Key changes for 2024-2025
The following information highlights the primary changes, effective October 1, 2024. Additional details are available at OEBBinfo.com and on the open enrollment page.
Eligibility change
New babies: your new baby receives coverage through your medical plan for the first 31 days of life. You pay no premiums during this 31-day period. Your new baby must be enrolled within 60 days of their birth date. Premiums will start on the first of the month following birth.
New EAP provider
Canopy will be the Employee Assistance Provider (EAP) as of October 1, 2024. Services include:
- Immediate access to professional support anytime, day or night.
- 8 sessions of counseling or coaching per incident.
- Comprehensive website with member resources and access through the Canopy EAP App.
- Resources and assistance for adult and childcare services, financial coaching, identity theft, legal consultations and mediation, home ownership and housing support, pet parent resources, and wellness tools.
- More details and contact information will be available closer to October 1, 2024.
Premium changes
Premium changes are effective October 1, 2024. Visit the benefits page for plan details, as well as premium and cap information.
Medical plan changes
All plans
- Doula services will now be available! Services include 8 prenatal and postnatal care visits and delivery care.
Kaiser only
- Omada’s weight management program will be available to Kaiser members. Omada will be no cost to members 18 years and older.
- There are slight changes in certain benefits to Plans 1 and 2B, including:
- Prescription drugs increase to $10 for generic, $30 for preferred brand drugs, $50 for non-preferred brand drugs, and 25% up to $150 for specialty drugs.
- Separate prescription out of pocket maximum will be removed, amounts paid for prescriptions will now apply to medical out of pocket maximum.
- Emergency room visits for Plan 1 only increase to $150 copay.
- Copay increases by $50 for specialty scans (CT/PET scans and MRIs), and will be $70 on Plan 1, and $80 on Plan 2B.
Moda only
- Teladoc, a virtual primary care provider, will be part of Moda’s Coordinated Care Model (CCM) network. This expands access to primary care for all OEBB members, especially those in rural Oregon and out of state.
- Mighty is a new program that offers an alternative approach to weight management. It focuses on improving mobility and decreasing pain, and includes a personalized eating plan, workouts, and coaching.
- Gabbi is a new breast cancer risk assessment and screening program to help you understand your breast cancer risk.
Dental plan changes
All plans
- Effective October 1, 2024, the 12-month wait for late enrollment in dental is going away.
- Members who currently have the 12-month wait will be rolled to whole plans as of October 1.
- Members newly enrolling themselves or dependents in dental will not be subject to the 12-month wait effective October 1.
Kaiser only
- The lifetime limit on dental implants will be removed.
- Increased member coinsurance from 10% to 35% for custom occlusal nightguard and athletic mouthguards.