HOW TO USE THIS BOOKLET

This booklet gives you the details you need to understand your health care benefits. We have tried to write it in simple terms that are easy to understand, and we hope you will read it carefully. Information has been organized into the following sections:

Definitions. This section defines terms that have special meanings in this booklet.

Eligibility. This section outlines who is eligible for coverage under your contract and when your coverage becomes effective.

Benefits and Services. This section describes some services in more detail than in your Benefit Chart located in the back of this booklet. It also gives you additional information about some services that are not on the Benefit Chart.

What Is Not Covered. This section lists what is not covered. We want to be sure that you are aware of services that are not included in your coverage.

General Provisions. This section describes the following:

• Appeals Procedure
• Third Party Liability
• Motor Vehicle Accidents
• Administrative Rules
• Services In Another Kaiser Permanente Service Area
• If You Move Outside Our Service Area
• Limit on Individual Supplemental Charges
• Arbitration of Claims

Benefit Chart. A Benefit Chart is included in the back of this booklet. It gives you information about the limits of your coverage. It tells you what amounts, if any, you must pay. Your Group may have benefits in addition to those basic ones outlined in this booklet or listed on your Benefit Chart. Summaries of your Group's additional benefits, if any, precede the Benefit Chart.

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NAVIGATION

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Introduction | Benefit Changes | How to Use | Definitions | How Your Plan Works | Who Is Eligible | When Coverage Starts | Benefits And Services | Referrals and Restrictions on Choice of Providers | Emergency Services | Urgent Care | Health Plan's Appeals Procedure | Special Claims Procedures for Medicare Members | General Provisions | Binding Arbitration | Coordination Of currentbenefits | Medicare | What Is Not Covered | When Coverage Stops | Continuation Of Coverage | Customer Satisfaction Procedure | Service Information | Statement Of Financial Condition | Important Phone Numbers | Local Designated Hospitals | Supplemental Benefits | Benefit Chart

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Website for Kaiser of Colorado

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