2021 2022 Benefits Guide - City of Avondale
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2021 – 2022 Benefits Guide
The City of Avondale Benefits Overview
• As of July 1, 2021, the City’s benefits will
now be known as “The City of Avondale
Employee Benefits Trust”
• Blue Cross Blue Shield of Arizona (BCBS)
is the Medical Benefit Administrator
• BCBS “Blue Care Anywhere” is the
Telemedicine option
• Dental is offered through Delta Dental
• Vision is offered through Avesis
• Health Equity is the Bank for Health
Savings Accounts (HSA) → (HDHP Plan)
• Health Equity is the Administrator for the
Flexible Spending Accounts (FSA)
• Employee Assistance Program (EAP) is
through IBH
• Sharecare is the Wellness platform through
BCBS
When to Enroll
• Basic Life and AD&D (City provided) and
Supplemental Life and AD&D is offered
through Minnesota Life (Securian/Ochs)
2
Enrollment Reminders
• Please review your 2021-2022 benefits guide for detailed benefit plan information
• Contact Human Resources at 623.333.2200 if you have any questions regarding plan
benefits or email at HR-Benefits@avondaleaz.gov
• Detailed benefit plan information and more can be found:
• In this benefits guide
• Online at https://avondaleaz.sharepoint.com or
• avondaleaz.gov/government/departments/human-resources/benefits
• Review the Blue Cross Blue Shield prescription formulary to find your tier of
medication
• Go to AZBlue - BCBSAZ Healthcare Professionals: Standard Pharmacy Plans
• Select the 3 & 4 Tier Standard Plans Drug List
• Search for your medication (Tier 4 medications will fall under Tier 3 for the City
of Avondale)
• For New Hires, elections are effective on the first day of the month following 31 days
of employment in a benefits-eligible position.
When to Enroll
You can enroll for benefits or change your benefit elections during the
following times:
This Benefits Guide gives you an overview of your benefits including eligibility, plan options, rates,
how to enroll, and other important information.
• Within 30 days of your initial eligibility date (as a newly-hired employee)
More detailed information is available in the official plan documents.
• During the annual benefit
For information aboutopen enrollment
your other period
City benefits, please go to:
• Within 30 days of experiencing a Qualifying Event
https://www.avondaleaz.gov/government/departments/human-resources/benefits
In the case of conflict between the information presented in the
Benefits Guide and the official Plan documents, the Plan Document(s) determines the coverage
3
Table of Contents
Benefits Overview________________ Pages 2-3
Employee Benefits Contribution Rates Page 5
As You Enroll _________________________________________ Page 6
City of Contributions for Medical Coverage___________________ Page 7
Annual Enrollment Period Page 8
Qualifying Events _ Page 9
Benefits Eligibility Page 10
Blue Cross Blue Shield of Arizona Health Plans Pages 11-12
Medical Plan Summary of Benefits Pages 13-14
Prescription Plan Comparison Page 15
Blue Cross of Arizona 24-hour Health Page 16
BlueCare Anywhere Page 16
Medical Plan Resources Page 17
Employee Assistance Program Page 18
Dental Benefits Page 19
Vision Benefits Page 20
Basic Life and AD&D Insurance Page 21
Supplemental Life and AD&D Insurance Pages 21-22
Tax Free Savings for Medical Expenses (HSA) Pages 23-24
Flexible Spending Accounts (FSA) Page 25
Customer Service Support Page 26
Required Notices Pages 27-31
4
Employee Benefits Contribution Rates
Medical Rates
Employee City Employee Per Total per
City per Month
per PP Contribution Month Month
HDHP Plan
Employee Only $21.56 $198.09 $46.72 $429.20 $475.92
EE + Family $58.30 $466.24 $126.31 $1,010.19 $1,136.50
PPO Plan
Employee Only $25.32 $211.98 $54.85 $459.29 $514.14
EE + Family $160.04 $412.91 $346.76 $894.63 $1,241.39
EPO Plan
Employee Only $31.36 $216.62 $67.95 $469.35 $537.30
EE + Family $224.31 $375.31 $486.01 $813.17 $1,299.18
Dental Rates
Employee City Employee Per
City per Month Total per Month
per PP Contribution Month
Employee Only $3.95 $15.78 $8.55 $34.19 $42.74
EE + Spouse $11.42 $26.65 $24.75 $57.75 $82.50
EE + Child(ren) $13.42 $31.31 $29.07 $67.84 $96.91
EE + Family $19.81 $46.23 $42.93 $100.16 $143.09
Vision Rates
Employee City Employee Per Total per
City per Month
per PP Contribution Month Month
Employee Only $3.72 $0.00 $8.06 $0.00 $8.06
EE + Spouse $6.66 $0.00 $14.43 $0.00 $14.43
EE + Child(ren) $7.88 $0.00 $17.07 $0.00 $17.07
EE + Family $9.84 $0.00 $21.31 $0.00 $21.31
City of Avondale HSA Employer Contribution:
Employee Only: $25 per paycheck Employee + Family: $50 per paycheck
5
As You Enroll
The City of Avondale offers a comprehensive health and welfare benefits program
designed to meet the needs of our diverse workforce.
This Benefits Guide is designed to help you make informed decisions regarding your benefit elections for
the 2021-2022 plan year. It highlights your options and key program features to consider before making
enrollment elections. You will also find medical plan comparison charts for convenient at-a-glance
referencing, enrollment instructions, and plan contact information. Please review the materials carefully
and choose the plans that best meet your needs.
We encourage you to use this Benefits Guide as a reference throughout the plan year. If you have
questions, contact the HR Department or the plan providers directly. Plan phone numbers and websites
are listed in the Contact Information section on page 27 of this Benefits Guide.
To assist with your initial enrollment
• Dependent data: Gather this information before proceeding with enrollment: Names, birthdates, and
social security numbers to complete your enrollment process.
• Beneficiary designations: Employees can update beneficiaries at any time. It is encouraged you
designate/allocate at least a primary beneficiary for enrollments in the Basic and/or Supplement Life
and AD&D, deferred compensation plans, retirement system etc. Reach out to the HR Benefits
Department for questions regarding beneficiary changes.
• Personal information: When you move or have changes in your contact information, be sure to enter
the change in ADP. If you changed your name, notify your HR department. It’s important to keep your
personal information up-to- date at all times.
When to Enroll
You can enroll for benefits or change your benefit
elections during the following times:
• During the annual benefit open enrollment
period
• For New Hires, elections are effective on the
first day of the month following 31 days of
employment in a benefits-eligible position.
• New Hires have 31 days to submit their benefits
enrollment from their benefit eligibility date.
• Example: Hire Date: 6/17/21
• Benefit Eligibility Date: 8/1/2021 → must
submit benefits forms to HR no later than
8/31/2021
•Within 31 days of experiencing a Qualifying Event
You may be required to provide proof of eligibility for your dependents such as a copy of a
birth certificate, marriage certificate, court order, or any other qualifying legal document.
6
City Contributions for Medical Coverage
You and the City share in the costs of your medical plan benefits. The plans are funded through the City’s
and your contributions toward medical plan premiums; costs are incurred as plan participants seek
medical care and claims are paid for that care. As is the case with most health plans, the total medical
premium costs increase from year-to-year. In addition, because employees pay the difference between
the total premium cost and the City’s contribution, premium increases have a direct effect on your
contribution cost.
The relationship between premiums and plan participant’s use of the plans is important to understand
because plan utilization is a key driver of the premium rates. This means that your decisions as you use
your plan benefits can make a difference.
Use your benefits wisely:
• Be aware of the costs of the services you select
• Use in-network providers when possible
• Choose generic drugs when possible
• Commit to making healthy lifestyle choices to avoid chronic health conditions
7
Annual Enrollment Period
The City holds an annual benefits enrollment period prior to the start of each new plan year (typically in
May). This is your one-time opportunity (outside of any mid-year qualifying events) to make changes to
your benefits for the new plan year. Please watch for commination from the HR Department prior to the
new plan year.
What Can I Do During The Annual Enrollment Period?
• Enroll or waive coverage (due to enrollment in other group coverage).
• Change your medical plan or dental/vision plan.
• Add or waive (due to enrollment in other group coverage) medical and/or dental and vision coverage for
your dependents.
• Apply for supplemental and/or dependent life insurance. Note: Supplemental life insurance takes effect
after approval from Minnesota Life.
What If I Want To Make A Change Mid-year? (Qualifying Event)
• In accordance with a federal law, which grants the ability for employers to offer non-taxable benefits
to employees, plan elections are irrevocable for the plan year unless a Qualifying Life Event (QLE) is
experienced. Requirements of a mid-year change are:
• Requested change must be consistent with the qualifying mid-year event;
• Requested change must meet the guidelines of The City of Avondale contracts/agreements, plan
documents, and IRC Section 125
• Must be received by HR within 31 days of the qualifying mid-year event.
• To view a summary of the most common qualifying mid-year QLE events, please refer to the Section
125 Change- of-Status Events and Mid-Year Enrollment Changes matrix on page 10 of this Benefits
Guide.
Effective Date of Mid-Year Changes
Elections shall be effective prospectively. Generally, elections that add or change coverage will be
effective on the first day of the month following or coinciding with the date the completed online change
and applicable supporting documentation is received by HR. (The exception is that when enrollment is
requested for a marriage or newborn, newly adopted child or child placed for adoption, coverage is
effective When to Enroll
on the date of the event, as long as timely election is made). For New Hires, elections are
effective on the first day of the month following 31 days of employment in a benefits-eligible position.
Elections that cancel or drop coverage will be effective on the last day of the month in which the qualifying
event occurs. If your coverage was terminated or lapsed while on leave, you will need to re-enroll for
coverage through Human Resources upon return from your leave and your coverage will be effective on
the first day of the month following your return from leave. If you are returning from a Military leave of
absence, your benefits will be effective on the date you return from leave. It is the employee’s
responsibility to ensure all benefits are active.
8
CHANGE OF STATUS EVENTS AND MID-YEAR ENROLLMENT CHANGES
Qualifying Event Effective Date Changes / Forms You May Make the Following Changes(s)
Due
Marriage or registration Date of event 31 days of marriage • Enroll yourself, if applicable
of domestic partnership • Enroll your new spouse and other eligible
dependents
Divorce, legal First of the month following 31 days of the date of • Coverage will terminate for your spouse.
separation, the date of the event final divorce decree or • Enroll yourself and dependent child(ren) if you, or
or annulment annulment they, were previously enrolled in your spouse’s
plan
Birth of your child Date of event 31 days of birth • Enroll yourself
• Enroll the newborn child
Adoption, placement for adoption, Date of event 31 days of event • Enroll yourself
foster child, or legal guardianship • Enroll the newly adopted child
of a child
Your dependent child reaches First of the month following Notify within 31 days of • Coverage will terminate for the child who lost
maximum age for coverage the date of the event loss of eligibility eligibility from your health coverage
Death of your spouse Date of event 60 days of spouse’s or • Coverage will terminate for the dependent from
or dependent child dependent’s death your health coverage
A change in employment status in First of the month following 31)days of change in • Enroll yourself, if your employment change results
employment classification or work the date of the event employment status in you being eligible for a new set of benefits
schedule for you, your spouse, or classification • Enroll your spouse and other eligible dependents
dependent child • Drop health coverage
• Drop your spouse and other eligible dependents
from your health coverage
Change of residence or worksite if First of the month following 31 days of change in • Enroll or drop coverage for yourself, your spouse,
change impairs ability to access the date of the event employment status or covered dependent children
network providers classification
Significant change in or cost of First of the month following 31 days of effective • Enroll yourself and other eligible dependents
your or your spouse’s or the date of the event date of change in
dependent’s health coverage due coverage
to spouse’s or dependent’s
employment, including open
enrollment
Significant change in benefits First of the month following 31 days of effective • Enroll yourself and other eligible dependents
the date of the event date of change in
coverage
Spouse or covered dependent First of the month following Notify within 31 day of • Drop coverage for yourself, your spouse, or
obtains coverage in another group the date of the event gain of coverage • covered dependent children
health plan
Loss of other coverage, including First of the month following 31 days of the date of • Enroll yourself, your spouse and eligible dependent
COBRA coverage the date of the event loss of coverage children
Spouse’s loss of coverage, First of the month following 31 days of the date of • Enroll your spouse and eligible dependent children
including COBRA coverage the date of the event loss of coverage • Enroll yourself in a health plan if previously not
enrolled because you were covered under your
spouse’s plan
Eligibility for government- First of the month following 31 days of eligibility • Drop coverage for the person who became entitled
sponsored plan, such as Medicare the date of the event date to Medicare, Medicaid, other eligible coverage
(excluding the government
sponsored Marketplace)
CHIP Special Enrollment – Loss of First of the month following 60 days of loss of • Enroll yourself, if applicable
eligibility for coverage under a state the date of the event eligibility or eligibility • Add the person who lost entitlement to CHIP
Medicaid or CHIP program, or date • Drop coverage for the person entitled to CHIP
eligibility for state premium coverage
assistance under Medicaid or CHIP
Qualified Medical Support Order First of the month following 31 days of order • Enroll yourself, if applicable
affecting a dependent child’s receipt of the notice • Enroll the eligible child named on QMCSO
coverage
9Benefits Eligibility
To be eligible for medical, dental and vision benefits listed in this Benefits Guide, you must be an
employee scheduled to work a minimum of 30 hours per week on a regular basis. All new employees will
be covered on the first day of the month following 31 days of employment. Coverage will be effective
provided proper enrollment has been made and any required contributions have been authorized.
Dependent Eligibility
If you are eligible to participate in the City-sponsored medical, dental and vision plans, your eligible
dependents may also participate. Your eligible dependents include:
• Your lawfully married spouse
• Your domestic partner who is the same or opposite sex as the eligible employee and who has
shared a long-term committed relationship with the eligible employee for a minimum of the last
twelve (12) months. Domestic Partners are only eligible for Medical coverage.
• You or your spouse/Domestic Partner dependents including natural child(ren), legally adopted
child(ren), child(ren) placed with you for adoption, eligible foster child(ren), or child(ren) under legal
guardianship substantiated by a court order
• Child(ren) under QMCSO
• Dependent child(ren) over the limiting age who are considered disabled
Eligible dependent child(ren) will be covered through the last day of the month of their 26th
birthday. It is the employee’s responsibility to notify Human Resources of dependent’s age.
Coverage will be terminated once the dependent reaches age 26, unless Human Resources is
notified that the dependent has a qualifying disability.
For Newborn Children
Newborn children must be enrolled in the plan to
receive benefits. Failure to request enrollment for your
newborn within 31 days of the date of birth will result in
your newborn not having coverage from date and time
of birth until the next plan year. You will be liable for any
services and/or expenses incurred for a newborn who
is not timely and properly enrolled.
To enroll your newborn, submit a completed
Election/Change Form to HR within 31 days of the
newborn’s date of birth. If enrollment is requested
timely, coverage will be retroactively effective to
the date of birth. You are encouraged to request
newborn enrollment and submit enrollment paperwork
as soon as possible (and no later than 31 days after
the date of birth) to avoid non-coverage for your
newborn child.
10Blue Cross Blue Shield of Arizona
Health Plans
As an employee, the health benefits available to you represent a significant component of your
compensation package and they provide important protection to keep you and your family in good health.
Eligible employees that elect one of the three medical plans will automatically be enrolled in the
prescription, wellness program, EAP, and telemedicine benefits which are all included in your premiums.
The City of Avondale is pleased to offer you the following medical plans:
• High Deductible Health Plan (HDHP) – $2,900/$5,800 Deductible
• Preferred Provider Organization (PPO) - $750/$1,500 Deductible
• Exclusive Provider Organization (EPO) - $300/$600 Deductible
You can choose two levels of coverage: Employee Only or Employee + Family.
If you want dependents to be covered, your eligible dependents have to be enrolled in the same medical,
dental and visions plans you select.
All medical plan options are self-funded, meaning the contributions from The City of Avondale and eligible
employees are used to pay plan benefits, including services provided to the members and claims
administration.
Blue Cross Blue Shield of Arizona (BCBSAZ) is the claims administrator and network provider. Plan
members have access to more than 25,100 doctors and specialists that make up a strong local Arizona
network. BCBSAZ has contracted with more than 95% of hospitals in Arizona, including 80 acute care
hospitals. If you use services within the BCBSAZ network, eligible benefits will be paid based on the
benefit level of the plan you chose. If you utilize services outside of the BCBSAZ network, services will be
paid at a Medicare Like Rate and the provider can balance bill you, potentially leaving you with thousands
of dollars owed out-of-pocket.
To find a network provider, visit www.azblue.com/member or call BCBSAZ at 1-844-899-4073.
When to Enroll
11Blue Cross Blue of Arizona
Health Plans Continued
Exclusive Provider Organization (EPO) Plan
The EPO Plan is a network of hospitals, physicians, medical laboratories, and other health care providers
who are located within Arizona and who have agreed to provide medically necessary services and
supplies for favorable negotiated discount fees, applicable only to BCBSAZ members.
Under the EPO plan there is coverage ONLY when you use an EPO provider.
All care in the EPO plan must be obtained within the plan network, unless you have an
emergency. Most doctor office visits are available at a $20 copay and most in-network
preventive services, such as well baby/child visits, immunizations, routine physicals,
mammograms, and routine preventive screenings are covered at no cost. Other in-network
services are covered at 90% after the deductible ($300 per individual or $600 per family) is met.
Preferred Provider Organization (PPO) Plan
A PPO Plan offers you a choice between an in-network group of providers who offer their services at
discounted rates and out-of-network providers without discounted rates. Under a PPO plan, you may
choose the level of benefits you receive based on the providers you use when you receive care. Keep in
mind that if you choose to use an out-of-network provider you will be subject to a higher deductible and
the provider has the option to balance bill. Most in-network doctor office visits are available at a $25
copay and most in-network preventive services, such as well baby/child visits, immunizations, routine
physicals, mammograms, and routine preventive screenings are covered at no cost. Other in-network
services are covered at 80% after the deductible ($750 per individual or $1,500 per family) is met.
High Deductible Health Plan (HDHP)
An HDHP is similar to the PPO plan, in that you can choose between an in-network group of providers
and out-of-network providers. Under the HDHP, you are responsible for payment of all services and
prescriptions until you meet your deductible/maximum out-of-pocket ($2,900 per individual or $5,800 per
family), then eligible services are payable at 100%. In-network preventive services, such as well
baby/child visits, immunizations, routine physicals, mammograms, and routine preventive screenings are
covered at no cost.
Key Items To Consider In Choosing A Medical Plan
• Compare benefit coverage levels and premium costs carefully to see which option benefits your
needs.
• In the PPO and HDHP plans, you may obtain services from either In-Network or Out-of-Network
providers, but you will pay less out of your own pocket when you use an In-Network provider.
• In the EPO, all services must be obtained from within the EPO network; there are no Out-of-Network
benefits except in an emergency.
• Dependents must be enrolled in the same plan as yourself.
• Medical plan costs vary based on the plan and coverage you select. (You and the City share the cost
of the premiums). You pay your share of the cost through payroll deductions for the premiums and
when you use services, such as when you pay the cost for deductibles, copays, and the coinsurance.
12Medical Plans Summary of Benefits
Exclusive
High Deductible Preferred Provider Provider
Health Plan (HDHP) Organization (PPO) Organization
(EPO)
Out-of- Out-of- In-Network
In-Network In-Network
Network Network ONLY
Deductible Per Plan Year
Individual $2,900 $5,000 $750 $2,000 $300
Family $5,800 $10,000 $1,500 $4,000 $600
Out of Pocket Limit
Individual $2,900 $10,000 $3,500 $5,000 $2,750
Family $5,800 $20,000 $7,000 $10,000 $5,500
Coinsurance 0% after ded. 50% 20% after ded. 10% after ded.
50%
coinsurance
coinsurance &
Allergy Testing and & balance
0% after ded. 20% after ded. balance bill 10% after ded.
Treatment bill
Hearing Aid Benefit $1,000 $1,000 $1,000
Genetic Testing
0% after ded. 20% after ded. 10% after ded.
(Limitations Apply)
Chemotherapy
0% after ded. 20% after ded. 10% after ded.
(Outpatient) 50%
50%
Chiropractic Care/Spinal coinsurance
coinsurance &
Manipulation 0% after ded. & balance $45 Copay $40 Copay
balance bill
Plan year Maximum Benefit bill
Office Visit
Diagnostic Testing, X-Ray Office Visit Copay
0% after ded. Copay or
& Lab Service or 10% after ded.
20% after ded.
Preventive Care
(Includes the office visit and
any other eligible item or
0% after ded. $0 Copay $0 Copay
service billed and received at
the same time as any 50%
preventive service) 50%
coinsurance
coinsurance &
Primary Care Physician 0% after ded. & balance $25 Copay $20 Copay
balance bill
bill
Specialist 0% after ded. $45 Copay $40 Copay
Urgent Care Facility
Copay applies per visit regardless 0% after ded. $50 Copay $50 Copay
of what services are rendered
$300 Copay,
$300 Copay,
Ded. + 10%
Emergency Room 0% after ded. Ded. + 20%
Copay waived
Copay waived if admitted
if admitted
Ambulance Services 0% after ded. 20% after ded. 10% after ded.
13Medical Plans Summary of Benefits Continued
Exclusive
High Deductible Preferred Provider Provider
Health Plan (HDHP) Organization (PPO) Organization
(EPO)
Out-of- Out-of- In-Network
In-Network In-Network
Network Network ONLY
0% after ded. 20% after ded. 10% after ded.
Home Health Care
60 Days 60 Days 60 Days
0% after ded. 20% after ded. 10% after ded.
Hospice Care
6 Months 6 Months 6 Months
Hospital Expenses or 0% after ded. 20% after ded. 10% after ded.
Long- Term Acute 60 Days 60 Days 60 Days
Maternity
First Visit
(PCP / Specialist) 0% after ded. $25 /$45 $20 / $40
Prenatal & Postnatal Care 0% after ded. 20% after ded. 10% after ded.
Delivery Charges 0% after ded. 50% 20% after ded. 10% after ded.
50%
coinsurance
coinsurance
& balance
& balance
Mental Health/Substance bill Office Visit bill Office Visit Copay
Abuse Disorders 0% after ded. Copay or
or 10% after ded.
Inpatient /Outpatient 20% after ded.
Physician Office Surgery 0% after ded. 20% after ded. 10% after ded.
Radiation Therapy
0% after ded. 20% after ded. 10% after ded.
(Outpatient)
Skilled Nursing Facility
0% after ded. 20% after ded. 10% after ded.
and Rehabilitation Facility
60 Visits 60 Visits 60 Visits
Plan Year Maximum Benefit
All Other Eligible Medical
0% after ded. 20% after ded. 10% after ded.
Expenses
14Prescription Plans Summary
High Deductible Preferred Provider Exclusive Provider
Health Plan (HDHP) Organization (PPO) Organization (EPO)
Retail Pharmacy:
30- Day Supply
Tier 1, Tier 2, Tier 3: $15, $35, $55 $15, $35, $55
Retail Pharmacy:
90- Day Supply
No Charge after
Tier 1, Tier 2, Tier 3: Deductible is Met $30,$80,$130 $30,$80,$130
Mail Order Pharmacy:
90- Day Supply
Tier 1, Tier 2, Tier 3: $30,$80,$130 $30,$80,$130
Specialty RX 20% to Max $300 20% to Max $300
Out Of Pocket $3,600 per participant $4,100 per participant
N/A
Maximum $7,200 per family $8,200 per family
Note: Members pays the network pharmacy copay plus the difference between the non-network and network pharmacy amount
Prescription Coverage
When you elect medical coverage, you are automatically enrolled to receive prescription drug
benefits.
Retail Program
You have access to a large national network of retail pharmacies where you can have your prescriptions
filled for a 30-day supply of medication. The amount you will be required to pay for the cost of your
medication will depend upon the level/tier the prescription falls under. You can locate participating
pharmacies and check the prescription level/tier anytime at www.azblue.com/member.
90 Day Retail Program
Many members require maintenance medications for conditions such as diabetes, high blood pressure,
asthma, etc. For these members, Blue Cross Blue Shield of AZ contracted pharmacies provide 90 days
worth of medication at one fill.
Mail Order Program
Blue Cross Blue Shield of AZ also offers members a mail order program for filling maintenance
medications through Optum RX. Members are able to receive a 90-day supply of medications mailed to
their home for a reduced copayment. Access by Logging into www.azblue.com/member. Click on Plan
Benefits and select Mail Order under Pharmacy Benefits or call the Pharmacy Benefits number on the
back of your member ID card or Mail your completed order form and prescription to the address on the
Mail Order form.
Dispense as Written Penalty
Members who choose a brand name medication when a generic is available will be subject to a penalty
equivalent to the cost difference between the generic and brand.
15Blue Cross of Arizona’s
24-Hour Health Line
Using one toll-free number, you and your family can
speak with Registered Nurses for health-related adult
and pediatric issues and get help making informed
healthcare decisions. Nurses can also assist callers
24/7
ACCESS
with choosing appropriate medical care and preparing
questions to discuss with your physician about
treatment plans. When appropriate, the nurses will
suggest care either through self-care techniques, a
provider appointment or, if needed, a visit to the urgent
care or emergency room.
Information Line 1-866-422-2729
BlueCare Anywhere
The City of Avondale offers Telehealth to all employees
who are enrolled in one of The City of Avondale medical www.BlueCareAnywhereAz.com
plans through BlueCare Anywhere. BlueCare Anywhere PPO Network Plans:
provides consultations with board-certified, currently • Medical: $10
practicing medical providers for common illnesses, • Counseling/ Psychiatry $20
assessments, evaluations and treatment, including HDHP Plan:
prescription support. Employees can use this web- • Medical: $59
based service from home, from the office, or while • Psychiatry: $199 initial visit, $95 Follow-up
traveling. Employees can visit with a doctor, counselor • Counseling: $99 at Doctorate Level, $85 at
or psychiatrist any day, anytime from their smartphone, Masters Level
computer, or tablet.
The services available through BlueCare Anywhere include the following:
MEDICAL
Board-certified doctors provide immediate care for a range of common illnesses,aches and pains as well as
prescribing medication.
Colds Bronchitis Sore Throat Ear Infection Migraines
Flu Rash Diarrhea Sprains
Fever Abdominal Pain Vomiting Strains
Cough Sinus Infection Pink Eye
COUNSELING
A certified psychologist or counselor is available to treat issues affecting emotional, psychological and social well-
being. Anxiety Panic attacks PTSD trauma Bereavement/grief
Stress management Social anxiety Insomnia Couples counseling
OCD LGBTQ counseling Depression Life transitions
PSYCHIATRY
On demand or by appointment, board-certified psychiatrists are available for assessments, evaluation and
treatment, including prescription support.
Anorexia Social anxiety OCD Depression
Bulimia Anxiety disorders PTSD Panic attacks
Insomnia Cognitive disorders Bipolar disorder General anxiety
16Medical Plan Resources
MyBlue Preventive Care
www.azblue.com/member All the medical plans cover In-Network
Once you receive your ID card, you can register preventive care at 100% (no deductible applies).
on the member portal to check claims status and This includes routine health care services to
details, track deductibles, review benefits online, maintain your health and prevent disease,
compare hospitals and contracted health care including services such as annual physical
providers by name, specialty or location. exams, well-woman exams and certain
immunizations. Services received at out-of-
Mobile App network providers are subject to the out-of-
network deductible.
Search “MyBlue AZ” in your app store and
download it for quick, simple access to your What isn’t a Preventive Care
personalized benefit information and ID Card. If abnormal test results or a diagnosis is
You can also search providers, check your determined during a preventive care service the
symptoms and call Nurse on Call at the tap of a visit would be considered diagnostic, not
button. Available at Google Play™ and the App preventive. An example of diagnostic care would
Store™. be having a polyp removed during a
colonoscopy.
Healthy Blue
Login to the MyBlue member portal to receive the health related tools, resources and services listed below
• Healthy Blue Beginnings: Provides pregnancy education and support.
• Help with Prescriptions: Search MyBlue for cost comparisons or call (602) 864-4400 or (800) 232-2345
• Blue 365 Discounts: Exclusive to members with deals designed to help live a healthier life.
• Provides access to discounts on a broad range of products and services such as: fitness, nutrition,
vision, hearing, alternative medicine, Jenny Craig, SNAP Fitness, and more. Treatment Cost Estimator:
Life has enough surprises.
• Why should medical bills be one of them? Blue Cross® Blue Shield® of Arizona's online Treatment
Cost Estimator can help you avoid those types of surprises.
• Use this tool before getting care to help you make an informed decision about many common medical
tests and procedures. Login to your MyBlue account to utilize the tool.
Sharecare
Blue Cross® Blue Shield® of Arizona has partnered with Sharecare to provide you simple tools to
manage all your health and wellness needs in one place. You’ll start by taking the RealAge health
assessment to get a measure of the true age of your body in terms of health and vitality, versus your
calendar age. The program then delivers personalized insights, challenges, daily tracking, and one-of-a-
kind tools to help you reduce your RealAge and live healthier, no matter where you are in your health
journey. Learn what you need to be healthier with tips on how to eat better, exercise smarter, reduce
stress, and more.
It’s time to meet the healthier YOU. To get started, visit azblue.sharecare.com.
17Employee Assistance Program
Life presents us with challenges at work and at home on a daily basis. You do not have to face these
challenges alone, even if you’re far away.
The EAP Can Help with Almost Any Issue
EAP benefits are available to all employees and their families at NO COST to you. Help is just a phone call
away. The EAP offers confidential advice, support, and practical solutions to real-life issues. You can
access these confidential services by calling the toll-free number and speaking with a consultant.
EAP Services for Employees and Families
• Confidential Counseling: Up to 6 face-to-face, video or telephonic counseling sessions for
relationship and family issues, stress, anxiety, and other common challenges.
• Tess, AI Chat-bot: 24/7 chatbot for emotional support and check-ins to boost wellness. You can text
“Hi” to +1 650 825 9634 to get started.
• 24-hour Crisis Help: Toll-free access for you or a family member experiencing a crisis.
• Peer Support Groups: Online support groups for addiction, depression, bipolar and anxiety.
Your EAP provides a wide range of work-life balance services
• Such as: Childcare Services, Legal Services, Home Ownership Program, Adult and Eldercare Services,
Financial Help, College Planning Program, Online Legal Forms, Mediation Services, & Identity Theft
Services
Call: 800-395-1616
Visit the Website:
ibhsolutions.com/members:
Access life-balance and
wellbeing resources, monthly
webinars, newsletters, and
more.
Username: IBHEAP
Password: WL0103a
Download the EAP App:
Easy access to information
about the EAP, upcoming
Events and resources
(search for “IBHMobile”
in the App Store).
18Dental Benefits
Dental is an important part of your benefits package and regular dental care is key to
your overall health. The City is pleased to offer a dental plan administered through Delta
Dental of Arizona.
Delta Dental is the country’s largest dental network, with more than four out of five of the nation’s dentists
participating. Participating dentists have agreed to accept pre-negotiated fees for dental procedures and
are prohibited from billing a patient above the predetermined amount (balance billing). This arrangement
results in protection and savings for patients.
Always request a pre-treatment estimate from your dentist before having major dental work done. Don’t be
afraid to ask questions! Do not agree to any treatment unless you fully understand what condition is being
treated, why it is being treated, and the costs of that treatment. When in doubt, contact Delta Dental.
To learn more about Delta Dental, visit www.deltadentalaz.com or call 800.352.6132.
Covered Services PPO Plus Premier Out-of-Network
Benefit Coverage Delta Dental PPO & Premier Dentist
Contract Year - Individual /Family Deductible $50/$150
Contract Year - Maximum Benefit $4,000
Lifetime Orthodontia Maximum Adult & Child $2,000
Preventive Services
• Exams
• Routine Cleanings
• Fluoride: For children to age 18 100% 80%
• Sealants: For children up to age 19
• X-Rays
• Space Maintainers
Basic Services
• Fillings
• Stainless Steel Crowns
• Emergency Treatment 80%** 60%
• Endodontics: Root Canal Treatment
• Periodontics: Treatment of gum disease
• Oral Surgery: Simple and Surgical extractions
Major Services
• Prosthodontics: Bridges, partial/complete dentures
• Bridge and Denture Repair 50%** 40%
• Implants
• Restorative: Crowns and onlays
Orthodontia 50% 50%
• Benefit for adults and children 8+
*Members may incur higher out-of-pocket costs when seeing a Premier or out-of-network dentist.
**Deductible applies to these services.
19Vision Benefits
Vision coverage is provided as a part of your health benefits package through Avesis. Under the plan, you
can seek care from any licensed optometrist, ophthalmologist, or dispensing optician. However, the plan
pays more when you use an Avesis provider.
Manage your benefits through the Member Portal. Go to www.avesis.com and click Members. Register
using your name and date of birth to access everything you need such as:
• Print ID Cards
• See Claims Status
• View Benefit Summaries
• Check Eligibility
• Search for Providers
• Nominate Providers
Vision at a Distance – update your look from the comfort of your home. Introducing Avesis Vision
Delivered. Shop online using your in-network benefits-no claim form required.
When you need to see an eye care professional, simply visit www.avesis.com or contact Avesis Customer
Care Center Monday – Friday, 7am to 8pm (EST) at 855-214-6777
In-Network Out-of-Network
Vision Care Services
Vision Examination
Covered in full after $10 copay Up to $45
(includes Retraction)
Contact Lens Fit and Follow-Up
Up to $50 member
Standard Contact Lens Fitting N/A
out-of-pocket maximum
Up to $75 member
Custom Contact Lens Fitting N/A
out-of-pocket maximum
Materials $10 copay
Frame Allowance $225 allowance Up to $70
Standard Spectacle Lenses
Single Vision Covered in full after $10 copay Up to $30
Bifocal Covered in full after $10 copay Up to $50
Trifocal Covered in full after $10 copay Up to $65
Lenticular Covered in full after $10 copay Up to $80
Contact Lenses (In lieu of frame and spectacle lenses)
Elective $175 allowance Up to $148
Medically Necessary Covered in Full Up to $250
Retractive Laser Surgery Onetime/lifetime $150 allowance
Eye Examination/ Lenses or Contact Lenses/ Frames: 12/12/12
20Basic and Supplemental Life and AD&D Insurance
• Basic Life Insurance, Accidental Death & Disability (AD&D), and Supplemental Life Insurance are
insured by Minnesota Life.
• All benefit-eligible employees receive Basic Life Insurance and AD&D benefits paid by the City.
• All benefit-eligible employees may also purchase Supplemental Life Insurance coverage and AD&D.
Basic Life and AD&D Insurance - 100% Paid by the City
2x Annual Salary
Employee Up to $200,000 maximum
Dependent $5,000 spouse
Life $2,500 children (up to age 26)
• Guarantee issue is the amount of supplemental life insurance that you are automatically approved for.
• Evidence of Insurability (EOI) is required for elections above the guaranteed amounts.
• Supplemental Life insurance packets can be found on SharePoint at https://avondaleaz.sharepoint.com
(Internal City site) or send an email request to HR at HR-Benefits@avondaleaz.gov
Elect Supplemental Coverage – Employee Paid
Employee
Elect up to $750,000 maximum Elect in $10,000 increments
Term Life
Elect up to $250,000 maximum
Spouse Not to exceed 100% of the
Elect in $5,000 increments
Term Life employee’s total basic & supp life
coverage
Child Elect $2,500 increments to $10,000 One premium insures all eligible
Term Life or $15,000 children from live birth to age 26
Elect $10,000 increments
Voluntary AD&D
Elect up to $500,000 maximum Family benefits is a percentage of the
Employee or Family
employee’s elected AD&D amount
Note: If your spouse or child is eligible for employee coverage, they cannot be covered as a dependent. Only one employee may cover
a dependent child. It is the employee’s responsibility to notify their employer when dependents are no longer eligible for coverage.
*Coverage reduces to 50% at age 75 (see certificate for details).
Newly Hired Employees
A special guaranteed issue opportunity is available for newly hired employees during their initial 31-day
enrollment period. No evidence of insurability is required for the following guaranteed amounts:
• Employee- up to $250,000
• Souse – up to $30,000
• Child – all coverage
• Voluntary AD&D – all coverage
Evidence of insurability is required for elections above the guaranteed amounts.
21Supplemental Life and AD&D Insurance
Employee or Spouse Supplemental Life Insurance Cost
Additional Features
2021-2022 Employee and Spouse
Supplemental Term Life • Waiver of Premium: If you become
totally and permanently disabled,
Age Employee Rate/$1,000 Spouse Rate/$1,000 according to the terms of yourTax Free Savings for Medical Expenses
Health Savings Account (HSA)
What is an HSA?
An HSA is an individual savings account that can be used to pay for qualified medical expenses. The
HDHP option allows you to open an HSA and take advantage of terrific tax savings. The money in your
account accumulates on a tax-deferred basis and can be rolled over from year to year. You can save your
money for future medical expenses, and as long as you use the money for a qualified medical expense,
your funds are never taxed. This account is only available if you select the High-Deductible Health Plan
(HDHP). A participant cannot contribute to an HSA if they are covered on any other non-qualified plan,
are covered as a dependent on another person’s tax return (excluding spouses).
How Does an HSA Work?
A High-Deductible Health Plan offers a lower monthly premium in exchange for a higher deductible. The
money you would normally spend on monthly premiums can now be contributed on a pre-tax basis to
your HSA account. You will receive a debit card to use for qualified medical expenses, which will draw
from your HSA. Distributions from your HSA are tax-free when used to pay for qualified medical
expenses. The 2021 maximum contribution for single coverage is $3,600, and family is $7,200. HSA
participants who are 55 or older can contribute an additional $1,000, or $4,600 for single coverage and
$8,200 for family coverage. The City of Avondale uses Health Equity for all HSA accounts. Please note,
HSA accounts operate on a calendar-year basis. A participant can elect to contribute the maximum
amount from July 1, 2021 - December 31, 2021; however, to avoid tax issues, the individual must remain
on the HDHP through the full plan year following elections. If you would like to change your deduction,
see Human Resources for the form. Please make sure to consider that the contributions that the City
makes to your HSA account toward the maximum contribution.
What is considered a “Qualified Medical Expense”?
Some of the most common expenses include:
• Deductible • Contact lenses • Eyeglasses • Over-the-counter medications
• LASIK surgery • Office visit co-pays • Dental treatment • Hospital Services
• Prescription drugs • Chiropractor visits • Vaccinations • Insurance Premiums
*You should refer to www.irs.gov/pub/irs-pdf/p502.pdf for a full list of qualified expenses. If HSA funds are
used for non-qualified medical expenses, those purchases are subject to a 10% penalty tax and will be
considered income for tax purposes.
What are the eligibility requirements for an HSA?
The eligibility requirements to open and contribute to a health savings account (HSA) are mandated by
the Internal Revenue Service (IRS), not by your employer. Individuals who enroll in a Health Savings
Account (HSA) but are later determined to be ineligible for that account are subject to financial penalties
from the IRS. It is an individual’s responsibility to ensure that he/she meets the eligibility requirements to
open an HSA and to have contributions made to that HSA, as outlined below:
•To be eligible to open an HSA and have contributions made to the HSA during the year, an individual
must be covered by an HSA-qualified health plan (HDHP) and must not be covered by other health
insurance that is not an HSA-qualified plan.
23Tax Free Savings for Medical
Expenses Continued
IMPORTANT: Individuals enrolled in Medicare are not eligible to open an HSA or have
contributions made to the HSA during the year.
If you think you could become eligible for Medicare in the next 12 months, you should consider whether
enrolling in the medical plan that is paired with a health savings account is a wise choice.
• You may not be claimed as a dependent on someone else's tax return.
• Individuals may not open an HSA, or have contributions made to the HSA during the year, if a spouse’s
health insurance, Health Care Flexible Spending Account (Health Care FSA) or health reimbursement
arrangement (HRA) can pay for any of the individual’s medical expenses before the HSA-qualified plan
deductible is met. This means that a standard general-purpose Health Care FSA may make you
ineligible to open an HSA and have contributions made to the HSA during the year.
• If an individual received any health benefits from the Veterans Administration (or one of its facilities)—
including prescription drugs— in the three months prior, he or she is not eligible to open an HSA and
have contributions made to the HSA during the year.
What are the benefits of an HSA?
• The contributions are 100% tax-
deductible. The fund grows tax-deferred.
• The money withdrawn for qualified
medical expenses is tax-free. The
money you put in can reduce your
taxable income.
• You can roll the savings over from year
to year.
• Your HSA is portable and can move with
you from job to job.
• After age 65, you can use your HSA
account to pay Medicare premiums,
deductibles, co-pays, and coinsurance
under any part of Medicare.
How do I pay the bill at my doctor’s office with an HSA?
Health Equity offers a debit card for convenient access to your money as well as online banking tools
If you have an HSA, it is important not to overpay for medical expenses. Since you’re paying “cash” from
your HSA, if you pay the entire bill up front, you may be paying too much, since network discounts would
not have been applied. For example, most claims must be re-priced before you know what you owe. If
you pay cash at the time of service, you could be paying before the network discounts are applied. This
may pose a problem if you are reimbursed by your physician’s office, because you have technically made
an unqualified withdrawal from your HSA. We strongly suggest you wait until you receive your Explanation
of Benefits (EOB) before paying the provider.
For questions, contact Health Equity at 866-960-8026 or online at www.healthequity.com.
24Flexible Spending Accounts
Flexible Spending Accounts (FSA’s) are now available through Health Equity to help you pay for a variety
of out-of-pocket health care and/or dependent care expenses with pre-tax dollars. These accounts are
100% funded by you through pre-tax payroll deductions (based on 26 pay periods). Please note these
plans are regulated by IRS Guidelines and receipts are required.
Things to Consider Before Contributing to an FSA
• You cannot stop or change your FSA contribution(s) during the calendar year unless you experience a
qualifying event.
• You cannot take income tax deductions for expenses you pay with your FSA(s).
• These are all separate accounts so money cannot be transferred between accounts.
Health Care FSA
Maximum Contribution for 2021 – $2,750
• You do not need to be enrolled in a medical plan to participate; however, if you are enrolled in the
HDHP with HSA, you may only participate in the Limited Purpose Healthcare FSA.
• Pay for qualified medical expenses as defined IRS Publication 502
• Can be used for you and/or an eligible dependent; even if they are not covered on your medical plan.
• Your annual contribution is available on day one of the plan.
• Active participants in a Health Care FSA and Healthcare FSA Limited Purpose can carry over up to
$500 in unused money at the end of the plan year to be used to reimburse expenses incurred in the
following plan year. The carry-over does not count toward the Annual Maximum Limit.
Health Care FSA Limited Purpose (LPFSA)
For those enrolled in the HDHP Plan your HSA will be used to pay for all medical related expenses,
therefore, you are eligible to enroll in a LPFSA to pay for eligible dental and vision expenses, thereby
preserving your HSA funds for savings and investment opportunities.
Dependent Care FSA (DCFSA)
$5,000 (Single or Married/Joint tax return) $2,500 (Married/ separate returns)
Employees may also elect to participate in the DCFSA account which allows you to pay for dependent
care expenses with tax-free dollars for eligible dependents. The maximum contribution amounts are
$5,000 or $2,500 if married and filing separate. Dependent Daycare eligible expenses are for children
under the age of 13 and dependents of any age who are physically or mentally unable to care for
themselves. By enrolling in this plan, you save money on daycare expenses incurred so that you (and
your spouse, if married) can work, look for work, or attend school on a full-time basis. This account is Use
it or Lost it; unused funds will be forfeited at the end of the year or upon separation from The City of
Avondale and will not carryover.
Health Equity administers all of the Flexible Spending Accounts and can be reached
by calling at 866.960.8026 or online at www.healthequity.com.
25Customer Service Support
If you have specific questions related to your benefits enrollment, contact Human Resources at
623.333.2200. Need help or have questions about your coverage, claims, etc.? Contact any of the
vendors below for assistance.
Benefits Carriers Contact
Website:
Medical www.azblue.com
Group #040329 Phone Number:
1-844-899-4073
Website:
www.healthequity.com
Health Savings Account
Flexible Spending Accounts Phone Number:
866-960-8026
Website:
www.deltadentalaz.com
Dental
Phone Number:
Group #5476
602-938-3131 (option 1)
800-352-6132 (option 1)
Website:
Vision www.avesis.com
Group #30781-1254 Phone Number:
800-828-9341
Website:
Employer Life Insurance www.securian.com
Voluntary Life Phone Number:
Group #34489 651-665-3789
800-392-7295
Employee Assistance Program Website:
Click on the IBH logo www.ibhsolutions.com/members
• Username: IBHEAP
• Password: WL0103 Phone Number:
800-395-1616
• Click the My Benefits button
Website:
Sharecare
https://azblue.sharecare.com
Website:
www.bluecareanywhereaz.com
BlueCare Anywhere
Phone Number:
844-606-1612
26Required Notices
IMPORTANT NOTICE FROM The City of Avondale ABOUT YOUR PRESCRIPTION DRUG COVERAGE AND
MEDICARE – YOUR MEDICARE PART D NOTICE
Please read this notice carefully and keep it where you can find it. This notice has information about your current
prescription drug coverage with The City of Avondale and about your options under Medicare’s prescription drug
coverage. This information can help you decide whether or not you want to join a Medicare drug plan. Information
about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
There are four important things you need to know about the current coverage and Medicare’s prescription drug
coverage:
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this
coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or
PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of
coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
2. The City of Avondale has determined that the prescription drug coverage offered under the Exclusive Provider
Organization (EPO), and Preferred Provider Organization plans are, on average for all plan participants,
expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore
considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this
coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
3. The City of Avondale has determined that the prescription drug coverage offered under the High Deductible
Health Plan is, on average for all plan participants, NOT expected to pay out as much as standard Medicare
prescription drug coverage pays. Therefore, your coverage is considered Non-Creditable Coverage. This is
important because, most likely, you will get more help with your drug costs if you join a Medicare drug plan,
than if you only have prescription drug coverage from The City of Avondale. This is also important because it
may mean that you may pay a higher premium (a penalty) if you do not join a Medicare drug plan when you first
become eligible.
• You can keep your current coverage from The City of Avondale. However, because your coverage is
non-creditable, you have decisions to make about Medicare prescription drug coverage that may affect
how much you pay for that coverage, depending on if and when you join a drug plan. When you make
your decision, you should compare your current coverage, including what drugs are covered, with the
coverage and cost of the plans offering Medicare prescription drug coverage in your area. Read this
notice carefully – it explains your options.
When Can You Join a Medicare Drug Program?
You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th
to December 7th. However, if you lose your current creditable prescription drug coverage, through no fault of your
own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.
When Will You Pay A Higher Premium (Penalty) To Join a Medicare Drug Plan?
You should also know that if you drop or lose your current coverage with The City of Avondale and don’t join a
Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a
penalty) to join a Medicare drug plan later.
If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may
go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have
that coverage. For example, if you go 19 months without creditable coverage, your premium may consistently be
at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a
penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the
following October to join.
27Required Notices
What Happens to Your Current Coverage If You Decide to Join a Medicare Drug Plan?
If you decide to join a Medicare drug plan, your current coverage with The City of Avondale will not be affected.
Your current medical coverage with The City of Avondale pays for other health expenses in addition to prescription
drugs. If you enroll in a Medicare drug plan, you will still be eligible to receive medical and prescription drug
benefits through The City of Avondale. If you do enroll in a Medicare drug plan, in general, the following guidelines
apply:
• If you are an active employee, or the covered dependent of an active employee, you are required to obtain your
outpatient prescription drug benefits through The City of Avondale plan first. You can then file on a secondary
basis with your Medicare drug plan.
• If you are a COBRA participant, or the covered dependent of a COBRA participant, you are required to obtain
your outpatient prescription drugs through your Medicare drug plan first. Secondary coverage is not available
through The City of Avondale.
Important: You can only waive prescription drug coverage by waiving the entire medical/prescription plan coverage
for yourself and your dependents with The City of Avondale. Remember, if you do waive The City of Avondale
coverage, active employees can only re-enroll in the medical/prescription combined plan during the next Open
Enrollment Period.
For More Information About This Notice or Your Current Prescription Drug Coverage…
Contact the person listed below for further information. NOTE: You’ll get this notice each year. You will also get it
before the next period you can join a Medicare drug plan and if this coverage through The City of Avondale
changes. You may also request a copy of this notice at any time.
For More Information About Your Options Under Medicare Prescription Drug Coverage…
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You”
handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted
directly by Medicare drug plans.
For more information about Medicare prescription drug coverage:
• Visit www.medicare.gov/
• Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the
• “Medicare & You” handbook for their telephone number) for personalized help
• Call 800.MEDICARE (800.633.4227). TTY users should call 877.486.2048.
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available.
For information about this extra help, visit Social Security on the web at www.socialsecurity.gov or call them at
800.772.1213 (TTY 800.325.0778).
Name of Entity/Sender: The City of Avondale
Contact Person: HR
Phone Number: 623-333-2220
28You can also read
