Prior to enrolling in the COSE MEWA, all employers must read and agree to the administration and compliance guidelines. Employers are also required to provide a Summary of Benefits and Coverage (SBC). Please see the below links for detailed information on employer requirements, plan SBCs, Underwriting Guidelines and more.
Annual Notice: Benefits Reminders
The Annual Notice of Health Benefits reminders will be mailed every year, during the first quarter, to all employers enrolled in the COSE MEWA. It is the employer’s responsibility to distribute this information to their employees.
Administration and Compliance Guide
This guide contains information on administering your plan and provides summary guidance with applicable state and federal laws.
These guidelines summarize your group’s requirements for participating in the MEWA. Refer to this document for help with setting up funding rate contributions, determining residency and enrollment requirements, and more.
Summary of Plan Description
The summary plan description (SPD) describes benefits and terms of coverage. Medical Mutual will create a generic SPD by wrapping the Plan Document with the Benefit Book for each employee. However, employers are responsible for creating and distributing group-specific plan documents and the SPD. To help you create a group-specific SPD, the COSE MEWA offers a template.
Summary Plan Description Help
Summary of Benefits and Coverage
Health insurers are required by the Affordable Care Act to provide a Medical Summary of Benefits and Coverage (SBC). An SBC helps you better understand your health plan by using a standard format that helps you easily compare plans.
Premium Only Plan
A Section 125 Premium-Only-Plan (POP) is a cafeteria plan that lets employees pay their health insurance premiums using tax-free dollars. Traditionally, POP plans have been used in combination with employer-sponsored group health insurance.