Sierra Vista 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

Supplemental Life and AD&D........................................................12

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

Employee Assistance Program.....................................................13

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

Unum............................................................................................................. 14

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

Employee Rate Worksheet...............................................................15

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

Important Phone Numbers.............................................................16

Dental Plans.............................................................................................. 10

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. Sierra Vista 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 supplemental programs. In addition, we provide health savings accounts (HSA) to assist employees in managing their out-of-pocket expenses with before tax dollars for those electing either the HDHP 1500 or HDHP 2500 medical plans. 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 16. 2. Contact Nikki Longoria or Jamie Bennett in the Rothery Education Center HR/Business Office or at Dominique.Longoria@svps.k12.az.us or Jamie.Bennett@svps.k12.az.us. This booklet highlights important features of Sierra Vista 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 April 27th - May 11th, 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.

All benefit eligible employees are required to elect coverages via the iVisions portal 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.

Post-Tax Dollars: Some insurance premiums may be paid after taxes. Please contact Nikki Longoria or Jamie Bennett 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 Sierra Vista Unified School District benefit plan immediately preceding the employee’s COBRA event has the right to continue his or her medical, dental or vision plans. 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 company that will provide medical insurance to Sierra Vista Unified School District.

The network Sierra Vista Unified School District will use for hospitals and physicians when in Arizona.

The company that will process Sierra Vista Unified School District’s prescription drug benefits.

Summit Sierra Vista USD 2

Blue Cross Blue Shield

SmithRx

SUMMARY Medical benefits provide you and your family access to quality health care. Sierra Vista Unified School District offers you four medical plans with different coverage levels from which to choose. All plans are provided through Summit. Summit contracts with Blue Cross Blue Shield of AZ to use their network with claims processing and customer service being provided by Summit. To contact Summit for questions about medical information and ID cards, please go to summit-inc.net or contact them at 888.690.2020.

SUMMIT CONTACT

summit-inc.net

Medical Plans PPO 500

PPO 750

HDHP 1500**

HDHP 2500**

In Network Unlimited Unlimited

$750 $1,500/employee +1 OR $2,250/employee +2 or more 20%

$1,500 $3,000**

$2,500 $5,000**

Coinsurance

$500 $1,000/employee +1 OR $1,500/employee +2 or more 20%

20%

Out-of-Pocket Maximum (Plan Year) Individual Family

$4,500 $9,000

$5,000 $10,000

$3,500 $6,550**

$3,450 $6,550**

Hospital Services Inpatient Hospital Outpatient Hospital Emergency Room Urgent Care

Deductible, then 20% Deductible, then 20% Deductible, then 20% Deductible, then 20%

Deductible, then 20% Deductible, then 20% Deductible, then 20% $40 Copay

Deductible, then 20% Deductible, then 20% Deductible, then 20% Deductible, then 20%

Routine Services Office Visit Specialist Visit Preventive Care Lab & X-Ray

Deductible, then 20% Deductible, then 20% Covered in Full Deductible, then 20%

$20 Copay $40 Copay Covered in Full Deductible, then 20%

Deductible, then 20% Deductible, then 20% Covered in Full Deductible, then 20%

Prescription Drugs Tier 1 Tier 2 Tier 3 Mail-Order (90-day supply)

$10 Copay $60 Copay $110 Copay $25/$120/$220

Deductible, then $10 Copay Deductible, then $60 Copay Deductible, then $110 Copay Deductible, then $25/$120/$220

Lifetime Maximum Plan Year Deductibles (Plan Year) Individual Family

with Health Savings Account

**If you have Family coverage under the HDHP 1500 or HDHP 2500 plans, 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.

with Health Savings Account

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.

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

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

HOW AN HSA WORKS: 1. Enroll in either the HDHP 1500 or the HDHP 2500 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 HSA qualified plan (such as the HDHP 1500 and HDHP 2500) 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. You cannot be claimed as a dependent on someone else’s taxes.

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.

When should I use Teladoc? ■

■

■ ■ ■ ■ ■ ■ ■ ■ ■

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!

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? ■

What can be treated?

Instead of going to the ER or an urgent care center for a non-emergency issue

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)

Urgent Care

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:

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.

■ ■ ■ ■ ■

■ ■ ■ ■ ■ ■

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.

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.

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.

Dental Plans METLIFE PPO PDP Plus Network

EMPLOYERS DENTAL SERVICES (EDS) Dental HMO In Network

Annual Deductibles Individual

$50

Family

$150

Annual Plan Maximum

$1,500

Pre-Paid Dental Discount Plan IN NETWORK Coverage ONLY Coverage examples: ■ ■ ■

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

■

Routine Office Visit: $5 Copay Oral Exam (Periodic): No Charge Routine Cleaning: $5 Copay Amalgam Restoration: $13 Copay Porcelain Crown: $285 Copay + Lab

Please refer to the materials provided by Human Resources for the complete schedule of benefits. Plan Features

Orthodontic Benefits

■

Orthodontia Age Limitation

Child to Age 19

■

Lifetime Maximum

50% to $1,500

■

Lifetime Deductible

N/A

Adult Orthodontia

N/A

Adult and Child Orthodontic coverage offered No Annual Maximum Must Use Your Selected Dentist within the EDS Network for you and any covered family members

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 plans include preventive services and office visits.

Vision Plan

Standard lenses are covered.

METLIFE VISION MetLife Vision PPO

In Network

Out of Network

Exam

$10 Copay

Reimbursed to $45

Frequency

Every 12 Months

Lenses

Covered 100%

Reimbursed from up to $30 to up to $100

Single/Bifocal/Trifocal/

after $25 copay

depending on lens

Frequency

Every 12 Months

Frames

Reimbursed to $70

Frequency

$200 Allowance after $25 Copay (Costco, Sam’s Club and Walmart are $110 Allowance after $25 Copay) Every 12 Months

Contact Lenses

Medically Necessary

(In lieu of frames

Covered in Full after $25 Copay

Reimbursed to $210

and lenses)

Elective

$200 Allowance

Reimbursed to $105

Every 12 Months

Lenticular

Frequency

Every 12 Months

This plan includes a Second Pair benefit that gives you additional eyewear coverage. You can get two pairs of prescription eyeglasses OR one pair of prescription eyeglasses and an allowance toward contact lenses OR double your contact lens allowance.

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 Sierra Vista Unified School District offers a voluntary benefit through Unum. Please refer to the materials provided by Human Resources and contained later in this benefits guide.

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

Sierra Vista Unified School District pays 100% of the cost of a MetLife Term Life Insurance Plan. Coverage for each benefit eligible employee is $50,000 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.

Supplemental Life and AD&D Employee: Available in $10,000 increments. Maximum of $500,000 or 5 times base annual earnings Spouse: Available in $5,000 increments. Maximum of $250,000 (not to exceed 50% of employee elected amount) Child: $1,000, $2,000, $4,000, $5,000 or $10,000 (not to exceed 50% of employee elected amount) Please note that if you currently have supplemental life, your existing coverage amount will continue with MetLife. If you are increasing your current amount, enrolling after you were initially eligible or requesting an amount above the Guarantee Issue, an Evidence of Insurability form will be required to be completed to obtain approval from MetLife for the requested amount.

Employee Assistance Program

Coming

you to a professional in the Blue Cross Blue Shield Network.

July 1, 2022

Beginning on 7.1.2022, Contact SupportLinc at 888.881.LINC (5462) 24 hours a day / 7 days a week.

Sierra Vista USD has contracted with SupportLinc 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 counselor who can help with almost any issue ranging from medical and family matters to personal, emotional, legal or financial needs.

Emotional wellbeing and work-life balance Or, visit supportlinc.com. resources for you and your family Username: sierravistausd (Beginning 7.1.2022)

After 6 sessions, if additional face to face visits are needed, an EAP representative will assist in referring

SupportLinc offers expert guidance to help Coming address and resolve everyday issues SupportLinc offers expert guidance to help In-the-moment Financial expertise Legal consultation July 1, 2022 address and resolve everyday issues support Planning and consultation Emotional wellbeing and work-life balance with a licensed financial Reach a licensed clinician resources you and yourcounselor. family by phone 24/7/365 for for In-the-moment support Financial expertise immediate assistance. Reach a licensed clinician by Planning and consultation

By phone or in-person with a local attorney.

Short-term assistance. counseling

with a local attorney. SupportLinc ensures no one will know you have accessed the program without your written permission except Confidentiality as required by law.

Legal consultation Confidentiality

Convenience resources

phone 24/7/365 for immediate

By phone or in-person

with a licensed financial counselor.

Referrals for child and elder care, home repair, housing needs, education, pet care to offers expert guidance Convenience and so much more. resources

Access in-person or video SupportLinc counseling sessions to Short-term counseling resolve concerns such as Access in-person or video address and stress, anxiety, depression, counseling sessions to resolve relationship issues, concerns such as stress, anxiety, In-the-moment support work-related pressures, depression, relationship issues, Reach a licensed clinician by work-related pressures, or or substance abuse. phone 24/7/365 for immediate substance abuse. assistance.

Short-term counseling

help resolve everyday issues Referrals for child and elder care, home repair, housing Financial expertise needs, education, pet care Planning and consultation and so much more. with a licensed financial counselor.

Convenience

Your webportal portal & mobile app Your web and mobile app

resources Access in-person or video counseling sessions to resolve Referrals for child and elder • anxiety, The one-stop shop for program services, concerns such as stress, care, home repair, housing ■ The one-stop shop for program depression, relationship issues, information and more. needs, education, pet care and more. work-related pressures, or services, information and so much more. substance abuse. • Discover on-demand training to boost

SupportLinc ensures no one will know you have accessed the program Legal consultation without your written By phone or in-person permission except as with a local attorney. required by law.

Confidentiality

Convenient, on-the-go support Convenient, on-the-go support SupportLinc ensures no one will know you have

• Textcoach® accessed the®program Textcoach without yourcoaching written Personalized with a licensed Personalized coaching with a licensed permission as or desktop counselor on except mobile

Discover wellbeing andon-demand life balance. training to

required by on law. mobile or desktop counselor

• Animo boostwellbeing and life balance. Self-guided resources to improve Animo web portal and mobile app Convenient, on-the-go support • FindYour search engines, financial calculators focus, wellbeingresources and emotional fitness Self-guided to improve •career Thesearch one-stop shop for programfinancial services, • Textcoach® ■and Find engines, resources. information and more. Personalized coaching with a licensed • Virtual Support Connect focus, wellbeing and emotional calculators and career resources. on mobile or desktop group therapy sessions on an • Explore thousands of training articles, tip sheets, counselorModerated fitness • Discover on-demand to boost • Animo wellbeing and life balance. anonymous, chat-based platform and videos. ■self-assessments Explore thousands of articles, tip ■

• Find search engines, financial calculators sheets, self-assessments and and career resources. videos. • Explore thousands of articles, tip sheets, self-assessments and videos.

Self-guided resources to improve Virtual Support focus, wellbeing and emotional fitnessConnect

Moderated group therapy sessions on • Virtual Support Connect Moderated group therapy sessions on an an anonymous, chat-based platform anonymous, chat-based platform

Support for everyday issues. Every day. Support for everyday issues. Every day.

Unum Unum Insurance Company is pleased to offer Sierra Vista Unified School District employees and qualified dependents the opportunity to elect coverage under several Unum policies. A few things to remember about these policies: ■

■

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

ACCIDENT Accident Insurance pays a set benefit amount based on the type of injury you have and the type of treatment you need. It covers accidents that occur on and off the job. And it includes a range of incidents, from common injuries to more serious events.

CRITICAL ILLNESS If you’re diagnosed with an illness that is covered by this insurance, you can receive a lump sum benefit payment. You can use the money however you want.

You are able to enroll in any of these benefits in the iVisions portal.

HOSPITAL

Your Unum plan pays a Be Well Benefit for one Be Well screening each year.

Hospital Insurance helps covered employees and their families cope with the financial impacts of a hospitalization. You can receive benefits when you’re admitted to the hospital for a covered accident, illness or childbirth.

With Unum’s Be Well Benefit, you and other covered family members can receive a valuable incentive for important tests and screenings. Many of these tests are routinely performed, so it’s easy to take advantage of this benefit. Your Critical Illness Be Well benefit is $50. Your Accident Be Well benefit is $50. Your Hospital Be Well benefit is $50.

SHORT-TERM DISABILITY If a covered illness or injury keeps you from working, Short Term Disability Insurance replaces part of your income while you recover. As long as you remain disabled, you can receive payments for up to 11 weeks. You’re generally considered disabled if you’re unable to do important parts of your job — and your income suffers as a result.

Employee Rate Worksheet 2022-2023

EMPLOYEE ONLY EMPLOYEE & SPOUSE EMPLOYEE & CHILDREN EMPLOYEE & FAMILY

MEDICAL PLANS PPO 500

PPO 750

HDHP 1500

HDHP 2500

21 PAY PERIODS $75.75 $450.87 $356.96 $713.61

21 PAY PERIODS $63.27 $423.18 $333.07 $675.61

21 PAY PERIODS $29.07 $347.73 $267.93 $570.30

21 PAY PERIODS $19.30 $326.56 $250.01 $542.07

DENTAL PLANS

EMPLOYEE ONLY EMPLOYEE & SPOUSE EMPLOYEE & CHILDREN EMPLOYEE & FAMILY

VISION PLAN

METLIFE PPO

EDS HMO

METLIFE PPO

21 PAY PERIODS $15.79 $30.50 $37.35 $56.05

21 PAY PERIODS $4.89 $9.72 $11.83 $13.57

21 PAY PERIODS $4.11 $8.23 $8.81 $14.07

Important Phone Numbers Summit Member Services

Arizona State Retirement System

Medical 888.690.2020 summit-inc.net

Long Term Disability 520.239.3100 800.621.3778 www.azasrs.gov

HealthEquity Health Savings Account 866.346.5800 www.healthequity.com

MetLife Dental PPO, Life Insurance 800.GET.MET8 (800.438.6388) metlife.com

MetLife Vision 855.MET.EYE1 (855.638.3931) metlife.com/vision

SupportLinc EAP 888.881.LINC (5462) supportlinc.com Username: sierravistausd (Please note that this will not be active until 7.1.2022)

Dominique “Nikki” Longoria Payroll / Benefits Specialist 520.515.2731 Dominique.Longoria@svps.k12.az.us

Jamie Bennett Payroll / Benefits Specialist 520.515.2732 Jamie.Bennett@svps.k12.az.us

Teladoc 800.835.2362 teladoc.com

Unum Voluntary Supplemental Insurance 800.635.5597 unum.com

ABOUT THIS BOOKLET This booklet highlights important features of Sierra Vista 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