Managing COBRA

This chapter provides an overview of managing COBRA (Consolidated Omnibus Budget Reconciliation Act) and discusses how to:

Click to jump to parent topicUnderstanding COBRA Management

The system searches the database for COBRA qualifying events that you define and identifies those employees and dependents who are eligible for COBRA benefits. Once these qualified beneficiaries are identified, you can retrieve data through the COBRA pages and track the qualifying event, the calculated coverage begin and end dates, and COBRA status for each beneficiary. You can also enter health and FSA benefit elections.

To administer COBRA:

  1. Perform PeopleSoft Enterprise Human Resources functions as usual.

    For example, terminate employees, retire employees, and record marital status changes. These functions trigger COBRA activity.

  2. Run the COBRA process to identify qualifying events and beneficiaries.

  3. Generate COBRA notification letters and enrollment forms.

  4. Enter COBRA elections or coverage waivers.

  5. Manage COBRA benefits for non-employee COBRA beneficiaries and their dependents.

  6. Terminate COBRA enrollment for beneficiaries who lose their coverage due to lack of payment or voluntary termination.

Click to jump to parent topicDetermining Qualified COBRA Events

This section discusses:

Click to jump to top of pageClick to jump to parent topicUnderstanding COBRA Events

A qualified COBRA event:

In the Manage Base Benefits business process, qualifying events are triggered through PeopleCode. In PeopleSoft Enterprise Benefits Administration, qualifying events are triggered after Event Maintenance has been finalized. The exception (for both the Manage Base Benefits business process and Benefits Administration) is overage dependent processing. Overage dependent events are identified during the COBRA batch process and are automatically adjusted.

Information about triggered events is transferred to the COBRA Activity table for further analysis during the COBRA process.

There are two types of COBRA events: initial and secondary. An initial event is the first qualifying event for an employee.

Understanding Initial COBRA Events

The following table shows the initial qualifying COBRA events that PeopleSoft delivers, the user actions that trigger them, and the potential COBRA beneficiaries of each event.

Qualifying COBRA Event

User Action Trigger

Potential COBRA Beneficiaries

Loss of eligibility due to termination

Employee status changes to Terminated or Suspended.

Employee and dependents

Loss of eligibility due to reduction in hours

Employee status remains Active; Standard hours decrease.

Employee and dependents

Loss of eligibility due to retirement

Employee status changes to Retired.

Employee and dependents

Loss of eligibility due to military leave

Leave of Absence/Military Leave action/action reason combination is entered for the employee.

Employee and dependents

Death of employee

Employee status changes to Deceased or a Family Status Change/Death action/action reason combination is entered for an employee.

All dependents

Divorce

Marital status changes to Divorced; spouse becomes ex-spouse.

Spouse

Marriage of dependent

Dependent marital status changes to Married.

Individual dependent

Dependent reaches coverage age limit (overage dependent)

No user action; current age of dependent exceeds maximum dependent age or maximum student dependent age. (The system checks whether or not the dependent is a student.)

Individual dependent

Employee becomes entitled to Medicare

Medicare entitlement date is entered.

All dependents

Note. According to federal government guidelines, employees and spouses of employees who undergo voluntary or involuntary termination for "gross misconduct" are not eligible for COBRA coverage. COBRA Administration does not differentiate between terminations for gross misconduct and other termination types, but you can set up action reason codes and add PeopleCode to perform this function.

Understanding Secondary COBRA Events

Secondary events extend coverage eligibility and are limited to dependents who are currently enrolled in COBRA coverage. A secondary event must meet the following requirements:

The triggers for secondary events are identical to the triggers for initial events, with one exception. If the initial event is a termination and the secondary event is a death, you must use the delivered action/action reason combination of FSC/DEA to successfully process the event.

See Also

Processing Enrollments for Secondary Events

Click to jump to top of pageClick to jump to parent topicPage Used to Determine Qualified COBRA Events

Page Name

Object Name

Navigation

Usage

COBRA Activity

COBRA_ACTIVITY

Benefits, Administer COBRA Benefits, Manage Automated Participation, Review COBRA Triggers, COBRA Activity

Add, delete, and review COBRA events.

Click to jump to top of pageClick to jump to parent topicAdding, Deleting, and Reviewing COBRA Events

Access the COBRA Activity page.

Activity Tab

CBR Action (COBRA action)

Describes the type of event that took place.

Activity Source

Indicates who or what initiated the event.

Ben Rcd# (benefit record number)

Indicates the benefit record affected by the event.

Coverage Override Tab

CBR Act Src (COBRA action source)

This identifies the source of the activity record.

Coverage Override

Select when an alternate coverage termination date should be used to determine qualified COBRA coverage.

Alt Covrg Term Date (alternate coverage termination date)

The date when coverage was previously terminated. Required when the coverage override flag is selected.

Covrg As-Of Date (coverage as of date)

The date that coverage should begin if the event is fully qualified. The system sets the COBRA event date if this field is left blank.

See Also

Defining Eligibility Rules

Creating Event Rules

Event Maintenance

Click to jump to top of pageClick to jump to parent topicOverriding Initial and Secondary COBRA Events

The system assumes that the date of the event and the date that an employee’s benefits terminate are the same, which is not always true.

For example, suppose that an employee drops spousal coverage during Open Enrollment and then later gets divorced. The benefit plan must make COBRA coverage available upon receiving notice of the divorce.

Another example is when an employee decides not to return to work from FMLA. COBRA coverage becomes available on the day human resources is notified the employee is not returning, not on the last day of the FMLA, unless notification is made on the last day of FMLA. The maximum coverage period usually begins on that day also.

In order for the COBRA process to recognize these events as enabling dependents to become eligible for COBRA benefits, you must enter the event directly into the COBRA Activity Table.

You cannot enter an event unless you have selected Manual Events Allowed in the COBRA Event Rules Table for the COBRA event classification. You may want to add a new COBRA event classification to identify these specific situations. COBRA events triggered through the Manage Base Benefits business process or Benefits Administration can be deleted on the COBRA Activity Table, but not modified. COBRA events that you enter through the COBRA Activity page can be changed.

Click to jump to parent topicRunning the COBRA Process

This section provides an overview of the COBRA process and describes how to:

Click to jump to top of pageClick to jump to parent topicUnderstanding the COBRA Process

The COBRA process determines employee and dependent eligibility for COBRA benefit coverage.

For an employee or dependent to become a qualified COBRA beneficiary, the following two requirements must be met:

If these requirements are met, COBRA process assigns the beneficiary a benefit program and allows that person to elect COBRA health coverage.

Click to jump to top of pageClick to jump to parent topicPages Used to Run the COBRA Process

Page Name

Object Name

Navigation

Usage

Run Control

COBRA_RUNCTL

Benefits, Administer COBRA Benefits, Manage Automated Participation, Qualify Event/Proc Enrollment, Run Control

Determine COBRA eligibility.

Process Messages

COBRA_MESSAGES

Benefits, Administer COBRA Benefits, Review Processing Results, Review Processing Message, Process Messages

View error messages for the COBRA process.

Click to jump to top of pageClick to jump to parent topicRunning the COBRA Process

Access the Run Control page.

COBRA Processing Phase

Displays the phase where processing begins. Possible phases are:

Ready: Ready for processing.

Overage: Processing overage dependents.

Activity: Processing COBRA activity.

Qualify: Processing qualifying events.

Participant: Processing COBRA participants.

Complete: Processing completed.

Process Overage Dependents

Clear this check box to skip overage dependent processing during the batch run.

Chk Point Interval in Minutes (check point interval in minutes)

Enter the number of minutes before the process commits information that's been processed so far and updates the information displayed in the Restart Position group box.

If an error occurs, the system restarts the process from the last checkpoint.

Restart Position

Displays the position from which to restart the COBRA process from if a system failure occurs.

Note. On the Process Scheduler page, select the COBRA Admin & Non Employee process to run the COBRA process. This runs both the COBRA Administration and COBRA Non Employee processes. The COBRA Administration process takes the relevant data and puts it into a temporary table. The COBRA Non Employee process writes the data to the correct PERSON table.

Click to jump to top of pageClick to jump to parent topicUnderstanding COBRA Event Status

Once a COBRA event has been triggered (online or through Benefits Administration), the COBRA process determines whether any employees or dependents have lost health coverage due to the event. The system considers these people to be qualified COBRA beneficiaries.

Each person analyzed by the COBRA process receives three status values:

The event qualification status identifies participants who qualify for COBRA. Values are:

The initial event status tracks the process of the event in the COBRA cycle; it also marks whether participants have their options prepared and are notified of coverage. Values include:

The secondary event status is always Not Qualified unless the COBRA participant has been affected by a secondary event, such as divorce or Medicare entitlement. Other values include:

When a participant is enrolled in COBRA coverage through an initial event and a qualified secondary event occurs for all of that participant’s plans, the system sets the participant’s initial event status to Not Qualified.

In the case of a combination event, which acts as an initial event for certain plans and as a secondary event for other plans, plans for which the combination event acts as a secondary event are set to Not Qualified. Initial event status values for plans where the combination event acts as an initial event are set to appropriate levels for the current stage of processing.

Status values for initial and secondary events are updated as participants move through the COBRA process.

See Also

Processing Enrollments for Secondary Events

Click to jump to top of pageClick to jump to parent topicAssigning Qualified COBRA Beneficiaries to Benefit Programs

Benefit program assignment differs for COBRA events initiated by the Manage Base Benefits business process and Benefits Administration.

If a COBRA event is initiated by the Manage Base Benefits business process, the system assigns each qualified beneficiary to the benefit program that the employee was enrolled in on the day prior to the COBRA event date.

If the event is processed through Benefits Administration, then the system determines benefit program eligibility for each qualified COBRA beneficiary, using the eligibility parameters from the latest run of Benefits Administration and the qualified beneficiary’s ZIP code. If no benefit programs satisfy this eligibility criteria, then the participant is assigned to the benefit program enrolled in on the day prior to the COBRA event date.

Note. This process only occurs for qualified participants who have a COBRA process status of Open For Processing (as opposed to Closed or Void).

See Also

Adjusting and Reprocessing COBRA Events

Event Maintenance

Click to jump to top of pageClick to jump to parent topicDetermining Eligible Plan Types

Beneficiaries are eligible for all COBRA-qualified group health plan types they were enrolled in prior to the COBRA event. This includes all Health (1x) plan types and the Health FSA (60) plan type.

In order for a plan type within a specific benefit program to be designated as COBRA-qualified, you must select the COBRA Plan check box in the Plan Type and Option page of the Benefit/Deduction Program component.

Click to jump to top of pageClick to jump to parent topicDetermining Eligible Options

Eligible options are determined for each qualified plan type.

For employees, spouses, and ex-spouses, eligible options must satisfy the following criteria:

For all dependents besides spouses and ex-spouses, eligible options must satisfy the following criteria:

Benefits Administration uses a different method to determine option eligibility.

See Also

Event Maintenance

Click to jump to top of pageClick to jump to parent topicCalculating COBRA Costs for Eligible Options

This section describes how to calculate COBRA costs.

To calculate COBRA cost:

  1. Access the Benefit Program page.

  2. Enter the COBRA percentage amount.

    The COBRA process calculates a charge for each option using the sum of the total coverage costs (employee plus employer) multiplied by the surcharge defined here.

  3. Enter the COBRA disabled surcharge percentage.

    If the COBRA participant is disabled, the COBRA cost for months 19-29 is multiplied by this surcharge.

When you select Waive COBRA Surcharge on the COBRA Event Rules Table page for a specific COBRA event classification, the system does not add the COBRA surcharge or disabled surcharge.

COBRA charges are sent to the COBRA beneficiary through Benefits Billing processes, as long as Benefits Billing is selected in the Products page of the Installation table.

See Also

Managing Benefits Billing

Click to jump to top of pageClick to jump to parent topicProcessing Secondary COBRA Qualifying Events

Although COBRA governmental regulations describe how secondary COBRA qualifying events should be processed, PeopleSoft event rules allow for a different implementation of secondary event processing.

Three fields defined on the Event Rules page are used to process secondary events.

Secondary Event Role

Identifies whether the event can be considered a secondary event.

Second Event Additional Months

Defines by how many months the secondary event extends a COBRA participant’s coverage.

Secondary Event Add Mode

Defines whether the additional months extend the coverage 36 months from the coverage begin date of the initial event or add 36 months to the COBRA event date of the secondary event.

See Also

Setting Up COBRA Administration

Processing Enrollments for Secondary Events

Click to jump to top of pageClick to jump to parent topicViewing Error Messages

Access the Process Messages page.

Benefit Rcd# (benefit record number)

The employee benefit record number that was affected by the COBRA event.

CBR Evt ID (COBRA event identification)

The identification number assigned to the event by the COBRA process.

Dep/Benef (dependents/beneficiaries)

Any relevant dependents or beneficiaries.

Click to jump to parent topicCreating Notification Letters

This section describes how to:

See Also

Processing Enrollments for Secondary Events

Manage Base Benefit Reports

Click to jump to top of pageClick to jump to parent topicPages Used to Print Notification Letters

Page Name

Object Name

Navigation

Usage

COBRA Qualify Ltr (COBRA qualify letter)

RUNCTL_CBR001

Benefits, Administer COBRA Benefits, Manage Automated Participation, Create Initial Letter, COBRA Qualify Ltr

Print notification letters for initial COBRA events.

Secondary Evt Ltr (secondary event letter)

RUNCTL_CBR002

Benefits, Administer COBRA Benefits, Manage Automated Participation, Create Secondary Letter, Secondary Evt Ltr

Print notification letters for secondary COBRA events.

Letter Reprinting

CBR_PRT

Benefits, Administer COBRA Benefits, Manage Automated Participation, Reprint Selected Letters, Letter Reprinting

Select parameters for reprinting notification letters.

Click to jump to top of pageClick to jump to parent topicDetermining Notification Recipients

The qualifying event determines recipients.

Click to jump to top of pageClick to jump to parent topicPrinting Notification Letters for Initial Events

Access the COBRA Qualify Ltr page.

The Initial Notification Letter process generates letters for COBRA participants with an initial event status of Options Prepared and an event status of Open For Processing. Letters include:

Along with each initial notification letter, the system prints a COBRA continuation coverage election form for employees to record their elections.

Once an initial notification letter is generated for a qualified COBRA participant, the initial event status is changed to Notified. The election end date is calculated for each plan type as 60 days past the latter of the notification date (on the notification letter) or the loss of coverage.

As of Date

Enter the date for the time period that you want the letters.

‘Reprint’ Appears on Letters

Select this check box if you want the word Reprint to appear on the letter.

Reprint ID

Select the ID number associated with the letters that you want reprinted.

Click to jump to top of pageClick to jump to parent topicPrinting Notification Letters for Secondary Events

Access the Secondary Evt Ltr page.

The process for printing notification letters for secondary events is identical to that for initial events.

The secondary notification letter includes information on how long COBRA coverage is to be extended.

Recipients have their secondary event status changed to Notified and their process status changed to Closed for Processing.

Click to jump to top of pageClick to jump to parent topicReprinting Notification Letters

Access the Letter Reprinting page.

This page enables you to reprint all letters, or to select specific employees for whom letters are to be reprinted. You can specify a notification date range for which the reprint is to occur.

Click to jump to parent topicEntering COBRA Elections and Waivers

This section provides an overview of COBRA elections and describes how to:

Click to jump to top of pageClick to jump to parent topicUnderstanding COBRA Elections

Qualified COBRA beneficiaries can:

Unlike Benefits Administration, COBRA participants can make enrollment decisions at the plan type level.

Employees and dependents are individually qualified for COBRA coverage, and they can choose to be covered as individuals.

For example, suppose that an employee with Employee plus Spouse coverage terminates employment and loses all regular health coverage. The employee and the spouse both qualify for COBRA coverage. The spouse can select either to be covered individually as a non-employee (even if the employee doesn’t elect coverage), she can continue to be covered under the employee as a dependent, or the spouse may elect Spouse Only coverage (if the terminated employee coverage code is set to Spouse Allowed).

When you enter elections for qualified COBRA participants, the system sets their Initial Event Status to Election Entered.

See Also

Managing Non-Employee COBRA Participants

Click to jump to top of pageClick to jump to parent topicPage Used to Enter COBRA Elections and Waivers

Page Name

Object Name

Navigation

Usage

Participant Data

COBRA_PARTIC_ENT1

Benefits, Administer COBRA Benefits, Manage Automated Participation, Participant Elections, Participant Data

Record elections or waivers for COBRA coverage.

Click to jump to top of pageClick to jump to parent topicRecording COBRA Elections and Waivers

Access the Participant Data page.

COBRA Election

Indicate whether to elect or waive COBRA coverage.

To revoke a waiver of coverage, change the selection from Waive to Elect. Waivers cannot be revoked after the election end date.

The current date is automatically set as the election, waive, or revoke date, although you can override that value for elections.

Participant Enrollment

Plan Type

Enter the elected option choices.

Covrg Begin (coverage begin), Covrg End (coverage end) and, Election End

Predetermined by the COBRA process.

COBRA Election

Elect or waive each plan type.

The election or waive date is automatically set, although you can override the election date.

Provider ID

For health plan types. Enter the name of the employee's doctor, an ID number, or any other format that the health provider requires.

Previously Seen

Select to indicate that the employee is a current patient of the indicated physician.

Once an election has been entered, validated and enrolled, the election cannot be changed without COBRA reprocessing. After reprocessing, you can add new elections or make election changes if the coverage election date is on or before the coverage election end date and if the elections have not been entered.

Click to jump to top of pageClick to jump to parent topicValidating and Enrolling Elections

The system reviews plan type, option code, and dependent/beneficiary elections made for qualified COBRA participants as their elections are saved. If all of the plan types for which the participant is eligible reflect either an enrollment election or waiver, the system changes the participant’s initial event status to Enrollment Completed and the process status to Closed for Processing. If some of the plans have not had an entry made, the participant’s initial event status changes to Enrolled (for the specific plan), and the process status remains Open for Processing. In either case, if errors are discovered, the initial event status becomes Election Error.

Enrollment in Health or FSA Plans

If the initial election status is Enrollment Completed or Enrolled, you can access health and/or FSA plan information in the Health Benefits and FSA Benefits pages.

Creation of Non-Employee Status

If a dependent elects individual COBRA coverage or has a qualifying second event, then that non-employee participant receives a system-generated employee ID.

Notification to Billing System

If Benefits Billing is selected in the Installation Table, validated and enrolled COBRA participants are enrolled in the Benefits Billing system for elected plan types. COBRA surcharges and coverage start and end dates are also sent to Benefits Billing.

Validation and Enrollment Error Messages

Error messages generated during validation and enrollment can be viewed either by using the Process Messages page or by running the COBRA Error report. Each time the COBRA validation and enrollment process is run, error messages from the previous run are deleted.

See Also

Managing Non-Employee COBRA Participants

Viewing Error Messages

Managing Benefits Billing

Click to jump to parent topicProcessing Enrollments for Secondary Events

This section describes issues regarding:

Click to jump to top of pageClick to jump to parent topicUnderstanding Initial Event Status and Secondary Events

When a secondary event is processed, the system reviews the initial event to determine if its event status is Closed to Processing (indicating that the participant has made an election or waived COBRA coverage). If the initial event is not closed, the secondary event’s status becomes Qualified Pending. The secondary event needs to be reprocessed after the initial event is closed.

This can happen if dependents are covered under an employee’s coverage instead of electing independent coverage.

For example, suppose that an employee and her dependents become qualified beneficiaries after she terminates her employment. She enrolls in family coverage for plan types 10 and 11—covering herself, her spouse, and her daughter—and waives plan type 14. As a result, the terminated employee’s record is Closed to Processing. But the dependents’ records remain Open for Processing, because they have not independently elected or waived coverage.

To close an initial event and reprocess a secondary event:

  1. A secondary event, such as a divorce or dependent marriage, occurs.

    The Human Resources system processes the personnel action.

    The COBRA process evaluates the secondary event and returns a status of Qualified Pending.

  2. Determine that the initial event is still Open for Processing because the dependent records were not waived or enrolled.

  3. Waive or elect options for the dependents and run the COBRA process to close the initial event.

  4. Use the Event Status Update page to reprocess the secondary event by changing the reprocess status for the secondary event to Qualify Event.

    After you run the COBRA process again, the secondary event should be set to Qualified.

See Also

Adjusting and Reprocessing COBRA Events

Click to jump to top of pageClick to jump to parent topicIdentifying Differences in Individual and Dependent Coverage Processing

When secondary events occur, COBRA participants with individual coverage are processed differently than those with dependent coverage.

For participants with individual coverage, a secondary event extends coverage according to the defined secondary event rules. The system deletes the existing termination record, reinserts it into the coverage begin date, and sets an effective date equal to the extended COBRA coverage end date + 1. The COBRA enrollment status is set to Coverage Extended.

Participants with dependent coverage are switched to individual COBRA participants, with individual COBRA coverage as of the COBRA event date of the secondary event. The system automatically establishes the participant as a non-employee in the system and enrolls the participant in employee-only coverage for all plan types that meet this condition. The employee-only coverage is within the same benefit plan that the participant was covered in as a dependent under COBRA. The coverage end date is calculated based on the predefined secondary event rules, and the COBRA enrollment status is set to Coverage Inserted.

Click to jump to top of pageClick to jump to parent topicUnderstanding Combination Events

A COBRA event can be an initial event for one plan type and a secondary event for another type. For example, suppose that an employee has Employee Plus Spouse coverage for plan types 10, 11, and 14. Then the employee transfers and both the employee and the spouse lose coverage under plan types 11 and 14; they are eligible for 18 months of COBRA coverage for these types, and they elect this coverage.

The employee divorces while the COBRA coverage is still active. The divorce event causes the employee’s ex-spouse to lose coverage for plan type 10 (an initial event); the ex-spouse is qualified for 36 months of COBRA coverage under that plan. The divorce is also a secondary event for plan types 11 and 14; the ex-spouse is qualified to have coverage extended for those plans for up to 36 months from the original coverage begin date.

The two events—the initial event for plan type 10 and the secondary event for plan types 11 and 14—progress through the COBRA system independently in terms of notification letters and ongoing status indicators.

Click to jump to parent topicManaging COBRA Events

This section describes how to:

Click to jump to top of pageClick to jump to parent topicPages Used to Manage COBRA Events

Page Name

Object Name

Navigation

Usage

Event Summary

COBRA_EVENT_INQ1

Benefits, Administer COBRA Benefits, Review Processing Results, Review Event Summary, Event Summary

Review information about COBRA events and associated beneficiaries.

Event Status

COBRA_STATUS1

Benefits, Administer COBRA Benefits, Manage Automated Participation, Update Event Status, Event Status

Adjust, reprocess, and void COBRA events.

Click to jump to top of pageClick to jump to parent topicReviewing COBRA Event Summaries

Access the Event Summary page.

Click to jump to top of pageClick to jump to parent topicAdjusting and Reprocessing COBRA Events

Access the Event Status page.

Reprocess Indicator

Set to reprocess a COBRA phase for events, participants, or plan types.

To reprocess any level, the process status for that level and any above it must be Open for Processing.

You cannot reprocess initial events that have secondary events dependent on them.

At the event level, you can only reprocess to Prepare Options if the Option Prepare phase has already been completed.

At the participant plan type level, you can only select Elect Options when the plan type is Enrolled and the associated event is an initial event.

After choosing a value, run the COBRA process again to reprocess to the selected status.

COBRA Event Conflict

Selected if the system determines that two or more events are in conflict with each other. An example is when an event is entered and processed, and another event is entered with an earlier date than the first event.

The system sends a message to the COBRA administrator to analyze the conflicting events and take any appropriate actions.

Voiding Events, Participants, or Benefit Plans

When you enter Void Event in the Reprocess Indicator at the COBRA event level, the system ignores all reprocessing indicators at the lower levels. All COBRA participants and participant plans are voided, and all enrolled COBRA benefits are deleted. Notification is sent to the Benefits Billing system to terminate billing for voided participants.

When you enter Void Event in the Reprocess Indicator at the COBRA participant level, the result is similar to voiding a COBRA event. The COBRA participant record and all COBRA benefit plan records associated with that participant are deleted. Benefits Billing is notified to terminate billing.

Voiding a COBRA benefit plan associated with an initial event deletes all enrolled COBRA benefit records associated with that plan; Benefits Billing is notified to terminate billing. Voiding a COBRA benefit plan associated with a secondary event readjusts termination dates back to those associated with the initial plan; Benefits Billing is notified to adjust billing.

Qualifying Events

When you enter Qualify Event in the Reprocess Indicator at the COBRA event level, all reprocessing indicators at the lower levels are ignored. All enrolled COBRA benefits are deleted.

Preparing and Electing Options

When you set Prepare Options at the event level, if a participant or plan has a Reprocess Indicator setting of Void Event, that reprocessing command takes precedence over Prepare Options. For example, if you want to void the COBRA election plan type 10 and prepare options for plan type 11, the system first voids plan type 10 and then prepares options for plan type 11.

Prepare Options reprocessing deletes all of the plan, option, and dependent records associated with that event. Benefits Billing is notified to terminate billing.

See Also

Running the COBRA Process

Click to jump to parent topicManaging COBRA Benefit Plan and Dependent Information

This section describes how to:

Click to jump to top of pageClick to jump to parent topicPages Used to Manage COBRA Benefit Plan and Dependent Information

Page Name

Object Name

Navigation

Usage

Prog Participatn (program participation)

COBRA_PROG_PARTIC1

Benefits, Administer COBRA Benefits, Enroll in Benefits, Assign to Benefit Program, Prog Participatn

Change benefit program participation for Open Enrollment and Family Status Change events.

Election

COBRA_HEALTH1

Benefits, Administer COBRA Benefits, Enroll in Benefits, Health Benefits, Election

View or update health plan elections.

Dependents

COBRA_HEALTH2

Benefits, Administer COBRA Benefits, Enroll in Benefits, Health Benefits, Dependents

Enroll dependents in health plans.

FSA Benefit Enrol (flexible spending account benefit enrollment)

COBRA_FSA

Benefits, Administer COBRA Benefits, Enroll in Benefits, FSA Benefits, FSA Benefit Enrol

View or update FSA enrollments.

Name

COBRA_DEP_BENEF1

Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Modify Dependent/Beneficiaries, Name

Add or Update COBRA dependent/beneficiary information.

Address

COBRA_DEP_ADDR

Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Modify Dependent/Beneficiaries, Address

Enter or update COBRA dependent address information.

Personal Profile

COBRA_DEP_BENEF2

Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Modify Dependent/Beneficiaries, Personal Profile

Enter or update COBRA dependent details.

Click to jump to top of pageClick to jump to parent topicChanging Benefit Programs

Access the Prog Participatn page.

Click to jump to top of pageClick to jump to parent topicViewing and Updating Health Plan Elections

Access the Election page.

Coverage Begin Date

Automatically set to the date in the Event Summary 2 page.

Coverage Election

Displays whether the COBRA health benefit record in view is currently elected or terminated.

Coverage Code

When you exit this field, the system calculates the monthly cost of the benefit.

Health Provider

Enter the name of the employee's doctor, an ID number, or any other format that the health provider may require.

Previously Seen

Indicate that the employee is a current patient of the indicated physician. Becomes available when a health provider ID is entered.

HIPAA Report Date (Emp) (Health Insurance Portability and Accountability Act report date [employee])

Displays the date that the employee's certificate of creditable health coverage was printed, if health coverage was terminated. These certificates are guaranteed to employees by HIPAA of 1996; you can print them by running HIPAA reports.

Note. The certificate of creditable coverage lists all group health coverage that an employee had for the 18 month period prior to the date coverage ended.

Click to jump to top of pageClick to jump to parent topicEnrolling Dependents in Health Plans

Access the Dependents page.

ID

Select a dependent ID to add available beneficiaries to the selected COBRA plan.

Health Provider ID

Enter the name of the dependent’s doctor, an ID number, or any other format that the health provider may require.

Previously Seen

Select to indicate that the dependent is a current patient of the indicated physician. Becomes available when a health provider ID is entered.

Click to jump to top of pageClick to jump to parent topicViewing and Updating FSA Enrollments

Access the FSA Benefit Enrol page.

Use the Coverage Election field to view and change whether the displayed COBRA FSA plan is elected or terminated.

Click to jump to top of pageClick to jump to parent topicAdding Dependents

Access the Name page

Click to jump to parent topicManaging Non-Employee COBRA Participants

When a COBRA-qualified dependent selects individual coverage after an initial event or undergoes an event that involves a loss of dependent status, that dependent becomes a non-employee COBRA participant. Non-employee COBRA participants can declare their own dependents and change benefit programs and plans.

This section describes how to:

Note. When you add a non-employee through COBRA, the non-employee record may not show in other PeopleSoft Human Resources processes until the Refresh Personal Data process is run.

See Also

Adding a Person in PeopleSoft Human Resources

Increasing the Workforce

Click to jump to top of pageClick to jump to parent topicPages Used to Manage Non-Employee COBRA Participants

Page Name

Object Name

Navigation

Usage

Name and Contact

PERSONAL_DATA1

Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Modify Personal Information, Name and Contact

Update COBRA-qualified dependent name and biographical information.

Medicare and Job

CBR_PERSONAL_DATA3

Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Modify Personal Information, Medicare and Job

Maintain department security information for non-employee COBRA participants.

Click to jump to top of pageClick to jump to parent topicMaintaining Non-Employee Identity and Department Security Information

Access the Medicare and Job page.

Employment Information

During the COBRA processing, automatically populates with the original data of the employee that experienced the COBRA event.

Job Information

Review and update a historical record of the non-employee participant's business unit and department affiliations.

Click to jump to top of pageClick to jump to parent topicConverting Non-Employee Individual Coverage to Dependent Coverage

When a spouse or ex-spouse COBRA participant enrolls in individual non-employee COBRA coverage, the child dependents of the employee are inherited as dependents for the non-employee.

All non-employee participants are assigned a unique system-generated employee ID, for which the numbering convention is established in the Installation Table. All dependents of the non-employee participant also have this new COBRA employee ID, along with their original dependent/beneficiary ID.

When a secondary event occurs, however, all of an employee’s dependents become independently covered. For example, a former employee elects COBRA coverage for himself, his spouse, and his child. He later dies, which qualifies as a secondary event for the dependents. The spouse,and child all become non-employee participants, and are assigned IDs as shown in the following table.

Person

Employee ID

Dependent/Beneficiary ID

Employee (Deceased)

Z001

00

Spouse (Non-employee)

C00015

01

Child (Non-employee)

C00016

02

If no further action is taken, the system creates COBRA health benefit records with employee-only coverage for the spouse and dependents, with their COBRA coverage extended to a total of 36 months from the initial event.

However, the spouse can also enroll the children as dependents under her coverage. To change from independent coverage for non-employees to dependent coverage, follow the steps below.

To convert non-employee independent coverage to non-employee dependent coverage:

  1. Access the COBRA health benefit record for the non-employee who’s remaining independently covered.

  2. Change the coverage code to an appropriate coverage code for dependent coverage for the plan types affected and add the dependent IDs to cover.

  3. Access the Participation Termination page and create Voluntary Termination records for the dependents that are now covered under the spouse. The termination date for each termination record should be the same date that dependent coverage begins.

See Also

Managing COBRA Benefit Plan and Dependent Information

Click to jump to parent topicTerminating COBRA Coverage

COBRA can be terminated:

This section describes how to:

Click to jump to top of pageClick to jump to parent topicPages Used to Terminate COBRA Coverage

Page Name

Object Name

Navigation

Usage

Participant Term (participant terminate)

COBRA_PARTIC_TERM

Benefits, Administer COBRA Benefits, Terminate COBRA Coverage, Terminate Participant, Participant Term

Manually terminate COBRA coverage if bills are unpaid or on participant's request.

Termination Ltr (termination letter)

RUNCTL_CBR003

Benefits, Administer COBRA Benefits, Terminate COBRA Coverage, Create Termination Letter, Termination Ltr

Send letters to COBRA participants with plans about to expire.

Click to jump to top of pageClick to jump to parent topicManually Terminating COBRA Coverage

Access the Participant Term page.

For each plan type to terminate, enter the Termination Date and Reason.

When you save this page, the Coverage End Date of the enrolled plan type is adjusted to the termination date.

Click to jump to top of pageClick to jump to parent topicSending Termination Letters

Access the Termination Ltr page.

Termination letters are printed for employees whose coverage ends during the period between the start and end dates.

See Also

Setting Up and Generating Form Letters

Manage Base Benefit Reports

Click to jump to parent topicEnrolling Participants in COBRA Coverage Manually

You can bypass the automated COBRA Administration batch process and force the system to enroll employees and dependents into COBRA health benefits.

When you bypass the batch process, participants do not require COBRA-qualifying events in order to be eligible for COBRA benefits. Instead, the system automatically gives all participants enrolled in COBRA coverage through these pages a COBRA event ID of 900.

Note. When you manually enroll an employee or dependent in COBRA coverage, subsequent COBRA processing, such as secondary event processing, is not aware of the manually enrolled COBRA coverage. When you add a non-employee through COBRA, the non-employee record may not show in other Human Resources processes until the Refresh Personal Data process is run.

Warning! Because these pages ignore the processing rules that regulate COBRA coverage eligibility, manually process COBRA coverage only after careful consideration.

This section describes how to:

See Also

Managing COBRA Benefit Plan and Dependent Information

Managing Non-Employee COBRA Participants

Adding a Person in PeopleSoft Human Resources

Click to jump to top of pageClick to jump to parent topicPages Used to Enroll Participants in COBRA Coverage Manually

Page Name

Object Name

Navigation

Usage

Non-Employee

CBR_MANUAL_ENT1

Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Create COBRA Non-Employee, Non-Employee

Manually establish an employee dependent as a non-employee, in preparation for manually enrolling the dependent into COBRA coverage.

Program Partic (program participation)

CBR_MANUAL_PARTIC1

Benefits, Administer COBRA Benefits, Enroll Manually, Assign Benefit Program, Program Partic

Manually assign an employee or COBRA non-employee to a benefit program or make changes to that manual assignment over time.

Elections

CBR_MANUAL_HEALTH1

Benefits, Administer COBRA Benefits, Enroll Manually, Select Health Benefits, Elections

Manually enroll participants in COBRA health benefits.

Dependents

CBR_MANUAL_HEALTH2

Benefits, Administer COBRA Benefits, Enroll Manually, Select Health Benefits, Dependents

Manually enroll dependents in COBRA health benefits.

Click to jump to top of pageClick to jump to parent topicChanging Employee Dependents to Non-Employees Manually

Access the Non-Employee page.

EmplID (employee ID) and Empl Rcd# (employee record number)

Enter the ID and employee record number for the employee that the non-employee participant is a dependent or beneficiary of.

Dep/Benef (dependent/beneficiary)

Enter the dependent or beneficiary number.

COBRA Event Date

Enter the event date for the non-employee participant’s COBRA enrollment.

Save and Add Next

Click to save the information. A message appears informing you of the COBRA employee ID assigned to this person.

Take note of the new employee ID for the COBRA non-employee and click OK.

Click to jump to top of pageClick to jump to parent topicAssigning Participants to Benefit Programs Manually

Access the Program Partic page.

The benefit program is assigned a COBRA event ID of 900.

Click to jump to top of pageClick to jump to parent topicEnrolling Participants in Benefit Plans Manually

Access the Elections page.

The health benefit record of the selected participant receives a COBRA Event ID of 900.

Coverage Begin Date

Automatically set to the current date.

Coverage Election

Elect or terminate a benefit plan.

Option

The system displays the COBRA option that goes with the selected benefit plan.

Health Provider ID

Enter the name of the employee's doctor, an ID number, or any other format that the health provider may require.

Previously Seen

Select to indicate that the employee is a current patient of the indicated physician. Becomes available when you enter a health provider ID.

HIPAA Report Date (Emp)

Displays the date that the employee's certificate of creditable health coverage was printed, if health coverage was terminated. These certificates are guaranteed to employees by the Health Insurance and Accountability Act of 1996, and you can print them by running HIPAA Reports.

Note. The certificate of creditable coverage lists all group health coverage that an employee had for the 12 month period prior to the date that coverage ended.

Click to jump to top of pageClick to jump to parent topicEnrolling Dependents in Benefit Plans Manually

Access the Dependents page.

Relationship

Identifies the dependent's relationship to the participant.

Dependent ID

Select the dependent ID to add available beneficiaries to the selected COBRA participant/plan type/benefit plan combination.

Health Provider ID

Enter the name of the employee's doctor, an ID number, or any other format that the health provider may require.

Previously Seen

Select to indicate that the employee is a current patient of the indicated physician. Becomes available when you enter a health provider ID.