The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.
COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise end.
COBRA outlines how employees and family members may elect continuation coverage. It also requires employers and plans to provide notice.
HR Simplified performs the legally required steps to administer COBRA continuation for your Qualified Beneficiaries.
Initial Notification Of COBRA Rights
HR Simplified will provide the Initial/General COBRA Notification to all covered employees under the health plan as required by law. The notification letter explains the options a plan participant has regarding the continuation. COBRA regulations require that this notification be provided when coverage is first available; the employee & dependents need to know their COBRA rights before the qualifying event occurs.
Qualifying Event Data
HR Simplified has the capability of receiving most forms of electronic data. In addition, employers can submit qualifying event information using our secure web site.
Provide The Election Packet When A Qualifying Event Occurs
Upon notification of a qualifying event by the employer, HR Simplified mails the qualified beneficiary the following:
- Introductory letter that defines their qualifying event and election time period
- Continuation plan election form
- Separate Family enrollment form
- Payment instruction
- Toll Free phone number for live customer service.
All forms and letters used by HR Simplified can be customized to meet your needs.
Once the qualified beneficiary has elected to continue and has made the initial premium payment, HR Simplified will notify the TPA or insurance carrier or the employer of the election.
Premium Verification (Billings)
HR Simplified provides individualized coupons to each qualified beneficiary electing coverage. When premium is received by HR Simplified, payment accuracy & time requirements are verified. Collected premiums are remitted to the employer on a monthly basis along with detailed reports.
Benefit Change, Open Enrollment & Rate Change Notification
HR Simplified notifies all enrolled and pending Qualified Beneficiaries of any change to your benefit plans.
Terminations and Eligibility Changes
Whether due to nonpayment or reaching the maximum period, HR Simplified will promptly notify the Qualified Beneficiary, the Plan Sponsor and the insurance company or TPA in the event of termination of coverage or Change in Eligibility.
HR Simplified provides a toll free voice and fax lines to all participants. All calls and faxes are digitally recorded and maintained for continual reference.
Monthly Reports and Premium Payments
HR Simplified provide monthly reporting detailing the status of enrolled and pending qualified beneficiary. Employers will have access to the HR Simplified web site and receive detailed information on the status of new, pending, enrolled and terminated beneficiaries. These reports can be downloaded into an MS Excel. Ad hoc reporting is typically available at no additional fee.
Live Benefit Counselors (Toll-Free Telephone Support)
Our Customer Service hours of operation are:
- 7:00 a.m. to 7:00 p.m. Monday through Thursday
- 7:00 a.m. to 5:00 p.m. Friday
(Central Time Zone)
All of our Benefit Counselors are highly trained and are ready to answer your employees’ questions.