Oregon
Rule Rule 111-040-0001
Effective Dates


(1)

Effective Dates for Newly Eligible Employees. Initial benefit elections, unless otherwise specified in a collective bargaining agreement or documented Entity policy in effect on June 30, 2008, are effective on the later of:

(a)

The first of the month following a completed online enrollment in the OEBB benefit management system or submission of a paper enrollment or change form, or
(b)(A) The first of the month following the date of hire or the date of eligibility; with the following exception:

(B)

The first of the month following approval of Evidence of Insurability for Optional Life Insurance above the guarantee issue amount, Long Term Disability, or Long Term Care insurance. The approval letters sent to the member are not official until entered into OEBBs benefit management system.

(2)

Effective Dates for Qualified Status Changes. Covered dependent changes are effective the first of the month following the date of the event causing the dependent to be eligible under OEBB administrative rules with the following exceptions:

(a)

Coverage for a newborn child is effective on the date of birth. The active eligible employee must add the newborn child to their benefit plans within 60 calendar days from the date of birth in order for the newborn child to be eligible for benefit coverage. If the newborn is born between the first and the fifteenth of the month, the eligible employee is billed for any applicable premium beginning the first month in which the baby is born. If the newborn is born between the sixteenth of the month and the end of the month, the eligible employee is billed for any applicable premium beginning the first of the following month. With a newborn, the baby begins incurring their own expenses from their date of birth and since premiums are not pro-rated, this balances premiums.

(b)

Coverage for a newly adopted child is effective the date of the adoption decree or date of placement for adoption. The eligible employee must add the adopted child to their benefit plans within 60 calendar days from the date of the decree or placement in order for the newly adopted child to be eligible for benefit coverage; and

(A)

The eligible employee must submit the adoption agreement with the enrollment forms to the Entity.

(B)

Claims payments will not be made for expenses incurred prior to the date of decree or placement.

(c)

Coverage for an eligible grandchild is as follows:

(A)

If the legal guardianship is finalized within the first 60 days following the birth of the grandchild, coverage will be effective retroactive to the date of the birth.

(B)

If the legal guardianship is finalized 61 or more days from the date of birth of the grandchild, the coverage will be effective the first of the month following the date the guardianship documents are finalized.

(C)

If the legal guardianship is finalized 61 to 180 days from the date of birth of the grandchild, and the effective date of legal guardianship is retroactive to the grandchilds date of birth, coverage will be effective retroactive to the date of birth. If legal guardianship is finalized after 180 days coverage will be effective the first of the month following the date the guardianship documents are finalized.

(d)

The first of the month following approval of Evidence of Insurability for Optional Spouse/Domestic Partner Life insurance above the guaranteed issue amount, if applicable, or Long Term Care Insurance.

(3)

Elections made during an open enrollment period are effective on the first day of the new plan year. There will be a 12-month waiting period for services other than preventive dental exams and cleanings for coverage added during the open enrollment period if enrolling in a dental plan in which the employee and/or dependents were previously eligible.
Source
Last accessed
Oct. 13, 2019