Headlines about "Health plan admin - COBRA"
Gathered from the web by the editors at BenefitsLink.com.
[Guidance Overview] Year End Update Regarding COBRA Subsidy
Excerpt: "First, Employers are not required to issue any information reporting documents (Forms W-2 or 1099) to involuntarily terminated workers to report the amount of the COBRA subsidy. Employers claiming the credit must, however, maintain documentation to support the credit claimed. Second, Employers must claim the COBRA subsidy using Form 941 and must file such claims on a Form 941 filed for a quarter in the year in which the subsidy was provided to the assistance-eligible individual." (Miller & Chevalier Chartered)
[Guidance Overview] Court Refuses to Impose Separate Penalties for Multiple Beneficiaries Affected by a Single COBRA Notice Violation
Excerpt: "EBIA Comment: This appears to be the first reported case in which a court awarded penalties for a timely but deficient election notice. Regarding the question of whether multiple penalties are available, the few courts to address this issue have not been in agreement. Certain other courts have separately calculated and awarded statutory penalties for spouses or dependent children. Still another court, noting that a failure to provide an election notice to a former employee and his spouse constituted two notice violations, concluded that the violations had 'merged' so that a single penalty was appropriate. Notwithstanding that disagreement, this case illustrates an important lesson for plan sponsors. Care should be taken to ensure that election notices conform to the detailed requirements of the DOL's notice regulations because failure to do so creates the potential for large penalty awards in court." (Employee Benefits Institute of America)
[Guidance Overview] DOL's Expedited Review of Health Plan's Denial of ARRA COBRA Premium
Excerpt: "EBIA Comment: Individuals who are denied the COBRA premium subsidy have a right to request expedited review of the denial from either the DOL or CMS (see our Checkpoint Newsstand article), but this is the first court appeal we have seen of an expedited review. As one might expect, the facts that led to this review and appeal are complicated -- involving two periods of employment, two terminations, and two plan rules for calculating eligibility for coverage -- but the plan, the DOL, and the court all agreed that he was not eligible for the subsidy." (Employee Benefits Institute of America)
The COBRA Subsidy and Health Insurance for the Unemployed (PDF)
9 pages. Excerpt: "The COBRA subsidy was designed to help support health coverage during the recession and is allowing some of the unemployed to temporarily continue their coverage. However, the subsidy's temporary structure means that soon it will no longer provide help to those trying to maintain their health coverage after a layoff. Specifically, peoplewho are laid-off after December 31, 2009 will not qualify for the subsidy, since it only applies to those who become unemployed from September 1, 2008 to December 31, 2009. In addition, the subsidy will soon come to an end for those who will have been paying the reduced premiums for nine months, which is the maximum length of the subsidy. While Congress may consider extending the COBRA subsidy, the program's reach may remain limited due to gaps in who is eligible for COBRA and the difficulty ofaffording even the subsidized premiums for those with limited resources." (Kaiser Family Foundation)
The Health Insurance Options When COBRA Runs Out
Excerpt: "The [COBRA subsidy] expires after nine months. That means time is running out for laid-off workers who signed up in March, when the benefit first became available. To keep COBRA coverage, they'll have to pay 102% of the premiums. . . . Mindful of the 10% unemployment rate, some lawmakers have proposed extending the benefit, but that hasn't happened yet. Tips for people who are losing their COBRA subsidy . . . . Don't drop COBRA until you've found another source of insurance coverage, 'even if you're paying through the nose for a month or two,' . . . ." (USA TODAY)
Congress Considering Extensions of COBRA Premium Subsidy
Excerpt: "There are now three separate bills pending in Congress to expand both the amount of time COBRA continuation coverage may be available as well as to extend the previous COBRA premium subsidy under ARRA." (Gary Kushner's Benefits Blog)
[Guidance Overview] IRS Explaination of How COBRA Premium Subsidy Is Reimbursed When Subsidy Exceeds the Employer's Payroll Tax Liability
Excerpt: "EBIA Comment: According to the letter, this employer didn't have the funds to pay the subsidy and was considering terminating its health plan. Thus, the IRS's suggestion to pay the tax and then recover it as a refund may not have been much help, from a cash flow standpoint. The employer's suggestion that the subsidy payment be reimbursed through the insurer is a practical one, but ARRA's rule that permits reimbursement through the insurer is only available for comparable continuation coverage under state law and is not available for employers, such as this one, that are subject to federal COBRA." (Employee Benefits Institute of America)
Senate Bill Would Boost, Extend Federal COBRA Subsidy
Excerpt: "With hundreds of thousands of laid-off employees soon to lose a federal subsidy of their COBRA health insurance premiums, more lawmakers are introducing legislation to extend and increase the subsidy. Under bill, S. 2730, proposed by Sens. Sherrod Brown, D-Ohio, and Bob Casey, D-Pa., the nine-month subsidy would be extended by six months to 15 months, and the 65% federal premium subsidy would be raised to 75%. In addition, workers who lose their jobs through June 30, 2010, would be eligible for the subsidy. Under the current law, employees who lose their jobs after Dec. 31 will not be eligible for the subsidy." (Business Insurance)
Small Business Employees Are 50% More Likely To Lose Health Care Coverage
Excerpt: "Employees of small businesses are 50% more likely to lose coverage as workers at large businesses, according to a recent report released jointly by the Department of Health and Human Services (HHS) and the Small Business Administration (SBA). In addition, the report, Insurance at Risk: Small Business Employees Risk Losing Coverage, found that half of workers in small firms that do not offer health benefits remain uninsured." (Wolters Kluwer Law & Business)
[Guidance Overview] 2009 Year-End Health and Welfare Issues
Excerpt: "2009 is quickly coming to a close and health and welfare plan sponsors should address several recent legal developments and ongoing compliance requirements before year-end. In particular, calendar year plans should be amended (and SPDs updated) to reflect the new requirements that will be effective January 1, 2010, including Michelle's Law, expanded mental health parity requirements and GINA. Plan Sponsors should also ensure that plan changes needed for CHIPRA and the COBRA subsidy are implemented and documented." (DrinkerBiddle)
COBRA Expansion Bills Introduced
Excerpt: "After months of speculation and murmurings in Washington, D.C., two bills were introduced in the House in late October to expand the COBRA subsidy program created by the American Recovery and Reinvestment Act of 2009 (ARRA). The more expansive of the two bills is HR 3930. The bill has four major provisions: . . . ." (Infinisource)
[Guidance Overview] Bill Would Extend and Expand COBRA Subsidy Program
Includes link to the bill. Excerpt: "The temporary COBRA subsidy program would expand to cover more involuntarily terminated people for longer periods, under a recently introduced House bill. HR 3930 would increase the subsidy period from nine to 15 months and extend subsidies to people eligible for COBRA due to involuntary job loss between Jan. 1 and June 30, 2010. Under the current subsidy program, people losing their jobs after 2009 would not be eligible. The bill also would expand the maximum COBRA period from 18 to 24 months for certain individuals losing health coverage due to employment termination or reduction in hours." (Mercer)
[Guidance Overview] IRS Rapidly Begins COBRA Subsidy Audits
Excerpt: "[T]he IRS has already begun audits of employers and insurers claiming the subsidy on their 2009 Forms 941 (Employer Quarterly Federal Tax Return). The IRS information document request asks for the identity of all individuals represented on line 12b of the Form 941, each individual's request for the COBRA subsidy, and a copy of the insurance premium invoice to the employer with proof that the employee paid the premium . . . ." (Miller & Chevalier)
House Bill Would Extend COBRA
Excerpt: "Legislation has been introduced in the U.S. House of Representatives that would extend COBRA provisions for workers who are involuntarily terminated." (PLANSPONSOR)
[Guidance Overview] New Treasury Regulations Require Group Health Plans to Self-Report Excise Tax Liability
Excerpt: "Beginning January 1, 2010, plan sponsors (plan administrators for multiemployer plans) will need to self-report excise tax liabilities for failure to meet certain health plan requirements, including requirements under: * COBRA; * HIPAA's portability and nondiscrimination rules; * Newborns' and Mothers' Health Protection Act; * Mental Health Parity and Addiction Equity Act; * Health savings account comparability provisions; * Michelle's Law; * Genetic Information Nondiscrimination Act (GINA)" (Ballard Spahr)
Wellpoint and Other Health Insurers Say Claim Costs Increasing with COBRA and the Flu
Health insurer officials say that between flu and COBRA claims' costs, they will be forced to raise premiums. (The Associated Press via Google)
IRS Personnel Share Unofficial Comments on Compliance Issues with ABA Employee Benefits Committee
Excerpt: "IRS representatives shared their unofficial views on certain benefits issues that were presented earlier this year by the Employee Benefits Committee of the Tax Section of the American Bar Association. Although the views cited by the IRS representatives are not binding and do not represent the policy of the agency, they provide useful insight into areas of concern. Some of the notable unofficial and non-binding views shared by the IRS representatives were the following . . . ." (Deloitte via BenefitsLink.com)
[Guidance Overview] Employer That Did Not Comply with Health Plan's COBRA Notice Requirements Is Not Entitled to Stop-Loss Reimbursement
Excerpt: "EBIA Comment: Because COBRA does not apply directly to insurers and stop-loss carriers, these entities are generally not obligated to provide COBRA coverage (or stop-loss coverage for COBRA claims) unless they enter into a contract requiring them to provide that coverage. The policies issued by group health insurers and by stop-loss insurers will generally include provisions requiring them to cover (or provide stop-loss coverage for) qualified beneficiaries who elect COBRA. But such policies often include provisions that allow the insurer to refuse payment unless certain conditions, including notices being given pursuant to the terms of the plan, are met. Employers that fail to follow the terms of their plan may, therefore, end up with no insurance coverage for an individual's COBRA claims." (Employee Benefits Institute of America)
IRS Representatives Address Employee Benefits Issues at Meeting
Excerpt: "In a meeting on employee benefits issues raised by the American Bar Association's (ABA) employee benefits committee section on taxation, representatives of the Internal Revenue Service addressed COBRA, imputing fair-market value to self-insured employer-provided health care coverage, and one-time lump sum cash payments for irreversible waiver of retiree health benefits. Two of the COBRA situations involved the tax treatment of employer voluntarily continued coverage after COBRA ends for certain beneficiaries, and waiver of the COBRA subsidy." (Wolters Kluwer)
Administrative Hassles from COBRA Subsidy Limited Usefulness
Excerpt: "Ceridian Benefits Services said the new COBRA subsidy enacted by the U.S. government may have been able to help greater numbers of displaced workers afford health care if it required fewer compliance, paperwork, and recordkeeping responsibilities from employers. . . . The report lists several possible reasons for the low COBRA enrollment rate, including tight deadlines to implement the mandate, the additional accounting burdens presented by the subsidy, and the difficulty of tracking eligibility to only those involuntarily terminated. 'Our data shows that the COBRA enrollment rate under ARRA is less than anticipated and that the unique challenges the law presents to employers may have discouraged participation,' said Colleen O'Reilly, Ceridian's chief author of the report . . . ." (PLANSPONSOR.com; free registration required)
[Guidance Overview] Missed COBRA Qualifying Events Cause Forfeiture of Stop Loss Coverage
Excerpt: "The district court's opinion in Majestic v. Trustmark addresses numerous aspects of a controvery between an employer on the one hand and its stop loss carrier and MGU on the other. Though not dispositive of the case, the opinion does cover a broad swath of issues than can arise in the stop loss reimbursement setting . . . . In this post, I will note the facts that cost the employer stop loss coverage on several claims based upon discontinuities in the plan language and that in the stop loss policy." (Roy Harmon III via Health Plan Law)
COBRA Assistance May Be Extended: President, Congress Weighing Options on Premium Subsidy
Excerpt: "Last week, White House Press Secretary Robert Gibbs said President Obama is looking into whether the subsidy, embedded in economic stimulus legislation that the president signed into law in February, should be extended. 'There are a number of ideas that have been implemented that are coming to a legislative end,' including the COBRA premium subsidy, which the administration is analyzing, Mr. Gibbs said. In addition, Washington sources say, the House Democratic leadership is considering extending the COBRA subsidy." (Business Insurance)
[Guidance Overview] IRS Final Regs on COBRA, HIPAA and HSA Penalty Reporting, Clarifies HSA Comparability Rules
Excerpt: "Final IRS rules require filing Form 8928 to report and pay excise taxes for violations of HIPAA portability, COBRA, or comparability rules for employer contributions to health savings accounts (HSA) outside of a cafeteria plan or to Archer medical savings accounts. The regulations also clarify certain HSA comparability rules, including the allowance for some higher-paid employees and contributions for midyear plan entrants. The new requirements and clarifications apply to filings due and employer HSA contributions made on or after Jan. 1, 2010." (Mercer LLC)
Obama Administration Mulls Extending COBRA Subsidy
Excerpt: "An economic stimulus law that went into effect early this year includes a provision in which the federal government pays 65% of the COBRA premium for up to nine months for workers who are involuntarily terminated through the end of this year. Without an extension, employees who lost their jobs earlier this year soon will lose the federal COBRA subsidy. The availability of that subsidy resulted in a doubling of the percentage of laid-off employees opting for COBRA, found a Hewitt Associates Inc. survey released in August." (Business Insurance)
[Guidance Overview] Former Employees Have No Claim Against Bankrupt Employer for Unpaid Medical Bills, But Can Seek Unpaid Employee Health Premiums
Excerpt: "EBIA Comment: At the end of the day, the only relief that these employees could seek from their employer was the recovery of the employee portion of the unremitted health insurance premiums. This illustrates not only the litany of claims that employees may make when their employer fails to remit health insurance premiums, but also the harsh reality that in many instances this is a wrong without a remedy." (Employee Benefits Institute of America)
[Guidance Overview] No COBRA for Former Spouse Who Did Not Provide Timely Notice of Divorce
Excerpt: "EBIA Comment: Other courts have held that a plan with 'inquiry notice' of a qualifying event must send a COBRA election notice. A plan has inquiry notice when the covered employee or the qualified beneficiary has given enough information about the occurrence of the qualifying event to allow the plan administrator, upon due inquiry, to reasonably ascertain that a qualifying event has occurred. But as this court concluded, knowledge of a pending divorce is not knowledge of a qualifying event since the actual entry of a divorce decree is the triggering event for the COBRA qualifying event of divorce. The outcome might have been different if the plan had inquiry notice of a final divorce." (Employee Benefits Institute of America)
[Guidance Overview] Mental Health Parity: Is Your Health Plan Ready?
Excerpt: "A number of legislative and regulatory changes affecting group health plans recently have or soon will become effective in the 15 months between October 1, 2008, and January 1, 2010 [including]: * The COBRA subsidy; * Michelle's Law; * Genetic Information Nondiscrimination Act; * Special enrollment rights for persons losing CHIP or Medicare coverage or obtaining premium assistance from a state under a CHIP or Medicare program; * HIPAA privacy and security changes, including a breach notification requirement; * Final cafeteria plan regulations; and * Changes in state health insurance laws, such as the expansion of the available continuation coverage period from 18 to 36 months (New York) and modifications to the Massachusetts Health Care Reform Act. [In addition, the] Mental Health Parity and Addiction Equity Act of 2008 . . . becomes effective for plan years beginning after October 3, 2009 (a special rule applies to collectively bargained plans). Thus, the effective date is January 1, 2010, for calendar year plans." (Jackson Lewis)
[Guidance Overview] IRS and Treasury Officials Provide Informal Views on COBRA Premium Subsidy Issues
Excerpt: "[O]fficials were asked whether an employee who was eligible to be added as a dependent under his spouse's health plan at all times before his involuntary termination is entitled to the COBRA premium subsidy. They responded that the employee was not entitled to the subsidy . . . ." (Employee Benefits Institute of America)
[Guidance Overview] Recent New York Laws Affect Health and Welfare Plans
Excerpt: "The State of New York recently enacted two laws that will dramatically impact insured employee benefit plans, and the group health insurance industry as a whole, in the Empire State. The first law effectively extends the maximum length of federal COBRA and state-mandated continuation coverage to three years, while the second law allows certain children to continue coverage under their parents' employer-based group health plans through age 29. Perhaps as important as the provisions of the new laws themselves is the possibility that other states may follow suit in the near future." (Miller Chevalier)
[Guidance Overview] IRS Updates Its Website Sept. 2 to Provide More Guidance on COBRA Premium Subsidy
Excerpt: "The IRS updated its website to provide more guidance on the COBRA premium subsidy. New Q&A addresses changes in eligibility and the potential tax liability of high income individuals who receive the subsidy." (Deloitte via BenefitsLink.com)
[Guidance Overview] New Law Will Have Significant Impact on Group Health Plans Insured in New York (PDF)
2 pages. Excerpt: "[Significant group health plan legislation was passed by the New York] legislature and signed by Gov. David A. Paterson on July 29. The new legislation will extend dependent coverage and expand Consolidated Omnibus Budget Reconciliation Act (COBRA) protections to health plan participants in the state, and may raise interesting questions in its coordination with the federal COBRA statute." (Pension & Benefits Reporter via McDermott Will & Emery)
[Guidance Overview] No Small-Employer Exception Where Lack of Time Records Prevents Counting Commission-Only Employees as Part-Time
Excerpt: "EBIA Comment: When an employee is not paid by the hour and doesn't keep time records, an employer may have difficulty convincing a court to count the employee as a part-time employee for purposes of the full-time equivalency method. In this case, the court was not satisfied with a formula the employer created solely for the purpose of satisfying the IRS's COBRA regulations. In other cases, however, an employer might be successful using generally recognized hourly equivalency formulas -- for example, a mileage-to-hours formula for truck drivers authorized under a State prevailing wage law." (Employee Benefits Institute of America)
[Guidance Overview] Ohio Health Reforms Mandate Cafeteria Plans, Expand Access for Adult Children and Increase State COBRA Coverage Period (PDF)
3 pages. Excerpt: "Ohio's recently enacted state budget (Am. Sub. H.B. 1) includes several provisions that may affect employer-sponsored plans. The new law requires employers with 10 or more employees to offer full-time employees the opportunity to pay for health insurance with pre-tax dollars, requires insurers and public employee benefit plans to offer coverage to dependents up to age 28, and extends the period of health continuation under the state COBRA law from 6 to 12 months." (Buck Consultants)
IRS's New Webpage With Q&As for Employees and Former Employees on COBRA Premium Subsidy
Excerpt: "EBIA Comment: These Q&As appear on a new IRS webpage that houses COBRA premium subsidy information for employees and former employees. Although the information in these Q/As is not new . . ., it may be more accessible to employees in this new location." (Employee Benefits Institute of America)
[Guidance Overview] IRS Reminder to Public About COBRA Subsidy Ineligibility Notice and Penalties
Excerpt: "An IRS news item reminds COBRA qualified beneficiaries receiving federal premium assistance that they must notify the former employer sponsoring their coverage when they lose eligibility for the COBRA premium subsidy. Qualified beneficiaries who fail to give this notice may incur penalties of up to 110 percent of the subsidy received after loss of eligibility. Others aware of a beneficiary's failure to provide notice of subsidy ineligibility can use Form 3949-A to report the violation to the IRS." (Mercer LLC)
[Guidance Overview] COBRA Premium Payment Postmarked One Day After the End of the Grace Period Was Late
Excerpt: "EBIA Comment: The language in the election notice in this case certainly helped the court reach its holding. However, the DOL COBRA regulations simply require that election notices contain a description of due dates, grace periods, and consequences of delayed payment or nonpayment, and we don't read the case to require warnings about the pitfalls of delayed mailings. Another provision in the IRS COBRA regulations -- under which a premium payment is considered made on the date it is sent to the plan -- also supports the court's holding. The case is also a useful reminder for those plans that do provide benefits through insurance: A longer-than-30-day grace period may apply in cases where the insurer imposes a longer period for the employer." (Employee Benefits Institute of America)
Health Care Bills Would Offer the Unemployed Alternatives to COBRA
Excerpt: "The health care reform bills under consideration by Congress would maintain COBRA but also let displaced workers buy alternative insurance policies through a health insurance exchange that anyone would be eligible to use. 'There is nothing in the bill that says you can keep your insurance if you lose your job, but it would make it easier and less expensive for you to buy another policy,' says Paul Fronstin of the Employee Benefit Research Institute, a private, nonprofit, nonpartisan research institute that studies employee benefits." (Cleveland Live, Inc.)
[Guidance Overview] New York State Insurance Law Changes Extend Continuation Coverage and Dependent Coverage Under Insured Medical Plans
Excerpt: "New York State Governor David Paterson recently signed legislation that will affect the administration of insured medical plans in New York State. The legislation generally extends the period that terminated employees may elect continuation coverage under an insured plan from 18 months to 36 months and requires medical insurers to offer continued coverage to employees' unmarried children through age 29, regardless of financial dependence." (Bond, Schoeneck & King, PLLC)
EBSA Web Page on COBRA Rights Now Includes Video on Protecting Benefits After Job Loss
Accompanying link takes you to the video; Internet Explorer web browser seems to be required. The EBSA web page is at http://www.dol.gov/ebsa/cobra.html (Employee Benefits Security Administration, U.S. Department of Labor)
[Official Guidance] COBRA Subsidy Recipients Who Later Become Eligible for Insurance Coverage Should Notify Their Former Employer to Avoid a Penalty
Excerpt: "Individuals who have qualified and received the 65 percent subsidy for COBRA health insurance, due to involuntary termination from a prior job, should notify their former employer if they become eligible for other group health coverage. . . . in writing that they are no longer eligible for the COBRA subsidy. . . . If an individual continues to receive the subsidy after they are eligible for other group health coverage, such as coverage from a new job or Medicare eligibility, the individual may be subject to the new IRC ? 6720C penalty of 110 percent of the subsidy provided after they became eligible for the new coverage." (Internal Revenue Service)
[Guidance Overview] IRS Reminder That COBRA Subsidy Recipients Must Notify Plan of Other Coverage or Face Penalty
Excerpt: "EBIA Comment: The DOL notice that group health plans were required to send to individuals advising them of their right to subsidized COBRA premium payments includes the form individuals should use to notify the plan that they are eligible for other group health plan coverage or Medicare . . . ." (Employee Benefits Institute of America)
[Guidance Overview] Changes to New York Insurance Rules Provide Longer Coverage for Terminated Employees and Dependents
Excerpt: "Unlike mini-COBRA, the law also applies to insurance policies issued to large employers that are subject to federal continuation coverage laws under the Consolidated Omnibus Budget Reconciliation Act (COBRA). . . . Perhaps out of ERISA preemption concerns, the law regulates not employers but the content of insurance policies issued in New York State. Therefore, it is unclear if employers have any enforceable obligations under this law or whether it will be fully [administered] by the insurance companies." (Littler)
New York Laws Increase State COBRA Period and Age for Dependent Health Insurance Coverage (PDF)
3 pages. Excerpt: "On July 29, 2009, New York Governor David Paterson (D) signed into law three health reform bills -- one extending the period for state health coverage continuation rights from 18 to 36 months, one requiring insurers to offer continued coverage for unmarried adults through age 29 under their parent's individual or group health insurance policies, and one instituting a series of managed care reforms." (Buck Consultants)
[Guidance Overview] MSP Rules Prohibit Terminating Group Health Plan Coverage Based Solely on ESRD Eligibility, Except as Permitted by COBRA
Excerpt: "EBIA Comment: This case reminds us that the rules regarding Medicare eligibility and entitlement (including those for ESRD) are detailed and complex. It highlights that the rule prohibiting termination of group health plan coverage because of ESRD Medicare eligibility or entitlement does not prohibit termination of COBRA when termination of such coverage is expressly permitted (e.g., upon entitlement to Medicare)." (Employee Benefits Institute of America)
[Guidance Overview] Pennsylvania's New Mini-COBRA Law Helps Additional Workers
Excerpt: "In sum, Pennsylvania's new Mini-COBRA law extends federal COBRA-like benefits to employees and dependents of small employers that in the past would have lost their rights to group medical care coverage, and permits certain employees and dependents to take full advantage of the ARRA's 65 percent COBRA premium subsidy." (Buchanan Ingersoll & Rooney PC)
Hewitt Analysis Shows Average COBRA Enrollments Doubled Since Subsidy Became Available
Excerpt: "According to Hewitt's research, companies in the industrial manufacturing industry saw an 800 percent increase in COBRA enrollments since the subsidy was enacted. COBRA enrollments rose from 7 percent (September 2008 to February 2009) to 59 percent (March 2009 to June 2009). Enrollments for companies in the construction, leisure, and retail industries tripled." (Hewitt Associates)
More Unemployed Workers Sign Up for COBRA Now
Excerpt: "In the past, the vast majority of laid-off workers were unable to afford COBRA, says Ron Pollack, executive director of Families USA, a health care advocacy group. Without the subsidy, the average COBRA family premium consumes 84% of the average jobless worker's unemployment benefits, according to Families USA. Employers also are seeing an increase in the number of dependents covered by COBRA, says Patricia Friedman, a senior consultant at Watson Wyatt, a human resources consulting firm. Some employers have raised concerns that higher COBRA enrollments will increase their health care costs. Individuals who sign up for COBRA tend to file more claims than other workers, according to Edward Kaplan, national health practice leader at Segal, a human resources consulting firm, because they want to get as much medical treatment as possible before their coverage expires." (USA Today)
[Guidance Overview] Domestic Partner's Right to Continued Health Coverage Under COBRA, Cal-COBRA and Analogous State Laws
Excerpt: "[Recent] guidance from the San Francisco Regional Office of the U.S. Department of Labor (the 'DOL') indicates that an employee's domestic partner may be eligible for continued health coverage under COBRA in certain circumstances and that, as a result, the [Defense of Marriage Act] would not preclude such coverage. . . . [Also, t]here are continuation coverage statutes in some (but certainly not all) states that, like Cal-COBRA, consider domestic partners to be qualified beneficiaries for purposes of state-mandated continuation coverage. Accordingly, it is important to identify any applicable state statute in order to determine what right, either individually or derivatively through the former employee, an employee's domestic partner may have to continued health coverage." (Cooley Godward Kronish LLP)
[Guidance Overview] New York State Expands Continuation Coverage for Insured Medical Plans
Excerpt: "Although it is possible that this new law might be challenged as preempted to the extent that it applies to employers subject to federal COBRA, there is an exception to preemption for state laws regulating insurance. Since it is unlikely that any challenge would be resolved before compliance is required and it is unclear whether such challenge would succeed, we recommend that preparation for compliance start now." (Osler, Hoskin & Harcourt LLP)
[Guidance Overview] Group Health Plan Eligibility, COBRA and the Importance of Clear Leave of Absence Policies
Excerpt: "An employee's leave of absence can raise a number of practical and legal issues. That is why employers need to include clear leave of absence policies in employee handbooks and in employee benefit plans. A recent federal court decision illustrates how important this is in the group health plan and COBRA context. In Jennings v. D.F. Crane Constr. Corp., 2009 U.S. Dist. LEXIS 41794 (W.D. Ky. Apr. 10, 2009), Mr. Jennings was participating in the company's health plan. Mr. Jennings took a leave of absence, and while he was on leave the company terminated his employment. The dispute boiled down to when Jennings lost his coverage under the company's health plan (i.e., when the COBRA qualifying event occurred)." (Poyner Spruill LLP)
[Guidance Overview] New Law Makes Significant Changes to Group Health Plans Insured in New York: Dependent Coverage Extended and COBRA Protections Expanded
Excerpt: "Changes apply to any employer that offers insured group coverage in New York; employers should prepare for the new rules and decide whether to offer parity in self-insured options." (McDermott Will & Emery)
Characteristics of People Insured through COBRA versus through a Current Job, 2005?2006 (PDF)
6 pages. Excerpt: "This Statistical Brief compares selected characteristics of people who reported health insurance coverage through COBRA and people who reported coverage through a current job with 20 or more employees for the years 2005 and 2006. The populations include workers and their dependents. Four characteristics are compared: 1) age, 2) race/ethnicity, 3) general health status and disability, and 4) presence of selected chronic conditions. The age distribution is compared for children (age 17 and younger) and adults." (U.S. Agency for Healthcare Research and Quality)
[Guidance Overview] New York Extends COBRA Continuation Coverage
Excerpt: "New York State recently made significant changes to its 'Mini-COBRA' law and health insurance regulatory scheme. These changes are designed to increase benefits and reduce the number of New Yorkers without health insurance. Employees who are eligible for group health coverage and their covered beneficiaries will be directly affected by these changes, which are retroactively effective as of July 1, 2009." (Blank Rome LLP)
[Guidance Overview] Pennsylvania Adopts Mini-COBRA Requirements for Small Employers with Health Insurance Plans
Excerpt: "[39] states and the District of Columbia have various mini-COBRA rules in their state insurance codes that apply to small businesses (usually those with 2 to 19 employees) that provide medical benefits to their employees. These rules tend to be similar to, although often not exactly like, federal COBRA rules." (Morgan, Lewis & Bockius LLP)
New York Governor Signs Bills to Improve Health Insurance Access
Excerpt: "New Yorkers who lose their jobs will now be able to continue to get lower cost health care coverage for twice as long under a new law. Gov. David Paterson said the bill he signed Wednesday will make health care more affordable and accessible through several changes. It will give people 36 months to use COBRA after losing their jobs. COBRA allows people who have lost their jobs to continue with the same insurance plan they had under an employer. It's less than half the cost of insurance on the open market." (AP via CNHI)
[Guidance Overview] Alternative Coverage Case Involving Premium Hike Raises COBRA Issues
Excerpt: "A Michigan federal district court denied a former employee's claim for subsidized COBRA coverage following 12 months of coverage at active rates. The claim was denied, even though the employer had mistakenly confirmed a lower premium for the COBRA coverage, because the employer's clear plan terms explained that terminated employees would get 12 months of continued coverage at active rates followed by 18 months of coverage at full cost. The case is Ten Harmsel v. Pfizer Inc., 2009 WL 1771377 (W.D. Mich., June 18, 2009)." (Thompson Publishing Group Inc.)
Managing Health Benefits in Challenging Times: Mercer Survey on Recession and Reform
Excerpt: "Mercer's Survey on Recession and Reform explores how the downturn and health care reform efforts are affecting employers' health benefit programs. This Perspective reports the survey's findings on employers' expected health benefit costs in 2009 and cost-control plans for 2010; impact of the recently enacted federal COBRA subsidy, special CHIP enrollment rights and mental health parity expansion; and views on proposals to impose individual-coverage or employer pay-or-play mandates, curb employer deductions for benefits, waive ERISA pre-emption, or create a single-payer health care system. (Perspective, 13 Jul 2009, 11 pages)" (Mercer LLC)
COBRA Expansion Added to House Health Reform Bill
Excerpt: "Employers' obligation to extend COBRA health care continuation coverage to former employees and dependents would be expanded dramatically under an amendment tucked into sweeping health care reform legislation approved by a House panel. The House Education and Labor Committee on Friday approved H.R. 3200. It includes the COBRA expansion amendment proposed by Rep. Susan Davis, D-Calif., which the panel approved in an earlier voice vote." (Business Insurance)
[Guidance Overview] Recent Legislation and Regulations Require Changes to Health and Welfare Benefit Plans
Excerpt: "Congress and federal regulatory agencies have been busy enacting legislation and proffering guidance which implements many new requirements for group health and welfare benefit plans. Many of the changes will require thoughtful action on the part of administrators and sponsors of group health and welfare benefit plans. This brief outline of current health and welfare compliance developments is not intended to be exhaustive, but rather serves to illustrate the depth and breadth of changes facing plan sponsors now and in the coming months." (Littler Mendelson P.C.)
Phyllis Borzi Confirmed by Senate as New EBSA Head
Excerpt: " The U.S. Senate has approved the nomination of Phyllis Borzi as assistant secretary of labor for the Department of Labor's Employee Benefits Security Administration (EBSA)." (PLANSPONSOR.com)
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