Oregon's continuation requirements apply to grandfathered health plans providing coverage under a group health insurance policy for hospital or medical expenses (other than coverage limited to expenses from accidents or specific diseases) (ORS Sec. 743B.347). The requirements also cover group health insurance policies that provide coverage for one or more of the essential health benefits.
Employees who have been covered under a group policy for at least 3 months and were covered on the day before a qualifying event are covered by the continuation requirements. Continuation of coverage is not available to employees or qualified beneficiaries who are eligible for Medicare or the same coverage under any other program that was not covering them on the day before a qualifying event.
Qualifying events include the loss of membership in a group health insurance policy caused by:
• Voluntary or involuntary termination of employment;
• A reduction in hours;
• A covered person becoming eligible for Medicare;
• A qualified beneficiary losing dependent child status under a covered person’s group health insurance policy;
• Termination of membership in the group covered by the group health insurance policy; or
• The death of a covered person.
Oregon’s continuation coverage requirements apply only to employers that are not required to make continuation benefits available under federal COBRA.