You may terminate your PHIP coverage any time you choose.
If you are the PERS retiree:
If your spouse passes away, your PHIP coverage will continue as usual. To end your spouse’s coverage, please notify both PHIP and the PERS Pension office. You will need to mail a copy of your spouse’s death certificate to PHIP.
If you are the surviving spouse or dependent child of a PERS retiree:
If the PERS retiree passes away, your PHIP coverage will continue automatically. You will need to mail a copy of the retiree’s death certificate to PHIP and also separately to the PERS Pension office. If you do not want your coverage to continue, please send PHIP a Disenrollment Form.
If coverage was paid via pension deduction, your account will change to self-pay, and you will receive an invoice. If you are eligible for a PERS survivor benefit you can submit a PHIP Payment Option Form, selecting the pension deduction as your payment method.
If the surviving spouse or dependent is not enrolled at the time of the PERS retiree’s death, the spouse or dependent may enroll within 90 calendar days of the death or by meeting another enrollment opportunity. However, in the event of remarriage, coverage cannot be extended to the new spouse.
If you would like to end your PHIP coverage, you will need to complete and send a PHIP Disenrollment Form. This is legally required by PHIP and Medicare. This change will be effective on the first of the month after we receive your PHIP Disenrollment Form, unless you request a later date. If your spouse and/or dependent child (over 18) are part of your plan, they will also need to sign the form.
If anyone in your family stops their dental coverage, the whole family will lose their dental coverage.
Once you end your coverage from PHIP, you may not re-enroll unless you experience a new enrollment opportunity.
PHIP may be required to end your coverage if you:
In order to be eligible for PHIP, you must be enrolled in and maintain Medicare Part A and Part B. Part B premiums must be paid to Medicare. If you drop or lose your Part A or Part B coverage through Medicare, you will no longer be eligible for coverage through PHIP.
Your premium payment is due on the first of each month. If your payment is not received by then, your account will be considered delinquent. If you do not pay your premium, your health plan coverage will be terminated. If your coverage is terminated, you may have to pay for all claims, unless they are covered under Original Medicare.
You can only be enrolled in one Medicare Advantage and Medicare Part D prescription drug plan at a time. Enrolling in another Medicare Advantage or Medicare Part D plan outside of PHIP will disenroll you completely from PHIP, including your optional dental coverage.
If you are no longer an eligible retiree under PERS as defined under ORS 238.305(3), 238.315, or 238A.195, or payment(s) under ORS 238A.400, or a person who is receiving retirement pay or pension calculated under ORS 1.314 to 1.380 (1989 Edition), you are no longer eligible for the PHIP.
Your coverage will be terminated the end of the month in which you are no longer an eligible retiree.
Once your coverage is terminated for any reason, you may not re-enroll unless you experience a new enrollment opportunity.
If you experience one of these qualifying events you or your dependent may be eligible for continuation of coverage through COBRA. In accordance with federal and state of Oregon guidelines, PHIP provides opportunities for the continuation of coverage through COBRA following specific qualifying events. If you experience one of the qualifying events listed below, please contact PHIP for additional information. A qualifying event will occur if eligibility for coverage is
lost because of:
Once COBRA has been secured, timely payment of premiums is essential.
Timely COBRA Premium Payments
Once you elect COBRA coverage you have 45 days to pay the initial premium. After that, premiums are due the first day of each month. If your initial payment is not (postmarked or received) by the due date, your coverage will be terminated and cannot be reinstated. You have a 30-day grace period for monthly payments, after which your policy will be cancelled and cannot be reinstated. The initial premium must be paid within 45 days of the date COBRA is elected. Thereafter, premiums are due the first day of each month for that month’s coverage. If payment is not postmarked on or before the 45th day (for the initial premium) or the 30th day following the monthly due date, coverage will be terminated and cannot be reinstated.
If you are disenrolled by PHIP, you may lose all eligibility in PHIP. Typically, you may not re-enroll in PHIP unless you experience a new enrollment opportunity.