2017 Idaho Large Group Plans

The information on this page is for plans beginning January 1 and April 1, 2017. 

Medical Plans

Medical handbook samples:


Deductible and out-of-pocket limit amounts shown below are the costs for individuals. Amounts for families are twice the individual amounts. If members receive services from out-of-network providers, their deductible and out-of-pocket limit will be higher than the amounts listed in the table below.  

Plan

Deductible

Out-of-pocket limit

Co-pay for office visits
Services performed during an office visit may be billed separately.

Co-insurance after    deductible   

SBCs
effective January 1

by Network
SBCs
effective April 1

by Network
Summaries
by Network
1000+30-45_20 $1,000 $5,000 $30 20% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
1000+30-45_30 $1,000  $5,000 $30 30% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
1500+30-45_20 $1,500  $5,500 $30 20% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
1500+30-45_30 $1,500 $5,500 $30 30% PacificSource / SmartAlliance / SmartHealth / BrightPath   PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
2000+30-45_20 $2,000 $6,000 $30 20% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
2000+30-45_30  $2,000 $6,000 $30 30% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
2500+30-45_20  $2,500 $6,000 $30 20% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
2500+30-45_30 $2,500 $6,000  $30 30% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
3000+30-45_20 $3,000 $6,000  $30 20% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
3000+30-45_30 $3,000 $6,000  $30 30% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
4000+30-45_20 $4,000 $6,000  $30 20% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
4000+30-45_30 $4,000 $6,000  $30 30% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
5000+30-45_20 $5,000 $6,850  $30 20% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
5000+30-45_30 $5,000 $6,850  $30 30% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
HSA 1500+Rx Non-embedded $1,500 $4,500 No co-pay 20% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
HSA 3000+50+Rx $3,000 $6,350 No co-pay 50% PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
HSA 3000+Rx $3,000 $3,000 No co-pay No charge after deductible PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
HSA 4000+Rx $4,000 $4,000 No co-pay No charge after deductible PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath
HSA 5000+Rx $5,000 $5,000 No co-pay No charge after deductible PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath PacificSource / SmartAlliance / SmartHealth / BrightPath

 

Dental Plans 

Dental handbook samples:


Dental Advantage Plus 0-20-50 50-1000   Dental Choice Plus 0-20-50 25-1000
Dental Advantage Plus 0-20-50 50-1500 Dental Choice Plus 0-20-50 25-1500
Dental Advantage Plus 20-20-50 50-1000 Dental Choice Plus 0/20/50 50-1000
Dental Advantage Plus 20-20-50 50-1500 Dental Choice Plus 0/20/50 50-1500
Kids Dental Advantage 0/20/50 Kids Dental Advantage 20/40/50
Orthodontia 1000 Orthodontia 1500

Voluntary Dental Option Plans

Our Voluntary Dental option is available to businesses with ten or more enrolled employees. For information and requirements, please see our Voluntary Dental flier.

Dental Advantage 0/20/50 50-1000 Voluntary Dental Choice 0/20/50 25-1500 Voluntary  
Dental Advantage 0/20/50 50-1500 Voluntary   Dental Choice 0/20/50 50-1500 Voluntary

 

Pharmacy Plans


ID 3000D IDL  ID 20P 1500D IDL
ID 4000D IDL  ID 50P 3000D IDL  
ID 5000D IDL  ID 7-25-50 250D IDL
   ID 7-25-50 IDL

 

Chiropractic Manipulation and Acupuncture


 Summary

 

Vision Plans

Vision 100 Vision Plus
Vision 200 Vision Exam Only

 

Network Availability (Medical)


Network availability varies depending on geographic location.

PacificSource Network (PSN)

 

Availability: All Idaho businesses can choose health plans on the PacificSource Network, regardless of location.

Notable features: The PacificSource Network (PSN) includes the broadest access to in-network providers and facilities, such as hospitals and urgent care centers. Plans on the PacificSource Network will typically cost more because members will have more providers to choose from.

 

SmartAlliance Network

 

Availability: Businesses located in the following counties can choose plans on the SmartAlliance Network:

  • Ada
  • Boise
  • Canyon
  • Gem
 
  • Owyhee
  • Payette
  • Washington
 

Notable features: The SmartAlliance Network is designed to give members a coordinated-care experience through select provider groups and facilities. This level of provider collaboration means great care at a lower cost. This network includes coverage with Saint Alphonsus providers and facilities, as well as other local healthcare providers.

 

BrightPath Network

 

Availability: Businesses located in the following counties can choose plans on the BrightPath Network:

  • Ada
  • Blaine
  • Boise
  • Camas
  • Canyon
  • Elmore
 
  • Gem
  • Gooding
  • Jerome
  • Lincoln
  • Minidoka
  • Owyhee
 
  • Payette
  • Twin Falls
  • Valley
  • Washington
 

Notable features: The BrightPath Network is designed to give members a coordinated-care experience through select provider groups and facilities. This level of provider collaboration means great care at a lower cost. This includes coverage with St. Luke's providers and facilities, as well as other local healthcare providers.