OREGON STATE UNIVERSITY

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Benefits Overview

1. Public Employees' Benefit Board (PEBB)
2. Cost of Health Insurance Coverage
3. PEBB Health Programs
4. Your Eligibility
5. Who is eligible to enroll in coverage
6. Enrollment Options
7. Enrollment Timelines
8. When coverage goes 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
14. How to Enroll
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 Health Insurance Coverage

Effective for 2013 Plan Year Coverage:

CORE Benefits (Medical, Vision, Dental, Employee Basic Life $5k):

  • 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 December 2011, OSU will pay an additional monthly premium subsidy of $40 toward your premium costs. *Base salary rate is determined by the Salary Schedule Salary Range/Step and is the full-time equivalent. Furlough, differentials, etc. do not factor into the base.

Estimate your total Monthly premium costs:

3. PEBB Health Programs:

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

Health Engagement Model (HEMi) Program

  • 2013 HEM program is not available to employees hired on or after October 1, 2012. 
  • There is no incentive for participating and/or penalty for not participating in the program.
  • Employees hired on or after October 1, 2012 will be eligible to participate in the 2014 HEM program. 
  • Enrollment in the 2014 HEM program will be part of the Open Enrollment process for 2014 benefits held in October 2013.

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. Your eligibility

  • Classified employee in a full-time position (1.0 fte) for at least 90 days
  • Continued eligibility
    • A classified employee must work or be in a paid leave status for at least 80 hours in the month to earn health insurance coverage for the following month (i.e., work 80 hours in September, earns health insurance coverage for month of October).
    • If you do not meet the hours eligibility requirements in a month, you will lose employer paid insurance coverage the following month.

5. Who is eligible to enroll in coverage

  • Employee
  • 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 Information

6. Enrollment Options

Enroll in benefits

  • Core Benefits (Medical/Vision, Dental) and any optional coverages

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 complete enrollment process to opt-out and receive cash back
  • Must provide proof of other employer coverage with your enrollment forms
  • MUST use Paper Forms  
  • Forward paper forms to Employee Benefits at
    • Campus Mail: 204 Kerr Administration Building
    • US Mail: 122 Kerr Administration Building, Corvallis OR 97330-2132
    • Fax 541-737-0553

RESOURCES:

PEBB Dental Rates
PEBB Opt Out information

Decline Benefits

  • Can decline coverage by:
    • Not completing the enrollment process within 30 days of hire; OR
    • Completing the enrollment process and choosing “decline” coverage
  • 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
    • You must complete the enrollment process within 30 days of your 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 Information
  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 coverage goes 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)

Comparison of "full-ime"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-time– available in certain cities/counties only

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

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

For Additional Information on PEBB Benefits visit:

10.  Core Benefits – Vision Plans

VSP Vision Services Plan

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

11. Core Benefits - Dental Plans

Comparison of Dental plans 

ODS Traditional 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

  • Use Statewide Preferred Provider Network (Delta Dental PPO 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 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

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

  • Online
    • Guide for Enrolling Online 
    • Must enroll within 30 days of hire date
    • You cannotuse the Online system 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

    Problems registering?

    • Use your OSU ID number, DO NOT use dashes (i.e., 930111111)
    • Call Employee Benefits for assistance at 541-737-2805 if you continue to receive the following error:
      “You may have made an error in entering your information.  Please review the information you entered and try again”

    Problems with the online program after you successfully registered; call PEBB for assistance at 503-373-1102

  • Paper Forms
    • Forms
    • Guide for Enrolling with Forms
    • Must be received by Employee Benefits within 30 days of your hire date
    • You MUSTuse 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

15. Verify your benefit deductions on your earnings statement

More Information

16. Required Notices

More Information