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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
- 20 chiropractic manipulation visits and 12 acupuncture visits per calendar year, deductible waived
- Offering the most robust level of coverage
- Three EAP visits covered in full
- $5 copay for each of the first three PCP and BH visits
- $10 copay for PCP and mental health virtual visits
- Separate deductibles and out-of-pocket maximums, in and out-of-network
- Deductible waived on select benefits, including primary care and specialist office visits, urgent care and in-network physical therapy
- 20 chiropractic manipulation visits and 12 acupuncture visits per calendar year, deductible waived
- Cost-saving features tailored to your employees’ needs.
- Balance plans are certified for SHOP
- Three EAP visits covered in full
- $5 copay for each of the first three PCP and BH visits
- $10 copay for PCP and mental health virtual visits
- Separate deductibles and out-of-pocket maximums, in and out-of-network
- 20 chiropractic manipulation visits and 12 acupuncture visits per calendar year, deductible waived
- Three EAP visits covered in full
- $5 copay for each of the first three PCP and BH visits
- $10 copay for PCP and mental health virtual visits
- Choice plans are certified for SHOP
- Separate deductibles and out-of-pocket maximums, in and out-of-network
- 20 chiropractic manipulation visits and 12 acupuncture visits per calendar year, deductible waived
- Three EAP visits covered in full
- $5 copay for each of the first three PCP and BH visits
- $10 copay for PCP and mental health virtual visits
- Connect plans are certified for SHOP
- Separate deductibles and out-of-pocket maximums, in and out-of-network
- A formulary that includes ACA preventive and safe harbor medications that are exempt from the deductible
- 20 chiropractic manipulation visits and 12 acupuncture visits per calendar year
- Free health savings account through HealthEquity available for all eligible HSA Qualified plan members
- HSA Qualified plans are certified for SHOP
- Three EAP visits covered in full
- Separate deductibles and out-of-pocket maximums, in and out-of-network
- Copays starting as low as $20 and deductibles as low as $1,800
- 20 chiropractic manipulation visits and 12 acupuncture visits per calendar year, deductible waived
- Defined by the State of Oregon. Available from Providence
- Standard plans are certified for SHOP
- Three EAP visits covered in full
- $5 copay for each of the first three PCP and/or BH visits combined
Provider Network
Signature Network
Broad PPO-style network
No referrals required for in-network specialty care
Signature Network
Broad PPO-style network
No referrals required for in-network specialty care
Choice Network
Local medical home model
No referrals required for in-network specialty care
Connect Network
Local medical home model
No referrals required for in-network specialty care
Signature Network
Broad PPO-style network
No referrals required for in-network specialty care
Signature Network
Broad PPO-style network
No referrals required for in-network specialty care
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 all drug tiers
Coverage for 20 chiropractic manipulation visits and 12 acupuncture visits
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 drug tiers 1-4 for Gold and Silver plans
Coverage for 20 chiropractic manipulation visits and 12 acupuncture visits
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 on drug tiers 1-4 for Gold and Silver plans, and on tiers 1-2 for Bronze plans
Coverage for 20 chiropractic manipulation visits and 12 acupuncture visits
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 on drug tiers 1-4 for Gold and Silver plans, and on tiers 1-2 for Bronze plans
Coverage for 20 chiropractic manipulation visits and 12 acupuncture visits
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
Tier 1 drugs covered in full for all plans.
Coverage for 20 chiropractic manipulation visits and 12 acupuncture visits
Deductible applies 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 applies for lab and X-ray
Deductible waived for all drug tiers for Gold and Silver plans and for tiers 1-2 for Bronze plans
Coverage for 20 chiropractic manipulation visits and 12 acupuncture visits
Deductible waived for chiropractic manipulations, physical therapy and acupuncture
Pediatric dental coverage not included
Adult vision exam coverage not 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
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
Star Ratings
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.
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