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PEBB October Newsletter
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Article Content
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| Enroll now for healthcare FSA |
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Open Enrollment is the time when you can sign up for a healthcare flexible spending account (FSA).
A healthcare FSA makes it easy for you to save on taxes. You specify pretax monthly deductions from your pay to be deposited to your account. You use those untaxed dollars to cover co-pays, deductibles and other valid healthcare expenses not paid by your plan.
The new FSA administrator, ASIFlex, will manage accounts in 2008. The company reviews claims, determines if they qualify and sends out reimbursements.
ASIFlex offers a new option – a healthcare FSA debit card. The card makes it even easier for you to use your account and save tax dollars.
When you enroll in the FSA program, ASIFlex will send you a debit-card application along with a claim form (if you decide not to use a card). After you send the completed application to ASIFlex, you should receive your card in about two weeks.
Using the FSA debit card
The debit card is convenient and easy to use. You can use the card to cover
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Co-pays and coinsurance payments at hospitals, vision centers, and medical and dental clinics
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Prescription co-pays at retail outlets with an IRS-approved inventory control system (currently Walgreens and Wal-Mart/Sam’s Club – more to come in 2008)
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Recurring orthodontic payments.
Easy claims process
If you use the standard claim process, ASIFlex offers
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Next-business-day processing
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Personal phone assistance
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Toll-free fax number
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E-mail notification
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Electronic funds transfer
It’s a good idea to keep all receipts for any healthcare FSA expense, whether you use the card or submit claims. They’re proof of valid pre-tax expenses if you ever have to show them to the IRS.
How to enroll
To participate in a healthcare FSA, you must enroll during Open Enrollment. If you have an account his year and want one in 2008, you must re-enroll. See the PEBB Web site for plan information and to enroll online.
Visit the ASIFlex Web site to see what expenses qualify, estimate your 2008 expenses and calculate your potential savings.
This is summary information only. See plan documents for details.
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| Open Enrollment checklist |
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Update your security questions
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Certify if dependents age 19 to 24 will be eligible for coverage
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Review your current enrollment
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Enroll or make changes to
Medical and dental plans
Flexible spending accounts
Optional life insurance (may require medical history)
Optional dependent life insurance
Long and short term disability insurance
Long term care insurance (enroll any time)
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Contact PEBB if you have questions
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| What's new for 2008 |
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Eligibility
If you cover a dependent age 19-24, you must certify the dependent's eligibility for coverage in 2008.
Seasonal and intermittent employees are no longer eligible to enroll in short term or long term disability insurance.
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Medical Plans
The Regence and Samaritan PPO plans offer new pilot programs to improve care for members with chronic conditions.
Hearing aids are covered at $4,000, with a 10 percent member coinsurance. The benefit renews every four years.
The materials allowance for glasses and contacts in the routine vision care benefit increases to $200.
Dental Plans
Kaiser Permanente offers a Traditional Dental Plan Design. Members pay a percentage coinsurance rather than set co-payment for services that require a payment.
Kaiser Permanente offers a new Part-time and Retiree Traditional Dental Plan design.
The maximum annual benefit in the Kaiser and ODS plans increases from $1,500 to $1,750 per person.
The maximum annual benefit in the Part-time and Retiree Plans increases from $1,000 to $1,250 per person.
The lifetime orthodontia benefit in the Kaiser and ODS plans increases from $1,000 to $1,500 per person.
Routine dental cleaning is covered once per year, or moreif your dentist determines they are indicated.
X-rays are covered on an age-based schedule.
Replacement crowns and similar attachments are covered every seven years.
Dental implants are covered at a member coinsurance rate of 50 percent in the Kaiser and ODS plans and 75 percent in the Willamette Dental plan.
Member coinsurance for crowns decreases from 50 percent to 25 percent in the Kaiser and ODS plans.
Optional Benefits
Long and short term disability benefits have enhanced features, with no premium increase, for eligible employees.
Optional life insurance premium rates decrease.
Flexible Spending Accounts
Healthcare FSA debit cards are available through ASIFlex, the new FSA third-party administrator, along with enhanced online support for claims processing.
Travel Assistance Benefit
A free travel benefit provides assistance to you or your dependents if you become ill while traveling 100 or more miles from home. It’s available for all eligible employees enrolled in the employee basic life insurance.
Find more information about allo these topics on the PEBB Web site.
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| Meet your Benefit Board |
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Your Benefit Board is unique in three important ways:
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First, these people care about you and know how important healthcare is to you and your family.
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Second, it’s a labor-management group appointed by the governor and approved by the senate. Four members represent employees covered by collective bargaining agreements. Four represente management and the state as the employer. This means the Board considers your and your employer’s interests in every decision.
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Third, your Board designs your medical plans based on a long-term Vision of better healthcare for you and your family.
This hard-working group invests as much effort on improving the care and services you get from your plans as they do on negotiating premiums. Their goal is to use the best scientific evidence to increase the quality of your care while holding down costs.
Example: Evidence-based prescription drug plan
As prescription drug costs continue to rise, your Board looked at expert studies on classes of drugs to treat such common conditions as high cholesterol. Studies show that most drugs in each class are equally effective. Yet some brand-name drugs in these classes cost two or three times as much without showing better outcomes.
Based on the evidence, the Board designed a new prescription drug benefit. In this design
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At least one drug in each of these classes is available at the lowest cost.
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You and your provider work together to choose the best treatment option for you.
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If you must use a higher-cost drug, your plan offers an exception process.
Connect with your Board
You are welcome to attend Board meetings, usually held on the third Tuesday of each month. The agenda includes a public comment period for you to share your input. For schedules, agendas and minute, select "Board" on the PEBB Web site.
If you can’t take time or travel to attend Board meetings, you can send an e-mail to the Board at pebb.connect@state.or.us. They want to hear from you.
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Board Members
Diane Lovell, chair, healthcare worker representative for American Federation of State, County and Municipal Employees. Represents employees covered by second-largest union.
Sue Nelson, vice chair, interim executive director, Board of Nursing. Represents state as employer.
Peter Callero, Western Oregon University sociology professor. Represents non-management representable employees not covered by the largest or second-largest union.
Rocky King, administrator, Office of Private Health Partnerships and Oregon Medical Insurance Pool. Represents state as employer.
Paul McKenna, research director, Service Employees International Union Local 503. Represents employees covered by largest union.
Rich Peppers, assistant director, Service Employees International Union Local 503. Represents employees covered by largest union.
Jeanene Smith, M.D., administrator, Oregon Health Policy and Research. Holds position designated for OHPR.
Bret West, administrator, Deparment of Administrative Services Operations Division. Holds position designated for DAS.
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| Depression: common, treatable |
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Depression is a common medical condition. About 25 percent of the U.S. population will have this illness at some time in their life.
On Oct. 11, Cascade Centers, your EAP provider, is holding a day of outreach for all members who may be dealing with depression in their lives.
Call the EAP on Oct. 11 for a private, completely confidential screening or to talk with a trained professional about your or a loved one’s mental health.
The good news is that depression is highly treatable. Talk therapy and medications, alone and in combination, help many people recover from depression.
The bad news is that, without help, some people with depression may become so ill they consider and even attempt suicide.
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Remember: you can call your EAP at any time for help with home, work or life issues. You could save a life.
(800) 433-2320
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| Calling some PEBB members |
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You may be one of the 2,000 employees selected at random to participate in PEBB’s second member health survey. The results help your Benefit Board create or modify wellness programs and other activities to meet your needs. The Board values your opnions and participation.
Schedule at your convenience
If you get a call, you will be able to schedule the 15-minute survey interview at your convenience to respond to questions about:
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Your health risks
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PEBB wellness programs
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Worksite health and wellness activities
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Your experience with the healthcare system.
Your information is confidential
All responses are completely confidential. The independent survey firm will use member phone numbers for this survey, only. It will securely dispose of all individual information when the survey is completed. The firm will report results only in the aggregate. No person can be identified by any reported data.
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| Get a free flu shot |
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Your Benefit Board is sponsoring free flu shot clinics in worksites throughout the state this fall. If you’re enrolled ina PEBB medical plan, you can sign up for any one of the clinics.
The clinic schedules are updated weekly on the PEBB Web site. New clinics will be posted as they are scheduled.
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| Sign up for a health screening |
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Now through December, you can sign up for a free worksite health screening. Check the schedule on the PEBB Web site to find a location near you, and call for an appointment.
It’s free, quick and easy. And it tells you some important numbers – your blood pressure, your cholesterol and blood sugar levels, and your body mass index.
A fasting screening gives the most-detailed results. See the Web site for details.
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