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. Click here for the Summary Plan Description.
For most current provider information visit PEBB’s website.
Medical Coverage
Employees may choose between five medical plans: You pay 5% of the monthly premium cost, unless you enroll in the lowest cost plan in your zip code, then you pay 3%.
PEBB Statewide Plan
Providence Health Plan Powered by Collective health
Contact
PO Box 3125
Portland, OR 97208-3125
Phone: (800) 423-9470
Group Number: 108601
Member Number: Assigned by carrier
Providence Choice
(HMO Plan) - available to employees who live or work in Benton, Clackamas, Clatsop, Hood River, Lane, Lincoln, Linn, Marion, Multnomah, Polk, Wasco, Washington, Yamhill in Oregon; Clark, Walla Walla in Washington.
Contact
PO Box 3125
Portland, OR 97208-3125
Phone: (800) 878-4445
Group Number: 106528
Member Number: Assigned by carrier
Kaiser Permanente
Kaiser Traditional HMO Plan or Kaiser Deductible HMO Plan – available to employees who live or work in Benton, Clackamas, Columbia, Hood River, Linn, Marion, Multnomah, Polk, Washington, and Yamhill in Oregon; Clark, Cowlitz, Lewis, Skamania & Wahkiakum in Washington. You must coordinate medical care through a Kaiser facility.
Contact
500 NE Multnomah, STE 100
Portland, OR 97232-2099
Phone: (800) 813-2000
Group Number: 18273
Member Number: Assigned by carrier
Moda Health
Available to employees who live or work in Benton, Clackamas, Clatsop, Lane, Linn, Marion, Multnomah, Polk, Tillamook, Wasco, Washington, Yamhill, in Oregon; Clark in Washington.
Contact
PO Box 40384
Portland, OR 97240
Phone: (877)605-3229
Medical/Pharmacy: 844-776-1593 Dental: 844-827-7100
Group Number: 10002802
Member Number: Assigned by carrier
Health Engagement Model
Signing up for the HEM program gives you and your spouse or partner lower monthly deductions for health coverage and important tools for better health. See the HEM Program Page for more information.
If you participate in the HEM program you receive an incentive of $17.50 (employee only) per month.
Tobacco Use Program
Employees enrolled in a medical plan who use tobacco have a deduction to help offset the risks they bring to the group.
For employees and/or their covered spouse/domestic partner who use tobacco there is a monetary monthly deduction. Tobacco users can stop the deduction if they quit using tobacco mid-year.
Employees to whom this applies have a monthly surcharge of $25 per person.
Spouse-Other-Coverage Program
If an employee covers a spouse or domestic partner on their medical plan and their spouse or partner waives coverage offered by their employer, it shifts risk and costs to PEBB.
Employees to whom this applies have a monthly surcharge of $50.
Dental Coverage
PEBB sponsors four dental plans: (You may choose to enroll or not enroll.)
You pay either 5% or 3% of the monthly premium cost dependent on your medical plan enrollment.
Moda Health Premier
Provides nationwide coverage, employees may choose any dentist.
Contact
Moda refers to plan as Delta Dental Premier
601 SW 2nd Avenue
Portland, OR 97204
Phone: (800) 452-1058
Group Number: 6570
Member Number: *PEBB.Benefits Number
*(You should receive a card in the mail.)
Moda Health PPO
Provides coverage under a select list of dentists.
Contact
Moda refers to plan Delta Dental PPO
601 SW 2nd Avenue
Portland, OR 97204
Phone: (800) 452-1058
Group Number: 6571
Member Number: *PEBB.Benefits Number
*(You should receive a card in the mail.)
Willamette Dental Group
A dental health maintenance organization with select locations throughout the Willamette Valley.
Contact
14025 SW Farmington Rd, Ste 300
Beaverton, OR 97005
Phone: 855-433-6825
For free language assistance, please call 1-855-433-6825.
Group Number: Z250I
Member Number: *PEBB.Benefits Number
*(You should receive a card in the mail.)
Kaiser Permanente Plan
Employees must live in the service area and coordinate dental care through a Kaiser facility.
Contact
500 NE Multnomah, Ste 100
Portland, OR 97232-2099
Phone: (800) 813-2000
Group Number: 18273
Member Number: Assigned by carrier
Vision Coverage
PEBB sponsors one vision plan (VSP Vision Plan) if you aren’t with Kaiser medical: (You may choose to enroll or not enroll.) You pay either 5% or 3% of the monthly premium cost dependent on your medical plan enrollment.
Vision Service Plan (VSP)
Except for Kaiser Members
Contact
PO Box 997105
Sacramento, CA 95899
Phone: (800) 877-7195
Group Number: 12179989
Member Number: PEBB.Benefits Number
*(You should receive a card in the mail.)
Kaiser Provided
Kaiser provides the vision coverage for all of the Kaiser plans
- Kaiser “Part-time” plans offer a limited vision benefit limited to the exam only
- Refer to your medical plan summary for details on the Kaiser vision benefits
Contact
500 NE Multnomah, Ste 100
Portland, OR 97232-2099
Phone: (800) 813-2000
Optional Benefits
Optional benefits include, optional life insurance, short-term disability and long-term disability insurance and medical/dependent flexible spending accounts.
Optional Life Insurance
Benefit eligible employees may elect for additional life insurance coverage through The Standard.
- Optional life insurance is available up to $600,000 for employee’s coverage and $400,000.00 for spouse/domestic partner coverage.
- The first $45,000 of employee life insurance is paid on a pre-tax basis.
- Amounts above $45,000, and spouse life insurance, are deducted on a post-tax basis
Contact
PO Box 2800
Portland, OR 97208
Phone: (800)628-8600
Plan: Basic Life & Optional Life Insurance
Policy Number: 606814-D
Plan: Accidental Death & Dismemberment
Policy Number: 603073-A
Short Term & Long Term Disability Insurance
PEBB offers a short-term disability plan, and long-term disability coverage to our employees through The Standard.
- Disability plans offer income protection during times when an employee is unable to work due to an injury or illness.
- Premiums for disability insurance are paid on a post-tax basis, and rates vary depending on the plan(s) chosen and gross monthly salary.
- Accidental Death and Dismemberment insurance is also available for employees and family.
Contact
Short Term Disability
Phone: (800) 368-2859
Policy Number: 442210-C
Long Term Disability
Phone: (800) 368-1135
Policy Number: 606717-A
UNUM Long Term Care Insurance
UNUM’s Long Term Care Insurance pays benefits when you require substantial assistance with two out of six activities of daily living. Once you qualify, you will receive the monthly benefit you selected, even if your benefit payment exceeds the actual monthly charge you incur.
When your plan pays a benefit, you can use the money to meet the needs that you decide are most important. How and where you receive services depends on your needs, family situation, finances, and plan selection. Employees can enroll in Long Term Care at any time.
Contact
2211 Congress St
Portland, ME 04122
Phone: 800-227-4165
Plan Number: 025758-003 6
Medical/Dependent Flexible Spending Accounts
Any benefit eligible employee may establish a flexible spending account to use pre-tax income to pay for eligible healthcare and dependent-care expenses.
Employees may enroll in accounts within 30 days of initial date of hire, during Open Enrollment, or within 30 days of and consistent with a qualified status change.
FSAs are “use it or lose it” accounts. If your expense is less than the amount that you deposit for the year you will forfeit the balance.
Contact
PO Box 6044
Columbia, MO 65205-6044
Phone: 800656-3035
Employee Assistance Program
Canopy Inc.
7180 S.W. Fir Loop Suite 100
Portland, OR 97223-8023
info@canopywell.com
(503) 639-3009
1-800-433-2320
You will need your Medical Card ID# issued by provider.
To enroll online use Company Name “PEBB”
Mail Order Pharmacy- Statewide & Providence Choice Plans
Walgreens
800-636-3070 or 800-797-3345
Postal Prescription Services
503-797-2100 or 800-552-6694
Wellpartner
877-935-5797
MEDEX Travel Assist (included with Employee Basic Life Insurance)
US, Canada, Puerto Rico, Bermuda, US Virgin Islands
800-527-0218
All Other Countries (Call collect.)
410-453-6330
Retirement Provider Information
Public Employees Retirement System (PERS)
11410 SW 68th Parkway
Tigard, OR 97223
P: 503-598-7377
F: 503-598-0561
Employer Number:
Western Oregon University
01255
PERS Health Insurance Program
PO Box 40187
Portland, OR 97240
P: 1-800-768-7377
Employer Number:
Western Oregon University
01255
Fidelity
Justin Blatny
Justin.blatny@fmr.com
P: 541-554-5711
Oregon Public Universities
ORP: 71681
TDI: 71678
TIAA-CREF
Braden Danielson, Financial Consultant
4730 University Way NE, Suite 201
Seattle, WA 98105
P: 1-800-842-2888
P: 503-452-6986
F: 206-523-6866
Oregon Public Universities
ORP: 101528
TDI: 101529
Oregon Savings Growth Plan
800 Summer Street NE, Suite 200
Salem, OR 97301
P: 503-378-3730
F: 503-378-5888
CONTACT
Human Resources
Lieuallen Administration 305P: 503-838-8490 | F: 503-838-8522 | E-mail: hr@wou.edu
