Provider Information/Policy Numbers
WOU’s PEBB Agency Number is 58020. Don’t know your PEBB Benefits number, or have other questions? Contact the Office of Human Resources at benefitsretirement@wou.edu or Michelle Sides, Benefits Coordinator, at 503-838-9390. Click here for the Summary Plan Description.
Kaiser Permanente HMO
500 NE Multnomah, STE 100
Portland, OR 97232-2099
Phone: (800) 813-2000
Group Number: 18273
Member Number: Assigned by carrier
Kaiser Deductible
500 NE Multnomah, STE 100
Portland, OR 97232-2099
Phone: (800) 813-2000
Group Number: 18273
Member Number: Assigned by carrier
PEBB Statewide Plan (Administered by Providence)
PO Box 3125
Portland, OR 97208-3125
Phone: (800)423-9470
Group Number: 108601
Member Number: Assigned by carrier
Providence Choice
PO Box 3125
Portland, OR 97208-3125
Phone: (800) 878-4445
Group Number: 106528
Member Number: Assigned by carrier
Moda Health (Synergy)
PO Box 40384
Portland, OR 97240
Phone: (877)605-3229
Group Number: 10002802
Member Number: Assigned by carrier
Willamette Dental
14025 SW Farmington Rd, Ste 300
Beaverton, OR 97005
Phone: (800) 460-7644
Group Number: Z250I
Member Number: *PEBB.Benefits Number
Moda Health Premier
(Previously ODS Traditional)
Moda refers to plan as Delta Dental Premier
601 SW 2nd Avenue
Portland, OR 97204
Phone: (800) 452-1058
Group Number: 6570
Member Number: *PEBB.Benefits Number
Moda Health PPO
(Previously ODS Preferred)
Moda refers to plan Delta Dental PPO
601 SW 2nd Avenue
Portland, OR 97204
Phone: (800) 452-1058
Group Number: 6571
Member Number: *PEBB.Benefits Number
Kaiser Permanente
500 NE Multnomah, Ste 100
Portland, OR 97232-2099
Phone: (800) 813-2000
Group Number: 18273
Member Number: Assigned by carrier
*(You should receive a card in the mail.)
Vision Service Plan (VSP)
PO Box 997105
Sacramento, CA 95899
Phone: (800) 877-7195
Group Number: 12179989
Member Number: PEBB.Benefits Number
The Standard
PO Box 2800
Portland, OR 97208
Phone: Life Insurance/AD&D: (800)628-8600
Phone: Short-Term Disability: (800) 368-2859
Phone: Long-Term Disability: (800) 368-1135
Plan: Basic Life & Optional Life Insurance
Policy Number: 606814-D
Plan: Accidental Death & Dismemberment
Policy Number: 603073-A
Plan: Short-Term Disability
Policy Number: 442210-C
Plan: Long-Term Disability
Policy Number: 606717-A
UNUM
2211 Congress Street
Portland ME 04122
800-227-4165
Plan Number: 025758-003 6
Plan Highlights
Certificate of Coverage
ASIFlex
PO Box 6044
Columbia, MO 65205-6044
800-659-3035
Canopy Inc.
7180 S.W. Fir Loop Suite 100
Portland, OR 97223-8023
info@canopywell.com
(503) 639-3009
1-800-433-2320
You will need your Medical Card ID# issued by provider.
To enroll online use Company Name “State of Oregon”
Walgreens
800-636-3070 or 800-797-3345
Postal Prescription Services
503-797-2100 or 800-552-6694
Wellpartner
877-935-5797
US, Canada, Puerto Rico, Bermuda, US Virgin Islands
800-527-0218
All Other Countries (Call collect.)
410-453-6330
Public Employees Retirement System (PERS)
11410 SW 68th Parkway
Tigard, OR 97223
P: 503-598-7377
F: 503-598-0561
Employer Number:
Western Oregon University
01255
PERS Health Insurance Program
PO Box 40187
Portland, OR 97240
P: 1-800-768-7377
Employer Number:
Western Oregon University
01255
Fidelity
Greg Weston, Workplace Planning & Guidance Consultant
825 SW Fifth Avenue
Portland, OR 97204
P: 1-800-343-0860
P: 503-716-2533
F: 508-460-2704
Oregon Public Universities
ORP: 71681
TDI: 71678
TIAA-CREF
Braden Danielson, Financial Consultant
4730 University Way NE, Suite 201
Seattle, WA 98105
P: 1-800-842-2888
P: 503-452-6986
F: 206-523-6866
Oregon Public Universities
ORP: 101528
TDI: 101529
Oregon Savings Growth Plan
800 Summer Street NE, Suite 200
Salem, OR 97301
P: 503-378-3730
F: 503-378-5888
CONTACT
Human Resources
Lieuallen Administration 305P: 503-838-8490 | F: 503-838-8522 | E-mail: hr@wou.edu
