Performance Race Engineering, Inc. 
Employee Benefit Programs
Documents and Resources December 2022 - November 2023

Providence Health Plan
Balance 8000 Bronze Benefit Summary
Balance 8000 Bronze Summary of Benefits and Coverage
Balance 4000 Silver Benefit Summary
Balance 4000 Silver Summary of Benefits and Coverage
Balance 1500 Gold Benefit Summary
Balance 1500 Gold 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

Companion Life Dental
Enrollment Form
Benefit Summary
Find a Dentist
Employee Online Account Access

Notices
ACA Exchange Model Notice
Medicare Non-Creditable Pharmacy Disclosure Balance 8000 Bronze
Medicare Creditable Pharmacy Disclosure Balance 4000 Silver
Medicare Creditable Pharmacy Disclosure Balance 1500 Gold
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

Oregon Paid Leave Program
Paid Leave Model Notice-Poster

Eligibility
40 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 for the Medical and Dental plan is from December 1st through December 31st annually
Employer pays 50% on the Providence Standard Bronze Plan, employees can elect Silver or Gold as a buy-up option
Employee's can enroll dependents with premium contributions
Employees can enroll in the dental plan with full premium contribution, as well as their dependents

Premium Contributions
Premium Contribution Reference Sheet

Contact Paris Laughlin
Contact Katie Ostgarden
Contact Rachel Laughlin
Contact Sarah Selix - Assistant
Contact Providence (503) 574-7500