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Group Agents
- Quotes (2-50)
- Quotes (51+)
- Corporate Reports
- Medical Plans
- Dental Plans
- Enrollment
- News
- Forms & Resources
- 503-243-3948 or
800-578-1402
Forms & Resources
Resources
- Provider Search
- Explanation of Benefits
- Medical and Dental Reports
- ODS Rx2.0 Prior Authorization list
- ODS Rx2.0 Preferred Drug List
- ODS Rx2.0 FAQ
- ODS Rx1.0 Prior Authorization list
- ODS Rx1.0 Preferred Drug List
Enrollment for Employer
- Group Application 2-50 (Excel)
- Group Application 2-50
- Group Application 51+ (Excel)
- Group Application 51+
- Preauthorized Payment Authorization Form
Enrollment for Employee
Group Size 2-4
Group Size 5-99
Group Size 100+
- Dental Only
- Medical Only
- Dual Medical
- Medical and Dental
- Dual Medical and Dental
- Dental and Vision
- Dual Medical w/PCP and Dental
Affidavit of Domestic Partnership
Declination of coverage
Oregon Continuation of Coverage
Renewal
- Oregon Group Profile Form
- Oregon Group Profile Form (Online version)
Quote Request
- Census Form (Excel)
- Census Form
- Proposal Request Form (Excel)
- Proposal Request Form
- Business Verification Statement Requirement (2-4pp)
Claims
- Medical Claim Form
- Dental Claim Form
- Prescription Drug Claim Form for Major Medical Plans
- Prescription Drug Claim Form for Med Impact Plans
- Prescription Compound Drug Claim Form
- Tobacco Cessation Claim Form