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Overview of OEBB
The Oregon Educators Benefit Board (OEBB) was created to provide health, dental, vision and other benefits for most of Oregon’s school district employees.
The Board was created with the signing of 2007 Senate Bill 426 (SB 426) on March 21. Because of the concern about the state of the health care and the skyrocketing premiums being charged to school districts in Oregon, OEBB was considered an emergency and the Board became effective from the moment the bill was signed.
OEBB changes the way K-12 grade school districts, education service districts (ESDs), community colleges and some charter schools provide benefits to employees. School districts and ESDs were purchasing plans for employees independently, through one of two health plan trusts or through the Oregon School Employees Association. Under OEBB’s authority, most of these districts now pool employees together to purchase healthcare and other benefits.
OEBB designed, contracted and will manage the benefit plans the Board put in place on October 1, 2008.
Currently, about 150,000 people receive their health benefits through OEBB. When all districts have entered the program -- all participating school districts must participate in the pool by October 2010 -- it is expected that OEBB will cover about 170,000 people. 

Governor Theodore Kulongoski appointed the member of the 10-member Board on May 25, 2007; all of whom were confirmed by the Senate on June 13, 2007. Board members serve terms of between one and four years.

Overview of OEBB: Inception to Current
Senate Bill 426 (2007) created the Oregon Educators Benefit Board (OEBB). The Board was charged with designing, implementing and administering a benefits program for employees in Oregon’s school, education service and community college districts that provides high-quality benefits at the lowest possible cost to districts and the taxpayers of Oregon.
OEBB changes the way K-12 school districts, education service districts (ESDs) and community colleges provide benefits to employees. These educational entities purchase plans for employees independently, through one of two health plan trusts or through brokered arrangements. Under OEBB, most of these entities now pool employees together to purchase healthcare and other benefits.
OEBB provides nine medical plans, four pharmacy options, eight dental plans and five vision plans to more than 200 educational entities and their employees.  The plan designs and benefit components support the Board’s vision of providing high-quality benefits to educators at the lowest possible cost.
The OEBB benefits program was implemented on October 1, 2008, as required.

Guiding Principles, Processes and Roles
Legislation forming the Oregon Educators Benefit Board passed on March 21, 2007. The 10-member Board was appointed by the Governor and confirmed by the Senate. The group became a governing body on July 2, 2007, and held its first official Board meeting on July 10, 2007.
Given the Board’s tight timeline for designing and implementing a benefits program for Oregon school and education service district employees, the Board decided to meet twice per month through May 2008. This schedule allowed the Board to accomplish its goals and meet the October 1, 2008, implementation date for the program.

Administrative Model
The OEBB Administration Model
The Administrative Workgroup considered three different administrative models.
These included continuing administering benefits the same as it had been done in the past on a district-by-district basis, contract with a third party administrator (TPA), or administer benefits internally using OEBB resources and staff. After careful consideration, the Workgroup recommended and the Board voted to administer benefits internally.
OEBB created its Administration Model by conducting surveys with school district business personnel and studying the current administrative environment educational entities were experiencing with their benefit plans. OEBB received valuable feedback that identified challenges districts now faced in several areas and offered suggestions of how to improve the current level of service that was being provided by insurance brokers, insurance carriers and Trusts. Based on the information gathered, OEBB identified the following three areas that could be improved:
  1. Customer Service
  2. Manual Enrollment and Eligibility (paper-based)
  3. Invoicing and Reconciliation
These areas were identified as opportunities for OEBB to develop a consistent and standardized model of efficient administration across all demographics while reducing the amount of time spent performing multiple tasks related to the administration of benefits.
Implementing the OEBB Administration Model
Past Practice
  1. Enrollment was a manual/paper-based system for more than 85 percent of the districts and educational entities
  2. Eligibility was a manual/paper-based process
  3. Customer Service lacked timely communications and training resources for the educational entities staff to correct or respond to questions or issues. Premium Collection was a paper-based system and adequate tools were not provided for reconciliation and reporting
Current Practice, since OEBB Implementation
  1. Employees can now enroll online and their elections are fed back to the Educational Entity and the carriers they enroll with
  2. Educational Entities can now enter and manage their employees’ eligibility online in real-time with multiple reporting tools at their disposal and their data is fed to carriers electronically on a weekly basis
  3. Conducted statewide system training and presented plan information to every entity in Oregon
  4. An automated electronic payment system has been implemented along with electronic reporting for reconciling invoices
Enrollment Numbers -- OEBB’s First Year
OEBB originally anticipated enrolling 65,000 members (22,000 district employees and their eligible dependents) the first year of a three-year implementation period (October 1, 2008, 2009 and 2010).
During the 2008 open enrollment period, 145,645 members enrolled for OEBB benefits that began on October 1, 2008, including 61,657 subscribers and 83,988 dependents.
OEBB currently serves 192 school districts, 17 education service districts and 14 community colleges.
OEBB Call Volume
OEBB customer service team received 14,007 calls during the initial enrollment period, from August 15 through September 15, 2008, and averaged 667 calls per day. The average wait time for a caller to receive a live OEBB customer service representative was just over a minute and a half.
Since open enrollment ended on September 15, the overall average call volume is 503 calls per week and the average wait time is 30 seconds.

Challenges Encountered
Project scope and timeline
Implementing a program the size and scope of the Oregon Educators Benefit Board (OEBB) benefits program typically takes at least two years. The implementation timeline depended on the availability and expertise of staff, consultants and board members. The abbreviated timeline required rigorous planning and an orchestrated coordination of efforts.
The magnitude of enrollment by entities and members
OEBB originally anticipated enrolling 65,000 members (22,000 district employees and their eligible dependents) the first year of a three-year implementation period (October 1, 2008, 2009 and 2010). The mandated movement to the OEBB benefits program aligned with the end of the collective bargaining agreements. The intent was that the statewide pool would grow by about a third which represented a manageable growth rate for the OEBB pool. However, the OEBB
Board and staff planned for all eventualities in terms of enrollment.
In May 2008 the Oregon School Boards Association (OSBA) announced it would no longer offer medical and dental benefits to districts based on the projected double-digit rate increases for the 2008-09 plan year. Effective October 1, 2008, OEBB enrolled 145,645 members (61,657 employees and their eligible dependents) from over 200 educational entities including 192 school districts, 17 education service districts and 14 community colleges. OEBB was able to meet most of the districts’ and employees’ needs in all areas including communication of options available, timely assistance via the telephone or e-mail and access to an online enrollment system.
The size and geographic disbursement of the larger than anticipated enrollment stretched staff and carriers to their limits. OEBB staff and carriers spent a significant amount of time during May and June 2008 traveling to districts throughout the state to explain the new program and plan offerings available to districts to select and offer to their employees. OEBB staff and carriers were again on the road visiting more than 100 districts and entities during the statewide open enrollment period (August and September) to explain benefit options and online enrollment to new OEBB members and staff of educational entities. More than 98 percent of the employees enrolled for benefits online during the month-long enrollment period.
OEBB staff will began working with districts and carrier representatives in late January 2009 to schedule informational and training sessions for the next plan selection and open enrollment periods. The plan selection period for educational entities is from May 1 through 31, 2009, and the open enrollment period for members is from August 15 through September 15. OEBB will use information and comments received during and following the enrollment period to improve the online enrollment system and communication materials to better meet the needs of continuing members as well as new members in 2009.
Access to care in eastern Oregon
Access to providers throughout the state of Oregon was one of the key factors considered during selection of the carriers that would provide benefits under the OEBB program. During the carrier selection process for the medical, pharmacy, dental and vision plans, the Board compared provider networks in Oregon. The carriers selected offered strong networks and expanded the availability of a health maintenance organization-type of plan into areas of Oregon that traditionally have not had access to the benefit levels offered by such a plan.
Selected carriers were aware that while their current networks in Oregon were strong, future members were likely using providers they had not yet contracted with. Immediately following being selected for the contract, both ODS Health Plan and Providence Health Plan started working to enhance their provider networks. They requested data from the largest carrier providing benefits to districts prior to the inception of OEBB to identify the specific providers future members were using for their health care. Regence provided the requested data in early August and future members began nominating providers that were not yet under contract with the OEBB carriers.
District employees in eastern Oregon, particularly those in Malheur County, contacted OEBB beginning in early September with concerns that there were few providers they traditionally used in the southwest Idaho area participating with either ODS or Providence. OEBB contacted both carriers and emphasized the need for focusing contracting efforts in southwest Idaho to meet the needs of members in that region.
ODS and Providence actively pursued contracts with providers in Malheur County, Boise and the surrounding area with little success up until the time they could identify the potential number of members enrolled in plans in that area. In September 2008, ODS had 143 providers in southwest Idaho and Providence had 713. By the first part of November, ODS had 603 providers in southwest Idaho contracted for in-network benefits and Providence increased its panel to 918.
In February 2009, OEBB announced that ODS Health Plan had expanded the ODS Plus Network used for the Oregon Educators Benefit Board (OEBB) medical plans to include Idaho Physicians Network (IPN) providers in Idaho. This expansion gives OEBB members covered by one of the ODS medical plans access to a large number of physicians and facilities (more than 7,000) throughout Idaho.
Three pharmacies in eastern Oregon declined to join the Oregon Prescription Drug Plan (OPDP) network, used under the ODS medical plans, because they did not believe the rates were adequate to cover their costs. The Administrator of the OPDP met with the pharmacies and agreed to investigate methods to assure the adequacy of reimbursement while not increasing costs that would have a negative impact on OPDP, OEBB, other purchasers and the uninsured.

MyOEBB Benefit Management System
MyOEBB is an online eligibility and enrollment system that allows the employer and plan administrator to manage eligibility. It also gives members access to make their enrollment selections and allows benefit and dependent enrollment and changes online 24/7 during open enrollment without using multiple paper enrollment forms and duplicative administrative processes.
The MyOEBB system was developed in five months (April through August 2008) beginning with the migration of more than 61,000 employee records from educational entities around the state. The open enrollment period concluded with more than 98 percent of all subscribers self-enrolled for benefits using the online system.
Prescription benefits and the Oregon Prescription Drug Program (OPDP)
In 2003, the Oregon Legislature authorized the formation of the OPDP, a prescription drug purchasing pool, to help increase access to prescription drugs by the uninsured and lower costs for state and city governments. The OPDP would meet these goals by pooling prescription drug purchasing power, using evidence-based research to develop a preferred list of lowest cost drugs, securing competitive discounts with pharmacies and bringing transparent pharmacy benefit management services to groups. The OPDP went live on March 1, 2005. In 2006 voters passed Measure 44 that removed the eligibility criteria and opened the program to any resident without adequate prescription drug coverage.
The OPDP now offers group insurance pharmacy benefits and a discount card program for uninsured or underinsured Oregonians. ODS Health Plan included the OPDP in the benefit plan offering available to the OEBB Board during the request for proposal bid process. The OPDP pharmacy panel includes 83 percent of pharmacies in Oregon and is part of a nationwide pharmacy network.
OEBB members may use pharmacies that are not part of the OPDP network. Members are reimbursed for their prescriptions up to the reimbursement rate offered by OPDP. OEBB staff, ODS and OPDP monitor access to pharmacy services via phone calls, emails and surveys as well as through reimbursement requests and claims analyses.
Outreach Efforts
The Board used various stakeholder groups to involve districts in development of the OEBB benefits program. These groups include the Outreach Network, the Administrative Rules Advisory Group and the MyOEBB System Pilot group. The members of these groups are volunteers who provide input on OEBB rules, policies, procedures and systems on behalf of educational entity staff and OEBB members throughout Oregon. OEBB also created and maintains numerous e-mail groups to communicate and gather information.
Comparability Model
The Board, with the assistance of the actuary of its consulting firm Watson Wyatt, developed a comparability model to determine whether the OEBB benefits program met the comparability requirements under Section 17(2), chapter 7, Oregon Laws 2007. This model was applied to all plans offered by districts. It was also used for individual districts who believed their current benefits were not comparable to OEBB’s. For example, the model was used for the comparability assessment of the Bethel School District in Eugene. When it was determined that the total district benefit costs would increase under OEBB, one employee group slated to enter OEBB in October 2008 stayed out of OEBB, while another Bethel employee group voluntarily chose to enter OEBB to save money. OEBB adopted a policy that if OEBB benefits are not comparable on a district-wide level to the district’s current carrier’s rates, then the district or employee group does not have to enter OEBB and an assessment will be repeated the following year.
Focus on Quality
In September 2008, the Board combined the Quality and Plan Design workgroups to create the Strategies on Evidence and Outcomes Workgroup. This workgroup analyzes benefit and plan components to enhance the benefits program.


Medical, Dental and Vision 
During the 2007 legislative session the potential savings from a statewide educators benefit pool was estimated to be five percent, or $40 million a year, primarily due to savings in administrative costs. Administrative costs are embedded in premium costs and cover the expenses of plan administration, such as plan set-up, account management, network contracting, claims payment, and customer service. OEBB streamlined the number of medical plan designs offered in the state from 88 to nine. This is one example of efficiency in administration that yields savings in a benefit pool arrangement.
After the OEBB rates were announced in April 2008, Watson Wyatt, OEBB’s actuary, estimated savings of 4.8 percent, or $37 million, based on an estimated fully-populated pool of 65,000 employees. This estimate assumed that OEBB members would enroll in plans comparable to their pre-OEBB plans. It was also assumed that pre-OEBB plans would experience average renewal rate increases for 2008-2009, based on a survey of all insurance carriers doing business in the State of Oregon.
Calculating cost savings from the implementation of OEBB is complicated by a few important factors. First, plan design choices are not static. That is, school districts and employees have some choice of plan, and are not necessarily required to select an OEBB plan which is similar in value to their pre-OEBB plan. To fairly compare the cost of plans offered pre-OEBB to the cost of plans selected this year under OEBB, you have to assume that each employee enrolled in the plan identified as comparable to his or her pre-OEBB plan.
A second confounding factor is that only a very few districts and entities received renewals or bids for coverage for the 2008-2009 benefit year. This means that for many districts there were not actual rates for 2008-2009 to use for comparison purposes. There were only a small number of entities who received rates for 2008-2009. The findings showed that joining OEBB saved them between one percent and 18 percent over the other carriers’ rates. Where renewal rates were provided to districts, they have been used in the savings calculation; where they did not exist, average renewal rates have been assumed according to the Oregon insurance carrier survey mentioned above.
OEBB’s actuary developed a methodology to estimate the savings by accounting for the factors described above and actual OEBB enrollment in the medical plans, excluding retirees and COBRA* enrollees. This enrollment includes school
districts, education service districts and community colleges. Using this methodology, the actuary calculated OEBB savings for 2008-2009 of 5.8 percent,
or at least $36 million, for active employees (and family members). Additional savings for retirees, COBRA beneficiaries, and potential future OEBB enrollees have not been calculated.
Savings – Optional Benefits 
Estimates of savings for the optional benefits (life insurance, disability insurance and accidental death insurance) to be offered in October 2009 were $660,000 a year. Following the evaluation of the proposal received from vendors vying for the OEBB optional benefit plan and selection of the vendor, it is now estimated that the OEBB optional benefit plans will save educational entities and employees about $6.3 million annually with two-thirds of those savings attributed to entities. Savings calculations will be updated following enrollment in the new plan offerings in October 2009.
In 2011 the Task Force on Educator Health Benefits will meet as outlined in statute to evaluate the success of OEBB, including the savings that have been realized. The Task Force will benefit from the additional rate experience available at that time.
* Consolidated Omnibus Reconciliation Act (COBRA) is a federal law that requires employers to provide access to continued group health and dental coverage on a self-pay basis following certain qualifying events. Revised 3/12/2009 (Following selection of the vendor for optional benefits) Prepared by: Department of Administrative Services Oregon Educators Benefit Board 2 of 2 January 2009

Optional Benefits
Optional Benefits and Long Term Care Benefits
In addition to the requirement that OEBB contract for health, dental and vision benefit plans, the statute allows OEBB to contract with carriers for optional benefit plans. Those benefits can include life, supplemental medical, supplemental dental, accidental death or disability insurance plans. OEBB is also directed by statute to offer fully-insured long term care insurance to members.
The OEBB Board will offer life, short- and long-term disability and accidental death and dismemberment (AD&D) policies to members beginning in October 2009. OEBB’s consultant initially estimated that savings to members and districts in the first year will total about $660,000 ($440,000 to districts and $220,000 to members) based on estimates of current enrollment in optional benefit programs.
A request for proposal (RFP) for optional benefits was posted for bidders on December 30, 2008. At its March 12, 2009, meeting the Board selected The Standard Insurance Company to provide the life, short- and long-term disability, and AD&D plans to participating entities.
Based on the rates included in the successful bid, the savings increased to an estimated $6.3 million annually with two-thirds of the savings going to educational entities.
The Board will offer long-term care insurance in October 2010; evaluation of the long-term care benefit will begin in the latter part of 2009.

2008 Open Enrollment Survey Summary
Executive Summary of the 2008 OEBB Open Enrollment Survey 
Survey Parameters 
In October 2008, the Oregon Educators Benefit Board (OEBB) published a member survey following the first open enrollment period. The survey covered topics ranging from the quality of open enrollment meetings and benefits, the user-ability of the MyOEBB Enrollment System, and the effectiveness of OEBB communications. It also provided space for members to post candid comments about how OEBB might improve its operations in the future.
Information gathered from the survey will be used by the Board and staff to identify member concerns related to OEBB services and communication efforts. The feedback will help guide improvements in benefit programs, enrollment system enhancements and communication materials for future enrollment periods.
The survey was e-mailed to more than 49,700 members who provided an e-mail address as part of their contact information while enrolling in the MyOEBB Enrollment System. Of those members, 10,891 people responded to the survey.
Survey Results 
Questions were categorized by Open Enrollment Meetings, Enrolling for Benefits, OEBB Customer Service, Plan Selection Materials, Communications and Member Satisfaction Surveys.
I. Open Enrollment Meetings 
Of the 32.2 percent of respondents who attended an open enrollment meeting, more than 77 percent found the information presented helpful. The top suggestions given by those who did not find the information helpful included:
  1. Hold meetings on multiple meeting dates
  2. Provide more specific details regarding the OEBB plans, focus on OEBB plans, not organizational information of the agency
  3. Hold smaller meetings to address more specific issues
  4. Representatives need more training and knowledge about the plans offered
II. Online Enrollment 
More than 98 percent of respondents indicated they enrolled for benefits using the on-line enrollment system, MyOEBB. More than 83 percent reported it took them 20 minutes or less to complete the enrollment process and more than 93 percent found that MyOEBB was an acceptable method for enrolling, with nearly 70 percent saying the system was easy or very easy to use. Of the 20 percent of respondents who indicated they encountered problems while enrolling, 32 percent had troubles logging into the system and registering.
III. OEBB Customer Service 
Though more than 70 percent of respondents said they did not contact OEBB during open enrollment, of those that did, 89 percent said the information they received from OEBB customer service was always or usually timely.
IV. Plan Selection Materials and Communications 
Of all the materials provided to members during open enrollment, 82 percent of respondents said the OEBB plan comparison sheets were the most valuable source of information followed by 77 percent of members who indicated the educational entity plan cost sheets were the most valuable information they received. More than 55 percent of the respondents said the plan summary documents posted on the OEBB Web site were valuable to their selection of benefits.
Regarding OEBB’s communication materials distributed to members, more than 80 percent of all respondents thought the quality of the information provided were either excellent or good and the top suggestions for improving the communications materials included:
  1. Continue to update the Web site
  2. Provide written communications such as the plan summary documents
  3. Send occasional e-mails regarding open enrollment and plan changes
  4. Carriers and OEBB present plan details using the same “language”
V. Member Satisfaction Ratings 
Members rated the following OEBB services from 1 (excellent) to 5 (poor) including:
Benefits Offered 
Of the benefits offered through the OEBB benefits program, more than 71 percent of respondents indicated the benefits were either excellent or good.
Carrier Options 
Of the carrier options offered through the OEBB benefits program including ODS Health Plan, Kaiser Permanente, Willamette Dental, and Providence Health Plan, more than 63 percent of respondents indicated the options were either excellent or good.
Access to services 
Regarding access to providers and facilities, nearly 70 percent of respondents indicated that access was either excellent or good.
Online Enrollment System 
When rating the MyOEBB on-line enrollment system, more than 80 percent of respondents indicated the system was either excellent or good.

Participating Educational Entities 2009
This is a complete list of OEBB participating educational entities: 2009