2009-2010 Medical Benefits
- Eligible employees - full-time and part-time:
- Faculty, Classified, Managerial, Academic Professionals, and Confidentials.
PCC offers four medical plans to choose from including 3 preferred provider organization (PPO) plans, and a health maintenance organization (HMO). All plans include prescription drug coverage. There is no pre-existing condition waiting period for new employees or eligible dependents, including domestic partners, with exception of some transplant services. Employees choosing to opt out of medical, vision and dental coverage receive up to $200 cash back per month (Part-time Faculty are not eligible for the opt out incentive).
New employees who are benefits eligible must enroll in their choice of medical plan on the first of the month following an initial 30-day waiting period, except for part-time faculty. Part-time faculty must meet the minimum qualifications for eligibility, then benefits will be effective October 1st each year. If the benefits eligible employee does not make a benefits election, the PCC default plan (ODS plan 8) will be assigned. Changes to medical insurance elections can be made during the fall open enrollment period of each year. These changes become effective on October 1st of each year. Certain “qualified status changes” permit enrollment in medical plans mid-year. Consult with a benefits specialist for details.
The four medical plans available to PCC employees with benefits and their families are listed and compared below. The column headings are links to more detailed information. To receive more information on any or all of these plans, please fill out this Benefit Materials Request form. To enroll, please use the Benefits Enrollment form or the OEBB online enrollment system. This information is effective October 1, 2009.
Cost of Medical Plans
Here are the monthly premium costs for the plans. For amount PCC pays toward these plans, please see the College Contributions page.
| OEBB Plan | Employee Only | Employee + Spouse |
Employee + Child(ren) |
Family | |
|---|---|---|---|---|---|
| Medical-Pharmacy | |||||
| ODS Plan 3 w/Pharmacy Plan A | $470.87 | $1,035.92 | $894.65 | $1,459.69 | |
| ODS Plan 6 w/Pharmacy Plan A | $409.16 | $900.17 | $777.42 | $1,268.40 | |
| ODS Plan 8 w/Pharmacy Plan A | $343.12 | $754.88 | $651.92 | $1,063.66 | |
| Kaiser Plan 1 with Pharmacy Plan 1 | $397.14 | $873.72 | $754.58 | $1,231.15 | |
Medical Plan Comparison Chart
Effective October 1, 2009 through September 30, 2010
Here are the costs that you pay, depending on the plan you choose. For plan summaries, click on the medical plan name in the column header.
| Plan Option | ODS Medical Plan 3 PPO |
ODS Medical
Plan 6 PPO |
ODS Medical Plan 8 PPO |
Kaiser
Medical Plan 1 HMO |
|
|---|---|---|---|---|---|
| Lifetime Benefit Maximum |
|||||
| In Network | $2,000,000 | $2,000,000 | $2,000,000 | unlimited | |
| Out of Network | $2,000,000 | $2,000,000 | $2,000,000 | --- | |
| Preventative Services (per schedule) |
|||||
| In Network (no deductible) | 0% | 0% | 0% | 0% | |
| Out of Network | 30% | 40% | 40% | --- | |
| Deductible (Individual/Family) |
|||||
| In Network/Out of Network | $100/$300 | $300/$900 | $1000/$3000 | None | |
| Annual Coinsurance Maximum (Individual/Family) | |||||
| In Network | $500 | $1500 | $2000 | $1000 | |
| Out of Network | $1500 | $3000 | $4000 | --- | |
| Coinsurance | |||||
| In Network | 10% | 20% | 20% | 0% | |
| Out of Network | 30% | 40% | 40% | --- | |
| Office Visit Copay | |||||
| In Network | $10 | $20 | 20% | $10 | |
| Out of Network | 30% | 40% | 40% | --- | |
| Hospital Copay | |||||
| In Network | 10% | 20% | 20% | $100 co-pay per day; $500 co-pay max per stay. | |
| Out of Network | 30% | 40% | 40% | --- | |
| Emergency Room Copay | |||||
| In Network/Out of Network |
$100 per visit then $10% (copay waived if admitted) |
$100 per visit then $20% (copay waived if admitted) |
$100 per visit then $20% (copay waived if admitted) |
$100 | |
| Alternative Care (combined max. of $2,500/yr) Acupuncture/Chiropractic/Naturopathic |
|||||
| In Network | 10% | 20% | 20% | $10 | |
| Out of Network | 30% | 40% | 40% | $10 (In network massage therapy: $25 co-pay, limit of 12 visits/year) | |
| Supplies, Appliances and Durable Medical Equipment (subject to limitations) | |||||
| In Network | 10% | 20% | 20% | 20% | |
| Out of Network | 30% | 40% | 40% | --- | |
Pharmacy Plans Comparison Chart (tied to medical plan)
For plan summaries, click on the pharmacy plan name in the column header.
| Plan Option | ODS Pharmacy Option A (tied to all ODS medical plans) | Kaiser Pharmacy Plan 1 | |
|---|---|---|---|
| Deductible | None | None | |
| Annual Copay/Coinsurance Maximum | $1000 | $1000 | |
| Retail | |||
| Generic | $5 | $5 | |
| Preferred | 20% | $15 | |
| Non-Preferred | 50% | N/A | |
| Generic | $10 | $10 | |
| Preferred | 20% | $30 | |
| Non Preferred | 50% | N/A | |