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content of the notices required under the continuation coverage provisions and establish standards for administering the notice process. These rules affect administrators of group health plans, participants and beneficiaries (including qualified beneficiaries) of group health plans, and the sponsors and fiduciaries of such plans. These rules also provide model notices for use by administrators of single-employer group health plans to satisfy their obligation to provide general notices and election notices.

The final COBRA notice rules consist of four separate regulations.

  • The general notice of continuation coverage requirement.

  • The general notice must be written in a manner to be understood by the average plan participant.

  • The general notice must meet the content requirements as listed in the final rule.

  • A single notice addressed to a covered employee and covered spouse is usually sufficient provided they reside at the same location.

There is no requirement to provide a separate notice to dependent children who share a residence with the employee or spouse when the general notice was provided in accordance with notice requirements.

The New DOL Regulations create rules for employer-provided notices of the occurrence of a qualifying event. These COBRA rules require employers to provide notice to the administrator of the plan of the occurrence of a qualifying event that is the employee's death, termination of employment (other than by reason of gross misconduct), reduction of hours, Medicare entitlement of the covered employee, and certain bankruptcy proceedings. The notice must include sufficient information to enable the plan administrator to determine the applicable plan, the covered employee, the qualifying event and the date of the qualifying event. The notice must be provided not later than 30 days after the date of the qualifying event.

The new regulations also address the responsibilities of qualified beneficiaries to provide notice of a qualifying event or a disability. These include notices of qualifying events for:

  • A divorce or legal separation of the covered employee from his or her spouse.

  • A dependent child ceasing to be covered as a dependent under the plan.

  • Second qualifying events after a qualified beneficiary has become entitled to continuation coverage with a maximum of 18 (or 29) months.

  • A qualified beneficiary's entitlement to receive continuation coverage with a maximum duration of 18 months after disability has been determined by the Social Security Administration (SSA).

  • The end of a disabled qualified beneficiary's disability as determined by the SSA.

To order additional copies of Self-Funding of Health Care Benefits , Fifth Edition, visit the International Foundation Web page at http://www.ifebp.org/bookstore/selffundhc.asp or call (888) 334-3327, option 4.

© 2004 International Foundation of Employee Benefit Plans, Inc. All rights reserved.

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