2023-24 New Braunfels ISD Benefit Guide

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NEW BRAUNFELS ISD BENEFIT GUIDE EFFECTIVE: 09/01/2023 - 8/31/2024 WWW.MYBENEFITSHUB.COM/NEWBRAUNFELSISD 2023 - 2024 Plan Year 1
Table of Contents How to Enroll 4-5 Annual Benefit Enrollment 6-11 2. Section 125 Cafeteria Plan Guidelines 6 3. Annual Enrollment 7 4. Eligibility Requirements 8 5. Helpful Definitions 9 6. Health Savings Account (HSA) vs. Flexible Spending Account (FSA) 10 Medical 12-17 Health Savings Account (HSA) 18 Dental 19 Vision 20-21 Hospital Indemnity 22-23 Critical Illness 24-25 Accident 26-27 Identity Theft 28-29 Disability 30-31 Life and AD&D 32 Individual Life 33 Flexible Spending Account (FSA) 34-35 Employee Assistance Program (EAP) 36 FLIP TO... SUMMARY PAGES PG. 6 YOUR BENEFITS PG. 12 HOW TO ENROLL PG. 4 2

Benefit Contact Information

NEW BRAUNFELS ISD BENEFITS MEDICAL - TRS ACTIVECARE MEDICAL - TRS HMO

Financial Benefit Services

(800) 583-6908

www.mybenefitshub.com/ newbraunfelsisd

BCBSTX

(866) 355-5999

www.bcbstx.com/trsactivecare

Scott & White HMO

(844) 633-5325

www.trs.swhp.org

HEALTH SAVINGS ACCOUNT (HSA) DENTAL VISION

EECU

(817) 882-0800

www.eecu.org

Guardian Group #426151 (800) 541-7846

www.guardiananytime.com

Superior Vision Group #323680 (800) 507-3800

www.superiorvision.com

HOSPITIAL INDEMNITY CRITICAL ILLNESS ACCIDENT

The Hartford Group #681970 (866) 547-4205

www.thehartford.com

The Hartford Group #681970 (866) 547-4205

www.thehartford.com

The Hartford Group #681970 (866) 547-4205

www.thehartford.com

IDENTITY THEFT DISABILITY LIFE AND AD&D

iLOCK360 (855) 287-8888

www.ilock360.com

INDIVIDUAL LIFE

Texas Life (800) 283-9233

www.texaslife.com

The Hartford Group #681970 (866) 547-4205

www.thehartford.com

Lincoln Financial Group Group #400194501 (800) 423-2765

www.lfg.com

FLEXIBLE SPENDING ACCOUNT (FSA) EMPLOYEE ASSISTANCE PROGRAM (EAP)

National Benefit Services (800) 274-0503

www.nbsbenefits.com

ComPsych Group #LFGsupport (888) 628-4824

www.GuidanceResources.com

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Employee benefits made easy through the FBS Benefits App! All Your BenefitsOne App OR SCAN Text “FBS NBISD” to (800) 583-6908 App Group #: FBSNBISD Text “FBS NBISD” to (800) 583-6908 and get access to everything you need to complete your benefits enrollment:
Benefit Resources
Online Enrollment
Interactive Tools
And more! 4

1

2

3

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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.

SUMMARY PAGES
6

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 eligible employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.

Q&A

Who do I contact with Questions?

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

Where can I find forms?

For benefit summaries and claim forms, go to your benefit website: www.mybenefitshub.com/ newbraunfelsisd. Click the benefit plan you need information on (i.e., Dental) and you can find the forms you need under the Benefits and Forms section.

How can I find a Network Provider?

For benefit summaries and claim forms, go to the New Braunfels ISD benefit website: www.mybenefitshub.com/newbraunfelsisd. Click on the benefit plan you need information on (i.e., Dental) and you can find provider search links under the Quick Links section.

When will I receive ID cards?

If the insurance carrier provides ID cards, you can expect to receive those 3-4 weeks after your effective date. For most dental and vision plans, you can login to the carrier website and print a temporary ID card or simply give your provider the insurance company’s phone number and they can call and verify your coverage if you do not have an ID card at that time. If you do not receive your ID card, you can call the carrier’s customer service number to request another card.

If the insurance carrier provides ID cards, but there are no changes to the plan, you typically will not receive a new ID card each year.

SUMMARY PAGES
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Annual Benefit Enrollment

Employee Eligibility Requirements

Supplemental Benefits: Eligible employees must work 20 or more regularly scheduled hours each work week.

Eligible employees must be actively at work on the plan effective date for new benefits to be effective, meaning you are physically capable of performing the functions of your job on the first day of work concurrent with the plan effective date. For example, if your 2023 benefits become effective on September 1, 2023, you must be actively-at-work on September 1, 2023 to be eligible for your new benefits.

Dependent Eligibility Requirements

Dependent Eligibility: You can cover eligible dependent children under a benefit that offers dependent coverage, provided you participate in the same benefit, through the maximum age listed below. Dependents cannot be double covered by married spouses within the district as both employees and dependents.

Please note, limits and exclusions may apply when obtaining coverage as a married couple or when obtaining coverage for dependents.

Potential Spouse Coverage Limitations: When enrolling in coverage, please keep in mind that some benefits may not allow you to cover your spouse as a dependent if your spouse is enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Financial Benefit Services, or contact the insurance carrier for additional information on spouse eligibility.

FSA/HSA Limitations: Please note, in general, per IRS regulations, married couples may not enroll in both a Flexible Spending Account (FSA) and a Health Savings Account (HSA). If your spouse is covered under an FSA that reimburses for medical expenses then you and your spouse are not HSA eligible, even if you would not use your spouse’s FSA to reimburse your expenses. However, there are some exceptions to the general limitation regarding specific types of FSAs. To obtain more information on whether you can enroll in a specific type of FSA or HSA as a married couple, please reach out to the FSA and/or HSA provider prior to enrolling or reach out to your tax advisor for further guidance.

Potential Dependent Coverage Limitations: When enrolling for dependent coverage, please keep in mind that some benefits may not allow you to cover your eligible dependents if they are enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Financial Benefit Services, or contact the insurance carrier for additional information on dependent eligibility.

age 18

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 Medical Through 25
Savings Account (HSA
Tax Dependent Status Dental Through 25 Vision Through 25 Basic & Voluntary Life and AD&D Through 25 Individual Life Insurance
Spending Account (FSA) Through
Tax Dependent Status Hospital Indemnity
Illness Through 25
Through 25
Monitoring
Health
IRS
Throught 23 Flexible
25 or IRS
Through 25 Critical
Accident
Identity Theft
Through
8

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 prescription drugs or is under a health care provider’s orders to take drugs, or received medical care or services (including diagnostic and/or consultation services).

SUMMARY PAGES
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Health Savings Account (HSA) (IRC Sec. 223) Flexible Spending Account (FSA) (IRC Sec. 125)

Approved by Congress in 2003, HSAs are actual bank accounts in employee’s names that allow employees to save and pay for unreimbursed qualified medical expenses tax-free.

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

Eligibility A qualified high deductible health plan. All employers

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

Year-to-year rollover of account balance?

Does the account earn interest?

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.

No. Access to some funds may be extended if your employer’s plan contains a 2 1/2 –month grace period or $610 rollover provision.

FLIP TO FOR HSA INFORMATION FLIP TO FOR FSA INFORMATION PG. 18 PG. 35 SUMMARY PAGES
HSA vs. FSA
Description
Employer
Contribution Source Employee
Account Owner Individual Employer Underlying Insurance Requirement High deductible health plan None Minimum Deductible $1,500
$3,000 family
N/A Maximum Contribution $3,850
$7,750
55+ catch
$3,050
and/or employer Employee and/or employer
single (2023)
(2023)
single (2023)
family (2023)
up +$1,000
(2023) Permissible Use Of Funds
Yes No Portable? Yes,
No 10

Notes

11

Medical Insurance

TRS

ABOUT MEDICAL

Major medical insurance is a type of health care coverage that provides benefits for a broad range of medical expenses that may be incurred either on an inpatient or outpatient basis.

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

Monthly Premium District Contribution Employee Cost TRS ActiveCare HD Employee Only $408.00 $331.53 $408.00 Employee & Spouse $1,102.00 $331.53 $1,102.00 Employee & Child(ren) $694.00 $331.53 $694.00 Employee & Family $1,388.00 $331.53 $1,388.00 TRS ActiveCare 2 Employee Only $1,013.00 $331.53 $1,013.00 Employee & Spouse $2,402.00 $331.53 $2,402.00 Employee & Child(ren) $1,507.00 $331.53 $1,507.00 Employee & Family $2,841.00 $331.53 $2,841.00 TRS ActiveCare Primary Employee Only $395.00 $331.53 $395.00 Employee & Spouse $1,067.00 $331.53 $1,067.00 Employee & Child(ren) $672.00 $331.53 $672.00 Employee & Family $1,343.00 $331.53 $1,343.00 TRS ActiveCare Primary+ Employee Only $463.00 $331.53 $463.00 Employee & Spouse $1,204.00 $331.53 $1,204.00 Employee & Child(ren) $788.00 $331.53 $788.00 Employee & Family $1,528.00 $331.53 $1,528.00 WTX HMO Employee Only $865.00 $331.53 $865.00 Employee & Spouse $2,103.16 $331.53 $2,103.16 Employee & Child(ren) $1,361.42 $331.53 $1,361.42 Employee & Family $2,233.34 $331.53 $2,233.34 Central & North Texas Baylor Scott & White Employee Only $515.37 $331.53 $515.37 Employee & Spouse $1,293.46 $331.53 $1,293.46 Employee & Child(ren) $828.11 $331.53 $828.11 Employee & Family $1,488.60 $331.53 $1,488.60 EMPLOYEE BENEFITS 12
762383.0523 Remember the Alamo... and that TRS-ActiveCare has the largest network of doctors and hospitals in Texas! 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. 13

Being

*Available

All

TRS-ActiveCare participants have three plan options. TRS-ActiveCare Primary TRS-ActiveCare Plan Summary
premium of
three plans
Lowest
all
for doctor visits
deductible
Copays
before you meet your
network
Statewide
Primary Care Provider (PCP) referrals required
to see specialists
compatible
Health Savings Account (HSA)
Not
with a
out-of-network coverage
No
Lower deductible than
Copays for many services
Higher premium
Statewide network
PCP referrals required
compatible with
Not
No out-of-network Monthly Premiums Employee Only $376 $ $442 Employee and Spouse $1,016 $ $1,150 Employee and Children $640 $ $752 Employee and Family $1,279 $ $1,459 Total Premium Total Premium Your Premium How to Calculate Your Monthly Premium Total Monthly Premium Your District and State Contributions Your Premium
your Bene ts Administrator for your district’s speci c premiums. Wellness Bene ts at No Extra Cost*
Ask
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
more!
much
See
bene
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 14
for all plans.
the
ts guide for more details.

Each includes a wide range of wellness bene ts.

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

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

$ $388 $ $ $1,048 $ $ $660 $ $ $1,320 $ Premium Total Premium Your Premium Your Premium Total Premium Your Premium $1,013 $ $2,402 $ $1,507 $ $2,841 $ $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 15

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.

Key Plan Changes

• 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

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
2022-23 Total Premium New 2023-24 Total Premium Change in Dollar Amount TRS-ActiveCare Primary Employee Only $346 $376 $30 Employee and Spouse $976 $1,016 $40 Employee and Children $622 $640 $18 Employee and Family $1,168 $1,279 $111 TRS-ActiveCare HD Employee Only $357 $388 $31 Employee and Spouse $1,005 $1,048 $43 Employee and Children $641 $660 $19 Employee and Family $1,202 $1,320 $118 TRS-ActiveCare Primary+ Employee Only $434 $442 $8 Employee and Spouse $1,062 $1,150 $88 Employee and Children $699 $752 $53 Employee and Family $1,336 $1,459 $123 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
16
Compare Prices for Common Medical Services www.trs.texas.gov 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 *Pre-certi cation for genetic and specialty testing may apply. Contact a PHG at 1-866-355-5999 with questions. 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 17

Health Savings Account (HSA)

ABOUT HSA

A Health Savings Account (HSA) is a personal savings account where the money can only be used for eligible medical expenses. Unlike a flexible spending account (FSA), the money rolls over year to year however only those funds that have been deposited in your account can be used. Contributions to a Health Savings Account can only be used if you are also enrolled in a High Deductible Health Care Plan (HDHP).

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

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

A type of personal savings account, an HSA is always yours even if you change health plans or jobs. The money in your HSA (including interest and investment earnings) grows tax-free and spends tax-free if used to pay for qualified medical expenses. There is no “use it or lose it” rule — you do not lose your money if you do not spend it in the calendar year — and there are no vesting requirements or forfeiture provisions. The account automatically rolls over year after year.

HSA Eligibility

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

• Enrolled in an HSA-eligible HDHP

• Not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan

• Not enrolled in a Health Care Flexible Spending Account

• Not eligible to be claimed as a dependent on someone else’s tax return

• Not enrolled in Medicare or TRICARE

• Not receiving Veterans Administration benefits

You can use the money in your HSA to pay for qualified medical expenses now or in the future. You can also use HSA funds to pay health care expenses for your dependents, even if they are not covered by the HDHP.

Maximum Contributions

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

• Individual – $3,850

• Family (filing jointly) – $7,750

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

Opening an HSA

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

Important HSA Information

• Always ask your health care provider to file claims with your medical provider so network discounts can be applied. You can pay the provider with your HSA debit card based on the balance due after discount.

• You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.

• You may open an HSA at the financial institution of your choice, but only accounts opened through EECU are eligible for automatic payroll deduction and company contributions.

How to Use your HSA

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

• Call/Text: (817) 882-0800. EECU’s dedicated member service representatives are available to assist you with any questions. Their hours of operation are Monday through Friday from 8:00 a.m. to 7:00 p.m. CT, Saturday 9:00 a.m. – 1:00 p.m. CT and closed on Sunday.

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

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

EMPLOYEE BENEFITS 18
EECU

Dental Insurance Guardian

ABOUT DENTAL

Dental insurance is a coverage that helps defray the costs of dental care. It insures against the expense of routine care, dental treatment and disease.

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

or

up NAP plan, you can visit any dentist; but you pay less out-of-pocket when you choose a PPO dentist. Out-of-network benefits are based on a percentile of the prevailing fee data for the dentist’s zip code.

Value plan, you can visit any dentist; but you pay less out-of-pocket when you choose a PPO dentist. Out-ofnetwork benefits are limited to our PPO fee schedule.

Find out if your dentist is in the Guardian network at www.GuardianAnytime.com

For more detailed information regarding the Rollover Benefit, plan design or exclusions for what is not covered, please refer to the benefit website: www.mybenefitshub.com/NewBraunfelsISD

Dental Plans Option 1 Base NAP Option 2 Buy Up NAP Option 3 Value Plan Benefit Highlight: Base NAP
Buy
Deductible: (3 per family max) In and Out of Network $25.00 $25.00 $25.00 Preventative Care: 80% 100% 100% Basic Care: 80% 80% 100% Major Care: Not Covered 50% 60% Orthodontia: Not Covered 50% for all children under 26 50% for all children under 26 Annual Max: $1,000 $1,000 $1,000 Benefit Rollover: No Yes Yes Dental Base NAP Buy Up NAP Value Plan Employee $20.35 $38.58 $38.58 Employee + Spouse $46.94 $72.76 $72.76 Employee + Child(ren) $51.61 $97.31 $97.31 Family $71.89 $131.49 $131.49
EMPLOYEE BENEFITS 19

Vision Insurance Superior Vision

ABOUT VISION

Vision insurance provides coverage for routine eye examinations and can help with covering some of the costs for eyeglass frames, lenses or contact lenses.

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

How to Print your Vision ID Card:

You can request your vision id card by contacting Superior Vision directly at 800-507-3800. You can also go to www.superiorvision.com and register/login to access your account by clicking on “Members” at the top of the page. You can also download the Superior Vision mobile app on your smart phone.

1.

2. Eyewear copay applies to

is a

of eyeglasses (frame and lenses)

3. Covered to provider’s in-office standard retail lined trifocal amount; member pays difference between progressive and standard retail lined trifocal, plus applicable co-pay

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

Copays Services/frequency Monthly Premiums Exam1 $10 Exam 12 months Employee Only $6.96 Eyewear2 $25 Frame 24 months Employee & Spouse $11.77 Lenses 12 months Employee & Child(ren) $11.77 Contact lenses 12 months Employee & Family $17.42 (Based on date of service) Benefits through Superior Select Southwest network In-network Out-of-network Exam (ophthalmologist) Covered in full Up to $50 retail Frames $130 retail allowance Up to $76 retail Lenses (standard) per pair Single vision Covered in full Up to $50 retail Bifocal Covered in full Up to $70 retail Trifocal Covered in full Up to $90 retail Progressive See description3 Up to $90 retail Anti-reflective coating (standard) Covered in full Up to $25 retail Scratch resistant coating Covered in full Up to $35 retail Contact lenses4 $130 retail allowance Up to $115 retail Medically necessary contact lenses Covered in full Up to $220 retail Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements
Eye exam copay is a single payment due to the provider at the time of service.
contact
single
entire purchase
eyeglass lenses / frame and
lenses. Eyewear copay
payment that applies to the
EMPLOYEE BENEFITS 20

Vision Insurance Superior Vision EMPLOYEE BENEFITS

Discount Features

off amount over allowance Discounts on non-covered exam, services and materials

Exams, frames, and prescription lenses:

off retail Contacts, miscellaneous options:

Disposable

off retail

off retail Retinal imaging:

maximum out-of-pocket

The following options have out-of-pocket maximums5 on standard (not premium, brand, or progressive) lenses.

5. Discounts and maximums may vary by lens type. Please check with your provider. Discounts are subject to change without notice.

Laser vision correction (LASIK)

Laser vision correction (LASIK) is a procedure that can reduce or eliminate your dependency on glasses or contact lenses. This corrective service is available to you and your eligible dependents at a special discount (20-50%) with your Superior Vision plan. Contact QualSight LASIK at (877) 201-3602 for more information.

Hearing discounts

A National Hearing Network of hearing care professionals, featuring Your Hearing Network, offers Superior Vision members discounts on services, hearing aids and accessories. These discounts should be verified prior to service.

The Plan discount features are not insurance. All allowances are retail; the member is responsible for paying the provider directly for all non-covered items and/or any amount over the allowances, minus available discounts. These are not covered by the plan.

Discounts on covered materials Frames: 20%
Contacts: 20%
Contact: 20%
off amount over allowance Conventional
off amount over allowance Disposable
30%
20%
10%
Maximum member out-of-pocket6
contact lenses:
$39
Ultraviolet coat $12 Tints, solid $15 Tints, gradient $18 Polycarbonate $40 Blue light filtering $15 Digital single vision $30 Progressive lenses: Standard/Premium/Ultra/Ultimate $55 / $110 / $150 / $225 Anti-reflective coating: Premium/Ultra/Ultimate $70 / $85 / $120 Polarized lenses $75 Plastic photochromic lenses $80 High Index (1.67 / 1.74) $80 / $120
21

Hospital Indemnity

The Hartford

ABOUT HOSPITAL INDEMNITY

This is an affordable supplemental plan that pays you should you be inpatient hospital confined. This plan complements your health insurance by helping you pay for costs left unpaid by your health insurance.

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

Hospital indemnity (HI) insurance pays a cash benefit if you or an insured dependent (spouse or child) are confined in a hospital for a covered illness or injury. Even with the best primary health insurance plan, out-of-pocket costs from a hospital stay can add up. The benefits are paid in lump sum amounts to you, and can help offset expenses that primary health insurance doesn’t cover (like deductibles, co-insurance amounts or co- pays), or benefits can be used for any non-medical expenses (like housing costs, groceries, car expenses, etc.). To learn more about Hospital Indemnity insurance, visit thehartford.com/employeebenefits

Coverage Information

You have a choice of two hospital indemnity plans, which allows you the flexibility to enroll for the coverage that best meets your needs. Benefit amounts are based on the plan in effect for you or an insured dependent at the time the covered event occurs. Unless otherwise noted, the benefit amounts payable under each plan are the same for you and your dependent(s).

PLAN INFORMATION LOW HIGH Coverage Type On and off-job (24 hour) On and off-job (24 hour) Covered Events Illness and injury Illness and injury HSA Compatible Yes Yes BENEFITS LOW HIGH HOSPITAL CARE First Day Hospital Confinement Up to 1 day per year $1,000 $2,000 Daily Hospital Confinement (Day 2+) Up to 30 days per year $100 $100 Daily ICU Confinement (Day 1+) Up to 30 days per year $200 $200 VALUE ADDED SERVICES LOW HIGH Ability Assist® EAP – 24/7/365 access to help for financial, legal or emotional issues Included Included HealthChampionSM – Administrative & clinical support following serious illness or injury Included Included Hospital Indemnity Low - $1,000 High - $2,000 Employee $13.06 $22.70 Employee + Spouse $23.74 $41.12 Employee + Child(ren) $23.86 $41.04 Family $36.34 $62.48 22
EMPLOYEE BENEFITS

Hospital Indemnity The Hartford

ASKED & ANSWERED

IS THIS COVERAGE HSA COMPATIBLE?

If you (or any dependent(s)) currently participate in a Health Saving Account (HSA) or if you plan to do so in the future, you should be aware that the IRS limits the types of supplemental insurance you may have in addition to a HSA, while still maintaining the tax exempt status of the HSA. This plan design was designed to be compatible with Health Savings Accounts (HSAs). However, if you have or plan to open an HSA, please consult your tax and legal advisors to determine which supplemental benefits may be purchased by employees with an HSA.

WHO IS ELIGIBLE?

You are eligible for this insurance if you are an active fulltime employee who works at least 20 hours per week on a regularly scheduled basis. Your spouse and child(ren) are also eligible for coverage. Any child(ren) must be under age 26.

AM I GUARANTEED COVERAGE?

This insurance is guaranteed issue coverage – it is available without having to provide information about your or your family’s health. All you have to do is elect the coverage to become insured.

HOW MUCH DOES IT COST AND HOW DO I PAY FOR THIS INSURANCE?

Premiums are provided above. You have a choice of plan options. You may elect insurance for you only, or for you and your dependent(s), by choosing the applicable coverage tier.

Premiums will be automatically paid through payroll deduction, as authorized by you during the enrollment process. This ensures you don’t have to worry about writing a check or missing a payment.

WHEN CAN I ENROLL?

You may enroll during any scheduled enrollment period, within 31 days of the date you have a change in family status, or within 31 days of the completion of any eligibility waiting period established by your employer.

WHEN DOES THIS INSURANCE BEGIN?

The initial effective date of this coverage is September 1, 2018. Subject to any eligibility waiting period established by your employer, if you enroll for coverage prior to this date, insurance will become effective on this date. If you enroll for coverage after this date, insurance will become effective in accordance with the terms of the certificate (usually

the first day of the month following the date you elect coverage). You must be actively at work with your employer on the day your coverage takes effect. Your spouse and child(ren) must be performing normal activities and not be confined (at home or in a hospital/care facility).

WHEN DOES THIS INSURANCE END?

This insurance will end when you or your dependents no longer satisfy the applicable eligibility conditions, premium is unpaid, you are no longer actively working, you leave your employer, or the coverage is no longer offered.

CAN I KEEP THIS INSURANCE IF I LEAVE MY EMPLOYER OR AM NO LONGER A MEMBER OF THIS GROUP?

Yes, you can take this coverage with you. Coverage may be continued for you and your dependent(s) under a group portability policy. Your spouse may also continue insurance in certain circumstances. The specific terms and qualifying events for portability are described in the certificate.

EMPLOYEE BENEFITS 23

Critical Illness Insurance The Hartford

ABOUT CRITICAL ILLNESS

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

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

Benefit amounts for covered illnesses are based on the coverage amount in effect for you or an insured dependent at the time of diagnosis. Benefits & Features COVERAGE

Employee

Spouse

$10,000; $20,000; or $30,000

of $5,000 or 50% of your coverage amount

VASCULAR

Heart Attack* (Myocardial Infarction); Heart Failure/Transplant*; Stroke*

Angioplasty/Stent; Coronary Artery Bypass Graft

OTHER

Coma*; End Stage Renal Failure; Loss of Hearing; Loss of Speech; Loss of Vision; Major Organ Failure/Transplant*; Paralysis

NEUROLOGICAL

Advanced Multiple Sclerosis; Advanced Parkinson’s; Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s); Advanced Alzheimer’s Disease

CHILD CONDITIONS

Cerebral Palsy; Congenital Heart Disease; Cystic Fibrosis; Muscular Dystrophy; Spina Bifida 100% of coverage amount

ADDITIONAL BENEFITS

Recurrence - Pays a benefit for a subsequent diagnosis of conditions marked with an asterisk(*) 100% of original benefit amount

Health Screening Benefit (once per year per covered Person) $50

COVERAGE INFORMATION
AMOUNTS
Coverage Amount
Coverage Amount Greater
Child(ren) Coverage Amount 50%
COVERED ILLNESSES BENEFIT AMOUNTS CANCER CONDITIONS Invasive Cancer* 100% of coverage amount Benign Brain Tumor* 25% of coverage amount Non-invasive Cancer 25% of coverage amount Non-Melanoma Skin Cancer $250 (once per lifetime)
of your coverage amount
CONDITIONS
100%
50%
of coverage amount Aneurysm
of coverage amount
25%
of coverage amount
100% of coverage amount Bone Marrow Transplant 25% of coverage amount Other Dread Diseases+ 25% of coverage amount
SPECIFIED CONDITIONS
CONDITIONS
100%
of coverage amount
EMPLOYEE BENEFITS 24

Critical Illness Insurance The Hartford

FEATURES

Coverage Maximum – Primary Insured & Spouse

Coverage Maximum – Child(ren)

Ability Assist® EAP2– 24/7/365 access to help for financial, legal or emotional issues

HealthChampionSM3 – Administrative and clinical support following serious illness or injury

DETAILS

500% of coverage amount

300% of coverage amount

†Other Dread Disease means a covered severe disease that results in a covered person being confined to a Hospital for five (5) or more consecutive days. Covered severe diseases are: Addison’s disease (primary adrenal insufficiency/hypocortisolism); bacterial cerebrospinal meningitis; COVID-19, formally SARS-CoV-2/2019nCoV; diphtheria; encephalitis; Huntington’s chorea; Legionnaire’s disease; malaria; myasthenia gravis; necrotizing fasciitis; osteomyelitis; poliomyelitis; rabies; sickle cell anemia (excluding sickle cell trait); systemic lupus erythematosus (SLE); systemic sclerosis (scleroderma); tetanus; and tuberculosis. Please refer to the policy for complete definitions of each covered illness.

Critical Illness Benefit Amount Coverage Tier Under 25 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80+ $10,000 Employee Only $2.80 $3.40 $3.80 $4.90 $6.80 $10.50 $14.70 $20.00 $28.20 $38.60 $52.00 $69.40 $83.70 Employee & Spouse $4.50 $5.40 $6.10 $7.60 $10.60 $16.40 $22.80 $31.20 $43.90 $59.90 $80.30 $106.80 $128.50 Employee & Child(ren) $4.60 $5.20 $5.60 $6.60 $8.60 $12.30 $16.40 $21.80 $29.90 $40.40 $53.70 $71.20 $85.50 Employee & Family $6.50 $7.50 $8.10 $9.70 $12.70 $18.40 $24.80 $33.20 $45.90 $61.90 $82.40 $108.80 $130.60 $20,000 Employee Only $5.60 $6.80 $7.60 $9.80 $13.60 $21.00 $29.40 $40.00 $56.40 $77.20 $104.00 $138.80 $167.40 Employee & Spouse $9.00 $10.80 $12.20 $15.20 $21.20 $32.80 $45.60 $62.40 $87.80 $119.80 $160.60 $213.60 $257.00 Employee & Child(ren) $9.20 $10.40 $11.20 $13.20 $17.20 $24.60 $32.80 $43.60 $59.80 $80.80 $107.40 $142.40 $171.00 Employee & Family $13.00 $15.00 $16.20 $19.40 $25.40 $36.80 $49.60 $66.40 $91.80 $123.80 $164.80 $217.60 $261.20 $30,000 Employee Only $8.40 $10.20 $11.40 $14.70 $20.40 $31.50 $44.10 $60.00 $84.60 $115.80 $156.00 $208.20 $251.10 Employee & Spouse $13.50 $16.20 $18.30 $22.80 $31.80 $49.20 $68.40 $93.60 $131.70 $179.70 $240.90 $320.40 $385.50 Employee & Child(ren) $13.80 $15.60 $16.80 $19.80 $25.80 $36.90 $49.20 $65.40 $89.70 $121.20 $161.10 $213.60 $256.50 Employee & Family $19.50 $22.50 $24.30 $29.10 $38.10 $55.20 $74.40 $99.60 $137.70 $185.70 $247.20 $326.40 $391.80
EMPLOYEE BENEFITS 25

Accident Insurance The Hartford

ABOUT ACCIDENT

Do you have kids playing sports, are you a weekend warrior, or maybe accident prone? Accident plans are designed to help pay for medical costs associated with accidents and benefits are paid directly to you.

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

COVERAGE INFORMATION

You have a choice of two accident plans, which allows you the flexibility to enroll for the coverage that best meets your needs. This insurance provides benefits when injuries, medical treatment and/or services occur as the result of a covered accident. Unless otherwise noted, the benefit amounts payable under each plan are the same for you and your dependent(s).

PLAN INFORMATION LOW PLAN HIGH PLAN Coverage Type On and off-job (24 hour) BENEFITS EMERGENCY, HOSPITAL & TREATMENT CARE LOW PLAN HIGH PLAN Accident Follow-Up Up to 3 visits per accident $100 $150 Acupuncture/Chiropractic Care Up to 10 visits each per accident $50 $75 Ambulance – Air Once per accident $2,000 $2,500 Ambulance – Ground Once per accident $750 $1,000 Blood/Plasma/Platelets Once per accident $300 $400 Child Care Up to 30 days per accident while insured is confined $35 $50 Daily Hospital Confinement Up to 365 days per lifetime $400 $600 Daily ICU Confinement Up to 30 days per accident $600 $800 Diagnostic Exam Once per accident $300 $400 Emergency Dental Once per accident Up to $450 Up to $600 Emergency Room Once per accident $200 $250 Health Screening Benefit Once per year for each covered person $50 $50 Hospital Admission Once per accident $1,500 $2,000 Initial Physician Office Visit Once per accident $100 $150 Lodging Up to 30 nights per lifetime $150 $175 Medical Appliance Once per accident $200 $300 Physical Therapy Up to 10 visits each per accident $75 $100 Rehabilitation Facility Up to 15 days per lifetime $300 $450 Transportation Up to 3 trips per accident $600 $800 Urgent Care Once per accident $150 $200 X-ray Once per accident $150 $200 Accident Low High Employee $8.34 $11.60 Employee + Spouse $13.12 $18.26 Employee + Child(ren) $13.94 $19.40 Family $21.92 $30.52
EMPLOYEE BENEFITS 26

Accident Insurance The Hartford

SPECIFIED INJURY & SURGERY LOW PLAN HIGH PLAN Abdominal/Thoracic Surgery Once per accident $3,000 $4,000 Arthroscopic Surgery Once per accident $500 $750 Burn Once per accident Up to $15,000 Up to $20,000 Burn – Skin Graft Once per accident for third degree burn(s) 50% of burn benefit Concussion Up to 3 per year $200 $250 Dislocation Once per joint per lifetime Up to $8,000 Up to $12,000 Eye Injury Once per accident Up to $750 Up to $1,000 Fracture Once per bone per accident Up to $10,000 Up to $12,000 Hernia Repair Once per accident $400 $600 Joint Replacement Once per accident $4,000 $6,000 Knee Cartilage Once per accident Up to $2,000 Up to $3,000 Laceration Once per accident Up to $1,000 Up to $1,500 Ruptured Disc Once per accident $2,000 $3,000 Tendon/Ligament/Rotator Cuff Once per accident Up to $2,000 Up to $3,000 CATASTROPHIC LOW PLAN HIGH PLAN Accidental Death Within 90 days; Spouse @ 50% and child @ 25% $75,000 $100,000 Common Carrier Death Within 90 days 2 times death benefit Coma Once per accident $15,000 $20,000 Dismemberment Once per accident Up to $75,000 Up to $100,000 Home Health Care Up to 30 days per accident $75 $100 Paralysis Once per accident Up to $75,000 Up to $100,000 Prosthesis Once per accident Up to $3,000 Up to $4,000 FEATURES LOW PLAN HIGH PLAN Ability Assist® EAP – 24/7/365 access to help for financial, legal or emotional issues Included Included HealthChampionSM – Administrative & clinical support following serious illness or injury Included Included
BENEFITS 27
EMPLOYEE

Identity Theft iLOCK360 EMPLOYEE BENEFITS

ABOUT IDENTITY THEFT PROTECTION

Identity theft protection monitors and alerts you to identity threats. Resolution services are included should your identity ever be compromised while you are covered.

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

Available protections for your identity

Identity theft resolution services

Full-Service Identity

Restoration & Lost Wallet Protection

MOST VALUABLE SERVICE.

Dependable help that’s just a phone call away!

If your identity is compromised, a U.S.-based certified Identity Theft Restoration Specialist will work on your behalf to restore your good name, so that you can get on with your life. All restoration activities can be completed for you, and your case will be managed until your identity is fully restored. Even pre-existing conditions can be dealt with.

Restoration Specialists offer robust case knowledge in both credit and non-credit fraud situations and can help you with closing accounts, re-ordering cards, placing a fraud alert with each of the three credit bureaus, and removing fraudulent activity from your credit report.

$1M Identity Theft Insurance If you incur expenses associated with your identity theft recovery, you will be covered with $1M reimbursement ($0 deductible). Covered costs include:

• Lost wages or income

• Attorney and legal fees

• Expenses incurred for refiling of loans, grants and other lines of credit

• Costs of childcare and/or elderly care incurred as a result of identity restoration

Comprehensive identity monitoring

CyberAlert™️ Monitors:

• one Social Security Number

• two Email Addresses

• one Drivers License Number

• two Medical ID Numbers

• one Passport

• five Credit/Debit Cards

• two Phone Numbers

• five Bank Accounts

Change of Address Monitoring

Payday Loan Monitoring

Adult & Child under 18

Adult & Child under 18

Adult Only

Adult Only

We scour Internet properties, including the Dark Web, as well as hacker websites, blogs, bulletin boards, peer-to-peer sharing networks and chat rooms to identify the illegal trading and selling of your personal information.

Adult & Child under 18

Adult & Child under 18

A thief may try to establish “your” new identity by changing your address. Receive an alert if your mail is redirected in the USPS National Change of Address (NCOA) Registry.

High-interest, easy-to-obtain payday loans can negatively impact your credit score. Alerts you if a non-credit loan was opened in your name at a payday/quick cash loan provider.

Social Security Number Trace Provides you with a report of all names and/or aliases as well as current and reported addresses associated with your Social Security number. If there are findings that you don’t recognize, this could be a sign of possible identity theft.

Medical ID Monitoring

If your Medical ID number is found compromised by CyberAlertTM, a Restoration Specialist can help you report it as fraud.

Court/Criminal Records Monitoring Tracks municipal court systems and notifies you if a crime has been committed under your name and date of birth

Adult only

Adult only

Adult & Child under 18

Adult only

Adult only

Adult only

Adult & Child under 18

Adult only

Adult only

Service
Plan features
description Essential Elite
28

Identity Theft iLOCK360

Credit monitoring services

Bank Account Takeover & Credit Card Application

Monitoring

Daily Monitoring of Experian Credit

Daily Monitoring of all 3 Credit Bureaus

ScoreTracker

3-Bureau Credit Score & Report

Experian Positive Activity

Notifications

Experian Score Variance Alerts

Advanced tools

Sex Offender Alerts

Social Media Monitoring

Solicitation Reduction

Notifies you when your Social Security number and personal information have been used to apply for or open a new bank or credit card account; or if changes have been made to your existing bank account - such as an attempt to add a new account holder.

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

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

Receive a monthly report that helps you understand how your credit score has trended over time and what is impacting it with credit score insight.

Provides you with access to your credit score and report reported by each credit bureauExperian, Equifax & TransUnion. These are reported once a year.

Alerts you when positive activity is reported on your Experian credit file, a key indicator that your credit may be improving.

Receive alerts when your Experian credit score increases or decreases by a certain amount, changes risk level/score rank, or reaches a target score value.

Keep your family safe with awareness of where registered sex offenders live in your immediate area. You’ll also be notified when a new one moves to your area.

Receive notifications if the content you share on social media could pose a privacy or reputational risk. With Family coverage, you can monitor your child’s social media presence.

Limit access to the amount of personal information that is public to reduce your exposure to fraud and declutter your mailbox and phone line. Also, opt- out of direct marketing campaigns including utilizing the National Do Not Call Registry.

Adult only

Adult only

Adult only

Adult only

Adult only

Adult only

Adult only

Adult only

Adult only

Adult Only

Adult Only

Adult Only

Adult Only

Adult Only

Adult Only

Identity Theft Essential Plan Elite Plan Employee $6.95 $11.95 Family $13.95 $22.95
29
EMPLOYEE BENEFITS

Disability Insurance The Hartford

ABOUT DISABILITY

Disability insurance protects one of your most valuable assets, your paycheck. This insurance will replace a portion of your income in the event that you become physically unable to work due to sickness or injury for an extended period of time.

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

What is Educator Disability Income Insurance?

Educator Disability insurance combines the features of a short-term and long-term disability plan into one policy. The coverage pays you a portion of your earnings if you cannot work because of a disabling illness or injury. The plan gives you the flexibility to choose a level of coverage to suit your need.

PRE-Existing Condition: Your policy limits the benefits you can receive for a disability caused by a pre-existing condition. EX: if you were diagnosed or received care for a disabling condition within the 3 consecutive months just prior to the effective date of this policy in this case(09/01/2023), your benefit payment will be limited, unless: You have been insured under this policy for 12 months before your disability begins. If your disability is a result of a pre-existing condition, we will pay benefits for a maximum of 2 months.

Benefit Integration: For the first 12 months your benefit may be reduced by other income you receive or are eligible to receive due to your disability, such as Workers’ Compensation Law, the Jones Act, occupational disease law, similar law or substitutes or exchanges for such benefits; 2) income that You receive from Your Employer’s sabbatical leave plan or similar leave of absence plan 3) income that You receive from Your Employer’s assault leave plan, or similar leave of absence plan, because of you were physically assaulted while acting in Your official capacity.

Eligibility: You are eligible if you are an active employee who works at least 20 hours per week on a regularly scheduled basis.

Enrollment: You can enroll in coverage within 31 days of your date of hire or during your annual enrollment period.

Effective Date: Coverage goes into effect subject to the terms and conditions of the policy. You must satisfy the definition of Actively at Work with your employer on the day your coverage takes effect.

Actively at Work: You must be at work with your Employer on your regularly scheduled workday. On that day, you must be performing for wage or profit all of your regular duties in the usual way and for your usual number of hours. If school is not in session due to normal vacation or school break(s), Actively at Work shall mean you are able to report for work with your Employer, performing all of the regular duties of Your Occupation in the usual way for your usual number of hours as if school was in session.

Benefit Amount: You may purchase coverage that will pay you a monthly flat dollar benefit in $100 increments between $200 and $8,000 that cannot exceed 66 2/3% of your current monthly earnings. Earnings are defined in The Hartford’s contract with your employer.

Elimination Period: You must be disabled for at least the number of days indicated by the elimination period that you select before you can receive a Disability benefit payment. The elimination period that you select consists of two numbers. The first number shows the number of days you must be disabled by an accident before your benefits can begin. The second number indicates the number of days you must be disabled by a sickness before your benefits can begin.

For those employees electing an elimination period of 30 days or less, if you are confined to a hospital for 24 hours or more due to a disability, the elimination period will be waived, and benefits will be payable from the first day of hospitalization.

EMPLOYEE BENEFITS 30

Disability Insurance The Hartford EMPLOYEE

Maximum Benefit Duration: Benefit Duration is the maximum time for which we pay benefits for disability resulting from sickness or injury. Depending on the schedule selected and the age at which disability occurs, the maximum duration may vary. Please see the schedules below:

Injury:

Sickness:

Mental Illness, Alcoholism and Substance Abuse: You can receive benefit payments for Long-Term Disabilities resulting from mental illness, alcoholism, and substance abuse for a total of 24 months for all disability periods during your lifetime.

Partial Disability covered provided you have at least a 20% loss of earnings and duties of your job.

Additional Benefits:

Survivor Benefit: If you die while receiving disability benefits, a benefit will be paid to your spouse or child under age 26, equal to three times your last monthly gross benefit.

The Hartford’s Ability Assist: You have access to Ability Assist services both prior to a disability and after you’ve been approved for an LTD claim and are receiving LTD benefits. It provide assistance with child/elder care, substance abuse, family relationships and more.

Travel Assistance Program: This program aids employees and their dependents who travel 100 miles from their home for 90 days or less.

Identity Theft Protection: Support services to help victims restore their identity.

For additional information on this plan please visit the carrier website and your benefits portal linked above.

Disability Elimination Period Monthly Benefit per $200 0/7 $6.24 14/14 $5.14 30/30 $3.76 60/60 $3.56 Age at Disability Maximum Duration of Benefits Prior to 63 To Normal Retirement Age or 48 months if greater Age 63 To Normal Retirement Age or 42 months if greater Age 64 36 months Age 65 30 months Age 66 27 months Age 67 24 months Age 68 21 months Age 69 and older 18 months Age at Disability Maximum Duration of Benefits Prior to 67 3 years Age 67-69 To age 70, but no less than one year Age 70 and Older 1 year
31
BENEFITS

Educator 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. This type of disability plan is called an educator disability plan and includes both long and short term coverage into one convenient plan.

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 preexisting condition limitations.

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

1. First choose your elimination period. The elimination period, sometimes referred to as the waiting period, is how long you are disabled and unable to work before your benefit will begin. This will be displayed as 2 numbers such as 0/7, 14/14, 30/30, 60/60, 90/90, etc.

The first number indicates the number of days you must be disabled due to Injury and the second number indicates the number of days you must be disabled due to Sickness

When choosing your elimination period, ask yourself, “How long can I go without a paycheck?” Based on the answer to this question, choose your elimination period accordingly.

Important Note- some plans will waive the elimination period if you choose 30/30 or less and you are confined as an inpatient to the hospital for a specific time period. Please review your plan details to see if this feature is available to you.

2. Next choose your benefit amount. This is the maximum amount of money you would receive from the carrier on a monthly basis once your disability claim is approved by the carrier.

When choosing your monthly benefit, ask yourself, “How much money do I need to be able to pay my monthly expenses?” Based on the answer to this question, choose your monthly benefit accordingly.

Choose your Benefit Amount from the drop down box. Choose your desired elimination period. EMPLOYEE BENEFITS
32
Disability The Hartford

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/newbraunfelsisd

Voluntary Life Insurance

• Provides a cash benefit to your loved ones in the event of your death

• Features group rates for New Braunfels ISD employees

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

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

• To file a claim contact Lincoln Financial at (800) 423-2765

Note: You must be an active New Braunfels Independent School District employee to select coverage for a spouse and/or dependent children. To be eligible for coverage, a spouse or dependent child cannot be confined to a health care facility or unable to perform the typical activities of a healthy person of the same age and gender.

Employee Guaranteed coverage amount during initial offering or approved special enrollment period $200,000 Newly hired employee guaranteed coverage amount $200,000 Continuing employee guaranteed coverage annual increase amount Choice of $10,000 or $20,000 Maximum coverage amount 5 times your annual salary
maximum in increments
Minimum coverage amount $10,000 Spouse Guaranteed coverage amount during initial offering or approved special enrollment period $30,000 Newly hired employee guaranteed coverage amount $30,000 Continuing employee guaranteed coverage annual increase amount Choice of $5,000 or $10,000 Maximum coverage amount 50% of the employee coverage amount ($100,000 maximum in increments of $5,000) Minimum coverage amount $5,000 Dependent Children Day 1 months to age 26 guaranteed coverage amount $10,000 Benefit Exclusions: Like any insurance, this term life insurance policy does have exclusions. A suicide exclusion may apply. A complete list of benefit exclusions is included in the policy. State variations apply.
($500,000
of $10,000)
Plan Benefits Accelerated Death Benefit Included Premium Waiver Included Conversion Included Portability Included Voluntary Group Life Age Employee per $10,000 Spouse per $5,000 18-24 $0.50 $0.50 25-29 $0.50 $0.50 30-34 $0.60 $0.60 35-39 $0.70 $0.70 40-44 $1.00 $1.00 45-49 $1.60 $1.60 50-54 $2.40 $2.40 55-59 $4.00 $4.00 60-64 $6.20 $6.20 65-69 $10.90 $10.90 70-74 $10.90 $10.90 75-79 $10.90 $10.90 80-99 $10.90 $10.90 Voluntary Group Life - Child(ren) Per $10,000 in coverage 0-26 $1.80 Spouse rates based on Employee’s age. EMPLOYEE BENEFITS
Additional
33

Individual Life Insurance

Texas Life

ABOUT INDIVIDUAL LIFE

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

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

Voluntary permanent life insurance can be an ideal complement to the group term and optional term your employer might provide. Designed to be in force when you die, this voluntary universal life product is yours to keep, even when you change jobs or retire, as long as you pay the necessary premium. Group and voluntary term, on the other hand, typically are not portable if you change jobs and, even if you can keep them after you retire, usually cost more and decline in death benefit. The policy, purelife-plus, is underwritten by Texas Life Insurance Company, and it has the following features:

• High Death Benefit. With one of the highest death benefits available at the worksite, purelife-plus gives your loved ones peace of mind.

• Minimal Cash Value. Designed to provide a high death benefit at a reasonable premium, purelife-plus provides peace of mind for you and your beneficiaries while freeing investment dollars to be directed toward such tax-favored retirement plans as 403(b), 457 and 401(k).

• Long Guarantees.2 Enjoy the assurance of a policy that has a guaranteed death benefit to age 121 and level premium that guarantees coverage for a significant period of time.

• Refund of Premium. Unique in the marketplace, purelifeplus offers you a refund of 10 years’ premium, should you surrender the policy if the premium you pay when you buy the policy ever increases. (Conditions apply.)

• Accelerated Death Benefit Rider. Should you be diagnosed as terminally ill with the expectation of death within 12 months (24 months in Illinois), you will have the option to receive 92% (84% in Illinois) of the death benefit, minus a $150 ($100 in Florida) administrative fee. This valuable living benefit gives you peace of mind knowing that, should you need it, you can take the large majority of your death benefit while still alive. (Conditions apply.)

You may apply for this permanent, portable coverage, not only for yourself, but also for your spouse, children and grandchildren by answering just 3 questions:

During the last six months, has the proposed insured:

a. Been actively at work on a full time basis, performing usual duties?

b. Been absent from work due to illness or medical treatment for a period of more than five consecutive working days?

c. Been disabled or received tests, treatment or care of any kind in a hospital or nursing home or received chemotherapy, hormonal therapy for cancer, radiation therapy, dialysis treatment, or treatment for alcohol or drug abuse?

EMPLOYEE BENEFITS 34

Flexible Spending Account (FSA) NBS

ABOUT FSA

A Flexible Spending Account allows you to pay for eligible healthcare expenses with a pre-loaded debit card. You choose the amount to set aside from your paycheck every plan year, based on your employer’s annual plan limit. This money is use it or lose it within the plan year (unless your plan contains a $500 rollover or grace period provision).

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

Health Care FSA

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).

How the Health Care FSAs Work

You can access the funds in your Health Care FSA two different ways:

• Use your NBS Debit Card to pay for qualified expenses, doctor visits and prescription copays.

• Pay out-of-pocket and submit your receipts for reimbursement:

◊ Fax – 844-438-1496

◊ Email – service@nbsbenefits.com

◊ Online – my.nbsbenefits.com

◊ Call for Account Balance: 855-399-3035

◊ Mail: PO Box 6980 West Jordan, UT 84084

Contact NBS

• Hours of Operation: 6:00 AM – 6:00 PM MST, Mon-Fri

• Phone: (800) 274-0503

• Email: service@nbsbenefits.com

• Mail: PO Box 6980 West Jordan, UT 84084

Dependent Care FSA

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.

Dependent Care FSA Guidelines

• Overnight camps are not eligible for reimbursement (only day camps can be considered).

• If your child turns 13 midyear, you may only request reimbursement for the part of the year when the child is under age 13.

• You may request reimbursement for care of a spouse or dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self-care.

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

Important FSA Rules

• The maximum per plan year you can contribute to a Health Care FSA is $3,050.00. The maximum per plan year you can contribute to a Dependent Care FSA is $5,000 when filing jointly or head of household and $2,500 when married filing separately.

• You cannot change your election during the year unless you experience a Qualifying Life Event.

EMPLOYEE BENEFITS 35

Flexible Spending Account (FSA) NBS

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

• The IRS has amended the “use it or lose it rule” to allow you to carry-over up to $610 in your Health Care FSA into the next plan year. The carry-over rule does not apply to your Dependent Care FSA.

Over-the-Counter Item Rule Reminder (OTC)

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

FSA

Dependent Care FSA

FSAstore.com

Most medical, dental and vision care expenses that are not covered by your health plan (such as copayments, coinsurance, deductibles, eyeglasses and doctorprescribed over-the-counter medications)

Dependent care expenses (such as day care, after-school programs or elder care programs) so you and your spouse can work or attend school full-time

$3,050

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

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

Reduces your taxable income

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

Flexible Spending Accounts Account Type Eligible Expenses Annual Contribution Limits Benefit
Care
Health
EMPLOYEE BENEFITS 36

Employee Assistance Program (EAP)

ComPsych | Lincoln Financial Group

ABOUT EAP

An Employee Assistance Program (EAP) is a program that assists you in resolving problems such as finding child or elder care, relationship challenges, financial or legal problems, etc. This program is provided by your employer at no cost to you.

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

ComPsych EAP

Life has its share of ups and downs — and sometimes you may need a little guidance through the “downs.” EmployeeConnectSM services included with your employer’s long-term disability insurance offer an array of confidential services to help you and your loved ones meet the challenges that life, work, and relationships can bring. Unlimited 24/7 assistance

You can access the following services anytime, online or with a toll-free call:

• Information, resources, and referrals on family matters, such as child and elder care; kennels and pet care; event and vacation planning; moving and relocation; car buying; college planning; and more

• Legal information and referrals for situations requiring expertise in family law, estate planning, landlord/tenant relations, con-sumer and civil law, and more

• Guidance with financial matters, including household budgeting, and short and long-term planning.

In-person guidance Some matters are best resolved by meeting with a professional in person. With EmployeeConnect, you get: The resources you need to meet life’s challenges.

• In-person help for short-term issues (up to five* sessions with a counselor per person, per issue, per year)

• In-person consultations with network lawyers, including one free 30-minute in-person consultation per legal issue, and subse-quent meetings at a reduced fee

*In California, up to three sessions in six months, starting with initial contact by employee.

Employee Assistance Program Services

Confidential help 24 hours a day, 7 days a week for employees and family members Visit www.GuidanceResources.com (user name = LFGsupport; password = LFGsupport1). Or talk with a specialist at 888-628-4824.

EMPLOYEE BENEFITS 37

Notes

38

Notes

39

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 New Braunfels ISD Benefits Website. This summary does not replace or amend the underlying plan documentation. In the event of a discrepancy between this summary and the plan documentation the plan documentation governs. All plans and benefits described in this summary may be discontinued, increased, decreased, or altered at any time with or without notice.

Rate Sheet General Disclaimer: The rate information provided in this guide is subject to change at any time by your employer and/or the plan provider. The rate information included herein, does not guarantee coverage or change or otherwise interpret the terms of the specific plan documentation, available at the New Braunfels ISD Benefits Website, which may include additional exclusions and limitations and may require an application for coverage to determine eligibility for the health benefit plan. To the extent the information provided in this summary is inconsistent with the specific plan documentation, the provisions of the specific plan documentation will govern in all cases.

WWW.MYBENEFITSHUB.COM/NEWBRAUNFELSISD

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