NAVIGATION Introduction Health Insurance Dental Insurance Vision Insurance Sick Leave   Life and Accidental Spending Accounts Employee Assistance Retirement Shelters and Savings Closing Site Contents

Health Insurance DPS offers a comprehensive package of health care benefits for eligible employees and dependents that covers doctor visits, prescription drugs, office and surgical procedures, hospital coverage, mental health benefits and substance abuse care. Depending on the health plan you choose, you will select either a primary care physician (PCP) or a care facility from the network of providers in your area. Employees can choose a level of coverage from three different plans offered by Kaiser Permanente and PacifiCare. All plans emphasize preventive care so you can maintain good health before problems arise. Key features of each plan are highlighted in the next section. Kaiser Permanente If you choose to enroll in the Kaiser Permanente plan, your health coverage is administered by Kaiser physicians, who coordinate your care in Kaiser facilities throughout the metro area. The Kaiser plan covers all preventive care visits at $5 per visit. If you need to see a doctor for a specific diagnosis, a $15 office co-payment will be required. There are no deductibles or claim forms associated with this option. PacifiCare You can choose one of two available plans: PacifiCare HMO and PacifiCare Plus.  PacifiCare HMO is a Health Maintenance Organization which requires that you select a primary care physician (PCP). An office visit with a PCP is $15 per visit; an office visit with a specialist is $30 per visit.  PacifiCare Plus is a point-of-service plan. As a participant in this option, you have a choice each time you need health care. You may go:  In-network and have your care coordinated by the PCP you have selected and pay a $20 co-payment for each PCP visit or $40 per specialist visit, or  Out-of-network and coordinate your own care and file your own claims. If you receive care out-of-network, you must satisfy a $500 deductible per person. With PacifiCare Plus, you can go in- or out-of-network as you choose. However, you generally pay more for out-of-network care. Deductibles and coinsurance payments apply when you go out-of-network. Also, dependent premiums in the point-of-service plan can cost more than the other options. Full-time teachers receive coverage for themselves in these plans at no cost. Full-time classified employees receive coverage at no cost for themselves for the HMO and Kaiser Plans. If you are not a full-time, contract employee, different rules apply. Contact the Employee Benefits Department at 764-3371 for more information. You may waive the health insurance if you have access to coverage through another plan. Because DPS wants to make sure you have adequate health care protection, you need to sign and submit a waiver form stating you have coverage elsewhere. You will need to pay for coverage for your eligible dependents. Generally, "dependents" are the employee's spouse and unmarried children, who are covered from birth to age 24. Employees may also enroll same-sex domestic partners in the health insurance program. An employee must pay for his or her partner's health coverage on an after-tax basis. Dental and vision coverage is not available for same-sex domestic partners. You may change coverage during the Open Enrollment period. You have 31 days to make changes in your coverage in the event of a change in status (such as marriage, birth or adoption of a child, etc.). Health insurance becomes effective on the first day of the month following your effective hire date, provided the Employee Benefits Department has received your completed enrollment form and the Board of Education has approved your employment.