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Premium Assistance for Continuation Coverage under ARRA Application Now Available: "Request for Review If You Have Been Denied Premium Assistance" New! See the "Helpful Information for Beneficiaries on COBRA Premium Assistance under the American Recovery and Reinvestment Act" document under the Downloads section. The application to request CMS review of your denial of premium assistance is now available on this Website. Go to the "Downloads" section towards the bottom of the page, and click on the first item entitled "Request for Review If You Have Been Denied Premium Assistance". Please see item #3 for contact information for the CMS-sponsored helpdesk which provides help with filling out the form, where to send the completed form, as well as answering questions about premium assistance for continuation coverage under the American Recovery and Reinvestment Act of 2009 (ARRA). ARRA provides Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) premium assistance for certain individuals whose qualifying event is the covered employee's involuntary termination of employment. Also, certain individuals, whose qualifying event is the covered employee's involuntary termination of employment, who initially declined to elect COBRA coverage, or elected it and subsequently discontinued it, may be afforded another opportunity to elect COBRA coverage. ARRA applies to group health plans sponsored by private sector employers and state and local governmental employers that employ at least 20 employees. ARRA also applies to the Federal Employees Health Benefits Program. State "mini-COBRA" plans provided through health insurance issuers are also subject to the ARRA premium assistance provisions, but not the additional election period requirement (unless state insurance law or regulation adopts that requirement). For more information about ARRA, go to the "Downloads" section at the bottom of this page and select "Helpful Information about State Continuation Coverage and ARRA". Also, links to ARRA information that is posted on the Department of Labor's (DoL) and the Department of the Treasury's Websites are provided below under "Related Links Outside CMS". Model ARRA-related notices and forms are posted on DoL's Website. If after reviewing the ARRA-related material on the above cited Websites, you have additional ARRA-related questions, you may direct your questions to the appropriate entity as follows: (1) with respect to continuation coverage provided by private sector employers that employ at least 20 employees and ARRA premium assistance and appeals available to individuals denied that benefit under COBRA through such employers, contact the US Department of Labor, Employee Benefits Security Administration, at 1-866-444-3272. A form to request that the DoL review your denial of ARRA premium assistance is now available on the following Website: http://www.dol.gov/ebsa/COBRA/main.html (link entitled "ARRA COBRA DoL Form" located under the "Downloads" section). (2) regarding the applicability of ARRA to State mini-COBRA plans, contact your State's Department of Insurance, go to "Related Links Inside CMS" select the "Health Insurance Reform for Consumers" Web page, scroll to the "Downloads" section and select "DOI Contact Information - State Status Chart". (3) with respect to ARRA premium assistance and appeals available to people who have been denied that benefit under continuation coverage provided by the Federal government, state and local governments and in plans regulated by comparable State mini-COBRA laws, contact the CMS-sponsored premium assistance continuation coverage help desk via e-mail at continuationcoverage@maximus.com or call toll-free at (866) 400-6689. Staff members are available to help you from 8 a.m. until 8 p.m. EST. A form to request review by CMS if you are denied premium assistance is now available and located under the "Downloads" section. It is entitled "Request for Review If You Have Been Denied Premium Assistance". The link to the Premium Assistance Appeals Website is located in the "Related Links Outside CMS" section. Additionally, the help desk staff members would be glad to assist you with any questions about completing the application. You can mail your completed form to: MAXIMUS Federal Services, Inc. COBRA--Continuation Coverage Assistance Appeals Project 800 Cross Keys Office Park First Floor - Suite 820 Fairport, New York 14450 Alternatively, you can fax your form, toll-free, to (866) 941-0170. To confirm receipt when faxing, please call the toll-free number (866) 400-6689. COBRA This section provides information about public sector COBRA continuation of coverage. The information in this section will be of interest to state and local government employers that maintain group health plan coverage for their employees, their plan administrators and plan enrollees. The landmark COBRA health benefit provisions became law in 1986. The law amends the Employee Retirement Income Security Act, the Internal Revenue Code and the Public Health Service Act to provide continuation of employer-sponsored group health coverage that otherwise might be terminated. CMS has advisory jurisdiction for the COBRA law as it applies to state and local government (public sector) employers and their group health plans. (See Related Link Outside CMS at the bottom of this page.) Click on "Federal Jurisdiction" on the left navigation bar for information about contacting the federal agencies that administer private sector COBRA and the continuation of coverage provisions for federal employees. The COBRA law generally applies to group health plans maintained by employers with 20 or more employees in the prior year. The law does not, however, apply to plans sponsored by the governments of the District of Columbia or any territory or possession of the United States, certain church-related organizations or the federal government. (The Federal Employees Health Benefit Program is subject to generally similar, although not parallel, temporary continuation of coverage provisions under the Federal Employees Health Benefits Amendments Act of 1988.) Individuals who work for a state or local government employer, and their dependents, should be aware of their rights regarding COBRA. A good starting point is reading your summary plan description (SPD) booklet, if a state or local government employer distributes an SPD to its employees. Most of the specific rules on COBRA rights may be found there or with the person who manages your health benefits plan. Also, this Website provides detailed information about COBRA. Use the left navigation bar to access information related to a specific area of COBRA-related inquiry. Also, see "COBRA Helpful Tips" in the downloads section below. Additionally, the "More Information" page contains a link to COBRA questions and answers. If you are unable to find the COBRA-related information you are looking for on this Website, you may e-mail us at phig@cms.hhs.gov, except for ARRA COBRA related inquiries which should be emailed to continuationcoverage@maximus.com.
Page Last Modified: 06/18/2009 8:53:52 AM
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