Accurate Insurance Solutions tips for avoiding Cobra penalties and other risks, such as lawsuits to compel coverage and adverse selection of COBRA coverage. 813-994-4114 o
Compliance is defined as “a state of being in accordance with established guidelines, specifications or legislation.” There’s a perception that COBRA compliance is as easy as mailing a couple of notices. However, proper COBRA
compliance entails many required notices and tracking numerous time frames.
Compliance is defined as “a state of being in accordance with established guidelines, specifications or legislation.” There’s a perception that COBRA compliance is as easy as mailing a couple of notices. However, proper COBRA
compliance entails many required notices and tracking numerous time frames. The notice requirements and the work related to them are endless. Let’s review what one little compliance regulation requires.
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires that employers provide former employees and dependents who lose group health benefits with an opportunity to continue group health insurance coverage for a limited period of time. Compliance with the complex rules regarding COBRA coverage can be difficult and mistakes can be costly. Penalties for non-compliance can include IRS excise taxes and ERISA statutory fines.
This Legislative Brief provides practical information and tips for avoiding these penalties and other risks, such as lawsuits to compel coverage and adverse selection of COBRA coverage.
Group health plans can require qualified beneficiaries to pay for COBRA continuation coverage, although plan sponsors can choose to provide continuation coverage at reduced or no cost.
The maximum amount charged to qualified beneficiaries cannot exceed 102 percent of the plan’s total cost of coverage. The cost amount is based on the cost of coverage for similarly situated individuals who have not incurred a qualifying event. For qualified beneficiaries receiving the 11-month disability extension, the premium for those additional months may be increased to 150 percent of the plan's total cost of coverage...
Compliance is defined as “a state of being in accordance with established guidelines, specifications or legislation.” There’s a perception that COBRA compliance is as easy as mailing a couple of notices. However, proper COBRA
compliance entails many required notices and tracking numerous time frames.
Compliance is defined as “a state of being in accordance with established guidelines, specifications or legislation.” There’s a perception that COBRA compliance is as easy as mailing a couple of notices. However, proper COBRA
compliance entails many required notices and tracking numerous time frames. The notice requirements and the work related to them are endless. Let’s review what one little compliance regulation requires.
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires that employers provide former employees and dependents who lose group health benefits with an opportunity to continue group health insurance coverage for a limited period of time. Compliance with the complex rules regarding COBRA coverage can be difficult and mistakes can be costly. Penalties for non-compliance can include IRS excise taxes and ERISA statutory fines.
This Legislative Brief provides practical information and tips for avoiding these penalties and other risks, such as lawsuits to compel coverage and adverse selection of COBRA coverage.
Group health plans can require qualified beneficiaries to pay for COBRA continuation coverage, although plan sponsors can choose to provide continuation coverage at reduced or no cost.
The maximum amount charged to qualified beneficiaries cannot exceed 102 percent of the plan’s total cost of coverage. The cost amount is based on the cost of coverage for similarly situated individuals who have not incurred a qualifying event. For qualified beneficiaries receiving the 11-month disability extension, the premium for those additional months may be increased to 150 percent of the plan's total cost of coverage...
This webinar will covers:
• What is COBRA?
• When does it need to be provided?
• What are the triggering events?
• How long does it have to be provided?
• What are notice requirements?
• Payment requirements
Webinar | COBRA Pitfalls: Common Mistakes and How to Avoid Thembenefitexpress
Leaving the organization isn't the end of the benefits cycle for employees. This webinar focuses on how to avoid one of the most common compliance pitfalls in benefits ... COBRA administration.
Some of the top takeaways were:
• The basics of successful COBRA administration
• Required notices associated with COBRA coverage
• How Medicare interacts with COBRA for employees and dependents
• Penalties for noncompliance
Smooth and successful off-boarding of departing employees is as important as well-planned on-boarding of new hires. Log on to your roadmap for a smooth ride into COBRA compliance.
How Medicare Affects Employer Health Coveragebenefitexpress
This presentation reviews the topic of Medicare and how it can affect Employers Health Coverage offerings, including: employer secondary rules, COBRA, notice requirements, and reporting requirements.
The Marketplace: What Every Employer Should Knowbenefitexpress
This presentation helps assist employers in talking to their employees about the Marketplace. It will cover all you need to know about the Marketplace.
This webinar covers a basic review of the requirements under ERISA, including: what is an ERISA benefit, what documentation requirements have to be met, what disclosure requirements have to be met, what reporting requirements need to be met, what is a fiduciary, and what are other requirements.
This presentation covers how Medicare affects employer health coverage in: Providing opt out amounts | Paying for Medicare for active employees | Electing COBRA
This presentation reviews: what information must be protected, what policies and procedures need to be in place, what disclosures have to be given to employees, what agreements have to be in place for business associates, and what breach procedures have to be followed.
Health Care Reform Legislative Brief
2013 Compliance Checklist
In light of the Supreme Court's June 28, 2012, decision to uphold the health care reform law, or Affordable Care Act (ACA), employers must continue to comply with ACA mandates that are currently in effect.
Campaign for Revival of Policies is back from 16th August.
You can revive policies which are lapsed for more than 5 years and
also policies which are in lapsed condition for which PPT is completed
and Policy term is not yet over. Make best use of the opportunity.
This webinar will covers:
• What is COBRA?
• When does it need to be provided?
• What are the triggering events?
• How long does it have to be provided?
• What are notice requirements?
• Payment requirements
Webinar | COBRA Pitfalls: Common Mistakes and How to Avoid Thembenefitexpress
Leaving the organization isn't the end of the benefits cycle for employees. This webinar focuses on how to avoid one of the most common compliance pitfalls in benefits ... COBRA administration.
Some of the top takeaways were:
• The basics of successful COBRA administration
• Required notices associated with COBRA coverage
• How Medicare interacts with COBRA for employees and dependents
• Penalties for noncompliance
Smooth and successful off-boarding of departing employees is as important as well-planned on-boarding of new hires. Log on to your roadmap for a smooth ride into COBRA compliance.
How Medicare Affects Employer Health Coveragebenefitexpress
This presentation reviews the topic of Medicare and how it can affect Employers Health Coverage offerings, including: employer secondary rules, COBRA, notice requirements, and reporting requirements.
The Marketplace: What Every Employer Should Knowbenefitexpress
This presentation helps assist employers in talking to their employees about the Marketplace. It will cover all you need to know about the Marketplace.
This webinar covers a basic review of the requirements under ERISA, including: what is an ERISA benefit, what documentation requirements have to be met, what disclosure requirements have to be met, what reporting requirements need to be met, what is a fiduciary, and what are other requirements.
This presentation covers how Medicare affects employer health coverage in: Providing opt out amounts | Paying for Medicare for active employees | Electing COBRA
This presentation reviews: what information must be protected, what policies and procedures need to be in place, what disclosures have to be given to employees, what agreements have to be in place for business associates, and what breach procedures have to be followed.
Health Care Reform Legislative Brief
2013 Compliance Checklist
In light of the Supreme Court's June 28, 2012, decision to uphold the health care reform law, or Affordable Care Act (ACA), employers must continue to comply with ACA mandates that are currently in effect.
Campaign for Revival of Policies is back from 16th August.
You can revive policies which are lapsed for more than 5 years and
also policies which are in lapsed condition for which PPT is completed
and Policy term is not yet over. Make best use of the opportunity.
Creative Customer Retention and Engagement Strategies: 10 ways to increase team productivity and keep customers satisfied
Are you committed to a workforce development strategy that focuses on skills that retain, engage, and cultivate customers? As organizations invest time, money, and other valuable resources in products and services for customers, it is critical not to overlook the intangible value that employees can provide customers with increased interpersonal effectiveness, focused communication strategies, and proven methods that increase customer loyalty. As competition increases and the economy fluctuates, it is more important than ever to ensure that front line employees and leaders throughout the organization have the skills to transform the customer experience. This seminar will explore top ten real-world strategies that create cultures where customers and employees are loyal and happy.
Learning Outcomes: Increase productivity and customer engagement skills
At the end of this seminar, participants will be able to:
a) Examine common mistakes that businesses make with loyal customers
b) Explore communication strategies and questioning techniques that clarify customer needs and values
c) Identify tools to increase customer loyalty and satisfaction
d) Examine strategies to encourage a customer centric culture and increase team productivity
When many of us think of fall, our mind wanders to the changing colors on trees, raking leaves and football.
Human resource and benefit professionals must have one more thing top of mind–open enrollment. Annually, HR and benefit professionals must provide employees with options for the next plan year. Check out these 6 Open Enrollment Items everyone should have on their to-do list.
Intertwined Guidelines: Untangling Your Enrollment Notice Requirementbenefitexpress
DOL, PPACA, ERISA, COBRA, and HIPAA all have guidelines for enrollment notices - learn best practices for including the notice in your benefits strategy.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows individuals to continue their group health plan coverage in certain situations. Specifically, COBRA requires group health plans to offer continuation coverage to covered employees and dependents when coverage would otherwise be lost due to certain specific events...
There's nothing like the fear of a COBRA audit. As a result of revised IRS audit guidelines, audits have increased along with penalties. Be prepared with these items for your COBRA audit.
In early July, the Department of Treasury announced it is delaying a key mandate of the Affordable Care Act: what's known as the 'Pay or Play' mandate. While pushing pause on this mandate gives large employers another year to prepare, we strongly advise businesses not to wait to start making strategic decisions. For more information, contact Fraser Trebilcock Senior Health Care and Business Attorney Mike James at mjames@fraserlawfirm.com or 517.377.0823. You can also find more information at www.milhealthlaws.com.
There's nothing more scarey than the fear that presents itself when a COBRA administrator hears the words, "COBRA audit". Review these survival tips to make it through a requested COBRA audit.
Similar to 10 Cobra mistakes to Avoid. Accurate Insurance Solutions Tampa, Fl. (20)
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
2. Introduction to COBRA
Consolidated Omnibus Budget Reconciliation Act
COBRA continuation coverage = temporary
continuation of health coverage at group rates
Available to “Qualified Beneficiaries” upon
occurrence of “Qualifying Events”
4. #10 – Assuming COBRA Doesn’t
Apply to You
COBRA applies to group health plans for
employers with 20 or more employees
Small employer exemption
Rule is – 20 or more employees on more than
50% of typical business days in the previous
calendar year
Count full-time and part-time employees
Part-time employees = fraction
5. #9 – Assuming COBRA Doesn’t
Apply to Your Plan
COBRA applies to group health plans maintained
by employers
Health plans subject to COBRA:
Medical, dental, vision and Rx plans
Drug and alcohol treatment program
Employee assistance plans that provide medical care
On-site health care
Health FSAs and HRAs
Self-funded medical reimbursement plans
Wellness programs that provide medical care
6. #9 – Assuming COBRA Doesn’t
Apply to Your Plan
Health plans not subject to COBRA:
Long-term care plans
AD&D plans
Group term life insurance plans
LTD & STD plans
Wellness programs or employee assistance programs that do not provide
medical care
Exercise or fitness centers
Onsite first-aid facilities
Cancelling plan doesn’t always cancel COBRA
responsibility
If employer continues to provide any group health plan, obligation to
provide COBRA coverage continues
7. #8 – Not Knowing Your Qualifying
Events or Qualified Beneficiaries
Qualifying events trigger COBRA coverage for
qualified beneficiaries (QBs)
Who is a QB?
An individual covered by a group health plan on the day
before a qualifying event
Employee, employee’s spouse, employee’s dependent
children
Sometimes includes retired employee and spouse and
dependent children
Any child born to or placed for adoption with covered
employee during COBRA coverage period
May include agents, independent contractors and
directors
8. What is a Qualifying Event?
Elements of a qualifying event:
Specified triggering event
Causes (or will cause) a loss of coverage
Within maximum coverage period
While the plan is subject to COBRA
Loss in anticipation of events
FMLA Leave – qualifying event occurs when
employee does not return following leave
Pay attention to plan terms for eligibility – listed
event may not cause a loss of coverage,
individual may not be QB
9. What is a Qualifying Event?
Qualifying events for employees:
Termination of employment (for reasons other than gross
misconduct)
Reduction in hours of employment
Qualifying events for spouses:
Termination of covered employee’s employment (for any
reason other than gross misconduct)
Reduction in hours of covered employee’s employment
Covered employee becoming entitled to Medicare
Divorce or legal separation from covered employee
Death of covered employee
10. What is a Qualifying Event?
Qualifying events for dependent children:
Loss of dependent child status under plan rules
Termination of covered employee’s employment (for
any reason other than gross misconduct)
Reduction in hours of covered employee’s
employment
Covered employee becoming entitled to Medicare
Divorce or legal separation of covered employee
Death of covered employee
11. #7 – Giving No Information
Plan administrators are required to provide certain
information to plan participants and beneficiaries and
QBs
COBRA Notice Rules
Set minimum standards for timing and content of
COBRA notices
Require reasonable procedures for providing notices
Not providing timely/proper notices puts plan at risk
Avoid problems by establishing procedures for sending
notices
12. COBRA Notices – General Notice
Provides information to plan participants regarding
COBRA and plan procedures
Must be provided within 90 days after plan coverage
begins
Must be written to be understood by average plan
participant
May be provided in Summary Plan Description
Single notice can be provided to employee and
spouse at same address
13. COBRA Notices – Election Notice
Gives QBs information about rights and obligations
regarding a specific qualifying event and coverage
Must be provided to QBs within 14 days after plan
administrator is notified of Qualifying Event
If employer is plan administrator, notice must be
provided within 44 days of qualifying event or loss of
coverage (whichever is later)
14. COBRA Notices –
Notice of Unavailability
Plan administrator must notify individual with
explanation of why s/he is not entitled to COBRA
coverage
No Qualifying Event has occurred
QB did not furnish required notice
QB did not provide complete information
Deadline is same as that for sending election notice
Generally must give notice of COBRA ineligibility
within 14 days after receipt of notice of Qualifying
Event
15. COBRA Notices –
Notice of Early Termination
Plan administrator must notify QBs when
continuation coverage terminates before the end
of the maximum coverage period
Timing – must notify as soon as practicable
Must contain the following information:
Reason for early termination
Date coverage terminated or will terminate
Available conversion rights
16. COBRA Notices – Employer’s
Notice of Qualifying Event
Employer must notify plan administrator within 30
days of the later of qualifying event or loss of
coverage
Notice must be given of employee’s death,
termination of employment, reduction in hours of
employment, Medicare entitlement
Must include sufficient information to determine plan,
employee, qualifying event and date
No notice necessary where employer is plan
administrator
17. #6 – Giving Bad Information
General Notice – Required Content
Plan name
Name, address and phone number for contact person for
information about the plan and COBRA
Description of COBRA coverage under the plan
Plan procedures for QBs to provide notice of certain
qualifying events
Plan procedures for QBs to provide notice of SSA
determination of disability
Statement that notice does not fully describe COBRA or
other rights and plan administrator and SPD can provide
more info
Importance of advising administrator if address changes
Model notice available
18. #6 – Giving Bad Information
Election Notice – Required Content
Plan name and name, address and phone number for contact
person for information about the plan and COBRA
Identification of the qualifying event
Date plan coverage will terminate
Identification of the QBs by status or name
Statement that each QB has independent right to elect
coverage
Description of COBRA coverage
Amount each QB required to pay and procedures for making
payments
Explanation of how to elect coverage and date by which
election must be made
Consequences of failing to elect or waiving COBRA
19. #6 – Giving Bad Information
Election Notice, continued
Explanation of duration of COBRA coverage
Explanation of circumstances where coverage may be
extended
QB’s responsibility to provide notice of second qualifying
event or SSA disability determination (including procedures
for providing notice)
QB’s responsibility to provide notice of determination that
QB is no longer disabled
Explanation of importance of keeping plan administrator
informed of current address
Statement regarding more complete information
Model notice available
20. #5 – Not Following Procedures
Plans must establish reasonable notice procedures for
covered employees and QBs to notify plan of certain
events
Qualifying events: divorce, legal separation, dependent
child losing dependent status
Second qualifying events
SSA disability determination (or cessation of disability)
Consequences of not having reasonable procedures
QB deemed to have given notice if s/he has communicated
a specific event in a manner reasonably calculated to
inform those customarily considered responsible for the
plan
21. Reasonable Notice Procedures
Described in SPD
Specify individual or entity designated to receive
notices
Specify how notice is to be given
May require use of specific form
Must allow covered employee, QB or representative to
provide notice
Describe the information required
Specify deadlines for providing notice
Provide for proper handling of incomplete notices
22. COBRA Notices – Employee’s
Notice of Qualifying Event
Covered employees and QBs are generally
required to notify plan administrator within 60
days of the later of:
Qualifying event or second qualifying event,
Loss of coverage or
Date they were first notified of notice obligations
Prompt notification decreases risk to plan
23. COBRA Notices – Employee’s
Notice of Disability Determination
QBs determined to be disabled by SSA are
generally required to notify plan administrator
within 60 days of receipt of disability
determination and before end of original 18-
month continuation coverage period
QBs must notify plan administrator within 30 days
of determination that they are no longer disabled
24. COBRA Election Procedures
QB must be given at least 60 days to elect COBRA
Election period begins on date election notice is
provided or date on which coverage would be lost
(whichever is later)
Each QB has independent right to elect COBRA
Covered employee or spouse can elect on behalf of
all other QBs and parent or guardian can elect on
behalf of minor child
If QB waives coverage during election period, s/he
can revoke waiver before end of election period
25. Payment Procedures
Plan can require payment of “applicable premium” for
COBRA coverage
102% of employer’s cost
150% for disabled QBs
Premium payments must be made in a timely manner
Payment = made when sent
Initial premium = due 45 days after election
Premium due date is usually 1st of month – plan must allow 30
day grace period
Late payments and short payments
Forwarding payments to insurers
26. #4 – Not Giving Enough Coverage
Continuation coverage provided to QBs must be the
same as coverage provided to “similarly situated”
individuals covered under the plan (not receiving
COBRA coverage)
Intended to be the same coverage the QB had before
the qualifying event
QBs entitled to same benefits, rights and privileges
that similarly situated participant or beneficiary
receives under the plan
Changes to plan’s terms that affect similarly situated
participants and beneficiaries apply to QBs receiving
COBRA coverage
27. #3 – Charging Too Much or Too Little
Group health plans can require QBs to pay for
COBRA coverage
May choose to provide coverage at a discount or no cost
Maximum COBRA premium cannot exceed 102% of
cost to plan for similarly situated plan participants
Disabled QBs receiving disability extension may be
charged up to 150% of the plan’s total cost of
coverage
COBRA premiums may be increased if plan cost
increases, but must be fixed in advance of each 12-
month premium cycle
28. #2 – No Documentation
Notice information and procedures – document in
SPD and notices
Document notices sent
Certificate of mailing
Business records method
Keep records of notices received
Document payments received
Accurate and thorough records will assist in
administration and support plan in event of a claim
29. #1 – Bad Timing
Maximum coverage period
18 months for termination of employment and reduction
in hours
36 months for death of covered employee, divorce or
separation, covered employee’s entitlement to Medicare
Can be extended or terminated early
Special rule for newborn/adopted children – maximum
coverage period is the remainder of the original
maximum coverage period
30. Expanding COBRA Coverage
Extended notice rule ➨ permits maximum
coverage period to run from date of loss of
coverage, not date of triggering event
Disability extending rule ➨ extends 18-month
period to 29 months for all related QBs
Multiple qualifying event rule ➨ extends 18-month
period to 36 months for spouse and children
when 2nd qualifying event occurs during initial 18-
month period
31. Expanding COBRA Coverage
Medicare entitlement rule ➨ extends 18-month
period for spouses and children when covered
employee becomes entitled to Medicare within 18
months before triggering event
Bankruptcy of sponsoring employer ➨ extends
coverage for retired employee, spouse and
dependent children
32. Terminating COBRA Coverage
COBRA coverage generally terminates at end of
maximum coverage period
No notice to QB required
COBRA may be terminated early if:
QB fails to make timely premium payments
Employer ceases to make any health plan available to
any employee
QB becomes covered under another group health plan
Disabled QB is determined not to be disabled
For cause
Notice required for early termination