OEBB

General benefits

Are the medical, vision, pharmacy and dental benefit plans administered on a calendar-year basis or a plan-year basis?

All benefits, including medical, vision, pharmacy and dental plans, are administered on a plan-year basis. The plan year begins Oct. 1 and goes through Sept. 30.

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What are the benefits, copayments and out-of-network benefits for each plan?

Plan comparison documents with complete plan information for 2016-17 are located on the plan summaries page.

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Are there any late enrollee penalties?

Members who do not enroll when originally eligible can only enroll during the annual open enrollment period, unless members experience a qualified status change. Members who do not enroll in the dental and vision plans when originally eligible and later elect to enroll during open enrollment will be eligible for preventive services only for dental and exam only for vision for the first 12 months of coverage.

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Does OEBB or Moda Health require members to use their social security numbers as identification?

Members are not required to use their social security numbers as identification. OEBB will assign unique identification numbers. These numbers also are used by Moda Health. OEBB members should present their Moda Health ID cards when receiving services. Providers should bill Moda Health using the memberís unique ID number.

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When an OEBB member has dual OEBB coverage, does the deductible have to be satisfied or will it be picked up by the other plan?

The deductible still must be satisfied prior to any benefit reimbursement. Examples of how plans coordinate benefits can be found in the medical, pharmacy and dental sections.

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