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Rocky Mountain Health Insurance Forms

 

Employee Application Employer Application
Employee Waiver Employee Change Form
Employee Disenrollment Form EFT Premium Payment

 

NOTICE TO EMPLOYEES: You are NOT required to share your medical information with your employer. You may, at your discretion, return the completed application in a sealed envelope or fax it to (303) 495-2222. Please call to confirm receipt.   

 

Health Plan Comparison Guide 

 

Plan Descriptions  

PPO Plans

Basic PPO

Basic PPO w/ MPHH

Standard PPO

Std PPO w/ alcohol/ substance abuse

Choice 500 80-60

Choice 500 90-70

Choice 1000 80-60

Choice 1000 90-70

Choice 1500 80-60

Choice 3000 80-60

Choice 5K 80-50

Choice 10K 80-50

Direct A200

Direct A600

Direct B400

Direct B800

Direct C600

Direct C1200

Direct D100

Direct D300

Direct E200

Direct E400

Direct E1200

Direct E3000

Direct F300

Direct F600

Direct F1200

Direct G1800

 

HSA Plans

HMO 1000

HMO 2500

HMO 5000

PPO 1000

PPO 2500

PPO 5000

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Elite Insurance Group 9798 Mayfair St., Suite D, Englewood, Co 80112 | Phone: 303-317-6650
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