Open Enrollment Summary & 2023 Plan Year Changes
PEBB open enrollment is mandatory this year during. It takes place October 1-31, 2022.
What does that mean for you?
It means you must login to your PEBB portal and confirm your plans. (Failure to complete open enrollment could result in higher out of pocket costs or the loss of benefits).
This is the time that you can change any of your coverages, add eligible dependents, remove dependents, enroll, or re-enroll in a flexible spending account (FSA), change your Health Engagement Model (HEM) status, update your personal information, or update your beneficiaries. Open Enrollment is your once-a-year opportunity to make changes to your benefit packages without having experienced a qualifying life event or family status change (marriage, birth, divorce, loss/gain of other insurance, etc.).
The changes you make during Open Enrollment will be effective in the new plan year beginning January 1, 2023.
There are two (2) Actions required to complete both the Open Enrollment and the HEM:
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Action 1: PEBB Open Enrollment completion: Confirm your benefit elections, make changes, re-enroll in flexible spending accounts, AND indicate your HEM participation status for 2023. If Opting Out, you MUST take action and affirm you and your dependents have minimal essential coverage.
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Action 2: (If planning to participate in the Health Engagement Model HEM) - Complete the HEM Health Assessment by October 31, 2022 at your current medical carrier’s website. The HEM program will provide a financial incentive in your pay of $17.50 a month if you elect to participate and an increased deductible on your health plan if you choose not to participate.
The Three easy steps to participate in both are:
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Enroll in a PEBB medical plan by October 31, 2022. (Be sure to say you plan to take part in HEM.)
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Take your health assessment on by October 31, 2022. Health assessments done after this date will not be accepted.
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Complete two healthy actions during the new plan year. You don’t need to report them. You just need to let us know you did them at open enrollment next year. Remember, spouses and partners don’t participate. When you participate, they get the advantage of your low family deductible.
Please refer to the Health Engagement Model landing page for links to the medical carrier’s websites, questions about healthy actions and health assessment related questions.
** Plan early to complete your Health Assessment. You may need to have your password reset which can take time. For example, Kaiser Permanente may require 10 business days to reset your password.
How do you complete open enrollment?
Employees can enroll online or use paper forms.
Go to: www.Pebbenroll.com to complete this process online.
To use Paper Forms to Complete Enrollment:
Download at: http://www.oregon.gov/oha/pebb/Pages/forms.aspx. Search for Open Enrollment forms.
Paper forms can be faxed, scanned and e-mailed or sent through mail.
Please return the forms to Employee Benefits by October 31, 2022, at:
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Campus Mail: 236 Kerr Administration Building, Corvallis OR
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US Mail: 236 Kerr Administration Building, Corvallis OR 97331-8578
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Fax: 541.737.0541
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Scan and send via e-mail to employee.pebbbenefits@oregonstate.edu
Life Events Outside of Open Enrollment: If you incur or anticipate incurring a qualifying life event during Open Enrollment such as birth, marriage, divorce, contact Employee Benefits at 541-737-2805 or employee.pebbbenefits@oregonstate.edu in order to complete the Midyear Change process prior to completing Open Enrollment. If you incur a qualifying life event during the year, don’t wait until Open Enrollment to update your elections. Contact Employee Benefits or refer to our website on how to update you benefit elections. Visit the “Midyear Changes to Health & Optional Benefits” website for additional information.
Surcharges and Optional Life Rates
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Tobacco Surcharge - $25/month if employee uses tobacco + $25/month if enrolled spouse/domestic partner uses tobacco.
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Spouse/Domestic Partner Surcharge - $50/month if spouse/domestic partner waives coverage in another employer’s group plan (non-PEBB plan) in favor of coverage through PEBB.
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Tobacco User Life Insurance Rates – The rates for optional employee life and optional spouse/domestic partner life insurance is higher for members that have used tobacco within the past 12 months.
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OEBB/PEBB double coverage Surcharge - You will have to pay a monthly $5 surcharge if you are an active full-time employee and:
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Someone in your family is covered as a member under their own PEBB or Oregon Educators Benefit Board (OEBB) plan, and
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That person is covered as a dependent (spouse, partner or child) on your PEBB medical plan.
2023 Plan Changes
Medical Plans
General/All Medical Carriers:
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PEBB is adding breast reduction surgery when deemed medically necessary.
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Continuous Glucose Monitors (CGM) and diabetic testing supplies will only be covered under the pharmacy benefit- no longer covered under DME.
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You can obtain these supplies through a retail pharmacy or mail-order pharmacy, Postal Prescription Services and Costco for more savings
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You will be notified 60 days in advance if you are impacted by this change
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If you currently have a prior authorization approved under the medical benefit, you do not need to seek an additional prior authorization. It will be loaded under the pharmacy benefit to ensure there is no disruption in coverage.
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NEW! Effective 1/1/2023: PEBB members will have access to Livongo’s Diabetes Prevention Program (DPP). The program will identify members who are at risk for developing Type 2 diabetes.
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Members who sign up will receive:
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An advanced smart scale and app
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Unlimited one-on-one expert coaching
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Guidance on creating healthy habits that last
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All-in-one weight, activity and food tracking
MODA Plans
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No 2023 plan changes with MODA
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Dental members with a Moda medical plan: 833-681-2117
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Dental only members: 844-827-7100 (current dental phone number)
Kaiser Plans
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No 2023 plan changes with Kaiser
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Kaiser will be offering the following:
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Recorded Presentations for medical and dental
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1:1 Office Hours- Employees may set up appointments to speak to representatives about benefit questions.
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Virtual Open Enrollment Materials
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Live Webinars
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Link to Kaiser Permanente Microsite for PEBB enrollment materials: https://mybenefits.kaiserpermanente.org/pebb/enrollment
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English Presentations (Video)
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Spanish Presentations (Video)
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English Benefit Summaries
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Spanish Benefit Summaries
Providence Plans
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No 2023 plan changes for Providence
Dental Plans
PEBB increased the lifetime maximum for orthodontia (Delta Dental Plans) from $1500 to $1800.
Willamette Dental: No 2023 benefit changes.
Delta Dental: No 2023 benefit changes except lifetime orthodontia maximum increased from $1500 to $1800.
Kaiser Permanente Dental: No 2023 benefit changes.
Vision Plans
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VSP No 2023 benefit changes
Optional Plans
Opt-Out or Decline? There is a difference
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Opt-out is a choice that results in PEBB membership. Employees that have other qualifying medical coverage can elect to opt-out of the PEBB medical enrollment and receive a cash payment in their monthly payroll checks. Employee’s MUST attest that all tax dependents have minimal essential health insurance coverage in order to qualify. To continue to opt out of medical benefits in 2023 you must:
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Complete open enrollment between Oct. 1 and Oct. 31, 2022.
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Attest that you still have other group (employer) coverage to receive the opt out incentive. If you don’t complete open enrollment you will remain without medical coverage and lose your monthly incentive.
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Opt out is allowed for medical only and employees must attest to having other employer group coverage to be eligible. This means all current enrolled opt out employees need to complete open enrollment to attest regarding other coverage. If employees who have opted out previously do not attest, they will be removed from opt-out cash back and will be defaulted into a medical plan.
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Decline is that an employee didn’t take an action to enroll in any PEBB option (including the opt-out cash payment option). You are not a PEBB member and receive no PEBB benefits.
Part-time Faculty Benefits
New this fall, related to SB 551, actively working part-time faculty working at least half-time at a single public institution of higher education or in aggregate at multiple public institutions of higher education in Oregon (Public Community College or University) during at least three of the four previous academic terms may be eligible for employee only, medical only insurance coverage. Please note current members and dependents in PEBB/OEBB plans are not eligible for this coverage. For more details regarding eligibility please visit the website here.
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