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Benefits Upon Separation of Employment - FY2004 (REVISED) <br /> February 13, 2004 <br /> Page 2 of 4 <br /> Our contract with BestChoice Administrators does not affect your health insurance coverage. You will <br /> continue to process health claims through your current carrier, either the City Health Plan (administered <br /> by ODS Health Plans) or PacificSource. <br /> Coverage: Medical/dental/vision coverage is available. You may purchase medical-only or the entire <br /> medical/dental/vision package. Dental/vision coverage alone is not an option. If you continue the <br /> II medical-only coverage, you can not add dental/vision back to your plan until the next open enrollment <br /> ~ period. <br /> <br /> I <br /> <br /> I <br /> Coverage may change annually. You may elect to continue only the medical plan you were on at the time <br /> of termination; however, you are eligible to participate in the City's annual open enrollment period, held <br /> each May or June. During the open enrollment period you may change medical plans if you choose. <br /> Regardless of your medical plan, the dental and vision coverage is provided through the City of Eugene <br /> Health Plan, administered by ODS Health Plans. <br /> If you are covered by PacificSource and move out of the designated service area, you are eligible for <br /> coverage under the City Health Plan. Contact me for information at x8868. <br /> Premiums: You pay the cost of this coverage. Premium rates may chance annually. See the Health <br /> Insurance Premium Rates for FY2003 attachment of monthly premiums effective July 1, 2002, for the <br /> various City of Eugene pay units. <br /> Premium Collection: BestChoice Administrators (the City's premium collection administrator) will be <br /> sending you information regarding premium payment options. Their address is: <br /> BestChoice Administrators Telephone: 1-800-822-3173 <br /> P.O. Box 67240 <br /> Portland OR 97268-1240 <br /> Monthly Payments: Payment for coverage for any month is due on the first day of the month, <br /> and, in all events, must be made within 30 days of the due date. The only exception is the <br /> premium payment for former employee coverage during the period preceding the election of such <br /> coverage, which must be made within 45 days of the date of election. In all regards, former <br /> employee coverage will terminate as of the last day of the prior month for which the monthly <br /> self-pay premium was not timely made. <br /> Portability Information: <br /> For those on City Hea/th P/an: At the end of the 18-month period following your employment <br /> termination, you may be eligible to secure major medical insurance coverage on a self-pay basis through <br /> Oregon Medical Insurance Pool (OMIP). OMIP is not part of the City Health Plan, nor is it sponsored by <br /> the City of Eugene. OMIP is underwritten by the Oregon Department of Consumer & Business Services, <br /> and is currently administered by Regence BlueCross BlueShield of Oregon. For more information, contact <br /> Regence BlueCross BlueShield at 1-800-848-7280. <br /> For those on PacificSource: Portability is available at termination of employment or at the end of the <br /> COBRA continuation period. This Portability option is through PacificSource. For information on this <br /> option, contact PacificSource at 1-888-977-9299. <br /> <br />