COASTAL BEND EMPLOYEE BENEFITS COOPERATIVE
BENEFIT GUIDE EFFECTIVE: 09/01/2019 - 8/31/2020 WWW.CBEBC.COM 1
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. Health Savings Account (HSA) vs. Flexible Spending Account (FSA) 7. Health Savings Account (HSA) Participation 8. Flexible Spending Account (FSA) Participation TRS-ActiveCare MDLIVE Telehealth Aflac Hospital Indemnity APL Accident Cigna Dental Superior Vision Cigna Long Term Disability APL Cancer Texas Life Individual Life UNUM Life and AD&D Aflac Critical Illness EECU Health Savings Account (HSA) NBS Flexible Spending Account (FSA) MASA Medical Transport ID Watchdog Identity Theft
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FLIP TO... PG. 4
HOW TO ENROLL
PG. 6
SUMMARY PAGES
PG. 14
YOUR BENEFITS
11 12 13 14-15 16-17 18-21 22-25 26-29 30-31 32-35 36-39 40-41 42-45 46-49 50-51 52-55 56-57 58-59
Benefit Contact Information CBEBC BENEFITS
DISABILITY
FLEXIBLE SPENDING ACCOUNT
Financial Benefit Services (800) 583-6908 www.cbebc.com
Cigna (800) 362-4462 www.cigna.com
National Benefit Services (800) 274-0503 www.nbsbenefits.com
TELEHEALTH
CANCER
IDENTITY THEFT
MDLIVE (888) 365-1663 www.consultmdlive.com
Group # 13254 American Public Life (800) 256-8606 www.ampublic.com
ID Watchdog (800) 970-5182 www.idwatchdog.com
HOSPITAL INDEMNITY
INDIVIDUAL LIFE
MEDICAL
Aflac (800) 992-3522 www.aflac.com
Texas Life (800) 283-9233 www.texaslife.com
Aetna (800) 222-9205 www.trsactivecareaetna.com
ACCIDENT
LIFE AND AD&D
MASA MEDICAL TRANSPORT
Group # 13254 American Public Life (800) 256-8606 www.ampublic.com
UNUM (800) 858-6843 www.unum.com
MASA (800) 423-3226 www.masamts.com
DENTAL
CRITICAL ILLNESS
VISION
Group # 3335865 Cigna (800) 244-6224 www.cigna.com
Aflac (800) 992-3522 www.aflac.com
Group # 28836 Superior Vision (800) 507-3800 www.superiorvision.com
HEALTH SAVINGS ACCOUNT EECU 817-882-0800 www.eecu.org 3
MOBILE ENROLLMENT Enrollment made simple through your smartphone or tablet. Text “FBS CBEBC” to 313131 and get access to everything you need to complete your benefits enrollment:
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•
Benefit Information
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Online Support
•
Interactive Tools
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And more.
Text “FBS CBEBC” to 313131 OR SCAN
How to Log In
1 BENEFIT INFO
INTERACTIVE TOOLS
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www.cbebc.com
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.
ONLINE 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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Annual Benefit Enrollment
SUMMARY PAGES
Benefit Updates - What’s New: •
Social Security Numbers for your dependents are required regardless if they are enrolled in coverage or not. Please make sure you have these items on hand when going through your open enrollment.
•
NEW CARRIER! This year, all HSA’s will now be administered through EECU, a credit union for educators. Employees who currently have an HSA with HSA Bank will need to complete a rollover form that will be posted to the benefits website. Individual maximum contribution is $3,500 and Family maximum • contribution is $7,000 per year. Make sure to login and complete a walkthrough if you are wanting this benefit for the 2019-20 plan year, it is not automatically • renewed. An employee and a spouse may both contribute to their own Health Savings Account, but their combined total can not exceed the family maximum in any given tax year. You MUST RE-ELECT • this benefit each year.
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NEW CARRIER– Critical Illness by Aflac pays cash benefits directly to you. The Aflac Lump Sum Critical Illness plan is designed to provide you with cash benefits if you experience a serious health event, such as a heart attack or stroke. This means that you will have added financial resources to help with
• •
expenses incurred due to a serious health event, to help with ongoing living expenses, or to help with any purpose you choose. •
Telehealth services allow you the ability to save on out-of-pocket expenses and will reduce time away from your work and your family. Please remember to utilize your Telehealth services for minor medical needs. Medical, HSA, & FSA elections will NOT be enrolled until the August enrollment for the 2019-2020 plan year. Please remember, in order to maximize insurance coverage and reduce out of pocket expenses you should utilize In-Network providers for both your Dental and Vision benefits. Benefit elections will become effective 9/1/2019 (elections requiring evidence of insurability, such as life Insurance, may have a later effective date, if approved). After annual enrollment closes, benefit changes can only be made if you experience a qualifying event (and changes must be made within 30 days of event).
Enrollment assistance is available by calling Financial Benefit Services at (866) 914-5202 to speak to a representative. Please be sure to update your profile information (home address, phone numbers, email).
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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
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 the CBEBC
Changes are not permitted during the plan year (outside of
benefit website: www.cbebc.com. Click on your school
annual enrollment) unless a Section 125 qualifying event occurs.
district, then click on the benefit plan you need information on (i.e., Dental) and you can find the forms you need under
•
Changes, additions or drops may be made only during the
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.cbebc.com. Click on your school
included in the dependent profile. Additionally, you must
district, then click on the benefit plan you need information
notify your employer of any discrepancy in personal and/or
on (i.e., Dental) and you can find provider search links under
benefit information.
•
For benefit summaries and claim forms, go to the CBEBC
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.
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
Employee Eligibility Requirements
Dependent Eligibility Requirements
Supplemental Benefits: Eligible employees must work 20 or more
Dependent Eligibility: You can cover eligible dependent
regularly scheduled hours each work week.
children under a benefit that offers dependent coverage, provided you participate in the same benefit, through the
Eligible employees must be actively at work on the plan effective
maximum age listed below. Dependents cannot be double
date for new benefits to be effective, meaning you are physically
covered by married spouses within the CBEBC or as both
capable of performing the functions of your job on the first day of
employees and dependents.
work concurrent with the plan effective date. For example, if your 2019 benefits become effective on September 1, 2019, you must be actively-at-work on September 1, 2019 to be eligible for
your new benefits. PLAN
CARRIER
MAXIMUM AGE
Accident
American Public Life
To Age 26
Cancer
American Public Life
To Age 26
Critical Illness
Aflac
To Age 26
Dental
Cigna
To Age 26
Identity Theft
ID Watchdog
To Age 25
Individual Life
Texas Life
To Age 26
Hospital Indemnity
Aflac
To Age 26
Telehealth
MDLIVE
To Age 26
Vision
Superior Vision
To Age 26
Voluntary Life and AD&D
UNUM
To Age 26
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. 9
Helpful Definitions
SUMMARY PAGES
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 9/1/2019 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
Cash-Outs of Unused Amounts (if no medical expenses)
$1,300 single (2019) $2,600 family (2019) $3,500 single (2019) $7,000 family (2019) Employees may use funds any way they wish. If used for non-qualified medical expenses, subject to current tax rate plus 20% penalty. Permitted, but subject to current tax rate plus 10% penalty (penalty waived after age 65).
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
Minimum Deductible Maximum Contribution
Permissible Use Of Funds
FLIP TO FOR HSA INFORMATION
PG. 50
N/A $2,700 Reimbursement for qualified medical expenses (as defined in Sec. 213(d) of IRC). Not permitted
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PG. 52
SUMMARY PAGES
HSA (Health Savings Account)
An HSA is a tax free savings account available to employees enrolled in a high deductible medical plan. The money is tax deductible, and these funds are used to pay for medical expenses. Any funds that are in the account after the employee reaches the age of 65 can be withdrawn for any purpose. See below for a list of participating districts to see if an HSA is available to you. If you enroll in a Health Savings Account, you are not eligible for FSA.
PARTICIPATING DISTRICTS Aqua Dulce ISD
Ingleside ISD
Refugio ISD
Banquete ISD
Kenedy ISD
Ricardo ISD
Beeville ISD
London ISD
Riviera ISD
Ben Bolt-Palito ISD
Louise ISD
San Diego ISD
Benavides ISD
Lyford ISD
Santa Getrudis ISD
Bloomington ISD
Meyersville ISD
San Perlita ISD
Cuero ISD
Odem-Edroy ISD
Sinton ISD
Driscoll ISD
Odyssey Charter School
Skidmore-Tynan ISD
Ezzell ISD
Orange Grove ISD
St. Mary’s Charter School
Gregory Portland ISD
Pettus ISD
Weimar ISD
Hallettsville ISD
Port Aransas ISD
Webb ISD
Ramirez CSD
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PG. 11
FLIP TO FOR MORE HSA INFORMATION
PG. 50
SUMMARY PAGES
FSA (Flexible Spending Account)
Tax-sheltered flexible spending accounts allow an individual to set aside dollars to pay for future health care and dependent care expenses. Eligible expenses must be incurred within the plan year and contributions are use it or lose it. See below for a list of participating districts to see if an FSA is available to you. If you enroll in an FSA, you are not eligible for a Health Savings Account.
PARTICIPATING DISTRICTS Aqua Dulce ISD
London ISD
Ricardo ISD
Banquete ISD
Louise ISD
Riviera ISD
Beeville ISD
Lyford ISD
San Diego ISD
Ben Bolt-Palito ISD
Meyersville ISD
Santa Getrudis ISD
Cuero ISD
Odem-Edroy ISD
Sinton ISD
Driscoll ISD
Odyssey Charter School
San Perlita ISD
Ezzell ISD
Orange Grove ISD
Skidmore-Tynan ISD
Gregory Portland ISD
Pettus ISD
St. Mary’s Charter School
Hallettsville ISD
Port Aransas ISD
Weimar ISD
Ingleside ISD
Ramirez CSD
Webb ISD
Kenedy ISD
Refugio ISD
FLIP TO FOR HSA VS. FSA COMPARISON
PG. 11
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PG. 54 13
2019 – 20 TRS-ActiveCare Plan Highlights Effective Sept. 1, 2019 through Aug. 31, 2020 | In-Network Level of Benefits1 TRS-ActiveCare 1-HD
TRS-ActiveCare Select or TRS-ActiveCare Select Whole Health
TRS-ActiveCare 2
(Baptist Health System and HealthTexas Medical Group; Baylor Scott and White Quality Alliance; Kelsey Select; Memorial Hermann Accountable Care Network; Seton Health Alliance)
NOTE: If you’re currently enrolled in TRSActiveCare 2, you can remain in this plan. However, as of Sept. 1, 2018, TRS-ActiveCare 2 is closed to new enrollees.
$500 copay per visit plus 20% after deductible
$500 copay per visit plus 20% after deductible
Deductible (per plan year) In-Network Out-of-Network Out-of-Pocket Maximum (per plan year; medical and prescription drug deductibles, copays, and coinsurance count toward the out-of-pocket maximum) In-Network Out-of-Network Coinsurance In-Network Participant pays (after deductible) Out-of-Network Participant pays (after deductible) Office Visit Copay Participant pays Diagnostic Lab Participant pays Preventive Care See below for examples Teladoc® Physician Services
High-Tech Radiology (CT scan, MRI, nuclear medicine) Participant pays Inpatient Hospital Facility Charges Only (preauthorization required) In-Network
Out-of-Network
Urgent Care Freestanding Emergency Room Participant pays
$500 copay per visit plus 20% after deductible
Emergency Room (true emergency use) Participant pays Outpatient Surgery Participant pays Bariatric Surgery (only covered if performed at an 10Q facility) Physician charges; Participant pays Annual Vision Examination (one per plan year; performed by an ophthalmologist or optometrist)Participant pays Annual Hearing Examination Participant pays Preventive Care Some examples of preventive care frequency and services: • • • •
Routine physicals – annually age 12 and over Mammograms – 1 every year age 35 and over Smoking cessation counseling – 8 visits per 12 months Well-child care – unlimited up to age 12
• • •
Colonoscopy – one every 10 years age 50 and over Healthy diet/obesity counseling – unlimited to age 22; age 22 and over – 26 visits per 12 months Well woman exam & pap smear – annually age 18 and over
• •
Prostate cancer screening – one per year age 50 and over Breastfeeding support – six lactation counseling visits per 12 months
Note: Covered services under this benefit must be billed by the provider as “preventive care.” Non-network preventive care is not paid at 100%. If you receive preventive services from a non-network provider, you will be responsible for any applicable deductible and coinsurance under the TRS-ActiveCare 1-HD and TRS-ActiveCare 2. There is no coverage for non-network services under the TRS-ActiveCare Select plan or TRS-ActiveCare Select Whole Health. For more information, please view the Benefits Booklet at www.trsactivecareaetna.com. TRS-ActiveCare is 14administered by Aetna Life Insurance Company. Aetna provides claims payment services only and does not assume any financial risk or obligation with respect to claims. Prescription drug benefits are administered by Caremark
2019 – 20 TRS-ActiveCare Plan Highlights TRS-ActiveCare 1-HD
TRS-ActiveCare Select or ActiveCare Select Whole Health
TRS- ActiveCare 2
(Baptist Health System and HealthTexas Medical Group; Baylor Scott and White Quality Alliance; Kelsey Select; Memorial Hermann Accountable Care Network; Seton Health Alliance)
NOTE: If you’re currently enrolled in TRS-ActiveCare 2, you can remain in this plan. However, as of Sept. 1, 2018, TRS-ActiveCare 2 is closed to new enrollees.
Drug Deductible Short-Term Supply at a Retail Location 20% coinsurance after deductible, except for certain generic preventive $15 copay drugs that are covered at 100%.2 3 25% coinsurance after deductible 25% coinsurance (min. $404; max. $80)3 3 50% coinsurance after deductible 50% coinsurance3 Extended-Day Supply at Mail Order or Retail-Plus Pharmacy Location (60- to 90-day supply)5 20% coinsurance after deductible $45 copay 25% coinsurance after deductible3 25% coinsurance (min. $1054; max. $210)3 3 50% coinsurance after deductible 50% coinsurance3 Specialty Medications (up to a 31-day supply)
$20 copay 25% coinsurance (min. $404; max. $80)3 50% coinsurance (min. $1004; max. $200)3 $45 copay 25% coinsurance (min. $1054; max. $210)3 50% coinsurance (min. $2154; max. $430)3 20% coinsurance (min. $2004 , max $900)
Specialty Medications
20% coinsurance after deductible 20% coinsurance Short-Term Supply of a Maintenance Medication at Retail Location up to a 31-day supply
The second time a participant fills a short-term supply of a maintenance medication at a retail pharmacy, they will be charged the coinsurance and copays in the rows below. Participants can save more over the plan year by filling a larger day supply of a maintenance medication through mail order or at a Retail-Plus location.
Tier 1 – Generic Tier 2 – Preferred Brand Tier 3 – Non-Preferred Brand
20% coinsurance after deductible 25% coinsurance after deductible3 50% coinsurance after deductible3
$30 copay 25% coinsurance (min. $604; max. $120)3 50% coinsurance3
$35 copay 25% coinsurance (min. $604; max. $120)3 50% coinsurance (min. $1054; max. $210)3
What is a maintenance medication? Maintenance medications are prescriptions commonly used to treat conditions that are considered chronic or long-term. These conditions usually require regular, daily use of medicines. Examples of maintenance drugs are those used to treat high blood pressure, heart disease, asthma and diabetes.
When does the convenience fee apply? For example, if you are covered under TRS-ActiveCare Select, the first time you fill a 31-day supply of a generic maintenance drug at a retail pharmacy you will pay $15, then you will pay $30 each month that you fill a 31-day supply of that generic maintenance drug at a retail pharmacy. A 90-day supply of that same generic maintenance medication would cost $45, and you would save $180 over the year by filling a 90-day supply. A specialist is any physician other than family practitioner, internist, OB/GYN or pediatrician. 1 Illustrates benefits when in-network providers are used. For some plans non-network benefits are also available; there is no coverage for non-network benefits under the TRS-ActiveCare Select or TRS-ActiveCare Select Whole Health Plan; see Enrollment Guide for more information. Non-contracting providers may bill for amounts exceeding the allowable amount for covered services. Participants will be responsible for this balance bill amount, which maybe considerable. 2 For TRS-ActiveCare 1-HD, certain generic preventive drugs are covered at 100%. Participants do not have to meet the deductible ($2,750 – individual, $5,500 – family) and they pay nothing out of pocket for these drugs. Find the list of drugs at info.caremark.com/trsactivecare. 3 If a participant obtains a brand-name drug when a generic equivalent is available, they are responsible for the generic copay plus the cost difference between the brand-name drug and the generic drug. 4 If the cost of the drug is less than the minimum, you will pay the cost of the drug. 5 Participants can fill 32-day to 90-day supply through mail order.
Monthly Premiums
Full monthly premium*
Premium with min. state/ district contribution**
$378
+Spouse +Children +Family
Individual
Your Monthly Premium***
Full monthly premium*
Premium with min. state/ district contribution**
$153
$556
$1,066
$841
$722
$497
$1,415
$1,190
Your Monthly Premium***
Full monthly premium*
Premium with min. state/ district contribution**
$331
$852
$627
$1,367
$1,142
$2,020
$1,795
$902
$677
$1,267
$1,042
$1,718
$1,493
$2,389
$2,164
Your Monthly Premium***
* If you are not eligible for the state/district subsidy, you will pay the full monthly premium. Please contact your Benefits Administrator for your monthly premium. ** The premium after state, $75 and district, $150 contribution is the maximum you may pay per month. Ask your Benefits Administrator for your monthly cost. (This is the amount you will owe each month after all available subsidies are applied to your premium.) *** Completed by your benefits administrator. The state/district contribution may be greater than $225. 15
MDLIVE
Telehealth
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.
YOUR BENEFITS PACKAGE
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 This is a general overview of your plan benefits.inIfthe thesummary terms of plan this outline differlocated from your policy, the policy will govern. Additional plan description on the 16 details on covered expenses, limitationsCBEBC and exclusions are included in the summary plan description located on the Benefits Website: www.cbebc.com. CBEBC Benefits Website: www.cbebc.com.
Telehealth When should I use MDLIVE?
• If you’re considering the ER or urgent care for a nonemergency 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!
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? $8 for Employee Only. $16 for Family. One cost covers entire family 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 • •
Pediatric Care related to: • • • • • • •
Cold & Flu Constipation Ear Infection Fever Nausea & Vomiting Pink Eye And More!
• • •
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 17 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
AFLAC YOUR BENEFITS PACKAGE
Hospital Indemnity
About this Benefit Hospital Confinement Indemnity Insurance pays a daily benefit if you have a covered stay in a hospital*, critical care unit and rehabilitation facility. The benefit amount is determined based on the type of facility and the number of days you stay. Hospital Confinement Indemnity 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.
The median hospital costs per stay have steadily grown to over $10,000.
$8,800
9,600
10,400
2003
2008
2012
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 18 details on covered expenses, limitations and exclusions are included in the summary plan description located on the CBEBC Benefits Website: www.cbebc.com.
Hospital Indemnity The plan that can help with expenses and protect your savings. Does your major medical insurance cover all of your bills? Even a minor trip to the hospital can present you with unexpected expenses and medical bills. And even with major medical insurance, your plan may only pay a portion of your entire stay. That’s how the Aflac Group Hospital Indemnity plan can help. It provides financial assistance to enhance your current coverage. So you may be able to avoid dipping into savings or having to borrow to address out-of-pocket-expenses major medical insurance was never intended to cover. Like transportation and meals for family members, help with child care, or time away from work, for instance.
The Aflac Group Hospital Indemnity plan benefits include the following: • Hospital Confinement Benefit • Hospital Admission Benefit
Hight Plan Coverage
Low Plan Coverage
Employee
$32.42
$17.44
Employee and Spouse
$65.48
$33.09
Employee and Dependent Children
$51.04
$26.78
Family
$84.10
$42.42
Monthly Rates
How it works:
Amount payable was generated based on benefit amounts for: Hospital Admission ($2,000), and Hospital Confinement ($200 per day). The plan has limitations and exclusions that may affect benefits payable. This brochure is for illustrative purposes only. Refer to your certificate for complete details, definitions, limitations, and exclusions.
Benefits Overview High Low HOSPITAL ADMISSION BENEFIT per confinement (once per covered sickness or accident per calendar year for each insured) Payable when an insured is admitted to a hospital and confined as an in-patient because of a covered $2,000 $1,000 accidental injury or covered sickness. We will not pay benefits for confinement to an observation unit, or for emergency room treatment or outpatient treatment. HOSPITAL CONFINEMENT per day (maximum of 31 days per confinement for each covered sickness or accident for each insured) Payable for each day that an insured is confined to a hospital as an in-patient as the result of a covered accidental injury or covered sickness. If we pay benefits for confinement and the insured becomes con$200 $100 fined again within six months because of the same or related condition, we will treat this confinement as the same period of confinement. This benefit is payable for only one hospital confinement at a time even if caused by more than one covered accidental injury, more than one covered sickness, or a covered accidental injury and a covered sickness. HEALTH SCREENING BENEFIT The Health Screening Benefit is payable once per calendar year for health screening tests performed as $50 per $50 per the result of preventive care, including tests and diagnostic procedures ordered in connection with roucalendar calendar tine examinations. This benefit is payable for each insured. year year Residents of Massachusetts are not eligible for the Health Screening Benefit. COVERED TESTS INCLUDE • Blood test for triglycerides • Immunization • Bone marrow testing • Hemoccult stool analysis • Breast ultrasound • Mammography • CA 15-3 (blood test for breast cancer) • Pap smear • CA 125 (blood test for ovarian cancer) • PSA (blood test for prostate cancer) • CEA (blood test for colon cancer) • Serum cholesterol test to determine level of of HDL and LDL • Chest X-ray • Serum protein electrophoresis (blood test for myeloma) • Colonoscopy • Spiral CT screening for lung cancer • DNA stool analysis • Stress test on a bicycle or treadmill • Fasting blood glucose test • Thermography • Flexible sigmoidoscopy • Urinalysis • Non-diagnostic vascular screening • Vision screening In order to receive benefits for accidental injuries due to a covered accident, an insured must be admitted within six months 19 of the date of the covered accident (in Washington, twelve months).
Hospital Indemnity LIMITS & EXCLUSIONS We will not pay for loss due to:
Elective Abortion - an abortion for any reason other than to preserve the life of the person upon whom the abortion is performed.
• In Tennessee, or if the pregnancy was the result of rape or incest, or if the War - voluntarily participating in war, any act of war, or military conflicts, fetus is non-viable. declared or undeclared, or voluntarily participating or serving in the military, armed forces, or an auxiliary unit thereto, or contracting with any country or Dental Services or Treatment. international authority. (We will return the prorated premium for any period not covered by the certificate when the insured is in such service.) War also includes Cosmetic Surgery, except when due to: voluntary participation in an insurrection, riot, civil commotion or civil state of • Reconstructive surgery, when the service is related to or follows surgery belligerence. War does not include acts of terrorism (except in Illinois). resulting from a Covered Accidental Injury or a Covered Sickness, or is • In Connecticut: a riot is not excluded. related to or results from a congenital disease or anomaly of a covered • In Oklahoma: War, or any act of war, declared or undeclared, when serving dependent child. in the military, armed forces, or an auxiliary unit thereto. (We will return • Congenital defects in newborns. the prorated premium for any period not covered by the certificate when the insured is in such service.) War does not include acts of terrorism.
TERMS YOU NEED TO KNOW
Suicide - committing or attempting to commit suicide, while sane or insane.
• • •
In Colorado, Missouri, Montana, and Vermont: committing or attempting to commit suicide, while sane. In Idaho: committing or attempting to commit suicide, while sane or insane, or intentionally self-inflicting injury. In Minnesota and Ohio: this exclusion does not apply.
Racing – riding in or driving any motor-driven vehicle in a race, stunt show or speed test in a professional or semi-professional capacity. Self-Inflicted Injuries - injuring or attempting to injure oneself intentionally.
• •
In Missouri: injuring or attempting to injure oneself intentionally which is obviously not an attempted suicide. In Vermont: injuring or attempting to injure oneself intentionally, while sane
Illegal Occupation - voluntarily participating in, committing, or attempting to commit a felony or illegal act or activity, or voluntarily working at, or being engaged in, an illegal occupation or job.
• • • • •
In Connecticut : voluntarily participating in, committing, or attempting to commit a felony. In Illinois: committing or attempting to commit a felony or being engaged in an illegal occupation. In Nebraska and Tennessee: voluntarily participating in, committing, or attempting to commit a felony or voluntarily working at, or being engaged in, an illegal occupation or job. In Pennsylvania: committing or attempting to commit a felony, or being engaged in an illegal occupation. In South Dakota: voluntarily committing a felony.
Sports – participating in any organized sport in a professional or semiprofessional capacity. Custodial Care - this is non-medical care that helps individuals with the basic tasks of everyday life, the preparation of special diets, and the self-administration of medication which does not require the constant attention of medical personnel. Treatment for being overweight, gastric bypass or stapling, intestinal bypass, and any related procedures, including any resulting complications. Services performed by a family member.
•
In South Dakota: this exclusion does not apply.
Services related to sex or gender change, sterilization, in vitro fertilization, vasectomy or reversal of a vasectomy, or tubal ligation.
•
In Washington D.C. and Washington: Services related to sterilization, in vitro fertilization, vasectomy or reversal of a vasectomy, or tubal ligation.
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A Covered Accident is an accident that occurs on or after an insured’s effective date while coverage is in force, and that is not specifically excluded by the plan. Dependent means your spouse or dependent children, as defined in the applicable rider, who have been accepted for coverage. Spouse is your legal wife, husband, or partner in a legally recognized union. Refer to your certificate for details. Dependent Children are your or your spouse’s natural children, step-children, grandchildren who are in your legal custody and residing with you, foster children, children subject to legal guardianship, legally adopted children, or children placed for adoption. Newborn children are automatically covered from the moment of birth for 60 days. Newly adopted children are automatically covered for 60 days also. See certificate for details. Dependent children must be younger than age 26 (and in Louisiana, unmarried), however this limit will not apply to any insured dependent child who is incapable of self-sustaining employment due to mental or physical handicap and is chiefly dependent on a parent for support and maintenance. Doctor is a person who is duly qualified as a practitioner of the healing arts acting within the scope of his license, and: is licensed to practice medicine; prescribe and administer drugs; or to perform surgery, or is a duly qualified medical practitioner according to the laws and regulations in the state in which treatment is made. In Montana: For purposes of treatment, the insured has full freedom of choice in the selection of any licensed physician, physician assistant, dentist, osteopath, chiropractor, optometrist, podiatrist, licensed social worker, psychologist, licensed professional counselor, acupuncturist, naturopathic physician, physical therapist, or advanced practice registered nurse. A Doctor does not include you or any of your Family Members. For the purposes of this definition, Family Member includes your spouse as well as the following members of your immediate family: son, daughter, mother, father, sister, or brother. In South Dakota, however, a doctor who is your family member may treat you if that doctor is the only doctor in the area and acts within the scope of his or her practice. A Hospital is not a nursing home; an extended care facility; a skilled nursing facility; a rest home or home for the aged; a rehabilitation facility; a facility for the treatment of alcoholism or drug addiction (except in Vermont); an assisted living facility; or any facility not meeting the definition of a Hospital as defined in the certificate. Sickness means an illness, infection, disease, or any other abnormal physical condition or pregnancy that is not caused solely by, or the result of, any injury (In Maine, illness or disease of an insured). A Covered Sickness is one that is not excluded by name, specific description, or any other provision in this plan. For a benefit to be payable, loss arising from the covered sickness must occur while the applicable insured’s coverage is in force (except in Montana).
Hospital Indemnity Treatment is the consultation, care, or services provided by a doctor. This includes receiving any diagnostic measures and taking prescribed drugs and medicines. Treatment does not include telemedicine services (except in Kansas). You May Continue Your Coverage Your coverage may be continued with certain stipulations. See certificate for details. Termination of Coverage Your insurance may terminate when the plan is terminated; the 31st day after the premium due date if the premium has not been paid; or the date you no longer belong to an eligible class. If your coverage terminates, we will provide benefits for valid claims that arose while your coverage was in force.
NOTICES If this coverage will replace any existing individual policy, please be aware that it may be in your best interest to maintain your individual guaranteed-renewable policy. Notice to Consumer: The coverages provided by Continental American Insurance Company (CAIC) represent supplemental benefits only. They do not constitute comprehensive health insurance coverage and do not satisfy the requirement of minimum essential coverage under the Affordable Care Act. CAIC coverage is not intended to replace or be issued in lieu of major medical coverage. It is designed to supplement a major medical program. For more information, ask your insurance agent/producer, call 1.800.433.3036, or visit aflacgroupinsurance.com. Continental American Insurance Company (CAIC ), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. CAIC is not licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands. Continental American Insurance Company • Columbia, South Carolina The certificate to which this sales material pertains may be written only in English; the certificate prevails if interpretation of this material varies. This brochure is a brief description of coverage and is not a contract. Benefits, terms, and conditions may vary by state. This brochure is subject to the terms, conditions, and limitations of Policy Series C80000. In Arkansas, C80100AR. In Oklahoma, C80100OK. In Oregon, C80100OR. In Pennsylvania, C80100PA. In Texas, C80100TX. In Virginia, C80100VA.
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AMERICAN PUBLIC LIFE YOUR BENEFITS PACKAGE
Accident
About this Benefit 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.
2/3 of disabling injuries suffered by American workers are not work related. American workers 36% ofreport they always or
usually live 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 22 details on covered expenses, limitations and exclusions are included in the summary plan description located on the CBEBC Benefits Website: www.cbebc.com.
A-3 Supplemental Limited Benefit Accident Expense Insurance Coastal Bend EBC THE POLICY UNDER WHICH THIS CERTIFICATE IS ISSUED IS NOT A POLICY OF WORKERS’ COMPENSATION INSURANCE. THE EMPLOYER DOES NOT BECOME A SUBSCRIBER TO THE WORKERS’ COMPENSATION SYSTEM BY PURCHASING THE POLICY AND IF THE EMPLOYER IS A NON-SUBSCRIBER, THE EMPLOYEE LOSES THOSE BENEFITS WHICH WOULD OTHERWISE ACCRUE UNDER THE WORKERS’ COMPENSATION LAWS. THE EMPLOYER MUST COMPLY WITH THE WORKERS’ COMPENSATION LAW AS IT PERTAINS TO NON-SUBSCRIBERS AND THE REQUIRED NOTIFICATIONS THAT MUST BE FILED AND POSTED.
SUMMARY OF BENEFITS Level 1 - 1 Unit
Benefit Description Accidental Death - per unit
Level 2 - 2 Units
$5,000
$10,000
Medical Expense Accidental Injury Benefit - per unit Daily Hospital Confinement Benefit
actual charges up to $500
actual charges up to $1,000
$75 per day
$150 per day
Air and Ground Ambulance Benefit
actual charges up to $1,250
actual charges up to $2,500
$500 $500 $2,500 $5,000
$1,000 $1,000 $5,000 $10,000
$2,500 $5,000
$5,000 $10,000
Accidental Dismemberment Benefit Single finger or toe Multiple fingers or toes Single hand, arm, foot or leg Multiple hands, arms, feet or legs Accidental Loss of Sight Benefit - per unit Loss of Sight in one eye Loss of Sight in both eyes
Total Monthly Premiums by Plan* Individual
Individual & Spouse
1 Parent Family
2 Parent Family
Level 1 - 1 Unit
$10.80
$19.40
$21.20
$29.80
Level 2 - 2 Units
$17.10
$29.80
$34.90
$47.60
*Total premium includes the Plan selected and any applicable rider premium. Premiums are subject to increase with notice. The premium and amount of benefits vary dependent upon the Plan selected at time of application.
Limitations and Exclusions Eligibility
This policy will be issued to only those persons who meet American Public Life Insurance Company’s insurability requirements. Persons not meeting APL’s insurability requirements will be excluded from coverage by an endorsement attached to the policy.
Base Policy
No benefits are payable for a pre-existing condition. Pre-existing condition means an Injury that pertains solely to an Accidental Bodily Injury which resulted from an accident sustained before the Effective Date of coverage. Pre-Existing Conditions specifically named or described as permanently excluded in any part of this contract are never covered. A Hospital is not an institution which is primarily a place for alcoholics or drug addicts; the aged; a nursing, rest or convalescent nursing home; a mental institution or sanitarium; a facility contracted for or operated by the United States Government for treatment of members or ex-members of the armed forces (unless You are legally required to pay for services rendered in the absence of insurance); or, a long-term nursing unit or geriatrics ward.
Medical Expense Accidental Injury Benefit
Expenses must commence within 60 days of the covered accident. The maximum benefit amount payable for any one accident for the Insured Person shall not exceed the Medical Expense Benefit.
Air and Ground Ambulance Benefit
Emergency transportation must occur within 21 calendar days of the accident causing such Injury.
Daily Hospital Confinement Benefit
The maximum benefit period for this benefit is 30 days per covered accident.
Accidental Death
Accidental Death must result within 90 days of the covered accident causing the injury.
Accidental Dismemberment Benefit
The total amount payable for all Losses resulting from the same accident will not exceed the Maximum Dismemberment Benefit of $5,000 cumulative per unit, per Accident. Loss must be within 90 days of the accident causing such Injury.
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APSB-22329 (TX) MGM/FBS Coastal Bend EBC
Exclusions
Benefits otherwise provided by this Policy will not be payable for services or expenses or any such Loss resulting from or in connection with: (1) sickness, illness or bodily infirmity; (2) suicide, attempted suicide or intentional self-inflicted Injury, whether sane or insane; (3) dental care or treatment unless due to accidental Injury to natural teeth; (4) war or any act of war (whether declared or undeclared) or participating in a riot or felony; (5) alcoholism or drug addiction; (6) travel or flight in or descent from any aircraft or device which can fly above the earth’s surface in any capacity other than as a fare paying passenger on a regularly scheduled airline; (7) Injury originating prior to the effective date of the Policy; (8) Injury occurring while intoxicated (Intoxication means that which is determined and defined by the laws and jurisdiction of the geographical area in which the loss or cause of loss is incurred.); (9) Voluntary inhalation of gas or fumes or taking of poison or asphyxiation; (10) Voluntary ingestion or injection of any drug, narcotic or sedative, unless administered on the advice and taken in such doses as prescribed by a Physician; (11) Injury sustained or sickness which first manifests itself while on full-time duty in the armed forces; (Upon notice, We will refund the proportion of unearned premium while in such forces.) (12) Injury incurred while engaging in an illegal occupation; (13) Injury incurred while attempting to commit a felony or an assault; (14) Injury to a covered person while practicing for or being a part of organized or competitive rodeo, sky diving, hang gliding, parachuting or scuba diving; (15) driving in any race or speed test or while testing an automobile or any vehicle on any racetrack or speedway; (16) hernia, carpal tunnel syndrome or any complication therefrom;
Guaranteed Renewable
You have the right to renew this Policy until the first premium due date on or after Your 69th birthday, if you pay the correct premium when due or within the Grace Period. When an Insured’s coverage terminates at age 70, coverage for other Insured Persons, if any, shall continue under this Policy. We have the right to change premium rates by class.
If You are entitled to benefits under this Policy as a result of sprained or lame back, or any intervertebral disk conditions, such benefits shall be payable for a maximum period of time, not exceeding in the aggregate three (3) months for any Injury.
2305 Lakeland Drive | Flowood, MS 39232 ampublic.com | 800.256.8606 Underwritten by American Public Life Insurance Compnay. This is a brief description of the coverage. For complete benefits, limitations, exclusions and other provisions, please refer to the policy. This coverage does not replace Workers’ Compensation Insurance. This product is inappropriate for people who are eligible for Medicaid coverage. | Policy Form A-3 Series | Texas | Supplemental Limited Benefit Accident Expense Insurance Policy | (10/14) | Coastal Bend EBC
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APSB-22329 (TX) MGM/FBS Coastal Bend EBC
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CIGNA
Dental
YOUR BENEFITS PACKAGE
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 This is a general overview of your plan benefits.inIfthe thesummary terms of plan this outline differlocated from your policy, the policy will govern. Additional plan description on the 26 details on covered expenses, limitationsCBEBC and exclusions are included in the summary plan description located on the Benefits Website: www.cbebc.com. CBEBC Benefits Website: www.cbebc.com.
Dental PPO - High Option Benefits
Network Calendar Year Maximum (Class I, II, and III expenses) Annual Deductible Individual Family Reimbursement Levels**
Cigna Dental PPO - High Option In-Network Out-of-Network Total Cigna DPPO $1,500
$1,500
$50 per person $150 per family
$50 per person $150 per family
Based on Reduced Contracted Fees
90th percentile of Reasonable and Customary Allowances
Plan Pays
You Pay
Plan Pays
You Pay
Class I - Preventive & Diagnostic Care Oral Exams Routine Cleanings Bitewing X-rays Full Mouth X-rays Panoramic X-ray Fluoride Application Sealants Emergency Care to Relieve Pain
100%
No Charge
100%
No Charge
Class II - Basic Restorative Care Fillings Root Canal Therapy/Endodontics Osseous Surgery Periodontal Scaling and Root Planing Surgical Extractions of Impacted Teeth Brush Biopsies Oral Surgery—All except simple extractions Oral Surgery—Simple extractions
80%*
20%*
80%*
20%*
Class III - Major Restorative Care Crowns Anesthetics Denture Repairs Denture Relines, Rebases and Adjustments Repairs to Bridges, Crowns and Inlays Dentures Bridges Inlays/Onlays Prosthesis Over Implant Space Maintainers
50%*
50%*
50%*
50%*
50%
50% $1,000 Dependent children to age 19
50%
Class IV - Orthodontia Lifetime Maximum
50% $1,000 Dependent children to age 19
Monthly PPO Premiums Tier
Rate
EE Only
$35.06
EE0 + Spouse
$67.44
EE + Child(ren)
$69.30
Family Coverage
$97.74
Missing Tooth Limitation – The amount payable is 50% of the amount otherwise payable until insured for 12 months; thereafter, considered a Class III expense. Pretreatment review is available on a voluntary basis when extensive dental work in excess of $200 is proposed. * Subject to annual deductible Dental Oral Health Integration Program (OHIP) - All dental customers = Clinical research shows an association between oral health and overall health. The Cigna Dental Oral Health Integration Program (OHIP)® is designed to provide enhanced dental coverage for customers with certain eligible medical conditions. Eligible conditions for the program include cardiovascular disease, cerebrovascular disease (stroke), diabetes, maternity, chronic kidney disease, organ transplants, and head and neck cancer radiation. The program provides: • 100% coverage for certain dental procedures • guidance on behavioral issues related to oral health • discounts on prescription and non-prescription dental products For more information and to see the complete list of eligible conditions, go to www.mycigna.com or call customer service 24/7 at 1.800.CIGNA24. **For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Contracted Fee Schedule. For services provided by an out-of-network dentist, Cigna Dental will reimburse according to Reasonable and Customary Allowances but the dentist may balance bill up 27to their usual fees.
Dental PPO - Low Option Benefits
Network Calendar Year Maximum (Class I, II, and III expenses) Annual 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 Reduced Contracted Fees
Based on Maximum Allowable Charge (Innetwork fee level)
Plan Pays
You Pay
Plan Pays
You Pay
Class I - Preventive & Diagnostic Care Oral Exams Routine Cleanings Bitewing X-rays Full Mouth X-rays Panoramic X-ray Fluoride Application Sealants Emergency Care to Relieve Pain
80%
20%
80%
20%
Class II - Basic Restorative Care Fillings Root Canal Therapy/Endodontics Osseous Surgery Periodontal Scaling and Root Planing Surgical Extractions of Impacted Teeth Brush Biopsies Oral Surgery—All except simple extractions Oral Surgery—Simple extractions
50%*
50%*
50%*
50%*
Class III - Major Restorative Care Crowns Anesthetics Denture Repairs Denture Relines, Rebases and Adjustments Repairs to Bridges, Crowns and Inlays Dentures Bridges Inlays/Onlays Prosthesis Over Implant Space Maintainers
25%*
75%*
25%*
75%*
50%
50% $1,000 Dependent children to age 19
50%
Class IV - Orthodontia Lifetime Maximum
50% $1,000 Dependent children to age 19
Monthly PPO Premiums Tier
Rate
EE Only
$18.97
EE + Spouse
$37.92
EE + Child(ren)
$41.64
Family Coverage
$60.61
Missing Tooth Limitation – The amount payable is 50% of the amount otherwise payable until insured for 12 months; thereafter, considered a Class III expense. Pretreatment review is available on a voluntary basis when extensive dental work in excess of $200 is proposed. * Subject to annual deductible Dental Oral Health Integration Program (OHIP) - All dental customers = Clinical research shows an association between oral health and overall health. The Cigna Dental Oral Health Integration Program (OHIP)® is designed to provide enhanced dental coverage for customers with certain eligible medical conditions. Eligible conditions for the program include cardiovascular disease, cerebrovascular disease (stroke), diabetes, maternity, chronic kidney disease, organ transplants, and head and neck cancer radiation. The program provides: • 100% coverage for certain dental procedures • guidance on behavioral issues related to oral health • discounts on prescription and non-prescription dental products For more information and to see the complete list of eligible conditions, go to www.mycigna.com or call customer service 24/7 at 1.800.CIGNA24. **For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Contracted Fee Schedule. For services provided by 28an out-of-network dentist, Cigna Dental will reimburse according to Reasonable and Customary Allowances but the dentist may balance bill up to their usual fees.
Dental PPO - High and Low Options Procedure
Exclusions and Limitations
Late Entrants Limit Exams Prophylaxis (Cleanings) Fluoride Histopathologic Exams X-Rays (routine) X-Rays (non-routine) Model Minor Perio (non-surgical) Perio Surgery Crowns and Inlays Bridges Dentures and Partials Relines, Rebases Adjustments Repairs - Bridges Repairs - Dentures Sealants Space Maintainers Prosthesis Over Implant
None Two per Calendar year Two per Calendar year 1 per Calendar year for people under 19 Various limits per Calendar year depending on specific test Bitewings: 2 per Calendar year Full mouth: 1 every 36 consecutive months., Panorex: 1 every 36 consecutive months Payable only when in conjunction with Ortho workup Various limitations depending on the service Various limitations depending on the service Replacement every 5 years Replacement every 5 years Replacement every 5 years Covered if more than 6 months after installation Covered if more than 6 months after installation Reviewed if more than once Reviewed if more than once Limited to posterior tooth. One treatment per tooth every three years up to age 14 Limited to non-Orthodontic treatment 1 per 60 consecutive months if unserviceable and cannot be repaired. Benefits are based on the amount payable for nonprecious metals. No porcelain or white/tooth colored material on molar crowns or bridges 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
Alternate Benefit
Benefit Exclusions • • • • •
• • • • • • • • • • • • • • • • • • • •
Services performed primarily for cosmetic reasons Replacement of a lost or stolen appliance Replacement of a bridge or denture within five years following the date of its original installation Replacement of a bridge or denture which can be made useable according to accepted dental standards Procedures, appliances or restorations, other than full dentures, whose main purpose is to change vertical dimension, diagnose or treat conditions of TMJ, stabilize periodontally involved teeth, or restore occlusion Veneers of porcelain or acrylic materials on crowns or pontics on or replacing the upper and lower first, second and third molars Bite registrations; precision or semi-precision attachments; splinting A surgical implant of any type Instruction for plaque control, oral hygiene and diet Dental services that do not meet common dental standards Services that are deemed to be medical services Services and supplies received from a hospital Charges which the person is not legally required to pay Charges made by a hospital which performs services for the U.S. Government if the charges are directly related to a condition connected to a military service Experimental or investigational procedures and treatments Any injury resulting from, or in the course of, any employment for wage or profit Any sickness covered under any workers’ compensation or similar law Charges in excess of the reasonable and customary allowances To the extent that payment is unlawful where the person resides when the expenses are incurred; Procedures performed by a Dentist who is a member of the covered person’s family (covered person’s family is limited to a spouse, siblings, parents, children, grandparents, and the spouse’s siblings and parents); For charges which would not have been made if the person had no insurance; For charges for unnecessary care, treatment or surgery; To the extent that you or any of your Dependents is in any way paid or entitled to payment for those expenses by or through a public program, other than Medicaid; To the extent that benefits are paid or payable for those expenses under the mandatory part of any auto insurance policy written to comply with a “no-fault” insurance law or an uninsured motorist insurance law. Cigna HealthCare will take into account any adjustment option chosen under such part by you or any one of your Dependents. In addition, these benefits will be reduced so that the total payment will not be more than 100% of the charge made for the Dental Service if benefits are provided for that service under this plan and any medical expense plan or prepaid treatment program sponsored or made available by your Employer.
This benefit summary highlights some of the benefits available under the proposed plan. A complete description regarding the terms of coverage, exclusions and limitations, including legislated benefits, will be provided in your insurance certificate or plan description. Benefits are insured and/or administered by Connecticut General Life Insurance Company. "Cigna HealthCare" refers to various operating subsidiaries of Cigna Corporation. Products and services are provided by these subsidiaries and not by Cigna Corporation. These subsidiaries include Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, and HMO or service company subsidiaries of Cigna Health Corporation and Cigna Dental Health, Inc. DPPO insurance coverage is set forth on the following policy form numbers: AR: HP-POL77; CA: HP-POL57; CO: HP-POL78; CT: HP-POL58; DE: HP-POL79; FL: HP-POL60; ID: HPPOL82; IL: HP-POL62; KS: HP-POL84; LA: HPPOL86: MA: HP-POL 63; MI: HP-POL88; MO: HP- POL65; MS: HP-POL90; NC: HP-POL96; NE: HP-POL92; NH: HP-POL94; NM: HP-POL95; NV: HP-POL93; NY: HP-POL67; OH: HP-POL98; OK: HP-POL99; OR: HP-POL68; PA: HP-POL100; RI: HP-POL101; SC: HP-POL102; SD: HP-POL103; TN: HP-POL69; TX: HP-POL70; UT: HP-POL104; VA: HP-POL72; VT: HP-POL71; WA: POL-07/08; WI: HP-POL107; WV: HP-POL106; and WY: HP-POL108. “Cigna,” the “Tree of Life” logo and “Cigna Dental Care” are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Connecticut General Life Insurance Company (CGLIC), Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Connecticut, Inc., and Cigna Dental Health, Inc. and its subsidiaries. Cigna Dental PPO plans are underwritten or administered by CGLIC or CHLIC, with network management services provided by Cigna Dental Health, Inc. and certain of its subsidiaries. In Arizona and Louisiana, the insured Dental PPO plan offered by CGLIC is known as the “CG Dental PPO”. In Texas, the insured dental product offered by CGLIC and CHLIC is referred to as the Cigna Dental Choice Plan, and this plan utilizes the national Cigna Dental PPO network. Cigna Dental Care (DHMO) plans are underwritten or administered by Cigna Dental Health Plan of Arizona, Inc., Cigna Dental Health of California, Inc., Cigna Dental Health of Colorado, Inc., Cigna Dental Health of Delaware, Inc., Cigna Dental Health of Florida, Inc., a Prepaid Limited Health Services Organization licensed under Chapter 636, Florida Statutes, Cigna Dental Health of Kansas, Inc. (Kansas and Nebraska), Cigna Dental Health of Kentucky, Inc. (Kentucky and Illinois), Cigna Dental Health of Maryland, Inc., Cigna Dental Health of Missouri, Inc., Cigna Dental Health of New Jersey, Inc., Cigna Dental Health of North Carolina, Inc., Cigna Dental Health of Ohio, Inc., Cigna Dental Health of Pennsylvania, Inc., Cigna Dental Health of Texas, Inc., and Cigna Dental Health of Virginia, Inc. In other states, Cigna Dental Care plans are underwritten by CGLIC, CHLIC, or Cigna HealthCare of Connecticut, Inc. and administered by Cigna Dental Health, Inc. BSD46380 © 2015 Cigna
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SUPERIOR VISION
Vision
YOUR BENEFITS PACKAGE
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 This is a general overview of your plan benefits.inIfthe thesummary terms of plan this outline differlocated from your policy, the policy will govern. Additional plan description on the 30 details on covered expenses, limitationsCBEBC and exclusions are included in the summary plan description located on the Benefits Website: www.cbebc.com. CBEBC Benefits Website: www.cbebc.com.
Vision Benefits Exam (ophthalmologist) Exam (optometrist) Frames Contact Lens Fitting (standard₂) Contact Lens Fitting (specialty₂) Contact Lenses4
In-Network
Out-of-Network
Covered in full
Up to $42 retail
EE Only
$7.23
Covered in full $125 retail allowance
Up to $37 retail Up to $68 retail
EE + Spouse
$14.36
EE + Child(ren)
$14.06
Covered in full
Not Covered
EE + Family
$21.41
$50 retail allowance
Not Covered
Monthly Premiums
Co-Pays
$120 retail allowance Up to $100 retail
Lenses (standard) per pair Single Vision Bifocal Trifocal Progressive lens upgrade
Covered in full Covered in full Covered in full
Up to $32 retail Up to $46 retail Up to $61 retail
See description3
Up to $61 retail
Discounts on Covered Materials5 Frames: Lens options: Progressives:
20% off amount over allowance 20% off retail 20% off amount over retail lined trifocal lens, including lens options
The following options have out-of-pocket maximums on standard (not premium, brand, or progressive) plastic lenses.
$10
Materials₁
$25
Contact Lens Fitting (standard & specialty)
$25
Services/Frequency Exam
12 months
Frame
12 months
Contact Lens Fitting
12 months
Lenses
12 months
Contact Lenses
12 months
Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements. ₁ Materials co-pay applies to lenses & frames only, not contact lenses. ₂Visit FAQs on www.superiorvision.com for definitions of standard and specialty CLF. ₃Covered to the provider's retail amount for a standard lined trifocal lens; member pays the difference between the retail price of the progressive lens they have chose and their provider's standard lined trifocal lens, plus applicable copay. 4Contact lenses are in lieu of eyeglass lenses and frames benefit.
Exam
Discounts on Non-Covered Exam and Materials5 Exams, frames, and prescription lenses: Lens options, contacts, other prescription materials: Disposable contact lenses: 5Discounts
30% off retail 20% off retail 10% off retail
and maximums may vary by lens type. Please check with your
provider. 5Discounts
and maximums may vary by lens type. Please check with your
provider.
Refractive Surgery Maximum Member Out-of-Pocket Single Vision Bifocal & Trifocal Scratch coat $13 $13 Ultraviolet coat $15 $15 Tints, solid or gradients $25 $25 Anti-reflective coat $50 $50 Polycarbonate $40 20% off retail High index 1.6 $55 20% off retail Photochromics $80 20% off retail
Superior Vision has a nationwide network of refractive surgeons and leading LASIK networks who offer members a discount. These discounts range from 5%-50%, and are the best possible discounts available to Superior Vision. The Plan discount features are not insurance.
All allowances are retail; member is responsible for any amount over the allowance, minus available discounts. 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. 31
CIGNA YOUR BENEFITS PACKAGE
Disability
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 32 details on covered expenses, limitations and exclusions are included in the summary plan description located on the CBEBC Benefits Website: www.cbebc.com.
Long Term Disability Long Term Disability (LTD) Insurance Coverage Eligibility Eligibility Waiting Period
Monthly Benefit
If you are an active employee who works at least 20 hours per week, you are eligible on the first of the month following 30 days actively at work. No waiting period.
Benefit Amount Maximum
Elimination Period
Benefit Duration
Flat dollar benefit in $100 increments between $200 and $7,500 that cannot exceed 66 2/3% of your current monthly earnings. Your benefit amount will be reduced by any amounts payable to you by any of the sources listed under the “Effects of Other income Benefits” section. $7,500 per month
Select from Six Options: Accident/Sickness 0 days/7 days* 14 days/14 days* 30 days/30 days* 60 days/60 days 90 days/90 days *If because of your disability, you are hospital confined an inpatient, benefits begin on the first day of inpatient confinement Once you qualify for benefits under this plan, you continue to receive them until the end of the benefit or until you no longer qualify for benefits, whichever occurs first. Should you remain Disabled, your benefits continue according to one of the following schedules, depending on your age at the time you become Disabled and the plan you select. Please refer to the “Maximum Benefit Duration” table below for more details.
Important Definitions and Features Definition of Disability “Disability” or “Disabled” means that, solely because of a covered injury or sickness, you are unable to perform the material duties of your regular occupation and you are unable to earn 80% or more of your indexed earnings from working in your regular occupation. After benefits have been payable for 24 months, you are considered disabled if solely due to your injury or sickness, you are unable to perform the material duties of any occupation for which you are (or may reasonably become) qualified by education, training or experience, and you are unable to earn 80% or more of your indexed earnings. We will require proof of earnings and continued disability.
Covered Earnings “Covered Earnings” means your wages or salary, not including bonuses, commissions, and other extra compensation.
Monthly Rates by Type of Plan (Per $100 Benefit) Duration
Acc Sick
EP (Days)
Acc Sick
All Ages
Age 65 Age 65 0 7
14 14
30 30
60 60
90 90
180 180
$3.70 $3.14 $2.72 $2.22 $1.28 $0.92
Maximum Benefit Duration Age at Disability
Under 60
60 -64
Duration of To age 65, Payments but not less 5 years (Accident and than 5 years Sickness)
65-69
70 and over
To age 70, but not less than 1 year
1 year
When Benefits Begin You must be continuously Disabled for your elected benefit waiting period before benefits will be payable for a covered Disability. 33
Long Term Disability Termination of Disability Benefits
Pre-existing Condition Limitation
Your benefits will terminate when your Disability ceases, when your benefit duration period is exceeded, or on the following events: (1) the date you earn from any occupation more than 80% of your Covered Earnings, or the date you fail to cooperate with us in a rehabilitation plan, or transitional work arrangement, or the administration of the claim.
Benefits are not payable for medical conditions for which you incurred expenses, took prescription drugs, received medical treatment, care or services (including diagnostic measures,) during the 3 months just prior to the most recent effective date of insurance. Benefits are not payable for any disability resulting from a pre-existing condition unless the disability occurs after you have been insured under this plan for at least 12 months after your most recent effective date of insurance.
Effects of Other Income Benefits This plan is structured to prevent your total benefits and postdisability earnings from equaling or exceeding pre-disability earnings. Therefore, we reduce this plan’s benefits by Other Income Benefits payable to you, your dependents, or a qualified third party on behalf of you or your dependents. Disability benefits maybe reduced by amounts received through Social Security disability benefits payable to you, your dependents, or a qualified third party on behalf of you or your dependents. Your disability benefits will not be reduced by any Social Security disability benefits you are not receiving as long as you cooperate fully in efforts to obtain them and agree to repay any overpayment when and if you do receive them. Disability benefits will also be reduced by amounts received through other government programs, sick leave, employer’s sabbatical leave, employer’s assault leave plan, employer funded retirement benefits, workers’ compensation, franchise/group insurance, auto no-fault, and damages for wage loss. For details, see your outline of coverage, policy certificate, or your employer’s summary plan description. Note: Some of the Other Income Benefits, as defined in the group policy, will not be considered until after disability benefits are payable for 6 months.
Additional Plan Details & Features Earnings While Disabled During the first 24 months that benefits are payable, benefits will be reduced if benefits plus income from employment exceeds 100% of pre-disability Covered Earnings. After that, benefits will be reduced by 50% of earnings from employment.
Pre-existing Condition Waiver The Insurance Company will waive the Pre-Existing Condition Limitation for the first month of Disability even if the Employee has a Pre-Existing Condition. The Disability Benefits as shown in the Schedule of Benefits will continue beyond 1 month only if the Pre-Existing Condition Limitation does not apply.
34
Limited Benefit Period Disabilities caused by or contributed to by any one or more of the following conditions are subject to a lifetime limit of 24 months for outpatient treatment: Anxiety-disorders, delusional (paranoid) or depressive disorders, eating disorders, mental illness, somatoform disorders (including psychosomatic illnesses) ,alcoholism, drug addiction or abuse. Benefits are payable during periods of hospital confinement for these conditions for hospitalizations lasting more than 14 consecutive days that occur before the 24-month lifetime outpatient limit is exhausted.
Exclusions This plan does not pay benefits for a Disability which results, directly or indirectly, from any of the following: • Suicide, attempted suicide, or intentionally self-inflicted injury while sane or insane; • war or any act of war, whether or not declared; • active participation in a riot; • commission of a felony; • the revocation, restriction or non-renewal of an Employee’s license, permit or certification necessary to perform the duties of his or her occupation unless due solely to Injury or Sickness otherwise covered by the Policy; • any cosmetic surgery or surgical procedure that is not Medically Necessary; • an Injury or Sickness for which the Employee is entitled to benefits from Workers’ Compensation or occupational disease law; • an Injury or Sickness that is work related. In addition, the plan does not pay disability benefits any period of Disability during which you are incarcerated in a penal or corrections institution.
Long Term Disability Plan Termination Coverage terminates if the group policy is terminated, if you cease to be in active service, if you are no longer a member of an eligible class of employees, the day after the last date for which premium has been paid by you or the employer, or the date you become eligible for a plan of benefits intended to replace this coverage. If you are disabled and receiving benefits under this plan, your benefits and coverage will continue until the expiration of your benefit period, or until you no longer qualify for benefits under the plan, whichever comes first.
When Coverage Takes Effect Your coverage takes effect on the later of the policy’s effective date, the date you become eligible, the date we receive your completed enrollment form, or the date you authorize any necessary payroll deductions. If you’re not actively at work on the date your coverage would otherwise take effect, your coverage will take effect on the date you return to work. If you have to submit evidence of good health, your coverage takes effect on the date we agree, in writing, to cover you.
Rehabilitation Requirement To be eligible for Disability benefits under this plan, you may be required to participate in a rehabilitation plan at the sole discretion and expense of the insurance company or company administering benefits under this plan. If you fail to fully cooperate with the rehabilitation plan, no Disability benefits will be paid, and coverage will end. For details, see your Certificate of Insurance.
Terms and conditions of coverage for Long-Term Disability insurance are set forth in Group Policy No. SLH100006. This is not intended as a complete description of the insurance coverage offered. This is not a contract. Complete coverage details, including premiums, are contained in the Policy Certificate. If there are any differences between this summary and the group policy, the information in the group policy takes precedence. Product availability and/or features may vary by state. Please keep this material as a reference. Insurance coverage is issued on group policy form number: Policy Form TL-004700. Coverage is underwritten by Life Insurance Company of North America, 1601 Chestnut St. Philadelphia, PA 19192. “Cigna” and the “Tree of Life” logo are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries, including Life Insurance Company of North America and Cigna Life Insurance Company of New York, and not by Cigna Corporation.
35
AMERICAN PUBLIC LIFE
Cancer
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.
YOUR BENEFITS PACKAGE
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 36 details on covered expenses, limitations and exclusions are included in the summary plan description located on the CBEBC Benefits Website: www.cbebc.com.
GC3 Limited Benefit Group Cancer Indemnity Insurance Coastal Bend EBC
THE POLICY UNDER WHICH THIS CERTIFICATE IS ISSUED IS NOT A POLICY OF WORKERS’ COMPENSATION INSURANCE. THE EMPLOYER DOES NOT BECOME A SUBSCRIBER TO THE WORKERS’ COMPENSATION SYSTEM BY PURCHASING THE POLICY AND IF THE EMPLOYER IS A NON-SUBSCRIBER, THE EMPLOYEE LOSES THOSE BENEFITS WHICH WOULD OTHERWISE ACCRUE UNDER THE WORKERS’ COMPENSATION LAWS. THE EMPLOYER MUST COMPLY WITH THE WORKERS’ COMPENSATION LAW AS IT PERTAINS TO NON-SUBSCRIBERS AND THE REQUIRED NOTIFICATIONS THAT MUST BE FILED AND POSTED.
Summary of Benefits Benefits
Level 1 Plan
Level 2 Plan
Radiation Therapy/Chemotherapy/ Immunotherapy Benefit
$500 per calendar month of treatment
$1,500 per calendar month of treatment
Hormone Therapy Benefit
$50 per treatment, up to 12 per calendar year
$50 per treatment, up to 12 per calendar year
Surgical Schedule Benefit
$1,600 max per operation; $15 per surgical unit
$4,800 max per operation; $45 per surgical unit
Anesthesia Benefit
25% of the amount paid for covered surgery
25% of the amount paid for covered surgery
Hospital Confinement Benefit
$100 per day 1-90 days; $100 per day, 91+ days in lieu of other benefits
$300 per day 1-90 days; $300 per day, 91+ days in lieu of other benefits
US Government/Charity Hospital/HMO
$100 per day in lieu of most other benefits
$300 per day in lieu of most other benefits
Outpatient Hospital or Ambulatory Surgical Center Benefit
$200 per day of surgery
$600 per day of surgery
Drugs & Medicine Benefit - Inpatient
$150 per confinement
$150 per confinement
Drugs & Medicine Benefit - Outpatient
$50 per prescription, up to $50 per cal month
$50 per prescription, up to $150 per cal month
Transportation & Outpatient Lodging Benefit
$0.50 per mile per round trip $100 per day, up to 100 days per calendar year
$0.50 per mile per round trip $100 per day, up to 100 days per calendar year
Family Member Transportation & Lodging Benefit
$0.50 per mile per round trip $100 per day, up to 100 days per calendar year
$0.50 per mile per round trip $100 per day, up to 100 days per calendar year
Blood, Plasma & Platelets Benefit
$150 per day, up to $7,500 per calendar year
$250 per day, up to $12,500 per calendar year
Bone Marrow/Stem Cell Transplant
Autologous - $500 per calendar year Non-Autologous - $1,500 per calendar year
Autologous - $1,500 per calendar year Non-Autologous - $4,500 per calendar year
Experimental Treatment Benefit
Pays as any non-experimental benefit
Pays as any non-experimental benefit
Attending Physician Benefit
$30 per day of confinement
$50 per day of confinement
Surgical Prosthesis Benefit
$1,000 per device (includes surgical fee); max 1 device per site, 2 lifetime max
$3,000 per device (includes surgical fee); max 1 device per site, 2 lifetime max
Hair Prosthesis Benefit
$50 per hair prosthetic, 2 lifetime max
$50 per hair prosthetic, 2 lifetime max
Dread Disease Benefit
$100 per day, 1-90 days of hospital confinement
$300 per day, 1-90 days of hospital confinement
Hospice Care Benefit
$50 per day, $9,000 lifetime max
$100 per day, $18,000 lifetime max
Inpatient Special Nursing Services
$150 per day of confinement
$150 per day of confinement
Ambulance Ground Benefit
$200 per ground trip
$200 per ground trip
Ambulance Air Benefit
$2,000 per air trip; up to 2 trips per hospital confinement (any combination of ground/air)
$2,000 per air trip; up to 2 trips per hospital confinement (any combination of ground/air)
Extended Care Benefit
$100 per day
$300 per day
Home Health Care Benefit
$100 per day
$300 per day
Second & Third Surgical Opinions
$300 per diagnosis; additional $300 if third opinion required
$300 per diagnosis; additional $300 if third opinion required
Waiver of Premium
Premium waived after 90 days of primary insured continuous total disability due to cancer
Premium waived after 90 days of primary insured continuous total disability due to cancer
Physical/Speech Therapy Benefit
$25 per visit, up to 4 visits per calendar month, $1,000 lifetime max
$25 per visit, up to 4 visits per calendar month, $1,000 lifetime max
Riders Diagnostic Testing Benefit Rider
$50; 1 person, per calendar year
$50; 1 person, per calendar year
Critical Illness Rider: Cancer
$2,500 lump sum benefit
$2,500 lump sum benefit
$600 up to a max of 30 days per confinement
$600 up to a max of 30 days per confinement
Optional Benefit Rider Intensive Care Unit Rider
37
APSB-22356(TX) MGM/FBS Coastal Bend EBC
GC3 Limited Benefit Group Cancer Indemnity Insurance Monthly Premium
Level 1
Level 1 + ICU Rider
Level 2
Level 2 + ICU Rider
Individual
$13.80
$17.10
$29.90
$33.20
One-Parent Family
$19.10
$23.60
$40.90
$45.40
Two-Parent Family
$24.30
$31.20
$51.90
$58.80
*Premium and amount of benefits provided vary dependent upon the level selected at time of application.
Eligibility
Diagnostic Testing Benefit Rider
If You are working either under contract to or as a Full-Time Employee for the Policyholder, or You are a member in or employed by the association, You are eligible for insurance provided You qualify for coverage as defined in the Master Application. You must apply for insurance within thirty (30) days of the Policy Effective Date or the date that You become eligible for coverage. If You do not apply within thirty (30) days of the Policy Effective Date or the date You become eligible for coverage, You may be subject to additional underwriting by Us.
Critical Illness Rider
This policy/certificate will be issued only to those persons who meet American Public Life Insurance Company’s insurability requirements. The policy/certificate and the Internal Cancer coverage under the Critical Illness Rider will not be issued to anyone who has been diagnosed or treated for Cancer in the previous ten years. The Heart Attack or Stroke coverage under the Critical Illness Rider will not be issued to anyone who has been diagnosed or treated for any heart or stroke related conditions. The Hospital Intensive Care Unit Rider will not cover heart conditions for a period of two years following the Effective Date of coverage for anyone who has been diagnosed or treated for any heart related condition prior to the 30th day following the Covered Person’s Effective Date of coverage.
Base Policy
All diagnosis of cancer must be positively diagnosed by a legally licensed doctor of medicine certified by the American Board of Pathology or American Board of Osteopathic Pathology. This policy/certificate pays only for loss resulting from definitive cancer treatment including direct extension, metastatic spread or recurrence. Proof must be submitted to support each claim. This policy/certificate also covers other conditions or diseases directly caused by cancer or the treatment of cancer. No benefits are payable for any covered person for any loss incurred during the first year of this policy/certificate as a result of a Pre-Existing Condition. A PreExisting Condition is a specified disease for which, within 12 months prior to the covered person’s effective date of coverage, medical advice, consultation or treatment, including prescribed medications, was recommended by or received from a member of the medical profession, or for which symptoms manifested in such a manner as would cause an ordinarily prudent person to seek diagnosis, medical advice or treatment. Pre-Existing Conditions specifically named or described as excluded in any part of this contract are never covered. This policy/certificate contains a 30-day waiting period during which no benefits will be paid under this policy/certificate. If any covered person has a specified disease diagnosed before the end of the 30-day period immediately following the covered person’s effective date, coverage for that person will apply only to loss that is incurred after one year from the effective date of such person’s coverage. If any covered person is diagnosed as having a specified disease during the 30-day period immediately following the effective date, you may elect to void the policy/certificate from the beginning and receive a full refund of premium. All benefits payable only up to the maximum amount listed in the schedule of benefits in the policy/certificate. A Hospital is not an institution which is primarily a place for alcoholics or drug addicts; the aged; a nursing, rest or convalescent nursing home; a mental institution or sanitarium; a facility contracted for or operated by the United States Government for treatment of members or ex-members of the armed forces (unless You are legally required to pay for services rendered in the absence of insurance); or, a long-term nursing unit or geriatrics ward. 38
APSB-22356(TX) MGM/FBS Coastal Bend EBC
We will pay the indemnity amount for one generally medically recognized internal cancer screening test per covered person per calendar year. Screening test include, but limited to: mammogram; breast ultrasound; breast thermography; breast cancer blood test (CA15-3); colon cancer blood test (CEA); prostate-specific antigen blood test (PSA); flexible sigmoidoscopy; colonoscopy; virtual colonoscopy; ovarian cancer blood test (CA-125); pap smear (lab test required); chest x-ray; hemocult stool specimen; serum protein electrophoresis (blood test for myeloma); thin prep pap test. Screening tests payable under this benefit will only be paid under this benefit. Benefits will only be paid for tests performed after the 30-day period following the covered person’s effective date of coverage.
Benefits will only be paid for a covered critical illness as shown on the policy/ certificate schedule page in the policy. No benefits will be provided for any loss caused by or resulting from: intentionally self-inflicted bodily injury, suicide or attempted suicide, whether sane or insane; or alcoholism or drug addiction; or any act of war, declared or undeclared , or any act related to war; or military service for any country at war; or a pre-existing condition; or a covered critical illness when the date of diagnosis occurs during the waiting period; or participation in any activity or event while intoxicated or under the influence of any narcotic unless administered by a physician or taken according to the physician’s instructions; or participation in, or attempting to participate in a felony, riot or insurrection (a felony is as defined by the law of the jurisdiction in which the activity takes place). Internal cancer does not include: other conditions that may be considered pre-cancerous or having malignant potential such as: acquired immune deficiency syndrome (AIDS); or actinic keratosis; or myelodysplastic and non-malignant myeloproliferative disorders; or aplastic anemia; or atypia; or non-malignant monoclonal gamopathy; or Leukoplakia; or Hyperplasia; or Carcinold; or Polycythemia; or carcinoma in situ or any skin cancer other than invasive malignant melanoma into the dermis or deeper. For a pre-existing condition no benefits are payable.
Hospital Intensive Care Unit Rider
No benefits will be provided during the first two years of this rider for hospital intensive care unit confinement caused by any heart condition when any heart condition was diagnosed or treated prior to the 30th day following the covered person’s effective date of this rider. The heart condition causing the confinement need not be the same condition diagnosed or treated prior to the effective date. No benefits will be provided if the loss results from: attempted suicide, whether sane or insane; or intentional self-injury; or alcoholism or drug addiction; or any act of war, declared or undeclared, or any act related to war; or military service for a country at war. No benefits will be paid for confinements in units such as surgical recovery rooms, progressive care, burn units, intermediate care, private monitored rooms, observation units, telemetry units or psychiatric units not involving intensive medical care; or other facilities which do not meet the standards for intensive care unit as defined in the rider. For a newborn child born within the tenmonth period following the effective date of this rider, no benefits will be provided for hospital intensive care unit confinement that begins within the first 30 days following the birth of such child.
GC3 Limited Benefit Group Cancer Indemnity Insurance Conditionally Renewable
This policy/certificate is conditionally renewable. This means that We have the right to terminate your policy/certificate on any premium due date after the first Policyholder’s Anniversary Date. We must give the Policyholder at least 60 days written notice prior to cancellation. We cannot cancel Your coverage because of a change in Your age or health. We can change Your premiums if We change premiums for all similar Certificates issued to the Policyholder. We must give the Policyholder at least 60 days written notice before We change Your premiums.
Continuation Rider Continuation
Coverage is continued when the Insured (You) cease employment with the employer through whom You originally became insured under the Policy. You will have the option to continue this Certificate (including any Riders, if applicable) by paying the premiums directly to Us at Our home office. Premiums must be paid within thirty-one (31) days after employment with your employer terminates. Premium rates required under this Continuation provision will be the same rates as those charged under the Employer’s Policy as if You had continued employment. We will bill You for these premiums after You notify Us to continue this coverage. Coverage will continue until the earlier of: (1) the Policy under which You originally became insured ends; or (2) You stop paying premiums under this option (subject to the terms of the Grace Period).
Termination of Coverage
Your Insurance coverage will end on the earliest of these dates: (a) the date You no longer qualify as an Insured; (b) the last day of the period for which a premium has been paid, subject to the Grace Period; (c) the date the Policy terminates (See Conversion provision); (d) the date You retire; (e) the date You cease employment, or terminate Your contract with the employer through whom You originally became insured under the Policy (See Conversion provision); or (f) the date We receive Your written request for termination. Termination of Dependent(s) Insurance coverage on Your Dependent(s) will end on the earliest of these dates: (a) the date the coverage under the Certificate terminates; (b) the date the Dependent no longer meets the definition of Dependent, as defined in the Policy/Certificate (See Conversion provision); (c) the date We receive Your written request for termination.
Termination of Rider Coverage
This rider terminates: (a) when Your coverage terminates under the Policy/ Certificate to which this Rider is attached; or, (b) when any premium for this rider is not paid before the end of the Grace Period; or, (c) when You give Us a written request to do so. Coverage on a Dependent terminates under this rider when such person ceases to meet the definition of Dependent, as defined in the Policy.
Conversion
If the Employer’s Policy is terminated, this Certificate will terminate. Upon termination of the Employer’s Policy, the employee (You) will be entitled to convert to an individual policy of insurance issued by Us without evidence of insurability provided the required premiums have been paid on your behalf and You notified Us in writing within thirty-one (31) days of the Employer’s Policy termination. Premiums for the individual policy of insurance will be figured from the premium rate table in effect on the date of conversion. Subject to the terms of this provision, a covered child who ceases to be eligible may convert to an individual policy of insurance and a covered spouse who ceases to be eligible for coverage because of divorce or annulment may convert to an individual policy. Terms of this provision include: (1) Application for the individual policy and payment of the first premium must be made within 60 days after coverage ceases under the Policy/Certificate. Premiums will be figured from the premium rate table in effect on the date of conversion. (2) The individual policy will be issued without proof of insurability. It will provide benefits that most nearly approximates those of the Policy/Certificate. (3) The individual policy will take effect the day after coverage ceases under the Policy/Certificate. However, no benefits will be payable under the individual policy for any loss for which benefits are payable under the Policy/Certificate. (4) The Pre-Existing Condition Limitation and Time Limit on Certain Defenses provisions for the individual policy will be figured from the Covered Person’s Effective Date of coverage under the Policy/ Certificate. (5) Any benefit maximums will be figured from the Effective Date of the Policy/Certificate. This rider is subject to all the provisions of the Policy and Certificate to which it is attached that are not in conflict with this rider.
2305 Lakeland Drive | Flowood, MS 39232 ampublic.com | 800.256.8606
Underwritten by American Public Life Insurance Company. This is a brief description of the coverage. For complete benefits, limitations, exclusions and other provisions, please refer to the policy and riders. This coverage does not replace Workers’ Compensation Insurance. This product is inappropriate for people who are eligible for Medicaid coverage. | This policy is considered an employee welfare benefit plan established and/or maintained by an association or employer intended to be covered by ERISA, and will be administered and enforced under ERISA. Group policies issued to governmental entities and municipalities may be exempt from ERISA guidelines. | Policy Form GC-3 Series | Texas | Limited Benefit Group Cancer Indemnity Insurance Policy | (11/14) | Coastal Bend EBC
39
APSB-22356(TX) MGM/FBS ESC Coastal Bend EBC
TEXAS LIFE
Individual Life
About this Benefit Group termlife life the most to Individual is is a policy thatinexpensive provides a way specified purchase life insurance. You have at thethe freedom death benefit to your beneficiary time ofto select amount of lifeofinsurance death.an The advantage having ancoverage individualyou lifeneed to help protect theopposed well-being your family. insurance plan as to aofgroup supplemental term life plan is that this plan is guaranteed renewable, portable and typically premiums remain the same over the life of the policy.
YOUR BENEFITS PACKAGE
Experts recommend at least
x 10 your gross annual income in coverage when purchasing life insurance.
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 40 details on covered expenses, limitations and exclusions are included in the summary plan description located on the CBEBC Benefits Website: www.cbebc.com.
Individual Life Life Insurance Highlights Voluntary permanent life insurance can be an ideal complement to the group term and optional term your employer might provide. Designed to be in force when you die, this voluntary universal life product is yours to keep, even when you change jobs or retire, as long as you pay the necessary premium. Group and voluntary term, on the other hand, typically are not portable if you change jobs and, even if you can keep them after you retire, usually costs more and declines in death benefit.
DID YOU KNOW? Those with no life insurance think it’s 3 times more expensive than it actually is.
The policy, PureLife-plus, is underwritten by Texas Life Insurance Company, and it has these outstanding features: •
High Death Benefit. With one of the highest death benefit available at the worksite,1 PureLife-plus gives your loved ones peace of mind, knowing there will be significant life insurance in force should you die prematurely.
•
Minimal Cash Value. Designed to provide high death benefit, PureLife-plus does not compete with the cash accumulation in your employer-sponsored retirement plans.
•
Long Guarantees. Enjoy the assurance of a policy that has a guaranteed death benefit to age 121 and level premium that guarantees coverage for a significant period of time (after the guaranteed period, premiums may go down, stay the same, or go up).
•
Refund of Premium. Unique in the marketplace, PureLife-plus offers you a refund of 10 years’ premium, should you surrender the policy if the premium you pay when you buy the policy ever increases. (Conditions apply.)
•
Accelerated Death Benefit Rider. Should you be diagnosed as terminally ill with the expectation of death within 12 months (24 months in Illinois), you will have the option to receive 92% (84% in Illinois) of the death benefit, minus a $150 ($100 in Florida) administrative fee. This valuable living benefit gives you peace of mind knowing that, should you need it, you can take the large majority of your death benefit while still alive. (Conditions apply.)
You may apply for this permanent, portable coverage, not only for yourself, but also for your spouse, minor children and grandchildren.
Like most life insurance policies, Texas Life policies contain certain exclusions, limitations, exceptions, reductions of benefits, waiting periods and terms for keeping them in force. Please contact a Texas Life representative for costs and complete details. 1
Voluntary and Universal Whole Life Products, Eastbridge Consulting Group, October 2008
41
UNUM
Life and AD&D
YOUR BENEFITS PACKAGE
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 42 details on covered expenses, limitations and exclusions are included in the summary plan description located on the CBEBC Benefits Website: www.cbebc.com.
Term Life Insurance and AD&D
All employees working at least 20 hours each week in active employment in the U.S. with the employer, and their eligible spouses and children to age 26.
Coverage amount(s) will reduce according to the following schedule: Age: Insurance Amount Reduces to: 65 65% of original amount 70 50% of original amount
Coverage Amounts
Guarantee Issue
Eligibility
Your Term Life coverage options are: Employee: Up to 5 times salary in increments of $10,000. Not to exceed $500,000. Spouse: Up to 100% of employee amount in increments of $5,000. Not to exceed $500,000. Benefits will be paid to the employee. Child: Up to 100% of employee coverage amount in increments of $2,000. Not to exceed $10,000. The maximum death benefit for a child between the ages of live birth and 6 months is $1000. Benefits will be paid to the employee. In order to purchase Life coverage for your spouse and/or child, you must purchase Life coverage for yourself.
Your AD&D coverage options are: Employee: Up to 5 times salary in increments of $10,000. Not to exceed $500,000. You may purchase AD&D coverage for yourself regardless of whether you purchase Life coverage. Spouse: 50% of Employee AD&D amount. Not to exceed $250,000. Benefits will be paid to the employee. Child: 10% of Employee AD&D amount. Not to exceed $50,000. The maximum death benefit for a child between the ages of live birth and 6 months is $1,000. Benefits will be paid to the employee. In order to purchase AD&D coverage for your spouse and/or child, you must purchase AD&D coverage for yourself. AD&D Benefit Schedule: The full benefit amount is paid for loss of: • Life • Both hands or both feet or sight of both eyes • One hand and one foot • One hand and the sight of one eye • One foot and the sight of one eye • Speech and hearing
Current Employees: If you and your eligible dependents enroll on or before the enrollment deadline, you may apply for any amount of Life insurance coverage up to $220,000 for yourself and any amount of coverage up to $50,000 for your spouse. Any Life insurance coverage over the Guarantee Issue amount(s) will be subject to evidence of insurability. If you and your eligible dependents do not enroll on or before the enrollment deadline, you can apply for coverage only during an annual enrollment period and will be required to furnish evidence of insurability for the entire amount of Life insurance coverage. AD&D coverage does not require evidence of insurability. If you and your eligible dependents enroll on or before the enrollment deadline and later wish to increase your Life insurance coverage, you may increase your coverage with evidence of insurability at anytime during the year. However, you may wait until the next annual enrollment and only coverage over one benefit unit increase will be subject to evidence of insurability. Employees hired on or after 09/01/2012: If you and your eligible dependents enroll within 31 days of your eligibility date, you may apply for any amount of Life insurance coverage up to $220,000 for yourself and any amount of coverage up to $50,000 for your spouse. Any Life insurance coverage over the Guarantee Issue amount(s) will be subject to evidence of insurability. If you and your eligible dependents do not enroll within 31 days of your eligibility date, you can apply for coverage only during an annual enrollment period and will be required to furnish evidence of insurability for the entire amount of coverage. AD&D coverage does not require evidence of insurability. If you and your eligible dependents enroll within 31 days of your eligibility date, and later, wish to increase your coverage, you may increase your Life insurance coverage, with evidence of insurability, at anytime during the year. However, you may wait until the next annual enrollment and only coverage over one benefit unit increase will be subject to evidence of insurability. Please see your Plan Administrator for your eligibility date.
Other losses may be covered as well. Please see your Plan Administrator. 43
Term Life Insurance and AD&D Term Life Coverage Rates
Portability/Conversion
Rates shown are your Monthly deduction:
If you retire, reduce your hours or leave your employer, you can take this coverage with you according to the terms outlined in the contract. However, if you have a medical condition which has a material effect on life expectancy, you will be ineligible to port your coverage. You may also have the option to convert your Term life coverage to an individual life insurance policy.
Age Band
Employee per $1,000
Spouse per $1,000
Child per $1,000 $.160
24 and under 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64
$.048
$.048
$.048 $.067 $.076 $.095 $.143 $.228 $.371 $.561
$.048 $.067 $.076 $.095 $.143 $.228 $.371 $.561
65-69
$1.083
$1.083
70-74
$1.758
$1.758
75+
$2.480
$2.480
Accelerated Benefit NOTE: The premium paid for child coverage is based on the cost of coverage for one child, regardless of how many children you have.
NOTE: Your rate will increase as you age and move to the next age band.
AD&D Coverage Rates AD&D Cost Per:
Monthly Rate
$1,000 $1,000 $1,000
$.030 $.030 $.030
Employee Spouse Child
If you become terminally ill and are not expected to live beyond a certain time period as stated in your certificate booklet, you may request up to 50% of your life insurance amount up to $750,000, without fees or present value adjustments. A doctor must certify your condition in order to qualify for this benefit. Upon your death, the remaining benefit will be paid to your designated beneficiary(ies). This feature also applies to your covered dependents.
Waiver of Premium If you become disabled (as defined by your plan) and are no longer able to work, your premium payments will be waived during the period of disability.
Retained Asset Account Benefits of $10,000 or more are paid through the Unum Retained Asset Account. This interest bearing account will be established in the beneficiary's name. He or she can then write a check for the full amount or for $250 or more, as needed.
Additional AD&D Benefits
Your rate is based on your insurance age, which is your age immediately prior to and including the anniversary/effective date.
Education Benefit: If you or your insured spouse die within 365 days of an accident, an additional benefit is paid to your dependent child(ren). Your child(ren) must be a full-time student beyond grade 12. (Not available in Illinois or New York.) Seat Belt/Air Bag Benefit: If you or your insured dependent(s) die in a car accident and are wearing a properly fastened seat belt and/or are in a seat with an air bag, an amount will be paid in addition to the AD&D benefit.
Additional Benefits Life Planning Financial & Legal Resources
Limitations/Exclusions/Termination of Coverage Suicide Exclusion
Insurance Age
This personalized financial counseling service provides expert, objective financial counseling to survivors and terminally ill employees at no cost to you. This service is also extended to you upon the death or terminal illness of your covered spouse. The financial consultants are master level consultants. They will help develop strategies needed to protect resources, preserve current lifestyles, and build future security. At no time will the consultants offer or sell 44 any product or service.
Life benefits will not be paid for deaths caused by suicide in the first twenty-four months after your effective date of coverage. No increased or additional benefits will be payable for deaths caused by suicide occurring within 24 months after the day such increased or additional insurance is effective.
Term Life Insurance and AD&D AD&D Benefit Exclusions AD&D benefits will not be paid for losses caused by, contributed to by, or resulting from: • Disease of the body or diagnostic, medical or surgical treatment or mental disorder as set forth in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders; • Suicide, self-destruction while sane, intentionally selfinflicted injury while sane, or self-inflicted injury while insane; • War, declared or undeclared, or any act of war; • Active participation in a riot; • Attempt to commit or commission of a crime; • The voluntary use of any prescription or nonprescription drug, poison, fume, or other chemical substance unless used according to the prescription or direction of your or your dependent’s doctor. This exclusion does not apply to you or your dependent if the chemical substance is ethanol; • Intoxication. (“Intoxicated” means that the individual’s blood alcohol level equals or exceeds the legal limit for operating a motor vehicle in the state or jurisdiction where the accident occurred.)
Termination of Coverage Your coverage and your dependents’ coverage under the Summary of Benefits ends on the earliest of: • The date the policy or plan is cancelled; • The date you no longer are in an eligible group; • The date your eligible group is no longer covered; • The last day of the period for which you made any required contributions; • The last day you are in active employment unless continued due to a covered layoff or leave of absence or due to an injury or sickness, as described in the certificate of coverage; • For dependent’s coverage, the date of your death. In addition, coverage for any one dependent will end on the earliest of: • The date your coverage under a plan ends; • The date your dependent ceases to be an eligible dependent; • For a spouse, the date of divorce or annulment.
For employees hired on or after 09/01/2012: To apply for coverage, complete your enrollment form within 31 days of your eligibility date. All employees: If you apply for coverage after your effective date, or if you choose coverage over the guarantee issue amount, you will need to complete a medical questionnaire which you can get from your Plan Administrator. You may also be required to take certain medical tests at Unum’s expense.
Delayed Effective Date of Coverage Employee: Insurance coverage will be delayed if you are not in active employment because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective. Dependent: Insurance coverage will be delayed if that dependent is totally disabled on the date that insurance would otherwise be effective. Exception: infants are insured from live birth. “Totally disabled” means that, as a result of an injury, a sickness or a disorder, your dependent is confined in a hospital or similar institution; is unable to perform two or more activities of daily living (ADLs) because of a physical or mental incapacity resulting from an injury or a sickness; is cognitively impaired; or has a life threatening condition.
Changes to Coverage Each year you and your spouse will be given the opportunity to change your Life coverage and AD&D coverage. You and your spouse may purchase additional Life coverage up to one benefit unit increase without evidence of insurability if you are already enrolled in the plan. Elected Life coverage over the one benefit unit increase will be medically underwritten and will require evidence of insurability and approval by Unum’s Medical Underwriters. The suicide exclusion will apply to any increase in coverage. AD&D coverage does not require evidence of insurability for increase amounts.
Questions Your coverage will become effective on 09/01/2012. For employees who become eligible after this date, please see your Plan Administrator for your effective date.
Unum will provide coverage for a payable claim which occurs while you and your dependents are covered under the policy or plan.
Next Steps How to Apply Current employees: To apply for coverage, complete your enrollment by the enrollment deadline
45
AFLAC
Critical Illness
YOUR BENEFITS PACKAGE
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 46 details on covered expenses, limitations and exclusions are included in the summary plan description located on the CBEBC Benefits Website: www.cbebc.com.
Critical Illness Plan Description The Aflac Group Critical Illness Plan provides cash benefits when an insured person is diagnosed with a covered critical illness-and these benefits are paid directly to your employees (unless otherwise assigned). The plan provides a lump-sum benefit to help with out-of-pocket medical expenses and the living expenses that can accompany a covered critical illness. It is also H.S.A.-compatible. Features and Plan Provisions (specific benefit provisions may vary by situs state) Benefit Amounts See Premium Rates and Plan Benefits for available options Spouse Coverage Up to 100% of the face amount elected by the employee Child Coverage Up to 50% of the face amount elected by the employee Guaranteed Issue Amounts Employee: Up to $30,000 Spouse: Up to $30,000 Participation Requirement: 0% Guaranteed for 2 years Requirement for Group Billing To establish group billing, 25 distinct individuals must be paying premiums Payment Method Payroll Deducted Pre-existing Condition Exclusion 12/12 Waiting Period There is no waiting period Benefit Reductions No reduction at any age Rate Guarantee 2 Year(s) Portability/Continuation Standard Rate Type Attained Age Eligibility Work Week Hours: Employee must work at least 16 hours per week Length of Employment: No minimum requirement; set by employer Waiver of Premium After 90 days of total disability for an employee due to a covered critical illness, we will fully waive all premiums for the duration specified in the certificate Successor Insured Waiver of Premium Not Included Separation Period - Additional Additional Diagnosis: 6 consecutive months Diagnosis/ Reoccurrence Reoccurrence: 6 consecutive months (an insured must always be in complete remission and 12 months treatment-free to be eligible for the cancer benefit)
Successor Insured Issue Ages
Included Employee: 18+ Spouse: 18+ Children: Under age 26 None Coverage is effective on the billing effective date
Termination Age Certificate Effective Date
Plan Benefits (Benefit provisions may vary by situs state)
Base Benefits Heart Attack (Myocardial Infarction) Sudden Cardiac Arrest Coronary Artery Bypass Surgery Major Organ Transplant Bone Marrow Transplant (Stem Cell Transplant) Kidney Failure (End-Stage Renal Failure) Stroke (Ischemic or Hemorrhagic)
100% 100% 25% 100% 100% 100% 100%
Cancer Benefits Cancer (Internal or Invasive) 100% Non-Invasive Cancer 25% Skin Cancer $250 per calendar year Health Screening Benefit Health Screening (payable for $50 per calendar year employee and spouse only)
Additional Benefits Coma Severe Burns Paralysis Loss of Sight Loss of Speech Loss of Hearing
100% 100% 100% 100% 100% 100%
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Critical Illness Premium Rates Age 18-29 30-39 40-49 50-59 60+
$5,000 $2.71 $3.62 $4.85 $7.82 $18.92
$10,000 $3.90 $5.71 $8.17 $14.11 $36.31
$15,000 $5.09 $7.81 $11.50 $20.41 $53.71
$20,000 $6.28 $9.90 $14.82 $26.70 $71.10
$25,000 $7.47 $12.00 $18.15 $33.00 $88.50
$30,000 $8.66 $14.09 $21.47 $39.29 $105.89
Age 18-29 30-39 40-49 50-59 60+
$5,000 $2.71 $3.62 $4.85 $7.82 $18.92
$10,000 $3.90 $5.71 $8.17 $14.11 $36.31
$15,000 $5.09 $7.81 $11.50 $20.41 $53.71
$20,000 $6.28 $9.90 $14.82 $26.70 $71.10
$25,000 $7.47 $12.00 $18.15 $33.00 $88.50
$30,000 $8.66 $14.09 $21.47 $39.29 $105.89
Benefits Summary (Benefit provisions vary by situs state) Where applicable, covered conditions must be caused by underlying diseases as defined in the plan. Benefits will be based on the face amount in effect on the critical illness date of diagnosis.
Additional Benefits Benefits for burns are only payable for burns due to, caused by, or attributed to, a covered accident. Benefits for Coma, Paralysis, and Loss of Sight, Hearing or Speech are payable for loss due to a covered underlying disease or a covered accident.
Initial Diagnosis+ An insured may receive up to 100% of his face amount upon the diagnosis of a covered critical illness.
*Plan designs vary and appearance of benefit provisions here does not guarantee coverage.
Limitations & Exclusions Additional Diagnosis+ Once benefits have been paid for a covered critical illness, we will Pre-Existing Conditions Limitation pay benefits for each different critical illness when the date of Pre-existing condition is a sickness or physical condition that diagnosis is separated by at least 6 consecutive months. existed within the 12-month period before the insured’s effective date. A medical professional must have advised, diagnosed, or Reoccurrence+ treated the insured for the condition to be considered preOnce benefits have been paid for a covered critical illness, existing. benefits are payable for that same critical illness when the date We will not pay benefits for any critical illness resulting from or of diagnosis is separated by at least 6 consecutive months. affected by a pre-existing condition if the critical illness was +If the claim is for a cancer diagnosis, the insured must be diagnosed within the 12-month period after the insured’s treatment-free from cancer for at least 12 months and must be effective date. in complete remission before the date of a subsequent cancer Cancer Diagnosis Limitation diagnosis. Benefits are payable for cancer and/or non-invasive cancer as long as the insured: Health Screening Benefit • Is treatment-free from cancer for at least 12 months before The Health Screening Benefit is payable once per calendar year the diagnosis date; and for health screening tests performed as the result of preventive • Is in complete remission prior to the date of a subsequent care, including tests and diagnostic procedures ordered in diagnosis, as evidenced by the absence of all clinical, connection with routine examinations. This benefit is payable for radiological, biological, and biochemical proof of the the covered employee and spouse. This benefit is not paid for presence of the cancer. dependent children. See Master Policy for the full list of covered health screening tests. 48
Critical Illness Exclusions We will not pay for loss due to: • Self-Inflicted Injuries - injuring or attempting to injure oneself intentionally or taking action that causes oneself to become injured • Suicide - committing or attempting to commit suicide, while sane or insane • Illegal Acts - participating or attempting to participate in an illegal activity, or working at an illegal job • Participation in Aggressive Conflict of any kind, including: • War (declared or undeclared) or military conflicts • Insurrection or riot • Civil commotion or civil state of belligerence • Illegal substance abuse, which includes the following: • Abuse of legally-obtained prescription medication • Illegal use of non-prescription drugs
coverage, you may be subject to a tax penalty. Please consult your tax advisor. In Washington DC: NOTICE TO CONSUMER: THIS IS A SUPPLEMENTAL TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMUM ESSENTIAL COVERAGE) MAY RESULT IN AN ADDITIONAL PAYMENT WITH YOUR TAXES. ALSO, THE BENEFITS PROVIDED BY THIS POLICY CANNOT BE COORDINATED WITH THE BENEFITS PROVIDED BY OTHER COVERAGE. PLEASE REVIEW THE BENEFITS PROVIDED BY THIS POLICY CAREFULLY TO AVOID A DUPLICATION OF COVERAGE.
Diagnosis, treatment, testing, and confinement must be in the United States or its territories. All benefits under the plan, including benefits for diagnoses, treatment, confinement and covered tests, are payable only while coverage is in force.
Notices This proposal is a brief description of coverage, not a contract. Read your policy and riders (as applicable) carefully for exact plan language, terms, and conditions. If this coverage will replace any existing individual policy, please be aware that it may be in your employees' best interest to maintain their individual guaranteed-renewable policy. Notice to Consumer: The coverages provided by Continental American Insurance Company (CAIC) represent supplemental benefits only. They do not constitute comprehensive health insurance coverage and do not satisfy the requirement of minimum essential coverage under the Affordable Care Act. CAIC coverage is not intended to replace or be issued in lieu of major medical coverage. It is designed to supplement a major medical program. In Nevada: This limited plan provides supplemental benefits only. It does not constitute comprehensive health insurance coverage (often referred to as "major medical coverage") and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.
In New Mexico: This type of plan is NOT considered "minimum essential coverage" under the Affordable Care Act and therefore does NOT satisfy the individual mandate that you have health insurance coverage. If you do not have other health insurance
49
EECU
HSA (Health Savings Account)
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.
YOUR BENEFITS PACKAGE
The interest earned in an HSA is tax free.
FLIP TO‌ FOR A LIST OF PARTICIPATING SCHOOL DISTRICTS
PG. 12
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 This is a general overview of your plan benefits.inIfthe thesummary terms of plan this outline differlocated from your policy, the policy will govern. Additional plan description on the 50 details on covered expenses, limitationsCBEBC and exclusions are included in the summary plan description located on the Benefits Website: www.cbebc.com. CBEBC Benefits Website: www.cbebc.com.
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 – Save your receipts – for all qualified medical expenses. compounded daily and paid monthly from deposit to EECU does not verify eligibility. You are responsible for withdrawal making sure payments are for qualified medical expenses. • Conveniently pay for qualified healthcare expenses – with a free, no annual fee EECU HSA Debit Mastercard® or via EECU’s free online bill pay. (HSA checks are also available How To Manage Your Account upon request, for a nominal fee**) • Online - check your balance, pay healthcare providers and • Free online, mobile and branch access – allows you to arrange deposits; sign-up for online banking at actively manage your account however you prefer www.eecu.org. • Comprehensive service and support – to assist you in • Mobile - EECU’s mobile app allows you to manage your optimizing your healthcare saving and spending account on the go; download “EECU Mobile Banking” in • Federally insured – to at least $250,000 by NCUA Apple’s App Store and Google Play. • Contact Member Service – call 817-882-0800 for help with 2019 Annual HSA Contribution Limits your HSA questions or transactions. You can also chat with Individual: $3,500 us online at eecu.org or use our secure email. Member Family: $7,000 Service is available Monday through Friday from 8:00am – Catch-Up Contributions: Accountholders who meet the 7:00pm CT, Saturdays from 9am – 1pm CT and closed on qualifications noted below are eligible to make an HSA Sunday. catch-up contribution of an additional $1,000. • Account Statements – monthly statements show all your • Health Savings accountholder account activity for that period. You can receive free online • Age 55 or older (regardless of when in the year an statements or pay $2 per printed statement. accountholder turns 55) * Contributions, investment earnings, and distributions are tax free for federal tax purposes if • Not enrolled in Medicare (if an accountholder enrolls in used to pay for qualified medical expenses, and may or may not be subject to state taxation. Medicare mid-year, catch-up contributions should be A list of Eligible Medical Expenses can be found in IRS Publication 502, http://www.irs.gov/ pub/irs-pdf/p502.pdf. As described in IRS publication 969, http://www.irs.gov/pub/irs-pdf/ prorated) p969.pdf, certain over-the-counter medications (when prescribed by a doctor) are Authorized Signers who are 55 or older must have their own considered eligible medical expenses for HSA purposes. If an individual is 65 or older, there is no penalty to withdraw HSA funds. However, income taxes will apply if the distribution is not HSA in order to make the catch-up contribution used for qualified medical expenses. For more information consult a tax adviser or your state department of revenue. All contributions and distributions are your responsibility and must be within IRS regulatory limits. ** Call 817-882-0800 or stop-by an EECU branch to order standard checks at no charge (excludes shipping and handling) or order custom checks - prices vary.
51
NBS
FSA (Flexible Spending Account)
YOUR BENEFITS PACKAGE
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 FOR A LIST OF PARTICIPATING SCHOOL DISTRICTS
PG. 13
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 52 details on covered expenses, limitations and exclusions are included in the summary plan description located on the CBEBC Benefits Website: www.cbebc.com.
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
Current plan participants: KEEP YOUR CARDS! NBS debit cards are good for 3 years. If you need a replacement card please contact NBS directly at (800) 274-0503.
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.
Expect Flex Cards to be delivered to the address listed in THEbenefitsHUB near the end of September. Don’t forget, Flex Cards Are Good For 3 Years!
For a list of sample expenses, please refer to the CBEBC benefit website: www.cbebc.com
NBS Contact Information: 8523 South Redwood Road West Jordan, UT 84088 Phone (800) 274‐0503 Fax (800) 478‐1528 Email: claims@nbsbenefits.com
DID YOU KNOW? FSAs use tax-free funds to help pay for your Health Care Expenses?
FSA Annual Contribution Max: $2,700
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 Claim forms, Direct Deposit form, worksheets, etc. Online claim FAQs 53
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.cbebc.com
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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). Please contact your benefits admin to determine if your district has the grace period or the $500 Roll-Over option. If your district does not have the roll-over, your plan contributions are use-it-or-lose-it.
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.cbebc.com 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.
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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 56 details on covered expenses, limitations and exclusions are included in the summary plan description located on the CBEBC Benefits Website: www.cbebc.com.
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.
Emergent Card Example:
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.
Plan Comparison
MASA provides medical emergency transportation solutions AND cover your out of pocket medical transport cost when your insurance falls short.
BENEFIT Emergency Air Medical Transport
✔
✔
“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
Emergency Ground Ambulance Transport
✔
✔
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 only/family coverage. MASA Platinum is $24.50/employee per month and $32.50/family per month.
EMERGENT PLATINUM $9/mo. $29-$39/mo. (30% off) (35% off)
Non-Emergent Air Transport
✔
Minor Child/Grandchild Return
✔
Organ Recipient Transport
✔
Organ Retrieval
✔
Repatriation/Recuperation
✔
Non-injury Transport
✔
Pet Return
✔
Vehicle Return
✔
Return Transportation
✔
Escort Transportation
✔
Mortal Remains Transport
✔
Worldwide Coverage
✔
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ID WATCHDOG
Identity Theft
YOUR BENEFITS PACKAGE
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 58 details on covered expenses, limitations and exclusions are included in the summary plan description located on the CBEBC Benefits Website: www.cbebc.com.
Identity Theft Identity theft can strike anyone, at any time. More than 11 million Americans were victimized by identity theft in 2011, including more than 500,000 children.
Identity theft devastates its victims financially. The average victim will lose $4,841, and spend an additional $1,400 in out-of-pocket expenses resolving their case.
Repairing the damage caused by identity theft is frustrating and time consuming. The average victim spends 330 hours repairing the damage from identity theft—the equivalent of working a full-time job for more than 2 months.
ID Watchdog Dual Monthly Pricing 1B
Platinum
Individual Plan
$7.95
$11.95
Family Plan
$14.95
$22.95
ID Watchdog Services Basic & Advanced Identity Monitoring Cyber Monitoring Full-Service Identity Restoration Non-Credit Loan Monitoring Address Monitoring Credit Report Monitoring 100% Resolution Guarantee
The impact of identity theft follows victims for years. 50% of identity theft victims experience trouble getting loans or credit cards as a result of identity theft. 12% of identity theft victims end up having warrants issued by law enforcement in their name for crimes committed by the identity thief.
Who’s Evaluating your Credit Report? Potential Creditors, Potential Employers, Insurance Companies, Current Creditors, Government Agencies
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WWW.CBEBC.COM 60