WebCOBRA.com Letter Changes

Your customizations are never overwritten; new letters are available instantly without you having to edit them. All templates, wording selections, or data elements can be modified and/or customized to fit your needs.

WebCOBRA 9 Release

• DOL ARRA AEI Request Form
• DOL ARRA Disclosure Statement
• ARRA Denial Letter
• ARRA Stimulus Confirmation Letter
• ARRA Enrollment Form
• ARRA Open Enrollment Letter

DOL ARRA Disclosure Statement
Description	This letter is sent with the Re-Notification Letter sets when the Re-Notification Wizard is ran and for events regardless of type from 2/17/2009 through 12/31/2009.
Where can I find this in the Internet Word Processor?	This template is not currently editable
What do I need to do?	This form is designed for the QB to fill out and send back to the Administrator.
What does it look like?

DOL ARRA Disclosure Statement
Description	This letter is sent with the Re-Notification Letter sets when the Re-Notification Wizard is ran and for events regardless of type from 2/17/2009 through 12/31/2009.
Where can I find this in the Internet Word Processor?	This template is not currently editable
What do I need to do?	This letter describes to the participant what ARRA is and how it could potentially impact their premiums, as well as lists government contacts and websites.
What does it look like?

ARRA Denial Letter
Description	This letter is sent when QBs who are ineligible for the ARRA 65% reduction in premiums.
Where can I find this in the Internet Word Processor?
What do I need to do?	This denial Letter is for QBs that do not qualify for ARRA Assistance.
What does it look like?

ARRA Stimulus Confirmation Letter
Description	This letter is sent when QBs who are authorized to receive the ARRA Stimulus.
Where can I find this in the Internet Word Processor?
What do I need to do?	This letter is generated to help confirm ARRA Stimulus eligibility.
What does it look like?

ARRA Enrollment Form
Description	This letter can be sent either through the Re-Notification Wizard or manually scheduled to for either a QB or a class of QBs.
Where can I find this in the Internet Word Processor?
What do I need to do?	This enrollment form is for QBs that qualify for ARRA assistance.
What does it look like?

ARRA Open Enrollment Letter
Description	This letter has to be manually scheduled to print for either a QB or a class of QBs.
Where can I find this in the Internet Word Processor?
What do I need to do?	This letter is designed to be used to inform QBs of their ARRA Stimulus options.
What does it look like?

Summer '08 Release

• Retiree Termination Letter (New Letter)
• Retiree Eligibility Letter (New Letter)
• Retiree Enrollment Form (New Form)
• Retiree Premium Computation Form (New Form)

Retiree Termination Letter
Description	Generated when a Retiree Terminates from Coverage
Where can I find this in the Internet Word Processor?
What do I need to do?	This letter is used in conjunction with the Retiree Billing Add-on Module, and is generated when a Retiree terminates from coverage.
What does it look like?

Retiree Eligibility Letter
Description	Letter for Retiree Participants Informing them of their Coverage Opportunity
Where can I find this in the Internet Word Processor?
What do I need to do?	This letter is used in conjunction with the Retiree Billing Add-on Module, and is used to inform Retiree Participants of their coverage opportunity.
What does it look like?

Retiree Enrollment Form
Description	Form for Retirees to Return in order to Enroll
Where can I find this in the Internet Word Processor?
What do I need to do?	This form is used in conjunction with the Retiree Billing Add-on Module, and is sent to the Retiree for them to return in order to enroll in coverage.
What does it look like?

Retirees Premium Computation Form
Description	Retirees Projection of Premiums
Where can I find this in the Internet Word Processor?
What do I need to do?	This form is used in conjunction with the Retiree Billing Add-on Module, and is will give Retirees a projection of their premiums.
What does it look like?

March '07 Release

• Benefit Termination Notice (New Letter)
• Cobra Election Notice (Added Subsidy Listing Data Element)
• End of COBRA Coverage (Added Social Security Extension Clause Data Element)

Benefit Termination Notice
Description	Generated when a QB is dropped from a Benefit Plan
Where can I find this in the Internet Word Processor?
What do I need to do?	This letter used to be the same as the Rate Change Notice, but it now has its own letter to go out to QBs when they are dropped from a benefit plan.
What does it look like?

Subsidy Listing
Description	If you need to be able to show different Subsidy amounts and end dates to a QB, use this data element. It will only show up if you have subsidies for that QB, and works best on the Cobra Election Notice.
Where can I find this in the Internet Word Processor?
What do I need to do?	If you'd like to use it, insert it into any letter (Cobra Election Notice works best).
What does it look like?

Social Security Extenstion Clause
Description	One of only a few Federally required letters to send is the End of COBRA Notice, which prints in the final 90 days of Federal Coverage. If you have setup a QB to be on the 11 month Social Security Disability Extension, this data element will give them additional information on when their extension will end.
Where can I find this in the Internet Word Processor?
What do I need to do?	If you've edited the End of COBRA Notice, you'll want to paste in this Data Element.
What does it look like?

Previous Releases:

January '07 Release

• Dependent Eligibility Reminder (New Letter)
• Rate Expiration Reminder (New Letter)
• Premium Disbursement Check (Generate Test Check)

Dependent Eligibility Reminder
Description	Generated when a Dependent has reached the age limit for this plan assignment
Where can I find this in the Internet Word Processor?
What do I need to do?	You will need to use "QB Dependent Age Limit Eligibility for Plan Assignment" Benefit Plan Option to see this letter print.
What does it look like?

Rate Expiration Reminder
Description	Generated when a benefit plan rate is about to expire.
Where can I find this in the Internet Word Processor?
What do I need to do?	If you have entered a rate expiration date at the Benefit Plan Detail page, a letter will print on that date.
What does it look like?

Premium Disbursement Check
Description	Check created for Carrier/Sponsor during the Premium Disbursement Wizard
Where can I find this in the Internet Word Processor?
What do I need to do?	Align or customize your check on your check stock and then generate a test check.
What does it look like?

July '06 Release

• Cobra Election Notice (Added Severance Data Element)
• Deficient Letter (Changed Account Balance to Total Amount Due)

Cobra Election Notice
Description	Main notice to new QBs notifying them of their rights
Where can I find this in the Internet Word Processor?
What do I need to do?	If you have modified your Cobra Election Notice, you may want to add this data element to your letter.
What does it look like?

Deficient Payment
Description	Generated for a QB with a deficient premium payment. The amount paid and balance due will be printed in the letter. The QB will have 30 days from the date of the letter to pay the amount owed
Where can I find this in the Internet Word Processor?
What do I need to do?	If you have modified the Deficient Payment Notice, you should use the Total Amount Due instead of the Account Balance.
What does it look like?

February '06 Release

• Premium Disbursement Check (New Template)
• HRA Information (Wording Update, Enrollment Form)
• Moving from Federal to State (New Letter)
• Auto QB Login (Wording Update, Cobra Election Notice)
• Rate Change Letter (Wording Update, Rate Change Notice)
• USERRA (Wording Update, Cobra Election Notice)

Premium Disbursement Check
Description	Check created for Carrier/Sponsor during the Premium Disbursement Wizard
Where can I find this in the Internet Word Processor?
What do I need to do?	Nothing! This is a new letter and is already in your system, ready for you to use.
What does it look like?

Healthcare Reimbursement Account Wording
Description	Inserted into the COBRA Election Notice if the QB has one or more HRA plans assigned
Where can I find this in the Internet Word Processor?
What do I need to do?	Nothing! This is new wording and is already in your system, ready for you to use.
What does it look like?

QB Moving from Federal Coverage to State Coverage
Description	This letter will be printed when coverage changes from federal to state
Where can I find this in the Internet Word Processor?
What do I need to do?	Nothing! This is a new letter and is already in your system, ready to automatically be created when this circumstance arises.
What does it look like?

Auto QB Login
Description	This letter provides notification to the QB of their ability to view their COBRA account. It will provide them with the necessary information to activate their account.
Where can I find this in the Internet Word Processor?
What do I need to do?	Insert the new Automated QB Login Notification data element into your COBRA Election Notice in the Internet Word Processor and turn on the new Client/Employer option to enable.
What does it look like?

Rate Change
Description	Inserted into the Rate Change Letter when there is an account balance greater than zero after the rate change.
Where can I find this in the Internet Word Processor?
What do I need to do?	If you have customized your rate change notice, you'll want to add this Data Element to the end of your notice. It will act as a "coupon" for QBs to send back to you.
What does it look like?

USERRA
Description	Used instead of the generic opening paragraph when the Qualifying Event is USERRA, this is the opening greeting paragraph in the COBRA Election Notice
Where can I find this in the Internet Word Processor?
What do I need to do?	Nothing! This is a new letter and is already in your system, ready to automatically be created when this circumstance arises.
What does it look like?