Open Enrollment is a mandatory two-step process where all benefit-eligible employees elect benefit options for the coming plan year, taking effect January 1, 2022.
The annual Health & Wellness Fair will again be virtual and this year it will be held in collaboration with PEBB. Events will be held the whole month of October and PEBB will also be hosting live Q&A sessions on Wednesdays. Members can join webinars from PEBB, plan providers, wellness providers, retirement providers, and more to ask questions and learn about plans/programs.
POST OPEN ENROLLMENT
Flexible Spending Account (FSA) corrections for members who complete Open Enrollment are now due by December 20, 2021 (was originally December 10; FSA's to not carry forward and require re-enrollment). Members may submit the FSA Open Enrollment form to PEBB, marking the corresponding correction at the top of the form.
All other corrections to member plans can be made until February 28, 2022, by submitting the Open Enrollment form to PEBB, marking the correction option at the top of the form.
Members who are new to the HEM this Open Enrollment should save a copy of their completion certificate or final page showing it has been completed. Since PEBB members pay benefits a month in advance, starting in December 2021 payroll, members who are enrolled in the HEM will get the $17.50 incentive added to their check each month for the 2022 plan year (will be -$17.50 in check). If this is not in your December check and you newly enrolled in the HEM in October during Open Enrollment, provide the proof of completion to PEBB and PEBB will update their system. Details and step-by-step guides about the HEM can be found on the PEBB website.
OPEN ENROLLMENT STEPS
- Re-Enroll in benefits online by visiting PEBBEnroll.com between October 1st and 31st. This is required even if members have no plan changes, though members can modify benefits, add or remove dependents, and enroll in flexible spending accounts.
- Complete the HEM (Health Engagement Model or Personal Health Assessment) from your 2021 medical providers’ website by October 31st. Print or digitally save your completion certificate proving eligibility for the HEM incentive, to be supplied to PEBB only if needed. It is recommended that members complete the HEM early in the month, in case there is a delay in medical insurance providers resetting passwords.
- Members who enroll in the HEM receive a $17.50 incentive in their monthly check starting with the December payroll.
- Opt-out employees and Declines who want to enroll in a Medical plan for the 2022 plan year must complete the HEM. Call PEBB for an access code, 503-373-1102, then log into the Providence website to complete the HEM.
- Exemptions to the HEM may apply per specific situations, as stated on the PEBB HEM Exemption Request form, which is required if seeking an exception (still must be completed within the month of October).
WHAT IS NEW FOR 2022
|Family Tier Subsidy for Medical||
The family tier subsidy that was applied to members who enrolled a family under medical will go away with the 2022 plan year.
|Change to Lowest Cost Medical Plan (3% monthly premiums vs. 5% monthly premiums)||
Starting with the 2022 plan year, the Providence Choice Medical plan will no longer be the lowest-cost plan for SOU employees. This means that members enrolled with Providence Choice will begin paying 5% for core benefits monthly premiums, instead of 3%. Moda Synergy will now be our lowest-cost medical plan and members enrolled in Moda Synergy will begin paying 3% for their core benefits monthly premiums.
|Changes to Spinal Manipulation, Acupuncture, and Massage Therapy||For Providence Choice and Moda Synergy members, massage therapy is now separated from spinal manipulation and acupuncture services. Members will pay a $10 copay for massage therapy services, with a limit of up to $1,000 in service charges. Members will then be allowed 20 spinal manipulation treatments and 12 acupuncture treatments per calendar year with a $10 copay. (Statewide plan does not offer massage therapy.)|
|Providence Choice and Statewide||Providence Choice and Providence PEBB Statewide will now allow wig coverage for drug-induced Alopecia, remove exclusion for neurofeedback within the Applied Behavioral Analysis (ABA) benefit, and will eliminate visit limitation for pain management under outpatient services|
|Moda Synergy||Moda will be offering Moda 360 enhancements, including access to a digital musculoskeletal program, align certain pharmacy copays to encourage biosimilar drug usage (pharmacy providers may change, check with Moda about in-network pharmacies), and they are adding coordinated specialty behavioral health programs to better address member needs and social determinants of health.|
Medical plans will now cover fertility services. Members will have an annual max of $35k for medical and pharmacy as it relates to fertility services.
|Willamette Dental||Waiving 2022 office visit copays to encourage members back for cleanings and maintenance work.|
|Flexible Spending Accounts||
Health Care FSA contribution limit will remain the same at $2,750.
|Gender Affirming Surgery||All medical plans now cover facial feminization surgery for male to female gender reassignment.|
|Vision Therapy||VSP is adding vision therapy coverage – up to $85 annually
for exams and up to $750 annually for training/therapy.
VIRTUAL HEALTH & WELLNESS FAIR - Provider Booth's, Information, and Webinar Schedule
Due to the COVID-19 pandemic, the annual Health & Wellness Fair will again be virtual this year. During the month of October, members can join webinars from PEBB, plan providers, wellness providers, retirement providers, and more. PEBB will also be hosting their first benefits fair, with activities also spread over the whole month of October, allowing members access to even more events and resources. PEBB will also be hosting a meeting each Wednesday in October for carriers to answer your questions in Live Chat. Visit PEBBWebinars.com to register for these PEBB sessions and for other upcoming webinars. Visit PEBBonDemand.com to view prior webinars.
Join the PEBB Virtual Benefits Fair here.
PEBB will be holding a 2022 Open Enrollment Webinar on Monday, October 4, from 10:00 am to 12:00 pm; Register Here
Upcoming PEBB sessions with Live Chat from providers are listed below; Registration found in the PEBB Virtual Benefits Fair under 'Information Booth':
- October 6 from 10:00 am - 2:00 pm
- October 13 from 10:00 am - 2:00 pm
- October 20 from 10:00 am - 2:00 pm
- October 27 from 10:00 am - 2:00 pm
Core Health Benefits
|Providence Choice and Providence PEBB Statewide Members||
Providence is here to help you make the most of your coverage. With a focus on your health and safety amid theCOVID-19 pandemic, PEBB members have access to the virtual benefits fair experience. The virtual benefits fair helps you learn about your benefit options from the comfort of your home. Below you will find everything you need to make the most of your health plan this year. Providence Member Services can be reached at 503-574-7500 or 800-878-4445, Monday through Friday, 8 am to 5 pm. Log into the myProvidence member portal for more information and to complete your HEM.
Moda Synergy is made for PEBB members like you. Moda includes nearby providers who work with you to keep you and your family well. As a public employee, you and your family deserve a health plan that’s centered on your healthcare needs. Moda is excited to support you on your journey to better health and wellness. Moda member services can be reached at 503-243-3962 or 888-217-2363. Log into the Moda Member Dashboard for more information and to complete your HEM.
Willamette Dental Group provides a unique combination of affordable dental insurance AND quality dental care. Take advantage of dental benefits made exclusively available to PEBB members. Willamette Dental believes dental insurance should be simple so they have eliminated the guessing game. Willamette Dental blends preventive dental care with broad insurance coverage, making it affordable, with no annual maximum or deductibles and predictable out-of-pocket costs. Willamette Dental can be reached at 855-433-6825 Monday - Friday, 7 am -6 pm.
When it comes to Delta Dental dental care, you're in for a treat. PEBB members and their families have access to Delta Dental, the nation's largest dental network. Whichever network you choose, your smile will thank you, wherever you roam. For members who have Moda Synergy Medical, Delta Dental can be reached at 833-681-2117. For members who are not enrolled in Moda for medical, Delta Dental can be reached at 844-827-7100. Delta Dental members can log into the Moda Member Dashboard for member-specific information (Moda and Delta Dental members will use the Moda Member Dashboard).
|VSP - Vision Plan||
VSP is designed to meet member needs, with savings on eyewear and eye care and an average of five VSP network doctors within six miles of you, it’s easy to find a nearby in-network doctor. Maximize your coverage with bonus offers and additional savings that are exclusive to Premier Program locations. VSP can be reached at 800-877-7195 Monday to Friday, 5 am - 6 pm, and Saturday and Sunday, 7 am - 5 pm. For the hearing impaired, call 800-428-4833 for assistance. Log into the VSP member portal for more member-specific information.
Optional Health Benefits
|The Standard - Life Insurances, Disability Insurance, and Travel Assistance||
Standard Insurance Company is pleased to provide group Life, Accidental Death, and Dismemberment (AD&D), Short Term Disability (STD), and Long Term Disability (LTD) insurance to eligible agencies, universities, or local governments of the Public Employees' Benefit Board (PEBB). You will be in good company. The Standard is a nationally recognized provider of employee benefits products and services. The Standard provides insurance to more than 23,000 groups, covering over 6 million employees nationwide. The Standard can be reached at 800-242-1888 from 8 am - 5 pm daily. The Standard's Travel Assistance can be reached at 866-455-9188 for the United States, Canada, Puerto Rico, U.S. Virgin Islands, and Bermuda, or call collect at 240-330-1380 for worldwide assistance.
|ASIFlex - Flexible Spending||
The State of Oregon offers pre-tax spending programs you can use to save money. The Health Care Flexible Spending Account is a PEBB-sponsored benefit program that allows you to use pre-tax money to pay for certain out-of-pocket medical, vision, and dental expenses, and now certain over-the-counter items. Enrolling in the Health Care FSA can lead to savings of up to 40% on each dollar that is set aside for medical expenses you are going to incur anyway. The Dependent Care Flexible Spending Account allows you to save on child or elder care expenses (e.g. babysitting, daycare, in-home care for an older dependent incapable of self-care). Flexible spending account participants can file claims via the free mobile app, online by signing into your account, or by fax at 877-879-9038. Please also consider signing up for direct deposit and electronic communications via email or text as this will also reduce paper usage and wait times. ASIFlex can be reached at 800-659-3035 Monday through Friday, 5 am - 5 pm, and Saturdays 7 am -11 am, or at firstname.lastname@example.org. Participants can log into the ASIFlex member portal for member-specific information.
|Cascade Centers - Employee Assistance Program (EAP)||
The Employee Assistance Program (EAP) is a FREE and CONFIDENTIAL benefit that can assist you and your eligible family members with any personal problems, large or small.
|LifeBalance (Providence Members)||LifeBalance - learn how to easily enroll, access our contact information, and enter to win our door prize - a Calm app 1-year membership!||Visit LifeBalance's virtual fair booth|
|WW (Weight Watchers)||
PEBB is committed to helping you and your family reach your wellness goals – to lose weight, eat healthier, move more, develop a more positive mindset, or all of the above by covering 100% of the cost for the WW and Kurbo by WW programs.
|Watch the WW Experience Pre-Recorded Webinar|
PERS, PERS Health Insurance Program (PHIP), and The Oregon Savings Growth Plan 457 (OSGP)
PERS will be holding their annual Expo on October 5 and 6, members can sign up for presentations from PERS, PERS Health Insurance Program (PHIP), and the Oregon Savings Growth Plan 457 (OSGP).
|Oregon Public Universities Retirement Plans (OPURP) - Optional Retirement Program (ORP) and the Tax-Deferred Investment (TDI) 403b||
OPURP, who administers our ORP mandatory retirement programs and our TDI 403b voluntary retirement savings program, will host live help sessions between October 4 - October 8 to answer any questions about retirement planning and savings, zoom links will be posted on the day of the meeting.
|Fidelity Retirement Investments||
Fidelity is available to employees who enroll in the voluntary retirement savings program, the Tax-Deferred Investment 403(b) (TDI), and/or the mandatory retirement savings program, the Optional Retirement Program (ORP).
|TIAA Retirement Investments||
TIAA is available to employees who enroll in the voluntary retirement savings program, the Tax-Deferred Investment 403(b) (TDI), and/or the mandatory retirement savings program, the Optional Retirement Program (ORP).
TIAA - SAVI
Take advantage of a new student debt solution from Savi that makes it easier to pursue generous federal programs like reduced payments and loan forgiveness.
|SHIBA - Senior Health Insurance Benefits Assistance - Medicare Help||
The Senior Health Insurance Benefits Assistance program uses trained counselors to educate and advocate for Oregonians with Medicare.
TOOLS FOR OPEN ENROLLMENT
- Where to enroll-
- Go to PEBBEnroll.com to elect 2022 benefits online (open for re-enrollment October 1st through 31st)
- Go to your medical provider's website to complete the HEM (Health Engagement Model)
- Where to find information-
- Visit the PEBB website at PEBBinfo.com where you can find the 2022 plan year information
- Use alex, PEBB's digital benefit counselor who will explain and walk you through your plan options
- 2022 Enrollment Guide - Coming Soon!
- 2022 Summary of CORE Benefits
- Estimate your monthly payroll deductions with PEBB's Payroll Estimator tool
- Compare plans side by side with PEBB's Plans Benefits Comparison tool
- Additional Resources-
- Sign up for text or email reminders from PEBB about Open Enrollment by visiting PEBBreminders.com
- 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
- If you increased life insurance, be sure to complete the Medical History Statement
RESOURCES FOR OPEN ENROLLMENT
SEE WHAT PLANS ARE AVAILABLE TO YOU
- PEBB Statewide members pay 5% of Core premiums
- Providence Choice member will now pay 5% of Core premiums
- Moda Synergy members will now pay 3% of Core premiums
MAKE SURE YOUR PROVIDERS ARE IN THE PLAN’S NETWORK
- Use the plan’s provider directory (navigate to your 2021 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 2021 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 - you typically pay less for specialty services when you see a specialist referred by your primary care provider/medical home (referral required for specialty services).
- Moda Synergy - you will choose a “PCP 360” provider. This is a primary care provider who has agreed to be accountable for your health. Family members can pick the same PCP 360 or a different one (no referrals needed for in-network providers, as long as PCP360 is selected).
- 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