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2019 Summary ofYour NAU BenefitsInside You Will Find Information on . Who is eligible for benefits How to enroll in benefits When benefits are effective Information on life and disability insurance Description of your health care options Details on retirement plans
Table of ContentsWelcome to Northern Arizona University (NAU)1Eligibility and Enrollment in Voluntary Benefits2Paying for Coverage4Changing your Benefits5Medical7Campus Health Services12Wellness Programs14Dental16Vision19Flexible Spending Account (FSA)21Basic Life Insurance24Individual Supplemental Life Insurance25Dependent Life Insurance26Short Term Disability27Long Term Disability29Mandatory Retirement Plans30Supplemental Retirement Plans35Financial Wellness Education39Paid Time Off40Leaves of Absence43Worker’s Compensation and Work Related Injuries44Educational Assistance45When Benefit Coverage Ends47Benefit Contact Information49Benefit programs are subject to change without prior notice, as determined by changes in federal or statelaws or regulations, policies of the Arizona Board of Regents, Arizona Department of Administration rules or,determinations by Northern Arizona University or plan changes implemented by benefit providers.
Welcome to the Northern Arizona University (NAU) benefits program!The benefits you receive from NAU are an important part of your total compensation package. Becausenot everyone has the same needs, you can select the plans and levels of coverage that are right for youand your family.As a regular benefit employee you are eligible for the following benefits: Medical, Dental and Vision CoverageFlexible Spending AccountsLife and Disability InsuranceRetirementPaid Time OffEducational AssistanceThis guide will give you information on the features of each plan and the employee premiums for all of thesebenefits. You can also find benefits information on the Human Resources website at ts orientationNAU provides a benefit orientation for employees that are newly eligible for coverage. During the orientation,representatives review the details of NAU’s benefit programs. You are encouraged to attend.To register for Benefits Orientation, go to https://in.nau.edu/human-resources/orientation/ or call (928) 523-2223.
2Eligibility and Enrollment in Voluntary BenefitsRegular employees can enroll in medical, dental, vision, life insurance and short term disability. You can also enrollyour legal spouse and legally dependent children under the age of 26. Spouse: A spouse as designated by a legally valid existing marriage certificate acknowledged by theState of Arizona.Children: Biological children, legally adopted children, step-children, children placed for adoption,children under legal guardianship substantiated by a court order, foster children, children who areentitled to coverage under a medical support order, and disabled dependent children over age 26 areeligible. Children are eligible for dependent coverage until the end of the month in which they turn26 regardless of employment, marital status, or school enrollment.NAU reserves the right to verify dependent eligibility or to change employee and dependent eligibility requirements.Change in dependent eligibilityIf you have a dependent who becomes ineligible, you must remove them from your plan. If the loss of coverage isdue to a qualified life event, you need submit the change within 31 days of the event.Dual CoverageDual coverage of an employee, spouse and dependent, is not permitted under this Plan. If you, your spouse and\oryour child are State of Arizona or Arizona Univerisity System employees and/or retirees, you cannot enroll as asingle subscriber and be enrolled as a dependent on your spouse’s or parent’s policy simultaneously. If anindividual is enrolled in this manner, the dual coverage will be terminated and no refunds will be made for thepremiums paid.Voluntary benefit enrollment deadlinesYou have 31 days from your date of hire into a benefit eligible position to complete your voluntary benefitenrollment. Your voluntary benefits will be effective the first day of the pay period following your completedenrollment or your benefit eligible hire date, whichever is later.How to enrollYou will enroll in benefits through LOUIE self-service.Sign on to Louie Select Self Service Benefits Benefits Enrollment. Click Select for the event displayed. Click Edit on each benefit to enroll in or change your election. Click Save and Continue when your enrollment is completed. Authorize your enrollments by clicking Submit.Q: What if I do not enroll by the 31 day deadline?If you do not enroll within the 31 days, your voluntary benefits will be waived by default and you will have towait until the next open enrollment period in the fall or until you experience a Qualified Life Event.
3Benefit EligibilityEligibility for benefits is determined by the employee’s employment category and the benefit plan’s rules.The chart below shows the eligibility requirements for each benefit plan by employment category.Post Doctoral Scholar Flexible spending accounts Life insurance Short term disability Vision insurance Administrative leave (jury duty,bereavement, military) Extended Medical leave of absence Medical insuranceLeaveBenefitsPaid TimeOffRetirement& LongTermDisabilityEligibility Rule If average 30 hours per week over the measurementperiod 6 months of continuous regular service Employee must have 12 months of service and haveworked 1,250 hours or more in the previous 12 months Family medical leave of absence(FMLA) Military Leave Personal leave of absence Parental Leave Paid holidays Sick time Vacation Only Fiscal Year Faculty are eligible for vacationCompassionate transfer of leave(CTL) 12 months of continuous regular service. Only employeeswho earn vacation are eligible to receive CTL paymentsArizona State Retirement System(ASRS) Optional Retirement Plan (ORP)Supplemental Retirement Plans(403b and 457)Long term disabilityOtherBenefitsGraduate Assistants**FacultyDental insuranceTemporaryAppointed Staff *VoluntaryBenefitsStudent WorkersBenefitOther PositionsPart time FacultyTypeClassified StaffRegular PositionsEducation Assistance (TuitionReduction)Employee Assistance and Wellness(EAW)Social Security(OASDI) andMedicare (MED)Unemployment insuranceWorker's compensation 6 months of continuous regular serviceWork more than 19 hours per week for more than 19weeks of the fiscal year Work more than 19 hours per week for more than 19weeks of the fiscal year Work more than 19 hours per week for more than 19weeks of the fiscal year Student worker are subject to IRS rules*** Eligible for benefit Eligible for benefit if eligibility rule is met*Appointed Staff includes Academic Professionals, Administrative Faculty, Administrators, Head Coaches and Service Professionals** Graduate Assistants may qualify for a separate Medical Insurance and Education Assistance (Tuition Reduction) offerings through the GraduateCollege. Information can be found at tships-tuition-waivers/*** Information about the FICA exemption for student workers can be found at exception-to-fica-tax
4Paying for CoverageYou are required to pay a portion of the cost of all voluntary benefits except basic life insurance which is provided toyou at no cost. Your deductions and benefit coverage will start at the beginning of the pay period following yourenrollment. Employees paid over 12 months: If you are paid over 12 months equal deductions are taken fromeach pay check.Employees who are paid over a contract period: If you work less than a full calendar year and arepaid over a contract period, you must “Pre-Pay” for your benefits in order to cover the cost ofyour benefits for the period of time when you are not receiving a pay check.‘Pre-Payment Amount’The ‘Pre-Payment’ amount is taken starting with the first payday in January and the ‘Pre-Payments’ continuethrough the end of the academic year (normally 10 pay periods). Your deductions for these 10 pay periods will be1.6 times your regular amount. These ‘Pre-Payments’ will be used to cover the missed pay periods in May, June, Julyand August (normally 6).Deductions may be adjusted for the following reasons: If you are hired or enroll in coverage after the initial “Pre-Payment” period begins, additional‘Pre-Payments’ will be taken in order to fully pay for your summer coverage.If you leave the university at the end of the academic year you are not eligible for coverage overthe summer. Your benefit coverage will end as of the last day of the pay period including yourlast day worked. Your pre-payments will be refunded to you in a separate payment the payperiod following your final paycheck.ExampleIf the regular deduction amount is 10 per pay period then your total deduction would be 16.00. 10.00for the current pay period, and an additional 6.00 is collected to ‘Pre-Pay’ for coverage over the summer.Pre- PaymentsPre -Payment Amount# of Pre - Payments CollectedCost of Summer Coverage 6.0010 60.00Regular Deduction AmountNumber of Summer Pay Periods 10.006 60.00
5Changing Your BenefitsOnce you make your benefit elections, you will not be able to make changes until the next open enrollmentperiod unless you experience a Qualified Life Event (QLE). These life changes can qualify you for a specialenrollment period to change your benefit coverage during the calendar year but you will only be able tomake changes to your benefits that are consistent with your event. In most cases, you will be required tosubmit supporting documentation confirming the reason for your QLE.You have 31 days from the date of the QLE to complete the process. To submit an online notification use the“Qualified Life Event Form” located on the Human Resource website at fit-Plan/.Q: I just had a baby but I do not have the social security card yet, should I wait to change my benefits?No, to be eligible for this special enrollment period, you must request the change to your benefits andcomplete the enrollment process within 31 days of your QLE. Do not delay initiating your QLE request even ifyou are waiting to receive the required supporting documentation, such as social security card.Children's Health Insurance Program Reauthorization ActPursuant to the Children's Health Insurance Program Reauthorization Act (CHIPRA), the following events areconsidered QLEs as of April 1, 2009: you or your dependent loses Medicaid/CHIPRA coverageyou or your dependent becomes eligible for Medicaid/CHIPRA premium assistanceUnder CHIPRA, you have 60 days following the event to request a change to your benefits plan.
6Types of Qualified Life Events (QLE)Adding coverageReason for QLEI and/or my dependent(s) havelost coverage under anothergroup planEffective Date of CoverageDate of the eventSupporting DocumentationOfficial letter or document the includes thefollowing: Employee and\or dependent name Termination date of coverage Plans terminatedI have a newly eligible child(birth, adoption, guardianshipor placed in foster care)Date of the eventCopy of the birth certificate or a copy of thesigned and dated official document of the: Adoption Guardianship Foster CareI received a court orderrequiring me to add coveragefor my eligible child(ren)First day of the pay periodfollowing eventCopy of the court orderI was marriedFirst day of the pay periodfollowing eventMarriage CertificateEnding coverageReason for QLEI and/or my dependent(s)gained coverage under anothergroup plan.Effective Date of CoverageFirst day of the pay periodfollowing eventSupporting DocumentationOfficial letter or document the includes thefollowing: Employee and\or dependent name Effective date of coverage Plan enrolledI have received a divorce or legalseparationFirst day of the pay periodfollowing eventCopy of a signed and dated official documentof the divorce or legal separationI received a court order allowingme to drop coverage for mychild(ren)First day of the pay periodfollowing eventCopy of the court orderMy spouse or child diedDay after the eventCopy of the death certificateDependent Care Flexible Spending Account OnlyReason for QLEYour child is no longer inchildcare because they startedkindergarten or first grade orturned age 13Effective Date of CoverageFirst day of the pay periodfollowing eventSupporting DocumentationOfficial letter or document indicating yourchild has started kindergarten or first gradeor Birth CertificateYour dependent care providerwho is not your relativesignificantly changes your costsFirst day of the pay periodfollowing eventOfficial letter or document indicating yourdependent care provider has significantlychanged your costYou changed dependent careprovidersFirst day of the pay periodfollowing eventOfficial letter or document indicating youhave changed dependent care provider
7MedicalYou have the option of three types of medical plans and five networks offered through NAU and the State ofArizona. Preferred Provider Organization (PPO) You have two options, the NAU PPO through BCBSAZ or theState of Arizona PPO through Aetna, BCBSAZ or United Health Care. In a PPO, you receive the greatestbenefit when you use providers included in the plan's 'Preferred' network. You may use providers notin the plan's 'Preferred' network, but your out of pocket expenses will be greater. Exclusive Provider Organization (EPO) State of Arizona offers the EPO through the followingnetworks: Aetna, BCBSAZ CIGNA and United Health Care. To receive any benefit under an EPO youneed to use the providers included in the plan's 'Exclusive' provider network. Services received fromproviders not in the plan's ‘Exclusive’ network are not covered.High Deductible Health Plan (HDHP) & Health Savings Account (HSA) The State of Arizona’s High DeductibleHealth Plan is provided through Aetna and the Health Savings Account is administered by PayFlex. This option hastwo pieces: HDHP - This plan has a high deductible, which is the amount you pay out of pocket before you receiveany benefit. HSA - Pre-tax contributions are made by both you & NAU into an account from which you can pay forout-of-pocket expenses.You can review the plan features and premiums for your medical options on pages 9 through 12.Review medical provider networksAn important step in choosing a medical plan is to go to the vendor’s website and review the providers included inthe network to make sure they meet your needs. NAU Blue Cross Blue Shield of Arizona azblue.comBlue Cross Blue Shield of Arizona https://adoa.azblue.com/CIGNA cigna.com/stateofazAetna aetna.comUnited Healthcare welcometouhc.com/stateofaz*Aetna is the only network available for the High Deductible Health Plan (HDHP) and the name of the network forthis plan is Aetna Choice POS II.
8NAU BCBSAZ Preferred Provider Organization (PPO)In a PPO, you receive the highest benefit when you use providers included in the plan's 'Preferred' network (InNetwork). You may use providers not in the plan's 'Preferred' network (Out-of-Network), but your out of pocketexpenses will be greater. For out of network services, members are responsible for any balance billing amounts.DeductibleOut of Pocket MaximumIn-NetworkOut-of-NetworkIndividualFamily 250 500 550 1,100IndividualFamily 1,000 2,000None 11,250 22,500NoneLife Time MaximumYour Cost for CareCoinsuranceOffice VisitsPreventive CareCampus Health ServiceMental HealthPrimary CareSpecialistRadiology (CAT,MRI,PET)EmergencyFacilityUrgent CareEmergency RoomVisit 1Visit 2Visit 3 InpatientOut PatientPrescriptionsRetailUp to a 90 day supplyMail OrderUp to a 90 day supplyNone50% 2 0 per visit 0 per visit 0 per visit 25 per visit1 40 per visit150% 2 50150% 2 50 per visit 150% per visit 2 250 per visit 1 350 per visit 1 450 per visit 1 100 per surgery 1 250 per admission 1Level1 - 102 - 253 - 454 - 85One co-pay for each 30 day supplyLevel1 - 10 (1 copay)2 - 25 (1 copay)3 - 135 (3 co pays)4 - 255 (3 copays)You Pay 250 per visit 2 350 per visit 2 450 per visit 250%Level1 - 10 32 - 25 33 - 45 34 - 85 3Co-pay balance billingLevel1 - 10 (1 copay) 32 - 25 (1 copay) 33 - 135 (3 co pays) 34 - 255 (3 copays) 32019 Per Pay Period PremiumsNAU PaysTotalEmployee Only 38.83 298.83 337.66Employee Adult 107.78 601.31 709.09Employee Child 76.98 429.51 506.49Family 161.37 750.31 911.681 Members must first meet all deductibles.2 Members must first meet all deductibles and they are also responsible for any balance billing amounts for out of network services.3 Members are responsible for any balance billing amounts for out of network services.
9State of Arizona Preferred Provider Organization (PPO)In a PPO, you receive the highest benefit when you use providers included in the plan's 'Preferred' network (InNetwork). You may use providers not in the plan's 'Preferred' network (Out-of-Network), but your out of pocketexpenses will be greater. For out of network services, members are responsible for any balance billing amounts.You can select one of the following networks: Aetna, BCBSAZ or United Health Care.DeductibleOut of PocketMaximumLife Time MaximumIn-NetworkOut-of-Network*Employee 500Employee Adult 1,000Employee Child 1,000Family 1,000Employee 1,000Employee Adult 2,000Employee Child 2,000Family 2,000NoneEmployee 1,000Employee Adult 2,000Employee Child 2,000Family 2,000Employee 2,000Employee Adult 4,000Employee Child 4,000Family 4,000NoneYour Cost for CareNone50% 2 050% 2 20 per visit 1 40 per visit 1 20 per visit 1 100 copay 150% 250% 250% 250% 2 75 per visit 1 200 per visit 1 100 per admit 1 250 per surgery 1Generic 15Preferred 40Non-Preferred 60Generic 30 (2 copays)Preferred 80 (2 copays)Non-Preferred 120 (2 copays) 75 per visit 2 200 per visit 250% 2CoinsuranceRoutine Preventive ServicesOffice VisitsPrimary CareSpecialistMental HealthRadiology (CAT,MRI,PET)EmergencyFacilityUrgent CareEmergency RoomOut PatientInpatientPrescriptionsRetail (30 days)Mail Order (90 days)You PayNot CoveredNot Covered2019 Per Pay Period PremiumsNAU PaysTotalEmployee Only 53.34273.30326.64Employee Adult 112.43577.89690.32Employee Child 75.30386.73462.03Family 131.25674.20805.451 Members must first meet all deductibles.2 Members must first meet all deductibles and they are also responsible for any balance billing amounts for out of network services.Important: Chiropractors and Therapists (Occupational, Physical, Respiratory and Speech) will be considered specialist and the copay will be 40per visit.
10State of Arizona Exclusive Provider Organization (EPO)To receive any benefit under an EPO, you need to use providers included in the plan's 'Exclusive' network (In-Network). Services received from providers not in the plan's ‘Exclusive’ network (Out-of-Network) are not covered.You can select one of the following networks: Aetna, BCBSAZ, CIGNA or United Health Care.In-Network Providers OnlyEmployee 100Employee Adult 200Employee Child 200Family 200DeductibleEmployee 7,350Employee Adult 14,700Employee Child 14,700Family 14,700Out of PocketMaximumNoneLife Time MaximumYour Cost for CareCoinsuranceNoneRoutine Preventive ServicesOffice Visits 0 20 per visit 1 40 per visit 1 20 per visit 1Primary CareSpecialistMental Health 100 copay 1Radiology (CAT,MRI,PET)EmergencyFacility 75 per visit 1 200 per visit 1Urgent CareEmergency RoomInpatientOut Patient 100 per admit 1 250 per surgery 1Retail (30 days)Generic 15Preferred 40Non-Preferred 60PrescriptionsMail Order (90 days)Generic 20 (2 copays)Preferred 40 (2 copays)Non-Preferred 80 (2 copays)2019 Per Pay Period PremiumsYou PayNAU PaysTotalEmployee Only 20.92268.90289.92Employee Adult 62.23552.47614.
Welcome to Northern Arizona University (NAU) 1 Eligibility and Enrollment in Voluntary Benefits 2 Paying for Coverage 4 Changing your Benefits 5 Medical 7 Campus Health Services 12 Wellness Programs 14 Dental 16 Vision 19 Flexible Spending Account (FSA) 21 Basic Li
