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SPS+ Benefits Package Descriptions

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Published by anders.b, 2021-04-14 13:19:34

SPS+ Benefits

SPS+ Benefits Package Descriptions

2020 – 2021

SPS+ ARCHITECTS, LLP
BENEFITS
Effective August 1st, 2020, through July 31st, 2021

PICK THE BEST BENEFITS FOR YOU AND YOUR FAMILY

SPS+Architects, LLP offers all eligible employees and their eligible family members a comprehensive
and robust benefits program. These benefits include Medical, Dental, Employer-Paid Life and AD&D,
Short-Term and Long-Term Disability, Telebenefits through HealthiestYou, AFLAC, PTO and a 401K plan.
We encourage you to take the time to educate yourself about your options and choose the best
coverage for you and your family.

Open enrollment is a short period each year when you can make changes to your benefits. This
guide will outline all of the different benefits offered. For full benefit summaries and benefit costs see
HR. Elections you make during open enrollment will become effective on August 1st, 2020, and will
remain effective until July 31, 2021.

WHO IS ELIGIBLE? WHEN DOES COVERAGE BEGIN?

All employees who are active ANNUAL OPEN ENROLLMENT
full-time employees working a
minimum of 30 hours per week The elections you make during Annual Open Enrollment are
are eligible. effective on August 1st, 2020. Due to IRS regulations, once
you have made your choices for the 2020 - 2021 plan year
you can’t change your benefits until the next enrollment
period unless you have a qualifying life event.

NEW HIRE

If you are a new hire you are eligible on the first day of the
month following 30 calendar days of employment.

YOUR ELIGIBLE DEPENDENTS

• Your legal spouse

• Your domestic partner

• Your dependent children up to age 26 (includes
stepchildren and legally adopted children)

• Your dependent child, regardless of age, provided
he or she is incapable of self-support due to a mental
or physical disability, is fully dependent on you for the
support as indicated on your federal tax return, and is
approved by your medical plan to continue coverage
past age 26.

COVERAGE TERMINATION

Plan coverage will terminate at the end of the month in which the employee terminates employment
or is no longer an eligible employee under the Plan’s provisions for Medical and Dental coverage. Plan
coverage will terminate the last day of work for Life, STD, LTD.

HOW TO MAKE CHANGES (QUALIFYING LIFE EVENTS)

If you are a new hire you are eligible on the first day of the month following 30 calendar days of
employment.

• Marriage, divorce, or legal separation
• Birth or adoption of a child
• Change in child’s dependent status
• Death of a spouse, child, or other qualified dependent
• Change in residence
• Change in employment status or a change in coverage under another employer-sponsored plan

You have 30 calendar days to notify Human Resources of your change in status if it impacts your
benefits status. Your new coverage becomes effective on the date of change or the first of the following
month. Make sure you provide Human Resources with verification of the qualifying event.

IN-NETWORK VS OUT-OF-NETWORK

Stay In-Network and Save! their pre-selection to provide quality care at a
contracted rate. The main advantage in using
Each carrier (Blue Cross Blue Shield (BCBS) of an in-network provider is that you receive this
Arizona and Reliance Standard) has contracted negotiated discounted rate for their services and
with a vast number of providers on your behalf to you are not balance billed. The following example
get services at discounted rates in their networks. shows how much you can save by choosing an
In return, these health care and dental providers in-network provider when you seek medical and
have higher volumes of patients and a consistent dental care.
flow of insured patients. These providers are
designated as being “in-network” because of

Example: An in-network doctor may regularly charge $100 for an appointment at the doctor’s office.
BCBS, however, has contracted with them to discount this visit to $60. In addition, our plan covers 100%
of this preventive care reduced cost, so your cost would be $0

In-Network Amount Out-of-Network Amount
$100 $100
PCP Visit -$40 PCP Visit $0
$60 $100
Network Discount Network Discount
$60 -$30
Balance $0 Balance
$70
Insurance Coverage at 100% Insurance Coverage at 50% of the $30
Network payout (50% of what BCBS $40
Patient Responsibility pays in-network providers - $60) $70
Remaining Balance

Patient Responsibility
- 50% of network payout
- Balance billing

Compare this to an out-of-network physician who also charges $100.00 for an appointment at the doctor’s office.
For out-of-network providers, BCBS will pay the rate they pay in- network providers which is $60. Your coverage
out-of-network is 50%, so BCBS will pay the out-of-network provider 50% of $60 which is $30. You are responsible for
the other 50% which is $30. The out-of-network doctor can then turn around and balance bill you $40 to recoup
the balance of the $100 bill. You owe a total of $70 out-of-network

MEDICAL AND PRESCRIPTION DRUGS

Effective August 1, 2020, we will continue offering medical coverage to our employees with Blue Cross Blue Shield
of Arizona. This year we will be offering two plans both still HSA plans but with different networks. The plans will
allow you to see the doctor of your choice in or out-of-network, but you always receive the greatest benefit by
seeing in-network providers. The following chart outlines your benefit choice effective August 1, 2020.

BLUE CROSS BLUE SHIELD OF ARIZONA

Plan Design HSA $6,000 = 90%/50% HSA $6,900 = 100%/50%
- Alliance Network - Statewide Network
Benefit Highlights
Deductible (with Deductible Reimbursement) (with Deductible Reimbursement)
Individual
In-Network Out-of-Network^ In-Network Out-of-Network^

$6,000 $12,000 $6,900 $13,800

Family $12,000 $24,000 $13,800 $27,600
Coinsurance 90% 50% 100% 50%
Coinsurance

Maximum out-of-pocket (includes deductible)

Individual $6,900 $13,800 $6,900 $13,800

Family $13,800 $27,600 $13,800 $27,600
Office Visit
Preventive 100% deductible 50% after deductible 100% deductible 50% after deductible
Primary Care waived 50% after deductible waived

90% after deductible 100% after deductible 50% after deductible

Specialists 90% after deductible 50% after deductible 100% after deductible 50% after deductible
$49 copay n/a
Telehealth through $49 copay n/a
BlueCare Anywhere (MD)

Diagnostic Care

Diagnostic Lab 90% after deductible 50% after deductible 100% after deductible 50% after deductible

Diagnostic X-ray 90% after deductible 50% after deductible 100% after deductible 50% after deductible
Emergency Services
Urgent Care Services 90% after deductible 50% after deductible 100% after deductible 50% after deductible
Emergency Room 90% after deductible 90% after deductible 100% after deductible 100% after deductible
Hospitalization

In-Patient 90% after deductible 50% after deductible 100% after deductible 50% after deductible

Out-Patient 90% after deductible 50% after deductible 100% after deductible 50% after deductible
Prescription Drugs 90% after deductible 50% after deductible 100% after deductible 50% after deductible
Prescription Drugs

Specialty Drugs 90% after deductible Not Covered 100% after deductible Not Covered

Deductible Reimbursement: SPS+ Architects, LLP will Continue the deductible reimbursement program for both
plans being offered. For the Alliance plan after meeting the first $3,250 of your deductible, SPS+ Architects will
reimburse employees and their dependents 90% of the last $2,750 of the deductible. For the Statewide option
after meeting the first $3,250 of your deductible, SPS+ Architects will reimburse employees and their dependents
100% of the last $3,650 of the deductible To receive reimbursement send an Explanation of Benefits (EOB) and
Request Form to FBC Insurance, Benefits & Consulting.

^ There may be balance billing on all out-of-network services

FINDING IN-NETWORK PROVIDERS & FACILITIES WITH BCBS

1. Go to www.azblue.com and select “find a doctor” – then choose “I am NOT yet a member … but
might get a BCBSAZ health plan through my employer”

2. Where it says “Choose a Network”
• Alliance Plan: select “Alliance”,
• Statewide Plan: select “PPO” (on the next page the network will show as Statewide PPO/EPO
(this also includes the Statewide HSA plan as well)

YOUR MEDICAL COST IN 2020 – 2021, EFFECTIVE AUGUST 1st, 2020

SPS+ Architects will cover 100% of the cost of employee’s medical benefits for the base or the state plan. Employees
are responsible for all of their dependent coverage costs. Bi-weekly (each paycheck) payroll deductions are as
shown below.

PAYROLL DEDUCTIONS (BI-WEEKLY)

Employee Only Employee & Spouse Employee & Child(ren) Employee & Family

HSA $6,000 $0 $131 $124 $301
$149 $141 $342
Alliance Network

HSA $6,900 $0

Statewide Network

DEDUCTIBLE REIMBURSEMENT 2020 – 2021 BASE PLAN: WHO PAYS WHAT?

***IMPORTANT: DEDUCTIBLE REIMBURSEMENT IS FOR IN-NETWORK SERVICES ONLY***

$6,000 Deductible { $6,000 In-Network Deductible

First $3,250 of the 90% of the last $2,750
deductible is the of the deductible is the
employee’s portion employer’s portion of the
of the deductible

DEDUCTIBLE REIMBURSEMENT 2020 – 2021 Statewide Option: WHO PAYS WHAT?

***IMPORTANT: DEDUCTIBLE REIMBURSEMENT IS FOR IN-NETWORK SERVICES ONLY***

$6,900 Deductible { $6,900 In-Network Deductible

First $3,250 of the The last $3,650 of
deductible is the the deductible is the
employee’s portion employer’s portion of the
of the deductible deductible

Example of how it works: • Fill out a deductible reimbursement form and
supply FBC with your EOB.
• Your child breaks their arm and you take them to
the Emergency Room. The ER will submit a claim to • FBC processes your form and informs
BCBS. SPS+Architects, LLP what you are due in
reimbursement. You receive reimbursement
• Once your claim has been processed by BCBS from SPS+Architects, LLP, and use the money
an Explanation of Benefits (EOB) is posted online. to pay your medical bills.
When you look at the EOB you see you had $4,000
applied to your son’s in-network deductible and • Deductible reimbursement form is available at
you are due reimbursement. the back of the enrollment guide.

Reimbursement Example – reimbursed 90% after $3,250: $4,000 90%
Deductible that has been met is $3,250
Employee Responsibility
Amount Eligible for Reimbursement $750
SPS+Architects reimburses you 90% of the $750: $675

SPS + Architects HSA CONTRIBUTIONS FOR 2020-2021

SPS + Architects will contribute to employee’s HSA accounts each pay period. The pay period
contributions are shown in the chart below.

HSA 2020 - 2021 CONTRIBUTIONS (PAID BY SPS + ARCHITECTS)

Alliance Per Paycheck Annually Statewide Per Paycheck Annually

Employee Only $40 $1,040 $20 $520

Employee & Spouse $40 $1,040 $20 $520
$1,040 $20 $520
Employee & $40 $1,040 $20 $520
Child(ren) $40

Family

You are also able to contribute pre-tax dollars to your HSA bank account up to a certain limit. The
contribution limits for each year are those set by the IRS. Please see the table below for IRS annual
contribution limits. Limits include the SPS+Architects, LLP contributions, and your contributions.

HSA Contribution Limits 2020 2021

Individual $3,550 $3,600
Family $7,100 $7,200
“Catch Up” contributions Age 55 or older, $1,000 Age 55 or older, $1,000

DENTAL

Effective August 1, 2020, we will be continuing our dental plan with SecureCare Dental. You can use
any dentist you wish but receive the deepest discounts if you see a SecureCare Dentist. The following
chart briefly outlines the Dental benefits.

Services SecureCare Dental The Copay Plan The PPO Plan The Indemnity Plan

Preventative Exams, cleanings, x-rays Scheduled 100% 100%
Deductible $50 $50
Basic Services Applies to Basic and Major None $150 $150
Major Services Services only None
Annual Maximum 80% 80%
- Individual
- Family 50% 50%

Fillings, simple extraction, Scheduled $2,000 $2,000
Oral surgery

Root canal, Crowns, Scheduled
Dentures, Bridges, None
Prosthetics

The maximum amount the
plan pays per year per
covered person

YOUR DENTAL COST 2020 - 2021, EFFECTIVE AUGUST 1, 2020

SPS + Architects will continue to contribute to the cost of coverage for you and your family. Bi-weekly
payroll deductions are as shown below. If you choose to not enroll in the dental plan, SPS + Architects
will contribute an additional $20 into your HSA per month.

HSA 2020 - 2021 CONTRIBUTIONS (PAID BY SPS + ARCHITECTS)

Employee Only Employee + One Employee & Family

The Copay Plan $0 $7.92 $16.77
The PPO Plan
The Indemnity Plan $11.69 $29.84 $50.16

$21.84 $48.83 $78.93

Note: Employees with Medical and Dental coverage through another provider may elect to waive the BCBS and
Dental benefits offered by SPS+ above and may be eligible to receive an “In-Lieu of Health Insurance” benefit as
additional pay. A statement of Alternative Health Care Coverage must be completed

The following Disability and HealthiestYou benefits are provided at no charge to all full time employees.

LIFE AND AD&D INSURANCE

SPS + Architects provides $20,000 of group term life and accidental death & dismemberment (AD&D)
insurance to all eligible employees. Effective August 1, 2020, we will be continuing our coverage with
The Standard. SPS + Architects pays the full cost of this benefit. Contact Human Resources to update
your beneficiary.

SHORT TERM DISABILITY INCOME BENEFITS

SPS+Architects, LLP will begin to provide employees short term disability insurance through The Standard.
In the event you become disabled from a non-work injury or sickness, disability income benefits are
provided as a source of income. The first day of your disability triggers your elimination period (14 day
waiting period). On the 15th day of your disability, your STD benefits begin.

Eligibility Requirements SHORT TERM DISABILITY
Benefits Begin Full-time active employees
Benefits Payable 15th day for an accident 15th days for an illness
Percentage of Income Replaced Up to 11 weeks
Maximum Benefit 60%
Pre-existing condition limitation $1,500 per week
None

LONG TERM DISABILITY INCOME BENEFITS

SPS+Architects, LLP will continue to provide employees long term disability insurance through The
Standard but has upgraded the maximum benefit from $7,000 to $12,500. In the event you become
disabled from a non-work injury or sickness, disability income benefits are provided as a source of
income.

Benefits Begin LONG TERM DISABILITY
Benefits Payable After 90 days
Percentage of Income Replaced 2 years
Maximum Benefit 60%
Pre-existing condition limitation $12,500 per month
None

HEALTHIEST YOU!

Effective August 1st, 2020 SPS+ Architects, LLP will begin to provide you and your
dependents access to HealthiestYou services. You can connect (via phone,
email, video) with one of the HealthiestYou 2,300 licensed doctors for diagnosis
AT NO COST. HealthiestYou also provided access to other benefits AT NO COST
such as Behavioral Health, Back Care, and Dermatology services. After open
enrollment go to www.healthiestyou.com and register for online access or call
1-866-703-1259 anytime to utilize the service (available 24 hours / 7 days a week
/ 365 days a year).

NEED HELP WITH YOUR COVERAGE AND PLAN?

START WITH THE CARRIER or contact Brett Durkin at FBC Insurance, Benefits & Consulting for assistance
with the benefits listed below 602.277.8477.

Medical: Blue Cross Blue Shield of Arizona
• Group Number: 033013
• Customer Service: 602.864.4197 and say “I’m a member”
• Website: www.azblue.com
• In-network provider search: Network: “Alliance” or “PPO”

Dental: SecureCare Dental
• Policy Number: 10004300
• Customer Service: 888.429.0914
• Website: www.securecaredental.com
• In-network provider search website: https://www.securecaredental.com/pages/search_new.aspx

Life, STD, LTD: The Standard
• Policy Number: 00613888
• Customer Service: 888.937.4783
• Website: www.standard.com

Contact our benefit consultant Brett Durkin at FBC Insurance, Benefits & Consulting
• Call or Email: 602.277.8477 or [email protected]

* I’m not found in the system
* BCBS/Reliance Standard gave me the run around
* I’m having trouble with anything related to the benefits
* I’m just not sure where to start…

The information in this Enrollment Guide is presented for illustrative purposes and is based on information provided
by your employer. The text contained in this Guide was taken from various summary plan descriptions and benefit
information. While every effort was taken to accurately report your benefits, discrepancies or errors are always
possible. In case of discrepancy between this Guide and the actual plan documents, the actual plan documents
will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of
1996. If you have any questions about your Guide, contact Human Resources.
Under ERISA, the Plan Administrator of the group health plan may have fiduciary responsibilities regarding
distribution of dividends, demutualization and use of the Medical Loss Ratio rebates from group health insurers.
Some or all of any rebate may be an asset of the plan, which must be used for the benefit of the participants
covered by the policy. Participants should contact the Plan Administrator directly for information on how the
rebate will be used.
The Employer has the right to modify or amend the plan with a 60-day written notice.

AFLAC

WHAT IS AFLAC? HOSPITAL – Benefits provided for accidents and
sickness when admitted into the hospital, along with
AFLAC – provides cash benefits when you or anyone daily benefits. Designed to off set medical expenses.
covered gets sick or hurt. These benefits pay you This is a plan great for anyone over 30 years of
directly and often used for off setting medical age, families, or those planning to have a baby.
expenses, everyday living expenses and being unable Compatible with all HSA and non HSA medical plans.
to work due to accidents or sicknesses. You can use Employees can choose from $500- $2000 admission
them however you need with benefits being directly benefits.
deposited to your bank account within 24 hours!
CANCER – Benefits provided for any type of cancer,
ACCIDENT – Any injury 24 hours a day, 7 days a week. internal and skin. If you have children under the
Coverage can be provided to employee or family. If age of 26, they can be enrolled with the employee
you have an active family, play sports, drive a vehicle at no cost. There is no maximum benefit payout for
this might be a good plan for you. Benefits provided treatments. Whether it’s 3, 30 or 300 rounds of chemo
are based on the severity of the injury and treatments a benefit is provided. Annual wellness for anyone
provided. There is one annual wellness benefit also covered on this plan each year.
included in this plan.

PAYROLL PREMIUM RATES ARE BIWEEKLY

AFLAC HOSPITAL CHOICE - Option H Benefit AFLAC HOSPITAL CHOICE - Option H Benefit AFLAC HOSPITAL CHOICE - Option H Benefit
Amount 500 Series B4010H Amount 1000 Series B4010H Amount 1500 Series B4010H

Premium Total Premium Total Premium Total

18-49 INDIVIDUAL $9.84 $9.84 18-49 INDIVIDUAL $14.52 $14.52 18-49 INDIVIDUAL $19.80 $19.80

50-59 $10.56 $10.56 50-59 $14.94 $14.94 50-59 $19.80 $19.80

60-75 $12.30 $12.30 60-75 $17.52 $17.52 60-75 $23.22 $23.22

18-49 INSURED/SPOUSE $13.68 $13.68 18-49 INSURED/SPOUSE $21.12 $21.12 18-49 INSURED/SPOUSE $29.40 $29.40

50-59 $16.80 $16.80 50-59 $24.72 $24.72 50-59 $33.42 $33.42

60-75 $20.46 $20.46 60-75 $29.40 $29.40 60-75 $39.18 $39.18

18-49 ONE-PARENT FAMILY $11.22 $11.22 18-49 ONE-PARENT FAMILY $16.80 $16.80 18-49 ONE-PARENT FAMILY $23.04 $23.04

50-59 $11.82 $11.82 50-59 $17.10 $17.10 50-59 $23.28 $23.28

60-75 $13.26 $13.26 60-75 $18.06 $18.06 60-75 $23.34 $23.34

18-49 TWO-PARENT FAMILY $13.92 $13.92 18-49 TWO-PARENT FAMILY $21.36 $21.36 18-49 TWO-PARENT FAMILY $29.88 $29.88

50-59 $17.04 $17.04 50-59 $24.96 $24.96 50-59 $33.66 $33.66

60-75 $20.70 $20.70 60-75 $29.64 $29.64 60-75 $39.42 $39.42

AFLAC HOSPITAL CHOICE - Option H Benefit ACCIDENT ADVANTAGE -24-HOUR ACCIDENT OPTION 3 - Series A36000
Amount 2000 Series B4010H

Premium Total Premium Total
$10.14 $10.14
18-49 INDIVIDUAL $25.80 $25.80 18-75 INDIVIDUAL $14.40 $14.40
18-75 INSURED/SPOUSE $17.04 $17.04
50-59 $26.04 $26.04 18-75 ONE-PARENT FAMILY $22.08 $22.08
18-75 TWO-PARENT FAMILY
60-75 $29.82 $29.82

18-49 INSURED/SPOUSE $38.88 $38.88

50-59 $43.44 $43.44 AFLAC CANCER CARE PLAN CLASSIC - Series A78300

60-75 $50.46 $50.46 18-75 INDIVIDUAL Premium IDR*(5units) SDR* Total
18-75 INSURED/SPOUSE $14.64 $2.70 $0.42 $17.76
18-49 ONE-PARENT FAMILY $30.18 $30.18 18-75 ONE-PARENT FAMILY $24.90 $6.00 $0.78 $31.68
18-75 TWO-PARENT FAMILY $14.64 $2.70 $0.42 $17.76
50-59 $30.42 $30.42 $24.90 $6.00 $0.78 $31.68

60-75 $30.66 $30.66

18-49 TWO-PARENT FAMILY $39.66 $39.66

50-59 $43.68 $43.68 IDR*=Optional Initial Diagnosis Rider SDR*= Optional Specified Disease Rider
(Series A-78050) premium 1-5 units (Series A-78052) premium
60-75 $50.70 $50.70

AFLAC AGENT CONTACT: Alexandra DiBiasi AFLAC Digital Brochures and Rates:
SPS+ Architects Dropbox Access
Cell: 602-369-1000
Email: [email protected] Schedule Enrollment:
https://my.timetrade.com/book/73PZL

PAID TIME OFF (PTO)

Vacation and Sick Leave PTO includes 22 workdays (176 hours) per year,
which increases to 23 workdays (184 hours) per year after four years, to 24
workdays (192 hours) per year after five years, 25 workdays (200 hours) per
year after six years, 26 workdays (208 hours) per year after seven years and
27 workdays (216 hours) per year after eight years of employment. Staff
members will normally use their PTO hours in lieu of the normal 9-hour and
4-hour workdays as occurs.

SPS+ Architects Office will be closed on seven holidays. Employees will
accrue an additional 8 hours of PTO on New Year’s Day - January 1st,
Memorial Day - last Monday in May, Independence Day - July 4th, Labor
Day 1st Monday in September, Thanksgiving - fourth Thursday in November, plus the following Friday
and Christmas Day - December 25th, for a total of 56 hours. Staff members may use 9 hours of their PTO
for a normal workday as occurs, or bank hours during the same week and only use 8 hours PTO.

401K PROFIT SHARING RETIREMENT PLAN AND BONUS:

SPS+ sponsors a 401k Profit Sharing Retirement Plan which is available to all employees upon
employment. Each individual is encouraged to contribute to his or her Plan as much as possible. The
formula for the match is SPS+ will match 100% of the first 3% of pay the employee defers and 50% of

the next 2% the employee defers, which means if the employee defers
5%, SPS+ will match 4%. Of course, the employee may defer up to the
limits established by the IRS for any given year. All employer and employee
contributions are immediately vested.

In addition to the 401k Retirement Plan, the partners may make periodic
or end of the year bonus or profit- sharing distributions to the members of
the firm based on our profitability and their individual contributions,
the efforts they have expended, their attitude and commitment to their
assigned projects, as well as to the success of our organization. While
there is no guarantee that there will be profits for this purpose, the partners
will endeavor to reward the staff efforts and share any profits with them.

SPS+ ARCHITECTS | SCOTTSDALE SPS+ ARCHITECTS | TUCSON
8681 East Via de Negocio 1790 West Sahuaro Drive
Scottsdale, Arizona 85258 Tucson, Arizona 85745
480.991.0800 520.428.1180


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