Cobra Outline of Responsibilities The Employer Responsibilities Qualified Beneficiary Responsibilities 1. Notify Your Insurance Company of Termination of Coverage Coverage normally runs until the end of the month of termination 1. Qualified Event Occurs causing loss of Coverage Voluntary or involuntary termination of employee's employment for ANY reason except gross misconduct Loss of working hours resulting it being no longer eligible for coverage Dissolution of marriage Dependent child no longer eligible due to not qualifying as a dependent Death of employee Employee enrolls in Medicare 2. Notify Qualified Beneficiaries of Continuation Rights Provide written notification within 10 Days in Minnesota or 14 Days if Federal Cobra The employer must inform the qualified beneficiary of: 1. The right to elect to continue coverage 2. The amount of the premium 3. How and when to remit the premium 4. The time frame for premium payments to the employer has different Cobra requirements. Consult an attorney 2. Notify Employer of Continuation Election of Insurance Each Beneficiary has option individually to retain coverage Dental and Group Life may need to be offered as well as medical 3. Notify Insurance Company if Qualified Beneficiary Elects Coverage Usually within 30 days, (do it immediately) Beneficiaries can individually select coverage 4. Collect the Premiums from the Qualified Beneficiary Beneficiary has 45 days to remit the premium Can change mind during the 60 day election period Premium is 100% of the amount charged plus an optional 2% 3. Pay Premium to the Employer Coverage is retroactive to termination date Premium is 100% of billed amount with no Employer contribution Premiums MUST be paid on time to continue coverage 5. Remit Qualified Beneficiary's Premium to Insurance Company Insurance Company will add beneficiary back to employer bill 6. Notify Insurance Company of Termination of Coverage Employer must notify company of changes in desired coverage Track the Cobra Period Employee's termination of employment 18 months Reduction in employee's hours worked 18 months Dissolution of marriage or divorce Unlimited Dependent loses eligibility 36 months Death of employee Unlimited (MN Law) 36 months (Cobra) Employee enrolls in Medicare 36 months 4. Notify Employer of Change or Termination of Coverage 7. Terminating Events Employer Terminates Group Contract and no longer provides coverage Beneficiary is covered by another group health plan or Medicare Beneficiary does not pay the first premium within specified period Beneficiary does not pay future premiums within specified premium 5. Obtain Other Insurance Coverage after Termination of Coverage Cobra law applies to Employers with 20 or more employees MN law applies to ALL Employers with fully insured health plans and self-insured governmental plans Who is a Qualified Beneficiary? A covered employee A covered spouse of a covered employee A covered dependent of a covered employee