A healthier you
starts here!
Employee Benefits Guide
2024 - 2025
Table of Contents Introduction.........................................................................................2 Enrollment Information...............................................................3 Qualifying Life Event..................................................................... 4 COBRA.................................................................................................... 4 Medical Plan Information...........................................................5 2024-2025 BCBS of Arizona Medical Plans.....................6 BCBS Alliance Network................................................................7
Telehealth Services.........................................................................9 Dental Plan.........................................................................................10 Vision Plan........................................................................................... 11 MetLife Life Insurance................................................................ 12 Employee Rate Sheet.................................................................. 13 Employee Assistance Program............................................14 Important Phone Numbers.................................................... 15
Introduction Whether you are a new employee enrolling into your benefits for the first time or considering your benefits during open enrollment, this guide is designed to help you through the process. Aspire Business Consultants is proud to offer a benefits package that includes medical, dental and vision insurance coverage for you and your dependents. Please take the time to read this information and ask questions so you can make the best benefits decisions for both you and your family.
2
If you should have any questions: 1. Contact the carrier directly. Phone number and website information is on page 13. 2. Contact Heather Jones at 602.881.2483 or heather@aspirebc.net. This booklet highlights important features of Aspire Business Consultants’ benefits for it’s benefit eligible employees. While efforts have been made to ensure the accuracy of the information presented, in the event of any discrepancies your actual coverage and benefits will be determined by the legal plan documents and the contracts that govern these plans.
Enrollment Information OPEN ENROLLMENT
PRE-TAX VS POST-TAX DEDUCTIONS
Open Enrollment for current employees is from February 1st through February 16th. This is your one time per year to make changes.
Pre-Tax Dollars: Your insurance premiums are paid with money removed from your gross wages prior to any tax calculations. This reduces your tax liability and is a more efficient way to pay for premiums.
All benefit eligible employees are required to elect coverage via Aspire Business Consultants’ enrollment form. Any coverage not actively selected will be considered a waiver of coverage.
Post-Tax Dollars: If you elect to enroll in the Supplemental Term Life benefit, your premiums will be deducted from your gross pay after taxes are deducted.
NEW EMPLOYEES New Employees have 31 days from your hire date to complete enrollment in the group insurance program. If you have moved from a non-benefits eligible status to a benefits eligible status, you will have 31 days from the new benefits eligible status to complete your enrollment. All insurance coverage starts at the first of the month. Remember, if elections are not made within the 31day initial period of eligibility, you will be required to wait until Annual Open Enrollment or until a Qualifying Life Event takes place. Late Enrollees may be required to satisfy a waiting period for the dental plan for certain services.
3
Qualifying Life Event The elections that you make during Open Enrollment or at initial benefits eligibility will remain in effect for the plan year (March 1, 2024 – February 28, 2025). During that time, if your life or family status changes according to the recognized events listed below, you are permitted to revise your benefits coverage to accommodate your new status. You may make benefits changes by contacting the Benefits Department and providing the proper documentation. IRS regulations govern under what circumstances you may make changes to your benefits, which benefits you can change and what kinds of changes are permitted.
QUALIFYING LIFE EVENTS LIST Marital Status Changes
Covered Dependent Changes
■
Marriage
■
Death of spouse
■
Divorce
■
Spouse gains or loses coverage from another source
■
■
■
Spouse employer’s
■
Open Enrollment
■
Birth or adoption of a child Death of dependent child Dependent becomes ineligible for coverage
✓ All changes must be consistent with the qualifying life event.
✓ In most cases, you cannot change your benefit plan, but may modify the level of your coverage (in other words, you can add or delete dependents, enroll or dis-enroll yourself or dependents, but not switch insurance carriers or plans). Any changes in benefit levels must be completed within 31 days of the qualifying life event.
COBRA In most cases, if your employment ends, benefits will terminate on the last day of the month in which you stopped working. Benefits will end on the day of termination in cases of employee fraud. Through federal legislation known as the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), you may choose to continue coverage by paying the full monthly premium cost plus an administrative charge of 2% (if applicable). Each individual who is covered by a Aspire Business Consultants benefit plan immediately preceding the
4
employee’s COBRA event has the right to continue his or her medical, dental or vision plan. The right to continuation of coverage ends at the earliest of the date:
✓ you, your spouse or dependents become covered under another group health plan; or,
✓ you become entitled to Medicare; or, ✓ you fail to pay the cost of coverage; or ✓ your COBRA Continuation Period expires.
Medical Plan Information 1
BCBS of AZ Statewide PPO Network or Alliance Network Aspire Business Consultants
2
BlueCare Anywhere
AZ Technology Council Association Health Program
3
1
The networks Aspire Business Consultants will use for hospitals and physicians for their medical plans.
2
The virtual visit (telemedicine) provider for the medical plans from BCBS of AZ.
3
The association that Aspire Business Consultants is a part of to bring robust benefit options to it’s employees
SUMMARY Medical benefits provide you and your family access to quality health care. Aspire Business Consultants offers two comprehensive medical plans that you may choose from for yourself or for yourself and your dependents. The medical plans are provided through the Arizona Technology Council (AZTC). AZTC contracts with Blue Cross Blue Shield of Arizona to use their PPO plans with either the Alliance Network or the Statewide Network. The medical plans provide major medical coverage to include hospitalization, physician and emergency room visits, prescriptions, telemedicine (BlueCare Anywhere) and more. To search for a Blue Cross Blue Shield of Arizona PPO provider in either the Alliance or Statewide networks, visit azblue. com/member after you are enrolled or call 602.864.4400.
5
2024-2025 BCBS of Arizona Medical Plans Network Lifetime Maximum Calendar Year
Deductibles Individual Family Coinsurance Out-of-Pocket Max Individual Family Hospital Services Inpatient Hospital Outpatient Hospital Emergency Room Urgent Care Routine Services Office Visit Specialist Visit Preventive Care Lab & X-Ray Prescription Drugs Tier 1 Tier 2 Tier 3 Tier 4 Mail-Order
PPO 1500
PPO 1500
In Network
In Network
Alliance
Statewide PPO
Unlimited
Unlimited
Unlimited
Unlimited
$1,500
$1,500
$3,000
$3,000
80%
80%
$5,000
$5,000
$10,000
$10,000
20% After Deductible
20% After Deductible
20% After Deductible
20% After Deductible
$350 Copay
$350 Copay
$50 Copay
$50 Copay
$25 Copay
$25 Copay
$50 Copay
$50 Copay
Covered In Full
Covered In Full
Copay OR 20% After Deductible
Copay OR 20% After Deductible
$15 Copay
$15 Copay
$45 Copay
$45 Copay
$75 Copay
$75 Copay
$130 Copay
$130 Copay
2x Copay
2x Copay
Certain maintenance medications are available at network retail pharmacies for 2.5x copay for a 90-day supply. Mail-Order for these medications are available at only 2x copay.
6
ALLIANCE
ETWORK
BCBS Alliance Network
Alliance network from Blue Cross® Blue Shield® of Arizona vers on our commitment to improve care quality and create tter healthcare experience—while lowering costs.
network of doctors and hospitals that are close d convenient
he Alliance network is for residents of Maricopa and Pinal counties.
The Alliance network from Blue Cross® Blue Shield® of Arizona delivers
he network features doctors and hospitals affiliated with Banner on our commitment to improve care quality and create a better healthe ealth and HonorHealth. care experience—while lowering costs.
unties. keep your healthcare costs lower, it is important to use a
A network of doctors and hospitals that are close and convenient nner articipating lab or imaging service such as Sonora Quest
aboratories, Banner Imaging, Southwest Diagnostic Imaging, ✓ The Alliance network is for residents of Maricopa and Pinal counties. nd Sun Radiology. ✓ The network features doctors and hospitals affiliated with Banner
,
Health and HonorHealth. nly providers contracted with the Alliance network are considered ✓ dered To keep your healthcare costs lower, it is important to use a particin-network. ” Please check with your doctors, facilities, and other ther pating lab or imaging service such as Sonora Quest Laboratories, work professionals to make sure they are in the ealth Alliance network Banner Imaging, Southwest Diagnostic Imaging, and Sun Radiology. efore receiving care.
ailable
✓ Only providers contracted with the Alliance network are considered
ure nding in-network care is easy with the Find a Doctor tool, available “in-network.” Please check with your doctors, facilities, and other e SM azblue.com/findadoctor or on the MyBlue AZ app. Be sure to make sure they are in the Alliance network health professionals search for providers in the Alliance network, indicated at the before receiving care. etwork p-right of the search page. ✓ Finding in-network care is easy with the Find a Doctor tool, avail-
able at azblue.com/findadoctor or on the MyBlue AZSM app. Be sure Alliance to searchNetwork for providers in the Alliance network, indicated at the top-right of the search page.
CAVE CREEK
Wickenburg Community Hospital
WICKENBURG
SCOTTSDALE HonorHealth Scottsdale Thompson Peak Medical Center
John C Lincoln er
HonorHealth Scottsdale Shea Medical Center/Piper Surgery Center
1
NEW RIVER
HonorHealth Scottsdale Greenbaum/Osborn Medical Center 202
al Center
Banner Desert Medical Center
TEMPE
10
MESA 60
Banner Baywood Medical Center Banner Goldfield Medical Center Banner Gateway
GILBERT Medical Center
CHANDLER
17
CAVE CREEK
Banner Heart Hospital
PEORIA Cobre Valley Regional Medical Center
60
APACHE JUNCTION
PHOENIX
QUEEN CREEK
Banner Del E Webb Medical Center
Banner Ironwood Medical Center
SCOTTSDALE
HonorHealth Deer Valley Medical Center HonorHealth Scottsdale Thompson Peak Medical Center
101
SURPRISE
er Casa Grande Medical Center
SUN CITY
See reverse side Banner Boswell Medical Center BUCKEYE
HonorHealth John C Lincoln Medical Center Banner Thunderbird Medical Center
HonorHealth Scottsdale Shea Medical Center/Piper Surgery Center
51 HonorHealth Scottsdale Greenbaum/Osborn Medical Center
Banner Estrella Medical Center Core Institute Specialty Hospital
202
10 Banner University Medical Center Phoenix Campus
Banner Desert Medical Center
TEMPE
GOODYEAR
Banner Heart Hospital
MESA 60 GILBERT
Banner Baywood Medical Center Banner Goldfield Medical Center Banner Gateway Medical Center
Cobre Valley Regional Medical Center
APACHE JUNCTION
AVONDALE
10 Banner Casa Grande Medical Center
CHANDLER
QUEEN CREEK Banner Ironwood Medical Center
7
See reverse sid
Hospitals/Medical Centers in the Alliance Network
Location
Banner Baywood Medical Center
6644 E. Baywood Ave., Mesa, AZ 85206
Banner Boswell Medical Center
10401 W. Thunderbird Blvd., Sun City, AZ 85351
Banner Casa Grande Medical Center
1800 E. Florence Blvd., Casa Grande, AZ 85122
Banner Del E Webb Medical Center
14502 W. Meeker Blvd., Sun City West, AZ 85375
Banner Desert Medical Center
1400 S. Dobson Rd., Mesa, AZ 85202
Banner Estrella Medical Center
9201 W. Thomas Rd., Phoenix, AZ 85037
Banner Gateway Medical Center
1900 N. Higley Rd., Gilbert, AZ 85234
Banner Goldfield Medical Center
2050 W. Southern Ave., Apache Junction, AZ 85120
Banner Heart Hospital
6750 E. Baywood Ave., Mesa, AZ 85206
Banner Ironwood Medical Center
37000 N. Gantzel Rd., San Tan Valley, AZ 85140
Banner Thunderbird Medical Center
5555 W. Thunderbird Rd., Glendale, AZ 85306
Banner University Medical Center Phoenix Campus
1111 E. McDowell Rd., Phoenix, AZ 85006
Cobre Valley Regional Medical Center
5880 N. Hospital Dr., Globe, AZ 85501
HonorHealth Deer Valley Medical Center
250 E. Dunlap Ave., Phoenix, AZ 85020
HonorHealth Greenbaum Surgical Specialty Hospital
3535 N. Scottsdale Rd., Scottsdale, AZ 85251
HonorHealth John C Lincoln Medical Center
250 E. Dunlap Ave., Phoenix, AZ 85020
HonorHealth Piper Surgery Center
9007 E. Shea Blvd., Scottsdale, AZ 85260
HonorHealth Scottsdale Greenbaum/Osborn Medical Center
7400 E. Osborn Rd., Scottsdale, AZ 85251
HonorHealth Scottsdale Shea Medical Center/Piper Surgery Center
9003 E. Shea Blvd., Scottsdale, AZ 85260
HonorHealth Scottsdale Thompson Peak
7400 E. Thompson Peak Pkwy., Scottsdale, AZ 85255
The Core Institute Specialty Hospital
6501 N. 19th Ave., Phoenix, AZ 85015
Wickenburg Community Hospital
520 Rose Ln., Wickenburg, AZ 85390
Urgent-Care/Retail Health Clinics Did you know that urgent-care centers and retail health clinics can treat many injuries and illnesses, and often cost less than an emergency room? However, visits to retail health clinics, urgent-care centers, and emergency rooms are not a substitute for an ongoing relationship with a primary care physician. In a true emergency, always dial 911 first.
For more information, please call the number on the back of your member ID card.
8 ©2022 Blue Cross Blue Shield of Arizona, Inc. All rights reserved. D32277 07/22
NT-MB-0362-072022
1049905-22
Blue Cross, Blue Shield, and the Cross and Shield Symbols are registered service marks, and MyBlue AZ is a service mark, of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.
Telehealth Services NURSE ON CALL Members can connect with a nurse 24/7 to get answers to questions about symptoms they are experiencing, minor illnesses and injuries, medical tests, or preventive care, as well as suggestions for next steps based on their situation.1
BLUECARE ANYWHERESM With BlueCare Anywhere, members can connect to board-certified doctors by live video for urgent medical care, psychiatry, and counseling sessions. The BlueCare Anywhere telehealth service is available any day, any time—from a computer, tablet, or mobile device.
MEDICAL Board-certified doctors provide immediate care for a range of common illnesses, aches, and pains, and can prescribe medication.
COUNSELING Licensed psychologists or counselors are available to treat issues—such as mental health and substance use—that can affect emotional, psychological, and social well-being.
Download the BlueCare Anywhere mobile app2 or visit BlueCareAnywhereAZ.com. Call 911 in an emergency. 1 BCBSAZ members should always consult with their healthcare provider about medical care or treatment. Recommendations, advice, services, or online resources are not a substitute for the advice, opinion, or recommendation of a healthcare provider.
Your wireless plan’s phone and data rates may apply. Search for “MyBlue AZ” and “BlueCare Anywhere” in the Google Play™ or Apple® App Store® online marketplaces.
2
Apple and App Store are trademarks of Apple Inc., registered in the U.S. and other countries. Google Play is a trademark of Google Inc.
PSYCHIATRY Board-certified psychiatrists are available for assessments, evaluation, treatment, and can prescribe medication. By appointment only.
9
9
Dental Plan BLUE CROSS BLUE SHIELD OF AZ BLUE PPO AND BLUE PPO PRIME NETWORK Individual
In Network
Out of Network
$50
$50
Family
$150
$150
Annual Plan Maximum
$1,000
$1,500
Type I (Deductible waived for Type I services) Diagnostic & Preventive Services
100%
80%
Exams
100%
80%
Cleanings
100%
80%
Bitewing x-rays
100%
80%
Floride treatment
100%
80%
80%
60%
Type II Basic Services Amalgam & composite fillings
80%
60%
Simple Extractions
80%
60%
Type III Major Services
50%
40%
Crowns
50%
40%
Dentures
50%
40%
Bridges Root canals Periodontal maintenance
50% 50% 50%
40% 40% 40%
The Aspire Business Consultants dental plan includes preventive services and office visits.
10
Vision Plan
Standard lenses are covered.
20% savings on additional glasses and sunglasses, including lens enhancements, from any VSP provider within 12 months of your last WellVision Exam
VSP VSP CHOICE NETWORK
In Network
Out of Network
Exam
$10 Copay
Reimbursed to $45
Frequency
Every 12 Months
Every 12 Months
Lenses
Covered 100%
Reimbursed to $65
Single/Bifocal/Trifocal
with no copay
depending on lens
Frequency
Every 12 Months
Every 12 Months
Frames
$150 Allowance ($80 Allowance at Costco)
Reimbursed to $70
Frequency
Every 24 Months
Every 24 Months
Contact Lenses (instead of glasses)
$150 Allowance
Reimbursed to $105
Every 12 Months
Every 12 Months
Average 15% off the regular price or 5% off the promotional price
Not covered
Lasik Surgery
11
MetLife Life Insurance BASIC LIFE INSURANCE AND AD&D Aspire Business Consultants pays 100% of the cost of this MetLife Term Life Insurance Policy. Coverage for each benefit eligible employee enrolled in on of the medical plans is $25,000 Life and AD&D Benefit. Life insurance provides protection for those who depend on you financially. Your need varies greatly
due to age, number of dependents, dependent ages and your financial situation. Accidental Death and Dismemberment (AD&D) benefits provide a benefit to you or your beneficiary if you are seriously injured or die in an accident.
VOLUNTARY SUPPLEMENTAL LIFE INSURANCE AND AD&D You can also elect to purchase additional life insurance from MetLife for yourself, your spouse and child(ren). • Employee: $10,000 increments to a maximum of $500,000. • Spouse: $5,000 increments to a maximum of $250,000 not to exceed 50% of the employee’s Supplemental Life Benefit. • Child(ren) to age 19 (23 years old if full-time student): $2,500. NOTE: If you are electing an amount above the Guaranteed Issue amount of $100,000 for an employ-
12
ee or $50,000 for your spouse/domestic partner, you MUST complete an Statement of Health form within 5 days of submitting your completed enrollment. Instructions for submitting your completed Statement of Health are included on the form. EMPLOYEES ENROLLING AFTER INITIAL ELIGIBILITY AT TIME OF HIRE (LATE ENTRANTS) or EMPLOYEES REQUESTING TO INCREASE COVERAGE: Any amount of coverage elected requires a Statement of Health. You MUST complete a Statement of Health within 5 days of submitting your completed enrollment. Return instructions are included on the form.
Employee Rate Sheet Use this sheet for your per-paycheck benefit costs for the upcoming plan year. This is a great place to start planning for your, and your family’s, health and wellness for next year.
MEDICAL PLANS
DENTAL PLAN
VISION PLAN
All prices are per payday based on 26 pays.
ALLIANCE NETWORK
STATEWIDE NETWORK
$0.00 $153.33 $153.05 $369.67
$84.56 $217.80 $208.72 $463.43
EMPLOYEE ONLY EMPLOYEE & SPOUSE EMPLOYEE & CHILDREN EMPLOYEE & FAMILY
$10.65 $21.28 $28.20 $38.31
$2.86 $5.72 $6.12 $9.78
Voluntary Supplemental Life / AD&D rates and enrollment forms were provided to you separately.
13
Employee Assistance Program Arizona Technology Council Your EAP is a confidential & professional resource-available 24/7-paid for byyour company and available to you and eligible dependents without cost. Benefits include:
COUNSELING ASSESSMENTS Up to 3 in-person meetings with a counselor.
For support: 1-866-607-4535
LEGAL SERVICES
wellspringeap.org | username: AZTC
Free initial 30-minute phone consultation; ongoing consultations with a lawyer at 25% off attorney’s regular fees; unlimited access to do-it-yourself legal documents online.
A service provided by
FINANCIAL SERVICES Free initial 30-minute phone consultation, and access to financial calculators and resource documents.
ID THEFT VICTIM RESOURCES Free initial 60-minute phone consultation, ID theft response kit, and prevention information.
DAILY LIVING INFORMATION SERVICES Unlimited phone or live chat consultations/requests for finding consumer services and resources.
CHILDCARE & PARENTING RESOURCES
SUBSCRIPTIONS Monthly emails featuring the webinar of the month, spotlight on an EAP benefit, and a feature article on well-being or productivity, with direct links to the website.
WELLSPRING STRESS CENTER™ Unlimited access to an online stress management and prevention center, including instant relief tools and longterm solutions.
Unlimited phone or live chat consultations
IN-THE-MOMENT SUPPORT
OLDER ADULT & ELDERCARE RESOURCES
24/7 access to a professional, masterslevel therapist who will help you manage your distress, create a plan of action, & provide resources (which may include referrals for further services).
Unlimited phone or live chat consultations
WEBSITE ACCESS Unlimited access to online resources including: • Live Chat with a resource consultant (for Childcare, Eldercare & Daily Living) • Online referral request • Skill builders/online trainings • Well-being & productivity content • Monthly live & on-demand webinars • Search tools
14
Important Phone Numbers Blue Cross Blue Shield of Arizona Medical / Dental 602.864.4400 www.azblue.com BlueCare Anywhere Telehealth www.BlueCareAnywhereAZ.com or Download the BlueCare Anywhere app MetLife Basic Life and Supplemental Life Insurance w/AD&D 800.275.4638 www.metlife.com
VSP Vision 800.877.7195 www.vsp.com www.eyeconic.com to use your VSP benefit for glasses or contacts online Heather Jones Aspire Business Consultants 602.881.2483 heather@aspirebc.net Wellspring EAP Employee Assistance Program 866.607.4535 www.wellspringeap.org Username: AZTC
15
About this booklet This booklet highlights important features of Aspire Business Consultants’ benefits for its benefit eligible employees. While efforts have been made to ensure the accuracy of the information presented, in the event of any discrepancies your actual coverage and benefits will be determined by the legal plan documents and the contracts that govern these plans.
Capital Financial 14614 N. Kierland Blvd., Suite N230, Scottsdale, AZ 85254 Office / 480.347.0926 Fax / 480.360.6417