On this page, you'll find plan documents and legal notices related to your employee benefits package as well as important Health Insurance Portability and Accountability Act (HIPAA) and COBRA information.
Plan Documents (FY 2022-23)
Medical
Cigna Copay Basic Plan Benefits Summary
Cigna Copay Plus Plan Benefits Summary
Cigna HDHP Benefits Summary
Cigna Preventive Drugs List
Optum RX Plan Description and Premium Standard Formulary
Kaiser Permanente Copay Benefits Summary
Kaiser Permanente Copay Plus Benefits Summary
Kaiser Permanente HDHP Benefits Summary
Kaiser Permanente Preventive Drugs List
Vision
EyeMed Basic and Enhanced Benefits Summaries
EyeMed Basic Plan Certificate
EyeMed Enhanced Plan Certificate
Dental
Delta Dental Basic Plan Summary and Plan Description
Delta Dental Basic Plus Plan Summary and Plan Description
Disability
Unum Short-Term Disability (STD) Certificate
Unum Long-Term Disability (LTD) Certificate
Life Insurance
Securian Financial Term Life Certificate
Securian Financial Life and AD&D Plan Summary
Health Insurance Portability and Accountability Act (HIPAA) - Privacy & Security
HIPAA Notice of Privacy Practices for Personal Health Information
As sponsor of the group health plans and flexible spending accounts offered to state employees, DPA is subject to the privacy and security regulations of the Health Insurance Portability and Accountability Act (HIPAA) (45 CFR Parts 160 and 164). These regulations are better known as the Privacy Rule (45 CFR 164 subpart E) and the Security Rule (45 CFR 164 subpart C). The requirements placed upon DPA by the Privacy and Security Rules include the following.
For more information about HIPAA privacy or security contact steven.halterman@state.co.us.
COBRA
The Consolidated Omnibus Reconciliation Act of 1985 (COBRA) allows employees and their covered dependents to continue group health coverage under certain circumstances. The State uses a COBRA third-party administrator (TPA). The TPA is responsible for sending COBRA notices and for managing COBRA enrollment, billing, payment, and cancellation. Your COBRA coverage will become effective once your first premium is received by the COBRA TPA. Coverage is retroactive once payment is received.
For questions related to enrollment or payment, contact the COBRA Third-Party Administrator (TPA) at:
- Phone - 1-877-725-4545
- Fax - 515-273-1545
Employee Resources