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

2018 Small Group Certificate for Health & Wellbeing, Standard and New Performance Plans
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
2018 Vision Plan
2018 Prior Authorization List
2018 Credible Coverage Summary

Prescription Drugs

2018 Small Group Formulary
2018 Pharmacy Directory

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 Vision Plan
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