Brochure PDF: Health Plans for Idaho Large Groups2019 Idaho Large Group Plans 

The information on this page is for plans beginning January 1, 2019.

Medical Plans

Medical handbook samples (PDFs): 


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 Maximum

Preventive Services
No deductible, member pays:

Office Visits
After deductible, member pays:

SBCs (PDFs)
by Network
(
HSA rev. 11/27/18)
Summaries (PDFs)
by Network
1000+30-45_20 $1,000 $5,000 Covered in Full

Primary: $30*
Specialist: $45*

PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
1000+30-45_30 $1,000  $5,000 Covered in Full Primary: $30*
Specialist: $45*
PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
1500+30-45_20 $1,500  $5,500 Covered in Full Primary: $30*
Specialist: $45*
PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
1500+30-45_30 $1,500 $5,500 Covered in Full Primary: $30*
Specialist: $45*
PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
2000+30-45_20 $2,000 $6,000 Covered in Full Primary: $30*
Specialist: $45*
PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
2000+30-45_30  $2,000 $6,000 Covered in Full Primary: $30*
Specialist: $45*
PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
2500+30-45_20  $2,500 $6,000 Covered in Full Primary: $30*
Specialist: $45*
PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
2500+30-45_30 $2,500 $6,000  Covered in Full Primary: $30*
Specialist: $45*
PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
3000+30-45_20 $3,000 $5,000  Covered in Full Primary: $30*
Specialist: $45*
PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
3000+30-45_30 $3,000 $6,000  Covered in Full Primary: $30*
Specialist: $45*
PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
4000+30-45_20 $4,000 $6,000  Covered in Full Primary: $30*
Specialist: $45*
PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
4000+30-45_30 $4,000 $6,000  Covered in Full Primary: $30*
Specialist: $45*
PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
5000+30-45_20 $5,000 $6,850  Covered in Full Primary: $30*
Specialist: $45*
PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
5000+30-45_30 $5,000 $6,850  Covered in Full Primary: $30*
Specialist: $45*
PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
HSA 1500_20+Rx Non-embedded $1,500 $4,500 Covered in Full 20% PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
HSA 3000_20+Rx $3,000 $5,000 Covered in Full 20% PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
HSA 3000_50+Rx $3,000 $6,350 Covered in Full 50% PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
HSA 3000+Rx $3,000 $3,000 Covered in Full Covered in Full PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
HSA 4000+Rx $4,000 $4,000 Covered in Full Covered in Full PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance
HSA 5000+Rx $5,000 $5,000 Covered in Full Covered in Full PacificSource / BrightPath / SmartAlliance PacificSource / BrightPath / SmartAlliance

 * Not subject to deductible.

 

Dental Plans (PDFs)

Dental handbook samples:  


Dental Advantage Plus 0-20-50 1000   Dental Choice Plus 0-20-50 25-1000
Dental Advantage Plus 0-20-50 1500 Dental Choice Plus 0-20-50 50-1000
Dental Advantage Plus 20-20-50 1000 Dental Choice Plus 0-20-50 25-1500
Dental Advantage Plus 20-20-50 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.

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

 

Pharmacy Plans (PDFs, revised October 9, 2018)


ID 7-25-50 IDL ID 20P 1500D IDL ID 3000D IDL
ID 7-25-50 250D IDL (rev. 10/22)  ID 20P 3000D IDL ID 4000D IDL
   ID 50P 3000D IDL ID 5000D IDL

  

Vision Plans (PDFs)


Vision 100
Vision 200
Vision Exam Only
Vision Plus

 

Brochures and Forms (PDFs)


Brochures:

Forms:

Visit our Idaho Forms and Materials page for more sales materials.

Brokers: You can order sales kits for large group clients online!

Order printed materials today >  

  

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
  • Adams
  • Blaine
  • Boise
  • Camas
  • Canyon
  • Cassia
  • Custer
  • Elmore
 
  • Gem
  • Gooding
  • Jerome
  • Lemhi
  • 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.