When an employee leaves or has another significant change in their life that would result in losing eligibility for health insurance, COBRA regulates the continuance of an employee’s or their dependant's insurance.

Disregard of COBRA can result in fines and other legal repercussions - especially if someone’s health ends up at risk. The best way to avoid problems is to ensure that your record keeping is accurate and that you are aware of COBRA guidelines.


Private/federal employers with 20 or more employees. Employers with under 20 employees fall under state continuance which closely follows COBRA requirements.


A COBRA notice must be provided at the start of Employee coverage or hire.

A COBRA election notice must be provided within 14 days after notified of qualifying event; delivery in person or by first class mail to each person who qualifies.

The employer must notify plan administrator of an employee death, termination, medicare qualification, or a reduction of work hours within 30 days.

(fines of up to $100 per day for not complying with above requirements)


To notify employer/plan adminstrator within 60 days of: divorce, legal separation, or change in dependant status (e.g. leaving school).

Must respond to election notice within 60 days and will have an additional 45 days before premium payment is due. (Each person who qualifies may choose to elect coverage separately.)

(neglecting to respond to election notice within 60 days will result in loss of COBRA coverage)


Beneficiary may be billed for up to 102% of the group health rate.

Plan administrator is not required to send a monthly premium invoice, but must make it clear when payment will be due. Beneficiary is required to make timely payments to avoid cancellation of coverage.

This is an overview of the time requirements under COBRA, for a thorough review please contact us for a COBRA FAQ Sheet.

 

1. Lower Back Disorders
2. Depression
3. Heart Disease
4. Arthritis
5. Pulmonary Disease

These are chronic conditions that account for nearly 30% of all disability claims.

The pricetag on just these claims? An estimated $500 billion in lost productivity and healthcare costs.

Preventative care and wellness services can reduce the risks and out of work time for your employees.


In 2003, the rate of unscheduled absences fell to a historical low of 1.9%. This has lowered costs from an average of $789 per employee in 2002 to $645 per employee in 2003.

The change is attributed to morale boosting efforts in many companies. Companies that report poor morale have absentee rates 17% higher than companies with good morale.



The US outspends the rest of the world in annual healthcare costs per capita:

  •  $4887 on healthcare

  •  $605 on pharmaceuticals

  •  Totals 13.9 of the US GDP

The next highest spender on healthcare is Switzerland at $3248 per capita; which is only 10.9 of its GDP. (source: OECD)


Volume 2/Winter 2004/Benefit Matters is a publication of Shepard Insurance Group
1700 East Putnam Ave, Old Greenwich, CT 06870 Phone: 203.637.6655 Fax: 203.637.6700
www.shepardinsgrp.com
Contact us: Benefit Matters