Symphony Employer Solutions Keeps YOUR Business Compliant ~ Cobra Subsidy Model Notices

100% Cobra Subsidy Model Notices Available

The U.S. Department of Labor (DOL) has released to its website guidance and model notices to help employers comply with the federal COBRA premium subsidy put in place by thAmerican Rescue Plan Act (ARPA).

To review the benefits and requirements of the Cobra Subsidy, click here.

New Model Notices

The ARPA requires group health plans to provide required notices to Assistance Eligible Individuals (AEIs) who have lost or will be losing their health care coverage and are eligible for COBRA 100% premium assistance.

There are five (5) Model notices that cover the notification responsibilities of a group health plan sponsor (click here for Notices and Associated FAQs – COBRA Premium Subsidy | U.S. Department of Labor).

1. Model General Notice and COBRA Continuation Coverage Election Notice

This general notice is for use by group health plans for any qualified beneficiaries who loses coverage due to a reduction in hours or involuntary termination of employment with COBRA between April 1 – Sept. 30, 2021. This notice may be provided as a supplement to your standard COBRA election notice, or its terms may be incorporated into your COBRA election notice. Model Notice is available in MS Word and PDF.

2. Model Notice in Connection with Extended Election Period

For use by group health plans for any qualified beneficiaries currently enrolled in COBRA continuation coverage, due to a reduction in hours or involuntary termination (Assistance Eligible Individuals), as well as those who would currently be Assistance Eligible Individuals if they had elected and/or maintained COBRA continuation coverage. Send this notice to AEIs who are still in their 18-month COBRA window in April 2021, which means anyone who was involuntarily terminated or lost coverage due to a reduction in hours on or after Oct. 1, 2019, whether the individual is currently enrolled in COBRA, previously declined COBRA coverage, or enrolled and then later dropped COBRA coverage. THIS NOTICE MUST BE PROVIDED BY MAY 31, 2021. Model Notice is available in MS Word and PDF.

3. Model Alternative Notice

This notice is for COBRA coverage subject to state health plan continuation requirements such as Divorce or legal separation, Death of an employee, Entitlement to Medicare, or Loss of dependent child status. Depending on the type of qualifying event, “qualified beneficiaries” can include the employee (or retired employee) covered under the group health plan, the covered employee’s spouse, and the dependent children of the covered employee. Model Notice is available in MS Word and PDF.

4. Model Notice of Expiration of Premium Assistance

Send this notice to any AEIs 15 to 45 days before their COBRA subsidy will expire. Model Notice is available in MS Word and PDF.

5. Summary of COBRA Premium Assistance Provisions under the American Rescue Plan Act of 2021

This document includes a DOL form for employees to request treatment as an assistance eligible individual. Model Summary notice is available in MS Word and PDF.

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