In mid-March the U.S. Department of Labor drafted model notices to be provided to qualified beneficiaries informing them of the COBRA premium reduction that is available to assistance eligible individuals and to provide certain individuals a second COBRA continuation election period under the American Recovery and Reinvestment Act of 2009 (ARRA). Group health plans of 20 or more employees should already be providing terminated insureds with the required notices.
ARRA also makes the premium reduction for continuation coverage available to assistance eligible individuals who are provided continuation coverage under state law. The Office of the Commissioner of Insurance is providing the following two model notices that may be used by group health plans with less than 20 employees that are not subject to COBRA but are required to comply with the Wisconsin continuation and conversion law. These notices are NOT intended to replace the notices employers currently provide to terminated insureds to inform them of their continuation and conversion rights, but rather can be used as supplemental information that is required to be provided in accordance with state and federal law.
The first notice, "Summary of the Premium Reduction Provisions under ARRA," (see Attachment A) provides premium reduction information to all terminated insureds between the period of September 1, 2008, through December 31, 2009. This notice should be included when an employer provides newly terminated insureds with information concerning their state continuation and conversion rights, and must also be provided to individuals who already elected and are currently on state continuation coverage due to a qualifying event on or after September 1, 2008, but who have not yet received information concerning the premium reduction. Insurers are required to provide this notice if the employer fails to so provide.
The second notice (see Attachment B) provides information concerning the availability of a second continuation election period. Employers must provide this notice to any terminated insured who is or would be an assistance eligible individual who had a qualifying event at any time from September 1, 2008, to the effective date of the amendment to s. 632.897 that permits a second continuation election period, and either did not elect continuation coverage or who elected it but subsequently discontinued the coverage. Insurers are required to provide this notice if the employer fails to so provide.
If you have questions concerning this bulletin, please contact Mike Honeck, Chief of Health & Life Section at email@example.com.