Benefits

GROUP INSURANCE PROGRAM

The Pendergast School District offers a variety of group insurance and benefit programs. The UnitedHealthcare PPO Plan provides medical, and the Delta Dental PPO Plan provides dental coverage. The District pays the total premium costs of the employee's medical/dental and basic life coverage. Optional benefit plans, such as managed-care dental, vision, voluntary life, short-term disability, cancer/accident, flexible spending accounts and tax-sheltered annuities are also available. Under Section 125 of the Internal Revenue Code, employees use pre-tax dollars to pay uninsured medical expenses, dependent care expenses and their portion of the District insurance premiums for dependent coverage. Employee contributions are taken from gross wages before taxes, which reduce taxable income and give the employee more take-home pay.

The information provided here is a brief summary of the benefits provided to you by the District. The purpose of this information is to help you better understand the value of your benefits program. Every effort has been made to accurately communicate them to you. If you need any help in understanding the content or have questions about your coverage, please contact the Benefits Specialist at 623- 772-2233.


ELIGIBILITY

Active employees regularly scheduled to work 30 hours or more each week, and employees holding a certificate from the Arizona State Board of Education and under contract with the District half-time or more in a position that requires certification, are eligible for group insurance benefits. Temporary/ seasonal employees are not eligible for the group benefit program.


EFFECTIVE DATES

Group health insurance benefits for new hires become effective on the first day of the month following the date of hire. Basic life insurance and optional benefits also become effective on the first day of the month following the date of hire.

Insurance coverage is on a 12-month plan year cycle that begins July 1 and ends June 30. Employees have the opportunity to make changes to their insurance program during an annual open enrollment period which precedes the plan year. These changes become effective on the first day of the new plan year.

However, the short-term disability plan and the voluntary life plan each have active-at-work requirements. Employees who are newly enrolling or requesting an increase in coverage for either of these plans must meet the active at work requirements on July 1 in order for these benefits to become effective.

Current employees who receive an increase in hours or are hired into a position that is benefit-eligible will receive health insurance benefits the first of the month following the date he/she starts the increase in hours.

You must complete and submit your enrollment to the District Benefits Office within 31 days of your hire date or increase in hours for coverage to be effective. Failure to enroll during your initial enrollment will delay your enrollment until the next open enrollment period and coverage may be subject to pre-existing conditions.


OPEN ENROLLMENT

Open Enrollment is the annual time period when employees may make changes to their group insurance benefits without a qualifying change of status. Open enrollment is typically held during a designated time period in April-May. Changes made during open enrollment become effective on July 1. Carrier representatives and District Human Resources staff will be available to answer questions during open enrollment.


QUALIFYING CHANGE OF STATUS

If a plan member has any of the qualifying change of status situations during the Plan Year (July 1 - June 30), the plan member will be allowed to make a mid-year change in their coverage selections and change who is covered under the plan. The Plan must be notified in writing within thirty-one (31) days of the qualifying change:

  1. Change in legal, marital status: marriage, divorce, legal separation, annulment, death of spouse
  2. Change in the number of dependents: birth, adoption or death of dependent child
  3. Change in employment status or work schedule: start or termination of employment or change in employment status of the employee, their spouse or their dependent child
  4. Change in dependent status: age or any other reason provided under the definition of eligible dependent
  5. Change of residence or worksite: if the change impairs the plan member's ability to access the services of In-Network providers
  6. Change required under the terms of a Qualified Medical Child Support Order (QMCSO)
  7. Eligibility for or cancellation of coverage under Medicare, Medicaid or the Children's Health Insurance Program (CHIP) as stated in the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA).
  8. Increase in the cost of the benefits
  9. Significant changes in the benefits
  10. Changes in spouse's, former spouse's or dependent's coverage through their employer


DEPENDENT AGE LIMIT

The age limits for dependent coverage vary from one insurance plan to another. Here's a quick look at what each requires:
UnitedHealthcare/Delta Dental: Eligible dependents shall include a Covered Employee's:

a] Lawful spouse (not common-law spouses) to whom the Covered Employee is married, pursuant to and permitted by the laws of the State of Arizona, provided they are not legally separated.

b] With respect to Medical Coverage, natural-born children, step-children, eligible foster children, including legally-adopted children (from the date of placement in the Employee's home for the purpose of adoption), until their twenty-sixth (26th) birthday. The term "eligible foster child" means an individual who is placed with the Covered Employee by an authorized placement agency or by judgment, decree or other order of any court of competent jurisdiction. In addition, any child for which the Covered Employee has obtained legal guardianship, eligibility will remain in effect until their twenty-sixth (26th) birthday.

c] With respect to Dental Coverage, unmarried, natural-born children, step-children, eligible foster children, including legally adopted children (from the date of placement in the Employee's home for the purpose of adoption) and children for which the Covered Employee has obtained legal guardianship substantiated by a court order, until their twenty-sixth (26th) birthday. The term "eligible foster child' means an individual who is placed with the Covered Employee by an authorized placement agency or by judgement, decree or other order of any court of competent jurisdiction.

Assurant Dental: Children up to age nineteen (19) or up to age twenty-eight (28) if they are in full-time attendance at an accredited school, college or university.

Voluntary Life Insurance: Children age 14 days to age twenty-one (21) or up to age twenty-five (25) if a full-time student.

Cancer Insurance: Children up to age twenty-six (26) unless he/she continues to meet the requirements of an eligible dependent (full-time student and whose studies were interrupted by active duty service in the military).


INSURANCE PLANS

UNITEDHEALTHCARE - PPO
UnitedHealthcare - This PPO plan is part of a group of hospitals, physicians and other health care providers contracted to furnish medical care at negotiated costs. Use of PPO providers is referred to as "In-Network." By receiving your care and services from a provider in the network, you will receive a higher level of benefits and, therefore, have fewer out-of-pocket expenses. With this plan, participants do not have to select a primary care physician and can select specialist care as needed without a referral. This plan allows participants to use both in-network and out-of-network physicians, hospitals and facilities.

DELTA DENTAL - PPO
Delta Dental allows you to access any licensed dental provider. By using an "In-Network" dentist, you will receive two (2) routine oral exams and cleanings and two (2) sets of bite-wing x-rays covered at 100% per calendar year. The individual deductible per calendar year is $25 and the family deductible per calendar year is $75. The maximum benefit per calendar year is $1500.

UNITEDHEALTHCARE PRESCRIPTION PLAN
Your UnitedHealthcare card can be used at your local pharmacy or you may obtain your prescriptions by mail order thru OptumRX.

ASSURANT DENTAL
This supplemental dental program is a "managed-care" plan offering comprehensive benefits through a network of plan dentists. The features of the plan include: no deductibles, no claims to file, no annual dollar maximum, no waiting periods for covered members, coverage for pre-existing conditions, worldwide emergency coverage, and a wide range of covered procedures. The program also includes a Specialty Benefit Amendment. Should you need the services of a dental care specialist, you may do so without a referral from your plan dentist. You will simply pay the member co-payment amount at the time of service. There is no annual maximum for procedures performed by a plan specialist.

MUTUAL OF OMAHA - BASIC LIFE INSURANCE
Basic life and accidental death and dismemberment insurance in the amount of one time your annual salary with a minimum of $20,000 is provided for eligible employees. The District pays 100% of the premium. The plan is administered through Mutual of Omaha Life Insurance Company. You may also convert this policy to an individual policy if you leave District employment.

MUTUAL OF OMAHA - VOLUNTARY LIFE INSURANCE
Eligible employees may also purchase additional life insurance at a maximum of five times their annual salary up to $250,000. They also have the option to select spouse and dependent child(ren) coverage. Spouses may be insured at a maximum of 50% of the employee benefit up to $50,000. If coverage is waived during the initial enrollment period, satisfactory evidence of insurability including a completed health application will be required. A physical examination may also be required. The plan is portable, meaning participants may retain it at the same premium rate upon leaving District employment.

ASSURANT – SHORT-TERM DISABILITY INSURANCE
Employees working 20 hours or more per week can purchase a monthly short-term disability insurance benefit. You may participate in the policy under any one of the benefit levels outlined in the Rate Schedule, provided the monthly disability benefit of the level selected does not exceed 66 2/3% of your regular monthly salary. If you become insured under the short-term disability policy, you will be eligible to receive benefits after you have been continuously disabled for 5 days. This plan provides benefits up to a maximum of 26 weeks from the date of disability. No benefits are payable for disabilities that commence within 12 months of your effective date if you received medical treatment, consultation, care or services, including diagnostic measures or took prescribed drugs or medicines for the disabling condition in the 12 months just prior to your effective date.

ARIZONA STATE RETIREMENT SYSTEM – LONG-TERM DISABILITY
Eligible employees have long-term disability benefits through their membership in the Arizona State Retirement System (ASRS). Eligibility for long-term disability benefits begins after six months of disability, subject to approval. Broadspire Services, Inc. administers the ASRS long-term disability benefit program.

ALLSTATE WORKPLACE DIVISION - CANCER/ACCIDENT INSURANCE
Allstate Workplace Division is the marketing name used by American Heritage Life Insurance Company. American Heritage Life Insurance Company pays you benefits that can be used for non-medical, cancer-related expenses that health insurance might not cover. The policy is guaranteed renewable for life, subject to change in premiums by class. The benefits are paid directly to you unless assigned. Benefits are paid in addition to any other coverage. Individual or family coverage is available.

The accident insurance can pay you a lump sum benefit for on-or-off-the-job accidental injuries, plus some medical benefits. Because accident insurance is supplemental, it works in addition to other insurance you may have. You can use this policy on its own or to fill a gap left by your other coverage. Guarantee renewable until age 70. Subject to change in premiums by class.
Participation in Allstate Workplace Division is only available at the beginning of the school year. Employees hired mid-year must wait until the next open enrollment period to enroll in this plan.

SHEAKLEY - FLEXIBLE SPENDING ACCOUNT
Sheakley administers the flexible spending accounts for the District. The flexible spending account plan allows certain qualified benefits for dependent care and health care reimbursement to be deducted directly from your paycheck before taxes, therefore, reducing your taxable income. Employees can set aside a portion of their salary into a flexible spending account to pay medical, dental and vision expenses not covered by insurance. Over-the-counter and non-prescription medications are both now excludible from your income and may be considered a covered medical expense through the flexible spending account. Medical care reimbursement is limited to $2,000 a year. Dependent childcare (daycare) or elder care expenses is limited to $5,000 a year per family before taxes.

The Internal Revenue Code Section 125 governs the administration of flexible spending accounts. These regulations specify that:

  1. Any unused money in flexible spending accounts at the end of the plan year must be forfeited.
  2. Amounts deposited in a Medical Reimbursement Account cannot be used for dependent care expenses and vice versa. Expenses in these two categories are reimbursed separately. Once monies are assigned to an account, they cannot be transferred to the other account.
  3. Once a flexible spending account is selected, it is irrevocable during the plan year unless the employee has a qualifying event and notifies Human Resources to change his / her benefits within 31 days of this event.

Participation in the flexible spending account is only available at the beginning of the school year. Employees hired mid-year must wait until the next open enrollment period to enroll in this plan.

457(b) DEFERRED COMP & 403(b) TAX SHELTERED ANNUITIES & ROTH 403(b) AFTER TAX PLANS

Contributions which are pre-tax dollars can be invested in either a 457(b) deferred compensation plan or a 403(b) tax-sheltered annuity or an after-tax Roth 403(b) through the convenience of payroll deduction. Our four approved vendors and representatives are as follows:

ING – Sallie Rader 602-759-6737
MetLife - David Hickson 480-473-0117
Security Benefit - Erica Gargol 480-557-9727
Plan Member Services – Robert Young 602-686-5300