OAR 259-070-0020: Discretionary Benefits

(1) The Fund provides immediate, temporary financial assistance to public safety officers, family members of public safety officers, and parents or designees of public safety officers when the public safety officer suffers a qualifying death or disability in the line of duty. The Board may provide these financial assistance benefits to assist with health and dental insurance, mortgage payments and education scholarships. Applicant eligibility for the award of discretionary benefits is based upon the eligibility requirements pursuant to ORS 243.956 and the rules adopted in OAR chapter 259 division 70. (2) Health and Dental Insurance. The Board may award benefits to afford health and dental insurance to a public safety officer, eligible family members or designees if an applicant for benefits does not have alternate health and dental coverage. (a) “Alternate health and dental coverage” means insurance coverage effective on the date of the public safety officer’s qualifying death or disability that is separate from, or in addition to, the coverage that was provided through the public safety officer’s employment on the date the qualifying death or disability occurred. Alternate coverage does not need to be comparable to the public safety officer’s coverage to be considered alternate coverage. (A) “Alternate health and dental coverage” includes health and dental insurance provided by: (i) A current employer; (ii) A government healthcare program such as Medicare or the Oregon Health Plan; (iii) An insurance policy obtained through the Affordable Care Act (ACA) exchange that is currently in effect at the time of the application, is subsidized by a federal or state program and that provides coverage for the applicant at the time of the application; (iv) An educational institution; or (v) Any other source that insures the applicant at the time of the application. (B) “Alternate health and dental coverage” does not include: (i) Unsubsidized health and dental coverage or health and dental coverage available through the ACA exchange unless the applicant has applied for and received coverage from an insurer through the exchange; or (ii) Health and dental insurance coverage obtained by, or for, an applicant after the public safety officer’s qualifying death or disability to replace the public safety officer’s insurance coverage that was in place prior to the qualifying death or disability. (b) Upon a determination that an applicant is eligible for the award of health and dental insurance benefits, the Board will determine the amount of benefits to be awarded up to, but not to exceed, an amount sufficient to allow recipients to purchase health and dental insurance comparable to that provided by the public safety officer at the time of their qualifying death or disability. (c) The Board will review an application for health and dental insurance benefits made by a public safety officer, an eligible family member, or designee who has declined or lost alternate health and dental coverage to determine eligibility for reimbursement from the Fund. The Board will consider the totality of the circumstances surrounding the applicant’s request for benefits , including but not limited to, the reasons for declining or for the loss of alternate health and dental coverage. (d) For the purposes of ORS 243.956 (5)(a) and (c), a spouse or designee is eligible to apply for health and dental insurance benefits for five years from the date the Board enters a final order of eligibility or until remarriage, whichever occurs first. A spouse or designee is required to notify the Department immediately upon remarriage. (e) Children or dependents between 18 and 23 years old must be attending school full-time to be eligible for the health and dental insurance benefits under ORS 243.956 (5)(b). For the purposes of this rule, “attending school full-time” means being enrolled as a student in school full-time, in accordance with the school’s definition for full-time enrollment, during a minimum of any part of five calendar months during the calendar year. A recipient is required to notify the Department immediately upon the change of student enrollment status of an eligible child or dependent. (3) Mortgage Payments. For the purposes of ORS 243.956 (7), a n applicant is eligible to apply for mortgage payment benefits within the first 12 months following the date the Board enters a final order of eligibility. (4) Scholarships. (a) The Board may award scholarship benefits for the following: (A) A graduate program of higher education if the applicant has exhausted benefits received under the Public Safety Officers’ Educational Assistance Program administered by the United States Department of Justice (PSOEA) and the applicant applies for scholarship benefits within one year from the date of exhaustion of the benefits received under the PSOEA. The date of exhaustion is the date on which the applicant receives the last payment of PSOEA benefits. (B) An undergraduate degree program if the applicant is not eligible for benefits under PSOEA or the PSOEA no longer exists. (b) To be eligible for scholarship benefits, an applicant must apply for other available public education benefits, including: (A) The Free Application for Federal Student Aid (FAFSA) administered by the United States Department of Education; and (B) Scholarships available under ORS 348.270 as administered by the Oregon Higher Education Coordinating Commission. (c) In determining the amount of scholarship benefits, the Board will consider the following: (A) The financial need of the applicant based on the degree program sought by the applicant; (B) The institution where the degree will be obtained; (C) The cost of the degree; and (D) The applicant’s sources of income anticipated over the period that the applicant estimates the applicant can obtain the degree. (d) If a beneficiary of an undergraduate scholarship is the surviving spouse of a public safety officer, the beneficiary must notify the Department immediately upon remarriage. If the beneficiary of an undergraduate scholarship is the spouse of a public safety officer who suffered a qualifying disability, the beneficiary must give notice immediately in the event of a divorce from the public safety officer.