What is COBRA Coverage?

COBRA is a federal law that requires large employers (including Multnomah County) to offer employees and their families the opportunity to continue their health care coverage when there is a qualifying event that would result in a loss of coverage in the County's health plan. {C}Depending on the type of Qualifying Event, "Qualified Beneficiaries" can include the employee (or retired employee) covered under the group health plan, the covered employee's spouse, and the dependent children of the covered employee. (Certain newborns, newly adopted children, and alternate recipients under QMSCOs may also be qualified beneficiaries. This is discussed in more detail in separate paragraphs below.)

COBRA coverage is the same coverage that the Plan gives to other participants or beneficiaries under the Plan who are not receiving COBRA coverage. Each Qualified Beneficiary who elects COBRA will have the same rights under the Plan as other participants or beneficiaries covered under the components of the Plan elected by the Qualified Beneficiary, including special enrollment rights.

The description of COBRA contained herein applies only to the Medical Expense Reimbursement Plan (MERP) and not to any other benefits offered by Multnomah County.

The Plan provides no greater COBRA rights than what COBRA requires - nothing herein is intended to expand your rights beyond COBRA's requirements.

How can you elect MERP COBRA?

To elect MERP COBRA, you must complete the Election Form according to the directions on the Election Form and mail or fax it to Multnomah County by the date specified on the Election Form. Failure to do so will result in loss of the right to elect COBRA coverage under the Plan.

COBRA coverage under MERP is offered only to certain qualified beneficiaries and is available only for a limited period. COBRA coverage will consist of MERP coverage in force at the time of the qualifying event (i.e., the elected annual limit reduced by expenses reimbursed up to the time of the qualifying event.) The use-it-or-lose-it rule will continue to apply, so any unused amounts will be forfeited at the end of the Plan year, and MERP COBRA coverage will terminate at the end of the Plan year. All qualified beneficiaries who were covered under MERP will be covered together for MERP COBRA coverage.

Additional information about MERP is available in the Plan's summary plan description. If you do not have a copy of the summary plan description, you may obtain one from Multnomah County.

How long does MERP COBRA coverage last?

When the Qualifying Event occurs, MERP COBRA coverage under the Plan component can last only until the end of the Plan year in which the qualifying event occurred. The period of MERP COBRA coverage under the Plan cannot be extended under any circumstances.

Your notice shows the maximum period of MERP COBRA coverage available to the Qualified Beneficiaries. MERP COBRA coverage will automatically terminate before the end of the maximum period if any required premium is not paid in full on time.

How much does MERP COBRA coverage cost?

The entire cost of MERP COBRA coverage is required to be paid unless the Election Form states otherwise. The amount a COBRA participant may be required to pay may not exceed 102% of the cost the plan participant was previously paying during active MERP participation. The required semi-monthly payment for MERP COBRA is described on the first page of your Notice.

When and how must payment for MERP COBRA coverage be made?

All MERP COBRA premiums must be paid by check and made payable to Multnomah County. MERP participation is broken into two monthly periods: 1) the 1st through the 15th and 2) the 16th through the final day of the month.

* First payment for MERP COBRA coverage
If you elect MERP COBRA, you do not have to send any payment with the Election Form. However, you must make your first payment not later than 45 days after the date of your election. (This is the date your Election Form is postmarked, if mailed, or the date your Election Form is received by the individual at the address specified for delivery on the Election Form, if hand-delivered or faxed.) If you do not make your first payment for MERP COBRA coverage in full within 45 days after the date of your election, you will lose all COBRA rights under the Plan. Your first payment must cover the cost of MERP COBRA participation from the time your coverage under the Plan would have otherwise terminated up through the end of the semi-monthly period before the semi-monthly period in which you make your first payment. (For example Sue's employment terminates on September 30 and she loses coverage on September 30. Sue elects MERP COBRA on November 15. Her initial premium payment equals the premiums for October 1-15, October 16-31 and November 1-15 and is due on or before December 30, the 45th day after the date of her COBRA election.) You are responsible for making sure that the amount of your first payment is correct. Claims for reimbursement will not be processed and paid until you have elected MERP COBRA and your first payment has been received and processed.

* Semi-monthly payments for MERP COBRA coverage
After you make your first payment for MERP COBRA coverage; you will be required to make payments for each subsequent semi-monthly period of MERP COBRA coverage. The amount due for each semi-monthly period is shown in this notice. Under the Plan, each of these semi-monthly payments for MERP COBRA coverage is due on the first day of the semi-monthly period for that period's MERP COBRA coverage. If your semi-monthly payment is received and processed before Multnomah County transmits contributions to the MERP administrator for that period, your MERP COBRA coverage under the Plan will continue for that period without any break. If your semi-monthly payment is received and processed after Multnomah County transmits contributions to the MERP administrator for that period, but before the end of the grace period for that period, your participation will be retroactively reinstated (going back to the first day of the period) when the semi-monthly payment is received and processed. As a courtesy, Multnomah County will send one payment schedule to you after your Election Form is received. You will not receive any additional notice of payments due for these coverage periods (that is, we will not send a bill to you for your MERP COBRA coverage - it is your responsibility to pay your MERP COBRA premiums on time.)

* Ability of pre-payment
For your convenience, you may pre-pay for any semi-monthly period by submitting payments before they are due (for instance, you could submit a payment for periods October 1st-15th and October 16th-31st by paying with one check in the amount equal to two semi-monthly periods on or before October 1st.) If you choose to pre-pay, your payments are non-refundable. Your participation periods will not be changed after payments are processed.

* Grace periods for monthly payments
Although semi-monthly payments are due on the first day of each period for MERP COBRA coverage, you will be given a grace period of 30 days after the first day of the period to make each semi-monthly payment. Your MERP COBRA coverage will be provided for each period as long as payment for that period is made before the end of the grace period for that payment. However, if your semi-monthly payment is received and processed after Multnomah County transmits contributions to the MERP administrator for that period, but before the end of the grace period for the period, your coverage under the Plan will be suspended as of the first day of the period and then retroactively reinstated (going back to the first day of the period) when the semi-monthly payment is received and processed. This means that any claim you submit for reimbursement while your coverage is suspended may be denied and may have to be resubmitted once your coverage is reinstated. If you fail to make a semi-monthly payment before the end of the grace period for that period, you will lose all rights to MERP COBRA coverage under the Plan.

Your first payment and all semi-monthly payments for MERP COBRA coverage should be mailed to:

Multnomah County Employee Benefits Office ATTN: COBRA
501 SE Hawthorne Blvd, Suite 400
Portland, OR 97214

Hand-delivered payments may be brought to:
Multnomah County Employee Benefits Office
501 SE Hawthorne Blvd, Suite 320
Portland, OR 97214

If mailed, your payment is considered to have been made on the date that it is postmarked. If hand-delivered, your payment is considered to have been made when it is received by the individual at the address specified above. You will not be considered to have made any payment by mailing or hand delivering a check if your check is returned due to insufficient funds or otherwise. If you pay by cashier's check, funds will be transmitted to the MERP administrator during the next bi-monthly contribution cycle. If you pay by personal check, funds will be transmitted to the MERP administrator during the next bi-monthly contribution cycle after your check has been cleared.

For more information

This notice does not fully describe COBRA coverage or other rights under the Plan. More information about COBRA coverage and your rights under the Plan is available in your summary plan description or from Multnomah County at the address below.

If you have questions concerning the information in this notice, or your rights to coverage, you should contact:

Multnomah County Employee Benefits Office
501 SE Hawthorne Blvd, Suite 400
Portland, OR 97214
503-988-3477
Employee.Benefits@co.multnomah.or.us

State and local government employees seeking more information about rights under PHSA, including COBRA, the Health Insurance Portability and Accountability Act (HIPAA), and other laws affecting group health plans should contact HHS-CMS at www.cms.gov.

Keep your plan informed of address changes

In order to protect you and your family's rights, you should keep Multnomah County informed of any changes in your address. You should also keep a copy, for your records, of any notices you send to Multnomah County.