Frequently Asked Questions
Q: What health insurance benefits am I eligible for as a benefited employee of Colorado College? A: Colorado College offers both a Point of Service (POS) and a Preferred Provider Organization (PPO). Q: What is a PPO? A: A PPO is typically a 2-tier plan offering the option of obtaining services from a network provider or a non-network provider. The choice to obtain services from a network provider or a non-network provider is made by the participant each time services are required. No Primary Care Physician (PCP) is required. Typically, insurance carriers require that participants meet applicable deductibles before benefits are paid. Q: How do I know if my doctor is in-network? A: It is always best to check the provider directories. Your best resource is the carrier website. You may also contact the physician's office directly or the customer service number for the insurance carrier. Q: What is a POS? A: One aspect of POSs that separate them from other types of health plans is the use of a concept referred to as a 'gatekeeper' or 'Primary Care Physician (PCP)'. Most POS plans require participants to select a PCP and coordinate all their medical care through that provider. Most POS insurance carriers have empowered medical groups with the responsibility for approving and authorizing the levels of care and procedures recommended by their member doctors. Under an HMO it is a good idea to build a strong relationship with the PCP as well as to learn to be your own health advocate. Q: Can I change my PCP? A: This can vary from carrier to carrier. Most POSs allow plan members to switch PCPs once a month with an effective date of the first of the month. Q: When can I enroll on the health insurance plan? A: Employees that are benefit eligible and any eligible dependents can choose to enroll in the plan when they are first hired, the effective date would be the first of the month coincident with or next following the benefited date of hire. The only other time to enroll may be if you experience a qualifying event. Q: What is a qualifying event? A: A qualifying event is listed by the Internal Revenue Service (IRS) as marriage, divorce, birth or adoption of a child, death of a spouse or child, termination of a spouse's employment or spouse gains employment, part-time to full-time employment change (or vice versa), the employee or spouse taking a leave of absence. Colorado College also allows employees to change on the effective date of their spouse or partner's open enrollment. Another family status change is if a dependent child reaches the maximum age limitation on the insurance plan. Changes to your benefit plans due to any of the above named reasons must be made within 31 days of the event through Human Resources. Q: Can I waive or discontinue the health insurance at Colorado College? A: When you are first eligible to participate in the health insurance, you may choose at that time to waive out of the coverage. The only other time is when any of the above named qualifying events occur. You must complete a termination form with Human Resources within 31 days of the event.
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Human Resources Office |
