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

• CUGME Health Plan Document
• Summary of Benefits and Coverage
• ​Resident Premium Rates​​​

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

• In-Network Medical/Surgical Provider Directory​ ​​ *
• Mental/Behavioral Health Providers Located on the Anschutz Campus
• Mental/Behavioral Health Providers Located outside of the Anschutz Campus (Mines & Associates Search tool) 
• Mental/Behavioral Health Resources for Residents
• Urgent Care and Other Emergency Room Alternatives​​
• Where to go for Care Quick Access Guide
• ​In-Network and Out-of-Network Benefit Levels​​

Useful Links

• Access MyAmeriBen.com **NEW**
• Changes to your Benefits
• Order a new CU GME Health Plan ID Card ​​
• Update your address with the GME Benefits Office​
• Plan Contact Information​
• Breast Pump Benefit​​​

CU GME Health Plan Required Notices

• CU GME Health/Dental Benefits Plan Notice of Privacy Practices
• Su​mmary of Benefits and Coverage​
• Important Notice from CUGME Health Benefits Plan About Your Prescription Drug Coverage and Benefits
• Women's Health and Cancer Rights Act of 1998
• Newborns' and Mothers' Health Protection Act
• Required chip model notice

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.​
  • CU GME Dental Network providers can be found by calling 1-800-513-7177, Option 7 or at www.aetna.com/DentalAdministrators​. 

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 31^st) 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.*

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. 

                          

Other Benefits & Resources For Residents

Retirement Savings Plans

Flexible Spending Accounts

Workers Compensation (Needlesticks, Workplace Exposures & Injuries)

Financial Wellness

Immunizations & TB Screenings

Benefits for Exiting Residents

Prospective Resident Benefits Summary