Most of our local contracts include a financial incentive to opt-out of medical coverage, but only if the worker already has other coverage that the state Legislature has deemed “eligible.” At OSEA Legislative Education Day (LED) in 2023, our participants told us that several OSEA members receive medical coverage through Indian Health Services (IHS), also referred to as tribal coverage, but this type of coverage did not make them eligible to opt-out if their workplace receives benefits through the Oregon Educators’ Benefit Board (OEBB).
OSEA persistently and successfully pursued a legislative change to include HIS in the opt-out options. OEBB, including Governor-appointed OSEA member Sally Duerfeldt and Executive Director Susan Miller, voted on Tuesday to approve amended rules giving OSEA members with IHS the ability to qualify for the financial incentive in their collective bargaining agreement (CBA).
OSEA is committed to advocating for our members at all levels, whether it be local, in the state Legislature or anywhere necessary to make the lives of our members better. Please see the new rules below:
(2) Unless otherwise specified in a collective bargaining agreement, documented Entity policy or employment contract in effect on July 1, 2008, an Eligible Employee may opt out of enrollment in an OEBB-sponsored medical benefit plan. Eligible Employees electing to opt-out must:
(a) Maintain minimum essential medical coverage for themselves and all other individuals for whom the employee can reasonably expect to claim a personal tax exemption deduction for. The medical coverage must be another employer-sponsored group medical benefit plan, Medicare, TRICARE, Veterans' Administration Health Benefit Program or Indian Health Services (IHS). The employee must attest to the coverage at initial enrollment and annually thereafter.
(b) Be employed by an Entity that administers their benefits program in compliance with the requirements of Section 125 of the Federal Internal Revenue Code (IRC).
(3) Eligible Employees electing to opt-out must:
(a) Meet the requirements of the Entity opt-out program in which they are participating;
(b) Submit their election to opt-out through the OEBB benefit management system; and
(c) If requested, provide proof of current coverage under another employer-sponsored group medical benefit plan.
(4) An Eligible Employee participating with or enrolled in coverage bought on the individual market, the Oregon Health Plan/Medicaid, or the Student Health Insurance market may not elect to opt-out of OEBB-sponsored medical benefit plans. The Eligible Employee may elect to waive benefits or enroll in an OEBB-sponsored medical benefit plan.