2017 Idaho Small Group Plans

The information on this page is for small group plans beginning January 1 and April 1, 2017. Small groups in Idaho are employers with two to 50 employees.

Medical Plans

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 chart below. All plans are available direct with PacificSource and through YourHealthIdaho.org.

Medical handbook samples:


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
Bronze HSA 6550 $6,550 $6,550  No charge No charge PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath
Bronze 7150 $7,150 $7,150  $20 co-pay^+, then no charge No charge PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath
Silver HSA 3600 $3,600 $3,600  No charge No charge PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath
Silver 2500 $2,500 $7,150 $20 co-pay^ 30% PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath
Silver 3000 $3,000 $7,150  $20 co-pay^  30% PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath
Silver 4000  $4,000 $7,150 $20 co-pay^ 30% PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath
Silver 5000  $5,000 $7,150 $20 co-pay^ 30% PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath
Gold 1000 $1,000 $5,000 $20 co-pay^ 20% PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath PacificSource / SmartAlliance / BrightPath

^Not subject to annual deductible.

+The first five office visits combined are paid at 100 percent after any applicable co-pay. After that, office visits are subject to deductible and co-insurance.

 

Dental Plans

Dental handbook samples:


Dental Choice 0/20/50 50-1000    
Dental Choice Plus 0/20/50 25-1000 Dental Choice Plus 0/20/50 50-1000
Dental Choice Plus 0/20/50 25-1500 Dental Choice Plus 0/20/50 50-1500
Dental Advantage Core  
Dental Advantage 0/20/50 750  
Dental Advantage 0/20/50 1000 Dental Advantage 0/20/50 1500
Dental Advantage Plus 0/20/50 1000 Dental Advantage Plus 0/20/50 1500
Kids Dental Advantage 0/20/50 Kids Dental Advantage 20/40/50
Ortho 1000 WP*  

*Available direct from PacificSource 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.