COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) is a Federal law which requires "qualified beneficiaries" be offered the opportunity to temporarily continue certain employer sponsored health care benefits, at full cost, after experiencing a "qualifying event" that causes them to lose coverage. Qualified beneficiaries include covered employees and their dependents, and qualifying events include employment termination, reduction in hours, divorce, death, and Medicare eligibility.
For more information on COBRA, please see your enrollment materials or the US Department of Labor's COBRA FAQs.
1. New Hire Entry: All New Hires should be entered into our COBRA portal to have the General Rights Notice sent out.
2. Employee Termination: Within 30 days of termination, the employee's data will need to be entered into our COBRA portal as a Qualified Beneficiary.
Example: If the member is terminated on January 1st, the client has until January 31st to submit their information to Ameriflex.
3. COBRA Packet: The business day after the member is entered as a Qualified Beneficiary, the system will generate the Specific Rights Notice (COBRA Election Packet).
4. Election Period: Once the COBRA Election Packet is printed and mailed out, the member will have 60 days to elect COBRA online or via mail.
5. Payment Grace Period: Once the member makes their election either online or by mail, they have 45 days from that date to make their first full premium payment. All subsequent payments must be received within 30 days of the first of each month thereafter.
Example: If the member elects coverage on February 2nd, they have until March 19th to submit their first payment to Ameriflex.
6. Enrollment Notices: An Enrollment Notice will be emailed to the enrollment contact provided to us for each of the plans. The group is ultimately responsible for ensuring all enrollments and enrollment contacts are updated.
7. Remittance Report: Around the 9th of each month, a Remittance Report is generated. The Remittance Report shows all premiums collected through the end of the previous month.
8. Remittance Payment: Around the 15th of each month, Ameriflex will pay out all premiums collected from the prior month, minus subsidized admin fees, via ACH or Check.
9. Monthly Audit: It is highly advised that the group audits their carrier bills against the remittance report each month. Failure to do so could cause overbilling with the carrier.
10. COBRA Termination: Once a member is terminated from COBRA, a notice will again be sent to the enrollment contact for each plan, advising of the termination and the effective date.
11. COBRA Open Enrollment: Your COBRA members must go through Open Enrollment each plan year, just like a regular employee. Ameriflex is happy to run your COBRA Open Enrollment for you at an additional cost.
