To simplify, an employer group is considered to be CAL COBRA if they have 19 or less employees on a typical business day during the previous calendar year. ASI is an administrator of Federal COBRA. Federal COBRA is for employer groups of 20 or more employees on a typical business day during the previous calendar year. CAL COBRA is usually administered through the insurance carrier. For further information, please consult your insurance carriers, broker or legal counsel.
Of all the COBRA notices, there are two that are of utmost importance. The Initial Notice and the Election (Qualifying Event) Notice. ASI would like to take a moment to give you a brief rundown of what each one is. Initial Notice: The Initial Notice is to be sent when an active employee is enrolling on any group benefit plan sponsored by the employer that is a COBRA eligible plan. This is a notification sent to enrolled employees and their spouses that are enrolled on your group benefit plan to make them aware of their rights under COBRA. This is also referred to as the General Rights Notice. Qualifying Event Notice: The Qualifying Event Notice is to be sent when an active employee on your COBRA eligible group benefit plan is losing benefits due to one of the COBRA triggering events. These events are listed on our ASI Qualifying Event Form found on our website. This is also called an Election notice or Specific Rights Notice.
Some basic examples of COBRA eligible health plans are: Medical, Dental, Vision, FSA (Section 125 or “Flex” plan), HRA (Health Reimbursement Arrangement), Employee Assistance Programs (not all are COBRA eligible), Prescription Drug Plans, and MERP (Medical Expense Reimbursement Plans).
Actually, it would not. In most cases, ASi does not have access to your invoices, medical group numbers or medical IDs with your carriers. If you were to give us the carrier name and the group number, ASi would not be able to determine which plan you are referring to (the HMO, the PPO). It is preferred you put the type of plan or name of the plan on the line.
On the ASi qualifying event form, there is a “Health plans” section. Within this section, it is requested you mark if ASi is to offer the QBs “Medical, dental or vision”. There is also a blank line for you to submit any details that would assist our processors in sending out the COBRA notice. A COBRA qualified beneficiary should only be offered the plans they had at the time of their loss of benefits. If the qualified beneficiary only had a medical plan, you would only check the medical box on the form. The line next to the medical box is for further detail. If your company offers multiple plans or carriers, you would want to specify that on the form. This helps ensure our processors offer the correct plans to the qualified beneficiaries with the correct rate.
To simplify, you can have both COBRA and Medicare, but only if the Medicare coverage came first (you enrolled in Medicare prior to COBRA). If you elect COBRA, and then become covered under Medicare, your COBRA coverage can terminate. The rule is the same for enrollment in other group health plan coverage.
No, the ASi COBRA Department does not terminate active employee benefits. ASi relies on the client or their broker to terminate the active employee benefits. The ASi COBRA Department administers COBRA benefits, not active benefits.
On the ASi qualifying event form, you want to use the actual date of the qualifying event, or, the true date the event happened. If an employee resigned on May 3rd, you would complete the form with a May 3rd date. Not May 31st or April 1st—when coverage would end on the group health plan.
A triggering event is an event that would cause a loss in group health plan benefits. The triggering events are Death, Divorce, Retirement, Resignation, Termination, Child Ceasing to be a Dependent on the Plan (because of age), Reduction of Hours and sometimes Medicare Entitlement of the Employee. If an employee is on one (or all) of your group health plans and loses benefits due to a triggering event (other than gross misconduct) they have the right to COBRA and should be sent a Qualifying Event (Election) letter with the option to enroll in COBRA.
The employer must notify the administrator within 30 days of the triggering event. The administrator then has an additional 14 days to notify the Qualified Beneficiary by letter. The Qualified Beneficiary then has 60 days to elect to continue coverage through COBRA. COBRA will continue for 18 or 36 months on the condition that premium payments are made timely. Payments are due on the first of each month with a 30 day grace period. The initial payment must be made within 45 days of electing COBRA coverage. This payment must bring your account current.
COBRA penalties can be pretty high for non-compliance. Statutory penalties of up to $110 per day under ERISA (Employee Retirement Income Security Act), Qualified Beneficiaries can sue to recover damages under ERISA, and failure to provide adequate notices (Election and Initial) can create exposure and lead to contractual damages. In all suits under ERISA, the court is permitted to award attorney’s fees and interest.
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This could be for several reasons. Most common is that the card hasn’t been activated. You can call the number on the sticker on the front of the card or call our office (559) 256-1320.
Another reason is the amount attempting to be swiped is not available on the card. You must swipe with the exact amount or less. Another reason is the merchant’s category code (MCC) is not an MCC that is allowed on the debit card, even if the facility is a doctor’s office or pharmacy. Member will need to pay out of pocket and submit a manual reimbursement request.
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Check out the FSA Store for a complete list of Eligible Items
For medical accounts, both the username and password is the number on your ASi ID card, including dashes, and sometimes with two zeros (00) at the end of the number. To login to your FSA account, the username and password will be your Social Security number. If you have both accounts with ASi, you will need to log in to them separately.