| CommCare Premiums Stay Put |
On March 12, 2009, the Commonwealth Health Insurance Connector Authority's Board voted not to increase enrollee premiums for the Commonwealth Care program in fiscal year 2010. Please visit the Health Care For All website for further details.
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| COBRA Help for Laid-Off Workers |
Under the American Recovery and Reinvestment Act of 2009 (Division C, Title V, Subtitle B), employees with annual adjusted gross income below $125,000 ($250,000 for joint filers) who are involuntarily terminated between September 1, 2008 and December 31, 2009 may receive a nine-month subsidy of 65 percent of their COBRA premium. Employees who earn between $125,000 and $145,000 ($250,000 to $290,000 joint filers) may qualify for a reduced subsidy.
Notice
Effective February 17, 2009, private employers that offer group health coverage must identify and notify eligible employees (Assistance Eligible Participants or AEPs). Notices must state:
- Who is eligible for the subsidy
- Amount of the subsidy
- When the subsidy begins and ends
- How and when to apply for the subsidy
- Company contact information
- How to report other coverage and penalties for failing to do so
"Second chance" election notices must include:
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Description of subsidy rights
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Who is eligible to make a “second chance” election
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How and when to make a “second chance” election
Further guidance is available from the Department of Labor.
| "Second Chance” COBRA Elections
COBRA elections must be offered to AEPs who became eligible on or after September 11, 2008, but who did not elect (or who elected and later terminated) COBRA coverage. This special election period begins February 17, 2009 and ends 60 days after the company notifies the AEP of his or her rights. Companies must provide "second chance" notice and election forms by April 18, 2009.
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Duration of Subsidy
The subsidy begins with the first COBRA premium period beginning after February 17, 2009, and ends on the earlier of: a) nine months from the date it begins, or b) the end of the maximum COBRA period.
For AEPs who elect second chance COBRA coverage, the maximum COBRA period runs from the date of the original qualifying event to the first of a) the date the AEP fails to pay the required portion of the COBRA premium or b) the date the AEP becomes eligible for coverage under another group health plan or Medicare. For most plans, coverage for second chance AEPs will begin March 1, 2009 and end on or before December 31, 2009.
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Lower Cost Options
ARRA allows companies to offer AEPs the choice to enroll in (or switch to) lower cost options; AEPs must choose whether to elect such options within 90 days of receiving notice of the options. Notices must describe any lower cost coverage options, how and when to elect them, and when such coverage will begin and end.
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| New Special Enrollment Rights |
Children's Health Insurance Program Reauthorization Act of 2009
The Health Insurance Portability and Accountability Act (HIPAA) currently provides special enrollment rights upon the loss of eligibility for prior health coverage under certain circumstances, and upon the acquisition of a new dependent. Pursuant to the Children's Health Insurance Program Reauthorization Act of 2009, effective April 1, 2009, group health plans must also permit eligible employees and dependents to enroll outside of open enrollment where: (1) the employee's or dependent's Medicaid or CHIP coverage is terminated due to loss of eligibility, and (2) the employee or dependent becomes eligible for a premium assistance subsidy for the group plan through Medicaid or CHIP. To qualify, the eligible employee or dependent must request enrollment within 60 days after the special enrollment event. Click here for a Kaiser Family Foundation fact sheet on the Act.
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