Employee forms can be faxed to our office at (303) 721-1085. Please confirm that application was received by calling (303) 721-1145. Please call with any questions regarding eligibility or waiting periods.
Plan Descriptions

HMO Plans

Health Plan Name
Office Visit Copay
Hospital Copay

Outpatient Copay

Basic HMO
$40

$500/day, max $2000

 $300
Standard HMO $25 $250/day, max $1000

$100
15-35/200d $15 $200/day, max $1000 $175
25-40/400d $25 $400/day, max $2000 $250
30-50/500a $30 $500 + 20% to $30K $250 + 20% to $30K
POS 15-30/300a $15 $300 $100

PPO Plans

Plan Name
Office Visit Copay
Deductible
Coinsurance
$40
$3000

30% to $10K
$25
$1500

20% to $7500
$20
$1000
20% to $10K
$25
$1500
20% to $15K
$30
$2000
20% to $20K
$20
$500
20% to $10K
$30
$2000
30% to $17K
Self-Directed Office Visit Copay Hospital Copay
Outpatient Copay
paid by SDA
$1500
20% to $15K
paid by SDA
$2000
30% to $17K

 

HSA Plans

Plan Name
Deductible
Coinsurance
Max Out-of-Pocket
$2700/$5400
80/20
$5000/$10,000
$3500/$7000
70/30
$5000/$10,000
$5000/$10,000
100/0
$5000/$10,000