Sample Plan Summaries for Idaho

The sample summaries below are approved PacificSource employer plan designs. At enrollment, members receive customized benefit books showing their specific benefits, lifetime maximums, and any optional coverage provided by the employer. For group-specific member benefit summaries, or previously offered summaries, contact your regional PacificSource office.

Group Medical Plans

Preferred CoDeduct Plans

500+20/80%	1000+40/70%	3000+40/80%
500+30/80%	1500+20/80%	3000+40/70%
500+30/70%	1500+30/80%	5000+20/80%
500+40/80%	1500+30/70%	5000+30/80%
500+40/70%	1500+40/80%	5000+30/70%
750+20/80%	1500+40/70%	5000+40/80%
750+30/80%	2000+20/80%	5000+40/70%
750+30/70%	2000+30/80%	7500+20/80%
750+40/80%	2000+30/70%	7500+30/80%
750+40/70%	2000+40/80%	7500+30/70%
1000+20/80%	2000+40/70%	7500+40/80%
1000+30/80%	3000+20/80%	7500+40/70%
1000+30/70%	3000+30/80%
1000+40/80%	3000+30/70%

Preferred Deductible and Percentage Plans

80+500	70+500	50+1000
80+750	70+750	50+2000
80+1000	70+1000	50/3500
80+1500	70+1500
80+2000	70+2000
80+3000	70+3000
80+5000	70+5000
80+7500	70+7500

Preferred HSA Plans

Rx Subject to Deductible:	No Rx Coverage:
HSA 80+1500+Rx	HSA 80+1500
HSA 80+2000+Rx	HSA 80+2000
HSA 80+3000+Rx	HSA 80+3000
HSA 100+5000+Rx	HSA 100+5000

SmartHealth for Businesses

Summaries to be added in early 2010.

Traditional Plans

Summaries to be added in early 2010.

Mandated Plans

Basic	Catastrophic
Standard	Conversion

Optional Benefits

Prescription Drug Plans

Tiered 10/20/40

Tiered 15/30/50

Tiered 15/20%/50%

Dental Plans

Preventive $25/$1500	Preventive $50/$1000	Comp $50/$1500
Preventive $25/$1000	Comp $25/$1500	Comp $50/$1000
Preventive $50/$1500	Comp $25/$1000	Orthodontia

Vision Plans

Vision Plus

Vision 10/200

Vision 10/100

Life and Disability Plans

$10,000	$10,000 with dependent option
$20,000	$20,000 with dependent option
$30,000	$30,000 with dependent option
$40,000	$40,000 with dependent option
$50,000	$50,000 with dependent option

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Looking for more plan summaries?

Idaho plan summaries en Español coming soon
Sample Oregon plan summaries
Oregon plan summaries en Español
For group-specific benefit summaries, contact our Boise office at (208) 342-3709 or (888) 492-2875

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Especially for Individual Agents - Find Idaho BrightIdea, Idaho SmartHealth, Oregon Elect, Short Term Medical, and Agent iStore materials.

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Last updated 2/18/2010