Changes That can Cause a Health Plan to Lose Grandfathered Status
If your health plan was purchased prior to March 23, 2010 it is considered to have grandfathered status and doesn’t have to follow the ACA’s rules...
2 min read
Kayla Kelly : May 6, 2015 6:30:04 AM
COBRA stands for the Consolidated Omnibus Budget Reconciliation Act. It is a law that requires health insurance providers to offer continuation coverage to employees and dependents when their coverage ends for certain reasons. The laws of COBRA apply to health plans managed by companies with at least 20 full-time employees.
Unfortunately, COBRA can be difficult to manage in an organization, especially for business owners who are inexperienced with it. Here are some of the best practices for handling COBRA concerns in your organization.
The biggest difference between COBRA and the Affordable Care Act (ACA) is that COBRA is continuation coverage for people who have recently left a job or were laid off.
The Affordable Care Act is a sweeping reform to healthcare, both employer-sponsored and individual. The Affordable Care Act has resulted in the creation of insurance marketplaces, where employers and employees can go to shop for the plans that work best for them. COBRA does not have this type of open plan system; it is limited to one plan, the same one that the employee had at their former workplace.
Generally speaking, someone who has eligibility for COBRA will also be able to purchase an insurance plan on a state’s marketplace. However, COBRA usually requires the policy holder to pay for the full cost of the insurance premium, while the Affordable Care Act provides tax credits for citizens below a certain income level.
COBRA isn’t just for employees; it also extends to their dependents, including spouses and children. However, there are some qualifying events that may cause a person to lose COBRA coverage. For example, if an employee divorces their spouse, they can only get COBRA coverage for a maximum of 36 months after the divorce is finalized. This is why it’s important to take a thorough survey of your team and understand who is eligible for COBRA benefits.
It’s very important that your staff knows their rights when it comes to COBRA and other insurance concerns. For example, last year the Department of Labor announced that employers must make it clear to employees eligible for COBRA that they are allowed to choose a plan from the Health Insurance Marketplace. You should also be certain that you have a resource available for them to consult with when they need to get questions answered about the various employer-sponsored insurance options that are available.
It’s vital to make sure that you are up to date on laws that relate to COBRA and the Affordable Care Act, as this is an area that is currently changing quickly as a result of new legislation going into effect over the next few years.
To help you create an easier, more efficient system of monitoring, consider investing in modern tools designed to simplify the way that businesses handle COBRA and other insurance concerns. Paypro offers numerous HR solutions to help manage insurance plans, as well as a number of group health options to ensure that your employees have access to all of the health insurance that they need. You can also turn to Paypro for help with your benefits administration: the Employee Self-Service platform allows your team to get the information they need, while our Benefits Specialists are able to provide expert insight into how you should be managing employee benefits. Paypro has everything your business needs to spend less time worrying about staying compliant with insurance laws and more time leading the company to success.
If your health plan was purchased prior to March 23, 2010 it is considered to have grandfathered status and doesn’t have to follow the ACA’s rules...
Many employers are still using paper to enroll their employees even though the ability to automatically apply eligibility rules, collect elections...