Medical Benefits

State of Colorado Medical Plan Options

One of the State of Colorado’s goals is to provide employees with cost-effective, high-quality health care. The State of Colorado offers copay plans with a deductible, and high deductible health plans (HDHPs) from UnitedHealthcare and Kaiser Permanente. The plan designs differ based on how you and the insurance company share the costs of your care. The plan designs have no effect on the quality of care you receive

UnitedHealthcare

  • Copay Choice Plus Plan

  • HDHP with HSA Plan

Kaiser Permanente

  • Deductible HMO Plan

  • HSA qualified HDHP

What You Can Expect

Vision and Optical Benefits are Covered.

  • All of our medical plans include vision and optical benefits. All employees are automatically enrolled in an optical plan through their medical insurance carrier.

100% Coverage For Your Preventive Care.

  • All of our medical plans pay 100% for preventive care when you use in-network providers, even before you meet your annual deductible.

An Employer HSA Contribution of $720!

  • Our high deductible health plans (HDHPs) are eligible for a health savings account (HSA), which lets you save money for medical expenses.

  • The State of Colorado will contribute $60 each month to your HSA at Optum Bank if you enroll in a HDHP with UnitedHealthcare or Kaiser Permanente.

Deductible CoPay Plans

How They Work

  • Copay: A copay is the fixed dollar amount you pay when you use medical services. For example, your plan could require you to pay $30 for primary care doctors, $50 for specialists, and $15 for generic prescription drugs. When you go to the doctor or fill a prescription, this is the amount you’ll pay, plus any deductible or coinsurance.
     
  • Deductible: The State’s copay plans have a deductible. For medical services for which a deductible applies, you will be required to pay the full cost of services until you meet your deductible. For example, if you have a copay plan and visit your primary care physician, you pay a $30 copay for the visit, plus the full cost of medical services you receive during that appointment. Copays usually do not count toward your deductible.
     
  • Coinsurance: Copay plans have coinsurance (the cost sharing with the health insurance company). Once you meet your deductible, you pay coinsurance for medical services received until you satisfy your annual out-of-pocket maximum.
     
  • Annual Out-of-Pocket Maximum: Copay plans have an annual out-of-pocket maximum. Copays, deductible and coinsurance count toward your out-of-pocket maximum. If you reach your out-of-pocket maximum, the insurance company pays 100% of covered medical services.

Advantages

  • You’ll have a set dollar amount, or copay, when you visit the doctor.
     
  • Works well for people who do not want to pay the full cost of a medical bill or prescription out-ofpocket.
     
  • Makes sense for people who are willing to pay more each month for the security of knowing how much they will pay when they visit the doctor. 

 

High-Deductible Health Plans

How They Work

High deductible health plans are designed to help keep premium costs low for you and your family. How much you pay out-of-pocket depends on two things: Your deductible and out-of-pocket maximum.

  • Deductible: You are expected to pay the full charges for services until you meet the deductible.  

  • HSAs or FSAs Help You Pay Your Deductible: You can use a health savings account (HSA) or flexible spending account (FSA) to cover medical expenses. All HDHPs with the State of Colorado are HSA qualified and eligible for an employer contribution of $60 per month ($720 annually) to an HSA with Optum Bank.

  • Coinsurance: Once you meet your deductible, your health insurance pays coinsurance, or 80% of your medical costs.

  • Annual Out-of-Pocket Maximum: You’ll continue to pay coinsurance on the covered expenses that require it until you meet your out-of-pocket maximum. If you reach your out-of-pocket maximum, the insurance company pays 100% of medical services.

Advantages

  • You’ll have lower monthly premiums than copay plans.
     
  • If you enroll in a HDHP, you’re eligible for a health savings account (HSA) to help pay for expenses until you meet your deductible and out-of-pocket maximum and the State of Colorado will contribute $60 monthly to your HSA.
     
  • Works well when you know you will meet your out-of-pocket maximum early in the year. After that, insurance will cover the full cost of services and you’ll continue to enjoy a low monthly premium.
     
  • You’ll have low monthly premiums and preventive care, including annual exams, cancer screenings and other services at no cost to you. 

How High Deducible Health Plans Work:
(Click to enlarge)

High Deductable Example

 

 

Preventive Services

Regardless of your health insurance plan, all preventive care services are covered at little or no out-of-pocket cost to you.

  • Annual physical exams (e.g. well-woman, well-child exams etc.)
  • Preventive Cancer Screenings 
  • Preventive Mammograms
  • Biometric screenings (e.g. cholesterol, blood pressure, diabetes, etc.)
  • Flu Shots and other immunizations
  • Diabetes Prevention Program 

And, more! Please see the following resources and your health insurance plan for a complete list of preventive services.

Employee Resources 

State Resources

Division of Human Resources

colorado.gov/dhr
Contact: state_benefits@state.co.us
303-866-3434 or 1-800-719-3434

Your Department’s Human Resources Office

Employees and supervisors are encouraged to contact their respective Department Benefit Administrators with initial questions.

Employee Wellness Program

colorado.gov/dhr/wellness
Contact: state_wellness@state.co.us
303-866-3892

Colorado State Employee Assistance Program (C-SEAP)
colorado.gov/c-seap
Contact: 303-866-4314 or Toll Free 1-800-821-815

Medical Providers

UnitedHealthcare

Group# 718733
myuhc.com (member site)
welcometouhc.com/colorado (a pre-member site)
Contact: 1-877-283-5424

Kaiser Permanente

Group# 0225
my.kp.org/stateofcolorado
Denver/Boulder & Northern Colorado
Contact: 303-338-3800, 1-800-632-9700

Southern Colorado
Contact: 1-888-681-7878

Related Links 

Send an email to state_benefits@state.co.us to ask a benefits question anytime.