Your Benefit Board is sprinting toward the deadline for decisions on 2012 health benefits. Projections show renewal of current plan designs would put insurance reserves below recommended levels, so the Board is discussing a range of plan-design options with the goal of cutting costs while providing quality plans.

 

Additional-cost tier
One option would put more procedures on the Additional-cost Tier in the Providence Choice and Statewide plans. Procedures on this tier typically have alternatives that may provide equal or better outcomes with less cost and risk. Additional copays act as incentives for members to learn about the alternatives and discuss them with their providers, first.

 

Surcharges

Another option could require state employees to pay a monthly surcharge when they cover a spouse or domestic partner who could get insurance through the spouse’s or domestic partner’s employer. PEBB plans could also charge a monthly amount to members who use tobacco. Surcharges like these usually fall in the range of $25-$50 per month.

 

Prescription drugs

A different prescription plan design or adjustments to current plans could act as an incentive for members to switch from brand name drugs to generics.

 

Health-engagement model

HEM plans could offer a cost break for members who contract to assess their health risks and take actions to lower them. Providers would have access to member results; employers and plan sponsors wouldn’t. Financial breaks would be big enough to be incentives but not so big they would price other plans out of reach.

 

Cost share

Other options include changes to cost share. Examples are higher out-of-pocket maximums and implementation of deductibles.

 

Stay informed

The Board’s next regularly scheduled meeting is April 19.

 

Click here for meeting schedules, agendas, minutes, and live and recorded video streams.

Covering ineligible dependents in the PEBB program increases costs for all members and the state. PEBB’s 2011 Dependent Eligibility Verification (DEV) program ensures that only eligible dependents have coverage.

 

"Dependents" includes children, spouses and domestic partners.

 

PEBB has partnered with the Mercer benefits group to coordinate both steps of this two-step program.

 

During DEV Step 1, which ends April 21, all members who cover dependents must complete an online questionnaire to confirm their dependents are eligible. If you cover a dependent, click here to learn more on the Step 1 process. Click here to log in to the online questionnaire.

 

As part of Step 1, members can remove ineligible dependents. If the process indicates the dependents aren’t eligible but the member believes they are, the member should check "disagree."

 

In May, a subset of members will be selected to participate in Step 2. This group will include members who checked "disagree." These members will need to document their dependents’ eligibility.

 

Click here for questions and answers on the DEV program based on member input. Members with process questions should call Mercer at 1-866-614-1114, Monday-Friday, 9 a.m.-5 p.m., Pacific Time.

 

 

Kaiser Permanente also offers fitness discounts to members through its contract with the CHP group. Members can also save money on nearly everything active, healthy and fun. Click here for CHP offerings.

 

The federal government requires plans to provide such ID information or pay a heavy fine. Not providing the required information may cause an interruption in coverage. Members who have questions should contact their plan.

 

Click here for information from the Oregon Department of Revenue.