Open Enrollment

PEBB Open Enrollment
It’s Mandatory!
October 1 – 31, 2015
• All new, current and returning employees must take action for 2016 benefits
• 2-Step Process for completing Open Enrollment*
1.
Enroll in plans and elect Health Engagement Model (HEM) participation for 2016
• To continue in or make changes to your current plans and elect HEM participation, enroll online
https://pebb.benefits.oregon.gov/members/!pb.main or
• Submit enrollment forms to the Benefits Office before 5:00 pm on October 31, 2015
2.
Complete your Health Assessment (HA)
• If you, your spouse or domestic partner are enrolled in a medical plan and elect to participate in the
Health Engagement Model (HEM) for 2016, http://www.oregon.gov/DAS/PEBB/Pages/16HA.aspx
* Additional steps will be required if you enroll in or make changes to life or long term care insurance
Open Enrollment resources and forms available online http://hr.uoregon.edu/benefits/2016-benefits-open-enrollment
Medical Plan & Opt Out Information
Changes for 2016:
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Trillium will not be available
Approximately 4% premium increase
Plan comparisons, provider directories and additional resources available online
http://www.oregon.gov/DAS/PEBB/Pages/16toold.aspx
• Plan Choices
• PEBB Statewide - PPO (Administered by Providence Health Systems)
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Access to a nationwide directory of preferred providers
Does not require designated primary care provider
Co-insurance (percentage of usual, customary and reasonable rates)
Does not require referrals to specialists
• Providence Choice, Moda Synergy and AllCare – Managed Care Plans
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Only available in certain counties
Requires pre-designation of medical home or primary care physician
Co-payments (fixed amount)
Requires referrals to specialists
• Kaiser - HMO (not available in Lane County)
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Only available in certain counties
No deductible
Access care only through Kaiser facilities
Co-payments (fixed amount)
Requires referrals to specialists
• All Medical Plans (except Kaiser)
• Deductibles * - Accumulate separately and are not combined
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In-network $250/person, $750/family
Out-of-network $500/person, $1500/family
• Out-of-pocket maximum*
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In-network $1500/person, $4500/family
Out-of-network $2500/person, $7500/family
• Full coverage of nationally recommended preventive services
• First 4 visits to primary care (nurse or family practitioner, OB/GYN or internist),
deductible does not apply. Copayment or coinsurance will apply
• Certain chronic conditions (Asthma, Hypertension, Diabetes, COPD, Congestive Heart
Failure and Cholesterol) visits covered in full
• No limitation on pre-existing conditions
• Medical Opt Out – No changes
• Monthly taxable cashback $233
• May enroll in dental and/or vision and optional benefits
• Requires proof of other coverage
Dental and Vision Plan Information
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No changes for 2016
Participation is optional
Must be enrolled in a medical plan or opt out to participate
Plan comparisons, provider directories and additional resources available online at
http://www.oregon.gov/DAS/PEBB/pages/index.aspx
• Dental Plan Choices
• ODS Moda Premier*
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Nationwide network through Delta Dental
• ODS Moda PPO*
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Local preferred provider network
Provider directory available online
https://www.modahealth.com/ProviderSearch/faces/webpages/search.xhtml
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If you and your dependents are not enrolled in a dental plan for 2015 and elect participation for 2016, there will be a 12-month waiting
period for any services other than preventative and 24-month waiting period for orthodontia.
• Willamette
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Willamette clinics and dentists only
• Kaiser Dental
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Not available in Lane County
Kaiser clinics and dentists only
• Vision Plan
• VSP
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Preferred provider network
Provider directory available online https://www.vsp.com
Employee Monthly Premium Share
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No Changes for 2016
• Unclassified Employees (.50fte or more)
 5% monthly premium share for each plan selected (medical, vision and dental)
• Classified Full Time Employees (1.0 fte)
 5% or 3% monthly premium share for each plan selected (medical, vision and dental)
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Enrollment in lowest cost medical plan* for your county/zip code = 3%
Monthly premium share for dental and vision = same as medical
*Lowest cost medical plan for Lane County and most of NW Oregon is Providence Choice. A complete list of lowest cost plan
by county is available online https://hr.uoregon.edu/benefits/2016-benefits-open-enrollment
• Classified Part Time Employees (.50 -.99 fte)
 Continue to receive a monthly contribution based on hours worked or paid in their pay period
Monthly Premium Estimator is available online http://www.mypebb.com/calc2016.html
Flexible Spending Accounts
Changes for 2016
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Healthcare FSA annual maximum increase
• Healthcare and Dependent Care FSA
• Annual enrollment required
• Healthcare FSA maximum $2550/year
• Dependent Care FSA maximum $5000/year
• Minimum contribution $20/month
• Contributions for 2015 will end December 31, 2015
 Deadline is March 15, 2016 to incur eligible expenses and draw out of your
2015 account. Any funds remaining after March 31, 2016 will be forfeited.
• How to calculate your Healthcare and Dependent Care FSA
contributions
Monthly contribution amount x number of paychecks received (10 or 12) = total
annual contribution
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If you have a 9-m0nth contract, you will make 10 monthly contributions
 Contributions will NOT be deducted from any summer pay
 Summer expenses can be submitted for reimbursement upon your
return in the fall
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If you have a 9-month contract and elect to receive 12 paychecks
(deferred pay), you will make 12 monthly contributions
 Contributions will be deducted from your summer pay
 Summer expenses can be submitted at any time
Health Engagement Model (HEM)
No Changes for 2016
The goal of the HEM program is to engage people in improving their health. Participating in HEM helps you
learn about your health risks so you can take action to reduce them in partnership with your provider.
Elect participation when enroll in your medical plan (online or by paper form).
• Employees who elect to participate
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Must complete an online Health Assessment* (including spouse/domestic partner if enrolled in medical
plan) by October 31, 2015 http://www.oregon.gov/DAS/PEBB/Pages/16HA.aspx
Will receive monthly incentive
 $17.50 employee only
 $35 employee and spouse or domestic partner (if covered on your medical plan)
Must complete 2 healthy activities by October 2016
* Print a copy of your Completion Certificate for your personal records (do not send to the Benefits Office)
• Employees who elect not to participate
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Will pay a higher medical plan deductible
Will not receive monthly incentive
HEM program information is available online http://www.oregon.gov/DAS/PEBB/Pages/HEMDescription.aspx
Surcharges
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No Changes for 2016
• Tobacco Use
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$25/month if employee or spouse/domestic partner uses
$50/month if both use
Higher life insurance premiums will apply
• Spouse/Domestic Partner Other Coverage
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$50/month if your spouse/domestic partner waives coverage through their employer
Surcharge does not apply if spouse has other PEBB medical coverage
Optional Benefits
No changes for 2016:
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Employee and Spouse/Domestic Partner Life Insurance
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Adding or increasing life insurance requires submission of a Medical History
Statement and approval by Standard Insurance
Short and Long Term Disability
Accidental Death & Dismemberment (AD&D)
Long Term Care
PEBB Wellness Programs
Changes for 2016:
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ExerciseRewards name change
• ExerciseRewards
• Name will change to Stay Fit and will be administered by PEBB
• No changes to the program design
• 8 visits/month to an approved fitness facility
• Receive $15/month reimbursement on a quarterly basis
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Healthy Team Healthy U
Mood Helper
Weight Watchers
Better Choices Better Health
Quit for Life Smoking Cessation
Information is available online http://www.oregon.gov/DAS/PEBB/pages/index.aspx
No Action Taken
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Pay an additional $100/person medical plan deductible
Pay Tobacco Surcharge (even if you don’t use tobacco)
Pay Spouse/Domestic Partner Surcharge (if enrolled on your
medical plan
Resources
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UO Benefits Open Enrollment website
http://hr.uoregon.edu/benefits/2016-benefits-open-enrollment
Benefits Staff
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Lynn Petersen, [email protected] or 541-346-3086
Kathryn Daniel, [email protected] or 541-346-2964
Cindi Peterson, [email protected] or 541-346-2956
Reminders
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Employees and retirees leaving the University in December should
complete Open Enrollment – coverage end date will be January 31, 2016
Dependent children who turn 26 in 2015 will automatically be terminated
December 31, 2015 and receive COBRA continuation information. No action
required.
Status changes (divorce, termination of domestic partnership, marriage,
birth, etc.) occurring in 2015 require submission of a Midyear Change Form
within 30 days of the change
9/29/15
Open Enrollment Meeting Schedule
• EMU Gumwood Room
• October 13 11:30 am – 12:30 pm
• October 21 4:00 pm – 5:00 pm
• October 28 9:00 am – 10:00 am