Agent Bulletin

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March 7, 2018

Updates for New and Renewing Small Groups

Meeting with small group clients

Checklist for New Small Groups

Ensure smooth, delay-free onboarding by submitting everything we need to process your client’s group. For your reference, here’s a simple checklist of what we need:

  • First month’s premium check (binder payment)
  • Completed and signed Group Master Application (Medical and Dental) (pdf)
  • Copy of sold rates — circle the plan(s) the group would like
  • Complete Group Medical and Dental Enrollment Form (pdf) for enrolling eligible employees, including plan choices, dates of hire, dates of birth, and Social Security numbers for enrolling employees and any dependents
  • Waivers for eligible employees who are not enrolling (The group medical and dental enrollment form includes the waiver form.)
  • Group Verification Documentation (Please include ONE of the following forms.)
    • UI5 Form
    • K-1 Form(s) for the owner(s), plus three months paystubs for each employee
    • Unemployment filings
    • If the group is signing up for SHOP, indicate it on the application and provide a copy of the submitted SHOP eligibility form with the Group Master Application and applications/waivers for eligible employees.

Easy Online Renewal Option

Our online renewal system is up and running! It offers convenience for you and your clients and helps to streamline the renewal process. Your clients will still receive a renewal packet, but beginning with January 1, 2018, renewals, your clients will have two options for renewing their plans as proposed—by paper or online.

Who can use this online renewal option?

Currently, this system is only set up for small groups (Montana SHOP groups excluded) who are renewing as proposed. If your client wants changes, they will need to use the traditional paper renewal process.

How the online system works 

Prior to their renewal date, you will receive an email from The subject line will be “PacificSource Health Plans Renewal Reminder.” A week later, we’ll email your client with the same message. 

The email will include the group name and ID number, renewal date, and a PIN. Either you or your client can click the Renew button in the email to go to our secure online renewal website. You will need the information in the email and your email address to log in.

Once logged in, you will see buttons for either renewing as proposed or having one of our representatives contact you. 

Remember: Your small group clients still have the option of renewing using the renewal packet they received and the traditional process. As always, you and your clients are welcome to contact us with questions.  

SHOP Renewal Process Change

The renewal process for SHOP small groups has changed for 2018. Groups will still keep their SHOP eligibility, and simply work directly with PacificSource instead of going through a Marketplace program. Groups will send member enrollments, terminations, and premium payments directly to us.

For your reference, here’s a simple checklist of what we need for an FFM-SHOP-eligible plan:

Please return all paperwork to PacificSource in one of the following ways:

Fax: (406) 422-1010
Mail: 828 Great Northern Blvd Ste 101, Helena, MT 59601

Montana Commercial Sales Team Grows

MontanaTo better serve you and your clients, our commercial sales team has grown! And one person has changed roles. These changes will affect who you contact for information.

Welcome to Our New Team Members

Serving Western Montana: Jeff Hasskamp, Sales Executive, and Sarah Martinie, Small Group Client Service Representative, join Erin Woodrow, Large Group Account Manager.

Serving Eastern Montana: Janean Honadel, Large Group Account Manager, joins Mel Reinhardt, Sales Executive, and Kristi Hostetler, Small Group Client Service Representative

Congratulations to Michelle St Germain, new Regional Sales Manager, Medicare Sales.

Contacts Online

We look forward to our continued partnership with you as we work to service our mutual clients.



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Questions? You’re Always Welcome to Contact Us

PacificSource Health Plans:

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Agent Coordinators:

PacificSource Administrators:

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

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

Website: >

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

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