-
Employers
- Provider Search
- ODS Plans
- Employer Online Services
- Value-Added Services
- Third Party Administration
- Group Administrator Guide (PDF)
- Samples & Forms
- FAQs
- Need Help?
- Medical
- 503-243-3962 or
877-605-3229 - Dental
- 503-265-5680 or
877-277-7280 - Employer Online Services
- 503-265-5691 or
877-277-7075
NCQA is committed to providing healthcare quality information through the web and the media to help consumers, employers and others make more informed healthcare choices.
Samples & Forms
Samples
- Dental Explanation of Benefits
(EOB)
- Dental Explanation of Benefits
(EOB)
en Español
- Medical Explanation of Benefits
(EOB)
- Sample Bill
- Saving Money
on Your Healthcare Benefits
Forms
Claims
- Prescription
Drug Claim Form for Major Medical Plans
- Prescription Drug Claim Form for
Med Impact Plans
- Prescription Compound Drug Claim Form
- Tobacco Cessation Claim Form
Enrollment for Employee
Group Size 2-4
Group Size 5-99
Group Size 100+
- Dental Only
- Medical Only
- Dual Medical
- Medical and Dental
- Dual Medical and Dental
- Dental and Vision
- Dual Medical w/PCP and Dental
Affidavit of Domestic Partnership
Declination of coverage
Oregon Continuation of Coverage
Administrative