2023 Clint ISD Benefit Guide

SUMMARY PAGES PG. 6 YOUR BENEFITS PG. 12

Benefit Contact Information

CLINT ISD BENEFITS HOSPITAL INDEMNITY PLAN TELEHEALTH

Financial Benefit Services

(800)583-6908

www.mybenefitshub.com/clintisd

The Hartford (866)547-4205

www.thehartford.com/employeebenefits/claims

DENTAL VISION

Cigna

Group #3338267

(800)244-6224

www.mycigna.com

Superior Vision

(800)507-3800

www.superiorvision.com

MDLIVE Group #FBS

(888)365-1663

www.consultmdlive.com

DISABILITY

The Hartford (888)563-1124

www.thehartford.com/employeebenefits/claims

CANCER ACCIDENT CRITICAL ILLNESS

American Public Life

(800)256-8606

www.ampublic.com

The Hartford (888)563-1124

www.thehartford.com/employeebenefits/claims

LIFE AND AD&D IDENTITY THEFT

The Hartford Group #395333

(888)563-1124

www.thehartford.com/employee-benefits/ claims

Experian

(888)397-3742

www.experian.com

The Hartford Group #VCI-395333 (866)547-4205

www.thehartford.com

EMERGENCY MEDICAL TRANSPORT

MASA

U.S. (800) 423-3226

International (800) 643-9023

www.masamts.com

FLEXIBLE SPENDING ACCOUNT HEALTH SAVINGS ACCOUNT EMPLOYEE ASSISTANCE PROGRAM

National Benefit Services

(800)274-0503

www.nbsbenefits.com

HSA Bank

(800) 357-6246

www.hsabank.com

Lifeworks

(888)456-1324

www.lifeworks.com/us

How to Log In

1 www.mybenefitshub.com/clintisd

2 CLICK LOGIN

3 ENTER USERNAME & PASSWORD

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

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

Annual Benefit Enrollment

• Accident, Critical Illness & ID theft Protection has new carriers!

• Health Savings Account (HSA) contribution Limit increased!

• Flexible Spending Account (FSA) contribution Limit Increased!

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

• REQUIRED!! Due to the Affordable Care Act (ACA) reporting requirements, you must add your dependent’s CORRECT social security numbers in the online enrollment system. If you have questions, please contact your Benefits Administrator.

Annual Benefit Enrollment

Section 125 Cafeteria Plan Guidelines

A Cafeteria plan enables you to save money by using pre-tax dollars to pay for eligible group insurance premiums sponsored and offered by your employer. Enrollment is automatic unless you decline this benefit. Elections made during annual enrollment will become effective on the plan effective date and will remain in effect during the entire plan year.

Changes in benefit elections can occur only if you experience a qualifying event. You must present proof of a qualifying event to your Benefit Office within 30 days of your qualifying event and meet with your Benefit/HR Office to complete and sign the necessary paperwork in order to make a benefit election change. Benefit changes must be consistent with the qualifying event.

CHANGES IN STATUS (CIS): QUALIFYING EVENTS

Marital Status

Change in Number of Tax Dependents

Change in Status of Employment Affecting Coverage Eligibility

Gain/Loss of Dependents' Eligibility Status

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

A change in number of dependents includes the following: birth, adoption and placement for adoption. You can add existing dependents not previously enrolled whenever a dependent gains eligibility as a result of a valid change in status event.

Change in employment status of the employee, or a spouse or dependent of the employee, that affects the individual's eligibility under an employer's plan includes commencement or termination of employment.

An event that causes an employee's dependent to satisfy or cease to satisfy coverage requirements under an employer's plan may include change in age, student, marital, employment or tax dependent status.

Judgment/Decree/ Order

Eligibility for Government Programs

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

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

Annual Benefit Enrollment

Annual Enrollment

During your annual enrollment period, you have the opportunity to review, change or continue benefit elections each year. Changes are not permitted during the plan year (outside of annual enrollment) unless a Section 125 qualifying event occurs.

• Changes, additions or drops may be made only during the annual enrollment period without a qualifying event.

• Employees must review their personal information and verify that dependents they wish to provide coverage for are included in the dependent profile. Additionally, you must notify your employer of any discrepancy in personal and/or benefit information.

• Employees must confirm on each benefit screen (medical, dental, vision, etc.) that each dependent to be covered is selected in order to be included in the coverage for that particular benefit.

New Hire Enrollment

All new hire enrollment elections must be completed in the online enrollment system within the first 30 days of benefit 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/clintisd 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 Clint ISD benefit website: www.mybenefitshub.com/clintisd. Click on the benefit plan you need information on (i.e., Dental) and you can find provider search links under the Quick Links section.

When will I receive ID cards?

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

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

Annual Benefit Enrollment

Employee Eligibility Requirements

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

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

Telehealth Unmarried to age 26

Dental To age 26 Vision To age 26 Cancer To age 26

Accident To age 26

Critical Illness To age 26

Voluntary Life Unmarried to age 26

Individual Life Issue age: Children to age 26, Grandchildren to age 18; Keep to age 121

Identity Theft Unmarried to age 26

Medical FSA To age 26

Dependent Care FSA

12 or younger or qualified individual unable to care for themselves and claimed as tax dependent

Employee Assistance Plan 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.

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 1/1/2023 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

January 1st through December 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).

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

Spending Account (FSA) (IRC Sec. 125)

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

Permissible Use Of Funds

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

Year-to-year rollover of account balance?

Does the account earn interest?

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.

Employees may use funds any way they wish. If used for non-qualified medical expenses, subject to current tax rate plus 20% penalty.

Permitted, but subject to current tax rate plus 20% penalty (penalty waived after age 65).

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

Reimbursement for qualified medical expenses (as defined in Sec. 213(d) of IRC).

Yes, 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 $500 rollover provision.

No

Basic Life and AD&D

The Hartford

ABOUT LIFE AND AD&D

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

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

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

Benefit Highlights

What is basic life and AD&D insurance?

Your employer provides, at no cost to you, basic life and AD&D insurance in an amount equal to $25,000. Life insurance pays your beneficiary (please see below) a benefit if you die while you are covered.

This highlight sheet is an overview of your basic life and AD&D insurance. Once a group policy is issued to your employer, a certificate of insurance will be available to explain your coverage in detail.

Am I eligible? You are eligible if you are an active full time employee who works at least 30 hours per week on a regularly scheduled basis.

When can I enroll? As an eligible employee, you are automatically covered by basic life and AD&D insurance; you do not have to enroll. If you have not already done so, you must designate a beneficiary as described below.

When is it effective? Coverage goes into effect subject to the terms and conditions of the policy. You must be actively at work with your employer on the day your coverage takes effect.

Benefit Reductions

None. All coverage cancels at retirement.

What is a beneficiary? Your beneficiary is the person (or persons) or legal entity (entities) who receives a benefit payment if you die while you are covered by the policy. You must select your beneficiary when you complete your enrollment application; your selection is legally binding.

AD&D Coverage AD&D provides benefits due to certain injuries or death from an accident. The covered injuries or death can occur up to 365 days after that accident. The insurance pays:

• 100% of the amount of coverage you purchase in the event of accidental loss of life, two limbs, the sight of both eyes, one limb and the sight of one eye, or speech and hearing in both ears or quadriplegia.

• 75% for paraplegia or triplegia (paralysis of three limbs).

• One-half (50%) for accidental loss of one limb, sight of one eye, or speech or hearing in both ears or hemiplegia.

• One-quarter (25%) for accidental loss of thumb and index finger of the same hand or uniplegia.

Your total benefit for all losses due to the same accident will not be more than 100% of the amount of coverage you purchase.

Basic Life and AD&D The Hartford EMPLOYEE BENEFITS

Can I keep my life coverage if I leave my employer?

Yes, subject to the contract, you have the option of:

• Converting your group life coverage to your own individual policy (policies).

• If you leave your employer, portability is an option that allows you to continue your life insurance coverage. To be eligible, you must terminate your employment prior to Social Security Normal Retirement Age. This option allows you to continue all or a portion of your life insurance coverage under a separate portability term policy. Portability is subject to a minimum of $5,000 and a maximum of $250,000 and does not include coverage for your dependents. To elect portability, you must apply and pay the premium within 31 days of the termination of your life insurance. Evidence of insurability will not be required.

What is the Living Benefits Option?

If you are diagnosed as terminally ill with a 12-month life expectancy, you may be eligible to receive payment of a portion of your life insurance. The remaining amount of your life insurance would be paid to your beneficiary when you die.

Important Details

As is standard with most term life insurance, this insurance coverage includes certain limitations and exclusions:

• The amount of your coverage may be reduced when you reach certain ages.

AD&D insurance does not cover losses caused by or contributed by:

• sickness; disease; or any treatment for either;

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

• intentionally self-inflicted injury, suicide or suicide attempt;

• war or act of war, whether declared or not;

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

• taking prescription or illegal drugs unless prescribed for or administered by a licensed physician;

• injury sustained while committing or attempting to commit a felony;

• the injured person’s intoxication.

Other exclusions may apply depending upon your coverage. Once a group policy is issued to your employer, a certificate of insurance will be available to explain your coverage in detail.

Hospital Indemnity The Hartford EMPLOYEE BENEFITS

ABOUT HOSPITAL INDEMNITY

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

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

BENEFIT HIGHLIGHTS

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, coinsurance 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).

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.

Hospital Indemnity The Hartford

WHO IS ELIGIBLE?

You are eligible for this insurance if you are an active full-time employee who works at least 20 hours per week on a regularly scheduled basis. 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.

ABOUT TELEHEALTH

Telehealth provides 24/7/365 access to board-certified doctors via telephone or video consultations that can diagnose, recommend treatment and prescribe medication. Telehealth makes care more convenient and accessible for non-emergency care when your primary care physician is not available.

BENEFITS

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

Alongside your medical coverage is access to quality telehealth services through MDLIVE. Connect anytime day or night with a board-certified doctor via your mobile device or computer. While MDLIVE does not replace your primary care physician, it is a convenient and cost-effective option when you need care and:

• Have a non-emergency issue and are considering a convenience care clinic, urgent care clinic

• or emergency room for treatment

• Are on a business trip, vacation or away from home

• Are unable to see your primary care physician

When to Use MDLIVE:

At a cost that is the same or less than a visit to your physician, use telehealth services for minor conditions such as:

• Sore throat

• Headache

• Stomachache

• Cold

• Flu

• Allergies

• Fever

• Urinary tract infections

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

Registration is Easy

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

• Online – www.mdlive.com/fbs

• Phone – 888-365-1663

• Mobile – download the MDLIVE mobile app to your smartphone or mobile device

• Select –“MDLIVE as a benefit” and “FBS” as your Employer/Organization when registering your account.

Telehealth

Employee and Family $10.00

Dental Insurance Cigna 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/clintisd

Our dental plans help you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work. Premium contributions are deducted from your paycheck on a pretax basis. Coverage is provided through Cigna Dental.

Dental PPO Plans

The Dental PPO Plans allow you to visit any dental provider. However, when you use a CIGNA network dentist you usually pay less out of your pocket because the network dentists have agreed to charge prenegotiated reduced fees. If you visit a dentist outside the network, you may be responsible for additional fees.

How to Find a Dentist

Visit https://hcpdirectory.cigna.com/ or call 800-244-6224 to find an in-network dentist.

How to Request a New ID Card

You can request your dental id card by contacting Cigna directly at 800-244-6224. You can also go to www.mycigna.com and register/login to access your account. In addition, you can download the “MyCigna” app on your smartphone and access your id card right there on your phone.

These summaries only show a few of the covered procedures.

*Subject to annual deductible

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/clintisd

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

Discount Features

Non-Covered Eyewear Discount: Members may also receive a discount of 20% from a participating provider’s usual and customary fees for eyewear purchases which exceed the benefit coverage (except disposable contact lenses, for which no discount applies). This includes eyeglass frames which exceed the selected benefit coverage, specialty lenses (i.e. progressives) and lens “extras” such as tints and coatings. Eyewear purchased from a Walmart Vision Center does not qualify for this additional discount because of Walmart’s “Always Low Prices” policy.

Disability Insurance The Hartford EMPLOYEE BENEFITS

ABOUT DISABILITY

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

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

What is Educator Disability Income Insurance?

Why do I need Disability Insurance Coverage?

EDUCATOR DISABILITY – POLICY # 395333

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. You could purchase Disability Insurance through your employer. This highlight sheet is an overview of your Disability Insurance.

1

More than half of all personal bankruptcies and mortgage foreclosures are a consequence of disability

1 Facts from LIMRA, 2016 Disability Insurance Awareness Month

The average worker faces a 1 in 3 chance of suffering a job loss lasting 90 days or more due to a disability

2Facts from LIMRA, 2016 Disability Insurance Awareness Month

Only 50% of American adults indicate they have enough savings to cover three months of living expenses in the event they’re not earning any income3

3Federal Reserve, Report on the Economic Well-Being of U.S. Households in 2018

ELIGIBILITY AND ENROLLMENT

Eligibility

Enrollment

Effective Date

Actively at Work

FEATURES OF THE PLAN

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

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

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.

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 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 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 benefit of 30%, 40%, 50% or 60% of your monthly income, to a maximum of $8,000. 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.

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.

2

Disability Insurance

FEATURES OF THE PLAN (cont’d)

PROVISIONS OF THE PLAN

Pre-Existing Condition Limitation

Your policy limits the benefits you can receive for a disability caused by a pre-existing condition. In general, if you were diagnosed or received care for a disabling condition within the 3 consecutive months just prior to the effective date of this policy, your benefit payment will be limited, unless: You have not received treatment for the disabling condition within 3 months, while insured under this policy, before the disability begins, or You have been insured under this policy for 12 months before your disability begins.

If your disability is a result of a pre-existing condition, we will pay benefits for a maximum of 4 weeks.

Other Important Benefits

Survivor Benefit - If you die while receiving disability benefits, a benefit will be paid to your spouse or child under age 25, equal to three times your last monthly gross benefit.

The Hartford's Ability Assist service is included as a part of your group Long Term Disability (LTD) insurance program. 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. Once you are covered you are eligible for services to aid with child/elder care, substance abuse, family relationships and more. In addition, LTD claimants and their immediate family members receive confidential services to assist them with the unique emotional, financial, and legal issues that may result from a disability. Ability Assist services are provided through ComPsych®, a leading provider of employee assistance and work/life services.

Travel Assistance Program – Available 24/7, this program aids employees and their dependents who travel 100 miles from their home for 90 days or less. Services include pre-trip information, emergency medical assistance and emergency personal services.

Identity Theft Protection – An array of identity fraud support services to help victims restore their identity. Benefits include 24/7 access to an 800 number; direct contact with a certified caseworker who follows the case until it’s resolved; and a personalized fraud resolution kit with instructions and resources for ID theft victims.

Workplace Modification provides for reasonable modifications made to a workplace to accommodate your disability and allow you to return to active full-time employment.

Cancer Insurance

ABOUT CANCER

Cancer insurance offers you and your family supplemental insurance protection in the event you or a covered family member is diagnosed with cancer. It pays a benefit directly to you to help with expenses associated with cancer treatment.

EMPLOYEE BENEFITS

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

Treatment for cancer is often lengthy and expensive. Cancer insurance through American Public Life helps pay for these direct and indirect treatment costs so you can focus on your health.

Should you need to file a claim contact APL at 800-256-8606 or online at www.ampublic.com. You can find additional claim forms and materials at www.mybenefitshub.com/clintisd

Pre-Existing Condition Exclusion: Review the Benefit Summary page that can be found at www.mybenefitshub.com/ clintisd

Internal Cancer First Occurrence Benefit Rider: Pays a lump sum benefit amount when a Covered Person receives a first diagnosis of a covered Internal Cancer and the Date of Diagnosis occurs after the Waiting Period. The Internal Cancer lump sum benefit amount will reduce by 50% at age 70.

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

Accident Insurance The Hartford EMPLOYEE BENEFITS

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/clintisd

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).

Accident Insurance The Hartford EMPLOYEE BENEFITS

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

Administrative & clinical support following serious illness or injury

ASKED & ANSWERED WHO IS ELIGIBLE?

• You are eligible for this insurance if you are an active full-time employee who works at least 20 hours per week on a regularly scheduled basis.

• 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 must 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.

WHEN DOES THIS INSURANCE BEGIN?

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), unless already insured with the prior carrier.

Critical Illness Insurance The Hartford EMPLOYEE BENEFITS

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/clintisd

Employee

Dependent(s)

To be eligible for coverage, an Employee must be performing the normal duties of their regular job for the policyholder for 20 or more hours each week (excluding on call hours) and be receiving compensation from the policyholder for work performed.

Dependent(s) must be able to perform normal and customary activities and not be confined (at home or in any medical facility) to be eligible for coverage. In addition, Dependent Child(ren) must be under age 26 otherwise allowed by the policy.

New Hire Enrollment

Ongoing Enrollment

An Employee may enroll for coverage for the Employee and any Dependent(s) within 31 days following the day the Employee or Dependent(s) first become(s) eligible for coverage under the Policy. If an Employee does not elect coverage during the Employee’s or Dependent’s initial enrollment period, future enrollment may only occur as provided in the Changes in Coverage provision of the Certificate.

An Employee may enroll for coverage for the Employee and any Dependent(s) within an Annual Enrollment Period specified by the Policyholder or during an Additional Enrollment Event.

To be insured under the Policy an Employee must elect coverage for themself and any Dependent(s). The Employee is required to pay premium for the coverage elected. Payment of premium does not guarantee eligibility for coverage.

Any amount of insurance for a Spouse or Dependent Child(ren) will be rounded to the next higher multiple of $1,000, if not already an even multiple of $1,000. All Coverage Amount(s) are Guaranteed Issue. Employee Choice of $10,000 to $30,000 in increments of $10,000 ($10,000; $20,000 or $30,000)

of the Employee’s elected Coverage Amount

elected Coverage Amount (per child)

CRITICAL ILLNESS BENEFITS

All Critical Illness Benefits are subject to all the applicable Definitions, Additional Requirements, maximums, limitations, Exclusions, and other provisions of the Policy. The amounts shown below may be adjusted or reduced based on other benefits payable or previously paid under the Policy. All Initial Occurrence Benefit Amounts are a percentage of the applicable Coverage Amount in effect for a Covered Person at the time of Diagnosis of a Critical Illness. All Reoccurrence Benefit Amounts are a percentage of the Initial Occurrence Benefit Amount for the applicable Critical Illness that is payable or was previously paid under the Policy for a Covered Person.

Critical Illness Insurance The

Critical Illness(es) included in the Occupational Diseases Category are only covered under the Policy if the exposure to or contraction of the illness is accidental and occurs while a Covered Person is performing the duties of their normal occupation.

ADDITIONAL BENEFITS

All Additional Benefits are subject to the applicable Definitions, Exclusions, and other provisions of the Policy. The amounts and maximums shown below may be adjusted or reduced based on other benefits payable or previously paid under the Policy, as described in the Additional Benefit(s) and General Limitations & Exclusions sections of this Certificate.

Voluntary Life

The Hartford

ABOUT LIFE

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.

EMPLOYEE BENEFITS

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

Benefit Highlights

What is supplemental life insurance?

Supplemental life insurance is coverage that you pay for. Supplemental life insurance pays your beneficiary (please see below) a benefit if you die while you are covered.

Am I eligible?

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

When can I enroll?

You can enroll during your scheduled enrollment period, within 31 days of the date you have a change in family status, or within 31 days of the completion of your eligibility waiting period as stated in your group policy.

When is it effective?

Coverage goes into effect subject to the terms and conditions of the policy. You must be actively at work with your employer on the day your coverage takes effect.

How much supplemental life insurance can I purchase?

You can purchase supplemental life insurance in increments of $10,000.

The maximum amount you can purchase cannot be more than $500,000. Annual earnings are as defined in The Hartford’s contract with your employer.

I already have supplemental life insurance coverage; do I have to do anything?

If you take no action, your coverage and coverage for your eligible dependents will automatically continue with The Hartford subject to the terms of the contract.

Am I guaranteed coverage?

If you enroll during your annual enrollment period or are newly eligible and elect an amount that exceeds the guaranteed issue amount of $200,000, you will need to provide evidence of insurability that is satisfactory to The Hartford before the excess can become effective. If you enroll after your annual or initial enrollment period, evidence of insurability will be required for all coverage amounts.

What is a beneficiary?

Your beneficiary is the person (or persons) or legal entity (entities) who receives a benefit payment if you die while you are covered by the policy. You must select your beneficiary when you complete your enrollment application; your selection is legally binding.

Spouse voluntary life insurance

If you elect supplemental life insurance for yourself, you may choose to purchase spouse voluntary life insurance in increments of $5,000, to a maximum of $250,000.

Coverage cannot exceed 50% of the amount of your employee voluntary/supplemental life insurance coverage. You may not elect coverage for your spouse if they are in active full- time military service or is already covered as an employee under this policy.

If your spouse is confined in a hospital or elsewhere because of disability on the date his or her insurance would normally have become effective, coverage (or an increase in coverage) will be deferred until that dependent is no longer confined and has performed all the normal activities of a healthy person of the same age for at least 15 consecutive days.

Voluntary Life

The Hartford

Child(ren) voluntary life insurance

If you elect supplemental life insurance for yourself, you may choose to purchase child(ren) voluntary life insurance coverage in the amount(s) of $10,000 for each child – no medical information is required.

• If your dependent child(ren) is confined in a hospital or elsewhere because of disability on the date his or her insurance would normally have become effective, coverage (or an increase in coverage) will be deferred until that dependent is no longer confined and has performed all the normal activities of a healthy person of the same age for at least 15 consecutive days.

• Your child(ren) must be at least 15 days but not yet age 26 to be covered.

• Child(ren) age 26 or older may be covered if they were disabled prior to attaining age 26.

Does my coverage reduce as I get older?

No. All coverage cancels at retirement.

Important Details

As is standard with most term life insurance, this insurance coverage includes certain limitations and exclusions:

• the amount of your coverage may be reduced when you reach certain ages.

• death by suicide (two years). Other exclusions may apply depending upon your coverage.

Voluntary AD&D The Hartford

ABOUT AD&D

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/clintisd

Benefit Highlights

What is voluntary accidental death and dismemberment insurance?

Voluntary accidental death and dismemberment insurance pays your beneficiary (please see below) a death benefit if you die due to a covered accident while you are insured. It also pays you a benefit for certain accidental losses. Once a group policy is issued to your employer, a certificate of insurance will be available to explain your coverage in detail.

• Death benefits are paid in addition to any life insurance benefits.

• Voluntary accidental death and dismemberment insurance pays benefits for accidental loss of limbs, thumb and index finger, speech, hearing, and sight.

• Voluntary accidental death and dismemberment insurance covers losses that occur away from work or at work. Benefits are paid regardless of any worker’s compensation benefits you collect. This highlight sheet is an overview of your voluntary accidental death and dismemberment insurance.

What does voluntary accidental death and dismemberment insurance cover?

You may receive benefits due to certain losses or death from an accident. The covered losses or death can occur up to 365 days after that accident. The policy pays for:

• 100% of the amount of coverage you purchase in the event of accidental loss of life, or speech and hearing in both ears.

• One-half (50%) for accidental loss of one hand or foot, sight of one eye, or speech or hearing in both ears.

• One-quarter (25%) for accidental loss of thumb and index finger of the same hand.

Additionally, your employer may have elected optional/ supplemental benefits as part of your AD&D coverage. Refer to the certificate of insurance for further information. Your total benefit for all losses due to the same accident will not be more than 100% of the amount of coverage you purchase.

What optional benefits has my employer selected as part of my voluntary accidental death and dismemberment insurance?

• Child Education Benefit

• Coma Benefit

• Conversion Privilege

• Paralysis Benefit

• Repatriation Benefit

• Seat Belt & Air Bag

• Spouse Education Benefit

Am I eligible?

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

When can I enroll?

You can enroll during your scheduled enrollment period, within 31 days of the date you have a change in family status, or within 31 days of the completion of your eligibility waiting period as stated in your group policy.

When is it effective?

Coverage goes into effect subject to the terms and conditions of the policy. You must be actively at work with your employer on the day your coverage takes effect.

Voluntary AD&D The Hartford EMPLOYEE BENEFITS

How much voluntary accidental death and dismemberment insurance can I purchase?

You can purchase voluntary accidental death and dismemberment insurance in increments of $10,000.

The maximum amount you can purchase cannot be more than 5 times your annual earnings or $500,000. Earnings are as defined in The Hartford’s contract with your employer.

Does my coverage reduce as I get older?

No.

Do I have to provide medical information to receive coverage?

No medical information is required. You are guaranteed the amount of coverage that you select, subject to maximum amounts defined in your policy.

What is a beneficiary?

Your beneficiary is the person (or persons) or legal entity (entities) who receives a benefit payment if you die while you are covered by the policy. You must select your beneficiary when you complete your enrollment application; your selection is legally binding. You are automatically the beneficiary for any dependent coverage and for any AD&D losses other than life.

Are there other limitations to enrollment?

This coverage, like most group benefit insurance, requires that a certain percentage of eligible employees participate. If that group participation minimum is not met, the insurance coverage that you have elected may not be in effect.

Voluntary accidental death and dismemberment insurance for your dependents

You may also choose voluntary accidental death and dismemberment insurance for your spouse and/or dependent child(ren).

You may choose voluntary accidental death and dismemberment insurance for your spouse in the following amounts:

• 50% of the amount you select for yourself if you do not have any child(ren) whom you cover under this voluntary accidental death and dismemberment insurance policy.

• 40% if you have child(ren) whom you cover under this voluntary accidental death and dismemberment insurance policy.

You may not elect coverage for your spouse if your spouse is already covered as an employee under this policy.

You may choose guaranteed voluntary accidental death and dismemberment insurance for each child at least 15 days but under age 25 in the following amounts:

• 15% of the amount you select for yourself if you do not have a spouse whom you cover under this voluntary accidental death and dismemberment insurance policy

• 10% if you have a spouse whom you cover under this voluntary accidental death and dismemberment insurance policy.

Financial Wellness & ID Protection Experian 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/clintisd

Achieve your credit & financial goals sooner with unique insights

With features like Digital Financial Management, you will have tools to help manage your finances and credit profile in a single experience.

Digital Financial Management

• 360° view of financial accounts: Link your financial accounts to generate unique insights that can help improve your financial health and build good credit habits. Stay on top of your daily spending with recommended budgets powered by AI and machine learning of past transactional behavior.

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

• Industry leading monitoring & alerts: Consistent monitoring of your Experian® credit report and Vantage Score* can help you better understand your current credit profile and personal finances. Financial Alerts will notify you, via push notifications and emails, when certain financial events are detected.

Identity protection for the whole family

As identity theft continues to increase, an evolving suite of identity products helps you monitor any potential threats to your identity and alerts you if there are any areas of concern. In addition, you’ll have access to a suite of proactive digital privacy tools to help you keep passwords and other personal information private and

secure while surfing the web.

An evolving suite of identity products to help you guard against the rising threat of fraud.

• Identity Restoration: Get back on track with support from an expert restoration agent that will walk you through the process of reclaiming what’s rightfully yours.

• Dark Web Monitoring: If we detect any threats on the thousands of websites and millions of data points we scan, we’ll alert you so you can keep your family’s personal information safe.

• Medical Identity Monitoring: If your insurance information is used to receive medical care or fill prescriptions, we’ll send you an alert to verify the service or act if you suspect identity theft.

• Experian CreditLock™: Block fraudsters from using your information to get new credit and act quickly to help prevent identity theft. Unlock it when you want to apply for credit.

Proactive Digital Privacy features to help keep your family’s personal data secure and reduce the threat of potential fraud

• Secure VPN: Helps to prevent people and companies from seeing and collecting your data.

• Password Manager: Safely store and protect your logins and payment information in one place.

• Safe Browser: Get alerted of unsafe websites, block ads and help prevent the tracking of your data. Identity

Emergency Medical Transport MASA EMPLOYEE BENEFITS

ABOUT MEDICAL TRANSPORT

Medical Transport covers emergency transportation to and from appropriate medical facilities by covering the out-of-pocket costs that are not covered by insurance. It can include emergency transportation via ground ambulance, air ambulance and helicopter, depending on the plan.

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

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. After the group health plan pays its portion, MASA MTS works with providers to deliver our members’ $0 in out-ofpocket costs for emergency transport.

If a member has a high deductible health plan that is compatible with a health savings account, benefits will become available under the MASA membership for expenses incurred for medical care (as defined under Internal Revenue Code (“IRC”) section 213 (d)) once a member satisfies the applicable statutory minimum deductible under IRC section 223(c) for high-deductible health plan coverage that is compatible with a health savings account.

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

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

Non-Emergency Inter-Facility Transportation In the event that a member is in stable condition in a medical facility but requires a heightened level of care that is not available at their current medical facility, Members have access to non-emergency 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.

Should you need assistance with a claim contact MASA at 800-643-9023. For full plan details, please visit your benefit website: www.mybenefitshub.com/clintisd

Flexible Spending Account (FSA)

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).

EMPLOYEE BENEFITS

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

The Health Care FSA covers qualified medical, dental and vision expenses for you or your eligible dependents. You may contribute up to $2,850 annually to a Health Care FSA and you are entitled to the full election from day one of your plan year. Eligible expenses include:

• 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 mid-year, 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

Flexible Spending Account (FSA)

home and is mentally or physically incapable of self-care.

BENEFITS

• 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 $2,850. The maximum per plan year you can contribute to a Dependent Care FSA is $5,000 when filing jointly or head of household and $2,500 when married filing separately.

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

• You can continue to file claims incurred during the plan year for another 30 days (up until date).

• 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 $570 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.

Flexible Spending Accounts

Health 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)

$3,850

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.

Health Savings Account (HSA) HSA Bank EMPLOYEE BENEFITS

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/clintisd

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, nor should your spouse be contributing towards a Health Care Flexible Spending Account

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

• Not enrolled in Medicare or TRICARE

• Not receiving Veterans Administration benefits

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

Maximum Contributions

Your HSA contributions may not exceed the annual maximum amount established by the Internal Revenue Service. The annual contribution maximum for 2022 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 HSABank. You will receive a debit card to manage your HSA account reimbursements. Keep in mind, available funds are limited to the balance in your HSA.

Important HSA Information

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

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

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

How to Use Your HSA

• HSA Bank Mobile App – Download to check available balances, view HSA transaction details, save and store receipts, scan items in-store to see if they’re qualified, and access customer service contact information.

• myHealth PortfolioSM – Track your healthcare expenses, manage receipts and claims from multiple providers, and view expenses by provider, description, and more.

• Account preferences – Designate a beneficiary, add an authorized signer, order additional debit cards, and keep important information up to date.

• Access online at: http://www.hsabank.com

Employee Assistance Program (EAP) Lifeworks EMPLOYEE BENEFITS

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/clintisd

The Employee Assistance Program and innovative wellbeing resource will allow you to feel supported and connected with a confidential.

Life can be complicated. Get help with all of life’s questions, issues, and concerns with LifeWorks. Any time, 24/7, 365 days a year. LifeWorks offers support with mental, financial, physical, and emotional wellbeing. Whether you have questions about handling stress at work and home, parenting and childcare, managing money, or health issues, you can turn to LifeWorks for a confidential service that you can trust.

• Retirement

• Midlife

• Student life

• Legal Relationships

• Disabilities

• Crisis

• Personal issues

• Parenting

• Couples

• Separation/divorce

• Older relatives

• Adoption

• Death/loss

• Childcare Education

• Mental health

• Addictions

• Fitness

• Managing stress

• Nutrition

• Sleep

• Smoking cessation

• Alternative health

• Time management

• Career development

• Work relationships

• Work stress

• Managing people

• Shift work

• Coping with change Communication

• Saving

• Investing

• Budgeting

• Managing debt

• Home buying

• Renting

• Estate planning

• Bankruptcy

2023 PlanYear

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 Clint 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 Clint 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.