ATI Benefits Book 2018

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ANNUAL ENROLLMENT
October 1, 2017 is the annual renewal date for the insurance benefits for all full-time, eligible employees of Assessment
Technology Inc. (ATI). If you have in the past declined coverage, either for yourself or your dependents, this is the annual
Open Enrollment period in which to enroll. You may enroll yourself and your dependents at this time for coverage effective
October 1, 2017.
In addition to this Open Enrollment, “Special Enrollment Periods” may be available to you and/or your dependents provid-
ing you request enrollment within 31 days of the qualifying event. The “special enrollment periods” include a loss of other
coverage, marriage, divorce, legal separation, birth, adoption or placement of adoption.
As in years past, ATI continues to strike a balance between absorbing the increasing cost of coverage and controlling employ-
ee out-of-pocket costs. Despite the increasing cost in healthcare, ATI continues to offer employees a competitive benefits
package. ATI will continue to offer the same plan design with Blue Cross Blue Shield of Arizona (BCBSAZ). ATI will continue to
pay 100% of the employee only premium for both the health and dental plans. Employees wishing to enroll dependents will
pay the premium difference. If you are currently enrolled in the health plan, you will automatically continue coverage under
the plan with no need to complete a new enrollment form. If you are a new employee, newly enrolling in the health plan, or
changing your enrollment status by adding or removing dependents, you must complete a new BCBSAZ enrollment form and
turn it in to HR by the enrollment deadline specified by HR.
BENEFIT PLAN ELIGIBILITY
Medical and Dental Insurance: You can enroll your legal spouse or your dependent children to age 26 regardless if they are
married or a full-time student. Voluntary Short-Term Disability: Employee coverage only. Voluntary Life: Self, legal spouse and
dependent children to age 18 or 23 if a fulltime student.
NOTICE OF GRANDFATHERED HEALTH PLAN
ATI believes this BCBSAZ PPO $500 80% plan is a “grandfathered health plan” under the Patient Protection and Affordable
Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve
certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan
means that your BCBSAZ PPO Blue Preferred $500 plan may not include certain consumer protections of the Affordable
Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any
cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable
Care Act, for example, the elimination of lifetime limits on benefits. Questions regarding which protections apply and which
protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health
plan status can be directed to Human Resources. You may also contact the Employee Benefits Security Administration, U.S.
Department of Labor at 1-866-444-3272 or This website has a table summarizing which
protections do and do not apply to grandfathered health plans.
YOUR EMPLOYEE BENEFITS
October 1, 2017 - September 30, 2018 2018
YOUR EMPLOYEE BENEFITS
October 1, 2017 - September 30, 2018
ANNUAL ENROLLMENT
October 1, 2017 is the annual renewal date for the insurance benefits for all full-time, eligible
employees of Assessment Technology Inc. (ATI). If you have in the past declined coverage, either
for yourself or your dependents, this is the annual Open Enrollment period in which to enroll. You may
nroll yourself and your dependents at this time for coverage effectiv October 1, 2017.
In additio to this Open Enrollment, “Special Enrollment Periods” may be available to you and/or your
dependents providing you request enrollment within 31 days of the qualifying event. The “special
e rollment periods” include a loss of other coverage, marriage, divorce, legal separati n, birth, adoption
or placement of adoption.
As in years past, ATI continues to strike a balance between absorbing the increasing cost of coverage
and controlling employee out-of-pocket costs. Despite the increasing cost in healthcare, ATI continues
to offer employees a competitive benefits package. ATI will continue to offer the same plan design with
Blue Cross Blue Shield of Arizona (BCBSAZ). ATI will continue to pay 100% of the employee only
premium for both the health and dental plans. Employees wishing to enroll dependents will pay the
premium difference. If you are currently enrolled in the health plan, you will automatically continue
coverage under the plan with no need to complete a new enrollment form. If you are a new employee,
newly enrolling in the health plan, or changing your enrollment status by adding or removing
dependents, you must complete a new BCBSAZ enrollment form and turn it in to HR by the enrollment
deadline specified by HR.
BENEFIT PLAN ELIGIBILITY
Medical and Dental Insurance: You can enroll your legal spouse or your dependent children to age 26
r gardless if they are married or a full-time student. Voluntary Short-Term Disability: Employee
coverage only. Voluntary Life: Self, legal spouse and dependent children to age 18 or 23 if a fulltime
student.
NOTICE OF GRANDFATHERED HEALTH PLAN