Go to Top
Federal law (COBRA) gives certain individuals the right to continue Plan benefits at their own
expense when those benefits would otherwise terminate because of one or another of the reasons listed in the law.
The employer will notify UnitedHealthcare if an employee ceases to render the “Requisite Amount of Compensated Service.”
However, employees must notify the Plan administrator within 60 days after a divorce occurs or a child no longer meets
the definition of a dependent. Please complete the Divorced Spouse or Dependent Not Eligible COBRA Enrollment Form.
To obtain more information regarding your rights under this law, please call 1-800-842-5252 and/or refer to the section
labeled “Optional Continuation Coverage under COBRA” in your Health Summary Plan Description. This law applies to:
- The Railroad Employees National Health and Welfare Plan
- The National Railway Carriers and United Transportation Union (NRC/UTU) Health and Welfare Plan
- The Railroad Employees National Dental Plan administered by the Aetna Life Insurance Company under Group Policy GP-12000
- The Railroad Employees National Vision Plan administered by EyeMed
Only the coverage(s) you have when the event that triggers your right to continue benefits can be continued.
Mail completed form to:
Railroad Administration (COBRA)
PO Box 30791
Salt Lake City, UT 84130-0791
Or fax to: 1-855-779-5892