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.
- Create a COBRA participant.
- Click the Dependents tab.
- Click Create.
-
Specify the COBRA participant's personal information on the
Main tab:
-
Specify this information in the Name
section:
- Title
- First name
- Middle name
- Last name
- Suffix
- Professional designation
- Preferred first name
- Preferred last name
- Entity
- Optionally, select the Active check box if the dependent is active.
-
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.
-
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.
-
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.
-
Specify this information in the Name
section:
-
Click the Contact Information tab and specify the
contact information of the COBRA participant to create:
-
Specify this information in the Home Phone and
Work Phone sections:
- Country or jurisdiction code
- Phone number
- Extension
- 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.
-
Specify this information in the Home Phone and
Work Phone sections:
- Click Save.