Providence

Product Portfolio

Oregon Plans - Groups sized 51+

Effective:  January 01, 2021 - December 31, 2021

  Effective:  January 01, 2021 - December 31, 2021

Product Type

Annual Deductible

Benefit

Providence Option Advantage Base

Option Advantage Base$1000OP ADV BASE 20/20/40/3500/1000sd/30/250/2X/SIG
$2500OP ADV BASE 20/20/40/6350/2500cd/30/250/2X/SIG
$4000OP ADV BASE 35/30/50/7900/4000sd/45/250/2X/SIG
$5000OP ADV BASE 25/20/40/7900/5000sd/35/250/2X/SIG
$5000OP ADV BASE 35/20/40/7900/5000cd/45/250/2X/SIG
$5000OP ADV BASE 35/30/50/7900/5000sd/45/250/2X/SIG

Providence Option Advantage Plus

Option Advantage Plus$500OP ADV PLUS 15/20/40/3500/500cd/25/250/2X/SIG
$500OP ADV PLUS 20/20/50/6850/500sd/30/250/2X/XPPO
$500OP ADV PLUS 25/20/40/2000/500cd/35/250/2X/SIG
$500OP ADV PLUS 25/20/40/4000/500sd/35/250/2X/SIG
$1000OP ADV PLUS 20/20/40/7900/1000sd/30/250/2X/SIG
$1000OP ADV PLUS 25/20/40/4000/1000cd/35/250/2X/SIG
$1000OP ADV PLUS 25/30/50/3500/1000cd/35/250/2X/SIG
$1000OP ADV PLUS 35/20/40/4000/1000cd/45/250/2X/SIG
$1500OP ADV PLUS 15/20/40/3500/1500sd/25/250/2X/SIG
$1500OP ADV PLUS 25/20/40/4000/1500cd/35/250/2X/SIG
$1500OP ADV PLUS 25/30/50/7900/1500cd/35/250/2X/SIG
$1500OP ADV PLUS 35/30/50/5000/1500cd/45/250/2X/SIG
$2000OP ADV PLUS 20/20/40/4000/2000cd/30/250/2X/SIG
$2000OP ADV PLUS 20/20/40/6000/2000cd/20/250/2X/XPPO
$2000OP ADV PLUS 20/30/50/7900/2000sd/30/250/2X/SIG
$2000OP ADV PLUS 25/30/50/7900/2000cd/35/250/2X/SIG
$2500OP ADV PLUS 15/20/40/6350/2500sd/25/250/2X/SIG
$2500OP ADV PLUS 25/30/50/7900/2500sd/35/250/2X/SIG
$2500OP ADV PLUS 35/20/40/6350/2500sd/45/250/2X/SIG
$3000OP ADV PLUS 20/20/40/6350/3000sd/30/250/2X/SIG
$3000OP ADV PLUS 20/30/50/7900/3000sd/30/250/2X/SIG
$3000OP ADV PLUS 25/30/50/6350/3000cd/35/250/2X/SIG
$3000OP ADV PLUS 35/30/50/7900/3000cd/45/250/2X/SIG
$3500OP ADV PLUS 35/20/40/6850/3500cd/45/250/2X/SIG
$4000OP ADV PLUS 35/30/50/7900/4000cd/45/250/2X/SIG
$5000OP ADV PLUS 20/20/40/7900/5000sd/30/250/2X/SIG
$5000OP ADV PLUS 25/30/50/8150/5000sd/35/250/2X/SIG
$5000OP ADV PLUS 35/20/40/7900/5000cd/45/250/2X/SIG
$5000OP ADV PLUS 35/30/50/7900/5000cd/45/250/2X/SIG

Providence Option Advantage Premium

Option Advantage Premium$250OP ADV PREM 25/20/40/3500/250sd/25/200/2X/XPPO
$500OP ADV PREM 15/20/40/2500/500sd/15/250/2X/SIG
$750OP ADV PREM 20/20/40/2500/750sd/20/200/2X/SIG
$750OP ADV PREM 20/20/40/3000/750sd/20/250/2X/SIG
$1000OP ADV PREM 15/10/20/2000/1000cd/15/250/2X/SIG
$1000OP ADV PREM 15/20/40/2500/1000sd/15/250/2X/SIG
$1500OP ADV PREM 20/20/50/5500/1500sd/20/250/2X/XPPO
$1500OP ADV PREM 25/20/40/7900/1500sd/25/250/2X/SIG
$1500OP ADV PREM 25/20/40/4000/1500cd/25/250/2X/XPPO
$2000OP ADV PREM 25/20/40/3500/2000sd/25/250/2X/SIG
$2000OP ADV PREM 25/20/40/4000/2000sd/25/250/2X/SIG
$2500OP ADV PREM 25/20/40/7900/2500sd/25/250/2X/SIG
$2500OP ADV PREM 35/30/50/6350/2500sd/35/250/2X/XPPO
$3000OP ADV PREM 25/20/40/6350/3000sd/25/250/2X/SIG
$3000OP ADV PREM 25/20/40/7900/3000sd/25/250/2X/SIG
$4000OP ADV PREM 25/20/40/7900/4000sd/25/250/2X/SIG

Providence Personal Option

Personal Option$1500PE 15/30/3000/1500d/25/250/2X/SIG

Providence HSA

HSA Plan$1500HSA 20/40/3000/1500cd/20/20/2X/SIG
$1500HSA 20/40/3000/1500cd/20/20/2X/XPPO
$1500HSA 20/40/4000/1500cd/20/20/2X/SIG
$1500HSA 20/40/4000/1500sd/20/20/2X/SIG
$1500HSA 20/40/5500/1500cd/20/20/2X/SIG
$1500HSA 20/40/5500/1500sd/20/20/2X/SIG
$1500HSA 20/40/6750/1500cd/20/20/2X/SIG
$2000HSA 20/40/5000/2000cd/20/20/2X/SIG
$2000HSA 20/40/5000/2000sd/20/20/2X/SIG
$2000HSA 20/40/5500/2000cd/20/20/2X/SIG
$2500HSA 20/40/5500/2500sd/20/20/2X/SIG
$2500HSA 20/40/6750/2500sd/20/20/2X/SIG
$2500HSA 20/50/5000/2500sd/20/20/2X/XPPO
$2500HSA 30/50/6750/2500sd/30/30/2X/SIG
$3000HSA 0/0/3000/3000sd/0/0/2X/SIG
$3000HSA 20/40/5500/3000cd/20/20/2X/SIG
$3000HSA 20/40/6750/3000sd/20/20/2X/SIG
$3000HSA 20/40/6900/3000sd/20/20/2X/SIG
$3000HSA 50/50/4000/3000cd/50/50/2X/SIG
$3500HSA 20/40/5500/3500sd/20/20/2X/SIG
$3500HSA 20/40/6750/3500cd/20/20/2X/SIG
$3500HSA 20/40/6900/3500cd/20/20/2X/SIG
$4000HSA 20/40/6750/4000cd/20/20/2X/SIG
$4000HSA 30/50/6900/4000sd/30/30/2X/SIG
$4000HSA 50/50/6750/4000sd/50/50/2X/SIG
$5500HSA 0/0/5500/5500sd/0/0/2X/SIG
$5500HSA 20/40/6750/5500cd/20/20/2X/SIG
$5500HSA 20/40/6900/5500cd/20/20/2X/SIG
$5500HSA 50/50/6750/5500sd/50/50/2X/SIG
$6650HSA 0/0/6650/6650sd/0/0/2X/SIG

Providence HSA Embedded

HSA Embedded$3000HSA E 20/40/5500/3000sd/20/20/2X/SIG
$3000HSA E 20/40/6900/3000cd/20/20/2X/SIG
$5500HSA E 0/0/5500/5500cd/0/0/2X/SIG

Providence Connect

Connect$500CNC 10/20/40/2500/500sd/20/250/2X/CNC
$500CNC 15/20/40/3000/500sd/30/250/2X/CNC
$500CNC 25/30/50/3000/500sd/50/250/2X/CNC
$750CNC 25/20/40/5000/750sd/50/250/2X/CNC
$1000CNC 15/20/40/2000/1000sd/30/250/2X/CNC
$1000CNC 15/20/40/3000/1000sd/30/250/2X/CNC
$1000CNC 15/20/40/3500/1000sd/30/250/2X/CNC
$1000CNC 15/20/40/6350/1000sd/30/250/2X/CNC
$1000CNC 25/20/30/4000/1000sd/35/250/3X/CNC
$1000CNC 25/20/40/4000/1000sd/50/250/2X/CNC
$1000CNC 25/20/40/6350/1000sd/50/250/2X/CNC
$1000CNC 25/30/50/6350/1000sd/50/250/2X/CNC
$1000CNC 30/20/50/6850/1000sd/30/250/2X/CNC
$2000CNC 15/20/40/4000/2000sd/30/250/2X/CNC
$2000CNC 15/20/40/5000/2000sd/30/250/2X/CNC
$2000CNC 25/20/40/3500/2000sd/50/250/2X/CNC
$2000CNC 25/20/40/4000/2000sd/50/250/2X/CNC
$2000CNC 25/20/40/6350/2000sd/50/250/2X/CNC
$2000CNC 25/30/50/4000/2000sd/50/250/2X/CNC
$2000CNC 25/30/50/6350/2000sd/50/250/2X/CNC
$2000CNC 35/20/40/5000/2000sd/45/250/2X/CNC
$3000CNC 25/20/40/5000/3000sd/50/250/2X/CNC
$3000CNC 25/20/40/6350/3000sd/50/250/2X/CNC
$3000CNC 25/30/50/6350/3000sd/50/250/2X/CNC
$3000CNC 25/30/50/7900/3000sd/50/250/2X/CNC
$3000CNC 25/35/50/8150/3000sd/50/450/2X/CNC
$3000CNC 30/20/50/6850/3000sd/30/250/2X/CNC
$3000CNC 35/20/40/6350/3000sd/70/250/2X/CNC
$3000CNC 35/30/50/7900/3000sd/70/250/2X/CNC
$4000CNC 25/20/40/7900/4000sd/50/250/2X/CNC
$4000CNC 25/30/50/7900/4000sd/50/250/2X/CNC
$4000CNC 35/30/50/7900/4000sd/70/250/2X/CNC
$5000CNC 35/30/50/8150/5000sd/70/250/2X/CNC
$6000CNC 25/30/50/7900/6000sd/50/250/2X/CNC

Providence Choice

Choice$500CHC 20/20/50/3500/500sd/30/250/2X/CHC
$1500CHC 20/20/50/5500/1500sd/30/250/2X/CHC
$1500CHC 20/30/50/4000/1500sd/40/250/2X/CHC
$1500CHC 25/30/50/4000/1500sd/50/250/2X/CHC
$2000CHC 25/30/50/6350/2000sd/50/250/2X/CHC
$2000CHC 25/30/50/7900/2000sd/50/250/2X/CHC
$3000CHC 25/20/40/7900/3000sd/50/250/2X/CHC
$3000CHC 25/20/40/8150/3000sd/50/250/2X/CHC
$3000CHC 25/30/50/7900/3000sd/50/250/2X/CHC
$3000CHC 25/30/50/8150/3000sd/50/250/2X/CHC
$3000CHC 40/20/50/7000/3000sd/40/200/2X/CHC

 

Group Riders

Product Type

Benefit

DentalProvidence Preventive Dental
Essential Dental
Essential Access Dental
Essential Dental Plus
Essential Access Dental Plus
Advantage Access 1500 Dental
Advantage Access 2000 Dental
Advantage Access 1500 Dental Plus
Advantage Access 2000 Dental Plus