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West Linn-Wilsonville School District employee health plan information

 

 

Open enrollment is August 1st-31st

West Linn-Wilsonville School District employees now have the option to choose PacificSource Health Plans as their health insurance provider. New plans will be effective on October 1, 2020.
 

See below for some of our benefits highlights, but for a complete benefit summary of each plan, please visit the school district benefits page.

All employee group classes are eligible for a plan, including Administrative, Confidential, Licensed, and Classified.

Employees need to log in to the benefits portal to elect which health insurance option they prefer. Employees who wish to opt-out of coverage still need to sign in to the portal and follow the instructions for waiving coverage.

How to enroll

To get started, use the West Linn-Wilsonville School District BenefitElect enrollment system.

Log in

Understanding health insurance terms

Health insurance terms can sound like a foreign language. We do our best to avoid jargon, but there are instances where we need to use health insurance terms that are related to your plan, for specificity and clarity. Here are some definitions of those words.

Benefit Year
The annual cycle in which a health insurance plan operates. Your plan follows the calendar year, renewing in January. Deductibles and other benefit year limits typically reset at the beginning of each new benefit year.

Copayment (also Copay)
A fixed amount ($35, for example) you pay for a covered healthcare service, usually when you receive the service. The amount can vary by the type of covered health care service. 

Coinsurance
Coinsurance is how much you owe for a covered healthcare service or prescription, calculated as a percentage of the allowed service amount.

Cost sharing
When a member is responsible for paying a portion of the cost of care via deductibles, copayments, or coinsurance.

Deductible
The dollar amount you pay out-of-pocket for covered services before your health insurance plan begins to pay for your care.

Out-of-pocket limit (OOP)
Your out-of-pocket limit (or out-of-pocket max) is the most you could pay for covered care in a calendar year aside from your monthly premium. 

Explanation of benefits (EOB)
Every time you use your health insurance benefits, your insurance company will send you a statement that shows the service you had (like an office visit) and how they applied your benefits to it. This statement is called an Explanation of Benefits.

Network
The facilities, providers, and suppliers your health insurer or plan has contracted with to provide healthcare services.

In-network/Participating provider panel
A listing of the providers and facilities that have contracted with your health insurer to provide services at a discount to members.

Nonpreferred/Nonparticipating provider (also Out-of-network provider)
A provider who doesn’t have a contract with your health insurer or plan to provide services to you. You’ll pay more to see a nonpreferred provider. Check your policy to see if you can go to all providers who have contracted with your health insurance or plan, or if your health insurance or plan has a “tiered” network and you must pay extra to see some providers.

Preauthorization
This is an approval given in advance by an insurance company to a doctor for certain types of care.


Looking for definitions to other health insurance terms? Please visit our glossary page.

Quick links to popular benefits

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Mail order pharmacy

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Maximize my
Rx savings 

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Vision

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Online Tools

Sign up for InTouch

Download our app:

Download the myPacificSource app on Android
Download the myPacificSource app from Apple

 

 

 

Flexible Spending Account

From our affiliate organization, PacificSource Administrators

Download our app:

Download the myPacificSource app on Android
Download the myPacificSource app from Apple

 

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Convenience

No referrals required by our plans
to see a specialist

Digital member ID cards
via our website and mobile app

Mail-order and retail pharmacy
for up to a 90-day supply

Worry-free travel
with global emergency medical services from Assist America®

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Cost savings

$0 copays on select preventive
prescription drugs from in-network pharmacies

Affordable fitness center access
from our partner, Active&Fit Direct™

WW®
Weight-management program reimbursement

On-call care and health advice
 

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Video or phone-based doctor visits
on demand, available on most plans.

Telehealth benefits

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24-Hour NurseLine
Access to registered nurses for your health-related questions:

(855) 834-6150
TTY (844) 514-3774

Documents and forms

This is where specific downloadable documents for your group members would appear, such as claim forms.

 

Looking for other forms? Visit our documents and forms and page.

Contacts

WLWV Payroll and Benefits Team
PR-Ben@wlwv.k12.or.us

PacificSource
Toll Free (888) 735-2382   |   Local (971) 222-1054
wlwv@pacificsource.com