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COBRA/continuation administration

The COBRA/Continuation administration is included for fully insured medical groups with less than 100 covered employees, provided that the group is eligible for COBRA.

COBRA
Employers are subject to federal COBRA law if they employed 20 or more employees during at least 50 percent of their typical business days during the preceding calendar year. Employers are required to offer COBRA to employees and their eligible dependents when they lose coverage due to certain qualifying events, which may include the following:

Termination of employment
Death of the employee
Loss of coverage because of retirement
Medicare entitlement
Reduction in the employee’s work hours
Divorce or legal separation
A child’s loss of dependent status

Continuation
If employers are not subject to COBRA, they are subject to Oregon continuation laws. Qualifying events may include the following:

Termination of employment
Divorce or annulment
A covered dependent spouse’s or child’s loss of coverage because of the employee's death

Portability
If an ODS members’ coverage terminated under a group medical benefit plan, they may be eligible to enroll in an ODS Portability Plan. The subscriber and all dependents may obtain coverage under the ODS Portability Plan provided that the dependents were covered as dependents under the prior plan. Dependents include dependent children and spouse or same-sex domestic partner who qualifies pursuant to the Oregon Family Fairness Act.

BenefitHelp Solutions for administration

With so many intricate policies, guidelines and regulations, benefits administration is best left to the experts. BenefitHelp Solutions, an ODS subsidiary, offers several third-party administrative products to make benefit administration easy. Contact a BenefitHelp Solutions marketing representative for a proposal or visit the website for more information.

Learn more about these BenefitHelp Solutions services: