Eligibility, Enrollment Options, and Timelines


 

Public Employee Benefit Board (PEBB)

The Public Employees’ Benefit Board (PEBB) is a labor-management board that designs, contracts and administers benefits for Oregon state employees. These benefits meet IRS code requirements as a Cafeteria Plan, so they provide tax advantages.  For additional information visit the PEBB website.

 

 

Benefits eligibility

Staff (Classified) and Faculty (Unclassified) academic and professional employees, including academic wage appointments, working at least half-time* on appointments of 90 days or longer are eligible for health insurance benefits. 

Benefit eligible employees must continue to meet eligibility requirements each month to earn health insurance coverage for the following month.  If you do not meet the hours eligibility requirement in a month, you will lose coverage the following month.  The monthly hours requirement is:

  • Staff (classified) employees must work or be in a paid leave status for at least 80 hours in the month.
  • Faculty (unclassified) employees must work or be in a paid leave status for at least one half of the available work hours in the month.  For example if the month has a total of 22 possible work days, you must work or be in a paid leave status for at least 88 hours to earn health insurance coverage for the following month.

*Eligibility can be through a single appointment or a combination of appointments.  Temporary Service (TS) positions are not eligible for benefits unless the position meets the criteria under the Affordable Care Act (ACA).

Eligible dependents

  • Spouse
  • Domestic Partner (same sex/opposite sex)
  • Beginning Jan. 1, 2019, PEBB will terminate all plan coverage for dependent children who reach age 26 during a calendar year at midnight on the last day of the month in which the dependent turned 26. PEBB will not terminate coverage for children age 26 or older when approved by the health plan as incapable of self-sustaining employment because of a developmental disability, mental illness or physical disability pursuant to section (4) of this rule. The exception would be Child and Grandchild by Affidavit, see section B(i). Find out more information about eligibility.
  • 2019 domestic partner imputed values

Enrollment options

Enroll in benefits

  • Enroll in a medical plan
  • Enroll or "Not Enroll" in a Vision Plan
    • There is no Cash Back for electing to "Not Enroll" in a Vision plan
    • Vision plans are also available to Part-time Classified employees enrolling in a Part-time Medical Plan
  • Enroll or "Not Enroll" in a Dental Plan
    • There is no Cash Back for electing to "Not Enroll" in a Dental plan
  • Enroll in Employee Basic Life Insurance
  • Enroll in any of the PEBB optional insurance coverage

Opt Out of Medical Coverage

  • Opt out of medical coverage.
  • To be eligible to opt out you must be covered by another employer sponsored health insurance program. Other group coverage does not include Medicare, Medicaid, Veterans Administration Health Benefits, Student Health Insurance, or an individual plan.
  • Provides a cash incentive for not enrolling in a medical plan or medical/dental plan
    • Cash back is subject to Federal, State, and Social Security taxes
    • Cash back is $233 per month less the cost of employee basic life insurance ($1.00) for a total monthly cash back amount of $232.
  • Enroll or "Not Enroll" in VSP vision plan
    • There is no Cash Back for electing to "Not Enroll" in a Vision plan
  • Enroll or "Not Enroll" in a dental plan
    • There is no Cash Back for electing to "Not Enroll" in a Dental plan
  • Enroll in any of the PEBB optional insurance coverage
  • Must enroll in employee basic life insurance
  • Must attest to having other employer coverage
  • Additional information on Medical Opt Out

Decline Benefits

  • If you decline coverage, you are declining enrollment in the CORE benefits (medical, vision, dental and employee basic life insurance). You will also not be eligible to enroll in any of the other PEBB optional insurances (e.g., optional life, long-term care, etc.)

Enrollment timelines

Within 30-days of hire date

  • If you don’t complete the enrollment process within 30 days, you will not have benefits and you will have to wait until Open Enrollment to enroll for the next calendar year. 
  • You may be eligible to enroll prior to Open Enrollment if you experience a Qualified Status Change during the year.

During the year if you experience a Qualified Status Change

  • Must complete Mid-year Update Form within 30 days of the qualifying event and return to Employee Benefits.
  • Qualifying Mid-year events include, but not limited to:  Marriage, Divorce, Birth, Death, Loss of other Coverage, Gain Other Coverage, etc.
    More Information...

Open Enrollment each year

  • This is the time of year when you can make changes to your benefit elections, increase coverage, drop coverage, etc.
  • Open Enrollment is the month of October.
  • Changes and new elections take effect in January.  Plans that require a review of medical history before approving/denying coverage will take effect upon approval (optional life insurance and long-term care insurance).
  • Each year you must re-enroll in your Flexible Spending Accounts if applicable.
  • Each year you must select your HEM participation status.
  • Each year you and your enrolled spouse/domestic partner must complete the online Health Assessment if you elect to participate in the HEM program for the new plan year.

When does coverage go into effect?

Generally, coverage goes into effect the first of the month, following your hire month, as long as you have completed your online enrollment or receipt of enrollment forms by OSU. Exceptions are when a plan requires review of medical history before approving or denying coverage (Optional Life and Long-term Care insurance). Coverage in these plans goes into effect the first of the month after approval by the plan.

Required notices