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Benefit Plan Documents and Policies
Benefit plans are governed by detailed plan descriptions and policies. In addition, medical plan are required to provide plan participants Summaries of Benefit Coverage. The following documents, policies and summaries are provided for your review.
Benefit programs are subject to change without prior notice, as determined by changes in federal or state laws or regulations, policies of the Arizona Board of Regents, Arizona Department of Administration rules, determinations by Northern Arizona University or plan changes implemented by benefit providers.
| NAU Plan Documents | |
|---|---|
| NAU BCBSAZ Summary of Benefits and Coverage (SBC) | 2021 NAU BCBSAZ PPO SBC 2021 NAU BCBSAZ HDHP\HSA 2020 NAU BCBSAZ PPO SBC 2020 NAU BCBSAZ HDHP\HSA 2019 NAU BCBSAZ PPO SBC 2019 NAU BCBSAZ PPO SBC in Spanish |
| Plan Certificate and Change Documents | 2021 BCBSAZ PPO Plan Changes 2020 BCBSAZ PPO Benefit Book 2020 BCBSAZ HDHP/Saver Benefit Book 2020 BCBSAZ PPO Plan Changes 2018 BCBSAZ PPO Plan Rider |
| Other Documents | Precertification Requirements for Medical Services NAU BCBSAZ Change Sheet, COVID-19 Notice NAU BCBSAZ PPO Active Employee Plan Disclosure |
| Short Term Disability | Unum STD |
| Flexible Spending Account (ASI Flex) | FSA Plan Description |
| Life Insurance - NAU | The Hartford (formerly Aetna) Employee Plan Doc The Hartford (formerly Aetna) International Employee Plan Doc |
| State of Arizona Plan Documents | |
|---|---|
| Medical Summary of Benefits and Coverage (SBC) | 2021 State TCP 2021 State HDHP/HSA 2020 State PPO 2020 State PPO Spanish SBC 2020 State EPO 2020 State EPO Spanish SBC 2020 State HDHP/HSA 2020 State HDHP/HSA Spanish SBC State Medical Plan Policies |
| Delta Dental | State Dental Plan Policies |
| Life Insurance | 2020 Securian. 2019 The Hartford |
| Short Term Disability | 2020 MetLife 2019 The Hartford |
| Long Term Disability | ASRS LTD with Broadspire ORP and PSPRS LTD with MetLife |
| Retirement Plans | ASRS ORP PSPRS 457 403b Adoption Agreement |
| Retiree Accumulated Sick Leave (RASL) | RASL Plan Description |
| Leaves of Absence |