Certificate of Registered Domestic Partnership. When a Registered Domestic Partnership exists and the eligible employee wants to enroll the domestic partner or the domestic partner’s eligible children in benefit plans, the employee may electronically enroll or submit enrollment update forms to the agency at the appropriate time as defined by PEBB enrollment rules.
PEBB Affidavit of Domestic Partnership. An eligible employee and an individual of the opposite sex, or of the same sex without a Certificate of Registered Domestic Partnership, who want enrollment in PEBB plans as Domestic Partners must meet all of the following criteria:
Are both at least 18 years of age;
Are responsible for each other’s welfare and are each other’s sole domestic partners;
Are not married to anyone;
Share a close personal relationship and are not related by blood closer than would bar marriage in the State of Oregon;
Currently share the same regular permanent residence;
Are jointly financially responsible for basic living expenses defined as the cost of food, shelter, and any other expenses of maintaining a household. Financial information must be provided if requested, and;
Eligible employees must submit enrollment forms and a notarized affidavit to enroll domestic partners and children. To enroll eligible dependent children of a domestic partnership by affidavit in benefit plans, whether or not the enrollment includes the domestic partner, the employee must submit an Affidavit of Domestic Partnership.
For open enrollment, the agency must receive the notarized affidavit within five business days following close date of the open enrollment period. The exception is for an employee who is a newly eligible employee after the closure of the open enrollment period but before the start of the new plan year. The employee must complete paper open enrollment forms and submit the notarized affidavit to their agency before the start of the new plan year. The agency or PEBB will not process an employee’s domestic partner or partner’s children until the enrollment documentation submission is complete.
Newly eligible employees or employees with qualified mid-year changes may only enroll a domestic partner or partner’s children by submitting the correct enrollment forms and notarized affidavit within the allowable time for the enrollment type. Agencies will not process a domestic partner or a partner’s children’s enrollment until the enrollment documentation submission is complete.
An imputed value for the fair market value of the domestic partner and domestic partner’s dependent children’s insurance premium will be added to the eligible employee’s taxable wages.
An eligible employee ending a domestic partnership established under the PEBB Affidavit of Domestic Partnership must complete and submit a Termination of Domestic Partnership form and enrollment update forms to the agency within 30 days of the event. If the domestic partnership was established under the Certificate of Registered Domestic Partnership, only enrollment update forms must be submitted to the agency within 30 days of the event. Insurance coverage for the domestic partner and domestic partner’s dependent children ends the last day of the month that eligibility is lost.