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We're here for you. Member to member.

In this brave new world PEBB understands the need for convenient information and efficiencies. We are currently working to make all our forms fillable. This process is important. We are working diligently to train staff to make this happen for you quickly. As we make forms fillable, they will be identified in the description column.

Be sure to fill in all the required blanks. When you’re done, just save and email. You will find who to send it to on the last page of the form. You may want to keep a copy for your records. You will be able to print the form also.

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.




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.

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