Changes are Coming -Take a look at the new DHMP

DHMO vs HDHP

A broader network offered in both our plans

The HighPoint Denver Plus Network

HighPoint Denver Plus consists of:UCHealth

University of Colorado Hospital

Poudre Valley Hospital Medical Center of the Rockies Memorial Hospital Memorial Hospital North

Children’s Hospital ColoradoCU Health PartnersDenver Health networkFirst Health national network

Cofinity network

1st tier

2nd tier

Who is in HighPoint Denver?

1st tier providers in HighPoint Denver Plus

Cofinity providers are the 2nd tier of HighPoint Denver Plus This includes facilities such as:

The “PLUS” in HighPoint Denver Plus

This includes providers such as:

Cofinity has thousands of primary care and specialty physicians in the Denver Metro area. Go to Cofinity.net to check for your provider.

2016 DHMP Monthly Premiums

HDHP* DHMOEmployee $22.50 $84.52

Employee/Spouse $123.75 $278.91

Employee/Child(ren) $90.00 $225.38

Family $216.01 $450.76

Familyplans

Individual plan

*HSA eligible

HDHP vs DHMO

HDHP DHMODeductible Out-of-Pocket Max Copays Coinsurance HSA account

Deductible

HDHP DHMOIndividual/Family Individual/Family

Deductible $1,350/$2,700 $500/$1,500

The deductible is the amount you must pay before your insurance begins to pay.

In an HDHP, the individual deductible does not apply to a family plan. A family must meet the entire family deductible before the Plan begins toPay for any services.

HDHP DHMOIndividual/Family Individual/Family

Out-of-Pocket Max $2,700/$5,400 $2,500/$5,000

The Out-of-Pocket Maximum is the most you will ever have

to pay for health care services in any given year.

Out-of-Pocket Max

In an HDHP, the individual out-of-pocket maximum does not apply to a family plan. A family must meet the entire family out-of-pocket maximum before the Plan begins to pay at 100% for covered services.

■ Preventive care is covered at no charge in BOTH plans

■ Annual check ups

■ Prenatal visits

■ Well child care

■ Well woman exams

■ Immunizations

All of the above are covered at no charge Deductible and coinsurance do not apply.

IMPORTANT NOTE

Preventive Care

Accessing Care: PCP/Specialty

HDHP DHMO1st tier

HighPoint Denver2nd tier

Plus (Cofinity)1st tier

HighPoint Denver2nd tier

Plus (Cofinity)

When I visit my PCP, what will I pay?(non-preventative)

Deductible and 10% coinsurance

Deductible and 20% coinsurance

$25/visit $30/visit

What about when I visit a specialist?

Deductible and 10% coinsurance

Deductible and 20% coinsurance

$50/visit $50/visit

Urgent Care Visit Deductible and 10% coinsurance

Deductible and 20% coinsurance

$75/visit $75/visit

Emergency Room visit Deductible and 10% coinsurance

Deductible and 20% coinsurance

$300/visit $300/visit

Inpatient Stay/Outpatient Surgery

Deductible and 10% coinsurance

Deductible and 20% coinsurance

Deductible and 20% coinsurance

Deductible and 30% coinsurance

You will pay more out of pocket at the beginning of the year with the HDHP. However, your monthly premiums are lower AND you have a

Health Savings Account (HSA) to help pay these costs.

HDHP plan Save money on

monthly premiums Have a tax-free HSA to

help you with unexpected health care expenses

Which is the plan for you?

Traditional plan Pay larger monthly premiumsLess out of pocket, butNo HSA

Broader network More than 18,000 providers Easy Access – DHMP requires

NO referrals

Don’t forget…

Questions?