Job loss and health insurance coverage

Updated March 26, 2020 | Page 1 of 3

Due to the coronavirus (COVID-19) crisis, many Oregon workers are experiencing lay-offs,

drastically reduced hours, and uncertainty in their jobs. For those with employer-based health

insurance, this can mean the loss of access to health care when it’s most vital..

Six ways workers with employer-based insurance can

maintain coverage after a layoff or reduction in hours

1. A worker who loses employer-based coverage is eligible for COBRA.

COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) is a federal law that

requires businesses of 20 or more employees to continue any health benefit coverage for

individuals and their families who would otherwise lose their benefits due to termination of

employment, reduction in hours, or certain other events.

• Details: With COBRA, the employee’s family can continue on the same employer-based

health insurance for up to 18 months, but the employee must pay the entire cost of the

premium. A business must contact the employee with information about COBRA

coverage, and then the employee has 60 days to decide on purchasing the COBRA

coverage. COBRA is only available if an employer is still offering coverage to its existing

employees and would not be available if the employer canceled coverage for all

employees entirely.

• Learn more: COBRA coverage on HealthCare.gov

2. The employee and their family members may be eligible for free coverage

through the Oregon Health Plan, our state’s Medicaid program

The Oregon Health Plan providers physical, dental, and mental health care for households with

lower incomes. You can apply for OHP at any time. Enrollment is always open.

• Details: You can have OHP even if you still have a job. Eligibility is based on current

monthly income and varies by household size and other circumstances. Household

income is calculated from all taxable income sources, including any unemployment

insurance benefits. See the table below for income examples.

Individual

Percentage of Federal

Poverty Level (FPL)

Monthly income examples

Adults

Up to 138%

$1,468 a month for a single person or

$3,013 for a family of four

Pregnant adults

Up to 190%

$2,730 for a single pregnant adult or

$4,149 for a family of four

Children and teens

Up to 305%

$4,382 for a family of two or $6,660

for a family of four.

• Learn more: OHP.Oregon.gov.

Updated March 26, 2020 | Page 2 of 3

3. After a loss of employer-based coverage, a person can purchase insurance on

the Oregon Health Insurance Marketplace

The loss of employer-sponsored health coverage (e.g., from a job loss) triggers a special

enrollment period that allows someone get a private health plan and a subsidy through the

Oregon Health Insurance Marketplace and HealthCare.gov. The person has up to 60 days after

the date the coverage is lost to get a health plan at HealthCare.gov. People who sign up prior to

losing their employer-based coverage can secure Marketplace coverage that begins the next

month and avoid a gap in coverage.

• Details: People may be eligible for federal subsidies for insurance purchased on the

Marketplace if their expected household income for 2020 is less than four times the

federal poverty level. This is about $50,0000 a year for a single person or about

$103,000 a year for a family of four. In many cases the children in these families are

eligible for coverage through the Oregon Health Plan. Open enrollment for anyone to

purchase insurance on the Marketplace is usually in November-December.

• Learn more: Oregon Health Insurance Marketplace

4. A worker over 65 and some blind and disabled people younger than 65 can

enroll in Medicare

Medicare is for U.S. citizens 65 and older who meet residency requirements and some disabled

people younger than 65.

• Details: Workers over 65 years who lose their employer-based insurance can enroll in

Medicare immediately with no penalty.

• Learn more: Medicare.gov. The Oregon Senior Health Insurance Benefits Assistance

(SHIBA) program provides free Medicare information and enrollment assistance at

SHIBA.Oregon.gov or call 800-722-4134.

5. The business decides to continue paying for employer-based coverage

Some employers may continue to offer health insurance for employees whose work hours have

been reduced, although in many cases part-time workers may have different coverage options

and could face different cost-sharing for their coverage.

• Details: For employees who remain on their same coverage, their health insurance

would continue with the same rules on deductibles and copays as before; however,

some employees may have to pay additional monthly premiums. A reduction in income

and an increase in monthly premiums may make some people eligible for federal

subsidies for individual insurance coverage through the Marketplace. People can check

their eligibility by going to HealthCare.gov.

• Learn more: Workers should check with their employers.

6. Accessing coverage through a spouse’s employer-based insurance

People who lose their employer-based coverage may be able to obtain coverage through their

spouse’s or domestic partner’s employer-based coverage.

Updated March 26, 2020 | Page 3 of 3

• Details: Employee paid premiums and other cost-sharing will vary, depending on the

rules of the partner’s employer.

• Learn more: The worker’s spouse or partner should check with their employer.

Additional resources

Health insurance for small business owners, contractors, and others who have

purchased their own individual insurance plans at HealthCare.gov

People who have purchased Marketplace insurance at HealthCare.gov may receive additional

federal subsidies as their income declines. The actual subsidy is calculated based on annual

income. People can update their income information on HealthCare.gov to be sure they receive

the correct amount of subsidies.

COVID-19 information and resources:

• COVID-19 Updates in Oregon (Oregon Health Authority)

• National COVID-19 Information (Centers for Disease Control and Prevention)

• Food assistance programs in Oregon:

o Women, Infants and Children (WIC)

o Supplemental Nutrition and Assistance Program (SNAP)

For general information on COVID-19, call 211. If you are having an emergency, call 911.