KP CO Bronze 6250/50/HSA - 21032CO0710091 Health Insurance Plan

Kaiser Foundation Health Plan of Colorado health insurance plan with the Plan ID 21032CO0710091. The plan is called KP CO Bronze 6250/50/HSA.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 64.29% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 35.71% of the costs of all covered benefits (according to the Issuer).

Health Insurance Plan ID 21032CO0710091
Health Insurance Plan Year 2024
State Colorado
Health Insurance Issuer Kaiser Foundation Health Plan of Colorado
Health Insurance Plan Variant 21032CO0710091-01
Provider Network(s) ['CON003']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 17 Dec 2024 06:12 GMT).

Providers Colorado All US States
All N/A N/A
PCP N/A N/A
Allergy N/A N/A
OB/GYN N/A N/A
Dentists N/A N/A
Available Variants of the Health Plan

Standard On Exchange Plan - 21032CO0710091-01

Last Plan Update Date Fri, 31 May 2024 00:00 GMT
Last Import Date Tue, 17 Dec 2024 06:12 GMT

KP CO Bronze 6250/50/HSA Health Insurance Plan Variant 21032CO0710091-01 Attributes

Plan Attribute Value
Business Year 2024
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Bronze On Exchange Plan
Dental Only Plan No
Disease Management Programs Offered High Blood Pressure & High Cholesterol, Diabetes, Asthma
First Tier Utilization 100%
Formulary ID COF037
HIOS Product ID 21032CO071
HSA/HRA Employer Contribution No
Import Date 5/31/2024
HSA Eligible Yes
IsItANewPlan Existing
Notice Required for Pregnancy No
Is a Referral Required for Specialist? No
Issuer Actuarial Value 64.29%
Issuer ID 21032
Market Coverage SHOP (Small Group)
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Expanded Bronze
Multiple In Network Tiers No
National Network No
Network ID CON003
Out of Country Coverage Yes
Out of Country Coverage Description Emergency Services
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Emergency Services
Plan Effective Date 1/1/2024
Plan Expiration Date 12/31/2024
Plan ID (Standard Component ID with Variant) 21032CO0710091-01
Plan Level Exclusions Refer to the EOC
Plan Marketing Name KP CO Bronze 6250/50/HSA
Plan Type HMO
Plan Variant Marketing Name KP CO Bronze 6250/50/HSA
QHP/Non QHP On the Exchange
SBC Scenario, Having a Baby, Coinsurance $1,300
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $6,250
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $0
SBC Scenario, Having Diabetes, Deductible $4,600
SBC Scenario, Having Diabetes, Limit $0
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $0
SBC Scenario, Treatment of a Simple Fracture, Deductible $2,800
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID COS006
Source Name SERFF
Plan ID 21032CO0710091
State Code CO
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual Not Applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family per person not applicable | per group not applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 35.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family $6250 per person | $12500 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $6,250
TEHBDedOutofNetFamily per person not applicable | per group not applicable
Combined Medical and Drug EHB Deductible, Out of Network, Individual Not Applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family $7500 per person | $15000 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $7,500
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual Not Applicable
Unique Plan Design Yes
Version Number 1
Wellness Program Offered No

Copay & Coinsurance of KP CO Bronze 6250/50/HSA Health Insurance Plan, 21032CO0710091

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order

Frequently Asked Questions(FAQ) about KP CO Bronze 6250/50/HSA, 21032CO0710091 Health Insurance Plan, 21032CO0710091

  • Does KP CO Bronze 6250/50/HSA Health Insurance Plan, 21032CO0710091 support Mail Ordering?

    Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.

  • Does (21032CO0710091) Health Insurance Plan, Variant (21032CO0710091-01) offer Disease Management Programs?

    Yes, and here is the list of available programs: High Blood Pressure & High Cholesterol, Diabetes, Asthma

    Does (21032CO0710091) Health Insurance Plan, Variant (21032CO0710091-01) have Out Of Country Coverage?

    Yes. Details: Emergency Services

    Does (21032CO0710091) Health Insurance Plan, Variant (21032CO0710091-01) have Out of Service Area Coverage?

    Yes. Details: Emergency Services

    Does (21032CO0710091) Health Insurance Plan, Variant (21032CO0710091-01) offer Disease Management Programs?

    Yes, and here is the list of available programs: High Blood Pressure & High Cholesterol, Diabetes, Asthma

    Does KP CO Bronze 6250/50/HSA Health Insurance Plan, Variant (21032CO0710091-01) offer Disease Management Programs for Asthma?

    Yes, the KP CO Bronze 6250/50/HSA Health Insurance Plan Variant 21032CO0710091-01 offers Disease Management Program for Asthma.

    Does KP CO Bronze 6250/50/HSA Health Insurance Plan, Variant (21032CO0710091-01) offer Disease Management Programs for Diabetes?

    Yes, the KP CO Bronze 6250/50/HSA Health Insurance Plan Variant 21032CO0710091-01 offers Disease Management Program for Diabetes.

    Does KP CO Bronze 6250/50/HSA Health Insurance Plan, Variant (21032CO0710091-01) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the KP CO Bronze 6250/50/HSA Health Insurance Plan Variant 21032CO0710091-01 offers Disease Management Program for High blood pressure & high cholesterol.

 

Disclaimer: This is based on the import(Date: Tue, 17 Dec 2024 06:12 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