Medical Benefits - Health Insurance

  • Each plan is selected to help you manage your health, your way. DPS also contributes money to help pay for the cost of these plans (called Benefit Credits). Each Employee Association (or union) has their own Benefit Credit amounts.

    • Aetna provides high-quality care through a diverse network of distinguished, high-quality healthcare providers associated with hospitals and facilities throughout Denver.  Aetna provides a 24/7 nurse line to answer any urgent medical questions. The Aetna National Behavioral Health (BH) Network includes 5,200 facilities and 264,000 outpatient providers and is available for all of our Aetna members. Visit Aetna's microsite for DPS for additional information.
    • Kaiser Permanente provides high-quality care and coverage in one place for a connected, coordinated experience. At most medical offices, you can see a doctor, get labs and X-rays, and pick up a prescription in one location. Kaiser Permanente doctors are part of the largest multi-specialty medical group in the state, offering preventive and specialty care, a 24/7 medical advice line, and convenient video, phone, and online care options.  Visit Kaiser Permanente's microsite for DPS for more information.
    • MotivHealth has partnered with Town and Country and Centura to create a medical network that provides access to high-quality care at the best price. MotivHealth combines unique tools that allow members to shop and compare the costs of various providers before receiving care = no more guessing. MotivHealth also offers prescription assistance programs that can help significantly lower or eliminate out-of-pocket medication costs. Customer service representatives, called Personal Health Assistants, are available 24/7/365 to assist members with finding affordable care, answering any questions, and being a resource when navigating the complexities of healthcare. Visit MotivHealth's microsite for DPS or call 844-234-4472.
       
  • High Deductible Plans

    You have to meet the deductible level before the insurance provider starts to pay for a portion of services. Employees are eligible to contribute to a pre-tax savings plan, called a Health Savings Account (HSA), so that money is available to pay for services applied towards their deductible. DPS contributes an additional $27.92 per paycheck directly to the HSA of employees enrolled in a high deductible plan.

    If you select the plan with a $3,500 deductible, the cost you pay semi-monthly from your paycheck, or premium, will be less than if you select the plan with a $2,800 deductible. With 100% preventive care coverage, an individual with few medical expenses may choose a higher deductible plan as the premiums are the lowest. Conversely, an individual with specialized medical needs might choose a lower deductible plan, as the insurance provider starts to pay for a portion of services once the deductible is met.

    With the high deductible plans, preventive medications are free of charge. 

  • Deductible HMO Plans

    You have to meet the deductible level of $1000 before the insurance provider starts to pay for a portion of some services, and there are copays for other services. A copay is a fee paid to receive the service, such as a $60 copay for a specialist office visit. 

    Employees who participate in the HMO are eligible to contribute to a pre-tax spending plan, called the Flexible Spending Account. DPS discounts the cost of the HMO premiums an additional $27.92 per paycheck. This discounted cost is reflected in the rate shown on the Benefits Enrollment Site and in the enrollment guide.

    With the Deductible HMO plans, there is a set copay for prescriptions, depending on whether they are generic, preferred, or specialty drugs.

  • Cost

    • Preventative care is always covered 100% including an annual preventative visit to your primary care doctor.
    • DPS provides a semi-monthly benefit credit to help offset the cost of medical premiums 
      • Determine the amount of your benefit credit on your Employee Association page in our Benefits Enrollment Guide (available in English and Spanish) 
      • If using a PC, refer to the links on the right side of this page for each Employee Association's per paycheck medical rates for 2022. 
      • If using a mobile device, refer to the links below for Employee Association's per paycheck medical rates for 2022.
    • Pay attention to the costs of the different options:
      • Think about whether you want to pay more out of each paycheck (premium cost) but less when you need care (deductible or out-of-pocket max), or vice versa; 
      • For all the specifics you need, visit our Benefits Enrollment Guide (available in English and Spanish) 

  • Network

    • Is your current doctor in your new provider’s network?
    • Remember you can only enroll in a Health Savings Account (HSA) if you are enrolled in a qualified-high deductible health plan (CDHP).  

    Are you and/or your family eligible for free or low-cost insurance? Call the DPS Medicaid department to find out and receive more information at 720-423-3661.

  • How to Enroll

    You can enroll during the open enrollment period each spring, or during your new hire open enrollment period when you join Team DPS. You’ll be prompted to sign up as you go through the benefit enrollment process. Enrollment outside of our annual Open Enrollment period is restricted to specific situations. See the Qualifying Life Event page for additional information on mid-year changes.

  • How to Access

    Aetna Members: Get everything you need on the Aetna Portal or call Aetna at 855-736-9469.

    Kaiser Permanente Members: Access everything you need at kp.org or call Kaiser Permanente Customer Service at 877-883-6698.

    MotivHealth: Visit dps.motivhealth.com or call the DPS hotline at 800-392-7786

  • How to Change

    You may make changes to your enrollment during Open Enrollment each year or if you experience a Qualifying Life Event. Visit the Qualifying Life Event page to learn more about what events allow for benefit changes, what you need to do, and deadlines for appropriate paperwork. 

    I was auto-enrolled. Now what? 

    Go to our Auto-Enrolled page for information on your plans and what to do next.

  • Who to Contact

    • Kaiser Permanente
      • Visit kp.org
      • Call Kaiser Permanente's pre-enrollment line at 800-324-9208

  • What benefits am I enrolled in?

    • To view your benefits selections for the 2022-23 plan year, click here to log in and view your Confirmation Statement (bottom of the page, under Benefits).   

  • What is my employee association?

    Determine your employee association here.

  • What if I don’t pay union dues? Am I still part of that employee association?

    Yes, regardless of whether you pay dues or not, you are still part of your designated employee association.

  • How do I find out if my doctor is in network?

    • Aetna - Go to Aetna.comBased on your plan, select either: (CO) Aetna Whole Health - Colorado Front Range Health Network Only or Aetna Health Network Only (Open Access)
    • Kaiser Permanente—visit kp.org/doctors to find providers.
    • Motivhealth: go to dps.motivhealth.com to find network providers.

  • What plan should I choose?

    To learn more about available medical plans, please review the Benefits Enrollment Guide. We also recommend that you use the Plan Decision Tool within the Benefits Enrollment site if you are uncertain about which medical plan to choose.

  • How much does DPS contribute to my benefits?

    DPS contributions vary based on your Employee Association (union). For information on your specific Employee Association, please consult the Benefits Enrollment Guide.

    • Benefit Credits: Benefit credits are what DPS contributes to offset your cost for premiums for medical, dental, and vision plans. Most employees are eligible to receive them. The amount varies by employee association and how many hours you work a week.
    • Medical Subsidy: Employees who don’t receive benefit credits may qualify for a medical subsidy, which is a discount off the cost of your premiums for medical plans.
    • Child Subsidy: All benefit-eligible employees qualify to receive a child subsidy to offset the cost of premiums for medical plans that cover children.
    • HSA or HMO Subsidy: Employees who enroll in one of the CDHP medical plans and open a Health Savings Account (HSA) are eligible to receive this subsidy. You are not required to make HSA contributions to receive this subsidy, however it is recommended that you do so. Employees enrolled in a DHMO plan automatically receive the HMO subsidy as a premium discount.

  • How will I receive my benefit credits and/or subsidies?

    • Benefit Credits: Listed under deductions on your paystub. They show as a negative number, which means it is a credit to you and lowers the cost of the premium. Benefit Credits are automatically applied to discount the cost of your medical premium.
    • Medical Subsidy: This will not appear on your paystub, but will be automatically applied to discount the cost of your medical premium.
    • Child Subsidy: This will not appear on your paystub, but will be automatically applied to discount the cost of your medical premium.
    • HSA or HMO Subsidy: HSA subsidies will be automatically added to your HSA account twice a month. HMO subsidies will be automatically applied to discount the cost of your medical premiums and will not appear on your paystub.

  • Do I need to provide documentation during open enrollment (i.e., marriage/birth certificates)?

    No. Documentation is not required during open enrollment. If you need to change your benefits after a qualifying life event (such as a birth, marriage, or divorce) and are eligible to change benefits during the plan year, documentation may be required.

  • When can I change/update/stop supplemental benefits? When do they start?

    Supplemental Benefits include: Critical Illness, Accident, Hospital, and Legal Supplemental Insurance; Auto, Home and Pet Insurance; Life Insurance & Disability Insurance; Long-Term Care Insurance and the Denver Teachers Club Voluntary Payroll Protection Plan & Assistance Fund.

    You can enroll or change supplemental benefits during the new hire and open enrollment periods. You can drop coverage at any time by emailing hr_connect@dpsk12.org and completing required forms.

  • What’s the difference between pre-tax and post-tax? When would I want to select either?

    • Pre-tax: The cost of your benefits is deducted from your paycheck before taxes are calculated, and you are therefore only taxed on your remaining paycheck balance. You pay less in taxes with this option.
    • Post-tax: The cost of your benefits is deducted from your paycheck after taxes are calculated. You pay more taxes with this option.
      • Employees who are within three to five years of retirement may want to select post-tax deductions to maximize pensionable income under Colorado PERA. You will be prompted to select pre or post-tax on one of the Benefits Enrollment screens during your enrollment selections. Although Health Saving Account (HSA) contributions are deducted on a pre-tax basis, it does not count against the highest average salary calculated by Colorado PERA.


    **
    Pre-tax and post-tax selections can only be changed during open enrollment or during a qualifying life event.

  • When will I get my insurance cards?

    • Aetna: For annual enrollment, you will receive your insurance card in the mail by July 1. (Note: Not all employees will get new ID cards. Only new hires, those with dependent changes, those with name changes, and those with network changes will be mailed an ID card). You can also download a digital version of your card from your Aetna.com account.
    • Kaiser Permanente: You will receive your insurance card in the mail within 10 days of your coverage start date. You can also print a copy or download a digital version of your card by logging into your Kaiser Permanente account online or the KP app.
    • MotivHealth: Member ID cards will be made available 10-14 days, after your MotivHealth effective date. ID cards will be received, via mail. Additionally, electronic copies of member ID cards can be viewed, emailed, or downloaded within your MotivHealth member portal.  If you have any questions regarding member ID cards or need to order additional ID cards, please contact MotivHealth by dialing 844-234-4472.

       

  • What happens if I need medical care outside of the Denver metro area?

    All individuals enrolled in an Aetna, Kaiser Permanente, or MotivHealth medical plan are covered for urgent and emergency care anywhere in the world. Covered means that expenses will apply towards your deductibles and out of pocket maximums, and insurance will cover the claim as if it were within the network. Urgent and emergency care are defined by each provider.

    • Aetna: 800-556-1555
      • Routine services aren’t covered outside of the Denver Metro area, so make sure to get them before your trip if you’re traveling elsewhere. Routine services include prevention, exams, checkups, and services for ongoing medical conditions.
      • If possible, talk through symptoms with your provider prior to visiting a medical facility.
    • Kaiser Permanente: 951-268-3900
      • For those dependents who are outside of a Kaiser Permanente service area and under the age of 26, the out-of-area benefit covers them for limited office visits, diagnostic x-rays, RX refills and therapy visits. For more information, call 877-883-6898 or download the Out-of-Area Benefit overview.
    • MotivHealth: 844-234-4472 
      • For any eligible covered dependents residing outside of Colorado, they will have access to network providers via the First Health network. For more information on locating providers in the First Health network, visit DPS.motivhealth.com  

  • I have a child who is away at college and needs medical coverage. What do I do?

    Children under 26 years of age may be covered under their parents’ medical, dental, and vision insurance plans. Aetna, Kaiser Permamente, and MotivHealth offer plans/benefits for dependents who live outside of the Denver-metro area. Check to see if your provider has doctors and medical offices in the area where your child will be living. 

    • Aetna: Aetna offers an Out-of-Area (OOA) Dependents Plan for dependents who permanently live outside of the Front Range. For more information or to enroll, email employee_benefits@dpsk12.org with your full name and phone number; and your dependent’s full name, date of birth, address, phone number, and relationship to you. 
    • Kaiser Permanente: For those dependents who are outside of a Kaiser Permanente service area and under the age of 26, the out of area benefit covers them for limited office visits, diagnostic x-rays, RX refills and therapy visits. For more information, call 877-883-6898 or click here for more details.
    • MotivHealth: For any eligible covered dependents residing outside of Colorado, they will have access to network providers via the First Health network. For more information on locating providers in the First Health network, visit dps.motivhealth.com  

CONTACT


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    HRHelp@dpsk12.net

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    Denver, CO 80203

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    Derek Bell

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