Plan year July 1, 2023 through June 30, 2024
Use this form to enroll in COBRA insurance coverage, available to UK employees which allows you to continue your group health, dental and vision insurance on an individual basis when you or your dependent(s) become ineligible for University benefits.
Revision date: 04/13/2023
Submit paper form to Benefits Office, 112 Scovell Hall, Lexington KY 40506-0064