by Scott Herson-Hord, on Dec 22, 2023 10:11:35 AM
Federal COBRA requirements state that all covered private-sector employers must maintain group healthcare coverage for employees who would otherwise lose coverage due to a qualifying event. However, Federal COBRA only covers private-sector employers with 20 or more employees. In Oregon, employers who are not covered under Federal COBRA law may still be covered under Oregon mini-COBRA law. The following article covers the employer requirements under Oregon mini-COBRA.
Oregon COBRA Overview
While Federal COBRA requirements cover all private-sector employers in Oregon with 20 or more employees, the remainder of private-sector employers in the state are covered under Oregon mini-COBRA requirements.
Under Oregon COBRA, otherwise referred to as Oregon mini-COBRA or State Continuation, small employers with fewer than 20 employees must offer employees the ability to elect continuation coverage for up to 9 months when coverage under the employer's group health plan would otherwise be lost due to certain specified events. Continuation of coverages extends to eligible spouses and dependents of employees as well.
Important to note is that an employee does not have to continue coverage for other family members to use state continuation for themselves.
Oregon COBRA Eligibility Requirements
In order for an employee to qualify for continuation of coverage under Oregon COBRA law, an employee must have had continuous health coverage for at least three months prior to the date that coverage ends. This includes the employee’s spouse and children.
Continuous health coverage does not necessarily need to be with the same employer.
Once an employee is determined to qualify for Oregon state continuation coverage, and is working for an Oregon COBRA-qualified employer, they must also experience a qualifying life event in order to receive continuation benefits.
Oregon COBRA Qualifying Events
Qualified employees working for qualified employers must experience one of the following events in order to take advantage of Oregon State Continuation coverage:
- A family member or employee loses his or her job
- A family member maintains employment but loses health coverage due to a cutback in hours
- The family member who is insured through work becomes eligible for Medicare and no longer has group coverage but other members of the family still need insurance
- The family member with coverage dies and a spouse and / or children need insurance
- The family member with coverage divorces a spouse and the spouse and / or children need insurance
How to Apply for Oregon COBRA Coverage
Employers are required to notify the insurer when an employee is no longer eligible for coverage under the employer’s plan and thus eligible for Oregon COBRA coverage. Once notified, the insurer has 10 days to notify the employee of their eligibility.
Employees who decide they’d like to continue coverage must notify the insurer in writing either within 10 days of the date of eligibility or within 10 days of being notified of eligibility by the insurer, whichever allows for the most time.
It’s recommended that employees contact the insurer as soon as they become eligible for state continuation in the event the employer’s notification isn’t sent to the insurer right away.
Who Pays for Oregon COBRA?
Employees are required to pay the full price of the state continuation coverage and most small employer group policies require employees to pay the premiums for state continuation insurance directly to their employers.
However, an employer should be able to communicate the cost of the insurance, the date by which an employee's payment is due, and how payment must be provided.
Get Help with Oregon COBRA and mini-COBRA Law
While employers with questions regarding the continuation of coverage laws can check the Oregon COBRA FAQ, true help is best attained by contacting an Oregon Payroll and HR company with an established Oregon Insurance Partner Network.
Let us help you get connected with a provider, today.
Guest Author: Scott Herson-Hord
Scott Herson-Hord is the CEO of Great Northern Staff Administrators (GNSA), an Oregon payroll services company that specializes in serving small to mid-size businesses with administrative solutions to streamline back-office processes from benefits to human resources. Starting his career in finance and working more than 10 years as a controller for various companies, Scott leveraged this experience over the next 22 years with GNSA to become one of the pacific northwest’s foremost experts in human capital management (HCM).
