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HSA 3000

HSA plans offer lower insurance premiums through a high deductible health plan coupled with a bank account in which you accumulate tax-advantaged savings through your contributions to pay for qualified medical expenses until your deductible is met.

Benefit Summary
Plan yearThe 12-month period commencing on the effective date and each 12-month period thereafter. deductible options $3,000 (individual) $6,000 (family)(1)
  Member Responsibility
In Network Out of Network
Out-of-pocketA specified amount of applicable claims expenses in a plan year that must be met before benefits are paid in full. Once the member has met his or her out-ofpocket maximum, the plan begins covering eligible expenses at 100 percent. The out-of-pocket maximum starts over every plan year. maximum, per person for services other than preventive care $0 no maximum
Out-of-pocket maximum, for preventive care services only $2000 (individual)
/$4000 (family		 no maximum
Preventive Care
Annual women's exam — pap, pelvic, breast 50%* 50%
Women's routine mammogram 50%* 50%
Well-baby care 50%* 50%
Routine physical exams 50%* 50%
Immunizations 50%* 50%

*DeductibleThe portion of an individual's applicable healthcare expenses that must be paid by the member in a given year before the insurance plan will start paying for treatment. waived.

(1)Family deductible can be met by 1 or more family members. This deductible must be met before benefits will be paid.

This is a benefit summary only. For a complete description of benefits, refer to your Policy. Effective December 1, 2009 through October 31, 2010
Professional Services
Office visits 0% 50%
Alternative Care ($1000 Annual Benefit Maximum):
Chiropractic, Naturopathic and Acupuncture		 0% 50%
Maternity
All pre/post office visits and doctor delivery; hospital charges 0% 50%
Hospital Services
Inpatient and outpatient surgery; room, ancillary and
physician charges; skilled nursing facility care		 0% 50%
Emergency Services
Urgent care 0% 50%
Emergency room (deductible applies) 0% 0%
Ambulance 0
Other Facilities and Services
Lab and X-ray services; rehabilitation services; medical supplies and devices; in-hospital care; home healthcare 0% 50%
Prescription services 0%

Lifetime maximum

 $2,000,000
($250,000 out-of-network)
Accident benefit Paid as any other illness subject to deductible/coinsurance.
Value-Added Services

When you join ODS, you get health plans enhanced by a wide variety of helpful value-added services. Medical members have access to:

  • myODS, a personalized website allowing you to manage your own plan.
  • WorldDoc, a personalized website allowing you to improve your health and reduce your healthcare costs..
  • eDocAmerica a secure account for emailing health questions and concerns directly to a physician.
  • Registered Nurse Advice Line, a toll free number providing access to a nurse's advice 24 hours a day.
  • PersonalHealth Rx, online access to detailed claims history, benefit information and tax reports.
  • Free & Clear, a tobacco reduction program.

In addition to these tools, you'll discover benefit plans that are actually easy to understand. And teams of ODS Health Professionals dedicated to your healthy, happy life.

All of our health plans include access to the largest directly contracted PPO medical provider network in Oregon. With more than 11,000 providers in the ODS Network participating across all specialties — including primary care, surgery, radiology, anesthesiology, vision, chiropractic, naturopathic and acupuncture — your service needs have been anticipated.