Some of your health care benefits will change on Nov. 1, 2011, including:

• Plan year aggregate limit: Previously, a plan year aggregate limit did not apply to your plan. For this contract year, a plan year aggregate limit of $1,250,000 applies to essential health benefits.
• Essential health benefit definition: For this contract year, a definition for essential health benefits has been added to your contract. Established under the Patient Protection and Affordable Care Act, essential health benefits include general categories of health care services. See your Individual & Family Plan Contract for details.
• Alcohol dependency: Previously, a $4,500 limit every two calendar years for alcohol dependency applied to your plan. For this contract year, alcohol dependency services are limited to 2 days detox and 20 outpatient visits every two calendar years.
• Tobacco cessation: Previously, a $500 lifetime maximum for tobacco cessation applied to your plan. For this contract year, the $500 lifetime maximum is removed.
• Periodic health exams; well baby care: For HSA plans only. Previously, a $250 limit on periodic health exams and well baby care applied to HSA plans. For this contract year, the $250 limit has been removed.
• Diabetes supplies: For HSA plans only. Previously, your deductible did not apply to purchases of diabetes supplies. For this contract year, diabetes supplies will apply to the deductible.
• Mental health: For Optimum and Value plans only. Previously, a $2,000 calendar year limit applied to your mental health benefit. For this contract year, mental health benefits are limited to 15 outpatient visits per calendar year on Optimum and Value plans.
• Mental health: For Prime and HSA plans only. Previously, a $2,000 calendar year limit applied to your mental health benefit. For this contract year, mental health benefits are limited to 10 outpatient visits per calendar year on Prime and HSA plans.
• Pharmacy: For Prime plan only. Previously, prescription drug coverage was provided at $20 generic and 50% brand name copay. For this contract year, prescription drug coverage has been removed from Prime plan.
• HSA 3500 plan: We have modified our plan portfolio to include a new HSA 3500 plan that features a 50% coinsurance in-plan and out-of-plan and a $5,950 out-of-pocket maximum, with premiums starting at $99.
• Service area expansion: Members residing in Jackson, Josephine and Douglas counties may now apply for Providence Individual and Family plans.

View our entire plan portfolio for health insurance effective Nov. 1, 2011:

• Individual & Family Plan Comparison – Optimum, Value and Prime plans (PDF)
• Individual & Family Plan Comparison – HSA plans (PDF)

For health insurance effective Nov. 1, 2011, our premium rates include:

• Individual & Family Plan Rates (PDF)

We want you to have all the choices you need for your physical and financial well-being. If you 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, 2011.

• 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.

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.