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Making the Most of Your Benefits. Enrollment Guide For Plan Year 7/1/11 – 6/30/12

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What to Expect During Benefit Enrollment

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What to expect during benefit enrollment

Making the Most ofYour Benefits

  • Enrollment Guide For Plan Year 7/1/11 – 6/30/12

  • Crisis Response Network of Southern Arizona , Inc. has taken great care in designing a comprehensive benefit program that will allow you to select benefit options that are right for you and your family. We offer Medical, Dental and Vision coverage as well as Life and Disability Insurance all through United Healthcare. You are eligible for benefits on the first of the month following your date of hire. Highlights to the plan include:

  • Company Paid Care24 Employee Assistance Program (EAP) offers 11 face to face visits per issue for employees and their household family members.

  • Voluntary Employee Paid Supplemental Life for employees and their Dependents, Short Term and Long Term Disability benefits customized to meet your individual needs.

  • What to Expect During Benefit Enrollment

  • This benefit guide summarizes the key features of Crisis Resource Network of Southern Arizona employee benefits program. You have the option to enroll yourself and your dependents. Important Note: Please review all coverage options carefully. After your initial eligibility selection(s) you cannot make changes to your coverage until our next annual enrollment or unless you experience a qualifying event.

  • Qualifying events include:

    • Loss or gain of coverage through your spouse

    • Loss of eligibility of a covered dependent

    • Eligibility change based on full or part-time status

    • Birth or adoption of a child

    • Marriage, divorce, legal separation

    • Death of your covered spouse or child

Online Enrollment Through BeneTrac

You may elect no benefits, one benefit, or choose to enroll in all of the benefits offered by using the BeneTrac System at: www.mypaychex.com

Disclaimer: This enrollment guide contains only highlights of the major provisions of the benefit programs of Crisis Response Network of Southern Arizona, Inc.. Legal documents describe the plans in complete detail and govern their operation. If there is a disagreement between this guide and any legal document, the terms of the legal document will always govern.


What to expect during benefit enrollment

Medical Benefits

United Healthcare: Group Number 04M6309

We offer a quality medical and prescription benefit plan through UnitedHealthcare. The UHC network of physicians and facilities is extensive. However, it is always a good idea to confirm that a provider or facility is contracted in the UHC network prior to making an appointment, especially if you are referred to another provider.

To determine whether or not your provider is a participating provider

please visit www.myuhc.com, or call 1-888-842-4571.

Disclaimer: This enrollment guide contains only highlights of the major provisions of the benefit programs of Crisis Response Network of Southern Arizona, Inc.. Legal documents describe the plans in complete detail and govern their operation. If there is a disagreement between this guide and any legal document, the terms of the legal document will always govern.


What to expect during benefit enrollment

Dental Benefits

Crisis Response Network of Southern Arizona offers you a quality dental program through United Healthcare. This plan will allow you to visit any dental provider you choose. Please note; however, any time you visit a dentist that is a non-contracted provider you may be subject to balance billing and a higher out of pocket expense. Any non-covered services that are performed will be your responsibility.A pre-treatment estimate is always recommended for any services estimated to cost over $300.00.

To find a dentist please visit www.myuhcspecialtybenefits.com. Once there select “Members/Dental”. Or, you can call 1-800-839-3242 24 hours a day, seven days a week.

*The non-network percentage of benefits is based on the allowable amount applicable for the same service that would have been rendered by an in-network provider

Vision Benefits

Crisis Response Network of Southern Arizona offers full vision coverage through United Healthcare that includes a vast in-network provider list. The vision plan will allow out-of network coverage also. To find a vision provider visit www.myuhcspecialtybenefits.com. Once there select “Members/Vision”. Or, you can call 1-800-839-3242 24 hours a day, seven days a week.

Disclaimer: This enrollment guide contains only highlights of the major provisions of the benefit programs of Crisis Response Network of Southern Arizona, Inc.. Legal documents describe the plans in complete detail and govern their operation. If there is a disagreement between this guide and any legal document, the terms of the legal document will always govern.


What to expect during benefit enrollment

Vision Benefits Premium

Flexible Spending Accounts

Crisis Response Network of Southern Arizona offers Flexible Spending Accounts to their employees. An FSA is an account in an employee’s name that can reimburse the employee for qualified expenses. There are two-main flexible spending accounts; a Medical Care Reimbursement Account and a Dependent Care Reimbursement Account.

An annual election or a waiver is required and you must complete this process through the BeneTrac System. For enrollment, you must specify how much you would like to contribute for the 2012 calendar year. A Flexible Spending Account has a “Use it or Lose it” provision as required by the Internal Revenue Service (IRS), which states that any unused funds at the end of the plan year will be forfeited. Your goal is choosing an amount that will cover all medical or dependent care expenses, being careful not to over fund your account and therefore forfeiting your unused contributions.

Group Life and Accidental Death & Dismemberment (AD&D)

Life insurance provides financial benefits to your beneficiary in the event of the death of a covered person. As an employee, Crisis Response Network of Southern Arizona provides you with basic life insurance in the amount of $50,000 at no cost to you. Enrollment is automatic as soon as you become eligible as a new hire. This benefit is offered through United Healthcare. In addition, you will be enrolled with Accidental Death & Dismemberment. If you should die for any reason related to an accident, your beneficiary will be paid an additional amount of $50,000.

Please review the BeneTrac System and add or update your Beneficiary or Beneficiaries.

Disclaimer: This enrollment guide contains only highlights of the major provisions of the benefit programs of Crisis Response Network of Southern Arizona, Inc.. Legal documents describe the plans in complete detail and govern their operation. If there is a disagreement between this guide and any legal document, the terms of the legal document will always govern.


What to expect during benefit enrollment

Voluntary Supplemental Life and Accidental Death & Dismemberment (AD&D)

You also have the opportunity to elect Supplemental Life and AD&D insurance as an additional benefit. This coverage is available for you and your dependents. NOTE: You cannot elect dependent coverage unless you elect employee coverage. Late entrants and new hires applying for coverage limits over the guarantee issue are required to complete an *EOI (Evidence of Insurability) Form.

AD&D coverage is equal to the life insurance benefit and is paid in the event of accidental death or dismemberment.

*Enrolling for any amount over the guarantee issue will require the member to complete a health statement form

What’s My Cost?

Disclaimer: This enrollment guide contains only highlights of the major provisions of the benefit programs of Crisis Response Network of Southern Arizona, Inc.. Legal documents describe the plans in complete detail and govern their operation. If there is a disagreement between this guide and any legal document, the terms of the legal document will always govern.

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What to expect during benefit enrollment

Voluntary Employee Paid Short Term Disability

You have the opportunity to enroll in Voluntary employee paid Short Term Disability through United Healthcare. A Short Term Disability benefit can provide a source of income if you have an illness or injury that keeps you out of work for an extended period of time.

What’s My Cost?

For example:if you are 32 and earn $38,000 annually, here’s how to figure your monthly and per pay period cost:

  • SHORT TERM DISABILITY

  • Cost is based on weekly benefit (up to the plan maximum).

  • (weekly benefit x rate)

  • Divided by 10 = monthly premium

  • Plan design: 60% to $1,000

  • Rate: .84 per $10.00 of weekly benefit

  • To get weekly benefit amount:

  • Employee earns $38,000 a year

  • Divide income by 52 and multiply by .60

  • (38,000/52) x .60 = $438.46 weekly benefit

    To calculate premium:

    (438.46 x .84) divided by 10 = $36.83 monthly premium

    To calculate per pay period deduction:

    (36.83 x 12) = $441.97 divided by 26 = $17.00

Disclaimer: This enrollment guide contains only highlights of the major provisions of the benefit programs of Crisis Response Network of Southern Arizona, Inc.. Legal documents describe the plans in complete detail and govern their operation. If there is a disagreement between this guide and any legal document, the terms of the legal document will always govern.

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What to expect during benefit enrollment

Voluntary Employee Paid Long Term Disability

You also have the opportunity to enroll in a Voluntary Employee Paid Long Term Disability through United Healthcare. Long Term Disability coverage provides a source of income if you are unable to work due to a covered injury or illness that continues beyond the maximum Short Term Disability benefit period.

For example:if you are 32 and earn $38,000 annually, here’s how to figure your monthly cost:

What’s My Cost?

  • LONG TERM DISABILITY

  • Cost is based on monthly salary (up to the plan maximum).

  • (monthly salary x rate)

  • Divided by 100 = monthly premium

  • Plan design: 60% to $10,000

  • Rate: .56 per $100.00 of covered payroll

  • Annual Salary: $38,000

  • Monthly Salary: $3,167.00

  • To get the monthly premium:

    (3,167 x .56) divided by 100 = $17.73 monthly premium

    To calculate per pay period deduction:

    (17.73 x 12) = $212.80 divided by 26 = $8.18

Disclaimer: This enrollment guide contains only highlights of the major provisions of the benefit programs of Crisis Response Network of Southern Arizona, Inc.. Legal documents describe the plans in complete detail and govern their operation. If there is a disagreement between this guide and any legal document, the terms of the legal document will always govern.

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What to expect during benefit enrollment

Company Paid Care24 Employee Assistance Program Services

You can visit: www.LiveandWorkWell.com / Access Code: Care24EAP

Call your Care24 EAP and NurseLine Services 24/7 at : 1.888.887.4114

Important Contact Information

Medical: United Healthcare - www.myuhc.com or 888-842-4571

Dental: United Healthcare - www.myuhcspecialtybenefits.com or 800-839-3242

Vision: United Healthcare – www.myuhcspecialtybenefits.com or 800-839-3242

Life/Disability: United Healthcare - www.myuhcspecialtybenefits.com or 800-839-3242

Brown & Brown Insurance – Ann Deakman [email protected] or 602-664-7012

For information on Medicare please contact Brown & Brown Insurance at 1-888-284-3405

Healthcare Reform Notices

*Notice Regarding Grandfathered Plan Status

Your group health plan believes your current plan is a “grandfathered health plan” under the Patient Protection and Affordable Care Act. As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits.

Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to the plan administrator at your employer group. For ERISA plans: You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform. This website has a table summarizing which protections do and do not apply to grandfathered health plans. For individual market policies and nonfederal governmental plans: You may also contact the U.S. Department of Health and Human Services at www.healthreform.gov

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What to expect during benefit enrollment

  • Women’s Health & Cancer Rights Act

  • You or your dependents may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient for:

    • All stages of reconstruction of the breast on which the mastectomy was performed;

    • Surgery and reconstruction of the other breast to produce symmetrical appearance;

    • Prostheses; and

    • Treatment of physical complications of the mastectomy, including lymph edema

      Plan limits, deductibles, co-payments, and coinsurance apply. For more information on WHCRA benefits, contact your Human Resources Department.

*Notice Lifetime Limit No Longer Applies and Enrollment Opportunity

The lifetime limit on the dollar value of benefits under your group health plan no longer applies. Individuals whose coverage ended by reason of reaching a lifetime limit under the plan are eligible to enroll in the plan. Individuals have 30 days from the date of this notice to request enrollment. For more information please contact the Human Resources Department

*Notice of Opportunity to Enroll in Connection with Extension of Dependent Coverage to Age 26

Individuals whose coverage ended, or who were denied coverage (or were not eligible for coverage), because the availability of dependent coverage of children ended before attainment of age 26 are eligible to enroll in your group health plan. Individuals may request enrollment for such children for 30 days from the date of notice. Enrollment will be effective retroactively to the first day of the first plan year beginning on or after September 23, 2010. For more information please contact the Human Resources Department.

Notice Regarding Rescission of Coverage

Coverage may only rescinded (i.e. retroactively revoked) due to fraud or intentional misrepresentation, or due to failure to pay premiums. A 30 day advance notice is now required before coverage can be rescinded and a rescission will now be considered an adverse benefit determination subject to the claims and appeals rules.

Children’s Health Insurance Program:

If you are eligible for health coverage from your employer, but are unable to afford the premiums, some states have premium assistance programs that can help pay for coverage. These states use funds from their Medicaid or CHIP programs to help people who are eligible for employer sponsored health coverage, but need assistance in paying their health premiums.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in Arizona, you can contact your state Medicaid of CHIP office to find out if premium assistance is available.

Website for Arizona:

http://www.azahcccs.gov/applicants/default.aspx or phone (in state) 1-877-764-5437

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your state Medicaid or CHIP office or dial 1-877-KIDS NOW or you can visit www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the state if it has a program that might help you pay the premiums for an employer-sponsored plan.

Once it has been determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.

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