Or. Admin. Code § 101-015-0050 - Dependent Eligibility Verification and Review Appeals

Dependent Eligibility Verifications and Review Appeals

(1) Following the termination of dependents due to a dependent eligibility review, Eligible Employees, Retirees, Self Pays or COBRA participants may file an appeal and submit requested documentation within 60 days from the date coverage ended.

(2) For Eligible Employees/Retirees/Self-Pay/COBRA, if the appeal and submitted requested documentation is received by PEBB prior to 60 days from the date coverage ended, and dependents are verified, PEBB will unlock the dependent records in the PEBB benefit management system and dependents will be added retrospectively.

(3) For Eligible Employees/Retirees/Self-Pay/COBRA, if the appeal and submitted requested documentation is received by PEBB after 60 days from the date the coverage ended then dependents will be added prospectively.

Notes

Or. Admin. Code § 101-015-0050

PEBB 3-2018, temporary adopt filed 02/23/2018, effective 02/23/2018 through 08/21/2018; PEBB 5-2018, adopt filed 08/15/2018, effective 8/15/2018

Statutory/Other Authority: ORS 243.125 & ORS 243.061-302, 659A.060-069, 743.600-602 and 743.707

Statutes/Other Implemented: ORS 243 & ORS 243.061-302, 292.501 and 2007 OL Chap. 99