Or. Admin. Code § 459-035-0080

Current through Register Vol. 63, No. 12, December 1, 2024

Section 459-035-0080 - Effective Date of Coverage

(1) For an eligible person who enrolls in a PERS sponsored health insurance plan under the provisions of OAR 459-035-0070, the effective date of coverage shall be the first of the month following receipt of a completed PERS Medical & Dental Insurance Application form but not before the date described as follows:

(a) For an eligible retiree, the latest of the following dates:

(A) The effective date of retirement if enrolled within 90 days of the effective date of retirement;

(B) The termination date of other group health insurance coverage;

(C) For a Medicare Companion Plan, the effective date of enrollment in Parts A and B of Medicare; or

(D) The date specified in an announcement of a plan change period or an open enrollment period, if applicable.

(b) For an eligible spouse or dependent, the latest of the following dates:

(A) The date the retiree's coverage is effective;

(B) The first of the month following the termination date of other group health insurance coverage;

(C) For a Medicare Companion Plan, the effective date of enrollment in Parts A and B of Medicare; or

(D) The date specified in an announcement of a plan change period or an open enrollment period, if applicable.

(c) For a new eligible spouse, dependent, or dependent domestic partner, the first day of the month following the date the completed enrollment form is filed and in the case of a domestic partner, an Affidavit of Dependent Domestic Partnership, except in the following situations:

(A) A newborn child is covered from the moment of birth.

(B) An adopted child is covered from the date he or she is placed in the custody of the eligible retiree.

(d) For an eligible surviving spouse or dependent, the first of the month following the filing of an application for health insurance coverage.

(2) Coverage shall cease for an eligible person on the earliest of the following dates:

(a) The end of the month in which a signed notification is received by PERS from the covered person to terminate coverage.

(b) The end of the month for which the last premium is paid.

(c) The end of the month in which a person ceases to be an eligible person, subject to any continuation of coverage rights under state or federal law.

Or. Admin. Code § 459-035-0080

PERS 4-1996, f. & cert. ef. 6-11-96; PERS 14-2002, f. & cert. ef. 11-18-02

Stat. Auth: ORS 238.410 & ORS 238.650

Stats. Implemented: ORS 238.410, ORS & ORS 238.420