Employee Benefits Guide 2022 - 2023 Here’s to a healthier you!
TABLE OF CONTENTS
Enrollment Information 3
Qualifying Life Event 4 COBRA 4
Medical Plan Information . . . . . . . . . . . . . . . . . . . 5 Medical Plans 6 Health Savings Account (H S A ) 7 Telehealth 8 Dental Plans 9
Vision Plan 10
Flexible Spending Accounts 11 Life & Disability Insurance 12 Employee Assistance Program . . . . . . . . . . . . . . 13 Trustmark 14 Core Benefit Rate Sheet 15 Important Phone Numbers & Websites 16
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
Maricopa 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, and voluntary supplemental 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 yourself and your family
If you should have any questions:
1 Contact the carrier directly Phone number and website information is on page 16
2 Contact the Human Resources Department at 520-568-5100 ext 1060 or saguilar-nelson@musd20.org .
This booklet highlights important features of Maricopa 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 .
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Enrollment Information
OPEN ENROLLMENT
Open Enrollment is from April 14th through April 30th, 2023 This is your one time per year to make changes
All employees are required to login to the online enrollment platform and make your elections
New Employees have 30 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 30 days from the new benefits eligible status date to complete your enrollment All insurance coverage starts at the first of the following month.
Remember, if elections are not made within the 30-day initial period of eligibility, you will be required to wait until Annual Open Enrollment or until a Qualifying Life Event takes place.
WHO IS ELIGIBLE?
Employees who work 30+ hours per week are eligible for benefits. Your eligible dependents include your legally married spouse and your child(ren) up to age 26
PRE-TAX VS POST-TAX DEDUCTIONS
Pre-Tax Dollars: Your insurance premiums are paid with money deducted 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 .
Post-Tax Dollars: Some insurance premiums may be paid after taxes Please contact Human Resources for more information related to the specific premiums that are deducted post-tax
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Qualifying Life Event
The elections that you make during Open Enrollment or at 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 as per 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 Human Resources Department and providing the proper documentation
IRS regulations govern which circumstances allow you to 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 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 30 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) Contact Human Resources for the COBRA premium
Each individual who is covered by a Maricopa 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
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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
Medical Plan Information
The company that will provide medical insurance to Maricopa Unified School District.
AmeriBen
The network Maricopa Unified School District will use for hospitals and physicians
The company that will process Maricopa Unified School District’s prescription drug benefits.
SUMMARY
Medical benefits provide you and your family access to quality health care. Maricopa Unified School District offers two medical plans with different coverage levels from which to choose All plans are provided through AmeriBen. AmeriBen contracts with Blue Cross Blue Shield of Arizona to use their network, with claims processing and customer service being provided by AmeriBen
To contact Ameriben, please go to ameriben.com/MyAmeribenLogin.htm or contact them at 800-786-7930
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1 2
Maricopa USD
Flipt / Vivio
1 2
BCBSAZ
3 3
AMERIBEN CONTACT ameriben.com
Medical Plans
HDHP with Health Savings Account PPO Plan In Network In Network
Lifetime Maximum Unlimited Unlimited Calendar Year Unlimited Unlimited
Deductibles
Individual $2,800 $1000 Family $5,600 $3,000 Coinsurance 20% 20%
Out-of-Pocket Maximum Individual $6,350 $6,350 Family $12,700 $12,700
Hospital Services
Inpatient Hospital
Deductible, then 20% Deductible, then 20% Outpatient Hospital Deductible, then 20% Deductible, then 20% Emergency Room Deductible, then 20% $250 Copay Urgent Care Deductible, then 20% $50 Copay
Routine Services
Office Visit
Deductible, then 20% $30 Copay Specialist Visit Deductible, then 20% $40 Copay Preventive Care Covered in Full Covered in Full Lab & X-Ray Deductible, then 20% Deductible, then 20% Chiropractic Deductible, then 20% $40 Copay Rehabilitation Deductible, then 20% Deductible, then 20%
Prescription Drugs
Tier 1
Deductible, then $15 Copay $15 Copay
Tier 2 Deductible, then $40 Copay $40 Copay
Tier 3 Deductible, then $70 Copay $70 Copay
Tier 4 Specialty Deductible, then cost varies by drug** No Charge** Mail-Order Deductible, then $37.50 / $100 / $175 $37.50 / $100 / $175
**Contact specialty pharmacy, Vivio Health for cost details by drug.
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Health Savings Account (H.S.A.)
If you choose to enroll in the High Deductible Health Plan (HDHP), you will have the option of opening an H S A provided by HealthEquity An H S A is a taxadvantaged savings and spending account that can be used to pay for qualified health care expenses
THERE ARE TWO COMPONENTS TO AN H.S.A.-BASED COVERAGE PLAN:
1 A qualified health plan is the insurance component that provides medical coverage for you and your family This health plan includes a deductible of $2,800 for individuals and $5,600 for family coverage
HOW AN H.S.A. WORKS:
1 Enroll in the HDHP offered by the district
2 Contribute to your H S A by payroll deductions: Up to $3,650 for an individual or $7,300 for a family
2 An H.S.A. bank account with Ameriflex which can be funded by pre-tax payroll contributions from you, the district, or both.
The district will match your contribution up to $250 each plan year.
3 With your HSA debit card, use those funds to pay for qualified expenses such as:
■ copays
■ deductibles
■ chiropractor
■ dental treatment
H.S.A. ELIGIBILITY
■ hearing aids
■ glasses/ contacts
■ prescriptions
The money contributed to the account is yours to keep and will roll over year after year – no ‘use it or lose it’ rule!
To make tax-free contributions to an H.S.A., the IRS requires that:
■ You are covered by an H.S.A.-qualified medical plan (such as the HDHP)
■ You have no other health coverage (such as other health plan, Medicare, military health benefits, medical FSA)
■ You cannot be claimed as a dependent on someone else’s taxes
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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
■ 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
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
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teladoc.com 1.800.835.2362 Download the Teladoc app for easier access!
Dental
Other
Periodontic
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Plans The dental plans include preventive services and office visits.
PPO Plans
Dental
Network
Deductibles
$50 Family $150
Plan Maximum Low Plan
High
- Diagnostic & Preven
Out
Service
Benefits
Maximum 50%
Deductible
Orthodontia
DELTA DENTAL
CIGNA
HMO In
Annual
Individual
Annual
- $1,500
Plan - $2,500 Benefits Type 1
tive 100% In / 100%
Type II - Basic
80% In / 80% Out Type III - Major Services 50% In / 50% Out Orthodontic
Lifetime
to $1,000 Lifetime
N/A Adult
N/A
Benefits
Coverage
Coverage
Dental Discount Plan IN NETWORK Coverage ONLY
examples: ■ Routine Office Visit: No Charge ■ Oral Exam (Periodic): No Charge ■ Routine Cleaning: No Charge ■ Amalgam Restoration: $22 Copay ■ Porcelain Crown: $470
Features ■ Adult and Child Orthodontic coverage offered ■ No Annual Maximum ■ Must Use Your
you
80% In / 80% Out Endodontic
80% In / 80% Out * In and out-of-network coverage available, however, you will pay more when using an out-of-network provider. Pre-Paid
Coverage
Copay Please refer to the materials provided by Human Resources for the complete schedule of benefits. Plan
Selected Dentist within the Cigna Dental Care Access Plus Network for
and any covered family members
10 Vision Plan SIGHTCARE SightCare Network Out of Network Exam $10 Copay Reimbursed to $35 Frequency Every 12 Months Every 12 Months Lenses Covered 100% Reimbursed: $25 - $80 Single/Bifocal/Trifocal/ depending on lens Lenticular Frequency Every 12 Months Every 12 Months Frames $130 Allowance $68 Walmart/Costco Allowance Reimbursed to $45 Frequency Every 12 Months Every 12 Months Contact Lenses (instead of glasses) $130 Allowance Reimbursed to $130 Every 12 Months Every 12 Months Standard lenses are covered.
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-of-pocket 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)
To help you pay for predictable out-of-pocket, un-reimbursed medical and dental expenses for yourself and your family, Maricopa Unified School District is offering a Health Care Spending Account
How it Works:
■ You make pre-tax deposits (via payroll deductions) to your HCSA
■ You can deposit from $100 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 MUSD’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 FSA 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 job status resulting in a loss of benefit eligibility, 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
■ You may not enroll in both the HDHP (with Health Savings Account) and the HCSA .
DEPENDENT CARE SPENDING ACCOUNT (DCSA)
You can use a Dependent Care Spending Account (DCSA) to accumulate pre-tax funds that you will use to reimburse yourself for dependent care expenses that you incur so that you, and/or your spouse (if married), can work or attend school.
How it Works:
You make pre-tax deposits (via payroll deduction) to your Dependent Care Spending Account. You can deposit from $100 to $5,000 per year.
In some cases, your maximum allowed annual contribution may be less than $5,000. For example:
■ If you are married and your spouse contributes to a similar account, your combined contributions may not exceed $5,000 per year.
■ Your contributions cannot exceed the amount of your income, or your spouse’s income, whichever is lower
For reimbursement of an eligible expense, you pay the bill and then submit a claim form for reimbursement Reimbursement is processed based on payroll contributions collected
All expenses must be incurred between July 1, 2022 and June 30, 2023. If you do not use all the money in this account, it will be forfeited after June 30, 2022.
IRS RULES FOR FLEXIBLE SPENDING ACCOUNTS
■ Your deposit amount cannot be changed, stopped or started during the year, unless you have a change in family or job status
■ 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 or request Publication 969
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Life & Disability 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
SHORT TERM DISABILITY
Maricopa Unified School District offers voluntary short term disability coverage through Madison National Life (Ochs Inc )
Elimination Period: Base - 30 days / Buy-up - 14 days Accident and Sickness
Benefit Amount: 66.67% of pre-disability weekly earnings up to $1,900.
Benefit Duration: 24 Weeks
NOTE: If you previously waived the Short Term Disability coverage and wish to enroll during open enrollment, you will be required to answer medical questions and coverage may be declined
BASIC LIFE INSURANCE AND AD&D
Maricopa Unified School District pays 100% of the cost of this Securian Financial (Ochs Inc.) Group Term Life Insurance Plan
Coverage for each full-time benefit eligible employee is $50,000.
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
SUPPLEMENTAL LIFE & AD&D
Employee: Availabile in $10,000 increments to a maximum of $750,000
Spouse: Available in $10,000 increments up to 100% of the employee’s total basic & supplemental coverage, not to exceed $250,000
Child(ren): $10,000 or $15,000
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
Maricopa Unified School District pays 100% of the cost of the Term Life and AD&D.
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Employee Assistance Program
National Insurance Services - An EAP provides valuable services at no cost to employees and their families in the form of short-term counseling, legal and financial consultations. Seven days a week, 24 hours a day, using one toll-free phone number (866-451-5465), you can speak with registered nurses and master’s-level counselors who can help with almost any problem ranging from medical and family matters to personal legal, financial and emotional needs
If face-to-face resources are appropriate for your situation, up to 3 face-to-face counseling sessions are available at no cost. If appropriate, the program also provides access to a wide range of national and community resources
The Employee Assistance Program provides Solution-Focused Counseling for issues such as:
■ Job Performance
■ Relationship Difficulties
■ Family Issues
■ Managing Depression/Anxiety
■ Anger / Stress Management
■ Grief & Bereavement
■
■
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THE EAP ALSO PROVIDES RESOURCES FOR:
Child
Care
/ Elder
Legal
& Financial Issues
■ Substance Abuse
EMPLOYEE ASSISTANCE PROGRAM CONTACT: 866-451-5465 • www.niseap.com All EAP services are 100% confidential and free to use.
■ Will Preparation
Trustmark
Trustmark is pleased to offer Maricopa Unified School District employees and qualified dependents the opportunity to elect coverage under several Trustmark policies A few things to remember about these policies:
■ A Trustmark policy is separate from the other policies listed in this book Trustmark does not replace your medical insurance coverage
■ Trustmark pays you directly, no matter what other insurance you may have
ACCIDENT INSURANCE
This plan pays cash benefits in the event of an accidental injury that needs emergency treatment
HOSPITAL INDEMNITY INSURANCE
This plan pays cash benefits when an individual is confined in a hospital. It also provides HSA-compliant coverage
LEGALSHIELD
LegalShield options are also available to include IDShield to help in the event of an identity theft
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Core Benefit Rate Sheet
Use this sheet to provide a general estimate of your monthly 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 - MONTHLY RATES
PPO
EMPLOYEE ONLY
EMPLOYEE & SPOUSE
EMPLOYEE & CHILDREN
EMPLOYEE & FAMILY
$71 23 $643 .74 $606 88 $1,074.95
$15 51 $541 .58 $507 72 $937 .84
DENTAL PLANS
EMPLOYEE ONLY
EMPLOYEE & SPOUSE EMPLOYEE & CHILDREN
EMPLOYEE & FAMILY
PPO - HIGH $42 .79 $85 12 $93 17 $136 02
PPO - LOW $38 .26 $76 17 $83 .39 $121 76
DHMO $9 .87 $19 52 $21 .88 $24 02
$6 .20 $11 78 $12 .40 $17 67
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PLAN HDHP PLAN VISION
Important Phone Numbers & Websites
AmeriBen Medical Plans
866 438 0145 maricopausd myameriben com FliptRx Prescriptions 866 522 2920 www.fliptRx.com/maricopa
VIVIO Health Specialty Prescriptions
800 470 4034 www myvivio com
AmeriFlex HSA / FSA 888 868 3539 www.myameriflex.com
National Insurance Services Employee Assistance Program (EAP) 866 451 5465 www niseap com
Arizona State
Retirement System
Long Term Disability 520-239-3100 800-621-3778 azasrs gov Delta Dental PPO Plans 800 352 6132 deltadentalaz.com/member
Cigna
Dental HMO Plan 800 244 6224 www myCigna com
SightCare Vision 480 961 1702 sightcareaz com
Ochs Inc. Life & Disability 800 392 7295 ochsinc com Trustmark
Voluntary Supplemental Benefits 866 813 7192 trustmarkvb com Teladoc Telehealth 800 835 2362 teladoc com
Maricopa USD HR Department
520 568 5100 x1060 saguilar-nelson@musd20 org
ABOUT THIS BOOKLET
This booklet highlights important features of Maricopa 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
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