2022-23 Anna ISD Benefit Guide

Benefit Contact Information

BENEFIT ADMINISTRATORS ANNA ISD ADMINISTRATOR

Financial Benefit Services (800) 583 6908 www.mybenefitshub.com/annaisd

HOSPITAL INDEMNITY

MetLife Group #1998 (800) 845 7519 www.mybenefits.metlife.com

Kimberly Ruiz Demaree (972) 924 1000 x1047 kimberly.ruiz demaree@annaisd.org

TRS ACTIVECARE MEDICAL

Blue Cross Blue Shield of Texas (866) 355 5999 www.bcbstx.com/trsactivecare

HEALTH SAVINGS ACCOUNT (HSA) TELEHEALTH

EECU (817) 882 0800 www.eecu.org

DENTAL VISION

Cigna Group #3345042 (800) 244 6224 www.mycigna.com

ACCIDENT

The Hartford Policy # 681986 (800) 583 6908/Claims:(866) 547 4205 www.thehartford.com Claims: https://benefitsclaims.thehartford.com

Superior Vision Group # 36411 (800) 507 3800 www.superiorvision.com

CRITICAL ILLNESS

Aflac Policy # AGC000165270 (800) 433 3036 www.aflacgroupinsurance.com

WellVia (855) WELLVIA www.wellviasolutions.com

DISABLITY

The Hartford Policy # 681986 (800) 583 6908/Claims:(866) 547 9124 www.thehartford.com Claims: https://benefitsclaims.thehartford.com

LIFE AND AD&D

Lincoln Financial Group Policy # GL 000400266806 (800) 423 2756 www.lfg.com Claims: custservsupportteam@lfg.com

INDIVIDUAL LIFE IDENTITY THEFT

Texas Life (800) 283 9233 www.texaslife.com

ilLOCK360 (855) 287 8888 www.ilock360.com

FLEXIBLE SPENDING ACCOUNT (FSA)

National Benefit Services (855) 399 3035 www.nbsbenefits.com Claims: service@nbs.com

Annual Benefit Enrollment

Benefit Updates What’

NEW DENTAL PLAN WITH CIGNA

s New:

Your new Cigna Dental Plan offers the same rates as your previous MetLife plan. The Cigna Dental plan offers both in and out of network benefits. In network providers have contracted fees while out of network providers charges are based on the Maximum Reimbursable charge which allows balance billing. Therefore, it is recommended that you choose an in network provider to minimize your out of pocket expenses.

NEW NO COST DIGITAL MENTAL HEALTH PROGRAM

TRS No Cost Digital Mental Health Program Learn to Live offers digital cognitive behavioral therapy tools to help participants learn new skills and break old patterns. To check our Learn to Live, participants:

1) Log in to Blue Access for Members

2) Click Wellness

3) Choose Digital Mental Health

If participants have questions or need help registering for Learn to Live, they should call a Personal Health Guide at (866) 355 5999.

TEXAS LIFE PLANS ARE BEING REMOVED FROM PAYROLL DEDUCTION EFFECTIVE 9/1/2022

Your Texas Life Individual Life plan will no longer offer payroll deduction after 9/1/22. Please get the Bank Draft Authorization Form from the employee portal. You can email it back to customerservice@texaslife.com. For questions call 1 800 283 9233 ext. 6814.

Don

• Login and complete your benefit enrollment from 07/08/2022 08/12/2022

• Enrollment assistance is available by calling Financial Benefit Services at (866) 914 5202.

• Update your information: home address, phone numbers, email, and beneficiaries.

• REQUIRED!! Due to the Affordable Care Act (ACA) reporting requirements, you must add your dependent’s CORRECT social security numbers in the online enrollment system. If you have questions, please contact your Benefits Administrator.

Annual Benefit Enrollment

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 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 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.

CHANGES IN STATUS (CIS): QUALIFYING EVENTS

Marital Status

Change in Number of Tax Dependents

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. You can add existing dependents not previously enrolled whenever a dependent gains eligibility as a result of a valid change in status event.

Change in Status of Employment Affecting Coverage Eligibility

Gain/Loss of Dependents' Eligibility Status

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 under an employer's plan may include change in age, student, marital, employment or tax dependent status.

Judgment/Decree/ Order

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 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

Programs

Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change.

Annual Benefit Enrollment

Annual Enrollment

During your annual enrollment period, you have the opportunity to review, change or continue benefit elections each year. Changes are not permitted during the plan year (outside of annual enrollment) unless a Section 125 qualifying event occurs.

• Changes, additions or drops may be made only during the annual enrollment period without a qualifying event.

• Employees must review their personal information and verify that dependents they wish to provide coverage for are included in the dependent profile. Additionally, you must notify your employer of any discrepancy in personal and/or benefit information.

• 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.

New Hire Enrollment

All new hire enrollment elections must be completed in the online enrollment system within the first 30 days of benefit eligible 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 department or you can call Financial Benefit Services at 866 914 5202 for assistance.

Where can I find forms?

For benefit summaries and claim forms, go to your benefit website: www.mybenefitshub.com/annaisd Click the benefit plan you need information on (i.e., Dental) and you can find the forms you need under the Benefits and Forms section.

How can I find a Network Provider?

For benefit summaries and claim forms, go to the Anna ISD benefit website: www.mybenefitshub.com/annaisd. Click on the benefit plan you need information on (i.e., Dental) and you can find provider search links under the Quick Links section.

When will I receive ID cards?

If the insurance carrier provides ID cards, you can expect to receive those 3 4 weeks after your effective date. For most dental and vision plans, you can login to the carrier website and print a temporary ID card or simply give your provider the insurance company’s phone number and they can call and 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.

If the insurance carrier provides ID cards, but there are no changes to the plan, you typically will not receive a new ID card each year.

Annual Benefit Enrollment

Employee Eligibility Requirements

Supplemental Benefits: Eligible employees must work 20 or more regularly scheduled hours each work week.

Eligible employees must be actively at work on the plan effective date for new benefits to be effective, meaning you are physically capable of performing the functions of your job on the first day of work concurrent with the plan effective date. For example, if your 2022 benefits become effective on September 1, 2022, you must be actively at work on September 1, 2022 to be eligible for your new benefits.

Dependent Eligibility Requirements

Dependent Eligibility: You can cover eligible dependent children under a benefit that offers dependent coverage, provided you participate in the same benefit, through the maximum age listed below. Dependents cannot be double covered by married spouses within the district as both employees and dependents.

PLAN MAXIMUM AGE

Please note, limits and exclusions may apply when obtaining coverage as a married couple or when obtaining coverage for dependents.

Potential Spouse Coverage Limitations: When enrolling in coverage, please keep in mind that some benefits may not allow you to cover your spouse as a dependent if your spouse is enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Financial Benefit Services, or contact the insurance carrier for additional information on spouse eligibility.

FSA/HSA Limitations: Please note, in general, per IRS regulations, married couples may not enroll in both a Flexible Spending Account (FSA) and a Health Savings Account (HSA). If your spouse is covered under an FSA that reimburses for medical expenses then you and your spouse are not HSA eligible, even if you would not use your spouse's FSA to reimburse your expenses. However, there are some exceptions to the general limitation regarding specific types of FSAs. To obtain more information on whether you can enroll in a specific type of FSA or HSA as a married couple, please reach out to the FSA and/or HSA provider prior to enrolling or reach out to your tax advisor for further guidance.

Potential Dependent Coverage Limitations: When enrolling for dependent coverage, please keep in mind that some benefits may not allow you to cover your eligible dependents if they are enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Financial Benefit Services, or contact the insurance carrier for additional information on dependent eligibility.

Disclaimer: You acknowledge that you have read the limitations and exclusions that may apply to obtaining spouse and dependent coverage, including limitations and exclusions that may apply to enrollment in Flexible Spending Accounts and Health Savings Accounts as a married couple. You, the enrollee, shall hold harmless, defend, and indemnify Financial Benefit Services, LLC from any and all claims, actions, suits, charges, and judgments whatsoever that arise out of the enrollee's enrollment in spouse and/or dependent coverage, including enrollment in Flexible Spending Accounts and Health Savings Accounts.

If your dependent is disabled, coverage may be able to 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 Administrator to request a continuation of coverage.

Helpful Definitions

Actively at Work

You are performing your regular occupation for the employer on a full time basis, either at one of the employer’s usual 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 9/1/2022 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.

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.

In Network

Doctors, hospitals, optometrists, dentists and other providers who have contracted with the plan as a network provider.

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 prescription drugs or is under a health care provider’s orders to take drugs, or received medical care or services (including diagnostic and/or consultation services).

Description

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 tax free.

Minimum Deductible

Maximum Contribution

$1,400 single (2022) $2,800 family (2022) N/A

$3,650 single (2022) $7,300 family (2022) $2,850 (2022)

Permissible Use Of Funds

Cash Outs of Unused Amounts (if no medical expenses)

Year-to-year rollover of account balance?

Employees may use funds any way they wish. If used for non qualified medical expenses, subject to current tax rate plus 20% penalty.

Reimbursement for qualified medical expenses (as defined in Sec. 213(d) of IRC).

Permitted, but subject to current tax rate plus 20% penalty (penalty waived after age 65). Not permitted

Yes, will roll over to use for subsequent year’s health coverage.

No. Access to some funds 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

Medical Insurance

ABOUT MEDICAL

Major medical insurance is a type of health care coverage that provides benefits for a broad range of medical expenses that may be incurred either on an inpatient or outpatient basis.

For full plan details, please visit your benefit website: www.mybenefitshub.com/annaisd

Employee Only

$422.00 $315.00 $107.00

Employee & Spouse $1,187.00 $315.00 $872.00

Employee & Child(ren) $757.00 $315.00 $442.00

Employee & Family $1,419.00 $315.00 $1,104.00

TRS ActiveCare 2

Employee Only

$1,013.00 $315.00 $698.00

Employee & Spouse $2,402.00 $315.00 $2,087.00

Employee & Child(ren) $1,507.00 $315.00 $1,192.00

Employee & Family $2,841.00 $315.00 $2,526.00

TRS ActiveCare Primary

Employee Only

$410.00 $315.00 $95.00

Employee & Spouse $1,157.00 $315.00 $842.00

Employee & Child(ren) $738.00 $315.00 $423.00

Employee & Family $1,384.00 $315.00 $1,069.00

TRS ActiveCare Primary+

Employee Only

$515.00 $315.00 $200.00

Employee & Spouse $1,259.00 $315.00 $944.00

Employee & Child(ren) $829.00 $315.00 $514.00

Employee & Family $1,584.00 $315.00 $1,269.00

Central & North Texas Baylor Scott and White HMO

Employee Only $543.35 $315.00 $228.35

Employee & Spouse $1,364.92 $315.00 $1,049.92

Employee & Child(ren) $873.57 $315.00 $558.57

Employee & Family $1,570.98 $315.00 $1,255.98

Life and AD&D Lincoln Financial Group

ABOUT LIFE AND AD&D

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.

For full plan details, please visit your benefit website: www.mybenefitshub.com/annaisd

AT A GLANCE

• A cash benefit of $20,000 to your loved ones in the event of your death, plus a matching cash benefit if you die in an accident

• A cash benefit to you if you suffer a covered loss in an accident, such as losing a limb or your eyesight

• LifeKeys® services, which provide access to counseling, financial, and legal support

• TravelConnect® services, which give you and your family access to emergency medical assistance when you're on a trip 100+ miles from home

You also have the option to increase your cash benefit by securing additional coverage at affordable group rates.

ADDITIONAL DETAILS

Conversion: You can convert your group term life coverage to an individual life insurance policy without providing evidence of insurability if you lose coverage due to leaving your job or for another reason outlined in the plan contract. AD&D benefits cannot be converted.

Continuation of Coverage: You may be able to continue your coverage if you leave your job for any reason other than sickness, injury, or retirement.

Benefit Reduction: Coverage amounts begin to reduce at age 70. See the plan certificate for details.

For complete benefit descriptions, limitations, and exclusions, refer to the employee portal at www.mybenefitshub.com/annaisd

Hospital Indemnity MetLife

ABOUT HOSPITAL INDEMNITY

This is an affordable supplemental plan that pays you should you be in patient hospital confined. This plan complements your health insurance by helping you pay for costs left unpaid by your health insurance.

For full plan details, please visit your benefit website: www.mybenefitshub.com/annaisd

How to file a claim:

• Visit your benefit website for detailed claims instructions and forms: www.mybenefitshub.com/annaisd

Hospital

Indemnity

BENEFITS

Coverage Type

Benefit Amount

Underwriting Offer

Waiting Period for Sickness Hospital Admission and Confinement Benefits

Pre Existing Condition Limitation

Complications of Pregnancy

Plan Summary

Hospitalization Reason Accident: 24 Hour Coverage

Hospitalization Reason Sickness: 24 Hour Coverage

Employees will select a single plan of coverage on a Guaranteed Issue basis.

Guaranteed Issue

Benefits are paid directly to the employee based on flat schedule (not reimbursement) and there is no coordination with other insurance coverage.

None

Not Included.

Complications of pregnancy and emergency Cesarean section are covered.

Routine Childbirth Routine, vaginal delivery of a child or children or delivery of a child or children by non emergency Cesarean section are covered.

Elimination Period for Routine Childbirth Not Included.

Mental Illness

Drugs & Alcohol

Treatment for mental illness is not covered.

Treatment for alcoholism and drug addiction in a hospital is not covered. Injury or illness resulting from drug misuse, alcohol taken in combination with drugs, or driving under the influence is not covered.

Benefit Reduction Due to Age Not Included.

Portability (continuation of insurance with premium payment)

“Portability” is available through our Continuation of Insurance provision. Employees who are no longer eligible for coverage under the plan (e.g. if their employment ends or if they retire or due to their movement to a non eligible class) may continue their coverage on a direct billed basis.

Other

Other Benefit Features

Health Screening Benefit Paid one time per calendar year. The screening/prevention measures for which a Health Screening Benefit may be paid are: routine health check up exam; biopsies for cancer; blood chemistry panel; blood test to determine total cholesterol; blood test to determine triglycerides; bone marrow testing; breast MRI; breast ultrasound; breast sonogram; cancer antigen 15 3 blood test for breast cancer (CA 15 3); cancer antigen 125 blood test for ovarian cancer (CA 125); carcinoembryonic antigen blood test for colon cancer (CEA); carotid doppler; chest x rays; clinical testicular exam; colonoscopy; complete blood count (CBC); dental exam; digital rectal exam (DRE); Doppler screening for cancer; Doppler screening for peripheral vascular disease; echocardiogram; electrocardiogram (EKG); electroencephalogram (EEG); endoscopy; eye exam; fasting blood glucose test; fasting plasma glucose test; flexible sigmoidoscopy; hearing test; hemoccult stool specimen; hemoglobin A1C; human papillomavirus (HPV) vaccination; immunization; lipid panel; mammogram; oral cancer screening; pap smears or thin prep pap test; prostate specific antigen (PSA) test; serum cholesterol test to determine LDL and HDL levels; serum protein electrophoresis; skin cancer biopsy; skin cancer screening; skin exam; stress test on bicycle or treadmill; successful completion of smoking cessation program; tests for sexually transmitted infections (STIs); thermography; two hour post load plasma glucose test; ultrasounds for cancer detection; ultrasound screening of the abdominal aorta for abdominal aortic aneurysms; or virtual colonoscopy. The Health Screening Benefit is not available in all states.

Complete Details and Limitations and Exclusions are at www.mybenefitshub.com/annaisd and go to the Hospital Indemnity Section.

Health Savings Account (HSA)

EECU

ABOUT HSA

A Health Savings Account (HSA) is a personal savings account where the money can only be used for eligible medical expenses. Unlike a flexible spending account (FSA), the money rolls over year to year however only those funds that have been deposited in your account can be used. Contributions to a Health Savings Account can only be used if you are also enrolled in a High Deductible Health Care Plan (HDHP).

For full plan details, please visit your benefit website: www.mybenefitshub.com/annaisd

A Health Savings Account (HSA) is more than a way to help you and your family cover health care costs it is also a tax exempt tool to supplement your retirement savings and cover health expenses during retirement. An HSA can provide the funds to help pay current health care expenses as well as future health care costs.

A type of personal savings account, an HSA is always yours even if you change health plans or jobs. The money in your HSA (including interest and investment earnings) grows tax free and spends tax free if used to pay for qualified medical expenses. There is no “use it or lose it” rule you do not lose your money if you do not spend it in the calendar year and there are no vesting requirements or forfeiture provisions. The account automatically rolls over year after year.

HSA Eligibility

You are eligible to open and contribute to an HSA if you are:

• Enrolled in an HSA eligible High Deductible Health Plan (HDHP)

• Not enrolled in Medicare or TRICARE

• If you enroll in an HSA and FSA, the FSA becomes a Limited Purpose FSA and may only be used for Dental and Vision, not medical expenses.

• Not eligible to be claimed as a dependent on someone else’s tax return

You can use the money in your HSA to pay for qualified medical expenses now or in the future. You can also use HSA funds to pay health care expenses for your dependents, even if they are not covered by the HDHP.

Maximum Contributions

Your HSA contributions may not exceed the annual maximum amount established by the Internal Revenue Service. The annual contribution maximum for 2022 is based on the coverage option you elect:

• Individual $3,650

• Family (filing jointly) $7,300

BENEFITS

If you are 55 or older, you may make a yearly catch up contribution of up to $1,000 to your HSA. If you turn 55 at any time during the plan year, you are eligible to make the catch up contribution for the entire plan year.

Qualified Expenses

You can use your HSA for a wide range of qualified expenses, such as doctor’s visits, prescription drugs, lab work, medical equipment, contacts lenses, dental work, physical therapy the list goes on! Refer to IRS Publication 502 for comprehensive guidelines.

Important HSA Information

• You will receive a debit card to manage your Health Savings Account. Keep in mind, available funds are limited to the balance in your HSA.

• Always ask your health care provider to file claims with your medical provider so network discounts can be applied. You can pay the provider with your HSA debit card based on the balance due after discount.

• You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.

• You may open an HSA at the financial institution of your choice, but only accounts opened through EECU are eligible for automatic payroll deduction.

• Online/Mobile: Sign in for 24/7 account access to check your balance, pay bills and more.

• Call/Text: (817) 882 0800 EECU’s dedicated member service representatives are available to assist you with any questions. Their hours of operation are Monday through Friday from 8:00 a.m. to 7:00 p.m. CT, Saturday 9:00 a.m. to 1:00 p.m. CT and closed on Sunday.

• Lost/Stolen Debit Card: Call the 24/7 debit card hotline at (800) 333 9934.

• Stop by a local EECU financial center for in person assistance; find locations & service hours at www.eecu.org/locations

Telehealth

Well Via

ABOUT TELEHEALTH

Telehealth provides 24/7/365 access to board certified doctors via telephone or video consultations that can diagnose, recommend treatment and prescribe medication. Telehealth makes care more convenient and accessible for non emergency care when your primary care physician is not available.

For full plan details, please visit your benefit website: www.mybenefitshub.com/annaisd

BENEFITS

Our doctors diagnose, recommend treatment and prescribe medication via phone or video from anywhere your home, office or while on vacation 24/7, 365 days a year by phone, online portal, or app. only $0 per consult

When medically necessary, your doctor will issue a prescription to your pharmacy Member Services: (855) WELLVIA

For updated full disclosures, please visit www.wellviasolutions.com. Or call Member Services (855) WellVia

Dental

ABOUT DENTAL

How to Find a Dentist

Visit https://hcpdirectory.cigna.com/ or call 800 244 6224 to find an in network dentist.

Class III: Major Restorative Inlays and Onlays, Prosthesis Over Implant, Crowns: prefabricated stainless steel / resin, Crowns: permanent cast and porcelain Bridges and Dentures, Oral Surgery: major, Anesthesia: general and IV sedation, Periodontics: minor and major, Endodontics: minor and major, Repairs: bridges, crowns and inlays, Repairs: dentures

Class IV: Orthodontia

Children to age 19

$1,500

50% After Deductible 50% After Deductible

Dental Insurance Cigna

Benefit Plan Provisions:

In Network Reimbursement

Non Network Reimbursement

Late Entrant Limitation Provision

BENEFITS

For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Fee Schedule or Discount Schedule.

For services provided by a non network dentist, Cigna Dental will reimburse according to the Maximum Reimbursable Charge. The MRC is calculated at the 90th percentile of all provider allowed amounts in the geographic area. The dentist may balance bill up to their usual fees.

Payment will be reduced by 50% for Class III, IV and IX services for 12 months for eligible members that are allowed to enroll in this plan outside of the designated open enrollment period. This provision does not apply to new hires.

Oral Health Integration Program® The Cigna Dental Oral Health Integration Program offers enhanced dental coverage for customers with certain medical conditions. There is no additional charge to participate in the program. Those who qualify can receive reimbursement of their coinsurance for eligible dental services. Eligible customers can also receive guidance on behavioral issues related to oral health. Reimbursements under this program are not subject to the annual deductible but will be applied to the plan annual maximum. For more information on how to enroll in this program and a complete list of terms and eligible conditions, go to www.mycigna.com or call customer service 24/7 at 1 800 Cigna24.

Timely Filing Out of network claims submitted to Cigna after 365 days from date of service will be denied.

Benefit Limitations:

Missing Tooth Limitation

Oral Evaluations/Exams

For teeth missing prior to coverage with Cigna, the amount payable is 50% of the amount otherwise payable until covered for 12 months; thereafter, considered a Class III expense.

2 per calendar year.

X rays (routine) Bitewings: 2 per calendar year.

X rays (non routine) Complete series of radiographic images and panoramic radiographic images: Limited to a combined total of 1 per 36 months.

Diagnostic Casts Payable only in conjunction with orthodontic workup. Cleanings 3 per calendar year, including periodontal maintenance procedures following active therapy.

Fluoride Application 1 per calendar year for children under age 19.

Sealants (per tooth) Limited to posterior tooth. 1 treatment per tooth every 36 months for children up to age 14.

Space Maintainers

Limited to non orthodontic treatment for children under age 19.

Inlays, Crowns, Bridges, Dentures and Partials Replacement every 60 months if unserviceable and cannot be repaired. Benefits are based on the amount payable for non precious metals. No porcelain or white/tooth colored material on molar crowns or bridges.

Denture and Bridge Repairs Reviewed if more than once.

Denture Adjustments, Rebases and Relines Covered if more than 6 months after installation.

Prosthesis Over Implant

1 every 60 months if unserviceable and cannot be repaired. Benefits are based on the amount payable for non precious metals. No porcelain or white/tooth colored material on molar crowns or bridges.

ABOUT VISION

How to Print your Vision ID Card:

You can request your vision id card by contacting Superior Vision directly at 800 507 3800. You can also go to www.superiorvision.com and register/login to access your account by clicking on “Members” at the top of the page. You can also download the Superior Vision mobile app on your smart phone.

Need to search an in network provider?

Call 800 507 3800 or Visit https://superiorvision.com/locator/ to locate a provider.

to $150 Laser vision correction5 $200 retail allowance $200 retail allowance Co pays apply to in network benefits; co pays for out of network visits are deducted from reimbursements 1. Eye exam copay is a single payment due to the provider at the time of service. 2. Eyewear copay applies to eyeglass lenses / frame and contact lenses. Eyewear copay is a single payment that applies to the entire purchase of eyeglasses (frame and lenses) 3. Covered to provider’s in office standard retail lined trifocal amount; member pays difference between progressive and standard retail lined trifocal, plus applicable co pay 4. Contact lenses and related professional services (fitting, evaluation and follow up) are covered in lieu of eyeglass lenses and frames benefit 5. Lasik Vision Correction is in lieu of eyewear benefit, subject to routine regulatory filings and certain exclusions and limitations.

Vision Insurance Superior Vision

Scratch Coat $15 Ultraviolet coat $12 Tints, solid $15 Tints, gradient $18 Polycarbonate $40 Blue light filtering $15

Digital single vision $30 Progressive lenses: Standard/Premium/Ultra/Ultimate $55 / $110 / $150 / $225 Anti reflective coating: Premium/Ultra/Ultimate $70 / $85 / $120

Laser vision correction (LASIK)6

Laser vision correction (LASIK) is a procedure that can reduce or eliminate your dependency on glasses or contact lenses. This corrective service is available to you and your eligible dependents at a special discount (20 50%) with your Superior Vision plan. Contact QualSight LASIK at (877) 201 3602 for more information.

Hearing discounts6

A National Hearing Network of hearing care professionals, featuring Your Hearing Network, offers Superior Vision members discounts on services, hearing aids and accessories. These discounts should be verified prior to service.

Please refer to www.mybenefitshub.com/annaisd under the Vision section for full plan details and limitations.

Disability Insurance The Hartford EMPLOYEE BENEFITS

ABOUT DISABILITY

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.

For full plan details, please visit your benefit website: www.mybenefitshub.com/annaisd

What is Educator Disability Insurance?

Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness.

How to file a Claim: Just call The Hartford at 1 866 547 9124

Actively at Work: You must be at work with your Employer on your regularly scheduled workday. On that day, you must be performing for wage or profit all of your regular duties in the usual way and for your usual number of hours. If school is not in session due to normal vacation or school break(s), Actively at Work shall mean you are able to report for work with your Employer, performing all of the regular duties of Your Occupation in the usual way for your usual number of hours as if school was in session.

Benefit Amount: You may purchase coverage that will pay you a monthly benefit of 50% or 66 2/3% of your current monthly earnings to a maximum of $7,500. Earnings are defined in The Hartford’s contract with your employer.

Elimination Period: You must be disabled for at least the number of days indicated by the elimination period that you select before you can receive a Disability benefit payment. For those employees electing an elimination period of 30 days or less, if you are confined to a hospital for 24 hours or more due to a disability, the elimination period will be waived, and benefits will be payable from the first day of hospitalization.

Definition of Disability: Typically, disability means that you cannot perform one or more of the essential duties of your occupation due to injury, sickness, pregnancy, or other medical conditions covered by the insurance, and as a result, your current monthly earnings are 80% or less of your pre disability earnings. One you have been disabled

for 24 months, you must be prevented from performing one or more essential duties of any occupation, and as a result, your monthly earnings are 66 2/3% or less of your pre disability earnings.

Pre Existing Condition Limitation: Your policy limits the benefits you can receive for a disability caused by a pre existing condition. In general, if you were diagnosed or received care for a disabling condition within the 3 consecutive months just prior to the effective date of this policy, your benefit payment will be limited, unless: You have not received treatment for the disabling condition within 3 months, while insured under this policy, before the disability begins, or You have been insured under this policy for 12 months before your disability begins.

If your disability is a result of a pre existing condition, we will pay benefits for a maximum of 4 weeks.

Maximum Benefit Duration: Benefit Duration is the maximum time for which we pay benefits for disability resulting from sickness or injury. Depending on the age at which disability occurs, the maximum duration may vary.

Age at Disability

Prior to 63

Age 63

Maximum Duration of Benefits

To Normal Retirement Age or 48 months if greater

To Normal Retirement Age or 42 months if greater

Age 64 36 months

Age 65 30 months

Age 66 27 months

Age 67 24 months

Age 68 21 months

Age 69 and older 18 months

Disability Insurance The Hartford

Benefit Integration: Your benefit may be reduced by other income you receive or are eligible to receive due to your disability, such as:

• Social Security Disability Insurance

• State Teacher Retirement Disability Plans

• Workers’ Compensation

• Other employer based disability insurance coverage you may have

• Unemployment benefits

• Retirement benefits that your employer fully or partially pays for (such as a pension plan)

Survivor Benefit: If you die while receiving disability benefits, a benefit will be paid to your spouse, or in equal shares to your surviving children under the age of 26, equal to three times the last monthly gross benefit.

Extra Value Benefits:

The Hartford's Ability Assist service is included as a part of your group Long Term Disability (LTD) insurance program. You have access to Ability Assist services both prior to a disability and after you’ve been approved for an LTD claim and are receiving LTD benefits. Ability Assist services are provided through ComPsych®, a leading provider of employee assistance and work/life services. Includes emotional work life counseling, financial information and resources, Legal Support and Heath benefits services. Call 1 800 964 3577 or visit www.guidanceresources.com

Web ID HLF902 Company Name Field ABILI

Travel Assistance Program: Available 24/7, this program provides assistance to employees and their dependents who travel 100 miles from their home for 90 days or less. Services include pre trip information, emergency medical assistance and emergency personal services.

Identity Theft Protection: An array of identity fraud support services to help victims restore their identity. Benefits include 24/7 access to an 800 number; direct contact with a certified caseworker who follows the case until it’s resolved; and a personalized fraud resolution kit with instructions and resources for ID theft victims.

Disability

BENEFITS

7/7 $3.13 $3.64 14/14 $2.66 $3.08 30/30 $1.76 $2.04 60/60 $1.36 $1.56 90/90 $1.00 $1.16 180/180 $0.66 $0.76

Accident

ABOUT ACCIDENT

Do you have kids playing sports, are you a weekend warrior, or maybe accident prone? Accident plans are designed to help pay for medical costs associated with accidents and benefits are paid directly to you.

For full plan details, please visit your benefit website: www.mybenefitshub.com/annaisd

COVERAGE INFORMATION

You have a choice of two accident plans, which allows you the flexibility to enroll for the coverage that best meets your needs. This insurance provides benefits when injuries, medical treatment and/or services occur as the result of a covered accident. Unless otherwise noted, the benefit amounts payable under each plan are the same for you and your dependent(s).

BENEFITS

EMERGENCY, HOSPITAL & TREATMENT CARE LOW PLAN HIGH PLAN

Accident Follow Up

Ambulance Air

Ambulance Ground

Blood/Plasma/Platelets

Child Care

Daily Hospital Confinement

Daily ICU Confinement

Diagnostic Exam

Emergency Dental

Emergency Room

Health Screening Benefit

Hospital Admission

Up to 10 visits each per accident $50 $75

Up to 3 visits per accident $100 $150 Acupuncture/Chiropractic Care

Once per accident $2,000 $2,500

Once per accident $750 $1,000

Once per accident $300 $400

Up to 30 days per accident while insured is confined $35 $50

Up to 365 days per lifetime $400 $600

Up to 30 days per accident $600 $800

Once per accident $300 $400

Once per accident Up to $450 Up to $600

Once per accident $200 $250

Once per year for each covered person $50 $50

Once per accident $1,500 $2,000

Initial Physician Office Visit Once per accident $100 $150

Lodging

Medical Appliance

Physical Therapy

Rehabilitation Facility

Transportation

Urgent Care

X ray

Up to 30 nights per lifetime $150 $175

Once per accident $200 $300

Up to 10 visits each per accident $75 $100

Up to 15 days per lifetime $300 $450

Up to 3 trips per accident $600 $800

Once per accident $150 $200

Once per accident $150 $200

Accident Insurance

The Hartford

SPECIFIED INJURY & SURGERY

Abdominal/Thoracic Surgery

Arthroscopic Surgery

BENEFITS

LOW PLAN HIGH PLAN

Once per accident $3,000 $4,000

Once per accident $500 $750

Burn Once per accident Up to $15,000 Up to $20,000

Burn Skin Graft

Once per accident for third degree burn(s) 50% of burn benefit

Concussion Up to 3 per year $200 $250

Dislocation

Eye Injury

Fracture

Once per joint per lifetime Up to $8,000 Up to $12,000

Once per accident Up to $750 Up to $1,000

Once per bone per accident Up to $10,000 Up to $12,000

Hernia Repair Once per accident $400 $600

Joint Replacement Once per accident $4,000 $6,000

Knee Cartilage

Laceration

Once per accident Up to $2,000 Up to $3,000

Once per accident Up to $1,000 Up to $1,500

Ruptured Disc Once per accident $2,000 $3,000

Tendon/Ligament/Rotator Cuff Once per accident

CATASTROPHIC

Accidental Death

Up to $2,000 Up to $3,000

LOW PLAN HIGH PLAN

Within 90 days; Spouse @ 50% and child @ 25% $75,000 $100,000

Common Carrier Death Within 90 days 2 times death benefit

Coma

Dismemberment

Home Health Care

Paralysis

Prosthesis

FEATURES

Once per accident $15,000 $20,000

Once per accident Up to $75,000 Up to $100,000

Up to 30 days per accident $75 $100

Once per accident Up to $75,000 Up to $100,000

Once per accident

Up to $3,000 Up to $4,000

LOW PLAN HIGH PLAN

Ability Assist® EAP 24/7/365 access to help for financial, legal or emotional issues Included Included

HealthChampionSM Administrative & clinical support following serious illness or injury Included Included

ABOUT CRITICAL ILLNESS

Life and AD&D Lincoln Financial Group

ABOUT LIFE AND AD&D

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.

For full plan details, please visit your benefit website: www.mybenefitshub.com/annaisd

Voluntary Life Benefits At A Glance

Employee

Guaranteed coverage amount during initial offering or approved special enrollment period

Newly hired employee guaranteed coverage amount

$250,000

$250,000

Continuing employee guaranteed coverage annual increase amount Choice of $10,000 or $40,000

Maximum coverage amount 5 times your annual salary ($500,000 maximum in increments of $10,000)

Minimum coverage amount $10,000

Spouse

Guaranteed coverage amount during initial offering or approved special enrollment period

Newly hired employee guaranteed coverage amount

Continuing employee guaranteed coverage annual increase amount

$30,000

$30,000

Choice of $5,000 or $10,000

Maximum coverage amount 150% of the employee coverage amount ($100,000 maximum in increments of $5,000)

Minimum coverage amount

Dependent Children

Day 1 months to age 26

guaranteed coverage amount

What your benefits cover

Employee Coverage

Guaranteed Life Insurance Coverage Amount

$5,000

$10,000

BENEFITS

• Initial Open Enrollment: When you are first offered this coverage, you can choose a coverage amount up to $250,000 without providing evidence of insurability.

• Annual Limited Enrollment: If you are a continuing employee, you can increase your coverage amount by $10,000 or

• $20,000 without providing evidence of insurability . If you submitted evidence of insurability in the past and were declined for medical reasons, you may be required to submit evidence of insurability.

• If you decline this coverage now and wish to enroll later, evidence of insurability may be required and may be at your own expense.

• You can increase this amount by up to $20,000 during the next limited open enrollment period.

Maximum Life Insurance Coverage Amount

• You can choose a coverage amount up to 5 times your annual salary ($500,000 maximum) with evidence of insurability. See the Evidence of Insurability page for details.

• Your coverage amount will reduce by 50% when you reach age 70

Spouse Coverage

You can secure term life insurance for your spouse if you select coverage for yourself.

Guaranteed Life Insurance Coverage Amount

• Initial Open Enrollment: When you are first offered this coverage, you can choose a coverage amount up to 50% of your coverage amount ($30,000 maximum) for your spouse without providing evidence of insurability.

• Annual Limited Enrollment: If you are a continuing employee, you can increase the coverage amount for your spouse by

• $5,000 or $10,000 without providing evidence of insurability. If you submitted evidence of insurability in the past and were declined for medical reasons, you may be required to submit evidence of insurability.

• If you decline this coverage now and wish to enroll later, evidence of insurability may be required and may be at your own expense.

• You can increase this amount by up to $10,000 during the next limited open enrollment period.

Maximum Life Insurance Coverage Amount

• You can choose a coverage amount up to 50% of your coverage amount ($250,000 maximum) for your spouse with evi-

dence of insurability.

• Coverage amounts are reduced by 50% when an employee reaches age 70.

Dependent Children Coverage

You can secure term life insurance for your dependent children when you choose coverage for yourself to age 26

• Guaranteed Life Insurance Coverage Options: $10,000.

Voluntary AD&D Benefits At A Glance

• Provides a cash benefit to your loved ones if you die in an accident

• Provides a cash benefit to you if you suffer a covered loss in an accident

• Features group rates for Anna Independent School District employees

• Includes LifeKeys® services, which provide access to counseling, financial, and legal support

• Also includes TravelConnectSM services, which give you and your family access to emergency medical assistance when you’re on a trip 100+ miles from home

Employee

• Maximum coverage amount: 5 times your annual salary ($500,000 maximum) in $10,000 increments

• Minimum coverage amount: $10,000

• Your employee AD&D coverage amount will reduce by 50% when you reach age 70. Benefits end when you retire.

Spouse

• You can secure AD&D insurance for your spouse if you select coverage for yourself.

• Maximum coverage amount: 50% of the employee coverage amount ($250,000 maximum) in $5,000 increments

• Minimum coverage amount: $5,000

• The spouse AD&D coverage amount will reduce by 50% when you reach age 70. Benefits end when you retire.

Dependent Children

• You can secure AD&D insurance for your dependent children when you choose coverage for yourself.

• 6 months to age 26 Maximum coverage amount: Up to $100,000 in $1,000 increments

• Minimum coverage amount: $1,000

• Age 1 Day to 6 months Maximum coverage amount: $1,000.

This is a summary of limited benefits and complete details can be found at www.mybenefitshub.com/annaisd under the AD&D section of the portal.

Individual Life Insurance Texas Life EMPLOYEE BENEFITS

ABOUT INDIVIDUAL LIFE

Individual insurance is a policy that covers a single person and is intended to meet the financial needs of the beneficiary, in the event of the insured’s death. This coverage is portable and can continue after you leave employment or retire.

For full plan details, please visit your benefit website: www.mybenefitshub.com/annaisd

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 cost more and decline in death benefit. The policy, purelife plus, is underwritten by Texas Life Insurance Company, and it has the following features:

• High Death Benefit. With one of the highest death benefits available at the worksite, purelife plus gives your loved ones peace of mind.

• Minimal Cash Value. Designed to provide a high death benefit at a reasonable premium, purelife plus provides peace of mind for you and your beneficiaries while freeing investment dollars to be directed toward such tax favored retirement plans as 403(b), 457 and 401(k).

• 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.

• 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, children and grandchildren by answering just 3 questions:

During the last six months, has the proposed insured:

a. Been actively at work on a full time basis, performing usual duties?

b. Been absent from work due to illness or medical treatment for a period of more than five consecutive working days?

c. Been disabled or received tests, treatment or care of any kind in a hospital or nursing home or received chemotherapy, hormonal therapy for cancer, radiation therapy, dialysis treatment, or treatment for alcohol or drug abuse?

This policy must be set up on bank draft and is not available for payroll deduction effective 9/1/2022.

See complete details regarding policy plan information and rates under the Individual Life Section of the employee portal, www.mybenefitshub.com/annaisd

Identity Theft iLOCK360

ABOUT IDENTITY THEFT PROTECTION

Identity theft protection monitors and alerts you to identity threats. Resolution services are included should your identity ever be compromised while you are covered.

For full plan details, please visit your benefit website: www.mybenefitshub.com/annaisd

Plus Plan Covers:

Social Security number trace, Change of address, Sex offender alerts, Payday loans, Court/criminal records, Full service restoration and lost wallet protection up to $1M insurance, Daily Monitoring of TransUnion Credit Bureau

Premium Plan Covers All of the Above and In Addition:

Daily monitoring of TransUnion credit bureau, Daily monitoring of Experian credit bureau, Daily monitoring of Equifax credit bureau, ScoreTracker

CyberAlertTM Internet Surveillance

Get peace of mind knowing that our exclusive technology scours websites, chat rooms and bulletin boards 24/7/365 to identify trading or selling of your personal information online.

CyberAgent monitors:

• one Social Security number

• two email addresses

• two phone numbers

• one driver’s license

• two medical ID numbers

• five credit/debit cards

• five bank accounts

• one passport

$1 Million of Identity Theft Insurance

For even more peace of mind, you are insured with a one million dollar insurance policy against expenses in the event that your identity is compromised.

Lost Wallet Protection

If you lose your wallet, iLOCK360 agents will make all the calls necessary to replace missing cards and IDs: quick, easy, and less stress for you.

Full Service Identity Restoration

Contact an iLOCK360 Certified Identity Theft Restoration

BENEFITS

Management Specialist, who’ll work on your behalf to restore your ID, and let you get on with your life.

Change of Address

Prevent criminals from accessing your bank statements, credit card statements, and other identifying information by monitoring any changes to your address.

Sex Offender Reports

Understand if and when any sex offenders reside or move into your zip code and ensure that your identity isn’t being used fraudulently in the sex offender registry.

Court Records

Know if and when your name, date of birth and Social Security number appear in court records for an offense or crime that you did not commit.

Credit Report Monitoring

Find out your credit score, analyze your credit report, and monitor your identity for credit related activity.

Social Security Number Trace

Know if your Social Security number becomes associated with another individual’s name or address.

Non Credit Loans

See if your personal information becomes linked to payday loans that do not require hard credit inquiries.

ScoreTrackerTM

Receive a month after month report that provides relevant information with trends and credit score insight.

Flexible Spending Account (FSA) NBS

ABOUT FSA

A Flexible Spending Account allows you to pay for eligible healthcare expenses with a pre loaded debit card. You choose the amount to set aside from your paycheck every plan year, based on your employer’s annual plan limit. This money is use it or lose it within the plan year (unless your plan contains a $500 rollover or grace period provision).

For full plan details, please visit your benefit website: www.mybenefitshub.com/annaisd

Health Care FSA

The Health Care FSA covers qualified medical, dental and vision expenses for you or your eligible dependents. You may contribute up to $2,850 annually to a Health Care FSA and you are entitled to the full election from day one of your plan year. Eligible expenses include:

• Dental and vision expenses

• Medical deductibles and coinsurance

• Prescription copays

• Hearing aids and batteries

You may not contribute to a Health Care FSA if you enrolled in a High Deductible Health Plan (HDHP) and contribute to a Health Savings Account (HSA).

How the Health Care FSAs Work

You can access the funds in your Health Care FSA two different ways:

• Use your NBS Debit Card to pay for qualified expenses, doctor visits and prescription copays.

• Pay out of pocket and submit your receipts for reimbursement:

 Fax 844 438 1496

 Email service@nbsbenefits.com

 Online my.nbsbenefits.com

 Call for Account Balance: 855 399 3035

 Mail: PO Box 6980 West Jordan, UT 84084

Contact NBS

• Hours of Operation: 6:00 AM 6:00 PM MST, Mon Fri

• Phone: (800) 274 0503

• Email: service@nbsbenefits.com

• Mail: PO Box 6980 West Jordan, UT 84084

Dependent Care FSA

The Dependent Care FSA helps pay for expenses associated with caring for elder or child dependents so you or your spouse can

BENEFITS

work or attend school full time. You can use the account to pay for day care or baby sitter expenses for your children under age 13 and qualifying older dependents, such as dependent parents. Reimbursement from your Dependent Care FSA is limited to the total amount deposited in your account at that time. To be eligible, you must be a single parent or you and your spouse must be employed outside the home, disabled or a full time student.

Dependent Care FSA Guidelines

• Overnight camps are not eligible for reimbursement (only day camps can be considered).

• If your child turns 13 midyear, you may only request reimbursement for the part of the year when the child is under age 13.

• You may request reimbursement for care of a spouse or dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self care.

• The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.

Important FSA Rules

• The maximum per plan year you can contribute to a Health Care FSA is $2,850.00. The maximum per plan year you can contribute to a Dependent Care FSA is $5,000 when filing jointly or head of household and $2,500 when married filing separately.

• You cannot change your election during the year unless you experience a Qualifying Life Event.

• Your Health Care FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care expenses.

• The IRS has amended the “use it or lose it rule” to allow you to carry over up to $570 in your Health Care FSA into the next plan year. The carry over rule does not apply to your Dependent Care FSA.

Enrollment Guide General Disclaimer: This summary of benefits for employees is meant only as a brief description of some of the programs for which employees may be eligible. This summary does not include specific plan details. You must refer to the specific plan documentation for specific plan details such as coverage expenses, limitations, exclusions, and other plan terms, which can be found at the Anna ISD Benefits Website. This summary does not replace or amend the underlying plan documentation. In the event of a discrepancy between this summary and the plan documentation the plan documentation governs. All plans and benefits described in this summary may be discontinued, increased, decreased, or altered at any time with or without notice.

Rate Sheet General Disclaimer: The rate information provided in this guide is subject to change at any time by your employer and/or the plan provider. The rate information included herein, does not guarantee coverage or change or otherwise interpret the terms of the specific plan documentation, available at the Anna ISD Benefits Website, which may include additional exclusions and limitations and may require an application for coverage to determine eligibility for the health benefit plan. To the extent the information provided in this summary is inconsistent with the specific plan documentation, the provisions of the specific plan documentation will govern in all cases.