How To Make Health Insurance Selection Changes
(Qualifying Life Event)

 As a reminder, participants must notify the Health Trust within 31 days of their acquiring a dependent or any other change affecting dependent status. The notice shall be in writing and shall further provide proof of such changes as may be required by the Board, (for example: divorce decrees, birth certificates, marriage licenses, etc.).

To avoid penalties or missing these deadlines, please follow the instructions below to add your dependent(s) using our secure web portal.

To add your new dependent(s), please go to https://plansource.com/login/ and click on the “Benefits” box.

***You can also download the PlanSource Mobile App on the app store for your phone***

Your Login ID/Username will be the first initial of your first name, up to the first 6 letters of your last name, and the last four digits of your SSN.  Your initial password will be your birthdate in the YYYYMMDD format. 

(Example - Login ID: jwillia1234, Password: 19820104)

Please note, that if you have logged in during the current calendar year, you would use password and login you created at that time.

Once you have logged in:

• Choose the “Need to update your current benefits?” box and click on “Update your current benefits”
• From the Report Life Event, select the Qualifying Event (New Baby =“Birth”, Spouse =”Marriage”, Domestic Partner = “Domestic Partnership”, etc.)
• Enter the date of the Qualifying Event, once entered, click “Next” at the bottom of the page
• Verify your personal information and if changes or additions are needed, click the “+ Edit Info” at the top of the page to do so
• Once your personal information is verified or updated, click “Save” at the bottom of the page
• Review and reverify your personal details and if correct, click “Next: Review My Family” at the bottom of the page
• Add your new dependent(s) by selecting the “+ Add Family Member”
  • Please enter the information here so that it is exactly the way it is on the Social Security Card
• Repeat this for as many dependents you wish to add at this time
• This is also a good time to update the information for any other dependent(s), click “View Details” or “Edit” for each person listed in “Current Family Members”
• Review, verify and edit the information making sure that the information matches exactly the way it is on their Social Security Card
• Once updated, click “Save” at the bottom of the page
• Repeat this for as many dependents needed add at this time.
• Once all dependents are updated click “Next: Shop for Benefits” at the bottom of the page
• Click on the “+” next to Medical or the “”View and Change Plan” to the right of the page
• In the drop down make sure to click to select the new dependent(s) you want to add to your plan.
  • Make sure the person is checked marked prior to closing the window or they will not be covered in the health insurance
• Once all dependents are selected, scroll down and click “Start Survey” on each of the statement boxes that have not been completed.
• Review and accept and confirm the statements. 
  • To proceed you must acknowledge and accept each of the statements on this page.  If you have questions or concerns with any of the statements, please contact our office.
• Click “Review and Checkout” at the bottom of the page.
• If selections are correct click “Checkout” at the bottom of the page
• Click on the “Update Cart” button
• Review your selections again , once complete click “Review and Checkout” at the bottom of the page
• If selections are correct click “Checkout” at the bottom of the page
• Upload documents* for each dependent added to plan

If necessary, your contributions will be adjusted on future payroll to include your new dependent(s). 

* Your enrollment will not be finalized until we receive all the documents requested.  If adding a spouse or domestic partner, a copy of the Marriage Certificate or Domestic Partnership Certificate and a copy of your spouse’s or domestic partner’s Driver’s License or Passport must be uploaded as one document.  If adding a baby and you have not received the State Birth Certificate, you can upload the hospital’s Certificate as proof of birth.  If adding children, a State Birth Certificate naming you or your spouse or domestic partner as the parent.

Please note, this is a year-round portal, which allows you to visit frequently to confirm your benefits elections, update demographic information and/or make qualified life event changes. If you have questions, please contact your Benefits team at benefits@healthtrustmaff.org 

Health Reimbursement Account (HRA)

The IAFF Local 587, has established a plan to reimburse you for any eligible IRS permitted medical, dental or vision expense.

Here is how it works: 
Once you become a Participant, a reimbursement trust account will be maintained in your name, to keep a record of the amounts available to you for certain eligible expenses.

The maximum dollar amount that may be credited to the account in any plan year is: 

• $500.00 for those with employee only coverage
• $1,000 for those with employee plus 1 coverage
• $1,500.00 for those with employee plus family coverage.  

As you incur eligible expenses, you may be required to provide supporting documentation. Cash register receipts, canceled checks, credit card slips or credit card bills will not be accepted.  If the expense is eligible, you will receive a reimbursement and the amount will be recorded in your account.  If the reimbursement request is rejected as not eligible, you will be notified why. 

You can access your account balance and MySourceCard activity at any time by signing into our website. If you have never created a login ID for our website, please follow the following instructions:

1. Go to www.div125.com
2. Login ID field – type in your SSN# without spaces or dashes
3. Skip the password field and click login
4. Enter employer code: 48898691
5. You can then personalize your ID and password

Ways to Use Your HRA Funds

Click image to access full packet of forms and information.

Option 1- MySourceCard: Important - If you do not follow this step you will not receive a MySourceCard.
You must submit  the MySourceCard Enrollment Agreement form included in the packet as directed.

How To Use the MySourceCard:
1- The card will only work at eligible medical, dental, vision & Rx providers.
2- Simply swipe your card at your provider’s office.
3- Payment is automatically deducted from your available balance.
4- No need to pay cash up front and wait to be reimbursed.
5- Always remember to **SAVE YOUR DETAILED RECEIPTS. **Canceled checks, credit card slips or credit card bills will not be accepted.
6- No need to submit every claim!
a. Many card swipes will automatically be approved without additional documentation.
b. If we need to see any detailed receipts, we’ll let you know by email.
c. Make sure to submit your documentation within 60 days of the swipe, to avoid an interruption on 
your card!

Option 2- Claim Submission:

A. Submitting a Claim online:
After you sign in to www.div125.com, all online claims can be accessed from your user home page screen. Simply follow the prompts to submit your claim.

B. Mobile App Submission:
Note: You must create your login ID using the website, before you can log into the mobile app.
 - For the iPhone  you can download the app here: https://itunes.apple.com/us/app/myrsc/id561492867?mt=8
 - For Android Phones you can download the app here: https://play.google.com/store/apps/details?id=com.dpath.myrsc&hl=en

C. Submit a claim form Via email:
Send claim form with all supporting documents to claims@div125.com.

D. Submit a claim via fax: (954) 983-9695.

E. Submit your claim via USPS mail:
Please allow additional time for processing.

Diversified Administration, Inc.
6600 Taft Street, Suite 304
Hollywood FL. 33024

Once your claim has been approved, you will be reimbursed via direct deposit into the account of your choosing.
Note: Please make sure you have submitted a direct deposit form when sending in your claim information.

Important Notes

1. When using the claim form, please make sure to put “IAFF Local 587” in the line that says "employer".
2. When submitting a claim for reimbursement, and it is your first time doing so, please make sure to include the direct deposit form.
3. Attached to this document, you will find both the claim and direct deposit forms.
4. If you have any additional questions or any concerns, please feel free to call: (954)983-9970, Option 3

Lasik Reimbursement

Lasik Procedures will be covered with a maximum allowance of $1,000 per eye on a reimbursement basis paid directly to the Member by the Trust. 

ADMINISTRATION OF THIS BENEFIT/REIMBURSEMENT REQUESTS: Unfortunately, Cigna has advised that it cannot administer the approved benefit through their system. 

The member is required to fill out a reimbursement form and provide appropriate documentation to be reimbursed.  Reimbursement shall be limited to reasonable and customary costs.

Reimbursement requests for expenses must be submitted as follows:

Expenses incurred January 1, 2022 - December 31, 2022 prior to March 31, 2023.

Reimbursement requests shall be submitted to the Benefits Administrator by email or USPS mail to:

MAFF L587 Health Insurance Trust
2980 NW South River Drive
Miami, Florida 33125

or via email to:

benefits@healthtrustmaff.org

If you have any questions about these improvements, feel free to contact the Trust at 305-425-1938 or by email at benefits@healthtrustmaff.org.

Summary Plan Documents (SPD's)

Please click on the links below to download.

AETNA Premium Plan

AETNA Premium Annual Notice of Changes

AETNA Mid-Range Plan

AETNA Mid-Range Annual Notice of Changes

AETNA Medicare Plan (PPO) with Extended Service Area (ESA) & Aetna Medicare Rx Plan

AETNA Non-Part D Supplemental Benefit

CIGNA Point of Service Medical Benefits (NPOS)

CIGNA NPOS Rider

CIGNA Comprehensive Medical Benefits (COM)

CIGNA COM Rider

CIGNA Dental Preferred Provider (DPPO)

CIGNA Dental Preferred Provider (Texas Only)

Transparency in Coverage - Machine Readable Files (MRF's)

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.

url: https://www.cigna.com/legal/compliance/machine-readable-files

Contact Numbers

BENEFITS (HEALTH TRUST) - 305-425-1938
AETNA - 1-800-307-4830
CIGNA - 1-800-244-6224
CITY OF MIAMI (FSA) - 305-416-1380
DIVERSIFIED ADMINISTRATION (HRA) - 954-983-9970