If you submit payments after the deadline, or if you submit payment and are then determined to be ineligible for coverage, we will return your payment s to you.
Submission of premiums, or acceptance of premiums by UnifyHR, does not indicate that coverage is in force. If your coverage is canceled for non-payment or late payment of premiums, it cannot be reinstated. Continuation coverage under COBRA generally lasts for 18 months due to employment termination or a reduction in hours worked.
Certain qualifying events lead to a maximum of 36 months of continuation coverage. These "month" qualifying events include the death of an employee, the covered employee's divorce or legal separation, or a dependent child's losing eligibility as a dependent child. In limited circumstances, the covered employee's entitlement to Medicare may also be a qualifying event. Continuation coverage may end before the date noted above in certain circumstances like failure to pay premiums, fraud, or the individual becomes covered under Medicare or another group health plan.
The plan can charge qualified beneficiaries an increased premium, up to percent of the cost of coverage, during the month disability extension. The requirements are: The Social Security Administration SSA must determine that the disabled qualified beneficiary is disabled before the 60th day of continuation coverage; and, The disability continues during the rest of the initial month period of continuation coverage. The disabled qualified beneficiary or another person on his or her behalf also must notify the plan of the SSA determination.
The plan can set a time limit for providing this notice of disability, but the time limit cannot be shorter than 60 days, starting from the latest of: The date on which SSA issues the disability determination; The date on which the qualifying event occurs; The date on which the qualified beneficiary loses or would lose coverage under the plan as a result of the qualifying event; or The date on which the qualified beneficiary is informed, through the furnishing of either the SPD or the COBRA general notice, of the responsibility to notify the plan and the procedures for doing so.
The right to the disability extension may be terminated if SSA determines that the disabled qualified beneficiary is no longer disabled. The plan can require disabled qualified beneficiaries to provide notice when such a determination is made. The plan must give the qualified beneficiaries at least 30 days after the SSA determination to provide such notice.
An extension of coverage due to a determination of disability is available only if you notify UnifyHR of the disability determination.
This notice must be provided within 60 days as described above. To provide notice, you must use the form titled "Notice of Disability" available from UnifyHR, and you must follow the procedures outlined in the notice. Additional information is available in the "Notice Procedures" section later in this document. Second qualifying events are: Death of the covered employee Divorce or legal separation of the covered employee and spouse Medicare entitlement only in certain circumstances The loss of dependent child status under the plan.
The additional period of coverage is available only if the second event would have caused the qualified beneficiary to lose coverage under the plan assuming the first event had not happened.
An extension of coverage due to a second qualifying event is available only if you notify UnifyHR that the second qualifying event has happened. This notice must be provided within 60 days after the date of the second qualifying event. To provide notice, you must use the form titled "Notice of Second Qualifying Event" available from UnifyHR, and you must follow the procedures outlined in the notice.
You can lose COBRA coverage early before the maximum period of coverage expires for the following reasons: You fail to make full payment for coverage on a timely basis Your former employer ceases to maintain any group health plan You become covered under another group health plan after electing continuation coverage You become entitled to Medicare benefits after electing continuation coverage You engage in conduct that would justify the termination of your coverage such as fraud If your continuation coverage is terminated early, you will receive a notice that outlines the date coverage will terminate, the reason for termination, and any rights you may have under the plan or applicable law to elect alternative coverage.
This notice will also include instructions for filing an appeal. If you decide to terminate your COBRA coverage early, you generally won't be able to get a Marketplace plan outside of the open enrollment period.
More information about the Marketplace is available below. You should compare your other coverage options with COBRA continuation coverage and choose the coverage that is best for you. For example, if you move to other coverage, you may pay more out of pocket than you would under COBRA because the new coverage may impose a new deductible.
When you lose job-based health coverage, it's important that you choose carefully between COBRA continuation coverage and other coverage options, because once you've made your choice, it can be difficult or impossible to switch to another coverage option. What is the Health Insurance Marketplace? Being offered COBRA continuation coverage won't limit your eligibility for coverage or a tax credit through the Marketplace.
If you elect through the Marketplace, you may experience a gap in coverage between the date you lose coverage under the group health plan, and the date coverage begins through the Marketplace you will not experience a gap if you elect and pay for COBRA continuation coverage. When can I enroll in Marketplace coverage?
To find out more about enrolling in the Marketplace, such as when the next open enrollment period will be and what you need to know about qualifying events and special enrollment periods, visit www.
Once you've exhausted your COBRA continuation coverage and the coverage expires, you'll be eligible to enroll in Marketplace coverage through a special enrollment period, even if Marketplace open enrollment has ended.
Can I enroll in another group health plan? Other options, like coverage on a spouse's plan or through the Marketplace, may be less expensive. Provider Networks : If you're currently getting care or treatment for a condition, a change in your health coverage may affect your access to a particular health care provider.
You may want to check to see if your current health care providers participate in a network as you consider options for health coverage. Drug Formularies : If you're currently taking medication, a change in your health coverage may affect your costs for medication - and in some cases, your medication may not be covered by another plan.
You may want to check to see if your current medications are listed in drug formularies for other health coverage.
Severance payments : If you lost your job and got a severance package from your former employer, your former employer may have offered to pay some or all of your COBRA payments for a period of time. In this scenario, you may want to contact the Department of Labor at to discuss your options. Service Areas : Some plans limit their benefits to specific service or coverage areas - so if you move to another area of the country, you may not be able to use your benefits.
You may want to see if your plan has a service or coverage area, or other similar limitations. Other Cost-Sharing : In addition to premiums or contributions for health coverage, you probably pay copayments, deductibles, coinsurance, or other amounts as you use your benefits.
We would love to chat with you about your current benefits offerings and best practices that may save you and your employees even more. Search through our interactive database of videos, flyers, tutorials, and other tools to help maximize your BRI experience.
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