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Model Notices to include Health Insurance Marketplace Coverage Option

On May 2, 2014 it was announced by the Obama administration that model notices have been updated to inform workers of their eligibility for continuation of health-care coverage through COBRA.  The updates make it clear to workers that if they are eligible for COBRA continuation coverage when leaving a job, they may instead choose to purchase coverage through the Health Insurance Marketplace.

The Model General Notice of COBRA Continuation Coverage Rights is available on the Department of Labor Website (http://www.dol.gov/ebsa/modelgeneralnotice.doc). The notice includes the following paragraph:

“You may have other options available to you when you lose group health coverage.  For example, you may be eligible to buy an individual plan through the Health Insurance Marketplace.  By enrolling in coverage through the Marketplace, you may qualify for lower costs on your monthly premiums and lower out-of-pocket costs.  Additionally, you may qualify for a 30-day special enrollment period for another group health plan for which you are eligible (such as a spouse™s plan), even if that plan generally doesn™t accept late enrollees.”

The Model COBRA Continuation Coverage Election Notice document can be accessed on the Department of Labor website (http://www.dol.gov/ebsa/modelelectionnotice.doc). The notice includes the following paragraph:

“This notice has important information about your right to continue your health care coverage in the [enter name of group health plan] (the Plan), as well as other health coverage options that may be available to you, including coverage through the Health Insurance Marketplace at www.HealthCare.gov or call 1-800-318-2596.  You may be able to get coverage through the Health Insurance Marketplace that costs less than COBRA continuation coverage.”

In addition, the Department of Health and Human Services is publishing a clarifying bulletin regarding a special enrollment period in the Marketplace for individuals already enrolled in COBRA continuation coverage. The bulletin is posted on the HHS website at http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/SEP-and-hardship-FAQ-5-1-2014.pdf.

A related notice of proposed rulemaking on the COBRA notice requirements will be published in the May 7 edition of the Federal Register.

If you have any questions please do not hesitate to contact one of our professional consultants.

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