compliance
COBRA administration looks straightforward on paper: an employee has a qualifying event, you send a notice, they elect coverage or they don't. In practice, it's one of the more unforgiving corners of benefits compliance. The timelines are strict, the notice requirements are specific, and the penalties for getting it wrong can add up fast, even when the mistake was completely unintentional.
The good news is that most COBRA missteps fall into a handful of predictable categories. Once you know where employers typically go wrong, it's much easier to build a process that avoids those pitfalls altogether.
Here are five of the most common COBRA mistakes, and what to do instead.
Tis the season where open enrollments are occurring throughout the country. Employees are generally offered an array of benefits to choose from by their employer. This includes, but is not limited to, health insurance, dental insurance, vision insurance, Flexible Spending Accounts (FSAs), and more. It’s the most wonderful time of the year; however, employers need to make sure they comply with a very simple, but important rule.
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires employers with 20 or more employees to offer continuation coverage under a group health plan for periods of 18, 29 or 36 months depending on the qualifying event.
COBRA has been an administrative challenge for employers dating back to 1986 when it first became effective. On the surface, it’s easy to comprehend COBRA and its purpose, but behind the scenes, an employer has a lot of obligations it must account for to ensure compliance with the law. Take this scenario for example:
The fourth quarter is finally over, and you made it through! Now you’re probably planning to sit back, relax, and enjoy a well-earned break. Not so fast!
Open enrollment season can be unbelievably stressful and exhausting. With all the time you spent setting up enrollment meetings, chasing down employee applications and entering new benefit elections, you probably didn’t have a spare moment to think about benefits compliance. Unfortunately, compliance obligations don’t go away just because it’s your busiest time of the year.
The Employee Retirement Income Security Act of 1974 (ERISA) requires employers to provide a Summary Plan Description (SPD) to employees if they offer health, dental, vision, life, disability or other benefits.
It’s that time of year again. The days are getting shorter, the trees are mostly bare, the holidays are just around the corner and open enrollment is in full swing. If you’re like most benefits professionals, you probably head into open enrollment with a mixture of enthusiasm and dread.
Each year employers must provide a written notice to Medicare-eligible employees who are covered under their group health plan. The notice must include information about the creditable coverage status of the prescription drug benefit. In other words, the notice tells employees if the prescription drug benefit on the group health plan is at least as good as the standard Medicare Part D plan.
ERISA Section 607 defines the term group health plan as an employee welfare benefit plan providing “medical care” to participants or beneficiaries:
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