More Related Content Similar to Conquering cobra public (2) (20) Conquering cobra public (2)2. Agenda
© 2015 WageWorks Inc. All rights reserved. 2
1 COBRA: A quick primer
2 Liability is reality
3 There’s coping with COBRA…
4 …and there’s conquering COBRA
5 System Demonstration
6 DIY or Administrator?
7 What to look for in a COBRA Administrator
8 Questions
3. COBRA: A quick primer
Why COBRA?
• Consolidated Omnibus Budget Reconciliation Act of 1985
• Requires employers who sponsor group health plans to allow
individuals to continue coverage:
• Qualifying events
• Limited time, at applicable rates
• Covered employees and qualified beneficiaries
© 2015 WageWorks Inc. All rights reserved. 3
4. COBRA: A quick primer
• Health plan changes for current employees must also apply to
former employees
• Required Notices:
• General Notice of Continuation Coverage
• Election Notice
• Early Termination Notice
• Notice of Unavailability
© 2015 WageWorks Inc. All rights reserved. 4
5. COBRA: A quick primer
Thanks to the ACA, there are now Fair Health Insurance
Premium requirements:
• These individual or “member-level” rates are determined
using:
• Age
• Location
• Tobacco status of each family member
• Applies to individual and small group (<50) markets now
• Groups <100 employees: 1/1/2016
• Large groups >100 employees: 1/1/2017
© 2015 WageWorks Inc. All rights reserved. 5
6. Liabilities are real
The penalties and liability with COBRA violations can be
significant
Here’s what happens if you don’t comply:
• $100 per day to the IRS for each day of
non-compliance
• Excise taxes of $200 per day on each day
the plan fails to comply with COBRA
• $110 per day to the beneficiary
for each day of non-compliance
• Payment of claims incurred during
non-compliance period
• Legal expenses
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7. Significant and constant notification and communication requirements.
Constantly coping with COBRA
© 2015 WageWorks Inc. All rights reserved. 7
Date of Hire
•HIPAA Special
Enrollment
Rights
Commencement
of Coverage
•COBRA General
Rights Notice
Qualifying Event
•COBRA Election
Notice
Other Notices
•HIPAA Privacy
Notice
•Women’s Health
and Cancer Rights
Ongoing
•Monthly Premium Invoice
•Notice of Unavailability
•Conversion Notice
•Termination Notice
8. There’s coping with COBRA...
And there are more administrative duties, such as:
• Compliance
• Coordination with insurance
carriers
• Eligibility tracking
• Payments
• Audits
© 2015 WageWorks Inc. All rights reserved. 8
9. ... And there’s conquering it
• Automation is key
• Online, 24-7, real-time visibility
• Self service options for business:
• Add/terminate employees
• Review participant history
• Case monitoring and tracking of issues
(in real time)
• Self service options for participants:
• Online payment of one or multiple
premiums
• Advance payments
• Mobile App
• IVR
9
Make it easy on yourself.
10. Conquering COBRA
Alleviate fear and uncertainty.
Transition assistance:
• Licensed benefit advisors ease fear and uncertainty of former
employees
• Provide education to new COBRA enrollees
• Assist with transition from COBRA to individual or public
options
© 2015 WageWorks Inc. All rights reserved. 10
11. Conquering COBRA
Send COBRA election notices via USPS
Upload images of notices to website
Track election periods related to electing or declining continuation
coverage
Report eligibility to carriers
Apply payments received to appropriate accounts and return payments
that are not within COBRA guidelines
Answer questions from qualified beneficiaries
© 2015 WageWorks Inc. All rights reserved. 11
We do the hard work.
12. Conquering COBRA
We also:
• Provide courtesy monthly invoices to all COBRA participants
• Payments must be made by the end of the grace period or the
participant loses their COBRA rights
• EZ payment
• Standard mail
• Over the phone
• Online
• Automatic withdrawal
© 2015 WageWorks Inc. All rights reserved. 12
13. Conquering COBRA
When a COBRA coverage is terminated or cancelled, we:
• Send a termination letter to qualified beneficiaries, employer
and carrier
• Notify of conversion or extension rights
© 2015 WageWorks Inc. All rights reserved. 13
14. What to look for in a COBRA
Administrator
© 2015 WageWorks Inc. All rights reserved. 14
Participant
Advocacy
• Education
• Notifications
• Customer Service
• Transition
Assistance
Performance
Guarantees
& Indemnity
• Contractually
agree to service
standards
• Offer indemnity:
Penalties, fines
Claims,
Excise taxes,
Attorneys’ fees
Compliance &
Security
• Security of all
online data
• Election period
tracking
• Record and
store coverage,
elections, and
notifications
Comprehensive,
Flexible
System
• Support ACA MLRs
• Accommodate
custom severance,
benefits packages
• Provide 24/7
online access
• Case tracking,
reliable reports
• Flexible payment
options
15. Choosing the right administrator
Key questions to ask:
• Do you offer any performance guarantees?
• Do you indemnify ?
• Can you accommodate custom severance
packages?
• Does your system enable brokers and employers
visibility and self-service options?
• What types of reports are available to brokers and
employers?
• Are participant notices available online?
• How do you track premiums and payments?
• What types of support and education do you provide to COBRA participants?
• What are your service standards for COBRA participants, and how are they
monitored?
• How do you support an audit?
16. Who is WageWorks?
© 2015 WageWorks Inc. All rights reserved. 16
• Leading administrator of Consumer-Directed Benefits (CDBs)
• Servicing approx. 15,000 COBRA clients and 6 million participants
• Proprietary COBRA and CDB platforms