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December 2010
Download the Agency Update



 PEBB seeks to support agency and university administration of benefits. These periodic newsletters keep you updated on plans and changes. We look forward to your ideas and feedback.
 
Download the December Agency Update (pdf) 
 

 
 


Impacts of Affordable Care Act
Amended Administrative Rules Effective Jan. 1, 2011. Attached are amended OARs that take effect January 1. It’s vital that all agency representatives read and understand the implications of all these rules. PEBB staff has no doubt that there will be additional changes as federal agencies provide continued clarification on impacts of the federal Affordable Care Act.
 
These rules are of special importance for benefit administration: OAR 101-015-0011 Dependent Eligibility and OAR 101-020-0025 - Terminating Coverage due to a Midyear Plan Change Event, Rescissions, Agency Premium Refunds
 
Beginning 2011, all terminations are prospective except termination of enrollment of an Ex Spouse, Ex Domestic Partner, and any children of these individuals who are not their biological children or children adopted by or placed for adoption with the employee. These enrollments will terminate retroactively to the last day of the month when the individual lost eligibility.
  • Imputed value will be applied to late prospective terminations.
  • Premium refunds will be applied to retroactive terminations according to the rule.
Agencies cannot enter retroactive terminations or enrollments in the benefit system. Fax a copy of the forms to PEBB for processing. Do not scan and e-mail the forms, as e-mail is not a secure delivery method and the forms contain PHI. PEBB staff will process the forms as quickly as possible and notify the agency of the action.
 
Remember that once a premium is paid and coverage is active, agencies cannot retroactively terminate or take back the premium. Exceptions are cases of fraud, termination of coverage for ex spouses and ex domestic partners (as stated above), or non-payment of premium.
 
It’s very important that you process employment terminations within the month. If you pay the premium for the month following the month when an employee’s employment actually terminated, the month starts with the coverage. You cannot retroactively terminate the coverage back to the first of the month when the employment ended. In this case, you will have paid for a month of coverage and you must terminate the enrollment at the end of the month of coverage.
 
Oregon Tax Implications of Covering Adult Children Who are Not Tax Dependents. A provision of the federal Affordable Care Act requires plans to allow coverage of employees’ children who are not tax dependents. PEBB applied this provision beginning June 1, 2010.
The federal Act excludes the value of this coverage from federal income tax. However, current Oregon law does not exclude it from state income tax. This means employees may need to report it on their state tax return.
For 2010: Payroll will add the value of this coverage June 1-Dec. 31, 2010, to the employees’ W-2 form. The value is calculated based on PEBB’s estimate of market value for coverage of children in each of its health plans.
 
For 2011. Employees who enrolled to provide this coverage during Open Enrollment and who don’t want it to go into effect because it may affect their 2011 Oregon income taxes can submit a Correction Form to the agency by Dec. 31, 2010. They can submit a Correction Form within 30 days of receiving their first pay of the year. However, removal of coverage will prospective to the first of the following month.
Note:  The Oregon legislature may exclude the value of this coverage from state income tax in 2011. If the employee un-enroll a child for coverage that begins January 1, and the legislature takes action after that, the employee will not be able to add the child back to coverage for 2011 except through a qualified change in eligibility status.
PEBB sent a copy of the attached memo to affected employees.

Communications
Online Health Assessment. A short video on PEBB’s website shows employees how to register for and start their online health assessment. See the video at [link]. Completion of an assessment is required for principal-subscriber access to no-cost participation in Weight Watchers beginning 2011. The Questions section of the website includes a set of questions and answers on the topic.
 
December Newsletter. The newsletter will be posted tomorrow, December 14, and notice of its availability will be sent tomorrow evening. Covered items include benefits for health in 2011; the imputed value of covering adult non-tax dependents; and availability of federal funds for Oregonians facing foreclosure.
 

Resources


Suggest topics for future editions of the Agency Update via e-mail to pebb.hottopics@state.or.us. 
 
Agency Resources: User Access Form  
                                 Agency, University & PEBB Contacts 
 
Public Employees' Benefit Board   
1225 Ferry St SE Salem, OR 97301  
E-mail: Eligibility and Enrollment
E-mail:Comments for the Board   
(503) 373-1102, fax (503) 373-1654  
Medical PlansDental Plans
       ●   Kaiser Permanente        ●    Kaiser Permanente 
       ●   Providence Choice         ●    ODS 
       ●   PEBB Statewide Plan         ●    Willamette Dental 
       ●   VSP (Vision Service Plan)   
Mail-order PrescriptionsOptional Plans
       ●    Kaiser Permanente        ●    The Standard 
       ●    PPS        ●    UnumProvident 
       ●    Walgreens Other Benefits
       ●    Wellpartner       ●    Flexible Spending Accounts (FSA) 
        ●    Employee Assistance Program (EAP)
              (800) 433-2320