ARPA COBRA Presentation Notes

On May 12th Benefit Profiles Inc hosted a webinar with Howard Lancaster, President of Insight Benefit Administrators. Here is a copy of the powerpoint we discussed.


COBRA ARPA PPT May 12 2021
.pdf
Download PDF • 158KB

It was a very good meeting and the biggest question the agents had on the call was that of voluntary terminations and/or reduction in hours. Are these considered qualifying events to make someone eligible for the subsidy? It was fuzzy on the call but Howard did his research and his responses are below.


Basically I just copied and pasted a few follow up emails. If you have any questions about this I include Howard's information below or you can reach out to me, Dominic Siciliano at dominic@benefitprofilesinc.com.


All documents refernced are outlined below.


Thank you again for attending the session this morning on the topic of COBRA Premium Subsidy under ARPA. As a quick recap, I’ve included:


  • DOL FAQ on the ARPA. I feel this is a very easy read that provides a solid overview of the program.

  • 4 DOL Model Notices for your review. Again, the goal is to ensure administrators aren’t straying too far from these model notices.

  • The DOL application that I referred to as the Request for Treatment as an Assistance Eligible Individual (referenced as RFTAEI in the powerpoint).

  • The Insight talking points powerpoint.


summary-of-provisions
.docx
Download DOCX • 82KB


summary-of-provisions
.docx
Download DOCX • 82KB

model-general-and-election-notice
.docx
Download DOCX • 57KB

cobra-premium-assistance-under-arp
.pdf
Download PDF • 139KB

model-alternative-election-notice
.docx
Download DOCX • 50KB

model-extended-election-periods-notice
.d
Download D • 47KB


Great discussion on what is considered COBRA Premium Assistance Eligible based on a ‘reduction of hours’ and whether any reason for a reduction of hours would constitute eligibility; even an employee initiated voluntary reduction. I have reached out to a direct contact at the DOL, Heidi, for her assistance and am awaiting a response. Heidi and I have discussed other topics in the past related to Health and Welfare Benefits and she’s a trusted resource.


We also discussed the definition of ‘involuntary’ v. ‘voluntary’ termination related to determining eligibility for COBRA subsidy. “Voluntary’ termination of employment is fairly clear cut for loss of coverage; employee leaves the job of their own accord. However, with ‘involuntary’ termination, there seems to be a little more clarification needed and I didn’t get too in the weeds on the different scenarios during our call. In reviewing scenarios such as layoffs, elimination of a position or suspension of employment where the employer initiates the termination, these appear clearly ‘involuntary’ and participants would be eligible for the COBRA subsidy. However, what about the following scenarios? Which of the below would be considered ‘involuntary’ versus ‘voluntary?’ While the IRS/DOL have not taken positions on the potential different scenarios under ARPA, they did under ARRA. I’ll share the historical 2009 positions on these as whether they were considered voluntary v. involuntary from the IRS perspective. I will let you know if we see any clarifying language from IRS/DOL on these scenarios if/where the outcomes are different under ARPA then they were under ARRA.


  1. Employee elected severance package? Involuntary under ARRA.

  2. Employee ‘Good Reason’ quit where the employee was compelled to leave employment due to the fact that it was no longer a healthy work environment for the employee appreciating this is a gray area (feeling of harassment, bullying, etc.)? Involuntary under ARRA.

  3. Employer leaving the area or closing a plant where the employee was working and the employee could not have followed the employer to another physical location for continued employment? Involuntary under ARRA.

  4. Employer not renewing a contract for a contracted employee or not being called back for seasonal work? Involuntary under ARRA.

  5. Employees called up for active duty/reserve duty and leaves employment? Involuntary under ARRA.

  6. Public service employees who failed to be re-elected or who meet term limits? Involuntary under ARRA.

  7. Public service employees who could have run again for re-election but chose not to run? Please note this was considered Voluntary termination under ARRA.


Hello to all.


As an update on our specific discussion on #2 below, this afternoon I received notification from our ERISA attorney regarding a notification from the IRS on additional guidance via an FAQ: IRS Notice 2021-31. Reading through the new 42 page Q&A, of specific interest is a clarification from the IRS (starting on page 13) specifically calling out that for situations of voluntary terminations (employee initiated), these “would cause the beneficiary to be a potential AEI regardless of whether the reduction in hours is voluntary or involuntary.” I wanted to forward this update on to everyone since we had much discussion on this particular point and it’s now specifically clarified for us by the IRS.


Howard Lancaster, MHA, PAHM

Insight Benefit Administrators LLC

3033 Orchard Vista Dr. S.E.

Suite 312

Grand Rapids, MI 49546

Office: (616) 588-5382

Mobile: (616) 826-7205


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