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Insurance navigation information for transgender employees
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
- Introduction to PEBB Benefits
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PEBB Benefit Deduction Estimator - Refer to page 16 of the open enrollment guide. To calculate the 5% or 3% of your insurance premium, please add up the total of the medical, dental and vision, then multiply by your percentage.
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