The Seminar Series Copyright 2007 Infinisource, Inc. Presented by: Karen L. Kirkpatrick America’s Leading Employee Benefit Administration and Compliance Specialist

The Seminar Series Copyright 2007 Infinisource, Inc. Goals of Proper COBRA Administration KEEP the IRS out of your business KEEP your business out of court

The Seminar Series Copyright 2007 Infinisource, Inc.

The Seminar Series Copyright 2007 Infinisource, Inc. Intent of COBRA COST SHIFTING Private employers Federal government Expense TO

The Seminar Series Copyright 2007 Infinisource, Inc. Compliance with COBRA Required Employers with 20 or more employees Church plans [Under IRC 414 (e)] Federal government Not Required Manual Page 1

The Seminar Series Copyright 2007 Infinisource, Inc. Manual Page 2

The Seminar Series Copyright 2007 Infinisource, Inc. Employee Count (cont.) Common ownership- Manual Page 3 Foreign employees Multi/multiple employer plan- Manual Page 4 and 5

The Seminar Series Copyright 2007 Infinisource, Inc. Established criteria for IRS auditing of COBRA compliance program TAMRA 1988 Technical and Miscellaneous Revenue Act Manual Page 7

The Seminar Series Copyright 2007 Infinisource, Inc. Manual Page 8

The Seminar Series Copyright 2007 Infinisource, Inc. Manual Page 10

The Seminar Series Copyright 2007 Infinisource, Inc. Manual Page 11

The Seminar Series Copyright 2007 Infinisource, Inc. Qualified Beneficiaries Covered Employee Covered Spouse Covered Dependent Child born to, or adopted by, covered employee Manual Page 14

The Seminar Series Copyright 2007 Infinisource, Inc. Manual Page 16

The Seminar Series Copyright 2007 Infinisource, Inc. Manual Page 17

The Seminar Series Copyright 2007 Infinisource, Inc. Manual Page 19

The Seminar Series Copyright 2007 Infinisource, Inc. Manual Page 23, 24

The Seminar Series Copyright 2007 Infinisource, Inc. COBRA Coverage Manual Page 29

The Seminar Series Copyright 2007 Infinisource, Inc. Manual Page 36

The Seminar Series Copyright 2007 Infinisource, Inc. Time Frames Manual Page 53

The Seminar Series Copyright 2007 Infinisource, Inc. 45-Day Retroactive Premium Payment Loss of coverage date Date of election All retroactive premiums due March 31May 29July 13 Manual Page 57

The Seminar Series Copyright 2007 Infinisource, Inc. COBRA Expires: At the end of the maximum coverage period 18 months* for36 months* for *29 months with a Social Security disability determination * Under the Medicare entitlement Manual Page 63

The Seminar Series Copyright 2007 Infinisource, Inc. COBRA Terminates *Insignificant premium payment Failure to make TIMELY payment* Manual Page 64

The Seminar Series Copyright 2007 Infinisource, Inc. COBRA Terminates Manual Page 64

The Seminar Series Copyright 2007 Infinisource, Inc. COBRA Terminates Manual Page 64

The Seminar Series Copyright 2007 Infinisource, Inc. COBRA Terminates Manual Page 64

The Seminar Series Copyright 2007 Infinisource, Inc. COBRA Terminates Applies within the 11-month extension ONLY Manual Page 65

The Seminar Series Copyright 2007 Infinisource, Inc. COBRA Terminates Manual Page 65

The Seminar Series Copyright 2007 Infinisource, Inc. Premiums *If disabled Qualified Beneficiary is part of the extension Manual Page 67

The Seminar Series Copyright 2007 Infinisource, Inc. If your goal is to … KEEP the IRS out of your business KEEP your business out of court

The Seminar Series Copyright 2007 Infinisource, Inc. COBRA Compliance Checklist Documentation of TAMRA Notices Elections and premiums Documentation systems =100% Compliance Manual Page 80

The Seminar Series Copyright 2007 Infinisource, Inc. HIPAA Portability New notices –General Notice –Individual Notice Certificates of Creditable Coverage Special Enrollment –What is and isn’t a SE event

The Seminar Series Copyright 2007 Infinisource, Inc. Key Privacy/Security Rules PHI and EPHI: What are they? Who has PHI and EPHI at your facility? Disclosure of PHI in three major circumstances: –Treatment –Payment –Health care operations

The Seminar Series Copyright 2007 Infinisource, Inc. Key Privacy/Security Rules (cont.) Security Concerns: Reporting form Limited access to facilities Protection from malicious software Need for unique user IDs and passwords Access to EPHI on need-to-know basis Encryption and Password protection of EPHI Business Associate Agreements Security Reminders

The Seminar Series Copyright 2007 Infinisource, Inc. Recent and Current Developments HIPAA criminal actions Notable security breaches Recent guidance on remote devices April 14, 2007 deadline for HIPAA Notice of Privacy Practices

The Seminar Series Copyright 2007 Infinisource, Inc. Contact Infinisource For information on employee benefits administration and compliance issues, visit or call