Agent Bulletin

PSHP logo horizontal

Montana | November 2018

Update to Montana Commercial Sales Collateral  

We recently discovered some inaccuracies in our commercial sales brochures and plan comparisons for the Individual and Small Group lines of business. We apologize for any inconvenience this may have caused and are working diligently to correct the situation. 

Upon discovery, we immediately removed the incorrect sales materials from our website and stopped new orders of printed materials.

Updated electronic versions of these documents are available as of November 8, 2018. Revised printed versions will be sent to you directly based on your previous order quantities. Plan comparisons should arrive by November 15, and brochures/sales kit replacements will be shipped to you the week of November 22.

Please recycle all your existing 2019 Individual and Small Group commercial sales brochures and plan comparisons.

Below is a summary of the changes we have made to the original materials.

Individual & Family

We added the phrase “in-network” where we mentioned $0 co-pays for preventive care, to clarify that this benefit applies to care received from in-network providers only.

We added limitations to several of the benefits on the plan comparison charts, as follows:

  • 10 chiropractic visits and 12 acupuncture visits per benefit period for chiropractic and acupuncture
  • Out-of-network: 30-day max fill, no more than 3 per year for prescription (Rx) drug coverage
  • One exam per benefit period for pediatric eye exam
  • One item per benefit period for pediatric vision hardware

We corrected the mention of out-of-network pediatric eye exams from being subject to deductible to not subject to the deductible.

We corrected the mention of in-network pediatric eye exams and vision hardware on the Catastrophic plans from not being subject to deductible to subject to the deductible.

We are including two new documents in the back pocket of the new brochures:

  • Preventive Care Summary
  • Exclusions List

Small Group

We added the phrase “in-network providers” where we mentioned $0 co-pays for preventive care, to clarify that this benefit applies to care received from in-network providers only.

We added the phrase “in-network pharmacies” where we mentioned select preventive prescription drugs, to clarify that this benefit applies to drugs purchased from in-network pharmacies only.

We removed the mention of Dental Advantage Essentials and Dental Advantage Essentials Plus plans from the cosmetic orthodontia section, since these plans aren't available in Montana.

We corrected the minimum number of enrolled employees required for cosmetic orthodontia from 26 to 16. 

We added limitations to several of the benefits on the plan comparison charts, as follows:

  • 10 chiropractic visits and 12 acupuncture visits per benefit period for chiropractic and acupuncture
  • Co-pay waived if admitted for emergency services
  • Out-of-network: 30-day max fill, no more than 3 per year for prescription (Rx) drug coverage

We added the sentence “Preventive mammograms are not subject to the deductible and are covered in full both in- and out-of-network.”

We are including two new documents in the back pocket of the new brochures:

  • Preventive Care Summary
  • Exclusions List
Thank you for your patience and understanding as we ensure that you 
receive the most accurate and useful sales tools to aid you in selling PacificSource health plans.

BKR2_1118_MT

Subscribe to the PacificSource Agent Bulletin

You can subscribe or unsubscribe to our Agent Bulletin at any time. Click "Subscribe to the PacificSource Agent Bulletin" above to be redirected to our newsletter profile page on ConstantContact.com.

We value your privacy


Questions? You’re Always Welcome to Contact Us

PacificSource Health Plans:

Sales and Service Directory >

Agent Coordinators: agentcoordinator@pacificsource.com

PacificSource Administrators:

(541) 485-7488 or toll-free (800) 422-7038

Fax (541) 681-8792 or toll-free (800) 575-1109

Website: PSA.PacificSource.com/PSA >

Liz Manley, Sales Representative, (541) 225-2777 or toll-free (800) 422-7038, ext. 2777


Agent Bulletin is published by PacificSource Health Plans.
See our agent newsletter page for past issues.
Copyright 2018 • PacificSource Health Plans • All rights reserved