Palo Verde Elementary School District
A healthier you starts here!
Employee Benefits Guide 2024 - 2025
TABLE OF CONTENTS
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.
Palo Verde Elementary 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 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 19.
2. Contact Abraham Amezcua at aamezcua@pvesd.org or Lindsay Young at lyoung@pvesd.org, or either of them by phone at 623.327.3690.
This booklet highlights important features of
Verde Elementary 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
actual coverage and benefits will be determined by the legal plan documents and the contracts that govern these plans.
Palo
your
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 Disability Information 11 Life / AD&D Insurance ................................................................. 11 Flexible Spending Accounts .................................................. 12 Employee Assistance Program 13 AFLAC 15 AFLAC Rates 16 Employee Rate Worksheet 18 Important Phone Numbers & Websites ........................ 19
Enrollment Information
OPEN ENROLLMENT
Open Enrollment is from April 8th through May 10th, 2024. This is your one time per year to make changes.
All benefit eligible employees are required to elect coverage this year using the online enrollment platform. If you do not want to make changes from the current plan year, you do not need to complete the online enrollment questionnaire indicating your desire to keep your current elections in-force as your current elections will roll over into the 2024/25 plan year.
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 date 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 will be required to complete an evidence of insurability form for voluntary life insurance. You may be turned down for these benefits if you do not enroll within your first 31 days as a new hire.
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. You may elect to opt-out of this method of paying.
Post-Tax Dollars: Some insurance premiums may be paid after taxes are deducted from your gross pay. Please contact Sandi Wilson or Jody Stanberry for more information related to the specific premiums that are deducted post-tax.
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Palo Verde Elementary School District
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, 2024 – June 30, 2025). 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 Benefits 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 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 Palo Verde Elementary School District benefit plan immediate-
QUALIFYING LIFE EVENTS LIST
Marital Status Changes
• Marriage
• Death of spouse
• Divorce
• Spouse gains or loses coverage from another source
• Spouse employer’s Open Enrollment
Covered Dependent Changes
• Birth or adoption of a child
• Death of dependent child
• Dependent becomes ineligible for coverage
ly 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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Medical Plan Information
The Trust that will provide medical insurance to Palo Verde Elementary School District.
The network Palo Verde Elementary School District will use for hospitals and physicians.
The company that will process Palo Verde Elementary School District’s medical claims.
SUMMARY
Medical benefits provide you and your family access to quality health care. Palo Verde Elementary School District offers you three medical plans with different coverage levels from which to choose. All plans are provided through Arizona School Boards Association Insurance Trust (ASBAIT). ASBAIT contracts with Aet-
na to use their Choice POS II and Banner networks with claims processing and customer service being provided by Meritain Health Company.
To contact Meritain, please go to mymeritain.com or contact them at 866.300.8449.
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MERITAIN CONTACT www.mymeritain.com 1 2 ASBAIT Palo Verde ESD Meritain Health Company Aetna Choice POS II and Banner 1 2 3 3
Medical Plans
you have
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Palo Verde Elementary School District
HDHP 1600 In Network Classic Gold Copay Gold In Network In Network Aetna Banner Aetna Banner Aetna Banner Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Calendar Year Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Deductibles Individual $2,150 $1,600 $300 $240 None None Family $4,300** $3,200** $900 $720 None None Coinsurance 20% 20% 15% 15% N/A N/A Out-of-Pocket Maximum Individual $5,500 $4,500 $4,000 $3,200 $6,350 $5,080 Family $11,000 $9,000 $8,000 $6,400 $12,700 $10,160 Hospital Services Inpatient Hospital $250 + Deductible, then 20% $200 + Deductible, then 20% $250 Copay, then 15% $200 Copay, then 15% $250 Copay $200 Copay Outpatient Hospital Deductible, then 20% Deductible, then 20% Deductible, then 15% Deductible, then 15% $75 Copay $60 Copay Emergency Room Deductible, then 20% Deductible, then 20% Deductible, then 15% Deductible, then 15% $150 Copay $120 Copay Urgent Care Deductible then $45 copay Deductible then $40 copay $45 $38 $50 Copay $40 Copay
Office Visit Deductible, then $25 Copay Deductible, then $20 Copay $25 Copay $20 Copay $30 Copay $24 Copay Specialist Visit Deductible, then $35 Copay Deductible, then $30 Copay $35 Copay $28 Copay $40 Copay $32 Copay Preventive Care Covered in full Covered in full Covered in Full Covered in full Covered in Full Covered in Full Lab &
Deductible,
20% Deductible, then 20% $25 Copay $20 Copay $30 Copay $24 Copay
Deductible,
20% $25 Copay $20 Copay $30 Copay $24 Copay
20% $25 Copay $20 Copay $30 Copay $24 Copay
Deductible then: Tier 1 $15 Copay $15 Copay $15 Copay Tier 2 20% Copay ($25 min/$80 max) 20% Copay ($25 min/$80 max) 20% Copay ($25 min/$80 max) Tier 3 40% Copay ($40 min/$110 max) 40% Copay ($40 min/$110 max) 40% Copay ($40 min/$110 max)
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$200
$200 Copay $200 Copay Mail-Order 2x Retail 2x Retail 2x Retail Diabetic Medications $5 Generic, $15 Brand $5 Generic, $15 Brand $5 Generic, $15 Brand
must be satisfied
plan
Routine Services
X-Ray
then
Chiropractic Deductible, then 20%
then
Rehabilitation Deductible, then 20% Deductible, then
Prescription Drugs
Tier
Specialty
Copay
**If
Family coverage under the HDHP 1600, the Family Deductible
before the
will pay any benefits.
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 tax advantaged 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 $1,600 - $2,150 for individuals and $3,000 - $4,000 for family coverage.
2. An H.S.A. with HealthEquity which can be funded by pre-tax payroll contributions from you, the district, or both.
The district contributes $2,334 annually to an employee’s H.S.A. when enrolled in the HDHP.
HOW AN H.S.A. WORKS:
1. Enroll in the HDHP 1500 offered by the district.
2. Contribute to your H.S.A. by payroll deductions:
Up to $4,150 for an individual or $8,300 for a family
3. With your H.S.A. debit card, use those funds to pay for qualified expenses such as:
• copays
• deductibles
• doctors, hospitals chiropractor
H.S.A. ELIGIBILITY
The money contributed to the account is yours to keep and will roll over year after year – no ‘use it or lose it’ rule!
• dental treatment
• hearing aids
• glasses/ contacts prescriptions
To make tax-free contributions to an H.S.A., the IRS requires that:
• You are covered by an H.S.A.-qualified plan (such as the HDHP 1600)
• 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
• Headache
• Insect Bite
• Joint Aches
• Nausea
• Rashes
• Sinus Infection
• Sore Throat
• UTI
• And more!
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
Palo Verde Elementary School District
www.MyDrConsult.com 1.800.362.2667 Download the Teladoc app for easier access! 8
Dental Plans
*While benefits are available out of network, a non-contracted provider may balance bill for services. You will pay less when using an in-network provider.
Type 1 - Diagnostic & Preventive (no deductible) 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
In / 80% Out
In / 80% Out
The dental plan includes preventive services and office visits.
METLIFE In Network Annual Deductibles Individual $50 Family $150 Annual Plan Maximum $1,750 Benefits
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Lifetime Maximum 50%
Lifetime Deductible N/A Adult Orthodontia N/A Other
Periodontic Coverage 80%
Endodontic Coverage 80%
years old
to $1,500
Benefits
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Vision Plan
Standard lenses are covered.
AVESIS VISION
Exam
In Network
$10 Copay
Out of Network
Reimbursed to $35
Frequency Every 12 Months Every 12 Months
Lenses Covered 100%
Reimbursed: $25 to $80
Single/Bifocal/Trifocal/ after $10 copay depending on lens Lenticular
Frequency Every 12 Months Every 12 Months
Frames Up to $150 Allowance, after $10 copay
Reimbursed to $45
Frequency Every 24 Months Every 24 Months
Contact Lenses
$130 Allowance
Reimbursed to $130
(In lieu of all other lens and frame benefits) Every 12 Months Every 12 Months
Lasik Surgery 25% discount, to $150
Reimbursed to $150
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Palo Verde Elementary School District
Disability Information
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.
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
Palo Verde Elementary School District pays 100% of the cost of the Term Life.
Life / AD&D Insurance
BASIC LIFE INSURANCE AND AD&D
Palo Verde Elementary School District pays 100% of the cost of this Lincoln Group Term Life Insurance Plan.
Coverage for each benefit eligible employee is $30,000.
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.
DEPENDENT LIFE / AD&D INSURANCE
You can also elect to purchase life insurance for your spouse or children.
• Spouse
$10,000
• Children Age 14 days to 6 months: $500 Age 6 months to 19 years (to age 23 if full-time student): $5,000
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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.
Please Note: Employees will become eligible to participate effective July 1st following completion of an agreement (classified) or contract year (certified).
HEALTH CARE SPENDING ACCOUNT (HCSA)
How it Works:
• You make before-tax deposits (via payroll deductions) to your HCSA.
• You can deposit from $100 to $3,200 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 PVESD’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, 2024 and June 30, 2025 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 maximum that can be rolled over to the next year is $640.
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 $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.
• 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, 2024 and June 30, 2025.
• 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 4).
• 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
Palo Verde
Elementary School District
Employee Assistance Program
Alliance Work Partners - An EAP provides valuable services at no cost to employees and their families in the form of short-term counseling, legal and financial consultations through LawAccess, and worklife resources and referral through Work/ Life Standard. Seven days a week, 24 hours a day, using one toll-free phone number, 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, a representative can refer you to a local professional in the Aetna Choice POS II or Banner network. If appropriate, the program also provides access to a wide range of national and community resources.
An EAP Teen Line 800-334-TEEN (8336) specializing in teen issues is an additional resource available as well as a 24-Hour Nurseline at 888-771-9116 for all medical questions and health issues.
TO CREATE A PERSONAL ACCOUNT:
Go to www.awpnow.com:
• Select “Access Your Benefits”
• Registration Code: AWP-ASBAIT-2811
• You will be prompted to create a unique username and password.
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Palo Verde Elementary School District
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AFLAC
American Family Life Assurance Company (AFLAC) is pleased to offer Palo Verde Elementary School District employees and qualified dependents the opportunity to elect coverage under several AFLAC policies. A few things to remember about these policies:
• An AFLAC policy is separate from the other policies listed in this book. AFLAC does not replace your medical insurance coverage.
• AFLAC 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.
For the 2024/2025 plan year, you can enroll in these plans through the online enrollment system. Contact MaryAlyce Skree at 602.456.1208 for more information or to set up an appointment.
ACCIDENT INDEMNITY ADVANTAGE
These plans pay cash benefits in the event of an accidental injury that needs emergency treatment.
CANCER INDEMNITY PLANS
These plans pay cash benefits to an individual diagnosed with internal cancer.
SHORT TERM DISABILITY
These plans pay a percentage of your weekly income to you while you are not working.
CRITICAL CARE INDEMNITY
These plans pay a cash benefit to an individual for a specific diagnosis.
HOSPITAL INDEMNITY PLANS
These plans help with the expenses not covered by major medical if you are hospitalized.
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AFLAC Rates
ACCIDENT ADVANTAGE - 24-HOUR ACCIDENT OPTION 2 - SERIES A36000
AFLAC HOSPITAL CHOICE - OPTION 1 BENEFIT AMOUNT 1000 - SERIES B40100
EBR*: Extended Benefit Rider Premium (Available for ages 18-75)
HSSCR*: Hospital Stay and Surgical Care Rider Premium (Available for ages 18-75)
*Note – The Extended Benefit Rider and Hospital Stay and Surgical Care Rider are not available with Option H.
AFLAC HOSPITAL CHOICE - OPTION H BENEFIT AMOUNT 1000 - SERIES B4010H
18-49
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Palo Verde Elementary School District
Premium Total 18-75 INDIVIDUAL $17.29 $17.29 18-75 NAMED INSURED/SPOUSE $24.57 $24.57 18-75 ONE-PARENT FAMILY $29.25 $29.25 18-75 TWO-PARENT FAMILY $38.22 $38.22
Premium EBR HSSCR Total 18-49 INDIVIDUAL $26.78 $11.57 $18.20 $56.55 50-59 $27.30 $13.00 $23.27 $63.57 60-75 $28.08 $13.26 $30.42 $71.76 18-49 INSURED/SPOUSE $37.83 $24.18 $33.28 $95.29 50-59 $40.04 $27.17 $46.28 $113.49 60-75 $42.90 $27.43 $58.11 $128.44 18-49 ONE-PARENT FAMILY $33.93 $23.01 $25.22 $82.16 50-59 $34.45 $23.53 $28.60 $86.58 60-75 $34.97 $24.05 $37.57 $96.59 18-49 TWO-PARENT FAMILY $40.17 $29.38 $33.93 $103.48 50-59 $40.56 $29.90 $47.19 $117.65 60-75 $43.42 $31.20 $62.01 $136.63
Premium Total 18-49 INDIVIDUAL $31.46 $31.46 50-59 $32.37 $32.37 60-75 $37.96 $37.96 18-49 INSURED/SPOUSE $45.76 $45.76 50-59 $53.56 $53.56 60-75 $63.70 $63.70 18-49 ONE-PARENT FAMILY $36.40 $36.40 50-59 $37.05 $37.05 60-75 $39.13 $39.13
TWO-PARENT FAMILY $46.28 $46.28 50-59 $54.08 $54.08 60-75 $64.22 $64.22
CRITICAL CARE AND RECOVERY LEVEL TWO - SERIES A71200
One Parent Family
Insured/Spouse
Two Parent Family
18-35 $35.88 $35.88
$45.50 $45.50
46-55 $60.84 $60.84 56-70 $83.59 $83.59
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Age Range Individual Spouse Only One Parent Family Two Parent Family 18-75 $16.59 $26.35 $16.59 $26.35
Age Range Individual Spouse Only One Parent Family Two Parent Family 18-75 $33.50 $57.64 $33.50 $57.64
AFLAC Rates (continued) AFLAC CANCER PROTECTION ASSURANCE - B70100
AFLAC CANCER PROTECTION ASSURANCE - B70200
AFLAC-SHORT TERM DISABILITY - SERIES A-57600 Elimination Period Accident/Sickness - 0/7 DAYS Annual Income $20,000 $22,000 $24,000 $26,000 $28,000 $30,000 $32,000 $34,000 $36,000 $38,000 Benefit Period Age $1,000 $1,100 $1,200 $1,300 $1,400 $1,500 $1,600 $1,700 $1,800 $1,900 3 MONTHS 18-49 $28.60 $31.46 $34.32 $37.18 $40.04 $42.90 $45.76 $48.62 $51.48 $54.34 50-64 $29.90 $32.89 $35.88 $38.87 $41.86 $44.85 $47.84 $50.83 $53.82 $56.81 65-74 $36.40 $40.04 $43.68 $47.32 $50.96 $54.60 $58.24 $61.88 $65.52 $69.16 6 MONTHS 18-49 $36.40 $40.04 $43.68 $47.32 $50.96 $54.60 $58.24 $61.88 $65.52 $69.16 50-64 $39.00 $42.90 $46.80 $50.70 $54.60 $58.50 $62.40 $66.30 $70.20 $74.10 65-74 $49.40 $54.34 $59.28 $64.22 $69.16 $74.10 $79.04 $83.98 $88.92 $93.86 Individual Age Premium Total 18-35 $16.38 $16.38 36-45 $23.40 $23.40 46-55 $31.85 $31.85 56-70 $41.08 $41.08
Age Premium Total 18-35 $31.59 $31.59 36-45 $41.08 $41.08
$55.25 $55.25 56-70 $76.96 $76.96
46-55
Age Premium Total 18-35 $28.08 $28.08 36-45 $33.02 $33.02 46-55 $42.51 $42.51 56-70 $55.90
$55.90
Age Premium Total
36-45
Employee Rate Worksheet
Use this worksheet to provide a general estimate of your benefits costs for the upcoming plan year. This is a great place to start planning for your, and your family’s, health and wellness for the next year.
MONTHLY INSURANCE RATES FOR 2024-2025 PLAN YEAR
If you choose the HDHP 1500, the district will contribute $178.50 monthly ($2,142.00 annually) to your HSA. Employees waiving health insurance must have other health coverage. For employees that waive health, PV will pay up to $1,000 per year toward other policies of your choice. If you waive health insurance, a maximum of $500 may be put into an FSA medical flexible spending account.
DISTRICT’S CONTRIBUTION
Divide by # of paychecks
PER PAYCHECK
INSTRUCTIONS
1. Write down the rates for each plan you have chosen. 2. Add up the rates for a Total Monthly Cost. 3. Multiply the Total Monthly Cost by 12 for Annual Cost.
4. Divide the Total Annual Cost by 20 or 25 (this is the number of designated paychecks benefit deductions will be taken during the school year).
5. You now have the approximate Cost per Pay Check for the 2024 - 2025 School Year.
6. All voluntary supplement benefits will be deducted over the same pays on a post-tax basis. Enrollment in any voluntary program is a separate deduction.
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Palo Verde Elementary School District
Medical Plan Rate Dental Plan Rate Vision Plan Rate TOTAL MONTHLY COST x 12 MONTHS TOTAL ANNUAL COST
COST
MONTHLY CONTRIBUTION $946.00 ANNUAL CONTRIBUTION $11,352.00 EMPLOYEE ONLY EMPLOYEE + 1 DEPENDENT EMPLOYEE & FAMILY MEDICAL DENTAL $37.77 $74.04 $136.62 CLASSIC GOLD $0.00 $948.00 $1,505.00 VISION $6.33 $11.07 $16.45 COPAY GOLD $94.00 $1,132.00 $1,746.00
COST CALCULATOR
HDHP 1600 $0.00 $748.00 $1,189.00
Important Phone Numbers & Websites
ASBAIT
Aetna Choice POS II or Banner | Aetna Network
Medical
866.300.8449
www.aetna.com/docfind/custom/mymeritain
Employee Portal: www.mymeritain.com
HEALTHEQUITY / HSA
866.346.5800 www.healthequity.com
ALLIANCE WORK PARTNERS
EAP & Nurse Support
800.343.3822 (EAP)
800.334.8336 (Teen Line) 888-771-9116 (Nurse) www.alliancewp.com
ARIZONA STATE RETIREMENT SYSTEM
Long Term Disability
520-239-3100
800-621-3778
www.azasrs.gov
WAGE WORKS / FSA
877.924.3967 (FSA) www.wageworks.com
METLIFE
Dental PPO
800.275.4638 www.metlife.com/mybenefits
Select “PDP” network when searching for providers
AVESIS VISION
800.828.9341 www.avesis.com
AFLAC MaryAlyce Skree 602.456.1208
TELADOC
800.362.2667 www.MyDrConsult.com
LINCOLN LIFE INSURANCE
800.423.2765 www.Lincoln4benefits.com
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ABOUT THIS BOOKLET
This booklet highlights important features of Palo Verde Elementary 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. plans.
Capital Financial 14614 N. Kierland Blvd., Suite N220 Scottsdale, AZ 85254 Office / 480.347.0926, Fax / 480.360.6417
