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PEBB 2022 Enrollment Guide

PEBB 2022 Summary of Benefits

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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 $3,016.  The base salary rate is determined by the salary schedule (Step/Column) and is based on the full-time equivalent.

PEBB Resources

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 to 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)

  • Coordinated care model plan.  Members must pick a PCP 360. A PCP 360 delivers full-circle care, coordinating your care with other providers, as needed. They are high-quality primary care providers who are willing to partner with you and be accountable for your health.
  • You must notify Moda of your PCP 360 before seeking medical care to receive In-network coverage
  • Your PCP 360 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
  • Moda Health does not require referrals for specialists.
  • Text a doctor and mobile therapy options
  • Moda Health website
  • Plan Summary
  • Member Handbooks
  • Virtual Visits
  • Active&Fit Direct Program

 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
  • Providence Choice website
  • Plan Summary and Member Handbooks

 

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

  • Facilities are located in the Eugene, 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