Qualifying Event Form

All Qualifying Events (terminations, new enrollments, voluntarily cancellation of benefits, loss of dependent status, etc.,) will need to be processed on our COBRA Portal at https://dev.basiconline.com/new-england/. You should have previously received a username and password for our online portal. If you need your username resent to you or your password reset, please email us at basicne@dev.basiconline.com.