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.

2024 Required Notices

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.

 KaiserProvidence
Personal Option
Providence
Open Option
medical servicesin-network coverage onlyin-network coverage onlyin-networkout 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 - First 3 visits $5

$15 co-pay – First 3 visits $5;
covered in full after 30 visits

$15 co-pay

$15 co-pay –First 3 visits
$5; covered in full after 24
visits

$15 co-pay

30% co-insurance*
preventive care$0 co-pay$0 co-pay$0 co-pay30% co-insurance*
inpatient hospital - including maternity10% co-insurance20% co-insurance10% co-insurance30% 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-pay30% co-insurance
outpatient surgery$10 co-pay20% co-insurance10% co-insurance30% 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-paynot covered
name brand$20 co-pay50% ($150 max)$30 co-paynot covered
vision benefits
exam - every 12-months$10 co-pay$10 co-pay$10 co-paysee summary
contact lenses & frames - every 12-months$250 benefit$175 benefit$175 benefitsee summary

*deductible waived

Print the side-by-side plan comparison

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94806

Choose from four dental plans.

 KaiserDelta Dental
Preventive
Delta Dental
Incentive
Delta Dental
Constant
dental servicesin-network coveragein-network coveragein-network coveragein-network coverage
annual max benefitno max$2,000$2,000$2,000
annual deductible$0$50/$100$00%
preventive$5 office co-pay$01st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
50%
basic services$5 office co-pay20%1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
50%
major services$5 office co-pay30%1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
50%
ortho - adult50% up to $2,000 lifetime50% up to $3,000 lifetimenot coverednot covered
ortho - child50% 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-COMFull TimePart Time 
AFSCME: Department of Transportation and Development (DTD)Full TimePart Time 
AFSCME: Water Environment Services (WES)Full TimePart Time 
Elected OfficialsFull TimePart Time 
Employees' Association (EA)Full TimePart TimeJob Share
Employees' Association Temporary (EA)Full Time  
Federation of Oregon Parole and Probation Officers (FOPPO)Full TimePart TimeJob Share
Housing Authority Non-RepresentedFull TimePart Time 
Housing Authority RepresentedFull TimePart Time 
Non-Represented Group 1Full Time  
Non-Represented Group 2Full TimePart Time 
Non-Represented  Job Share

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94806

Choose from three medical plans.

 KaiserProvidence
Personal Option
Providence
Open Option
medical servicesin-network coverage onlyin-network coverage onlyin-networkout 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 – First 3 visits $5$15 co-pay – First 3 visits $5$10 co-pay – First 3 visits $520% co-insurance*
preventive care$0 co-pay$0 co-pay$0 co-pay20% co-insurance*
inpatient hospital - including maternitycovered in fullcovered in fullcovered in full20% co-insurance
emergency room visit$75 co-pay$100 co-pay$100 co-pay$100 co-pay
X-ray & lab servicescovered in fullcovered in fullcovered in full20% co-insurance
outpatient surgery$10 co-paycovered in full$10 co-pay20% 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-paynot covered
name brand$20 co-pay$15 co-pay$15 co-paynot covered
vision benefits
exam - every 12-months$10 co-pay$10 co-pay$10 co-paysee 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.

 KaiserDelta Dental
Incentive
dental servicesin-network coveragein-network coverage
annual max benefitno max$2,000
annual deductible$0$0
preventive$5 co-pay1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
basic services$5 co-pay1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
major servicessee plan summary1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
ortho - adult50% up to
$2,000 lifetime
not covered
ortho - child50% 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 TimePart Time

Review side-by-side rate comparison

94831

Peace Officers

94831

Choose from three medical plans.

 KaiserProvidence
Personal Option
Providence
Open Option
medical servicesin-network coverage onlyin-network coverage onlyin-networkout 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 - First 3 visits $5

$15 co-pay – First 3 visits $5;
covered in full after 30 visits

$15 co-pay

$15 co-pay –First 3 visits
$5; covered in full after 24
visits

$15 co-pay

30% co-insurance*
preventive care$0 co-pay$0 co-pay$0 co-pay30% co-insurance*
inpatient hospital - including maternity10% co-insurance20% co-insurance10% co-insurance30% 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-pay30% co-insurance
outpatient surgery$10 co-pay20% co-insurance10% co-insurance30% 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-paynot covered
name brand$20 co-pay50% ($150 max)$30 co-paynot covered
vision benefits
exam - every 12-months$10 co-pay$10 co-pay$10 co-paysee summary
contact lenses & frames - every 12-months$250 benefit$175 benefit$175 benefitsee summary

*deductible waived

Print the side-by-side plan comparison

return to top

94806

Choose from four dental plans.

 KaiserDelta Dental
Preventive
Delta Dental
Incentive
Delta Dental
Constant
dental servicesin-network coveragein-network coveragein-network coveragein-network coverage
annual max benefitno max$2,000$2,000$2,000
annual deductible$0$50/$100$00%
preventive$5 office co-pay$01st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
50%
basic services$5 office co-pay20%1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
50%
major services$5 office co-pay30%1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
50%
ortho - adult50% up to $2,000 lifetime50% up to $3,000 lifetimenot coverednot covered
ortho - child50% 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-COMFull TimePart Time 
AFSCME: Department of Transportation and Development (DTD)Full TimePart Time 
AFSCME: Water Environment Services (WES)Full TimePart Time 
Elected OfficialsFull TimePart Time 
Employees' Association (EA)Full TimePart TimeJob Share
Employees' Association Temporary (EA)Full Time  
Federation of Oregon Parole and Probation Officers (FOPPO)Full TimePart TimeJob Share
Housing Authority Non-RepresentedFull TimePart Time 
Housing Authority RepresentedFull TimePart Time 
Non-Represented Group 1Full Time  
Non-Represented Group 2Full TimePart Time 
Non-Represented  Job Share

return to top

94806

Choose from three medical plans.

 KaiserProvidence
Personal Option
Providence
Open Option
medical servicesin-network coverage onlyin-network coverage onlyin-networkout 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 – First 3 visits $5$15 co-pay – First 3 visits $5$10 co-pay – First 3 visits $520% co-insurance*
preventive care$0 co-pay$0 co-pay$0 co-pay20% co-insurance*
inpatient hospital - including maternitycovered in fullcovered in fullcovered in full20% co-insurance
emergency room visit$75 co-pay$100 co-pay$100 co-pay$100 co-pay
X-ray & lab servicescovered in fullcovered in fullcovered in full20% co-insurance
outpatient surgery$10 co-paycovered in full$10 co-pay20% 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-paynot covered
name brand$20 co-pay$15 co-pay$15 co-paynot covered
vision benefits
exam - every 12-months$10 co-pay$10 co-pay$10 co-paysee 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.

 KaiserDelta Dental
Incentive
dental servicesin-network coveragein-network coverage
annual max benefitno max$2,000
annual deductible$0$0
preventive$5 co-pay1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
basic services$5 co-pay1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
major servicessee plan summary1st year - 30%*
2nd year - 20%*
3rd year - 10%*
4th year - 0%*
ortho - adult50% up to
$2,000 lifetime
not covered
ortho - child50% 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 TimePart 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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