ACA Back to COBRA???

Nov 17, 2016

  1. LostDollar
    Offline

    LostDollar Guru

    Posts:
    2,741
    Likes Received:
    533
    State:
    Kansas
    (I'm a consumer-do not want to give my wife bad advice on this one.)

    My wife's employment terminated mid year. (Kansas). Her 18 month COBRA eligibility period includes the entirety of 2017. She declined COBRA health coverage and went to a Marketplace plan for the balance of 2016. (I went to Medicare.)

    I Kept COBRA dental and we kept the family COBRA vision plan. As a result my wife has received a COBRA election/change form which appears to give her the option of opting back into COBRA health and dental coverage for 2017. Reduction of the number of carriers and premium increases in the KS market make this an attractive option.

    So is this a normal type COBRA situation-that if you decline portions of a COBRA coverage when initially eligible-but keep some of them--you can then re-elect to take them all during an annual enrollment period (up to the length of your COBRA eligibilty period based on your termination date)?

    I just don't want to suggest a decision that leaves her without coverage.
    Thanks.
    LD
     
  2. TN_agent
    Offline

    TN_agent Guru

    Posts:
    619
    Likes Received:
    37
    State:
    Tennessee
    Here is a good document for these sorts of questions. Sink your teeth into it, then you can let us know what you find out. I hesitate to make a judgment call because what you are describing is unusual, but I believe it may be an error and that you were sent a generic form. Either that, or something to do with you going onto Medicare and I am wrong. Which happens a lot.

    https://www.dol.gov/sites/default/files/ebsa/laws-and-regulations/laws/cobra/COBRAemployee.pdf
     
    TN_agent, Nov 17, 2016
    #2
  3. LostDollar
    Offline

    LostDollar Guru

    Posts:
    2,741
    Likes Received:
    533
    State:
    Kansas
    (11/18/16 ):
    TN thank you. I see a number of these kinds of posts that don't get any answers. I was hoping to get at least one.

    All: If anyone else has comments about this type of situation, would appreciate seeing them.

    I appreciate the document, have/am using it, and will post some lengthier feedback than the preliminary note below in the next 2-3 days.

    ----------
    (11/18/16 Initial comment):
    I am still asking questions but being given the following as justification for allowing the reentry:

    26 CFR 54.4980B-5 Q-4 4(c) and examples in 4(d).

    (12/07/16)
    Still in process on this-still intend future comment.
     
    Last edited: Dec 7, 2016
  4. LostDollar
    Offline

    LostDollar Guru

    Posts:
    2,741
    Likes Received:
    533
    State:
    Kansas
    ============================
    The short answer to this:

    Yes she could.

    ============================

    The longer answer in the event it is helpful to someone else in the future:

    I called the former employer's Third Party Cobra administrator twice and two different people said that could happen.

    I did an electronic communication with DOL per the back cover of the document posted here. I had a call back from DOL rep that said that could happen.

    The COBRA election paperwork was processed without issue-except that it took a bit longer than the marketplace coverage cancellation date, so I had to tell my wife to cancel her marketplace plan before we had the acknowledgement letters back from the Cobra administrator.

    My wife had to make 2-3 calls to the marketplace but they finally told her that her marketplace health plan was cancelled for 2017. Come January 2017 she discovered that in spite of those phone calls she had been auto reenrolled in a 2017 Marketplace plan and her bank account had been drafted for the Jan premium. More phone calls to both Marketplace and the carrier and she finally got the cancellation done and a refund of the premium.

    She is having to do the same thing with Marketplace dental-I don't know if that has been sucessfully reversed and refunded yet or not.

    The detail that created the confusion in my mind (and I think that of tnagent too) is that Medicare and DOL seem to handle the components of an employer group health plan differently.

    Medicare seems to see Medical (and subsets of Medical non-drug and Medical drug), Dental and Vision coverage as separate components. A Medicare eligible person on COBRA is allowed to keep COBRA dental and vision coverages as long as they are eligible under the plan. They just have to give up the Medical coverage.

    In the DOL system, they all seem to be one piece. That, and the requirements that all participants in a large employer's COBRA plan be treated equally for changes, seem to be the underlying basis for being allowed to go back on COBRA health coverage.

    In my prior post you can see the code reference that the DOL representative gave me as justification. The manual in the thread does not have page numbers on it but if you look

    WHAT IS COBRA COVERAGE -- paragraph 5 including the list
    and
    BENEFITS UNDER CONTINUATION COVERAGE -- 2nd sentence


    I believe you see in that document the key points that allow a person participating in just a vision component of a COBRA plan, to go back to Medical, Dental and Vision coverage during an employer open enrollment (to the extent of the original 18 or 36 month eligibility period).
     
    Last edited: Jan 19, 2017
Loading...