| Non-Medicare Eligible Retirees |
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| Consider your options |
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Employees who are thinking of retiring before they are eligible for Medicare have several insurance options to consider. Keep in mind that eligible retirees who enroll in PEBB benefits must self pay the premiums; the state does not contribute.
Retiree Medical and Dental Options
If you are a state retiree eligible for Medicare, you are no longer eligible for PEBB plans (except for people with end-stage renal disease). Your options include:
- A PERS Medicare supplement plan
- An individual Medicare supplemental plan.
For more information on these options, contact the PERS health insurance programs.
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| Who is eligible for coverage? |
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To be eligible for PEBB participation as a retiree, you must meet both of the following requirements:
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Be eligible to receive retirement benefits under PERS rules, and
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Be enrolled in a PEBB medical and/or dental plan.
The following individuals are eligible for retiree coverage:
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Eligible employees who will be eligible retirees
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Their spouse or domestic partner, and
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Their dependent children covered on the active employees' plans at the time of retirement.
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| What plans are available? |
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Retirees may choose from all available medical and dental plans including full-time and part-time and retiree plans available in your service area. You may change medical or dental plans when you enroll in a PEBB retiree plan. You and your dependents may choose medical only, dental only, or medical and dental coverage; however, when you choose only dental coverage you cannot add medical coverage at a later time, and vice versa.
Read descriptions of plans offered by
View coverage comparisons for:
What are the monthly premium rates?
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2007 Retiree Medical Plan Monthly Premium Rates
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Retiree
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Retiree & Spouse/Partner
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Retiree & Children
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Retiree & Family
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Kaiser Permanente HMO 1
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677.42
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907.73
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779.03
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928.06
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Kaiser Permanente Added Choice POS 2
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710.90
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952.61
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817.55
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973.95
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Providence Choice PPO 3
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662.85
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888.22
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762.29
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908.11
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Regence BCBSO PPO 3
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738.49
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989.48
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849.21
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1011.62
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Samaritan Select PPO 3
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667.65
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894.65
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767.80
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914.68
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Kaiser Permanente Part-time & Retiree HMO 4
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574.87
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770.31
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661.11
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787.55
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Kaiser Permanente Added Choice Part-time & Retiree POS 4
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575.89
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771.69
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662.27
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788.96
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ProvidenceChoice Part-time & Retiree PPO 5
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529.07
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708.94
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608.42
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724.82
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Regence BCBSO Part-time & Retiree PPO 5
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593.12
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794.69
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682.05
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812.51
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Samaritan Select Part-time & Retiree PPO 5
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537.47
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720.21
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618.08
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736.33
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1 Kaiser Permanente HMO routine vision services.
2 Kaiser Permanente HMO Tier 1 vision services.
3 Vision services through VSP.
4 Routine vision exam only.
5 No routine vision benefit.
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2007 Retiree Dental Plan Monthly Premium Rates
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Retiree
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Retiree & Spouse/Partner
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Retiree & Children
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Retiree & Family
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Kaiser Permanente
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88.97
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119.23
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102.31
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121.89
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ODS Preferred
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61.70
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82.68
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70.95
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84.53
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ODS Traditional
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66.80
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89.51
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76.82
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91.52
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Willamette Dental Group
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62.30
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83.48
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71.64
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85.35
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ODS Part-time & Retiree
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48.06
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64.41
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55.28
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65.86
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| How long can I continue? |
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As long as:
- You are not eligible for Medicare (except those with end-stage renal disease)
- Premium payments are current
- PEBB continues to offer retiree coverage.
In the event of your death, your enrolled dependents may continue coverage as long as they meet the eligibility requirements.
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| When can I enroll? |
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PEBB coverage must be continuous. You must enroll within 60 days of when your active PEBB coverage ends. Contact your employing agency for the date your active group coverage will end. The enrollment deadline is 60 days from that date.
Exceptions:
- If you have coverage under a spouse or partner’s active PEBB plan, you may enroll in the PEBB retiree plan later if you lose the current coverage.
- If you choose COBRA continuation coverage and then become eligible to retire, you can transfer to the retiree group during or at the end of the COBRA period.
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| When can I change plans? |
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You may make plan changes only during the Plan Change period. The Board sets the Plan Change period for retirees. The Plan Change period allows retirees the opportunity to change plans; it does not allow them to add coverage they did not already have.
For example, if you chose not to enroll in medical coverage when you retired, you may not enroll for medical during subsequent Plan Change periods. You may not add dependents during this period. You may add dependents only within 60 days of and consistent with a qualified status change.
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| What are the effective dates? |
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PEBB retiree coverage is effective immediately following the transition from PEBB employee coverage or COBRA coverage. There must be no break in coverage.
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| If I move out of the area? |
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Retirees who leave a plan’s service area may enroll in a new plan. They must do so within 60 days. If they fail to enroll within 60 days, they may apply for late enrollment, which must be approved by PEBB.
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| If my child loses coverage? |
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If an eligible dependent not enrolled on your retiree plan later loses other employer group coverage, you may enroll the dependent for coverage in the retiree plan. You must do so within 60 days. If you fail to submit the correct forms within 60 days of the event, you may apply for late enrollment, which must be approved by PEBB.
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| Can I continue optional plans? |
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Life insurance: The Standard Insurance Company guarantees your acceptance without submitting evidence of insurability if you enroll in conversion or PEBB retiree life insurance coverage within 60 days from the date of your retirement. Review your life insurance options. Please contact the Standard Insurance Company at (800) 628-860 for more information.
Long term care insurance: If you have long term care insurance, you must convert the policy to an individual plan to continue the coverage. Please contact UNUMProvident for more information about this option.
| Retirees cannot continue dependent life, disability, or accidental death and dismemberment insurance. |
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| What other options do I have? |
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PERS. Contact the PERS Health Insurance Program for more information.
COBRA. The federal COBRA law allows you to continue the same coverage you had as an employee, but you must self pay your premium. However, there are some important differences to keep in mind.
COBRA usually allows continuation of your participation in the active-employee group for only 18 months. If you retire because of disability, you may be eligible for an additional 11 months of COBRA coverage, for a total of 29 months.
COBRA coverage ends if you:
- Become eligible for Medicare in the 18-month period (except those with end-stage renal disease
- Become covered by another group medical plan that does not exclude or limit coverage for pre-existing conditions
- Fail to make a timely premium payment.
In the event of your death, COBRA coverage may continue for dependents up to 36 months from the time you began to pay your own premium. Other provisions may apply for COBRA coverage. Contact BHS for more information.
Portability Coverage or Oregon Medical Insurance Program. The PEBB Regence and Kaiser medical plans are "portable." Portability means that you may purchase an individual medical plan offered by your insurance company on a guaranteed issue basis within 63 days after leaving the PEBB group. To be eligible you must:
- Have 180 days of continuous employer group medical coverage
- Be an Oregon resident
- Not be eligible for Medicare
- Currently not be enrolled in another medical plan.
In the case of your death your dependents may continue coverage if they continue to meet the eligibility requirements. For portability information and rates, call the individual plan carriers directly.
Samaritan and Providence medical plans are self-insured medical plans. If you leave a self-insured plan, you may access coverage through the Oregon Medical Insurance Program (OMIP). To apply for coverage through OMIP, you must first exhaust your COBRA coverage. Contact OMIP for more information.
Medicare Coverage. Medicare covers:
- People 65 years of age and older
- Certain younger people with disabilities.
When you become eligible for Medicare (except for end-stage renal disease), you are no longer eligible to participate in PEBB plans. When you become eligible for Medicare but your spouse or partner and dependents are not, these family members may continue PEBB coverage if they were enrolled on your coverage when you became Medicare eligible.
For information about individual plans to supplement Medicare coverage, contact the Senior Health Insurance Benefits Assistance program at (800) 722-4134.
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