reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 20 - ENROLLMENT RULES › Section 101-020-0060 - Dependent Care Flexible Spending Account

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Employees may use a Dependent Care
			 Flexible Spending account (Dependent Care FSA) to be reimbursed for
			 employment-related dependent care expenses for eligible dependents that allow
			 the employee and his or her spouse to be "gainfully employed." The plan is
			 subject to federal Revenue Code requirements and Internal Revenue Service
			 regulations.
(2) Employees enrolled
			 in a Dependent Care FSA contribute a pre-tax amount from each month's salary
			 during the plan year. Employees receive reimbursement from the account during
			 the plan year for incurred qualified Dependent Care expenses by submitting a
			 claim.
(3) FSA plans are annual
			 plans, eligible employees must enroll for each plan year to participate. The
			 enrollment does not roll over from one plan year to the next. All plan year FSA
			 enrollments terminate December 31. The period of coverage is the 12 months
			 during the plan year.
(4) An
			 employee's failure to take an enrollment action is not considered an employee
			 enrollment error. An enrollment action means that the employee during the
			 allowable enrollment times must take an action to enroll, add to, save an
			 active enrollment, or change benefit plan enrollment elections.
(5) The eligible employee is responsible for
			 identifying enrollment errors and maintaining a valid and accurate Dependent
			 Care flexible spending enrollment. The employee has 30 days from date of their
			 first paycheck with their Dependent Care FSA enrollment to request a
			 correction. The exception is open enrollment see OAR101-020-0037 (c).
(6) PEBB must review enrollment errors
			 reported by the employee. Corrections, if allowable, must be consistent with
			 the IRS regulations that govern flexible spending accounts.
(7) An employee's pretax contribution under a
			 Dependent Care FSA in a calendar year is (not exhaustive list):
(a) $5,000 if the employee is married and
			 filing a joint return or if the employee is single parent.
(b) $2,500 if the employee is married but
			 files separately.
(c) When a
			 spouse's employer also has a dependent care FSA plan, the $5000 limit applies
			 to the total amount of pre-tax dependent care assistance that the employee and
			 his or her spouse, as a couple, can receive in any tax year from all
			 employer-sponsored plans.
(d) The
			 limit is not affected by the number of qualified persons an employee
			 has.
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 20 - ENROLLMENT RULES › Section 101-020-0065 - Health Flexible Spending Arrangement

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An eligible employee may enroll in a
			 pretax Health Care Flexible Spending Account (Health Care FSA). A Health Care
			 FSA is regulated by various federal government regulations. Health Care FSAs
			 can be defined in part by the following categories.
(a) It is a self-insured medical
			 reimbursement plan subject to certain Internal Revenue Code
			 requirements.
(b) It is a flexible
			 spending account subject to additional requirements in the IRS
			 regulations.
(c) It is a group
			 health plan subject to COBRA, HIPAA, health care reform and other federal
			 mandates that affect group health plans.
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 20 - ENROLLMENT RULES › Section 101-020-0066 - Public Employees' Benefit Board Appeal Procedure

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Eligible employees may submit appeal
			 requests to PEBB concerning PEBB policy, eligibility, or plan enrollments. PEBB
			 staff and the Board Appeals Subcommittee use relevant state and federal
			 regulations, policy, PEBB's documented Internal Revenue Code (IRC) 125
			 Cafeteria plan, and Oregon Administrative Rules to provide appeal
			 decisions.
(2) PEBB does not accept
			 appeals related to contracted plans or plan administrators, such as but not
			 limited to medical, dental, life, disability, COBRA, and long term care,
			 services, decisions, or claims. The Board's Appeal Committee may hear appeals
			 concerning benefit design.
(3) If
			 PEBB rescinds plan coverage due to an individual's ineligibility for coverage,
			 the ineligible individual may appeal the rescission decision to PEBB using this
			 rule. Until the appeal process for the rescission is exhausted the individual's
			 premium and claim payments will continue as if the rescission had not occurred.
			 Upon final appeal determination and the rescission is upheld the employee will
			 be responsible to pay all claims and premium payments paid by the Plan or PEBB
			 during the period of ineligibility.
(4) Eligible Employees, or individuals who
			 believe they received an incorrect or unfair decision from PEBB staff, an
			 employing agency, retiree plan administrator, or an individual notified of a
			 rescission have three levels of PEBB appeal.
(a) Level One: An eligible employee who
			 believes he or she received an incorrect or unfair decision from PEBB, an
			 employing agency, or retiree plan administrator, or an individual notified of a
			 rescission may appeal the decision to PEBB. The appeal must be within 30 days
			 the decision or action considered by the employee or individual as unfair or
			 incorrect.
(A) The employee or individual must
			 submit the appeal to PEBB using the correct forms and provide any supporting
			 documentation for the appeal.
(B) A
			 PEBB Benefit Analyst will review the appeal documents and may request
			 additional information from the employee, individual, employer, or plan.
			 Information requested from the employee must be received within 10 business
			 days or PEBB will close the appeal.
(C) The analyst will complete the review of
			 the appeal within 30 days from the date PEBB receives all necessary appeal
			 documentation. PEBB will notify the employee or individual of any
			 delay.
(D) When the review is
			 complete, the analyst will provide a written explanation and determination to
			 the employee or individual. If the appeal is denied, continued appeal steps
			 will be included in the document.
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 30 - CONTINUATION OF INSURANCE-ACTIVE EMPLOYEES › Section 101-030-0005 - Continuation of Group Medical and Dental Insurance Coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA)

Current through Register Vol. 63, No. 7, July 1, 2024
COBRA allows an eligible individual who is losing an employer's
				group health plan coverage due to a qualifying event to continue coverage for a
				limited time. PEBB COBRA is a self-pay premium by the eligible
				individual.
(1) PEBB participating
			 organizations will issue an initial COBRA notice to all newly eligible
			 employees and individuals that explains the right to continue employer medical
			 and dental insurance plans if lost.
(a) The
			 notice must be mailed to the eligible employee's address of record immediately
			 following enrollment in PEBB medical or dental insurance plans or personally
			 delivered to the employee. The notice must include all PEBB covered individuals
			 residing at the address, including family members, a domestic partner, and a
			 domestic partner's dependent children. Agencies must send a separate notice to
			 the address of record for eligible individuals residing separately from the
			 eligible employee.
(b) An initial
			 COBRA notice must be mailed to individuals who become newly eligible for PEBB
			 coverage due to marriage or the formation of a domestic partnership.
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 30 - CONTINUATION OF INSURANCE-ACTIVE EMPLOYEES › Section 101-030-0007 - Portability of Medical Insurance Coverage

Current through Register Vol. 63, No. 7, July 1, 2024
Some PEBB sponsored group medical insurance plans allow
				portability. An eligible individual enrolled in one of these medical plans may
				continue insurance coverage under the plan's portability provisions before,
				during, or at the end of the period that medical insurance coverage is provided
				under COBRA, if:
(1) They were
			 continuously covered for 180 days or more under one or more PEBB sponsored
			 group medical insurance plans and they lost eligibility for group medical
			 insurance coverage;
(2) They are
			 not covered by another group medical insurance plan, Medicare, or
			 TriCare;
(3) They enroll in a
			 continued medical insurance plan under the portability provisions within 63
			 days after termination of the group medical insurance coverage; and
(4) They comply with all requirements of the
			 applicable insurance carrier for continuation of medical insurance coverage
			 under the carrier's portability plan provisions.
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 30 - CONTINUATION OF INSURANCE-ACTIVE EMPLOYEES › Section 101-030-0010 - Continuation of Group Health Benefit Coverage for Injured Workers (CBIW)

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The state is
			 required by ORS 659A.060-069 to continue to pay
			 the benefit amount for PEBB health benefit coverage in effect at the time an
			 eligible employee has a work-related injury or illness. The benefit amount may
			 continue for up to 12 consecutive months or until one of the events listed in
			 ORS 659A.063 occurs, whichever
			 occurs first. Health benefit coverage for this purpose includes the medical,
			 dental, vision, and prescription drug coverage of the employee, family members,
			 and domestic partner.
(2) An
			 eligible employee may continue coverage for life, accidental death and
			 dismemberment and Long Term Care insurance plans for up to 12 months if they
			 self-pay the premiums to the agency.
(3) Refer to OAR 101-020-0002(7)(d)  for
			 employee premium payment requirements.
(4) When an employee returns to work within
			 12 months, they will have their previous enrollment for medical, dental, life,
			 and disability insurance reinstated the first of the month following their
			 return to work. The employee may make midyear plan changes within 30 days of
			 the date they return to work.
(5)
			 An employee returning to work will not be reinstated in any pretax Flexible
			 Spending Accounts, or PEBB Commuter Accounts. They may reenroll within 30 days
			 of the date they return to work.
(6) A previously benefit eligible employee
			 returning to paid regular status immediately following CBIW is not required to
			 work at least half-time in the month they return to be eligible for benefits
			 the following month.
(7) A COBRA
			 qualifying event occurs at the end of the CBIW continuation period, or when the
			 current benefit eligible stability period ends the allowable benefit period, if
			 the employee has not returned to paid regular status.
Stat. Auth.: ORS
				  243.061 - 302 & 659A.060 -
				  069
Stats. Implemented: ORS
				  243.061 - 302 & 659A.060 -
				  069
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 30 - CONTINUATION OF INSURANCE-ACTIVE EMPLOYEES › Section 101-030-0015 - Continuation of Core Benefit Coverage for Employees Covered under the Federal Family Medical Leave Act (FMLA) and the Oregon Family Leave Act (OFLA)

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Employees
			 taking approved FMLA or OFLA leave are entitled to the continuation of employer
			 provided health coverage. The agency is obligated to maintain the employee's
			 health coverage under the same conditions that would have applied had the
			 employee not been in leave.
(a) If the FMLA
			 or OFLA leave is substituted paid leave, then the employee's share of premiums
			 for continuation must be paid by payroll deduction.
(b) An agency may offer one or more of the
			 following options, to an employee who continues core benefit coverage while on
			 an unpaid FMLA or OFLA leave. Before commencing the leave, or shortly
			 thereafter, the employee and the agency must agree to one of the following
			 options for employee premium share.
(A)
			 Prepay. The employee is given the opportunity to prepay their premium share due
			 during the leave period before the leave begins. The prepay option cannot be
			 the sole option offered to employees on FMLA or OFLA leave.
(B) Pay as you go. The employee pays the cost
			 of coverage in installments during the leave. Contributions are paid with
			 after-tax dollars or with pre-tax dollars to the extent that the employee
			 receives compensation (e.g. unused sick or vacation days) during the
			 leave.
(C) Catch-up options. The
			 employer and employee agree in advance that the employer will advance payment
			 of the employee's share of the cost of coverage during the leave and that the
			 employee will repay the advanced amounts when the employee returns to
			 work.
(D) Revoke Coverage.
			 Employees may revoke the employer offered core health coverages during the
			 leave. In this event the agency sends a COBRA notice of availability.
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 30 - CONTINUATION OF INSURANCE-ACTIVE EMPLOYEES › Section 101-030-0020 - Repealed

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS
				  243.061-302 &
				  659A.150-186
Stats. Implemented: ORS
				  243.061-302 &
				  659A.150-186
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 30 - CONTINUATION OF INSURANCE-ACTIVE EMPLOYEES › Section 101-030-0022 - Continuation of Benefit Coverage for Employees on Active Military Leave

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The state will
			 continue to pay the benefit amount for core benefit coverage in effect at the
			 time an eligible employee begins active military duty. This benefit coverage
			 will continue for the duration of the active military leave, up to 24
			 consecutive months. The agency may end this coverage before or during the 24
			 months of active duty only if the member submits a signed written request to
			 end the coverage.
(2) An eligible
			 employee may continue the following optional plans during active military duty
			 up to 12 months by self-paying premiums or contributions to the agency:
(a) Optional Life Insurances,
(b) Accidental Death and Dismemberment
			 Insurance,
(c) Long Term Care
			 (LTC), and,
(d) Health Flexible
			 Spending Account (FSA).
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 30 - CONTINUATION OF INSURANCE-ACTIVE EMPLOYEES › Section 101-030-0026 - Employer Designated Furlough Leaves

Current through Register Vol. 63, No. 7, July 1, 2024
The State of Oregon as the employer may designate furlough
				leave without pay. Furlough leave does not affect an employee's eligibility or
				current enrollment in medical, dental, and employee basic life
				insurance.
Stat. Auth.: ORS
				  243.061 - 302
Stats. Implemented: ORS
				  243.061-302 &
				  292.05
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 30 - CONTINUATION OF INSURANCE-ACTIVE EMPLOYEES › Section 101-030-0027 - Non-medical Leave Without Pay (LWOP) - Continuation of Optional Insurance Plans

Current through Register Vol. 63, No. 7, July 1, 2024
An eligible employee who is in a non-medical LWOP status may
				continue coverage for optional life insurances, accidental death and
				dismemberment insurance plans and Long Term Care (LTC) for up to 12 months if
				they self-pay the premium to the agency. The employee is not eligible to
				continue short term or long term disability insurance plans while on
				LWOP.
Stat. Auth.: ORS
				  243.061 - 302
Stats. Implemented: ORS
				  243.061 -
				  302
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 30 - CONTINUATION OF INSURANCE-ACTIVE EMPLOYEES › Section 101-030-0070 - Life, Disability, and Accidental Death and Dismemberment Insurance - Continuation of Coverage

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 When an eligible employee separates from state service optional life insurance
			 coverage may continue through the plan, not PEBB, as follows:
(a) Portability. An eligible employee
			 terminating employment, other than for disability or retirement, may continue
			 the employee's optional employee, spouse, and domestic partner life insurance
			 coverage at the group rate, plus billing fees. The policy remains a term life
			 insurance policy. The employee must apply directly to the plan within 30 days
			 of the date coverage ends. Portability is not available for employee basic life
			 or dependent life coverage. A survivor of a covered eligible employee may
			 continue optional life insurance through the plan upon the death of the
			 employee.
(b) Conversion Rights.
			 An eligible employee terminating employment for any reason, including
			 disability or retirement, or experiencing a reduction in hours to less than 80
			 paid regular hours in the month, may be eligible to convert the employee's term
			 life insurance coverage. Not all policy types are available for conversion. The
			 employee must apply directly to the plan within 30 days of the date insurance
			 coverage ends. A survivor of a covered eligible employee may convert life
			 insurance coverage through the plan upon the death of the employee.
(c) Retiree Life Insurance Option. An
			 eligible employee who retires may purchase the Retiree Life Insurance Option
			 without submitting evidence of insurability. The employee must apply directly
			 to the insurance plan within 30 days of the date insurance coverage ends.
(d) Transfer of Premium Payment
			 for Optional Employee Life Insurance. When two active eligible employees are
			 married or in a domestic partnership and both are state employees, one employee
			 can transfer their optional life insurance coverage to the other employee's
			 life insurance coverage or to themselves upon:
(A) Terminating employment for any reason;
(B) Beginning an active military
			 leave;
(C) Divorce;
(D) Termination of their domestic
			 partnership, or;
(E) Retirement.
			 The remaining employed eligible employee must submit the completed and signed
			 transfer form to their agency within 30 days of the date of the events listed
			 in (1)(d) of this rule.
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 50 - RETIREE RULES › Section 101-050-0005 - PEBB Retiree Health Plan Eligibility

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An active employee enrolled in PEBB plans
			 immediately prior to retirement and who meets PEBB retiree plan eligibility may
			 continue participation in PEBB health plans upon retiring.
(2) To be eligible a retiring employee must
			 not be eligible for Medicare and be:
(a)
			 Receiving a service or disability retirement allowance under the Public
			 Employees Retirement System (PERS) or under any other retirement or disability
			 benefit plan or system offered by the State of Oregon for its officers and
			 employees;
(b) Eligible to receive
			 a service retirement allowance under PERS and have reached earliest retirement
			 age under ORS Chapter 238; or;
(c)
			 Eligible to receive a service retirement allowance or pension under another
			 retirement benefit plan or system offered by the State of Oregon and has
			 reached earliest retirement age under the plan or system.
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 50 - RETIREE RULES › Section 101-050-0010 - Retiree Plan Enrollment and Termination

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An active employee meeting PEBB retiree
			 eligibility may enroll themselves and other eligible individuals in PEBB
			 retiree health plans.
(2) Retiree
			 plan coverage must be continuous with active or COBRA PEBB plan enrollments.
			 Employees that retire and receive PEBB plan coverage through another active
			 employee may move to PEBB retiree coverage when the other employee coverage
			 ends.
(3) An active employee
			 meeting PEBB retiree eligibility must submit retiree enrollment forms within 30
			 days of the date the active employee insurance terminates. Enrollments
			 submitted within this 30-day window are retroactive to the date of active
			 coverage termination.
(4) A Retiree
			 may elect any PEBB full time or part-time health plan. A Retiree may elect
			 medical only, dental only, or medical and dental insurance coverage. If the
			 retiree does not initially enroll in both medical and dental insurance plans,
			 they may not add the other plan later.
(5) PEBB may offer a plan change period for
			 retiree insurance plan participants. The plan change period allows the retiree
			 to change benefit plans. The plan change period does not allow the retiree to
			 add dependents or coverage not already in place.
(6) A retired eligible employee electing to
			 continue PEBB health plans under COBRA can transfer to a PEBB retiree health
			 plan at any time during or immediately following COBRA.
(7) A retired eligible employee and their
			 eligible individuals must terminate from PEBB retiree plans when they:
(a) Fail to self-pay the premiums;
			 or
(b) Fail to continue to meet
			 PEBB eligibility; or
(c) Become
			 Medicare eligible; or
(d) PEBB no
			 longer offers retiree health plan coverage.
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 50 - RETIREE RULES › Section 101-050-0015 - Retiree Returning to Work for a PEBB Participating Organization in a Benefit Eligible Status

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A
			 retiree returning to work within a PEBB participating organization in a benefit
			 eligible position is eligible for active employee PEBB benefit plans. Insurance
			 coverage must be continuous between active employee benefit plans and retiree
			 plans.
(a) A retiree returning to paid regular
			 status within 12 months will have their previous enrollment for medical,
			 dental, life and disability insurance reinstated the first of the month
			 following their return to work.
(b)
			 A retiree returning to paid regular status 12 months after an active insurance
			 coverage end date must enroll as a newly eligible employee. There is no second
			 guarantee issue of long-term care insurance.
(c) A retiree either enrolling as a new hire
			 or being reinstated to active employee optional life insurance must cancel
			 retiree life that was ported from PEBB when the employee retired.
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 50 - RETIREE RULES › Section 101-050-0020 - Retiree Survivor Medical and Dental Insurance Coverage

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An eligible spouse, domestic partner,
			 dependent child, and dependent child of a domestic partner enrolled in PEBB
			 retiree health plans at the time of a retiree's death (or subscriber's death)
			 may elect to continue the retiree insurance coverage. The individual electing
			 to continue the coverage becomes the subscriber. Subscribers must self-pay the
			 premiums and maintain continuous coverage. It is the responsibility of the
			 subscriber to notify the retiree plan administrator if they do not want
			 continued coverage.
(2) The retiree
			 plan coverage terminates for a surviving spouse or domestic partner when they:
(a) Remarry or form a domestic partnership;
			 or
(b) Fail to make premium
			 payments; or
(c) PEBB no longer
			 offers retiree insurance plans.
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 60 - PEBB-PROVIDED HEALTH BENEFIT PLAN FOR LIQUOR CONTROL COMMISSION AGENTS › Section 101-060-0005 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
The following definitions will apply as used in OAR chapter 101
				division 60:
(1) "Eligible employee"
			 means a retail sales agent, appointed under ORS
			 471.705, who is subject to an
			 agency agreement with the Oregon Liquor Control Commission to sell distilled
			 spirits in the Commission's agency stores. A temporary liquor agent is not
			 considered an eligible employee for PEBB administrative purposes.
(2) "Newly eligible employee" means an agent
			 who has signed a contract with an effective date of July 1, 1985 or
			 later.
Stat. Auth.: ORS
				  243.061 - 302
Stats. Implemented: ORS
				  243.061 - 302
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 60 - PEBB-PROVIDED HEALTH BENEFIT PLAN FOR LIQUOR CONTROL COMMISSION AGENTS › Section 101-060-0010 - Eligibility for Medical and Dental Insurance Coverage

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A newly eligible employee may enroll in
			 medical and dental insurance coverage within 30 days of their contract
			 effective date. Insurance coverage will be effective on the first day of the
			 month following:
(a) The signing of the
			 standard OLCC contract;
(b) The
			 receipt of the completed applicable forms for enrollment in PEBB medical and
			 dental insurance coverage; and
(c)
			 The authorization of a monthly premium payment deduction from the contracted
			 amount.
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 60 - PEBB-PROVIDED HEALTH BENEFIT PLAN FOR LIQUOR CONTROL COMMISSION AGENTS › Section 101-060-0015 - Insurance Provision

Current through Register Vol. 63, No. 7, July 1, 2024
PEBB may establish insurance rates consistent with the active
				employees' group expected actuarial experience including administrative
				costs.
Stat. Auth.: ORS
				  243.061 -
				  243.302
Stats. Implemented: ORS
				  243.061 -
				  243.302
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 65 - SB 551 › Section 101-065-0001 - Administration of SB 551 Program

Current through Register Vol. 63, No. 7, July 1, 2024
(1)  For purposes of this rule:
(a)  "SB 551 eligible member" is defined as a part-time faculty
				employee who is deemed eligible to receive coverage through PEBB by an Oregon
				public institution of higher education based on the requirements of SB 551
				(2021). "SB 551 eligible member" does not mean or include a part-time faculty
				member who is currently eligible for employer-paid benefits through the Public
				Employees Benefit Board (PEBB) or the Oregon Educators Benefit Board
				(OEBB).
(b)  "SB 551 program" is the benefits program established by SB
				551(2021) and codified in ORS 350.355.
(c)  "PEBB coverage" means coverage that is available to
				part-time faculty members who are eligible for employer-paid benefits.
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 70 - LOCAL GOVERNMENT PARTICIPATION › Section 101-070-0001 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
"Local Government" means any city, county, or special district
				or any intergovernmental entity created under ORS chapter 190 in the State of
				Oregon.
Statutory/Other Authority: ORS
				  243.061-243.302
Statutes/Other Implemented: ORS
				  243.125(1),
				  ORS
				  243.129
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 70 - LOCAL GOVERNMENT PARTICIPATION › Section 101-070-0005 - Participation Requirements

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Notice of Interest:
(a) Local Governments
			 choosing voluntarily to participate in PEBB must complete and submit to PEBB a
			 written Notice of Interest to Participate. The following notification timeline
			 applies if the Local Government employs:
(A)
			 50 or fewer participating, eligible employees - 90 days prior to the Local
			 Government's coverage effective start date with PEBB, or;
(B) 51 participating, eligible employees but
			 fewer than 500 participating, eligible employees - 120 days prior to the Local
			 Government's coverage effective start date with PEBB, or;
(C) More than 501 participating, eligible
			 employees - 180 days prior to the Local Government's coverage effective start
			 date with PEBB.
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 80 - OPERATIONS › Section 101-080-0010 - Hospital Payments

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Except as provided in section (10), the maximum reimbursement amount for each
			 claim subject to ORS
			 243.256 and these rules shall be determined by the carrier applying the applicable
			 percentage of the Medicare rate, or the Medicare rate for similar services or
			 supplies, as of the date of service of the claim.
(2) The actual reimbursement amount for each
			 claim subject to ORS
			 243.256 and these rules shall be based on the lesser of billed charges, the carrier's
			 contracted rate for the provider, or the maximum reimbursement amount
			 established in ORS
			 243.256 and these rules.
(3) The carrier
			 shall determine the PEBB member's cost sharing based on the actual
			 reimbursement amount as determined in section (2) above.
(4) Any actions taken by the Centers for
			 Medicare and Medicaid Services (CMS) that result in retroactive adjustment of
			 the maximum reimbursement amount for an inpatient or outpatient hospital
			 service or supply shall not result in retroactive increases to member cost
			 sharing.
(5) The following payments
			 shall not be included under ORS
			 243.256(1)
			 or these rules:
(a) services or supplies that
			 are not covered by Medicare
(b)
			 services or supplies provided at Ambulatory Surgery Centers
(c) professional services provided in a
			 Hospital
(d) services or supplies
			 provided at CMS designated children's hospitals that are not reimbursed via the
			 Inpatient Prospective Payment System (IPPS).
Oregon Administrative Rules › Chapter 101 - OREGON HEALTH AUTHORITY, PUBLIC EMPLOYEES' BENEFIT BOARD › Division 80 - OPERATIONS › Section 101-080-0020 - Exempt Hospitals

Current through Register Vol. 63, No. 7, July 1, 2024
(1) As
			 specified in ORS
			 243.256,
			 these payment limits do not apply to reimbursements paid by a carrier or
			 third-party administrator to:
(a) Type A or
			 type B hospitals (defined in ORS
			 442.470);
(b) Rural critical access hospitals (defined
			 in ORS
			 315.613);
			 or
(c) Hospitals that are located
			 in a county with a population of less than 70,000 on August 15, 2017,
			 classified as a sole community hospital by the Centers for Medicare and
			 Medicaid Services, and have Medicare payments composing at least 40 percent of
			 the hospital's total annual patient revenue.
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 1 - PROCEDURAL RULES › Section 104-001-0000 - Notice of Proposed Adoption, Amendment, or Repeal of Rules

Current through Register Vol. 63, No. 7, July 1, 2024
Prior to the adoption, amendment, or repeal of any rule, other
				than a temporary rule which shall be adopted in accordance with ORS 183.335(5),
				the Oregon Department of Emergency Management shall give notice of the intended
				action:
(1) In the Secretary of
			 State's Bulletin referred to in ORS 183.360 at least 15 days before the
			 effective date of the intended action;
(2) By mailing a copy of the notice to
			 persons on the mailing list established pursuant to ORS 183.335(7);
			 and
(3) By mailing or furnishing a
			 copy of the notice to:
(a) The United Press
			 International;
(b) The Associated
			 Press;
(c) For rules pertaining to
			 9-1-1 emergency telephone systems: The Oregon 9-1-1 Advisory Committee, the
			 Oregon Chapter of the Associated Public Safety Communications Officers
			 Incorporated, and the Oregon Chapter of the National Emergency Number
			 Association;
(d) For rules
			 pertaining to the Oregon Emergency Response System: the Oregon Emergency
			 Response System Council;
(e) For
			 rules pertaining to Search and Rescue: The Oregon Search and Rescue Advisory
			 Council, the Mt. Hood Search and Rescue Council, the Oregon Association of
			 Mounted Posse's, and the Oregon Mountain Rescue Council;
(f) For all Division rules: The Oregon
			 Emergency Management Advisory Committee; and
(g) Capitol Press Room.
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 1 - PROCEDURAL RULES › Section 104-001-0005 - Model Rules of Procedure

Current through Register Vol. 63, No. 7, July 1, 2024
The Oregon Department of Emergency Management adopts by
				reference the Attorney General's Model Rules of Procedure for the adoption of
				rules and conduct of proceedings, effective July 31, 2014.
The full text of the Attorney General's Model Rules of
				  Procedures is available from the office of the Attorney General or Emergency
				  Management
Statutory/Other Authority: ORS 183 & 184
Statutes/Other Implemented: ORS
				  183.341(1)
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 1 - PROCEDURAL RULES › Section 104-001-0010 - Confidentiality and Inadmissibility of Mediation Communications

Current through Register Vol. 63, No. 7, July 1, 2024
Pursuant to ORS 36.224, the Oregon Department of Emergency
				Management adopts by reference OAR 137-005-0052  as promulgated by the Attorney
				General effective as of November 13, 2018.
Statutory/Other Authority: ORS 36.224 & 401.092
Statutes/Other Implemented: ORS 36.224, 36.228, 36.230 &
				  36.232
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 10 - PARTICIPATION OF LOCAL AND TRIBAL GOVERNMENTS IN THE EMERGENCY MANAGEMENT PERFORMANCE GRANT (EMPG) PROGRAM OF THE FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA) › Section 104-010-0005 - Participation of Local and Tribal Governments in the Emergency Management Performance Grant (EMPG) Program of the Federal Emergency Management Agency (FEMA)

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The Oregon Department of Emergency Management (ODEM), and local and
								 tribal emergency management/services agencies participating in the Emergency Management Performance Grant
								 (EMPG) Program will implement the EMPG Program in the State of Oregon consistent with these rules, the
								 Federal Emergency Management Agency's (FEMA) annual EMPG Program guidance, and an annual grant agreement and
								 work plan agreed to by ODEM and each participating local or tribal emergency management agency.
(2) Eligible applicants for participation in the Oregon EMPG Program
								 include the state's 36 counties, nine (9) federally recognized tribes, and cities with a population of over
								 85,000.
(3) Each county, tribal government and city must meet the
								 following requirements to be eligible to participate in the program:
(a)
								 Have an assigned emergency manager.
(b) Be National Incident
								 Management System (NIMS) compliant.
(c) Have an Emergency
								 Operations Plan (EOP) that is consistent with ODEM's statewide planning guidance, updated every two years,
								 and promulgated by agency officials every four years.
(d) Have a
								 FEMA approved Hazard Mitigation Plan that is updated every five years.
(e) Have an Emergency Operations/Coordination facility.
(f) Have an incident command structure.
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 20 - EARTHQUAKE PREPAREDNESS DRILLS › Section 104-020-0000 - Purpose

Current through Register Vol. 63, No. 7, July 1, 2024
The purpose of the rule is to provide guidance for all private,
				state, local government agencies and non-governmental employers with 250 or
				more full-time employees to conduct mandatory annual earthquake drills for
				employees located within office buildings.
Stat. Auth.: Ch. 366, OL 2001
Stats. Implemented: Ch. 366, OL
				  2001
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 20 - EARTHQUAKE PREPAREDNESS DRILLS › Section 104-020-0010 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
(1) "State and local agency" means a state or
			 local government office, department, division, bureau, board, or commission
			 that is assigned, renting, leasing, owning or controlling office space for
			 carrying out its duties either in one or multiple locations. 'State or local
			 agency' includes the legislative assembly (i.e. legislators) when in regular
			 session.
(2) "Employers with 250 or
			 more full-time employees" mean employers with 250 or more full time employees
			 in Oregon, who are not state and local agencies.
(3) "Office Building" means a building whose
			 primary function is office work. It does not include those non-office buildings
			 whose primary function is manufacturing, assembly, warehouse, laboratory,
			 maintenance, or other non-office situations. Employers are encouraged to hold
			 drills in non-office environments.
(4) "Earthquake drill", as outlined in
			 guidelines established by The Oregon Department of Emergency
			 Management.
Statutory/Other Authority: Ch. 366 & OL 2001
Statutes/Other Implemented: Ch. 366 & OL
				  2001
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 20 - EARTHQUAKE PREPAREDNESS DRILLS › Section 104-020-0020 - Drill Requirements

Current through Register Vol. 63, No. 7, July 1, 2024
Those required to conduct the drill are certain office
				employees of state and local agencies and certain office employees of other
				employers who have 250 or more full-time employees.
(1) State and local agencies
(a) State and local agencies fall under the
			 drill requirement regardless of the type (full and part time) and number of
			 employees and number of works sites.
(b) All office employees are required to
			 drill, except where there is a mix of office and non-office employees at a work
			 site. If the office employees at a mixed work site are in the majority they are
			 required to drill. If not, they are not required to drill. If an agency has
			 more than one work site, each work site is evaluated separately according to
			 this majority rule. A work site is defined as a site that has one street
			 address, which may contain one or more buildings.
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 20 - EARTHQUAKE PREPAREDNESS DRILLS › Section 104-020-0030 - Drill Guidelines

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The
			 earthquake drill shall be the drop, cover and hold on, or if not possible,
			 other protective action. Written information on pre-designated evacuation
			 routes and procedures for exiting the building shall be made available to
			 employees.
(2) The employer, state,
			 or local agency may drill earthquake response procedures in addition to "drop,
			 cover, and hold on" when it is determined on scientific evaluation of specific
			 engineering and structural issues related to a building and with the
			 consultation of state and local emergency management, that "drop, cover, and
			 hold on" may not be the most effective earthquake emergency response procedure
			 to prevent or limit injury or loss of life.
(3) Entities are encouraged to participate in
			 the annual state-wide "drop, cover, and hold on" earthquake drill.
(4) Guidelines for the drill and evacuation
			 procedures are posted on the web sites of The Oregon Department of Emergency
			 Management (ODEM) and the Oregon Department of Geology and Mineral Industries
			 (DOGAMI).
Statutory/Other Authority: Ch. 366 & OL 2001
Statutes/Other Implemented: Ch. 366 & OL
				  2001
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 20 - EARTHQUAKE PREPAREDNESS DRILLS › Section 104-020-0040 - Drill Records

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Each state
			 and local agency and employer with 250 or more full-time employees shall
			 maintain a file that documents the date the earthquake drill was conducted. The
			 file can be either maintained at one central location, for those agencies or
			 employers that have multiple locations, or maintained at each location. If
			 maintained at a central location, the record shall be kept in the office of the
			 agency or company head. If maintained at each agency location, then the record
			 shall be kept in the office of the manager at that site.
(2) For those agencies, companies and
			 organizations that fit the drill criteria, drill waivers may be granted each
			 year in exceptional circumstances and for good cause. Petitions must be
			 submitted by the executive head of the state agency, local agency, company, or
			 organization requesting the waiver to the Earthquake Program Coordinator, The
			 Oregon Department of Emergency Management, P. O. Box 14370, Salem, OR
			 97309-5062.
Statutory/Other Authority: Ch. 366 & OL 2001
Statutes/Other Implemented: Ch. 366 & OL
				  2001
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 30 - ADOPTION OF A UNIFORM TSUNAMIWARNING SIGNAL › Section 104-030-0000 - Purpose

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The rules in
			 this division seek to establish a Uniform Tsunami Warning Siren Signal for the
			 Oregon coast (Oregon Senate Bill 557, Section 2).
(2) The objective of the tsunami statutes and
			 these implementing rules is to reduce the risk of loss of life. Risk will be
			 reduced by applying a uniform siren signal to inform the public of an
			 approaching tsunami on the Oregon coast.
(3) Establish a Uniform Tsunami Warning Siren
			 Signal standard.
(4) Require
			 tsunami warning sirens to adhere to this standard.
Stat. Auth.: ORS
				  401.863 -
				  401.864
Stats. Implemented: ORS
				  401.863
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 30 - ADOPTION OF A UNIFORM TSUNAMIWARNING SIGNAL › Section 104-030-0010 - Applicability

Current through Register Vol. 63, No. 7, July 1, 2024
(1) This rule
			 applies to all Tsunami Warning sirens, including existing Tsunami Warning
			 sirens.
(2) Existing Tsunami
			 Warning sirens must comply within 5 years of the effective date of these
			 rules.
(3) The siren signal is the
			 "wail," a siren tone that oscillates up and down repeatedly from high to low
			 over a period of three minutes.
(4)
			 Voice broadcast may be included in addition to the wail, but not in replacement
			 of the wail.
Stat. Auth.: ORS
				  401.863 -
				  401.864
Stats. Implemented: ORS
				  401.863
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 30 - ADOPTION OF A UNIFORM TSUNAMIWARNING SIGNAL › Section 104-030-0020 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
(1) "Tsunami
			 Warning Siren signal" is the wail, a siren tone that oscillates up and down
			 repeatedly from high to low over a period of three minutes.
(2) "Tsunami inundation zone" for the purpose
			 of these rules means the area subject to tsunami inundation as depicted on maps
			 adopted under OAR 632-005-0030  of these rules and intended for the
			 implementation of ORS
			 455.446 and
			 455.447.
(3) A "Tsunami Warning Siren" is a siren or
			 other audible warning device for the purpose of providing warning to the public
			 within the Tsunami Inundation Zone of an approaching tsunami.
Stat. Auth.: ORS
				  401.863 -
				  401.864
Stats. Implemented: ORS
				  401.863
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 30 - ADOPTION OF A UNIFORM TSUNAMIWARNING SIGNAL › Section 104-030-0030 - Guidance on Tone, Signal, and Placement

Current through Register Vol. 63, No. 7, July 1, 2024
A rotating siren using a solid tone that produces the same
				effect as a fixed siren using a "wail" when observed from a stationary location
				and meets the intent of these rules.
Stat. Auth.: ORS
				  401.863 -
				  401.864
Stats. Implemented: ORS
				  401.863
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 30 - ADOPTION OF A UNIFORM TSUNAMIWARNING SIGNAL › Section 104-030-0040 - Guidance on Testing

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The
			 siren test time is designed to roughly coincide with the weekly National
			 Oceanic and Atmospheric Administration (NOAA) Weather Radio tests. Tsunami
			 Warning Sirens will be tested on Wednesdays at 11:00 hours (a.m.) for routine
			 testing of tsunami warning systems. Testing will be done on the first Wednesday
			 of each month at 11:00 am.
(2) The
			 recommended siren test duration is not to exceed 60-seconds excluding voice
			 message, except during system coverage evaluations, unless using a unique sound
			 for the test, such as Cows or Chimes.
(3) A sign or placard shall be affixed to
			 each siren stating the routine test time and day.
Stat. Auth.: ORS
				  401.863 -
				  401.864
Stats. Implemented: ORS
				  401.863
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 30 - ADOPTION OF A UNIFORM TSUNAMIWARNING SIGNAL › Section 104-030-0050 - Guidance on Other Methods of Warning

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Recommend use of other methods for
			 tsunami warning in conjunction with sirens.
(2) Work with emergency responders to provide
			 alternative means such as weather radios, loudspeakers on beach vehicles,
			 door-to-door notification and welfare-checks.
Stat. Auth.: ORS
				  401.863 -
				  401.864
Stats. Implemented: ORS
				  401.863
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 30 - ADOPTION OF A UNIFORM TSUNAMIWARNING SIGNAL › Section 104-030-0060 - Guidance on Visual Methods of Warning

Current through Register Vol. 63, No. 7, July 1, 2024
Consider a visual warning signal recommendation used in
				conjunction with fixed siren facilities; such as the blue strobe or flashing
				light, the most commonly used visual warning.
Stat. Auth.: ORS
				  401.863 -
				  401.864
Stats. Implemented: ORS
				  401.863
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 30 - ADOPTION OF A UNIFORM TSUNAMIWARNING SIGNAL › Section 104-030-0070 - Guidance on All Clear Signal

Current through Register Vol. 63, No. 7, July 1, 2024
The All Clear signal shall NOT be a Siren sound, either Solid
				or Wailing.
Stat. Auth.: ORS
				  401.863 -
				  401.864
Stats. Implemented: ORS
				  401.863
Oregon Administrative Rules › Chapter 104 - OREGON DEPARTMENT OF EMERGENCY MANAGEMENT › Division 30 - ADOPTION OF A UNIFORM TSUNAMIWARNING SIGNAL › Section 104-030-0080 - Guidance on Location of Tsunami Warning Systems

Current through Register Vol. 63, No. 7, July 1, 2024
Locate sirens in areas where there are either large
				concentrations of population within the inundation zone; or where other means
				of warning people is not available and/or practical, such as at parks and beach
				access areas.
Stat. Auth.: ORS
				  401.863 -
				  401.864
Stats. Implemented: ORS
				  401.863