Moda Plans

**Notice: Moda Medical Members: Please be advised that your prescription benefit manager will change on January 1. Find out more information on our FAQ.

When reviewing your plan information below, please be sure to choose the document that corresponds to the plan you are enrolled in, as these documents are specific to the stated plan.

If you would like a printed copy of any of these documents, or access in another language, contact the Benefits Office at 503-988-3477 or employee.benefits@multco.us.

View your current benefits on the Workday Benefits and Pay Hub.

Who Do I Contact?

www.modahealth.com

Moda Medical Customer Service: 888-445-7413

Moda Delta Dental Customer Service: 888-447-8194

WellDyne (Pharmacy) Customer Service: 888-479-2000 (Note: Moda's Prescription Benefit Manager will be changing on January 1, 2025 to Array Rx. See more information here: Prescription Plan Manager for Moda Medical.)

VSP*(Vision) Customer Service: 800-877-7195

Claims to submit? Send an itemized statement from your provider to multco@modahealth.com or submit through your member dashboard.

Moda Provider Search - You can search for Moda's providers as a guest by selecting the "Connexus" network. After your plan start date, you can also search by using your subscriber ID# or member dashboard.

Look below for your plan handbooks and program flyers. Additional Moda forms, e.g. reimbursement or release of information forms, are available on the Moda Forms page.

2025 Plan Documents

Moda PPO 400 Plan

• Document

  2025 Moda PPO 400 Summary of Benefits and Coverage (SBC) (2.74 MB)
• Document

  2025 Moda PPO 400 Summary (142.48 KB)

Moda Major Medical Plan

• Document

  2025 Moda Major Medical Summary of Benefits and Coverage (SBC) (2.09 MB)
• Document

  2025 Moda Major Medical Summary (140.15 KB)

Delta Dental 50 Plan

• Document

  2025 Delta Dental 50 Plan Summary (809.14 KB)

2024 Plan Documents

Moda PPO 400 Plan

• Document

  2024 Moda PPO 400 Summary of Benefits and Coverage (SBC) (2.07 MB)
• Document

  2024 Moda PPO 400 Handbook (2.3 MB)
• Document

  2024 Moda PPO 400 Summary (144.52 KB)

Moda Major Medical Plan

• Document

  2024 Moda Major Medical Summary of Benefits and Coverage (SBC) (2.09 MB)
• Document

  2024 Moda Major Medical Handbook (2.23 MB)
• Document

  2024 Moda Major Medical Summary (144.15 KB)

Delta Dental 50 Plan

• Document

  2024 Delta Dental 50 Benefit Plan Summary (959.61 KB)
• Document

  2024 Delta Dental 50 Plan Handbook (2.33 MB)

For Medicare Retirees

• Document

  2024 Moda Medicare Plan Summary (906.7 KB)
• Document

  2024 Moda Medicare Plan Evidence of Coverage (EOC) (1.6 MB)

Moda Medical - Additional Documents

• Document

  Active & Fit (276.5 KB)
• Document

  Aetna Network User Guide (619.3 KB)
• Document

  Behavioral Health Champions (2.03 MB)
• Document

  Care Options (505.38 KB)
• Document

  Case Management (957.94 KB)
• Document

  Chronic Condition Management (116.26 KB)
• Document

  CirrusMD Member Flyer (427.3 KB)
• Document

  CirrusMD Member FAQ (267.96 KB)
• Document

  Diabetic Supplies - Moda (1.13 MB)
• Document

  Gender Confirming Care Needs (153.46 KB)
• Document

  Healthcare Cost Estimator (155.25 KB)
• Document

  Health Coaching (614.67 KB)
• LGBTQIA+ Support Hub
• Machine Readable Files - This link leads to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.
• Document

  Member Dashboard (143.24 KB)
• Document

  Member Dashboard - Be Better Tools (1.24 MB)
• Document

  Member Reimbursement (144.7 KB)
• Document

  Out of Area Dependent (165.46 KB)
• Document

  Provider Directory Tool (219.61 KB)
• Document

  Resources for Mental Health and Substance Abuse Treatment (655.87 KB)
• Document

  Retiree National Network (166.8 KB)
• Document

  Moda Travel Network (104.23 KB)
• Document

  Women's Health & Maternity Care (665.43 KB)

WellDyne (Pharmacy Benefits) - Additional Documents

• Document

  WellDyne Overview (473.15 KB)
• Document

  Pharmacy Benefits FAQ (414.19 KB)
• Document

  Mail Order Overview (118.09 KB)
• Document

  Specialty Pharmacy Overview (386.22 KB)
• Document

  WellDyne Retail Pharmacy List (268.93 KB)
• Document

  WellConnect (266.9 KB)
• Document

  Wellview Member Portal (257.98 KB)
• Document

  WellDyne Reimbursement Claim Form (178.51 KB)
• Document

  Free Glucose Meter (234.99 KB)
• WellDyne Member Resources

Moda Pharmacy Benefits - Additional Documents (Effective 1/1/25)

• Prescription Drug List (Formulary)
• Document

  Ardon Health Specialty Pharmacy Overview (575.58 KB)
• Document

  Mail Order Overview (766.34 KB)
• Document

  Costco Mail Order Form (325.04 KB)
• Document

  Postal Prescription Services Order Form (108.85 KB)

VSP* (Vision) - Additional Documents

• Document

  Exclusive Member Extras (2.92 MB)
• Document

  Eyeconic (384.58 KB)
• Document

  A Look At Your Coverage (Adults) (1.81 MB)
• Document

  A Look At Your Coverage (Kids) (617.35 KB)
• Document

  Your Vision Coverage Works Overtime (In-Network) (821.92 KB)

* VSP coverage is included in Moda PPO 400 plans. The Moda Major Medical Plan does not include vision coverage.

Moda Delta Dental

Choose your provider from the available networks:

• Delta PPO Network dentists offer services with the lowest out-of-pocket costs.
• Dentists on the Premier Network are also in-network providers, but services can be more costly.
• Services provided by an out-of-network provider are subject to balance billing and therefore, most costly.

Moda Delta Dental - Additional Documents

• Document

  Health Through Oral Wellness (820.8 KB)
• Document

  Oral Health, Total Health flyer and enrollment form (572.09 KB)
• Document

  Delta Dental PPO Provider Guide (821.03 KB)