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The Lucky Labrador Brew Pub, LTD
The Lucky Labrador Brew Pub, LTD
Employee Benefit Program Forms, Materials, and Resources 2023
Providence Health Plan
Standard Silver Benefit Summary
Standard Silver Summary of Benefits and Coverage
Enrollment and Waiver Form
Provider directory
Pharmacy resources
About Providence
Customer Service
MyProvidence
MyChart
LifeBalance
Virtual Care
How to use your benefits
ProvRN
Employee Assistance Program
Notices
Exchange Model Notice
Model Individual Creditable Coverage Disclosure Notice for Medicare Pharmacy
COBRA model-general-notice
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
Eligibility and Contribution
30 hours per week on a regularly scheduled basis
Coverage begins on first of the month following 60 days
Open enrollment is from December 1st through December 31st for a January 1st start date
Employer pays 85% for employees on the Providence Standard Silver plan
Employees may enroll dependents on the plan with premium contributions
Premium Contribution Summary
IRS Forms
I-9
W-4
Account Manager and Support Staff Contact Information
Paris Laughlin - Agent
Katie Ostgarden - Account Manager
Sarah Selix - Assistant