The Department of Labor (DOL), Department of Health and Human Services and IRS jointly issued an important piece of guidance in June. In a single FAQ, the agencies confirmed that group plan administrators may include in COBRA election notices information about Health Insurance Marketplace coverage beyond that provided by the DOL's model notice. (The DOL revised its model election notice in 2013 and again in 2014 to include basic information about the Marketplaces. The model is available on the agency's website.) The FAQ states that administrators may include additional content, such as:
- How to obtain assistance with Health Insurance Marketplace enrollment (including special enrollment)
- The availability of financial assistance
- Marketplace website addresses and contact info
- General points regarding particular products offered by Marketplaces
- 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 plans. The FAQ also includes a reminder that COBRA notices must be "easily understood by the average plan participant."
Although use of the DOL's model COBRA notice isn't mandatory, many plans use the model as the basis for their own notices. Plan administrators must customize the notice by providing plan specifics, selecting among various alternatives and deleting inapplicable information.
In addition, administrators may wish to better inform qualified beneficiaries by including additional Health Insurance Marketplace details as contemplated by the FAQ. Administrators might also better protect their plans by describing notice procedures by which qualified beneficiaries must notify the plan of certain events.
If you have questions about COBRA notices, please contact Ron Present, Partner and Health Care Industry Group Leader, at rpresent@bswllc.com or 314.983.1358.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
