Open Enrollment is a mandatory two-step process where employees can elect to change benefit options for the next calendar year, taking effect January 1, 2019.
- If you do not complete both steps of Open Enrollment (listed below), your deductible will go up, potentially $300 for the year, and you will be charged additional fees, up to $100 extra a month.
- If you do complete both steps of Open Enrollment, your deductible will NOT go up and you will NOT be charged additional fees. Also, by doing both parts of Open Enrollment, you will receive an incentive of $17.50 in your paycheck every month for the calendar year to help cover the cost of benefits.
Two-steps of Open Enrollment:
1. Re-Enroll in benefits through the PEBB member portal by October 31 (paper form available)
2. Complete the HEM (Health Engagement Model), a health questionnaire, on your 2018 medical providers’ website by October 31 (printable instructions available below)
Note: Opt Out employees and Declines who want to enroll in a Medical plan need to call PEBB for an access code, 503-373-1102, and will go to the Providence website to complete the HEM.
WHAT IS NEW FOR 2019
| Premiums | Most members will see premiums increase between $1 and $4 per month. |
| Emergency room copays change | Moda, Providence Choice, and Providence Statewide will increase the emergency room visit copay from $100 to $150. Your copay is waived if admitted to the hospital. |
| Providence Statewide out-of-pocket maximum |
From $15020 to $1900 per individual, $4500 to $5700 per family. |
| Willamette Dental copays | Office visits increase from $5 to $10; fillings $5 to $20; orthodontia from $1500 to $2,500. |
| Delta Dental (previously Moda Dental) | Adds nitrous oxide benefit. |
| PEBB policy on child dependent coverage | Coverage will go to the end of the month following a child’s 26th birthday. Previously, children could stay covered until the end of the plan year in which they turned 26. |
| Flexible Spending Account (FSA) | Members can contribute up to $2,650 to a health care FSA in 2019, an increase of $50. |
| VSP | Breaks out the fitting and evaluation fee giving members more options. Adds standard progressive or Ethos lenses. |
| The Standard (life insurances) | Rates increase for 2019. View 2019 life insurance information and rates here. |
TOOLS FOR OPEN ENROLLMENT
- Where to enroll-
- PEBB Member Portal to Re-Enroll in benefits online (open for re-enroll October 1st through 31st)
- HEM (Health Engagement Mode), the annual health questionnaire that you do at your current medical provider's website
- Where to find information-
- PEBB website
- Use alex, PEBB's digital benefit counselor who will explain and walk you through your plan options
- 2019 Enrollment Guide (copay summary for medical, dental, vision, optional benefits)
- The PEBB Open Enrollment website (on Oregon.gov) with the most up-to-date information
- 2019 Plan Highlights in a presentation format (will be given by Benefit Officer at Open Enrollment presentations, listed below)
- Estimate your monthly payroll deductions with the PEBB's Payroll Estimator tool
- Compare plans side by side with PEBB's Plans Benefits Comparison tool
- Additional Resources-
- HR Open Enrollment Calendar of Events
- Sign up for Text or Email reminders from PEBB about Open Enrollment
- Use printable instructions to assist you with your Health Assesment for Moda or Providence (Statewide members use the Providence website)
- SOU's agency code is 58040. You may need this when logging into your medical provider's website.
- Review a glossary of Health Care terms
- Learn about the Coordinated Care Model
- If you increased life insurance, be sure to complete the Medical History Statement by November 30, 2018 (Spouse/Domestic Partners must complete on their own behalf)
ATTEND A PRESENTATION OF PLAN HIGHLIGHTS OR A WEBINAR
- Open Enrollment plan highlights presentations:
- Friday, October 12th from 1-2:30 in SU 323
- Friday, October 19th from 10:00 - 11:30 in SU 319
- Open Enrollment webinars will be:
- Wednesday, October 3rd at 2 PM, register here To watch this recorded webinar, click here.
- Tuesday, October 9th at 9 AM, register here
ATTEND AN OPEN LAB TIME
These sessions are held during open lab times, where our Benefits Officer will be present to assist employees with completing their re-enrollment for 2019 in the PEBB system and the HEM from your medical provider's website. Stop in during any of the below times for assistance (all labs are held in the Computing Services East building):
- PC East: October 9th from 3:00 - 5:00 PM
- PC West: October 12th from 8:00 - 10:00 AM
- PC East: October 16th from 8:00 - 10:00 AM
- PC East: October 23rd from 4:00 - 5:00 PM
- PC East: October 25th from 8:00 - 10:00 AM
SEE WHAT PLANS ARE AVAILABLE TO YOU
- PEBB Statewide member pays 5% of Core premiums
- Moda Synergy member pays 5% of Core premiums
- Providence Choice member pays 3% of Core premiums
MAKE SURE YOUR PROVIDERS ARE IN THE PLAN’S NETWORK
- Use the plan’s provider directory (navigate to your 2018 medical provider's website) to determine who is in network;
- Then, call the provider you wish to be your primary and ask if they can accept you as a patient (online directories are not always up-to-date, a phone call is a good idea);
- If they accept you, log in to your medical providers' member portal (navigate to your 2018 medical provider's website), or call them, to notify your medical plan of who your primary care provider is.
FIND OUT HOW THE PLAN HANDLES REFERRALS TO SPECIALISTS - CALL THE PLAN AND ASK
- In Coordinated Care Model plans, or CCO's:
- Providence Choice and Moda Synergy- you typically pay less for specialty services when you see a specialist referred by your primary care provider/medical home.
- In Preferred Provider Plans, or PPO's:
- PEBB Statewide is a preferred provider organization (PPO) plan, where you may see any provider; however, you pay more when you see out-of-network providers, including specialists
- alex, PEBB's digital benefit counselor, can also help you determine how your plan handles referrals
