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FAQs

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I am not a member of the PFFA Healthcare Trust

  • The Professional Firefighters of Arizona Healthcare Trust is a VEBA Trust designed for and run by firefighters. Our philosophy, plan recommendations, and innovative benefit solutions are derived from the needs of our members and their families. Our members are scattered throughout Arizona residing in multiple counties Mohave, Yavapai, Navajo, and Maricopa. The healthcare and fire district model are unique within America, navigating the needs for firefighters in Arizona and aligning the access to care is what the IAFF and the PFFA have continuously worked to try to accomplish.

  • The minimum contract period is 12 months with no conditions on extending or cancelling. We work to earn your business every year and continuously enhance benefits that align with the Union, the Arizona market, and the Trust membership to ensure our vision and mission are executed.

  • We have a dedicated service team consisting of multiple full-time client managers. This team is led by two full-time client managers consisting of 30 years of experience each in employee benefits and service. We offer full support to both the employer and the employee to help resolve and coordinate issues as they arise and support on an ongoing basis all enrollment and claims items.

    Additional support offered by our dedicated team of advisors includes:

    • Strategic Planning

    • ERISA Attorneys and Compliance

    • PCORI and ACA Reporting

    • Pharmacy Benefit Management

    • Stop Loss Management

    • Actuarial Services

    • Member Communications

    • Open Enrollment

    • Claims Support

    • HR Support

  • Request a quote from the PFFA Health team. We'll promptly reach out to discuss your organization's needs and guide you through the process of obtaining your quote, including:

    • Census: We kindly request a comprehensive census of all members, including spouses and children, associated with your organization. Please include zip codes, gender, age, plan elections, and salaries for all participating members.  Please ensure there is no identifiable information within the census. This may be provided in Excel format.

    • History: To accurately assess the healthcare needs of your members, we require the latest 24 months of medical and prescription drug claims data alongside monthly enrollment. This will enable us to understand historical usage patterns and tailor our healthcare package accordingly. Additionally, providing a detailed large claims report indicating any claims exceeding the $25,000 threshold over the specified period will help us identify potential areas of risk and develop appropriate coverage strategies.

    • Benefits Structure: To align our proposal with your organization's specific needs and preferences, we request a summary of your current plan benefits. This will enable us to tailor our offering to complement your existing coverage and address any gaps or areas for improvement.

      • Your current medical and pharmacy plan designs (Summary of Benefits and Coverage, or SBC).

      • Comparison of medical carrier rates across tiers: prior year, current year, and any available renewal quotes.

I am a member of the PFFA Healthcare Trust’

  • A deductible is a flat dollar amount that you must pay each year before your medical plan begins sharing the cost of care and services with you.

  • This is the percentage of covered medical expenses you are responsible for after you have met your deductible. The plan covers the remaining costs.

  • Each family member has their own deductible, and there is also a deductible for the entire family. Once an individual meets their deductible, the plan begins to pay benefits for that person. When the family deductible is met, the plan pays benefits for all family members.

  • This is the highest amount you'll be responsible for paying for covered services in a single plan year. The out-of-pocket maximum limits your healthcare costs, providing financial protection in case of a major illness or injury.

  • An HDHP is a medical plan with a lower monthly premium and a higher annual deductible. It is often paired with a health savings account (HSA) to cover medical expenses.

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    A PPO, on the other hand, has a higher monthly premium but a lower annual deductible. PPO plans may include copays for services, unlike HDHPs.

  • This refers to the pre-approval required for specific services, prescriptions, and medical equipment to be covered by the plan. It may also be known as "preauthorization" or "precertification."

  • You can make changes or elect benefits once a year during open enrollment. Outside of open enrollment, the IRS says a "qualified life event" must occur in order to make changes. If you experience a qualified life event and need to make a change to your benefits, you must notify your employer within 30 days of the event. Otherwise, you will have to wait until the next open enrollment period.

  • Contact your HR staff within 30 days if you have experienced a life change including:

    • Marriage, divorce, legal separation, or annulment

    • Birth, adoption, placement for adoption, or legal guardianship of a child

    • Death of a dependent

    • Change in your spouse’s employment or involuntary loss of health coverage under another employer’s plan

    • Change in your dependent’s eligibility status

     

    Reminder: Newborns are not automatically added to your medical coverage. You must notify your HR team within 30 days of the date of birth and pay the full premium amount for the month the child is added. 

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