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Agency FAQ: COBRA Notice May Include Additional Information About Exchange Options

FAQs About Affordable Care Act Implementation (Part 32) (June 21, 2016)

DOL Website

HHS Website

Visit the Health Care Reform Community on Checkpoint to join the discussion on this development (for Checkpoint subscribers to EBIA’s Health Care Reform manual).

The DOL, HHS, and IRS have jointly issued a single FAQ confirming that group health plan administrators may include in their COBRA election notices information about Exchange coverage that goes beyond the information included in the DOL’s model notice. (The DOL revised its model election notice in 2013 and again in 2014 to include basic information about the Exchanges. The model is available on the DOL website.) The FAQ states that administrators may include additional information, such as (1) how to obtain assistance with Exchange enrollment (including special enrollment), (2) the availability of financial assistance, (3) information about Exchange websites and contact information, (4) general information regarding particular products offered in the Exchanges, and (5) other information that may help qualified beneficiaries choose between COBRA and other coverage options. The agencies encourage administrators to consider how they can help individuals maintain the coverage that would best suit their needs and note that COBRA notices may be tailored to particular groups, such as young adults aging out of dependent coverage under their parents’ health plan. The FAQ also includes a reminder that COBRA notices must be “easily understood by the average plan participant.”

EBIA Comment: While use of the DOL’s model COBRA notice is not mandatory, many plans use the model as the basis for their own notices. Plan administrators must customize the notice by providing plan-specific information, selecting among various alternatives, and deleting information that is inapplicable. In addition, administrators may wish to add information to better inform qualified beneficiaries (e.g., additional Exchange details as contemplated by the FAQ) or to better protect the plan (e.g., notice procedures by which qualified beneficiaries must notify the plan of certain events). For more information, see EBIA’s COBRA manual at Sections XVIII.E (“The DOL’s Model Election Notice”) and XXVI.N (“Health Insurance Exchanges”); see also EBIA’s Health Care Reform manual at Section XXI.A.3 (“Annual and Special Enrollment Periods Required for Exchanges”).

Contributing Editors: EBIA Staff.

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