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NEW** Beginning with the FY25 plan year, July 1, 2024, the medical coverage for the State Health Plan will be serviced by Regence BlueShield of Idaho. Full plan documents are being prepared and will be posted in addition to the Summaries of Benefits & Coverage (SBC’s), program flyers, and other resource documents.
The State offers three medical plan options so that employees can select the plan that best meets their needs as well as access providers in their geographic area. Each medical plan provides comprehensive coverage, with different levels of out-of-pocket expenses and premium contribution rates. A Vision Benefit and Prescription Drug Coverage are included with medical plan enrollment. All benefit eligible employees also have access to an Employee Assistance Program (EAP) and Wellness Resources. Deductibles and benefits for all plans are provided on a fiscal year, from July 1 through June 30.
PPO Highlights
- You save money when you use In-Network Blue Cross of Idaho providers
- Most employees choose this plan
High Deductible (HDHP) Highlights
- HSA compatible. All services and prescriptions that are not preventive in nature are subject to the deductible before the plan begins to pay.
FY24 Medical Plan Comparison & Plan Contracts (Start July 1, 2023)
| Feature Name | PPO In-Network | PPO Out-of-Network | Traditional | High Deductible |
|---|---|---|---|---|
| FY24 Plan Contracts | Active PPO Contract | Active PPO Contract | Active Trad Contract | Active HDHP Contract |
| FY24 Plan Summary | Active PPO SBC | Active PPO SBC | Active Trad SBC | Active Single HDHP SBC Active Family HDHP SBC |
| Deductible - Individual | $350 | $600 | $500 | $2000 |
| Deductible - Family | $950 | $1,700 | $1,400 | $4,000 |
| Out-of-Pocket Limit - Individual | $3,250 | $6,500 | $4,350 | In Network: $5,000 Out-of-Network: $6,500 |
| Out-of-Pocket Limit -Family | $6,750 | $13,500 | $8,700 | In Network: $10,000 Out-of-Network: $13,000 |
| Plan Payment (% of allowable charges after deductible) | ChoiceDocs $0 copay, $20 Specialist copay / 80% Non-ChoiceDocs $20 copay, $40 Specialist copay / 80% | 60% | 70% | In Network: 70% Out-of-Network: 50% |
| Wellness/Preventive Care | No copay for listed services | 60% | 100% | In Network: 100% Out-of-Network: 50% after deductible |
| Telehealth/MDLive | No copay | N/A | No copay | 100% after deductible |
I’m traveling out of the country, what should I know?
As an enrolled member in the State’s health plan, you have the ability to take your healthcare benefits with you when you go abroad. Through the Blue Cross Blue Shield Global Core program, you have access to doctors, hospitals, support tools, and resources around the world.
Here is what you need to know:
- Always carry your insurance card.
- Contact the plan before you travel for questions about using services.
- If direct payment has not been arranged or your local plan is unable to verify your benefit coverage at time of service, you may need to pay upfront and submit a claim for reimbursement.
To learn more, review these resources available from the Global Core program: