September
is Open Enrollment Month(back to top) All insurance-eligible employees should
have received an enrollment packet via district mail.
Your enrollment packet contains relevant forms
and information, as well as the Classified Benefits Overview, which
outlines our benefit package.
ODS remains our carrier for medical, vision, and
dental coverage. Regence will continue to provide long-term disability
and life insurance coverage. Dental coverage remains the same.
New this year: We have an ODS Preferred Provider
Organization (PPO) medical insurance plan. Refer to your Classified
Benefits Overview for details. If you have questions, plan to attend
one of the meetings listed below.
If all the information on your pre-printed
enrollment form is accurate, you do not need to send in the form.
You will be automatically enrolled. Do send in your tax shelter form. All required forms must be turned in by Sept.
30.
Although contract negotiations are still underway,
the Joint Benefits Committee has reached agreement to keep the payroll
deduction amounts for active employees the same as last year.
Employees in the part-time (4 to less than 6 hour)
bracket will continue to pay an additional $30 per month more than those
in the full-time (6 to 8 hour) bracket.
As of press time, the district contribution for
part-time employees remains $72 per month less than the full-time district
contribution. The remaining $42 per month cost will be paid by insurance
reserves again this year. (If there were no reserve subsidy, part-time
employee payroll costs would be $72 per month higher.)
Read
Before You Call (back
to top) Our Employee Benefits Office is extremely
busy during Open Enrollment month. The proper enrollment of thousands
of people demands a huge amount of time. At the same time, our Human
Resources department is busy filling positions for the new school year.
You can help by limiting your calls to Human Resources/Employee
Benefits to those that are absolutely necessary.
Your Classified Benefits
Overview contains a wealth of information. Be sure to review it
before you make any calls. The answer to your question may be found
there.
I’m also available to help with insurance
questions and/or problems. If you’ve read through the
enrollment information, and still have questions, call me (x3248)
or send an e-mail to me at munyon@4j.lane.edu
Insurance
Open Enrollment Meetings(back to top) Plan on attending one of the following meetings to
learn more about your insurance plan. A representative
from ODS will be there to answer any questions:
Thursday, September 15
12:00 – 1:00 p.m.
(Ed Center Auditorium)
Thursday, September 15
4:30 – 6:30 p.m.
(During OSEA meeting in the Tower Room)
Tuesday, September 20
7:00 – 8:30 p.m.
(Ed Center Auditorium)
Important
Points to Remember with the ODS PPO Plan (effective
October 1, 2005)
(back to top)
It is your responsibility to ensure that all
providers and services are within the ODS PPO Network. Failure to
do so will greatly increase your costs for doctor visits and
other medical services.
The ODS PPO Network is the same network of providers
we currently have to receive “In Network” benefits.
However, if there is any question about a particular provider call
ODS at 1-800-420-7758.
As of October 1, you no longer are required to coordinate
all care through a Primary Care Physician (PCP). For example, you
won’t need a PCP referral to see a specialist. Again, you
must ensure that your providers are within the ODS PPO Network.
There is a $20 copayment for office visits (deductible
waived). Most other services are covered at 80%, after meeting a $200
deductible.
Any amount you pay toward a medical deductible from
October through December will be carried over to the new calendar
year. (You won’t have to meet the deductible twice)
The procedure for mental health benefits remains the
same: In order to receive any coverage for mental health or substance
abuse, you must call Cascade Centers Employee Assistance Program (1-800-433-2320)
first.
ODS
Dental Coverage Remains the Same(back
to top)
Our ODS Dental coverage remains essentially the same as our current
plan year. Remember, in order to receive maximum dental coverage, use
a dentist from the ODS Preferred Provider dental panel. You can call
ODS Dental at 1-800-337-3962 to check on a dental provider’s
status.
Prescription
Plan Changes(back to top)
The prescription plan is described on Page 2.6 of the Classified
Benefits Overview. The ODS Preferred Drug Chart is located in the
back pocket of the Overview.
The format of the plan remains the same:
$15 minimum for coverage, then 50%
member co-payment, up to set maximum limit.
Local pharmacies: One co-payment for
a 34-day supply.
Mail order pharmacy: One co-payment
for a 90-day supply.
Important: What’s
changed?
The maximum limit for member co-payment will vary, depending on the
drug that is prescribed. The new three-tier plan is based upon the following
system:
Generic drugs: 50% member co-payment,
up to maximum of $35.
Preferred brand drugs: 50%
member co-payment, up to maximum of $50.
Non-preferred brand drugs:
50% member co-payment, up to maximum of $75.
Over-the-counter (OTC) drugs: Certain
OTC drugs are now covered under our prescription plan under the
lower “generic” co-pay. (They must be prescribed by your
provider.) If any of these OTC drugs are right for you, there could
be substantial savings over the brand name drugs.
ODS Pharmacy Customer Service can be reached
at 1-888-361-1610
The
4J Wellness Clinic: a No-cost Option for Quality, Family-practice Health
Care(back to top)
Remember the 4J Wellness Clinic as an option for you and your benefits-eligible
dependents. See page 6.1 of the Benefits Overview
for a description of some the services that are available, at no
cost to you.
The Clinic has three nurse practitioners and a support
staff who work together to provide high quality health care for you
and your family.
CALL 686-1427 FOR AN APPOINTMENT
If you have any questions,
feel free to contact me via e-mail munyon@4j.lane.edu
or phone call (x3248).
The information in this newsletter has been summarized. It is presented
as information --not advice or counsel. In all instances, the benefits,
conditions, and limitations as outlined in the 4J Master Contracts prevail
over this representation. Please refer to your Benefits booklet or the
master contracts available at the District offices for additional information
regarding your benefit plans.