One - Time Special Enrollment Period
The deadline is getting very close. Did you know that the Human and Health Services Department announced a one-time special enrollment period for individuals who are eligible for or enrolled in COBRA? If you are unsure how to go about enrolling, Mason and Associates can help. Small business health insurance will be impacted by this change as those terminated employees will have the opportunity to go on the Exchange and will no longer impact the renewal increases for their employer.
On May 2 the Department of Health and Human Services (HHS) announced a special enrollment periods and Hardship exemptions for persons meeting certain criteria. The reason HHS is allowing the one-time special enrollment is that they felt that the required notices did not include the information about the market place so the COBRA beneficiaries may not have had the information they needed to make a decision for their healthcare coverage.
- People who have coverage through COBRA (the Consolidated Omnibus Budget Reconciliation Act) are eligible
- In California, the Special Enrollment Period runs through July 15th, 2014. During this time, eligible consumers can shop and buy coverage through Covered California
- COBRA enrollees can apply at the Covered California website and use the €Other qualifying life event€ during the application process. They may choose any health plan offered through Covered California and get premium assistance and/or cost sharing reductions if they qualify.
- If your employer pays for your COBRA premium and stops, the loss of COBRA will not qualify the person for special enrollment. The person must wait until next fall at open enrollment.
Below are some FAQ's from the Covered California Website that may be helpful:
What is COBRA?
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires most employers with group health insurance plans to offer employees the opportunity to continue their coverage under their employer's plan even after termination, layoff or other change in employment status.
When employers offer health coverage, they usually pay part of the monthly premium for their employees. After losing a job, COBRA allows you to continue to be in the employer's group plan, but you will likely have to pay the full cost of the premium, plus an administrative fee.
Do I have to enroll in COBRA after losing a job?
You are not obligated to participate in COBRA. If you decline the initial offer of COBRA and are therefore newly uninsured, you will qualify for special enrollment in a Covered California health insurance plan. To take advantage of the special enrollment period, you must apply for and select a Covered California plan no more than 60 days after your employer coverage ends.
New information: If you are eligible for or currently enrolled in COBRA coverage, you can enroll in a Covered California health insurance plan through July 15, 2014.
If I lose employer health coverage, how do I decide whether to enroll in COBRA or in a health insurance plan through Covered California?
The choice of which program to enroll in is up to you, but here are some factors to consider when deciding between COBRA and a Covered California health insurance plan:
€ What doctors and hospitals are available in each plan?
€ What is the total monthly premium for you and your dependents?
€ What are the copays and deductibles in the various plans?
You may qualify for tax credits to help pay for a health plan with Covered California. These tax credits may make a difference when you are comparing the cost of COBRA and Covered California plans. The Shop and Compare Tool can help estimate tax credits and the cost of a plan with Covered California.
COBRA coverage and Covered California plans qualify as sufficient coverage to avoid the tax penalty, so choose based on cost and the doctors and medical services that are best for you.
For more information contact Mason and Associates or click on the resources below:
Covered California also has more information available at http://www.CoveredCA.com/faqs/cobra/
For more information about the special enrollment period: http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/SEP-and-hardship-FAQ-5-1-2014.pdf
On May 2 the Department of Health and Human Services (HHS) announced a special enrollment periods and Hardship exemptions for persons meeting certain criteria. The reason HHS is allowing the one-time special enrollment is that they felt that the required notices did not include the information about the market place so the COBRA beneficiaries may not have had the information they needed to make a decision for their healthcare coverage.
- People who have coverage through COBRA (the Consolidated Omnibus Budget Reconciliation Act) are eligible
- In California, the Special Enrollment Period runs through July 15th, 2014. During this time, eligible consumers can shop and buy coverage through Covered California
- COBRA enrollees can apply at the Covered California website and use the €Other qualifying life event€ during the application process. They may choose any health plan offered through Covered California and get premium assistance and/or cost sharing reductions if they qualify.
- If your employer pays for your COBRA premium and stops, the loss of COBRA will not qualify the person for special enrollment. The person must wait until next fall at open enrollment.
Below are some FAQ's from the Covered California Website that may be helpful:
What is COBRA?
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires most employers with group health insurance plans to offer employees the opportunity to continue their coverage under their employer's plan even after termination, layoff or other change in employment status.
When employers offer health coverage, they usually pay part of the monthly premium for their employees. After losing a job, COBRA allows you to continue to be in the employer's group plan, but you will likely have to pay the full cost of the premium, plus an administrative fee.
Do I have to enroll in COBRA after losing a job?
You are not obligated to participate in COBRA. If you decline the initial offer of COBRA and are therefore newly uninsured, you will qualify for special enrollment in a Covered California health insurance plan. To take advantage of the special enrollment period, you must apply for and select a Covered California plan no more than 60 days after your employer coverage ends.
New information: If you are eligible for or currently enrolled in COBRA coverage, you can enroll in a Covered California health insurance plan through July 15, 2014.
If I lose employer health coverage, how do I decide whether to enroll in COBRA or in a health insurance plan through Covered California?
The choice of which program to enroll in is up to you, but here are some factors to consider when deciding between COBRA and a Covered California health insurance plan:
€ What doctors and hospitals are available in each plan?
€ What is the total monthly premium for you and your dependents?
€ What are the copays and deductibles in the various plans?
You may qualify for tax credits to help pay for a health plan with Covered California. These tax credits may make a difference when you are comparing the cost of COBRA and Covered California plans. The Shop and Compare Tool can help estimate tax credits and the cost of a plan with Covered California.
COBRA coverage and Covered California plans qualify as sufficient coverage to avoid the tax penalty, so choose based on cost and the doctors and medical services that are best for you.
For more information contact Mason and Associates or click on the resources below:
Covered California also has more information available at http://www.CoveredCA.com/faqs/cobra/
For more information about the special enrollment period: http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/SEP-and-hardship-FAQ-5-1-2014.pdf
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