Or. Admin. Code § 101-030-0010

Current through Register Vol. 63, No. 11, November 1, 2024

Section 101-030-0010 - Continuation of Group Health Benefit Coverage for Injured Workers (CBIW)

(1) The state is required by ORS 659A.060-069 to continue to pay the benefit amount for PEBB health benefit coverage in effect at the time an eligible employee has a work-related injury or illness. The benefit amount may continue for up to 12 consecutive months or until one of the events listed in ORS 659A.063 occurs, whichever occurs first. Health benefit coverage for this purpose includes the medical, dental, vision, and prescription drug coverage of the employee, family members, and domestic partner.

(2) An eligible employee may continue coverage for life, accidental death and dismemberment and Long Term Care insurance plans for up to 12 months if they self-pay the premiums to the agency.

(3) Refer to OAR 101-020-0002(7)(d) for employee premium payment requirements.

(4) When an employee returns to work within 12 months, they will have their previous enrollment for medical, dental, life, and disability insurance reinstated the first of the month following their return to work. The employee may make midyear plan changes within 30 days of the date they return to work.

(5) An employee returning to work will not be reinstated in any pretax Flexible Spending Accounts, or PEBB Commuter Accounts. They may reenroll within 30 days of the date they return to work.

(6) A previously benefit eligible employee returning to paid regular status immediately following CBIW is not required to work at least half-time in the month they return to be eligible for benefits the following month.

(7) A COBRA qualifying event occurs at the end of the CBIW continuation period, or when the current benefit eligible stability period ends the allowable benefit period, if the employee has not returned to paid regular status.

Or. Admin. Code § 101-030-0010

PEBB 1-1999, f. 12-8-99, cert. ef. 1-1-00; PEBB 1-2004, f. & cert. ef. 7-2-04, PEBB 3-2004, f. & cert. ef. 10-7-04; PEBB 2-2007, f. 9-28-07, cert. ef. 10-1-07; PEBB 7-2010, f. 12-10-10, cert. ef. 1-1-11; PEBB 1-2015, f. & cert. ef. 5/12/2015; PEBB 2-2017, f. & cert. ef. 8/17/2017

Stat. Auth.: ORS 243.061 - 302 & 659A.060 - 069

Stats. Implemented: ORS 243.061 - 302 & 659A.060 - 069