— ISSUE 31 —

COBRA-UPMC Employer OnLine Review


You are receiving this newsletter because you are a valued client of UPMC BMS COBRA administration. We aim to provide you with important information regarding recent errors identified in COBRA subgroup plans, which have resulted in premium billing discrepancies with UPMC Health Plan. Additionally, we would like to reiterate the UPMC Health Plan Employer OnLine (EOL) terminations and UPMC BMS COBRA notifications process.

We are experiencing situations where BMS COBRA client employers, brokers, or client representatives are mistakenly enrolling members into COBRA subgroups via UPMC Health Plan Employer OnLine. Specifically, COBRA subgroup plan codes are being selected for active employees instead of the appropriate active employee subgroup plan codes. While UPMC BMS has reporting mechanisms in place to identify these post-enrollment, we aim to be more proactive in preventing incorrect enrollments from occurring in the first place.

When adding or updating enrollments for active employees, please be mindful of the plan subgroup code you are selecting. We are seeing a higher occurrence with the UPMC dental and vision plans. However, similar errors have also been identified with the medical plans.

These enrollment errors are resulting in COBRA subgroup plans being in arrears with the Health Plan, as no COBRA premiums are being remitted. Please refer to the example below, which illustrates how the EOL indicates whether a plan subgroup is for active employees or COBRA.

Example:

This month UPMC Health Plan will implement an enhancement to UPMC Health Plan Employer OnLine that will require the selection of a subgroup for either Employee Member Type or COBRA Beneficiary Member Type in all areas of EOL. Please see below example.

Example:

We would like to reinforce the COBRA notification process received through UPMC Health Plan Employer OnLine terminations and BMS COBRA administration. This process applies to clients who have all lines of coverage with UPMC Health Plan, utilize UPMC Health Plan Employer OnLine for coverage terminations, and have opted in to have their COBRA qualifying events automatically reported to our team via a daily termination report from the Health Plan.

If you have opted into the EOL COBRA functionality, you will need to access EOL to process only the employee termination. UPMC BMS will receive the employee termination on the daily termination report from the Health Plan and will generate a COBRA notice for the terminated employee. If the former employee elects COBRA and remits their initial payment, BMS will reinstate the COBRA coverage. Terminating an employee and automatically adding the member to a COBRA subgroup plan counteracts BMS COBRA administration and billing processes.

If you have any questions, please don't hesitate to reach out to your COBRA analyst. If you're unsure who your COBRA analyst is, feel free to email us at cobra@upmc.edu.

Disclaimer: The above information is for informational purposes only and is not legal or tax advice. UPMC Health Plan and UPMC Benefit Management Services do not provide legal or tax advice. For legal or tax advice, please contact your attorney or tax adviser.