SDIS Benefit Applications

• Regence Application 
• Moda Application (Dental) 
• Willamette Dental Application
• Standard Insurance Application 
• Cobra and Disability Forms: Contact SDAO

OFCA Benefit Applications

• OFCA Moda Medical and Dental Application
• Standard Insurance Application 
• Cobra and Disability Forms: Contact SDAO

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
• Women's Health and Cancer Rights Act of 1998 Enrollment Notice / Model WHCRA Enrollment Notice
• Creditable Prescription Drug Coverage and Medicare / Model Creditable Coverage Disclosure Notice
• General Notice of COBRA Continuing Coverage and Rights / DOL Model COBRA Notice

Additional Notices

• Community Wellness Benefit

Summary Plan Documents

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  

Delta Dental Premier Plan: 

• Constant with Pediatric Plan
• Incentive with Pediatric Plan

Willamette Dental Plans:

• Standard III
• Enhanced IV
• Willamette Dental Privacy Notice

OFCA Plans

Regence BlueCross BlueShield of Oregon

• OFCA Medical Plan 1
• OFCA Medical Plan 2
• OFCA Medical Plan 3
• OFCA Medical Plan 4
• OFCA Medical Plan 5
• OFCA Medical Plan 6

Dental 

• OFCA Dental Plan 1
• OFCA Dental Plan 2
• OFCA Orthodontia Benefit (if applicable)

Redmond Fire District

• Redmond Fire Medical Plan 2P
• Redmond Fire Medical Plan 3P
• Redmond Fire Dental Plan

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