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.
Read more about HSA options
View 2016 Small Group HSA Plan Documents
Summit HMO Bronze HSA 5500/50
$5,500/$11,000
50% after deductible
50% coinsurance
$6,550/$13,100
After Medical Deductible:
Tier 1: $20
Tier 2: $60
Tier 3: 30%
Tier 4: 40%
Tier 5: 50%
Summit HMO Bronze HSA 6550/100
$6,550/$13,100
100% covered after deductible
100% covered after deductible
$6,550/$13,100
After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%
Summit HMO Gold HSA 2000/100
$2,000/$4,000
100% covered after deductible
100% covered after deductible
$2,000/$4,000
After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%
Summit HMO Silver HSA 3750/100
$3,750/$7,500
100% covered after deductible
100% covered after deductible
$3,750/$7,500
After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%
Summit PPO Bronze HSA 5500/50
In Network: $5,500/$11,000
Out-of-Network: $11,000/$22,000
In Network: 50% after deductible
Out-of-Network: 50% after deductible
In Network: 50% coinsurance
Out-of-Network: 50% coinsurance
In Network: $6,550/$13,100
Out-of-Network: $13,100/$26,200
After Medical Deductible:
Tier 1: $20
Tier 2: $60
Tier 3: 30%
Tier 4: 40%
Tier 5: 50%
Out-of-Network: Not covered
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
Summit PPO Gold HSA 2000/100
In-Network: $2,000/$4,000
Out-of-Network: $4,000/$8,000
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: $2,000/$4,000
Out-of-Network: $8,000/$16,000
After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%
Out-of-Network: Not covered
Summit PPO Silver HSA 3750/100
In-Network: $3,750/$7,500
Out-of-Network: $7,500/$15,000
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: $3,750/$7,500
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
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Our plans offer the coverage, network, and health management resources you and your family need for your Colorado lifestyle. Get the personalized attention and quality care you deserve from your local health insurance option that has been serving our communities for over 40 years.
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