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This document is used to elect Oregon state continuation coverage for health insurance and to attest eligibility for the American Recovery and Reinvestment Act (ARRA) premium subsidy.
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How to fill out state continuation election premium
How to fill out State Continuation Election / Premium Subsidy Attestation
01
Obtain the State Continuation Election / Premium Subsidy Attestation form from your state’s insurance department or your employer.
02
Fill in your personal information, including your name, address, and policy number.
03
Indicate the qualifying event that allows you to apply for continuation coverage.
04
Provide documentation required to support your claim for premium subsidy if applicable.
05
Sign and date the form to certify the information is accurate.
06
Submit the completed form to your insurance provider or appropriate state agency by the specified deadline.
Who needs State Continuation Election / Premium Subsidy Attestation?
01
Individuals who have lost their health insurance due to certain qualifying events, such as job loss or reduction in hours.
02
Employees of companies that offer group health insurance plans and are eligible for state continuation coverage.
03
Dependents of individuals who are covered under group health plans and are seeking coverage after losing eligibility.
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What is State Continuation Election / Premium Subsidy Attestation?
State Continuation Election / Premium Subsidy Attestation refers to the process that allows certain eligible individuals to continue their health insurance coverage under state law, often at subsidized rates, following a qualifying event such as job loss or reduction in hours.
Who is required to file State Continuation Election / Premium Subsidy Attestation?
Individuals who have experienced a qualifying event that impacts their health insurance coverage and wish to continue their coverage under state law must file the State Continuation Election / Premium Subsidy Attestation.
How to fill out State Continuation Election / Premium Subsidy Attestation?
To fill out the State Continuation Election / Premium Subsidy Attestation, individuals should complete the provided form with accurate personal information, details of their qualifying event, and any required documentation. Instructions are typically included with the form to guide the process.
What is the purpose of State Continuation Election / Premium Subsidy Attestation?
The purpose of the State Continuation Election / Premium Subsidy Attestation is to ensure individuals have the opportunity to maintain their health insurance coverage after a qualifying event, making it more affordable through premium subsidies provided by the state.
What information must be reported on State Continuation Election / Premium Subsidy Attestation?
The information that must be reported includes personal identification details, the date of the qualifying event, the type of health coverage the individual wishes to continue, and any necessary supporting documents that validate eligibility for continuation.
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