Or. Admin. Code § 459-035-0090

Current through Register Vol. 63, No. 11, November 1, 2024

Section 459-035-0090 - Retiree Health Insurance Premium Payment Process

(1) An eligible person who elects to participate in a PERS-sponsored health insurance plan shall choose one of the following methods for the payment of contributions for that coverage:

(a) The direct payment method by an electronic transfer of the monthly contribution for the PERS-sponsored health insurance plan from an eligible person's bank account to the Third Party Administrator; or

(b) The direct payment method by issuing a check or money order for the monthly contribution for the PERS-sponsored health insurance plan to the Third Party Administrator; or

(c) The pension deduction method wherein PERS shall deduct the monthly contribution from the service or disability retirement allowance or other benefit payable to the eligible person and forward the contribution to the Standard Retiree Health Insurance Account.

(A) The total monthly contribution due shall be deducted for the benefit option selected by the eligible person.

(B) If an eligible person's monthly PERS benefits are not sufficient to cover the monthly contribution for the PERS-sponsored health insurance plan, the deduction method may not be used.

(2) Employee contributions for the PERS-sponsored health insurance plan shall be paid monthly and shall consist of the following:

(a) The premium charged by the carrier for the eligible person's health insurance coverage, less any amount contributed on the eligible person's behalf from the RHIA or RHIPA; and

(b) The eligible person's share of the administrative costs incurred by PERS in administering the health insurance program as provided for in ORS 238.410(4).

(3) If payment is by check or money order, the check or money order must be physically received by the Third Party Administrator on or before the due date.

(4) Failure to make the payment by the due date shall result in termination of a person's PERS-sponsored health insurance coverage.

(5) Notwithstanding section (4) of this rule, no person's PERS-sponsored health insurance coverage shall be terminated in a manner contrary to the requirements of any emergency order issued by the Governor or the Department of Consumer and Business Services regarding termination of health insurance policies. When any such emergency order is in effect, the due date referenced in section (4) of this rule shall be extended to the extent required by such emergency order.

(6) On receipt of an eligible person's contribution, the Third Party Administrator shall deposit the contributions in the Standard Retiree Health Insurance Account. Amounts deposited in the Standard Retiree Health Insurance Account shall be used only to pay health insurance premiums on behalf of eligible persons and the costs incurred by PERS in administering the health insurance program.

Or. Admin. Code § 459-035-0090

PERS 4-1996, f. & cert. ef. 6-11-96; PERS 5-1999, f. & cert. ef. 11-15-99; PERS 14-2002, f. & cert. ef. 11-18-02; PERS 15-2020, temporary amend filed 10/02/2020, effective 10/02/2020 through 12/04/2020; PERS 18-2020, amend filed 12/04/2020, effective 12/4/2020

Statutory/Other Authority: ORS 238.410 & 238.650

Statutes/Other Implemented: ORS 238.410, 238.415 & 238.420