2022 - 2023 Plan Year
NEW BRAUNFELS ISD
BENEFIT GUIDE EFFECTIVE: 09/01/2022 - 8/31/2023 WWW.MYBENEFITSHUB.COM/NEWBRAUNFELSISD
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Table of Contents How to Enroll Annual Benefit Enrollment 1. Benefit Updates 2. Section 125 Cafeteria Plan Guidelines 3. Annual Enrollment 4. Eligibility Requirements 5. Helpful Definitions 6. Health Savings Account (HSA) vs. Flexible Spending Account (FSA) Medical Health Savings Account (HSA) Dental Vision Hospital Indemnity Critical Illness Accident Identity Theft Disability Life and AD&D Individual Life Flexible Spending Account (FSA) Employee Assistance Program (EAP)
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4-5 6-11 6 7 8 9 10
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12-17 18 19 20-21 22-23 24-25 26-27 28-29 30-31 32 33 34-35 36
PG. 4
HOW TO ENROLL
PG. 6
SUMMARY PAGES
PG. 12
YOUR BENEFITS
Benefit Contact Information NEW BRAUNFELS ISD BENEFITS
MEDICAL - TRS ACTIVECARE
MEDICAL - TRS HMO
Financial Benefit Services (800) 583-6908 www.mybenefitshub.com/ newbraunfelsisd
BCBSTX (866) 355-5999 www.bcbstx.com/trsactivecare
Scott & White HMO (844) 633-5325 www.trs.swhp.org
HEALTH SAVINGS ACCOUNT (HSA)
DENTAL
VISION
EECU (800) 333-9934 www.eecu.org
Guardian Group #426151 (800) 541-7846 www.guardiananytime.com
Superior Vision Group #323680 (800) 507-3800 www.superiorvision.com
HOSPITIAL INDEMNITY
CRITICAL ILLNESS
ACCIDENT
The Hartford Group #681970 (866) 547-4205 www.thehartford.com
The Hartford Group #681970 (866) 547-4205 www.thehartford.com
The Hartford Group #681970 (866) 547-4205 www.thehartford.com
IDENTITY THEFT
DISABILITY
LIFE AND AD&D
iLOCK360 (855) 287-8888 www.ilock360.com
The Hartford Group #681970 (866) 547-4205 www.thehartford.com
Lincoln Financial Group Group #400194501 (800) 423-2765 www.lfg.com
INDIVIDUAL LIFE
FLEXIBLE SPENDING ACCOUNT (FSA)
EMPLOYEE ASSISTANCE PROGRAM (EAP)
Texas Life (800) 283-9233 www.texaslife.com
National Benefit Services (800) 274-0503 www.nbsbenefits.com
ComPsych Group #LFGsupport (888) 628-4824 www.GuidanceResources.com
FINANCIAL PLANNING TCG Group Holdings (800) 943-9179 www.tcgservices.com Enrollment Hotline: (512) 600-5304 www.tcgservices.com/telewealth
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All Your Benefits One App Employee benefits made easy through the FBS Benefits App! Text “FBS NBISD” to (800) 583-6908 and get access to everything you need to complete your benefits enrollment: •
Benefit Resources
•
Online Enrollment
•
Interactive Tools
•
And more!
App Group #: FBSNBISD
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Text “FBS NBISD” to (800) 583-6908 OR SCAN
How to Log In 1
www.mybenefitshub.com/newbraunfelsisd
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CLICK LOGIN
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ENTER USERNAME & PASSWORD Your Username Is: Your email in THEbenefitsHUB. (Typically your work email) Your Password Is: Four (4) digits of your birth year 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.
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Annual Benefit Enrollment Benefit Updates - What’s New: Disability plan—moving from The Standard to The Hartford No change in plan design or premiums (unless you select a different plan or coverage amount) TRS rates have reduced for most plans! FSA and HSA—new max contribution amounts allowed.
Don’t Forget! • Login and complete your benefit enrollment from 07/05/2022 - 08/18/2022 • Enrollment assistance is available by calling Financial Benefit Services at (866) 914-5202.
• Update your information: home address, phone numbers, email, and beneficiaries. • REQUIRED!! Due to the Affordable Care Act (ACA) reporting requirements, you must add your dependent’s CORRECT social security numbers in the online enrollment system. If you have questions, please contact your Benefits Administrator. 6
SUMMARY PAGES
Annual Benefit Enrollment
SUMMARY PAGES
Section 125 Cafeteria Plan Guidelines A Cafeteria plan enables you to save money by using pre-tax dollars to pay for eligible group insurance premiums sponsored and offered by your employer. Enrollment is automatic unless you decline this benefit. Elections made during annual enrollment will become effective on the plan effective date and will remain in effect during the entire plan year.
CHANGES IN STATUS (CIS): Marital Status
Changes in benefit elections can occur only if you experience a qualifying event. You must present proof of a qualifying event to your Benefit Office within 31 days of your qualifying event and meet with your Benefit 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.
QUALIFYING EVENTS A change in marital status includes marriage, death of a spouse, divorce or annulment (legal separation is not recognized in all states).
A change in number of dependents includes the following: birth, adoption and placement for Change in Number of adoption. You can add existing dependents not previously enrolled whenever a dependent Tax Dependents gains eligibility as a result of a valid change in status event. Change in Status of Change in employment status of the employee, or a spouse or dependent of the employee, Employment Affecting that affects the individual's eligibility under an employer's plan includes commencement or Coverage Eligibility termination of employment. Gain/Loss of Dependents' Eligibility Status
Judgment/Decree/ Order
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. If a judgment, decree, or order from a divorce, annulment or change in legal custody requires that you provide accident or health coverage for your dependent child (including a foster child who is your dependent), you may change your election to provide coverage for the dependent child. If the order requires that another individual (including your spouse and former spouse) covers the dependent child and provides coverage under that individual's plan, you may change your election to revoke coverage only for that dependent child and only if the other individual actually provides the coverage.
Eligibility for Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change. Government Programs
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Annual Benefit Enrollment
SUMMARY PAGES
Annual Enrollment During your annual enrollment period, you have the opportunity to review, change or continue benefit elections each year. Changes are not permitted during the plan year (outside of annual enrollment) unless a Section 125 qualifying event occurs. •
Changes, additions or drops may be made only during the annual enrollment period without a qualifying event.
• Employees must review their personal information and verify that dependents they wish to provide coverage for are included in the dependent profile. Additionally, you must notify your employer of any discrepancy in personal and/or benefit information. •
Employees must confirm on each benefit screen (medical, dental, vision, etc.) that each dependent to be covered is selected in order to be included in the coverage for that particular benefit.
New Hire Enrollment All new hire enrollment elections must be completed in the online enrollment system within the first 31 days of benefit eligible employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.
Q&A Who do I contact with Questions? For benefit questions, you can contact your Benefit Office or you can call Financial Benefit Services at (866)914-5202 for assistance.
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Where can I find forms? For benefit summaries and claim forms, go to your benefit website: www.mybenefitshub.com/ newbraunfelsisd. Click the benefit plan you need information on (i.e., Dental) and you can find the forms you need under the Benefits and Forms section. How can I find a Network Provider? For benefit summaries and claim forms, go to the New Braunfels ISD benefit website: www.mybenefitshub.com/newbraunfelsisd. Click on the benefit plan you need information on (i.e., Dental) and you can find provider search links under the Quick Links section. When will I receive ID cards? If the insurance carrier provides ID cards, you can expect to receive those 3-4 weeks after your effective date. For most dental and vision plans, you can login to the carrier website and print a temporary ID card or simply give your provider the insurance company’s phone number and they can call and verify your coverage if you do not have an ID card at that time. If you do not receive your ID card, you can call the carrier’s customer service number to request another card. If the insurance carrier provides ID cards, but there are no changes to the plan, you typically will not receive a new ID card each year.
Annual Benefit Enrollment
SUMMARY PAGES
Employee Eligibility Requirements
Dependent Eligibility Requirements
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.
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.
PLAN
MAXIMUM AGE
Medical
Through 25
Health Savings Account (HSA)
IRS Tax Dependent Status
Dental
Through 25
Vision
Through 25
Basic & Voluntary Life and AD&D
Through 25
Individual Life Insurance
Through 23
Flexible Spending Account (FSA)
Through 25 or IRS Tax Dependent Status
Hospital Indemnity
Through 25
Critical Illness
Through 25
Accident
Through 25
Identity Theft Monitoring
Through age 18
Please note, limits and exclusions may apply when obtaining coverage as a married couple or when obtaining coverage for dependents. Potential Spouse Coverage Limitations: When enrolling in coverage, please keep in mind that some benefits may not allow you to cover your spouse as a dependent if your spouse is enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Financial Benefit Services, or contact the insurance carrier for additional information on spouse eligibility. FSA/HSA Limitations: Please note, in general, per IRS regulations, married couples may not enroll in both a Flexible Spending Account (FSA) and a Health Savings Account (HSA). If your spouse is covered under an FSA that reimburses for medical expenses then you and your spouse are not HSA eligible, even if you would not use your spouse's FSA to reimburse your expenses. However, there are some exceptions to the general limitation regarding specific types of FSAs. To obtain more information on whether you can enroll in a specific type of FSA or HSA as a married couple, please reach out to the FSA and/or HSA provider prior to enrolling or reach out to your tax advisor for further guidance. Potential Dependent Coverage Limitations: When enrolling for dependent coverage, please keep in mind that some benefits may not allow you to cover your eligible dependents if they are enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Financial Benefit Services, or contact the insurance carrier for additional information on dependent eligibility. Disclaimer: You acknowledge that you have read the limitations and exclusions that may apply to obtaining spouse and dependent coverage, including limitations and exclusions that may apply to enrollment in Flexible Spending Accounts and Health Savings Accounts as a married couple. You, the enrollee, shall hold harmless, defend, and indemnify Financial Benefit Services, LLC from any and all claims, actions, suits, charges, and judgments whatsoever that arise out of the enrollee's enrollment in spouse and/or dependent coverage, including enrollment in Flexible Spending Accounts and Health Savings Accounts.
If your dependent is disabled, coverage may be able to continue past the maximum age under certain plans. If you have a disabled dependent who is reaching an ineligible age, you must provide a physician’s statement confirming your dependent’s disability. Contact your Benefit Office to request a continuation of coverage.
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SUMMARY PAGES
Helpful Definitions Actively-at-Work
In-Network
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.
Doctors, hospitals, optometrists, dentists and other providers who have contracted with the plan as a network provider.
Annual Enrollment The period during which existing employees are given the opportunity to enroll in or change their current elections.
Annual Deductible The amount you pay each plan year before the plan begins to pay covered expenses.
Calendar Year January 1st through December 31st
Co-insurance After any applicable deductible, your share of the cost of a covered health care service, calculated as a percentage (for example, 20%) of the allowed amount for the service.
Guaranteed Coverage The amount of coverage you can elect without answering any medical questions or taking a health exam. Guaranteed coverage is only available during initial eligibility period. Actively-at-work and/or preexisting condition exclusion provisions do apply, as applicable by carrier. 10
Out-of-Pocket Maximum The most an eligible or insured person can pay in coinsurance for covered expenses.
Plan Year September 1st through August 31st
Pre-Existing Conditions Applies to any illness, injury or condition for which the participant has been under the care of a health care provider, taken prescription drugs or is under a health care provider’s orders to take drugs, or received medical care or services (including diagnostic and/or consultation services).
SUMMARY PAGES
HSA vs. FSA Health Savings Account (HSA) (IRC Sec. 223)
Flexible Spending Account (FSA) (IRC Sec. 125)
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 taxfree.
Employer Eligibility
A qualified high deductible health plan.
All employers
Contribution Source
Employee and/or employer
Employee
Account Owner
Individual
Employer
Underlying Insurance Requirement
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 Not permitted 65).
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 $500 rollover provision.
Does the account earn interest?
Yes
No
Portable?
Yes, portable year-to-year and between jobs.
No
Description
FLIP TO FOR HSA INFORMATION
PG. 18
FLIP TO FOR FSA INFORMATION
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Medical Insurance
EMPLOYEE BENEFITS
TRS 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/newbraunfelsisd
Monthly Premium
District Contribution
Employee Cost
TRS ActiveCare HD Employee Only
$346.00
$331.53
$14.47
Employee & Spouse
$976.00
$331.53
$644.47
Employee & Child(ren)
$622.00
$331.53
$290.47
$1,168.00
$331.53
$836.47
$434.00
$331.53
$102.47
$1,062.00
$331.53
$730.47
$699.00
$331.53
$367.47
$1,336.00
$331.53
$1,004.47
Employee & Family
TRS ActiveCare 2 Employee Only Employee & Spouse Employee & Child(ren) Employee & Family
TRS ActiveCare Primary Employee Only Employee & Spouse Employee & Child(ren) Employee & Family
$357.00
$331.53
25.47
$1,005.00
$331.53
$673.47
$641.00
$331.53
$309.47
$1,202.00
$331.53
$870.47
TRS ActiveCare Primary+ Employee Only
$1,013.00
$331.53
$681.47
Employee & Spouse
$2,402.00
$331.53
$2,070.47
Employee & Child(ren)
$1,507.00
$331.53
$1,175.47
Employee & Family
$2,841.00
$331.53
$2,509.47
Central & North Texas Baylor Scott & White
Employee Only Employee & Spouse Employee & Child(ren) Employee & Family
$543.35
$331.53
$211.82
$1,364.92
$331.53
$1,033.39
$873.57
$331.53
$542.04
$1,570.98
$331.53
$1,239.45
* Closed to new enrollees; rates are for current enrollees only 12
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Health Savings Account (HSA) EECU
EMPLOYEE BENEFITS
ABOUT HSA A Health Savings Account (HSA) is a personal savings account where the money can only be used for eligible medical expenses. Unlike a flexible spending account (FSA), the money rolls over year to year however only those funds that have been deposited in your account can be used. Contributions to a Health Savings Account can only be used if you are also enrolled in a High Deductible Health Care Plan (HDHP). For full plan details, please visit your benefit website: www.mybenefitshub.com/newbraunfelsisd
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.
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.
A type of personal savings account, an HSA is always yours even if you change health plans or jobs. The money in your HSA (including interest and investment earnings) grows tax-free and spends tax-free if used to pay for qualified medical expenses. There is no “use it or lose it” rule — you do not lose your money if you do not spend it in the calendar year — and there are no vesting requirements or forfeiture provisions. The account automatically rolls over year after year.
Opening an HSA
HSA Eligibility
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. To open an account, go to https://www.eecu.org/.
Important HSA Information •
Always ask your health care provider to file claims with your medical provider so network discounts can be applied. You can pay the provider with your HSA debit card based on the balance due after discount. You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit. You may open an HSA at the financial institution of your choice, but only accounts opened through EECU are eligible for automatic payroll deduction and company contributions.
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 You can use the money in your HSA to pay for qualified medical How to Use your HSA expenses now or in the future. You can also use HSA funds to pay • Online/Mobile: Sign-in for 24/7 account access to check your health care expenses for your dependents, even if they are not balance, pay bills and more. covered by the HDHP. • Call/Text: (817) 882-0800. EECU’s dedicated member service representatives are available to assist you with any Maximum Contributions questions. Their hours of operation are Monday through Your HSA contributions may not exceed the annual maximum Friday from 8:00 a.m. to 7:00 p.m. CT, Saturday 9:00 a.m. – amount established by the Internal Revenue Service. The annual 1:00 p.m. CT and closed on Sunday. contribution maximum for 2022 is based on the coverage option • Lost/Stolen Debit Card: Call the 24/7 debit card hotline at you elect: (800) 333-9934 • Individual – $3,650 • Stop by: a local EECU financial center for in-person • Family (filing jointly) – $7,300 assistance: www.eecu.org/locations. 18
Dental Insurance
EMPLOYEE BENEFITS
Guardian 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 disease.
For full plan details, please visit your benefit website: www.mybenefitshub.com/newbraunfelsisd
Dental Plans Option 1 Base NAP
Benefit Highlight:
Deductible: (3 per family max) In and Out of Network
Option 2 Buy Up NAP
Option 3 Value Plan
Base NAP or Buy up NAP plan, you can visit any Value plan, you can visit any dentist; dentist; but you pay less out-of-pocket when but you pay less out-of-pocket when you choose a PPO dentist. Out-of-network you choose a PPO dentist. Out-ofbenefits are based on a percentile of the network benefits are limited to our PPO prevailing fee data for the dentist's zip code. fee schedule. $25.00
$25.00
$25.00
Preventative Care:
80%
100%
100%
Basic Care:
80%
80%
100%
Major Care:
Not Covered
50%
60%
Not Covered
50% for all children under 26
50% for all children under 26
$1,000
$1,000
$1,000
No
Yes
Yes
Orthodontia: Annual Max: Benefit Rollover:
Find out if your dentist is in the Guardian network at www.GuardianAnytime.com For more detailed information regarding the Rollover Benefit, plan design or exclusions for what is not covered, please refer to the benefit website. Dental
Base NAP
Buy Up NAP
Value Plan
Employee
$19.76
$37.46
$37.46
Employee + Spouse
$45.57
$70.64
$70.64
Employee + Child(ren)
$50.11
$94.48
$94.48
Family
$69.80
$127.66
$127.66 19
Vision Insurance
EMPLOYEE BENEFITS
Superior Vision 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/newbraunfelsisd
How to Print your Vision ID Card: You can request your vision id card by contacting Superior Vision directly at (800)507-3800. You can also go to www.superiorvision.com and register/login to access your account by clicking on “Members” at the top of the page. You can also download the Superior Vision mobile app on your smart phone.
Copays 1
Exam Eyewear2
$10 $25
Services/frequency Exam 12 months Frame 24 months Lenses 12 months Contact lenses 12 months
Monthly Premiums Employee Only Employee + 1 Employee & Family
$6.96 $11.77 $17.42
(based on date of service)
Benefits through Superior Select Southwest network
In-network
Out-of-network
Covered in full
Up to $50 retail
$130 retail allowance
Up to $76 retail
Single vision
Covered in full
Up to $50 retail
Bifocal
Covered in full
Up to $70 retail
Trifocal
Covered in full
Up to $90 retail
See description3
Up to $90 retail
Lenticular
Covered in full
Up to $90 retail
Scratch resistant coating
Covered in full
Up to $25 retail
Anti-reflective coating (standard)
Covered in full
Up to $35 retail
$130 retail allowance Covered in full
Up to $115 retail Up to $220 retail
Exam (ophthalmologist) Frames Lenses (standard) per pair
Progressive
4
Contact lenses Medically necessary contact lenses
Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements 1. Eye exam copay is a single payment due to the provider at the time of service. 2. Eyewear copay applies to eyeglass lenses / frame and contact lenses. Eyewear copay is a single payment that applies to the entire purchase of eyeglasses (frame and lenses) 3. Covered to provider’s in-office standard retail lined trifocal amount; member pays difference between progressive and standard retail lined trifocal, plus applicable co-pay 4. Contact lenses and related professional services (fitting, evaluation and follow-up) are covered in lieu of eyeglass lenses and frames benefit
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Vision Insurance
EMPLOYEE BENEFITS
Superior Vision Discount Features
Look for providers in the provider directory who accept discounts, as some do not; please verify their services and discounts (range from 10%-30%) prior to service as they vary. Discounts on covered materials Frames:
20% off amount over allowance
Conventional Contacts:
20% off amount over allowance
Disposable Contact:
20% off amount over allowance
Discounts on non-covered exam, services and materials 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 6
Maximum member out-of-pocket
The following options have out-of-pocket maximums5 on standard (not premium, brand, or progressive) lenses.
Ultraviolet coat
$12
Tints, solid
$15
Tints, gradient
$18
Polycarbonate
$40
Blue light filtering
$15
Digital single vision
$30
Progressive lenses: Standard/Premium/Ultra/Ultimate
$55 / $110 / $150 / $225
Anti-reflective coating: Premium/Ultra/Ultimate
$70 / $85 / $120
Polarized lenses
$75
Plastic photochromic lenses
$80
High Index (1.67 / 1.74)
$80 / $120
5. Discounts and maximums may vary by lens type. Please check with your provider.
Discounts are subject to change without notice.
Laser vision correction (LASIK)
Hearing discounts
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.
A National Hearing Network of hearing care professionals, featuring Your Hearing Network, offers Superior Vision members discounts on services, hearing aids and accessories. These discounts should be verified prior to service.
The Plan discount features are not insurance. All allowances are retail; the member is responsible for paying the provider directly for all non-covered items and/or any amount over the allowances, minus available discounts. These are not covered by the plan.
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Hospital Indemnity
EMPLOYEE BENEFITS
The Hartford ABOUT HOSPITAL INDEMNITY This is an affordable supplemental plan that pays you should you be inpatient 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/newbraunfelsisd
Hospital indemnity (HI) insurance pays a cash benefit if you or an insured dependent (spouse or child) are confined in a hospital for a covered illness or injury. Even with the best primary health insurance plan, out-of-pocket costs from a hospital stay can add up. The benefits are paid in lump sum amounts to you, and can help offset expenses that primary health insurance doesn’t cover (like deductibles, coinsurance amounts or co- pays), or benefits can be used for any non-medical expenses (like housing costs, groceries, car expenses, etc.). To learn more about Hospital Indemnity insurance, visit thehartford.com/employeebenefits
Coverage Information You have a choice of two hospital indemnity plans, which allows you the flexibility to enroll for the coverage that best meets your needs. Benefit amounts are based on the plan in effect for you or an insured dependent at the time the covered event occurs. Unless otherwise noted, the benefit amounts payable under each plan are the same for you and your dependent(s).
PLAN INFORMATION Coverage Type Covered Events HSA Compatible BENEFITS
LOW
HIGH
On and off-job (24 hour) Illness and injury Yes LOW
On and off-job (24 hour) Illness and injury Yes HIGH
$1,000 $100 $200 LOW
$2,000 $100 $200 HIGH
Included
Included
Included
Included
HOSPITAL CARE First Day Hospital Confinement Up to 1 day per year Daily Hospital Confinement (Day 2+) Up to 30 days per year Daily ICU Confinement (Day 1+) Up to 30 days per year VALUE ADDED SERVICES Ability Assist® EAP – 24/7/365 access to help for financial, legal or emotional issues HealthChampionSM – Administrative & clinical support following serious illness or injury Hospital Indemnity Employee Employee + Spouse Employee + Child(ren) Family 22
Low - $1,000 $13.06 $23.74 $23.86
High - $2000 $22.70 $41.12 $41.04
$36.34
$62.48
Hospital Indemnity The Hartford ASKED & ANSWERED IS THIS COVERAGE HSA COMPATIBLE? If you (or any dependent(s)) currently participate in a Health Saving Account (HSA) or if you plan to do so in the future, you should be aware that the IRS limits the types of supplemental insurance you may have in addition to a HSA, while still maintaining the tax exempt status of the HSA. This plan design was designed to be compatible with Health Savings Accounts (HSAs). However, if you have or plan to open an HSA, please consult your tax and legal advisors to determine which supplemental benefits may be purchased by employees with an HSA. WHO IS ELIGIBLE? You are eligible for this insurance if you are an active fulltime employee who works at least 20 hours per week on a regularly scheduled basis. Your spouse and child(ren) are also eligible for coverage. Any child(ren) must be under age 26.
EMPLOYEE BENEFITS in accordance with the terms of the certificate (usually the first day of the month following the date you elect coverage). You must be actively at work with your employer on the day your coverage takes effect. Your spouse and child(ren) must be performing normal activities and not be confined (at home or in a hospital/care facility). WHEN DOES THIS INSURANCE END? This insurance will end when you or your dependents no longer satisfy the applicable eligibility conditions, premium is unpaid, you are no longer actively working, you leave your employer, or the coverage is no longer offered. CAN I KEEP THIS INSURANCE IF I LEAVE MY EMPLOYER OR AM NO LONGER A MEMBER OF THIS GROUP? Yes, you can take this coverage with you. Coverage may be continued for you and your dependent(s) under a group portability policy. Your spouse may also continue insurance in certain circumstances. The specific terms and qualifying events for portability are described in the certificate.
AM I GUARANTEED COVERAGE? This insurance is guaranteed issue coverage – it is available without having to provide information about your or your family’s health. All you have to do is elect the coverage to become insured. HOW MUCH DOES IT COST AND HOW DO I PAY FOR THIS INSURANCE? Premiums are provided above. You have a choice of plan options. You may elect insurance for you only, or for you and your dependent(s), by choosing the applicable coverage tier. Premiums will be automatically paid through payroll deduction, as authorized by you during the enrollment process. This ensures you don’t have to worry about writing a check or missing a payment. WHEN CAN I ENROLL? You may enroll during any scheduled enrollment period, within 31 days of the date you have a change in family status, or within 31 days of the completion of any eligibility waiting period established by your employer.
WHEN DOES THIS INSURANCE BEGIN? The initial effective date of this coverage is September 1, 2021. Subject to any eligibility waiting period established by your employer, if you enroll for coverage prior to this date, insurance will become effective on this date. If you enroll for coverage after this date, insurance will become effective 23
Critical Illness Insurance The Hartford
EMPLOYEE BENEFITS
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/newbraunfelsisd
COVERAGE INFORMATION Benefit amounts for covered illnesses are based on the coverage amount in effect for you or an insured dependent at the time of diagnosis.
Benefits & Features COVERAGE AMOUNTS Employee Coverage Amount Spouse Coverage Amount Child(ren) Coverage Amount COVERED ILLNESSES CANCER CONDITIONS Invasive Cancer* Benign Brain Tumor* Non-invasive Cancer Non-Melanoma Skin Cancer VASCULAR CONDITIONS Heart Attack* (Myocardial Infarction); Heart Failure/Transplant*; Stroke* Aneurysm Angioplasty/Stent; Coronary Artery Bypass Graft OTHER SPECIFIED CONDITIONS Coma*; End Stage Renal Failure; Loss of Hearing; Loss of Speech; Loss of Vision; Major Organ Failure/Transplant*; Paralysis Bone Marrow Transplant Other Dread Diseases+ NEUROLOGICAL CONDITIONS Advanced Multiple Sclerosis; Advanced Parkinson’s; Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s); Advanced Alzheimer's Disease CHILD CONDITIONS Cerebral Palsy; Congenital Heart Disease; Cystic Fibrosis; Muscular Dystrophy; Spina Bifida ADDITIONAL BENEFITS Recurrence - Pays a benefit for a subsequent diagnosis of conditions marked with an asterisk(*) Health Screening Benefit (once per year per covered Person)
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$10,000; $20,000; or $30,000 Greater of $5,000 or 50% of your coverage amount 50% of your coverage amount BENEFIT AMOUNTS 100% of coverage amount 25% of coverage amount 25% of coverage amount $250 (once per lifetime) 100% of coverage amount 50% of coverage amount 25% of coverage amount 100% of coverage amount 25% of coverage amount 25% of coverage amount 100% of coverage amount
100% of coverage amount 100% of original benefit amount $50
Critical Illness Insurance
EMPLOYEE BENEFITS
The Hartford FEATURES Coverage Maximum – Primary Insured & Spouse Coverage Maximum – Child(ren) Ability Assist® EAP2– 24/7/365 access to help for financial, legal or emotional issues HealthChampionSM3 – Administrative and clinical support following serious illness or injury
DETAILS 500% of coverage amount 300% of coverage amount
†Other Dread Disease means a covered severe disease that results in a covered person being confined to a Hospital for five (5) or more consecutive days. Covered severe diseases are: Addison's disease (primary adrenal insufficiency/hypocortisolism); bacterial cerebrospinal meningitis; COVID-19, formally SARS-CoV-2/2019-nCoV; diphtheria; encephalitis; Huntington's chorea; Legionnaire's disease; malaria; myasthenia gravis; necrotizing fasciitis; osteomyelitis; poliomyelitis; rabies; sickle cell anemia (excluding sickle cell trait); systemic lupus erythematosus (SLE); systemic sclerosis (scleroderma); tetanus; and tuberculosis. Please refer to the policy for complete definitions of each covered illness.
Critical Illness Benefit Amount
$10,000
Coverage Tier
Under 25-29 30-34 35-39 40-44 45-49 50-54 55-59 25
Employee Only
$2.80
$3.40
$3.80
$4.90
$6.80
Employee & Spouse
$4.50
$5.40
$6.10
Employee & Child(ren)
$4.60
$5.20
Employee & Family
$6.50
Employee Only
$20,000 $30,000
60-64
65-69
70-74
75-79
80+
$10.50 $14.70 $20.00 $28.20
$38.60
$52.00
$69.40
$83.70
$7.60
$10.60 $16.40 $22.80 $31.20 $43.90
$59.90
$80.30
$106.80 $128.50
$5.60
$6.60
$8.60
$12.30 $16.40 $21.80 $29.90
$40.40
$53.70
$71.20
$7.50
$8.10
$9.70
$12.70 $18.40 $24.80 $33.20 $45.90
$61.90
$82.40
$108.80 $130.60
$5.60
$6.80
$7.60
$9.80
$13.60 $21.00 $29.40 $40.00 $56.40
$77.20 $104.00 $138.80 $167.40
Employee & Spouse
$9.00
$10.80 $12.20 $15.20 $21.20 $32.80 $45.60 $62.40 $87.80 $119.80 $160.60 $213.60 $257.00
Employee & Child(ren)
$9.20
$10.40 $11.20 $13.20 $17.20 $24.60 $32.80 $43.60 $59.80
Employee & Family
$13.00 $15.00 $16.20 $19.40 $25.40 $36.80 $49.60 $66.40 $91.80 $123.80 $164.80 $217.60 $261.20
Employee Only
$8.40
Employee & Spouse
$13.50 $16.20 $18.30 $22.80 $31.80 $49.20 $68.40 $93.60 $131.70 $179.70 $240.90 $320.40 $385.50
$85.50
$80.80 $107.40 $142.40 $171.00
$10.20 $11.40 $14.70 $20.40 $31.50 $44.10 $60.00 $84.60 $115.80 $156.00 $208.20 $251.10
Employee & Child(ren) $13.80 $15.60 $16.80 $19.80 $25.80 $36.90 $49.20 $65.40 $89.70 $121.20 $161.10 $213.60 $256.50 Employee & Family
$19.50 $22.50 $24.30 $29.10 $38.10 $55.20 $74.40 $99.60 $137.70 $185.70 $247.20 $326.40 $391.80
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Accident Insurance
EMPLOYEE BENEFITS
The Hartford 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/newbraunfelsisd
Accident
COVERAGE INFORMATION You have a choice of two accident plans, which allows you the flexibility to enroll for the coverage that best meets your needs. This insurance provides benefits when injuries, medical treatment and/or services occur as the result of a covered accident. Unless otherwise noted, the benefit amounts payable under each plan are the same for you and your dependent(s).
Employee Employee + Spouse
Low $8.34 $13.12
High $11.60 $18.26
Employee + Child(ren)
$13.94
$19.40
Family
$21.92
$30.52
PLAN INFORMATION Coverage Type
LOW PLAN HIGH PLAN On and off-job (24 hour)
BENEFITS EMERGENCY, HOSPITAL & TREATMENT CARE Accident Follow-Up Up to 3 visits per accident Acupuncture/Chiropractic Care Up to 10 visits each per accident Ambulance – Air Once per accident Ambulance – Ground Once per accident Blood/Plasma/Platelets Once per accident Child Care Up to 30 days per accident while insured is confined Daily Hospital Confinement Up to 365 days per lifetime Daily ICU Confinement Up to 30 days per accident Diagnostic Exam Once per accident Emergency Dental Once per accident Emergency Room Once per accident Health Screening Benefit Once per year for each covered person Hospital Admission Once per accident Initial Physician Office Visit Once per accident Lodging Up to 30 nights per lifetime Medical Appliance Once per accident Physical Therapy Up to 10 visits each per accident Rehabilitation Facility Up to 15 days per lifetime Transportation Up to 3 trips per accident Urgent Care Once per accident X-ray Once per accident
LOW PLAN $100 $50 $2,000 $750 $300 $35 $400 $600 $300 Up to $450 $200 $50 $1,500 $100 $150 $200 $75 $300 $600 $150 $150
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HIGH PLAN $150 $75 $2,500 $1,000 $400 $50 $600 $800 $400 Up to $600 $250 $50 $2,000 $150 $175 $300 $100 $450 $800 $200 $200
Accident Insurance The Hartford SPECIFIED INJURY & SURGERY Abdominal/Thoracic Surgery Once per accident Arthroscopic Surgery Once per accident Burn Once per accident Burn – Skin Graft Once per accident for third degree burn(s) Concussion Up to 3 per year Dislocation Once per joint per lifetime Eye Injury Once per accident Fracture Once per bone per accident Hernia Repair Once per accident Joint Replacement Once per accident Knee Cartilage Once per accident Laceration Once per accident Ruptured Disc Once per accident Tendon/Ligament/Rotator Cuff Once per accident CATASTROPHIC Accidental Death Within 90 days; Spouse @ 50% and child @ 25% Common Carrier Death Within 90 days Coma Once per accident Dismemberment Once per accident Home Health Care Up to 30 days per accident Paralysis Once per accident Prosthesis Once per accident FEATURES Ability Assist® EAP – 24/7/365 access to help for financial, legal or emotional issues HealthChampionSM – Administrative & clinical support following serious illness or injury
EMPLOYEE BENEFITS LOW PLAN HIGH PLAN $3,000 $4,000 $500 $750 Up to $15,000 Up to $20,000 50% of burn benefit $200 $250 Up to $8,000 Up to $12,000 Up to $750 Up to $1,000 Up to $10,000 Up to $12,000 $400 $600 $4,000 $6,000 Up to $2,000 Up to $3,000 Up to $1,000 Up to $1,500 $2,000 $3,000 Up to $2,000 Up to $3,000 LOW PLAN HIGH PLAN $75,000 $100,000 2 times death benefit $15,000 $20,000 Up to $75,000 Up to $100,000 $75 $100 Up to $75,000 Up to $100,000 Up to $3,000 Up to $4,000 LOW PLAN HIGH PLAN Included Included Included Included
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Identity Theft iLock360
EMPLOYEE BENEFITS
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/newbraunfelsisd
Available protections for your identity Plan features Identity theft resolution services Full-Service Identity Restoration & Lost Wallet Protection
MOST VALUABLE SERVICE. Dependable help that’s just a phone call away! $1M Identity Theft Insurance
Service description
Essential
Elite
If your identity is compromised, a U.S.-based certified Identity Theft Restoration Specialist will work on your behalf to restore your good name, so that you can get on with your life. All restoration activities can be completed Adult & Adult & for you, and your case will be managed until your identity is fully restored. Even pre-existing conditions can be dealt with. Child under Child under Restoration Specialists offer robust case knowledge in both credit and non18 18 credit fraud situations and can help you with closing accounts, re-ordering cards, placing a fraud alert with each of the three credit bureaus, and removing fraudulent activity from your credit report. If you incur expenses associated with your identity theft recovery, you will be covered with $1M reimbursement ($0 deductible). Covered costs include: • Lost wages or income • Attorney and legal fees Adult only Adult Only • Expenses incurred for refiling of loans, grants and other lines of credit • Costs of childcare and/or elderly care incurred as a result of identity restoration
Comprehensive identity monitoring We scour Internet properties, including the Dark Web, as well as hacker CyberAlert™️ Monitors: • one Social Security Number • two Email Addresses • one Drivers License Number • two Medical ID Numbers • one Passport • five Credit/Debit Cards • two Phone Numbers • five Bank Accounts
websites, blogs, bulletin boards, peer-to-peer sharing networks and chat rooms to identify the illegal trading and selling of your personal information.
A thief may try to establish “your” new identity by changing your address. Receive an alert if your mail is redirected in the USPS National Change of Address (NCOA) Registry. High-interest, easy-to-obtain payday loans can negatively impact your credit Payday Loan Monitoring score. Alerts you if a non-credit loan was opened in your name at a payday/ quick cash loan provider. Provides you with a report of all names and/or aliases as well as current and Social Security Number Trace reported addresses associated with your Social Security number. If there are findings that you don’t recognize, this could be a sign of possible identity theft. If your Medical ID number is found compromised by CyberAlertTM, a Medical ID Monitoring Restoration Specialist can help you report it as fraud. Court/Criminal Records Monitoring Tracks municipal court systems and notifies you if a crime has been committed under your name and date of birth
Adult & Adult & Child under Child under 18 18
Change of Address Monitoring
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Adult only Adult only
Adult only Adult only
Adult & Adult & Child under Child under 18 18 Adult only Adult only Adult only
Identity Theft
EMPLOYEE BENEFITS
iLock360 Credit monitoring services Notifies you when your Social Security number and personal information have Bank Account Takeover & Credit Card Application Monitoring been used to apply for or open a new bank or credit card account; or if
changes have been made to your existing bank account - such as an attempt Adult only Adult only to add a new account holder. Daily Monitoring of Experian Credit Provides you with notifications for changes in a credit report such as loan Adult only Adult only data, inquiries, new accounts, judgments, liens and more. Provides higher-level credit protection with monitoring from all three credit Daily Monitoring of all 3 Credit bureaus: Experian, Equifax & TransUnion. You receive notifications for Bureaus Adult only changes in your credit report such as loan data, inquiries, new accounts, judgments, liens and more. Receive a monthly report that helps you understand how your credit score has ScoreTracker Adult only trended over time and what is impacting it with credit score insight. Provides you with access to your credit score and report reported by each 3-Bureau Credit Score & Report credit bureau - Experian, Equifax & TransUnion. These are reported once a Adult only year. Alerts you when positive activity is reported on your Experian credit file, a key Experian Positive Activity Adult only indicator that your credit may be improving. Notifications
Experian Score Variance Alerts Advanced tools Sex Offender Alerts
Social Media Monitoring
Solicitation Reduction
Receive alerts when your Experian credit score increases or decreases by a certain amount, changes risk level/score rank, or reaches a target score value.
Adult only
Keep your family safe with awareness of where registered sex offenders live in your immediate area. You’ll also be notified when a new one moves to your Adult Only Adult Only area.
Receive notifications if the content you share on social media could pose a privacy or reputational risk. With Family coverage, you can monitor your child’s social media presence.
Adult Only Adult Only
Limit access to the amount of personal information that is public to reduce your exposure to fraud and declutter your mailbox and phone line. Also, optout of direct marketing campaigns including utilizing the National Do Not Call Registry.
Adult Only Adult Only
Identity Theft Essential Plan
Elite Plan
Employee
$6.95
$11.95
Family
$13.95
$22.95
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Disability Insurance
EMPLOYEE BENEFITS
The Hartford ABOUT DISABILITY Disability insurance protects one of your most valuable assets, your paycheck. This insurance will replace a portion of your income in the event that you become physically unable to work due to sickness or injury for an extended period of time.
For full plan details, please visit your benefit website: www.mybenefitshub.com/newbraunfelsisd
What is Educator Disability Income Insurance? 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.
Pre-Existing Condition: Your policy limits the benefits you can receive for a disability caused by a pre-existing condition. EX: 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 in this case (09/01/2022), your benefit payment will be limited, unless: You have been insured under this policy for 12 months before your disability begins. If your disability is a result of a pre-existing condition, we will pay benefits for a maximum of 2 months.
Enrollment: You can enroll in coverage within 31 days of your date of hire or during your annual enrollment period. Effective 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.
Actively at Work: You must be at work with your Employer on your regularly scheduled workday. On that day, you must be performing for wage or profit all of your regular duties in the usual way and for your usual number of hours. If school is not in session due to normal vacation or school break(s), Actively at Work shall mean you are able to report for work with your Employer, performing all of the regular duties of Your Occupation in the usual way for your usual number of hours as if school was in session.
Benefit Amount: You may purchase coverage that will pay you a monthly flat dollar benefit in $100 increments Benefit Integration: For the first 12 months your benefit between $200 and $8,000 that cannot exceed 66 2/3% of may be reduced by other income you receive or are eligible your current monthly earnings. Earnings are defined in The to receive due to your disability, such as Workers' Hartford’s contract with your employer. Compensation Law, the Jones Act, occupational disease Elimination Period: You must be disabled for at least the law, similar law or substitutes or exchanges for such benefits; 2) income that You receive from Your Employer’s number of days indicated by the elimination period that you select before you can receive a Disability benefit sabbatical leave plan or similar leave of absence plan 3) payment. The elimination period that you select consists of income that You receive from Your Employer’s assault leave plan, or similar leave of absence plan, because of you two numbers. The first number shows the number of days you must be disabled by an accident before your benefits were physically assaulted while acting in Your official can begin. The second number indicates the number of capacity. days you must be disabled by a sickness before your Eligibility: You are eligible if you are an active employee benefits can begin. who works at least 20 hours per week on a regularly For those employees electing an elimination period of 30 scheduled basis. days or less, if you are confined to a hospital for 24 hours or more due to a disability, the elimination period will be 30
Disability Insurance
EMPLOYEE BENEFITS
The Hartford waived, and benefits will be payable from the first day of hospitalization. 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 schedules below: Injury: Age at Disability
Additional Benefits: Survivor Benefit: If you die while receiving disability benefits, a benefit will be paid to your spouse or child under age 26, equal to three times your last monthly gross benefit. The Hartford's Ability Assist: You have access to Ability Assist services both prior to a disability and after you’ve been approved for an LTD claim and are receiving LTD benefits. It provide assistance with child/elder care, substance abuse, family relationships and more.
Age 64
Maximum Duration of Benefits To Normal Retirement Age or 48 months if greater To Normal Retirement Age or 42 months if greater 36 months
Age 65
30 months
Age 66
27 months
Elimination Period
Monthly Benefit per $200
Age 67
24 months
0/7
$6.24
Age 68
21 months
14/14
$5.14
Age 69 and older
18 months
30/30
$3.76
60/60
$3.56
Prior to 63 Age 63
Sickness: Age at Disability
Maximum Duration of Benefits
Prior to 67
3 years
Age 67-69
To age 70, but no less than one year
Age 70 and Older
1 year
Travel Assistance Program: This program aids employees and their dependents who travel 100 miles from their home for 90 days or less. Identity Theft Protection: Support services to help victims restore their identity. Disability
For additional information on this plan please visit the carrier website and your benefits portal linked above.
Mental Illness, Alcoholism and Substance Abuse: You can receive benefit payments for Long-Term Disabilities resulting from mental illness, alcoholism, and substance abuse for a total of 24 months for all disability periods during your lifetime. Partial Disability covered provided you have at least a 20% loss of earnings and duties of your job.
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Life and AD&D
EMPLOYEE BENEFITS
Lincoln Financial Group ABOUT LIFE AND AD&D Group term life is the most inexpensive way to purchase life insurance. You have the freedom to select an amount of life insurance coverage you need to help protect the well-being of your family. Accidental Death & Dismemberment is life insurance coverage that pays a death benefit to the beneficiary, should death occur due to a covered accident. Dismemberment benefits are paid to you, according to the benefit level you select, if accidentally dismembered. For full plan details, please visit your benefit website: www.mybenefitshub.com/newbraunfelsisd
Voluntary Life Insurance • • • • •
Additional Plan Benefits
Provides a cash benefit to your loved ones in the event of your death Features group rates for New Braunfels ISD employees Includes LifeKeys® services, which provide access to counseling, financial, and legal support services Also includes TravelConnect® services, which give you and your family access to emergency medical assistance when you’re on a trip 100+ miles from home To file a claim contact Lincoln Financial at (800) 423-2765
Employee Guaranteed coverage amount during initial offering or approved special enrollment period Newly hired employee guaranteed coverage amount Continuing employee guaranteed coverage annual increase amount Maximum coverage amount
$200,000
$200,000 Choice of $10,000 or $40,000 5 times your annual salary ($500,000 maximum in increments of $10,000) $10,000
Minimum coverage amount Spouse Guaranteed coverage amount during $30,000 initial offering or approved special enrollment period Newly hired employee guaranteed $30,000 coverage amount Continuing employee guaranteed Choice of $5,000 or $20,000 coverage annual increase amount Maximum coverage amount 50% of the employee coverage amount ($100,000 maximum in increments of $5,000) Minimum coverage amount $5,000 Dependent Children Day 1 months to age 26 guaranteed $10,000 coverage amount
Accelerated Death Benefit
Included
Premium Waiver
Included
Conversion
Included
Portability
Included
Voluntary Group Life Employee Spouse Age per $10,000 per $5,000 18-24 $0.50 $0.50 25-29 $0.50 $0.50 30-34 $0.60 $0.60 35-39 $0.70 $0.70 40-44 $1.00 $1.00 45-49 $1.60 $1.60 50-54 $2.40 $2.40 55-59 $4.00 $4.00 60-64 $6.20 $6.20 65-69 $10.90 $10.90 70-74 $10.90 $10.90 75-79 $10.90 $10.90 80-99 $10.90 $10.90 Voluntary Group Life - Child(ren) Per $10,000 in coverage 0-26 $1.80 Spouse rates based on Employee's age. Benefit Exclusions: Like any insurance, this term life insurance policy does have exclusions. A suicide exclusion may apply. A complete list of benefit exclusions is included in the policy. State variations apply.
Note: You must be an active New Braunfels Independent School District employee to select coverage for a spouse and/or dependent children. To be eligible for coverage, a spouse or dependent child cannot be confined to a health care facility or unable to perform the typical activities of a healthy person of the same age and gender.
32
Individual Life Insurance Texas Life
EMPLOYEE BENEFITS
ABOUT INDIVIDUAL LIFE Individual insurance is a policy that covers a single person and is intended to meet the financial needs of the beneficiary, in the event of the insured’s death. This coverage is portable and can continue after you leave employment or retire.
For full plan details, please visit your benefit website: www.mybenefitshub.com/newbraunfelsisd
Voluntary permanent life insurance can be an ideal complement to the group term and optional term your employer might provide. Designed to be in force when you die, this voluntary universal life product is yours to keep, even when you change jobs or retire, as long as you pay the necessary premium. Group and voluntary term, on the other hand, typically are not portable if you change jobs and, even if you can keep them after you retire, usually cost more and decline in death benefit. The policy, purelife-plus, is underwritten by Texas Life Insurance Company, and it has the following features: • •
• •
•
High Death Benefit. With one of the highest death benefits available at the worksite, purelife-plus gives your loved ones peace of mind. Minimal Cash Value. Designed to provide a high death benefit at a reasonable premium, purelife-plus provides peace of mind for you and your beneficiaries while freeing investment dollars to be directed toward such tax-favored retirement plans as 403(b), 457 and 401(k). Long Guarantees.2 Enjoy the assurance of a policy that has a guaranteed death benefit to age 121 and level premium that guarantees coverage for a significant period of time. Refund of Premium. Unique in the marketplace, purelife-plus offers you a refund of 10 years’ premium, should you surrender the policy if the premium you pay when you buy the policy ever increases. (Conditions apply.) Accelerated Death Benefit Rider. Should you be diagnosed as terminally ill with the expectation of death within 12 months (24 months in Illinois), you will have the option to receive 92% (84% in Illinois) of the death benefit, minus a $150 ($100 in Florida) administrative fee. This valuable living benefit gives you peace of mind knowing that, should you need it, you can take the large majority of your death benefit while still alive. (Conditions apply.)
You may apply for this permanent, portable coverage, not only for yourself, but also for your spouse, children and grandchildren by answering just 3 questions: During the last six months, has the proposed insured: a. Been actively at work on a full time basis, performing usual duties? b. Been absent from work due to illness or medical treatment for a period of more than five consecutive working days? c. Been disabled or received tests, treatment or care of any kind in a hospital or nursing home or received chemotherapy, hormonal therapy for cancer, radiation therapy, dialysis treatment, or treatment for alcohol or drug abuse?
33
Flexible Spending Account (FSA) NBS
EMPLOYEE BENEFITS
ABOUT FSA A Flexible Spending Account allows you to pay for eligible healthcare expenses with a pre-loaded debit card. You choose the amount to set aside from your paycheck every plan year, based on your employer’s annual plan limit. This money is use it or lose it within the plan year (unless your plan contains a $500 rollover or grace period provision).
For full plan details, please visit your benefit website: www.mybenefitshub.com/newbraunfelsisd
Health Care FSA
Dependent 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).
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.
How the Health Care FSAs Work
•
You can access the funds in your Health Care FSA two different ways: • Use your NBS Debit Card to pay for qualified expenses, doctor visits and prescription copays. • Pay out-of-pocket and submit your receipts for reimbursement: Fax – (844)438-1496 Email – service@nbsbenefits.com Online – my.nbsbenefits.com Call for Account Balance: (855)399-3035 Mail: PO Box 6980 West Jordan, UT 84084
Contact NBS • • • •
34
Hours of Operation: 6:00 AM – 6:00 PM MST, Mon-Fri Phone: (800) 274-0503 Email: service@nbsbenefits.com Mail: PO Box 6980 West Jordan, UT 84084
Dependent Care FSA Guidelines •
•
•
Overnight camps are not eligible for reimbursement (only day camps can be considered). If your child turns 13 midyear, you may only request reimbursement for the part of the year when the child is under age 13. You may request reimbursement for care of a spouse or dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self-care. The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.
Important FSA Rules •
•
The maximum per plan year you can contribute to a Health Care FSA is $2,850.00. The maximum per plan year you can contribute to a Dependent Care FSA is $5,000 when filing jointly or head of household and $2,500 when married filing separately. You cannot change your election during the year unless
Flexible Spending Account (FSA) NBS • •
EMPLOYEE BENEFITS
you experience a Qualifying Life Event. Your Health Care FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care expenses. The IRS has amended the “use it or lose it rule” to allow you to carry-over up to $500 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 (OTC) 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. Flexible Spending Accounts Account Type
Health Care FSA
Dependent Care FSA
Eligible Expenses Most medical, dental and vision care expenses that are not covered by your health plan (such as copayments, coinsurance, deductibles, eyeglasses and doctor-prescribed over-the-counter medications) Dependent care expenses (such as day care, after-school programs or elder care programs) so you and your spouse can work or attend school full-time
Annual Contribution Limits
Benefit
$2,850
Saves on eligible expenses not covered by insurance, reduces your taxable income
$5,000 single $2,500 if married and filing separate tax returns
Reduces your taxable income
FSAstore.com FSAstore.com offers thousands of FSA-eligible products and services to purchase using your FSA Debit Card or any major credit card. Competitive pricing and free shipping on orders over $50 can save you up to 40% using your FSA pretax dollars. Shop directly at FSAstore.com or have your physician submit prescriptions (when required). The FSAstore.com Services Channel allows you to search a database of more than 300,000 health care providers for nearby eligible services, such as acupuncture and chiropractic care. The FSAstore.com Learning Center focuses on answering common questions and keeping you informed about changes to your FSA benefits.
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Employee Assistance Program (EAP) ComPsych | Lincoln Financial Group
EMPLOYEE BENEFITS
ABOUT EAP An Employee Assistance Program (EAP) is a program that assists you in resolving problems such as finding child or elder care, relationship challenges, financial or legal problems, etc. This program is provided by your employer at no cost to you.
For full plan details, please visit your benefit website: www.mybenefitshub.com/newbraunfelsisd
ComPsych EAP Life has its share of ups and downs — and sometimes you may need a little guidance through the “downs.” EmployeeConnectSM services included with your employer’s long-term disability insurance offer an array of confidential services to help you and your loved ones meet the challenges that life, work, and relationships can bring. Unlimited 24/7 assistance You can access the following services anytime, online or with a toll-free call: • Information, resources, and referrals on family matters, such as child and elder care; kennels and pet care; event and vacation planning; moving and relocation; car buying; college planning; and more • Legal information and referrals for situations requiring expertise in family law, estate planning, landlord/tenant relations, consumer and civil law, and more • Guidance with financial matters, including household budgeting, and short and long-term planning. In-person guidance Some matters are best resolved by meeting with a professional in person. With EmployeeConnect, you get: The resources you need to meet life’s challenges. • In-person help for short-term issues (up to five* sessions with a counselor per person, per issue, per year) • In-person consultations with network lawyers, including one free 30-minute in-person consultation per legal issue, and subsequent meetings at a reduced fee *In California, up to three sessions in six months, starting with initial contact by employee.
Employee Assistance Program Services Confidential help 24 hours a day, 7 days a week for employees and family members Visit www.GuidanceResources.com (user name = LFGsupport; password = LFGsupport1). Or talk with a specialist at (888)628-4824.
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2021 - 2022 Plan Year
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 New Braunfels ISD Benefits Website. This summary does not replace or amend the underlying plan documentation. In the event of a discrepancy between this summary and the plan documentation the plan documentation governs. All plans and benefits described in this summary may be discontinued, increased, decreased, or altered at any time with or without notice. Rate Sheet General Disclaimer: The rate information provided in this guide is subject to change at any time by your employer and/or the plan provider. The rate information included herein, does not guarantee coverage or change or otherwise interpret the terms of the specific plan documentation, available at the New Braunfels 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.
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