OAR 101-020-0052
Surcharges

(1) For the purposes of this rule, the following definitions apply:

(a) Double Coverage means a subscriber/employee that is also an eligible dependent and is enrolled in two PEBB/PEBB or PEBB/OEBB medical plans.

(b) OEBB means the Oregon Educators Benefit Board in Oregon.

(c) Subscriber/employee means the individual who subscribes to their employer’s health plan. For the purposes of this rule, a subscriber excludes a COBRA participant, part-time employee, retiree or self-pay member.

(d) Dependent means and includes a dependent child as defined by OAR 101-015-0011 (Dependent Child), Spouse as defined by OAR 101-015-0005 (Eligible Individuals), and Domestic Partner as defined by OAR 101-015-0011 (Dependent Child).

(e) Surcharge means an extra fee deducted from the employee’s monthly pay.

(2) Tobacco Use Surcharge:

(a) Employees and spouses/Domestic Partners who are enrolled in a PEBB medical plan and use tobacco products may pay a monthly surcharge. The surcharge is deducted from the employee’s monthly paycheck. The monthly surcharges are determined by the PEBB Board.

(b) Employees who opt-out of a PEBB medical plan are not subject to this surcharge.

(c) Tobacco usage status can be updated prospectively at any time during the plan year by completing and submitting a Midyear change form.

(3) Spouse/Domestic Partner Other Group Coverage Surcharge:

(a) Employees will pay a monthly surcharge if the spouse/Domestic Partner is covered on the employee’s PEBB plan and chooses to not enroll in their own employer’s medical coverage (non-PEBB coverage). The monthly surcharges are determined by the PEBB Board.

(b) Employees who have a spouse/Domestic partner who opts out of PEBB coverage are not subject to this surcharge.

(c) Employees may submit a Midyear change form if this changes anytime during the plan year. The change request form must be submitted to their employer’s payroll or university benefits office within 30 days of the change. Changes take effect prospectively upon receipt of the appropriate form.

(4) Double Coverage:

(a) Effective January 1, 2021, any active full-time employees who cover an eligible dependent that is also enrolled as a subscriber for either a PEBB or an OEBB-sponsored medical plan will be assessed a monthly surcharge.

(b) The amount of the surcharge is determined annually by the PEBB Board.

(d) The subscriber will only pay one double coverage surcharge no matter how many dependents are double covered.

(e) The Double Coverage surcharge does not apply to Opt Out, Retirees, COBRA participants, self-pay participants or part-time employees.

Source: Rule 101-020-0052 — Surcharges, https://secure.sos.state.or.us/oard/view.action?ruleNumber=101-020-0052.

101‑020‑0002
Plan Effective Dates, Employee Eligibility Continuation, and Plan Termination Dates 101‑020‑0005
Newly Hired and Newly Eligible Employee 101‑020‑0012
Working in Two or More Positions or for Two or More PEBB Participating Organizations 101‑020‑0015
Opting Out of Medical Insurance Coverage 101‑020‑0018
Declining Benefits 101‑020‑0020
Newborn and Adopted Child Enrollment 101‑020‑0025
Removing an Ineligible Individual from Benefit Plans 101‑020‑0032
Open Enrollment 101‑020‑0037
Correcting Enrollment Errors and Open Enrollment Errors 101‑020‑0038
Correcting Processing Errors 101‑020‑0040
Late Enrollment 101‑020‑0045
Returning to Work 101‑020‑0047
Transfer 101‑020‑0050
Midyear Benefit Plan Changes 101‑020‑0052
Surcharges 101‑020‑0059
Commuter Accounts (Fringe Benefits) 101‑020‑0060
Dependent Care Flexible Spending Account 101‑020‑0065
Health Flexible Spending Arrangement 101‑020‑0066
Public Employees’ Benefit Board Appeal Procedure

California:	Codes
Colorado:	C.R.S.
Nevada:	NRS
New York:	Laws
Oregon:	OAR, ORS
Texas:	Statutes
World:	Rome Statute, International Dictionary

OAR 101-020-0052 Surcharges

OAR 101-020-0052
Surcharges