COBRA: What Employers Need to Know By Larry Grudzien Attorney at Law
Areas of Discussion Benefits Subject to COBRA Eligibility Coverage Premium Amounts Mergers & Acquisitions Medicare Health FSAs HRAs Dropping COBRA Coverage Mistakes Then your questions
Benefits Subject to COBRA Issues Which of these benefits is subject to COBRA? • Medical Benefits • Telemedical Benefits • Dental Benefits • Short-Term Disability Benefits • Vision Benefits • Dependent Care Benefits • Voluntary Benefits • HRAs • Wellness Benefits • Health FSA Benefits • Employee Assistance Benefits • QSEHRAs
Eligibility Issues • Does an employer have to offer COBRA to 1099 employees if it covered them? • Does an employee have to offer COBRA to an individual who is dropped in a dependent audit? • Does an employer have to offer coverage to a spouse of an employee that was dropped from coverage at open enrollment? • Does an employer have to offer COBRA to an employee who is eligible for its retiree medical coverage?
Eligibility Issues • Does an employer have to offer coverage to an employee who failed to pay his or her premium during FMLA leave? • Does an employer have to offer coverage to an employee who is out on Workers Compensation or short-term disability? • Does an employer have to offer COBRA to a former employee who waives medical coverage but wants to continue coverage under the HRA or Health FSA?
Coverage Issues • Does a COBRA participant have a right to add coverages at the next open enrollment or qualifying event? • Can a COBRA participant add a spouse or child if lost coverage during coverage period? • What coverage should an employer offer to a former employee at open enrollment occurs during the election period? • Does an employer have to give a separate election under COBRA for coverage under medical, dental and vision benefits?
Premium Amount Issues • How often can an employer change the COBRA premium amount during a year? • What COBRA premium is due at the end of the 45 day period? • Under what consequences can the premium payments be waived or tolled?
Mergers & Acquisitions • Does the Seller have to offer COBRA to its former employees in a stock sale? • Does the Buyer have to offer COBRA to former employees who they fail to employ in an asset sale? • Is the Buyer in an asset sale obligated to offer COBRA if the Seller drops medical coverage months after the sale?
Medicare Issues • Does an employer have to offer COBRA to family members if an employee voluntarily drops medical coverage to enroll in Medicare? • Does the employer have to offer COBRA to an employee who enrolls in Medicare before enrolling in COBRA? • Can an employer drop COBRA coverage for a former employee who becomes entitled to Medicare, but does not enroll?
Health FSA issues • When can an employer deny COBRA coverage to an employee who has a balance in his or her Health FSA at the time of the qualifying event? • Does an employee have to enroll in medical coverage to be entitled to COBRA coverage of his or her Health FSA? • What period of coverage is an employee entitled to under Health FSA? • Can an employee stop paying COBRA premiums for Health FSA coverage once he or she cleans out his or her FSA? • Can dependents elect COBRA coverage for the Health FSA?
HRA issues • Can a former employee waive group medical coverage and just enroll in the HRA under COBRA? • Can a dependent elect COBRA for HRA if the employee waives COBRA? • If each family member separately elects COBRA coverage for the HRA, what amount are they entitled to? • How is the COBRA premium determined?
Dropping COBRA Coverage Issues • Can an employer drop coverage for a COBRA participant who refuses to complete enrollment information from a new insurer? • What is gross misconduct? • When can an employer drop COBRA coverage for nonpayment?
Mistake Issues • What are an employer’s options if it did not provide a COBRA election notice to a former employee? • What are the employer’s options if it miscommunicated the amount of the COBRA premium? • What’s the consequences if an employer waives payment deadlines for one employee?
QUESTIONS?
Contact Information 708.717.9638 larry@larrygrudzien.com www.larrygrudzien.com Larry Grudzien Attorney at Law
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