PacificSource Materials in Spanish

You're welcome to download the following materials, or contact your regional marketing office to request hard copies. Looking for plan benefit summaries in Spanish? You'll find them here.

AccordantCare Rare Disease Program

Address/Name Change Form

Average Cost of Care flier - temporarily unavailable

Expectations Prenatal Care Program

COBRA Initial Notice

Continuation Election Form - Federal

Continuation Election Form - State

Diabetes Benefits

Dual Choice Provider Network (for Portland metro only)

First Health Network - members living outside Oregon

Free & Clear Tobacco Cessation Program

Group Medical/Dental Enrollment Form

Health Resources For Your Family

Healthy Returns Care Management Program - clients with 51+ employees

Hospital-Based Health Education Classes flier

Informed Healthcare Consumer flier

International Travel/Emergency Care Outside the U.S.
Mail Order Pharmacy Options for Prescription Drugs
Maternity Benefits

Preferred Drug List (PDL)

Privacy Policy

Prescription Discount Program flier - plans with pharmacy coverage

Prescription Discount Program flier - plans without pharmacy coverage

Prescription Drug List - Alternatives for Nonpreferred Drugs

Rising Healthcare Costs: Information and Tips

Third Party Recovery

Travel Benefits

Using Your PacificSource Group Health Plan

Using Your Tiered Prescription Drug Plan flier

Vision Benefits

Waiver of Coverage Form

Unless otherwise stated, all text and images © 2006 PacificSource. All rights reserved.