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Coronavirus Updates to Share with Members

Breaking news for health plan members: $0 cost COVID-19 testing and telehealth. To keep you up to date with changes that impact you and your plan benefits, we’ve developed a news page for your convenience. Please visit the page for frequent updates. 

Download plan documents and forms to help you serve your clients. Can’t find something? Contact us to let us know what you need.

Small Group Plan Information

Certificate 

For plans with an effective start date in 2021, review the 2021 Certificate - Small Group Plans.

Some Services Require Authorization

Coverage of certain medical services and surgical procedures requires Samaritan Health Plans’ written authorization before the services are performed. Your provider can request prior authorization by phone, fax or mail. If for any reason your provider will not or does not request prior authorization for you, you must contact Samaritan Health Plans yourself. In some cases, additional information or a second opinion can be required before authorizing coverage. Review the 2021 Authorization List - Small Group Plans

Benefit Summaries

The deductibles and out-of-pocket maximums reflect costs for individuals using in-network providers. Costs will be higher when using out-of-network providers. Please refer to the plan documents for a full description of benefits.

Standards Plans

2021 Summary of Benefit Changes - Standard Bronze Plan
2021 Plan Summary - Standard Bronze Plan
2021 Summary of Benefit Changes - Standard Silver Plan
2021 Plan Summary - Standard Silver Plan

Tier 1 - 20% Coinsurance Plans

2021 Summary of Benefit Changes -  Platinum 500 Tier 1
2021 Plan Summary - Platinum 500 Tier 1
2021 Summary of Benefit Changes - Gold 1250 Tier 1
2021 Plan Summary - Gold 1250 Tier 1
2021 Summary of Benefit Changes -  Gold 2000 Tier 1
2021 Plan Summary - Gold 2000 Tier 1
2021 Summary of Benefit Changes - Gold 3150 Tier 1
2021 Plan Summary - Gold 3150 Tier 1
2021 Summary of Benefit Changes - Gold 4000 Tier 1
2021 Plan Summary - Gold 4000 Tier 1

Tier 2 - 30% Coinsurance Plans

2021 Summary of Benefit Changes - Gold 500 Tier 2
2021 Plan Summary - Gold 500 Tier 2
2021 Summary of Benefit Changes - Gold 1000 Tier 2
2021 Plan Summary - Gold 1000 Tier 2
2021 Summary of Benefit Changes -  Gold 1500 Tier 2
2021 Plan Summary - Gold 1500 Tier 2
2021 Summary of Benefit Changes - Gold 2500 Tier 2
2021 Plan Summary - Gold 2500 Tier 2
2021 Summary of Benefit Changes - Silver 5200 Tier 2
2021 Plan Summary - Silver 5200 Tier 2

Tier 3 - 50% Coinsurance Plan

2021 Summary of Benefit Changes -  Silver 6850 Tier 3
2021 Plan Summary - Silver 6850 Tier 3

HDHP Plan

2021 Summary of Benefit Changes - Silver 2800 HDHP
2021 Plan Summary - Silver 2800 HDHP
2021 Summary of Benefit Changes - Bronze 7000 HDHP
2021 Plan Summary - Bronze 7000 HDHP