Skip to main content
Oregon.gov Homepage

PEBB Forms

 

Below are forms for PEBB benefits and processes, including those used by PEBB members, PEBB-participating entities, and the general public.

Not sure which form to fill out or have other benefit related questions? Contact Member Services at (503) 373-1102 or inquiries.pebb@dhsoha.state.or.us.
Having trouble navigating this page, or used a search term that didn't come up? Contact Amy Bartlett. Click here to email or call (503) 378-6466.



Still can't find it? Check the DHS/OHA Publications Library 
 




Form page Instructions:

  1. Search
      • Enter keywords in the Search box, (example: mid-year change, divorce, affidavit, enrollment, fsa, etc.)
    1. Sort
      • Click desired column Header (example: category, url, description, form number) to sort or;
      • Use Sort dropdown and choose a different column to sort A-Z.
    2. Filter 
      • Click Filter dropdown to choose filter options or;
    3. More Pages
      • Click 'Next' to see more forms, if needed, or; 
      • Use the lower right hand corner 'Per Page' dropdown to adjust how many forms you see at a time.

    Your browser is out-of-date! It has known security flaws and may not display all features of this and other websites. Learn how

    ×