Health Benefit Information

BENEFIT ELIGIBILITY

Eligibility requires employees to work over 90 days and at least half-time or greater. Any other form of eligibility would come from notification from the Benefits Officer, such as qualifying for health benefits coverage under the Affordable Care Act. Irregular instructors or faculty members may qualify for PEBB health coverage if working over .50 FTE in one term, which is typically equivalent to a half-time position.

Senate Bill 551/ House Bill 2611

Insurance coverage for Part Time Faculty

Senate Bill 551 passed into law during the 2021 Oregon legislative session provides part time faculty who are working an aggregate of .50 FTE at a single or multiple Oregon public institution(s) of higher education (includes universities and/or community colleges) with the opportunity to enroll in employee only, medical/prescription only coverage. Medical plans are the same plans available to full time faculty. Medical opt out and enrollment in a dental and/or vision coverage is not available.

If eligible for coverage, the faculty member will designate a “home institution” that will administer and determine eligibility for coverage. The faculty member must be actively working and receiving a paycheck from the selected home institution and will select a medical plan available to employees at that institution.  It is the faculty members responsibility to research and compare medical plan options and costs at the different institutions they are employed with, prior to selecting a home institution.

ENROLLMENT WINDOW

Employees have 30 days from their date of hire to make benefit elections and to change elections. If no elections are made after 30 days, the employee would be considered a Decline. Employees that Decline benefits may enroll during the annual Open Enrollment period in the month of October, which takes effect January 1 of the coming plan year, or if they have a qualifying Midyear Change event. If the employee has other group medical coverage, they may consider Opting-Out of medical. Opt-outs can still enroll in dental, vision, and optional benefits, and will receive a monthly cash incentive in their paycheck of about $233/month (prorated if part-time, more details about opting out can be found here).

ELIGIBLE DEPENDENTS

Eligible dependents include a spouse or domestic partner (see note below for domestic partners) and dependent children. PEBB reviews dependent eligibility and will contact members who enroll a spouse/partner or children under their plans for documentation proving the dependent is eligible. Review PEBB’s dependent eligibility information here.

PEBB DOMESTIC PARTNERSHIP

To enroll a domestic partner, members must also complete and submit a PEBB Domestic Partner Affidavit form within their 30-day enrollment window. Domestic partnership requires the employee to pay an Imputed Value Tax, which is a pre-determined dollar amount that the employee is taxed on for core benefits that the partner and/or partner’s children are enrolled in. The requirements and documents needed for domestic partnership can be reviewed here and the 2023 Imputed Value Tax amounts here. If the domestic partner is a tax dependent, the PEBB Domestic Partner Tax Status form may be submitted to remove the Imputed Value tax (Affidavit only needs to be submitted at the time of enrollment, Tax Status form must be submitted annually before December payroll).

Newly hired or newly eligible employees may enroll online by visiting PEBBenroll.com within their first 30 days. When enrolling online, new members will click the ‘register here’ button and will input their legal first name, legal last name, date of birth (with dashes mm-dd-yyyy), ID Type will be ‘university ID number’, and input your EOU ID number (starts with 910 and is nine digits). Benefits will take effect the first of the following month after enrollment is received. If needed, paper enrollment forms are available to employees:

• PEBB Enrollment Form 
• 2023 PEBB Flexible Spending Account Enrollment Form
• Enrollment and all other PEBB forms can be found on the PEBB Forms Webpage.

Newly benefits-eligible employees may enroll in plans and change any plan elections within their first 30 days of hire or eligibility. Outside of this 30-day window, employees may update benefits during our annual Open Enrollment period or if they have a qualifying midyear event.  

OPEN ENROLLMENT

Aside from your initial 30-day window enrollment, you can adjust your benefit elections annually during PEBB’s annual Open Enrollment period, which is October 1-31 of every year. Open Enrollment is a two-step process and requires all benefit-eligible employees to (1) go into the PEBBenroll.com system to re-save their benefits or make necessary changes AND (2) go into their medical provider’s website to complete the HEM (Health Engagement Model), a required health questionnaire (opt-outs go to the Providence Choice website to complete the HEM only if they anticipate enrolling in a medical plan, otherwise opt-outs don’t need to complete HEM). For the plan year following Open Enrollment, if both steps were completed, employees will receive a $17.50 incentive in their monthly paycheck (not available for opt-outs). Those who do not complete Open Enrollment will have their deductible increased up to $300 for the plan year and PEBB may also assume you are a tobacco user and that you have other group coverage, charging you higher rates and surcharges. New employees get the benefit of a low deductible and by completing Open Enrollment in October, they will continue to have a low deductible into the following plan year. 

MIDYEAR PLAN CHANGES

Outside of Open Enrollment, existing employees may change benefits midyear if they have a qualifying status change. PEBB has created a Midyear Plan Change Matrix of qualifying events which states what benefits are available to change. If a member has a qualifying mid-year event, they can submit the Midyear Change form to HR within 30-days of the event date. Changes submitted will take effect the first of the following month after the event. Also, if adding a new baby to coverage, babies are covered under the subscriber for the first 30-days automatically.  

MOST PREMIUMS PAID A MONTH IN ADVANCE 

Most health insurance premiums are paid a month in advice. Therefore, if enrollments are submitted after the month’s payroll cutoff (typically the 15th of the month) and health insurance is intended to begin the first of the following month, the employee will pay for two months of premiums in that following month’s payroll. For example, if an employee submits their benefit elections on January 30, coverage will take effect on February 1, but because the elections were made after the January 15 payroll cutoff, the employee will pay for January and February coverage in the February payroll. NOTE:  Flexible Spending premiums are the only enrollments paid the month the contribution is due (example: January contribution covers January).

COST OF MONTHLY PREMIUMS

For Core benefits (medical, dental, vision, and $10k of basic life insurance), employees pay 3% or 5% of the monthly premiums and EOU covers the rest of the cost. If the employee enrolls in the lowest cost medical plan available to them, they will pay 3% for all Core benefit monthly premiums. If the employee enrolls in any of the other medical plans that are not the lowest cost, then the employee will pay 5% for all Core benefit premiums. Employees enrolled to opt-out of medical will get a monthly incentive of $233 (prorated if part-time) and will pay 5% for the $10k of basic life insurance, dental, and vision. Please use the 2023 Estimated Employee 3% vs. 5% Premiums (XLS) to estimate the cost of your core benefits. 

For Optional benefits, employees pay 100% of the premiums. Health insurance premiums are automatically taken out of the employee’s paycheck after the employee has enrolled.

CLASSIFIED EMPLOYEE SUBSIDY

Classified employees whose full-time 1.0 FTE salary or equivalent is less than or equal to Salary Range 11 Step 10 (effective 7/1/2022, SR 11 Step 10 equals  $3279/mo). If eligible, EOU will pay up to $40/month to help cover the cost of the employees’ 3% or 5% portion of Core benefit premiums. View the SEIU Collective Bargaining Agreement on the EOU HR homepage.

ACADEMIC YEAR EMPLOYEES 

Employees who are paid on the academic year cycle and are determined to return the following academic year will pay three months of health insurance premiums in the month of May to cover benefits over the summer. Renewable employees in 9 or 10-month positions may contact Payroll about enrolling in Deferred Pay (spreading pay over 12 months). If interested in Deferred Pay, call the Payroll office at (541) 962-3286 for more information.

Core Health Benefits cover medical, dental, vision, and an automatic $10,000 of employee life insurance (medical election is required to participate, though opting out is considered a medical election, declining is not). Employees pay either 3% or 5% of the total benefit premium cost, depending on what medical plan they elect. Employees enrolling in the lowest-cost medical plan will pay 3% for their core benefits premiums and employees enrolled in either of the other plans will pay 5%(opt-out employees pay 5% for any other core benefits). 

Optional Health Benefits include life insurance, disability insurance, accidental death & dismemberment, long-term care, and flex-spending accounts. The employee pays 100% of these premiums.

Wellness Programs are available and provide information, assistance, and resources to employees, encouraging a wholesome and complete lifestyle.

Helpful Resources

• Enroll online at PEBBenroll.com
• Find more information on the PEBB website by visiting PEBBinfo.com
• Use the 2023 Enrollment Guide (interactive online document) for a plan overview (PDF version)
• Use the 2023 Summary of Benefits Guide to compare Medical, Dental, and Vision summaries
• PEBB New Hire Resource Center
• Find other forms on the PEBB Forms page

Eastern Oregon University’s benefit-eligible employees have access to Medical, Dental, and Vision plans (a medical election is required to participate, though opting out is considered a medical election, declining is not). Automatically included in Core Benefit is $10K of guaranteed issue Basic Life Insurance, the full monthly premium is $1.60/month, employee’s monthly portion is either $0.05 or $0.08, depending on which medical plan is elected. Employees only pay 3% or 5% of the total premium cost of their Core benefits, EOU covers the rest. Please use the 2023 Estimated Employee 3% vs. 5% Premiums (XLS) to estimate the cost of your core benefits. 

MEDICAL PLANS

Medical plans available are determined by location, where employees pay only 3% or 5% of their total Core Benefit costs, depending on which medical plan they enroll in (Opt-Outs pay 5%). Some big differences between medical plans are how you navigate the plan and the network of providers and facilities. Employees’ standard deductible is $250 per tier ($250 for employee-only coverage, $500 for employee+spouse/partner coverage or employee+children, and $750 for family coverage). Check out the PEBB CORE Benefits Plan summary document for more information. 

Available to Union and Baker County residents are the following medical plans:

• Providence Statewide (employee pays 5% of Core benefit premiums for the 2023 plan year) – A nationwide network with numerous providers in the plan, where employees do not need referrals and typically pay 15% for most services.
• Moda Synergy (employee pays 5% of Core benefit premiums for the 2023 plan year) – The network is defined within counties in Oregon and as long as providers are in-network and you have PCP 360 elected on file (location of primary doctor), members do not need referrals and often pay about $10 for most services.
• Providence Choice (employee pays 3% of Core benefit premiums for the 2023 plan year) – The network is defined within counties in Oregon and members must obtain referrals for specialty services, members often pay about $10 for most services. 

Plans available by county for Oregon

DENTAL PLANS

Through Moda, PEBB members have access to two Delta Dental plans (through Moda), which require the member to elect a dentist within the network. Willamette Dental is also available, which is a clinic location, with one clinic in Meridian, ID and Tri-Cities, WA, and more clinics located across the state; members do not elect their dentist but are rather scheduled with whoever is available at their clinic, though members out-of-pocket costs for services are greatly reduced. Check out the PEBB CORE Benefits Plan summary document for more information. 

Available to Union and Baker County residents are the following dental plans:

• Delta Dental PPO (through Moda)
• Delta Dental Premier (through Moda)
• Willamette Dental (a clinic location)

VISION

VSP (Vision Service Plan) is the only vision plan available to PEBB members, though members can upgrade to Vision Plus, which allows a better benefit for glasses. VSP is a national provider where most local eye centers are in the network. Check out the PEBB CORE Benefits Plan summary document for more information. (Note: VSP members do not get vision cards. Instead, find a local vision center and share your medical ID card with them and they can find you in the VSP system. Members who opt out of medical can use their PEBB ID number.)

Review VSP coverage and find providers:

• VSP Brochure
• VSP.com member website

Optional Benefits: Optional Life, Disability, Long Term Care, & Flexible Spending Accounts

Employees who enroll in optional benefits pay 100% of the cost of premiums. Employees may have other benefits available to them through their elected medical insurance provider. 

Employee and Spouse/Partner Optional Life Insurance
EMPLOYEE:  When employees are first eligible for health insurance they have a one-time allowable enrollment of up to $100k of guaranteed issue coverage without having to do a medical history statement. Employees can enroll in up to $600k of coverage but are required to complete a medical history statement and if approved can enroll in additional coverage. If the employee enrolls in no life insurance or less than the $100k guaranteed issue amount, they must complete a medical history statement for any increase in the future. This is term life insurance, which means that the insurance benefit is payable only if the insured person dies during the period specified by the policy (while covered under the plan). The beneficiary receives the benefit payment if the insured person dies while covered under the policy. In this case, that is while the person is a PEBB-eligible state employee whose premium payments are current. The Standard pays the benefit upon death from any cause (excluding suicide during the first two years of coverage).

SPOUSE/PARTNER:  This is term life insurance. Term life insurance means that the insurance benefit is payable only if the insured person dies during a specified period. The beneficiary receives the benefit payment if the insured person dies while covered under the policy. In this case, that is while the employee who purchases the coverage is a PEBB-eligible state employee, and premium payments for the coverage are current.

Dependent Life
This is term life insurance. The beneficiary (the enrolled employee) is the recipient for individuals who die while covered under the policy.
In this case, that is when the employee who purchases the coverage is a PEBB-eligible state employee, and premium payments for the coverage are current.

Short-Term Disability
The benefit covers 60 percent of your insured earnings. For short-term disability, the insured earnings amount is based on your weekly earnings in effect on your last full day of work. When your insured earnings increase (for example, with a pay increase), your premium rate increases. Insured earnings do not include overtime pay, bonuses, or dollars received when you opt out of medical coverage. (Note: Temporary employees cannot enroll in disability.)

Long Term Disability
The benefit covers a percentage of your monthly insured earnings. You determine the percentage when you choose from the four options. For long-term disability, the insured earnings amount is based on your monthly earnings in effect on your last full day of work. When your insured earnings increase (for example, with a pay increase), your premium rate increases. Insured earnings do not include overtime pay, bonuses, or dollars received when you opt out of medical coverage. (Note: Temporary employees cannot enroll in disability.)

Accidental Death and Dismemberment
The AD&D plan provides 24-hour coverage for accidental loss of life or limb loss for employees and their eligible dependents. You may select a coverage amount from $50,000 to $500,000, in increments of $50,000.

Long-Term Care
Members eligible for long-term care insurance can enroll for coverage at any time – not just during your initial enrollment or Open Enrollment. During Open Enrollment, you can begin the enrollment process online through your record in the benefits system; however, you will still need to submit forms from the carrier, UNUM, directly to PEBB.

Flexible Spending Accounts (FSA)
FSAs allow you to use pre-tax dollars to reimburse yourself for IRS-Qualified expenses. Use a Health Care FSA for IRS-qualified medical and dental expenses not covered in your plan, or use a Dependent Care FSA for IRS-qualified daycare expenses that allow you to work. FSAs are annual accounts. If you want an FSA for the coming plan year, you must enroll in Open Enrollment. You can’t revoke your participation in an FSA after it goes into effect. When enrolling in flexible spending, PEBB will ask how many “pay events” the employee has in a calendar year. If paid on the academic year cycle, employees will report that they have 10-PAY EVENTS. NOTE:  Commuter parking and transportation accounts are available through PEBB but typically do not benefit EOU employees. If the employee pays for public parking or transportation for the purpose of work, then the Commuter plans may be useful. 

Well-Being (n.): The state of being healthy, happy, and prosperous

More Wellness related resources can be found at PEBB’s Wellness Central webpage.

Health Engagement Model (HEM)
The goal of the HEM program is to engage as many people as possible in improving their health. Participating in HEM helps you learn about your health risks and take action to reduce them. Becoming healthier together can help contain healthcare costs for all of us over time. Enrollment in HEM for the coming year occurs during Open Enrollment and is MANDATORY. Participants receive a health incentive in their monthly pay, available in January after completion of Open Enrollment.

Employee Assistance Program (EAP) – Canopy Wellbeing
Eastern Oregon University contracts with Canopy Wellbeing (formerly known as Cascade Centers, Inc.) to provide a comprehensive EAP for eligible employees and their dependents. the EAP is a FREE and CONFIDENTIAL benefit that can assist you and your eligible family members with any personal problems, large or small. A summary of services can be found here.
 
Healthy Team Healthy U (HTHU)
Healthy Team Healthy U targets your overall health to maximize results and create healthier minds, healthier bodies, and a healthier workplace. Through this program, you gain access to an online support community and vast resources to cultivate a healthier lifestyle.
 
Tobacco Cessation
Employees enrolled in medical insurance have access to a smoking cessation program to assist with quitting tobacco consumption and lower health care costs.

Travel Assistance
All PEBB members are automatically enrolled in Travel Assistance, which offers worldwide medical assistance and medical transport, personal security services, and trip/pre-trip assistance. 

WW (formerly Weight Watchers)
Weight Watchers program assists employees with achieving weight loss goals in a healthy supportive environment. Weight Watchers group is available on campus.

Better Choices, Better Health

Join Better Choices, Better Health for online workshops, information, and tools you need to manage chronic conditions and live a better life. Empower yourself with management techniques and a flexible 6-week online workshop so you can go at your own pace. 

Diabetes Prevention Programs (Available through Providence medical plans and Moda medical plans)
All of EOU’s medical plan programs are designed to help you improve your health and lower your risk of developing diabetes. Weekly lessons, 24×7 online tools, and dedicated personal health coaches empower you to take small practical steps to reach your health goals.

Active & Fit Direct (Available through Providence medical plans and Moda medical plans)

PEBB insurance companies offer discounts to over 11,000 participating fitness centers and programs nationwide for only $25/month. Check out your medical carrier’s website for more information and details. They also offer fitness-related discounts!

Forms

PEBB Forms

Resources

EOU’s Agency Code is 58010

PEBB Website – PEBBinfo.com

Domestic Partnership Information

Insurance Plan Contacts Plan Contacts

Plan Documents

Flex Spending Tax Saving Accounts (link to ASIFlex, which manages our programs)

PEBB Summary Plan Description

PEBB News and Events

PEBBonDemand.com for past webinars, videos, presentation slides, or handouts

Medical Group Numbers

PEBB Statewide: 108601

Providence Choice: 106528

Moda Synergy: 10002802

Dental Group Numbers

Delta Dental (Moda) PPO: 10002802

Delta Dental (Moda) Premier: 10002802

Willamette Dental: OR90

Vision Group Number

VSP Basic/Plus: 12179989 (No insurance cards for vision, use medical ID or PEBB ID number and the provider will find you in the VSP system)