After a competitive request for proposal (RFP) process, the State of Colorado will offer new healthcare and dental plans starting July 1, 2015. This means that all state employees must go through the active enrollment process in order to be covered in the new fiscal year.
Here are your options during the 2015 Open Enrollment period:
The only exception would be if you have what’s called a qualifying life event like marriage, birth, or adoption. If you do not enroll in State of Colorado benefits, you will be dropped and you will not have coverage in FY 2015-16.
For more information go to Colorado.gov/dhr/benefits.
This year, Colorado WINS members secured a 2.5% base-building increase for state workers. We also secured funds to cover any increases to medical premiums, so that our raise is not eaten away by rising healthcare costs. And for the past 6 months, Colorado WINS members have been at the table, working with management to improve healthcare options for state employees.
This is the last fiscal year for which the current healthcare providers are under contract. For FY 2015/16, through a Request for Proposal (RFP) process, the state will request applications form health insurance companies to provide state workers with coverage.
Beginning in October 2013, a group of Colorado WINS members attended three DPA-led meetings to set expectations for the RFP process. The RFP creates the parameters and application for health insurance companies that wish to potentially provide health care coverage to state employees. Colorado WINS members who participated in the meetings included Joe Rogers (Heath Care Policy and Financing, Denver), Pat Roybal (Adams State University, Alamosa) and Dawn Tripp (Colorado Mental Health Institute at Pueblo).
From the beginning WINS members had 4 goals that would increase access and affordability of healthcare for Colorado state workers:
After the three meetings, a smaller group of DPA officials and WINS members met regularly for 2 full months to craft the RFP. In mid-January 2014 the RFP was released with a question or comment period for interested insurance companies.
The comment section is now closed and the state is reviewing submitted proposals. The final committee, of which WINS is a member, will make final recommendations to the DPA Executive Director on May 15 and a decision is expected not long after.
WINS members have been at the table, working to provide better healthcare options for all of Colorado’s state workers. This means that as the RFP process comes to an end you should have access to better, more affordable care, no matter where you live in the state.
Colorado WINS members secured millions in additional funding to fully cover Health/Life/Dental premium increases.
Here are a few widely used terms you should be familiar with. Our definitions are based on those provided by DPA in their April 2012 Healthline newsletter. You can find an archive of the Healthline newsletters here.
Co-insurance – A percentage of costs for covered services that the insurance company pays after a deductible is met.
Co-pay – A flat fee that is paid for health care services at the time service is provided. Co-payments are specific amounts, which is convenient in planning for the cost of care.
Deductible – An amount an individual must pay for covered health care expenses before insurance begins to cover costs. Deductibles in health insurance work the same as deductibles in auto or home owner’s insurance.
Out-of-pocket maximum – The maximum amount of money a person will pay for covered health claims, which is in addition to premium payments. These maximums are usually the sum of deductibles and co-insurance payments or the sum of all co-payments.
The plan with the lowest premium may not be the best plan for you. If you have chronic conditions or expect to see a doctor more than usual this year, you may want to consider other factors, besides just the monthly premium cost.
The statewide Child Health Plan Plus (CHP+) has been expanded to allow health coverage for the underage and pregnant dependents of state employees (spouses, same-gender domestic partners and children of employees). Employee dependents (children and pregnant women) who are not covered by the state or another employer’s plan may qualify for the coverage.
CHP+ rules require a three-month waiting period without insurance coverage for all dependents eligible for coverage. Because of IRS regulations, employees with dependents currently covered cannot drop or cancel their coverage in order to qualify for CHP+. The dependents of state employees must also meet all other CHP+ eligibility criteria.