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COBRA Employer Guide

Key Details To Remember

Thank you for being a member of SBAM and choosing our team to carry out all administrative matters regarding COBRA for your organization. We appreciate your business and strive to reduce your involvement to only a few simple, but important tasks.

1. Tell us about any changes within your company’s group health plan using the secure SBAM through our sbam.org/freshdesk web portal.

2. Pay your employee benefit plan(s) group insurance invoice in full and on time each month.

3. Your company’s COBRA enrolled individuals, spouses and dependents should always send their COBRA premium payments directly to the SBAM COBRA team at 101 S Washington Square, Suite 900, Lansing, MI 48933.

4. Review the monthly reports we provide you. Compare these reports with the information on your employee benefit plan(s) group insurance invoice to make sure the information we have is correct. This includes premium rates, employees enrolled or removed from coverage, names, addresses, plan types.

5. Take advantage of your online WebCOBRA login to easily view all COBRA activity within your company.  Simply request access from your COBRA Coordinator and we’ll email you instructions.

6. Stay in constant contact with your COBRA coordinator – we’re here to help!

Notify Us Of a Qualifying Event

For our team to accurately administer COBRA for your company, we rely on you to submit your current rates, group numbers and subscriber information for your medical, dental, vision and prescription coverage.

When there is a qualifying event, your company must immediately notify our COBRA team in writing. Qualifying events include the following:

  • Premium rate change
  • New employee hired
  • Employee change of address
  • Employee termination
  • Divorce
  • Dependents added or removed
  • Death

Due to HIPAA regulations, this is only permitted via encrypted email, fax or standard mail.  We make it easy to communicate with your COBRA Coordinator by offering a convenient SBAM Freshdesk web portal to send the qualifying event information.

Letters to PQBs

Timely communication regarding a qualifying event is critical because the Principle Qualified Beneficiary (PQB) must be notified of their COBRA rights, benefits, and costs within 44 days of the qualifying event that resulted in loss of coverage.

Upon receipt of the qualifying event information, your COBRA Coordinator inputs the data for the PQB into our software system, and sends a letter to the PQB.  This letter includes:

  • Eligibility Notice (to briefly explain their rights under COBRA)
  • COBRA Enrollment Form
  • Premium Computation Form
  • Waiver Letter Form
  • Credible Coverage Letter
  • Eligibility Notice (to briefly explain their rights under COBRA) to spouse – if applicable

COBRA law requires that upon receipt of the enrollment notification letter the PQB has 60 days, from the date of the letter, to enroll. The PQB then has an additional 45 days to pay for that enrollment.  We will not initiate a COBRA enrollment without payment. If the 60 days expires without enrollment, we send the PQB a letter informing them that the enrollment period has lapsed. When a PQB does enroll, we notify the carrier informing them of this event. The carrier codes this accordingly and coverage is reinstated.

PQB Premium Payments

COBRA Primary Qualified Beneficiary (PQB) Premium Notice & Payments All PQB’s are sent a courtesy premium payment reminder on the next working day after the 10th of each month. According to the Department of Labor (DOL) law, a PQB has 30 days to make payment from the due date, which is the first of each month.

If our COBRA team does not receive payment by the last day of the month prior to the due date, the PQB’s insurance plans will be deactivated until payment is received. This prevents unauthorized use of benefits – including prescriptions – from occurring without premiums being paid.

The PQB should send their COBRA premium payments directly to our office, 101 S Washington Square, Suite 900, Lansing, MI 48933.

Questions?

Contact our COBRA team with any questions at membercare@sbam.org or (877) 949-7226.