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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