On May 2, 2014, the Department of Labor (DOL) issued a proposed rule and an FAQ (Part XIX) with clarifying information about the Affordable Care Act.
New COBRA Model Notices
The DOL has issued updated versions of the model general and election notices to reflect that the Marketplace is now open and better describe special enrollment rights in Marketplace coverage.
The general notice must be furnished to each covered employee (and their spouses if covered under the plan) within 90 days from the date they become covered under the plan, or as otherwise provided in DOL guidance. The election notice must be provided after the plan administrator receives notice that a qualifying event has occurred.
Please note that there is no legal obligation to use these model COBRA notices. However, any administrator who uses the revised notices (appropriately completed) will be deemed to have complied with the notification requirements. Employers that self-administer COBRA and rely on the model notices should begin using the new model notices immediately. Employers that use a third party to administer COBRA should determine their responsibility for distributing these notices and confirm that the updated notices are being used.
Your Compliancedashboard has been updated with the new model notices as part of the COBRA Notices compliance activity. Compliancedashboard users who have the COBRA category on their dashboard will soon receive a compliance activity email with a link to this activity.
Marketplace Special Enrollment
A person eligible to elect COBRA may want to compare COBRA continuation coverage with coverage that is available through the Health Insurance Marketplace. Certain individuals may be eligible for a premium tax credit and cost-sharing reductions that make the Marketplace coverage more affordable than COBRA. However, individuals who elect COBRA are generally not eligible to enroll in Marketplace coverage outside of the annual Open Enrollment, unless they qualify for a special enrollment or their COBRA coverage is exhausted.
Because the Model COBRA Election Notices (available prior to this proposed rule) did not sufficiently address Marketplace options, individuals may not have had sufficient information to understand that they could enroll in in the Marketplace as a result of their COBRA qualifying event. Therefore, these individuals will be provided an additional special enrollment period based on exceptional circumstances so that they can select coverage in the Marketplace.
Affected individuals may enroll through July 1, 2014 by contacting the Marketplace call center at 1-800- 318-2596.
New CHIPRA Model Notice
The proposed rulemaking also included an updated model notice regarding premium assistance under CHIPRA. This model notice has information about the Marketplace and may be used to satisfy the notice requirement regarding premium assistance under CHIPRA. The CHIPRA compliance activity has more information about this requirement and the new model notice.