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COBRA Open Enrollment
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COBRA Open Enrollment
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If someone declines COBRA medical coverage during the 60 day window, but elects vision, Can they then turn around and add medical coverage during an Open Enrollment period? Example: John Doe elects d
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Forums » Topic Forums » Benefits & Compensation » COBRA Open Enrollment
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COBRA Open Enrollment
posted at 3/28/2012 7:56 PM EDT
on Workforce Management
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Posts: 3
First: 3/28/2012 Last: 4/4/2012 |
If someone declines COBRA medical coverage during the 60 day window, but elects vision, Can they then turn around and add medical coverage during an Open Enrollment period? Example: John Doe elects dental and vision COBRA but declines medical during the 60 day window. During Open Enrollment he requests to be to COBRA medical. My gut is telling me "no" since the plans are independent of one another, and he declined COBRA for medical during his 60 day window. Everything I have read, states that you have to provide OE the same open enrollment period rights but as per the example I gave, I believe only if they have a valid COBRA medical election, correct? Please help - any guidance or clarification is welcome. |
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Re: COBRA Open Enrollment
posted at 3/29/2012 10:04 AM EDT
on Workforce Management
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Posts: 127
First: 9/21/2011 Last: 11/12/2012 |
it is my understanding that they would no longer be a qualifying beneficiary or have a qualifying event for the medical plan at open enrollment once declined, even if they keep another part of the COBRA benefit. They can change the specific COBRA benefit that they chose to keep, but can't add on others. You can also check the EBSA at : http://www.dol.gov/ebsa/pdf/cobraemployer.pdf and there is a number on there to call. And there is a COBRA booklet from which I am quoting and my comments are in parentheses: "A qualified beneficiary is an individual who was covered by a group health plan on the day before a qualifying event occurred and who is either an employee, the employee’s spouse or former spouse, or the employee’s dependent child.... (the ex-employee was a QB at the time of termination)If a qualified beneficiary waives continuation coverage during the election period, he or she must be permitted to later revoke the waiver of coverage and elect continuation coverage, as long as the revocation is done before the end of the election period. If a waiver is later revoked, however, the plan is permitted to make continuation coverage begin on the date the waiver was revoked... (the ex-employee waived continuation coverage and therefore is no longer a QB once the election period has passed) beneficiary is currently receiving under the plan, such as the right during an open enrollment season to choose among available coverage options." (since he/she is no longer a QB for health insurance, the OE doesn't count for that benefit) |
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Re: COBRA Open Enrollment
posted at 4/2/2012 11:36 AM EDT
on Workforce Management
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Posts: 3
First: 3/28/2012 Last: 4/4/2012 |
That was my understanding as well. What you describe is the minimum required by the law, and if it has been allowed for COBRA participants to add coverage that they previously waived, then we have been going above and beyond for participants. Thank you! |
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Re: COBRA Open Enrollment
posted at 4/2/2012 3:24 PM EDT
on Workforce Management
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Posts: 127
First: 9/21/2011 Last: 11/12/2012 |
And I don't know many group insurance contracts that allow for adding them back into a COBRA status. Usually it's not the employer that makes the decision but rather whether the carrier will allow it (and I don't know any who will save an error on the part of the carrier/employer) I know that with us BCBS makes us jump through major hoops for things like this, there is no way to automatically get them back into the system. Are you self-insured? |
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Re: COBRA Open Enrollment
posted at 4/11/2012 1:56 PM EDT
on Workforce Management
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Posts: 1
First: 4/11/2012 Last: 4/11/2012 |
I recently attended a US DOL benefits seminar and was told they would be eligible to enroll since they must be given the same rights as all other employees and assuming your medical plan is as described in the regulations above "such as the right during an open enrollment season to choose among available coverage options." and carriers have allowed it in my experience - you may wish to call the DOL directly to confirm - they are very easy to get in touch with and are actually helpful. |
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Re: COBRA Open Enrollment
posted at 4/11/2012 2:06 PM EDT
on Workforce Management
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Posts: 2
First: 3/22/2012 Last: 4/11/2012 |
I've been doing COBRA for 18 years and only last year learned while attending a COBRA seminar that COBRA enrollees do have the right to enroll in previously declined plans. It seems ludicrous to me but that's our federal government.  I also checked with our carrier and it is allowed because of the COBRA law. (If you can get to one of Matt Isbell's COBRA seminars, you'll learn more than you ever wanted to about COBRA. www.cobraman.com) |
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Re: COBRA Open Enrollment
posted at 4/11/2012 5:12 PM EDT
on Workforce Management
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Posts: 2
First: 11/15/2011 Last: 4/11/2012 |
The QB should be allowed to enroll in COBRA medical during open enrollment. From the DOL's "An Employer's Guide to Group Health Coverage" under the "Benefits Under Continuation Coverage" section, located at: http://www.dol.gov/ebsa/publications/cobraemployer.html#BenefitsUnderContinuationCoverage "A qualified beneficiary receiving continuation coverage must receive the same benefits, choices, and services that a similarly situated participant or beneficiary is currently receiving under the plan, such as the right during an open enrollment season to choose among available coverage options." So basically, what you offer to your active participants, you need to offer to your COBRA QBs (with respect to COBRA benefits only). This includes allowing QBs to add dependents to coverage during open enrollment. |
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