PacificSource Materials for Idaho in Spanish

You're welcome to download the following materials, or contact your regional marketing office to request hard copies.

AccordantCare Rare Disease Program

Address/Name Change Form

AlternaCare Savings Program flier

Average Cost of Care flier

Care Coordination Request form

COBRA Initial Notice

Continuation Election Form - Federal

Continuation Election Form - State

Diabetes Benefits

Expectations Prenatal Care Program

First Health Network - for members outside the service area

Free & Clear Tobacco Cessation Program

Global Emergency Services - Assist America flier

Group Medical/Dental Enrollment Form

Health Management with PacificSource - clients with 2-50 employees

Health Management with PacificSource - clients with 50+ employees

Healthy Returns Care Management Program - clients with 51+ employees

Hospital-Based Health Education Classes flier

Informed Healthcare Consumer flier

International Travel/Emergency Care Outside the U.S.
Mail Order Pharmacy Options for Prescription Drugs
Maternity Benefits

Preferred Drug List (PDL)

Privacy Policy

Prescription Discount Program flier - plans with pharmacy coverage

Prescription Discount Program flier - plans without pharmacy coverage

Prescription Drug List - Alternatives for Nonpreferred Drugs

Rising Healthcare Costs: Information and Tips

Travel Benefits

Using Your PacificSource Group Health Plan

Using Your Tiered Prescription Drug Plan flier - mac B

Using Your Tiered Prescription Drug Plan flier - no mac

Using Your Tiered Prescription Drug Plan flier - value

Value-Added Programs and Services - clients with 2-50 employees

Value-Added Programs and Services - clients with 51+ employees

Vision Benefits

Waiver of Coverage Form

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