COBRA COBRA EXPANSIONEXPANSION

How It Impacts YouHow It Impacts You

What Is COBRA?What Is COBRA?

The opportunity to continue group The opportunity to continue group health coverage when there is a health coverage when there is a “qualifying event” that would result “qualifying event” that would result in the loss of coverage under an in the loss of coverage under an employer’s plan.employer’s plan.

This continuance of group coverage This continuance of group coverage is also available to all “qualified is also available to all “qualified beneficiaries”.beneficiaries”.

What Is COBRA What Is COBRA Expansion?Expansion?

Included in the recently passed Stimulus Included in the recently passed Stimulus Package are changes that impact COBRA Package are changes that impact COBRA premiums.premiums.

Those who involuntarily lost their jobs, on Those who involuntarily lost their jobs, on or after September 1, 2008 are eligible for or after September 1, 2008 are eligible for a COBRA subsidy effective March 1, 2009.a COBRA subsidy effective March 1, 2009.

The subsidy is for 65% of the cost of The subsidy is for 65% of the cost of COBRA for a maximum of 9 months.COBRA for a maximum of 9 months.

The subsidy reduces your COBRA costs by The subsidy reduces your COBRA costs by 65% for those 9 months.65% for those 9 months.

Which Benefits qualify for Which Benefits qualify for COBRA?COBRA?

Group Health InsuranceGroup Health Insurance Dental InsuranceDental Insurance Vision InsuranceVision Insurance Medical Flex Spending AccountsMedical Flex Spending Accounts

Flex Spending Accounts costs are NOT Flex Spending Accounts costs are NOT impacted by COBRA Expansionimpacted by COBRA Expansion

Examples of Costs?Examples of Costs? Without Subsidy Without Subsidy

Health SingleHealth Single $300.00$300.00 Health Family $750.00Health Family $750.00 Dental SingleDental Single $ 30.00$ 30.00 Dental FamilyDental Family $ 70.00$ 70.00 Vision Single Vision Single $ 10.00$ 10.00 Vision FamilyVision Family $ 20.00$ 20.00

With SubsidyWith Subsidy Health SingleHealth Single $105.00$105.00 HMO FamilyHMO Family $262.50$262.50 Dental SingleDental Single $ 10.50$ 10.50 Dental FamilyDental Family $ 22.79$ 22.79 Vision Single Vision Single $ 3.50$ 3.50 Vision FamilyVision Family $ 7.00$ 7.00

Subsidies last up to 9 months

FROM your last day of employment.

How Long Does COBRA How Long Does COBRA Last?Last?

Most employees will be able to Most employees will be able to remain on COBRA for up to 18 remain on COBRA for up to 18 months.months.

Some circumstances allow for a Some circumstances allow for a longer period of coverage.longer period of coverage.

What Kind of Coverage is What Kind of Coverage is COBRA?COBRA?

COBRA is a continuation of the policy COBRA is a continuation of the policy that you are currently enrolled in. The that you are currently enrolled in. The group plans your former employer has group plans your former employer has for active employees.for active employees.

If the group plan changes, while you If the group plan changes, while you are on COBRA, your coverage changes are on COBRA, your coverage changes to the new plan, just as it would have, to the new plan, just as it would have, if you had remained employed.if you had remained employed.

When Does COBRA When Does COBRA Coverage End?Coverage End?

COBRA coverage will terminate for any COBRA coverage will terminate for any of the following reasonsof the following reasons You reach the maximum period of coverage You reach the maximum period of coverage

allowed; generally 18 months.allowed; generally 18 months. Premiums are not paid in full and on time.Premiums are not paid in full and on time. A qualified beneficiary become covered A qualified beneficiary become covered

under another group plan.under another group plan. A covered employee A covered employee BECOMESBECOMES eligible for eligible for

Medicare benefits under Part A, Part B, or Medicare benefits under Part A, Part B, or Both.Both.

The employer ceases to provide a group The employer ceases to provide a group health plan.health plan.

How Do HIPPA and COBRA How Do HIPPA and COBRA Work Together?Work Together?

HIPPA ensures that if you do not have a HIPPA ensures that if you do not have a break in coverage of 63 days or longer, that break in coverage of 63 days or longer, that you will be credited with having had prior you will be credited with having had prior coverage with regard to pre-existing health coverage with regard to pre-existing health condition exclusions on the next group condition exclusions on the next group health policy you enroll in.health policy you enroll in.

There are special enrollment rights to a There are special enrollment rights to a new employers health plan through HIPPA new employers health plan through HIPPA to ensure continuous coverage.to ensure continuous coverage.

COBRA allows you to keep your current COBRA allows you to keep your current coverage, so that you do not have a 63 day coverage, so that you do not have a 63 day break in coverage.break in coverage.

How Do You Elect How Do You Elect COBRA?COBRA?

You and your qualified beneficiaries You and your qualified beneficiaries will receive a packet of COBRA will receive a packet of COBRA information covering your rights, information covering your rights, and an enrollment form.and an enrollment form.

Each “beneficiary” has the right to Each “beneficiary” has the right to elect or waive coverage.elect or waive coverage.

You have 60 days to elect coverage, You have 60 days to elect coverage, by completing and returning the by completing and returning the enrollment form.enrollment form.

How Do You Pay for How Do You Pay for COBRA?COBRA?

You have 45 days after electing You have 45 days after electing coverage, to pay for the coverage. coverage, to pay for the coverage.

At that time coverage must be paid for At that time coverage must be paid for in full, back to the date of termination.in full, back to the date of termination.

Thereafter, payments are due the first of Thereafter, payments are due the first of every month for that month of coverage.every month for that month of coverage.

Payments are made to your former Payments are made to your former employer usually, but check your employer usually, but check your COBRA notice, for where to send your COBRA notice, for where to send your payments.payments.

Other Coverage Options?Other Coverage Options?

Private PoliciesPrivate Policies In some instances may cost lessIn some instances may cost less Not eligible for subsidy benefitsNot eligible for subsidy benefits

Medicare; for those age 65Medicare; for those age 65 Medicaid; for those who meet the income Medicaid; for those who meet the income

guidelinesguidelines Hawk-i for children of qualifying parentsHawk-i for children of qualifying parents

Recent changes have increased the income Recent changes have increased the income limits for children to qualify for this service to limits for children to qualify for this service to 300% of poverty rate.300% of poverty rate.

What is Hawk-i?What is Hawk-i?

Hawk-i is low cost or free coverage Hawk-i is low cost or free coverage for children, under the age of 19. for children, under the age of 19.

The amount you pay is based on your The amount you pay is based on your families income. No family pays families income. No family pays more then $20.00 per month for a more then $20.00 per month for a single child or $40.00 per month for single child or $40.00 per month for 2 or more children.2 or more children.

How Do I Qualify?How Do I Qualify? July 1, 2009 the income guidelines for July 1, 2009 the income guidelines for

Hawk-i were increased from 200% of the Hawk-i were increased from 200% of the poverty rate to 300% of the poverty rate.poverty rate to 300% of the poverty rate.

Currently a family of 5 can make Currently a family of 5 can make between$34,302 and $38,684 per year, between$34,302 and $38,684 per year, and qualify for Hawk-i at NO cost to the and qualify for Hawk-i at NO cost to the insured.insured.

Currently a family of 5 can make Currently a family of 5 can make between $38,685 and $77,370 per year, between $38,685 and $77,370 per year, and qualify for Hawk-i for a nominal and qualify for Hawk-i for a nominal premium.premium.

What Services does Hawk-i What Services does Hawk-i Cover?Cover?

Doctor VisitsDoctor Visits Outpatient ServicesOutpatient Services Well Child VisitsWell Child Visits Vaccines & Vaccines &

ImmunizationsImmunizations Inpatient Hospital Inpatient Hospital

ServicesServices Prescription Prescription

MedicinesMedicines Eye Glasses and Eye Glasses and

ExamsExams

Dental Care and Dental Care and ExamsExams

Hospice CareHospice Care Speech Therapy & Speech Therapy &

Physical TherapyPhysical Therapy Ambulance ServicesAmbulance Services Nursing Care Nursing Care

ServicesServices Hearing ExamsHearing Exams Home Health CareHome Health Care Chiropractic CareChiropractic Care

How do I Apply for Hawk-How do I Apply for Hawk-i?i?

You can obtain a form from most doctors You can obtain a form from most doctors offices or your schooloffices or your school

You can also go on-line to You can also go on-line to www.hawk-i.orgwww.hawk-i.org and download an and download an application or complete an application application or complete an application on line.on line.

You can reach Hawk-i and request an You can reach Hawk-i and request an application by calling 1-800-257-8563, application by calling 1-800-257-8563, and an application will be mailed to your and an application will be mailed to your residence.residence.

HCTC & COBRAHCTC & COBRA

HCTC is essentially another Health HCTC is essentially another Health Insurance subsidy program for employees Insurance subsidy program for employees who lose their job, due to that job being who lose their job, due to that job being moved to a location outside of the U.S.moved to a location outside of the U.S.

It applies to health insurance ONLY.It applies to health insurance ONLY. The subsidy is currently 80% , IF your The subsidy is currently 80% , IF your

previous employer is NOT paying at least previous employer is NOT paying at least 50% of your COBRA premiums.50% of your COBRA premiums.

You must be receiving UI, TAA or ATAA You must be receiving UI, TAA or ATAA benefits and be age 50 or over to qualify.benefits and be age 50 or over to qualify.

HCTC & COBRAHCTC & COBRA

You are NOT eligible for HCTC if you You are NOT eligible for HCTC if you are receiving benefits throughare receiving benefits through MedicareMedicare Military Health System (excluding those Military Health System (excluding those

thru Veterans Affairs benefits)thru Veterans Affairs benefits) MedicaidMedicaid SCHIPSCHIP Federal Employees Health Benefits Federal Employees Health Benefits

ProgramProgram

Other Scenarios for Other Scenarios for HCTCHCTC

You are eligible for HCTC if you and your You are eligible for HCTC if you and your spouse pay MORE than 50% of the cost of the spouse pay MORE than 50% of the cost of the spousal coverage for a “Qualified Health spousal coverage for a “Qualified Health Plan”.Plan”.

You are eligible for HCTC if you buy a state-You are eligible for HCTC if you buy a state-qualified health plan. These are “guarantee qualified health plan. These are “guarantee issue” plans. issue” plans.

You are eligible for HCTC if you have a You are eligible for HCTC if you have a “qualified” private insurance plan in place 30 “qualified” private insurance plan in place 30 days prior to your termination date.days prior to your termination date.

Medicare supplement plans are not Medicare supplement plans are not considered “Qualified Health Plans”.considered “Qualified Health Plans”.

Your Responsibilities for Your Responsibilities for COBRACOBRA

Timely completion of all forms.Timely completion of all forms. Timely payment of your coverage.Timely payment of your coverage. It is VERY important that you keep It is VERY important that you keep

your former employer informed of your former employer informed of your current mailing address and your current mailing address and the current mailing address of your the current mailing address of your “qualified beneficiaries” in order for “qualified beneficiaries” in order for them to notify you of plan changes, them to notify you of plan changes, price changes, etc.price changes, etc.

Questions?Questions?