2018–2019Benefits Enrollment GuideFor Benefits Effective July 1, 2018

Open Enrollment is April 16 through May 4, 2018Welcome to Gilbert Public Schools (GPS) 2018–2019 Open Enrollment. The Plan Year is from July 1, 2018 through June 30, 2019. GPS will offer a comprehensive benefits program to benefits-eligible employees. This Benefits Enrollment Guide will provide highlights and information to help you make the best choice for you and your family.

Enrolling Online Before you make any decisions, you should review this Enrollment Guide thoroughly.

Be sure to choose your benefit options carefully. You will not be able to make changes to your coverage until the next open enrollment period unless you have a qualifying life event. You must notify GPS in writing within 31 days of the status change. All employees must complete their Online Enrollment through the iVisions Employee Self-Service Portal. If you do not complete the enrollment process, you will run the risk of fines being imposed to you by the IRS.

If you wish to participate in the Flexible Spending Accounts (FSA), you are required to enroll each year.

Important Notice:GPS will no longer cover out-of-network (OON) care for the 2018-2019 Plan Year.

During open enrollment you can: Y Add/drop/change medical, dental and vision plans Y Add/drop/change dependents Y Enroll in the Flexible Spending Accounts (FSAs)

Y Change your beneficiary information

Y Add/drop/change any voluntary insurance plans

Y Get more information about your benefit plans

Completeyour

benefitenrollment

online!

You have three medical plan options: Y The Trust Plus Plan (EPO Plan) Y The Trust Savings $1,500 Plan (HDHP) Y The Trust Savings $2,500 Plan (HDHP)

Paying For Your BenefitsGPS will pay the full cost (no employee contribution) for employee-only medical coverage in the 2018 – 2019 plan year for the Trust Savings $1,500 Plan and the Trust Savings $2,500 Plan. Additionally, GPS will contribute $375 to the your Trust Savings $1,500 Plan HSA or $725 to your Trust Savings $2,500 Plan HSA. GPS’s contributions are deposited in equal increments on a pre-tax basis over 20 pay periods.

You will be responsible for the cost of your dependents’ coverage and any voluntary coverage you elect for you and your family. With the exception of the voluntary benefits, your portion of the costs are deducted from your paycheck on a pre-tax basis — saving you federal, state and Social Security taxes by reducing your taxable income.

Please continue to use your benefits wisely:

Y Review your medical bills thoroughly to ensure proper billing.

Y Get your medical care from doctors, hospitals, and health care providers who participate in the BlueCross BlueShield of Arizona (BCBSAZ) network.

Y Have your short-term prescriptions filled at retail pharmacies and your maintenance medications filled through mail order.

Y Take responsibility for your health by working toward a healthy weight, getting your flu shot annually, keeping your blood pressure in a safe range and having your cancer screening tests when appropriate.

Medical Plan OptionsOut-of-Network (OON) care will no longer be covered in any of these plans. In the case of a medical emergency, coverage will be extended regardlessof location.

With each medical plan option, you have access to providers in a medical network administered by BCBSAZ. Their EPO network consists of doctors, hospitals, health care facilities including the Mayo Clinic, that have contracted with them to provide care and services at discounted fees. Since BCBSAZ has a large network, chances are good that your current provider is in the network. Refer to page 8 for contact information should you need to verify your provider’s participation or locate a doctor or hospital in your area.

Your 2018 – 2019 Benefit ChoicesGPS is dedicated to offering you a comprehensive and competitive benefits package designed to address the health care needs of both you and your family, including: Health care programs — medical, prescription drug, and vision benefits

Wellness benefits — adult and well-child care such as routine immunizations, exams and screenings

Flexible Spending Accounts (FSA) — offer tax advantages when you set aside pre-tax dollars to pay for eligible health care and/or dependent care expenses

Financial protection programs — voluntary life insurance, voluntary dental insurance, voluntary short-term disability, and critical illness

An Employee Assistance Program (EAP) — offering confidential counseling to help you deal with a range of life’s issues

District Paid Short-Term Disability Insurance — no cost to benefit eligible employees

District Paid Basic Life and AD&D Insurance — no cost to benefit eligible employees

For more information or to find an in-network provider, log on to www.azblue.com/chsnework

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Your Medical Plan OptionsThe Trust Savings $1,500 and $2,500 Plans With the Health Savings Account (HSA)Although this option has a higher in-network deductible per person than the other medical option, the HDHP includes an HSA, which will help you save money by allowing you and GPS to deposit before-tax dollars into the HSA to pay for qualified medical expenses. NOTE: If an employee elects dependent coverage (spouse, children or family) the family deductible must be met before the Plan will pay.

How the HSA Works Y GPS will contribute up to $375 to your HSA for the plan year if you choose the Trust Savings $1,500 Plan. GPS will contribute up to $725 to your HSA for the plan year if you choose the Trust Savings $2,500 Plan. GPS’s contributions are deposited in equal increments on a pre-tax basis over 20 pay periods.

Y In 2018 your contributions plus contributions made by GPS may not exceed the IRS annual maximum contribution amount of $3,450 for Employee Only coverage and $6,850 for Family coverage.

Y Your contributions to the HSA will be deducted from your paycheck in equal increments over 20 pay periods, on a pre-tax basis (before federal income, FICA, or state taxes are calculated). You save money because you pay less in taxes. NOTE: You will need to elect enrollment in an HSA each year.

Y If you are over age 55, you can also set aside an additional $1,000 per year as a “catch-up” contribution. However, GPS will not provide a matching contribution for employee “catch-up” contributions.

Y GPS will submit all contributions to a bank and an HSA will be established for you. Contributions will be available for use once they are deposited to your account.

Y Your HSA funds may be used by you, your spouse and dependent children to pay for eligible medical expenses, such as deductibles, copays, coinsurance, certain uncovered health care expenses, and many over-the-counter (OTC) medicines and supplies.

Y If a balance remains in your HSA at the plan year’s end, the funds will roll over for your use during the next plan year as they never expire.

Y Your HSA is portable. If you leave GPS or switch medical plans, you can continue to use your funds for qualified health care expenses.

Y You and your employer cannot contribute to your HSA if you are covered by another health plan (unless that other health plan is also a qualified HDHP). For example, if you are covered under your spouse's medical plan, you can only contribute to your HSA if your spouse's medical plan is ALSO a qualified HDHP.

Y You and your spouse cannot be enrolled in the HDHP with HSA and also be enrolled in a Health Care FSA that reimburses for medical services.

Y Other types of coverage such as veterans' benefits, Tricare, Medicaid, or supplemental medical insurance may also prevent you and your employer from being able to contribute to your HSA.

Y If you have any type of Medicare coverage, you nor your employer cannot contribute to your HSA. If your spouse has Medicare, but you do not, you may contribute to your HSA as "individual" coverage, not family coverage.

Important Information if you are Considering an HDHP (Trust Savings $1,500 or $2,500 Plans) with an HSA Are you in a financial position to pay the annual deductible amount under the HDHP if you or your family have large medical expenses before you accumulate a balance in your HSA? Can you make additional voluntary contributions to an HSA so that funds can accumulate for future health care expenses? If your answers are “yes,” an HDHP could be right for you.

The Trust Plus PlanThe Trust Plus Plan no longer offers out-of-network care, and will now be referred to as an Exclusive Provider Organization (EPO) plan instead of a PPO plan. You can see any BCBSAZ in-network provider. Out-of-network providers are no longer covered.

The Trust Savings $1,500 and $2,500 PlansThe Trust Savings $1,500 and $2,500 Plans are High Deductible Health Plans (HDHP) that include a Health Savings Account (HSA) component. You can see any BCBSAZ EPO provider. Out-of-network providers are no longer covered.

A Comparison of Medical and Prescription Drug Benefits is provided

on page 5, and in the Summary of Benefits & Coverage (SBC)

provided separately.

NOTE: Prescriptions are applied toward the medical deductible and claims are handled through Meritain Health.

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What can I use Teladoc for?Teladoc doctors can help with the following common medical conditions:

Y Allergies Y Bronchitis Y Cold/flu Y Headaches/migraines Y Eye/ear infections Y Rash/skin infections Y Sinus infections Y Stomachache/diarrhea Y Urinary tract infections Y Plus many other conditions

If you are enrolled in the Trust Plus Plan, there is no cost for using Teladoc.

For those enrolled in either the Trust Savings $1,500 Plan (HDHP) or the Trust Savings $2,500 Plan (HDHP), using Teladoc is $40 per consult and the cost is applied to your out-of-pocket limit.

Need to consult a doctor about a non-urgent illness, but can’t get an appointment with your primary doctor? Teladoc allows you to see a U.S. Board-certified doctor anytime, through phone and video consults.

What is Teladoc?Teladoc is an on-demand health care solution that gives you access to the medical care you need, when you need it. You can talk to a doctor anytime, anywhere about non-emergent medical conditions.

What kind of doctors will I be talking with?Teladoc offers highly qualified, experienced doctors who have an average of over 10 –15 years in practice, use the latest technology to provide excellent care, are U.S. board-certified and state licensed and specially trained in treating patients through telemedicine.

How do I reach Teladoc?

Y By phone —Just call (800) 362-2667

Y Online —Request a video consultation online at www.MyDrConsult.com

Y On the go —You can download the Teladoc mobile app by visiting the App Store or Google Play

When Do I Use Teladoc?Use Teladoc for medical advice and care when:

Y Your primary care doctor isn’t available Y You’re at home, traveling or don’t want take time off work to see a doctor

Y You need a prescription or refills Note: There is no guarantee you will be prescribed medication.

Employee

Assistance Program

You have free access to an Employee Assistance Program (EAP) through EAP Preferred. Under the EAP, you and your household members can speak with a professional counselor (up to 10 sessions) who can help you with a variety of issues, such as:

Y Marital or family problems Y Financial or legal difficulties Y Emotional or stress-related

problems Y Drug or alcohol abuse Y Problems related to work

To speak with a confidential EAP

counselor, or to make an appointment

call EAP Preferred at (602) 264-4600.

Online AccessFor more information or to find an in-network provider, log on

to www.eappreferred.com

User name: GPS123 Password: eappreferred.

Get the Care You Need Anytime, Anywhere!

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Express ScriptsWe want to make sure that everyone who currently is prescribed medication gets the medication they need for their condition. Often a generic, over-the-counter (OTC), or preferred brand name drug is just as effective as a non- preferred brand name drug. The Preferred Drug Step Therapy Program (PDST) directs plan participants currently using non-preferred brands to switch to these less costly, but equally effective medications.

If you have questions, contact Express Scripts at (800) 711-0917.

Out-of-Network (OON) care will no longer be covered in any of these plans.

Medical Benefits

Trust Plus EPO PlanTrust Savings $1,500 Plan

(HDHP with HSA)

Trust Savings $2,500 Plan

(HDHP with HSA)In-Network Only In-Network Only In-Network Only

Calendar Year* Deductible

$750/individual$2,250/family

$1,500/individual$3,000/family

$2,500/individual$5,000/family

Calendar Year Out-of-Pocket Limit** $6,350/individual; $12,700 family,

then Plan pays 100%

$5,000/individual$10,000/family,

then Plan pays 100%

$6,350/individual$12,700/family,

then Plan pays 100%

Physician Office Services 75%*** 75%*** 75%***

Routine Physicals & Wellness — employee & spouse only (exams, Pap smears, mammograms, immunizations)

100%No deductible

100%No deductible

100%No deductible

Colonoscopy Screening — for adults 50 and over (once every 10 years)

100% No deductible

100% No deductible

100% No deductible

Well Child Care – through age 18 (exams, immunizations)

100% No deductible

100% No deductible

100% No deductible

Inpatient Hospital $100 copay per admission, then Plan pays 75% after deductible* 75%* 75%*

Rehabilitation Services— In-patient (60-day maximum)

$100 copay per admission, then Plan pays 75% after deductible*

75% per illness or injury*

75% per illness or injury*

Urgent Care 75%* 75%* 75%*

Prescription Drug Benefits

Calendar Year* Deductible $50/individual; $150/family

Subject to medical deductible and

out-of-pocket limit

Subject to medical deductible and

out-of-pocket limit

Retail Pharmacy (up to a 30-day supply)

Generic: 20% coinsurance, $10 minimum;

Brand: 30% coinsurance****Non-Formulary: 40% coinsuranceSpecialty: 5% coinsurance, $150

maximum

Plan pays 75% after deductible is met

and 100% after out-of-pocket limit

is met.

Plan pays 75% after deductible is met

and 100% after out-of-pocket limit

is met.

Mail Order (up to a 90- day supply)

Generic: $20 copayBrand: $40 copay****

Non-Formulary: $60 copay

Plan pays 75% after deductible is met

and 100% after out-of-pocket limit

is met.

Plan pays 75% after deductible is met

and 100% after out-of-pocket limit

is met.

*Deductibles are based on the calendar year and run from January 1 through December 31.**In-network deductibles, copays and coinsurance accumulate to the annual out-of-pocket limit.***After your medical plan deductible has been met.**** If you purchase a brand-name drug when a generic is available, your cost will be the copay amount plus the cost

difference between the generic drug and the brand-name drug.

Comparison of Medical and Prescription Drug Benefits

Questions?Call GPS

BenefitsDepartment

(480) 497-3384

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Vision Benefits Vision Plan for the Trust Plus or Trust Savings PlansVSP In-Network Providers Non-VSP Providers

Calendar Year Deductible $0 $0

Vision Exam 100% (once every 12 months) $35 allowance (once every 12 months)

Single Vision Lenses 100% (once every 12 months) $25 allowance (once every 12 months)

Bifocal Lenses 100% (once every 12 months) $40 allowance (pair once every 12 months)

Trifocal Lenses 100% (once every 12 months) $55 allowance (pair once every 12 months)

Lenticular Lenses 100% (once every 12 months) $100 allowance (pair once every 12 months)

Frames 100% (once every 24 months/retail frame allowance $115) $45 allowance (pair once every 12 months)

Contact Lenses (elective) $105/pair (once every 12 months) $105/pair (once every 12 months)

Contact Lenses (when determined by VSP to be medically necessary — not elective)

100% (once every 12 months) $210 allowance (pair once every 12 months)

Vision Service Plan (VSP)If you enroll in any medical plan, you may also elect vision coverage to help you maintain healthy vision, including coverage for routine exams, lenses, frames, and contact lenses.

Available through Vision Service Plan (VSP), many vision services are covered in full, without claims to file when you use a VSP in-network provider. Charges by non-VSP providers are payable up to the allowable amount. The VSP network consists of optometrists and eyewear providers nationwide.

Your Vision and Dental Plan Options

The Voluntary Trust Choice Dental PlanEnrolling in dental coverage is optional. You and your dependents may receive dental care from any provider you choose within the BCBSAZ dental network. NOTE: An employee may only enroll dependents in the voluntary dental plan if the employee is enrolled.

Dental Benefits Trust Choice Dental PlanIn-Network Out-of-Network

Calendar Year Deductible $50/person, $150/familyCalendar Year Maximum $1,250/personLifetime Orthodontia/TMJ Benefit $1,750/personDiagnostic & Preventive 100% 80%

Restorative (basic) 80%* 60%*

Endodontics & Periodontics 60%* 40%*Orthodontia, TMJ, Prosthodontics 60%* 40%*Oral Surgery 60%* 40%*

* After your dental plan deductible has been met

To find an in-network VSP provider, visit the VSP website at www.vsp.com, or call VSP Member Services at (800) 877-7195.

To find a Trust Choice Dental Plan in-network provider, log on to www.azblue.com/chsnetwork

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2018 Premium CostsGPS will contribute $5,360 per year toward employee medical, prescription drug, vision, district paid basic life insurance, and district paid short-term disability coverage. Employees are responsible for the cost of dependent coverage.

All employees enrolled in a GPS medical plan are eligible to participate in the GPS Be Well Program. If you do, you will receive an incentive.

Y See the Trust Plus Plan chart on this page for premium differences.

Y If you enroll in either the Trust Savings $1,500 or $2,500 Plan, you will receive a lump sum contribution of $240 to your Health Savings Account (HSA), in the last pay period prior to the 2018 winter break.

Pay Deductions

Monthly 20 Pay Periods 26 Pay Periods

Trust Choice Dental Plan

Employee Only $32.00 $19.20 $14.77

Employee + Spouse $92.00 $55.20 $42.46

Employee + Child(ren) $73.00 $43.80 $33.69

Employee + Family $107.00 $64.20 $49.38

Trust Choice Dental Plan Premiums

Medical Plan Premiums

Employee Contributions

With Wellness Incentive Without Wellness Incentive

20 Pay Periods

26 Pay Periods

20 Pay Periods

26 Pay Periods

Trust Plus Plan

Employee Only $16.20 $12.46 $28.20 $21.69

Employee + Spouse $264.60 $203.54 $276.60 $212.77

Employee + Child(ren) $181.80 $139.85 $193.80 $149.08

Employee + Family $446.40 $343.38 $458.40 $352.62

Trust Savings $1,500 Plan*

Employee Only $0 $0

Employee + Spouse $222.60 $171.23

Employee + Child(ren) $148.20 $114.00

Employee + Family $388.20 $298.62

Trust Savings $2,500 Plan**

Employee Only $0 $0

Employee + Spouse $205.20 $157.85

Employee + Child(ren) $136.20 $104.77

Employee + Family $357.00 $274.62

* Includes District HSA contribution of $375 annually** Includes District HSA contribution of $725 annually

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For Questions About... Contact...

• Medical Plan Claims AdministrationMeritain Health(602) 789-1170 or (866) 300-8449 www.meritain.com

• Teladoc Meritain Teladoc (800) 362-2667www.MyDrConsult.com

• Voluntary Trust Choice Dental PlanMeritain Health(602) 789-1170 or (866) 300-8449www.azblue.com/chsnetwork

• District Paid Life Insurance UNUM - (866) 220-8460

• District Paid Short-Term Disability Meritain - (517) 349-7010

• Voluntary Short-Term Disability Lincoln - (800) 423-2765

• In-Network Providers (BlueCross BlueShield of Arizona)

BlueCross BlueShield of Arizonawww.azblue.com/chsnetwork

• Prescription Drug Coverage• Retail Pharmacy Locations• Mail Order

Express Scripts(800) 711-0917www.express-scripts.com

• Vision Plan Vision Services Plan (VSP)(800) 877-7195 or (800) 821-8130www.vsp.com

• Flexible Spending Accounts (FSA)

Meritain Health(602) 789-1170 or (877) 637-4824, select option 3, then enter 1200002675www.meritain.com

• Employee Assistance Plan (EAP) EAP Preferred(602) 264-4600

www.eappreferred.com username: eappreferred password: GPS123

• Health Saving Account (HSA)Health Equity(866) 346-5800www.healthequity.com

• General Benefit Questions

GPS Benefits Department (480) 497-3384 Adriane Dutchover (480) 497-3323 Julie Gustin (480) 497-3493 Stacey Baleme (480) 545-2178

Important Contact Information

The information provided in this Benefits Enrollment Guide is of a general nature only and does not replace or alter the official rules and policies in the official plan documents that legally govern the terms and operation of the plans. Receipt of this Guide does not guarantee benefits eligibility.

Online AccessAll benefit information can be accessed under the Benefits tab in the Benefits Information Center when you log into the iVisions Employee Self-Service Portal.

Caution: If You Decline Medical Plan

Coverage Offered Through Gilbert Public Schools

If you are in a benefits-eligible position and choose to waive/ decline your insurance offer, remember that you must maintain medical plan coverage elsewhere.

Employees without medical coverage may have to pay a penalty when they file their personal income taxes. Visit the Health Insurance Marketplace for detailed information www.healthcare.gov.

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