Employee Benefit Plans

Benefit Plan Documents & Forms

Medical Plan Summaries 2023

Effective January 1, 2023 - December 31, 2023

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
  • PPO Plan B | $7000
• 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 2022

Effective January 1, 2022 - December 31, 2022

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

• 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
  • PPO Plan B | $7000
• 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 2022

Effective January 1, 2022 - December 31, 2022

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
  • PPO Plan B | $7000
• 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 Benefit Summaries 2023

Effective January 1, 2023 - December 31, 2023

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
  • PPO Plan B | $7000
• 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, 2022 - December 31, 2022

Delta Dental

Dental Plan Summaries

Effective January 1, 2023 - December 31, 2023

Delta Dental

Vision Plan Summaries

VSP

Employee Assistance Program (EAP)

UpriseHealth

Life/AD&D Plan Summaries

LifeMap