Oregon Administrative Rules
Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD
Division 20 - ENROLLMENT RULES
Section 101-020-0050 - Midyear Benefit Plan Changes

(1) Eligible employee plan elections are irrevocable for the plan year. There are limited exceptions to the irrevocability rule if certain conditions or events are met. These events fall into three broad groups:

(2) The eligible employee may request only those midyear plan change elections that are consistent with the event.

Example: In the middle of the plan year, John moves from his current medical plan's service area and can no longer access the plan's closed panel of providers. However, all of John's other coverages (dental, life, etc.) remain active for his new address. John may request to change his medical plan, because it is consistent with the event due to a move from his current medical plan's service area. John may not request to change or add any other elections at this time because that would not be consistent with the allowable midyear event occurrence.

(3) Eligible employees experiencing a qualified midyear event, and who request a change of enrollment elections must complete and submit to their agency the correct update forms and all required documentation within 30 days of the event. Agencies receiving employee midyear change requests can make only those changes that are consistent with the event. All election changes are effective the later of the first of the month after receiving all required update forms and documents or the event date. Agencies will not process enrollment request changes when enrollment and change request information is incomplete or missing required documentation.

(4) The tag-a-long rule applies when the eligible employee experiences a QSC addition of a new family member, domestic partner, or domestic partner's child. The rule allows the employee to add another eligible family member, domestic partner, or domestic partner's child who was previously eligible for PEBB plan coverage but never added to coverage, to be added to coverage.