Part D Part D Obligation Special Special Part C Basic with Full Organization Contract Plan Needs Needs Benefit Premium Premium County Name Plan Name ID ID Plan Type Plan Plan Type Type 2 3 Assistance Moda Health Plan, Moda Health Local Enhanced Baker Inc. (PPO) H3813 006 PPO No Alternative $40.60 $57.40 $22.60 Moda Health Plan, Moda Health HMO Enhanced Baker Inc. (HMO-POS) H8506 001 HMOPOS No Alternative $0.00 $63.00 $28.20 AARP MedicareComplete Enhanced Benton UnitedHealthcare Plan 1 (HMO) H3805 007 HMO No Alternative $24.80 $21.20 $0.00 AARP MedicareComplete Enhanced Benton UnitedHealthcare Plan (HMO) H3805 013 HMO No Alternative $0.00 $0.00 $0.00 Samaritan Samaritan Advantage Health Advantage Premier Enhanced Benton Plan Plan (HMO) H3811 002 HMO No Alternative $56.60 $53.40 $18.60 Samaritan Samaritan Advantage Health Advantage Premier Enhanced Benton Plan Plan Plus (HMO) H3811 009 HMO No Alternative $70.90 $69.10 $34.30 Moda Health Plan, Moda Health Local Enhanced Benton Inc. PPORX (PPO) H3813 006 PPO No Alternative $40.60 $57.40 $22.60 Regence BlueCross Regence BlueShield of MedAdvantage + Basic Benton Oregon Rx Classic (PPO) H3817 008 PPO No Alternative $51.50 $49.50 $14.70 Regence Regence BlueCross MedAdvantage + BlueShield of Rx Enhanced Local Enhanced Benton Oregon (PPO) H3817 009 PPO No Alternative $147.40 $66.90 $55.80 Health Net Life Health Net Violet Local Enhanced Benton Insurance Company Option 1 (PPO) H5520 002 PPO No Alternative $76.30 $39.70 $4.90 Health Net Life Health Net Violet Local Basic Benton Insurance Company Option 2 (PPO) H5520 012 PPO No Alternative $0.00 $24.00 $0.00
County Organization Name Plan Name Contract ID Plan ID Plan Type Special Needs Plan Special Needs Plan Type Benefit Type Part C Part D Basic Part D Premium Obligation with Full Premium Assistance Baker Moda Health Plan, Inc. Moda Health (PPO) H3813 006 Local PPO No Enhanced Alternative $40.60 $57.40 $22.60 Baker Moda Health Plan, Inc. Moda Health HMO (HMO-POS) H8506 001 HMOPOS No Enhanced Alternative $0.00 $63.00 $28.20 Benton UnitedHealthcare AARP MedicareComplete Plan 1 (HMO) H3805 007 HMO No Enhanced Alternative $24.80 $21.20 $0.00 Benton UnitedHealthcare AARP MedicareComplete Plan 2 (HMO) H3805 013 HMO No Enhanced Alternative $0.00 $0.00 $0.00 Benton Samaritan Advantage Health Plan Samaritan Advantage Premier Plan (HMO) H3811 002 HMO No Enhanced Alternative $56.60 $53.40 $18.60 Benton Samaritan Advantage Health Plan Samaritan Advantage Premier Plan Plus (HMO) H3811 009 HMO No Enhanced Alternative $70.90 $69.10 $34.30 Benton Moda Health Plan, Inc. Moda Health PPORX (PPO) H3813 006 Local PPO No Enhanced Alternative $40.60 $57.40 $22.60 Benton Regence BlueCross BlueShield of Oregon Regence MedAdvantage + Rx Classic (PPO) H3817 008 PPO No Basic Alternative $51.50 $49.50 $14.70 Benton Regence BlueCross BlueShield of Oregon Regence MedAdvantage + Rx Enhanced (PPO) H3817 009 Local PPO No Enhanced Alternative $147.40 $66.90 $55.80 Benton Health Net Life Insurance Company Health Net Violet Option 1 (PPO) H5520 002 Local PPO No Enhanced Alternative $76.30 $39.70 $4.90 Benton Health Net Life Insurance Company Health Net Violet Option 2 (PPO) H5520 012 Local PPO No Basic Alternative $0.00 $24.00 $0.00 3