The Manual Enrollment tool is intended to allow the ability to add a COBRA enrollment if you:
- Are setting up a new client in EN and there are employees who had a COBRA event outside the EN system and they are enrolled in COBRA
- Add a plan at open enrollment that the employee / dependent may not have had at time of termination (e.g. they did not have dental when they had a COBRA event but at OE they added it since they have the same rights as active employees)
- There are no “COBRA Qualifying Enrollment Events” on employees COBRA overview page in which you could add the enrollment
Important Note!! This tool DOES NOT work in conjunction with the COBRA EN-Exchange. Using it WILL NOT send a notice to the connected TPA. This should only be used if an employee / dependent is ALREADY enrolled in COBRA. EN would not expect to send the TPA a notice so they can mail a notice of COBRA rights if the member is already enrolled.
Step 1: Make sure the employee and dependents have been added to the system. Even if the enrollment is going to be for a dependent and NOT the employee, you still need to enter the employee in the system. If it is an ex-spouse that will be enrolled, make sure the relationship selected is ex-spouse.
Step 2: If not already on the Manual COBRA Enrollment tool, from the employee management page, under Actions, select Manage COBRA.
Step 3: Select "Add enrollment" under Manual Enrollment.
Step 4: Who is the primary qualified beneficiary (PQB)?
- If employee is enrolled, they are PQB
- If employee is not enrolled but a spouse and child are, then the spouse is PQB
- If employee is not enrolled but a child is, then the child is PQB
- If child enrolled had their own event due to aging off the plan, they are the PQB
- If ex-spouse enrolled had their own event due to divorce / legal separation, then they are PQB
You can enter as many manual enrollments as needed. Here is an example:
You took over a client in August of 2019. The client has an employee that had a child age off in June of 2018 and the child enrolled in COBRA The employee then got divorced in November 2018 and the ex-spouse enrolled in COBRA and then the employee terminated employment in March 2019 and they enrolled in COBRA.
In this example, you would enter a manual enrollment 3 times. One selecting child as PQB, one selecting ex-spouse as PQB, and one selecting the employee as PQB.
Step 5: If child was selected as PQB, then select the child from the drown down list under "child".
Step 6: Event:
- If employee is PQB, you will see employee related COBRA event reasons from which to select
- If spouse is PQB, you will see employee related COBRA event reasons from which to select. Why? The employee had the event but only the spouse enrolled. That is why spouse is PQB but the event was due to an employee reason
- If child is PQB, you will see both employee related COBRA event reasons and child related COBRA event reasons from which to select
- If ex-spouse is PQB, you will only see a reason of divorce and or legal separation
The selection of the event allows the system to calculate how many months of COBRA the member is eligible. 18 months for employee reasons, 36 months for "death of employee", 36 months for "divorce or legal separation", 36 months for "drop coverage when dependent over eligible age" or " Loss of dependent child status".
Step 7: Plan
Select the plan enrolled. Only current active plans will be listed as it is assumed COBRA members would be enrolled in the same plans as active members. You will need to add a manual enrollment for each plan enrolled.
Note! EAP, HRA, and FSA are not enrollable plans at this time.
Step 8: Eligible COBRA Start Date
Enter the date that the member originally started on COBRA coverage. Typically this is the day after the members active coverage ended. However, you should confirm the date with the clients COBRA TPA.
Step 9: Paid Through
Enter the date that the member is paid up to on COBRA premium.
Step 10: Save and elect for other dependents (if applicable):
After the save the system will take you back to the COBRA overview page. You can select "edit" and elect for other applicable dependents. You should see dependents that were on the profile page if the event was an employee event reason.
If you do not see a needed dependent under "enrollee" then go add them to the employees profile. Then you can go back and elect for them.
After the Enrollment Has Been Entered
After the enrollment has been entered, it works the same as any added from a COBRA Qualifying Enrollment Event. Refer to all articles in this section for instructions on maintaining / editing COBRA enrollments including plans and dates.
Questions & Answers
Q: What happens if I added a manual enrollment but there was a COBRA Qualifying Enrollment Event that I could have used?
A: EN encourages you to use COBRA Qualifying Enrollment Events that exist but it will not have any impact if you added a manual enrollment instead. The COBRA Qualifying Enrollment Event will remain on the overview page and you will need to disregard it. EN will not remove these and they do not impact anything on the back end.
Q: We closed open enrollment and I am trying to add a manual COBRA plan as the participant changed plans but we are getting an error that "Employee is already enrolled in medical". What should I do?
A: Go back to COBRA overview and select edit under COBRA enrollments. Find the plan that the participant was enrolled prior to close of open enrollment. Then click the following link and review article to find how to update participants plan. Manage COBRA During Open Enrollment
Q: I am getting an error when trying to save enrollment. Error is "Enrollment exists for X Benefit". Why?
A: There is another enrollment event in which you can enroll this dependent. It is likely they are showing as an enrollee under an enrollment you already entered and you just need to go elect for them.
Example: You added an enrollment for an employee and now you are adding one because his child is also enrolled, not with their own event due to aging off, but enrolling under the parents COBRA event. In a scenario like this, go to the employees enrollment, select edit, and then enter a paid through date for the dependent.
Q: I am getting an error when trying to save enrollment. Error is "Employee (Dependent) is already enrolled in X Benefit". Why?
A: We do not allow duplicate enrollments. This means an enrollment is already elected for this plan type and participant. Review that enrollment and edit as needed. You can re-elect, change the plan, edit the eligible from and to, and paid through date. If you truly need to enter a new enrollment, as perhaps there was a new event, end the open COBRA enrollment and you should be able to add a new one.
For more information on editing a current enrollment, please review all the articles in this section.
Q: How is the system calculating the eligible dates? What should I do if they are not what I am needing?
A: The system looks at the event reason and adds 18 or 36 months starting from the eligible COBRA start date. If the dates are not what you expect or need, select edit on the COBRA enrollment which will take you to COBRA editor, then click on "Modify". From there you can change the start and end date to as needed.