Employer Plan Summaries Montana2018 Montana Small Group Plans

The information on this page is for small group plans beginning January 1, 2018. Small groups in Montana 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 network plans are available direct with PacificSource and through HealthCare.gov, unless noted.

Medical handbook samples: (to come)

  • PacificSource Network  
  • PacificSource Network Bronze  
  • PacificSource Network HSA  
  • PacificSource Network with vision  
  • SmartHealth Network  
  • SmartHealth Network Bronze  
  • SmartHealth Network HSA  
  • SmartHealth Network with vision  

Plan

Deductible

Out-of-pocket limit

Office visits
Services performed during an office visit may be billed separately.

Co-insurance

SBCs
by Network
Summaries
by Network
Bronze HSA 4000
$4,000
$6,550 
After deductible, 50%
After deductible, 50%
Bronze HSA 6550
$6,550
$6,550 
After deductible, covered in full
After deductible, covered in full
Bronze 7350
$7,350
$7,350 
$20 co-pay^
After deductible, covered in full
Silver HSA 2700
$2,700
$6,550 
After deductible, 20%
After deductible, covered in full
Silver HSA 3600
$3,600
$3,600
After deductible, covered in full
After deductible, covered in full
Silver 3000
$3,000
$7,350 
$20 co-pay^ 
After deductible, 30%
Silver 3000 VH
$3,000
$7,350 
$20 co-pay^ 
After deductible, 30%
Silver 4000
$4,000
$7,350
$20 co-pay^
After deductible, 30%
Silver 4000 VH
$4,000
$7,350
$20 co-pay^
After deductible, 30%
Silver 5000 
$5,000
$7,350
$20 co-pay^
After deductible, 30%
Silver 5000 VH
$5,000
$7,350
$20 co-pay^
After deductible, 30%
Gold 1000
$1,000
$5,000
$20 co-pay^
After deductible, 20%
Gold 1000 VH
$1,000
$5,000
$20 co-pay^
After deductible, 20%
Gold 2000
$2,000
$5,000
$20 co-pay^
After deductible, 20%
Gold 2000 VH
$2,000
$5,000
$20 co-pay^
After deductible, 20%

^Not subject to annual deductible. 

 

Dental Plans 


Dental handbook samples:


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

*Available direct from PacificSource only.

 

Brochures and Forms 


Brochures:  

Quote Request and Forms

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

 

Choose a Medical Plan in One of Two Networks


Access more providers with our PacificSource Network.

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 your employees will
have more providers to choose from.

PacificSource Network Availability

All Montana businesses can choose health plans on the PacificSource Network, regardless of location.

 

Lower your costs with our SmartHealth Network.

The SmartHealth Network is designed to give your employees a coordinatedcare experience through select provider groups and facilities. This level of provider collaboration means great care for your employees at a lower cost.

SmartHealth Network Availability

If your business is in one of the following counties, you can choose plans on the SmartHealth Network:

  • Carbon
  • Missoula
  • Musselshell
  • Park
  • Stillwater
  • Sweet Grass
  • Yellowstone