Headlines about "Health plan admin - COBRA"
Gathered from the web by the editors at BenefitsLink.com.
[Official Guidance] Text of First Periodic Update to IRS 2007-2008 Priority Guidance Plan (PDF)
49 pages. Excerpt: "The attached update sets forth the guidance on the original 2007-2008 Priority Guidance Plan that we have published. Although the update may indicate that a particular item on the plan has been completed, it is possible that one or more additional projects may be completed in the plan year relating to that item. The update also includes 61 items of additional guidance, some of which have already been published.' See section entitled EMPLOYEE BENEFITS and section entitled EXECUTIVE COMPENSATION, HEALTH CARE AND OTHER BENEFITS, AND EMPLOYMENT TAXES. (Internal Revenue Service)
Staying on the Job May Prevent Erosion of Health Benefits for Employees Aged 55 to 64
Excerpt: "One legislative proposal would help bridge the three-year coverage gap between age 62, a common retirement age, and age 65, the age of Medicare eligibility: The Health Care and Training for Older Workers Act (S. 708) would provide COBRA coverage for this 36-month period." (Wolters Kluwer)
Before Medicare - Health Insurance Sticker Shock and Rejection
Excerpt: "IF you want to retire before you are 65 and eligible for Medicare, health insurance is vital to your plans. Without it, you risk losing everything. . . . Those without [company-provided] retiree health benefits who are eligible can use a patchwork of federal and state laws to build an insurance bridge -- although an expensive one -- to Medicare." (The New York Times; free registration required)
[Guidance Overview] Last Known Address Important for COBRA
Excerpt: "While this case did not discuss proof of mailing, a successful COBRA compliance program includes proof that a Qualifying Event Notice is sent timely. The best manner to fulfill that is to send these important notifications via U.S. Postal Service first class mail with a certificate of mailing from the Post Office." (infinisource)
[Guidance Overview] CRS Report for Congress: Summary of the Employee Retirement Income Security Act (ERISA) (PDF)
76 pages; April 10, 2008. Excerpt: "The Employee Retirement Income Security Act of 1974 (ERISA) provides a comprehensive federal scheme for the regulation of employee pension and welfare benefit plans offered by employers. ERISA contains various provisions intended to protect the rights of plan participants and beneficiaries in employee benefit plans. These protections include requirements relating to reporting and disclosure, participation, vesting, and benefit accrual, as well as plan funding. ERISA also regulates the responsibilities of plan fiduciaries and other issues regarding plan administration. ERISA contains various standards that a plan must meet in order to receive favorable tax treatment, and also governs plan termination. This report provides background on the pension laws prior to ERISA, discusses various types of employee benefit plans governed by ERISA, provides an overview of ERISA's requirements, and includes a glossary of commonly used terms." (Congressional Research Service, U.S. Library of Congress)
[Guidance Overview] Insurer Seeks Indemnification from TPA for Not Providing Timely Notice of Qualified Beneficiary's COBRA Election
Excerpt: "The COBRA statute does not apply directly to insurers. Rather, an insurer's COBRA obligations will be dictated by the terms of its contract, which will often impose conditions, such as timely notice requirements, that must be met before the insurer will be obligated to provide COBRA coverage. As this case demonstrates, it is crucial to be clear about what notices are required and who is responsible for providing them, especially when, as here, COBRA administration is outsourced to a TPA." (Employee Benefits Institute of America)
[Guidance Overview] Using Alternative Coverage To Offset COBRA
Excerpt: "Why do employers offer alternative coverage independently from COBRA? Sometimes, the employer is legally required to do so, as in the case of State continuation laws affecting insured plans. Other times, as with retiree plans, coverage is provided as a reward for service to the employer. In other instances, employers effectively use alternative coverages to reduce their COBRA liability or COBRA administrative expenses. For instance, alternative coverage often is used as part of a severance package negotiated incident to an employee's involuntary termination of employment." (HRTrainingCenter.com)
[Opinion] Issues on COBRA and Dependent Eligibility Audits
Excerpt: "Included among [California state employee benefits] is health care coverage for workers and their dependents, which is specifically provided under the state's Consolidated Omnibus Budget Reconciliation Act of 1985 () (COBRA). [T]he article, 'Employers Are Taking Steps to Reduce Costs Associated with Employee Benefits', posted on November 29, 2007, contradicts nearly everything the law says. This article is about the practice of some employers who terminate medical coverage for worker's dependents unless they can show proof of qualification to the benefit." (Los Angeles Attorney Services and Legal Resources)
[Guidance Overview] No Claim for Failure to Provide COBRA Notice for Employee Who Did Not Follow Standard Procedures for an Address Change
Excerpt: "EBIA Comment: Generally, the proper address to which the COBRA election notice should be sent is the last-known address of the qualified beneficiary. An ounce of prevention, of course, is worth a pound of cure. Employers should have a policy of obtaining up-to-date mailing addresses from departing employees and of forwarding them to those responsible for COBRA notifications. And all COBRA forms and other communications with qualified beneficiaries should impose an obligation to inform the plan in writing, at a specified address, of any address changes." (Employee Benefits Institute of America)
[Guidance Overview] Court Addresses Start Date for 60-Day COBRA Election Period
Excerpt: "EBIA Comment: We think it was the court that was confused here. The employer gave the employee only 60 days from the date of his termination of employment to make an election, but under COBRA, the election period must run for 60 days after the termination of coverage or, if later, the date the election notice is provided. The employer's well-intentioned extension of coverage should have expanded the election period by at least one month. (The employer's notice also apparently failed to identify when coverage under the plan would terminate, as required by the DOL's COBRA notice regulations.) Ironically, had the employer not extended the coverage, the termination of coverage would have coincided with the termination of employment, making the election notice accurate." (Employee Benefits Institute of America)
Fighting to Live, and, Remain Insured
Excerpt: "What kind of society builds obscene profit into healthcare, makes medical insurance a luxury, replaces secure pensions with risky 401(k)s and saddles its hard-working citizens with doubts and fears about being able to afford their most basic needs as they grow old? Something to think about when you vote for president this year." (Los Angeles Times)
Baby Boomers Find Bridge from Early Retirement to Medicare
Excerpt: "[T]here may be hope on the horizon. Lured by the baby boomer generation's size and affluence, a number of insurers have begun to market policies specifically geared to the 50-to-64 age group. Some of the nation's largest health insurers -- Aetna, Humana and WellPoint -- are introducing more comprehensive products designed for people who were used to benefit-rich plans in their jobs." (Dallas Morning News)
Buffalo-Area School District Determines COBRA Violation Caused Retirees to Overpay for Health Coverage
Excerpt: "Such a change and sharp difference is allowed in general, with many employers doing it as a way to lower their health-care expenses and premiums as those costs continue to soar. But applying it to recent retirees ran afoul of . . . COBRA. That means someone who retires can continue their health insurance under CO- BRA, with ERISA limiting the premium for the first 18 months to no more than what active employees pay for the same coverage." (The Buffalo News)
Expanded COBRA Continuation Coverage for Small Firm Employees, 2007
Excerpt: "Updated information on continuation and conversion coverage offered to employees of small firms is now available for all states. Information on states that offer expanded COBRA continuation coverage to employees who are not currently covered by COBRA under federal law has been added and includes information on maximum duration amounts and rating restrictions. Updated information on conversion coverage rights for people leaving small firms that offer fully insured group health plans is also available for all states." (Kaiser Family Foundation)
[Guidance Overview] Laws Don't Speak to Non-English COBRA Notice Requirement
Excerpt: "You have a multilingual workforce. Must you provide COBRA notices in languages other than English?" (CCH Incorporated)
No COBRA Notice Required at End of Combined FMLA/Non-FMLA Leave for Employee Who Did Not Pay Premiums While on Leave
Excerpt: "EBIA Comment: Employee leaves of absence can present special difficulties for COBRA compliance unless an employer adopts clear rules (reflected, as necessary, in plan documentation) regarding what triggers COBRA rights: the reduction in hours at the start of a leave or the termination of employment for those employees who do not return at the end of a leave. Although the IRS COBRA regulations contain a special rule that addresses the issue for FMLA leaves, as this case illustrates, combined FMLA/non-FMLA leaves raise many of the same issues and create the same need for clear policies." (Employee Benefits Institute of America)
Cost of COBRA Affects Safety Net Appeal
Excerpt: "Under COBRA, the former employee -- not the employer -- is typically responsible for up to 100 percent of the cost of the premium, as well as a 2 percent administrative fee. According to a federal government survey, the average total premium among businesses offering insurance in Colorado in 2005 was $3,891 per year for single coverage and $10,850 per year for family coverage." (The Denver Post)
COBRA Notice not Due to Employee Who Failed to Pay Health Premiums
Excerpt: "The 6th U.S. Circuit Court of Appeals has agreed with a lower court ruling that a former Tyson Foods employee was not entitled to notification under the Consolidated Omnibus Budget Reconciliation Act (COBRA) - because he failed to pay his health care plan premiums while on medical leave prior to his termination." (PLANSPONSOR.com; free registration required)
Court Considers 44-Day Timeline for COBRA Election Notices
Excerpt: "EBIA Comment: The court's opinion is frustrating because it does not discuss whether the employer and plan administrator are separate entities. Under the DOL's COBRA notice regulations, when the employer and the plan administrator are the same entity (as is typically the case with single-employer plans), the election notice deadline is 44 days from the date of the qualifying event (or loss of coverage, for those plans following the alternate rule). Indeed, this single 44-day period controls even if a TPA handles election notices (unless the TPA has agreed to be the ERISA plan administrator)." (Employee Benefits Institute of America)
Employer's Gross Misconduct Defense Fails, but Court Severely Limits Employee's Recovery
Excerpt: "EBIA Comment: An employer takes a big risk when it denies COBRA due to gross misconduct. Being wrong about gross misconduct can lead not only to penalties, as it did in this case, it might also result in an award of retroactive COBRA coverage and attorney's fees. Accordingly, gross misconduct COBRA denials should be reserved for flagrant conduct that clearly constitutes a substantial and willful disregard of the employer's interests. As this case demonstrates, however, notifying qualified beneficiaries of the denial may greatly reduce any award if a court later disagrees with the gross misconduct conclusion." (Employee Benefits Institute of America)
Court Limits COBRA Award for Worker Terminated for Misconduct
Excerpt: "The U.S. Bankruptcy Court for the Southern District of New York awarded a former Delphi Corporation employee $10 per day for his claim of COBRA violations by the company, instead of the statutory $110 a day." (PLANSPONSOR.com; free registration required)
Paid Leave Was a Reduction of Hours Triggering COBRA Rights
Excerpt: "Relying on the definition of qualifying event in the IRS's COBRA regulations, which states that a reduction of hours occurs whenever there is a decrease in the hours that a covered employee is required to work or actually works, the court rejected the employee's argument that only an uncompensated absence from work constitutes a reduction of hours that triggers a qualifying event." (Employee Benefits Institute of America (EBIA))
Overview: House Approves New COBRA Entitlements and Tax Credits for 'Displaced Workers'
Excerpt: "The bill now moves to the Senate. President Bush has threatened a veto if the current version of the legislation reaches his desk." (Watson Wyatt)
Online DOL Booklet for Individuals: Retirement And Health Care Coverage -- Q&As For Dislocated Workers
Excerpt: "This booklet addresses some of the common questions dislocated workers ask. In addition, there is a brief guide to additional resources at the back. Together, they can help you in making critical decisions about your health care coverage and your retirement benefits." (Employee Benefits Security Administration, U.S. Department of Labor)
Case Sheds Light on Church Plan Exception
Excerpt: "Most benefits and insurance professionals familiar with COBRA administration clearly know that church plans are exempted from COBRA's requirements. What is less clear is when this exception actually applies. A recent district court case shed some light." (infinisource)
American Benefits Council Summary of COBRA Provisions in the Trade and Globalization Assistance Act of 2007 (PDF)
4 pages. Excerpt: "On October 31, 2007, the House passed H.R. 3920, the Trade and Globalization Assistance Act of 2007, which amends certain health provisions of the Trade Act of 2002. The 2002 Trade Act created a health care tax credit of 65% of the cost of qualified health insurance coverage for certain workers who were terminated due to foreign competition. The Act also gave these workers a second COBRA election period." (American Benefits Council)
COBRA Coverage May Be Terminated if Qualified Beneficiary Fails to Re-Enroll During Open Enrollment
Excerpt: "EBIA Comment: We agree with the court's reasoning and interpretation of the COBRA regulations. We also think that the outcome in this case was dictated in large part by the clarity of the employer's communications regarding open enrollment." (Employee Benefits Institute of America)
From the Employers Council on Flexible Compensation: Text of Extensive Comments on Proposed Cafeteria Plan Regs (PDF)
37 pages; filed November 5, 2007. Very well-written: clear, precise; includes explanation of issues and a detailed suggested revision for each issue. (Employers Council on Flexible Compensation)
Summary: Proposed Changes to 2002 Trade Act's Health Provisions on COBRA and Health Care Tax Credit (PDF)
5 pages. Excerpt: "Two committees of the House of Representatives recently proposed several changes to the health provisions under The Trade Act of 2002. The 2002 Trade Act created a health care tax credit of 65% of the cost of qualified health insurance coverage for certain workers who were terminated due to globalization. The Act also gave these workers a second COBRA election period. Two bills that would either expand the COBRA rights for these workers or change the tax credit provisions are working their way through House Committees." (American Benefits Council)
Failure to Provide Election Notice to Spouse Violated COBRA but Penalties Against Employer Were Not Justified
Excerpt: "EBIA Comment: DOL COBRA notice regulations issued in 2004 contain detailed guidance on how to provide notice to multiple qualified beneficiaries, resolving much of the conflict in the case law. Under the regulations, a covered employee and spouse may be notified by furnishing a single notice addressed to both of them if based on the most recent information available to the plan, the spouse resides at the same location as the employee." (Employee Benefits Institute of America)
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