Employee Benefits Summary (2025–2026 Plan Year)
1. Overview
This guide summarizes all employee benefits available for the plan year December 1, 2025 – November 30, 2026. It provides an overview of eligibility, medical plan options, dental and vision coverage, life and disability insurance, flexible spending accounts, health savings accounts, and additional employee resources.
2. Eligibility & Enrollment
Who Is Eligible
You are eligible for benefits if you work 30 or more hours per week. Eligible dependents include:
- Legally married spouse
- Registered domestic partner and their children
- Biological, adopted, or stepchildren, or those for whom you have legal custody
Disabled children age 26+ may remain covered if they meet plan criteria.
When Coverage Begins
- New hires: Coverage begins the first of the month following your hire date, provided enrollment is completed within 30 days.
- If you do not enroll on time, you must wait until the next Open Enrollment period.
Open Enrollment
Changes made during Open Enrollment are effective for the full plan year.
Changing Benefits (Qualifying Life Events)
Per IRS rules, elections generally cannot be changed mid‑year unless a qualifying life event occurs, such as:
- Marriage or divorce
- Birth or adoption of a child
- Death of a dependent
- Loss of other coverage
- Gaining Medicaid or CHIP eligibility
To make changes, notify HR within 30 days and provide documentation.
3. Medical Plans
Impact Development Fund offers three medical options through UnitedHealthcare. Below is a high-level overview of each.
A. 25/1250/90% HMO (Navigate Direct Gold)
Type: In‑network only (Colorado employees)
- Deductible: $1,200 individual / $2,500 family
- Out-of-pocket max: $6,600 individual / $13,200 family
- Office visits: $25 PCP / $50 specialist
- Preventive care: Covered 100%
- Diagnostics: Vary by location (freestanding centers recommended)
- Hospital services: Copay + coinsurance
- Emergency room: 10% after deductible
- Prescriptions: Tiered copays; specialty medications subject to additional rules
Notes:
- No out-of-network coverage
- PCP required
- Online referrals required for specialists
- Must use freestanding facilities for certain services
B. 30/1500/80% PPO (Choice Gold)
- Deductible: $1,500 individual / $3,000 family
- Out-of-pocket max: $6,000 individual / $12,000 family
- Office visits: $35 PCP / $70 specialist
- Preventive care: Covered 100%
- Diagnostics, imaging, surgery, hospital: Coinsurance after deductible
- Emergency room: 20% after deductible
- Prescriptions: Tiered copays; pharmacy deductible applies to tiers 3–4
C. High Deductible Health Plan (HDHP) + HSA
- Deductible: $5,250 individual / $10,500 family
- Out-of-pocket max: $6,000 individual / $12,000 family
- Office visits, diagnostics, surgery, ER: 0% after deductible
- Preventive care: Covered 100%
- Prescriptions: Deductible applies; then tiered copays
- Eligible for a Health Savings Account (HSA) (see Section 7)
4. Freestanding Facility Benefit
You may reduce your medical costs by using freestanding facilities for:
- Lab work
- Imaging (CT, MRI, X-ray, PET)
- Outpatient surgery
Benefits often include lower copays or coinsurance compared to hospital-based facilities. Speak with your physician to request referrals to freestanding centers.
5. Dental Plan
The dental plan is offered through Delta Dental PPO plus Premier, including Right Start 4 Kids®.
Key Benefits
- Deductible: $50 individual / $150 family
- Benefit maximum: $1,500 per individual
- Preventive: No charge
- Basic services: 20–50% after deductible
- Major services: 50% after deductible
- Orthodontia: Not included
Right Start 4 Kids® provides enhanced coverage for children under age 13 when using PPO or Premier providers.
6. Vision Plan
Coverage is provided through UnitedHealthcare Vision.
Key Benefits
- Exam (12 months): $10 copay
- Materials copay: $25
- Lenses (12 months): Allowances for single vision, bifocal, trifocal
- Frames (12 months): $200 allowance
- Contact lenses: $200 elective / $210 medically necessary
7. Life & AD&D Insurance
Basic Life/AD&D
- Provided at no cost to employees.
- Coverage amount: $50,000 (Guaranteed Issue).
Supplemental Life/AD&D
Employees may purchase additional coverage for self, spouse/partner, and children.
Guaranteed Issue amounts apply during initial eligibility without health evidence.
8. Disability Insurance
Coverage is provided through The Hartford.
Short-Term Disability (STD)
- Cost: Provided at no employee cost
- Benefit: 60% of weekly salary
- Maximum: $1,500/week
- Begins: 8th day
- Duration: Up to 26 weeks
Long-Term Disability (LTD)
- Cost: Provided at no employee cost
- Benefit: 60% of monthly salary
- Maximum: $6,000/month
- Begins: After 180 days of disability
- Duration: To Social Security Normal Retirement Age
9. Employee Assistance Program (EAP)
Available at no cost through UnitedHealthcare and The Hartford.
Key Features
- 3 free visits per issue
- In‑person or virtual
- Support for: mental health, relationships, substance abuse, elder/child care, grief, legal, and financial challenges
10. Flexible Spending Accounts (FSAs)
Administered by Rocky Mountain Reserves.
Health Care FSA
- Contribute up to $3,300
- Covers medical, dental, vision, prescriptions, orthodontia, and more
- Up to $660 may carry over each plan year
Dependent Care FSA
- Contribute up to $5,000 per family ($2,500 if married filing separately)
- No carryover; use-it-or-lose-it applies
Employees enrolled in the HDHP may only use a Limited Purpose FSA for dental and vision.
11. Health Savings Account (HSA)
Paired with the HDHP.
Key Features
- Pre-tax payroll contributions
- Funds roll over annually
- You keep the account if you leave the organization
- Must meet IRS eligibility rules (cannot be enrolled in Medicare or another non-HDHP)
Contribution Limits
2025
- Individual: $4,300
- Family: $8,500
- Catch-up (55+): $1,000
2026
- Individual: $4,400
- Family: $8,550
- Catch-up (55+): $1,000
12. DispatchHealth (On-Demand Urgent Care)
DispatchHealth provides urgent care in your home, workplace, or location of need.
They treat conditions such as:
- Flu, fever, cold
- UTIs
- Pinkeye
- Rashes
- Asthma, allergies
- Nausea, vomiting, diarrhea
- Ear, nose, and throat infections
Hours: 7 days/week, 8am–10pm
No membership required; billed through your insurance.
13. Cost of Benefits
Your contributions are deducted pre-tax each pay period. Costs vary based on the plans and dependents you elect.