Cover Oregon Rates

Cover Oregon Online Rates and Application Assistance


Cover Oregon Rates

Cover Oregon rates are available on our website. All information submitted is private. Portland Benefits Group works with all carriers on the Cover Oregon Health Insurance Exchange. Through our site you can view Cover Oregon rates and tax subsidy information and then if you want to apply through the exchange just call Portland Benefits Group.

Obamacare is confusing and if you choose the wrong plan you could be forfeiting thousands of dollars in government assistance. We can help you understand all of your options under the new law, and assist you with the application process. 

503-828-1970This email address is being protected from spambots. You need JavaScript enabled to view it. This email address is being protected from spambots. You need JavaScript enabled to view it.

As a Licensed Agent certified with the Cover Oregon and the other health exchanges I can explain how  the ACA works and let you know if Tax Credits and Reduced premiums are available, and what Health Insurance will cost for you from the health exchange and on the private market circumventing the exchange. Buying off-exchange means you won’t get cost assistance, however you will have better networks and more plan varieties to choose from. 

All Information Submited on this website is Private and NOT Sold to Hundreds of Insurance Agents LIKE OTHER SITES. 


Cover Oregon Health Marketplace Rates and Tax Credits Explained

For some people, health insurance delivers a secure feeling and a safety net in time of trouble. For others, depending on their situation, it may provide little more than a piece of paper.

Whatever health insurance means to you, the rules and the reality are changing under the landmark 906-page law passed by Congress in 2010 called the Patient Protection and Affordable Care Act. Most people know it as Obamacare, and it’s about to kick in for real.

In Oregon, people soon will have the ability to interact with what the  law created: Cover Oregon, an online marketplace to help people shop for insurance, enroll in health insurance and qualify for premium tax  credits.

Specifically, individuals and families who buy their own insurance can use the site, as well as small businesses and employees of those businesses that sign up.

Check it off
Here’s a handy checklist to get ready to use Cover Oregon:
First, check yourself: What will you spend for health care in the coming year? How often will you need a doctor and what sort of copay can you afford? When it comes to a high deductible, how much risk can you afford to take?
Will you use an agent or application assister to help? Unless you are a stubborn do-it-yourselfer, you probably could use some help. An agent can give you advice, unlike an assister. Both are free, and can be found at
Have paper on hand: Have your most-recent tax return ready. You’ll need to know your most-recent adjusted gross income, and be prepared to estimate it for the coming year. If your projected income is more than 10 percent off from your 2012 tax return, you’ll be asked to submit pay stubs or other documentation.
Know your dependents: Be prepared to submit Social Security numbers and income, if any, for dependents.
Keep your doctor? If keeping your current doctor is a priority, have their name, specialty and address on hand.
Get ready for more research: Once you have your options, you might want to ask around about plan quality.

The website at reflects 2014’s new reality under the law. Insurers must cover even the sickest people with a higher level of minimum benefits. And most people must enroll in coverage or – and this is important – pay a fine.

Oregon’s leaders have embraced the federal changes. The state was one of the first to start work on a state marketplace, even as dozens of other states dragged their feet or rejected the idea altogether, leaving it to the federal government to implement.

Still, not everyone will be enthusiastic about 2014. Health premiums will go up for many people who buy their own insurance but who aren’t on Medicare.

The good news in Oregon? Rates won’t go up as much as in other states, and not by as much as expected. Not only that, but lower-income people may be able to use tax credits to bring their premiums down.

The bad news? The tax credits here won’t be as generous as thought. The credits are set up to cap spending on premiums as a portion of income, so Oregon’s cheaper premiums mean less in tax credits.

Depending on your needs and your income, you might find it’s cheaper to buy a more expensive plan on Cover Oregon, one with better copays and caps on out-of-pocket spending.

Interviews with insurance agents, state officials and others revealed things we didn’t expect. First, the wisdom of using the new marketplace probably will depend on your income. Commercial plans offered outside the exchange may offer different benefits, bigger provider networks or even lower prices.

But you can’t get tax credits without using Cover Oregon’s website or printed application.

Second, while critics of the new law have predicted a large number of people won’t enroll, people who don’t get covered risk a serious financial hit if something happens. You can’t just wait until you get sick to enroll. The enrollment period happens only once a year.

Finally, although insurance agents had been concerned new insurance marketplaces like Cover Oregon could make their assistance unnecessary, they don’t say that much now. That’s because the new health insurance world remains a very complicated place.

PacificSource individual and family plan information

2014 Oregon Individual and Family Plans Available Through Cover Oregon

As notices of health insurance changes go out, some experience rate shock

Some Oregonians who buy insurance on their own are experiencing rate shock as the first wave of required notices go out about changes to their plans under health reform.

Health insurers are required to give their customers 90 days notice if their plan is discontinued. Most insurance plans bought by individuals will end in 2014 to meet requirements of the Affordable Care Act.

Regence BlueCross BlueShield of Oregon customers appear to be the first to receive their notices this week. Three customers contacted The Oregonian complaining that they face premium hikes of between 30 and more than 100 percent if they stay with Regence.

Another lamented the loss of Regence’s high-deductible plan that qualifies for a health savings account. A few called the offices of U.S. Rep. Kurt Schrader and Oregon Gov. John Kitzhaber to complain, officials said.

Washington’s Office of the Insurance Commissioner also received complaints this week about the notices sent out by LifeWise and other insurers, The Seattle Times reported.

Bottom line: The changes mandated by Obamacare will impact consumers in different ways, depending on their age, their current plan and other factors. Consumers will want to shop around — on the state’s health exchange Cover Oregon when it opens Oct. 1 or outside the exchange via health insurance agents and brokers — to determine their best options, experts say.

“People really need to shop,” said Cheryl Martinis, a spokeswoman with the Oregon Insurance Division. “And we’ll be telling them that generally the best place to shop is Cover Oregon. It’s important that people understand they have options.”

Karin Swenson-Moore and Don Antonucci of Regence BlueCross BlueShield of Oregon testify before the Oregon Insurance Division in 2012 during a public hearing on a rate increase request. This week, individuals began receiving notices in the mail of rate changes stemming from federal health reform, and some report increases of more than 100 percent.

About 200,000 Oregonians buy insurance on their own, outside of employers, Martinis said. Regence is one of the state’s largest providers in that market. But others carriers are offering more plans both inside and outside Cover Oregon, one broker said.

“Regence went really bare bones,” said Lisa Lettenmaier, who owns health insurance brokerage Health Source NW in Tigard. “Other carriers are trying to be innovative.”

Regence, in a statement, noted that health reform requires it to provide more comprehensive coverage than it did in plans it’s now eliminating. That includes coverage for mental health concerns, childhood vision and dental procedures, births and preventative doctor visits.

The new rates also reflect new taxes under the law, Regence said.

“As a result, benefits and premiums will increase for some of our members,” Regence said today in a statement.

Some Regence customers were on plans that limited office visits and had an annual out-of-pocket limit of $10,000, Lettenmaier said. Its  new Silver plan will allow unlimited office calls and a $6,350 maximum annual  out-of-pocket, she said.

But for customers who wanted only catastrophic coverage, that plan worked, and their options going forward will be fewer, she said.

Regence’s affiliate, Cambia Health Solutions Inc., will be offering plans on the exchange under the name BridgeSpan Health Co.

“They can choose another plan with us or with another insurance company on or off the state health insurance exchange,” Regence’s statement said. “We are happy to help members consider their choices in the evolving health insurance marketplace.” The state insurance division has a consumer rate liaison who can answer questions about rate changes. Contact Ethan Baldwin at 503-947-7660 or via email.

“Patience is the number one key,” Lettenmaier said. “We actually have from Oct. 1 to the end of March to find (consumers) the right plan and get them enrolled.”


Two Oregon insurers rethink 2014 premiums as state posts first-ever rate comparison


This is what competitionlooks like: One health insurer wants to charge $169 a month next year to cover a 40-year-old Portland-area non-smoker. Another wants $422 a month for the same standard plan.


The new health insurance marketplace envisioned by federal health reforms doesn’t formally kick in until fall. But it already is taking shape – and consumers for the first time can compare, premium by premium, identical plans by different insurers.


Soon they’ll be able to compare benefit-by-benefit as well.


On Thursday, a comparison of proposed 2014 health premiums became public online, causing two insurers to request do-overs to lower their rates even before the statedetermines whetherthey’re justified.


The unusual development was sparked by a comparison that used to be impossible because plan benefits varied so widely. But under the federal reforms that take effect Jan. 1, health insurance is mandated and every insurer must offer certain standard plans.


Starting in October, the change will drive competition in a health insurance marketplace calledCover Oregonwhere individual consumers and small business owners can comparison shop. Though the state’s comparison charts are far less detailed, they foreshadow what Cover Oregon is trying to do.

“Posting rate comparisons company-by-company is a taste of what is to come,” says Cheryl Martinis of the Oregon Insurance Division.

Judging by the reaction, there’s already an impact.

Providence Health Planon Wednesday asked to lower its requested rates by 15 percent. Gary Walker, a Providence spokesman, says the “primary driver” was a realization that the plan’s cost projections were incorrect. But he conceded a desire to be competitive was part of it.

AFamily Care Health Plansofficial on Thursday said the insurer will ask the state for even greater decrease in requested rates. CEO Jeff Heatherington says the company realized its analysts were too pessimistic after seeing online that its proposed premiums were the highest.

“That was my question when I saw the rates was, ‘Can we go in and refile these?'” he said. “We’re going to try to get these to a competitive range.”

Theoregonhealthrates.orgwebsite provides the filings by the individual carriers and a comparison of certain requested rates in the individual and small business market,broken down by region. The rate comparison showsidentical standard-benefit plansrated bronze, silver or gold for their level of benefits forsmall businesses, as well as individual non-smokers aged 21, 40 and 60.

The easy rate comparison is only one of the changes consumers who buy their own insurance can expect in 2014.

Another is higher premiums in the 2014 individual market, though for many people they’ll be offset by tax credits. The higher rates are because people with pre-existing conditions can no longer be denied coverage. Also, plans have to offer stronger benefits than they used to, leading to higher premiums.

The changes have spawned much speculation, with some predicting “rate shock” for people who buy their own policies. Now consumers can see for themselves what premiums could be available, at least for certain plans.

Meanwhile, at least half the potential customers who buy their own insurance will qualify for a sliding scale ofincome-based tax creditsthat could more than-eliminate any price hikes. Nearly 400,000 Oregonians are expected to purchase their own insurance as tax credits lure previously uninsured consumers.

In addition to comparing insurance plans, Cover Oregon can enroll people and qualify them for tax credits.

Individual consumers and small businesses will be able to talk by phone or use computers to get questions answered. Insurance agents and outreach workers in the community will also be available to help.

It’s too soon to start shopping. The rates posted Thursday by the Oregon Insurance Division still must be approved by the state in July. The full Cover Oregon website launchesin early October.


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