Health Benefits | Human Resources

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COVID-19 VACCINATION: information about COVID-19 vaccines can be found on the HR Vaccination webpage.

Southern Oregon University is committed to offering a benefits package that provides employees with options to choose the appropriate coverage to help manage health and wellness. PEBB (Public Employees’ Benefit Board) is the labor-management board that designs, contracts, and administers benefits for the state of Oregon employees, which SOU is a part of. Find more information about our benefits package at PEBBInfo.com.

HEALTH BENEFITS ELIGIBILITY

ELIGIBLITY

Employees that are benefit eligible work over 90 days at half-time or greater. Any other form of eligibility would come from notification from the Benefits Officer, such as qualifying for health benefits coverage under the Affordable Care Act. Irregular instructors or faculty members may qualify for health coverage if working over 8 ELU’s in one term, which is typically equivalent to a half-time position.

Employees have 30 days from their date of hire to make benefit elections. If no elections are made after 30 days, the employee would be enrolled as a Decline. Eligible employees that Decline benefits may enroll during our annual Open Enrollment period the month of October, which take effect January 1 of the coming plan year. Employees may intentionally decline, though if other coverage is available employees may consider Opting-Out to receive a cash incentive.

Eligible dependents include a spouse or domestic partner (review requirements and documents needed for domestic partnership, review the 2021 Imputed Value Tax amounts) and any dependent children. PEBB reviews dependent eligibility and will contact members who enroll a spouse/partner or children under their plans for documentation proving the dependent is eligible. Review PEBB's dependent eligibility information here.

CHANGING ELECTIONS

OPEN ENROLLMENT

Visit the HR Open Enrollment webpage for details about Passive Enrollment for 2021.

Aside from your initial enrollment, you can adjust your benefit elections yearly during PEBB’s annual Open Enrollment period, which is October 1-31 each year. Open Enrollment is a two-step process and requires all benefit-eligible employees to (1) go into the PEBBenroll.com system to re-save their benefits or make necessary changes AND (2) go into their medical provider's website to complete the HEM (Health Engagement Model), a required health questionnaire (Opt-Outs go to the Providence Choice website to complete the HEM only if they anticipate enrolling in a medical plan). For the plan year following Open Enrollment, if both steps were completed, employees will receive a $17.50 incentive in their monthly paycheck; not completing Open Enrollment will raise your deductible up to $300 a year and because you did not re-attest, PEBB will assume you are a tobacco user and that you have other group coverage, charging you higher rates and fees. New employees get the benefit of a low deductible and by completing Open Enrollment in October, they will continue to have a low deductible into the following plan year.

MIDYEAR PLAN CHANGES

Outside of Open Enrollment, existing employees may change benefits midyear if they have a qualifying status change. PEBB has created a Midyear Plan Change Matrix of qualifying events which states what benefits are available to change. If a member has a qualifying mid-year event, they can submit the Midyear Change form to HR within 30-days of the event date. Changes submitted will take effect the first of the following month after the event. Also, if adding a new baby to coverage, babies are covered under the subscriber for the first 30-days automatically.

TERMINATION

WHEN DOES COVERAGE END?

Coverage will always run through the end of the month in which coverage is set to terminate. If the employee has at least 80-hours worked in their final check, Payroll will take contributions for another month of benefits. Since we pay for coverage a month in advance, employees often have coverage through the end of the month after they separate. As an example, if the employee was full-time and terminated on June 15, they would have coverage through July 31. Dependent children who age out of coverage will have their benefits terminated at the end of the month in which they turn age 26.

Employees and their dependents who terminate coverage will automatically be sent COBRA information in the mail. COBRA allows PEBB members the ability to continue coverage for a certain period of time. Check out HR's COBRA Information webpage for more details.

Explore SOU’s health benefits with the below resources:

Summary

The Benefit Summary is given to all new hires at the Benefits Orientation and is available for prospective hires as well (prospective employees should review the HR Prospective Employee webpage for more details). For detailed benefits information, refer to the Core, Optional, and Wellness tabs below.

Core Benefits cover medical, dental, vision, and a guaranteed $5,000 of employee life insurance (which is automatic, not elected). Employees pay either 3% or 5% of the total benefit premium cost, depending on what medical election they choose. Currently, if electing Providence Choice, employees will pay 3% of the total premium cost for Core benefits. If electing either of the other medical plans, PEBB Statewide or Moda Synergy, the employee will pay 5% of the total cost of Core benefits.

Optional Benefits include life insurances, disability insurances, accidental death & dismemberment, long-term care, and flex-spending accounts are available for employees and employees eligible dependents. The employee pays 100% of these premiums.

Wellness Benefits are benefits available at no charge, where information, assistance, and resources are provided to employees, encouraging a wholesome and complete lifestyle.

Tips for New Hires:

Enroll online at PEBBenroll.com
Find more information on the PEBB website
Use the 2021 Enrollment Guides for a plan overview
Use the 2021 Summary of Benefits Guide for Medical, Dental, and Vision summaries
Use the 2021 PEBB Payroll Deduction Estimator to determine the cost of benefits
View Subsidies and Notices (Family Tier Subsidy, Classified Employee Subsidy, Payment for Summer Benefits, etc.)
PEBB's New Hire Resource Center
Meet Alex, PEBB's virtual benefit counselor
Find other forms on the PEBB Forms page

Core

Core Benefits: Medical, Dental, Vision & Automatic Basic Life Insurance

Southern Oregon University’s benefit-eligible employees have access to Medical, Dental, and Vision plans (medical election is required to participate, though opting-out is considered a medical election, declining is not). Automatically included in Core Benefit is $10K of guaranteed issue Basic Life Insurance, the full monthly premium is $1.60/month, employee's monthly portion is either $0.05 or $0.08, depending on which medical plan elected. Employees only pay 3% or 5% of the total premium cost of their Core benefits, SOU covers the rest.

Medical Plans
Plans available are determined by location, where employees pay only 3% or 5% of their total Core Benefit costs, depending on which medical plan they enroll in (Opt-Outs pay 5%). Some big differences between medical plans are how you navigate the plan (PEBB Statewide and Moda Synergy do not require referrals) and the network (PEBB Statewide has state and nation coverage, Moda Synergy and Providence Choice are defined by counties within Oregon). Employees' standard deductible is $250 per tier ($250 for employee-only coverage, $500 for employee+spouse/partner coverage or employee+children, $750 for family coverage). Check out the PEBB CORE Benefits Plan summary document for more information.

Available to Jackson County residents are the following medical plans:

PEBB Statewide (employee pays 5% of Core benefit premiums) - Nationwide network (out of state in-netowrk coverage) with the numerous providers in the plan, where employees do not need referrals and typically pay 15% for most services.
Moda Synergy (employee pays 5% of Core benefit premiums) - Network is defined within counties in Oregon and as long as providers are in-network, members do not need referrals and pay about $10 for most services. (For children going to college out of state, Moda may allow a 30-mile in-network radius around their college location, contact Moda for details.)
Providence Choice (employee pays 3% of Core benefit premiums) Network is defined within counties in Oregon and members must obtain referrals for specialty services, where members pay about $10 for most services.

Dental Plans
The available Delta Dental plans (through Moda) require the member to elect a dentist within the network. Willamette Dental is also available, which is a clinic location, with one in Medford, Grants Pass, and more clinics located across the state, where members do not elect their dentist but are rather scheduled with whoever is available at their clinic, drastically reducing the cost of services. Check out the PEBB CORE Benefits Plan summary document for more information.

Available to Jackson County residents are the following dental plans:

Delta Dental PPO (through Moda)
Delta Dental Premier (through Moda)
Willamette Dental (a clinic location)

Vision
VSP (Vision Service Plan) is the only vision plan available to PEBB members, though members can upgrade for Vision Plus, which allows a better benefit for glasses. VSP is a national provider where most local eye centers are in the network. Check out the PEBB CORE Benefits Plan summary document for more information. (Note: VSP members do not get vision cards. Instead, find a local vision center and share your medical ID card with them and they can find you in the VSP system. Members who opt-out of medical can use their PEBB ID number.)

Review VSP coverage and find providers:

VSP

Optional

Optional Benefits: Disability, Life Insurances & Flexible Spending Accounts

Employees may enroll in optional benefits but are responsible for 100% of the premiums.

Accidental Death and Dismemberment
The AD&D plan provides 24-hour coverage for accidental loss of life or limb loss for employees and their eligible dependents. You may select a coverage amount from $50,000 to $500,000, in increments of $50,000.

Long-Term Care
Members eligible for long-term care insurance can enroll for coverage at any time - not just during your initial enrollment or Open Enrollment. During Open Enrollment, you can begin the enrollment process online through your record in the benefits system; however, you will still need to submit forms from the carrier, UNUM, directly to PEBB.

Long Term Disability
The benefit covers a percentage of your monthly insured earnings. You determine the percentage when you choose from the four options. For long-term disability, the insured earnings amount is based on your monthly earnings in effect on your last full day of work. When your insured earnings increase (for example, with a pay increase), your premium rate increases. Insured earnings do not include overtime pay, bonuses, or dollars received when you opt-out of medical coverage.

Short-Term Disability
The benefit covers 60 percent of your insured earnings. For short-term disability, the insured earnings amount is based on your weekly earnings in effect on your last full day of work. When your insured earnings increase (for example, with a pay increase), your premium rate increases. Insured earnings do not include overtime pay, bonuses, or dollars received when you opt-out of medical coverage.

Employee Optional Life Insurance
Employees when first eligible for health insurance have a one-time allowable enrollment of up to $100k of guaranteed issue coverage without having to do a medical history statement. Employees can enroll in up to $600k of coverage but are required to complete a medical history statement and if approved can enroll in additional coverage. If the employee enrolls in no life insurance or less than the $100k guaranteed issue amount, they must complete a medical history statement for any increase in the future. This is term life insurance, which means that the insurance benefit is payable only if the insured person dies during the period specified by the policy (while covered under the plan). The beneficiary receives the benefit payment if the insured person dies while covered under the policy. In this case, that is while the person is a PEBB-eligible state employee whose premium payments are current. The Standard pays the benefit upon death from any cause (excluding suicide during the first two years of coverage).

Spouse/Partner Optional Life Insurance
This is term life insurance. Term life insurance means that the insurance benefit is payable only if the insured person dies during a specified period. The beneficiary receives the benefit payment if the insured person dies while covered under the policy. In this case, that is while the employee who purchases the coverage is a PEBB-eligible state employee and premium payments for the coverage are current.

Dependent Life
This is term life insurance. The beneficiary (the enrolled employee) is the recipient if the covered individual dies while covered under the policy.
In this case that is when the employee who purchases the coverage is a PEBB-eligible state employee and premium payments for the coverage are current.

Flexible Spending Accounts (FSA)

FSAs allow you to use pre-tax dollars to reimburse yourself for IRS-Qualified expenses. Use a Health Care FSA for IRS-qualified medical and dental expenses not covered in your plan, or use a Dependent Care FSA for IRS-qualified daycare expenses that allow you to work. FSAs are annual accounts. If you want an FSA for the coming plan year, you must enroll in Open Enrollment. You can't revoke your participation in an FSA after it goes into effect.

Well-Being

Well-Being (n.): The state of being healthy, happy, and prosperous

Health Engagement Model (HEM)
The goal of the HEM program is to engage as many people as possible in improving their health. Participating in HEM helps you learn about your health risks and take actions to reduce them. Becoming healthier together can help contain health care costs for all of us over time. Enrollment in HEM for the coming year occurs during Open Enrollment and is MANDATORY. Participants receive a health incentive in their monthly pay, available in January after completion of Open Enrollment.

Bus Pass Program
Pick up a new bus pass TouchPass Card at the Service Center so that you can ride the bus for free, a service through RVTD (Rogue Valley Transportation District). Enjoy a trip downtown for lunch, ride to and from work without worrying about parking, or even enjoy the bus for easy weekend transportation.

Employee Assistance Program (EAP)
The Southern Oregon University contracts with Cascade Centers, Inc. to provide a comprehensive employee assistance program for eligible employees, their dependents. If you are struggling with work or family issues, free confidential help is available through the EAP.

LifeBalance
Available to PEBB Statewide and Providence Choice members, LifeBalance is an online wellness program designed to help members find well-being by participating in a wide variety of healthy deals and activities that meet your needs.

Healthy Team Healthy U (HTHU)
Healthy Team Healthy U targets your overall health to maximize results and create healthier minds, healthier bodies, and a healthier workplace. Through this program, you gain access to an online support community and vast resources to cultivate a healthier lifestyle.

Tobacco Cessation
Employees enrolled in medical insurance have access to a smoking cessation program to assist with quitting tobacco consumption and lower health care costs.

Travel Assistance
All PEBB members are automatically enrolled in Travel Assistance, which offers worldwide medical assistance and medical transport, personal security services, and trip/pre-trip assistance.

WW (formerly Weight Watchers)
Weight Watchers program assists employees with achieving weight loss goals in a healthy supportive environment. Weight Watchers group is available on campus.

Diabetes Prevention Programs (Available through Providence medical plans and Moda medical plans)
All of SOU’s medical plans programs designed to help you improve your health and lower your risk of developing diabetes. Weekly lessons, 24x7 online tools, and dedicated personal health coaches empower you to take small practical steps to reach your health goals.

Better Choices, Better Health

Join Better Choices, Better health for online workshops, information, and tools you need to manage chronic conditions and live a better life. Empower yourself with management techniques and a flexible 6-week online workshop so you can go at your own pace.

Active & Fit Direct (Available through Providence medical plans and Moda medical plans)

PEBB insurance companies offer discounts to over 11,000 participating fitness centers and programs nationwide for only $25/month. Check out your medical carrier’s website for more information and details. They also offer fitness-related discounts!

Preventative Services

No Cost Preventative Services: Free services when delivered by a provider in network

Most health plans must cover a set of preventive services — like shots and screening tests — at no cost to you. All Marketplace health plans and many other plans must cover the following list of preventive services without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible. These services are only free when delivered by a doctor or other provider in your plan’s network. For details and more information, visit the Healthcare.Gov site for preventative services.

FOR ALL ADULTS

1.       Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked
2.       Alcohol misuse screening and counseling
3.       Aspirin use to prevent cardiovascular disease for men and women of certain ages
4.       Blood pressure screening
5.       Cholesterol screening for adults of certain ages or at higher risk
6.       Colorectal cancer screening for adults over 50
7.       Depression screening
8.       Diabetes (Type 2) screening for adults with high blood pressure
9.       Diet counseling for adults at higher risk for chronic disease
10.   Hepatitis B screening for people at high risk, including people from countries with 2% or more Hepatitis B prevalence, and U.S.-born people not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence.
11.   Hepatitis C screening for adults at increased risk, and one time for everyone born 1945 – 1965
12.   HIV screening for everyone ages 15 to 65, and other ages at increased risk
13.   Immunization vaccines for adults — doses, recommended ages, and recommended populations vary:
       Diphtheria
       Hepatitis A
     Hepatitis B
     Herpes Zoster
     Human Papillomavirus(HPV)
     Influenza (flu shot)
     Measles
     Meningococcal
      Mumps
       Pertussis
     Pneumococcal
     Rubella
       Tetanus
         Varicella (Chickenpox)
14.   Lung cancer screening for adults 55 - 80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years
15.   Obesity screening and counseling
16.   Sexually transmitted infection (STI) prevention counseling for adults at higher risk
17.   Syphilis screening for adults at higher risk
18.   Tobacco Use screening for all adults and cessation interventions for tobacco users

FOR WOMEN

Services for pregnant women or women who may become pregnant:
1.       Anemia screening on a routine basis
2.       Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women.
3.       Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt “religious employers.”
4.       Folic acid supplements for women who may become pregnant
5.       Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
6.       Gonorrhea screening for all women at higher risk
7.       Hepatitis B screening for pregnant women at their first prenatal visit
8.       Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
9.       Syphilis screening
10.   Expanded tobacco intervention and counseling for pregnant tobacco users
11.   Urinary tract or other infection screening

Other covered preventative services for women:
1.       Breast cancer genetic test counseling (BRCA) for women at higher risk
2.       Breast cancer mammography screenings every 1 to 2 years for women over 40
3.       Breast cancer chemoprevention counseling for women at higher risk
4.       Cervical cancer screening for sexually active women
5.       Chlamydia infection screening for younger women and other women at higher risk
6.       Domestic and interpersonal violence screening and counseling for all women
7.       Gonorrhea screening for all women at higher risk
8.       HIV screening and counseling for sexually active women
9.       Human Papillomavirus (HPV) DNA test every 3 years for women with normal cytology results who are 30 or older
10.   Osteoporosis screening for women over age 60 depending on risk factors
11.   Rh incompatibility screening follow-up testing for women at higher risk
12.   Sexually transmitted infections counseling for sexually active women
13.   Syphilis screening for women at increased risk
14.   Tobacco use screening and interventions
15. Well-woman visits to get recommended services for women under 65

FOR CHILDREN

1.       Alcohol and drug use assessments for adolescents
2.       Autism screening for children at 18 and 24 months
3.       Behavioral assessments for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
4.       Blood pressure screening for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
5.       Cervical Dysplasia screening for sexually active females
6.       Depression screening for adolescents
7.       Developmental screening for children under age 3
8.       Dyslipidemia screening for children at higher risk of lipid disorders ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
9.       Fluoride Chemoprevention supplements for children without fluoride in their water source
10.   Gonorrhea preventive medication for the eyes of all newborns
11.   Hearing screening for all newborns
12.   Height, weight, and body mass index (BMI) measurements for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
13.   Hematocrit or hemoglobin screening for all children
14.   Hemoglobinopathies or sickle cell screening for newborns
15.   Hepatitis B screening for adolescents at high risk, including adolescents from countries with 2% or more Hepatitis B prevalence, and U.S.-born adolescents not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence: 11 – 17 years.
16.   HIV screening for adolescents at higher risk
17.   Hypothyroidism screening for newborns
18.   Immunization vaccines for children from birth to age 18 — doses, recommended ages, and recommended populations vary:
         Diphtheria
     Tetanus
           Pertussis (Whooping Cough)
           Haemophilus influenza type b
           Hepatitis A
           Hepatitis B
           Human Papillomavirus
           Inactivated Poliovirus
           Influenza (flu shot)
           Measles
           Meningococcal
           Pneumococcal
           Rotavirus
         Varicella (Chickenpox)
19.   Iron Supplements for children ages 6 to 12 months at risk for anemia
20.   Lead screening for children at risk of exposure
21.   Medical history for all children throughout development ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
22.   Obesity screening and counseling
23.   Oral health risk assessment for young children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years
24.   Phenylketonuria (PKU) screening for newborns
25.   Sexually transmitted infection (STI) prevention counseling and screening for adolescents at higher risk
26.   Tuberculin testing for children at higher risk of tuberculosis ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
27.   Vision screening for all children