Chino Valley USD, Employee Benefits Guide 2022-2023 by Educational Services, Inc.

Here’s to a

healthier you!

Employee Benefits Guide 2022 - 2023

TABLE OF CONTENTS Enrollment Information....................................................................... 3

Vision Plan....................................................................................................11

Qualifying Life Event.............................................................................. 4

Disability Information..........................................................................12

COBRA............................................................................................................. 4

Life / AD&D Insurance..........................................................................12

Medical Plan Information................................................................... 5

Flexible Spending Accounts............................................................13

Medical Plans.............................................................................................. 6

Employee Assistance Program..................................................... 14

Health Savings Account (HSA)........................................................ 7

Colonial Life.................................................................................................15

Telehealth...................................................................................................... 8

Employee Rate Worksheet...............................................................16

Live Well, Work Well............................................................................... 9

Medical Coverage Example..............................................................17

Dental Plan................................................................................................. 10

Important Phone Numbers.............................................................19

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. Chino Valley Unified School District is proud to offer you a broad range of benefit options. You can choose from a number of plans including medical, dental, vision, life insurance and voluntary supplement programs. In addition, we provide health care and dependent care reimbursement accounts to assist employees in managing their out-of-pocket expenses with before-tax dollars. 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.

If you should have any questions: 1. Contact the carrier directly. Phone number and website information is on page 19. 2. Contact Shelly Dailey, Human Resources Coordinator at 928.583.5421 or sdailey@chinovalleyschools.com This booklet highlights important features of Chino Valley Unified School District’s 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.

Enrollment Information OPEN ENROLLMENT

PRE-TAX VS POST-TAX DEDUCTIONS

Open Enrollment is from May 1 - 19, 2022. 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. Remember, you must choose pre-tax deductions for all your benefits to participate in a flexible spending account. You may elect to opt-out of this method of paying.

All benefit eligible employees are required to elect coverages via the application provided to you from Human Resources this year even if you are not making changes to your current elections. Your current elections will NOT roll over into the 2022/23 plan year. You are also required to re-elect medical/dependent FSA amounts for the new plan year.

Post-Tax Dollars: Some insurance premiums may be paid after taxes. Please contact Shelly Dailey for more information related to the specific premiums that are deducted post-tax.

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 31-day initial period of eligibility, you will be required to wait until the Annual Open Enrollment or until a Qualifying Life Event takes place. You may be turned down for these benefits if you do not enroll within your first 31 days as a new hire.

Qualifying Life Event

COBRA

The elections you make during Open Enrollment or at your initial benefits eligibility will remain in effect for the plan year (July 1, 2022 – June 30, 2023). 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 Human Resources and providing the proper documentation.

In most cases, if your employment ends, benefits will terminate on the last day of the month in which you worked. Benefits will end on the day of termination in cases of employee fraud.

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. ■

■

All changes must be consistent with the qualifying life event. In some cases, you can change your benefit plan and modify the level of coverage (such as add or delete dependent).

Any changes in benefit levels must be completed within 31 days of the qualifying life event.

QUALIFYING LIFE EVENTS LIST Marital Status Changes

Covered Dependent Changes

• • • •

• Birth or adoption of a child • Death of dependent child • Dependent becomes ineligible for coverage

Marriage Death of spouse Divorce Spouse gains or loses coverage from another source • Spouse employer’s Open Enrollment

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 Chino Valley Unified School District benefit plan immediately preceding the employee’s COBRA event has the right to continue his or her medical, dental, vision, or Flexible Spending Accounts (FSA) 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

The Trust that will provide medical insurance to Chino Valley Unified School District.

The network Chino Valley Unified School District will use for hospitals and physicians.

The company that will process Chino Valley Unified School District’s medical claims.

1 Kairos Chino Valley USD 2

United Healthcare Choice Plus

UMR

SUMMARY Medical benefits provide you and your family access to quality health care. Chino Valley Unified School District offers you three medical plans with different coverage levels from which to choose. All plans are provided through Kairos Health Arizona. Kairos contracts with UnitedHealthcare to use their network with claims processing and customer service being provided by UMR. To contact UMR for questions about medical information and ID cards, please go to umr.com or contact them at 844.212.6811.

UMR CONTACT

umr.com

Medical Plans Copay Plan Lifetime Maximum

In Network

HDHP $2,500*

HDHP $5,000

with Health Savings Account

In Network

Unlimited

Individual

$750

$2,500

$5,000

Family

$1,500/employee +1 OR $2,250/employee +2 or more 20%

$5,000**

$10,000

20%

Individual

$5,000

$3,450

$6,450

Family

$10,000

$6,550**

$12,900

Inpatient Hospital

Deductible, then 20%

Outpatient Hospital

Deductible, then 20%

Emergency Room

Deductible, then 20%

Urgent Care

$50 Copay

Deductible, then 20%

Office Visit

$25 Copay

Deductible, then 20%

Specialist Visit

$50 Copay

Deductible, then 20%

Preventive Care

Covered in Full

Lab & X-Ray

Deductible, then 20%

Tier 1

$10 Copay

Deductible, then $10 Copay

Tier 2

$60 Copay

Deductible, then $60 Copay

Tier 3

$110 Copay

Deductible, then $110 Copay

Mail-Order (90-day supply)

$20/$120/$220

Deductible, then $20/$120/$220

Preventive Medications

Covered in Full

Ambulatory Surgical Center

$250 Copay

Deductible, then 20%

Non-Hospital Infusion Center

$250 Copay

Deductible, then 20%

Non-Hospital Radiology Center

$75 Copay

Deductible, then 20%

Non-Hospital Lab/Pathology

$25 Copay

Deductible, then 20%

Calendar Year

Deductibles

Coinsurance Out-of-Pocket Maximum

Hospital Services

Routine Services

Prescription Drugs

**If you have Family coverage under the $2,500 HDHP, the Family Deductible must be satisfied before the Plan will pay any benefits (except for preventive/wellness care) and the Family out-of-pocket maximum will apply.

Hearing aids are now covered under the medical plans and coverage includes one hearing aid every 3 years, per impaired ear, up to $3,000 6

Health Savings Account (HSA) If you choose to enroll in either of the High Deductible Health Plans (HDHP), you will have the option of opening an HSA provided by HealthEquity. An HSA is a tax advantaged savings and spending account that can be used to pay for qualified health care expenses.

THERE ARE TWO COMPONENTS TO AN HSA-BASED COVERAGE PLAN: 1. A qualified health plan is the insurance component that provides medical coverage to you and your family.

The District will contribute $1,872 annually ($156/month) to your Health Savings Account if you enroll in the HDHP $5,000 as employee only.

2. An HSA with HealthEquity which can be funded by pre-tax payroll contributions from you, the District, or both.

Questions? Visit www.healthequity.com or contact HealthEquity at 866.346.5800.

HOW AN HSA WORKS: 1. Enroll in the $2,500 HDHP or the $5,000 HDHP plans offered by the District

The money contributed to the account is yours to keep and will roll over year after year – no ‘use it or lose it’ rule!

2. Contribute to your HSA by payroll deductions on a pre-tax basis: ■ ■ ■

Up to $3,650 for single coverage Up to $7,300 if you enroll a dependent An additional $1,000 if you are age 55 or older

3. With your HSA debit card, use your HSA funds to pay for qualified expenses such as: ■ ■ ■ ■

copays deductibles chiropractor dental treatment

■ ■ ■ ■

hearing aids glasses/ contacts prescriptions over the counter drugs and medications

HSA ELIGIBILITY To make tax-free contributions to an HSA, the IRS requires that: ■ ■ ■

You are covered by an H.S.A qualified plan (such as the HDHP 2500 and HDHP 5000) You are not enrolled in any other plan that is not considered a High Deductible Health Plan. You are not enrolled in Medicare, medical FSA or have other military health benefits.

Telehealth Teladoc-24/7/365 on-demand access to affordable, quality healthcare. Anytime, Anywhere. Regardless of the plan you choose you should never be without Teladoc, the only 24/7 telehealth and wellness service designed for the modern family. Whenever you have an issue, simply connect with a Teladoc board-certified doctors, available by phone, video or chat. They are specially trained to diagnose, treat and prescribe medications for a wide variety of common medical conditions, helping you avoid the costly and time-consuming trips to the doctor or urgent care centers. ■

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Talk to a real doctor, 24/7. No need to schedule an appointment or limit your visits. Save money and time, while avoiding costly trips to a doctor’s office, urgent care or ER.

What can be treated? ■ ■ ■ ■ ■ ■ ■ ■ ■

Acne Allergies Asthma Bronchitis Cold & Flu Constipation Diarrhea Ear Infection Fever

■ ■ ■ ■ ■ ■ ■ ■ ■

Headache Insect Bite Joint Aches Nausea Rashes Sinus Infection Sore Throat UTI And more!

teladoc.com 1.800.835.2362

Download the Teladoc app for easier access!

When should I use Teladoc? ■

■

Instead of going to the ER or an urgent care center for a non-emergency issue During or after normal business hours, nights, weekends and holidays

■

If your primary care physician is not available

■

To request prescriptions (when appropriate)

■

If traveling and in need of medical care

Are my children eligible? ■

Yes! Teladoc has pediatricians on call 24/7

Live Well, Work Well EMERGENCY ROOM OR URGENT CARE? More than 10% of all emergency room visits could have been better addressed in either an urgent care facility or a doctor’s office. If you’re suddenly faced with symptoms of an illness or injury, how can you determine which facility is most appropriate for your condition?

Emergency Room (ER) Emergency rooms are equipped to handle life-threatening injuries, illnesses and other serious medical conditions. An emergency is a condition that may cause loss of life or permanent or severe disability if not treated immediately. You should go directly to the nearest emergency room if you experience any of the following: ■ ■ ■ ■ ■

■ ■ ■ ■ ■ ■

Chest pain Shortness of breath Severe abdominal pain following an injury Uncontrollable bleeding Confusion or loss of consciousness, especially after a head injury Poisoning or suspected poisoning Serious burns, cuts or infections Inability to swallow Seizures Paralysis Broken bones

Patients at the emergency room are sorted, or triaged, according to the seriousness of their condition. For example, a patient with severe injuries from a car accident would likely be seen before a child with an ear infection, even if the child was brought in first. Those who go to the ER with relatively minor injuries or

illnesses often have to wait more than an hour to be seen, depending on the severity of the other patients’ conditions. Often they could have been seen more quickly at an urgent care facility.

Urgent Care Urgent care centers are usually located in clinics or hospitals, and, like emergency rooms, offer after-hours care. Unlike emergency rooms, they are not equipped to handle life-threatening situations. Rather, they handle conditions that require immediate attention— those where delaying treatment could cause serious problems or discomfort. Some examples of conditions that require urgent care are these: ■ ■ ■ ■ ■

Ear infections Sprains Urinary tract infections Vomiting High fever

Urgent care centers are usually more cost-effective than ERs for these conditions. In addition, the waiting time in urgent care centers is usually much shorter. Choosing the appropriate place of care can not only ensure prompt medical attention but will also help reduce any unnecessary expenses.

KAIROS HAS DEDICATED NURSES TO HELP YOU! Navigating the health care system and insurance can be complicated and leave you feeling overwhelmed. That’s where Kairos can assist. Through their Clinical Advocacy Program, they have dedicated in-house nurses to help guide you and your family through the health care system, choose the best treatment, and keep costs to a minimum. You will have a champion in your corner with a clinical background, an understanding of the Kairos insurance coverage, a sensitivity to patient needs, and a genuine desire to help.

Examples of ways our nurses can help you and your family: ■

■

acting as a liaison between the patient, doctor,and insurance; facilitating the use of manufacturer’s medication programs; finding assistance, if needed, through community assistance programs; providing guidance through the prior authorization (PA) process; and coordinating with health care providers when alternative site of care is needed.

Dental Plan DELTA DENTAL PPO In Network Annual Deductibles Individual

$50

Family

$150

Annual Plan Maximum

$1,500

Benefits Type 1 - Diagnostic & Preventive 100% In / 100% Out

Type II - Basic Service

80% In / 80% Out

Type III - Major Services

50% In / 50% Out

Orthodontic Benefits Orthodontia Age Limitation

19; Banded prior to Age 17

Lifetime Maximum

50% to $1,500

Lifetime Deductible

N/A

Adult Orthodontia

N/A

Other Benefits Periodontic Coverage

80% In / 80% Out

Endodontic Coverage

80% In / 80% Out

* In and out-of-network coverage available, however, you will pay more when using an out-of-network provider.

The dental plan includes preventive services and office visits.

Vision Plan

Standard lenses are covered.

AVESIS VISION OPTION In Network

Out of Network

Exam

$10 Copay

Reimbursed to $35

Frequency

Every 12 Months

Lenses

Covered 100%

Reimbursed to $25 to $80

Single/Bifocal/Trifocal/

after $10 copay

depending on lens

Frequency

Every 12 Months

Frames

$50 Wholesale Allowance up to $150 Retail Value

Reimbursed to $45

Frequency

Every 24 Months

Contact Lenses

Medically Necessary

(In lieu of frames

Covered in Full

Reimbursed to $250

and lenses)

Elective

$130 Allowance

Reimbursed to $130

Every 12 Months

Lenticular

Frequency

Disability Information

Life / AD&D Insurance

Disability coverage can be one of the most important benefits you have. It provides you and your family with financial protection if you are ever unable to work due to an illness or non-work related injury.

BASIC LIFE INSURANCE AND AD&D

SHORT TERM DISABILITY Chino Valley Unified School District offers a voluntary benefit through Colonial Life. Please refer to the materials provided by Human Resources.

LONG TERM DISABILITY All employees who work 20 or more hours per week for 20 weeks per year will pay premiums through mandatory contributions to Arizona State Retirement System (ASRS) for Long Term Disability (LTD). Elimination period:

180 Days

Benefit Amount: 66 2/3% of monthly base salary as determined by ASRS

Chino Valley Unified School District pays 100% of the cost of The Hartford Term Life Insurance Plan. Coverage for each benefit eligible employee is $20,000 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. Please note that your life benefit will reduce by 35% at age 65, by 60% of the original amount at age 70 and by 75% of the original amount at age 75.

Flexible Spending Accounts The Health Care Spending Account (HCSA) and the Dependent Care Spending Account (DCSA) allow you to reduce your taxable income by paying for out-ofpocket health care and dependent day care expenses with pre-tax dollars. Since these accounts are to be used for predictable expenses, careful planning is required.

HEALTH CARE SPENDING ACCOUNT (HCSA)

How it Works: ■

■

You make before-tax deposits (via payroll deductions) to your HCSA.

DEPENDENT CARE SPENDING ACCOUNT (DCSA)

How it Works: You make before-tax deposits (via payroll deduction) to your Dependent Care Spending Account. You can deposit from $500 to $5,000 per year. In some cases, your maximum allowed annual contribution may be less than $5,000. For example: ■

You can deposit from $500 to $2,850 per year. ■

■

Eligible expenses for both you and eligible family members are covered. You or your family members do NOT have to be enrolled in CVUSD’s health insurance to participate in the Health Care Spending Account. When you or an eligible family member has a medical expense, you pay for the expense via debit card.

■

All expenses must be incurred between July 1, 2022 and June 30, 2023 while you are employed. If your employment terminates or you change to non-benefit-eligible status, your “plan year” will end effective the last day of the month in which the change occurred. Eligible expenses must be incurred before that date. If you do not use the money in this account through the plan year, the balance will be forfeited.

■

If you are married and your spouse contributes to a similar account, your combined contributions may not exceed $5,000 per year. If you are married but file separate tax returns, your annual contribution is limited to $2,500. Your contributions cannot exceed the amount of your income or your spouse’s income, whichever is lower. Expenses for DCSA must be incurred between July 1, 2022 and June 30, 2023. If you do not use the money in this account through the plan year, the balance will be forfeited. For reimbursement of an eligible expense, you pay the bill and then submit a claim form for reimbursement.

You must include an original receipt from your dependent care provider and report the provider’s taxpayer ID.

IRS RULES FOR ALL FLEXIBLE SPENDING ACCOUNTS ■

■

Your deposit amount cannot be changed, stopped or started during the year for any reason, unless you have a Qualifying Life Event (see page 3). Only those expenses that are considered tax deductible by the IRS, as listed in Publication 502, are eligible for reimbursement. IRS guidelines can be found at http://www.irs.gov/publications/p969/ar02.html

Employee Assistance Program KAIROS Health Arizona, Inc. in cooperation with the Trust has contracted with ComPsych to provide employees up to 6 face to face sessions per issue per year at no cost to you. Short-term counseling, legal/financial consultations and work-life services are are provided to employees and their families at no cost. You can speak to a master’s level counselor who can help with almost any issue ranging from medical and family matters to personal, emotional, legal or financial needs.

After 6 sessions, if additional face to face visits are needed, an EAP representative will assist in referring you to a professional in the UnitedHealthcare Network.

Contact ComPsych at 833-955-3386 24 hours a day / 7 days a week. Or, visit guidedresources.com and login using the Web ID: KairosEAP

Colonial Life Colonial Life & Accident Insurance Company is pleased to offer Chino Valley Unified School District employees and qualified dependents the opportunity to elect coverage under several Colonial Life policies. A few things to remember about these policies: ■

■

A Colonial Life policy is separate from the other policies listed in this book. Colonial Life does not replace your medical insurance coverage.

ACCIDENT This plan pays cash benefits in the event of an accidental injury that needs emergency treatment.

CRITICAL ILLNESS & CANCER This plan pays cash benefits for an individual diagnosed with cancer.

Colonial Life pays you directly, no matter what other insurance you may have. You can enroll in one or all of the policies and are eligible to participate in these policies the first of the month following date of hire.

To enroll in these policies, please complete the application provided to you by Human Resources. You may call Noah Oropeza at 623.760.8780 to discuss any questions you may have on any of the plans.

MEDICAL BRIDGE This plan pays cash benefits when an individual is confined in a hospital. It also provides HSA-compliant coverage.

SHORT-TERM DISABILITY This plan provides paycheck protection with partial income replacement if you miss work due to off-job injury or sickness.

Employee Rate Worksheet 2022-2023 MEDICAL PLANS

EMPLOYEE ONLY EMPLOYEE & SPOUSE EMPLOYEE & CHILDREN EMPLOYEE & FAMILY

COPAY PLAN

HDHP 2500

HDHP 5000

MONTHLY $238.00 $1221.00 $1043.00 $2029.00

MONTHLY $0.00 $725.00 $592.00 $1318.00

MONTHLY $0.00 $396.00 $296.00 $847.00

DENTAL PLAN EMPLOYEE ONLY EMPLOYEE & SPOUSE EMPLOYEE & CHILDREN EMPLOYEE & FAMILY

VISION PLAN

MONTHLY $41.00 $83.00 $69.00

MONTHLY $6.21 $10.85 $13.02

$107.00

$16.13

DEPENDENT LIFE

$5.02/MONTH

The District pays $658/month ($7,896/year) towards the Copay and HDHP 2500 plans. The District pays $502/month ($6,024/year) towards the HDHP 5000 and $1,872/year ($156/mo) to the Health Savings Account (HSA) when enrolled in the HDHP 5000 as employee only. If enrolling in HDHP 5000 with dependents, the district will contribute the $1,872 to the premium rather than the HSA (this has been accounted for in the rates shown above).

Medical Coverage Example The following examples show how each plan might cover medical care in given situations. Use these examples to see, in general, how much financial protection a sample patient might get if they are covered under the different plans available at Chino Valley Unified School District. Each example assumes self-only coverage and reflects CVUSD’s HSA yearly contribution for those that enroll in self-only coverage in the HDHP 5000 plan. You may contribute to your HSA if you are enrolled in either the HDHP 2500 or HDHP 5000 plans up the the yearly maximum (including any CVUSD contributions) on a tax-free basis to further reduce your costs.

Example 1 Managing a Well-Controlled Condition

Total Charges

$5,600

Copay Plan

HDHP 2500

HDHP 5000

Deductibles

$200

$2,500

$5,000

Copays

$2,000

$800

$100

Coinsurance

$200

$100

Limits or Exclusions

$20

Patient Pays

$2,220

$3,520

$5,220

Annual Employee Premuim

$2,856

Less HSA Funds

$1,872

Total Employee Cost

$5,076

$3,520

$3,348

Total Charges

$12,700

Routine maintenance of Type 2 Diabetes.

Example 2 Having a Baby

The cost of a normal delivery including services for the obstetrician, hospital or birthing center, anesthesiologist and pediatrician. Copay Plan

HDHP 2500

HDHP 5000

Deductibles

$750

$2,500

$5,000

Copays

$200

$20

Coinsurance

$1,800

$900

$1,300

Limits or Exclusions

Patient Pays

$2,750

$3,420

$6,320

Annual Employee Premuim

$2,856

Less HSA Funds

$1,872

Total Employee Cost

$5,606

$3,420

$4,448

The information on this page should be used as an estimate and is not a price guarantee. Coverage examples are not cost estimators. They are for comparative purposes only. Your own costs will be different depending on the care you receive, the prices your providers charge, and the reimbursement your health plan allows. Before seeking treatment we recommend that you call the provider to verify they are currently in your network and confirm their in-network price for healthcare services you need.

Important Phone Numbers UnitedHealthcare / UMR

Shelly Dailey

Medical 844.212.6811 umr.com

Human Resources Coordinator 928.583.5421 sdailey@chinovalleyschools.com

HealthEquity

MaxorPlus

Health Savings Account 866.346.5800 www.healthequity.com

Prescription Drug Questions 800.687.0707 maxorplus.com

Delta Dental

Flexible Spending Account (FSA)

Dental PPO 800.352.6132 www.deltadentalaz.com

888.331.0222

Avesis Vision 800-522-0258 www.avesis.com

ComPsych EAP 833.955.3386 guidedresources.com Web ID: KairosEAP

Arizona State Retirement System Long Term Disability 520.239.3100 800.621.3778 www.azasrs.gov

Teladoc 800.835.2362 teladoc.com

Colonial Life Noah Oropeza 623.760.8780

Kairos Member Services General plan questions 888.331.0222 Member Website - svc.kairoshealthaz.org

ABOUT THIS BOOKLET This booklet highlights important features of Chino Valley Unified School District’s 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

Chino Valley USD, Employee Benefits Guide 2022-2023

Articles inside

Colonial Life

Vision Plan

Health Savings Account (HSA

Flexible Spending Accounts

Live Well, Work Well

Dental Plan

Employee Assistance Program

Enrollment Information

Telehealth