Open Enrollment
**This year’s Open Enrollment is Required. It takes place October 1-31.
Please note: Materials are added as they are made available.
All PEBB members must complete Open Enrollment, even if you decline or opt out of coverage.
- Starting October 1, go to PEBBenroll.com and make your selections
during Open Enrollment. This includes: - Enrolling or re-enrolling in a Health Care or Dependent Care
Flexible Spending Account (FSA). - Making your plan selections.
- Enrolling as a new hire.
- Adding or dropping a dependent.
- Updating your surcharge answers, personal information, or
beneficiaries.
If you don’t complete Open Enrollment by Oct. 31, 2025:
- Your current medical, dental, and vision coverage will stay the
same. You won’t have an option to change them later. - All PEBB surcharges will be automatically deducted from your
paycheck throughout 2026. See Additional Member Costs and
Incentives for more information. - You won’t be able to contribute to a flexible spending account
(FSA). You must enroll or re-enroll each year to participate in an
FSA. You must enroll or re-enroll during Open Enrollment to have a
Flexible Savings Account (FSA) in 2026. FSA enrollments do not roll
over to the next plan year.
Open Enrollment is the one time each year you can make changes to your plans or dependents without a Qualified Status Change (QSC). Your benefit selections are effective January 1–December 31 of the following year
- Enrollment and Benefits
- Open Enrollment Guide
- Dependent Eligibility
- Forgot User Name or Password
- Flexible Spending Accounts
- Health Engagement Model (HEM) is going away
PEBB’s wellness program, the Health Engagement Model or HEM, will no
longer be offered after Dec. 31, 2025 (Page 9 of Guide)
Enrolling
How do you complete open enrollment?
Employees can enroll online or use paper forms.
- Go to: www.Pebbenroll.com to complete this process online.
- To use Paper Forms to Complete Enrollment:
- Download at: http://www.oregon.gov/oha/pebb/Pages/forms.aspx. Search for Open Enrollment forms.
- Paper forms can be faxed, scanned and e-mailed or sent through mail.
Please return the forms to Human Resources by October 31, 2023.
Surcharges
Tobacco usage surcharge
If you and/or you spouse/domestic partner are enrolled in a PEBB medical
plan and use tobacco products, you’ll pay a monthly surcharge. The fee is
deducted from your pay:
- $25/month for employee
- $25/month for spouse/domestic partner, or
- $50/month for both employee and spouse/domestic partner.
If you and your spouse/domestic partner opt out of PEBB medical coverage,
you are not subject to the tobacco usage surcharge.
PEBB offers tobacco cessation programs to help you quit using tobacco and
avoid the surcharge.
Double coverage surcharge
The Oregon state legislature requires a surcharge for those who have
double medical coverage through PEBB and OEBB. This means you’ll pay a
monthly $5 surcharge if you’re an active full-time employee and:
- Someone in your family is covered as a member under their own
PEBB or Oregon Educators Benefit Board (OEBB) medical plan, and - That person is covered as a dependent (spouse, partner, or child) on
your PEBB medical plan.
Spouse/domestic partner waives other employer group coverage
You’ll pay a $50 monthly fee if your spouse/domestic partner chooses to
waive their own employer’s (not PEBB) group coverage.You can submit a
Midyear Change form if your spouse’s/domestic partner’s
coverage status changes during the plan year. You must send in the change
request within 30 days of status change to your payroll or university
benefits office
2026 Medical Plan Changes
General/All Medical Carriers
Doula services: Doula services will now be available. Services include eight pre- and post-natal care visits, plus delivery.
Providence Health Plan and Moda Health
There is a mandatory pharmacy program now required for certain regular medications. If you take certain regular medications, you will have two options to fill these prescriptions. Examples of regular medications are those for high blood pressure or high cholesterol that are filled monthly. The options are:
» Use the mail-order program.
» Fill prescriptions at specific, preferred pharmacies. Preferred pharmacies include many chain and independent pharmacies.You can visit your medical plan’s website to find pharmacies that are convenient for you.
No matter which option you pick, you will get a 90-day supply of your medicine. Your copay (the amount you pay) will be the same as if you paid for two and a half 30-day supplies of medication. If you decide not to use these options, you may pay the full price for your medicine. Also, the money you pay won’t count toward your plan’s deductible or the plan’s out-of-pocket maximum.
Providence Health and Moda Health are partnering with Garner.
Garner helps connect Providence Health and Moda Health medical plan members with high-quality care. The providers listed in the directory are called “Top Providers.” Garner is especially useful when looking for specialists or a new provider.
When you choose to visit a Garner-approved provider, you can be repaid for the costs for your visit. This includes your deductible, copay, or coinsurance. It also includes other services like labs, prescriptions, and X-rays when they’re ordered by your Garnerapproved provider. You may be repaid up to:
» $1,000 per year if you have individual coverage.
» $2,000 per year if you cover yourself and family members.
Note: You’re not required to use Garner. Your Providence Health or Moda Health medical plan network will remain the same even if you don’t use Garner.
You can set up a Garner account starting Oct. 1 to search for Garner providers. You won’t get repaid for any care from a Garner-approved provider before Jan. 1, 2026
Providence Health medical plans
Partnership with Collective Health. Providence Health is now partnering with Collective Health. Together, their name will be Providence Health Powered by Collective Health®. Collective Health will help manage health insurance and medical care. There are no changes to your medical plan coverage or Providence Health’s provider network. However, you will:
» Use a new, dedicated member services phone number.
» Use an upgraded website and app.
» Have new virtual care options for primary care, urgent care, and behavioral health through Galileo.
You will also receive new ID cards with a new member ID number. Besure to share your new ID card with your providers.
Moda Health medical plans
- Out-of-area provider network is changing. When you’re outside
of Moda Health’s service area, you will have access to an Aetna PPO
network. This network is called the Aetna® PPO Network through
Aetna Signature Administrators®. You can visit these Aetna PPO
providers where Moda Health providers aren’t available. This includes
care that’s not urgent or an emergency. - Behavioral Health 360 is available. You will have access to mental
health support and services through the Behavioral Health 360
program. You can find mental health care with personal support and
a screening tool. - Nurseline will no longer be available. CirrusMD will continue
to offer this type of care. Your PCP may also offer something
comparable. - New ID cards will be provided. You will receive new ID cards for
2026. Be sure to share your new ID card with your providers
Kaiser Permanente medical plans
New doula network
» Doula Love: www.portlanddoulalove.com
» Community Doula Alliance: www.communitydoulaalliance.com
Wellness coaching: access free wellness coaching over the phone.
Wellness tools through Calm and Headspac
Kaiser Permanente Dental Plan
- The orthodontia lifetime maximum will increase. The amount the
plan will cover will go up from $1,500 to $2,500. - Nitrous Oxide: The cost share for Nitrous Oxide for patients up to
age 12 is increasing from $0 to $25. - Emergency dental services: The cost for out-of-network emergency
dental services will change to also include usual and customary
charges. - Composite fillings: Coverage will expand to cover teeth outside of
the smile line
Dental & Vision Plan Changes
Delta Dental (Moda Health) Dental Plan
New dental services will be covered.
» Sinus lifts and dental implant bone grafting will be covered.
» Non-IV conscious sedation will be available if you have intellectual or developmental disabilities
Opt-Out or Decline?
Opt-out is a choice that results in PEBB membership. Employees that have other qualifying medical coverage can elect to opt-out of the PEBB medical enrollment and receive a cash payment in their monthly payroll checks. Employee’s MUST attest that all tax dependents have minimal essential health insurance coverage in order to qualify. To continue to opt out of medical benefits in 2026 you must:
- Complete open enrollment between Oct. 1 and Oct. 31, 2025.
- Attest that you still have other group (employer) coverage to receive the opt out incentive. If you don’t complete open enrollment you will remain without medical coverage and lose your monthly incentive.
- Opt out is allowed for medical only and employees must attest to having other employer group coverage to be eligible. This means all current enrolled opt out employees need to complete open enrollment to attest regarding other coverage. If employees who have opted out previously do not attest, they will be removed from opt-out cash back and will be defaulted into a medical plan.
- Decline is that an employee didn’t take an action to enroll in any PEBB option (including the opt-out cash payment option). You are not a PEBB member and receive no PEBB benefits.
