Two federal agencies are providing resources to resolve conflicts regarding a former employee’s right to COBRA subsidy.
In some cases, employers will believe it is within the law and within their rights to deny a former employee’s request for the COBRA premium subsidy. The Department of Labor and Centers for Medicare and Medicaid Services are providing forms and a channel that former employees can use to appeal those decisions.
The American Recovery and Reinvestment Act of 2009 (ARRA, commonly known as the “Economic Stimulus Package”) created a COBRA premium subsidy whereby certain qualified beneficiaries known as “Assistance Eligible Individuals” (AEIs) may pay only 35% of the normal COBRA premium for a limited period of time. The employer would pay the other 65% of the COBRA premium and be reimbursed for these costs in the form of a payroll tax credit.
The Department of Labor (DOL) and the Centers for Medicare and Medicaid Services (CMS) have posted on their web sites the application forms a qualified beneficiary may complete to request an expedited review by the DOL or CMS of the AEI’s denied request by a former employer for the reduced COBRA premium.
The DOL application form available online is for use only by AEIs covered under private-sector group health plans. AEIs covered under group health plans sponsored by federal, state or local governments, and AEIs covered under a state’s “mini-COBRA” law should use the CMS equivalent application.
The DOL version of the application form is available at http://www.dol.gov/ebsa/COBRA/main.html.
The CMS version of the form is available at http://www.cms.hhs.gov/COBRAContinuationofCov/.
