Member Renewal Information

For plans effective Nov. 1, 2009 certain plan benefits will be changing, including:

• Urgent care services: Previously, you paid a coinsurance percentage for urgent care services. For this contract year, urgent care services require only a $20 copay, with deductible waived.
• Emergency services: Previously, you paid a $125 copay, after your deductible, for emergency services. For this contract year, you will pay a $250 copay, after your deductible, for emergency services.
• Durable medical equipment: Previously, there were no limits on benefits. For this contract year, benefits are limited to $2,500 per member per year.
• Dental service clarification: Services for temporomandibular joint syndrome (TMJ) and orthognathic surgery are excluded.
• Service area expansion: Residents of Clatsop and Tillamook counties may now apply for coverage on our plans.

We are pleased to offer a new product offering starting Nov. 1, 2009. The Prime 10,000 plan, a high deductible plan with most benefits covered at 50%, is designed for those looking for a basic coverage option at a low cost. Plus, we have expanded our Service Area to include residents of Clatsop and Tillamook counties.

View our entire plan portfolio for health insurance effective Nov. 1, 2009:

• Individual & Family Plan Comparison (PDF)
• Individual & Family HSA-Qualified Plans (PDF)
• Individual & Family Plan Overview (PDF)

Nationally, overall spending on health care continues to rise. Medical costs for Providence Health Plan continue to be affected by this trend. Because of our experience with these cost increases, our Individual and Family Plans will have a premium rate increase effective Nov. 1, 2009.

In addition, our health insurance premiums reflect a new one percent tax. Funds raised by this tax will be matched more than 2 to 1 by the federal government and will provide access to health care coverage for 80,000 low- and moderate-income Oregon children who currently have no health insurance.

For health insurance effective Nov. 1, 2009, our premium rates include:

• Individual & Family Plan Rates (PDF)
• Individual & Family HSA-Qualified Plans (PDF)

We want you to have all the choices you need for both your physical and your financial well-being. If you choose to stay with your current coverage, there is nothing you need to do. If a new plan is a better fit for you, we can help make the transition easier.

To change your health plan option, print and return this form by Nov. 30, 2009.

• Individual & Family Plan Change Form (PDF)

We offer multiple plans, with a range of deductibles and monthly premiums. If you are concerned about your monthly premium, you may consider changing to a plan with a higher deductible to lower your monthly premium. That means you will pay more out-of-pocket before the health plan begins to pay for covered services. Remember, many of our covered services, including most preventive care services, are offered with the deductible waived (you can use these services without having to meet your deductible first).

We understand health insurance can be confusing. If you’d like more information about choosing a new plan option, please call your insurance agent or Providence Health Plan Customer Service at 503-574-7500 or 1-800-878-4445, Monday through Friday, 8 a.m. to 5 p.m.