Rocky Mountain Summit is our statewide HMO product line, offered to small employers in every county in Colorado. Rocky Mountain Summit offers access to our statewide and national network of providers and facilities. No referrals are needed.
Rocky Mountain Range HMO regional health plans are available in - Archuleta, Delta, Dolores, Grand, Gunnison, Hinsdale, Jackson, La Plata, Moffat, Montezuma, Montrose, Ouray, Rio Blanco, Routt, San Juan, and San Miguel counties. . Members have access to a comprehensive network of West Slope Colorado physicians and facilities as well as access to physicians and facilities in Denver and Colorado Springs as well as our national network. No referrals are needed.Rocky Mountain Range Service Area Map
(New for 2019!) Rocky Mountain Canyon HMO regional health plans are available in Archuleta, Dolores, La Plata, Montezuma, and San Juan counties. These tiered benefit plans offer access to the Rocky Mountain Range and national network of providers and facilities. No referrals are needed.
Rocky Mountain Canyon Service Area Map
To view coverage and deductible information for each Colorado Small Group HMO health plan offered by Rocky Mountain Health Plans, review our HMO Plan Comparison Grid below, or download our Small Employer Group plan brochures.
2019 Rocky Mountain Canyon Brochure 2019 Rocky Mountain Range Brochure 2019 Rocky Mountain Summit Brochure
2019 Rocky Mountain Canyon HMO Group Plans
Rocky Mountain Canyon HMO Bronze HSA 6500/100%
Deductible Individual / Family
$6,500 Individual/$13,000 Family
Office Visits
PCP: 0% coinsurance after deductible
Specialist: 0% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
0% coinsurance after deductible
Out of Pocket Maximum
$6,500 Individual/$13,000 Family
Prescription Drug Coverage
0% coinsurance after deductible
Rocky Mountain Canyon HMO Bronze 6700/60%/$50
Deductible Individual / Family
$6,700 Individual/$13,400 Family
Office Visits
PCP 1st 3 visits 100%, then $50 no deductible;
Specialist $80 no deductible
Inpatient Hospital Stay (after deductible)
40% coinsurance after deductible
Out of Pocket Maximum
$7,900 Individual/$15,800 Family
Prescription Drug Coverage
No Deductible
Tier 1: $25
Tier 2: $50
Tier 3: $1000 Ded, then $150
Tier 4: $1000 Ded, then $300
Tier 5: $1000 Ded, then $350
Rocky Mountain Canyon HMO Silver HSA 4500/100%
Deductible Individual / Family
$4,500 Individual/$9,000 Family
Office Visits
0% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
0% coinsurance after deductible
Out of Pocket Maximum
$4,500 Individual/$9,000 Family
Prescription Drug Coverage
0% coinsurance after deductible
Rocky Mountain Canyon HMO Silver 4500/70%/$35
Deductible Individual / Family
$4,500 Individual/$9,000 Family
Office Visits
$35/$70 Copay, no deductible
Inpatient Hospital Stay (after deductible)
30% coinsurance after deductible
Out of Pocket Maximum
$7,200 Individual/$14,400 Family
Prescription Drug Coverage
No Deductible
Tier 1: $20
Tier 2: $50
Tier 3: $200 Ded $80
Tier 4: $200 Ded 20%
Tier 5: $200 Ded 30%
More Information1
Rocky Mountain Canyon HMO Silver 3000/75%/$35
Deductible Individual / Family
$3,000 Individual/$6,000 Family
Office Visits
PCP $35 / Specialist 25% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
25% coinsurance after deductible
Out of Pocket Maximum
$6,800 Individual/$13,600 Family
Prescription Drug Coverage
No Deductible
Tier 1: $15
Tier 2: $50
Tier 3: $100
Tier 4: $200
Tier 5: $300
Rocky Mountain Canyon HMO Gold 1000/80%/$25
Deductible Individual / Family
$1,000 Individual/$2,000 Family
Office Visits
PCP 1st 3 visits 100%, then $25 no deductible/Specialist $55 no deductible
Inpatient Hospital Stay (after deductible)
20% coinsurance after deductible
Out of Pocket Maximum
$6,500 Individual/$13,000 Family
Prescription Drug Coverage
No Deductible
Tier 1: $15
Tier 2: $50
Tier 3: $100
Tier 4: $200
Tier 5: $300
2019 Rocky Mountain Range Regional HMO Plans
Range HMO Bronze HSA 6550/100
Deductible Individual / Family
$6,550/$13,100
Office Visits
0% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
0% coinsurance after deductible
Out of Pocket Maximum
$6,550/$13,100
Prescription Drug Coverage
After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%
Range HMO Bronze 6800/65 - $60
Deductible Individual / Family
$6,800 Individual/$13,600 Family
Office Visits
PCP 1st 4 visits $60, then 35% coinsurance after deductible
Specialist $130, no deductible
Inpatient Hospital Stay (after deductible)
35% coinsurance after deductible
Out of Pocket Maximum
$7,900 Individual/$15,800 Family
Prescription Drug Coverage
Tier 1: $20
Tier 2: $50
Tier 3: $125
Tier 4: $300
Tier 5: $500
(no deductible)
Range HMO Silver 5000/50 - $55
Deductible Individual / Family
$5,000 Individual/$10,000 FamilyOffice Visits
PCP: First 5 visits: $55, no deductible, then 50% after deductibleSpecialist: $80, no deductible
Inpatient Hospital Stay (after deductible)
50% coinsurance after deductibleOut of Pocket Maximum
$7,900 Individual/$15,800 FamilyPrescription Drug Coverage
Tier 1: $20Tier 2: $55
Tier 3: $100
Tier 4: $300
Tier 5: $500
(no deductible)
Range HMO Silver 4500/75 - $55
Deductible Individual / Family
$4,500 Individual/$9,000 FamilyOffice Visits
$55/$80, no deductibleInpatient Hospital Stay (after deductible)
25% coinsurance after deductibleOut of Pocket Maximum
$7,000 Individual/$14,000 FamilyPrescription Drug Coverage
Tier 1: $20, no deductibleAfter $200 Rx deductible:
Tier 2: $50
Tier 3: $80
Tier 4: 25%
Tier 5: 30%
Range HMO Silver HSA 4000/100
Deductible Individual / Family
$4,000 Individual/$8,000 Family
Office Visits
0% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
0% coinsurance after deductible
Out of Pocket Maximum
$4,000 Individual/$8,000 Family
Prescription Drug Coverage
After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%
Range HMO Silver 3500/70 - $55
Deductible Individual / Family
$3,500 Individual/$7,000 Family
Office Visits
$55/$80 copay no deductible
Inpatient Hospital Stay (after deductible)
30% coinsurance after deductible
Out of Pocket Maximum
$7,900 Individual/$15,800 Family
Prescription Drug Coverage
Tier 1: $20
Tier 2: $50
Tier 3: $80
Tier 4: $300
Tier 5: $400
(no deductible)
Range HMO Silver 2800/65 - $45
Deductible Individual / Family
$2,800 Individual/$5,600 Family
Office Visits
PCP - First 3 visits $45, no deductible, then 35% after deductible
Specialist - $70, no deductible
Inpatient Hospital Stay (after deductible)
35% coinsurance after deductible
Out of Pocket Maximum
$7,600 Individual/$15,200 Family
Prescription Drug Coverage
Tier 1: $20
Tier 2: $50
Tier 3: $80
Tier 4: $300
Tier 5: $400
(no deductible)
Range HMO Gold HSA 2800/100
Deductible Individual / Family
$2,800 Individual/$5,600 Family
Office Visits
0% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
0% coinsurance after deductible
Out of Pocket Maximum
$2,800 Individual/$5,600 Family
Prescription Drug Coverage
After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%
Range HMO Gold 1000/75 - $40
Deductible Individual / Family
$1,000 Individual/$2,000 Family
Office Visits
$40/$60 no deductible
Inpatient Hospital Stay (after deductible)
25% after deductible
Out of Pocket Maximum
$6,500 Individual/$13,000 Family
Prescription Drug Coverage
Tier 1: $20
Tier 2: $40
Tier 3: $65
Tier 4: $175
Tier 5: $275
(no deductible)
Range HMO Gold 500/80 - $40
Deductible Individual / Family
$500 Individual$1,000 Family
Office Visits
$40/$60 no deductible
Inpatient Hospital Stay (after deductible)
20% coinsurance
Out of Pocket Maximum
$5,000 Individual/$10,000 Family
Prescription Drug Coverage
Tier 1: $20
Tier 2: $40
Tier 3: $65
Tier 4: $175
Tier 5: $275
(no deductible)
2019 Rocky Mountain Summit HMO Plans
Summit HMO Bronze HSA 6550/100
Deductible Individual / Family
$6,550 Individual/$13,100 Family
Office Visits
100% covered after deductible
Inpatient Hospital Stay (after deductible)
100% covered after deductible
Out of Pocket Maximum
$6,550 Individual/$13,100 Family
Prescription Drug Coverage
After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%
Summit HMO Bronze 6800/65 - $60
Deductible Individual / Family
$6,800 Individual/$13,600 Family
Office Visits
PCP: First 4 visits: $60 no deductible, then 35% coinsurance after deductible.
Specialist: 35% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
35% coinsurance after deductible
Out of Pocket Maximum
$7,900 Individual/$15,800 Family
Prescription Drug Coverage
Tier 1: $20
Tier 2: $50
Tier 3: $125
Tier 4: $300
Tier 5: $500
(no deductible)
Summit HMO Silver 5000/50 - $55
Deductible Individual / Family
$5,000 Individual/$10,000 Family
Office Visits
PCP: First 5 visits $55, no deductible, then 50% after deductible
Specialist: $80, no deductible
Inpatient Hospital Stay (after deductible)
$1750 per stay, then 50% coinsurance after deductible
Out of Pocket Maximum
$7,900 Individual/$15,800 Family
Prescription Drug Coverage
Tier 1: $20
Tier 2: $55
Tier 3: $100
Tier 4: $300
Tier 5: $500
(no deductible)
Summit HMO Silver 4500/75 - $55
Deductible Individual / Family
$4,500 Individual/$9,000 Family
Office Visits
$55/$80 no deductible
Inpatient Hospital Stay (after deductible)
25% coinsurance after deductible
Out of Pocket Maximum
$7,000 Individual/$14,000 Family
Prescription Drug Coverage
Tier 1: $20, no deductible
After $200 Rx deductible
Tier 2: $50
Tier 3: $80
Tier 4: 25%
Tier 5: 30%
Summit HMO Silver HSA 4000/100
Deductible Individual / Family
$4,000 Individual/$8,000 Family
Office Visits
100% covered after deductible
Inpatient Hospital Stay (after deductible)
100% covered after deductible
Out of Pocket Maximum
$4,000 Individual/$8,000 Family
Prescription Drug Coverage
After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%
More Information1
Summit HMO Silver 3500/70 - $55
Deductible Individual / Family
$3,500 Individual/$7,000 Family
Office Visits
$55/$80 no deductible
Inpatient Hospital Stay (after deductible)
30% coinsurance after deductible
Out of Pocket Maximum
$7,900 Individual/$15,800 Family
Prescription Drug Coverage
Tier 1: $20
Tier 2: $50
Tier 3: $80
Tier 4: $300
Tier 5: $400
(no deductible)
Summit HMO Silver 2800/65 - $45
Deductible Individual / Family
$2,800 Individual/$5,600 Family
Office Visits
PCP: First 3 visits $45, no deductible, then 35% after deductible
Specialist: $70 no deductible
Inpatient Hospital Stay (after deductible)
35% coinsurance after deductible
Out of Pocket Maximum
$7,600 Individual/$15,200 Family
Prescription Drug Coverage
Tier 1: $20
Tier 2: $50
Tier 3: $80
Tier 4: $300
Tier 5: $400
(no deductible)
Summit HMO Gold HSA 2800/100
Deductible Individual / Family
$2,800 Individual/$5,600 Family
Office Visits
100% covered after deductible
Inpatient Hospital Stay (after deductible)
100% covered after deductible
Out of Pocket Maximum
$2,800 Individual/$5,600 Family
Prescription Drug Coverage
After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%
Summit HMO Gold 1000/75 - $40
Deductible Individual / Family
$1,000 Individual/$2,000 Family
Office Visits
$40/$60 no deductible
Inpatient Hospital Stay (after deductible)
25% coinsurance after deductible
Out of Pocket Maximum
$6,500 Individual/$13,000 Family
Prescription Drug Coverage
Tier 1: $20
Tier 2: $40
Tier 3: $65
Tier 4: $175
Tier 5: $275
(no deductible)
Summit HMO Gold 500/80 - $40
Deductible Individual / Family
$500 Individual$1,000 Family
Office Visits
$40/$60 no deductible
Inpatient Hospital Stay (after deductible)
20% coinsurance after deductible
Out of Pocket Maximum
$5,000 Individual/$10,000 Family
Prescription Drug Coverage
Tier 1: $20
Tier 2: $40
Tier 3: $65
Tier 4: $175
Tier 5: $275
(no deductible)
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