PEBB (Public Employees' Benefit Board) webpage

PEBB Medical Benefits Resources webpage

Comparison of PEBB Medical Plans (Full-time & Part-time Plans)

“Full-time” plans are available to:  Unclassified employees (.50-1.00FTE); Classified employees (full-time and part-time); and Retirees

 “Part-time” plans are only available to:  Classified Part-time employees (.50-.74FTE) and Retirees

  • Plans are designed specifically for part-time employees in an effort to keep plans more affordable.
  • Part-time classified employees may choose from any of the plans offered:  Full-time or Part-time.
  • Part-time classified employees that enroll in a part-time medical plan receive an additional “part-time subsidy” to help cover the cost of the premium. Part-time employees that enroll in a full-time medical plan will receive an additional monthly premium subsidy of $40 if their base salary rate is less than or equal to $2,816.  The base salary rate is determined by the salary schedule (Step/Column) and is based on the full-time equivalent.

PEBB Resources

  • PEBB Enrollment Guide (2017) provides information on all health plans (medical, vision, dental) and optional plans; Health Engagement Model (HEM), Wellness Programs, service plan areas, and how to enroll.

  • PEBB Summary Plan Description

  • Plans by County (2017)

  • Plans by Region (2017)

  • PEBB Videos – includes:  Medical Plans Overview, Medical Plans Comparison, Benefits Overview

  • PEBB Medical Plan Cost Estimator - use this medical expense estimator to compare your out-of-pocket medical costs and premium costs amongst the available plans in your area.  Your estmated out-of-pocket expenses is just one factor in determining which plan is best for your family.  Other items to consider include:  access to your current providers and specialists; provider network; family members living in other states; ability to self-refer; managed care vs. PPO; etc.  (Unclassified .50-1.0FTE  and Classified .75-1.0 FTE employees use the "Full-time" estimator; Classified .50-.74FTE employees use the "Part-time" estimator).

PEBB Medical Plans - Overview

PEBB Statewide (Full-time & Part-time Plans)

  • PPO plan
  • You have lower costs when you use providers in the plan’s network (including specialists, facilities and pharmacies)
  • You may self-refer specialists
  • When you access primary care from a Patient Centered Primary Care Home (PCPCH), you have a lower coinsurance level
  • Service Area:  Statewide and Nationwide
  • PEBB Statewide website
  • Plan Summary and Member Handbooks

 Moda Health (Full-time & Part-time Plans)

  • Medical home plans built around the coordinated care model
  • You select a medical home in the plan and a primary care provider
  • You must  notify the plan of your medical home before seeking medical care to receive In-network coverage
  • Your primary care provider coordinates your medical care
  • You may have higher costs when you access care outside your medical home and without a referral from your medical home
  • Service Area 2017 – Summit:  Baker, Gilliam, Grant, Harney, Lake, Malheur, Morrow, Sherman, Umatilla, Union, Wallowa, Wheeler.
  • Service Area 2017– Synergy:  Oregon – Benton, Clackamas, Clatsop, Columbia, Coos, Crook, Curry, Deschutes, Douglas, Hood River, Jackson, Jefferson, Josephine, Klamath, Lane, Lincoln, Linn, Marion, Multnomah, Polk, Tillamook, Wasco, Washington, Yamhill; Washington:  Clark
  • Moda Health website
  • Plan Summary
  • Member Handbooks

 Providence Choice (Full-time & Part-time Plans)

  • Medical home plan built around the coordinated care model
  • You select a medical home from the plan’s network
  • You must  notify the plan of your medical home before seeking medical care to receive In-network coverage
  • Access medical care through that medical home, including referrals to specialists
  • You have higher costs if you access care out of your medical home
  • Service Area 2017:  Oregon – Baker, Benton, Clackamas, Clatsop, Columbia, Coos, Crook, Curry, Deschutes, Douglas, Grant, Harney, Hood River, Jackson, Jefferson, Josephine, Klamath, Lane, Lincoln, Linn, Malheur, Marion, Morrow, Multnomah, Polk, Tillamook, Umatilla, Union, Wallowa, Wasco, Wheeler, Yamhill; Washington - Clark and Walla Walla; Idaho - Payette.
  • Providence Choice website
  • Plan Summary and Member Handbooks

 AllCare (Full-time & Part-time Plans)

  • Plan has three provider tiers:  Preferred, Participating and Out-of-Network
  • You have lower costs when you use a preferred provider
  • You are required to select a primary care provider from among the network of preferred providers
  • Your cost for specialist care is lower with a referral from your preferred primary care provider
  • Service Area – Curry, Jackson, Josephine counties; and Glendale and Azalea in Douglas County
  • AllCare PEBB website
  • Plan Summary and Member Handbooks

 Kaiser HMO & Kaiser Deductible (Full-time & Part-time Plans)

  • Facilities are located in the Salem and Portland areas
  • You access care only through Kaiser providers and facilities
  • The HMO plan has lower out-of-pocket costs than the deductible plan, which has a lower premium.
  • Both plans offer a medical home in which your primary care provider directs all your care, including specialist care.
  • Service Area – Zip Codes in:  Oregon – Benton, Clackamas, Columbia, Hood River, Linn, Marion, Multnomah, Polk, Washington and Yamhill; Washington – Clark, Cowlitz, Lewis, Skamania, Wahkiakum
  • Kaiser HMO & Kaiser Deductible website
  • Plan Summary and Member Handbooks