PEBB Healthcare Changes

Some Highlights:
Here is the summary of PEBB plan design changes for 2009. This document was prepared by PEBB (I just now we received it) and we’re planning to use it as is.

Highlights include:

--eliminating the deductible on Kaiser dental;

--changing vision coverage to cover exam and hardware every 12 months, instead of every 24 months;

--increasing basic life insurance coverage from $5000 to $25000.



PEBB also took steps to eliminate or reduce cost barriers to certain highly effective treatments or screenings, including:

----tobacco cessation programs

----weight management programs

----certain highly effective generic drugs for treating heart disease, diabetes, high cholesterol or depression.

----screenings for cancer of the breast, cervix, colon or prostate.



The overall increase in the composite rate will be 4.83%, less than half of the budgeted amount of 12%.



From the memo:

Align Vision Coverage

After review of routine vision coverage offered by other government employers, the Board adjusted the vision plan to cover exam and hardware every 12 months. Members may “bank” any unused portion of the $200 hardware benefit for use at another time during the 12-month period.


Adjust Kaiser Dental

For 2008, the Board asked Kaiser Permanente to make its plan more affordable by mirroring the ODS design, which includes a deductible. For 2009, the Board voted to remove the deductible from the Kaiser dental plan.


Use Life Insurance Assets for the Benefit of Members

Increased Basic Life All eligible employees will receive $25,000 in basic life insurance coverage. Agencies will pay premiums for the first $5,000; PEBB will pay premiums for the additional $20,000. This is guarantee issue, which means the carrier does not require approval. Coverage is automatic; enrollment is not required.

Increased Optional Life
Eligible employees not currently enrolled may purchase up to $40,000 in guarantee-issue coverage during Open Enrollment for 2009. This applies even for employees whose previous application was denied.

Currently enrolled employees may increase their coverage by 50 percent as guarantee issue during Open Enrollment for 2009.

Newly eligible employees may enroll in $40,000 of optional life insurance coverage as guarantee-issue within 60 days of their date of hire or eligibility.

Increased Optional Life Maximum Eligible employees may purchase optional life coverage to a new maximum amount of $600,000. Amounts must be in $20,000 increments, and amounts above $40,000 require plan approval. The $600,000 maximum applies to the employee only; spouse or domestic partner maximum remains $400,000. If both are state employees, each may have up to $600,000 maximum coverage.