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Cafeteria Plans They are insurance plans offered by employers that allow the employees to choose their benefits from different taxable and non taxable options. Sometimes it is often known as a flexible benefit plans. Employers choose cafeteria plans to make the employees happy with their plans and to control benefit costs.
Certificate of Credible Coverage A written required document, that has to be provided to individuals by the plan. Certificate is issued when the coverage ends or when the individual becomes eligible for COBRA, the COBRA coverage ends or at any time upon request. The certificate includes the plan type and time periods of coverage. The certificate is used to produce record of coverage and to eliminate a pre-existing condition exclusion time period.
Church plans Group health plans sponsered by churches or other religious institutions that are exempt from the COBRA law requirements.
COBRA The Consolidated Omnibus Budget Reconciliation Act of 1985. COBRA is the name of a Federal law that mandates employers to offer certain individuals a continuation of their group health plan at affordable group rates, if the loss of insurance was due to certain qualifying events or change in family status. Specific time period are offered due to each qualifying event.
COBRA plan administrator A company and or individual who perform tasks need on a daily basis to administer COBRA information to the covered employee and their qualified beneficiaries. The administrator is sometimes hired as a 3rd party by the employer.
Continuation coverage Is an extension of the group health plan given by the employer. The date is usually the day following the qualifying event or the date following the loss of coverage. That date is to be determined without discrimination by the employer, to all beneficiaries of the policy.
disability A physical or mental condition which makes an individual unable to perform one or more dutiesof his or her occupation. A qualified beneficiary who is deemed totally disabled at any time durnign the first 60 days of COBRA coverage may be eligible for up to 29 months of continuation coverage. That is an additional 11 months added to the original 18 months.
Duplicate coverage When an individual and his/her qualified beneficiaries are using COBRA and are also covered under a new employer’s group health plan. An employer does not have to continue COBRA coverage for them if they are insured with a company that does not have a preexisting exclusion or limitations.
election form The form that is used to indicate whether or not a qualified beneficiary wishes to continue their health coverage following the occurance of a qualifying event.
Election notice A letter used to notify qualified beneficiaries of their COBRA rights.The letter is sent following the occurrence of a qualifying event.
Election period The amount of time during which a qualified beneficiary can make an election to continue their group health plan and chose COBRA coverage. The time period for election is 60 days from whichever is later; the day the insurance coverage ended or the date that the election notice was sent.
ERISA The Employee Retirement Income Security Act of 1974. The Act protects and guarantees employees and their beneficiaries by regulating the provisions for some employee benefits. It was amended in 1986 to include the provisions of COBRA
Group health plan A group health plan is defined by the law as benefits that include medical, dental, and vision insurance. It may also include prescription drug plans and also employer sponsered HSA accounts.
Premium For COBRA purposes, it is the cost of the group health plan that is offered as a continuation. When a qualifying event has happened, the qualified benificiary can be charged up to 102% of the cost of their health insurance.