Oregon Administrative Rules
Chapter 111 - OREGON HEALTH AUTHORITY, OREGON EDUCATORS BENEFIT BOARD
Division 40 - ENROLLMENT
Section 111-040-0055 - Surcharges
Universal Citation: OR Admin Rules 111-040-0055
Current through Register Vol. 63, No. 3, March 1, 2024
(1) For the purposes of this rule, the following definitions apply:
(a) Double Coverage means a
subscriber/employee that is also an eligible dependent and is enrolled in two
OEBB/OEBB or OEBB/PEBB medical plans.
(b) PEBB means the Public Employees' Benefit
Board in Oregon.
(c)
Subscriber/employee means the individual who subscribes to their employer's
health plan. For the purposes of this rule, a subscriber excludes a COBRA
participant, part-time employee, retiree or self-pay member.
(d) Dependent means and includes the eligible
employee's spouse or domestic partner, or child as defined by OAR
111-010-0010(7), unless otherwise defined in another OEBB rule.
(e) Surcharge means an extra fee deducted
from the employee's monthly pay.
(2) Double Coverage:
(a) Effective October 1, 2020, any active
full-time subscriber/employees who covers an eligible dependent that is also
enrolled as a subscriber on either an OEBB or PEBB medical plan will be
assessed a monthly surcharge.
(b)
The amount of the surcharge is determined annually by the OEBB Board.
(c) The monthly surcharge will only be
charged to the subscriber.
(d) The
subscriber will only pay one double coverage surcharge no matter how many
dependents are covered.
(e) The
surcharge does not apply to Retirees, COBRA participants, self-pay
participants, part-time employees or medical opt-outs.
Statutory/Other Authority: ORS 243.860 - 243.886
Statutes/Other Implemented: ORS 243.866(2) & ORS 243.864(1)(a)
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