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 a Moda Health members’ coverage terminated under a group medical benefit plan, they may be eligible to enroll in a Moda Health Portability Plan. The subscriber and all dependents may obtain coverage under the Moda Health 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, a Moda Health 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:
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