Medical plans for Oregon employers
ODS medical plans provide you and your employees with flexible plan designs; access to the largest directly contracted PPO network in Oregon, the ODS Plus Network; evidence-based plans so you know your members and their dependents are getting the care they need; and access to our Healthcare Services team, a group of health professionals dedicated to helping members manage their health.
Benefits of being an ODS member
Personalized member website
All our medical plans come with access to myODS, a personalized website just for members. myODS helps members manage their benefits and get the most from their health plan. With myODS, members can track their benefits and claims, access their Member Handbook, order ID cards and more.
ODS Well
ODS Well™ offers a variety of heath tools, available online and via phone, to empower members to take an active role in their health.
- E-mail answers from doctors, dentists, psychologists, pharmacists, dietitians and fitness experts
- 24/7 access to the Registered Nurse Advice Line
- Online tools to track healthy living habits
- Tobacco cessation counseling
- Condition and disease management
- Care coordination and case management
Groups with a pharmacy benefit can access additional health tools, including:
- Web-based health and symptom evaluator
- Health assessments
- Online medical library
- Health news articles, forums and more
Medical plans
For more information on our group medical plans for employers, please contact the ODS Sales & Account Service team at 503-243-3948 or toll-free at 800-578-1402, or contact your producer. For your reference, below is an outline of the types of medical plans we provide.
Indemnity
Traditional indemnity plans provide members with the widest choice and flexibility. Members can see any licensed doctor or specialist they choose, without the need for a referral.
Preferred Provider Organizations (PPO)
A PPO contracts with physicians and hospitals to secure preferred rates for you and your covered employees. Members can visit a PPO provider any time medical care is needed. Should a member choose a non-PPO provider, a lower benefit level may apply. Choosing a PPO provider guarantees that members will receive quality medical care and the highest level of benefits. The ODS Plus Network is the largest directly contracted PPO network in Oregon.
Point of Service (POS)
Under a point-of-service (POS) plan, participants can choose a primary care physician (PCP) to help manage their healthcare. The PCP manages all healthcare needs, including referrals to specialists and hospitals as well as emergency care, if needed. At any time, day or night, 365 days a year, the member’s PCP assumes the primary responsibility for medical care.
Health Savings Account (HSA)
An ODS HSA-qualified, high-deductible plan allows members to use tax-free funds for eligible healthcare expenses. HSA members enjoy a number of tax advantages including tax-free withdrawal of funds to pay for qualified medical expenses. Unused funds carry over from year to year, growing tax-deferred.
Medical plans effective July 1, 2011
| In plan benefits | Out of plan benefits | ||||||||
|---|---|---|---|---|---|---|---|---|---|
* Plan eligible for FHIAP ** Deductible Waived Purchasing an Rx rider with a PPO or Beneficial medical plan is optional. However, an Rx rider cannot be purchased with an HSA plan. HSA plans continue to include a major medical Rx benefit. |
|||||||||
| Plan | Ded | Office visit |
coins. | OOP | Ded | coins. | OOP | ||
| Beneficial plans | |||||||||
| BEN2500_11A1 | $2,500 | $25** | 70% | $5,000 | $2,500 | 50% | $15,000 | ||
| BEN3500_11A1 | $3,500 | $25** | 70% | $5,000 | $3,500 | 50% | $15,000 | ||
| BEN5000_11A1 | $5,000 | $25** | 70% | $5,000 | $5,000 | 50% | $15,000 | ||
| BEN7500_11A1 | $7,500 | $25** | 70% | $5,000 | $7,500 | 50% | $15,000 | ||
| PPO plans | |||||||||
| PPO500_11B1 | $500 | $20** | 80% | $2,500 | $500 | 50% | $7,500 | ||
| PPO500_11E1 | $500 | $30** | 80% | $3,500 | $500 | 50% | $10,500 | ||
| PPO750_11B1 | $750 | $25** | 80% | $3,000 | $750 | 50% | $9,000 | ||
| PPO750_11E1 | $750 | $30** | 80% | $4,000 | $750 | 50% | $12,000 | ||
| PPO1000_11B1 | $1,000 | $25** | 80% | $3,000 | $1,000 | 50% | $9,000 | ||
| PPO1000_11E1 | $1,000 | $30** | 80% | $4,000 | $1,000 | 50% | $12,000 | ||
| PPO1500_11A1 | $1,500 | $25** | 80% | $3,000 | $1,500 | 50% | $9,000 | ||
| PPO1500_11B1 | $1,500 | $25** | 75% | $3,500 | $1,500 | 50% | $10,500 | ||
| PPO1500_11E1 | $1,500 | $30** | 70% | $4,500 | $1,500 | 50% | $13,500 | ||
| PPO2000_11A1 | $2,000 | $25** | 80% | $3,000 | $2,000 | 50% | $9,000 | ||
| PPO2000_11B1 | $2,000 | $25** | 75% | $3,500 | $2,000 | 50% | $10,500 | ||
| PPO2000_11E1 | $2,000 | $30** | 70% | $4,500 | $2,000 | 50% | $13,500 | ||
| PPO2500_11A1 | $2,500 | $25** | 80% | $3,000 | $2,500 | 50% | $9,000 | ||
| PPO3000_11A1 | $3,000 | $25** | 80% | $3,000 | $3,000 | 50% | $9,000 | ||
| PPO4000_11A1 | $4,000 | $25** | 80% | $3,000 | $4,000 | 50% | $9,000 | ||
| PPO1000_11B1_EvBid | $1,000 | $25** | 80-70% | $3,000 | $3,000 | 60-50% | No Max | ||
| PPO1500_11B1_EvBid | $1,500 | $25** | 80-70% | $3,000 | $4,500 | 60-50% | No Max | ||
| PPO2000_11B1_EvBid | $2,000 | $25** | 80-70% | $3,000 | $6,000 | 60-50% | No Max | ||
| HSA PPO plans | |||||||||
| HSA1200_11A1 | $1,200 | 80% | $3,800 | $1,200 | 50% | $7,600 | |||
| HSA2000_11A1 | $2,000 | 80% | $3,000 | $2,000 | 50% | $6,000 | |||
| HSA2800_11A1 | $2,800 | 50% | $2,200 | $2,800 | 50% | $4,400 | |||
| HSA4000_11A1 | $4,000 | 50% | $1,000 | $4,000 | 50% | $2,000 | |||
| Indemnity plan | |||||||||
| Basic Oregon plan1 | 50% | 50% | $3,750 | $0 | 50% | $3,750 | |||
| Dual Option 1 | |||||||||
| PPO1000_11B1 | $1,000 | $25** | 80% | $3,000 | $1,000 | 50% | $9,000 | ||
| HSA2000_11A1 | $2,000 | 80% | $3,000 | $2,000 | 50% | $6,000 | |||
| Dual Option 2 | |||||||||
| PPO1500_11B1 | $1,500 | $25** | 75% | $3,500 | $1,500 | 50% | $10,500 | ||
| HSA2800_11A1 | $2,800 | 50% | $2,200 | $2,800 | 50% | $4,400 | |||
| Riders are only available to PPO plans. If you chose one of the ODS Dual Option plans, the riders you select below will be available to the PPO plan but not the HSA plan. |
| Standard Rx: $15/50% whichever greater copay, 3x Mail Order copay |
| Rx: 40% copay; Mail Order: 40% copay |
| Rx: $2/$10/$40/$60; 3x Mail Order copay |
| Rx: $2/$10/$35/$50; 3x Mail Order copay |
| Rx: $2/$15/$45/$75; 3x Mail Order copay |
| 100% w/ $300 Max |
| 100% w/ $200 Max |
| 100% Eye Exam Only |
Not all plans have access to all benefits. Please contact ODS Sales & Account Service for more information on plan designs and benefits.
More information
For more information on our health plans for employers, please contact the ODS Sales & Account Service team at 503-243-3948 or toll-free at 800-578-1402, or contact your producer.
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