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IMPORTANT NOTICE RE: CONTINUATION OF COVERAGE UNDER COBRA – Interim LSU Public Hospital Employees who had active coverage with Office of Group Benefits PPO, EPO, MCO or Humana; or DEFINITY/LSU System Health Plan

Office of Group Benefits (OGB):

COBRA information and instructions regarding COBRA that were recently sent by the Office of Group Benefits (OGB) regarding the process for continuation of medical coverage under COBRA. Disregard the notice instructions to contact your former employer to complete the proper documents to enroll in COBRA.

OGB will be sending out a corrected/revised notice this week. Interim LSU Public Hospital employees are to use either the letter or the “Certificate of Prior Coverage” page that was with the initial letter sent to you, or wait for the revised/corrected notice to write in the following:

I (your name) do want to continue coverage under COBRA.
Include you SS#
Name of Plan you want to continue under COBRA (PPO, EPO, MCO, Humana)
Sign and Date

The letter of Prior Coverage page with the above information indicated MUST be returned to:

Office of Group Benefits
Attention: Eligibility - COBRA
P. O. Box 66678
Baton Rouge, LA. 70896

The HCSD - Interim LSU Public Hospital Benefits Office cannot provide you with the enrollment information for COBRA. You must notify OGB as indicated above. For additional information or enrollment forms you must contact Office of Group Benefits at:
1-800-272-8451 or (225) 925-6625.

Definity/LSU System Health Plan Participants :

Definity will be sending the COBRA information directly to plan members. Please do not contact Interim LSU Public Hospital Benefits, they cannot provide the COBRA information. If you do not receive correspondence within the next 20 to 30 days you must contact “Acclaim” at 1-800-777-4925.

Any information will be returned directly to Acclaim benefits.

COBRA coverage for any plan is retroactive to the date that the employer coverage ended. You have 60 days from the date of coverage termination to apply.

UPDATED 12.07.05




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