COBRA
Continuation Summary (78K pdf)
Event Notice (20K pdf)

PacificSource
2008 HRA Flyer (2080K pdf)
Benefit Book-PPO Plan (2986K pdf)
Benefit Book-Prime Plan (2990K pdf)
Employee Address Change (21K pdf)
Enrollment and Change Form (48K pdf)
Health Risk Assessment-2008 Flyer (2080K pdf)
Health Risk Assessment-How to Complete Your HRA (188K pdf)
How to Complete Your HRA (188K pdf)
Link to PacificSource Web Site
Medical Benefit Summary-PPO Plan (11K pdf)
Medical Benefit Summary-Prime Plan (11K pdf)
Medical or Prescription Drug Claim (82K pdf)
Termination of Dependent Coverage (97K pdf)
Web Site

PacificSource-Mail Service Pharmacy
Pharmacy Mail Order Options-PPO only (1086K pdf)
Pharmacy Mail Service-CVS Caremark-Information (150K pdf)
Pharmacy Mail Service-CVS Caremark-Order Form (170K pdf)

ODS Health Plans
Benefit Summary-Dental and Vision (17K pdf)
Benefit Handbook-Dental (1380K pdf)
Benefit Handbook-Vision (1356K pdf)
Enrollment-Change Form (358K pdf)
Finding a Provider (1811K pdf)
Vision Reimbursement Claim Form (108K pdf)
Web Site

Health Insurance Portability and Accountability Act (HIPAA)
Initial Notice (11K pdf)
Notice of Privacy Practices (41K pdf)

Travel Insurance
A comprehensive program of information, referral, assistance, transportation and evacuation services designed to help you respond to medical care situations and many other emergencies that may arise during travel. (Provided by MEDEX Assistance Corporation.)
Medex Employee Brochure (743K pdf)

COBRA
Continuation Summary (78K pdf)
Event Notice (20K pdf)

Regence Blue Cross Blue Shield of Oregon
Benefit Summary (174K pdf)
Complimentary Care Benefit Summary (24K pdf)
Enrollment Change (350K pdf)
Enrollment and Change Form (47K pdf)
New Enrollment (50K pdf)
Pharmacy Benefit Summary (97K pdf)
Request a new ID Card
Vision Coverage Summary (51K pdf)
Web Site

Health Insurance Portability and Accountability Act (HIPAA)
Initial Notice (11K pdf)
Notice of Privacy Practices (41K pdf)