|
Introduction -COBRA/N.H. State Continuation
In the event you lose your group health coverage (medical or dental) you may be eligible to continue your benefits for up to 18 months or longer. The options available to you are based on whether you were insured under a:
- Self-funded plan sponsored by your employer or
- An insurance plan provided by your employer through an insurance company (also referred to as a fully-insured plan)
COBRA -If your employer had 20 or more employees then you may be eligible for COBRA  (Consolidated Omnibus Budget Reconciliation Act of 1985) which allows for you and your dependents to continue on the group health (medical and dental) benefit plan at the employer's full price, plus a 2% administrative fee.
Fewer than 20 employees - If your employer offers a self-funded plan and has fewer than 20 employees, then you are not eligible for COBRA continuation and you should look for other options.
ARRA - Continuation coverage Assistance Under the American Recovery and Reinvestment Act of 2009 (USDOL). The American Recovery and Reinvestment Act of 2009 (ARRA) provides for premium reductions and additional election opportunities for health benefits under COBRA and N.H. State Continuation (This law applies to N.H. State Continuation if you were involuntary terminated from your job after September 1, 2008.) For more information go to the United States Department of Labor/ Employee Benefits Security Administration.
Government/Church Plans -If your group health plan is self-funded but offered through a government or church employer, you should contact your employer's human resources department for more information on what options are available for continuation of benefits.
Bankruptcy or Cancellation of Plan -If your employer discontinues the group self-funded health plan or closes it's business, then COBRA is not available to you and you should look for other options.
Health Care Tax Credits -The Health Care Tax Credits Act (HCTC) helps certain trade affected workers, retirees and their family pay for their health benefit plan premiums. The HCTC makes health coverage more affordable by paying 65% of the health premiums for individuals who are eligible for the tax credit.
Jurisdiction -The U.S. Department of Labor has jurisdiction over self-funded group health plans. They may be reached toll free at 1-866-444-EBSA (3272) or visit their web site at www.dol.gov.
***
N.H. State Continuation - If your group heath plan is a fully insured health insurance policy and you are a resident of N.H. then you may be eligible for N.H. State Continuation which allows for you and your dependents to continue on the group health (medical and dental) insurance plan at the employer's full price, plus a 2% administrative fee. This option is available to all sized employers who are fully insured.
20 or more employees - Employers with 20 or more employees offering a fully insured health plan can also offer
COBRA. You can elect either N.H. State Continuation or COBRA but not both.
ARRA - Continuation coverage Assistance Under the American Recovery and Reinvestment Act of 2009 (USDOL). The American Recovery and Reinvestment Act of 2009 (ARRA) provides for premium reductions and additional election opportunities for health benefits under COBRA and N.H. State Continuation (This law applies to N.H. State Continuation if you were involuntary terminated from your job after September 1, 2008.
Bankruptcy or Cancellation of Plan - 39 Week Continuation -If your employer discontinues the fully insured health (medical and dental) insurance plan or closes it's business and you are a resident of N.H. and working in N.H. you may be eligible for 39 week continuation. This option allows for you and your dependents to continue on the group health insurance plan at the employer's full price plus a 2% administrative fee for a period of 39 weeks. If this occurs, ask your employer or insurance carrier about this option. Contact the N.H. Insurance Department. (RSA 415:18 xvii (a-d))
ARRA is now applicable to 39 week continuation. http://www.irs.gov/newsroom/article/0,,id=205364,00.html
Health Care Tax Credits -The Health Care Tax Credits Act (HCTC) helps certain trade affected workers, retirees and their family pay for their health benefit plan premiums. The HCTC makes health coverage more affordable by paying 65% of the health premiums for individuals who are eligible for the tax credit. HCTC's are under the jurisdiction of the Federal Government.
Jurisdiction - The N.H. Insurance Department has jurisdiction over insurance companies and group health insurance contracts that are issued to N.H. residents. We may be reached at 800-852-3416, option 2, 603-271-2261 or via email at consumerservices@ins.nh.gov.
ARRA - Continuation coverage Assistance Under the American Recovery and Reinvestment Act of 2009 (USDOL). The American Recovery and Reinvestment Act of 2009 (ARRA) provides for premium reductions and additional election opportunities for health benefits under COBRA and N.H. State Continuation (This law applies to N.H. State Continuation if you were involuntary terminated from your job after September 1, 2008 or if your employer cancels the group health plan or employer goes out of business. http://www.irs.gov/newsroom/article/0,,id=205364,00.html
- Eligible individuals pay only 35 percent of their COBRA premiums and the remaining 65 percent is reimbursed to the coverage provider through a tax credit.
- The premium reduction applies to periods of health coverage BEGINNING ON OR AFTER FEBRUARY 17, 2009 AND LASTS FOR UP TO NINE MONTHS FOR THOSE ELIGIBLE FOR COBRA (This law applies to N.H. State Continuation and 39 week continuation) DURING THE PERIOD BEGINNING SEPTEMBER 1, 2008 AND ENDING DECEMBER 31, 2009 due to an INVOLUNTARY TERMINATION of employment that occurred during that period.
- My request for premium assistance has been denied. What can I do now? If you believe you are entitled to the premium assistance, you may request that either CMS or the DOL review your case. Each is accepting a separate review form. The DOL handles all cases arising under private sector employers with twenty or more employees, while CMS handles all cases arising under public sector government employers and private sector employers with fewer than 20 employees in states with "mini-COBRA" laws. For more information about the COBRA continuation coverage laws administered by CMS and DOL, visit the About Premium Assistance page on this website.
- U.S. Department of Labor information on ARRA
- Appeals Information
Resources
Adobe Acrobat Reader format. You can download a free reader from Adobe.
|
