Accurate Auto 
Employee Benefit Programs
Documents and Resources December 2024 - November 2025

Providence Health Plan
Standard Silver Benefit Summary
Standard Silver Summary of Benefits and Coverage
Total Enhanced 500 Platinum Benefit Summary
Total Enhanced 500 Platinum Summary of Benefits and Coverage 
HSA 3500 Silver Benefit Summary
HSA 3500 Silver Summary of Benefits and Coverage 
Enrollment/Change Form
Provider directory
Pharmacy resources
About Providence
Customer Service
MyProvidence
MyChart
LifeBalance 
Virtual Care 
How to use your benefits
ProvRN
Employee Assistance Program

125b Cafeteria Plan
Summary Plan Description
Election Form
Change and Revocation Form
Pre-Tax Savings Calculator

Notices
ACA Exchange Model Notice
ERISA Wrap Notice
Medicare Creditable Pharmacy Disclosure
Primary Care Provider Model Disclosure
Notice of Rights Under The Women's Health and Cancer Rights Act (WHCRA)
HIPAA Special Enrollment Rights Notice
Premium Assistance under Medicaid and the Children's Health Insurance Program (CHIP)
Notice Regarding Patient Protections Against Surprise Billing
Paid Leave Model Notice-Poster

COBRA
COBRA General Model Notice

Eligibility and Contribution
30 hours per week on a regularly scheduled basis
Coverage begins first of the month following date of hire days of working the required amount of hours
Open enrollment is from Nov 1 through Nov 15 annual for Dec 1 start date
Employer pays 100% for employee only on the Providence Standard Silver plan, and employees can buy up to higher options with additional premium contributions
Employees may enroll dependents on the plan with premium contributions
The Providence plans renew on December 1st each year
Premium Contribution Summary 

Account Manager and Support Staff Contact Information
Contact Katie Ostgarden - Account Manager
Contact Sarah Selix - Assistant