Welcome
The American Recovery and Reinvestment Act of 2009 provides premium assistance for COBRA continuation coverage.
- The Act also says that if a group health plan denies an individual's application for premium assistance, the individual can ask for an expedited review of the Plan's decision.
- The Centers for Medicare & Medicaid Services (www.cms.hhs.gov/COBRAContinuationofCov) chose MAXIMUS Federal to provide administrative case management services and answer the public's questions about premium assistance and COBRA continuation coverage.
My request for premium assistance has been denied. What can I do now?
If you believe you are entitled to the premium assistance, you may request that either CMS or the DOL review your case. Each is accepting a separate review form. The DOL handles all cases arising under private sector employers with twenty or more employees, while CMS handles all cases arising under public sector government employers and private sector employers with fewer than 20 employees in states with "mini-COBRA" laws. For more information about the COBRA continuation coverage laws administered by CMS and DOL, visit the About Premium Assistance page on this website.
How do I access and submit the expedited review form?
 | You can access the form entitled Request for Review If You Have Been Denied Premium Assistance by downloading the pdf document at the left. CMS Request for Review If you Have Been Denied Premium Assistance |
You must use this form to request an expedited review of a denial of your application for premium assistance.
Closely follow all the instructions on the form and either mail, or fax the form, or have it delivered (by hand or by courier) to MAXIMUS Federal Services at the mailing address or fax number that appears immediately below.
If you experience difficulty faxing us your expedited appeal form, the problem may be due to older fax equipment or technology. If you find you are having a problem, please call us toll free at 1-866-400-6689 to verify whether we have received your fax. You may also wish to consider using a nearby commercial service to send us your fax. This service is offered by many commercial copy and mail service companies
Note: If you need the DOL expedited review form because you or a family member worked for a private sector employer with 20 or more employees, you can access the form by visiting the Department of Labor website (www.dol.gov/ebsa/COBRA/html).
Who is MAXIMUS Federal Services?
MAXIMUS Federal Services is part of MAXIMUS (www.maximus.com), a government contractor with experience in performing impartial reviews of benefit claim disputes.
- MAXIMUS Federal works for The Centers for Medicare & Medicaid Services - not for health plans, individual members of health plans, employers or insurance companies.
To ask questions about premium assistance or COBRA continuation coverage, call 1-866-400-6689.
(TTY: 1-866-631-5610) The call is free.
Contact Us:
Maximus Federal Services
COBRA Continuation Coverage - Assistance Appeals Project
800 Cross Keys Office Park
1st Floor - Suite 822
Fairport, NY 14450
Toll Free Fax No. (866) 941-0170
www.ContinuationCoverage.net
You can also send questions by e-mail. A Help Desk representative will respond within one business day.
E-mail address: ContinuationCoverage@maximus.com
Our phone number: (866) 400-6689. Help Desk staff are available between 8 a.m. and 8 p.m. EST
