2017-18

oAll enrollments are completed on-lineoInstructions are included in new hire packetoAll rates are composite, meaning the cost is the

same to cover just yourself, or you and your family.

o31 days to enroll (try to enroll by the 15th of the month to avoid a double deduction on your next paycheck)

How to Enrollwww.OEBBINFO.com

Medical Plans are separate from Dental and Vision plans.Medical carriers are Kaiser or Moda Plans

Medical Insurance

http://www.oregon.gov/oha/OEBB/Pages/Videos.aspx

Kaiser: HMO Most care doesn’t require a deductibleCo-pay systemMUST use Kaiser providersRequires a referral to see a specialist

Moda SYNERGY: CCM (Coordinated Care Model)Deductible must be met before services are renderedLess expensive premium that Moda StatewideMust choose medical homeMore limited network of providers than Statewide

Moda Statewide: PPO Conexus NetworkDeductible must be met before services are renderedBroader network of providers

View helpful videos here:

� Understanding and reading the Medical Summary Sheets

� How to compare plans

� How are Moda Plan Evergreen/Kaiser 3 Plans different from other plans? � (High deductible, HSA compliant plans)

Medical Plan Summary

Example: Moda Alder plan

$400 plan year deductible per person

$1,520.75 PER MONTH premium

Compare the deductible per person, and out of pocket max across plans

The lower the deductible, the HIGHER the monthly premium you will pay

• Lowest monthly premium of all plans

• Higher deductible than most plans

• Deductible must be met before any services are covered

• When more than one person is on the plan, the FAMILY deductible must be met before services are covered.

• No services use a co-pay system

• Prescriptions: deductible must be met before co-insurance kicks in.

High deductible/HSA compliant plans: Moda Evergreen and Kaiser 3

http://www.oregon.gov/oha/OEBB/Pages/Videos.aspxSee OEBB video:

HSA and High Deductible Plans

District will contribute $100/month into your HSA account IF you sign up for plan AND sign up for HSA account.

1. Enroll for your health plan online. (ONLY Moda Evergreen or Kaiser 3)

2. Sign up with PAPER FORM for your HSA account. (Enrollment form located on District Benefits website)

Yellow rate sheet lists all monthly premium costs.

All monthly premiums for medical, dental, and vision are composite –meaning there is no additional monthly premium cost to add your family members to your plan.

The district contribution applies toward your Medical, Dental, Vision, and Basic Life/AD&D only. � Any additional or optional coverages you purchase are paid for by you, even if you have

money remaining from District contribution.

Medical Plan Rate Sheets

Use the top right hand corner of yellow sheet to calculate what you will owe.

If you choose not to enroll when you are very first eligible, you face a 12 month wait period if you are a late enrollee. This means your basic cleanings are covered but any services beyond that are not covered until your 12 month wait has been met.

¡ Moda/ODS Dental is now called DELTA DENTAL¡ Plans 1 and 5 are “incentive plans”. You earn more coverage level each year from 70%

your first year to 100% your fourth year¡ Plans 6 and Exclusive PPO Plan are “non-incentive plans”, same level of coverage each

year

¡ Kaiser Dental ¡ Co-pay system, no lifetime max for orthodontia¡ Must use Kaiser dental facilities

¡ Willamette Dental¡ Co-pay system, no lifetime max for orthodontia, no annual maximum¡ Must use Willamette dental facilities

Dental Plans

¡ Moda Vision:¡ Plans Opal, Pearl, and Quartz¡ Coverage level is the same for each plan, but the plan year maximum payout for each plan is different.

¡ Kaiser Vision:¡ Must use Kaiser facility & also have Kaiser medical¡ Co-pay system, must be enrolled in Kaiser medical¡ If enrolling in Kaiser medical plan 3 (High deductible plan), you must meet medical deductible before

vision insurance kicks in.

� VSP: NEW vision carrier - Copay system for exams. Lenses/frames or contacts every 12 months.

¡ VSP Choice Plus Plan: Frames/contacts up to $300, then 20% off amount over retail allowance¡ VSP Choice Plan: Frames/contacts up to $150, then 20% off amount over retail allowance

Vision insurance

� Definition: Both you and your spouse/domestic partner work for Salem-Keizer Public Schools.

� District will pay the portion of the premium covered by both employees’ allocated district cap. This is applicable when the following criteria are met:� Both employee and spouse/partner work for Salem-Keizer� Both employee and spouse/partner are benefit eligible� Both benefit eligible employees complete a form enrolling in the “Two on Contract” benefit arrangement.

� NOTE: You must still enroll in an insurance plan online.� Required:

� One spouse/employee declines the medical, dental, and vision enrollments offered through their employment.

� The other spouse/employee enrolls all eligible family members in a medical, dental, and/or vision plan offered by OEBB.

� The family has one set of medical, vision and dental benefits and is not double covered through the District.

What is “2 on Contract”?

Check out these additional benefits that are available!

BUT WAIT . . . . THERE’S MORE!!!!

� Short-Term Disability� Long-Term Disability (required for Licensed) � Long Term Care insurance� Employee Assistance Program (EAP) – free!� Weight Watchers – free for those enrolled in medical ins.� 403(b) and 457 Deferred Comp Plans (save $ for retirement!)� FSA – Flexible Spending Plan (American Fidelity)� HSA – Health Saving Account (must be enrolled in Moda Evergreen or Kaiser Plan 3,

high deductible plans, for eligibility) � (District contributes $100/month into HSA if you open an HSA account with American

Fidelity)� PERS Retirement� Sick Leave Bank – enrollment form on employee benefits website� Emergency assistance when traveling – part of The Standard’s basic life insurance

plan

Other Benefits

ENROLLING

www.OEBBINFO.com

YAY INSURANCE!!

Main District webpage with limited Benefits info:

https://salkeiz.sharepoint.com/departments/humanresources/SitePages/benefits.aspx

District Benefits Webpage located on Insight 24 J (intranet) website:

31 days from start date to enroll. Try to enroll by September 15th

for Payroll purposes to avoid double deduction in October check.

http://www.salemkeizer.org/staff/employee-benefits

� Premium: The monthly cost you pay out of your paycheck just to have the insurance. (Think about monthly car insurance).

� Deductible: The amount you pay out of pocket for services, before your health plan begins to pay.

� Copay: A fixed $ amount (e.g. $35) you pay to the provider at the time of service.

� Co-insurance: A person’s share of the cost of care (usually a percentage, often 20%)

Insurance Definitions

� Out of pocket costs: expenses for medical care that aren’t covered by insurance (e.g. deductibles, co-pays)

� Out of pocket maximum: the maximum amount an individual will have to pay in out-of-pocket costs in one Plan Year before insurance will cover at 100%

� Plan Year: a consecutive 12-month period in which a health plan provides coverage for health benefits. (October 1 – September 30)

Insurance definitions continued