Benefits Offered Through Rural Arizona Group Health Trust
RAGHT BENEFIT OFFERINGS
The Trust offers four medical plans, each utilizing the Blue Cross Blue Shield of Arizona (BCBSAZ) provider network for services received within Arizona and the Aetna POS II network for services delivered in the remaining forty-nine states. The four plan offerings are:
- Two qualified High Deductible Health Plans (HDHP); and
- Two Exclusive Provider Organization (EPO) plans
RAGHT member employers may offer one or any combination of the four plans, at the discretion of their management. As a compliment to these plans, RAGHT members may likewise offer supplementary benefit services based on their respective plan offerings. These potentially include:
- A Health Savings Account (HSA) through the savings bank of the member employer’s choice.
- A Limited Purpose Flexible Spending Account (FSA) [limited to Dental and Vision out of pocket expenses], each administered by Meritain;
- For members electing an EPO option, a full-purpose Flexible Spending Account (FSA), also administered by Meritain; and
- For members on EITHER an HDHP or EPO, a Dependent Care FSA for use in paying qualified childcare and other expenses, also administered by Meritain.
Please note that eligibility to participate in and annual dollar limits for HSA and FSA accounts, as well as the definition of qualified expenses and other limitations, are established and/or modified not less than annually by the Internal Revenue Service (IRS). Members should consult their tax advisor before enrolling in any such account.
All of the HDHP and EPO prescription drug benefits are administered by RAGHT’s Prescription Benefit Manager (PBM), Navitus Health Solutions. Eligible medications and services are identical between the HDHP and EPO plan designs. However, member cost shares differ by plan.
For more complete information on benefit terms, limitations, cost shares, eligibility and anything else, please contact Navitus as shown on the Vendor Partner page, or your employer’s Human Resources department.
All of the HDHP and EPO plans incorporate a broad Wellness Program that provides members with opportunities to participate in onsite preventive screenings and services, reduce risks for chronic conditions, and a means to manage chronic conditions. For more complete information on the Wellness Program, please visit the Wellness page.
Ameritas Dental Plan:
The Dental Plan through the Rural Arizona Group Health Trust offers a network of dental providers through the Ameritas Dental Network. Network providers have agreed to charge members based on a set schedule of fees that are discounted from the usual and customary charges in their geographical area. Choosing to receive services from a network provider will give you the most savings. You may also visit out-of-network dental providers for reimbursement based on the usual and customary charges in their geographical area.
- You can find network providers for Ameritas at: dentalnetwork.ameritas.com
Ameritas also offers a network in Mexico. These providers have met the Ameritas qualification guidelines and agreed to charge members based on a set schedule of fees that are discounted from the usual and customary charges in their geographical area. You may also visit out-of-network dental providers in Mexico but you may need to pay up front and then request reimbursement using the Ameritas dental claim form along with a copy of the bill. Claims will be reimbursed based on the usual and customary charges in their geographical area. Claims do not need to convert foreign currency to U.S. dollars.
Ameritas Dual Choice EyeMed or VSP Vision Plan:
The Vision Plan through the Rural Arizona Group Health Trust offers you the choice between two national networks, EyeMed and VSP. Network vision providers have agreed to charge members based on a set schedule of fees that are discounted from the usual and customary charges in their geographical area. Choosing to receive services from a network vision provider will give you the most savings. You may also visit out-of-network vision providers for a lower reimbursement based on the details outlined in the plan. Please review both plans and networks to decide which one works best for you and your family.
- You can find network providers for EyeMed at www.eyemed.com
- You can find network providers for VSP at www.vsp.com
Coverage is also available for services by vision providers in any other country including Mexico. Members will pay up front and then request reimbursement using the appropriate claim form along with a copy of the bill. Claims do not need to convert foreign currency to U.S. dollars.
Basic (employer paid) Life and Accidental Death (Life and AD&D) Insurance
Basic Life and AD&D insurance for RAGHT is provided through Securian Financial. The amount of Life insurance provided varies by member employer. For more complete information on Basic Life insurance benefit terms, limitations, eligibility and anything else, please contact Securian Financial as shown on the Vendor Partner page, or your employer’s Human Resources department.
Voluntary (additional) Life Insurance
In addition to the Basic Life and AD&D, most RAGHT employers offer employees the opportunity to purchase additional Life insurance on themselves, their spouses and/or children. Eligibility for these purchases are subject to very specific terms and conditions. For more complete information on Voluntary Life Insurance, please contact Securian Financial as shown on the Vendor Partner page, or your employer’s Human Resources department.
Aetna Accident Plan
Accidents happen when you least expect them. But an Aetna Accident plan can help you be more financially prepared when they do. The plan pays you cash benefits when you or a covered family member are faced with a covered accidental injury that happens off the job.
Unlike regular medical insurance, which pays your provider, an Aetna Accident plan pays you cash directly for things like medical treatment, deductibles…even rent or mortgage! The money is yours to spend however you need it most.
Aetna Critical Illness Plan
Nobody is ready to receive a diagnosis of a serious illness. But an Aetna Critical Illness Plan pays benefits when you are diagnosed with a covered illness or condition, after your coverage effective date. This can help you feel a little more financially prepared to focus on the road to recovery.
The plan pays for diagnosis such as cancer, stroke, major organ failure, and more. Check out the benefit plan summary for a full list of covered diagnoses and complete plan details.
Aetna Hospital Indemnity plan
Whether you’re planning a hospital stay, or one comes up unexpectedly, the costs can really add up fast. The Aetna Hospital Indemnity Plan pays cash benefits when you have a hospitalization due to an illness, injury, surgery, or even delivering a baby.
The plan pays benefits for an inpatient hospital admission, plus extra for each day you’re in the hospital.
Health Screening Benefit
The accident plan includes a $75 health screening benefit, while the critical illness and hospital plans each include a $50 benefit, when a covered member completes a qualifying health screening. This annual benefit is available once per plan year to each enrolled member on each of the plans.
To learn more about these plans, check out the RAGHT Aetna Supplemental Health Plan microsite.
Voluntary Short Term Disability
RAGHT is offers a new Voluntary Group Short Term Disability plan, underwritten by Madison National Life Insurance Company, Inc and serviced by Ochs.
Choice of Benefit Amount
You may elect your benefit in $100 increments up to 66 2/3% of your basic weekly earnings, to a maximum weekly benefit of $1,000. A minimum election of $200 is required.
Rates are age banded and your premiums will calculate in the enrollment platform.
When Benefits Begin
Benefit payments will begin after one of the following timeframes:
For a covered injury: 0 calendar days
For a covered sickness (including pregnancy): 7 calendar days
When Benefits Ends
Benefits continue for 26 weeks or until Long Term Disability Benefits commence, whichever comes first.
Definition: A pre-existing condition is a condition for which you have consulted a medical provider or received medical treatment or services during the 3-month period prior to your effective date of coverage.
Coverage under this plan: You cannot receive benefits due to a pre-existing condition until you have been continuously covered under the group policy for at least 12 months and been actively at work for at least one day after the end of the 12 months.
A Pre-existing Condition Limitation applies to all new elections and increases.
Complete details including all benefits, exclusions, and limitations, will be contained in the certificate of insurance which will be issued at a later date.
For questions about your plan, please contact Ochs: (800) 392-7295 or email@example.com