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.
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.
*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.
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.
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.
See complete details of coverage in the CUGME Health Plan Document.
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.
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 + 1 dependent
Resident + family
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
Qualifying Event Enrollment
Current EyeMed Members
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
Late enrollment change requests will not be accepted.
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.
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:
EyeMed website: https://eyemed.com/
EyeMed Member Services Department: 1-866-723-0513
CU GME Benefits Office: 303-724-6024 or 303-724-7325
Optional In-Training Coverage: Residents/Fellows not in their final year of training may choose a $2500 or $5000/mo. benefit.
Dental residents are not eligible for the conversion policy or optional in-program plan.
*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.
For further information, contact Lynn A. Johnson, ChFC, CLU at 805-750-8438. She is the only representative authorized by the insurance carrier and GME to provide this disability product.
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.
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.
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 complete the form, return it to Joe LaFond, GME Benefits Coordinator, using one of these methods:
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.
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.
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.