Colorado Health OP

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Colorado Health OP is the state’s first non-profit health insurance cooperative (co-op), established with funding granted by the Affordable Care Act and sponsored by the Rocky Mountain Farmers Union Educational and Charitable Foundation.  The co-op was created in March 2012, and began selling policies at the start of open enrollment in October 2013, with effective dates starting in January 2014.

Colorado Health OPThe co-op is a member-driven plan, and it encourages members to take an active role both in maintaining their own health and in keeping costs down.  Colorado Health OP provides members with a price comparison tool called The Health Care Blue Book. Members can use it to compare costs for various providers for specific procedures, so that the members know beforehand roughly how much their treatment will cost, and which providers offer the best value.

Colorado Health OP Focus on Prevention

As part of the co-op’s initiative to get members to focus on maintaining their health, the plan also rewards members who participate in a few basic preventive care measures throughout the year (a health survey, a biometrics screening and a checkup with the patient’s primary care doctor).  Patients who complete all three are bumped up to a Colorado Health OP’s “enhanced” plan, which means that they pay less for their care and they also get money deposited to a debit card that they can use to pay for future medical costs.

As a Colorado HealthOP member, you will be upgraded from the “standard” version of your plan to the
“enhanced” version when you complete three health actions.

How to Complete the 3 Health Actions

1) Take a Health Survey

Take a quick, confidential online health survey. It will give you and your primary care doctor a snapshot of your current health and risk for health issues.

2) Get a Biometric Screening

Schedule a visit at your primary care doctor’s office, and get a biometric screening. This free and confidential test will screen for illnesses and identify your risk for certain health conditions.

3) Have a Wellness Visit With Your Primary Care Provider

Go to your primary care doctor for an annual wellness visit. The visit is free and it’s your chance to discuss your health survey, biometric screening and other health concerns with your doctor.

4) Profit!

When you complete all three health actions, you could be rewarded with extra free doctors visits or even a $900 debit card to be used for qualified medical expenses, like on the Bison Flex plans. See benefits below.

Member Driven CO-OP

Colorado Health OP does not have shareholders.  Instead, the members elect their own board of directors, and members are eligible to serve on the board.  Members also get to play a role in determining how excess revenue should be used (lower premiums, enhanced benefits, etc.).

As with all plans that are available in the Colorado marketplace/exchange (Connect for Health Colorado), tax subsidies are available to help cover the premiums for Colorado Health OP plans if an enrollee qualifies.  Cost-sharing subsidies are also available on silver plans, for eligible enrollees.

PPO and EPO Provider Finder

Find doctors and hospitals on the Colorado HealthOP EPO and PPO networks here.

2015 Colorado Health OP Plans

HealthOP Bobcat PPO
CATASTROPHICProduct Brochure

Coverage Summary

Limitations & Exclusions

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HSA Compatible:   No
Deductible:   $6,600
Coinsurance:   0%
Out-of-Pocket Maximum:   $6,600
Primary Care Visits:   You pay $0 for first visit, then $50 copay for next 2 visits, then you pay 0% after deductible
Prescriptions:   Gen: 0% after deductible
Pref: 0% after deductible
HealthOP Bear HSA Qualified HDHP EPO
BRONZEProduct BrochureCoverage Summary

Limitations and Exclusions

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Description: Lower monthly premium option with higher deductibles, coinsurance, and out-of-pocket maximums.  Medical visits are limited to the EPO network only.
HSA Compatible: Yes
Deductible: $6,250 individual/$12,500 family
Once family deductible is met, it is met for all.
Coinsurance: 0%
Out-of-Pocket Maximum: $6250 Individual/$12,500 Family
Once family out-of-pocket is met, it is met for all.
Primary Care Visits: You pay 0% after deductible
Prescriptions: Gen: 0% after deductible Pref: 0% after deductible
HealthOP Bear EPO
BRONZEProduct BrochureCoverage Summary

Limitations and Exclusions

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Description: Lower monthly premium option with higher deductibles, coinsurance, and out-of-pocket maximums. Medical visits are limited to the EPO network only.
HSA Compatible: No
Deductible: $6,500 individual/$13,000 family
No individual pays more than the individual deductible. Once family deductible is met, it is met for all.
Coinsurance: 0%
Out-of-Pocket Maximum: $6,500 Individual/$13,000 Family
No Individual pays more than the individual out-of-pocket. Once family out-of-pocket is met, it is met for all.
Primary Care Visits: You pay $0 for first 2 visits, then 0% after deductible
Prescriptions: Gen: $20 copay Pref: 0% after deductible
HealthOP BisonFlex EPO
SILVERProduct Brochure

Coverage Summary

Limitations and Exclusions

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Description: Low monthly premiums, low costs when you seek medical care. Medical visits are limited to the EPO network only.
HSA Compatible: No
Deductible: $3,900 individual/$7,800 family
No individual pays more than the individual deductible. Once family deductible is met, it is met for all.
Coinsurance: 40%
Out-of-Pocket Maximum: $6,600 Individual/$13,200 Family
No Individual pays more than the individual out-of-pocket. Once family out-of-pocket is met, it is met for all.
Primary Care Visits: You pay $0 for first 2 visits, then 40% after deductible
Prescriptions: Gen: $20 copay Pref: 40% deductible waived
HealthOP BisonHSA Qualified HDHP EPO
SILVERProduct Brochure

Coverage Summary

Limitations and Exclusions

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Description: Low monthly premiums, low costs when you seek medical care. Medical visits are limited to the EPO network only.
HSA Compatible: Yes
Deductible: $2,050 individual/$4,100 family
Once family deductible is met, it is met for all.
Coinsurance: 40%
Out-of-Pocket Maximum: $4,200 Individual/$8,400 Family
Once family out-of-pocket is met, it is met for all.
Primary Care Visits: You pay 40% after deductible
Prescriptions: Gen: $15 copay after deductible Pref:40% after deductible
HealthOP BisonEPO
SILVERProduct Brochure

Coverage Summary

Limitations and Exclusions

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Description: Low monthly premiums, low costs when you seek medical care. Medical visits are limited to the EPO network only.
HSA Compatible: No
Deductible: Std: $2,050 individual/$4,100 family
Enh: $2,000 individual/$4,000 family
No individual pays more than the individual deductible. Once family deductible is met, it is met for all.
Coinsurance: 40%
Out-of-Pocket Maximum: $6,600 Individual/$13,200 Family
No Individual pays more than the individual out-of-pocket. Once family out-of-pocket is met, it is met for all.
Primary Care Visits: Standard: You pay $0 for first 2 visits, then $25 copay/visit Enhanced: You pay $0 copay/visit
Prescriptions: Gen: Std: $15 copay; Enh: $0 copay Pref: $40 copay
HealthOP Bear HSA Qualified HDHP PPO
BRONZEProduct Brochure

Coverage Summary

Limitations and Exclusions

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Description: Lower monthly premium option with higher deductibles, coinsurance, and out-of-pocket maximums.
HSA Compatible: Yes
Deductible: $6,250 individual/$12,500 family
Once family deductible is met, it is met for all.
Coinsurance: 0%
Out-of-Pocket Maximum: $6250 Individual/$12,500 Family
Once family out-of-pocket is met, it is met for all.
Primary Care Visits: You pay 0% after deductible
Prescriptions: Gen: 0% after deductible Pref: 0% after deductible
HealthOP Bear PPO
BRONZEProduct Brochure

Coverage Summary

Limitations and Exclusions

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Description: Lower monthly premium option with higher deductibles, coinsurance, and out-of-pocket maximums.
HSA Compatible: No
Deductible: $6,500 individual/$13,000 family
No individual pays more than the individual deductible. Once family deductible is met, it is met for all.
Coinsurance: 0%
Out-of-Pocket Maximum: $6,500 Individual/$13,000 Family
No Individual pays more than the individual out-of-pocket. Once family out-of-pocket is met, it is met for all.
Primary Care Visits: You pay $0 for first 2 visits, then 0% after deductible
Prescriptions: Gen: $20 copay Pref: 0% after deductible
HealthOP Bighorn HSA Qualified EPO
GOLDProduct Brochure

Coverage Summary

Limitations and Exclusions

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Description: Higher monthly premiums, lowest costs when you seek medical care.  Medical visits are limited to the EPO network only.
HSA Compatible: Yes
Deductible: Std: $2,000 individual/$4,000 family
Enh: $1,800 individual/$3,600 family
No individual pays more than the individual deductible. Once family deductible is met, it is met for all.
Coinsurance: 0%
Out-of-Pocket Maximum: Once family out-of-pocket is met, it is met for all. Standard: $2,000 Individual/$4,000 Family
Enhanced: $1,800 Individual/$3,600 Family
Primary Care Visits: You pay 0% after deductible
Prescriptions: Gen: 0% after deductible Pref: 0% after deductible
HealthOP BisonFlex PPO
SILVERProduct Brochure

Coverage Summary

Limitations and Exclusions

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Description: Low monthly premiums, low costs when you seek medical care.
HSA Compatible: No
Deductible: $3,900 individual/$7,800 family
No individual pays more than the individual deductible. Once family deductible is met, it is met for all.
Coinsurance: 40%
Out-of-Pocket Maximum: $6,600 Individual/$13,200 Family
No Individual pays more than the individual out-of-pocket. Once family out-of-pocket is met, it is met for all.
Primary Care Visits: You pay $0 for first 2 visits, then 40% after deductible
Prescriptions: Gen: $20 copay Pref: 40% deductible waived
HealthOP Bighorn EPO
GOLDProduct Brochure

Coverage Summary

Limitations and Exclusions

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Description: Higher monthly premiums, lowest costs when you seek medical care.  Medical visits are limited to the EPO network only.
HSA Compatible: No
Deductible: $1,000 individual/$2,000 family
No individual pays more than the individual deductible. Once family deductible is met, it is met for all.
Coinsurance: 35%
Out-of-Pocket Maximum: No Individual pays more than the individual out-of-pocket. Once family out-of-pocket is met, it is met for all. Standard: $3,750 Individual/$7,500 Family
Enhanced: $3,250 Individual/$6,500 Family
Primary Care Visits: Standard: You pay $0 for first visit, then $20 copay/visit Enhanced: You pay $0/visit
Prescriptions: Gen: $0 copay Pref: $30 copay
HealthOP BisonHSA Qualified HDHP PPO
SILVERProduct Brochure

Coverage Summary

Limitations and Exclusions

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Description: Low monthly premiums, low costs when you seek medical care.
HSA Compatible: Yes
Deductible: $2,050 individual/$4,100 family
Once family deductible is met, it is met for all.
Coinsurance: 40%
Out-of-Pocket Maximum: $4,200 Individual/$8,400 Family
Once family out-of-pocket is met, it is met for all.
Primary Care Visits: You pay 40% after deductible
Prescriptions: Gen: $15 copay after deductible Pref:40% after deductible
HealthOP BisonPPO
SILVERProduct Brochure

Coverage Summary

Limitations and Exclusions

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Description: Low monthly premiums, low costs when you seek medical care.
HSA Compatible: No
Deductible: Std: $2,050 individual/$4,100 family
Enh: $2,000 individual/$4,000 family
No individual pays more than the individual deductible. Once family deductible is met, it is met for all.
Coinsurance: 40%
Out-of-Pocket Maximum: $6,600 Individual/$13,200 Family
No Individual pays more than the individual out-of-pocket. Once family out-of-pocket is met, it is met for all.
Primary Care Visits: Standard: Tier 1: You pay $0 for first 2 visits, then $25 copay/visit Tier 2: You pay $40 copay/visit Enhanced: Tier 1: You pay $0 copay/visit Tier 2: You pay $0 for first 2 visits, then $20 copay/visit
Prescriptions: Gen: Std: $15 copay; Enh: $0 copay Pref: $40 copay
HealthOP Bighorn HSA Qualified PPO
GOLDProduct Brochure

Coverage Summary

Limitations and Exclusions

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Description: Higher monthly premiums, lowest costs when you seek medical care.
HSA Compatible: Yes
Deductible: Std: $2,000 individual/$4,000 family
Enh: $1,800 individual/$3,600 family
No individual pays more than the individual deductible. Once family deductible is met, it is met for all.
Coinsurance: 0%
Out-of-Pocket Maximum: Once family out-of-pocket is met, it is met for all. Standard: $2,000 Individual/$4,000 Family
Enhanced: $1,800 Individual/$3,600 Family
Primary Care Visits: You pay 0% after deductible
Prescriptions: Gen: 0% after deductible Pref: 0% after deductible
HealthOP Bighorn PPO
GOLDProduct Brochure

Coverage Summary

Limitations and Exclusions

Apply Online

Description: Higher monthly premiums, lowest costs when you seek medical care.
HSA Compatible: No
Deductible: $1,000 individual/$2,000 family
No individual pays more than the individual deductible. Once family deductible is met, it is met for all.
Coinsurance: 35%
Out-of-Pocket Maximum: No Individual pays more than the individual out-of-pocket. Once family out-of-pocket is met, it is met for all. Standard: $3,750 Individual/$7,500 Family
Enhanced: $3,250 Individual/$6,500 Family
Primary Care Visits: Standard: Tier 1: You pay $0 for first 2 visits, then $20 copay/visit Tier 2: You pay $30 copay/visit Enhanced: Tier 1: You pay $0 copay/visit Tier 2: You pay $0 for first 2 visits, then $15 copay/visit
Prescriptions: Gen: $0 copay Pref: $30 copay