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2022 Employee BenefitsOpen EnrollmentWelcome to your open enrollment period for APBHT! Open enrollment is a once-a-yearopportunity for you to customize your benefits for the next plan year, such as waiving coverage,adding or dropping dependents and making other benefits changes such as the FSA or HSA.The Open Enrollment period for APBHT starts Monday, November 15, 2021, and ends Friday,December 10, 2021, Please take a few minutes to review this memo so you are aware of anychanges and actions items you need to complete. Your next opportunity to make enrollmentchanges will not be until next year’s open enrollment period, unless you have a qualifying event(i.e. marriage, birth, adoption, or loss of health coverage).Making informed decisions for Open EnrollmentTo help make informed decisions about your benefit options during the Open Enrollment period,review benefit summaries, plan costs and annual notifications. Below is a brief overview of whatis changing this year, as well as action items you need to do. You can also review your benefitdetails by visiting APBHT FlippingBook Open Enrollment Guide by 022689/What’s New or Changing?Medical, Rx, Vision: No changes to currentbenefits.Action ItemsooDental: No changes to current benefits.oBasic Life/AD&D: No changes to current benefitsYou can enroll between November 15th andDecember 10th, 2021.All employees who waive coverage need tocomplete a waiver form.It is not necessary to complete newenrollment forms during open enrollmentunless you are making changes to yourbenefits, and/or adding or droppingdependents.Please keep in mind there are typically changes to the premiums; please contact your HRRepresentative for detailed Benefits information.Remember Open Enrollment is also the time to add/drop any dependents if necessary. Remember that thechoices you make during open enrollment will take effect on Saturday, January 01, 2022, andwill remain in effect until Saturday, December 31, 2022. Only qualifying events will allow you tomake a change before that date.Please submit all forms no later than Friday, December 10, 2021Where to Go if You Have Questions:Should you have any questions about your benefits or questions in general, contactyour plan administrator, Kim Pigg, kim@coastalaska.org.
2022 EMPLOYEEBENEFITS GUIDEEffective January 1, 2022 toDecember 31, 2022APBHT
2022 Benefits GuideWelcome to APBHT2022 Benefits!Inside This GuideWelcome2Benefits Overview3Eligibility and Enrollment5Medical Plan6Prescription Drugs9Where to Seek Care10Health Savings Account (HSA)15How to Save17Dental Plan18Basic Life/AD&D Insurance19BenefitHub20Cost of Coverage21Resources & Contact Information23Benefit Definitions24Employee Notices27Forms48Your needs, and those of your family, are unique toyou. That’s why we provide a comprehensive andflexible benefits program that you can customize tofit your personal situation. Our program offers youand your family important healthcare coverage andfinancial security.Some of the benefits we offer are paid for in full bythe company. For others, it is a shared contributionbetween you and the company. Other benefits arealso available to you at reasonable group rates.Your benefits are an important part of your totalcompensation. Please take the time to review andevaluate all the options available to you and yourfamily.This guide is not intended to be a complete descriptionof the insurance coverage offered, nor is it a bindingcontract. Controlling provisions are provided in eachbenefit plan policy. Should there be a differencebetween this guide and the office plan documents, theofficial plan documents will govern.More information about specific terms and conditionsof each plan is included in the Summary PlanDescription (SPD) and Summary of Benefits andCoverage (SBC).APBHT2
2022 Benefits GuideBenefits OverviewEMPLOYER PAID BENEFITSBenefitsCarrierBasic Life/AD&DSymetraBENEFIT OPTIONS REQUIRING EMPLOYEE CONTRIBUTIONSBenefitsCarrierMedical, Rx, VisionPremera Blue Cross BlueShield of AlaskaDentalPremera Blue Cross BlueShield of AlaskaOpen EnrollmentOpen Enrollment is your once a year opportunity toreview your benefit plan elections and make adjustmentsthat meet the needs of you and your family.Changes to medical, dental and vision benefits madeduring Open Enrollment will go into effect January 1,2022.APBHTReturn to Table of Contents3
2022 Benefits GuideWhat’s New or Changing?What’s New or Changing?1. Medical, Rx, Vision: No changes to currentbenefits.2. Dental: No changes to current benefits.3. Basic Life/AD&D: No changes to current benefits.Action Itemso You can enroll between November 15th andDecember 10th , 2021.o All employees who waive coverage need tocomplete a waiver form.o It is not necessary to complete new enrollmentforms during open enrollment unless you aremaking changes to your benefits, and/or adding ordropping dependents.Making Benefit Changes Duringthe YearThe benefit elections you make during your openenrollment period will be in effect throughDecember 31, 2022.If you have a “qualified life event,” you may makechanges to certain benefits if you apply for thechange and provide supporting documentation toHuman Resources. Proof of life events is subject toapproval by your company. Changes are effectiveretroactive to the date of the event. You have 30days after a qualifying event to make enrollmentchanges.Qualifying life events include: Your marriage Your divorce or legal separation Birth, adoption or placement for adoption ofan eligible child Death of your spouse, domestic partner orcovered child Change in you or your spouse/domesticpartner’s work status that affects benefitseligibility (for example, starting a new job,leaving a job, changing from part-time to fulltime, starting or returning from an unpaidleave of absence, etc.) Your spouse’s Open Enrollment A change in your child’s eligibility for benefits Gain or loss of Medicare or Medicaid duringthe year RelocationOther qualifying events may also apply.Please contact Human Resources.APBHTReturn to Table of Contents4
2022 Benefits GuideEligibility and EnrollmentWho is Eligible?When Does Coverage Begin?You are eligible for benefits if you are:Benefits for new hires, unless explained otherwise, willbecome effective on the first of the month following30 days. An active full-time employee working 30 ormore hours per weekYour dependents are eligible if they are:Termination of Coverage Your legal spouse or domestic partner Your and/or your domestic partner’schild(ren)* up to age 26 Your disabled child(ren)* up to any age (ifdisabled prior to age 19)* Includes natural, step, legally adopted/or a child placed foradoption, or a child under your legal guardianship.When Can You Enroll in Benefits?Basic Life/AD&D coverages will end on the day youbecome ineligible. Your life coverages are convertible.You are responsible for informing Human Resources ifany of your dependents become ineligible for benefits.You can enroll for benefits: When you are initially eligible for coverage;you have a certain number of days from thedate you are eligible for coverage to submityour enrollment. During the annual Open Enrollment period. During the plan year, if you experience aQualifying Life Event.Please Note:Federal regulations require your company toobtain the following information duringenrollment: Social Security numbers for your dependentscovered by the medical plan Dates of birth and your relationship to yourdependentsAPBHTIf you or a covered dependent no longer meet theeligibility requirements or if your employment ceases,your medical/rx/vision and dental coverages will endon the last day of the month in which you becomeineligible. You may be eligible to elect COBRA foryourself and your eligible dependents formedical/rx/vision and dental coverages.About Domestic Partner CoverageTo enroll your same-sex or opposite-sex domesticpartner and his or her dependents for coverage, youwill be required to submit appropriate declarationforms, and proof of domestic partnership may benecessary.Under federal law, your company contribution towardthe cost of healthcare coverage for your domesticpartner and his or her dependents is consideredtaxable income to you.Domestic partner premiums will be deducted on apost-tax basis. You may wish to consult with a taxadviser for more information.Return to Table of Contents5
2022 Benefits GuideMedical PlanAPBHT offers medical plan throughPremera Blue Cross Blue Shield ofAlaska with the following features: Option to receive care from innetwork or out-of-network providers;higher benefits are paid when usingin-network providers. Preventive care is covered at 100%when using an in-network provider. Includes prescription drug coverage. Deductibles and out-of-pocketmaximums accumulate on a calendaryear. If you enroll in the HSA plan, you canopen and contribute to a HealthSavings Account (HSA) to help coversome of your medical plan costs(refer to HSA section for moreinformation). Always refer to your plan booklet forspecific benefit levels and limitations.How to Find a DoctorFind a Doctor, Dentist, and more athttps://www.premera.com. Login to yourPremera account and click the “Find aDoctor” tab in the upper left hand corner.Follow the online instructions to performa general search. Or, go mobile withPremera Mobile app (available forWindows Phone, Android, and iPhone).Premera Mobile allows one touch accessto finding doctors and urgent caresfacilities, customer service, 24-HourNurseLine, etc.APBHTReturn to Table of Contents6
2022 Benefits GuideMedical PlanHP HSA Aggregate 2,000/20%/ 3,500 EssentialsMedicalYou PayIn-NetworkPlan Year Deductible(Individual / Family)CoinsurancePlan Year Out-of-Pocket Maximum1(Individual / Family)Preventive Care2 2,000 / 4,000 (Aggregate)20% Preferred / 40% Participating 3,500 / 7,000 (Embedded)Covered In FullPrimary Care Office VisitIn Network Deductible, then 20% Preferred / 40% ParticipatingSpecialty Care Office VisitIn Network Deductible, then 20% Preferred / 40% ParticipatingUrgent Care FacilityIn Network Deductible, then 20% Preferred / 40% ParticipatingVirtual Care – Telemedicine(General Medical)In Network Deductible, then 20% PreferredEmergency Room CareIn Network Deductible, then 20% PreferredInpatient HospitalIn Network Deductible, then 20% Preferred / 40% ParticipatingOutpatient SurgeryIn Network Deductible, then 20% Preferred / 40% ParticipatingRoutine Radiology / LabIn Network Deductible, then 20% Preferred / 40% ParticipatingAdvanced Radiology(MRI, CT, PET Scan)In Network Deductible, then 20% Preferred / 40% ParticipatingLimitations and maximums may apply. Please refer to the plan summaries and Summary of Benefits and Coverage for moreinformation.1Plan Year Out-of-Pocket Maximum includes deductibles, copays and coinsurance2 Preventive Office Visit, Immunizations, Preventive Laboratory Screens, Preventive Imaging, Preventive RoutineMammographyAPBHTReturn to Table of Contents7
2022 Benefits GuideMedical Plan – Additional BenefitsHP HSA Aggregate 2,000/20%/ 3,500 EssentialsYou PayIn-NetworkPediatric Vision Exam1 PCY Under age 19In Network Deductible, then 20% PreferredPediatric Vision HardwareUnder age 19: One pair of glasses PCY(frames & lenses). 12-month supply ofcontacts PCY, in lieu of glasses (frames &lenses).Covered in FullRoutine Vision Exam1 PCYCovered in FullVision Hardware 200 PCYCovered in FullAPBHTReturn to Table of Contents8
2022 Benefits GuidePrescription DrugsWhen you enroll in a medical plan, you receive comprehensive prescriptiondrug coverage through Premera Blue Cross Blue Shield of Alaska.Some medications may be subject to prior authorization, quantity limits or steptherapy requirements to be approved for coverage.HP HSA Aggregate 2,000/20%/ 3,500 EssentialsPrescription Drugs DeductibleMedical DeductibleYou PayRetail(preferred generic/preferredbrand/preferred specialty/all nonpreferred)After Deductible is met 15/ 30/ 50/30%; Coinsurance is waivedMail Order(preferred generic/preferredbrand/preferred specialty/all nonpreferred)After deductible is met 37.50/ 75/ 50/30%; Coinsurance is waivedRetail: up to 90 daysMail Order: up to 90 daysSpecialty: up to 30 daysSupply Limit Per FillE1 Essentials FormularyNo TiersDrug ListRetail Pharmacy Locate a participating retailpharmacy View a list of approved drugsAPBHTMail Order Use for maintenance drugssuch as medication for highblood pressure, arthritis ordiabetes No additional cost for deliveryReturn to Table of ContentsSpecialty Pharmacy Medication used to treatcomplex conditions likemultiple sclerosis, hepatitis Cand rheumatoid arthritis Prescription can only be filledonce every 30 days9
2022 Benefits GuideWhere to Seek CaremyCare AlaskaPrimary and urgent care are availablevirtually!When should I use myCare Alaska?Getting care is as easy as sending a text message. Youcan connect with a doctor in seconds from anycomputer or mobile device. A doctor will reply in lessthan 60 seconds.Use myCareAlaska when you: Feel sick, but it’s not an emergency* Have a minor injury Have general medical questions Want to refill a prescription Are not sure where to go to get care Available from anywhere you can access theinternet, 24 hours a day and 7 days a week. This is a text-based virtual care program that allowsyou to securely message, send photos, or videochat with a doctor instantly. Ask general or urgent medical questions from yourdesk – no need to go into a medical office.Get started at mycarealaska.comExamples of conditions to discuss: Coughs, fevers, sore throat Earaches, stomach pain, diarrhea Rashes, allergic reactions, animal/insect bites Back/abdominal pain Sports injuries, burns, heat-related illness Urinary tract infections Urgent or general health questions*You should always call 9-1-1 for medical emergencies. A medical emergency is an event that you reasonably believe threatens you orsomeone else's life or limb in such a manner that immediate medical care is needed to prevent death or serious impairment of health.APBHTReturn to Table of Contents10
2022 Benefits GuideWhere to Seek Care (Continued)Doctor On DemandFor Primary/Urgent Care and Mental Health optionsTalkspace: Therapy as Close as YourPhoneFor Mental Health optionsA video or phone-based consultation with a boardcertified doctor. Doctor on Demand board-certifiedphysicians offer consultation similar to what a patientgets in a face-to-face office visit. Physicians can send aprescription to the member’s preferred pharmacy, if itis medically necessary. Doctor on Demand can sendrecords of the consultation by fax or electronic medicalrecord transfer to your primary care doctor forcontinuity of care with a local doctor.Medical doctors are available on demand everyday,holidays included. Get care from home, or on the road.Think of Doctor On Demand as your first stop foreveryday care. Example of what Doctor On Demandtreat: Cold & FluSinus InfectionsUrinary Tract InfectionsAllergiesAnxieties & Depression, and much morePremera believes behavioral health is critical to theirmember’s overall health and well-being. Talkspace isavailable by live, face-to-face video appointments andtext messaging. Text messaging means a therapist willrespond quickly, usually in less than a day. Talkspaceprovides access to 5,000 licensed therapists by videoand text messaging regardless of date, location, ortime of day.Virtual behavioral health therapy sessions will havethe same cost shares as equivalent to face-to-facevisits, as described in your benefit plan.Here’s how to access Talkspace: Sign up for Talkspace at talkspace.com/premera You will then be shown the 3 best matches for yourneeds, and you will choose a therapist. Once you’ve selected your therapist, you can startmessaging with their therapist right away. Pleaseknow, Talkspace is not a live chat where animmediate response will happen from yourtherapist.For more information, visit the Doctor on Demandwebsite at: www.doctorondemand.com/premeraAPBHTReturn to Table of Contents11
2022 Benefits GuideWhere to Seek Care (Continued)Premera’s 24-Hour Nurse LinePremera Medical Travel SupportRegistered Nurses are trained to offer advice, guidanceand support to members and their families. RNs aretrained to ask the right questions to make arecommendation about when or where a membershould seek treatment for an injury or illness. RNs alsohave access to high-quality health resources and willlisten to members’ concerns, answer questions, andoffer advice about many health-related topics.Premera understands the price of medical care may belower outside of Alaska and offers Medical TravelSupport. With approval, this feature helps you obtaincare at in-network hospitals and surgical centersacross the United States. Free and confidential service Available 24 hours a day, 7 days a week Available in English, Spanish and 140 additionallanguages The contact number can be found on the back ofyour ID card Member and one companion; pre-authorizationrequired Air: 1 round-trip per episode Surface transportation & parking: 35/day Ferry transportation: 50 per person each way Lodging: 50/day per person Travel: in-network deductible, then 0% Medical procedures: covered as any other serviceContact Premera at 800-364-2994 to learn more.Boulder CareWorkit HealthFor Substance use disorderFor Substance use disorderBoulder Care offers telehealth treatment for opioiduse disorder and alcohol use disorder.Workit Health offers telehealth treatment for opioiduse disorder and alcohol use disorder.Participants can connect with their providers fromanywhere through secure video and messaging on theBoulder App.Quit alcohol, drugs, smoking, or other addictions withonline therapy in the Premera network.Teams of care providers collaborate to supportparticipants with expert medical care, peer recoverycoaching, and care coordination.Get started at https://boulder.care/getstartedAPBHTJust like a traditional rehab, you will meet withclinicians, stay on track with coaching, join recoverygroups, and complete addiction courses built byexperts — all from the privacy of your own home.For more information, go tohttps://www.workithealth.com/premeraReturn to Table of Contents12
2022 Benefits GuideWhere to Seek Care (Continued)Premera Designated Centers of ExcellenceThis benefit program includes enhanced services that support youand your dependents when you seek care from a Premera Center ofExcellence (COE) provider. Premera Blue Cross Blue Shield of Alaskahas selected Virginia Mason Medical Center in Seattle as a PremeraDesignated Center of Excellence (PDCOE) to provide certain specialtymedical services for you.Fair pricesCost for the same healthcare procedurecan vary greatly from one provider to thenext, this is why Premera is collaboratingwith providers to help eliminateunpredictable prices.What’s included Access to three of the most common specialty procedures: Total joint replacements (knee and hip) Spine surgeries Gynecological procedures Bundled payment arrangements for eligible specialty medicalprocedures which include: Pre-surgical consultations and related services Hospitalization, surgery, and related inpatient care Post-surgical checkups If you are not on a qualified high-deductible health plandeductible, the employee cost share is waived. Predictive analytics, targeting, and outreach to identify eligiblemembers, increase awareness, and educate members on thebenefits of using a PDCOE provider for eligible services. Air travel for you and a companion, black car services fromairport to hotel, and lodging at a select Virginia Mason Hotel (upto IRS limits). Dedicated care coordination from Premera medical travelexperts and Clinical Programs clinicians during and after yourprocedure.High-quality careFor the third year in a row, Virginia Mason is rated in the top onepercent of healthcare facilities in the nation. Its network of specialtycare medical centers and providers offer superior treatment results.When you need one of the qualifying procedures, Premera will usepredictive analytics to engage them at the right time and encouragethem to seek high-quality, affordable care at Virginia Mason.APBHTReturn to Table of ContentsPremera Designated Centers of Excellenceoffer bundled rates for you who receivethe specialty procedures covered by thisbenefit. A bundled rate is one lump sumfor pre- and post-appointments and allrelated surgery costs.Bundled rates help manage healthcarecosts. They also help you know you arepaying a fair price for the care you need.Plus, certain cost shares are waived fornon-qualifiedpreferredproviderorganization (PPO) health plans andqualified high-deductible health plans.Premera makes it easy A medical travel expert will helpanswer your questions about eligibility,covered services and costs. They willalso provide travel assistance, includingmaking travel arrangements andhandling travel prepayments. A Premera clinician will coordinateyour out-of-state care with VirginiaMason, before, during, and after yourprocedure.Call Premera Customer Service to beginyour coordination of travel at800-508-4722.13
2022 Benefits GuideWhere to Seek Care (Continued)USE VIRTUAL CAREEmergency Care vs. Urgent Care When you need help in a hurry, you have choices. Ofcourse, when it’s a life-threatening problem, youshould call 911 or go straight to the nearest hospitalemergency room (ER).In the ER, true emergencies are treated first, so unlessyour life is in danger, you’ll wait – sometimes forhours. The ER is also the most expensive option forcare.Cold and flu symptomsNasal congestionSinus problemsBronchitisRespiratory infectionsAllergiesEar infectionsNauseaSkin infections and acneORFor non-life-threatening problems, call your doctor,call your nurse line or go to an urgent care center. GO TO URGENT CARE Moderate feverColds, cough or fluBruises and abrasionsCuts and minor lacerationsMinor burns and skin irritationsEye, ear, or skin infectionsSprains or strainsPossible fracturesUrinary tract infectionsRespiratory infectionsORGO TO EMERGENCY ROOM APBHTHeart attack or strokeChest pain or intense painShortness of breathSevere abdominal painHead injury or other major traumaLoss of consciousnessMajor burns or severe bleedingOne-sided weakness or numbnessOpen fracturesPoisoning or suspected overdoseReturn to Table of Contents14
2022 Benefits GuideHealth Savings Account (HSA)(Continued)A Health Savings Account (HSA) is a tax-advantagedsavings vehicle available to individuals covered by aHigh Deductible Health Plan (HDHP). Funds in theaccount are used to pay for qualified medical, dentaland vision expenses.An HSA is a great way to save for the future. You canset aside money from each paycheck now and savefunds to cover healthcare expenses that come uplater. Plus, your contributions are free from federalincome tax, so you’re stretching your healthcaredollars while lowering your taxable take-home payamount.HSA funds can only be used for yourself, yourspouse and your taxable dependents. Expenses fordomestic partners and/or other dependents who donot qualify as tax dependents are not reimbursableunder the HSA.Advantages of an HSA Balance rolls over each year and accruesinterest, so you won’t lose your contributions. Triple tax savings — you do not pay federal tax*on: Contributions to the account. Spending on qualified expenses. Interest that accrues. Account is portable, so the funds are yours evenif you change medical plans next year or leavethe company in the future. Use the funds for eligible medical, dental orvision expenses, including coinsurance costs,prescriptions, glasses, orthodontia and more—now or in the future. Money left in the savings account earns tax-freeinterest*.*Tax treatment of HSAs for state tax purposes mayvary by state.APBHTReturn to Table of Contents15
2022 Benefits GuideHealth Savings Account (HSA)(Continued)2022 HSA Contributions and LimitsEach year, you can contribute up to the IRS annual limit for HSAsIndividualFamily2021 IRS Annual ContributionLimits 3,600 7,200Age 55 Additional 1,0002022 IRS Annual ContributionLimits 3,650 7,300Age 55 Additional 1,000Funding and Enrolling in an HSAWho Can Open an HSA?To enroll in an HSA, you must enroll in the HDHP planoption. You can open an HSA account through afinancial institution of your choice; however, youwould have to make after-tax contributions, theywould not be automatically deducted from yourpaycheck, and you would need to claim thosecontributions as a tax deduction when you file yourtaxes.You can contribute to an HSA if you: Are covered under an HSA-qualified highdeductible health plan (HDHP). Are not enrolled in Medicare***,TRICARE or TRICARE for Life. Cannot be claimed as a dependent onsomeone else’s tax return. Have not received Veterans Affairs (VA)benefits within the past 3 months You (or your spouse) do not contribute toa Healthcare FSA.Once your HSA is opened, remember to designate abeneficiary for this account.*** Enrollment in Medicare Part A may be retroactive byup to 6 months when you begin taking social securityretirement after your Social Security Normal RetirementAge (SSNRA). This may affect your HSA eligibility.Other restrictions and exceptions may also apply. Formore information, visit www.irs.gov/publications/p969/.APBHTReturn to Table of Contents16
2022 Benefits GuideHow To SaveWhen Using Your Medical And Prescription Plans:Use In-Network DoctorsAsk Your Doctor for Generic DrugsBy using in-network doctors, clinics, hospitals andpharmacies, you pay the lowest cost for care. Whenyou visit out-of-network doctors, our health plancovers less of the cost.The next time you need a prescription, ask your doctorif it is appropriate to use a generic drug rather than abrand name drug. Generic drugs contain the sameactive ingredients, are identical in dose, form andadministrative method AND are less expensive thantheir brand name counterparts.Choose the Right Type of CareWhen you need care, know your options. Urgent carecenters, online doctor visits or a call to the medicalplan nurse line can help save time and money.If you must take a brand name drug, ask your doctorfor samples or coupons. Also check the drugmanufacturer’s website for available rebates anddiscounts.Use freestanding imaging centers for MRIs, CT Scansand other imaging can help save money. Just be surethey are in-network.Search GoodRx for CheaperRx PricesUse Your Preventive Care BenefitsDrug prices sometimes vary significantly betweenpharmacies. GoodRx collects and compares prices forevery FDA approved prescription drug at more than70,000 pharmacies.Most preventive care services are covered at 100%when you use in-network providers. Getting regularexams, screenings and immunizations can save you alot of money in the long run by catching problemsearly or preventing them altogether.APBHTAccess GoodRx at www.goodrx.com to find the lowestprice pharmacy near you and/or print FREE coupons.You can also get coupons on-the-go through Good Rx’smobile app – just show your phone to the pharmacist.Return to Table of Contents17
2022 Benefits GuideDental PlanAPBHT offers dental plan throughPremera Blue Cross Blue Shield ofAlaska. Your choice of dentists candetermine the cost savings you receive.In-Network providers are paid directlyby Premera and agree to acceptnegotiated fees as “payment in full” forservices rendered.When you use out-of-network providers,Premera will apply the applicablepercentage of the allowed amount andyou are responsible for paying thebalance of the bill.In-network coverage is provided whenyou use Premera network providers.The Dental benefit is only available tothose eligible employees enrolling in theMedical benefit.Dental Optima 1500You PayIn-NetworkCalendar Year PlanDeductibleCalendar YearMaximum 50 Per Individual / 150 Per FamilyUp to 1,500 per person each calendaryearapplies to Basic & Major ServicesPreventive Services(no deductible)0%Basic Services(after deductible)20%EndodonticsPeriodontics(after deductible)20%Major Services(after deductible)50%Important Information!If you do not enroll in dental benefitswhen you are first eligible, you willbecome a late entrant. Late entrants willonly be eligible for exams, cleanings andfluoride applications for the first 12months they are covered.How to Find a DentistFind a Doctor, Dentist, and more athttps://www.premera.com. Login to yourPremera account and click the “Find aDoctor” tab in the upper left hand corner.Follow the online instructions to performa general search. Or, go mobile withPremera Mobile app (available forWindows Phone, Android, and iPhone).APBHTReturn to Table of Contents18
2022 Benefits GuideBasic Life/AD&D InsuranceAPBHT provides Basic Life insurance coverage, which includes an Accidental Death and Dismemberment (AD&D)provision that also pays the same amount in the event of accidental death and certain other conditions. Basic Lifeand AD&D insurance is administered by Symetra and is paid for by your company. The Life/AD&D benefit is onlyavailable to those eligible employees enrolling in the Medical benefit. Class 1: 1x annual earnings up to 100,000 Class 2: 20,000 Class 3: 5,000According to federal law, only the first 50,000 of employer-paid life insurance is not taxable. Premium paid byAPBHT for coverage levels over 50,000 will be taxable to you and will be included on your year-end W-2statement.Please check with your station manager to see which class you are covered under.APBHTReturn to Table of Contents19
2022 Benefits GuideBenefitHubExplore your APBHT Perks Portal!Enjoy discounts, rewards and perks on thousands of brands you love in a variety of categories: TravelAutoElectronicsApparelLocal DealsEducationEntertainment RestaurantsHealth andWellnessBeauty and SpaTicketsSports & OutdoorsIt’s easy to access and s
Welcome to your open enrollment period for APBHT! Open enrollment is a once-a-year opportunity for you to customize your benefits for the next plan year, such as waiving coverage, adding or dropping dependents and making other benefits changes such as the FSA or HSA. The Open Enrollment period for APBHT starts Monday, November 15, 2021, and .
