Continuation Coverage: COBRA

I am pleased to offer expert advice to employers, administrators and third party administrators in untangling some of the difficult questions arising from the administration of COBRA continuation health coverage, particularly how it interacts with other federal mandates.

These include:

  • The Patient Protection and Affordable Care Act of 2010 (PPACA, commonly referred to as the Affordable Care Act (ACA));
  • The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA);
  • The Family and Medical Leave Act of 1993 (FMLA); and
  • The Health Insurance Portability and Accountability Act of 1996 (HIPAA).

My practice encompasses the following areas of expertise:

Auditing COBRA documentation and operational procedures

This review is performed in order to ensure accurate and timely processing of COBRA transactions and notifications. Areas of focus include the updating of notifications for open enrollment and coordination with ACA notices. I prefer working with legal counsel in order to preserve the attorney-client privilege to the greatest possible extent.

Training and education

Training staff on COBRA administration and concepts. This is particularly important in succession planning and maintaining continuity in benefits administration as key positions become vacant on account of retirements.

Troubleshooting complex issues in mergers and acquisitions

This is an especially compelling area, as there exists the possibility that without a proper due diligence review performed by an attorney with ERISA and COBRA expertise, the acquiring company might acquire a COBRA liability – a very unpleasant surprise.

Assisting in resolving day-to-day issues

I am a certified mediator and arbitrator, and regularly assist in the resolution of benefit disputes, including COBRA. Typically, disputes involve issues such as improper notice, entitlement, determining who is a qualified beneficiary, determining whether a qualifying event has occurred, length of continuation coverage, late premium payments and cancellation of coverage, divorce and qualified domestic relations orders (QDROs), domestic partner arrangements and FMLA-related issues.

Monthly