(aka Initial Notice) no more than 90 days after you start your group health plan coverage. Since newly hired employees usually have a waiting period before they get offered company sponsored health insurance, they should not be given the notice until they are enrolled.
If the spouse lives with the covered employee, the General Notice should be sent to the home addressed to both. Covered dependents do not need a separate notice. The employer may substitute a general notice with a summary plan description, if the summary plan description has all the info required in the initial notice.
Notice to Plan Administrator
Qualified Beneficiaries must advise the plan administrator within 60 days of a qualifying event, such as: Divorce or legal separation, loss of dependent child status, or social security ruled disability.
If the Administrator has no written procedures outlining the notice requirements from the Qualified Beneficiary, verbal notice (or any type of notice) will be acceptable.
Notice of Unavailability
Once the Qualified Beneficiary gives the plan administrator notice of a qualifying event, if the plan administrator determines the Qualified Beneficiary is not entitled to the COBRA extension, they must provide written explanation inside a 14 day period.
COBRA Election Notice
After a Qualifying Event, the Plan Administrator must send every Qualified Beneficiary a notice with 14 minimum requirements outlined by the DOL. Your employer has 30 days to notify the Plan Administrator once you have a Qualifying Event. The Plan Administrator must send the COBRA Election Notice inside a 14 day period. If the employer self administers the group insurance plan, they have up to 44 days to send the notice.
If a participant has a chronic medical condition, it's not recommended to wait the full 44 days to send the election notice. The sick person may not get needed care because they cannot afford to pay for health care out of pocket.
Here in California, the Plan Administrator must also include a HIPP notice from the California Department of Insurance.
Extension Notice
The Plan Administrator should inform Qualified Beneficiaries that COBRA can be continued an additional 18 months (for a total of 36 months) in cases of Medicare Qualification or Disability (ruled by SSA). The extension notice should include details about when the premium payments are due, and costs are up to 150% of the full premium.
Open Enrollment Notice
COBRA enrollees and former participants (within the 60 day election period) must be kept informed of any plan or premium changes.
Conversion or Portability Notice
Conversion coverage option: Under the 1999 final COBRA regulations, if conversion coverage is available under your plan to active employees, you must provide COBRA qualified beneficiaries the option of enrolling under the conversion health plan. This offer must be made during the 180-day period that ends on the date on which the beneficiary's maximum COBRA coverage will expire. The COBRA regulation does require a separate notice requirement, but administrators must give qualified beneficiaries the choice of converting their health plan if possible.
The Summary Plan Description might have the required conversion info to satisfy the HIPAA requirement. Many professional administrators will send separate written notice of conversion 180 days of less of your ending your COBRA.
Craig Casey is an Writer, Coach, Blogger, Husband, and Former Health Insurance Agent helping people on the web since 1999 with their health insurance problems.
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