All of the following are true of a Multiple Employer Trust (MET) EXCEPT
a) METs allow small employers an opportunity to band together and purchase insurance at a lower group rate
b) The trusts are formed by insurers, agents, brokers, or third party administrators, who are call sponsors
c) The sponsor develops the plan, sets the underwriting rules, and administers it
d) The employee has a right of conversion upon leaving the group insurance
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This Act states employers with 20 or more employees must provide a health coverage continuation option to all covered employees and dependents up to 18 months in the event of:
-Termination of employee (unless it is for cause as defined by federal law)
-Reduction of hours for employee, so they no longer qualify as a full-time employee
-Coverage may continue up to 29 months if an employee (or dependent) is totally disabled at the time of a qualifying event
Coverage may
continue for dependents up to 36 months for certain qualifying events:
-Death of employee
-Divorce or legal separation
-Employee's entitlement to Medicare benefits
-A child ages out of the group plan as a dependent at age 26
Employees must be notified of their right to continue coverage within 14 days of a qualifying event.
---The employee or the beneficiary must notify the employer within 60 days if they elect to continue coverage.
Recipients of COBRA continuation
will be required to pay premiums to the employer.
---Employers may require a former employee or their surviving spouse to pay up to 102% of the premium.
Because the continuation coverage is the same group plan the employee or dependent was enrolled in, it:
-Requires no evidence of insurability and provides the same benefits as the group policy
-Covers preexisting conditions if covered under the group policy
---If the insured carried dependent coverage on the group, dependent
coverage must be made available on the continuation policy.
Events that will cause termination of continuing health coverage by COBRA are:
-Timely premium payments are not made
-Employer ceases to maintain any group health plan
-Employee becomes eligible for Medicare benefits; dependents may remain under COBRA
-Employee becomes eligible for any other group health plan
-Employee converts to an individual health plan
Notification of an individual's right to continue
coverage under COBRA is required at two times.
---The first time is when a group plan commences or is amended to include the continuation of coverage provision.
---The second time that an insured must be notified under COBRA is when a qualifying event occurs.