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Group Medical Plans
ODS offers the following types of standard Medical Plans. Other plan options are available for larger groups.
ODS also offers Administrative Services Only (ASO) plans.
Value-Added Services
The following services are provided to ODS plans at no additional cost.
myODS
With myODS, our customized member website, you can:
- View your member handbook online
- View claims status and history, including deductibles
and out-of-pocket balances - Print an Explanation of Benefits (EOB)
- Change your address
- E-mail customer service
The following services are provided to ODS medical plans at no additional cost.
eDoc America
eDocAmerica provides unlimited communication with board certified physicians via secure e-mail. This service gives you access to physicians who can answer questions about and assist you with healthcare choices.
Registered Nurse Advice Line
The Registered Nurse Advice Line provides 24/7 access to a registered nurse (RN) who can answer your healthcare questions regarding symptoms, medications, medical tests, procedures and staying healthy.
PersonalHealth Rx
PersonalHealth Rx gives members online access to detailed claims history, benefit information and tax reports.
Free & Clear
We are proud to offer an effective tobacco cessation program to employers. The Free & Clear Quit For Life program, which has been in existence for 20 years, is based on scientific evidence that supports reduced tobacco use through telephone counseling, nicotine replacement therapy and prescription drugs.
The following service is provided to ODS medical plans for an additional cost.
ODS Wellness Solutions -Think Healthy, Live Healthy, Be Healthy
We have taken a positive step by expanding ODS health promotion offerings with ODS Wellness Solutions. This evidence based health and productivity management program is a means of pro-active health care and disease prevention that can improve and retain the health and well-being of your employees. For more information on comprehensive wellness solutions, contact
Third Party Administration
With so many intricate policies, guidelines and regulations, benefits administration should be left to the experts. BenefitHelp Solutions, one of the ODS Companies, can answer your questions regarding the following and much more.
- FSA Administration
- COBRA / Continuation
(included with fully insured medical groups with less than 100 covered employees) - Premium Administration
(included with fully insured medical groups with less than 100 covered employees)
| In Plan Benefits | Out Of Plan Benefits | ||||||||
|---|---|---|---|---|---|---|---|---|---|
|
*HSA deductible and out of pocket maximums apply to employee only enrollment. Please refer to the benefit summary for amount when coverage is for employee with one or more dependents. **Beneficial PPO plans allow five Office visits per year at a $25 copay, prior to deductible. In addition, Preventive care benefits are payable after co-payment, according to our standard schedule. All medical plans except HSAs are required to include a RX option. HSA plans include a major medical RX benefit. RX riders are not available for HSA plans. | |||||||||
| Plan | Ded | Office Visit |
Co-ins. | OOP | Ded | Co-ins. | OOP | ||
| BEN5000 | $5,000 | $25 ** | 30% | $5,000 | $5,000 | 50% | $10,000 | ||
| BEN2500 | $2,500 | $25 ** | 30% | $5,000 | $2,500 | 50% | $10,000 | ||
| PPO150025 | $1,500 | $25 | 25% | $3,500 | $1,500 | 50% | $7,000 | ||
| PPO1000251 | $1,000 | $25 | 20% | $3,000 | $1,000 | 40% | $9,000 | ||
| PPO750251 | $750 | $25 | 20% | $3,000 | $750 | 40% | $9,000 | ||
| PPO500201 | $500 | $20 | 20% | $2,500 | $500 | 40% | $7,500 | ||
| HSA2800 | $2,800 * | 50% | 50% | $2,200 * | $2,800 * | 50% | $4,400 * | ||
| HSA2000 | $2,000 * | 20% | 20% | $3,000 * | $2,000 * | 40% | $6,000 * | ||
| HSA1200 | $1,200 * | 20% | 20% | $3,800 * | $1,200 * | 40% | $7,600 * | ||
| Basic Oregon Plan | N/A | 50% | 50% | $3,750 | N/A | 50% | $3,750 | ||
| Dual Option 1 | |||||||||
| PPO500201 | $500 | $20 | 20% | $2,500 | $500 | 40% | $7,500 | ||
| HSA1200 | $1,200 * | 20% | 20% | $3,800 * | $1,200 * | 40% | $7,600 * | ||
| Dual Option 2 | |||||||||
| PPO1000251 | $1,000 | $25 | 20% | $3,000 | $1,000 | 40% | $9,000 | ||
| HSA2000 | $2,000 * | 20% | 20% | $3,000 * | $2,000 * | 40% | $6,000 * | ||
Medical Riders
| Riders are only available to PPO plans. If you chose one of the ODS Dual Option plans, the riders you select below will be available to the PPO plan but not the HSA plan. |
| Standard Rx: $15/50% whichever greater copay, 2x Mail Order copay; $5,000 annual limit |
| Rx: 40% copay; Mail Order: 40% copay |
| Rx: $10/$40/$60; 2x Mail Order copay |
| Rx: $10/$35/$50; 2x Mail Order copay |
| Rx: $10/$30/$50; 2x Mail Order copay |
| 100% w/ $300 Max |
| 100% w/ $200 Max |
| 100% Eye Exam Only |