What is COBRA Coverage?
COBRA is a federal law that requires the County to offer employees and their families the opportunity to purchase continuing health care coverage when you lose medical/dental or MERP coverage.
Following a loss of your MERP coverage, a COBRA Specific Rights Notice with pricing and enrollment information will be mailed to your home address.
How can you elect MERP COBRA?
To elect MERP COBRA, you must complete the Election Form according to the directions on the form and return it to PacificSource Administrators by the date specified on the form. Failure to do so will result in loss of the right to elect COBRA coverage under the Plan.
COBRA coverage under MERP is offered only to certain qualified beneficiaries and is available only for a limited period. COBRA coverage will consist of MERP coverage in force at the time of the qualifying event (i.e., the elected annual limit reduced by expenses reimbursed up to the time of the qualifying event.) All qualified beneficiaries who were covered under MERP will be covered together for MERP COBRA coverage.
Additional information about MERP is available in the Plan's summary plan description. If you do not have a copy of the summary plan description, you may obtain one from Multnomah County.
How long does MERP COBRA coverage last?
MERP COBRA coverage under the Plan component can last only until the end of the Plan year in which the qualifying event occurred. The period of MERP COBRA coverage under the Plan cannot be extended under any circumstances.
The MERP carryover provision applies to COBRA MERP participants who are receiving coverage at the end of the plan year. However, the carryover provision would not last beyond the end of the 18-month or other applicable maximum COBRA coverage period. For 2023, if you elect MERP COBRA coverage, up to $610 in unused funds will automatically be carried over at the end of the year to 2024. Unused funds in excess of the $610 rollover limit will be forfeited.
Your notice shows the maximum period of MERP COBRA coverage available to the Qualified Beneficiaries. MERP COBRA coverage will automatically terminate before the end of the maximum period if any required premium is not paid in full on time.
How much does MERP COBRA coverage cost?
The entire cost of MERP COBRA coverage is required to be paid unless the Election Form states otherwise. The amount a COBRA participant may be required to pay may not exceed 102% of the cost the plan participant was previously paying during active MERP participation. The required monthly payment for MERP COBRA is described on the first page of your Election Form.
When and how must payment for MERP COBRA coverage be made?
All MERP COBRA premiums must be paid monthly. Payment options will be outlined in your COBRA Specific Rights Notice.
If you elect MERP COBRA, you do not have to send any payment with the Election Form. However, you must make your first payment no later than 45 days after the date of your election. (This is the date your Election Form is postmarked.) If you do not make your first payment for MERP COBRA coverage in full within 45 days after the date of your election, you will lose all COBRA rights under the Plan. You are responsible for making sure that the amount of your first payment is correct. Claims for reimbursement will not be processed and paid until you have elected MERP COBRA and your first payment has been received and processed.
After you make your first payment for MERP COBRA coverage, you will be required to make payments for each subsequent monthly period of MERP COBRA coverage. The amount due for each monthly period is shown on your Election Form. Under the Plan, each of these monthly payments for MERP COBRA coverage is due on the first day of the month for that month's MERP COBRA coverage. If your payment is late but is received before the end of the grace period, your participation will be retroactively reinstated (going back to the first day of the period) once the payment is received and processed. As a courtesy, PacificSource Administrators will send one payment schedule to you after your Election Form is received. You will not receive any additional notice of payments due for these coverage periods (that is, we will not send a bill to you for your MERP COBRA coverage - it is your responsibility to pay your MERP COBRA premiums on time.)
* Grace periods for monthly payments
Although payments are due on the first of the month for MERP COBRA coverage, you will be given a grace period of 30 days after the first day of the period to make each payment. Your MERP COBRA coverage will be provided for each period as long as payment is made before the end of the grace period. If you fail to make a payment before the end of the grace period, you will lose all rights to MERP COBRA coverage under the Plan.
See your COBRA Specific Rights Notice for payment options.
If mailed, your payment is considered to have been made on the date that it is postmarked. You will not be considered to have made any payment if your check is returned due to insufficient funds or otherwise.
For more information
This page does not fully describe COBRA coverage or other rights under the Plan. More information about COBRA coverage and your rights under the Plan is available in your summary plan description or from Multnomah County.
If you have questions concerning this information, or your rights to coverage, you should contact:
PacificSource Administrators at (877)355-2760.
State and local government employees seeking more information about rights under 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 you and your family's rights, you should keep PacificSource Administrators informed of any changes in your address. You should also keep a copy, for your records, of any notices you send to PacificSource Administrators.