CEDAR HILL ISD BENEFIT GUIDE EFFECTIVE: 09/01/2022 8/31/2023 WWW.MYBENEFITSHUB.COM/CEDARHILLISD 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 12 15 Health Savings Account (HSA) 16-17 Hospital Indemnity 18-19 Basic Life and AD&D 20 Employee Assistance Program (EAP) 21 Telehealth 22 Behavioral Health 23 Dental 24-25 Vision 26-27 Disability 28-29 Cancer 30 Critical Illness 31-32 Voluntary Life 33 Voluntary AD&D 34 Individual Life 35-36 Emergency Medical Transport 37 Identity Theft 38 Flexible Spending Account (FSA) 39-40 2
BENEFIT ADMINISTRATORS CEDAR HILL ISD ADMINISTRATORBENEFITS MEDICAL Financial Benefit Services (469) 385 www.mybenefitshub.com/cedarhillisd4685 Kathy Shaw (972) 291 kathy.shaw@chisd.net1581 Texas Schools Health Benefits Program (TSHBP) (888) 803 0081 All Plans: https://tshbp.info/DrugPhamGroupPharmacywww.tshbp.orgBenefits:SouthernScripts#50000 HEALTH SAVINGS ACCOUNT HOSPITAL INDEMNITY LIFE AND AD&D EECU (800) 333 9934 www.eecu.org Cigna Group # HC961359 (800) 754 www.mycigna.com3207 AUL a OneAmerica Company Group #G614168 (800) 583 www.oneamerica.com6908 EMPLOYEE ASSISTANCE PROGRAM (EAP) TELEHEALTH BEHAVIORAL HEALTH ComPsych Guidance Resources Group #ONEAMERICA3 (855) 365 www.guidanceresources.com4754 (888)MDLive365 www.mdlive.com/fbs1663 Listeners on https://listeners.io/cedarhillCall DENTAL VISION DISABILITY GroupCigna #3331960 (800) 244 www.mycigna.com6224 Superior Vision Group #29283 (800) 507 www.superiorvision.com3800 The www.thehartford.com(800)GroupHartford#3953215232233 CANCER CRITICAL ILLNESS INDIVIDUAL LIFE American Public Life Group #24725 (800) 256 www.ampublic.com8606 GroupUnum #473105 (866) 679 www.unum.com3054 5Star Life Insurance Company (866) 863 https://5starlifeinsurance.com9753 EMERGENCY MEDICAL TRANSPORT IDENTITY THEFT FLEXIBLE SPENDING ACCOUNTS MASA Group #MKCHISD (800) 423 3226 claims@masaglobal.com iLock360 (800) 287 www.ilock360.com8888 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 CHISD” to (800) 583-6908 App Group #: FBSCHISD Text “FBS CHISD” 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
CLICK LOGIN
3 ENTER USERNAME & PASSWORD
5
1 www.mybenefitshub.com/cedarhillisd How to Log In 2
TheUsername:firstsix (6) characters of your last name, followed by the first letter of your first name, followed by the last four (4) digits of your Social Security Number. If you have six (6) or less characters in your last name, use your full last name, followed by the first letter of your first name, followed by the last four (4) digits of your Social Security Number. Default Password: Last Name (lowercase, excluding punctuation) followed by the last four (4) digits of your Social Security Number.
Two Directed Care Plans (HealthSmart Network)
STILL INCLUDES EMPLOYER CONTRIBUTION!
• NEW BENEFIT! Listeners On Call You can access a platform where you can be connected to a trained individual who will listen to what you have to say. These calls are completely anonymous, and you can browse listeners by gender, race, profession, topic and more and can even hear an audio message of their personal stories to find the right match. These listeners are not licensed Therapist or Clinical Psychologist. They are simply trained listeners. Listeners are available 24/7/365 you can reference. This benefit is being offered in addition to your Employee Assistance Program
• Both plans include in & out of network benefits.
• Update your information: home address, phone numbers, email, and beneficiaries.
SUMMARY PAGES
• Care Coordinators required for procedures/hospital services
MEDICAL EnhancedINSURANCETSHBPAetna Medical Plans!
• Similar to TRS Active Care
• “ High Cost” Specialty Drugs full coverage
• Hospital Indemnity Plan New Carrier is Cigna! This plan pays for in patient hospital confinement. CHISD will contribute $5.62 to either plan.
• Basic Life with AD&D CHISD offers $25,000 life insurance coverage to all full time eligible employees at no cost to you. (You must elect a beneficiary)
HOSPITAL INDEMNITY CARRIER IS BEING CHANGED TO CIGNA!
Benefit Updates - What’s New:
CHISD EMPLOYER PAID BENEFITS
• Visit www.tshbp.org to locate a provider.
Annual Benefit Enrollment
• ID Theft Plan Identity theft protection monitors and alerts you to identity threats.
ONE TIME ENROLLMENT FOR 2022 2023 BENEFITS! TRS MEDICAL WILL NO LONGER BE OFFERED AFTER 9/1/2022!
• Neither of these plans require a PCP selection or referrals.
• Signature Plan Aetna $2,000/$7,500 individual Deductible/Out of Pocket Max 25% Coinsurance, $30 Primary Care, $0 Virtual Visits
• Telehealth Provides 24/7/365 access to board certified doctors via telephone or video consultations that can diagnose, recommend treatment, and prescribe medication.
ER paid benefits are available to all full time eligible employees.
• “High Cost” Specialty Drugs limited coverage
Don’t Forget!
Two Traditional PPO Plans (Aetna Network)
• Signature HD Plan $3,000/$7,000 individual Deductible/Out of Pocket Max 30% Coinsurance, $30 Virtual Visits
• Care Coordinator is an Optional Benefit
• Login and complete your benefit enrollment from 05/16/2022 06/13/2022
• 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.
• TSHBP Copay Plan $0 Deductible, $35 in network office/specialist copay
$0 Virtual visits, Lowest up front Out of Pocket Max • TSHBP HD Plan HSA Compatible, $3,000 individual embedded Deductible Deductible, then plan pays 100%, $30 Virtual Visits
• Neither of these plans require a PCP selection, referrals.
• Visit www.aetna.com/asa to locate a provider 6
• Enrollment assistance is available by calling Financial Benefit Services at (866) 914 5202.
Note: If you had the TRS Medical Plan, you have been automatically moved to the New PPO Aetna plans which only provide in network services. See plan summaries below for complete details.
Eligibility for Government Programs
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.
Gain/Loss EligibilityDependents'ofStatus
Judgment/Decree/Order
Change in Status of Employment Affecting Coverage Eligibility
Change in employment status of the employee, or a spouse or dependent of the employee, that affects the individual's eligibility under an employer's plan includes commencement or termination of employment.
Change in Number of Tax Dependents
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 31 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.
CHANGES IN (CIS):STATUS QUALIFYING EVENTS
A change in marital status includes marriage, death of a spouse, divorce or annulment (legal separation is not recognized in all states).
Marital Status
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.
Section 125 Cafeteria Plan Guidelines SUMMARY PAGESAnnual Benefit Enrollment 7
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.
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.
• 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.
When will I receive ID cards?
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 Enrollment
• 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.
For benefit summaries and claim forms, go to the Cedar Hill ISD benefit www.mybenefitshub.com/cedarhillisdwebsite:.
Q&A Who do I contact with Questions?
Where can I find forms?
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.
• Changes, additions or drops may be made only during the annual enrollment period without a qualifying event.
Howsection.can
I find a Network Provider?
SUMMARY PAGESAnnual Benefit Enrollment 8
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.
New Hire Enrollment
For supplemental benefit questions, you can contact your Benefits/HR department or you can call Financial Benefit Services at 866 914 5202 for assistance.
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 benefit summaries and claim forms, go to your benefit website: www.mybenefitshub.com/ cedarhillisd. Click the benefit plan you need information on (i.e., Dental) and you can find the forms you need under the Benefits and Forms
Click on the benefit plan you need information on (i.e., Dental) and you can find provider search links under the Quick Links section.
SUMMARY PAGESAnnual Benefit Enrollment 9
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 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.
Employee RequirementsEligibility
Supplemental Benefits: Eligible full time employees must have a reasonable assurance of working 20 hours or more per week. Eligible full time 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.
PLAN MAXIMUM AGE Medical 26 Dental 26 Vision 26 Life 26 Cancer 25 AD&D 26 TransportMedical 26 ProtectionFamilyPlan 24 Critical Illness 26 IndemnityHospital 26 Telehealth 26 ID ProtectionTheft 18
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.
Dependent RequirementsEligibility
Please note, limits and exclusions may apply when obtaining coverage as a married couple or when obtaining coverage for dependents.
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.
The most an eligible or insured person can pay in co insurance for covered expenses.
Calendar Year
Pre Existing Conditions
The period during which existing employees are given the opportunity to enroll in or change their current elections. Annual Deductible
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.
SUMMARY PAGESHelpful Definitions 10
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).
Plan Year September 1st through August 31st
The amount you pay each plan year before the plan begins to pay covered expenses.
Actively at Work
In Network Doctors, hospitals, optometrists, dentists and other providers who have contracted with the plan as a network provider. Out of Pocket Maximum
Annual Enrollment
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.
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.
SUMMARY PAGESHSA vs. FSA 11
Employer
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
Permissible Use Of Funds
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. Eligibility A qualified high deductible health plan. All employers Contribution Source Employee and/or employer Employee and/or employer Account Owner Individual Employer
Description
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).
FLIP TO FOR HSA INFORMATION PG. 16 FLIP TO FOR FSA INFORMATION PG. 39 Health Savings Account (HSA) (IRC Sec. 223) Flexible Spending Account (FSA) (IRC Sec. 125)
Cash Outs of Unused (if no medical expenses)
High deductible health plan None
Amounts
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)
Underlying RequirementInsurance
The TSHBP Directed Care Plans utilize a national network to provide physician and ancillary services access to all members. Enrolled school districts will access the HealthSmart practitioner and ancillary only network to gain access to over 478,000 providers in over 1,222,000 unique locations across the United States, Please note, hospitals are excluded from the PPO networks. All hospital and other medical facility based services are accessed via an assigned Care Coordinator.
Aetna Network Highlights
No one likes changing doctors every year. We make it easier, so you don’t have to. Our local network teams work with doctors and hospitals to promote effective member care and better customer satisfaction. As a result, the turnover in our network is remarkably low, year after year.
PPO Deductible Credits
With the Aetna PPO plans, if you choose to utilize the services of a Care Coordinator for a procedure or admission to a facility, you will receive a $500 credit toward your deductible1. If you have already met your deductible, the $500 credit will apply to your out of pocket maximum! 1On the HDHP plan, a member must meet a minimum of $1,400 of the deductible accumulation before receiving the credit to comply with HSA requirements. Access the MyTSHBP Digital Wallet for easy access to all your benefit resources.
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Medical Insurance Texas Schools Health Benefits Program
ABOUT TSHBP
TSHBP members will experience the lowest out of pocket costs for physician and ancillary medical services when utilizing network providers. HealthSmart Network Solutions’ Physician and Ancillary Only Primary PPO contains approximately 478,000 contracted providers in over 1,222,000 unique locations across the country. It is easy to look up providers in your area by looking up providers in your area by clicking on the link below. Your searches can be saved to your computer or sent to your email. https://tshbp.info/HSNetwork
Directed Care Highlights
You want a network that is comprehensive, is easy to use and can help you save on costs. Look no further. You can now find support through our Aetna Signature Administrators® preferred provider organization network. Discover provider options and reduced costs. With our network, you now have access to over 1.2 million participating doctors, 8,700 hospitals, and strong, negotiated discounts. We know quality care is important. So we make sure our doctors successfully complete our credentialing requirements. Our credentialing process meets industry standards, as well as state and federal requirements. You’ll also have access to over 600 Institutes of Excellence™ facilities and Institutes of Quality® facilities. We measure these publicly recognized institutes by clinical performance, outcomes and efficiency. Then, we pass this guidance along to you so you can choose the best facility.
Ready to search our network? Just visit http://aetna.com/asa
EMPLOYEE BENEFITS
The TSHBP is proud to offer a variety of plans and benefits to meet your school district’s needs. All plans are designed so members can easily navigate through their health medical needs. For full plan details, please visit your benefit website: www.mybenefitshub.com/cedarhillisd
Urgent Care Facility Deductible, then Plan pays 100% Deductible, then Plan pays 100% $50 copay $75 copay Freestanding Emergency Room Deductible, then Plan pays 100% Deductible, then Plan pays 100% $500 copay $500 copay Hospital Room Deductible, then Plan pays 100% Deductible, then Plan pays 100% $500 copay $500 copay Ambulance Services Deductible, then Plan pays 100% Deductible, then Plan pays 100% $220 copay $220 copay Surgery Deductible, then Plan pays 100% In Network Only $500 copay In then Plan pays 100% In $500 copay In then Plan pays 100% In $100 copay In then Plan pays 100% In $500 copay In then Plan pays 100% In $250 copay
Network Only Surgeon Fees Deductible,
Network Only
Network Only Hospital Services Deductible,
Outpatient
Network Only
Emergency
Network Only
Network Only Routine Newborn Care Deductible,
Network Only
In Network Only Prescription Drug Benefits Drug Deductible Drug Deductible No Drug Deductible Generic You pay 0% after deductible; $0 certain generics $0 certain generics / $10 copay Preferred Brand Non Preferred You pay 0% after deductible You pay 0% after deductible $35 copay or 50% copay / Max $100 $70 copay or 50% copay / Max $200 Specialty Limited Drugs over $670 require participation in Specialty Drug Program *The Care Coordinator program must be used to access facility services or no benefits will be available under the Plan These services include routine colonoscopy and related services; hospital providers for MRIs, Cat Scans, and Pet Scans; hospital providers for outpatient Lab/Radiology Services; Inpatient Hospital Admissions; Outpatient Hospital/Ambulatory Surgical Facility Services; Maternity and Newborn Services; Rehabilitation/Therapy Services; Extended Care Services; and Other Services including durable medical equipment/supplies, orthotics/prosthetics, facilities for diabetic self management training, and sleep disorder services. To review the complete plan document and services that require access through the Care Coordinator program, please call 888 803 0081. 13
DIRECTED CARE PLAN HIGHLIGHTS WWW.TSHBP.ORG TSHBP HD Plan TSHBP HD Plan TSHBP CoPay Plan TSHBP CoPay Plan Coverage In Network Coverage Out of Network Coverage In Network Coverage Out of CoverageNetwork Network HealthSmart National N/A HealthSmart National N/A Plan Deductible Feature Deductible, then Plan pays 100% Deductible, then Plan pays 100% Copayments, then Plan pays 100% Copayments, then Plan pays 100% Individual/Family Deductible $3,000/$9,000 $3,500/$9,500 $0 Deductible $0 Deductible Individual/Family Maximum Out of Pocket $3,000/$9,000 $3,500/$9,500 $3,500/$10,500 $4,000/$11,000 Health Savings Account (HSA) Eligible Yes Yes No No Required Primary Care Provider (PCP) No No No No Required PCP Referral to Specialist No No No No Prescription Drug Benefits Yes Deductible, then Plan pays 100% Yes Deductible, then Plan pays 100% Yes, copayments, then Plan pays 100% Yes, copayments, then Plan pays 100% Doctor Visits Preventive Care Yes $0 copay Yes $0 copay Yes $0 copay Yes $0 copay Virtual Health Teladoc $30 per consultation $30 per consultation $0 per consultation $0 per consultation Primary Care Deductible, then Plan pays 100% Deductible, then Plan pays 100% $35 copay $40 copay Specialist Deductible, then Plan pays 100% Deductible, then Plan pays 100% $35 copay $40 copay Office Services
Network Only Maternity and Newborn Services Maternity Charges (prenatal and postnatal care) Deductible,
Allergy Injections Deductible, then Plan pays 100% Deductible, then Plan pays 100% $5 copay $10 copay Allergy Serum Deductible, then Plan pays 100% Deductible, then Plan pays 100% $35 copay $40 copay Chiropractic Services Deductible, then Plan pays 100% Deductible, then Plan pays 100% $35 copay $40 copay Office Surgery Deductible, then Plan pays 100% Deductible, then Plan pays 100% $110 copay $125 copay MRI's, Cat Scans, and Pet Scans Deductible, then Plan pays 100% Deductible, then Plan pays 100% $275 copay $325 copay Urgent Care Facility Deductible, then Plan pays 100% Deductible, then Plan pays 100% $50 copay $75 copay Care Facilities
WWW.TSHBP.ORG PPO PLAN HIGHLIGHTS TSHBP AETNA HD TSHBP AETNA Signature Coverage In-Network Only In-Network Only Network AETNA AETNA Preferred Facility AETNA AETNA Plan Deductible Feature You pay 30% after deductible You pay 25% after deductible Individual/Family Deductible $3,000/$6,000 $2,000/$4,000 Coinsurance You pay 30% after deductible You pay 25% after deductible Individual/Family Maximum Out of Pocket $7,000/$14,000 $7,500/$15,000 Health Savings Account (HSA) Eligible Yes No Required Primary Care Provider (PCP) No No Required PCP Referral to Specialist No No Doctor Visits Preventive Care Yes $0 copay Yes $0 copay Virtual Health Teladoc $30 per consultation $0 per consultation Primary Care You pay 30% after deductible $30 copay Specialist You pay 30% after deductible $70 copay Care Facilities Urgent Care Facility You pay 30% after deductible $50 copay Freestanding Emergency Room You pay 30% after deductible You pay $500 copay + 25% after deductible Hospital Emergency Room You pay 30% after deductible You pay $500 copay + 25% after deductible Ambulance Services You pay 30% after deductible You pay 25% after deductible Outpatient Surgery You pay 30% after deductible You pay 25% after deductible Hospital Services You pay 30% after deductible You pay 25% after deductible Surgeon Fees You pay 30% after deductible You pay 25% after deductible Prescription Drug Benefits Drug Deductible Integrated into Medical $500 brand deductible Generic You pay 20% after deductible; $0 certain generics $15 copay; $0 for certain generics Preferred Brand You pay 25% after deductible You pay 25% after deductible Non Preferred You pay 50% after deductible You pay 50% after deductible Specialty Full Coverage Drugs over $670 require participation in Specialty Drug Program The Care Coordinator program is optional and guaranteed coverage for specialty drugs. PPO Deductible Credits The PPO Deductible Credits: With the Aetna PPO plans, if you choose to utilize the services of a Care Coordinator for a procedure or admission to a facility, you will receive a $500.00 credit toward your deductible1. If you have already met your deductible, the $500 credit will apply to your out of pocket maximum! 1On the HDHP plan, a member must meet a minimum of $1400 of the deductible accumulation before receiving the credit to comply with HSA requirements. 14
Group Health Medical Rates WWW.TSHBP.ORG The TSHBP is a regional rated program for Texas school districts. The purpose of the plan is to support the school children of Texas. The TSHBP utilizes an AM Best A Excellent rated carrier with a financial size of XV ($2.0 billion or more) for financial protection against unexpected claim losses. Effective 9/1/2022– 8/31/2023 Cedar Hill Rates With C0ntribution $300.00 HIGH DEDUCTIBLE HEALTH PLAN HDHP) EMPLOYEE ONLY - $71.00 EMPLOYEE + CHILDREN - $394.00 EMPLOYEE + SPOUSE - $715.00 EMPLOYEE + FAMILY - $1,030.00 COPAY PLAN (CPP) EMPLOYEE ONLY - $113.00 EMPLOYEE + CHILDREN - $485.00 EMPLOYEE + SPOUSE - $855.00 EMPLOYEE + FAMILY - $1,225.00 AETNA HIGH DEDUCTIBLE (HDHP) EMPLOYEE ONLY - $127.00 EMPLOYEE + CHILDREN - $468.00 EMPLOYEE + SPOUSE - $904.00 EMPLOYEE + FAMILY - $1,139.00 AETNA SIGNATURE PLAN EMPLOYEE ONLY - $175.00 EMPLOYEE + CHILDREN - $507.00 EMPLOYEE + SPOUSE - $943.00 EMPLOYEE + FAMILY - $1,226.00 15
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:
Health Savings Account (HSA) EMPLOYEE BENEFITS
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.
• Family (filing jointly) $7,300
• Individual $3,650
• Not receiving Veterans Administration benefits
You are eligible to open and contribute to an HSA if you are:
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• Not enrolled in a Health Care Flexible Spending Account, nor should your spouse be contributing towards a Health Care Flexible Spending Account
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 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 under your HDHP.
A Health Savings Account (HSA) is more than a way to help you and your family cover health care costs; it is 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.
Maximum Contributions
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/cedarhillisd
• Not enrolled in Medicare or TRICARE
ABOUT HSA
• Enrolled in an HSA eligible HDHP (TSHBP HD).
EECU
HSA Eligibility
• Not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan
Important HSA Information
• You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.
• 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.
• 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.
EECU EMPLOYEE BENEFITS 17
• 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.
Health Savings Account (HSA)
• 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
Opening an 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.
• Stop by a local EECU financial center for in person assistance; find EECU locations & service hours a www.eecu.org/ locations
EMPLOYEE
For full plan details, please visit your benefit website: www.mybenefitshub.com/cedarhillisd
• Email your scanned documents to: SuppHealthClaims@Cigna.com
Hospitalization Benefits Plan 1 Plan 2 Hospital Admission No Elimination Period. Limited to 1 day, 1 benefit(s) every 365 days. $500 $2,000 Hospital Chronic Condition Admission No Elimination Period. Limited to 1 day, 1 benefit(s) every 365 days. $50 $50
Hospital Stay No Elimination Period. Limited to 30 days. $100 $100 Hospital Intensive Care Unit (ICU) Stay No Elimination Period. Limited to 30 days. $200 $200
Hospital Indemnity Cigna BENEFITS Hospital Care coverage provides a benefit according to the schedule below when a Covered Person incurs a Hospital stay resulting from a Covered Injury or Covered Illness.
Benefit Waiting Period:* None, unless otherwise stated. No benefits will be paid for a loss which occurs during the Benefit Waiting Period.
Hospital Observation Stay 24 hour Elimination Period. Limited to 72 hours. $500 per 24 hour period $500 per 24 hour period Newborn Nursery Care Admission Limited to 1 day, 1 benefit per newborn child. This benefit is payable to the employee even if child coverage is not elected. $500 $500 Newborn Nursery Care Stay* Limited to 30 days, 1 benefit per newborn child. This benefit is payable to the employee even if child coverage is not elected. Not Available $100 18
Complete the claim form with the link provided below: https://www.cigna.com/static/www cigna com/docs/individuals families/member resources/hospital care claim form.pdf Options for filing the Claim Form:
• Call 800.754.3207 to speak with one of our dedicated customer service representatives.
How do I submit a claim?
Available Coverage: The benefit amounts shown in this summary will be paid regardless of the actual expenses incurred and are paid on a per day basis unless otherwise specified. Benefits are only payable when all policy terms and conditions are met. Please read all the information in this summary to understand the terms, conditions, state variations, exclusions, and limitations applicable to these benefits. See your Certificate of Insurance for more information.
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.
Intensive Care Unit (ICU) Stay: Must be admitted as an Inpatient and confined in an ICU of a Hospital, due to a Covered Injury or Covered Illness, at the direction and under the care of a physician. If also eligible for the Hospital Stay Benefit, only 1 benefit will be paid for the same Covered Injury or Covered Illness, whichever is greater. ICU stays within 90 days for the same or a related Covered Injury or Covered Illness is considered one ICU stay.
This Employer paid benefit is available to all
time
employees. HospitalPlanIndemnity1 Plan 2 Employee $0.00 $8.90 Employee + Spouse $10.66 $25.36 Employee + Child(ren) $4.40 $16.04 Family $13.02 $29.82 19
Hospital Admission: Must be admitted as an Inpatient due to a Covered Injury or Covered Illness. Excludes: treatment in an emergency room, provided on an outpatient basis, or for re admission for the same Covered Injury or Covered Illness (including chronic conditions).
Hospital Chronic Condition Admission: Must be admitted as an Inpatient due to a covered chronic condition and treatment for a covered chronic condition must be provided by a specialist in that field of medicine. Excludes: treatment in an emergency room, provided on an outpatient basis, or for re admission for the same Covered Injury or Covered Illness (including chronic conditions).
Newborn Nursery Care
Benefit Specific Conditions, Exclusions & Limitations (Hospital Care):
Hospital Observation Stay: Must be receiving treatment for a Covered Injury or Covered Illness in a Hospital, including an observation room, or ambulatory surgical center, for more than 24 hours on a non inpatient basis and a charge must be incurred. This benefit is not payable if a benefit is payable under the Hospital Stay Benefit or Care Unit Admission and Stay: Must be admitted as an Inpatient and confined in a hospital immediately following birth at the direction and under the care of a physician. full eligible
Portability Feature:* You, your spouse, and child(ren) can continue 100% of your coverage at the time your coverage ends. You must be covered under the policy and be under the age of 100 in order to continue your coverage. Rates may change and all coverage ends at age 100. Applies to United States Citizens and Permanent Resident Aliens residing in the United States.
Hospital Stay: Must be admitted as an Inpatient and confined to the Hospital, due to a Covered Injury or Covered Illness, at the direction and under the care of a physician. If also eligible for the ICU Stay Benefit, only 1 benefit will be paid for the same Covered Injury or Covered Illness, whichever is greater. Hospital stays within 90 days for the same or a related Covered Injury or Covered Illness is considered one Hospital Stay.
Hospital Indemnity Cigna EMPLOYEE BENEFITS
Stay NewbornBenefit.Nursery Care
NOTE: The following are some of the important policy provisions, terms and conditions that apply to benefits described in the policy. This is not a complete list. See your Certificate of Insurance for more information.
Hospital Intensive
Reductions: Upon reaching certain ages, your original benefit amount will reduce to the percentage shown in the following schedule.
What you need to know about your Basic Life and AD&D Benefits
Accelerated Life Benefit: If diagnosed with a terminal illness and have less than 12 months to live, you may apply to receive 25%, 50% or 75% of your life insurance benefit to use for whatever you choose
Basic Employee Life and AD&D Coverage
Accidental Death and Dismemberment (AD&D): Additional life insurance benefits may be payable in the event of an accident which results in death or dismemberment as defined in the contract. Additional AD&D benefits include seat belt, air bag, repatriation, child higher education, childcare, paralysis/loss of use, severe burns, disappearance, and exposure.
Guaranteed Issue: Employee: $25,000
Your Life and AD&D insurance coverage amount is $25,000. Coverage is provided at no cost to you if you are a full time eligible employee. Age: 65 70 Reduces To: 65% 50%
ABOUT LIFE AND AD&D Basic term life is one of the most important benefits your employer can offer. Cedar Hill ISD is providing this coverage at no cost to you.
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/cedarhillisd
Basic Life and AD&D One America EMPLOYEE BENEFITS 20
An Employee Assistance Program (EAP) is a program that assists you in
› Landlord/tenant issues › Contracts Work Life Solutions Delegate your “to do” list. Our Work Life specialists will do the research for you, providing qualified referrals and customized resources for: › Child and elder care › College planning › Moving and relocation › Pet care › Making major purchases › Home repair GuidanceResources® Online Knowledge at your fingertips. GuidanceResources Online is your one stop for expert information on the issues that matter most to you...relationships, work, school, children, wellness, legal, financial, free time and more.self assessments › “Ask the Expert” personal responses to your questions › Child care, elder care, attorney and financial planner searches Free Online Will Preparation Get peace of mind. w w computer. Just go to www.guidanceresources.com and click on the EstateGuidance link. Follow the prompts to create and download your will at no cost. Online support and instructions for executing and filing your will are included. You can: › Name an executor to manage your estate
Carrier Name EMPLOYEE BENEFITS
For full plan details, please visit your benefit website: www.mybenefitshub.com/cedarhillisd
› Stress, anxiety and depression › Job pressures › Relationship/marital conflicts › Grief andloss › Problems with children › Substanceabuse Financial Information and Resources Discover your best options. Speak by phone with our Certified Public Accountants and Certified Financial Planners on a wide range of financial issues, including:
› Debt and bankruptcy › Civil and criminal actions
› Credit card or loan problems › Estate planning › Tax questions › Saving for college Legal Support and Resources Expert info when you need it. Talk to our attorneys by phone. If you require representation, we’ll refer you to a qualified attorney in your area for a free 30 minute consultation with a 25% reduction in customary legal fees thereafter. Call about: › Divorce and family law › Real estatetransactions
› Choose a guardian for your children › Specify your wishes for your property › Provide funeral and burial instructions Call Your ComPsych Guidance Resources program anytime for confidential assistance. Call: 855.365.4754 TDD: 800.697.0353 Go online: guidanceresources.com Your company Web ID: ONEAMERICA63
Employee Assistance Program (EAP)
› Getting out of debt › Retirement planning
21
resolving problems such as finding child or elder care, relationship challenges, financial or legal problems, etc. This program is provided by your employer at no cost to you.
ABOUT EAP
Confidential Counseling 3 Session Plan This no cost counseling service helps you address stress, relationship and other personal issues you and your family may face. It is staffed clinicians who will listen to your concerns and quickly refer you to in person counseling (up to 6 sessions per issue per year) and other resources for:
Personal issues, planning for life events or simply managing daily life can affect your work, health and family. Your GuidanceResources program provides support, resources and information for personal and work life issues. The program is company sponsored, confidential and provided at no charge to you and your dependents. This flyer explains how GuidanceResources can help you and your family deal with everyday challenges.
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 • Stomachache • 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/fbs • 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. This Employer paid benefit is available to all full time eligible employees. 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/cedarhillisd Telehealth MDLive EMPLOYEE BENEFITS 22
This Employer paid benefit is available to all full-time eligible employees. 24/7 AVAILABILITY Accessible. Connect with a Listener at your convenience, no scheduling necessary. EARN REWARDS Rewarding. Earn rewards for checking in with yourself regularly. 30+ TOPICS Approachable. Empathetic Listeners connect on real world topics. 100% PRIVATE CONNECTIONS Anonymous. All connects are private to provide a safe place to share. 23
ABOUT BEHAVIORAL HEALTH
Give your employees the benefit and support of Human Connection from someone who’s been there before. Members have the opportunity to connect weekly and participate in one on one personal conversations with a Listener who relates to their experiences. For full plan details, please visit your benefit website: www.mybenefitshub.com/cedarhillisd
Behavioral on Your Benefit of Listening. Whenever you need to share, there’s a trained Listener who can relate and take your call. Connect anonymously and privately today! Your Benefits Include: 97% REPORT FEELING BETTER FOLLOWING A CALL
Health Listeners
Call EMPLOYEE BENEFITS
How hcpdirectory.cigna.com/https:// contacting Cigna directly 800 go www.mycigna.comto the
244 6224. You can also
“MyCigna” app on your smartphone and access your id card right there on your phone. 24
and register/login to access your account. In addition, you can download
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.mybenefitshub.com/cedarhillisd Dental Insurance Cigna EMPLOYEE BENEFITS DENTAL HIGH PLAN Network Options In Network: Total Cigna DPPO Network Out of Network: See Non Network Reimbursement Reimbursement Levels Based on Contracted Fees Maximum Reimbursable Charge WellnessPlusSM Progressive Maximum Benefit: When you or your family members receive any preventive care service during one plan year, the annual dollar maximum will increase in the following plan year; until it reaches the highest level specified below. Please refer to your plan materials for additional information on this plan feature. Policy Year Benefits Maximum Applies to: Class I, II & III expenses Year 1: $1,000 Year 2: $1,250 Year 3: $1,500 Year 4 & Beyond: $1,750 Policy Year Deductible FamilyIndividual $150$50 $150$50 Benefit Highlights Plan Pays You Pay Plan Pays You Pay Class I: Diagnostic & Preventive Oral Prophylaxis:Evaluationsroutine cleanings X rays: SpaceSealants:FluoridebitewingApplicationpertoothMaintainers:non orthodontic Emergency Care to Relieve Pain X rays: full mouth/panoramic/periapical Deductible100%No No Charge Deductible100%No No Charge Class II: Basic Restorative Restorative: fillings Oral Surgery: simple extractions Repairs: bridges, crowns and inlays, dentures Denture Relines, Rebases and Adjustments Anesthesia: general and IV sedation DeductibleAfter80% DeductibleAfter20% DeductibleAfter80% DeductibleAfter20% Class III: Major Restorative Periodontal Periodontics:Endodontics:Maintenancerootcanaltherapyscalingandrootplaning Periodontics: osseous surgery Oral Surgery: oral surgical procedures Oral Surgery: extractions of impacted teeth Inlays and StainlessOnlaysSteel and Resin Crowns Crowns, Bridges and Dentures Prosthesis Over Implant After50% Deductible After50% Deductible After50% Deductible After50% Deductible Class IV: Orthodontia Coverage for Dependent Children to age 19 Lifetime Benefits Maximum: $1,000 Deductible50%No Deductible50%No Deductible50%No Deductible50%No
or call 800 244 6224 to find an in network dentist. Your network will be Total Cigna DPPO. How to Request a New ID Card You can request your dental id card by
to Find a Dentist Visit
at
DENTAL LOW PLAN Network Options In Network: Total Cigna DPPO Network Out of Network: See Non Network Reimbursement Reimbursement Levels Based on Contracted Fees Maximum Allowable Charge WellnessPlusSM Progressive Maximum Benefit: When you or your family members receive any preventive care service during one plan year, the annual dollar maximum will increase in the following plan year; until it reaches the highest level specified below. Please refer to your plan materials for additional information on this plan feature. Policy Year Benefits Maximum Applies to: Class I, II & III expenses Year 1: $1,000 Year 2: $1,250 Year 3: $1,500 Year 4 & Beyond: $1,750 Year 1: $1,000 Year 2: $1,250 Year 3: $1,500 Year 4 & Beyond: $1,750 Policy Year Deductible FamilyIndividual $150$50 $150$50 Benefit Highlights Plan Pays You Pay Plan Pays You Pay Class I: Diagnostic & Preventive Oral Prophylaxis:Evaluationsroutine cleanings X rays: SpaceSealants:FluoridebitewingApplicationpertoothMaintainers:non orthodontic Emergency Care to Relieve Pain X rays: full mouth/panoramic/periapical Deductible100%No No Charge Deductible100%No No Charge Class II: Basic Restorative Restorative: fillings Oral Surgery: simple extractions Repairs: bridges, crowns and inlays, dentures Denture Relines, Rebases and Adjustments Anesthesia: general and IV sedation 80% After Deductible 20% After Deductible 80% After Deductible 20% After Deductible Class III: Major Restorative Periodontal Crowns,StainlessInlaysOralOralPeriodontics:Periodontics:Endodontics:MaintenancerootcanaltherapyscalingandrootplaningosseoussurgerySurgery:oralsurgicalproceduresSurgery:extractionsofimpactedteethandOnlaysSteelandResinCrownsBridgesandDenturesProsthesisOver Implant 50% After Deductible 50% After Deductible 50% After Deductible 50% After Deductible Class IV: Orthodontia Coverage for Dependent Children to age 19 Lifetime Benefits Maximum: $1,000 Deductible50%No 50% No Deductible Deductible50%No 50% No Deductible Dental Cigna EMPLOYEE BENEFITS Dental RatesLow High Employee Only $26.41 $37.29 Employee + One Dependent $51.43 $73.75 Employee + Family $77.50 $112.45 25
and register/login to access your account by
How 800 also go to www.superiorvision.com clicking on “ at the top of
Members”
the page. You can also download the Superior Vision mobile app on your smart phone. 26
507 3800. You can
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.mybenefitshub.com/cedarhillisd Vision Insurance Superior Vision EMPLOYEE BENEFITS Benefits through Superior National network In network Out of network Exam (ophthalmologist) Covered in full Up to $42 retail Exam (optometrist) Covered in full Up to $37 retail Frames $125 retail allowance Up to $68 retail Contact lens fitting (standard2) Covered in full Not covered Contact lens fitting (specialty2) $50 retail allowance Not covered Lenses (standard) per pair Single vision Covered in full Up to $32 retail Bifocal Covered in full Up to $46 retail Trifocal Covered in full Up to $61 retail Progressives lens upgrade See description3 Up to $61 retail Contact lenses4 $120 retail allowance Up to $100 retail Co pays apply to in network benefits; co pays for out of network visits are deducted from reimbursements 1. Materials co pay applies to lenses and frames only, not contact lenses 2. Standard contact lens fitting applies to a current contact lens user who wears disposable, daily wear, or extended wear lenses only. Specialty contact lens fitting applies to new contact wearers and/or a member who wear toric, gas permeable, or multi focal 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 are in lieu of eyeglass lenses and frames benefit Copays Services/frequency Monthly Premiums Exam $10 Exam 12 months Employee Only $7.63 Materials1 $25 Frame 24 months Employee + One Dependent $14.83 Contact lens fitting (standard & specialty) Contact lens fitting 12 months Employee + Family $21.80 $25 Lenses 12 months Contact lenses 12 months
to Print your Vision ID Card: You can request your vision id card by contacting Superior Vision directly at
Discount Features Look for providers in the provider directory who accept discounts, as some do not; please verify their services and discounts (range from 10% 30%) prior to service as they vary. Discounts on covered materials Frames: 20% off amount over allowance Lens options: 20% off retail Progressives: 20% off amount over retail lined trifocal lens, including lens options Specialty contact lens fit: 10% off retail, then apply allowance Discounts on non covered exam, services and materials Exams, frames, and prescription lenses: 30% off retail Lens options, contacts, miscellaneous options: 20% off retail Disposable contact lenses: 10% off retail Retinal imaging: $39 maximum out of pocket Maximum member out of pocket The following options have out of pocket maximums5 on standard (not premium, brand, or progressive) lenses. Single Vision Bifocal Trifocals& Scratch Coat $13 $13 Ultraviolet coat $15 $15 Tints, solid or gradients $25 $25 Anti reflective coat $50 $50 Polycarbonate for adults $40 20% off retail High index 1.6 $55 20% off retail Photochromics $80 20% off retail 5. Discounts and maximums may vary by lens type. Please check with your provider. EMPLOYEE BENEFITS Vision Insurance Superior Vision
Surgery Superior Vision has a nationwide network of independent refractive surgeons and partnerships with leading LASIK networks who offer members a discount. These discounts range from 10% 50%, and are the best possible discounts available to Superior Vision. 27
Refractive
If your disability is a result of a pre existing condition, we will pay benefits for a maximum of 4 weeks
If you need to file a claim, please contact the vendor at 866 278 2655 and provide Group #395321
Benefit Amount: You may purchase coverage that will pay you a monthly flat dollar benefit in $100 increments between $200 and $7,500 that cannot exceed 66 2/3% of your current monthly earnings. Earnings are defined in The Hartford’s contract with your employer.
Disability Insurance
The Hartford What is Educator Disability Insurance?
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.
Educator Disability insurance is a hybrid that combines features of short term and long term disability into one plan. Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. The plan gives you flexibility to be able to choose an amount of coverage and waiting period that suits your needs. We offer Educator Disability insurance for you to purchase through The Hartford.
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/cedarhillisd
EMPLOYEE BENEFITS
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. The elimination period that you select consists of two numbers. The first number shows the number of days you must be disabled by an accident before your benefits can begin. The second number indicates the number of days you must be disabled by a sickness before your benefits can begin. 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.
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 been insured under this policy for 12 months before your disability begins.
Continuity of Coverage: If you were insured under your district’s prior plan and not receiving benefits the day before this policy is effective, there will not be a loss in coverage and you will get credit for your prior carrier’s coverage. 28
Definition of Disability: Disability is defined as The Hartford’s contract with your employer. 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.
employer
Benefit Integration after 12 months of eligible disability: Your benefit may be reduced by other income you receive or are eligible to receive due to your disability, such as: your fully or partially pays for a pension plan) plan includes a minimum benefit of 10% of your elected benefit.
of active work • The nature of your claim or leave request • Your treating physicians name, address, and fax numbers • With
answer your questions,
and
a
For a full schedule of benefits and costs,please refer to the employee benefits portal at telephonicallyHowwww.mybenefitshub.com/cedarhillisisdtofileaclaim:Claimsarenowprocessedbycalling86654791247:007:00 CST. Just refer to policy number 395321 and follow these easy steps:
your claim. Disability Insurance The Hartford EMPLOYEE BENEFITS Age Disabled Benefits Payable Prior to Age 63 To Normal Retirement Age or 48 months if greater Age 63 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 Elimination Period (per $200 in benefit) 0/7 $9.84 14/14 $7.84 30/30 $6.48 60/60 $4.44 90/90 $3.84 180/180 $2.96 29
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. Please see the applicable schedule below based on the Premium benefit option. Premium Option: For the Premium benefit option the table below applies to disabilities resulting from sickness or injury.
2. Have your information ready address other key department last day full day your information handy, you assisted by member who will take your information, and file
• 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
(such as
1. If your absence is scheduled, call 30 days prior and if unscheduled, please call as soon as possible.
information • Name of
• Name
will be
Treatment for cancer is often lengthy and expensive. While your health insurance helps pay the medical expenses for cancer treatment, it does not cover the cost of non medical expenses, such as out of town treatments, special diets, daily living and household upkeep. In addition to these non medical expenses, you are responsible for paying your health plan deductibles and/or coinsurance. Cancer insurance through American Public Life helps pay for these direct and indirect treatment costs so you can focus on your health. Should need at 800 256 or at
www.ampublic.com. You can find additional claim forms and materials at www.mybenefitshub.com/cedarhillisd Cancer Plan MonthlyPLANPremiums1PLAN 2 Employee Only $14.80 $24.52 Employee and Spouse $28.34 $43.28 Employee and Child(ren) $18.52 $25.96 Employee and Family $30.52 $48.74 Plan 1 Plan 2 Internal Cancer First Occurrence* $2,500 $5,000 Lump Sum for Eligible Dependent Children maximum 1 per covered person per lifetime $3,750 $7,500 Cancer Treatment Policy benefits Plan 1 Plan 2 Radiation and Chemotherapy, Immunotherapy Maximum Per 12 month period $10,000 $20,000 Hormone Therapy Maximum of 12 treatments per calendar year $50 per treatment $50 per treatment Surgical Rider Benefits Plan 1 Plan 2 Surgical $30 unit dollar amount Max $3,000 per operation $30 unit dollar amount Max $3,000 per operation Anesthesia 25% of amount paid for covered surgery Bone Marrow Transplant Maximum per lifetime $6,000 $6,000 Stem Cell Transplant Maximum per lifetime $600 $600 Prosthesis Surgical Implantation/Non surgical (not Hair Piece) 1 device per site, per lifetime $1,000/$100 $1,000/$100 Heart Attack/Stroke First Occurrence Rider Benefits Plan 1 Plan 2 Lump Sum Benefit Maximum per 1 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 Hospital Intensive Care Unit Rider Benefits Plan 1 Plan 2 Intensive Care Unit $600 per day $600 per day Step Down Unit Maximum of 45 days per Confinement of any combination of Intensive Care Unit or Step Down Unit $300 per day $300 per day *Carcinoma in situ is not considered internal cancer Pre Existing Condition Exclusion: Review the Plan Summary page that can be found at www.mybenefitshub.com/cedarhillisd for full details 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.mybenefitshub.com/cedarhillisd Cancer Insurance APL EMPLOYEE BENEFITS 30
to file a claim contact APL
you
8606
online
Critical Illness insurance provides financial protection by paying a lump sum benefit if you are diagnosed with a covered critical illness. To file a claim, call UNUM at 800 858 6843 or find claim form at www.mybenefitshub.com/ cedarhillisd.
Covered Conditions* Percentage of Coverage Amount CriticalCoronaryIllnessesArtery Disease (major) 50% Coronary Artery Disease (minor) 10% End Stage Renal (Kidney) Failure 100% Heart Attack (Myocardial Infarction) 100% Major Organ Failure Requiring Transplant 100% Stroke 100% Supplemental Critical Illnesses Benign Brain Tumor 100% Coma 100% Loss of Hearing 100% Loss of Sight 100% Loss of Speech 100% Infectious Disease 25% Occupational Human Immunodeficiency Virus (HIV) or Hepatitis 100% Permanent Paralysis 100% 31
For your Spouse and Children: 100% of employee coverage amount Can I be denied coverage? Coverage is guarantee issue. When is coverage effective? Please see your Plan Administrator for your effective date of coverage. Insurance coverage will be delayed if you are not in active employment because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective. What critical are covered?
illness conditions
Who is eligible for this coverage? All employees in active employment in the United States working at least 20 hours per week and their eligible spouses and children (up to age 26 regardless of student or marital status). What are the Critical Illness coverage amounts? The following coverage amounts are available. For you: Select one of the following $10,000, $20,000 or $30,000
EMPLOYEE
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.
ABOUT CRITICAL ILLNESS
For full plan details, please visit your benefit website: www.mybenefitshub.com/cedarhillisd
Critical Illness Insurance Unum BENEFITS
An insured has a pre existing condition if, within the 3 months just prior to their coverage effective date, they have an injury or sickness, whether diagnosed or not, for which:
• drugs or medications were taken, or prescribed to be taken during that period; or • symptoms existed.
* Please refer to the policy for complete definitions of covered conditions.
75 79
70 74
25
50 54
• medical treatment, consultation, care or services, or diagnostic measures were received or recommended to be received during that period;
45 49
55 59
35
85+
Pre existing Conditions We will not pay benefits for a claim when the covered loss occurs in the first 12 months following an insured’s coverage effective date and the covered loss is caused by, contributed to by, or occurs as a result of any of the following:
Critical Illness Insurance Unum EMPLOYEE BENEFITS What critical illness conditions are covered? (cont’d) ProgressiveAmyotrophicDiseasesLateral Sclerosis (ALS) 100% Dementia (including Alzheimer’s Disease) 100% Functional Loss 100% Multiple Sclerosis (MS) 100% Parkinson’s Disease 100% Additional Critical Illnesses for your Children Cerebral Palsy 100% Cleft Lip or Palate 100% Cystic Fibrosis 100% Down Syndrome 100% Spina Bifida 100%
30
• a pre existing condition; or • complications arising from treatment or surgery for, or medications taken for, a pre existing condition.
32
The pre existing condition provision applies to any Insured’s initial coverage and any increases in coverage. Coverage effective date refers to the date any initial coverage or increases in coverage become effective.Critical Illness Employee/Spouse$10,000 Employee/Spouse$20,000 Employee/Spouse$30,000 <25 $1.10 $2.20 $3.30 29 $1.40 $2.80 $4.20 34 $1.90 $3.80 $5.70 39 $2.60 $5.20 $7.80 40 44 $3.50 $7.00 $10.50 $5.10 $10.20 $15.30 $7.20 $14.40 $21.60 $9.30 $18.60 $27.90 64 $13.60 $27.20 $40.80 $21.60 $43.20 $64.80 $39.50 $79.00 $118.50 $67.30 $134.60 $201.90 $115.20 $230.40 $345.60 $210.80 $421.60 $632.40
60
65 69
80 84
• Spouse
What $10,000 to $500,000, in $10,000 increments, not to exceed 7 times your annual salary under age 99: $5,000 to $250,000, in $5,000 increments, not to exceed 50% of the $50,000
employee’s amount Guaranteed Issue: • Employee: $180,000 • Spouse:
• Child: Dependent$10,000LifeCoverage: Optional dependent life coverage is available to eligible employees. You must select employee coverage in order to cover your spouse and/or child(ren). Accelerated Life Benefit: If diagnosed with a terminal illness and have less than 12 months to live, you may apply to receive 25%, 50% or 75% of your life insurance benefit to use for whatever you choose Guaranteed Increase In Benefit: You may be eligible to increase your coverage annually until you reach your maximum amount without providing evidence of insurability. Reductions: Upon reaching certain ages, your original benefit amount will reduce to the percentage shown in the following schedule. Age: 70 75 80 85 90 Reduces To: 65% 45% 30% 20% 15% Voluntary Group Life Age (perEmployee$10,000) (perSpouse$10,000) <24 $0.60 $0.30 25 29 $0.60 $0.30 30 34 $0.80 $0.40 35 39 $0.90 $0.45 40 44 $1.30 $0.65 45 49 $1.70 $0.85 50 54 $3.30 $1.65 55 59 $5.30 $2.65 60 64 $8.30 $4.15 65 69 $15.50 $7.75 70 74 $31.40 $15.70 75+ $31.40 $15.70 Voluntary Group Life Child(ren) ($10,000 in coverage) 0 26 $1.00 33
Voluntary Life OneAmerica EMPLOYEE BENEFITS ABOUT LIFE INSURANCE 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. For full plan details, please visit your benefit website: www.mybenefitshub.com/cedarhillisd
you need to know about your Voluntary Term Life Benefits Flexible Options: • Employee:
• Employee: Up to $500,000, in $10,000 increments Spouse:60% of the employee AD&D benefit, 50% if child included Child: 15% of the employee AD&D benefit, 10% if spouse included, not to exceed $30,000 Issue: Employee: $500,000 Spouse: $300,000 Child: Accidental$30,000Deathand
Reductions:included.Upon
Voluntary AD&D OneAmerica EMPLOYEE BENEFITS ABOUT AD&D INSURANCE
Dependent
Age: 70 75 80 85 90 Reduces To: 65% 45% 30% 20% 15% AD&D (per $10,000) Employee Only $0.19 Employee & Family $0.30 34
premiums
Guaranteed
•
•
Flexible AD&D Options:
For
Note:schedule.Employee and
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. full plan details, please visit your benefit website: www.mybenefitshub.com/cedarhillisd
Dismemberment (AD&D): If AD&D is selected, additional life insurance benefits may be payable in the event of an accident which results in death or dismemberment as defined in the contract. AD&D Coverage: Optional dependent AD&D coverage is available to eligible employees. You must select employee coverage in order to cover your spouse and/or child(ren). If employee AD&D is declined, no dependent AD&D will be reaching certain ages, your original benefit amount will reduce to the percentage shown in the following schedule. The amounts of dependent AD&D principal sum will reduce according to the employee's reduction Family are based on the amount of Employee coverage chosen.
•
•
•
What you need to know about your Voluntary AD&D Benefits
FAMILY PROTECTION Coverage is available for spouses and financially dependent children, even if the employee doesn’t elect coverage on themselves.
QUALITY OF LIFE Optional benefit that accelerates a portion of the death benefit on a monthly basis, up to 75% of your benefit, and is payable directly to you on a tax favored basis for the following:
Shouldcedarhillisdyouneed to file a claim, contact 5Star directly at (866) 863 9753.
CONVENIENCE Easy payments through payroll deduction.
*Quality of Life not available ages 66 70. Quality of Life benefits not available for children
PROTECTION TO COUNT ON Within one business day of notification, payment of 50% of coverage or $10,000 whichever is less is mailed to the beneficiary, unless the death is within the two year contestability period and/or under investigation. This coverage has no war or terrorism exclusions.
Enhanced coverage options for employees. Easy and flexible enrollment for employers. The 5Star Life Insurance Company’s Family Protection Plan offers both Individual and Group products with Terminal Illness coverage to age 121, making it easy to provide the right benefit for you and your CUSTOMIZABLEemployees.With several options to choose from, employees select the coverage that best meets the needs of their families.
Child life coverage available only on children and grandchildren of employee (age on application date: 14 days through 23 years).$7.15 monthly for $10,000 coverage per child. 35
*Financially dependent children 14 days to 23 years old.
TERMINAL ILLNESS ACCELERATION OF BENEFITS Coverage that pays 30% (25% in CT and MI) of the coverage amount in a lump sum upon the occurrence of a terminal condition that will result in a limited life span of less than 12 months (24 months in IL).
Individual Life Insurance 5Star EMPLOYEE
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/cedarhillisd BENEFITS
PORTABLE Coverage continues with no loss of benefits or increase in cost if employment terminates after the first premium is paid. We simply bill the employee directly.
• Permanent severe cognitive impairment, such as dementia, Alzheimer’s disease and other forms of senility, requiring substantial supervision.
Find full details and rates at www.mybenefitshub.com/
• Permanent inability to perform at least two of the six Activities of Daily Living (ADLs) without substantial assistance; or
Individual Life Insurance 5Star EMPLOYEE BENEFITS MONTHLY RATES WITH QUALITY OF LIFE RIDER DEFINED BENEFIT Age on Eff. Date Employee Coverage Amounts $10,000 $20,000 $30,000 $40,000 $50,000 $75,000 $100,000 $125,000 $150,000 18 25 $9.90 $13.28 $16.68 $20.07 $23.46 $31.94 $40.42 $48.89 $57.38 26 $9.91 $13.34 $16.75 $20.16 $23.59 $32.13 $40.66 $49.21 $57.75 27 $9.98 $13.46 $16.96 $20.44 $23.92 $32.62 $41.34 $50.04 $58.76 28 $10.08 $13.66 $17.26 $20.84 $24.42 $33.37 $42.34 $51.29 $60.26 29 $10.23 $13.95 $17.68 $21.40 $25.13 $34.44 $43.75 $53.07 $62.38 30 $10.43 $14.35 $18.28 $22.20 $26.12 $35.94 $45.75 $55.56 $65.38 31 $10.64 $14.76 $18.90 $23.04 $27.16 $37.50 $47.84 $58.16 $68.50 32 $10.87 $15.23 $19.61 $23.97 $28.34 $39.25 $50.17 $61.09 $72.01 33 $11.11 $15.72 $20.33 $24.93 $29.55 $41.06 $52.58 $64.11 $75.63 34 $11.40 $16.30 $21.20 $26.10 $31.00 $43.26 $55.50 $67.75 $80.00 35 $11.72 $16.93 $22.16 $27.37 $32.59 $45.63 $58.67 $71.71 $84.76 36 $12.08 $17.65 $23.23 $28.80 $34.37 $48.31 $62.25 $76.18 $90.13 37 $12.46 $18.44 $24.40 $30.36 $36.34 $51.25 $66.16 $81.09 $96.00 38 $12.88 $19.25 $25.63 $32.00 $38.38 $54.32 $70.25 $86.19 $102.13 39 $13.33 $20.17 $27.00 $33.83 $40.67 $57.76 $74.83 $91.92 $109.00 40 $13.83 $21.15 $28.48 $35.80 $43.13 $61.44 $79.75 $98.06 $116.38 41 $14.38 $22.25 $30.13 $38.00 $45.87 $65.57 $85.25 $104.94 $124.63 42 $14.98 $23.46 $31.96 $40.44 $48.92 $70.12 $91.34 $112.54 $133.76 43 $15.60 $24.70 $33.81 $42.90 $52.00 $74.75 $97.50 $120.25 $143.01 44 $16.26 $26.02 $35.78 $45.53 $55.30 $79.69 $104.08 $128.48 $152.88 45 $16.93 $27.37 $37.80 $48.23 $58.67 $84.75 $110.83 $136.92 $163.00 46 $17.67 $28.83 $40.00 $51.17 $62.33 $90.26 $118.17 $146.09 $174.00 47 $18.43 $30.35 $42.28 $54.20 $66.13 $95.94 $125.75 $155.56 $185.38 48 $19.19 $31.88 $44.58 $57.27 $69.96 $101.69 $133.42 $165.15 $196.88 49 $20.02 $33.55 $47.08 $60.60 $74.13 $107.94 $141.75 $175.57 $209.38 50 $20.93 $35.36 $49.81 $64.24 $78.67 $114.75 $150.84 $186.92 $223.01 51 $21.94 $37.39 $52.83 $68.26 $83.71 $122.32 $160.91 $199.52 $238.13 52 $23.11 $39.74 $56.35 $72.96 $89.59 $131.13 $172.66 $214.21 $255.75 53 $24.42 $42.33 $60.26 $78.17 $96.09 $140.87 $185.67 $230.46 $275.26 54 $25.88 $45.27 $64.65 $84.03 $103.42 $151.88 $200.33 $248.80 $297.25 55 $27.44 $48.37 $69.31 $90.23 $111.17 $163.50 $215.83 $268.17 $320.51 56 $29.19 $51.87 $74.56 $97.23 $119.92 $176.63 $233.33 $290.04 $346.76 57 $30.99 $55.49 $79.98 $104.46 $128.96 $190.19 $251.41 $312.64 $373.88 58 $32.84 $59.19 $85.53 $111.86 $138.21 $204.06 $269.91 $335.77 $401.63 59 $34.74 $62.97 $91.21 $119.43 $147.67 $218.25 $288.83 $359.42 $430.01 60 $36.71 $66.94 $97.15 $127.36 $157.59 $233.13 $308.66 $384.21 $459.75 61 $38.77 $71.05 $103.33 $135.60 $167.88 $248.57 $329.25 $409.94 $490.63 62 $40.93 $75.37 $109.80 $144.23 $178.67 $264.75 $350.83 $436.92 $523.00 63 $43.22 $79.95 $116.68 $153.40 $190.13 $281.94 $373.75 $465.56 $557.38 64 $45.72 $84.93 $124.16 $163.37 $202.59 $300.62 $398.67 $496.71 $594.76 65 $48.50 $90.50 $132.51 $174.50 $216.50 $321.50 $426.50 $531.50 $636.51 66* $49.13 $91.75 $134.38 $177.00 $219.63 $326.19 $432.75 $539.31 $645.88 67* $52.62 $98.73 $144.85 $190.97 $237.08 $352.38 $467.67 $582.96 $698.25 68* $56.58 $106.67 $156.75 $206.83 $256.92 $382.13 $507.33 $632.54 $757.75 69* $61.09 $115.68 $170.28 $224.87 $279.46 $415.94 $552.42 $688.90 $825.38 70* $66.18 $125.85 $185.53 $245.20 $304.88 $454.06 $603.25 $752.44 $901.63 36
37
Repatriation/Recuperation
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.
Emergency Medical Transport MASA EMPLOYEE BENEFITS
Emergent Ground Transportation In the event of a serious medical emergency, Members have access to emergency ground transportation into a medical facility or between medical facilities.
Non Emergency Inter Facility Transportation 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 facilities.
Emergent Air Transportation In the event of a serious medical emergency, Members have access to emergency air transportation into a medical facility or between medical facilities.
www.mybenefitshub.com/cedarhillisdEmergencyMedicalTransportEmployee&Family$14.00
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.
www.mybenefitshub.com/cedarhillisd
Suppose you or a family member 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 Shouldrecuperation.youneed assistance with a claim contact MASA at 800 643 9023. You can find full benefit details
For full plan details, please visit your benefit website:
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/cedarhillisd Identity Theft iLock360 EMPLOYEE BENEFITS PEACE OF MIND FOR YOU AND YOUR FAMILY Your district pays the employee amount of your premium. With mass data breaches and identity theft becoming a part of daily life, you want help that is a phone call or click away. • iLOCK360 is a comprehensive identity theft & credit monitoring service • that helps you maintain control over your personal information. • Scours the Internet’s Black Market (the Dark Web) 24/7/365 to identify if your identity has been bought or sold online. • Automatically alerts you via email so action may be taken to address the issue. • If you are a victim of identity theft, you will be assisted by a U.S. based certified Identity Theft Restoration Specialist who will work on your behalf to restore your good name. • You will be covered under the $1M insurance policy (with $0 deductible) for costs associated with restoring your identity. *Includes the employer contribution Family includes coverage for Spouse and up to 8 children. This Employer paid benefit is available to all full time eligible employees. ESSENTIAL PLAN FEATURESEmployeeCoverage FamilyOptionUpgrade CyberAlert™ monitors: • one SSN • two Medical ID Numbers • two Phone Numbers • five Bank Accounts • two Email Addresses • one Driver’s License Number • five Credit/Debit Cards • one Passport Bank Account Takeover & Credit Card Application Monitoring Change of Address Monitoring Sex Offender Alerts Social Media Monitoring Payday Loan Monitoring Solicitation Reduction $1M Identity Theft Insurance Lost Wallet Protection Full Identity Restoration Daily Monitoring of Experian Credit Bureau SSN Trace (Child) adults children to age 18 Identity Theft Monitoring Employee $0.00 (Employer Paid) Employee and Family $8.70* 38
•
Dependent Care FSA
NBS
•
You can access the funds in your Health Care FSA two different ways:
• Phone: (800) 274 0503 Email: service@nbsbenefits.com
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).
ABOUT 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. 39
• Mail: PO Box 6980 West Jordan, UT 84084
•
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).
•
•
For full plan details, please visit your benefit website: www.mybenefitshub.com/cedarhillisd
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
Flexible Spending Account (FSA) EMPLOYEE BENEFITS Health Care FSA
How the Health Care FSAs Work
• 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
Important FSA Rules
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. Flexible Spending Accounts Account Type Eligible Expenses Annual Contribution Limits Benefit Health Care FSA
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.
• 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.
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) $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 40
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.
Over the Counter (OTC) Item Rule
Flexible Spending Account (FSA)
• You cannot change your election during the year unless you experience a Qualifying Life Event.
NBS EMPLOYEE BENEFITS
• You can continue to file claims incurred during the plan year for another 30 days (up until date).
• 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.
FSAstore.Com
• 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.
Notes 41
Notes 42
Notes 43
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 Cedar Hill 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.
44
WWW.MYBENEFITSHUB.COM/CEDARHILLISD 2022 - 2023 PlanYear
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 Cedar Hill 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.
