Bookmark & ShareFor Immediate Release: 10/28/2008
Read details on hearing aid benefit, premium increase and other topics. If your question isn’t answered here, try our Frequently Asked Questions search tool.
Topics:
Hearing aid benefit change
If the Health Care Authority approved an $800 hearing aid benefit beginning in 2009, why don’t SecureHorizons and the Kaiser Permanente Senior Advantage Value Plan offer a hearing aid benefit?
Plans that never covered hearing aids can continue not covering hearing aids. Neither Kaiser Permanente Senior Advantage Value, nor SecureHorizons Value, offered a hearing aid benefit in 2008. However, SecureHorizons has decided to offer a minimum $500 hearing aid benefit to all of its subscribers, at no additional cost to the state or the enrollee. You can contact SecureHorizons for details at 1-866-572-9396.
Who can I talk to about the benefits changes?
Representatives from our health plans and the Health Care Authority will be available at our benefits fairs during open enrollment. Or you may contact your health plan directly.
Adult Dependents
What is the difference between a student dependent and an adult dependent?
Starting January 1, 2009, unmarried children age 20 through age 24 who do not meet PEBB eligibility as students or dependents with disabilities are eligible for adult dependent coverage. If eligible as students or dependents with disabilities, then they should be enrolled as such to take advantage of the lower premium.
Subscribers must pay the full cost of an adult dependent's coverage. This means there is no employer contribution for adult dependents. (You can find the rates on the Adult Dependent Enrollment/Change form.) The adult dependent is enrolled directly with PEBB and the subscriber is billed by PEBB under a separate account.
Other differences:
- An adult dependent does not have to be a student or an IRS qualified dependent.
- Student dependents can be covered through age 23. Adult dependents can be enrolled through age 24.
- If an employee waives his or her enrollment in PEBB medical, the adult dependent can still enroll or remain enrolled in medical coverage.
- If a retiree or survivor defers his or her enrollment in PEBB retiree insurance, the adult dependent may enroll or remain enrolled.
- The adult dependent cannot enroll in PEBB life insurance.
2009 premium increases
Why are Group Health’s Classic Plan premiums increasing so much for 2009?
Group Health saw a sharp increase in their members’ claim costs. The increase in premiums in 2009 reflects this increase in costs.
Why does Group Health’s Value Plan cost so much less than the Classic Plan?
Members in the Value Plan pay an annual deductible (a fixed amount the member pays before the health plan pays for services) and they have higher copayments than members in the Classic Plan.
As a group, members in the Value Plan used fewer, less-expensive services than members in the Classic Plan, so the costs for providing services to Value Plan members was less.
Why are Group Health Classic‘s premiums so much more than premiums for the Uniform Medical Plan?
Health plans’ premiums are based on the plans’ costs for health care services for its members. Both Group Health Classic and the Uniform Medical Plan (UMP) offer substantially the same services, but Group Health Classic members pay less out-of-pocket for services than members in UMP. In the Group Health Classic Plan, members pay a low fixed copayment (for example, $10 for an office visit) and no deductibles.
When UMP members receive services, they usually pay a percentage of the total costs of those services after they pay their annual deductibles (for example, a $200 per-person deductible for medical, $100 per-person deductible for some prescription drugs, and then in most cases, 10% of the cost of services after the medical deductible has been met).
Enrollment guide mailing
I usually receive an enrollment guide every year before the annual open enrollment period. Why hasn’t it arrived?
If you are an employee:
You may request of employee enrollment guide through your or benefits office. You also can download a copy from the Publications page of our Web site.
If you are a retiree:
In response to feedback from our retiree members, we are no longer mailing the Retiree Enrollment Guide automatically to retirees. You can download a copy from the Publications page of our Web site or have one mailed to you by calling 1-866-577-2793.
