What Exactly is COBRA? An opportunity must be provided by a covered group health insurance plan under COBRA (Consolidated Omnibus Budget Reconciliation Act ) for continuing health plan coverage to every single qualified beneficiary. Otherwise, he or she would lose coverage because of a qualifying event.
Health Plan Types Covered
COBRA comprises of the criteria for figuring out whether the employees who are enrolled in group health plans are qualified for insurance coverage or not. MSAs along with several group health plans (which are region-specific) need special consideration.
Employers Covered By COBRA
This coverage is going to apply to those employers who have twenty or even more employees. Nevertheless, it can be quite complicated when it comes to figuring out the number of the employees which depends on issues such as modifications in the workforce as well as part-time or full-time employment.
Employees Covered By COBRA
In most cases, those employees who have been registered in your health care plan one day prior to a qualifying event will be qualified for the COBRA coverage.
Extent of Coverage for the Qualifying Events
Loss of health plan coverage can be caused by as many as 6 events which can result in an employee’s eligibility for the COBRA coverage. Apart from being aware of these events, you should likewise look at them taking into consideration some other conditions like the occurrence of more than one qualifying event and so on. Below we have listed several factors by which the insurance coverage eligibility can be affected:
- Divorce and remarriage
- Entitlement to Medicare
- Retirement status
- Causes for termination
COBRA Notice Specifications:
As per the regulations, you must send several COBRA-related notices to qualified beneficiaries as well as employees when they are not entitled to continue the coverage and also when the health plan coverage starts and ends. The health insurance plan administrator must also be notified regarding the particulars of the qualifying events of any particular employee. Employees must also inform you once a qualifying event takes place and valid procedures can be established for the employees to provide notifications.
Electing the COBRA Coverage:
There are only 30 days in the hands of the qualifying beneficiaries for electing COBRA coverage, and a proper faith report must be made so that beneficiaries are able to receive election notifications on time. Moreover, some employees can also get a second chance for electing coverage in case increased imports of competing products affect their jobs.
Paying for the Coverage:
Clear guidance is provided by the COBRA regulations on permissible premium amounts as well as premium due dates. Moreover, proper guidance is also provided by them on how to deal with inadequate premium payments.
Terminating COBRA insurance Coverage:
The coverage is going to terminate once any of the 4 events happens or on completion of the coverage period as per law. Amongst the other causes which are responsible for the termination of the coverage, mention may be made of HIPAA requirements as well as ERISA provisions.
Final COBRA regulations prohibit specific acts explicitly on the part of the employer.
Penalties for COBRA infractions:
There is a huge risk of serious financial penalties in case one does not comply with the COBRA regulations even though the error was not deliberate.
California Extension of the Coverage?
An enrollee must be provided with an opportunity by California health plans for continuing the coverage for as much as thirty-six months since the start of the continuation coverage in case he is eligible for less than thirty-six months of continuation coverage under the COBRA health insurance and the continuation coverage has been exhausted.
CAL-COBRA Required Notifications
According to CAL-COBRA, specific notifications regarding the coverage must be provided to employees as well as insurance carriers on certain occasions.
Length and Cost of the Coverage
The CAL-COBRA has specified the amount which can be charged from any qualified beneficiary for the continuation of the coverage, the length of time the coverage is going to last, and also when it can be terminated.