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Basic Oregon Plan
Health care reform for group business emerged in the early 1990's. In 1993,
all carriers were mandated to offer a guaranteed issue small group plan, with
the benefit design and coverage levels identified by the state. This plan became
known as the Basic Oregon Plan. Small groups could request coverage with the
carrier of their choice, and carriers could identify if the small group presented
a risk that was acceptable. If not, but the small group still wanted coverage
with that carrier, the carrier was obligated to offer the small group Basic
Oregon Plan.
Plan Overview
Benefit Summaries
Plan Overview |
|
Traditional Plan
Member Cost
|
Traditional Plan with Dental
Member
Cost
|
Deductible |
None |
None |
Maximum Coinsurance |
$3,750 per person
$7,500 per family
|
$3,750 per person
$7,500 per family
|
Preventive Care Services |
$15 copayment |
$15 copayment |
Professional Services |
50% |
50% |
Hospital Services |
50% |
50% |
Other Services |
50% |
50% |
Prescription Medications |
Member pays $15 copay or 50%, whichever
is greater |
Member pays $15 copay or 50%, whichever
is greater |
Preventive Dental care
(ages 3 through 12)
|
Not Covered |
$15 copayment |
Features and Advantages |
- Choice of providers with higher benefit for Participating providers
- Preventive care included
- Prescription medication included
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Service
Area |
All Oregon counties |
Provider
Directory |
Participating (Traditional) |
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