Public Employees Retirement System

Enrollment Opportunities

PHIP enrollment opportunities, as defined in OAR 459-035-0070, mark the only enrollment opportunities for PERS retirees and their dependents to enroll in PHIP health coverage. Once all of these opportunity events have passed you and your eligible dependents will not be able to enroll in PHIP coverage. For dependents to enroll in PHIP the retiree must be eligible to enroll in PHIP, and at some point, enroll with the dependent.

Dependents may enroll when the retiree experiences an enrollment opportunity and enrolls in PHIP coverage. Enrollment Request forms can be submitted as early as 90 days prior to the event date for any these enrollment opportunities.

During peak enrollment times (i.e., plan change, peak retirement periods, end of month), processing delays may occur

Please allow time for PHIP to process your Enrollment Request Form and notify your health carrier. In the event you need immediate access to your health plan information, please contact PHIP.

 

Enrollment opportunities are:
New Oregon PERS Retirement
Initial Medicare Eligibility
Loss of employer-sponsored coverage
Surviving spouse/dependent

New Oregon PERS retirement

New Oregon PERS retirees can enroll within 90 days of their PERS effective retirement date. Coverage will be effective either on the PERS effective retirement date if the completed Enrollment Request Form is received prior to that event, or the first of the month after the completed Enrollment Request Form is received by PHIP, whichever is later. Any Enrollment Request Form received after 90 days of the PERS effective retirement date is considered outside of the enrollment opportunity and will be ineligible.

If retirement is due to disability your enrollment opportunity is calculated from the date on your PERS disability approval letter.

Some employers allow employer-sponsored coverage to go beyond the retirement date, so you will want to verify the end date of your employer-sponsored coverage to determine your effective date with PHIP to prevent overlapping coverage.

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Initial Medicare eligibility

PERS retirees can enroll within 90 days of their initial Medicare eligibility, if enrolled in both Medicare Parts A and B. Enrollment in a PHIP medical plan includes enrollment in the PHIP Medicare Part D prescription plan.

Eligibility for Medicare begins the first of the month of your 65th birthday or, if receiving Social Security due to disability, on the 25th month of receiving Social Security benefits. You must be enrolled in both Medicare Parts A and B to be covered by PHIP once you are eligible for Medicare.

PHIP Coverage will be effective either on the initial Medicare eligibility date if the completed Enrollment Request Form is received prior to that event, or the first of the month after the completed Enrollment Request Form is received by PHIP, whichever is later. Any Enrollment Request Form received after 90 days of the initial Medicare eligibility is considered outside of the enrollment opportunity and will be ineligible.

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Loss of employer-sponsored health coverage

PERS retirees or their eligible dependents can enroll in PHIP coverage within 30 calendar days of losing other employer-sponsored group coverage. This would include active employer, retiree or COBRA coverage under either the retiree or spouse. PHIP coverage will be effective the first of the month after the loss of prior employer-sponsored group coverage if the completed Enrollment Request Form is received before the employer-sponsored group coverage has ended or the first of the month after the completed Enrollment Request Form has been received by PHIP, whichever is later. Any Enrollment Request Form received after 30 days of loss of employer group coverage is considered outside of the enrollment opportunity and will be ineligible.

If you work past age 65 or are covered by employer-sponsored group coverage past age 65 this would be your enrollment opportunity to enroll in PHIP coverage.

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Surviving spouse/dependent

If a surviving spouse or dependent is not enrolled in PHIP at the time of the retiree passing away the surviving spouse can submit an Enrollment Request Form within 90 days from the death of the retiree. The effective date will be the first of the month after the Enrollment Request Form is received by PHIP. A surviving spouse can wait for future enrollment opportunities, such as Medicare eligibility or loss of employer-sponsored coverage, to enroll in PHIP after the death of the retiree. However, in the event the non-PERS surviving spouse remarries, PHIP coverage cannot be extended to the new spouse.

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