Managers, Supervisors and HR Professionals

Benefits Information Checklist: For Employees at Layoff

Required Information: The department is required to give employees the following benefits publications and resources:

1. Indefinite Layoff Benefits Checklist (KP# 3002)
2. Indefinite Layoff Benefits Checklist Supplement (HR website)
3. COBRA PACKET: The COBRA process has changed, effective January 1, 2005. The new COBRA forms and instructions are available at: http://atyourservice.ucop.edu/administrators/public/cobra_docsprocs/index.html
   • Please follow the instructions on this website to complete the COBRA packet. You will need to complete the COBRA form on-line, then print it out and send to the employee. The entire COBRA packet will print out as one document.
   • You will need to mail the completed COBRA packet in a special envelope. You may order these envelopes from KP (#UBEN102ENV).
   • The department will need to keep a copy of the COBRA packet for 5 years.
   • The complete COBRA packet includes:
     
     • Completed COBRA UBEN 102 form
     • Continuation of Group Health Coverage pamphlet The current year's COBRA rate and address chart
   • PLEASE NOTE: Laid-off employees eligible for COBRA may switch from their current medical plan to the Core Medical plan at the time of COBRA/Continuation election. This exception applies only to layoff actions, it does not apply to other COBRA qualifying events. Therefore, it is important that the Department Benefits Counselor mark the appropriate "Layoff" indicator in the qualifying event section when preparing the COBRA form UBEN 102.
4. At Your Service website homepage (http://atyourservice.ucop.edu)
5. Always At Your Service brochure (KP# 4003)

Useful information:

1. Retirement Handbook (KP# 1400)
2. Retirement Plan Summary Plan Description
   1. Coordinated with Social Security (KP# 1001)
   2. Not Coordinated with Social Security (KP# 1002)
   3. Safety (KP# 1003)
   4. Tier II (KP# 1004)
3. Returning to UC Employment After Retirement Factsheet (KP# 3109)
4. UCRP/CalPERS Reciprocity Factsheet (KP# 3105)
5. UCRP/CalSTRS Concurrent Retirement Factsheet (KP# 3106)

HR Benefits Unit Resources: (642-7053 or benefits@berkeley.edu):

1. Life Insurance Portability or Conversion Form: for last names beginning A-L, contact Ruby Thomas (3-5835, rthom@berkeley.edu), and M-Z, contact Sheila taliaferro (643-7986, sheilat@berkeley.edu)
   
2. Retirement Plan Questions: if your last name begins with A-F, contact Art Leon (643-7549 or aleon@berkeley.edu), G-L contact Emily Ladner (642-1122 or ladner@berkeley.edu), and M-Z contact Darda Swanson (642-9310 or dswanson@berkeley.edu)
3. COBRA Questions: Contact Shirley Silveira at 643-7547 or sas@berkeley.edu

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