Or. Admin. Code § 111-020-0010 - Entities Electing to Join OEBB
(1) Effective January 1, 2014 an Entity can
elect to participate in benefit plans provided by the Board subject to the
following conditions:
(a) The Entity
completes and submits a Notice of Intent to join OEBB at least 90 days prior to
the date OEBB coverage is to go into effect;
(b) OEBB will not transfer any deductibles or
annual out-of-pocket maximums met with the prior carrier;
(c) For those members with an existing life
insurance policy through the Entity, OEBB will transfer the life insurance
amount in force on the last day the prior group coverage was in effect, rounded
to the next highest $10,000 increment, if requested and documented by the
Entity.
(d) Early retiree
participation in the OEBB plans will be limited to those individuals and
eligible dependents currently enrolled in the Entity's medical, dental and/or
vision plans and those Early Retirees who retire on or after the effective date
of OEBB coverage and their eligible dependents.
(2) Entities electing to participate in
benefit plans provided by the Board are limited to offering the coverages and
plans provided by OEBB for medical, dental, vision, life, AD&D, disability
plans, Employee Assistance Program (EAP) and Long Term Care (LTC). Entities
cannot choose to offer some coverages or plans through OEBB and other coverages
or plans outside of the OEBB benefits program.
(3) A Local Government must provide OEBB with
medical plan premium rates and loss ratios for the two most-recent years, if
available, with its Notice of Intent to join OEBB to allow OEBB's Consultant to
perform an actuarial plan comparison. For self-funded groups, two years of
claims experience data should be submitted in lieu of premium rates or loss
ratios. The results of the actuarial analysis shall be used as follows:
(a) If the actuarial plan comparison for a
Local Government demonstrates that costs are less than 10 percent over OEBB's
costs during the same two-year period, the Local Government may participate in
the OEBB plan(s) at current OEBB rates.
(b) If an actuarial plan comparison for a
Local Government demonstrates that costs are equal to or greater than 10
percent higher than OEBB's costs during the same two year period, the Local
Government may participate in the OEBB plan(s) subject to a special rate
category, or surcharge, for three years. After three years, the special rate
category will be discontinued and the Local Government will move to OEBB's
current rates.
(4) The
Local Government must submit a final Letter of Participation to OEBB at least
30 days prior to the effective date of participation.
(5) Local Governments who elect to
participate in benefit plans provided by the Board and then subsequently elect
to leave OEBB and offer a plan or plans available through the health insurance
exchange may re-elect to participate in benefit plans provided by the Board
under the rate category the Local Government was in just prior to leaving OEBB
on a one-time basis provided the Local Government completes and submits a
Letter of Participation to OEBB at least 60 days prior to the date OEBB
coverage is to go into effect.
(6)
Once a Local Government re-elects to participate in benefit plans provided by
the Board after leaving, they are not eligible to offer alternative plans
through any other source or sponsor.
(7) Local Governments electing to join OEBB
on or after April 1, 2015, are limited to using the tiered rate structure for
medical, dental and vision plans.
Notes
Stat. Auth.: ORS 243.860 - 243.886
Stats. Implemented: ORS 243.864(1)(a)
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