Frequently Asked Questions
Effective October 1, 2009 through September 30, 2010
- When is open enrollment this year?
- Open Enrollment runs from Saturday, August 15 to Tuesday, September 15 at 5:00 p.m.
- When will changes to benefit plans be effective?
- Any changes you make during Open Enrollment will be effective on October 1, 2009.
- Is there a period of forgiveness following the deadline?
- No. In order to make PCC’s payroll processing deadlines, September 15 at 5:00 p.m. is an absolute deadline for PCC employees, retirees, and dependents to enroll, opt out, or make changes. Please make your benefits a priority and plan your time accordingly. You are provided a month in which to participate in Open Enrollment.
- If I opted out last year, do I still need to go online?
- Yes. Employees who opted out of medical, vision and dental will have to go online to verify that their other group coverage is still in place and/or update information regarding that coverage if changes have occurred. A second reason to go online is that all employees receiving life insurance paid by the college will need to enter beneficiary information through MyOEBB.
- How do I enroll or make changes to my benefits?
- Use MyOEBB, OEBB’s online system for enrollment and changes to your plan selections. Here is the link: https://myoebb.org/oebb/!pb.main. Posted to the OEBB website is a updated guide to help you navigate through the OEBB system. In addition, HR/Benefits has enrollment assistance sessions scheduled at several drop-in locations across the district. The schedule for those sessions is included in the PCC benefits mailing (YELLOW ENVELOPE).
- What will happen if I don’t make any selections during Open Enrollment?
- Those who don’t make changes during open enrollment will continue with the same plans from last year, if they are still available. ODS Vision Plan 5 has been dropped by PCC. ODS Vision Plan 1 is the new offering. If you were on ODS Vision Plan 5, you must go through the enrollment process to make a vision plan selection. Absent a new selection, you won’t have vision coverage.
- Those PT faculty members and others who are newly eligible for PCC benefits and miss the open enrollment timeframe will be enrolled in the default medical plan only (ODS Plan 8) for the employee only, with no vision coverage.
- If I wanted ODS Plan 8 anyway, can I just let the college process my coverage as a default?
- HR/Benefits is asking that our benefits-eligible employees go online and select their plans rather than wait to be defaulted. Employee defaults create more work for HR/Benefits with the possibility of two months’ deductions for the employee portion of the premiums coming out of a single paycheck.
- If nothing is changing with my plan selections from last year, do I have to do anything?
- Yes. The majority of PCC benefits-eligible employees will need to participate in the on-line process, to either enroll, opt out, and/or designate a beneficiary for their life insurance. New this year, OEBB will be the college’s source for life insurance, AD&D and Long-Term Disability (LTD). In addition, there are changes to plan offerings this year, which may interest you in making changes. First, Willamette Dental is including orthodontia in its dental plans. Also, PCC has made a decision to move the ODS Vision coverage from Plan 5, with itemized allowances, to ODS Plan 1 with a total vision benefit of $250 per years.
- What more can you tell us about life, AD&D and LTD through OEBB?
- New this year are the offerings of life insurance, AD&D and Long-term Disability (LTD) through OEBB with The Standard Insurance Company. Current voluntary coverage you’ve purchased through UNUM will end at the end of the current plan year. If you want to continue coverage with the new carrier, you’ll need to enroll with The Standard during Open Enrollment. See more information in the life insurance section of this document.
- If nothing is changing that impacts me and I don’t have voluntary life or AD&D, do I need to do anything?
- Yes. If you receive life insurance from the college, you will need to go online to designate your beneficiary.
- What medical plans are available to PCC benefits-eligible employees?
- There are four medical plan options available to benefits-eligible employees at PCC. One plan is an HMO with Kaiser. The remaining three plans are with ODS and have different levels of deductible, co-payments, etc. Because of the difference in benefits provided, the premiums for each of the ODS plans (Plans 3, 6 and 8) vary with plan 3 having the highest premium and the highest level of coverage, and Plan 8 having the lowest premium and the lowest level of coverage. Check the plan comparison sheet included with this mailing for summaries of plan coverage.
- If I select a medical plan and it doesn’t work for me, can I change my mind later?
- Once a plan is selected, the only opportunity to make a plan change is at the next Open Enrollment. For that reason, we encourage employees to think through their family’s medical histories and past utilization to determine what makes sense. Included in Open Enrollment materials is information on “Choosing a Plan” which should help. If you still have concerns, Benefits Specialists are available to help you think through your selection. NOTE: HR/Benefits will not “recommend” plans to employees; what’s “best” varies based on individual circumstances and priorities.
- Are there opportunities outside of Open Enrollment to make insurance changes if my employment status, or the employment status of my spouse/partner, changes during the year?
- If there is a change to employment status during the plan year, you have 31 days from the time of losing the other insurance coverage to make a change to your PCC insurance. The timing is important, because beyond the 31-day window, no change can be made. If the window of opportunity is missed, you would have to wait until the next Open Enrollment. Contact HR/Benefits as soon as possible to ensure there’s no lapse in coverage.
- I’m trying to figure out which plan would be best for me and my family from a financial standpoint, but all of the terms associated with insurance confuse me. I don’t know how to figure out coinsurance, co-pays, deductibles and out-of-pocket maximums. Who can help me?
- Included in the Open Enrollment packets are three things that should be helpful. First, the PCC OPEN ENROLLMENT 2009 packet has a section called, “Choosing a Plan” that may be helpful. Secondly, we have included a glossary for benefits terminology that is used throughout the plan documents. The intent is to help employees’ understanding of industry terms. Finally, side-by-side plan comparisons show the benefits associated with each plan. If you’ still have questions, feel free to attend a benefits presentation or contact HR/Benefits to request assistance.
- Has the PCC “cap” (the college’s contribution towards the cost of insurance premiums) gone up this year? (Part-time Faculty see M6)
- Yes. The “caps” will increase, effective October 1, 2009, as noted here:
Tier Employee only Employee + spouse/partner Employee + child/children Empl + Spouse/Partner + Child/Children “Cap” $540 $815 $815 $975
- Is the “cap” for benefits-eligible Part-time Faculty still 50% of the “Employee Only” cap?
- No. This year the “cap” for benefits-eligible, part-time faculty is moving from 50% of the “employee only” cap to 60%. As a result the monthly “cap” for PT Faculty will be $324.
- Do I need to select a pharmacy plan?
- No. Pharmacy plans are included in the medical plans. PCC has selected ODS pharmacy plan A and Kaiser pharmacy plan 1.
- I’m on an ODS medical plan. Can I go to any pharmacy?
- You may go to any pharmacy, however, if you utilize a pharmacy that is affiliated with ODS you should save money. The pharmacies identified on the ODS website have negotiated discounts with ODS for prescriptions.
- Do both Kaiser and ODS have mail-order pharmacies?
- Yes. Both provide the convenience of receiving a 90-day supply of medications through the mail. Many pharmacies will only dispense 30 days of medication. With ODS mail order you may receive 90 days of a generic prescription for two co-pays. With the Kaiser mail order you may receive 90 days of generic and preferred brand name prescriptions for only two co-pays.
- Why did PCC decide to switch to ODS Vision Plan 1 from ODS Vision Plan 5?
- The Joint Committee on Insured Benefits (JCIB), a management and labor committee, felt Plan 5 was confusing in terms of how coverage was applied to individual items related to vision care. The feedback received from employees who responded to a recent benefits survey confirmed this. With Plan 1 the benefit is simply $250 per plan year (frames allowed every 2 years for adults).
- If I want to keep ODS vision and the college’s only ODS vision option has changed from ODS Plan 5 to ODS Plan 1, do I need to do anything at Open Enrollment? Or, will my coverage just roll to the new ODS vision plan if I don’t do anything?
- You will need to go into MyOEBB to select a new vision option. Your choices include ODS Vision Plan 1, Kaiser Vision (but only if you sign up for Kaiser medical), or no vision coverage. As previously noted, OEBB will not automatically transfer ODS Vision Plan members over to Vision Plan 1.
- If I got glasses or contacts under ODS Plan 5 last year, do I start out as a new patient under ODS Plan 1, eligible for glasses or contacts again?
- Both plans are with ODS, therefore, any benefit provided for services under Vision Plan 5 will count against Vision Plan 1. The frames are limited to once every two years for adults.
- I am interested in orthodontia for my kids. Is it true that we have orthodontia coverage under Willamette Dental again? Do the other plans also offer orthodontia?
- Orthodontia is available again through Willamette Dental. PCC’s plans with ODS Dental and Kaiser Dental do not provide orthodontia.
- What is the member’s responsibility for Willamette Dental’s (WD) orthodontic treatment?
- The member pays a total of $1,500 co-payment, plus $10 office visits, for their complete comprehensive orthodontic treatment. Even if their orthodontic treatment plan costs WD $6,000 to complete, the patient only pays $1,500, plus $10 office visits. At the patient’s initial orthodontic consultation appointment they will be charged $150 (for x-rays, molds and case presentation) and if the patient accepts the treatment plan, this fee is credited towards the $1,500 co-payment, requiring only $1,350 additional, plus $10 office visits.
- My family won’t use orthodontia, but we like Willamette Dental. Do I have to pay the premium for orthodontia?
- Willamette Dental made the decision to end their plans without orthodontia in favor of plans that include orthodontia. ODS and Kaiser both offer plans that don’t include orthodontia, so there are other options available. If price is of concern, be sure to check the premiums for all dental options before selecting a dental plan.
- My child was in the process of having braces when the college dropped orthodontia last year. I ended up paying a lot out of pocket as a result. Now that orthodontia is included in the Willamette Dental plan again, is there any consideration to repaying employees for their out-of-pocket expenses last year?”
- Members who are currently in treatment for orthodontia and paid Value-Added orthodontia fees for their services can be prorated to the $1,500 plan for the remainder of treatment after Oct 1st, if they are not “fully vested,” 24 months+ of treatment completed, as of Oct 1st. This does not necessarily mean that their entire treatment will be the $1,500 co-payment, however, eligible members will be credited based on their account status and treatment status for the remainder of their orthodontic treatment after Oct 1st. Members should contact WD Patient Accounts department at (800) 460-7644 or email@example.com to inquire about individual situations.
- If an employee who understood the Willamette Dental (WD) plan selected by the college last year didn’t have orthodontia, so started care with a private orthodontist, is there any benefit to them in getting back on WD or transitioning their child’s orthodontia care to WD?
- Per Willamette Dental, this truly depends on each member’s situation. For continuity of care and for the amount of expense that may have already been incurred, it may be in the member’s best interest to continue treatment with their current orthodontist. WD always likes to provide the worst-case scenario, which would be that the Willamette Dental Orthodontist does not agree with the treatment provided by the initial Orthodontist and may order the removal and re-banding of the members appliances.
- Members who are considering this option are encouraged to contact WD Patient Relations department at (800) 460-7644 to discuss their options and see if this option would be the best for their situation. WD wants to make the transition as smooth as possible for members, and the best way to do that is to have WD trained staff walk them through the process of pro-rating their accounts and explaining the available avenues for treatment.
- My dentist tells me that I need to have my teeth cleaned more than twice a year. ODS talked about providing cleanings four times a year. Is everybody eligible for additional cleanings under the ODS dental plan?
- Under the ODS dental plan, two groups of members are eligible for more than two cleanings in a plan year. Those groups are pregnant women in the third trimester of pregnancy (three cleanings) or diabetics (four cleanings). In order to take advantage of these additional cleanings, the employee must sign up for the Oral Health Total Health program once enrolled in ODS dental. Additional cleanings provided for members who are not in either of these two groups would not be covered by ODS dental insurance. NOTE: This is one potential use of Flexible Spending Accounts (FSAs), which pays for allowable health expenses using your pre-tax income.
- Willamette Dental assesses a member’s oral health when determining how many cleanings will be provided in a plan year. In some cases that could mean a single cleaning, in other cases more.
- How do I let ODS know that I want to be part of the dental program that allows up to four cleanings per year?
- Contact ODS Dental Customer service for more information on Oral Health Total Health. An application form is required. OEBB ODS Dental contact numbers are: Toll-free: 866-923-0410 and Local: 503-265-2910.
- Are part-time faculty eligible for dental insurance?
- No. Part-time faculty members are not eligible for dental insurance through PCC.
“OPTIONAL” BENEFITS THROUGH OEBB EFFECTIVE OCTOBER 1, 2009
- Life, AD&D and Long-Term Disability
- Why did PCC change providers for life insurance?
- As members of OEBB, if a benefit that we provide to our employees is available through OEBB, we are obligated to purchase that benefit through OEBB. Through a competitive process, OEBB selected The Standard Insurance Company as the provider for LTD, Life and AD&D insurance.
- UNUM guaranteed the issuance of $100K in life insurance for employees, $25,000 for spouse or partners, and $10,000 for children. What is the Standard Insurance Company’s level for guarantee issue?
- Guarantee issue for The Standard’s life insurance is $200,000 for employees, $30,000 for spouse or partners, and $10,000 for children. That means if you want to enroll in life insurance or increase your insurance coverage to $200,000 without going through an underwriting process (which requires an application and medical documentation), you may do so at this open enrollment ONLY.
- If the PCC provided life insurance has to move to OEBB/The Standard, does that mean that my voluntary coverage has to move, too? Can I keep my policy for self-paid insurance with UNUM?
- The optional insurance you purchase at group rates needs to be purchased through OEBB which has contracted with The Standard Insurance Company.
- I’ve previously gone through the underwriting process to get insurance above the guaranteed issue level. Will I have to do through that again?
- If you currently purchase optional life insurance above Standard’s guarantee issue ($200,000), enter the amount of your policy in MyOEBB. HR/Benefits will review a report of optional life insurance enrollment and verify those employees who are currently carrying that amount of insurance with UNUM. In these cases, no further underwriting review will be required as long as there is no lapse in coverage. Employees will be grandfathered.
- What do I have to do to transition my plans from UNUM to Standard?
- All you need to do is enter your current level of life insurance in the MyOEBB system. You will also need to designate a beneficiary. If that current level of life insurance is beyond The Standard’s guarantee issue of $200,000, HR/Benefits will verify that you had the same amount with UNUM, with no lapse in coverage.
- Will I need to complete new beneficiary forms with my life insurance transfer to The Standard?
- Yes, you will need to designate your beneficiary in MyOEBB. Hardcopy forms are not being used by The Standard. Please read the beneficiary guidelines on the next page. Note: It’s a good practice to revisit beneficiary forms on all accounts periodically as life circumstances change; i.e. marriage, divorce, etc.
- Are part-time faculty eligible for life, AD&D and LTD insurance?
- No. Part-time faculty members are not eligible for life, AD&D, nor LTD insurance through PCC.
AD&D: (Accidental Death & Dismemberment)
- What level of AD&D coverage does the college pay for me?
- The dollar value of the AD&D policy provided by PCC for eligible employees is equal to the life insurance policy amounts as designated in the bargaining agreements or handbooks.
- I currently have an open disability claim with UNUM? What will happen to that claim? Will I be moved over to The Standard in the middle of things?
- Disability claims that have been accepted by UNUM will continue to be administered by UNUM. There will be no transfer of claims.
- How does the Long-Term Disability coverage with The Standard compare with the benefit PCC got from UNUM?
- The Standard plan, in which PCC has enrolled, has the same 66 2/3% benefit after the same 90-day waiting period. The maximum monthly benefit is $8,000 with The Standard vs. the $10,000 maximum with UNUM. This change impacts only a handful of people at PCC.
If you have any additional, general questions they may be asked at the Open Enrollment meetings on August 25 at 3:00 or September 9 at 9:00 a.m. or emailed to HR/Benefits staff. (See enclosed material for Open Enrollment meeting locations.)
If you have individualized questions, please email HR/Benefits staff, as noted below.
|Alphabet covered:||HR/Benefits Specialist||Email address|
|A - J||Jonna Alexanderfirstname.lastname@example.org|
|K – R||Kim Searcyemail@example.com|
|S – Z||Paula Johnsonfirstname.lastname@example.org|