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BENEFIT SUMMARIES AND FORMS

Forms and Materials

Plan Summaries

Medical

Pharmacy

Ancillary Benefits

Vision

Dental

Plan 1000
Plan 1500
Preventive Only
Orthodontia 1500 (Only available to groups with 26+ enrolled)

Spanish Plan Summaries

Ancillary Benefits

Alternative & Chiropractic (HSA option)

No-Cost Extras for PacificSource Members

PacificSource members have access to extra benefits and services as part of their medical coverage.

PacificSource Value-Added Programs and Services
PacificSource Extras member flier (for groups with 51 or more employees)
The Forms and Materials for Oregon Agents page provides links to download sales and member fliers for many of our value-added programs and services.

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