The Consolidated Omnibus Reconciliation Act of 1985 (COBRA) is a law giving employees the right to continue participation in group health insurance coverage after leaving their job. Employers who sponsor group medical, dental, vision, flexible spending accounts and EAP health plans must permit covered individuals who lose coverage to elect to continue their coverage for a prescribed period of time on a self-pay basis.
The COBRA law lays out specific employer notification requirements and administrative guidelines. Failure to provide proper and timely notifications, or carefully adhere to COBRA regulations can result in severe penalties and possible litigation.
It is important to note that COBRA regulations periodically change in accordance with subsequent laws passed by Congress, or by individual State mandates. The most recent Federal law affecting COBRA was the American Recovery and Reinvestment Act of 2009 (ARRA). Under this law the government required additional notifications, and subsidized COBRA premiums for eligible terminated employees. Several states are now requiring employers to extend COBRA coverage beyond what is required under federal guidelines.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a law that provides important protections for people who have pre-existing medical conditions or might suffer discrimination in health coverage based on a factor that relates to an individual's health. Under the law is a requirement to provide a "Certificate of Creditable Coverage" to employees when their health coverage is terminated. Benefit Strategies administrative system will automatically generate the HIPAA certificate when a COBRA notice is generated to a new qualified beneficiary (QB), and again when the QB terminates COBRA coverage.
Benefit Strategies can take over the responsibility to provide proper, legal notifications to employees who newly join the employer's health plan and to those employees and/or dependents who lose their health plan eligibility. We will receive and record monthly payments from COBRA participants and notify insurance carriers to reinstate or terminate coverage as appropriate. On a monthly basis, funds received from COBRA participants will be remitted back to the employer. Accuracy and efficiency are built-in to our systems, and we continue to exceed all industry performance benchmarks for notification turnaround, response time and processing accuracy.
Our Enhanced COBRA Connection (ECC) system fully automates all administrative functions and provides diverse reporting and document tracking. Clients may access this on-line system 24/7/365 to enter the information needed to generate letters to new plan members and qualified beneficiaries, check the status and information of their COBRA participants, and generate a wide variety of reports. This state-of-the-art system is flexible enough to meet all of your administrative needs.
If you currently administer the COBRA/HIPAA processes at your organization, you already know that processing the required documentation is complicated and labor intensive. Our staff will help you with this intensive process by taking care of all related COBRA/HIPAA paperwork and by ensuring that your plan is administered within the required compliance guidelines. Between our Certified COBRA Administrators and our software vendor, we ensure that you stay in compliance.
With Benefit Strategies as your COBRA/HIPAA Administrator, you have the option of calling our offices to inquire about activity on your account or checking a participant's status via our Enhanced COBRA Connection web site. Not only do we support you and your Human Resources staff, we will also support your employees who have questions regarding COBRA.