If you sponsor a group health plan subject to the federal Consolidated Omnibus Budget Reconciliation Act (COBRA), now may be a good time to review your compliance. The Internal Revenue Service (IRS) recently issued updated COBRA Audit Guidelines intended to provide IRS examiners with a procedural guide to conduct COBRA compliance checks.
The Internal Revenue Code imposes a tax penalty for failure to comply with COBRA requirements. The tax amount is $100 per day, per qualified beneficiary (those individuals entitled to COBRA continuation coverage), for each day of the noncompliance period.
COBRA Continuation Coverage
COBRA generally requires that group health plans sponsored by employers with 20 or more employees on more than 50% of typical business days in the prior year offer employees and eligible spouses and dependent children the opportunity for a temporary extension of health insurance where coverage under the group plan would otherwise end due to certain qualifying events. Group health plans must provide covered employees and dependents with specific notices explaining their COBRA rights.
New Audit Guidelines
The updated COBRA Audit Guidelines direct IRS examiners to probe specific areas for noncompliance by asking questions regarding:
- The number of qualifying events occurring in the year under examination through the current date;
- How qualified beneficiaries are notified of their COBRA rights;
- How the plan administrator is notified when a qualifying event occurs;
- The COBRA election made by qualified beneficiaries; and
- The premium paid by qualified beneficiaries for COBRA.
Additionally, IRS examiners are instructed to determine what continuation coverage procedures are in place by obtaining certain information related to the plan, including:
- A copy of the continuation coverage procedures manual;
- Copies of standard form letters sent to qualified beneficiaries;
- A copy of internal audit procedures for continuation coverage;
- Copies of all group health care plans; and
- Details pertaining to any past or pending lawsuits for failing to provide appropriate continuation coverage.
Employers required to comply with COBRA should review the Audit Guidelines in detail. If you have any questions regarding your responsibilities or the type of documentation you should maintain, please consult with your plan administrator or a knowledgeable employment law attorney.