MissionSquare Retirement (formerly ICMA-RC) Lane County's deferred compensation administrator! www.missionsq.org DeLana Hansen 888-803-2726
Contact your MissionSquare representative to schedule an appointment!
You may also call MissionSquare at 800-669-7400 (press “0” to speak with a representative). Monday through Friday 5:30 a.m. to 6:00 p.m. PT.
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Retirees - For assistance, please contact [email protected] or by calling 541-682-3660 to leave a message or to schedule an appointment.
Please see the contacts below for further assistance.
Lane County Retirees on Medicare
For questions, please contact QVI at (800) 408-9717
2024 Medicare Proof of Enrollment
January 1, 2024
DUE: February 17, 2024
Please note:
You can complete, sign and date the 2024 Medicare Proof of Enrollment" form under the Quick Links on the right side of this page and they are due back to QVI by February 17, 2024.
QVI Risk Solutions, on behalf of Lane County, requests annual Medicare Proof of Enrollment needed to reimburse amounts due for eligible retirees.
The form/proofs needed for 2024 are:
1) Medicare Proof of Enrollment Form for 2024 Quarterly Reimbursements
Please complete, sign and date the "2024 Proof of Enrollment" form under the Quick Links on the right side of this page.
Please return to QVI Risk Solutions no later than February 17, 2024 to ensure your reimbursements continue without interruption.
2) 2024 Proof of Part B Premium
Please provide a copy of your “Benefit Verification Letter.” You can request this letter from Social Security by:
If you are not yet receiving monthly Social Security benefits, please contact Medicare for your “Notice of Premium Payment Due.” You can request this letter from Medicare by:
3) 2024 Proof of Medicare Advantage or Supplemental Plan (if applicable)
Please provide proof of what plan and monthly premium rate you will pay in 2024.
Please call your plan provider directly for your Medicare Advantage or Supplement plan to receive proof of your monthly plan cost for 2024.
If you are on the Lane County Regence Group plan or PERS plan, please write in the name of the plan only on the Proof of Enrollment Form - NO PROOF is necessary.
Once you have the form/proofs required, please mail by February 17, 2024 to:
QVI Risk Solutions, Inc.
PO Box 7199
Bend, OR 97708
For further assistance, contact QVI at (800) 408-9717
QVI BANK AUTHORIZATION FORM
2024 Regence BlueCross BlueShield Plans
There are premium changes for the Lane County Regence Plan Group rates in 2024
Lane County Retiree monthly rates for Regence Group Plans:
2024 Regence Basic or Primary Plan: No cost to Retiree
2024 Regence Classic Plan: $41.00 per month
2024 Regence Enhanced Plan: $95.00 per month
Please see below for the 2024 Plan Summary and Annual Notices of Changes to the Regence Group plans.
Regence PPO Plan Star Rating
Coming Soon - 2024 Annual Notice of Changes
2023 Basic Plan - Annual Notice of Changes
2023 Classic Plan - Annual Notice of Changes
2023 Enhanced Plan - Annual Notice of Changes
Regence Long Form for NEW enrollees
Regence Short Form (Current Members Only)
Regence Disenrollment Request Form
Contact Information
QVI Risk Solutions, Inc.
(Billing for: Retirees, COBRA, Medicare)
(800) 408-9717
[email protected]
Social Security Administration
(800) 772-1213
www.ssa.gov
PERS Health Insurance Program
(800) 768-7377
www.pershealth.com/
Regence Medicare Advantage
(888) 319-8904
Benefit Resource Center for PacificSource
(866) 468-7272
Optum Bank - Health Savings Accounts
(877) 470-1771
https://mycdh.optum.com/
PacificSource Health Plans
(541) 684-5582
www.PacificSource.com
Delta Dental (formerly MODA)
(888) 217-2365
www.MODAhealth.com
Willamette Dental Group
(855) 433-6825
www.willamettedental.com
Lane County Benefits & Wellness
(MUST CALL OR EMAIL FIRST, NO DROP IN'S WILL BE ACCEPTED)
125 E 8th Ave, Eugene, OR 97401
(541) 682-3124
[email protected]