Oregon Administrative Rules › Chapter 459 - OREGON PUBLIC EMPLOYEES RETIREMENT SYSTEM › Division 35 - HEALTH INSURANCE PROGRAMS › Section 459-035-0050 - Contribution Payment From Retiree Health Insurance Premium Account for Eligible Retired State Employees Not Eligible for Medicare

Current through Register Vol. 63, No. 7, July 1, 2024
This rule establishes the procedure for determining the amount
				of contribution that will be paid from the Retiree Health Insurance Premium
				Account (RHIPA)(ORS 238.415) on behalf of an
				eligible retired state employee under age 65, as described in OAR 459-035-0040,
				who is enrolled in a health insurance plan sponsored by PERS.
(1) On or before November 1 of each calendar
			 year, staff shall determine the monthly amount available to be paid from the
			 RHIPA on behalf of an eligible retired state employee enrolled in a PERS health
			 insurance plan contracted for under ORS
			 238.410. In determining the
			 average difference between the health insurance premiums paid by retired state
			 employees under contracts entered into by the Public Employees Retirement Board
			 and the health insurance premiums paid by state employees who are not retired
			 under contracts entered into by PEBB (without regard to employees who have
			 opted out of PEBB-sponsored health insurance coverage), the staff shall
			 calculate the change in value of the average of active PEBB plans after
			 adjusting for the demographic (age/sex) differences between:
(a) The active employee participants; and
(b) Retired members receiving a
			 subsidy and participating in one of the PERS non-Medicare health insurance
			 plans as follows:
(A) Obtain the average
			 employee participation for each health insurance plan sponsored by PEBB for the
			 most recent three-month period;
(B) Obtain the health insurance premium for
			 each health insurance plan sponsored by PEBB for the plan year next following;
(C) Obtain the average eligible
			 retired state employee participation for each health insurance plan sponsored
			 by PERS for the most recent three-month period;
(D) Compute the average health insurance
			 premium for all plans sponsored by PEBB pursuant to the following formula:
(i) Step 1. Multiply the average
			 participation in paragraph (A) of this subsection by the health insurance
			 premium in paragraph (B) of this subsection for each plan;
(ii) Step 2. Total the average participation
			 for all plans;
(iii) Step 3. Total
			 the result for all of the calculations in Step 1 of sub-paragraph (i) of this
			 paragraph; and
(iv) Step 4. Divide
			 the total in Step 3 of sub-paragraph (iii) of this paragraph by the total in
			 Step 2 of sub-paragraph (ii) of this paragraph.
(E) Compute the change in value of the
			 average active PEBB plan pursuant to the following formula:
(i) Step 1. Divide the total in paragraph (C)
			 of this subsection by the total in Step 2 of paragraph (D) of this subsection;
(ii) Step 2. Multiply the average
			 participation for each plan in paragraph (A) of this subsection by the result
			 of Step 1 of sub-paragraph (i) of this paragraph for each plan;
(iii) Step 3. Multiply the premium for each
			 plan in paragraph (B) of this subsection by the estimated factor of
			 non-Medicare retiree claims cost to active claims cost;
(iv) Step 4. Multiply the result of Step 2 of
			 sub-paragraph (ii) of this paragraph by the result of Step 3 of subparagraph
			 (iii) of this paragraph for each plan;
(v) Step 5. Total the results for all of the
			 calculations in Step 4 of sub-paragraph (iv) of this paragraph;
(vi) Step 6. Total the results of the average
			 participation calculations for all plans in Step 2 of sub-paragraph (ii) of
			 this paragraph; and
(vii) Step 7.
			 Divide the total premium in Step 5 of sub-paragraph (v) of this paragraph by
			 total average participation as calculated in Step 6 of sub-paragraph (vi) of
			 this paragraph.
(F) The
			 result of Step 7 of sub-paragraph (E)(vii) of this subsection minus Step 4 of
			 sub-paragraph (D)(iv) of this subsection is the maximum monthly amount
			 available to be paid by PERS on behalf of an eligible retired state employee.
			 Under no circumstances will this amount be less than $0.
(G) The maximum monthly amount paid by PERS
			 on behalf of an eligible retired state employee shall be determined using
			 qualifying service.