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Public Employees' Benefit Board

June 2010
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Board Moves Forward on 2011 Plans
compass
 
The Benefit Board is moving forward on contract renewals with current health plans for the 2011 plan year. It has also begun the process to request proposals for 2012 medical plans.
 
Renewals for 2011
 
The renewal process moves current health-plan contracts forward for 2011. It does not establish new contracts.
For medical plans, the Board currently contracts with
  • Providence Health Plans, which administers the Providence Choice and PEBB Statewide plans
  • Kaiser Permanente, which insures the Kaiser plan
The Board also contracts with ODS, Kaiser and Willamette Dental for dental plans, and VSP for routine vision coverage.
 
Results of contract renewals will determine premium rates and plan designs for the 2011 plan year. Plan design means what services are covered and the level of coverage paid by the plan and the member.
 
Proposals for 2012
 
When it issues a request for proposals this fall, the Board will be looking for proposals that align with elements of the Board’s vision:
  • Innovative ways to deliver evidence-based care
  • Improved quality of care
  • Promotion of health and wellness
  • Incentives for the right care at the right time and place
  • Access to useful data
  • Affordable benefits
The Board last selected medical plans through an RFP for plans beginning 2006. In 2009, the Board moved to self-insurance for its largest medical plan and selected Providence to administer the plan through 2011.

Changes in Coverage for Adult Children
 
 
Beginning with the next benefit plan year, members will be able to cover children to age 26 in their health plans. Changes to eligibility rules will align PEBB plans with this requirement of new federal law.
  • The term "child" will apply to any son, daughter, stepson, stepdaughter, foster child, adopted child, or child for whom a member is legally obligated.
  • Eligibility will not depend on marital, student, employment, residency or tax status.
Members will be able to enroll a child during Open Enrollment for coverage beginning Jan. 1, 2011. They will be able to continue covering the child through the end of the year in which the child becomes 26.
 
Beginning June 1 and through the rest of this year, PEBB will not drop coverage for children who are currently enrolled as of that date and who would otherwise lose coverage.
 
Materials on PEBB’s website responds to commonly asked questions on these changes.

Early Retiree Reinsurance Program
 
The Early Retiree Reinsurance program sets up a federal fund to reimburse employers for a portion of large claims incurred by retirees at least age 55 and not eligible for Medicare. PEBB staff is looking into requirements to apply for a portion of the $5 billion pool of funds.

Get the Facts on Alcohol Use
 
For many people, the facts about alcoholism aren’t clear. What is alcoholism, exactly? How does it differ from alcohol abuse? When should someone seek help for a problem related to drinking?
 
Get the facts from your employee assistance program. Their website explains alcoholism and alcohol abuse, symptoms, how to seek help, and treatments.
 
If you’re struggling with a work or personal issue, free confidential help is just a call away. Call the EAP Line. 1-800-433-2320

Quitting: In their own words
quit smoking
 
PEBB members talk about how Quit Coaches helped them quit tobacco.
 
"Some are sweet and soft, some are hard and abrasive. But the combination made it happen."
"I was skeptical when I first called you guys. I thought it was going to be someone telling me not to chew, or like I would get someone at the end of their shift who didn’t really want to talk to me. But then I called, and I really felt like I could talk to you if I needed help."
"Even when I had troubles with the pharmacy, someone from the Support Line checked up on me. I can tell that you care if I quit."
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
If you use tobacco, your Benefit Board gives you access to a complete support program through Free & Clear© to help you quit.

Lose Weight Your Way
 
When you join Weight Watchers©, you can choose the way you want to lose – a group in your community, worksite meetings, or online.
 
Members offer glowing comments for the at-work option.
 
 "One of the surprising effects is the change in office behavior. The whole atmosphere has changed."
"It took ALL excuses away. It was convenient and didn’t cost a thing."
"The women who come to our office from Weight Watchers are extremely supportive and thoughtful. They make it easy. I actually like working here more than I used to."
  
PEBB plans cover Weight Watchers at no cost for eligible employees. Eligible employees are those who are enrolled in a PEBB medical plan.
 
There’s no better time to get on the path to a healthy lifestyle! Select the offering that suits your lifestyle and preference.

Make Sure You Get Quality Care
stethoscope
 
Quality health care happens when people take an active role in their own care. Here are four ways to be informed and involved in your care.
  1. Ask questions. When you visit your doctor, bring a list of questions or concerns. If you don’t understand something or want more information, ask your providers. They will appreciate your interest in your own care.
  2. Be involved in making decisions. When your provider recommends treatment, ask questions so you make an informed decision.
  3. Learn more. Ask questions about your condition and ways to stay healthy. It’s your health; you need to take care of it, too!
  4. Do your part to stay healthy. Stay up to date on tests and screenings. Manage your condition, and follow your treatment plan. Eat healthy foods, stay active and keep a healthy weight.
Source: Partner for Quality Care, Oregon Health Care Quality Corporation

Resources
 
PEBB    
(503) 373-1102, fax (503) 373-1654      
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