Along with all the new wrinkles in COBRA, here comes another: a special Department of Labor form for ex-employees who want to appeal their denial of COBRA subsidy benefits — putting more pressure on employers to make sure denials are valid.
The DOL just posted on its Web site the form — “Application for Review of Denial of COBRA Premium Reduction.” (To see the form, go to www.dol.gov/ebsa/COBRA/main.html). The appeal form, available both to former employees and their eligible family members, can be completed online or filled out on paper and mailed or faxed to the agency.
DOL is telling applicants to include anything they think would help review the application, such as the COBRA election notice, insurance card, paystubs showing deductions for health benefits, and any documents detailing the date/circumstances of the termination and denial of premium reduction. The online version makes appeals easy — and probably more common — by walking applicants through the process screen by screen.
Check your denials
The availability of this form makes it critical that you reject for a COBRA subsidy only those terminated employees you’re certain don’t qualify — otherwise, you may hear from DOL. Remember, the subsidy only applies to those meeting these requirements:
- be eligible for continuation coverage under COBRA or a state law that provides comparable continuation coverage (for example, so-called “mini-COBRA” laws) at any time during the period beginning 9/1/08 and ending 12/31/09
- elect continuation coverage (when first offered or during the additional election period), and
- have a qualifying event for the continuation coverage that is the employee’s involuntary termination during the period beginning 91//08 and ending 12/31/09.