Notice Requirements Under the Massachusetts Mini-COBRA Law

Notice Requirements

Notice to Qualified Beneficiaries of their Rights Under Mini-COBRA The Mini-COBRA law requires small group carriers to provide the Qualified Beneficiary with certain notices of the right to continue coverage.   Notice of Rights at the Time Coverage Begins The small group carrier must provide notification to each employee and spouse of his/her rights under Mini-COBRA at the time of commencement of coverage.   Notice of Rights when the Small Group Carrier is Aware of a Qualifying Event Once the small group carrier is aware that a Qualifying Event has occurred, it must provide notice to the Qualified Beneficiary of his/her rights under Mini-COBRA. This notice must be provided within 14 days of the date the small group carrier becomes aware of the Qualifying Event.   If the Qualifying Event is either: (1) the divorce or legal separation of the employee from the employee's spouse or 2) a dependent child is no longer considered to be dependent under the terms of the small group health benefit plan, the small group carrier must provide the Qualified Beneficiary with a notice of his/her rights within 14 days of the date the small group carrier obtains actual knowledge of the event. The Qualified Beneficiary or employee is responsible for notifying the small group carrier that such a Qualifying Event has occurred. The Qualified Beneficiary or employee must notify the small group carrier within 60 days of the date that the divorce/legal separation occurred or that the dependent child is no longer considered dependent under the plan.   If the Qualifying Event is either: (1) the termination of employee's employment or reduction in work hours; (2) the death of the employee; or (3) the employee becomes entitled to Medicare, the small group carrier must provide the Qualified Beneficiary with a notice of his/her rights within 14 days of the date the small group carrier obtains actual knowledge of the event.   Small Group Carriers May Require Notices to be Issued by an Employer/ Intermediary According to the Mini-COBRA provisions, a small group carrier may require the small employer/intermediary to issue notices to Qualified Beneficiaries. If the small group carrier requires such notices to be issued by small employers/intermediaries, it must do the following pursuant to the Division's Bulletin 97-05:   the small group carrier must notify the small employer/intermediary in writing that it is required to issue all applicable notices; the small group carrier must provide the small employer/intermediary with the name and telephone number of a contact person who is familiar with Mini-COBRA and such carrier's procedures for implementing Mini-COBRA; and the small group carrier must provide the small employer/intermediary with the form and content of the language required to be provided in any notice it is requiring the small employer/intermediary to issue.   Note: Small group carriers may require small employers/intermediaries to issue notices to Qualified Beneficiaries under the terms of its contract with the small employer/intermediary. However, if the small group carrier requires the small employer/intermediary to issue such notices or if the contract terms indicate that a small employer/intermediary must issue such notices, the small group carrier should provide the small employer/intermediary written instructions that clearly and simply define the small group carrier's procedures regarding Mini-COBRA and the small employer's/intermediary's responsibilities with regard to the issuance of such notices.   Notification to a Small Group Carrier that a Qualifying Event Has Occurred   Notifying the Small Group Carrier of a Divorce or Legal Separation or that a Dependent Child is No Longer Dependent under the Terms of the Small Group Plan If the Qualifying Event is either: (1) a divorce or legal separation or (2) a dependent child is no longer considered to be dependent under the terms of the small group health benefit plan, the employee or Qualified Beneficiary is responsible for notifying the small group carrier of the event. If the Qualified Beneficiary does not know how to contact the small group carrier directly, the small employer/intermediary should be able to help a Qualified Beneficiary or employee to notify the small group carrier of a Qualifying Event since it is likely to have the name and telephone number of a contact person at the small group carrier who is familiar with its Mini-COBRA procedures.   Notifying the Small Group Carrier of the Termination or Reduction in Employee's Work Hours, Death of the Employee or that the Employee has Become Entitled to Medicare Benefits If the Qualifying Event is either: (1) the termination or reduction in employee's work hours; (2) the death of the employee; or (3) the employee becomes entitled to Medicare benefits, the small group carriers and small employers/intermediaries should work together to ensure that the small group carrier is fully informed of the Qualifying Event. Small group carriers may require small employers/intermediaries to provide: them with notices of these Qualifying Events under the terms of their contracts with small employers/intermediaries. If the contract terms indicate that small employers/intermediaries must notify the small group carrier of these Qualifying Events, the small group carrier should also provide the small employer/intermediary with written instructions that clearly and simply define the small group carrier's procedures regarding Mini-COBRA and the small employer's/intermediary's responsibilities with regard to notifying it of a Qualifying Event.