Guidance – Employees eligible for the COBRA Subsidy

Washington State Health Care Authority sent this bulletin at 07/06/2021 03:19 PM PDT

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When ending your employees’ benefits in SEBB My Account (SMA), be sure to consider whether the employee would be eligible for the COBRA subsidy.

The COBRA subsidy is available to individuals from April 1 through September 30. 2021. This means that employees terminating employer-sponsored coverage between March 31 and August 31, 2021, may be eligible for the COBRA subsidy if they meet certain eligibility criteria (i.e., they are federally eligible for COBRA during the subsidy, AND they lost group health coverage to involuntarily termination OR a reduction in hours, AND they do not have access to other group health coverage or Medicare).

The reason selected in SMA helps HCA staff determine if the employee is eligible for the subsidy when processing their COBRA enrollment forms.

The 2021 COBRA Subsidy Eligible reason was specifically created to identify COBRA Subsidy eligible individuals. Use the 2021 COBRA Subsidy Eligible reason when an employee experiences one of the following initial qualifying events:

A reduction in hours that results in the loss of eligibility for the employer contribution for benefits. The reduction in hours may be involuntary (employer-initiated) or voluntary (employee-initiated).

An employer-initiated termination.
- Examples include, but are not limited to layoff, unpaid leave, disability retirement, and employer ended employment. Also included are employees who choose to retire or terminate due to layoff, termination, or a reduction in hours.

By using the correct termination reason in SMA, the individuals and any enrolled dependents on the account will receive a COBRA packet with the information needed to apply.

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.

Guidance – Employees eligible for the COBRA Subsidy

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About the Health Care Authority (HCA)

Disclosure notice

Nondiscrimination