COBRA EXPANSION How It Impacts You

What Is COBRA? The opportunity to continue group health coverage when there is a “qualifying event” that would result in the loss of coverage under an employer’s plan. The opportunity to continue group health coverage when there is a “qualifying event” that would result in the loss of coverage under an employer’s plan. This continuance of group coverage is also available to all “qualified beneficiaries”. This continuance of group coverage is also available to all “qualified beneficiaries”.

What Is COBRA Expansion? Included in the recently passed Stimulus Package are changes that impact COBRA premiums. Included in the recently passed Stimulus Package are changes that impact COBRA premiums. Those who involuntarily lost their jobs, on or after September 1, 2008 are eligible for a COBRA subsidy effective March 1, Those who involuntarily lost their jobs, on or after September 1, 2008 are eligible for a COBRA subsidy effective March 1, The subsidy is for 65% of the cost of COBRA for a maximum of 9 months. The subsidy is for 65% of the cost of COBRA for a maximum of 9 months. The subsidy reduces your COBRA costs by 65% for those 9 months. The subsidy reduces your COBRA costs by 65% for those 9 months.

Which Benefits qualify for COBRA? Group Health Insurance Group Health Insurance Dental Insurance Dental Insurance Vision Insurance Vision Insurance Medical Flex Spending Accounts Medical Flex Spending Accounts Flex Spending Accounts costs are NOT impacted by COBRA Expansion Flex Spending Accounts costs are NOT impacted by COBRA Expansion

Examples of Costs? Without Subsidy Without Subsidy Health Single$ Health Single$ Health Family $ Health Family $ Dental Single$ Dental Single$ Dental Family$ Dental Family$ Vision Single $ Vision Single $ Vision Family$ Vision Family$ With Subsidy Health Single$ HMO Family$ Dental Single$ Dental Family$ Vision Single $ 3.50 Vision Family$ 7.00 Subsidies last up to 9 months FROM your last day of employment.

How Long Does COBRA Last? Most employees will be able to remain on COBRA for up to 18 months. Most employees will be able to remain on COBRA for up to 18 months. Some circumstances allow for a longer period of coverage. Some circumstances allow for a longer period of coverage.

What Kind of Coverage is COBRA? COBRA is a continuation of the policy that you are currently enrolled in. The group plans your former employer has for active employees. COBRA is a continuation of the policy that you are currently enrolled in. The group plans your former employer has for active employees. If the group plan changes, while you are on COBRA, your coverage changes to the new plan, just as it would have, if you had remained employed. If the group plan changes, while you are on COBRA, your coverage changes to the new plan, just as it would have, if you had remained employed.

When Does COBRA Coverage End? COBRA coverage will terminate for any of the following reasons COBRA coverage will terminate for any of the following reasons You reach the maximum period of coverage allowed; generally 18 months. You reach the maximum period of coverage allowed; generally 18 months. Premiums are not paid in full and on time. Premiums are not paid in full and on time. A qualified beneficiary become covered under another group plan. A qualified beneficiary become covered under another group plan. A covered employee BECOMES eligible for Medicare benefits under Part A, Part B, or Both. A covered employee BECOMES eligible for Medicare benefits under Part A, Part B, or Both. The employer ceases to provide a group health plan. The employer ceases to provide a group health plan.

How Do HIPPA and COBRA Work Together? HIPPA ensures that if you do not have a break in coverage of 63 days or longer, that you will be credited with having had prior coverage with regard to pre- existing health condition exclusions on the next group health policy you enroll in. HIPPA ensures that if you do not have a break in coverage of 63 days or longer, that you will be credited with having had prior coverage with regard to pre- existing health condition exclusions on the next group health policy you enroll in. There are special enrollment rights to a new employers health plan through HIPPA to ensure continuous coverage. There are special enrollment rights to a new employers health plan through HIPPA to ensure continuous coverage. COBRA allows you to keep your current coverage, so that you do not have a 63 day break in coverage. COBRA allows you to keep your current coverage, so that you do not have a 63 day break in coverage.

How Do You Elect COBRA? You and your qualified beneficiaries will receive a packet of COBRA information covering your rights, and an enrollment form. You and your qualified beneficiaries will receive a packet of COBRA information covering your rights, and an enrollment form. Each “beneficiary” has the right to elect or waive coverage. Each “beneficiary” has the right to elect or waive coverage. You have 60 days to elect coverage, by completing and returning the enrollment form. You have 60 days to elect coverage, by completing and returning the enrollment form.

How Do You Pay for COBRA? You have 45 days after electing coverage, to pay for the coverage. You have 45 days after electing coverage, to pay for the coverage. At that time coverage must be paid for in full, back to the date of termination. At that time coverage must be paid for in full, back to the date of termination. Thereafter, payments are due the first of every month for that month of coverage. Thereafter, payments are due the first of every month for that month of coverage. Payments are made to your former employer usually, but check your COBRA notice, for where to send your payments. Payments are made to your former employer usually, but check your COBRA notice, for where to send your payments.

Other Coverage Options? Private Policies Private Policies In some instances may cost less In some instances may cost less Not eligible for subsidy benefits Not eligible for subsidy benefits Medicare; for those age 65 Medicare; for those age 65 Medicaid; for those who meet the income guidelines Medicaid; for those who meet the income guidelines Hawk-i for children of qualifying parents Hawk-i for children of qualifying parents Recent changes have increased the income limits for children to qualify for this service to 300% of poverty rate. Recent changes have increased the income limits for children to qualify for this service to 300% of poverty rate.

What is Hawk-i? Hawk-i is low cost or free coverage for children, under the age of 19. Hawk-i is low cost or free coverage for children, under the age of 19. The amount you pay is based on your families income. No family pays more then $20.00 per month for a single child or $40.00 per month for 2 or more children. The amount you pay is based on your families income. No family pays more then $20.00 per month for a single child or $40.00 per month for 2 or more children.

How Do I Qualify? July 1, 2009 the income guidelines for Hawk-i were increased from 200% of the poverty rate to 300% of the poverty rate. July 1, 2009 the income guidelines for Hawk-i were increased from 200% of the poverty rate to 300% of the poverty rate. Currently a family of 5 can make between$34,302 and $38,684 per year, and qualify for Hawk-i at NO cost to the insured. Currently a family of 5 can make between$34,302 and $38,684 per year, and qualify for Hawk-i at NO cost to the insured. Currently a family of 5 can make between $38,685 and $77,370 per year, and qualify for Hawk-i for a nominal premium. Currently a family of 5 can make between $38,685 and $77,370 per year, and qualify for Hawk-i for a nominal premium.

What Services does Hawk-i Cover? Doctor Visits Doctor Visits Outpatient Services Outpatient Services Well Child Visits Well Child Visits Vaccines & Immunizations Vaccines & Immunizations Inpatient Hospital Services Inpatient Hospital Services Prescription Medicines Prescription Medicines Eye Glasses and Exams Eye Glasses and Exams Dental Care and Exams Hospice Care Speech Therapy & Physical Therapy Ambulance Services Nursing Care Services Hearing Exams Home Health Care Chiropractic Care

How do I Apply for Hawk-i? You can obtain a form from most doctors offices or your school You can obtain a form from most doctors offices or your school You can also go on-line to and download an application or complete an application on line. You can also go on-line to and download an application or complete an application on line. You can reach Hawk-i and request an application by calling , and an application will be mailed to your residence. You can reach Hawk-i and request an application by calling , and an application will be mailed to your residence.

HCTC & COBRA HCTC is essentially another Health Insurance subsidy program for employees who lose their job, due to that job being moved to a location outside of the U.S. HCTC is essentially another Health Insurance subsidy program for employees who lose their job, due to that job being moved to a location outside of the U.S. It applies to health insurance ONLY. It applies to health insurance ONLY. The subsidy is currently 80%, IF your previous employer is NOT paying at least 50% of your COBRA premiums. The subsidy is currently 80%, IF your previous employer is NOT paying at least 50% of your COBRA premiums. You must be receiving UI, TAA or ATAA benefits and be age 50 or over to qualify. You must be receiving UI, TAA or ATAA benefits and be age 50 or over to qualify.

HCTC & COBRA You are NOT eligible for HCTC if you are receiving benefits through You are NOT eligible for HCTC if you are receiving benefits through Medicare Medicare Military Health System (excluding those thru Veterans Affairs benefits) Military Health System (excluding those thru Veterans Affairs benefits) Medicaid Medicaid SCHIP SCHIP Federal Employees Health Benefits Program Federal Employees Health Benefits Program

Other Scenarios for HCTC Other Scenarios for HCTC You are eligible for HCTC if you and your spouse pay MORE than 50% of the cost of the spousal coverage for a “Qualified Health Plan”. You are eligible for HCTC if you and your spouse pay MORE than 50% of the cost of the spousal coverage for a “Qualified Health Plan”. You are eligible for HCTC if you buy a state-qualified health plan. These are “guarantee issue” plans. You are eligible for HCTC if you buy a state-qualified health plan. These are “guarantee issue” plans. You are eligible for HCTC if you have a “qualified” private insurance plan in place 30 days prior to your termination date. You are eligible for HCTC if you have a “qualified” private insurance plan in place 30 days prior to your termination date. Medicare supplement plans are not considered “Qualified Health Plans”. Medicare supplement plans are not considered “Qualified Health Plans”.

Your Responsibilities for COBRA Timely completion of all forms. Timely completion of all forms. Timely payment of your coverage. Timely payment of your coverage. It is VERY important that you keep your former employer informed of your current mailing address and the current mailing address of your “qualified beneficiaries” in order for them to notify you of plan changes, price changes, etc. It is VERY important that you keep your former employer informed of your current mailing address and the current mailing address of your “qualified beneficiaries” in order for them to notify you of plan changes, price changes, etc.

Questions?