Health Benefits 2014-15

Frequently used forms are near the bottom of this page and on the HR Forms Index. 



The 2014-15 Open Enrollment period for COCC benefit-eligible employees begins on Friday, August 15, 2014, and runs through Thursday, September 25, 2014 with benefits in effect as of October 1, 2014.  

OEBB is mailing out employee benefit packets  to anyone who is currently enrolled through OEBB.  In addition, there are two sessions of the Open Enrollment Benefits Meetings scheduled with OEBB, August 19th and 20th (see schedule attached) at which the changes to the coverage will be explained in more detail.  If you are unable to attend one of these sessions, a video recording of this presentation will be available shortly after through a link on our HR website. Below you will find some information to help you make informed benefit decisions for you and your family.

Open Enrollment Information 2014-15:

Open Enrollment Employee Checklist
Calendar of Events
Frequently Asked Questions


For the 2014-15 plan year, COCC will continue to offer the same five medical plans, two dental plans, and one vision plan that were offered in 2013-14.

Moda Health Medical Plan Comparison 2014-15


Moda Health Plan B Handbook 
Moda Health Plan C Handbook  
Moda Health Plan D Handbook  
Moda Health Plan E Handbook  
Moda Health Plan H (HSA) Handbook  

Moda Health Plan B Summary ($350)
Moda Health Plan C Summary ($500)
Moda Health Plan D Summary ($750)
Moda Health Plan E Summary ($1,000)
Moda Health Plan H Summary (HSA)


Setting up an HSA Bank account: If you are enrolled in Moda Medical Plan H, the Moda medical plan that is HSA compliant, you will need to maintain an active HSA account through HSA Bank.  You are also required to submit a HSA Employee Contribution Form to Human Resources when you are first enrolled in Plan H AND at the start of each plan year thereafter.  Please contact the COCC HR Department to set up your account with HSA Bank Account, specifically for COCC employees. Pretax payroll deductions or contributions from the College (for those who are eligible) cannot be processed unless you have your HSA Bank account set up.

Please contact the HR Department to have your COCC Employee specific HSA bank account set up.

HSA Employee Contribution Form (Must be submitted at the start of each plan year if you are enrolled in Moda Medical Plan H.) 
HSA FAQ Document
HSA Bank Overview (HSA Bank overview.  Do NOT use this link to set up an HSA account)


Dental Plan Comparison 2014-15  

ODS Dental Handbook
ODS Dental Summary 
Willamette Dental Plan 8 with Ortho Handbook
Willamette Dental Summary
Willamette FAQ - service information

Willamette Customer Service: 855-433-6825  
Willamette Dental Website


Moda Health Vision Plan 2 Summary 2014-15
Moda Health Vision Handbook 

LASIK staff discount from Restore Vision Centers call for details 1-877-508-2020                 

RATE SHEETS 2014-15:
The premium rates for Moda Medical Plans increased 8.4% overall.  The premiums shown on the rate sheets below are based on a 90 /10 split and are in effect on October 1, 2014.

Full-Time Employees - Composite Rates based on 90 /10 split   
Part-Time .50 FTE - Tiered Rates based on 90 / 10 split 
Part-Time .75 FTE - Tiered Rates based on 90 / 10 split
Retiree - Tiered Rates - Entire Premium


  • See if Healthy Futures is right for you and your family!
  • To complete the Health Risk Assessment through Moda - Log into your myModa account (same as your former myODS account), or register for a new account, then click  "Health Risk Assessment (HRA)"
  • Looking for ways to fulfill your two Healthy Futures Wellness requirements? Try Staff Wellness!


Optional Life insurance through  Standard Insurance

Optional Long-term Care Insurance through Unum

Medical Leave Assistance Program (MLAP)  (offered through the College)


Employee Assistance Program (EAP) through OEBB - Reliant Behavioral Health

Tax Sheltered Annuities / 403(b) & 457(b) Plans


2014-15 Health Insurance Forms:
Reimbursement Forms -- Moda Health medical, dental, vision and pharmacy
All OEBB Forms -- Link to OEBB forms page. Remember that any changes are made online through the OEBB member module

2014-15 Flexible Spending Account Forms - PacificSource:
PacificSource Administrators FSA - Enrollment Form 2014-15  (only required if you want health reimbursement or dependent care account(s). Premium is now automatically taken out pre-tax)
Reimbursement Form (Health & Dependent Care)
Direct Deposit Enrollment Form
Status Change Form



Moda Health Customer Service: 866-923-0409      
Moda Health web site & "Login to myModa" 

Moda Health Website (My Moda Login): 888-374-8907

Moda Health Provider Search  

To view the Moda Health Drug lists and check for drugs requiring pre-authorization see:

Moda Health Mail Order Pharmacy Enrollment Information: 
Postal Prescription Services (PPS) mail-order pharmacy form can be printed, visit the PPS website, or you may call 800-552-6694 to enroll. 

Other FREE Moda Health plan programs:  

  • Cardiac Care Program
  • Health Coaching
  • Depression Care Program
  • Diabetes Care Program
  • Lifestyle Coaching Program
  • Women's Health and Maternity Care Program
  • Respiratory Care Program
  • Spine & Joint Care Program
  • Weight Care Program

Simply login to "myModa" for enrollment/participation information!


PacificSource Administrator FSA Enrollment Form
$500 Flexible Spending Account Rollover
PacificSource Administrators FSA Customer Service: 800-422-7038
PacificSource Administrators web site & "MyFlex" 

PacificSource Administrators - Eligible expenses list for 2014-15
PacificSource Plan Document
PacificSource Plan Acknowledgement Form
PacificSource FAQ Sheet


Standard (Life) Insurance Customer Service: 866-756-8115
Standard Website    


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