why b3pa for cobra administration?

COBRA Administration

Why Choose B3PA for COBRA Administration?

We have successfully managed COBRA participants through innovative software, superior service and offering total transparency in our solutions. In today’s world, many companies are taking advantage of the abilities and capabilities of Third Party Administrators.

COBRA outsourcing has become the trusted way of reducing compliance risks while decreasing costs. But, let’s face it, the more employees, the more potential compliance issues.

  • We are a trusted name in the industry – 20 years of experience; B3PA, powered by partner COBRA Management Services, has been administering COBRA since 1997.
  • Fast implementation in the industry; we can fully implement a group in one week.
  • User-friendly state-of-the-art systems.
  • Fast and accurate mail fulfillment ensures high-quality and timely mailings; we can provide same-day fulfillment when needed.
  • B3PA’s well-trained COBRA experts will work closely with HR staff and COBRA participants for thoughtful and timely responses.
  • Integrated with Employee Navigator.
  • Excellent customer service with a dedicated Account Manager.
  • 24/7 Access to online accounts for COBRA participants.
  • $1 per eligible participant per month for groups under 100 and $0.75 per eligible participant per month for groups over 100 ($50 per month minimum).

Initial Qualifying Event

  • Notice and Election Form to qualified beneficiaries with USPS proof of mailing.
  • General (Initial) Notice to newly enrolled, active employees and, if applicable, spouses, with USPS proof of mailing.

COBRA Extension 

  • Notices due to second qualifying events and Social Security disability.
  • Early Termination Letter if COBRA coverage is terminated early for any reason.
  • Insufficient Premium Letter sent to COBRA participants whose underpayment is less than or equal to 10% of the total premium due but at most $50.00.

Courtesy Notices

  • Late Payment Reminders are sent on or around the 20th of each month to those participants whose premium payments have yet to be received.
  • Partial Payment Letter sent to COBRA participant whose underpayment does not fall within the “insufficient premium” guidelines above and will lose coverage at the end of a month unless payment for the balance owing is timely made.
  • Maximum Continuation Notice sent 6‐8 weeks before the end of a participant’s maximum continuation period as an alert and again after COBRA exhausts.

Reporting and Monthly Accounting

  • Reports are provided after the close of the prior month. The customer has 24/7 access to interim activity reports and previous months’ audited reports in their online MyCOBRA account.

COBRA FAQ

How long do I have to decide if I want COBRA coverage?

You will have an election period of at least 60 days to decide whether to continue your health plan with COBRA or to seek coverage through the Health Insurance Marketplace, through a spouse’s employer or Medicaid. 

Don’t wait too long to make a health coverage decision. Several of your best choices are only available for a limited time. Generally, you must request special enrollment in your spouse’s employer’s plan within 30 days of losing eligibility for other health coverage, and you must elect COBRA continuation coverage within 60 days of receiving the COBRA election notice.

Even though the Department has extended those timeframes in the Joint Notice, you should be aware of the limited time available to exercise your healthcare coverage options. Additionally, you must apply for special enrollment in an individual health plan within 60 days of losing employer-sponsored coverage, and that timeframe has not been extended.

If you still have questions about your rights or need help getting benefits, you may contact one of our benefits advisors at www.askebsa.dol.gov or 1-866-444-3272.

How much does COBRA health insurance cost?

It costs the same as your previous monthly health plan, plus a 2 percent service charge.

However, because you will now be responsible for the premiums that were once subsidized by your employer, your parents’ employer, or your spouse’s employer, the monthly cost shouldered by the consumer are much more significant. On average, employers pay nearly 82 percent of the cost of their employees’ health insurance, and almost 70 percent of the total family premium, so this means COBRA insurance can be up to 82 percent costlier for a consumer than their previous monthly payment. 

You may be able to get coverage that is more affordable than COBRA coverage through the Health Insurance Marketplace, which provides special enrollment periods for certain qualifying events, including loss of qualifying health coverage due to the death of a family member or when an employer stops contributing to a temporary continuation of your coverage (such as COBRA). For more information, visit https://www.healthcare.gov/coverage-outside-open- enrollment/special-enrollment-period/.

What counts as a qualifying event for COBRA? 

According to the U.S. Department of Labor, the following are qualifying events for covered employees:

  • Termination of the employee’s employment for any reason other than gross misconduct
  • Reduction in the number of hours of employment 

My employer did not pay the insurance premium for my group coverage. May I pay the premium to continue my coverage?

 You should contact your employer to determine whether the employer intends to pay the premium. You may also wish to contact your state insurance commissioner regarding any rights you may have under state law to pay premiums directly to the insurance company or convert your health coverage to an individual policy. 

Can my employer terminate or reduce my health benefits at any time?

Employers offer health benefits on a voluntary basis. Federal law does not require employers to offer health coverage to their employees, nor does it generally prevent employers from cutting or reducing benefits.

However, employers may have to take certain steps (such as providing advance notice) before reducing health benefits. If an employer terminates your health benefits, depending on the reason for termination, you and your family may have a right to continuation coverage under COBRA, if the plan still exists or a related employer still has a plan. You may also have a contractual right to coverage if, for example, benefits are required under a collective bargaining agreement. In addition, a plan cannot deny eligibility or continued eligibility based on an individual’s health status.

Depending on your coverage, the law may restrict the plan or health insurer from making mid- year changes. In response to the COVID-19 outbreak, plans otherwise restricted from making mid-year changes may add telehealth and other remote health services, in addition to services related to diagnosis and treatment of COVID-19, mid-year and without providing 60 days’ advance notice as required under federal law. 

Such plans may not limit or eliminate other benefits or increase cost-sharing, to offset the costs of those services and must provide notice of the changes as soon as reasonably practicable. See Families First Coronavirus Response Act FAQs Part 42,  at https://www.dol.gov/sites/dolgov/files/ebsa/about-ebsa/our- activities/resource-center/faqs/aca-part-42.pd(setting forth non-enforcement policies for certain expansions in coverage in response to the COVID-19 outbreak).

 

For information on the Affordable Care Act and how it relates to employers offering health coverage, visit https://www.cms.gov

The following are qualifying events for the spouse and dependent child of a covered employee:

  • Termination of the covered employee’s employment for any reason other than gross misconduct
  • Reduction in the hours worked by the covered employee
  • Covered employee becomes entitled to Medicare
  • Divorce or legal separation of the spouse from the covered employee
  • Death of the covered employee
  • Loss of dependent child status under the plan rules (plans that offer coverage to children on their parents’ plan must make the coverage available until the adult child reaches the age of 26)

Why is focusing on health coverage right away important when I lose eligibility for my employer’s plan?

Employers offer health benefits on a voluntary basis. Federal law does not require employers to offer health coverage to their employees, nor does it generally prevent employers from cutting or reducing benefits. However, employers may have to take certain steps (such as providing advance notice) before reducing health benefits.

If an employer terminates your health benefits, depending on the reason for termination, you and your family may have a right to continuation coverage under COBRA, if the plan still exists or a related employer still has a plan. You may also have a contractual right to coverage if, for example, benefits are required under a collective bargaining agreement. In addition, a plan cannot deny eligibility or continued eligibility based on an individual’s health status.

Depending on your coverage, the law may restrict the plan or health insurer from making mid- year changes. In response to the COVID-19 outbreak, plans otherwise restricted from making mid-year changes may add telehealth and other remote health services, in addition to services related to diagnosis and treatment of COVID-19, mid-year and without providing 60 days’ advance notice as required under federal law. Such plans may not limit or eliminate other benefits or increase cost-sharing, to offset the costs of those services and must provide notice of the changes as soon as reasonably practicable. See Families First Coronavirus Response Act FAQs Part 42,  at https://www.dol.gov/sites/dolgov/files/ebsa/about-ebsa/our- activities/resource-center/faqs/aca-part-42.pdf(setting forth non-enforcement policies for certain expansions in coverage in response to the COVID-19 outbreak).

For information on the Affordable Care Act and how it relates to employers offering health coverage, visit https://www.cms.gov/

I had COBRA coverage before the COVID-19 outbreak. The location I was sending my COBRA premium to is closed. Where do I send my premium?

Contact your employer for the information needed to continue making your COBRA premium payments. If you can’t contact your employer, you may contact one of our benefits advisors at www.askebsa.dol.gov or 1-866-444-3272.

I am a retiree and I receive retiree health benefits from my former employer. The company was affected by the COVID-19 outbreak. Can my retiree health benefits be terminated or changed?

Employees and retirees should know that private sector employers are not required by law to promise retiree health benefits. When employers do offer retiree health benefits, nothing in federal law prevents them from cutting or eliminating those benefits unless they have made a specific legally binding promise to maintain the benefits. 

The key to understanding your retiree health benefits lies in the documents governing your plan. If you have not already done so, you should obtain a copy of the Summary Plan Description (SPD) to determine the nature of the employer’s promise to you. If you do lose your retiree benefits, you may qualify for a special enrollment period to enroll in other coverage, discussed more above.

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