Oregon Administrative Rules
Chapter 459 - OREGON PUBLIC EMPLOYEES RETIREMENT SYSTEM
Division 35 - HEALTH INSURANCE PROGRAMS
Section 459-035-0030 - Eligibility, Retirement Health Insurance Account

Universal Citation: OR Admin Rules 459-035-0030

Current through Register Vol. 63, No. 9, September 1, 2024

This rule describes the requirements for an "eligible retired member" participating in a PERS-sponsored Medicare Companion Plan to be eligible for contributions from the RHIA toward the cost of premiums for that plan. The amount of the contribution is defined in OAR 459-035-0060.

(1) An "eligible retired member" includes the following:

(a) A retired member of the Tier One or Tier Two program who is enrolled in Parts A and B of Medicare and who:
(A) Is receiving a PERS service or disability retirement allowance or benefit, and had eight or more years of qualifying service at the time of retirement; or

(B) Is receiving a PERS disability retirement allowance or benefit computed as if he or she had eight years or more of creditable service.

(b) A surviving spouse or dependent of a deceased eligible retired member as described in subsection (a) of this section, who is enrolled in Parts A and B of Medicare, and who:
(A) Is receiving a retirement allowance or benefit from PERS; or

(B) Was covered under the retired member's PERS-sponsored health insurance plan and the deceased retired member retired before May 1, 1991.

(2) An eligible surviving spouse or dependent receiving benefits under the 15-year certain optional form of benefit payment (ORS 238.305 Option 4) will be entitled to contributions from the RHIA only until the remainder of the 180 monthly benefit payments are paid, unless he or she meets the requirements in subsection (1)(b)(B) of this rule.

(3) If both an eligible surviving spouse and an eligible surviving dependent are receiving benefits at the same time under the 15-year certain optional form of benefit payment (ORS 238.305 Option 4), only the eligible surviving spouse shall be entitled to contributions from the RHIA unless the surviving spouse, in writing, waives the contribution in favor of the eligible surviving dependent.

Stat. Auth: ORS 238.650

Stats. Implemented: ORS 238.420

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