Glossary
Accident Rider
SOLO Smart Choice Plans offer an optional Accident Rider which provides up to $500 immediate coverage for an accident. Without this rider, you will need to meet your deductible before coverage begins. Please note that this Accident Rider is built into SOLO Select Plans.
Applicant
The Primary Applicant can be an adult under age 65, or a child (age 2 months or older) applying for child-only coverage.
Child
For quoting and enrollment purposes, "Child" is the applicant?s or applying spouse?s natural or legally adopted child, or legal ward, age 19 or under, financial dependent aged 20-25, or disabled dependent of any age. We encourage any children who do not meet these requirements to apply separately, and will consider their applications on an individual basis.
Children Only
If only children are applying for coverage, please check this box then list the oldest child as the applicant. Please list any additional children in the "sibling" fields that will appear once this box is checked.
Co-insurance
Co-insurance is the percentage of the cost of care which you continue to pay after you have met your deductible. You pay co-insurance until you meet your out-of-pocket or lifetime maximum.
Deductible
Deductible is a dollar amount that you must pay annually before certain medical services are covered.
Effective Date
Your effective date of coverage is the first day of the month following RMHP's approval of your application. Applications typically take up to 10 business days to process. You can select an effective date of the first of the month for up to 60 days in the future.
Electronic Check
What is an Electronic Check? RMHP can set up an automatic bank withdrawal directly from your checking account. Simply provide your bank and checking account information here.
Email Address
Please use an email address that will be valid for at least the next 90 days. If your email address becomes invalid before you have completed and submitted your application, you may have to create a new account and start your application again.
Emergency Room
Emergency Room is the coverage for care received at a hospital Emergency Room for urgent and emergent conditions. Please note that the benefit amount is different for in-network and out-of-network facilities.
Hobbies
Please list all hobbies that you participate in on a regular basis (i.e., golf, race car driving, water skiing, running marathons).
Individual In-Network
The benefit details provided below represent benefits for an individual, receiving services from a participating (in-network) provider. This includes the Private Health Care Systems (PHCS) national network for care received outside the state of Colorado.
In-Network
In-Network Coverage is the coverage available for care received through an RMHP participating provider (or a PHCS Healthy Directions participating provider for care received outside of Colorado).
Lifetime Max
Lifetime maximum is the maximum benefit amount available for each individual enrolled in a SOLO Health Plan.
Monthly Premium
This is the monthly premium you will pay for the plan indicated, based on the information you provided. If you click on the monthly premium you will see a breakdown of the premium by family member (if applicable). Please note that if you elect to add an optional rider (accident and/or prescription), your monthly premium will change accordingly.
Office Visit Co-pay
Office visit co-pays are the amount you pay when you visit an in-network care provider. Co-pays are either flat dollar amounts (for example $30 per visit) or percentages (for example 20% of the cost of the visit) depending on your plan.
Out of Network
Out of Network Coverage is the coverage available for care received through a non-participating provider (inside or outside of Colorado).
Out of Pocket Max
Out of Pocket Maximum is the maximum you will pay, per family member, per year. Please note that office visit copays, the optional prescription rider copays and certain other benefits copays will continue to apply even if you reach your out-of-pocket maximum.
Plan Description Form
The Plan Description Form provides detailed benefit information for each plan.
Plan Name
These are the names of the SOLO Health Plans available to you. You can click on any plan name to view its Plan Description Form. The Plan Description Form provides you with very detailed benefit information about the selected plan.
Prescription Drug
A Generic-Only prescription drug benefit is automatically included in all plans--there is no additional cost for this prescription drug benefit.
With the Optional Prescription Rider, you get more robust coverage including brand-name drug benefits. For example $10/$40/$60 means you pay a $10 copay for a generic drug, a $40 copay for a preferred brand drug, and a $60 copay for a non-preferred brand drug.
The retail drug benefits shown are for a 30-day supply, while the mail-order benefits shown are for a 90-day supply. If you order a 30-day supply of a prescription drug using the mail order system, the retail copays will apply. A 90-day supply (and the associated discount price) is only available through mail-order.
Prescription Rider
Choose expanded prescription drug coverage by purchasing a prescription rider--All SOLO Health Plans include a generic drug benefit automatically. The optional prescription rider offers expanded coverage to include preferred and non-preferred brand name drugs with an up-front copay.
Preventive Care
Preventive care applies to adults and includes annual exams (up to $100), annual mammograms and pap smears for women, and annual prostate screenings for men. These benefits are in-network only, and are covered right away; you do not need to satisfy your deductible.
Security Question
Security Question and Answer will help you retrieve your password, in case you forget it. Please write down your question and answer, and store them in a safe place for future reference.
Mail Bill Via US Mail
RMHP can send you a paper bill for your SOLO Health Plan premium via US Mail, based on the payment frequency you designate.
SSN
RMHP asks for your social security number for internal administration of your health plan. All printed materials (including your Member ID Card) will have a unique member number for privacy purposes. If you do not have a social security number, please contact us for assistance.
Spouse
For quoting and enrollment purposes, "Spouse" must be your spouse through marriage as recognized by the laws of the State of Colorado, including common-law marriages. We?re sorry but same-sex unions are not recognized as a legal marriage in the State of Colorado and therefore cannot qualify for spousal status. We encourage you to apply separately, and will consider your applications on an individual basis.
Tobacco
"Tobacco Use" includes smoking and/or chewing tobacco.
Well Child
Well child benefits apply to children ages 2 months to 18 years. Well Child benefits are covered right away; you do not need to satisfy your deductible.