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Whether you're looking for plan information, our privacy policy or other legal information, you'll find it all here.
Bronze Plan 1 AI/AN Limited Cost Sharing
ViewBronze Plan 1 AI/AN Zero Cost Sharing
ViewBronze HDHP Plan 2 AI/AN Limited Cost Sharing
ViewBronze HDHP Plan 2 AI/AN Zero Cost Sharing
ViewSilver Plan 3 AI/AN Limited Cost Sharing
ViewSilver Plan 3 AI/AN Zero Cost Sharing
ViewGold Plan 4 AI/AN Limited Cost Sharing
ViewGold Plan 4 AI/AN Zero Cost Sharing
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No Surprises Act
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Cancellation of Authorized Representative Form
ViewClient Portal Access Form - Small Group
ViewDesignation of Authorized Representative Form
ViewGrievance Form
ViewHigher Level of Benefits Waiver Form
ViewIndividual Application (for enrollment outside of the Idaho Exchange)
ViewIndividual Application Cover Sheet
ViewMedical Appeal Form
ViewMedical Claim Reimbursement Form
ViewMultiple Coverage Inquiry Form
ViewPharmacy Appeal Form
ViewPharmacy Designation of Authorized Representative (DAR) Form
ViewPre-Authorization Form
ViewProvider Appeal and Claims Inquiry Form
ViewRelease of Protected Health Information Form
ViewRelease of Protected Health Information Form - Psychotherapy
ViewVision Claim Reimbursement Form
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