Plan year July 1, 2024 through June 30, 2025
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: 04/11/2024
Submit paper form to Benefits Office, 112 Scovell Hall, Lexington KY 40506-0064