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Oregon Small Business Groups

Enrollment and Change Application

Open Enrollment Medical Plan Change Request Form

Renewal Election Form

Group Plan Contract Application

Group Plan contract applications must be completed and signed by the Employer Group and Broker at time of enrollment and submitted along with a check for first month's premium and enrollment forms. For renewals, this form must be completed and signed by the Employer Group and submitted to SBG Account Management for processing.

New Group Implementation Forms

Pharmacy

This kit is for members only and may not be included in Open Enrollment Kits.

Pharmacy Reimbursement Form

Pharmacy Reimbursement Form (PDF)

Continuation of Coverage Forms

HIPAA Disclosures

Additional Forms and Materials

CommunityCare 1T Plans

Available to Oregon groups located in Multnomah, Clackamas, Washington, Clatsop, Columbia, and Tillamook counties.

CommunityCare 3T Plans

Available to Oregon groups located in Multnomah, Clackamas, Washington, Clatsop, Columbia, and Tillamook counties.

PPO Plans

Available to Oregon groups statewide.

PPO High Deductible Plans

Available to Oregon groups statewide.

PPO Standard Plans

Available to Oregon groups statewide.

CommunityCare 1T Plans

Available to Oregon groups located in Multnomah, Clackamas, Washington, Clatsop, Columbia, and Tillamook counties.

CommunityCare 3T Plans

Available to Oregon groups located in Multnomah, Clackamas, Washington, Clatsop, Columbia, and Tillamook counties.

PPO Plans

Available to Oregon groups statewide.

PPO High Deductible Plans

Available to Oregon groups statewide.

PPO Standard Plans

Available to Oregon groups statewide.

CommunityCare 1T Plans

Available to Oregon groups located in Multnomah, Clackamas, Washington, Clatsop, Columbia, and Tillamook counties.

CommunityCare 3T Plans

Available to Oregon groups located in Multnomah, Clackamas, Washington, Clatsop, Columbia, and Tillamook counties.

PPO Plans

Available to Oregon groups statewide.

PPO High Deductible Plans

Available to Oregon groups statewide.

PPO Standard Plans

Available to Oregon groups statewide.

Health Care Reform

Preventive Care and Screenings (Facts about ACA-Covered Services) (PDF)

PDF provides detailed instructions for distribution and reproduction of the Summary of Benefits and Coverage form required under the Affordable Care Act.

Summary of Benefits and Coverage (SBC) Employer Group Instructions Sheet (PDF)

CommunityCare

Additional Tools

Uniform Glossary of Health Coverage and Medical Terms

Health insurance companies and group health plans are required to make available a uniform glossary of health coverage and medical terms commonly used in plan documents. The Uniform Glossary is meant to help the consumer understand some of the most common language used in health insurance documents. Please log in to request a hard copy of the document by mail.

Are your clients looking for greater convenience, service and choice in consumer directed health care benefits? We have partnered with HealthEquity for HSA integration alongside our Small group high deductible health plans (HDHP’s). A proven expert in financial arrangement integration and administration, HealthEquity offers easy-to-use tools and comprehensive resources.

Learn more about HealthEquity HSA Plans on the HealthEquity website. Go to HealthEquity sales resource site.