1. Take a look at the new DHMP
Changes are Coming -
Take a look at the new DHMP
DHMO vs HDHP

2. A broader network offered in both our plans
The HighPoint Denver Plus Network
A broader network offered in both our plans
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 Colorado
CU Health Partners
Denver Health network
First Health national network
Cofinity network
1st tier
Denver Health Medical Plan - DHMP has made big changes in our network. You will no longer be tied to the narrow Denver Health network. We have contracted with a much wider group of providers to offer you this new, broad network, HighPoint Denver Plus. HighPoint Denver includes Denver Health, UCHealth System, Children’s Hospital Colorado, CU Health Partners and a group of community Pediatric PCPs. You can choose any of these providers for the same cost sharing amount. We can help you look up your doctor so you can see if he/she is within our network.
The “Plus” in HIghPoint Denver Plus is Cofinity. This is a second tier of service with cost sharing that is a little bit higher than the first tier but offers an even broader network.
The HighPoint Denver Plus network offers you more than 18,000 providers in the front ranges as well as a national network for members residing outside of Colorado
In addition, we have First Health to care for members residing outside of Colorado.
First Health is a wraparound national network.
2nd tier

3. 1st tier providers in HighPoint Denver Plus
Who is in HighPoint Denver?
1st tier providers in HighPoint Denver Plus
Denver Health providers
University Physicians, Inc.
All physicians employed by University and Children’s
Colorado Pediatric Partners
Community pediatricians such as:
Advanced Pediatric Associates
Arvada Pediatrics Associates, Pc
Greenwood Pediatrics
Kids First Pediatrics
And many more (we are happy to look up your provider!)
Colorado Health Medical Group
Community physicians in both northern and southern Colorado (Fort Collins up to Colorado Springs) contracted by UC Health

4. Cofinity providers are the 2nd tier of HighPoint Denver Plus
The “PLUS” in HighPoint Denver Plus
Cofinity providers are the 2nd tier of HighPoint Denver Plus
This includes facilities such as:
Rose Medical Center
PSL Medical Center
Parker Adventist Hospital
Swedish Medical Center
Medical Center of Aurora
And more!
This includes providers such as:
New West Physicians in Arvada
Rose Pediatrics
Parker Square Family Practice
Highlands Pediatrics
Centura Medical Consultants in Wheatridge
And more!
Cofinity has thousands of primary care and specialty physicians in the Denver Metro
area. Go to Cofinity.net to check for your provider.

5. 2016 DHMP Monthly Premiums HDHP* DHMO
Employee
$22.50
$84.52
Employee/Spouse
$123.75
$278.91
Employee/Child(ren)
$90.00
$225.38
Family
$216.01
$450.76
Family
plans
Individual
plan
As you can see, the monthly premiums for the HDHP plan are much lower than the premiums for the DHMO. This is because the member has the responsibility for the higher deductible before DHMP begins to pay.
However, with the HDHP, the member is eligible for the Health Savings Account or HSA. This allows both the employee and the employer to contribute funds, tax-free. These funds can be used for all qualified health care expenses.
You KNOW you are going to have to pay the premium every month. Most of us do not know how often we will need to access health care.
*HSA eligible

6. HDHP vs DHMO HDHP DHMO P O Deductible Out-of-Pocket Max Copays
Coinsurance
HSA account
For 2016, you will be able to choose from either the DHMO or the HDHP plan.
Both plans will cover the same health care benefits, such as PCP visits, specialty visits, x-ray, MRI, etc. It is the monthly premium and the cost-sharing for those services that will be different.
Both plans that you can choose from for 2016 have a deductible and an out-of-pocket maximum, although they are different.
In addition, there are generally NO copays in a HDHP and members of the DHMO are NOT eligible for the HSA account or the $600/$1,200 the employer offers to fund the HSA account.

7. Deductible HDHP DHMO Individual/Family Deductible $1,350/$2,700
$500/$1,500
The deductible is the amount you must pay before
your insurance begins to pay.
The dollar amounts for the deductible different for the HDHP and the DHMO. The HDHP has higher amounts, this is what makes the premium for the HDHP lower. Remember, for an individual plan, you can save more than $700 in premium by choosing the HDHP.
In addtiion, the way the deductible works is different in each plan.
In the DHMO, one family member can meet the individual deductible of $500, and the Plan will begin to pay for a portion of that member’s services.
This is NOT the case in the HDHP. In a HDHP, there is no individual deductible, the family must meet the entire family deductible before the Plan begins to pay for a portion of the costs.
The family deductible can be met with services for all family members, a couple of family members or even by just one family member.
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 to
Pay for any services.

8. Out-of-Pocket Max HDHP DHMO 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.
The dollar amounts for the out-of-pocket maximum is also different for the HDHP and the DHMO. Once again, the HDHP has higher amounts, and lower premiums.
In addition, the the out-of-pocket maximum works much like the deductible in how it is satisfied.
In the DHMO, one family member can meet the out-of-pocket maximum of $2,500, and the Plan will begin to pay 100% of that member’s covered health care expenses.
Again, this is NOT the case in the HDHP. In a HDHP, there is no individual out-of-pocket maximum, the family must meet the entire family out-of-pocket maximum before the Plan begins to pay 100%.
The family out-of-pocket maximum can be met with services for all family members, a couple of family members or even by just one family member.
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.

9. Preventive Care IMPORTANT NOTE
Preventive care is covered at no charge in BOTH plans
Annual check ups
Prenatal visits
Well child care
Well woman exams
Immunizations
Just as in previous plans BOTH plans offer you all eligible preventive care for $0.
All of the above are covered at no charge
Deductible and coinsurance do not apply.

10. Accessing Care: PCP/Specialty
HDHP
DHMO
1st tier
HighPoint Denver
2nd 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?
$50/visit
Urgent Care Visit
$75/visit
Emergency Room visit
$300/visit
Inpatient Stay/Outpatient Surgery
Deductible and 30% coinsurance
When you are ill and visit your provider (meaning it is NOT preventive care), you will pay a copay with the DHMO and deductible/coinsurance with the HDHP. The DHMO also has copays for ER and Urgent Care while the HDHP has deductible and coinsurance. For items like inpatient stays and outpatient surgery, the two plans (both the HDHP and the DHMO) are pretty much the same. The only difference is in the percentage of coinsurance. You can see that it is lowest in the HDHP network where you can access the HighPoint Denver network for 10% coinsurance and the Cofinity or the Plus network for 20% coinsurance.
The difference between copays and coinsurance may seem really big, but the truth Is that the money you save on your premium and the HSA money your employer will give you, will make the HDHP out-of-pocket costs more affordable.
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.

11. Which is the plan for you?
The choice is up to you. You can choose to save money on your monthly premium and pay for your care as you go – with the help of your HSA and the funds your employer puts in it. Or, you can choose to stay with a plan much like you have today. You will pay higher monthly rates and you will not be eligible for an HSA.
HDHP plan
Save money on monthly premiums
Have a tax-free HSA to help you with unexpected health care expenses
Traditional plan
Pay larger monthly premiums
Less out of pocket, but
No HSA

12. Don’t forget… Broader network More than 18,000 providers
Easy Access – DHMP requires NO referrals
Don’t forget how much the DHMP has grown. With HighPoint Denver Plus, you have access to a much broader network with more than 18,000 providers and DHMP does NOT require referrals to pay your claims. You can decide how much you pay for services. Stay within the HighPoint Denver network and pay lower costs in both the DHMP and HDHP. But if you need more choice, pay a little bit more and access the Cofinity network, the “Plus” in HighPoint Denver Plus.

13. Questions?