Health Benefits Solution, Inc
Health Benefits Solution, Inc
Referrals are the Life Blood of our company -  503-922-2903  877-786-8347

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Cascade Mountains
CITIES:  Brightwood, Camp Sherman, Cascade Locks, Cascadia, Chemult, Chiloquin, Crescent, Crescent Lake, Detroit, Diamond Lake, Drew, Estacada, Fort Klamath, Gates, Gilchrist, Government Camp, Idanha, Klamath Agency, La Pine, Lakeview, McKenzie Bridge, Mill City, North Umpqua, Oakridge, Prospect, Rhododendron, Sandy, Sisters, Sunriver, Warm Springs, Welches, Westfir, Zigzag
AREAS:  Crater Lake National Park, Deshutes National Forest, Fremont National Forest, Mount Hood National Forest, Rogue River National Forest, The Three Sisters, Umpqua National Forest, Willamette National Forest, Winema National Forest

Central Oregon
CITIES:  Antelope, Arlington, Bend, Brothers, Condon, Culver, Dufur, Fossil, Grass Valley, Hampton, Lonerock, Madras, Maupin, Metolius, Mitchell, Moro, Mosier, Paulina, Post, Prineville, Redmond, Rowena, Rufus, Shaniko, Spray, The Dalles, Wasco

Northeast Oregon
CITIES:  Adams, Arlington, Athena, Baker City, Boardman, Canyon City, Condon, Cove, Dayville, Echo, Elgin, Enterprise, Fossil, Greenhorn, Haines, Halfway, Heppner, Hermiston, Huntington, Imbler, Imnaha, Irrigon, Island City, John Day, Joseph, La Grande, Lexington, Long Creek, Lostine, Medical Springs, Milton-Freewater, Monument, Mt Vernon, North Powder, Oxbow, Pendleton, Pilot Rock, Prairie City, Richland, Seneca, Summerville, Sumpter, Ukiah, Umatilla, Union, Unity, Wallowa, Weston
AREAS Hell's Canyon

Oregon Coast
North Coast
Astoria, Bay City, Beaver, Cannon Beach, Garibaldi, Gearhart, Hebo, Nehalem, Manzanita, Neahkahnie, Oceanside, Pacific City, Rockaway Beach, Seaside, Tillamook, Warrenton, Wheeler
Central Coast
Depoe Bay, Dunes City, Florence, Gleneden Beach, Lincoln City, Mapleton, Newport, Otter Rock, Reedsport, Seal Rock, Siletz, Toledo, Waldport, Winchester Bay, Yachats
South Coast

Agness, Bandon, Brookings, Charleston, Coos Bay, Coquille, Gold Beach,
Lakeside, Myrtle Point, North Bend, Port Orford, Powers, Wedderburn

Portland and Vicinity
Banks, Barlow, Beaverton, Camas, Canby, Clackamas, Clatskanie, Columbia City, Cornelius, Forest Grove, Gaston, Gresham, Happy Valley, Hillsboro, Lake Oswego, Marquam, Milwaukie, Molalla, North Plains, Oregon City, Portland, Rainier, Sandy, Scappoose, St. Helens, Tigard, Troutdale, Tualatin, Vernonia, West Linn, Wilsonville

Southeast Oregon
Adel, Adrian, Burns, Diamond, Drewsey, Frenchglen, Hines, Jordan Valley, Juntura, Lakeview, Nyssa, Ontario, Plush, Vale

Southern Oregon
CITIES Ashland, Butte Falls, Cave Junction, Canyonville, Central Point, Dillard, Drain, Eagle Point, Elkton, Glendale, Glide, Gold Hill, Grants Pass, Jacksonville, Klamath Falls, Malin, Medford, Merlin, Myrtle Creek, Oakland, Phoenix, Prospect, Riddle, Rouge River, Roseburg, Shady Cove, Sutherlin, Talent, Umpqua, White City, Winchester, Winston, Wolf Creek, Yoncalla
AREAS:  Applegate Valley, Illinois Valley


Willamette Valley
Albany, Alsea, Amity, Aumsville, Aurora, Brooks, Brownsville, Canby, Canyonville, Carlton, Corvallis, Coburg, Cottage Grove, Creswell, Culp Creek, Dallas, Dayton, Detroit, Donald, Dundee, Eugene, Falls City, Gates, Gervais, Halsey, Harrisburg, Independence, Jefferson, Junction City, Keizer, Lebanon, Lowell, Lyons, McMinnville, Mill City, Millersburg, Mt.Angel, Molalla, Monmouth, Newberg, Oakridge, Oregon City, Philomath, Salem, Scio, Scott Mills, Sheridan, Silverton, Sodaville, Springfield, Stayton, St. Paul, Sublimity, Sweet Home, Tangerit, Turner, Veneta, Walterville, Waterloo, Willamina, Woodburn, Yamhill

 

 

 

Pacificsource health plans of oregon 2015

Provider Directory

1-800-624-6052

Use the Provider Directory to find doctors and facilities, use "Preferred PSN" as the network, and enter specific search requirements

 


2015 Individual and Family Medical and Dental Policy Enrollment Form

First Health Network - Outside Oregon


2015 Oregon Individual and Family Plans

The information on this page is for plans beginning January 1, 2015. 2015 plans are pending State and CMS approval.

PSN Plans


  Plan  

Deductible  

Out-of-pocket Limit  

Co-insurance  

Plan Details  

  Balance Bronze PSN 6600
$6,600 / $13,200
$6,600 / $13,200
0%
Value Bronze PSN 6250
$6,250 / $12,500
$6,250 / $12,500
0%
Value Bronze PSN 3000
$3,000 / $6,000
$6,450 / $12,900
50%
Standard Bronze PSN
$5,000 / $10,000
$6,350 / $12,700
50%
  Balance Silver PSN 2500 AC
$2,500 / $5,000
$6,450 / $12,900
30%
Balance Silver PSN 1500 AC
$1,500 / $3,000
$6,450 / $12,900
30%
Value Silver PSN 3600
$3,600 / $7,200
$3,600 / $7,200
0%
Value Silver PSN 3000
$3,000 / $6,000
$3,000 / $6,000
0%
Standard Silver PSN
$2,500 / $5,000
$6,350 / $12,700
30%
  Standard Gold PSN
$1,000 / $2,000
$6,350 / $12,700
10%
  Catastrophic PSN
$6,600 / $13,200
$6,600 / $13,200
0%

 

SmartChoice Plans


 

Plan

Deductible

Out-of-pocket Limit

Co-insurance

Plan Details

  Balance Bronze 6600
$6,600 / $13,200
$6,600 / $13,200
0%
Value Bronze 6250
$6,250 / $12,500
$6,250 / $12,500
0%
Value Bronze 3000
$3,000 / $6,000
$6,450 / $12,900
50%
Standard Bronze
$5,000 / $10,000
$6,350 / $12,700
50%
  Balance Silver 2500 AC 
$2,500 / $5,000
$6,450 / $12,900
30%
Balance Silver 1500 AC
$1,500 / $3,000
$6,450 / $12,900
30%
Value Silver 3600
$3,600 / $7,200
$3,600 / $7,200
0%
Value Silver 3000
$3,000 / $6,000
$3,000 / $6,000
0%
Standard Silver
$2,500 / $5,000
$6,350 / $12,700
30%
  Standard Gold
$1,000 / $2,000
$6,350 / $12,700
10%
  Catastrophic
$6,600 / $13,200
$6,600 / $13,200
0%

 

SmartHealth Plans


 

Plan

Deductible

Out-of-pocket Limit

Co-insurance

Plan Details

  Balance Bronze 6600
$6,600 / $13,200
$6,600 / $13,200
0%
Value Bronze 6250
$6,250 / $12,500
$6,250 / $12,500
0%
Value Bronze 3000
$3,000 / $6,000
$6,450 / $12,900
50%
Standard Bronze
$5,000 / $10,000
$6,350 / $12,700
50%
  Balance Silver 2500 AC 
$2,500 / $5,000
$6,450 / $12,900
30%
Balance Silver 1500 AC
$1,500 / $3,000
$6,450 / $12,900
30%
Value Silver 3600
$3,600 / $7,200
$3,600 / $7,200
0%
Value Silver 3000
$3,000 / $6,000
$3,000 / $6,000
0%
Standard Silver
$2,500 / $5,000
$6,350 / $12,700
30%
  Standard Gold
$1,000 / $2,000
$6,350 / $12,700
10%
  Catastrophic
$6,600 / $13,200
$6,600 / $13,200
0%

    

Dental Plans


  Dental Advanatage Essentials Core*
  Dental Advantage 0/20/50
  Kids Dental Advantage 0/20/50

*Available only through HealthCare.gov.  

 

 

2014 Oregon Individual and Family Plans Available Direct from PacificSource

A Real Person Will Answer give me a call: Doug Ellsworth 503-922-2903

The information on this page is for plans beginning January 1, 2014. View 2013 information.

Download our Guide to PacificSource Individual and Family Plans for Oregon Residents.

PacificSource Application "Direct"  /  PacificSource Dental Application "Direct"

Rates


Area 1 Rates: Clackamas, Multnomah, Washington, and Yamhill
Area 2 Rates: Benton, Lane, and Linn Counties
Area 3 Rates: Marion and Polk Counties
Area 4 Rates: Deschutes, Klamath, and Lake Counties
Area 5 Rates: Clatsop, Columbia, Coos, Curry, Lincoln, and Tillamook Counties
Area 6 Rates: Baker, Crook, Gilliam, Grant, Harney, Hood River, Jefferson, Morrow, Malheur, Sherman, Umatilla, Union, Wallowa, Wasco, and Wheeler Counties
Area 7 Rates: Douglas, Jackson, and Josephine Counties
Dental Rates: Statewide

Plans


PSN  

  Balance Bronze PSN 6350 (AC)
Value Bronze PSN 6250
Value Bronze PSN 3000
Oregon Standard Bronze PSN Plan
  Balance Silver PSN 2500 (AC)
Value Silver PSN 3000
Oregon Standard Silver PSN Plan

 

SmartHealth

  SmartHealth Balance Bronze 6350 (AC)
SmartHealth Value Bronze 6250
SmartHealth Value Bronze 3000
Oregon Standard Bronze SHN Plan
  SmartHealth Balance Silver 2500 (AC)
SmartHealth Balance Silver 1500 (AC)
SmartHealth Value Silver 3000
Oregon Standard Silver SHN Plan

 

 

Application

Application PacificSource Elect Oct 2012  

Elect Plans and Rates

Rates for all plans below 2013

Download our at-a-glance Elect product brochure (3 MB).

The Elect sample summary of benefits and coverage (SBC) documents below can also help you compare plans:
Premiere Preferred Value Option Balance HSA-qualified
Premiere 500   Preferred 500   Value Option 2500   Balance 2500 HSA 1500
Premiere 750   Preferred 750 Value Option 5000 Balance 5000 HSA 2000
Premiere 1000 Preferred 1000 Value Option 7500 Balance 7500 HSA 3000
Premiere 2500 Preferred 2500 Value Option 10000   HSA 5000
Premiere 5000 Preferred 5000      
Premiere 7500 Preferred 7500      
Premiere 10000 Preferred 10000      

Choose from five Elect plans:

  • Elect Premiere is our most expansive coverage. You'll pay just a $25 co-pay for office visits, acupuncture, naturopathic, and chiropractic care. Elect Premiere plans also include vision care. Annual deductibles range from $1,000 to $10,000.
  • Elect Preferred is comprehensive coverage. It offers $30 co-pays for office visits and chiropractic care. It also offers an accident benefit, urgent care, and prescription drug coverage. Most other in-network services are covered at 70% after the annual deductible. Annual deductibles range from $500 to $10,000.
  • Elect Balance offers extensive coverage, at an affordable price. It offers $35 co-pays for office visits, acupuncture, and chiropractic care.  Annual deductibles range from $2,500 to $7,500.
  • Elect Value Option is low cost, catastrophic coverage. It offers peace of mind with basic coverage for a low monthly rate. Most in-network services are covered at 60% after the annual deductible; prescription drugs are covered at 50% after the deductible. Elect Value deductibles range from $2,500 to $10,000.
  • Elect HSA plans are high-deductible health plans eligible for combination with a health savings account (HSA). Learn more about HSAs and consumer-directed health plans. Elect HSA plan deductibles range from $1,500 to $5,000. Most other in-network services are covered at 70% after the annual deductible.

Elect plan highlights at a glance:

  • Coverage for maternity, illness and injury, and prescription drugs
  • First-dollar accident benefit
  • On-the-job coverage if you are self-employed
  • No lifetime maximum benefit
  • Preventive care 100% covered for participating providers
  • Some plans cover alternative practitioner services, and vision care
  • No-cost extras to help you save money and stay healthy
  • Your choice of providers; no need for referrals from a primary care practitioner
  • All provide the highest level of benefits if you choose participating providers, and reduced benefits for nonparticipating providers.
  • An extensive network of participating providers within Oregon, plus in-network coverage throughout the U.S. 
    • You'll receive the highest level of benefits by using participating providers.
    • Participating providers accept benefits paid under the policy as full payment, and will not bill you for the balance (other than for deductibles, co-insurance, or co-payments).

Find an Oregon Individual Health Plan

Our Elect product line includes comprehensive health plans for Oregonians who aren't covered by Medicare. If you're self-employed, you are eligible for on-the-job health coverage at no extra cost. You are not required to choose a primary care practitioner or seek referrals for specialist care. Applications for these policies are health underwritten, and coverage is offered or declined based on your health. Watch our video to learn more.

Consumer-Directed Health Plans 101:

2. Health Savings Accounts (HSAs)

An HSA is a true bank account into which you deposit money to be used for your future healthcare expenses. Your HSA contributions can be deducted from your paycheck before taxes, or you can contribute your own money and deduct your contributions when you file your income taxes. Your employer or family members can also contribute to your HSA. No matter who contributes, the money is yours and will stay with you even if you change jobs or retire. The money in your HSA earns interest just like a regular bank account.

You’ll need a qualifying “high-deductible health plan”—also known as an HDHP—to go with your HSA. HDHPs must have a deductible of $1,150 or more, but sometimes preventive care is exempt from that deductible. The great thing about HSAs is that you can use the money in your account to pay those deductible expenses. Any unused money in your HSA carries over from year to year just like a regular savings account, so you can save your money for future medical expenses.

HSAs are available from most banks, credit unions, and other financial institutions. They come with checkbooks and debit cards you can use to access your account funds. Your bank won’t check to make sure you only use HSA funds for eligible healthcare expenses. You’re responsible for keeping those receipts or other documentation to prove that you used your HSA appropriately in case of an IRS audit.

For more detail on HSA regulations, visit the U.S. Treasury’s HSA FAQ site.

HSA highlights:
 

  • Your, your employer, or your family members can contribute to your HSA.
  • You own your account and all the money in it, no matter who contributed.
  • Money you or your employer deposit is tax deductible, earns tax-free interest, and can build from year to year.
  • You can withdraw funds to pay for medical expenses any time without taxes or penalties.
  • You can withdraw funds for nonmedical use subject to taxes and an IRS penalty.
  • HSAs are regulated by the federal government.
  • You must have a qualifying high-deductible health plan (HDHP) to contribute to your HSA. If your HDHP coverage ends, the HSA is still yours. You can spend those funds on qualifying healthcare expenses, but can’t make additional contributions without an HDHP.

Next, we’ll cover HRAs.

Continue to page 3...

Ready to find a consumer-directed health plan?

 

 

 

 
 
 
 
 
 
 

 


 Health Benefit Solution, Inc.

The focus of this website is to provide consumers a simple, and professional environment when looking for Affordable, and Low Cost Health Insurance.  Licensed Health Insurance Agents are available and will take the time to answer all your questions, and help find the Health Plan that best meets the needs of the Individual, Family, or Small Business.

Health Insurance Benefits are always changing, and health insurance companies are providing more options that benefit the consumer.  Alternative, or Holistic health care is now offered through many of the health insurance companies.  You can now see your Naturopathic Physician, and be covered under the doctor office co-pay, and have unlimited visits.  Chiropractic, and Acupuncture are also included as standard health care benefits.

If you are looking for Dental and Vision benefits included within the health plan, we can help you select the Health Insurance Company that will meet your needs.

Health Benefit Solution, Inc is licensed through the Oregon Insurance Division, and has contracted with most all the major health insurance companies to provide the consumer with choice and options when looking for the plan that meets the life style and needs of the insured.


PacificSource is an independent, not-for-profit health plan serving the Pacific Northwest. Founded in 1933, PacificSource provides medical and dental benefits to more than 4,000 employers and covers more than 151,000 people with its group and individual health insurance plans. It also provides self-funded employee benefit plans, flexible spending accounts, HRAs, and COBRA administration services through its subsidiaries, Manley Services and Select Benefit Administrators. Together, PacificSource and its subsidiaries employ 324 people.

At PacificSource, we're committed to helping people get the healthcare they need. We offer group insurance clients a wide range of medical, dental, prescription drug, and vision benefits. We also meet the needs of individuals and families with comprehensive medical plans, portability policies, and Medicare supplement policies.

At PacificSource, we're known for taking good care of people. Members can call our toll-free number to speak with a customer service representative for friendly, professional benefits and claims assistance. Our client service representatives are available for on-site visits and benefit meetings with our group insurance clients. And we strive to provide all our customers with the information and tools they need to make informed healthcare decisions. In everything we do, we will always maintain the friendly, personal manner which lets you know that serving you is our pleasure.

PacificSource Community Giving Program Helps Build "Healthy Communities"

At PacificSource, we strive to improve the communities we serve, with a particular emphasis on increasing access to healthcare services. But we know that the health of a community relates to more than just healthcare – it also relates to the support network available to those who require assistance in making healthy lifestyle choices or providing for their basic needs.

As members of the communities in which we do business, PacificSource seeks to promote the capacity of individuals, families, and communities to increase healthy behaviors and lifestyle choices and to provide a safe and nurturing environment for children to develop into healthy adults.

Healthy Communities, our community giving program, is designed to benefit nonprofit organizations that serve people in the communities where we do business. Through this program, we provide financial support, in-kind donations, and employee volunteer assistance to organizations working toward some or all of the following goals:

  • To educate and empower individuals and families to adopt healthy behaviors and lifestyles,

  • To sponsor safe, healthy, educational, and fun family-oriented activities, and

  • To build local capacity to improve the health of the community.

Our Healthy Communities program is administered by an employee committee charged with reviewing requests and making recommendations on PacificSource’s involvement. We are pleased to consider requests from organizations that:

  • Meet the IRS’s qualifications for nonprofit charitable organizations;

  • Are not arts, political, or faith-specific/religious causes; and

  • Earmark the funds to benefit people in the communities we serve.

The committee evaluates requests based on the following criteria:

  • Match with the “Healthy Communities” program mission

  • PacificSource’s past history with the organization

  • Opportunity for recurring or long-term involvement

  • Opportunity for personal involvement by our employees

  • Budget availability by region/market

  • Value of public awareness opportunities or name recognition for PacificSource

Sources for Information on Hospital Quality:

First Health Provider Directory
Search for participating First Health physicians, hospitals, and facilities outside Oregon, western Idaho, and southwest Washington.

Caremark® Web Site
The Caremark site offers health and wellness information plus tools to manage your prescriptions, look up drug coverage and pricing, and locate a participating pharmacy.

 

PacificSource PDL (Preferred Drug List)

This list of preferred brand name medications is updated monthly. If your benefits include prescription drug coverage, the drugs on this list are available for your plan's Tier 2 (Preferred) copayment.

Caremark® Prescribing Guide
You'll use this list of preferred medications if you're covered under a prescription drug plan that's based on a formulary, and not on the PDL or VDL.

Mail Order Prescription Drug Service
PacificSource members with mail order prescription drug benefits can order prescription refills from Walgreens Mail Service or Wellpartner Pharmacy right over the Internet.

Oregon Health Plan
Find information on eligibility requirements and applying for coverage under the state-sponsored Oregon Health Plan.

Oregon Insurance Division

This is the Web site of the state agency that oversees the insurance industry in Oregon.

Healthfinder
The site features links to more than 1,250 government and other consumer health resources on the Web.

PacificSource Grievance & Appeal Information

This publication includes common questions and answers about our member grievance and appeal process.