Benefit Fair Backgroud

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

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
Do note if you are unable to access your HEM through your current 2018 medical provider's website, you will need to contact your medical plan for assistance. However, our Benefits Officer is able to assist employees with accessing the PEBB member system.

SEE WHAT PLANS ARE AVAILABLE TO YOU

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