MID-YEAR PLAN CHANGES

A Qualified Status Change (QSC) is a change in work or family status that affects eligibility for coverage.  A QSC allows limited changes to benefit plans outside of the annual open enrollment period.

Examples of QSCs include (but are not limited to) marriage, establishment of domestic partnership, birth, adoption, divorce, college graduation, loss of other group coverage or a change in employment status.  A change in FTE for an employee previously eligible for benefits is not a QSC.

If you experience a QSC and need to add or delete a dependent from your coverage, you’ll need to submit a completed enrollment form to 4J Human Resources. If you add a dependent to your insurance, the new coverage will be effective the first of the month following the QSC.  In the case of birth or adoption, the coverage is effective at birth or placement. If you drop a dependent, the coverage will terminate at the end of the month of the QSC.  The enrollment form is available from the District website and must be turned in within 31 days of the QSC.   http://www.4j.lane.edu/files/benefits/4J_BENE_OEBB_Enrollment_Change_Form-revised_110909.pdf   

If you are an active employee, adding or deleting dependents will not affect your monthly premium.  If you are a retiree, your monthly premium could change.  Whether you are active or retired, federal law requires that additional taxes be assessed on the value of the coverage for a domestic partner.  For more details about domestic partnership issues, please visit this link on the 4J website: http://www.4j.lane.edu/hr/domesticpartner

If you have questions about eligibility issues, the OEBB phone number is 1-888-469-6322.  You are also welcome to contact me at 541-790-7682 or by e-mail at wenzl@4j.lane.edu.

OUT OF AREA DEPENDENTS

If you are covering a dependent under your insurance who is attending school and lives outside of your service area, you will need to contact ODS and let them know that you have an out-of-area dependent.  When an enrolled dependent child resides outside the service area, plan benefits will be extended for treatment of an illness or injury, preventive healthcare (including routine physicals and immunizations) and maternity services, as if the care were rendered by in-network physicians or providers, subject to the following limitations:

• All non-emergency hospital confinements must be authorized;
• Services will be paid at the in-network benefit level if provided within a 30-mile radius of the dependent child’s residence or at the closest appropriate facility;
• Services will be paid at the out-of-network benefit level if such services are provided outside the 30-mile radius of the dependent child’s residence; and
• Fees charged by out-of-area physicians and providers of care will be reimbursed at the maximum plan allowance for those services.
• This special coverage for out-of-area students will begin the first of the month following notification.

In-Network Benefits are those delivered by in-network physicians and providers; Out-of-Network Benefits are those delivered by out-of-network physicians and providers.  By using the services of an in-network physician or provider, members will receive quality healthcare and will have a higher level of benefits.

You can find additional details about your OEBB/ODS coverage, including plan summaries and full member handbooks, on the ODS website: http://www.odscompanies.com/oebb/members_help.shtml

MEET THE WELLNESS CLINIC STAFF

For those of you who haven’t yet visited the 4J Wellness Clinic, you are missing out on a valuable service.  For those of you who are clinic regulars, you may have noticed a few new faces.  Please allow me to introduce you to the 4J Wellness Clinic staff members.

Janice Madsen:  Janice is the Clinic Coordinator, and in that role, she wears many hats.  She works mainly at the front desk, and is often the first clinic staff member you’ll see.  Janice has worked for PeaceHealth for 21 years and has been at our clinic for almost 10 years.  When she’s not at the clinic, Janice can usually be found spending time with her family.

Patti Lovdokken, CMA:  Patti is a Certified Medical Assistant and has also taken several pre-nursing courses.  She has worked for PeaceHealth since May of 2002 and for the past 7 years has been at the 4J clinic (according to Patti – the best clinic in town!).  She works both at the front desk and in the back of the clinic.  When not at work, Patti enjoys being an aunt, spending time with her family and friends, her church group, road trips, beading, rafting and her cats. 

Larissa Platt, CMA:  Larissa is also a Certified Medical Assistant.  She moved to Oregon from Eagle River, Alaska in 2002 to pursue her education at Lane Community College.  She graduated from her CMA program in 2005 and earned her Certificate in Medical Records and Medical Coding as well.  Larissa began working for PeaceHealth in December of 2005 and has been a member of the 4J clinic family since July of 2006.  Off duty, Larissa can be found RV camping and fishing with her family and friends.  She also enjoys hanging out with her dog, a five year old female boxer named Harley.  Larissa likes to cook and bake, and quilt when she can fit it in.

Cathleen Reyes, CMA:  Cathie is the third Certified Medical Assistant on the clinic staff.   Like Larissa, Cathie also received her training at LCC.  She started her PeaceHealth career in Internal Medicine, and came to the 4J clinic in July of 2009.  Cathie is married and has four daughters and one son.  She enjoys cooking, gardening and outdoor activities.

Andrea Blattler, FNP:  Andrea is a nationally certified Family Nurse Practitioner who has been with the 4J clinic since September of 2008.  She has a Bachelor of Science in Nursing from Northern Arizona University and a Master of Nursing form Oregon Health & Science University.  Before coming to Eugene in 2001, Andrea worked for a year at a small hospital on the Navajo Indian reservation in Northern Arizona and then spent six years at the Flagstaff Medical Center in the cardiac unit and the ER.  Andrea is married and has one daughter, Megan, who is rapidly approaching her terrible twos.  When she isn’t chasing her daughter, Andrea enjoys family, friends, sporting events, visiting relatives in Arizona, reading and exercising.

Marjorie Lynch, FNP:  Marjorie is a nationally certified Family Nurse Practitioner who earned both her Bachelor of Science in Nursing and her Master of Science in Nursing from the University of Texas at Austin. She has been happily practicing at the 4J clinic for almost nine years.  Marjorie is a Louisiana native who married her native Oregonian Prince Charming in 2003, and they have one poodle and two cats.  In her spare time, she loves to read, and practice yoga, and she makes a mean pot of gumbo!

Courtney Nixon, FNP:  Courtney is the newest member of the clinic family, starting in 4J in November 2009.  Our third nationally certified Family Nurse Practitioner, she obtained her Master of Science in Nursing at the Massachusetts General Hospital Institute of Health Professions in Boston and has been working mostly in Family Medicine ever since.  Prior to coming to PeaceHealth, Courtney worked as a National Health Corps Scholar at a community health clinic helping the underserved in Bremerton, Washington.  She also worked for the Public Health Department in Seattle at a clinic for adolescents. Courtney is married and has two children, ages 3 and 6.  When not at work, she enjoys being with her family and friends, running, hiking, reading and going to the beach.

The Wellness Clinic is open Monday through Friday, from 9:00 AM – 6:00 PM, with the last appointment slot at 5:30 PM.  They close for lunch from 1:00 – 2:00 PM.  The phone number for the clinic is 541-686-1427. 

Please remember there is a $20 no-show fee for missed appointments at the Wellness Clinic.  If you must miss your appointment, please call to cancel.  (If the clinic is closed, you can leave a voicemail.)

One more reminder:  the Wellness Clinic will be closed March 22- 26, 2010 for spring vacation.