Employee Benefit Plans

Benefit Plan Documents & Forms

Medical Plan Summaries 2021

Effective January 1, 2021 - December 31, 2021

Regence BlueCross BlueShield of Oregon
A Series, B Series, C Series, D Series

• VGBT Plan Menu

• A Plans
  • PPO Plan A | $500
  • PPO Plan A | $1000
  • PPO Plan A | $1500
  • PPO Plan A | $2000
  • PPO Plan A | $2500
  • PPO Plan A | $3500
  • PPO Plan A | $5000
• B Plans
  • PPO Plan B | $500
  • PPO Plan B | $1000
  • PPO Plan B | $1500
  • PPO Plan B | $2000
  • PPO Plan B | $2500
  • PPO Plan B | $3500
  • PPO Plan B | $5000
• C Plans
  • PPO Plan C | $2500
  • PPO Plan C | $3000
  • PPO Plan C | $4000
  • PPO Plan C | $5500
  • PPO Plan C | $7000
• D Plans
  • PPO Plan D | $1500
  • PPO Plan D | $2500
  • PPO Plan D | $3500
  • PPO Plan D | $5000

Medical Plan Summaries 2020

Effective January 1, 2020 - December 31, 2020

Regence BlueCross BlueShield of Oregon
A Series, B Series, C Series, D Series

• VGBT Plan Menu

• A Plans
  • PPO Plan A | $500
  • PPO Plan A | $1000
  • PPO Plan A | $1500
  • PPO Plan A | $2000
  • PPO Plan A | $2500
  • PPO Plan A | $3500
  • PPO Plan A | $5000
• B Plans
  • PPO Plan B | $500
  • PPO Plan B | $1000
  • PPO Plan B | $1500
  • PPO Plan B | $2000
  • PPO Plan B | $2500
  • PPO Plan B | $3500
  • PPO Plan B | $5000
• C Plans
  • PPO Plan C | $2500
  • PPO Plan C | $3000
  • PPO Plan C | $4000
  • PPO Plan C | $5500
  • PPO Plan C | $7000
• D Plans
  • PPO Plan D | $1500
  • PPO Plan D | $2500
  • PPO Plan D | $3500
  • PPO Plan D | $5000

Medical Plan Booklets 2021

Effective January 1, 2021 - December 31, 2021

Regence BlueCross BlueShield of Oregon
A Series, B Series, C Series, HSA Series, Vision Rider available on all medical plans

• A Plans
  • PPO Plan A | $500
  • PPO Plan A | $1000
  • PPO Plan A | $1500
  • PPO Plan A | $2000
  • PPO Plan A | $2500
  • PPO Plan A | $3500
  • PPO Plan A | $5000
• B Plans
  • PPO Plan B | $500
  • PPO Plan B | $1000
  • PPO Plan B | $1500
  • PPO Plan B | $2000
  • PPO Plan B | $2500
  • PPO Plan B | $3500
  • PPO Plan B | $5000
• C Plans
  • PPO Plan C | $2500
  • PPO Plan C | $3000
  • PPO Plan C | $4000
  • PPO Plan C | $5500
  • PPO Plan C | $7000
• D Plans
  • PPO Plan D | $1500
  • PPO Plan D | $2500
  • PPO Plan D | $3500
  • PPO Plan D | $5000

Medical Plan Booklets 2020

Effective January 1, 2020 - December 31, 2020

Regence BlueCross BlueShield of Oregon
A Series, B Series, HSA Series, Vision Rider available on all medical plans

• A Plans
  • PPO Plan A | $500
  • PPO Plan A | $1000
  • PPO Plan A | $1500
  • PPO Plan A | $2000
  • PPO Plan A | $2500
  • PPO Plan A | $3500
  • PPO Plan A | $5000
• B Plans
  • PPO Plan B | $500
  • PPO Plan B | $1000
  • PPO Plan B | $1500
  • PPO Plan B | $2000
  • PPO Plan B | $2500
  • PPO Plan B | $3500
  • PPO Plan B | $5000
• C Plans
  • PPO Plan C | $2500
  • PPO Plan C | $3000
  • PPO Plan C | $4000
  • PPO Plan C | $5500
  • PPO Plan C | $7000
• D Plans
  • PPO Plan D | $1500
  • PPO Plan D | $2500
  • PPO Plan D | $3500
  • PPO Plan D | $5000

Dental Plan Summaries

Effective January 1, 2021 - December 31, 2021

Delta Dental

Vision Plan Summaries

VSP

Life/AD&D Plan Summaries

LifeMap

Employee Assistance Program (EAP)

Reliant Behavioral Health