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Posted

If a COBRA administrator does not send an invoice to an employee, does the responsibility fall on the administrator or the employee?

We have a former employee in this situation who did not make their payment since they didn't receive the invoice. They were termed from COBRA for non-payment.

As the employer, what concerns should we have with this?

Posted

By COBRA administrator, do you the Plan administrator who is an entity other than the employer, or a TPA?

Posted

Oop! I meant the TPA.

Posted

There is no regulation requiring an invoice. However, if you normally send an invoice and for some reason did not then the obligation is the Plan's. Your COBRA election notice should state specifically how and to whom payments are to be made.

Posted

So if the employee that was termed decided to take legal action, do they have a good chance of winning? In one case, the person did not even give us a chance to resolve the issue.

Posted

I would think that if the election notice gave the appropriate payment information and the COBRA QB did not pay the premium in the specified period of time, billing or no billing, the COBRA QB would be at fault.

Posted

I thought that may be the case, but wanted to concur with the experts! Thanks!

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