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What’s the best way to get information about my benefits?

Register online on your benefit carriers’ websites to view your benefits, services, claims and more. Click here for quick links to the benefit carriers in the Plan you’ve selected.

Who can I talk to about my benefits?

We’re here to help. Click here to find out who to contact to answer the questions you have.

Where can I see what Plan I am enrolled in?

Log in to edge.zenith-american.com to see your personalized eligibility and enrollment information, send secure messages and more. Or, call Zenith American Solutions at 833-255-4123 (toll-free) or 503-486-2107.

If you are an Active member of the Trust, you can view your benefit selections and enrolled dependents by logging in to PPS Peoplesoft Employee Self-Service with your PPS username and password. (You must be in a PPS building and connected to the PPS Wi-Fi network.)

Don’t remember your PPS login information? Contact the PPS IT Service Desk.
Will I get new ID card(s) after Open Enrollment each year?

If you are a new enrollee for Trust benefits, you will receive ID cards for medical, prescription drug and dental coverage. If you have vision coverage through VSP, you can access an ID card online at vsp.com if you’d like.

If you were already enrolled in Trust benefits, you can expect to receive a new medical plan ID card if you are enrolled in a Providence medical plan (Providence Option Advantage or Providence Personal Option), you changed medical plans, and/or you added or removed dependents.

Otherwise, keep and use the ID cards you currently have, including your dental plan ID and prescription drug ID cards. If you have vision coverage through VSP, you access an ID card online at vsp.com if you’d like.

How do I use my benefits before I receive my new ID card(s)?

If you haven’t received your new ID cards (see above) when the Plan Year begins, and you need to access your benefits, please contact the benefit carrier directly. Click here for contact information.

Who can I talk to about enrollment or eligibility?

If you have questions about your enrollment or eligibility, please feel free to contact the Trust Administrative Office at 503-486-2107 or 833-255-4123 (toll free). If you are a Substitute Teacher or an Early Retiree member, select Option 2 when you call.

What’s the best way to get information about my medical benefits?

Register online on your medical carrier’s website to view your benefits, then you can:

  • View the services available to you
  • Find a doctor in your network
  • View your personal benefit coverage details
  • View your claims

Click here for a link to your medical carrier.

What is preauthorization/precertification?

Preauthorization is an evaluation of a procedure or treatment to determine whether it is medically necessary. Some medical carriers require preauthorization for certain services (such as inpatient/outpatient surgery and imaging tests). If you don’t obtain preauthorization when it is required, it may affect your benefit coverage and you may pay more.

Refer to your carrier’s Benefit Handbook or call your medical carrier to ask if preauthorization is required for certain services and how to request it … before you receive the service.

What’s the best way to get information about my prescription benefits?

If you chose the Kaiser Permanente Plan, your prescription benefits are provided through Kaiser Permanente. All other Plans receive their prescription benefits through the Trust Prescription Drug Plan, administered by Express Scripts.

Register online on your prescription carrier’s website to view your prescription benefits, then you can:

  • View the services available to you
  • Find a pharmacy in your network
  • Learn how to order prescriptions for home delivery
  • See the list of approved drugs (the formulary)
  • View your claims

Click here for a link to your prescription carrier.

What’s the best way to get information about my dental benefits?

Trust members are covered by the Trust Dental plan which is administered by Delta Dental of Oregon.

Register online on the Delta Dental of Oregon website to view your dental benefits, and:

  • View the services that your benefits cover
  • Find out how to request a dental treatment plan (an estimate of what you pay for services)
  • View your claims
How do I search for an in-network dentist?

The Trust does not have a network for the Dental Plan. You may choose any licensed dentist and the benefit level is the same if you see an in-network or an out-of-network provider. However, if you see an out-of-network provider, you may be balance billed by that provider for the difference between what the provider charges and what your Dental Plan (Kaiser Permanente or Delta Dental) pays.

What’s the best way to get information about my vision benefits?

If you chose the Kaiser Permanent Plan, your vision benefits are provided through Kaiser Permanente. All other Plans receive their vision benefits through the Trust Vision Plan, administered by VSP.

Register online on your vision carrier’s website to view your vision benefits. They you can:

  • View your vision benefits and the services available to you.
  • Find an in-network vision services provider.

Click here for a link to your vision carrier.

What’s the best way to get information about my life insurance/AD&D coverage?

We’ve rounded up all the resources and information you’ll need in the Life Insurance and AD&D Coverage.

You can also contact the Standard Insurance Company with questions. Click here for contact information.

How do I get reimbursed from my Flexible Spending Account?

You can manage your account online at Pacific Source Administrators. This is where you can view your balance, see your payments, request reimbursements, set up recurring reimbursements, and sign up for direct deposit.

What’s the best way to get more information about my Flexible Spending Account?

Go to the Benefits page on the Portland Public Schools website for more information about Flexible Spending Accounts.

How do I access my Employee Assistance Program (EAP) benefits?

You can get help 24 hours a day, 365 days a year:

For more information about the program, please refer to the Employee Assistance Program section of the PPS website.

How can I learn about benefits the PPS District offers?

Portland Public Schools offers many benefits for eligible employees, including:

  • Retirement savings plans
  • Leave of absence
  • Professional development
  • Transit passes and mileage reimbursement
  • Credit Union membership

Go to the Benefits page on the Portland Public Schools website for more information about these programs.

How does “Coordination of Benefits” work?

Coordination of Benefits applies when you or covered dependents have health care coverage under more than one plan. Plan rules determine how the Trust Plans work with other plans, which plan pays first, and how benefits are paid. Please refer your plan handbook for detailed information.

Can I appeal a denied claim, eligibility decision or other decision affecting my coverage?

Yes, you always have the right to appeal a denied decision. The appeals process is very specific and must be followed carefully.

Can I continue coverage when I am no longer eligible?

You and each of your covered dependents may have the independent right to elect to continue the health coverages available through the Trust on a self-pay basis after your coverage under the Trust would otherwise end.

Click here for detailed information about qualifying events, eligibility and how to get started.

How does the Trust protect my privacy?

The HIPAA Privacy Rules require that the School District No. 1 Health and Welfare Trust not use or disclose Protected Health Information ("PHI") unless it is for Payment, Treatment or Health Care Operations or authorized by the affected Individual. Under the Privacy Rules, all disclosures of PHI shall be limited to the minimum necessary requirements.

The School District No. 1 Health and Welfare Trust's complies with the requirements of the HIPAA Privacy Rules and provides guidance for handling issues which may arise under the HIPAA Privacy Rules. Other Covered Entities with which the Trust contracts will follow their own privacy policies adopted pursuant to the HIPAA Privacy Rules.

Click here for more information.

What are my rights under the Trust?

Click here to download the Trust legal notices.