conquering cobra public

Go Beyond Coping… and Conquer COBRA.

© 2015 WageWorks Inc. All rights reserved. 2

Agenda1 COBRA: A quick primer

2 Liability is reality

3 There’s coping with COBRA…

4 …and there’s conquering COBRA

5 System Demonstration

6 DIY or Administrator?

7 What to look for in a COBRA Administrator

8 Questions


COBRA: A quick primer

Why COBRA?

• Consolidated Omnibus Budget Reconciliation Act of 1985

• Requires employers who sponsor group health plans to allow individuals to continue coverage:• Qualifying events

• Limited time, at applicable rates

• Covered employees and qualified beneficiaries



• Health plan changes for current employees must also apply to former employees

• Required Notices:• General Notice of Continuation Coverage

• Election Notice

• Early Termination Notice

• Notice of Unavailability



Thanks to the ACA, there are now Fair Health Insurance Premium requirements:

• These individual or “member-level” rates are determined using:• Age

• Location

• Tobacco status of each family member

• Applies to individual and small group (<50) markets now

• Groups <100 employees: 1/1/2016

• Large groups >100 employees: 1/1/2017


Liabilities are real

The penalties and liability with COBRA violations can be significantHere’s what happens if you don’t comply:

• $100 per day to the IRS for each day of non-compliance

• Excise taxes of $200 per day on each day the plan fails to comply with COBRA

• $110 per day to the beneficiary for each day of non-compliance

• Payment of claims incurred during non-compliance period

• Legal expenses


Significant and constant notification and communication requirements.

Constantly coping with COBRA

Date of Hire•HIPAA Special Enrollment Rights

Commencement of Coverage•COBRA General Rights Notice

Qualifying Event•COBRA Election Notice

Other Notices•HIPAA Privacy Notice•Women’s Health and Cancer Rights

Ongoing•Monthly Premium Invoice•Notice of Unavailability•Conversion Notice•Termination Notice

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There’s coping with COBRA...

And there are more administrative duties, such as:

• Compliance

• Coordination with insurance carriers

• Eligibility tracking

• Payments

• Audits

© 2015 WageWorks Inc. All rights reserved.

9

... And there’s conquering it

• Automation is key• Online, 24-7, real-time visibility

• Self service options for business:

• Add/terminate employees

• Review participant history

• Case monitoring and tracking of issues (in real time)

• Self service options for participants:

• Online payment of one or multiple premiums

• Advance payments

• Mobile App

• IVR

Make it easy on yourself.


Conquering COBRA

Alleviate fear and uncertainty.

Transition assistance:

• Licensed benefit advisors ease fear and uncertainty of former employees

• Provide education to new COBRA enrollees

• Assist with transition from COBRA to individual or public options


Conquering COBRA

Send COBRA election notices via USPS

Upload images of notices to website

Track election periods related to electing or declining continuation coverage

Report eligibility to carriers

Apply payments received to appropriate accounts and return payments that are not within COBRA guidelines

Answer questions from qualified beneficiaries

We do the hard work.


Conquering COBRA

We also:

• Provide courtesy monthly invoices to all COBRA participants• Payments must be made by the end of the grace period or the

participant loses their COBRA rights

• EZ payment• Standard mail

• Over the phone

• Online

• Automatic withdrawal


Conquering COBRA

When a COBRA coverage is terminated or cancelled, we:

• Send a termination letter to qualified beneficiaries, employer and carrier

• Notify of conversion or extension rights


What to look for in a COBRA Administrator

Participant Advocacy

• Education• Notifications • Customer Service• Transition

Assistance

Performance

Guarantees & Indemnity

• Contractually agree to service standards

• Offer indemnity:Penalties, finesClaims, Excise taxes,Attorneys’ fees

Compliance & Security

• Security of all online data

• Election period tracking

• Record and store coverage, elections, and notifications

Comprehensive,

Flexible System

• Support ACA MLRs • Accommodate

custom severance, benefits packages

• Provide 24/7 online access

• Case tracking, reliable reports

• Flexible payment options

Choosing the right administratorKey questions to ask:

• Do you offer any performance guarantees?• Do you indemnify ?• Can you accommodate custom severance

packages?• Does your system enable brokers and employers

visibility and self-service options?• What types of reports are available to brokers and

employers?• Are participant notices available online?• How do you track premiums and payments?• What types of support and education do you provide to COBRA participants?• What are your service standards for COBRA participants, and how are they

monitored?• How do you support an audit?

Who is WageWorks?


• Leading administrator of Consumer-Directed Benefits (CDBs)

• Servicing approx. 15,000 COBRA clients and 6 million participants

• Proprietary COBRA and CDB platforms

Questions?


Thank you.


conquering cobra public

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