Actives & Retirees: ENROLL BETWEEN October 7 AND October 25 FOR YOUR BENEFITS FOR THE 2025 Plan Year (JANUARY 1 – DECEMBER 31)

Welcome to Open Enrollment letter.

Steps to Enroll:

STEP 1: Compare your options for the 2025 Plan Year. (IMPORTANT NOTE: As of July 1, 2024, the Portland Clinic is no longer an in-network provider for the Kaiser Permanente Plan.)

Includes: Medical, Prescription, Dental, Vision, Long-Term Disability (LTD), Basic Term Life, Basic Accidental Death & Dismemberment (AD&D), Optional Term Life, and Voluntary AD&D.

• 2025 Plan Year ATU and DCU Active Benefit Guide: See an overview of your benefits: compare plans, view eligibility guidelines, rates, enrollment instructions, and more.
• 2025 Plan Year Comparison Chart: Compare how your Plan options cover and pay for various services.
• 2025 Plan Year Rate Sheet: Compare costs including deductibles, out-of-pocket maximums and monthly contribution rates for your Plan options.
• Optional Life and Voluntary AD&D: View your options to purchase additional life and AD&D, get rates and application instructions.

STEP 2: Get your questions answered.

If you have any benefits questions, including how the Trust Plans coordinate with other coverage, please call the Trust Administrative Office before you enroll.

You can find answers to many questions online, such as:

• Who can I enroll as dependents? Click here: Eligible Dependents
• How do I enroll a domestic partner? You must meet the requirements in the Affidavit of Domestic Partnership; then contact benefits@pps.net for next steps. (To understand how this affects your income; click here: Current Plan Year Domestic Partner Imputed Income.)
• What is the Plan coverage for a specific health service? Click here: ATU/DCU Trust Benefit Handbook
• What are my rights regarding continuation of coverage, appeals, privacy, etc.? Click here: Legal Notices

STEP 3: Enroll online by October 25:

1. Log in to selfservice.pps.net with your PPS username and password, then click Benefits Enrollment.
   • We encourage you to access PeopleSoft Employee Self-Service (ESS) while on-site. In order to access PeopleSoft ESS off-site, you must be set up with Duo 2-Step Security.
   • For assistance, contact the IT Service Desk at 503-916-3375.
2. Make your enrollment selections and enroll dependents. Or, if you are already enrolled, change your selections and dependents.
   Note: If you are enrolling dependents, please make sure you check the box next to each dependent you want to enroll.
3. To decline coverage, click Waive Medical Plan Coverage. You will be required to provide proof of other health coverage.
   Eligible DCU employees cannot decline coverage. If you don’t enroll, you will be enrolled in the employee-only Providence Option Advantage Medical and Trust Dental Plans.
4. Click Submit to complete your enrollment.
   
   If you are required to pay a monthly contribution for your benefits selections, it will be automatically deducted from your paycheck.

Step 4: Verify your enrolled dependents:

1. After you have enrolled, an independent firm, Secova, will contact you to verify the eligibility for any enrolled dependents.
2. You must submit the required documents to Secova for each covered dependent by the deadline as instructed in the verification packet, or your dependent’s coverage will be terminated retroactive to the coverage effective date.
3. Click here for details about this process.

ATU Type 10 Drivers Bi-Annual Enrollment has now ended. Please contact the Trust Administrative Office if you have any questions

Welcome to Open Enrollment letter.

Steps to Enroll:

STEP 1: Compare your options for the 2025 Plan Year. (IMPORTANT NOTE: As of July 1, 2024, the Portland Clinic is no longer an in-network provider for the Kaiser Permanente Plan.)

• 2025 Plan Year ATU and DCU Retiree Benefit Guide: See an overview of your benefits: compare plans, view eligibility guidelines, rates, enrollment instructions, and more.
• 2025 Plan Year Comparison Chart: Compare how your Plan options cover and pay for various services.
• 2025 Plan Year Rate Sheet: Compare costs including deductibles, out-of-pocket maximums and monthly rates.

STEP 2: Get your questions answered.

If you have any questions about your coverage options, please call the Trust Administrative Office before you enroll.

You can find answers to many questions online, such as:

• Who can I enroll as dependents? Click here: Eligible Dependents
• How do I enroll a domestic partner? You must meet the requirements in the Affidavit of Domestic Partnership; then contact benefits@pps.net for next steps. (To understand how this affects your income; click here: Domestic Partner Imputed Income.)
• What is the Plan coverage for a specific health service? Click here: ATU/DCU Early Retiree Trust Benefit Handbook
• What are my rights regarding continuation of coverage, appeals, privacy, etc.? Click here: Legal Notices

STEP 3: Enroll by October 25. You have two options to complete your enrollment:

Option 1: Enroll on-line at edge.zenith-american.com. Register to create your account and complete your enrollment. Click here for an Online Enrollment Guide.

Option 2: Print and fill out the ATU Benefits Enrollment/Change Form/DCU Benefits Enrollment/Change Form and fax, mail or drop it off at the Trust Administrative Office, so that it is received on or before the deadline.

Payment must be received by the 5th day of each month for that month of coverage (i.e., by Feb. 5th for February coverage). You may either:

• Mail your monthly contribution payments to the Trust Administrative Office.
• Or, submit the Electronic Funds Transfer Authorization form to set up automatic withdrawal from your bank account (payments deducted on the 5th day of each month).
  Your first payment for Early Retiree benefits must be submitted by check.

Step 4: Verify your enrolled dependents:

1. After you have enrolled, an independent firm, Secova, will contact you to verify the eligibility for any enrolled dependents.
2. You must submit the required documents to Secova for each covered dependent by the deadline as instructed in the verification packet, or your dependent’s coverage will be terminated retroactive to the coverage effective date.
3. Click here for details about this process.

Welcome to Open Enrollment letter.

Steps to Enroll:

STEP 1: Compare your options for the 2025 Plan Year. (IMPORTANT NOTE: As of July 1, 2024, the Portland Clinic is no longer an in-network provider for the Kaiser Permanente Plan.)

Option 1 Plans (full coverage available to full-time and part-time employees) include: Medical, Prescription, Dental, Vision, Long-Term Disability (LTD), Basic Term Life, Basic Accidental Death & Dismemberment (AD&D), Optional Term Life, and Voluntary AD&D.

Option 2 Plans (partial coverage available to part-time employees only) include: Medical, Prescription, Long-Term Disability (LTD), Basic Term Life, Basic Accidental Death & Dismemberment (AD&D), Optional Term Life, and Voluntary AD&D. Dental and vision coverage is not included.

• 2025 Plan Year PAT Active Benefit Guide: See an overview of your benefits: compare plans, view eligibility guidelines, rates, enrollment instructions, and more.
• 2025 Plan Year Comparison Chart: Compare how your Plan options cover and pay for various services.
• 2025 Plan Year Rate Sheet: Compare costs including deductibles, out-of-pocket maximums and monthly contribution rates for your Plan options.
• Optional Life and Voluntary AD&D: View your options to purchase additional life and AD&D, get rates and application instructions.

STEP 2: Get your questions answered.

If you have any benefits questions, including how the Trust Plans coordinate with other coverage, please call the Trust Administrative Office before you enroll.

You can find answers to many questions online, such as:

• Who can I enroll as dependents? Click here: Eligible Dependents
• How do I enroll a domestic partner? You must meet the requirements in the Affidavit of Domestic Partnership; then contact benefits@pps.net for next steps. (To understand how this affects your income; click here: Domestic Partner Imputed Income.)
• What is the Plan coverage for a specific health service? Click here: PAT Trust Benefit Handbook
• What are my rights regarding continuation of coverage, appeals, privacy, etc.? Click here: Legal Notices

STEP 3: Enroll online by October 25:

1. Log in to selfservice.pps.net with your PPS username and password, then click Benefits Enrollment.
   • We encourage you to access PeopleSoft Employee Self-Service (ESS) while on-site. In order to access PeopleSoft ESS off-site, you must be set up with Duo 2-Step Security.
   • For assistance, contact the IT Service Desk at 503-916-3375.
2. Make your enrollment selections and enroll dependents. Or, if you are already enrolled, change your selections and dependents.
   Note: If you are enrolling dependents, please make sure you check the box next to each dependent you want to enroll.
3. To decline coverage, click Waive Medical Plan Coverage. You will be required to provide proof of other health coverage.
4. Click Submit to complete your enrollment.
   
   If you are required to pay a monthly contribution for your benefits selections, it will be automatically deducted from your paycheck.

Step 4: Verify your enrolled dependents:

1. After you have enrolled, an independent firm, Secova, will contact you to verify the eligibility for any enrolled dependents.
2. You must submit the required documents to Secova for each covered dependent by the deadline as instructed in the verification packet, or your dependent’s coverage will be terminated retroactive to the coverage effective date.
3. Click here for details about this process.

PAT Substitute Teachers Annual Enrollment has now ended. Please contact the Trust Administrative Office if you have any questions

Welcome to Open Enrollment letter.

Steps to Enroll:

STEP 1: Compare your options for the 2025 Plan Year. (IMPORTANT NOTE: As of July 1, 2024, the Portland Clinic is no longer an in-network provider for the Kaiser Permanente Plan.)

• 2025 Plan Year PAT Retiree Benefit Guide: See an overview of your benefits: compare plans, view eligibility guidelines, rates, enrollment instructions, and more.
• 2025 Plan Year Comparison Chart: Compare how your Plan options cover and pay for various services.
• 2025 Plan Year Rate Sheet: Compare costs including deductibles, out-of-pocket maximums and monthly rates.

STEP 2: Get your questions answered.

If you have any questions about your coverage options, please call the Trust Administrative Office before you enroll.

You can find answers to many questions online, such as:

• Who can I enroll as dependents? Click here: Eligible Dependents
• How do I enroll a domestic partner? You must meet the requirements in the Affidavit of Domestic Partnership; then contact benefits@pps.net for next steps. (To understand how this affects your income; click here: Domestic Partner Imputed Income.)
• What is the Plan coverage for a specific health service? Click here: PAT Early Retiree Trust Benefit Handbook
• What are my rights regarding continuation of coverage, appeals, privacy, etc.? Click here: Legal Notices

STEP 3: Enroll by October 25. You have two options to complete your enrollment:

Option 1: Enroll on-line at edge.zenith-american.com. Register to create your account and complete your enrollment. Click here for an Online Enrollment Guide.

Option 2: Print and fill out the Benefits Enrollment/Change Form and fax, mail or drop it off at the Trust Administrative Office, so that it is received on or before the deadline.

Payment must be received by the 5th day of each month for that month of coverage (i.e., by Feb. 5th for February coverage). You may either:

• Mail your monthly contribution payments to the Trust Administrative Office.
• Or, submit the Electronic Funds Transfer Authorization form to set up automatic withdrawal from your bank account (payments deducted on the 5th day of each month).
  Your first payment for Early Retiree benefits must be submitted by check.

Step 4: Verify your enrolled dependents:

1. After you have enrolled, an independent firm, Secova, will contact you to verify the eligibility for any enrolled dependents.
2. You must submit the required documents to Secova for each covered dependent by the deadline as instructed in the verification packet, or your dependent’s coverage will be terminated retroactive to the coverage effective date.
3. Click here for details about this process.

Welcome to Open Enrollment letter.

Steps to Enroll:

STEP 1: Compare your options for the 2025 Plan Year. (IMPORTANT NOTE: As of July 1, 2024, the Portland Clinic is no longer an in-network provider for the Kaiser Permanente Plan.)

Option 1 Plans (full coverage available to full-time and part-time employees) Include: Medical, Prescription, Dental, Vision, Long-Term Disability (LTD), Basic Term Life, Basic Accidental Death & Dismemberment (AD&D), Optional Term Life, and Voluntary AD&D.

Option 2 Plans (partial coverage available to part-time employees only) include: Medical, Prescription, Long-Term Disability (LTD), Basic Term Life, Basic Accidental Death & Dismemberment (AD&D), Optional Term Life, and Voluntary AD&D. Dental and vision coverage is not included.

• 2025 Plan Year PFSP Active Benefit Guide: See an overview of your benefits: compare plans, view eligibility guidelines, rates, enrollment instructions, and more.
• 2025 Plan Year Comparison Chart: Compare how your Plan options cover and pay for various services.
• 2025 Plan Year Rate Sheet: Compare costs including deductibles, out-of-pocket maximums and monthly contribution rates for your Plan options.
• Optional Life and Voluntary AD&D: View your options to purchase additional life and AD&D, get rates and application instructions.

STEP 2: Get your questions answered.

If you have any benefits questions, including how the Trust Plans coordinate with other coverage, please call the Trust Administrative Office before you enroll.

You can find answers to many questions online, such as:

• Who can I enroll as dependents? Click here: Eligible Dependents
• How do I enroll a domestic partner? You must meet the requirements in the Affidavit of Domestic Partnership; then contact benefits@pps.net for next steps. (To understand how this affects your income; click here: Domestic Partner Imputed Income.)
• What is the Plan coverage for a specific health service? Click here: PFSP Trust Benefit Handbook
• What are my rights regarding continuation of coverage, appeals, privacy, etc.? Click here: Legal Notices

STEP 3: Enroll online by October 25:

1. Log in to selfservice.pps.net with your PPS username and password, then click Benefits Enrollment.
   • We encourage you to access PeopleSoft Employee Self-Service (ESS) while on-site. In order to access PeopleSoft ESS off-site, you must be set up with Duo 2-Step Security.
   • For assistance, contact the IT Service Desk at 503-916-3375.
2. Make your enrollment selections and enroll dependents. Or, if you are already enrolled, change your selections and dependents.
Note: If you are enrolling dependents, please make sure you check the box next to each dependent you want to enroll.
3. To decline coverage, click Waive Medical Plan Coverage. You will be required to provide proof of other health coverage.
4. Click Submit to complete your enrollment.
   
   If you are required to pay a monthly contribution for your benefits selections, it will be automatically deducted from your paycheck.

Step 4: Verify your enrolled dependents:

1. After you have enrolled, an independent firm, Secova, will contact you to verify the eligibility for any enrolled dependents.
2. You must submit the required documents to Secova for each covered dependent by the deadline as instructed in the verification packet, or your dependent’s coverage will be terminated retroactive to the coverage effective date.
3. Click here for details about this process.

Welcome to Open Enrollment letter.

Steps to Enroll:

STEP 1: Compare your options for the 2025 Plan Year. (IMPORTANT NOTE: As of July 1, 2024, the Portland Clinic is no longer an in-network provider for the Kaiser Permanente Plan.)

• 2025 Plan Year PFSP Retiree Benefit Guide: See an overview of your benefits: compare plans, view eligibility guidelines, rates, enrollment instructions, and more.
• 2025 Plan Year Comparison Chart: Compare how your Plan options cover and pay for various services.
• 2025 Plan Year Rate Sheet: Compare costs including deductibles, out-of-pocket maximums and monthly rates.

STEP 2: Get your questions answered.

If you have any questions about your coverage options, please call the Trust Administrative Office before you enroll.

You can find answers to many questions online, such as:

• Who can I enroll as dependents? Click here: Eligible Dependents
• How do I enroll a domestic partner? You must meet the requirements in the Affidavit of Domestic Partnership; then contact benefits@pps.net for next steps. (To understand how this affects your income; click here: Domestic Partner Imputed Income.)
• What is the Plan coverage for a specific health service? Click here: PFSP Early Retiree Trust Benefit Handbook
• What are my rights regarding continuation of coverage, appeals, privacy, etc.? Click here: Legal Notices

STEP 3: Enroll by October 25. You have two options to complete your enrollment:

Option 1: Enroll on-line at edge.zenith-american.com. Register to create your account and complete your enrollment. Click here for an Online Enrollment Guide.

Option 2: Print and fill out the Benefits Enrollment/Change Form and fax, mail or drop it off at the Trust Administrative Office, so that it is received on or before the deadline.

Payment must be received by the 5th day of each month for that month of coverage (i.e., by Feb. 5th for February coverage). You may either:

• Mail your monthly contribution payments to the Trust Administrative Office.
• Or, submit the Electronic Funds Transfer Authorization form to set up automatic withdrawal from your bank account (payments deducted on the 5th day of each month).

Step 4: Verify your enrolled dependents:

1. After you have enrolled, an independent firm, Secova, will contact you to verify the eligibility for any enrolled dependents.
2. You must submit the required documents to Secova for each covered dependent by the deadline as instructed in the verification packet, or your dependent’s coverage will be terminated retroactive to the coverage effective date.
3. Click here for details about this process.