Volume 2, Issue 6: March 14, 2007

On-the-job Coverage Update—
More Coverage, Easier Enrollment!

Effective March 1, 2007, we've updated our on-the-job (OTJ) coverage (also referred to as occupational coverage or 24-hour coverage) and streamlined the process. Occupational coverage extends a member's medical and pharmacy benefits to also cover on-the-job injury or illness.

Our on-the-job coverage at a glance:

  • More coverage. Owners, partners, or principals who are covered under the PacificSource medical policy and exempt from state or federal workers' compensation law are now eligible for OTJ coverage.
  • Easier enrollment. We no longer require OTJ application forms (for covered owners, partners, or principals). Instead, simply provide the names of owners, partners, or principals on the master application when the group enrolls, and report any changes to us as they occur after enrollment. OTJ coverage can be added at a new group's initial enrollment, or on the first of the month after we receive written notification to enroll an owner, partner, or principal on this coverage.
  • Master application update. We've revised our Request for Group Insurance form (also referred to as the master application) so it reflects this change and others that have occurred during the past year. Please discard any old versions of this form and replace it with this current version.

If you have questions or would like additional information, please contact your Marketing Sales Representative.

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Remember to Register for CE Classes

Class space is limited, so be sure to register as soon as you receive your invitation. Please e-mail Marketing Agent Coordinator Candice Wilkins to register or for more information. You can find a detailed 2007 schedule in the For Agents/Prof'l Development section of our Web site. April classes:

  • April 5 in Medford (Six credit hours total)
    Errors & Omissions, Medicare Planning, Legal Requirements for Producers
  • April 17 in Eugene (Six credit hours total)
    Legal Requirements for Prod ucers, Risk

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Handy Links to Hospital Class Schedules

PacificSource is pleased to provide links to a few of the hospitals and medical centers offering health and wellness classes, covering such topics as preventing diabetes, preparing for childbirth, weight reduction, and quitting smoking. Clients and members may want to bookmark this page for quick access to class information. While our Web site provides links to class offerings at several hospitals in our region, it is not an exclusive list; members may attend qualified classes at any hospital.

Our hospital-based class program will reimburse all PacificSource members and their covered dependents up to $50 per class, series, or program, to a maximum of $150 per member per plan year.

Although hospital schedules may list many events, only their health and wellness classes are eligible for reimbursement. The reimbursement does not apply to health screenings, classes offered by organizations other than hospitals or hospital medical centers (i.e., fitness centers, weight loss clinics, colleges), classes on topics other than health and wellness (i.e., safe driving, caregiver training), or classes taken before January 1, 2007. If you have questions about this program or class eligibility, you're welcome to contact our Customer Service Department by phone at (541) 684-5582, or toll-free at (888) 977-9299, or by e-mail at cs@pacificsource.com.

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Coverage for Domestic Partners

For some groups, healthcare coverage for domestic partners and their children can be an important factor in choosing a carrier and plan. Many groups may not realize that they can request this endorsement at their initial PacificSource enrollment or when they renew. Although “domestic partner” can be broadly defined as an employee's unmarried partner of the same or opposite sex, there are several criteria that determine if an employee's partner actually qualifies as a domestic partner for insurance purposes. The Domestic Partner Affidavit lists these criteria. This document needs to accompany the member's enrollment application.

Our domestic partner coverage at a glance:

  • Coverage can be added by endorsement at the request of the group, but only at initial new group enrollment or renewal.
  • Both partners must complete an enrollment application and sign a PacificSource Domestic Partner Affidavit.
  • Adding the endorsement at renewal will result in a one-time open enrollment for qualified domestic partners.
  • Premium for a domestic partner is the same as premium for a spouse.
  • There's no group premium adjustment.

If you have questions or would like additional information, please contact your Marketing Sales Representative.

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Karla Long is Long on Experience

This month, Membership Representative Karla Long celebrates eleven years at PacificSource. She's among the fifty employees who have been with us for ten years or more. Before joining our Membership Services Department, she worked for two independent insurance agents for ten years. In all, Karla has more than twenty years experience helping people and answering health insurance questions. And as a department trainer and Mentor Team Leader, she shares her knowledge and experience with her newer coworkers, helping them achieve the same high level of customer service for which PacificSource is known.

On-the-job Coverage Update—More Coverage, Easier Enrollment!

Remember to Register for CE Classes

Handy Links to Hospital Class Schedules

Coverage for Domestic Partners

Karla Long is Long on Experience

 

Karla Long
Membership Representative Karla Long
While processing an enormous amount of paperwork may seem daunting, Karla has the experience to handle it with ease. Karla also fields phone calls and e-mails from members, agents, and administrators. Their calls and e-mails can range from questions about enrollment to the more complicated areas of COBRA and state continuation. “I like the personal contact I have with the members, group administrators, and agents,” Karla says. “I like solving problems and ensuring that everyone involved is satisfied with the results.”

When not at work, you may find Karla taking care of her pets. She and her husband have a Sheltie named Katy, two cats, and two parrots. Rumor has it that Karla's animals help her polish some of her work skills—patience, clear communication, and the ability to herd cats.

Even after eleven years as a Membership Services Representative, Karla still loves the work she does and demonstrates the golden rule of customer service—do the very best job you can every day and give the quality of customer service you would want to receive yourself. “I love working for PacificSource,” she says. “There is no place I'd rather be.”

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“I like solving problems and ensuring that everyone involved is satisfied with the results.”
Questions? You’re always welcome to contact us!

Eugene
(541) 687-7047 or toll-free (877) 657-9797
fax (541) 485-0915
Troy Kirk, Vice President Sales and Marketing
Doug Sheffer, Eugene District Manager

Bend
(541) 330-8896 or toll-free (888) 877-7996
fax (541) 330-8948
John Wright, Bend District Manager

Medford
(541) 858-0381 or toll-free (800) 899-5866
fax (541) 858-0486
Fred Cornett, Medford District Manager

Portland
(503) 699-6561 or toll-free (877) 657-9797
fax (503) 697-1075
Dennis Reed, Portland District Manager
Julie Doran, Marketing Representative

Manley Services
(541) 485-7488 or toll-free (800) 422-7038
fax (541) 681-8792
or toll-free (800) 575-1109
Stan Manley, President

Select Benefit Administrators
(503) 598-8908 • fax (503) 598-0197
Nancy Louris, President

Agent Bulletin is published by PacificSource Health Plans • Each issue is archived at http://www.pacificsource.com/for_agents_N.html
Copyright 2007 • PacificSource Health Plans • All rights reserved
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