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Explore and compare 2025 health plans that meet your business and employees’ needs.
View 2024 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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Choice

Patient-centered medical home model of care with a statewide network that includes more than 400 primary care clinics

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Connect

Substantial premium savings with Portland metro area Connect network medical home model that includes more than 100 patient-centered clinics

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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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  • 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 core preventive 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

    Rating: Not rated

    Overall Star Rating

    Overall star rating is based on the categories below.

    Not rated.

    Member Experience

    Based on member satisfaction surveys about their health care, doctors, and ease of getting appointments and services.

    Not rated.

    Medical Care

    Based on providers improving or maintaining the health of their patients with regular screenings, tests, vaccines, and condition monitoring.

    Not rated.

    Plan Administration

    Based on how well a plan is run, including customer service, access to needed information, and providers ordering appropriate tests and treatment.

    Not rated.

    Disclaimer: Plan quality ratings and enrollee survey results are calculated by CMS using data provided by health plans in 2024. The ratings will be displayed for health plans for the 2025 Plan Year. Learn more about these ratings.

    Rating: Not rated

    Overall Star Rating

    Overall star rating is based on the categories below.

    Not rated.

    Member Experience

    Based on member satisfaction surveys about their health care, doctors, and ease of getting appointments and services.

    Not rated.

    Medical Care

    Based on providers improving or maintaining the health of their patients with regular screenings, tests, vaccines, and condition monitoring.

    Not rated.

    Plan Administration

    Based on how well a plan is run, including customer service, access to needed information, and providers ordering appropriate tests and treatment.

    Not rated.

    Disclaimer: Plan quality ratings and enrollee survey results are calculated by CMS using data provided by health plans in 2024. The ratings will be displayed for health plans for the 2025 Plan Year. Learn more about these ratings.

    Rating: Not rated

    Overall Star Rating

    Overall star rating is based on the categories below.

    Not rated.

    Member Experience

    Based on member satisfaction surveys about their health care, doctors, and ease of getting appointments and services.

    Not rated.

    Medical Care

    Based on providers improving or maintaining the health of their patients with regular screenings, tests, vaccines, and condition monitoring.

    Not rated.

    Plan Administration

    Based on how well a plan is run, including customer service, access to needed information, and providers ordering appropriate tests and treatment.

    Not rated.

    Disclaimer: Plan quality ratings and enrollee survey results are calculated by CMS using data provided by health plans in 2024. The ratings will be displayed for health plans for the 2025 Plan Year. Learn more about these ratings.

    Rating: Not rated

    Overall Star Rating

    Overall star rating is based on the categories below.

    Not rated.

    Member Experience

    Based on member satisfaction surveys about their health care, doctors, and ease of getting appointments and services.

    Not rated.

    Medical Care

    Based on providers improving or maintaining the health of their patients with regular screenings, tests, vaccines, and condition monitoring.

    Not rated.

    Plan Administration

    Based on how well a plan is run, including customer service, access to needed information, and providers ordering appropriate tests and treatment.

    Not rated.

    Disclaimer: Plan quality ratings and enrollee survey results are calculated by CMS using data provided by health plans in 2024. The ratings will be displayed for health plans for the 2025 Plan Year. Learn more about these ratings.

    Rating: Not rated

    Overall Star Rating

    Overall star rating is based on the categories below.

    Not rated.

    Member Experience

    Based on member satisfaction surveys about their health care, doctors, and ease of getting appointments and services.

    Not rated.

    Medical Care

    Based on providers improving or maintaining the health of their patients with regular screenings, tests, vaccines, and condition monitoring.

    Not rated.

    Plan Administration

    Based on how well a plan is run, including customer service, access to needed information, and providers ordering appropriate tests and treatment.

    Not rated.

    Disclaimer: Plan quality ratings and enrollee survey results are calculated by CMS using data provided by health plans in 2024. The ratings will be displayed for health plans for the 2025 Plan Year. Learn more about these ratings.

    Rating: Not rated

    Overall Star Rating

    Overall star rating is based on the categories below.

    Not rated.

    Member Experience

    Based on member satisfaction surveys about their health care, doctors, and ease of getting appointments and services.

    Not rated.

    Medical Care

    Based on providers improving or maintaining the health of their patients with regular screenings, tests, vaccines, and condition monitoring.

    Not rated.

    Plan Administration

    Based on how well a plan is run, including customer service, access to needed information, and providers ordering appropriate tests and treatment.

    Not rated.

    Disclaimer: Plan quality ratings and enrollee survey results are calculated by CMS using data provided by health plans in 2024. The ratings will be displayed for health plans for the 2025 Plan Year. Learn more about these ratings.

2025 plan overview PDF  Summary of Benefits & Coverage


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

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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Travel Assistance

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

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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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One Pass Select™

One Pass Select™ makes it easy with access to a nationwide network of gyms and on-demand workouts along with grocery delivery for healthy eating.

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