Or. Admin. Code § 101-050-0010

Current through Register Vol. 63, No. 12, December 1, 2024

Section 101-050-0010 - Retiree Plan Enrollment and Termination

(1) An active employee meeting PEBB retiree eligibility may enroll themselves and other eligible individuals in PEBB retiree health plans.

(2) Retiree plan coverage must be continuous with active or COBRA PEBB plan enrollments. Employees that retire and receive PEBB plan coverage through another active employee may move to PEBB retiree coverage when the other employee coverage ends.

(3) An active employee meeting PEBB retiree eligibility must submit retiree enrollment forms within 30 days of the date the active employee insurance terminates. Enrollments submitted within this 30-day window are retroactive to the date of active coverage termination.

(4) A Retiree may elect any PEBB full time or part-time health plan. A Retiree may elect medical only, dental only, or medical and dental insurance coverage. If the retiree does not initially enroll in both medical and dental insurance plans, they may not add the other plan later.

(5) PEBB may offer a plan change period for retiree insurance plan participants. The plan change period allows the retiree to change benefit plans. The plan change period does not allow the retiree to add dependents or coverage not already in place.

(6) A retired eligible employee electing to continue PEBB health plans under COBRA can transfer to a PEBB retiree health plan at any time during or immediately following COBRA.

(7) A retired eligible employee and their eligible individuals must terminate from PEBB retiree plans when they:

(a) Fail to self-pay the premiums; or

(b) Fail to continue to meet PEBB eligibility; or

(c) Become Medicare eligible; or

(d) PEBB no longer offers retiree health plan coverage.

(8) Retiree plan coverage termination dates due to loss of eligibility:

(a) Coverage terminates the last day of the month before the month of Medicare eligibility.

Example: Joe becomes Medicare-eligible may 1st because his 65th birthday will be May 15th. Joe's retiree health coverage will terminate April 30th.

(b) Failure to meet PEBB eligibility requirements; e.g., a dependent ages out of coverage, coverage terminates the last day of the month that the eligibility is lost.

(8) Division 20 Enrollment Rules apply to retirees in the following situations:

(a) Midyear benefit plan changes such as those resulting in the addition of a family member, domestic partner, or domestic partner's dependent child to the retiree's insurance coverage. See OAR 101-020-0050.

(b) Removing an ineligible individual from the retiree's insurance coverage. See OAR 101-020-0025.

(c) Enrollment or processing errors. See OAR 101-020-0037.

Or. Admin. Code § 101-050-0010

PEBB 1-1999, f. 12-8-99, cert. ef. 1-1-00; PEBB 1-2000, f. 11-15-00, cert. ef. 1-1-01; PEBB 1-2001, f. & cert. ef. 9-6-01; PEBB 1-2002, f. 7-30-02, cert. ef. 8-1-02; PEBB 1-2003, f. & cert. ef. 12-4-03; 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 3-2010, f. 9-23-10, cert. ef. 10-1-10; PEBB 2-2017, f. & cert. ef. 8/17/2017

Stat. Auth.: ORS 243.061 - 243.302

Stats. Implemented: ORS 243.061 - 243.302