Your first payment and all monthly payments for COBRA continuation coverage should be sent 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 a Benefits Staff Member at the address specified above. You will not be recognized to have made any payment by mailing or hand-delivering a check if your check is returned due to insufficient funds or otherwise. There is a $25 service fee charged for any denied check.


Payment Information

Making the first payment for continuation coverage:
If you elect continuation coverage, you do not have to send any payment for the continuation coverage with your completed COBRA Election Form. However, you must make your first payment for continuation coverage not later than 45 days after the date of your election. (This is the date the COBRA Election Notice is post-marked, if mailed, or the date your COBRA Election Form is received by Multnomah County, if faxed.) If you do not make your first payment for continuation coverage in full not later than 45 days after the date of your election, you will lose all continuation coverage rights. Coverage is not in effect until premiums have been paid.

Your first payment must cover the cost of COBRA continuation coverage from the time your coverage under employer sponsored coverage would have otherwise terminated up through the end of the month before the month in which you make your first payment. For example, Joan's employment ends on September 14, and her employer sponsored health plan coverage will end on September 30. Joan elects COBRA on November 15. Her initial premium payment equals the premiums for October and November and is due on or before December 30, the 45th day after the date of her COBRA election period.

Participant is responsible for making sure that the amount of the first premium payment is correct. You may contact the Multnomah County Employee Benefits Office to confirm the correct amount of your first payment. Claims for reimbursement under the health coverage elected will not be processed and paid until you have elected COBRA and made your appropriate payment.

Making monthly payments for continuation coverage:
After you make your first payment for continuation coverage, you will be required to make monthly payments for each subsequent coverage period. The amount due for each month for each individual is shown in this notice. The monthly payments for continuation coverage are due on the first day of the month for which coverage is provided. If you make a monthly payment on or before the first day of the coverage period to which it applies, your coverage will continue for that coverage period without any break. As a courtesy, Multnomah County will send one payment schedule to you after your completed COBRA Election Form is received. You will not receive any additional notice of payments due (that is, we will not send a bill to you for your COBRA continuation coverage - it is your responsibility to pay your premiums on time.)

Pre-payment of monthly premium:
For your convenience, you may pre-pay for any month by submitting payments before they are due (for instance, you could submit a payment for October and November coverage by paying with one check in the amount equal to two months' premium on or before October 1st.) If you choose to pre-pay your payments are non-refundable. Your coverage periods will not be changed after payments are processed and eligibility has been submitted to the insurance carrier.

Grace periods for premium payments:
Although monthly payments are due on the first day of each month of coverage, you will be given a grace period of 30 days after the first day of the month to make each monthly payment. Your COBRA continuation coverage will be provided for each month as long as payment for that month is made before the end of the grace period for that monthly payment.

However, if you pay a monthly payment later than the first day of the month to which it applies, but before the end of the grace period for the month, your COBRA continuation coverage will be suspended as of the first day of the coverage period and then retroactively reinstated during the next regularly scheduled eligibility transmission to the insurance carrier (going back to the first day of the coverage period) when the monthly payment is received. This means that any claim you submit for benefits 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 monthly payment before the end of the grace period for that month, you will lose all rights to COBRA continuation coverage.


EFT Information

EFT processing cycle:
Multnomah County processes the EFT accounts on the last business day of the month for the coming month's premium. For example, on March 31 Multnomah County will process EFTs for April premium. Usually this activity is reported on your bank statement on the business day after the EFT has been processed. For example, the EFT we withdraw on March 31 will be reported on your bank statement as an April 1 activity. Once your premium has been deducted by EFT it is NON-REFUNDABLE.

Insufficient funds:
In the event your bank account does not have sufficient funds to pay an EFT which results in non-payment or short payment of the required monthly premium by the due date, COBRA health plan coverage will be suspended, retroactive to the end of the month the last full premium was paid, until the full monthly premium is paid within the designated grace period. If payment is made within the grace period, coverage will be reinstated and vendors will be notified of the reinstatement at the next regular eligibility reporting cycle. If payment is not made within the grace period, coverage will terminate retroactive to the last fully paid month and there will be no option to restart COBRA coverage.

Unreported change to banking information:
It is your responsibility to keep Multnomah County informed of any change to your banking information. You must report such changes to Multnomah County in writing. In the event unreported changes to your banking information results in non-payment or short payment of the required monthly premium by the due date, COBRA health plan coverage will be suspended, retroactive to the end of the month the last full premium was paid, until the full monthly premium is paid within the designated grace period. If payment is made within the grace period, coverage will be reinstated and vendors will be notified of the reinstatement at the next regular eligibility reporting cycle. If payment is not made within the grace period, coverage will terminate retroactive to the last fully paid month and there will be no option to restart COBRA coverage.

Failed EFT:
It will be the member's responsibility to remit premium payment to the County by check or money order within the COBRA premium payment grace period. You can mail or hand-deliver your payment to Multnomah County at the address listed at the end of this notice. Repeated failure of the EFT process may result in our refusal to use the EFT process for that participant.

EFT service fee:
Any situation resulting in failure to fund the full monthly COBRA premium amount, such as insufficient funds in the account or unreported banking changes, which prevent EFT, will result in a $25.00 service fee from the County to the COBRA participant. This fee is payable to the County in addition to the required premium. Banking service fees charged to your account by your own bank are also your financial responsibility.

Authorized Agreement:
Your signature on the Authorized Agreement for Electronic Fund Transfer means you:

1) Have authorized Multnomah County to automatically withdraw funds from your checking or savings account at your designated financial institution for the purpose of paying your monthly COBRA health insurance premium (medical and/or dental coverage).

2) Understand it is your responsibility to keep this financial information current in County records. You are responsible for immediately notifying Multnomah County of any change in your account information or financial institution.

3.) Understand failure to provide and maintain current banking account information and/or financial institution information to the County may result in non-payment of COBRA health insurance premium resulting in immediate suspension of your COBRA health plan coverage and may eventually result in termination of your COBRA continuation coverage.

3) Understand if the County is required to initiate a collection process, you will be required to pay the County a service fee for the processing costs. You may also incur service fees from your own banking institution which are also your responsibility.

4) Authorize Multnomah County to initiate a change to the monthly health insurance premium withdrawal if the cost of COBRA health insurance premiums change.

Your authorization remains in force until you provide Multnomah County with written notification to change the information or terminate the EFT process. Written notification of change needs to be provided to the County in a timely manner and cannot be implemented retroactively.

Future premium increases:
Premiums generally increase each year, usually on January 1 following open enrollment. Your new premium amount will automatically be deducted from your account after any requested open enrollment changes have been processed. You will be notified by mail in advance of any premium increases. You may contact our office at any time to verify the amount of your premium, due dates, grace periods and any other applicable information.