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<p class="MsoNormal"><span style="font-size:14.0pt">Dear Business Managers, Superintendents & Benefits Administrators:<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt">We’ve received some requests for clarification regarding double-coverage under SB1067. The core concept is … the new law will eliminate double-coverage (including opt-out funds in lieu of coverage) for spouses/partners
who are both eligible for a PEBB or OEBB plan. If the spouse/partner’s benefits are through another employer (not PEBB or OEBB), nothing changes.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt">To illustrate, let’s look at some scenarios using a hypothetical family of two adults, Mary and John, and their child, Billy.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt"><o:p> </o:p></span></p>
<ol style="margin-top:0in" start="1" type="A">
<li class="MsoNormal" style="margin-left:0in;mso-list:l1 level1 lfo1"><span style="font-size:14.0pt">If Mary is eligible for OEBB benefits, and
<b>John works for some other employer</b> that offers other benefits (not OEBB or PEBB) …
<b>nothing changes</b> for them. All three of them can be double-covered if they want. They could enroll in one plan and opt-out of the other if they wanted to, and receive a cash incentive for doing so. Life goes on as usual.<o:p></o:p></span></li></ol>
<p class="MsoNormal"><span style="font-size:14.0pt"><o:p> </o:p></span></p>
<ol style="margin-top:0in" start="2" type="A">
<li class="MsoNormal" style="margin-left:0in;mso-list:l1 level1 lfo1"><span style="font-size:14.0pt">If Mary is eligible for OEBB benefits, and
<b>John is ALSO eligible for either OEBB or PEBB benefits</b>, that’s where the restrictions come in. Each family member can only be covered once, and no opt-out incentives would be allowed.<o:p></o:p></span></li></ol>
<p class="MsoNormal"><span style="font-size:14.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal" style="margin-left:1.0in"><b><span style="font-size:14.0pt">Option 1:</span></b><span style="font-size:14.0pt"> All three enroll under Mary’s plan and John waives coverage (no financial incentive).<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:1.0in"><span style="font-size:14.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal" style="margin-left:1.0in"><b><span style="font-size:14.0pt">Option 2:</span></b><span style="font-size:14.0pt"> All three enroll under John’s plan and Mary waives coverage (no financial incentive).<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:1.0in"><span style="font-size:14.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal" style="margin-left:1.0in"><b><span style="font-size:14.0pt">Option 3:</span></b><span style="font-size:14.0pt"> Mary enrolls under her plan, John enrolls under his plan, and only one of them covers Billy. Billy cannot be enrolled in both.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt">The key to the language we published yesterday was the word “enrolled”. Upon first reading, many people didn’t lock into the idea that “enrolled” means actually taking the coverage … it was commonly misinterpreted
as being “eligible” for coverage regardless of whether the person actually took the coverage or not.
<o:p></o:p></span></p>
<p class="MsoNormal"><b><span style="font-size:14.0pt"><o:p> </o:p></span></b></p>
<ul style="margin-top:0in" type="disc">
<li class="MsoNormal" style="margin-bottom:14.0pt;margin-left:0in;line-height:105%;mso-list:l0 level1 lfo2">
<span style="font-size:12.0pt;line-height:105%">Members <span style="background:yellow;mso-highlight:yellow">
enrolled</span> in OEBB as a subscriber (the benefits-eligible individual whether an active employee, early retiree or COBRA participant), may not
<span style="background:yellow;mso-highlight:yellow">enroll</span> as a dependent under another OEBB or Public Employees’ Benefit Board (PEBB) plan. OEBB subscribers
<u>may</u><b> </b>enroll as a dependent in another employer plan that is <u>not</u> OEBB or PEBB.<o:p></o:p></span></li></ul>
<p class="MsoNormal" style="margin-bottom:14.0pt;line-height:105%"><span style="font-size:14.0pt;line-height:105%">I hope this helps clarify the impact on OEBB members who have a spouse/partner also eligible for OEBB or PEBB benefits.
<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom:14.0pt;line-height:105%"><span style="font-size:14.0pt;line-height:105%">If you have additional questions, please contact OEBB Member Services at 888-469-6322 or send an email to:
<a href="mailto:oebb.benefits@state.or.us"><span style="color:#0563C1">oebb.benefits@state.or.us</span></a>.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:15.75pt"><span style="font-size:14.0pt;font-family:"Arial",sans-serif">Thank you,<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:15.75pt"><span style="font-size:14.0pt;font-family:"Arial",sans-serif"><img border="0" width="262" height="84" style="width:2.7291in;height:.875in" id="Picture_x0020_1" src="cid:image001.jpg@01D3860C.6B711920" alt="LindaSignature"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:15.75pt"><span style="font-size:14.0pt;font-family:"Arial",sans-serif">Linda Freeze<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:15.75pt"><span style="font-size:14.0pt;font-family:"Arial",sans-serif">OEBB Benefits Manager<o:p></o:p></span></p>
<p class="MsoNormal"><o:p> </o:p></p>
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