Navia Benefit Solutions administers COBRA for Fred Hutchinson Cancer Center. To protect your and your qualified beneficiaries' right to elect COBRA, please refer to the information below about the notification process for your COBRA-qualifying event.
Notices
Notice of Qualifying Event
If the qualifying event is a divorce or legal separation, your notice must include a copy of the decree of divorce or legal separation. If your coverage is reduced or eliminated and later a divorce or legal separation occurs, and if you are notifying us that your Plan coverage was reduced or eliminated in anticipation of the divorce of legal separation, your notice must include evidence satisfactory to us that your coverage was reduced or eliminated in anticipation of the divorce or legal separation.
Notice of Disability
You must notify Navia Benefit Solutions of a disability event while covered by COBRA. Navia may request the following:
- the name and address of the disabled qualified beneficiary;
- the date that the qualified beneficiary became disabled;
- the names and addresses of all qualified beneficiaries who are still receiving COBRA coverage;
- the date that the Social Security Administration made its determination;
- a copy of the Social Security Administration's determination; and
- a statement whether the Social Security Administration has subsequently determined that the disabled qualified beneficiary is no longer disabled.
Notice of Second Qualifying Event
You must notify Navia Benefit Solutions of any additional qualifying event while covered by COBRA. Navia may request additional information including:
- the names and addresses of all qualified beneficiaries who are still receiving COBRA coverage;
- the second qualifying event and the date that it happened; and
- if the second qualifying event is a divorce or legal separation, a copy of the decree of divorce or legal separation.
How, When and Where to Send Notices
Notice of Qualifying Event for a Divorce/Legal Separation: You must submit a Change Benefits event in Workday. The deadline for providing this is 60 days after the later of: (1) the qualifying event; and (2) the date on which the covered spouse would lose coverage under the terms of the Plan as a result of the qualifying event.
Notice of Disability or a Notice of Second Qualifying Event: Contact Navia Benefit Solutions to provide a notice or if you have questions regarding your COBRA coverage. You may also notify Navia electronically using their COBRA participant portal. Electronic or written notice must be given within 60 days.
Navia Benefit Solutions
P.O. Box 3961
Seattle, WA 98124
Navia COBRA Customer Service: 425.452.3490 or cobra@naviabenefits.com.
The applicable notice periods are described in the paragraphs entitled "You must give notice of some qualifying events," "Disability extension of COBRA coverage," and "Second qualifying event extension of COBRA coverage" in the General Notice of COBRA Continuation Coverage Rights:
Sample COBRA Coverage General Notice
Who may provide notices: The covered employee (i.e., the employee or former employee who is or was covered under the Plan), a qualified beneficiary who lost coverage due to the qualifying event described in the notice, or a representative acting on behalf of either may provide notices. A notice provided by any of these individuals will satisfy any responsibility to provide notice on behalf of all qualified beneficiaries who lost coverage due to the qualifying event described in the notice.