Small Group Resources

Administrative Quick Guide
Oregon standardized group profile form
2018 Group application
2018 Member enrollment, change & waiver form
2017 Group application
2017 Member enrollment, change & waiver form
Member termination form
Declination of coverage

Benefit information 

Pending state approval

2018 Health & Wellbeing 2500
2018 Health & Wellbeing 3000
2018 Health & Wellbeing 5000
2018 Samaritan Oregon Standard Bronze
2018 Samaritan Oregon Standard Silver
2018 New Performance

Benefit information

2017 Health & Wellbeing 5000/60 
2017 Health & Wellbeing 3000/20
2017 Health & Wellbeing 2500/20 
2017 Bronze Standard 
2017 Silver Standard 
2017 New Performance
2017 Prior Authorization List
2017 Benefit Exclusions

Prescription Drugs

2017 Formulary
2017 Pharmacy Directory

Benefit information

2016 Health & Wellbeing 5000/60
2016 Health & Wellbeing 3000/20
2016 Health & Wellbeing 2500/20
2016 Bronze Standard
2016 Silver Standard
2016 Benefit exclusions
2016 Benefit limitations
Underwriting guidelines

Prescription Drugs

2016 Formulary 
2016 Pharmacy Directory