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Right Angle Digital Print and Supply

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Employee Benefit Programs
Documents and Resources 2024


Providence Health Plan
Connect 9450 Benefit Summary
Connect 9450 Summary of Benefits and Coverage
Connect 6900 Benefit Summary
Connect 6900 Summary of Benefits and Coverage
Balance 2500 Benefit Summary
Balance 2500 Summary of Benefits and Coverage
Enrollment/Change Form – Connect
Enrollment/Change Form – Balance
Provider Directory – Connect
Provider Directory – Balance
Pharmacy resources
About Providence
Customer Service
MyProvidence
MyChart
LifeBalance
Virtual Care
How to use your benefits
ProvRN
Employee Assistance Program

Notices
ACA Exchange Model Notice
Medicare Non-Creditable Pharmacy Notice Connect 9450
Medicare Creditable Pharmacy Notice Connect 6900
Medicare Creditable Pharmacy Notice Balance 2500
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 on the day following 90 days of working the required amount of hours


Open enrollment is from December 1st through December 31st for a January 1st start date


Employer pays 50% for employee only on the Providence Connect 9450 plan, and employees can enroll in the buy-up plans with extra premium contributions and enroll dependents with extra premium contributions



Premium Contributions

Premium Contribution Reference Sheet 2024

IRS Forms
Form W-4
Form I-9

Account Manager and Support Staff Contact Information
Stuart Ouellette – Agent
Contact Katie Ostgarden – Account Manager
Contact Sarah Selix – Assistant

We make finding affordable insurance easy. We shop the market for the provider with the lowest price to fit your needs. Do you know if you are saving the maximum amount possible on your current insurance policy? We can review it for you to find out.

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