Skip to Main Content

Helping You Manage Your Account

Small group plan administrators may access the administrative forms, member forms and plan documents you need below. Get answers to your frequently asked questions.

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

 
Employees may contact Customer Service at 541-768-4550, toll-free 800-832-4580 or TTY 800-735-2900, Monday through Friday, 8 a.m. to 8 p.m. Employees may also come to our office location at 2300 NW Walnut Blvd., Corvallis, Oregon, Monday through Friday, 8:30 a.m. to 5 p.m.
No. Products are offered on a sole carrier basis.
Employees may receive urgent and emergent services nationwide as they could in network. If your employees do see an out-of-network provider for services other than for urgent care services and emergencies, out-of-pocket costs will be higher than they would if received in network. Samaritan Health Plans has contracted with discount provider networks to keep both in- and out-of-network costs down. You can call the plan for specific questions regarding provider networks, benefits and service area.

A minimum of 51% of the enrolled population must reside in the Samaritan Small Group service area. An eligible employer is one that:

  • employs an average of at least one but not more than 50 employees on business days during the preceding calendar year, the majority of whom are employed within the Samaritan Health Plans Small Group Service area (currently the entire state of Oregon).
  • employs at least one eligible employee on the effective date of coverage.

Samaritan Health Plans is not on the Exchange. Enrolling onto a health plan on the Exchange opens up the employers’ opportunity to get these tax credits. You will not be eligible for the IRS Small Business Health Care Tax Credit. This tax credit is available to those employers who meet specific criteria and who enroll through the SHOP Marketplace.

For more information, reference the following websites: