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Mandatory Open Enrollment for 2013 Benefits

MANDATORY
PEBB Health Insurance Open Enrollment
For 2013 BENEFITS
October 1 – October 31, 2012

 

 

 

Mandatory Open Enrollment Summary

Open Enrollment is MANDATORY.  If you do not re-enroll or opt out during Open Enrollment:

  • You will be charged a $25 monthly ($50 couples) Tobacco Surcharge
  • You will be charged a $50 monthly Spouse/Domestic Partner Waives Other Coverage Surcharge (applicable only if spouse/domestic partner is enrolled)
  • You will be charged the higher tobacco user rate on optional life insurance plans
  • You will NOT participate in the 2013 HEM program and will have an additional $100 per person deductible added to your plan’s standard deductible (family max of $300).  The additional $100 per person deductible is added to both the In Network and Out-of-Network deductibles.

 

Changes you can make during Open Enrollment and questions you need to answer

Open Enrollment is your once-a-year opportunity to make changes to your benefit packages without having a qualifying family status change (marriage, birth, divorce, loss of other insurance, etc).  You also need to elect participation in the 2013 HEM program and answer a couple of specific questions related to PEBB surcharges.

Questions that will need to be answered

  • Do you and your enrolled spouse/domestic partner elect to participate in the HEM program
  • Have you and/or your enrolled spouse/domestic partner used tobacco within the last 12 months
  • Do you and/or your enrolled spouse/domestic partner currently use tobacco
  • Does your enrolled spouse/domestic partner waive other employer group coverage (non-PEBB) in favor of PEBB coverage

Changes you can make during Open Enrollment and/or re-enrollment in a flexible spending account

  • Enroll or Re-enroll in Flexible Spending Account(s) – Medical and/or Dependent Care.  Annual enrollment is required.
  • Add and/or Drop Dependents
  • Enroll, Opt-Out, or Make changes to your Core Benefits (Medical and Dental)
  • Optional Insurances – Enroll, Terminate, Increase, or Decrease coverage (Life, STD/LTD, Long-term Care)

 

How to re-enroll and make changes during Open Enrollment

  • Online Enrollment on or after October 1, 2012 through midnight October 31, 2012
  • Paper Forms – download: forms available October 1, 2012 from PEBB’s website
    • Campus Mail: 204 Kerr Administration Building, Corvallis OR
    • US Mail: 122 Kerr Administration Building, Corvallis OR 97331-2132
    • Fax: 541.737.0553

WHEN are Changes Effective – Changes made during Open Enrollment are effective January 1, 2013, except for policies and/or amounts that require the approval of underwriters (life/ long-term care).

VERIFY that Changes Have Been Processed – Review your Earnings Statement to confirm that your enrollments and deductions are correct.

  • December 2012 Earnings Statement will reflect changes to Medical, Dental, Life, Accidental Death, Short-term Disability, Long-term Disability, and Long-term Care.*
  • January 2013 Earnings Statement will reflect enrollment in the Flexible Spending Account(s) for 2013 and will include the HEM financial incentive.

*For policies that require approval of an underwriter the change will be on the Earnings Statement the month following approval (life/long-term care).

CORRECTIONS to Enrollments – if you notice an error on your Earnings Statement contact Employee Benefits at 541-737-2805 or by email at employee.benefits@oregonstate.edu

 

2013 Surcharges and Optional Life Rate Changes

  • Tobacco Surcharge - $25/month if employee uses tobacco + $25/month if enrolled spouse/domestic partner uses tobacco.
  • Spouse/Domestic Partner Surcharge - $50/month if spouse/domestic partner waives coverage in another employer’s group plan (non-PEBB plan) in favor of coverage through PEBB. 
  • Tobacco User Life Insurance Rates – The rates for optional employee life and optional spouse/domestic partner life insurance will be higher for members that have used tobacco within the last 12 months.

 

2013 Health Engagement Model (HEM)

PEBB has made some changes to the Health Engagement Model program for the 2013 plan year.  The HEM program will provide a financial incentive in your pay if you elect to participate and a financial disincentive in your health plan if you choose not to participate.

PARTICIPATION in the 2013 HEM program:

  • You MUST enroll in the HEM program during Open Enrollment (October 1 – October 31, 2012).
  • You MUST complete the online health assessment between September 1 and October 31, 2012. 
  • Your enrolled Spouse/Domestic Partner MUST complete the online health assessment by October 31, 2012.
  • You WILL RECEIVE a taxable incentive in your monthly pay of $17.50 (employee only) or $35 (employee + spouse/domestic partner).  HEM incentive will begin with your January 2013 paycheck.
  • You MUST complete two health related activities before the next open enrollment period to be eligible for participation in 2014. 
    • For employees and/or spouse/domestic partners that use tobacco, one activity will involve trying to quit.
    • For employees and/or spouse/domestic partners that are overweight, one activity will involve trying to lose weight.
    • Additional list of PEBB approved activities
    • Employees will attest to completing the requirements during Open Enrollment for 2014 benefits.
    • There are no other additional deadlines and/or tracking of completion of HEM activities during 2013.

NON-PARTICIPATION in the 2013 HEM program:

  • You did not complete the Open Enrollment process and defaulted into Non-participant status
  • You elected not to enroll in the HEM program during Open Enrollment; or
  • You elected to participate during Open Enrollment but you and/or your enrolled spouse/domestic partner (if applicable) did not complete the required health assessment by October 31, 2012; or
  • You will have an additional $100 per person deductible added to your medical plan’s deductible (family maximum of $300).  The additional deductible applies to both the In Network and Out-of-Network deductibles. 

EXEMPTION from the HEM can be requested in the following situations:

  • Spouses in the military serving overseas
  • Members enrolled in Hospice or extended hospital stays preventing them from completing their HEM action requirements
  • Incarceration
  • Members who are out of the country from their plan year coverage effective date and their HEM action requirements.
  • Exemption Form

 

COMPLETING THE 2013 HEM REQUIREMENTS

  • You MUST enroll during Open Enrollment, October 1 – October 31, 2012
  • You MUST complete the online health assessment between September 1, 2012 and October 31, 2012*.  You and your enrolled Spouse/Domestic Partner must complete the assessment by 11:59pm on October 31, 2012.
  • You and your enrolled spouse/domestic partner MUST complete two health related activities before the next open enrollment period to be eligible for participation in 2014. 
    • If you and/or your enrolled spouse/domestic partner use tobacco, one activity will involve trying to quit.
    • If you and/or your enrolled spouse/domestic partner are overweight, one activity will involve trying to lose weight.
    • Additional list of PEBB approved activities is found at: http://oregon.gov/das/pebb/pages/hemactivites.aspx
    • You will attest to completing the requirements during Open Enrollment for 2014 benefits.

*Completing the online Health Assessment (by October 31, 2012):

  • PEBB Statewide and Providence Choice members:
    • Log into myProvidence
    • You do not need an “activation code” to complete the health assessment (this is the red banner at the top of the page) if you want to use the site's enhanced features, you can request the "activation code". Otherwise, you can ignore this message.
    • Click on the health assessment located in
      • "The Welcome PEBB Member" box located in the center of the page, or
      • Self Help quick link under “My Health” located on the left hand side of the page

      For assistance with access to your myProvidence website, call Providence customer service at 877-814-9909 or 877-569-7768, Monday-Friday, 8am-5pm

  • Kaiser Permanente
    Because Kaiser locks the health assessment for 201 days, not all Kaiser members need to complete a new health assessment. To determine if you or your enrolled spouse/domestic partner need to complete the 2013 health assessment, you will need to verify the date the 2012 health assessment was completed.  If the 2012 health assessment was completed:
    • Between January 1, 2012 and February 13, 2012: The online 2013 health assessment MUST be completed by October 31, 2012
    • After February 13, 2012: you DO NOT  complete a new assessment.
       
  • Log into Kaiser Permanente. For assistance logging into your kp.org account, contact Kaiser at 800-556-7677, Monday-Friday, 6am-7pm, weekends 7am-3pm

 

2013 Plan Changes

All Plans

  • Medical Flexible Spending Account (FSA) contribution limit is $2,500 for 2013
  • Optional Life and Optional Spouse/Domestic Partner Life insurance rates will be higher for members and/or spouse/domestic partners that have used tobacco within the last 12 months

PEBB Statewide Plan (administered by Providence): 

  • Maximum out-of-pocket of $1,000 for prescription drugs in the PEBB Statewide and Providence Choice plans. This is a per person maximum out-of-pocket. 
  • If your physician is certified by the Oregon Health Authority for attaining a level of performance as a patient centered primary care home (PCPCH), you will receive a 5% reduction in the co-insurance.  This is a reduction from 15% to 10%. For additional information

Providence Choice Plan:

  • Maximum out-of-pocket of $1,000 for prescription drugs in the PEBB Statewide and Providence Choice plans. This is a per person maximum out-of-pocket.
  • Providence has added more medical homes in some areas of the state.  View the current list of medical homes.
  • Note:  To receive Medical Home level of benefits, you must choose a medical home in the plan and notify Providence of our choice before accessing services.  All care must be received through providers in that medical home or through providers referred by the medical home.

 

2013 Employee Premium Share (monthly employee cost for health insurance)

Worksheets

 

2013 Employee Benefits Fair & Workshops

Thursday, October 4, 2012, 10 am – 2pm, MU Ballroom

Meet with health and retirement providers and get all of your questions answered.

Workshops:

  • Oregon Senior Health Insurance Benefits Assistance (SHIBA) will present a 2-hour workshop on Medicare and Medicare Supplement Plans. 1-3 pm, MU 208
  • ASIFlex will present information on Flexible Spending Accounts.  (Medical & Dependent Care Expenses).  9:30-10:00 am, MU 208
  • Standard Insurance will present information on Short-term and Long-term Disability Insurance.  10:15am-11am, MU 208.
  • PEBB presented two informational sessions on 2013 Open Enrollment, plan changes, HEM changes, etc.  This presentation was recorded and is now posted on the Benefits website for viewing. To watch the event, please visit: http://media.oregonstate.edu/index.php/show/?id=0_ff5u9ji7

Health Benefit & Insurance Providers:

  • Providence – PEBB Statewide & Providence Choice Plans
  • Providence Life Balance Program
  • Kaiser HMO & Kaiser Dental
  • VSP (vision plan)
  • ODS Dental
  • Willamette Dental
  • BenefitHelp Solutions – COBRA/Retiree
  • Cascades Centers – EAP (Employee Assistance Program)
  • Optional Plans:
    • Standard Insurance (Life, Short-term Disability, Long-term
    • Disability, and MEDEX Travel Assist)
    • Long-term Care
    • ASIFlex – Flexible Spending Accounts (medical and dependent care)

 Pension Plan & Voluntary Retirement Providers:

  • PERS
  • OUS – ORP
  • Fidelity
  • TIAA-CREF
  • Oregon Savings Growth Plan (OSGP)

Social Security & Medicare:

  • Social Security
  • Oregon Senior Health Insurance Benefits Assistance Program (SHIBA)

Other Employee Services:

  • Dixon Recreation
  • Faculty/Staff Fitness
  • Orange Rewards
  • Healthy Campus Initiatives/BeWell
  • Childcare & Family Resources
  • Student Health Center
  • Free & Clear (Tobacco cessation)
  • Public Safety - learn about the Stop Tag program for Laptops, enroll in the Emergency notification system, etc.
  • Office of Equity & Inclusion
  • University Ombuds Office
  • Office of Human Resources
  • Environmental Health & Safety
  • OSURA – OSU Retirement Association
  • Oregon College Savings Plan (529 Plan)

 

2013 Open Enrollment & HEM “Drop-in” Help Sessions

If you have questions or need assistance in completing Open Enrollment or the HEM online health assessment, please attend one of the Open Enrollment & HEM Help Sessions.  All Help Sessions are located at the Valley Library, Barnard Classroom (5th Floor, #5420):

  • October 3rd:  1pm – 4pm
  • October 8th:  9am – Noon
  • October 12th:  Noon – 4pm
  • October 16th:  1pm – 4pm
  • October 17th:  1pm – 4pm
  • October 19th:  9am – Noon
  • October 22nd:  11am – 2pm
  • October 26th:  9am – Noon
  • October 29th:  9am – Noon
  • October 30th:  11am – 2pm     

Resources

Contact Info

Office of Human Resources,
Oregon State University,
122 Kerr Administration Building,
Corvallis, OR 97331-2132
Phone: 541-737-3103
Fax: 541-737-7771 or 541-737-0553.
E-mail
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