Rocky Mountain HMO-Std - Most of Colorado

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General Information

Plan Name:	Rocky Mountain HMO-Std
Service Area:	Most of Colorado
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	Yes
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	HMO
Enrollment Code-Self:	XJ4
Enrollment Code-Self & Family:	XJ5
Link to Plan Home Page:	http://www.rmhmo.org
Telephone:	800/346-4643
Summary results of the 2001 consumers assessment of health plans survey

Benefits

Doctor Care/ Primary Office Visits:	$25
Hospital Inpatient Room and Board Charges:	$500
RX/ Generic/ Retail:	$10
RX/ Brand/ Retail:	$20+
RX/ Brand/ NonFormulary:	$35+

Rates

Non-Postal
___Biweekly	Self: $44.73	Self: & Family: $110.08
___Twice Biweekly	Self: $89.46	Self: & Family: $220.16
___Monthly	Self: $96.92	Self: & Family: $238.50
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Annuitants
___Monthly	Self: $96.92	Self: & Family: $238.50
_
U.S. Postal Service Employees (Type A)
___Biweekly	Self: $27.07	Self: & Family: $69.74
___Monthly	Self: $58.66	Self: & Family: $151.10
_
U.S. Postal Service Employees (Type B)
___Monthly	Self: $72.28	Self: & Family: $213.09
___Biweekly	Self: $33.36	Self: & Family: $98.35
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Worker's Compensation Recipients
___Twice Biweekly	Self: $89.46	Self: & Family: $220.16
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Certain Temporary Employees
___Biweekly	Self: $142.59	Self: & Family: $333.49
___Monthly	Self: $308.95	Self: & Family: $722.56
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Former Spouse Enrollees
___Monthly	Self: $308.95	Self: & Family: $722.56
___Biweekly	Self: $142.59	Self: & Family: $333.49
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Temporary Continuation of Coverage
___Monthly	Self: $315.13	Self: & Family: $737.01
___Biweekly	Self: $145.44	Self: & Family: $340.16
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FDIC
___Biweekly	Self: $27.07	Self: & Family: $69.74
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