Benefits

Overview of PCSD Benefits: Benefits Summary 2022-23

Benefits will be offered to employees who are working a minimum of 20 hours per week or .50 FTE (Full Time Equivalency) and work in a benefits eligible position. Employees working in Instructional Assistant I & II positions must work a minimum of 30 hours per week or .75 FTE to be eligible for benefits. Benefits premiums are prorated for FTE. Benefits are effective the first day of the month following the employees hire date.

Employees are not automatically enrolled in any insurance benefits. Employees must make benefits elections through www.employeenavigator.com within 30 days of your hire date. If you do not make your elections within this 30 day window, benefits will automatically waive until the next open enrollment period or QLE (qualifying life event).
PCSD currently pays 100% of the Family premium for the QHDHP/HSA, Silver 70/30, Dental and Single Vision coverage for full-time employees (1.0 FTE or 40 hours per week). Two Party and Family Vision coverage is available at reduced group rates.

The District provides a life insurance policy equal to annual base salary rounded to the nearest thousand dollars to a maximum of $110,000 at no cost to employees; and two thousand dollars of life insurance on your legal dependents. Supplemental voluntary life insurance is available at an additional cost to the employee at reduced group rates.

If an employee is working less than 1.0 FTE, the District will pay the FTE equivalent of the premium and the employee will be responsible for the remainder. (Example: For an employee working .75 FTE or 30 hours per week, the District pays 75% of premium and the employee contributes via automatic payroll deduction the remaining 25%).

Employees must login to www.employeenavigator.com to report a qualifying life event. The District benefits office must receive notice of the change from employee navigator by the 10th of the month in order to be reflected in the current month’s payroll. Changes received after the 10th of the month will be reflected in the following month’s payroll.

The PCSD will allow terminations as provided in insurance carriers’ group service agreements. Benefits will remain in place until the end of the month in which the employee last worked. Employees may have a COBRA option to continue insurance coverage and will receive additional information following termination.

2022-23 Insurance Rates

• Gold: Schedule of Benefits/Grid – Summary of Benefits and Coverage
• Silver: Schedule of Benefits/Grid – Summary of Benefits and Coverage
• Bronze: Schedule of Benefits/Grid – Summary of Benefits and Coverage
• QHDHP/HSA: Schedule of Benefits/Grid – Summary of Benefits and Coverage

Information

• Delta Dental Benefits
• Opticare of Utah Benefits
• Cafeteria Plan Benefits
• Medicare Creditable Coverage

Medical insurance is provided to you and your dependents at no cost to you! (Full-time eligible employees). Coverage is available with a contribution to eligible part-time employees working a minimum of 20 hours a week. 30 hours for Instructional Asst. I & II.

PEHP
Address: 560 East 200 South, Salt Lake City, UT 84102
Customer Service: 801-366-7555 or 800-765-7347 or use the Message Center 
Preauthorization:  801-366-7755
Wellness: 801-366-7300
WeeCare: (801) 366-7400
Web Site: www.pehp.org
Network: Summit Exclusive

Note: the Wise-Network is for in-network providers in Utah. The out of state network is the First Health Network.

• Find a PEHP Provider
• Summary Plan Document

Dental insurance is provided to you and your dependents at no cost to you! (Full-time eligible employees). Coverage is available with a contribution to eligible part-time employees working a minimum of 20 hours per week. 30 hours for Instructional Asst. I & II.

Delta Dental
Address: PO Box 1809, Alpharetta, GA 30023
Group #: 03268
Phone: 800-510-9915
Fax: 801-575-5171
Web Site: www.deltadentalins.com

• Benefit Highlights for Delta Dental
• Dental Cards

Vision insurance is provided at no cost to you! (Full-time eligible employees). Coverage is available to your dependents for a nominal contribution.

Opticare of Utah
Address: 1901 W. Parkway Blvd, SLC, Utah 84119
Group #: 130CC
Phone: 800-363-0950
Web Site: www.opticareofutah.com

• Vision Plan Summary
• Select Network Providers
• Broad Network Providers
• Provider Location
• Opticare Out-of-Network Reimbursement

This notice has information about your current prescription drug coverage with Park City School District 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.

Medicare Prescription Drug Coverage

A 125 flexible spending cafeteria plan is provided for all benefits eligible employees to utilize pre-tax dollars to pay for out of pocket medical, prescription, dental, day care etc. expenses. A debit card is provided at no cost to you when you enroll in this tax savings plan.

National Benefit Services
Address: 8523 South Redwood Road, West Jordan, Utah 84088
Mailing Address: National Benefit Services, PO Box 6980, West Jordan, Utah 84084
Phone: 800-274-0503
Fax: 801-330-2631
Web Site: www.nbsbenefits.com

www.irs.gov/forms-pubs/about-publication-969

• Benefit Access Portal
• Cafeteria Plan
• Eligible 125 Flexible Spending Account Expenses
• NBS (Flex Spending) Change of Status
• Examples of Eligible Expenses
• Changes to Eligible OTC Expenses
• NBS Orthodontic Expense Worksheet

Health Reimbursement Account

• Plan Highlights
• Plan Document
• Summary Plan Description
• Claim Form
• Eligible Expenses

A life insurance policy, equivalent to your annual salary, is provided at no cost to you! (All benefits eligible employees). Each of your dependents is also provided with a $2000 life insurance policy. Supplemental life insurance policies are available for you and your dependents to purchase at a reduced group rate.

LifeMap

LifeMap Assurance Company®
P.O. Box 1271 M/S E8L
Portland, Oregon 97207-1271
1 (800) 794-5390 https://lifemapco.com

• Evidence of Insurability

• Travel Assistance Program
• Employee Assistance Program

AFLAC

Phone: 801-265-1783
Web Site: www.aflac.com

Educators’ Mutual Insurance Association

Phone (toll free): 800-662-5851
Phone: 801-262-7475
Web Site: www.educatorsmutual.com

Physician’s Mutual

Phone: 877-602-0930
Web Site: www.physiciansmutual.com

Utah Retirement Systems

Phone (toll free): 800-365-8772
Phone: 801-366-7700
Web Site: https://www.urs.org

NBS Benefits – 403(b)

Universal Availability Notice

RxBenefits (Pharmacy Benefits Manager)

Member Service is Available:       

Monday-Friday from 6:00 AM – 7:00 PM Mountain Time

Member Services is available to assist members with any questions or concerns regarding their pharmacy benefits, such as:

• Benefit Details
• Claims Status
• Pharmacy Network
• Coverage Determination/Inquiries
• Mail & Specialty Scripts
• Pharmacy Information 

Phone:  1.800.334.8134

Email:  RxHelp@rxbenefits.com

Washington National Insurance Company

Phone (toll free): 800-628-6428
Web Site: www.washingtonnational.com