HSA Value

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
	Member Responsibility
Plan yearThe 12-month period commencing on the effective date and each 12-month period thereafter. deductible options	$2,800 (individual) $5,600 (family)⁽¹⁾
	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 (after deductible)	$2,200 (individual) $4,400 (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 applies when an individual and a spouse or one (1) or more dependents are enrolled. Therefore, prior to benefits being paid, the entire family deductible must be met. 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	50%	50%
Alternative Care ($1000 Annual Benefit Maximum): Chiropractic, Naturopathic and Acupuncture	50%	50%
Maternity
All pre/post office visits and doctor delivery; hospital charges	50%	50%
Hospital Services
Inpatient and outpatient surgery; room, ancillary and physician charges; skilled nursing facility care	50%	50%
Emergency Services
Urgent care	50%	50%
Emergency room (deductible applies)	50%
Ambulance	50%
Other Facilities and Services
Lab and X-ray services; rehabilitation services; medical supplies and devices; in-hospital care; home healthcare	50%	50%
Prescription services	50%
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.

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