2018 Rocky Mountain Range - HMO HSA Group 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 Silver HSA 4000/100
Deductible Individual / Family
$4,000/$8,000
Office Visits
0% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
0% coinsurance after deductible
Out of Pocket Maximum
$4,000/$8,000
Prescription Drug Coverage
After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%
Range HMO Gold HSA 2800/100
Deductible Individual / Family
$2,800/$5,600
Office Visits
0% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
0% coinsurance after deductible
Out of Pocket Maximum
$2,800/$5,600
Prescription Drug Coverage
After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%
2018 Rocky Mountain Summit HMO HSA Plans
Summit HMO Bronze HSA 6550/100
Deductible Individual / Family
$6,550/$13,100
Office Visits
100% covered after deductible
Inpatient Hospital Stay (after deductible)
100% covered 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%
Summit HMO Silver HSA 4000/100
Deductible Individual / Family
$4,000/$8,000
Office Visits
100% covered after deductible
Inpatient Hospital Stay (after deductible)
100% covered after deductible
Out of Pocket Maximum
$4,000/$8,000
Prescription Drug Coverage
After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%
Summit HMO Gold HSA 2800/100
Deductible Individual / Family
$2,800/$5,600
Office Visits
100% covered after deductible
Inpatient Hospital Stay (after deductible)
100% covered after deductible
Out of Pocket Maximum
$2,800/$5,600
Prescription Drug Coverage
After Medical Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%
Let's Create a Benefit Program That Works For You
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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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