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OEBB Educational Entities

Educational Entity Forms and Reports
Not a Benefits Administrator?
 
This page is intended for benefits administrators at educational entities.

OEBB members click here

 
Forms for Educational Entities
 
       ●   2012 Open Enrollment Meeting Request Form 
       ●   2012-13 Enrollment Form (Customizable for your entity - Microsoft Word format)​
       ●   Division 60 Social Security Numbers Consent Form​
     ​  ●   MyOEBB Rules Selection Form
​       ●   MyOEBB Security Access and Access Termination Form

 
Comparability Assessment

       ●   Comparability Assessment Application - revised May 2012 
       ●   Summary of Enrollment Premium Rates - revised May 2012 
       ●   Comparability Policy - revised May 2012 

 
Demographic Reports
 
       ●   2008-09 Demographic Report 
       ●   2009-10 Demographic Report 
       ●   2010-11 Demographic Report 
       ●   2011-12 Demographic Report 
       ●   2012-13 Demographic Report ​

 
Financial
 
       ●   Electronic Funds Transfer Brochure 
       ●   Automated Clearing House (ACH) Payment Election
       ●   Automated Clearing House (ACH) Debit Agreement

 
Questions & Member Forms

If you have questions, please call OEBB at 888-469-6322
Click here to view member forms.