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JOSEPH CITY UNIFIED SCHOOL DISTRICT

Feel Healthier. See Clearer. Smile More. Live Better.

2016-2017 EMPLOYEE BENEFITS GUIDE


TABLE OF CONTENTS

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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. Joseph City 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. 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.

Enrollment Information Life Status Change / COBRA Medical Medical Coverage Examples Telehealth Dental Vision Life & Disability Employee Assistance Program Rate Worksheet Contact Information

If you should have any questions: 1. Contact the carrier directly. Phone number and website information is on page 13. 2. Contact Stephanie Farr, District Payroll & Benefits Specialist at 928.288.3307 x336 or stephanief@jcusd.org. This booklet highlights important features of Joseph City 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 May 13 through May 28, 2016. This is your one time per year to make changes. If you do not make changes during Open Enrollment, your current benefit elections will carry over to the new plan year. You are required to re-elect medical/dependent FSA amounts for the new 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 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 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.

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PRE-TAX VS POST-TAX DEDUCTIONS 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. 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 Stephanie Farr for more information related to the specific premiums that are deducted post-tax. 


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, 2016 – June 30, 2017). During that time, if your life or family status changes according to the recognized events listed below, you are permitted to revise your benefits coverage to accommodate your new status. You may make benefits changes by contacting the Benefits Department and providing the proper documentation. IRS regulations govern under what circumstances you may make changes to your benefits, which benefits you can change and what kinds of changes are permitted. • 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).

COBRA 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. 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 Joseph City 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,

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

• you fail to pay the cost of coverage; or • your COBRA Continuation Period expires.

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

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MEDICAL PLAN INFORMATION 1

The Trust that will provide medical insurance to Joseph City Unified School District.

2

The network Joseph City Unified School District will use for hospitals and physicians.

3

The company that will process Joseph City Unified School District’s medical claims.

1 ASBAIT

JCUSD 2

Blue Cross/ Blue Shield

Meritain Health Company

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SUMMARY

HEALTH SAVINGS ACCOUNT (H.S.A.)

Medical benefits provide you and your family access to quality health care. Joseph City Unified School District offers 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 BlueCross BlueShield of Arizona to use their PPO Network with claims processing and customer service being provided by Meritain Health Company.

If you choose to enroll in the HDHP plan, you will be enrolled in a Health Savings Account (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.

To search for a BlueCross BlueShield of Arizona PPO provider please go to www.azblue.com. Click on the Search the Provider Directory. To contact Meritain, please go to www.mymeritain. com or contact them at 866.300.8449.

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 $1,300 for individuals and $2,600 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. Please visit www.healthequity.com or contact them at 866.346.5800 for more information.

MERITAIN CONTACT

www.mymeritain.com


MEDICAL PLANS HDHP* with Health Savings Account

Value Gold

Copay Gold

In Network

In Network

In Network

Lifetime Maximum

Unlimited

Unlimited

Unlimited

Calendar Year

Unlimited

Unlimited

Unlimited

Individual

$1,300

$750

None

Family

$2,600**

$1,500

None

Coinsurance

20%

25%

N/A

Individual

$6,000

$5,000

$6,350

Family

$12,000

$10,000

$12,700

Inpatient Hospital

$250 Copay, Deductible, then 20%

$250 Copay, Deductible, then 25%

$250 Copay

Outpatient Hospital

Deductible, then 20%

Deductible, then 25%

$75 Copay

Emergency Room

Deductible, then 20%

Deductible, then 25%

$150 Copay

Urgent Care

$50 Copay, Deductible, then 20%

$50 Copay, then 25%

$50 Copay

Office Visit

Deductible, then 20%

$35 Copay

$30 Copay

Specialist Visit

Deductible, then 20%

$45 Copay

$40 Copay

Preventive Care

Covered in Full

Covered in Full

Covered in Full

Lab & X-Ray

Deductible, then 20%

Deductible, then 25%

$30 Copay

Chiropractic

Deductible, then 20%

$35 Copay

$30 Copay

Rehabilitation

Deductible, then 20%

$35 Copay

$30 Copay

Tier 1

Deductible, then 20%

$15 Copay

$15 Copay

Tier 2

Deductible, then 20%

20% ($25 min/$80 max)

20% ($25 min/$80 max)

Tier 3

Deductible, then 20%

30% ($40 min/$110 max)

30% ($40 min/$110 max)

Tier 4 Specialty

Deductible, then 20%

20% Copay ($100 min/$150 max)

20% Copay ($100 min/$150 max)

Mail-Order

Deductible, then 20%

2x Retail

2x Retail

Diabetic Medications

Deductible, then 20%

$5 Generic, $10 Brand

$5 Generic, $10 Brand

Deductibles

Out-of-Pocket Maximum

Hospital Services

Routine Services

Perscription Drugs

**If you have Family coverage under the HDHP, the Family Deductible must be satisfied before the Plan will pay any benefits.

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MEDICAL COVERAGE EXAMPLES 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 Joseph City Unified School District.

Example 1 - Managing a Well-Controlled Condition

Prescriptions

$2,900

Routine maintenance of Type 2 Diabetes.

Medical Equipment/Supplies

$1,300

Office Visits/Procedures

$700

Education

$300

Laboratory Tests

$100

Total Charges

$5,400

HDHP

Value Gold

Copay Gold

Deductibles

$1,300

$500

$0

Copays

$0

$920

$1,520

Coinsurance

$800

$290

$0

Limits or Exclusions

$80

$80

$80

Patient Pays

$2,180

$1,790

$1,600

Example 2 - Having a Baby

Hospital Charges (mother/baby)

$3,600

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

Routine Obstetric Care

$2,100

Anesthesia

$900

Laboratory Tests/Radiology

$700

Prescriptions

$200

Vaccines, other Preventive

$40

Total Charges

$7,540

HDHP

Value Gold

Copay Gold

Deductibles

$1,300

$500

$0

Copays

$250

$270

$970

Coinsurance

$310

$570

$0

Limits or Exclusions

$150

$150

$150

Patient Pays

$2,010

$1,490

$1,120

The information on the next two pages should be used as an estimate and it 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.

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TELEHEALTH HealthiestYou-24/7/365 on-demand access to affordable, quality healthcare. Anytime, Anywhere. Regardless of the plan you choose you should never be without HealthiestYou, the only 24x7 telehealth and wellness service designed for the modern family. Whenever you have an issue, simply connect with a HealthiestYou 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, 24x7. No need to schedule an appointment or limit your visits. • Pay no copay or consultation fee. Every call to our doctors is free. • 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!

www.healthiestyou.com 1.866.703.1259 support@healthiestyou.com

When should I use HealthiestYou? • Instead of going of 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! HealthiestYou has pediatricians on call 24/7 How much does it cost? • Nothing! Every consultation is free for you and all of your dependents


DENTAL PLAN

ASBAIT DENTAL OPTION In Network

Out-of-Network

Individual

$50

$50

Family

$150

$150

Annual Plan Maximum

$1,500

$1,500

Type 1 - Diagnostic & Preventive

100% In

100% Out

Type II - Basic Service

80% In

80% Out

Type III - Major Services

50% In

50% Out

Annual Deductibles

Benefits

Orthodontic Benefits Orthodontia Age Limitation

19 years old

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

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VISION PLAN

AVESIS VISION OPTION

In Network

Out of Network

Exam

$10 Copay

Reimbursed to $35

Frequency

Every 12 Months

Every 12 Months

Lenses

Covered 100%

Reimbursed to $25 to $80

Single/Bifocal/Trifocal/

after $10 copay

depending on lens

Frequency

Every 12 Months

Every 12 Months

Frames

$35 Wholesale

Reimbursed to $45

Frequency

Every 24 Months

Every 24 Months

Contact Lenses

Medically Necessary

Medically Necessary

(In lieu of frames)

Covered in Full

Reimbursed to $250

Elective

Elective

$110 Allowance

Reimbursed to $110

Every 12 Months

Every 12 Months

Lenticular

Frequency

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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

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.

Joseph City Unified School District pays the entire cost of the UNUM policy. Elimination Period: Benefit Amount: Benefit Duration:

30 Days 662/3% of pre-disability weekly earnings up to $4,000 17 Weeks

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

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Joseph City Unified School District pays 100% of the cost of the UNUM Term Life Insurance Plan. Coverage for each benefit eligible employee is $25,000 Life and AD&D Benefit.


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 BCBS of Arizona PPO 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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JOSEPH CITY UNIFIED SCHOOL DISTRICT

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 you and your family’s health and wellness for next year.

MEDICAL PLANS HDHP 26 PAYS EMPLOYEE ONLY $0.00 EMPLOYEE & SPOUSE $218.77 EMPLOYEE & CHILDREN $190.15 EMPLOYEE & FAMILY $251.08

MONTHLY $0.00 $474.00 $412.00 $544.00

DENTAL PLANS 26 PAYS $18.69 EMPLOYEE ONLY EMPLOYEE & SPOUSE $38.45 EMPLOYEE & CHILDREN $39.97 EMPLOYEE & FAMILY $51.92

MONTHLY $40.50 $83.30 $86.60 $112.50

VALUE GOLD

COPAY GOLD

26 PAYS $0.00 $249.23 $216.46 $286.15

26 PAYS $54.46 $359.08 $318.46 $403.38

VISION PLAN 26 PAYS $4.39 $10.11 $10.11 $10.11

The District pays $541/month ($6,492/year) toward the Copay Gold and Value Gold plans. The District pays $478/month ($5,736/year) and $1,358/year to the Health Savings Account (H.S.A.).

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MONTHLY $0.00 $540.00 $469.00 $620.00

MONTHLY $9.52 $21.90 $21.90 $21.90

MONTHLY $118.00 $778.00 $690.00 $874.00


IMPORTANT PHONE NUMBERS ASBAIT Blue Cross/Blue Shield Medical 866.300.8449 www.azblue.com Employee Portal: www.mymeritain.com HealthEquity Medical 866.346.5800 www.healthequity.com  Avesis Vision 800.522.0258 www.avesis.com  Alliance Work Partners EAP & Nurse Support 800.343.3822 (EAP) 800.334.8336 (Teen Line) 888.771.9116 (Nurse) www.alliancewp.com 

UNUM Life and Disability 866.679.3054 www.unum.com Arizona State Retirement System Long Term Disability 520.239.3100 800.621.3778 www.azasrs.gov Stephanie Farr District Payroll & Benefits Specialist 928.288.3307 x 336 stephanief@jcusd.org

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ABOUT THIS BOOKLET This booklet highlights important features of Joseph City 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 21819 N Scottsdale Road, Suite 100 Scottsdale, AZ 85255 Office / 623.719.3528 Fax / 480.794.1703

2016-17 Joseph City Employee Benefits Guide  
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