Managing COBRA Benefit Plan and Dependent Information

Pages Used to Manage COBRA Benefit Plan and Dependent Information

Page Name	Definition Name	Usage
Assign COBRA Benefit Program Page	COBRA_PROG_PARTIC1	Change benefit program participation for Open Enrollment and Family Status Change events.
COBRA Health Plan Enrollment	COBRA_HEALTH1	View or update health plan elections and enroll dependents.
COBRA FSA Plan Enrollment Page	COBRA_FSA	View or update FSA enrollments.
Name Page	COBRA_DEP_BENEF1	Add or Update COBRA dependent/beneficiary information.
Address	COBRA_DEP_ADDR	Enter or update COBRA dependent address information.
Personal Profile	COBRA_DEP_BENEF2	Enter or update COBRA dependent details.

Assign COBRA Benefit Program Page

Use the Assign COBRA Benefit Program page (COBRA_PROG_PARTIC1) to change benefit program participation for Open Enrollment and Family Status Change events.

Navigation:

Benefits, and then Administer COBRA Benefits, and then Enroll in Benefits, and then Assign COBRA Benefit Program, and then Assign COBRA Benefit Program

This example illustrates the fields and controls on the Assign COBRA Benefit Program page. You can find definitions for the fields and controls later on this page.

Health Plan Enrollment Page

Use the Health Plan Enrollment page (COBRA_HEALTH1) to view or update health plan elections and enroll dependents.

Navigation:

Benefits, and then Administer COBRA Benefits, and then Enroll in Benefits, and then Health Plan Enrollment, and then Health Plan Enrollment

This example illustrates the fields and controls on the Health Plan Enrollment page. You can find definitions for the fields and controls later on this page.

Field or Control	Description
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

Field or Control	Description
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.

COBRA FSA Plan Enrollment Page

Use the COBRA FSA Plan Enrollment (flexible spending account benefits) page (COBRA_FSA) to view or update FSA enrollments.

Navigation:

Benefits, and then Administer COBRA Benefits, and then Enroll in Benefits, and then COBRA FSA Plan Enrollment, and then COBRA FSA Plan Enrollment

This example illustrates the fields and controls on the COBRA FSA Plan Enrollment page. You can find definitions for the fields and controls later on this page.

Use the Coverage Election field to view and change whether the displayed COBRA FSA plan is elected or terminated.

Name Page

Use the Name page (COBRA_DEP_BENEF1) to add or Update COBRA dependent/beneficiary information.

Navigation:

Benefits, and then Administer COBRA Benefits, and then Maintain COBRA Non-Employees, and then Modify COBRA Dependent, and then Name

This example illustrates the fields and controls on the Name page. You can find definitions for the fields and controls later on this page.