COBRA & Section 125 Special Enrollment, Election Periods, and Payment Parameters
The Department of Labor final rule, "Extension of Certain Timeframes for Employee Benefit Plans, Participants, and Beneficiaries Affected by the COVID-19 Outbreak" extends time periods for federally mandated Special Enrollment Periods, COBRA election and payment parameters.
The IRS also released guidance, "Increased Flexibility with Respect to Mid-Year Elections under a §125 Cafeteria Plan during Calendar Year 2020". This guidance allows but does not require that employees covered under a §125 plan make mid-year elections for health coverage, health FSAs, and dependent care assistance programs, in response to a change of need due to COVID-19.
What is the duration considered for the COVID Outbreak Period (start and end)?
When is the end of the COVID-19 emergency considered? When does the 60 days expire?
Will Guardian honor retroactive COBRA reinstatements during the COVID Outbreak Period?
How long does the participant have to elect COBRA continuation coverage?
How long does a participant or qualified beneficiary have to notify the plan of the COBRA qualifying event or determination of disability?
How long does the participant have to make the initial COBRA premium payment?
How far back will the COBRA enrollment be processed?
Who is responsible for the COBRA premium payments?
Are there any special accommodations or considerations for participant payment of ongoing COBRA premiums?
How will retro terminations be processed?
If someone elects COBRA coverage, but does not make a premium payment, can the coverage be terminated back to the qualifying event date and premiums reimbursed to the employer?
What is the date range for the HIPAA special enrollment period?
What benefits do the Section 125 and HIPAA special enrollment accommodations apply to?
How will Guardian handle the extended HIPAA special enrollment periods?
What impact do the changes to Section 125 plans have on Guardian?
If a group with Section 125 wants to make plan changes (as noted above), do they need to submit anything to us, or will we allow these changes without question?
Will late entrant penalties, waiting periods, etc. apply?
What are the new extended claims and appeals procedures?
How will Guardian comply with the new extended claims and appeals procedures and provide the appropriate notices? (including dates claims can be filed, date claim appeals can be filed, date required to request an external review of denied claim)
