Frequently Asked Questions

Medical Insurance

Q.   At what age are children eligible as dependents?

A.   Up to age 26.

Q.   How often may I switch between the Kaiser plans?

A.   You may switch once per year at the open enrollment period.

Kaiser Side-By-Side Plan Summary

Q.   What if I don’t enroll in the health plan when I’m first eligible?

A.   You and/or your dependents are a late applicant if you don’t enroll yourself and/or your dependents within 30 days of the date you and/or your dependents become eligible for coverage. Late applicants may only enroll during Open Enrollment, once per year, and they may be subject to the plan’s pre-existing conditions limitations, if any. However, if you and/or your dependents fit one of the following categories, you may enroll outside of Open Enrollment. As long as you enroll within 30 days of the following events you and your dependents will not be considered late applicants:

  • Exhausting the maximum period of COBRA coverage; or
  • Legal separation, divorce, death of a spouse; or
  • Marriage, birth, adoption; or
  • A qualified court order requiring you to cover dependent coverage; or
  • Termination of employment or reduction in the number of hours of employment; or
  • Termination of employer’s contribution for the other plan’s coverage.

Q.   Do I need to choose a Primary Care Physician (PCP)?

A.   No.The Kaiser plans do not require employees to choose a PCP.

Q.   What should I do if one of my family members becomes ill or gets injured on the weekend, during a holiday, or while we’re on vacation?

A.   If you are experiencing a life or limb-threatening emergency (e.g., difficulty breathing, profuse bleeding, broken bone), go to the closest emergency room, or call 911. As soon as possible, contact Kaiser to let them know you've needed emergency service outside the service area and ask for instructions.

Q.  Must I see a Kaiser provider to receive benefits?

A.  Yes. In order to receive benefits under either of the Kaiser high-deductible plans, employees must seek care from a Kaiser provider or at a Kaiser facility. This does not apply to emergency situations. 

Q.   Where do I go to get prescriptions filled?

A.   Please contact member services (303-338-3800) or use Kaiser's website to locate the Kaiser pharmacy closest to you.

Q.   Where do I get information regarding Kaiser providers and locations?

A.   Please contact member services (303-338-3800) or use Kaiser's website. 

Q.   Does the Kaiser plan offer vision benefits?

A.   Yes. The plan allows employees to see a Kaiser eye doctor for an eye exam within the deductible structure for the high-deductible plans. The copay covers the cost of the exam and does not include lenses, frames, or contacts.

DENTAL INSURANCE

Q.   I never got a Dental Insurance card. What do I take to the dentist?

A.   Call 1-877-236-9622 and select the option for Cigna Dental.

Q.   What number do I call for assistance regarding dental coverage and claims?

A.  Call 1-877-236-9622 and select the option for Cigna Dental.

Q.   Where do I go for additional information?

A.  Call the number above or visit the website at www.cigna.com/YMCA.