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April 2010
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 April Agency Update (pdf) 

Federal Legislation
Health Reform. Federal legislation enacted in March will affect group health plans, including PEBB’s. While the act sketches out broad outlines, regulations will fill in most of the details. For example, it’s known that the act requires plans to extend coverage for dependents to age 26; but timelines and specific effects on PEBB rules are still being clarified. Administration and staff will communicate details to members and agencies as they become available.
COBRA. Look for guidance in the next few weeks on the Temporary Extension Act, which extends the COBRA subsidy eligibility period under ARRA to March 31, 2010. It also provides new rights for employees who lost eligibility for coverage because their hours were reduced and who then lost their jobs through involuntarily termination. Agencies may need to search their records to ensure all eligible individuals receive notice. Details to come.


Client Services
The client services group continues to be short-staffed. The group appreciates your patience as it works triage, and offers a few reminders:
  • Use PEBB’s main phone number – 503-373-1102 – to reach client services, rather than calling a staff member individually. Some staff members have taken on additional duties temporarily and may not be able to provide immediate assistance.
  • Send e-mail on system issues to PDB Administration and eligibility issues to PEBB Inquiries; this avoids redundant record-keeping, research and responses, all of which slow down resolution.
  • Continue to refer members with questions or concerns on coverage to their plans; this protects the privacy and security of their personal health information and reduces agencies’ HIPAA risks.

April Newsletter.  The April newsletter will be posted to the Web April 5, with notice distributed that evening. Content advises members on using their formulary to avoid surprises at the pharmacy; apprises them of PEBB attention to federal legislation; highlights online wellness resources in their plan; and reminds them about enrolling in long-term care coverage at any time. Link to newsletters: www.oregon.gov/DAS/PEBB/publications.shtml.
New Hire Resources.  Staff is finalizing a video for new hires that gives them information on available plans and on how to enroll. It should be on PEBB’s Web site the second week in April.

Following is a staff summary of issues the Board addressed in its March meeting.
Opt Out. For the 2011 plan year, the Board made the following decisions on opt out:
  • Continue to allow medical opt out with proof of other coverage
  • Allow combined medical and dental opt out, with proof of other coverage required for both
  • Adjust the opt-out split between PEBB reserves and employees who opt out of both to 50-50
  • Require those who opt out of medical but not dental to enroll in at least employee-only dental
  • Allow members with tricare to opt out with proof of other coverage
  • Require employees who opt out to pay the premium for $5,000 in basic life insurance coverage
Staff will meet with central payroll to work through details on applying these changes.
Rural Subsidy. For 2011, the Board voted to extend its policy on an implied subsidy for the current designated rural counties, with the exception of Deschutes and Jackson counties, which both contain a metropolitan statistical area. Discussions touched on rural-subsidy impacts on the following:
  • Contracting for a statewide provider network
  • The ability to demand and measure health-care quality
  • Ensuring access to primary care
Coverage Tiers. The Board moved to retain the current weighting of coverage tiers for 2011.
Employee Assistance Program. The Board accepted the recommendation of its proposal-review committee to continue Cascade Centers as the EAP provider under PEBB contract.  

Agency Resources

Suggest topics for future editions of the Agency Update via e-mail to pebb.hottopics@state.or.us. 
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        
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