The PSPRS Cancer Insurance Program provides active and eligible retired firefighters and peace officers with payments for cancer diagnoses and reimbursements for treatment-related expenses. Each year, the program distributes approximately $1.8 million in claim payments and reimbursements.
The Cancer Insurance Program is funded through employer annual premium payments made on behalf of members and investment returns generated by a separately maintained trust. The program is governed by the PSPRS Board of Trustees, which maintains both a plan document and a funding policy.
Learn more about:
- ELIGIBILITY
- PREMIUMS
- BENEFITS
- APPLY FOR BENEFITS
- PAYMENT PROCESS
- COVERAGE IN RETIREMENT
- TAXATION
- HIPAA
ELIGIBILITY
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MEMBER |
PSPRS |
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Active members: |
Yes |
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Retired members: (extended eligibility) |
Yes. Retired members are provided with 5 months of coverage, at no cost, for every year of credited service including years in DROP (if DROP effective September 2019 or later) |
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Retired members who have completed their extended eligibility |
Who had a diagnosis of cancer PRIOR to the end date of their extended eligibility coverage period, may elect to continue coverage and pay the annual premium |
PREMIUMS
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Cancer Insurance Program |
PSPRS Employers |
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Participation: |
Mandatory |
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Fees Paid by: |
Employer |
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Annual Premium*: |
$50 |
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Participants: |
Active, DROP and retired members (if eligible) |
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* Premiums are set annually by the Board of Trustees per statute (A.R.S. 38-641), not to exceed $180 per year, and are invested by PSPRS in a trust used to pay members claims. Members have a 24-month period to submit claims. |
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BENEFITS
Each year, the Cancer Insurance Program (CIP) provides eligible active members and retirees with benefits and/or reimbursements for out-of-pocket costs for the following:
- Initial diagnosis of cancer, including skin cancer
- Subsequent diagnosis of cancer (non-skin)
- Intensive care treatment
- Pharmaceuticals
- Experimental treatments
- Imaging, radiation and chemotherapy
- Genomic and genetic testing
- Hospital confinement
- Skilled nursing facilities
- Home hospice care
- Death
Benefits vary by diagnosis and reoccurrence. Please see table for full details:
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BENEFITS |
LIMITS & AMOUNTS |
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| Overall lifetime maximum benefit under plan | $100,000 | |
| Diagnosis of cancer* | First cancer diagnosis, not skin cancer | $15,000 |
| Second and subsequent new cancer diagnosis | Not skin cancer | $7,500 |
| Skin cancer diagnosis* | For each positive diagnosis, up to seven (7) | $500 |
| Lifetime maximum amount for this benefit | $3,500 | |
| Imaging (including scans), radiation and chemotherapy | Lifetime maximum amount for this benefit; Reimbursement not to exceed actual incurred expenses | $10,000 |
| Pharmacy | Benefit subject to overall lifetime maximum | |
| Genomic and genetic testing | Maximum benefit amount; Reimbursement not to exceed actual incurred expenses | $15,000 |
| Experimental treatment | Maximum benefit amount; Reimbursement not to exceed actual incurred expenses | $5,000 |
| Hospital confinement | Daily benefit; Reimbursement not to exceed actual incurred expenses | $200 |
| Cancer intensive care | Daily benefit; Reimbursement not to exceed actual incurred expenses | $500 |
| Skilled nursing facility | Daily benefit; Reimbursement not to exceed actual incurred expenses | $40 |
| Home hospice care | Daily benefit; Reimbursement not to exceed actual incurred expenses | $50 |
| Hospice care | Daily benefit; Reimbursement not to exceed actual incurred expenses | $180 |
| Death | Not subject to the lifetime maximum benefit | $10,000 |
*This maybe reported as taxable income. See Taxation section for more details.
APPLY FOR BENEFITS
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Cancer Insurance Program |
Forms to use |
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First claim: |
Complete and submit the Public Safety/CORP Cancer Insurance Policy Program INITIAL Claim Form PACKET. NOTE: Each skin cancer claim should use this packet as well even if it is not your first skin cancer diagnosis |
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Subsequent claims: |
Complete and submit the Public Safety/CORP Cancer Insurance Combined-Supplemental and Pharmacy Benefits claim form. |
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Additional forms: |
All current forms are available on our Members Forms & Resources, Retired Members Forms & Resources, and Employer Forms & Resources pages. (In the forms and resources page, select Cancer Insurance and HIPAA category for the cancer insurance forms). |
PAYMENT PROCESS
Once your claim is approved with a diagnosis of cancer or skin cancer:
For Active PSPRS:
- PSPRS will notify you and your employer, and we will mail paper payments and tax forms directly to your employer
- Payment will then be processed by your employer via regular payroll process and will be added to your W-2 tax forms in compliance with IRS regulations
- All other approved claims will be paid directly to you from our office
For Retired PSPRS:
- PSPRS will notify you and your former employer of any taxable portion, and we will mail paper payments and tax forms directly to your former employer
- Your former employer may need to add you to their payroll system to make this payment
- Payment will be processed by your former employer via their payroll process and will be added to your W-2 tax forms in compliance with IRS regulations
- Any non-taxable portion (if applicable) will be paid directly to you
- Diagnosis payments are considered a fringe benefit, and NOT a pensionable wage
COVERAGE IN RETIREMENT
- If you are an eligible retired member, you will receive 5 months continued CIP eligibility for every year of credited service and years in DROP at no cost
- If you have no cancer diagnosis at the end of the no cost (extended eligibility) timeframe, you may NOT continue this insurance
- If you are retired, with PRIOR cancer diagnoses, you CAN continue coverage past the no cost period IF you pay the annual premium in July/August each year
TAXATION
- As employers pay the premiums for CIP, the IRS considers CIP diagnosis payments as taxable income. However, on September 24, 2022, SB1084 (Laws 2022, Chapter 73) became law, making premium payments taxable, and over the next three years all diagnosis payments will become non-taxable per the table below:
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Member |
||||
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Premium: |
Paid by employer as imputed income to member |
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Payment Timeframe: |
2022 |
2023 |
2024 |
2025 |
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Payments are: |
100% taxable |
100% taxable |
66.67% taxable |
33.34% taxable |
0% taxable |
- Taxes include federal, state and employment taxes (social security (if applicable) and Medicare)
- Retired PSPRS members will be taxed as follows:
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Retired member |
Retired member |
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Premium: |
Free extended |
Self-pay premium |
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(Coverage) |
(5 months per year worked) |
2022 |
2023 |
2024 |
2025 |
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Payments are: |
100% taxable |
100% taxable |
66.67% taxable |
33.34% taxable |
0% taxable |
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) OVERVIEW
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was enacted to expand health coverage by improving the portability and continuity of health insurance coverage. Additionally, The United States Department of Health and Human Services established the HIPAA Privacy Regulation which took effect on April 14, 2003. The Privacy Rule, as it is commonly referred, provides for the protection and privacy of individually identifiable health information and guards against the misuse of this information. The Privacy Rule sets forth administrative requirements, privacy and security requirements, and individual rights regarding the use and disclosure of protected health information. The Privacy Rule also establishes penalties for the misuse or disclosure of individually identifiable protected health information.
As administrators of the Public Safety/CORP Cancer Insurance Program, which is a Group Health Plan, PSPRS is considered a covered entity and must adhere to the requirements outlined in HIPAA. As part of your rights under HIPAA, the PSPRS Notice of Privacy Practices provides a general description of the privacy practices of the Public Safety/CORP Cancer Insurance Program outlining when and in what circumstances protected health information (PHI) will be used, or disclosed, in addition to informing Cancer Insurance Program participants of their rights. As well as, there are several forms that may be used to view, obtain and alter your PHI, which all forms are located in the Forms & Resources section under Cancer Insurance & HIPAA Forms.
HIPAA regulations require the PSPRS Administration to assign a HIPAA Privacy Officer and the PSPRS Compliance Officer is the Agency's HIPAA Privacy Officer. Questions, concerns, and complaints about HIPAA Privacy matters may be sent to the following address:
PSPRS Administration
Attention: HIPAA Privacy Officer
3010 E. Camelback Road, Suite 200
Phoenix, AZ 85016
