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2013 Retiree Information

 

 

Retiree Administrator BHS
Retiree Couple
 
Click here to download this information as a printable document.  

Your Benefit Board contracts with BenefitHelp Solutions (BHS) to administer the benefit program for PEBB-eligible retirees. BenefitHelp Solutions is responsible for
  • Enrolling retirees in their selection of medical and dental benefits
  • Collecting, accounting for and transferring premium payments for these benefits
  • Notifying retirees of their coverage continuation options
BHS will enroll eligible retirees and continue their coverage only with timely payment of premium. Premium payment is due by the first of the month for coverage in that month. Retirees may make premium payments via electronic funds transfer between their financial insitution and BHS, or between their PERS pension administrator and BHS. 
 
To contact BHS about methods of premium payment, call 503-412-4241 (Portland) or 855-289-6314 (Statewide).
 
Important

If you are thinking of retiring before you are eligible for Medicare, you have several health care 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
 
Planning for health care coverage in retirement
 
Active state employees enrolled in PEBB benefits who are thinking of retiring before they are eligible for Medicare have several health coverage options to consider. They include
  • Continuing coverage directly by enrolling as an eligible retiree in PEBB plans
  • Enrolling in a plan offered by the Public Employees Retirement System (PERS)
  • Continuing coverage in PEBB plans through a federal law known as COBRA
  • Enrolling in a group plan through portability in Kaiser Permanente or through the Oregon Medical Insurance Pool (OMIP)
 
Eligibility for PEBB
 
Who is a PEBB-eligible retiree?
 
To be eligible you must meet both of the following requirements:
  • Eligible to receive retirement benefits through PERS or another state retirement system
  • Enrolled in a PEBB medical or dental plan
You may move to PEBB retiree coverage only from either active employee coverage or COBRA coverage.
 
Medicare Eligibility
 
Does Medicare eligibility make a difference?
 
Being eligible for Medicare makes you no longer eligible for PEBB plans as a retiree. If you are eligible for Medicare, contact the PERS health insurance program or Medicare. 
 
Who you can cover
 
Who else may I cover?
 
When you enroll for retiree coverage, you may also cover a spouse/domestic partner and dependents who are currently covered in your health care plans at the time of your retirement and who are not eligible for Medicare. You may not add any new dependents to coverage when you move to retiree status or during the annual retiree plan-change period.
 
Your plan options
 
What PEBB plans are available to me?
 
PEBB retirees may choose from all medical and dental plans available in their service area. This includes plans available to all active employees and plans available only to part-time employees.
 
You can enroll in different medical or dental plans from those you had as an active employee. You can enroll yourself and your dependents in medical only, dental only, or medical and dental plans.
 
However, if you choose only dental coverage, you cannot add medical later. The same holds true if you choose only medical. You may discontinue either coverage, but can't add the coverage later.
 
Pre-existing conditions
 
Can a PEBB plan deny coverage based on a pre-existing condition?
 
No. As long as you have no lapse in PEBB participation, the plan cannot deny coverage based on your health.

 
Survivors continuing 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.

 
Enrolling at Retirement
 
How do I enroll for PEBB coverage?
 
Complete the Retiree Enrollment Form and submit it to BenefitHelp Solutions (BHS), PEBB’s third-party administrator for retiree plans. For more information contact BHS (see Resources at the bottom of this page).
 
Premiums and Payment
Who pays the premium?
 
Retirees who enroll in PEBB plans are responsible for the premium payments with no contribution from the employer.
 
Click here for 2013 medical premiums.
 
Click here for 2013 dental premiums.

 

Click here for 2014 medical and dental premiums.

 

 
Coverage continues
 
How long will coverage continue?
 
Coverage continues as long as the covered individual is not eligible for Medicare; premiums are paid on time; and PEBB continues to offer retiree coverage.
 
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 agency for the date your active 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 group coverage ends. There are two exceptions to the continuous-coverage requirement.
 
First, if you and your spouse or domestic partner are both state employees eligible for PEBB and you have coverage through the other employee’s plan, you may enroll as a PEBB retiree later if you lose that coverage.
 
Second, if you choose COBRA coverage, you may transfer to the retiree group during or at the end of the COBRA period.
 
Plan Comparisons
 
How do I compare my choices in PEBB?
 
Compare your choices by viewing the comparisons posted on the PEBB Web site or in the PEBB materials provided by BHS.
2013 Medical Plan Comparisons
 
2013 Dental Plan Comparisons 

2014 Medical Plan Comparisons

2014 Dental Plan Comparisons

 
Part-time Plans
 
How are the part-time plans different?
 
In general, the Part-time Plans have lower premium costs but higher deductibles, coinsurance and copayments.
 
In addition, the medical plans don’t cover routine vision services, with the exception of the Kaiser Permanente Part-time medical plan, which covers an annual vision exam with a copayment of $30.
 
However retirees who enroll in a part-time version of a PEBB Statewide or Providence Choice medical plan can purchase vision coverage through VSP. Here are the rates for this coverage. 
 
VSP Vision In Part Time Plans for PEBB Retirees
Self only 
13.69
Self & Spouse/Partner 27.36
Self & Child(ren) 27.36
Family           32.15
 
Click here for the VSP brochure.

 
Changing enrollment
 
When may I change my enrollment choices?
 
You may make plan changes during the Plan Change Period or when you experience a change in eligibility. The retiree Plan Change Period is typically the same time as annual Open Enrollment for employees.
 
The Plan Change Period gives you the opportunity to change plans; it doesn’t 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 can’t enroll for medical coverage during a subsequent Plan Change Period. You can’t add dependents during this period. You may add dependents only within 60 days of a change in life or family status that affects your eligibility. Examples include marriage, divorce, and birth or adoption of a child.
 
Optional PEBB benefits
 
May I continue PEBB life or long term care insurance after I retire?
 
You can convert your existing optional employee life insurance coverage or enroll in PEBB retiree life insurance within 60 days from the date of your retirement. You can also roll payment of the premium for your plans to a spouse or domestic partner who is a state employee. Contact The Standard Insurance Company for more information.
 
If you want to continue long term care insurance you purchased through PEBB, you must convert the policy to an individual plan. You must do so within 60 days of the date of your retirement. Contact Unum Provident for more information.
 
Can I continue other optional PEBB benefits after I retire?
 
No; you can’t continue spouse or domestic partner life, dependent life, disability, or accidental death and dismemberment insurance through PEBB.
Resources
 
BenefitHelp Solutions (BHS)
PEBB Retiree Program Administrator
503-412-4241; 855-289-6314
Fax 503-765-3453
pebb@benefithelpsolutions.com
PEBB Statewide & Providence Choice Plans
Administered by Providence Health Plan
800-423-9470
www.providence.org/healthplans/pebb
Kaiser Plans (medical & dental)
503-813-2000, 800-813-2000
VSP (Vision Service Plan)
800-877-7195
www.vsp.com
The ODS Companies
800-452-1058
www.odscompanies.com/pebb
Willamette Dental Insurance
800-460-7644
www.willamettedental.com
The Standard Insurance Company
Phone 800-242-1888 Fax 800-227-4165
www3.standard.com
UnumProvident
800-227-4165
w3.unum.com/enroll/pebb/index.aspx 
Oregon Medical Insurance Pool (OMIP)
800-484-7280
www.omip.state.or.us
PERS Health Insurance
503-224-7377, 800-768-7377
www.pershealth.com
Medicare
800-MEDICARE or 800-633-4227
www.medicare.gov