Tag: COBRA coverage

COBRA

COBRA Continuation Coverage: Who Pays?

Most employers are aware that the Consolidated Omnibus Budget Reconciliation Act (COBRA) requires group health plans sponsored by covered employers to allow qualified beneficiaries to have “COBRA continuation coverage” in the event that they lose group health plan coverage for specified reasons.

COBRA

Employer Faces Class-Action Lawsuit Because of Vague Language in COBRA Notice

In addition to making sure Consolidated Omnibus Budget Reconciliation Act (COBRA) election notices are sent to qualified beneficiaries on a timely basis, employers and plan administrators should ensure that the notices’ content satisfies the COBRA regulations. They should consider using the model COBRA election notice published by the U.S. Department of Labor (DOL), which considers […]

COBRA

Employer Able to Fend Off COBRA Claim Thanks to Clear Notice Procedures

When an employee is terminated from employment and loses group health plan coverage (subject to Consolidated Omnibus Budget Reconciliation Act (COBRA)), plan administrators should ensure that all qualified beneficiaries are sent, in a timely fashion, COBRA election notices. Plan administrators are not required to ensure actual receipt of the COBRA election notice, but a good-faith […]

terminated

Theft was Gross Misconduct, but Inconsistencies May Make COBRA Ineligibility Less Clear

When an employee is terminated due to “gross misconduct,” the termination is not considered a qualifying event, and an employer does not have to offer Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage to the ex-employee (or his or her covered spouse or dependents). Neither the statute, legislative history, nor regulations specifically define the term “gross […]

Ask the Expert: Do We Have to Offer Our HRA with COBRA Benefits?

Question: If you offer a Health Reimbursement Account (HRA) to your regular full time employees, are you obligated to offer the HRA to people that terminate and elect COBRA? If yes, can you charge the employee for the COBRA premium AND can you charge for a premium equivalent rate for the HRA (or administrative charge)?

termination

COBRA: Gross Misconduct Determinations Aren’t Always a Piece of Cake

A recent court opinion from the 9th Circuit U.S. Court of Appeals—which covers Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada, Oregon, and Washington—highlights the perils of not offering Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage to a former employee on the basis that the employee was terminated due to gross misconduct.

COBRA

Ask the Expert: COBRA Quandary

Question: I just found out that a former employee near the end of his COBRA election period was in an accident and is currently incapacitated. What are my options administratively if the election period ends and he has not yet elected COBRA coverage?

COBRA

COBRA: Proper Mailing Procedures Trump Address Mistake

by Gwen Cofield Although an employer or plan administrator is not required to ensure actual receipt of the Consolidated Omnibus Budget Reconciliation Act (COBRA) notice, a good-faith effort to provide the COBRA notice must be made. Where an administrative error prevents the receipt of the COBRA notice, an employer or plan administrator can demonstrate good-faith […]

Ask the Expert: Handling Medical Benefits after Employee Exhausts FMLA

Question: We are looking for information regarding medical benefits when someone is out on leave under the FMLA. We understand that the eligible employee’s job is protected while out under the FMLA, and that they are able to make payments on their medical benefits while out on leave. If an employee exhausts all of his […]

COBRA

Appeals Court: Same-Sex Spouse Had No COBRA Notice Claim

by Gwen Cofield To have standing to sue an employer for a Consolidated Omnibus Budget Reconciliation Act (COBRA) notice violation, the individual alleging the violation must be either a participant or a beneficiary, as those terms are defined in Employee Retirement Income Security Act (ERISA). COBRA coverage is designed to continue, for a limited time, […]