Employee Insurance - Roseburg Public Schools

Open Enrollment

More ways to help protect
what's important to you.

During our upcoming enrollment, American Fidelity will be offering new supplemental benefits.

Schedule time to review your benefits today!

Our enrollment discussions begin March 31, 2025. Open Enrollment officially lasts from August 15^th – September 15^th, however you can begin making elections with American Fidelity now.

Schedule an appointment by visiting this link: americanfidelity.com/roseburg

Tax-saving options for common expenses:

New this year:

Life Insurance

Also, don't forget about current benefits options:

Here to Help

If you have any questions about your enrollment or benefits,
reach out to your account manager:

Faith Perry
Senior Account Manager
faith.perry@americanfidelity.com

General Info

Health Insurance Eligibility

All Licensed, Confidential, and Administrative staff are eligible for full health insurance benefits and District contributions.

Classified staff who work more than four (4) hours per day are eligible to enroll in health (medical, dental, and/or vision) insurance; District contributions are based on the employee's hours per day (see below).

District Paid Insurance Contribution (CAP)

The District provides employees eligible to enroll in insurance with a monthly contribution (CAP) toward their monthly premium expenses.

Licensed, Confidential, and Administrative employees receive the full District contribution if they are in an insurance eligible position. Cost Sheets: Licensed | Admin | Confidential

Classified employees receive a contribution from the District based on their hours/day:

Classified employees working 6.5 hours/day or more receive the full District contribution. Click here to see the cost sheet for these positions.
Classified employees working less than 6.5 hours/day but more than 4 hours/day receive a pro-rated contribution based on their hours per day. For example, a 6-hour employee receives 75% of the contribution as 6-hours is 75% of an 8-hour day (6/8 = 0.75). Click here to see the cost sheet for these positions.

The monthly contribution amount can be found in the Benefits section of the appropriate Collective Bargaining Agreement (CBA) for each group: Licensed CBA | Classified CBA

Open Enrollment

Open enrollment is from August 15th - September 15th. All employees eligible for insurance are required to login to their OEBB portal each year during this time to verify their choices and/or make changes. If an employee will be opting out for the upcoming plan year, they must also submit an opt-out form and proof of other employer-sponsored group coverage to Payroll during this time.

To make changes outside of open enrollment, an employee must be experiencing a Qualifying Status Change (QSC) event. See below for more information.

Opt-Out Stipend

Employees that work 6.5- to 8-hours per day that can provide proof of other employer-sponsored group coverage (not OHP), are eligible to receive the full financial stipend each month if they choose to 'opt-out' of medical insurance.

Classified employees that work less than 6.5-hours per day but more than 4-hours per day that can provide proof of other employer-sponsored group coverage (not OHP), are eligible to receive a pro-rated opt-out stipend based on their hours per day. For example, a 6-hour employee receives 75% of the contribution as 6-hours is 75% of an 8-hour day (6/8 = 0.75).

Employees must annually submit to Payroll an Opt-Out form along with their proof of other employer-sponsored group coverage each year during the Open Enrollment period (Aug 15th - Sept 15th) to continue qualifying for the stipend. The monthly stipend amount can be found in the Benefits section of the appropriate Collective Bargaining Agreement (CBA) for each group: Licensed CBA | Classified CBA

Making Changes Outside of Open Enrollment

Changes to medical insurance enrollment can only be made if an employee is experiencing a Qualifying Status Change (QSC) event: marriage, divorce, birth/adoption of a new child, loss/gain of other employer-sponsored group coverage, etc. Please review the OEBB QSC Matrix to see if you qualify to make changes outside of open enrollment. If you believe you do, please reach out to Jessica Atherton, the Leave & Benefits Administrator, for more information.

What does it cost?

Medical

Roseburg Public Schools currently offers medical insurance to eligible employees through the Oregon Employees Benefits Board (OEBB): All MODA Medical Plans (1, 2, 3, 4, 5, 6, and 7).

Medical Insurance Plan Comparison Chart

Helpful Links and Resources

FY 2024/2025 Plan Handbooks

Dental

Roseburg Public Schools offers dental insurance through the Oregon Employees Benefits Board (OEBB). Roseburg Public Schools currently offers the following five (5) dental plan choices to eligible employees: Delta Dental Plan 1, Delta Dental Plan 5, Delta Dental Plan 6, Delta Dental PPO Plan, and Willamette Dental

Click here to view a Dental Insurance Plan Comparison Chart

Delta Dental

Willamette Dental

Location Search
Scheduling an Appointment
- Please note, Willamette Dental does NOT provide insurance cards to its members. Simply call 1-855-433-6825 to schedule an appointment.

FY 2024/2025 Plan Handbooks

Vision

Roseburg Public Schools offers vision insurance through the Oregon Employees Benefits Board (OEBB). Roseburg Public Schools currently offers the following five (5) vision plan choices to eligible employees: Moda Opal, Moda Pearl, Moda Quartz, VSP Choice Plus, and VSP Choice.

Click here to view a Vision Insurance Plan Comparison Chart

Moda Vision (Opal, Pearl, Quartz)

VSP (Choice and Choice Plus)

FY 2024/2025 Plan Handbooks

Life and Disability Insurance

Optional Life Insurance Plans and Rate
2024-2025 Plan Year

Optional AD&D Insurance Rates
2024-2025 Plan Year

1-866-756-8115

Click Here for additional information

Whole Life Insurance
Portable Term Life Insurance

For additional questions for American Fidelity products, please contact:

Faith Perry
503-718-7040
faith.perry@americanfidelity.com

FSA/HSA/DCA

Pre-Tax Savings Accounts

Eligible employees may contribute to individual savings accounts on a pre-tax basis through voluntary payroll deductions. Using an Health Savings Account (HSA), Flexible Spending Account (FSA), or Dependent Care Account (DCA) may lower your taxable income and result in more take home pay. Click the links below to watch a short video explaining the various tax advantages.

Employees enrolled in an HSA or FSA-eligible health plan may enroll in an account funded with pre-tax employee deductions to help you pay for eligible medical expenses like copays, sunscreen, contact lenses, braces for children, dental implants, and other medical-related expenses. Employees enrolled in an FSA-eligible plan may enroll with American Fidelity during Open Enrollment, or if you have a Qualifying Status Change.

What is a Flexible Spending Account?

Employees enrolled in an FSA-eligible health plan may enroll their FSA with American Fidelity.
May only register for an FSA during Open Enrollment, or if you have a Qualifying Status Change.

What is a Health Savings Account?

If you are enrolled in an HSA-eligible health plan, contact payroll to set up or change your monthly HSA contributions.

What is a Dependent Care Account?

Eligible employees may also enroll in a Dependent Care Account during Open Enrollment, or if they have a Qualifying Status Change, to help pay for daycare or elder care expenses on a pre-tax basis.

COBRA

COBRA
Consolidated Omnibus Budget Reconciliation Act

COBRA is guaranteed continuation of your previous OEBB coverage, administered by BenefitHelp Solutions (BHS). Regardless of your health status, COBRA law allows eligible parties losing OEBB coverage to continue that same coverage for at least 18 months.

Click here to see COBRA Medical, Dental, and Vision Rates 2023-2024

If you are enrolled in COBRA and live outside Oregon, Southwest Washington (Pacific, Wahkiakum, Cowlitz or Clark counties), or Idaho, you can find a provider or pharmacy near you.

Montana: Health Info Net (HIN)
Washington state, excluding Pacific, Wahkiakum, Cowlitz and Clark counties: First Choice Health Network (FCH)
Alaska: Endeaver Providence
All other states, excluding ID, MT, OR and WA: Private HealthCare Systems (PHCS)

On the provider search page, select the PHCS option under “Front of Card” as indicated below. You do not need to select anything on the “Back of Card” section.

Insurance Opt Out

Before You Start:

To determine your Opt-Out eligibility, please refer to your Collective Bargaining Agreement:
Classified Staff: Article 13
Licensed Staff: Article 6

If you qualify for early retirement coverage and plan to retire this plan year, do not opt out.

OEBB: You will need to have your proof of other group medical coverage when you opt out on the OEBB website. For selections, you will need to opt out of health coverage, and if you do not wish to elect vision and/or dental, enter "decline". Keep the LTD and life coverage. The district will continue to provide you with life insurance and LTD coverage (if eligible).

What Insurance Qualifies for the Opt-Out Stipend?

Other employer-provided group insurance such as a plan through a spouse or parent
Medicare
VA Insurance

What Insurance DOES NOT Qualify for the Opt-Out Stipend?

Oregon Health Plan (OHP)
Medicaid
Student Health Insurance
Individual Marketplace Coverage

Can I Still Enroll in Dental and/or Vision Insurance and Receive a Stipend?

Yes, absolutely! Opting-out only applies to medical insurance. If you want to still enroll in vision and/or dental insurance, your opt-out stipend is reduced by the cost of your selected vision and/or dental plan(s).

Example: A 7-hour employee has other employer provided group insurance through their spouse and is going to opt out of medical insurance but chooses to enroll in Delta Dental Plan 6 and Vision Plan Opal.
- The employee would normally receive an opt-out stipend of $620/month.
- The monthly premium cost of the dental and vision insurance is $154.50/month.
  - Delta Dental Plan 6: $104.70
  - Vision Plan Opal: $49.80
- The employee’s opt-out stipend will be $465.50/month as it is being reduced by $154.50/month for the dental and vision insurance.

The District: Click here to log into your Frontline Central Account to complete the form online.

Questions? Call Human Resources at 541-440-4009.

Helpful Links

Paid Family Medical Leave Insurance

American Fidelity Administered PFMLI

What is Paid Family Medical Leave Insurance?

Benefits That Matter
Paid Family and Medical Leave Insurance (PFMLI) ensures you have the time needed to care for yourself and your loved ones. We have partnered with American Fidelity to provide you with these benefits.

You may take up to 12* weeks per benefit year for any combination of approved leave.
*An additional two weeks of paid leave may be available for complications related to pregnancy, childbirth or a related medical condition.

Medical Leave: Caring for your own serious health condition.
Family Leave: Bonding with a new child during the first 12 months of birth or caring for a family member with a serious health condition.
Safe Leave: Seeking help related to domestic violence, harassment, sexual assault or stalking.

To be eligible, you must have:

been continuously employed for 30 calendar days;
been eligible for benefits under your current or previous Oregon employer’s equivalent plan; and
earned at least $1,000 in four out of five quarters before requesting paid leave.
Click Here for a summary of definitions, limitations, and exclusions.

Contributions and Weekly Benefit Amounts

How much do I have to pay?
Contributions are 1% of your eligible wages* up to a maximum of $132,900* for 2023. The District pays 40% of this 1%, and the remaining 60% is deducted from your paycheck.

How much will I receive while on leave?
Benefits will depend on your earnings compared to Oregon’s Average Weekly Wage**
Here is an example based on annual earnings.

Annual Earnings

$26,000.00

$52,000.00

$125,000.00

Weekly Earnings

$500.00

$1,000.00

$2,403.85

Weekly Benefits

$500.00

$898.07

$1,469.78

If the employee’s average weekly wage is equal to or less than 65% of Oregon’s average weekly wage*, the benefit amount will be 100% of the employee’s average weekly wage. If the employee’s average weekly wage is greater than 65% of Oregon’s average weekly wage, the benefit amount will be 65% of Oregon’s average weekly wage and 50% of the employee’s average weekly wage that is greater than 65% of Oregon’s average weekly wage.

* Determined annually by the Oregon Employment Department.
**2022-2023 Oregon’s Average Weekly Wage is $1,224.82. These figures are subject to change.

What is a Benefit Year?

Benefit Year means 52 consecutive weeks beginning on a Sunday immediately preceding the day that Family, Medical or Safe Leave commences for the covered individual, except that the Benefit Year shall be 53 weeks if a 52-week Benefit Year would result in an overlap of any quarter of the base year of a previously filed valid claim. A covered individual may only have one valid benefit year at a time.

What is a Serious Health Condition?

Serious Health Condition means an: illness, injury, impairment, or physical or mental condition of a covered individual or their Family Member that:

requires inpatient care in a medical care facility such as, but not limited to, a hospital, hospice, or a residential facility such as, but not limited to, a nursing home or inpatient substance abuse treatment center;
in the medical judgment of the treating health care provider, poses an imminent danger of death or that is terminal in prognosis with a reasonable possibility of death in the future;
requires constant or continuing care, including home care administered by a health care professional;
involves a period of incapacity;
results in a period of incapacity or treatment for a chronic Serious Health Condition that requires periodic visits for treatment by a health care provider, continues over an extended period of time, and may cause episodic rather than a continuing period of incapacity, such as but not limited to, asthma, diabetes, or epilepsy;
involves permanent or long-term incapacity due to a condition for which treatment may not be effective, such as, but not limited to, Alzheimer’s Disease, a severe stroke, or terminal stages of a disease. The employee or Family Member must be under the continuing care of a health care provider but need not be receiving active treatment;
involves multiple treatments for restorative surgery or a condition such as, but not limited to, chemotherapy for cancer, physical therapy for arthritis, or dialysis for kidney disease that, if not treated, would likely result in incapacity of more than three calendar days;
involves any period of disability due to pregnancy, childbirth, miscarriage, or stillbirth, or a period of absence for prenatal care;
or any absence from work to donate a body part, organ, or tissue, including preoperative or diagnostic services, surgery, post-operative treatment, and recovery

How is a Family Member defined?

Family Member means:

the spouse of a covered individual;
a child of the covered individual, spouse or domestic partner;
a parent of the covered individual, spouse or domestic partner;
a sibling or stepsibling of the covered individual spouse or domestic partner;
a grandparent of the covered individual, spouse or domestic partner;
a grandchild of the covered individual, spouse or domestic partner;
the domestic partner of the covered individual; or
any individual related by blood or affinity whose close association with the covered individual is equivalent to a family relationship.

What is Safe Leave?

Safe Leave means leave taken by a covered individual while coverage under this policy is active for any of the following purposes:

to seek legal or law enforcement assistance or remedies to ensure the health and safety of the employee or the employee’s minor child or dependent, including preparing for and participating in protective order proceedings or other civil or criminal legal proceedings related to domestic violence, harassment, sexual assault, or stalking;
to seek medical treatment for or to recover from injuries caused by domestic violence, sexual assault, harassment, or stalking of the eligible employee or the employee’s minor child or dependent;
to obtain or to assist a minor child or dependent in obtaining, counseling from a licensed mental health professional related to domestic violence, harassment, sexual assault, or stalking;
to obtain services from a victim services provider for the eligible employee or the employee’s minor child or dependent;
or to relocate or secure an existing home to ensure the health and safety of the eligible employee or the employee’s minor child or dependent.

How do I apply?

Benefits start September 3, 2023.

How do I request leave?

Step 1: Familiarize yourself with the PFMLI application process.
Step 2. Review the PFMLI Checklist
Step 3: Complete an application online. Click Here to Apply.

Note: to be approved for PFMLI, you are generally required to supply the appropriate certification. Below are the most common certification form requirements:

When should I tell my employer about my leave request? If you know you’ll need to use paid leave or take time off for a PLO, FMLA, or OFLA-eligible reason exceeding four days, you must notify the Human Resources Department with a 30 days’ notice. In emergency situations, you must notify the Human Resources Department within 24 hours. An additional written notice is required within three days of starting leave.

Is intermittent or reduced schedule leave available? Yes. You’ll work with your Human Resources Department to determine what type of leave is best for your situation.

Will taking leave impact my retirement? It’s possible. Every leave request is unique. We recommend speaking with your American Fidelity account manager to discuss how paid leave may affect your retirement goals.

Will taking leave impact my tax liability?
Depending on which leave type you apply for, and what withholding selections you make, you may have additional tax liabilities to consider. Click Here for further information from American Fidelity.

How do I enter my absences during my anticipated PFMLI leave period?

Reporting Absences

You must follow your normal absence reporting procedure and keep your supervisor informed of any upcoming absences at your earliest opportunity. Your absences must be recorded in advance whenever possible for appropriate coverage to be arranged.

30-day notice

If you know you need to take paid leave, inform your employer at least 30 calendar days beforehand, unless giving advance notice is not possible.

24-hour emergency notice

In an emergency, you must at least verbally tell your employer that you plan to use paid leave within 24 hours. An additional written notice is required within three days after starting the leave.

What do I enter in Absence Management?
If using accrued leave, "Sick Leave" should be used first before drawing on any other leave types. For each absence, include the general reason and the absence relationship (self/son/spouse/etc.) in the notes section.

If you elect to use your accrued leave with PFMLI:
Sick-> Self or Sick-> Family
Add "PFMLI" to your notes.

If you elect NOT to use your accrued leave during your anticipated PFMLI period:
Unpaid Status -> Paid Family Leave Request

Add "PFMLI" to your notes.

If you DO NOT intend to apply for PFMLI:

Sick-> Self or Sick-> Family

Add "No PFMLI" to your notes.

Am I responsible for securing a substitute if my position normally requires one?
You must communicate with your Office Manager and supervisor about the need to secure a substitute in your absence at your earliest opportunity. You are not required to find a substitute during a statutorily protected leave of absence.

Your Office Manager should contact Edustaff at 877-974-6338 x1313 for long-term assignments. Additional requirements pertain to long-term substitutes subbing for a certified teacher.

Who do I contact if I have questions?

Employee Assistance Programs

Employee Assistance Program (EAP)
EAP benefits are available to all employees and their families at NO COST. The EAP offers confidential advice, support, and practical solutions to real-life issues. You can access these services by speaking with our care team over the phone or access services online.

Click Here to access the member page. Location ID: OEBB

Call Center: 1-800-433-2320

Confidential Counseling: Up to 6 face-to-face, video or telephonic counseling sessions for relationship and family issues, stress, anxiety, and other common challenges.

24-hour Crisis Help: Toll-free access for you or a family member experiencing a crisis.

Online Peer Support Groups: Online support groups for addiction recovery, anxiety, depression, frontline workers, grief and loss, parenting, and more.

Financial Help: 30-days of access with a personal money coach who will work with the member toward financial wellness by identifying financial goals, assessing current financial situation, and providing a suggested detailed action plan.

Legal Services: One 30-minute legal consultation per each separate legal matter at no cost, 25% reduction from the normal hourly rate if member retains attorney or mediator.

Child & Parenting Services: Get information and support on parenting, school issues, adoption, daycare, and other important issues for parents.

Adult & Eldercare Services: Get assistance in finding quality information and services including transportation, meals, activities, daytime care, housing, and more.

Webinars & Trainings: Industry experts will present monthly work-life webinars on a variety of topics.

Online Legal Forms: Create, save, print, and revise online legal forms including wills, contracts, leases, and many more. Click Here to learn how to navigate to the Canopy Legal Resource Center to create forms like the ones below.