Benefits Guide 2015-16 - Human Resources

July 1, 2015 June 30, 2016
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TABLE OF CONTENTS
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Employee Benefits Overview
Benefits Eligibility
Paying for Your Benefits: Pre-Tax Versus Post-Tax Elections
Changing Your Benefits During the Year
DPS Contribution for the DPS Flex Plan
Paraprofessional Reimbursement Accounts
Summer Coupons
Medical Insurance
DPS Medical Insurance Options
What is a Consumer-Driven Health Plan?
DPS Interest-Free Loan Program
Health Savings Account
Healthcare Flexible Spending Accounts
Aflac Voluntary Benefit Plans
Dental Insurance
Vision Insurance
Long-Term Disability Insurance
DPS Supplemental Benefits Program
Sick Leave Bank
Employee Assistance Program and Work-Life Services
Planning for Your Retirement
Dependent Care Flexible Spending Account
Commuter Benefits
Life and AD&D Insurance
Long-Term Care Insurance
Auto and Home Insurance
Pet Insurance
Employee Discount Program
Westerra Credit Union
Denver Educational Senior Citizens, Inc.
The You Revolution, Denver Public Schools Employee Wellness Program
Ready to Enroll?
Important Contact Information
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EMPLOYEE BENEFITS OVERVIEW
Denver Public Schools (DPS) is committed to providing you and your eligible
dependents with high quality, affordable benefit selections to support your health
and well-being. Every year DPS evaluates its benefit plans in an effort to ensure we
are providing our employees competitive benefits while still utilizing resources in
the most cost-effective way possible. Please familiarize yourself with the available
plans and make needed adjustments to ensure you have the appropriate coverage
to meet your family’s financial protection goals.
SPECIAL NOTE FOR OPEN ENROLLMENT: Within this Benefits Guide you will find
important information on the benefits available to you for the 2015–2016 plan year
(July 1, 2015–June 30, 2016). Flexible Spending Accounts (FSA) must be elected
every year, current elections do not roll over. Regarding the rest of the plans, we are
holding a passive enrollment this year, only employees wishing to make changes
(newly enroll, change plans, or waive) will need to log in to Employee Space to make
those updates. Before enrolling, please take a moment to review the benefits DPS
offers to determine which plans are best for you and your family.
BENEFITS ELIGIBILITY
All benefits-eligible employees are eligible to enroll in benefits within the first 30
days of their official hire date for benefits to be effective the first of the month
following 30 days of employment. If you aren’t sure what your official hire date is,
please check Employee Space for your “adjusted hire date.” Employees must enroll
online through Employee Space, no later than 30 calendar days from date of hire.
If you work 30 or more hours a week and do not enroll or waive coverage within
30 calendar days, you will automatically be enrolled in the lowest cost medical
plan. You will not be able to make any changes to this option until the next open
enrollment period unless you experience a qualifying event during the year.
Part-time (hourly) employees who work at least 20 hours per week are eligible to
enroll in benefits. Benefits will become effective the first of the month following 30
days of employment. Employees must enroll online through Employee Space, no
later than 30 calendar days from their hire date.
Employees who have a change in employment status (i.e., moving from a nonbenefit-eligible position to a benefit-eligible one) must enroll in benefits within 30
days from their change in employment status. Benefits become effective the first of
the month following the status change.
2015-2016
HIGHLIGHTS
• Consumer-driven
health plan options
offer employees
more affordable
choices.
• All consumerdriven health plan
options include
free preventive
prescriptions
(lists of covered
prescriptions
available online).
• DPS will contribute
$750 a year ($62.50
per month) into
your health savings
account when you
enroll in one of the
consumer-driven
health plans (to
receive the DPS
$62.50 contribution,
you must enroll in an
HSA).
• Special underwriting
will be allowed for
Employee Optional
Life insurance.
BENEFITS
PLAN YEAR
• The benefits plan
year runs from
July 1 through
June 30 annually.
• Open enrollment
for the 2015–2016
plan year begins
April 20, 2015, and
ends May 8, 2015.
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BENEFITS ELIGIBILITY, continued
You may also enroll your eligible family members. They include:
• Your legal spouse.
• Your common-law spouse, once you complete the common law affidavit provided by and with approval from
the benefits department. Please note that a common law marriage is a legal binding marriage in the state of
Colorado and requires the same divorce procedure as any other traditional marriage to dissolve. There is no
common law divorce.
• Your civil union partner upon providing confirmation of the partnership to the benefits department. (The
portion of premiums you pay for benefits for your civil union partner is not eligible to be paid with pre-tax
dollars by IRS regulations, unless they qualify as a tax-code dependent; contact the benefits department for
more information.)
• Your children to age 26, regardless of student, marital, or tax-dependent status, including a stepchild, legallyadopted child, a child placed with you for adoption, or a child for whom you are the legal guardian).
• Your mentally or physically disabled children age 26 and over. Contact the Benefits Department for more
information.
Benefits Eligibility Summary
EMPLOYEE TYPE
TEMPORARY EMPLOYEES
SUBSTITUTES
OOON-DESIGNATED
WORK YEAR
*PART-TIME HOURLY
(.5 FTE) WORKING AT LEAST
20 HOURS PER WEEK
FULL-TIME (.75FTE)
WORKING AT LEAST 30
HOURS PER WEEK
MEDICAL, DENTAL AND VISION
No
Yes
Yes
FLEXIBLE SPENDING ACCOUNT (FSA)
HEALTH SAVINGS ACCOUNT (HSA)
No
Yes
Yes
BASIC GROUP LIFE INSURANCE
No
Yes ($2,500 coverage amount)
Yes (2x annual salary)
ACCIDENTAL DEATH AND
DISMEMBERMENT
No
No
Yes (2x annual salary)
BENEFIT TYPE
LONG-TERM DISABILITY
No
No
Yes
PERA PENSION
Yes
Yes
Yes
VOLUNTARY RETIREMENT PLANS
403(b), 457(b) and 401(k)
No
Yes
Yes
VOLUNTARY INSURANCE
No
Yes
Yes
EMPLOYEE ASSISTANCE PROGRAM
Yes
Yes
Yes
EMPLOYEE DISCOUNT PROGRAM
Yes
Yes
Yes
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PAYING FOR YOUR BENEFITS:
PRE-TAX VERSUS POST-TAX ELECTIONS
You may elect to have your medical, dental, and vision premiums deducted from your paycheck on either a pretax or post-tax basis. When you pay the premiums with pre-tax dollars, you reduce the cost of the coverage. This
savings is the result of reduced PERA contributions and Medicare, federal, and state tax withholdings.
If you are not within a few years of retirement, you may wish to have your premiums taken out on a pre-tax
basis to lower your taxable income. However, if you are within three to four years of retirement, you need to be
aware of how pre-tax premiums, and healthcare and dependent care Flexible Spending Accounts (FSAs), impact
your pensionable salary calculation. PERA’s definition of pensionable (PERA-includable) salary is based on
compensation for services rendered. However, pre-tax deductions for your health insurance premiums (medical,
dental, and vision) or enrollment in healthcare or dependent care FSAs will not be included. For more details,
please review PERA’s Section125 Plan document.
During the years your salary will be included in your PERA Highest Average Salary (HAS) calculation, you may want
to consider electing a post-tax deduction of your health insurance premiums to ensure that your deduction does
not reduce your salary for pension purposes. Likewise, you may want to consider stopping participation in the
FSAs (healthcare and dependent care). The election of post-tax premium deductions and/or discontinuation of
FSAs can only be done during your initial eligibility period or during the annual open enrollment period.
Please contact your tax advisor for help determining whether to have your premiums deducted on a pre- or posttax basis.
CHANGING YOUR BENEFITS DURING THE YEAR
Due to IRS regulations, if you choose to pay your portion of the medical, dental, and vision plan costs on a pretax basis, and/or contribute pre-tax dollars to an FSA, once you have made your elections for the plan year, you
cannot change your benefits until the next annual open enrollment period. The only exception is if you experience
a qualifying life event. Election changes must be consistent with your life event.
Qualifying life events include, but are not limited to:
•
•
•
•
•
•
•
•
•
Marriage, divorce, or legal separation
Birth or adoption of an eligible child
Death of your spouse or covered child
Loss of your spouse’s or child’s benefits elsewhere
Change in your spouse’s or child’s work status that affects his or her benefits eligibility (resulting in a loss of
benefits)
Change in your child’s benefits eligibility status (e.g., dependent child exceeds the maximum age for coverage;
you may only drop the child from coverage as a result)
Change in place of residence causing a loss of eligibility (i.e., moving outside of the service area)
Qualified Medical Child Support Order
Enrollment in, or change in eligibility for, Medicare or Medicaid
To request a benefits change, notify the HR department within 30 calendar days of the qualifying life event by
filling out a benefits change form (located on the HR website) and send it to Employee Services at
connect_humanresources@dpsk12.org or by fax to 720-423-2505. You will need to provide proof of the change
such as a marriage or birth certificate. Change requests submitted after 30 days cannot be accepted.
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DPS CONTRIBUTION FOR THE DPS FLEX PLAN
DPS offers a flexible benefits plan which allows employees to choose from a menu of benefits. Most DPS
employees are eligible to receive an employer contribution to offset the cost of the medical, dental, and vision
insurance they choose.
The employer contribution amount varies by bargaining group and the hours you are regularly scheduled to work.
Please refer to the eligibility chart below to determine your employer contribution amount.
MONTHLY FLEX
DOLLARS
EMPLOYEE GROUP
ABGW (Building And Grounds)
$441.89
ADMINISTRATORS/MANAGERS/SUPERVISORS (includes Principals)
$325.61
ATU-TRANSPORTATION
$386.11
$190.45
$125.59
Bus drivers full-time
Hourly drivers (5+ years of service)
Hourly drivers (1–4 years of service)
Hourly drivers (–1 year of service .75 FTE or greater)
Parts/tool room clerk
Maintenance mechanic
Vehicle service tech ii
Vehicle service tech i
$389.36
$433.68
$403.42
$372.06
CWA
Full-time
Part-time
$385.79
EXTENDED LEARNING & COMMUNITY SCHOOLS
Full Time (30–40 hours per week)
Part Time (20-29.99 hours per week)
Full-time
Part-time: 75FTE to .999 FTE
Full-time working 7 or more hours per day
Part-time working 6 to 6.99 hours per day
$323.00
$150.00
$300.82
$150.00
$416.00
FACILITY MANAGERS
FOOD SERVICE MANAGERS
$190.00
$130.00
$422.17
DCTA
FOOD SERVICE
$150.00
$270.92
EGTC PREMIUM REDUCTIONS
DFP (Paraprofessional)
$125.59
$175.00
ATHLETIC TRAINERS
DAEOP (office support)
MONTHLY
MEDICAL
SUBSIDY
Hourly (6+ hours per day)
Hourly (4–5.99 Hours per day)
$200.00
$150.00
$277.28
$287.53
MATH FELLOW
PRO-TECH
$325.61
VTCF TEACHERS
$421.91
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PARAPROFESSIONAL FLEXIBLE SPENDING
ACCOUNTS
DPS contributes to a healthcare Flexible Spending Account (FSA) in the amount of $34.00 per month, up to a
maximum of $408.00 for the calendar year, for paraprofessionals who work between 4 and 6.99 hours a day.
This account has been set up to help with healthcare expenses, such as copays, deductibles, and coinsurance
amounts not paid by the medical and/or dental insurance plans. This account cannot be used for dependent care
expenses. All eligible employees are automatically enrolled in this account.
Paraprofessionals receiving this benefit can also contribute their own money into the healthcare FSA and/or enroll
in a dependent care FSA.
The healthcare FSA allows employees to set aside money from their paycheck on a pre-tax basis to pay for eligible
expenses, such as medical and dental deductibles, copays, coinsurance, eye exams, prescription expenses, LASIK
surgery, and other health-related expenses that are not otherwise reimbursed by insurance.
The dependent care FSA allows employees to set aside money from their paycheck on a pre-tax basis for day care
expenses.
Employees receive a special purpose debit card from WageWorks. This card provides instant access to their
healthcare FSA funds and allows payment for eligible products and services at the point-of-sale, eliminating
the need to submit a claim form and wait for reimbursement. The employee should always keep the debit card
receipts, as sometimes there is a need to provide documentation for certain transactions. NOTE: The card cannot
be used for dependent care reimbursement claims.
Paraprofessionals whose hours decrease to less than four hours per day or increase to over seven hours per day,
will no longer be eligible to participate in this employer-paid benefit. DPS’ contribution will be prorated for the
number of months worked while eligible during the calendar year (January–December).
To learn more about eligible expenses, please contact WageWorks Customer Service at 800-800-0133. If you
have questions regarding enrollment, please contact Employee Services at 720-423-3900.
SUMMER COUPONS
Employees who are not paid through the summer months may continue benefit(s) coverage through the summer
by paying their premium portion either by working enough hours through the summer to cover the premium costs
or by paying through the coupon program.
Hourly employees also have the option to waive (drop) their insurance coverage through the summer. The
employee will be responsible for any health claims incurred while waived. If the employee does not return to DPS
in the fall and had waived coverage during the summer or did not pay for summer coverage, he or she will not be
eligible for COBRA.
Individuals working in the summer or wanting to waive their insurance coverage must complete the Summer
Insurance Program Selection Form by June 15, 2015. Check your email and the HR website for the form and more
information on the Summer Coupon process for 2015. Please note: Failure to return the Selection Form will result
in benefits being waived for the summer (July and August).
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MEDICAL INSURANCE
Healthcare Reform Law Individual Mandate
You and your family members are required to have health insurance or pay a penalty to the government.
The Denver Public Schools medical plans meet all of the Healthcare Reform Law requirements to satisfy the
individual mandate. Additionally, DPS contributes a substantial amount toward the cost of your coverage.
You do not have to enroll in a DPS medical plan to fulfill the individual mandate. If you are covered by any of
the following you will meet the individual mandate requirements: Your parent’s or spouse’s employer plan, an
individual policy, a government plan such as Medicare, Medicaid, Child Health Plan Plus (CHP+), TRICARE, or
veterans coverage, student health coverage, state high-risk pool coverage, or coverage for non-U.S. citizens
provided by another country.
Key Terms
Deductible: The amount you must pay for medical expenses before the insurance plan will begin to pay.
Coinsurance: A form of cost-sharing where you and the insurance plan share expenses in a specified ratio after
you meet your deductible (until you reach the out-of-pocket maximum).
Out-of-Pocket Maximum: The maximum amount of money you will pay during the plan year. The out-of-pocket
maximum is the sum of your deductible and coinsurance payments.
Preventive Care
The Kaiser Permanente and Cigna medical plans cover in-network preventive care at 100%. This includes routine
screenings and checkups, as well as counseling to prevent illness, disease, or other health problems.
You won’t have to pay anything—no deductible, copay, or coinsurance—for preventive services when:
• You get them from a doctor or other healthcare provider in the Kaiser or Cigna network.
• The purpose of your visit is to get preventive care.
Due to Healthcare Reform, all of the medical plans offer additional no-cost preventive care for women.
Talk to your primary care physician to find out which screenings, tests, and vaccines are right for you, when you
should get them, and how often. Please be aware that you will be responsible for the cost of any non-preventive
care services you receive during your preventive care exam. Learn more about preventive care at
www.healthcare.gov.
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DPS MEDICAL INSURANCE OPTIONS
Denver Public Schools offers six medical plan options—three Kaiser Permanente plans and three Cigna plans.
Kaiser Permanente Consumer-Driven Health Plans with Health Savings Account (CDHP/HSA)
• Provide in-network benefits only. All services must be provided by a KP network provider (except in the case of a life- or
limb-threatening emergency).
• Two options for deductible and out-of-pocket maximums.
• Preventive medications are covered at no cost to members (no deductible, coinsurance, or copay).
• You must select a primary care physician (PCP) for each covered family member.
• Both CDHP/HSA plans are available to all employees.
• You may be eligible to fund an HSA.
• Locate a network provider at www.kp.org.
Kaiser Permanente DHMO Plan (Only available to employees who are currently enrolled in the Cigna
HMO plan or Kaiser DHMO plan)
• Provides in-network benefits only. All services must be provided by a KP network provider (except in the case of a life- or
limb-threatening emergency).
• You must select a primary care physician (PCP) for each covered family member.
• If you are currently enrolled in this plan or the Cigna Select HMO plan, you can elect or continue enrollment in this plan.
• You are eligible to fund a healthcare Flexible Spending Account (FSA).
• Locate a network provider at www.kp.org.
Cigna Consumer-Driven Health Plans with Health Savings Account (CDHP/HSA)
• Provide in-network benefits only. All services must be provided by a provider in the Cigna OA Plus/Choice Fund network
(except in the case of a life- or limb-threatening emergency).
• Two options for deductible and out-of-pocket maximums.
• Preventive medications are covered at no cost to members (no deductible, coinsurance, or copay).
• Both CDHP/HSA plans are available to all employees.
• You may be eligible to fund an HSA.
• Locate a network provider at www.mycigna.com.
Cigna Select HMO Plan (Only available to employees who are currently enrolled in the Cigna HMO
plan or Kaiser DHMO plan)
• Provides in-network benefits only. All services must be provided by a provider in the Cigna Colorado Select network
(except in the case of a life- or limb-threatening emergency).
• If you are currently enrolled in this plan or the Kaiser DHMO plan, you can elect or continue enrollment in this plan.
• You are eligible to fund a healthcare Flexible Spending Account (FSA).
• Locate a network provider at www.mycigna.com.
The tables on pages 11 and 12 summarize the key features of the medical plans. The coinsurance amounts listed reflect
the amount the member pays. Please refer to the official plan documents for additional information on coverage and
exclusions.
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Consumer-Driven Health Plans
SUMMARY
OF BENEFITS
KAISER PERMANENTE
CIGNA
$3,500/$7,000
CDHP/HSA
$2,000/$4,000
CDHP/HSA
$3,500/$7,000
CDHP/HSA
$2,000/$4,000
CDHP/HSA
IN-NETWORK ONLY
OA PLUS/CHOICE FUND
OA NETWORK ONLY
OA PLUS/CHOICE FUND
OA NETWORK ONLY
IN-NETWORK ONLY
All employees
All employees
All employees
All employees
PLAN YEAR DEDUCTIBLE
(July 1–June 30)
Individual
Family
$3,500
$7,000*
$2,000
$4,000*
$3,500
$7,000*
$2,000
$4,000*
PLAN YEAR OUT-OF-POCKET MAX
(July 1–June 30)
Individual
Family
$6,350
$12,700*
$4,000
$8,000*
$6,350
$12,700*
$4,000
$8,000*
Yes
Yes
Yes
Yes
PHYSICIAN SERVICES
Primary Care Physician
Specialist
Child/Adult Preventive
Deductible, 30%
Deductible, 30%
Covered at 100%
Deductible, 30%
Deductible, 30%
Covered at 100%
Deductible, 30%
Deductible, 30%
Covered at 100%
Deductible, 30%
Deductible, 30%
Covered at 100%
HOSPITAL SERVICES
Inpatient
Outpatient/Ambulatory Surgery
Emergency Room
After Hours Facility
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
DIAGNOSTICS
Diagnostic Lab
Diagnostic X-ray
Therapeutic X-ray
High Tech Services (MRI, CT scans, etc.)
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
THERAPIES (60 visits max per year)
Outpatient Physical, Occup. & Speech
Therapy
Deductible, 30%
Deductible, 30%;
Deductible, 30%
Deductible, 30%
Chiropractic Care
Not covered
Not covered
Deductible, 30%
Deductible, 30%
VISION
Refractive Exam
Deductible, 30%
Deductible, 30%
Not covered
Not covered
Deductible, $20 copay
Deductible, $40 copay
Deductible, $60 copay
Deductible, 20%
Deductible, $20 copay
Deductible, $40 copay
Deductible, $60 copay
Deductible, 20%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 30%
Deductible, 2x retail
copay
Deductible, 2x retail
copay
Deductible, 30%
Deductible, 30%
ELIGIBILITY
DEDUCTIBLE, COINSURANCE, & COPAYS
INCLUDED IN OOP MAX
PRESCRIPTIONS
Generic
Brand
Non-Formulary Brand
Specialty Injectable Drugs
MAIL ORDER (90-DAY SUPPLY)
*If you elect dependent coverage, the individual deductible does not apply. The family deductible must be met, either by one individual or by a combination of family
members, before the plan begins to pay. The same rule applies to the out-of-pocket maximum.
Medical Plan Costs—Per Month
The amount you pay for coverage can be deducted from your paycheck on either a pre-tax or post-tax basis.
KAISER
$3,500/$7,000
CDHP/HSA
KAISER
$2,000/$4,000
CDHP/HSA
CIGNA
$3,500/$7,000
CDHP/HSA
CIGNA
$2,000/$4,000
CDHP/HSA
EMPLOYEE ONLY
$287.53
$329.37
$324.48
$351.52
EMPLOYEE & SPOUSE
$675.70
$774.02
$761.87
$825.35
EMPLOYEE & CHILD(REN)
$506.81
$589.65
$580.09
$633.63
EMPLOYEE & FAMILY
$877.73
$1,014.54
$997.59
$1,085.94
COVERAGE LEVEL
Employees who enroll in a consumer-driven health plan will have a contribution of $62.50 per month made to
their health savings account.
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DHMO and HMO Plans
SUMMARY
OF BENEFITS
ELIGIBILITY
KAISER PERMANENTE
DHMO
IN-NETWORK ONLY
CIGNA
SELECT HMO
COLORADO SELECT NETWORK
ONLY
The Kaiser DHMO and Cigna HMO are only available to
employees who are currently enrolled in either the Kaiser DHMO
or Cigna HMO.
PLAN YEAR DEDUCTIBLE
(July 1–June 30)
Individual
Family
$500
$1,000
$1,500
$3,000
PLAN YEAR OUT-OF-POCKET MAX
(July 1–June 30)
Individual
Family
$3,000
$6,000
$4,500
$9,000
Yes
Yes
PHYSICIAN SERVICES
Primary Care Physician
Specialist
Child/Adult Preventive
$25 copay
$50 copay
Covered at 100%
$25 copay
$50 copay
Covered at 100%
HOSPITAL SERVICES
Inpatient
Outpatient/Ambulatory Surgery
Emergency Room
After Hours Facility
Deductible, 20%
Deductible, 20%
$150 copay
$75 copay
Deductible, 30%
Deductible, 30%
$150 copay
$50 copay
DIAGNOSTICS
Diagnostic Lab
Diagnostic X-Ray
Therapeutic X-Ray
High-Tech Services (MRI, CT scans, etc.)
Covered at 100%
Deductible, 20%
Deductible, 20%
$100 copay
Covered at 100%
Covered at 100%
Deductible, 30%
$100 copay, then ded., 30%
$25 copay
$25 or $50 copay
Chiropractic Care
Not covered
$25 or $50 copay
VISION
Refractive Exam
$25 copay
Not covered
$20 copay $40 copay
$60 copay
20% up to $250 max/script
$15 copay
$40 copay
$80 copay
20% up to $100 max/script
2x retail copay
2.5x retail copay
DEDUCTIBLE, COINSURANCE, & COPAYS INCLUDED IN OOP MAX
THERAPIES (60 visits max per year)
Outpatient Physical, Occup. & Speech
Therapy
PRESCRIPTIONS
Generic
Brand
Non-Formulary Brand
Specialty Injectable Drugs
MAIL ORDER (90-DAY SUPPLY)
Medical Plan Costs—Per Month
The amount you pay for coverage can be deducted from your paycheck on either a pre-tax or post-tax basis.
COVERAGE LEVEL
KAISER DHMO
CIGNA HMO
EMPLOYEE ONLY
$391.88
$675.80
EMPLOYEE & SPOUSE
$891.69
$1,487.91
EMPLOYEE & CHILD(REN)
$692.88
$1,203.95
$1,169.98
$1,979.14
EMPLOYEE & FAMILY
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WHAT IS A CONSUMER-DRIVEN HEALTH PLAN?
Consumer Driven Health Plans (CDHPs) offer lower premiums in exchange for increased accountability for health,
wellness, and consumption of health services. A consumer-driven health plan begins to pay for services after
you have met your annual deductible. After you meet your deductible, you pay coinsurance. This means that you
will be billed a certain percentage of each visit or procedure until you meet your out-of-pocket maximum. Once
you meet your out-of-pocket maximum, expenses are paid 100% by the plan. There are no copays with this plan
(except for prescription drugs after you meet your deductible for the Kaiser plans). If you enroll in a CDHP/HSA
plan, you may be eligible to open and fund a Health Savings Account (HSA).
Dependent Coverage: If you elect dependent coverage, the individual deductible and out-of-pocket maximum do
not apply. The family deductible must be met, either by one individual or by a combination of family members,
before the plan begins to pay. Once the family out-of-pocket maximum is met, expenses are paid 100% by the plan
for the entire family.
Preventive Care: The deductible does not apply to preventive care. All of the medical plans cover preventive care
with no member cost-sharing (no deductible, coinsurance, or copay).
Prescription Drugs: You must meet your annual deductible before the plan will begin to pay benefits towards
prescription drugs. Talk with your doctor about generic alternatives, which will help you reduce your out-of-pocket
costs. Plans pay 100% of the costs of certain preventive prescriptions. Please contact Cigna or Kaiser directly or
refer to the inserts in your packet for information on eligible medications.
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DPS INTEREST-FREE LOAN PROGRAM
Employees of Denver Public Schools that prove that they have financial hardship associated with a medical claim
are eligible, upon approval, for a one-time, lump sum HSA advance to be paid on the next available end-of-month
paycheck. The HSA advance must be paid back within the fiscal year (ending July 1) unless otherwise approved by
the Payroll Department. Employee payments will be spread out between 2 and 12 months, depending on months
remaining in the fiscal year.
Eligibility:
• Employee must be enrolled in a consumer-driven health plan with HSA within Denver Public Schools.
• The claim can be for an active benefited DPS employee or for a dependent of a DPS employee, if covered on
family coverage.
Amount of Advance:
• Amount of the advance will not exceed $2,000 for employee only or $4,000 for family coverage.
• In the case of a termination, the district will deduct remaining balance from final paycheck. If final paycheck
doesn’t cover the full amount of the balance, the district will work with a collections agency to recuperate the
funds.
Proof of Hardship:
Employee must provide the following prior to meeting eligibility for the advance.
• If enrolled in a Kaiser plan, the employee must show proof that he or she has worked with a Kaiser Financial
Counselor to negotiate a payment plan to make the payback more budget friendly (http://static.dpsk12.org/
gems/hr2009/FinancialCounselorFlyer.pdf). If enrolled in a Cigna plan, the employee must show proof that
he or she has worked with the hospital and doctors to negotiate a payment plan to make the payback more
budget friendly.
• Filed claims with Aflac, if enrolled, and factored in the benefit amount as payment towards the claim cost.
• Reviewed HSA current and projected annual contribution and calculate expense gap. The employee may
find adjusting his or her monthly contribution may be all that is necessary. (Remember there is an annual
contribution maximum.)
• Proved that the negotiated payments are a financial hardship to the employee or family through a devised
worksheet that starts with the household monthly income and lists most common household expenses found
on a budget, (mortgage/rent, food, heating/cooling, etc.) total the net, and add a line for negotiated claim
payment amount.
How to Apply:
1.
2.
3.
4.
Complete the Medical Advance Application Form.
Attach list of most common household expenses.
Attach proof of unsuccessful negotiated payment plan with provider.
The Benefits Department will contact you regarding approval of the advance.
Questions?
For more information regarding the HSA advance, please contact Sam_Lombardo@dpsk12.org.
14
HEALTH SAVINGS ACCOUNT (HSA)
An HSA is an individually-owned, personal health care savings account that
you can use to pay out-of-pocket health care expenses with pre-tax dollars.
Your contributions are tax-free, and the money remains in the account for you
to spend on eligible expenses no matter where you work or how long it stays in
the account.
2015 IRS CONTRIBUTION
MAXIMUMS
COVERAGE LEVEL
Employee only
$3,350
All other tiers
$6,650
DPS will help you start saving by contributing $62.50 per month to your
HSA. Contributions, including the DPS contribution, cannot exceed the annual IRS contribution maximums.
Employees who are at least 55 by December 31, 2015, may contribute additional funds to their HSA (up to
$1,000 in 2015).
Note: HSA contributions are PERA-includible, You and DPS make PERA contributions on your HSA
contributions.
If you fail to enroll in an HSA account, you will forfeit the $62.50 monthly DPS contribution.
HSA Eligibility
• You are eligible to open and fund an HSA if you meet all of the criteria below:
• You are enrolled in a CDHP/HSA plan.
• You are not covered by another health plan (unless it is an HSA-qualified plan), healthcare FSA (including a
spouse’s healthcare FSA), or health reimbursement arrangement.
• You are not eligible to be claimed as a dependent on someone else’s tax return.
• You are not enrolled in Medicare or TRICARE for Life.
• You have not received Veterans Administration Benefits in the last three months.
Use Your HSA to Pay for Qualified Medical Expenses
• Once you’ve opened your HSA, you can use HSA dollars to pay for eligible expenses now or in the future.
• Funds in your HSA can be used for your expenses and those of your spouse and eligible dependents, even if
they are not covered by the Kaiser or Cigna CDHP/HSA.
• Eligible expenses include deductibles, doctor’s office visits, dental expenses, eye exams, prescription
expenses, and LASIK eye surgery.
• A complete list of eligible expenses can be found on the WageWorks website.
Accessing Your HSA Funds
Three easy ways to access your HSA money:
• WageWorks debit card—DPS has contracted with WageWorks to administer our employee HSA accounts. You
may use your WageWorks debit card to draw directly from your HSA, and it can be used to pay for eligible
expenses at your doctor’s office, pharmacy, or other locations where you purchase health-related items or
services.
• Pay online—You can pay many of your eligible healthcare expenses directly from your HSA, with no need to fill
out paper forms. Log in to your account at www.wageworks.com and click “Submit Receipt or Claim.”
• Pay Me feature—Pay yourself back for eligible expenses that you’ve paid out of your pocket. You can elect to be
reimbursed via check or, the funds can be directly deposited into your checking or savings account.
15
HEALTH SAVINGS ACCOUNT, continued
Your HSA is an Individually Owned Account
• You own and administer your HSA.
• You determine how much you will contribute to your account and when to use the money to pay for eligible
health care expenses.
• You can change your contribution during the plan year without a qualifying event (allowed one time per month).
• Like a bank account, you must maintain a balance in order to pay for eligible healthcare expenses.
• Keep all receipts for tax documentation.
• An HSA allows you to save and “roll over” money from year to year.
• The money in the account is always yours, even if you change health plans or jobs.
• There are no vesting requirements or forfeiture provisions.
Maximize Your Tax Savings
• Contributions to an HSA are tax-free and will be made through payroll deduction on a pre-tax basis if you open
your account through WageWorks.
• The money in your HSA (including interest and investment earnings) grows tax-free.
• As long as you use the funds to pay for qualified health expenses, the money is spent tax- free.
Instructions for Opening an HSA
By enrolling in an HSA plan during your benefits enrollment, you are automatically opening an HSA. On occasion,
you may receive an email from the HSA Bank to verify some of your personal information before your account can
be activated. Soon after enrollment, you will receive a debit card in the mail from WageWorks.
HSA Savings Over Time
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HEALTHCARE FLEXIBLE SPENDING ACCOUNTS
Denver Public Schools offers three FSA options—the healthcare FSA, the limited purpose healthcare FSA, and the
dependent care FSA (discussed later in this guide), which allow you to pay for eligible healthcare and dependent
care expenses with pre-tax dollars. The FSAs are administered by WageWorks.
Healthcare FSA (not allowed if you fund an HSA)
The healthcare FSA allows you to set aside money from your paycheck on a pre-tax basis (before income taxes
are withheld) to pay for eligible out-of-pocket expenses, such as deductibles, copays, and other health-related
expenses, that are not paid by the medical, dental or vision plans. Over-the-counter (OTC) medications are not
eligible for reimbursement without a prescription.
The healthcare FSA maximum contribution is $2,550 for the 2015 plan year (July 1, 2015–June 30, 2016).
Limited Purpose Healthcare FSA (if you fund an HSA)
If you fund an HSA, you are not eligible to fund a healthcare FSA. However, you can fund a limited purpose
healthcare FSA. A limited purpose healthcare FSA can only be used to reimburse dental and vision expenses.
Funding a limited purpose FSA may be a good idea if you anticipate significant out-of-pocket dental and vision
expenses in the coming year.
The limited purpose healthcare FSA maximum contribution is $2,550 for the 2015 plan year (July 1, 2015–
June 30, 2016).
How Does a Healthcare FSA Work?
You decide how much to contribute to each FSA on a plan-year basis up to the maximum allowable amounts. Your
annual election will be divided by the number of pay periods and deducted evenly on a pre-tax basis from each
paycheck throughout the year.
You will receive a debit card from WageWorks, which can be used to pay for eligible healthcare expenses at the
point-of-service. If you do not use your debit card, you may submit a claim form and a bill or itemized receipt from
the provider to WageWorks. Keep all receipts in case WageWorks requires you to verify the eligibility of a purchase.
Things to consider before contributing to an FSA:
• Be sure to fund the account wisely. Due to the favorable tax treatment of FSAs, the IRS requires that you forfeit
any money left in your account if you do not spend it by the end of the plan year.
• You cannot take income tax deductions for expenses you pay with your healthcare FSA and/or dependent care
FSA.
• You cannot stop or change contributions to your FSA during the year unless you have a qualifying life event
consistent with your change in contributions. Also, you must re-enroll at open enrollment to continue your
contributions.
• During the years that your salary is included in your Highest Average Salary calculation, you may want to
consider stopping participation in the FSA accounts. (See page 6 of this guide for details.)
WageWorks Online Tools and Resource
Log in to your account at www.wageworks.com to:
• View your account balance(s)
• Calculate tax savings
• View eligible expenses
• Download forms
• View transaction history
• And more
17
AFLAC VOLUNTARY BENEFIT PLANS
Aflac is insurance that helps you protect what you already have by paying cash benefits directly to you. Denver
Public Schools offers the following voluntary benefit plans through Aflac: critical illness, hospital indemnity, and
accident.
To enroll in these benefits, you must make your elections during open enrollment.
For assistance, call Marsha Bickler at 720-291-6456.
Critical Illness Insurance
• Pays a lump sum benefit for a covered illness including: cancer, heart attack, stroke, major organ transplant,
and end-stage renal failure.
• Pays a benefit for a recurrence of the same critical illness if separated by at least 12 months or an additional
occurrence of a difference critical illness if separated by at least 6 months, with no lifetime maximum. Certain
limitations apply.
If you purchase coverage when newly eligible, you can elect up to the guarantee issue amounts: $30,000 for
employee; $15,000 for spouse.
Hospital Indemnity Insurance
Pays cash benefits to help with the following:
• Hospital admission
• Hospital confinement
• Intensive care unit
• Ambulance transportation
• Surgery and anesthesia
• Everyday living expenses (rent, mortgage, utility bills, groceries, etc.)
Accident Insurance
Provides cash benefits throughout the different stages of care, such as the following:
• Emergency treatment
• Hospital admission
• Intensive care unit
• Ambulance transportation
• Travel expenses to distant treatment centers
• Everyday living expenses (rent, mortgage, utility bills, groceries, etc.)
18
DENTAL INSURANCE
Denver Public Schools offers two dental insurance plan options through Delta Dental of Colorado. Locate a Delta
Dental network provider at www.deltadentalco.com.
Delta Dental EPO
• Provides in-network benefits only. All services must be provided by a Delta Dental PPO network dentist.
• You pay copays for covered services.
• There is no deductible or annual benefit maximum with this plan.
Delta Dental PPO + Premier
• Provides in- and out-of-network benefits, allowing you the freedom to choose any dentist.
• The amount you pay varies based on whether you see a Delta Dental PPO, Delta Dental Premier, or nonparticipating dentist.
»» If you see a Delta Dental PPO dentist, you will pay less out of your pocket.
»» If you see a Delta Dental Premier dentist, you will be responsible for the difference between the PPO dentist’s allowable fee and the fee from the Premier dentist.
»» If you see a non-participating dentist, you will be responsible for the difference between the PPO dentist’s
allowable fee and the full charges you are billed.
The table below summarizes the key features of the dental plans. The coinsurance amounts listed reflect the
amount the member pays. Please refer to the official plan documents for additional information on coverage and
exclusions.
SUMMARY OF
COVERED BENEFITS
DELTA DENTAL EPO PLAN
DELTA DENTAL PPO PLUS PREMIER PLAN
PPO NETWORK ONLY
PPO PROVIDER
PREMIER
PROVIDER
OUT-OF-NETWORK
$0/$0
CALENDAR YEAR DEDUCTIBLE
Individual/Family
$50/$150
$50/$150
$50/$150
PREVENTIVE CARE
Various Covered Amounts
(1)
Covered at 100%
Covered at 100%
Covered at 100%
BASIC SERVICES
Various Covered Amounts
(1)
Deductible, 20%
Deductible, 20%
Deductible, 20%
MAJOR SERVICES
Various Covered Amounts
(1)
Deductible, 50%
Deductible, 50%
Deductible, 50%
Not covered
Deductible, 50%
Deductible, 50%
Deductible, 50%
Unlimited
$1,500
$1,500
$1,500
Various Covered Amounts(1)
50%
$1,000
50%
$1,000
50%
$1,000
DENTAL IMPLANTS
CALENDAR YEAR MAXIMUM
BENEFIT
(per covered individual)
ORTHODONTIA (no age limit)
ORTHODONTIA LIFETIME MAX
(1)
Refer to Delta Dental plan documents for maximum amounts covered.
Dental Plan Costs—Per Month
The amount you pay for coverage can be deducted from your paycheck on either a pre-tax or post-tax basis.
DELTA DENTAL EPO
DELTA DENTAL PPO +
PREMIER
EMPLOYEE ONLY
$28.86
$35.97
EMPLOYEE & SPOUSE
$58.23
$69.06
EMPLOYEE & CHILD(REN)
$71.32
$97.90
EMPLOYEE & FAMILY
$100.67
$131.06
COVERAGE LEVEL
19
VISION INSURANCE
Denver Public Schools offers a vision insurance plan through VSP. You have the freedom to choose any vision
provider. However, you will maximize the plan benefits when you choose a VSP network provider. If you choose an
out-of-network provider, you may be responsible for paying in full at the time of service and submitting a claim to
VSP for reimbursement. Locate a VSP network provider at www.vsp.com (Choice Network).
The table below summarizes the key features of the vision plan. Please refer to the official plan documents for
additional information on coverage and exclusions.
VSP PLAN
SUMMARY OF BENEFITS
IN-NETWORK
(CHOICE NETWORK)
OUT-OF-NETWORK
Covered in full
$60 copay
Up to $45 reimbursement
Not covered
EYE EXAM
CONTACT LENS EXAM
Frequency
Every 12 months
LENSES
Single
Bifocal
Trifocal
Frequency
FRAMES
Frequency
Covered in full
Covered in full
Covered in full
Up to $30 reimbursement
Up to $50 reimbursement
Up to $65 reimbursement
Every 12 months
$120 allowance; 20% discount on remaining
balance
Every 12 months
Up to $70 reimbursement
CONTACT LENSES—ELECTIVE
(in lieu of glasses)
$120 allowance
Up to $105 reimbursement
LASER CORRECTION
15-20% discount
Not covered
Vision Plan Costs—Per Month
The amount you pay for coverage can be deducted from your paycheck on either a pre-tax or post-tax basis.
COVERAGE LEVEL
EMPLOYEE ONLY
EMPLOYEE & SPOUSE
VSP VISION
$7.77
$17.30
EMPLOYEE & CHILD(REN)
$17.85
EMPLOYEE & FAMILY
$25.62
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LONG-TERM DISABILITY INSURANCE
Denver Public Schools provides long-term disability insurance to eligible employees automatically and at no cost.
Disability insurance is designed to help you meet your financial needs if you become unable to work due to an
illness or injury.
Benefit: 60% of monthly earnings up to $5,000 per month
Elimination period: 90 days
DPS SUPPLEMENTAL BENEFITS PROGRAM
The Assistance Fund lends non-personal, durable medical equipment to any employee of DPS for as long as you
need it, FREE of charge. The Payroll Protection Plan provides an extra $50 a day if you are sick or injured. Vested
members can receive up to $5,000 in a year. The cost for this benefit is just $10 a month. Get all your questions
about this unique organization answered by visiting the website http://dpssbp.org or contacting office manager,
Teresa DeRose, at teresa@dpssbp.org.
SICK LEAVE BANK
Employees working in a position that accrues sick leave may be eligible to become members of the Sick Leave
Bank.
All eligible employees may enroll in the Sick Leave Bank (SLB) within 60 days of their date of hire or during the
annual Sick Leave Bank open enrollment period, Sept. 1–30. As a condition of enrollment, the personal sick
leave contribution will be deducted from an employee’s accruement the first of the month following 60 days of
employment. Every November, current members will have one personal accumulated sick leave day automatically
deducted to continue membership. If the employee does not have enough day(s) to donate, he or she will not
be eligible to enroll or continue membership and must enroll during the following year’s open enrollment period
(employees on medical leave or just returned from medical leave are excluded).
The SLB provides eligible employees who are on an extended personal illness leave and have exhausted all their
accumulated paid leave the means of obtaining additional sick leave days (upon proper approval) in order to avoid
going on unpaid leave. The SLB allows employees time to recover from their own personal illness so that they may
return to work. The intent of the SLB is not to provide additional days off for elective surgery, baby bonding, to care
for family members, in lieu of a health leave or prior to retirement or resignation. For more information view the
Sick Leave Bank website at http://hr.dpsk12.org/benefits.
21
EMPLOYEE ASSISTANCE PROGRAM (EAP) AND
WORK-LIFE SERVICES
The EAP and Work-Life Services program is a confidential referral and counseling service available to help you
balance the challenges of home, work, and contemporary life. Your GuidanceResources benefits will give you and
your dependents confidential support, resources and information for personal and work-life issues. This benefit is
provided at no cost to you.
Your GuidanceResources services include:
• Employee Assistance Program (EAP) for confidential counseling (including up to five face-to-face sessions per
issue per calendar year)
• Work-life solutions
• Legal support
• Financial information
• GuidanceResources® online
GuidanceResources is available to you 24 hours a day, seven days a week. There are two ways to access your
GuidanceResources benefits:
1. Call 855-327-1377 to speak to a counseling professional who will listen to your concerns and can guide you to
the appropriate services you require.
2. Visit GuidanceResources online at www.guidanceresources.com and enter your Organization Web ID, which is
DPS.
Remember, your GuidanceResources benefits are strictly confidential. To view the ComPsych HIPAA privacy notice,
please go to www.guidanceresources.com/privacy.
22
PLANNING FOR YOUR RETIREMENT
Reaching your retirement objective requires careful planning to build your retirement financial resources. Careful
planning is essential to a successful retirement. Once you have built your financial reserves and researched how
to prepare for retirement, you will reach a point in which you want to retire and need to know all of the steps. Visit
the Retirement section of the Human Resources website to learn how to save for retirement, how to prepare for
retirement through PERA, how to retire, and how to work for DPS after retirement.
Colorado PERA Retirement (Pension)
The following is quoted from the Colorado Public Employees’ Retirement Association (PERA) “Your PERA Benefits”
booklet. Please review the booklet for complete details surrounding your PERA pension plan. PERA provides
retirement and other benefits to employees of the State of Colorado; all school districts; the judicial system; and
numerous municipalities, special districts, and other local government entities. For funding purposes, members
and employers are divided into five divisions—State, School (other than DPS), Local Government, Judicial, and
Denver Public Schools (DPS).
On January 1, 2010, the Denver Public Schools Retirement System (DPSRS) merged with Colorado PERA and as of
Jan. 1, 2010, DPSRS ceased to exist. If you had an account at DPSRS, your account is now a PERA account under
the DPS benefit structure. Therefore, you may have two member contribution accounts with Colorado PERA—one
under the PERA benefit structure and one under the DPS benefit structure. Many of the benefits are not the same
for both benefit structures; differences are noted. General benefit information about both structures is included in
the “Your PERA Benefits” booklet.
For most members, PERA serves as a substitute for Social Security. PERA provides benefits to you when you retire
or are disabled, or to your survivors upon your death. In addition, PERA members may take advantage of voluntary
programs offered by PERA such as life insurance, a 401(k) plan, a 457 plan, and long-term care insurance. To
review your current PERA balance, and view different personal retirement outcomes, use the retirement calculator
on the PERA website. Access the PERA calculator by going to:
Go to www.copera.org
1. Click on “Account Access”
2. Enter SSN and PIN
3. Click “Continue”
4. Click on “Online Services”
5. Select “Financial Planning”
6. Click on the calculator that best fits what you are trying to model
To order your PIN, contact the PERA Customer Service number at 800-759-7372 or complete the PIN Request
Form on the PERA website.
Voluntary Tax Sheltered Retirement Options
The IRS allows full- and part-time employees of DPS to save for retirement and reduce their current income taxes.
Employees may defer a portion of their salary on a pre-tax basis by opening an account with one of DPS’ approved
403(b) vendors, the PERA 401(k) program, and/or the DPS 457(b) plan. DPS will deduct the amount authorized by
the employee and send it to the tax-deferred provider.
In 2015, employees can contribute up to the IRS maximum of $18,000. Employees who are over age 50 or who
will turn 50 in the 2015 calendar year can contribute an additional $6,000 to the plan. It is the responsibility of
the employee to ensure that if enrolled in both the 403(b) and the 401(k) plans, the total annual contribution to
these accounts does not exceed the IRS maximum. Employees are eligible to enroll in a 403(b) or the 401(k) and
the 457(b) plan to save twice the amount of the IRS limit.
23
For more information please go to http://hr.dpsk12.org/benefits-compensation/retirement-plans/.
It is very important that you read all the materials regarding tax sheltered options before choosing to participate.
Consult a tax or financial advisor for further information and advice about your personal financial situation.
Contributions into these plans do not reduce the calculation of PERA salary or the Highest Average Salary (HAS).
To enroll in, change or stop deductions for a DPS sponsored 403(b) or 457(b) tax sheltered annuity, go to
www.myretirementmanager.com. If you have any questions, you can contact the Retirement Manager support line
at 866 294-7950.
DPS 403(b) Plan
DPS offers employees a choice of qualified companies that provide tax sheltered annuity (TSA) products. To
find information about DPS sponsored 403(b) plans go to http://hr.dpsk12.org/wp-content/uploads/2015/07/
TSAInformationforDPSEmployees.pdf. Once you are ready to enroll go to the Retirement Manager web site at
www.myretirementmanager.com.
DPS 457(b) Plan
One of the main differences between the 403(b)/401(k) and the 457(b) is that the 457(b) does not have an early
withdrawal penalty of 10% if an employee takes a distribution before age 59. Distributions are subject to ordinary
income tax.
Refer to Empower Enrollment to find out more about the Empower 457(b) program. Use the DPS Empower
Educator’s Money group number 350218-01 to sign in as a guest. For assistance or if you have specific questions,
please call Todd Dunning, Senior Account Executive, for Empower, at 720-231-1513 or email
todd.dunning@empower-retirement.com. Enrollment is done on line through Retirement Manager at
www.myretirementmanager.com.
Please go to http://hr.dpsk12.org/wp-content/uploads/2015/07/TSAInformationforDPSEmployees.pdf for
additional information.
Colorado PERA 401(k) Plan
Colorado PERA's 401(k) plan offers you the opportunity to plan for a secure financial future. PERA's 401(k) plan
offers tax benefits by allowing participants to automatically save a portion of their salary before taxes and invest it
in a choice of 15 core investment funds or six asset allocation funds.
Please go to http://hr.dpsk12.org/benefits-compensation/retirement-plans/ for more information on this plan and
an enrollment kit.
Please note that this is NOT tied to the Colorado PERA pension plan, but is an additional way for you to defer a
portion of your salary toward your retirement savings. Email the completed PERA 401(k) Contribution Authorization
form to connect_humanresources@dpsk12.org or fax it to Employee Services at 720-423-2505 (not payroll, ING,
or PERA). The PERA 401(k) Beneficiary Designation Form should be sent to the ING address on the form.
24
DEPENDENT CARE FSA
The dependent care FSA allows you to set aside money from your paycheck on a pre-tax basis for day care
expenses to allow you and your spouse to work or attend school full-time. Eligible dependents are children under
13 years of age, or a child over 13, spouse, or elderly parent residing in your house who is physically or mentally
unable to care for him or herself. Examples of eligible expenses are day care facility fees, before- and after-school
care, and in-home babysitting fees (income must be reported by your care provider).
You may contribute up to $5,000 to the dependent care FSA for the 2015 plan year if you are married and file a
joint return or if you file a single or head of household return. If you are married and file separate returns, you can
each elect $2,500 for the 2015 plan year.
COMMUTER BENEFITS
DPS offers two tax-free programs as part of a Commuter Benefit administered by WageWorks:
• Pre-Tax Parking
• Pre-Tax Transit
Under the Pre-Tax Parking program, eligible employees can set aside tax-free dollars (up to $250/month) to
pay for parking expenses that are incurred in connection with commuting to work. The Pre-Tax Transit account
allows employees to pay for mass transit expenses with pre-tax dollars (up to $130/month). The Commuter
Benefits program is governed by Section 132(f) of the Internal Revenue Code. Parking expenses cannot be paid or
reimbursed from the transit account and vice versa. Similar to Flexible Spending Accounts, your take-home pay is
increased when you use a Commuter Benefit account because amounts deposited in the account are not subject
to FICA or federal tax withholdings and qualified reimbursements are not taxed (this provides a savings between
15% and 40% depending on your individual tax bracket).
Pre-Tax Transit Account
If you enroll in this type of account, you may be able to receive reimbursement for the following expenses: Any
pass, token, fare card, voucher or similar item that entitles the employee to transportation to and from work in a
“commuter highway vehicle”(or transportation at a reduced price), provided that such transportation is on mass
transit facilities such as a bus, train, ferry, etc., or provided by an entity in the business of transporting persons
if such transportation is provided in the type of highway vehicle eligible for use in van-pooling. A highway vehicle
is defined as having a seating capacity of 6 or more adults, not including the driver, and for which at least 80%
of the mileage can reasonably be expected to be for purposes of transportation of employees between work and
residences, and on trips where the number of employees carried is at least one-half of the adult seating capacity
of such vehicle (not including the driver).
Pre-Tax Parking Account
This benefit may be used to pay for parking provided to an employee at or near the business premises of the
employer. It can also pay for parking provided at or near a location from which the employee commutes to work by
van-pooling, in a commuter highway vehicle, or by carpool. It does not include residential parking.
The amount of the fringe benefits which are provided to an employee and which may be excluded from
gross income under subsection (a)(5) shall not exceed $250 per month for Parking or $130 per month for
Transportation. The maximum amount that can be reimbursed to a participant and/or charged on the debit card
cannot exceed $250 per month for Parking or $130 per month for Transportation. Employees can receive multimonth reimbursements provided the reimbursement for each month in the period is calculated separately and
doesn’t exceed $250 for Parking or $130 per month for Transportation.
25
Reimbursement of Expenses
Transit Options
• Buy My Pass — Home delivery of your monthly transit or vanpool agency pass.
• Smartcards — Contributions loaded directly onto Transit Agency SmartCards where available.
• WageWorks Commuter Card — Works at most points of purchase that accept credit and debit cards.
Parking Options
• Pay My Parking — Direct payment to your parking garage made from your account.
• Pay Me Back — Pay to park and then get reimbursed via check or direct deposit.
• WageWorks Parking Card — Works at most points of purchase that accept credit and debit cards.
REQUESTS FOR TRANSPORTATION REIMBURSEMENTS MUST BE SUBMITTED WITHIN 180 DAYS OF THE DATE THE
EXPENSE WAS INCURRED.
Changes in Election
Unlike other pre-tax benefit plan elections, an employee is able to change his or her transportation benefit election
without restriction, but the change will apply prospectively (i.e., you can change or add a type of transportation
benefit, change the election amount, or cease participation).
Use-it-or-Lose-It
The plan permits employees who remain employed by DPS to carry over unused amounts to subsequent months
for an indefinite period, provided the amounts are used solely for qualified transportation fringe benefits as
described above. Employees who terminate employment will forfeit any unused amounts; however, any qualified
transportation expenses incurred prior to the employee’s date of termination are eligible expenses and can be
reimbursed if submitted in a timely manner. COBRA does not apply to this benefit.
How to Enroll
To enroll in Commuter Benefits, please visit WageWorks www.wageworks.com. For detailed questions regarding
reimbursements, or to verify your account balance or check on the status of a reimbursement, please contact
WageWorks.
26
LIFE AND AD&D INSURANCE
Life and accidental death and dismemberment (AD&D) insurance is an important element of your income protection
planning, especially for those who depend on you for financial security. For your peace of mind, Denver Public Schools
provides basic life and AD&D insurance to all benefits-eligible employees at no cost. You have the option to purchase
supplemental life and AD&D insurance. Please be sure to keep your beneficiary designation(s) up to date.
Basic Life and AD&D Insurance
Denver Public Schools automatically provides basic life and AD&D insurance to all benefits-eligible employees at no cost
through MetLife. Should you die as a result of an accident, your beneficiary would receive both the life benefit and the
AD&D benefit.
Active full-time employee life benefit: Two times annual earnings up to a maximum of $300,000
Active full-time employee AD&D benefit: Two times annual earnings up to a maximum of $300,000
Benefit-eligible part-time (hourly) employee life benefit: $2,500
Benefits reduce at age 65. The amount you are eligible for at retirement can be converted to an individual plan through
MetLife. Please refer to the official plan documents for details.
Supplemental Life and AD&D Insurance
Denver Public Schools offers you the option to purchase supplemental life and AD&D insurance for yourself, your
spouse, and your dependent children through MetLife. You must purchase voluntary coverage for yourself in order to
purchase coverage for your spouse and/or dependents.
If you elect coverage when first eligible, you may purchase up to the guarantee issue amount(s) without completing
a statement of health (evidence of insurability). If you do not enroll when first eligible, and choose to enroll during a
subsequent annual open enrollment period, you will be required to submit evidence of insurability for any amount of
coverage. Coverage will not take effect until approved by the MetLife.
To be eligible to enroll in the guaranteed issue amount, you must enroll within the first 30 days of eligibility. If you
missed your initial enrollment period, MetLife is offering a special enrollment period this year to coincide with Open
Enrollment. During this enrollment period, you can enroll using a simplified application with just five medical questions.
Coverage options are from $10,000 to $500,000 in $10,000 increments. For more information, watch for the
enrollment packet being mailed directly to your home.
Employee: $10,000 increments up to $500,000 (minimum election: $20,000); guarantee issue: $100,000
Spouse: $10,000 increments up to $100,000; guarantee issue: $20,000
Dependent children: 15 days to 6 months: $100; 6 months to age 19 (or 23 if full-time student): $2,000 or $5,000
Will Preparation Service
Employees enrolled in MetLife supplemental life insurance can access the Will Preparation Service at no additional
cost. Call the Hyatt Legal Plans toll-free number (800-821-6400) and a Client Service Representative will assist you in
locating a participating plan attorney in your area. You may then call and make an appointment with your participating
attorney. That’s it! Many plan attorneys even offer evening and weekend appointments for your convenience.
Colorado PERA Optional Life Insurance
PERA offers an optional group decreasing term life insurance plan administered by Unum called Plan 1. Coverage with
Plan 1 is based on age and allows the member to purchase units of coverage to meet their life insurance needs. In
addition, the plan provides accidental death and dismemberment (AD&D) benefits, life insurance coverage for spouses
and eligible children, and an accelerated benefit option. Unum provides free survivor financial counseling to members,
inactive members, and their survivors. The cost for employees is $7.75 per unit.
For additional information, please visit the PERA website at www.copera.org.
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LONG-TERM CARE INSURANCE
Without proper planning, long-term care may be the greatest threat to your personal assets. Denver Public Schools
is pleased to offer a solution—long-term care (LTC) insurance through Unum (Policy #534675). Employees,
family members, and retirees can apply. LTC insurance can help secure your future and the futures of those you
love, and it may be one of the most economical ways to manage life’s risks. Please review the Unum Booklet for
more information. To complete an application, please visit the Unum website at http://w3.unum.com/enroll/
denverpublicschools. Employee premium payments are made through payroll deductions on a post-tax basis.
AUTO AND HOME INSURANCE
DPS offers employees the opportunity to purchase auto and home insurance at a group rate. Call the MetLife
Benefits Line at 800-438-6388, Monday through Saturday, for quotes, to apply for coverage, and for general
customer service. To find out more about the program and get instant auto insurance quotes online, log on to
www.metlife.com/mybenefits. For auto quotes, please have the following information available: Social Security
Number, Vehicle Identification Number (VIN), and the driver’s license number of each member of your household.
PET INSURANCE
Employees receive a group discount off of pet insurance plans through MetLife. A policy covers thousands of
medical problems and conditions related to accidents or illnesses (even cancer) for dogs, cats, birds, ferrets,
rabbits, reptiles, and other exotic pets. You have the freedom to visit any licensed veterinarian anywhere, even
when you’re away from home. For more information or to enroll, call 800-438-6388.
EMPLOYEE DISCOUNT PROGRAM
This program is designed exclusively for you—our employees. You can take advantage of special pricing on popular,
innovative products and services. For more information, go to http://www2.beneplace.com/dpsk12.
WESTERRA CREDIT UNION
Westerra is a local, members-owned financial institution that has earned a reputation as a trusted resource
and a valued partner. Members know they can count on their credit union as a safe place to save and borrow.
Westerra offers competitive rates, a full range of quality products, solid expertise, and top-notch service. For more
information about this offer and Westerra, please visit www.westerracu.com or call 303-321-4209.
DENVER EDUCATIONAL SENIOR CITIZENS, INC.
(DESCI)
The DESCI housing rental subsidy provides financial assistance to low income persons 55 years of age and older
who are DPS retirees, current and former employees, and members of their immediate families. To be considered
for a subsidy, please contact DESCI, c/o The Denver Foundation, 55 Madison St., 8th Floor, Denver, CO 80206 or
phone: The Denver Foundation: 303-300-1790 x126.
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THE YOU REVOLUTION, DENVER PUBLIC
SCHOOLS EMPLOYEE WELLNESS PROGRAM
We encourage our team members to make health a habit—both for the benefit of having more energy to do the
things you love to outside of work, while helping you be better prepared to serve our teammates throughout Team
DPS and ultimately, our students!
Our employee wellness program, the you revolution, offers a host of free information, resources and programs to
help you reach your health and wellness goals. Visit the Employee Wellness Program site for the latest information
on upcoming events, gym discounts, wellness competitions, and register for our comprehensive wellness portal.
To learn more, visit http://hr.dpsk12.org/benefits-compensation/employee-wellness-program.
READY TO ENROLL?
How to Enroll
Benefits enrollment can be completed online through Employee Space. Just follow these instructions to enroll.
This year you will have to enroll from a DPS computer. You will not be able to enroll from home
unless you have a VPN connection.
STEPS to SETUP COMPATIBILITY MODE
1. Safari is not a supported browser. If you are
using Chrome or Firefox, skip to "Begin Open
Enrollment" on the next page.
2. Open Internet Explorer. If you don't see the
Menu bar at the top left, right click on the
upper portion of the IE screen and make sure
that Menu bar has a check mark.
3. Click on Tools:
4. Click on Compatibility View settings
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4. Click on Compatibility View settings
5. Enter dpsk12.org in Add this website
6. Click on Add. This will add dspk12.org to
Websites you've added to Compatibility
View….
5. Enter dpsk12.org in Add this website
6. Click on Add. This will add dspk12.org to
7. Click on Close
Websites you've added to Compatibility
View….
8. Close Internet Explorer.
7. Click on Close
9. Open Internet Explorer again and proceed
8. with
Closeenrollment
Internet Explorer.
below.
9. Open Internet Explorer again and proceed
with enrollment below.
TO BEGIN OPEN ENROLLEMNT
TO BEGIN OPEN ENROLLEMNT
Open the DPS website at http://www.dpsk12.org/
using Internet Explorer.
1. In the middle of the page click on
Open the
DPS websiteinatthe
http://www.dpsk12.org/
“Employees”
blue banner.
using Internet Explorer.
1. In the middle of the page click on
“Employees” in the blue banner.
2. Near the bottom of the screen on the left
hand side, click on Infor Lawson “Read
More”.
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2. Near the bottom of the screen on the left
hand side, click on Infor Lawson “Read
More”.
3. Click on “Click here to access Pay, benefits,
Leave…….”.
4. Log in with your user name and password
(same login name and password as used on
the first screen).
5. Click on “Benefits” in the banner on the left
and then if you need to include dependents
in your enrollment click on “Dependents”.
6. Verify your dependents. To edit any of your
dependents’ details, click on their name. If
you need to add dependents, click the “Add”
button. You will need your dependents’ date
of birth and social security number to
continue.
If you are not adding or changing any
dependent information, skip to step 9.
7. If adding dependents, enter your dependents
information here. Fill in the required fields,
click Update to save.
8. Repeat Step 6 and 7 for each dependent.
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7. If adding dependents, enter your dependents
information here. Fill in the required fields,
click Update to save.
8. Repeat Step 6 and 7 for each dependent.
9. If you are done verifying or adding
dependents, click on “Benefit Enrollment” in
the banner on the left.
10. The Lawson Benefits Enrollment Welcome
screen will open. Here you will find a quick
overview of requirements. Click “Continue”
to begin your enrollment process. If you exit
at any point during the enrollment, your
elections will not be saved and you will have
to start over.
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11. Lawson will begin by showing you the
different plans available for you to enroll in.
Click “Continue”.
12. If you have a current enrollment Lawson will
display the options you currently have and
their associated cost. Click “Continue”.
13. Make your selection for Medical coverage for
the 2015-2016 plan year.
 If you would like to keep the same plan you
currently have, select that button and click
continue. Skip to step 18.
 If you would like to change your coverage
type, (ex. a change from single to family
coverage), select that button and click
continue. Skip to step 15.
 If you would like to choose a new plan (ex. A
change from waive to the Kaiser 2000
deductible plan) select the third option.
Click “Continue”.
14. If you are selecting a different plan, choose
the plan that’s best for yourself or your
family and select continue. If you choose
either to keep the same coverage or to
change the coverage type, you will not see
this screen.
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15. Choose the level of coverage that meets your
needs. You also have the option to select
whether you would like to pay for your
premiums pre or post tax. Most employees
choose pre-tax, but if you are close to
retirement, you may want to select after-tax.
If you choose to keep the same coverage in
step 13, you will not see this screen.
When you are satisfied with your selections, click
“Continue”.
16. If you choose to include dependents, you will
see eligible depends here. Chose the
dependents you want covered and click
“Continue”.
17. This screen confirms your selection. If it is
correct, select “Continue”.
18. Repeat steps 13 through 17 for Dental and
Vision coverage.
19. If you enrolled in any of our four CDHP plans,
you are eligible to enroll in a HSA. In order to
receive the $62.50 DPS contribution to your
HSA, you have to enroll in the HSA (you can
elect a zero contribution amount).
 If you are not enrolled in a CDHP medical
plan, you are not eligible for an HSA.
Please select the Waive HSA option.
20. Enter either the monthly or the annual
amount you wish to contribute to your HSA.
DPS will contribute $62.50 per month to your
account.
 Employees with an employee only CDHP
can choose to contribute up to $216.67
per month equaling $2600.00 annually.
 Employees with an Employee plus
Spouse, Employee plus Child(ren) or
Family coverage in a CDHP plan can
contribute up to $491.66 per month
equaling $5900.00 annually.
 If you are already 55 years of age or turn
55 on or before December 31, 2015, you
can contribute up to an extra $1000.00
annually. Click “Continue”.
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21. Lawson will confirm your elections. Click
“Continue”.
22. Employees that have enrolled in one of our
two HMO plans can elect to contribute funds
to a HealthCare Flexible Spending Account
(HC FSA). Enter the amount you wish to
contribute either monthly or annually and
choose “Continue”.
 For 2015, the maximum that an
employee can contribute to a HC FSA is
$2550.00.
 Employees enrolled in one of the four
CDHP plans can enroll in a HC FSA, but it
is then considered a limited use FSA and
can only be used for qualified dental or
vision expenses. For 2015, the maximum
contribution to a limited use FSA is also
$2550.00.
23. This screen confirms your selection. If it is
correct, select “Continue”.
24. Employees with dependent care needs can
elect to set aside up to $5,000.00 annually
into a Dependent Care Flexible Spending
Account (DC FSA). Choose your option and
hit “Continue”.
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24. Employees with dependent care needs can
elect to set aside up to $5,000.00 annually
into a Dependent Care Flexible Spending
Account (DC FSA). Choose your option and
hit “Continue”.
25. Enter your elections as either the monthly or
the total annual amount that you wish to put
into a DC FSA. Select “Continue”.
.
26. This screen confirms your selection. If it is
correct, select “Continue”.
27. Review your elections to ensure their
accuracy. If all elections are correct, select
“Continue”. To make changes, select “Make
Changes”.
28. If you wish to make changes to your
selections, click “Make Changes”.
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29. Chose the plans you wish to change and
make any corrections you wish. Click
“Continue”.
30. When you have completed any corrections,
you will again see your elections. Click
“Continue”.
31. Select “Print” to print your confirmation for
your records. If there is an error in our
records, we will need this to make any
corrections after Open Enrollment ends.
Keep in mind; you will remain in these plans until
the annual open enrollment next year unless you
experience a change in status throughout the
year.
32. Press “OK” to print your confirmation.
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33. Click “Continue” to complete the process.
34. Congratulations you are done.
READY TO ENROLL?
ID Cards
Medical ID cards will be mailed to the home address we have on file for you. Please verify that your address is
correct in Employee Space. Many important communications, in addition to your medical ID cards, are mailed to
your home throughout the year.
If you have elected Kaiser and have not received your ID card, contact Kaiser directly or visit their website to
confirm coverage. If they confirm coverage for you, you can request that a new ID card be mailed to you. You can
make appointments and receive services from Kaiser even if you do not have an ID card in hand.
If you have elected Cigna and have not received your ID cards, contact Cigna directly or visit their website to
confirm coverage. You can also print out a temporary card from their website to use until your new card arrives.
Both Delta Dental and VSP do not distribute ID cards. To receive services from a Delta Dental or VSP participating
provider, the provider will only need your Social Security number to verify your enrollment in these plans. The
dental or vision provider will confirm coverage before providing services.
Please visit the contact section of this guide to find phone numbers and websites for Cigna, Kaiser, Delta Dental
and more.
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IMPORTANT CONTACT INFORMATION
PLAN
PHONE NUMBER
WEB SITE/EMAIL
EMPLOYEE SERVICES
720-423-3900
http://hr.dpsk12.org/benefits-compensation/
MEDICAL PLANS—KAISER
303-338-3800
www.kp.org
MEDICAL PLANS—CIGNA
800-244-6224
www.mycigna.com
HEALTH SAVINGS ACCOUNT—WAGEWORKS
877-924-3967
www.wageworks.com
DENTAL PLANS—DELTA DENTAL OF COLORADO
303-741-9305
www.deltadentalco.com
VISION PLAN—VSP
800-877-7195
www.vsp.com
FLEXIBLE SPENDING ACCOUNTS—WAGEWORKS
877-924-3967
www.wageworks.com
LIFE AND AD&D INSURANCE—METLIFE
800-638-6420
www.metlife.com/mybenefits
303-832-9550 or
800-759-7372
www.copera.org
RETIREMENT MANAGER
866-294-7950
www.myretirementmanager.com/?dps
LONG-TERM CARE INSURANCE—UNUM
800-227-4165
—
EMPLOYEE ASSISTANCE PROGRAM (EAP)—
GUIDANCERESOURCES
855-327-1377
www.guidanceresources.com
(Organization Web ID: DPS)
WELLNESS INITIATIVE
720-423-3900
https://dpsk12wellness.motivation.cc/
DPS SUPPLEMENTAL BENEFITS PROGRAM
(CONTACT TERESA DEROSE)
303-377-0222
http://dpssbp.org
AFLAC (CONTACT MARSHA BICKLER)
720-291-6456
marsha_bickler@hotmail.com
AUTO, HOME, AND PET INSURANCE—METLIFE
800-438-6388
—
WESTERRA CREDIT UNION
303-321-4209
www.westerracu.com
COLORADO PERA
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