Glossary

Accident Rider

SOLO View Plans offer an optional Accident Rider which provides up to $1000 immediate coverage for an accident. Without this rider, you will need to meet your deductible before coverage begins.

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 18 or under, a dependent aged 19-25 who is financially dependent or resides in the same household as the parent, or disabled dependent of any age. We encourage any children who do not meet these requirements to apply separately, and RMHP 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 or fifteenth day of the month following RMHP's approval of your application. Applications typically take from 2 to 10 business days to process. You can select an effective date of the first or fifteenth 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.

Hobbies

Please list all hobbies that you participate in on a regular basis (e.g., 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 Multiplan/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 (Multiplan/PHCS 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 $35 per visit) or covered in full after deductible 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 or per family, per year. Please note that office visit copays, the optional prescription rider copays and certain other benefit 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 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 Rider, you get more robust coverage including brand-name drug benefits.  For example,

Optional prescription drug riders for the View plans are:
  • Discount Plan - You pay 100% of the RMHP price for generic and brand name drugs.  This is a discount off the retail price.
  • $15 Copay for Generic Drugs (no coverage for brand name drugs)
  • $15 Copay for Generic Drugs, then $250 per year deductible for brand name drugs, then $40 copay for preferred brand and $60 for non-preferred brand drugs
  • $15 Generic / $40 Preferred Brand Name / $60 Non-preferred brand name
Optional prescription drug riders for the View HSA plans are:
  • Generic drugs 100% covered after the medical plan deductible
  • Generic and brand name drugs 100% covered after the medical plan deductible
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 and specified retail pharmacies.

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 riders offer expanded coverage to include preferred and non-preferred brand name drugs.  The level of coverage and copay depends on the plan and rider selected.

Preventive Care

Preventive care includes an annual adult physical exam up to $200 paid by plan per year.  Routine screenings are covered 100% with no copay for annual mammograms and pap smears for women, and annual prostate screenings for men. A lipid panel and blood glucose screen are covered with a $10 copay before deductible once a year. 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 for payment plans setup on a quarterly frequency.  Monthly payments are processed electronically via ACH or credit card transaction.

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.

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.


Vision

Discounts on the fees for vision care services from doctors participating with the Vision Service Plan (VSP) network.


  • 20% discount on annual eye exam
  • 20% discount on full set of prescription eye glasses
  • 15% discount on contact lens fitting and evaluation exam
  • 15% discount on laser vision correction

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.  Routine immunizations are covered at 100% before deductible.
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