Employers Need to Know By Larry Grudzien Attorney at Law Areas of - - PowerPoint PPT Presentation

COBRA: What Employers Need to Know

By Larry Grudzien

Attorney at Law

Benefits Subject to COBRA Eligibility Coverage Premium Amounts Mergers & Acquisitions Medicare Health FSAs HRAs Dropping COBRA Coverage Mistakes Then your questions

Areas of Discussion

Which of these benefits is subject to COBRA?

• Medical Benefits
• Dental Benefits
• Vision Benefits
• Voluntary Benefits
• Wellness Benefits
• Employee Assistance

Benefits

Benefits Subject to COBRA Issues

• Telemedical Benefits
• Short-Term

Disability Benefits

• Dependent Care Benefits
• HRAs
• Health FSA 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

• r 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

• ccurs 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