Anthem s COBRA Solution

Transcription

1 Anthem s COBRA Solution EANBR3130N 06/08

2 Anthem s COBrA solution As a human resources professional, you need to be certain your company s employees understand their right to continue health coverage under the continuation provisions of the Consolidated Omnibus Budget reconciliation Act (COBrA) and related federal regulations. COBrA compliance can be challenging and burdensome, and failing to meet the continuation requirements can result in signiicant penalties, as high as $500,000, or 10 percent of group health plan costs. What s more, to avoid unnecessary costs, you need to have controls in place to be sure that continuation coverage is provided only when required by the law and the terms of your group health plan. The fact is, keeping up with this complex, ever-changing law and ensuring your company s continued compliance can be a full-time job. Unfortunately, dealing with the myriad of requirements for COBrA is not the only mission-critical task on your plate. Is YOUr COMPANY AT risk? Internal administration, with or without costly software, can subject your organization to unnecessary risk. The challenges of staying current in this evolving area of employee beneits law can overtax even the most resourceful Hr staff. In fact, the Irs estimates that more than 90 percent of all employers are not compliant with COBrA regulations. ArE YOU COBrA COMPLIANT? UsE THE FOLLOWING As A self-audit: Does your company have a written COBrA procedures manual? YEs NO Can you provide proof of general notices of continuation coverage for all your covered employees and their dependents? YEs NO Do you maintain documentation of any past requests for COBrA coverage? YEs NO Is your staff trained to answer all compliance questions? YEs NO Does your company understand when an extension of the COBrA continuation period is required? YEs NO Does your company keep up to date with changes to COBrA regulations? YEs NO If you answered no to any one of the above audit questions, your company may be at risk. No matter what your answers, Anthem s COBrA solutions can improve your COBrA program. Our expert staff can cost-effectively manage every aspect of your COBrA administrative requirements. The Irs currently performs more than a dozen audit procedures for COBrA compliance. Active enforcement by federal regulators is underway, and your company needs to be prepared. 24/7 Access to real-time data, ActiVity logs, And online reports At BeneFitAdminsolutions.com. Anthem s cobra services include timely notifications, premium AdministrAtion, customer service And reporting.

3 WE LL save YOU TIME, MONEY AND risk Let s face it COBrA administration can be risky. As an employer, you face signiicant liabilities for non-compliance. But an even greater risk exists that, without adequate controls, you could incur unnecessary expenses by providing continuation coverage when you are not required to by COBrA or the terms of your group health plan. Consider the following: Employers pay an average of $7500 per individual, per year, in COBRA-related costs. Claims costs for COBRA participants are 150 percent greater than the costs for active employees. COBRA non-compliance can be costly. The maximum excise tax penalty is $500,000, or 10 percent of health plan costs for the previous year whichever is less. WE re WITH YOU EVErY step OF THE WAY 24 HOUrs A DAY, 7 DAYs A WEEK Our beneits experts are trained to quickly and cost-effectively manage every aspect of your COBrA administrative requirements. Our COBrA services include timely notiications, premium administration, customer service and reporting. Plus, you ll have 24/7 access to real-time data, activity logs, online reports and other meaningful information that provides you with the tools to ensure your COBrA administration program is running smoothly. We can minimize these risks while delivering signiicant savings for our clients savings that you can re-invest in your business through: Administrative eficiencies such as automatic cancellation, payment screening and election processing systems. Conformance to the law and your plan terms, with controls to assure that only required elections and coverage durations are permitted. In fact, we ve been able to consistently outperform the competition in key areas such as number of COBrA participants, COBrA election rates, COBrA duration and call center wait times, which equate to savings for you. (see the following table.) Anthem Industry norm* Number of COBrA participants 2.3% 2.6% COBrA election rate 14.3% 16.2% Average COBrA 9.5 months 10.4 months duration Average call center 18 seconds, 30 seconds wait time or employers and participants can obtain instant results through IVr or online With Anthem providing your cobra AdministrAtion, you can Focus on your core Business. *Source: Spencer and Associates

4 OUr EXTENsIVE LIsT OF COBrA ADMINIsTrATIVE services INCLUDEs: reliable notiications and tracking 24/7 access to information for employers and participants via beneitadminsolutions.com Notiication in writing to all newly covered employees and dependents of their COBrA rights Notiication to qualiied beneiciaries of their conversion rights Notiication to the employer and qualiied beneiciaries when a participant s eligibility expires under COBrA Billing and collecting qualiied beneiciary COBrA premiums Notiication to qualiied beneiciaries of changes in premium rates Assistance with open enrollment changes for all qualiied beneiciaries Comprehensive management reports throughout the month informing the employer of all COBrA activity remittance of collected COBrA premiums to the employer (or insurance carriers as an optional service) with accounting documentation Documentation of all correspondence sent to qualiied beneiciaries Implementation of any new requirements for federal compliance as COBrA law changes Personalized responses to COBrA-related customer service inquiries from qualiied beneiciaries Toll-free customer service telephone numbers for active COBrA qualiied beneiciaries

5 Anthem s COBrA solutions... Compliance Is Just a Click Away Anthem s COBrA solutions are online at beneitadminsolutions.com. When you choose to use our service, you ll receive a user name and password that will allow you to log on to the Web site and access a host of special features designed to make complete COBrA compliance even quicker and easier. User-friendly online features include: For employers: Qualifying event submission report qualifying events in a matter of seconds online, instead of a matter of days via mail. COBrA general notice of continuation coverage requests Accelerate the process of notifying newly covered employees and their families. Qualiied Beneiciary Takeover submission Transfer your existing participants to Anthem s COBrA solutions as soon as you set up your account. Online reporting View your entire account history, including participant detail, online, in real time. Anthem s COBrA solutions tutorial Learn how to best use our innovative system. Online resource center review federal guidelines; learn about the latest Irs rulings and DOI opinions. research current issues and court cases. If you have a COBrA-related question, the answer is here! For participants: COBrA qualiied beneiciaries also have online access available for their convenience. Online elections Qualiied beneiciaries can instantly elect COBrA via the Web. Our online election process is secure, protected by assigning a unique user name and password, and automated so qualiied beneiciaries can immediately use the web site. View account history Qualiied beneiciaries can access their entire account in real time and view elections, payments and plan history. FAQs Qualiied beneiciaries can access an assortment of common questions related to COBrA and their accounts. Payments Qualiied beneiciaries can mail monthly COBrA payments or have premiums automatically paid through convenient ACH deductions. Once you and your participants have had a chance to use this extraordinarily eficient new administrative tool, you ll never want to use paper forms again! Best of all, you ll have access to Anthem s COBrA solutions online 24 hours a day, 7 days a week. so check it out AsAP. It s a convenient solution that clicks with the way today s companies and individual consumers do business. Anthem s cobra solutions compliance is just a click away. benefitadminsolutions.com

6 ENrOLLING YOUr COMPANY WITH ANTHEM s COBrA solutions COULDN T BE EAsIEr Expedite COBrA administration and transfer the entire burden from your shoulders to ours. Here s all you need to do to enroll your company: Call your Anthem National Accounts sales representative to request a quote. Request an application from your Anthem National Accounts sales representative. Complete the application for administrative services, including plan information, and fax or it to Anthem. An Anthem beneit expert will establish your account and provide you access to worry-free COBRA administration. WE re EXPErTs DEDICATED TO HELPING YOU MEET YOUr COBrA ADMINIsTrATION GOALs Anthem s customer service and client delivery teams are among the most experienced in the nation. Our comprehensive and cost-eficient methods of handling your COBrA compliance needs are recognized as among the most innovative in the country. Equally important, by choosing Anthem to fulill virtually all of your COBrA administrative responsibilities, you ll be free to concentrate on other areas of vital importance to your business. Anthem s COBrA solutions make full COBrA administration worry-free. simply notify us when a COBrA qualifying event takes place, or when an employee or spouse irst becomes covered under your group health plan. Anthem is dedicated to helping you meet your compliance goals.

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8 The Anthem National Accounts business unit serves members: of Anthem Blue Cross Life and Health Insurance Company and Blue Cross of California using the trade name Anthem Blue Cross in California; using the trade name of Anthem Blue Cross and Blue Shield for the following companies in: Colorado and Nevada: Rocky Mountain Hospital and Medical Service, Inc.; Connecticut: Anthem Health Plans, Inc.; Georgia: Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.; Indiana: Anthem Insurance Companies, Inc.; Kentucky: Anthem Health Plans of Kentucky, Inc.; Maine: Anthem Health Plans of Maine, Inc.; Missouri (excluding 30 counties in the Kansas City area): RightCHOICE Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-hmo benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits; New Hampshire: Anthem Health Plans of New Hampshire, Inc.; Ohio: Community Insurance Company; Virginia (excluding the Northern Virginia suburbs of Washington, D.C.): Anthem Health Plans of Virginia, Inc.; Wisconsin: Blue Cross Blue Shield of Wisconsin ( BCBSWi ) underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ( Compcare ) underwrites or administers the HMO policies; and Compcare and BCBSWi collectively underwrite or administer the POS policies. In 28 eastern and southeastern counties in New York, Empire Blue Cross Blue Shield, the trade name of Empire HealthChoice Assurance, Inc., underwrites and/or administers the PPO, EPO, POS and indemnity policies.. Independent licensees of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.