After notifying them, what does Surency do to make sure that my health plan vendors actually “turn on” a Qualified Beneficiary in their claim systems?

Depending on the size of the group and the number of Qualified Beneficiary’s enrolled, notifications can be monthly or weekly. With 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 them.

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?

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 reinstate 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.

What happens if a a Qualified Beneficiary (COBRA eligible employee or dependent) sends in the election form without any payment?

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.

What happens if a Qualified Beneficiary ignores the COBRA notice?

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.

Who does the Qualified Beneficiary, their medical provider or health plan representative call with questions about COBRA?

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.

Do the dependents of a Qualified Beneficiary get a separate notice?

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. 

What about the HIPAA certification notice required at the same time of notifying Surency that a Qualified Beneficiary (COBRA eligible employee or dependent) has been terminated?

Surency will produce and send the required HIPAA Certification Notice in the same envelope as the qualifying event notice. Once a Qualified Beneficiary’s COBRA coverage ends, we will also send an updated HIPAA Certification Notice. Surency provides this service at no extra charge to our clients.

What happens after I notify Surency that a Qualified Beneficiary (COBRA eligible employee or dependent) has been terminated?

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.

How do I notify Surency that a Qualified Beneficiary (COBRA eligible employee or dependent) has been terminated?

You may notify us by mail, fax, email or electronic file.