Forms

Member, Admin and Vendor Forms

Open Enrollment changes and corrections:

• If you completed - Open Enrollment (October 1, and October 31, 2025).
  
• Changes or corrections are allowed until February 28, 2026 (except FSA).
  
• Please use the Open Enrollment and Correction form.
• If you didn't complete - Open Enrollment (October 1, and October 31, 2025).
  
• Surcharge corrections only - allowed until February 28, 2026.
• No changes to Core (medical, dental, vision) or Optional Benefits (life, disability insurance, FSA, etc.).
• Please use the Open Enrollment and Correction form to update surcharges.

How to:

1. Click Document Title
2. Save, then
3. Complete all fields
   
4. Save again before sending or sharing
   

For questions: visit Contact Information

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 (not a spelling error) for internet and phone orders.
• You can also order records by mail, drop box, or by scheduling an in-person appointment.
  

Request Vital Records