Rate Increases Are Imperative For Billing COBRA Continuees

The start of a new year brings many activities including completing the final touches on Open Enrollment (if the plan year is a calendar year). There’s no time like the present to make sure Qualified Beneficiaries (QBs) are being charged the accurate amount for COBRA whether clients, agents, or an outside provider such as Infinisource is sending out monthly requests for payments.

It is important for the COBRA Administrator to be made aware of plan changes, rate changes or changes that QBs have made with regards to Open Enrollment. For Infinisource clients, providing new rates or plans is just a click away. Clients or agents provided online access can log in to the client home page and click on the Rate Renewal Form link to submit the changes.

Agents requesting to assist Infinisource clients with this information and needing additional assistance with plans, rates or providing this information to Infinisource, please contact a Customer Response Representative at 866-320-3040.

In addition, Infinisource would like to provide a few reminders with regards to Open Enrollment.

• During an open enrollment period, each QB must be offered the opportunity to switch to another plan, if similarly situated active employees have that option.

• Any QB, or anyone in their election period, must be notified of the Open Enrollment Period and options available.

• Employers are allowed to charge COBRA Continuees up to 102 percent of the “applicable premium” for continuation coverage.

• The premium for each determination period must be calculated and fixed by the group health plan before the determination period begins. A determination period is any 12-month period selected by the plan, but it must be applied consistently from year to year. The determination period is a single period for any benefit package. Therefore, each QB does not have a separate determination period.

• There are specific times within the determination period when a plan may increase a QB's COBRA premium.

• The plan has charged less than the maximum amount allowed.
• The increase permitted during the disability extension period.
• A QB chooses to become covered under a more expensive plan or adds a new benefit (e.g., at open enrollment).
• A QB adds a family member (e.g., at open enrollment, according to the plan terms, or is exercising HIPAA special enrollment).

For assistance with rate increases or questions on when it is allowed, please contact a Customer Response Representative at 866-320-3040.

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