2023-24 Cleveland ISD Benefit Guide

Benefit Contact Information

CLEVELAND ISD BENEFITS

Financial Benefit Services

(800) 583-6908

www.mybenefitshub.com/clevelandisd

HOSPITAL INDEMNITY

Cigna

(800) 754-3207

www.cigna.com

MEDICAL: TRS ACTIVECARE MEDICAL: HMO

BCBSTX

(866) 355-5999

www.bcbstx.com/trsactivecare

North and Central Texas Scott & White HMO

(844) 633-5325

trs.swhp.org

HEALTH SAVINGS ACCOUNT (HSA) TELEHEALTH

Gulf Coast Educators Federal Credit Union

(281) 487-9333

www.gcefcu.org

DENTAL VISION

Lincoln Financial Group

(800) 423-2765

www.lincolnfinancial.com

CRITICAL ILLNESS

CHUBB

(833) 453-1680

www.chubb.com

LIFE AND AD&D

Lincoln Financial Group

(800) 423-2765

www.lincolnfinancial.com

VSP - Vision Service Plan

(800) 877-7195

www.vsp.com

CANCER

American Public Life

(800) 256-8606

www.ampublic.com

INDIVIDUAL LIFE

5Star

(866) 863-9753

www.5starinsurance.com

Recuro Health

(855) 673-2876

www.recurohealth.com

DISABILITY

New York Life

(800) 225-5695

www.newyorklife.com

ACCIDENT

Cigna

(800) 244-6424

www.cigna.com

FINANCIAL WELLNESS & IDENTITY THEFT

Experian

(888) 397-3742

www.experian.com

EMERGENCY TRANSPORTATION FLEXIBLE SPENDING ACCOUNT (FSA) LEGAL SERVICES

MASA

(800) 423-3226

www.masamts.com

Higginbotham

(866) 419-3519

https://flexservices.higginbotham.net/

Legal Shield

(800) 654-7757

www.legalshield.com

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www.mybenefitshub.com/clevelandisd

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.

Benefit Updates - What’s New:

• NEW Consultant and TPA - FBS/Higginbotham

• Updated TRS Medical Plans

• NEW Voluntary Benefits and Carriers:

» Dental - Two plan options available through Lincoln Financial Group. Enhanced benefits including adult orthodontia, 3 cleanings and coverage for missing teeth!

» Vision - New Carrier through VSP. Frame allowance has been increased and frame replacement is now every 12 months.

» Hospital Indemnity Plan - Enhanced benefits and lower cost through Cigna. High and Low options available. Preexisting conditions are waived!

» Disability - Short term and Long Term disability has been combined to one plan offered through New York Life. Plan will pay up to 90 days of benefits for pre-existing conditions!

» Cancer Plan - Guarantee Issue! New plan design with richer benefits through American Public Life. High and Low plan options available. Rates are no longer based on age.

» Critical Illness - Guarantee Issue! Enhanced plan benefits and lower costs through Chubb. Children listed in the enrollment system are automatically covered at no additional cost when you enroll!

» Accident - Enhanced benefits and lower cost with Cigna. Low and High Option plans available. This plan is always guarantee issue.

Don’t Forget!

» Voluntary Term Life and AD&D - Guarantee issue up to $280,000 for employees, $60,000 for spouses and $10,000 for children.

» Individual Life - Guarantee issue through 5 Star! Rates do not increase as you age or if you leave Cleveland ISD. Employees may elect up to $100,000, spouses $30,000 and children $10,000 with no health questions required. Includes a terminal illness benefit and a quality of life benefit. Coverage stays in effect until age 121!

» Legal - Additional benefits offered through LegalShield. One rate covers employee, spouse, and dependent children up to age 26.

» Financial Wellness and ID Protection - Credit monitoring offered through Experian. Children are covered to age 18 at no additional cost.

» NEW H.S.A. Administrator - Gulf Coast Educators Federal Credit Union. IRS has increased contribution limits for the upcoming plan year.

» NEW Flex and Dependent Care AdministratorHigginbotham - IRS has increased Flex contribution limits for the upcoming plan year.

• Login and complete your benefit enrollment from 07/10/2023 - 08/11/2023

• 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.

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):

Marital Status

Change in Number of Tax Dependents

Change in Status of Employment Affecting Coverage Eligibility

Gain/Loss of Dependents’ Eligibility Status

Judgment/ Decree/Order

Eligibility for Government Programs

QUALIFYING EVENTS

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

A change in number of dependents includes the following: birth, adoption and placement for 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.

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.

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

Annual Benefit Enrollment

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 30 days of benefit eligibility 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/ clevelandisd. 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 Cleveland ISD benefit website: www.mybenefitshub.com/clevelandisd. 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

Medical and 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.

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 prescriptions 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).

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

Source Employee and/or employer Employee and/or employer

Permissible Use Of Funds

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

Year-to-year rollover of account balance?

$1,500 single (2023) $3,000 family (2023)

$3,850 single (2023) $7,750 family (2023) 55+ catch up +$1,000 $3,050 (2023)

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

Yes, will roll over to use for subsequent year’s health coverage.

portable year-to-year and between jobs.

If you have a balance of $500 by 8/31 it will be rolled over to the next plan year. Funds remaining above $500 threshold are forfeited. Does not apply to your Dependent Care FSA.

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/clevelandisd

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• Not compatible with

• No out-of-network

Each includes a wide range of wellness bene ts.

than the HD and Primary plans services and drugs

required to see specialists with a Health Savings Account (HSA)

• Compatible with a Health Savings Account (HSA)

• Nationwide network with out-of-network

• No requirement for PCPs or

• Must meet your deductible before plan pays for non-preventive care

This plan is closed and not accepting new enrollees. If you’re currently enrolled in TRS-ActiveCare 2, you can remain in this plan.

TRS-ActiveCare 2

• Closed to new enrollees

• Current enrollees can choose to stay in plan

• Lower deductible

• Copays for many services and drugs

• Nationwide network with out-of-network coverage

• No requirement for PCPs or referrals

What’s New and What’s Changing

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.

• 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.

Effective: Sept. 1, 2023

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.

Central and North Texas

Baylor Scott & White Health Plan

Brought to you by TRS-ActiveCare

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

Blue Essentials - South Texas HMO

Brought to you by TRS-ActiveCare

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

Blue Essentials - West Texas HMO

Brought to you by TRS-ActiveCare

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

Basic Life and AD&D

Lincoln Financial Group

ABOUT LIFE AND AD&D

Group term life is the most inexpensive way to purchase life insurance. You have the freedom to select an amount of life insurance coverage you need to help protect the well-being of your family.

Accidental Death & Dismemberment is life insurance coverage that pays a death benefit to the beneficiary, should death occur due to a covered accident. Dismemberment benefits are paid to you, according to the benefit level you select, if accidentally dismembered.

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

At a glance:

• A cash benefit of $10,000 to your loved ones in the event of your death, plus an additional cash benefit if you die in an accident.

• AD&D Plus: If you suffer an AD&D-covered loss in an accident, you may also receive benefits for the following in addition to your core AD&D benefits. Additional conditions are outlined in your policy.

• Includes LifeKeys® services, which provide access to counseling, financial, and legal support services.

• TravelConnect® services, which give you and your family access to emergency medical assistance when you’re on a trip 100+ miles from home.

You also have the option to increase your cash benefit by securing additional coverage at affordable group rates. See the vountary life insurance section for highlights.

Additional details

Continuation of coverage for ceasing active work: You may be able to continue your coverage if you leave your job for reasons including and not limited to Family and Medical Leave, lay-off, leave of absence, leave of absence due to disability.

Waiver of premium: This provision relieves you from paying premiums during a period of disability that has lasted for a specified length of time.

Accelerated death benefit: Enables you to receive a portion of your policy death benefit while you are living. To qualify, a medical professional must diagnose you with a terminal illness with a life expectancy of fewer than 12 months.

Conversion: You may be able to convert your group term life coverage to an individual life insurance policy if your coverage decreases or you lose coverage due to leaving your job or for other reasons outlined in the plan contract.

Benefit reduction: Your employee Life/AD&D coverage amount will reduce by 50% when you reach age 70. Benefits end when you retire.

Hospital Indemnity Cigna

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/clevelandisd

SUMMARY OF BENEFITS

Hospital Indemnity coverage provides a benefit according to the schedule below when a Covered Person incurs a hospital stay resulting from a Covered Injury or Covered Illness.

Available Coverage:

The benefit amounts shown in this summary will be paid regardless of the actual expenses incurred and are paid on a per day basis unless otherwise specified. Benefits are only payable when all policy terms and conditions are met. Please read all the information in this summary to understand the terms, conditions, state variations, exclusions, and limitations applicable to these benefits. See your Certificate of Insurance for more information.

Benefit Waiting Period:* None, unless otherwise stated. No benefits will be paid for a loss which occurs during the Benefit Waiting Period.

NOTE: This insurance is NOT a substitute for comprehensive or major medical insurance coverage.

Limited to 1 day, 1 benefit per newborn child. This benefit is payable to the employee even if child coverage is not elected.

Wellness Treatment, Health Screening Test and Preventative Care Incentive Benefit* Also includes COVID-19 Immunization, Tests, and Screenings. Virtual Care accepted.

to 1 per year.

Portability Feature:* You, your spouse, and child(ren) can continue 100% of your coverage at the time your coverage ends. You must be covered under the policy and be under the age of 100 in order to continue your coverage. Rates may change and all coverage ends at age 100. Applies to United States Citizens and Permanent Resident Aliens residing in the United States.

No

No

Health Savings Account (HSA) GCEFCU

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/clevelandisd

HOW YOUR HSA WORKS

Every pay period, you will have a small portion of your check deposited to your HSA pre-tax for qualified medical expenses. The maximum contribution limit to your HSA for 2023 is $3,850 for an individual and $7,750 for a family. The money that is contributed to your HSA continually rolls over every year and any dividends earned are also tax free. You can find more information regarding qualified medical contributions and FAQ by visiting the lRS's website and read Publication 969 and Publication 502.

HSA VISA DEBIT CARD

Once your HSA has been opened, you are eligible to receive a debit card to use your funds for qualified medical expenses. lf you did not place your debit card order when your account was initially opened, you may call us at 281487-9333 and we will be happy to have one shipped to your address on file.

WHAT STEPS TO TAKE NEXT

Now that you have registered for your HSA, you should also register for online banking. This will allow you to keep track of your balance and expenses. To register for online banking, you may visit our website at www.gcefcu.org and select “First Time Users Click Here” under “Online Banking Login”. To complete your registration, follow the prompts to create a username, security questions, and password. lf you experience any difficulty, please feel free to contact us at 281-487-9333.

QUESTIONS?

We are happy to help with any questions you may have regarding your new Health Savings Account. Feel free to give us a call at 281.487.9333 or visit us online at www. gcefcu.org.

FREQUENTLY ASKED QUESTIONS

Where can I use my HSA debit card?

Gulf Coast Educators is the trustee of your HSA, which means that we are not responsible for blocking charges that are not qualified medical expenses. lt is very important to view the lRS’s Publication 969 if you have questions of what may or may not qualify.

What happens when I make a purchase with my HSA card that is not a qualified medical expense?

HSA distributions not used for qualified medical expenses are subject to ordinary income tax and, if taken before age 65, a 20 percent lRS penalty tax (unless the distribution is because of death or disability).

Be sure to consult with a competent tax advisor regarding your HSA deductions and how to claim tax-free HSA distributions.

How can I check my HSA balance?

You can check your balance by logging in to your online banking or by calling us at 281-487-9333.

How much can I contribute?

You can make pretax contributions (or tax-deductible contributions, if you’re on your own) in 2023 of up to $3,850 a year if you have individual coverage, or up to $7,750 if you have family coverage.

Telehealth

Recuro 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/clevelandisd

INTRODUCTION

Access board-certified physicians 24/7, 365 days a year for you and your family for only $9/month! Doctors will discuss your symptoms, confirm a diagnosis, and prescribe any needed medication. Video and telephone-based visits are available, with an average wait time of just ten minutes.

Consult Fee: $0

HOW TO ACCESS

1. Sign up with the Recuro Care app or visit the webpage below to access: member.recurohealth.com

2. Enter your employer member ID

3. Create your username and password

4. Complete your medical history

5. Schedule your consult

Example Conditions Treated

• Acne / Rash

• Allergies

• Cold / Flu

• GI Issues

• Ear Problems

• Fever

• Insect Bites

• Nausea

• Pink Eye

• Respiratory

• UTI’s

• And More...

*Registering your account is not required to use the service, you can call 855.6RECURO anytime for 24/7 access to doctors.

Dental Insurance

Lincoln Financial Group

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/clevelandisd

• Deductibles are combined for basic and major In-Network services.

• Deductibles are combined for basic and major Out-ofNetwork services.

Other dental X-rays (including periapical films), Space maintainers for children, Problem-focused exams, Consultations, Palliative treatment (including emergency relief of dental pain)

Prefabricated

EMPLOYEE BENEFITS

Individual: $50

Family: $150 Waived for: Preventive

Individual: $50

Family: $150

Waived for: Preventive

Dental Insurance

Lincoln Financial Group

Policy (Annual) Deductible

• Deductibles are combined for basic and major In-Network services.

• Deductibles are combined for basic and major Out-ofNetwork services.

Other dental X-rays (including periapical films), Space maintainers for children, Problem-focused exams, Consultations, Palliative treatment (including emergency relief of dental pain)

Prefabricated

steel and resin crowns, Prosthetic repair and recementation services, Endodontics (including root canal treatment), Periodontal maintenance procedures, Non-surgical periodontal therapy

Individual: $50

Family: $150 Waived for: Preventive

Individual: $50

Family: $150

Waived for: Preventive

You are eligible as of date of hire for all services

Vision Insurance

VSP

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/clevelandisd

EMPLOYEE BENEFITS

Your VSP Vision Benefits Summary

CLEVELAND ISD and VSP provide you with an affordable vision plan.

PROVIDER NETWORK:VSP Advantage

EFFECTIVE DATE: 09/01/2023

LENS ENHANCEMENTS

CONTACTS (INSTEAD OF GLASSES)

LIGHTCARETM+

EXTRA SAVINGS

• Retinal screening for members with diabetes

• Additional exams and services beyond routine care to treat immediate issues from pink eye to sudden changes in vision or to monitor ongoing conditions such as dry eye, diabetic eye disease, glaucoma, and more.

• Coordination with your medical coverage may apply. Ask your VSP doctor for details.

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featured frame brands allowance

• $150 frame allowance

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savings on the amount over your allowance

• $150 Walmart®/Sam’s Club® and $80 Costco® frame allowance

• Single vision, lined bifocal, and lined trifocal lenses

• Impact-resistant lenses for dependent children

• Standard progressive lenses

• Premium progressive lenses

• Custom progressive lenses

• Average savings of 20-25% on other lens enhancements

• $130 allowance for contacts; copay does not apply

• Contact lens exam (fitting and evaluation)

• $150 allowance for ready-made non-prescription sunglasses, or ready-made nonprescription blue light filtering glasses, instead of prescription glasses or contacts

$0

$95 - $105 $150 - $175

$55

$10

Every 12 months

Every 12 months

Every 12 months

• Routine Retinal Screening: No more than a $39 copay on routine retinal screening as an enhancement to a WellVision Exam

• Laser Vision Correction: Average 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities

YOUR COVERAGE GOES FURTHER IN-NETWORK - With so many in-network choices, VSP makes it easy to get the most out of your benefits. You’ll have access to preferred private practice, retail, and online in-network choices. Log in to vsp.com to find an in-network provider.

+Coverage with a retail chain may be different or not apply.

Disability Insurance

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/clevelandisd

New York Life EMPLOYEE BENEFITS Summary of Benefits

Eligibility: All active, Full-Time Employees of the Employer regularly working a minimum of 20 hours per week in the United States, who are citizens or permanent resident aliens of the United States.

Employee: You will be eligible for coverage the first of the month following date of hire.

Available Coverage

Please refer to the “How Long Benefits Last” section below for more details.

Additional Features

Family Survivor Benefit: If you die while receiving benefits, we will pay a survivor benefit to your lawful spouse, eligible children, or estate. The plan will pay a single lump sum equal to 3 months of benefits.

Monthly Rate by Type of Plan

Disability

New York Life

How to Calculate your Monthly Cost

Step 1: Divide your annual salary by 12 to calculate your monthly earnings.

EMPLOYEE BENEFITS

Step 2: Multiply this amount by the benefit percentage defined above in the Available Coverage section. For example, 45% would be .45, 55% would be .55, and 65% would be .65. Now, you have your Gross Monthly Benefit.

Step 3: Use the chart above to find your Monthly rate. Multiply this rate by your Gross Monthly Benefit, or the Maximum Gross Monthly Benefit of $8,000, whichever is less.

Step 4: Divide the total by 100. The result is your Monthly cost.

To age 65 or the date the 42nd monthly benefit is payable, if later.

To age 65 or the date the 42nd monthly benefit is payable, if later.

When Benefits Begin - You must be continuously Disabled for your elected benefit waiting period before benefits will be payable for a covered Disability.

How Long Benefits Last - Once you qualify for benefits under this plan, you continue to receive them until the end of the benefit or until you no longer qualify for benefits, whichever occurs first. Should you remain Disabled, your benefits continue according to one of the following schedules, depending on your age at the time you become Disabled and the plan you select.

Traditional LTD and STD Disability - Definitions

What is disability insurance? 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.

Pre-Existing Condition Limitations - Please note that all plans will include pre-existing condition limitations that could impact you if you are a first-time enrollee in your employer’s disability plan. This includes during your initial new hire enrollment. Please review your plan details to find more information about pre-existing condition limitations.

How do I choose which plan to enroll in during my open enrollment?

You will enroll in Long Term and Short Term Disability on two separate pages during your open enrollment walkthrough. Generally your short term coverage and long term coverage work together so that once your short term coverage ends, at that time your long term coverage would begin if you are still disabled and approved to remain on your claim. In other words, your short term coverage may continue for up to 12 weeks and your long term coverage begins the 13th week.

Your short term coverage will generally be a weekly benefit. This is the maximum amount of money you will receive from the carrier on a weekly basis once your disability claim is approved by the carrier. This is generally a flat percentage of your salary.

Your long term coverage will generally be a monthly benefit. This is the maximum amount of money you will receive from the carrier on a monthly basis once your disability claim is approved by the carrier. This is generally a flat percentage of your salary.

Critical Illness Insurance

CHUBB

ABOUT CRITICAL ILLNESS

Critical illness insurance can be used towards medical or other expenses. It provides a lump sum benefit payable directly to the insured upon diagnosis of a covered condition or event, like a heart attack or stroke. The money can also be used for non-medical costs related to the illness, including transportation, child care, etc.

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

$10,000; $20,000; $30,000; or $40,000 face amounts Spouse $10,000; $20,000; $30,000; or $40,000 face amounts

Children Included in the employee rate

There is no pre-existing conditions limitation. All amounts are guaranteed issue — no medical questions are required for coverage to be issued.

Critical Illness Insurance CHUBB

Cancer Insurance APL

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/clevelandisd

THIS IS ONLY A SUMMARY OF BENEFITS. PLEASE REFER TO THE CERTIFICATE OF COVERAGE FOR LIMITATIONS AND EXCLUSIONS TO DETERMINE ACTUAL COVERAGES. GO TO www.mybenefitshub. com/clevelandisd UNDER THE CANCER SECTION FOR COMPLETE DETAILS.

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/clevelandisd

SUMMARY OF BENEFITS

Accidental Injury coverage provides a fixed cash benefit according to the schedule below when a Covered Person suffers certain Injuries or undergoes a broad range of medical treatments or care resulting from a Covered Accident. See State Variations (marked by *) below.

Who Can Elect Coverage:

Eligibility for You, Your Spouse and Your Children will be considered by Your employer.

You: All active, Full-time Employees of the Employer who are regularly working in the United States a minimum of 30 hours per week and regularly residing in the United States and who are United States citizens or permanent resident aliens or non-United States citizens legally working and living in the United States (Inpats) and their Spouse and Dependent Children who are United States citizens or permanent resident aliens or Spouse or Dependent Child Inpats and who are legally residing in the United States. You will be eligible for coverage the first of the month following date of hire.

Your Spouse*: Up to age 100, as long as you apply for and are approved for coverage yourself.

Your Child(ren): Birth to age 26; 26+ if disabled, as long as you apply for and are approved for coverage yourself.

Available Coverage: This Accidental Injury plan provides 24 hour coverage. The benefit amounts shown in this summary will be paid regardless of the actual expenses incurred and are paid on a per day basis unless otherwise specified. Benefits are only payable when all policy terms and conditions are met. Please read all the information in this summary to understand terms, conditions, state variations, exclusions and limitations applicable to these benefits. See your Certificate of Insurance for more information.

Accident Insurance

Cigna

Chip Fracture (percent of fracture benefit)

Per covered surgically-repaired dislocation $200-$6,000 $300-$6,000

Per covered non-surgically-repaired dislocation $100-$3,000 $150-$3,000

Follow-Up Care Plan 1 Plan 2

Follow-up Physician (or medical professional) Office Visit $100 $125

Follow-up Physical Therapy Visit $50 $75

Enhanced Accident Benefits Examples Plan 1 Plan 2

Small Lacerations (Less than or equal to 6 inches long and requires 2 or more sutures) $100 $150

Large Lacerations (more than 6 inches long and requires 2 or more sutures) $600 $800

Concussion $150 $200

Coma (lasting 7 days with no response) $20,000 $25,000

Additional Accidental Injury benefits included - See certificate for details, including limitations & exclusions. Virtual Care accepted for Initial Physician Office Visit and Follow-Up Care.

Accidental Death and Dismemberment Benefit Plan 1 Plan 2

Examples of benefits include (but are not limited to) payment for death from Automobile accident; total and permanent loss of speech or hearing in both ears. Actual benefit amount paid depends on the type of Covered Loss. The Spouse and Child benefit is 100% and 50% respective of the benefit shown.

Loss of Life: $50,000$100,000 Dismemberment: $2,000 - $30,000

Loss of Life: $75,000$100,000 Dismemberment: $3,000 - $40,000

Wellness Treatment, Health Screening Test & Preventive Care Benefit* Plan 1 Plan 2

Wellness Treatment, Health Screening Test and Preventive Care Benefit:* Benefit paid for all covered persons is 100% of the benefit shown. Also includes COVID-19 Immunization, Tests, and Screenings. Virtual Care accepted. $50 $50

Sports Accident Benefit Plan 1 Plan 2

Organized and Personal Sports Activity Limited to 10 per year

Portability Feature: You, your spouse, and child(ren) can continue 100% of your coverage at the time your coverage ends. You must be under the age of 100 in order to continue your coverage. Rates may change and all coverage ends at age 100. Only available to United States Citizens, Permanent Resident Aliens and non-United States Citizens working in the United States lawfully (Inpats) while residing in the United States.

Important Definitions and Policy Provisions:

Coverage Type: Benefits are paid when a Covered Injury results, directly and independently of all other causes, from a Covered Accident.

Covered Accident: A sudden, unforeseeable, external event that results, directly and independently of all other causes, in a Covered Injury or Covered Loss and occurs while the Covered Person is insured under this Policy; is not contributed to by disease, sickness, mental or bodily infirmity; and is not otherwise excluded under the terms of this Policy.

Covered Injury: Any bodily harm that results directly and independently of all other causes from a Covered Accident.

Covered Person: An eligible person who is enrolled for coverage under this Policy.

Covered Loss: A loss that is the result, directly and independently

25% of the qualified benefit 25% of the qualified benefit

of other causes, from a Covered Accident suffered by the Covered Person within the applicable time period described in the Policy.

Hospital: An institution that is licensed as a hospital pursuant to applicable law; primarily and continuously engaged in providing medical care and treatment to sick and injured persons; managed under the supervision of a staff of medical doctors; provides 24-hour nursing services by or under the supervision of a graduate registered Nurse (R.N.); and has medical, diagnostic and treatment facilities with major surgical facilities on its premises, or available to it on a prearranged basis, and charges for its services. The term Hospital does not include a clinic, facility, or unit of a Hospital for: rehabilitation, convalescent, custodial, educational, or nursing care; the aged, treatment of drug or alcohol addiction.

When your coverage begins: Coverage begins on the later of the program’s effective date, the date you become eligible, or the first of the month following the date your completed enrollment form is received unless otherwise agreed upon by Cigna. Your coverage will not begin unless you are actively at work on the effective date. Coverage for all Covered Persons will not begin on the effective date if hospital, facility or home confined, disabled or receiving disability benefits or unable to perform activities of daily living.

Voluntary Life and AD&D

Lincoln Financial Group

ABOUT LIFE AND AD&D

Group term life is the most inexpensive way to purchase life insurance. You have the freedom to select an amount of life insurance coverage you need to help protect the well-being of your family.

Accidental Death & Dismemberment is life insurance coverage that pays a death benefit to the beneficiary, should death occur due to a covered accident. Dismemberment benefits are paid to you, according to the benefit level you select, if accidentally dismembered.

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

Note: To be eligible for coverage, a spouse or dependent child cannot be confined on the date the increase or addition is to take effect, it will take effect when the confinement ends.

Voluntary Life and AD&D

Lincoln Financial Group

Voluntary AD&D Insurance

Employee AD&D

Coverage options

Maximum coverage amount

Increments of $10,000

This amount may not exceed $500,000

Dependent Spouse AD&D: The amount of dependent AD&D insurance coverage cannot be greater than 100% of the employee benefit.

Coverage options

Maximum coverage amount

Increments of $5,000

This amount may not exceed $500,000

You can secure AD&D insurance for your spouse if you select coverage for yourself.

Dependent Child(ren) AD&D

Coverage options

$10,000

You can secure AD&D insurance for your dependent children if you select coverage for yourself.

* The monthly rate is $0.17 per $1,000 or .017 per $10,000

Individual Life Insurance

5Star EMPLOYEE BENEFITS

ABOUT INDIVIDUAL LIFE

Individual insurance is a policy that covers a single person and is intended to meet the financial needs of the beneficiary, in the event of the insured’s death. This coverage is portable and can continue after you leave employment or retire.

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

Family Protection Plan including Quality of Life benefit

5Star Life Insurance Company Individual and Group Term Life Insurance with Terminal Illness coverage to age 121.

Enhanced coverage options for employees. Easy and flexibile 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.

Financial Wellness & ID Protection

Experian

ABOUT FINANCIAL WELLNESS & ID 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/clevelandisd

Experian: Elite Plan

Financial

Wellness & Identity Protection

360° view of financial accounts

Link your financial accounts to generate unique insights that can help improve your financial health and build good credit habits. Stay on top of your daily spending with recommended budgets powered by AI and machine learning of past transactional behavior.

Exclusive credit insights

Combine the power of financial transaction and credit data to unlock 50+ unique insights and recommendations to help achieve financial goals. Insights are displayed in your personalized feed and categories include account activity, spending and budgeting, VantageScore®* improvements, financial updates, and more.

Industry leading monitoring & alerts

Consistent monitoring of your Experian® credit report and VantageScore* can help you better understand your current credit profile and personal finances. Financial Alerts will notify you, via push notifications and emails, when certain financial events are detected.

Financial Wellness & Identity Protection

Employee $7.50

Employee & Family $14.00

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/clevelandisd

MASA MTS is here to protect its members and their families from the shortcomings of health insurance coverage by providing them with comprehensive financial protection for lifesaving emergency transportation services, both at home and away fromhome.

Many American employers and employees believe that their health insurance policies cover most, if not all ambulance expenses. The truth is, they DONOT!

Even after insurance payments for emergency transportation, you could receive a bill up to $5,000 for ground ambulance and as high as $70,000 for air ambulance. The financial burdens for medical transportation costs are very real.

A MASA Membership prepares you for the unexpected and gives you the peace of mind to access vital emergency medical transportation no matter where you live, for a minimal monthly fee.

• One low fee for the entire family

• NO deductibles

• NO health questions

• Easy claim process

EVERY FAMILY DESERVES A

Legal Services

Legal Shield EMPLOYEE BENEFITS

ABOUT LEGAL SERVICES

Legal plans provide benefits that cover the most common legal needs you may encounter - like creating a standard will, living will, healthcare power of attorney or buying a home.

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

LegalShield provides coverage for common personal legal needs at every stage of life. The LegalShield plan provides coverage for:

FAMILY

• Bullying Protection

• Post-Nuptial/ Domestic Partnership Agreements

• Gender Identifier Change

• Elder Law Matters

• Civil and Social Discrimination

• Divorce

• Child Custody

• Enforcement and Modification of a Support Order

• Conservatorship

• Domestic Violence Protection

• Guardianship

• Name Change

• Juvenile Court Proceedings

• Adoption

• Paternity

• Immigration Assistance

• Administrative Hearing

• Incompetency Defense

• Juvenile Defense

• Prenuptial Agreements

• Reproductive Assistance

HOME

• Contractor Disputes

• Deeds

• Eviction and Tenant Issues

• Foreclosure

• Neighbor Disputes/ Easements

• Refinancing

• Purchase/Sale of House

• Real Estate Contracts/Financial Disputes

• Small Claims Assistance

• Zoning Applications

• Mortgages

• Boundary Title Disputes

• Home Equity Loans

• Property Tax Assessments

FINANCIAL

• Consumer Credit Services

• Affidavits

• Bankruptcy

• Consumer Protection

• Contracts/Financial Disputes

• Debt Collection

• IRS Audit Protection

• Rental Agreements

• Medicaid/Medicare Disputes

• Habeas Corpus

• Civil Litigation

• Identity Theft

• Promissory Notes

• Small Claims Assistance

• Personal Property Disputes

• Tax Audit Protection

• Veterans Benefit Disputes

ESTATE PLANNING

• Living Wills/Wills

• Probate

• Living Trusts/Trusts

• Power of Attorney

• Codicils

• Physician’s Directive

AUTO

• Driver’s License Restoration

• Motor Vehicle Property Damage

• Moving Traffic Violations/Traffic Tickets

• Property Damage Claims

GENERAL

• Office Consultation

• Telephone Advice

• Document Review

• Mobile App

• 24/7 Emergency Legal Access

• Demand Letters/ Phone Calls

• 25% Preferred Member Discount

• Legal Forms FOR MORE INFORMATION, VISIT benefits.legalshield.com/clevelandisd

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. If the balance remaining on your card is $500 or less by 8/31, it will be rolled forward to the next plan year. Funds remaining above $500 threshold are forfeited. Does not apply to your Dependent Care FSA. For full plan details, please visit your benefit website: www.mybenefitshub.com/clevelandisd

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).

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).

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 self-care.

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

Important FSA Rules

• The maximum per plan year you can contribute to a Health Care FSA is $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 can continue to file claims incurred during the plan year for another 90 days (up until November 30th).

• Your Health Care FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care expenses.

Over-the-Counter Item Rule Reminder

Health care reform legislation requires that certain over-

Flexible Spending Account (FSA)

Higginbotham EMPLOYEE BENEFITS

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

Higginbotham Portal

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

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

• Update your personal information

• Utilize Section 125 tax calculators

• Look up qualified expenses

• Submit claims

• Request a new or replacement Benefits Debit Card

Register on the Higginbotham Portal

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

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

• Follow the prompts to navigate the site.

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

» Phone – 866-419-3519

» Email – flexclaims@higginbotham.net

» Fax – 866-419-3516

Higginbotham Flex Mobile App

Easily access your Health Care FSA on your smartphone or tablet with the Higginbotham mobile app. Search for Higginbotham in your mobile device’s app store and download as you would any other app.

• View Accounts – Includes detailed account and balance information

• Card Activity – Account information

• SnapClaim – File a claim and upload receipt photos directly from your smartphone

• Manage Subscriptions – Set up email notifications to keep up-to-date on all account and Health Care FSA debit card activity

Log in using the same username and password you use to log in to the Higginbotham Portal. Note: You must register on the Higginbotham Portal in order to use the mobile app.

FSAstore.Com

FSAstore.com offers thousands of FSA-eligible products and services to purchase using your Higginbotham Benefits Debit Card or any major credit card. Competitive pricing and free shipping on orders over $50 can save you up to 40% using your FSA pretax dollars. Shop directly at FSAstore.com or have your physician submit prescriptions (when required). The FSAstore.com Services Channel allows you to search a database of more than 300,000 health care providers for nearby eligible services, such as acupuncture and chiropractic care. The FSAstore.com Learning Center focuses on answering common questions and keeping you informed about changes to your FSA benefits.

Notes

Notes

Notes

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 Cleveland 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 Cleveland 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.

WWW.MYBENEFITSHUB.COM/CLEVELANDISD