Oregon Administrative Rules Chapter 165 - SECRETARY OF STATE, ELECTIONS DIVISION
Oregon Administrative Rules (OAR) Chapter 101 governs the Oregon Health Authority, Public Employees' Benefit Board (PEBB). This chapter details the administrative rules that dictate the operation and services of PEBB, which is responsible for providing health and other benefits to eligible state employees and retirees in Oregon.
Here's a breakdown of the key areas covered by OAR Chapter 101:
I. Core Purpose and Authority:
PEBB's primary role is to design, procure, and administer benefit plans for eligible public employees, retirees, and their dependents.
The Board operates under the authority granted by Oregon Revised Statutes (ORS) Chapter 243, particularly ORS 243.061 to 243.302.
II. Key Divisions/Sub-chapters within OAR Chapter 101:
Division 1: Procedural Rules: This division outlines the general administrative procedures for PEBB, including how rules are adopted, amended, or repealed. It also specifies the adoption of the Attorney General's Uniform and Model Rules of Procedure under the Administrative Procedure Act.
Division 2: Powers of the Board: This section defines the specific powers and duties of the PEBB Board, such as studying benefit plan coverage, preparing specifications, inviting bids from carriers, and awarding contracts for benefit plans. Emphasis is placed on employee choice, a competitive marketplace, plan performance, and quality customer service.
Division 5: Renewal, Screening and Selection for Benefits and Vendor Contracts: This division details the process for selecting and renewing contracts with benefit plan vendors.
Division 10: Definitions: Provides definitions for terms used throughout the chapter, such as "eligible employee," "active eligible employee," "retired eligible employee," "core benefits" (medical, dental, vision, basic life), "optional plans" (dependent life, optional life, AD&D, short-term and long-term disability), "half-time," and "final average salary."
Division 15: Eligibility: Lays out the criteria for who is eligible to receive benefits through PEBB, including requirements for employment status (e.g., full-time, half-time, temporary) and other conditions.
Division 20: Enrollment Rules: Specifies the procedures for employees to enroll in benefit plans, including plan effective dates, irrevocability rules for plan elections, and rules for mid-year changes due to qualified events. It also addresses situations like newly hired employees and those working in multiple positions.
Division 30: Continuation of Insurance — Active Employees: Covers rules related to the continuation of benefits for active employees, including provisions for leave, and outlines requirements for maintaining coverage, such as accruing a minimum number of paid regular status hours. It also references COBRA (Consolidated Omnibus Budget Reconciliation Act) for continuation of coverage.
Division 50: Retiree Rules: Details the eligibility criteria and rules for retired public employees to continue receiving benefits through PEBB.
Division 60: PEBB-Provided Health Benefit Plan for Liquor Control Commission Agents: This specific division addresses benefits for agents of the Oregon Liquor Control Commission.
Division 70: Local Government Participation: Outlines the rules for local government entities to participate in PEBB benefit plans.
Division 80: Operations: Covers general operational aspects of PEBB.
Division 65: SB 551: This division specifically addresses the administration of the SB 551 program, which relates to health benefit plans for part-time faculty members at Oregon public institutions of higher education.
III. Where to find the full text and further information:
Oregon Secretary of State's Office of Administrative Rules website: This is the official source for the Oregon Administrative Rules. You can typically navigate to Chapter 101.
Oregon Health Authority (OHA) Public Employees' Benefit Board (PEBB) website: The official PEBB website (often found under the OHA umbrella) provides direct access to their administrative rules, benefit information, forms, and contact details. This is an excellent resource for the most current information and specific details about benefit plans.
Legal information websites: Sites like Justia Regulations and Cornell Law School's Legal Information Institute (LII) also host the Oregon Administrative Rules.
When reviewing these rules, it's always advisable to consult the most current version available from official state sources, as regulations can be updated and amended.
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