Member, Self-pay, and Retiree Forms

Member, Admin and Vendor Forms

Open Enrollment changes and corrections ends February 28.

If you completed Open Enrollment (October 1, through October 31, 2025)

Changes and corrections are allowed (except FSA's) until February 28, 2026.

If you didn't complete Open Enrollment - surcharge corrections only.

Use this form:

Open Enrollment Correction and Change form

For questions: visit our Contact Information page

Records

Public

All Public Records requests related to the Public Employees' Benefit Board (PEBB) must be submitted directly to the Oregon Health Authority (OHA). Visit the OHA Public Records request page to find rules, fees, forms, and step-by-step directions.

Request Public Records.

Vital

Vital Records are legal documents made when there's an important Life Event like: a birth, death, marriage, Oregon Registered Domestic Partnership, adoption and divorce.

A Birth Certificate is the first document that's asked for to prove who you are or confirm someone's identity.

Important! - Please take notice that you're requesting records from the official State of Oregon Vital Records website.

In Oregon, the Center for Health Statistics issues certified copies of vital records for events that occurred within the state and partners with Vitalchek (http://www.vitalchek.com/) for internet and phone orders.
You can also order records by mail or drop box.

Request Records: www.oregon.gov/oha/PH/BirthDeathCertificates/GetVitalRecords/Pages/index.aspx