COBRA Continuation Coverage

The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows individuals to continue their group health plan coverage in certain situations. Specifically, COBRA requires group health plans to offer continuation coverage to covered employees and dependents when coverage would otherwise be lost due to certain specific events.

These events include the death of a covered employee, termination or a reduction in the hours of a covered employee’s employment, divorce of a covered employee and spouse, and a child’s loss of dependent status under the plan.

COBRA sets rules for how and when continuation coverage must be offered and provided, how employees and their families may elect continuation coverage and when continuation coverage may be terminated.

Employers may require individuals to pay for COBRA coverage. Group health coverage for COBRA participants is usually more expensive than coverage for active employees, since many employers pay a part of the premium for active employees.

Links and Resources

Cobra Basics 

  • COBRA allows certain employees, spouses and dependents to temporarily continue their health coverage at group rates.
  • COBRA coverage must be the same as the coverage that is available to similarly situated active employees who are not receiving COBRA benefits.

Compliance Tips

Avoid common compliance mistakes by:

  • Determining if COBRA applies to your health plan;
  • Knowing which events trigger the requirement to offer COBRA coverage;
  • Providing the required COBRA notices on a timely basis; and
  • Establishing payment procedures for COBRA premiums

When Does COBRA Apply?

Most private-sector employers that maintain group health plans for their employees must comply with COBRA’s continuation coverage requirements. This includes, for example, corporations, partnerships and tax-exempt organizations. However, COBRA does not apply to group health plans maintained by small employers. A “small employer” means an employer that had fewer than 20 employees on typical business days during the preceding calendar year.

COBRA also applies to plans sponsored by state and local governments. It does not apply, however, to plans sponsored by the federal Government or by churches and certain church-related organizations.

5 Healthy Snacks to Satisfy Your Workday Hunger

Snacking can be an important part of a healthy diet. Healthy snacks can provide midday energy boosts and fuel for exercising, and can help decrease your hunger and the odds of overeating at mealtime. Try incorporating these five simple snacks into your meal plan.

  • Almonds—1.5 ounces of almonds (about 35 nuts) provides enough fiber, protein and good fats to keep you feeling full until your next meal.
  • Greek yogurt parfait—1 cup of Greek yogurt with berries is a great way to get protein, calcium, fiber and antioxidants.
  • Blueberries and mini Babybel cheese—1 cup of fresh blueberries has only 80 calories. When paired with two mini Babybel cheeses, you get a high dose of fiber, antioxidants, protein and calcium.
  • Apple and ½ cup roasted chickpeas—Apples are fat-, sodium- and cholesterol-free. What’s more? One medium-sized apple has less than 100 calories. When paired with ½ cup roasted chickpeas, you get a snack that provides protein, and good fats and carbs.
  • Veggies with hummus—Snacking on raw, fiber-rich vegetables during the day can help keep you full between meals. For extra protein, eat your veggies with hummus. Be sure to check the serving size on your hummus container to keep your portion size in check.

Save Lives: Don’t Be a Distracted Driver

According to the Centers for Disease Control and Prevention, nine people are killed and over 1,000 others are injured every day in accidents that involve a distracted driver in the United States. The National Safety Council observes April as Distracted Driving Awareness Month to draw attention to this epidemic.

Distracted driving is driving while doing another activity that takes your attention away from the road, and can greatly increase the chance of a motor vehicle crash. While there is little you can do to control other people’s driving, there is plenty you can do to reduce your own distractions.

There are three main types of distractions:

  • Visual: taking your eyes off the road
  • Manual: taking your hands off the wheel
  • Cognitive: taking your mind off of driving

By practicing safe driving techniques, you can significantly reduce your chances of being involved in an auto accident. In addition to avoiding distractions, it’s important to be aware of other drivers around you and make adjustments to your driving accordingly.

Do You Know the Signs of a Kidney Stone? 

A recent study published in the Mayo Clinic Proceedings journal found that the prevalence of kidney stones has increased more than fourfold in women and more than twofold in men over the past 30 years.

If treated in a timely fashion, kidney stones usually don’t cause permanent damage. Seek immediate medical attention if you experience any of the following:

  • Pain so severe that you can’t sit still or find a comfortable position
  • Pain accompanied by nausea, vomiting, fever or chills
  • Blood in your urine
  • Difficulty passing urine

Apple Sage Wild Rice Stuffing

4 ounces pecans (chopped)

4 tsp. canola oil (divided)

1 ½ cups celery (diced)

1 ½ cups onions (diced)

1 medium-sized red apple (peeled, diced)

2 cups brown rice (cooked)

1 cup wild rice (cooked)

½ cup cranberries (dried)

1 jalapeno pepper (finely chopped)

1 ½ Tbsp. fresh sage (chopped)

¾ tsp. salt

Preparations

  • Heat a large skillet over medium-high heat. Add the pecans and cook 2-3 minutes or until beginning to brown, stirring frequently. Set aside on separate plate.
  • Heat 1 tsp. of the oil over medium heat. Cook the celery and onion 8 minutes or until beginning to lightly brown on edge, stirring occasionally.
  • Add the apples and cook 4 minutes or until fork-tender.
  • Stir in the pecans and the remaining ingredients and cook 3-4 minutes or until the rice mixture is heated, stirring occasionally.

Click Here to Access ARISTA’s April Wellness Calendar

Effective Benefit Plan Communication

The way that employers communicate benefits information to employees has a tremendous impact on how well the programs are understood, utilized and perceived by employees. Providing your employees with ample informative resources will help better convey your message.

Managers and supervisors can be effective in sharing important benefits information with employees, especially if it is scripted or “canned”.

Since they are most likely to know what their employees understand, they might be better able to present benefits information.

As an employee’s main point of contact, managers and supervisors also tend to be more approachable with questions.

Opportunities to ask questions, express dissatisfaction and discuss problems regarding benefits information with supervisors and managers should be encouraged.

Many employers use managers and supervisors to share benefits information, but this should be done with caution and help from the following tips.

Avoiding Verbal Communication Problems

Communicating inaccurate information to employees is always a major concern when using managers and supervisors to relate benefits information. Keep in mind that misinformation not only causes an employee relation problem, but has the possibility of causing litigation as well. Consider these tips to avoid problems:

  • Consider allowing only specific Human Resources personnel to discuss benefits information with employees.
  • Remind those who may be asked questions regarding benefits, such as supervisors and managers, to review their plan documents carefully. They should refer to the HR department any question they are at all unsure how to address.
  • Whether formal or informal, do not make promises regarding any aspect of the benefits plan that the company will not be able to keep.
  • State in the plan documents that plan amendments are to be made only in writing and approved by the corporate representative or plan administrator, if applicable.

Written Communication Cautions

Even if written material about benefits information is not an official plan document, informal written promises can still prevail in court. As a result, make sure even informal written communications about the plan is consistent with the official documents before distributing.

Employees often rely on summary plan descriptions to determine their rights under a specific plan. In the event of an issue due to discrepancies between plan documents and the summary plan document, the summary plan document can hold up in court. Because of this, it is crucial to make sure that the summary plan document is correct, current, clear and in agreement with the plan documents, handbooks and all other benefits information.

As a safety measure, be sure that the summary plan description, handbooks and other benefits communications state clearly that the plan document has absolute authority over them. This information should appear in a separate paragraph in a prominent position. Consider using larger, italic or boldfaced type, or by using a distinct border to make the information readily apparent.

Other general helpful tips include:

  • Keep a copy of each communication or disclosure sent to employees, however informal.
  • Grant discretion to fiduciaries in the plan document.
  • Make sure all documents relating to the plan do not include any misleading information before distributing. Request additional information from the plan administrator regarding information that you believe may be misleading.
  • Reserve the right to amend the plan at any time for any reason.

Summary of Benefits and Coverage

Since September 23, 2012 health insurance issuers and group health plans have been required to provide an easy-to-understand summary about health plans benefits and coverage.

Utilizing these simplistic health plan summaries can help you explain health benefits with your employees.

How to Handle an ACA Penalty Letter

The IRS has begun issuing letters to employers who are not offering health coverage to full-time employees. Under the Affordable Care Act’s (ACA) employer shared responsibility rule, applicable large employers must provide affordable health coverage to full-time employees or face stiff penalties.

There are two key provisions to the ACA’s employer shared responsibility rule that can trigger thousands of dollars in penalties:

  1. Full-time employees must be provided health coverage.
  2. That coverage must be adequate and affordable, as specified by the law.

Penalty amounts will depend on the year. Not offering health coverage could cost you between $2,080 and $2,320 per full-time employee. If coverage is unaffordable or inadequate, penalties range from $3,120 to $3,480 per affected employee.

Employer Takeaway 

Due to continued delays by the IRS, many employers may be surprised to see penalties dating back to 2015.

Receiving a letter does not necessarily mean you will be penalized. There is a response period where you can reply and indicate whether you agree to the fine or contest it.

For instance, an employee who triggers a penalty may have been working part time for a period or simply missed the enrollment deadline. In these types of situations, employers can argue against the penalties and explain themselves. Errors can usually be corrected by resubmitting forms.

Regardless if the penalty is contested or not, responding immediately is considered the best approach for employers. The forms required by the IRS can be complicated and time consuming to fill out, so waiting until the last minute could end up costing you.

Beyond responding immediately, employers are encouraged to speak with a tax or legal advisor on how to proceed if they receive a letter from the IRS.

Please let Arista Consulting Group know if you have any questions about these or any other ACA penalties.

The Importance of Plan Document Review

A recent supreme court ruling in CNH Industrial N.V. v. Reese exemplifies why carefully reviewing plan documents—like a collective bargaining agreement (CBA) or summary plan document (SPD)—is so important.

Employees claimed that the language of the agreement suggested benefits were vested for life, but the CBA itself listed an expiration date. The court conceded that if the agreement used ambiguous language like “lifetime” or “for life,” that would change the situation.

However, including an expiration date and avoiding such language makes it clear that the benefits are limited.

With these case details in mind, carefully review your plan documents, like your SPD or any other documents that discuss health benefits.

Make sure the language you use is not ambiguous and clearly lays out your intentions.
Speak with Arista Consulting Group for guidance.

Did You Know? 

Tax scams are on the rise. Don’t be fooled into giving your personal information or tax return to a thief. Scammers have complex methods for tricking individuals, most commonly by impersonating the IRS.

Know that the IRS will never demand immediate payment, request wire transfers, threaten to involve police or ask for credit card information.

Visit this site for more details on how to avoid being scammed this tax season and how to report scammers.
What Employres Need to Know about Account-Based Plans: halth FSAs, HSAs, HRAs, and QSE HRAs
This webinar will provide an overview of account-based plans, including health flexible spending arrangements (FSAs), health savings accounts (HSAs), health reimbursement arrangements (HRAs), and Qualified Small Employer Health Reimbursement Arrangements (QSE HRAs).