> Workers' compensation Most employers are required by law to provide workers' compensation insurance through a state system operated by the Department of Labor & Industries. Worker comp pays an employee's medical expenses and provides some income replacement when a worker is injured on the job.
> Indemnity Indemnity plans are also referred to as “fee-for-service.” Unlike managed-care plans, indemnity plans allow absolute freedom in selecting physicians or medical facilities and permit self-referral to a specialist.
> Basic Hospital Basic-hospital plans cover only in-hospital (inpatient) care, not other services. This benefit also may be limited to an approved or network facility. Hospitalization in a different facility may qualify for less coverage or none at all.
The landmark COBRA health benefit provisions became law in 1986. The law amends the Employee Retirement Income Security Act, the Internal Revenue Code and the Public Health Service Act to provide continuation of employer-sponsored group health coverage that otherwise might be terminated. The Centers for Medicare & Medicaid Services (CMS) has advisory jurisdiction for the COBRA law as it applies to state and local government (public sector) employers and their group health plans.
The COBRA law generally applies to group health plans maintained by employers with 20 or more employees in the prior year. The law does not, however, apply to plans sponsored by the governments of the District of Columbia or any territory or possession of the United States, certain church-related organizations or the federal government.
Individuals who work for a state or local government employer, and their dependents, should be aware of their rights regarding COBRA. A good starting point is reading your summary plan description (SPD) booklet, if a state or local government employer distributes an SPD to its employees. Most of the specific rules on COBRA rights may be found there or with the person who manages your health benefits plan.
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Did You Know?
Payments you receive from qualified long-term care insurance contracts will generally be excluded from income
As reimbursement of medical expenses received for personal injury or sickness under an accident and health insurance contract. Also, certain payments received under a life insurance contract on the life of a terminally or chronically ill individual (accelerated death benefits) can be excluded from income. Refer to Publication 17, Your Federal Income Tax, Chapter 13, Other Income.
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