Send us a request for Retiree information tailored just for you! You must have JavaScript enabled to use this form. Name Full Name Employee ID Last Working Day *Can be an estimate PERS Retirement Date This is typically the first of the month following your last day, unless you want to postpone your PERS retirement. PERS Membership Start Date This is needed if you've ever worked for another PERS employer. Need help? PERS: 888-320-7377 or oregon.gov/PERS/ Are you or any dependents currently eligible for Medicare? Yes No Do you want to defer your retiree medical/dental plan enrollment? - None -YesNo You can defer medical and dental plan enrollment when County employment ends or opt out of County retiree health insurance and reenroll at a later date if you remain continuously covered under another dental plan and/or a medical plan that meets the Minimum Essential Coverage (MEC) requirements under the Affordable Care Act (ACA), other than Medicare or coverage purchased on the individual market from the time you retire until the time you enroll in County Retiree coverage. Retiree Health Insurance Quote Retiree Medical Plan NoneKaiser 10/20 MedicalKaiser MaintenanceModa PPO 400Moda Major Medical You can select multiple plans to get multiple price quotes. Medical Coverage Level Single Two-Party Family You can select multiple coverage levels to get multiple price quotes. Retiree Dental Plan - Select -NoneKaiser DentalDelta DentalWillamette Dental Dental Coverage Level Single Two-Party Family You can receive a quote for the same plan you have, or choose a lesser plan with the same provider. If you currently opt-out, you may choose any plan. Personal Email Notes/Comments
