INTRODUCTION

This booklet is an Evidence of Coverage and describes the health care coverage you have through a Service Agreement between Kaiser Foundation Health Plan of Colorado and the employer or organization (Group) which pays us your monthly member dues. The Group will tell you your share, if any, of the monthly dues. This is a summary description. It is not intended to replace the Service Agreement which contains the complete provisions of this coverage.

The information in this booklet supersedes all previous Evidence of Coverage information. Because benefits may change from year to year, it is important that you use only this latest Evidence of Coverage as your reference.

Throughout this booklet, the words Kaiser Permanente, Health Plan, Plan, we, us and our mean Kaiser Foundation Health Plan of Colorado. The words Medical Group Physician and Plan Physician mean any doctor of medicine associated with or engaged by the Colorado Permanente Medical Group, P.C. The word you means the subscriber, each dependent enrolled under this Plan and any dependent who later becomes enrolled.

Certain words in this booklet are defined. They have precise meanings and will be capitalized throughout the booklet so that you can pay special attention to them. Capitalized words are defined where used in the text or in the Definitions section.

The services described in this booklet are benefits ONLY if they are provided, prescribed or directed by a Medical Group Physician. Otherwise, except for some Emergency Services, you must receive all covered services from Plan facilities or from a referral provider. We will not pay charges for services received from non-Medical Group Physicians or from non-Plan facilities.

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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