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Explore and compare 2021 health plans that meet your business and employees’ needs. View 2022 plans.

Total Enhanced

Offering best-in-class benefits with full access to the Providence Signature Network

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Balance

Excellent benefits, lower premiums & full access to the Providence Signature Network

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HSA Qualified

Affordable plans with lower-premiums, high-deductibles and provider choice in the national Providence Signature Network

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Standard

These plans take advantage of the national Providence Signature Network

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Choice

Patient-centered medical home model of care with a network that includes more than 410 primary care clinics

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Connect

Substantial premium savings with Portland metro area Connect network medical home model

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  • Plan Overview
    • In- and out-of-network common deductibles and out-of-pocket maximums
    • Deductible waived on all six pharmacy tiers
    • Chiropractic manipulation and acupuncture visits (up to 15 visits per calendar year combined; deductible waived)
    • Offering the most robust level of coverage
    • Separate deductibles and out-of-pocket maximums, in and out of the network
    • Deductible waived on select benefits, including primary care and specialist office visits, urgent care and in-network physical therapy
    • Chiropractic manipulation and acupuncture visits (up to 10 visits per calendar year combined; deductible waived)
    • Cost-saving features tailored to your employees’ needs.
    • NEW! Balance plans are certified for SHOP
    • Separate deductibles and out-of-pocket maximums, in and out of the network
    • A formulary that includes ACA preventive and safe harbor medications that are exempt from the deductible
    • Chiropractic manipulation and acupuncture visits (up to 10 visits per calendar year combined; deductible applies)
    • Free health savings accounts with HealthEquity included for all HSA Qualified plan members
    • NEW! HSA Qualified plans are certified for SHOP
    • Separate deductibles and out-of-pocket maximums, in and out of the network
    • Copays starting as low as $20 and deductibles as low as $1,500
    • Chiropractic manipulation and acupuncture are not covered
    • Defined by the State of Oregon. Available from Providence
    • Standard plans are certified for SHOP
    • Separate deductibles and out-of-pocket maximums, in and out of the network
    • Access to Choice network specialists via referral from the medical home for in-network coverage
    • Up to 10 combined chiropractic manipulation and acupuncture visits per calendar year (Does not apply to OOPM)
    • NEW! Three EAP visits covered in full before the deductible
    • NEW! Three visits covered in full before the deductible on Gold and Silver plans for each of the following: PCP and Mental / Behavioral health
    • Separate deductibles and out-of-pocket maximums, in and out of the network
    • Access to Choice network specialists via referral from the medical home for in-network coverage
    • Up to 10 combined chiropractic manipulation and acupuncture visits per calendar year (Does not apply to OOPM)
    • NEW! Three EAP visits covered in full before the deductible
    • NEW! Three visits covered in full before the deductible on Gold and Silver plans for each of the following: PCP and Mental / Behavioral health
  • Provider Network

    Signature Network

    Broad PPO-style network

    No in-network referrals required

    Signature Network

    Broad PPO-style network

    No in-network referrals required

    Signature Network

    Broad PPO-style network

    No in-network referrals required

    Signature Network

    Broad PPO-style network

    No in-network referrals required

    Choice Network

    Local medical home model

    In-network referrals required

    Connect Network

    Local medical home model

    In-network referrals required

  • Benefits

    Combined in-network and out-of- network deductibles and out-of-pocket maximums

    Deductible applies to out-of-pocket maximum

    ACA preventive care covered in full

    Deductible waived for Primary Care Provider and specialist visits

    Deductible waived for lab and X-ray


    Deductible waived for generic drugs

    Deductible waived for preferred brand name drugs

    Coverage for chiropractic manipulation and acupuncture

    Deductible waived for chiropractic manipulations, physical therapy and acupuncture

    Pediatric dental coverage included

    Adult vision exam coverage included

    Adult vision hardware coverage included

    Separate in-network and out-of- network deductibles and out-of-pocket maximums

    Deductible applies to out-of-pocket maximum

    ACA preventive care covered in full

    Deductible waived for Primary Care Provider and specialist visits

    Deductible waived for lab and X-ray (Gold and Silver plans only)

    Deductible waived for generic drugs

    Deductible waived for preferred brand name drugs (Gold and Silver plans only)

    Coverage for chiropractic manipulation and acupuncture

    Deductible waived for chiropractic manipulations, physical therapy and acupuncture

    Pediatric dental coverage included

    Adult vision exam coverage included

    Adult vision hardware coverage included

    Separate in-network and out-of-network deductibles and out-of-pocket maximums

    Deductible applies to out-of-pocket maximum

    ACA preventive care covered in full

    Deductible applies for Primary Care Provider and specialist visits

    Deductible applies for lab and X-ray


    Deductible applies for generic drugs

    Deductible applies for preferred brand name drugs

    Coverage for chiropractic manipulation and acupuncture

    Deductible applies for chiropractic manipulations, physical therapy and acupuncture

    Pediatric dental coverage included

    Adult vision exam coverage included

    Adult vision hardware coverage not included

    Separate in-network and out-of-network deductibles and out-of-pocket maximums

    Deductible applies to out-of-pocket maximum

    ACA preventive care covered in full

    Deductible waived for Primary Care Provider and specialist visits

    Deductible applies for lab and X-ray

     

    Deductible waived for generic drugs

    Deductible waived for preferred brand name drugs (Gold and Silver plans only)

    Coverage for chiropractic manipulation and acupuncture not included

    Chiropractic manipulations and acupuncture are not covered

     

    Pediatric dental coverage not included

    Adult vision exam coverage not included

    Adult vision hardware coverage not included

    Separate in-network and out-of-network deductibles and out-of-pocket maximums

    Deductible applies to out-of-pocket maximum

    ACA preventive care covered in full

    Deductible waived for Primary Care Provider and specialist visits

    Deductible waived for lab and X-ray (Gold and Silver plans only)

    Deductible waived for generic drugs

    Deductible waived for preferred brand name drugs (Gold and Silver plans only)

    Coverage for chiropractic manipulation and acupuncture

    Deductible waived for chiropractic manipulations, physical therapy and acupuncture

    Pediatric dental coverage included

    Adult vision exam coverage included

    Adult vision hardware coverage not included

    Separate in-network and out-of-network deductibles and out-of-pocket maximums

    Deductible applies to out-of-pocket maximum

    ACA preventive care covered in full

    Deductible waived for Primary Care Provider and specialist visits

    Deductible waived for lab and X-ray (Gold and Silver plans only)

    Deductible waived for generic drugs

    Deductible waived for preferred brand name drugs (Gold and Silver plans only)

    Coverage for chiropractic manipulation and acupuncture

    Deductible waived for chiropractic manipulations, physical therapy and acupuncture

    Pediatric dental coverage included

    Adult vision exam coverage included

    Adult vision hardware coverage not included

  • Health and Wellness Program

    ProvRN free 24/7 nurse line

    Disease management for chronic conditions

    LifeBalance recreational discount program

    Health coaching

    ProvRN free 24/7 nurse line

    Disease management for chronic conditions

    LifeBalance recreational discount program

    Health coaching

    ProvRN free 24/7 nurse line

    Disease management for chronic conditions

    LifeBalance recreational discount program

    Health coaching

    ProvRN free 24/7 nurse line

    Disease management for chronic conditions

    LifeBalance recreational discount program

    Health coaching

    ProvRN free 24/7 nurse line

    Disease management for chronic conditions

    LifeBalance recreational discount program

    Health coaching

    ProvRN free 24/7 nurse line

    Disease management for chronic conditions

    LifeBalance recreational discount program

    Health coaching

  • Integrated HSA, HRA, and FSA

    Can be paired with an integrated HealthEquity account

    HRA,FSA

    Can be paired with an integrated HealthEquity account

    HRA,FSA

    Can be paired with an integrated HealthEquity account

    HSA

    Can be paired with an integrated HealthEquity account

    HRA, FSA

    Can be paired with an integrated HealthEquity account

    HRA, FSA

    Can be paired with an integrated HealthEquity account

    HRA, FSA

NOTE:

The plan information listed in this compare table is intended to provide an overview only. Please refer to a benefit summary for specific details. Some benefit limitations and exclusions apply to our plans. For a complete listing of benefits and exclusions, please see the plan contract documents.

Choice is good. We have the options you deserve.

Multiple plan offering
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Add-on services
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Small group employers

Take advantage of the small business tax credits when purchasing a plan in Oregon.

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Our plans offer a number of perks designed to support your employees’ True Health

LifeBalance

Get discounts on things you love to do, from seeing a movie to getting away for less with unique vacation packages.

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ID Protection

Get peace of mind with Assist America Identity Theft Protection's fraud monitoring, warning, and resolution.

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Health Coaching

Providence health coaches are here to support your journey to a healthier, happier life.

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ChooseHealthy®

Save big on fitness and wellness products, services, and memberships.

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Travel Assistance

Get emergency medical help while traveling more than 100 miles away from home, or internationally with Assist America.

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Active&Fit™

Access 10,000 participating fitness centers and YMCAs nationwide for only $25/month plus taxes, fees and a 3 month commitment.

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