HHS and DOL Announce Special Marketplace Enrollment for COBRA Participants

On May 09, 2014, the Centers for Medicare and Medicaid Services (part of HHS) issued a bulletin to handle Special Enrollment Periods (SEPs).

HHS has a concern with the former Model COBRA Continuation Coverage Election Notices (Model Election Notices) published by the Department of Labor and other documents provided by employers, has not address, or did not sufficiently address, Marketplace options for persons eligible for COBRA.

Their concern is with persons eligible for COBRA and their qualified beneficiaries may have been provided insufficient information to understand, they cannot voluntarily drop COBRA and enroll in the Marketplace outside of the Marketplace open enrollment.

As a result, in accordance with 45 CFR 155.420(d)(9), HHS is providing an additional special enrollment period based on exceptional circumstances so persons, who are eligible for COBRA and COBRA beneficiaries are able to select Qualified Health Plans (QHPs) in the Federally Facilitated Marketplace (www.healthcare.gov).

Affected individuals have 60 days from the date of this bulletin (May 09, 2014), through July 1, 2014, to select QHPs in the Marketplace.

Individuals should contact the Marketplace call center at 1-800- 318-2596 to activate their special enrollment period.  When calling, individuals want to be sure to inform the Marketplace call center, they are calling in regard to their COBRA benefits and the Marketplace.  Once it has been determined they are eligible for the special enrollment period, the individual can view all of the plans available to them and continue the enrollment process over the phone or online through creating an account on healthcare.gov or logging into their existing account.

In addition, COBRA beneficiaries are able to choose QHPs in the Marketplace during the annual open enrollment period and if determined, they are eligible for any other special enrollment periods outside of the open enrollment period.

There are still many lingering questions needing to be answered surrounding notification of the 60-day special enrollment window, that include:

  • Will employers be required to notify only those in an active COBRA status as of May 1, 2014?
  • Will employers be required to notify former employees who were eligible for COBRA at any time during the open enrollment period (which ended March 31)?
  • What method(s) is/are required for notification? (i.e. US MAIL?  E-Mail? Phone?)
  • What sort of “proof” should each plan administrator have to show that they communicated to the right qualified beneficiaries in a timely manner?
  • Should employers and/or plan administrators re-send Initial Rights Notices for their 2014 active populations?

 

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