2024 Health Insurance Guide Books

ACTIVE EMPLOYEES	RETIREES NON-MEDICARE & MEDICARE (WITH NON-MEDICARE DEPENDENTS)	RETIREES MEDICARE A&B  ENROLLED SINGLE OR MARRIED BOTH ENROLLED IN MEDICARE
How to Enroll Actives must enroll or make changes using the  PlanSource  online portal.  Click Here for Instructions	How to Enroll Retirees are urged to`enroll  or make changes using the  PlanSource online portal.  Click Here for Instructions ~~ Non-Medicare & Medicare Retirees  with Non-Medicare Dependents  who prefer to send in their  changes, can fill out and return the form below.   Just  click on it & print it out.	How to Enroll Retirees are urged to`enroll  or make changes using the  PlanSource online portal.  Click Here for Instructions ~~ Medicare A&B Retirees (Single or if Married with both enrolled in Medicare A&B) who prefer to send in their changes,  can fill out and return the form below.  Just click on it & print it out.
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How To Make Health Insurance Selection Changes
(Open Enrollment)

Click Here to Download Instructions

Please follow the instructions below to login and make your elections. You may use a computer, smartphone or tablet device. 
 

If you do not need to make changes to your insurance, you do not need to follow these steps.  

• Go to https://benefits.plansource.com
• Follow the instructions below for your Login ID and Password. You will be prompted to choose a new password.
  Note:  If you’ve previously logged in, you will still need to use these login instructions during Open Enrollment, as the system resets previous logins/usernames to the default.
• Login ID/Username Your username is the first initial of your first name, up to the first six letters of your last name, and the last four digits of your SSN.
• Password: Your initial password is your birthdate in the YYYYMMDD format.
  • Example #1: Taylor Williams, SSN: XXX-XX-1234, Birthdate: January 4, 1982
  • Login ID: jwillia1234, Password: 19820104
• On the homepage, click “Get Started” to begin.
• First, you’ll be asked to review and update your profile and ensure that all information listed about yourself, and dependents is correct.
  • You can then begin shopping for benefits!
  • Educational material about the specific plan type is available at the top of the page.
  • Plan choices are displayed on “cards,” which provide a brief summary of what is included in the plan.
  • Click a card to get more details about a specific plan.
• To select a plan, indicate which family members are covered by clicking “edit family covered” and select the card for each family member you’d like to add to the plan.
• 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
• Click “Update Cart” to choose the plan.
• To finalize and save your choices, click “Checkout.”
  • You must complete the checkout process in order to be enrolled in benefits.
• You will then land on the Summary page that confirms you have completed the enrollment process.
  • You may download, email, or print the summary for your records.

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 

2024 Health Reimbursement Account (HRA)

Health Reimbursement Account (HRA) – The HRA will be administered by Diversified.  It can be used to pay for or reimburse for any IRS Code Section 213(d) Eligible Medical Expense.  Please see the entire booklet for more complete information. 

The maximum dollar amount that may be credited to the account for the 2024 plan year is: 

• $750.00 for those with employee only coverage
• $1,500 for those with employee plus 1 coverage
• $2,250.00 for those with employee plus family coverage.  

For 2024, the new debit card, the Benefits Card, will be replacing the mySource card.  All members and their dependents who already have a mySource card will be receiving their replacement cards before the end of the year. Please note that although this is a new card, if your HRA account is still blocked, this card will also be blocked until you resolve any outstanding issues with Diversified.

Members who have not yet signed up to receive a debit card must fill out this auto-fill form or print out and return this form to Diversified using the instructions on the form.

ALL USERS MUST LOG IN TO THE WEX ACCOUNT THE FIRST TIME USING THE FOLLOWING INSTRUCTIONS:

• Go to www.Div125.com
• Click on the blue WEX Login button in the upper right-hand corner
• Click in the Existing Users box, entering the Username and Password following the instructions on the next lines.
• Your first time username is your first initial, your last name, and the last 4 of your SSN - jsample9999
• Click the next button, and a password field will appear below where you entered your username
• Your first time password is your 5-digit zip, your first initial (lowercase), and the last 4 of your SSN - 33333j9999
• After setting up 3 security questions, you can customize your username and password. Answers are CASE sensitive

Advanced Eye Care Reimbursement
(formerly Lasik only)

Starting in 2024, members and their dependents covered by the Plan are eligible for up to a $5,000 maximum lifetime benefit for any FDA approved procedures to improve your eyesight.

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)

Click on the links below:

2024 SPD's

CIGNA OPEN ACCESS PLUS MEDICAL BENEFITS OAP Plan

CIGNA OPEN ACCESS PLUS MEDICAL BENEFITS RDS Plan

CIGNA VISION

CIGNA DENTAL PREFERRED PROVIDER INSURANCE

CIGNA DENTAL CHOICE For Texas Residents

Contact Numbers

BENEFITS ADMINISTRATION (HEALTH TRUST)
305-425-1938
CIGNA OAP MEDICAL
1-800-244-6224
CIGNA TRUE CHOICE MEDICARE ADVANTAGE
1-800-281-7867
CIGNA DENTAL
1-800-244-6224
CIGNA VISION
1-888-353--2653
DIVERSIFIED ADMINISTRATION (HRA) - 954-983-9970

CITY OF MIAMI (FSA) - 305-416-1380