Welcome to Web Instruction Guide! Next

In this section you will enter the information we supplied to you. It will prompt you to change your password. Once you complete that portion we can proceed to the next page. Next You can access the online services by going to and clicking on COBRA participant log in.

We will start with “New Employee Entry” Click here for a Qualified employee listing Click here to enter COBRA notification information request Click here to log off the online services Click here for a COBRA initial notice request Next Click here for a New Hire employee listing

Next Use this section to search for entries Click here to add a new hire

You will only need to complete the following:  Title  First Name  Last Name  SSN  Address Once completed just click on accept. If there is a spouse you will need to click on “Add Dependents” Next

You will only need to complete the following for the dependent information:  First Name  Last Name  SSN & Relationship  Address Once completed just click on accept. Next

Now you are ready to click accept at the top of the page and on to the next page! Next

You may continue adding new hires by clicking on “Add Employee” or if you are done then just click on “Close”. With this lesson you have successfully added a new hire to our system which will then print an Initial Notice on our end! Next

Let’s begin to add a qualified beneficiary To add an employee with a qualifying event click here. On the following slides we will explain how to set up a qualifying event notice, better known as COBRA Notification Request. Next

Use this section to search for entries Click here to add a Principle Qualified Beneficiary (PQB)

You will only need to complete the following:  Title  First Name  Last Name  SSN  Address  Branch (if any)  DOB  Hire Date  Phone  Sex Once completed just scroll down to the center of the page. (go to the next slide) Next

In this section of the “Primary Qualified Beneficiary Main Screen” you will only need to answer the questions. If, for example, on the 1 st question the answer is no, then you would click on the employee button and a box will pop up where you would enter the employee’s name. Answering yes on question #6 will hold any letter from printing. Once you complete this section just scroll down to the bottom of the page. (go to the next slide) Next

Here you will choose the number corresponding to the qualifying event in the drop down box, then click on “Continue Dates Entry” Next

You will need to enter the qualifying event date here then click on “Compute Coverage End Date” Then you will see COBRA Coverage End Date and First Day After Loss of Coverage filled, if correct simply click on “Submit Event Dates” and it will take you on to the next section. Next

We will now assign the benefits…from the drop down box select the appropriate coverage for the PQB. Once selected it will show you the benefits, from that section you will can choose Add or View Rates. Lets choose add and go on to the next section.

On the drop down menu you will have an option to choose what level of coverage the PQB had. Choose the level with amount shown. After completing all the needed sections click on “Finished with this Benefit Assignment”. It will bring you back to the Primary Qualified Beneficiary Benefit” screen you see on the right. If theres no other benefit to assign you can click on “Finished with Benefit”. Now lets proceed to the next screen to add dependents. Next

After the process on the previous screen you will be brought back to the main screen, here you will click on “Add Dependents (if any)” and it will bring you to the dependent screen you see on your right. Here you will complete the dependent information. Once done, just click on the “Accept” button. Next

If there are no more dependents to add you may now click on “Finishes with Dependents”. This will take you back to the main screen.

Once you know you have entered all the information you can just click on accept. Next

Once you are done entering all the Principle Qualified Beneficiaries you may simply log off!

Thank you for viewing our Online Services Web Guide. Always remember that you may call us at if you ever have any questions!