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Oregon Home Mortgage
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Employee Benefit Programs
Documents and Resources January 2025 - December 2025
Providence Health Plan
Choice 9200 Bronze Benefit Summary
Choice 9200 Bronze Summary of Benefits and Coverage
Balance 8000 Bronze Benefit Summary
Balance 8000 Bronze Summary of Benefits and Coverage
Enrollment/Change Form - Choice
Enrollment/Change Form - Balance
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ProvRN
Notices
ACA Exchange Model Notice
State Continuation Notice
Medicare Creditable Pharmacy Disclosure
Eligibility
30 hours per week on a regularly scheduled basis
Coverage begins first of the month following date of hire
Open enrollment is from Dec 1 through Dec 31 annual for Jan 1 start date
Employer pays 50% for employee only on the Providence Choice 9200 Bronze plan
Employees may enroll dependents on the plan with premium contributions
The Providence Medical and Dental plans renew on January 1st each year
IRS Forms
Form W-4
Form I-9
Account Manager and Support Staff Contact Information
Contact Paris Laughlin - Agent
Contact Katie Ostgarden - Account Manager
Contact Sarah Selix - Assistant