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COBRA, HIPAA, FMLA, ADA Certification And More
COBRA, HIPAA, Sec 125 Compliance Seminars
TABLE OF CONTENTS
Part 1: COBRA BASICS
An Overview Of COBRA
Employers And Plans Covered By COBRA
- Employers And Plans Subject To COBRA
- Defining A "Group Health Plan"
- "Maintaining" A Group Health Plan
The Initial COBRA Notice
- The Initial COBRA Notice
- Consequences Of Failure To Provide The Initial COBRA Notice
- How To Send The Initial COBRA Notice
Covered Employees And Qualified Beneficiaries
- Who Is A "Covered Employee"
- Who Is A "Similarly-Situated Non-COBRA Beneficiary"
- Who May Be A QB
- Who May Not Be A QB
- A QB’s Rights Under COBRA
- QBs Located Outside Of The Plan's Service Area
- Repeal Of The "Core" Coverage Requirement
Qualified Events
- Defining A Qualified Event
- List Of Qualified Events
- What May Be A QE
- Expansion Of COBRA's Loss Of Coverage Definition
- What May Not Be QE
- Duration Of COBRA Coverage
- Expanded Coverage For Additional QEs (Multiple QEs)
- Special QE Issues: Gross Misconduct
- Special QE Issues: Disability
- Special QE Issues: Cessation Of Dependency Status
- Special QE Issues: Divorce Or Legal Separation
- Special QE Issues: Medicare And Initial QEs
- Special QE Issues: Medicare And Multiple QEs
- Determining The QE Date
- Providing More Than The Required COBRA Coverage
QE Notices
- QE Notices
- What QE Notices Should Include
- To Whom Should QE Notices Be Sent
- When To Send A QE Notice
- How To Send A QE Notice
- Handling Coverage During The Election And Payment Period
- Responses To Provider Inquiries Concerning QBs
Administration And Documentation
- Coordination Of Administrative Resources
- Summary Plan Descriptions
- Keep The Envelopes, Use The Postmarks
Timelines
- The COBRA Timeline
- Understanding And Managing The COBRA Timeline
- Employer And QB Notification To The Plan Administrator
- 14-Day Notification Period
- 60-Day Election Period
- 45-Day Retroactive Premium Payment Period
- 30-Day Grace Period
- Using The Correct Procedures
- Strategies For Protecting Against Accidental Free COBRA Coverage
- Finding Out About Other Coverage
- Rules Governing Terminating COBRA Coverage
Calculating COBRA Premiums
- Determining COBRA Premiums For Insured Plans
- Determining COBRA Premiums For Self-Funded Plans
- Handling Rate Changes
- COBRA’s 12-Month Determination Period
- Determining Rates For Related QB’s Who Independently Elect COBRA
- Rates For A QB’s Newly Added Spouse or Dependent
Billing And Collection Of COBRA Premiums
- How To Bill Current QBs
- Who To Bill For COBRA Coverage
- Who Can Pay For COBRA Coverage
- What Is Timely Payment: Premium Payment Deadline
- What Is Timely Payment: Timely Payment
- What Is Timely Payment: Partial Payment
- What Is Timely Payment: Employer Subsidized / Alternative Coverage
Part 2: SPECIAL SITUATIONS
Open Enrollments
- Who Is Entitled To Open Enrollment Rights
- Changes In Coverages During Open Enrollments
- Effect Of Plan Terms On QBs' Open Enrollment Rights
- Plan Changes And Their Effect On QBs
- Open Enrollment Changes By Active Employees And Potential QEs
Medicare
- Medicare Basics
- Entitlement vs. Eligibility
- Medicare And Initial QEs
- Medicare And Multiple QEs
- Medicare As An Event Terminating COBRA Coverage
COBRA's Alternative Coverage Rules
- Defining Alternative Coverage
- Using Alternative Coverage To Offset COBRA
- Consecutive Coverage Method
- Concurrent Coverage Method
- Choice Method
- Making Your Alternative Coverage Method Work
- Choosing The Correct Method
Other Issues
- 1999 Final COBRA Regulations
- 1999 Proposed COBRA Regulations
- State Laws Health Care Continuation Rules
- COBRA And the Family And Medical Leave Act
- Conversion Coverage Rules
- Flexible Spending Accounts
- Deductibles, Limits, Split Family Units
- Mergers, Acquisitions, Business Reorganizations
- Penalties For Non-Compliance
Part 3: Sample Forms, Notices, And Checklists
- Documentation Form
- Initial COBRA Notice
- QE Notice - Termination/Reduction
- QE Notice - Cessation Of Dependency
- QE Notice - Death/Divorce - L.S./Medicare
- HIPAA Request For Certificate Of Coverage
- HIPAA Certificate Of Coverage
- HIPAA Certificate Of Coverage By Categories
- Termination Of COBRA Coverage Notice
- Responsibilities Checklist
- IRS Notice 98-12
Part 4: COBRA ADMINISTRATION PROCEDURES
- Suggested Procedure For Sending Initial COBRA Notice
- Suggested Procedure For Identifying QEs
- Suggested Procedure For Managing Cessation Of Dependency Status Issues
- Suggested Procedure For Sending QE Notices
- Suggested Procedure For Handling Coverage During The Election And Payment Period
- Suggested Procedure For Late And Partial Payments And Bounced Checks
- Suggested Procedure For Open Enrollment Changes
- Suggested Procedure For Determining Medicare Entitlement
- Suggested Alternative Coverage Procedure: Concurrent Coverage Method
- Suggested Alternative Coverage Procedure: Choice Method
Part 5: ABOUT THE MANUAL
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