FRISCO ISD BENEFIT GUIDE EFFECTIVE: 09/01/2022 8/31/2023 WWW.MYBENEFITSHUB.COM/FRISCOISD 2022 - 2023 PlanYear 1
Table of Contents FLIP TO... 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 12-18 Health Savings Account (HSA) 19 Flexible Spending Account (FSA) 20-21 Hospital Indemnity 22-23 Telehealth 24 Dental 25-26 Vision 27 Disability 28 Life and AD&D 29 Cancer 30 Critical Illness 31 32 Individual Life 33 Identity Theft 34 Emergency Medical Transportation 35 Legal Services 36 37 Retirement - 403(b) 38 Retirement - 457 39 Retirement 401(a) 40 Frisco ISD Wellness Programs 41 Miscellaneous 42 HOW TO ENROLLPG. 4 SUMMARYPAGESPG. 6 BENEFITSYOURPG. 12 2
Benefit Contact Information FRISCO ISD BENEFIT ADMINISTRATORS DENTAL MEDICAL TRANSPORT Financial Benefit Services (800) 583 www.mybenefitshub.com/friscoisd6908 GroupCigna #3339989 (800) 244 www.mycigna.com6224 GroupMASA #MKFRISC (800) 423 www.masamts.com3226 FRISCO ISD BENEFITS OFFICE DISABILTY INDVIDUAL LIFE Frisco ISD Benefits Admin. Brenna Rose (469) 633 rosebr@friscoisd.org6361 AUL a OneAmerica Company Policy #G00614159 (800) 537 www.oneamerica.com6442 5Star Life Insurance Company (866) 863 9753 Policy # http://5starlifeinsurance.com02484 FRISCO ISD CSR LEGAL PLANS VOLUNTARY LIFE AND AD&D Frisco ISD CSR Mary Kempa (469) 633 kempam@friscoisd.org6373 MetLife Legal Plans (800) 821 6400 Accessmembers.legalplans.comCode:9310010 AUL a OneAmerica Company Policy #G00614159 (800) 537 www.oneamerica.com6442 FRISCO ISD WELLNESS VISION FLEXIBLE SPENDING ACCOUNT (FSA) Wellness Coordinator 469 633 wellness@friscoisd.org6379 EyeMed Vision Care Group #VC 19 (888) 581 www.eyemedvisioncare.com3648 https://flexservices.higginbotham.net/(866)Higginbotham4193519 TRS ACTIVECARE MEDICAL CANCER COBRA (MEDICAL) Blue Cross Blue Shield (866) 355 www.bcbstx.com/trsactivecare5999 GroupAPL #24763 (800) 256 www.ampublic.com8606 (877)bSwift927 9438 TRS HMO MEDICAL IDENTITY THEFT COBRA (DENTAL & VISION) Scott & White HMO (800) 321 trs.swhp.org7947 Identity Guard (855) 443 www.identityguard.com7748 https://flexservices.higginbotham.net/(866)Higginbotham4193519 TELEHEALTH CRITICAL ILLNESS CAREMARK (888)MDLive365 www.consultmdlive.com1663 GroupUNUM#473142 011 (800) 583 6908 www.unum.com Employee: (800) 552 8159 Specialty Drugs: (800) 237 https://info.caremark.com/2767 trsactivecare HEALTH SAVINGS ACCOUNT (HSA) HOSPITAL INDEMNITY RETIREMENT PLANNING (800)EECU 333 www.eecu.org9934 GroupCigna #HC961351 (800) 754 www.cigna.com3207 (800)TCG 943 tcgservices.com9179 3
Employee benefits made easy through the FBS Benefits App! AllYour BenefitsOne App OR SCAN Text “FBS FRISCOISD” to (800) 583-6908 App Group #: FBSFRISCOISD Text “FBS FRISCOISD” 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.mybenefitshub.com/friscoisd How to Log In 2 CLICK LOGIN 3 ENTER USERNAME & PASSWORD Please use your District Username and Password to begin your insurance enrollment. If you do not know your FISD Network login, please contact the Benefits Office or the FISD Help Desk at 469 633 6222. 5
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The CIGNA Dental premiums will have a slight increase as of September 1; they are guaranteed for 3 years.
The TSHBP Medical plans will no longer be offered effective September 1, 2022. All employees who are enrolled currently are required to login and make another selection from the plans offered through TRS with Blue Cross Blue Shield/Baylor Scott and White HMO.
The MetLife Hospital Indemnity plan is being replaced by CIGNA as of September 1. The CIGNA plans will offer stronger benefits at a lower cost. You can view the summaries on the benefit portal under Hospital Indemnity. If you are already enrolled, you will automatically be rolled to the new plan that most closely matches what you have in place.
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The MDLive/FBS Telehealth Plan cost will increase to $12.00 per month but covers the ENTIRE family and you have unlimited consultation for Behavioral Health as of September 1. On this plan, there are NO copays when you call for a doctor. You don’t have to be enrolled in Medical to have this plan in place. There is now a Benefits Care Line available year around for benefit questions or enrollment assistance by calling (833) 453 1680. The hours of operation are Monday Thursday 8 am to 5:30, and Fridays 8 to 3 CST 6
Benefit Updates What’s New: Don’t Forget! • Login and complete your benefit enrollment from 07/18/2022 08/12/2022 • Enrollment assistance is available by calling Financial Benefit Services at (866) 914 5202. • Update your information: home address, phone numbers, email, and beneficiaries. • REQUIRED!! Due to the Affordable Care Act (ACA) reporting requirements, you must add your dependent’s CORRECT social security numbers in the online enrollment system. If you have questions, please contact your Benefits Administrator. SUMMARY PAGESAnnual Benefit Enrollment • GOOD NEWS! The premiums for the BCBS plans will have a slight decrease as of September 1. You can review the new costs on the chart posted to the benefit portal at www.mybenefitshub.com/friscoisd under Medical/TRS ActiveCare/Benefits and Forms.
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Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change.
A change in marital status includes marriage, death of a spouse, divorce or annulment (legal separation is not recognized in all states).
Section 125 Cafeteria Plan Guidelines SUMMARY PAGESAnnual Benefit Enrollment CHANGES
Marital Status
EligibilityDependents'ofStatus
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. IN EVENTS
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.
Eligibility for Government Programs
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.
Gain/Loss
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.
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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.
(CIS):STATUS QUALIFYING
Change in Number of Tax Dependents
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.
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.
Change in Status of Employment Affecting Coverage Eligibility
Judgment/Decree/Order
• 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.
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.
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.
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.
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.
For supplemental benefit questions, you can contact your Benefits/HR department or you can call Financial Benefit Services at 866 914 5202 for assistance.
Q&A Who do I contact with Questions?
New Hire Enrollment
Where can I find forms?
For benefit summaries and claim forms, go to your benefit website: www.mybenefitshub.com/ friscoisd. Click the benefit plan you need information on (i.e., Dental) and you can find the forms you need under the Benefits and Forms
Howsection.can I find a Network Provider?
All new hire enrollment elections must be completed in the online enrollment system within the first 30 days of benefit eligible employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.
• Changes, additions or drops may be made only during the annual enrollment period without a qualifying event.
SUMMARY PAGESAnnual Benefit Enrollment 8
For benefit summaries and claim forms, go to the Frisco ISD benefit www.mybenefitshub.com/friscoisdwebsite:. 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?
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.
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.
Supplemental Benefits: Eligible employees must work 20 or more regularly scheduled hours each work week.
SUMMARY PAGES
Annual Benefit Enrollment
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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. PLAN MAXIMUM AGE Medical To age 26 AlternativeMedical To age 26 Dental To age 26 Vision To age 26 Life To age 26 Cancer To age 26 Critical Illness To age 26 AD&D To age 26 Individual Life To age 26
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, limits and exclusions may apply when obtaining coverage as a married couple or when obtaining coverage for dependents.
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
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.
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.
Employee RequirementsEligibility
Actively at Work
Plan Year 1st through August 31st Pre Existing Conditions Applies to any illness, injury or condition for which the participant has been under the care of a health care provider, taken prescription drugs or is under a health care provider’s orders to take drugs, or received medical care or services (including diagnostic and/or consultation services).
September
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. Enrollment
Guaranteed
January 1st through December 31st Co-insurance 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. 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.
The most an eligible or insured person can pay in co insurance for covered expenses.
SUMMARY PAGESHelpful Definitions 10
Annual
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.
After
In Network Doctors, hospitals, optometrists, dentists and other providers who have contracted with the plan as a network provider. Out of Pocket Maximum
Calendar Year
SUMMARY PAGESHSA vs. FSA 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 FLIP TO FOR HSA INFORMATION PG. 19 FLIP TO FOR FSA INFORMATION PG. 20 11
Monthly Premium District Contribution Employee Cost TRS ActiveCare HD Employee Only $422.00 $350.00 $72.00 Employee & Spouse $1,187.00 $350.00 $837.00 Employee & Child(ren) $757.00 $350.00 $407.00 Employee & Family $1,419.00 $350.00 $1,069.00 TRS ActiveCare 2 Employee Only $1,013.00 $350.00 $663.00 Employee & Spouse $2,402.00 $350.00 $2,052.00 Employee & Child(ren) $1,507.00 $350.00 $1,157.00 Employee & Family $2,841.00 $350.00 $2,491.00 TRS ActiveCare Primary Employee Only $410.00 $350.00 $60.00 Employee & Spouse $1,157.00 $350.00 $807.00 Employee & Child(ren) $738.00 $350.00 $388.00 Employee & Family $1,384.00 $350.00 $1,034.00 TRS ActiveCare Primary+ Employee Only $515.00 $350.00 $165.00 Employee & Spouse $1,259.00 $350.00 $909.00 Employee & Child(ren) $829.00 $350.00 $479.00 Employee & Family $1,584.00 $350.00 $1,234.00 Scott and White HMO Employee Only $543.35 $350.00 $193.35 Employee & Spouse $1,364.92 $350.00 $1,014.92 Employee & Child(ren) $873.57 $350.00 $523.57 Employee & Family $1,570.98 $350.00 $1,220.98 ABOUT MEDICAL Major medical insurance is a type of health care coverage that provides benefits for a broad range of medical expenses that may be incurred either on an inpatient or outpatient basis. For full plan details, please visit your benefit website: www.mybenefitshub.com/friscoisd Medical Insurance TRS EMPLOYEE BENEFITS 12
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• Lost/Stolen Debit Card: Call the 24/7 debit card hotline at (800) 333 9934
• 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.
Contributions to a Health Savings Account can only be used if you are also enrolled in a High Deductible Health Care Plan (HDHP). full plan details, please visit your benefit website:
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• Online/Mobile: Sign in for 24/7 account access to check your balance, pay bills and more.
• 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.
• 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.
ABOUT HSA
A Health Savings Account (HSA) is a personal savings account where the money can only be used for eligible medical expenses. Unlike a flexible spending account (FSA), the money rolls over year to year however only those funds that have been deposited in your account can be used.
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Health Savings Account (HSA)
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. Eligibility
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You are eligible to open and contribute to an HSA if you are: Enrolled in an HSA eligible HDHP Not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan Not enrolled in a Health Care Flexible Spending Account Not eligible to be claimed as a dependent on someone else’s tax return Not enrolled in Medicare or TRICARE Not receiving Veterans Administration benefits
For
you elect: •
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
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www.mybenefitshub.com/friscoisd
You can use the money in your HSA to pay for qualified medical expenses now or in the future. You can also use HSA funds to pay health care expenses for your dependents, even if they are not covered by the HDHP. Contributions
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.
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Maximum
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 Individual $3,650 Family (filing jointly) $7,300 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.
• Stop by a local EECU financial center for in person assistance: www.eecu.org/locations.
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How to Use your HSA
EECU EMPLOYEE BENEFITS
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.
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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.
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For full plan details, please visit your benefit website: www.mybenefitshub.com/friscoisd Flexible Spending Account (FSA)
Important FSA Rules
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ABOUT FSA
The Higginbotham Benefits Debit Card gives you immediate access to funds in your Health Care FSA when you make a purchase without needing to file a claim for reimbursement. If you use the debit card to pay anything other than a copay amount, you will need to submit an itemized receipt or an Explanation of Benefits (EOB). If you do not submit your receipts, you will receive a request for substantiation. You will have 60 days to submit your receipts after receiving the request for substantiation before your debit card is suspended. Check the expiration date on your card to see when you should order a replacement card(s).
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A 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).
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Eligible expenses include: • Dental and vision expenses • Medical deductibles and coinsurance • Prescription copays • Hearing aids and batteries You
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. 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).
Dependent Care FSA
EMPLOYEE BENEFITS Health
Higginbotham Benefits Debit Card
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. You cannot change your election during the year unless you experience a Qualifying Life Event. You can continue to file claims incurred during the plan year for another 90 days after August 31st Your Health Care FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care expenses.
Higginbotham Care FSA
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The Dependent Care FSA 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. Reimbursement from your Dependent Care FSA is limited to the total amount deposited in your account at that time. To be eligible, you must be a single parent or you and your spouse must be employed outside the home, disabled or a full time student.
Flexible
• 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 Item Rule Reminder 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. Higginbotham Portal The Higginbotham Portal provides information and resources to help you manage your FSAs. • Access plan documents, letters and notices, forms, account balances, contributions and other plan information • Update your personal information • Utilize Section 125 tax calculators • Look up qualified expenses • Submit claims • Request a new or replacement Benefits Debit Card Register on the Higginbotham Portal Visit https://flexservices.higginbotham.net and click Register. Follow the instructions and scroll down to enter your information. • Enter your Employee ID, which is your Social Security number with no dashes or spaces. • Follow the prompts to navigate the site. • If you have any questions or concerns, contact Higginbotham: Phone 866 419 3519 Email flexclaims@higginbotham.net Fax 866 419 3516 Higginbotham Flex Mobile App Easily access your Health Care FSA on your smartphone or tablet with the Higginbotham mobile app. Search for Higginbotham in your mobile device’s app store and download as you would any other app. • View Accounts Includes detailed account and balance information • Card Activity Account information • SnapClaim File a claim and upload receipt photos directly from your smartphone • Manage Subscriptions Set up email notifications to keep up to date on all account and Health Care FSA debit card activity • Log in using the same username and password you use to log in to the Higginbotham Portal. Note: You must register on the Higginbotham Portal in order to use the mobile app. Flexible Spending Account (FSA) Higginbotham EMPLOYEE BENEFITS 21
Wellness Treatment, Health Screening Test and Preventative Care Incentive Benefit* Examples include (but are not limited to) routine gynecological exams, general health exams, mammography, and certain blood tests. Also includes COVID 19 Immunization, Tests, and Screenings. Virtual Care accepted. $50, limited to 1 per year.
Benefits Plan 1 Plan 2
Additional Benefits Plan 1 Plan 2
Hospital Admission No Elimination Period. Limited to 1 day, 1 benefit(s) every 180 days. $1,500 $2,500 Hospital Chronic Condition Admission No Elimination Period. Limited to 1 day, 1 benefit(s) every 90 days. $50 $100 Hospital Stay No Elimination Period. Limited to 30 days. $100 $200 Hospital Intensive Care Unit (ICU) Stay No Elimination Period. Limited to 30 days. $200 $400 Hospital Observation Stay 24 hour Elimination Period. Limited to 72 hours. (Benefit per 24 hour period) $500 $500 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. $100 $100
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ABOUT HOSPITAL INDEMNITY This is an affordable supplemental plan that pays you should you be in patient hospital confined. This plan complements your health insurance by helping you pay for costs left unpaid by your health insurance. For full plan details, please visit your benefit website: www.mybenefitshub.com/friscoisd Hospital Indemnity Cigna EMPLOYEE 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 Who Can Elect Coverage: You: All active, full time Employees of the Employer who are regularly working in the United States a minimum of 20 hours per week and regularly residing in the United States and who are United States citizens or permanent resident aliens and their Spouse, Domestic Partner, or Civil Union Partner and Dependent Children who are United States citizens or permanent resident aliens and who are residing in the United States. You will be eligible for coverage on the first of the month following date of hire or Active YourService.Spouse/Domestic Partner: Up to age 100, as long as you apply for and are approved for coverage yourself. Your Child(ren): Birth to age 26; 26+ if disabled, as long as you apply for and are approved for coverage yourself. 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. Benefit Waiting Period:* None, unless otherwise stated. No benefits will be paid for a loss which occurs during the Benefit Waiting Period.Hospitalization
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 Hospitalconditions).ChronicCondition
Benefit Amounts Payable: Benefits for all Covered Persons are payable at 100% of the Benefit Amounts shown, unless otherwise stated. Late applicants, if allowed under this plan, may be required to provide medical evidence of insurability.
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 Hospital Intensive Care Unit Stay Benefit.
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.
Newborn Nursery Care Admission and Newborn Nursery Care 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. LowIndemnity$1500 $2500
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.
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).
Cigna EMPLOYEE
Benefit Specific Conditions, Exclusions & Limitations (Hospital Care):
Portability
Hospital Indemnity BENEFITS 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
High
Employee $14.95 $25.26 Employee + Spouse $27.74 $46.46 Employee + Child(ren) $25.31 $42.24 Family $37.66 $63.00 23
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.
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/friscoisd 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 • Stomachache • Cold • Flu • Allergies • Fever • Urinary tract infections Do not use telemedicine for serious or life threatening emergencies. MDLIVE Behavioral Health: Managing stress or life changes can be overwhelming but it’s easier than ever to get help right in the comfort of your own home. Visit a counselor or psychiatrist by phone, secure video, or MDLIVE App. • Talk to a licensed counselor or psychiatrist from your home, office, or on the go! • Unlimited, confidential online consultations for a variety of counseling needs with no copay. • The MDLIVE app helps you stay connected with appointment reminders, important notifications and secure messaging. 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 & Family $12.00 24
DPPO Plans Our dental plan helps you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work. Premium contributions are deducted from your paycheck on a pretax basis. Coverage is provided through Cigna Dental. How to Find a Dentist Visit https:// hcpdirectory.cigna.com/ or call 800 244 6224 to find an in network dentist. Your network will be Total Cigna HowDPPO.to Request a New ID YouCardcan request your dental id card by contacting Cigna directly at 800 244 6224. You can also go to www.mycigna.com and register/login to access your account. In addition, you can download the “MyCigna” app on your smartphone and access your id card right there on your phone. Cigna Dental ENHANCED 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 Policy Year Benefits Maximum Applies to: Class I, II, III & IX expenses $1,500 $1,500 Policy Year Deductible FamilyIndividual $150$50 $150$50 Benefit Highlights Plan Pays You Pay Plan Pays You Pay Class I: Diagnostic & Preventive Oral Evaluations, Prophylaxis: routine cleanings, X rays: routine, Fluoride Application, Sealants: per tooth, Space Maintainers: non orthodontic 100% No Deductible No Charge 100% No Deductible No Charge Class II: Basic Restorative Restorative: fillings, Oral Surgery: minor, X rays: non routine, Emergency Care to Relieve Pain DeductibleAfter80% 20% After Deductible DeductibleAfter80% 20% After Deductible Class III: Major Restorative Inlays and Onlays, Prosthesis Over Implant, Crowns: prefabricated stainless steel / resin, Crowns: permanent cast and porcelain, Bridges and Dentures, Oral Surgery: major, Anesthesia: general and IV sedation, Endodontics: minor and major, Periodontics: minor and major, Denture Relines, Rebases and Adjustments, Repairs: Bridges, Crowns and Inlays, Repairs: Dentures DeductibleAfter50% 50% After Deductible DeductibleAfter50% 50% After Deductible Class IV: Orthodontia Coverage for Dependent Children to age 19 Lifetime Benefits Maximum: $1,000 50% No Deductible 50% No Deductible 50% No Deductible 50% No Deductible Class IX: Implants 50% No Deductible 50% No Deductible 50% No Deductible 50% No Deductible 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/friscoisd Dental Insurance Cigna EMPLOYEE BENEFITS EnhancedDentalPPO Basic PPO Dental HMO Employee $48.86 $21.71 $10.99 Employee + Spouse $94.44 $44.22 $20.88 Employee + Child(ren) $94.44 $44.22 $20.88 Family $135.50 $76.77 $31.13 25
If you enroll in the DHMO plan, you must select a Primary Care Dentist (PCD) from the DHMO network directory to manage your care. Each eligible dependent may choose their own PCD. The Patient Charge Schedule applies only when covered dental services are performed by your network dentist. Not all Network Dentist perform all listed services and it is suggested to check with your Network Dentist in advance of receiving services. Dental services are unlimited; you pay fixed co pays, there are no deductibles and there are no claim forms to file. There is no coverage for services provided without a referral from your PCD or if you seek care from out of network providers. Please refer to link below for patient charge schedule details on your benefit website: www.mybenefitshub.com/friscoisd How do I find an In network Dentist? Visit: https://hcpdirectory.cigna.com/ or call 800 244 6224 to find an in network dentist. Your network will be Cigna Dental Care DHMO.
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Late Entrant Limitation Provision Payment will be reduced by 50% for Class III services for 12 months for eligible members that are allowed to enroll in this plan outside of the designated open enrollment period. This provision does not apply to new hires.
DHMO PLAN
Dental Insurance Cigna EMPLOYEE BENEFITS Cigna Dental BASIC 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 Policy Year Benefits Maximum Applies to: Class I, II, III & IX expenses $1,000 $1,000 Policy Year Deductible FamilyIndividual $150$50 $150$50 Benefit Highlights Plan Pays You Pay Plan Pays You Pay Class I: Diagnostic & Preventive Oral Evaluations, Prophylaxis: routine cleanings, X rays: routine, Fluoride Application, Sealants: per tooth, Space Maintainers: non orthodontic 100% No Deductible No Charge 100% No Deductible No Charge Class II: Basic Restorative Restorative: fillings, Oral Surgery: minor, X rays: non routine, Emergency Care to Relieve Pain DeductibleAfter80% DeductibleAfter20% DeductibleAfter80% DeductibleAfter20% Class III: Major Restorative Inlays and Onlays, Prosthesis Over Implant, Crowns: prefabricated stainless steel / resin, Crowns: permanent cast and porcelain, Bridges and Dentures, Oral Surgery: major, Anesthesia: general and IV sedation, Endodontics: minor and major, Periodontics: minor and major, Denture Relines, Rebases and Adjustments, Repairs: Bridges, Crowns and Inlays, Repairs: Dentures DeductibleAfter50% DeductibleAfter50% DeductibleAfter50% DeductibleAfter50% Class IX: Implants DeductibleAfter50% DeductibleAfter50% DeductibleAfter50% DeductibleAfter50% Class IX: Implants 50% No Deductible 50% No Deductible 50% No Deductible 50% No Deductible Benefit Plan Provisions Enhanced Plan Basic Plan In Network Reimbursement For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Fee Schedule or Discount Schedule. Non Network Reimbursement For services provided by a non network dentist, Cigna Dental will reimburse according to the Maximum Reimbursable Charge. The MRC is calculated at the 90th percentile of all provider submitted amounts in the geographic area. The dentist may balance bill up to their usual fees. For services provided by a non network dentist, Cigna Dental will reimburse according to the Maximum Allowable Charge. The dentist may balance bill up to their usual fees.
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/friscoisd Vision Insurance EyeMed EMPLOYEE BENEFITS Vision Care Services In Network Member Cost Out of Network Reimbursement Exam With Dilation as Necessary $10 copay Up to $35 Retinal Imaging Up to $39 N/A Frame Allowance $0 Co pay, $150 Allowance, 20% off balance over $150 Up to $70 Standard Plastic Lenses Single Vision StandardLenticularTrifocalBifocalProgressive Lens Premium Progressive Lens Tier 1 / Tier 2 / Tier 3 / Tier 4 $10 copay $10 copay $10 copay $10 copay $75 Co pay $95 Co pay $120 Co pay $95 Co pay / $105 Co pay / $120 Co pay /$75 Co pay, 80% of charge less $120 Allowance Up to $25 Up to $40 Up to $50 Up to $80 Up to $40 Up to $40 (Tier 1 4) Lense Options UV TintTreatment(Solidand Gradient) Standard Plastic Scratch Coating Standard Polycarbonate Adults Standard Polycarbonate Kids under 19 Standard Anti Reflective Coating Premium Anti Reflective Coating Tier 1 / Tier 2 / Tier Photochromic/Transitions3 Adults OtherPolarizedAdd Ons and Services $0$15$15Co pay $0$40Co pay $57$45 $68 $57 / $68 / 80% of charge 20%$75 off retail 20% off retail UpN/AN/Ato $8 UpN/Ato $20 N/AN/AN/A (Tier 1 3) N/AN/AN/A Contact Lens Fit and Follow Up (Contact lens fit and follow up visits are available once a comprehensive eye exam has been completed) Standard Contact Lens Fit & Follow Up Premium Contact Lens Fit & Follow Up Up to $55 10% off retail price N/AN/A Contact Lenses (Contact lens allowance includes materials only.) MedicallyDisposableConventionalNecessary $0 Co pay, $150 Allowance, 15% off balance over $150 $0 Co pay, $150 Allowance; plus balance over $150 $0 Co pay, paid in full Up to $88 Up to $88 Up to $210 Laser Vision Correction LASIK or PRK from U.S. Laser Network 15% off the retail price or 5% off the promotional price N/A This plan has additional discounts and features. Refer to your benefit website for complete details. Frequency Vision Eye Examination Once every 12 months Employee $8.94 Lenses or contact lenses Once every 12 months Employee + 1 $15.64 Frame Once every 12 months Family $23.34 For a complete list of in network providers near you, use our Enhanced Provider Locator on www.eyemed.com or call 1.866.804.0982 27
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/friscoisd Disability Insurance OneAmerica EMPLOYEE BENEFITS What you need to know about your Group Educator Disability Benefits Elimination Period: Maximum Benefit Duration: This is the length of time that you may be paid benefits if continuously disabled as outlined in the Precontract.Existing Condition Period: Certain disabilities are not covered if the cause of the disability is traceable to a condition existing prior to your effective date of coverage. A limited benefit will be paid if the Person's Disability begins in the first 12 months following the Person's Individual Effective Date of Insurance; and the Person's Disability is caused by, contributed to by, or the result of a condition for which the Person received medical advice or treatment in the 3 months just prior to the Person's Individual Effective Date of Insurance. Group Educator Disability Options You may select a benefit percentage of 30%, 40%, 50% or 60% of your earnings, up to a maximum monthly benefit of $7,500. Elimination Period Maximum Benefit Duration Pre Existing Condition Period Age when total disability begins Maximum Duration Option 1: 14 days / 14 days Option 2: 30 days/ 30 days Option 3: 60 days/ 60 days Option 4: 90 days /90 days Option 5: 180 days/ 180 days Less than age 60 686766656463626160 69 and over Greater of Social Security Full Retirement Age or to age 65 5 years 4 121518212.53.5yearsyears3yearsyears2yearsmonthsmonthsmonthsmonths 2 months / 12 months Disability Benefit Option Option 1 14 days/ 14 days Option 2 30 days / 30 days Option 3 60 days / 60 days Option 4 90 days / 90 days Option 5 180 days / 180 days 30% $2.58 $2.04 $1.63 $1.34 $0.99 60%50%40% 28
Flexible AD&D Options: Employee: Up to $500,000, in $10,000 increments Spouse: 60% of the employee AD&D benefit, 50% if child Child:included15% of the employee AD&D benefit, 10% if spouse included, not to exceed $30,000
Dependent Life Coverage: Optional dependent life coverage is available to eligible employees. You must select employee coverage in order to cover your spouse and/or child(ren).
EMPLOYEE BENEFITS
What you need to know about your Voluntary Term Life Benefits
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/friscoisd
You have the freedom to select an amount of life insurance coverage you need to help protect the well being of your family.
Guaranteed Increase In Benefit: You may be eligible to increase your coverage annually until you reach your maximum amount without providing evidence of insurability.
is declined, no dependent AD&D will be included. Reductions: Upon 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 schedule. Age: 65 70 Reduces to: 65% 50% Age: 65 70 Reduces to: 65% 50% Voluntary Group Life and AD&D Age perEmployee$10,000 perSpouse$5,000 0 19 $0.50 $0.25 20 24 $0.50 $0.25 25 29 $0.50 $0.25 30 34 $0.70 $0.35 35 39 $0.80 $0.40 40 44 $0.90 $0.45 45 49 $1.40 $0.70 50 54 $2.10 $1.05 55 59 $3.90 $L95 60 64 $6.oo $3.00 65 69 $11.50 $5.75 70 74 $18.50 $9.25 75+ $22.00 $11.00 Voluntary Group Life and AD&D Child(ren) Per $10,000 in coverage 0 26 $1.00 Spouse rates based on Employee's age. 29
Group term life is the most inexpensive way to purchase life insurance.
Accidental Death and 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.
Reductions: Upon reaching certain ages, your original benefit amount will reduce to the percentage shown in the following schedule. The amounts of dependent life insurance will reduce according to the employee's reduction schedule.
Guaranteed Issue: Employee: $400,000 | Spouse: $80,000 | Child: $10,000
Flexible Options: Employee: $10,000 to $500,000, in $10,000 increments, not to exceed 7 times your annual salary Spouse: $5,000 to $200,000, in $5,000increments, not to exceed 100% of the employee's amount
Life and AD&D OneAmerica ABOUT LIFE AND AD&D
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.
AD&D Guaranteed Issue: Employee: $500,000 | Spouse: $300,000 | Child: $30,000
What you need to know about your Voluntary AD&D Benefits
Dependent 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
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/friscoisd Cancer Insurance APL EMPLOYEE BENEFITS 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 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.mybenefitshub.com/friscoisd Pre Existing Condition Exclusion: Review the Benefit Summary page that can be found at www.mybenefitshub.com/friscoisd for full details. *Carcinoma in situ is not considered internal cancer Benefit Highlights Low High Internal Cancer First Occurrence* $2,500 $2,500 Cancer Treatment Policy Benefits Radiation and Chemotherapy, Immunotherapy Maximum Per 12 month period $10,000 $20,000 Hormone MaximumTherapyof12treatments per calendar year $50 per treatment $50 per treatment Surgical Rider Benefits Surgical $30 unit dollar amount Max $3,000 operationper $45 unit dollar amount Max $4,500 operationper 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 Heart Attack/Stroke First Occurrence Rider Benefits Lump Sum Benefit Maximum per 1 covered person per lifetime $2500 $2500 Hospital Intensive Care Unit Rider Benefits Intensive Care Unit $600 per day $600 per day Cancer Low High Employee Only $16.92 $23.08 Employee and Spouse $32.04 $43.14 Employee and Child(ren) $21.78 $39.34 Employee and Family $34.72 $46.52 30
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.mybenefitshub.com/friscoisd Critical Illness Insurance Unum EMPLOYEE BENEFITS 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/ friscoisd 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 For your Spouse and Children: 50% 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 illness conditions are covered? 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% CancerInvasive Cancer (including all Breast Cancer) 100% Non Invasive Cancer 25% Skin Cancer $500 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
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 $5,000
Illness Age Employee $10,000 Spouse
Critical Illness Insurance Unum EMPLOYEE BENEFITS Progressive DiseasesWhat critical illness conditions are covered? (cont’d) Amyotrophic Lateral 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% * Please refer to the policy for complete definitions of covered conditions. Are wellness Screenings covered? Each insured is eligible to receive one Be Well Benefit per calendar year. Be Well Benefit For you, your spouse and your children: $50 Be Well Screenings include tests for the following: cholesterol and diabetes, cancer and cardiovascular function. They also include imaging studies, immunizations and annual examinations by a Physician. See certificate for details. 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: • a pre existing condition; or • complications arising from treatment or surgery for, or medications taken for, a pre existing condition. 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: • medical treatment, consultation, care or services, or diagnostic measures were received or recommended to be received during that period; • drugs or medications were taken, or prescribed to be taken during that period; or • symptoms existed.
Less than age 25 $1.90 $0.95 25 29 $2.70 $1.35 30 34 $3.80 $1.90 35 39 $5.70 $2.85 40 44 $8.00 $4.00 45 49 $11.00 $5.50 50 54 $14.30 $7.15 55 59 $19.80 $9.90 60 64 $28.30 $14.15 65 69 $41.50 $20.75 70 74 $65.30 $32.65 75 79 $96.80 $48.40 80 84 $0.00 $0.00 85 or over $228.90 $114.45 32
For
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.
*Quality
CONVENIENCE Easy payments through payroll deduction.
*Financially dependent children 14 days to 23 years old.
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: Permanent inability to perform at least two of the six Activities of Daily Living (ADLs) without substantial assistance; or Permanent severe cognitive impairment, such as dementia, Alzheimer’s disease and other forms of senility, requiring substantial supervision. full details and rates 5Star directly at (866) 863 9753. of Life not available ages 66 70. Quality of Life benefits not available for children
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).
FAMILY PROTECTION Coverage is available for spouses and financially dependent children, even if the employee doesn’t elect coverage on themselves.
www.mybenefitshub.com/friscoisd Individual Life Insurance 5Star EMPLOYEE BENEFITS 33
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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.
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.
ABOUT LIFE 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. full details, please visit your benefit website:
plan
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Individual
Shouldwww.mybenefitshub.com/friscoisdat:youneedtofileaclaim,contact
Find
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.
INDIVIDUAL
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/friscoisd Identity Theft Identity Guard EMPLOYEE BENEFITS Help protect yourself with the most, comprehensive identity theft protection available today. Identity Guard combines the best of traditional identity theft monitoring solutions, with the powerful processing of IBM Watson technology. We scan billions of online sources to assess your risk and suggest ways to reduce your exposure. Did You Know? • ID theft happens every two seconds • Account takeover fraud tripled in 2018 • 16.7M victims in 2017 Personal Cybersecurity to Alert You to: 1. Personal habits that put you at greater risk than the average person 2. Threats due to companies getting hacked and losing your personal information, phishing scams, and more 3. Your personal information being used to open new accounts and access existing accounts We Work Around the Clock to Help Protect You • Dedicated Support: Makes a stressful situation as easy as possible to resolve. • $1 Million Insurance with Stolen Funds Reimbursement: You are covered from any losses or stolen funds. • Cover the Entire Household: Family plans cover all adults and children residing within your household. • Leading Technology: Alerts in as few as three seconds, billions of pieces of information monitored, and IBM Watson artificial intelligence (AI) technology. All Plans Include (1TOTALBureau) (3Bureau)PREMIER IBM Watson AI ✓ ✓ $1 Million insurance with stolen funds reimbursement ✓ ✓ U.S. based customer care ✓ ✓ Risk management score ✓ ✓ Online identity dashboard ✓ ✓ Mobile application ✓ ✓ We’ll Alert You Of Your personal information on the dark web ✓ ✓ High risk transactions like account takeovers and tax refunds ✓ ✓ Potential threats detected by IBM Watson AI ✓ ✓ Requests to open checking or savings accounts with your information ✓ ✓ Monthly credit score ✓ ✓ Credit Bureau Monitoring ✓ ✓ Bank account takeovers ✓ ✓ 3 bureau credit report ✓ Additional Tools for Protection Anti phishing mobile app ✓ ✓ Safe browsing extension ✓ ✓ Social insight report ✓ Family Plan Additional Features Your child’s information on the dark web ✓ ✓ Cyberbullying on social media ✓ ✓ Identity Theft TOTAL PREMIER Employee $7.70 $9.60 Employee and Family $13.55 $17.40 34
Emergentaccount.
For
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. full plan details, please visit your benefit website: www.mybenefitshub.com/friscoisd
ABOUT MEDICAL TRANSPORT
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
Should you need assistance with a claim contact MASA at 800 643 9023. You can find full benefit details at: 35
Emergency Medical Transport
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 SupposeRepatriation/Recuperationfacilities.youorafamilymember
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
MASA EMPLOYEE BENEFITS
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
Air Transportation
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.
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Our service is tailored to your needs. With network attorneys available in person, by phone, or by email and online tools to do it yourself or plan your next move we make it easy to get legal help. And, you will always have a choice in which attorney to use. You can choose one from our network of prequalified attorneys, or use an attorney outside of our network and be reimbursed some of the cost. Best of all, you have unlimited access to our attorneys for all legal matters covered under the plan. For a monthly premium conveniently paid through payroll deduction, an expert is on your side as long as you need them.
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Legal plans provide benefits that cover the most common legal needs you may encounter like creating a standard will, living will, healthcare power of attorney or buying a home. plan details, please visit your benefit website:
ABOUT LEGAL SERVICES
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You may be thinking why would top attorneys need or want to join a legal plan network? But even experienced attorneys need to grow their practice. By providing exceptional service to you and other plan members, they can gain more clients through your referrals. That’s how we’ve established a large network of highly experienced attorneys, averaging 25 years of experience. Reduce the out of pocket cost of legal services with MetLife Legal Plans. How it works
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When you need help with a personal legal matter, MetLife Legal Plans is there for you to help make it a little easier. For additional protection, your spouse and dependent children are also covered.
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For full
Our attorneys are here to help when you’re: Getting married Buying or selling a home Starting a family Dealing with identity theft Sending kids off to college Caregiving for aging parents And more Helping you navigate life’s planned and unplanned events. For $19.50 a month, you get legal assistance for some of the most frequently needed personal legal matters with no waiting periods, no deductibles and no claim forms, when using a network attorney for a covered matter.
Legal experts on your side, whenever you need them Quality legal assistance can be pricey. And it can be hard to know where to turn to find an attorney you trust. For a monthly fee, you can have a team of top attorneys ready to help you take care of life’s planned and unplanned legal events.
www.mybenefitshub.com/friscoisd Legal Services MetLife EMPLOYEE BENEFITS
To learn more, visit info.legalplans.com and enter access code 9310010 or call 800.821.6400 Monday Friday 8:00 am 8:00 pm (ET).
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MetLife Legal Plans, formerly known as Hyatt Legal Plans, gives you access to experts who can assist you with a broad range of personal legal needs you might face throughout your life. This could be when you’re buying or selling a home, starting a family, dealing with identity theft, or caring for aging parents.
Legal Services MetLife EMPLOYEE BENEFITS Money Matters • Debt Collection Defense • Identity Theft Defense • Negotiations with Creditors • Personal Bankruptcy • Promissory Notes • Tax Audit Representation • Tax Collection Defense Home & Real Estate • Boundary & Title Disputes • Deeds • Eviction Defense • Foreclosure • Home Equity Loans • Mortgages • Property Tax Assessments • Refinancing of Home • Sale or Purchase of Home • Security Deposit Assistance • Tenant Negotiations • Zoning Applications Estate Planning • Codicils • Complex Wills • Healthcare Proxies • Living Wills • Powers of Attorney (Healthcare, Financial, Immigration)Childcare, • Revocable & Irrevocable Trusts • Simple Wills Family & Personal • Adoption • Affidavits • Conservatorship • Demand Letters • Divorce 20 hours • Enforcement or Modification of Support Order • Garnishment Defense • Guardianship • Immigration Assistance • Juvenile Court Defense, Including Criminal Matters • Name Change • Parental Responsibility Matters • Personal Property Protection • Prenuptial Agreement • Protection from Domestic Violence • Review of ANY Personal Legal Document • School Hearings Civil Lawsuits • Administrative Hearings • Civil Litigation Defense • Disputes Over Consumer Goods & Services • Incompetency Defense • Pet Liabilities • Small Claims Assistance Elder Care Issues Consultation & Document Review for your parents: • Deeds • Leases • Medicaid • Medicare Notes • Nursing Home Agreements • Powers of Attorney • Prescription Plans • Wills Vehicle & Driving • Defense of Traffic Tickets2 • Driving Privileges Restoration • License Suspension Due to DUI • Repossession E Services • Attorney Locator • Financial Planning • Insurance Resources • Law Firm E Panel • Self Help Legal Documents 37
ABOUT RETIREMENT PLANS A 403(b) plan is a U.S. tax advantaged retirement savings plan available for public education organizations. A 457(b) plan is a tax deferred compensation plan provided for employees of certain tax exempt, governmental organizations or public education institutions. For full plan details, please visit your benefit website: www.mybenefitshub.com/friscoisd Retirement Plan - 403(b) TCG EMPLOYEE BENEFITS Frisco ISD Summary Plan Description Plan Type Plan Administrator Excluded Employees Internal Revenue Code Section 403(b) TCG Administrators None Plan Password for Enrolling Online Written Plan Effective Date Plan Year End frisc403 if enrolling for Pre tax fri403xR if enrolling for Roth 1/1/2009 12/31 Contribution Tax Treatment Contribution Sources Roth 403(b) Pre Tax Employee Only Available Contribution Limit Catch Up Contribution Limit Automatic Enrollment $18,000 per year Available for Age 50+ Only Not Available Exchanges in Plan Transfers Into Plan Transfers Out of Plan Available only with companies listed in Appendix I Available from another employers 403(b) plan Not Available Distributions Loans Automatic Distributions Available under the following conditions: Separation of Service, Death, Disability, or Retirement Available, subject to availability and any additional conditions applied by individual vendors Not available Hardship Disability Beneficiaries Available if request meets IRS definition pursuant to§ 1.401(k) l(d)(3)(iii)(B) of the Income Tax Regulations Designated by each vendor and not by the 403(b) plan. Designated by each vendor and not by the 403(b) plan. Administrative Fees Fees Paid By: $1.50 per 403(b) participant per month Employer For more information please contact TCG Administrators, the Plan Administrator, at 1 800 943 9179 38
ABOUT RETIREMENT PLANS A 403(b) plan is a U.S. tax advantaged retirement savings plan available for public education organizations. A 457(b) plan is a tax deferred compensation plan provided for employees of certain tax exempt, governmental organizations or public education institutions. For full plan details, please visit your benefit website: www.mybenefitshub.com/friscoisd Retirement Plan - 457(b) TCG EMPLOYEE BENEFITS Frisco ISD Summary Plan Description Plan Type Plan Administrator Excluded Employees Internal Revenue Code Section 457(b) TCG Administrators None Plan Password for Enrolling Online Written Plan Effective Date Plan Year End frisc457 07/01/2007 2016 Contribution Tax Treatment Contribution Sources Pre Tax Employee Only Contribution Limit Catch Up Contribution Limit $18,000 per year Available for Age 50+ Only Rollovers Into Plan Rollovers Out of Plan Available from another qualified plan Available to another qualified plan, upon termination of service Distributions Unforeseeable Emergency Distributions Inactivity Distributions Available for the following: Separation Death Disability Available as defined by the IRS for this type of plan Available for accounts with balances of less than $5,000, and no activity for 2 years Loans Beneficiaries Grandfathered Vendors Available, see the Loan Agreement and Application Form A Designation of Beneficiary Form is only required if Spouse is not the Primary Beneficiary AUL/ One Source (contact AUL regarding any questions about the fees for these accounts)* Fees of Service Plan Providers TCG Administrators, TPA $18.50 per participants per year 0.25% of assets, paid by the participants TCG Advisors, Investment Advisor Sliding Scale (0.45% 0.25%), currently 0.35%, paid by participant Other Fees $30 Distribution Fee $50 Loan Set Up All of the above paid by participant Matrix 0.10%,Custodian/TrusteeTrustpaidbyparticipant ESC Region 10, Plan Coordinator $0.10 per participant per month, paid by participant For more information please contact TCG Administrators, the Plan Administrator, at 1 800 943 9179 39
Frisco ISD Summary Plan Description Plan Type Plan Administrator Eligible Employees Internal Revenue Code Section 401(a) TCG Administrators Employees who contribute to a 403(b) or 457(b) with Frisco ISD Online Account Access Written Plan Effective Date Plan Year End To view your account online: go to www.region10rams.org • click “Login” and select your Employer from the navigation bar • Under the 401(a) tab, click “Login” • The User ID is your SSN; the Password is your date of birth (mmddyyyy) 9/1/2006 12/31 Matching Contribution Rules Vesting Effective September 1, 2011, the Employer will match any contribution made to a 403(b) or 457(b) on behalf of the participant into the 401(a) account: Base Match is 25% of contribution up to 1% of Base Salary Contributions made to a Plan Participant’s account are subject to vesting requirements (the ownership of the contributions and earnings). The following schedule shows when a Participant will become the owner of the account balance. Years of Service Vesting % Yr 1 Yr 2 Yr 3 Yr 4 Yr 5 0% 0% 50% 75% 100% Distributions Loans Automatic Distributions Available for the following conditions: In Service, Separation of Service, Death, Disability, or Retirement Not Available Not Available Hardship Disability Beneficiaries Not Available Determined by TRS Record Keeper TCG Administrative Fees TCG Administrators Record Keeper $1.40 per participant per month Paid by Frisco ISD ESC Region 10 Plan Coordinator $.10 per participant per month, paid by Frisco ISD TCG Advisors, LP Investment SlidingAdvisorScale (.45% .25% of assets) Currently .40% Paid from plan assetsMatrix Trust Custodian .10% of assets paid by plan assets Distribution Fee $30, paid by the participant For more information please contact TCG Administrators, the Plan Administrator at 1 800 943 9179 ABOUT RETIREMENT PLANS A 403(b) plan is a U.S. tax advantaged retirement savings plan available for public education organizations. A 457(b) plan is a tax deferred compensation plan provided for employees of certain tax exempt, governmental organizations or public education institutions. For full plan details, please visit your benefit website: www.mybenefitshub.com/friscoisd Retirement Plan - 401a TCG EMPLOYEE BENEFITS 40
Highlights Include:
Wellness
For
A Program is designed to assist in improving your overall health and wellness. full plan details, please visit your benefit website: www.mybenefitshub.com/friscoisd
BCBS Wellness Programs (for those enrolled in the TRS Health coverage)
Includes the following services: Pregnancy Planning & Support, Total Wellness, Mental Health guide, Musculoskeletal HealthInformation on all available wellness options, the Employee Clinic, Wellness Connections newsletter and calendar events are outlined on Wellness website https://sites.google.com/friscoisd.org/fisdwellness/homeat:
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ABOUT FRISCO ISD WELLNESS PROGRAMS
Frisco ISD believes that financial wellness is a key part of overall wellness. The District provides free financial wellness resources to all employees via FinPath. Employees can schedule 1:1 time with a financial expert, access articles and videos, and attend workshops at no cost.
Employee EmployeesCliniccanreceive care at an onsite clinic and virtually, with virtual care available 24/7. The goal of the FISD Employee Clinic, made possible through an agreement with Children’s Health, is to reduce healthcare costs and improve access to quality care for all FISD employees. Employees are eligible whether they are insured through the District or not.
Frisco ISD’s Employee Assistance Program (EAP), provides a holistic assessment of and response to each employee’s needs. Through an extensive provider network, ComPsych supports employees through challenges and helps them prepare for the future. FISD employees can access articles and tips, videos, and experts at no cost.
Social Emotional
Frisco ISD Wellness Programs Frisco ISD EMPLOYEE BENEFITS
Physical Fitness Options include the Frisco and McKinney YMCA location, the Frisco Athletic Center, BCBS Fitness, Cigna Virtual Workouts and partial reimbursement for participation at the qualified facility of your choice.
Financial Wellness
Frisco ISD provides opportunities for employees to engage and grow in all areas of wellness including but not limited to physical, social emotional and financial.
Frisco ISD also provides retirement planning services to FISD employees at no cost. TCG advisors can work 1 on 1 with employees to set up retirement accounts (457b, 403b), educate about rollover options and investing, and create a plan based on unique retirement goals.
TCG Group Holdings 900 South Capital of Texas Hwy, Suite 350 Austin, TX 78746 943
As an FISD employee, you are eligible to participate in these plans through salary deferral. Please visit http:// tcgservices.com for detailed information and enrollment instructions or contact the FISD Third Party Administrator:
800
Sick Leave Bank
For full plan details, please visit your benefit website: www.mybenefitshub.com/friscoisd Miscellaneous FISD EMPLOYEE BENEFITS
9179 42
When an employee with ten or more years of service with FISD officially retires from the Teacher Retirement System of Texas and is no longer employed by the District, the employee shall be reimbursed for unused, accumulated State and Local leave days at a rate of $50.00 per day not to exceed a maximum of $5,000.00.
This is to inform you that Frisco ISD offers 403B and 457 Voluntary Retirement plans to its employees. These plans allow employees to save designated amounts of their paychecks before tax and place them into a variety of mutual funds, variable annuities and fixed annuities. All funds grow tax deferred until withdrawn and are intended to supplement your TRS Pension Plan.
Retirement Benefit/State & Local Days
The purpose of the Sick Leave Bank is to provide additional sick leave to members of the Bank in the event of a serious extended illness, surgery, or a temporary disability due to an injury. Days may be requested from the Bank only after the member has exhausted all accumulated state and local sick leave days. All District employees who work a minimum of 20 hours per week and are in an allocated budgetary position are eligible for membership. Membership in the Sick Leave Bank is voluntary. To become a member of the bank, an employee must contribute three days from his/her accrued local leave. Please visit the Resource Center at www.friscoisd.org/staff and search for Sick Leave Bank to review the official handbook that includes detailed information on eligibility, joining and applying for leave days. 403B/457 Voluntary Retirement Information
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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 Frisco 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.
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 Frisco 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.
2022 - 2023 PlanYear
WWW.MYBENEFITSHUB.COM/FRISCOISD
