Open Enrollment

Benefit Fair Backgroud

Post Open Enrollment Information

Open Enrollment corrections can be made until December 20, 2019, for Flexible Spending Accounts, and by February 29, 2020, for health enrollments, depending on Open Enrollment completion.

1. Health Benefit Changes:
A.  Members who have re-enrolled in their benefits health benefits and have completed the HEM from their medical providers' website by October 31. 2020, have completed Open Enrollment. Any health plan changes: Correctable.

B. Members who did not actively enroll during Open Enrollment will:
  • Default to the benefit elections they had for 2019 and will move from a standard deductible medical plan to the higher deductible medical plan as a HEM Non-Participant. All enrolled eligible dependents will follow. This action is: Not Correctable
  • If enrolled in an Optional life plan, you will now be enrolled in the “Tobacco” user Optional life plan tier (both Employee and Spouse/Partner are affected). This action is: Correctable.
  • Tobacco use status will be changed to "Both my Spouse/Partner and I currently use tobacco". This action is: Correctable.
  • Other Employer Group coverage will be changed if the member has an existing Spouse or Partner enrolled in the Medical plan to "My Spouse/Partner has other employer group coverage available and waives that coverage". This action is: Correctable.

2. Flexible Spending Account Changes:

FSA Corrections can be made until December 20, 2019, for the 2020 plan year, only for members who completed Open Enrollment. 

For Health Changes, complete the Open Enrollment Correction Form. For Flexible Spending changes, complete the Open Enrollment FSA Correction Form. Completed forms should be sent to Human Resources, Churchill Hall room 159. Plan changes outside of the stated timeline will only be allowed if a qualifying event has happened (review PEBB's qualified status change matrix of allowable benefit changes for the corresponding event).

 

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, 2020.

Two-steps of Open Enrollment:

  1. Re-Enroll in benefits online by visiting PEBBEnroll.com between October 1st and 31st.
  2. Do the HEM (Health Engagement Model or Personal Health Assessment) from your 2019 medical providers’ by October 31st. Print or digitally save your completion certificate proving eligibility for the HEM incentive, to be supplied to PEBB only if needed. (Note: Opt-out employees and Declines who want to enroll in a Medical plan for the 2020 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.) 
  • If you do not complete both steps of Open Enrollment your deductible will increase for the 2020 plan year up to $300, and surcharges may apply, up to $100 extra a month. 
  • If you do complete both steps of Open Enrollment, your deductible will stay low and surcharges may not apply. 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 health insurance.

ANNUAL HEALTH & WELLNESS FAIR

Join us on Monday, October 7 from 10:00 am to 2:00 pm for SOU's Annual Health & Wellness Fair, located in the Stevenson Union Arena (basement). This is your annual opportunity to connect with plan representatives, including:

  • Providence 
  • Moda
  • Willamette Dental
  • VSP
  • The Standard
  • OPURP, representing the ORP and TDI 403(b) plans
  • TIAA
  • Fidelity
  • RVTD 
  • and more!

We will be raffling off items from our vendors for those who attend! Also, stop at the Flu-Shot Clinic, located in the front of the Arena. Employees covered under SOU group medical receive a flu-shot for free, just complete the Rite-Aid Flu-Shot form and attache a copy (front and back) of your medical card and return to Human Resources. Read below for more information about the flu-shot clinic.

FLU SHOT CLINIC

During the Annual Health & Wellness Fair, described above, Rite-Aid will be putting on a Flu-Shot Clinic for SOU employees! Complete the Rite-Aid Flu-Shot form, including a copy of the front and back of your medical card, and return it to HR before by Friday, October 4. If you do not submit a form by October 4, you may still get a flu-shot of vaccine if they are available, previously completed forms will be prioritized first. Vaccine information can be found on the CDC website. 

WHAT IS NEW FOR 2020

Providence Choice Medical

Will add massage therapy to its spinal manipulation services

Will add coverage for varicose vein surgery

Will require a review after 12 physical or occupational therapy visits
Providence PEBB Statewide 

Updated plan name to include 'Providence'

Will add coverage for varicose vein surgery

Will require a review after 12 physical or occupational therapy visits
Moda Synergy

Synergy plan will encompass Summit plan starting in 2020 (Summit was for Eastern Oregon).

Will introduce a new coordinated care option, PCP 360, through the Synergy network requiring members to select a PCP 360, which is similar to selecting a medical home (the location of your primary care doctor)

Will add coverage for varicose vein surgery

Will add massage therapy to its spinal manipulation services
Willamette Dental  Will change coverage for dental implant surgery to a $1,500 annual maximum. Implants are limited to one tooth space per year.
Delta Dental PPO and Premier (though Moda) Will add coverage for composite fillings.
VSP  Will add SunCare to both VSP plans. Coverage includes a covered in-full eye exam after your applicable copay. In most cases, you can get non-prescription sunglasses from a VSP provider in place of prescription glasses or contacts.

TOOLS FOR OPEN ENROLLMENT

WATCH A WEBINAR

Visit PEBBWebinars.com to register for upcoming webinars and watch prior ones. Upcoming webinars are:

  • October 3 - CORE Benefits
    • Medical plans will be discussed from 2:30-3:30 pm, register here
    • Dental and Vision will be discussed from 4:00-5:00 pm, register here
  • October 10 -  MODA PCP 360 (their new model for primary care doctors) will be discussed from 2:00-4:00 pm, register here
  • October 17 - ASIFlex/Flexible Spending Accounts will be discussed from 10:00-11:00 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 11th from 8:00 - 10:00 AM
  • PC East: October 17th from 8:00 - 10:00 AM
  • PC East: October 25th from 8:00 - 10:00 AM
Do note if you are unable to access your HEM through your current 2019 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 2019 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 2019 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