Plan Designs and Rates

Overview

The lists below contain premium rates and plan design documents (also known as "plan comparisons" or the "summary of benefits") for OEBB plan offerings for the most recent two plan years.

Records Request

Documents more than two years old may be obtained by submitting a public records request to OHA. All policies, fees, forms, and instructions related to this process can be found on the Request Records page of the OHA website.

Plan Handbooks

For Plan Handbooks, Evidence of Coverage (EOC) or Benefit Summary documents, see the Plan Handbooks page.

2021-22 Plan Designs
(effective Oct. 1, 2021)

Upcoming Year's Plan

Medical/Rx, Dental and Vision Plan Designs 2021-22
Revision History:

5/18/2021 - corrected Moda Med Plan 6 Rx benefit, and updated improved benefits on VSP vision plans.

5/21/2021 - corrected Moda Med Plan 4 Incentive Office Visit benefit.

Look for revision date (05/21/2021) in the lower right corner of Page 8,

and refresh your browser if needed.

Long Term Care Plan Designs 2021-22

EAP Services 2021-22

"Bronze Plan" (Limited Use - ACA Group only) Medical/Rx Plan Designs 2021-22

2021-22 Premium Rates
(effective Oct. 1, 2021)

Upcoming Year's Rates

Note: These documents show the entire premium paid to OEBB. They do not factor in employer contributions and may not reflect the amount the member will pay for their benefits. Members should contact their employer for their specific out-of-pocket costs.

Medical/Rx, Dental and Vision Rates 2021-22

Life Insurance Rates 2021-22

AD&D - Accidental Death & Dismemberment Rates 2021-22

LTD - Long-Term Disability Rates 2021-22

STD - Short-Term Disability Rates 2021-22

Long-Term Care (Employee Paid) Rates 2021-22

Long-Term Care (Employer Paid) Rates 2021-22

EAP - Employee Assistance Program (Employer Paid) Rates 2021-22

"Bronze Plan" (Limited Use - ACA Group only) Medical/Rx Rates 2021-22

Imputed Tax Values for Domestic Partner Coverage

Imputed Value Medical/Rx, Dental and Vision Rates 2021-22

COBRA

COBRA Medical/Rx, Dental and Vision Rates 2021-22

COBRA Imputed Value Medical/Rx, Dental and Vision Rates 2021-22

"Category 2" Local Governments Only

Category 2 Special Medical/Rx, Dental and Vision Rates 2021-22

Category 2 Special Imputed Value Medical, Dental and Vision Rates 2021-22

Category 2 Special COBRA Medical/Rx, Dental and Vision Rates 2021-22

Category 2 Special COBRA Imputed Value Medical/Rx, Dental and Vision Rates 2021-22

2020-21 Plan Designs

Current Year's Plan

Medical/Rx Plan Designs 2020-21
v2 5-20-2020: adjusted formatting to correctly display Emergency room benefit - wrapped text was not visible in v1

Dental Plan Designs 2020-21

Vision Plan Designs 2020-21

Long Term Care Plan Designs 2020-21

EAP Services 2020-21

"Bronze Plan" (Limited Use - ACA Group only) Medical/Rx Plan Designs 2020-21