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
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.
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.
can choose one of two available plans: PacifiCare HMO and
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.
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:
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
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.
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.
teachers receive coverage for themselves in these
plans at no cost.
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.
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
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.
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
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.).
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