Reform update

As a result of the Affordable Care Act, important changes are coming to health care coverage in 2014.

It's difficult to compare the new health care plans with the plans offered today. Given the new government requirements, the plans for 2014 require higher benefit levels, defined member cost-sharing and no medical underwriting, which all affect rates and premiums. New plan features:

  • A broad range of mandated benefits will be covered under "Essential Health Benefits"
  • Many preventive care services will be covered in full
  • Dental and vision benefits that were previously excluded from medical plans are now included
  • Deductibles and out-of-pocket expenses will be capped at much lower levels than they are today
  • Everyone will qualify for coverage, even if they have a pre-existing condition
  • Premium rates among all ages ranges will be evened out to reduce the difference between premiums for older and younger members

Providence Health Plan filed rates and plans for coverage effective beginning Jan. 1, 2014 for individuals and families under age 65 and for small employer groups sized 1-50. These plans and rates will reflect the new, standardized medical benefits, cost-sharing and eligibility requirements as set by the Affordable Care Act and Cover Oregon.

The new Oregon health insurance marketplace will be more transparent than ever before. In 2014, subsidies and cost-sharing options will expand the number of people who have access to, and can better afford, health insurance. However, it's expected that the cost of broader benefits and eligibility will increase the vast majority of premiums for most carriers. Providence Health Plan will continue to provide clear, consistent information on what the premium cost includes.

The Oregon Insurance Division (OID) will publish all approved insurance carrier rates and plans the week of July 8 at

The timeframe during which individuals may purchase coverage for 2014 (called open enrollment) begins Oct. 1, 2013, for coverage that is effective beginning Jan. 1, 2014. Open enrollment for 2014 ends March 31, 2014. As October approaches , we will be sending all of our members more detailed information about the new products and about what decisions need to be made and by what dates.

Please check this site regularly for updates and additional information on health care reform.