COBRA: Add Employer Contact, Add dependent COBRA Event

Adding or removing an employer contact in OCA

To add or remove an employer contact in OCA, go to the OCA Change Form: https://oca125.com/erchangeform/

First Screen

Enter the ER Company Name, and select Employer Contact Change.

You may also use this form to change the Employer Address and Employer Name, if necessary.

Select Broker Contact.

Enter your personal first and last name and email.

Click Next.

Second Screen

Select Replacing, Additional Employer Contact, or Removed depending on the reason you are filling the form.

Enter the Employer Contact Name, Email, and Phone Number.

Click Employer Portal.

Do not add Additional Comments.

Click Submit.

Adding a COBRA event to OCA

If an enrolled dependent loses coverage, they require a COBRA notice. Likewise, if an enrolled employee loses coverage due to eligibility change, but remains an active employee, they require a COBRA notice.

The benefitbay system will not send either of these types of loss of coverage through the OCA integration, and you must add the event manually to OCA in order to generate the Event Letter.

Dependents may lose coverage by turning 26, divorce, or other loss of coverage. Employees may lose coverage by switching to a class (for example, going FT to PT)

Log into OCA (website here).

Locate the employer group, and click View [Employer's Name].

On the left navigation tab, click the Launch Employer Portal button (see image - the button is a square with an arrow through it) next to the ER's name.

Within the Employer Portal, go to the Dashboard, and select Add COBRA Event.

Fill out the pop-up form with the appropriate answers.

1. Event Information

Qualifying Event: Choose the appropriate response.
Qualifying Event Date: Date of coverage or eligibility end
Is this a second Qualifying Event: No
Disability Extension: No
Has this Qualifying Event been tracked in another system: No

2. Employee Information

Employee First Name: Enter EE's first name
Employee Last Name: Enter EE's last name
Social Security Number: Enter EE's SSN.
Employee Identifier: Leave blank
Hire Date: Leave blank
Termination Date: Leave blank
Rehire Date: Leave blank
Retirement Date: Leave blank
Primary Email: Leave blank
Secondary Email: Leave blank

3. Benefit Information

HRA: benefitbay ICHRA
- Monthly Contribution: Enter the EE's monthly contribution (find in the EE's benefitbay Enrollment tab)
- First Billing Period Premium: Leave blank
Other: Not Covered

4. Primary Participant

Who is the Primary Participant: Choose the dependent that is losing coverage
Primary Participant's Address: Enter the dependent's address
Primary Phone Number: Leave blank
Secondary Phone Number: Leave blank
Email: Leave blank
Gender: Choose the dependent's gender. Only use Male or Female.
Is Tobacco User: Unknown
Date of Birth: Enter the dependent's DOB.
Disability Start Date (Optional): Leave blank
Medicare Start Date: Leave blank
Medicare End Date: Leave blank
Which benefits is this person enrolled in?: benefitbay ICHRA

5. Dependents

Leave blank and click "Next."

6. Subsidies