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HB2557

2014-15 Enrollment Materials

  
ACH Debit Authorization Form
Cover letter
Enrollment Packet Q-A
HB 2557 Member Enrollment Form
Plan Comparison with Premium Rates
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Automatic Debit

2014-15 ACH Debit Authorization Form - Use this form to authorize payment if you are newly enrolling in coverage October 1, 2014 or if you wish to change your bank account after October 1, 2014.

If you are continuing coverage from 2013-14 and wish to continue using the same bank account, you do not need to submit another ACH Debit Authorization Form. Your previous authorization will automatically continue.​​

HSA (Health Savings Account) Information

For members enrolling in OEBB Moda Health Medical Plan H or Kaiser Permanente Medical Plan 3.

HB2557 Frequently Asked Questions

  
  
Answer
HB2557 Additional Assistance/Contact InformationHow can I get answers to other questions about HB2557 and my health insurance coverage?

You can contact OEBB at 888-469-6322 or the medical carrier:

Moda Health at 866-923-0409
Kaiser Permanente at 866-223-2375

HB2557 AppealsDo I have appeal rights?

Yes, each member has a right to file an appeal. For information about the OEBB appeal process, please go to OEBB forms.​

HB2557 Changes After Open EnrollmentWhat if I need to update my enrollment during the plan year?

You may make certain changes to your enrollment outside the Open Enrollment period if you experience a Qualified Status Change (QSC). You must submit a Midyear Change Form to OEBB within 31 days of a QSC. QSC's include, but are not limited to, the following:

  • Marriage
  • Divorce
  • Death
  • Birth/Adoption

Find the full menu in the QSC Matrix.​

HB2557 COBRA RightsWill I have COBRA rights after my HB2557 enrollment?

There are certain restrictions to COBRA determination. If you fail to make timely premium payments, then you will not be eligible for COBRA coverage. If your eligibility under HB2557 expires after the plan year and you made all your payments on time, you will be eligible for COBRA continuation coverage. Your last day of coverage will be September 30th and you should receive COBRA information from BenefitHelp Solutions.

For more information on continuing coverage and options other than COBRA, visit our "COBRA and Loss of Coverage" FAQ page.​

HB2557 EligibilityCan I find out now if OEBB has a record showing I'm eligible?

Yes, you can call OEBB customer service at (888) 469-6322 and ask a service representative.​

HB2557 EligibilityHow is eligibility determined?

Eligibility is defined as a member who is Oregon PERS-eligible during the previous calendar year who worked in either a part-time research and/or faculty position at an Oregon public institution of higher education and is not eligible for health insutrance through their employer.​

HB2557 EligibilityHow will I know if OEBB has a record showing I'm eligible?
enrollment postcard

OEBB mails enrollment materials in late July or early August to those identified by PERS as having worked the required number of hours.​

HB2557 EligibilityI'm currently enrolled in OEBB coverage under HB2557, but I didn't meet the eligibility requirements to continue coverage next year. What will happen to my coverage?

Your last day of coverage will be September 30th and you should receive COBRA information from BenefitHelp Solutions. For more information on continuing coverage and options other than COBRA, visit our "COBRA and Loss of Coverage" FAQ page.​

HB2557 EligibilityWhat if I believe I should be eligible but OEBB doesn't have a record of my eligibility?

If you believe you are eligible but OEBB doesn't have a record of your eligibility it could be due to a variety of reasons. Please call OEBB customer service at (888) 469-6322 and we will research your concern.​

HB2557 Enrolling and Plan DetailsCan I enroll my family?

You can enroll your eligible spouse/domestic partner (DP), eligible children (includes biological, legally adopted, or children for whom the Employee, Spouse, or DP is the legal guardian) up to age 26, and eligible disabled dependents. Review the dependent eligibility requirements.​

HB2557 Enrolling and Plan DetailsWhat if I didn't receive an Open Enrollment Packet?

If you didn't receive an Open Enrollment Packet, it could be due to OEBB not having your correct address. You can call OEBB customer service at (888) 469-6322 and we will be happy to assist you.​

HB2557 Enrolling and Plan DetailsWhat is my plan year?

Your plan year begins October 1st and ends on September 30th.​

HB2557 Enrolling and Plan DetailsWhen can I enroll?

You can enroll by submitting a completed Enrollment Form and ACH Debit Authorization Form to OEBB from August 15th to September 25th. You will not be able to enroll after September 25th, unless you experience a qualified status change (QSC) event which would allow a mid-year enrollment (for example, loss of other coverage). A full list of QSC events is available on the QSC Matrix page of the OEBB website.​

HB2557 Enrolling and Plan DetailsWhen will I receive my Open Enrollment Packet?

If you worked the required number of hours in the previous calendar year, you should receive your Open Enrollment packet by August 15. It will be mailed to your home/mailing address.​

HB2557 Premium PaymentsWhen are premium payments due and how are they submitted?

Members will submit payment for benefits to OEBB each month by electronic funds transfer (EFT), also known as an "auto debit" or "ACH debit". OEBB will work with members and their financial institutions to set up an auto debit. Use the ACH Debit Authorization form to establish these payments. Premium payments will be debited from accounts on the 25th day of the month prior to the next month's health care coverage. (For example: October premiums would be deducted from bank accounts on September 25th.)​

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