Facts about Mini Cobra

November 10th, 2009 | Posted in Useful Info

  • Act 2 of 2009 is a new law in Pa. that requires Employer groups (2-19 lives) to offer continuation of their group health plan to employees that are no longer employed by them. This coverage is referred to as Mini-Cobra.
  • Who is covered: Employees and eligible dependents who have been continuously insured under the group policy during the entire 3 months period prior to their termination of employment.
  • How will an employee be notified to elect continuation coverageWithin 30 days of the qualifying event, YOU (the employer) must notify the employee of his/her right to elect continuation coverage. (send attached Notice –Notice to Policyholder)
  • How will an employee or eligible dependent elect coverage: Within 30 days of receiving notice of his/her rights to elect continuation of coverage, each covered employee or eligible dependent must notify the employer. (complete attached – Qualified Event Notice )
  • What is a qualifying event: Termination of an employee (other than by reason of the employee’s gross misconduct), reduction of hours, death of a covered employee, divorce or legal separation of the covered employee, a covered employee becomes eligible for Medicare and their dependent still needs coverage, dependent child ceasing to be a dependent child. IMPORTANT – the employer will validate the qualifying event to determine eligibility for mini-cobra.
  • Cost of mini cobra: The premium for the continuation coverage may not be more the 105% of the group rate.
  • When will continuation coverage start: the date of the qualifying event
  • When will continuation coverage end: 9 months after the qualifying event, the end of the period for which the covered person paid the premium, if the covered person fails to make timely payments, or the group health plan terminates. IMPORTANT – the employee has 14 days to notify his former employer if he/she is no longer eligible for mini-cobra.
  • ARRA (American Recovery and Reinvestment Act of 2009): Assistance for employees or dependents that have been involuntarily terminated to reduce the amount they have to pay for min-cobra. The program is available until Dec 31, 2009. If an employee feels they qualify, they must submit the attached form – Request for treatment as an assistance eligible individual. You should include this form with all other documents you will be sending to the employee at the time of the qualifying event. If it is determined that they qualify for assistance, the employee will only be required to pay 35% of the total monthly cost.
  • Administration of mini-cobra: You can self-administer the plan or if you would like to have it administered for you, please contact us and we will give you your options and pricing.
  • Carriers: Each health insurance carrier will have some of their own forms to complete if an employee enrolls in mini-cobra.

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