Benefit Plan Information

Do I need to do anything during Open Enrollment if I want to keep my same benefits?

Yes. This year is a mandatory enrollment year.  You must confirm your plan selections even if you do not want to make any changes.

To enroll in benefit plans, access the MyOEBB enrollment system at https://myoebb.org/oebb/!pb.main and register (if you are a first-time user) or log in (if you are a returning user).

What is "waiving benefits?"

Waiving benefits means that an individual elects not to enroll in a medical, dental or vision plans available under the OEBB-sponsored benefits program and is not eligible to receive any portion of a cash contribution or other type of remuneration.

What is the dependent eligibility age?

Biological, step and adopted children under age 26 are eligible for coverage under OEBB benefit plans. Eligible employees also may obtain coverage for dependent children that are legal wards of the court or that they, their spouses, or domestic partners are required to support.

Dependent children age 26 or older are eligible for coverage if they are incapable of self-sustaining employment because of a developmental disability, mental illness, or physical disability and were covered under an educational entity plan prior to reaching the age of 26. There are some exceptions, please see a complete version of OEBB’s eligibility rules at http://www.oregon.gov/oha/OEBB/Pages/Eligibility.aspx.

Where do we find the provider lists (doctors, specialist, dentists, ophthalmologists and so forth) that are in the Moda network?

The list of doctors for Moda Health Plans can be found at https://www.modahealth.com/oebb/members/providers.shtml?dn=ods

I would like to have more details about medical plans than is available in the summaries the ESD provided. Will we receive member handbooks at the All Staff Inservice?

Vendors do not provide member handbooks to employees prior to enrollment in a specific plan.

Member handbooks for ODS plans can be found online at https://www.modahealth.com/oebb/members/handbooks.shtml?dn=ods

Are the premiums listed in the benefit summaries annual rates or monthly rates?

Premiums are monthly rates. To obtain your out-of-pocket costs you would subtract the ESD contribution.

What should I do if I am a current employee who is eligible for insurance but did not receive a packet from OEBB in mid-August or have misplaced my packet from OEBB?

If you moved after the deadline for submitting employee information to OEBB, your packet was most likely sent to your old address.

You can still register, even if you have not received the packet from OEBB with the registration directions. This packet was generic information and has nothing that is personally identifiable in the packet.

Go to the OEBB website https://myoebb.org/oebb/!pb.main and sign in if you are a returning user or click on the “register here” button to set up a new account.

If I am currently opting out or waiving medical insurance and want to continue to opt out, do I still need to register with OEBB?

Yes, you still need to register for two reasons. First, the enrollment process is the way you communicate to OEBB and Lane ESD that you are opting out of medical insurance. Second, even though you are opting out of medical insurance you may be enrolling in vision, dental and/or optional insurance.

If I want to waive insurance benefits do I still need to register?

Yes, you still need to register. The enrollment process is the way you communicate to OEBB and Lane ESD that you are waiving insurance. Even though you are waiving medical insurance you may be enrolling in vision, dental and/or optional insurance You will still be eligible for district provided Accidental Death and Dismemberment (AD&D) and Long-Term Disability coverage.

Can I enroll in the medical plan as employee and child and in a dental plan for employee only?

LCEA members can enroll in dental (and vision) plans as employee only, even if you enroll family members in a medical plan.

What if I opt out of medical, dental, or vision coverage and wish to enroll in the future?

Each year during open enrollment employees will have the option of enrolling in medical, dental, or vision coverage. There is no pre-existing condition exclusion period for medical coverage. For some plans there may be a waiting period imposed for certain types of services such as transplants.

How do I sign up for just the dental plan?

To sign up for a dental plan complete the registration process; select opt out of medical coverage (you must have other medical coverage), then select the dental plan coverage of your choice.

Can I sign up for pharmacy (Rx) coverage only?

No. Pharmacy (Rx) is part of the medical plans and is not available as a standalone option.

What if I do not enroll in dental or vision coverage and decide to enroll next year?

Members who do not enroll in the dental and vision plans when originally eligible, and later elect to enroll during open enrollment, will be eligible for preventive services only for the first 12 months of coverage. Dental coverage will allow preventive services only and no orthodontia coverage during the 12-month period. Enrollment in a vision plan will be covered only for a vision exam for the first 12 months.

Is there any additional cost for adding a domestic partner as a dependent?

The cost of covering a domestic partner may result in “imputed income” that is taxable to the employee. Imputed income is the difference between the cost of providing the insurance to the employee with and without the cost of covering a domestic partner (contact HR for more details).

What are the OEBB office business hours, if I need to contact them with questions?

OEBB office staff are available by phone or e-mail Monday through Friday (except holidays) from 8:00AM to 5:00PM.

Now that I have completed the OEBB registration process, when will I be receiving insurance cards?

To access a PDF of your Moda Health ID card, log in to myModa.  Enter your user name and password in the myModa login box on the right side of this screen.  Once logged into myModa you can access your digital card from the member shortcuts box on the myModa homepage, or the “resources” tab. 

If you are a smartphone user, you can download your ID card from the Moda Health mobile ID card app.  To search for your app, visit your app store and type “Moda Health eCard app” into your search.  To launch the app, enter your mobile PIN code and member ID (these can be found on the PDF version of your ID card in myModa, see above).  Your Moda Health ID card will appear on your phone.  Using the Moda Health ID card app, you can email or fax a copy to providers or email a copy to family members.

Medical Coverage

Is (therapeutic) massage covered on the medical plans?

No. Alternative care does not include massage.

Does the total deductible amount need to be met before the insurance will begin paying?

Yes.

Regarding coordination of benefits with my spouses plan - how do I know whose plan is primary?

You are primary on the plan you enroll in via your employment at Lane ESD. Your spouse is primary on the plan available through his/her employer. For dependents the primary carrier is associated with the spouse whose birthday comes first.

In some cases how coordination is implemented would be specific to the plan and benefits. In this case, it would be best to contact OEBB with your specific situation.

Is there a limit on the number of visits that can be made to an alternative care provider?

There is no limit on the number of visits; however, the payment for alternative services is capped at $2,000 (all plans). This benefit maximum (cap) is per person.

Are lab tests/x-rays that are ordered as part of an annual exam covered with the deductible waived (applicable to all plans)?

No. Only the exam is considered part of the preventative service with the deductible waived - any additional services identified as part of a preventative service are covered based on the type of service.

Are cornea transplants covered immediately?

This service is not subject to any waiting period and would be covered immediately.

Dental Coverage

Does Willamette Dental include orthodontia coverage?

Yes, orthodontia is available with this plan.

With the dental plans - do the amounts paid for preventative care count against the benefit maximum?

Yes.

On dental plans what is the difference between the benefit maximum and the plan year maximum?

The benefit maximum and the plan year maximum are just two different ways of describing the same thing - the maximum benefit amount that will be paid within the plan year. All Moda plans have a benefit/plan year maximum. The Willamette Dental plan does not have a maximum.

Vision Coverage

With the vision plan, does the plan year maximum include exam costs?

Yes.

Is the plan max for vision "per person" (employee, spouse, child) or a total for the whole family if you enroll in the family vision plan?

The plan max is "per person."

Life Insurance

How do I sign up for life insurance?

There is nothing that you need to do to enroll in life insurance. You will automatically be enrolled in a $25,000 life insurance plan.

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