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.
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.
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.
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.
Employees have the right to enroll under 3 situations only:
- 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.
- 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.
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.