To view, fill out and print the forms on this page, you will need the latest version of Adobe Acrobat Reader, which can be downloaded. However, Adobe Acrobat Reader does not allow you to save your completed, or partially completed, forms to a disk or on your computer. For that expanded capability you will need to have the complete Adobe Acrobat software package, version 5.0 or later.
Enrollment/change of status/waiver of coverage forms
Oregon small groups
Choose your small group plan:
Oregon large groups
Choose your large group plan:
- 2020 Choice, HSA, Option Advantage Base, Option Advantage Plus (A), Option Advantage B (Premium), or Integrated HSA plans (PDF)
- 2020 Connect plans (PDF)
- 2020 Choice, HSA, Option Advantage Base, Option Advantage Plus (A), Option Advantage B (Premium), or Integrated HSA plans – Spanish (PDF)
- 2020 Connect plans – Spanish (PDF)
Forms for all groups
Oregon small-group forms
Continuation of coverage forms
Termed members may be eligible for continued coverage. The following resources will help administrators determine continuation of coverage eligibility and steps to take to continue coverage.
Health information disclosure forms for all groups