Anthem Blue Cross Issues Update on CalCOBRA
The new CalCOBRA legislation, California Assembly Bill 23, is expected to be signed by the Governor by the end of this week. This bill will align the current CalCOBRA legislation with the Federal Subsidy as defined by ARRA (American Recovery and Reinvestment Act). The following are high-level details you should be aware of:- This bill states that health plans and health insurers have 14 days from the date of enactment to provide proper notification to those individuals who may qualify for the Cal-COBRA subsidy. The Department of Labor ("DOL") has agreed that the timeliness within which the state mini-COBRA programs must comply is to be determined by the states themselves. The DOL held a call with the California Department of Insurance ("CDI") and the Department of Managed Health Care ("DMHC") to assure this is understood by all three regulators.
- The mailing will go out to all individuals who had a qualifying event between Sept. 1, 2008, to the present, regardless of whether or not they had already elected CalCOBRA.
- The bill (AB23) currently states that California residents who were involuntarily terminated from their jobs between Sept. 1, 2008, and the present will qualify for the Cal-COBRA special election period.
- There is a notice letter being developed by Anthem in conjunction with the California Association of Health Plans ("CAHP") and other health plans in this state. Once finalized, this notice will be deemed approved by both the CDI and DMHC. Anthem will send the notice as soon as possible following the enactment of AB 23.
- Once the bill is finalized and signed into law, Anthem will share a more detailed summary of the specific provisions of this law.
In the interim
- Anthem isn't waiting on direction from the state. The Federal Subsidy is defined already and the materials and/or links to that information are at your disposal at www.dol.gov/cobra.
- Anthem is educating people, much like what you have already been doing.
- Anthem should not be forcing members to pay 100 percent premiums from March 1 to the present. They should be helping to educate people as to the qualifications to actually take part of the premium relief. If they don't qualify, they should be held accountable for the full premium. This is for CalCOBRA only. For Federal COBRA, the groups are required to manage this, bill their members directly and pay the carrier directly in full.
- Premium refunds are not an option. Keep in mind that the premium relief/subsidy is effective March 1 and doesn't qualify for premiums paid on behalf of COBRA or CalCOBRA prior to that. And this is only available for up to nine months.
- Participation in the subsidy is optional. The consumer must actively agree to take part in this. For Federal COBRA, the employer is held accountable for properly notifying their AEIs (Assistance Eligible Individuals) and collecting the attestation form. Anthem doesn't need this form on file -- the employer does. The employer is to notify Anthem only for reasons to re-enroll or enroll their previous employees into the COBRA program.
- There may be a gap in coverage for these members. However, only for those who had qualifying events stemming back from Sept. 1 through Feb. 17, their coverage, if now elected, must start on March 1 and the entire COBRA allowable timeframe must be deducted regardless of the effective date.