2025 Select Health Individual and Small Employer Plan Highlights.
Colorado Individual Plans.
- Select Health Value network provides access to more than 50 facilities and over 9,000 providers
- Includes access to Intermountain Health and our clinical partners UCHealth and Monument Health
- Urgent/Emergent care outside of Colorado are covered through the Multiplan & PHCS networks
- Prescription Benefits in 2025:
- All plans are moving from 5 tiers to 6 tiers
*Colorado Option plans going from 4 tiers to 5 tiers.
Tier 1 includes preventive drugs covered at no cost to members - Generic maintenance medications for COPD and diabetes are still covered at $0 copay
- Rx deductible is changing from per person to single/family
*plans with a combined Medical and Rx deductible will remain the same
- All plans are moving from 5 tiers to 6 tiers
- Renewals available mid-October
- Updates to APTC will show in your book of business report as available
- Ability to compare year over year
- Member letters arriving by October 31
- Also available in member portal
Idaho Individual plans.
- Med network expansion: adding Bannock, Power, Caribou, Minidonka and Cassia counties. Removing Oneida, Franklin and Bear Lake counties.
- Lower deductibles on Bronze plans
- Specialist & Urgent Care copays before deductible on Silver 3000 plan
- Some plans saw decreases to MOOP and deductibles
- Silver 3000 Specialist Copay and Urgent Care copay no longer after deductible
- Expansion to Wellness rewards for 2025
- $0 Virtual care, Primary care, mental health, urgent care
- $0 copay for most diabetic medications
- Member letters will be mailed out in the coming weeks and will also be available in the member portal
- Updates to APTC will show in your book of business report as available
Idaho Small Employer Plans.
- Med network expansion: adding Bannock, Power, Caribou, Minidonka and Cassia counties. Removing Oneida, Franklin and Bear Lake counties.
- Mineral HR platform, great value adds to clients
Idaho Large Employer Plans.
- Minimal plan changes, some decreases on deductibles and OOPM
- 2025 pricing is stable and competitive
Nevada Individual Plans.
- Med Network Plans changing from HMO to EPO. This creates an active enrollment for On-Exchange members
- Continue to offer before deductible copays for lab & x-ray on all non-HDHPs
- Small adjustments to deductibles and maximum out-of-pocket
- Intermountain Health Maule Clinic is open and accepting new patients
- Renewals available mid-October
- Updates to APTC will show on your book of business report as available
- Ability to compare year over year
- Member letters arriving by October 31
- Also available in member portal
Nevada Small Employer Plans.
- Renewals have been published and are ready to view
- Mineral HR platform, great value adds to clients
- Intermountain EAP is a helpful resource to groups
- Minor adjustments to deductibles and maximum out-of-pocket
- Continue to offer before deductible copays for lab & x-ray on all non-HDHPs
Utah Individual Plans.
- $2 increase to commission rate
- Renewals available mid-October
- Updates to APTC will show on your book of business report as available
- Ability to compare year over year
- Member letters arriving by October 31
- Also available in member portal
- CMS required changes to plan names – review all plan benefits
- 2025 Individual plan discontinuations
- Med Bronze HSA
- Consider Bronze Copay plan (lowest cost Bronze plan) or off-market Silver HSA
- Med Silver 5900
- Consider Silver 6000
- Med Bronze HSA
- Select Health Dental
- No rate increases for 2025
- Budget-friendly
- Comprehensive coverage
- Available Off-Marketplace only
Utah Small Employer Plans.
- HSA qualified
- Bronze 100% plan has increased deductible/OOP
- Silver $3,200 plan has increased deductible
- No change to Silver $4,000/$8,000 and Gold $1,750/$3,500
- Traditional
- Gold $750 plan has decreased OOP and decreased Rx deductible
- Silver Copay Plan has decreased OOP and decreased Rx deductible
- Silver $2,600 Plan has decreased member coinsurance
- All other plans remain unchanged
2025 Commercial Plans Commission Schedule and Bonuses.
Individual Agent of Record (AOR) helpful hints.
- If you are acquiring business from another agent within your agency or you have purchased a portion/all of their business, send an email to Amy.Koncar@selecthealth.org and include both agents. We will process those transfers effective the following month.
- Individual AORs must be submitted through the Select Health Link agent portal. You can find this function below the Agent Tools heading.
- Individual AORs must be received by January 15, 2025, for a January 1 effective date.
- AOR letters must be signed by both the member and the agent within 30 days of submission. AOR letters will be returned unprocessed if signatures are missing or the date on the letter is more than 30 days out.
- Be sure to fully explain to the member the purpose of an AOR. Ensure the member is well-informed on what the change entails.
NOTE: For AOR changes through the FFM/Marketplace, we require an AOR be submitted through Link. We do not accept updates for AOR through Marketplace 834 files.
Updated Marketing Materials.
Updated 2025 marketing materials for the Small Employer, Associations and Individual product lines are now available in Select Health Link to view, download, and order. These materials are tailored to the Utah, Idaho, Nevada and Colorado markets, where applicable.
Mineral® – Product Guide.
Select Health is excited to offer the Mineral PlatformTM as part of our Small Employer and Association plans. Mineral is a leading provider of HR and compliance solutions and services more than 1 million small and medium-sized businesses. To learn more about how Mineral can benefit your clients, view the product guide here.
Mineral® – Industry Value Report.
Select Health's Small Employer health plans in Utah and Nevada automatically include Mineral's HR and compliance solutions. Your clients could be saving thousands of dollars. For more details, view the industry value report here. These Mineral services will also be available to your SE Idaho and UT and ID Association groups beginning 1/1/25.
CAA Gag Clause Confirmation of Compliance.
The Consolidated Appropriations Act (CAA) of 2021 requires group health plans to submit gag clause prohibition compliance attestations annually. Select Health has completed the necessary review of its agreements to ensure compliance with the gag clause prohibition and will do the following:
- Make the attestation for fully insured customers as required.
- Provide a Confirmation of Compliance for self-funded customers to support them in doing their own attestation.
Select Health Brokers may share the following Select Health branded document with customers: Confirmation of Compliance - Gag Clause Attestation
Select Health hereby attests that the administrative services it provides to its self-funded customers are consistent with the requirements set forth in the Consolidated Appropriations Act, 2021 (PL 116260), Division BB, Section 201: INCREASING TRANSPARENCY BY REMOVING GAG CLAUSES ON PRICE AND QUALITY INFORMATION.
Please let your Select Health Account Manager know if you have any questions.
The annual attestation deadline is December 31.
You may use the Confirmation of Compliance to support your attestation for any Select Health administered medical, pharmacy and behavioral health services.
Health and Human Services (HHS) has supplied the portal and instructions for issuers and customers to do their attestation via CMS. It is important to follow the instructions that are accessible through the CMS site.
Your Select Health representative may have also sent the Confirmation of Compliance.
Please contact your broker or Select Health representative if you have any questions.