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Your Rights to Coverage

Federal (COBRA) and Oregon state law grant you and your covered dependents the right to continue your coverage when you would otherwise lose your group health coverage. You may purchase the same medical coverage (and in some cases the dental and vision coverage) you had before the qualifying event that resulted in the loss of your coverage. The type of continuation coverage you qualify for is partially based on how many people were employed by your employer during the previous year.

Who Qualifies for Continuation Coverage?

When you lose your group health coverage, you should contact your employer to find out what type of continuation coverage is available to you. The type of continuation coverage you qualify for is strongly associated with the size of the employer that offers your group health insurance coverage. It is your employer’s responsibility to correctly calculate and report the number of employees to the required federal and state agencies. If you lose your group health coverage, you should receive a notice from your employer, plan administrator or insurer that explains your continuation coverage rights, election options and premium payments.

Current Coverage Information

The plan documents describing your benefits while you are on continuation coverage are the same documents referenced while you were a covered employee, spouse or dependent. Current members with continuation coverage may log in to My Health Plan to access this information.

Member Forms

If you have rights to COBRA or state continuation coverage under ORS 743.600, ask your employer or plan administrator for the forms you need to provide them information. The following forms should be used only if you have rights to state continuation under ORS 743.610. Use these forms to provide information to Samaritan Health Plans:

Address Notification: Report a change of address for yourself or any covered dependent that receives mail at an address different from yours. If you are a current employee, please remember to also update your information with your employer.

State Continuation Coverage Election: After you have received an election notice, use this form to elect continuation coverage for yourself or your dependents.

State Continuation Report (C610): It is your responsibility to report certain events that occur while you or your dependents are on continuation coverage. You must report if you or any dependents become eligible for other group health coverage, including Medicare. You must also report the birth of a newborn or addition of an adopted child to your family if you want to add them to your coverage. This form can also be used to drop continuation coverage. Complete this form and follow the instructions to provide the required information and documentation to Samaritan Health Plans.

Member Grievances and Appeals Process: This document describes how to file a grievance and/or appeal.

Appeal Request: Use this form if you intend to appeal a benefit coverage decision made by Samaritan Health Plans.

Continuation Coverage Frequently Asked Questions