Protecting Your Employee Benefits

Transcription

1 Protecting Your Employee Benefits U.S. Department of Labor Employee Benefits Security Administration Who are we and why are we here? U.S. DOL, EBSA enforces ERISA ERISA is the law that governs many of the benefits sponsored by private sector employers Job Loss affects benefits Timely action needed to protect benefits 1

2 Health Insurance Options HIPAA Special Enrollment COBRA Young Adult Coverage Marketplace HIPAA HIPAA Preexisting condition exclusions are now prohibited effective January 1, 2014 Certificate of creditable coverage no longer necessary, but will be issued until December 31, 2014 Waiting periods not to exceed 90 days 2

3 HIPAA Special Enrollment Requires a group health plan to allow an employee/spouse/dependent to enroll for coverage upon loss of other group health coverage Employee must request special enrollment from the other plan within 30 days of loss of coverage Coverage takes effect by 1 st of the Month following the request to enroll COBRA Ability to continue group health coverage under employer s plan Includes dental and vision plans Excludes disability and life insurance plans Applies to plans in private and public sectors Covers plans if employer has 20 or more employees 3

4 COBRA Job Loss COBRA available for 18 months Participant can be charged up to 102% of the full cost of the insurance. Notice to the Participant within 44 days Participant has 60 days to elect COBRA and then 45 days to make initial payment COBRA coverage is always retroactive to date that active employee coverage was terminated Young Adult Coverage If a plan covers dependents, you may be added to or kept on a parent's health insurance policy until age 26 Adult children may be enrolled during a plan s open enrollment period or under special enrollment circumstances 4

5 Other Options Health Insurance Marketplace CHIP-Children s Health Insurance Program Medicaid Health Insurance Marketplace A new way to find quality health coverage Several ways to apply: online, by mail, by phone, or in person Healthcare.gov or call (800) Apply during open enrollment: for 2017, will run November February 2017 You can apply for special enrollment if you have a qualifying life event The Marketplace will tell you if you qualify for free or low-cost coverage available through Medicaid or CHIP (enroll anytime) 5

6 Replacing COBRA with Marketplace coverage Can ONLY be done during Marketplace open enrollment, even if COBRA coverage hasn t run out If you end your COBRA coverage and apply for a Marketplace plan during open enrollment, you may qualify for tax credits that can lower your monthly premiums and lower out-of-pocket costs If you end your COBRA coverage early outside of Marketplace open enrollment you will NOT be able to enroll in a Marketplace plan until the next open enrollment. Medicaid Free or low-cost care based on income and family size You can apply for and enroll in Medicaid any time of the year If you qualify, your coverage can begin immediately 6

7 Children s Health Insurance Program (CHIP) Low-cost health coverage for families with income above the limit for Medicaid Covers parents and pregnant women in addition to children Each state program has its own rules/qualifying guidelines or (877) Retirement Plan Keep plan informed of your address Make sure you are getting information from the plan at least annually Benefit Payment Rules Age 65 Some other time specified by the plan 7

8 What options do I have regarding my Retirement Benefits? Keep the funds in the old plan (and keep in touch) Benefit Payments Rollovers to- Personal IRAs New Employer s plan (if allowed) Direct Distributions Contact Information EBSA Benefits Advisors toll free EBSA Website for More Information Look for Brochure entitled, Retirement and Health Care Coverage Questions and Answers for Dislocated Workers in English and Spanish 8