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COBRA – the Consolidated Omnibus Budget Reconciliation Act (wow, that’s a mouthful!) – requires employers with 20+ employees and group health plans to offer continuation coverage to those that qualify when group health coverage would otherwise be lost due to certain qualifying events.
Employers with 20 or more employees during 50% or more the business days of the previous calendar year. There are some exceptions, such as church and government groups who do not need to comply with COBRA. Still unsure? Call us.
Typically, your new service can be fully implemented and ready to use within 10-15 business days upon receipt of all required information.
The qualified beneficiary’s coverage can be continued for 18 months for termination or reductions of hours.
An extended 29-month maximum coverage period is available in certain circumstances when a qualified beneficiary is disabled.
Covered dependents can continue coverage for 36 months as a result of divorce or legal separation, cessation of dependent status, employee entitlement of Medicare or employee death.
The initial or “general” COBRA notice must be provided to a covered employee or covered spouse within 90 days after the individual becomes covered under the plan.
There is no requirement to provide this notice to dependent children.
Qualifying event notices must be provided to your administrator (us) within 30 days of the event. As your administrator, we would than have 14 days to send the notice to the qualified beneficiary.
IMPORTANT! You are required to ensure termination of active coverage directly with the carriers.
Yes! We offer full Open Enrollment services for COBRA and premium billing participants. Additional fees may apply for groups with over 100 participants.
Certain Qualifying Events are described in the COBRA regulations that allow an employee to continue their health coverage. Examples of qualifying events are termination of employment, divorce or legal separation, cessation of dependent status, employee death, failure to return from FMLA or certain employer bankruptcies.
For a qualified beneficiary that elects COBRA, the first payment is due 45 days from the date they elect and must cover all months of COBRA premiums since the start of their COBRA coverage.
Example: The qualifying event date is December 31st; the qualified beneficiary receives their COBRA qualifying event letter on January 15th; they elect COBRA on March 1st; the first payment is due by April 15th and must cover the premiums for January, February, and March.
Subsequent premiums are due the first of each month but must be postmarked no later than the 30th day of that month.
You’ll receive a remittance payment on a monthly basis for any funds that were collected from your plan participants.
Premium remittance can be either sent to you or the carrier, but please keep in mind that not all carriers will accept payment from a third party.
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