Medical

Medical opt out incentive

I don't need City medical. Do I receive an incentive for waiving?

Benefits-eligible City of Tucson employees who waive City medical may be eligible to receive up to $960/year by requesting the Medical Opt Out incentive. 

Submitting Your Request

  • In Workday, go to Menu (upper left) > Requests > Create Request > All > Medical opt out 
  • Complete the request form
  • Upload recent proof of your non-City of Tucson medical insurance. Proof must be dated within the 60 days immediately preceding the date your City insurance otherwise would begin and must include your first and last names as they appear in Workday. 
    • See the Workday Opt Out Request form for additional requirements.

DEADLINES

  • For the new plan year - July 31
  • New hires - last day of the month during which your insurance benefits begin

Finding Care

Know before you go

Know Before You Go | Sepa antes de ir

  • You'll generally save money by using virtual care or a CVS clinic instead of going to urgent care or the ER.
  • You'll also save when you have your lab work done at network labs like LabCorp or SonoraQuest rather than in hospital or outpatient settings.

AZBlue customer care

Virtual Care

Virtual Care | Atención Virtual

  • Care from board-certified doctors and licensed counselors to diagnose, treat and prescribe medicine for common, non-emergency medical, mental and behavioral issues
  • Log in to azblue.com/member, click on Find Care, then select Telehealth.
  • Telehealth from AZ Blue customer service line: 1-844-606-1612

High Deductible Plan with HSA

HSA - Why choose it?

  • Visit any provider
    • National coverage
    • No referrals or PCP selection (primary care provider) required
    • You generally pay less by visiting providers in the network
    • As with all City plans, preventive care is covered 100%

  • Pay less from your paycheck

  • Free money

    • The City gives employees money each year to help pay for care received
      • $1,500 annually if you're single or $3,000 annually if you're covering dependents (prorated for part-year enrollment)
      • You can use the money for IRS qualified health expenses, including medical, dental, vision and Rx
    • Retirees don't receive a City contribution to their HSA accounts but may be able to make personal bank account contributions - Make sure you're eligible by checking with your tax consultant

  • Money is yours to keep

    • Unused funds roll over year to year - no "use or lose it" penalty
    • You keep the money, even after you leave the plan, and can continue using it to pay for COBRA premiums or qualified health expenses 

  • Tax savings

  • Investment potential

  • Save for retirement

    • They also can provide additional retirement savings: After age 65, funds can be withdrawn for any purpose without penalty
1 Assumes care is received in-network

HSA - What you need to know

Higher deductible: $2,000 individual/ $4,000 family1

  • You generally pay 10% after you meet the deductible, until you reach the annual out-of-pocket maximum ($3,000 individual/$6,000 family)1
  • You pay 100% for prescriptions, until you meet the deductible
    • This can be a challenge if you take expensive medications
  • Not everyone is eligible to make and receive HSA contributions
    Although benefits-eligible employees and retirees may join the high deductible health plan with HSA, you may not be eligible to make and/or receive contributions to the associated HSA Bank account that is opened on your behalf when you join the plan:
    • You must have a valid SSN and a U.S. primary residence
    • You cannot be covered by any other type of health plan, including Medicare A or B
    • You cannot be covered by TriCare or a general purpose health care flexible spending account (FSA)
    • You cannot have received medical benefits from Veterans Administration for any non-service-connected disabilities at any time during the previous 3 months
    • If you have a second insurance (like through a spouse), it must also meet IRS definition of qualified high-deductible health plan
    • You cannot be claimed as a dependent on another person's tax return (unless it's your spouse)
  • If you make or receive contributions to an HSA when you are not eligible, you'll face tax consequences and potentially a penalty. The IRS considers these contributions to be excess, and they are subject to income tax and an additional 6% penalty for the year of the excess contribution. Visit the excess contribution section of IRS Publication 969 for details.

  • Your contribution limit may be less than the published annual IRS limit
    • The IRS may reduce your HSA contribution limit based on factors including, but not limited to, the following:
      • Medicare A and/or B enrollment
      • If you were considered an "Eligible Individual" under IRS regulations
      • Level of coverage (single or family)

    • For details, visit the IRS Publication 969 and each year's HSA Limitation Chart and Worksheet in IRS Form 8889 instructions.

  • Until you're 65, don't use the funds for anything other than IRS-qualifying health care expenses, or you'll pay taxes and a penalty
    • After age 65, funds can be withdrawn for any purpose penalty-free
  • You'll receive a couple of tax forms each year (1099-SA and 5498-SA), and you'll have to file Form 8889 with your tax return to calculate taxes you may owe for non-qualified purchases

Visit HealthEquity's HSA Guide for additional details.

1 Assumes care is received in-network

HSA - What is an HSA?

A Health Savings Accounts (HSA) is a bank account that goes along with a medical insurance High Deductible Plan with HSA. Want to know more about the Health Savings Accounts (HSA)? In the video at this link, HealthEquity breaks down how HSAs can empower you to save more, spend smarter, and invest in your healthcare: What is a Health Savings Account?

To learn more about Health Savings Accounts visit: healthequity.com/learn/hsa

HSA - Plan documents

High Deductible Plan with HRA

HRA - Why choose it?

Why Choose the Health Reimbursement Account?

  • Visit any provider
    • National coverage
    • No referrals or PCP selection (primary care provider) required
    • You generally pay less by visiting providers in the network
    • As with all City plans, preventive care is covered 100%1
  • Pay less from your paycheck
  • The City provides financial support
    • The City-owned HRA fund helps cover covered medical costs when you receive services
      • Note that the fund may not be used for dental or vision costs, like it can be under the HSA
    • Unused funds generally roll over year to year
      • However, you can lose the funds - see "What you need to know" below

1 Assumes care is received in-network 

HRA - What you need to know

The City is actively looking at closing the HRA plan to new enrollees and phasing it out

  • Higher deductible: $2,000 individual/ $4,000 family1
    • You generally pay 20% after you meet the deductible, until you reach the annual out-of-pocket maximum ($5,000 individual/$10,000 family)1
  • You pay 100% for prescriptions, until you meet the deductible
    • This can be a challenge if you take expensive medications
  • The City owns the money in your HRA fund 
    • Think of the account as a "promise to pay" for qualified medical claims
    • Once you've spent the full fund, you're responsible for remaining costs
  • You can't use the funds for dental or vision expenses, like you can with the HSA
  • You can't use the funds for premiums
  • You will lose the money when you join another plan or leave City employment

1 Assumes care is received in-network

HRA - Plan documents

EPO In-Network Only Plan

In-Network Only Plan - Why choose it?

More predictable costs when you receive certain basic services

  • You pay copays for office, urgent care, and emergency room visits1
    • $50 primary care
    • $70 specialist 
    • $80 urgent care 
    • $500 emergency room 
  • As with all City plans, preventive care is covered 100%1 
  • Lower deductible 
    • $1,000 individual / $2,000 family deductible
  • You pay a copay for prescriptions1
    • $20 generic, $60 preferred, $120 non-preferred, $250 retail specialty
    • This may be easier to manage than the HSA drug plan if you have higher cost prescriptions, but your total annual costs could be higher

1 Must be received in-network, or coverage is 0%

In-Network Only Plan - What you need to know

  • Pay more for non-basic services
    • You pay the deductible and coinsurance for many services
  • Less flexibility when choosing where to receive care
    • You must receive care and prescriptions in the network
      • Not all providers and pharmacies are in the network
      • Only emergency services are covered outside the network, and emergency follow-up care must be received in-network
      • Be sure you verify network status before you receive care
  • Pay more out of your paycheck
    • The Network plan has a significantly higher premium than the HSA and HRA

Network - Plan documents

Comparing HSA and HRA

The HSA and HRA coverage look similar. Are there differences?

Yes. They differ in terms of the funds that the City provides (i.e., the "money"), such as:

  • Who owns the money (you or the City)
  • When you get the money
  • Whether you can make personal contributions to your account or invest the money
  • Whether you can use the money to pay for dental and vision expenses
  • What happens with the money if you leave the plan or remove dependents from the plan

In addition:

Who owns the money?

HSA

You own the money once it's deposited into your account.

HRA

The City owns the money. Think of the account as a "promise to pay" if you or a covered dependent has qualified medical claims. Eligible claims are paid automatically if funds are available. Once you've spent the full fund, you're responsible for remaining costs.

When do I receive the money?

HSA

The City's contribution to your account is deposited by the end of July. Personal contributions are deposited 1-2 weeks after each pay day.

If you join the plan after July 1 (for example, as a new hire or due to a qualifying life event), the amount is prorated.

HRA

The City no longer contributes funds to HRA balances.

Can I lose the money?

HSA

No. Unspent money is yours to keep and use on eligible expenses, even after you leave the plan.

HRA

Yes. If you disenroll or leave employment, you'll forfeit remaining funds.

May I make personal contributions?

HSA

Yes. You may make personal pre-tax contributions to help your account grow faster, and to save on taxes. The combined amount of your personal contribution and the City's contribution may not exceed annual limits set by the IRS.

HRA

No.

May I use the money for dental, vision and prescription expenses?

HSA

Yes, as long as the IRS considers them qualified health care expenses.

HRA

You can use funds for qualifying medical and prescription claims, but not for dental and vision.

May I invest the money?

HSA

Yes. You can invest your HSA funds in a wide range of mutual funds, stocks and bonds.

HRA

No. The money in the HRA account belongs to the City. It is a "promise to pay" if and when you have qualifying claims.

Is additional paperwork required?

HSA

When you join:

Although you usually won't have to provide additional documents when you join the plan, sometimes the bank will run into issues when it tries to verify the data in your profile as part of the federally required Customer Identification Process. This can happen if you've moved or changed your name. In that case, the bank will ask for additional documents. 

Every year:

You'll have to file IRS Form 8889 with your tax return. You'll receive both a 1099-SA tax form that shows total contributions to your account and a 5498-SA that shows withdrawals, including payments to health care providers. You'll want to save receipts showing how you spent the money to be able to demonstrate that funds were used for qualified expenses if you're ever audited by the IRS.

HRA

Because the City owns the funds and applies them only to qualifying expenses, no additional documents are required from you.

Pharmacy

Mail Order Pharmacy by OptumRx

Fill routine scripts by mail order

  • 90 day prescriptions at a discount for many medications

Step Therapy

Step therapy - Save money by trying generics before more expensive brand versions of medications

1095-C Forms and Transparency in Coverage Rule

1095-C forms

1095-C forms will be available each year by the federally mandated deadline.

  • These forms are not required to file your taxes and will be mailed only upon request. 
  • Once the forms are published for the year, printed copies will be mailed within 30 days of the request.*

How to View Your 1095-C Form

You can access your 1095-C form through Workday:

  • Enter “ACA Forms” in the Workday search bar.
  • Select “My ACA Forms” and choose the applicable year.

Retirees: When logging in, select the option to sign on with your ID and password:

  • Your former employee ID is your user ID. 
  • Your password is the one you set during Open Enrollment. 

If you've forgotten your password, email us to receive a password reset link.*

Requesting a Paper Copy*

To request a paper copy by mail, email benefitquestions@tucsonaz.gov, or contact us at:

  • City of Tucson Benefits Office, PO Box 27210, Tucson, AZ 85726
  • 520.791.4597

*Please include your employee ID number, name, address, and phone number with your request.

Transparency in Coverage Rule Readable Files & Legal Notices

This link leads to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.

AZBlue Legal Notices:

Search in this area

Need Help Choosing Your Medical Plan?

Contact the Benefits team

520-791-4597
benefitquestions@tucsonaz.gov

Bryana Montry
AZBlue Client Service Liaison
COTBenefitsDesk@azblue.com
602-864-2247

Contact AZBlue

Customer Service Team
888-901-6322
Monday - Friday, 6 a.m. - 6 p.m.

AZBlue.com

24-Hour Nurse Line
866-422-2729

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Included in all plans

Included in all plans

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