Compliance Briefing Center

COBRA

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WageWorks COBRA Bulletin #3

This is an update of WageWorks’ administrative process enhancements for general COBRA administration and those made necessary by the American Recovery and Reinvestment Act (ARRA) COBRA Premium Reduction provisions.

COBRA Participant Appeal Forms (Non ARRA Related)
We have recently developed new COBRA appeal forms for a participant to complete if they believe that their termination or non-commencement of COBRA continuation coverage was not appropriate.  WageWorks® will review any written participant appeals and respond to the participant in writing within 60-days. 

WW – Participants can locate these forms on our Web site at http://learnwageworks.com/LearningCenter

Note – This appeal form is not in any way related to the ARRA premium assistance appeal process which would always be handled through the Department of Labor (DOL) or Centers for Medicare and Medicaid Services (CMS).

Department Of Labor Appeal – Election Period for ARRA
WageWorks had originally interpreted the ARRA regulations to indicate that a participant only had 60-days from their notification date to enroll in ARRA premium assistance.  The 60-day deadline was added to all participant communications and followed the same enrollment requirement for COBRA continuation coverage.

WageWorks, however, recently received informal notification from the Department of Labor (DOL) in regards to a participant who was denied ARRA premium assistance because he turned in his ARRA enrollment form past the 60-day deadline.  Informal conversation with the DOL indicated that a COBRA participant may chose to elect ARRA premium assistance at any time during their eligible 9-months of premium assistance.

As a result of this DOL guidance, WageWorks has updated the prior denied COBRA participant’s accounts to enroll them in ARRA premium assistance as long as they were deemed eligible for all other ARRA requirements.   We have also updated our processing so that we will not deny a COBRA participant ARRA premium assistance for this reason.

 

State Continuation Coverage and ARRA
Over the last few months, several states have been releasing new or updating their existing COBRA state continuation coverage laws to include state sponsored premium assistance programs similar to the federally subsidized ARRA premium assistance.  WageWorks does not provide administration for state continuation coverage since these programs are intended to be managed by the individual healthcare providers.

In our efforts to ensure that all participants are made aware of the state premium assistance programs that may be available, WageWorks will include a general statement referencing state continuation as a possible option in our standard COBRA termination letter.  This information will be generic in nature as each state’s premium assistance laws will vary.  Participants will be instructed to contact their healthcare providers for specific details on the availability of the applicable state’s premium assistance program.

If you would like for WageWorks to assist you with an additional letter outlining your applicable state continuation coverage and premium assistance program for your participants, please contact your account manager for assistance.  Please note that additional fees for this special letter will apply.

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