2023-24 Celina ISD Benefit Guide

Benefit Contact Information

CELINA ISD BENEFITS TRS - ACTIVECARE MEDICAL

Financial Benefit Services (800) 583-6908

www.mybenefitshub.com/celinaisd

BCBSTX (866) 355-5999

www.bcbstx.com/trsactivecare

PHARMACY MANAGER FOR ACTIVE CARE PLANS ONLY

Express Scripts (844) 238-8084

https://www.express-scripts.com/ trsactivecare

TRS - HMO MEDICAL LIFE AND AD&D HOSPITAL INDEMNITY

Scott & White HMO (844) 633-5325

www.trs.swhp.org

The Hartford Group #873302 (888) 563-1124

www.thehartford.com/employeebenefits/employees

The Hartford Group #873302 (866) 547-4205

https:/thehartford.com/benefits/ myclaim

TELEHEALTH DENTAL VISION

MDLive (888) 363-1663

www.mdlive.com/fbs

FCL Dental Group #M1245-D (877) 493-6282

www.fcldental.com

Superior Vision Group #324700 (800) 507-3800

www.superiorvision.com

DISABILITY CANCER ACCIDENT

The Hartford Group #873302 (866) 547-9124

www.thehartford.com/employeebenefits/claims

IDENTITY THEFT

Ilock 360

(855) 287-8888

customerservice@ilock360.com

American Public Life Group #12697

(800) 256-8606

www.secured.ampublic.com

American Public Life Group #12697

(800) 256-8606

www.ampublic.com

EMERGENCY MEDICAL TRANSPORT FLEXIBLE SPENDING ACCOUNT (FSA)

MASA

Group #B2BCELISD

(800) 643-9023

claims@masaglobal.com

HEALTH SAVINGS ACCOUNT (HSA) INDIVIDUAL LIFE INSURANCE

EECU

(817) 882-0800

www.eecu.org

5 Star (866) 863-9753

https://5starlifeinsurance.com

Higginbotham

(866) 419-3519

https://flexservices.higginbotham.net/

EMPLOYEE ASSISTANCE PROGRAM

Ability Assist (800) 964-3577

www.guidanceresources.com

ID HLF902 Company ID ABILI

How to Log In

1

www.mybenefitshub.com/celinaisd

2

3 ENTER USERNAME &

PASSWORD

Your Username Is: The first Six (6) characters of your last name, followed by the first letter of your first name, followed by the last Four (4) digits of your Social Security Number.

Password Reset Date: 01/01/2023

If you HAVE NOT logged in since the Password Reset Date above, your Password is: Last Name (Excluding punctuation) followed by the last four (4) digits of your Social Security Number.

Annual Benefit Enrollment

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 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.

CHANGES IN STATUS (CIS): QUALIFYING EVENTS

Marital Status

Change in Number of Tax Dependents

Change in Status of Employment Affecting Coverage Eligibility

Gain/Loss of Dependents’ Eligibility Status

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 adoption. You can add existing dependents not previously enrolled whenever a dependent gains eligibility as a result of a valid change in status event.

Change in 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.

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. Judgment/ Decree/Order

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

Eligibility for Government Programs

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

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 supplemental benefit questions, you can contact your Benefits/HR department or you can call Financial Benefit Services at 866-914-5202 for assistance.

Where can I find forms?

For benefit summaries and claim forms, go to your benefit website: www.mybenefitshub.com/celinaisd 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 Celina ISD benefit website: www.mybenefitshub.com/celinaisd. 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

Employee Eligibility Requirements

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 2023 benefits become effective on September 1, 2023, you must be actively-at-work on September 1, 2023 to be eligible for your new benefits.

Dependent Eligibility Requirements

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.

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 HR/Benefit Administrator to request a continuation of coverage.

Helpful Definitions

Actively-at-Work

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 9/1/2023 please notify your benefits administrator.

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.

Don’t Forget!

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.

In-Network

Doctors, hospitals, optometrists, dentists and other providers who have contracted with the plan as a network provider.

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).

• For questions about benefits or enrollment assistance, please call the FBS Call Center at 866.914.5202. Bilingual assistance is available. Hours are Monday - Friday 8am - 6pm.

• Login & complete your benefit enrollment from 7/18/2023 ‐ 8/15/2023.

• Update your profile information: home address, phone numbers, email.

• Update dependent social security numbers and student status for college aged children.

Description

Health Savings Account (HSA) (IRC Sec. 223)

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.

Flexible Spending Account (FSA) (IRC Sec. 125)

Allows employees to pay out-of-pocket expenses for copays, deductibles and certain services not covered by medical plan, taxfree. This also allows employees to pay for qualifying dependent care tax-free.

Employer Eligibility A qualified high deductible health plan. All employers

Cash-Outs of Unused Amounts (if no medical expenses)

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).

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.

Access to some funds may be extended because your employer’s plan contains a 75 day grace period or $500 rollover provision.

Medical Insurance

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/celinaisd

TRS-ActiveCare Plan Highlights 2023-24

Learn the Terms.

• Premium: The monthly amount you pay for health care coverage.

• Deductible: The annual amount for medical expenses you’re responsible to pay before your plan begins to pay its portion.

• Copay: The set amount you pay for a covered service at the time you receive it. The amount can vary by the type of service.

• Coinsurance: The portion you’re required to pay for services after you meet your deductible. It’s often a speci ed percentage of the costs; i.e. you pay 20% while the health care plan pays 80%.

• Out-of-Pocket Maximum: The maximum amount you pay each year for medical costs. After reaching the out-of-pocket maximum, the plan pays 100% of allowable charges for covered services.

You bet your boots big things happen here, including TRS-ActiveCare’s large network of doctors and hospitals.

What’s New and What’s Changing

• Individual maximum-out-of-pocket decreased by $650. Previous amount was $8,150 and is now $7,500.

• Family maximum-out-of-pocket decreased by $1,300. Previous amount was $16,300 and is now $15,000.

• Individual maximum-out-of-pocket increased by $450 to match IRS guidelines. Previous amount was $7,050 and is now $7,500.

• Family maximum-out-of-pocket increased by $900 to match IRS guidelines. Previous amount was $14,100 and is now $15,000. These changes apply only to in-network amounts.

• Family deductible decreased by $1,200. Previous amount was $3,600 and is now $2,400.

• Primary care provider copay decreased from $30 to $15.

• No changes.

• This plan is still closed to new enrollees.

This table shows you the changes between 2022-23 statewide premium price and this year’s 2023-24 regional price for your Education Service Center.

Compare Prices for Common Medical Services

*Pre-certi cation for genetic and specialty testing may apply. Contact a PHG

with questions.

2023-24 Health Maintenance Organization (HMO) Plans and Premiums for Select Regions of the State

TRS contracts with HMOs in certain regions to bring participants in those areas additional options. HMOs set their own rates and premiums. They’re fully insured products who pay their own claims.

You can choose this plan if you live in one of these counties: Austin, Bastrop, Bell, Blanco, Bosque, Brazos, Burleson, Burnet, Caldwell, Collin, Coryell, Dallas, Denton, Ellis, Erath, Falls, Freestone, Grimes, Hamilton, Hays, Hill, Hood, Houston, Johnson, Lampasas, Lee, Leon, Limestone, Madison, McLennan, Milam, Mills, Navarro, Robertson, Rockwall, Somervell, Tarrant, Travis, Walker, Waller, Washington, Williamson

You can choose this plan if you live in one of these counties: Cameron, Hildalgo, Starr, Willacy

You can choose this plan if you live in one of these counties: Andrews, Armstrong, Bailey, Borden, Brewster, Briscoe, Callahan, Carson, Castro, Childress, Cochran, Coke, Coleman, Collingsworth, Comanche, Concho, Cottle, Crane, Crockett, Crosby, Dallam, Dawson, Deaf Smith, Dickens, Donley, Eastland, Ector, Fisher, Floyd, Gaines, Garza, Glasscock, Gray, Hale, Hall, Hansford, Hartley, Haskell, Hemphill, Hockley, Howard, Hutchinson, Irion, Jones, Kent, Kimble, King, Knox, Lamb, Lipscomb, Llano, Loving, Lubbock, Lynn, Martin, Mason, McCulloch, Menard, Midland, Mitchell, Moore, Motley, Nolan, Ochiltree, Oldham, Parmer, Pecos, Potter, Randall, Reagan, Reeves, Roberts, Runnels, San Saba, Schleicher, Scurry, Shackelford, Sherman, Stephens, Sterling, Stonewall, Sutton, Swisher, Taylor, Terry, Throckmorton, Tom Green, Upton, Ward, Wheeler, Winkler, Yoakum

Life and AD&D The Hartford

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/celinaisd

BASIC and SUPPLEMENTAL GROUP TERM LIFE and ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE BENEFIT HIGHLIGHTS

Celina Independent School District Group GLT-873302

The group term Life and Accidental Death and Dismemberment (AD&D) insurance available through your employer gives extra protection that you and your family may need. Life and AD&D insurance offers financial protection by providing you coverage in case of an untimely death or an accident that destroys your incomeearning ability. Life benefits are disbursed to your beneficiaries in a lump sum in the event of your death.

2: $10,000

Employee

Included

Spouse Not Included

Child(ren) Not Included

Benefit2: Increments of $10,000

Maximum: the lesser of 7x earnings or $500,000 AD&D: Not Included

Benefit1: Increments of $10,000

Maximum: the lesser of 50% of your supplemental coverage or $250,000

AD&D: Not Included

Benefit: Age 15 days to under 6 months$100; Age 6 months to 26 years - $10,000 AD&D: Not Included

AD&D BENEFITS – PERCENT OF COVERAGE AMOUNT PER ACCIDENT

Spouse rates are based on Employee’s age and cannot exceed 50% of the employees supplemental life amount.

Covered accidents or death can occur up to 365 days after the accident. The total benefit for all losses due to the same accident will not exceed 100% of your coverage amount.

Life and AD&D The Hartford

Your benefit will be reduced by 35% at age 65 and 50% at age 70. Reductions will be applied to the original amount.

LIMITATIONS & EXCLUSIONS

This insurance coverage includes certain limitations and exclusions. The certificate details all provisions, limitations, and exclusions for this insurance coverage. A copy of the certificate is listed on the employee portal www.mybenefitshub.com/celinaisd

GROUP LIFE INSURANCE

GENERAL LIMITATIONS AND EXCLUSIONS

• Your benefit will be reduced by 35% at age 65 and 50% at age 70. Reductions will be applied to the original amount.

• A supplemental or voluntary life benefit will not be paid if death occurs by suicide within two years (or as allowed by state law) of purchasing this coverage.

• You and your dependent(s) must be citizens or legal residents of the United States, its territories and protectorates.

DEPENDENT LIMITATIONS AND EXCLUSIONS

• Coverage may only be elected for dependents when you elect and are approved for coverage for yourself.

• Coverage may not be elected for a dependent who has employee coverage under this certificate.

• Coverage may not be elected for a dependent who is in active full-time military service.

• Child(ren) may only be covered as a dependent of one employee.

• Infants may receive a reduced benefit prior to the age of six months.

GROUP ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE

GENERAL LIMITATIONS AND EXCLUSIONS

• Your benefit will be reduced by 35% at age 65 and 50% at age 70. Reductions will be applied to the original amount.

• This insurance does not cover losses caused by:

• Sickness; disease; or any treatment for either

• Any infection, except certain ones caused by an accidental cut or wound

• Intentionally self-inflicted injury, suicide or suicide attempt

• War or act of war, whether declared or not

• Injury sustained while in the armed forces of any country or international authority

• Injury sustained on aircraft in certain circumstances

• Taking prescription or illegal drugs unless prescribed by or administered by a licensed physician

• Injury sustained while riding, driving, or testing any motor vehicle for racing

• Injury sustained while committing or attempting to commit a felony

• Injury sustained while driving while intoxicated

• You must be a citizen or legal resident of the United States, its territories and protectorates.

DEFINITIONS

• Loss means, with regard to hands and feet, actual severance through or above wrist or ankle joints; with regard to sight, speech or hearing, entire and irrecoverable loss thereof; with regard to thumb and index finger, actual severance through or above the metacarpophalangeal joints; with regard to movement, complete and irreversible paralysis of such limbs.

• Injury means bodily injury resulting directly from an accident, independent of all other causes, which occurs while you have coverage.

Hospital Indemnity The Hartford EMPLOYEE BENEFITS

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/celinaisd

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, co-insurance amounts or co- pays), or benefits can be used for any non-medical expenses (like housing costs, groceries, car expenses, etc.).

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).

HOW DO I FILE A CLAIM?

You can go online at https://www.thehartford.com/benefits/ myclaim or call 866-547-4205 Monday though Friday 8:00 am6:00 pm EST.

Group # 87332

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 full-time employee who works at least 20 hours per week on a regularly scheduled basis and are less than age 80.

Your spouse and child(ren) are also eligible for coverage. Any child(ren) must be under age 26.

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

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/celinaisd

Telehealth Employer Paid!

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

Do not use telemedicine for serious or life-threatening emergencies.

Registration is Easy

• Fever

• Urinary tract infections

Register with MDLIVE so you are ready to use this valuable service when and where you need it.

Online — www.mdlive.com/fbs

Phone — 888‐365‐1663

Mobile—download the MDLIVE mobile app to your smartphone or mobile device Select—“MDLIVE as a benefit” and “FBS” as your Employer/Organization when registering your account.

Telehealth

Employee and Family $0.00 (Employer Paid)

Dental Insurance FCL Dental EMPLOYEE BENEFITS

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/celinaisd

Celina ISD M1245-D

Passive PPO Dental Plan (100/80/50)

Annual Benefit - Per Person….….….….….….….…..….….….….….….$1,500

Percentage of Covered Benefits Per Policy Year

• 12-month waiting period (unless replacing prior coverage as described under “Takeover Benefit”)

• (USE NETWORK OFFICES FOR ADDITIONAL SAVINGS)

• DENTIST LIST AT DENTEMAX.COM

Calendar Year Deductible, Per Person $50/$150

This deductible applies to Type II and III services – Unmarried Dependent Children Covered to Age 26 Payment is based upon allowable charges in the area in which service is rendered. Services provided at a non-contracting provider are paid at the 90th percentile.

TYPE I (PREVENTIVE SERVICES)

Including:

• No waiting period

• Routine Exams

• Prophylaxis (cleanings-one per 6 months)

• Emergency exams for dental pain (minor procedures)

• Fluoride treatments for dependent children under age 19 (one per 12 months)

• Bitewing X-rays (once per 6 months)

TYPE II (BASIC SERVICES)

Including:

• No waiting period

• Periapical X-rays

• Full mouth or panorex X-rays (one per 36 months)

• Simple restorative services (fillings)

• Simple extractions

• Palliative treatment for dental pain, local anesthesia

• Sealants for children ages 6-15 (one per tooth)

TYPE III (MAJOR SERVICES)

Including:

• 12 month waiting period (new enrollees)

• Major restorative services (crowns and inlays)

• Prosthetics (bridges, dentures)

• Replacement of prosthodontics, dentures, crowns and inlays

• Denture relines

• Endodontics/root canal therapy

• Periodontics

• Space maintainers

• Complex Oral Surgery

• General anesthesia (for services dentally necessary)

ORTHODONTIC SERVICES-(12 MONTH WAIT)

• 50% coverage

• $1,000 lifetime maximum benefit

• Children under 19 only

For PPO Dental providers, you can visit the FCL Dental Web site at www.fcldental.com then in the drop down menu select Dentemax Plus network to find the most up-to-date list of DM dentists. You can also call toll-free at 800-752-1547 and a representative can help you locate a network provider in your area. Directories are available as well and are current as of the printed date. FCL Dental DHMO or PPO dental providers may be accessed at our website at www.fcldental.com

Vision Insurance 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/celinaisd

Vision plan benefits for Celina ISD

Benefits through Superior Select Southwest network

Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements

• Eye exam copay is a single payment due to the provider at the time of service.

• 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)

• 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

• Contact lenses and related professional services (fitting, evaluation, and follow-up) are covered in lieu of eyeglass lenses and frames benefit

• Lasik Vision Correction is in lieu of eyewear benefit, subject to routine regulatory filings and certain exclusions and limitations

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 eye-glass 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.

The national LASIK network of laser vision correction providers, featuring LasikPlus, offers members special program pricing on services. The program pricing should be verified prior to service.

Need Help?

Call 800-507-3800

provider?

Use this link: https://www.superiorvision.com/member/locate_provider?a=1

Disability Insurance The Hartford EMPLOYEE BENEFITS

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/celinaisd

What is Long Term Disability Insurance?

Long-Term Disability Insurance pays you a portion of your earnings if you cannot work because of a disabling illness or injury. You can purchase Long-Term Disability Insurance through your employer. This highlight sheet is an overview of your LongTerm Disability Insurance. Once a group policy is issued to your employer; a certificate of insurance will be available to explain your coverage in detail.

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.

Coverage Amount:

You may purchase coverage that will pay you a monthly flat dollar benefit: $500, $1,000,$1,500, $2,000, $2,500, $3,000, $4,000, $5,000, $6,000, $7,000, $7,500 that cannot exceed 66 2/3% of your current monthly earnings. Your plan includes a minimum benefit of 25% of your elected benefit. Earnings are defined in The Hartford’s contract with your employer

consists of two numbers. The first number shows the number of days you must be disabled by an accident before your benefits can begin. The second number indicates the number of days you must be disabled by a sickness before your benefits can begin. For those employees electing an elimination period of 30 days or less, if you are confined to a hospital for 24 hours or more due to a disability, the elimination period will be waived, and benefits will be payable from the first day of hospitalization.

Definition of Disability:

Disability is defined as The Hartford’s contract with your employer. Typically, disability means that you cannot perform one or more of the essential duties of your occupation due to injury, sickness, pregnancy or other medical conditions covered by the insurance, and as a result, your current monthly earnings are 80% or less of your pre-disability earnings. Once you have been disabled for 24 months, you must be prevented from performing one or more essential duties of any occupation, and as a result, your monthly earnings are 66 2/3% or less of your pre -disability earnings.

Pre-Existing Condition Limitation:

Your policy limits the benefits you can receive for a disability caused by a pre-existing condition. In general, if you were diagnosed or received care for a disabling condition within the 3 consecutive months just prior to the effective date of this policy, your benefit payment will be limited, unless: You have not received treatment for the disabling condition within 3 months, while insured under this policy, before the disability begins, or 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 4 weeks.

Elimination Period:

You must be disabled for at least the number of days indicated by the elimination period that you select before you can receive a Disability benefit payment. The elimination period that you select

Disability Insurance The Hartford EMPLOYEE

Maximum

Benefit Duration is the maximum time for which we pay benefits for disability resulting from sickness or injury. Depending on the age at which disability occurs, the maximum duration may vary. Please see the applicable schedule below based on the Premium benefit option. Premium Option: For the Premium benefit option – the table below applies to disabilities resulting from sickness or injury.

Benefit Integration:

Your benefit may be reduced by other income you receive or are eligible to receive due to your disability, such as:

• Social Security Disability Insurance

• State Teacher Retirement Disability Plans

• Workers’ Compensation

• Other employer-based disability insurance coverage you may have

• Unemployment benefits

• Retirement benefits that your employer fully or partially pays for (such as a pension plan)

How to file a claim:

Claims are now processed telephonically by calling (866) 547‐9124. Just refer to policy number 873302 and follow these easy steps:

1. If your absence is scheduled, call 30 days prior and if unscheduled, please call as soon as possible.

2. Have your information ready

• Name address other key information

• Name of department and last day full day of active work

• Your Manager’s or HR Representatives name and phone number

• The nature of your claim or leave request

• Your treating physicians name, address, and fax numbers

• With your information handy, you will be assisted by a member who will take your information, answer your questions, and file your claim.

Cancer Insurance

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.

EMPLOYEE BENEFITS

For full plan details, please visit your benefit website: www.mybenefitshub.com/celinaisd

Celina ISD Group # 12697

THIS IS A BRIEF OUTLINE OF BENEFITS. PLEASE REFER TO THE POLICY CERTIFICATE LOCATED AT WWW.MYBENEFITSHUB.COM/CELINAISD UNDER THE CANCER SECTION FOR COMPLETE DETAILS, LIMITATIONS, AND EXCLUSIONS.

SUMMARY OF BENEFITS

Heart Attack/Stroke First Occurrence Benefit Rider

Pays a lump sum amount when a Covered Person receives a first diagnosis of Heart Attack/Stroke and the Date of Diagnosis occurs after the Waiting Period. The Heart Attack/Stroke lump sum benefit amount will reduce by 50% at age 70.

Internal Cancer First Occurrence Benefit Rider

Pays a lump sum benefit amount when a Covered Person receives a first diagnosis of a covered Internal Cancer and the Date of

Diagnosis occurs after the Waiting Period. The Internal Cancer lump sum benefit amount will reduce by 50% at age 70.

How to file a Claim:

See requirements for filing a claim on the benefits website. You can also contact APL at 800-256-8606 or file a claim on line at: securedampublic.com

Accident Insurance

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/celinaisd

GA13 Series Limited Benefit Group Accident Only Insurance

for the Employees of Celina ISD Group # 12697

THIS POLICY IS A LIMITED PLAN AND ONLY COVERS ACCIDENTS. THIS IS NOT A POLICY FOR WORKERS’ COMPENSATION INSURANCE. PLEASE REFER TO THE EMPLOYEE PORTAL AT WWW.MYBENEFITSHUB.COM/CELINAISD UNDER THE ACCIDENT SECTION FOR COMPLETE DETAILS AND LIMITATIONS.

*Amounts shown are for individuals; amounts for spouse and child(ren) may vary. Please refer to your Schedule of Benefits for details.

How to file a Claim

Click on the link to get the claim form: https://docs.mgmbenefits.com/external.aspx?DocID=7320016&InBrowser=1

Contact APL at 800-256-8606 or online at www.ampublic.com

Identity Theft

Ilock

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/celinaisd

Essential Plan Feature Descriptions

CyberAlert™️ monitors:

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Bank Account Takeover & Credit Card

Application Monitoring

Change of Address Monitoring

Sex Offender Alerts

Social Media Monitoring

Scours Internet properties, including the dark web, websites, blogs, bulletin boards, peerto-peer sharing networks and chat rooms to identify the illegal trading and selling of a subscriber’s personal information.

Notifies subscribers when their Social Security number and personal information have been used to apply for or open a new bank or credit card account; or if changes have been made to their existing bank account.

Reports if a subscriber’s mail has been redirected through the U.S. Postal Service.

Provides a report of all registered sex offenders living within the subscriber’s immediate area, and notifies them when a new sex offender has been added.

Notifies the subscriber of privacy or reputational risks with the content they are sharing on social media. Enrolled subscribers can also monitor their child’s social media presence.

Payday Loan Monitoring Monitors transactional data from payday and quick cash loan providers to help subscribers determine if fraudulent activity has occurred. Alerts subscribers if a non-credit loan has been opened using an element of their identity.

Solicitation Reduction

Provides the subscriber with the ability to limit access to the amount of personal information that is public to reduce their exposure to fraud and declutter their mailbox and phone line. This service allows the subscriber to opt-out of direct marketing campaigns including utilizing the National Do Not Call Registry.

Offers up to $1M reimbursement with $0 deductible, for expenses associated with the subscriber’s identity theft recovery. Covers costs including:

• Lost wages or income

$1M Identity Theft Insurance

• Attorney and legal fees

• 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

Full Restoration & Lost Wallet Protection

Daily Monitoring of Experian Credit Bureau

Social Security Number Trace (Child)

Medical ID Monitoring

Gives the subscriber access to a U.S. based certified Identity Restoration Specialist to assist subscribers in restoring their identity. Assists in quickly and effectively terminating and re-ordering wallet contents. Users are not required to pre-register wallet contents before using this service.

Provides the subscriber with notifications for changes in a credit report such as loan data, inquiries, new accounts, judgments, liens and more.

Provides the subscriber with a report of all names and aliases associated with their child’s Social Security number, and notifies them if a new one is added.

Monitors the subscriber’s medical ID’s using CyberAlert®. If a Medical ID number is found compromised, the subscriber has access to a Restoration Specialist who will make contact with the healthcare provider where the compromised account is located and report it as fraud.

Identity Theft Ilock

Elite Plan Feature Descriptions

Bank Account Takeover & Credit Card Application Monitoring

Change of Address Monitoring

Sex Offender Alerts

Social Media Monitoring

Payday Loan Monitoring

Solicitation Reduction

Scours Internet properties, including the dark web, websites, blogs, bulletin boards, peer-to-peer sharing networks and chat rooms to identify the illegal trading and selling of a subscriber’s personal information.

Notifies subscribers when their Social Security number and personal information have been used to apply for or open a new bank or credit card account; or if changes have been made to their existing bank account.

Reports if a subscriber’s mail has been redirected through the U.S. Postal Service.

Provides a report of all registered sex offenders living within the subscriber’s immediate area, and notifies them when a new sex offender has been added.

Notifies the subscriber of privacy or reputational risks with the content they are sharing on social media. Enrolled subscribers can also monitor their child’s social media presence.

Monitors transactional data from payday and quick cash loan providers to help subscribers deter- mine if fraudulent activity has occurred. Alerts subscribers if a noncredit loan has been opened using an element of their identity.

Provides the subscriber with the ability to limit access to the amount of personal information that is public to reduce their exposure to fraud and declutter their mailbox and phone line. This service allows the subscriber to opt-out of direct marketing campaigns including utilizing the National Do Not Call Registry.

Offers up to $1M reimbursement with $0 deductible, for expenses associated with the subscriber’s identity theft recovery. Covers costs including:

• Lost wages or income

$1M Identity Theft Insurance

• Attorney and legal fees

• 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

Full Restoration & Lost Wallet Protection

Court/Criminal Records

Daily Monitoring of Experian Credit Bureau

Daily Monitoring of all 3 Credit Bureaus

Gives the subscriber access to a U.S. based certified Identity Restoration Specialist to assist the subscriber in restoring their identity. Assists in quickly and effectively terminating and re-ordering wallet contents. Users are not required to pre-register wallet contents before using this service.

Tracks municipal court systems and notifies the subscriber if a criminal act has been committed under their name, including bookings data from law enforcement agencies to find any criminal offenses under the subscriber’s name and date of birth.

Provides the subscriber with notifications for changes in a credit report such as loan data, inquiries, new accounts, judgments, liens and more.

Provides higher-level protection with monitoring from all three credit bureaus: Experian, Equifax & TransUnion. Provides the subscriber with notifications for changes in a credit report such as loan data, inquiries, new accounts, judgments, liens and more.

ScoreTracker Subscribers receive a monthly report that provides relevant information to help them understand how their credit score has trended over time and what is impacting it with credit score insight.

3-Bureau Credit Score

3-Bureau Credit Report

Provides the subscriber with access to their credit score reported by each credit bureauExperian, Equifax & TransUnion. Credit score is reported once a year.

Provides the subscriber with access to their credit report as recorded with each credit bureau - Experian, Equifax & TransUnion. This service is available once per year.

Medical ID Monitoring Monitors the subscriber’s medical ID’s using CyberAlert®. If a Medical ID number is found com- promised, the subscriber has access to a Restoration Specialist who will make contact with the healthcare provider where the compromised account is located and report it as fraud.

Experian Positive Activity Notifications

Experian Score Variance Alerts

Social Security Number Trace (Child)

Provides alerts when positive activity affects an Experian credit file. The service triggers on positive credit improvements such as paid collection accounts, closed accounts by the customer, and public records (liens released/civil action satisfied).

Provides alerts when a subscriber’s member benefit Experian credit score increases or decreases by a certain amount, changes risk level/score rank, or reaches a target score value.

Provides the subscriber with a report of all names and aliases associated with their child’s Social Security number, and notifies them if a new one is added.

Emergency Medical Transport MASA

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.

For full plan details, please visit your benefit website: www.mybenefitshub.com/celinaisd

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.

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

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

Non‐Emergency Inter‐Facility Transportation In the event that a member is in stable condition in a medical facility but requires a heightened level of care that is not available at their current medical facility, Members have access to nonemergency air or ground transportation between medical facilities.

Repatriation/Recuperation 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.

The cost is only $14 for you and your entire family!

Should you need assistance with a claim contact MASA at 800-643-9023 or refer to your benefit website for more detailed claims instructions.

If you need to review additional information or coverages, you can find that under the employee benefits portal at www.mybenefitshub.com/celinaisd under the Emergency Transportation section.

Flexible Spending Account (FSA) Higginbotham

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/celinaisd

Health Care FSA

The Health Care FSA covers qualified medical, dental and vision expenses for you or your eligible dependents. You may contribute up to $3,050 annually to a Health Care FSA and you are entitled to the full election from day one of your plan year. Eligible expenses include:

• Dental and vision expenses

• Medical deductibles and coinsurance

• Prescription copays

• Hearing aids and batteries

You may not contribute to a Health Care FSA if you enrolled in a High Deductible Health Plan (HDHP) and contribute to a Health Savings Account (HSA).

Limited Purpose Health Care FSA

The Limited Health Care FSA covers qualified dental and vision expenses for you or your eligible dependents. You may contribute up to $3,050 annually to a Limited Health Care FSA and you are entitled to the full election from day one of your plan year. A Limited Purpose Health Care FSA is only available if you elect it as Limited or enrolled in the HDHP medical plan and contribute to an HSA. You can use a Limited Purpose Health Care FSA to pay for eligible out-of-pocket dental and vision expenses only, such as:

• Dental and orthodontia care (i.e., fillings, X-rays and braces)

• Vision care (e.g., eyeglasses, contact lenses and LASIK surgery)

Dependent Care FSA

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.

Things to Consider Regarding the Dependent Care FSA

• 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 selfcare.

• The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.

Higginbotham Benefits Debit Card

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).

Important FSA Rules

• The maximum per plan year you can contribute to a Health Care or Limited Purpose FSA is $3,050. 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 cannot change your election during the year unless you experience a Qualifying Life Event.

Flexible Spending Account (FSA) Higginbotham EMPLOYEE BENEFITS

• You can continue to file claims incurred during the plan year for up to 90 days after 8/31/2024.

• You will continue to have a 75-day grace period where funds can be utilized up to 11/14/2024

• The IRS has amended the “use it or lose it rule” to allow you to carry-over up to $570 in your Health Care FSA into the next plan year.

Over-the-Counter Item Rule Reminder

Health care reform legislation requires that certain over-the-counter (OTC) items require a prescription to qualify as an eligible Health Care FSA expense. You will only need to obtain a one-time prescription for the current plan year. You can continue to purchase your regular prescription medications with your FSA debit card. However, the FSA debit card may not be used as payment for an OTC item, even when accompanied by a prescription.

Higginbotham Portal

The Higginbotham Portal provides information and resources to help you manage your FSAs.

• Access plan documents, letters and notices, forms, account balances, contributions and other plan information

• Update your personal information

• Utilize Section 125 tax calculators

• Look up qualified expenses

• Submit claims

• Request a new or replacement Benefits Debit Card

Register on the Higginbotham Portal

Visit https://flexservices.higginbotham.net and click Register. Follow the instructions and scroll down to enter your information.

• Enter your Employee ID, which is your Social Security number with no dashes or spaces.

• Follow the prompts to navigate the site.

• If you have any questions or concerns, contact Higginbotham:

• Phone – 866-419-3519

• Email – flexclaims@higginbotham.net

• Fax – 866-419-3516

Health Care FSA

Limited Purpose

Health Care FSA

Dependent Care FSA

Flexible Spending Accounts

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)

Dental and vision care expenses that are not covered by your health plan (such as eyeglasses, contacts, LASIK eye surgery, fillings, x-rays and braces)

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

$3,050

Saves on eligible expenses not covered by insurance, reduces your taxable income

$3,050

$5,000 single $2,500 if married and filing separate tax returns

Saves on eligible expenses not covered by insurance, reduces your taxable income

Reduces your taxable income

Health Savings Account (HSA)

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/celinaisd

A Health Savings Account (HSA) is more than a way to help you and your family cover health care costs – it is also a tax-exempt tool to supplement your retirement savings and cover health expenses during retirement. An HSA can provide the funds to help pay current health care expenses as well as future health care costs.

A 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

You are eligible to open and contribute to an HSA if you are:

• Enrolled in an HSA-eligible HDHP (TSBP HD)

• 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, nor should your spouse be contributing towards 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 expenses now or in the future. You can also use HSA funds to pay health care expenses for your dependents, even if they are not covered under your HDHP.

Maximum Contributions

Your HSA contributions may not exceed the annual maximum amount established by the Internal Revenue Service. The annual contribution maximum for 2023 is based on the coverage option you elect:

• Individual – $3,850

• Family (filing jointly) – $7,750

BENEFITS

You decide whether to use the money in your account to pay for qualified expenses or let it grow for future use. If you are 55 or older, you may make a yearly catch-up contribution of up to $1,000 to your HSA. If you turn 55 at any time during the plan year, you are eligible to make the catch-up contribution for the entire plan year.

Opening an HSA

If you meet the eligibility requirements, you may open an HSA administered by EECU. You will receive a debit card to manage your HSA account reimbursements. Keep in mind, available funds are limited to the balance in your HSA.

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.

How to Use your HSA

• Online/Mobile: Sign-in for 24/7 account access to check your balance, pay bills and more.

• 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.

• Lost/Stolen Debit Card: Call the 24/7 debit card hotline at (800) 333-9934

• Stop by: a local EECU financial center for in-person assistance; find EECU locations & service hours a www.eecu.org/locations

Individual Life Insurance

Individual Life Insurance

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/celinaisd

Enhanced coverage options for employees. Easy and flexible enrollment for employers. The 5Star Life Insurance Company’s Family Protection Plan offers both Individual and Group products with Terminal Illness coverage to age 121, making it easy to provide the right benefit for you and your employees.

CUSTOMIZABLE

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

TERMINAL ILLNESS ACCELERATION OF BENEFITS Coverage that pays 30% (25% in CT and MI) of the coverage amount in a lump sum upon the occurrence of a terminal condition that will result in a limited life span of less than 12 months (24 months in IL).

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. FAMILY PROTECTION Coverage is available for spouses and financially dependent children, even if the employee doesn’t elect coverage on themselves.

*Financially dependent children 14 days to 23 years old.

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.

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 are at: www.mybenefitshub.com/ celinaisd

If you need to make a policy change, please use the “Request for Change Form” located on the benefits website.

Should you need to file a claim, contact 5Star directly at (866) 863-9753.

*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.

2023 - 2024 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 Celina 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 Celina 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.