TAYLOR ISD BENEFIT GUIDE EFFECTIVE: 09/01/2022 8/31/2023 WWW.MYBENEFITSHUB.COM/TAYLORISD 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 Telehealth 20 Dental 21 Vision 22 Hospital Indemnity 23 Disability 24-25 Cancer 26 Accident 27-28 Critical Illness 29-30 Life and AD&D 31-32 Individual Life 33 Identity Theft 34 Emergency Medical Transportation 35 Flexible Spending Account (FSA) 36-37 Employee Assistance Program (EAP) 38 HOW TO ENROLLPG. 4 SUMMARYPAGESPG. 6 BENEFITSYOURPG. 12 2
TAYLOR ISD BENEFITS MEDICAL TRS ACTIVECARE MEDICAL TRS HMO Financial Benefit Services (800) 583 www.mybenefitshub.com/taylorisd6908 (866)BCBSTX355 www.bcbstx.com/trsactivecare5999 Scott & White HMO (844) 633 www.trs.swhp.org5325 HEALTH SAVINGS ACCOUNT (HSA) TELEHEALTH DENTAL (817)EECU 882 0800 www.eecu.org (888)MDLIVE365 1663 www.mdlive.com/fbs GroupMetLife#5969997 (800) 638 5433 www.metlife.com VISION HOSPITIAL INDEMNITY DISABILITY Superior Vision Group #327810 (800) 507 www.superiorvision.com3800 GroupAetna #802488 (800) 872 www.aetna.com3862 GroupUnum #217419001 (866) 679 www.unum.com3054 CANCER ACCIDENT CRITICAL ILLNESS American Public Life Group #22339 (800) 256 www.ampublic.com8606 American Public Life Group #22339 (800) 256 www.ampublic.com8606 GroupVoya #695246 CCI (800) 955 www.voya.com7736 LIFE AND AD&D INDIVIDUAL LIFE IDENTITY THEFT www.oneamerica.com(817)GroupOneAmerica#G006136568820800 5Star Life Insurance (866) 863 www.5starlifeinsurance.com9753 ID www.idwatchdog.com(800)Watchdog7743772 EMERGENCY MEDICAL TRANSPORT FLEXIBLE SPENDING ACCOUNT (FSA) EMPLOYEE ASSISTANCE PROGRAM (EAP) GroupMASA #MKTAISD (800) 423 www.masamts.com3226 https://flexservices.higginbotham.net/(800)Higginbotham9439179 Life www.lifeworks.com(888)Works4561324 Benefit Contact Information 3
Employee benefits made easy through the FBS Benefits App! AllYour BenefitsOne App OR SCAN Text “FBS TAYLOR” to (800) 583-6908 App Group #: FBSTAYLOR Text “FBS TAYLOR” 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/taylorisd How to Log In 2 CLICK LOGIN 3 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. 5
Benefit Updates What’s New: • TRS rates have reduced for most plans! • FSA and HSA new max contribution amounts allowed. • The Emergency Transportation plan now has an upgrade option that includes non emergency transfer from a facility to another facility for higher level of care, and, patriation services bringing you closer to home if you are hospitalized away from your area. The original base plan is still available that provides emergency only transportation to a hospital Don’t Forget! • Log in and complete your benefit enrollment from 7/5/2022 8/12/2022 • Enrollment assistance is available by calling Financial Benefit Services at (866) 914 5202. • Update your information: home address, phone numbers, email, and beneficiaries. • REQUIRED!! Due to the Affordable Care Act (ACA) reporting requirements, you must add your dependent’s CORRECT social security numbers in the online enrollment system. If you have questions, please contact your Benefits Administrator. SUMMARY PAGESAnnual Benefit Enrollment 6
Section 125 Cafeteria Plan Guidelines Benefit Enrollment CHANGES IN (CIS):STATUS QUALIFYING EVENTS
Marital Status
Change in employment status of the employee, or a spouse or dependent of the employee, that affects the individual's eligibility under an employer's plan includes commencement or termination of employment.
Change in Number of Tax Dependents
Judgment/Decree/Order
Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change.
Gain/Loss EligibilityDependents'ofStatus
Affecting Coverage Eligibility
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.
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.
A change in marital status includes marriage, death of a spouse, divorce or annulment (legal separation is not recognized in all states).
Eligibility for Government Programs
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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.
Change in Status of Employment
An event that causes an employee's dependent to satisfy or cease to satisfy coverage requirements under an employer's plan may include change in age, student, marital, employment or tax dependent status.
SUMMARY PAGESAnnual
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 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.
Where can I find forms?
All new hire enrollment elections must be completed in the online enrollment system within the first 30 days of benefit eligible employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.
For benefit summaries and claim forms, go to the Taylor ISD benefit www.mybenefitshub.com/taylorisdwebsite:.
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. Benefit
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?
SUMMARY PAGESAnnual
For supplemental benefit questions, you can contact your Benefits/HR department or you can call Financial Benefit Services at 866 914 5202 for assistance.
• 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.
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.
Annual Enrollment
• Employees must confirm on each benefit screen (medical, dental, vision, etc.) that each dependent to be covered is selected in order to be included in the coverage for that particular benefit.
Q&A Who do I contact with Questions?
For benefit summaries and claim forms, go to your benefit website: www.mybenefitshub.com/ taylorisd. Click the benefit plan you need information on (i.e., Dental) and you can find the forms you need under the Benefits and Forms
If the insurance carrier provides ID cards, you can expect to receive those 3 4 weeks after your effective date. For most dental and vision plans, you can login to the carrier website and print a temporary ID card or simply give your provider the insurance company’s phone number and they can call and verify your coverage if you do not have an ID card at that time. If you do not receive your ID card, you can call the carrier’s customer service number to request another card.
Enrollment 8
New Hire Enrollment
Howsection.can I find a Network Provider?
Enrollment 9
Dependent RequirementsEligibility
AGE Medical To 26 Hospital Indemnity To 26 Dental To 26 Vision To 26 HealthAccountSavings To 26 Cancer Unmarried To 25 Accident Unmarried To 25 Critical Illness Unmarried To 26 Voluntary Term Life Unmarried To 26 Basic Life AD&Dand Unmarried To 26 Individual Life Issuable to age 23 AssistanceEmployee(EAP) To 26 Identity Theft To 26 Flexible Spending Account IRS Dependent Status
Dependent Eligibility: You can cover eligible dependent children under a benefit that offers dependent coverage, provided you participate in the same benefit, through the maximum age listed below. Dependents cannot be double covered by married spouses within the district as both employees and dependents.
Supplemental Benefits: Eligible employees must work 20 or more regularly scheduled hours each work week. 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.
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:
PLAN MAXIMUM
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
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.
Please note, in general, per IRS regulations, married couples may not enroll in both a Flexible Spending Account (FSA) and a Health Savings Account (HSA). If your spouse is covered under an FSA that reimburses for medical expenses then you and your spouse are not HSA eligible, even if you would not use your spouse's FSA to reimburse your expenses. However, there are some exceptions to the general limitation regarding specific types of FSAs. To obtain more information on whether you can enroll in a specific type of FSA or HSA as a married couple, please reach out to the FSA and/or HSA provider prior to enrolling or reach out to your tax advisor for further Potentialguidance.Dependent Coverage Limitations: When enrolling for dependent coverage, please keep in mind that some benefits may not allow you to cover your eligible dependents if they are enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Financial Benefit Services, or contact the insurance carrier for additional information on dependent Disclaimer:eligibility.
Employee RequirementsEligibility
SUMMARY PAGES
Annual Benefit
The most an eligible or insured person can pay in co insurance for covered expenses.
You are performing your regular occupation for the employer on a full time basis, either at one of the employer’s usual places of business or at some location to which the employer’s business requires you to travel If you will not be actively at work beginning 9/1/2022 please notify your benefits administrator.
SUMMARY PAGESHelpful Definitions 10
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
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).
Actively at Work
Guaranteed Coverage
Pre Existing Conditions
Annual Enrollment
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.
Doctors, hospitals, optometrists, dentists and other providers who have contracted with the plan as a network provider. Out of Pocket Maximum
In Network
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.
Plan Year September 1st through August 31st
SUMMARY PAGESHSA vs. FSA Health Savings Account (HSA) (IRC Sec. 223) Flexible Spending Account (FSA) (IRC Sec. 125) Description Approved by Congress in 2003, HSAs are actual bank accounts in employee’s names that allow employees to save and pay for unreimbursed qualified medical expenses tax free. Allows employees to pay out of pocket expenses for copays, deductibles and certain services not covered by medical plan, tax free. This also allows employees to pay for qualifying dependent care tax free. Employer Eligibility A qualified high deductible health plan. All employers Contribution Source Employee and/or employer Employee and/or employer Account Owner Individual Employer Underlying RequirementInsurance High deductible health plan None Minimum Deductible $1,400 single (2022) $2,800 family (2022) N/A Maximum Contribution $3,650 single (2022) $7,300 family (2022) $2,850 (2022) Permissible Use Of Funds Employees may use funds any way they wish. If used for non qualified medical expenses, subject to current tax rate plus 20% penalty. Reimbursement for qualified medical expenses (as defined in Sec. 213(d) of IRC). Cash Outs of Unused Amounts (if no medical expenses) Permitted, but subject to current tax rate plus 20% penalty (penalty waived after age 65). Not permitted Year-to-year rollover of account balance? Yes, will roll over to use for subsequent year’s health coverage. No. Access to some funds may be extended if your employer’s plan contains a 2 1/2 month grace period 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. 36 11
Monthly Premium Employer Contribution Employee Cost TRS ActiveCare HD Employee Only $376.00 $376.00 $0.00 Employee & Spouse $1,058.00 $376.00 $682.00 Employee & Child(ren) $675.00 $376.00 $299.00 Employee & Family $1,265.00 $376.00 $889.00 TRS ActiveCare 2 Employee Only $1,013.00 $376.00 $637.00 Employee & Spouse $2,402.00 $376.00 $2,026.00 Employee & Child(ren) $1,507.00 $376.00 $1,131.00 Employee & Family $2,841.00 $376.00 $2,465.00 TRS ActiveCare Primary Employee Only $346.00 $364.00 $0.00 Employee & Spouse $976.00 $376.00 $600.00 Employee & Child(ren) $622.00 $376.00 $246.00 Employee & Family $1,168.00 $376.00 $729.00 TRS ActiveCare Primary+ Employee Only $457.00 $376.00 $81.00 Employee & Spouse $1,117.00 $376.00 $741.00 Employee & Child(ren) $735.00 $376.00 $359.00 Employee & Family $1,405.00 $376.00 $1,029.00 Blue Essentials West Texas HMO Employee Only $689.60 $376.00 $313.60 Employee & Spouse $1,672.26 $376.00 $1,296.26 Employee & Child(ren) $1,083.58 $376.00 $707.58 Employee & Family $1,775.58 $376.00 $1,399.58 Central & North Texas Baylor Scott and White HMO Employee Only $491.55 $376.00 $115.55 Employee & Spouse $1,232.58 $376.00 $856.58 Employee & Child(ren) $789.39 $376.00 $413.39 Employee & Family $1,418.42 $376.00 $1,042.42 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/taylorisd Medical Insurance Carrier Name EMPLOYEE BENEFITS 12
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• Call/Text: (817) 882 0800. EECU’s dedicated member service representatives are available to assist you with any questions. Their hours of operation are Monday through Friday from 8:00 a.m. to 7:00 p.m. CT, Saturday 9:00 a.m. 1:00 p.m. CT and closed on Sunday.
Opening an HSA
• Enrolled in an HSA eligible HDHP
If you meet the eligibility requirements, you may open an HSA administered by HSA Bank. 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.
Maximum Contributions Your HSA contributions may not exceed the annual maximum amount established by the Internal Revenue Service. The annual contribution maximum for 2022 is based on the coverage option you elect:
Health Savings Account (HSA)
• You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.
• You may open an HSA at the financial institution of your choice, but only accounts opened through EECU are eligible for automatic payroll deduction and company contributions.
How to Use your HSA
• Not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan
You are eligible to open and contribute to an HSA if you are:
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.
• Stop by: a local EECU financial center for in person assistance; find EECU locations & service hours a www.eecu.org/locations.
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.
HSA Eligibility
EECU EMPLOYEE BENEFITS
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• Online/Mobile: Sign in for 24/7 account access to check your balance, pay bills and more.
HSA
ABOUT
• Not enrolled in a Health Care Flexible Spending Account
• Not enrolled in Medicare or TRICARE
• Individual $3,650 • Family (filing jointly) $7,300 You decide whether to use the money in your account to pay for qualified expenses or let it grow for future use. If you are 55 or older, you may make a yearly catch up contribution of up to $1,000 to your HSA. If you turn 55 at any time during the plan year, you are eligible to make the catch up contribution for the entire plan year.
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 can use the money in your HSA to pay for qualified medical expenses now or in the future. You can also use HSA funds to pay health care expenses for your dependents, even if they are not covered by the HDHP.
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.
• Not eligible to be claimed as a dependent on someone else’s tax return
• Not receiving Veterans Administration benefits
• Lost/Stolen Debit Card: Call the 24/7 debit card hotline at (800) 333 9934
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/taylorisd
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/taylorisd Telehealth MD Live 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/fbsbh • Phone 888 365 1663 • Mobile download the MDLIVE mobile app to your smartphone or mobile device • Select “MDLIVE as a benefit” and “FBS” as your Employer/Organization when registering your account. Telehealth Employee & Family Employer Paid 20
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/taylorisd Dental Insurance MetLife EMPLOYEE BENEFITS How do I request a new ID Card? You can request your dental id card by contacting MetLife directly at 800 942 0854. You can also go to www.metlife.com and register/login to access your account. How do I find an in network Dentist? 1. Go to www.metlife.com 2. Select “Find a Dentist” 3. Select PDP Plus next to “Choose a network” High PPO Low PPO Coverage Type In Network1 % of PDP Fee2 Out of Network1 % of R&C Fee4 In Network1 % of PDP Fee2 Out of Network1 Type A Preventive 100% 100% 100% 100% Type B Basic Restorative 80% 80% 80% 80% Type C Major Restorative 50% 50% 50% 50% Type D Orthodontia 50% 50% 50% 50% Deductible3 Individual/Family $50 $50 $50 $50 Annual Maximum Benefit Per Individual $1,000 $1,000 $750 $750 Orthodontia Lifetime Maximum Ortho applies to Adult and Child Up to dependent age limit: 19 years old $1000 per Person 1. "In Network Benefits" refers to benefits provided under this plan for covered dental services that are provided by a participating dentist. "Out of Network Benefits" refers to benefits provided under this plan for covered dental services that are not provided by a participating dentist. 2. Negotiated fees refer to the fees that participating dentists have agreed to accept as payment in full for covered services, subject to any copayments, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change. 3. Applies to Type B and C services only. 4. Out of network benefits are payable for services rendered by a dentist who is not a participating provider. The Reasonable and Customary charge is based on the lowest of: • the dentist’s actual charge (the 'Actual Charge'), • the dentist’s usual charge for the same or similar services (the 'Usual Charge') or • the usual charge of most dentists in the same geographic area for the same or similar services as determined by MetLife (the 'Customary Charge'). For your plan, the Customary Charge is based on the 90th percentile. Services must be necessary in terms of generally accepted dental standards. DentalHigh PPO Low PPO Employee $36.72 $25.54 Employee + Spouse $65.71 $45.95 Employee + Child(ren) $65.71 $45.95 Family $103.65 $71.04 21
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/taylorisd Vision Insurance Superior Vision EMPLOYEE BENEFITS 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. Discount Features Non Covered Eyewear Discount: Members may also receive a discount of 20% from a participating provider’s usual and customary fees for eyewear purchases which exceed the benefit coverage (except disposable contact lenses, for which no discount applies). This includes eyeglass frames which exceed the selected benefit coverage, specialty lenses (i.e. progressives) and lens “extras” such as tints and coatings. Eyewear purchased from a Walmart Vision Center does not qualify for this additional discount because of Walmart’s “Always Low Prices” policy. Superior Select Southwest Network In network Out of network Exam Covered in full Up to $35 retail Frames $150 retail allowance Up to $70 retail Lenses (standard) per pair Single Vision Covered in full Up to $25 retail Bifocal Covered in full Up to $40 retail Trifocal Covered in full Up to $45 retail Progressive See description1 Up to $45 retail Lenticular Covered in full Up to $80 retail Scratch coating Covered in full Not covered Polycarbonate Covered in full Not covered Anti reflective coating Covered in full Not covered UV coating Covered in full Not covered Tint Covered in full Not covered Contact Lenses2 $200 retail allowance Up to $80 retail Medically Necessary Contact Lenses Covered in full Up to $150 retail Lasik Vision Correction $300 allowance3 Co pays apply to in network benefits; co pays for out of network visits are deducted from reimbursements 1. 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 2. Contact lenses and related professional services (fitting, evaluation and follow up) are covered in lieu of eyeglass lenses and frames benefit 3. Lasik Vision Correction is in lieu of eyewear benefit, subject to routine regulatory filings and certain exclusions and limitations Copays Services/frequency Monthly Premiums Exam $10 Exam 12 months Employee $11.44 Materials $10 Frame 12 months Employee + Spouse $19.76 Lenses 12 months Employee + Child(ren) $20.80 Contact lenses 12 months Family $31.20 22
Hospital Indemnity Aetna EMPLOYEE BENEFITS
IndemnityLow High Employee $16.80 $33.60 Employee + Spouse $37.44 $74.88 Employee + Child(ren) $28.77 $57.54 Family $47.57 $95.13 23
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/taylorisd
Service Benefit Plan 1 Plan 2
Hospital Stay (ICU) Daily Pays a daily benefit, beginning on day two of your stay in an ICU room of a hospital. Maximum 30 days per plan year $200 $400
Newborn routine care Provides a lump sum benefit after the birth of your newborn. This will not pay for an outpatient birth. $100 $200 Observation unit Provides a lump sum benefit for the initial day of your stay in an observation unit as the result of an illness or accidental injury. Maximum 1 day per plan year. $100 $200 Substance abuse stay Daily Pays a daily benefit for each day you have a stay in a hospital or substance abuse treatment facility for the treatment of substance abuse. Maximum 30 days per plan year. $100 $200
Hospital Stay Admission Pays a lump sum benefit for the initial day of your stay in a hospital.
Important Note: All daily inpatient stay benefits begin on day two and count toward the plan year maximum.
ABOUT HOSPITAL INDEMNITY
Maximum 1 stay per plan year. $1,000 $2,000 Hospital Stay Daily Pays a daily benefit, beginning on day two of your stay in a non ICU room of a hospital. Maximum 30 days per plan year $100 $200
The Hospital Indemnity Plan provided through Aetna helps with the high cost of medical care by paying you a set amount when you have an inpatient hospital stay. Unlike traditional insurance, which pays a benefit to the hospital or doctor, this plan pays you directly based on the care or treatment you receive. These costs may include meals and transportation, childcare or time away from work due to a medical issue that requires hospitalization. If you need to submit a claim you do so on the Aetna portal at
Mental Disorder stay Daily Pays a daily benefit for each day you have a stay in a hospital or mental disorder treatment facility for the treatment of mental disorders. Maximum 30 days per plan year. $100 $200
Rehabilitation unit stay Daily Pays a benefit each day of your stay in a rehabilitation unit immediately after your hospital stay due to an illness or accidental injury. Maximum 30 days per plan year. $50 $100
myaetnasupplemental.comHospital
EMPLOYEE BENEFITS Your Plan Eligibility
You are eligible for disability coverage if you are an active employee in the United States working a minimum of 20 hours per week. The date you are eligible for coverage is the later of: the plan effective date; or the day after you complete the waiting period.
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You may purchase a monthly benefit in $100 units, starting at a minimum of $200, up to 66 2/3% of your monthly earnings rounded to the nearest $100, but not to exceed a monthly maximum benefit of $8,000.
Elimination Period
Your duration of benefits is based on your age when the disability occurs. Plan: ADEA II: Your duration of benefits is based on the following table: Age at Disability Maximum Duration of Benefits Less than age 60 To age 65, but not less than 5 years Age 60 through 64 5 years Age 65 through 69 To age 70, but not less than 1 year Age 70 and over 1 year
Other Important Provisions
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/taylorisd
Disability Insurance Unum
If, because of your disability, you are hospital confined as an inpatient, benefits begin on the first day of inpatient confinement. Inpatient means that you are confined to a hospital room due to your sickness or injury for 23 or more consecutive hours. (Applies to Elimination Periods of 30 days or less.)
Pre Existing Condition Exclusion: Benefits will not be paid for disabilities caused by, contributed to by, or resulting from a pre existing condition. You have a pre existing condition if: • you received medical treatment, consultation, care or services including diagnostic measures, or took prescribed drugs or medicines in the 3 months just prior to your effective date of coverage; and • the disability begins in the first 12 months after your effective date of coverage.
Disability Elimination Period per $200 in benefit 14/14 $5.56 30/30 $4.78 60/60 $3.84 90/90 $2.16 180/180 $1.52
The Elimination Period is the length of time of continuous disability, due to sickness or injury, which must be satisfied before you are eligible to receive benefits. You may choose an Elimination Period (injury/sickness) of 14/14, 30/30, 60/60, 90/90 or 180/180 days.
Benefit Amount
Benefit Duration
The lifetime cumulative maximum benefit period for all disabilities due to mental illness and disabilities based primarily on self reported symptoms is 24 months. Only 24 months of benefits will be paid for any combination of such disabilities even if the disabilities are not continuous and/or are not related. Payments would continue beyond 24 months only if you are confined to a hospital or institution because of the disability. Limitations apply.
• After benefits have been paid for 24 months, you are disabled when Unum determines that due to the same sickness or injury, you are • unable to perform the duties of any gainful occupation for which you are reasonably fitted by education, training, or experience.
Benefit Integration: Your disability benefit will be reduced by deductible sources of income and any earnings you have while disabled.
• You must be under the regular care of a physician to be considered disabled.
How to File a Claim and Other Important Resources To get the claim form go to your benefit website, www.mybenefitshub.com/taylorisd To file a claim online: https://www.unum.com/employees/file a claim To check the status of a claim: • https://unum.com/claims • (800) 858 6843 M F 8 8 EST 25
After you have received monthly disability payments for 12 months, your gross disability payment will be reduced by such items as additional deductible sources of income you receive or are entitled to receive under state compulsory benefit laws.
Unum EMPLOYEE BENEFITS
Disability Insurance
Mental Illness/Self Reported Symptoms
Cancer Insurance Treatment for cancer is often lengthy and expensive. While your health insurance helps pay the medical expenses for cancer treatment, it does not cover the cost of non medical expenses, such as out of town treatments, special diets, daily living and household upkeep. In addition to these non medical expenses, you are responsible for paying your health plan deductibles and/or coinsurance. Cancer insurance through American Public Life helps pay for these direct and indirect treatment costs so you can focus on your health. Should you need to file a claim contact APL at 800 256 8606 or online at www.ampublic.com. claim and materials at www.mybenefitshub.com/taylorisd
You can find additional
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/taylorisd
APL EMPLOYEE BENEFITS
forms
Cancer LOW HIGH Employee Only $17.84 $24.86 Employee & Spouse $33.26 $47.28 Employee & Child(ren) $20.80 $31.74 Employee & Family $33.94 $47.98 Low High Internal Cancer First Occurrence (Carcinoma in situ is not considered internal cancer) $2,500 $5,000 Cancer Screening Rider Benefits 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 Cancer Treatment Policy Benefits Radiation and Chemotherapy, Immunotherapy Maximum Per 12 month period $10,000 $20,000 Hormone Therapy Maximum of 12 treatments per calendar year $50 per treatment $50 per treatment Surgical Rider Benefits 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 Miscellaneous Care Rider Benefits Hair Piece (Wig) 1 per lifetime $150 $150 Blood, Plasma &Platelets $300 per day $300 per day Ambulance Ground /Air Maximum of 2 trips per Hospital Confinement for all modes of transportation combined $200/$2000 per trip $200/$2000 per trip Heart Attack/Stroke First Occurrence Rider Benefits Lump Sum Benefit Maximum per 1 covered person per lifetime $2500 $2500 Hospital Intensive Care Unit Rider Benefits Intensive Care Unit $600 per day $600 per day Pre Existing Condition Exclusion: Review the Benefit Summary page located on your employee benefits portal for full details. 26
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/taylorisd Accident Insurance APL EMPLOYEE BENEFITS THIS POLICY IS A LIMITED PLAN ANDONLY COVERS ACCIDENTS. IS NOT A POLICY FOR WORKERS’ COMPENSATION INSURANCE. PLEASE REFER TO THE EMPLOYEE PORTAL AT TAYLOR ISD UNDER THE ACCIDENT SECTION FOR COMPLTE DETAILS AND LIMITATONS. Summary of Benefits 24 Hour Plan 1 Plan 2 Emergency Treatment 1 Unit 2 Units Initial Treatment within 72 hours of a Covered Accident in Emergency Room $150 $300 Initial Treatment within 72 hours of a Covered Accident in Physician’s Office $50 $100 Initial Treatment after 72 hours but within 30 days after a Covered Accident $25 $50 Follow Up Treatment Maximum of 6 visits $25 $50 Major Diagnostic Screening (MRI) $100 $200 X Ray $25 $50 Emergency Dental Work Crown/Extraction $75/$25 $150/$50 Patient Care 1 Units 2 Units Hospital Admission per admission $500 $1,000 Hospital Confinement per day Maximum of 365 days $100 $200 Intensive Care Unit Confinement per day Maximum of 15 days $200 $400 Step Down Unit Confinement per day Maximum of 15 days $150 $300 Rehabilitation Unit Confinement per day Maximum of 90 days $50 $100 Therapy Physical, Occupational or Speech per visit Maximum of 8 visits $25 $50 Injuries & Treatment 1 Unit 2 Units Fractures* up to $1,500 up to $3,000 Dislocation* up to $1,200 up to $2,400 Internal Injuries $250 $500 Tendons, Ligaments, Rotator Cuff up to $187.50 up to $375 Burns up to $12,500 up to $25,000 Skin Grafts up to $6,250 up to $12,500 Ruptured Disc or Torn Knee Cartilage 25% if occurs during first 12 months $125 $250 Eye Injury up to $62.50 up to $125 Concussion $50 $100 Lacerations up to $200 up to $400 AccidentLow High Employee $8.94 $12.53 Employee + Spouse $13.10 $18.92 Employee + Child(ren) $15.28 $25.26 Family $18.71 $31.38 27
Summary of Benefits (cont’d) Plan 1 Plan 2 Epidural Pain Management $25 $50 Blood, Plasma and Platelets $62.50 $125 Exploratory Surgery without Repair $62.50 $125 Hernia 25% if occurs during first 12 months $25 $50 Prosthesis $125 $250 Appliances $25 $50 Coma Due to a Covered Accident $2,500 $5,000 Transportation & Lodging 1 Unit 1 Units Ambulance Ground/Air $400/$1,200 $400/$1,200 Transportation per round trip Maximum of 3 round trips $300 $300 Family Member Lodging & Meals per day Maximum of 30 days $100 $100 Accidental Death & Dismemberment 1 Unit 1 Units Accidental Death Common Carrier/Other* $100,000/$25,000 $100,000/$25,000 Accidental Dismemberment* up to $15,000 up to $15,000 Catastrophic Loss* up to $30,000 up to $30,000 *Amounts shown are for individuals; amounts for spouse and child(ren) may vary. Please refer to your Schedule of Benefits for details. Accident Insurance APL EMPLOYEE BENEFITS 28
How many times can I receive the Maximum Critical Illness Benefit?
• For you: You also have the opportunity to purchase an additional Maximum Critical Illness Benefit of $5,000 $30,000 in $5,000 increments
• 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.
benefit does
Your plan includes the Restoration Benefit*, which provides a one time restoration of 100% of the maximum benefit amount in order to pay an additional benefit if you experience a second covered illness for a different condition. Your plan also 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 covered illness or 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 a partial benefit is paid out, it will not reduce the available maximum benefit amount for the illnesses or diseases in that same module. If you have reached the benefit limit by receiving the maximum benefit in each module, you may choose to end your coverage; however, if you have coverage for your spouse and/or child(ren), you must continue your coverage in order to keep their coverage active. Please see the certificate of for details.
For full plan details, please visit your benefit website: www.mybenefitshub.com/taylorisd
cancer module. Base Module • Heart attack • Major organ failure • Stroke • Permanent paralysis • Coronary artery bypass (25%) • End stage renal (kidney) failure • Coma Cancer Module • Cancer • Carcinoma in situ (25%) • Skin cancer (10%) 29
Who is eligible for Critical Illness Insurance?
*This not the
• You all active employees working 15+ hours per week.
• Taylor ISD provides its employees with a $5,000 Critical Illness Benefit at no cost to you.
• Your child(ren) to age 26. If you are covered for Basic employee coverage, you may elect child(ren) coverage, even if you do not elect Supplemental coverage on yourself.
• Your spouse* under age 70. If you are covered for Basic employee coverage, you may elect spouse coverage, even if you do not elect Supplemental coverage on yourself.
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.
Critical Illness Insurance pays a lump sum benefit if you are diagnosed with a covered illness or condition. Your employer provides Critical Illness Insurance at no cost to you. You also have the option to elect additional coverage. 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.
An affordable way to help protect against the financial stress of a serious illness.
• For your spouse: You have the opportunity to purchase a Maximum Critical Illness Benefit $5,000 $15,000 in $5,000 increments.
ABOUT CRITICAL ILLNESS
What is Critical Illness Insurance?
Usually you are only able to receive the Maximum Critical Illness Benefit for one covered illness or disease within each module.
coverage
For what critical illnesses and conditions are benefits available?
*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.
Illness Insurance Voya EMPLOYEE BENEFITS
Critical
apply to
What Maximum Critical Illness Benefit am I eligible for?
Critical Illness Insurance Voya EMPLOYEE BENEFITS How much does Critical Illness Insurance cost? Limitations Benefits reduce 50% for the employee and/or covered spouse on the policy anniversary following the 70th birthday, however, premiums do not reduce as a result of this benefit change. Who do I contact with questions? For more information, please call the Voya Employee Benefits Customer Service Team at (800) 955 7736.. Critical Illness ($5,000 increments) Employee $5,000.00 $10,000.00 $15,000.00 $20,000.00 $25,000.00 $30,000.00 Under 30 $1.80 $3.60 $5.40 $7.20 $9.00 $10.80 30 39 $2.50 $5.00 $7.50 $10.00 $12.50 $15.00 40 49 $5.10 $10.50 $15.30 $20.40 $25.50 $30.60 50 59 $11.35 $22.70 $34.05 $45.04 $56.08 $68.10 60 64 $17.00 $34.00 $51.00 $68.00 $85.00 $102.00 65 69 $22.75 $45.50 $68.25 $91.00 $113.75 $136.50 70+ $30.90 $61.80 $92.70 $123.60 $154.50 $185.40 Spouse $5,000.00 $10,000.00 $15,000.00 Under 30 $2.50 $5.00 $7.50 30 39 $3.00 $6.00 $9.00 40 49 $6.10 $12.20 $18.30 50 59 $14.55 $29.10 $43.65 60 64 $22.15 $44.30 $66.45 65 69 $23.15 $46.30 $69.45 70+ $40.75 $81.50 $122.25 Child $1,000.00 $2,500.00 $5,000.00 $10,000.00 All Ages $0.15 $0.38 $0.75 $1.50 30
Life and AD&D OneAmerica 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/taylorisd EMPLOYEE BENEFITS • Provides a cash benefit to your loved ones in the event of your death. • To file a claim contact One America at (800) 833 5569 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 Taylor ISD 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. Reduction Upon reaching certain ages, your original benefit amount will reduce to the percentage shown in the following schedule. The amounts of dependent life insurance will reduce according to the employee's reduction schedule. Employee: $10,000 to $500,000, in $10,000 increments Guaranteed coverage amount during initial offering or approved special enrollment period $180,000 Newly hired employee guaranteed coverage amount $150,000 Minimum coverage amount $10,000 Spouse: under age 70: $5,000 to $250,000, in $5,000 increments, not to exceed 50% of the employee’s amount Guaranteed coverage amount during initial offering or approved special enrollment period $50,000 Newly hired employee guaranteed coverage amount $50,000 Maximum coverage amount 100% of the employee coverage amount Minimum coverage amount $5,000 Dependent Children Day 1 months to age 26 guaranteed coverage amount $10,000 Additional Plan Benefits Accelerated Death Benefit If diagnosed with terminal illness 25%, 50% or 75% paid to use for whatever you choose. Included Conversion Included Portability Included Age: 65 70 Reduces to: 65% 50% 31
$80,000 $1.52 $2.40 $90,000 $1.71 $2.70 $100,000 $1.90 $3.00 $110,000 $2.03 $3.30 $120,000 $2.25 $3.60
$0.45 45 49 $1.50 $0.50 50 54 $2.40 $0.75 55 59
Spouse
• Employee: Up to $750,000, in $10,000 increments
Dependent AD&D Coverage: Optional dependent AD&D coverage is available to eligible employees. You must select employee coverage in order to cover your spouse and/or child (ren). If employee AD&D is declined, no dependent AD&D will be Reductionsincluded.:Upon reaching certain ages, your original benefit amount will reduce to the percentage shown in the following schedule. The amounts of dependent AD&D principal sum will reduce according to the employee's reduction schedule.
Voluntary Group Life Child(ren) $10,000 in coverage 0 26 $2.00
$40,000 $0.76 $1.20
70 74
32
• Child: 15% of the employee AD&D benefit AD&D Guaranteed Issue:
• Employee: $750,000 • Spouse: $450,000 • Child: $30,000 Accidental Death and Dismemberment (AD&D): If AD&D is selected, additional life insurance benefits may be payable in the event of an accident which results in death or dismemberment as defined in the contract.
60 64
$20,000 $0.39 $0.60
Age Employee Spouse to age 70 24 $0.60 $0.30 29 $0.60 $0.30 $0.80 $0.30 $0.90 $0.40 $1.00 $4.30 $1.20 $6.60 $12.70 $3.30 $20.60 $6.35 $20.60 N/A
$70,000 $1.33 $2.10
Life and AD&D OneAmerica EMPLOYEE BENEFITS What you need to know about your Basic Life and AD&D Benefits
rates based on Employee's age. AD&D to max of $750,000
35 39
75+
• Spouse: 60% of the employee AD&D benefit
Age: 65 70 Reduces to: 65% 50% coverage)
25
Guaranteed Issue: Employee: $10,000 Accidental Death and Dismemberment (AD&D): Additional life insurance benefits may be payable in the event of an accident which results in death or dismemberment as defined in the contract. Additional AD&D benefits include seat belt, air bag, repatriation, child higher education, childcare, paralysis/loss of use, severe burns, disappearance, and exposure. If diagnosed with a terminal illness and have less than 12 months to live, you may apply to receive 25%, 50% or 75% of your life insurance benefit to use for whatever you choose. What you need to know about your Voluntary AD&D Benefits AD&D is a very inexpensive form of life insurance that can give you additional protection in the event of an accidental death or Flexibledismemberment.AD&DOptions:
$30,000 $0.57 $0.90
30 34
$2.15 65 69
Employee AD&D $10,000 $0.19 $0.30
Employee Family
18
Voluntary Group Life per $10,000 in coverage (Spouse per $5,000 in
40 44
$50,000 $0.95 $1.50 $60,000 $1.14 $1.80
FAMILY PROTECTION Coverage is available for spouses and financially dependent children, even if the employee doesn’t elect coverage on themselves.
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/taylorisd
ILLNESS ACCELERATION OF BENEFITS Coverage that pays 30% (25% in CT and MI) of the coverage amount in a lump sum upon the occurrence of a terminal condition that will result in a limited life span of less than 12 months (24 months in IL).
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.
33
PORTABLE Coverage continues with no loss of benefits or increase in cost if employment terminates after the first premium is paid. We simply bill the employee directly. CONVENIENCE Easy payments through payroll deduction.
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.
CUSTOMIZABLE With several options to choose from, employees select the coverage that best meets the needs of their TERMINALfamilies.
QUALITY OF LIFE Optional benefit that accelerates a portion of the death benefit on a monthly basis, up to 75% of your benefit, and is payable directly to you on a tax favored basis for the following: • Permanent inability to perform at least two of the six Activities of Daily Living (ADLs) without substantial assistance; or • Permanent severe cognitive impairment, such as dementia, Alzheimer’s disease and other forms of senility, requiring substantial supervision. Find full details and rates at www.mybenefitshub.com/taylorisd Should you need to file a claim, contact 5Star directly at (866) 863 9753.
* Financially dependent children 14 days to 23 years old.
Enhanced coverage options for employees. Easy and flexible enrollment for employers. The 5Star Life Insurance
*Quality of Life not available ages 66 70. Quality of Life benefits not available for children Child life coverage available only on children and grandchildren of employee (age on application date: 14 days through 23 years).$7.15 monthly for $10,000 coverage per child.
Individual Life Insurance 5Star 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/taylorisd Identity Theft ID Watchdog EMPLOYEE BENEFITS Easy & Affordable Identity Protection Your identity is important it’s what makes you, you. You’ve spent a lifetime building your name and financial reputation. Let us help you better protect it. And we’ll even go one step further and help you better protect the identities of your family! Features • Credit Lock helps provide additional protection against unauthorized access to your credit • More For Families helps better protect your loved ones no matter the age. • Resolution Specialist manage the case for you until your identity is restored ID watchdog Monitors: social media, transaction records, public records, and more. How to file a claim: Call 866 513 1518 or download the app to additional services. IDENTITY THEFT PROTECTION The Powerful Features You Want All at an Affordable Price Monitor & Detect • Credit Report & VantageScore • Credit Score | 1 Bureau Monthly • Credit Score Tracker | 1 Bureau Monthly • Credit Report Monitoring1 | 3 Bureau • Dark Web Monitoring* • High Risk Transactions Monitoring* • Subprime Loan Monitoring* • Public Records Monitoring* • USPS Change of Address Monitoring • Identity Profile Report Manage & Alert • Child Credit Lock*| 1 Bureau • Credit Report Lock | 1 Bureau* • Financial Accounts Monitoring • Social Network Alerts* • Registered Sex Offender Reporting* • Customizable Alert Options • Breach Alert Emails • Mobile App • National Provider ID Alerts Support & Restore • Identity Theft Resolution Specialists (Resolution for Pre existing Conditions)* • 24/7/365 U.S. based Customer Care Center • Up to $1M Identity Theft Insurance* • Lost Wallet Vault & Assistance • Deceased Family Member Fraud Remediation • Fraud Alert & Credit Freeze Assistance Identity Theft Employee $9.95 Family $17.95 34
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.
Non Emergency Inter Facility Transportation (Emergent Plus Only)
Emergency Medical Transport MASA EMPLOYEE BENEFITS
ABOUT MEDICAL TRANSPORT Medical Transport covers emergency transportation to and from appropriate medical facilities by covering the out of pocket costs that are not covered by insurance. It can include emergency transportation via ground ambulance, air ambulance and helicopter, depending on the plan.
Emergent Air Transportation (Emergent & Emergent Plus)
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 Repatriation/Recuperationfacilities. (Emergent Plus Only)
In the event of a serious medical emergency, Members have access to emergency ground 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 recuperation. Should you need assistance with a claim contact MASA at 800 643 9023. You can find full benefit details at benefit website at www.mybenefitshub.com/taylorisd and select your school district.
Emergency Transportation Emergent Emergent Plus Employee and Family $9.00 $14.00 35
In the event of a serious medical emergency, Members have access to emergency air transportation into a medical facility or between medical facilities.
For full plan details, please visit your benefit website: www.mybenefitshub.com/taylorisd
Emergent Ground Transportation (Emergent & Emergent Plus)
• The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.
Flexible Spending Account (FSA)
Higginbotham EMPLOYEE BENEFITS Health Care FSA
For full plan details, please visit your benefit website: www.mybenefitshub.com/taylorisd
• Medical deductibles and coinsurance
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A Flexible Spending Account allows you to pay for eligible healthcare expenses with a pre loaded debit card. You choose the amount to set aside from your paycheck every plan year, based on your employer’s annual plan limit. This money is use it or lose it within the plan year (unless your plan contains a $500 rollover or grace period provision).
ABOUT FSA
• 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.
• 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.
Higginbotham Benefits Debit Card
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:
The Higginbotham Benefits Debit Card gives you immediate access to funds in your Health Care FSA when you make a purchase without needing to file a claim for reimbursement. If you use the debit card to pay anything other than a copay amount, you will need to submit an itemized receipt or an Explanation of Benefits (EOB). If you do not submit your receipts, you will receive a request for substantiation. You will have 60 days to submit your receipts after receiving the request for substantiation before your debit card is suspended. Check the expiration date on your card to see when you should order a replacement card(s).
Dependent Care FSA
• Overnight camps are not eligible for reimbursement (only day camps can be considered).
• Prescription copays
• Dental and vision expenses
• If your child turns 13 midyear, you may only request reimbursement for the part of the year when the child is under age 13.
Things to Consider Regarding the Dependent Care FSA
Flexible Spending Account (FSA) Higginbotham EMPLOYEE BENEFITS Important FSA Rules • The maximum per plan year you can contribute to a Health Care FSA is $2,850. The maximum per plan year you can contribute to a Dependent Care FSA is $5,000 when filing jointly or head of household and $2,500 when married filing separately. • You cannot change your election during the year unless you experience a Qualifying Life Event. • You can continue to file claims incurred during the plan year for another 90 days after August 31st • Your Health Care FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care TheHigginbothamexpenses.PortalHigginbothamPortal provides information and resources to help you manage your FSAs. • Access plan documents, letters and notices, forms, account balances, contributions and other plan information • Update your personal information • Utilize Section 125 tax calculators • Look up qualified expenses • Submit claims • Request a new or replacement Benefits Debit Card Register on the Higginbotham Portal Visit https://flexservices.higginbotham.net and click Register. Follow the instructions and scroll down to enter your information. • Enter your Employee ID, which is your Social Security number with no dashes or spaces. • Follow the prompts to navigate the site. • If you have any questions or concerns, contact Higginbotham: Phone 866 419 3519 Email flexclaims@higginbotham.net Fax 866 419 3516 Higginbotham Flex Mobile App Easily access your Health Care FSA on your smartphone or tablet with the Higginbotham mobile app. Search for Higginbotham in your mobile device’s app store and download as you would any other app. • View Accounts Includes detailed account and balance information • Card Activity Account information • SnapClaim File a claim and upload receipt photos directly from your smartphone • Manage Subscriptions Set up email notifications to keep up to date on all account and Health Care FSA debit card activity • Log in using the same username and password you use to log in to the Higginbotham Portal. Note: You must register on the Higginbotham Portal in order to use the mobile app. 37
• Our North American network of 11,300 EAP providers includes all 50 U.S. states, Puerto Rico, the Virgin Islands, Mexico, Canada and U.S. Territories.
•
• totally focused on short term, solution focused counseling with EAP clinicians.
• A fully staffed bilingual clinical consultant team answers calls from service centers in St. Petersburg, FL; Minneapolis, MN; Blue Bell, PA; Toronto, Winnipeg and Montreal, Canada.
• An app for mobile devices makes the LifeWorks.com site accessible from anywhere at any time for iPhone, Android and Blackberry users. IN PERSON
MOBILE
• Taylor ISD employees and their families will have access to “6 face to face sessions”
TELEPHONE •
confidential assistance
• Ceridian develops close relationships and carefully evaluates the national network of EAP providers who deliver in person counseling to your employees. This cohesive team includes consultants that complete the initial screening assessment and connect participants to the EAP provider and EAP affiliate managers to ensure a high quality experience. Ceridian also employs a Clinical Supervisor within Provider Network Services for case consultation and assistance to the local EAP affiliate.
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/taylorisd Employee Assistance Program (EAP) Life Works EMPLOYEE BENEFITS Taylor ISD employees and their families have anytime access to LifeWorks Integrated EAP and Work life services in a variety of ways that fit their preferences and unique 888needs.456 1324 | www.lifeworks.com Username: tisd; Password: lifeworks
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• Our entire network is composed of licensed mental health professionals. Minimum qualifications include a license to practice independently in the state in which services are provided along with five years post graduate experience and three years providing EAP services.
• Our counselors and providers possess strong EAP and work life skills, and we aggressively recruit Certified Employee Assistance Professionals (CEAPs) whose focus is on helping employees quickly resolve issues that may interfere with their work.
Taylor ISD employees and their families will have access to and support on a wide range of issues the areas of life, health, family, work and money. All calls are answered live by Ceridian employees who are trained clinical consultants with master’s/doctorate degrees. LifeWorks is a 24/7 operation, so there are no changes in our service delivery during non business hours your employees will not be directed to leave messages.
in
Notes 39
WWW.MYBENEFITSHUB.COM/TAYLORISD
2022 - 2023 PlanYear
40
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 Taylor 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 Taylor 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.