Health Care Frequently Asked Questions
How do I sign up for the insurance?
Enrollment for AY 2024/2025 will open mid-September.
There is a big orientation/sign up session during the Week of Welcome (Tues Sept. 24th from 10:30 AM to noon in Straub 156. Enrollment is done in person. If you can’t make that, no worries! Swing on by the Union office (609 E. 13th Ave) so our benefits administrator, Glenn, can walk through the benefits with you and answer questions in real time.
Rest assured, we will get you enrolled in your contractually mandated benefits, and if you are international, get you waived out of the UO’s International Student insurance plan, in a timely fashion.
Also know your benefits administrator, Glenn, will be available to answer your questions now and in the future!
Contact Glenn at benefits@gtff.net
When does coverage start?
For Fall term, September 16th. You will not receive your forms, insurance card, etc. until after this date, but coverage for you and any dependents you enroll will be retroactive to September 16th. If you sign up partway through the year coverage for you and your dependents will be retroactive to the 16th of the first month of the term that you enroll.
Insurance runs from:
- September 16 – December 15 for Fall Term
- December 16 – March 15 for Winter Term
- March 16 – June 15 for Spring Term
- June 16 – September 15 for Summer Term
Can I add dependents? Does that include Domestic Partners?
Yes, and Yes. If you choose not to insure your dependents when you initially enroll yourself, you will have the option to add them during one of our two “Open Enrollment” periods. First one is August 16 – September 15. The second one is February 16 – March 15. You can also add a new dependent within 30 days of a qualifying event (birth, adoption, marriage, domestic partnership). All dependent additions are effective on the nearest 16th of the month following their qualifying event. If you’re adding a Domestic Partner you will need to complete an Affidavit of Domestic Partnership (available at the GTFF Office, or under the health care tab above, under “Forms.”) as well as a new insurance enrollment application (available from Glenn or at the office).
How much does insurance cost?
Rates found here
How you pay: All GE’s will fill out a payroll deduction form, allowing us to take the premiums you owe out of your paychecks every month, automatically. GE’s are paid at the END of the month. When you fill it out, it will create a grand total and that grand total is divided–equally–out of the number of months remaining in the REGULAR academic year (the UO payroll office cannot deduct over the summer if you have a summer GE) beginning OCTOBER. e.g., if you fill out the payroll form on September 17th, your deductions will not begin until October’s paycheck, and will occur through June’s paycheck.
Summer payment: If you: 1) have a spring GE and 2) are NOT graduating spring term, you may continue the coverage into summer. Note: summer premiums vary based on your summer employment. If you HAVE a summer GE, you pay 5% like the regular year. If you do NOT have a summer GE, you pay 15% of the premium. If you’d like to have your summer insurance premium deducted form your academic year paychecks you can do so by selecting the summer insurance option on the payroll deduction form you complete when you enroll. If you choose not to have your summer premiums deducted form your academic year paychecks you will be billed for the summer coverage in June.
What is payroll deduction?
By signing the payroll deduction form, you authorize the UO to take a small amount of money out of your paycheck each month. When you fill out the form it asks what terms you have a GE and want coverage. That creates a grand total of premiums owed and this total will be divided by the number of paychecks remaining in the REGULAR academic year. We HIGHLY RECOMMEND if you want summer coverage, you mark summer term on your payroll deduction form. What you pay for summer depends on your summer employment status. If you HAVE a summer GE, you pay the same 5% premium, if you do NOT have summer GE, you pay 15% premiums. If you don’t know what your summer status is, you can still mark “will NOT” have a summer GE and we take out the higher 15%. If you get a summer GE, you let Glenn know and he’ll refund you that 10% difference! Many times folks do not mark summer and when summer rolls around you’ll need to cough up a big chunk of money to keep the coverage.
How much is my deductible?
The deductible is $100 per person and $300 per family before plan benefits begin. Please refer to the summary guides (choose “Summary of Benefits” under the health care tab) for a complete description of coverage levels and provided services.
How do I sign up for summer coverage? Am I eligible?
If you’re a Summer GE (*any* session), or a Spring GE, without a Summer GE, who will be continuing in your program past spring term (e.g., graduating summer term or returning back to your grad program in fall term–with or without a fall GE), you’ll be eligible for summer coverage at the rates listed above. If you haven’t paid or summer coverage through payroll deduction over the academic year, you’ll receive an email in early June; consider this your summer bill. If you pay your coverage continues. If you do not pay, your coverage ends June 15th. If you graduate spring term your coverage ends June 15th–no exceptions.
If I had summer health insurance, do I have to sign up again in the fall?
You don’t need to fill out a new enrollment form but you do need to fill out a new payroll deduction form for yourself and any dependents you’d like to continue coverage for.
If I had coverage last year, but didn’t have summer health insurance, do I have to re-apply?
Yes. Anytime there is a lapse in coverage, you need to come into the GTFF office and reapply for health insurance.
How do I find a Preferred Provider?
Want to maximize your benefits and get insurance to pay the most it will? Use a preferred provider!
For medical services in Oregon, Washington, Idaho, and Montana, go here. Skip the enter card ID and go to “plan year” and select current year –> type in the City –> then under “Plan or Network” choose “Navigator” –> then select the type of doc/provider you want.
For providers outside of Oregon, Washington, Idaho, Montana, go here. This takes you to the extended national-wide network under Aenta ASA. No need to enter network.
For Dental providers, go here. NOTE: the dental network is ONLY for Oregon! The PPO dental plan allows out-of-state, out-of-network claims for reimbursement, the EPO does NOT have any coverage outside of Oregon! Skip the enter card ID and go to “plan year” and select current year –> type in the City –> then under “Plan or Network” choose “Dental Advantage” for both the PPO and the EPO plan (they use the same network). Don’t know if you are on the PPO (also called “Advantage Dental”) or EPO (Dental Prepared”)? Can look at your card, or contact Glenn.
For Pharmacies: pick a pharmacy and go to it. Basically every pharmacy in the US takes your insurance and I have yet to hear of one that doesn’t!
Can I use the UO Student Health Center?
Yes. This is a very good option; it is conveniently located on campus. Most medical services and office visits at the Center will carry no charge! The only thing that is not covered 100% will be: massage, acupuncture, physical therapy, prescription drugs filled at pharmacy. Lab work: the sample collection (e.g., blood draw) will be free, BUT the UOHC is sending samples to the local Quest Diagnostics lab in town, where you will have $100 deductible (if not previously met for the year) and then 10% to pay.
The UOHC is able to bill your Regence insurance direct! Be sure to let them know you have our insurance.
Please note: the UOHC dental clinic is *not* part of our new Dental Advantage Essentials DMO network, so if you are on the HMO dental plan, you won’t be able to utilize the UOHC dental clinic. If you are on the PPO dental plan, you CAN use the UOHC dental clinic–free cleanings and then 20% on minor and 40% on major services just like in town.
Do I have to pay up front at medical providers?
In most cases, no. However, if you are using a non-preferred provider, or the pharmacy at the student health center, they might require some kind of payment. As long as you use preferred providers you should not have to pay the full amount up front. Note: some offices may run your benefits and see what your share would be and charge you for your 10% (in-network) and $100 deductible (if you have not met it previously for the year). If you use the Student Health Center you can bill your student account.
How do I file a claim?
If you are using a preferred provider, they should take care of all the claims processing for you. Be sure you give them your insurance information when you get there. If you are using a non preferred provider, or your doctor didn’t bill the insurance company, for whatever reason, submit your medical receipts and bills to PacificSource via your pacificsource.com account. Sign in, then go to left hand side “Claims and Costs” —> right hand side “Submit a Claim —> follow directions from there!
When does/do my deductible, and benefits, ‘reset?’
Benefits do not carry over, so if you don’t use it during the current plan year it’s gone. All benefits reset September 16. If you met your medical deductible, that also resets at the same time.
I am graduating, and or, will not have a GE next term, can I keep the coverage?
Yes! There is a federal law called COBRA. COBRA allows you to stay on an employer-based health insurance plan past your employment ending.
You can be on COBRA for 18 months. It is the EXACT same coverage you have now. Same ID#, same networks, same payouts, etc..
The only difference is you go from paying 5% of the premiums to 102% of the premiums. COBRA has a two month window to enroll from the period your coverage ends. You may jump back onto the GTFF plan under COBRA anytime in that window. If you enroll into COBRA in the second month of the window, you will need to pay the first month premium as well.
COBRA is month by month. You can enroll just yourself, or any dependents with or without you–you no longer have to be on the plan to have dependent on the insurance.
For information about costs and how to sign up, please click here.
I have still have questions about our health care plan. Whom do I contact?
Contact our benefits administrator at the GTFF office, Glenn Morris (541) 344-0832 or benefits@gtff.net.
More questions? Ask Glenn, benefits@gtff.net.