List of frequently asked questions and answers about COBRA coverage, participation and costs.
My last day of work is this week. Do I have to request my COBRA packet from someone?
No. The Employee Benefits Office will automatically mail a Notice of Right to Elect Continuation Coverage to your last known address after your employment ending action has been processed in the County payroll system. Please be sure to verify the County has an accurate mailing address in your payroll record. If you are moving, please ensure your HR department is informed of your forwarding address before your last day of work. If you lose or misplace your original Notice, or are worried that you did not receive it, you can request a replacement by contacting our office by phone, mail or fax. If you request the Notice be mailed to a different address than the address we have on file, we may require you to make your request in writing.
Why is COBRA coverage so expensive?
When an active employee has health insurance, the County pays a significant portion of the insurance premium on their behalf – many employees only pay 5%-10% of the total insurance premium for their elected coverage. In contrast, COBRA participants are required to pay 100% of the total insurance premium, plus a 2% administration fee. Since the full cost is borne by the participant, the cost of COBRA is more expensive than receiving coverage through active employment.
I was fired from my job at the County. Do I still have the right to elect COBRA?
Yes. Unless you were fired for “gross misconduct,” you still have the right to elect COBRA as long as you were enrolled in the County’s health insurance at the time your employment ends.
I used to cover my entire family while I was an employee. Now, I only want to elect COBRA for myself and my spouse, since my kids have other coverage. Can I do this?
Yes. COBRA can be elected for anyone who had coverage through your active employment, and each member has an independent election right. You do not have to elect COBRA for all of your family members, and you do not have to elect COBRA for yourself if you do not want it.
Do I have to choose the same plan under COBRA as I was enrolled in as an active employee or can I choose a cheaper plan?
You are able to elect coverage under a less expensive medical plan when electing COBRA if one is available from your existing carrier to similarly-situated employees. For example, if you were enrolled in the ODS Performance plan as an active employee, you have the option to select the ODS Preferred plan or the ODS Major Medical plan since both have reduced coverage and lower premiums than the Performance plan and both plans were available to you when you were an active employee.
However, not all employee groups have access to the same plans, so you may not be able to change your coverage at all. For example, if you were a full-time Local 88 employee enrolled in the ODS Platinum plan, you cannot choose a different plan because there were no other ODS plans available to full-time Local 88 employees. Your COBRA Election Form will provide you with a list of all plans you may choose from.
I recently ended employment with the County and am moving to the East Coast. I was enrolled in Kaiser as an active employee– can I sign up for my Kaiser plan through COBRA?
No. Kaiser is a geographically-specific HMO – the County Kaiser plans are only available in the Portland/Vancouver area. If you have moved outside of this area, you are not able to enroll in the Kaiser plan. However, you would be able to enroll in an ODS plan through COBRA. Please contact the Employee Benefits Office to discuss your options. You can also visit www.multco.us/healthplans for a comparison of the plans available.
I recently ended employment with the County and am moving to California. I was enrolled in Kaiser as an active employee– can I sign up for my Kaiser plan through COBRA since there are Kaiser facilities in California?
No. The Kaiser system in California is different than the Kaiser system available in the Portland/Vancouver area. Our plan is a geographically-specific HMO and is not available in other states. However, you would be able to enroll in an ODS plan through COBRA. Please contact the Employee Benefits Office to discuss your options. You can also visit www.multco.us/healthplans for a comparison of the plans available.
I lost my health insurance five months ago when I left employment, but I didn’t sign up for COBRA. Can I still enroll?
Probably not. In nearly all cases, you must elect COBRA coverage during your 60 day election period as explained in your COBRA notice. If you are beyond that period, you likely
have lost your right to elect COBRA coverage through Multnomah County. Please contact our office to request a review of your situation. The 60 day response period begins on the date you lost coverage, or the date of your initial COBRA notice, whichever is later.
I was enrolled in an ODS plan as an employee and am now enrolling in COBRA. Do I have to start over with my deductible and out-of-pocket maximum accruals?
No. COBRA coverage is an extension of the same coverage held during active employment. If you already satisfied your deductible during the current plan year, and you elect the same ODS plan through COBRA, you will not have to do so again during the current plan year while on COBRA. Any amount which has already accrued towards your out-of-pocket maximum for the current plan year will continue to count towards your out-of-pocket maximum for the current plan year. If you select a different ODS plan with a larger deductible or out-of-pocket maximum, you will have to meet those new thresholds.
I mailed in my COBRA Election Form but my insurance company says my coverage has been cancelled. Why?
COBRA coverage is not effective until it has been paid for. When coverage is lost due to end of employment or a change in eligibility, your coverage termination is sent to the insurance carrier. Once you have made a payment, COBRA coverage will be updated with the carrier only for the month/s for which you have made your payment.
I mailed in my COBRA Election Form. Now what do I do?
If you want your COBRA coverage to go into effect, you must make a payment by the due date. When your COBRA Election Form is received, our office will mail you a confirmation specifying your initial premium amount and due date, and one set of payment coupons. Our office does not send any other bills or payment reminders. It is your responsibility to make your COBRA payments on time to prevent loss of your right to continuation coverage. If you have lost your confirmation and/or billing coupons, you can request a replacement copy by contacting our office. You can also contact our office at any time to verify the amount due, date due or payment remission address.
Is there an open enrollment opportunity for COBRA participants ?
Yes, COBRA participants have the right to participate in the annual open enrollment. Materials and information are mailed to all participants in late fall. Enrollment changes are effective January 1. During open enrollment you can change your plan and add dependents to your coverage. You must return an open enrollment form if you wish to request a change to your coverage.
I just got divorced and my ex-spouse was removed from my County health insurance. Is my ex-spouse eligible for COBRA?
Yes, if your former spouse lost coverage because of your divorce, he or she will have the right to continue coverage through COBRA for up to 36 months. This also applies to any former step-children who may have lost coverage due to the divorce. Additionally, if your former spouse is over age 55 at the time of your divorce, he or she may even be able to continue coverage through ORS 743.600 for up to 10 years. You are responsible for notifying us of your divorce and your former spouse's address so we can provide proper notice regarding COBRA rights. The coverage ending date for an ex-spouse is always the end of the month in which the divorce became final - regardless of when employee reports the event. If employee delays reporting and benefits are issued on expenses incurred after the divorce, the employee may be required to reimburse the County for those benefits.
If I die while employed by the County, can my spouse/family continue their health insurance through COBRA?
Yes, if your spouse and/or family were enrolled in your health insurance while you were an active employee, they have the right to continue coverage if you die. Coverage is generally available through COBRA for up to 36 months for your dependents. However, if your spouse is over age 55 at the time of your death, they may be able to continue coverage through ORS 743.600 for themselves and any dependent children under the age of 18 for up to 10 years.
My child is too old to remain enrolled in my County insurance plan. Do they qualify for COBRA?
Yes, if your child was removed from County health insurance due to his or her age, your child will receive an offer to continue their coverage through COBRA for up to 36 months. The COBRA notice is automatically sent to your home address - if your child resides elsewhere, you are responsible to notify our office about their current address.
Who can I contact if I have more questions about COBRA?
Please contact the Employee Benefits Office at 503-988-3477 or email@example.com .Source: multco.us