2020 Large Group Plans
Plans for 51+ Employees
Samaritan Health Plans offers large group plans for Oregon businesses with more than 50 employees. Our integrated health plans and wellness programs help hold the line on your insurance costs by engaging employees and their families in maintaining and improving their health. All of our plans include:
- A nationwide provider network
- Free preventive services
- Wellness services (includes a health assessment, biometric screening and online health courses)
Certificate
For plans with an effective start date in 2021 review the 2020 Certificate - Large 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 2020 Authorization List - Large Group Plans.
Additional Benefits Available
Our large group plans can be customized with the following optional benefits:
- Alternative Care (including chiropractic, acupuncture and massage services):
Alternative Care Option 1 or Alternative Care Option 2 - Vision Coverage:
Vision Benefits - Employee Assistance Program (EAP):
EAP Enhanced, EAP Enhanced WholeLife Directions, EAP Platform or EAP Platform WholeLife Directions
Schedule of Benefits
The deductibles and out-of-pocket maximums listed below 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.
| Deductible | Out-of-pocket Maximum | Coinsurance | Office Visits | Urgent Care | Plan Documents | |
|---|---|---|---|---|---|---|
| Everyday Choices Option 1 | [$0–$8,150] | [$0–$8,150] | 10–50% | Primary care: $20 Specialty care: $35 Mental health: $35 |
$35 | Schedule of Benefits - Option 1 |
| Everyday Choices Option 2 | [$0–$8,150] | [$0–$8,150] | 10–50% | Primary care: $30 Specialty care: $45 Mental health: $45 |
$45 | Schedule of Benefits - Option 2 |
| Everyday Choices Option 3 | [$0–$8,150] | [$0–$8,150] | 10–50% | Primary care: $35 Specialty care: $50 Mental health: $30 |
$50 | Schedule of Benefits - Option 3 |
| Everyday Choices HDHP 2500 | $2,500 | $6,750 | 20% | Primary care: 20% Specialty care: 20% Mental health: 20% |
20% coinsurance | Schedule of Benefits - HDHP 2500 |
| Everyday Choices HDHP 2700 | $2,700 | $6,750 | 20% | Primary care: 20% Specialty care: 20% Mental health: 20% |
20% coinsurance | Schedule of Benefits - HDHP 2700 |
| Everyday Choices HDHP 5250 | $5,250 | $6,750 | 20% | Primary care: 20% Specialty care: 20% Mental health: 20% |
20% coinsurance | Schedule of Benefits - HDHP 5250 |
Looking for additional forms and documents?
Friendly, Local Service. Nationwide Networks.
And our large and small group plans use a comprehensive formulary and an extensive pharmacy network for prescription drug coverage.
Want to Learn More?
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