KP Colorado Option Silver - 21032CO1040006 Health Insurance Plan

Kaiser Foundation Health Plan of Colorado health insurance plan with the Plan ID 21032CO1040006. The plan is called KP Colorado Option Silver.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 70.80% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 29.20% of the costs of all covered benefits (according to the Issuer).

Health Insurance Plan ID 21032CO1040006
Health Insurance Plan Year 2023
State Colorado
Health Insurance Issuer Kaiser Foundation Health Plan of Colorado
Health Insurance Plan Variant 21032CO1040006-01
Provider Network(s) ['CON001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 07 May 2024 06:08 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 - 21032CO1040006-01

Open to Indians below 300% FPL - 21032CO1040006-02

Open to Indians above 300% FPL - 21032CO1040006-03

73% AV Silver Plan - 21032CO1040006-04

87% AV Silver Plan - 21032CO1040006-05

94% AV Silver Plan - 21032CO1040006-06

Last Plan Update Date Mon, 23 Jan 2023 00:00 GMT
Last Import Date Tue, 07 May 2024 06:08 GMT

KP Colorado Option Silver Health Insurance Plan Variant 21032CO1040006-01 Attributes

Plan Attribute Value
Business Year 2023
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Silver On Exchange Plan
Dental Only Plan No
Design Type Not Applicable
Disease Management Programs Offered Asthma, Diabetes, High Blood Pressure & High Cholesterol
EHB Percent of Total Premium 100%
First Tier Utilization 100%
Formulary ID COF009
HIOS Product ID 21032CO104
Import Date 1/23/2023
HSA Eligible No
IsItANewPlan New
Notice Required for Pregnancy No
Is a Referral Required for Specialist? No
Issuer Actuarial Value 70.80%
Issuer ID 21032
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Silver
Multiple In Network Tiers No
National Network No
Network ID CON001
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 1/1/2023
Plan Expiration Date 12/31/2023
Plan ID (Standard Component ID with Variant) 21032CO1040006-01
Plan Level Exclusions Refer to EOC
Plan Marketing Name KP Colorado Option Silver
Plan Type HMO
Plan Variant Marketing Name KP Colorado Option Silver
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $2,000
SBC Scenario, Having a Baby, Copayment $10
SBC Scenario, Having a Baby, Deductible $5,000
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $200
SBC Scenario, Having Diabetes, Copayment $1,900
SBC Scenario, Having Diabetes, Deductible $70
SBC Scenario, Having Diabetes, Limit $0
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $80
SBC Scenario, Treatment of a Simple Fracture, Copayment $200
SBC Scenario, Treatment of a Simple Fracture, Deductible $2,400
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID COS003
Source Name SERFF
Plan ID 21032CO1040006
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 40.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family $5000 per person | $10000 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $5,000
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 $8550 per person | $17100 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $8,550
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 Colorado Option Silver Health Insurance Plan, 21032CO1040006

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

Frequently Asked Questions(FAQ) about KP Colorado Option Silver, 21032CO1040006 Health Insurance Plan, 21032CO1040006

  • Does KP Colorado Option Silver Health Insurance Plan, 21032CO1040006 support Mail Ordering?

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

  • Does (21032CO1040006) Health Insurance Plan, Variant (21032CO1040006-01) offer Disease Management Programs?

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

    Does (21032CO1040006) Health Insurance Plan, Variant (21032CO1040006-01) have Out Of Country Coverage?

    Yes. Details: Emergency Services

    Does (21032CO1040006) Health Insurance Plan, Variant (21032CO1040006-01) have Out of Service Area Coverage?

    Yes. Details: Emergency Services

    Does (21032CO1040006) Health Insurance Plan, Variant (21032CO1040006-01) offer Disease Management Programs?

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

    Does KP Colorado Option Silver Health Insurance Plan, Variant (21032CO1040006-01) offer Disease Management Programs for Asthma?

    Yes, the KP Colorado Option Silver Health Insurance Plan Variant 21032CO1040006-01 offers Disease Management Program for Asthma.

    Does KP Colorado Option Silver Health Insurance Plan, Variant (21032CO1040006-01) offer Disease Management Programs for Diabetes?

    Yes, the KP Colorado Option Silver Health Insurance Plan Variant 21032CO1040006-01 offers Disease Management Program for Diabetes.

    Does KP Colorado Option Silver Health Insurance Plan, Variant (21032CO1040006-01) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the KP Colorado Option Silver Health Insurance Plan Variant 21032CO1040006-01 offers Disease Management Program for High blood pressure & high cholesterol.

 

Disclaimer: This is based on the import(Date: Tue, 07 May 2024 06:08 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