SDIS Benefit Applications

• Regence Application 
• Moda Application (Dental) 
• Willamette Dental Application
• Standard Insurance Application 
• Cobra and Disability Forms: Contact SDAO
• Regence Member Reimbursement Form
• Express Scripts Brochure and Order Form

OFCA Benefit Applications

• OFCA Regence Medical and Moda Dental Application 
• Standard Insurance Application 
• Cobra and Disability Forms: Contact SDAO
• Regence Member Reimbursement Form
• Express Scripts Brochure and Order Form

Carrier Links and Portal Registrations

• Regence Member Registration and Express Scripts Registration
• Regence Provider Search Link
• Moda Account Registration
• Moda Provider Seach Link
• Willamette Dental Group Links
• Willamette Dental Group Welcome Letter
• Standard and Enhanced

Employee Benefit Plan Documents

• 2020 SDIS Benefits Guide
• 2020 OFCA Benefits Guide
• SDIS Employee Benefits Plan 
• SDIS Medical and Dental Coverage Participating Employer Agreement
• OFCA Medical and Dental Coverage Participating Employer Agreement

Required Notices

• Medical Information Privacy Notice
• HIPAA Health Information Privacy Policies Manual
• HIPAA Electronic Security Policies Manual
• Premium Assistance Under Medicaid and the Children's Health Insurance Program (CHIP) / DOL Model Employer CHIP Notice
• Women's Health and Cancer Rights Act of 1998 Notice / Model WHCRA Annual Notice
• Creditable Prescription Drug Coverage and Medicare / Model Creditable Coverage Disclosure Notice
• General Notice of COBRA Continuing Coverage and Rights / DOL Model COBRA Notice
• New Health Insurance Marketplace Coverage Options and Your Health Coverage
• OFCA COVID-19 Continued Extension of Benefits Notice
• SDIS COVID-19 Continued Extension of Benefits Notice

Additional Notices

• Community Wellness Benefit
• COVID-19 Vaccine FAQs
• MDLive Flyer
• Regence Advantages Flyer
• Regence Babywise
• Regence Bluecard Brochure
• Regence Empower Program
• Delta Dental Teledentistry Flyer
• Express Scripts Brochure and Order Form

Summary Plan Documents

2021 SDIS Plans

Regence BlueCross BlueShield of Oregon

• HSA Medical Plan 

• Blue Plan  II 
• Blue Plan IIA  
• Blue Plan III  
• Blue Plan IV 
• Blue Plan V 
• Blue Plan VI 
• Blue Plan VII  

• Red Plan C 
• Red Plan D  
• Red Plan E  
• Red Plan F  
• Red Plan H  
• Red Plan J  
• Red Plan K  
• Red Plan L  

2021 SDIS SBC's

Moda/Delta Dental

• Moda Constant Plan
• Moda Constant Plan with Ortho
• Moda Incentive Plan
• Moda Incentive Plan with Ortho
• Moda Deschutes Public Library Plan

Willamette Dental Group

• WDG Standard Plan
• WDG Enhanced Plan

2021 OFCA Plans

Regence BlueCross BlueShield of Oregon

• OFCA Pharmacy Benefits Summary
• OFCA Medical Plan 1
• OFCA Medical Plan 2
• OFCA Medical Plan 3
• OFCA Medical Plan 4
• OFCA Medical Plan 5
• OFCA Medical Plan 6
   

2021 OFCA SBC's

• Calendar Year
• Plan Year
   

OFCA Moda/Delta Dental

• OFCA Moda Option 1
• OFCA Moda Option 1 with Ortho
• OFCA Moda Option 2
• OFCA Moda Option 2 with Ortho

OFCA Redmond Fire Medical and Dental

• OFCA Redmond Fire Medical Plan Option 2
• OFCA Redmond Fire Medical Plan Option 3
• OFCA Redmond Fire Dental Plan Option 2 with ortho

SDIS Life Insurance Plans

• $10,000
• $20,000
• $50,000
• One times salary amount

Standard Insurance Short Term Disability Plans

• Option I
• Option II
• Option III
• Option IV
• Option V
• Option VI

Standard Insurance Long Term Disability Plans

• Option 1
• Option 2

Public Safety EAP - For Career Professional Fire Fighters

• Announcement about the program
• Letter from the Oregon State Fire Fighters Council announcing the program and partnership
• Program flyer explaining the benefits
• Flyer with information about how to access these benefits
• Public Safety EAP Video