PacificSource Health Plans Welcomes Insure Montana

Eligibility

In order to be eligible to enroll your group, you will need to have at least two employees that work a minimum of 20 hours per week. In addition, a minimum of two employees will need to enroll to be eligible for a PacificSource plan. If your company has only two employees and they are related, each would need to enroll separately, instead of as an employee with a dependent.  

Forms and Materials

Plan Summaries (effective January 1, 2015)

These summaries provide an overview of PacificSource coverage options available through your Insure Montana membership.

 

Plan

Deductible

Out-of-pocket Limit

Co-insurance

Plan Details

  SmartHealth Balance Gold 500
$500 / $1,000
$3,000 / $6,000
20%
SmartHealth Balance Gold 1000 3000
$1,000 / $2,000
$3,000 / $6,000
20%
  SmartHealth Value Silver 3000HSA-qualified
$3,000 / $6,000
$3,000 / $6,000
0%
SmartHealth Balance Silver 1500
$1,500 / $3,000
$6,600 / $13,200
30%
  SmartHealthValue Bronze 6000HSA-qualified
$6,000 / $12,000
$6,000 / $12,000
0%