DOL Issues Model COBRA Subsidy Notices and Forms

Posted: March 19, 2009

The United States Department of Labor (“DOL”) today posted on its website model notices and application forms to be used by employer-sponsored health plans and individuals electing COBRA in connection with the American Recovery and Reinvestment Act of 2009 (“ARRA”) COBRA premium subsidy. The ARRA requires that group health plans notify certain current and former plan participants about the COBRA premium subsidy. (For more information about the ARRA subsidy and group health plan compliance requirements, see our article, COBRA Premiums Subsidized Under The American Recovery and Reinvestment Act of 2009).

The DOL’s model notices and forms are available in a file format that enables easy customization for your group health plan’s purposes at http://www.dol.gov/ebsa/COBRAmodelnotice.html.

The DOL included three model notices for use by employers (along with application forms for COBRA qualified beneficiaries to complete and return to get the subsidized COBRA premium):

a revised model General Notice to be sent to all COBRA qualified beneficiaries who had or have any COBRA qualifying event after August 31, 2008 and before January 1, 2010;
an abbreviated version of the General Notice which may be sent – in lieu of the full version in #1 above – to COBRA qualified beneficiaries who already elected and are currently covered under your plan’s COBRA coverage; and
an Extended Election Period Notice for individuals who had a qualifying event after August 31, 2008 and before February 17, 2009 and who are not covered under your plan’s COBRA coverage (either because they did not elect COBRA or because they let their COBRA coverage lapse). This notice must be provided to such individuals by April 18, 2009.

The model notices and forms must be modified for use with your group health plan by inserting specific information and deleting inapplicable provisions.

If you have any questions regarding the ARRA subsidy or would like assistance in customizing the applicable notices and forms, contact the attorneys in Jackson Lewis LLP’s Employee Benefits, including Complex ERISA Litigation and Workplace Privacy, Practice Group.