I’m happy to report that this year’s UBA Health Plan survey achieved a milestone. For the first time, we surpassed 20,000 health plans entered—20,099 health plans to be exact, which were sponsored by 11,221 employers. What we were able to determine from all this data was that a tumultuous Presidential election likely encouraged many employers to stay the course and make only minor increases and decreases across the board while the future of the Patient Protection and Affordable Care Act (ACA) became clearer.

There were, however, a few noteworthy changes in 2017. Premium renewal rates (the comparison of similar plan rates year over year) rose nearly 7%, representing a departure from the trend the last five years. To control these costs, employers shifted more premium to employees, offered more lower-cost CDHP and HMO plans, increased out-of-network deductibles and out-of-pocket maximums, and significantly reduced prescription drug coverage as six-tier prescription drug plans exploded on the marketplace. Self-funding, particularly among small groups, is also on the rise.

Percent Premium Increase Over Time

UBA has conducted its Health Plan Survey since 2005. This longevity, coupled with its size
 and scope, allows UBA to maintain its superior accuracy over any other benchmarking survey in the U.S. In fact, our unparalleled number of reported plans is nearly three times larger than the next two of the nation’s largest health plan benchmarking surveys combined. The resulting volume of data provides employers of all sizes more detailed—and therefore more meaningful—benchmarks and trends than any other source.

By Peter Weber
Originally Published By United Benefit Advisors

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) allows qualified beneficiaries who lose health benefits due to a qualifying event to continue group health benefits. The COBRA payment process is subject to various rules in terms of grace periods, notification, premium payment methods, and treatment of insignificant shortfalls.

Grace Periods

The initial premium payment is due 45 days after the qualified beneficiary elects COBRA. Premium payments must be made on time; otherwise, a plan may terminate COBRA coverage. Generally, subsequent premium payments are due on the first day of the month. However, under the COBRA grace period rules, premiums will still be considered timely if made within 30 days after the due date. The statutory grace period is a minimum 30-day period, but plans may allow qualified beneficiaries a longer grace period.

A COBRA premium payment is made when it is sent to the plan. Thus, if the qualified beneficiary mails a check, then the payment is made on the date the check was mailed. The plan administrators should look at the postmark date on the envelope to determine whether the payment was made on time. Qualified beneficiaries may use certified mail as evidence that the payment was made on time.

The 30-day grace period applies to subsequent premium payments and not to the initial premium payment. After the initial payment is made, the first 30-day grace period runs from the payment due date and not from the last day of the 45-day initial payment period.

If a COBRA payment has not been paid on its due date and a follow-up billing statement is sent with a new due date, then the plan risks establishing a new 30-day grace period that would begin from the new due date.

Notification

The plan administrator must notify the qualified beneficiary of the COBRA premium payment obligations in terms of how much to pay and when payments are due; however, the plan does not have to renotify the qualified beneficiary to make timely payments. Even though plans are not required to send billing statements each month, many plans send reminder statements to the qualified beneficiaries.

While the only requirement for plan administrators is to send an election notice detailing the plan’s premium deadlines, there are three circumstances under which written notices about COBRA premiums are necessary. First, if the COBRA premium changes, the plan administrator must notify the qualified beneficiary of the change. Second, if the qualified beneficiary made an insignificant shortfall premium payment, the plan administrator must provide notice of the insignificant shortfall unless the plan administrator chooses to ignore it. Last, if a plan administrator terminates a qualified beneficiary’s COBRA coverage for nonpayment or late payment, the plan administrator must provide a termination notice to the qualified beneficiary.

The plan administrator is not required to inform the qualified beneficiary when the premium payment is late. Thus, if a plan administrator does not receive a premium payment by the end of the grace period, then COBRA coverage may be terminated. The plan administrator is not required to send a notice of termination in that case because the COBRA coverage was not in effect. On the other hand, if the qualified beneficiary makes the initial COBRA premium payment and coverage is lost for failure to pay within the 30-day grace period, then the plan administrator must provide a notice of termination due to early termination of COBRA coverage.

By Danielle Capilla
Originally Published By United Benefit Advisors

Kathy! You are amazing! I was speaking with Dr. Abel today re a patient and on his own he brought up how you were able to fix his wife and daughter’s insurance in less than 24 hours AND you were so NICE and PROFESSIONAL. He then said you were AMAZING. I absolutely love working with you, Ron, and the entire gang! Just wanted to pass this on - and again thank you for all you do for us!!!!

- Office Manager, Surgical Center in San Francisco

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