Employers – COBRA Continuation, Minnesota State Continuation, and Minnesota Life Continuation
Required Items for COBRA Eligible Plans
Submit the below COBRA renewal information for all plans no later than 30 days before your benefit plans and rates renew:
- Minnesota Employer COBRA Renewal Form
- Full Monthly Premiums
- Full 100% monthly premiums (no 2% COBRA administration fee added)
- Please submit the total monthly premiums (do not separate employer/employee portions)
- Submit a rate sheet directly from your insurance carrier to ensure that the proper rates are utilized by Alerus
- Age-banded premiums must be submitted in Excel format
- If there are no changes to rates, please acknowledge this in the renewal submission to Alerus
- Full 100% monthly premiums (no 2% COBRA administration fee added)
- Tiered Rate Structure (if applicable)
- Individual Plan Summary of Benefit and Coverage documents (SBCs)
- Group Numbers for any COBRA Eligible Plan (if there is a COBRA sub-group, please indicate)
For new or changed benefit information, please provide the following information:
- Carrier Name/Network
- Group Number(s)
- Is the plan fully or self-insured?
- Does coverage end as of date of event or end of the month in which the employee terminates?
- Effective Date of the Plan and Rates
Additional Required Items for Minnesota Plans Only
For life insurance benefit changes, please provide all monthly premiums per 1,000 units of coverage, in addition to the information below:
- Is AD&D bundled in the cost for the basic and voluntary life policies?
- For voluntary life, is age determined by plan anniversary or birthday?
- Is spouse voluntary life based on the employee’s age or the spouse’s age?
- Does the member need to elect basic life to continue any voluntary policies under continuation coverage?
- Does the member need to elect employee voluntary life to continue dependent voluntary life?
- Is conversion available for these policies?
Please submit all finalized renewal information in one email to cobra@alerus.com
Alerus may charge additional fees if incorrect renewal information is submitted and correction is needed.
If you have any questions please contact the COBRA Client Service Center at 952.253.1261