Issue 16

What you need to know

As you approach your Open Enrollment period, it’s important to remember that COBRA-qualified beneficiaries have the same rights as active employees. During Open Enrollment, employees are given the option to change their benefits, as well as add or remove dependents. COBRA regulations provide that qualified beneficiaries may change their coverage at Open Enrollment to the same extent as similarly situated active employees.

If you are offering an Open Enrollment period to your active employees, you must offer those same Open Enrollment options to your COBRA participants. Here’s a look at the information and options that should be made available to them:

Review of plan options

Open Enrollment materials should be provided to each COBRA-qualified beneficiary and should include the following information:

• How long the Open Enrollment period lasts (including the deadline to submit requested changes)
• The plans available (medical, dental, and vision, as applicable)
• Rates for the upcoming plan year
• Steps the qualified beneficiary will need to take to renew and/or change coverage (such as completing and returning an Open Enrollment form)
• The contact information of the employer and/or COBRA administrator

Option to change plans

During Open Enrollment, qualified beneficiaries must be given the same options as similarly situated active employees, including adding new plans and changing from one plan to another. For example, if an employer offers medical and dental coverage under two separate health plans and a COBRA-qualified beneficiary initially elected medical only for his or her COBRA coverage, he or she must be given the opportunity to add dental to his coverage during the plan’s Open Enrollment period.

Option to add dependents

During Open Enrollment, COBRA-qualified beneficiaries must be given the option to add dependents to their coverage. If, for example, a COBRA-qualified beneficiary elected and paid for Individual Only COBRA coverage at the time of the qualifying event, he or she must be allowed to add family members to his or her COBRA coverage under the plan during Open Enrollment period (to the same extent that a similarly situated active employee can do so).

Don’t forget about coupons!

Once the Open Enrollment period has ended and all updates have been made, it’s important to send new premium payment coupons with the new monthly rates to your COBRA participants. If you use UPMC Benefit Management Services as your COBRA administrator, this service is standard.

We hope that you find these tips helpful as you approach your Open Enrollment period. We know that Open Enrollment is a busy time of year. Processing Open Enrollment is time consuming and requires a lot of effort and diligence. With everything that needs to be done—from updating rates to creating and mailing materials, receiving and tracking Open Enrollment forms and answering questions—we’re here to help. Our COBRA Administration service can alleviate some of the burden by handling your COBRA Open Enrollment process for you (if you have the buy up service).

If you have any questions, please get in touch with your dedicated COBRA analyst. If you’re not sure who your dedicated COBRA analyst is, please contact us at cobra@upmc.edu for further assistance.

Go Green

So many of us receive communications electronically these days, so why not get COBRA and other billing notifications via email as well?

UPMC Benefit Management Services offers a “Go Green” option that can ease the burden of mailing documents. Check out Issue 14 under the Archive tab to read the original article.

There are many benefits of using electronic delivery:

• Reduced use of paper
• Improved delivery and receipt of notices by avoiding undeliverable letters or lost mail
• Increased security with no incorrect or double stuffing of letters or theft from mailboxes
• Faster delivery time as participants can view notices immediately

Participants selecting this communication preference will receive an email alerting them when new notifications are sent to their COBRA participant account. The following communications will be available via email:

• COBRA enrollment confirmation notices
• Retiree/Direct bill enrollment confirmation notices
• COBRA premium coupon books and notices
• Retiree/Direct bill premium coupon books and notices
• 45-day notices (with or without payment)

Please contact your assigned COBRA analyst to activate the Go Green function or if you have any additional questions.

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 solicitor or tax adviser.