurance.
      Primary Care Physician
      Specify the code of the dependent's primary care physician.
      Prior Months Coverage
      Specify the number of months that the dependent is covered with benefits before the dependent is created as a COBRA participant.
      Medicare
      Select the coverage of the dependent's health plan.
    5. Specify this information in the Benefit Eligibility section:
      Benefits Eligible
      Select the eligibility status of the dependent's benefits.
      Eligibility
      Select the dependent's eligibility status.
      Verified
      Specify the date when the dependent's eligibility status is verified.
  5. Click the Contact Information tab and specify the contact information of the COBRA participant to create:
    1. Specify this information in the Home Phone and Work Phone sections:
      • Country or jurisdiction code
      • Phone number
      • Extension
    2. Specify this information in the Address section:
    Which Address?
    Specify the dependent's type of address:
    • Other Address
    • Mailing Address
    • Residence Address
    Country/Jurisdiction
    Select the country or jurisdiction of the dependent's address then specify the dependent's full address to search automatically.
    Enter Address Manually
    Select this check box to specify manually the street and city of the COBRA participant's address.
    Search For Address
    Select this check box to search the COBRA participant's full address automatically.

    If you select the Enter Address Manually check box, then this check box is displayed.

  6. Click Save.