Medical Plan Enrollment*

New Retiree

New retirees may enroll up to 90 days after the effective date of their retirement. Coverage will be effective on your retirement date if you apply before your retirement date and on the first day of the month after your application received if you apply after your retirement date.

Continuous Group Coverage

PERS retirees may enroll at any time if they have been covered under another group health plan for 24 consecutive months immediately preceding enrollment in a PERS health plan. Coverage will be effective on the date that your other coverage ends. (Preceding coverage must be with an employer sponsored group health plan. For example, if you are on Medicare A and B and are enrolled in AARP, this does not qualify as a group plan. AARP is not a group insurance plan, but an individual plan.) If you have any questions, please call the PERS Health Insurance Program at 1-800-768-7377 or 503-224-7377 in the Portland area.

Medicare Eligibility

PERS retirees may enroll up to 90 days after the date of their initial Medicare eligibility if they are enrolled in both Medicare Parts A and B. Coverage will be effective on the date that your Medicare coverage becomes effective if you enroll before the date of your Medicare eligibility. Coverage will be effective on the first day of the month after your application is received if you apply after the date of your Medicare eligibility. A spouse or dependent may enroll in a PERS sponsored health plan up to 90 days after their initial medicare eligibility in both medicare Part A and B, even though the retiree remains enrolled in his or her employer group plan.

Medicare Disability.

Medicare Disability. PERS retirees and/or dependents who are disabled and receiving Social Security benefits will become eligible for Medicare approximately 24 months following the established date of disability. The 90-day Medicare eligibility enrollment opportunity also applies in these circumstances.

*These enrollment times are the only enrollment opportunities offered. Retirees and their spouses or dependents who do not choose to enroll in a PERS health plan during one of these enrollment periods will lose their opportunity to enroll into the PERS Health Insurance Program.

Dental Plan Enrollment

Dependent Enrollment
Dependents may be enrolled during any of the enrollment periods available to retirees, including the retiree's date of retirement, the dependent's eligibility for Medicare or after the dependent has had at least 24 consecutive months of coverage under another employer group health plan. New dependents may also be enrolled within 30 days of becoming a dependent.

Dependents must be enrolled in the same plan as the retiree. If the retiree has Medicare coverage, and the dependent has non-Medicare coverage, then coverage must still be with the same health plans. A spouse or dependent may enroll in a PERS-sponsored health plan up to 90 days after their initial Medicare eligibility in both Medicare Part A and B even though the retiree remains enrolled in his/her employer group plan. Enrollment in a PERS-sponsored medical plan includes enrollment in Medicare Part D. The dependent may also enroll in a PERS-sponsored health plan if enrolled in Medicare Part A and B at the time of the PERS member's retirement.

Divorced spouses of PERS retirees are not eligible for a PERS-sponsored health plan, even if receiving a PERS benefit check. If a spouse is enrolled in a PERS-sponsored health plan at the time of divorce, COBRA continuation applies. The spouse will need to send a copy of the divorce decree to the PERS Health Insurance Program within 60 days of the dissolution of marriage in order to continue coverage.

The surviving spouse of a PERS member may continue enrollment as described in the current handbook. However, in the event of remarriage, coverage of the surviving spouse of the PERS retiree cannot be extended to the new spouse.