Benefit Options 2019

Benefit Options 2019

Benefit Options 2019 Benefit Program for State of Arizona Employees Offered by the Benefit Services Division (BSD) of the Arizona Department of Administration (ADOA) 1 Agenda Introductions Finding Benefits Information Liaison, Website, Rates How Benefits Are Funded Benefit Plans Wellness Benefits & Employee Assistance Plan Get the Most For Your Benefits Dollars Employee Discounts How to Enroll 2 Finding Benefits Information 3 Benefits Info - Liaison Answers questions Helps you enroll in benefit plans Shares benefits updates to the agency 4 Benefits Info - Web Key Tabs Employee > New Hire Enrollment Employee > Enrollment Guides Contacts > Vendors No password, share site with family Enrollment Web and mobile 5 Guide Rates Plan Information Custom Vendor Contact Info for State How Benefits Are Funded 6 How Your Benefits Are Funded 88 88 %

% Employee s & Retirees Employer Employer State of State of Arizona Arizona 7 12 % 12 Employe es & % Retirees Self-Funded Plan The state is self-insured through the Health Insurance Trust Fund - HITF Employees, Retirees and the State agencies pay into HITF The insurance companies

bill HITF to pay your claims Health Insurance Terms 8 Premium Deductible Amount you pay per paycheck for an insurance policy. Annual amount of expenses paid out-ofpocket that you must pay before the health plan will pay. Copayment/ Coinsurance Flat dollar amount or percent you pay for health care services, usually at the time of service. Out-of-Pocket Maximum Total Health Plan

Costs Annual maximum amount you will pay for health care services. Total of deductible and copays, not including premiums. Includes employer portion of premium, its percentage of remaining coinsurance, and remaining expenses for services. Benefit Plans 9 What to Consider When Choosing a Plan The question is: Whats the Best Plan For YOU? The same from each carrier Coverage offering All plans have nationwide networks a plan Networks Cost 10

Provider networks vary among carriers Make sure your providers are on the plan No referrals required - visit providers How the premiums and deductibles as needed work for your budget Out-of-Network costs are higher How The Medical Plans Work Deductible Met DEDUCTI BLE You Pay All Costs 11 Out-of-Pocket Max Met COPAYS/ COINSURA NCE PLAN PAYS Remainder of Costs

PLAN PAYS All Charges for Remainder of Year Family Deductibles - EPO & PPO Any 1EPO Member $100 PPO $500 + + OtherEPO Members $100 PPO $500 in qualified expenses in qualified expenses ALONE COMBINED =

EPO $200 PPO $1,000 DEDUCTIBLE MET All Members then only then all begin paying HDHP Family Deductible - All members that Member Members begin expenses COMBINED copays= 12 begins paying $2,700. Then coinsurance applies. copays paying copays Medical - Plan Types Overview Plan Type Features Network

EPO Lower premium & lowest deductible In-Network, Nationwide No Out-of-Network, except emergencies PPO Highest premium & larger deductible In-Network, Nationwide Out-of-Network costs more HDHP w/HSA Lowest premium & highest deductible In-Network,

Nationwide 15% off at Banner facilities Out-of-Network costs more Exclusive Provider Organization Preferred Provider Organization High Deductible Health Plan with a Health Savings 13 Account State contributes Carriers EPO Plan Deductibles Employee Carriers:

Primary Care Physician (PCP): not required, we recommend choosing one Specialist: Direct access, no referral required In-Network: Comprehensive networks in AZ and nationwide Out-of-Network: No out-ofnetwork services covered 14 except in emergency Family Copays - $10 0 $20 0 after deductible met Preventive Visits Primary Care Telemedicine Specialist Urgent Care ER Visit Hospital

$0 $20 $20 $40 $75 $20 0 $25 PPO Plan Carriers: Specialists: Direct access, no referral required Network: Comprehensive networks in AZ and nationwide Out-of-Network: out-ofnetwork services covered at a higher cost with separate deductible 15 InOut-ofDeducti Network Network bles Employe $500 $1,00 e 0 Copays Family In-Network $1,000 $2,00 after deductible met 0

Preventive Visits $0 Primary Care $20 Telemedicine $20 Specialist $40 Urgent Care $75 ER Visit $20 0 Hospital $25 Admission 0 HDHP w/HSA Plan Carrier: Specialists: Direct access, no referral required Network: Comprehensive networks in AZ and nationwide In-Network Services: covered with separate deductible Out-of-Network Services: covered at 16 a higher cost with separate

InOut-ofDeducti Network Network bles Employe $1,350 $2,70 e 0 Coinsurance In- $5,40 Family $2,700 Network 0 after deductible met Preventive Visits Primary Care Telemedicine Specialist Urgent Care $0 10 % 10 % 10 % 10 %

Health Savings Account (HSA) In Depth - Pt 1 What is an HSA? Only use with HDHP Savings account to pay for qualified health expenses Can pay deductibles and coinsurance Lowers your taxable income 17 State Contribution s Your Contribution s State contributes to your HSA biweekly Employee $27.69/pay period

$720/year Family $55.38/pay period $1,440/year IRS Pre-Tax Limits for State+Employee Funds Combined Individual $3,500 Family $7,000 Your Annual Limit Employee $2,730 ($105/ pay period) Family $5,560 Using the Funds Funds roll over yearly You own the funds & can take with you Funds over $1,000 can be invested Receive debit card to pay at

point-of-service Administrator: Health Savings Account (HSA) In Depth - Pt 2 How Your HSA Is Established State automatically opens in employees name after enrolled in Aetna HDHP & verified by PayFlex Open all mail from PayFlex to ensure your 18 account is open Common Reasons for Delays Incorrect Address P.O.Box (no card delivery allowed) Legal name inconsistent

Use Social Security card name, under IRS rules - names must match Not Eligible To Contribute to an HSA Not eligible to contribute if: Employee is enrolled in Medicare or Medicaid Employee or spouse has Health Reimbursement account (HRA) Employee is enrolled in TriCare Care is received from Veterans Administration (VA) Prescription Drug Plan Same Pharmacy for ALL Carriers Pharmacy Administrator Maintains the formulary, pharmacy network, and drug costs 19

Pharmacy Information On Back of Medical Card BUT, medical carrier is not the pharmacy administrator Pharmacy website links > Employee Tab > Pharmacy OR: Find pharmacy with best price You may pay lesser of pricing Prescription Drug Copays & Deductibles Copays Generic Preferred Brand Name NonPreferred Brand Name Retail 30-Day Supply $15 $40 $60 Retail 90-Day Supply $37.50 $100 $150

Walgreens Mail Order 90$30 $80 $120 Lesser of Copay: If the cost of the prescription is lower than the fixed copay Day Supply amount, you pay the lower amount. How Do Copays Apply? EPO/PPO HDHP w/HSA 20 Medical Deductible No Yes Out-of-Pocket Maximum Yes Yes Dental Plans PPO Plan | Dental HMO | Provider See any PPO or Premier Dentist

Type of Plan Provider charges negotiated rates You pay a coinsurance Nationwide coverage Deductibles Employee-$50, Employee+Spouse-$100 Employee+1 Child-$100, Family-$150 $2,000 per person per year See any Cigna DHMO provider Provider accepts set fees from Cigna You pay set fees for dental work Not available in all states None Maximum None When choosing a plan, consider

your dental history, level of care Benefit Orthodontia 21 Preventive needed, costs and budget. $1,500 per person lifetime max Covered 100% 24-month treatment fees No copay Vision Plan Advantage Plan | Discount Program | Cost Pay Premiums for Coverage No cost for discount program** Provid ers Servic es Extensive network

Providers take discounts Eye Exams - included Glasses - included Contacts - included See guide for specific coverages Eye Exams - 20% discount Glasses - 20% discount Contacts - 20% discount LASIK $600 allowance 10-20% discount Terms Advantage Plan cannot be combined Receive discount card in the mail if you DO NOT enroll in Avesis Advantage. Covers you & your family. with Avesis discount program. 22 Flexible Spending Accounts

Health Care Flex Spending Acct (FSA) Use with EPO & PPO Plans For medical, dental, vision, prescriptions, Maximum Pay eligible & over-the-counter medication medical expenses with pre-tax dollars Reduces taxable wages which decreases taxes Use to pay your deductible, copays, 23 over-the-counter Contribution $2,700 Choose total amount to contribute Divide by 26 for perpaycheck contribution

Limited Purpose Flex Spending Acct (FSA) Use with HDHP w/HSA Plan Administrat Use for dental & vision only or: Visa Debit Request card Pre-loaded with your annual election amount Pay at point of service May have to submit paperwork to prove claim Keep all bills with services listed not just card USE IT OR LOSE IT EACH YEAR Claims Jan 1-Dec 31 Reimbursement Check claims submitted byGET Mar 31 account

& upload the claim APP docs anytime Flexible Spending Accounts Dependent Care Flexible Spending Account (FSA) Pay expenses for dependent care outside your home Daycare facilities, babysitting services, preschool, practical nursing Administra Children under 13 for whom you have custody Disabled Dependent physically or mentally disabledtor: spending hrs/day in your Maximum home. USE IT OR LOSE Submit Pay8eligible dependent care expenses with pre-tax dollars Reduces taxable wages which decreases taxes 24 Contribution $5,000

(Married File Separately: $2,500) Choose total amount to contribute Divide by 26 for perpaycheck Receipts Submit receipts for reimbursement Can only submit for what you have in the account IT EACH YEAR Claims Jan 1-Dec 31 Reimbursement claims submitted by Mar 31 Life Insurance Basic BasicLife Life&and AD&D AD&D

$15,000 policy State pays Automatically signed up Administra tor: 25 Supplemental Life and AD&D You pay $5,000 increments above the $15,000 Basic Life provided by State On new hire only, may purchase in multiples of $5,000, not to exceed the lesser of three times your annual earnings, to a max of $500,000. AFTER initial election period/new hire, may add up to $20,000 annually during open enrollment only Premiums for first $35,000 are pre-tax Life Insurance Basic Life & AD&D Administra tor: 26

Dependent Life and AD&D You pay - one premium covers whole family, pays out for each individual person Spouses, children under age 26, & disabled dependent children Amounts: $2,000, $4,000, $6,000, $10,000, $12,000, $15,000, or $50,000 For $50,000 dependent coverage, you must elect at least $50,000 in combined basic and supplemental coverage for yourself Short-Term Disability - STD 27 Definition Wait Period Maximum Duration Benefit Payments Voluntary benefit coverage if you are unable to work due to: Non-work

related injury or illness Pregnancy & maternity Premium based on earned Administrator :monthly wages Based on enrollment At hire 30-day wait period After hire 60-day wait period during first year No Wait Period If Injured Maximum duration Weekly paid benefits: of benefits Up to 66% of payable: pre-disability Injury: earnings Up to 26 weeks Payable benefits: from injury date

Illness: Minimum $57.69 Based on Maximum enrollment $769.27 At Hire - 22 wks Payments offset After Hire -18 by 100% of any wks annual & sick leave paid after the wait Long-Term Disability - LTD Definition Protects from loss of income in the event that you are unable to work for a long time due to non-work related injury, illness, or accident 28 Wellness Benefits 29 Wellness Benefits Wellness

30 Weight & Diabetes Management Employee Assistance Program Health Impact Program - $200 31 What is HIP? Award-winning program to help you achieve your physical, financial, personal and professional well-being goals Earn points for healthy activities, including preventive screenings, immunizations and classes/coaching Earn 500 points for an annual incentive payment Who is Eligible? All active, benefits-eligible employees should

participate, whether or not you are enrolled in an ADOA medical plan. Health Impact Program 1) Enroll Online Enroll on Or get the app, search GET My Health By Telligen the APP Find challenges & track points 3) Take Health Assessment Use results from physical or mini-health screening completely confidential See focus areas to improve your health 32 2) Get Physical or Mini-Health Screening Get a snapshot of your current health Visit your doc or schedule mini-health screening on Completely confidential 4)Get $200 for 500 Points Earn points from qualified

wellness activities, screenings programs, classes or coaching Annual cycle - Jan-Dec Weight and Diabetes Management Programs Programs offered at work and online Employees, spouses and dependents over 18 are eligible No cost and low cost options HIP Points - Earn 150 to 200 points upon completion Participating Programs Weight Loss Programs 33 Diabetes Program Employee Assistance Program EAP Short-Term Counseling Resources/ Info Work/Life Balance Parenting & Eldercare Family Relationships Free &Legal Advice/WillsGE

Your Household Financial GuidanceT Confide the ntial 12 Sessions Per Person/Per Issue You & Members of 24/7 34 Call: 877-3272362 TDD: 800.697.0353 GuidanceResourc Click to Chat Web ID: HN8876C with AP Consult P ant Using Your Benefits Wisely 35

Get the most for your benefit dollars Flexible Spending Account or Health Savings Account Choose the Right Plan Paying for a plan you dont use? Would the HDHP w/HSA be better? Find out with ALEX the virtual benefits counselor. Choose the Right Pay for medical & dependent expenses with pre-tax dollars. Save up to 25%. Use for deductibles & copays. Earn $200 with HIP 36

Earn points for healthy activities, including preventive screenings & immunizations already covered! Care Match the service to your need, is the ER the right place? Get advice from the Nurseline for $0. Choose Primary Care Physician now, & establish relationship. Preventive Carea @ $0 Wellness Visits Immunizations Screenings Mammograms, Prostate Exams Protect Your Health & Your Wallet -- Choose Nurseline Telemedici Walk-In Doctors

Urgent Emergency the Right Care for Your Need ne CONDIT IONS TREATE D & SERVIC ES AVAILA BLE Headache Urinary Tract Infection Cold/Flu/Fever Acne Allergies Rash Sore Throat Stomach Ache Questions Treatment Referrals Headache

Urinary Tract Infection Cold/Flu/Fever Sore Throat Vomiting & Diarrhea Rash Screenings Prescriptions Doctor on Demand App Medical Carrier App HOURS 24 Hours via Phone 24 Hours via Smart Device WAIT 2-3 Minutes 5-10 Minutes TIME Average Average Note: This is for guidance only. LOCATI Your Home or Your Home or an emergency, call 911. ON Office Office Clinic Cold/Flu/Fever Sore Throat

Sinus Earache Minor Cut/Burn/Rash Immunizations Prescriptions Drug Store Locations Office Care Room Preventive Care Routine Check-up Annual Physical Medication Tracking Immunizations Screenings General Health Issues Referrals Headache Urinary Tract Infection Cold/Flu/Fever Minor Cut/Burn/ Rash/Bite

Lower Back Pain Joint Pain Sprain X-Rays (varies) Chest Pain Head Injury Short of Breath Suddenly Numb/ Weak Uncontrolled Bleeding Severe Cut/Burn/ Bite Overdose Broken Bone Seizure/ Unconscious Vision Blurred Resource for State Employees Premise Health Care Center 301 W Jefferson St 2nd Fl 480-347-4791 | M-F 8 am-4 pm Retail Hours Office Hours

8 am - 9 pm 24 Hours Typically 15 Minutes By Appointment 20 Minutes 2-4 Hours Average Average Average *Before deductible met. **After deductible met, If you are experiencing Drive to Location Drive to Office Drive to Facility copay/coinsurance applies Drive to Facility 37 Telemedicine Doctor on Demand 38 Available 24/7 Before deductible: $49 After deductible: EPO/PPO $20, HDHP w/HSA 10% Less Expensive than Urgent Care/ER Download app & register, so you are ready when you need it Works for all carriers

Most carriers also offer telemed CONDITIONS TREATED Cold & Flu Sinus Infections Vomiting & Diarrhea Allergies Chronic Care Labs & Screenings Prescriptions & More Employee Discounts 39 Employee Discounts Tuition Discounts 40 Purchasing Discounts Tuition Discounts For Direct Links Visit > Employee Tab> Education

Discounts Dedicated Web Links for State employees 41 Purchasing Discounts azbenefits.perksconne 42 Enrollment 43 Enrollment Eligibility Active Employee Seasonal, Temp, Variable Hour Employee Regularly scheduled to work 20 hours or more per week Paid for an average

of at least 30 hours per week Dependents Your legal spouse Your child(ren) under 26 years old defined as: Natural child, adopted child, stepchild, foster child, a child for whom you are a Using 12-month measurement court-ordered guardian or a child placed in period your home by court order pending adoption. Please Note: Your child who was disabled before age 26 Social Security numbers are needed for all dependents enrolled in the plan and continues to be disabled. Supporting documentation may be required for dependents (birth certificate, marriage license)-full list on website. Duplicate coverage is not permitted. (Both spouses work for state, or one for state/one for university.) 44 Enrollment Timelines HIRE DATE ENROLL WITHIN 31

DAYS ENROLLME NT COVERAGE FIRST PAY PERIOD AFTER BEGINS ENROLLMENT & SUBMITTING ALL REQUIRED SUPPORTING DOCUMENTATION 45 How To Enroll Step 1- Learn Go to Download Enrollment Guide from Employee Tab > New Hires Review rates & coverage 46 Step 2 - Learn More Visit

2019 Understand your options ALEX IS FOR INFORMATION ONLY, NOT ENROLLMENT Step 3 Enroll ENROLL ON YES.AZ.GOV, THE ONLY WAY TO ENROLL BY 31-DAY DEADLINE Benefits start the next pay period AFTER enrollment if all required documentation is submitted within 14 days New Hires - Open Enrollment for 2020 During Open Enrollment First: 2019 enrollment - Complete new hire enrollment on, (10/21 11/7) Second: 2020 enrollment - Wait one business day, then complete open enrollment on - (11/8 last day to complete 2020 OE online) After Open Enrollment

(11/11/19 12/31/19) First: 2019 enrollment - Complete new hire enrollment on Second: 2020 enrollment - Complete a paper enrollment form. 2020 Enrollment forms on starting 11/11/19. Form required - for benefit changes for 2020, if you want 2019 choices, they roll over Qualifying Life Events - QLE These conditions allow you to make changes mid-year. Marital Status marriage divorce legal separation annulment death of spouse Dependent Status Employment Status or Work Schedule (Hours) birth impacting

adoption benefits eligibility for placement for you or your adoption dependents death loss of dependent eligibility due to age Submit Changes Within 31 Days of Event 48 Enrolling A New Baby Newborns covered for THE FIRST 31 DAYS. BABY ON PLAN 31 DAY DEADLINE Note: During this time, there are several doctor visits where baby ENROLL YOURsoNEWBORN AS is A enrolled -is covered, it seems baby

DEPENDENT BY DAY 31 not the case. your newborn will not have or Miss deadline? Wait until the next Open coverage. Enrollment or QLE. Enroll newborn: submit a Declaration of Change form with the required documentation. Documents accepted: #1. Birth Certificate (Dont wait for this to enroll, use doc #2 or #3 temporarily. Required to submit birth certificate when you receive it.) 49 #2. Crib Card #3. Hospital Verification Letter Key Contact Information 50 Key Contact Information Enrollment - Info & Rates Member Services - Mon-Fri 8a-5p

(602) 542-5008 or (800) 3043687 [email protected] 51

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