Summary of Material Modifications Quiz

What is the age limit for children to be covered on their parents' plan under the Affordable Care Act?

26

What must group health plans provide to covered employees and their families under COBRA?

Specific notices explaining their COBRA rights

What is the purpose of the Summary Plan Description (SPD) in a group health plan?

To give important information about the plan, including benefits, rights, and how the plan works

When must group health plans provide participants with an SPD according to ERISA?

Within 90 days after becoming a plan participant Signup and view all the answers

What document must be provided to participants if there are material changes to the plan?

Summary of Material Modifications (SMM) Signup and view all the answers

What is the timeframe for providing participants with an SMM if there are material changes to the plan?

Not later than 210 days after the end of the plan year in which the changes become effective Signup and view all the answers

What is one of the protections contained in ERISA?

The right to COBRA continuation coverage Signup and view all the answers

Who is entitled to COBRA continuation coverage?

Covered employees, former employees, spouses, former spouses, and dependent children Signup and view all the answers

What are some events that trigger the right to COBRA continuation coverage?

A covered employee's death, job loss, becoming entitled to Medicare, divorce, legal separation, child's loss of dependent status Signup and view all the answers

What does COBRA stand for?

Consolidated Omnibus Budget Reconciliation Act Signup and view all the answers

What is the purpose of COBRA continuation coverage?

To offer temporary continuation of group health coverage that would otherwise be lost due to certain life events Signup and view all the answers

Who is this guide intended to help?

Employers that sponsor group health plans Signup and view all the answers

What is the minimum time limit for providing notice for continuation coverage?

60 days Signup and view all the answers

When is the latest date from which the 60-day notice period starts for continuation coverage?

The date on which the qualifying event occurs, the date on which the qualified beneficiary loses coverage, or the date on which the qualified beneficiary is informed of the responsibility to notify the plan. Signup and view all the answers

Where should the rules for continuation coverage be described?

In the plan's SPD (Summary Plan Description) Signup and view all the answers

What should the notice include for continuation coverage?

Responsibility to notify the plan and procedures for doing so Signup and view all the answers

What information should be included in the COBRA general notice?

Responsibility to notify the plan and procedures for doing so Signup and view all the answers

When must the plan administrator furnish the Summary of Material Modifications?

Within 60 days after the reduction is adopted Signup and view all the answers

Within how many days must the plan administrator provide plan documents if requested in writing by a covered participant or beneficiary?

Within 30 days Signup and view all the answers

When must group health plans give each employee and spouse a general notice describing COBRA rights?

Within the first 90 days of coverage Signup and view all the answers

How can group health plans satisfy the requirement of providing a general notice about COBRA rights?

By including the general notice in the plan's SPD and giving it to the employee and spouse within the first 90 days of coverage Signup and view all the answers

What information must be included in the general notice about COBRA rights?

Name of the plan, contact information, continuation coverage description, notification process for qualifying events, importance of updating addresses, and a disclaimer Signup and view all the answers

What has the Department of Labor developed for single-employer group health plans to use in satisfying the general notice requirement?

A model general notice Signup and view all the answers

What is the maximum period of continuation coverage for a family with a disabled qualified beneficiary?

29 months Signup and view all the answers

During the 11-month disability extension, how much can the plan charge qualified beneficiaries as an increased premium?

Up to 150 percent of the cost of coverage Signup and view all the answers

When must the Social Security Administration (SSA) determine that the qualified beneficiary is disabled for the family to be entitled to the 11-month extension?

Before the 60th day of continuation coverage Signup and view all the answers

What is one of the requirements for the disability extension to continue during the initial 18-month period of continuation coverage?

The disability must continue Signup and view all the answers

What is the minimum time limit, starting from the latest of specified dates, for notifying the plan of the SSA determination of disability?