EMPLOYEE BENEFITS RESOURCES INC.
50 Maple Hill Drive
San Rafael, CA 94903
ph: 415-446-5539
fax: 415-446-5542
sylvia
Frequently Asked Questions
| Q. | How and when should I add new employees? |
| A. | New employees MUST be added within 31 days of their eligibility. |
| Q. | If an employee gets married and wants to put their spouse on the plan, how and when do I need to do that? |
| A. | When an employee marries, the spouse must be added within 31 days of the event. |
| Q. | An employee either has naturally or adopts a child, when do I have to put the child on the insurance? |
| A. | The same rules apply for a dependent child as for a spouse, regarding the 31-day time frame of the enrollment. However, with the child the effective date will go back to the birth of the child. Under the HMO's the child is covered for the first 31 days, and then must be enrolled. IF THE EMPLOYEE REFUSES COVERAGE, EITHER FOR HIM/ HERSELF OR FOR DEPENDENTS, HAVE HIM/HER SIGN A WAIVER OR DECLINATION OF COVERAGE FORM, STATING WHY S/HE IS DECLINING. THIS IS A SAFEGUARD BOTH FOR YOU AND FOR THE EMPLOYEE. |
| Q. | How do I terminate an employee? |
| A. | If you are doing your own billing, you mark the employee off the current billing, noting the date of termination. The employee is covered through the end of the month in which they were terminated. Continue to monitor your bills to verify that they have removed the particular employee. |
| Q. | How do I deal with COBRA? |
| A. | If you have less than 20 employees, make sure you're aware of who has to be counted and who can be left off. Once the carrier is notified, they will send the COBRA information to the insured, and bill them directly, if they choose the coverage. If this is your situation, you are under to guidelines of Cal-COBRA, the under 20 employees plan. The employee can be charged up to 10% administration fee. If, however, you have more than 20 employees, you are subject to Federal COBRA and the rules and regulations apply to you, the employer. We strongly suggest that you send someone from your staff to attend a Cobra Seminar. The IRS, who now oversees COBRA compliance, requires that someone on staff be trained in COBRA compliance. Please call us with any questions regarding COBRA. If we don't know the answer, we will get it for you. The fines for COBRA "misconduct" are onerous. We agree strongly with COBRA Compliance: "Keep the IRS out of your business, and keep your business out of court". In addition to the COBRA Qualifying Event Notice, which is sent out when an employee |
| Q. | What is Open Enrollment, and what do I have to do? |
| A. | Open Enrollment is the period of time (usually one month before the effective date of your policy period) during which dependents can be added, if they were not added during the initial enrollment. If you have more than one plan, it is the time during which employees can make plan changes. It is also the time to add different coverages, or change the plan design that you currently have. You can also add riders at this time, such as Chiropractic and/or Acupuncture, life insurance, etc. |
| Q. | I have a pre-existing medical condition, and have not been able to get coverage. Are there any plans I can qualify for? |
| A. | Federal law (specifically, the Health Insurance Portability & Accountability Act of 1996, or HIPAA) guarantees that individuals coming off of COBRA coverage can obtain individual health insurance regardless of medical history. Additionally, California's Major Risk Program provides coverage to the uninsurable redardless of their past insurance (or lack thereof). |
Copyright 2009 Employee Benefits Resources Inc. All rights reserved.
50 Maple Hill Drive
San Rafael, CA 94903
ph: 415-446-5539
fax: 415-446-5542
sylvia
