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November 2009
Agency Update

 PEBB seeks to support agency and university administration of benefits. These periodic newsletters keep you updated on plans and changes. We look forward to your ideas and feedback.
Download the November Agency Update (pdf)
PDB Process Schedule (pdf)
2010 Medical Plan Correction Form (pdf)
Print the Annual Member Survey (pdf) or fill it out Online 

Post-open Enrollment Processes
Open Enrollment ended at midnight Oct. 31 for members and ends at midnight Nov. 15 for agencies. This Update covers enrollment processing going forward. See the attached for a summary schedule for PDB.
Open Enrollment Forms. Use the “Open Enrollment” QSC to process Open Enrollment forms starting Nov. 16. Agencies must not process Open Enrollment forms received or postmarked after Oct. 31. Use the new “Remedy Form” QSC to process Remedy Forms starting Nov. 16. 
Open Enrollment Corrections. OAR 101-020-0037 Correcting Enrollment and Processing Errors gives agencies authority to correct Open Enrollment processing errors after Open Enrollment but no later than 30 days from receipt of the first paycheck of the new plan year. PEBB will refer employees to the agency for these corrections. Based on paycheck schedules, the OSPS and BHS deadline is Jan. 31, and the university deadline is Feb. 28. The OAR does not recognize an employee’s failure to enroll as a correctible error.
Employees must submit an Open Enrollment form to request a correction, with “Open Enrollment Correction” printed at the top of the form. Exceptions:
  • Employees who enrolled in Providence Choice in error may request correction of the error using the form provided to them directly by PEBB on Nov 6. A copy of the form is attached.
  • Agencies may correct their processing errors using the original form as the source of correct data.

Open Enrollment Changes
OSPS Agencies: On Nov. 15, PEBB will send all 2010 enrollments to OSPS for the 12-31-2009 pay period. If agencies did not resolve prior rejections, these new enrollments will reject. This will require manual entries in P070.
OUS Agencies: On Nov. 15, PEBB will send OUS a special file with all transactions with an end date of 12-31-2009 and a begin date of 1-1-2010. 
Semi-independent Agencies: On Nov. 16, PEBB will send BHS an enrollment report listing all employees of semi-independent agencies who made changes during Open Enrollment.
2009 FSA Enrollments. Agencies must manually terminate 2009 FSAs processed during October, November and December. These accounts must terminate 12-31-2009. Through Nov. 15, use the cancellation button in the Open Section to process the termination; use the Open Enrollment QSC after that date. Members must enroll to have an FSA in 2010 FSA; there are no exceptions. Members must use separate forms to enroll for 2009 and 2010 even if enrolling only for one month in 2009. PEBB will continue to monitor FSA enrollments and will copy the agency on e-mails to members that request completion of 2010 FSA enrollment forms.
Unsaved Enrollments. If, during Open Enrollment, an agency made a midyear change after the member enrolled online and did not save the midyear change, the system will show the record as an “unsaved” member enrollment with a home page alert. Agencies must save all changes processed in the system as part of a midyear change or Open Enrollment change. PEBB is monitoring these home page alerts.
Default Enrollment. On November 15, all currently enrolled employees who did not enroll in a 2010 medical during Open Enrollment. PEBB will automatically enroll these employees in the employee-only tier of PEBB’s Statewide Plan. Their spouses, domestic partners and dependent children will be scheduled to lose medical coverage starting Jan. 1 and receive a COBRA notice. This will not affect coverage in dental and optional benefits.
Members may request that their dependents be added to 2010 coverage by completing the Remedy form, available on the Web Nov. 15. This form does not allow members to change from the Statewide Plan to another medical plan or to enroll in other benefits.
Plan Information. Plans use the 11-21-2009 weekly files to process enrollments and distribute ID cards to new plan members in December.
Dependent Certification. On Nov. 15, PEBB will terminate records of dependents not certified by members during Open Enrollment. The records will terminate effective 12-31-2009. These dependents will receive a COBRA notice.
Imputed Value. The imputed value report for 2010 is located in the Report page in the agency module.
IRS Tax Dependents. Members declaring tax dependent status for a domestic partner or domestic partner’s children must file the Domestic Partner for Tax Status form with their agency each year. Failure to file the form will change the employee’s payroll tax status by requiring tax on the imputed value of healthcare coverage.
Approval for Long Term Care Insurance. Agencies may process UnumProvident approvals for long term care insurance on receipt. The approval letter gives the coverage effective date, which is always the first of the month. Agencies must use the last day of the month prior to the effective date as the approval date. For example if the effective date is 11-1-2009, the agency must use 10-31-2009 as the approval date in the Pending Coverage page. This applies even for approvals provided during Open Enrollment. The system has built-in logic to apply the correct coverage effective date.
Approval for Employee Optional Life Insurance. Standard processes determinations in the Pending Approval page as soon as they make the determination. This sends the new enrollment to the OSPS and OUS daily file. If a new enrollment rejects in the OSPS Rejection page, the agency must review and correct P070 to reflect the new coverage.
Communications.  The November newsletter will be posted Nov. 16. PEBB will broadcast an e-mail that evening and during December and January.

Agency Resources

PEBB oregon.gov/das/pebb    
Benefit Questions: inquiries.pebb@state.or.us
Comments for the Board: pebb.connect@state.or.us   
(503) 373-1102, fax (503) 373-1654        
Agency Resources
User Access Form 
Agency, University & PEBB Contacts 
Current Medical Plans 
Mail-order Prescriptions    
Current Dental Plans 
Optional Plans Other Benefits