Summary of benefits and coverage (SBC)
The Summary of Benefits and Coverage (SBC) is a federally mandated document designed to allow "apples to apples" comparisons of health plan options. Helpful during the shopping phase, it is important to know the SBC is for plan comparison purposes only; it does not replace the benefit summary and contract of your purchased health plan.
Choose a plan type below to access the SBC:
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Total Enhanced plans
With the most robust level of coverage, our. Total Enhanced plans offer employees best-in-class benefits with full access to the Providence Signature Network for the ultimate flexibility.
2022 Total Enhanced plans
- Total Enhanced 250 Platinum (PDF)
- Total Enhanced 500 Platinum (PDF)
- Total Enhanced 1000 Gold (PDF)
- Total Enhanced 1500 Gold (PDF)
- Total Enhanced 2500 Gold (PDF)
- Total Enhanced 3500 Gold (PDF)
- Total Enhanced 4500 Gold (PDF)
- Total Enhanced 5500 Gold (PDF)
- Total Enhanced 7400 Silver (PDF)
2022 Total Enhanced plans – Spanish versions
- Total Enhanced 250 Platinum (PDF)
- Total Enhanced 500 Platinum (PDF)
- Total Enhanced 1000 Gold (PDF)
- Total Enhanced 1500 Gold (PDF)
- Total Enhanced 2500 Gold (PDF)
- Total Enhanced 3500 Gold (PDF)
- Total Enhanced 4500 Gold (PDF)
- Total Enhanced 5500 Gold (PDF)
- Total Enhanced 7400 Silver (PDF)
2021 Total Enhanced plans
- Total Enhanced 250 Platinum (PDF)
- Total Enhanced 500 Platinum (PDF)
- Total Enhanced 1000 Gold (PDF)
- Total Enhanced 1500 Gold (PDF)
- Total Enhanced 2500 Gold (PDF)
- Total Enhanced 3500 Gold (PDF)
- Total Enhanced 4500 Gold (PDF)
- Total Enhanced 5500 Gold (PDF)
- Total Enhanced 7200 Silver (PDF)
2021 Total Enhanced plans – Spanish versions
- Total Enhanced 250 Platinum - en español (PDF)
- Total Enhanced 500 Platinum - en español (PDF)
- Total Enhanced 1000 Gold - en español (PDF)
- Total Enhanced 1500 Gold - en español (PDF)
- Total Enhanced 2500 Gold - en español (PDF)
- Total Enhanced 3500 Gold - en español (PDF)
- Total Enhanced 4500 Gold - en español (PDF)
- Total Enhanced 5500 Gold - en español (PDF)
- Total Enhanced 7200 Silver - en español (PDF)
2020 Total Enhanced plans
- Total Enhanced 250 Platinum (PDF)
- Total Enhanced 500 Platinum (PDF)
- Total Enhanced 1000 Gold (PDF)
- Total Enhanced 1500 Gold (PDF)
- Total Enhanced 2500 Gold (PDF)
- Total Enhanced 3500 Gold (PDF)
- Total Enhanced 4500 Gold (PDF)
- Total Enhanced 5500 Gold (PDF)
- Total Enhanced 7000 Silver (PDF)
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Balance plans
Our Balance plans offer a harmonious mix of cost-saving features and coverage for the services your employees use the most.
2022 Balance plans
Plans sold direct
- Balance 750 Gold 00 (PDF)
- Balance 1500 Gold 00 (PDF)
- Balance 2500 Gold 00 (PDF)
- Balance 3500 Silver 00 (PDF)
- Balance 4500 Silver 00 (PDF)
- Balance 6000 Silver 00 (PDF)
- Balance 8000 Bronze 00 (PDF)
- Balance 8700 Bronze 00 (PDF)
SHOP-qualified plans
- Balance 750 Gold 01 (PDF)
- Balance 1500 Gold 01 (PDF)
- Balance 2500 Gold 01 (PDF)
- Balance 3500 Silver 01 (PDF)
- Balance 4500 Silver 01 (PDF)
- Balance 6000 Silver 01 (PDF)
- Balance 8000 Bronze 01 (PDF)
- Balance 8700 Bronze 01 (PDF)
2022 Balance plans – Spanish versions:
Plans sold direct
- Balance 750 Gold 00 (PDF)
- Balance 1500 Gold 00 (PDF)
- Balance 2500 Gold 00 (PDF)
- Balance 3500 Silver 00 (PDF)
- Balance 4500 Silver 00 (PDF)
- Balance 6000 Silver 00 (PDF)
- Balance 8000 Bronze 00 (PDF)
- Balance 8700 Bronze 00 (PDF)
SHOP-qualified plans
- Balance 750 Gold 01 (PDF)
- Balance 1500 Gold 01 (PDF)
- Balance 2500 Gold 01 (PDF)
- Balance 3500 Silver 01 (PDF)
- Balance 4500 Silver 01 (PDF)
- Balance 6000 Silver 01 (PDF)
- Balance 8000 Bronze 01 (PDF)
- Balance 8700 Bronze 01 (PDF)
2021 Balance plans
- Balance 750 Gold 00 (PDF)
- Balance 750 Gold 01 (PDF)
- Balance 1500 Gold 00 (PDF)
- Balance 1500 Gold 01 (PDF)
- Balance 2500 Silver 00 (PDF)
- Balance 2500 Silver 01 (PDF)
- Balance 3500 Silver 00 (PDF)
- Balance 3500 Silver 01 (PDF)
- Balance 4500 Silver 00 (PDF)
- Balance 4500 Silver 01 (PDF)
- Balance 6000 Silver 00 (PDF)
- Balance 6000 Silver 01 (PDF)
- Balance 7000 Bronze 00 (PDF)
- Balance 7000 Bronze 01 (PDF)
- Balance 8550 Bronze 00 (PDF)
- Balance 8550 Bronze 01 (PDF)
2021 Balance plans – Spanish versions:
- Balance 750 Gold 00 - en español (PDF)
- Balance 750 Gold 01 - en español (PDF)
- Balance 1500 Gold 00 - en español (PDF)
- Balance 1500 Gold 01 - en español (PDF)
- Balance 2500 Silver 00- en español (PDF)
- Balance 2500 Silver 01- en español (PDF)
- Balance 3500 Silver 00- en español (PDF)
- Balance 3500 Silver 01- en español (PDF)
- Balance 4500 Silver 00- en español (PDF)
- Balance 4500 Silver 01- en español (PDF)
- Balance 6000 Silver 00- en español (PDF)
- Balance 6000 Silver 01- en español (PDF)
- Balance 7000 Bronze 00- en español (PDF)
- Balance 7000 Bronze 01- en español (PDF)
- Balance 8550 Bronze 00- en español (PDF)
- Balance 8550 Bronze 01- en español (PDF)
2020 Balance plans
- Balance 750 Gold (PDF)
- Balance 1500 Gold (PDF)
- Balance 2500 Silver (PDF)
- Balance 3500 Silver (PDF)
- Balance 4500 Silver (PDF)
- Balance 6000 Silver (PDF)
- Balance 7000 Bronze (PDF)
- Balance 8150 Bronze (PDF)
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HSA Qualified plans
These lower-premium, high deductible plans combine health coverage with the ability to save pre-tax dollars to pay for future health care expenses.
2022 HSA Qualified plans
Plans sold direct
- HSA Qualified 1500 Gold 00 (PDF)
- HSA Qualified 2500 Silver 00 (PDF)
- HSA Qualified 3500 Silver 00 (PDF)
- HSA Qualified 4500 Silver 00 (PDF)
- HSA Qualified 6000 Bronze 00 (PDF)
- HSA Qualified 7000 Bronze 00 (PDF)
SHOP-qualified plans
- HSA Qualified 1500 Gold 01 (PDF)
- HSA Qualified 2500 Silver 01 (PDF)
- HSA Qualified 3500 Silver 01 (PDF)
- HSA Qualified 4500 Silver 01 (PDF)
- HSA Qualified 6000 Bronze 01 (PDF)
- HSA Qualified 7000 Bronze 01 (PDF)
2022 HSA Qualified plans – Spanish versions
Plans sold direct
- HSA Qualified 1500 Gold 00 (PDF)
- HSA Qualified 2500 Silver 00 (PDF)
- HSA Qualified 3500 Silver 00 (PDF)
- HSA Qualified 4500 Silver 00 (PDF)
- HSA Qualified 6000 Bronze 00 (PDF)
- HSA Qualified 7000 Bronze 00 (PDF)
SHOP-qualified plans
- HSA Qualified 1500 Gold 01 (PDF)
- HSA Qualified 2500 Silver 01 (PDF)
- HSA Qualified 3500 Silver 01 (PDF)
- HSA Qualified 4500 Silver 01 (PDF)
- HSA Qualified 6000 Bronze 01 (PDF)
- HSA Qualified 7000 Bronze 01 (PDF)
2021 HSA Qualified plans
- HSA Qualified 1500 Gold 00 (PDF)
- HSA Qualified 1500 Gold 01 (PDF)
- HSA Qualified 2500 Silver 00 (PDF)
- HSA Qualified 2500 Silver 01 (PDF)
- HSA Qualified 3500 Silver 00 (PDF)
- HSA Qualified 3500 Silver 01 (PDF)
- HSA Qualified 4500 Silver 00 (PDF)
- HSA Qualified 4500 Silver 01 (PDF)
- HSA Qualified 5500 Bronze 00 (PDF)
- HSA Qualified 5500 Bronze 01 (PDF)
- HSA Qualified 7000 Bronze 00 (PDF)
- HSA Qualified 7000 Bronze 01 (PDF)
2021 HSA Qualified plans – Spanish versions
- HSA Qualified 1500 Gold 00 - en español (PDF)
- HSA Qualified 1500 Gold 01 - en español (PDF)
- HSA Qualified 2500 Silver 00 - en español (PDF)
- HSA Qualified 2500 Silver 01 - en español (PDF)
- HSA Qualified 3500 Silver 00 - en español (PDF)
- HSA Qualified 3500 Silver 01 - en español (PDF)
- HSA Qualified 4500 Silver 00 - en español (PDF)
- HSA Qualified 4500 Silver 01 - en español (PDF)
- HSA Qualified 5500 Bronze 00 - en español (PDF)
- HSA Qualified 5500 Bronze 01 - en español (PDF)
- HSA Qualified 7000 Bronze 00- en español (PDF)
- HSA Qualified 7000 Bronze 01- en español (PDF)
2020 HSA Qualified plans
- HSA Qualified 2000 Silver (PDF)
- HSA Qualified 2500 Silver (PDF)
- HSA Qualified 3500 Silver (PDF)
- HSA Qualified 4500 Bronze (PDF)
- HSA Qualified 5500 Bronze (PDF)
- HSA Qualified 6750 Bronze (PDF)
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Connect plans
Using a member-selected medical home, Connect plans provide a collaborative and flexible approach to meet a wide range of health and wellness needs for members in the Portland metropolitan area.
2022 Connect plans
Plans sold direct
- Connect 750 Gold 00 (PDF)
- Connect 1500 Gold 00 (PDF)
- Connect 2800 Gold 00 (PDF)
- Connect 3800 Silver 00 (PDF)
- Connect 4900 Silver 00 (PDF)
- Connect 6000 Silver 00 (PDF)
- Connect 7200 Silver 00 (PDF)
- Connect 8700 Bronze 00 (PDF)
SHOP-qualified plans
- Connect 750 Gold 01 (PDF)
- Connect 1500 Gold 01 (PDF)
- Connect 2800 Gold 01 (PDF)
- Connect 3800 Silver 01 (PDF)
- Connect 4900 Silver 01 (PDF)
- Connect 6000 Silver 01 (PDF)
- Connect 7200 Silver 01 (PDF)
- Connect 8700 Bronze 01 (PDF)
2022 Connect plans – Spanish versions
Plans sold direct
- Connect 750 Gold 00 (PDF)
- Connect 1500 Gold 00 (PDF)
- Connect 2800 Gold 00 (PDF)
- Connect 3800 Silver 00 (PDF)
- Connect 4900 Silver 00 (PDF)
- Connect 6000 Silver 00 (PDF)
- Connect 7200 Silver 00 (PDF)
- Connect 8700 Bronze 00 (PDF)
SHOP-qualified plans
- Connect 750 Gold 01 (PDF)
- Connect 1500 Gold 01 (PDF)
- Connect 2800 Gold 01 (PDF)
- Connect 3800 Silver 01 (PDF)
- Connect 4900 Silver 01 (PDF)
- Connect 6000 Silver 01 (PDF)
- Connect 7200 Silver 01 (PDF)
- Connect 8700 Bronze 01 (PDF)
2021 Connect plans
- Connect 750 Gold (PDF)
- Connect 1500 Gold (PDF)
- Connect 2800 Silver (PDF)
- Connect 3500 Silver (PDF)
- Connect 4500 Silver (PDF)
- Connect 6000 Silver (PDF)
- Connect 7000 Bronze (PDF)
- Connect 8550 Bronze (PDF)
2021 Connect plans – Spanish versions
- Connect 750 Gold - en español (PDF)
- Connect 1500 Gold - en español (PDF)
- Connect 2800 Silver - en español (PDF)
- Connect 3500 Silver - en español (PDF)
- Connect 4500 Silver - en español (PDF)
- Connect 6000 Silver - en español (PDF)
- Connect 7000 Bronze - en español (PDF)
- Connect 8550 Bronze - en español (PDF)
2020 Connect plans
- Connect 750 Gold (PDF)
- Connect 1500 Gold (PDF)
- Connect 2500 Silver (PDF)
- Connect 3500 Silver (PDF)
- Connect 4500 Silver (PDF)
- Connect 6000 Silver (PDF)
- Connect 7000 Bronze (PDF)
- Connect 8150 Bronze (PDF)
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Standard plans
Defined by the state of Oregon, Standard plans can be purchased through SHOP or in the private market. Plans indicated with 00 are available direct and plans with 01 are available through SHOP.
2022 Standard plans
Plans sold direct
- Providence Oregon Standard Gold 00 Plan (PDF)
- Providence Oregon Standard Silver 00 Plan (PDF)
- Providence Oregon Standard Bronze 00 Plan (PDF)
SHOP-qualified plans
- Providence Oregon Standard Gold 01 Plan (PDF)
- Providence Oregon Standard Silver 01 Plan (PDF)
- Providence Oregon Standard Bronze 01 Plan (PDF)
2022 Standard plans – Spanish versions
Plans sold direct
- Providence Oregon Standard Gold 00 Plan (PDF)
- Providence Oregon Standard Silver 00 Plan (PDF)
- Providence Oregon Standard Bronze 00 Plan (PDF)
SHOP-qualified plans
- Providence Oregon Standard Gold 01 Plan (PDF)
- Providence Oregon Standard Silver 01 Plan (PDF)
- Providence Oregon Standard Bronze 01 Plan (PDF)
2021 Standard plans
- Providence Oregon Standard Gold 00 Plan (PDF)
- Providence Oregon Standard Gold 01 Plan (PDF)
- Providence Oregon Standard Silver 00 Plan (PDF)
- Providence Oregon Standard Silver 01 Plan (PDF)
- Providence Oregon Standard Bronze 00 Plan (PDF)
- Providence Oregon Standard Bronze 01 Plan (PDF)
2021 Standard plans – Spanish versions
- Providence Oregon Standard Gold 00 Plan - en español (PDF)
- Providence Oregon Standard Gold 01 Plan - en español (PDF)
- Providence Oregon Standard Silver 00 Plan - en español (PDF)
- Providence Oregon Standard Silver 01 Plan - en español (PDF)
- Providence Oregon Standard Bronze 00 Plan - en español (PDF)
- Providence Oregon Standard Bronze 01 Plan - en español (PDF)
2020 Standard plans
- Providence Oregon Standard Gold 00 Plan (PDF)
- Providence Oregon Standard Gold 01 Plan (PDF)
- Providence Oregon Standard Silver 00 Plan (PDF)
- Providence Oregon Standard Silver 01 Plan (PDF)
- Providence Oregon Standard Bronze 00 Plan (PDF)
- Providence Oregon Standard Bronze 01 Plan (PDF)
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Choice plans
Choice plans use a patient-centered medical home model of care to keep your employees healthy.
2022 Choice plans
Plans sold direct
- Choice 750 Gold 00 (PDF)
- Choice 1500 Gold 00 (PDF)
- Choice 2800 Gold 00 (PDF)
- Choice 3800 Silver 00 (PDF)
- Choice 4900 Silver 00 (PDF)
- Choice 6000 Silver 00 (PDF)
- Choice 7200 Silver 00 (PDF)
- Choice 8700 Bronze 00 (PDF)
SHOP-qualified plans
- Choice 750 Gold 01 (PDF)
- Choice 1500 Gold 01 (PDF)
- Choice 2800 Gold 01 (PDF)
- Choice 3800 Silver 01 (PDF)
- Choice 4900 Silver 01 (PDF)
- Choice 6000 Silver 01 (PDF)
- Choice 7200 Silver 01 (PDF)
- Choice 8700 Bronze 01 (PDF)
2022 Choice plans – Spanish versions
Plans sold direct
- Choice 750 Gold 00 (PDF)
- Choice 1500 Gold 00 (PDF)
- Choice 2800 Gold 00 (PDF)
- Choice 3800 Silver 00 (PDF)
- Choice 4900 Silver 00 (PDF)
- Choice 6000 Silver 00 (PDF)
- Choice 7200 Silver 00 (PDF)
- Choice 8700 Bronze 00 (PDF)
SHOP-qualified plans
- Choice 750 Gold 01 (PDF)
- Choice 1500 Gold 01 (PDF)
- Choice 2800 Gold 01 (PDF)
- Choice 3800 Silver 01 (PDF)
- Choice 4900 Silver 01 (PDF)
- Choice 6000 Silver 01 (PDF)
- Choice 7200 Silver 01 (PDF)
- Choice 8700 Bronze 01 (PDF)
2021 Choice plans
- Choice 750 Gold (PDF)
- Choice 1500 Gold (PDF)
- Choice 2800 Silver (PDF)
- Choice 3500 Silver (PDF)
- Choice 4500 Silver (PDF)
- Choice 6000 Silver (PDF)
- Choice 7000 Bronze (PDF)
- Choice 8550 Bronze (PDF)
2021 Choice plans – Spanish versions