Coos Bay School District

Coos Bay School District
1255 Hemlock
Coos Bay, OR 97420

OEBB Newsletter “The Benefits Bulletin”
January 2010
http://www.oregon.gov/DAS/OEBB/docs/Newsletters/2009December/DecJannewsletter.pdf

Insurance Carriers

ODS Health Plan
(benefit summaries are below, please scroll down)
http://www.odscompanies.com/oebb/
OEBB ODS Medical / Vision: 1-866-923-0409
OEBB ODS Dental: 1-866-923-0410
OEBB ODS Pharmacy: 1-866-923-0411

Providence Health Plan
(benefit summaries are below, please scroll down)
http://www.providence.org/resources/oebb/
Providence Medical: 1-800-878-4445

Standard Insurance
(benefit summaries are below, please scroll down)
http://www.standard.com/mybenefits/oebb/
Life, AD&D, Short Term Disability or Long Term Disability coverage:
1-866-756-8115

My OEBB
(view your plan selections, make an address change, etc.)
https://myoebb.org/oebb/!pb.main

INSURANCE FORMS

If you have a “Life Change” and need to add or remove a dependent from your coverage, you must fill out the appropriate paperwork (forms below) within 30 days of qualifying event. Life changes include adding or removing dependents due to marriage, divorce, birth, adoption, change in domestic partner status, etc. Return completed forms to the Personnel Office within the required timeline. If you have any questions you may contact Donna Thomas at
DonnaT@coos-bay.k12.or.us

OEBB Insurance Enrollment Change Form
Life and Disability Enrollment and Change
Affidavit of Dependency
Affidavit of Domestic Partnership
Termination of Domestic Partnership

BENEFIT SUMMARIES
Under your Bargaining group (below), you may access the benefit summary of the insurance plan you chose to participate in during the 2009-2010 Plan year
(October 1 – September 30)

Coos Bay Education Association
representing our Licensed staff members

MEDICAL
Providence Plan 2, RX 1
Providence RX Formulary
ODS Medical Plan 3B
ODS Medical Plan 4B
ODS Medical Plan 6B

DENTAL
ODS Dental Plan 1
ODS Dental Plan 2
ODS Dental Plan 4

VISION
ODS Vision Plan 2

Premium Calculator
Calculator – Licensed 09-10
Calculator – Licensed RETIREES 09-10

Oregon School Employees Association
representing our Classified staff members

MEDICAL
Providence Plan 1, RX 1
Providence RX Formulary
ODS Medical Plan 3B
ODS Medical Plan 5B
ODS Medical Plan 8B

DENTAL
ODS Dental Plan 2
ODS Dental Plan 4
ODS Dental Plan 6

VISION
ODS Vision Plan 3

Premium Calculator
Calculator-Classified 09-10
Calculator – Classified RETIREES 09-10

Coos Bay Administrator’s Association
representing our Administrative staff members

MEDICAL
Providence Plan 2, RX 1
Providence RX Formulary
ODS Medical Plan 3B
ODS Medical Plan 5B
ODS Medical Plan 8B