COBRA Administration Procedures/CONEXIS
CONEXIS: COBRA Administrator as of May 1, 2009
As of May 1, 2009, CONEXIS provides COBRA Administration services for the University of California. Here is an outline of how these new (faculty/staff) COBRA procedures work at UCSF and what the new administrative roles are.
EMPLOYEE QUALIFYING EVENTS
Separation Actions Hard-Coded in OLPPS:
All employee separation actions hard-coded into OLPPS (with a “Separation Date” of May 1, 2009 or later) will automatically be transmitted to the CONEXIS site on the 3rd and 17th of every month
CONEXIS: Provides COBRA materials directly to qualified COBRA beneficiaries within designated parameters
Note to DBR: Hard-coded separation actions automatically generate coverage end dates for all health insurance coverage (medical, dental, optical plans). Example: A hard-coded “Separation Date” of June 16, 2009 will auto-generate “Coverage End Date” of July 31, 2009.
If Eligible/paid (faculty) Appointment Ends and WOS (only) Appointment Continues and a hard-coded separation action is not entered into OLPPS, the “work-around” for the time being will be as follows:
DBR: Re-assign BELI to “5” during the month following the month in which the eligible/paid appointment ended. This must be done in order to generate coverage end dates for the health plans.
Example:
1. Eligible/paid appointment ends June 16, 2009
2. Re-assign BELI to “5” early in July prior to the payroll cutoff for the August 1, 2009 paydate
3. This will auto-generage “Coverage End Date” of July 31, 2009
• If these steps are not followed, invalid coverage at department cost may continue via Consolidated Billing
• Please also confirm that Retirement/FICA coding is changed to “H/M” (coordinate with UCSF Payroll Office)
DBR: Print out the OLPPS/IDOC for “Benefits Summary/Benefits Enrollment” and submit to UCSF HR/Benefits with pertinent instructions marked-up directly on the IDOC (e.g., “SUBMIT FOR COBRA"). Please be sure to include your name/contact information
Send: UCSF HR/Benefits--Box 0918 or,
Fax: 415.476.2328 or,
email scanned IDOC:
UCSF HR/Benefits: Transmits requisite data to the CONEXIS site
CONEXIS: Provides COBRA materials directly to qualified COBRA beneficiaries within designated parameters
Note to DBR: In hopes of eliminating this “work-around”, we will soon be collaborating with the UCSF Academic Personnel and Payroll Offices regarding the advent of CONEXIS and these new procedures. Our agenda will be to re-visit the inclusion of a hard-coded separation action into these transitions from “eligible/paid” to “WOS (only)” appointments. This would render these extra steps unnecessary. If implemented, COBRA administration for these transitions would be as simple as those in the “Separation Actions Hard-Coded in OLPPS” section (above). This would also eliminate the possibility of erroneous/invalid/costly coverage continuing should these steps be overlooked. Stay tuned.
Loss of Ongoing Eligibility Due to 17½ Hour Rule
DBR: Monitor the “Avg Hr/Wk” data element (OLPPS/IHRS) for those re-appointed to/working less than 43.75%. Once the 12-month rolling average has re-derived to below 17½ for two consecutive months,
DBR: Re-assign the BELI to “5” during the second month. This must be done in order to generate coverage end dates for the health plans
DBR: Print out the OLPPS/IDOC for “Benefits Summary/Benefits Enrollment” and submit to UCSF HR/Benefits with pertinent instructions marked-up directly on the IDOC (e.g., “SUBMIT FOR COBRA"). Please be sure to include your name/contact information
Send: UCSF HR/Benefits--Box 0918 or,
Fax: 415.476.2328 or,
email scanned IDOC:
UCSF HR/Benefits: Transmits requisite data to the CONEXIS site
CONEXIS: Provides COBRA materials directly to qualified COBRA beneficiaries within designated parameters
Leave-of-Absence Without Pay (non-FMLA)
DBR: Enter/Update appropriate LOA coding into OLPPS an employee’s non-FMLA leave-of-absence without pay
DBR: Print out the appropriate OLPPS/IDOC for “Leave/Sabbatical Documents” and submit to UCSF HR/Benefits with pertinent instructions marked-up directly on the IDOC (e.g., “SUBMIT FOR COBRA"). Please be sure to include your name/contact information
Send: UCSF HR/Benefits--Box 0918 or,
Fax: 415.476.2328 or,
email scanned IDOC:
UCSF HR/Benefits: Transmits requisite data to the CONEXIS site
CONEXIS: Provides COBRA materials directly to qualified COBRA beneficiaries within designated parameters
Note to DBR: Employees on an approved LOA will continue to have the option to make personal premium payments directly to the UCSF Payroll Office. Be advised that even though an employee chooses to make personal premium payments directly to UCSF Payroll during a non-FMLA leave-of-absence without pay, those months will count towards the overall COBRA continuation period should there be a subsequent separation action during the LOA. Further developments may yet occur in this area.
FAMILY MEMBER QUALIFYING EVENTS
Divorce/Termination of Domestic Partnership, Child’s Loss of Eligibility, etc:
Employee or Qualified Benficiary: Must provide the Notice to UC of a COBRA Qualifying Event form (UBEN 109). The form is available on the At Your Service website under “Forms and Publications”. If COBRA continuation is desired:
Notice to UC of a COBRA Qualifying Event form (UBEN 109):
Is required
Must be accurate/complete
Must be received by UCSF HR/Benefits within 60 days of the Qualifying Event
Telephone or email requests for COBRA materials will not be accepted
DBR: You might assist by providing the UBEN 109 form/link to the employee or qualified beneficiary with instructions to submit to:
UCSF HR/Benefits, LHts 330, Box 0918, SF, CA 94143-0918 or,
Fax: 415.476.2328 or,
email scanned UBEN 109:
UCSF HR/Benefits: Transmits requisite data to the CONEXIS site
CONEXIS: Provides COBRA materials directly to qualified COBRA beneficiaries within designated parameters
IMPORTANT: Unless the UBEN 109 form is received by UCSF HR/Benefits within 60 days of the Qualifying Event, the event should NOT be reported and the opportunity to continue coverage via COBRA has been forfeited. Inaccurate or incomplete forms will be returned to employee or qualified beneficiary and may cause delay/forfeiture.
Note to DBR: If you become aware of the qualifying event, please confirm that the family member is de-enrolled appropriately from the employee’s coverage (OLPPS/IINS & IMEM). If necessary, the employee must submit UPAY 850 to de-enroll the family member who is no longer eligible. If de-enrollment of ineligible family member is not processed in a timely manner, there will be no refunds of deductions/contributions.