1. Open Enrollment
For Full Time Employees and Families of J.O. Combs Unified School District

2. Which plans are affected by Open Enrollment?
Medical Plan
Dental Plan
Vision Plan
Short Term Disability
Voluntary Benefits

3. Medical Benefits
Medical/pharmacy benefits will be offered by Blue Cross Blue Shield of Arizona
New ID cards will be mailed to all members for a October 1 effective date or 60 days following the first of the month when you are hired
The provider network – BSBSAZ Preferred PPO network
Will be referred to as the High Plan
Will be referred to as the Low Plan

4. District will pay 100% premium for Low Plan for all eligible employees.
There is the option to by up to the High Plan coverage which includes out-of-network benefits. There is a 3.5% increase to this plan.
The Plan/PPO Network does not require the selection of a Primary Care Physician (PCP) nor are referrals required to receive medical services.

5. Accident Coverage
Coverage is available for you, your spouse, and child(ren)
Coverage lasts your life for any accidents that occurs outside of work
Portable
Helps with out of pocket expenses to your medical provider
Some benefits under this plan include:
Ambulance- you get $90.00
Dislocate a finger $90.00
Tear a tendon or ligament $465.00
Torn Knee Cartilage $185.00
Fracture a hand/ foot/ or wrists $465.00
Up to $100 back each year just for visiting your doctor
New - Must schedule appointment with the call center 5

6. Critical Illness With Cancer Coverage
Coverage is available for you, your spouse, and child(ren)
Coverage lasts your life
Portable
Helps with major out of pocket expenses to your medical provider
Covered conditions upon diagnosis:
Heart attack, stroke, renal kidney failure, blindness, Lou Gehrig’s Disease, major organ transplant, paralysis of two or more limbs, and invasive cancer
Partial benefit for coronary bypass surgery and carcinoma in situ
$100 back each year just for visiting your doctor
New - Must schedule appointment with the call center

7. Delta Dental of Arizona Voluntary Plan
Basic & Preventive services provided at no charge
No more wait periods for Basic, Major, and Ortho Services
Pays 70% of restorative & extractions
Pays 50% for Major services
Annual Deductible: $50/Person, $150/Family
Annual Maximum Benefit $1,000 per covered person
Orthodontic Benefit pays 50% with a $1,000 maximum (separate from Annual Maximum Benefit)

8. Delta Vision-Voluntary Plan Features of EyeMed Benefits
An Increase of 7.5% this year rates are in your packet
Exams - $10 Co-pay In-Network
Materials (Frames and Lenses) - $10 Co-pay In-Network
Standard Spectacle Lenses - $75 Co-pay – Premium lenses - 80% of charge less $120 allowance, plus $ Co-pay
Frames – Up to $120 allowance plus 20% discount
Contacts – once every 12 months; $80 allowance
Exam & Lenses or Contacts – once every 12 months
Please read enclosed benefit document for more details

9. Union Security – Short Term Disability
Type of Coverage Non-Occupational, Employee paid, includes maternity benefit
Max Benefit Percent Up to 66 2/3% of base pay up to $5,000/mo.
Elimination Period Accident/Sickness /14 Day
Benefit Period 6 Months
Cost for this year has increased 5% see new rates in your packet

10. Section 125 – Pre-tax Deductions
Your Medical and Dental premiums are taken on a pre-tax basis
Lowers your taxable income
May lower your taxes
Elections cannot be changed during the plan year, unless you experience a “qualified change”.

11. Flexible Benefit Plan Medical & Dependent Care Reimbursement
Set money aside for qualified expenses pre-tax
Elections are made for the entire year and cannot be changed, except with a “qualifying event”
Benefits must be used during the plan year
May lower your taxes
This is the plan that allows you to pay certain expenses with pre-tax dollars.
You save taxes - more take home income left for you.
The Diocese pay expenses of administering this for you.

12. Arizona State Retirement System
The employee contributes 11.54% of income to the plan.
District matches employee contribution.
You must contribute 5 yrs. to become vested.
Plan includes Long Term Disability benefits after 6 months of disability.
The average employee saved $300 last year and every year going forward.

13. 403(B)/457 Retirement/Savings
Five vendors to choose from
ING
Security Benefits
Hartford
MetLife
Valic
Tax deferred annuity
Employee contributions only
As an employee in a "not for profit" organization you have a real advantage over those of us in the corporate world - make sure you understand and take advantage of this benefit.

14. Legal Coverage
Coverage is available for you, your spouse, child(ren), your parents, and your spouse’s parents
Portable
3 types of service categories:
Free - initial consultations with a plan attorney, document reviews, simple wills, and more
Flat rate - name change, traffic ticket, will with a minor trust, plus much more
Discounted - anything that is not free or at a flat rate is discounted 25%
New - Must schedule appointment with the call center

15. Basic Life and AD&D Insurance
100% paid by the School District
1 ½ times salary to $50,000
AD & D doubles death benefit

16. Universal Life Insurance
Coverage is available for you, your spouse, and child(ren)
Policy lasts to age 100
Cash value account- guaranteed at 4%
Portable
Long term care is built into your policy
Can use long term care for nursing home, home health care, and adult day care
Will provide a long term care benefit to you for 50 months and it will not deduct from your life insurance amount that you have assigned to your beneficiary
New - Must schedule appointment with the call center

17. Benefit Election Form Employee Model WAIVE ABC Elementary Teacher
Last Name
First Name
Waive All Insurance
Department
Position
21 Pay Periods Effective July 1, 2012
BCBS of AZ
Annual Cost
Per Pay Period
DENTAL PLAN
C $30 Plan
Low Option
Employee Only
391.2
18.63
Employee + 1
$4,229.52
$201.41
Employee + Spouse
$657.60
$31.31
Employee + Family
$7,053.12
$316.57
Employee + Child(ren)
$853.20
$40.63
B $15 Plan
$1,267.68
$60.37
$1,105.44
$52.64
$6,440.40
$306.69
$10,008.96
$476.62
DELTA EYEMED
$62.28
$2.97
Employee+ Spouse
$126.48
$6.02
$121.44
$5.78
$189.96
$9.05
18 Pay periods beginning with the first pay in September and an October 1st effective date
** Effective July 1, 2012
Voluntary Insurance
Short Term Disability**
Transamerica Accident
Critical Illness
Universal Life
Term Life
Legal Access Insurance
Medical Reimbursement Plan ($2,500 annual maximum)
Dependent Care Reimbursement Plan ($5,000 annual maximum or $2,500 if married and filing separately)
TOTAL EMPLOYEE PAID INSURANCE PREMIUM
I understand that I may not change my election until the beginning of the next plan year - July 1, 2012, unless I have a qualified life changing event.
Employee Signature authorizing the elections
Date
Employee
Model
WAIVE
ABC Elementary
Teacher √ √ √ √
PLS CANCEL √
Model Employee
5/17/2013
Benefit Election Form

18. Next Step Determine which Health Insurance Plans fits your needs.
Low Plan at no cost to the employee
High Plan at a cost to the employee (please review insurance rate in your packet).

19. Representatives are available
Next Step
Do you want to participate in any of the following voluntary
benefits products?
Accident Coverage
Critical Illness with Cancer Coverage
Legal Coverage
Universal Life Insurance
You must schedule an appointment with a benefits counselor at the call center for the above products
Representatives are available
Monday – Friday
7:00 am to 4:00 pm PDT

20. Wednesday July 31st - NO EXCEPTIONS!!
Final Step
Review your personal options
TURN IN BENEFIT ELECTION FORM
Questions contact Human Resources at
Contact the Call Center for additional voluntary benefits
Please Remember, every employee is ACCOUNTABLE to complete their paperwork; otherwise, you run the risk of not securing insurance for the new school year ( ). All paperwork must be turned in by
Wednesday July 31st - NO EXCEPTIONS!!