2022-23 CBEBC Benefit Guide (TRS)

CBEBC BENEFIT GUIDE EFFECTIVE: 09/01/2022 8/31/2023 WWW.CBEBC.COM 2022 - 2023 PlanYear 1

Table of Contents FLIP TO... HOW TO ENROLLPG. 4 SUMMARYPAGESPG. 6 BENEFITSYOURPG. 12 How to Enroll 4-5 Annual Benefit Enrollment 6 11 1. Benefit Updates 6 2. Section 125 Cafeteria Plan Guidelines 7 3. Annual Enrollment 8 4. Eligibility Requirements 9 5. Helpful Definitions 10 6. Health Savings Account (HSA) vs. Flexible Spending Account (FSA) 11 Medical: Region 1 12-18 Medical: Region 2 20 25 Medical: Region 3 26-31 Medical: Region 4 32 38 Health Savings Account (HSA) 40-41 Hospital Indemnity 42 Telehealth 43 Dental 44 Vision 45 46 Disability 47-48 Cancer 49-50 Accident 51 Universal Life 52 Voluntary Life and AD&D 53 Critical Illness 54 Identity Theft 55 Emergency Medical Transportation 56 Flexible Spending Account (FSA) 57-58 FBS Benefits App Group # Index 59 2

CBEBC BENEFITS MEDICAL TRS ACTIVECARE MEDICAL TRS HMO Financial Benefit Services (469) 385 www.cbebc.com4685 (866)BCBSTX355 www.bcbstx.com/trsactivecare5999 Scott & White HMO (844) 633 BCBSTX:www.trs.swhp.org5325BlueEssentials HMO (888) 378 https://www.bcbstx.com/trshmo1633 HEALTH SAVINGS ACCOUNT (HSA) HOSPITAL INDEMNITY (817)EECU 882 www.eecu.org0800 GroupAflac #24444 (800) 992 3522 www.aflacgroupinsurance.com TELEHEALTH DENTAL VISION MD (888)Live365 www.consultmdlive.com1663 Lincoln Financial Group (800) 423 https://www.lfg.com2765 GroupUnum #440116 (866) 679 www.unum.com3054 DISABILITY CANCER ACCIDENT GroupCigna #SLH100006 (800) 244 www.cigna.com6224 American Public Life Group #127 (800) 256 www.ampublic.com8606 American Public Life Group #127 (800) 256 www.ampublic.com8606 UNIVERSAL LIFE VOLUNTARY LIFE AND AD&D CRITICAL ILLNESS Texas Republic Life (572) www.texasrepubliclife.com330.0099 BASIC:Unum Group #657216 VOLUNTARY: Group #292000 (866) 679 www.unum.com3054 GroupAflac #69456 8 (800) 992 www.aflacgroupinsurance.com3522 IDENTITY THEFT EMERGENCY MEDICAL TRANSPORT FLEXIBLE SPENDING ACCOUNTS (FSA) (800)GroupIDWatchdog#10157743772 www.IDWatchdog.com GroupMASA #MCKBEBC (800) 423 www.masamts.com3226 National Benefit Services (800) 274 www.nbsbenefits.com0503 Benefit Contact Information 3

Employee benefits made easy through the FBS Benefits App! AllYour BenefitsOne App OR SCAN Text “FBS CBEBC” to (800) 583-6908 App Group #: Go to PAGE 59 to find your district’s group # Text “FBS CBEBC” to (800) 583-6908 and get access to everything you need to complete your benefits enrollment: • Benefit Resources • Online Enrollment • Interactive Tools • And more! 4

1 www.cbebc.com How to Log In 2 CLICK LOGIN 3 ENTER USERNAME & PASSWORD Login Credentials vary by district. Please review the instructions on the login page for your district, as your instructions may have changed. 5

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Benefit Updates What’s New: Don’t Forget! • Login and complete your benefit enrollment from 07/05/2022 08/18/2022 • 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. SUMMARY PAGESAnnual Benefit Enrollment • NEW DENTAL CARRIER AND RATES LINCOLN FINANCIAL GROUP • NEW INDIVIDUAL LIFE CARRIER TEXAS REPUBLIC LIFE • CANCER PLAN TIER CHANGE • VOLUNTARY LIFE BENEFIT WITH UNUM ENHANCEMENTS • DentalDENTALinsurance

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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.

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is a coverage that helps defray the costs of dental care. It insures against the expense of routine care, dental treatment and disease. With a Life Time Maximum on is $1,000 for dependent children under age 19. Two Plan Options PPO (any dentist). Benefits are based on Calendar Year from 01/01 to 12/31. Low Plan $1,000 Annual Maximum; High Plan $2,000 Annual Maximum. Up to 3 cleanings per year. Deductible waived for Preventive Care. 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. CancerCANCERinsurance

Orthodontia

SUMMARY PAGESAnnual

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.

A change in marital status includes marriage, death of a spouse, divorce or annulment (legal separation is not recognized in all states).

EligibilityDependents'ofStatus

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.

Marital Status

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Section 125 Cafeteria Plan Guidelines Benefit Enrollment

CHANGES IN (CIS):STATUS QUALIFYING EVENTS

Change in Number of Tax Dependents

Eligibility for Government Programs Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change. 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.

Change in Status 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

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.

Gain/Loss

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.

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.

Q&A Who do I contact with Questions?

• 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.

All new hire enrollment elections must be completed in the online enrollment system within the first 30 days of benefit eligibility employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.

For supplemental benefit questions, you can contact your Benefits/HR 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.cbebc.com. 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?

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.

New Hire Enrollment

SUMMARY PAGESAnnual Benefit Enrollment 8

Annual Enrollment

For benefit summaries and claim forms, go to the CBEBC benefit website: www.cbebc.com. 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?

Dependent RequirementsEligibility 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. Benefit

Employee RequirementsEligibility

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 FSA/HSAeligibility.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 Potentialguidance.Dependent

AGE Accident To Age 26 Cancer To Age 26 Critical Illness To Age 26 Dental To Age 26 Identity Theft To Age 25 Individual Life To Age 26 IndemnityHospital To Age 26 Telehealth To Age 26 Vision To Age 26 Voluntary Life and AD&D To Age 26

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

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 Disclaimer:eligibility. 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/Benefit Administrator to request a continuation of coverage. MAXIMUM

PLAN

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.

SUMMARY PAGESAnnual

Enrollment 9

Actively at Work

January 1st through December 31st Co-insurance

September 1st through August 31st

Annual Enrollment

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.

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.

The most an eligible or insured person can pay in co insurance for covered expenses.

In Network

Calendar Year

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.

Pre Existing Conditions

Guaranteed Coverage

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

SUMMARY PAGESHelpful Definitions 10

Plan Year

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 (including diagnostic and/or consultation services).

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.

FLIP TO FOR HSA INFORMATION PG. 40 FLIP TO FOR FSA INFORMATION PG. 57 Health Savings Account (HSA) (IRC Sec. 223) Flexible Spending Account (FSA) (IRC Sec. 125) 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. Employer Eligibility A qualified high deductible health plan. All employers Contribution Source Employee and/or employer Employee and/or employer Account Owner Individual Employer Underlying RequirementInsurance High deductible health plan None Minimum Deductible $1,400 single (2022) $2,800 family (2022) N/A Maximum Contribution $3,650 single (2022) $7,300 family (2022) $2,850 (2022) Permissible Use Of Funds 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). Cash Outs of Unused Amounts (if no medical expenses) Permitted, but subject to current tax rate plus 20% penalty (penalty waived after age 65). Not permitted Year to year rollover of account balance? Yes, will roll over to use for subsequent year’s health coverage. No. Access to some funds 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 SUMMARY PAGESHSA vs. FSA 11

TRS ActiveCare HD Employee Only $341.00 Employee & Spouse $958.00 Employee & Child(ren) $611.00 Employee & Family $1,146.00 TRS ActiveCare 2 Employee Only $1,013.00 Employee & Spouse $2,402.00 Employee & Child(ren) $1,507.00 Employee & Family $2,841.00 TRS ActiveCare Primary Employee Only $331.00 Employee & Spouse $932.00 Employee & Child(ren) $594.00 Employee & Family $1,115.00 TRS ActiveCare Primary+ Employee Only $415.00 Employee & Spouse $1,014.00 Employee & Child(ren) $668.00 Employee & Family $1,275.00 Blue Essentials South Texas HMO Employee Only $614.64 Employee & Spouse $1,484.16 Employee & Child(ren) $961.22 Employee & Family $1,579.76 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.cbebc.com Medical Insurance TRS - Region 1 EMPLOYEE BENEFITS The below rates apply to the following districts: La Villa ISD Lyford CISD HorizonWebbMontessoriCISD San Perlita ISD 12

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TRS ActiveCare HD Employee Only $414.00 Employee & Spouse $1,163.00 Employee & Child(ren) $742.00 Employee & Family $1,391.00 TRS ActiveCare 2 Employee Only $1,013.00 Employee & Spouse $2,402.00 Employee & Child(ren) $1,507.00 Employee & Family $2,841.00 TRS ActiveCare Primary Employee Only $401.00 Employee & Spouse $1,130.00 Employee & Child(ren) $721.00 Employee & Family $1,353.00 TRS ActiveCare Primary+ Employee Only $504.00 Employee & Spouse $1,231.00 Employee & Child(ren) $810.00 Employee & Family $1,548.00 Medical Insurance TRS - Region 2 EMPLOYEE BENEFITS The below rates apply to the following districts: Agua Dulce ISD Banquete ISD Beeville ISD Ben Bolt Palito Blanco ISD Benavides ISD Dr. M L Garza Gonzalez ISD Skidmore-Tynan ISD St Mary’s Academy Charter Driscoll ISD Odem Edroy ISD Orange Grove ISD Port Aransas ISD Ramirez ISD Ricardo ISD Riviera ISD Santa Gertrudis ISD Sinton ISD 20

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TRS ActiveCare HD Employee Only $427.00 Employee & Spouse $1,202.00 Employee & Child(ren) $766.00 Employee & Family $1,437.00 TRS ActiveCare 2 Employee Only $1,013.00 Employee & Spouse $2,402.00 Employee & Child(ren) $1,507.00 Employee & Family $2,841.00 TRS ActiveCare Primary Employee Only $417.00 Employee & Spouse $1,176.00 Employee & Child(ren) $750.00 Employee & Family $1,405.00 TRS ActiveCare Primary+ Employee Only $524.00 Employee & Spouse $1,280.00 Employee & Child(ren) $843.00 Employee & Family $1,610.00 Medical Insurance TRS - Region 3 EMPLOYEE BENEFITS The below rates apply to the following districts: Bloomington ISD Cuero HallettsvilleISDISDKenedyISD Louise MeyersvilleISDISDRefugioISD 26

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$496.00 Employee

Employee

$848.31 Employee & Family $1,525.20 Medical Insurance TRS - Region 4 EMPLOYEE BENEFITS The below rates apply to the following districts: Odyssey Academy 32

TRS

$395.00 Employee

Employee

Spouse $1,145.00

Employee

Employee

TRS ActiveCare Primary Employee

TRS ActiveCare HD Employee Only $407.00

Family $1,332.00 TRS ActiveCare Primary+ Employee

Spouse $1,113.00 Employee

2 Employee

Employee

Family $1,523.00 Blue Essentials South Texas HMO Employee Only $527.81 Employee & Spouse $1,325.22 Employee

$709.00 Employee

Employee & Child(ren) $1,507.00 & Family $2,841.00 Only & & Child(ren) & Only & Spouse $1,212.00 & Child(ren) $798.00 & & Child(ren)

Employee & Child(ren) $731.00 & Family $1,370.00 ActiveCare Only $1,013.00 & Spouse $2,402.00

Employee &

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Notes 39

• Family (filing jointly) $7,300

• Not enrolled in a Health Care Flexible Spending Account, nor should your spouse be contributing towards a Health Care Flexible Spending Account

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.

HSA

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

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.

ABOUT

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

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

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Health Savings Account (HSA)

You decide whether to use the money in your account to pay for qualified expenses or let it grow for future use. 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.

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:

EECU EMPLOYEE BENEFITS

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.

• Not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan

• Not receiving Veterans Administration benefits

Maximum Contributions

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.cbebc.com

HSA Eligibility

• Individual $3,650

• Not enrolled in Medicare or TRICARE

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 under your HDHP.

• 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.

(HSA) EECU 41

• 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. 1:00 p.m. CT and closed on Sunday.

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

• 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 and company contributions. How to Use your HSA

If you meet the eligibility requirements, you may open an HSA administered by EECU. You will receive a debit card to manage your HSA account reimbursements. Keep in mind, available funds are limited to the balance in your HSA.

Opening an HSA

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

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

BENEFITS

Important HSA Information

EMPLOYEEHealth Savings Account

Hospital Indemnity EMPLOYEE BENEFITS

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.

How it Amountworkspayable was generated based on benefit amounts for: Hospital Admission ($2,000), and Hospital Confinement ($200 per day). Hospital IndemnityHigh Low Employee Only $32.42 $17.44 Employee and Spouse $65.48 $33.09 Employee and Child(ren) $51.04 $26.78 Employee and Family $84.10 $42.42

HOSPITAL CONFINEMENT per day (maximum of 31 days per confinement for each covered sickness or accident for each insured)

The Aflac Group Hospital Indemnity plan benefits include the following: HIGH LOW

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.

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.

Aflac

Payable when an insured is admitted to a hospital and confined as an in patient because of a covered accidental injury or covered sickness. We will not pay benefits for confinement to an observation unit, or for emergency room treatment or outpatient treatment. $2,000 $1,000

That’s how the Aflac Group Hospital Indemnity plan can help.

ABOUT HOSPITAL INDEMNITY

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 confined 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. $200 $100

For full plan details, please visit your benefit website: www.cbebc.com

NOTE: In order to receive benefits for accidental injuries due to a covered accident, an insured must be admitted within six months of the date of the covered accident (in Washington, twelve months).

It provides financial assistance to enhance your current coverage.

HOSPITAL ADMISSION BENEFIT per confinement (once per covered sickness or accident per calendar year for each insured)

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HEALTH SCREENING BENEFIT

The Health Screening Benefit is payable once per calendar year for health screening tests performed as the result of preventive care, including tests and diagnostic procedures ordered in connection with routine examinations. This benefit is payable for each insured. Check your benefit website for a full list of covered tests. $50 calendarperyear

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.cbebc.com Telehealth MDLive EMPLOYEE BENEFITS Alongside your medical coverage is access to quality telehealth services through MDLIVE. Connect anytime day or night with a board certified doctor via your mobile device or computer. While MDLIVE does not replace your primary care physician, it is a convenient and cost effective option when you need care and: • Have a non emergency issue and are considering a convenience care clinic, urgent care clinic or emergency room for treatment • Are on a business trip, vacation or away from home • Are unable to see your primary care physician When to Use MDLIVE: At a cost that is the same or less than a visit to your physician, use telehealth services for minor conditions such as: • Sore throat • Headache • Stomach ache • Cold • Flu • Allergies • Fever • Urinary tract infections Do not use telemedicine for serious or life threatening emergencies. Registration is Easy Register with MDLIVE so you are ready to use this valuable service when and where you need it. • Online www.mdlive.com/fbsbh • Phone 888 365 1663 • Mobile download the MDLIVE mobile app to your smartphone or mobile device • Select “MDLIVE as a benefit” and “FBS” as your Employer/Organization when registering your account. Telehealth Employee $8.00 Employee + Family $16.00 Check with your district to see if your employer offers this benefit at no cost to you and your family. 43

ABOUT DENTAL Dental insurance is a coverage that helps defray the costs of dental care. It insures against the expense of routine care, dental treatment and Fordisease.fullplan details, please visit your benefit website: www.cbebc.com Dental Insurance Lincoln Financial Group EMPLOYEE BENEFITS Benefit Highlights High Plan Low Plan Contracting Dentists Non Contracting Dentists Contracting Dentists Non Contracting Dentists Calendar Deductible(Annual) Individual: $50 Family: Waived$150forPreventive Individual: $50 Family: Waived$150forPreventive Individual: $50 Family: Waived$150forPreventive Individual: $50 Family: Waived$150forPreventive Deductibles are combined for basic and major Contracting Dentists’ services. Deductibles are combined for basic and major Non Contracting Dentists’ services. Annual Maximum $2,000 $2,000 $1,000 $1,000 Annual Maximums are combined for preventive, basic, and major services Lifetime Orthodontic Max $1,000 $1,000 $1,000 $1,000 Orthodontic Coverage is available for dependent children to age 19. Waiting Period There are no benefit waiting periods for any service types You can also go to www.lfg.com and register/login to access your account and Downloand the Lincoln Dental Mobile App. • Find a network dentist near you in minutes • Have an ID card on your phone • Customize the app to get details of your plan • Find out how much your plan covers for checkups and other services • Keep track of your claims You can request your dental ID card by contacting Lincoln Financial Dental directly at 800 423 2765. Plans Effective 09/01/2022: • Plan cover many preventive, basic, and major dental care services. (See Below) • Both plans allow you to choose any dentist you wish, though you can lower your out of pocket costs by selecting a contracting dentist. • Does not make you and your dependents wait six months between routine cleanings. • More information available to you at www.lfg.com Dental High Plan Low Plan Employee Only $33.20 $17.96 Employee and Spouse $63.86 $35.90 Employee and Child(ren) $65.61 $39.43 Employee and Family $92.53 $57.38 44

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ABOUT VISION Vision insurance provides coverage for routine eye examinations and can help with covering some of the costs for eyeglass frames, lenses or contact lenses. For full plan details, please visit your benefit website: www.cbebc.com Vision Insurance Unum EMPLOYEE BENEFITS Plan features: Our network offers members access to convenient, quality care with more than 40,000 vision access points1, including independent optometrists and retail stores like Walmart, Sam’s Club, JCPenney, Sear’s Optical, America’s Best and many more! • Find an in network provider at unumvisioncare.com • Manage benefits online with AlwaysAssist.com and on the go with the AlwaysAssist mobile app. Covered benefits: Exam: Each member is entitled to a comprehensive vision exam. An exam co pay applies and is outlined in the grid below. Materials: Each member may purchase eyewear in the form of an eyeglass frame and lenses, or contact lenses. Purchases are subject to benefit frequencies and co pays. Plan features include:

• Contact lens benefit: Members electing contact lenses instead of glasses may apply the contact lens allowance to any lenses in the provider’s collection. If the cost is greater than the plan’s benefits, you are responsible for the difference.

Premium

Single ProgressiveLenticularTrifocalBifocalVision Progressive Ultra Progressive Lens Lenses children to age

locations.

Laser vision correction: Discounts are available with participating surgery providers across the country (not an insured benefit)

• Frame benefit: You may choose any frame within a provider’s collection, subject to the retail frame allowance listed below. If the cost is greater than the plan’s benefits, you are responsible for the difference.

ScratchOptions:resistant coating Polycarbonate

for

Standard Plastic Lenses: (1 per 12 month)

months) Members

available

Contact Lenses3:

Vision Care Services All Participating Providers Out of Network Exam (1 per 12 month) $10 Co pay Up to $42 Materials $25 Co pay See Below

months) (Includes fit4, follow up and materials) MedicallyElective Necessary Standard contact lens fitting Exam Fee* Specialty contact lens fitting Exam Fee** $0 Co pay Up to $130 $50$25CoveredallowanceCopayallowance Up to $100 Up to $210 Not Covered Not Covered Monthly Premiums Employee Only $6.51 Employee and Spouse $12.92 Employee and Child(ren) $12.65 Employee and Family $19.27 45

Frames:

only Covered

providers)

Covered by Co pay Covered by Co pay Covered by Co pay Covered by Co pay Covered by Co pay Covered by Co pay + additional $60 Co pay $110 allowance (20% discount on overages at VA and SP Covered at Wal Mart Up to $32 Up to $46 Up to $61 Up to $84 Up to $46 Up to $46 Up to N/AN/A$46 (1 per 12 choose from any frame at provider Up to $130 allowance Up to $68 retail (1 per 12

• Eyeglass lens benefit: Standard plastic (CR 39 Plastic Material) single vision, bifocal and trifocal lenses are generally covered after any applicable materials copay. Plan allowances are listed below for specialty lenses. If the cost is greater than the plan’s benefits, you are responsible for the difference.

Some providers at optical and/or retail chains, such as Walmart, may charge for a contact lens fit and evaluation separately and apart from your contact lens allowance, leaving the entire allowance for materials. Covered materials that are lost or broken will be replaced only at normal service intervals indicated in the Plan Design; however, these materials and any items not covered below may be purchased at Preferred Pricing from a Participating Provider. In addition, benefits are payable only for expenses incurred while the Group and individual Member coverage is in force. This plan will not cover:

• Safety eyewear;

This is a primary vision care benefit and is intended to cover only eye examinations and corrective eyewear. Medical or surgical treatment of eye disease or injury is not provided under this plan. Coverage may not exceed the lesser of actual cost of covered services and materials or the limits of the policy.

• Orthoptics or vision training and any supplemental testing; Plano (non prescription) lenses; or two pair of eyeglasses in lieu of bifocals or trifocals;

Services not listed: If you expect to require a vision service not included on this brochure, it may still be covered. Please contact customer service at 888 400 9304, to confirm your exact benefits.

• Medical or surgical treatment of the eyes;

• An eye exam or corrective eye wear required by an employer as a condition of employment;

• Services rendered or materials purchased outside the U.S. or Canada, unless: the insured resides in the U.S. or Canada, and the charges are incurred while on a business or pleasure trip;

• Sub normal vision aids;

• Plain or prescription sunglasses or tinted lenses, and no line bifocals and blended lenses (subject to allowance);

EMPLOYEE BENEFITS

• Any injury or illness covered under Workers’ Compensation or similar law, or • which is work related;

• Charges in excess of Usual and Customary for services and materials; Experimental or non conventional treatments or devices;

46

Vision Insurance

• Spectacle lens styles, materials, treatments or “add ons” not shown in the Schedule of Benefits. Laser vision correction network Membership provides access to preferred pricing. Transactions are handled directly between members and providers. Refractive surgery is an elective procedure and may involve potential risks to patients. This is not an insured benefit. Unum cannot and does not guarantee the outcome of any refractive surgical procedure or a total elimination of the need for glasses or contacts. Providers may not be available in all metropolitan areas. Login to www.alwaysassist.com for a list of participating laser vision correction providers.

Unum Dependent children: Dependent age guidelines vary by state. Please refer to your policy certificate or contact customer service at 888 400 9304.

Benefit Period 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, $100 OF BENEFITS If you had an unexpected illness of injury and were unable to work, how long would you be able to pay your bills? term disability a

Disability per

in benefit Elimination Period Plan 1 0/7 $3.70 14/14 $3.14 30/30 $2.72 60/60 $2.22 90/90 $1.28 180/180 $0.92 SUMMARY

Long

ABOUT DISABILITY

portion of your salary if you’re unable to work due to a covered disability. Eligibility All active Full time Employees of the Employer who are citizens or permanent resident aliens of the United States and working a minimum of 20 hours per week in the United States. Gross Monthly Benefit1 Maximum Gross Monthly Benefit Benefit Waiting Period Maximum Benefit Period EmployeeOptions Select Monthly Benefit: Flat dollar benefit in $100 increments between $200 and $7,500 that cannot exceed 662/3% of your current monthly earnings $7,500 Select from Four Options: 180Accident/Sickness0days/7days*14days/14days*30days/30days*60days/60days90days/90daysdays/180days Please refer to the “Maximum Benefit Period” Schedules below for more details *If because of your disability, you are hospital confined an inpatient, benefits begin on the first day of inpatient confinement 47

pays

Employee's Monthly Cost of Coverage

Disability Insurance Cigna EMPLOYEE BENEFITS

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 60% 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 Whencompensation.BenefitsBegin You must be continuously Disabled for your elected benefit waiting period before benefits will be payable for a covered Disability. For any selected Benefit Waiting Period of 30 days or less, the Benefit Waiting Period will end of the date you are admitted as an inpatient in a hospital if that date is before the end of the time period Maximumspecified.

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. full plan details, please visit your benefit website: www.cbebc.com

Important Definitions and Policy Provisions:

For

Maximum Benefit Period Schedule

Exclusions: This plan does not pay benefits for a Disability which results, directly or indirectly, from any of the following:

• commission of a felony.

Prior to age 60 To age 65, but not less than 5 years

Age 60 through 64 5 years Age 65 through 69 To age 70, but not less than 1 year 70 and over 1 year

• Suicide, attempted suicide, or intentionally self inflicted injury while sane or insane.

Age

48

Pre existing Condition Limitation: 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.

EMPLOYEE BENEFITS

• 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.

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.

Effects of Other Income Benefits: This plan is structured to prevent your total benefits and post disability 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.

Age at Disability Duration of Payments (Accident and Sickness)

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.

Termination of Disability Benefits: 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.

• war or any act of war, whether or not declared.

Disability Insurance Cigna 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. 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.

Benefit Reductions, Conditions, Limitations and Exclusions:

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.

• active participation in a riot.

• an Injury or Sickness for which the Employee is entitled to benefits from Workers’ Compensation or occupational disease law.

In addition, the plan does not pay disability benefits any period of Disability during which you are incarcerated in a penal or corrections institution.

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.

• an Injury or Sickness that is work related.

ABOUT CANCER 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. For full plan details, please visit your benefit website: www.cbebc.com Cancer Insurance APL EMPLOYEE BENEFITS Limited Benefit Group Specified Disease Cancer Indemnity Insurance THE INSURANCE POLICY UNDER WHICH THIS CERTIFICATE IS ISSUED IS NOT A POLICY OF WORKERS’ COMPENSATION INSURANCE. YOU SHOULD CONSULT YOUR EMPLOYER TO DETERMINE WHETHER YOUR EMPLOYER IS A SUBSCRIBER TO THE WORKERS’ COMPENSATION SYSTEM. Summary of Benefits Low High Cancer Treatment Policy Benefits Level 1 Level 4 Radiation Therapy, Chemotherapy, Immunotherapy Maximum per 12 month period $10,000 $20,000 Hormone Therapy Maximum of 12 treatments per calendar year $50 per treatment Experimental Treatment paid in same manner and under the same maximums as any other benefit Cancer Screening Rider Benefits Level 1 Level 1 Diagnostic Testing 1 test per calendar year $50 per test $50 per test Follow Up Diagnostic Testing 1 test per calendar year $100 per test Medical Imaging per calendar year $500 per test/ 1 per calendar year $500 per test/ 1 per calendar year Surgical Rider Benefits Level 1 Level 4 Surgical $30 unit dollar amount Max $3,000 per operation $45 unit dollar amount Max $4,500 per operation Anesthesia 25% of amount paid for covered surgery Bone Marrow Transplant Maximum per lifetime $6,000 $9,000 Stem Cell Transplant Maximum per lifetime $600 $900 Prosthesis Surgical Implantation/Non Surgical (not Hair Piece) 1 device per site, per lifetime $1,000 / $100 $2,000 / $200 Patient Care Rider Benefits Level 1 Level 4 Hospital Confinement Per day of Hospital Confinement (1 30 days) Per day for Eligible Dependent Children (1 30 days) Per day of Hospital Confinement (31+ days) Per day for Eligible Dependent Children (31+ days) $200$100 $100 $200 $600$300 $600 $1,200 Outpatient Facility Per day surgery is performed $200 $600 Attending Physician Per day of Hospital Confinement $30 $50 Dread Disease Per day of Hospital Confinement (1 30 days / 31+ days) $100/$100 $300/$600 Extended Care Facility Up to the same number of Hospital Confinement Days $100 per day $300 per day 49

Cancer Insurance APL EMPLOYEE BENEFITS Cancer Low High Employee Only $17.10 $33.20 Employee and Spouse $31.20 $58.80 Employee and Child(ren) $23.60 $45.40 Employee and Family $31.20 $58.80 Patient Care Rider Benefits (cont’d) Level 1 Level 4 Donor $100 per day $300 per day Home Health Care Up to the same number of Hospital Confinement Days $100 per day $300 per day Hospice Care Up to maximum of 365 days per lifetime $100 per day $300 per day US Government, Charity Hospital or HMO Per day of Hospital Confinement (1 30 days / 31+ days) $100/$100 $300/$600 Miscellaneous Care Rider Benefits Level 1 Level 2 Cancer Treatment Center Evaluation or Consultation 1 per lifetime Not Included $750 Evaluation or Consultation Travel and Lodging 1 per lifetime Not Included $350 Second / Third Surgical Opinion per diagnosis of cancer $300 / $300 $300 / $300 Drugs and Medicine Inpatient / Outpatient (maximum $150 per month) $150 per confinement / $50 per prescription Hair Piece (Wig) 1 per lifetime $150 $150 Transportation Maximum 12 trips per calendar year for all modes of transportation combined Travel by bus, plane, or train Travel by car Lodging up to a maximum of 100 days per calendar year

$100 per day Family Transportation Maximum 12 trips per calendar year for all modes of transportation combined Travel by bus, plane or train Travel by car Family Lodging up to a maximum of 100 days per calendar year actual coach fare

per day Blood, Plasma and Platelets $300 per day Ambulance Ground/Air Maximum of 2 trips per Hospital Confinement for all modes of transportation combined $200 / $2,000 per trip Inpatient Special Nursing Services per day of Hospital Confinement $150 per day Outpatient Special Nursing Services Up to same number of Hospital Confinement days $150 per day Medical Equipment Maximum of 1 benefit per calendar year Not Included $150 Physical, Occupational, Speech, Audio Therapy & Psychotherapy / Maximum per calendar year $25 per visit / $1,000 Waiver of Premium Waive Premium Internal Cancer First Occurrence Rider Benefits Level 1 Level 1 Lump Sum Benefit Maximum 1 per Covered Person per lifetime $2,500 $2,500 Lump Sum for Eligible Dependent Children Maximum 1 per Covered Person per lifetime $3,750 $3,750 Heart Attack/Stroke First Occurrence Rider Benefits Level 1 Level 1 Lump Sum Benefit Maximum 1 per Covered Person per lifetime $2,500 Lump Sum for Eligible Dependent Children Maximum 1 per Covered Person per lifetime $3,750 Hospital Intensive Care Unit Rider Benefits Intensive Care Unit $600 per day Step Down Unit Maximum of 45 days per Confinement for any combination of Intensive Care Unit or Step Down Unit $300 per day Should you need to file a claim contact APL at 800 256 8606 or online at www.ampublic.com You can find additional claim forms and materials at www.cbebc.com 50

actual coach fare or $0.40 per mile $0.40 per mile $50 per day actual coach fare or $0.75 per mile $0.75 per mile or $0.40 per mile $0.40 per mile $50 per day actual coach fare or $0.75 per mile $0.75 per mile $100

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.cbebc.com Accident Insurance APL EMPLOYEE BENEFITS Summary of Benefits Benefit Description Level 1 1 Unit Level 2 2 Units Accidental Death per unit $5,000 $10,000 Medical Expense Accidental Injury Benefit per unit actual charges up to $500 actual charges up to $1,000 Daily Hospital Confinement Benefit $75 per day $150 per day Air and Ground Ambulance Benefit actual charges up to $1,250 actual charges up to $2,500 Accidental Dismemberment Benefit Single finger or toe Multiple fingers or toes Single hand, arm, foot or Multipleleghands, arms, feet or legs $5,000$2,500$500$500 $10,000$5,000$1,000$1,000 Accidental Loss of Sight Benefit per unit Loss of Sight in one eye Loss of Sight in both eyes $5,000$2,500 $10,000$5,000 Accident 1 Unit 2 Units Employee Only $10.80 $17.10 Employee and Spouse $19.40 $29.80 Employee and Child(ren) $21.20 $34.90 Employee and Family $29.80 $47.60 Accident insurance is designed to supplement your medical insurance coverage by covering indirect costs that can arise with a serious, or a not so serious, injury. Accident coverage is low cost protection available to you and your family without evidence of insurability. How to file a claim: Log in to ampublic.com or call 800.256.8606 51

ABOUT UNIVERSAL LIFE Universal 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.cbebc.com Universal Life Insurance Texas Republic Life EMPLOYEE BENEFITS CBEBC has a new offering! Introducing Texas Republic Life, a Texas based company, providing Universal Life Insurance built for Texas Educators. COVERAGE BENEFITS: • You can qualify for 100K Guaranteed Issue (1) and up to $150,000 of protection by answering 2 additional questions, NO MEDICAL EXAM!! • Your Spouse is Eligible for 50K and your Children for 25K. • Every Policy comes with Living Benefits. • Every Policy is Portable. • Every Policy includes Accidental Death Coverage which doubles your benefit if you are killed in an accident. • Every Policy covers you to age 121 with no reduction of benefits. (1) Guaranteed Issue for employees provided they are actively at work and answer a work status question. Don’t miss out this open enrollment period. 52

53

Group term life is the most inexpensive way to purchase life insurance.

per

Portability You may be able to keep coverage if you leave the company, retire, or change the number of hours you work. Employees or dependents who have a sickness or injury having a material effect on life expectancy at the time their group coverage ends are not eligible for portability. Group Life per $1,000 in coverage or

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.cbebc.com How does it work? You choose the amount of coverage that’s right for you, and you keep coverage for a set period of time, or “term.” If you die during that term, the money can help your family pay for basic living expenses, final arrangements, tuition and more. AD&D Insurance is also available, which pays a benefit if you survive an accident but have certain serious injuries. It pays an additional amount if you die from a covered accident. Why is this coverage so valuable?

Who can get Accidental Death & Dismemberment (AD&D) coverage?

ABOUT LIFE AND AD&D

• You: Get up to $500,000 of AD&D coverage for yourself in $10,000 increments to a maximum of 7 times your earnings.

A ‘Living’ Benefit If you are diagnosed with a terminal illness with less than 12 months to live, you can request 50% of your life insurance benefit (up to $750,000) while you are still living. This amount will be taken out of the death benefit and may be taxable. These benefit payments may adversely affect the recipient’s eligibility for Medicaid or other government benefits or entitlements and may be taxable. Recipients should consult their tax attorney or advisor before utilizing living benefit payments. Waiver of premium Your cost may be waived if you are totally disabled for a period of time.

Spouse 18 29 $0.048 30 34 $0.067 35 39 $0.076 40 44 $0.095 45 49 $0.143 50 54 $0.228 55 59 $0.371 60 64 $0.561 65 69 $1.083 70 74 $1.758 75+ $2.48

• Your spouse: Get up to $500,000 of coverage in $5,000 increments. Spouse coverage cannot exceed 100% of the coverage amount you purchase for yourself. If you previously purchased coverage for your spouse, they can increase their coverage up to $50,000, their guaranteed issue amount, with no health questions or exams, if eligible (see delayed effective date). If you previously declined spouse coverage, some health questions may be required.

• Your children: Get up to $10,000 of coverage in $2,000 increments if eligible (see delayed effective date). One policy covers all of your children until their 26th birthday. The maximum benefit for children live birth to 6 months is $100.

Voluntary Group

Voluntary Life and AD&D Unum EMPLOYEE BENEFITS

Voluntary

Age Employee

• Your spouse:50% of your AD&D coverage amount to a max of $250,000 for your Spouse, if eligible (see delayed effective date).

If you previously purchased coverage, you can increase it up to $250,000 to meet your growing needs with no health questions or exams. Who can get Term Life coverage? If you are actively at work at least 20 hours per week, you may apply for coverage for:

• You: Choose from $10,000 to $500,000 in $10,000 increments, up to 7 times your earnings. If you previously purchased coverage, you can increase it up to $250,000, your guaranteed issue amount, with no health questions. If you previously declined coverage, you may have to answer some health questions.

Child(ren) Life $10,000 in coverage rates based on Employee's age.

You have the freedom to select an amount of life insurance coverage you need to help protect the well being of your family.

• Your children: 10% of your AD&D coverage amount to a max of $50,000 for your children, if eligible (see delayed effective Whatdate).elseis included?

0 26 $1.60 Spouse

ABOUT CRITICAL ILLNESS Critical illness insurance can be used towards medical or other expenses. It provides a lump sum benefit payable directly to the insured upon diagnosis of a covered condition or event, like a heart attack or stroke. The money can also be used for non medical costs related to the illness, including transportation, child care, etc. For full plan details, please visit your benefit website: www.cbebc.com Critical Illness Insurance Aflac EMPLOYEE BENEFITS Critical Illness Employee or Spouse $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 > 29 $2.71 $3.90 $5.09 $6.28 $7.47 $8.66 30 39 $3.62 $5.71 $7.81 $9.90 $12.00 $14.09 40 49 $4.85 $8.17 $11.50 $14.82 $18.15 $21.47 50 59 $7.82 $14.11 $20.41 $26.70 $33.00 $39.29 60+ $18.92 $36.31 $53.71 $71.10 $88.50 $105.89 Overview COVERED CRITICAL ILLNESSES: CANCER (Internal or Invasive) 100% HEART ATTACK (Myocardial Infarction) 100% STROKE (Ischemic or Hemorrhagic) 100% KIDNEY FAILURE (End Stage Renal Failure) 100% BONE MARROW TRANSPLANT (Stem Cell Transplant) 100% SUDDEN CARDIAC ARREST 100% MAJOR ORGAN TRANSPLANT (25% of this benefit is payable for insureds placed on a transplant list for a major organ transplant) 100% SEVERE BURN* 100% PARALYSIS** 100% COMA** 100% LOSS OF SPEECH / SIGHT / HEARING** 100% NON INVASIVE CANCER 25% CORONARY ARTERY BYPASS SURGERY 25% INITIAL DIAGNOSIS We will pay a lump sum benefit upon initial diagnosis of a covered critical illness when such diagnoses is caused by or solely attributed to an underlying disease. Cancer diagnoses are subject to the cancer diagnosis limitation. Benefits will be based on the face amount in effect on the critical illness date of diagnosis. ADDITIONAL DIAGNOSIS We will pay benefits for each different critical illness after the first when the two dates of diagnoses are separated by at least 6 consecutive months. Cancer diagnoses are subject to the cancer diagnosis REOCCURRENCElimitation.We will pay benefits for the same critical illness after the first when the two dates of diagnoses are separated by at least 6 consecutive months. Cancer diagnoses are subject to the cancer diagnosis limitation. The Aflac Group Critical Illness plan benefits include: • Critical Illness Benefit payable for: • Cancer • Heart Attack (Myocardial Infarction) • Stroke • Kidney Failure (End Stage Renal Failure) • Major Organ Transplant • Bone Marrow Transplant (Stem Cell Transplant) • Sudden Cardiac Arrest • Coronary Artery Bypass Surgery • Non Invasive Cancer • Skin Cancer • Coma • Severe Burn • Paralysis • Loss of Sight / Hearing / Speech • Health Screening Benefit Features: • Benefits are paid directly to you, unless otherwise assigned. • Coverage is available for you, your spouse, and dependent children. • Coverage may be continued (with certain stipulations). That means you can take it with you if you change jobs or retire. For more information, call 1.800.433.3036, or visit aflacgroupinsurance.com. *This benefit is only payable for a burn due to, caused by, and attributed to, a covered accident. **These benefits are payable for loss due to a covered underlying disease or a covered accident. 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. 54

Identity Theft IDWatchdog Your identity is important it’s what makes you, you. You’ve spent a lifetime building your name and financial reputation. Let us help you better protect it. And, we’ll even go one step further and help you better protect the identities of your family.

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.cbebc.com

EMPLOYEE BENEFITS

Specialists

WHY CHOOSE ID WATCHDOG Credit Lock With our online and in app feature, lock your Equifax® credit report and your child’s Equifax credit report to help provide additional protection against unauthorized access to your credit. More for Families Our family plan helps you better protect your loved ones, with each adult getting their own account with all plan features. And, we offer more features that help protect minors than any other Dedicatedprovider.Resolution If you become a victim, you don’t have to face it alone. One of our certified resolution specialists will fully manage the case for you until your identity is restored.

ID WATCHDOG IS HERE FOR YOU ID Watchdog is everywhere you can’t be monitoring credit reports, social media, transaction records, public records and more to help you better protect your identity. And don’t worry, we’re always here for you. In fact, our U.S. based customer care team is available 24/7/365 at 866.513.1518.

EASY & AFFORDABLE IDENTITY PROTECTION With ID Watchdog®, you have an easy and affordable way to help better protect and monitor the identities of you and your family. You’ll be alerted to potentially suspicious activity and enjoy the peace of mind that comes with the support of dedicated resolution specialists. And, a customer care team that’s available any time, every day.

UNIQUE FEATURES INCLUDED IN ALL ID WATCHDOG PLANS Monitor & Detect • Dark Web Monitoring1 ✓ • High Risk Transactions Monitoring2 ✓ • Subprime Loan Monitoring2 ✓ • Public Records Monitoring ✓ • USPS Change of Address Monitoring • Identity Profile Report Manage & Alert • Child Credit Lock3 | 1 Bureau ✓ • Financial Accounts Monitoring • Social Network Alerts ✓ • Registered Sex Offender Reporting ✓ • Customizable Alert Options • Breach Alert Emails • Mobile App Support & Restore • Identity Theft Resolution Specialists (Resolution for Pre existing Conditions)✓ • 24/7/365 U.S. based Customer Care Center • Lost Wallet Vault & Assistance • Deceased Family Member Fraud Remediation • Fraud Alert & Credit Freeze Assistance ✓ Helps better protect children 1 Bureau = Equifax® 2 Multi Bureau = Equifax, TransUnion® 3 Bureau = Equifax, Experian®, TransUnion WHAT YOU NEED TO KNOW Plan Options ID WATCHDOG® 1B ID WATCHDOG® PLATINUM Credit Report(s) & VantageScore Credit Score(s) 1 Bureau Monthly 1 Bureau Daily & 3 Bureau Annually Credit Score Tracker 1 Bureau Monthly 1 Bureau Daily Credit Report Monitoring 1 Bureau Multi Bureau Credit Report Lock 1 Bureau $54.40 Identity Theft Insurance Up to $1M Up to $1M 401K/HSA Stolen Funds Reimbursement Up to $500k MONTHLY PREMIUMS Employee $7.95 $14.95 Employee and Family $11.95 $22.95 55

SupposeRepatriation/Recuperationfacilities.youorafamilymember is hospitalized more than 100 miles from your home. In that case, you have benefit coverage for air or ground medical transportation into a medical facility closer to your home for recuperation. Should you need assistance with a claim contact MASA at 800 643 9023. You can find full benefit details at: www.cbebc.com 56

In the event of a serious medical emergency, Members have access to emergency air transportation into a medical facility or between medical facilities.

Emergent Ground Transportation

A MASA MTS Membership provides the ultimate peace of mind at an affordable rate for emergency ground and air transportation service within the United States and Canada, regardless of whether the provider is in or out of a given group healthcare benefits network. If a member has a high deductible health plan that is compatible with a health savings account, benefits will become available under the MASA membership for expenses incurred for medical care (as defined under Internal Revenue Code (“IRC”) section 213 (d)) once a member satisfies the applicable statutory minimum deductible under IRC section 223(c) for high deductible health plan coverage that is compatible with a health savings account.

ABOUT MEDICAL TRANSPORT 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 can include emergency transportation via ground ambulance, air ambulance and helicopter, depending on the plan.

For full plan details, please visit your benefit website: www.cbebc.com

Non Emergency Inter Facility Transportation

Plan FeaturesEmergentMembershipPlus MembershipPlatinum Emergency TransportationAir x x Emergent TransportationGround x x Non Emergency Inter Facility Transportation x x RecuperationRepatriation/ x x Escort Transportation x Visitor Transportation x Return Transportation x Mortal TransportationRemains x Minor Return x Organ RecipientRetrieval/OrganTransportation x Vehicle Return x Pet Return x Worldwide Coverage x

In the event of a serious medical emergency, Members have access to emergency ground transportation into a medical facility or between medical facilities.

In the event that a member is in stable condition in a medical facility but requires a heightened level of care that is not available at their current medical facility, Members have access to non emergency air or ground transportation between medical

Emergent Air Transportation

Emergency Medical Transport MASA EMPLOYEE BENEFITS

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.cbebc.com Flexible Spending Account (FSA) NBS EMPLOYEE BENEFITS 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  Lost or Stolen Debit Cards Replacement Fee $5.00 (taken from account balance)  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 This account helps pay for expenses associated with caring for elder or child dependents so you or your spouse can 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. 57

$2,850 Saves on eligible expenses not covered by insurance, reduces your incometaxable Dependent Care FSA Dependent care expenses (such as day care, after school programs or elder care programs) so you and your spouse can work or attend school full time $5,000 single $2,500 if married and filing separate tax returns Reduces your taxable income

Flexible Spending Account (FSA)

The maximum per plan year you can contribute to a Health Care FSA is $2,850. 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.

Check out the FSAstore at: https://fsastore.com. It offers thousands of FSA eligible products and services to purchase using your FSA Debit Card or any major credit card. Competitive pricing and free shipping on orders over $50 can save you up to 40% using your FSA pretax dollars.

• You can continue to file claims incurred during the plan year for another 30 days (up until date).

NBS BENEFITS Important FSA Rules

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

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EMPLOYEE

• 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.

Over the Counter (OTC) Item Rule Health care reform legislation requires that certain over the counter (OTC) items require a prescription to qualify as an eligible Health Care FSA expense. You will only need to obtain a one time prescription for the current plan year. You can continue to purchase your regular prescription medications with your FSA debit card. However, the FSA debit card may not be used as payment for an OTC item, even when accompanied by a prescription. FSAstore.Com

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

Flexible Spending Accounts Account Type Eligible Expenses Annual Contribution Limits Benefit Health Care FSA Most medical, dental and vision care expenses that are not covered by your health plan (such as copayments, coinsurance, deductibles, eyeglasses and doctor prescribed over the counter medications)

District GROUP # Agua Dulce ISD CBEBCA Banquete ISD CBEBCB Beeville ISD CBEBCC Ben Bolt Palito Blanco ISD CBEBCD Benavides ISD CBEBCE Bloomington ISD CBEBCF Brooks County ISD CBEBCAJ Cuero ISD CBEBCH Dr M L Garza Gonzales Charter CBEBCI Driscoll ISD CBEBCJ Ezzell ISD CBEBCK Hallettsville ISD CBEBCL Horizon Montessori Public Schools CBEBCAM Ingleside ISD CBEBCM Kenedy ISD CBEBCN La Villa ISD CBEBCAK Louise ISD CBEBCP Lyford CISD CBEBCQ District GROUP # Meyersville ISD CBEBCR Monte Alto ISD CBEBCAL Odem Edroy ISD CBEBCS Odyssey Academy Inc. CBEBCT Orange Grove ISD CBEBCU Pettus ISD CBEBCV Port Aransas ISD CBEBCW Ramirez CSD CBEBCX Refugio ISD CBEBCY Ricardo ISD CBEBCZ Riviera ISD CBEBCAA San Perlita ISD CBEBCAC Santa Gertrudis ISD CBEBCAD Sinton ISD CBEBCAE Skidmore Tynan ISD CBEBCAF St. Marys Academy Charter School CBEBCAG Webb CISD CBEBCAH CBEBC Mobile App Login Group #’s Use your District’s group # to login to the FBS Benefits app. 59

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 CBEBC 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.

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 CBEBC 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.

WWW.CBEBC.COM 2022 - 2023 PlanYear

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