Rocky Mountain Hospital and Medical Service, Inc. (PPO) health insurance plan with the Plan ID 33670NV0980003. The plan is called Anthem Dental Family.
Health Insurance Plan ID | 33670NV0980003 | ||||||||||||||||||
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Health Insurance Plan Year | 2024 | ||||||||||||||||||
State | Nevada | ||||||||||||||||||
Health Insurance Issuer | Rocky Mountain Hospital and Medical Service, Inc. (PPO) | ||||||||||||||||||
Health Insurance Plan Variant | 33670NV0980003-01 | ||||||||||||||||||
Provider Network(s) | ['NVN005'] | ||||||||||||||||||
In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Thu, 21 Nov 2024 00:44 GMT). |
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Available Variants of the Health Plan | |||||||||||||||||||
Last Plan Update Date | Mon, 12 Feb 2024 00:00 GMT | ||||||||||||||||||
Last Import Date | Thu, 21 Nov 2024 00:44 GMT |
Plan Attribute | Value |
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Business Year | 2024 |
Child-Only Offering | Allows Adult and Child-Only |
Composite Rating Offered | No |
CSR Variation Type | Standard Low On Exchange Plan |
Dental Only Plan | Yes |
EHB Apportionment for Pediatric Dental | 100.00% |
First Tier Utilization | 100% |
HIOS Product ID | 33670NV098 |
Import Date | 2/12/2024 |
Guaranteed Rate | Guaranteed Rate |
IsItANewPlan | Existing |
Issuer ID | 33670 |
Market Coverage | Individual |
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family | per person not applicable | per group not applicable |
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out | Not Applicable |
Medical EHB Deductible, Combined In/Out of Network, Family | $50 per person | per group not applicable |
Medical EHB Deductible, Combined In/Out of Network, Individual | $50 |
Medical EHB Deductible, In Network (Tier 1), Family | per person not applicable | per group not applicable |
Medical EHB Deductible, In Network (Tier 1), Individual | Not Applicable |
Medical EHB Deductible, Out of Network, Family | per person not applicable | per group not applicable |
Medical EHB Deductible, Out of Network, Individual | Not Applicable |
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family | $375 per person | $750 per group |
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | $375 |
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family | per person not applicable | per group not applicable |
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual | Not Applicable |
Metal Level | Low |
Multiple In Network Tiers | No |
National Network | Yes |
Network ID | NVN005 |
Out of Country Coverage | Yes |
Out of Country Coverage Description | Out of Country covered services are reimbursed as out-of-network benefits. |
Out of Service Area Coverage | Yes |
Out of Service Area Coverage Description | If a member does not use a network dentist, services will be reimbursed at the out-of-network level. |
Plan Effective Date | 1/1/2024 |
Plan Expiration Date | 12/31/2024 |
Plan ID (Standard Component ID with Variant) | 33670NV0980003-01 |
Plan Marketing Name | Anthem Dental Family |
Plan Type | PPO |
Plan Variant Marketing Name | Anthem Dental Family |
QHP/Non QHP | Both |
Service Area ID | NVS001 |
Source Name | SERFF |
Plan ID | 33670NV0980003 |
State Code | NV |
Version Number | 1 |
Wellness Program Offered | No |
Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Disclaimer: This is based on the import(Date: Thu, 21 Nov 2024 00:44 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API