Your Benefits as a Clackamas County employee

Health Plan Coverage Notice

As the sponsor of group health plans, Clackamas County is required under various laws and regulations to provide certain notices about your rights related to health plan coverage. You do not need to do anything with regard to these notices. They are for your information only. If you have any questions regarding these notices, you may contact:

Clackamas County Human Resources
Attn: Benefits and Wellness Division
2051 Kaen Rd, Ste 310
Oregon City, OR 97045
503-655-8550
benefits@clackamas.us

Plan participants are responsible for providing a copy of this Notice to their Medicare eligible dependents covered under the plan.

2022 Required Notices

State and Federal authorities continue to issue guidance, orders and legislation resulting in benefit changes in response to COVID-19. Here is a summary of the changes we are tracking.

Clackamas County is committed to offering a high-quality benefits package to support employees and their families.

Below is a list of benefits available to regular status Clackamas County employees. Benefit eligibility for regular status employees is based on your employee group. You must enroll in any plan for which you also wish to enroll a dependent. Individual plans may have additional eligibility criteria. Benefit information is subject to change.

General County

94806

Choose from three medical plans.

  Kaiser Providence
Personal Option
Providence
Open Option
medical services in-network coverage only in-network coverage only in-network out of network
annual deductible - single/family $250/$500 $850/$1,700 $600/$1,200
annual out of pocket max - single/family $1,000/$2,000 $2,500/$5,000 $2,000/$4,000

office visit - primary and specialty

urgent care

$10 co-pay

$15 co-pay –covered in full after 30 visits

$15 co-pay

$15 co-pay –covered in full after 24 visits

$15 co-pay

30% co-insurance*
preventive care $0 co-pay $0 co-pay $0 co-pay 30% co-insurance*
inpatient hospital - including maternity 10% co-insurance 20% co-insurance 10% co-insurance 30% co-insurance
emergency room visit $75 co-pay $100 co-pay $100 co-pay $100 co-pay
X-ray & lab services $0 co-pay $0 co-pay $0 co-pay 30% co-insurance
outpatient surgery $10 co-pay 20% co-insurance 10% co-insurance 30% co-insurance
alternative care
chiropractic $10 co-pay
20 visit annual limit
$15 co-pay
30 visit annual limit
$15 co-pay
30 visit annual limit
not covered
massage $25 co-pay
12 visit annual limit
$15 co-pay
30 visit annual limit
$15 co-pay
30 visit annual limit
not covered
acupuncture $10 co-pay
12 visit annual limit
$15 co-pay
30 visit annual limit
$15 co-pay
30 visit annual limit
not covered
prescription drugs
generic $10 co-pay $10 co-pay $15 co-pay not covered
name brand $20 co-pay 50% ($150 max) $30 co-pay not covered
vision benefits
exam - every 12-months $10 co-pay $10 co-pay $10 co-pay see summary
contact lenses & frames - every 12-months $250 benefit $175 benefit $175 benefit see summary

*deductible waived

Print the side-by-side plan comparison

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94806

Choose from four dental plans.

  Kaiser Delta Dental
Preventive
Delta Dental
Incentive
Delta Dental
Constant
dental services in-network coverage in-network coverage in-network coverage in-network coverage
annual max benefit no max $2,000 $2,000 $2,000
annual deductible $0 $50/$100 $0 0%
preventive $5 office co-pay $0 1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
50%
basic services $5 office co-pay 20% 1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
50%
major services $5 office co-pay 30% 1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
50%
ortho - adult 50% up to $2,000 lifetime 50% up to $3,000 lifetime not covered not covered
ortho - child 50% up to
$2,000 lifetime
50% up to
$3,000 lifetime
50% up to
$2,000 lifetime
not covered

*Requires minimum of one dentist per visit per year to increase and maintain coinsurance level.

Print the side-by-side dental plan comparison

94806

Find your employee group below to review plan rates and benefits overview.

FT=Full Time     PT=Part Time     JS=Job Share

AFSCME: C-COM Full Time Part Time  
AFSCME: Department of Transportation and Development (DTD) Full Time Part Time  
AFSCME: Water Environment Services (WES) Full Time Part Time  
Elected Officials Full Time Part Time  
Employees' Association (EA) Full Time Part Time Job Share
Employees' Association Temporary (EA) Full Time    
Federation of Oregon Parole and Probation Officers (FOPPO) Full Time Part Time Job Share
Housing Authority Non-Represented Full Time Part Time  
Housing Authority Represented Full Time Part Time  
Non-Represented Group 1 Full Time    
Non-Represented Group 2 Full Time Part Time  
Non-Represented     Job Share

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94806

Choose from three medical plans.

  Kaiser Providence
Personal Option
Providence
Open Option
medical services in-network coverage only in-network coverage only in-network out of network
annual deductible - single/family $0 $0 $50/$150
annual out of pocket max - single/family $600/$1,200 $1,000/$3,000 $2,000/$6,000
office visit - primary, specialty, urgent care $10 co-pay $15 co-pay $10 co-pay 20% co-insurance*
preventive care $0 co-pay $0 co-pay $0 co-pay 20% co-insurance*
inpatient hospital - including maternity covered in full covered in full covered in full 20% co-insurance
emergency room visit $75 co-pay $100 co-pay $100 co-pay $100 co-pay
X-ray & lab services covered in full covered in full covered in full 20% co-insurance
outpatient surgery $10 co-pay covered in full $10 co-pay 20% co-insurance
alternative care
chiropractic $10 co-pay
20 visit annual limit
$10 co-pay
30 visit annual limit
$10 co-pay
30 visit annual limit
not covered
massage $25 co-pay
12 visit annual limit
$10 co-pay
30 visit annual limit
$10 co-pay
30 visit annual limit
not covered
acupuncture $10 co-pay
12 visit annual limit
$10 co-pay
30 visit annual limit
$10 co-pay
30 visit annual limit
not covered
prescription drugs
generic $10 co-pay $10 co-pay $10 co-pay not covered
name brand $20 co-pay $15 co-pay $15 co-pay not covered
vision benefits
exam - every 12-months $10 co-pay $10 co-pay $10 co-pay see summary
contact lenses & frames $200 benefit
every 24 months
$175 benefit
every 12 months
$175 benefit
every 12 months
see summary

*deductible waived

Print the side-by-side plan comparison

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94831

Choose from two dental plans.

  Kaiser Delta Dental
Incentive
dental services in-network coverage in-network coverage
annual max benefit no max $2,000
annual deductible $0 $0
preventive $5 co-pay 1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
basic services $5 co-pay 1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
major services see plan summary 1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
ortho - adult 50% up to
$2,000 lifetime
not covered
ortho - child 50% up to
$2,000 lifetime
50% up to
$3,000 lifetime

*Requires minimum of one dentist per visit per year to increase and maintain coinsurance level.

Print the side-by-side dental plan comparison

94831

Find your employee group below to review plan rates and benefits overview.

FT=Full Time     PT=Part Time

Peace Officers Association (POA) Full Time Part Time

Review side-by-side rate comparison

94831

Peace Officers

94831

Choose from three medical plans.

  Kaiser Providence
Personal Option
Providence
Open Option
medical services in-network coverage only in-network coverage only in-network out of network
annual deductible - single/family $250/$500 $850/$1,700 $600/$1,200
annual out of pocket max - single/family $1,000/$2,000 $2,500/$5,000 $2,000/$4,000

office visit - primary and specialty

urgent care

$10 co-pay

$15 co-pay –covered in full after 30 visits

$15 co-pay

$15 co-pay –covered in full after 24 visits

$15 co-pay

30% co-insurance*
preventive care $0 co-pay $0 co-pay $0 co-pay 30% co-insurance*
inpatient hospital - including maternity 10% co-insurance 20% co-insurance 10% co-insurance 30% co-insurance
emergency room visit $75 co-pay $100 co-pay $100 co-pay $100 co-pay
X-ray & lab services $0 co-pay $0 co-pay $0 co-pay 30% co-insurance
outpatient surgery $10 co-pay 20% co-insurance 10% co-insurance 30% co-insurance
alternative care
chiropractic $10 co-pay
20 visit annual limit
$15 co-pay
30 visit annual limit
$15 co-pay
30 visit annual limit
not covered
massage $25 co-pay
12 visit annual limit
$15 co-pay
30 visit annual limit
$15 co-pay
30 visit annual limit
not covered
acupuncture $10 co-pay
12 visit annual limit
$15 co-pay
30 visit annual limit
$15 co-pay
30 visit annual limit
not covered
prescription drugs
generic $10 co-pay $10 co-pay $15 co-pay not covered
name brand $20 co-pay 50% ($150 max) $30 co-pay not covered
vision benefits
exam - every 12-months $10 co-pay $10 co-pay $10 co-pay see summary
contact lenses & frames - every 12-months $250 benefit $175 benefit $175 benefit see summary

*deductible waived

Print the side-by-side plan comparison

return to top

94806

Choose from four dental plans.

  Kaiser Delta Dental
Preventive
Delta Dental
Incentive
Delta Dental
Constant
dental services in-network coverage in-network coverage in-network coverage in-network coverage
annual max benefit no max $2,000 $2,000 $2,000
annual deductible $0 $50/$100 $0 0%
preventive $5 office co-pay $0 1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
50%
basic services $5 office co-pay 20% 1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
50%
major services $5 office co-pay 30% 1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
50%
ortho - adult 50% up to $2,000 lifetime 50% up to $3,000 lifetime not covered not covered
ortho - child 50% up to
$2,000 lifetime
50% up to
$3,000 lifetime
50% up to
$2,000 lifetime
not covered

*Requires minimum of one dentist per visit per year to increase and maintain coinsurance level.

Print the side-by-side dental plan comparison

94806

Find your employee group below to review plan rates and benefits overview.

FT=Full Time     PT=Part Time     JS=Job Share

AFSCME: C-COM Full Time Part Time  
AFSCME: Department of Transportation and Development (DTD) Full Time Part Time  
AFSCME: Water Environment Services (WES) Full Time Part Time  
Elected Officials Full Time Part Time  
Employees' Association (EA) Full Time Part Time Job Share
Employees' Association Temporary (EA) Full Time    
Federation of Oregon Parole and Probation Officers (FOPPO) Full Time Part Time Job Share
Housing Authority Non-Represented Full Time Part Time  
Housing Authority Represented Full Time Part Time  
Non-Represented Group 1 Full Time    
Non-Represented Group 2 Full Time Part Time  
Non-Represented     Job Share

return to top

94806

Choose from three medical plans.

  Kaiser Providence
Personal Option
Providence
Open Option
medical services in-network coverage only in-network coverage only in-network out of network
annual deductible - single/family $0 $0 $50/$150
annual out of pocket max - single/family $600/$1,200 $1,000/$3,000 $2,000/$6,000
office visit - primary, specialty, urgent care $10 co-pay $15 co-pay $10 co-pay 20% co-insurance*
preventive care $0 co-pay $0 co-pay $0 co-pay 20% co-insurance*
inpatient hospital - including maternity covered in full covered in full covered in full 20% co-insurance
emergency room visit $75 co-pay $100 co-pay $100 co-pay $100 co-pay
X-ray & lab services covered in full covered in full covered in full 20% co-insurance
outpatient surgery $10 co-pay covered in full $10 co-pay 20% co-insurance
alternative care
chiropractic $10 co-pay
20 visit annual limit
$10 co-pay
30 visit annual limit
$10 co-pay
30 visit annual limit
not covered
massage $25 co-pay
12 visit annual limit
$10 co-pay
30 visit annual limit
$10 co-pay
30 visit annual limit
not covered
acupuncture $10 co-pay
12 visit annual limit
$10 co-pay
30 visit annual limit
$10 co-pay
30 visit annual limit
not covered
prescription drugs
generic $10 co-pay $10 co-pay $10 co-pay not covered
name brand $20 co-pay $15 co-pay $15 co-pay not covered
vision benefits
exam - every 12-months $10 co-pay $10 co-pay $10 co-pay see summary
contact lenses & frames $200 benefit
every 24 months
$175 benefit
every 12 months
$175 benefit
every 12 months
see summary

*deductible waived

Print the side-by-side plan comparison

return to top

94831

Choose from two dental plans.

  Kaiser Delta Dental
Incentive
dental services in-network coverage in-network coverage
annual max benefit no max $2,000
annual deductible $0 $0
preventive $5 co-pay 1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
basic services $5 co-pay 1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
major services see plan summary 1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
ortho - adult 50% up to
$2,000 lifetime
not covered
ortho - child 50% up to
$2,000 lifetime
50% up to
$3,000 lifetime

*Requires minimum of one dentist per visit per year to increase and maintain coinsurance level.

Print the side-by-side dental plan comparison

94831

Find your employee group below to review plan rates and benefits overview.

FT=Full Time     PT=Part Time

Peace Officers Association (POA) Full Time Part Time

Review side-by-side rate comparison

94831

Other County-Paid Benefits

In addition to life insurance, short-term disability, long-term disability and wellness program activities and events, the county benefits package includes the following county-paid benefits

Voluntary Benefit Options

Below are additional benefits you can select and pay for if they fit your needs. You can enroll in voluntary benefits as a new hire or during the annual open enrollment period. 

Phone:503-655-8459
Fax:503-742-5468
Email:jobs@clackamas.us

2051 Kaen Road Oregon City, OR 97045

Office Hours:

Monday to Thursday
7 a.m. to 6 p.m.

For employment verification:
finance-payroll@clackamas.us

102676
Public Service Building

Phone:503-655-8550
Fax:503-742-5468
Email:benefits@clackamas.us

2051 Kaen Road Oregon City, OR 97045

Office Hours:

Monday to Thursday
7 a.m. to 6 p.m.

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