Employee Benefits
2024 SDIS Benefit Coverage Annual Meeting - Webinar
- Click Here to view the webinar recording.
SDIS Benefit Applications
- Regence Application
- Moda Application (Dental)
- Willamette Dental Application
- Standard Insurance Application
- Cobra and Disability Forms: Contact SDAO
- Regence Member Reimbursement Form
- Express Scripts Brochure and Order Form
OFCA Benefit Applications
- OFCA Regence Medical and Moda Dental Application
- Standard Insurance Application
- Cobra and Disability Forms: Contact SDAO
- Regence Member Reimbursement Form
- Express Scripts Brochure and Order Form
Employee Benefit Plan Documents
- 2023-2024 SDIS Health Benefits Guide
- 2023-2024 OFCA Fire Districts Benefits Guide
- SDIS Employee Benefits Plan
- SDIS Medical and Dental Coverage Participating Employer Agreement
- OFCA Medical and Dental Coverage Participating Employer Agreement
Required Notices
- Notice of Privacy Practices
- HIPAA Health Information Privacy Policies Manual
- HIPAA Electronic Security Policies Manual
- Premium Assistance Under Medicaid and the Children's Health Insurance Program (CHIP) / DOL Model Employer CHIP Notice
- Women's Health and Cancer Rights Act of 1998 Notice / Model WHCRA Annual Notice
- Creditable Prescription Drug Coverage and Medical / Model Creditable Coverage Disclosure Notice
- General Notice of COBRA Continuing Coverage and Rights / DOL Model COBRA Notice
- New Health Insurance Marketplace Coverage Options and Your Health Coverage
Transparency in Coverage - Machine-Readable Files (MRF's)
The following link leads to the machine-readable files that are made available in response to the Federal Transparency in Coverage Rule, and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.
Regence Links & Flyers
- Active Fit
- Behavioral Health
- Community Wellness Benefit
- Hinge Health Overview Flyer
- Hinge Health - Video
- MDLive Flyer
- Omada Diabetes Flyer
- Omada FAQ Flyer
- Omada Health
- Regence Babywise Member Program
- Regence Bluecard Brochure
- Regence Empower Program
- Regence Member Registration and Express Scripts Registration
- Regence Provider Search
- Regence Provider Search Link
Regence Rx Links & Flyers
- Express Scripts - Accredo Brochure and Order Form
- Pharmacy and Mail Order Website Navigation
- Regence Search by RX
VSP Vision Flyer
MODA/DELTA Dental Links & Flyers
- Moda Account Registration
- Moda Dental - Member Registration & Dashboard
- Moda Dental - Oral Health
- Moda Dental Teledentistry Flyer
- Moda Provider Seach Link
Willamette Dental Group Links & Flyers
- Willamette Dental Group Enrollment Guide
- Willamette Dental Group Links
- Willamette Dental Group Welcome Letter
Canopy EAP Links & Flyers - (for non-Public Safety Districts)
Public Safety EAP Links & Flyers - (for career Emergency & Fire Fighters)
- Announcement About the Program
- Flyer with information about how to access these benefits
- Letter from the Oregon State Fire Fighters Council announcing the program and partnership
- Program flyer explaining the benefits
- Public Safety EAP Video
Summary Plan Documents
2024 SDIS Plan Summaries
Regence BlueCross BlueShield of Oregon
- Blue Plan II Red Plan C
- Blue Plan IIA Red Plan D
- Blue Plan III Red Plan E
- Blue Plan IV Red Plan F
- Blue Plan V Red Plan H
- Blue Plan VI Red Plan J
- Blue Plan VII Red Plan K
Red Plan L
2024 SDIS SBC's
Regence BlueCross BlueShield of Oregon
- HSA Medical Plan
- Blue Plan II SBC Red Plan C SBC
- Blue Plan IIA SBC Red Plan D SBC
- Blue Plan III SBC Red Plan E SBC
- Blue Plan IV SBC Red Plan F SBC
- Blue Plan V SBC Red Plan H SBC
- Blue Plan VI SBC Red Plan J SBC
- Blue Plan VII SBC Red Plan K SBC
Red Plan L SBC
2024 SDIS Dental
Moda/Delta Dental
- Moda Constant 1500
- Moda Constant with Ortho 1500
- Moda Incentive 1500
- Moda Incentive with Ortho 1500
- Moda Constant Plan 2000
- Moda Constant with Ortho 2000
- Moda Incentive Plan 2000
- Moda Incentive with Ortho 2000
Willamette Dental Group
2023 SDIS Booklet's
- HSA Medical Plan
- Blue Plan II - Booklet Red Plan C - Booklet
- Blue Plan IIA - Booklet Red Plan D - Booklet
- Blue Plan III - Booklet Red Plan E - Booklet
- Blue Plan IV - Booklet Red Plan F - Booklet
- Blue Plan V - Booklet Red Plan H - Booklet
- Blue Plan VI - Booklet Red Plan J - Booklet
- Blue Plan VII - Booklet Red Plan K - Booklet
Red Plan L - Booklet
Dental
- 2023 Constant Plan 1500 - Handbook
- 2023 Incentive Plan 1500- Handbook
- 2023 Constant Plan 2000 - Handbook
- 2023 Incentive Plan 2000 - Handbook
- 2023 Willamette Dental - Handbook
- 2023 WDG Member Enrollment Guide
2024 OFCA Plans
Regence BlueCross BlueShield of Oregon
- OFCA HSA Plan Summary
- OFCA Pharmacy Benefits Summary
- OFCA Medical Plan 1 Summary
- OFCA Medical Plan 1V Summary
- OFCA Medical Plan 2 Summary
- OFCA Medical Plan 2V Summary
- OFCA Medical Plan 3 Summary
- OFCA Medical Plan 3V Summary
- OFCA Medical Plan 4 Summary
- OFCA Medical Plan 4V Summary
- OFCA Medical Plan 5 Summary
- OFCA Medical Plan 5V Summary
- OFCA Medical Plan 6 Summary
- OFCA Medical Plan 6V Summary
OFCA Rx Plans
OFCA Moda/Delta Dental
- OFCA Moda Option 1 Incentive 1500
- OFCA Moda Option 1 Incentive with Ortho 1500
- OFCA Moda Option 2 Constant 1500
- OFCA Moda Option 2 Constant with Ortho 1500
- OFCA Moda Option 3 Constant 2000
- OFCA Moda Option 3 Constant with Ortho 2000
- OFCA Moda Option 4 Incentive 2000
- OFCA Moda Option 4 Incentive with Ortho 2000
2024 OFCA SBC's
Plan Year
- OFCA HSA SBC
- OFCA HSA VIS SBC
- OFCA Plan Year 1 - RX1
- OFCA Plan Year 1 - RX1 VIS
- OFCA Plan Year 1 - RX2
- OFCA Plan Year 1 - RX2 VIS
- OFCA Plan Year 1 - RX3
- OFCA Plan Year 1 - RX3 VIS
- OFCA Plan Year 2 - RX1
- OFCA Plan Year 2 - RX1 VIS
- OFCA Plan Year 2 - RX2
- OFCA Plan Year 2 - RX2 VIS
- OFCA Plan Year 2 - RX3
- OFCA Plan Year 2 - RX3 VIS
- OFCA Plan Year 3 - RX1
- OFCA Plan Year 3 - RX1 VIS
- OFCA Plan Year 3 - RX2
- OFCA Plan Year 3 - RX2 VIS
- OFCA Plan Year 3 - RX3
- OFCA Plan Year 3 - RX3 VIS
- OFCA Plan Year 4 - RX1
- OFCA Plan Year 4 - RX1 VIS
- OFCA Plan Year 4 - RX2
- OFCA Plan Year 4 - RX2 VIS
- OFCA Plan Year 4 - RX3
- OFCA Plan Year 4 - RX3 VIS
- OFCA Plan Year 5 - RX1
- OFCA Plan Year 5 - RX1 VIS
- OFCA Plan Year 5 - RX2
- OFCA Plan Year 5 - RX2 VIS
- OFCA Plan Year 5 - RX3
- OFCA Plan Year 5 - RX3 VIS
- OFCA Plan Year 6 - RX1
- OFCA Plan Year 6 - RX1 VIS
- OFCA Plan Year 6 - RX2
- OFCA Plan Year 6 - RX2 VIS
- OFCA Plan Year 6 - RX3
- OFCA Plan Year 6 - RX3 VIS
2023 OFCA Booklets
Plan Year
- OFCA Plan Year HSA Booklet
- OFCA Plan Year HSA - VIS Booklet
- OFCA Plan Year 1 - RX1 Booklet
- OFCA Plan Year 1 - RX1 VIS Booklet
- OFCA Plan Year 1 - RX2 Booklet
- OFCA Plan Year 1 - RX2 VIS Booklet
- OFCA Plan Year 1 - RX3 Booklet
- OFCA Plan Year 1 - RX3 VIS Booklet
- OFCA Plan Year 2 - RX1 Booklet
- OFCA Plan Year 2 - RX1 VIS Booklet
- OFCA Plan Year 2 - RX2 Booklet
- OFCA Plan Year 2 - RX2 VIS Booklet
- OFCA Plan Year 2 - RX3 Booklet
- OFCA Plan Year 2 - RX3 VIS Booklet
- OFCA Plan Year 3 - RX1 Booklet
- OFCA Plan Year 3 - RX1 VIS Booklet
- OFCA Plan Year 3 - RX2 Booklet
- OFCA Plan Year 3 - RX2 VIS Booklet
- OFCA Plan Year 3 - RX3 Booklet
- OFCA Plan Year 3 - RX3 VIS Booklet
- OFCA Plan Year 4 - RX1 Booklet
- OFCA Plan Year 4 - RX1 VIS Booklet
- OFCA Plan Year 4 - RX2 Booklet
- OFCA Plan Year 4 - RX2 VIS Booklet
- OFCA Plan Year 4 - RX3 Booklet
- OFCA Plan Year 4 - RX3 VIS Booklet
- OFCA Plan Year 5 - RX1 Booklet
- OFCA Plan Year 5 - RX1 VIS Booklet
- OFCA Plan Year 5 - RX2 Booklet
- OFCA Plan Year 5 - RX2 VIS Booklet
- OFCA Plan Year 5 - RX3 Booklet
- OFCA Plan Year 5 - RX3 VIS Booklet
- OFCA Plan Year 6 - RX1 Booklet
- OFCA Plan Year 6 - RX1 VIS Booklet
- OFCA Plan Year 6 - RX2 Booklet
- OFCA Plan Year 6 - RX2 VIS Booklet
- OFCA Plan Year 6 - RX3 Booklet
- OFCA Plan Year 6 - RX3 VIS Booklet
Dental
SDIS Life Insurance Plans
Standard Insurance Short Term Disability Plans
Standard Insurance Long Term Disability Plans