Follow this process to set up a COBRA program.

Define COBRA Programs and Plans

   To define COBRA programs and plans:

Define the plans that are subject to COBRA and link these plans to the COBRA program.

1. Define the benefit plans for which you provide continuing eligibility based on COBRA regulations.

   See: Defining a Benefits Plan

2. Indicate that the plan is subject to COBRA regulations by selecting a value of COBRA in the Regulations field of the Maintain Plan Related Details window.

3. Enter the day of the month (as a number) by which COBRA payments must be received for this plan in the COBRA Payment Date field of the Plans window.

4. Define the COBRA program.

   See: Defining a Benefits Program

5. Select a Program Type of COBRA or COBRA with Credits (if you use flex credits to offset COBRA costs) in the Programs window.

6. Select the level at which you are administering COBRA programs in the Determine Enrollment Period Level field.

   • Select Program if your COBRA administration rules are set at the program level and apply to all plan types and plans in the COBRA program.

   • Select Plan Type in Program if your COBRA administration rules vary between the plan types in the COBRA program.

7. Use the Plan and Plan Type window to link the plans you include in the COBRA program.

   Note: You also link the plans subject to COBRA to the regular program.

8. Define a maximum enrollment period of 18 months for the COBRA program. You must define a maximum enrollment period in order to cover qualified beneficiaries.

   Note: Advanced Benefits customers can use the Life Event window to vary the maximum enrollment period based on a defined qualifying life event such as a divorce or the death of the employee. You can indicate if the life event extends coverage for the spouse or a dependent.

Set up the Administrator Contact

You enter an administrator's information to provide the COBRA participant with the name of a contact and the address where they should return the COBRA election page.

You can set up contacts by plan, or establish one contact for all plans in a program. Contacts you set up at the program level override contacts you enter for any plans in the program.

See: Associating an Organization with a Benefits Program

See: Associating Options with a Plan

   To set up an administrator contact:

1. To enter an administrator for a program, open the Programs window and select the Organizations tab.

2. Select the administrator's Organization.

   You must first enter your administrator's organization using the Organization window. The address you define for the organization appears as the administrator's mailing address in a COBRA letter.

3. Enter the administrator's name in the Organization Roles field.

4. In the Organization Role Types field, select Administrator.

5. Save your work.

6. To enter an administrator for a plan, open the Plans window. Choose the Details button and select the Organizations tab.

7. Complete the fields as you would for a program, following steps 2-5.

Define COBRA Qualifying Life Events (Advanced Benefits)

Define the life events that qualify a participant for COBRA coverage or that extend the coverage period of a participant, spouse, or dependent.

   To define COBRA qualifying life events:

1. Define the Life Event, indicating that it qualifies an eligible person for COBRA, by checking the COBRA Qualifying Life Event field in the Life Event Reasons window.

   See: Defining General Characteristics of Life Event Reasons

Define COBRA Eligibility Profiles

Define participation eligibility profiles and link the profiles to your compensation objects.

   To define COBRA eligibility profiles:

1. Define the eligibility profiles which participants and dependents must meet in order to qualify for COBRA coverage.

   See: COBRA Eligibility Profiles for an overview of each eligibility profile that is applicable to COBRA.

2. Link the eligibility profile to the appropriate compensation object depending on the kind of profile you have defined.

Define Open Enrollment Requirements for COBRA

COBRA participants can change elections during an open enrollment period. The elections that a COBRA participant can make are limited based on COBRA regulations.

• Define the enrollment requirements for each COBRA plan.

Define COBRA Contribution Rates

Define the contribution activity rate for your compensation objects that are subject to COBRA. The contribution rate may be up to 102% of the actual premium.

You can define one activity rate for the regular compensation object--either a plan in program or an option in plan in program--and a second rate for the same compensation object in the COBRA program.

   To define COBRA contribution rates:

1. Define the activity rate for the compensation object subject to COBRA that is in the regular program.

2. Define the activity rate for the compensation object subject to COBRA that is in the COBRA program.

   See: Defining Activity Rates for a Standard Contribution/Distribution

Define COBRA Communication Types

Define the COBRA communication types that you send to participants, such as the notification of eligibility, a grace period expiration letter, and a COBRA expiration letter.

Use the Communication Types window to define the features of each COBRA communication type.

See: Defining Communication Types

   To define COBRA communication types:

1. Query one of the seeded COBRA communication types in the Communication Types window. Choose either:

   • COBRA Initial Information

   • COBRA Notification Letter

2. Choose the Triggers button to open the Communication Type Triggers window.

3. Select a COBRA communication trigger.

   • For the COBRA Benefit Initial Information letter, a typical example is Post Enrollment Confirmation Literature -Form- Enrollment Results Created/Modified/Deleted

   • For the COBRA Notification Letter, a typical example is Eligibility -BENMNGLE- Determines First Time Eligible

4. Close the Communication Type Triggers window.

5. Choose the Usages button.

6. Select the applicable COBRA program.

   For the COBRA Notification Letter, the application detects the communication type when a person becomes newly eligible for the COBRA program.

   Create PDF versions of COBRA letters

   You can create XML-driven PDF versions of the COBRA letters. To do so, you must use the System Administrator responsibility.

Generate COBRA Letters

You can generate and print COBRA letters directly from Oracle HRMS. Choose from the following reports:

• The COBRA Benefit Initial Information report provides employees with information about their rights under COBRA

• The COBRA Benefits Notification Letter report extracts electable choice information for selected persons

You cannot modify the seeded templates generated by the COBRA reports, but you can copy them and change the copies. See "To modify the seeded letter format" below.

You run reports from the Submit Requests window.

   To generate a COBRA letter:

1. Select the appropriate COBRA letter in the Name field.

2. Enter the Parameters field to open the Parameters window.

3. Select an individual in the Person Name field to generate a letter for a single person.

4. To generate a letter for multiple persons, select one or more of the following criteria:

   • Organization

   • Benefit Group

   • Location

   • Program (COBRA Benefits Notification Letter only)

   The report generates a letter for each person who has the COBRA communication type detected.

5. Choose the OK button.

6. Choose the Options button to select a printer if you want to send the letter directly to a printer.

7. Complete the batch process request and choose Submit.

   Note: THIS EXAMPLE LETTER/MATERIAL HAS BEEN PRODUCED BY OR FOR THE INTERNAL REVENUE SERVICE. ORACLE PROVIDES THIS LETTER/MATERIAL ON AN "AS IS" BASIS. ORACLE EXPRESSLY DISCLAIMS ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO THE IMPLIED WARRANTIES OR MERCHANTABILITY, FITNESS FOR PARTICULAR PURPOSE AND NON-INFRINGEMENT. IN NO EVENT SHALL ORACLE BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, PUNITIVE OR CONSEQUENTIAL DAMAGES, OR DAMAGES FOR LOSS OF PROFITS, REVENUE, DATA, INCURRED BY YOU OR ANY THIRD PARTY IN CONNECTION WITH THE LETTER/MATERIAL, WHETHER IN AN ACTION IN CONTRACT OR TORT, EVEN IF ORACLE HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. ORACLE'S ENTIRE LIABILITY FOR DAMAGES IN RESPECT OF THE LETTER/MATERIAL AND ANY RELATED MATERIAL SHALL IN NO EVENT EXCEED TEN THOUSAND DOLLARS (U.S. $10,000).

   To modify the seeded letter format:

1. Attach the XML Publisher responsibility to your User.

2. Log in to the XML Publisher responsibility.

3. Query "COBRA Initial Letter" or "COBRA Notification Letter" in the template of the XML Publisher Administrator.

4. Download the seeded RTF file and make your changes.

5. End Date the seeded template (but do not make any changes to the data source).

6. Create a new template including the new RTF file. Ensure that:

   • the application is Oracle Advanced Benefits or Advanced Benefits

   • the data source is either "COBRA Initial Letter" or "COBRA Notification Letter"

   • the template Type is RTF