ESC REGION 19 BENEFIT GUIDE EFFECTIVE: 09/01/2023 - 8/31/2024 WWW.MYBENEFITSHUB.COM/REGION19 2023 - 2024 Plan Year 1
TO ENROLL PG. 4 How to Enroll 4-5 Annual Benefit Enrollment 6-9 1. Annual Enrollment 6 2. Helpful Definitions 7 3. Section 125 Cafeteria Plan Guidelines 8 4. Eligibility Requirements 9 Medical 10-15 Hospital Indemnity 16 Dental 17-18 Vision 19 Disability 20 Accident 21 Critical Illness 22-23 Life and AD&D 24-25 Emergency Medical Transportation 26 Student Loan Assistance 27 2
Table of Contents FLIP TO... SUMMARY PAGES PG. 6 YOUR BENEFITS PG. 10 HOW
Benefit Contact Information
ESC REGION 19 BENEFITS TRS - ACTIVECARE MEDICAL HOSPITAL INDEMNITY
Financial Benefit Services (800) 583-6908
www.mybenefitshub.com/region19
BCBSTX (866) 355-5999
www.bcbstx.com/trsactivecare
Prudential Group #70168 (844) 455-1002
www.prudential.com
DENTAL VISION DISABILITY
Lincoln Financial Group (800) 423-2765
www.lfg.com
Superior Vision (800) 507-3800
www.superiorvision.com
New York Life 800-225-5695
www.newyorklife.com
ACCIDENT CRITICAL ILLNESS LIFE AND AD&D
Lincoln Financial Group (800) 423-2765
www.lfg.com
EMERGENCY MEDICAL TRANSPORTATION
MASA Group #B2BESCR19 (800) 423-3226
www.masamts.com
Unum Group #474633 (800) 858-6843
www.unum.com
STUDENT LOAN ASSISTANCE
GotZoom (866) 314-8888
www.gotzoom.com
Lincoln Financial Group (800) 423-2765
www.lfg.com
3
Employee benefits made easy through the FBS Benefits App! All Your BenefitsOne App OR SCAN Text “FBS REG19” to (800) 583-6908 App Group #: FBSREG19 Text “FBS REG19” to (800) 583-6908 and get access to everything you need to complete your benefits enrollment: • Benefit Resources • Online Enrollment • Interactive Tools • And more! 4
How to Log In
1 www.mybenefitshub.com/region19
2
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.
CLICK LOGIN
5
Annual Benefit Enrollment
Important
• Enrollment assistance is available by calling Financial Benefit Services at (866) 915-5202 to speak to a representative. Spanish speaking representatives are also available.
• Annual Open Enrollment Benefit elections will become effective 9/1/2023 (elections requiring evidence of insurability, such as life Insurance, may have a later effective date, if approved). After annual enrollment closes, benefit changes can only be made if you experience a qualifying event (and changes must be made within 30 days of event).
Q&A
Who do I contact with Questions?
For 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/region19 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 ESC Region 19 benefit website: www.mybenefitshub. com/region19. 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.
SUMMARY PAGES
6
Helpful Definitions
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.
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 please notify your benefits administrator.
Annual Deductible: The amount you pay each plan year before the plan begins to pay covered expenses.
Annual Enrollment: The period during which existing employees are given the opportunity to enroll in or change their current elections.
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. Activelyat-work and/or pre-existing 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 co-insurance 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).
SUMMARY PAGES
7
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.
SUMMARY PAGES
8
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.
Medical To age 26
Hospital
Indemnity To age 26
Dental To age 26
Vision To age 26
Life and AD&D To age 26
Disability To age 26
Critical Illness To age 26
Accident To age 26
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.
SUMMARY PAGES PLAN MAXIMUM AGE
9
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/region19
TRS Monthly Premium District Contribution Employee Cost TRS ActiveCare HD Employee Only $403.00 $403.00 $0.00 Employee & Spouse $1,089.00 $455.00 $634.00 Employee & Child(ren) $686.00 $455.00 $231.00 Employee & Family $1,371.00 $455.00 $916.00 ActiveCare 2 Employee Only $1,013.00 $455.00 $558.00 Employee & Spouse $2,402.00 $455.00 $1,947.00 Employee & Child(ren) $1,507.00 $455.00 $1,052.00 Employee & Family $2,841.00 $455.00 $2,386.00 TRS ActiveCare Primary Employee Only $388.00 $388.00 $0.00 Employee & Spouse $1,048.00 $455.00 $593.00 Employee & Child(ren) $660.00 $455.00 $205.00 Employee & Family $1,320.00 $455.00 $865.00 TRS ActiveCare Primary+ Employee Only $455.00 $455.00 $0.00 Employee & Spouse $1,183.00 $455.00 $728.00 Employee & Child(ren) $774.00 $455.00 $319.00 Employee & Family $1,502.00 $455.00 $1,047.00 EMPLOYEE
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BENEFITS
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. 11
762382.0523
TRS-ActiveCare has a network of doctors and hospitals that span all the way to the Rio Grande.
Monthly Premiums Employee Only $388 $ $455 Employee and Spouse $1,048 $ $1,183 Employee and Children $660 $ $774 Employee and Family $1,320 $ $1,502 Total Premium Total Premium Your Premium How to Calculate Your Monthly Premium Total Monthly Premium Your District and State Contributions Your Premium Ask your Bene ts Administrator for your district’s speci c premiums. All TRS-ActiveCare participants have three plan options. TRS-ActiveCare Primary TRS-ActiveCare Plan Summary • Lowest premium of all three plans • Copays for doctor visits before you meet your deductible • Statewide network • Primary Care Provider (PCP) referrals required to see specialists • Not compatible with a Health Savings Account (HSA) • No out-of-network coverage • Lower deductible than • Copays for many services • Higher premium • Statewide network • PCP referrals required • Not compatible with • No out-of-network Wellness Bene ts at No Extra Cost* Being healthy is easy with: • $0 preventive care • 24/7 customer service • One-on-one health coaches • Weight loss programs • Nutrition programs • OviaTM pregnancy support • TRS Virtual Health • Mental health bene ts • And much more! *Available for all plans. See the bene ts guide for more details. Immediate Care Urgent Care $50 copay Emergency Care You pay 30% after deductible You TRS Virtual Health-RediMD (TM) $0 per medical consultation $0 TRS Virtual Health-Teladoc® $12 per medical consultation $12 2023-24 TRS-ActiveCare Plan Highlights Sept. 1, 2023 –New Rx Bene ts! • Express Scripts is your new pharmacy bene ts manager! CVS pharmacies and most of your preferred pharmacies and medication are still included. • Certain specialty drugs are still $0 through SaveOnSP. Doctor Visits Primary Care $30 copay Specialist $70 copay Plan Features Type of Coverage In-Network Coverage Only In-Network Individual/Family Deductible $2,500/$5,000 Coinsurance You pay 30% after deductible You Individual/Family Maximum Out of Pocket $7,500/$15,000 Network Statewide Network PCP Required Yes Prescription Drugs Drug Deductible Integrated with medical $200 deductible Generics (31-Day Supply/90-Day Supply)$15/$45 copay; $0 copay for certain generics Preferred You pay 30% after deductible You Non-preferred You pay 50% after deductible You Specialty (31-Day Max) $0 if SaveOnSP eligible; You pay 30% after deductible You Insulin Out-of-Pocket Costs$25 copay for 31-day supply; $75 for 61-90 day supply$25 copay for 31-day 12
Each
This plan is closed and not accepting new enrollees. If you’re currently enrolled in TRS-ActiveCare 2, you can remain in this plan. $ $403 $ $ $1,089 $ $ $686 $ $ $1,371 $ Premium Total Premium Your Premium Your Premium Total Premium Your Premium $1,013 $ $2,402 $ $1,507 $ $2,841 $
wide
of wellness
ts. 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 TRS-ActiveCare Primary+ TRS-ActiveCare HD than the HD and Primary plans services and drugs required to see specialists with a Health Savings Account (HSA) coverage • Compatible with a Health Savings Account (HSA) • Nationwide network with out-of-network coverage • No requirement for PCPs or referrals • Must meet your deductible before plan pays for non-preventive care $50 copay You pay 30% after deductibleYou pay 50% after deductible You pay 20% after deductible You pay 30% after deductible $0 per medical consultation $30 per medical consultation $12 per medical consultation $42 per medical consultation $50 copay You pay 40% after deductible You pay a $250 copay plus 20% after deductible $0 per medical consultation $12 per medical consultation Aug. 31, 2024 $15 copay You pay 30% after deductibleYou pay 50% after deductible $70 copay You pay 30% after deductibleYou pay 50% after deductible $30 copay You pay 40% after deductible $70 copay You pay 40% after deductible In-Network Coverage Only In-Network Out-of-Network $1,200/$2,400 $3,000/$6,000 $5,500/$11,000 You pay 20% after deductible You pay 30% after deductibleYou pay 50% after deductible $6,900/$13,800 $7,500/$15,000 $20,250/$40,500 Statewide Network Nationwide Network Yes No In-Network Out-of-Network $1,000/$3,000 $2,000/$6,000 You pay 20% after deductibleYou pay 40% after deductible $7,900/$15,800 $23,700/$47,400 Nationwide Network No deductible per participant (brand drugs only) Integrated with medical $15/$45 copay You pay 20% after deductible; $0 coinsurance for certain generics You pay 25% after deductible You pay 25% after deductible You pay 50% after deductible You pay 50% after deductible $0 if SaveOnSP eligible; You pay 30% after deductible You pay 20% after deductible 31-day supply; $75 for 61-90 day supply You pay 25% after deductible $200 brand deductible $20/$45 copay You pay 25% after deductible ($40 min/$80 max)/ You pay 25% after deductible ($105 min/$210 max) You pay 50% after deductible ($100 min/$200 max)/ You pay 50% after deductible ($215 min/$430 max) $0 if SaveOnSP eligible; You pay 30% after deductible ($200 min/$900 max)/ No 90-day supply of specialty medications $25 copay for 31-day supply; $75 for 61-90 day supply 13
includes a
range
bene
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.
2022-23 Total Premium New 2023-24 Total Premium Change in Dollar Amount TRS-ActiveCare Primary Employee Only $362 $388 $26 Employee and Spouse $1,020 $1,048 $28 Employee and Children $650 $660 $10 Employee and Family $1,221 $1,320 $99 TRS-ActiveCare HD Employee Only $376 $403 $27 Employee and Spouse $1,058 $1,089 $31 Employee and Children $675 $686 $11 Employee and Family $1,265 $1,371 $106 TRS-ActiveCare Primary+ Employee Only $454 $455 $1 Employee and Spouse $1,110 $1,183 $73 Employee and Children $731 $774 $43 Employee and Family $1,396 $1,502 $106 TRS-ActiveCare 2 (closed to new enrollees) Employee Only $1,013 $1,013 $0 Employee and Spouse $2,402 $2,402 $0 Employee and Children $1,507 $1,507 $0 Employee and Family $2,841 $2,841 $0 Key Plan Changes At a Glance Primary HD Primary+ Premiums Lowest Lower Higher Deductible Mid-range High Low Copays Yes No Yes NetworkStatewide network Nationwide network Statewide network PCP Required? Yes No Yes HSA-eligible? No Yes No Effective: Sept. 1, 2023
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.
14
Compare Prices for Common Medical Services
*Pre-certi cation for genetic and specialty testing may apply. Contact a PHG
with questions.
Bene t TRS-ActiveCare Primary TRS-ActiveCare Primary+ TRS-ActiveCare HD TRS-ActiveCare 2 In-Network OnlyIn-Network OnlyIn-NetworkOut-of-NetworkIn-NetworkOut-of-Network Diagnostic Labs* Of ce/Indpendent Lab: You pay $0 Of ce/Indpendent Lab: You pay $0 You pay 30% after deductible You pay 50% after deductible Of ce/Indpendent Lab: You pay $0 You pay 40% after deductible Outpatient: You pay 30% after deductible Outpatient: You pay 20% after deductible Outpatient: You pay 20% after deductible High-Tech Radiology You pay 30% after deductible You pay 20% after deductible You pay 30% after deductible You pay 50% after deductible You pay 20% after deductible + $100 copay per procedure You pay 40% after deductible + $100 copay per procedure Outpatient Costs You pay 30% after deductible You pay 20% after deductible You pay 30% after deductible You pay 50% after deductible You pay 20% after deductible ($150 facility copay per incident) You pay 40% after deductible ($150 facility copay per incident) Inpatient Hospital Costs You pay 30% after deductible You pay 20% after deductible You pay 30% after deductible You pay 50% after deductible ($500 facility per day maximum) You pay 20% after deductible ($150 facility copay per day) You pay 40% after deductible ($500 facility per day maximum) Freestanding Emergency Room You pay $500 copay + 30% after deductible You pay $500 copay + 20% after deductible You pay $500 copay + 30% after deductible You pay $500 copay + 50% after deductible You pay $500 copay + 20% after deductible You pay $500 copay + 40% after deductible Bariatric Surgery Facility: You pay 30% after deductible Facility: You pay 20% after deductible Not CoveredNot Covered Facility: You pay 20% after deductible ($150 facility copay per day) Not Covered Professional Services: You pay $5,000 copay + 30% after deductible Professional Services: You pay $5,000 copay + 20% after deductible Professional Services: You pay $5,000 copay + 20% after deductible Only covered if rendered at a BDC+ facility Only covered if rendered at a BDC+ facility Only covered if rendered at a BDC+ facility Annual Vision Exam (one per plan year; performed by an ophthalmologist or optometrist) You pay $70 copayYou pay $70 copay You pay 30% after deductible You pay 50% after deductible You pay $70 copay You pay 40% after deductible Annual Hearing Exam (one per plan year) $30 PCP copay $70 specialist copay $30 PCP copay $70 specialist copay You pay 30% after deductible You pay 50% after deductible $30 PCP copay $70 specialist copay You pay 40% after deductible
www.trs.texas.gov
at 1-866-355-5999
Call a Personal Health Guide (PHG) any time 24/7 to help you nd the best price for a medical service. Reach them at 1-866-355-5999 REMEMBER: Revised 05/30/23 15
Hospital Indemnity Prudential
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/region19
Hospital Indemnity Insurance issued by The Prudential Insurance Company of America (Prudential) pays you regardless of what your medical plan covers. Your benefits are paid directly to you to spend however you like, including out-of-pocket medical costs and everyday living expenses.
Below is a summary of the coverage available to you, your spouse and child(ren). For a complete list of benefits, limitations, and exclusions, please refer to your Certificate of Coverage.
This is a summary of benefits and does not include all plan provisions, exclusions, and limitations. If there is a discrepancy between this document and the group contract issued by The Prudential Insurance Company of America, the terms of the group contract will govern.
Hospital Indemnity Low High Employee Only $17.89 $31.19 Employee and Spouse $31.50 $54.64 Employee and Child(ren) $25.70 $44.50 Employee and Family $41.22 $71.40 Benefit Type: Hospital Benefits Benefit Limits High Plan Benefit Amounts Low Plan Benefit Amounts Hospital Admission 5 times per calendar year $2,500 $1,500 ICU Admission 5 times per calendar year $2,500 $1,500 In-Hospital Stay Up to 3 confinements per calendar. When an admission benefit is paid, the confinement benefit pays on day 2. $200 $200 Hospital ICU Stay Up to 3 times per calendar year. When an admission benefit is paid, the confinement benefit pays on day 2. $200 $200
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EMPLOYEE BENEFITS
Dental Insurance
Lincoln Financial Group 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/region19
The Lincoln Dental – PPO LOW Contracting Dentists Non-Contracting Dentists
Calendar (Annual) Deductible
Individual: $50 Family: $150 Waived for: Preventive
Individual: $50 Family: $150 Waived for: Preventive
Deductibles are combined for basic and major Contracting Dentists’ services. Deductibles are combined for basic and major NonContracting Dentists’ services.
Period There are no benefit waiting periods for any service types
Preventive Services
Routine oral exams
Bitewing X-rays
Full-mouth or panoramic X-rays
Other dental X-rays - including periapical films Routine cleanings
Fluoride treatments
Space maintainers for children
Palliative treatment - including emergency relief of dental pain
Sealants
Basic Services
Problem focused exams
Injections of antibiotics and other therapeutic medications
Fillings
Simple extractions
General anesthesia and I.V. sedation
Major Services
Consultations
Prefabricated stainless steel and resin crowns
Surgical extractions
Oral surgery
Biopsy and examination of oral tissue - including brush biopsy
Prosthetic repair and cementation services
Endodontics - including root canal treatment
Orthodontics
Orthodontic exams
Dental Low High Employee Only $16.08 $23.42 Employee and Spouse $32.16 $46.86 Employee and Child(ren) $38.54 $56.14 Employee and Family $54.82 $79.84
Annual
$1,000 $1,000 Lifetime
Max $1,000 $1,000 Waiting
Maximum
Orthodontic
80% No Deductible 80% No Deductible
50% After Deductible 50% After Deductible
50% After Deductible 50% After Deductible
X-rays Extractions Study models Appliances 50% 50% 17
Dental Insurance Lincoln Financial Group
The Lincoln Dental – PPO HIGH Contracting Dentists Non-Contracting Dentists
Calendar (Annual) Deductible
Individual: $50
Family: $150
Waived for: Preventive
Individual: $50
Family: $150
Waived for: Preventive
Deductibles are combined for basic and major Contracting Dentists’ services. Deductibles are combined for basic and major NonContracting Dentists’ services.
Annual Maximum $1,000 $1,000
Lifetime Orthodontic Max $1,000 $1,000
Waiting Period
Preventive Services
Routine oral exams
Bitewing X-rays
Full-mouth or panoramic X-rays
Other dental X-rays - including periapical films
Routine cleanings
Fluoride treatments
Space maintainers for children
Palliative treatment - including emergency relief of dental pain
Sealants
Basic Services
Problem focused exams
Injections of antibiotics and other therapeutic medications Fillings
extractions
Major Services
Consultations
Prefabricated stainless steel and resin crowns
Surgical extractions
Oral surgery
Biopsy and examination of oral tissue - including brush biopsy
Prosthetic repair and re-cementation services
Endodontics - including root canal treatment
There are no benefit waiting periods for any service types
You can request your dental ID card by contacting Lincoln Financial Dental directly at 800-423-2765.
Contracting Dentists/Non-Contracting Dentists: Visit www.LincolnFinancial.com/FindADentist to find a contracting dentist near you. This plan lets you choose any dentist you wish. However, your out-of-pocket costs are likely to be lower when you choose a contracting dentist.
Contracting Dentists: you pay a deductible (if applicable), then 50% of the remaining discounted fee for PPO members. This is known as a PPO contracted fee.
Non-Contracting Dentists: you pay a deductible (if applicable), then 50% of the usual and customary fee, which is the maximum expense covered by the plan. You are responsible for the different between the usual and customary fee and the dentist’s billed charge.
100% No Deductible 100% No Deductible
Simple
General
80% After Deductible 80% After Deductible
anesthesia and I.V. sedation
50% After Deductible 50% After Deductible Orthodontics Orthodontic
X-rays Extractions Study models Appliances 50% 50%
exams
18
EMPLOYEE BENEFITS
Vision Insurance Superior Vision EMPLOYEE BENEFITS
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/region19
How to Print your Vision ID Card:
You can request your vision id card by contacting Superior Vision directly at 800-507-3800. You can also go to www.superiorvision.com and register/login to access your account by clicking on “Members” at the top of the page. You can also download the Superior Vision mobile app on your smart phone.
LASIK Discounts5
Multiple discounts on laser vision correction procedures may be available to you. To learn more, visit superiorvision.com or contact your benefits coordinator.
5
Hearing Aid Discounts
Through Your Hearing Network, you have access to discounts on hearing services, devices, and accessories. To learn more, visit superiorvision.com or contact your benefits coordinator.
Free Mobile App
With the free Superior Vision app (available for Android and Apple devices), you can create an account, check your eligibility and benefits, find providers, and view your member ID card.
information can be found on employee portal
Visions Copays Frequency Employee Only $6.25 Exam $10 Exam 1 per Plan Year Employee and Spouse $13.14 Materials1 $25 Frame 1 per Plan Year Employee and Child(ren) $10.94 Contact lens fitting $25 Contact Lens Fitting 1 per Plan Year Employee and Family $16.27 (standard & specialty) Eyeglass Lenses 1 Pair per Plan Year Contact Lenses 1 allowance per Plan Year
Non-Covered Services Discounts5 Amount Exams, frames, prescription lenses 30% off retail Contacts, miscellaneous options 20% off retail Disposable contact lenses 10% off retail Retinal imaging $39 cost Lenses (per pair) In-Network Coverage Out-of-Network Reimbursement Single vision Covered-in-full Up to $30 Bifocal Covered-in-full Up to $50 Trifocal Covered-in-full Up to $65 Progressives See description3 Up to $65 Lens Add-Ons Your Cost Anti-scratch coating Covered-in-full Ultraviolet coating Covered-in-full Tints - solid / gradient Covered-in-full Polycarbonate lenses for dependent children Covered-in-full Polycarbonate lenses for adults $40 Blue light filtering $15 Digital single vision $30 Progressive lenses (standard / premium / ultra / ultimate) $55 / $110 / $150 / $225 Anti-reflective coating (standard / premium / ultra / ultimate) $50 / $70 / $85 / $120 Polarized lenses $75
coverage
Additional
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Disability Insurance New York Life Group 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/region19
A disability doesn’t always mean a serious handicap. Any illness or injury can prevent you from earning your salary. Consider what would happen if you couldn’t work or pay your bills. How might this affect your savings and your lifestyle?
Disability insurance from New York Life Group Benefit Solutions (NYL GBS) can help provide the financial security and assurance you’ll need if you experience a covered illness or injury that keeps you out of work.
Why is disability insurance important?
Disability insurance can pay you benefits if you suffer a covered disability. Think of it as insurance for a portion of your paycheck. Payments may come directly to you or someone you designate and can help pay for things like groceries, the mortgage, utilities & even medical bills.
Who’s eligible for disability insurance, and what are the plan options?
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. Coverage is available for Long-term disability (LTD).
What features are included with my coverage?
Your Disability insurance includes access to a suite of programs and services, available from day one. They’re included in your plan, so you’re automatically enrolled, and it’s our way of saying thanks for being a valued customer.
Employee Assistance & Wellness Support2
Emotional support for you and/or family members at no additional cost. Access is available 24 hours a day, seven days a week. Includes work/life assistance, coaching, online articles, resources, and videos for work/life issues.
Financial, Legal & Estate Support2
Professional support for all types of financial, legal or estate issues including tax consultations, credit questions, and much more. Assistance also includes identity theft and fraud resolution services and online tools for state-specific wills and other important legal documents.
Disability Rate Summary Elimination Period 40% Plan 50% Plan 60% Plan 7/7 $2.41 $2.67 $3.03 14/14 $2.22 $2.46 $2.80 30/30 $1.80 $2.01 $2.30 90/90 $0.94 $1.05 $1.26 180/180 $0.70 $0.74 $0.90
Long Term Disability Monthly Benefit Maximum monthly Benefit Benefit Waiting Period Maximum Benefit period Option 1 40% of Current monthly earrings $10,000 Accident/Sickness 7 Days/7 Days 14 Days/14 Days 30 Days/30 Days 90 Days/90 Days 180/ Days/180/ Days
later of your social security normal retirement age of the maximum benefit period provided in your summary of benefits. Option 2 50% of Current monthly earrings $10,000 Accident/Sickness 7 Days/7 Days 14 Days/14 Days 30 Days/30 Days 90 Days/90 Days 180/ Days/180/ Days
later of your social security normal retirement age of the maximum benefit period provided in your summary of benefits. Option 3 60% of Current monthly earrings $10,000 Accident/Sickness 7 Days/7 Days 14 Days/14 Days 30 Days/30 Days 90 Days/90 Days 180/ Days/180/ Days
later of your social security normal retirement age of the maximum benefit period provided in your summary of benefits. 20
the
the
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Accident Insurance Lincoln Financial Group
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/region19
Accident Insurance pays you benefits for specific injuries and events resulting from a covered accident that occurs, on or after your coverage effective date. The benefit amount depends on the type of injury and care received. Accident Insurance is a limited benefit policy. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.
How can Accident Insurance help?
• Emergency Treatment
• Fractures:
* Fracture benefits listed are nonsurgical. Treatment for the fracture must occur within 90 days of the accident. The combined maximum of all fractures is two times the highest fracture payable.
• Dislocations:
* Dislocation benefits listed are nonsurgical. Treatment for the dislocation must occur within 90 days of the accident. The combined maximum of all dislocations is two times the highest dislocation payable.
• Specific Injuries:
* A full breakdown of injuries can be access on the employee portal.
* Benefits will be paid up to two times the highest surgical benefit payable for all surgeries
• Hospitalization an Ongoing Care
• Recovery Assistance
• Accident Death & Dismemberment Benefit
Health Assessment/ Wellness Benefit
You receive a cash benefit every year you and any of your covered family members complete a single covered assessment test $50
Additional Plan Benefits
• Portability
• Child Sports Injury Benefit
Please note that with any insurance policy exclusions do apply. Be sure to access plan summary on employee benefits portal or if you have Questions? Call 800-423-2765 and mention ID: EDUSERV19.
Accident Low High Employee Only $7.24 $12.10 Employee and Spouse $12.33 $20.15 Employee and Child(ren) $14.15 $22.52 Employee and Family $19.06 $30.36
EMPLOYEE
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BENEFITS
Critical Illness Insurance
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/region19
Critical Illness insurance provides financial protection by paying a lump sum benefit if you are diagnosed with a covered critical illness. To file a claim call UNUM at 800-858-6843 or find claim form at www.mybenefitshub.com/region19
Who is eligible for this coverage?
What are the Critical Illness coverage amounts?
All employees in active employment in the United States working at least 20 hours per week and their eligible spouses and children (up to age 26 regardless of student or marital status).
The following coverage amounts are available.
For you:
For your Spouse:
For your Children:
Select one of the following Choice $15,000, $20,000 or $30,000 50% of employee coverage amount 50% of employee coverage amount
Can I be denied coverage? Coverage is guarantee issue.
When is coverage effective? Please see your Plan Administrator for your effective date of coverage. Insurance coverage will be delayed if you are not in active employment because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective.
Critical Illness Employee $15,000.00 $20,000.00 $30,000.00 > 25 4.84/$3.34 $5.84 $7.84 25-29 $6.19 $7.64 $10.54 30-34 $7.99 $10.04 $14.14 35-39 $11.14 $14.24 $20.44 40-44 $14.59 $18.84 $27.34 45-49 $19.09 $24.84 $36.34 50-54 $23.59 $30.84 $45.34 55-59 $31.69 $41.64 $61.54 60-64 $44.14 $58.24 $86.44 65-69 $63.64 $84.24 $125.44 70-74 $99.79 $123.44 $197.74 75-79 $148.69 $197.64 $295.54 80-84 $218.74 $297.04 $435.64 85+ $354.04 $471.44 $706.24
Unum EMPLOYEE
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BENEFITS
Critical Illness Insurance
What is covered? Covered Conditions*
Are wellness Screenings covered?
Each insured is eligible to receive one Be Well Benefit per calendar year.
Be Well Benefit For you, your spouse, and your children: $50
Be Well Screenings include tests for the following: cholesterol and diabetes, cancer, and cardiovascular function. They also include imaging studies, immunizations, and annual examinations by a Physician. See certificate for details.
Additional Critical Illnesses for your Children
*Please refer to the policy for complete definitions of covered conditions.
Pre-existing Conditions
We will not pay benefits for a claim when the covered loss occurs in the first 12 months following an insured’s coverage effective date and the covered loss is caused by, contributed to by, or occurs because of any of the following:
• a pre-existing condition; or
• complications arising from treatment or surgery for, or medications taken for, a pre-existing condition.
An insured has a pre-existing condition if, within the 3 months just prior to their coverage effective date, they have an injury or sickness, whether diagnosed or not, for which:
• medical treatment, consultation, care or services, or diagnostic measures were received or recommended to be received during that period;
• drugs or medications were taken, or prescribed to be taken during that period; or
• symptoms existed.
The pre-existing condition provision applies to any Insured’s initial coverage and any increases in coverage. Coverage effective date refers to the date any initial coverage or increases in coverage become effective.
Cerebral Palsy 100% Cleft Lip or Palate 100% Cystic Fibrosis 100% Down Syndrome 100% Spina Bifida 100%
Percentage
Coverage Critical Illnesses Coronary Artery Disease (major) 50% Coronary Artery Disease (minor) 10% End Stage Renal (Kidney) Failure 100% Heart Attack (Myocardial Infarction) 100% Major Organ Failure Requiring Transplant 100% Stroke 100% Cancer Invasive Cancer (including all Breast Cancer) 100% Non-Invasive Cancer 25% Skin Cancer $500 Supplemental Critical Illnesses Benign Brain Tumor 100% Coma 100% Loss of Hearing 100% Loss of Sight 100% Loss of Speech 100% Infectious Disease 25% Occupational Human Immunodeficiency Virus (HIV) or Hepatitis 100% Permanent Paralysis 100% Progressive Diseases Amyotrophic Lateral Sclerosis (ALS) 100% Dementia (including Alzheimer’s Disease) 100% Functional Loss 100% Multiple Sclerosis (MS) 100% Parkinson’s Disease 100%
of
Unum EMPLOYEE BENEFITS 23
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/region19
Basic Life
Safeguard the most important people in your life.
Consider what your loved ones may face after you’re gone. Term life insurance can help them in so many ways, like helping to cover everyday expenses, pay off debt, and protect savings.
Accidental death and dismemberment (AD&D) insurance provides additional benefits if you die or suffer a covered loss in an accident, such as losing a limb or your eyesight.
AT A GLANCE:
• A cash benefit of $25,000 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: coma, plegia, education, childcare, spouse training. 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.
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 75. Benefits end when you retire.
Voluntary Group Life - per $10,000 in coverage Age Employee 18-29 $0.65 30-34 $0.75 35-39 $0.85 40-44 $1.25 45-49 $2.05 50-54 $3.35 55-59 $4.75 60-64 $5.75 65-69 $10.45 70-74 $17.75 75+ $34.35 Voluntary Group Life - Child(ren) $10,000 in coverage 0-26 $1.75 Spouse rates based on Employee’s age.
EMPLOYEE BENEFITS
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Life and AD&D Lincoln Financial Group
Voluntary Life
Guaranteed
Amount: Initial Open Enrollment: When you are first offered this coverage, you can choose a coverage amount up to $250,000 without providing evidence of insurability. Annual Limited Enrollment: If you are a continuing employee, you can increase your coverage amount by $10,000 without providing evidence of insurability. If you submitted evidence of insurability in the past and were declined for medical reasons, you may be required to submit evidence of insurability. If you decline this coverage now and wish to enroll later, evidence of insurability may be required and may be at your own expense. You can increase this amount by up to $20,000 during the next limited open enrollment period.
AD&D
• Provides a cash benefit to your loved ones if you die in an accident
• Provides a cash benefit to you if you suffer a covered loss in an accident, such as losing a limb or your eyesight
• Features group rates for employees
• Includes LifeKeys® services, which provide access to counseling, financial, and legal support
• Includes TravelConnect® services, which give you and your family access to emergency medical assistance when you’re on a trip 100+ miles from home
Employee
Coverage Options
Maximum coverage amount
Increments of $10,000
This amount may not exceed the lesser of seven times annual earnings or $500,000
Your employee AD&D coverage amount will reduce by 50% when you reach age 75. Benefits end when you retire.
Dependent spouse: 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.
Your spouse AD&D coverage amount will reduce by 50% when you reach age 75. Benefits end when you retire.
Dependent child(ren)
Coverage Options
$10,000
You can secure AD&D insurance for your dependent children if you select coverage for yourself.
Employee Life Coverage Options Increments of $10,000 Guaranteed Life coverage amount $250,000 Maximum coverage amount 7 times your annual salary ($500,000 maximum in increments of $10,000) Minimum coverage amount $10,000 Spouse Life: The amount of dependent Life Insurance coverage ca not be greater than 100% of the employee benefit. Coverage Options $5,000 Maximum coverage amount for Spouse This amount may not exceed the lesser
times employee annual earnings(round
to the
$1,000) Minimum coverage amount $5,000 Dependent Children Life Guaranteed coverage amount for dependent Live birth but under 26 years $10,000 Additional Plan Benefits Waiver of Premium Included Portability Included Accelerated Death Benefit Included Conversion Included
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Life Coverage
EMPLOYEE BENEFITS
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Emergency Medical Transport MASA EMPLOYEE
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/region19
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 highdeductible 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.
Emergency Medical Transportation Emergent Plus Platinum Employee and Family $14.00 $39.99 Emergent Plus Membership Platinum Membership Emergency Air Transportation x x Emergent Ground Transportation x x Non-Emergency Inter-Facility Transportation x x Repatriation/Recuperation x x Escort Transportation x Visitor Transportation x Return Transportation x Mortal Remains Transportation x Minor Return x Organ Retrieval/Organ Recipient Transportation x Vehicle Return x Pet Return x Worldwide Coverage x
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BENEFITS
Student Loan Assistance
ABOUT STUDENT LOAN ASSISTANCE
Student Loan debt in the United States currently exceeds $1.4 trillion dollars. If you are one of the millions of Americans that are stressed and struggling with high levels of student loan debt, this is a program that may provide student loan relief to those who qualify.
For full plan details, please visit your benefit website: www.mybenefitshub.com/region19
Your Path to Student Loan Relief Reduce your Student Loan Debt by 65%
What’s GotZoom? An established company with a seven-year track record of performance and customer satisfaction. The leader in student debt reduction services.
Where to Start
Employee Benefits
Service Fee
Go to the enrollment page: https://mystudentloan2.net/ Click on Enroll Now
GotZoom monitors DOE programs and reviews the employee’s status annually to find any additional debt reduction options.
Employee’s loan analysis and Benefits Summary are free (no obligation)
Service fees apply only after the employee has reviewed and approved repayment/ forgiveness programs
Application Fee: $307.
Annual Fee: $359.40 (Monthly Option: $32.95)
GotZoom EMPLOYEE BENEFITS 27
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 ESC Region 19 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 ESC Region 19 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/REGION19
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