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COBRA Procedures Manual & E-Alerts Agenda

Online Course: ID# 1000021

Agenda

An Overview Of COBRA
  • Background
  • Purpose
  • Administration
  • Cost To Employers
  • Penalties For Noncompliance With COBRA
Employers And Plans Covered By COBRA
  • Employers And Plans Subject To COBRA
  • Defining A Group Health Plan
  • Maintaining A Group Health Plan
The General COBRA Notice
  • The General COBRA Notice
  • Consequences Of Failure To Provide The General COBRA Notice
  • How To Send The General COBRA Notice
  • HIPAA Notice
Covered Employees And Qualified Beneficiaries
  • Who Is A Covered Employee
  • Who Is A Similarly-Situated Non-COBRA Beneficiary
  • Who May Be A QB
  • Who May Not Be A QB
  • A QB’s Rights Under COBRA
  • QBs Located Outside Of The Plan's Service Area
  • Repeal Of The Core Coverage Requirement
Qualified Events
  • Defining A Qualified Event
  • List Of Qualified Events
  • What May Be A QE
  • Expansion Of COBRA's Loss Of Coverage Definition
  • What May Not Be QE
  • Duration Of COBRA Coverage
  • Expanded Coverage For Additional QEs (Multiple QEs)
  • Special QE Issues: Gross Misconduct
  • Special QE Issues: Disability
  • Special QE Issues: Cessation Of Dependency Status
  • Special QE Issues: Divorce Or Legal Separation
  • Special QE Issues: Medicare And Initial QEs
  • Special QE Issues: Medicare And Multiple QEs
  • Determining The QE Date
  • Providing More Than The Required COBRA Coverage
  • COBRA Notice Rules: Reasonable Notice Procedures
QE Notices
  • QE Notices
  • What QE Notices Should Include
  • To Whom Should QE Notices Be Sent
  • When To Send A QE Notice
  • How To Send A QE Notice
  • Handling Coverage During The Election And Payment Period
  • Responses To Provider Inquiries Concerning QBs
COBRA Issues Under The Trade Act Of 2002
  • Introduction
  • Second Chance COBRA Election
  • Health Coverage Tax Credit
Administration And Documentation
  • Coordination Of Administrative Resources
  • Summary Plan Descriptions
  • Keep The Envelopes, Use The Postmarks
Timelines
  • The COBRA Timeline
  • Understanding And Managing The COBRA Timeline
  • Employer And QB Notification To The Plan Administrator
  • 14-Day Notification Period
  • 60-Day Election Period
  • 45-Day Retroactive Premium Payment Period
  • 30-Day Grace Period
  • Using The Correct Procedures
  • Strategies For Protecting Against Accidental Free COBRA Coverage
  • Finding Out About Other Coverage
Calculating COBRA Premiums
  • Determining COBRA Premiums For Insured Plans
  • Determining COBRA Premiums For Self-Funded Plans
  • Handling Rate Changes
  • COBRA’s 12-Month Determination Period
  • Determining Rates For Related QB’s Who Independently Elect COBRA
  • Rates For A QB’s Newly Added Spouse or Dependent
Billing And Collection Of COBRA Premiums
  • How To Bill Current QBs
  • Who To Bill For COBRA Coverage
  • Who Can Pay For COBRA Coverage
  • What Is Timely Payment: Premium Payment Deadline
  • What Is Timely Payment: Timely Payment
  • What Is Timely Payment: Partial Payment
  • What Is Timely Payment: Employer Subsidized / Alternative Coverage
Open Enrollments
  • Who Is Entitled To Open Enrollment Rights
  • Changes In Coverages During Open Enrollments
  • Effect Of Plan Terms On QBs' Open Enrollment Rights
  • Plan Changes And Their Effect On QBs
  • Open Enrollment Changes By Active Employees And Potential QEs
USERRA
  • Introduction
  • Protected Individuals
  • Health Care
    Interaction With COBRA
  • Election Notice
  • Health Care Premiums
  • USERRA Does Not Extend Beyond 18 Months Of Continuation Coverage
Medicare
  • Medicare Basics
  • Entitlement vs. Eligibility
  • Medicare And Initial QEs
  • Medicare And Multiple QEs
  • Medicare As An Event Terminating COBRA Coverage
COBRA's Alternative Coverage Rules
  • Defining Alternative Coverage
  • Using Alternative Coverage To Offset COBRA
  • Consecutive Coverage Method
  • Concurrent Coverage Method
  • Choice Method
  • Making Your Alternative Coverage Method Work
  • Choosing The Correct Method
Terminating COBRA Coverage
  • An Overview Of The Rules Governing Terminating COBRA Coverage
  • Events Terminating COBRA Coverage
  • Natural Expiration Of COBRA Continuation Period
  • Termination Of COBRA Because Of Employer's Cessation Of Health Plan Sponsorship
  • Termination Of COBRA For Failure To Pay Premiums
  • Termination Of COBRA Because Of Other Group Health Plan Coverage Or Medicare Entitlement
  • Termination Of Extended Disability COBRA Coverage Because Of Cessation Of Disabled Status
  • Procedures For Terminating COBRA Coverage
Other Issues
  • State Laws Health Care Continuation Rules
  • COBRA And the Family And Medical Leave Act
  • Conversion Coverage Rules
  • Flexible Spending Accounts
  • Deductibles, Limits, Split Family Units
  • Penalties For Non-Compliance
Sample Forms, Notices, And Checklists
  • Documentation Form
  • General COBRA Notice
  • QE Notice - Termination/Reduction
  • QE Notice - Cessation Of Dependency
  • QE Notice - Death/Divorce - L.S./Medicare
  • HIPAA Request For Certificate Of Coverage
  • HIPAA Certificate Of Coverage
  • HIPAA Certificate Of Coverage By Categories
  • Termination Of COBRA Coverage Notice
  • Responsibilities Checklist
  • About The Manual
  • IRS Notice 98-12
  • About COBRA Continuation Coverage Rights
  • Notice Of Unavailability Of Coverage
Adminstrative Procedures
  • Suggested Procedure For Sending The General COBRA Notice
  • Suggested Procedure For Identifying QEs
  • Suggested Procedure For Managing Cessation Of Dependency Status Issues
  • Suggested Procedure For Sending QE Notices
  • Suggested Procedure For Handling Coverage During The Election And Payment Period
  • Suggested Procedure For Late and Partial Payments And Bounced Checks
  • Suggested Procedure For Open Enrollment Changes
  • Suggested Procedure For Determining Medicare Entitlement
    Suggested Alternative Coverage Procedure: Concurrent Coverage Method
  • Suggested Alternative Coverage Procedure: Choice Method
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