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Dependent Eligibility Review


PEBB has implemented a Dependent Eligibility Review which began November 2017. The purpose of this review is to ensure that only eligible dependents are receiving core benefit (medical, dental and vision) coverage. As a Section 125 Cafeteria Plan, PEBB has a fiduciary responsibility to manage health care costs and to ensure that health plans offered through PEBB cover only those who meet the eligibility criteria.

Who Will be Included in the Dependent Eligibility Review?

All active employees and retirees who have a dependent(s) enrolled in the PEBB benefit management system will be required to complete and return the required verification documents when selected for the review process.  It is mandatory that members verify and submit the acceptable documentation by the review deadline in order to continue benefit coverage for their dependents.

What about the privacy of your Information?

Our member’s information and privacy is very important to us. All information that the member provides for the dependent eligibility review will be kept confidential. Copies of documents submitted to PEBB will be destroyed following verification of the member’s dependent(s). No documents will be retained! That is why it is especially important that members provide PEBB only copies of the documents.

How Do I Complete the Dependent Eligibility Review?

After you receive your Dependent Eligibility Review letter from PEBB:

  • Carefully review the documents included in your Dependent Eligibility Review Packet and
  • Confirm your covered dependent(s) status by mailing or faxing your copies (not originals) of the required documents, along with your completed Dependent Eligibility Worksheet to:

Public Employees’ Benefit Board
Attn: Dependent Eligibility Review Team
500 Summer St NE, E-89
Salem OR 97301-1063


Attn: Dependent Eligibility Review Team
FAX: 503-373-1654

What Documents are needed for Dependent Eligibility Review?

Required Documentation and Definitions

Is my Dependent Eligible?

Eligibility Scenarios

Review and Eligibility Rules



Sample Letters for the Eligibility Review:

Dependent Eligibility Worksheet

Dependent Eligibility Packet Letter

Reminder Letter

Confirmation Letter

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