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Public Employees' Benefit Board

The PEBB Connection for November 2012
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Download and print a copy to share with your family.  
   

 
Nov. 15 - the Great American Smoke Out
 
With Tobacco-Free State Properties on the way, Nov. 15  may be the best day ever for quitting tobacco.

Many state agency properties will be tobacco free in the New Year, with most scheduled to be tobacco free by July. It’s one more reason why it’s great to be a quitter on Nov. 15 and any other day.

Do you use tobacco?

Try not using just this one day. The feeling of freedom from and power over tobacco may be just the motivation you need to quit for life.

Do you love someone who uses tobacco?

Use this day to show extra love and empathy so they know they can count on your long-term support to quit for life.

Do you use the power of social media?

Get your network of friends on board with badges and buttons from the American Cancer Society Facebook page, and share this info-graphic that shows how each quitter helps us all.

Did you know your benefits can help to quit for life?

Quit for Life© is a proven, evidence-based tobacco cessation program that offers:
  • Unlimited online and phone support
  • Nicotine replacement therapy (patch or gum)
  • Prescription medications that help with quitting
It’s a covered benefit in your PEBB health plan for you, your spouse/partner, and your dependents age 18 and older. Any day is the best day ever to call 1-866-QUIT-4-LIFE (784-8454).
A Member's Perspective
Rebecca Mapes of DHS knows the impact Tobacco-Free State
Properties will have on the social group of smokers at her building. “The ban will disband that, and that’s another reason for me to quit.” Rebecca’s quit date is Jan. 1, 2013. More about Rebecca...
 
Vaccines: We all need to be protected
 

The Portland Metro area and Southwest Washington are reporting the highest number of confirmed cases of whooping cough in more than half a century. We asked Providence Health Express’s Lindsay Klepps about whooping cough and Pertussis vaccination (click here for a video interview with Lindsey).
 
What is whooping cough?
Whooping cough is caused by Pertussis bacteria. This highly contagious disease causes severe coughing spells that can lead to breathing difficulties, vomiting, and inability to sleep.

The infection usually starts with cold-like symptoms - a mild cough or fever. But unlike the common cold, pertussis can initiate series of violent and rapid coughing fits that continue for weeks. Infants may have little or no cough, but instead experience life-threatening apnea - periods when they stop breathing.
Who gets pertussis?
So far in this year, more than 600 cases have been reported in Oregon, with the highest rates in two age groups:
  • Infants under age 1 year, and
  • Children age 10-13 years.
 
Do adults need the vaccine?
Adults who haven’t had pertussis or been vaccinated against it risk infection, complications and spreading the infection.

Some vaccines require a booster shot to keep up your immunity. The Tdap vaccine does that for tetanus and diphtheria as well as pertussis. It’s recommended for people over age19 as a booster.
Who should get the Tdap pertussis vaccination?

All pregnant women

Caregivers in regular contact with small children, such as parents, grandparents and baby sitters

Adults who need a tetanus booster, because the combined Tdap vaccine used in this shot also boosts immunity to pertussis and diphtheria

 

How do I know if I need one?

If you’re uncertain about your last immunization date, know that Tdap is safe to receive no matter when you last received the pertussis vaccine.

Click here for the Tdap vaccine information statement from the national Centers for Disease Control. 

 
Need a booster shot? Providence Health eXpress can help
 
Providence Health eXpress providers will give free Pertussis vaccinations by appointment on Wednesday, Dec. 5, 9 a.m.-1 p.m. at Providence Health eXpress in Room 27 of the Labor and Industries Building on the Capitol Mall in Salem.  Vaccinations are free to PEBB members in the Kaiser plan as well as the PEBB Statewide and Providence Choice plans.
 
To schedule your Tdap vaccination call: 1-855-229-6460.
 
 
You can fix enrollment errors now

The last two months of the year give you a good window of time to look over your benefit statement and fix the following types of enrollment errors before deductions begin in 2013:

  • You enrolled in a health plan (including Opt Out) that’s not right for you or your family
  • You didn’t add a spouse/partner or dependent who’s eligible for coverage
  • You or your spouse/partner has incorrect status on current tobacco use (tobacco users have a $25-per-person monthly deduction)
  • Your spouse/partner takes group health coverage available from another employer (waiving this coverage means a $50 monthly deduction)
  • You meant to but didn’t enroll in or change your optional life, disability or AD&D insurance

You can also correct your or your spouse/partner’s status on tobacco use to make sure you have the right premium rates for optional life insurance (tobacco use in the previous 12 months means higher premium rates - see the rates here).

If you don’t catch these types of enrollment errors before the new plan year, you’ll have the opportunity to fix them them 30 days from your first 2013 premium deduction.  However, if your health already plan paid claims in 2013 before you make the correction, you’ll be responsible for those payments.

If you haven’t printed your 2013 benefit statement, you can access it by logging in here. PEBB will also send a copy to the address in your benefit record in December . You can correct or update the address in your benefit record at any time.

Complete this form to correct enrollment errors, and submit it to your payroll or benefits office by Dec. 31.

 
 
An FSA may help with next year's taxes
Here’s a tax-saving opportunity you may have missed when you enrolled during Open Enrollment – a health-care flexible spending account (FSA).
 
These accounts let you front-load up to $2,500 in untaxed pay for expenses like:
  • Deductibles – dollars you have to pay before your health plan begins to pick up its share of costs for covered services
  • Coinsurance and copayments – your part of the cost for health care services and prescriptions throughout the year
  • Costs for services and goods above or outside plan coverage – think braces, bunionectomy, non-formulary prescriptions drugs and progressive lenses

FSAs are governed by IRS rules. One important rule is that you need to establish your account before the start of the tax year – January 1.

Click here to learn more about health-care FSAs from ASIFlex, the FSA administrator for PEBB.

If a health-care FSA looks like a good fit for your 2013 finances, complete this form and submit it to PEBB no later than Dec. 31.

 
Connect with a primary care provider - for better health, better care and lower costs
No matter which health plan you have in 2013, you’ll have better health, better care and lower costs when you connect with a primary care provider.
 
These qualified medical practitioners and clinics guide your care, make referrals when needed, follow through with you on treatments and keep track of your care.
 
PEBB health plans are designed to give you lower costs – along with better health and better care – when you see your primary care provider.
 
In Providence Choice, this provider is called a Medical Home. You choose a medical home (see this list) and have low copays when you access care from that provider.
 
In PEBB Statewide, you have lower costs when you get primary care services from a state-recognized Patient-centered Primary Care Home that’s in the plan’s network (see this list). Your coinsurance for services from a Primary Care Home drops by 5% (from 15% to 10% in the full-time plan, and 20% to 15% in the part-time plan).
 
Kaiser plans are inherently designed to have primary care providers in the lead on your Kaiser care team to ensure the quality of your care and to keep costs down.
 
Call your plan’s customer service or member services phone line if you need assistance in locating or choosing a Medical home, Primary Care Home or Primary Care Provider. The number is listed on your health plan ID card. Click here for a list of plan customer service contacts.