The Empire Plan is a unique health insurance plan designed especially for public employees in New York State. Empire Plan benefits include inpatient and outpatient hospital coverage, medical/surgical coverage, Centers of Excellence for transplants, infertility and cancer, home care services, equipment and supplies, mental health and substance abuse coverage and prescription drug coverage.
DAVID A. PATERSON
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
NANCY G. GROENWEGEN
COMMISSIONER
NY10-02
SEHP10-01
TO: New York State Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: Extension of COBRA ARRA Premium Assistance
DATE: February 8, 2010
The American Recovery and Reinvestment Act of 2009 (ARRA) created a 9-month COBRA subsidy for employees and their dependents who lost group health plan coverage due to the employee’s involuntary termination between September 1, 2008 and December 31, 2009. In December 2009, Congress passed the Department of Defense Appropriations Act of 2010 (DDAA), which increased the maximum period for receiving the subsidy an additional six months (from 9 to 15 months) and applied the subsidy to involuntary terminations through February 28, 2010. Under the provisions of these laws, assistance eligible individuals pay only 35 percent of the COBRA continuation coverage premiums.
Notice of these changes will be sent by the Employee Benefits Division to all enrollees and dependents who experience any type of COBRA qualifying event between September 1, 2008 and February 28, 2010, and who have not yet been provided a COBRA election notice. This notice will be mailed during the week of February 8th.
Eligibility for the premium reduction was automatically extended for those qualified individuals who were in a transition period. A transition period consists of individuals who elected COBRA continuation coverage following an involuntary termination and who remained on COBRA coverage as of October 31, 2009. The transition period began immediately after the end of the maximum number of months of premium reduction available under ARRA (generally 9 months) and will end at the completion of the maximum number of months of premium reduction available under DDAA (generally 15 months), provided the COBRA enrollee continues to meet the eligibility requirements.
In order to process enrollee applications in a timely manner it is imperative that agencies provide a verification letter to each employee who experiences a loss of coverage due to an involuntary termination of employment during the period September 1, 2008 through February 28, 2010. Please ensure that the letter is addressed to the enrollee and is signed by a representative of your agency. Advise enrollees to include the letter when completing their Request for Treatment as an Assistance Eligible Individual. This letter serves as the required verification that the termination of employment was involuntary.
We have included with this memo, a copy of the material being sent to NYSHIP enrollees and qualified beneficiaries. This includes the COBRA Continuation Coverage Premium Assistance Extension Notice and the Summary of the COBRA Premium Reduction Provisions under ARRA, as amended.
If you have any questions you may contact your processor, or the Employee Benefits Division COBRA Unit at (518) 457-5754 or 1-800-833-4344.