1. Public Employees' Benefit Board (PEBB)
2. Cost of CORE health insurance coverage (medical/vision, dental, employee basic life)
3. PEBB Health Programs (HEM, Tobacco, Other Group Coverage)
4. Benefits eligibility
5. Eligible Dependents
6. Enrollment options
7. Enrollment timelines
8. When does coverage go into effect?
9. Core benefits - medical plans
10. Core benefits - vision plans
11. Core benefits - dental plans
12. Core benefits - employee basic life insurance
13. Optional benefits (optional life, disability, long-term care, flexible spending accounts)
14. How to enroll and/or Make Changes
15. Verify your benefit deductions on your earnings statement
16. Required notices


1. Public Employees’ Benefit Board (PEBB)

The Public Employees’ Benefit Board (PEBB) is a labor-management board that designs, contracts and administers benefits for Oregon state employees. These benefits meet IRS code requirements as a Cafeteria Plan, so they provide tax advantages.

2. Cost of CORE Health Insurance Coverage

Effective for 2014 Plan Year Coverage:

  • OSU employer contribution is 95% of the premium cost for the plan and enrollment tier you select
  • Employee contribution is 5% of the premium cost for the plan and enrollment tier you select
  • If your base* monthly salary rate was less than or equal to $2,816 as of September 2013, OSU will pay an additional monthly premium subsidy of $40 toward your premium costs.  The monthly subsidy will stop if your base salary later increases above $2,816 per month. *Base salary rate is determined by the Salary Schedule Salary Range/Step and is the full-time equivalent.  Furlough, differentials, cost-of-living adjustment, etc. do not factor into the base.
  • Part-time Classified Employees receive a pro-rated employer contribution based on the number of hours worked or in a paid leave status during the pay period.  Part-time employees must pay the difference between their benefit amount and the cost of the premiums for their choice of medical and dental plans. Part-time employees may be eligible for a premium subsidy based on the medical plan enrollment.

Estimate your total Monthly premium costs:

3. PEBB Health Improvement & Cost Containment Programs:

If you enroll in a Medical plan, you must also select your participation status in PEBB’s Health Improvement & Cost Containment Programs.  You may be assessed additional monthly surcharges based on your participation status.

Health Engagement Model (HEM) Program

  • 2014 HEM program is only applicable for employees that had coverage effective on or before November 1, 2013
  • Elected to participate during Open Enrollment in September/October 2013
  • Completed the online health assessment by October 31, 2013
  • Complete two health actions before the next Open Enrollment (October 2014).  You will attest to completing these with a “Yes/No” question during Open Enrollment in 2014.
  • If you elected to participate in the 2014 HEM and you and your enrolled spouse/partner (if applicable) completed the online health assessment by the deadline, you will receive a monthly taxable incentive each month beginning with your December paycheck ($17.50 for employee only coverage or $35 for employee and spouse/partner coverage).
  • If you elected not to participate in the 2014 HEM or either you and/or your enrolled spouse/partner did not complete the online health assessment by the deadline, you will not receive the monthly taxable incentive and your medical plan’s deductible will be increased by $100 per person (family maximum of $300).
  • For additional information on the 2014 HEM Program

Tobacco Use– you will be assessed a monthly surcharge based on your and/or your enrolled spouse/domestic partner’s tobacco use.

  • If you or your spouse/domestic partner use tobacco, the surcharge is $25 per month
  • If both you and your spouse/domestic partner use tobacco, the surcharge is $50 per month
  • For additional information on the Tobacco Use Program

Spouse/Domestic Partner Other Non-PEBB Employer Coverage – If your enrolled spouse/domestic partner has other employer group coverage available and does NOT enroll in that coverage, you will be assessed $50 per month.

  • If your spouse/domestic partner does not have access to employer coverage, there is no surcharge
  • If your spouse/domestic partner enrolls in their employer plan, there is no surcharge
  • If your spouse/domestic partner has access to other PEBB employer coverage and enrolls,  opts out or declines, there is no surcharge
  • Other Employer Group Coverage does NOT include:  Social Security, TRICARE, student insurance, individual coverage
  • For additional information on the Spouse/Domestic Partner Waives Other Coverage Program

4. Benefits eligibility

Classified and unclassified academic and professional employees working at least half-time* on appointments of 90 days or longer are eligible for health insurance benefits. 

Benefit eligible employees must continue to meet eligibility requirements each month to earn health insurance coverage for the following month.  If you do not meet the hours eligibility requirement in a month, you will lose coverage the following month.  The monthly hours requirement is:

  • A classified employee must work or be in a paid leave status for at least 80 hours in the month.
  • An unclassified employee must work or be in a paid leave status for at least one half of the available work hours in the month.  For example if the month has a total of 22 possible work days, you must work or be in a paid leave status for at least 88 hours to earn health insurance coverage for the following month.

 

*Eligibility can be through a single appointment or a combination of appointments.  Temporary Service (TS) positions are not eligible for benefits.

5. Eligible Dependents

  • Spouse
  • Domestic Partner (same sex/opposite sex)
    • Tax consequence per IRS regulations
    • Value of benefit is determined by PEBB and is subject to Social Security, Medicare, Federal  and State taxes
  • Qualifying dependent children and domestic partner’s dependent children up to age 27 (tax consequences for domestic partner’s children per IRS regulations).  The term “child” will apply to any son, daughter, stepson, stepdaughter, foster child, adopted child, or child for whom a member is legally obligated.  Eligibility will not depend on marital, student, employment, residency or tax status.
    more

6. Enrollment Options

Enroll in benefits

  • Core Benefits (Medical/Vision, Dental and employee basic life)
  • Can enroll in any of the PEBB optional insurance coverage

Opt Out of Coverage

  • Employees may opt out of either medical coverage only or medical and dental coverage
  • Provides a cash incentive for not enrolling in a medical plan or medical/dental plan
    • Cash back is subject to Federal, State, and Social Security taxes
    • Medical only opt out amount is $233 per month less the cost of dental plan and employee basic life insurance.  You will receive approximately $150-$170 per month cash back depending on the dental plan chosen and the number of family members enrolled.
    • Medical/Dental opt out amount is $193.50 per month less the cost of employee basic life insurance of $1 per month.  Thus, you will receive $192.50 per month in cash back.
  • To be eligible to opt out you must be covered by another employer sponsored health insurance program or employer sponsored health and dental programs.  Other group coverage does not include Medicare, Medicaid, Veterans Administration Health Benefits, Student Health Insurance, or an individual plan.
  • Can enroll in any of the PEBB optional insurance coverage
  • If opting out of Medical only, you must enroll in a dental plan
  • Must enroll in employee basic life insurance
  • Must provide proof of other employer coverage

Decline Benefits

  • If you decline coverage, you are declining enrollment in the CORE benefits (medical, vision, dental and employee basic life insurance). You will also not be eligible to enroll in any of the other PEBB optional insurances (e.g., optional life, long-term care, etc.)

7. Enrollment Timelines

  1. Within 30-days of hire date
    • If you don’t complete the enrollment process within 30 days, you will not have benefits and you will have to wait until Open Enrollment to enroll for the next calendar year.  You may be eligible to enroll prior to open enrollment if you experience a Qualified Status Change during the year.
  2. During the year if you experience a Qualified Status Change
    • Must complete Mid-year Update Form within 30 days of the qualifying event and return to Employee Benefits.
    • Qualifying Mid-year events include, but not limited to:  Marriage, Divorce, Birth, Death, Loss of other Coverage, Gain Other Coverage, etc.
      more
  3. Open Enrollment each year
    • This is the time you can make changes to your benefit elections, increase coverage, drop coverage, etc.
    • Month of October with changes taking effect in January.  Exception is when a plan requires review of medical history before approving or denying coverage (Optional life insurance and long-term care insurance).
    • Each year you must re-enroll in your Flexible Spending Accounts if applicable

8. When does coverage go into effect

Generally, coverage goes into effect the first of the month following your online enrollment or receipt of enrollment forms by OSU. Exceptions are when a plan requires review of medical history before approving or denying coverage (Optional Life and Long-term Care insurance). Coverage in these plans goes into effect the first of the month after approval by the plan.

9. Core Benefits – Medical Plans

PEBB “Full-time” plans available to Classified Employees (Full-time or part-time) and Unclassified Employees

Comparison of “Full-time” Medical plans

PEBB Statewide “Full-time” Plan administered by Providence 

  • PPO Plan – Statewide and National PPO networks
  • Medical deductible (In-Network) is $250/individual or a maximum family deductible of $750
  • Medical deductible is increased by $100/individual for non-HEM participants (up to a maximum of 3 individuals)
  • Deductible does not apply to the first 4 primary care office visits (per individual). Coinsurance amount applies (i.e., 15%, etc.) even if the deductible does not.
  • Prescription deductible is $50 per individual (up to a maximum of 3 individuals)
  • Prescription out-of-pocket maximum of $1,000 per individual (up to a maximum of 3 individuals)
  • PEBB Statewide Plan website
  • Plan Summary and Handbooks

Providence Choice Full-timeavailable in certain cities/counties only

  • Medical Home Plan
  • Must select a provider within an approved Medical Home AND notify Providence of your selection. Notify Providence online at myProvidence, Medical Home selection form, or by calling Providence Customer Service at 503.574.7500 or 800.878.4445.
  • Must live or work in Benton, Clackamas, Clark, Coos, Curry, Deschutes, Hood River, Jefferson, Lane, Linn, Marion-Polk, Multnomah, Wallowa, Washington, Yamhill counties.
  • Locate the Medical Home in your City
  • Medical deductible (In-Network) is $250/individual or a maximum family deductible of $750
  • Medical deductible is increased by $100/individual for non-HEM participants (up to a maximum of 3 individuals)
  • Deductible does not apply to the first 4 primary care office visits. Coinsurance amount applies (i.e., 15%, etc.) even if the deductible does not.
  • Prescription deductible is $50 per individual (up to a maximum of 3 individuals)
  • Prescription out-of-pocket maximum of $1,000 per individual (up to a maximum of 3 individuals)
  • Providence Choice Plan website  
  • Plan Summary and Handbooks 

Kaiser Permanente HMO Full-time – available in the Willamette Valley

  • Must live or work in the Kaiser Service Area (Oregon counties: Washington, Multnomah, Hood River, Yamhill, Clackamas, Polk, Marion, Benton, Linn; Washington counties: Cowlitz, Columbia, Clark, Wahkiakum, Lewis, Skamania). For a current list of Zip codes, contact Kaiser member services.
  • Facilities are located in Salem and the Portland area only
  • No Deductible for HEM participants
  • $5 co-pay for Office visits (primary care and specialist)
  • Non-HEM participants will have a $100/individual medical plan deductible (up to a maximum of 3 individuals)
  • Kaiser Permanente website
  • Plan Summary and Handbooks (Evidence of Coverage)

Kaiser Permanente Deductible HMO Full-time – available in the Willamette Valley

  • Must live or work in the Kaiser Service Area (Oregon counties: Washington, Multnomah, Hood River, Yamhill, Clackamas, Polk, Marion, Benton, Linn; Washington counties: Cowlitz, Columbia, Clark, Wahkiakum, Lewis, Skamania). For a current list of Zip codes, contact Kaiser member services.
  • Facilities are located in Salem and the Portland area only
  • Medical deductible is $250/individual or a maximum family deductible of $750
  • Medical deductible is increased by $100/individual for non-HEM participants (up to a maximum of 3 individuals)
  • Office visits and some services are not subject to the deductible
  • Kaiser Permanente website
  • Plan Summary and Handbooks (Evidence of Coverage) 

For Additional Information on PEBB Benefits visit:

PEBB “Part-time” plans are available to Classified part-time employees only (.50-.99 FTE)

For part-time employees, PEBB offers plans designed specifically for part-time employees in an effort to keep plans more affordable. Part-time employees may choose from any of the plans offered - Full-time or Part-time.

Part-time 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.

Comparison of “Part-time” medical plans 

PEBB Statewide Part-time Plan administered by Providence

  • PPO Plan – Statewide and National PPO networks
  • Medical Deductible is $500/individual or a maximum family deductible of $1,500
  • Medical Deductible is increase by $100/individual for non-HEM participants (up to a maximum of 3 individuals)
  • Deductible does not apply to the first 4 primary care office visits. Any coinsurance or copayments apply even if the deductible does not.
  • Prescription deductible is $50 per individual.
  • Prescription out-of-pocket maximum of $1,000 per individual (up to a maximum of 3 individuals)
  • No vision benefits
  • PEBB Statewide Plan website
  • Plan Summary and Handbooks

Providence Choice Part-time Plan– available in certain cities/counties only

Kaiser Permanente HMO Part-time Plan – available in the Willamette Valley

Kaiser Permanente HMO Deductible Part-time Plan – available in the Willamette Valley

For Additional Information on PEBB Benefits visit:

10.  Core Benefits – Vision Plans*

 

  • Kaiser Permanente
    • Kaiser provides the vision coverage for all of the Kaiser plans
    • Kaiser “Part-time” plans offer a limited vision benefit limited to the exam only
    • Refer to your medical plan summary for details on the Kaiser vision benefits

*PEBB Statewide and Providence Choice “Part-time” Plans have no vision coverage available.

11. Core Benefits – Dental Plans

PEBB “Full-time” dental plans available to Classified Employees (Full-time or part-time) and Unclassified Employees

Comparison of Dental plans 

ODS Traditional “Full-time” Plan

  • Can use any licensed dentist
  • Maximum annual benefit per covered individual is $1,750
  • ODS will apply a one-year waiting period for some services for dependents if you do not cover them in a PEBB dental plan when they are first eligible
  • ODS refers to the plan as “Delta Dental Premier”
  • ODS website

ODS Preferred “Full-time” Plan

  • Use Statewide Preferred Provider Network for higher benefit level 
  • Maximum annual benefit per covered individual is $1,750
  • Progressively higher benefit level for basic and maintenance services if you visit your preferred dentist at least once per year
    • Plan pays:  1st year = 80%; 2nd year = 90%; 3rd year = 100%.
    • Failure to visit your preferred dentist will cause a 10% reduction in payment the following year, although payment will not fall below 70%.
  • ODS will apply a one-year waiting period for some services for dependents if you do not cover them in a PEBB dental plan when they are first eligible
  • ODS refers to the plan as “Delta Dental PPO”
  • ODS website

Willamette Dental Plan

Kaiser Permanente “Full-time” Plan

  • Must Live or work in the Kaiser Service Area (Willamette Valley)
  • HMO– must use Kaiser facilities located in the Salem/Portland area
  • Maximum annual benefit per covered individual is $1,750
  • Do not need to be enrolled in the Kaiser medical plan
  • Kaiser Permanente website

PEBB “Part-time” plans are available to Classified part-time employees only (.50-.99 FTE)

Comparison of Dental plans

ODS Traditional “Part-time” Plan

  • Can use any licensed dentist
  • Maximum annual benefit per covered individual is $1,250
  • ODS will apply a one-year waiting period for some services for dependents if you do not cover them in a PEBB dental plan when they are first eligible
  • ODS refers to the plan as “Delta Dental Premier”
  • ODS website

Kaiser Permanente “Part-time” Plan

  • Must Live or work in the Kaiser Service Area (Willamette Valley)
  • Do not need to be enrolled in the Kaiser medical plan
  • HMO – must use facilities located in Salem and the Portland area only
  • Maximum annual benefit is $1,250
  • Do not need to be enrolled in the Kaiser medical plan
  • Kaiser Permanente website

12. CORE Benefits - Employee Basic Life Insurance

  • $5,000 term life policy
  • Includes MEDEX Travel Assist
  • You are automatically enrolled in the policy when you enroll in benefits or opt-out of medical or medical/dental coverage
  • Basic Life Insurance Additional Information
  • If you decline benefits, you do not have this policy

13. Optional Benefits

Optional benefits are voluntary choices you purchase on your own.  Below is a brief summary of the optional benefits available. Click on the benefit links for additional information (i.e., rates, etc.).

  • Employee Life Insurance – You are eligible to enroll in a $40,000 guarantee issue policy (no medical history statement required), if you enroll within 30 days of eligibility.  You may purchase up to $600,000 in term life coverage. A medical history statement is required for any amount above $40,000. 
  • Spouse/Domestic Partner Life Insurance – You are eligible to enroll in a $20,000 guarantee issue policy (no medical history statement required), if you enroll within 30 days of eligibility. You may purchase up to $400,000 in term life coverage. A medical history statement is required for any amounts above $20,000.
  • Dependent Life Insurance – You may purchase a basic $5,000 policy on each of your dependents.
  • Short Term Disability – Provides income replacement if you are injured/disabled for a short period of time and not able to work. (Seasonal Employees are not eligible to enroll in short  term disability plans). Short term disability can also be used for pregnancy related disability and the recovery period after the birth.
  • Long Term Disability – Provides income replacement if you are injured/disabled for a period of time and not able to work. (Seasonal Employees are not eligible to enroll in long term disability plans)
  • Accidental Death & DismembermentCoverage available for employee only or employee and dependents.  Policy covers accidental loss of life, limb, hand, foot, hearing, speech, sight, or thumb and index finger on the same hand.
  • Long Term Care – Plans available for employee and eligible family members. You can enroll at any time during the year. Medical history statement and approval of provider is required. There is a guarantee issue policy for the employee if enrolled within 30 days of hire, coverage level of up to $4,000/month benefit with a duration of 3 to 6 years (no medical history statement is required for the guaranteed issue amounts).
  • Flexible Spending Accounts – Allows you to use pre-tax dollars to reimburse yourself for qualified health care and dependent care expenses.  Expenses for a domestic partner and/or domestic partner’s children is not an allowable expense.  You forfeit any funds that you don’t use and claim for valid expenses by the deadline.

RESOURCES:

14. How to Enroll and/or Make Changes

New Employee – must enroll within 30 days of hire date

  • Online (Guide for Enrolling Online)
  • Paper Forms  (Guide for Enrolling with Forms).  You must use paper forms if you:
    • Opt Out of Medical or Medical/Dental coverage
    • Are enrolling the following dependents:
      • Dependent child by Affidavit
      • Grandchild by Affidavit
      • Domestic Partner by Affidavit or Domestic Partner’s Children
    • Return completed forms to Employee Benefits
      • Campus mail: 204 Kerr Administration Building
      • US mail: 122 Kerr Administration Building, Corvallis OR 97331-2132
      • Fax: 541-737-0553

Midyear Changes – must complete Midyear Change form within 30 days of the qualifying event

  • Allows changes to your plan elections during the year if you experience a Qualified Status Change.
  • Qualifying Midyear events include, but are not limited to: Marriage, Divorce, Birth, Death, Loss of other Coverage, Gain Other Coverage, etc
  • Complete and return the Midyear Change Form within 30 days of the qualifying event to Employee Benefits.
  • For more information on Midyear Plan Changes

Open Enrollment

  • Is your once-a-year opportunity to make changes to your benefit packages (i.e., increase/decrease coverage, add/drop coverage, etc.) without experiencing a qualified status change.
  • Open Enrollment is the month of October with changes taking effect in January. Exception is when a plan requires review of medical history before approving or denying coverage (Optional life insurance and long-term care insurance).
  • Each year you must re-enroll in your Flexible Spending Accounts if applicable.

15. Verify your benefit deductions on your earnings statement

For additional information

16. Required Notices

For additional information

Employee Benefits Staff List

Employee Benefits - 204 Kerr | 541-737-2805 | general email
Donna Chastain Donna Chastain Director, Workplace Solutions 541-737-2806
Heidi Melton Human Resources Officer
Workers’ Compensation, Standard Insurance Claims (STD&LTD)
541-737-2916
Christina Schaaf Benefits Consultant
Benefit Issues for Business Centers: HSBC, BEBC & AABC
541-737-2835
Jessica Dalziel Benefits Consultant
Benefit Issues for Business Centers: UABC, FOBC & Chancellor’s Office
541-737-3521
Roshni Sabedra Benefits Consultant
FMLA/OFLA/Military Leave
541-737-5946
Whitney Barstad Benefits Consultant
Benefit Issues for Business Centers: ASBC & AMBC
541-737-2269
Patricia Young Benefits Consultant
Retirement, Savings & Pension Programs
541-737-8254