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New  COBRA Guidance and Subsidies Released By DOL

New COBRA Guidance and Subsidies Released By DOL

New COBRA Guidance and Subsidies Released By DOL

Today, the IRS released the following:
Model Notices
  • Model General Notice and COBRA Continuation Coverage Election Notice: MS Word | PDF
  • Model Notice in Connection with Extended Election Period: MS Word | PDF
  • Model Alternative Notice: MS Word | PDF
  • Model Notice of Expiration of Premium Assistance: MS Word | PDF
  • Summary of COBRA Premium Assistance Provisions under the American Rescue Plan Act of 2021: MS Word | PDF

For more details and customized help with your HR, Compliance, HCM Payroll needs please contact World Insurance Payroll at 855-667-4621. 

Learn how a Private Exchange and our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

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Get Covered NJ and American Rescue Plan Act

Get Covered NJ and American Rescue Plan Act

Get Covered NJ and American Rescue Plan Act and the Extension of COVID-19 Special Enrollment Period

Governor Murphy announced an extension of the COVID-19 Special Enrollment Period for Get Covered New Jersey to May 1, 2021.

Special Enrollment Period Effective Dates:

  • Enroll by March 31, coverage effective April 1
  • Enroll by April 30, coverage effective May 1
  • Enroll by May 15, coverage effective June 1

The American Rescue Plan – Additional Financial Relief 

The new COVID-19 relief bill, the American Rescue Plan Act of 2021, will reduce health insurance premiums by providing more financial help to eligible consumers who purchase a plan through Get Covered New Jersey. These changes will make coverage more affordable at many income levels:

  • Increases in financial help (Advance Premium Tax Credits or APTC) for all eligible consumers. The amount of financial help is based on household income just like before, but has increased at every income level. Families making less than 150% of the Federal Poverty Level (FPL) – or $19,140 a year for an individual or $39,300 for a family of four – will be eligible for near zero-dollar premiums under the new law.
  • New financial help for higher incomes. Previously, financial help was not available for households making more than $51,040 for an individual or $104,800 for a family of four. The new law ensures that no family spends more than 8.5% of their income on health insurance premiums. This means many individuals who previously did not qualify for financial help from the federal government may now see more affordable premiums.
  • Financial help for unemployed. Additional financial help may be available for anyone who has received unemployment benefits in 2021

For more details visit the Get Covered New Jersey COVID-19 webpage at:

https://nj.gov/getcoverednj/findanswers/covid19/

Learn how a Private Exchange and our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

Put You & Your Employees in Good Hands

Get In Touch

For more information on PEOs or a custiomized quote please submit your contact. We will be in touch ASAP.

American Rescue Plan Act

American Rescue Plan Act

American Rescue Plan Act – Extension of EPSL and EFMLA and New COBRA Subsidies

The American Rescue Plan Act (ARPA), which is the latest bill to address the ongoing economic impacts of COVID-19, has been signed into law. We’ve outlined the key provisions of this new legislation that directly affect employers and employees – the optional extension of sick and family leave and the establishment of COBRA subsidies. 

Click here for a complete overview of these new provisions and how they affect employers and employees. 

Pertaining to the COBRA premium subsidy it is important to note:

  • ARPA provides a 100% COBRA subsidy if the employee’s work reduction or termination was involuntary. The subsidy applies for up to six months of coverage from April 2021 through September 2021 (unless the individual’s maximum COBRA period expires earlier).
  • For group plans subject to the federal COBRA rules, the employer will be required to pay the COBRA premium but then will be reimbursed through a refundable payroll tax credit.
  • Employers with fewer than 20 workers usually are exempt from the federal COBRA rules, but their group medical insurance plans may be subject to a state’s mini-COBRA law. In that case, it appears the subsidy will be administered by the carrier. The carrier will pay the premium and then be reimbursed by the government.
    Note: the premium subsidy will apply to NY continuation.
  • Although it takes effect April 1, 2021, employees who were terminated earlier but are still in their COBRA election window also are included.
  • Federal guidance is expected to be released by April 10, including model notices that
    plans can tailor for their use.

As this legislation is very new and vague in certain areas, we will keep you updated as more information and additional clarification becomes available. 

For more details visit  Understanding the $1.9 Trillion American Rescue Plan 

 

Learn how a Private Exchange and our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

Put You & Your Employees in Good Hands

Get In Touch

For more information on PEOs or a custiomized quote please submit your contact. We will be in touch ASAP.

COBRA Rule Changes

COBRA Rule Changes

COBRA Rule Changes

 

The Departments of Labor and Treasury has issued a final rule that creates an extension of timelines for employees due to COVID-19. These new rules apply for 60 days after the announced end of the declared National Emergency. This 60-day period is now called the ‘Outbreak Period’. See new model general and election notices for continued health coverage under COBRA. 

COBRA

Current Rules:

Employees impacted by a COBRA qualifying event have 60 days to elect COBRA, and 45 days thereafter to make payment for coverage retroactive to their last day of coverage.

A participant actively enrolled in COBRA has 30 days from the first of each month to make payment for continued coverage.

New Rules:

Initial election period is extended to 60 days from the last day of the ‘Outbreak Period’.

Actively enrolled COBRA participants now have 30 days from the last day of the ‘Outbreak Period’ to submit retroactive premium payments.

These Federal rules only apply for groups 20 or larger, each state has its own continuation rules for employers with less than 20 employees.

Our Recommendation:

Please notify your COBRA Participants and adjust your required notifications.We are automatically notifying all our COBRA Administration Clients and Participants of these brand-new Federal Rule changes.Employers are ultimately responsible for all COBRA rules, including notification requirements.

HEALTH INSURANCE

Current Rules:  

Employees have the right to enroll under 3 situations only:   

  1. When initially hired, subject to the company’s waiting period.
    2. At open enrollment, which normally coincides with the plan’s renewal date.
    3. When there is a life qualifying event (i.e. marriage, birth, etc.); the employee can enroll within 30 days of the qualifying event.

New Rules:

  • Employees with a Qualifying Life Event now have up to 30 days after the end of the ‘Outbreak Period’ to submit the request for retroactive enrollment.
  • The Special Election Period Allowance currently applies to Medical Insurance coverage only.

Additional New Rules:

  • Employees who previously opted out of coverage may now be able to join the employer’s plan. This is subject to carrier discretion. Call us for the particulars.
  • Health carriers continue to allow furloughed employees to remain eligible for coverage even though for many this does not meet their minimum eligibility guidelines.

Examples

Example One: Electing COBRA

Individual A works for Employer X and participates in X’s group health plan. Due to the National Emergency, Individual A experiences a qualifying event for COBRA purposes as a result of a reduction of hours below the hours necessary to meet the group health plan’s eligibility requirements and has no other coverage. Individual A is provided a COBRA election notice on April 1, 2020. What is the deadline for A to elect COBRA?

Answer – Individual A is eligible to elect COBRA coverage under Employer X’s plan. The Outbreak Period is disregarded for purposes of determining Individual A’s COBRA election period. The last day of Individual A’s COBRA election period is 60 days after June 29, 2020, which is August 28, 2020.

Example Two: Special Enrollment Period

Individual B is eligible for but previously declined participation in, her employer-sponsored group health plan. On March 31, 2020, Individual B gave birth and wants to enroll herself and the child into her employer’s plan. The open enrollment does not begin until November 15. When may Individual B exercise her special enrollment rights?

Answer – The Outbreak Period is disregarded for purposes of determining Individual B’s special enrollment period. Individual B and her child qualify for special enrollment into her employer’s plan as early as the date of the child’s birth. Individual B may exercise her special enrollment rights for herself and her child into her employer’s plan until 30 days after June 29, 2020, which is July 29, 2020, if she pays the premiums for any period of coverage.

The information provided on this website is intended for informational purposes only.  Millennium Medical Solutions Corp. does not offer legal or medical guidance.  Those with legal or medical questions should seek appropriate assistance from a licensed professional.  Stay up to date by signing up for Newsletter and Coronavirus Dashboard below.

 

Learn how our PEO Partnership can help your group please contact us at info@360peo.com or (855)667-4621.

Put You & Your Employees in Good Hands

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For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

COBRA New Notice

COBRA New Notice

COBRA New Notice

cobra-insurance

Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), an individual who was covered by a group health plan on the day before the occurrence of a qualifying event (such as a termination of employment or a reduction in hours that causes loss of coverage under the plan) may be able to elect COBRA continuation coverage upon that qualifying event.  Individuals with such a right are referred to as qualified beneficiaries.

Under COBRA, group health plans must provide covered employees and their families with certain notices explaining their COBRA rights. A group health plan must provide each covered employee and spouse (if any) with a written notice of COBRA rights “at the time of commencement of coverage” under the plan (general notice). A group health plan must also provide qualified beneficiaries with a notice which describes their rights to COBRA continuation coverage and how to make an election (election notice).

General Notice: The general notice must be furnished to each covered employee (and their spouse if covered under the plan) not later than the earlier of: (1) 90 days from the date on which the covered employee or spouse first becomes covered under the plan or, if later, the date on which the plan first becomes subject to the continuation coverage requirements; or (2) the date on which the administrator is required to furnish an election notice to the employee or to his or her spouse or dependent.

Election Notice: The election notice must be provided to the qualified beneficiaries within 14 days after the plan administrator receives notice that a qualifying event has occurred.
Some qualified beneficiaries may want to consider and compare health coverage alternatives to COBRA continuation coverage, such as coverage that is available through the Health Insurance Marketplace (Exchange). Qualified beneficiaries may be eligible for a premium tax credit (a tax credit to help pay for some or all of the cost of coverage in plans offered through the Exchange) and cost-sharing reductions (amounts that lower out-of-pocket costs for deductibles, coinsurance, and copayments), and may find that Exchange coverage is more affordable than COBRA.

The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) specifies that an employer that maintains a group health plan in a State that provides premium assistance for the purchase of coverage under a group health plan is required to notify each employee of potential opportunities currently available for premium assistance in the State in which the employee resides.

The Department of Labor has model notices that plans may use to satisfy the requirement to provide the general notice and election notice under COBRA, and the notice regarding premium assistance under CHIPRA. The COBRA model election notice was revised on May 8, 2013 to help make qualified beneficiaries aware of other coverage options that would soon become available in the Marketplace. Recently the DOL issued a Notice of Proposed Rulemaking, as well as updated versions of the model general notice and model election notice that reflect that the Exchange is now open and that better describes special enrollment rights in Exchange coverage.  The DOL is also issuing a revised CHIPRA notice with similar updates related to Marketplace coverage.

Link to the COBRA model notices:  http://www.dol.gov/ebsa/cobra.html
Link to the CHIPRA model notice:  
http://www.dol.gov/ebsa/pdf/chipmodelnotice.pdf

  Sign up for latest news updates. Please contact us for immediate information on how to implement these initiatives for your group-specific needs at info@medicalsolutionscorp.com or Call (855) 667-4621.

COBRA New Notice

COBRA Special Enrollment July

COBRA Special Enrollment July  cobra-insurance

COBRA members have a  special enrollment period extension according to new CMS guidance.  If you have individuals eligible for, or currently enrolled in COBRA you can enroll them on the Individual Exchange through June 30th 2014. Direction from The NY State of Health confirms that current COBRA Eligible Individuals have been granted a one-time open enrollment window.

Therefore, anyone who does not like his or her current COBRA coverage or cost, can now switch to Individual Exchange!

Qualifying Events for Exchange Marketplace after Open Enrollment:

A Special Enrollment Period (SEP) is the time outside of Open Enrollment that allows individuals and families facing special circumstances (Qualifying Life Events) to enroll in a Qualified Health Plan. Eligible individuals have 60 days to enroll after their Qualifying Life Event. 

 Individual or dependent loses minimum essential coverage due to: job loss; employer no longer offers coverage; divorce; death of a spouse; becoming ineligible for Medicaid or Child Health Plus; expiration of COBRA; or health plan is decertified

 Marriage, birth, adoption, or placement for adoption

 Gaining status as a citizen, national, or lawfully present individual

 Consumer is newly eligible or ineligible for tax credits and/or cost sharing reductions

 Permanent move to an area that has different health plan options

 Marketplace staff or contractor enrollment error

 Qualified Health Plan violated a provision of its contract

 American Indians can enroll or change plans one time per month throughout the year

 Other exceptional circumstances, as defined by HHS

To ensure your clients get great health insurance get in Contact us at (855)667-4621!

SEP ACA for Individuals and Families

Find us on the Health Insurance Marketplace where you may qualify for help to pay for your health insurance

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