2019 Idaho Small Group Plans

The information on this page is for small group plans beginning January 1, 2019. Small groups in Idaho are employers with one 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 (PDFs): 


Plan

Deductible

Out-of-pocket Maximum

Preventive Services
No deductible, member pays:

Office Visits
After deductible, member pays:

SBCs (PDFs)
by Network
Summaries (PDFs)
by Network
Gold 1000^  $1,000 $5,500 Covered in Full Primary/Urgent Care: $20 co-pay*
Specialist: $50 co-pay*
PacificSource / BrightPath PacificSource / BrightPath
Gold 2000^  $2,000 $5,500 Covered in Full Primary/Urgent Care: $20 co-pay*
Specialist: $50 co-pay*
PacificSource / BrightPath PacificSource / BrightPath
Silver 3500^   $3,500 $7,350  Covered in Full Primary/Urgent Care: $30 co-pay*
Specialist: $60 co-pay* 
PacificSource / BrightPath PacificSource / BrightPath
Silver 4000^   $4,000 $7,350 Covered in Full Primary/Urgent Care: $30 co-pay*
Specialist: $60 co-pay*
PacificSource / BrightPath PacificSource / BrightPath
Silver 5000^   $5,000 $7,350 Covered in Full Primary/Urgent Care: $30 co-pay*
Specialist: $60 co-pay*
PacificSource / BrightPath PacificSource / BrightPath
Bronze 7600 $7,600 $7,600  Covered in Full Primary/Urgent Care: $35 co-pay*
Specialist: Covered in Full
PacificSource / BrightPath PacificSource / BrightPath
Gold HSA 3000 $3,000 $3,000 Covered in Full Covered in Full PacificSource / BrightPath PacificSource / BrightPath
Silver HSA 3000 $3,000 $6,650  Covered in Full 20% PacificSource / BrightPath PacificSource / BrightPath
Silver HSA 4000 $4,000 $4,000  Covered in Full Covered in Full PacificSource / BrightPath PacificSource / BrightPath
Silver HSA 5400 $5,400 $5,400  Covered in Full Covered in Full PacificSource / BrightPath PacificSource / BrightPath
Bronze HSA 5200 $5,200 $6,650  Covered in Full 50% PacificSource / BrightPath PacificSource / BrightPath
Bronze HSA 6650 $6,650 $6,650  Covered in Full Covered in Full PacificSource / BrightPath PacificSource / BrightPath

^ Adult vision included on this plan. 

* Not subject to deductible.

 

Dental Plans

Dental handbook samples (PDFs):

Summaries (PDFs):

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 (Revised 10/25/18) Kids Dental Advantage 20-40-50 (Revised 10/25/18)
Ortho 1000 WP^*  

^ Available direct from PacificSource only.

* Additional eligibility requirements may apply. 

 

Brochure and Forms 

Brochures:

  SMG73_080918_Idaho_Medical_SmallGroup_cover


You can order sales kits for individual and small group clients online!

Order printed materials today >

Brochures (PDFs):

Quote Request and Enrollment Forms (PDFs):

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

  

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.

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.