[MyOEBB] Third message about COBRA Subsidy - ARPA

[MyOEBB system updates]

Dear OEBB Benefits Administrators, Business Managers, and Premium Contacts:

Over the past month, we sent you two emails describing the new COBRA subsidy requirement by the American Rescue Plan Act of 2021 (ARPA). Our first email described the requirement and our process for determining eligibility. The second email described our invoice and billing process. This third email is just to summarize it all for you and ensure you understand what will be required of you.


The Law
This new federal law subsidizes the full COBRA premium for "Assistance Eligible Individuals" (AEI). This premium assistance is available from April 1, 2021, to September 30, 2021.

An AEI qualifies for COBRA premium assistance if they:

  *   lose benefits due to involuntary employment termination or work hours reduction, AND
  *   not eligible for other group health coverage (a new employer or spouse's employer plan), AND
  *   not eligible for Medicare, AND
  *   are eligible and elect COBRA during the subsidy period.

Employers are responsible for paying 100 percent of an AEI's COBRA premium during the subsidy period (April 1, 2021, through September 30, 2021). You will be reimbursed by the federal government through:

  *   a credit against payroll taxes, and (if applicable)
  *   an overpayment refund for credit amounts exceeding payroll taxes.

More information on claiming reimbursement for COBRA subsidies can be found on IRS Notice 2021-31 at https://www.irs.gov/pub/irs-drop/n-21-31.pdf. A copy of the notice is also attached to this e-mail.
Employers that don't satisfy COBRA continuation coverage requirements may be investigated by the Department of Labor. They may also be subject to an excise tax under the Internal Revenue Code.

OEBB and BenefitHelp Solutions (BHS) have developed the following process for determining subsidy eligibility and billing/invoicing:


Eligibility Verification Process (your action items are in red bold type below)


  *   BHS will send legally required COBRA notices and an attestation form to COBRA members going back to the start of the pandemic (November 1, 2019 - forward).  The notices will go out no later than May 31, 2021.
  *   The attestation form outlines the eligibility requirements. If a COBRA-eligible individual (known as a "beneficiary") wishes to receive the subsidy, they will need to sign and date the form attesting that they are eligible for the COBRA subsidy program.
  *   BHS will prepare and send OEBB a weekly list of possible COBRA subsidy-eligible members (AEI's).
  *   OEBB will send your list to you for updates and review.  Please indicate the termination reason (involuntary, voluntary, reduction in hours) and return.  OEBB staff will send the list to BHS for processing.
  *   BHS will enroll eligible beneficiaries into the COBRA subsidy program retroactively effective April 1, 2021.


Invoice and Billing Process (your action items are in red bold type below)


*         OEBB will distribute invoices and collect premiums on behalf of BHS. This avoids the need for individual contracts between BHS and each employer.

*         Members who meet the eligibility requirements (listed above under "The Law") are eligible for the COBRA subsidy program.

*         BHS will enroll eligible beneficiaries (and their dependents, as applicable) retroactively effective April 1, 2021.

*         BHS will send OEBB monthly invoices for the eligible member/dependent(s).

*         OEBB will distribute the invoices to the appropriate employers.

*         Each employer will send the premium (payment) to OEBB. It's very important that the payment be sent timely, within 10-15 days of the receipt of the invoice.

*         OEBB will send BHS the premium received from each employer.

*         BHS will forward premiums to the appropriate health plan carriers.




Where to Find More Information



For more information on the subsidy and related questions, please visit the Department of Labor web site at https://www.dol.gov/cobra-subsidy or contact one of EBSA's Benefits Advisors at askebsa.dol.gov<https://askesba.dol.gov> or call 1-866-444-3272.

State or local government employers with questions regarding the premium assistance, can also contact the Centers for Medicare & Medicaid Services via email at mphig at cms.hhs.gov<mailto:mphig at cms.hhs.gov> or call 1-410-786-1565.



If you have questions

  *   about eligibility for the subsidy, please call BHS at 1-800-556-2230.
  *   the process we have described here, please email Sheila Clausen, OEBB/PEBB Policy Analyst at: SHEILA.C.CLAUSEN at dhsoha.state.or.us<mailto:SHEILA.C.CLAUSEN at dhsoha.state.or.us>.


Thank you for your cooperation and patience as we work through compliance with this law.

Regards,

Ali Hassoun
Director
Oregon Educators Benefit Board / Public Employees' Benefit Board
Oregon Health Authority - Health Policy & Analytics
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