COBRA Resource Guide. COBRA Provider Best in Class.

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1 COBRA Resource Guide COBRA Provider Best in Class They worked to ensure the provisions of the law were followed to the letter and required no additional steps from their customers. Discovery Benefits lives up to their company motto Simplify. Benefitfocus, July

2 COBRA Relationship Cycle, Discovery Benefits, Inc. Implementation Ongoing Administration Renewal Your implementation manager: Helps Discovery Benefits understand the specifics of your COBRA administration Discusses any concerns you may have (compliance, unique participant situations, etc.) Completes system setup upon receipt of paperwork An entire team of account managers: Communicate with your former employees regarding COBRA qualifying events and COBRA rights Assist you with your ongoing COBRA compliance Answer your day-to-day questions Your dedicated renewal specialist: Answers your questions about open enrollment Collects and processes rate and benefit change information Communicates changes to carriers Each year, members of your COBRA team recertify in COBRA administration compliance.

3 Table of Contents PG 3 COBRA Division of Responsibilities Four Keys to a Successful COBRA Partnership PG 4 One: Notify us of new employees covered by your insurance plan PG 4 Two: Notify us about qualifying events as soon as possible PG 7 Three: Reconcile reports and premiums PG 8 Four: Provide information for open enrollment PG 9 About Discovery Benefits PG 10 Contact Information We re here to make your life simpler Part of that commitment is adhering to aggressive service benchmarks. Our business is built around processes that help you operate efficiently and get help when you need it. The response time has been excellent with all aspects of Discovery Benefits service. I have never received a response outside of 24 hours. I am almost always able to call and receive immediate attention, or the response is usually within a few hours. Discovery Benefits customer 1

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5 COBRA Compliance Simplified Since 1994, Discovery Benefits has simplified COBRA administration for employers nationwide. We handle the administration, stay current on regulatory changes and communicate with your participants and insurance carriers. That leaves you free to concentrate on other areas of your business. COBRA Division of Responsibilities Discovery Benefits: Monitors changes in COBRA regulations and communicates their potential affect on your organization Assists COBRA-qualified beneficiaries Provides ongoing communication with qualified beneficiaries - Department of Labor General Rights notification - COBRA Specific Rights (COBRA Election Packet) notifications upon qualifying events - HIPAA Certificate of Creditable Coverage when there is a COBRA qualifying event and a loss of coverage - Verify ongoing eligibility with qualified beneficiary in regard to Medicare, other group health plan coverage - Open enrollment information for participants: rates, plan changes, benefit changes - Notify qualified beneficiaries of early termination Deals with every aspect of premium payments from qualified beneficiaries - Send payment coupons and member portal login notice to qualified beneficiaries - Collect COBRA premiums by check, automatic recurring ACH or online - Deposit collected premiums in your custodial account or pay carrier(s) directly depending on agreement during implementation Terminates COBRA coverage at the appropriate time Provides a secure, online portal for employers - Real-time information about qualified beneficiaries - Reports and history - Ability to upload information - Ability to transfer information from general rights notice recipient s record to qualified beneficiary record Provides an online portal for participants - Real-time information about their COBRA coverage and account activity - Online enrollment Supplies information if your company is audited Employer: Notify Discovery Benefits of individuals covered by your organization s group health plan(s) - Upload or enter online newly covered employees and dependents upon the start of their coverage Notify Discovery Benefits about qualifying events - Upload or enter online qualifying event information for employees and dependents View monthly remittance reports - Reconcile funds received from Discovery prior to remitting premiums to the carrier Provide information for open enrollment - Determine and supply premium rates and communicate them to Discovery Benefits (45 days in advance) - Advise Discovery Benefits of changes in benefit options You guys make this process seem so easy! I really appreciate all that Discovery Benefits does for us. Discovery Benefits customer COBRA Division of Responsibilities

6 Step One: Notify us of new employees covered by your insurance plan Frequency: as necessary The Department of Labor requires that all employees covered under a group health plan be notified of their rights under COBRA within 90 days of becoming covered. Once you notify us of newly covered employees, we ll take care of the rest. Step Two: Notify us about qualifying events Frequency: as necessary The following events trigger COBRA eligibility if they result in a loss of coverage. As you communicate the qualifying event to us, please remember to notify your insurance carrier to cancel coverage, subject to retroactive reinstatement. Qualifying Event Reduction in hours Voluntary or involuntary termination or retirement (except for reason of gross misconduct) Social Security disability Death of the covered employee Divorce or legal separation of the covered employee from the employee s spouse Dependent child loses dependent status under the generally applicable requirements of the plan Coverage Period 18 months* 18 months* 29 months** 36 months for spouse and dependents 36 months for spouse and dependents 36 months for effected dependent * A second qualifying event within the coverage period allows the participant to extend coverage up to 36 months. ** A Social Security disability may extend an 18 month period of coverage an additional 11 months, up to a total of 29 months from the qualifying event date. Do you offer employee-sponsored severance or subsidized premiums? If the severance program and COBRA run concurrently, the COBRA premium may be subsidized by a percentage of the premium or a flat dollar amount, by benefit. Discovery will collect the nonsubsidized portion of the premium from the qualified beneficiary and remit it to you to pay the carrier. Subsidized payments may be prorated for the first month but must end on the last day of the month. Discovery Benefits will collect a two percent COBRA administration fee on the subsidized payment. 4 Four Keys to a Successful COBRA Partnership

7 How to notify Discovery Benefits Choose your method of communicating new plan members and/or qualifying events: 1. Enter information directly onto 2. Electronic files the Discovery Benefits Employer Submit electronic file via: Web Portal Go to OR Choose EMPLOYERS/CONSULTANTS > LOGIN Choose COBRA Employer Login Enter user name and password Use the wizard data entry tool online Secure or Client portal upload option, or Upload to secure FTP site 5

8 The Discovery Benefits Employer Web Portal It s 24/7 access to your company s COBRA activity where you can: Enter or upload information on new hires or qualifying events View information on specific members such as COBRA status, payment history, etc. Access COBRA reports that will provide you information on paid-through dates, premium reconciliation, ARRA status and others Attend Live Web Casts Each week, your Discovery Benefits Account Management team gives live webcasts on using the web portal efficiently. Please contact a member of the Account Management team for webcast dates and times. 6

9 Step Three: Access reports and reconcile premiums Frequency: monthly On the Discovery Benefits Employer Web Portal, you ll find a wide variety of real-time COBRA reports. Each time you run a report, you access the most up-to-date information available. Report options include: Assistance-Eligible Individual Subsidy Taken Qualified beneficiaries paid under the ARRA/DOD subsidy; includes employer subsidy and amount needed to complete IRS form 941 Client Remittance Monthly reports to help reconcile premiums received from Discovery Benefits Member Status Summary of the status of each qualified beneficiary Carrier Notifications (pending) Beneficiary Status Shows unprocessed notifications; those to be processed the next business day Carrier Notifications (processed) Shows processed carrier notifications Proof of Mail Verification of letters generated and mailed to qualified beneficiaries Plan Rate Renewal Shows renewals in the last 30, 60 or 90 days Paid-Through Displays payment status of beneficiaries currently enrolled Generated Letters Summary Illustrates total of all system-generated letters for a specific date range Generated Letter Detail Shows detail of system-generated letters for a specific date range Members without Plans Shows qualified beneficiaries in the system but not linked to a specific plan Qualified Beneficiary Plan Members Attaches qualified beneficiaries to a specific plan Member by Postal Code Snapshot of members in the system, including name, address, Social Security number, qualifying event date and qualified beneficiary status New Plan Member Records General Rights notice mailing date, name, address, Social Security number Qualified Beneficiary Summary Snapshot of each beneficiary s record Special Plan Member Summary Snapshot of each plan member s record Premium Remittance Premiums are remitted monthly either to you or your carrier(s) based on your company s setup. Depending on your insurance carrier, your options include: Distributions to you - If you choose this method, we urge you to reconcile money received against the Remittance Report online before you pay the insurance carrier. Skipping this step may cause you to overpay insurance premiums. - Report any discrepancies to Discovery Benefits. Payments made directly to the insurance carrier - Discovery will distribute the employee s premiums collected and any employer subsidized payments directly to the carrier. Please note that if there are any employer subsidized premiums, the funds will be collected from the employer via ACH agreement. Changes in premium remittance may be addressed at open enrollment time. Four Keys to a Successful COBRA Partnership

10 Step Four: Provide information for open enrollment Frequency: annually A COBRA renewal specialist will contact you a minimum of 90 days prior to the end of your benefit year to remind you of your company s benefit anniversary date. Please have available: (45 days before effective date) Rate changes Benefit changes including carrier Once we receive your information, Discovery Benefits will: Communicate applicable changes to COBRA participants. - We provide a standard letter at no charge. - We include additional enclosures for an additional fee. Submit open enrollment forms to the appropriate carriers and update our records once the forms are returned. This resource guide provides a summary of COBRA rights and responsibilities. It is not intended to be a complete guide to COBRA regulations and guidelines. 8 Four Keys to a Successful COBRA Partnership

11 Discovery Benefits Award-winning, people-centered The cornerstone of our business is to provide responsive and flexible administrative services that create value for our clients and their employees. We are a customer-focused organization blending people and technology to provide high-quality customer service and administration. Our recent awards reflect a commitment to excellence. CDHC Solutions Innovative Service Provider Business Insurance Best Places to Work Benefitfocus COBRA Provider, Best in Class OnBase RealSolutions Award ITCND Technology Innovator Award INFORMATION TECHNOLOGY COUNCIL OF NORTH DAKOTA Where we do business Discovery Benefits has clients in all 50 states. Product history 1987 Flexible benefits administration 1994 COBRA administration 2003 Transportation benefit plans 2004 Health reimbursement arrangements, health savings accounts 9

12 COBRA Contacts For Employers, Consultants and Brokers: M-F, 7 a.m. 7 p.m. CST FAX: For COBRA Participants: cobraadmin@discoverybenefits.com M-F, 6 a.m. 9 p.m. CST FAX: Mail Payments to: Discovery Benefits PO Box 2079 Omaha, NE Phone: Fax: Discovery Benefits PO Box 829 Fargo, ND _0812