Maricopa County Employee Benefits Program

2021-22 Benefits Open Enrollment Guide

Your Benefits. Your Choice.

$

Open Enrollment is April 12 - May 7, 2021Make your elections in the BenefitSolver Portal: benefits.maricopa.gov

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 2

Table of Contents

Introduction Open Enrollment .....................................................3 Maricopa County's Health Plan Costs ................3 Comparing Maricopa County’s Benefits .............3

Plan Changes Medical Plans ............................................................4 Life Insurance ............................................................4 Flexible Spending Accounts ...................................4 Open Enrollment Checklist .....................................................................5 Before Open Enrollment ...................................5 During Open Enrollment ...................................5 After Open Enrollment ......................................5 Open Enrollment FAQs ...........................................6 When Do Benefits Begin? ................................6 Will I Receive a New ID Card? .........................6 What If I Am a New Hire? .................................6 What If I Have a Life Event? ............................6 How Do I Complete Elections in

BenefitSolver? ................................................7

Plan Overview The County's Medical Plans ...................................8 Cigna HMO Medical Copay/ Out-of-Pocket Costs ....................................... 10 Cigna and UnitedHealthcare HDHP with HSA Medical Coinsurance/ Out-of-Pocket Costs ....................................... 11 UnitedHealthcare PPO Medical Copay/Coinsurance/ Out-of-Pocket Costs ....................................... 12 Medical, Prescription, Behavioral Health Premiums ........................................................... 13 Vision Plan Premiums ........................................... 14 Dental Plan Premiums .......................................... 14 Life Insurance Plan Premiums ........................... 15 Short-Term Disability Plan Premiums ............... 16 MetLife Legal Plan Premiums ............................. 16 Pet Insurance ......................................................... 16

Making the Most of Your Benefits Financial Health Insurance Terms ...................... 17 Use In-Network Providers to Save Money ..... 17 Resources ................................................................ 18 Notices .................................................................... 18

Wellness at Work Wellness at Work .................................................. 19

Provider Contact Information ................................... 20

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 3

Open Enrollment This year Open Enrollment is passive. If you do not make any changes to your currentcoverage, your current elections will automatically carry over to Plan Year 2021-2022. There are exceptions. Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) require an annual election amount.

This Open Enrollment Guideincludes information forevaluating your benefit options. Please review it with your family to ensure you choose the health plan that’s right for you.

Any new elections and all changes become effective July 1, 2021.

Contact the benefits team at 602-506-1010 if you have questions or need assistance.

Maricopa County's Health Plan CostsMaricopa County's health plans are self-funded; the County assumes the financial risk for providing healthcare benefits to its employees. The County saves the money that an insurance company adds to its premium for a fully-insured plan, but is also responsible if the amount of claims is larger than expected.

The total expected increase for the coming plan year is budgeted at $14.8M. The County is picking up 92.3% of the cost, or $13.7M. The majority of employees will only see a small increase per pay period.

Refer to pages 13 through 16 for premiums by plan.

Comparing Maricopa County's BenefitsThe table below compares Maricopa County premiums to those of other government and private employer plans. Even without the wellness incentive of $30/paycheck ($60/month), County premiums remain competitive.

AVERAGE MONTHLY PREMIUM FOR INDIVIDUAL COVERAGE ($)Plan Type 2021-2022

Maricopa County

(w/Wellness Reward)

2021-2022 Maricopa County

Government 500+ emp.

County Gvts. 500+

emp.

10,000-19,999+

emp.

PPO $54 $114 $133 $99 $144

HDHP w/HSA $9 $69 $95 $59 $88

HMO $27 $87 N/A $83 $128

AVERAGE MONTHLY PREMIUM FOR FAMILY COVERAGE ($)PPO $307 $367 $514 $485 $535

HDHP w/HSA $70 $130 $383 $315 $329

HMO $188 $248 N/A $421 $480

Introduction

Maricopa County gives you access to benefits and resources to help you take care of your physical, emotional and financial health. It’s up to you to choose the benefits that best meet your needs. Open Enrollment is your annual opportunity to choose the benefits that are best for you and/or your family.

Maricopa County contributes a significant amount towards the cost of your benefits. Your share of the contributions for medical, vision, and dental benefits are deducted on a pre-tax basis which helps reduce your tax liability.

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 4

All Medical Plans • Treatment of Temporomandibular Joint (TMJ) will

be covered by all plans.• The number of nutritional counseling sessions will

increase from 3 to 12. You can see a nutritionist whenever you choose, not only when medically necessary.

Cigna and UHC HDHP with HSA Medical Plans:HSA / FSA Grace Period IRS Rule:• You cannot have both a Flexible Spending Account

(FSA) and a Health Savings Account (HSA). • If you switch from an HMO or PPO to a HDHP

plan during Open Enrollment you must exhaust your FSA balance before the end of the current plan year.• If not, you will not be able to contribute or

receive any contribution to the HSA until the end of the FSA grace period.

• This does not include the Dependent Care FSA or the Limited Scope FSA.

• If you choose to not contribute your money into your HSA, you must select $0 to receive the County's contribution.

The annual Health Savings Account (HSA) Contribution Limit is increased from:• $3,550 to $3,600 for individual coverage.• $7,100 to $7,200 for family coverage.• The County HSA contribution remains $500

individual/$1,000 family.• You are required to designate an annual

election. However, changes are allowed throughout the Plan Year.

• You must use a mailing address, not a PO Box, to open an HSA.

• The HSA will be funded on July 21, 2021. No ChangesThere are no plan changes to any of the other benefits: Employee Assistance Program (EAP), Vision, Dental, Short-Term Disability, Group Legal, Pet Insurance

Plan Changes

Life Insurance• You may elect or increase your additional life

insurance by 1x your annual base salary without having to provide Evidence of Insurability (EOI) during Open Enrollment, or if you get married, have a baby, or adopt, and record the life event within 30 days.

• The amount of insurance cannot exceed $750,000.

• Additional coverage is available with EOI anytime.

Flexible Spending AccountsThe annual maximum contribution for the Health Care and Limited Scope FSA's will remain at $2,750.• Refer to the chart below to determine what

savings/spending accounts you can participate in• Select the amount of your contribution in the

BenefitSolver Portal. You must make an annual contribution if you wish to participate in a FSA for the 2021-22 Plan Year.

Type of Medical Plan:

Health Savings Account (HSA)

Limited Scope Account (LSA)

Flexible Spending Account (FSA)

Cigna Medical HMO aCigna Medical HDHP a aUnitedHealthcare PPO aUnitedHealthcare HDHP a aWaived Medical a

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 5

Before Open Enrollment: rVisit www.maricopa.gov/

Open-Enrollment to review the 2021-2022 benefit changes.

r Attend an Open Enrollment webinar.

r Review informational videos: rBenefits 101 rWhat is a High Deductible

Health Plan? rWhat is a Health Savings

Account (HSA)? rWhat is a Flexible

Spending Account?r Compare your benefit options

to decide which ones are best for you.

r If enrolling in the Cigna HMO Plan for the first time, select a Primary Care Physician (PCP) before making your elections at www.cigna.com/cmgaz/doctor.

r If enrolling in the Cigna Pre-Paid Dental Plan for the first time, select a Primary Care Dentist (PCD) before making your elections.

r Gather documentation (i.e., marriage certificate, birth certificate, most recent tax return) to submit for the Dependent Verification process to validate newly-added dependents.*

r Call the Employee Benefits Division at 602.506.1010 with questions.

*Note: Dependents who have previously been approved as eligible for coverage AND who had coverage (medical, vision, and/or dental) in Plan Year 2020-2021 will not be re-verified.

Open Enrollment Checklist

During Open Enrollment:r Access the BenefitSolver

Enrollment System at benefits.maricopa.gov starting April 12, 2021.

r Make any plan changes you need for 2021-2022.

r Select the contribution amount if you are electing a Flexible Spending Account or Health Savings Account.

r Once you have reviewed your elections and they are accurate, click “Approve” and then select "I Agree" to submit your enrollment.

r If applicable, upload documentation required for dependent verification for any newly-added dependents.*

r Complete your elections by May 7, 2021 at 5:00 pm Arizona time.

r Print a copy of your Benefit Summary for your records.

After Open Enrollment:r If you added new dependents

to coverage upload verification documentation and respond no later than May 27, 2021.* • Failure to respond or

provide sufficient proof of eligibility will result in your dependent(s) not being enrolled in coverage.

r Securian Life Insurance will mail you a letter with instructions on how submit an Evidence of Insurability form for life insurance.

r Review your confirmation statement at benefits.maricopa.gov to know which benefits you elected for Plan Year 2021-2022.

r Print a copy of your confirmation statement for your records.

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 6

When Do Benefits Begin?• Benefits elected during Open

Enrollment begin July 1, 2021.• Benefit deductions will

begin with the July 21, 2021 paycheck.

• For new employees (or newly benefits-eligible employees) benefits begin on the first day of the month following date of hire or date of benefits eligibility.

• Benefits elected as a result of a Life Event begin the date of the event.

Will I Receive a New ID Card after Open Enrollment (OE)?• If you are enrolled in a Delta

Dental PPO Plan.• If you switch to a new plan or

are a new enrollee.• If your current FSA card is

expiring or you are a new enrollee. Existing members will have Health Care or Limited Scope FSA funds added to their current card.

Open Enrollment FAQ's

What if I Am a New Hire during OE?If you made your new hire elections before April 12, 2021:1. Access the BenefitSolver

Portal at benefits.maricopa.gov2. Complete current year (Plan

Year 2020-2021) benefit elections.

3. Print your Benefit Summary with your confirmation number.

4. Return to the BenefitSolver portal on or after April 12, 2021 to complete next year (Plan Year 2021-2022) benefit elections.

5. If you add a new dependent(s) you must complete the Dependent Verification process.

If you are making your new hire elections on or after April 12, 2021:1. Access the BenefitSolver

Portal at benefits.maricopa.gov2. Complete current year (Plan

Year 2020-2021) benefit elections.

3. Follow the system prompts to complete the next year (plan Year 2021-2022) benefit elections.

4. Print your Confirmation Page with your confirmation number.

5. If you add a new dependent(s) you must complete the Dependent Verification process by May 27.

What if I Have a Life Event?If you have a life event between April 12 and May 7:1. Access the BenefitSolver

Portal at benefits.maricopa.gov2. Complete Plan Year 2020-

2021 benefit elections with "Change My Benefits" link (birth/death, marriage/divorce, gain or loss of coverage.)

3. Complete the 2021-2022 Open Enrollment elections even if you have completed Open Enrollment prior to processing your Life Event.

If you have a life event between May 8 and June 30:1. Access the BenefitSolver

Portal at benefits.maricopa.gov2. Complete Plan Year 2020-

2021 benefit elections with "Change My Benefits" link (birth/death, marriage/divorce, gain or loss of coverage.)

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 7

1. Log in to the BenefitSolver portal between April 12 and May 7, 2021: benefits.maricopa.gov• If you are a first-time BenefitSolver user, this

"Enrolling is Easy" flyer can help you log in• Case-sensitive company key is "maricopa"• For help with User ID or password, click on

the link titled: “Forgot your user name or password?”

• If you experience login problems, call the benefits team at 602.506.1010

2. Click on the “Start Here” box in the banner• After 15 minutes of inactivity you will be

logged out of BenefitSolver

3. Read the “Welcome” screen, press “Start Enrollment,” and follow the prompts

4. The Benefit Enrollment System will take you through each available benefit option a. Read the instructions for completing each

screenb. Enter a contribution goal (for flexible spending

accounts and/or health savings account.) To continue with the FSA and/or HSA elections, you must designate a contribution

c. Click on the ‘Approve’ button on the “2021-2022 Benefit Summary” screen to save your elections. Make a note of your confirmation number

d. When you see the ‘Thank You’ screen, your enrollment has been completed

e. Print your 2021-2022 “Benefit Summary” for your records

How Do I Complete Open Enrollment in BenefitSolver?

Open Enrollment FAQ's (cont.)

2021-2022 Open Enrollment is Here!

5 Days Left Start Here

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 8

Plan Type Description: HMO (Health Maintenance Organization) An HMO is managed care directed by a primary care physician (PCP), who issues referrals to specialists and other contracted health care professionals within a defined network of providers. The HMO is the most restrictive form of managed care, but generally has lower premiums and out-of-pocket costs. Coverage is available only in Maricopa County, except for a life threatening emergency. Telehealth is available at no cost.

Vendor/Medical Plan Prescription Behavioral HealthEmployee Assistance Program

1. Cigna HMO (Coverage is limited to Maricopa County only)

OptumRx Coinsurance Prescription Plan

Magellan Behavioral Health Magellan EAP

2. Cigna HDHP with HSA Cigna HDHP Prescription Plan

Cigna Behavioral Health Magellan EAP

3. UnitedHealthcare PPO OptumRx Coinsurance Prescription Plan

MagellanBehavioral Health Magellan EAP

4. UnitedHealthcare HDHP with HSA OptumRx HDHP Prescription Plan

United Behavioral Health Magellan EAP

The County's Medical PlansMaricopa County offers four medical plan options to choose from when selecting the coverage that is best for you and your family. Each medical plan is bundled with a prescription and behavioral health benefit. Your medical plan choices are:

PPO (Preferred Provider Organization)A PPO offers access to a broad “preferred” provider network of physicians, specialists, and hospitals. Selection of a primary care physician (PCP) is not required, nor are referrals to see other providers within the network. These plans offer more flexibility but with higher premiums and out-of-pocket costs. Both nationwide in-network and out-of-network coverage is available. Telehealth is available at no cost.

HDHP (High Deductible Health Plan) An HDHP is a health insurance plan with lower premiums. With an HDHP, the plan pays nothing toward health care services, except for in-network preventive care, until the deductible has been met. There is access to a broad range of in-network providers, and both in-network and out-of-network coverage is available. Under IRS regulations, a Health Savings Account may be opened to set aside money to pay for eligible health care expenses. Telehealth is available.

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 9

Health Savings Account (HSA)To receive the County HSA contribution, you must sign up for an HSA even if you do not plan to contribute any of your own money. • The County HSA contribution is $500

individual/$1,000 family• The annual Health Savings Account (HSA)

Contribution Limit is increased from:• $3,550 to $3,600 for individual coverage• $7,100 to $7,200 for family coverage

• Per the IRS, you must meet these requirements to be eligible and qualify for an HSA:

• Must be covered under the Cigna or UnitedHealthcare High Deductible Health Plan (HDHP)

The County's Medical Plans (continued)

The County's Medical Plans (continued)• Must not have other health coverage, except

what the IRS permits• Must not be enrolled in Medicare• Must not be claimed as a dependent on someone

else’s Federal income tax return• Must not have an existing Health Care Flexible

Spending Account

Once you are enrolled in or sign up for Medicare, you no longer qualify to make contributions to a Health Savings Account. The exception is if you defer your enrollment in Medicare.

HEALTH SAVINGS ACCOUNTS 101With an HSA, you can lower your taxable income while setting aside money for medical expenses.

A WIN WIN FOR YOUR TAXES• Your money

goes in and grows tax-free

• Qualified withdrawals are tax-free

FUNDS ARE DEPOSITED INTO YOUR ACCOUNT :• Maricopa County contribution:

• $500/individual • $1,000/family

• Pre-tax payroll deduction

QUALIFIED EXPENSES INCLUDE: • Copayments• Eyeglasses & contacts• Hearing aids• Dental costs• Prescriptions

$3,600THIS IS NOT “USE IT OR LOSE IT” SAVINGS Your funds will roll over from year to year.

IT MOVES WITH YOUYou own all the money in your HSA. It stays with you when you change jobs, change insurance plans, or retire.

The max amount an individual can contribute to an HSA in 2021 is

$7,200

The max contribution per family is

TAXFREE

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 10

Benefit Provision Each Plan works differently. See the Benefits website for more information.

Cigna HMOIn-Network Coverage Only

Plan Deductible $350 Facility Deductible Individual $700 Facility Deductible Family

Standard Percent of Coinsurance N/A

Out-of-Pocket Maximum (OOP Max): Medical/Behavioral Health $1,600 Individual$3,200 Family

Out-of-Pocket Maximum (OOP Max): Prescription $1,500 Individual$3,000 Family

Allergy Injections $30

Ambulance $0

Chiropractic Services: limited to 24 visits/days per year $30

Convenience Care Clinic Visit $10

Durable Medical Equipment/Medical Supplies: no annual limit $0

Emergency Room $200, waived if admitted to hospital

Inpatient Hospital Facility & Professional Services $250 after deductible

Outpatient Advanced Radiology: CAT, PET, MRI, MRA Scans and Nuclear Cardiac Studies $0 after deductible1

Outpatient Lab and X-Ray Facility $0

Outpatient Surgery & Professional Services $150 after deductible

Physical Therapy: Limited to 60 In- & Out-of-Network visits/days per year combined $30

Preventive Care $0 (FREE)

Primary Care Physician (PCP) $30

Specialty Care Physician - CCD/Non-CCD & Tier 1 / Non-Tier 1 $45² / $70 ³

Telehealth $0 (FREE)

Urgent Care $75, waived if admitted to hospital

For more detail, review the plan summaries on the Benefits Home Page at www.maricopa.gov/benefits. In the event of a discrepancy between the information in this chart and the official plan documents and contracts, the official plan document and contracts govern.1. Does not apply to inpatient facility services. Subject to applicable place of service coinsurance and plan deductible. 2. You pay lower copays when you use a provider with the Cigna Care Designation (CCD). 3. You pay higher copays when you use a provider without the CCD. Not all specialties are included. When the provider is

not included in the CCD, the higher Non-CCD copay applies.

Medical Copay/Out-of-Pocket CostsCigna HMO

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 11

Medical Coinsurance/Out-of-Pocket CostsCigna and UnitedHealthcare HDHP

Benefit Provision Each Plan works differently. See the Benefits website for more information.

Cigna HDHP with H.S.A. UnitedHealthcare HDHP with H.S.A.¹

Employer Contribution to H.S.A. $500 Individual / $1,000 Family

In-Network Out-of-NetworkPlan Deductible

$1,500 Individual$3,000 Family

$3,000 Individual$6,000 Family

Standard Percent of Coinsurance 15% 50%

Out-of-Pocket Maximum (OOP Max): Medical/Behavioral Health

$3,275 Individual$6,550 Family

$6,550 Individual$13,100 Family

Out-of-Pocket Maximum (OOP Max): Prescription Included in Medical OOP Max: Individual and Family

Included in Medical OOP Max: Individual and Family

Allergy Injections 15% after deductible 50% after deductible

Ambulance 15% after deductible 15% after deductible

Chiropractic Services: limited to 24 visits/days per year 15% after deductible Covered In-Network only

Convenience Care Clinic Visit 15% after deductible 50% after deductible

Durable Medical Equipment/Medical Supplies: no annual limit 15% after deductible 50% after deductible

Emergency Room 15% after deductible 15% after deductible

Inpatient Hospital Facility & Professional Services 15% after deductible 50% after deductible

Outpatient Advanced Radiology: CAT, PET, MRI, MRA Scans and Nuclear Cardiac Studies

15% / 25% after deductible² 50% after deductible

Outpatient Lab and X-Ray Facility 15% / 25% after deductible² 50% after deductible

Outpatient Surgery & Professional Services 15% / 25% after deductible² 50% after deductible

Physical Therapy: limited to 60 In- & Out-of-Network visits/days per year combined 15% after deductible 50% after deductible

Preventive Care $0 (FREE) no deductible Covered In-Network only

Primary Care Physician (PCP) 15% after deductible 50% after deductible

Specialty Care Physician: CCD/Non-CCD & Tier 1 / Non-Tier 1 15% after deductible 50% after deductible

Telehealth 15% after deductible Covered In-Network only

Urgent Care 15% after deductible 15% after deductible

For more detail, review the plan summaries on the Benefits Home Page at www.maricopa.gov/benefits. In the event of a discrepancy between the information in this chart and the official plan documents and contracts, the official plan document and contracts govern.1. County contribution to the HSA is prorated based on benefit eligibility start date and calculated according to the pay

periods remaining in the plan year. 2. UnitedHealthcare HDHP Co-Insurance is 25% if in a hospital-based facility for outpatient services; 15% Co-Insurance

applies to freestanding office or facility.

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 12

Medical Coinsurance/Out-of-Pocket CostsUnitedHealthcare PPO

Benefit ProvisionUnitedHealthcare PPO

In-Network Out-of-Network

Plan Deductible $750 Individual$1,500 Family

$1,500 Individual$3,000 Family

Standard Percent of Coinsurance 15% 50%Out-of-Pocket Maximum (OOP Max): Medical/Behavioral Health

$3,500 Individual$7,000 Family

$7,000 Individual$14,000 Family

Out-of-Pocket Maximum (OOP Max): Prescription $1,500 Individual$3,000 Family N/A

Allergy Injections $40 50% after deductibleAmbulance 15% after deductible 15% after deductible Chiropractic Services: limited to 24 visits/days per year $40 Covered In-Network onlyConvenience Care Clinic Visit $20 50% after deductibleDurable Medical Equipment/Medical Supplies: no annual limit

15% after deductible per item per month 50% after deductible

Emergency Room $250, waived if admitted to hospital

$250, waived if admitted to hospital

Inpatient Hospital Facility & Professional Services 15% after deductible 50% after deductible

Outpatient Advanced Radiology: CAT, PET, MRI, MRA Scans and Nuclear Cardiac Studies 15% / 25% after deductible¹ 50% after deductible

Outpatient Lab and X-Ray Facility 15% / 25% after deductible ¹ 50% after deductibleOutpatient Surgery & Professional Services 15% / 25% after deductible ¹ 50% after deductiblePhysical Therapy: Limited to 60 In- & Out-of-Network visits/days per year combined $40 50% after deductible

Preventive Care $0 (FREE) Covered In-Network only

Primary Care Physician (PCP) $25² / $45³ 50% after deductible

Specialty Care Physician: CCD/Non-CCD & Tier 1 / Non-Tier 1 $55² / $70³ 50% after deductible

Telehealth $0 (FREE) Covered In-Network only

Urgent Care $75 50% after deductible

For more detail, review the plan summaries on the Benefits Home Page at www.maricopa.gov/benefits. In the event of a discrepancy between the information in this chart and the official plan documents and contracts, the official plan document and contracts govern.1. Co-Insurance is 25% if in a hospital-based facility for outpatient services; 15% Co-Insurance applies to freestanding

office or facility. 2. You pay lower copays when you use a Primary Care Physician or Specialist with the UnitedHealthcare Premium Tier 1

Designation. 3. You pay higher copays when you use a provider without the UHC Tier 1 Designation. Not all specialties are included.

When the provider is not included in the UHC Tier 1, the higher Non-UHC Tier 1 copay applies.

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 13

2021-2022 Per Pay Period Premium Medical, Prescription, Behavioral Health

Plan Tier EMPLOYER

Premium Per Pay Period

EMPLOYEE Premium

Per Pay Period¹

Cigna HMO

Employee 359.09 43.40 Employee + Spouse 697.03 88.83Employee + Child(ren) 575.53 69.48 Employee + Family 904.98 123.78

UnitedHealthcare PPO

Employee 364.57 56.86 Employee + Spouse 693.80 130.49 Employee + Child(ren) 569.03 107.26Employee + Family 895.93 183.64

Cigna and UnitedHealthcare HDHP with HSA

Employee 358.72 34.51 Employee + Spouse 719.51 47.55 Employee + Child(ren) 588.05 41.67 Employee + Family 938.89 65.04

Part-Time Active Employees²

Plan Tier EMPLOYER

Premium Per Pay Period

EMPLOYEE Premium

Per Pay Period¹

Cigna HMO

Employee 179.55 222.94 Employee + Spouse 348.52 437.34 Employee + Child(ren) 287.77 357.24 Employee + Family 452.49 576.27

UnitedHealthcare PPO

Employee 182.29 239.14 Employee + Spouse 346.90 477.39 Employee + Child(ren) 284.52 391.77 Employee + Family 447.96 631.61

Cigna and UnitedHealthcare HDHP with HSA

Employee 179.36 213.87 Employee + Spouse 359.76 407.30 Employee + Child(ren) 294.03 335.69 Employee + Family 469.45 534.48

1. Employees who earn the Wellness Incentive will receive a $30.00 credit toward their medical premium per pay period.2. Part-time hours are 20 to 29.99 per week.

Full-Time Active Employees

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 14

2021-2022 Per Pay Period Premium Vision and Dental

Vision

Dental

Plan Tier

Part-Time Active

EMPLOYER Premium Per Pay Period

Part-Time Active

EMPLOYEE Premium Per Pay Period¹

Full-Time Active EMPLOYER

Premium Per Pay Period

Full-Time Active

EMPLOYEE Premium Per Pay Period

Cigna Prepaid (DHMO)

Employee 1.13 3.50 2.26 2.37Employee + Spouse 1.68 6.15 3.36 4.47Employee + Child(ren) 2.51 8.33 5.02 5.82Employee + Family 3.04 9.72 6.07 6.69

Cigna (PPO)

Employee 5.26 14.23 10.52 8.97 Employee + Spouse 11.59 31.32 23.17 19.74 Employee + Child(ren) 12.54 33.88 25.07 21.35 Employee + Family 16.09 43.50 32.18 27.41

Delta (PPO)

Employee 4.52 15.72 9.03 11.21 Employee + Spouse 9.95 34.66 19.91 24.70 Employee + Child(ren) 10.76 37.50 21.52 26.74 Employee + Family 13.80 48.26 27.60 34.46

Plan Tier

Part-Time Active

EMPLOYER Premium

Per Pay Period

Part-Time Active

EMPLOYEE Premium Per Pay Period¹

Full-Time Active

EMPLOYER Premium

Per Pay Period

Full-Time Active

EMPLOYEE Premium

Per Pay Period

EyeMed

Employee 1.37 2.03 2.74 0.66

Employee + Spouse 2.53 3.98 5.06 1.45 Employee + Child(ren) 2.75 3.84 5.50 1.09 Employee + Family 3.98 5.93 7.96 1.95

1. Part-time hours are 20 to 29.99 per week.

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 15

2021-2022 Per Pay Period Premium Life Insurance

$

Rate/ $1,000 Coverage

Additional Accidental Death and Dismemberment - Employee 0.0100

Additional Accidental Death and Dismemberment - Family 0.0175

Dependent Child Life (can elect in increments of $5,000 up to $20,000) 0.0500

Additional Employee and Spouse Life (Spouse coverage may be elected in $10,000 increments up to a maximum of $100,000 and cannot exceed an employee’s total life insurance amount.)

Age Bands

Non-Tobacco User

Tobacco User

Under 25 0.0145 0.023525-29 0.0175 0.025530-34 0.0230 0.029035-39 0.0255 0.049540-44 0.0335 0.070545-49 0.0545 0.140050-54 0.0835 0.258055-59 0.1420 0.263060-64 0.2400 0.407565-69 0.3460 0.498570 and older 0.6405 0.8190

Formula to Estimate Additional Life Insurance Premium

x / 1,000 = Rate Coverage Amount Per Pay Period Premium

Example: Employee Additional Life 3x | Age 36 | Non-Tobacco User | Annual Base Salary = $45,900

.0255 x $138,000 / 1,000 = $3.52Rate Coverage Amount Per Pay Period Premium (For Employee - Annual Base Salary rounded to the nearest $1,000 multiplied by 1-5x)

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 16

$

MetLife Legal Plan

Short-Term Disability

Short-Term Disability Examples:

Short-Term Disability Coverage - Employee Only Multiplier x Annual Base Salary / 24 Pay Periods

40% 0.0018

50% 0.002960% 0.0055

Other Services Employee Premium Per Pay Period

MetLife Legal 7.87

Comparison of Short-Term Disability Premium at Various Salary Levels

Annual Base Salary Per Pay Period Premium Short-Term 60%

Per Pay Period Premium Short-Term 50%

Per Pay Period Premium Short-Term 40%

25,106 5.75 3.03 1.88

40,503 9.28 4.89 3.0450,336 11.54 6.08 3.7861,922 14.19 7.48 4.6473,923 16.94 8.93 5.54

115,981 26.58 14.01 8.70

2021-2022 Per Pay Period Premium Other Benefits

Pet Insurance

Plans Pricing

Pets Best Pet Health Insurance ($250 deductible, 90% reimbursement) Get a personalized quote at 800.891.2565

Pet Assure Veterinary Discount Plan $8/month single pet; $11/month all pets

PetPlus Prescription Savings Plan $3.75/single cat or dog; $7.50/month all cats or dogs

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 17

Financial Health Insurance Terms

Premium – The amount you pay per pay period for health insurance.

Copayment – A fixed dollar amount you pay for covered health services, such as a doctor’s visit.

Coinsurance – A percentage of the total cost of covered health services you pay. This often starts after the deductible is satisfied.

Deductible – A fixed, annual amount you pay for covered health services before the health plan (insurance) starts to pay. For certain services, such as in-network preventive care, you are not required to first satisfy the deductible.

Dual Coverage – The same person is enrolled under more than one of Maricopa County's employee benefits. Dual coverage is prohibited for employees and dependents on all County plans.

In-Network – A group of doctors, hospitals, pharmacies, and other providers who contract with the insurance companies and provide services at negotiated rates.

Out-of-Network – A group of doctors, hospitals, pharmacies, and other providers who do not contract with the insurance companies and do not provide services at negotiated rates. You pay more out of pocket and have fewer protections.

Balance Bill – The difference between the amount charged by an out-of-network provider for a covered health service and the amount your health plan (insurance) pays. Out-of-network providers may balance bill you for these costs.

Out-of-Pocket Maximum – The maximum annual out-of-pocket amount you pay before the health plan (insurance) pays 100% of covered health services. For out-of-network services, providers may balance bill even after the out-of-network, out-of-pocket maximum is reached.

Use In-Network Providers to Save Money While it’s a personal preference to use out-of-network providers, there are some protections you lose by doing so. 1. The health plans do not

contract with out-of-network providers which means they don't check into providers' history such as their medical license, education, training, work history, malpractice claims, board certification, health outcomes, etc.

2. Out-of-network providers may balance bill you, which means billing you for the difference between the amount they charge you for a covered service and the amount your insurance pays.

3. Overall, you pay more out of pocket for out-of-network services.

The language of health insurance can be hard to understand. Yet it is important to have a basic knowledge of the industry's terminology. Here are some of the most common financial insurance terms to help you make sense of it all—so you can make smart decisions that will benefit you and your family.

Making the Most of Your Benefits

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 18

Benefit Enrollment System BenefitSolver Portal:

benefits.maricopa.gov

Benefits Websites MyMC Intranet: https://

mymc.maricopa.gov/1138/Employee-Benefits

Internet: http://www.maricopa.gov/benefits

Cigna Medical/Claim Information

Find personal plan and claim information; print a temporary ID card or request a new cards; find a doctor, hospital, specialty facility

www.cigna.com

Cigna Pre-Enrollment Phone Line (Available March 15-June 30)

A representative can answer your questions about the Cigna HMO, Cigna HDHP with HSA, and Cigna dental plans

800.401.4041

General Questions or BenefitSolver Password Resets Maricopa County Employee

Benefits and Wellness Division 602.506.1010

Resources

Notices Important notices regarding the Maricopa County Employee Benefits Program may be found here: https://mymc.maricopa.gov/1163/Notices-for-Employee-Benefits

These notices include:• Maricopa County’s Group

Health Plan Notice of Privacy Practices

• COBRA Initial Notification• Women’s Health and Cancer

Rights Act (WHCRA)• Notice of Special Enrollment

Rights• Medicare Secondary Payer • Genetic Information

Nondiscrimination Act (GINA)• The Heroes Earning Assistant

and Relief Tax Act (HEART)• Notice of Medicaid or

Children’s Health Insurance Program (CHIP) Offer of Free or Low Cost Health Coverage to Children and Families

• Mental Health Parity and Addiction Equity Act of 2008

Review Cost of Medication and Lower Cost Alternatives

www.optumrx.com (for enrollees in the Cigna

HMO or UnitedHealthcare PPO only)

Short-Term Disability Calculator

https://www.maricopa.gov/DocumentCenter/View/36310/STD-Calculator-2020-2021

Specific Benefit Questions Contact vendors directly; see

the provider listing on the last page of this booklet

UnitedHealthcare Pre-Enrollment Phone Line

(Available March 15-June 30)

A representative can answer your questions about the UnitedHealthcare PPO and HDHP with HSA

888.876.7098 or www.welcometouhc.com/maricopa

Making the Most of Your Benefits (continued)Resources

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 19

Wellness IncentiveIf you are enrolled in a County-sponsored medical plan, and complete the required wellness activities, you could earn an incentive of up to $30/paycheck or $720 per year.

To Earn for Plan Year 2021-2022Create an account in the Wellness Portal.• Complete the Health Check

Survey • Complete two “Your Choice”

Activities

Wellness at Work

Smart Savings | Deferred CompSmart Savings allows you to put aside money from each paycheck that can grow into extra savings for your future. A plan can help you bridge the gap between what you will get from your pension and Social Security, and how much you'll need to have the retirement you want. Visit the website for more information and to enroll.

Maricopa County's Wellness Works program supports a strong and healthy workforce by providing programs and resources. Visit the Wellness Works webpage for more information.

Financial Wellness CoachingMy Secure Advantage is a financial coaching program that offers personalized, confidential help to meet financial goals. Coaching is available to you and your spouse/dependents for 30 consecutive days at NO cost each calendar year on non-work time. For more information and to enroll, visit the MSA website or call 888-724-2326.

2021-2022 BENEFITS OPEN ENROLLMENT GUIDE | 20

OptumRx HDHP Prescription Plan (UnitedHealthcare HDHP with HSA)

Group #901632Customer Service (888) 876-7098Home Delivery (888) 876-7098 Optum Specialty Pharmacy (855) 427-4682

www.myuhc.com

Employee Assistance Program (EAP)

Magellan Health Services Group #N/A

(888) 213-5125 www.magellanhealth.com/member

Behavioral Health

Magellan Health Services Group #N/A

(888) 213-5125 www.magellanhealth.com/member

Cigna Behavioral Health(Cigna HDHP with HSA only)

Group #3205496(800) 274-7603 www.mycigna.com

United Behavioral Health (UnitedHealthcare HDHP with HSA only)

Group #901632(888) 876-7098 www.myuhc.com

VisionEye Med

Group #1004141(866) 724-0782 www.eyemed.com

DentalCigna Pre-Paid Dental (DHMO)

Group #2465354(800) 244-6224 www.cigna.com

Cigna Dental | Group #2465354(888) 336-8258 www.cigna.com

Delta Dental | Group #14500(602) 938-3131 or (800) 352-6132

www.deltadentalaz.com

Life InsuranceSecurian

Group #70334 (Life Insurance)Group #70335 (AD & D)

General Plan Information (866) 293-6047Claims (888) 658-0193Medical Underwriting (800) 872-2214Continuation (866) 365-2374

Short -Term DisabilitySedgwick Group #435000

(800) 599-7797 https://www.claimlookup.com

Long-Term DisabilityBroadspire

(through the Arizona State Retirement System) (877) 232-0596 www.azasrs.gov

RetirementArizona State Retirement System

Phoenix (602) 240-2000Outside Phoenix (800) 621-3778

www.azasrs.gov

Public Safety Retirement System(602) 255-5575 www.psprs.com

Nationwide Retirement SolutionsSmart Savings

(602) 266-2733 (800) 598-4457www.maricopadc.com

Pet Insurance

Pet Benefit Solutions(800) 891-2565

https://www.petbenefits.com/land/ MaricopaCounty

OtherFlexible Spending Accounts

WEXM-F, 4 am–7 pm MST

(866) 451-3399www.wexinc.com

Maricopa County Dependent Verification Service Center

(866) 229-8292 M-F, 5 am–5 pm MSTPO Box 310552

Des Moines, IA. 50305-0552benefits.maricopa.gov

COBRA AdministratorEnrollment forms and ongoing payments

(866) 229-8292 M-F, 5 am–5 pm MST

P.O. Box 310512, Des Moines, IA 50331-0512benefits.maricopa.gov

Verification Administration(866) 229-8292 M-F, 5 am–5 pm MST

benefits.maricopa.gov

MetLife Legal PlanPlan 150 / Group #0518

(800) 821-6400 http://info.legalplans.com(Access Code - 1500518)

Wellness Portal(866) 941-2143 email: support@virginpulse.com

join.virginpulse.com/maricopacounty

Financial Wellness - My Secure Advantage

1 (888) 724-2326 mysecureadvantage.com M-F, 7 am–6 pm MST

Maricopa County Employee Benefits and Wellness

DivisionMaricopa County Administration Building

301 W. Jefferson St., 7th floorPhoenix, Arizona 85003-2143

Phone: (602) 506-1010Fax: (602) 506-2354

https://www.maricopa.gov/Benefits Benefits@maricopa.gov

Wellness WorksPhone: (602) 506-1010Fax: (602) 506-2354

Medical PlansCigna

Group #3205496Customer Service (800) 244-622424-Hour Health Information Line (800) 564-8982Your Health First (855) 246-1873Healthy Pregnancies, Healthy Babies (800) 615-2906Healthy Rewards (800) 870-3470Pre-Enrollment Line (800) 401-4041

www.mycigna.comwww.cigna.com

HSA Bank (800) 244-6224 8 am to 8 pm EST, M-F

UnitedHealthcareGroup #901632

Customer Service (888) 876-7098 Healthy Pregnancy Program (888) 246-7389myNurseline (855) 466-7886

www.myuhc.com

Optum Bank(800) 791-9361 8 am to 8 pm EST, M-F

Prescription PlansExpress Scripts HDHP Prescription Plan

(Cigna HDHP with HSA) Group #3205496

Customer Service (800) 244-6224Home Delivery (800) 835-3784Accredo Specialty Pharmacy (877) 826-7657

www.mycigna.com

OptumRx Coinsurance Prescription Plan(Cigna HMO, and UnitedHealthcare PPO)

Group #512229Customer Service (866) 312-1597Home Delivery (866) 312-1597Prior Authorization (877) 665-6609Optum Specialty Pharmacy (855) 427-4682Medication Therapy Mgt. (866) 352-5310

www.optumrx.com

Provider Contact Information