OAR 459-035-0040: Eligibility, Retiree Health Insurance Premium Account

This rule describes the eligibility requirements for an “eligible retired state employee” participating in a PERS-sponsored health insurance plan, exclusive of dental coverage and long term care coverage, to be eligible for a contribution from the RHIPA toward the cost of premiums for that health insurance plan. The amount of the contribution is established in OAR 459-035-0050. (1) An “eligible retired state employee” includes: (a) A Tier One or Tier Two member who is not eligible for Medicare, and whose PERS effective retirement date is the first of the month following termination of state employment, and who: (A) Is receiving a PERS service or disability retirement allowance or benefit, and had eight or more years of qualifying service at the time of retirement; or (B) Is receiving a PERS disability retirement allowance computed as if the member had eight or more years of creditable service, and has attained the earliest service retirement age. (b) A surviving spouse or dependent of a deceased eligible retired state employee, as described in subsection (a) of this section, who is not eligible for Medicare, and who: (A) Is receiving a retirement allowance or benefit from PERS; or (B) Was covered under the eligible retired state employee’s PERS-sponsored health insurance plan, and the eligible retired state employee retired on or after September 29, 1991. (2) An eligible surviving spouse or dependent receiving benefits under the 15-year certain optional form of benefit payment (ORS 238.305 Option 4) will be entitled to contributions from the RHIPA only until the remainder of the 180 monthly benefit payments are paid, unless he or she meets the requirement of paragraph (1)(b)(B) of this rule. (3) If an eligible surviving spouse and a dependent are receiving benefits under the same 15-year certain optional form of benefit payment (ORS 238.305 Option 4), only the eligible surviving spouse shall be entitled to contributions from the RHIPA unless the surviving spouse, in writing, waives the contribution in favor of the eligible surviving dependent.