2016 Oregon Large Group Plans

The information on this page is for plans beginning January 1, 2016.

Medical Plans


 

Plan

Deductible*

OOP*

Co-insurance

HSA-eligible?

SBCs and Handbooks
by Network
Summaries
by Network
  Balance 500+20_20
$500
$3,500
20%
No
PSNSCN
Balance 750+20_20
$750
$4,500
20%
No
PSNSCN
Balance 1000+20_20
$1,000
$5,000
20%
No
PSNSCN
Balance 1500+20_20
$1,500
$5,500
20%
No
PSNSCN
Balance 1500+30_30
$1,500
$5,500
30%
No
PSNSCN
Balance 2000+20_20
$2,000
$6,000
20%
No
PSNSCN
Balance 2000+30_30
$2,000
$6,000
30%
No
PSNSCN
Balance 2500+20_20
$2,500
$6,000
20%
No
PSNSCN
Balance 2500+30_30
$2,500
$6,000
30%
No
PSN / SCN
PSNSCN
Balance 3000+20_20
$3,000
$6,000
20%
No
 PSNSCN
Balance 3000+30_30
$3,000
$6,000
30%
No
PSNSCN
Balance 3500+30_30
$3,500
$6,000
30%
No
PSNSCN
Balance 4000+30_30
$4,000
$6,000
30%
No
PSN / SCN
PSN / SCN
Balance 5000+30_30
$5,000
$6,850
30%
No
PSN / SCN
PSN / SCN
  Value 1500_20+Rx 
Non-embedded
$1,500
$4,500
20%
Yes
PSNSCN
Value 3000_50+Rx
$3,000
$6,350
50%
Yes
PSNSCN
Value 3000+Rx
$3,000
$3,000
0%
Yes
PSNSCN
Value 4000+Rx
$4,000
$4,000
0%
Yes
PSNSCN
Value 5000+Rx
$5,000
$5,000
0%
Yes
PSN / SCN
PSN / SCN

*Deductible and out-of-pocket limit amounts shown below are the costs for individuals. Amounts for families are twice the individual amounts.

Dental Plans


  Dental Advantage Essentials Dental Choice Plus 0-20-50 25-1000
Dental Advantage Essentials Plus Dental Choice Plus 0-20-50 25-1500
Dental Advantage Plus 0-20-50 25-1000 Dental Choice Plus 0-20-50 50-1000
Dental Advantage Plus 0-20-50 25-1500 Dental Choice Plus 0-20-50 50-1500
Dental Advantage Plus 0-20-50 50-1000 Dental Choice Plus 20-20-50 50-1000
Dental Advantage Plus 0-20-50 50-1500 Dental Choice Plus 20-20-50 50-1500
Dental Advantage Plus 20-20-50 50-1000  
Dental Advantage Plus 20-20-50 50-1500
  Kids Dental Advantage 0/20/50 Kids Dental Advantage 20-40-50
  Ortho 1000 Ortho 1500

Voluntary Dental Option Plans

Our Voluntary Dental option is available to businesses with ten or more enrolled employees. For information and requirements, please see our Voluntary Dental flier.

  Dental Advantage 0-20-50 50-1000 Voluntary Dental Choice 0-20-50 25-1500 Voluntary
Dental Advantage 0-20-50 50-1500 Voluntary Dental Choice 0-20-50 50-1500 Voluntary

Pharmacy Plans


   OR 3000D ODL OR 50P ODL
OR 4000D ODL OR 10-50P-50P ODL
OR 5000D ODL OR 10-35-60 ODL

Chiropractic Manipulation and Acupuncture


  500 1000 1500 2000 2500

Vision Plans


  Vision 10-150 Vision Plus
  Vision 10-300 Vision Exam Only

Brochure and Forms


Visit our Oregon Forms and Materials page for more sales materials.

Network Availability


Plan availability varies depending on geographic location. All network plans are available direct with PacificSource.

PacificSource Network (PSN)

 
 

Available in the following counties:

  • All counties

Notable features:

  • Access to participating PSN providers in Oregon, Oregon, Montana, and southern counties in Washington, as well as access to a nationwide travel network of providers
  • Referrals not required for specialty care
  • Some plans qualified for health savings accounts
 

SmartChoice Network (SCN)

 
 

Available in the following counties:

  • Benton
  • Clackamas
  • Coos
  • Crook
  • Curry
  • Deschutes
 
  • Douglas
  • Jackson
  • Jefferson
  • Josephine
  • Lane
  • Linn
 
  • Marion
  • Multnomah
  • Polk
  • Washington
 
 

Notable features:

  • Partner with a primary care provider (PCP)
  • Referrals not required for specialty care
  • Some plans qualified for health savings accounts