BASIC INSURANCE BENEFITS ARIZONA PUBLIC SCHOOLS 2014-2015 Prepared by the Arizona Education Association Center for Research & Development Andrew Morrill, President Mark Simons, Executive Director Nancy Hall, Research Assistant Roxanne Rash, Printing Specialist January 2015 Arizona Education Association, affiliated with the National Education Association
TABLE OF CONTENTS Foreword 3 Explanation of Column Headings 4 Medical Expenses Insurance 5 Dental Expenses Insurance 19 Short-term Disability and Life Insurance 25 Eligibility for Insurance and Insurance Committees 29 AEA Research & Development 2
The information contained in this report was collected by a survey of local associations and school districts during the 2014-2015 school year. A total of 55 locals, school districts, or colleges submitted forms in varying states of completion. For districts for which there are multiple insurance plans or providers, or from which there is more than one submitted survey with differing information, multiple lines of data are shown. For each major category of the questionnaire on benefits, the responses are listed alphabetically by school district name. te page 4 listing an explanation of column headings and abbreviations. All cost information is presented on a monthly basis. FOREWORD A blank indicates that sufficient information was not provided for that field. COMMON ABBREVIATIONS ASHIP EBT HDHP HMO HSA Ind OAP POS PPO SDHP TPA - Arizona School Board Association Insurance Trust - Arizona State Health Insurance Plan - Benefit Trust - High Deductible Health Plan - Health Maintenance Organization - Health Savings Account - Indemnity - Open Access Plan (PPO/HMO hybrid) - Point of Service - Preferred Provider Organization - Self-directed Health Plan - Third Party Administrator AEA Research & Development 3
EXPLANATION OF COLUMN HEADINGS INSURANCE PREMIUM Single Premium individual monthly premium for employee coverage dollar amount employee pays per month dollar amount district pays per month Spouse coverage monthly premium for employeeplus-spouse (or one), Spouse, Children coverage monthly premium for family Children coverage monthly premium for employeeplus-children Cafeteria Plan? Is the benefit offered as one of several from which the employee may choose? MEDICAL Type Type of Coverage Ind = Indemnity HMO = Health Maintenance Organization PPO = Preferred Provider Organization POS = Point Of Service EPO = Exclusive Provider Option Deduct annual dollar deductible per person (also Dental) Co-Pay % percent of major medical paid by insured Co-Pay HMO co-pay amount per visit paid by insured Provider Insurance Company or Trust INSURANCE COMMITTEES Committee Representatives Emp = number of employee members Adm = number of administrator members Brd = number of school board members Specific Assn. Rep? Is the Local Association specifically represented on the committee? AEA Research & Development 4
School SINGLE PREMIUM MEDICAL EXPENSES INSURANCE EMPLOYEE & SPOUSE EMPLOYEE, SPOUSE & CHILDREN EMPLOYEE & CHILDREN AGUILA ELEM 0.00 485.00 479.00 0.00 769.00 0.00 429.00 0.00 ALHAMBRA ELEM (1) 0.00 437.99 561.00 437.99 561.00 437.99 561.00 437.99 ALHAMBRA ELEM (2) 675.00 401.99 675.00 401.99 675.00 401.99 675.00 401.99 ALHAMBRA ELEM (3) 0.00 482.41 812.85 482.41 812.85 482.41 812.85 482.41 AMPHITHEATER (1) 25 300.00 344.00 300.00 587.00 300.00 299.00 300.00 AMPHITHEATER (2) 97.00 300.00 488.00 300.00 763.00 300.00 429.00 300.00 AMPHITHEATER (3) 129.00 300.00 552.00 300.00 851.00 300.00 491.00 300.00 APACHE JUNCTION (1) 81.25 411.93 442.91 835.08 785.38 1235.77 398.10 782.65 APACHE JUNCTION (2) 158.17 501.93 595.75 1013.90 1016.17 1505.79 544.27 953.67 APACHE JUNCTION (3) 548.03 958.07 1448.73 2011.89 2185.73 2874.17 1315.49 1856.00 ARLINGTON ELEM 0.00 537.00 537.00 0.00 795.00 0.00 537.00 0.00 AVONDALE ELEM (1) 0.00 323.00 323.00 323.00 631.00 323.00 308.00 323.00 AVONDALE ELEM (2) 23.00 341.00 387.00 341.00 738.00 341.00 370.00 341.00 AVONDALE ELEM (3) 97.00 341.00 535.00 341.00 958.00 341.00 515.00 341.00 BEAVER CREEK ELEM (1) 0.00 496.00 496.00 496.00 824.00 496.00 362.00 496.00 BEAVER CREEK ELEM (2) 52.00 496.00 600.00 496.00 961.00 496.00 451.00 496.00 BEAVER CREEK ELEM (3) 74.00 496.00 644.00 496.00 1021.00 496.00 490.00 496.00 BENSON ELEM (1) 34 464.00 403.00 464.00 609.00 464.00 291.00 464.00 BENSON ELEM (2) 73.00 464.00 474.00 464.00 699.00 464.00 353.00 464.00 BENSON ELEM (3) 8.00 464.00 356.00 464.00 553.00 464.00 251.00 464.00 CAMP VERDE (1) 0.00 336.00 181.01 336.00 283.01 336.00 283.01 336.00 CAMP VERDE (2) 44.81 370.31 311.81 370.31 449.81 370.31 449.81 370.31 CAMP VERDE (3) 29.81 370.31 291.81 370.31 411.41 370.31 411.41 370.31 CASA GRANDE ELEM 10.00 475.93 586.67 0.00 586.67 0.00 586.67 0.00 CATALINA FOOTHILLS (1) 0.00 350.00 350.00 350.00 560.00 350.00 308.00 350.00 CATALINA FOOTHILLS (2) 0.00 304.00 282.00 350.00 451.00 350.00 222.00 350.00 CONCHO ELEM 0.00 468.00 468.00 468.00 635.00 468.00 468.00 468.00 ELFRIDA ELEM (1) 0.00 678.00 544.00 0.00 849.00 0.00 380.00 0.00 ELFRIDA ELEM (2) 0.00 499.00 400.00 0.00 623.00 0.00 281.00 0.00 FLAGSTAFF 20.00 458.24 728.58 458.24 728.58 458.24 728.58 458.24 FLORENCE (1) 0.00 468.00 468.00 468.00 695.00 468.00 352.00 468.00 FLORENCE (2) 0.00 354.00 354.00 354.00 525.00 354.00 267.00 354.00 FLORENCE (3) 38.00 468.00 544.00 468.00 792.00 468.00 420.00 468.00 AEA Research & Development 5
School SINGLE PREMIUM MEDICAL EXPENSES INSURANCE EMPLOYEE & SPOUSE EMPLOYEE, SPOUSE & CHILDREN EMPLOYEE & CHILDREN FLOWING WELLS 42.43 341.66 428.71 341.66 623.92 341.66 357.40 341.66 GILBERT (1) 58.33 393.05 451.38 393.05 714.74 393.05 321.68 393.05 GILBERT (2) 0.00 393.05 358.32 393.05 598.41 393.05 240.08 393.05 GILBERT (3) 0.00 393.05 0.00 333.60 0.00 557.12 0.00 223.51 GLOBE 0.00 427.13 854.27 427.13 1139.42 427.13 0.00 0.00 HEBER-OVERGAARD (1) 0.00 520.00 520.00 520.00 633.00 520.00 520.00 520.00 HEBER-OVERGAARD (2) 0.00 433.00 433.00 433.00 528.00 433.00 433.00 433.00 HEBER-OVERGAARD (3) 0.00 520.00 520.00 520.00 633.00 520.00 520.00 520.00 HEBER-OVERGAARD (4) 0.00 433.00 433.00 433.00 528.00 433.00 433.00 433.00 HIGLEY (1) 0.00 440.00 469.00 440.00 807.00 440.00 404.00 440.00 HIGLEY (2) 38.00 440.00 549.00 440.00 915.00 440.00 477.00 440.00 HIGLEY (3) 0.00 329.00 352.00 329.00 602.00 329.00 302.00 329.00 LITCHFIELD ELEM (1) 0.00 348.00 348.00 0.00 554.00 0.00 273.00 0.00 LITCHFIELD ELEM (2) 0.00 434.00 434.00 0.00 693.00 0.00 338.00 0.00 LITCHFIELD ELEM (3) 0.00 472.00 472.00 0.00 753.00 0.00 368.00 0.00 LITTLEFIELD ELEM (1) 0.00 351.20 364.00 351.20 630.00 351.20 288.00 351.20 LITTLEFIELD ELEM (2) 18.00 351.20 401.00 351.20 680.00 351.20 321.00 351.20 LITTLEFIELD ELEM (3) 0.00 351.20 285.00 351.20 491.00 351.20 229.00 351.20 MARANA (1) 0.00 266.00 280.00 266.00 406.00 266.00 251.00 266.00 MARANA (2) 0.00 346.00 377.00 346.00 652.00 346.00 338.00 346.00 MARANA (3) 57.00 346.00 478.00 346.00 791.00 346.00 434.00 346.00 MCNARY 0.00 550.00 525.00 0.00 637.00 0.00 525.00 0.00 MCNEAL ELEM 33.90 305.10 372.90 305.10 697.90 305.10 331.90 305.10 MOHAVE VALLEY ELEM 0.00 464.00 434.00 464.00 645.00 464.00 362.00 464.00 MORRISTOWN ELEM 0.00 404.67 404.66 404.67 674.82 404.67 674.82 404.67 MURPHY ELEM (1) 0.00 427.13 854.27 427.13 1139.42 427.13 854.27 427.123 MURPHY ELEM (2) 111.64 427.13 1077.51 427.13 1437.94 427.13 1077.51 427.13 NOGALES (1) 0.00 373.00 350.00 0.00 372.00 0.00 250.00 0.00 NOGALES (2) 0.00 373.00 350.00 0.00 372.00 0.00 250.00 0.00 NOGALES (3) 45.00 373.00 436.00 373.00 461.00 373.00 325.00 373.00 NOGALES (4) 0.00 306.00 286.00 306.00 307.00 306.00 208.00 306.00 NORTHLAND PIONEER COLLEGE (1) 0.00 520.00 567.00 520.00 721.00 520.00 574.00 520.00 AEA Research & Development 6
School SINGLE PREMIUM MEDICAL EXPENSES INSURANCE EMPLOYEE & SPOUSE EMPLOYEE, SPOUSE & CHILDREN EMPLOYEE & CHILDREN NORTHLAND PIONEER 0.00 520.00 480.00 520.00 616.00 520.00 487.00 520.00 COLLEGE (2) ORACLE ELEM (1) remaining 4560.00 remaining 0.00 remaining 0.00 remaining 0.00 balance balance balance balance ORACLE ELEM (2) remaining 4560.00 remaining 0.00 remaining 0.00 remaining 0.00 balance balance balance balance PARADISE VALLEYR (1) 0.00 492.03 430.44 652.03 589.06 887.03 382.43 577.03 PARADISE VALLEYR (2) 0.00 393.62 312.35 393.62 196.13 787.24 288.95 393.62 PARKER (1) 0.00 375.00 589.86 375.00 978.15 375.00 359.65 375.00 PARKER (2) 129.74 375.00 704.44 375.00 1272.02 375.00 442.40 375.00 PARKER (3) 0.00 375.00 414.81 375.00 759.60 375.00 333.12 375.00 PATAGONIA ELEM 12.00 323.00 347.00 323.00 511.00 323.00 273.00 323.00 PATAGONIA UNION 12.00 323.00 347.00 323.00 511.00 323.00 273.00 323.00 PHOENIX ELEM 0.00 539.00 539.00 539.00 739.00 539.00 739.00 539.00 PRESCOTT (1) 0.00 487.29 708.27 487.29 708.27 487.29 292.38 487.29 PRESCOTT (2) 43.40 487.29 814.74 487.29 814.74 487.29 361.81 487.29 PRESCOTT (3) 0.00 423.83 620.42 423.83 620.42 423.83 254.30 423.83 QUARTZSITE ELEM (1) 0.00 431.00 431.00 431.00 589.00 431.00 316.00 431.00 QUARTZSITE ELEM (2) 20.00 431.00 471.00 431.00 635.00 431.00 350.00 431.00 QUARTZSITE ELEM (3) 59.00 431.00 549.00 431.00 727.00 431.00 417.00 431.00 RIVERSIDE ELEM (1) 0.00 414.00 414.00 414.00 694.00 414.00 694.00 414.00 RIVERSIDE ELEM (2) 0.00 285.00 285.00 285.00 476.00 285.00 476.00 285.00 SADDLE MOUNTAIN (1) 0.00 490.00 490.00 490.00 777.00 490.00 490.00 490.00 SADDLE MOUNTAIN (2) 20.00 490.00 530.00 490.00 830.00 490.00 530.00 490.00 SADDLE MOUNTAIN (3) 43.00 490.00 576.00 490.00 886.00 490.00 576.00 490.00 SANTA CRUZ VLY 15.00 312.00 342.00 312.00 501.00 312.00 270.00 312.00 SANTA CRUZ VLY UNION (1) 0.00 486.00 486.00 486.00 780.00 486.00 368.00 486.00 SANTA CRUZ VLY UNION (2) 63.00 486.00 612.00 486.00 945.00 486.00 478.00 486.00 SNOWFLAKE (1) 0.00 520.00 433.00 520.00 528.00 520.00 433.00 520.00 SNOWFLAKE (2) 0.00 520.00 520.00 520.00 633.00 520.00 520.00 520.00 SOLOMON ELEM 0.00 505.00 505.00 505.00 730.00 505.00 0.00 0.00 SOMERTON ELEM (1) 50.00 340.00 440.00 340.00 624.00 340.00 282.00 340.00 SOMERTON ELEM (2) 109.00 340.00 558.00 340.00 769.00 340.00 375.00 340.00 SOMERTON ELEM (3) 25.00 287.00 337.00 287.00 483.00 287.00 211.00 287.00 AEA Research & Development 7
School SINGLE PREMIUM MEDICAL EXPENSES INSURANCE EMPLOYEE & SPOUSE EMPLOYEE, SPOUSE & CHILDREN EMPLOYEE & CHILDREN ST JOHNS (1) ST JOHNS (2) ST JOHNS (3) SUNNYSIDE (1) 108.93 350.59 602.20 350.59 847.67 350.59 499.95 350.59 SUNNYSIDE (2) 45.38 350.59 470.42 350.59 681.98 350.59 382.35 350.59 SUNNYSIDE (3) 116.54 350.59 617.93 350.59 867.46 350.59 514.00 350.59 SUPERIOR (1) 68.00 383.00 457.00 457.00 653.00 653.00 423.00 423.00 SUPERIOR (2) 37.00 379.00 421.00 421.00 602.00 602.00 391.00 391.00 SUPERIOR (3) 0.00 356.00 362.00 362.00 516.00 516.00 334.00 334.00 TEMPE ELEM (1) 0.00 580.58 638.57 580.58 1161.08 580.58 522.50 580.58 TEMPE ELEM (2) 73.94 580.58 867.82 580.58 1456.90 580.58 736.94 580.58 TEMPE ELEM (3) 0.00 505.72 556.24 505.72 1011.36 505.72 455.12 505.72 TOLLESON UNION (1) 0.00 368.12 166.67 368.12 707.16 368.12 150.00 368.12 TOLLESON UNION (2) 0.00 368.12 375.00 368.12 683.33 368.12 341.67 368.12 TOLLESON UNION (3) 200.00 368.12 691.67 368.12 1166.67 368.12 641.67 368.12 UNION ELEM 0.00 420.00 504.00 spouse - 20 pays 420.00 employee only 399.60 family - 20 pays 420.00 employee only 504.00 children - 20 pays 420.00 employee only VAIL ELEM (1) 0.00 354.00 382.00 354.00 576.00 424.00 365.00 354.00 VAIL ELEM (2) 3.00 354.00 410.00 354.00 577.00 424.00 393.00 354.00 WHITERIVER 0.00 439.00 439.00 439.00 647.00 439.00 348.00 439.00 WILLIAMS (1) 0.00 412.00 404.00 420.00 660.00 420.00 373.00 420.00 WILLIAMS (2) 35.00 420.00 490.00 420.00 771.00 420.00 455.00 420.00 WILLIAMS (3) 0.00 335.00 335.00 335.00 539.00 335.00 309.00 335.00 WILSON ELEM 0.00 427.13 427.13 427.13 712.29 712.29 712.29 712.29 WINDOW ROCK 0.00 465.27 579.02 465.27 579.02 465.27 579.02 465.27 AEA Research & Development 8
School MEDICAL EXPENSES INSURANCE New Emp Waiting Cafeteria Plan Type Available Deduct Co-Pay % Co-Pay Period Provider AGUILA ELEM Yes PPO 250.00 25.00 30 ASBA Insurance Trust ALHAMBRA ELEM (1) Yes HSA 2500.00 20% full amount first of the month until deductible is following the date of hire met then 20% This is the High Deductible Health Plan ALHAMBRA ELEM (2) Yes PPO 500.00 25% 35.00 first of the month following the date of hire This is the Value Gold Plan ALHAMBRA ELEM (3) Yes PPO 0.00 30.00 First of the month following the date of hire This is our Gold Plan AMPHITHEATER (1) PPO 1250.00 20% 1st of month after HDHP hire High Deductible Health Plan $1250 AMPHITHEATER (2) PPO 350.00 20% 30.00 1st of month after Classic Silver Plan hire Silver Plan AMPHITHEATER (3) PPO 0.00 0 30.00 1st of month after Co-Pay Gold Plan hire Gold Plan APACHE JUNCTION (1) Yes HSA 2500.00 20% 20% after The first day of the United Healthcare deductible is met month following a 60 day probationary period The above amounts are for the least expense plan (H.S.A. 2500 Deductible)for new hires only. The contribution is a larger amount for employees hired prior to 2009. APACHE JUNCTION (2) Yes HSA 1250.00 20% 20% after deducible is met Same as HSA 2500 The first day of the month following a 60 day probationary period United Healthcare AEA Research & Development 9
School MEDICAL EXPENSES INSURANCE New Emp Waiting Cafeteria Plan Type Available Deduct Co-Pay % Co-Pay Period Provider APACHE JUNCTION (3) Yes HMO 1000.00 20% Varies Same as HSA 2500 United Healthcare & 1250 Same as HSA 2500 & HSA 1250 ARLINGTON ELEM Yes PPO 0.00 30.00 1st of the month Meritain AVONDALE ELEM (1) Yes HSA 1250.00 20% <=30 /Meritain coverage begins 1st of the month following hire date. contributes $54.00 quarterly to HSA for employees enrolled in this plan. AVONDALE ELEM (2) Yes PPO 500.00 25% 35.00 <=30 /Meritain coverage begins 1st of the month following hire date. AVONDALE ELEM (3) Yes PPO 0.00 30.00 <=30 /Meritain coverage begins 1st of the month following date of hire. This plan is set copays for all medical expenses BEAVER CREEK ELEM (1) Yes PPO 500.00 35.00 0 Cert. and 60 Classified Benefit Plan-Value Gold BEAVER CREEK ELEM (2) Yes PPO 300.00 20.00 0 Cert. and 60 Classified Benefit Plan-Classic Gold BEAVER CREEK ELEM (3) Yes PPO 0.00 30.00 0 Cert and 60 Classified Benefit Plan - Co-Pay Gold BENSON ELEM (1) Yes PPO 350.00 20% 35.00 the first day of next month after employment BENSON ELEM (2) Yes PPO 0.00 0 30.00 the first day of next month after employment BENSON ELEM (3) Yes PPO 500.00 25% 35.00 1st day of the next month after employment CAMP VERDE (1) Yes HSA 1250.00 20% 30 CAMP VERDE (2) Yes PPO 350.00 20% 30.00 30 CAMP VERDE (3) Yes PPO 500.00 25% 35.00 30 CASA GRANDE ELEM Yes PPO 300.00 20% N/A Certified - ne, Classified - 1st day of the month in which empl reaches their 90th work day. Self-Insured CATALINA FOOTHILLS (1) Yes PPO 0.00 0 30.00 1-30 -It is effective the first of the month following employment Blue Cross/Blue Shield through /Meretain AEA Research & Development 10
School MEDICAL EXPENSES INSURANCE New Emp Waiting Cafeteria Plan Type Available Deduct Co-Pay % Co-Pay Period Provider CATALINA FOOTHILLS (2) Yes PPO 500.00 25% 40.00 1-30 -It is effective the first of the month following employment Blue Cross/Blue Shield thru /Meretain CONCHO ELEM Yes PPO 0.00-900.00 250.00 up to 30 days also provides dental, life, and AD&D insurance for the full time employee (35+ hrs/wk). s may pay for insurance for a spouse and/or children. Part-time employees may purchase insurance if they choose. ELFRIDA ELEM (1) PPO 0.00 0 35.00 First of the month Meritain / after hire eligible if working more than 30 hours per week ELFRIDA ELEM (2) PPO 1250.00 20% 0.00 First of the month Meritain/ after hire School provides the difference in premium from the regular plan and this high deductible plan. This money is placed in a HSA plan. FLAGSTAFF PPO 750.00 20% 35.00 30 BCBS OF AZ FLORENCE (1) Yes PPO 350.00 20% 30.00 30 and 60 The rates listed above are for the Employer Sponsored plan. FLORENCE (2) Yes HSA 1250.00 20% 30 and 60 THE RATES LISTED ABOVE ARE FOR THE HDHP PLAN AND THE DISTRICT PROVIDES EACH COVERED EMPLOYEE WITH AN HSA FUNDED WITH $104.00 PER MONTH IN IT. FLORENCE (3) Yes PPO 0.00 0 30.00 30 AND 60 THE RATES LISTED ABOVE ARE FOR OUR UPGRADE MEDICAL PLAN. FLOWING WELLS PPO 2000.00 20% 25.00 30 for certified and Health Net (specialist is 60 for support 50.00) These are figures for the mid-range medical plan; 87% of participating employees choose this plan. GILBERT (1) PPO 750.00 20% 30 days/certified, 60 days/classified Meritain - TPA BCBS of AZ GILBERT (2) HSA 1500.00 20% 30 days/certified, Meritain - TPA BCBS of AZ 60 days/classified The funds $375.00 to the employee's HSA. GILBERT (3) HSA 2500 20% 30 days/certified, 60 days/classified Meritain - TPA, BCBS of AZ The funds $725.00 to the employee's HSA. GLOBE PPO 500.00 30.00 80 Blue Cross Blue Shield waiting period is applied to classified employees only AEA Research & Development 11
School MEDICAL EXPENSES INSURANCE New Emp Waiting Cafeteria Plan Type Available Deduct Co-Pay % Co-Pay Period Provider HEBER-OVERGAARD (1) Yes PPO 500.00 20% 35.00 1st of the month following hire date Navajo County Schools Benefit Trust pays employee cost, employee pays for any additional coverage. Deductible is $500.00 individual or $1500.00 family HEBER-OVERGAARD (2) Yes HSA 2500.00 100% contracted rate 1st of the month following hire date Navajo County Schools Benefit Trust pays employee cost, employee pays for any additional coverage. This is a High Deductible Health Plan. pays 100% of medical cost until deductible is met, then insurance pays 100% $2500 deductible individual / $5000.00 Family HEBER-OVERGAARD (3) Yes PPO 350.00 20% 35.00 60 Navajo County Schools Benefit Trust pays employee cost, employee pays for any additional coverage. Deductible is $500.00 individual or $1500.00 family HEBER-OVERGAARD (4) Yes HSA 2500.00 100% contracted 60.00 Navajo County Schools rate Benefit Trust pays employee cost, employee pays for any additional coverage. This is a High Deductible Health Plan. pays 100% of medical cost until deductible is met, then insurance pays 100% $2500 deductible individual / $5000.00 Family HIGLEY (1) Yes PPO 350.00 20% 30.00 30 Meritain Health HIGLEY (2) Yes PPO 0.00 0 30.00 30 Meritain Health HIGLEY (3) Yes HSA 1250.00 20.00 0.00 30 Meritain Health LITCHFIELD ELEM (1) Yes HSA 1250.00 20% n/a 31 LITCHFIELD ELEM (2) Yes PPO 300.00 15% 20.00 31 LITCHFIELD ELEM (3) Yes PPO 0.00 0 30.00 31 LITTLEFIELD ELEM (1) Yes PPO 500.00 75% 35.00 1 LITTLEFIELD ELEM (2) Yes PPO 350.00 80% 30.00 1 LITTLEFIELD ELEM (3) Yes PPO 2500.0 80% 1 MARANA (1) Yes HSA 1250.00 20% N/A 30 /Meritain 1.0 FTE-$1000 HSA, 0.75 FTE-$750 HSA, 0.5 FTE-$500 HSA MARANA (2) Yes PPO 300.00 15% 20/30 30 Asbait/Meritain MARANA (3) Yes PPO 0.00 0 30/40 30 Asbait/Meritain MCNARY PPO 0.00 0 15.00 30 /ASBA MCNEAL ELEM PPO 0.00 0 15.00 Up to 30 days ASBA Insurance Trust MOHAVE VALLEY ELEM Yes PPO 300.00 20.00 First of month following hire date Meritain MORRISTOWN ELEM PPO 30 Blue Cross Blue Shild MURPHY ELEM (1) PPO 500.00 25% 30.00 0 BLUE CROSS BLUE SHIELD OF ARIZONA MURPHY ELEM (2) PPO 300.00 15% 15.00 0 BLUE CROSS BLUE SHIELD OF ARIZONA AEA Research & Development 12
School MEDICAL EXPENSES INSURANCE New Emp Waiting Cafeteria Plan Type Available Deduct Co-Pay % Co-Pay Period Provider NOGALES (1) Yes PPO 300.00 15% 20.00 30 The enrollment effective date is the 1st of the month following the date of employment. NOGALES (2) Yes PPO 300.00 80% 20.00 30 s are eligible for coverage on the 1st of the month following employment. This is for the Standard Plan - Classic Gold NOGALES (3) Yes PPO 0.00 25% 20.00 0 Effective date is 1st of the month following date of hire. This is the Buy-Up plan for the district; Co-Pay Platinum NOGALES (4) Yes HSA 1250.00 80% 0 Effective dates is 1st of the month following date of hire. This is the High Deductible Health Plan $1250 and the district contributes $60/mth to the HSA. NORTHLAND PIONEER COLLEGE (1) Yes PPO 500.00 20% 35.00 First day of month following start day Summit Administrative Services, Inc. NORTHLAND PIONEER COLLEGE (2) Yes HSA 2500.00 0 0.00 First day of month following start day Summit Administrative Services Inc. For 1c-ii An HSA is not an insurance plan. It is an HDHP. ORACLE ELEM (1) Yes PPO 0.00 0 20.00 0 for certified and Meritain / admin / 60 for classified "Platinum Coverage" - covers the first $4560.00 for FT employee. eligible to buy up and pay difference. ORACLE ELEM (2) Yes PPO 300.00 15% 0 for certified and Meritain/ admin / 60 for classified "Classic Gold" = covers first $4560.00 for FT employee. is eligible to buy up and pay difference. PARADISE VALLEYR (1) Yes PPO 1500 20% Primary Care 20/30 Specialist 45/55 1st of the month following hire date United Healthcare PARADISE VALLEYR (2) Yes HSA 2500.00 20% once deductible has been met 20/30 or 45/55 1st of the month following hire date United Healthcare PARKER (1) PPO 500.00 100% 35.00 First of the month following w/meritain Health - TPA employment The district pays 100% of the employee premium. s pay for their own dependent coverage. Plan Name: Value Gold. AEA Research & Development 13
MEDICAL EXPENSES INSURANCE School Cafeteria Plan Type Available Deduct Co-Pay % Co-Pay New Emp Waiting Period Provider PARKER (2) PPO 300.00 100% 30.00 First of the month following w/meritain Health- TPA employment pays 100% of employee premium. pays for their dependent coverage. Plan Name: Classic Gold PARKER (3) PPO 750.00 100% 40.00 30 days following employment w/meritain Health - TPA pays 100% of employee premium. pays for their dependents. Plan Name: Value Silver PATAGONIA ELEM Yes PPO 300.00 15% 20.00 30 PATAGONIA UNION Yes PPO 300.00 15% 20.00 30 ASBAiT PHOENIX ELEM POS 750.00 20% 25.00 31 UHC PRESCOTT (1) PPO 700.00 30% maximum of 30 BCBS OF AZ We also offer a "buy-up" where the employee pays an additional amount, and a HDHP with an HSA PRESCOTT (2) PPO 350.00 20% maximum of 30 BC/BS PRESCOTT (3) HSA 2500.00 0 max of 30 BC/BS (we are self funded--yuebt) The district also contributes &63.40 to an HSA for each employee QUARTZSITE ELEM (1) Yes PPO 350.00 30.00 0 QUARTZSITE ELEM (2) Yes PPO 300.00 20.00 0 QUARTZSITE ELEM (3) Yes PPO 0.00 30.00 0 RIVERSIDE ELEM (1) Yes HMO 0.00 0 30.00 30 Meritain/ RIVERSIDE ELEM (2) Yes HSA 1250.00 20% 0.00 30 Meritain/ HDHP$1250; ER contributes premium difference $129 per month from Gold HMO plan to HDHP to HSA for those enrolled in HDHP SADDLE MOUNTAIN (1) Yes PPO 350.00 20% 30.00 30 BCBS OF AZ Classic Silver plan SADDLE MOUNTAIN (2) Yes PPO 300.00 15% 20.00 30 BCBS OF AZ Classic Gold SADDLE MOUNTAIN (3) Yes PPO 0.00 0 30.00 30 BCBS OF AZ CO-PAY GOLD PLAN SANTA CRUZ VLY Yes PPO 300.00 85% 20.00 30 SANTA CRUZ VLY UNION (1) Yes PPO 350.00 30.00 First day of following month SANTA CRUZ VLY UNION (2) Yes PPO N/A 20.00 First day of following month SNOWFLAKE (1) HSA 2500.00 35.00 0 BLUE CROSS / BLUE SHEILD 5000.00 FAMILY DEDUCTIBLE AEA Research & Development 14
School MEDICAL EXPENSES INSURANCE New Emp Waiting Cafeteria Plan Type Available Deduct Co-Pay % Co-Pay Period Provider SNOWFLAKE (2) PPO 500.00 20% 35.00 0 BLUE CROSS / BLUE SHEILD SOLOMON ELEM PPO 35.00 0 Do not have children coverage either plus one or family SOMERTON ELEM (1) Yes PPO 500.00 25% 35.00 First day of the following month of hire BCBS OF AZ SOMERTON ELEM (2) Yes PPO 0.00 0 30.00 First day of the following month of hire BCBS of AZ SOMERTON ELEM (3) Yes PPO 1250.00 20% N/A First day of the following month of hire BCBS of AZ ST JOHNS (1) Yes PPO 30.00 0 Meritain ST JOHNS (2) Yes PPO 350.00 20% 30.00 0 Meritain ST JOHNS (3) Yes PPO 500.00 25% 35.00 Meritain SUNNYSIDE (1) Yes PPO 0.00 0 20.00 1st of the month following 30 Blue Cross Blue Shield SUNNYSIDE (2) Yes PPO 500.00 20% 30.00 1st of the month following 30 Blue Cross Blue Shield SUNNYSIDE (3) Yes PPO 1500.00 0 0.00 1st of the month following 30 Blue Cross Blue Shield SUPERIOR (1) Yes PPO First day of the Meritain month following the month the employee was hired We offer three different medical plans and each plan offers a different monthly premium amount. The information I included is the plan with the largest premium. SUPERIOR (2) Yes PPO First day of the month following the month the employee was hired Meritain SUPERIOR (3) Yes PPO First day of the month following the month the employee was hired. Meritain AEA Research & Development 15
School MEDICAL EXPENSES INSURANCE New Emp Waiting Cafeteria Plan Type Available Deduct Co-Pay % Co-Pay Period Provider TEMPE ELEM (1) Yes PPO 1500.00 30% 30.00 30 days after start Blue Cross Blue Shield and bumped up to next month This is for our Low PPO Plan with a $1500 deductible TEMPE ELEM (2) Yes PPO 750.00 20% 25.00 30 days after start Blue Cross Blue Shield and bumped up to next month This is for our High PPO with a $750 deductible TEMPE ELEM (3) Yes HSA 2500.00 10% depends on 30 days after start Blue Cross Blue Shield doctor and bumped up to next month This is for our PPO Saver with HSA TOLLESON UNION (1) HSA 2500.00 0 0.00 31 United Health Care 2500 HDHP plan TOLLESON UNION (2) HSA 1500.00 0 0.00 31 United Health Care 1500 HDHP TOLLESON UNION (3) PPO 750.00 20% 35.00 31 United Health Care Base Plan UNION ELEM PPO 0.00 0 25.00 30 Meritain Monthly premium amounts are calculated by amt x 12 months / by 20 pays VAIL ELEM (1) PPO 300.00 15% eligible first of month following hire date VAIL ELEM (2) PPO 0.00 0 30.00 eligible first of month following hire date WHITERIVER PPO 500.00 25% 35.00 0 WILLIAMS (1) PPO 500.00 25% 35.00 0 days certified, 1st of month after 60 days classified This is our mid grade plan. We have a buy up and a high deductible also. WILLIAMS (2) PPO 300.00 15% 20.00 0 days certified, 1st of month after 60 days classified This is the buy-up plan AEA Research & Development 16
School MEDICAL EXPENSES INSURANCE New Emp Waiting Cafeteria Plan Type Available Deduct Co-Pay % Co-Pay Period Provider WILLIAMS (3) Indemnity 1250.00 20% 0 for certified 1st of the month after 60 days for classified This is our high deductible plan WILSON ELEM Yes PPO 500.00 75% 30.00 30 Blue Cross Blue Shield of Arizona WINDOW ROCK PPO 150.00 70% 15.00 1st of the month following hire date Self Insured - TPA services provided by Summit AEA Research & Development 17
School SINGLE PREMIUM DENTAL EXPENSES INSURANCE EMPLOYEE & SPOUSE EMPLOYEE, SPOUSE & CHILDREN EMPLOYEE & CHILDREN AGUILA ELEM 0.00 35.00 35.00 0.00 64.00 0.00 37.00 0.00 ALHAMBRA ELEM (1) 7.00 0.00 13.64 0.00 20.29 0.00 ALHAMBRA ELEM (2) 29.46 0.00 84.28 0.00 84.28 0.00 84.28 0.00 AMPHITHEATER (1) 25.09 8.91 61.09 8.91 85.09 8.91 63.09 8.91 AMPHITHEATER (2) 0.00 8.91 8.83 8.91 17.83 8.91 14.27 8.91 APACHE JUNCTION (1) 9.50 0.00 18.78 0.00 23.10 0.00 21.05 0.00 APACHE JUNCTION (2) 30.93 0.00 63.41 0.00 109.41 0.00 74.07 0.00 ARLINGTON ELEM 0.00 37.00 37.00 0.00 61.00 0.00 37.00 0.00 AVONDALE ELEM (1) 10.95 0.00 21.37 0.00 34.09 0.00 28.97 0.00 AVONDALE ELEM (2) 31.68 0.00 61.09 0.00 118.00 0.00 77.21 0.00 BEAVER CREEK ELEM 0.00 28.44 32.72 28.44 94.00 28.44 45.86 28.44 BENSON ELEM Included in Medical 32.00 32.00 32.00 67.00 32.00 37.00 32.00 CAMP VERDE 9.50 24.00 34.66 24.00 72.67 24.00 72.67 24.00 CASA GRANDE ELEM 0.00 24.05 30.26 0.00 30.26 0.00 30.26 0.00 CATALINA FOOTHILLS (1) 375.00 0.00 768.00 0.00 1430.00 0.00 530.00 0.00 CATALINA FOOTHILLS (2) 115.00 0.00 230.00 0.00 312.00 0.00 312.00 0.00 CONCHO ELEM 0.00 37.00 37.00 37.00 59.00 37.00 37.00 37.00 ELFRIDA ELEM 32.00 0.00 64.00 0.00 99.00 0.00 69.00 0.00 FLAGSTAFF 0.00 30.02 50.50 30.02 50.50 30.02 50.50 30.02 FLORENCE (1) 0.00 11.27 11.09 11.27 20.98 11.09 16.14 11.27 FLORENCE (2) 19.52 11.27 47.61 11.27 69.74 11.27 43.08 11.27 FLOWING WELLS (1) 0.00 9.55 9.07 9.55 18.14 9.55 18.14 9.55 FLOWING WELLS (2) 22.48 114.60 53.35 114.60 90.40 114.60 59.54 114.60 GILBERT Included in Medical GLOBE 32.60 0.00 54.80 0.00 105.64 0.00 71.10 0.00 HEBER-OVERGAARD 41.00 0.00 88.00 0.00 129.00 0.00 95.00 0.00 HIGLEY (1) 32.00 0.00 65.00 0.00 88.00 0.00 68.00 0.00 HIGLEY (2) 8.69 0.00 17.31 0.00 26.08 0.00 22.50 0.00 LITCHFIELD ELEM 0.00 39.00 39.00 0.00 64.00 0.00 36.00 0.00 LITTLEFIELD ELEM Included in Medical 32.00 33.00 32.00 56.00 32.00 36.00 32.00 MARANA (1) 9.79 0.00 22.78 0.00 32.86 0.00 30.36 0.00 MARANA (2) 32.00 0.00 65.00 0.00 87.00 0.00 67.00 0.00 MCNARY 0.00 38.00 41.00 0.00 76.00 0.00 47.00 0.00 AEA Research & Development 18
School SINGLE PREMIUM DENTAL EXPENSES INSURANCE EMPLOYEE & SPOUSE EMPLOYEE, SPOUSE & CHILDREN EMPLOYEE & CHILDREN MCNEAL ELEM 33.00 0.00 66.00 0.00 61.00 0.00 68.00 0.00 MOHAVE VALLEY ELEM 0.00 29.80 30.48 29.80 63.02 29.80 43.74 29.80 MORRISTOWN ELEM MURPHY ELEM (1) 0.00 8.27 16.55 8.27 24.82 8.27 21.52 8.27 MURPHY ELEM (2) 44.87 8.27 75.42 8.27 145.40 8.27 97.85 8.27 NOGALES Included in Medical 32.00 32.00 0.00 41.00 0.00 30.00 0.00 NORTHLAND PIONEER COLLEGE 41.00 88.00 41.00 129.00 41.00 95.00 41.00 ORACLE ELEM 36.00 0.00 72.00 0.00 102.00 0.00 74.00 0.00 PARADISE VALLEYR (1) 29.26 0.00 82.71 0.00 82.71 0.00 82.71 0.00 PARADISE VALLEYR (2) 40.58 0.00 113.58 0.00 113.58 0.00 113.58 0.00 PARKER Included in Medical 26.00 0.00 24.00 0.00 63.00 0.00 40.00 PATAGONIA ELEM 0.00 35.00 35.00 35.00 64.00 35.00 37.00 35.00 PATAGONIA UNION 0.00 35.00 35.00 35.00 64.00 35.00 37.00 35.00 PHOENIX ELEM 0.00 35.00 38.00 35.00 83.00 35.00 83.00 35.00 PRESCOTT (1) 36.00 0.00 107.98 0.00 107.98 0.00 107.98 0.00 PRESCOTT (2) 27.90 0.00 88.78 0.00 88.78 0.00 88.78 0.00 QUARTZSITE ELEM 0.00 38.00 38.00 38.00 64.00 38.00 38.00 38.00 RIVERSIDE ELEM 0.00 41.33 38.24 41.33 99.17 41.33 99.17 41.33 SADDLE MOUNTAIN 0.00 37.00 38.00 37.00 61.00 37.00 38.00 37.00 SANTA CRUZ VLY (1) 5.00 23.96 53.02 23.96 53.02 23.96 53.02 23.96 SANTA CRUZ VLY (2) 11.66 23.96 70.68 23.96 70.68 23.96 70.68 23.96 SANTA CRUZ VLY UNION 0.00 32.00 33.00 32.00 56.00 32.00 36.34 32.00 SNOWFLAKE 41.00 0.00 88.00 0.00 129.00 0.00 95.00 0.00 SOLOMON ELEM 37.00 0.00 75.00 0.00 98.00 0.00 0.00 0.00 SOMERTON ELEM 0.00 29.24 29.23 29.24 54.15 29.24 34.66 29.24 ST JOHNS SUNNYSIDE (1) 10.20 0.00 17.27 0.00 28.28 0.00 23.96 0.00 SUNNYSIDE (2) 30.42 0.00 50.70 0.00 67.24 0.00 47.01 0.00 SUPERIOR 0.00 34.78 32.60 35.32 63.58 44.19 43.32 27.69 TEMPE ELEM (1) 16.36 0.00 35.92 0.00 51.14 0.00 31.56 0.00 TEMPE ELEM (2) 40.58 0.00 89.06 0.00 126.87 0.00 78.22 0.00 TOLLESON UNION (1) 0.00 33.87 35.56 33.87 82.22 33.87 44.90 33.87 TOLLESON UNION (2) 0.00 114.00 0.00 225.36 0.00 277.20 0.00 252.60 AEA Research & Development 19
School SINGLE PREMIUM DENTAL EXPENSES INSURANCE EMPLOYEE & SPOUSE EMPLOYEE, SPOUSE & CHILDREN EMPLOYEE & CHILDREN UNION ELEM Included in Medical 36.00 44.40 36.00 70.80 36.00 22.20 36.00 VAIL ELEM (1) Included in Medical 11.00 11.00 11.00 19.00 11.00 11.00 11.00 VAIL ELEM (2) Included 21.00 in Medical 11.00 48.00 11.00 90.00 11.00 48.00 11.00 WHITERIVER 0.00 26.32 26.40 26.32 70.76 26.32 40.08 26.32 WILLIAMS 28.44 0.00 61.16 0.00 122.44 0.00 74.30 0.00 WILSON ELEM Included in Medical 27.36 33.66 27.36 70.06 27.36 70.06 27.36 WINDOW ROCK Included in Medical AEA Research & Development 20
School Cafeteria Plan DENTAL EXPENSES INSURANCE Deduct New Emp Waiting Period AGUILA ELEM Yes 0.00 30 ASBA Insurance Trust ALHAMBRA ELEM (1) Yes 0.00 First of the month following the date of hire Employers Dental Services ALHAMBRA ELEM (2) Yes 50.00 First of the month following the date of hire AMPHITHEATER (1) 50.00 1st of month after hire AMPHITHEATER (2) 0.00 1st of month after hire Employers Dental Services (EDS) APACHE JUNCTION (1) Yes 0.00 Same as Healthcare Plans Total Dental Administrators APACHE JUNCTION (2) Yes 50.00 Same as Healthcare Plans ARLINGTON ELEM Yes 1st of the month Meritian AVONDALE ELEM (1) Yes 0.00 <=30 Total Dental Administrators AVONDALE ELEM (2) Yes 50.00 <=30 Total Dental Administrators BEAVER CREEK ELEM Yes 50.00 0 Cert and 60 Classified - Rural Schools Benefit Trust BENSON ELEM Yes 50.00 1st day of next month after employment CAMP VERDE Yes 50.00 30 DELTA DENTAL CASA GRANDE ELEM Yes 50.00 Same as medical CATALINA FOOTHILLS (1) Yes 50.00 0-30 days, starts 1st of the following month after employment date CATALINA FOOTHILLS (2) Yes varies 0-30 days, starts 1st of the following month after employment date EDS Dental CONCHO ELEM Yes 50.00 up to 30 days ELFRIDA ELEM 50.00 First of the month after hire Meritain / FLAGSTAFF 50.00 30 DELTA DENTAL OF AZ FLORENCE (1) Yes 0.00 30 AND 60 DAYS TOTAL DENTAL ADMINISTRATORS FLORENCE (2) Yes 50.00 30 AND 60 DAYS TOTAL DENTAL ADMINISTRATORS FLOWING WELLS (1) none 30 certified and 60 support EDS FLOWING WELLS (2) 1000.00 30 for certified and 60 for support Cigna GILBERT Yes 50.00 Meritain - TPA, BCBS of AZ GLOBE 50.00 80 Deltal Dental HEBER-OVERGAARD Yes 50.00 1st of the month following hire date(cert) or 1st of the month following probation for classified Blue Cross Blue Shield HIGLEY (1) Yes 50.00 30 Meritain Health AEA Research & Development 21 Provider
School Cafeteria Plan DENTAL EXPENSES INSURANCE Deduct New Emp Waiting Period HIGLEY (2) Yes 0.00 30 Employers Dental Services LITCHFIELD ELEM Yes 50.00 31 LITTLEFIELD ELEM Yes 50.00 1 MARANA (1) Yes 0.00 30 Employers Dental Service MARANA (2) Yes 50.00 30 Asbait/Meritain MCNARY 50.00 30 /ASBA MCNEAL ELEM 0.00 Up to 30 days ASBA Insurance Trust MOHAVE VALLEY ELEM Yes 50.00 First of month following hire date of AZ MORRISTOWN ELEM MURPHY ELEM (1) 0.00 0 EMPLOYER DENTAL SERVICES MURPHY ELEM (2) 25.00 0 DELTA DENTAL OF ARIZONA NOGALES Yes 50.00 0 NORTHLAND PIONEER COLLEGE Yes 50.00 First day of month following start day Summit Adminstative Services, Inc. ORACLE ELEM Yes 50.00 60 Meritain / PARADISE VALLEYR (1) Yes 50.00 1st of month following hire date PARADISE VALLEYR (2) Yes 25.00 1st of the month following hire date PARKER 50.00 30 days from date of employment Ameritas PATAGONIA ELEM Yes 50.00 30 PATAGONIA UNION Yes 50.00 30 PHOENIX ELEM 50.00 31 Delta PRESCOTT (1) Yes 100.00 max of 30 PRESCOTT (2) Yes 100.00 max of QUARTZSITE ELEM Yes 50.00 0 RIVERSIDE ELEM 50.00 30 United Concordia SADDLE MOUNTAIN Yes 50.00 30 BCBS of AZ SANTA CRUZ VLY (1) 50.00 30 SANTA CRUZ VLY (2) 25.00 30 SANTA CRUZ VLY UNION Yes 50.00 First day of next month SNOWFLAKE Yes 50.00 0 BLUE CROSS / BLUE SHIELD SOLOMON ELEM 0 SOMERTON ELEM Yes 50.00 First of the folllowing month of hire Guardian ST JOHNS Yes 50.00 0 Meritain SUNNYSIDE (1) Yes 0.00 1st of the month following 30 TDA SUNNYSIDE (2) Yes 0.00 1st of the month following 30 AEA Research & Development 22 Provider
School Cafeteria Plan DENTAL EXPENSES INSURANCE Deduct New Emp Waiting Period SUPERIOR Yes First day of the month following the month the employee was hired. Principal TEMPE ELEM (1) Yes 1500.00 30 days after start and bumped up to next month TEMPE ELEM (2) Yes 1500 30 days after start and bumped up to next month TOLLESON UNION (1) 25.00 31 TOLLESON UNION (2) 0.00 31 TDA UNION ELEM 0.00 30 Meritain VAIL ELEM (1) 0.00 first of the month following date of hire Employer's Dental Services VAIL ELEM (2) 50.00 first of the month following hire date Principal Dental WHITERIVER 1500.00 0 Reliance Standard WILLIAMS 50.00 0 for certified, 1st of month after 60 days for classified WILSON ELEM Yes 1000.00 30 Dental Dental of Arizona WINDOW ROCK 25.00 1st day of the month following hire Self-funded - TPA services provided by Summit Provider AEA Research & Development 23
SHORT-TERM DISABILITY LIFE INSURANCE School PREMIUM Number of Days Before Eligible Percent of Salary Covered Cafeteria Plan PREMIUM Dollar BENEFIT or Percent of Salary Cafeteria Plan AGUILA ELEM short-term disability. 0.00 7.00 50000 ALHAMBRA ELEM 8 100% Yes 0.00 Yes pays all cost of Short-term disability they qualify for. The cost to the district depends on the amount of salary of the employee AMPHITHEATER 0 45 60% 0.00 2.75 25000 APACHE JUNCTION 0.00 50000 ARLINGTON ELEM The premium amount is based on an employees salary amount, and there are a multitude of options available for employees to select. short-term disability. 0.00 4.80 30000 AVONDALE ELEM 7 66.667% Yes 0.00 100 Yes Premiums are flat rate determined by coverage amount selected. Therefore, premium amounts vary. Premiums $0.077 per $10,000 of coverage for Basic Life paid by. Additional life insurance available to employees up to 5 times annual compensation. Rate set based on age and coverage amount. BEAVER CREEK ELEM short-term disability. 0.00 4.60 20000 BENSON ELEM short-term disability. Included in medical. 3.50 25000 CAMP VERDE short-term disability. 0.00 1.62 15000 CASA GRANDE ELEM 0 30 66.7% Included in medical. 1.96 20000 CATALINA FOOTHILLS varies 0.00 42 66.66% Yes varies 52.00 50000 Yes provides 50,000 and employee can purchase more. CONCHO ELEM short-term disability. 0.00 3.50 25000 s may purchase $10,000 for spouse or $5,000 for each child ELFRIDA ELEM short-term disability. 0.00 11.36 71000 can purchase additional coverage for their family at there cost at $4.15 (flat rate for all dependents) FLAGSTAFF 0.00 0.00 FLORENCE.45 30 60%.076 100 THIS IS A VOLUNTARY PLAN 100% OF SALARY COVERED UP TO $80,000.00 FLOWING WELLS 0 60 66% 0.00 25000 pays $.12 per $1000 of volume. AEA Research & Development 24
SHORT-TERM DISABILITY LIFE INSURANCE School PREMIUM Number of Days Before Eligible Percent of Salary Covered Cafeteria Plan PREMIUM Dollar BENEFIT or Percent of Salary Cafeteria Plan GILBERT 90 66 Yes Included in medical. 100 Yes Voluntary insurance is available through Assurant to cover 15-90 days. Meritain - TPA self-funded STD covers 90-120 days is 1 times the employee's salary is paid by the district. Additional life insurance is available on a voluntary basis. included in the medical, dental, vision benefit. GLOBE short-term disability. 0.00 6.58 50000 We also having a matching AD&D HEBER-OVERGAARD short-term disability. 1.5 HIGLEY 0.00 0.00 8 66.66% 50000 Monthly premium cost based upon salary Premiums are based upon age/coverage amount. LITCHFIELD ELEM 0.00 0.00 2.40 15000 Policies vary per individual. 100% paid by employee LITTLEFIELD ELEM 1 Yes Included in medical. 2.80 20000 Yes All short term disability premium is paid by the employee. The rate is based on individual salary. MARANA 100 45 67% Yes 100.00 1.3 Yes MCNARY short-term disability. 0.00 1.5 MCNEAL ELEM short-term disability. 0.00 8.40 60000 MOHAVE VALLEY ELEM short-term disability. 0.00 6.80 40000 MORRISTOWN ELEM MURPHY ELEM 0.00 7 66.23% 0.00 27.60 20000 NOGALES short-term disability. Included in medical. 1.60 10000 NORTHLAND PIONEER short-term disability. 0.00 1.5 COLLEGE ORACLE ELEM 25.48 0.00 7 0 Yes 0.00 4.00 25000 Yes PARADISE VALLEYR STD Benefits dependent on age / plan enrolled in through AFLAC. short-term disability. 0.00.054 per 1K 1 x PARKER 0 0.00 24 66.66% 0.00.70/employ ee 1.5 is also self insured through. additional charges made by ADBAIT for STD coverage. 9-10 mo. Full-time enrolled employees must have 24 days of banked sick leave and have been here 3 years to qualify. 11-12 month Full-time employees must provides 1.5 x salary of employee and $2000 spouse and $2000 Children coverage through Group Life. Additional Voluntary Life and AD&D coverage available to employee that they pay for. PATAGONIA ELEM 0 30 66.3% 0.00 3.08 20000 PATAGONIA UNION 0 30 66.3% 0.00 3.08 20000 AEA Research & Development 25
SHORT-TERM DISABILITY LIFE INSURANCE School PREMIUM Number of Days Before Eligible Percent of Salary Covered Cafeteria Plan PREMIUM Dollar BENEFIT or Percent of Salary Cafeteria Plan PHOENIX ELEM 60 1.1 100 PRESCOTT short-term disability. Included in medical. 20000 QUARTZSITE ELEM short-term disability. 0.00 3.20 20000 RIVERSIDE ELEM 100% 0.00 14 60% 0.00 3.48 40000 SADDLE MOUNTAIN short-term disability. 0.00 4.80 30000 SANTA CRUZ VLY short-term disability. 0.00 2.84 20000 SANTA CRUZ VLY UNION short-term disability. 0.00 9.00 50000 SNOWFLAKE Included in medical. 1 1/2 times annual salary&cr;&lf;or at least 25000.00 SOLOMON ELEM 0.00 0 Yes 0.00 4.00 25000 Yes SOMERTON ELEM EMPLOYEE PAYS BASED ON AGE short-term disability. 50000 Life insurance is paid 100% by the and monthly premium is determine by gender, age, etc. ST JOHNS Yes Yes SUNNYSIDE 0.00 2.43 25000 Short Term Disability is a private plan offered as a payroll deduction. s can select a wide variety of waiting periods and benefit coverage levels. Basic Life Insurance is provided to non-administrative employees for $25,000. Administrative employees must pay for $100,000 life insurance at $8.95 per month. SUPERIOR 0 60 66% Yes 0.00 100 Yes TEMPE ELEM 0 0.00 7 66.66% Yes 0.00 100.00 1.5 Yes Premiums are based on employee's salary. s pay a monthly premium and receive a monthly benefit based on salary. Basic Life is paid for by the. It is 1.5 of employee's salary for certified and classifed full time employees. It is 2.0 of administrator's salary. The district pays 100% for 1 x's the employees annual salary. TOLLESON UNION 100% 0.00 14 0 0.00 100% 100 pays cost per amount per month selected up to 66% of pay. does not contribute to STD. UNION ELEM 30 life insurance. VAIL ELEM 0 60 66.6% 0.00 10000 WHITERIVER 0 0 50% 0.00 37.20 20000 WILLIAMS short-term disability. 3.45 0.00 15000 WILSON ELEM 0.00 7 66.23% Yes Included in medical. 5.75 50000 Yes AEA Research & Development 26
SHORT-TERM DISABILITY LIFE INSURANCE School PREMIUM Number of Days Before Eligible Percent of Salary Covered Cafeteria Plan PREMIUM Dollar BENEFIT or Percent of Salary Cafeteria Plan WINDOW ROCK differ 0.00 20 66.667% 2.80 40000 Premium is based on annual salary and maximum weekly benefits that would be paid for each salary. Voluntary and employee pays entire premium. provides $40,000 of coverage for each employee. Additional amounts for employee, spouse and children are available where employee pays entire premium. AEA Research & Development 27
ELIGIBILITY FOR INSURANCE INSURANCE COMMITTEE School Hours Required to Participate Hours Required for Full Part-time Prorated? COMMITTEE Pro-ration REPRESENTATIVES Formula Emp Admin Brd Specific Assn Rep? CHANGES REQUIRE APPROVAL BY Committee Assn Level Appeal Process AGUILA ELEM 30 30 ALHAMBRA ELEM 30 30 17 4 none Yes Yes AMPHITHEATER 30 30 Yes if Certified 4 2 0 Yes and less than 30 hours, 80% of district contribution (FET.75-.79) APACHE JUNCTION 30 30 ARLINGTON ELEM 30 30 AVONDALE ELEM 30 30 8 2 0 Yes Yes Yes BEAVER CREEK ELEM 30 30 BENSON ELEM 20 20 CAMP VERDE 30 30 3 2 1 Yes CASA GRANDE ELEM 25 25 CATALINA FOOTHILLS 30 40 Yes FTE amount 2 2 0 Yes Yes CONCHO ELEM 1 35 ELFRIDA ELEM 30 30 FLAGSTAFF 30 30 FLORENCE 30 30 12 2 0 Yes Yes Yes Yes FLOWING WELLS 30 30 5 3 0 Yes GILBERT 30 30 4 4 1 Yes Yes Yes GLOBE 30 30 HEBER-OVERGAARD 30 30 HIGLEY 30 30 4 1 0 LITCHFIELD ELEM 35 35 7 2 0 LITTLEFIELD ELEM 30 32 Yes 75% of 2 3 0 Yes Yes premium is paid by district MARANA 30 Yes 0.5 6 2 0 Yes Yes Yes Yes FTE/0.75 FTE/1.0 FTE MCNARY 30 AEA Research & Development 28
ELIGIBILITY FOR INSURANCE INSURANCE COMMITTEE School Hours Required to Participate Hours Required for Full Part-time Prorated? COMMITTEE Pro-ration REPRESENTATIVES Formula Emp Admin Brd Specific Assn Rep? CHANGES REQUIRE APPROVAL BY Committee Assn Level Appeal Process MCNEAL ELEM 30 30 6 1 0 Yes Yes MOHAVE VALLEY ELEM 37.5 37.5 MORRISTOWN ELEM MURPHY ELEM 30 30 NOGALES 32 32 16 2 0 NORTHLAND PIONEER COLLEGE 30 30 ORACLE ELEM 40 40 PARADISE VALLEYR 30 30 8 4 0 Yes Yes PARKER 30 30 1 2 5 Yes Yes Yes PATAGONIA ELEM 30 30 PATAGONIA UNION 30 30 PHOENIX ELEM 30 30 PRESCOTT 30 30 Yes see above QUARTZSITE ELEM 35 35 RIVERSIDE ELEM 30 30 SADDLE MOUNTAIN 30 30 7 4 0 Yes SANTA CRUZ VLY 30 30 SANTA CRUZ VLY UNION 30 30 4 1 0 SNOWFLAKE 40 40 SOLOMON ELEM 30 30 SOMERTON ELEM 30+ 1 2 0 Yes Yes Yes ST JOHNS 30 30 SUNNYSIDE 18.75 30 Yes $350.59 x.5 8 4 0 Yes Yes Yes SUPERIOR 30 30 TEMPE ELEM 25-30 0.00 11 1 1 Yes Yes Yes Yes TOLLESON UNION 30 30 7 1 0 Yes Yes UNION ELEM 30 30 VAIL ELEM 30 40 Yes Yes Yes Yes Yes WHITERIVER 30 30 WILLIAMS 20 20 WILSON ELEM 30 30 3 2 0 Yes Yes WINDOW ROCK 30 30 9 1 0 AEA Research & Development 29