Small Group Resources

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.

Benefit Information

For plans with an effective start date in 2016:

2016 Bronze Standard
2016 Silver Standard
2016 Health & Wellbeing 5000/60
2016 Health & Wellbeing 6850/50
2016 Health & Wellbeing 3000/20
2016 Health & Wellbeing 2500/20
2016 New Performance
2016 Benefit exclusions
2016 Benefit limitations 
2016 Prior authorization list

Prescription Drugs

2016 Formulary 
2016 Pharmacy Directory

 

     
Employees may contact Customer Service at 541-768-4550, toll-free 1-800-832-4580 or TTY 1-800-735-2900, 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:

 
Employees may contact Customer Service at 541-768-4550, toll-free 1-800-832-4580 or TTY 1-800-735-2900, 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: