Published by: Diana McElhinney, Classified Benefits Coordinator Phone: 541-790-7679 Email: mcelhinney_d@4j.lane.edu
2018-2019 Plan Rates and Deductibles
The new medical, vision, pharmacy and dental plan year begins October 1, 2018, and goes through September 30, 2019.
The deductible and accruals toward maximum out-of-pocket reset October 1st. regardless of whether they were met the previous plan year. However, if you did not meet your deductible during the previous plan year and had continuous coverage, any expenses applied to your deductible during the last 3 months of the previous plan year will be carried over and applied to the deductible for the new plan year.
The new plan year insurance rates that take effect October 1st will be reflected in the October 31st paychecks or for retirees from your bank account November 5th. Please check your paycheck or bank statement to verify you have been charged the correct amount for your insurance elections.
Kaiser Permanente Plan 2
New to Kaiser and need help with care transition? Help is available at 1-888-491-1124 (TTY11), Monday through Friday, 8 a.m. to 6 p.m. The New Member Welcome Desk can help with choosing a primary care doctor, scheduling a routine appointment, transferring prescriptions, connecting with specialist, and connecting with specialty care for conditions such as cancer, renal disease, and connecting with a pharmacy for specialty prescriptions.
If you chose Kaiser Permanente Plan 2 as your new insurance coverage there are a few things to make your transition easier. Getting Started (3 easy steps)
- Choose your primary care doctor: Choose from a wide range of primary care doctors. Browse the online doctor profiles at kp.org/newmember
- Register on kp.org: Once your coverage begins, you can register on kp.org and start using the many convenient features.
- Get prescriptions: help is available to transition your prescriptions to Kaiser Permanente (KP). You can use the KP mail-order pharmacy or pick them up at one of 5 local network pharmacy locations.
More care options: How you get care is up to you. Choose a phone or video appointment, email your doctor’s office with routine questions, or make an in- person appointment.
PPO Connexus or CCM Synergy? Moda Medical Home Election
For benefits beginning October 1, 2018, if you enrolled in a PPO Connexus Network plan, no action on your part is required.
If you enrolled in a CCM Synergy Network plan for the first time during open enrollment, you must select a Moda Medical Home (MMH) for each covered individual. Each family member can choose a different MMH if they desire. Moda Health will be mailing information about medical home selection to new Synergy Network enrollees soon.
Contact Moda Health Customer Service at 866-923-0409 and confirm MMH selection with a Medical Customer Service Representative.
In order to change a medical home selection, members will need to select their new medical home and communicate the change to Moda Health using the option provided above. This change will be effective the first of the month following the notification of your new selection
If you were enrolled in a CCM Synergy Network plan for the 2017-18 plan year, your current MMH election should roll-over for the new plan year.
Coping with Change and Transition Workshop
The 4J Joint Benefits Committee, in partnership with Cascade Health, is offering a free “Coping with Change and Transition” wellness class. The class will take place:
- Thursday, October 25, 2018
- 5:00 – 6:00 p.m.
- Education Center Auditorium
Life is full of times of change, transition and uncertainty. Whether it is a job change, financial insecurity, a health scare or a shaky relationship, we are often going about our day with a mind full of worry and stress. In this training you will learn practical tips you can utilize in your daily life, to help with symptoms of stress, anxiety and depression during times of uncertainty, change and transition.
Please RSVP by Friday, October 19th to Diana McElhinney: mcelhinney_d@4j.lane.edu or 541-790-7679.
Sick Leave Bank Donation Reminder
Those who elected to join the 2018-19 Classified Sick Leave Bank during last May’s enrollment period will see the donation reflected as a sick leave deduction in the leave section on their September 30th paystub report. We had a total of 436 employees join the bank this year! Thanks for your support to members in need!
4J Flu Shot Clinics Fall 2018
Getting a flu shot is the best protection we have from the flu and its complications, although it cannot prevent all cases of the flu. A flu vaccine also helps prevent spreading flu from person to person. It takes about two weeks after vaccination for antibodies that protect against flu to develop in the body, so make plans to get vaccinated early in fall, before flu season begins.
The 2018-19 vaccine at the flu shot clinics will help protect against 4 different viruses. The providers will be using latex-free prefilled syringes and the vaccine does not contain Thimerosal. The staff administering the vaccine will need easy access to your upper arm—specifically the deltoid muscle below the shoulder. Please dress accordingly.
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4J flu shot clinic eligibility extends to:
* all active employees (even those who are not insurance eligible due to less than half-time status)
* all insurance eligible dependents of active employees, including those who have waived coverage
* all retirees and their dependents who are currently covered on the 4J insurance
* student teachers and substitutes (licensed and classified)
4J flu shot eligibility does not extend to:
*retirees who are no longer on the 4J insurance
*retirees’ dependents who are not on the 4J coverage
Our particular vaccine is not approved for children under age 10 – parents with children under 10 years of age should contact their pediatrician. All children 10-16 years of age must have a parent or guardian with them to be vaccinated.
Other Flu Shot Options
If you can’t make the 4J flu shot clinics and have OEBB/Moda insurance, you can receive a flu shot at a network pharmacy – no copayment necessary! Call ahead of time to make sure the pharmacy has the vaccine you need. Show your Moda Health ID card to the pharmacist for billing before receiving a vaccine – otherwise it may not be covered.
The following Moda participating chain pharmacies provide vaccines: Fred Meyer, Target, Bi-Mart, Albertson Savon, Rite Aid and Safeway. Remember that Walgreens is not a participating pharmacy.
Kaiser Permanente Members: Kaiser offers drop-in flu shot clinics every day from 8:30 a.m. to 5:00 p.m., (Monday through Friday) at the downtown clinic office located at 101 W. 13th Avenue. Please call 541-228-3100 for more information.
Flexible Spending Dates
The Flexible Spending Account (FSA) plan year begins October 1, 2018, and runs through September 30, 2019. If you submitted an FSA enrollment for dependent care expenses and/or unreimbursed health expenses, you should see the first deduction come out of your October paycheck.
If you had a 2017-18 Flexible Spending Account and did not use all of your FSA money set aside for unreimbursed eligible health-related expenses, up to $500 of that unused money rolled over into the new 2018-19 plan year.
Because you have until December 31, 2018, to submit receipts for expenses incurred during the October 1, 2017 – September 30, 2018 plan year, the funds have not yet been released to cover expenses incurred on or after October 1, 2018. PacificSource Administrators (PSA) allows a run out period of 90 days to submit claims for the recently concluded plan year. The carryover of remaining funds will happen automatically after December 31, 2018.
Need your roll over amount sooner than January 1, 2019? PacificSource will grant requests of funds to roll early; however, once the funds roll the member can no longer submit claims for the 2017/18 plan year. Please be advised that any early roll requests take 7-10 days to complete.
If you had a Dependent Care FSA for the October 1, 2017 – September 30, 2018 plan year, you have until December 31, 2018 to submit receipts, but any unused money left in that account at the end of the plan year is forfeited, as per IRS regulations.
If you have any questions, the PacificSource Administrators Customer Service number is 541-485-7488. You can access the PSA website at: http://psa.pacificsource.com/PSA/.
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This newsletter is reviewed and edited each month by the District 4J and OSEA representatives of the Classified Joint Benefits Committee (JBC).The information in this newsletter is summarized, and is not intended as advice or counsel.
