Medical

  • Find the right balance between budget and healthcare needs.

    For specific details on our 2016 plans, review the following:

    Medical and Dental Benefit Guide

    Plan Summary Portfolio

    Summary of Benefits and Coverage

    Small Group Medicare Part D Matrix

    Our 2016 portfolio includes:

    Passport PPO plans

    LifeWise Passport preferred provider organizations (PPO) plans offer a combination of up-front, first-dollar benefits and standard coverage for other services. A lower copay applies when the member visits their designated primary care doctor.

    Passport HSA plans

    LifeWise Passport HSA plans offer valuable benefits for covered services and are qualified to work in combination with an employee owned, tax advantaged health savings account (HSA).

    Assure EPO plans

    LifeWise Assure exclusive provider organization (EPO) plans offer a combination of up-front, first-dollar benefits and standard coverage for other services.

    Standard plans

    These plans were designed by the Oregon Department of Consumer and Business Services to be included in our plan offerings. They differ from the Passport plans in that they do not offer alternative care coverage.

    Employee-only plans

    All LifeWise small group plans are available for employees only.

    Optional benefits

    Employers with 10 or more enrolled employees can choose from the following products:

    Life and disability

    Employers can offer an integrative benefits program to help reduce disability and healthcare costs, improve health, and increase workforce productivity. Through our partner, USAble Life, groups will find flexible products, high-quality customer service, and fast, reliable claims service. Several package options are available for groups with 1-50 employees.

    Group life insurance

    • Group term life- Provides benefits to a beneficiary in the event of an employee's death
    • Accidental death and dismemberment (AD&D)- Provides benefits in the event that a death or dismemberment is caused by an accident
    • Dependent life- Provides benefits to the employee in the event of a dependent's death
    • Supplemental life and AD&D- Provides additional coverage options for your employees

    Disability coverage

    • Short-term disability coverage- Protects a portion of employees' income in the event of a disability
    • Long-term disability coverage- Provides employees and their families the income needed to help meet financial commitments and give them financial stability

    New 2015 plans built with small business in mind!

    LifeWise offers small group employers a suite of metallic plans with a built-in wellness program that reward both employees and employers for participation. These metallic plans include a wide choice of Gold, Silver and Bronze plans. We provide employers with peace of mind and actively support and encourage employees to live the healthiest lives possible through our coverage, programs and services.

    For specific plan details, check out our medical plan summaries portfolio or refer to the benefit guide (below).

    Summary of benefits and coverage

    Benefit Guide

    Our new 2015 portfolio includes

    A variety of metallic plans

    These include high-deductible plans with tax-advantaged health savings accounts (HSA) and health reimbursement accounts (HRA), that balance coverage and cost.

    Passport

    These preferred provider plans offer a combination of upfront, first-dollar benefits, and standard coverage for other services.

    Passport PCP

    These innovative Passport plans offer a combination of upfront, first-dollar benefits, and standard coverage for other services. The difference is that a lower copay applies when a primary care provider (PCP) is designated and utilized.

    Passport HRA

    The Passport HRA plans include a pre-defined employer Health Reimbursement Account (HRA) contribution amount. This is a "member pay first" deductible design. The employer contributes the funds to satisfy the last 50 percent of the plan's deductible.

    Passport HSA

    The Passport HSA plans offer valuable benefits for covered services and are qualified to work in combination with an employee-owned, tax-advantaged Health Savings Account (HSA). Some of these plans offer a pre-defined employer HSA contribution amount.

    Dual plan option

    More choices

    Employers have the ability to provide more health plan choices to their employees by offering product combinations that allow for affordability and tax-advantaged saving opportunities.

    With this option, you can select both a Metallic Passport plan and a Metallic HSA plan to give your employees more choices about their health plan coverage.

    Review our Dual Plan Information Sheet for more details on this flexible plan.

    Optional benefits

    In addition to our health plans, you can enhance your employees' health benefits by selecting these additional options:

    Adult dental and adult orthodontia plans

    LifeWise dental plans feature a range of annual deductibles, maximum annual benefits, and coinsurance payments. For groups of five or more employees, available options include traditional, PPO, and self-funded plans.

    Enhanced benefits options for periodontal and endodontic services are available for groups of five or more employees. Orthodontia benefits are available to groups of 26 or more employees.

    Vision plans

    Employer groups who offer a Passport HSA plan can choose to add vision and hardware benefits to their plan design. See the benefit guide for more information.

    Hearing, vision and alternative care

    Employer groups who offer a Passport or Passport PCP plan can choose to add a hearing, vision and alternative care benefits to their plan design.

    Additional resources

    Benefit Guide for Closed Plans - For plans with effective dates between Jan. 1, 2013 and Dec. 31, 2013. Please note, these do not include any required changes for healthcare reform.

    Benefit Plan Summaries - Are available in the 2013 tab and include both grandfathered and non-grandfathered small group plan summaries to help you service your existing group clients.

    Supplemental Guide for Small Group Plans - Small Group Supplemental Guides - Includes privacy policy provider organization, key utilization management procedures, pharmaceutical management procedures

    2014 plans built with small business in mind!

    LifeWise offers small group employers a suite of metallic plans with a built-in wellness program that reward both employees and employers for participation. These metallic plans include a wide choice of Gold, Silver and Bronze plans. We provide employers with peace of mind and actively support and encourage employees to live the healthiest lives possible through our coverage, programs and services.

    For specific plan details, check out our medical plan summaries portfolio or refer to the benefit guide (below).

    Summary of Benefits and Coverage

    Benefit Guide

    Our 2014 portfolio includes

    A variety of metallic plans

    These include high-deductible plans with tax-advantaged health savings accounts (HSA) and health reimbursement accounts (HRA), that balance coverage and cost.

    Passport

    These preferred provider plans offer a combination of upfront, first-dollar benefits, and standard coverage for other services.

    Passport PCP

    These innovative Passport plans offer a combination of upfront, first-dollar benefits, and standard coverage for other services. The difference is that a lower copay applies when a primary care provider (PCP) is designated and utilized.

    Passport HRA

    The Passport HRA plans include a pre-defined employer Health Reimbursement Account (HRA) contribution amount. Some plans offer a combination of upfront, first-dollar benefits. Other plans offer valuable benefits for covered services, which typically apply to the deductible.

    Passport HSA

    The Passport HSA plans offer valuable benefits for covered services and are qualified to work in combination with an employee-owned, tax-advantaged Health Savings Account (HSA). Some of these plans offer a pre-defined employer HSA contribution amount.

    Dual plan option

    More choices

    Employers have the ability to provide more health plan choices to their employees by offering product combinations that allow for affordability and tax-advantaged saving opportunities.

    With this option, you can select both a Metallic Passport plan and a Metallic HSA plan to give your employees more choices about their health plan coverage.

    Review our Dual Plan Information Sheet for more details on this flexible plan.

    Optional benefits

    In addition to our health plans, you can enhance your employees' health benefits by selecting these additional options:

    Adult dental and adult orthodontia plans

    LifeWise dental plans feature a range of annual deductibles, maximum annual benefits, and coinsurance payments. For groups of five or more employees, available options include traditional, PPO, and self-funded plans.

    Enhanced benefits options for periodontal and endodontic services are available for groups of five or more employees. Orthodontia benefits are available to groups of 26 or more employees.

    Vision plans

    Employer groups who offer a Passport HSA plan can choose to add vision and hardware benefits to their plan design. See the benefit guide for more information.

    Hearing, vision and alternative care

    Employer groups who offer a Passport, Passport PCP or Passport HRA plan can choose to add a hearing, vision and alternative care benefits to their plan design.

    Additional resources

    Benefit Guide for Closed Plans - For plans with effective dates between Jan. 1, 2013 and Dec. 31, 2013. Please note, these do not include any required changes for healthcare reform.

    Benefit Plan Summaries - Are available in the 2013 tab and include both grandfathered and non-grandfathered small group plan summaries to help you service your existing group clients.

    Innovative medical plan options

    LifeWise offers everything from familiar PPO and traditional plans, to alternatives that work with special healthcare funding arrangements, to give employees more control and responsibility over their healthcare spending.

    For specific plan details, check out our medical plan summaries or refer to the benefit guide (below).

    Benefit guide

    Sample benefit booklet

    Pharmacy benefits

    Frontline™

    Innovative PPO plans

    These plans offer a combination of up-front, first-dollar benefits, and standard coverage for other services.

    We also have a high deductible plan option with a first 6-visit structure for employers interested in balancing cost and value.

    These plans allow your organization to:

    • Save money on premiums
    • Encourage the use of preventive care benefits
    • Provide all or most office visits subject to a copay
    • Include alternative care benefits

    LifeWise HSA™

    HSA-Qualified health plans

    These plans offer valuable benefits for a wide range of covered services and are qualified to work in combination with an employee-owned tax-advantaged Health Savings Account (HSA). Employees use the account to fund qualifying medical expenses, while investing or generating interest on their savings balance. HSAs allow your organization to:

    • Minimize costs and add an affordable healthcare program to your total compensation package
    • Encourage a more health-conscious, productive and satisfied workforce
    • Help employees offset out-of-pocket expenses with potential tax advantages

    Dual plan option

    More choices

    Employers have the ability to provide more health plan choices to their employees by offering product combinations that allow for affordability and tax-advantaged saving opportunities.

    With this option, you can select both a Frontline plan and a LifeWise HSA plan to give your employees more choices about their health plan coverage.

    Review our Dual Plan Information Sheet for more details on this flexible plan.

    Optional benefits

    In addition to our health plans, you can enhance your employees' health benefits by selecting these additional options:

    Dental and orthodontia plans

    LifeWise dental plans feature a range of annual deductibles, maximum annual benefits, and coinsurance payments. For groups of five or more employees, available options include traditional, PPO, and self-funded plans.

    Enhanced benefits options for periodontal and endodontic services are available for groups of five or more employees. Orthodontia benefits are available to groups of 26 or more employees.

    Outpatient prescription drug plans

    Affordable prescription drugs are important to your employees' health and healthcare costs. Each plan includes coverage of generic prescriptions or you may have the option to purchase an alternative four-level plan. See the benefit guide for more information.

    Vision plans

    You can offer employees the option of regular vision and hardware benefits through any of our health plans. See the benefit guide for more information.