First off, there has been no decision to move to OEBB.
Please don’t assume that this is being posted because of some decision. I simply want to share with you so you can be informed. Information is power.
2019-20 RATES & PLAN DESIGNS
OEBB is pleased to announce the new plan designs and rates have been posted. You can find this information at:
We appreciate your patience during this time as it has taken longer than previous years. Moda medical plan offerings are changing this year, which required extra time to assure rates and designs were accurate.
You will notice some changes as you review the benefit and rate summaries. We will cover some of the highlights here. We encourage you to join one of our upcoming webinars to learn more. Scroll down to find the schedule and registration links below.
INSURANCE COMMITTEE WEBINARS
During these webinars you will hear directly from OEBB staff and the carriers. You will also have an opportunity to ask questions. Please click your preferred date/time below to register.
Insurance Committee Live Webinar Schedule:
Everyone who registers will receive an email after the session with a link to the slides and recording, so please register even if you can’t tune in. You can watch the recording at your convenience and still submit your questions the same way you would live. Your question will be delivered to OEBB staff via email and you can expect a response within the next few business days.
HIGHLIGHTS FOR 2019-20
Medical Plan Highlights
- All medical plans will include a new fertility benefit.
- Kaiser Permanente will expand coverage of services and prescriptions related to reproductive health and women’s preventive health with no cost-share.
- Kaiser Permanente will enhance hearing aid coverage.
- Moda is launching all new plans under just one network. All Moda plans will utilize Moda’s statewide Connexus provider network. The Synergy and Summit networks will be discontinued for all OEBB plans effective October 1, 2019.
- Under Moda, members will still have a choice of plans with various deductibles and copays/coinsurance. OEBB will make a “crosswalk” available to members to help them identify which new plan has a deductible closest to their previous plan.
- Each family member on a Moda medical plan will have the option to participate in coordinated care and receive an enhanced benefit compared to those who choose not to participate in coordinated care. To receive the enhanced benefit, the member must choose a primary care provider known as a “PCP 360” with Moda. These PCP 360 providers have agreed to:
- deliver full-circle care, coordinating their care with other providers, as needed, and
- be held accountable for the health of the patients who choose them.
- Moda is in the process of contracting with PCP 360 providers. They will be updating their Find Care tool over the summer so members will be able to see which providers they may choose as their PCP 360.
- Compared to those who do not choose coordinated care, the enhanced benefit includes:
- a lower individual deductible,
- a lower individual out-of-pocket maximum, and
- lower copays for office, specialist, and alternative care visits.
- Many OEBB members already see a PCP 360, so their choice will be easy. Others may need to change providers to receive the enhanced benefit of coordinated care. Keep in mind, all Connexus network providers will be “in-network”, so if a member prefers to stay with their current Connexus network provider who is not a PCP 360, they can still receive the non-coordinated care benefit by using a Connexus provider without going “out-of-network”.
- The OEBB Board is introducing an additional set of rates on the Moda medical plans for this upcoming plan year, called “Select” rates.
- For some plans, the Select rates will be the same as the traditional rates. For other plans, they will differ.
- Select rates apply only to members whose most recent OEBB medical plan enrollment between June 30, 2019 and September 30, 2019 was in a Moda CCM Synergy/Summit Plan.
- Members will not qualify for the Select rates if they were not eligible for OEBB benefits June 30, 2019 through September 30, 2019, or if their most recent OEBB medical plan enrollment June 30, 2019 through September 30, 2019, was Waiving, Opting Out or enrolled in a Kaiser Permanente or Moda PPO Connexus plan.
Dental and Vision Plan Highlights
- Willamette Dental Group will have a change to their dental implant surgery benefit effective October 1, 2019.
- Delta Dental and Kaiser Permanente dental plans will remain the same for the 2019-20 plan year.
- The VSP vision plans will remain the same for the 2019-20 plan year.