BENEFITS GUIDE

Welcome

to the

Superior Court System

in

Mohave County

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Mohave County Superior Court System

Benefits Summary 2004 - 2005

Table of Contents

Insurance Coverage Page(s) Effective Dates & Eligibility Information 3 Medical & Prescription Drug Program 4 - 6 Audiological Services 7 Dental 8 - 9 Vision 10 - 11 Employee Assistance Program (EAP) 12 Continuation of Coverage (COBRA) 12 Basic Life / Accidental Death & Dismemberment (A D & D ) 13 Voluntary Life Insurance 14 Short -Term Disability 14 Workers' Compensation 14 Long - Term Disability 14 Retirement Plans Arizona State Retirement System 15 Social Security 15 Deferred Compensation 16 Miscellaneous Benefits Flexible Spending Account (FSA) 16 Section 125 Flexible Plan 16, 18 & 19 Automatic Direct Deposit 16 Pre-Paid Legal Services 16 Educational Allowance 17 AFLAC Supplemental Insurance 17 Leave Policies Paid Time Off (PTO) 20 Bereavement 20 Donated Leave 20 Holiday Leave 21 Overview of Benefits 22 Overview of Enrollment Times 23 Note: The information contained in this booklet is provided only as a summary of benefits. For detailed information, please refer to the plan documents or applicable Judicial Merit Rules.

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EFFECTIVE DATES & ELIGIBILITY : If you are an insurance eligible employee and are hired between the 1st and 15th of the month, your insurance will be effective on the first day of the month following your date of hire. If you are hired between the 16th and 31st of the month, your insurance will be effective on the first day of the second month following your date of hire. Payroll deductions for insurance elections are deducted one month in advance. As a result, it may be necessary for some new hires to have double deductions on their first paycheck(s). Employees who separate from court service will have insurance coverage through the end of the month in which they separate. Any premiums paid in advance will be refunded to the separating employee. You will have five (5) days from your date of hire to return your completed benefit forms to the Superior Court Personnel Office. If your paperwork is not returned by the required date, you will not be eligible for insurance coverage until the next open enrollment period. ELIGIBLE EMPLOYEE: Benefits eligible employees must work at least thirty two (32) hours per week on a regular basis to retain insurance coverage. ELIGIBLE DEPENDENTS: Eligible dependents shall include a covered employee's:

Lawful spouse, provided they are not legally separated (Unmarried, life partners (common law spouses) are not eligible for coverage.) Unmarried children, including legally adopted children(from the date of placement in

the employee's home for the purpose of adoption), until their nineteenth (19th) birthday. The following children will also be considered as eligible dependents provided they reside with the employee in a normal parent-child relationship, and the employee or the employee's spouse is legally responsible to provide medical care:

Stepchild; Lawfully placed foster child for whom coverage is not available through a

state agency; A child who is under the legal guardianship of the employee substantiated

by a court order. Unmarried children nineteen (19) years of age but less than twenty-five (25)

years of age, provided they are a full-time student (as defined by the institution they are attending) at an accredited university, college, vocational or other institutions of higher learning, and they are dependent upon the employee for principal financial support. If a dependent student has completed the spring semester at their school, eligibility will continue through the months of June, July and August. Documentation of student status will be required by the Claims Administration before benefits will be considered.

If both husband and a wife are covered employees, dependent children can be covered under either parent, but not by both parents.

For more information on eligibility requirements and effective dates, please see the plan documents.

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MEDICAL Mohave County offers a partially self-funded Preferred Provider Organization (PPO) medical plan. The medical plan is administered by Administrative Enterprises, Inc. The plan utilizes the BlueCross BlueShield of Arizona Provider Network for Arizona, Health Management Network (HMN) for Nevada, and Behavioral Healthcare Options for mental health and substance abuse services. Eligible employees and their dependents can utilize all of these PPO networks. HMN of Utah network is available for Colorado Strip area employees only. BlueCross BlueShield of Arizona provider information is available on the web at www.bcbsaz.com or by calling (800) 232-2345. Health Management Network, Inc. provider information is available on the web at www.hma-inc.com or by calling (800) 762-2234. You will receive two medical cards (one for Arizona and one for Nevada), a prescription card, and a summary plan document prior to the effective date of your coverage. Walgreens Health Iniatives, (Prescription Plan), provider information is available on the web at http://www.walgreenshealth.com or by calling (800) 207-2568. For claim information or other general medical plan inquiries, please contact Administrative Enterprises, Inc. (AEI) at (602) 789-1170 or 1-800-762-2234. Pre-existing Condition Limitation A pre-existing condition is any medical condition for which the covered person received treatment including, but not limited to, diagnosis, consultation, treatment or taking prescribed drugs/medication (including self-administered drugs or biologicals not requiring a physician’s prescription) for an illness or injury, during the six (6) month period immediately preceding the covered person’s enrollment date of coverage under this plan. Pre-existing limitation does not apply to newborns, newly adopted children, or pregnancy. New employees and their covered dependents will not be eligible for benefits related to a pre-existing condition until they have been continuously covered by the Plan for twelve (12) consecutive months. Employees and their dependents who enroll in the Plan more than thirty (30) days after their original eligibility date are considered "Late Enrollees" and will not be eligible for benefits related to a pre-existing condition until they have been continuously covered by the Plan for eighteen (18) months. Employees and their dependents may receive credit for previous "creditable coverage" under a prior health plan in accordance with the provisions of the plan document.

MEDICAL PPO RATES EFFECTIVE JULY 1, 2004

Month Total County Per Month

Employee Per Month

Employee Per Pay Period

Employee Only $345.28 $332.00 $13.28 $6.64

Employee & Spouse $694.34 $573.46 $120.88 $60.44

Employee & Child(ren) $624.34 $515.06 $109.28 $54.64

Employee & Family $1,044.90 $866.10 $178.80 $89.40

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MOHAVE COUNTY EMPLOYEE BENEFIT TRUST MEDICAL PLAN January 1, 2005

BENEFIT In-Network Out-of-Network Maximum Lifetime Benefit $2,000,000 Per Individual Calendar Year Deductible Individual $150 $300 Family $450 $900 Annual Out-of-Pocket Maximum Excluding deductible and co-payments Individual $2,000 $6,000 Family $6,000 $10,000 Pre-existing Condition Limitation Newly eligible emps/deps - 12 month waiting period for conditions diagnosed/treated 6 months prior to enrollment Late Enrollees - 18 month waiting period for conditions diagnosed/treated 6 months prior to enrollment Physician Services NO PCP REQUIREMENT Office Visits

Nurse Only Visit $15 Co-payment

$ 5 Co-payment 60%* of eligible expenses

60%* of eligible expenses Routine Physicals $15 Co-payment Not Covered Annual Well-Woman/Man Exams $15 Co-payment Not Covered Routine injections and $15 Co-payment Not Covered immunizations Well-child care $15 Co-payment Not Covered Allergy Tests & Treatments $15 Co-payment 60%* of eligible expenses Lab and X-ray (including

mammograms) Surgical Procedures in the physician’s office (when not part of an office visit

$15 Co-payment

$15 Co-payment

60%* of eligible expenses

60%* of eligible expenses

Prescription Drugs NO DEDUCTIBLE Retail Prescriptions Retail: (Per prescription - 30-day supply

max.) $7 Co-payment - Generic

$20 Co-payment - Preferred Brand $35 Co-payment - Non-Preferred Brand Mail Order/Maintenance Drug

Program Mail Order:

(Per prescription - 90-day supply max.)

$7 Co-payment - Generic

$40 Co-payment - Preferred Brand $70 Co-payment - Non-Preferred Brand Maternity Care Prenatal/Postnatal Care $15 Co-payment 60%* of eligible expenses First Visit to confirm pregnancy $15 Co-payment 60%* of eligible expenses Per visit thereafter $15 Co-payment 60%* of eligible expenses Hospital Charges per admission 80%* of eligible charges 60%* of eligible expenses Delivery Charges per admission 80%* of eligible charges 60%* of eligible expenses Family Planning Office Visit per visit $15 Co-payment 60%* of eligible expenses Surgical procedures Vasectomy - $100 Co-

payment 60%* of eligible expenses

(vasectomy, tubal ligation) per Tubal - $200 Copayment 60%* of eligible expenses

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MOHAVE COUNTY EMPLOYEE BENEFIT TRUST MEDICAL PLAN

JULY 1, 2004

BENEFIT In-Network Out-of-Network Emergency Care Urgent Care facility per visit 80% of eligible charges; deductible waived In-hospital emergency room Add'l '$50 Deductible, then 80%* of eligible expenses (Add'l $50 deductible waived if admitted) Ambulance 80% of eligible charges; deductible waived Supplemental Accident Benefit: $300 per incident Hospital Services Inpatient Services including 80%* of eligible charges Semiprivate room & board Operating & Recovery Rooms Physician & surgeon charges Drugs and medication Anesthesia & respiratory therapy Outpatient Services Surgery (Physician & Facility) 80%* of eligible charges 60%* of eligible expenses Lab & X-ray (including

mammograms) $15 Co-payment 60%* of eligible expenses

Special Services Short-term outpatient 80%* of eligible charges rehabilitative & physical therapy up to 40 visits per calendar year 60%* of eligible expenses Home Health Care per visit 80%* of eligible charges 60%* of eligible expenses Special inpatient care facilities

such as skilled nursing up to 90 80%* of eligible charges 60%* of eligible expenses

days per calendar year CT Scan & MRI 80%* of eligible charges 60%* of eligible expenses Other Medical Services not

specified elsewhere in this chart 80%* of eligible charges 60%* of eligible expenses

Durable Medical Equipment Short-term rental or purchase of 80%* of eligible charges 60%* of eligible expenses certain durable medical equipment such as crutches, wheelchairs, oxygen tents and respirators is covered per item External Prosthetics Initial purchase & fitting of certain 80%* of eligible charges 60%* of eligible expenses external prosthetic devices, such as artificial arms & legs Mental Health & Substance Abuse 1 Confinement per Calendar year (max. 30 days) Inpatient Services 2 Confinements per Lifetime Mental Health/Substance Abuse 80%* of eligible charges 60%* of eligible expenses Outpatient Counseling $15 Co-payment 60%* of eligible expenses (maximum of 30 visits per calendar year) Chiropractic Care $15 Co-payment 60%* of eligible expenses 30 visits per year-$40 eligible per visit

* Subject to Calendar Year Deductible PRECERTIFICATION is required for Inpatient Admissions (excluding emergency or maternity admissions), Inpatient Extended Active Rehabilitation, Outpatient Surgery, Therapy, Skilled Nursing Facility, Hospice.

Audiological Benefits

Effective July 1, 2003, employees and their eligible dependents covered under the Mohave County Employee Benefit Trust health insurance program are eligible for discount Audiological Services offered by the Colorado River Hearing Center. Services Offered at No Charge Include:

Hearing Evaluations &

Consultations Cleaning & Service of current

hearing instruments Information on assistive devices for

the hearing impaired

Information on accessory products for hearing protection

Adjustments (re-programming of

digital and digitally programmable hearing instruments

Lifetime, in-office, service and adjustments to any hearing instruments purchased at any of the Colorado River Hearing Center locations.

Discounts and reduced price benefits are also offered on the following:

• Conventional, Analogue Hearing Instruments

• Shooters Ear Plugs (factory made)

• Factory made hearing aid earmolds (standard molds)

• Digitally, Programmable Hearing Instrument

• Custom made (in-office) Sound, Sleep and Swim Plugs

• Dry and Store Hearing Aid Maintenance Kit

• 100% Digital Hearing Instruments

• Hearing Aid Batteries

• Battery Club (6pkg + 6 free pkgs after 5 purchases)

Two Convenient Locations

Kingman 2116 Stockton Hill Road,

Kingman 928-753-6688

Bullhead City 2400 Hwy 95, Suite 50

Bullhead City 928-763-1973

Note: This discount program is not a guaranteed benefit, may be cancelled at anytime and pricing is subject to change.

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DENTAL Mohave County offers a partially self-funded dental plan. The dental plan is administered by Delta Dental and has a High and Low Option. For dental claims, inquiries, or to order new cards, call Delta Dental of Arizona at (800) 352-6132. For a complete list of participating dentists, go to http://www.deltadental.com/ or contact Delta Dental at (800) 352-6132 extension 2. You will receive dental cards and a summary plan document prior to the effective date of your coverage. If you need new or additional cards, please contact Delta Dental of Arizona at the above number. If you have dual insurance, there is an additional form that needs to be completed. DENTAL HIGH OPTION RATES

EFFECTIVE JULY 1, 2004 DENTAL LOW OPTION RATES

EFFECTIVE JULY 1, 2004

Month Total

County Per

Month

Employee Per

Month

Employee Per

Payday

Month Total

County Per

Month

EmployeePer

Month

Employee Per Pay Period

Employee Only $30.00 $14.54 $15.46 $7.73 $13.32 $13.32 $ 0 $ 0

Employee & Spouse $60.28 $24.28 $36.00 $18.00 $26.76 $21.80 $4.96 $2.48

Employee & Child(ren) $61.20 $24.68 $36.52 $18.26 $27.18 $22.16 $5.02 $2.51

Employee & Family $91.18 $36.76 $54.42 $27.21 $40.46 $32.98 $7.48 $3.74

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DENTAL PLAN SUMMARY JULY 1, 2002 PREMIER PLAN

Group #3888

HIGH PLAN 0001

LOW PLAN 0002

CALENDAR YEAR DEDUCTIBLE

$25 Per person; $75 Per family

$100 Per person; $300 Per family

CLASS 1 – ROUTINE SERVICES DIAGNOSTIC: Exams including consultations (Two in a calendar year) Oral Exams (Two in a calendar year) X-rays: Full Mouth (Once in a 2 year period) Bitewing/Pano (One per calendar year) Periapical PREVENTIVE: Routine Cleanings (limited to twice in a calendar year, or one difficult cleaning may be exchanged for two routine cleanings. However, the difficult cleaning is limited to not more than one in a two-year period.) Topical Application of Fluoride (children under 19 years of age – twice in a calendar year) Space Maintainers (for missing posterior primary teeth) Sealants for Children (once per three year period for permanent molars & bicuspids under 19 years of age)

100% 80%

CLASS II - BASIC SERVICES RESTORATIVE: Fillings – silver amalgam, silicone, acrylic, composite (regardless of front/rear) Stainless Steel Crowns (for primary teeth only) Cast Crowns (HIGH PLAN ONLY) (five year waiting period for replacement last benefited by Delta) ORAL SURGERY: Extractions ENDODONTICS: Root Canal Treatment (permanent teeth); Pulpotomy (primary teeth) PERIODONTICS: Treatment of Gum Disease (non-surgical once every two years/ Surgical once every three years) EMERGENCY: (Palliative Treatment) Treatment for relief of pain

80% 50%

CLASS III – MAJOR SERVICES *PROSTHODONTICS: Bridges Partial Dentures Complete Dentures *RESTORATIVE: Inlays – Jackets –Onlays Cast Crowns (LOW PLAN ONLY) *Does not provide for lost, misplaced or stolen bridges or dentures. Five-year waiting period for replacement last benefited by Delta. BRIDGE AND DENTURE REPAIR: Repair of such appliances to their original condition including relining of dentures

50% 50%

CLASS IV – ORTHODONTIC SERVICES Orthodontic Services are for children age eight and older. Children must be banded prior to age 19. Benefits are limited to a maximum of $1,500 per lifetime of the patient. This maximum is separate from the calendar year maximum for your other dental benefits

50% 50%

CALENDAR YEAR BENEFIT MAXIMUM $1,000 $1,000 Deductible does not apply to Class I – Routine Services. Predetermination recommended for services over $250

VISION Mohave County offers a "voluntary" vision care program at employee cost. Employees may elect vision coverage with premiums paid through payroll deductions. The plan available is administered by VSP WellVision. To locate a provider:

Visit www.vsp.com or

Call VSP’s Member Services Department at 1-800-877-7195 You will not receive a benefit card and no claims forms are necessary when using a VSP provider. More information is provided on the following page.

VISION RATES EFFECTIVE JULY 1, 2002

Employee Per Month

Employee Per Pay Period

Employee Only $6.35 $3.18

Employee & Spouse $9.22 $4.61

Employee & Child(ren) $9.42 $4.71

Employee & Family $15.18 $7.59

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MOHAVE COUNTY #12140865 VSP WELLVISION COVERAGE AT A GLANCE Benefit Frequency

(Based on calendar year)

Copayment

Coverage from a VSP doctor

Out-of-Network Reimbursement

Eye Care Wellness – Regular exams are essential for protecting your visual wellness. Exam

12 months $10.00 Covered in full. Up to $35.00 allowance

Prescription Eyewear – You may choose between glasses or contacts. When contact lenses are chosen you will be eligible for a frame twelve months from the date contact lenses were obtained. Before selecting your eyewear, ask your doctor what is covered by your VSP plan. Lenses

12 months $10.00 (applied to lenses & frame)

Single vision, lined bifocal and lined trifocal lenses are covered in full. 1

Single vision up to $25.00 allowance Lined bifocal up to $40.00 allowance Lined trifocal up to $50.00 allowance Lenticular up to $100.00 allowance

Frame

24 months VSP fully covers a wide selection of frames.2

Up to $45.00 allowance

Contact Lenses

12 months None Covered up to $100.00 allowance

Up to $250.00 allowance

This allowance is applied toward both your contact lens exam and your contact lenses. Your plan includes a 15 percent discount off the cost of your contact lens exam (fitting & evaluation) when obtained from a VSP doctor. This exam is performed in addition to your routine eye exam. It is essential to check for eye health risks associated with improper wearing or fitting of contacts that if left untreated, can affect the overall health of your eyes.

Value Added Discounts Laser VisionCareSM - VSP has contracted with many of the nation’s finest laser surgery facilities and doctors, offering you a discount off PRK and LASIK surgeries, available through contracted laser centers. Visit VSP’s Web site at www.vsp.com to learn more about this exciting program. Prescription Glasses - Your plan provides a 20 percent discount on additional pairs of prescription glasses (lenses and a frame) including prescription sunglasses. Simply return to the same VSP doctor who performed your last covered eye exam within twelve months from the date of the exam.

Also available are lens types and treatments, which can add to the appearance, durability and function of your glasses. These enhancements are available to you a at VSP’s preferred member pricing. Ask your doctor for details.

Your VSP benefit also provides guaranteed savings whether you choose a frame that is covered in full or one that exceeds the plan allowance. If you choose a a frame valued at more than the plan’s allowance, the difference you’ll pay is based on VSP’s preferred member pricing.

Locating Your VSP Doctor When you obtain services from a VSP doctor, you get the most value from your VSP benefits. VSP offers two convenient ways to locate a VSP doctor near your home or office, or to verify your doctor is a VSP doctor:

•

•

•

•

•

At www.vsp.com, simply sign-on from the VSP homepage by entering the covered member’s ID to begin your search. You can search for a doctor by name or location. Call VSP’s Member Services Department at (800) 877-7195. VSP’s automated service allows you to search for a doctor by ZIP code or name.

Using Your VSP Benefit No cards, no claim forms, no hassles. VSP makes it easy for you to use your benefits, simply:

Make an appointment with a VSP doctor. Tell the doctor you are a VSP member when making the appointment. Provide the doctor with the covered member’s ID.

Out-of-Network Providers

Although more than 90 percent of VSP members receive care from VSP doctors, you have the option of seeing an out-of-network provider. If you see an out-of-network provider, be aware your out-of-network benefits do not guarantee full payment. For out-of-network reimbursement, pay the entire bill when you receive services, then send your itemized receipt to VSP within six months from your date of service. Included with your receipt should be the covered member’s name, phone number, address, member ID, the name of the group, the patient’s name, date of birth, phone number and address, and the patient’s relationship to the covered member (such as spouse, child, etc.) Please keep a copy of the information for your records and send the originals to the following address: VSP, P.O. Box 997105, Sacramento, CA 95899-7105.

This information is a summary of your VSP benefit. In the event of a conflict between this information and your organization’s contract with VSP, the terms of the contract will prevail. WellVision Enhanced Plan B w/Oon 4/02

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EMPLOYEE ASSISTANCE PROGRAM (EAP) All employees (except short term temporaries) are offered the services of the Employee Assistance Program. The EAP offers assessment, short-term counseling, referral and follow-up services to help employees and their families work through personal problems. The EAP is staffed by trained and experienced mental health professionals and all sessions are strictly confidential. EAP services are available to all employees and to members of their immediate household. This service provides up to six visits per calendar year at no cost to the employee. For more information, you may contact the program directly at 1-800-873-2246. CONTINUATION OF BENEFITS (COBRA) Mohave County offers continued health care coverage for benefit eligible employees, their spouses, and dependent children in accordance with Title IX of the Comprehensive Omnibus Budget Reconciliation Act (COBRA), if any of the following qualifying events occur which would otherwise result in loss of coverage:

1. Termination of employment, voluntary or involuntary, except in cases of gross misconduct. 2. Death of a covered employee. 3. Divorce or legal separation of a covered employee.

4. A covered employee that becomes entitled to Medicare benefits.

Covered employees or their beneficiaries are responsible for notifying the Superior Court Personnel Office of qualifying events. Continuation coverage will generally be identical to the coverage that the employee had immediately before the loss of coverage but does not include life insurance or disability coverage. The employe, or qualified dependents, electing extended coverage must pay 102% of the applicable premium or 150% in the event of a disability extension. COBRA coverage is extended for employees covered under the existing health plan for 18 months. For widows/widowers, divorcees, or other qualifying dependents, the extended COBRA coverage is 36 months. Coverage will end earlier than 18/36 months if the County’s plan ends, premiums are not paid, coveage begins under another group health plan, or the person becomes entitled to Medicare.

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BASIC LIFE / ACCIDENTAL DEATH & DISMEMBERMENT (AD & D)

Mohave County provides a Basic Life and Accidental Death & Dismemberment policy equal to your annual salary, up to a maximum of $50,000, for all insurance eligible employees. This coverage is offered through Standard Life Insurance Company.

BASIC LIFE: One times annual earnings to a maximum of $50,000 Basic Group Term Life features include:

No exclusions; death benefit paid for any cause

Waiver of premium included

Accelerated Death Benefit (Living Benefit)

Repatriation Benefit

Portability

ACCIDENTAL DEATH AND DISMEMBERMENT (AD & D): Equal to the amount of your basic life coverage Accidental death and dismemberment features include:

Family Care Benefit

Child Care Benefit - Assists surviving spouse with child care expenses within 36 months after the date of death for all children under age 13.

Career Adjustment Benefit - Assists surviving spouse with tuition

expenses for training within 36 months after the date of death, exclusive of room and board.

Higher Education Benefit - Assists surviving children with tuition

expenses within four years after the date of death at an accredited institution of higher learning (no trade schools), exclusive of room and board.

Seat Belt Benefit

For further explanation of these benefits, please refer to your plan documents.

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VOLUNTARY LIFE INSURANCE

The County also provides the opportunity to purchase additional life insurance for insurance eligible employees and their dependents. This plan offers new employees a guaranteed issue of $100,000 for the employee and $30,000 for your spouse upon eligibility (subject to some age restrictions.) If either the employee or spouse purchases the voluntary life, all dependent children can be covered for $10,000 each for only $2.00 per month. For further explanation, please consult the plan document.

SHORT TERM DISABILITY (STD)

Upon six (6) months of continuous service, full-time benefits eligible employees, who work at least 32 hours per week are covered under the County's Short Term Disability program at no cost to the employee. This program provides income replacement at 60% of an employee’s base salary up to a maximum weekly salary of $850 for approved personal illness or a non-occupational injury. Income replacement begins after completion of a thirty (30) day elimination period. For further explanation, please consult the plan document.

WORKERS’ COMPENSATION

All Judicial employees are covered by Workers’ Compensation Insurance. Compensation and expenses for injured employees are prescribed by the Industrial Commission of Arizona.

If you are injured on the job, contact your supervisor immediately to complete the State of Arizona Workers’ Compensation Supervisors Report of Industrial Injury form. All accidents, whether they require medical care or not, should be reported immediately to your supervisor. Accidents not reported within 10 days may be denied benefits.

LONG TERM DISABILITY INSURANCE

Arizona State Retirement System provides Long-term disability coverage for employees who are members of the Arizona State Retirement System. Effective July 1, 2003, payroll deductions are taken at .50% and matched by the County for this insurance. Long-term disability is administered through VPA Inc. Insurance Company of Calabasus, CA. Each employee receives a separate booklet explaining this coverage. In general, the basic monthly benefit for eligible employees is 66 2/3% of the employee’s monthly earnings as of the date the employee became disabled. Long-term disability benefits begin following the sixth consecutive month period in which an employee has been totally disabled. Employees should contact the Superior Court Personnel Office as soon as they think or know their leave will exceed three months to discuss application for Long-term disability.

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ARIZONA STATE RETIREMENT SYSTEM (ASRS)

Any employee who works 20 or more hours per week for 20 or more weeks in a fiscal year must be covered by the Arizona State Retirement System. A Judicial employee who also works for another Arizona State Retirement employer must immediately report that coverage to the Superior Court Personnel Office, as the total hours worked for both employers will count toward retirement eligibility and retirement deductions will be made by the County.

Effective July 1, 2003, the contribution rate is 5.20% for retirement and .50% for long term disability (LTD), which is paid by the employee and matched by Mohave County. Unlike retirement contributions, LTD contributions are not treated on a pre-tax basis, and are not refundable to the employee if the employee terminates employment prior to retirement.

The Arizona State Retirement System provides the following benefits to members:

Retirement benefits are available to members as early as age 50 with five or

more years of credited service. Members may retire before age 50 if they have at least 80 points (age plus credited years of service.)

Survivor benefits are payable to the named beneficiary of a non-retired member

upon the death of the member. Long-term disability (LTD) program provides benefits to active ASRS members

who become totally disabled before retirement. There is a six-month waiting period, and the LTD administrator must approve the disability before the member receives disability compensation.

Group health insurance coverage is available to retired and disabled ASRS

members who do not select their former ASRS employer’s group health insurance plan.

Health insurance premium benefits help cover the cost of health insurance

premiums to retired or disabled ASRS members with five or more years of credited service. Eligible members must be insured through the ASRS or their former employer’s health insurance program.

If you have further questions regarding your retirement benefits under ASRS, please refer to your member handbook available on the web at http://www.asrs.state.az.us/web/index.do or contact ASRS Member Services at 1-800-621-3778 or (602) 240-2000.

SOCIAL SECURITY SYSTEM

The Social Security System covers all non-elected employees. The contribution rate for Social Security is presently 7.65%, which is paid by the employee and matched by the County. (The 7.65% is actually a 6.2% tax for FICA tax and 1.45% tax for Medicare.) For more information on Social Security please visit their website at www.ssa.gov or call 1-800-772-1213.

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DEFERRED COMPENSATION Mohave County offers two voluntary deferred compensation plans, ICMA and Nationwide Retirement Solutions. Deferred compensation is a way to prepare for retirement in addition to the pension plans that the County provides. Also effective January 1, 2000, a ROTH IRA is available through Nationwide Retirement Solutions.

For more information regarding ICMA go to www.icmarc.org or contact Steve Jensen at (800) 735-7202 Ext. 5956. For more information regarding Nationwide Retirement Solutions or for on-line services go to www.nrsretire.com or contact John Bennett at (888) 224 -1011 Ext. 38.

FLEXIBLE SPENDING ACCOUNT (FSA) Mohave County gives you the opportunity to set aside money in a flexible spending account for health care or dependent care. A Flexible Spending Account (FSA) allows you to designate a certain amount of your taxable income on a pre-tax basis to pay for out-of-pocket health care and/or dependent care expenses. Money from these accounts can be used to pay for either health care expenses or dependent care expenses. Certain restrictions apply. Please consult the provided Flexible Spending Accounts Summary for further information. You may only enroll in this plan during regular open enrollment.

SECTION 125 FLEXIBLE PLAN Section 125 is part of the Internal Revenue Code that allows employees to convert a taxable cash benefit (salary) into nontaxable benefits. Under a Section 125 program, or Flexible Benefits Plan, you may choose to pay qualified benefit premiums before any taxes are deducted from your paycheck. For more information, please see Frequently Asked Questions About Section 125 on page 18 -19.

AUTOMATIC DIRECT DEPOSIT Automatic Direct Deposit is available for all employees. Direct Deposit offers the convenience of having your paycheck automatically deposited to the bank of your choice. After Direct Deposit is in effect, you will receive a direct deposit advice form, which will list all of the same payroll information for each pay period that your former check stub listed. Your funds will be available for withdrawal on payday. Participation in the Direct Deposit in strongly encouraged for all employees to avoid any possible delays due to mail delivery. Additional Direct Deposit forms may be obtained from Superior Court Personnel at extension 4928. PRE-PAID LEGAL SERVICES: This voluntary plan is available to employees through payroll deduction. This service provides legal council for free or reduced costs. The monthly fee for this plan is $14.95 plus an additional $1.00 if you are purchasing the Legal Shield plan. Participating employees may enroll or withdraw at any time. If you would like more information regarding this plan, you may contact Pre-Paid Legal Serves directly at (800) 801-5509.

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EDUCATIONAL ALLOWANCE

The Superior Court System recognizes that the skills and knowledge of its employees are important to the organization’s success. The education assistance program encourages professional development through formal education so that employees can maintain and improve job-related skills or enhance their ability to compete for reasonably attainable jobs with the Superior Court System. Up to fifty percent (50%) of eligible tuition, texts, workbooks or required materials may be reimbursed. Certain limitations apply; please see Judicial Merit Rule 412 for further information.

AFLAC SUPPLEMENTAL INSURANCE

This is a voluntary supplemental insurance available to employees through payroll deductions. Plans are available for employee only, employee & spouse, or employee & family coverage. Currently, AFLAC is offering four different plans consisting of:

Personal Accident Expense Plan: Plan benefits include Emergency Treatment,

Initial Hospitalization, Hospital Confinement, Specific-Sum Injuries, Accidental-Death, Wellness, and more. This plan is designed to help cover the expenses associated with an accidental injury.

Personal Recovery Plus: Specified health events covered by this plan include Heart

attack, Stroke, Coronary Artery Bypass Surgery, Coma, Paralysis, Major Third-Degree Burns, End-Stage Renal Failure, and Major Human Organ Transplant. Transportation, hospitalization, lodging, and continuing care for the above events are also covered under this plan.

Personal Sickness Indemnity Plan: Plan benefits include Physician Visits, Initial

Hospitalization, Hospital confinement, Major Diagnostic Exams, Surgical, plus more. Personal Cancer Protector Plan: Plan benefits include First Occurrence, Hospital

Confinement, Radiation and Chemotherapy, Cancer Screening Wellness, Surgical/Anesthesia, NCI Evaluation and Consultation, Home Health Care, plus more.

These plans are designed to help cover the expenses associated with injuries/illnesses noted above. AFLAC pays directly to the plan subscriber, unless you assign the benefits, regardless of any other insurance you may have. Open enrollment periods will be held periodically throughout the year. If you are interested in signing up for any of these plans, you must speak with an AFLAC representative during the appropriate open enrollment period. The enrollment periods will be announced to all Mohave County employees. The above information is meant to be a summary of coverage only. Please refer to plan documents for specific coverage. For more information, please visit http://www.aflac.com/.

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FREQUENTLY ASKED QUESTIONS ABOUT SECTION 125 FLEXIBLE PLAN

What is Section 125? Section 125 is part of the Internal Revenue Code that allows employees to convert to a taxable cash benefit (salary) into nontaxable benefits. Under a Section 125 program, or Flexible Benefits Plan, you may choose to pay qualified benefits premiums before any taxes are deducted from your paycheck.

Is Section 125 legal? YES! Even though Section 125 may sound "too good to be true," the program is legal and beneficial. The United States Congress created Code Section 125 in an effort to make benefit programs more affordable for employees. Code Section 125 was established in the Revenue Act of 1978.

How Can Section 125 work for me? Your Section 125 program can make your benefit plans more affordable. You can pay for your qualified benefits before you pay taxes; you actually lower your taxable income, which means you pay less taxes. Paying less taxes usually results in more spendable income.

What are pre-tax dollars? Pre-tax dollars are the premiums you pay for qualified benefits under your Section 125 program. These premiums are deducted from your gross earnings BEFORE taxes are taken out.

What benefits can I pay for with pre-tax dollars? Mohave County's present benefits package includes benefits that qualify for a Section 125 program such as medical coverage, dental coverage, and vision coverage.

How will this affect my paycheck? The illustration attached gives an estimate of potential tax savings through Mohave County's Section 125 program. For personalized information on how the Section 125 could affect your salary, please consult your personal tax advisor.

Do I have to participate? No. You are under no obligation to participate in a Section 125 program. However, you are required to sign an election form to indicate your choice.

Can I enroll in a Section 125 Program whenever I want to? Mohave County's Section 125 program is an annual plan. You must enroll in the program during the eligible enrollment period. However, you can enroll in a Section 125 during the plan year if you experience specified changes in family status.

What do I do to participate? During the enrollment process or open enrollment, if you decide to enroll in the plan, you will need to sign the election form to indicate your participation.

Can I change my selection in the Section 125 program at any time during the plan year? NO! You cannot change your selection during the plan year, except for certain specified changes in family status. Those changes include marriage, divorce, death of a spouse, death of a child, birth or adoption of a child or change in employment of your spouse that affects his/her eligibility for benefits under another plan.

Some additional points you need to know about Section 125:

Your annual tax withholding (W2-statement) will reflect your reduced taxable income. Therefore, you should not report premiums paid on your income tax returns.

Salary increases, amount of Life, AD & D, Long Term Disability and retirement contributions will

be calculated by using your "gross" wages rather than your "adjusted gross wages."

Since Section 125 reduces your taxable income, it could in turn reduce your contribution to the Social Security Retirement System, which could have an effect on your retirement benefit amount.

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SECTION 125 FLEXIBLE BENEFIT PLAN

Mohave County implemented a Flexible Contribution Plan effective July 1, 1989. The plan allows participating employees to pay their portion of the cost for Dependent Medical, Dental Care and Supplemental health insurance premiums (i.e. Vision) with pre-tax money as opposed to after tax dollars.

This means that your take-home pay may increase because premium payments are deducted from your gross pay, before federal, state and Social Security (FICA) taxes are applied. Below is an example comparing take-home pay with and without a Flexible Benefit Plan. This example is based on an employee who is married and claiming four (4) exemptions.

SALARY ILLUSTRATION After tax Pre tax

Bi-Weekly Base Salary $962.00 $962.00

(Gross Earnings)

Flexible Benefits:

Health - Dependant Coverage $84.46

Dental - Employee/Family $18.93

Vision - Employee/Family $8.26

Total Benefit Premiums $111.65

Pre tax Benefit Premiums $000.00 -$111.65

Taxable Earnings $962.00 $850.35

Taxes:

Federal -$76.80 -$57.84

State -$13.06 -$9.83

F.I.C.A. -$72.25 -$62.76

Arizona State Retirement -$19.24 -$19.24

AFTER TAX EARNINGS $780.65 $700.68

Benefit Premiums -$111.65 $000.00

TAKE HOME PAY $669.00 $700.68

Bi Weekly savings using the Flexible Benefits Plan $31.68

NOTE: Payroll taxes and benefit premiums used in this example may not be the same as the amounts shown in the current payroll tax tables. For personalized information, please consult your personal tax advisor.

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PAID TIME OFF (PTO)

The Superior Court System has a combined leave program to provide eligible employees with paid leave to cover time away from work (vacation, sick days, personal days, etc.) Paid time off is accrued from your start date but cannot be used until you complete three (3) full continuous months of service. Your accrued PTO will begin to show on your first pay stub and the rate of accrual will be determined by your years of service, see chart below. If separation of employment occurs before the end of an employee’s original probationary period, the employee is not eligible to secure payment of accrued PTO. There is no limit on the hours of accrual, however, Mohave County will only pay out a maximum of 400 hours for regular status employees who separate from court/county service.

YEARS OF CONTINUOUS SERVICE HOURS ACCRUED PER PAYPERIOD

1 8 2 through 4 9 5 through 9 10

10 through 14 11 15 and over 12

For more information regarding PTO, please refer to Judicial Merit Rule 402.

BEREAVEMENT

Bereavement leave is paid leave granted to a benefits eligible employee to attend services and handle matters related to the death of a member of the employee’s immediate family. Judicial Merit Rule 101.50 defines a member of the immediate family as a spouse or significant life partner, child (including adopted, foster, ex-nuptial, step child, or legal ward), parent (including step parent, foster parent or legal guardian), grandparent, grandchild or sibling. An employee may also use bereavement leave for children, parents and grandparents of their spouse or significant life partner, or any other relative who is a member of the employee’s household.

Regular and probationary status employees, except temporary, emergency, and intermittent, are eligible to receive bereavement leave. A full-time benefits eligible employee who works 32 – 40 hours per week may be absent for up to three (3) consecutive working days based upon normally scheduled hours, not to exceed twenty-four (24) hours. Upon request, bereavement leave may be extended for two (2) more working days not to exceed sixteen (16) hours if travel distance of 200 or miles is required.

DONATED LEAVE

The Superior Court System currently provides a donated leave program in which eligible employees may request leave donations when they find themselves facing an emergency or crisis in which they have no accrued leave. After completing twelve (12) months of continuous service in a benefits eligible position, an employee may receive donated leave from another employee when circumstances meet the guidelines outlined in the Judicial Merit Rule 413. This rule is currently being revised. Updates will be distributed as soon as they are available.

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Mohave County Superior Court System 2005 Holiday Schedule

Monday, January 17, 2005 Martin Luther King Jr./Civil Rights Day

Monday, February 21, 2005 Lincoln/Washington Presidents Day

Monday, May 30, 2005 Memorial Day

Monday, July 4, 2005 4th of July/Independence Day

Monday, September 5, 2005 Labor Day

Monday, October 10, 2005 Columbus Day

Friday, November 11, 2005 Veteran's Day

Thursday, November 24, 2005 Thanksgiving Day

Monday, December 26, 2005 Christmas Day

Plus an additional *floating holiday for one (1) of the following days:

The day after Thanksgiving, Friday, November 25, 2005

The day prior to Christmas Eve, Friday, December 23, 2005

The day before New Year’s Eve, Friday, December 30, 2005

* The floating holiday must be scheduled with your Division Head in order to maintain adequate staff coverage to remain open for business to the public.

In instances where it is not operationally feasible for an employee to take their additional holiday on one of the holidays listed above, the Division Head may schedule the employee’s additional holiday for a mutually acceptable future date, provided the alternative date is prior to the following April 1. For more information, please refer to Judicial Merit Rule 304.

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Overview of Benefits

Medical Coverage Arizona State Retirement System

Deferred Compensation Prescription Drug Coverage

Flexible Spending Accounts Dental Coverage

Section 125 Flexible Plan Vision Coverage

Automatic Direct Deposit Audiological Services

Educational Allowance Employee Assistance Program

AFLAC Supplemental Insurance Basic Life/ AD & D

Pre-Paid Legal Services Voluntary Life

Donated Leave Short Term Disability

Eleven Paid Holidays Workers’ Compensation

Social Security Long Term Disability

Various Leaves (Educational, Personal, FMLA, etc.)

Continuation of Coverage (COBRA)

Paid Time Off -

26 days after the first year

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Overview of Enrollment Times Benefit

Within 5 days of Hire Date

Open Enrollment

Fall

Open Enrollment

Summer Other

Arizona State Retirement & Long Term Disability Automatic Enrollment

Basic Life/ A D & D Automatic Enrollment Employee Assistance Program Automatic Enrollment Short Term Disability Insurance Automatic Enrollment

Workers’ Compensation Automatic Enrollment Medical Insurance w/ Prescription Drug Coverage & Audiological Services

May enroll anytime w/qualifying event

Dental Coverage May enroll anytime w/qualifying event

Vision Coverage May enroll anytime w/qualifying event

Voluntary Life Insurance

Section 125 Flexible Plan

AFLAC Supplemental Ins.

Open enrollment as determined by County Human Resources

Flexible Spending Account

Deferred Compensation May enroll at anytime

Automatic Direct Deposit May enroll at anytime

Pre Paid Legal Services May enroll at anytime

BENEFITS ARE SUBJECT TO ALL PROVISIONS, TERMS, AND CONDITIONS OF THE GROUP CONTRACT. PLEASE REFER TO YOUR SUMMARY PLAN DOCUMENT FOR FUTHER DETAILS.

Eligible employees are provided benefits, including leave, by Mohave County based on the County’s financial ability to provide; therefore, benefits shall vary from time to time. None of the benefits or leaves are intended by reason of their publication to confer any rights, privileges or

entitlements to employees.

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