(1)
Refer to the following rules for an employee returning to paid regular status
from the following leave status:
(a)
Continuation of Benefits for Injured Workers (CBIW). See OAR
101-030-0010.
(b) Federal Family
Medical Leave Act (FMLA). See OAR
101-030-0015.
(d) Active Military
Duty Leave (USERRA). See OAR
101-030-0022.
(2) A benefit eligible employee who is not in
a current benefit eligible stability period and is returning to paid regular
status must work at least half-time in the month of return to be eligible for
core benefits and optional plan coverage the following month if returning from:
(a) A leave without pay that is not listed in
subsection (1) of this rule and has a break in active employee coverage;
or
(b) A reduction in hours below
benefit eligibility criteria, unless the employee is a benefit eligible
employee in a job share position.
(3) Any benefit eligible employee returning
to paid regular status within 30 days without a break in core coverage from
either a leave not listed in (1) of this rule or from an employment termination
will have all available previous coverage reinstated. The employee cannot make
benefit plan changes. A benefit eligible employee who:
(a) Is not in a current benefit eligible
stability period, must work at least half-time in the month of return for
benefits to be active the following month.
(b) Is in a current benefit eligible
stability period will receive benefits in the month following the return to
work regardless of the number of paid regular status hours in the month of
return.
Example 1: Gary is employed by an agency and
receives PEBB benefits. On May 20 Gary begins a leave without pay that does not
provide for continued benefits throughout the leave. Gary worked more than 80
hours in May, and the agency correctly schedules his benefit coverage end date
as June 30. Gary returns to paid regular status June 5, within 30 days of the
leave start and with no break in core coverage. If Gary is in a current benefit
eligible stability period, his return to paid regular status will reinstate his
coverage for July 1. If he is not in a current benefit eligible stability
period, he must work 80 hours in June for his coverage to continue in July.
Gary cannot make any election changes to his enrollments.
Example 2: Mark terminates employment at his
agency on May 31. At the time of his termination he is in a current benefit
stability period. . Mark had 80 paid hours in the month of May; therefore, his
agency ends his coverage on June 30. Mark is rehired by an agency as a
temporary employee, his hire date is July 1. This is less than 30 days;
however, a break in coverage occurred on June 30. Even if Mark is in a current
benefit eligible stability period his benefits will not be reinstated until
August 1.
(4) A
temporary or impermanent position benefit eligible employee who is in a current
benefit eligible stability period and has no hours of service for either 13
weeks, or a period lasting at least four weeks and longer than the employee's
prior employment, is considered a new employee upon return to regular pay
status. Benefits are not reinstated.
(5) A permanent previously benefit eligible
employee returning to a permanent benefit eligible position within 12 months of
the prior core benefit termination date is not required to work at least
half-time in the month of return to be eligible for benefits the following
month. The agency will reinstate the previous plan enrollments, if available,
effective the first of the month following the employee's return to work. The
reinstatement excludes Health and Dependent Care Flexible Spending Accounts,
Commuter Accounts, and Long Term Care. The employee may make midyear plan
changes to their enrollments within 30 days of the return to work date. This
rule applies regardless of the employee's current stability period
status.
(6) A permanent benefit
eligible employee who terminates employment for at least 13 weeks, and later
returns to work must start a new initial measurement period.
(a) When returning to a permanent position
benefits are reinstated according to (5) or (6) of this rule.
(b) When returning as a temporary worker the
employee is not reinstated to benefits and will enroll for benefits according
to temporary employee benefit policy.
(7) Any previously active benefit eligible
employee returning to paid regular status in a benefit eligible position after
a termination of core benefits of 12 months or longer must enroll as a newly
eligible employee.
Notes
Or. Admin. Code §
101-020-0045
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 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 2-2008, f. & cert. ef. 8-1-08;
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 &
659A.060-069
