2020-2021 BENEFITS

TOWN OF PAYSON

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WHAT’S NEW?

1. BCBSAZ requires you to use a Blue Distinction facility for certain procedures.

2. Diabetics can get up to six nutritional counseling sessions per year at no cost!

3. Prescription assistance programs now apply towards your deductible.

4. VSP frame allowance increased to $180/year.

5. HSA allowable contributions are going up, so you can save more money this year.

6. Hang on to your medical ID card.

7. EAP now offers video counseling, online support groups, and artificial intelligent

chatbots.

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THE ELECTIONS MADE DURING THIS ENROLLMENT PERIOD

ARE EFFECTIVE FROM

July 1, 2020 to June 30, 2021

Benefit plans are administered on a “policy year

basis,” from July 1 through June 30 of each year

Only a qualified "change in status" event will allow

for changes outside of the open enrollment period;

changes must be made within 31 days of the

change in status event

REMINDERDon’t throw away your ID card.

BENEFIT PLAN COVERAGE AND ENROLLMENT DATES

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PREVENTIVE BENEFITS

Preventive care is available at no cost to you or family

members enrolled in coverage, no matter what medical

plan you are enrolled in:

• annual wellness exam (adults and children)

• biometric screening lab work and flu shots

• mammograms, prostate screenings, and colonoscopy

• annual dental cleanings and x-rays

Preventive care (in-network) is covered at 100%, with no

deductible; out-of-network benefits are covered at 50%

Your physician must use wellness codes when billing

services to the plan

AND NOW

WHAT

YOU’VE

BEEN

WAITING

FOR…

HEALTHCARE

PLANS!

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COPAY PLAN BENEFIT OVERVIEW $750 COPAY PLAN

Plan Year Deductible$750/employee

$1,500/employee +1

$2,250/employee +2 or more

Out-of-Pocket Maximum$5,000/employee

$10,000/employee +1 or more

Well Adult CarePlan pays 100%, no deductible

Well Child Care

Office Visit$20 copay primary care physician

$40 copay specialist

Emergency Room Plan pays 80%, after deductible

Urgent Care $40 copay

Retail Prescription Drugs

(30-day supply)

You pay:

• Generic: $10

• Preferred: 30% (maximum of $35)

• Non-preferred: 50% (maximum of $75)

• Specialty: 50% (maximum of $75)

Mail Order Drugs

(90-day supply)

You pay:

• Generic: $25 copay

• Preferred: $50 copay

• Non-preferred: $90 copay

• In-network coverage

• Embedded deductible

• Prescription copay not

subject to deductible

• Telehealth is free

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$1,500 HDHP

PLAN

BENEFIT OVERVIEW $1,500 HDHP ($3,000 FAMILY)

Plan Year Deductible$1,500/employee

$3,000/employee +1

Out-of-Pocket Maximum$3,500/employee

$6,550/employee +1 or more

Well Adult CarePlan pays 100%, no deductible

Well Child Care

Office Visit

Plan pays 80%, after deductibleEmergency Room

Urgent Care

Retail Prescription Drugs

(30-day supply)

You pay:

• Generic: $10

• Preferred: 30% (maximum of $35)

• Non-preferred: 50% (maximum of $75)

• Specialty: 50% (maximum of $75)

Mail Order Drugs

(90-day supply)

You pay:

• Generic: $25 copay

• Preferred: $50 copay

• Non-preferred: $90 copay

• In-network coverage

• Non-embedded deductible

• Prescription copay subject to

deductible, unless considered

a preventive medication

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$2,500 HDHP

PLAN

BENEFIT OVERVIEW $2,500 HDHP ($5,000 FAMILY)

Plan Year Deductible$2,500/employee

$5,000/employee +1

Out-of-Pocket Maximum$3,450/employee

$6,550/employee +1 or more

Well Adult CarePlan pays 100%, no deductible

Well Child Care

Office Visit

Plan pays 80%, after deductibleEmergency Room

Urgent Care

Retail Prescription Drugs

(30-day supply)

You pay:

• Generic: $10

• Preferred: 30% (maximum of $35)

• Non-preferred: 50% (maximum of $75)

• Specialty: 50% (maximum of $75)

Mail Order Drugs

(90-day supply)

You pay:

• Generic: $25 copay

• Preferred: $50 copay

• Non-preferred: $90 copay

• In-network coverage

• Non-embedded deductible

• Prescription copay subject to

deductible, unless considered

a preventive medication

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$5,000 HDHP

PLAN

BENEFIT OVERVIEW $5,000 HDHP

Plan Year Deductible$5,000/employee

$10,000/employee +1

Out-of-Pocket Maximum$6,450/employee

$12,900/employee +1 or more

Well Adult CarePlan pays 100%, no deductible

Well Child Care

Office Visit

Plan pays 80%, after deductibleEmergency Room

Urgent Care

Retail Prescription Drugs

(30-day supply)

You pay:

• Generic: $10

• Preferred: 30% (maximum of $35)

• Non-preferred: 50% (maximum of $75)

• Specialty: 50% (maximum of $75)

Mail Order Drugs

(90-day supply)

You pay:

• Generic: $25 copay

• Preferred: $50 copay

• Non-preferred: $90 copay

• In-network coverage

• Embedded deductible

• Prescription copay subject to

deductible, unless considered

a preventive medication

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MAXOR TOOLS

Your prescription drug benefit can be used to obtain prescriptions

from any participating pharmacy listed on the MaxorPlus network.

The MaxorPlus member portal allows easy access to:

Locate a network

pharmacy near you

View the plan formulary

Order replacement ID

cards

Sign up for mail order

Review your prescription

history

Calculate my copay

DID YOU KNOW: IF YOU REQUEST A BRAND NAME MEDICATION WHEN A GENERIC IS

AVAILABLE, YOU'RE RESPONSIBLE FOR THE COST DIFFERENCE BETWEEN THE 2, IN ADDITION

TO THE BRAND COPAY. THIS IS KNOWN AS A DISPENSE AS WRITTEN (DAW) PENALTY.

Sign up for myMaxorLink

today to start saving!

This is a free MaxorPlus service that

sends you discounts savings and

reminders about your prescription

benefits.

mymaxorlink.com/maxorplus

800-687-0707

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MAXOR TOOLS

The following tips can help reduce the amount of

money you pay for prescriptions:

Consider generic medications

Buy medications through the mail

Shop around for your medications

Ask your doctor if there is an over-the-counter

alternative to your prescription

GETTING THE MOST FROM

YOUR PRESCRIPTION BENEFIT

To use the Preventive List, double check

the formulary to make sure it is first on

the formulary, then on the preventive list.

HDHP Preventive Listing

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BLUECARE ANYWHERE

Why not see a doctor, for less, in the convenience of your own home? With

BlueCare Anywhere, you can sign in on a computer or mobile device and

conduct a live virtual visit with a board-certified medical professional, any day,

anytime, anywhere, for things like:

Average Costs:

Cold, flu, fever

Cough, bronchitis

Diarrhea, vomiting

Download the

mobile app

available on Apple

or Google Play

Pinkeye

Rashes

Sinus infection

Sore throat

Sprains & strains

Stomach bugs

DID YOU KNOW: YOU CAN USE YOUR HEALTH

SAVINGS ACCOUNT FOR BLUECARE ANYWHERE.

ER $1,800

Urgent Care $126

BlueCare Anywhere $49**Price varies for

mental health services

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WELLNESS TOOLS

NEW ONLINE WELLNESS

ASSESSMENT TOOLShareCare, live 7/1/20

VIRTUAL COACHINGSelf-paced online health & behavior

change program

HEALTHYBLUE ONLINENo-cost online health tools & resources

NURSE ON CALLRegistered nurses available 24/7

BLUE365Select savings for products

& services to maintain health

LIFESTYLE COACHINGPersonalized one-on-one

health support

CONDITION MANAGEMENTSupport & resources for chronic conditions

CARE MANAGEMENTInteractive support for complex

or unexpected events

azblue.com/healthcareprofessionals/live-healthy

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MORE BENEFITS WITH

YOUR BENEFITS

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HSA WHAT? SAVINGS!

HSA ADVANTAGES

Triple Tax BenefitContributions are tax deductible; qualified

medical expenses are tax-free; and, funds

grow with no tax liability.

It’s Yours ForeverThe money in your HSA rolls over every

year and is yours to keep, even if you

leave your employer.

Grow and SaveYou can invest the funds, and your

earnings grow tax-free. After age 65, you

can use the HSA like a traditional

retirement account.

COVERAGE TYPE2020-2021 MAXIMUM

CONTRIBUTION LIMIT

Individual $3,550

Family $7,100

Age 55+ Catch Up

ContributionAdditional $1,000

HOW MUCH CAN YOU

CONTRIBUTE?

Watch our HSA Saves the Day video

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You’re covered under a qualified high

deductible HDHP

You are not also covered by a spouse’s

non-HDHP employer plan

You aren’t enrolled in Medicare, Tricare or

another non-qualified healthcare plan

You can’t be claimed as a dependent on

someone else’s tax return

YOU’RE ELIGIBLE FOR AN HSA IF:

WANT TO FIND OUT WHAT IS AND IS NOT A QUALIFIED MEDICAL EXPENSE?

VISIT LEARN.HEALTHEQUITY.COM/QME/

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PPO DENTIST

ANNUAL MAXIMUM BENEFIT $1,500

*ANNUAL DEDUCTIBLE (INDIVIDUAL/FAMILY) $50/$150

LIFETIME ORTHODONTIA Child $1,500 maximum

PREVENTIVE SERVICES 100%

*BASIC SERVICES 80%

*MAJOR SERVICES 50%

ORTHODONTIC SERVICES 50%

SELECT DENTAL PLAN

See a Premier or

PPO dentistHigher

out-of-pocket

costs may be incurred

when

seeing a non-

participating

dentist.

Delta’s dental plan allows you and your eligible dependents to visit

any dentist or specialist without a referral. The plan also travels

with you anywhere in the country.

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VOLUNTARY VISION

COPAY

WELL VISION EXAM $10

PRESCRIPTION GLASSES $25

FRAME

LENSES

LENS ENHANCEMENTS

$180 allowance for select frames

$100 Walmart/Costco frame allowance

20% savings on amount over allowance

Single vision, lined bifocal, and lined trifocal lenses

Standard progressive

UV protection

Premium progressive

Custom progressive

Included

Included

$0

$0

$95-105

$150-175

CONTACTS (instead of glasses) $150 allowance for contacts

Contact lens exam

$60

There’s no ID card

necessary, just give your

provider your social

security number.

If you’d like a card for

reference, you can print

one at vsp.com.

Frame allowance

$180 for a wide

selection of frames!

Using your VSP Choice benefit is easy. Simply create an account at vsp.com.

Once your account is activated, you can review your benefit information and find

an eye doctor who’s right for you. At your appointment, tell the office staff that you

have VSP.

Exam, frames, lenses and contacts-every 12 months

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BASIC LIFE

$10,000

100% employer-paid

BASIC LIFE AND AD&D- Retiree

BASIC ACCIDENTAL DEATH & DISMEMBERMENT

$10,000

100% employer-paid

Includes:

• Travel assistance

• Estate resolution

services

• Grief counseling

After age 65, basic life

reduces to $6,500; then

at age 70, to $0You may convert the $6,500 at age 70

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EMPLOYEE ASSISTANCE PROGRAM

The Kairos Employee Assistance Program (EAP) offers 24-

hour access to confidential counseling services that can

help with a variety of everyday issues and challenges.

Counseling services*:

Stress and anxiety

management

Family matters

Substance abuse

Call EAP at

(800) 327-3517

*Includes 6 one-on-one

counseling sessions

EAP now offers:

• Video

counseling

• Online peer

support

groups

• Artificial

intelligent

chat-bots

Online resources:

Childcare resources

Will preparation

Legal and financial

resources

Visit EAP at

eappreferred.com

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KEY REMINDERS

Elections you make will be effective 7/1/2020

Deductibles and OOP maximums will reset

7/1/2020

Find in-network providers on azblue.com

New medical ID cards will NOT be mailed for

existing members, so hang on to last year’s

ID card

Remember to update your beneficiaries

and address

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TELL US HOW WE DID!

Complete our feedback survey, at:

www.surveymonkey.com/r/KairosOpenEnrollment

This survey is anonymous, unless you choose to leave your

name. We appreciate your most honest and sincere

feedback!