COBRA Compliance Main Menu

 

DUTIES WHEN YOU SELF−ADMINISTER (Not Complete)

It is time-consuming for your companyís COBRA administrator to learn this very complex law. In addition, COBRA law is constantly changing and the courts are frequently re-interpreting this law so keeping up-to-date alone is a daunting task. In addition, the employer who chooses to self-administer should have a competent back-up employee who is up to speed on COBRA matters due to vacations, illnesses and inevitable turnovers. Without this, the likelihood that something will slip through the cracks increases greatly.

  • Your various employee notification forms must be updated as the law changes and are re-interpreted by the courts incurring ongoing legal fees.

  • Billing and collection of premiums plus adding and deleting of COBRA participants

  • Take phone calls and answer questions from ex-employees

  • Tracking of election periods as specified by law

 

REQUIRED COBRA NOTIFICATIONS

  • General Notice (overall mailing required when first subject to COBRA).  This notice informs your employees what their responsibilities are.

  • Qualifying Event Election notice

  • Disability Extension Notification

  • Conversion Notification (required if your group health plan has a conversion option)

  • Notice of open enrollment rights

  • Notice of Early Termination of coverage

  • Notice of Insignificant premium underpayment

  • Notification to carrier of reinstatement

  • Notification to carrier  to terminate COBRA coverage

  • Unavailability of COBRA continuation coverage

  • Notice of Plan Changes (open enrollment)

  • Notification of Rate Changes

  • Disclosure to health care provider

ACCEPTING ELECTIONS AND PREMIUM

  • Insignificant premium underpayment procedure

  • Complete & accurate disclosure to health care providers

  • Cancellation procedures (voluntary and involuntary)

  • Verification of correct election

DOCUMENTATION NECESSARY TO PROVE COMPLIANCE

Even if you did everything properly, can you prove it in court? There is no statute of limitations on COBRA compliance so you can never throw anything away.

  • Documentation of each notice sent

  • Documentation if COBRA dates (29 dates possible per beneficiary)

  • Documentation of notification language updates (1986 to present)

  • Documentation of procedural updates (1986 to present)

  • Documentation of events reported to employer/plan administrator for divorce/dependent events and disabilities

  • Documentation of all oral and written communication with Qualified Beneficiaries

COBRA COMPLIANCE REQUIREMENTS UNDER TAMRA

(Technical and Miscellaneous Revenue Act)

To pass the TAMRA portion of an IRS audit, all four requirements must be met

  • Proof  of COBRA training

  • Written COBRA procedures (manual with instructions)

  • Documentation of program design (when first subject to COBRA) and program updates      through  present

  • Documentation of program monitoring

  • Monitoring needs to be done by a qualified, independent third party