Home » Human Resources » Employee Benefits » Health and Medical Plans » Medical and Prescription Plans

Medical and Prescription Plans

Eugene School District 4J currently offers 3 different health plans through our partnership with OEBB and MODA to choose from.   Our goal is to offer enough plans and options to employees that everyone is able to find one that best fits their needs.   You can view the comparison chart of all OEBB plans here but please note that we only offer the following plans:

  • Kaiser Permanente Plan 2 – $800 Deductible (Classified Staff Only)
  • Medical Plan Birch – $800 Deductible (Licensed and MAPS Staff Only)
  • Medical Plan Cedar – $1,200 Deductible
  • Medical Plan Dogwood – $1,600 Deductible
    Pharmacy and vision coverage is built into the medical plan.  You will not need to make a separate election

Kaiser Permanente

Kaiser Permanente*New* (Classified Staff Only)

About Kaiser: In an effort to offer more access to high quality, affordable coverage, along with a lower deductible plan choice, the 4J Classified Joint Benefits Committee has elected to offer Kaiser Permanente Plan 2 to benefit eligible, classified staff for the 2018-2019 plan year.

Network: Kaiser Permanente uses a Provider Network that combines care coverage featuring physician directed care, primary care access, tele-health services, video and phone visits with Kaiser Permanente providers, and a mobile app. Through collaboration with PeaceHealth, Kaiser Permanente members will have access to Kaiser facilities and providers across the US, along with many existing health care providers in the Eugene/Springfield area. See the list of contracted facilities at the end of this document.

Plan: 4J is offering Kaiser Permanente Plan 2 HMO for the 2018-19 benefit plan year. See plan handbook and summary for details.

Plan 2 HMO: $800 individual/$2,400 family deductible; $25 co-pay for primary care visits within Kaiser Network; $25 alternative care office visit co-pay; $35 co-pay for specialist visits; no out-of-network coverage.

Virtual Visits: Kaiser Permanente offers virtual visits, where members are able to connect with a Kaiser healthcare professional via computer or mobile device without having to leave their home. See plan handbook for additional information and conditions.

***Notice***: The 4J Wellness Clinic is not part of the Kaiser Permanente Network. Active employees and retirees who elect the Kaiser Permanente Plan 2 will not be charged the mandatory monthly fee and will be ineligible to access services at the 4J Wellness Clinic.

MODA

Within those 3 health plans there are 2 medical provider networks to choose from:

  • Connexus/PPO – has a larger network of providers but has a higher monthly premium
    • If you see a provider that is a Moda Medical Home, your office visit will only cost you a co-pay.  If you see a provider that is part of the Connexus Network but not a Moda Medical Home, that visit is subject to your deductible.
      • You do NOT have to choose a Moda Medical Home provider.
      • You do NOT need a referral to see a specialist
      • If you or a dependent live outside of the local network, this is the network you will need to choose for the best coverage.
  • Synergy/CCM – has a smaller network of providers and utilizes the ‘medical home’ concept
    • You must select a Moda Medical Home provider and notify Moda of that choice.
      • You must visit that Moda Medical Home for all primary care services in order to receive the highest benefit allowance.  If you visit a provider, that is NOT your Moda Medical Home for primary care services those will be paid at the Out-of-network rates.  You may still visit the Wellness Clinic at no charge or you can designate the Wellness Clinic as your Moda Medical Home.
    • You do not need a referral to see a specialist but the provider you self refer to for specialty services must be within the Synergy Network in order to receive the highest benefit possible.
    • To learn more about the Synergy network, click here

When making your enrollment election, you will need to choose a Plan and a network.

Plan Summaries:

Medical:

2017-18 PPO
Connexus Plans
2017-18 CCM
Synergy Plans
Birch Birch
Cedar Cedar
Dogwood Dogwood

Member Handbooks:

2017-18 PPO
Connexus Plans
2017-18 CCM
Synergy Plans
Birch Birch
Cedar Cedar
Dogwood Dogwood

You can look up providers and what networks they participate in here.
You can view Plan Rates here.
Make sure that you are looking within the correct network when searching for a participating providers or viewing plan summaries

Pharmacy Services:

All medical plans include prescription coverage. For details, discounts and FAQs regarding prescription and pharmacy services, please visit