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Hessel Law Offices
Hessel Law Offices
Employee Benefit Programs
Documents and Resources 2023
Providence Health Plan
Balance 2500 Gold Benefit Summary
Advantage Access Dental Benefit Summary
Balance 2500 Gold Summary of Benefits and Coverage
Enrollment/Change Form
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125b Cafeteria Plan
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Notices
ACA Exchange Model Notice
State Continuation Notice
Medicare Creditable Pharmacy Disclosure
ERISA Wrap Document
Oregon Paid Leave Model Notice
Eligibility and Contribution
25 hours per week on a regularly scheduled basis
Coverage begins first of the month following 60 days
Open enrollment is from December 1st through December 31st annual for January 1st start date
Employer pays 50% for employee only on the Providence Balance 2500 health plan and the Providence Advantage Access Dental plan
Employees may enroll dependents on the plan with premium contributions
The Providence Balance 2500 Gold plan and Advantage Dental plan renew on January 1st each year
Premium Contribution Summary 2023
Account Manager and Support Staff
Paris Laughlin, Agent
Rachel Laughlin, Agent
Sarah Selix, Assistant