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Updates to PEBB administrative rules may affect how you and your agency manage your benefits. Two of them affect timeframes for enrollment corrections and plan changes with life events.
Correcting enrollment errors
Timeframe: You still have 30 days from your first pay of the year to make enrollment corrections. However, corrections to core benefits – medical and dental – aren’t retroactive to January 1. Instead, they go into effect the first of the following month.
Impact: If you enrolled in a "wrong" plan, you’ll be responsible for your portion of claims in the enrolled plan until the correction goes into effect. The correct enrollment won’t be in effect until the first of the month following agency receipt of the Correction form. If you submit the form after 30 days, PEBB must review the request and may ask for more information.
Action: If your first pay shows that you made an enrollment mistake, get the Correction form to your agency within 30 days. For agency employees, that's January 31; for university employees, it’s February 28. Review the benefit summary and member handbook of your enrolled plan, and use the benefits accordingly until the correct plan goes into effect.
Making midyear changes
Timeframe: You have 30 days, not 60 days, to request qualified benefit changes when
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A life event affects your eligibility status or plan choices (see example life events)
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Your employer increases out-of-pocket premium, or a change in the benefit program decreases coverage or reduces the number of plans
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Other laws, regulations or court orders require it
Qualified changes go into effect the first of the month after your agency gets your Midyear Change form and any other required paperwork.
Impact: Your agency can’t process benefit changes if they get the Midyear Change form after 30 days and until you provide all required documentation. If you miss the 30-day window, your benefit will not go into effect. You may appeal to PEBB.
Action: If you experience one of these midyear events, get the Midyear Change form to your agency within 30 days. Make sure to include any required documentation with the form.
Example life events
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Marry or Divorce
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Establish or terminate domestic partnership
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Legally foster a child
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Assume responsibility for a grandchild
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Change employment status - you or dependent
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Move out of the plan’s service area
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"My 24-year-old and her son Zack moved in with me, and I’m supporting them now. I gave the form and grandchild affidavit in 30 days, so I’m able to cover Zack this year."
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"Getting divorced involves so many changes. I almost missed removing my ex from my benefits. I gave the form to payroll in time to remove him the first of the following month."
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"I had the whole family in Kaiser, which helped with costs and coordinating the kids’ care. With the move to Bend, I put in the form to enroll us in Providence Choice that same month and enrolled in a medical home."
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"I was so wrapped up in the new baby that I forgot to add her to my benefits right away. Luckily, PEBB rules give automatic coverage to newborns for 31 days and I turned in the form to continue coverage."
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