%PDF-1.4 %���� 2021 Open Enrollment Summary 500 Summer Street NE of Benefits Salem, OR 97301-1063 www.PEBBinfo.com 2021 PEBB Benefits www.PEBBinfo.com 2021 Summary of Benefits This information gives a high-level summary only. PEBB plan changes for 2021 The Public Employees Benefits Board (PEBB) approved a number of changes to PEBB Program rules, policies, benefits, and premiums that will go into effect on January 1, 2021. Began: 11/01/20 Ended: 11/30/20 . 0000010131 00000 n Inaccurate, incomplete, or illegible information may delay coverage. h�b```c``1g`e`��ad@ A�+� �ʅ�% ���6,�� You may enroll during the 2021 plan year if you or an eligible family member has a qualified change in status event that creates a special open enrollment. 0000008539 00000 n Just Medical, Dental and Vision rates (Page 11 from the Enrollment Guide) Members pay 1-5% of these rates. December • Social Security Benefit Rate Change Notice – informs people about benefit changes and Medicare premiums due to cost of living increases, etc. PEBB Program’s Annual Open Enrollment. '/_layouts/15/hold.aspx' javascript:if (typeof CalloutManager !== 'undefined' && Boolean(CalloutManager) && Boolean(CalloutManager.closeAll)) CalloutManager.closeAll(); commonShowModalDialog('{SiteUrl}'+ 0000002123 00000 n DEFER YOUR ENROLLMENT. 0000001016 00000 n  Website Feedback​. Whether you’re a member or are thinking about joining, we’ll help you get the information you need to make an informed decision about your health coverage. Oregon state and university employees' 2021 medical, dental and vision benefit information. Open Enrollment Transfers from Old Carrier to New Carrier: Medical - All Subscribers ... Enrollment Selections Made through 12-28-2020 New Carrier Original Enrolled Current ... Tf.fi Th.ni f.el Ähange T Dental. If you have been asked to re-attest to the spouse or SRDP premium surcharge, complete a 2021 Premium Surcharge Attestation form. Therefore, you must complete the entire form, including the dependent section for any children you want to continue to cover. Addendum 45-2A (effective 1/1/2021) Health Care Authority Page: 2 of 16 Special Open Enrollment (SOE) Matrix ERB Division Policy, Rules, and Compliance This matrix only summarizes special open enrollment events in chapters 182-08 and 182-12 WAC and the corresponding actions that are allowed. Enrollment forms ..... 6 4. To learn more about working with My Account, visit our Help with My Account webpage. +'?ID={ItemId}&List={ListId}'); return false;}}, null); Other Health System Reform Related Topics, Birth, Death, Marriage and Divorce Records, Residential and Outpatient Behavioral Health, Other License and Certificate Related Topics, Open Enrollment and Health Engagement Model (HEM) Quick Guide, Accidental Death and Dismemberment (AD&D), OHA ADA Policy and Request for Modification. Open enrollment is the one time each year when you can change your medical or dental plan, add or remove dependents, enroll or re-enroll in FSA/DCAP for the next year, and re-attest to the spousal surcharge questionnaire. 0000002210 00000 n Title: PEBB Program Open Enrollment Switching Report 2021 … To learn more about your new benefits, your welcome packet, and what to do if you have an urgent health care issue please visit the New to Oregon Health Care web page​. It has known security flaws and may not display all features of this and other websites. 0 Exception: If you attest to the spouse or state-registered domestic partner coverage premium surcharge during the PEBB Program’s annual open enrollment, the change will become effective January 1, 2021. 2021 Open Enrollment. 0000014863 00000 n 34 36 0000000016 00000 n 0000115910 00000 n This is "PEBB dental open enrollment 2021 webinar" by Moda Health on Vimeo, the home for high quality videos and the people who love them. 2021PEBB Employee Enrollment/Change The information written on this form replaces all enrollment/change forms previously submitted. '/_layouts/15/itemexpiration.aspx' 0000002703 00000 n 0000003154 00000 n 2021PEBB Retiree Open Enrollment Election/Change Form Complete this form to make changes during the PEBB Program’s annual open enrollment. We accept all relay calls or you can dial 711. +'?ID={ItemId}&List={ListId}', 'center:1;dialogHeight:500px;dialogWidth:500px;resizable:yes;status:no;location:no;menubar:no;help:no', function GotoPageAfterClose(pageid){if(pageid == 'hold') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+ 0000080811 00000 n 0000115266 00000 n FDA-authorized COVID-19 vaccines are covered at $0 cost-share to you through Dec. 31, 2021. (University of Washington employees must enroll online in Workday.) 0000001818 00000 n HCA/PEBB ENROLLMENT FORMS > ... 2021 Premium Rate Sheet; PEBB MEDICAL ONLY-if you are not making any changes, you do not need to complete a new form. ... 2021 Enrollment Change Form; TEAMSTERS PROBATION. 69 0 obj <>stream 0000001360 00000 n Therefore, you must complete the entire form, including the dependent section for any children you want to continue to cover. Need help or have questions? 0000058956 00000 n The Open Enrollment period for 2021 begins November 1 and will run through November 30. +'?ID={ItemId}&List={ListId}'); return false;} if(pageid == 'audit') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+ 0000013252 00000 n Your PEBB Benefits. The annual open enrollment period runs November 1-30 with an effective date of January 1, 2020 for all changes. 0000016682 00000 n startxref 0000005071 00000 n Continued on back 2021 plan information PEBB virtual benefits fair Welcome to UMP Plus PEBB Employees For more information watch the UMP Plus – Puget Sound High Value Network (PEBB) Open Enrollment Webinar for 2021: UMP Plus — Puget Sound High Value Network (UMP Plus — PSHVN) brings together top-quality, independent providers from across Washington to deliver high quality, high value health care. 0000001621 00000 n More information and a summary of Open Enrollment changes are available at the Health Care Authority’s website. Learn how. * You can get this document in other languages, large print, braille or a format you prefer. 0000001297 00000 n All 2021 forms will be available November 1, 2020: What’s Changing? 3 Delta Dental plans • Delta Dental Premier® Network −Largest dental network in Oregon −Over 2,400 providers in Oregon & over 155,000 providers nationwide • Delta Dental PPO SM Network −Over 1,300 providers in Oregon & over 112,000 providers  Follow us on Twitter 0000006652 00000 n +'?Category=Auditing&backtype=item&ID={ItemId}&List={ListId}'); return false;} if(pageid == 'config') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+ HUMAN RESOURCES WILL BE UPDATING THIS INFORMATION AS WE RECEIVE IT. 0000059199 00000 n PEBB 2021 Open Enrollment: Dental Delta Dental. Members may submit the FSA Open Enrollment form to HR or PEBB, marking the corresponding correction at the top of the form. 2020 Benefit Information here. Looking for last year's information? Any changes you make during this Open Enrollment period will be effective July 1, 2020 through June 30, 2021. Forms received after November 30, 2020, will not be accepted for Medical FSA or DCAP enrollment. To estimate your portion, visit the Payroll Deduction Estimator below . We recommend using your personal email address to access your account. 0000001640 00000 n 0000081287 00000 n – You must do open enrollment during October 2020 and CHOOSE to participate in HEM – You must do your Health Assessment on your current PEBB medical plan between September 1 st and October 31 2020 I wanna play in 2021! Compare plans available in your county with the Medical Benefit Comparison Tool. Your browser is out-of-date! '/_layouts/15/Reporting.aspx' 2021 PEBB Employee Enrollment/Change 2021 PEBB Employee Enrollment Change for Medical Only Groups Long-term Disability (LTD) Enrollment/Change Form Premium Surcharge Attestation Help Sheet HCA is committed to providing equal access to our services. PEBB Health Insurance Open Enrollment for 2021 Benefits Takes place October 1 through October 31, 2020 2021 PEBB Enrollment Guide 2021 PEBB Summary of Benefits 2021 PEBB Benefits Comparison Tool 2021 Payroll Deduction Estimator Flu Shot 2020 Information Open Enrollment Summary & Plan Changes Dependent Eligibility and PEBB’s Dependent Eligibility Review Process Children turning '/_layouts/15/expirationconfig.aspx' 0000081233 00000 n This page is intended for 2021 Enrollment information. Submit a new PEBB Retiree Election form within 60 days – Have no break in other qualifying medical coverage (not even one day) – Include a loss of coverage letter – Questions: Contact Health Care Authority at 1-800-200-1004. 0000016739 00000 n 2021 Open Enrollment Forms and Information. Open Enrollment Webinar UMP Plus-UW Medicine Accountable Care Network is a cost-effective option for Public Employees Benefits Board (PEBB) eligible employees living in King, Snohomish, Kitsap, Pierce, Skagit, Thurston and Spokane counties. xref This is "PEBB medical open enrollment 2021 webinar" by Moda Health on Vimeo, the home for high quality videos and the people who love them. Change medical and dental plan online through PEBB … All changes made during open enrollment are effective January 1, 2021. 0000058723 00000 n December 7 2020 Annual OEP ends. Contact PEBB at 503-373-1102 or email inquiries.pebb@dhsoha.state.or.us. Oregon state and university employees' 2021 medical, dental and vision benefit information. , will not be accepted for medical FSA or DCAP Enrollment to your... In your county with the medical benefit Comparison Tool from Kaiser Permanente 2021 begins November 1, 2021 Monday! In other languages, large print, braille or a format you prefer make during Open! 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