Bend Chamber of Commerce:
PacificSource Health Plans

Bend Chamber logoAgents and agencies are required to be licensed in the State of Oregon, appointed with PacificSource Health Plans and Johnson Benefit Planning, and a member of the Bend Chamber in good standing. 

Coverage at a glance:

  • At least two people need to enroll in a group. 
  • Domestic Partner Benefits are available to all groups.
  • Dental plans are available to all medical groups and on a stand-alone basis for groups of five or more.
  • Orthodontic coverage is available to groups of 10 or more enrolled employees.
  • Acupuncture/Chiropractic Manipulation coverage is available to all groups.
  • Vision coverage is available to all groups.

For more information, please refer to the Bend Chamber sales brochure, or contact:

Johnson Benefit Planning
(541) 382-3571 or toll-free (800) 314-3571
Fax: (541) 382-3807
Email: Lisa Thompson at Lisa@johnsonbenefitplanning.com
Website: johnsonbenefitplanning.com  
777 NW Wall St Ste 100, Bend OR 97701

Quick Links:

2018 Plans

2018 Notice of Change sample

2018 Sales Brochure

2017 Plans

Forms

Additional Materials

 

2018 Plans

Medical Plan

Deductible

Out-of-pocket limit

Office visits

Co-insurance

Summaries 
by Network with 
10-50-75 Pharmacy Plan
Summaries 
by Network with 
10-50p-50p Pharmacy Plan
1500+25-50_30
$1,500
$5,000  
$25-50 co-pay^
After deductible, 30%
2000+25-50_30
$2,000
$6,850
$25-50 co-pay^
After deductible, 30%
3000+25-50_30
$3,000
$6,850
$25-50 co-pay^
After deductible, 30%
5000+25-50_30
$5,000
$7,000
$25-50 co-pay^
After deductible, 30%
Chamber Core 5000+35-70_50
$5,000
$7,000
$35-70 co-pay^
After deductible, 50%
-
HSA-qualified Plan
 
 
 
 
Summaries
by Network with
50p Pharmacy Plan
Summaries
by Network with
6000D Pharmacy Plan
 HSA 3000_50+Rx 
$3,000
$6,000
After deductible, 50%
After deductible, 50%
-
 HSA 6000+Rx
$6,000
$6,000
After deductible, covered in full
After deductible, covered in full
-

Dental Plans

Dental Advantage  0-20-50 50-1000

Dental Advantage  0-20-50 50-1500

Dental Advantage  20-50-75 50-1000

Orthodontia 1000

Vision

10-150

Chiropractic Manipulation and Acupuncture

1000

 

2017 Plans


PacificSource (PSN) or SmartChoice (SCN) Network Plans:  

  • 1500+35_30+Rx     PSN / SCN
  • 2000+35_30+Rx     PSN / SCN
  • 3000+35_30+Rx     PSN / SCN
  • 5000+35_30+Rx     PSN / SCN  

     Prescription Drug Benefits: 

Medical with Integrated Rx:  

  • 1500+35_30+Rx     PSN / SCN
  • 2000+35_30+Rx     PSN / SCN
  • 3000+35_30+Rx     PSN / SCN
  • 5000+35_30+Rx     PSN / SCN  

HSA-qualified Medical Plans:

  • HSA 3000_50_Rx   PSN / SCN
  • HSA 6000_Rx         PSN / SCN

Chamber Core Plans:

Vision Care Benefits: Vision 10-150

Alternative Care Benefits: Acupuncture and chiropractic manipulation

Dental:

*Groups of 10 or more enrolled employees may purchase orthodontia coverage with any of the above dental policies.

  

Forms


Sales Brochure

Renewal Confirmation

2017 Member Group Application (Master Application) 

2018 Member Group Application (Master Application)

Enrollment Application

Continuation Election Form (State)

Associate Application

Affidavit of Domestic Partnership

Termination of Dependent Coverage  

Wellness Commitment Certificate:

 

Additional Materials


Sales:  

Underwriting Guidelines for the Bend Chamber Plans

Value-Added Programs and Services

InTouch for Employers

Global Emergency Services from Assist America  

Member Fliers:

InTouch: Access Your Plan Info from Your Computer, Tablet, or Phone

Provider Directory - Online

Quit For Life (tobacco cessation program)  

24-Hour NurseLine  

CaféWell: Personalized Healthy Life Guidance  

Hospital-based Health Education Classes  

More forms and materials for members >

 

 

Last updated 11/14/2017