INTRODUCTION

To Eligible Employees: This booklet contains a description of the benefits available to you and your family through the Group Dental Plan offered by the COLORADO PREPAID DENTAL PROGRAM.

Please take a few minutes and read through the booklet, so that you and your family will become familiar with the benefits, as well as the most effective ways to use the Plan.

In order to obtain a copy of the Master Policy, please submit your written request to:

Administrator
Department of Employee Benefits
Denver Public Schools
900 Grant Street
Denver, Colorado 80203

If you have any questions regarding this Plan, please call the above referenced individual at (303) 764-3372.

ELIGIBILITY FOR BENEFITS

Eligibility All full-time salaried, full-time contract and long-term substitute teachers who work at least 33 1/2 hours each school day shall become eligible to enroll in the Dental Program on the first of the month next following the date you begin service with the School District.

Dependents Defined Your eligible dependents are your spouse and your unmarried dependent children from birth to December 31st of the calendar year in which the child attains age twenty-four (24) provided the child is dependent upon you for support and maintenance. Dependent children who are unable to gain employment because of permanent physical or mental defect shall qualify as a dependent beyond the limiting age, provided that, upon request from the Board, the employee furnishes proof that such incapacity and dependency have been continuous since the child's attainment of the limiting age. The Board may also require the employee to furnish proof, but not more frequently than annually, that any such dependent remains so incapacitated and dependent.

The term "child" includes any child of the employee including a stepchild, adopted child, foster child, or any child of a dependent supported solely by the employee and permanently residing in the employee's household.

Dependents must be residents of the United States or Canada.

No one may be covered as a dependent and also as an employee, and if both parents are covered as employees, children may be covered as dependents of one employee only.

Dependents in military service are not eligible.

How You Enroll When you first become eligible, you may select dental benefits provided by Colorado Prepaid Dental Program or the alternative Plan.

The School District presently pays the cost of an employee's coverage and the employee is required to pay any cost to cover an eligible, enrolled dependent. The required dependent coverage contribution is described on the Dental Plan premium rate sheet distributed to newly hired employees and the Open Enrollment notice distributed to all current employees.

You will receive an enrollment card for each Plan. Select the Plan of your choice, and complete the card for the Plan selected only . The enrollment card should then be returned promptly to the Department of Employee Benefits.

ENROLLMENT OF DEPENDENTS

Newly acquired dependents must be enrolled within thirty-one (31) days of acquisition. Newborn children may be enrolled at anytime up to the open enrollment period following the child's attainment of age three (3).

Dependents not enrolled in the plan may be added after the effective date only if the dependent suffers an involuntary loss of coverage through another source. The effective date of coverage will be retroactive to the first day of the month subsequent to the date similar coverage was lost.

If you enroll your dependents, they must remain enrolled in the Plan until they are no longer eligible dependents.

Transfer Period

You may change coverage from Colorado Prepaid Dental Program to the alternative Plan or vice-versa during the transfer period of May 1 through May 31 of each year. Coverage under the plan selected during May will become effective the following July 1.

Colorado Prepaid Dental Program or the alternative plan does not permit change in classifications during the above period. If you selected employee only or employee with dependent(s) coverage on your initial eligibility date, this is the class for which you are covered under the plan selected during the transfer period. No dependents may be added or discontinued.

Effective Date of Coverage

If the employee enrolls on or before his eligibility date, coverage is effective on that eligibility date. If the employee enrolls within thirty-one (31) days following his eligibility date, coverage is effective on the first day of the month following the date he enrolls. A teacher whose contract is effective September 1 shall be eligible to enroll on September 1.

TERMINATION OF COVERAGE

Unless continued coverage is elected by the employee or any eligible dependents, your dental coverage will cease on the earliest of the following dates:

1. on the last day of the month in which employment terminated for any reason, including retirement. If your employment terminates or you retire on the first day of the month, coverage will terminate on the last day of the previous month,

2. on the date you enter military service; or

3. on the date of your death; or

4. leave of absence without pay, except under special conditions. Please contact the Department of Employee Benefits for an explanation of these conditions.

Dependent coverage will cease on the following dates, whichever occurs first:

1. on the date of termination of your coverage; or

2. if the dependent is a child, on the last day of the calendar year during which the child attains the limiting age; or

3. on the last day of the month the dependent child marries; or

4. on the last day of the month the dependent child enters full-time employment; or

5. on the date the dependent enters military service; or

6. the date of expiration of the period for which the last payroll deduction was made for dependents.

In the event of the employee's death, dependent coverage will continue until the end of the month in which death occurs. If death occurs on the first day of the month coverage will terminate on the last day of the previous month.

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NAVIGATION

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Introduction | Welcome | Plan Requirements | Co-Ordination of Benefits | Patient Charges | Exclusions | Dental Offices and Codes

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Denver Public Schools
Employee Benefits Department
900 Grant Street, Room 502
Denver, Colorado 80203
(303) 764-3371