COBRA

What is COBRA?

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives employees and their families who lose their PEBB health benefits the right to choose to continue group health benefits provided by PEBB for limited periods of time. PEBB members who lose coverage are allowed to enroll in any PEBB Core benefits (medical, dental, vision) and may continue health care flexible spending. Members who lose coverage will have information sent to them in the mail by BenefitHelp Solutions (BHS), who is PEBB’s third-party administrator for COBRA. This will include an enrollment form, premium costs, and information about how to submit payment for benefits to BHS.

Electing COBRA

If the employee or a qualified dependent loses coverage, they will have an independent right to elect COBRA. Covered members may elect COBRA on behalf of all the qualified beneficiaries, and parents may elect COBRA on behalf of their children. Any qualified beneficiary for whom COBRA is not elected within the 60-day election period specified may lose their right to elect COBRA.

How Long Does COBRA Coverage Last?

COBRA coverage is a temporary continuation of coverage that generally lasts for 18 months due to employment termination or reduction of hours of work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit a beneficiary to receive up to a maximum of 36 months of coverage under the Plan’s Medical, Dental, and Vision components. These “36-month” qualifying events include the death of the employee, the covered employee’s divorce or a dependent child’s losing eligibility as a dependent child.

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 coverage under the Plan’s Medical, Dental and Vision components for qualified beneficiaries (other than the employee) who lose coverage as a result of the qualifying event can last until up to 36 months after the date of Medicare entitlement. For example, if a covered employee becomes entitled to Medicare 8 months before the date on which his employment terminates, COBRA coverage for his spouse and children who lost coverage as a result of his termination can last up to 36 months after the date of Medicare entitlement, which is equal to 28 months after the date of the qualifying event (36 months minus 8 months). This COBRA coverage period is available only if the covered employee becomes entitled to Medicare within 18 months before the termination or reduction of hours.

Otherwise, when the qualifying event is the end of employment or reduction of the employee’s hours of employment, COBRA coverage under the Plan’s Medical, Dental, and Vision components generally can last for only up to a total of 18 months.

COBRA coverage under the Health FSA component can last only until the end of the year in which the qualifying event occurred—see the paragraph below entitled “Health FSA Component.”

The COBRA coverage periods described above are maximum coverage periods. COBRA coverage can end before the end of the maximum coverage periods described in this notice for several reasons. Please check with the Third Party Administrator BenefitHelp Solutions (BHS) at
800-556-3137 or 503-765-3581.

Are There Other Coverage Options Besides COBRA Coverage?

Yes. In lieu of enrolling in COBRA coverage, there may be other coverage options for you and your family through the Health Insurance Marketplace, Medicaid, or other group health plan coverage State of Oregon Public Employees’ Benefit Board Summary Plan Description 92 | Page options (such as a spouse’s plan) through what is called a “special enrollment period.” Some of these options may cost less than COBRA coverage. You can learn more about many of these options at www.HealthCare.gov or by calling 1-800-318-2596. You can also visit www.OregonHealthCare.gov or call 1-855-268-3767 to find a local insurance agent to help you find the right plan for you or your family.

Information

• Current rates for medical, dental, and vision can be found on PEBB’s COBRA webpage.
• For detailed information, check out pages 87-92 of the PEBB Summary Plan Description.
• BenefitHelp Solutions (BHS) can be reached at 503-412-4257 or by email at BenefitHelpSolutionsCDHSupport@healthaccountservices.com.