UT FLEX COBRA Application

Enrollment form to request COBRA continuation of a UT FLEX Health Care Reimbursement Account (HCRA). Please note that HCRA accounts are eligible for continuation under federal COBRA provisions only if the employee to whom the account belongs has contributed more to the account than they have been reimbursed at the time of the COBRA qualifying event. Additionally, please note that Dependent Care Reimbursement Accounts are not eligible for continuation under federal COBRA rules.