Frequently Asked Questions

No, the Benefit Convenience Card cannot be used for dental, vision + hearing, or employee assistance program expenses.

Carewell SEIU 503 does not offer other options for your Dental coverage. However, if you reside outside of the Kaiser Service Area, you’ll be enrolled into Kaiser Permanente’s Dental Choice PPO plan. Under the KP Dental Choice PPO you will be able to visit any licensed dentist. However, you will pay less if you visit a dentist that participates in Kaiser’s PPO network. To confirm whether you reside inside or outside of the Kaiser Service Area, contact the Benefits Administrative Office at 1-844-507-7554, option 3 then option 2.

For questions regarding coordination of benefits, please contact Kaiser Permanente Customer Service.

If you reside outside of the Kaiser service area and have a specific provider who is not in-network, you can ask your dentist if they would be willing to get credentialed with Kaiser Permanente so they can become part of the network.

If you reside inside the Kaiser service area you will not receive coverage for any services performed by an out-of-network dentist.

No. Carewell SEIU 503 benefits are available only to eligible homecare and personal support workers.

Benefits Waiver Form (Digital)

No, the Benefit Convenience Card cannot be used for dental, vision + hearing, or employee assistance program expenses.

You can visit VSP’s website at vsp.com/eye-doctor or call 1-800-877-7195.

You must submit a reimbursement claim form within 90 days from the date of service. For example, if you purchase eyeglasses from an out-of-network provider you will have 90 days to submit the VSP Member Reimbursement Claim Form. Call Ameritas at 1-800-255-4931 to find out more about how much you will be reimbursed if you go to an out-of-network provider.

No. Carewell SEIU 503 benefits are available only to eligible homecare and personal support workers.

Yes. You can fill out the Waiver Form and submit it to the Benefits Administrative Office.

Benefits Waiver Form (Digital)

No, the Benefit Convenience Card cannot be used for dental, vision + hearing, or employee assistance program expenses.

You can access services by visiting ibhsolutions.com or calling 1-866-750-1327. Your access code is: OHWBT.

No. Carewell SEIU 503 benefits are available only to eligible homecare and personal support workers.

Yes. You can fill out the Waiver Form and submit it to the Benefits Administrative Office. 

Benefits Waiver Form (Digital)

If you are eligible for medical coverage through your spouse, but you choose not to enroll in that coverage, you may be eligible for Carewell SEIU 503 Healthcare Cost Assistance. Call 1-844-503-7348 for more information.

You can, although it is highly recommended you use the services of Valley Insurance Professionals, who have years of experience working with the Carewell benefits program, assisting care providers with enrolling into approved Marketplace plans, and ensuring care providers can access Healthcare Cost Assistance. If you use your own insurance agent, you do not have to fill any Agent of Record form included in the annual paperwork, but please call 1-844-503-7348 to let one of our representatives know you are using your own agent and not completing an Agent of Record form.

You may qualify for Healthcare Cost Assistance if you became eligible for Carewell SEIU 503 benefits after the end of the last Open Enrollment period and you are enrolled in a non-approved plan on a Healthcare Marketplace. In that case, you would receive a Benefit Convenience Card to pay covered out-of-pocket expenses, and you would be eligible for reimbursement of your premium costs up to the lesser of your actual premiums or the average premium amount received by eligible care providers on Healthcare Cost Assistance. To continue receiving Healthcare Cost Assistance after the end of the year, you must enroll into an approved plan at your first opportunity and no later than Open Enrollment (between November 1 and December 15). Otherwise, your Healthcare Cost Assistance will stop at the end of the calendar year. To check if you qualify for average premium reimbursements, call 1-844-507-7554, option 3, option 2.

Your net premium is the monthly amount that you must pay to your insurance company to maintain your insurance. For example, if your gross premium (the full cost of the premium from your insurance carrier) is $500 per month and your Advance Premium Tax Credit or APTC (the financial assistance from the Federal Government) is $200 per month, your net premium would be $300 per month.

If the plan you enrolled in is still an approved plan for the following calendar year, the decision on your appeal still stands. You will need to review the information on this page to make sure that you take the appropriate steps during Open Enrollment to renew your medical coverage and continue receiving Healthcare Cost Assistance. You are also encouraged to review the new plan summary and provider networks to make sure this option still works for you.

No, you do not have to change plans. You can change to the 2021 Approved KP Silver 2500/40 plan if you would like, or you can stay in the Approved Providence plan. Once you transition to the Approved Kaiser plan, that will be your Approved Plan for the rest of the year and you will no longer have the option to receive Carewell SEIU 503 benefits for the Providence plan after you switch.

No, if you live in the Lane County or Linn County Kaiser Service Area and you are newly enrolling into Carewell SEIU 503 benefits for 2021, your Approved Plan is the Kaiser KP Silver 2500/40 plan.

Your Card works just like a regular debit card, with two important differences:

1. Your card is limited in use, meaning you can only use it for the covered expenses listed under “What can I use the Card to pay for?”

2. You cannot use your Card at an ATM or to obtain cash back when making a purchase.

There are two “accounts” on your Card. One account is preloaded with the annual amount for paying medical and prescription copays, deductibles and coinsurance expenses for covered services and prescriptions. In 2021, that amount is $6,500, but this may change from year to year. The other account is preloaded with the amount necessary to pay your net monthly premium: the portion of your individual health insurance premium that is not covered by your Federal tax credit (APTC).

No. The maximum amount you can be reimbursed for covered expenses incurred in each calendar year is the set amount for that calendar year. Any portion that is not used for a calendar year cannot be rolled over for payment of expenses incurred in a future calendar year.

Your Benefit Convenience Card will expire on the date you are no longer eligible for Carewell SEIU 503 HCA benefits, or the month and year listed on the front of the Card, whichever date is first. Ameriflex will send you a new Benefit Convenience Card a month before the expiration date on your current Card if you are still eligible for HCA benefits at that time. If you have questions about this, you can reach Ameriflex by calling 1-888-868-3539.

Check your balance with Ameriflex, the Card Administrator, either using your MyAmeriflex Mobile App or Ameriflex online account, or by calling 1-888-868-3539. If there is enough money to pay the premium, ask your insurance carrier to try again. If you do not have enough money on your Card, please call 1-844-507-7554, option 3, option 2 right away.

Call Ameriflex, the Card Administrator, at 1-888-868-3539. You will want to identify yourself as a Homecare Worker and have the following available at the time of your call: your Card, the date and type of service you were attempting to pay for and a description of the issue you experienced.

You can only use the Benefit Convenience Card to pay for covered services received in the same year. If you receive claims from a previous calendar year for out-of-pocket expenses relating to a covered service, you will need to utilize the reimbursement process.

To qualify for Healthcare Cost Assistance for payment of your approved Marketplace plan premiums and out-of-pocket expenses, you must apply the full amount of any Advance Premium Tax Credit (APTC) you qualify for toward your plan premiums. If you underestimate your annual household income, and receive a higher APTC than you should have, and as a result, you owe a reconciliation fee to the IRS at your annual tax filing, you may be eligible for reimbursement of the reconciliation fee from the Benefits Administrative Office.

When you apply for coverage through the Health Insurance Marketplace, you’ll find out if you qualify for an Advance Premium Tax Credit based on what you estimate for your income and family size. However, if your income changes, or if you add or lose members of your household, your Premium Tax Credit will probably change too. It’s very important to report income and household changes to the Marketplace as soon as possible. For assistance, contact Valley Insurance Professionals at 1-503-974-8471.

No. If you qualify for Medicaid, you are not eligible for Carewell SEIU 503 HCA benefits, and you are also not eligible for any Advance Premium Tax Credits or Marketplace Cost Share Reductions. If you qualify for Medicaid and are currently enrolled in a Marketplace plan, please call 1-844-503-7348 as soon as possible. For more information about Medicaid and a Marketplace plan refer to healthcare.gov/medicaid-chip/cancelling-marketplace-plan/ and for more information on other coverage and a Marketplace plan refer to healthcare.gov/have-job-based-coverage/options/.

If anyone in your household has a Marketplace plan, you should receive Form 1095-A, Health Insurance Marketplace Statement for your taxes. The 1095 forms are sent out in January-February for the previous year’s coverage. It includes information about the Marketplace plans under which anyone in your household had coverage. It comes from the Marketplace, not the IRS. You should receive it by mail or in your online Marketplace account. You or your tax preparer will need the 1095 form to complete the IRS Form 8962, which needs to be filed each year with your taxes in order to reconcile your Advance Premium Tax Credits. Learn more about Form 1095 at healthcare.gov/tax-form-1095/. If you did not receive a 1095-A, you can download a copy in your Marketplace account or contact the Health Insurance Marketplace directly at 1-800-318-2596.

Call the Benefits Administrative Office. You will need to send copies of your tax forms 1040, 1095A and 8962 to the Benefits Administrative Office, along with the Premium Adjustment Reimbursement Form.

Submit the Premium Adjustment Reimbursement Form along with your tax forms 1040, 1095A and 8962 to the Benefits Administrative Office to receive reimbursement for all or part of what you owe the Federal government.

If you lose eligibility for an APTC because the Marketplace determines your household size and/or income disqualifies you from receiving a tax credit, you will still qualify for Carewell SEIU 503 HCA benefits relating to your approved Marketplace plan. However, if you lost eligibility for the APTC because you did not respond to a request for information, or otherwise failed to take any action required to maintain such APTC, you will only be eligible to receive the premium assistance benefit that would have been payable had your APTC not been terminated. You will be responsible for the difference in the premium.

If you lost eligibility for the APTC because you did not respond to a request for information from the Marketplace, or otherwise failed to take any action required to maintain such APTC, you need to submit the information the Marketplace is requesting and attempt to restore your tax credit or be re-determined for a tax credit. You will be responsible for the difference in the premium until the Marketplace redetermines what, if any, APTC you qualify for. Call 1-844-503-7348 for questions or Valley Insurance Professionals at 1-503-974-8471 for assistance in restoring your APTC.

• The deductible applicable to your Medicare plan. A deductible is the amount you must pay for the services that your Medicare plan covers before Medicare begins to pay.
• The co-payments for medical services and prescriptions covered by your Medicare plan. A co-payment (or co-pay) is a fixed amount your Medicare plan may require you to pay, and is usually due at the time that you receive the service or prescription.
• The coinsurance for medical services and prescriptions covered by your Medicare plan. Coinsurance is a percentage of the costs you must pay for services your Medicare plan covers. Cost sharing may range from 20% to 50% of a covered service, depending on your Medicare plan. For example, if your Medicare plan has an “80/20” coinsurance arrangement, this means that, after you pay any deductible, your Medicare plan will pay 80% of the cost of the covered medical expense and you must pay the remaining 20%.

The Benefit Convenience Card is pre-loaded with the annual amount for paying medical and prescription co-pays, deductibles and coinsurance expenses for covered services and prescriptions. In 2021, that amount is $6,500, but this may change from year to year.

No. The maximum amount you can be reimbursed for covered expenses incurred in each calendar year is the set amount for that calendar year. Any portion that is not used for a calendar year cannot be rolled over for payment of expenses incurred in a future calendar year.

Your Benefit Convenience Card will expire on the date you are no longer eligible for Carewell SEIU 503 benefits, or the month and year listed on the front of the Card, whichever date is earlier. Ameriflex will send you a new Benefit Convenience Card a month before the expiration date on your current Card if you are still eligible for HCA benefits at that time. If you have questions about this, you can reach Ameriflex by calling 1-888-868-3539.

You will receive a letter from the Benefits Administrative Office each February and July with your benefit amount. If you request a portion of your benefit and do not know what your remaining balance is you can call the Benefits Administrative Office at 1-844-507-7554, option 3, option 2.

The Designation of Beneficiary Form allows you to select someone to receive any accrued PTO benefit remaining upon your death prior to receiving such benefit. If no beneficiary designation is made, or if your designated beneficiary does not survive you or if they cannot be located, the accrued balance will be paid to the executor of your estate.

Banks charge fees to cancel a check after it’s been issued. For this reason, you are encouraged to wait a minimum of ten business days after a check has been issued before requesting a new check.

Paid Time Off is taxable income. If you receive $600 or more of paid time off benefits in one year, you will receive a Form 1099 from the Benefits Administrative Office. The benefit is still taxable income even if you do not receive a Form 1099.

It is not your responsibility to find your own replacement when you take paid leave. The consumer has the primary responsibility for selecting and hiring their providers. Paid leave must be prior authorized by the consumer, relief must be available if necessary and the appropriate agency must be notified in order to authorize the substitute worker’s hours. Sometimes the consumer will require assistance from the case manager/personal agent/service coordinator in finding a suitable replacement provider.

No, you do not need to report your time off to the Benefits Administrative Office.

Current homecare and personal support workers will need to complete 12 hours of refresher training by March 31, 2022.

New personal support and homecare workers will need to complete a four-hour orientation before they begin working for a consumer, and eight hours of core training within 120 days of beginning employment.

In addition, all care providers must also complete 12 hours of continuing education every two years before they are re-certified.

For trainings offered by Carewell SEIU 503 Training, you can access your training completion information through the Carewell Learning Portal. You can also contacting us by calling 1-844-503-7348 or emailing CarewellSEIU503training@RISEpartnership.com.

For trainings and certifications offered by the Oregon Home Care Commission, contact OHCC by calling (877) 867-0077 or emailing Certifications.OHCC@dhsoha.state.or.us.

Yes. All homecare and personal support workers who are compensated through Medicaid or Oregon Project Independence— even those who work solely for family members ─ are required to meet the new training requirements.

You are required to take the training if you are a homecare or personal support worker who works directly for a consumer. You are not required to take the training if you work in a setting like a foster home, group home, residential care facility, assisted living facility, or nursing facility. There are different requirements you must follow. You also do not have to take the training if you work with in-home agencies or provider agencies. You are not required to take the training if you are part of the Independent Choices Program (ICP), but you may take the training if you would like to. 

SEIU 503 and the Oregon Home Care Commission developed a training work group to establish minimum training standards for care providers. The work group is made up of community partners, stakeholders, advocacy groups, the union that represents the workforce (SEIU), homecare and personal support workers, consumers, and Oregon Department of Human Services representatives. The work group identified many important topics to be included that benefit consumers and care providers.

If you do not meet the deadlines, you will most likely have to stop working for you consumer until you meet the requirements. This will be determined through the rule-making process.

Training schedules and course information will be available online. You will be able to monitor your progress and will receive reminders about upcoming deadlines. 

Currently Carewell is only offering training online. When it is safe to return to the classroom, training will be held all around the state of Oregon. Dates and locations will be posted on the Carewell Learning Portal.

The Carewell SEIU 503 Training team is working toward offering training in a variety of languages including Arabic, Spanish, Russian, Vietnamese, Mandarin (voice-over), and simplified Chinese (written). If a training is not currently offered in your preferred language, the Carewell SEIU 503 Training team will work with you to schedule an interpreter for the course(s) you attend. To request an interpreter send an email to carewellseiu503training@risepartnership.com or call 1-844-503-7348.

No. However, if you have earned a certification through the Oregon Home Care Commission and continue to meet the certification requirements, you do not need to take additional continuing education courses other than what is required to maintain the specific certification. Click here to find more information about career development and certifications.

If you have one of the following certifications, you will be exempt from the refresher training series:

• Professional Development Certification (PDC)
• Enhanced Homecare or Personal Support Worker
• Exceptional Personal Support Worker
• Ventilator Dependent Quadriplegia (VDQ), when available
• Traditional Health Worker

Please note that to remain exempt, you will need to keep the certification active. If you are unsure whether you have one of these certifications active, please contact the Oregon Home Care Commission by calling 877-867-0077 or sending an email to Certifications.OHCC@dhsoha.state.or.us. 

We’re here to help! We have a variety of alternative learning options. Please reach out to us so we can find an option that works well for you. Call us at 844-503-7348 or email CarewellSEIU503training@RISEpartnership.com. 

If you don’t have access to a computer, you can also use your smartphone or tablet to access the training.

Don’t have access to a smartphone or tablet? We’re here to help! We have a variety of alternative learning options. Please reach out to us so we can find an option that works well for you. Call us at 844-503-7348 or email CarewellSEIU503training@RISEpartnership.com.

Click the link in the upper right hand corner of the Carewell Learning Portal to log in. From this link, if you do not know your password, you can click “Forgot Password” which will email you a link to reset your password.

Those who are applying to be a homecare or personal support worker will be given a $65 stipend for successfully completing Online Core and a $65 stipend for attending Core Workshop. There is no stipend for attending Orientation.

Current care providers will be provided a stipend for time spent participating in required refresher training sessions. There is a $135 stipend for completing Online Refresher and a $65 stipend for completing Refresher Workshop. 

If you are a homecare worker, for more information about how to fill out and submit vouchers, please visit the Tutorials section of the OHCC Homecare Workers Resources page.

You can also refer to the video here.

If you are a personal support worker, for more information about how to use eXPRS please visit the Personal Support Workers Resources page on the ODDS website.