Or. Admin. Code § 101-020-0005

Current through Register Vol. 63, No. 11, November 1, 2024

Section 101-020-0005 - Newly Hired and Newly Eligible Employee

(1) All newly hired or a newly eligible active employees have 30 days from the date of hire or date of eligibility to enroll in PEBB core and optional benefit plans. Benefit plan elections are irrevocable for the plan year except as specified in OAR 101-020-0050.

(a) Full time temporary or impermanent employees that will be benefit eligible by the fourth month of employment enroll for benefits during the third employment month for benefits to be effective by the first of the fourth month.

(b) Variable hour temporary or impermanent employees that become benefit eligible after an initial measurement period have 30 days from their benefit eligibility date to enroll.

(2) A newly hired benefit eligible employee or newly eligible employee can enroll in benefit plans for the following month regardless of the number of paid regular hours in the month of hire or eligibility. The employee must be actively at work, as specified in OAR 101-010-005(2) on the coverage effective date. In the months following initial eligibility and enrollment, to continue to receive coverage a benefit eligible employee:

(a) Not in a current benefit eligible stability period must meet the requirement of a minimum of 80 hours paid regular status each month to receive benefits the following month.

(b) In a current benefit eligible stability period is eligible for benefits the following month regardless of the number of paid regular status hours in the month.

Example: Sarah was a new hire and she enrolled in benefit plans on June 25. Sarah was in paid regular status on July 1; her coverage is effective July 1. Sarah will need to be in paid regular status for 80 hours in July in order to receive August coverage.

(c) Who enrolls in benefit plans and terminates employment before the effective date of insurance coverage will not receive active employee benefits or COBRA.

Example 1: Sarah was a new hire into a benefit eligible position, she enrolled in benefit plans on June 25. Sarah was in paid regular status on July 1; on July 2, she terminated employment. Sarah's coverage was effective July 1 and will remain in place through July 31. Sarah will not receive PEBB coverage in August, but will receive a COBRA notice.

Example 2: Ron was a new hire into a benefit eligible position, he enrolled in benefit plans on June 25. He terminated employment on June 30. Ron is not eligible for insurance coverage because he was not in paid regular status on July 1. He will not receive a COBRA notice because he did not receive active coverage.

(3) Any employee that becomes eligible for benefits during or after the open enrollment period but before the start of the new plan year must receive the opportunity to complete open enrollment elections before the start of the plan year.

Or. Admin. Code § 101-020-0005

PEBB 1-1999, f. 12-8-99, cert. ef. 1-1-00; PEBB 1-2000, f. 11-15-00, cert. ef. 1-1-01; PEBB 1-2001, f. & cert. ef. 9-6-01; PEBB 1-2002, f. 7-30-02, cert. ef. 8-1-02; PEBB 1-2004, f. & cert. ef. 7-2-04; PEBB 3-2004, f. & cert. ef. 10-7-04; PEBB 3-2005, f. 8-31-05, cert. ef. 9-1-05; PEBB 2-2007, f. 9-28-07, cert. ef. 10-1-07; PEBB 3-2009, f. 9-29-09 cert. ef. 10-1-09; PEBB 7-2010, f. 12-10-10, cert. ef. 1-1-11; PEBB 1-2015, f. & cert. ef. 5/12/2015; PEBB 2-2017, f. & cert. ef. 8/17/2017

Stat. Auth.: ORS 243.061 - 302

Stats. Implemented: ORS 243.061 - 302