COBRA Employer Questions
COBRA Employer Answers
Q: How do I notify Surency that a Qualified Beneficiary (COBRA eligible employee or dependent) has terminated?
A: You may notify us by mail, fax, e-mail or electronic file.
Q: What happens after I notify Surency?
A: We will immediately enter the information into our database and mail a "qualifying event notice" informing the Qualified Beneficiary of their COBRA rights. This letter will include the name, address and phone number of a specific Surency processor for them to contact with any questions they might have. A separate election form will be enclosed with instructions to mail the form to Surency.
Q: What about the HIPAA certification notice required at the same time?
A: Surency will produce and send the required HIPAA Certification Notice in the same envelope as the qualifying event notice. If a Qualified Beneficiary actually enrolls in COBRA we will also send an updated HIPAA Certification Notice when COBRA coverage ends. Surency provides this service at no extra charge to our clients.
Q: Do the dependents of a Qualified Beneficiary get a separate notice?
A: Surency will send a separate COBRA notice each time we are notified that a dependent Qualified Beneficiary has lost coverage. This includes dependent children exceeding the maximum eligible age, divorcing spouses and spouses of deceased employees. As an extra protection we can also send a separate notice to spouses of terminating employees.
Q: Who does the Qualified Beneficiary, their medical provider or health plan representative call with questions about COBRA?
A: It is our goal to be the primary contact for all COBRA related questions. Our processors work hard to solve problems so that you don’t have to get involved later.
We put our local and toll free phone number on all correspondence and each letter includes the name and direct extension of the processor actually doing the daily work. Our processors continually cultivate relationships with plan vendors throughout the country. A Qualified Beneficiary that may have gotten the “run around” from other plan vendors will discover that Surency is their advocate in solving problems that used to require your involvement.
Q: What happens if a Qualified Beneficiary ignores the COBRA notice?
A: A letter will be sent to the Qualified
Beneficiary confirming that their right to elect COBRA coverage has expired. This notice will specify the date their “active” coverage terminated and will also include an additional HIPAA certification.
Q: What happens if a Qualified Beneficiary sends in the election form without any payment?
A: As per law, if an enrollment form is received without the initial premium payment, they receive an additional 45 days in which to pay all premiums (retroactive to termination date). Upon receipt of an enrollment form without payment, Surency will send out an enrollment confirmation letter notifying the Qualified Beneficiary that we received their form, as well as the specific date by which all back premiums must be paid to avoid termination. We also include premium payment coupons and remittance envelopes with this notice.
Should a Qualified Beneficiary fail to make payment by the deadline, we follow the same procedure that we do for a Qualified Beneficiary who ignores the initial notice entirely.
Q: When a Qualified Beneficiary first elects and pays for COBRA, what does Surency send them and how does Surency notify me and my health plan vendors?
A: Upon receipt of an enrollment form and initial premium payment, our system will automatically produce and mail a confirmation letter, premium payment coupons and return envelopes to the Qualified Beneficiary.
A notice to each health plan elected by the Qualified Beneficiary is also sent out at this time. The notice to the carrier will include a copy of the Qualified Beneficiary enrollment form containing any and all information the carrier might request in order to re-instate benefits.
Surency will provide reporting to you monthly (or more often if requested) showing all elections, terminations, etc. This information is also available online every day.
Q: After notifying them, what does Surency do to make sure that my health plan vendors actually "turn on" a Qualified Beneficiary in their claims systems?
A: Depending on the size of the group, and the number of Qualified Beneficiary’s enrolled, notification can be monthly, or weekly. With our large groups Surency sends weekly files in the specific file layout specifications to both health and prescription vendors. Smaller groups are normally handled via hard copy paper reporting either weekly or monthly as per your request.
If we receive a call from a Qualified Beneficiary who is unable to access benefits, Surency will contact the vendor to determine why and work to resolve the issue for your Qualified Beneficiary.
Surency also has online access to healthcare and prescription vendors allowing us to update their system directly.
Q: What if a Qualified Beneficiary is late making their payment?
A: Surency follows the letter of the law, and will terminate
benefits for anyone who does not make their premium payment on time, unless it is specifically requested otherwise, in writing, from the employer not to do so.
Q: What if a Qualified Beneficiary "bounces" a check to Surency?
A: Our system will notify any Qualified Beneficiary
whose premium payment is returned by the bank, or is short by a “significant amount”. The letter informs the Qualified Beneficiary they have until either the end of the grace period, or ten days from the date of the letter, whichever is later, for replacement funds to be sent in order to avoid termination.
Q: How often does Surency transfer the premium they collect from Qualified Beneficiaries?
A: Surency will remit to you ALL premium payments received each month, early the following month, or more often if requested.
Q: Does Surency keep the 2% administrative fee collected from Qualified Beneficiaries?
A: Generally no, except in specially negotiated contracts.
Q: Can Surency keep track of different plans/rates from different vendors?
A: Surency's COBRA Administration system is capable of tracking an unlimited number of plans and rates for each employer.
Q: Can Surency report by branch?
Q: Can Surency administer subsidized rate programs such as the California State extension, RIF/severance, early retirement, and other special programs that might precede or run concurrently with COBRA?
A: Surency's system is capable of handling all types of subsidies, severance and retirement programs. Additionally, there are several mechanisms for dealing with individual state laws and requirements.
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