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September 24, 2001
Benefits Must Continue for Reservists
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Download Now loyers are being reminded of their obligation to continue their group health insurance for those employees being called up for military service in Operation Infinite Justice.
"Both the USERRA and CHAMPUS programs were designed expressly for situations like the one we are currently facing," said Corey Procuniar, vice president of administrative services of Cobrapro, a California-based COBRA administrator.
Under the Uniformed Services Employment and Reemployment Rights Act, or USERRA, a group health plan must provide up to 18 months of continuous group health coverage to employees on uniformed service leave.
This coverage also applies to any of their dependents that were covered under the plan at the commencement of the employee's leave. In contrast to COBRA and Cal COBRA (the California version of COBRA) USERRA applies to all employers regardless of their size.
"USERRA does not specify the manner in which employers must provide notice of continuation coverage," said Procuniar. "However, USERRA explicitly provides that it does not affect the operation of other federal laws such as COBRA.
"For plans to which COBRA applies, the plan administrator should provide the same COBRA notice that it normally would provide to qualified beneficiaries. For plans covered by Cal COBRA, the insurance carrier is responsible for notifying the reservist and dependents of Cal COBRA continuation coverage rights."
The IRS clarified COBRA in 1999, spelling out that if health coverage is provided to a qualified beneficiary without regard to COBRA or Cal COBRA - for example, as a result of the USERRA - that coverage is treated as alternative coverage that does not extend the maximum COBRA continuation period.
Therefore, employers that voluntarily maintain coverage under their plans for reservists and their families for at least the maximum COBRA period are not required to offer COBRA coverage to such individuals.
USERRA provides that if the period of military service does not exceed 31 days, the employer may charge the employee for coverage only to the extent that the employee would have been charged if employed. If the leave period exceeds 31 days, the employer may charge up to 102 percent of the full premium for coverage under COBRA and 110 percent of the full premium under Cal COBRA, Procuniar said.
Don't Forget CHAMPUS
"Employers must also be aware that those who are called up for active duty in the armed forces may be covered under the Civilian Health and Medical Program of the Uniformed Services," he said.
CHAMPUS does not permit an employer to terminate COBRA or Cal COBRA coverage for having CHAMPUS coverage. Likewise, insurance carriers may not terminate Cal COBRA coverage for reservists and/or their families who are covered by CHAMPUS on the grounds that they have other coverage under CHAMPUS.
It's important, he added, "that the employer as well as those who are called to active duty be aware of all of the health coverage laws and the obligation employers have to assure that health insurance coverage remain uninterrupted."