COBRA Exchange Overview for Brokers
Tip: We do not discuss the Manage COBRA Tool within Employee Navigator in these articles. These articles are specific to the COBRA EN-Exchange that sends notice for Initial Rights and Qualifying Events.
How does COBRA work with Employee Navigator? EN supports COBRA in two ways.
1. COBRA notifications - when an employee newly enrolls in a group plan or an employee or dependent(s) lose coverage due to a qualifying event, the employee or dependent(s) need to be issued a notice of COBRA rights. EN supports the notifications through our COBRA exchange if you are connected to an integrated TPA.
2. COBRA enrollment reporting - after an employee or dependent(s) have lost coverage, the Carrier will terminate the coverage. If the employee or dependent(s) decide to elect coverage through COBRA, their coverage needs to be reinstated with the Carrier's. EN supports reporting the reinstatement's (COBRA enrollments) to Carrier's ONLY if the client is connected to EN's 834 files or the Carrier EN-Exchange if the Carrier excepts COBRA enrollments on the file.
The following articles are related to #1 - COBRA notifications. The COBRA EN-exchange works separate from our COBRA enrollment tool. For more information on our COBRA enrollment tool, refer to this article. COBRA Enrollment Reporting
The Supported Files
Employee Navigator’s COBRA Exchange provides connected COBRA vendors with two XML files; An Initial Rights Notice file (referred to as DOL) and a Qualifying Event File (Referred to as QE).
The COBRA files are event based files meaning data only sends on the files when certain events are entered in the system and those events have a COBRA Qualified Plan enrollment tied to it. Employee Navigator has system logic that will trigger COBRA on the file when:
- DOL File: the employee / dependent newly enrolls in a COBRA Qualified Plan. The notice is sent on the file upon commencement of coverage (coverage effective date).
- QE File: the employee / dependent has a COBRA Qualified Event such as termination of employment, reduction in hours, divorce, loss of dependent status, etc. AND the employee / dependent loses coverage in a COBRA Qualified Plan such as medical, dental, vision, etc. The notice is sent on the file directly upon entering the event.
Available COBRA TPA's
TPA's can opt to set a schedule for the file and select the day(s) received. The schedule set is for all of their connected companies. They are not able to set a schedule per client.
See below for a list of available TPA's and the file transmission schedule** they have selected:
**Note! If they do not have a schedule listed then a user within the TPA should be logging in to generate and download files. For specific questions on when the file is being pulled, contact the TPA directly.
This list was created as a general list of information for our users. Schedules are subject to change. EN is not notified when a TPA updates their schedule. If a schedule has changed, EN will update quarterly or as needed. The TPA should always be the resource to confirm if files are received and processed.
|COBRA DOL||COBRA QE|
|Accrue Solutions||See Note ** Above||See Note ** Above|
|Admin America||See Note ** Above||See Note ** Above|
|American Benefit Administrators||See Note ** Above||See Note ** Above|
|American Benefits Group||See Note ** Above||See Note ** Above|
|APA Benefits||Weekly||Mon||Weekly||Mon, Wed, Fri|
|BBP Admin||Weekly||Sun, Tue, Thu||Weekly||Sun, Tue, Thu|
|Benefit Coordinators||See Note ** Above||See Note ** Above|
|Clarity Benefit Solutions||Weekly||Wed||Weekly||Wed|
|ConnectYourCare||See Note ** Above||See Note ** Above|
|David K. Young Consulting||Weekly||Thu||Weekly||Thu|
|ebm||Weekly||Mon - Fri||Weekly||Mon - Fri|
|Employee Benefits Corporation||Weekly||Tue||Weekly||Tue|
|Flexible Benefit Administrators||Weekly||Mon - Fri||Weekly||Mon - Fri|
|IGOE||See Note ** Above||See Note ** Above|
|Infinisource||Weekly||Mon - Fri||Weekly||Mon - Fri|
|McGregor & Associates||Weekly||Thu||Weekly||Thu|
|MyHRConcierge||See Note ** Above||See Note ** Above|
|National Benefit Services||Weekly||Tue, Thu||Weekly||Tue, Thu|
|Navia Benefit Solutions||Weekly||Thu||Weekly||Thu|
|NueSynergy||See Note ** Above||Weekly||Mon - Fri|
|OCA Benefit Services||See Note ** Above||See Note ** Above|
|P&A Administrative Services||Weekly||Wed||Weekly||Wed|
|Paylocity Benefit Services||See Note ** Above||See Note ** Above|
|Proficient Benefit Solutions||Weekly||Tue, Thu||Weekly||Tue, Thu|
|Sound Benefit Administration||Weekly||Mon - Fri||Weekly||Mon - Fri|
|Stanley Benefit Services||Weekly||Mon, Thu||Weekly||Mon, Thu|
|StreamlineHR||See Note ** Above||See Note ** Above|
|The Advantage Group||Weekly||Thu||Weekly||Thu|
|The Employers Association||Weekly||Mon, Wed||Weekly||Mon, Wed|
File integration is supported for new and existing cases. Brokers should contact the TPA Representative to discuss using the EN-Exchange
Prior to Connecting to the COBRA Exchange:
- If the group is currently with the TPA then just ask the representative if they require anything to be completed but typically you will just need to make the connection request.
- If the group is going to be new to the TPA's then you still need to complete their required group applications / implementation paperwork (including COBRA rates) & make sure to tell them you will be using the EN-Exchange to send the groups COBRA events.
- Ensure the TPA has setup the same plans in their system as you have setup in EN (that is those that the group offers COBRA). 1:1 match is required.
- It is best practice to audit employee/dependent demographic data before connecting. If the TPA has received notice of the event and later the employee / dependents demographic information, such as address, is updated, the file WILL NOT send the update. SSN is typically ALWAYS required for both employee & dependents and the upload to the TPA system will fail if missing.
Make the Connection to the COBRA Exchange:
Follow this link for step by step instructions on making the connection and excluding needed plans: How to connect a client to the COBRA EN-Exchange and exclude plans
TPA Error Reports
It is the broker / HR on-going responsibility to work through any errors/discrepancies provided by the TPA in a timely manner. EN does not know what the TPA's error reports mean so please 1st contact the TPA. If you have reached out the the TPA and need EN assistance, contact email@example.com
Extremely important: COBRA notifications only send at the time of the event. If information is corrected in EN, the file will not resend the notice. You will need to work with the TPA to manually enter events that had errors.
Other Helpful Articles
Support & Questions
- For Employee Navigator related questions on Employee Navigator’s EN-Exchange with the carrier, reach out to firstname.lastname@example.org
- For TPA related questions, please contact your TPA Representative