COBRA / HIPAA Administration

ABY Benefits COBRA Administration

ABY Benefits offers full web-based administration and compliance to take the worry and stress out of complying with all COBRA and HIPAA mandates.

COBRA guidelines are federally mandated, and compliance with these guidelines is solely the responsibility of the employer; and failure to comply can come with heavy fines and penalties. In addition to Federal COBRA rules, most States also require a continuation of coverage, usually called Mini COBRA or simply State Continuation.

Employers who meet the federal definition of an employer with 20 or more full-time or part-time employees are subject to COBRA. An employer is said to have employed 20 or more employees during a calendar year if, 20 or more employees were employed for at least 50% of its working days during that year.

Mini COBRA / State Continuation rules apply to employers few than 20 employees who are not subject to Federal COBRA rules.

In determining the number of employees, an employer shall treat employees as full-time, part-time and all employees within the meaning of section 201C(1). Please note that each part-time employee counts for a fraction of a full-time employee. The fraction is calculated by the number of hours actually worked by the part-time employee divided by the number of work hours normally required of a full-time employee. This calculation is for the purpose of determining COBRA eligibility only.

Please note that if an employer is determined COBRA eligible within the course of a calendar year, the group will become COBRA effective on January 1 of the calendar year immediately following that in which the employer attained COBRA eligibility. An employer subject to COBRA is responsible for notification to their insurance carrier(s).

COBRA eligible benefits include group Medical, Dental, Vision, FSA and HRA plans. Employees (and/or their dependents) must be enrolled in the eligible benefit at the time of the qualifying event in order to continue the coverage under COBRA.

By IRS rule, Employers are allowed to charge COBRA participant 102% of the applicable premium. The additional 2% is generally used to help pay for the administration of COBRA services. For disabled COBRA participants, employers may charge 150% of the premium from month 19 to 29.

The standard COBRA period is 18 months, but secondary qualifying events or disabilities can extend coverage to 29 or even 36 months from the qualifying event date.

ABY Benefits provides COBRA compliance and administration for employers meeting COBRA eligibility guidelines. Outsourcing your COBRA administration will protect your company from potential COBRA noncompliance. Noncompliance can lead to fines starting at $100.00 per day per employee.

Our web-based COBRA Administration provides you with:

  • Required notices
  • COBRA elections and premium payment management
  • Customer Support for the employer and participant
  • Web-based COBRA reporting
  • COBRA updates and regulations
  • State Continuation support
  • HIPAA Certificates of Creditable Coverage
  • Direct billing of premiums

Employer Services

  • Web-based entry of new hires and terminated employees
  • Staff training and manual regarding COBRA rules and regulations
  • Sending open enrollment information to participants
  • Notification to insurance carriers upon acceptance of COBRA
  • Notification to insurance carriers upon termination of COBRA
  • Reports for tracking premiums received
  • Records of each termination through the length of participation (18 and 36 months)
  • Constant monitoring changes of rules and regulations for COBRA
  • Forwarding premiums to employer at the end of each month accompanied with reports

COBRA Participants

  • Providing Initial Rights Notices and HIPAA Notices to new employees
  • Sending COBRA Rights Notices upon employee termination (includes all required pages and Certificate of Coverage)
  • Receipt of premium for COBRA participants
  • Clearing of premium checks
  • Customer service for participants and non-participants
  • Notification and COBRA Rights for divorces, dependents becoming ineligible for benefits due to age, retirement (Medicare), and disability
  • Certificate of Coverage for up to two years for ex-employees
  • Participants can pay COBRA premiums online with a Credit Card

Premium Billing

COBRA participants are provided with Premium Coupon Books during their eligibility period, showing the amount due, due date, and grace periods. We inspect each premium in our system for timeliness and correctness, relieving your Human Resource professionals from the time-consuming task of collecting and tracking payments and forward premiums to the employer on the first of each month with a report showing each benefit paid for by the participant and the amount of premiums.

We forward premiums to the employer on the first of each month with a report showing each benefit paid for by the participant and the amount of premiums.

Any benefit changes, or rate changes are monitored and the participant is notified.

Contact Us

For immediate assistance please call us toll-free.