Benefits

Subject to enrollment and verification of eligibility, the following benefits are available to CU GME residents and fellows through the University of Colorado Denver Graduate Medical Education.

 

CU GME Health Benefits Plan

Welcome to the CU GME Health/Dental Benefits Plan, the health, dental, and prescription drug program available to eligible CU GME residents, fellows, and their dependents.​

CU GME Health Plan Details

Refer to the Plan Document​​​​​ for details of health, prescription and dental insurance coverage. It is the resident's responsibility to know the terms of coverage.​

In-Network Providers & Where to go for Care

Useful Links

CU GME Health Plan Required Notices

Disclaimers

*This plan does not require PCP selection, however, residents are STRONGLY ENCOURAGED to establish care with a PCP. This will improve access to care should you become ill or have an injury, may help avoid an ER visit, etc. Many PCP providers have same day access when immediate care is necessary. Residents should seek medical attention when needed and know how to do so BEFORE an urgent situation arises. 

PRE-CERTIFICATION IS REQUIRED on services specified in the Plan Document. Contact CU Health Plan Medical Management: phone: 303-493-7507; fax: 303-493-7501. If you are unsure of pre-certification requirement, ASK. It is the insured's responsibility to make certain pre-certification is obtained when required. When pre-certification is required and not obtained, all associated charges will be the responsibility of the insured. AVOID PROBLEMS. Pre-cert when required! Please note: pre-certification is NOT A GUARANTEE of payment.  All services are subject to plan provisions.

Final determination of a claim is possible only when the actual claims for services rendered is received and reviewed. Any oral or written statement or representation that alters, modifies, amends or is inconsistent with the written terms of the Plan is invalid and unenforceable.

Residents are not allowed to provide treatment or prescribe medication that is self prescribed, prescribed by one resident for another, prescribed by resident for a family member, or prescribed by resident for a family member of another resident. ​​

Dental Insurance

Residents and their dependents are automatically enrolled in dental insurance when they enroll in the CU GME Health/Dental Plan (unless dental coverage is specifically waived by the resident). There is NO additional premium for dental insurance.

Dental Providers

  • The dental portion of your coverage has no network of providers. You may obtain services from any dentist (or hygienist) licensed to practice in the state where services are rendered.
  • CU GME Health Plan members now have access to the Aetna Dental Administrators Network. You do not have to use these providers, but utilizing a network provider can save you money on covered care and the network providers will file claims for you.​

PLEASE NOTE that while the Aetna Network is available to plan members, your insurance is not through Aetna. Make sure that you always present your CU GME Health/Dental Benefits ID card when accessing services.  ​

Dental Benefit Highlights

Maximums: 

  • Dental maximum per plan year $2,000 per person
  • Orthodontics lifetime maximum $2,000 per person
  • Occlusal Guards lifetime maximum $500 per person

Deductibles:

  • $50 per individual/$100 per family per plan year

Eligible Expenses:

  • 100% of Usual, customary and reasonable (UCR) for eligible preventive services - (deductible does not apply). 
  • 80% of UCR - basic dental services (other x-rays, fillings, root canals).
  • 50% of UCR - major dental services (crowns, inlays).

See complete details of coverage in the CUGME Health Plan Document.

Payment of Dental Services

If your provider is willing to submit your claim to the insurance on your behalf, they may send their statement directly to the Health/Dental Claims Administrator identified on your ID card. Their statement should include the name and Health Insurance ID number of the Plan Member (resident/fellow) and the name of the patient. Payment will be made directly to your provider and you will receive a copy of the payment notice/EOB (Explanation of Benefits). If your provider requires payment at time of service, or they do not bill insurance for their patients or this Plan, they should give you an itemized statement to send to the Claims Administrator. If you pay the provider, please indicate clearly on the statement that reimbursement should be made payable to the plan member.


Optional EyeMed Vision Care

Vision care services such as routine eye examinations, prescription glasses and contact lenses are not covered by the CU GME Health/Dental Benefits Plan. Residents and fellows may purchase this optional vision care plan through payroll deduction.

 

Vision Plan Monthly Premiums & Details

Review the CU GME Vision Plan Summary.

Resident only

$11.12

Resident + 1 dependent

$21.09

Resident + family

$30.98 


Enrollment

Once you enroll in the EyeMed Vision Care Plan, you may only cancel your coverage during the next open enrollment period for termination on July 31st or within 31 days of a qualifying event (e.g. birth, marriage, new hire, etc.).

New Vision Plan Members 

  • If you enroll during your initial onboarding process or during open enrollment (April/May) your coverage begins on August 1st. The Plan year for the vision coverage is August 1-July 31st.

Qualifying Event Enrollment 

  • Outside of open enrollment or the initial onboarding process, enrollment in the vision plan is allowed only within 31 days of a qualifying event (e.g. birth, marriage, or new hire).

Current EyeMed Members

  • It is not necessary to re-enroll during open enrollment for the next Plan year. Your enrollment with EyeMed will carry forward. If you want to cancel your coverage, you may only do so during open enrollment (coverage ends on July 31st) or within 31 days of a qualifying event (coverage ends on last day of month your cancellation is received).  

How to Enroll

Print and complete the CU GME Vision Plan Enrollment Form. Return the form via scan and e-mail to Joe LaFond, GME Benefits Coordinator, using one of these methods

  • Email (preferred): joseph.lafond@cuanschutz.edu
  • Fax the enrollment form to 303-724-6034
  • Mail to:
    Graduate Medical Education
    13001 East 17th Place, Mail Stop C293
    Fitzsimons Bldg, Rm N4223  
    Aurora, CO 80045

Late enrollment change requests will not be accepted.

Providers

The Provider listing for EyeMed is at https://eyemed.com. (You are on the ACCESS Network.)

NOTE:  The provider network for EyeMed is NOT the same as the provider network for the CU GME Health/Dental Benefits Plan. University of Colorado Hospital, Children's Hospital Colorado, and CU Medicine are NOT providers for EyeMed.

Accessing Your Vision Benefits

The EyeMed Vision Care Plan ID card is separate from your health/dental ID card. You have a few options for obtaining your EyeMed Vision Care Plan ID card and accessing vision services:

  1. Provide your first & last name, and date of birth when presenting for your appointment at the EyeMed Vision Care Provider’s office.
  2. Members can download the EyeMed app to have an electronic copy of their ID Card.
  3. Members can create an account on eyemed.com and print an ID Card.

Questions or Issues

EyeMed website:  https://eyemed.com/

EyeMed Member Services Department:  1-866-723-0513

CU GME Benefits Office:  303-724-6024 or 303-724-7325

 


 

Long Term Disability Insurance

Group Coverage Highlights

  • Resident pays no premium for this coverage while in training.
  • Plan is offered by the Standard Insurance Company, AM Best A rated company.
  • Monthly disability benefits payable beginning the 91st day of disability.
  • Benefit period to age 65.
  • Monthly benefit levels:
               PGY I & II $3,000
               PGY III & IV $3,500
               PGY V & above $4,000
  • Group-to-individual conversion policy (and increase in coverage) offered to residents completing their CU GME training program.*

For details, please view the Certificate of Coverage 
Please contact GME Benefits Office with questions.​

Conversion Policy Features

  • True "specialty specific" definition of disability. Tax free benefits payable if unable to perform specialty, even if working in another occupation.
  • $5,000/month or $2,500/month individual tax-free benefit with up to additional $10,000 per month benefit based on financial qualification.
  • Guaranteed issue. No lengthy application or medical exam.* 
  • Substantial premium discount exclusively for GME Residents and Fellows. Up to 50% reduction in rates.  
  • Partial/residual disability benefits.  Benefit proportional to income loss due to illness or injury.
  • Benefits payable to age 67 and premium remains constant to age 67.
  • Annual cost of living adjustments while disabled. 
  • Optional catastrophic benefit up to an additional $10,000 per month.  
  • Optional student loan rider up to an additional $2,500 per month.   
  • This benefit may be combined with and will not be reduced by typical, employer-sponsored, group disability plans​.
Optional In-Program Plan:  It may be possible to obtain a guaranteed issue plan for $1,500/month coverage during training.

*Please be aware that if you choose to apply or have applied for coverage outside of the GME disability program in the past 7 years and that coverage has been postponed or declined by the carrier you will be ineligible to participate in the GME disability conversion program. A 3/12 pre-existing condition provision applies.

Dental residents are not eligible for the conversion policy or optional in-program plan. 

Questions about Disability Insurance

For further information on the conversion policy or in-program plan, contact your GBS representatives: Lynn A. Johnson, ChFC, CLU at 805-750-8438 and Don Bloomfield at 303-889-2656. These are the only representatives authorized by the insurance carrier and GME to provide this conversion product.​

 

The GME group long-term disability policy is administered by Gallagher Benefit Services (GBS) a professional brokerage/benefits consultation firm under contract with GME. Lynn Johnson is well-versed on the intricacies of the conversion policy. She is available to answer your questions, to compare this policy and outside policies, and to determine how to best serve the needs of the residents, whether during residency, or at program completion. A resident considering any long term disability product is encouraged to speak with Lynn before purchasing individual coverage. Outside individual coverage may affect the amount of the guaranteed-issue policy for which you may be eligible.

Note: This represents highlights for information purposes only. The Master Contract contains all of the controlling provisions of this coverage.

Life Insurance

Eligible residents and fellows have group term life insurance. No proof of good health is required. You must however, complete the Life Insurance Beneficiary Designation Form and list your beneficiary(ies). This policy is for the resident or fellow only and is not available for other family members. The policy has no cash value.

Coverage Highlights

  • $50,000 term life insurance
  • Additional $50,000 for accidental death or dismemberment 
  • Accelerated benefits if diagnosed with terminal illness and meet eligibility requirements
  • Coverage terminates on the last day of your training
  • Review Coverage Details - Certificate of Life Insurance

Beneficiaries

The carrier will make payment to the most recently named beneficiary if you die while insured under this coverage. The beneficiary is the person you named on the Life Insurance Beneficiary Designation Form. Definitions and instructions regarding beneficiaries are on the Life Insurance Beneficiary Designation form.

To Change Beneficiaries:
Complete and print the Life Insurance Beneficiary Designation Form​​. After you sign and date the form, return it to Joe LaFond, GME Benefits Coordinator, using one of these methods: 

  • Scan and email it to joseph.lafond@cuanschutz.edu​​
  • Fax to Attention:  Benefits at 303-724-6034. 
  • Mail to: 
    Graduate Medical Education
    13001 East 17th Place, Mail Stop C293
    Fitzsimons Bldg, Rm N4223  
    Aurora, CO 80045

Accelerated Benefits

The Accelerated Benefit allows you to receive an early payout of a portion of your group life insurance benefit if you are diagnosed with a terminal illness and meet eligibility requirements.


Accidental Death and Dismemberment Insurance (AD&D)

In addition to basic life insurance coverage, this policy provides you with $50,000 in Accidental Death and Dismemberment (AD&D) coverage. Accidental death benefits are payable to your named beneficiary if you die from an accidental bodily injury while insured under this coverage. Accidental dismemberment benefits may be payable if you suffer a covered dismemberment. The AD&D coverage may also help protect against certain financial losses resulting from a variety of accidents. ​

Extra Features of this plan

As a participant in this group life insurance, you also have Travel Assistance

Standard Life Services Toolkit

Conversion and Portability Information for Exiting Residents

Frequently Asked Questions

Conversion Application

Portability Application

Exiting Residents may have options for conversion or portability of your current group life insurance within 31 days of exit through Standard Insurance Company. 

Contact Standard Insurance Company Continued Benefits at 1-800-378-4668 with questions.