HMO
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 (9KB PDF)
CIGNA Ohio Plan Summary Plan Description (9KB PDF)
HealthPartners Minnesota Summary Plan Description (9KB PDF)

State Specific HMO Charts
To download state specific HMO charts, select the state in which you live from the list below.
Arizona (87KB PDF)
California (109KB PDF)
Connecticut (75KB PDF)
Florida (74KB PDF)
Illinois (90KB PDF)
Louisiana (155KB PDF)
Michigan (77KB PDF)
Minnesota (70KB PDF)
New Jersey (98KB PDF)
New York (291KB PDF)
North Carolina (70KB PDF)
Ohio (82KB PDF)
Pennsylvania (90KB PDF)
Texas (90KB PDF)
West Virginia and Maryland (75KB PDF)

Who to Contact for HMO’s
UltraLink Helpline: (888) 282-0424

Triple-S PPO
Triple-S PPO Charts (82KB PDF)

Who to Contact for Triple-S PPO:
Triple-S: (787) 749-4777
Web site: Triple-S