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Benefits Enrollment and Forms

New Employee Enrollment
New employees* must submit the Benefits Enrollment Form to the OHR Benefits Office within 30 days of their hire date. Please also include the supporting documentation if you are enrolling dependents.
 
The enrollment form is used to enroll in medical**, dental, vision, flex cash and prepaid legal. These plans all defaulted to "waive" if no form with elections is received in the OHR Benefits Office.
 
The dependents listed below are eligible for coverage under our medical, dental, and vision plans:
  • Spouse
  • Spousal Equivalent (same-sex domestic partner)
  • Child (eligible until end of  month of age 26)
  • Step-child (eligible until end of month age 26)

 *Half-time employees will use the Half-Time Benefits Enrollment Form as premium rates differ.

 
**Important:  If enrolled in Navigate, you must choose a Primary Care Physician (PCP). In order to see the doctor of your choice, email ccdnavigate@uhc.com with your PCP's 11 digit Provider ID. You can find the Provider ID by going to https://www.myuhc.com/member/prewelcome.do, clicking "Find Physician, Laboratory or Facility" and then selecting the "UnitedHealthcare Navigate/Navigate Balanced" plan and searching for your PCP. 


 

Family Status Changes
If an employee* experiences a family status change due to a qualified event, the employee has the option to update benefit enrollments (medical, dental, vision, flex cash). Qualified events include:
  • Birth or adoption of a child
  • Death of a dependent
  • Marriage or divorce
  • Change in hours worked
  • Gain or loss of other coverage
To update your benefits, complete the Benefits Enrollment Form** and submit it to the OHR Benefits Office within 30 days of the event date. Please also include the required supporting documentation if you are enrolling new dependents. (For newborns, please submit your enrollment form in the first 30 days, do not wait for the birth certificate. You can submit the birth certificate once you've received it later.)
 
*Half-time employees will use the Half-Time Benefits Enrollment Form as premium rates differ.
 

**Important:  If newly enrolled in Navigate, you must choose a Primary Care Physician (PCP). In order to see the doctor of your choice, email  ccdnavigate@uhc.com  with your PCP's 11 digit Provider ID. You can find the Provider ID by going to  https://www.myuhc.com/member/prewelcome.do , clicking "Find Physician, Laboratory or Facility" and then selecting the "UnitedHealthcare Navigate/Navigate Balanced" plan and searching for your PCP.


Open Enrollment
 
Open enrollment occurs every October. During open enrollment you will have the opportunity to change your medical, dental, vision, short-term disability, and flex cash elections for the following calendar year.
 
If you do not make elections during this time, you will be assigned the same coverage you had in the previous year, except for flex cash which requires re-enrollment every year. 

Enrollment Forms

Common-Law / Spousal Equivalent Affidavit
Employees wishing to add an opposite-sex spouse (without a marriage certificate) must complete the Common-Law Affidavit. Employees wishing to add a same-sex spouse must complete the Spousal Equivalent Affidavit.
 

Please Note: If you were previously married and are adding a common-law spouse, you must provide a divorce decree for the prior marriage.



 

Dental
Review Delta Dental benefit summary guides and copay lists, or print out ID Cards.  

 

 


 

Disability Benefits

Short-Term Disability
Standard Insurance Company is the carrier for short-term disability. The City has 2 short-term disability plans. One is a voluntary benefit for those employees hired prior to January 1, 2010. This benefit is paid for by the employee through payroll deductions.  The other is an automatic benefit for those employees hired after January 1, 2010. This benefit is paid for by the City.

 

Long-Term Disability
Standard Insurance is the carrier for the City and County of Denver's Long Term Disability plan. All benefit eligible employees are enrolled and premiums are provided to employees as part of their benefit package.



Flex Spending Account (24HourFlex)

 

Health Savings Account (Optum Bank)


 

Life Insurance

Basic
The City provides a basic life insurance benefit to all benefit-eligible employees. The policy is 2 times the employee's annual salary to a maximum of $100,000 (reduced if a 1/2 or 3/4-time employee). Employees need only complete the following beneficiary designation form to ensure the benefit is appropriately distributed.

 
 
Additional
Standard Insurance Company is the carrier for Supplemental/Additional Life and Accidental Death and Dismemberment coverage. Employees may elect to purchase up to $300,000 of additional life insurance for themselves and their spouses at group rates. Employees may also elect to purchase up to $500,000 of Accidental Death and Dismemberment coverage for themselves or their family.
 

 


 

Denver Employee Retirement Plan (DERP)

 

Deferred Compensation Enroll/Change
Personal Total Compensation Statement

RTD Eco Pass

 


 

HIPAA Notices

The privacy rules under the Health Insurance Portability and Accountability Act (HIPAA) require the City and County of Denver (the “City”) to provide participants with Privacy Notices for the following Health Plans: the City’s Flex Cash Plan (administered by Denver Reserve Corporation) and the City’s Self-Insured Dental Plan (administered by Delta Dental Plan of Colorado). Each respective Privacy Notice explains participants’ rights under that Plan and the Plan’s legal duties with respect to protected health information (PHI) and how the Plan may use and disclose PHI.