There are two types of COBRA notices you should get if you participated in a group health plan. The requirements can be different if your employer has less than 20 employees over 50% of the calender year. An initial notice when you are first employed that goes over many of the rights you have under COBRA, and a final notice, repeating that info and giving you the exact premiums and due date to maintain COBRA. Many companies use the model notice provided by the DOL or use their summary plan description as the initial notice or part of the final notice (minus premium and personal info).
The initial notice is usually less of a problem because you've just started employment at the company and actively engaging with HR, usually on much better terms. The only thing you may have to contend with are waiting periods while you wait for the subsidized employer sponsored group health insurance.
The final COBRA notice is trickier, especially with smaller companies that may not know how to send it, or what's required to be in it.
Who is in charge of getting me the notice?
Getting your COBRA notice revolves around the "Health Plan Administrator." That is who you need to contact in order to get your notice. Often it will be the employer who retains an "assistant" or "advisor" to tell them when to generate notices.
What must the COBRA notice include?
Name of the plan
Name, address and phone number of the party to reach for additional info
A general description of the coverage
Who is a qualified beneficiary
The type of qualifying events that give rise to coverage
The obligation of the employer to notify the plan administrator of certain qualifying events
The maximum period that continuation coverage is available
When coverage may be extended
The plans requirements about payment of premiums
When and how the beneficiary must notify the administrator of a qualifying event
When and how to give notice of a SSD determination
The importance of why to ensure the plan has current addresses for the plan beneficiary
Information that the notice does not describe all continuation rights and that more information is available from the plan administrator
An explanation that the plan may furnish both the covered person and the spouse only one notice if both persons reside at the same address
Is the SPD considered a COBRA notice?
The final rule does provide that notice in the Summary Plan Description (SPD) of the above would satisfy this notice requirement.
Many people get nervous when there's no health insurance to protect them financially. I know I do. If you suffer from a chronic illness and must forego treatment and medication while waiting for the notices to arrive, that can get infuriating and stressful.
For the benefit of the administrator / employer, the best course of action would be to provide the notice right away and not wait!
The time limits under COBRA are: Within 30 days of the date of a COBRA qualifying event, an employer must notify the administrator of the occurrence of that event; and Within 14 days of the date on which the administrator is notified of the event, the qualified beneficiary must be notified of the right to elect COBRA benefits
How long should I wait for the COBRA notice?
A frequent question is when an employer is also the plan administrator, how many days do they have to send the election notice?
It really depends on a document you most likely will never see the contract between the "Administrator" and employer. Some administration services are designated as "assistants" and not true administrators. Some COBRA administration, especially in a larger company, is done in house.
In a 1995 opinion letter, the Department of Labor concluded an employer who is also the plan administrator has 44 days to notify a qualified beneficiary of COBRA entitlement.
It all comes down to a case (Anderson v. Royal Crest Dairy, Inc., U.S. District Court, District of Colorado, Dkt. No. 001-K-2096, March, 2003) where the court ruled that since the employer had actual knowledge of the qualifying event on the day of the event, the court asked: "Why should the administrator/employer be given an additional 30 days when the COBRA statute specifically says the administrator should have 14 days?"
Does the COBRA notice have to be in writing?
You might be supposed to learn that the COBRA notice does not have to be in writing! But it will be harder to prove the notice was sent, if it was delivered in anything other than written form. If the participant does not agree that they were given all their rights verbally, an administrator going over their rights in person or by phone will not be sufficient and dependents or spouses would not be considered notified of their COBRA entitlement.
If it is found that the COBRA administrator is not notifying planned participants and willful about non compliance, there are significant DOL fines involved.
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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