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February 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 February Agency Update (pdf) 
 
 

Advisory Committee Meeting - Jan. 18
PEBB staff met with the agency advisory committee Jan. 18. This group, which comprises representatives of the larger agencies, gave feedback on Open Enrollment and the transition to the new Statewide Plan. This update summarizes discussions and related actions.
Plan Transitions
Addresses and New ID Cards. Providence used the contact address in member records to mail ID cards. The plan received hundreds of returns without a forward. Any employee enrolled in the Statewide Plan who has not received an ID card should call Providence Customer Service at (800) 423-9470.  
Correcting Enrollment Errors. Employees may have elected a plan by mistake during Open Enrollment. They have 30 days from receipt of their first pay of the year to correct such an error. This window of opportunity has closed for OSPS-paid agency employees; agency payroll staff cannot correct such errors after Jan. 31. OUS benefits administrators may correct these errors through Feb. 28. Mid-February, PEBB will send an e-mail message to campus employees who moved from the Regence plan to Providence Choice, urging them make sure their enrollment represents their choice of plans.
 
New Formulary and Current Prescriptions. Providence mailed about 10,000 letters to members advising them on how the new formulary affects their current prescriptions. A majority of these letters communicated that
  • A specific brand drug is not on the formulary
  • The plan will cover the drug as a formulary brand only for 90 days
  • The member may want to contact the provider to discuss an effective alternative.
Other letters informed members that a current prescription for a non-FDA-approved drug would not be covered. About 10,000 plan members have lower co-pays for their prescriptions in the new formulary. Direct members who have concerns about their prescriptions and the new formulary to Providence Pharmacy Services (503) 574-7400.
 
Kaiser Co-pay Error. Because of an error in its system, Kaiser charged a number of members an incorrect co-pay in January. Kaiser has corrected the error and is mailing reimbursement to affected members.
 
Optional Life Medical History Statements. PEBB sent an e-mail to members who enrolled for new or increased amounts of optional life during Open Enrollment but who had not submitted a medical history statement. OSPS-paid employees must complete the process by Feb. 5; OUS-paid employees must do so by Feb. 28. Employees should contact The Standard if they have questions.
 

Communication Channels
 
Communicating with Plans. Do not contact the plans to assist members with coverage related to their medical, pharmacy or dental issues, including questions on coverage. Privacy rules allow the plans to discuss issues that touch on personal health information only with covered individuals or their personal representative. Members need to contact the plans directly.
 
Communicating with Civility. Staff members with the plans and with PEBB have the option to disengage from members who are abusive or use inappropriate or vulgar language. “Disengaging” includes hanging up the phone. State employees should understand the need to maintain civility, as many of their own jobs involve interactions with clients and customers in stressful situations.
 
Agency Access to PDB Support. PEBB is re-programming its phone scripts to list Option 1 last. Option 1 gives agency and university representatives access to support with the pebb.benefits system. For assistance with pebb.benefits, call (503) 373-1102 and press 1. Follow the prompts for other options.
 
Phone Schedule. Staffing resources require a new schedule for telephone assistance as shown below.  
 
Hours
Staff Available
Voice Message Available
8-9 a.m.
No
Yes
9 a.m.-noon
Yes
Yes
Noon-1 p.m.
No
Yes
1-5 p.m.
Yes
Yes

Member Communications
 
Resources for New Hires. Direct newly hired and newly eligible members to their own resource section on the Web: www.oregon.gov/DAS/PEBB/2010Benefits/NewHire/landingpage.shtml. The site gives them information and resources on eligibility, choosing benefits and enrolling in plans. It also includes a letter of welcome from PEBB Administrator Joan Kapowich.
 
February Newsletter: The February newsletter will be posted on the Web on Feb. 4. PEBB will send e-mail notice on its availability the evening of Feb. 3. Topics include a new Web site that helps members find quality care; members’ role in an important health survey; and upcoming Board discussions on opt out, family tiers and the rural subsidy.
 
 
Suggest topics for future editions of the Agency Update via e-mail to pebb.hottopics@state.or.us

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