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Caerus Insurance
Caerus Insurance
Employee Benefit Programs
Documents and Resources October 2023 to September 2024
Providence Health Plan
Connect 2
500 Gold Benefit Summary
Connect 2500 Gold Summary of Benefits and Coverage
Balance 2500 Gold Benefit Summary
Balance 2500 Gold Summary of Benefit and Coverage
Advantage Access Dental Benefit Summary
Enrollment/Change Form
- Balance
Enrollment/Change Form - Connect
Provider directory
- Connect
Provider directory - Balance
Pharmacy resources
About Providence
Customer Service
MyProvidence
MyChart
LifeBalance
Virtual Care
How to use your benefits
ProvRN
125b Cafeteria Plan
Summary Plan Description
Pre-Tax Savings Calculator
Notices
ACA Exchange Model Notice
ERISA Wrap Document
Medicare Creditable Pharmacy Disclosure
- Connect 2500
Medicare Creditable Pharmacy Disclosure - Balance 2500
Primary Care Provider Model Disclosure
Notice of Rights Under The Women's Health and Cancer Rights Act (WHCRA)
HIPAA Special Enrollment Rights Notice
Premium Assistance under Medicaid and the Children's Health Insurance Program (CHIP)
Notice Regarding Patient Protections Against Surprise Billing
Paid Leave Model Notice-Poster
Eligibility and Contribution
40 hours per week on a regularly scheduled basis
Coverage begins first of the month following 90 days of working the required amount of hours
Open enrollment is from September 1 through September 30 for an October 1 start date annually
Employer pays 100% for employee premium on the Providence Connect 2500 Gold and Advantage Access Dental plan
Employees can enroll in the Providence Balance 2500 plan with premium contributions
Employees may enroll dependents on the plan with premium contributions
Premium Contributions Summary
IRS Forms
Form W-4
Form I-9
Account Manager and Support Staff Contact Information
Contact Stuart Ouellette - Agent
Contact Katie Ostgarden - Account Manager
Contact Sarah Selix - Assistant