Employer-Administered State Continuation
If you elect to administer your own State Continuation Coverage plan, you must follow these steps:
- Notify BCBSTX when an employee is terminated. You can easily do this by e-mailing bluecrossblueshield_COBRA@bcbstx.com. You will receive a system e-mail reply directing you to a web site, where you will be instructed to create a protected account to securely submit information to BCBSTX. The e-mail will also include a Request for Information Form as an attachment. Complete the form online, making sure to indicate RETURN in the subject line of the return e-mail before clicking "Submit."
- Following receipt of your notification, BCBSTX will mail an enrollment packet that includes the Texas Nine (9) Months Continuation of Insurance Application form to eligible applicants. The applicant must complete, sign and fax the application to Continuation Services at 1-618-998-2747.
NOTE: If the employee was involuntarily terminated, he or she may be eligible for the federally legislated premium subsidy. The Request for Information form you submitted in Step 1 will serve as confirmation that the applicant's employment was terminated involuntarily. To apply for the subsidy, the applicant must also complete and return the Request for Treatment as an Assistance Eligible Individual form included in the packet.
- Bill the applicant for the continuation coverage he or she selects. You will receive a monthly statement once membership is established. State continuants will appear in a separate billing section on your statement.
- If an applicant qualifies for the premium subsidy, bill for 35% of the appropriate group premium and submit that amount to BCBSTX.
- If an applicant does not qualify for the premium subsidy, you may bill for up to 102% of the appropriate group premium. The additional 2% is an optional employer administration charge. Pay 100% of the employee premium to BCBSTX and retain the 2% administration charge, if applicable.
- Submit payment to BCBSTX. You must collect the initial premium from all continuants within 45 days of the date coverage was first elected. Then submit your total group payment to BCBSTX by business check. BCBSTX must receive all subsequent payments within 30 days of the due date.
- Cancel continuants from State Continuation Coverage when the nine (9)-month continuation coverage period ends or any of the following events occur:
- You discontinue offering your group plan to all employees
- The continuant fails to submit a premium payment within 30 days* of the due date
- The continuant obtains other group coverage
- The continuant becomes eligible for Medicare coverage
- The continuant requests to drop coverage
You may submit your cancellation requests online through Blue Access® for Employers or by notifying BCBSTX in writing.
*The 30-day payment grace period does not apply to the initial premium payment. Eligible continuants have 60 days from the date you notify them of their continuation rights to apply for coverage. They have an additional 45 days from the date they apply for coverage to submit the first premium payment to you. You must then submit payment to BCBSTX by business check. To avoid delays in membership set up, it is important that you act promptly.