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.   

Read more about HSA options

2016 Rocky Mountain Summit HMO HSA Plans

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%

SBC
Benefit Summary
EOC

Summit HMO Silver HSA 3500/100

$3,500/$7,000

100% covered after deductible

100% covered after deductible

$3,500/$7,000

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

SBC
Benefit Summary
EOC

Summit HMO Bronze HSA 4500/50

$4,500/$9,000

50% after deductible

50% coinsurance

$6,500/$13,500

After Medical Deductible:
Tier 1: $20
Tier 2: $60
Tier 3: 30%
Tier 4: 40%
Tier 5: 50%

SBC
Benefit Summary
EOC

Summit HMO Bronze HSA 5050/100

$5,050/$10,100

100% covered after deductible

100% covered after deductible

$6,550/$13,100

After Medical Deductible:
Tier 1: $25
Tier 2: $70
Tier 3: $300
Tier 4: $450
Tier 5: $540

SBC
Benefit Summary
EOC

Summit HMO Bronze HSA 5950/100

$5,950/$11,900

100% covered after deductible

100% covered after deductible

$5,950/$11,900

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

SBC
Benefit Summary
EOC

Summit HMO Bronze HSA 6500/100

$6,500/$13,000

100% covered after deductible

100% covered 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

2016 Rocky Mountain Summit PPO HSA Plans

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% covered 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

In-Network: 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 3500/100

In-Network: $3,500/$7,000

Out-of-Network: $7,000/$14,000

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: $3,500/$7,000

Out-of-Network: $14,000/$28,000

In-Network: 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 Bronze HSA 4500/50

In-Network: $4,500/$9,000

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

In-Network: 50% after deductible

Out-of-Network: 50% after deductible

In-Network: 50% coinsurance

Out-of-Network: 50% coinsurance

In-Network: $6,500/$13,000

Out-of-Network: $13,000/$26,000

In-Network: After Medical Deductible:
Tier 1: $20
Tier 2: $60
Tier 3: 30%
Tier 4: 40%
Tier 5: 50%


Out-of-Network: Not covered

SBC
Benefit Summary
EOC

Summit PPO Bronze HSA 5050/100

In-Network: $5,050/$10,100

Out-of-Network: $10,100/$20,200

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: $13,100/$26,200

In-Network: After Medical Deductible:
Tier 1: $25
Tier 2: $70
Tier 3: $300
Tier 4: $450
Tier 5: $540


Out-of-Network: Not covered

SBC
Benefit Summary
EOC

Summit PPO Bronze HSA 5950/100

In-Network: $5,950/$11,900

Out-of-Network: $11,900/$23,800

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: $5,950/$11,900

Out-of-Network: $23,800/$47,000

In-Network: 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 Bronze HSA 6500/100

In-Network: $6,500/$13,000

Out-of-Network: $13,000/$26,000

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: $6,500/$13,000

Out-of-Network: $26,000/$52,000

In-Network: 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

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