PLEASE READ THE FOLLOWING IMPORTANT DISCLOSURE NOTICES.
Class of Business
Your group will be included in the Small Employer class and will not be considered part of a separate class of business. This class is comprised of small employer groups with at least one but not more than one hundred (100) eligible employees.
RatesThe total premium for small employer groups will be determined by summing the total premium of each enrolled employee. The total premium for each enrolled employee will be determined by summing the separate premiums of the employee and their dependents for the health plan the employee has selected. Premiums will be summed up for the employee, spouse, dependent children between the ages of 21 and 26, and the three oldest dependents under 21.
Access PlansAn access plan is available upon request to any interested party for each managed care network offered by RMHP. Such access plans contain information on providers, hospitals, referral and grievance procedures, quality assurance, access for members with special needs, emergency coverage provisions, and other information on how to access services.
Geographic Areas Served
Upon request, we will provide you or any enrollee a description of the geographic areas served by Rocky Mountain Health Plans.
Benefits and Premiums
Information about benefits for all the health benefit plans you request or for which you qualify can be provided. If you provide us sufficient information to determine premiums for your group, such premium information will also be included. A summary of the benefits that highlights the most salient differences among the plans for all the plans for which an employer qualifies will be made available. Colorado law requires carriers to make available a Colorado Supplement to the Summary of Benefits of Coverage, which is intended to facilitate comparison of health plans. The form must be provided automatically within seven (7) business days to a potential policyholder who has expressed interest in a particular plan or who has selected the plan as a finalist from which the ultimate selection will be made. The carrier also must provide the form, upon oral or written request, within (7) business days to any person who is interested in coverage under or who is covered by a health benefit plan of the carrier.
Patient Protection and Affordable Care Act Group Notices for Rocky Mountain Health Plans ("Your Plan")
Your Plan may require the designation of a primary care provider (PCP). A Member has the right to designate any PCP who participates in RMHP's network and who is available to accept the Member as a Patient. If required, until a Member makes this designation, a PCP will be designated for the Member. For information on how to select a PCP, and for a list of the participation PCPs, contact customer service at 970-243-7050 or 800-346-4643. For children, a pediatrician may be designated as the PCP. A Member does not need prior authorization in order to obtain access to obstetrical or gynecological care from a health care professional in RMHP's network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals. For a list of participating health care professionals who specialize in obstetrics or gynecology, contact customer service at 970-243-7050 or 800-346-4643.
Your group may renew its coverage for successive one-year periods. Your group may terminate the agreement by giving RMHP written notice of intent to terminate. RMHP must receive such written notice no later than 5:00 P.M. Mountain Time on the first business day of the month following the termination effective date; otherwise, the effective date of termination shall be the end of the next calendar month.
RMHP shall not discontinue coverage or refuse to renew a plan except for the following reasons:
This policy is available on tape in Human Resources.
It is the policy of Rocky Mountain Health Plans (RMHP) to provide equal opportunity and to prevent discrimination based on race, color, national origin, age, or disability in admission or access to, or treatment or employment in, RMHP programs, health care plans, and activities to the extent required by applicable law.
All federally funded benefits and services are provided in accordance with Title VI of the Civil Rights Act, as amended, Section 504 of the Rehabilitation Act, as amended, the Age Discrimination Act of 1975, as amended, the Americans with Disabilities Act of 1990, as amended, as well as other related laws. All subcontractors are notified of their responsibility to comply with these laws.
The EEO Officer is responsible for compliance with state and federal equal opportunity laws. The EEO Officer is also responsible for implementing the Equal Opportunity Plan. If you would like more information regarding these provisions, or if you believe you have not been treated in accordance with this policy, please contact the Member Concerns Coordinator at 800-346-4643, 970-243-7050, or TTY 800-704-6370 or 970-248-5019; para asistencia en español llame al 800-346-4643.
This page was last updated: 01/06/2017. Please call to confirm you have the most up to date information about our Medicare Cost plans.
Important Disclaimers: RMHP is a Medicare-approved Cost plan. Enrollment in RMHP depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. This information is available for free in other languages. Please call our customer service number at 888-282-1420 (TTY dial 711). Hours are 8am - 8pm, 7 days/week, Oct. 1–Feb.14, and 8am - 8pm, M-F, Feb.15–Sept.30. Esta información está disponible gratuitamente en otros idiomas. Por favor llame a la línea de Atención a Clientes, al 888-282-1420 (TTY marque 711). Horario de 8am - 8pm, 7 días a la semana, del 1 de octubre al 14 de febrero; y de 8am - 8pm, de lunes a viernes, del 15 de febrero al 30 de septiembre. Other pharmacies, physicians, providers are available in our network. Medicare beneficiaries may also enroll in RMHP through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. If you need help finding a network provider, please call 888-282-1420 (TTY 711) or visit www.rmhpMedicare.org to access our online searchable directory. If you would like a provider directory mailed to you, you may call the number above, request one at the website link provided above, or email customer_service@RMHP.org.
Multi Language Interpreter Service Information (English)
Multi Language Interpreter Service Information (Espanól)