PacificSource Oregon Standard Silver Plan Navigator · 10091OR0700034
PacificSource Health Plans offers this marketplace health insurance plan (Plan ID 10091OR0700034) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.
Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Oregon). Submit changes before the deadline to avoid a coverage gap.
Enroll by Dec 15 for Jan 1 starts.
Finalize plan switches before the window closes.
Special Enrollment Periods
You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).
Report the event within 60 days.
Keep documentation handy for Healthcare.gov or your state exchange.
CSR & subsidy reminders
Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.
Enter accurate income to maximize Advanced Premium Tax Credits.
Standard Silver On Exchange Plan plans like this one keep deductibles and copays lower if you qualify.
Thinking about switching?
Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.
Match provider networks so ongoing care isn’t disrupted.
Confirm prescriptions stay on-formulary or budget for tier changes.
Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.
Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).
Variant 10091OR0700034-01 (Standard On Exchange Plan) currently displayed.
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Variant attributes
PacificSource Oregon Standard Silver Plan Navigator · Variant 10091OR0700034-01
Plan identifiers & tier
Issuer-provided metadata for this variant.
Business Year
2025
CSR Variation Type
Standard Silver On Exchange Plan
HIOS Product ID
10091OR070
Metal Level
Silver
Plan ID (Standard Component ID with Variant)
10091OR0700034-01
Plan Marketing Name
PacificSource Oregon Standard Silver Plan Navigator
Plan Variant Marketing Name
PacificSource Oregon Standard Silver Plan Navigator
Issuer & service area
Issuer-provided metadata for this variant.
Issuer Actuarial Value
71.36%
Issuer ID
10091
Market Coverage
SHOP (Small Group)
Multiple In Network Tiers
No
National Network
Yes
Network ID
ORN002
Out of Country Coverage
Yes
Out of Country Coverage Description
Emergency Care Only
Out of Service Area Coverage
Yes
Out of Service Area Coverage Description
In and out-of-network providers
Service Area ID
ORS003
State Code
OR
Cost sharing & actuarial values
Issuer-provided metadata for this variant.
AV Calculator Output Number
0.714383636
Drug EHB Deductible, In Network (Tier 1), Default Coinsurance
50.00%
Medical Drug Deductibles Integrated
No
Medical Drug Maximum Out of Pocket Integrated
Yes
Medical EHB Deductible, In Network (Tier 1), Default Coinsurance
30.00%
SBC Scenario, Having a Baby, Coinsurance
$2,100
SBC Scenario, Having a Baby, Copayment
$10
SBC Scenario, Having a Baby, Deductible
$5,500
SBC Scenario, Having Diabetes, Coinsurance
$0
SBC Scenario, Having Diabetes, Copayment
$1,000
SBC Scenario, Having Diabetes, Deductible
$900
SBC Scenario, Treatment of a Simple Fracture, Coinsurance
$0
SBC Scenario, Treatment of a Simple Fracture, Copayment
$400
SBC Scenario, Treatment of a Simple Fracture, Deductible
$2,100
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family
per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual
Not Applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family
$9200 per person | $18400 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual
$9,200
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family
$11250 per person | $22500 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual
$11,250
Enrollment & documents
Issuer-provided metadata for this variant.
Formulary ID
ORF018
SBC Scenario, Having a Baby, Limit
$60
SBC Scenario, Having Diabetes, Limit
$20
SBC Scenario, Treatment of a Simple Fracture, Limit
$0
Additional attributes
Issuer-provided metadata for this variant.
Begin Primary Care Cost-Sharing After Number Of Visits
3
Child-Only Offering
Allows Adult and Child-Only
Composite Rating Offered
Yes
Drug EHB Deductible, Combined In/Out of Network, Family
per person not applicable | per group not applicable
Drug EHB Deductible, Combined In/Out of Network, Individual
Not Applicable
Drug EHB Deductible, In Network (Tier 1), Family
$0 per person | $0 per group
Drug EHB Deductible, In Network (Tier 1), Individual
$0
Drug EHB Deductible, Out of Network, Family
$7500 per person | $15000 per group
Drug EHB Deductible, Out of Network, Individual
$7,500
Dental Only Plan
No
Disease Management Programs Offered
Pregnancy, Diabetes, Heart Disease, Asthma
First Tier Utilization
100%
HSA/HRA Employer Contribution
No
Import Date
1/13/2025
HSA Eligible
No
IsItANewPlan
Existing
Notice Required for Pregnancy
No
Is a Referral Required for Specialist?
No
Medical EHB Deductible, Combined In/Out of Network, Family
per person not applicable | per group not applicable
Medical EHB Deductible, Combined In/Out of Network, Individual
Not Applicable
Medical EHB Deductible, In Network (Tier 1), Family
$5500 per person | $11000 per group
Medical EHB Deductible, In Network (Tier 1), Individual
$5,500
Medical EHB Deductible, Out of Network, Family
$7500 per person | $15000 per group
Medical EHB Deductible, Out of Network, Individual
$7,500
Plan Effective Date
1/1/2025
Plan Expiration Date
12/31/2025
Plan Type
PPO
QHP/Non QHP
Both
Source Name
SERFF
Plan ID
10091OR0700034
Unique Plan Design
Yes
Version Number
1
Wellness Program Offered
Yes
Copay & coinsurance
Pharmacy cost sharing by tier
Drug tier
Pharmacy type
Copay amount
Copay option
Coinsurance rate
Coinsurance option
Mail order
Questions & answers
Frequently asked questions
How do I choose the right ACA plan in Oregon?
PacificSource Oregon Standard Silver Plan Navigator (10091OR0700034) is a Silver PPO from PacificSource Health Plans in Oregon for the 2025 coverage year.
Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.
Does PacificSource Oregon Standard Silver Plan Navigator support telehealth or virtual urgent care?
The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.
Is PacificSource Oregon Standard Silver Plan Navigator HSA-eligible and does it include dental or vision coverage?
It is not marked as HSA-eligible, so confirm with the issuer before relying on tax-advantaged savings.
Dental coverage is not listed for this plan.
Vision coverage is not listed for this plan.
Does PacificSource Oregon Standard Silver Plan Navigator support mail-order prescriptions?
Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.
Which disease management programs come with PacificSource Oregon Standard Silver Plan Navigator?
Is there out-of-country coverage for PacificSource Oregon Standard Silver Plan Navigator?
Yes, limited out-of-country coverage is available. Review the Summary of Benefits for reimbursement steps. Details: Emergency Care Only
Does PacificSource Oregon Standard Silver Plan Navigator cover care outside the service area?
Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: In and out-of-network providers
How do I enroll in or manage payments for PacificSource Oregon Standard Silver Plan Navigator?
Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
