COBRA Subsidy Extended 6 More Months

With less than two weeks left in the year, the U.S. Senate on Saturday passed legislation that extends until the end of February eligibility deadlines for some key unemployment benefits.

That’s especially important in Michigan, which continues to have the nation’s highest unemployment rate – 14.7% in November.

Attached to the $636-billion defense spending bill passed on an 88-10 vote by the Senate on Saturday morning, the unemployment extensions now go to President Barack Obama for his signature, which is expected to come quickly.

U.S. Sen. Debbie Stabenow of Michigan said the unemployment extensions and other measures provide help at a time when Michiganders “are struggling to put food on the table, pay heating bills, and afford the health care they need.”

“While recovery from this recession and the creation of jobs cannot come quickly enough, I am relieved Congress was able to pass these important measures to soften the blow of unemployment,” added Michigan’s senior U.S. senator, Carl Levin.

The legislation makes some key changes to programs which were set to expire. For instance:
•The congressional stimulus bill passed in February created a program that paid 65% of monthly insurance premiums for people who lost their employer-based health care coverage because they were laid off. But that program was only open to people who lost their jobs – and their coverage – by the end of 2009. The new bill extends that eligibility deadline by two months, until the end of February 2010.
•It also adds six months to what was a 9-month period that the federal government would make the 65% of payments through the COBRA health plan, extending the period of payments to 15 months.
•The legislation also extends the deadline to qualify for additional unemployment benefits. Last month, Congress passed legislation adding 14 more weeks of emergency benefits – and six more on top of that for people in hard-hit states like Michigan. But they were only available to people exhausting all their other unemployment benefits by the end of December. The new bill extends that deadline to the end of February.
•It also maintains 2009 federal poverty guidelines – which if reset could have moved some people off food stamps and Medicaid – and adds additional funding to the food stamp program.
•Finally, the legislation authorizes the Small Business Association to continue programs to make loans more attractive to borrowers and lenders, in order to free up credit for businesses.

House Passes COBRA Subsidy Extension; Next, Senate Needs to Act

WASHINGTON-The U.S. House of Representatives overwhelmingly approved legislation Wednesday that would extend the federal subsidy of COBRA health insurance premiums for employees who are involuntarily terminated.

Embedded in H.R. 3326, a measure appropriating funds for the Department of Defense, the nine-month, 65% premium subsidy would be extended by six months to a total of 15 months. It would apply to those who lose their jobs through Feb. 28, 2010. Under current law, employees who lose their jobs after Dec. 31 are ineligible for the subsidy.

The measure, approved on 395-34 vote, also would provide an additional six months of subsidized coverage for beneficiaries whose nine-month COBRA premium subsidy has run out.

In addition, the legislation would give beneficiaries whose subsidy ran out and who didn’t pay the full premium a second chance to opt for coverage. For example, a beneficiary whose nine months of subsidized coverage ran out Nov. 30 and who didn’t pay the regular unsubsidized December premium could pay the 35% premium share in January and receive coverage for December.

The legislation would require employers to notify current COBRA beneficiaries and future beneficiaries of the new 15-month premium subsidy.

The House also is expected to take up another appropriations bill, H.R. 2847, with a provision that would extend the premium subsidy to those who lose their jobs through June 30, 2010.

The Department of Defense bill, Washington observers say, is on “fast-track” consideration and could be quickly approved by the Senate.

COBRA Extension Bill Introduced

Representative Joe Sestak (D-PA), a member of the House of Representatives Education and Labor Committee, introduced  the Extended COBRA Continuation Protection Act (H.R. 3930) on October 26, 2009. The measure would amend the American Recovery and Reinvestment Act of 2009 (ARRA) to extend the eligibility period and maximum period for COBRA premium assistance.  Currently, eligibility for the nine-month subsidy is limited to individuals who have been involuntarily terminated from employment on or after September 1, 2008, through December 31, 2009 and who lose coverage during that period. 

Specifically, H.R. 3930 would extend the ARRA COBRA subsidy eligibility to those who are involuntarily terminated between January 1 and June 30, 2010 and extend the maximum period of assistance to 15 months. 

H.R. 3930 also includes a six-month extension of COBRA coverage. For individuals who are eligible for COBRA as a consequence of termination (or reduction in hours) of employment “occurring on or after April 1, 2008 and before January 1, 2010, if the maximum required period of COBRA continuation coverage is 18 months, such period is extended to 24 months.”  The Council is seeking clarification of this legislative language, however, as the time frame for eligibility for this six month extension is inconsistent with timeframes that appear in the introduction to the bill and other section headings. 

This measure could be included as part of comprehensive health care reform legislation, currently pending in both chambers of Congress or in legislation extending unemployment benefits and other expiring provisions of the stimulus legislation. H.R. 3200, the Affordable Health Care for America Act in the House already includes a provision extending the duration of COBRA coverage.

Senate Finance Committee Health Care Reform Bil

According to http://boston.bizjournals.com/boston/stories/2009/09/14/daily31.html 

“The legislation calls for taxing insurance companies if they offer high-end insurance plans. A $6 billion annual fee also would be assessed on all health insurance companies. Pharmaceutical companies, medical device companies and clinical laboratories also would be hit with new taxes.”

Now, who is going to pay the $6 billion? I can’t believe those insurers are going to take it off their bottom line, so how does this reduce the cost of insurance, and how can this be claimed as reform?

Aetna offers Employers Sample ARRA Attestation Form

Aetna has published a sample of the form client employers may use to attest to a involuntary separation eligible for ARRA. Follow this link.

http://www.mmamktg.com/aetna/midatlanticsmallgroup2009/pa_hb1089_continuation_psletter.pdf

Pennsylvania Department of Insurance Link Reviews the Mini Cobra PA Q&A and links for Model notices included in the Q&A

Pennsylvania Department of Insurance Link  Reviews the Mini Cobra PA Q&A and links for Model notices included in the Q&A; follow this link for details:

 http://www.ins.state.pa.us/ins/cwp/view.asp?a=1274&Q=550035&PM=1#when

IBC wants PA Mini-COBRA Model Notice Portion Returned when Employee Eligible for ARRA

Independence Blue Cross (IBC) of Philadelphia, Pennsylvania has announced that it wants the PA Model Notice Election Form from PA Dept of Insurance – returned if a separated employee is eligible for ARRA  ( Premium Assistance).

Note: Cobra Control Services, LLC will provide its clients’ separated employees with a facsimile version of this election form in its standard PA Mini-COBRA Qualifying Event Notice. Such clients do not need to be concerned about sending this form. However, clients will be required to provide such election form to IBC when their separated employees enroll in an IBC coverage and is eligible for ARRA.

http://s3.amazonaws.com/pgica/556/employee_model_notice_fiinal070909.pdf

Aetna’s Letter to Insurance Brokers re: Pennsylvania Mini-COBRA

The following letter was provided insurance agents/brokers from Aetna regarding PA Mini-COBRA

New Pennsylvania requirements for state continuation

New Pennsylvania legislation (HB 1089) became effective on July 10, 2009.  We’ll be sending letters to plan sponsors explaining the law and our joint requirements established by the state.

The law

The law effects employees (and their eligible dependents) who are employed by a small group (2 to 19 employees); and makes them eligible for Pennsylvania state continuation when coverage is lost due to a qualifying event (i.e. the date the coverage would otherwise terminate). This coverage is available for up to 9 months.

Who is eligible for the subsidy

  • Former employees that elect continuation coverage of health benefits, as made available under state law, between July 10, 2009 and December 31, 2009.
  • Former employees who have not exhausted his or her state continuation rights as mandated by state law.
  • Former employees whose modified adjusted gross income is not more than $125,000 (individual filer)/$250,000 (joint filer).

Plan sponsor requirements

  • Complete and submit an Employer Attestation for any individuals who are eligible for the subsidy.
  • Give the terminating employee notice of continuation within 30 days of the date insurance would otherwise terminate.
  • Notify us within 14 days of the member’s election for state continuation.

For your information, click here for a copy of the letter that your clients will receive. 

Additional information, such as examples of qualifying events and premium costs, may be found on the PA legislation site.

If you have any questions, contact your Aetna Small Group Account Executive or our Broker Sales Support Team at
1-877-28-Aetna (1-877-288-3862).

Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies. Those companies include Aetna Health Inc.,and Aetna Health Insurance Company.© 2009 Aetna Inc.
980 Jolly Road
Blue Bell, PA 19422

Independence Blue Cross (IBC) PA Mini-COBRA Frequently Asked Questions

 

Q     
Who is covered under
Mini-COBRA?

A      
Those covered under
Mini-CORBA include former employees and eligible dependents who were
continuously insured under their group policy for an entire three-month period
ending with the employee’s termination.

 

Q   Who is not available for continuation coverage
under Mini-COBRA?

A   Mini-COBRA coverage is not available
for:

§ 
anyone covered under the
policy who is covered by, or is eligible for coverage under Medicare;

§ 
anyone who fails to verify
that he or she is ineligible for employer-based group health insurance as an
eligible dependent;

§ 
anyone who is a member of an
Individual medical plan, self-insured plan, or stand-alone dental plan;

§ 
anyone who is or could be
covered by any other insured or uninsured group health coverage arrangement and
under which the person was not covered immediately prior to such termination
(excluding Medical Assistance, CHIP, and adultBasic);

§ 
a group that is no longer a
viable business.

 

Q     
What benefits will be available under the continuation
plan?

A      
The same hospital, surgical,
or major medical benefits provided to everyone else under the plan.

 

Q     
When will continuation coverage start?

A      
Coverage will start on the
date of the qualifying event.

 

Q     
When will continuation coverage end?

A      
Coverage will terminate when
the former employee or eligible dependent is no longer eligible for the coverage
(see eligibility list above), or the first of the following triggering events:

§ 
nine months after coverage
terminated as a member of the group because of a qualifying
event;

§ 
the end of the period for
which the covered person paid a premium, if the covered person fails to make
timely payment of premium;

§ 
the date the group policy is
terminated.

 

Please note that if a former employee or eligible
dependent is no longer eligible for the coverage, he or she must notify the
administrator within 14 days of the triggering event.

 

Q     
How much will continuing coverage
cost?

A      
Mini-COBRA premiums will be
billed to the employer. Employers may be billed up to 105 percent of the current
group rate to cover the premium and administrative fees.  

  

Q     
Is there any assistance available for reducing the
Mini-COBRA premium?

A      
The American Recovery and
Reinvestment Act (ARRA) of 2009 temporarily reduces the Mini-COBRA premium in
some cases. If a former employee or eligible dependent is eligible for
continuation coverage as a result of an involuntary termination during the
period from July 10, 2009, to December 31, 2009, he or she may be eligible for a
premium reduction through ARRA. Because of ARRA, the premium for continuation
coverage will be reduced to 35 percent, with IBC covering the remaining 65
percent.

 

Q     
How does an involuntarily terminated employee apply for
the ARRA subsidy?

A      
If your employee elects
Mini-COBRA continuation coverage and
believes that he or she meets the criteria for the premium reduction, please
complete the section of the application labeled – “Application for Treatment as
an Assistance Eligible Individual” and return it to IBC. You can find the
application online at www.ins.state.pa.us.

 

Q     
Is everyone, who is involuntarily terminated, eligible
for a premium reduction through ARRA?

A      
No. The following individuals
are not eligible for COBRA premium
assistance through ARRA:

§ 
individuals eligible for
other group health coverage (such as a spouse’s plan) or
Medicare;

§ 
individuals involuntarily
terminated prior to July 10, 2009, whether or not they elected
COBRA;

§ 
individuals terminated for
gross misconduct;

§ 
registered domestic partners or same-sex spouses.

Q     
What are group leaders required to do? 

A      
When a qualifying event
occurs, group leaders are responsible for notifying the former employee and IBC
within 30 days. The Pennsylvania Insurance Department provides model notices on
its website, www.ins.state.pa.us, which
you can use to notify your employees.

 

Q     
What are members required to do? 

A      
If a former employee or
eligible dependent elects to continue coverage under Pennsylvania Mini-COBRA, he
or she must complete the Mini-COBRA application and return it to you for
verification within 30 days of notice of the qualifying event. Group leaders
have 14 days to return the application to their independent broker, consultant,
or IBC account executive.

 

Q     
Where is the application?

A      
The application is available
online at www.ins.state.pa.us.

 

Information about COBRA and New York Mini-COBRA from Empire Blue Cross

Empire Blue Cross (New York) offers this helpful summary of COBRA: http://www.empireblue.com/employer/noapplication/f0/s0/t0/pw_b131391.pdf