Provider Information/Policy Numbers
WOU’s PEBB Agency Number is 58020. Don’t know your PEBB Benefits number, or have other questions? Contact the Office of Human Resources at benefitsretirement@wou.edu or Michelle Sides, Benefits Coordinator, at 503-838-9390. Click here for the Summary Plan Description.
| Medical Plans | Group Number | Member Number |
| Kaiser Permanente HMO 500 NE Multnomah, STE 100 Portland, OR 97232-2099 Phone: (800) 813-2000 Member Handbook |
18273 | Assigned by carrier |
| Kaiser Deductible 500 NE Multnomah, STE 100 Portland, OR 97232-2099 Phone: (800) 813-2000 Member Handbook |
18273 | Assigned by carrier |
| PEBB Statewide Plan (Administered by Providence) PO Box 3125 Portland, OR 97208-3125 Phone: (800)423-9470 Member Handbook |
108601 | Assigned by carrier |
| Providence Choice PO Box 3125 Portland, OR 97208-3125 Phone: (800) 878-4445 Member Handbook |
106528 | Assigned by carrier |
| Moda Health (Synergy) PO Box 40384 Portland, OR 97240 Phone: (877)605-3229 Member Handbook |
10002802 | Assigned by carrier |
| Dental Plans | Group Number | Member Number |
| Willamette Dental 14025 SW Farmington Road, Ste 300 Beaverton, OR 97005 Phone: (800) 460-7644 |
Z250I | PEBB.Benefits Number |
| Moda Health Premier (Previously ODS Traditional) Moda refers to plan as Delta Dental Premier 601 SW 2nd Avenue Portland, OR 97204 Phone: (800) 452-1058 Member Handbook |
6570 | PEBB.Benefits Number (You should receive a card in the mail.) |
| Moda Health PPO (Previously ODS Preferred) Moda refers to plan Delta Dental PPO 601 SW 2nd Avenue Portland, OR 97204 Phone: (800) 452-1058 Member Handbook |
6571 | PEBB.Benefits Number (You should receive a card in the mail.) |
| Kaiser Permanente 500 NE Multnomah, Ste 100 Portland, OR 97232-2099 Phone: (800) 813-2000 |
18273 | Assigned by carrier |
| Vision Plan (Except for Kaiser Members) | Group Number | Member Number |
| Vision Service Plan (VSP) PO Box 997105 Sacramento, CA 95899 Phone: (800) 877-7195 |
12179989 | PEBB.Benefits Number |
| Life Insurance, AD&D, Disability | Plan Type | Policy Number |
| The Standard PO Box 2800 Portland, OR 97208 Phone: Life Insurance/AD&D: (800)628-8600 Phone: Short-Term Disability: (800) 368-2859 Phone: Long-Term Disability: (800) 368-1135 |
Basic Life & Optional Life Insurance |
606814-D |
| Accidental Death & Dismemberment | 603073-A | |
| Short-Term Disability | 442210-C | |
| Long-Term Disability | 606717-A |
| Long Term Care | Plan Number | Telephone Number | |||
|
025758-003 6 Plan Highlights Certificate of Coverage |
800-227-4165 |
| Flexible Spending Account- Medical and Dependent Care | Telephone Number | |||
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800-659-3035 |
| Employee Assistance Program | Telephone Number | Policy Info. | |||
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Toll Free 800-433-2320Salem 503-588-0777Portland 503-639-3009 |
You will need your Medical Card ID# issued by provider. To enroll online use Company Name “State of Oregon” |
| Mail Order Pharmacy- Statewide & Providence Choice Plans | Telephone Number | Website |
| Walgreens | 800-636-3070 or 800-797-3345 | www.walgreenshealth.com |
| Postal Prescription Services | 503-797-2100 or 800-552-6694 | www.ppsrx.com |
| Wellpartner | 877-935-5797 | www.wellpartner.com |
| MEDEX Travel Assist (included with Employee Basic Life Insurance) | Telephone Number | Website |
| US, Canada, Puerto Rico, Bermuda, US Virgin Islands | 800-527-0218 | http://www.standard.com/eforms/12092.pdf |
| All Other Countries (Call collect.) | 410-453-6330 | http://www.standard.com/eforms/12092.pdf |
| Retirement Provider Information | Telephone/Fax Number/ Email | Employer Number | ||||||||
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Western Oregon University 01255 |
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P: 1-800-768-7377 | Western Oregon University 01255 |
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Oregon Public Universities ORP: 71681 TDI: 71678 |
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Oregon Public Universities ORP: 101528 TDI: 101529 |
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