AFSME 2076 Open Enrollment 2023

2022 OPEN

ENROLLMENT

OPEN ENROLLMENT
CHECKLIST

• Visit www.afscme2076benefits.com to review your
contact information. Be sure to update your address,
phone number, and personal email address!

• Review your current benefits enrollment information for
you and your dependents

• Review and update your beneficiary information
• Reminder: All members are auto-enrolled in

Basic Life/AD&D
• Contact the AFSCME Local 2076 Benefit Center at

(844)533-2956 to discuss any questions or address any
issues as you walk through Open Enrollment
• A virtual meeting will be scheduled to discuss Open
Enrollment. Please be sure to update your email address
at www.afscme2076benefits.com to receive your
registration email.

2

It’s that time again! AFSCME Local 2076 (AFSCME) will
hold its annual Open Enrollment period March 1st –
March 23rd, 2022. All coverage changes made during
Open Enrollment will become effective May 1, 2022.
Now is the time to update your AFSCME MetLife Dental and
Legal, and VSP Vision plans.

COME AND JOIN US FOR OUR
OPEN ENROLLMENT BENEFITS
MEMBERSHIP EVENTS

All attendees will have access to giveaways and will be
entered into a raffle to win prizes!

VIRTUAL MEETING

Registration is available for the following meeting date:

MARCH 3RD AT 6:30PM

CATCH UP DRIVE-THRU EVENT

The Drive-Thru will be held at the Orange County
Labor Federation
309 N Rampart St. Orange, CA 92868

MARCH 19TH FROM 11AM - 1PM

Meeting details and registration information will be sent
out via email so please be sure to update
your email address at www.afscme2076benefits.com!

3

2022- 2023

OPEN ENROLLMENT

BENEFIT HIGHLIGHTS

METLIFE

No change to MetLife Dental HMO and PPO benefits, and no
change to rates!

VSP

No change to VSP Vision benefits! See rate changes on page 6.

METLIFE LEGAL PLANS

No change to MetLife Legal plans benefits, and no change to rates!

GUARDIAN

No change to Voluntary Life, Disability, AD&D, Critical Illness, and
Accident benefits, and no change to rates!

4

DENTAL

AFSCME Local 2076 partners with MetLife Dental to offer comprehensive dental benefits
to our members.

AFSCME Local 2076 MetLife Dental

MetLife PPO MetLife HMO Dental Plan
Dental Plan

Providers PPO PDP Plus Non-Network Dental HMO
Network Providers* Network Only
Plan: Met185AB

Calendar Year $50 per individual None
Deductible $150 per family

Calendar Year $2,000 $1,500 None
Maximum

Preventive & 100% (2/year) 80% (2/year) $0
Diagnostic 100% 80% $0
100% 80% $0
• Cleanings
• Exams
• X-rays

Basic 80% 60% $0 - $5
• Extractions 80% 60% $10 - $40
• Fillings 80% 60% $85 - $275 co-pay per tooth
• Root Canal 80% 60% $0 - $980 co-pay per tooth
• Oral Surgery

Major 50% 40% $0 - $350 co-pay per tooth
• Crowns & Bridges 50% 40% $0 - $365 co-pay per tooth
• Dentures 50% 40% $0 - $2,380 co-pay per tooth
• Implants

Orthodontia (including 50% 40% $1,695 co-pay
adults and children to (Benefits cover 24 month
age 26) of usual and customary
Orthodontic treatment and
an additional 24 months of

retention)

Orthodontia Lifetime $1,000 N/A
Maximum

AFSCME Local 2076 MetLife Dental Semi-Monthly Cost

Member Only $27.47 $0.00

Two-Party $62.03 $6.99

Family $106.78 $13.21

*Benefits are based on Reasonable and Customary charge, which is based on the lowest of (1) the dentist’s
actual charge, (2) the dentist’s usual charge for the same or similar services, or (3) the charge of most
dentists in the same geographic area for the same or similar services as determined by MetLife

This is a summary of benefits only. Refer to the actual policy for details.

5

VISION

AFSCME Local 2076 partners with VSP Vision to provide members with comprehensive
vision care with access to care from great eye doctors, quality eyewear, and affordability,
all at low out-of-pocket costs.

AFSCME Local 2076 VSP PPO Vision

Your coverage with a VSP Provider
VSP Provider Network: VSP Choice

Benefit Description Copay Frequency

WellVision Focuses on your eyes and overall wellness $0 Every 12
Exam months

Prescription Glasses

Frame • $170 allowance for a wide selection Combined Every 12
of frame with exam months

• Single vision, lined bifocal, and lined Combined
trifocal lenses with Every 12
Lenses exam months
• Polycarbonate lenses for dependent
children

• UV Coating $0
Lens • Standard progressive lenses $0 Every 12
Enhancements • Premium progressive lenses $95 - $105 months
• Custom progressive lenses $150 - $175

Contacts • $170 allowance for contacts; copay Up to $60 Every 12
(instead of does not apply months
glasses)
• Contact lens exam (fitting and evaluation)

Diabetic • Services related to diabetic eye disease, glaucoma $20 As needed
Eyecare Plus and age-related macular degeneration (AMD). Retinal
Program screening for eligible members with diabetes.
Extra Savings Limitations and coordination with medical coverage
may apply. Ask your VSP doctor for details.

Glasses and Sunglasses
• Extra $20 to spend on featured frame brands.

Go to vsp.com/specialoffers for details.
• 20% savings on additional glasses and sunglasses, including

lens enhancements, from any VSP provider within 12 months of
your last WellVision Exam.

Retinal Screening
• No more than a $39 copay on routine retinal screening as an

enhancement to a WellVision Exam

Laser Vision Correction
• Average 15% off the regular price or 5% off the promotional price;

discounts only available from contracted facilities

AFSCME Local 2076 VSP Vision
Semi-Monthly Member Cost

Current Effective May 1st, 2022

Member Only $0.00 $0.00

Two-Party $4.33 $5.87

Family $9.61 $13.16

This is a summary of benefits only. Refer to the actual policy for details.

6

LEGAL

AFSCME Local 2076 partners with MetLife Legal Plans to provide access to legal expertise
for both expected and unexpected events.

MetLife Legal plans give you access to experts who can assist you with a broad range of
personal legal needs you might face throughout your life. This could be when you’re buying
or selling a home, starting a family, dealing with identity theft, or caring for aging parents.

AFSCME Local 2076 MetLife Legal Plans

Money • Debt Collection • Negotiations with • Tax Audit
Matters Defense Creditors Representation

• Identity Management • Personal Bankruptcy • Tax Collection
Services • Promissory Notes Defense

• Identity Theft Defense

Home & • Boundary & Title • Home Equity Loans • Sale or Purchase of
Real Estate Disputes • Mortgages Home
• Property Tax
• Deeds Assessments • Security Deposit
• Eviction Defense • Refinancing of Home Assistance
• Foreclosure • Tenant Negotiations
• Zoning Applications

Estate • Codicils • Powers of Attorney • Revocable &
Planning • Complex Wills (Healthcare, Irrevocable Trusts
• Healthcare Proxies Financial, Childcare,
• Living Wills Immigration) • Simple Wills

Family & • Adoption • Juvenile Court • Prenuptial Agreement
Personal • Affidavits Defense, Including • Protection from
• Conservatorship Criminal Matters
• Demand Letters Domestic Violence
• Garnishment Defense • Name Change • Review of ANY
• Guardianship • Parental
• Immigration Personal Legal
Assistance Responsibility Document
Matters • School Hearings
• Personal Property
Protection

Civil • Administrative • Disputes Over • Pet Liabilities
Lawsuits Hearings Consumer Goods & • Small Claims
Services Assistance
• Civil Litigation
Defense • Incompetency
Defense

Elder-Care • Consultation & • Medicaid • Powers of Attorney
Issues Document Review for • Medicare • Prescription Plans
your parents: • Notes • Wills
• Nursing Home
• Deeds Agreements
• Leases

Vehicle & • Defense of Traffic • License Suspension • Repossession
Driving Tickets Due to DUI

• Driving Privileges
Restoration

E-Services • Attorney Locator • Insurance Resources • Self-Help Legal
• Financial Planning • Law Firm E-Panel Documents

AFSCME Local 2076 MetLife Legal Plans Semi-Monthly Cost

Member and Eligible Dependents $9.00

This is a summary of benefits only. Refer to the actual policy for details.

7

LIFE AND
ACCIDENTAL DEATH
& DISMEMBERMENT
(AD&D) INSURANCE

This may not be enough based on your specific needs. If something
were to happen to you, make sure your loved ones would be able to
meet financial obligations.

COVERAGE

• All ET and EES employees are auto enrolled in $20k of Basic Life and
AD&D**

• Members can elect a maximum of $500k Voluntary Life coverage or
Voluntary AD&D coverage

• Spouse Voluntary Life and AD&D coverage available to the lesser of
$250k or 50% of member’s coverage

• Child Voluntary Life and AD&D coverage available to the lesser of
$10k or 10% of member’s coverage

*All members increasing or adding coverage must complete and submit an Evidence of Insurability (EOI)
form. Coverage subject to Guardian’s approval.
**You must designate a beneficiary for your Basic Life/AD&D, Voluntary Life, and Voluntary AD&D coverage.

8

LIFE AND
ACCIDENTAL DEATH
& DISMEMBERMENT
(AD&D) INSURANCE
CONTINUED

Guardian Guardian Voluntary AD&D
Voluntary Life Semi-Monthly Cost
Member and Spouse Life
Semi-Monthly Cost Per $10,000 of Coverage
Per $10,000 of Coverage
Member $0.10
< 30 $0.31 Spouse $0.10
$0.10
30 - 34 $0.40 Child

35 – 39 $0.50

40 – 44 $0.75 *You must designate a beneficiary for your Basic
Life/AD&D, Voluntary Life, and Voluntary AD&D
45 – 49 $1.21 coverage.

50 - 54 $1.90

55 – 59 $3.00

60 – 64 $3.81

65 – 69 $6.35

70 + $10.86

Child(ren) $0.35

9

DISABILITY

AFSCME Local 2076 offers fully insured STD and LTD plans through
Guardian that covers you for injuries and illnesses.

SHORT TERM DISABILITY

AFSCME Local 2076 Guardian STD*

Plan Basic Buy up

Maximum payment 12 weeks
period

Maximum Benefit 50% of salary up to $175 60% of salary up to $700
per week per week

Elimination Period 7 days

AFSCME Local 2076 Guardian STD Semi-Monthly Cost

STD Basic STD Buy up

Member $0.00 $11.85

This is a summary of benefits only. Refer to the actual policy for details.
*All members increasing or adding coverage must complete and submit an Evidence of Insurability (EOI)
form. Coverage subject to Guardian’s approval.

LONG TERM DISABILITY

AFSCME Local 2076 Guardian LTD*

Plan Basic Buy up

Maximum payment Social Security Normal Retirement Age
period

Maximum Benefit 50% of salary up to $600 60% of salary up to $3,000
per month per month

Elimination Period 90 days

AFSCME Local 2076 Guardian LTD Semi-Monthly Cost

LTD Basic LTD Buy up

Member $0.00 $15.13

This is a summary of benefits only. Refer to the actual policy for details.
*All members increasing or adding coverage must complete and submit an Evidence of Insurability (EOI)
form. Coverage subject to Guardian’s approval.

10

ACCIDENT

AFSCME Local 2076 partners with Guardian to provide members with
access to Accident insurance. Accidents happen every day and if you
were injured from an accident, chances are you will have expenses
that you were not anticipating. Accident insurance can help you deal
with those expenses. Coverage is guaranteed without any medical
questions!

HIGHLIGHTS OF THE ACCIDENT
PLAN FOR SERVICES RENDERED
DUE TO AN ACCIDENT INCLUDE

• AD&D
• Catastrophic loss
• Accident ER treatment
• Ground/Air ambulance transportation
• Burns
• Hospital admission
• Surgery
• Wellness benefit
• And more! (Refer to the actual policy for further details)

AFSCME Local 2076 Guardian Accident Semi-Monthly Cost

Member Only $10.17

Member + Spouse $16.10

Member + Child(ren) $16.26

Family $22.19

This is a summary of benefits only. Refer to the actual policy for details.

11

CRITICAL ILLNESS

AFSCME Local 2076 offers members access to Guardian’s Critical Illness plan. Critical
Illness coverage can help with expenses that medical insurance doesn’t cover like
deductibles or out of pocket costs. A lump sum benefit is paid when you need it most, upon
diagnosis.

COVERAGE

Coverage AFSCME Local 2076 Guardian Critical Illness
Benefit Type
Member: $1,000 -$25,000
($1,000 increments)

Spouse: $500 -$12,500
($500 increments)

Lump Sum

Guaranteed Issue* Member: $25,000
Spouse: $12,500

Covered Illnesses Heart attack, stroke, heart failure,
coronary arteriosclerosis, cancer, benign brain tumor,

organ failure, kidney failure, heart failure

Miscellaneous • Child coverage included with member coverage
Benefits • $50 annual Wellness benefit

• 2nd occurrence in same category receives partial benefit

This is a summary of benefits only. Refer to the actual policy for details.
*All members increasing or adding coverage must complete and submit an Evidence of Insurability (EOI)
form. Coverage subject to Guardian’s approval.

Guardian Critical Illness Semi-Monthly Cost Sample Rates

Age Band Member Spouse
$25,000 $12,500

<30 $4.36 $2.26
30 - 39 $6.53 $3.37
40 - 49 $13.18 $6.77
50 - 59 $25.38 $13.04
60 – 69 $44.18 $22.71
$78.61 $40.26
70 +

12

AFSCME LOCAL 2076
BENEFIT ENROLLMENT
WEBSITE

AFSCME’s online enrollment website provides our members with the power to access their
benefits when and where they need them.

WWW.AFSCME2076BENEFITS.COM

provides easy access to:
• Review and update your personal information
• Review your current benefit elections
• Make benefit changes for the 2022 – 2023 plan year
• Add/Remove your dependents
• Update your beneficiary information
• Access benefit information

Get started

Visit www.afscme2076benefits.com and login by entering your username and password.
If you are a first-time user, click on ‘Register’ to set up your user name, password and
security questions

Forgot your password?

1. Visit www.afscme2076benefits.com and click on the ‘Forgot your password?’ link.
2. Enter your social security number, company key and date of birth.
3. Answer your security phrase.
4. Enter and confirm your new password, then click ‘Continue’ to return to this

page and login

Register

As a first-time user, you
will be required to set up a
username, password and
security question using your
SSN and Date of Birth

13

AFSCME LOCAL 2076
BENEFIT ENROLLMENT
WEBSITE CONTINUED

Begin Enrollment

Click ‘Start Here’ and follow the instructions to enroll in your benefits or waive coverage

Want to review your current plan?

You have year-round access to your benefit summary and specific benefit elections at
www.afscme2076benefits.com
1. Click on ‘Benefits Summary’
2. Review your current plan elections

Want more information on AFSCME plans?

View the AFSCME Benefit Summaries and other important documents in the ‘Reference
Center’

14

AFSCME LOCAL 2076
BENEFIT ENROLLMENT
WEBSITE CONTINUED

Review and update your personal information?

Be sure to update your personal email address
If you are married or have a domestic partner, please be sure they are updated and listed
as a dependent.
Please be sure to update your marital status if you’ve recently been married or divorced
by adding or removing them as a dependent.

15

AFSCME LOCAL 2076
BENEFIT ENROLLMENT
WEBSITE CONTINUED

Make your elections

Review your options as you walk through the enrollment process. Select the plan(s) you
choose. Track your choices along the enrollment bar which updates your total cost.
If you have any questions as you go through enrollment, please call the AFSCME Local
2076 Benefits Center at 844-533-2956.
Use the ‘Reference Center’ tools to help you make elections

Confirm your choices

Your enrollment isn’t complete until you confirm your benefit elections by clicking on
‘I Agree”

16

AFSCME LOCAL
2076 BENEFIT
ENROLLMENT
MOBILE APP

Getting Started

Step 1: Log into your benefits portal account at www.afscme2076benefits.com and click on
the MyChoice Mobile App icon. You will enter your cell phone number and the link for the app
will be texted to you. Enter your unique access code when prompted.

Step 2: Download the MyChoice mobile app to your Apple or Android mobile device.
The link will be texted to you in Step 1. However, you can also search for it in the
App Store or Google Play.
Step 3: Launch the app on your device and input your Access Code from
Step 1. When you initially enter the app, you will be prompted to create a 4-digit
PIN number for your security. If you ever forget your PIN, you can simply
request a new access code as in Step 1.

17

CONTACT US

If you have any questions regarding Open Enrollment
or the AFSCME Local 2076 Benefits, please contact
the AFSCME 2076 Benefits Center.
Phone: 844.533.2956
Email: [email protected]
Web: www.afscme2076benefits.com

18