Employee Benefits

*** Information on OEBB plans for 2008-2009 posted at the bottom of this page (scroll down) ***

                                                                                                                 TSA - 403(b) Information

4J OVERVIEW BOOKLETS 

CURRENT PLAN YEAR (Effective October 1, 2007 - September 30, 2008)

Administrative 2007-2008                 Administrative Mental Health Changes Only

     MEDICARE PART D - NOTICE OF CREDITABLE COVERAGE (Administrative)

Classified 2007-2008                       Classified Mental Health Changes Only

     MEDICARE PART D - NOTICE OF CREDITABLE COVERAGE (Classified)

                                                                                                                                    

Licensed 2007-2008                        Licensed Mental Health Changes Only

     MEDICARE PART D - NOTICE OF CREDITABLE COVERAGE (Licensed)                                                                                                

Licensed Sub 2007-2008                 (no changes to Sub plan, 2006-2007 book still applies)

     MEDICARE PART D - NOTICE OF NON-CREDITABLE COVERAGE (Licensed Subs)                  

 

Official plan books with ALL the details of your coverage:

Regence BlueCross BlueShield of OR  

         (all medical/vision plans for Administrative, Licensed & Classified groups)

ODS - Administrative Dental Plan

ODS - Classified Dental Plan

ODS - Licensed Dental Plan

ODS - Licensed Substitute Medical Plan

 

RATES 

CURRENT PLAN YEAR  (Effective October 1, 2007 - September 30, 2008) 

          Administrative 2007-2008

          Classified 2007-2008 

             Classified Supplemental Life Insurance Rates 2007-2008

          Licensed 2007-2008

          Licensed Subs 2007-2008

FORMS

New Hire Enrollment Form

Enrollment Change Form (medical/dental)

ACH Form (Authorization for Automatic Withdrawal from your bank account)

Member Claim Form - Regence BlueCross Blue Shield

Certificate of Domestic Partnership

Incapacitated Dependent Application

Certification of Dependency (for step-children not living with you or cases of legal guardianship)

 

Manley Flexible Spending Account (FSA) Forms:

 

FSA Claim Form (to submit receipts if you're already enrolled)

 

FSA Enrollment Form (enrollment restricted to first 30 days of benefitted status or FSA enrollment period in Nov/Dec for upcoming calendar year -- dates for plan year 2008 not yet announced)

FSA Change Form (to update contact information or change contribution amount)

Only Dependent Care amounts may be changed mid-year.  Health Care amounts cannot be changed.

FSA Direct Deposit Form (to authorize Manley to deposit reimbursements into your bank account)

Estimation Worksheet (helps you estimate how much to set aside)

Examples of Eligible Healthcare Expenses (also notes some exclusions)

Note: Insurance premiums are NOT eligible for reimbursement.

OEBB Information for 2008-2009

Open Enrollment will be Aug. 15 - Sept. 15, 2008.  Plan elections will take effect October 1, 2008.

More detailed information will be distributed as it becomes available.

Summaries of Coverage:

(The Administrative, Classified and Licensed Groups will all be offering the same plan options.)

Medical and Prescription Summary of Benefits - Administrative, Classified and Licensed Groups

Vision Summary of Benefits - Administrative, Classified and Licensed Groups

Dental Summary of Benefits - Administrative, Classified and Licensed Groups

 

Employee Out-of-Pocket Costs for OEBB Plan Options:

Administrative Employee Rates 2008-2009

Classified Employee Rates 2008-2009

     Employees Receiving 12 checks per year

     Employees Receiving 10 checks per year

Licensed Employee Rates 2008-2009