2022-23 Huntsville ISD Benefit Guide

HUNTSVILLE ISD BENEFIT GUIDE EFFECTIVE: 09/01/2022 8/31/2023 WWW.MYBENEFITSHUB.COM/HUNTSVILLEISD 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 Hospital Indemnity 20 Telehealth 21 Dental 22 Vision 23 Disability 24-25 Cancer 26-27 Accident 28 Critical Illness 29-30 Life and AD&D 31 Individual Life 32 Emergency Medical Transportation 33 Identity Theft 34 Flexible Spending Account (FSA) 35-36 HOW TO ENROLLPG. 4 SUMMARYPAGESPG. 6 BENEFITSYOURPG. 12 2

HUNTSVILLE ISD BENEFITS TRS ACTIVECARE MEDICAL HEALTH SAVINGS ACCOUNT (HSA) Financial Benefit Services (800) 583 www.mybenefitshub.com/huntsvilleisd6908 (866)BCBSTX355 www.bcbstx.com/trsactivecare5999 HSA (800)Bank357 www.hsabank.com6246 HOSPITAL INDEMNITY TELEHEALTH DENTAL American Public Life (800) 256 www.ampublic.com8606 (888)MDLIVE365 www.mdlive.com/fbs1663 (800)Cigna244 www.cigna.com6224 VISION DISABILITY CANCER Superior Vision (800) 507 www.superiorvision.com3800 The www.thehartford.com(866)Hartford5479124 American Public Life (800) 256 www.ampublic.com8606 ACCIDENT CRITICAL ILLNESS LIFE AND AD&D American Public Life (800) 256 www.ampublic.com8606 (800)Voya 955 www.voya.com7736 (800)Cigna244 www.cigna.com6224 INDIVIDUAL LIFE EMERGENCY TRANSPORTATIONMEDICAL IDENTITY THEFT 5Star Life Insurance (866) 863 www.5starlifeinsurance.com9753 (800)MASA423 www.masamts.com3226 ID www.idwatchdog.com(800)Watchdog7743772 FLEXIBLE SPENDING ACCOUNT (FSA) EAP flexservices.higginbotham.net(866)Higginbotham4193519 (888)Lifeworks456 http://login.lifeworks.com1324 Benefit Contact Information 3

Employee benefits made easy through the FBS Benefits App! AllYour BenefitsOne App OR SCAN Text “FBS HISD” to (800) 583-6908 App Group #: FBSHISD Text “FBS HISD” 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/huntsvilleisd How to Log In 2 CLICK LOGIN 3 ENTER USERNAME & PASSWORD Your Username Is: he first six (6) characters of your last name, followed by the first letter of your first name, followed by the last four (4) digits of your Social Security Number Your Password Is: Your last name followed by the last four (4) digits of your Social Security Number If you have previously logged in, you will use the password that you created, NOT the password format listed above. 5

Benefit Updates What’s New: Don’t Forget! • Login and complete your benefit enrollment from 7/11/2022 8/15/2022. • Enrollment assistance is available by calling Financial Benefit Services at (866) 914 5202 to speak to a representative. Hours are Monday Friday, 8am 6pm CST. • Update your profile information: home address, phone numbers, email. • Update dependent social security numbers and student status for college aged children. SUMMARY PAGESAnnual Benefit Enrollment New Educator Disability Carrier The Hartford All who have been enrolled in the current Unum Educator DI plan will have continuity of coverage at your same benefit level. New coverage or increases to existing coverage will be subject to pre existing condition limitations within the first 12 months of the new plan. However, this plan will pay up to 1 month of benefits for pre existing conditions. NEW! FLEXIBLE ACCOUNT ADMINISTRATOR Higginbotham FSAs will now be administered by Higginbotham all employees who enroll will receive a new debit card. Employees are encouraged to use up current year funds prior to September 1st to ease the transition to Higginbotham. 6

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

Marital Status

Section 125 Cafeteria Plan Guidelines SUMMARY PAGESAnnual Benefit Enrollment CHANGES

A change in number of dependents includes the following: birth, adoption and placement for adoption. You can add existing dependents not previously enrolled whenever a dependent gains eligibility as a result of a valid change in status event.

Change in Status of Employment Affecting Coverage Eligibility

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

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.

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

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.

Change in Number of Tax Dependents

Judgment/Decree/Order

If a judgment, decree, or order from a divorce, annulment or change in legal custody requires that you provide accident or health coverage for your dependent child (including a foster child who is your dependent), you may change your election to provide coverage for the dependent child. If the order requires that another individual (including your spouse and former spouse) covers the dependent child and provides coverage under that individual's plan, you may change your election to revoke coverage only for that dependent child and only if the other individual actually provides the coverage.

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.

Gain/Loss

(CIS):STATUS QUALIFYING

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.

Eligibility for Government Programs

EligibilityDependents'ofStatus

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

SUMMARY PAGESAnnual Benefit Enrollment 8

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

• Employees must confirm on each benefit screen (medical, dental, vision, etc.) that each dependent to be covered is selected in order to be included in the coverage for that particular benefit.

For benefit summaries and claim forms, go to the Huntsville ISD benefit www.mybenefitshub.com/huntsvilleisdwebsite:. 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?

Howsection.can I find a Network Provider?

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

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 31 days of benefit eligible 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/ huntsvilleisd. Click the benefit plan you need information on (i.e., Dental) and you can find the forms you need under the Benefits and Forms

Q&A Who do I contact with Questions?

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

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.

Where can I find forms?

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

Annual Benefit Enrollment

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 Dental Through 25 Vision Through 25 Life Through 25 IndemnityHospital Through 25 Cancer Through 25 Accident Through 25 Critical Illness Through 25 Telehealth Through 25 ID Theft Through 25 AD&D Through 25 Individual Life Through 23

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

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

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

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

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.

Employee RequirementsEligibility

SUMMARY PAGES

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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.

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

Calendar Year

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).

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

After

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

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

Actively at Work

Guaranteed

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.

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.

September

SUMMARY PAGESHelpful Definitions 10

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. However, your employer’s plan contains a $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. 35 11

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/huntsvilleisd Medical Insurance TRS EMPLOYEE BENEFITS Monthly Premium District Contribution Employee Cost TRS ActiveCare HD Employee Only $415.00 $300.00 $115.00 Employee & Spouse $1,166.00 $300.00 $866.00 Employee & Child(ren) $744.00 $300.00 $444.00 Employee & Family $1,394.00 $300.00 $1,094.00 TRS ActiveCare Primary Employee Only $402.00 $300.00 $102.00 Employee & Spouse $1,133.00 $300.00 $833.00 Employee & Child(ren) $723.00 $300.00 $423.00 Employee & Family $1,356.00 $300.00 $1,056.00 TRS ActiveCare Primary+ Employee Only $505.00 $300.00 $205.00 Employee & Spouse $1,234.00 $300.00 $934.00 Employee & Child(ren) $812.00 $300.00 $512.00 Employee & Family $1,552.00 $300.00 $1,252.00 TRS ActiveCare 2 Employee Only $1,013.00 $300.00 $713.00 Employee & Spouse $2,402.00 $300.00 $2,102.00 Employee & Child(ren) $1,507.00 $300.00 $1,207.00 Employee & Family $2,841.00 $300.00 $2,541.00 12

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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

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.

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www.mybenefitshub.com/huntsvilleisd

You are eligible to open and contribute to an HSA if you are: Enrolled in an HSA eligible HDHP (AC HD)

• Not enrolled in Medicare or TRICARE

Health Savings Account (HSA)

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

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

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Important HSA Information

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:

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.

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How to Use your HSA

• myHealth PortfolioSM Track your healthcare expenses, manage receipts and claims from multiple providers, and view expenses by provider, description, and more.

For

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.

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

• Not receiving Veterans Administration benefits

• HSA Bank Mobile App Download to check available balances, view HSA transaction details, save and store receipts, scan items in store to see if they’re qualified, and access customer service contact information.

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

If you meet the eligibility requirements, you may open an HSA administered by HSABank. 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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A Health Savings Account (HSA) is more than a way to help you and your family cover health care costs it is also a tax exempt tool to supplement your retirement savings and cover health expenses during retirement. An HSA can provide the funds to help pay current health care expenses as well as future health care costs.

A 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.

• Account preferences Designate a beneficiary, add an authorized signer, order additional debit cards, and keep important information up to date. Access online at: http://www.hsabank.com

HSA Bank EMPLOYEE BENEFITS

HSA Eligibility

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

you elect: Individual $3,650 Family (filing jointly) $7,300

ABOUT HSA

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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

Opening an 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.

Maximum Contributions

Hospital Confinement Benefit Pays a per day benefit when a covered person is confined as an inpatient to a hospital due to an injury or covered sickness.

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Hospital Admission Benefit Pays a benefit when a covered person is admitted and confined as an inpatient in a hospital due to an injury or covered sickness. APL will not pay this benefit for outpatient treatment, emergency room treatment or a stay less than 18 hours in an observation unit. This benefit is only payable once per period of confinement. A hospital is not an institution, or part thereof, used as a place for rehabilitation, a place for rest or for the aged, a nursing or convalescent home, a long term nursing unit or geriatrics ward or an extended care facility for the care of convalescent, rehabilitative or ambulatory patients.

Rehabilitation Benefit Pays a per day benefit when a covered person is receiving rehabilitation care services while confined in a rehabilitation unit or skilled nursing facility immediately after a covered period of confinement due to an injury or covered sickness. This benefit is not payable in addition to any other confinement benefit provided under the policy on the same day. If more than one confinement occurs on the same day, the higher benefit will be paid.

* Total premium includes the Plan selected and any applicable rider premium.

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/huntsvilleisd Hospital Indemnity APL EMPLOYEE BENEFITS Plan 1 HSA Compatible Monthly Premiums Ages 18+ Individual Individual & Spouse Individual & Child(ren) Individual & Family Plan 1 $15.98 $37.05 $20.55 $38.45 Plan 2 $22.40 $46.60 $25.40 $49.85 Summary of Benefits Plan 1 Plan 2 Hospital Admission Benefit $1,500 per day; maximum of 1 day $2,500 per day; maximum of 1 day Hospital Confinement Benefit $200 per day; maximum of 30 days $200 per day; maximum of 30 days Intensive Care Unit Benefit $200 per day; maximum of 30 days $200 per day; maximum of 30 days Rehabilitation Benefit $200 per day; maximum of 5 days $200 per day; maximum of 5 days Additional Rider Portability Rider Included Included Huntsville ISD MedChoice Hospital Indemnity Benefits Benefits are per day, up to the maximum number of days per calendar year, per covered person. Benefit amounts may vary based upon place of service. Benefits will only be paid for a covered loss incurred while covered under the certificate. A covered person is a person who is eligible for coverage under the certificate and for whom the coverage is in force. An eligible dependent means your lawful spouse; your natural, adopted or stepchild who is under the age of 26; and/or any child under the age of 26 who is under your charge, care and control, and who has been placed in your home for adoption, or for whom you are a party in a suit in which adoption of the child is sought; or any child under the age of 26 for whom you must provide medical support under an order issued under Chapter 154 of the Texas Family Code, or enforceable by a court in Texas; or grandchildren under the age of 26 if those grandchildren are your dependents for federal income tax purposes at the time application for coverage of the grandchild is made.

Intensive Care Unit Benefit Pays a per day benefit when a covered person is confined in an ICU due to an injury or covered sickness. Benefits will be paid beginning the first day of ICU confinement when the ICU confinement begins after the covered person’s effective date.

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/huntsvilleisd 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. 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. Telehealth Employee and Family $10.00 21

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/huntsvilleisd Dental Insurance Cigna EMPLOYEE BENEFITS Dental Coverage 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. DPPO Plan Two levels of benefits are available with the DPPO plan: in network and out of network. You may select the dental provider of your choice, but your level of coverage may vary based on the provider you see for services. You could pay more if you use an out of network provider. Dental schedule of benefits Plan Low High Plan Deductible Annually on a Plan Year Basis Contracted Dentist Non Contracted Dentist Contracted Dentist Non Contracted Dentist Individual $50 $50 $50 $50 Family $150 $150 $150 $150 Deductible applies to: Type 2 & 3 Type 2 & 3 Type 2 & 3 Type 2 & 3 Benefit Levels Type 1 Diagnostic & Preventative 100% 100% 100% 100% Type 2 Basic Services 70% 70% 80% 80% Type 3 Major Services 50% 50% 50% 50% Type 4 Orthodontic Services 50% 50% Maximum Benefit (per covered person): Types 1, 2 & 3 combined $750 Per Plan Year $750 Per Plan Year $1,250 Per Plan Year $1,250 Per Plan Year Type 4, while covered by the plan Not Covered Not Covered $1,000 Lifetime $1,000 Lifetime Progressive Maximum Benefit: Progressive Benefit Year 2: Increase contingent upon receiving Preventive Services in Plan Year 1. Progressive Benefit Year 3: Increase contingent upon receiving Preventive Services in Plan Years 1 and 2. Progressive Benefit Year 4: Increase contingent upon receiving Preventive Services in Plan Years 2 and 3Progressive Benefit Year 4: Increase contingent upon receiving Preventive Services in Plan Years 2 and 3 Dental Low High Employee Only $32.94 $38.22 Employee and Spouse $71.38 $82.83 Employee and Child(ren) $60.40 $70.09 Employee and Family $93.34 $108.31 22

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/huntsvilleisd Vision Insurance Superior Vision EMPLOYEE BENEFITS Vision Copays Frequency Employee Only $9.53 Exam $10 Exam 12 months Employee and Spouse $16.22 Materials1 $25 Frame 12 months Employee and Child(ren) $17.17 Contact lens fitting $25 Contact lens fitting 12 months Employee and Family $25.76 (standard & specialty) Lenses 12 months Contact lenses 12 months (based on date of service) 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 Scratch coat Covered in full Not covered Ultraviolet coat Covered in full Not covered 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 Discounts on covered materials5 These discounts apply to the glasses and contacts that are covered under the vision benefits. Frames: 20% off amount over allowance Conventional contacts: 20% off amount over allowance Disposable contact: 10% off amount over allowance Discounts on non covered exam, services and materials5 Exams, frames, and prescription lenses: 30% off retail Contacts, miscellaneous options: 20% off retail Disposable contact lenses: 10% off retail Retinal imaging: $39 maximum out of pocket Laser vision correction (LASIK)5 Laser vision correction (LASIK) is a procedure that can reduce or eliminate your dependency on glasses or contact lenses. This corrective service is available to you and your eligible dependents at a special discount (20 50%) with your Superior Vision plan. Contact QualSight LASIK at (877) 201 3602 for more information. Hearing discounts5 Lens type* Member out of pocket5 Tints, solid Tints, gradient BluePolycarbonatelightfiltering Digital single vision Progressive AntiStandard/Premium/Ultra/UltimatelensesreflectivecoatingStandard/Premium/Ultra/UltimatePolarizedlensesPlasticphotochromiclenses $15$18 $15$40 $30 $55 / $110 / $150 / $225 $50 / $70 / $85 / $120 $80$75 Discount features superiorvision.com(800)5073800 23

www.mybenefitshub.com/huntsvilleisd Disability Insurance The Hartford EMPLOYEE BENEFITS

Insurance?

Only 50% of American adults indicate they have enough savings to cover three months of living expenses in the event they’re not earning any income3 3 Federal Reserve, Report on the Economic Well Being of U.S. Households in 2018

The average worker faces a 1 in 3 chance of suffering a job loss lasting 90 days or more due to a disability2 2 Facts from LIMRA, 2016 Disability Insurance Awareness Month

ELIGIBILITY AND ENROLLMENT Eligibility

Educator Disability insurance combines the features of a short term and long term disability plan into one policy. The coverage pays you a portion of your earnings if you cannot work because of a disabling illness or injury. The plan gives you the flexibility to choose a level of coverage to suit your need. You have the opportunity to purchase Disability Insurance through your employer. This highlight sheet is an overview of your Disability Insurance. Once a group policy is issued to your employer, a certificate of insurance will be available to explain your coverage in detail.

For

Effective

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.

ABOUT DISABILITY

Enrollment You

Disability per $200 in benefit 14/14 30/30 60/60 90/90 180/180 $7.20 $5.40 $4.44 $3.04 $2.80 $2.20

Plan 1

Disability insurance protects one of your most valuable assets, your paycheck. This insurance will replace a portion of your income in the event that you become physically unable to work due to sickness or injury for an extended period of time. full plan details, please visit your benefit website:

More than half of all personal bankruptcies and mortgage foreclosures are a consequence of disability1 1 Facts from LIMRA, 2016 Disability Insurance Awareness Month

Elimination Period 0/7

You are eligible if you are an active employee who works at least 20 hours per week on a regularly scheduled basis. can enroll in coverage within 31 days of your date of hire or during your annual enrollment period. Date Coverage goes into effect subject to the terms and conditions of the policy. You must satisfy the definition of Actively at Work with your employer on the day your coverage takes effect.

Why do I need Disability Insurance Coverage?

OVERVIEW

What is DisabilityEducatorIncome

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EDUCATOR DISABILITY INSURANCE

In

you

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Benefit

Disability

The PLAN Amount

Age Disabled Maximum Benefit Duration Prior to 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 Pre Existing Condition Limitation Your policy limits

You may purchase coverage that will pay you a monthly flat dollar benefit in $100 increments between $200 and $8,000 that cannot exceed 66 2/3% of your current monthly earnings.

Maximum Benefit Duration Benefit Duration is the maximum time for which we pay benefits for disability resulting from sickness or injury. Depending on the schedule selected and the age at which disability occurs, the maximum duration may vary. Please see the applicable schedules below based on your election of the Premium benefit option.

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.

Hartford EMPLOYEE BENEFITS FEATURES OF THE

Earnings are defined in The Hartford’s contract with your employer.

Premium Option: For the Premium benefit option the table below applies to disabilities resulting from sickness or injury. the benefits can receive for a disability caused by a pre existing condition. 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 is a result of a pre existing condition, we will pay benefits for a maximum of 1 month.

Ifbegins.yourdisability

Insurance

Elimination Period

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.

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/huntsvilleisd Cancer Insurance APL EMPLOYEE BENEFITS SUMMARY OF BENEFITS Plan 1 Plan 2 Cancer Treatment Policy Benefits Level 1 Level 1 Radiation Therapy, Chemotherapy, Immunotherapy Maximum per 12 month period $10,000 $10,000 Hormone Therapy Maximum of 12 treatments per calendar year $50 per treatment $50 per treatment Experimental Treatment paid in same manner and under the same maximums as any other benefit Cancer Screening Rider Benefits Level 1 Level 1 Diagnostic Testing 1 test per calendar year $50 per test $50 per test Follow Up Diagnostic Testing 1 test per calendar year $100 per test $100 per test Medical Imaging per calendar year $500 per test / 1 per calendar year $500 per test / 1 per calendar year Surgical Rider Benefits Level 1 Level 1 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 Patient Care Rider Benefits Level 1 Level 1 Hospital Confinement Per day of Hospital Confinement (1 30 days) Per day for Eligible Dependent Children (1 30 days) Per day of Hospital Confinement (31+ days) Per day for Eligible Dependent Children (31+ days) $200$100$200$100 $200$100$200$100 Outpatient Facility Per day surgery is performed $200 $200 Attending Physician Per day of Hospital Confinement $30 $30 Dread Disease Per day of Hospital Confinement (1 30 days / 31+ days) $100 /$100 $100 /$100 Extended Care Facility Up to the same number of Hospital Confinement Days $100 per day $100 per day Donor $100 per day $100 per day Home Health Care Up to the same number of Hospital Confinement Days $100 per day $100 per day Hospice Care Up to maximum of 365 days per lifetime $100 per day $100 per day US Government, Charity Hospital or HMO Per day of Hospital Confinement (1 30 days / 31+ days) $100 /$100 $100 /$100 Miscellaneous Care Rider Benefits Level 1 Level 1 Cancer Treatment Center Evaluation or Consultation 1 per lifetime Not Included Not Included Evaluation or Consultation Travel and Lodging 1 per lifetime Not Included Not Included Second / Third Surgical Opinion per diagnosis of cancer $300 / $300 $300 / $300 Drugs and Medicine Inpatient / Outpatient (maximum $150 per month) $150 per confinement $50 per prescription $150 per confinement $50 per prescription Hair Piece (Wig) 1 per lifetime $150 $150 Cancer (Total premium includes the Plan selected and any applicable rider premium.) Employee Only Employee and Spouse Employee and Child(ren) Employee and Family Low $19.80 $41.70 $25.78 $47.62 High $22.70 $48.00 $29.14 $54.40 26

Cancer Treatment Benefits

If the policy replaced group specified disease cancer coverage from any company that terminated within 30 days of the certificate effective date, the waiting period will be waived for those covered persons that were covered under the prior coverage. However, the pre existing condition exclusion provision will still apply.

Termination of Coverage: Insurance coverage for a covered person under the certificate and any attached riders for a covered person will end as follows: the date the policy terminates; the date the certificate terminates; the end of the grace period if the premium remains unpaid; the end of the certificate month in which the policyholder requests to terminate the coverage for an eligible dependent; the date a covered person no longer qualifies as an insured or eligible dependent; or the date of the covered person’s death.

Termination of Certificate: Insurance coverage under the certificate and any attached riders will end on the earliest of these dates: the date the policy terminates; the end of the grace period if the premium remains unpaid; the date insurance has ceased on all persons covered under this certificate; the end of the certificate month in which the policyholder requests to terminate this coverage; the date you no longer qualify as an insured; or the date of your death.

For limitations and exclusions, please visit your benefit website: www.mybenefitshub.com/huntsvilleisd

Eligibility: You and your eligible dependents are eligible to be insured under this certificate if you and your eligible dependents meet our underwriting rules and you are actively at work with the policyholder and qualify for coverage as defined in the master application.

Miscellaneous Care Rider Benefits Con’t. Level 1 Level 1 Transportation Maximum 12 trips per calendar year for all modes of transportation combined Travel by bus, plane or train Travel by car Lodging up to a maximum of 100 days per calendar year actual coach fare or $0.40 per mile $0.40 per mile $50 per day actual coach fare or $0.40 per mile $0.40 per mile $50 per day Family Transportation Maximum 12 trips per calendar year for all modes of transportation combinedTravelby bus, plane or train Travel by car Family Lodging up to a maximum of 100 days per calendar year actual coach fare or $0.40 per mile $0.40 per mile $50 per day actual coach fare or $0.40 per mile $0.40 per mile $50 per day Blood, Plasma and Platelets $300 per day $300 per day Ambulance Ground/Air Maximum of 2 trips per Hospital Confinement for all modes of transportation combined $200 / $2,000 per trip $200 / $2,000 per trip Inpatient Special Nursing Services per day of Hospital Confinement $150 per day $150 per day Outpatient Special Nursing Services Up to same number of Hospital Confinement days $150 per day $150 per day Medical Equipment Maximum of 1 benefit per calendar year Not Included Not Included Physical, Occupational, Speech, Audio Therapy & Psychotherapy / Maximum per calendar year $25 per visit / $1,000 $25 per visit / $1,000 Waiver of Premium Waive Premium Waive Premium Internal Cancer First Occurrence Rider Benefits Level 1 Level 2 Lump Sum Benefit Maximum 1 per Covered Person per lifetime $2,500 $5,000 Lump Sum for Eligible Dependent Children Maximum 1 per Covered Person per lifetime $3,750 $7,500 Hospital Intensive Care Unit Rider Benefits Intensive Care Unit $600 per day $600 per day Step Down Unit Maximum of 45 days per Confinement for any combination of Intensive Care Unit or Step Down Unit $300 per day $300 per day Cancer Insurance APL EMPLOYEE BENEFITS GC14 Limited Benefit Group Cancer Indemnity Insurance Benefits are only payable following a diagnosis of cancer for a loss incurred for the treatment of cancer while covered under the policy. A charge must be incurred for benefits to be payable. When coverage terminates for loss incurred after the coverage termination date, our obligation to pay benefits also terminates for a specified disease that manifested itself while the person was covered under the policy. All benefits are subject to the benefit maximums.

Limitations and Exclusions: No benefits will be paid for any of the following: treatment by any program engaged in research that does not meet the definition of experimental treatment; or losses or medical expenses incurred prior to the covered person’s effective date regardless of when specified disease was diagnosed.

We may end the coverage of any Covered Person who submits a fraudulent claim.

Waiting Period: The policy and any attached riders contain a waiting period during which no benefits will be paid. If any covered person has a specified disease diagnosed before the end of the waiting period immediately following the covered person’s effective date, coverage for that person will apply only to loss that is incurred after one year from the covered person’s effective date. If any covered person is diagnosed as having a specified disease during the waiting period immediately following the covered person’s effective date, you may elect to void the certificate from the beginning and receive a full refund of premium.

27

Pre Existing Condition Exclusion: No benefits are payable for any loss incurred during the pre existing condition exclusion period, following the covered person’s effective date as the result of a pre existing condition.

Pre existing conditions specifically named or described as excluded in any part of the policy are never covered. If any change to coverage after the certificate effective date results in an increase or addition to coverage, the time limit on certain defenses and pre existing condition exclusion for such increase will be based on the effective date of such increase.

Only Loss for Cancer: The policy pays only for loss resulting from definitive cancer treatment including direct extension, metastatic spread or recurrence. Proof must be submitted to support each claim. The policy also covers other conditions or diseases directly caused by cancer or the treatment of cancer. The policy does not cover any other disease, sickness or incapacity which existed prior to the diagnosis of cancer, even though after contracting cancer it may have been complicated, aggravated or affected by cancer or the treatment of cancer.

ABOUT ACCIDENT Do you have kids playing sports, are you a weekend warrior, or maybe accident prone? Accident plans are designed to help pay for medical costs associated with accidents and benefits are paid directly to you. For full plan details, please visit your benefit website: www.mybenefitshub.com/huntsvilleisd Accident Insurance APL EMPLOYEE BENEFITS Accident Low Plan High Plan Employee Only $11.70 $28.10 Employee and Spouse $20.70 $50.10 Employee and Child(ren) $22.70 $58.00 Employee and Family $31.70 $80.00 Summary of Benefits* Benefit Description Level 1 Low Option Level 4 High Option Accidental Death per unit $5,000 $20,000 Medical Expense Accidental Injury Benefit per unit actual charges up to $500 actual charges up to $2,000 Daily Hospital Confinement Benefit $75 per day $300 per day Air and Ground Ambulance Benefit actual charges up to $1,250 actual charges up to $5,000 Accidental Dismemberment Benefit Single finger or toe Multiple fingers or toes Single hand, arm, foot or leg Multiple hands, arms, feet or legs $5,000$2,500$500$500 $20,000$10,000$2,000$2,000 Accidental Loss of Sight Benefit per unit Loss of Sight in one eye Loss of Sight in both eyes $5,000$2,500 $20,000$10,000 Benefit Rider Level 1 Low Option Level 4 High Option Hospital Admission Benefit $100 upon admission $400 upon admission Accident Only Intensive Care Benefit $150 per day $150 per day *Total premium includes the Plan selected and any applicable rider premium. 28

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/huntsvilleisd Critical Illness Insurance Voya EMPLOYEE BENEFITS Critical Illness Insurance pays a lump sum benefit if you are diagnosed with a covered illness or condition on or after your coverage effective date. Your employer provides Critical Illness Insurance to meet your needs. Critical Illness Insurance is a limited benefit policy. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. Features of Critical Illness Insurance include: • Guaranteed Issue: No medical questions or tests are required for coverage. • Flexible: You can use the benefit payments for any purpose you like. • Payroll deductions: Premiums are paid through convenient payroll deductions. • Portable: If you leave your current employer or retire, you can take your coverage with you. Critical Illness (Uni Tobacco) Employee $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 Under 30 $2.25 $4.50 $6.75 $9.00 $11.25 $13.50 30 39 $2.50 $5.00 $7.50 $10.00 $12.50 $15.00 40 49 $4.30 $8.60 $12.90 $17.20 $21.50 $25.80 50 59 $10.00 $20.00 $30.00 $40.00 $50.00 $60.00 60 64 $16.50 $33.00 $49.50 $66.00 $82.50 $99.00 65 69 $20.95 $41.90 $62.85 $83.80 $104.75 $125.70 70+ $31.45 $62.90 $94.35 $125.80 $157.27 $188.70 Spouse $2,500 $5,000 $10,000 $15,000 Child(ren) Under 30 $1.45 $2.90 $5.80 $8.70 Coverage Rate 30 39 $1.55 $3.10 $6.20 $9.30 $1,000 $0.32 40 49 $2.88 $5.75 $11.50 $17.25 $2,500 $0.80 50 59 $6.38 $12.75 $25.50 $38.25 $5,000 $1.60 60 64 $10.20 $20.40 $40.80 $61.20 $10,000 $3.20 65 69 $12.33 $24.65 $49.30 $73.95 70+ $17.90 $35.80 $71.60 $107.40 For what critical illnesses and conditions are benefits available? Critical Illness Insurance provides a benefit payment for the following illnesses and conditions. Covered illnesses/conditions are broken out into groups called “modules”. Benefits are paid at 100% of the Maximum Critical Illness Benefit amount unless otherwise stated. For a complete description of your benefits, along with applicable provisions, conditions on benefit determination, exclusions and limitations, see your certificate of insurance and any riders. Base Module Module A Module B • Heart attack (cardiac arrest is not a heart attack) • Stroke • Coronary artery bypass (25%) • Coma • Major organ failure • Permanent paralysis • End stage renal (kidney) failure • Benign brain tumor • Deafness • Occupational HIV • Blindness • Multiple sclerosis • Amyotrophic lateral sclerosis (ALS) • Parkinson’s disease • Alzheimer’s disease • Infectious disease 29

Critical Illness Insurance Voya EMPLOYEE BENEFITS How can Critical Illness Insurance help? Below are a few examples of how your Critical Illness Insurance benefit could be used (coverage amounts may vary): • Medical expenses, such as deductibles and copays • Child care • Home healthcare costs • Mortgage payment/rent and home maintenance Who is eligible for Critical Illness Insurance? • You all active employees working 20+ hours per week. • Your spouse* Coverage is available only if employee coverage is elected • Your children to age 26. Coverage is available only if employee coverage is elected. *The use of “spouse” in this document means a person insured as a spouse as described in the certificate of insurance or rider. This may include domestic partners or civil union partners as defined by the group policy. Please contact your employer for more information. What Maximum Critical Illness Benefit am I eligible for? • For you  You have the opportunity to purchase a Maximum Critical Illness Benefit of $5,000 $30,000 in $5,000 increments • For your spouse  You have the opportunity to purchase a Maximum Critical Illness Benefit of $2,500 $15,000 for your spouse. • For your children  You have the opportunity to purchase a Maximum Critical Illness Benefit of $1,000, $2,500, $5,000 or $10,000 for each covered child. How many times can I receive the Maximum Critical Illness Benefit? Usually you are only able to receive the Maximum Critical Illness Benefit once for each covered condition. Your plan includes the Recurrence Benefit, which allows you to receive a benefit for the same condition a second time. It’s important to note that in order for the second occurrence of the illness to be covered, it must occur after 12 consecutive months without the occurrence of any covered critical illness named in your certificate, including the illness from the first benefit payment. If you have reached the benefit limit by receiving the maximum benefit for each covered condition, you may choose to end your coverage; however, if you have coverage for your spouse and/or children, you must continue your coverage in order to keep their coverage active. Please see your certificate of coverage for details. 30

Life and AD&D Cigna ABOUT LIFE AND AD&D Group term life is the most inexpensive way to purchase life insurance. You have the freedom to select an amount of life insurance coverage you need to help protect the well being of your family. Accidental Death & Dismemberment is life insurance coverage that pays a death benefit to the beneficiary, should death occur due to a covered accident. Dismemberment benefits are paid to you, according to the benefit level you select, if accidentally dismembered. For full plan details, please visit your benefit website: www.mybenefitshub.com/huntsvilleisd EMPLOYEE BENEFITS Voluntary Term Life Insurance Coverage Employee If you are an active, full time, U.S. Employee, regularly working a minimum of 20 hours per week, you are eligible for coverage on the first day of active service. • Benefit Amount Units of $10,000 to the lesser of 5 times annual compensation or $500,000. • Guaranteed Coverage Amount the lesser of 5 times annual compensation or $200,000. • Maximum The lesser of 5 times Annual Compensation or $500,000. • Benefit Reduction Schedule Providing you are still employed, your benefits will reduce to 65% at age 65, 45% at age 70, 30% at age 75 and 20% at age 80, 15% at age 85, 10% at age 90, 10% at age 95. Your Spouse* is eligible provided that you apply for and are approved for coverage for yourself. • Benefit Amount Units of $5,000 • Guaranteed Coverage Amount $50,000 • Maximum $250,000, not to exceed 50% of the employee’s coverage amount Your Unmarried, Dependent Children As long as you apply for and are approved for coverage for yourself: Birth to 6 months: $100; 6 months to 25 years age: • Benefit Amount Units of $2,000 • Maximum $10,000 No one may be covered more than once under this plan. Voluntary Life Employee Age per $10,000 of Benefit < 25 $0.40 25 29 $0.40 30 34 $0.50 35 39 $0.60 40 44 $0.90 45 49 $1.50 50 54 $2.50 55 59 $4.00 60 64 $6.20 65 69 $11.10 70 74 $19.90 75+ $32.80 Spouse rates based on Employee's age. Voluntary Group Life$10,000Child(ren)incoverage 0 26 $2.00 AD&D Per $10,000 Benefit Employee Employee and Family 0.19 $0.30 Benefit Amount Maximum Employee Units of $10,000 Lesser of 10 Times Salary or $500,000 Spouse Units of $5,000 $100,000 Children Units of $2,000 $10,000 If, within 365 days of a Covered Accident, bodily injuries result in: We’ll pay this % of the Benefit Amount: Loss of life; Total paralysis of both upper and lower limbs; Loss of two or more hands or feet; Loss of sight in both eyes; or Loss of speech and hearing (both ears) 100% Total paralysis of both lower limbs or both upper limbs 75% Total paralysis of upper and lower limbs on one side of the body; Loss of one hand, one foot, sight in one eye, speech, or hearing in both ears; or Severance and Reattachment of one hand or foot 50% Total paralysis of one upper or one lower limb; Loss of all four fingers of the same hand; or Loss of thumb and index finger of the same hand 25% Loss of all toes of the same foot 20% AVAILABLE COVERAGE: ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) BENEFIT DETAILS:SUMMARY OF BENEFITS If you pass away or are seriously injured as a result of a covered accident or injury, you or your beneficiaries will receive a set amount to help pay for unexpected expenses, or help your loved ones pay for future expenses after you’re gone. Basic Life Your employer provides $10,000 of Basic Life coverage to all full time employees. 31

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/huntsvilleisd

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WithCUSTOMIZABLEseveraloptions

TERMINAL ILLNESS ACCELERATION OF BENEFITS

FAMILY CoveragePROTECTIONisavailable

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.

EasyCONVENIENCEpayments

Individual Life Insurance 5Star EMPLOYEE BENEFITS

CoveragePORTABLEcontinues

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). with no loss of benefits or increase in cost if employment terminates after the first premium is paid. We simply bill the employee directly. through payroll deduction. for spouses and financially dependent children, even if the employee doesn’t elect coverage on themselves. Financially dependent children 14 days to 23 years old.

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 employees. to choose from, employees select the coverage that best meets the needs of their families.

ABOUT INDIVIDUAL LIFE

• 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.



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:

assistance with a claim contact MASA at 800 643 9023. You can find full benefit details at

For full

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.

Repatriation/Recuperation

www.mybenefitshub.com/huntsvilleisd

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

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

Emergent Air Transportation

EmployeeEmergencyhttp://www.mybenefitshub.com/huntsvilleisdTransportationandFamily$14.00 33

ABOUT MEDICAL TRANSPORT

please

Emergency 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. plan details, visit your benefit website:

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.

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.

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/huntsvilleisd Identity Theft ID Watchdog EMPLOYEE BENEFITS The Powerful Features You Want All at an Affordable Price UNIQUE FEATURES INCLUDED IN ALL ID WATCHDOG PLANS  What You Need to Know The credit scores provided are based on the VantageScore® 3.0 model. For three bureau VantageScore credit scores, data from Equifax, Experian, and TransUnion are used respectively. Any one bureau VantageScore uses Equifax data. Third parties use many different types of credit scores and are likely to use a different type of credit score to assess your creditworthiness. Monitor & Detect • Dark Web Monitoring1  • High Risk Transactions Monitoring2  • Subprime Loan Monitoring2  • Public Records Monitoring  • USPS Change of Address Monitoring • Identity Profile Report Manage & Alert • Child Credit Lock3 | 1 Bureau  • Financial Accounts Monitoring • Social Network Alerts  • Registered Sex Offender Reporting  • Customizable Alert Options • Breach Alert Emails • Mobile App Support & Restore • Identity Theft Resolution Specialists (Resolution for Pre existing Conditions)  • 24/7/365 U.S. based Customer Care Center • Lost Wallet Vault & Assistance • Deceased Family Member Fraud Remediation • Fraud Alert & Credit Freeze Assistance PLAN OPTIONS ID WATCHDOG® 1B ID WATCHDOG® PLATINUM Credit Report(s)4 & VantageScore Credit Score(s) 1 Bureau Monthly 1 Bureau Daily & 3 Bureau Annually Credit Score Tracker 1 Bureau Monthly 1 Bureau Daily Credit Report Monitoring5 1 Bureau 3 Bureau Credit Report Lock6 1 Bureau Multi Bureau Identity Theft Insurance7 Up to $1M Up to $1M 401K/HSA Stolen Funds Reimbursement7 Up to $500k SPECIAL EMPLOYEE PRICING PER MONTH ID WATCHDOG® 1B ID WATCHDOG® PLATINUM Employee (Includes 1 child <18) $7.95 $11.95 Employee + Family $14.95 $22.95 Helps better protect children 1 Bureau = Equifax® Multi Bureau = Equifax, TransUnion® 3 Bureau = Equifax, Experian®, TransUnion 34

for

35

you

•

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

• 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.

your

you

your

ABOUT FSA A Flexible Spending Account allows you to pay for eligible healthcare expenses with a pre loaded debit card. You choose the amount to set aside from your paycheck every plan year, based on your employer’s annual plan limit. This money is use it or lose it within the plan year (your plan contains a $500 rollover or grace period provision). For full plan details, please visit your benefit website: www.mybenefitshub.com/huntsvilleisd Flexible Spending Account (FSA) Higginbotham EMPLOYEE BENEFITS Health Care FSA The Health Care FSA covers qualified medical, dental and vision expenses for you or your eligible dependents. You may contribute up to $2,850 annually to a Health Care FSA and you are entitled to the full election from day one of your plan year. Eligible expenses include: • Dental and vision expenses • Medical deductibles and coinsurance • Prescription copays • Hearing aids and batteries You may not contribute to a Health Care FSA if you enrolled in a High Deductible Health Plan (HDHP) and contribute to a Health Savings Account (HSA). Limited Purpose Health Care FSA A Limited Purpose Health Care FSA is available if you enrolled in the HDHP medical plan and contribute to an HSA. You can use a Limited Purpose Health Care FSA to pay for eligible out of pocket dental and vision expenses only, such as: • Dental and orthodontia care (i.e., fillings, X rays and braces) • Vision care (e.g., eyeglasses, contact lenses and LASIK surgery) How the Health Care and Limited Purpose FSAs Work You can access the funds in your Health Care or Limited Purpose FSA two different ways: • Use your Higginbotham Benefits Debit Card to pay for qualified expenses, doctor visits and prescription copays. • Pay out of pocket and submit your receipts for reimbursement:  Fax 866 419 3516  Email flexclaims@higginbotham.net  Online https://flexservices.higginbotham.net Higginbotham Benefits Debit Card

to

The maximum per plan year you can contribute to a Health Care or Limited Purpose 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.

Important FSA Rules

• 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.

(EOB).

copay

The Higginbotham Benefits Debit Card gives immediate access to funds in your Health Care or Limited Purpose FSA when make a purchase without needing to file a claim reimbursement. If you use the debit card pay anything other than a amount, you will need to submit an itemized receipt or an Explanation of Benefits If you do not submit receipts, you will receive a request for substantiation. You will have 60 days to submit 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).

Flexible Spending Account (FSA) Higginbotham EMPLOYEE BENEFITS 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 36

Notes 37

Notes 38

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WWW.MYBENEFITSHUB.COM/HUNTSVILLEISD

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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 Huntsville 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.

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 Huntsville 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.