OAR 101-015-0050: Dependent Eligibility Verification and Review Appeals

Dependent Eligibility Verifications and Review Appeals (1) Following the termination of dependents due to a dependent eligibility review, Eligible Employees, Retirees, Self Pays or COBRA participants may file an appeal and submit requested documentation within 60 days from the date coverage ended. (2) For Eligible Employees/Retirees/Self-Pay/COBRA, if the appeal and submitted requested documentation is received by PEBB prior to 60 days from the date coverage ended, and dependents are verified, PEBB will unlock the dependent records in the PEBB benefit management system and dependents will be added retrospectively. (3) For Eligible Employees/Retirees/Self-Pay/COBRA, if the appeal and submitted requested documentation is received by PEBB after 60 days from the date the coverage ended then dependents will be added prospectively.