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:

Search

Enter keywords in the Search box, (example: mid-year change, divorce, affidavit, enrollment, fsa, etc.)

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.

Filter

Click Filter dropdown to choose filter options or;

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.