HSA Plan Comparisons for Small Employer Groups

HSA Plan Comparisons for Small Employer Groups

To view coverage and deductible information for each Colorado Small Group HSA option offered by Rocky Mountain Health Plans, review our HSA Option Comparison Grid below.

2019 Rocky Mountain Canyon HMO HSA Plans

Rocky Mountain Canyon HMO Bronze HSA 6500/100

$6,500/$13,000

0% coinsurance after deductible

0% coinsurance after deductible

$6,500/$13,000

After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%

SBC
Benefit Summary
EOC

Rocky Mountain Canyon HMO Silver HSA 4500/100

$4,500/$9,000

0% coinsurance after deductible

0% coinsurance after deductible

$4,500/$9,000

After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%

SBC
Benefit Summary
EOC

2019 Rocky Mountain Range - HMO HSA Group Plans

Range HMO Bronze HSA 6550/100

$6,550/$13,100

0% coinsurance after deductible

0% coinsurance after deductible

$6,550/$13,100

After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%

SBC
Benefit Summary
EOC

Range HMO Silver HSA 4000/100

$4,000/$8,000

0% coinsurance after deductible

0% coinsurance after deductible

$4,000/$8,000

After Medical Deductible
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%

SBC
Benefit Summary
EOC

Range HMO Gold HSA 2800/100

$2,800/$5,600

0% coinsurance after deductible

0% coinsurance after deductible

$2,800/$5,600

After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%

SBC
Benefit Summary
EOC

2019 Rocky Mountain Summit HMO HSA Plans

Summit HMO Bronze HSA 6550/100

$6,550/$13,100

0% coinsurance after deductible

0% coinsurance after deductible

$6,550/$13,100

After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%

SBC
Benefit Summary
EOC

Summit HMO Silver HSA 4000/100

$4,000/$8,000

0% coinsurance after deductible

0% coinsurance after deductible

$4,000/$8,000

After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%

SBC
Benefit Summary
EOC

Summit HMO Gold HSA 2800/100

$2,800/$5,600

0% coinsurance after deductible

0% coinsurance after deductible

$2,800/$5,600

After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%

SBC
Benefit Summary
EOC

2018 Monument Health - PPO HSA Group Plans

Monument Health PPO Bronze HSA 6500/6550

In-Network:
Tier 1: $6,500/$13,000
Tier 2: $6,550/$13,100

Out-of-Network:
$10,000/$20,000

In-Network:
Tier 1: PCP: 0% coinsurance after deductible
Specialist: 0% coinsurance after deductible

Tier 2: PCP: 0% coinsurance after deductible
Specialist: 0% coinsurance after deductible


Out-of-Network:
50% coinsurance after deductible

In-Network:
Tier 1:  0% coinsurance after deductible
Tier 2:  0% coinsurance after deductible


Out-of-Network:
50% coinsurance after deductible

In-Network:
Tier 1: $6,500/$13,000
Tier 2: $6.550/$13,100


Out-of-Network:
$15,000/$30,000

In-Network:
After Tier 1 Deductible: 
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%


Out-of-Network: Not covered

SBC
Benefit Summary
EOC

Monument Health PPO Silver HSA 4500/6500

In-Network:
Tier 1: $4,500/$9,000
Tier 2: $6,500/$13,000


Out-of-Network:
$9,000/$18,000

In-Network:
Tier 1: PCP: 0% coinsurance after deductible
Specialist: 0% coinsurance after deductible

Tier 2: PCP: 0% coinsurance after deductible
Specialist: 0% coinsurance after deductible


Out-of-Network:
50% coinsurance after deductible

In-Network:
Tier 1: 0% coinsurance after deductible
Tier 2: 0% coinsurance after deductible


Out-of-Network:
50% coinsurance after deductible

In-Network:
Tier 1: $4,500/$9,000
Tier 2: $6,500/$13,000


Out-of-Network:
$12,000/$24,000

In-Network:
After Tier 1 Deductible: 
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%


Out-of-Network: Not covered

SBC
Benefit Summary
EOC

2018 Rocky Mountain Summit PPO HSA Plans

Summit PPO Bronze HSA 6550/100

In-Network: $6,550/$13,100

Out-of-Network: $13,100/$26,200

In-Network: 100% covered after deductible

Out-of-Network: 50% after deductible

In-Network: 100% covered after deductible

Out-of-Network: 50% coinsurance

In-Network: $6,550/$13,100

Out-of-Network: $15,000/$30,000

After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%

Out-of-Network: Not covered

SBC
Benefit Summary
EOC

Summit PPO Silver HSA 4000/100

In-Network: $4,000/$8,000

Out-of-Network: $8,000/$16,000

In-Network: 100% covered after deductible

Out-of-Network: 50% after deductible

In-Network: 100% covered after deductible

Out-of-Network: 50% coinsurance

In-Network: $4,000/$8,000

Out-of-Network: $16,000/$32,000

After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%

Out-of-Network: Not covered

SBC
Benefit Summary
EOC

Summit PPO Gold HSA 2800/100

In-Network: $2,800/$5,600

Out-of-Network: $5,600/$11,200

In-Network: 100% covered after deductible

Out-of-Network: 50% after deductible

In-Network: 100% covered after deductible

Out-of-Network: 50% coinsurance

In-Network: $2,800/$5,600

Out-of-Network: $5,600/$22,400

After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%

Out-of-Network: Not covered

SBC
Benefit Summary
EOC
1Specialty Drugs may not be available at all pharmacies. Call customer service to confirm drug availability.

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