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<div class=Section1>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;color:navy'>Good afternoon,<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;color:navy'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;color:navy'>Please see the important information below regarding Federal
Health Care Reform’s new restrictions on the Rescission of Coverage. This
is effective October 1<sup>st</sup>. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;color:navy'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;color:navy'>Thank you! OEBB Financial Services<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;color:navy'><o:p> </o:p></span></font></p>
<div>
<div class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt;font-family:"Times New Roman"'>
<hr size=2 width="100%" align=center tabindex=-1>
</span></font></div>
<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> oebbbusman-bounces@listsmart.osl.state.or.us
[mailto:oebbbusman-bounces@listsmart.osl.state.or.us] <b><span
style='font-weight:bold'>On Behalf Of </span></b>Business Managers-OEBB<br>
<b><span style='font-weight:bold'>Sent:</span></b> Thursday, September 30, 2010
4:58 PM<br>
<b><span style='font-weight:bold'>To:</span></b>
myoebb@listsmart.osl.state.or.us; OEBBBUSMAN@listsmart.osl.state.or.us; OEBBSUPERINFO@listsmart.osl.state.or.us<br>
<b><span style='font-weight:bold'>Subject:</span></b> [OEBBBUSMAN] OEBB to
Implement Federal Rescission Reforms onOctober 1, 2010<br>
<b><span style='font-weight:bold'>Importance:</span></b> High</span></font><font
face="Times New Roman"><span style='font-family:"Times New Roman"'><o:p></o:p></span></font></p>
</div>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b><i><u><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-weight:bold;font-style:
italic'>Federal Health Care Reform -- Rescission of Coverage<o:p></o:p></span></font></u></i></b></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>As you may have already heard, the federal health
care reform bill enacted new restrictions on an Employers’ rescission of
coverage. OEBB will implement the new restrictions effective <b><i><u><span
style='font-weight:bold;font-style:italic'>October 1, 2010</span></u></i></b>.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>Rescission of coverage can simply be defined
as: The <u>retroactive cancellation</u> of a health insurance policy.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>Under the new restrictions, a rescission
(retroactive cancellation) by the Employer is illegal <u>except</u> in cases of
fraud or intentional misrepresentation of material fact as prohibited by the
terms of the plan or coverage. <font color=red><span style='color:red'>Please
read this entire e-mail. It explains how this change <b><i><u><span
style='font-weight:bold;font-style:italic'>will</span></u></i></b> affect your
educational entity and members. I also encourage your educational entity
benefits team to participate in one of the phone conferences listed below.</span></font><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b><i><u><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-weight:bold;font-style:
italic'>Grandfathering Medical Plans<o:p></o:p></span></font></u></i></b></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>OEBB will not grandfather any plans
currently available. This means the Rescission of Coverage will apply to
all OEBB plans and that overage dependents age 19 through 25 may be enrolled
regardless of whether they are eligible for or have other group coverage.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b><i><u><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-weight:bold;font-style:
italic'>QSC Changes<o:p></o:p></span></font></u></i></b></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>Effective October 1, 2010, OEBB will limit
QSC date ranges in MyOEBB. You will not be able to back date any coverage
termination date; you will only be able to go forward. This means you
will not be able to access a 60-day retro feature as you have in the
past. If you need to retro adjust someone’s enrollment due to
intentional misrepresentation, you will need to contact OEBB for assistance.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b><i><u><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-weight:bold;font-style:
italic'>Invoicing Changes<o:p></o:p></span></font></u></i></b></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>Effective October 1, 2010, the following
invoicing rules will apply due to rescission:<o:p></o:p></span></font></p>
<p class=MsoNormal><b><i><u><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-weight:bold;font-style:
italic'>Active Employees<o:p></o:p></span></font></u></i></b></p>
<ul style='margin-top:0in' type=disc>
<li class=MsoNormal style='color:black;margin-top:5.0pt;margin-bottom:5.0pt;
mso-list:l1 level1 lfo3'><font size=3 color=black face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua"'>If the <b><u><span
style='font-weight:bold'>Educational Entity fails to notify OEBB</span></u></b>
of a retroactive employee termination, coverage must end on the last day
of the current month. *<u>No retroactive terminations</u> or adjustments
can be allowed.<a name="OLE_LINK1"></a><o:p></o:p></span></font></li>
<li class=MsoNormal style='color:black;margin-top:5.0pt;margin-bottom:5.0pt;
mso-list:l1 level1 lfo3'><font size=3 color=black face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua"'>If the <b><u><span
style='font-weight:bold'>Active Eligible Employee fails to notify their
Educational Entity</span></u></b> within 31 days in the event their
spouse, domestic partner or other dependent no longer meets eligibility
criteria, the affected individual’s coverage will be retroactively
terminated to the end of the month in which eligibility was lost.
OEBB considers this to be intentional misrepresentation and grounds
for retroactive termination of coverage. *<u>Credits for retroactive
adjustments will be issued</u> to the Entity for up to 90 days.<o:p></o:p></span></font></li>
<li class=MsoNormal style='color:black;margin-top:5.0pt;margin-bottom:5.0pt;
mso-list:l1 level1 lfo3'><font size=3 color=black face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua"'>If the <b><u><span
style='font-weight:bold'>Active Eligible Employee notifies the Educational
Entity within 31 days after an event</span></u></b> terminating
eligibility of the employee’s spouse, domestic partner or other
dependent, coverage for the affected individual will end on the last day
of the month in which OEBB receives notification of the event from the
Educational Entity. *<u>No retroactive terminations or adjustments</u>
are allowed.<o:p></o:p></span></font></li>
</ul>
<p class=MsoNormal style='mso-margin-top-alt:5.0pt;margin-right:0in;margin-bottom:
5.0pt;margin-left:.25in'><font size=3 color=black face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";color:black'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b><i><u><font size=3 color=black face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";color:black;font-weight:
bold;font-style:italic'>Retirees (Self-Pays)<o:p></o:p></span></font></u></i></b></p>
<ul style='margin-top:0in' type=disc>
<li class=MsoNormal style='color:black;margin-top:5.0pt;margin-bottom:5.0pt;
mso-list:l0 level1 lfo6'><font size=3 color=black face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua"'>OEBB <b><u><span
style='font-weight:bold'>can retroactively terminate coverage in the case
of non-payment</span></u></b><u>.</u> Retroactive terminations for failure
to pay premiums or contributions are not rescissions. Coverage will
be terminated on the last day of the month for which premiums were paid in
full by the retiree to the Entity and credits for retroactive adjustments
will be issued to the Entity for up to 90 days.<o:p></o:p></span></font></li>
<li class=MsoNormal style='color:black;margin-top:5.0pt;margin-bottom:5.0pt;
mso-list:l0 level1 lfo6'><font size=3 color=black face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua"'>The <b><u><span
style='font-weight:bold'>retiree is responsible for reporting to their
Educational Entity within 31 days of the date he/she or a dependent
becomes eligible for Medicare</span></u></b> coverage due to a disability.
<u>Failure to report</u> this loss of eligibility within 31 days is
considered by OEBB to be intentional misrepresentation and grounds for
retroactive termination of the affected individual’s coverage back
to the last day of the month prior to the Medicare effective date.<o:p></o:p></span></font></li>
<li class=MsoNormal style='color:black;margin-top:5.0pt;margin-bottom:5.0pt;
mso-list:l0 level1 lfo6'><font size=3 color=black face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua"'>OEBB automatically
terminates coverage for early retirees who become eligible for Medicare
due to age.<o:p></o:p></span></font></li>
</ul>
<p class=MsoNormal><b><i><u><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-weight:bold;font-style:
italic'><o:p><span style='text-decoration:none'> </span></o:p></span></font></u></i></b></p>
<p class=MsoNormal><b><i><u><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-weight:bold;font-style:
italic'>OEBB to Provide Statewide Question & Answer Phone Conferences<o:p></o:p></span></font></u></i></b></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>OEBB has scheduled several statewide phone
conferences (listed below) to discuss federal health care reform, rescission of
coverage, overage dependent children, and the post Open Enrollment Mail Out.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>Monday, October 4<sup>th</sup> – 2:00
to 3:30 PST<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>Tuesday, October 5<sup>th</sup> – 2:00
to 3:30 PST<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>Wednesday, October 6<sup>th</sup> –
11:00 to 12:30 PST<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>Thursday, October 7<sup>th</sup> –
3:30 to 5:00 PST<o:p></o:p></span></font></p>
<p class=MsoNormal><u><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p><span style='text-decoration:none'> </span></o:p></span></font></u></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>If you would like to participate in one of
the above calls, please call 503-378-2167 using code 31381.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b><i><u><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-weight:bold;font-style:
italic'>Scenarios<o:p></o:p></span></font></u></i></b></p>
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
style='border-collapse:collapse'>
<tr>
<td width=293 valign=top style='width:3.05in;border:solid windowtext 1.0pt;
padding:0in 5.4pt 0in 5.4pt'>
<p class=MsoNormal align=center style='text-align:center'><b><font size=3
face="Book Antiqua"><span style='font-size:12.0pt;font-family:"Book Antiqua";
font-weight:bold'>Scenario<o:p></o:p></span></font></b></p>
</td>
<td width=278 valign=top style='width:2.9in;border:solid windowtext 1.0pt;
border-left:none;padding:0in 5.4pt 0in 5.4pt'>
<p class=MsoNormal align=center style='text-align:center'><b><font size=3
face="Book Antiqua"><span style='font-size:12.0pt;font-family:"Book Antiqua";
font-weight:bold'>Rescind coverage?<o:p></o:p></span></font></b></p>
</td>
<td width=278 valign=top style='width:2.9in;border:solid windowtext 1.0pt;
border-left:none;padding:0in 5.4pt 0in 5.4pt'>
<p class=MsoNormal align=center style='text-align:center'><b><font size=3
face="Book Antiqua"><span style='font-size:12.0pt;font-family:"Book Antiqua";
font-weight:bold'>What does this mean for my educational entity?<o:p></o:p></span></font></b></p>
</td>
</tr>
<tr height=88 style='height:66.1pt'>
<td width=293 height=88 valign=top style='width:3.05in;border:solid windowtext 1.0pt;
border-top:none;padding:0in 5.4pt 0in 5.4pt;height:66.1pt'>
<p class=MsoNormal><b><i><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-weight:bold;
font-style:italic'>Employment Termination</span></font></i></b><i><font
face="Book Antiqua"><span style='font-family:"Book Antiqua";font-style:italic'><o:p></o:p></span></font></i></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>In the event an educational entity does not
enter the termination of coverage timely due to lost paperwork, untimely
reconciliation, or other administrative reasons.<o:p></o:p></span></font></p>
</td>
<td width=278 height=88 valign=top style='width:2.9in;border-top:none;
border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0in 5.4pt 0in 5.4pt;height:66.1pt'>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>No, this can't be considered intentional
misrepresentation and thus is not grounds for rescission. The employer
was aware of the change and the terminated employee didn't misrepresent
anything. The termination of benefits in the MyOEBB system is the
responsibility of the educational entity.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>Coverage must end on the last day of the
current month. No retroactive terminations or adjustments can be made.<o:p></o:p></span></font></p>
</td>
<td width=278 height=88 valign=top style='width:2.9in;border-top:none;
border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0in 5.4pt 0in 5.4pt;height:66.1pt'>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>This means when the educational entity
discovers the error in MyOEBB they will only be able to terminate coverage in
MyOEBB at the end of the month of discovery. There will be no retro
terminations allowed or credits available for the educational entity.
The terminated employee will have these extra months of benefit coverage.<o:p></o:p></span></font></p>
</td>
</tr>
<tr>
<td width=293 valign=top style='width:3.05in;border:solid windowtext 1.0pt;
border-top:none;padding:0in 5.4pt 0in 5.4pt'>
<p class=MsoNormal><b><i><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-weight:bold;
font-style:italic'>Qualified Status Changes – Death, Divorce, dropping
Domestic Partner, child ceasing to meet eligibility and, on retiree plans,
gaining of Medicare.<o:p></o:p></span></font></i></b></p>
<p class=MsoNormal><i><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-style:italic'><o:p> </o:p></span></font></i></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>In the event a member (this applies to
self-pay and partial self-pay groups also) experiences a qualified status
change or, on a retiree plan, gains Medicare and fails to notify their
educational entity within the timeframe specified in our administrative rules.<o:p></o:p></span></font></p>
</td>
<td width=278 valign=top style='width:2.9in;border-top:none;border-left:none;
border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0in 5.4pt 0in 5.4pt'>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>Yes, this can be considered intentional
misrepresentation only if OEBB takes the following action steps to notify
educational entities and members that failure to take action in these types
of scenarios is considered intentional misrepresentation.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>These terminations dates would need to be
effective at the end of the current month or the month the QSC is occurring
the member fails to notify the educational entity of the QSC event within the
timeframe specified in the OEBB administrative rules.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>Only if the member fails to report this
timely can we rescind coverage.<o:p></o:p></span></font></p>
</td>
<td width=278 valign=top style='width:2.9in;border-top:none;border-left:none;
border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0in 5.4pt 0in 5.4pt'>
<p class=MsoNormal style='line-height:14.4pt'><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua"'>If the member <u>did not</u>
report this change timely it will be considered misrepresentation. When
an eligibility or enrollment violation has been discovered and investigated, OEBB
will notify the member and the Educational Entity of the outcome<b><span
style='font-weight:bold'>. </span></b>If the outcome includes rescission of
coverage, OEBB will give a 30-day notice of such rescission prior to
terminating the affected individual’s coverage retroactively to the
date the affected individual was no longer eligible for benefits.</span></font><font
size=2 color=blue face="Book Antiqua"><span style='font-size:11.0pt;
font-family:"Book Antiqua";color:blue'> </span></font><font
face="Book Antiqua"><span style='font-family:"Book Antiqua"'>The notice will
include the specific reason(s) for the decision, a reference to the specific
plan provision or <st1:stockticker w:st="on">OAR</st1:stockticker> on which
the determination was based, a description of any additional information required
and a description of the OEBB appeals process, as the member has the right to
appeal the decision through OEBB.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>The member may be responsible for any
claims paid and expenses incurred during the period of time the affected
individual was enrolled inappropriately.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>Policy term violations may apply to the
subscriber and their dependents.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>There will be up to a 90-day credit
available (if applicable) for the educational entity.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>If the member <u>did</u> report this
change timely it will not be considered misrepresentation but an error
originating from the educational entity. This means when the
educational entity discovers the error in MyOEBB they will only be able to
terminate the benefits in MyOEBB at the end of the month of discovery.
There will be no retros allowed or credits available for the educational
entity. The terminated employee will have these extra months of benefit
coverage.<o:p></o:p></span></font></p>
</td>
</tr>
<tr>
<td width=293 valign=top style='width:3.05in;border:solid windowtext 1.0pt;
border-top:none;padding:0in 5.4pt 0in 5.4pt'>
<p class=MsoNormal><b><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-weight:bold'>100% <i><span
style='font-style:italic'>Self-pay Groups (COBRA/HB 2557/Retiree)<o:p></o:p></span></i></span></font></b></p>
<p class=MsoNormal><i><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-style:italic'><o:p> </o:p></span></font></i></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>In the event a member in one of
OEBB’s self-pay groups stops paying their premiums, coverage is
terminated retroactive to the end of the month that the full premium was
paid.<o:p></o:p></span></font></p>
</td>
<td width=278 valign=top style='width:2.9in;border-top:none;border-left:none;
border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0in 5.4pt 0in 5.4pt'>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>OEBB can retroactively terminate coverage
in the case of non-payment. Retroactive terminations for failure to pay premiums
or contributions are not rescissions. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>Coverage will be terminated on the last
day of the month for which premiums were paid in full.<o:p></o:p></span></font></p>
</td>
<td width=278 valign=top style='width:2.9in;border-top:none;border-left:none;
border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0in 5.4pt 0in 5.4pt'>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>OEBB or its contractor will terminate
coverage on the last day of the month that premiums were paid in full. <o:p></o:p></span></font></p>
</td>
</tr>
<tr>
<td width=293 valign=top style='width:3.05in;border:solid windowtext 1.0pt;
border-top:none;padding:0in 5.4pt 0in 5.4pt'>
<p class=MsoNormal><b><i><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-weight:bold;
font-style:italic'>Partial Self-pay Groups - Employees, Early retirees, or
COBRA participants who pay a portion of their total premium<o:p></o:p></span></font></i></b></p>
<p class=MsoNormal><i><font size=3 face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";font-style:italic'><o:p> </o:p></span></font></i></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>When a member in a partial self-pay group
fails to pay their portion of the premium and the educational entity
continues to “float” the entire premium (pay the entire premium
to OEBB) while waiting for the employee, early retiree, or COBRA participant
to make up their portion. Once the entity notifies OEBB, we will terminate
coverage back to when the member stopped paying their portion and will give
the entity up to a 90-day credit.<o:p></o:p></span></font></p>
</td>
<td width=278 valign=top style='width:2.9in;border-top:none;border-left:none;
border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0in 5.4pt 0in 5.4pt'>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>OEBB can retroactively terminate coverage
in the case of non-payment – whether or not the member was responsible
for the full premium or partial premium. Retroactive terminations for failure
to pay premiums or contributions are not rescissions.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>Coverage will be terminated on the last
day of the month for which premiums were paid in full.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 color=red face="Book Antiqua"><span
style='font-size:12.0pt;font-family:"Book Antiqua";color:red'><o:p> </o:p></span></font></p>
</td>
<td width=278 valign=top style='width:2.9in;border-top:none;border-left:none;
border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0in 5.4pt 0in 5.4pt'>
<p class=MsoNormal><font size=3 face="Book Antiqua"><span style='font-size:
12.0pt;font-family:"Book Antiqua"'>This means when an educational entity
discovers the non-payment they will notify OEBB and provide the necessary
information so OEBB can terminate coverage(s) in MyOEBB at the end of the
month of last full payment was received. There will be up to a 90-day
credit available (if applicable) for the educational entity.<o:p></o:p></span></font></p>
</td>
</tr>
</table>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt'><o:p> </o:p></span></font></p>
</div>
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