EPSD9 OEBB Plan Rates - Click Here
Introduction to OEBB / EPSD9 Health Insurance Plans
EPSD9 participates in the Oregon Educators Benefits Board, “OEBB”. OEBB offers a variety of Medical, Dental, Vision, and optional insurance plans for the benefit of school employees. As an employee of EPSD9, you may be eligible to enroll in these insurance packages (depending on your scheduled work hours). The selection of which medical, dental, and vision plans to choose can be complicated; this introduction is intended to explain some of the basics for new employees to help you decide which plans to consider. This is not meant to be a complete description, but just an introduction to help you get started with plan selections.
The best sources of information for OEBB health insurance plans are the OEBB website at
https://www.oregon.gov/oha/OEBB/Pages/index.aspx, OEBB’s “2023-24 Enrollment Guide”, and the School District’s website and intranet benefits pages. The OEBB website includes summaries and explanations of all available medical, dental, vision, and optional insurance packages; the School District website includes links to many related documents and websites.
Important Terms: It might be helpful to know a few terms as you review the plan summary documents. For a complete list of terms see the “2023-24 Enrollment Guide” on the OEBB website. A few of the more important terms include:
Deductible: The amount you must pay each plan year before your insurance begins to pay for covered health care services.
Out-of-Pocket Maximum: The most you will pay for services in a year before your plan begins paying 100% of eligible expenses. Monthly insurance premiums are not included in this limit and must continue to be paid even after the Out-of-Pocket Maximum has been met. In addition, certain expenses are excluded from your Out-of-Pocket maximum as explained on the plan summary sheets.
Coinsurance: The percentage of health care expenses you pay after meeting your annual deductible.
Copayment or Copay: A fixed dollar amount you pay for certain services.
Six OEBB medical plans (Moda plans 2 through 7)
Six dental plans (offered by Delta Dental or Willamette Dental Group), and
Five Vision plans (offered by Moda or VSP).
EPSD9 does not offer all the medical, dental, and vision plans sponsored by OEBB. Please see the OEBB EPSD9 plan summary sheets: https://drive.google.com/file/d/1Ag2yEfHvADAsPW6Ec9mCcY6HMIUJutsL/view?usp=drive_link
for details of the OEBB plans offered by EPSD9.
Moda Medical plans 2 through 7 all utilize the Connexus Network of providers. In general, the more expensive plans offer lower deductibles, lower Out-of-Pocket Maximums, lower Copays or Coinsurances, and certain other enhancements. The Deductibles and Out-of-Pocket Maximums are shown for each plan, along with other important differences explained in the Notes.
Medical plans 2 through 5 are traditional medical insurance plans where you pay your deductible and then a stated copay or coinsurance for listed types of services. You pay reduced amounts when you use “In-Network” providers or higher amounts when you use “Out-of-Network” providers.
Plans 6 and 7 are “High Deductible Health Plans” (HDHP’s) that allow you to also open a Health Savings Accounts (HSA). Plans 6 and 7 have higher deductibles and use percentage-based Coinsurance amounts for certain services (vs flat dollar amount Copayments) and other differences as shown on the plan summary sheets. If you choose medical plans 6 or 7 EPSD9 will contribute $75 per month into your HSA in addition to any amount you choose to contribute (up to IRS limits). See our website “Employment Benefits” section for more details about this option. It is important to know that “Note 1” waiving your deductible for certain services (explained below) does not apply to Plans 6 and 7.
“Note 1” on the OEBB Medical plan summary sheets explains that the Deductible is waived for certain services in certain medical Plans (as shown for each different plan) which can be a very important cost difference when selecting a medical plan.
“Coordinated Care” is an option in the Moda medical plans that allows you to choose a PCP360 to coordinate your care with other providers as needed, and receive lower deductibles and lower office visit costs. See the OEBB or Moda website for more information on this option.
12-Month Waiting Period for Dental benefits: If you or a dependent don’t enroll in dental coverage when initially eligible, then choose to enroll during an Open Enrollment period, you or your dependent will be considered a “late enrollee” for dental coverage and will be subject to a 12-month waiting period for all dental services other than diagnostic and preventive care.
The cost for each Medical, Dental, and Vision plan is shown on the attached sheet along with the School District contribution amount (the “District Cap”). District caps are based on your coverage category (“Employee Only”, “Employee & Spouse”, “Employee and Child(ren)”, or “Family”) and your work hours, as shown on the sheet. Your monthly cost for Medical, Dental, and Vision insurance is the total cost of your selected health insurance packages minus your District cap.