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- Health Benefits Advisor for Employers

Determining Compliance with the HIPAA Provisions in Part 7 of ERISA

Compliance with the Certificate of Creditable Coverage Provisions - Automatic Certificates Upon Loss of Coverage

Does the plan provide complete and timely certificates of creditable coverage to individuals automatically upon loss of coverage?

Plans are required to provide each participant and dependent covered under the plan an automatic certificate, free of charge, when coverage ceases. (If the plan is insured and there is an agreement with the issuer that the issuer is responsible for providing the certificates, select "Not Applicable" above.)

Under 29 CFR 2590.701-5(a)(2)(ii), plans and issuers must furnish an automatic certificate of creditable coverage:

  • To an individual who is entitled to elect COBRA, at a time no later than when a notice is required to be provided for a qualifying event under
  • COBRA (usually not more than 44 days);
  • To an individual who loses coverage under the plan and who is not entitled to elect COBRA, within a reasonable time after coverage ceases; and
  • To an individual who ceases COBRA, within a reasonable time after COBRA coverage ceases (or after the expiration of any grace period for nonpayment of premiums).