What is COBRA continuation 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. 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 dependent children of the covered employee. (Certain newborns, newly adopted children and alternate recipients under Qualified Medical Child Support Orders may also be qualified beneficiaries.)
COBRA continuation coverage is the same coverage that the County provides to other participants or beneficiaries under the health plan who are not receiving COBRA continuation coverage. Each Qualified Beneficiary who elects continuation coverage will have the same rights under the health plan as other participants or beneficiaries covered under the health plan including open enrollment and special enrollment rights.
The description of COBRA continuation coverage on this page applies only to the group health benefits under the plan and not to any other benefits offered by Multnomah County. Nothing herein is intended to expand your rights beyond COBRA's requirements.
Although Multnomah County will allow domestic partners to purchase COBRA-like continuation coverage, they do not meet the requirements of a Qualified Beneficiary and do not have all the rights explained herein available to them. For more information, please contact the Multnomah County Employee Benefits Office.
How can you elect COBRA continuation coverage?
To elect COBRA continuation coverage, you must complete a COBRA Election Form and furnish it according to the directions on the form. Each listed individual has a separate right to elect continuation coverage. For example, the employee's spouse may elect continuation coverage even if the employee does not. Continuation coverage may be elected for only one, several, or for all dependent children who are Qualified Beneficiaries. A parent may elect to continue coverage on behalf of any dependent children. The employee or the employee's spouse (if the spouse is a Qualified Beneficiary) can elect continuation coverage on behalf of all of the Qualified Beneficiaries.
You may elect COBRA coverage for any one or more of the plans under which you were covered on the day before the Qualifying Event. For example, if you had the option to choose medical and/or dental coverage, you will have the option to continue any of the plans that you were covered under on the day before the Qualifying Event. If the health plan you are enrolled in at the time of your Qualifying Event is regionally specific (such as a managed care plan) and you move outside the service area, you may elect coverage under another health plan offered by Multnomah County if it is available in the area you have moved to. This also applies if you move after electing COBRA coverage. It is your responsibility to inform PacificSource Administrators (our COBRA administrator) of your move.
Additional information about the benefits available under the plan is available in the plan's summary plan description (benefit booklet.) If you do not have a copy of the summary plan description, you may obtain one by contacting Multnomah County or by visiting the health care plans page.
Qualified Beneficiaries who are entitled to elect COBRA may do so even if they have other group health plan coverage or are entitled to Medicare benefits on or before the date on which COBRA is elected. However, as discussed in more detail below, a Qualified Beneficiary's COBRA coverage will terminate if, after electing COBRA, they become entitled to Medicare benefits or become covered under other group health plan coverage.
Special considerations in deciding whether to elect COBRA continuation coverage
In considering whether to elect continuation coverage, you should take into account that a failure to continue your group health coverage will affect your future rights under Federal Law. You should take into account that you have special enrollment rights under Federal Law. You have the right to request special enrollment in another group health plan for which you are otherwise eligible (such as a plan sponsored by your spouse's employer) within 30 days after your group health coverage ends because of a Qualifying Event. You will also have the same special enrollment right at the end of continuation coverage if you purchase continuation coverage for the maximum time available to you.
How long will COBRA continuation coverage last?
When loss of coverage is due to end of employment or a reduction in hours of employment, coverage generally may be continued for up to a total of 18 months. When loss of coverage is due to an employee's death, divorce or legal separation, the employee's becoming entitled to Medicare benefits, or a dependent child ceasing to be a dependent under the terms of the plan, coverage may be continued for up to a total of 36 months. When the Qualifying Event is the end of employment or reduction of the employee's hours of employment, and the employee became entitled to Medicare benefits less than 18 months before the Qualifying Event, COBRA continuation coverage for the Qualified Beneficiaries other than the employee lasts until 36 months after the date of Medicare entitlement. Your notice will show the maximum period of continuation coverage available to the individuals listed on your Election Form.
Continuation coverage will be terminated before the end of the maximum period if:
- any required premium is not paid in full on time; or
- a Qualified Beneficiary becomes covered, after electing continuation coverage, under another group health plan; or
- a covered employee becomes entitled to Medicare benefits (under Part A, Part B, or both) after electing continuation coverage; or
- the employer ceases to provide any group health plan for its employees.
Continuation coverage may also be terminated for any reason the plan would terminate coverage of a participant or beneficiary not receiving continuation coverage (such as fraud).
You must notify PacificSource Administrators in writing within 30 days if, after electing COBRA, a qualified beneficiary becomes entitled to Medicare (Part A, Part B, or both) or becomes covered under other group health plan coverage. You must follow the notice procedures specified.
How can you extend the length of COBRA continuation coverage?
If you elect continuation coverage, an extension of the maximum period of coverage may be available if a Qualified Beneficiary is disabled or a second Qualifying Event occurs. You must notify PacificSource Administrators of a disability or a second Qualifying Event in order to extend the period of continuation coverage. Failure to provide notice of a disability or second Qualifying Event may affect the right to extend the period of continuation coverage.
Disability
If any of the Qualified Beneficiaries is determined by the Social Security Administration (SSA) to be disabled, the maximum COBRA coverage period that results from a covered employee's termination of employment or reduction of hours (generally 18 months, as described above) may be extended to a total of up to 29 months. The disability has to have started at some time before the 61st day of COBRA continuation coverage and must last at least until the end of the 18-month period of continuation coverage. Each Qualified Beneficiary who has elected continuation coverage will be entitled to the 11-month disability extension if one of them qualifies.
The disability extension is available only if you notify PacificSource Administrators in writing of the SSA's determination of disability within 60 days after the latest of:
- the date of the SSA's disability determination;
- the date of the covered employee's termination of employment or reduction of hours; and
- the date on which the qualified beneficiary loses (or would lose) coverage under the terms of the plan as a result of the covered employee's termination or reduction of hours.
If the Qualified Beneficiary is determined to no longer be disabled by the SSA, you must notify PacificSource Administrators of that fact within 30 days after the SSA determination. You must follow the notice procedures specified.
Second Qualifying Event
An 18-month extension of coverage will be available to spouses and dependent children who elect continuation coverage if a second Qualifying Event occurs during the first 18 months of continuation coverage due to original Qualifying Event of employment loss. The maximum combined coverage period for continuation coverage available when a second Qualifying Event occurs is 36 months. Such second Qualifying Events may include the death of a covered employee, divorce or legal separation from the covered employee, the covered employee's becoming entitled to Medicare benefits (under Part A, Part B, or both), or a dependent child's ceasing to be eligible for coverage as a dependent under the Plan. These events can be a second Qualifying Event only if they would have caused the Qualified Beneficiary to lose coverage under the Plan if the first Qualifying Event had not occurred. (For example, Mark Smith terminated employment on January 14, 2024 and COBRA coverage for his spouse, Julie, and himself began on February 1, 2024. Coverage could last for up to 18 months - until July 31, 2025. However, on March 6, 2024, Mark and Julie divorced. Julie is now eligible for up to 36 months of COBRA coverage, measured from the date of the original COBRA event. Julie's COBRA coverage could last until January 31, 2027, Mark's COBRA coverage could last until July 31, 2025.) You must notify the Plan within 60 days after a second qualifying event occurs if you want to extend your COBRA continuation coverage by following the notice procedures specified.
How much does COBRA continuation coverage cost?
Generally, each Qualified Beneficiary may be required to pay the entire cost of continuation coverage unless the COBRA Election Form states otherwise. The amount a Qualified Beneficiary may be required to pay may not exceed 102% (or, in the case of an extension of continuation coverage due to a disability, 150%) of the cost to the group health plan (including both employer and employee contributions) for coverage of a similarly situated plan participant or beneficiary who is not receiving continuation coverage. The required payment for each continuation coverage period for each option will be described in your notice.
Continuation of Coverage for Spouses Age 55 or Older:
Under Oregon law (ORS 743.600-743.602), if you are the legal spouse or state registered same sex domestic partner (age 55 or older) of an employee and your eligibility for group health plan coverage has ended due to legal separation, termination of marriage, termination of domestic partnership or the employee's death, you may be entitled to continue your plan coverage (including coverage for dependent children) until one of the following events occur:
- the date you become covered under any other group health plan;
- the date you become eligible for federal Medicare coverage, regardless if you enroll in Medicare;
- the last day of the month that premiums were paid to Multnomah County in the event of non-payment of premiums;
- the date the plan terminates or the date Multnomah County terminates participation under this plan;
- a dependent child may remain on the plan with you until they no longer meet the plan's definition of a dependent child.
Oregon continued coverage is available only if you (spouse or state registered same sex domestic partner age 55 or older) notify PacificSource Administrators in writing of the legal separation, termination of marriage, termination of domestic partnership, or the death of your spouse/domestic partner within:
- thirty days of the date of the member's death;
- sixty days of the date of legal separation; or
- sixty days of the date your divorce or dissolution of domestic partnership becomes final.
For more information
This information does not fully describe COBRA continuation coverage or other rights which may be available to you. If you have any questions concerning your rights to coverage, you should contact:
Multnomah County Employee Benefits Office
501 SE Hawthorne Blvd, Suite 320
Portland, OR 97214
503-988-3477
Employee.Benefits@multco.us
State and local government employees seeking more information about rights under Public Health Service Act (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 your and your family's rights, you should keep PacificSource Administrators informed of any changes in your address and the addresses of family members. You should also keep a copy, for your records, of any notices you send to PacificSource Administrators.