Employer Plan Summary Oregon2017 Oregon Small Group Plans

The information on this page is for small group plans beginning January 1 and April 1, 2017. Small groups in Oregon are employers with one to 50 employees.

Medical Plans


Deductible and out-of-pocket limit amounts shown below are the costs for individuals. Amounts for families are twice the individual amounts. If members receive services from out-of-network providers, their deductible and out-of-pocket limit will be higher than the amounts listed in the chart below. Plans are available direct with PacificSource and through OregonHealthcare.gov, unless otherwise noted.

Medical handbook samples:


Plan

Deductible

Out-of-pocket limit

Co-pay for office visits

Co-insurance
after deductible

SBCs
effective January 1

by Network
SBCs
effective April 1

by Network
Summaries
by Network
Bronze HSA 6550 $6,550 $6,550  No charge No charge PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy
Bronze 7150 $7,150 $7,150  $20 co-pay^+, then no charge No charge PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy
Silver HSA 3600 $3,600 $3,600  No charge No charge PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy
Silver 2500* $2,500 $7,150 $20 co-pay^ 30% PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy
Silver 3000 $3,000 $7,150  $20 co-pay^  30% PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy
Silver 4000  $4,000 $7,150 $20 co-pay^ 30% PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy
Silver 5000  $5,000 $7,150 $20 co-pay^ 30% PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy
Gold 1000 $1,000 $5,000 $20 co-pay^ 20% PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy PacificSource / SmartChoice / Legacy
Standard Bronze**  $7,150  $7,150  $70 co-pay^ No charge PacificSource PacificSource PacificSource
Standard Silver**  $2,500 $6,850 $35 co-pay^ 30% PacificSource PacificSource PacificSource
Standard Gold** $1,000 $6,850 $20 co-pay^ 20% PacificSource PacificSource PacificSource

*Available direct from PacificSource only.  

**Only available on the PacificSource network.

^Not subject to annual deductible.

+The first five office visits combined are paid at 100 percent after any applicable co-pay. After that, office visits are subject to deductible and co-insurance.

 

Dental Plans


Dental handbook samples: 


Dental Choice 0/20/50 50-1000    
Dental Choice Plus 0/20/50 25-1000 Dental Choice Plus 0/20/50 50-1000
Dental Choice Plus 0/20/50 25-1500 Dental Choice Plus 0/20/50 50-1500
Dental Advantage Core  
Dental Advantage 0/20/50 1000 Dental Advantage 0/20/50 1500
Dental Advantage 20/20/50 1000 Dental Advantage 20/20/50 1500
Dental Advantage Plus 0/20/50 1000 Dental Advantage Plus 0/20/50 1500
Kids Dental Advantage 0/20/50 Kids Dental Advantage 20/40/50
Dental Advantage Essentials Core  
Dental Advantage Essentials  Dental Advantage Essentials Plus
Ortho 1000 WP*  

*Available direct from PacificSource only.

 

 Choose a Medical Plan in One of Three Networks


Access more providers with our PacificSource Network.

The PacificSource Network (PSN) includes the broadest access to in-network providers and facilities, such as hospitals and urgent care centers. Plans on the PacificSource Network will typically cost more because your employees will have more providers to choose from.

PacificSource Network Availability

All Oregon businesses can choose health plans on the PacificSource Network, regardless of location.

 

Lower your costs with our SmartChoice and Legacy Health networks.

The SmartChoice and Legacy Health Networks are designed to give your employees a coordinated-care experience through select provider groups and facilities. This level of provider collaboration means great care for your employees at a lower cost.

SmartChoice Network Availability

If your business is in one of the following counties, you can choose plans on the SmartChoice Network:

  • Benton
  • Coos
  • Crook
  • Curry
  • Deschutes
 
  • Douglas
  • Jackson
  • Jefferson
  • Josephine
 
  • Lane
  • Linn
  • Marion
  • Polk
 

Legacy Health Network Availability

If your business is in one of the following counties, you can choose plans on the Legacy Health Network:

  • Clackamas
  • Multnomah
  • Washington