2020 Montana Small Group Plans

The information on this page is for small group plans beginning January 1, 2020. Small groups in Montana are employers with one to 50 employees.

Quicklinks

 

Learn what we have to offer

Download a brochure (PDFs):

 

At your service: plans and networks come with choice

PacificSource is excited to introduce Navigator and Voyager.

Navigator—for exceptional coordinated care

Navigator gives you a more integrated approach to care—helping members get the right care, at the right time, in the right place. It’s care that’s coordinated to simplify the member experience, improve access to care, and promote member engagement through shared decision-making within an accountable network of providers.

Navigator is available for purchase by employers located in the following counties:

  • Carbon
  • Flathead
  • Lake
  • Lewis and Clark
  • Missoula
  • Musselshell
  • Park
  • Stillwater
  • Sweet Grass
  • Yellowstone

Voyager gives you the broadest choice of networks

Voyager is our rebranded evolution of the PSN (PacificSource Network) product. As a preferred provider organization (PPO), Voyager means greater choice for members. For those who prefer a more self-guided experience, Voyager gives members expanded access to our broadest network of providers.

Voyager is available for purchase by businesses located throughout the state of Montana.

 

Review 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 network plans are available direct with PacificSource and through  HealthCare.gov, unless noted.

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: $30* Specialist: $60* Navigator / Voyager Navigator / Voyager
Gold 1000 VH
with adult vision
$1,000 $5,500 Covered in Full Primary/Urgent Care: $30* Specialist: $60* Navigator / Voyager Navigator / Voyager
Gold 2000 $2,000 $5,500 Covered in Full Primary/Urgent Care: $30* Specialist: $60* Navigator / Voyager Navigator / Voyager
Gold 2000 VH
with adult vision
$2,000 $5,500 Covered in Full Primary/Urgent Care: $30* Specialist: $60* Navigator / Voyager Navigator / Voyager
Silver 3000 $3,000 $8,150 Covered in Full Primary/Urgent Care: $35* Specialist: 40% Navigator / Voyager Navigator / Voyager
Silver 4500 $4,500 $7,500 Covered in Full Primary/Urgent Care: $30* Specialist: $60* Navigator / Voyager Navigator / Voyager
Silver 4500 VH
with adult vision
$4,500 $7,500 Covered in Full Primary/Urgent Care: $30* Specialist: $60* Navigator / Voyager Navigator / Voyager
Silver 5500 $5,500 $7,500 Covered in Full Primary/Urgent Care: $30* Specialist: $60* Navigator / Voyager Navigator / Voyager
Silver 5500 VH
with adult vision
$5,500 $7,500 Covered in Full Primary/Urgent Care: $30* Specialist: $60* Navigator / Voyager Navigator / Voyager
Silver 6500 $6,500 $7,500 Covered in Full Primary/Urgent Care: $30* Specialist: $60* Navigator / Voyager Navigator / Voyager
Silver 6500 VH
with adult vision
$6,500 $7,500 Covered in Full Primary/Urgent Care: $30* Specialist: $60* Navigator / Voyager Navigator / Voyager
Bronze 8150 $8,150 $8,150 Covered in Full Primary/Urgent Care: $40*
Specialist: Covered in Full
Navigator / Voyager Navigator / Voyager
Gold HSA 3000 $3,000 $3,000 Covered in Full Covered in Full Navigator / Voyager Navigator / Voyager
Silver HSA 3000 $3,000 $6,750 Covered in Full 20% Navigator / Voyager Navigator / Voyager
Silver HSA 4500 $4,500 $4,500 Covered in Full Covered in Full Navigator / Voyager Navigator / Voyager
Silver HSA 5500 $5,500 $5,500 Covered in Full Covered in Full Navigator / Voyager Navigator / Voyager
Bronze HSA 5000 $5,000 $6,750 Covered in Full 50% Navigator / Voyager Navigator / Voyager
Bronze HSA 6750 $6,750 $6,750 Covered in Full Covered in Full Navigator / Voyager Navigator / Voyager

*Not subject to deductible. 

 

Decide on dental plans 

Dental handbook samples (PDFs): 

Summaries (PDFs):

Dental Choice Core^  
Dental Choice 0-20-50 750    
Dental Choice 0-20-50 1000^ Dental Choice 0-20-50 1500^
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^
Kids Dental Choice 0-20-50^ Kids Dental Choice 20-40-50^
Ortho 1000 WP^*  

^ Available direct from PacificSource only.

* Additional eligibility requirements may apply.
 

 

Brochures, enrollment forms, and more  

Brochures (PDFs):   

Quote Request and Forms (PDFs):

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

 

For producers

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

Order printed materials 

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