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4J Classified Benefits Update

2005-06 Issue No. 1

Patrick Munyon, Classified Benefits Coordinator phone: 687-3248 email: munyon@4j.lane.edu


In this issue:

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.