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Melzer and Breckenridge PC
Melzer and Breckenridge PC
Employee Benefit Programs
Documents and Resources November 2022-October 2023
Providence Health Plan
Balance 2500 Gold Benefit Summary
Balance 2500 Gold Summary of Benefits and Coverage
Enrollment/Change Form
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Notices
ACA Exchange Model Notice
Medicare Creditable Pharmacy Disclosure
Paid Leave Model Notice-Poster
Eligibility and Contribution
30 hours per week on a regularly scheduled basis
Coverage begins first of the month following 60 days of working the required amount of hours
Open enrollment is from October 1st through October 15th annual for November 1st start date
Employer pays 50% for employee only on the Providence Balance 2500 Gold plan
Employees may enroll dependents on the plan with premium contributions
The Providence Balance 2500 Gold plan renews on November 1st each year
Account Manager and Support Staff Contact Information
Contact Katie Ostgarden - Account Manager
Contact Sarah Selix - Assistant