This chapter provides an overview of managing COBRA (Consolidated Omnibus Budget Reconciliation Act) and discusses how to:
Determine qualified COBRA events.
Run the COBRA process.
Create notification letters.
Enter COBRA elections and waivers.
Process enrollments for secondary events.
Manage COBRA events.
Manage COBRA benefit plan and dependent information.
Manage nonemployee COBRA participants.
Terminate COBRA coverage.
Enroll participants in COBRA coverage manually.
The system searches the database for COBRA qualifying events that you define and identifies those employees and dependents who are eligible for COBRA benefits. When these qualified beneficiaries are identified, you can retrieve data through the COBRA pages and track the qualifying event, the calculated coverage begin and end dates, and COBRA status for each beneficiary. You can also enter health and flexible spending account (FSA) benefit elections.
To administer COBRA:
Perform PeopleSoft HR functions as usual.
For example, terminate employees, retire employees, and record marital status changes. These functions trigger COBRA activity.
Run the COBRA process to identify qualifying events and beneficiaries.
Generate COBRA notification letters and enrollment forms.
Enter COBRA elections or coverage waivers.
Manage COBRA benefits for nonemployee COBRA beneficiaries and their dependents.
Terminate COBRA enrollment for beneficiaries who lose their coverage due to lack of payment or voluntary termination.
This section provides an overview of COBRA events and discusses how to:
Add, delete, and review COBRA events.
Override initial and secondary COBRA events.
A qualified COBRA event:
Is defined in the COBRA Event Rules Table.
Results in a recognized loss of coverage in a health or FSA plan.
In the Manage Base Benefits business process, qualifying events are triggered through PeopleCode. In PeopleSoft Benefits Administration, qualifying events are triggered after Event Maintenance has been finalized. The exception (for both the Manage Base Benefits business process and Benefits Administration) is overage dependent processing. Overage dependent events are identified during the COBRA batch process and are automatically adjusted.
Information about triggered events is transferred to the COBRA Activity table for further analysis during the COBRA process.
Two types of COBRA events exist: initial and secondary. An initial event is the first qualifying event for an employee.
Understanding Initial COBRA Events
The following table shows the initial qualifying COBRA events that PeopleSoft software delivers, the user actions that trigger them, and the potential COBRA beneficiaries of each event.
Qualifying COBRA Event |
User Action Trigger |
Potential COBRA Beneficiaries |
Loss of eligibility due to termination |
Employee status changes to Terminated or Suspended. |
Employee and dependents |
Loss of eligibility due to reduction in hours |
Employee status remains Active; standard hours decrease. |
Employee and dependents |
Loss of eligibility due to retirement |
Employee status changes to Retired. |
Employee and dependents |
Loss of eligibility due to military leave |
Leave of Absence/Military Leave action/action reason combination is entered for the employee. |
Employee and dependents |
Death of employee |
Employee status changes to Deceased or a Family Status Change/Death action/action reason combination is entered for an employee. |
All dependents |
Divorce |
Marital status changes to Divorced; spouse becomes ex-spouse. |
Spouse |
Marriage of dependent |
Dependent marital status changes to Married. |
Individual dependent |
Dependent reaches coverage age limit (overage dependent) |
No user action; current age of dependent exceeds maximum dependent age or maximum student dependent age. (The system checks whether the dependent is a student.) |
Individual dependent |
Employee becomes entitled to Medicare |
Medicare entitlement date is entered. |
All dependents |
Note. According to federal government guidelines, employees who undergo voluntary or involuntary termination for gross misconduct and their spouses are not eligible for COBRA coverage. COBRA Administration does not differentiate between terminations for gross misconduct and other termination types, but you can set up action reason codes and add PeopleCode to perform this function.
Understanding Secondary COBRA Events
Secondary events extend coverage eligibility and are limited to dependents who are currently enrolled in COBRA coverage. A secondary event must meet the following requirements:
The dependent must currently be enrolled in COBRA coverage as a result of an initial COBRA event.
The initial COBRA event must be associated with a change to an employee's job status (such as a reduction in hours, termination, or retirement), and the secondary event must involve loss of coverage for the employee's dependent (such as divorce, marriage of dependent, overage dependent, death of employee, or a Medicare entitlement).
The triggers for secondary events are identical to the triggers for initial events, with one exception: If the initial event is a termination and the secondary event is a death, you must use the delivered action/action reason combination of FSC/DEA (family status change/death) to successfully process the event.
See Also
Processing Enrollments for Secondary Events
Page Name |
Definition Name |
Navigation |
Usage |
COBRA_ACTIVITY |
Benefits, Administer COBRA Benefits, Manage Automated Participation, Review COBRA Triggers, Review COBRA Triggers |
Add, delete, and review COBRA events. |
Access the Review COBRA Triggers page (Benefits, Administer COBRA Benefits, Manage Automated Participation, Review COBRA Triggers, Review COBRA Triggers).
Activity Tab
CBR Action (COBRA action) |
Describes the type of event that took place. |
Activity Source |
Indicates who or what initiated the event. |
Ben Record (benefit record number) |
Indicates the benefit record affected by the event. |
Coverage Override Tab
Coverage Override |
Select when to use an alternate coverage termination date to determine qualified COBRA coverage. |
Alt Covrg Term Date (alternate coverage termination date) |
The date when coverage was previously terminated. Required when the coverage override flag is selected. |
Coverage As-Of Date |
The date that coverage should begin if the event is fully qualified. The system sets the COBRA event date if this field is left blank. |
See Also
The system assumes that the date of the event and the date that an employee's benefits terminate are the same, which is not always true.
For example, suppose that an employee drops spousal coverage during Open Enrollment and then later gets divorced. The benefit plan must make COBRA coverage available upon receiving notice of the divorce.
Another example is when an employee decides not to return to work from FMLA. COBRA coverage becomes available on the day human resources is notified that the employee is not returning, not on the last day of the FMLA, unless notification is made on the last day of FMLA. The maximum coverage period usually begins on that day also.
For the COBRA process to recognize these events as enabling dependents to become eligible for COBRA benefits, you must enter the event directly into the COBRA Activity Table.
You cannot enter an event unless you have selected Manual Events Allowed in the COBRA Event Rules Table for the COBRA event classification. You may want to add a new COBRA event classification to identify these specific situations. COBRA events triggered through the Manage Base Benefits business process or Benefits Administration can be deleted on the COBRA Activity Table, but not modified. COBRA events that you enter through the Review COBRA Triggers page can be changed.
This section provides an overview of the COBRA process and describes how to:
Run the COBRA process.
Understand COBRA event status.
Assign qualified COBRA beneficiaries to benefit programs.
Determine eligible plan types.
Determine eligible options.
Calculate COBRA costs for eligible options.
Process secondary qualified COBRA events.
View error messages.
The COBRA process determines employee and dependent eligibility for COBRA benefit coverage.
For an employee or dependent to become a qualified COBRA beneficiary, the following two requirements must be met:
The person must have experienced a qualifying event.
The person must have had health coverage on the day of the qualifying event and have lost coverage.
If these requirements are met, the COBRA process assigns the beneficiary a benefit program and allows that person to elect COBRA health coverage.
Page Name |
Definition Name |
Navigation |
Usage |
COBRA_RUNCTL |
Benefits, Administer COBRA Benefits, Manage Automated Participation, Qualify Event/Proc Enrollment, Qualify Event/Proc Enrollment |
Run the COBRA process to determine eligibility. |
|
COBRA_MESSAGES |
Benefits, Administer COBRA Benefits, Review Processing Results, Review Processing Message, Review Processing Messages |
View error messages for the COBRA process. |
Access the Qualify Event/Proc Enrollment page (Benefits, Administer COBRA Benefits, Manage Automated Participation, Qualify Event/Proc Enrollment, Qualify Event/Proc Enrollment).
COBRA Processing Phase |
Displays the phase where processing begins. Possible phases are: Ready: Ready for processing. Overage: Processing overage dependents. Activity: Processing COBRA activity. Qualify: Processing qualifying events. Participant: Processing COBRA participants. Complete: Processing completed. |
Process Overage Dependents |
Deselect to skip overage-dependent processing during the batch run. |
Chk Point Interval in Minutes (check point interval in minutes) |
Enter the number of minutes before the process commits information that's been processed so far and updates the information displayed in the Restart Position group box. If an error occurs, the system restarts the process from the last checkpoint. |
Restart Position |
Displays the position from which to restart the COBRA process if a system failure occurs. |
Note. On the Process Scheduler page, select COBRA Admin & Non Employee to run the COBRA process. This runs both the COBRA Administration and COBRA Non Employee processes. The COBRA Administration process takes the relevant data and puts it into a temporary table. The COBRA Non Employee process writes the data to the correct PERSON table.
When a COBRA event has been triggered (online or through Benefits Administration), the COBRA process determines whether any employees or dependents have lost health coverage due to the event. The system considers these people to be qualified COBRA beneficiaries.
Each person analyzed by the COBRA process receives three status values:
Event qualification status
Initial event status
Secondary event status
The event qualification status identifies participants who qualify for COBRA. Statuses are:
Not COBRA Qualified
COBRA Qualify Error
COBRA Qualified
Qualify Pending
Unprocessed
The initial event status tracks the process of the event in the COBRA cycle; it also marks whether participants have their options prepared and are notified of coverage. Values include:
Qualify Pending
Qualified
Not Qualified
Options Prepared
Notified
Election Entered
Election Error
Election Enrolled
Enrollment Complete
The secondary event status is always Not Qualified unless the COBRA participant has been affected by a secondary event, such as divorce or Medicare entitlement. Other values include:
Qualify Pending
Qualified
Notified
Coverage Extended
When a participant is enrolled in COBRA coverage through an initial event and a qualified secondary event occurs for all of that participant's plans, the system sets the participant's initial event status to Not Qualified.
In the case of a combination event, which acts as an initial event for certain plans and as a secondary event for other plans, plans for which the combination event acts as a secondary event are set to Not Qualified. Initial event status values for plans for which the combination event acts as an initial event are set to appropriate levels for the current stage of processing.
Status values for initial and secondary events are updated as participants move through the COBRA process.
See Also
Processing Enrollments for Secondary Events
Benefit program assignment differs for COBRA events initiated by the Manage Base Benefits business process and Benefits Administration.
If a COBRA event is initiated by the Manage Base Benefits business process, the system assigns each qualified beneficiary to the benefit program that the employee was enrolled in on the day prior to the COBRA event date.
If the event is processed through Benefits Administration, then the system determines benefit program eligibility for each qualified COBRA beneficiary, using the eligibility parameters from the latest run of Benefits Administration and the qualified beneficiary's ZIP code. If no benefit programs satisfy this eligibility criteria, then the participant is assigned to the benefit program enrolled in on the day prior to the COBRA event date.
Note. This process occurs only for qualified participants who have a COBRA process status of Open For Processing (as opposed to Closed or Void).
See Also
Adjusting and Reprocessing COBRA Events
Beneficiaries are eligible for all COBRA-qualified group health plan types that they were enrolled in prior to the COBRA event. This includes all Health (1x) plan types and the Health FSA (60) plan type.
For a plan type within a specific benefit program to be designated as COBRA-qualified, you must select the COBRA Plan check box in the Plan Type and Option page of the Benefit Program Table (BEN_PROG_DEFN) component.
Eligible options are determined for each qualified plan type.
For employees, spouses, and ex-spouses, eligible options must satisfy the following criteria:
The benefit plan associated with the options matches the benefit plan of the lost coverage of the employee, spouse, or ex-spouse.
The coverage code has the COBRA Coverage Set field selected and is less than or equal to the coverage code of the lost coverage of the employee, spouse, or ex-spouse.
For spouses and ex-spouses, the coverage code selected cannot require a spouse or ex-spouse (Spouse Only Coverage codes).
For all dependents besides spouses and ex-spouses, eligible options must satisfy the following criteria:
The benefit plan associated with the options matches the benefit plan of the dependent's lost coverage.
The dependent's coverage code is Employee Only (Dependent Only Coverage).
Note. The Employee Only code is used when the dependent is covered on his or her own and as a dependent of the COBRA participant. The code is used to indicate the coverage of a single person.
Benefits Administration uses a different method to determine option eligibility.
See Also
This section describes how to calculate COBRA costs.
To calculate COBRA cost:
Access the Benefit Program page.
Enter the COBRA percentage amount.
The COBRA process calculates a charge for each option using the sum of the total coverage costs (employee plus employer) multiplied by the surcharge defined here.
Enter the COBRA disabled surcharge percentage.
If the COBRA participant is disabled, the COBRA cost for months 19–29 is multiplied by this surcharge.
When you select Waive COBRA Surcharge on the COBRA Event Rules Table page for a specific COBRA event classification, the system does not add the COBRA surcharge or disabled surcharge.
COBRA charges are sent to the COBRA beneficiary through Benefits Billing processes, as long as Benefits Billing is selected in the Products page of the Installation table.
See Also
Although COBRA governmental regulations describe how secondary COBRA qualifying events should be processed, PeopleSoft event rules allow for a different implementation of secondary event processing.
Three fields defined on the Event Rules page are used to process secondary events.
Secondary Event Role |
Identifies whether the event can be considered a secondary event. |
Second Event Additional Months |
Defines by how many months the secondary event extends a COBRA participant's coverage. |
Secondary Event Add Mode |
Defines whether the additional months extend the coverage 36 months from the coverage begin date of the initial event or add 36 months to the COBRA event date of the secondary event. |
See Also
Setting Up COBRA Administration
Processing Enrollments for Secondary Events
Access the Process Messages page (Benefits, Administer COBRA Benefits, Review Processing Results, Review Processing Message, Process Messages).
Benefit Rcd# (benefit record number) |
The employee benefit record number that was affected by the COBRA event. |
CBR Evt ID (COBRA event identification) |
The identification number assigned to the event by the COBRA process. |
Dep/Benef (dependents/beneficiaries) |
Any relevant dependents or beneficiaries. |
This section describes how to:
Determine notification recipients.
Print notification letters for initial events.
Print notification letters for secondary events.
Reprint notification letters.
See Also
Processing Enrollments for Secondary Events
Page Name |
Definition Name |
Navigation |
Usage |
RUNCTL_CBR001 |
Benefits, Administer COBRA Benefits, Manage Automated Participation, Create Initial Letter, Create Initial Letter |
Print notification letters for initial COBRA events. |
|
RUNCTL_CBR002 |
Benefits, Administer COBRA Benefits, Manage Automated Participation, Create Secondary Letter, Create Secondary Letter |
Print notification letters for secondary COBRA events. |
|
CBR_PRT |
Benefits, Administer COBRA Benefits, Manage Automated Participation, Reprint Selected Letters, Reprint Selected Letters |
Select parameters for reprinting notification letters. |
The qualifying event determines recipients.
For termination, reduction in hours, and retirement events, the employee and each covered dependent are notified.
When Medicare entitlement or death of employee events occur, each dependent is notified.
When divorce or loss of dependent status events occur, the spouse or dependent is notified.
Access the Create Initial Letter page (Benefits, Administer COBRA Benefits, Manage Automated Participation, Create Initial Letter, Create Initial Letter).
The Initial Notification Letter process generates letters for COBRA participants with an initial event status of Options Prepared and an event status of Open For Processing. Letters include:
The nature of the qualifying event and the date it occurred.
The last day of active coverage of the qualified participant's original benefit plans.
The plan types for which the qualified participant is eligible to receive COBRA coverage.
The COBRA coverage start and end dates for each plan, and the response date by which the qualified participant must notify you of his or her elections.
Along with each initial notification letter, the system prints a COBRA continuation coverage election form for employees to record their elections.
When an initial notification letter is generated for a qualified COBRA participant, the initial event status is changed to Notified. The election end date is calculated for each plan type as 60 days past the latter of the notification date (on the notification letter) or the loss of coverage.
As Of Date |
Enter the date for the time period during which you want the letters. |
'Reprint' Appears on Letters |
Select this check box if you want the word Reprint to appear on the letter. |
Reprint ID |
Select the ID number associated with the letters that you want reprinted. |
Access the Create Secondary Letter page (Benefits, Administer COBRA Benefits, Manage Automated Participation, Create Secondary Letter, Create Secondary Letter).
The process for printing notification letters for secondary events is identical to that for initial events.
The secondary notification letter includes information about how long COBRA coverage is to be extended.
Recipients have their secondary event status changed to Notified and their process status changed to Closed for Processing.
Access the Reprint Selected Letters page (Benefits, Administer COBRA Benefits, Manage Automated Participation, Reprint Selected Letters, Reprint Selected Letters).
This page enables you to reprint all letters, or to select specific employees for whom letters are to be reprinted. You can specify a notification date range during which the reprint is to occur.
This section provides an overview of COBRA elections and describes how to:
Record COBRA elections and waivers.
Validate and enroll elections.
Qualified COBRA beneficiaries can:
Select COBRA for one or more plan types.
Waive COBRA for all plan types.
Revoke a waiver for one or more plan types.
Unlike PeopleSoft Benefits Administration, COBRA participants can make enrollment decisions at the plan type level.
Employees and dependents are individually qualified for COBRA coverage, and they can choose to be covered as individuals.
For example, suppose that an employee with Employee plus Spouse coverage terminates employment and loses all regular health coverage. The employee and the spouse both qualify for COBRA coverage. The spouse can select either to be covered individually as a nonemployee (even if the employee doesn't elect coverage), she can continue to be covered under the employee as a dependent, or the spouse may elect Spouse Only coverage (if the terminated employee coverage code is set to Spouse Allowed).
When you enter elections for qualified COBRA participants, the system sets their initial event status to Election Entered.
See Also
Managing Nonemployee COBRA Participants
Page Name |
Definition Name |
Navigation |
Usage |
COBRA_PARTIC_ENT1 |
Benefits, Administer COBRA Benefits, Manage Automated Participation, Participant Elections, Participant Elections |
Record elections or waivers for COBRA coverage. |
Access the Participant Elections page (Benefits, Administer COBRA Benefits, Manage Automated Participation, Participant Elections, Participant Elections).
COBRA Election |
Indicate whether to elect or waive COBRA coverage. To revoke a waiver of coverage, change the selection from Waive to Elect. Waivers cannot be revoked after the election end date. The current date is automatically set as the election, waive, or revoke date, although you can override that value for elections. |
Participant Enrollment
Plan Type |
Enter the elected option choices. |
Covrg Begin (coverage begin), Covrg End (coverage end), and Election End |
Predetermined by the COBRA process. |
COBRA Election |
Elect or waive each plan type. The election or waive date is automatically set, although you can override the election date. |
Provider ID |
For health plan types. Enter the name of the employee's doctor, an ID number, or any other format that the health provider requires. |
Previously Seen |
Select to indicate that the employee is a current patient of the indicated physician. |
When an election has been entered, validated, and enrolled, the election cannot be changed without COBRA reprocessing. After reprocessing, you can add new elections or make election changes if the coverage election date is on or before the coverage election end date and if the elections have not been entered.
The system reviews plan type, option code, and dependent/beneficiary elections made for qualified COBRA participants when their elections are saved. If all of the plan types for which the participant is eligible reflect either an enrollment election or waiver, the system changes the participant's initial event status to Enrollment Completed and the process status to Closed for Processing. If some of the plans have not had an entry made, the participant's initial event status changes to Enrolled (for the specific plan), and the process status remains Open for Processing. In either case, if errors are discovered, the initial event status becomes Election Error.
Enrollment in Health or FSA Plans
If the initial election status is Enrollment Completed or Enrolled, you can access health plan information, FSA plan information, or both in the Health Benefits and FSA Benefits pages.
Creation of Non-Employee Status
If a dependent elects individual COBRA coverage or has a qualifying second event, then that nonemployee participant receives a system-generated employee ID.
Notification to Billing System
If Benefits Billing is selected in the Installation Table, the system enrolls validated and enrolled COBRA participants in the Benefits Billing system for elected plan types. The system also sends COBRA surcharges and coverage start and end dates to Benefits Billing.
Validation and Enrollment Error Messages
You can view error messages generated during validation and enrollment either by using the Process Messages page or by running the COBRA Error report. Each time the COBRA validation and enrollment process runs, it deletes error messages from the previous run.
See Also
Managing Nonemployee COBRA Participants
This section discusses:
Initial event status and secondary events.
How to identify differences in individual and dependent coverage processing.
Combination events.
When a secondary event is processed, the system reviews the initial event to determine whether its event status is Closed to Processing (indicating that the participant has made an election or waived COBRA coverage). If the initial event is not closed, the secondary event's status becomes Qualified Pending. The secondary event needs to be reprocessed after the initial event is closed.
This can happen if dependents are covered under an employee's coverage instead of electing independent coverage.
For example, suppose that an employee and her dependents become qualified beneficiaries after she terminates her employment. She enrolls in family coverage for plan types 10 and 11—covering herself, her spouse, and her daughter—and waives plan type 14. As a result, the terminated employee's record is Closed to Processing. But the dependents' records remain Open for Processing because they have not independently elected or waived coverage.
To close an initial event and reprocess a secondary event:
A secondary event, such as a divorce or dependent marriage, occurs.
The HR system processes the personnel action.
The COBRA process evaluates the secondary event and returns a status of Qualified Pending.
Determine whether the initial event is still Open for Processing because the dependent records were not waived or enrolled.
Waive or elect options for the dependents and run the COBRA process to close the initial event.
Use the Update Event Status page to reprocess the secondary event by changing the reprocess status for the secondary event to Qualify Event.
After you run the COBRA process again, the secondary event should be set to Qualified.
See Also
Adjusting and Reprocessing COBRA Events
When secondary events occur, COBRA participants with individual coverage are processed differently from those with dependent coverage.
For participants with individual coverage, a secondary event extends coverage according to the defined secondary event rules. The system deletes the existing termination record, reinserts it into the coverage begin date, and sets an effective date equal to the extended COBRA coverage end date + 1. The COBRA enrollment status is set to Coverage Extended.
Participants with dependent coverage are switched to individual COBRA participants, with individual COBRA coverage as of the COBRA event date of the secondary event. The system automatically establishes the participant as a nonemployee in the system and enrolls the participant in employee-only coverage for all plan types that meet this condition. The employee-only coverage is within the same benefit plan under which the participant was covered as a dependent under COBRA. The coverage end date is calculated based on the predefined secondary event rules, and the COBRA enrollment status is set to Coverage Inserted.
A COBRA event can be an initial event for one plan type and a secondary event for another type. For example, suppose that an employee has Employee Plus Spouse coverage for plan types 10, 11, and 14. Then the employee transfers and both the employee and the spouse lose coverage under plan types 11 and 14; they are eligible for 18 months of COBRA coverage for these types, and they elect this coverage.
The employee divorces while the COBRA coverage is still active. The divorce event causes the employee's ex-spouse to lose coverage for plan type 10 (an initial event); the ex-spouse is qualified for 36 months of COBRA coverage under that plan. The divorce is also a secondary event for plan types 11 and 14; the ex-spouse is qualified to have coverage extended for those plans for up to 36 months from the original coverage begin date.
The two events—the initial event for plan type 10 and the secondary event for plan types 11 and 14—progress through the COBRA system independently in terms of notification letters and ongoing status indicators.
This section describes how to:
Review COBRA event summaries.
Adjust and reprocess COBRA events.
Page Name |
Definition Name |
Navigation |
Usage |
COBRA_EVENT_INQ1 |
Benefits, Administer COBRA Benefits, Review Processing Results, Review Event Summary, Review Event Summary |
Review information about COBRA events and associated beneficiaries. |
|
COBRA_STATUS1 |
Benefits, Administer COBRA Benefits, Manage Automated Participation, Update Event Status, Update Event Status |
Adjust, reprocess, and void COBRA events. |
Access the Review Event Summary page (Benefits, Administer COBRA Benefits, Review Processing Results, Review Event Summary, Review Event Summary).
Access the Update Event Status page (Benefits, Administer COBRA Benefits, Manage Automated Participation, Update Event Status, Update Event Status).
Reprocess Indicator |
Set to reprocess a COBRA phase for events, participants, or plan types. To reprocess any level, the process status for that level and any above it must be Open for Processing. You cannot reprocess initial events that have secondary events dependent on them. At the event level, you can reprocess to Prepare Options only if the Option Prepare phase has already been completed. At the participant plan type level, you can select Elect Options only when the plan type is Enrolled and the associated event is an initial event. After choosing a value, run the COBRA process again to reprocess to the selected status. |
COBRA Event Conflict |
Selected if the system determines that two or more events are in conflict with each other. An example is when an event is entered and processed, and another event is entered with an earlier date than the first event. The system sends a message to the COBRA administrator to analyze the conflicting events and take any appropriate actions. |
Voiding Events, Participants, or Benefit Plans
When you enter Void Event in the Reprocess Indicator at the COBRA event level, the system ignores all reprocessing indicators at the lower levels. It voids all COBRA participants and participant plans, and deletes all enrolled COBRA benefits. Notification is sent to the Benefits Billing system to terminate billing for voided participants.
When you enter Void Event in the Reprocess Indicator at the COBRA participant level, the result is similar to voiding a COBRA event. The COBRA participant record and all COBRA benefit plan records associated with that participant are deleted. Benefits Billing is notified to terminate billing.
Voiding a COBRA benefit plan associated with an initial event deletes all enrolled COBRA benefit records associated with that plan; Benefits Billing is notified to terminate billing. Voiding a COBRA benefit plan associated with a secondary event readjusts termination dates back to those associated with the initial plan; Benefits Billing is notified to adjust billing.
When you enter Qualify Event in the Reprocess Indicator at the COBRA event level, all reprocessing indicators at the lower levels are ignored. All enrolled COBRA benefits are deleted.
Preparing and Electing Options
When you set Prepare Options at the event level, if a participant or plan has a Reprocess Indicator setting of Void Event, that reprocessing command takes precedence over Prepare Options. For example, if you want to void the COBRA election plan type 10 and prepare options for plan type 11, the system first voids plan type 10 and then prepares options for plan type 11.
Prepare Options reprocessing deletes all of the plan, option, and dependent records associated with that event. Benefits Billing is notified to terminate billing.
See Also
This section describes how to:
Change benefit programs.
View and update health plan elections.
Enroll dependents in health plans.
View and update FSA enrollments.
Page Name |
Definition Name |
Navigation |
Usage |
COBRA_PROG_PARTIC1 |
Benefits, Administer COBRA Benefits, Enroll in Benefits, Assign to Benefit Program, Assign to Benefit Program |
Change benefit program participation for Open Enrollment and Family Status Change events. |
|
COBRA_HEALTH1 |
Benefits, Administer COBRA Benefits, Enroll in Benefits, Health Benefits, Election |
View or update health plan elections and enroll dependents. |
|
COBRA_FSA |
Benefits, Administer COBRA Benefits, Enroll in Benefits, FSA Benefits, FSA Benefits |
View or update FSA enrollments. |
|
COBRA_DEP_BENEF1 |
Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Modify Dependent/Beneficiaries, Name |
Add or Update COBRA dependent/beneficiary information. |
|
COBRA_DEP_ADDR |
Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Modify Dependent/Beneficiaries, Address |
Enter or update COBRA dependent address information. |
|
COBRA_DEP_BENEF2 |
Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Modify Dependent/Beneficiaries, Personal Profile |
Enter or update COBRA dependent details. |
Access the Assign to Benefit Program page (Benefits, Administer COBRA Benefits, Enroll in Benefits, Assign to Benefit Program, Assign to Benefit Program).
Access the Health Benefits page (Benefits, Administer COBRA Benefits, Enroll in Benefits, Health Benefits, Health Benefits).
Coverage Begin Date |
Automatically set to the date in the Review Event Summary page. |
Coverage Election |
Displays whether the COBRA health benefit record in view is currently elected or terminated. |
Coverage Code |
When you exit this field, the system calculates the monthly cost of the benefit. |
Health Provider ID |
Enter the name of the employee's doctor, an ID number, or any other information that the health provider may require. |
Previously Seen |
Indicate that the employee is a current patient of the indicated physician. This field becomes available when a health provider ID is entered. |
HIPAA Report Date (Emp) (Health Insurance Portability and Accountability Act report date [employee]) |
Displays the date that the employee's certificate of creditable health coverage was printed if health coverage was terminated. These certificates are guaranteed to employees by HIPAA of 1996; you can print them by running HIPAA reports. Note. The certificate of creditable coverage lists all group health coverage that an employee had for the 18 month period prior to the date on which coverage ended. |
Dependent/Beneficiaries
ID |
Select a dependent ID to add available beneficiaries to the selected COBRA plan. |
Health Provider ID |
Enter the name of the dependent's doctor, an ID number, or any other information that the health provider may require. |
Previously Seen |
Select to indicate that the dependent is a current patient of the indicated physician. This check box becomes available when a health provider ID is entered. |
Access the FSA Benefits page (Benefits, Administer COBRA Benefits, Enroll in Benefits, FSA Benefits, FSA Benefits).
Use the Coverage Election field to view and change whether the displayed COBRA FSA plan is elected or terminated.
Access the Name page (Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Modify Dependent/Beneficiaries, Name).
When a COBRA-qualified dependent selects individual coverage after an initial event or undergoes an event that involves a loss of dependent status, that dependent becomes a nonemployee COBRA participant. Nonemployee COBRA participants can declare their own dependents and change benefit programs and plans.
This section describes how to:
Maintain nonemployee identity and department security information.
Convert nonemployee individual coverage to dependent coverage.
Note. When you add a nonemployee through COBRA, the nonemployee record may not show in other PeopleSoft HR processes until the Refresh Personal Data process is run.
See Also
Adding a Person in PeopleSoft Human Resources
Page Name |
Definition Name |
Navigation |
Usage |
PERSONAL_DATA1 |
Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Modify Personal Information, Name and Contact |
Update COBRA-qualified dependent name and biographical information. |
|
CBR_PERSONAL_DATA3 |
Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Modify Personal Information, Medicare and Job |
Maintain department security information for nonemployee COBRA participants. |
Access the Medicare and Job page (Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Modify Personal Information, Medicare and Job).
Employment Information |
During the COBRA processing, automatically populated with the original data of the employee that experienced the COBRA event. |
Job Information |
Review and update a historical record of the nonemployee participant's business unit and department affiliations. |
When a spouse or ex-spouse COBRA participant enrolls in individual nonemployee COBRA coverage, the child dependents of the employee are inherited as dependents for the nonemployee.
All nonemployee participants are assigned a unique system-generated employee ID for which the numbering convention is established in the Installation Table. All dependents of the nonemployee participant also have this new COBRA employee ID, along with their original dependent/beneficiary ID.
When a secondary event occurs, however, all of an employee's dependents become independently covered. For example, a former employee elects COBRA coverage for himself, his spouse, and his child. He later dies, which qualifies as a secondary event for the dependents. The spouse and child become nonemployee participants, and are assigned IDs as shown in the following table.
Person |
Employee ID |
Dependent/Beneficiary ID |
Employee (Deceased) |
Z001 |
00 |
Spouse (Nonemployee) |
C00015 |
01 |
Child (Nonemployee) |
C00016 |
02 |
If no further action is taken, the system creates COBRA health benefit records with employee-only coverage for the spouse and dependents, with their COBRA coverage extended to a total of 36 months from the initial event.
However, the spouse can also enroll the children as dependents under her coverage. To change from independent coverage for nonemployees to dependent coverage, follow these steps.
To convert nonemployee independent coverage to nonemployee dependent coverage:
Access the COBRA health benefit record for the nonemployee who is remaining independently covered.
Change the coverage code to an appropriate coverage code for dependent coverage for the plan types affected and add the dependent IDs to cover.
Access the Participation Termination page and create Voluntary Termination records for the dependents who are now covered under the spouse. The termination date for each termination record should be the same date that dependent coverage begins.
See Also
Managing COBRA Benefit Plan and Dependent Information
COBRA can be terminated:
Automatically, when the COBRA coverage end date is reached.
Manually, when the COBRA participant fails to pay bills or requests to terminate coverage ahead of the scheduled end date.
This section describes how to:
Terminate COBRA coverage manually.
Send termination letters.
Page Name |
Definition Name |
Navigation |
Usage |
COBRA_PARTIC_TERM |
Benefits, Administer COBRA Benefits, Terminate COBRA Coverage, Terminate Participant, Terminate Participant |
Terminate COBRA coverage manually if bills are unpaid or on participant's request. |
|
RUNCTL_CBR003 |
Benefits, Administer COBRA Benefits, Terminate COBRA Coverage, Create Termination Letter, Create Termination Letter |
Send letters to COBRA participants with plans about to expire. |
Access the Terminate Participant page (Benefits, Administer COBRA Benefits, Terminate COBRA Coverage, Terminate Participant, Terminate Participant).
For each plan type to terminate, enter the termination date and reason.
When you save this page, the coverage end date of the enrolled plan type is adjusted to the termination date.
Access the Create Termination Letter page (Benefits, Administer COBRA Benefits, Terminate COBRA Coverage, Create Termination Letter, Create Termination Letter).
Termination letters are printed for employees whose coverage ends during the period between the start and end dates.
See Also
Setting Up and Generating Form Letters
You can bypass the automated COBRA Administration batch process and force the system to enroll employees and dependents into COBRA health benefits.
When you bypass the batch process, participants do not require COBRA-qualifying events in order to be eligible for COBRA benefits. Instead, the system automatically gives all participants enrolled in COBRA coverage through these pages a COBRA event ID of 900.
Note. When you manually enroll an employee or dependent in COBRA coverage, subsequent COBRA processing, such as secondary event processing, is not aware of the manually enrolled COBRA coverage. When you add a nonemployee through COBRA, the nonemployee record may not show in other HR processes until the Refresh Personal Data process is run.
Warning! Because these pages ignore the processing rules that regulate COBRA coverage eligibility, manually process COBRA coverage only after careful consideration.
This section describes how to:
Change employee dependents to non-employees manually.
Assign participants to benefit programs manually.
Enroll participants in benefit plans manually.
See Also
Managing COBRA Benefit Plan and Dependent Information
Managing Nonemployee COBRA Participants
Adding a Person in PeopleSoft Human Resources
Page Name |
Definition Name |
Navigation |
Usage |
CBR_MANUAL_ENT1 |
Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Create COBRA Non-Employee, Create COBRA Non-Employee |
Manually establish an employee dependent as a nonemployee in preparation for manually enrolling the dependent into COBRA coverage. |
|
CBR_MANUAL_PARTIC1 |
Benefits, Administer COBRA Benefits, Enroll Manually, Assign Benefit Program, Assign Benefit Program |
Manually assign an employee or COBRA nonemployee to a benefit program or make changes to that manual assignment over time. |
|
CBR_MANUAL_HEALTH1 |
Benefits, Administer COBRA Benefits, Enroll Manually, Select Health Benefits, Select Health Benefits |
Enroll participants in COBRA health benefits manually. |
Access the Create COBRA Non-Employee page (Benefits, Administer COBRA Benefits, Maintain COBRA Non-Employees, Create COBRA Non-Employee, Create COBRA Non-Employee).
Empl ID (employee ID) and Empl Record (employee record number) |
Enter the ID and employee record number for the employee whom the nonemployee participant is a dependent or beneficiary of. |
Dep/Benef (dependent/beneficiary) |
Enter the dependent or beneficiary number. |
COBRA Event Date |
Enter the event date for the nonemployee participant's COBRA enrollment. |
Save and Add Next |
Click to save the information. A message appears informing you of the COBRA employee ID assigned to this person. Note the new employee ID for the COBRA nonemployee and click OK. |
Access the Assign Benefit Program page (Benefits, Administer COBRA Benefits, Enroll Manually, Assign Benefit Program, Assign Benefit Program).
The benefit program is assigned a COBRA event ID of 900.
Access the Select Health Benefits page (Benefits, Administer COBRA Benefits, Enroll Manually, Select Health Benefits, Select Health Benefits).
The health benefit record of the selected participant receives a COBRA event ID of 900.
Coverage Begin Date |
Automatically set to the current date. |
Coverage Election |
Elect or terminate a benefit plan. |
Option |
The system displays the COBRA option that goes with the selected benefit plan. |
Health Provider ID |
Enter the name of the employee's doctor, an ID number, or any other format that the health provider may require. |
Previously Seen |
Select to indicate that the employee is a current patient of the indicated physician. Becomes available when you enter a health provider ID. |
HIPAA Report Date (Emp) |
Displays the date on which the employee's certificate of creditable health coverage was printed if health coverage was terminated. These certificates are guaranteed to employees by the Health Insurance and Accountability Act of 1996, and you can print them by running HIPAA reports. Note. The certificate of creditable coverage lists all group health coverage that an employee had for the 12–month period prior to the date that coverage ended. |
Dependent/Beneficiaries
ID |
Select the dependent ID to add available beneficiaries to the selected COBRA participant/plan type/benefit plan combination. |
Relationship to Employee |
Identifies the dependent's relationship to the participant. |
Health Provider ID |
Enter the name of the employee's doctor, an ID number, or any other information that the health provider may require. |
Previously Seen |
Select to indicate that the employee is a current patient of the indicated physician. Becomes available when you enter a health provider ID. |