(1) As used in subsections (1) to (6) of this section, “plan administrator” means:
(a) The person designated as the plan administrator by the instrument under which the group health insurance plan is operated; or
(b) If no plan administrator is designated, the plan sponsor.
(2) Within 60 days of legal separation or the entry of a judgment of dissolution of marriage, a legally separated or divorced spouse eligible for continued coverage under ORS 743.600 who seeks such coverage shall give the plan administrator written notice of the legal separation or dissolution. The notice shall include the mailing address of the legally separated or divorced spouse.
(3) Within 30 days of the death of a certificate holder whose surviving spouse is eligible for continued coverage under ORS 743.600, the group policyholder shall give the plan administrator written notice of the death and of the mailing address of the surviving spouse.
(4) Within 14 days of receipt of notice under subsection (2) or (3) of this section, the plan administrator shall notify the legally separated, divorced or surviving spouse that the policy may be continued. The notice shall be mailed to the mailing address provided to the plan administrator and shall include:
(a) A form for election to continue the coverage;
(b) A statement of the amount of periodic premiums to be charged for the continuation of coverage and of the method and place of payment; and
(c) Instructions for returning the election form by mail within 60 days after the date of mailing of the notice by the plan administrator.
(5) Failure of the legally separated, divorced or surviving spouse to exercise the election in accordance with subsection (4) of this section shall terminate the right to continuation of benefits.
(6) If a plan administrator fails to notify the legally separated, divorced or surviving spouse as required by subsection (4) of this section, premiums shall be waived from the date the notice was required until the date notice is received by the legally separated, divorced or surviving spouse.
(7) The provisions of ORS 743.600 to 743.602 apply only to employers with 20 or more employees and group health insurance plans with 20 or more certificate holders. [Formerly 743.852; 2003 c.576 §557]
Section: Previous 743.573 743.576 743.579 743.582 743.585 743.588 743.600 743.601 743.602 743.603 743.606 743.607 743.609 743.610 743.611 NextLast modified: August 7, 2008