HB 1164, effective September 30, 2004, allowed for rates to be increased up to 10% or discounted up 25%. Creating a rate between .75 to 1.1. Rates may also be adjusted uniformly or individually up to 15% for tobacco use. Renewal rates cannot increase by more than 15% due to claims experience and health status.
House Bill 1355 is a measure to return to “community rating” whereby the same medical costs are charged to employees across the board without regard to individual group claims experience or health status. This bill eliminates the current rating structure of HB 1164 which was .75% to 1.1% by the following changes. Effective January 1, 2008 for all small group health (1-50 employees) insurance renewals will no longer be rated up using the surcharge of 10% that was allowed for non-healthy groups. Changing the rating structure to the following .75% to 1.0 % thus eliminating the 10% rate up/surcharge for groups with apparent medical risks. In January 1, 2009 the rating structure changes to a flat table rate of 1.0 thereby eliminating the surcharge or discount available under HB1164 .
If you are interested in reading the entire House Bills please click on the links provided above.
Saturday, December 15, 2007
Wednesday, November 28, 2007
Colorado Cobra Law & Guidelines
COBRA
Federal Law
Employer groups with 20 or more employees (full and part time) on more than 50% of typical business days in the previous calendar year. Church groups and federal government employees are exempt from COBRA; Federal employees have Temporary Continuation Coverage (TCC) – refer to Feds EOC. Any employee, spouse, dependent or child born to or adopted by a covered employee during COBRA coverage is eligible if covered under a group health plan the day before the qualifying event. COBRA participant must pay 100% of group premium + a 2% administrative fee may be added to the Dues, or up to an additional 50% may be added to the Dues for a COBRA participant during any disability extension of the COBRA eligibility period.
QUALIFYING EVENTS:
Termination of employment (except for gross misconduct) or reduction of working hours of covered employee (and enrolled dependents) so as to not qualify for group coverage: 18 months
Death of covered employee, dependents can continue for: 36 months
Divorce or legal separation from covered employee, dependents can continue: 36 months
Dependent child ceases to be a dependent under the requirements of this Agreement: 36 months
Covered employee becomes entitled to Medicare; dependents can continue: 36 months
A determination of disability of a qualified COBRA beneficiary under the Social Security Act prior to termination or reduction of hours (other than for gross misconduct) or within the initial sixty (60) days of COBRA coverage: 29 months
USERRA (Military Leaves): 24 months
ADMINISTRATION:
Employer or a third party administrator administers plan. It is the EMPLOYER”S responsibility to notify subscriber and
dependents of COBRA coverage option. Employer is responsible to notify The Insurance Carrier of employees or dependents who have elected COBRA. Continuee will be billed on group bill. Employer is responsible for collecting the premium; 2% (or 50% for disability extension) may by added by employer for administration costs. If the group bills COBRA, it is their responsibility to bill the additional 2% or 50% for administration costs.
Notification: Employer must notify plan administrator of employee qualifying event within 30 days. Plan administrator has 14 days following date of termination to notify employee of continuation rights. If employer and plan administrator are one and the same, employer has 44 days to notify employee.
Employee has 60 days to elect or waive COBRA coverage from date of loss of coverage or date of notification by employer, whichever is later. A qualified beneficiary must pay current Dues for COBRA coverage no later than 45-days after the beneficiary’s election to continue coverage. After the initial 45 day period, payment due dates are determined by the employer, employee must pay within 30 days of established due date.
It is the EMPLOYERS responsibility to notify continuee of benefit or premium changes.
Federal Law
Employer groups with 20 or more employees (full and part time) on more than 50% of typical business days in the previous calendar year. Church groups and federal government employees are exempt from COBRA; Federal employees have Temporary Continuation Coverage (TCC) – refer to Feds EOC. Any employee, spouse, dependent or child born to or adopted by a covered employee during COBRA coverage is eligible if covered under a group health plan the day before the qualifying event. COBRA participant must pay 100% of group premium + a 2% administrative fee may be added to the Dues, or up to an additional 50% may be added to the Dues for a COBRA participant during any disability extension of the COBRA eligibility period.
QUALIFYING EVENTS:
Termination of employment (except for gross misconduct) or reduction of working hours of covered employee (and enrolled dependents) so as to not qualify for group coverage: 18 months
Death of covered employee, dependents can continue for: 36 months
Divorce or legal separation from covered employee, dependents can continue: 36 months
Dependent child ceases to be a dependent under the requirements of this Agreement: 36 months
Covered employee becomes entitled to Medicare; dependents can continue: 36 months
A determination of disability of a qualified COBRA beneficiary under the Social Security Act prior to termination or reduction of hours (other than for gross misconduct) or within the initial sixty (60) days of COBRA coverage: 29 months
USERRA (Military Leaves): 24 months
ADMINISTRATION:
Employer or a third party administrator administers plan. It is the EMPLOYER”S responsibility to notify subscriber and
dependents of COBRA coverage option. Employer is responsible to notify The Insurance Carrier of employees or dependents who have elected COBRA. Continuee will be billed on group bill. Employer is responsible for collecting the premium; 2% (or 50% for disability extension) may by added by employer for administration costs. If the group bills COBRA, it is their responsibility to bill the additional 2% or 50% for administration costs.
Notification: Employer must notify plan administrator of employee qualifying event within 30 days. Plan administrator has 14 days following date of termination to notify employee of continuation rights. If employer and plan administrator are one and the same, employer has 44 days to notify employee.
Employee has 60 days to elect or waive COBRA coverage from date of loss of coverage or date of notification by employer, whichever is later. A qualified beneficiary must pay current Dues for COBRA coverage no later than 45-days after the beneficiary’s election to continue coverage. After the initial 45 day period, payment due dates are determined by the employer, employee must pay within 30 days of established due date.
It is the EMPLOYERS responsibility to notify continuee of benefit or premium changes.
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