SOU Health Insurance

ENROLLING

Newly hired or newly eligible employees may enroll online by visiting PEBBenroll.com within their first 30 days. When enrolling online, new members will click the 'register here' button and will input their legal first name, legal last name, date of birth (with dashes mm-dd-yyyy), ID Type will be 'university ID number', and input your SOU ID number (starts with 940 and is nine digits). Benefits will take effect the first of the following month after enrollment is received. If needed, paper enrollment forms are available to employees:

• PEBB Enrollment Form 
• 2024 PEBB Flexible Spending Account Enrollment Form
• Enrollment and all other PEBB forms can be found on the PEBB Forms Webpage.

Once completed, forms can be digitally submitted to HR by uploading them to the HR Secure Inbox.

DID YOU MISS YOUR NEW HIRE ENROLLMENT WINDOW?

Employees who miss their 30-day enrollment window may enroll midyear if they have a qualifying midyear event or during the annual Open Enrollment period in October (coverage starting January 1 of the following year). Outside of these enrollment opportunities, employees may Appeal to enroll with PEBB. More information about these enrollment opportunities and Appeals can be found on the next tab under 'Changing Elections'. 

CHANGING ELECTIONS

Newly benefits-eligible employees may enroll in plans and change plan elections within their first 30 days of hire or eligibility. Outside of this 30-day window, employees may update benefits during our annual Open Enrollment period or if they have a qualifying midyear event. Plan changes outside of these opportunities may be possible if the member Appeals to enroll or change plans, which is approved or denied by PEBB. Details about these enrollment opportunities are explained below.

OPEN ENROLLMENT 

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

Aside from your initial 30-day window enrollment, you can adjust your benefit elections annually during PEBB’s Open Enrollment period, which is October 1-31 of every year for all benefits-eligible employees. 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;
2. Those who are currently enrolled in a medical plan and elect to continue to enroll in a medical plan for the following year will log into their medical provider's member portal to complete the HEM (Health Engagement Model), a required health questionnaire (Opt-outs who enroll in a medical plan do not complete the HEM, though this is subject to change depending on PEBB guidelines as decided upon for each annual Open Enrollment period).

For the plan year following Open Enrollment, if both of the above-listed steps are completed and the employee is enrolled in a medical plan, the employee will receive a $17.50 incentive in their monthly paycheck (not available for Opt-outs as they already receive an incentive). Those who do not complete Open Enrollment will have their deductible increased up to $300 for the plan year and PEBB may also assume other surcharges now apply (if not already applicable). New employees receive 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.  

PEBB APPEAL PROCESS

If employees miss their 30-day new hire enrollment window or if they have missed enrolling midyear within 30 days of a qualifying event, they can Appeal to PEBB to make changes to plans outside of the standard enrollment opportunities. To file an Appeal with PEBB, members are required to complete the PEBB Appeal form, stating what the issue is and what action they would like PEBB to take, and accompany that with a PEBB Midyear Change form, selecting the enrollment changes they wish to make. Appeals must be sent directly to PEBB's Appeals email, benefit.appeals@odhsoha.oregon.gov, who will review the submitted forms and either approve or deny the Appeal. If approved, coverage changes typically take effect the first of the following month after forms are submitted, though this will be communicated by PEBB. 

MONTHLY BENEFIT PREMIUMS

Visit HR's Total Compensation Calculator webpage to further discover the significance of SOUs benefits package and how it is an important complement to salary.

MOST PREMIUMS PAID A MONTH IN ADVANCE 

Most health insurance premiums are paid a month in advice. Therefore, if enrollments are submitted after the month’s payroll cutoff (typically the 15th of the month) and health insurance is intended to begin the first of the following month, the employee will pay for two months of premiums in that following month’s payroll. For example, if an employee submits their benefit elections on January 30, coverage will take effect on February 1, but because the elections were made after the January 15 payroll cutoff, the employee will pay for January and February coverage in the February payroll. NOTE:  Flexible Spending premiums are the only enrollments paid the month the contribution is due (example: January contribution covers January).

COST OF MONTHLY PREMIUMS

For Core benefits (medical, dental, vision, and $10k of basic life insurance), employees pay 3% or 5% of the monthly premiums and SOU covers the rest of the cost. If the employee enrolls in the lowest cost medical plan available to them, they will pay 3% for all Core benefit monthly premiums. If the employee enrolls in any of the other medical plans that are not the lowest cost, then the employee will pay 5% for all Core benefit premiums. Employees enrolled to Opt-out of medical-out of medical will get a monthly incentive of $233 (prorated if part-time) and will pay 5% for the $10k of basic life insurance, dental, and vision. 

For Optional benefits, employees pay 100% of the premiums. Health insurance premiums are automatically taken out of the employee's paycheck after the employee has enrolled.

To estimate the cost of your monthly premiums, use the PEBB Premium Estimator Tool.

CLASSIFIED EMPLOYEE SUBSIDY

Classified employees whose full-time 1.0 FTE salary or equivalent is less than or equal to Salary Range 11 Step 10 (effective 4/1/2024, SR 11 Step 10 equals  $3562/month or $20.55/hour). If eligible, SOU will pay up to $40/month to help cover the cost of the employees' 3% or 5% portion of Core benefit premiums. Visit the HR Policies and Procedures webpage to review the Classified employee SEIU Collective Bargaining Agreement. 

ACADEMIC YEAR EMPLOYEES 

Employees who are paid on the academic year cycle and are determined to return the following academic year will pay three months of health insurance premiums in the month of May to cover benefits over the summer. Renewable employees in 9 or 10-month positions may contact Payroll about enrolling in Deferred Pay (spreading pay over 12 months). If interested in Deferred Pay, check out the SOU Payroll website for more information.

Core Health Benefits

Southern Oregon University’s benefit-eligible employees have access to Medical, Dental, and Vision plans (a medical election is required to participate, though opting out is considered a medical election, declining is not). Employees only pay 3% or 5% of the total premium cost of their Core benefits, SOU covers the rest. For 2024 benefit costs, please use PEBB's Premium Estimator Tool. Automatically included in Core Benefit is $10K of guaranteed issue Basic Life Insurance where the full monthly premium is $1.60/month, though the employee's monthly portion is either $0.05 or $0.08, depending on which medical plan is elected. Available plans vary by location (Kaiser medical and dental plans are only available between Eugene and Portland, all other plans are available throughout the State of Oregon). 

Please note that member ID cards for medical and Delta Dental plans should arrive within a few weeks. However, once enrollments have been fed over to provider systems, members can log in via the member portal to view enrollments and member ID information (group numbers are listed under the Forms and Resources tab to the right). Willamette Dental and VSP members DO NOT GET MEMBER CARDS, member enrollment information will be in the provider systems (service locations can be found below and on the PEBB website).

MEDICAL PLANS

As mentioned above, medical plans available are determined by location and depending on which medical plan they enroll in (Opt-outs pay 5%). Some big differences between medical plans are how you navigate the plan and the network of providers and facilities. Employees' standard deductible is $250 per tier ($250 for employee-only coverage, $500 for employee+spouse/partner coverage or employee+children, and $750 for family coverage). Check out the PEBB CORE Benefits Plan summary document for more information or use PEBB's Online Plan Comparison Tool. Available medical plans:

DENTAL PLANS

Through Moda, PEBB members have access to two Delta Dental plans (through Moda), which require the member to elect a dentist within the network. Willamette Dental is also available, which is a clinic location, with one clinic in Medford, Grants Pass, and more clinics located across the state; members do not elect their dentist but are rather scheduled with whoever is available at their clinic, though members out-of-pocket costs for services are greatly reduced. Check out the PEBB CORE Benefits Plan summary document for more information or use PEBB's Online Plan Comparison Tool.  Available dental plans:

VISION

VSP (Vision Service Plan) is the only vision plan available to PEBB members, though members can upgrade to Vision Plus, which allows a better benefit for glasses. VSP is a national provider where many local eye centers are in the network. Check out the PEBB CORE Benefits Plan summary document for more information or use PEBB's Online Plan Comparison Tool. (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 Brochure
• VSP.com member website
• VSP Provider Search Tool
• Create a VSP Online Member Account
• Log In to the VSP Online Member System

Optional Health Benefits

Optional Benefits: Optional Life, Disability, Long Term Care, & Flexible Spending Accounts

Employees who enroll in optional benefits pay 100% of the cost of premiums. Employees may have other benefits available to them through their elected medical insurance provider. 

Employee and Spouse/Partner Optional Life Insurance

EMPLOYEE:  When employees are first eligible for health insurance they 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: When employees are first eligible for health insurance, they have a one-time allowable enrollment of up to $20k of guaranteed issue coverage for their spouse or domestic partner without having to do a medical history statement. Employees can enroll their spouse or domestic partners in up to $400k of coverage, though the spouse or domestic partner is required to complete a medical history statement, and if approved, they can be enrolled in additional coverage. If the employee does not enroll their spouse or domestic partner in life insurance within their new hire 30-day enrollment window, a medical history statement is required for any enrollment and increase in the future. 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. Spouse and domestic partners are eligible for 

• If enrolling in life insurance coverage over the guarantee issue amount that is available to newly eligible employees (within the 30-day enrollment window), then the medical history statement is required. This can be accessed on the PEBB Life Insurance wepbage (about halfway down) and on The Standard's webpage for PEBB members under the forms section. 

Dependent Life
This is term life insurance. The beneficiary (the enrolled employee) is the recipient for individuals who die 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.

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 monthly premium increases. Insured earnings do not include overtime pay, bonuses, or dollars received when you Opt-out of medical coverage. (Note: Temporary employees cannot enroll in disability.)

• To learn more about Short-Term Disability and the differences between Paid Leave Oregon, check out this recording between PEBB and The Standard, which manages our Short-Term Disability benefit. For detailed information about Paid Leave Oregon, visit our HR Leave Information webpage. 

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 monthly premium increases. Insured earnings do not include overtime pay, bonuses, or dollars received when you Opt-out of medical coverage. (Note: Temporary employees cannot enroll in disability.)

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.

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. When enrolling in flexible spending, PEBB will ask how many "pay events" the employee has in a calendar year. If paid on the academic year cycle, employees will report that they have 10-PAY EVENTS. NOTE:  Commuter parking and transportation accounts are available through PEBB but typically do not benefit SOU employees. If the employee pays for public parking or transportation for the purpose of work, then the Commuter plans may be useful. 

Wellness Programs

More Wellness-related resources can be found at PEBB's Wellness Central webpage and additional SOU employee perks can be found on the HR Perks and Discounts webpage. 

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 action to reduce them. Becoming healthier together can help contain healthcare 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.

24/7 Telehealth
The doctor will see you now – on your smartphone, tablet, or computer! ​​Telemedicine is available to all PEBB members at no cost! PEBB members and their dependents can talk with a healthcare worker while at work, home, school, or anywhere if a health issue is a concern.

• Providence Choice and PEBB Statewide – Express Care Virtual is our licensed and board-certified providers and are here to see you from 8 a.m. to midnight. No appointment is needed.
  • PEBB members receive a diagnosis and treatment plan, even a prescription or doctor’s note if you need one all at no cost to the member.
  • Just go to Express Care Virtual​ to get started.
• Moda – Moda members can access CirrusMD by logging into their Member Dashboard at www.modahealth.com/pebb or CirrusMD website at patients.cirrusmd.com/modahealth.
  • CirrusMD is a text-based virtual care app that lets you connect to a doctor in seconds from your phone or computer.
  • CirrusMD is available at no cost to the member. Doctors are available 24 hours a day, 7 days a week, and prescribe medication if necessary.
  • Members can also access our Nurse Advice Line by calling 800-501-5046 for help with medical issues ranging from home-care remedies to recommended emergency care at no cost.

Bus Pass Program (SOU Benefit)
Sign up for a free UMO bus pass by connecting with the Service Center (servicecenter@sou.edu) so that you can ride the bus for free, a service provided 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) - Canopy Wellbeing
Southern Oregon University contracts with Canopy Wellbeing (formerly known as Cascade Centers, Inc.) to provide a comprehensive EAP for eligible employees and their dependents. the EAP is a FREE and CONFIDENTIAL benefit that can assist you and your eligible family members with any personal problems, large or small. A summary of services can be found here and more detailed information on the HR Employee Assistance Program webpage.
 
HealthyYou Powered by WebMD
The HealthyYou portal helps you set goals, tracks your progress, keeps you motivated, and provides valuable information along the way. You and any dependents ages 18+ are eligible to enroll on the HealthyYou portal as long as you are enrolled in a Kaiser, Moda, or Providence medical plan. There’s no cost to you! Watch this short video to learn more.
 
Tobacco Cessation with Quit for Life
Using tobacco costs you more than just what you pay at the counter. PEBB members who use tobacco have $25 deducted monthly from their pay to offset the known risks for health care costs they bring to their health plan. You can end the deduction after you quit by filling out a Mid-year Change form.​ Members who use tobacco also have higher rates for optional life insurance. They can get the lower non-tobacco rate when they don't use tobacco for 12 months prior to the next Open Enrollment.

• Members in PEBB Statewide, Providence Choice, or Moda plans:
  • Call Quit for Life at 1-866-QUIT-4-LIFE (1-866-784-8454). There is also a chat feature.
• Members in a Kaiser Permanente plan:
  • Call the "Talk With a Health Coach" service at 503-286-6816 or 1-866-301-3866 (toll-free) and select option 2.

Your PEBB benefits give you comprehensive support to quit through no-cost access to:

• Consultations with a trained Quit Coach who knows how tough it can be to quit and ways you can stay or get back on track.
• Materials to help you plan and stick to a personalized quit program
• Nicotine replacement therapy
• Coverage of certain prescribed medications to help you quit

Many have been able to quit on their own, but the chances of being successful are eight times greater with support. Whatever your reasons for wanting to quit, start your plan today!

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)
WeightWatchers is committed to helping you reach your wellness goals - to lose weight, eat healthier, move more, and develop a more positive mindset or all of the above. 

Who is eligible:

• Anyone age 18 or older enrolled in a PEBB medical plan can sign up at NO COST to you.
• To learn more and sign-up visit PEBB.ww.com.

If you have any questions or issues, call 1-866-454-2144.

Diabetes Prevention Programs (Available through Providence medical plans and Moda medical plans)
All of SOU’s medical plan programs are 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.

• Moda Synergy medical members or Delta Dental members: As a Moda Health or Delta Dental member, you have access to the Active&Fit Direct program. With memberships starting at $28 a month, you can choose from over 12,200 participating gyms nationwide.
  • The program offers:
    • A free guest pass to try out a gym before joining
    • A robust online library of on-demand workout videos
    • Access to online directory maps and a health club locator from any device
    • Online tracking from a variety of wearable fitness devices, apps, and exercise equipment
  • To join the program:
    1. Log in to your Moda Member Dashboard account and open the benefits drop-down menu
    2. Select Benefit Programs
    3. Select Gym discounts with Acctive&Fit Direct
    4. Members should contact their gym of choice before signing up to see if there are any additional membership conditions or requirements
  • More information and additional programs available can be found on the Moda site for PEBB members under the 'Wellness Resouces' menu.
• Providence medical members: As a Providence member, you have access to the One Pass Select program. The One Pass program gives you access to gyms, studios, online workouts, and grocery delivery with one monthly membership. Monthly membership tiers can vary in cost depending on the tier enrolled for.
  • The program offers: 
    • Access to a large network of gyms and members may try classes like yoga, cycling, or group training
    • If you prefer to workout at home, you can join live, online fitness classes and explore on-demand workouts
    • Perks may include grocery delivery services with some tiers
    • Family memberships are also available
  • To join the program:
    • Go to OnePassSelect.com and create a profile (you will need your PEBB ID number, which can be found by logging into the PEBBenroll.com member portal, it starts with the letter 'P')
    • Chose your coverage tier
    • Then select classes, gyms, or other perks that you'd like to access
  • More information about the program can be found on the Providence site for PEBB members under the 'diet and exercise' header.

Forms and Resources

 

Forms

Use PEBB's Forms webpage to search for enrollment forms, change forms, or required affidavits.

Resources

• SOU's Agency Code under PEBB is 58040
• Contact PEBB
  • 503-373-1102
  • or pebb.benefits@odhsoha.oregon.gov 
  • Fax 503-373-1654)
• PEBB Website - PEBBinfo.com
• Insurance Plan Contacts (phone numbers, member documents/portals, etc.)
• PEBB Legislative Updates
• Domestic Partnership Information 
• PEBB Premium Cost Estimator Tool
• Plan Documents
• Flex Spending Tax Saving Accounts (link to ASIFlex, which manages flex spending for PEBB)
• PEBB Summary Plan Description
• PEBB News and Events

Medical Group Numbers

• PEBB Statewide: 108601
• Providence Choice: 106528
• Moda Synergy: 10002802

Dental Group Numbers

• Delta Dental (Moda) PPO: 10002802
• Delta Dental (Moda) Premier: 10002802
• Willamette Dental: OR90

Vision Group Number

• VSP Basic/Plus: 12179989 (No insurance cards for vision, use medical ID or PEBB ID number and the provider will find you in the VSP system)