COBRA going out of the country

njjel

An employee was on FMLA leave and now advises she will not be returning and will be moving to Puerto Rico. Our carrier does not provide coverage there. Where do we go from here as far as offering COBRA goes?

Crout

This would be a great one to look up, but off the top of my head I would say that you still have a requirement to OFFER the benefit, which of course the former EE can turn down at her discretion as her situation dictates. I see that as a separate issue from what your obligations are in regard to the coverage provided by your carrier....that's the part you have to look up. Does the law encompass US Territories, or just the States?

nietra

Offer what you would offer any other employee. It's her money and if she wants to spend it on something that won't work for you it is no longer your problem...

She probably will decline and you won't have to think about it again.

LarryC

If your carrier does not offer coverage there, then you do not need to offer COBRA. Region-specific benefits are covered in 54.4980B-5, Q&A #4, part C. To quote, "the employer....is not required to make any other coverage available to the relocating qualified beneficiary if the only coverage the employer makes available to active employees is not available in the area to which the qualified beneficiary relocates."

I would make sure that this applies to all the insurances you offer, including your FSA.

Hope this helps, njjel.

Crout

Way to go, Larry.

njjel

Are we required to notify the employee that our carrier does not offer coverage where they are relocating?

LarryC

I don't see that anywhere in the regs, but just out of courtesy and CYA, I would do it.

Geno

[font size="1" color="#FF0000"]LAST EDITED ON 01-20-05 AT 12:20PM (CST)[/font][br][br]njjel,

The previous posters are correct, COBRA does not require you to make coverage available to a relocating Qualified Beneficiary (QB) other than coverage already available to active employees. But, it would still be wise to inform the employee (and other QB's) of their COBRA rights and offer them coverage (such as it is) because remember, the relocating former employee might not be the only QB in the picture and a qualifying child or former spouse who are not relocating may well choose to exercise their COBRA rights.

On the other hand, (and I don't want to stir up a hornet's nest here) but I was wondering if you were going to attempt to recover the ER's portion of the monthly health insurance premium that were paid in the EE's behalf during the his/her FMLA absence? I not saying that you should, just wanted to know that in some instances you can.

G

njjel

We are VERY employee friendly here and that would not be something they would consider, even though it is an option. :-)

pork1

You must offer COBRA!!! It does not matter for what reason the x-employee will decide to take the medical coverage or how the employee will get to the medical facilities covered by your plan. In our case the COBRA coverage for a family is $1000+ paid in advance and on time, monthly. Any medical facility in the world used can apply for claims activity, however, the deductible and the "out of network medical facility or physician used", the cost jumps to a 60/40 and a $400.00 deductible.

Accepting COBRA or denying COBRA is the x-employee's burden not the plan's burden!!! The plan's burden is to insure COBRA as written is offered.

PORK

Ethel

In our case the COBRA coverage for a
>family is $1000+ paid in advance and on time,
>monthly. Any medical facility in the world used
>can apply for claims activity, however, the
>deductible and the "out of network medical
>facility or physician used", the cost jumps to a
>60/40 and a $400.00 deductible.



I can't believe that someone else has the type of costs we do for medical!!!! I thought ours were so outrageous that we were probably one of the only ones with this sort of "hi-jack" premiums. Guess misery does love company, because this makes me fee a tiny bit better -- really felt terrible this year that we could not negotiate any lower premiums.

stilldazed

Our family policy is above $900. A 10% increase (a very real possibility) will push us to $1,000 if we don't change our policy. And we are in a very rural setting, somewhat economically depressed (no palm trees) part of Florida.

pork1

I am still dazed too! Our employee premium for family coverage is $41.50 a week and $12.00 per week for the employee and this is our third year of being at these rates. We are lucky to have a caring company that is willing to foot the bill for a fully self-insured plan. However, the 401 K has suffered, as a result the owners have chosen to push supplemental 401 K awards to the medical plan cost instead of giving the 401 K any profit sharing hits. Which is bad for some who are not sickly and don't use the plan but pay the premium for the insurance factor. The owners are getting the biggest bang for their buck, while helping the young wage earners verses us old "boomers" (I stretch it just alittle to call my self a "boomer")! May everyone have a Blessed day.