Beginning July 1, 2016, COBRA will be administered through ProView’s sister company, Stanley, Hunt, Dupree & Rhine (SHDR). Participants will continue to have access to a dedicated customer service team through SHDR. Following are frequently asked questions about COBRA and how to access COBRA benefits through SHDR. You can also call the COBRA Administration Team (888) 888-3442, M-F 8:00am – 8:00pm ET, or email cobraadmin@shdr.com.

COBRA PARTICIPANTS

FAQs

General Questions

In 1986, Congress passed the landmark Consolidated Omnibus Budget Reconciliation Act health benefits provisions. It is a federal law containing provisions that most employers provide employees, spouses and dependent children who lose group health benefits due to a qualifying event an opportunity to continue coverage for a limited time period.

The basic definition of a qualifying event is a “triggering event” listed under the COBRA law that causes a loss of coverage. Not all losses of coverage are COBRA qualifying events.

Examples of qualifying events include:

  • Termination of a covered employee’s employment (other than gross misconduct)
  • A reduction of a covered employee’s hours of employment resulting in loss of benefit eligibility
  • A divorce from the covered employee
  • The death of a covered employee
  • Ceasing to be a dependent child under the terms of the plan
  • The covered employee’s entitlement to Medicare

An individual who is a covered employee, the employee’s covered spouse, and the employee’s covered dependent children who are covered under the group health plan immediately prior to the qualifying event. This includes the covered employee (only if the qualifying event is a termination or reduction in hours)

Your employer will have 30 days to notify SHDR of the COBRA qualifying event. Once SHDR receives the notification from your employer, SHDR will then have up to 14 days to mail the COBRA Specific Rights notice to you. Please be sure that your former employer has the most recent mailing address on file for you.

The maximum length of the COBRA coverage period depends on the type of qualifying event. In the case of loss of group health plan coverage due to termination of employment (other than gross misconduct) or a reduction in work hours, coverage may be continued for a maximum period of 18 months. Please refer to your COBRA Specific Rights notice for the duration of your COBRA coverage period.

Your insurance coverage ended on the date specified in your COBRA Specific Rights notice. All COBRA related time frames are provided in the COBRA Specific Rights notice that was mailed to you.

An election form will be enclosed in the COBRA Specific Rights notice that you will receive from SHDR. To elect COBRA via the election form you will need to complete, sign, and submit to the address listed on the form. You may also elect to continue COBRA coverage online by logging onto the COBRA member portal. Your member portal login information will be sent to you from SHDR at the same time as your COBRA Specific Rights notification. The “Last Day to Elect” will be indicated on the COBRA Specific Rights notice.

You are given an election period of 60 days to choose whether or not to elect COBRA continuation coverage. Your COBRA election must be received within the specific timeframe listed on your COBRA Specific Rights notice. You may elect COBRA by completing and signing the election form and submitting the form to SHDR or you have the option to elect COBRA by logging into the COBRA member portal. In order to be considered your online election or completed election form must be received by SHDR with a process date (if electing online) or a postmark date (if mailing via US Postal Service) on or before the “Last Day to Elect” that is listed in the Specific Rights notice.

No, you may select from the available benefits listed on your COBRA election form. Accept or waive the coverages by checking the boxes next to the corresponding plans that you wish to keep. You will need to elect for you and your family members who were covered under your group health plan immediately prior to your COBRA qualifying event. You may not add new dependents who were not previously covered prior to the qualifying event (exceptions birth of a new child or adoption). (You are also able to make coverage selections from available benefits when enrolling via the online portal.)

Your monthly COBRA premiums will be the actual full cost of the premium that your former employer paid for the group health plan plus a 2% administrative fee. Refer to your COBRA Specific Rights Notice to view the actual cost of the COBRA premium.

Rules for the first premium payment:

  • Your first/initial COBRA premium payment must be made within 45 days from the date that you make your COBRA continuation election.
  • This date is based on the postmarked date if mailed. If you do not make your first payment for continuation coverage within the 45 day time period, you will no longer be allowed to continuation coverage under the plan.

You will not receive a separate billing notice for the initial premium payment. The Specific Rights notice and election form serves as the initial premium payment notification. Your initial COBRA premium payment must be made within 45 days from the date that you make your COBRA continuation election.

After we have received your completed and signed election form (or online election) and full initial COBRA premium payment, the insurance carrier will be notified within 4 business days to activate your coverage as of the COBRA effective date. In addition the following notifications will be mailed to you:

  • Enrollment Confirmation Notice: This notice will confirm the benefits that you have selected to continue through COBRA.
  • Payment Coupons: You will receive preprinted payment coupons with your name and additional identifying information (attached to the Enrollment Confirmation) that can be used to mail in with your check or money order.
  • New Member Registration Letter: As a member you will have access to our online client portal where you can manage your COBRA account electronically. You will have the capability to make your COBRA election online if you prefer, make online credit card payments (fees apply), or view your account at your convenience.

Please allow a minimum of 7-10 business days for the insurance carrier to process the reinstatement request after receiving it from SHDR.

Yes. In order to continue your coverage under COBRA, and for the employer to pay for your COBRA coverage (if applicable), a completed and signed COBRA election form must be received (within the timeframe specified on the election form) in order to process your COBRA coverage election. We cannot automatically elect COBRA coverage for you or your family.

This is controlled by your insurance carrier. Please contact our customer service department at (888) 888 -3442 if you should need assistance.

The health care coverage will function the exact same way it did prior to your COBRA qualifying event. You will continue to have the same level of coverage you had prior to your COBRA qualifying event. However, an employer plan sponsor may make changes during their annual open enrollment period that may affect your benefits and/or changes to your insurance carrier. If changes are made to your plan you will be notified in writing regarding your benefits or insurance carrier changes.

Please contact the health insurance provider for information regarding, your co – pay, deductibles and for submitting insurance claims.

You are given an election period of 60 days to choose whether or not to elect COBRA continuation coverage. The completed and signed election form (or online election) must be submitted within the specified timeframe that is listed on the COBRA Specific Rights notice for your COBRA election to be considered.

After you have submitted your completed election form and made the full initial COBRA premium payment; your COBRA continuation coverage will be effective as of the date that health care coverage would otherwise have been lost by reason of a qualifying event.

COBRA Premiums and Payment Methods

Each subsequent COBRA premium payment is due on the first day of each month.

COBRA allows a 30 – day grace period from the first day of each month to submit your COBRA premium payments. The payment must be postmarked no later than the last calendar day of the month in which the premium is due. Example: Premium payment is due Jan 1st = payment must be postmarked no later than Jan 31st to be accepted and applied to your account. If your payment is received after the grace period has expired; it will not be accepted. Your COBRA continuation coverage will be terminated.

SHDR offers three convenient options for you to pay your COBRA premium payments each month:

  • Check or money order.
  • Credit card payments via our online portal for a convenience fee of $20.00 per transaction (you must be a registered user).
  • Automatic drafts (ACH) can be set up each month to pull premiums from your banking account at no charge. The first initial premium payment cannot be drafted via automatic debit. Please contact our COBRA Administration Team at (888) 888-3442 for detailed information.
  • Currently SHDR is unable to process payments over the phone. Cash payments are not accepted.

The SHDR premium payment remittance address is located on the COBRA election form and the premium payment coupons. If you are remitting a COBRA premium payment without a coupon please contact COBRA Services for your member ID number to include on your payment.

COBRA premium payments should be made payable and mailed to SHDR at:
SHDR
P O Box 2734
Omaha, NE 68103-2734

Overnight payments will not be accepted at our payment processing center. Please contact our COBRA Administration Team at (888) 888-3442 for additional information or feel free to send us an email at cobraadmin@shdr.com.

No, nonpayment of COBRA premiums within the grace period will result in termination of your COBRA Continuation Coverage with no option for reinstatement.

If your premium payment is returned for nonsufficient funds, you will be mailed a Voided Payment Notice and given 10 days from the date of the notice to remit an alternate form of payment plus a $10.00 service fee. The $10.00 service fee will need to be a separate payment and not included with the original COBRA monthly premium payment. If the alternate payment is not postmarked by the 10th day, your COBRA continuation coverage will be terminated for nonpayment of premiums within the grace period.

You may contact our COBRA Administration Team at (888) 888-3442 or via email at cobraadmin@shdr.com for information regarding ACH recurring payments. You may also setup a recurring ACH payment via the online portal.

COBRA Terminations

It is your responsibility to find other health coverage after your COBRA coverage eligibility period has expired. You may contact your insurance carrier to determine your options after your COBRA coverage terminates, or obtain individual coverage elsewhere. SHDR is not an insurance carrier and cannot provide additional coverage.

You may wish to contact McGriff Insurance Services to obtain answers to your health insurance questions and options to best fit your health care needs. McGriff Insurance Services can be reached at (800) 474-1471.

COBRA regulation requires this notice be sent to COBRA participants to advise when their COBRA eligibility is scheduled to expire.

If you no longer intend to pay for COBRA coverage or have obtained health care coverage elsewhere, please submit a written request to SHDR COBRA Administrators at cobraadmin@shdr.com stating that you wish to terminate your COBRA continuation coverage voluntarily and include the effective date in which you are requesting to terminate your COBRA coverage. Please note that all termination requests are permanent: you will not be eligible for reinstatement of COBRA coverage at a later date.

Yes, you may choose to stop paying for one or all of your benefits. If you plan to stop paying for one of your benefit plans, you may send in a written request to SHDR COBRA Administrators at cobraadmin@shdr.com stating which benefit plan you wish to drop, for which dependents (if not for all enrolled), and the effective date in which you want the benefit plan coverage to end. Please not that all termination request are permanent: coverages will not be eligible for reinstatement at a later date.

If you fail to make a monthly premium payment within the 30-day grace period you will lose all rights to COBRA continuation coverage under the group health plan.

COBRAPoint – How to use our online portal

Once you are enrolled in COBRA, you will receive a New Member Login letter with a registration code that will allow you to access your COBRA account online. If you are enrolled in COBRA, but have not received your registration code please contact our COBRA Administration Team at (888) 888-3442 or send an email to cobraadmin@shdr.com for assistance.

If your COBRA coverage is currently active and you are registered online, you may make a one-time online credit card payment. A $20.00 convenience fee (this fee is nonrefundable) is added to each online payment transaction.

Visit our online portal COBRAPoint and click on “Forgot My Password”. You will need the registration code that was provided to you in the New Member Login letter. The registration code is case sensitive.

Please contact our COBRA Administration Team at (888) 888-3442 or send a request to have your account unlocked to cobraadmin@shdr.com.

A written request is required for all address and COBRA changes. Please email your updates to our COBRA Administration Team at cobraadmin@shdr.com.

Cal - COBRA

Cal-COBRA is a California state law that extends COBRA-like benefits to employees and employee’s dependent spouse and children for companies that have less than 20 employees. It may allow you to keep your coverage for up to 36 months. Some COBRA qualified beneficiaries enroll in Cal-COBRA when their original 18 months of federal COBRA continuation of coverage ends. Not all COBRA beneficiaries will qualify and Cal-COBRA does not apply to all coverage plans. If you are interested in enrolling in Cal-COBRA when your original 18 months of federal COBRA continuation of coverage ends, please contact your current insurance company to receive information on Cal-COBRA election forms and application process. SHDR does not have information regarding Cal-COBRA offered by your insurance company.

Cal-COBRA is offered directly by your insurance carrier. Not all benefit plans are eligible for Cal-COBRA. SHDR does not have information regarding your insurance company's Cal-COBRA coverage information, as it varies by insurance company. Please contact your insurance carrier for more information regarding Cal-COBRA coverage and application process.

Your insurance carrier will be able to provide information on Cal-COBRA. Please contact your insurance company regarding Cal-COBRA.

Proof Of Coverage

If you need a Certificate of Creditable Coverage, while you are still enrolled in COBRA, to provide with your application for other coverage, please email a request to our COBRA Administration Team at cobraadmin@shdr.com.

If you have paid your COBRA premiums to the last day of your COBRA eligibility, SHDR can provide a HIPAA Certificate of Creditable coverage that will include the scheduled end date of your COBRA coverage. Please email a request to our COBRA Administration Team at cobraadmin@shdr.com.

ProView services are available exclusively through McGriff Insurance Services' CarePlus employee benefit programs, solutions, and strategies. For more information, visit www.careplusbenefits.com.

ProView Advanced Administrators, LLC a Division of BB&T Insurance Services Inc. BB&T and its representatives do not offer tax advice.
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