[MyOEBB] NEXT STEPS AFTER OPEN ENROLLMENT

Fri Sep 18 13:15:29 PDT 2015

NEXT STEPS AFTER OPEN ENROLLMENT

We made it! Open enrollment has ended!  OEBB staff received over 11,100 calls and over 3,500 emails in our office, attended 163 on-location open enrollment meetings and over 51,000 subscribers completed their enrollments online.  I am sure each of you experienced a significant increase in your calls and emails as well.  We sincerely appreciate all the important work you do, both during Open Enrollment and all year long.

OEBB's goal is to offer affordable health care to all eligible school, ESD, community college, city, county and special district employees, early retirees, and their families. We do not want any employees to go without insurance for any period of time.  Therefore we ask you to please consider assisting your employees that missed online open enrollment to ensure their families have appropriate coverage effective October 1st.

Administrative Rule 111-040-0025 (1) (a) allows employing entities to make corrections within a 45 day period. Please do not refer your employees back to OEBB to complete any open enrollment selections or changes, as OEBB will direct them back to you. Each employing entity has unique policies for their employees. We encourage you to please assist your employees in making any open enrollment selections or corrections.

MYOEBB Administrative Module

  *   September 16th - OEBB carriers are receiving their first Post-OE HIPAA files which will include all the 9/30/2015 terminations due to mandatory open enrollment plan termination rollovers and new enrollments for the 2015-16 plan year.  They will receive another file from OEBB with changes on 9/19/2015 and 9/26/2015.  They will receive a final Post-OE file on 10/01/2015 and weekly thereafter.
  *   September 16th through September 30th - We have an Open Enrollment Segment in the MyOEBB Enrollment Management program specifically to allow entities to easily enroll employees.  This feature will be available through September 30th.  When you use the Open Enrollment Segment you do not have to assign a QSC to an employee to accommodate changes.  Please remember to use a New Hire QSC when appropriate to avoid a 12-month wait on Dental and Vision plans.  Proactive steps to enroll members using this Open Enrollment Segment before October 1st will minimize the worry for employees and the workload for office staff.
  *   September 16th through September 30th - Entities will have the opportunity to update Healthy Futures participation in the MyOEBB Administrative Module under Enrollment Management.  After September 30th, admins will not be able to update a member's Healthy Futures participation for the 2015-16 plan year.
  *   Now through October 15th - Members have the opportunity to complete their Health Assessments either through Moda Health or Kaiser Permanente.  Moda Health members can go to www.modahealth.com/oebb<http://www.modahealth.com/oebb> and Kaiser members can go to http://kp.org/tha to complete their assessments.  Please note, members who were enrolled in a Healthy Futures medical plan because they promised to complete their Health Assessments by October 15th but then fail to do so will be reverted back to the regular non-incentivized medical plan and may be responsible for additional charges incurred during this time period. OEBB will mail notifications to these members informing them of the retro change as soon as they are identified - we anticipate a mail date of November 1st (see "Mailings" below).
  *   October 1st through October 31st - Your administrative office will be able to assign an "Open Enrollment" QSC to back-date coverage effective October 1st.  Make sure to use a "QSC Event Date" of 9/30/2015 to ensure a "Coverage Effective Date" of 10/01/2015.  Again, OEBB encourages you to assist employees not currently enrolled in 2015-16 insurance benefits to enroll in coverage using the Enrollment Management program in MyOEBB, but this is an entity's choice.  Please note that OEBB has specified in our Post Open Enrollment mailings for members to contact their entities by Friday, October 16th of any errors in their benefits.  Also note that OEBB Division 40 OAR authorizes entities to correct enrollment errors reported by eligible employees within 45 calendar days of the open enrollment period end date.  OEBB encourages entities to please assist your employees in correcting open enrollment errors during this time period within your benefits office.

  *   November 1st - Employees not enrolled in benefits as of November 1st will need to contact OEBB to formally appeal their right to enroll in benefits.  We sincerely hope to see all employees with insurance, but OEBB will continue to respect the authority and decisions of entities as we have in past years.
  *   November 1st - Carriers will receive retro changes for OEBB members that didn't complete their Health Assessments by October 15th, retroactively changing their medical enrollments back to the non-incentivized plans effective October 1st.

REPORTING
The following reports are accessible and may be helpful to you over the next couple of weeks:

  *   "Subscriber Open Enrollment Activity": This report can be used to track the activity of the subscribers during open enrollment. If you are monitoring whether your employees saved their benefits during open enrollment, you will want to go to the column "Last Saved Benefits Date". The report is sorted by this column with the most recent first.  If you page through to the end of the report you will find any employees who have not yet gone in and saved their benefits. Employees may have modified their benefits without saving those selections. They will still need to be saved to take effect in MyOEBB.  If you see employees on this report that are no longer an employee, check to make sure the employment record has been ended in MyOEBB.
  *   "No Medical Dental or Vision 2015": Use this report to identify subscribers who have not gone into MyOEBB and made plan selections.  If an employee has selected benefits but has not yet saved those selections, they will not show up on this report.

  *   "Entity Medical Opt Out or Waive": This report lists employees who have opted out or waived medical coverage.  When selecting the End Date make sure to enter a date greater than the first day of the new plan year (e.g., 10/02/2015).

  *   "Entity Opt Out and Waive": This is a more detailed version of the above report, listing employees who have opted out or waived medical coverage, but it also lists by employee group the type of opt out and the other coverage the subscriber has entered into the system and displays the expiration date.  When selecting the End Date, make sure to enter a date greater than the first day of the new plan year (e.g., 10/02/2015).

Synergy and Summit Networks
With the continuation and growth of the Synergy and Summit networks through Moda we realize that members may need to make their medical home selections.  So, we have the following processes in place:

September 16th and after - Members enrolled in a Synergy or Summit plan need to select their medical home directly through Moda by either calling 1-866-923-0409 or they can send an email to medical at modahealth.com<mailto:medical at modahealth.com>.  It is not necessary to update their medical home selections if they are continuing in a Synergy or Summit plan from 2014-15 unless they want to change that medical home selection.  Moda will also be sending out a communication to members enrolling in Synergy or Summit network for the first time this open enrollment and members re-enrolling that haven't selected a medical home.

MAILINGS (reference samples will be emailed separately)

  *   September 16th through 18th - OEBB will pull data from MyOEBB for those entities whose Open Enrollment period ended September 15th or earlier to be used in the Post Open Enrollment mailing, which will include a benefits statement showing each member their 2015-16 enrollments as well as a letter asking them to review their statement and report any errors to their entity benefits administrator no later than October 16, 2015. (As mentioned above, we encourage you to assist them in correcting errors, but we support each entity's policy decisions.)  We are targeting a mail date of September 29th.  This year OEBB will send this communication to all members via USPS (hard copy).  We will not send any electronic email communications for this particular mailing.
  *   September 28th - OEBB will pull data from MyOEBB for those community colleges that extend open enrollment until September 25th to be used in the Post Open Enrollment mailing, which will include a benefits statement showing each member their 2015-16 enrollments as well as a letter asking them to review their statement and report any errors to their entity benefits administrator no later than October 16, 2015. (As mentioned above, we encourage you to assist them in correcting errors, but we support each entity's policy decisions.)  We are targeting a mail date of September 29th.  This year OEBB will send this communication to all members via USPS (hard copy).  We will not send any electronic email communications for this particular mailing.
  *   Also on September 28th - OEBB will pull data for our annual letter informing members who will be subject to a 12-month waiting period on Dental and Vision plans. This mailing will also be sent USPS hard copy to all affected members - no emails.
  *   Approximately October 1st - BenefitHelp Solutions (OEBB COBRA administrator) will mail letters to members who dropped coverage completely during open enrollment, dropped a specific healthcare coverage or dropped a dependent from one or all healthcare coverages.  This communication will inform members that coverage was dropped during this open enrollment and if a qualifying event happened they may be COBRA eligible.
  *   Approximately November 1st - OEBB will mail USPS (hard copy) notifications to all members being reverted back to the normal non-incentivized medical plans for not completing their health assessments by October 15th as they had promised. The letter will explain that the plan change will be retroactively effective October 1, 2015 and that they may be responsible for additional charges for medical claims incurred since October 1st.

Our OEBB team stands ready to assist your entity with any enrollment issues or questions during the coming months as well as throughout the year.  Thank you for your continued cooperation. Your efforts made the 2015 OEBB Open Enrollment yet one more success for OEBB members.
Linda Freeze
Benefits Manager
Oregon Educators Benefit Board
1225 Ferry Street SE
Salem, OR 97301
Office:  (503) 378-3329
Fax:  (503) 378-5832

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