TAYLOR ISD
BENEFIT GUIDE EFFECTIVE: 09/01/2018 - 8/31/2019 WWW.MYBENEFITSHUB.COM/ TAYLORISD
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Table of Contents Benefit Contact Information How to Enroll Annual Benefit Enrollment 1. Benefit Updates 2. Section 125 Cafeteria Plan Guidelines 3. Annual Enrollment 4. Eligibility Requirements 5. Helpful Definitions 6. HSA vs FSA Comparison Century Healthcare Medical Gap EECU Health Savings Account MDLIVE Telehealth FBS LifeWorks EAP CIGNA Dental PPO Superior Vision UNUM Educator Disability Loyal American Cancer Loyal American Accident Voya Critical Illness OneAmerica Life and AD&D 5Star Family Protection Plan Term Life Insurance with Long Term Care ID Watchdog Identity Theft Protection NBS Flexible Spending Accounts MASA Medical Transport
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3 4-5 6-11 6 7 8 9 10 11 12-15 16-17 18-19 20-21 22-25 26-27 29-31 32-35 36-39 40-41 42-47 48-51 52-53 54-77 58-59
FLIP TO... PG. 4 HOW TO HOW TO ENROLL ENROLL
PG. 6 SUMMARY PAGES
PG. 12 YOUR BENEFITS
Benefit Contact Information TAYLOR ISD BENEFITS
DENTAL
ACCIDENT
INDIVIDUAL LIFE
Financial Benefit Services (800) 583-6908 www.mybenefitshub.com/ taylorisd
Cigna (800) 244-6224 www.mycigna.com
Loyal American (800) 366-8354
5 Star Life Insurance Company (866) 863-9753 www.5starlifeinsurance.com
TAYLOR ISD BENFITS OFFICE
DISCOUNT DENTAL PLAN HEALTH SAVINGS ACCOUNTS ID THEFT PROTECTION
(512) 352-6361 www.taylorisd.org
Humana Comp Benefits EECU (800) 488-2801 (800) 333-9934 www.mycompbenefits.com www.eecu.org
ID Watchdog (800) 237-1521 www.idwatchdog.com
MEDICAL GAP
VISION
CRITICAL ILLNESS
FLEXIBLE SPENDING ACCOUNTS
Special Insurance Services Inc. (SIS) (214) 291-1222 (800) 767-6811 www.specialinc.com
Superior Vision (800) 507-3800 www.superiorvision.com
Voya (800) 955-7736 www.voya.com
National Benefit Services (800) 274-0503 www.nbsbenefits.com
TELEHEALTH
EDUCATOR DISABILITY
BASIC LIFE & VTL LIFE
COBRA (Dental, Vision, MEDlink, Medical Flex)
MDLIVE (888) 365-1663 www.consultmdlive.com
UNUM (800) 583-6908 www.unum.com
AUL a OneAmerica Company (800) 583-6908 www.oneamerica.com
National Benefit Services (800) 274-0503 option 4 www.nbsbenefits.com
EMPLOYEE ASSISTANCE PROGRAM
CANCER
AD&D
403(B) INVESTMENTS
LifeWorks (888) 456-1324 www.ceridian.com
Loyal American (800) 366-8354
AUL a OneAmerica Company (800) 583-6908 www.oneamerica.com
National Benefit Services (800) 274-0503 option 5 www.nbsbenefits.com
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MOBILE ENROLLMENT Enrollment made simple through your smartphone or tablet. Text “FBS TAYLOR” to 313131 and get access to
everything you need to complete your benefits enrollment:
Benefit Information
Online Support
Interactive Tools
And more. PLAY VIDEO
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Text “FBS TAYLOR” to 313131 OR SCAN
How to Log In
1 BENEFIT INFO
INTERACTIVE TOOLS
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www.mybenefitshub.com/taylorisd
CLICK LOGIN
ENTER USERNAME & PASSWORD All login credentials have been RESET to the default described below:
Username: The first six (6) characters of your last name, followed by the first letter of your first name, followed by the last four (4) digits of your Social Security Number.
ONLIINE SUPPORT
If you have less than six (6) characters in your last name, use your full last name, followed by the first letter of your first name, followed by the last four (4) digits of your Social Security Number.
Default Password: Last Name (lowercase, excluding punctuation) followed by the last four (4) digits of your Social Security Number.
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SUMMARY PAGES
Annual Enrollment During your annual enrollment period, you have the opportunity
Where can I find forms?
to review, change or continue benefit elections each year.
For benefit summaries and claim forms, go to your benefit
Changes are not permitted during the plan year (outside of
website:
annual enrollment) unless a Section 125 qualifying event occurs.
www.mybenefitshub.com/taylorisd. Click on the benefit plan you need information on (i.e., Dental) and you can find the
Changes, additions or drops may be made only during the
forms you need under the Benefits and Forms section.
annual enrollment period without a qualifying event. How can I find a Network Provider?
Employees must review their personal information and verify that dependents they wish to provide coverage for are
benefit website: www.mybenefitshub.com/taylorisd. Click on
included in the dependent profile. Additionally, you must
the benefit plan you need information on (i.e., Dental) and
notify your employer of any discrepancy in personal and/or benefit information.
For benefit summaries and claim forms, go to the Taylor ISD
Employees must confirm on each benefit screen (medical, dental, vision, etc.) that each dependent to be covered is selected in order to be included in the coverage for that particular benefit.
you can find provider search links under the Quick Links section. When will I receive ID cards? If the insurance carrier provides ID cards, you can expect to receive those 3-4 weeks after your effective date. For most dental and vision plans, you can login to the carrier website and print a temporary ID card or simply give your provider the insurance company’s phone number and they can call and
New Hire Enrollment All new hire enrollment elections must be completed in the online enrollment system within the first 31 days of benefit eligibility employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.
Q&A Who do I contact with Questions? For supplemental benefit questions, you can contact your Benefits/HR department or you can call Financial Benefit Services at 866-914-5202 for assistance.
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verify your coverage if you do not have an ID card at that time. If you do not receive your ID card, you can call the carrier’s customer service number to request another card.
SUMMARY PAGES
must be actively-at-work on September 1, 2018 to be eligible for
Employee Eligibility Requirements
your new benefits.
Supplemental Benefits: Eligible employees must work 20 or more regularly scheduled hours each work week.
Dependent Eligibility Requirements Dependent Eligibility: You can cover eligible dependent
Eligible employees must be actively at work on the plan effective
children under a benefit that offers dependent coverage,
date for new benefits to be effective, meaning you are physically
provided you participate in the same benefit, through the
capable of performing the functions of your job on the first day
maximum age listed below. Dependents cannot be double
of work concurrent with the plan effective date. For example, if
covered by married spouses within Taylor ISD or as both
your 2018 benefits become effective on September 1, 2018, you
employees and dependents.
PLAN
CARRIER
MAXIMUM AGE
CONTINUATION
Medical
Aetna/First Care
To 26
COBRA (Wellsystems)
Medical Supplement Gap
Century Healthcare
To 26
COBRA (NBS)
Dental
Cigna Humana
To 26
COBRA (NBS)
Vision
Superior Vision
To 26
COBRA (NBS)
Health Savings Account
HSA
To 26
Portable
Cancer
Loyal American
Unmarried To 25
Portable after 12 mos. coverage*
Accident
Loyal American
Unmarried To 25
Portable*
Critical Illness
Voya
Unmarried To 26
Portable*
Voluntary Term Life
AUL a OneAmerica Company
Unmarried To 26
Port/Convert*
Basic Life and AD&D
AUL a OneAmerica Company
Unmarried To 26
Port/Convert*
Individual Life w/LTC
5Star
Issuable to age 23
Direct Pay*
Employee Assistance (EAP)
Ceridian
To 26
N/A
Identity Theft
ID Watchdog
To 26
N/A
*Contact carrier within 30 days of termination to be elibile for continuation
If your dependent is disabled, coverage can continue past the maximum age under certain plans. If you have a disabled dependent who is reaching an ineligible age, you must provide a physician’s statement confirming your dependent’s disability. Contact your HR/Benefit Administrator to request a continuation of coverage. 7
Annual Benefit Enrollment
SUMMARY PAGES
Benefit Updates - What’s New:
MASA provides medical emergency transportation solutions AND covers your out of pocket medical transport cost when your insurance falls short. MASA does not use a network so you are covered anywhere nationwide. The Emergent plan covers your family for 9.00/month. New Carrier! If you are enrolled in a high deductible health care plan the opportunity to contribute to an HSA to pay for eligible medical, dental and vision expenses. This year, all HSA’s will now be administered through EECU, a credit union for educators. Individual maximum contribution is $3,450 and Family maximum contribution is $6,900 per year. Make sure to login and complete a walkthrough if you are wanting this benefit for the 2018-19 plan year, it is not automatically renewed. Ask your benefit administrator for more information if you would like to transfer a current HSA with HSABank to EECU. Current health savings accounts will not be automatically transferred to EECU. Effective 9/1/2018 Cigna Dental will have a slight increase for the High and Low PPO Plans.
If you currently participate in a Healthcare or Dependent Care FSA, you MUST re-elect a new contribution amount every year to continue to participate. You can view account balance using the CHECK FSA link on the Benefit website or use the NBS smart phone app. New Carrier! One America - AD&D pays a benefit for a critical or fatal injury caused by a covered acci-dent. All rates and coverages remain the same. Taylor ISD provides, at no cost to you, the following benefits: Critical Illness-Employee only MDLive Telehealth- Employee + Family EAP (Employee Assistance Program)Employee + Family Basic Group Life of $10,000- Employee only.
Don’t Forget! Login and complete your benefit enrollment from 7/16/2018—8/24/2018. Enrollment assistance is available by calling Financial Benefit Services at (800) 583-6908 to speak to
a representative. Update your profile information: home address, phone numbers, email. Update dependent social security numbers and student status for college aged children.
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SUMMARY PAGES
Section 125 Cafeteria Plan Guidelines A Cafeteria plan enables you to save money by using pre-tax dollars to pay for eligible group insurance premiums sponsored and offered by your employer. Enrollment is automatic unless you decline this benefit. Elections made during annual enrollment will become effective on the plan effective date and will remain in effect during the entire plan year.
CHANGES IN STATUS (CIS): Marital Status
Changes in benefit elections can occur only if you experience a qualifying event. You must present proof of a qualifying event to your Benefit Office within 30 days of your qualifying event and meet with your Benefit/HR Office to complete and sign the necessary paperwork in order to make a benefit election change. Benefit changes must be consistent with the qualifying event.
QUALIFYING EVENTS A change in marital status includes marriage, death of a spouse, divorce or annulment (legal separation is not recognized in all states).
A change in number of dependents includes the following: birth, adoption and placement for adoption. Change in Number of Tax You can add existing dependents not previously enrolled whenever a dependent gains eligibility as a Dependents result of a valid change in status event. Change in Status of Employment Affecting Coverage Eligibility
Change in employment status of the employee, or a spouse or dependent of the employee, that affects the individual's eligibility under an employer's plan includes commencement or termination of employment.
An event that causes an employee's dependent to satisfy or cease to satisfy coverage requirements Gain/Loss of Dependents' under an employer's plan may include change in age, student, marital, employment or tax dependent Eligibility Status status. If a judgment, decree, or order from a divorce, annulment or change in legal custody requires that you provide accident or health coverage for your dependent child (including a foster child who is your dependent), you may change your election to provide coverage for the dependent child. If the order Judgment/Decree/Order requires that another individual (including your spouse and former spouse) covers the dependent child and provides coverage under that individual's plan, you may change your election to revoke coverage only for that dependent child and only if the other individual actually provides the coverage. Eligibility for Government Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change. Programs
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SUMMARY PAGES
Helpful Definitions Actively at Work
In-Network
You are performing your regular occupation for the employer
Doctors, hospitals, optometrists, dentists and other providers
on a full-time basis, either at one of the employer’s usual
who have contracted with the plan as a network provider.
places of business or at some location to which the employer’s business requires you to travel. If you will not be actively at work beginning 9/1/2018 please notify your benefits administrator.
Annual Enrollment The period during which existing employees are given the opportunity to enroll in or change their current elections.
Annual Deductible The amount you pay each plan year before the plan begins to pay covered expenses.
Out of Pocket Maximum The most an eligible or insured person can pay in co-insurance for covered expenses.
Plan Year September 1st through August 31st
Pre-Existing Conditions Applies to any illness, injury or condition for which the participant has been under the care of a health care provider, taken prescriptions drugs or is under a health care provider’s orders to take drugs, or received medical care or services
Calendar Year January 1st through December 31st
Co-insurance After any applicable deductible, your share of the cost of a covered health care service, calculated as a percentage (for example, 20%) of the allowed amount for the service.
Guaranteed Coverage The amount of coverage you can elect without answering any medical questions or taking a health exam. Guaranteed coverage is only available during initial eligibility period. Actively-at-work and/or pre-existing condition exclusion provisions do apply, as applicable by carrier.
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(including diagnostic and/or consultation services).
SUMMARY PAGES
HSA vs. FSA Health Savings Account (HSA) (IRC Sec. 223)
Flexible Spending Account (FSA) (IRC Sec. 125)
Approved by Congress in 2003, HSAs are actual bank accounts in employee’s names that allow employees to save and pay for unreimbursed qualified medical expenses tax-free.
Allows employees to pay out-of-pocket expenses for copays, deductibles and certain services not covered by medical plan, tax-free. This also allows employees to pay for qualifying dependent care taxfree.
Employer Eligibility
A qualified high deductible health plan.
All employers
Contribution Source Account Owner Underlying Insurance Requirement
Employee and/or employer Individual
Employee and/or employer Employer
High deductible health plan
None
Description
Minimum Deductible Maximum Contribution
$1,300 single (2018) $2,600 family (2018) $3,450 single (2018) $6,900 family (2018)
N/A $2,650
Permissible Use Of Funds
If used for non-qualified medical expenses, subject to current tax rate plus 20% penalty.
Reimbursement for qualified medical expenses (as defined in Sec. 213(d) of IRC).
Cash-Outs of Unused Amounts (if no medical expenses)
Permitted, but subject to current tax rate plus 20% penalty (penalty waived after age 65).
Not permitted
Year-to-year rollover of account balance?
Yes, will roll over to use for subsequent year’s health coverage.
No. Access to some funds can may be extended if your employer’s plan contains a 2 1/2 –month grace period or $500 rollover provision.
Does the account earn interest?
Yes
No
Portable?
Yes, portable year-to-year and between jobs.
No
FLIP TO FOR HSA INFORMATION
PG. 16
FLIP TO FOR FSA INFORMATION
PG. 55
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CENTURY HEALTHCARE YOUR BENEFITS PACKAGE
Gap Plan
PLAY VIDEO
About this Benefit A Gap Plan is designed to help supplement your Employer's major medical plan. This plan provides supplemental coverage to help offset out-of-pocket costs that you may experience due to deductibles, co -payments and coinsurance of your medical plan.
33% of total healthcare costs are paid out-of-pocket.
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 12 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
Custom Link - HSA Compatible Gap Plan Options
Plan exclusions
The GAP Plans provide coverage for medically necessary eligible out-ofpocket expenses related to the insured’s major medical plan’s coinsurance and deductibles up to the maximum benefit selected, provided such expenses are the result of treatment for a covered injury or sickness.
The Policy does not provide any benefits for the following: 1. any Expenses Incurred during any period the Insured Person does not have coverage under a Medical Plan; 2. any expenses which are not Medically Necessary; 3. war, declared or undeclared; 4. suicide or any attempt thereat, while sane or insane (in Colorado, Missouri or Montana, while sane); 5. any intentionally self-inflicted Injury or Sickness, while INPATIENT HOSPITAL BENEFIT sane or insane (in Colorado, Missouri or Montana, while sane); 6. any loss The benefit option offers a $2,500 In-Hospital benefit per covered while the Insured Person is in the service of the Armed Forces of any person per calendar year. Note: This coverage may not cover 100% of country. Orders to active military service for training purposes of two out-of-pocket expenses. months or less will not constitute service in the Armed Forces. Upon BENEFITS INCLUDE: notice to the Company of entering the Armed Forces, the Company will Coverage for out-of-pocket expenses due to an inpatient hospital return to the Insured Person pro rata any premium paid, less any benefits confinement. paid, for any period during which the Insured Person is in such service; 7. Inpatient surgeries and physician in-hospital charges any expense for which there is no legal obligation to pay, no charge is Emergency room treatment and ambulance for a covered injury or made or in the absence of coverage, no charge would be made; 8. drugs sickness when it results in hospital confinement within 24 hours or medicines, except medicines prescribed and taken while Hospital Routine Newborn Care Durable medical equipment (DME) when provided while confined in Confined; 9. dental or vision services unless: a. resulting from an Injury occurring while the Insured Person’s coverage under the Policy is in a hospital force; or b. due to congenital disease or anomaly of a Dependent OUTPATIENT HOSPITAL BENEFIT newborn child; 10. mental illness or functional or organic nervous The Outpatient Hospital benefit limit is 50% of the In-hospital benefit disorders, regardless of the cause; 11. treatment of alcoholism, drug amount selected and two times the individual outpatient benefit for addiction or complications thereof; 12. any Injury that occurs while an dependent coverage Insured Person has been determined to be intoxicated: a. by judicial or BENEFITS INCLUDE: Emergency room treatment and ambulance as long as the person is administrative judgment or order; b. by evidence of an alcohol concentration in the Insured Person’s blood, breath or urine which NOT hospitalized within 24 hours of being transported to the equals or exceeds the limits set by applicable motor vehicle laws; or c. by hospital and ER treatment, other evidence demonstrating the Insured Person was under the Outpatient surgery in an outpatient surgical facility, emergency influence of any alcohol, narcotic, barbiturate or hallucinatory drug, facility or physician’s office unless the same was administered on the advice of a Physician and was Diagnostic testing, x-rays, labs, MRI’s, and CT scans taken according to the prescribed dosage; and the use of such substance Outpatient radiation therapy or chemotherapy was a proximate cause of the Injury; 13. any treatment, services or Physical therapy or chiropractic care supplies for Wellness Services. For this exclusion, “Wellness Services” Durable medical equipment (DME) means treatment, services or supplies provided for routine health care, The Outpatient Benefit does not cover a physician’s office visit charge. including, but not limited to, routine health or check-up examinations, Deductible - In order for your GAP plan to be compatible with a Health Savings Account (HSA), it has a deductible amount of $1,300 that must be routine well child visits, mammograms and other charges incurred during the course of a routine physical examination or checkup; 14. Injury or satisfied before any benefits are payable. When dependent coverage is Sickness for which compensation is payable under any Workers’ elected, benefits are payable only after the entire family deductible has Compensation Law, any Occupational Disease Law or similar legislation, been satisfied by one or more insured persons. Please note that in order for a service to be covered under the GAP Plan, it or if the Policyholder opts out of such requirements, any similar coverage purchased or self-funded by the Policyholder to cover work-related needs to be covered under the major medical plan. Injuries or Sicknesses; 15. any loss for which the Insured Person is not Gap Plan Pricing required to pay a Deductible, Copayment and/or Coinsurance under the Insured Person’s Medical Plan; 16. any expense for which benefits are AGE BASED ON MONTHLY COST BY COVERAGE AMOUNT excluded under the Insured Person’s Medical Plan; or 17. an Insured Benefit Amount $2,500 IP / $1,250 OP Person engaging in any act or occupation which is a violation of the law of the jurisdiction where the loss or cause of loss occurred. A violation of Under Age 40: law includes both misdemeanor and felony violations. Insured Only $20.11 Insured & Spouse Insured & Child(ren) Insured & Family
$36.19 $44.44 $60.53
Ages 40 – 49: Insured Only Insured & Spouse Insured & Child(ren) Insured & Family
$27.89 $50.19 $51.31 $73.62
Ages 50 & Above: Insured Only Insured & Spouse Insured & Child(ren) Insured & Family
$45.02 $81.03 $72.94 $108.95
Limitations Medical Plan. If the Insured Person did not have a Medical Plan on the Insured Person’s Effective Date under the Policy, the Company’s sole obligation will then be to refund all premiums paid for that Insured Person. This plan is underwritten by Fidelity Security Life Insurance Company arranged through Special Insurance Services, Inc
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Custom Link Traditional Gap Plan Gap Plan Options The GAP Plans provide coverage for medically necessary eligible out-ofpocket expenses related to the insured’s major medical plan’s coinsurance and deductibles up to the maximum benefit selected, provided such expenses are the result of treatment for a covered injury or sickness.
INPATIENT HOSPITAL BENEFIT The benefit option offers a $2,500 In-Hospital benefit per covered person per calendar year. Note: This coverage may not cover 100% of out-of-pocket expenses. BENEFITS INCLUDE: Coverage for out-of-pocket expenses due to an inpatient hospital confinement. Inpatient surgeries and physician in-hospital charges Emergency room treatment and ambulance for a covered injury or sickness when it results in hospital confinement within 24 hours Routine Newborn Care Durable medical equipment (DME) when provided while confined in a hospital
OUTPATIENT HOSPITAL BENEFIT
Gap Plan Pricing AGE BASED ON MONTHLY COST BY COVERAGE AMOUNT Benefit Amount
$2,500 IP / $1,250 OP
Under Age 40: Insured Only Insured & Spouse Insured & Child(ren) Insured & Family
$35.04 $63.07 $77.43 $105.46
Ages 40 – 49: Insured Only Insured & Spouse Insured & Child(ren) Insured & Family
$48.59 $87.46 $89.41 $128.28
Ages 50 & Above: Insured Only Insured & Spouse Insured & Child(ren) Insured & Family
$78.45 $141.21 $127.08 $189.84
Plan exclusions
The Policy does not provide any benefits for the following: 1. any Expenses Incurred during any period the Insured Person does not have coverage under a Medical Plan; 2. any expenses which are not Medically Necessary; 3. war, declared or undeclared; 4. suicide or any attempt thereat, while sane or insane (in Colorado, Missouri or Montana, BENEFITS INCLUDE: Emergency room treatment and ambulance as long as the person is while sane); 5. any intentionally self-inflicted Injury or Sickness, while sane or insane (in Colorado, Missouri or Montana, while sane); 6. any loss NOT hospitalized within 24 hours of being transported to the while the Insured Person is in the service of the Armed Forces of any hospital and ER treatment, country. Orders to active military service for training purposes of two Outpatient surgery in an outpatient surgical facility, emergency months or less will not constitute service in the Armed Forces. Upon facility or physician’s office notice to the Company of entering the Armed Forces, the Company will Diagnostic testing, x-rays, labs, MRI’s, and CT scans return to the Insured Person pro rata any premium paid, less any benefits Outpatient radiation therapy or chemotherapy paid, for any period during which the Insured Person is in such service; 7. Physical therapy or chiropractic care any expense for which there is no legal obligation to pay, no charge is Durable medical equipment (DME) made or in the absence of coverage, no charge would be made; 8. drugs or medicines, except medicines prescribed and taken while Hospital The Outpatient Benefit does not cover a physician’s office visit charge. Confined; 9. dental or vision services unless: a. resulting from an Injury Please note that in order for a service to be covered under the GAP Plan, it occurring while the Insured Person’s coverage under the Policy is in force; or b. due to congenital disease or anomaly of a Dependent needs to be covered under the major medical plan. newborn child; 10. mental illness or functional or organic nervous disorders, regardless of the cause; 11. treatment of alcoholism, drug addiction or complications thereof; 12. any Injury that occurs while an Insured Person has been determined to be intoxicated: a. by judicial or administrative judgment or order; b. by evidence of an alcohol concentration in the Insured Person’s blood, breath or urine which equals or exceeds the limits set by applicable motor vehicle laws; or c. by other evidence demonstrating the Insured Person was under the influence of any alcohol, narcotic, barbiturate or hallucinatory drug, unless the same was administered on the advice of a Physician and was taken according to the prescribed dosage; and the use of such substance was a proximate cause of the Injury; 13. any treatment, services or supplies for Wellness Services. For this exclusion, “Wellness Services” means treatment, services or supplies provided for routine health care, including, but not limited to, routine health or check-up examinations, routine well child visits, mammograms and other charges incurred during the course of a routine physical examination or checkup; 14. Injury or Sickness for which compensation is payable under any Workers’ The Outpatient Hospital benefit limit is 50% of the In-hospital benefit amount selected and two times the individual outpatient benefit for dependent coverage
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Custom Link Traditional Gap Plan Compensation Law, any Occupational Disease Law or similar legislation, or if the Policyholder opts out of such requirements, any similar coverage purchased or self-funded by the Policyholder to cover workrelated Injuries or Sicknesses; 15. any loss for which the Insured Person is not required to pay a Deductible, Copayment and/or Coinsurance under the Insured Person’s Medical Plan; 16. any expense for which benefits are excluded under the Insured Person’s Medical Plan; or 17. an Insured Person engaging in any act or occupation which is a violation of the law of the jurisdiction where the loss or cause of loss occurred. A violation of law includes both misdemeanor and felony violations.
Limitations Medical Plan. If the Insured Person did not have a Medical Plan on the Insured Person’s Effective Date under the Policy, the Company’s sole obligation will then be to refund all premiums paid for that Insured Person. This plan is underwritten by Fidelity Security Life Insurance Company arranged through Special Insurance Services, Inc.
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EECU
HSA (Health Savings Account)
YOUR BENEFITS PACKAGE
PLAY VIDEO
About this Benefit A Health Savings Account is a tax-advantaged medical savings account available to employees who are enrolled in a high-deductible health plan. The funds contributed to the account are not subject to federal income tax at the time of deposit. Unlike a flexible spending account (FSA), funds roll over and accumulate year to year if not spent.
The interest earned in an HSA is tax free.
Money withdrawn for medical spending never falls under taxable income.
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 16 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
HSA (Health Savings Account) What is an HSA?
How to Use Your Funds
Health Savings Account (HSA) enables you to save for and conveniently pay for qualified healthcare expenses, while you earn tax-free interest and pay no monthly service fees. Opening a Health Savings Account provides both immediate and long term benefits. The money in your HSA is always yours, even if you change jobs, switch your health plan, become unemployed or retire. Your unused HSA balance rolls over from year to year. And best of all, HSAs have tax-free deposits, tax-free earnings and tax-free withdrawals. And after age 65, you can withdraw funds from your HSA penalty-free for any purpose.
HSA Debit Card – use your EECU HSA Mastercard® debit card to pay healthcare providers at point-of-sale or by following the instructions provided on a bill from a medical provider.
Online Bill Pay – sign up, at eecu.org, and use EECU’s free online banking and bill pay to make payments to medical providers directly from your HSA. Online Transfers – use EECU’s online banking or mobile app; reimburse yourself for out-of-pocket expenses by making a transfer from your HSA to your personal checking or savings account. Check – optional HSA checks can be ordered upon request for a fee. You can use these checks to pay healthcare providers and suppliers.
EECU HSA Benefits
Save money tax-free for healthcare expenses – contributions are not subject to federal income taxes and can be made by you, your employer or a third party* No monthly service fee – so you can save more and earn more Earn competitive dividends on your entire balance – compounded daily and paid monthly from deposit to withdrawal Conveniently pay for qualified healthcare expenses – with Save your receipts – for all qualified medical a free, no annual fee EECU HSA Debit Mastercard® or via expenses. EECU does not verify eligibility. You EECU’s free online bill pay. (HSA checks are also available are responsible for making sure payments are upon request, for a nominal fee**) for qualified medical expenses. Free online, mobile and branch access – allows you to actively manage your account however you prefer Comprehensive service and support – to assist you in How To Manage Your Account optimizing your healthcare saving and spending • Online - check your balance, pay healthcare providers Federally insured – to at least $250,000 by NCUA and arrange deposits; sign-up for online banking at www.eecu.org. 2018 Annual HSA Contribution Limits • Mobile - EECU’s mobile app allows you to manage your Individual: $3,450 account on the go; download “EECU Mobile Banking” in Family: $6,900 Apple’s App Store and Google Play. Catch-Up Contributions: Accountholders who meet the • Contact Member Service – call 817-882-0800 for help qualifications noted below are eligible to make an HSA with your HSA questions or transactions. You can also catch-up contribution of an additional $1,000. chat with us online at eecu.org or use our secure email. Health Savings accountholder Member Service is available Monday through Friday from Age 55 or older (regardless of when in the year an 8am – 6:30pm CT, Saturdays from 9am – 1pm CT and accountholder turns 55) closed on Sunday. Not enrolled in Medicare (if an accountholder enrolls in • Account Statements – monthly statements show all your Medicare mid-year, catch-up contributions should be account activity for that period. You can receive free prorated) Authorized Signers who are 55 or older must have their own online statements or pay $2 per printed statement. HSA in order to make the catch-up contribution
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MDLIVE YOUR BENEFITS PACKAGE
Telehealth
PLAY VIDEO
About this Benefit Telehealth provides 24/7/365 access to boardcertified doctors via telephone consultations that can diagnose, recommend treatment and prescribe medication. Whether you are at home, traveling or at work, Telehealth makes care more convenient and accessible for non-emergency care when your primary care physician is not available.
75%
of all doctor, urgent care, and ER visits could be handled safely and effectively via telehealth.
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 18 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
Telehealth When should I use MDLIVE? If you’re considering the ER or urgent care for a non-emergency medical issue Your primary care physician is not available At home, traveling, or at work 24/7/365, even holidays!
What can be treated?
Allergies Asthma Bronchitis Cold and Flu Ear Infections Joint Aches and Pain Respiratory Infection Sinus Problems And More!
Pediatric Care related to:
Cold & Flu Constipation Ear Infection Fever Nausea & Vomiting Pink Eye And More!
Are children eligible? Yes. MDLIVE has local pediatricians on-call 24/7/365. Please note, a parent or guardian must be present during any interactions involving minors. We ask parents to establish a child record under their account. Parents must be present on each call for children 18 or younger.
How much does it cost? $0 Covers you, your spouse, and children up to age 26, with unlimited phone consultations.
Download the App Doctor visits are easier and more convenient with the MDLIVE App. Be prepared. Download today. www.mdlive.com/getapp
Access to a doctor anywhere: at home, at work, or on the go Choose doctors from one of the nation's largest telehealth networks Available 24/7 by video or phone Private, secure and confidential visits Connect instantly with MDLIVE Assist
Who are our doctors? MDLIVE has the nation’s largest network of telehealth doctors. On average, our doctors have 15 years of experience practicing medicine and are licensed in the state where patients are located. Their specialties include primary care, pediatrics, emergency medicine and family medicine. Our doctors are committed to providing convenient, quality care and are always ready to take your call.
Scan with your smartphone to get the app.
Call us at (888) 365-1663 or visit us at www.consultmdlive.com
Disclaimers: MDLIVE does not replace the primary care physician. MDLIVE operates subject to state regulation and may not be available in certain states. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for 19 abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services. For complete terms of use visit www.mdlive.com/terms-of-use/ 010113
LIFEWORKS
EAP (Employee Assistance Program)
YOUR BENEFITS PACKAGE
About this Benefit An Employee Assistance Plan (EAP) is an employee benefit program offered to help employees manage personal and professional problems that might adversely impact their work performance, health, and well-being. Employee Assistance Plans generally include short-term counseling and referral services for employees and their household members. Your Employee Assistance Program benefit is provided to you by your employer.
38%
of employees have missed life events because of bad worklife balance.
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 20 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
Employee Assistance Program (EAP) LifeWorks With LifeWorks Integrated EAP and Work-life services, Taylor ISD employees and their families will have access to confidential assistance and support on a wide range of issues in the areas of life, health, family, work and money. EAP is employer-paid by Taylor ISD for employees and their dependents. TOPIC Emotions and Stress Parenting Midlife and Retirement Addictive Behaviors
DESCRIPTION
TOOL
Relationship issues, depression and anxiety – even an online “calm room” Parenting skills, adoption, talking with your teenager, help in finding child care Financial considerations, work and career in midlife, relationships with adult children, growing as a couple
Online authorization Employees
Drug and alcohol abuse, eating disorders, gambling
Applying to college, understanding financial aid and scholarships, advocating in the schools Caregiver support, referrals to in-home and Caring of older other services, and adults federally funded programs Special needs programs, advocacy and Disability specific disabilities information Community resources and consumer Everyday Issues information Credit management, budget analysis, 401(k) plan questions, basic Financial Issues estate planning, and questions about federal tax planning and preparation On-staff attorneys provide information and referrals for family matters, Legal Issues real estate, consumer credit and criminal matters. Also online program with forms, guides and simple wills. Special content for managers includes employee relations, interpersonal conflicts, performance issues, Work discrimination and workplace change. Also general support for co-worker relationships and stress. Education
DESCRIPTION
Employees can obtain authorization for in-person sessions and choose a counselor right on the website Find child care, elder care, EAP Resource locators counselors, public and private schools, and summer camps. Employees get immediate feedback, descriptions of services Interactive selfavailable and links to relevant content all assessments dynamically generated by their responses More than 1,200 expert-reviewed articles covering the full range Articles of EAP, work-life and wellness issues plus access to more than 4,000 health articles through the Health Library. Monthly audio podcasts for employees and quarterly podcasts Audio podcasts for managers featuring nationally recognized experts and Ceridian consultants. Financial calculators to help employees make savings and Audio CDs purchase decisions and health calculators to help them manage their health Special needs programs, advocacy and Calculators specific disabilities information Online seminars Dozens of online sessions for easy access and workshops at anytime. Employees can subscribe to the monthly LifeWorks email Monthly newsletter, customized for each e-newsletter subscriber from a choice of eight topic areas. Monthly web discussion
Hosted by experts on a variety of topics, these interactive discussions are open to all individuals.
888.456.1324 | WWW.CERIDIAN.COM
21
CIGNA
Dental
YOUR BENEFITS PACKAGE
PLAY VIDEO
About this Benefit Dental insurance is a coverage that helps defray the costs of dental care. It insures against the expense of routine care, treatment and dental disease.
Good dental care may improve your overall health. Also Women with gum disease may be at greater risk of giving birth to a preterm or low birth weight baby.
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 22 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
Dental PPO - Low Option Benefits Network Contract Year Maximum (Class I, II, and III expenses) Contract Deductible Individual Family Reimbursement Levels**
Cigna Dental PPO - Low Option In-Network Out-of-Network Total Cigna DPPO $750
$750
$50 per person $150 per family
$50 per person $150 per family
Based on Contracted Fees
Based on Maximum Allowable Charge (Innetwork fee level)
Plan Pays
You Pay
Plan Pays
You Pay
100% No Deductible
No Charge
100% No Deductible
No Charge
80%* After Deductible
20%*
80%* After Deductible
20%*
50%* After Deductible
50%* After Deductible
50%* After Deductible
50%* After Deductible
50%* After Deductible
50%* After Deductible
50%* After Deductible
50%*
Monthly PPO Premiums Tier
Rate
EE Only
$27.12
EE + 1 Dependent
$48.79
EE + 2 or more Dependents
$75.42
Class I - Preventive & Diagnostic Care Oral Evaluations Prophylaxis: routine cleanings X-rays: routine X-rays: non-routine Fluoride Application Sealants: per tooth Space Maintainers: non-orthodontic Emergency Care to Relieve Pain
Class II - Basic Restorative Care Restorative: Fillings Oral Surgery – Simple Extractions onl;y
Class III - Major Restorative Care Endodontics: minor and major Periodontics: minor and major Oral Surgery: All Except Simple Extractions Inlays and Onlays Prosthesis Over Implant Crowns: prefabricated stainless steel / resin Crowns: permanent cast and porcelain Bridges and Dentures Anesthesia: general and IV sedation Repairs: Bridges, Crowns and Inlays Repairs: Dentures Denture Relines, Rebases and Adjustments
Class IV - Orthodontia Coverage for Dependent Children to age 19 Lifetime Benefits Maximum: $1,000
Benefit Limitations: Missing Tooth Limitation: For teeth missing prior to coverage with Cigna, the amount payable is 50% of the amount otherwise payable until covered for 12 months; thereafter, considered a Class III expense. Oral Evaluations: 2 per policy year X-rays (routine): Bitewings: 2 per policy year X-rays (non-routine): Complete series of radiographic images and panoramic radiographic images: Limited to a combined total of 1 per 36 consecutive months Diagnostic Casts: Payable only in conjunction with orthodontic workup Cleanings: 2 per policy year, including periodontal maintenance procedures following active therapy Fluoride Application: 1 per policy year for children under age 19 Sealants (per tooth): Limited to posterior tooth. 1 treatment per tooth every 36 months for children under age 14 Space Maintainers: Limited to non-orthodontic treatment for children under age 19 Inlays, Crowns, Bridges, Dentures and Partials: Replacement every 60 months if unserviceable and cannot be repaired. Benefits are based on the amount payable for non-precious metals. No porcelain or white/tooth-colored material on molar crowns or bridges. Denture and Bridge Repairs: Reviewed if more than once Denture Adjustments, Rebases and Relines: Covered if more than 6 months after installation 23 Prosthesis Over Implant: 1 every 60 months if unserviceable and cannot be repaired. Benefits are based on the amount payable for non-precious metals. No porcelain or white/tooth colored material on molar crowns or bridges.
Dental PPO - High Option Benefits Network Contract Year Maximum (Class I, II, and III expenses) Contract Deductible Individual Family Reimbursement Levels**
Cigna Dental PPO - Low Option In-Network Out-of-Network Total Cigna DPPO $1,000
$1,000
$50 per person $150 per family
$50 per person $150 per family
Based on Contracted Fees
Maximum Reimbursable Charge
Plan Pays
You Pay
Plan Pays
You Pay
100% No Deductible
No Charge
100% No Deductible
No Charge
80%* After Deductible
20%* After Deductible
80%* After Deductible
20%* After Deductible
50%* After Deductible
50%* After Deductible
50%* After Deductible
50%* After Deductible
50%* After Deductible
50%* After Deductible
50%* After Deductible
50%* After Deductible
Monthly PPO Premiums Tier
Rate
EE Only
$38.99
EE + 1 Dependent
$69.78
EE + 2 or more Dependents
$110.05
Class I - Preventive & Diagnostic Care Oral Evaluations Prophylaxis: routine cleanings X-rays: routine X-rays: non-routine Fluoride Application Sealants: per tooth Space Maintainers: non-orthodontic Emergency Care to Relieve Pain
Class II - Basic Restorative Care Restorative: Fillings Oral Surgery – Simple Extractions Only
Class III - Major Restorative Care Endodontics: minor and major Periodontics: minor and major Oral Surgery: All Except Simple Extractions Inlays and Onlays Prosthesis Over Implant Crowns: prefabricated stainless steel / resin Crowns: permanent cast and porcelain Bridges and Dentures Anesthesia: general and IV sedation Repairs: Bridges, Crowns and Inlays Repairs: Dentures Denture Relines, Rebases and Adjustments
Class IV - Orthodontia Coverage for Dependent Children to age 19 Lifetime Benefits Maximum: $1,000
Benefit Limitations: Missing Tooth Limitation: For teeth missing prior to coverage with Cigna, the amount payable is 50% of the amount otherwise payable until covered for 12 months; thereafter, considered a Class III expense. Oral Evaluations: 2 per policy year X-rays (routine): Bitewings: 2 per policy year X-rays (non-routine): Complete series of radiographic images and panoramic radiographic images: Limited to a combined total of 1 per 36 consecutive months Diagnostic Casts: Payable only in conjunction with orthodontic workup Cleanings: 2 per policy year, including periodontal maintenance procedures following active therapy Fluoride Application: 1 per policy year for children under age 19 Sealants (per tooth): Limited to posterior tooth. 1 treatment per tooth every 36 months for children under age 14 Space Maintainers: Limited to non-orthodontic treatment for children under age 19 Inlays, Crowns, Bridges, Dentures and Partials: Replacement every 60 months if unserviceable and cannot be repaired. Benefits are based on the amount payable for non -precious metals. No porcelain or white/tooth-colored material on molar crowns or bridges. Denture and Bridge Repairs: Reviewed if more than once Denture Adjustments, Rebases and Relines: Covered if more than 6 months after installation Prosthesis 24 Over Implant: 1 every 60 months if unserviceable and cannot be repaired. Benefits are based on the amount payable for non-precious metals. No porcelain or white/tooth colored material on molar crowns or bridges.
Dental PPO - High and Low Options Benefit Plan Provisions In-Network Reimbursement For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Fee Schedule or Discount Schedule. Non-Network Reimbursement For services provided by a non-network dentist, Cigna Dental will reimburse according to the Maximum Reimbursable Charge. The MRC is calculated at the 90th percentile of all provider charges in the geographic area. The dentist may balance bill up to their usual fees. Cross Accumulation All deductibles, plan maximums, and service specific maximums cross accumulate between in and out of network. Benefit frequency limitations are based on the date of service and cross accumulate between in and out of network. Policy Year Benefits Maximum The plan will only pay for covered charges up to the yearly Benefits Maximum, when applicable. Benefit-specific Maximums may also apply. Policy Year Deductible This is the amount you must pay before the plan begins to pay for covered charges, when applicable. Benefit-specific deductibles may also apply. Late Entrant Limitation Provision Payment will be reduced by 50% for Class III and IV services for 12 months for eligible members that are allowed to enroll in this plan outside of the designated open enrollment period. This provision does not apply to new hires. Pretreatment Review Pretreatment review is available on a voluntary basis when dental work in excess of $200 is proposed. Alternate Benefit Provision When more than one covered Dental Service could provide suitable treatment based on common dental standards, Cigna HealthCare will determine the covered Dental Service on which payment will be based and the expenses that will be included as Covered Expenses. Oral Health Integration Program (OHIP) Cigna Dental Oral Health Integration Program offers enhanced dental coverage for customers with the following medical conditions: diabetes, heart disease, stroke, maternity, head and neck cancer radiation, organ transplants and chronic kidney disease. There’s no additional charge for the program, those who qualify get reimbursed 100% of coinsurance for certain related dental procedures. Eligible customers can also receive guidance on behavioral issues related to oral health and discounts on prescription and non-prescription dental products. Reimbursements under this program are not subject to the plan deductible, but will be applied to and are subject to the plan annual maximum. Discounts on certain prescription and non-prescription dental products are available through Cigna Home Delivery Pharmacy only, and you are required to pay the entire discounted charge. For more information including how to enroll in this program and a complete list of program terms and eligible medical conditions, go to www.mycigna.com or call customer service 24/7 at 1.800.CIGNA24.
Benefit Exclusions
Procedures and services not listed under Benefit Highlights; Diagnostic: cone beam imaging; Preventive Services: instruction for plaque control, oral hygiene and diet; Restorative: Veneers of porcelain or acrylic materials on crowns or pontics on or replacing the upper and lower first, second and/or third molars; Periodontic: bite registrations; splinting; Prosthodontic: precision or semi-precision attachments; Implants: implants or implant related services; Procedures, appliances or restorations, except full dentures, whose main purpose is to: change vertical dimension; diagnose or treat conditions or dysfunction of the temporomandibular joint (TMJ); stabilize periodontally involved teeth; or restore occlusion; Athletic mouth guards; Replacement of a lost or stolen appliance; Services performed primarily for cosmetic
reasons; Personalization; Services that are deemed to be medical in nature; Services and supplies received from a hospital; Drugs: prescription drugs Charges in excess of the Maximum Allowable Charge. Contracted providers are not obligated to provide discounts on non-covered services and may charge their usual fees.
25
SUPERIOR VISION YOUR BENEFITS PACKAGE
Vision
PLAY VIDEO
About this Benefit Vision insurance provides coverage for routine eye examinations and may cover all or part of the costs associated with contact lenses, eyeglasses and vision correction, depending on the plan.
75% of U.S. residents between age 25 and 64 require some sort of vision correction.
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 26 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
Vision Benefits
In-Network
Out-of-Network
Covered in full
Up to $35 retail
EE Only
$11.44
$150 retail allowance $200 retail allowance
Up to $70 retail Up to $80 retail
EE + Spouse
$19.76
EE + Child(ren)
$20.80
Covered in full
Up to $150 retail
EE + Family
$31.20
Exam Frames Contact Lenses2 Medically Necessary Contact Lenses
$300.00 allowance3
Laser Vision Correction
Lenses (standard) per pair Single Vision
Covered in full
Up to $25 retail
Bifocal
Covered in full
Up to $40 retail
Trifocal
Covered in full
Progressive
Monthly Premiums
See description
1
Co-Pays Exam
$10.00
Materials
$10.00
Services/Frequency
Up to $45 retail
Exam
12 months
Up to $45 retail
Frame
12 months
Lenticular
Covered in full
Up to $80 retail
Lenses
12 months
Scratch coating
Covered in full
Not covered
Contact Lenses
12 months
Polycarbonate
Covered in full
Not covered
Anti-reflective coating
Covered in full
Not covered
UV coating
Covered in full
Not covered
Tint
Covered in full
Not covered
(Based on date of service)
Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements 1 Covered to provider’s in-office standard retail lined trifocal amount; member pays difference between progressive and standard retail lined trifocal, plus applicable co-pay 2 Contact lenses and related professional services (fitting, evaluation and follow-up) are covered in lieu of eyeglass lenses and frames benefit 3 Lasik Vision Correction is in lieu of eyewear benefit, subject to routine regulatory filings and certain exclusions and limitations
Discount Features Non-Covered Eyewear Discount: Members may also receive a discount of 20% from a participating provider’s usual and customary fees for eyewear purchases which exceed the benefit coverage (except disposable contact lenses, for which no discount applies). This includes eyeglass frames which exceed the selected benefit coverage, specialty lenses (i.e. progressives) and lens “extras” such as tints and coatings. Eyewear purchased from a Walmart Vision Center does not qualify for this additional discount because of Walmart’s “Always Low Prices” policy.
SuperiorVision.com Customer Service 800.507.3800
The Plan discount features are not insurance. All allowances are retail; the member is responsible for paying the provider directly for all non-covered items and/or any amount over the allowances, minus available discounts. These are not covered by the plan. Discounts are subject to change without notice. Disclaimer: All final determinations of benefits, administrative duties, and definitions are governed by the Certificate of Insurance for your vision plan. Please check with your Human Resources department if you have any questions 27
UNUM YOUR BENEFITS PACKAGE
Educator Disability
PLAY VIDEO
About this Benefit Disability insurance protects one of your most valuable assets, your paycheck. This insurance will replace a portion of your income in the event that you become physically unable to work due to sickness or injury for an extended period of time.
Just over 1 in 4 of today's 20 year -olds will become disabled before they retire.
34.6 months is the duration of the average disability claim.
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 28 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
Educator Disability Please read carefully the following description of your Unum Educator Select Income Protection Plan insurance.
Eligibility You are eligible for disability coverage if you are an active employee in the United States working a minimum of 20 hours per week. The date you are eligible for coverage is the later of: the plan effective date; or the day after you complete the waiting period.
Guarantee Issue Current Employees: Coverage is available to you without answering any medical questions or providing evidence of insurability. You may enroll on or before the enrollment deadline. After the initial enrollment period, you can apply only during an annual enrollment period. New Hires: Coverage is available to you without answering any medical questions or providing evidence of insurability. You may apply for coverage within 60 days after your eligibility date. If you do not apply within 60 days after your eligibility date, you can apply only during an annual enrollment period. Benefits will not be paid for disabilities caused by, contributed to by, or resulting from a pre-existing condition. You have a pre-existing condition if: you received medical treatment, consultation, care or services including diagnostic measures, or took prescribed drugs or medicines in the 3 months just prior to your effective date of coverage; and the disability begins in the first 12 months after your effective date of coverage.
Benefit Amount You may purchase a monthly benefit in $100 units, starting at a minimum of $200, up to 66 2/3% of your monthly earnings rounded to the nearest $100, but not to exceed a monthly maximum benefit of $8,000. Please see your Plan Administrator for the definition of monthly earnings.
Elimination Period The Elimination Period is the length of time of continuous disability, due to sickness or injury, which must be satisfied before you are eligible to receive benefits. You may choose an Elimination Period (injury/sickness) of 14/14, 30/30, 60/60, 90/90 or 180/180 days. If, because of your disability, you are hospital confined as an inpatient, benefits begin on the first day of inpatient confinement. Inpatient means that you are confined to a hospital room due to your sickness or injury for 23 or more consecutive hours. (Applies to Elimination Periods of 30 days or less.)
Benefit Duration Your duration of benefits is based on your age when the disability occurs. Plan: ADEA II: Your duration of benefits is based on the following table: Age at Disability Less than age 60 Age 60 through 64 Age 65 through 69 Age 70 and over
Maximum Duration of Benefits To age 65, but not less than 5 years 5 years To age 70, but not less than 1 year 1 year
Next Steps How to Apply/Effective Date of Coverage Current Employees: To apply for coverage, complete your enrollment form by the enrollment deadline. Your effective date of coverage is 9/01. New Hires: To apply for coverage, complete your enrollment form within 60 days of your eligibility date. Please see your Plan Administrator for your effective date. If you do not enroll during the initial enrollment period, you may apply only during an annual enrollment.
Delayed Effective Date of Coverage If you are absent from work due to injury, sickness, temporary layoff or leave of absence, your coverage will not take effect until you return to active employment. Please contact your Plan Administrator after you return to active employment for when your coverage will begin.
Questions If you should have any questions about your coverage or how to enroll, please contact your Plan Administrator. This plan highlight is a summary provided to help you understand your insurance coverage from Unum. Some provisions may vary or not be available in all states. Please refer to your certificate booklet for your complete plan description. If the terms of this plan highlight summary or your certificate differ from your policy, the policy will govern. For complete details of coverage, please refer to policy form number C.FP-1, et al. Underwritten by: Unum Life Insurance Company of America 2211 Congress Street, Portland, Maine 04122, www.unum.com Š2007 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.
29
Educator Disability TAYLOR INDEPENDENT SCHOOL DISTRICT Costs below are based on a Monthly payroll deduction (Employer billing mode is based on 12 Payments per year)
Product: Educator Select Income Protection Plan
Annual Earnings
Monthly Earnings
3600 5400 7200 9000 10800 12600 14400 16200 18000 19800 21600 23400 25200 27000 28800 30600 32400 34200 36000 37800 39600 41400 43200 45000 46800 48600 50400 52200 54000 55800 57600 59400 61200 63000 64800 66600 68400 70200 72000 73800 75600 77400 79200 81000 82800 84600 86400 88200 90000 91800 93600
300 450 600 750 900 1050 1200 1350 1500 1650 1800 1950 2100 2250 2400 2550 2700 2850 3000 3150 3300 3450 3600 3750 3900 4050 4200 4350 4500 4650 4800 4950 5100 5250 5400 5550 5700 5850 6000 6150 6300 6450 6600 6750 6900 7050 7200 7350 7500 7650 7800
30
Plan A ADEA II Duration of Benefits Elimination Period (Days) Injury (Days) Sickness (Days) Maximum Monthly Benefit 200 300 400 500 600 700 800 900 1000 1100 1200 1300 1400 1500 1600 1700 1800 1900 2000 2100 2200 2300 2400 2500 2600 2700 2800 2900 3000 3100 3200 3300 3400 3500 3600 3700 3800 3900 4000 4100 4200 4300 4400 4500 4600 4700 4800 4900 5000 5100 5200
5.56 8.34 11.12 13.90 16.68 19.46 22.24 25.02 27.80 30.58 33.36 36.14 38.92 41.70 44.48 47.26 50.04 52.82 55.60 58.38 61.16 63.94 66.72 69.50 72.28 75.06 77.84 80.62 83.40 86.18 88.96 91.74 94.52 97.30 100.08 102.86 105.64 108.42 111.20 113.98 116.76 119.54 122.32 125.10 127.88 130.66 133.44 136.22 139.00 141.78 144.56
4.78 7.17 9.56 11.95 14.34 16.73 19.12 21.51 23.90 26.29 28.68 31.07 33.46 35.85 38.24 40.63 43.02 45.41 47.80 50.19 52.58 54.97 57.36 59.75 62.14 64.53 66.92 69.31 71.70 74.09 76.48 78.87 81.26 83.65 86.04 88.43 90.82 93.21 95.60 97.99 100.38 102.77 105.16 107.55 109.94 112.33 114.72 117.11 119.50 121.89 124.28
3.84 5.76 7.68 9.60 11.52 13.44 15.36 17.28 19.20 21.12 23.04 24.96 26.88 28.80 30.72 32.64 34.56 36.48 38.40 40.32 42.24 44.16 46.08 48.00 49.92 51.84 53.76 55.68 57.60 59.52 61.44 63.36 65.28 67.20 69.12 71.04 72.96 74.88 76.80 78.72 80.64 82.56 84.48 86.40 88.32 90.24 92.16 94.08 96.00 97.92 99.84
2.16 3.24 4.32 5.40 6.48 7.56 8.64 9.72 10.80 11.88 12.96 14.04 15.12 16.20 17.28 18.36 19.44 20.52 21.60 22.68 23.76 24.84 25.92 27.00 28.08 29.16 30.24 31.32 32.40 33.48 34.56 35.64 36.72 37.80 38.88 39.96 41.04 42.12 43.20 44.28 45.36 46.44 47.52 48.60 49.68 50.76 51.84 52.92 54.00 55.08 56.16
1.52 2.28 3.04 3.80 4.56 5.32 6.08 6.84 7.60 8.36 9.12 9.88 10.64 11.40 12.16 12.92 13.68 14.44 15.20 15.96 16.72 17.48 18.24 19.00 19.76 20.52 21.28 22.04 22.80 23.56 24.32 25.08 25.84 26.60 27.36 28.12 28.88 29.64 30.40 31.16 31.92 32.68 33.44 34.20 34.96 35.72 36.48 37.24 38.00 38.76 39.52
Educator Disability TAYLOR INDEPENDENT SCHOOL DISTRICT
Annual Earnings
Monthly Earnings
Monthly Benefit
95400 97200 99000 100800 102600 104400 106200 108000 109800 111600 113400 115200 117000 118800 120600 122400 124200 126000 127800 129600 131400 133200 135000 136800 138600 140400 142200 144000
7950 8100 8250 8400 8550 8700 8850 9000 9150 9300 9450 9600 9750 9900 10050 10200 10350 10500 10650 10800 10950 11100 11250 11400 11550 11700 11850 12000
5300 5400 5500 5600 5700 5800 5900 6000 6100 6200 6300 6400 6500 6600 6700 6800 6900 7000 7100 7200 7300 7400 7500 7600 7700 7800 7900 8000
147.34 150.12 152.90 155.68 158.46 161.24 164.02 166.80 169.58 172.36 175.14 177.92 180.70 183.48 186.26 189.04 191.82 194.60 197.38 200.16 202.94 205.72 208.50 211.28 214.06 216.84 219.62 222.40
126.67 129.06 131.45 133.84 136.23 138.62 141.01 143.40 145.79 148.18 150.57 152.96 155.35 157.74 160.13 162.52 164.91 167.30 169.69 172.08 174.47 176.86 179.25 181.64 184.03 186.42 188.81 191.20
101.76 103.68 105.60 107.52 109.44 111.36 113.28 115.20 117.12 119.04 120.96 122.88 124.80 126.72 128.64 130.56 132.48 134.40 136.32 138.24 140.16 142.08 144.00 145.92 147.84 149.76 151.68 153.60
57.24 58.32 59.40 60.48 61.56 62.64 63.72 64.80 65.88 66.96 68.04 69.12 70.20 71.28 72.36 73.44 74.52 75.60 76.68 77.76 78.84 79.92 81.00 82.08 83.16 84.24 85.32 86.40
40.28 41.04 41.80 42.56 43.32 44.08 44.84 45.60 46.36 47.12 47.88 48.64 49.40 50.16 50.92 51.68 52.44 53.20 53.96 54.72 55.48 56.24 57.00 57.76 58.52 59.28 60.04 60.80
31
LOYAL AMERICAN
Cancer
YOUR BENEFITS PACKAGE
PLAY VIDEO
About this Benefit Cancer insurance offers you and your family supplemental insurance protection in the event you or a covered family member is diagnosed with cancer. It pays a benefit directly to you to help with expenses associated with cancer treatment.
Breast Cancer is the most commonly diagnosed cancer in women.
If caught early, prostate cancer is one of the most treatable malignancies.
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 32 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
Cancer ADDITIONAL BENEFIT AMOUNTS
PLAN A Maximum
PLAN B Maximum
ANNUAL CANCER SCREENING BENEFIT RIDER (form LG-6041) A. Basic Benefit We will pay the expense incurred, but not to exceed the maximum benefit amount shown on the Certificate Schedule, once per calendar year per Insured Person for screening tests performed to determine whether Cancer exists in an Insured Person. Covered annual Cancer screening tests include but are not limited to: mammogram, pap smear, breast ultrasound, ThinPrep, biopsy, chest x-ray, thermography, colonoscopy, flexible sigmoidoscopy, hemocult stool specimen, PSA (blood test for prostate cancer), CEA (blood tests for colon cancer), CA125 (blood test for ovarian cancer), CA15-3 (blood test for breast cancer), serum protein electrophesis (blood test for myeloma).
B.
$50 $50 Per Calendar Per Calendar Year Year
Additional Benefit
$100 We will pay the expense incurred, but not to exceed two times the maximum benefit amount per calendar year as shown on the Certificate Schedule, for one additional invasive diagnostic procedure required as the result of an abnormal cancer screening test Per Calendar Year for which benefits are payable under the Basic Benefit above for an Insured Person. This additional benefit is payable regardless of the results of the additional diagnostic procedure. However, the amount payable will be reduced dollar for dollar for any amount payable under the Positive Diagnosis Benefit contained in the base Certificate. FIRST OCCURRENCE BENEFIT RIDER (form LG-6043) If an Insured Person receives a positive diagnosis of Internal Cancer, We will pay the First Occurrence benefit amount shown on the Certificate Schedule. If the Insured Person receiving the positive diagnosis of Internal Cancer is a child under the age of 21, we will pay one and onehalf times the First Occurrence benefit amount shown on the Certificate Schedule.
$2,000 Once per Lifetime $3,000 Once per Lifetime
$100 Per Calendar Year
$500 Once per Lifetime $750 Once per Lifetime
ANNUAL RADIATION, CHEMOTHERAPY, IMMUNOTHERAPY and EXPERIMENTAL TREATMENT BENEFIT RIDER (form LG-6045) We will pay the expense incurred, but not to exceed the maximum benefit amount shown on the Certificate Schedule, per calendar year per Insured Person for Radiation Treatment, Chemotherapy, Hormonal Therapy, Immunotherapy or Experimental $15,000 Treatment. The Radiation Treatment, Chemotherapy, Hormonal Therapy, Immunotherapy or Experimental Treatment must be Per Calendar for the treatment of an Insured Person’s Cancer. The benefit amount shown on the Certificate Schedule is the maximum calendar Year year benefit available per Insured Person regardless of the number or types of Cancer treatments received in the same year.
SURGICAL BENEFIT RIDER (form LG-6048) Surgical Expense We will pay the Surgical Expense benefit for a surgical procedure for the treatment of an Insured Person’s Cancer (except Skin Cancer) according to the Surgical Schedule shown in this rider. However, in no event will the amount payable exceed the maximum Surgical Expense benefit shown on the Certificate Schedule, nor will it exceed the expense incurred.
Anesthesia Expense We will pay the anesthesia expense incurred, not to exceed 25% of the covered Surgical Expense benefit for the operation performed. This includes the services of an anesthesiologist or of an anesthetist under supervision of a physician for the purpose of administering anesthesia.
$5,000 Per Calendar Year
$5,000 Procedure Maximum
$500 Procedure Maximum
$1,250 Procedure Maximum
$125 Procedure Maximum
$4,500 Procedure Maximum
$450 Procedure Maximum
Breast Reconstruction With transverse rectus adominis myocutaneous flap (TRAM), single pedicle, including closure of donor site, with microvascular anastomosis (supercharging) is one of the surgical procedures listed in the Surgical Schedule. If this procedure is performed on an Insured Person as the result of a mastectomy for which We paid a Surgical Expense benefit for the treatment of Breast Cancer, We will pay the expense incurred not to exceed $900 per $1,000 of the Surgical Benefit issued.
Skin Cancer Surgery Expense We will pay the expense incurred, not to exceed the procedure amount listed in this rider ($125 to $750 depending on the procedure) when a surgical operation is performed on an Insured Person for treatment of a diagnosed Skin Cancer. This benefit is payable in lieu of any benefits for Surgical Expense and Anesthesia Expense which are not applicable to Skin Cancer.
DAILY HOSPITAL CONFINEMENT BENEFIT RIDER (form LG-6042) Confinements of 30 Days or Less We will pay the Daily Hospital Confinement benefit amount shown on the Certificate Schedule for each of the first 30 days in each period of hospital confinement during which an Insured Person is confined to a hospital, including a government or charity hospital, for the treatment of Cancer.
Confinements of 31 Days or More If an Insured Person is continuously confined to a hospital, including a government or charity hospital, for longer than 30 consecutive days for the treatment of Cancer, We will pay two times the Daily Hospital Confinement benefit amount shown on the Certificate Schedule. This benefit payment will begin on the 31st continuous day of such confinement and continue for each day of confinement until the Insured Person is discharged from the Hospital.
Benefits for an Insured Dependent Child under Age 21 The amount payable under this benefit will be double the Daily Hospital Confinement benefit shown on the Certificate Schedule if the Insured Person so confined is a dependent child under the age of 21.
Per Procedure Per Procedure
$200 Per Day
$100 Per Day
$400 Per Day
$200 Per Day
$400/ $800 Per Day
$200/ $400 Per Day
33
Cancer Additional Benefits Amounts SPECIFIED DISEASE BENEFIT RIDER (form LG-6052) If an Insured Person is first diagnosed with one or more covered Specified Diseases and is hospitalized for the definitive treatment of any covered Specified Disease, We will pay benefits according to the provisions of this rider. Covers These 38 Specified Diseases Addison’s Disease Amyotrophic Lateral Sclerosis Botulism Bovine Spongiform Encephalopathy Budd-Chiari Syndrome Cystic Fibrosis Diptheria Encephalitis Epilepsy Hansen’s Disease Histoplasmosis Legionnaire’s Disease Lyme Disease
Lupus Erythematosus Malaria Meningitis Multiple Sclerosis Muscular Dystrophy Myasthenia Gravis Neimann-Pick Disease Osteomyelitis Poliomyelitis Q Fever Rabies Reye’s Syndrome Rheumatic Fever
Rocky Mountain Spotted Fever Sickle Cell Anemia Tay-Sachs Disease Tetanus Toxic Epidermal Necrolysis Tuberculosis Tularemia Typhoid Fever Undulant Fever West Nile Virus Whipple’s Disease Whooping Cough
Benefits If an Insured Person is first diagnosed with one or more covered Specified Diseases and is hospitalized for the definitive treatment of any covered Specified Disease, We will pay benefits according to the provisions of this rider. An applicant may select 1, 2 or 3 units of coverage. Initial Hospitalization Benefit We will pay a benefit of $1,500 per unit of coverage selected when an Insured Person is confined to a hospital (for 12 or more hours, not applicable in SD) as a result of receiving treatment for a Specified Disease. This benefit is payable only once per period of confinement and once per calendar year for each Insured Person. Hospital Confinement Benefit We will pay a benefit of $300 per day per unit of coverage selected when an Insured Person is hospitalized during any continuous period of 30 days or less for the treatment of a covered Specified Disease. Benefits will double per day beginning with the 31st day of continuous confinement. If the hospital confinement follows a previously covered confinement, it will be deemed a continuation of the first confinement unless it is the result of an entirely different Specified Disease, or unless the confinements are separated by 30 days or more.
34
$32.67
Employee and Spouse $45.30
$45.30
$17.07
$23.12
$23.12
Monthly Rates
Employee
Single Parent
Base Plan A
$27.01
Base Plan B
$13.43
Family
Cancer
OPTIONAL BENEFITS YOU MAY SELECT FOR ADDITIONAL PREMIUM
HOSPITAL INTENSIVE CARE UNIT BENEFIT RIDER (form LG-6047) Intensive Care Unit Benefit We will pay the daily Hospital Intensive Care Unit Benefit shown on the Certificate Schedule for an Insured Person’s confinement in an ICU for sickness or injury.
$1,000 Per Day
Double Intensive Care Unit Benefit We will pay double the daily Hospital Intensive Care Unit benefit amount shown on the Certificate Schedule for an Insured Person’s confinement in an ICU as a result of Cancer. We will also double this ICU benefit for only the initial ICU confinement resulting from an Insured Person’s travel related injury, provided that the ICU confinement begins within 24 hours of the accident causing the travel related injury. A travel related injury includes being struck by an automobile, bus, truck, van, motorcycle, train or airplane; or being involved in an accident where the Insured Person was the operator or passenger in or on such vehicle.
$2,000 Per Day
Step Down Unit Benefit We will pay one-half of the daily Hospital Intensive Care Unit benefit amount shown on the Certificate Schedule for an Insured Person’s confinement in a Step Down Unit for a sickness or injury.
$500 Per Day
*Additional Limitations and Exclusions for the Hospital Intensive Care Unit Benefit Rider If the rider is issued and coverage is in force, it will provide benefits if an Insured Person goes into a hospital Intensive Care Unit (including a Cardiac Intensive Care Unit or Neonatal Intensive Care Unit). Benefits start the first day of confinement in an ICU for sickness or injury. Any combination of benefits payable under this rider is limited to a maximum of 45 days per each period of confinement. ALL BENEFITS CONTAINED IN THIS HOSPITAL INTENSIVE CARE UNIT BENEFIT RIDER REDUCE BY ONE-HALF AT AGE 75. Benefits are not payable for any ICU or Step Down Unit confinement that results from intentional self-inflicted injury; or the Insured Person’s being intoxicated or under the influence of alcohol, drugs or any narcotics, unless administered on and according to the advice of a medical practitioner. THIS IS A LIMITED RIDER.
Monthly Rates
Employee
Single Parent
Employee and Spouse
Family
Base Plan A + ICU
$31.66
$39.06
$54.10
$54.10
Base Plan B + ICU
$18.08
$23.46
$31.92
$31.92
35
LOYAL AMERICAN YOUR BENEFITS PACKAGE
Accident
PLAY VIDEO
About this Benefit
2/3
Accident insurance is designed to supplement your medical insurance coverage by covering indirect costs that can arise with a serious, or a not-soserious, injury. Accident coverage is low cost protection available to you and your family without evidence of insurability.
of disabling injuries suffered by American workers are not work related. American workers 36% ofreport they always or
usually live paycheck to paycheck.
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 36 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
Accident Group #1575 Plan pays benefit amounts for covered medical expenses as a result of an accident, directly to you! Coverage is available for ages 18-64 and is portable, you can choose to keep your benefit even if you leave the district or retire. This policy does not pay for losses resulting from sickness, only accident. Always refer to your policy for detailed terms and conditions. This policy is guaranteed renewable.
Summary of Benefits
Plan A
Plan B
$150
$75
$600
$300
Ambulance Ground Ambulance Benefit: Loyal American will pay this benefit if you require transportation by a licensed professional ambulance company to or from a hospital or between medical facilities within 90 days for injuries sustained after a covered accident. Payable once per accident. Air Ambulance Benefit: Loyal American will pay this benefit if you require transportation by a license professional air ambulance company to or from a hospital or between medical facilities within 48 hours for injuries sustained after a covered accident. Payable once per accident.
Indemnity Benefits Insured/Spouse: Insured/Spouse: Emergency Room Treatment Benefit: Loyal American will pay this benefit if you received hospital emergency room treatment within 72 hours of injuries sustained in a covered accident $150 $75 and for which charges are submitted. Child: $75 Child: $40 Accident Follow-Up Treatment Benefit: Loyal American will pay this benefit for three additional treatments of injuries sustained in a covered accident over and above emergency treatment administered during the first 72 hours following the accident. Treatment must begin within 30 days of the covered accident and must be within the 6 month period following the covered accident. Specific Sum Injuries Benefit: Loyal The specific indemnity amount as listed in the policy's Benefit Schedule will be paid according to the type of injury received in a covered accident. Loyal American will pay for dislocations (separated joint), burns, tendon (torn, ruptured, severed, ligaments, or rotator cuff), torn knee cartilage, eye injuries, lacerations, and fractures (broken bones). Blood, Plasma, Platelets Benefit: Loyal American will pay this benefit if you require transfusion, administration, cross matching, typing and processing of blood, plasma or platelets when administered within 90 days for injuries sustained in a covered accident. Payable once per accident.
$50 per visit
$25 per visit
$100
$50
$500
$250
$200 per day
$100 per day
$400 per day
$200 per day
Hospital Benefits Initial Accident Hospitalization Benefit: Loyal American will pay this benefit if hospital confinement is required within six (6) months for injuries sustained in a covered accident. Payable once per accident. Hospital Confinement Benefit: Loyal American will pay this benefit for a maximum of 180 days per confinement.* if you require confinement in a hospital or in a hospital intensive care unit– sub acute within six (6) months for injuries sustained in a covered accident.
Intensive Care Hospital Intensive Care Unit Confinement Benefit: Loyal American will pay this benefit for a maximum of 15 days per confinement* if you are confined in a hospital intensive care unit within 30 days because of injuries received in a covered accident. *Confinements separated by less than 90 days will be considered as the same period of confinement.
37
Accident Summary of Benefits
Plan A
Plan B
$50 per treatment
$25 per treatment
Physical Therapy Physical Therapy Benefit: Loyal American will pay this benefit, not to exceed five treatments per accident, for services prescribed by a doctor and rendered by a licensed physical therapist. Physical therapy must be for injuries sustained in a covered accident and must start within 60 days after the accident. Treatment must be completed within 6 months after the accident.
Prostheses Benefit: Loyal American will pay this benefit if a doctor prescribes the use of 1 prosthetic a prosthetic device due to the loss of a hand, foot or sight of an eye in a covered accident. device/artificial The prosthetic must be received within 1 year of the covered accident. This benefit is limb: $100 payable once per accident and is not payable for hearing aids, dental aids, false teeth or More than 1: for cosmetic prosthesis (e.g. hair wigs). We will not pay for joint replacement (e.g. artificial $500 hip or knee). Appliance Benefit: Loyal American will pay this benefit if a doctor advises you to use a medical appliance as an aid to personal locomotion within 90 days as a result of injuries sustained in a covered accident. Benefits are payable for crutches, wheelchairs, braces, etc. Benefits are payable for crutches and wheelchairs once per accident.
1 prosthetic device/artificial limb: $50 More than 1: $250
$50
$25
$100 per day
$50 per day
$300
$150
Family Lodging & Transportation Family Lodging Benefit: Loyal American will pay this benefit for a maximum of 30 days per accident, during the time you are confined in a hospital, for one motel/hotel room for a family member to accompany you if injuries sustained in a covered accident require hospital confinement, and if the hospital and motel/hotel are more than 100 miles from your residence. Transportation Benefit: Loyal American will pay this benefit for a maximum of three trips per calendar year if you require special treatment and confinement in a hospital located more than 100 miles from your residence or site of the accident for injuries sustained in a covered accident.
Accidental Death Accidental Death* Benefit: This policy will pay the following benefit for death if it is the result of injuries sustained in a covered accident. Death must occur within 90 days of a covered accident.
Insured: Common-Carrier: You must be a fare paying passenger on a common-carrier. CommonInsured: $50,000 $100,000 Spouse: carrier vehicles are limited to commercial airplanes, trains, buses, trolleys, subways, ferries and boats that operate on a regular scheduled basis between predetermined points $50,000 Child: Spouse: $25,000 Child: $7,500 or cities. Taxies and privately chartered vehicles are not included. $15,000 Insured: $25,000 Insured: $12,500 Spouse: $5,000 Child: $5,000 Child: $2,500
Other Accidents: Other Accidents are those not classified as common-carrier and are not Spouse: $10,000 specifically excluded in the limitations and exclusions section of the policy.
Dismemberment Accidental Dismemberment* Benefit This policy will pay a percentage of the Accidental Death-Other Accidents Benefit for the selected plan.
Both arms and both legs Two arms or legs Sight of two eyes, hands, or feet Sight of one eye, hand, foot, arm, or leg One or more fingers and/or one or more toes
100% 50% 50% 20% 5%
100% 50% 50% 20% 5%
*Death or dismemberment must occur within 90 days of the accident. Only the highest single benefit will be paid for accidental dismemberment. 38
Accident This is a limited benefit policy. This policy does not pay for losses resulting from sickness. RENEWABILITY CONDITIONS: The policy is guaranteed renewable. Premium rates may be changed on a class basis. A class may be defined by age, sex, occupation, premium payment method, issue state,elimination period, benefit period, etc. WHAT IS NOT COVERED BY THIS POLICY. We will not pay benefits for any injury as a result of you(r): Operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven. Engaging in hang gliding, bungee jumping, parachuting, sailgliding , parakiting, or hot-air ballooning. Participating or attempting to participate in an illegal activity. Riding in or driving any motor-driven vehicle in a race, stunt show, or speed test. Intentionally causing a self-inflicted injury. Having any sickness or declining process caused by a sickness, including physical or mental infirmity. We also will not pay benefits to diagnose or treat the sickness. Sickness means any disease or disorder that is not caused by an injury. Practicing for or participating in any semi-professional or professional competitive athletic contest for which any type of compensation or remuneration is received. Committing or trying to commit suicide, whether sane or insane. Being in an accident which occurs more than 40 miles outside the territorial limits of the United States, Canada, Puerto Rico,and Virgin Islands. Involvement in any period of armed conflict, even if it is not declared. This brochure contains a summary of the Accident Insurance Policy form L-6020. Coverage as described in the brochure is provided only through the issuance of a policy. The policy should be consulted for full terms and conditions of coverage.
ACCIDENT EXPENSE INSURANCE POLICY (L-6020) Payroll Deduction Rates – Available for Issue Ages 18 – 64 Plan A - Monthly
Plan B - Monthly
Employee Only
$12.70
$ 9.00
Employee & Spouse
$19.50
$13.50
One Parent Family
$20.40
$14.20
Family
$27.20
$18.70
39
VOYA
Critical Illness
YOUR BENEFITS PACKAGE
PLAY VIDEO
About this Benefit Critical illness insurance is designed to supplement your medical and disability coverage easing the financial impacts by covering some of your additional expenses. It provides a benefit payable directly to the insured upon diagnosis of a covered condition or event, like a heart attack or stroke.
$16,500 Is the aggregate cost of a hospital stay for a heart attack.
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 40 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
Critical Illness What is Critical Illness Insurance? Critical Illness Insurance pays a lump-sum benefit if you are diagnosed after your effective date of coverage with a covered illness or condition listed below. Please review certificates of coverage for any limitations that may apply. Critical Illness Insurance is a limited benefit policy. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.
For what critical illnesses and conditions are benefits available? Critical illness insurance provides a benefit for the following illnesses and conditions. Benefits are paid at 100% of the Maximum Critical Illness Benefit unless otherwise stated. For a complete description of your benefits, along with applicable provisions, exclusions and limitations, see your certificate of insurance and any riders. BASE MODEL Heart attack Stroke Coronary artery bypass (25%) Coma Major organ failure Permanent paralysis End stage renal (kidney) failure CANCER MODEL Cancer Skin cancer (10%) Carcinoma in situ (25%)
How much does Critical Illness Insurance cost? See chart for the premium amounts. Rate shown are guaranteed until August 31, 2019. Taylor ISD will provide the first $5,000 in employee coverage.
Employee Coverage Monthly Uni-Tobacco Rates Attained $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 Age Under 30 $1.80
$3.60
$5.40
$7.20
$9.00
$10.80
30-39
$2.50
$5.00
$7.50
$10.00
$12.50
$15.00
40-49
$5.10
$10.20
$15.30
$20.40
$25.50
$30.60
50-59
$11.35 $22.70
$34.05
$45.40
$56.75
$68.10
60-64
$17.00 $34.00
$51.00
$68.00
$85.00 $102.00
65-69
$22.75 $45.50
$68.25
$91.00 $113.75 $136.50
70+
$30.90 $61.80
$92.70 $123.60 $154.50 $185.40
Spouse Coverage* Monthly Uni-Tobacco Rates Coverage Amount Under 30 30-39 40-49 50-59 60-64 65-69 70+
$5,000
$10,000
$15,000
$2.50 $3.00 $6.10 $14.55 $22.15 $23.15 $40.75
$5.00 $6.00 $12.20 $29.10 $44.30 $46.30 $81.50
$7.50 $9.00 $18.30 $43.65 $66.45 $69.45 $122.25
Children Coverage Monthly Rates Includes Wellness Benefit Rider Coverage Amount
Rate
$1,000
$0.15
$2,500
$.38
$5,000
$0.75
$10,000
$1.50
Limitations Benefits reduce 50% for the employee and/or covered spouse on the policy anniversary following the 70th birthday, however, premiums do not reduce as a result of this benefit change.
41
AUL A ONEAMERICA COMPANY YOUR BENEFITS PACKAGE
Life and AD&D
PLAY VIDEO
About this Benefit Group term life is the most inexpensive way to purchase life insurance. You have the freedom to select an amount of life insurance coverage you need to help protect the well-being of your family. Accidental Death & Dismemberment is life insurance coverage that pays a death benefit to the beneficiary, should death occur due to a covered accident. Dismemberment benefits are paid to you, according to the benefit level you select, if accidentally dismembered.
Motor vehicle crashes are the
#1
cause of accidental deaths in the US, followed by poisoning, falls, drowning, and choking.
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 42 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
Life and AD&D Group Term Life including matching AD&D Coverage
Life and AD&D insurance coverage amount of $10,000 at no cost to you Waiver of premium benefit Accelerated life benefit Additional AD&D Benefits: Seat Belt, Air Bag, Repatriation, Child Higher Educa�on, Child Care, Paralysis/Loss of Use, Severe Burns Life and AD&D insurance reduces at age 65 to 65% of the original amount and again at age 70 to 50% of the original amount
AUL's Group Voluntary Term Life Insurance Terms and Definitions Eligible Employees: This benefit is available for employees who are actively at work on the effective date and working a minimum of 20 hours per week.
Guaranteed Increase in Benefit: If eligible, this benefit allows you to increase your coverage every year as your life insurance needs change. You may be able to increase your benefit amount by $10,000 every year until you reach the guaranteed issue amount, without providing Evidence of Insurability. NOTE: If Evidence of Insurability is applied for and denied, please be aware Guaranteed Increase in Benefits will not be made available to you in the future.
Continuation of Coverage Options: Portability Should your coverage terminate for any reason, you may be eligible to take this term life insurance with you without providing Evidence of Insurability. You must apply within 31 days from the last day you are eligible. The Portability option is available until you reach age 70.
OR
Conversion Should your life insurance coverage, or a portion of it, cease for Flexible Choices: Since everyone's needs are different, this plan offers flexibility for any reason, you may be eligible to convert your Group Term you to choose a benefit amount that fits your needs and budget. Coverage to Individual Coverage without providing Evidence of Insurability. You must apply within 31 days from the last day you are eligible. Guaranteed Issue Amounts: This is the most coverage you can purchase without having to answer any health questions. If you decline insurance coverage now and decide to enroll later, you will need to provide Evidence of Insurability. Employee Guaranteed Issue Amount
$150,000
Spouse Guaranteed Issue Amount
$50,000
Child Guaranteed Issue Amount
$10,000
Timely Enrollment: Enrolling timely means you have enrolled during the initial enrollment period when benefits were first offered by AUL, or as a newly hired employee within 31 days following completion of any applicable waiting period.
Evidence of Insurability: If you elect a benefit amount over the Guaranteed Issue Amount shown above for you or your eligible dependents, or you do not enroll timely, you will need to submit a Statement of Insurability form for review. Based on health history, you and / or your dependents will be approved or declined for insurance coverage by AUL.
Accelerated Life Benefit: If diagnosed with a terminal illness and have less than 12 months to live, you may apply to receive 25%, 50% or 75% of your life insurance benefit to use for whatever you choose. Waiver of Premium: If approved, this benefit waives your and your dependents' insurance premium in case you become totally disabled and are unable to collect a paycheck. Reductions: Upon reaching certain ages, your original benefit amount will reduce to a percentage as shown in the following schedule.
Age:
65
70
Reduces To:
65%
50%
This invitation to inquire allows eligible employees an opportunity to inquire further about AUL's group insurance and is limited to a brief description of any losses for which benefits are payable. The contract has exclusions, limitations reduction of benefits, and terms under which the contract may be continued in force or discontinued.
43
Life and AD&D Group Voluntary AD&D Insurance Options Offered for Class 1 Class Description: Required Minimum Number of Hours Worked: Maximum Amount of AD&D Insurance: Minimum Amount of AD&D Insurance: Guaranteed Issue Amount: Coverage will reduce upon reaching certain ages as follows:
All Eligible Full-Time Employees 20 hours weekly $750,000, in increments of $10,000. $10,000 $750,000
Employee’s Age when reduction occurs
65
70
Percent of Life Amount Remaining
65%
50%
Coverage terminates at retirement. Benefit Features Offered for Group Voluntary AD&D
Seat Belt Benefit Air Bag Benefit Repatriation Benefit Paralysis/Loss of Use Benefit Child Higher Education Benefit Child Care Benefit Disappearance/Exposure Benefit Severe Burns
Dependent Voluntary AD&D Insurance Options Offered Spouse Without Child Coverage
60% of the Employee’s coverage
Spouse With Child Coverage
50% of the Employee’s coverage
Child(ren) Without Spouse Coverage
15% of the Employee’s coverage, not to exceed $30,000.00
Child(ren) With Spouse Coverage
10% of the Employee’s coverage, not to exceed $30,000.00
Monthly Premium Rates Per $1,000 of Employee Coverage* Voluntary AD&D for Employees
$0.019
Voluntary AD&D for Family
$0.030
Rate Guarantee Offered**
Align with VTL
Voluntary AD&D rates are contingent on a package sale with Voluntary Life
44
Life and AD&D Monthly Payroll Deduction Illustration About your benefit options:
You may select a minimum benefit of $10,000 up to a maximum amount of $500,000, in increments of $10,000, not to exceed 7 times your annual base salary only, rounded to the next higher $10,000. Amounts requested above $250,000 for an Employee, $60,000 for a Spouse, or any amount not requested timely will require Evidence of Insurability. Employee must select coverage to select any Dependent coverage. Dependent coverage cannot exceed 100% of the Voluntary Term Life amount selected by the Employee.
EMPLOYEE ONLY OPTIONS (based on Employee's age as of 09/01) Life Options
0-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75+
$10,000
$.45
$.45
$.45
$.55
$.65
$1.00
$1.55
$2.40
$3.67
$5.89
$9.79
$14.61
$26.72
$20,000
$.90
$.90
$.90
$1.10
$1.30
$2.00
$3.10
$4.80
$7.34
$11.78
$19.58
$29.22
$53.44
$30,000
$1.35
$1.35
$1.35
$1.65
$1.95
$3.00
$4.65
$7.20
$11.01
$17.67
$29.37
$43.83
$80.16
$40,000
$1.80
$1.80
$1.80
$2.20
$2.60
$4.00
$6.20
$9.60
$14.68
$23.56
$39.16
$58.44 $106.88
$50,000
$2.25
$2.25
$2.25
$2.75
$3.25
$5.00
$7.75
$12.00
$18.35
$29.45
$48.95
$73.05 $133.60
$80,000
$3.60
$3.60
$3.60
$4.40
$5.20
$8.00
$12.40 $19.20
$29.36
$47.12
$78.32 $116.88 $213.76
$100,000
$4.50
$4.50
$4.50
$5.50
$6.50
$10.00 $15.50 $24.00
$36.70
$58.90
$97.90 $146.10 $267.20
$150,000
$6.75
$6.75
$6.75
$8.25
$9.75
$15.00 $23.25 $36.00
$55.05
$88.35 $146.85 $219.15 $400.80
$200,000
$9.00
$9.00
$9.00
$11.00 $13.00 $20.00 $31.00 $48.00
$73.40 $117.80 $195.80 $292.20 $534.40
$250,000
$11.25 $11.25 $11.25 $13.75 $16.25 $25.00 $38.75 $60.00
$91.75 $147.25 $244.75 $365.25 $668.00
SPOUSE ONLY OPTIONS (based on Employee's Age as of 09/01) Life Options
0-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75+
$10,000
$.45
$.45
$.45
$.55
$.65
$1.00
$1.55
$2.40
$3.67
$5.89
$9.79
$14.61
$26.72
$20,000
$.90
$.90
$.90
$1.10
$1.30
$2.00
$3.10
$4.80
$7.34
$11.78
$19.58
$29.22
$53.44
$30,000
$1.35
$1.35
$1.35
$1.65
$1.95
$3.00
$4.65
$7.20
$11.01
$17.67
$29.37
$43.83
$80.16
$40,000
$1.80
$1.80
$1.80
$2.20
$2.60
$4.00
$6.20
$9.60
$14.68
$23.56
$39.16
$58.44 $106.88
$50,000
$2.25
$2.25
$2.25
$2.75
$3.25
$5.00
$7.75
$12.00
$18.35
$29.45
$48.95
$73.05 $133.60
$60,000
$2.70
$2.70
$2.70
$3.30
$3.90
$6.00
$9.30
$14.40
$22.02
$35.34
$58.74
$87.66 $160.32
45
Life and AD&D CHILD(REN) OPTIONS (Premium shown for Child(ren) reflects the cost for all eligible dependent children) Child(ren) 6 months to age 26
Child(ren) live birth to 6 months
Monthly Payroll Deduction Life Amount
Option 1:
$2,500
$1,000
$.50
Option 2:
$5,000
$1,000
$1.00
Option 3:
$7,500
$1,000
$1.50
Option 4:
$10,000
$1,000
$2.00
About Premiums: The premiums shown above may vary slightly due to rounding; actual premiums will be calculated by American United Life Insurance Company® (AUL), and may increase upon reaching certain age brackets, according to contract terms, and are subject to change.
Monthly Payroll Deduction Illustration About your benefit options:
You may select a minimum benefit of $10,000 up to a maximum amount of $500,000, in increments of $10,000. Employee must select coverage to select any Dependent coverage. The Spouse benefit is equal to 50% of the amount elected by the Employee, the Child benefit is equal to 10% of the amount elected by the Employee.
Employee Only AD&D Volume $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
46
10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 90,000 100,000 150,000 200,000 250,000 300,000 350,000 400,000 450,000 500,000
Monthly Deduction $ 0.176 $ 0.352 $ 0.528 $ 0.704 $ 0.880 $ 1.056 $ 1.232 $ 1.408 $ 1.584 $ 1.760 $ 2.640 $ 3.520 $ 4.400 $ 5.280 $ 6.160 $ 7.040 $ 7.920 $ 8.800
Family AD&D Employee Volume $ 10,000 $ 20,000 $ 30,000 $ 40,000 $ 50,000 $ 60,000 $ 70,000 $ 80,000 $ 90,000 $ 100,000 $ 150,000 $ 200,000 $ 250,000 $ 300,000 $ 350,000 $ 400,000 $ 450,000 $ 500,000
Spouse Volume $ 5,000 $ 10,000 $ 15,000 $ 20,000 $ 25,000 $ 30,000 $ 35,000 $ 40,000 $ 45,000 $ 50,000 $ 75,000 $ 100,000 $ 125,000 $ 150,000 $ 175,000 $ 200,000 $ 225,000 $ 250,000
Child Volume $ 1,000 $ 2,000 $ 3,000 $ 4,000 $ 5,000 $ 6,000 $ 7,000 $ 8,000 $ 9,000 $ 10,000 $ 15,000 $ 20,000 $ 25,000 $ 30,000 $ 35,000 $ 40,000 $ 45,000 $ 50,000
Monthly Deduction $ 0.318 $ 0.636 $ 0.954 $ 1.272 $ 1.590 $ 1.908 $ 2.226 $ 2.544 $ 2.862 $ 3.180 $ 4.770 $ 6.360 $ 7.950 $ 9.540 $ 11.130 $ 12.720 $ 14.310 $ 15.900
Life and AD&D
47
5STAR
Individual Life
YOUR BENEFITS PACKAGE
PLAY VIDEO
About this Benefit Individual life is a policy that provides a specified death benefit to your beneficiary at the time of death. The advantage of having an individual life insurance plan as opposed to a group supplemental term life plan is that this plan is guaranteed renewable, portable and typically premiums remain the same over the life of the policy.
1/3 of Americans would be financially impacted by the loss of the primary wage earner in just one month.
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 48 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
Term Life with Terminal Illness and Quality of Life Rider The Family Protection Plan: Term Life Insurance with Terminal Illness Coverage to Age 100 Nearly 85% of Americans say most people need life insurance; unfortunately only 62% have coverage and a staggering 33% say they don’t have enough life insurance, including one-fourth who already have life insurance coverage.** Nobody wants to be a statistic - especially during a period of grief. That’s why 5Star Life Insurance Company developed its FPP policy - to ensure you and your loved ones are covered during a period of loss.
Affordability - With several options to choose from, select the coverage that best meets the needs of your family. Terminal Illness - This plan pays the insured 30% (25% in Connecticut and Michigan) of the policy coverage amount in a lump sum upon the occurrence of a terminal condition that will result in a limited life span of less than 12 months. Portability - You and your family continue coverage with no loss of benefits or increase in cost should you terminate employment after the first premium is paid. If this happens, we can simply bill you directly. Coverage can never be cancelled by the insurance company or your employer unless you stop paying premiums.
DID YOU KNOW? Protecting your financial well being is easier than you think. It’s like trading in a daily latte for peace of mind.
$4.30 per day to start your morning with a $1.75
gourmet coffee OR per day to enrich your employee benefits package
It’s less expensive than you think.
Family Protection - Individual policies can be purchased on the employee, their spouse, children and grandchildren (ages newborn through 23). Quality of Life Benefit - Following a diagnosis of either a chronic illness or cognitive impairment, this rider accelerates a portion of the death benefit on a monthly basis – 4%; up to 75% of your benefit, and payable directly to you on a tax favored basis for the following: Permanent inability to perform at least two of the six Activities of Daily Living (ADLs) without substantial assistance; or Permanent severe cognitive impairment, such as dementia, Alzheimer’s disease and other forms of senility, requiring substantial supervision. Convenience - Premiums are taken care of simply and easily through payroll deductions. Protection You Can Count On - Within 24 hours after receiving notice of an insured’s death, an emergency death benefit of the lesser of 50% of the coverage amount, or $10,000, will be mailed to the insured’s beneficiary, unless the death is within the twoyear contestability period and/or under investigation. This product also contains no war or terrorism exclusions.
* Life insurance product underwritten by 5Star Life Insurance Company (a Baton Rouge, Louisiana company). Product may not be available in all states or territories. Request FPP insurance from Dell Perot, Post Office Box 83043, Lincoln, Nebraska 68501, (866) 863-9753.
49
Family Protection Plan - Terminal Illness MONTHLY RATES GUARANTEED ISSUE RATES WITH QUALITY OF LIFE RIDER DEFINED BENEFIT Employee Coverage Amounts
Spouse Coverage Amounts
Age on App. Date
$10,000
$25,000
$50,000
$75,000
$100,000
$10,000
$20,000
$30,000
18-25
$7.56
$12.40
$20.46
$28.52
$36.58
$7.56
$10.78
$14.01
26
$7.58
$12.46
$20.58
$28.71
$36.83
$7.58
$10.83
$14.08
27
$7.65
$12.63
$20.92
$29.21
$37.50
$7.65
$10.97
$14.28
28
$7.74
$12.85
$21.38
$29.90
$38.42
$7.74
$11.15
$14.56
29
$7.88
$13.21
$22.08
$30.96
$39.83
$7.88
$11.43
$14.98
30
$8.07
$13.67
$23.00
$32.33
$41.67
$8.07
$11.80
$15.53
31
$8.27
$14.17
$24.00
$33.83
$43.67
$8.27
$12.20
$16.13
32
$8.49
$14.73
$25.13
$35.52
$45.92
$8.49
$12.65
$16.81
33
$8.73
$15.31
$26.29
$37.27
$48.25
$8.73
$13.12
$17.51
34
$9.00
$16.00
$27.67
$39.33
$51.00
$9.00
$13.67
$18.33
35
$9.30
$16.75
$29.17
$41.58
$54.00
$9.30
$14.27
$19.23
36
$9.64
$17.60
$30.88
$44.15
$57.42
$9.64
$14.95
$20.26
37
$10.02
$18.54
$32.75
$46.96
$61.17
$10.02
$15.70
$21.38
38
$10.41
$19.52
$34.71
$49.90
$65.08
$10.41
$16.48
$22.56
39
$10.84
$20.60
$36.88
$53.15
$69.42
$10.84
$17.35
$23.86
40
$11.31
$21.77
$39.21
$56.65
$74.08
$11.31
$18.28
$25.26
41
$11.83
$23.08
$41.83
$60.58
$79.33
$11.83
$19.33
$26.83
42
$12.41
$24.52
$44.71
$64.90
$85.08
$12.41
$20.48
$28.56
43
$13.00
$26.00
$47.67
$69.33
$91.00
$13.00
$21.67
$30.33
44
$13.63
$27.56
$50.79
$74.02
$97.25
$13.63
$22.92
$32.21
45
$14.28
$29.19
$54.04
$78.90
$103.75
$14.28
$24.22
$34.16
46
$14.97
$30.92
$57.50
$84.08
$110.67
$14.97
$25.60
$36.23
47
$15.69
$32.73
$61.13
$89.52
$117.92
$15.69
$27.05
$38.41
48
$16.43
$34.56
$64.79
$95.02
$125.25
$16.43
$28.52
$40.61
49
$17.22
$36.54
$68.75
$100.96
$133.17
$17.22
$30.10
$42.98
50
$18.08
$38.69
$73.04
$107.40
$141.75
$18.08
$31.82
$45.56
51
$19.04
$41.10
$77.88
$114.65
$151.42
$19.04
$33.75
$48.46
52
$20.16
$43.90
$83.46
$123.02
$162.58
$20.16
$35.98
$51.81
53
$21.40
$47.00
$89.67
$132.33
$175.00
$21.40
$38.47
$55.53
54
$22.79
$50.48
$96.63
$142.77
$188.92
$22.79
$41.25
$59.71
55
$24.27
$54.17
$104.00
$153.83
$203.67
$24.27
$44.20
$64.13
56
$25.93
$58.33
$112.33
$166.33
$220.33
$25.93
$47.53
$69.13
57
$27.66
$62.65
$120.96
$179.27
$237.58
$27.66
$50.98
$74.31
58
$29.42
$67.04
$129.75
$192.46
$255.17
$29.42
$54.50
$79.58
50
Family Protection Plan - Terminal Illness MONTHLY RATES GUARANTEED ISSUE RATES WITH QUALITY OF LIFE RIDER DEFINED BENEFIT Employee Coverage Amounts
Spouse Coverage Amounts
Age on App. Date
$10,000
$25,000
$50,000
$75,000
$100,000
$10,000
$20,000
$30,000
59
$31.23
$71.56
$138.79
$206.02
$273.25
$31.23
$58.12
$85.01
60
$33.12
$76.29
$148.25
$220.21
$292.17
$33.12
$61.90
$90.68
61
$35.08
$81.19
$158.04
$234.90
$311.75
$35.08
$65.82
$96.56
62
$37.13
$86.31
$168.29
$250.27
$332.25
$37.13
$69.92
$102.71
63
$39.31
$91.77
$179.21
$266.65
$354.08
$39.31
$74.28
$109.26
64
$41.68
$97.71
$191.08
$284.46
$377.83
$41.68
$79.03
$116.38
65
$44.33
$104.33
$204.33
$304.33
$404.33
$44.33
$84.33
$124.33
66*
$44.93
$105.81
$207.29
$308.77
$410.25
$44.93
$85.52
$126.11
67*
$48.25
$114.13
$223.92
$333.71
$443.50
$48.25
$92.17
$136.08
68*
$52.03
$123.58
$242.83
$362.08
$481.33
$52.03
$99.73
$147.43
69*
$56.33
$134.31
$264.29
$394.27
$524.25
$56.33
$108.32
$160.31
70*
$61.17
$146.42
$288.50
$430.58
$572.67
$61.17
$118.00
$174.83
Quality of Life not available ages 66 - 70. Quality of Life benefits not available for children. Child life coverage available only on children and grandchildren of employee (age on application date: full term new born to 23 years). $4.98 monthly for $10,000 coverage and $9.97 monthly for $20,000 coverage. 51
ID WATCHDOG
Identity Theft
YOUR BENEFITS PACKAGE
PLAY VIDEO
About this Benefit Identity theft protection monitors and alerts you to identity threats. Resolution services are included should your identity ever be compromised while you are covered. An identity is stolen every 2 seconds, and takes over
300 hours
to resolve, causing an average loss of $9,650.
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 52 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
Identity Theft
1B + 3
RATES Single
Family
$9.95
$17.95
Store your wallet contents in our secure digital vault. Lost Wallet Replacement will assist with cancelling and replacing contents from the Lost Wallet Vault.
Credit Monitoring, Report & Score(s)
Monthly Credit Score Tracker
Tri-bureau monitoring and TransUnion® report and score.
Historical view of TransUnion scores.
Rapid Credit Alerts Credit alerts provided within minutes of detected activity change.
Credit Freeze Assistance with putting a security freeze on your credit report. Credentials are securely stored for easy access.
Fraud Alert Assistance & Reminders Assistance with setting credit bureau fraud alerts and reminders.
Public Records & NCOA Monitoring We monitor the National Change of Address Registry and public records databases (over 37 billion consumer records). Direct network access enables us to detect potential fraud faster.
Payday Loan Monitoring
Enhanced Non-Credit Loan Monitoring
Our expanded fraud detection network includes monitoring of auto pawn, rent-to-own, sub-prime, and cell phone accounts. Protection is increased by scanning for these common transactions that require minimal information to obtain.
Social Network Alerts Add alert customizations to Facebook, LinkedIn, Instagram, and Twitter accounts to stay on top of potential cyberbullying, cyber predators, and reputation-damaging items directed at you and your family. Our exclusive identity exposure report highlights PII published on social sites and calls out increased potential for identity theft.
Registered Sex O- ender Reporting & Alerts
National Provider Identifier (NPI) Alerts
Password Manager Securely store and use login information and access it with a single master password. COMING IN 2018
ADVANCED CUSTOMER CARE CENTER
Real-time alerts cover new account applications such as finan- cial and wireless. Real-time alerts inform you of critical transactions including bank password resets, online healthcare, payroll account, or insurance records access. We catch potential identity theft up to 90 days sooner.
Cyber Monitoring Underground websites are scanned daily in search of personal information being sold. When detected in our scans, we send a compromised credentials alert.
Instant-On™ Monitoring Instant-On promptly activates all monitoring on the benefit effective date without any further action required by the employee.
Our report helps surface any pre-existing conditions going back 30 years or more.
We monitor the NPI database for activity that indicates potential fraud. We are the only vendor who monitors this database and provides alerts to physicians, pharmacists, and more if their credentials are compromised.
We work directly with alternative credit bureaus that service the under-banked market. Our network monitors the largest database so we can alert faster.
High-Risk Application & Transaction Monitoring
Identity Profifle Report
Run a report for a specific address showing location, photo ID, and the offense committed. Search for sex o enders in your area and receive alerts when new o enders move into your neighborhood. We track and report offenders who move from state to state who can be missed in an online state search. Real-time reporting is available for all ID Watchdog plans. Collect maximum information from one source to keep loved ones safe.
PROACTIVE IDENTITY MONITORING
2-Step Authentication To ensure your information is accurate and secure, we require a 2-step authentication process when logging in to and registering your account.
CREDIT PROTECTION SERVICES
Lost Wallet Vault & Replacement
Fully Managed Resolution Service Dedicated CITRMS work with you to assess your identity theft situation and will manage your case until it is completely restored.
$1M Expense Reimbursement Insurance The plan covers fi nancial damages incurred as a result of the theft.
Call Center Commitment to Excellence Real-time language support ensures clear communication with over 100 languages.
24/7 Call Center Reach an identity theft protection specialist when you need help.
ADVANCED TOOLS
Breach Notification
Solicitation Reduction
Receive email notification of prominent data breaches. Opt in or out of the National Do Not Call Registry, preapproved credit offers, junk mail, or email. 53
NBS
FSA (Flexible Spending Account)
YOUR BENEFITS PACKAGE
PLAY VIDEO
About this Benefit A Cafeteria Plan is designed to take advantage of Section 125 of the Internal Revenue Code. It allows you to pay certain qualified expenses on a pre-tax basis, thereby reducing your taxable income. You can set aside a pre-established amount of money per plan year in a Healthcare Flexible Spending Account (FSA). Funds allocated to a healthcare FSA must be used during the plan year or are forfeited unless your plan contains a $500 rollover or grace period provision.
Unlimited FSA (Non HSA Compatible) The funds in the unlimited healthcare FSA can be used to pay for eligible medical expenses like deductibles, co-payments, orthodontics, glasses and contacts.
FLIP TO‌ PG. 11 FOR HSA VS. FSA COMPARISON
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 54 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
FSA (Flexible Spending Account) NBS Flexcard
When Will I Receive My Flex Card?
You may use the card to pay merchants or service providers that accept MasterCard® credit cards, so there is no need to pay cash up front, then wait for reimbursement. If you are participating in the Dependent Care portion, the money isn’t loaded to the card. You must file web or paper claims or enroll in continual reimbursement.
NBS Prepaid MasterCard® Debit Card
Expect Flex Cards to be delivered to the address listed in THEbenefitsHUB near the end of May. Don’t forget, Flex Cards Are Good For 3 Years!
For a list of sample expenses, please refer to the Taylor ISD benefit website: www.mybenefitshub.com/taylorisd
NBS Contact Information: Current plan participants: KEEP YOUR CARDS! NBS debit cards are good for 3 years. If you throw away your cards, there is a $5.00 fee to replace them.
8523 South Redwood Road West Jordan, UT 84088 Phone (800) 274‐0503 Fax (800) 478‐1528 Email: claims@nbsbenefits.com
New Plan Participants NBS will mail out your new benefit cards to the address listed in THEbenefitsHUB. They will be sent in unmarked envelopes so please watch for them as they should arrive within 21 business days of effective date. NBS debit cards are good for 3 years.
FSA Annual Contribution Max:
DID YOU KNOW? FSAs use tax-free funds to help pay for your Health Care Expenses?
$2,650
Dependent Care Annual Max: $5,000
Account Information: Participant Account Web Access: www.participant.nbsbenefits.com Participants may call NBS and talk to a representative during regular business hours, Monday-Friday, 8 am to 7 pm Central Time. Participants can also obtain account information using the Automated Voice Response Unit, 24 hours a day, 7 days a week at (801) 838-7324 or toll free (800) 274-0503. For immediate access to your account information at any time, log on to the NBS website: www.NBSbenefits.com Detailed claim history and processing status Health Care and Dependent Care account balances Health Care and Dependent Care account balances Claim forms, Direct Deposit form, worksheets, etc. Online claim FAQs 55
FSA Frequently Asked Questions What is a Flexible Spending Account? A Flexible Spending Account allows you to save money by paying out-of-pocket health and/or dependent care related expenses with pre-tax dollars. Your contributions are deducted from your pay before taxes are withheld and your account is up fronted with an annual amount. Because you are taxed on a lower amount of pay, you pay less in taxes and you have more to spend.
How does a Flexible Spending Account Benefit Me? A Cafeteria plan enables you to save money on group insurance, health-related expenses, and dependent-care expenses. You may save as much as 35 percent on the cost of each benefit option! Eligible expenses must be incurred within the plan year and contributions are use-it-or- lose-it. Remember to retain all your receipts.
Health Care Expense Account Example Expenses:
Acupuncture Body scans Breast pumps Chiropractor Co-payments Deductible Diabetes Maintenance Eye Exam & Glasses Fertility treatment First aid
Hearing aids & batteries Lab fees Laser Surgery Orthodontia Expenses Physical exams Pregnancy tests Prescription drugs Vaccinations Vaporizers or humidifiers
Dependent Care Expense Account Example Expenses:
Before and After School and/or Extended Day Programs The actual care of the dependent in your home. Preschool tuition. The base costs for day camps or similar programs used as care for a qualifying individual.
What Can I Use My Flexible Spending Account On? For a full list of eligible expenses, please refer to www.mybenefitshub.com/taylorisd
56
What Happens If I Don’t Use All of My Funds by The End of the Plan Year (August 31st)? Eligible expenses must be incurred within the plan year +75 day grace period. Contributions are use-it-or- lose-it. Remember to retain all your receipts (including receipts for card swipes).
How Do I File A Claim? In most situations, you will be able to swipe your card however, in the event you lose your card or are waiting to receive one, you can visit www.mybenefitshub.com/taylorisd and complete the “Claim Form” to send to NBS or use the web or phone app to file online.
How To Receive Your Dependent Care Reimbursement Faster. A Direct Deposit form is available on the Benefits Website which will help you get reimbursed quicker!
How the FSA Plan Works You designate an annual election of pre-tax dollars to be deposited into your health and dependent-care spending accounts. Your total election is divided by the number of pay periods in the Plan year and deducted equally from each paycheck before taxes are calculated. By the end of the Plan year, your total election will be fully deposited. However, you may make a claim for eligible health FSA expenses as soon as they are incurred during the Plan year. Eligible claims will be paid up to your total annual election even if you have not yet contributed that amount to your account.
Get Your Money 1. 2. 3. 4.
Complete and sign a claim form (available on our website) or an online claim. Attach documentation; such as an itemized bill or an Explanation of Benefits (EOB) statement from a health insurance provider. Fax or mail signed form and documentation to NBS. Receive your non-taxable reimbursement after your claim is processed either by check or direct deposit.
NBS Flexcard—FSA Pre-paid Benefit Card Your employer may sponsor the use of the NBS Flexcard, making access to your flex dollars easier than ever. You may use the card to pay merchants or service providers that accept credit cards, so there is no need to pay cash up front then wait for reimbursement.
Account Information Participants may call NBS and talk to a representative during our regular business hours, Monday–Friday, 7am to 6pm Mountain Time. Participants can also obtain account information using the Automated Voice Response Unit, 24 hours a day, 7 days a week at (801) 838-7324 or toll free (800) 274-0503. For immediate access to your account information at any time, log on to our website: www.NBSbenefits.com Information includes: Detailed claim history and processing status Health Care and Dependent Care account balances Claim forms, worksheets, etc. Online Claim Submission
Enrollment Considerations After the enrollment period ends, you may increase, decrease, or stop your contribution only when you experience a qualifying “change of status” (marriage status, employment change, dependent change). Be conservative in the total amount you elect to avoid forfeiting money that may be left in your account at the end of the year. Your employer may allow a short grace period after the Plan year ends for you to submit qualified claims for any unused funds.
57
MASA YOUR BENEFITS PACKAGE
Medical Transport
About this Benefit Medical Transport covers emergency transportation to and from appropriate medical facilities by covering the out-of-pocket costs that are not covered by insurance. It includes emergency transportation via ground ambulance, air ambulance and helicopter.
A ground ambulance can cost up to
$2,400
and a helicopter transportation fee can cost
over $30,000
This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the 58 Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd
Medical Transport MASA provides medical emergency transportation solutions and covers your out of pocket medical transport cost when your insurance falls short. MASA does not use a network, which means you are covered anywhere.
THE TRUTH... Americans today suffer from a false sense of security that their medical coverage will pay for all costs associated with emergency or critical care transport. The reality is that a majority of Americans are only partially covered for these high costs. Most healthcare policies will only pay based off of the “Usual and Customary Charges” while Medicare pays based off a set fee schedule, both leaving you with the remainder of the bill. You face the possibility that your medical coverage will deny the claim leaving you responsible for the ENTIRE bill.
MASA MTS for Employees Ensures...
NO health questions NO age limits NO claim forms NO deductibles NO provider network limitations NO dollar limits on emergency transport costs
What is Covered?
Emergency Helicopter Transport Emergency Ground Ambulance Transport
How Much Does It Cost? MASA Emergent rates are $9 a month, per employee/family coverage.
Emergent Card Example:
We provide medical emergency transportation solutions AND cover your out of pocket medical transport cost when your insurance falls short. “All I had to do was send the bill which was never paid by Medicare and TriCare for Life --- and the rest is history. When MASA received that bill, it was paid and all amounts owed satisfied.” --- MASA Member, 2015
59
WWW.MYBENEFITSHUB.COM/ TAYLORISD 60