Menu


For Agents
 
Sample Plan Summaries for Idaho

The sample summaries available here represent our approved Idaho small employer plan designs. Upon enrollment, members receive customized summaries showing their specific benefits, lifetime maximums, and any optional coverage provided by the employer. For group-specific member benefit summaries, please contact our Boise office at (208) 342-3709 or (888) 492-2875.

View Oregon plan summaries

MEDICAL PLANS

Preferred CoDeduct Plans:
500+20/80% 1000+40/80% 3000+30/80%
500+20/70% 1000+40/70% 3000+30/70%
500+30/80% 1500+20/80% 3000+40/80%
500+30/70% 1500+20/70% 3000+40/70%
500+40/80% 1500+30/80% 5000+20/80%
500+40/70% 1500+30/70% 5000+20/70%
750+20/80% 1500+40/80% 5000+30/80%
750+20/70% 1500+40/70% 5000+30/70%
750+30/80% 2000+20/80% 5000+40/80%
750+30/70% 2000+20/70% 5000+40/70%
750+40/80% 2000+30/80% 7500+20/80%
750+40/70% 2000+30/70% 7500+20/70%
1000+20/80% 2000+40/80% 7500+30/80%
1000+20/70% 2000+40/70% 7500+30/70%
1000+30/80% 3000+20/80% 7500+40/80%
1000+30/70% 3000+20/70% 7500+40/70%

Preferred Deductible and Percentage Plans:
50+1000 70+7500 50/3500
50+2000 80+500  
70+500 80+750  
70+750 80+1000  
70+1000 80+1500  
70+1500 80+2000  
70+2000 80+3000  
70+3000 80+5000  
70+5000 80+7500  

Preferred FlexPerks Plans (HSA-Qualified):
No Rx Coverage: Rx Subject to Ded.:
FP 80+1500 FP 80+1500 + Rx
FP 80+2000 FP 80+2000 + Rx
FP 80+3000 FP 80+3000 + Rx
FP 100+5000 FP 100+5000 + Rx

Mandated Plans:
Basic Conversion
Catastrophic Standard

OPTIONAL BENEFITS

Prescription Drug Plans:
Tiered 10/20/40 Tiered 15/30/50 Tiered 15/20%/50%
Dental Plans:
Preventive $25/$1000 Preventive $50/$1500 Comp $50/$1000
Preventive $25/$1500 Comp $25/$1000 Comp $50/$1500
Preventive $50/$1000 Comp $25/$1500 Orthodontia
Vision:
Vision 10/100 Vision 10/200 Vision Plus

rule

Unless otherwise stated, all text and images © 2006 PacificSource. All rights reserved.