Revised Notices Inform Individuals of Marketplace Coverage & Special Enrollment Rights

The U.S. Department of Labor has updated its Model General Notice of COBRA Rights, Model COBRA Election Notice, and Model CHIP Notice to reflect that coverage is now available in the Health Insurance Marketplace (also known as the Exchange) and provide information on special enrollment rights in the Marketplace.

COBRA Notice Requirements

COBRA (the Consolidated Omnibus Budget Reconciliation Act) generally applies to group health plans sponsored by employers with 20 or more employees (including both full- and part-time employees) on more than 50% of their typical business days in the previous calendar year.

Plan administrators are required to provide each covered employee and spouse with a written notice of COBRA rights within 90 days after the date group health plan coverage begins (general notice). Upon the occurrence of a qualifying event which results in loss of coverage under the group health plan, the plan administrator must provide “qualified beneficiaries” with an election notice, generally within 14 days after the administrator receives notice of the qualifying event.

 

CHIP Notice Requirement

Employers that provide coverage in states with premium assistance through Medicaid or the Children’s Health Insurance Program (CHIP) must inform employees of potential opportunities for assistance in obtaining health coverage annually before the start of each plan year.

FAQs related to the revised notices are available, along with agency guidanceregarding the Marketplace special enrollment period for individuals already enrolled in COBRA continuation coverage.