Employee healthcare
Employee healthcareArizona State University offers comprehensive medical insurance plans, as well as dental, vision, pharmacy and health spending accounts. Employees may enroll in these benefits within 30 calendar days of hire, qualified life event or during the annual open enrollment period.
Medical plans
Medical plansASU offers two medical plan options for 2022-23. Within 30 calendar days of your eligibility, hire date, a qualified life event or during the annual open enrollment period, you may enroll in one of the two medical plan options. Both medical plans provide the option to choose Blue Cross Blue Shield or United Healthcare medical networks. Please refer to the eligibility and enrollment section for information about coverage effective dates.
Medical plan options
Download details of the Triple Choice Plan and High Deductible Health Plan.
2022-23 medical plan resources
- Benefits medical plans slides.
- HDHP HSA United Healthcare.
- HDHP summary of benefits and coverage.
- Search for providers.
- Triple Choice Plan United Healthcare.
- Triple Choice summary of benefits and coverage.
2022-23 plan year deductibles and copays
Triple Choice Plan and HDHP with HSA out-of-network benefits are subject to reasonable and customary charges as defined by the insurance industry.
Annual deductibles | |||||
Triple Choice Plan | HDHP with HSA | ||||
Tier 1 in-network | Tier 2 in-network | Tier 3, out-of-network | In-network | Out-of-network | |
Individual | $200 | $1,000 | $5,000 | $1,500 | $5,000 |
Family aggregate | $400 | $2,000 | $10,000 | $3,000 | $10,000 |
Annual out-of-pocket maximum | |||||
Triple Choice Plan | HDHP with HSA | ||||
Tier 1 in-network | Tier 2 in-network | Tier 3, out-of-network | In-network | Out-of-network | |
Individual | $7,350 | $7,350 | $8,700 | $3,500 | $8,700 |
Family aggregate | $14,700 | $14,700 | $17,400 | $7,000 | $17,400 |
Office visits - preventative | |||||
Triple Choice Plan | HDHP with HSA | ||||
Tier 1 in-network | Tier 2 in-network | Tier 3 out-of-network | In-network | Out-of-network | |
PCP | $0 | $0 | 50% after deductible. | $0 | 50% coinsurance after deductible. |
OBGYN | $0 | $0 | 50% subject to deductible. | $0 | 50% coinsurance after deductible. |
Specialist | $0 | $0 | 50% after deductible. | $0 | 50% coinsurance after deductible. |
Non-preventative services | |||||
Triple Choice Plan | HDHP with HSA | ||||
Tier 1 in-network | Tier 2 in-network | Tier 3 out-of-network | In-network | Out-of-network | |
PCP | $20 after a deductible. | $20 after a deductible. | 50% after deductible. | 10% coinsurance after deductible. | 50% coinsurance after deductible. |
OBGYN | $20 after a deductible. | $20 after a deductible. | 50% after deductible. | 10% coinsurance after deductible. | 50% coinsurance after deductible. |
Specialist | $40 after a deductible. | $40 after a deductible. | 50% after deductible. | 10% coinsurance after deductible. | 50% coinsurance after deductible. |
Outpatient services | |||||
Triple Choice Plan | HDHP with HSA | ||||
Tier 1 in-network | Tier 2 in-network | Tier 3 out-of-network | In-network | Out-of-network | |
Ambulance | $0 | $0 | $0 | 10% coinsurance after deductible. | 10% coinsurance after deductible. |
ER | $200 after deductible. Fee is waived if admitted. |
$200 after deductible. Fee is waived if admitted. |
$200 after deductible. Fee is waived if admitted. |
10% coinsurance after deductible. | 10% coinsurance after deductible. |
Urgent care | $75 after deductible. | $75 after deductible. | 50% after deductible. | 10% coinsurance after deductible. | 50% coinsurance after deductible. |
Hospital admissions | |||||
Triple Choice Plan | HDHP with HSA | ||||
Tier 1 in-network | Tier 2 in-network | Tier 3 out-of-network | In-network | Out-of-network | |
Admission | $250 after deductible. | $250 after deductible. | 50% after deductible. | 10% coinsurance after deductible. | 50% coinsurance after deductible. |
International coverage | |||||
Triple Choice Plan | HDHP with HSA | ||||
Tier 1 in-network | Tier 2 in-network | Tier 3 out-of-network | In-network | Out-of-network | |
Coverage for emergency services only. |
Mammogram - preventative | ||||
Triple Choice Plan | HDHP with HSA | |||
Tier 1 in-network | Tier 2 in-network | Tier 3 out-of-network | In-network | Out-of-network |
$0 | $0 | 50% after deductible. | $0 | 50% coinsurance after deductible. |
Durable medical equipment | ||||
Triple Choice Plan | HDHP with HSA | |||
Tier 1 in-network | Tier 2 in-network | Tier 3 out-of-network | In-network | Out-of-network |
$0 | $0 | 50% after deductible. | 10% coinsurance after deductible. | 50% coinsurance after deductible. |
Chiropractic - limited to 20 visits-plan year | ||||
Triple Choice Plan |
HDHP with HSA |
|||
Tier 1 in-network | Tier 2 in-network | Tier 3 out-of-network | In-network | Out-of-network |
$40 after deductible. | $40 after deductible. | 50% after deductible. | 10% coinsurance after deductible. | 50% coinsurance after deductible. |
Radiology | ||||
Triple Choice Plan | HDHP with HSA | |||
Tier 1 in-network | Tier 2 in-network | Tier 3 out-of-network | In-network | Out-of-network |
$100 after deductible. | $100 after deductible. | 50% after deductible. | 10% coinsurance after deductible. | 50% coinsurance after deductible. |
Home health services | |||||
Triple Choice Plan | HDHP with HSA | ||||
Tier 1 in-network | Tier 2 in-network | Tier 3 out-of-network | In-network | Out-of-network | |
Days during plan year. | 42, $0 | 42, $0 | 42, 50% coinsurance after deductible. | 42 days, 10% coinsurance after deductible. | 42 days, 50% coinsurance after deductible. |
Bariatric surgery | ||||
Triple Choice Plan | HDHP with HSA | |||
Tier 1 in-network | Tier 2 in-network | Tier 3 out-of-network | In-network | Out-of-network |
20% | Not covered. | Not covered. | 20% coinsurance after deductible. | Not covered. |
Behavioral health | |||||
Triple Choice Plan | HDHP with HSA | ||||
Tier 1 in-network | Tier 2 in-network | Tier 3 out-of-network | In-network | Out-of-network | |
Inpatient | $250 after deductible. | $250 after deductible. | 50% after deductible. | 10% coinsurance after deductible. | 50% coinsurance after deductible. |
Outpatient primary care | $20 after deductible. | $20 after deductible. | 50% after deductible. | 10% coinsurance after deductible. | 50% coinsurance after deductible. |
Outpatient specialist | $40 after deductible. | $40 after deductible. | 50% after deductible. | 10% coinsurance after deductible. | 50% coinsurance after deductible. |
Medical plan premiums
Medical plan premiums2022-2023 Triple Choice Plan rates per pay period
Coverage level | Employee | Employer |
---|---|---|
Employee only | $26.17 | $351.96 |
Employee, plus spouse | $71.49 | $724.82 |
Employee, plus one child | $57.30 | $471.40 |
Family | $121.61 | $820.71 |
2022-2023 High deductible health plan rates per pay period
Coverage level | Employee | Employer, plus HSA |
---|---|---|
Employee only | $10.15, plus HSA | $237.66, plus $27.69 |
Employee, plus spouse | $30.46, plus HSA | $492.59, plus $55.38 |
Employee, plus one child | $25.89, plus HSA | $321.99, plus $55.38 |
Family | $56.35, plus HSA | $548.80, plus $55.38 |
Medical management
Medical managementCase management
This is a collaborative process whereby a case manager from your designated medical management vendor works with you to assess, plan, implement, coordinate, monitor and evaluate the services you may need. Often, case management is used with complex treatments for severe health conditions. The caseworker uses available resources to achieve cost-effective health outcomes for both the member and the medical plans.
Disease management
The purpose of disease management programs is to reach out to you and your dependents who want help managing their health conditions or information about complex or chronic health conditions. The programs are typically designed to improve self-management skills and help make lifestyle changes that promote healthy living. The following disease management programs are available to all members, regardless of their selected networks:
- Asthma.
- Chronic obstructive pulmonary disease.
- Congestive heart failure.
- Coronary artery disease.
- Diabetes.
- Pregnancy-maternity.
If you are eligible or become eligible for one of the programs above, a disease manager from your designated medical management vendor will assess your needs and work with your physicians to develop a personalized plan. Your personalized plan will establish goals and steps to help you positively change your specific lifestyle habits and improve your health. Your assigned disease manager may provide the following services:
- Assist with understanding your doctor’s treatment plan.
- Help you to maintain your necessary medical tests and annual exams.
- Offer tips on how to manage stress and help control the symptoms of stress.
- Provide tips on how to keep your diet and exercise program on track.
- Review and discuss medications, how they work and how to use them.
Participation is optional, private and tailored to your specific needs. Generally, a disease manager will work with you as quickly or as slowly as you like allowing you to complete the program at your own pace. Over the course of the program, participants learn to incorporate healthy habits and improve their overall health.
Medical management services
When you choose medical coverage, you get more than basic health care coverage. You get personalized medical management programs at no additional cost. Each medical network provides medical management services as follows:
- American Health Holding serves Blue Cross Blue Shield of Arizona network only.
- UnitedHealthcare serves only UnitedHealthcare members.
Professional, experienced staff work on your behalf to make sure you are getting the best care possible and that you are properly educated on all aspects of your treatment.
Nurse Line
A dedicated team of physicians, nurses and dietitians are available 24/7 for member consultations. Individuals needing medical advice or who have treatment questions can call the toll-free nurse line:
- American Health Holding 866-244-8977.
- UnitedHealthcare 800-401-7396.
Utilization management
AHH and UnitedHealthcare provide prior authorization and utilization review when members require non-primary care services. Prior to any elective hospitalization and/or certain outpatient procedures, you or your doctor must contact your designated medical management vendor for authorization. Please refer to your plan document for the specific list of services that require prior authorization. Each vendor has a dedicated line to accept calls and inquiries:
- American Health Holding 866-244-8977.
- UnitedHealthcare 800-896-1067.
Medical plan FAQs
Medical plan FAQsHow do I obtain medical ID cards?
Visit the following carriers online for information about how to obtain your insurance cards.
- BCBS of AZ. If you have a different last name, notify the provider you are covered under the employee listed on the card. Contact BCBS of AZ for confirmation of coverage.
- UHC
How do names appear on issued medical ID cards?
BCBS of AZ issues two cards in the employee’s name only. Additional cards may be obtained. If the employee requires additional cards then the employee will need to contact BCBS of AZ to request the card. For those with different last names, they will need to notify the provider they are covered under that employee listed on the card and to contact BCBS of AZ for confirmation of coverage.
UHC issues separate cards for the employee and each covered dependent in their names.
How do I change my doctor?
An employee enrolled in the Triple Choice Plan(TCP) or HDHP with HSA— BCBS of AZ and United Healthcare—has access to any physician in the network without a referral or without having to notify the plan administrator.
I am turning 65 in October but still plan to work until January. Should I enroll in Medicare and how does it work?
You can defer enrolling in Part B while you are actively employed. You should apply for Part B three months prior to retiring. The SSA will provide you with a form for your employer to verify that you have been covered by a group medical plan. Fax the form to 480-993-0008.
Pharmacy plan
Pharmacy plan
Mail-order pharmacy You may fill your prescription via the MedImpact mail order service. You must submit a 90-day written prescription along with two copayments using the mail service prescription order form. Other forms and services |
Retail pharmacy If you elect and enroll in any medical plan, MedImpact will be the network of drugstores, supermarkets and discount stores for pharmacy benefits to fill prescriptions at a network pharmacy. You will be required to present your medical card in order to have prescriptions filled. The cost of prescriptions filled out-of-network will not be reimbursed. HSA members: Preventive prescriptions have a copay. Nonpreventive prescriptions are subject to a deductible. |
|
Generic $15 retail, 30-day supply $37.50 retail, 90-day supply $30 mail-order, 90-day supply |
Preferred formulary $40 retail, 30 day supply $100 retail, 90 day supply $80 mail-order, 90 day supply |
Nonpreferred, nonformulary $60 retail, 30 day supply $150 retail, 90 day supply $120 mail-order, 90 day supply |
Note: If your doctor prescribes a brand name drug and indicates that the generic equivalent is acceptable, but you decline the generic, you will be responsible for the copay, plus the retail cost of the brand name minus the retail cost of the generic. |
Preventive prescriptions
Some preventive prescriptions will be covered at 100% for the Triple Choice Plan. The HSA will have a copay associated with preventive drugs. Visit MedImpact for details.
Limited prescription drug coverage
Prescription drug coverage will generally be limited to medications that do not have an equally effective over-the-counter substitute. If traveling outside of the U.S., pharmacy benefit coverage applies only to emergencies on a reimbursement basis.
Noncovered drugs
Certain medications are not covered as part of the plan. If you find such a drug has been prescribed for you, discuss alternative treatment with your doctor.
Formulary
The formulary is the list of medications chosen by a committee of doctors and pharmacists to help you maximize the value of your prescription benefit. Formulary changes can occur during the plan year. Medications that no longer offer the best therapeutic value are deleted from the formulary. Ask your pharmacist to verify the current copay amount when your prescription is filled. Sharing this information with your doctor helps ensure you get the best value, which saves you and your plan money.
- Preferred Drug List has commonly prescribed medications within select classes of drugs covered on your formulary. The formulary is updated regularly and is subject to change without advance notice.
- Specialty Drug List is monitored to ensure that employees receive the most clinically effective medications at the lowest cost. The Specialty Drug List is updated regularly and is subject to change without advance notice. All Specialty Drug List medications are provided through a MedImpact Direct Specialty network pharmacy. Members may enroll in services by calling 877-391-1103.
- Essential Health Benefits List, ACA is in compliance with healthcare reform requirements under the Affordable Care Act, certain preventive medications are covered at zero-copay under the pharmacy benefit as needed. State-specific requirements may vary.
- HSA Safe Harbor Preventive Drug List is prescribed for people who are at risk for certain diseases but not yet showing signs and symptoms. These are used to prevent a disease or condition, a complication from a disease, or prevent a recurrence of a condition. These drugs are typically not used to treat an existing illness. You will not pay the full cost of these drugs and the copays will not accumulate to meet the HSA deductible. Only the normal flat dollar copay will apply to these drugs as shown in the list.
Medication prior authorization may require clinical approval before it can be filled, even with a valid prescription. These prescriptions may be limited to quantity, frequency, dosage or may have age restrictions. The authorization process may be initiated by you, your local pharmacy, or your physician by calling MedImpact at 888-648-6769.
Step therapy program promotes the use of safe, cost-effective and clinically appropriate medications. Members use generic, alternative medication that is safe and equally effective before a brand-name medication is covered. Refer to the Formulary Lookup in the MedImpact member portal for a complete list of drugs under this program.
MedImpact member portal benefits
- Determine drug coverage and obtain a cost estimate for a selected medication.
- Find a pharmacy without registration. Select General Pharmacy Locator.
- Health tips plus info on diseases and health conditions.
- Personal Health Rx® – Print your prescription history for a physician visit or tax reporting.
- Pharmacy locator – Find a participating pharmacy near you.
- Research more than17,000 medications.
- View your current copayment amounts and other pharmacy benefit considerations.
Mayo Clinic medical networks
Mayo Clinic medical networksOne of the advantages of our medical plans is access to the Mayo Clinic, hospital and providers. Under the Triple Choice Plan, each provider may be placed into a different tier by the two networks—Blue Cross Blue Shield or UnitedHealthcare. Here's what you need to understand about this coverage.
Blue Cross Blue Shield
The Blue Cross Blue Shield network offers all providers in the Mayo Clinic health system in Tier 1 for the TCP Plan. Similarly, all providers in the Mayo system are in-network on the High Deductible Health Plan. The Mayo Clinic health system includes multi-specialty community clinics, physicians, durable medical equipment suppliers, general acute care hospitals and transplant centers.
Some Mayo Clinic physicians have elected not to be shown in the directory and will not appear in a provider search. Most elect not to be shown because they may not be accepting new patients or just want to be assigned patients by the clinic instead of members requesting the provider. These providers are still considered Tier 1 providers.
UnitedHealthcare
All Mayo Clinic providers are in-network for the Triple Choice Plan and for the High Deductible Health Plan. However, not all providers are Tier 1 for the TCP. UHC evaluates physicians individually. Services under the TCP will be processed based on the individual Mayo provider’s tier as indicated on UHC’s website, and will not automatically fall under Tier 1 as was previously communicated.
General tier information - not Mayo specific
Tier 1 providers and facilities
These in-network providers and facilities are always considered Tier 1 for both networks:
- Ambulance services.
- Behavioral health, mental health and substance abuse services
- Chiropractors.
- Emergency room.
- General acute care hospitals in Arizona.
- Surgery services that require the use of a Centers of Excellence, UHC, or BlueDistinction Specialty Care, BCBSAZ.
- Telehealth services or virtual visit providers including Doctor on Demand, Amwell, Teladoc and BlueCare Anywhere.
The websites for both networks show the proper tier status for each provider. If a provider is in Tier 1, the status will not change throughout the calendar year. If during the calendar year, a Tier 2 provider meets the qualifications to become a Tier 1 provider, the status can be updated midyear.
Both UHC and BCBS have nationwide networks of providers. UHC has designated Tier 1 providers throughout their network. BCBS providers may not have a Tier 1 designation outside of Arizona. If you are looking for a Tier 1 provider for BCBS outside of Arizona, please look for the BlueDistinction Center + symbol as an indicator of the Tier 1 status.
Use the following custom websites and phone numbers for our plans to find a provider:
Blue Cross Blue Shield or 866-287-1980
UnitedHealthcare or 800-896-1067
Partnership
Arizona State University is pleased to partner with Mayo Clinic to bring its employees options for in-network access to Mayo Clinic’s integrated medical expert teams.
You and your dependents can receive the very best health care from some of the nation’s leading physicians at Mayo Clinic who are contracted with all medical networks – Blue Cross Blue Shield of Arizona and United Healthcare. Mayo Clinic and ASU have developed a strong collaborative partnership over the past several years, working together on a wide range of joint initiatives, including:
- An ASU Nursing program on Mayo Clinic’s Phoenix campus.
- Dual degree programs, including M.D., J.D., M.D., MBA and bioinformatics
- Multiple collaborative research projects
Mayo Clinic is known for its unique, integrated approach, with physicians working together as a team on behalf of patients and their families. Since expanding to Arizona in 1987, Mayo Clinic evolved into the Valley’s premier academic medical center, serving over 100,000 patients each year. Mayo delivers healthcare services in more than 65 medical and surgical specialties, including nationally recognized cancer treatment and organ transplantation programs.
Mayo also has outstanding programs in medical education and research, including clinical trials led by world-class Mayo Clinic investigators that allow eligible participants access to new research treatments in addition to playing an active role in their own healthcare. Mayo Clinic has several facilities located throughout the valley.
Visit the Mayo Clinic for more information.
Appointments
Call 480-301-8484 or 800-446-2279.
Request an appointment online.
In some cases, your insurance plan will require a physician referral.
Locations
Mayo Clinic Family Medicine | Thunderbird
92nd St. and Thunderbird
- Cardiac rehab.
- Newborn and pediatric care.
- Obstetrical care.
- Primary care.
- Women’s health, internal medicine
Mayo Clinic Family Medicine | Arrowhead at 75th and Glendale avenues
- Anticoagulation monitoring.
- Laboratory.
- Newborn and pediatric care.
- Primary care.
- X-rays.
Mayo Clinic | Phoenix campus at 56th Street and Mayo Boulevard.
- Mayo Clinic Hospital, inpatient care.
- Mayo Clinic Specialty Building, outpatient.
Mayo Clinic | Scottsdale campus at 134th Street and Shea Boulevard.
- Mayo Clinic Building – outpatient specialty care
- 240 exam rooms, pharmacy
Dental plans
Dental plansWithin 30 calendar days of your eligibility-hire date or a qualifying life event or during the annual open enrollment period, you may enroll in one of the two dental plan options. There are two plan types: prepaid-dental health maintenance organization and the indemnity-preferred provider organization.
How to choose the best dental plan for you and your family.
When choosing between a prepaid DHMO plan and an indemnity PPO plan, you should consider the following: Dental history, level of dental care required, costs-budget and provider in the network.
Make sure your current dentist participates in the plan you are considering.
2023 dental plans
Prepaid-DHMO Plan, UnitedHealthcare Solstice S800B
UHC Solstice dental member services 844-208-0223. Each family member may choose a different general dentist. You can select or change your dentist by visiting the Solstice directory. Select Find a Provider, select S800B plan, select a specialty, enter your ZIP code and select Search Providers. The following list of states and territories are not covered under the UHC DHMO plan: Alabama, Alaska, Arkansas, Delaware, Idaho, Iowa, Louisiana, Maine, Mississippi, Montana, Nebraska, New Hampshire, North Dakota, Oklahoma, Rhode Island, South Dakota, Vermont, West Virginia, Wyoming, Guam, Puerto Rico and US Virgin Islands. |
Indemnity-PPO Plan, Delta Dental PPO Plus Premier
Delta Dental claim form 800-352-6132. More than 85% of Arizona’s licensed dentists participate in the Delta Dental PPO Plus Premier plan and agree to accept Delta’s allowable fee as payment in full after any deductibles or copayments are met. Amounts billed by network providers in excess of the allowable fee will not be billed to the patient. If you see a non-participating dentist, Delta will still provide benefits, although typically at reduced levels. You may need to submit a claim form for eligible expenses to be paid. |
2023 dental plans comparison
2023 dental plan rates per pay period
UHC Solstice - DHMO | Delta Dental - PPO | |||
---|---|---|---|---|
Coverage level | Employee | Employer | Employee | Employer |
Employee only | $1.64 | $2.29 | $14.30 | $2.29 |
Employee, plus spouse | $3.29 | $4.58 | $30.33 | $4.58 |
Employee, plus one child | $3.08 | $4.58 | $23.34 | $4.58 |
Family | $5.46 | $6.32 | $48.26 | $6.32 |
2023 plan year deductibles and copays
UHC Solstice | Delta Dental | |
---|---|---|
Plan year deductibles | None | $50, $100 or $150 |
Annual combined basic and major service | No dollar limit | $2,000 per person |
Orthodontia lifetime | No dollar limit | $1,500 per person |
Preventive Care Class I | UHC Solstice | Delta Dental |
---|---|---|
Oral exam | $0 | $0 Deductible waived1 |
Emergency exam | $35 after-hours office visit | $0 Deductible waived1 |
Prophylaxis - cleaning | $0 | $0 Deductible waived1 |
Fluoride treatment | Without varnish: $0 | With varnish: $20 | $0 to age 18 deductible waived |
X-rays | $0 | $0 Deductible waived |
Other services | UHC Solstice | Delta Dental |
---|---|---|
Sealants | $0 | 20% to age 19 |
Fillings | Amalgam: $16 | Resin: $37 | 20% |
Extractions | Simple: $35 | Surgical: $105 | 20% |
Periodontal gingivectomy | $119 for one-three teeth | $180 for four or more teeth | 20% |
Oral surgery | $25 - $270 | 20% |
Crowns | $195 - $290, plus lab and material | 50% |
Dentures | $485 - $502 | 50% |
Fixed bridgework | $290, plus lab and material per unit | 50% |
Crown or Bridge repair | $80 - $95 | 50% |
Implant body | $795 | 50%2 |
Orthodontia | $1,375 - $2,875 | See lifetime |
TMJ exam and services | $150 - $250 | Not covered |
External bleaching | $30 - $240 | Not covered |
1Routine visits, exams and cleanings, and fluoride treatments are covered two times per plan year at 100%. Emergency exams are covered once per plan year at 100%. Bitewing and periapical X-rays are covered once per plan year at 100%.
2Subject to both the benefit year allowance and the lifetime maximum limit, $1,000 per tooth. Subject to all provisions, terms and conditions of the plan description.
Dental plan FAQs
How can I choose the best dental plan for my needs?
When choosing between a prepaid or DHMO plan and an indemnity or PPO plan, consider the following: dental history, level of dental care required, costs and budget and a provider in the network. If you have a preferred dentist, make sure he or she accepts the plan you are considering.
Is my dentist in-network?
DHMO Plan | UnitedHealthcare Solstice
UnitedHealthcare Solstice providers are located nationwide, except for in Alabama, Alaska, Arkansas, Delaware, Idaho, Iowa, Louisiana, Maine, Mississippi, Montana, Nebraska, New Hampshire, North Dakota, Oklahoma, Rhode Island, South Dakota, Vermont, West Virginia, Wyoming, Guam, Puerto Rico and US Virgin Islands.
- Visit UnitedHealthcare Solstice. Select Find a Provider at top of the screen.
- Make sure Dental is selected.
- Select plan: S800B.
- Select a Specialty.
- Enter a ZIP code and search area.
- Check the box I'm not a robot and then select Search Providers.
If you have a current dentist, they could be in-network. Call their office and ask if they are contracted in the UnitedHealthcare Solstice S800B network.
PPO Plan | Delta Dental
More than 85% of Arizona’s licensed dentists participate in the Delta Dental Plan and agree to accept Delta’s allowable fee as payment in full after any deductibles or copayments are met. Amounts billed by network providers in excess of the allowable fee will not be billed to the patient.
- A maximum annual benefit of $2,000 will exclude Preventive Class I services, which include office visits, oral exams, cleaning, fluoride treatments and x-rays.
- Benefits may be based on reasonable and customary charges.
- Deductible or out-of-pocket payments apply.
- There is a maximum lifetime benefit of $1,500 per person for orthodontia.
- You have a maximum benefit of $2,000 per person per plan year for dental services.
- You may see a licensed dentist anywhere in the world.
- You may need to submit a claim form for eligible expenses to be paid.
- Visit Delta Dental and set up an ID and password to have access to the Delta online features.
When should I receive my ID card?
New enrollees should receive a card within 10 to 14 business days after the benefits become effective.
Vision plans
Vision plansWithin 30 calendar days of your eligibility-hire date, a qualifying life event, or during the annual open enrollment period, you may enroll in the Avesis Advantage Program.
Please refer to the Enrollment and Administration section for information about coverage effective dates.
Avesis Advantage Program
Employees are responsible for the full premium of this voluntary plan.
Program highlights
- Extensive provider access throughout the state.
- $750 maximum allowance for LASIK surgery.
- Hearing discount plan.
- Increased in-network contact lens allowance.
- Unlimited discounts on additional optical purchases.
- Yearly coverage for a vision exam, glasses or contact lenses.
How to use the Advantage Program
Visit Avesis to find a provider. Using in-network providers allows you to maximize your vision care benefit. Next, schedule an appointment with your chosen provider for services and identify yourself as an Avesis member employed by the state of Arizona.
Out-of-network benefits and claim form
If services are received from a non-participating provider, you will pay the provider in full at the time of service and submit a claim to Avesis for reimbursement. The out-of-network claim form and itemized receipt should be sent to Avesis within three months of the date of service to be eligible for reimbursement. The Avesis claim form can be obtained at the website. Reimbursement will be made directly to the member.
Avesis benefits details
In-network benefits |
|
Avesis Vision Plans | Advantage Vision Care |
Frequency and copay | |
Examination frequency | Once every 12 months |
Lenses frequency | Once every 12 months |
Frame frequency | Once every 12 months |
Examination copay | $10 copay |
Optical materials copay - lenses and frames combined | $0 |
Standard spectacle lenses | |
Single vision lenses | 100% covered |
Bifocal lenses | 100% covered |
Trifocal lenses | 100% covered |
Lenticular lenses | 100% covered |
Standard progressive lenses | Covered up to $50, plus 20% off retail |
Selected lens tints and coatings | Up to 20% discount |
Frame | |
Frame | Covered up to $100 to $150 retail value - $50 wholesale cost allowance |
Contact Lenses - in lieu of frame-spectacle lenses |
|
Elective | 10% to 20% discount and $150 allowance |
Medically necessary | 100% covered |
Lasik-PRK | |
Lasik-PRK |
$750 maximum allowance for one or both eyes. This benefit is in addition to the corrective eyewear benefit. |
Out-of-network benefits |
|
Avesis Vision Plans | Advantage Vision Care |
Frequency and copay | |
Examination frequency | Once every 12 months |
Lenses frequency | Once every 12 months |
Frame frequency | Once every 12 months |
Examination | Up to $50 reimbursement |
Standard spectacle lenses | |
Single vision lenses | Up to $33 reimbursement |
Bifocal lenses | Up to $50 reimbursement |
Trifocal lenses | Up to $60 reimbursement |
Lenticular lenses | Up to $110 reimbursement |
Standard progressive lenses | Up to $60 reimbursement |
Selected lens tints and coatings | No benefit |
Frame | |
Frame | Up to $50 reimbursement |
Contact Lenses - in lieu of frame/spectacle lenses |
|
Elective | Up to $150 reimbursement |
Medically necessary | Up to $300 reimbursement |
Lasik-PRK | |
Lasik-PRK |
Up to $750 reimbursement |
International coverage | Covered as out-of-network. Reimbursed based on the Avesis reimbursement schedule. |
Vision Premiums
Advantage Vision Care
Pay Period | Monthly | |||
---|---|---|---|---|
Employee | University | Employee | University | |
Employee | $1.72 | N/A | $3.73 | N/A |
Employee and spouse | $5.70 | N/A | $12.35 | N/A |
Employee and one child | $5.65 | N/A | $12.24 | N/A |
Family | $7.11 | N/A | $15.41 | N/A |
Health care accounts
Health care accountsEnroll in one of three health care accounts within 30 calendar days of your eligibility or hire date or a qualifying life event or during the annual open enrollment period.
- Health care flexible spending account.
- Optum health savings account.
- Limited health care flexible spending account.
You contribute on a pre-tax basis and then reimburse yourself on a tax-free basis for eligible expenses. Refer to the eligibility and enrollment section of the benefits guide for details about coverage effective dates.
Note: In order to enroll in the HSA Option, you must elect the High Deductible Health Plan medical plan. If you are an HSA option medical plan participant, your FSA election is limited to a limited health care flexible spending account for dental and vision expenses only. The IRS will not allow the submission of the same eligible expenses to both an HSA and a Health care FSA in the same plan year.
Flexible spending account
Flexible spending accountHealth care flexible spending account and limited health care flexible spending account
An FSA allows you to use pre-tax dollars for health care expenses not covered by your insurance. It reduces your taxable income, which saves you money. Eligible health care expenses can be reimbursed by submitting claims and supporting documentation to the claims administrator, ASIFlex. Some health care expenses can be paid at the point of service with an ASIFlex-issued debit card. More information on the debit card and documentation requirements can be found on the ASIFlex Debit Card website.
New enrollment is required each year during the annual open enrollment period for the next calendar plan year, January to December. If you elect a limited health care flexible spending account, reimbursement is restricted to dental and vision expenses.
Contribution limits for plan year 2023
- You may contribute up to $3,050 to pay uninsured, eligible health care expenses for both you and your tax-qualified dependents each calendar year, January to December.
- If you and your spouse both work and a plan is offered by both employers, you can each contribute $3,050.
- Your contributions cannot exceed $3,050 for the calendar year. If you contributed to another employer’s FSA during the calendar year, you will need to take those contributions into consideration when selecting a contribution amount with ASU.
Use-it-or-lose-it-rule
Any unused balance, up to $610, remaining in the participant’s FSA at the end of the 2023 plan year will be carried over to the 2024 plan year for reimbursement of medical care expenses incurred during the subsequent plan year.
Participants should estimate their expenses carefully using ASIFlex’s tax savings calculator. Claims must be submitted by April 30 each year for FSA-eligible expenses incurred in the previous calendar year.
Employment ineligibility or separation
If you become ineligible during the plan year, your deductions and participation will cease. Your last deduction will be withheld from the paycheck issued for the pay period in which you became ineligible. Claims for eligible expenses incurred during the plan year must be submitted by April 30, following the end of the plan year.
FSA resources
- ASIFlex debit card information.
- Account balance and availability, ASIFlex.
- FSA claim form.
- FSA Plan Document.
Health savings account
Health savings accountOptum health savings account
HSA monies are used to pay uninsured health care expenses for you and your tax-qualified dependents using a debit card. Fees may apply for using the savings account. Optum is required under Section 326 of the USA Patriot Act to confirm some of your personal information to establish your account.
If you misplace or did not receive your welcome packet, enroll online. Select Open an HSA at the top of the webpage. Call Optum Bank at 866-610-4839 for any additional assistance. The group number is A04791AS.
Eligible participants can enroll, increase, decrease or stop contributions to their health savings account at any time by submitting a completed HSA payroll deduction authorization form to HR benefits online or fax the form to 480-993-0007. The annual election amount remains in effect until a new HSA payroll deduction authorization form is completed and submitted to HR Benefits. HSA funds roll over from year-to-year.
Contributions and annual election amounts are as follows below:
- Participants cannot have any health insurance other than an HDHP to be able to contribute pre-tax dollars to their HSA.
- Participants no longer can contribute pre-tax dollars to their HSA if enrolled in Medicare part A or B.
- Participants may continue to withdraw funds from their HSA to help pay for medical expenses after enrollment in Medicare.
- Payroll-deducted contributions are withheld on a pre-tax basis and will be effective on the first day of the pay period following receipt of the completed form.
- The contribution remains in effect until a new authorization is received or until coverage in the High Deductible Health Plan medical plan ends.
- The annual election amount is divided by the number of biweekly pay dates in the calendar year. If effective the first pay period that ends in January, the amount is divided by 26.
- For faculty paid more than nine months during an academic year, no contributions are made during the summer. Upon return to work during the fall, the annual election remaining balance is divided by the number of pay dates remaining in the calendar year.
Contributions limits
Annual contribution limits are established every year by the IRS based on the HSA medical option plan level of coverage. It is each participant’s responsibility to manage contributions in accordance with federal guidelines to ensure that contributions do not exceed the limits.
2023 HSA IRS annual maximum contributions | University annual mandatory contributions | Employee annual voluntary contributions under 55 years old | Employee annual voluntary contributions age 55 or older - additional $1,000 |
---|---|---|---|
Single coverage: $3,850 | Up to $720 | Up to $3,130 | Up to $4,130 |
Non-single coverage $7,750 | Up to $1,440 | Up to $6,310 | Up to $7,310 |
2022 HSA IRS annual maximum contributions | University annual mandatory contributions | Employee annual voluntary contributions under 55 years old | Employee annual voluntary contributions age 55 or older - additional $1,000 |
---|---|---|---|
Single coverage: $3,650 | Up to $720 | Up to $2,930 | Up to $3,930 |
Non-single coverage $7,300 | Up to $1,440 | Up to $5,860 | Up to $6,860 |
Family assistance and reimbursements
Family assistance and reimbursementsASU offers three resources to benefits-eligible employees and their families during important stages of their lives. We provide financial support to help offset the high cost of adoption, fertility services and gender-affirming medical care.
ASU recognizes that you may need to be away from work for an extended period as a result of these services and events. Read our leave of absence guide for information about requesting a leave of absence.
Adoption benefits
ASU provides a one-time reimbursement to assist with adoption expenses. To request a reimbursement, please complete an adoption benefits request.
- Amount: $2,500.
- Tax: Only subject to FICA taxes.
- Usage: One reimbursement per family for each adopted child.
- Who is eligible: Benefits-eligible employees. Review our adoption benefits policy for more eligibility details.
- Timeframe: Available for adoptions finalized on or after July 1, 2019. Submit your request within six months of the adoption’s finalization.
Medical care reimbursements
ASU provides reimbursement for fertility services and gender-affirming medical care through Navia Benefits Solutions. To request reimbursement through Navia, follow these steps.
- Incur services and allow your service provider to submit the claim to your health insurance provider.
- When your claim is denied by the insurer, contact the Employee Service Center to ask for a reimbursement. For privacy, do not include documentation of services in this communication.
- An HR benefits partner will contact you with instructions and information about submitting a confidential claim to Navia Benefits Solutions, the administrator of these two reimbursements.
For additional help, please contact the Employee Service Center.
Fertility benefits
Reimbursement is available to assist with fertility expenses not currently covered by the Arizona Department of Administration health care plan.
- Amount: $2,500.
- Tax: Tax-free.
- Usage: Per-family maximum lifetime benefit.
- Who is eligible: Benefits-eligible employees and dependents enrolled in an ASU medical plan. Review our fertility benefits subsidy policy for more eligibility details.
- You must exhaust your annual deductible before receiving this benefit if you are enrolled in a High Deductible Health Plan.
- Timeframe: Available for fertility services or prescriptions received on or after July 1, 2019. Submit your request within six months of receiving services or prescriptions.
Gender-affirming medical care
Reimbursement is available for gender-affirming medical care services not currently covered by the Arizona Department of Administration health care plan.
- Amount: $10,000.
- Tax: Tax-free.
- Usage: Per-person maximum lifetime benefit.
- Who is eligible: Benefits-eligible employees and dependents enrolled in an ASU medical plan.
- You must exhaust your annual deductible before receiving this benefit if you are enrolled in a High Deductible Health Plan.
- Timeframe: Available for medical services performed on or after Jan. 1, 2023.