Administrative Solutions for Company Health Care

COBRA Administration

In 1986 Congress passed the Consolidated Omnibus Budget Reconciliation Act (COBRA). COBRA requires most group health plans to provide temporary continuation of group health coverage to covered employees and their dependents when they have lost their coverage under certain circumstances.

You are subject to COBRA requirements if you are a private sector employer group with at least 20 employees who work more than 50 percent of your typical business day, and you offer a group health plan. Full- and part-time employees are counted in the number of employees. There is also mini-COBRA, which is offered to covered individuals in group health plans with between 2 and 19 employees. This option varies by state.

There are many reasons to choose UPMC COBRA Advantage as your COBRA administrator. You will receive the same excellent customer service, easy administration, and efficient reporting that you have come to expect from UPMC Health Plan. We offer:

Customized billing and payment collection

• Monthly billing and collection from the COBRA participant.
• Flexible remittance options so you can choose how the premium will be paid — to you, the carrier, or both.
• Regular monitoring of nonpayment and subsequent late payment notice.

Detailed account monitoring and reporting

• Monitoring and tracking, including the 60-day election period, 45-day initial premium payment period, ongoing 30-day grace period, and coverage cessation.
• User-friendly monthly activity and summary reports.
• Archived documentation.

Superior service

• Dedicated and experienced COBRA administrators.
• 24/7 online access to account information.
• Electronic data exchanges with carriers for seamless membership updates.
• Award-winning customer service from our Health Care Concierge team.

Member and client-focused communication

• Members receive a COBRA-qualifying event package, including personalized election form and premium information.
• Employer groups can communicate qualifying events through an employer portal, electronic file transfers, and fax transmission.
• UPMC COBRA Advantage can help employer groups with open enrollment mailings and carrier updates.
• Members experience a smooth transition from active employee to COBRA coverage with UPMC Health Plan as a result of our seamless integration of products and services.

Retiree Billing

Ease and convenience for you and your retirees

Our retiree billing includes a web-based service that coordinates enrollment, billing, and reimbursement of retiree benefits.

With our retiree premium reimbursement method, we can assist you in reducing your FAS 106 liability. We can also coordinate electronic payment of monthly premiums directly to your carriers, eliminating the need to write checks and issue multiple payments.

Process

Our flexible process allows you to use electronic file transfer, internet, fax, and email to share retirement events with us. We mail retiree enrollment packets and follow up with retirees as necessary. Premium billing begins after we have received the retirees' benefit elections.

Service

We provide a toll-free customer service number for your retirees so they can get their questions answered and discuss their concerns with our knowledgeable Health Care Concierge team members.

Our website allows you to access your retirees’ information at any time and provides a wide array of reporting options. Our administrative staff will work directly with all of your carriers to resolve any billing problems or issues that may arise.