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