Public Employees' Benefit Board PEBB Retiree Information

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Public Employees' Benefit Board

Department

PEBB Retiree Information


You and BenefitHelp Solutions	Your medical & dental options	Survivors coverage
Important	Rate comparisons	Changing enrollment
Retiree options	Plan comparisons	Continuing optional insurance
Medicare eligibility	When do I enroll	Alternative healthcare options
PEBB retiree eligibility	How to enroll	2009 Resources
Who you can cover	Coverage

You and BenefitHelp Solutions

View retiree information as a PDF

Your Benefit Board contracts with BenefitHelp Solutions (BHS) to administer the benefit program for PEBB-eligible retirees. BenefitHelp Solutions is responsible for

Enrolling these retirees in their selection of medical and dental benefits for which they are eligible
Collecting, accounting for and transferring premium payments for these benefits
Notifying retirees of their coverage continuation options

To contact BHS, see the list of Resources on this page.

Important

If you are thinking of retiring before you are eligible for Medicare, you have several healthcare options to consider. Keep in mind that if you enroll in PEBB plans, you must self pay the premiums; the state makes no contribution.


Retiree options

What are my retiree medical and dental options? Your options for group coverage when you are not eligible for Medicare include: Continuing healthcare coverage directly through any PEBB plan Enrolling in a plan offered by the Public Employees’ Retirement System (PERS) Continuing coverage in a PEBB plan through a federal law known as COBRA Enrolling in a group plan through portability with your current insurance carrier or through the Oregon Medical Insurance Pool (OMIP) if you are in a self-insured plan.


Medicare eligibility

Does Medicare eligibility make a difference? Being eligible for Medicare makes you or your dependent no longer eligible for PEBB plans.* If you are eligible for Medicare, contact the PERS health insurance program or Medicare. *Medicare rules are different for those with end-stage renal disease. Contact Medicare.

PEBB retiree eligibility

Who is a PEBB-eligible retiree?

To be eligible you must meet both of the following requirements:

Eligible to receive a retirement benefit through a state of Oregon retirement system
Enrolled in a PEBB medical and/or dental plan

View the discussion of who is eligible in the Summary Plan Description.

Remember: You may move to PEBB retiree coverage only from either active employee or COBRA coverage in a PEBB plan.


Who you can cover

Who else may I cover? When you enroll for PEBB retiree coverage, you may also cover Your spouse or domestic partner Dependents who are covered in your healthcare plans at the time of your retirement. Note that you may not add dependents to coverage when you move to retiree status. You may cover a spouse or domestic partner and dependent children who meet eligibility criteria. Review eligibility criteria in the Summary Plan Description.


Your medical & dental options

What PEBB medical and dental plans are available to me? As a PEBB retiree, you may choose from all available medical and dental plans, including plans for full-time and part-time employees and retirees, available in your service area. View 2009 medical rate comparison and 2009 dental rate comparison. You may choose the following medical plans: Kaiser Permanente and Kaiser Added Choice (service area defined by Zip codes in most of the Willamette Valley) View zip codes. Providence Choice (Multnomah, Clackamas, Washington and Yamhill counties). View Locations. The service area for the Regence BlueCross BlueShield plan covers the state and the world. You can enroll in this plan no matter where you live or work. View more information on your 2009 medical plan choices You may choose the following dental plans: Kaiser Permanente Dental if you live or work (at least 50 percent of the time) in the plan’s service areas. View zip codes. ODS Preferred or ODS Traditional no matter where you live or work. Willamette Dental, which provides covered services only through its facilities and providers. View locations. View more information on your 2009 dental plan choices You may choose different medical or dental plans when you enroll as a retiree than you had as an active employee. You and your dependents may choose medical only, dental only, or medical and dental coverage. However, if you choose only dental coverage, you cannot add medical coverage later. The same holds true if you choose only medical coverage. You may discontinue either coverage, but you may not enroll for the coverage later.


Rate comparisons

View 2009 medical rate comparison View 2009 dental rate comparison


Plan comparisons

How do I compare my choices? Your Benefit Board offers a range of medical and dental plans for employees. You may select from any of these plans. You can compare your plan choices by viewing side-by-side comparisons (see links the below). Or, you may compare the benefits and costs of the plans using the plan comparison tool, online at https://pebb.benefits.oregon.gov/members. View 2009 medical plan comparisons View 2009 dental plan comparisons


When do I enroll

When do I enroll as a PEBB Retiree? Your PEBB coverage must be continuous, without a lapse, and you must enroll within 60 days of when your active PEBB coverage ends. Contact your employing agency for the date your active group coverage will end. The enrollment deadline is 60 days from that date. If you enroll and pay premiums during this 60-day window, coverage is retroactive to the date your active coverage ended. Exceptions: If you are eligible for dual coverage and have coverage under a spouse or partner’s active PEBB plan, you may enroll as a PEBB retiree later if you lose that coverage. If you choose COBRA continuation coverage, you can transfer to the retiree group during or at the end of the COBRA period.


How to enroll

How do I enroll for medical or dental coverage? Complete the Medical and Dental Enrollment Form and submit it to Benefit Help Solutions (BHS). BHS is PEBB’s third-party administrator for retiree plans. For more information contact BHS or PEBB.


Coverage

How long will coverage continue? As long as: You and the dependents covered in your plans are not eligible for Medicare You pay your premiums on time PEBB continues to offer this coverage for retirees


Survivors coverage

May survivors continue coverage? Your PEBB-covered survivors may continue coverage in the plans as long as they continue to pay the premium, do not have a lapse in coverage and are not eligible for Medicare. Survivors need to notify BHS if they do not want to continue coverage. Surviving spouses or domestic partners lose coverage eligibility if they remarry or enter into another domestic partnership.


Changing enrollment

When can I change my choices after initial enrollment? You may make plan changes during the Plan Change Period or when you experience a change in eligibility. The Board typically sets the Plan Change Period for retirees to run concurrent with the annual Open Enrollment for employees. The Plan Change Period allows you the opportunity to change plans; it does not allow you to add coverage you did not already have. For example, if you choose not to enroll in medical coverage when you retire, you may not enroll for medical coverage during a subsequent Plan Change Period. You may not add dependents during this period. You may add dependents only within 60 days of and consistent with a qualified status change that affects your eligibility. Examples include marriage, divorce, or birth or adoption of a child.


Continuing optional insurance

Can I continue PEBB life and long term care insurance after I retire? You can convert your existing employee life insurance coverage or enroll in PEBB retiree life insurance coverage within 60 days from the date of your retirement. Contact the Standard Insurance Company for more information about these options. Long term care insurance is different. If you have long term care insurance through PEBB, you must convert the policy to an individual plan to continue the coverage. You must do so with in 60 days of the date of your retirement. Contact Unum Provident for more information about this option. Can I continue other optional benefits? No. You cannot continue spouse or domestic partner life, dependent life, disability, or accidental death and dismemberment insurance through PEBB.


Alternative healthcare options

What are my alternatives to PEBB healthcare coverage? PERS. Contact the PERS Health Insurance Program for information. COBRA. The federal COBRA law allows you to continue the same coverage you had as an employee. COBRA allows you to purchase coverage in the group plan for 18 months. If you retire because of disability, you may be eligible for an additional 11 months of COBRA coverage. You may enroll in a PEBB plan at any time during your COBRA coverage. Contact BHS for information about coverage through COBRA. Portability. If you are in a Kaiser or Regence medical plan, you may purchase individual coverage from your plan on a guaranteed issue basis within 63 days after leaving the PEBB group. To be eligible you must: Have 180 days of continuous employer group medical coverage Be an Oregon resident Not be eligible for Medicare Currently not be enrolled in another medical plan For portability information, call the plans directly. OMIP. The Providence plan is self-insured. If you leave a self-insured plan, you may be able to access coverage through the Oregon Medical Insurance Program (OMIP). To apply for coverage through OMIP, you must first exhaust your COBRA coverage. Contact OMIP for more information. Medicare. Medicare covers: People 65 years of age and older Certain younger people with disabilities Individuals who are eligible for Medicare are not eligible to participate in PEBB. If you are eligible for Medicare but your dependents are not, they may continue coverage through PEBB. Contact Medicare for more information.