PEBB General FAQs
Are the medical, pharmacy and dental benefit plans administered on a calendar-year basis or a plan-year basis?
All benefits, including medical, pharmacy and dental plans, are administered on a calendar-year basis. The plan year begins Jan. 1 and goes through Dec. 31.
What are the benefits, copayments and out-of-network benefits for each plan?
Plan comparison documents with complete plan information for 2021 are located on the plan summaries page.
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.
Does PEBB 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. PEBB will assign unique identification numbers. These numbers also are used by Moda Health. PEBB members should present their Moda Health ID cards when receiving services. Providers should bill Moda Health using the member’s unique ID number.
When a PEBB member has dual PEBB coverage, does the deductible have to be satisfied or will it be picked up by the other plan?
The deductible still must be satisfied before any services subject to a coinsurance can receive benefit reimbursement. Examples of how plans coordinate benefits can be found in the medical, pharmacy and dental sections.
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Hello.
We have exciting news to share. ODS is changing its name to Moda Health.
Moda comes from the latin term "modus" and means "a way". We picked it because that's what we are here to do: help our communities find a way to better health.
Together, we can be more, be better.
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