HMOs are also available to Retirees and access is determined by geographic location and Medicare eligibility status.
HMO Wrapper
Download the HMO/Insured Health Plan Summary Plan Description (SPD) Wrapper. Besides the HMO SPD Wrapper, you will need to contact the specific HMO for a brochure that describes coverage information and terms and conditions.
| HMO Wrapper (9 KB PDF) |
| CIGNA Ohio Plan Summary Plan Description (9 KB PDF) |
| HealthPartners Minnesota Summary Plan Description (9 KB PDF) |
State Specific HMO Charts
To download state specific HMO charts, select the state in which you live from the list below.
| Arizona (87 KB PDF) |
| California (109 KB PDF) |
| Connecticut (75 KB PDF) |
| Florida (74 KB PDF) |
| Illinois (90 KB PDF) |
| Louisiana (155 KB PDF) |
| Michigan (77 KB PDF) |
| Minnesota (70 KB PDF) |
| New Jersey (98 KB PDF) |
| New York (291 KB PDF) |
| North Carolina (70 KB PDF) |
| Ohio (82 KB PDF) |
| Pennsylvania (90 KB PDF) |
| South Carolina (9 KB PDF) |
| Texas (90 KB PDF) |
| West Virginia and Maryland (75 KB PDF) |
Who to Contact for HMO’s
UltraLink Helpline: (888) 282-0424
Triple-S PPO
| Triple-S PPO Chart (82 KB PDF) |
Who to Contact for Triple-S PPO:
Triple-S: (787) 749-4777
Web site: Triple-S
