Benefit Contact Information
Higginbotham Public Sector (800) 583-6908 www.mybenefitshub.com/allenisd
Recuro Health (855) 673-2876 www.recurohealth.com
BCBSTX (866) 355-5999 www.bcbstx.com/trsactivecare
CHUBB
Group # 1000000217 (888) 499-0425
educatorclaims@chubb.com
EECU (817) 882-0800 www.eecu.org
BlueCross BlueShield of Texas Group #391481 (877) 442-4207 www.bcbstx.com Network: BlueCare DPPO VISION DISABILITY ACCIDENT
VSP
Group #40160448 (800) 877-7195
www.vsp.com
Network: VSP Enhanced Advantage
UNUM Group #449022 (800) 858-6843 www.unum.com
Cigna Group #A112371 (800) 754-3207 www.cigna.com CANCER
CHUBB
Group # 1000000217 (888) 499-0425 educatorclaims@chubb.com
PERMANENT LIFE
Texas Life (800) 283-9233 www.texaslife.com
EMERGENCY
MASA (800) 423-3226 www.masamts.com
Don’t Forget!
CHUBB
Group # 1000000217 (888) 499-0425 educatorclaims@chubb.com
Higginbotham (866) 419-3519 https://flexservices.higginbotham.net/
Guidance Resources (888) 628-4824 www.guidanceresources.com Username: LFGSupport Password: FLGSupport1
• Login and complete your benefit enrollment from 07/15/2024 - 08/09/2024
• Enrollment assistance is available by calling Higginbotham Public Sector at (866) 914-5202.
• Update your information: home address, phone numbers, email, and beneficiaries.
Lincoln Financial Group Group #1200568 (800) 423-2765 www.lfg.com
LegalShield & IDShield (888) 807-0407 access.legalshield.com
Michelle Lofton, Sr Benefit Specialist (972) 727-7196 michelle.lofton@allenisd.org
Tracy L. Henderson, Payroll/Benefits Director (972) 727 0530 tracyl.henderson@allenisd.org
• 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.
1 www.mybenefitshub.com/allenisd
2
3
4
Enter your Information
• Last Name
• Date of Birth
• Last Four (4) of Social Security Number
NOTE: THEbenefitsHUB uses this information to check behind the scenes to confirm your employment status. CLICK LOGIN
Once confirmed, the Additional Security Verification page will list the contact options from your profile. Select either Text, Email, Call, or Ask Admin options to receive a code to complete the final verification step.
5
Enter the code that you receive and click Verify. You can now complete your benefits enrollment!
Annual Benefit Enrollment
Annual Enrollment
During your annual enrollment period, you have the opportunity to review, change or continue benefit elections each year. Changes are not permitted during the plan year (outside of annual enrollment) unless a Section 125 qualifying event occurs.
• Changes, additions or drops may be made only during the annual enrollment period without a qualifying event.
• Employees must review their personal information and verify that dependents they wish to provide coverage for are included in the dependent profile. Additionally, you must notify your employer of any discrepancy in personal and/or benefit information.
• Employees must confirm on each benefit screen (medical, dental, vision, etc.) that each dependent to be covered is selected in order to be included in the coverage for that particular benefit.
New Hire Enrollment
All new hire enrollment elections must be completed in the online enrollment system within the first 30 days of benefit eligibility employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.
Q&A
Who do I contact with Questions?
For supplemental benefit questions, you can contact your Benefits Office or you can call Higginbotham Public Sector 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/allenisd. 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 Allen ISD benefit website: www.mybenefitshub.com/allenisd. 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 log in 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.
What is 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.
What is a Pre-Existing Conditions?
Applies to any illness, injury or condition for which the participant has been under the care of a health care provider, taken prescriptions drugs or is under a health care provider’s orders to take drugs, or received medical care or services (including diagnostic and/or consultation services).
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 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
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 Benefits 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.
QUALIFYING EVENTS
A change in marital status includes marriage, death of a spouse, divorce or annulment (legal separation is not recognized in all states).
A change in number of dependents includes the following: birth, adoption and placement for adoption. You can add existing dependents not previously enrolled whenever a dependent gains eligibility as a result of a valid change in status event.
Change in employment status of the employee, or a spouse or dependent of the employee, that affects the individual’s eligibility under an employer’s plan includes commencement or termination of employment.
An event that causes an employee’s dependent to satisfy or cease to satisfy coverage requirements under an employer’s plan may include change in age, student, marital, employment or tax dependent status.
If a judgment, decree, or order from a divorce, annulment or change in legal custody requires that you provide accident or health coverage for your dependent child (including a foster child who is your dependent), you may change your election to provide coverage for the dependent child. If the order requires that another individual (including your spouse and former spouse) covers the dependent child and provides coverage under that individual’s plan, you may change your election to revoke coverage only for that dependent child and only if the other individual actually provides the coverage.
Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change.
Annual Benefit Enrollment
Employee Eligibility Requirements
Medical and Supplemental Benefits: Eligible employees must work 15 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 2024 benefits become effective on September 1, 2024, you must be actively-at-work on September 1, 2024 to be eligible for your new benefits.
Dependent Eligibility Requirements
Dependent Eligibility: You can cover eligible dependent
To age 26
Hospital Cash To age 26 Vision To age 26
Dental To age 26
Accident To age 26
Life To age 26
Cancer To age 26
Critical Illness To age 26
FSA To age 26
HSA To age 26
Telehealth To age 26
Emergency Medical Transportation To age 26, including disabled children
Legal Shield Varies, see plan
ID Theft To age 18, limited services to 26
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.
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 9/1/2024 please notify your benefits administrator.
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 Higginbotham Public Sector, 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 Higginbotham Public Sector, 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 Higginbotham Public Sector 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 Benefits Office to request a continuation of coverage.
Description
Health Savings Account (HSA) (IRC Sec. 223)
Approved by Congress in 2003, HSAs are actual bank accounts in employee’s names that allow employees to save and pay for unreimbursed qualified medical expenses tax-free.
Employer Eligibility A qualified high deductible health plan
Contribution Source Employee and/or employer
Account Owner Individual
Underlying Insurance
Requirement
Minimum Deductible
Maximum Contribution
High deductible health plan
$1,600 single (2024)
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?
Portable?
Flexible Spending Account (FSA) (IRC Sec. 125)
Allows employees to pay out-of-pocket expenses for copays, deductibles and certain services not covered by medical plan, taxfree. This also allows employees to pay for qualifying dependent care tax- free.
All employers
Employee and/or employer
Employer
None
$3,200 family (2024) N/A
$4,150 single (2024)
$8,300 family (2024) 55+ catch up +$1,000
Employees may use funds any way they wish. If used for non-qualified medical expenses, subject to current tax rate plus 20% penalty.
$3,200 (2024)
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. No. Plan does include $610 rollover provision.
Yes
No
Yes, portable year-to-year and between jobs. No
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/allenisd
bet your boots
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.
• Copay: The set amount you pay for a covered service at the time you receive it. The amount can vary based on the service.
• Coinsurance: The portion you’re required to pay for services after you meet your deductible. It’s often a specified percentage of the costs; e.g., 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.
Health Savings Account (HSA) EECU
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.mybeneitshub.com/sampleisd
www.mybenefitshub.com/allenisd
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 (High Deductible Health Plan) 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 2024 is based on the coverage option you elect:
• Individual – $4,150
• Family (filing jointly) – $8,300
You decide whether to use the money in your account to pay for qualified expenses or let it grow for future use. If you are 55 or older, you may make a yearly catch-up contribution of up to $1,000 to your HSA. If you turn 55 at any time during the plan year, you are eligible to make the catch-up contribution for the entire plan year.
Opening an HSA
If you meet the eligibility requirements, you may open an HSA administered by EECU. You will receive a debit card to manage your HSA account reimbursements. Keep in mind, available funds are limited to the balance in your HSA.
Important HSA Information
• Always ask your health care provider to file claims with your medical provider so network discounts can be applied. You can pay the provider with your HSA debit card based on the balance due after discount.
• You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.
• You may open an HSA at the financial institution of your choice, but only accounts opened through EECU are eligible for automatic payroll deduction and company contributions.
How To Use Your HSA
• Online/Mobile: Sign-in for 24/7 account access to check your balance, pay bills and more.
• Call/Text: (817) 882-0800 EECU’s dedicated member service representatives are available to assist you with any questions. Their hours of operation are Monday through Friday from 8:00 a.m. to 7:00 p.m. CT, Saturday 9:00 a.m. to 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: www.eecu.org/ locations.
Hospital Cash CHUBB
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/allenisd
Cash if admitted into a hospital!
• No Pre-Existing Limitations
• HSA Compatible
• Newborn Nursery Benefit
• Must be active at work on effective date for plan to go into effect.
Choose from 1 of 2 plans
First Hospitalization Benefit
This benefit is payable for the first covered hospital confinement per certificate.
Hospital Admission Benefit
This benefit is for admission to a hospital or hospital sub-acute intensive care unit.
Hospital Admission ICU Benefit
This benefit is for admission to a hospital intensive care unit.
Hospital Confinement Benefit
This benefit is for confinement in hospital or hospital sub-acute intensive care unit.
Hospital Confinement ICU Benefit
This benefit is for confinement in a hospital intensive care unit.
Newborn Nursery Benefit
This benefit is payable for an insured newborn baby receiving newborn nursery care and who is not confined for treatment of a physical illness, infirmity, disease, or injury.
Observation Unit Benefit
This benefit is for treatment in a hospital observation unit for a period of less than 20 hours.
• $500
• Maximum benefit per certificate: 1
• $1,500
• Maximum benefit per calendar year: 5
• $3,000
• Maximum benefit per calendar year: 3
• $100 per day
• Maximum days per calendar year: 30
• $200 per day
• Maximum days per calendar year: 30
• $500 per day
• Maximum days per confinementnormal delivery: 2
• Maximum days per confinementcaesarean section: 2
• $500
• Maximum benefit per calendar year: 2
• $500
• Maximum benefit per certificate: 1
• $3,000
• Maximum benefit per calendar year: 5
• $6,000
• Maximum benefit per calendar year: 3
• $200 per day
• Maximum days per calendar year: 30
• $400 per day
• Maximum days per calendar year: 30
• $500 per day
• Maximum days per confinementnormal delivery: 2
• Maximum days per confinementcaesarean section: 2
• $500
• Maximum benefit per calendar year: 2
Hospital Cash CHUBB
of
This benefit waives premium when the employee or spouse is confined for more than 30 continuous days.
Exclusions and Limitations*
We will not pay for any Covered Accident or Covered Sickness that is caused by, or occurs as a result of 1) committing or attempting to commit suicide or intentionally injuring oneself; 2) war or serving in any of the armed forces or units auxiliary; 3) participating in an illegal occupation or attempting to commit or actually committing a felony; 4) sky diving, hang gliding, parachuting, bungee jumping, parasailing, or scuba diving; 5) being intoxicated or being under the influence or any narcotic or other prescription drug unless taken in accordance with Physician’s instructions 6) alcoholism; 7) cosmetic surgery, except for reconstructive surgery needed as the result of an Injury or Sickness or is related to or results from a congenital disease or anomaly of a covered Dependent Child; 8) services related to sterilization, reversal of a vasectomy or tubal ligation, in vitro fertilization, and diagnostic treatment of infertility or other related problems.
A Physician cannot be You or a member of Your Immediate Family, Your business or professional partner, or any person who has a financial affiliation or business interest with You.
Dental Insurance BlueCross BlueShield of Texas
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/allenisd
Two Dental plans to choose from. The following information only provides highlights, please see plan documents for details and limitations.
Class 1: Preventive Services (Deductible does not apply)
Periodic Oral Evaluations
Problem Focused Oral Evaluations
Comprehensive Oral Evaluations
Prophylaxis/routine cleanings
X-rays Full-Mouth, Pano, Bitewing, Periapical
Sealants
Topical Fluoride
Space maintainers
Class 2: Basic Restorative Services
Amalgam & Composite Fillings
Non-surgical Extractions
Perio Maintenance
Full Mouth Debridement
Scaling & Root Planning
Denture Reline/Rebase
Repairs – Crown & Bridge
Palliative Treatment (emergency care to relieve pain)
Deep Sedation/General Anesthesia
Class 3: Major Restorative Services
Bridges & Dentures
Implants: Yes No
Crowns, Inlays, Onlays
Endodontics (root canal)
Major Periodontics
Oral Surgery & Surgical Extractions
Class 4: Orthodontics
Orthodontic Diagnostic Procedures & Treatment
for Adults & Dependent Children (to age 26)
Dental
Insurance BlueCross BlueShield of Texas
Three Month Deductible Carryover Applies
Graduated
&
Class 1: Preventive Services (Deductible does not apply)
Periodic Oral Evaluations
Problem Focused Oral Evaluations
Comprehensive Oral Evaluations
Prophylaxis/routine cleanings
X-rays Full-Mouth, Pano, Bitewing, Periapical
Sealants
Topical Fluoride
Space maintainers
Class 2: Basic Restorative Services
Amalgam & Composite Fillings
Non-surgical Extractions
Perio Maintenance
Scaling & Root Planning
Endodontics (root canal)
Oral Surgery & Surgical Extractions
Major Periodontics
Palliative Treatment (emergency care to relieve pain)
Deep Sedation/General Anesthesia
Class 3: Major Restorative Services
Bridges
Implants: Yes No
Crowns, Inlays, Onlays
Dentures (fixed/removable)
Denture Reline/Rebase
Class 4: Orthodontics
Orthodontic Diagnostic Procedures & Treatment Coverage
Dependent Children (to age 19)
Vision Insurance
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/allenisd
Exam Services
Lenses
Lens Enhancements
Benefits through a VSP Enhanced Advantage Network Provider
• Comprehensive WellVision Exam® covered in full after Exam Copay
• Routine retinal screening covered after a no more than $39 copay
• Glass or plastic single vision, lined bifocal, lined trifocal, or lenticular lenses are covered in full after material copay.
• Standard progressive lenses
• Premium progressives lenses
• Custom progressive lenses
• Anti-glare coating
• Tints/Light-reactive lenses
• Impact-resistant lenses
• Average savings of 30% on other lens enhancements
$0
$95-105
$150-175
$41
$75
$35
Frame
Additional Pairs of Glasses
Elective Contact Lenses
• Frames covered in full* up to the retail allowance of $175
• Featured frame brands frame allowance of $195
• 20% off any amount above the retail allowance
• Within 12 months of exam: 20% off unlimited additional pairs of prescription glasses and/or non-prescription sunglasses from any VSP doctor
• Contact lens exam (fitting and evaluation): Standard and Premium fits are covered in full after copay. Member receives 15% off of contact lens exam services and member’s copay will never exceed $60
• Prescription contact lens materials are covered in full up to the retail allowance of $175 (in lieu of frame & lenses)
• Members can choose from any available prescription contact lens materials
Out-of-Network Schedule We offer a generous reimbursement schedule for services from other providers. Exam
Lenses:
Single vision
$45
$30
Lined bifocal $50
Lined trifocal $60
Frame $50
Elective contact lenses (in lieu of lenses and frame)
$100
Disability Insurance UNUM
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/allenisd
Short Term Disability Insurance can pay you a weekly benefit if you have a covered disability that keeps you from working.
How does it work?
If a covered illness or injury keeps you from working, Short Term Disability Insurance can replace part of your income while you recover. You’re generally considered disabled if you’re unable to do important parts of your job — and your income suffers as a result.
Why is this coverage so valuable?
You can use the money however you choose. It can help you pay for your rent or mortgage, groceries, out-of-pocket medical expenses and more.
Coverage Information
You are eligible for coverage if you are an active employee in the United States working a minimum of 15 hours per week.
Coverage amounts
Cover 40%, 50% or 662/3% of your weekly income to a maximum benefit of $1,850 per week. The weekly benefit may be reduced or offset by other sources of income.
Elimination period (EP)
This is the number of days that must pass between your first day of a covered disability and the day you can begin to receive your disability benefits.
Elimination Period Options:
• 0 days injury/7 days illness
• 14 days injury/14 days illness
• 30 days injury/30 days illness
If you are hospital confined as an inpatient (23 or more hours), benefits begin on the first day of inpatient confinement. (Applies to Elimination Periods of 30 days or less.)
How
long
will Short Term Disability continue?
For Disabilities due to a Pre-Existing Condition: Unum will send you a maximum payment of 4 weeks.
For all other Disabilities: Unum will send you a maximum payment of 13 weeks.
Disability Insurance UNUM
Long Term Disability Insurance can replace part of your income if a disability keeps you out of work for a long period of time.
How does it work?
This coverage can pay a monthly benefit if you have a covered illness or injury and you can’t work for a few months - or longer. You’re generally considered disabled if you’re unable to do important parts of your job - and your income suffers as a result.
How much coverage can I get?
You are eligible for coverage if you are an active employee in the United States working a minimum of 15 hours per week. The elimination period for Long Term Disability is 60 days injury or illness.
Coverage amounts
Choose to cover 40%, 50% or 662/3% of your monthly income, up to a maximum payment of $8,000. The monthly benefit may be reduced or offset by other sources of income.
How long will my benefits last?
Age at Disability
Less than age 60 To age 65, not less than 60 months
60
Active employee
You are considered in active employment, if on the day you apply for coverage, you are being paid regularly by Allen Independent School District for the 15 hours each week and you are performing the material and substantial duties of your regular occupation.
Definition of disability
You are considered disabled when Unum determines that, due to sickness or injury:
• You are limited from performing the material and substantial duties of your regular occupation; and
• You have a 20% or more loss in weekly earnings
You must be under the regular care of a physician in order to be considered disabled.
After 12 months, you are considered disabled when Unum determines that due to the same sickness or injury, you are unable to perform the duties of any gainful occupation for which you are reasonably fitted by education, training or experience.
Pre-existing conditions
You have a pre-existing condition if:
• You received medical treatment, consultation, care or services including diagnostic measures for the condition, or took prescribed drugs or medicines for it in the 3 months just prior to your effective date of coverage; and
• The disability begins in the first 12 months after your effective date of coverage.
Deductible sources of income
Your disability benefit may be reduced by deductible sources of income and any earnings you have while you are disabled, including such items as group disability benefits or other amounts you receive or are entitled to receive.
Please see plan documents for exclusions, limitations and details.
Accident Insurance Cigna
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/allenisd
Accidental Injury coverage provides a fixed cash benefit according to a schedule below when a Covered Person undergoes a listed medical treatment from a Covered Accident.
Available Coverage: This Accidental Injury plan provides 24 hour coverage.
Chose from 2 plans! Following is a SAMPLE of benefits. Please see plan documents for full schedule, policy exclusions, limitations and details.
Accident Insurance Cigna
Examples of benefits include (but are not limited to) payment for death from Automobile accident; total and permanent loss of speech or hearing in both ears. Actual benefit amount paid depends on the type of Covered Loss. The Spouse and Child benefit is 100% and 100% respective of the benefit shown.
Hospital Admission Wellness Treatment, Health Screening Test and Preventive Care Benefit:* Benefit paid for all covered persons is 100% of the benefit shown. Also includes COVID-19 Immunization, Tests, and Screenings. Virtual Care accepted.
Cancer Insurance CHUBB
ABOUT CANCER
Cancer insurance offers you and your family supplemental insurance protection in the event you or a covered family member is diagnosed with cancer. It pays a benefit directly to you to help with expenses associated with cancer treatment.
For full plan details, please visit your benefit website: www.mybenefitshub.com/allenisd
Cash benefits for every step of the way. Choose the right level of coverage during the enrollment period to better protect your family. Following is a sample of the benefits provided, please review plan documents on the benefit website for details.
Sample Cancer Insurance Benefits
First cancer benefit
Diagnosis of cancer
Hospital confinement
Hospital confinement ICU
Radiation therapy, chemotherapy, immunotherapy
Medical imaging
Skin cancer initial diagnosis
Low Plan High Plan
$100 paid upon receipt of first covered claim for cancer; only one payment per covered person per certificate per calendar year
$5,000 employee or spouse
$7,500 child(ren)
$200 per day – days 1 through 30
Additional days: $200
Maximum days per confinement: 31
$600 per day – days 1 through 30
Additional days: $600
Maximum days per confinement: 31
Maximum per covered person per calendar year per 12-month period: $10,000
$500 per imaging study
Maximum studies per calendar year: 2
$100 per diagnosis
Lifetime maximum: 1
First bone marrow transplant: $6,000
Additional transplant: 50%
Lifetime maximum transplant(s): 2
Bone marrow or stem cell transplant
First stem cell transplant: $600
Additional transplant: 50%
Lifetime maximum transplant(s): 2
$100 paid upon receipt of first covered claim for cancer; only one payment per covered person per certificate per calendar year
$10,000 employee or spouse
$15,000 child(ren)
$200 per day – days 1 through 30
Additional days: $200
Maximum days per confinement: 31
$600 per day – days 1 through 30
Additional days: $600
Maximum days per confinement: 31
Maximum per covered person per calendar year per 12-month period: $20,000
$500 per imaging study
Maximum studies per calendar year: 2
$100 per diagnosis
Lifetime maximum: 1
First bone marrow transplant: $6,000
Additional transplant: 50%
Lifetime maximum transplant(s): 2
First stem cell transplant: $600
Additional transplant: 50%
Lifetime maximum transplant(s): 2
Cancer Insurance CHUBB
Heart Attack or Stroke Benefit
Heart attack or stroke
Surgical Treatment Benefits
$5,000
Recurrence benefit: $2,500
$10,000
Recurrence benefit: $5,000
Surgery Up to $3,000 Up to $4,500
Reconstructive surgery
Second and third opinion
Skin cancer surgery
Pre-existing conditions limitation
Breast TRAM flap: $2,000
Breast reconstruction: $500
Breast symmetry: $500
Facial reconstruction: $500
$300 Maximum benefit 2/year
$100 Maximum benefit 2/year
Breast TRAM flap: $2,000
Breast reconstruction: $500
Breast symmetry: $500
Facial reconstruction: $500
$300, Maximum benefit 2/year
$100 Maximum benefit 2/year
A condition for which a covered person received medical advice or treatment within the 12 months preceding the certificate effective date.
Continuity of coverage
Continuity of coverage is included for employees remaining on the same level plan. Pre-existing condition limitation applies for those changing plan levels or enrolling for the first time.
No benefits will be paid for services rendered by a member of the immediate family of a covered person.
We will not pay benefits for other conditions or diseases, except losses due directly from cancer or skin cancer.
We will not pay benefits for cancer or skin cancer if the diagnosis or treatment of cancer is received outside of the territorial limits of the United States and its possessions. Benefits will be payable if the covered person returns to the territorial limits of the United States and its possessions, and a physician confirms the diagnosis or receives treatment.
Rates
Critical Illness Insurance CHUBB
ABOUT CRITICAL ILLNESS
Critical illness insurance can be used towards medical or other expenses. It provides a lump sum benefit payable directly to the insured upon diagnosis of a covered condition or event, like a heart attack or stroke. The money can also be used for non-medical costs related to the illness, including transportation, child care, etc.
For full plan details, please visit your benefit website: www.mybenefitshub.com/allenisd
Available Coverage Choices
Employee
Spouse
$10,000 – $50,000 in $10,000 increments
$10,000 – $50,000 in $10,000 increments
Child Included in the employee amount
No benefits will be paid for a date of diagnosis that occurs prior to the coverage effective date. Covered individuals must be treatment free from cancer for 12 months prior to diagnosis date and in complete remission. There is no pre-existing conditions limitation. All amounts are Guaranteed Issue — no medical questions are required for coverage to be issued.
Sample list of Benefits, refer to plan documents for full list.
Critical Illness Insurance CHUBB
Occupational Package
Pays 100% of the face amount; benefits payable for HIV or Hepatitis B, C, or D, MRSA, Rabies, Tetanus, or Tuberculosis contracted on the job.
Childhood Conditions
Pays 100% of the dependent child face amount; Provides benefits for childhood conditions (Autism Spectrum Disorder; Cerebral Palsy; Congenital Birth Defects; Heart, Lung, Cleft Lip, Palate, etc; Cystic Fibrosis; Down Syndrome; Gaucher Disease; Muscular Dystrophy; Type 1 Diabetes).
Benefits are payable for a subsequent diagnosis of Aneurysm –Cerebral or Aortic, Benign Brain Tumor, Cancer, Coma, Coronary Artery Obstruction, Heart Attack, Major Organ Failure, Severe Burns, Stroke, and Sudden Cardiac Arrest.
Wellness benefit – payable once per insured per year. $100
Exclusions and Limitations
No benefits will be paid for losses that are caused by, contributed, or occur as a result of a Covered Person’s: 1) injuring oneself intentionally or committing or attempting to commit suicide; 2) committing or attempting to commit a felony or engaging in an illegal occupation or activity.
A Physician cannot be You or a member of Your Immediate Family, Your business or professional partner, or any person who has a financial affiliation or business with you.
Please see plan details for additional details.
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/allenisd
Life and AD&D Insurance
Life and Accidental Death and Dismemberment (AD&D) insurance are important parts of your financial security, especially if others depend on you for support. With Life insurance, your beneficiary(ies) can use the coverage to pay off your debts, such as credit cards, mortgages and other final expenses.
Claims: Please contact the Allen ISD Benefits office for assistance in filing a life claim.
Basic Life and AD&D
Basic Life insurance is provided to eligible employees at Allen ISD at no cost to you. Benefit amount reduces by 50% at age 70. Matching AD&D coverage included equal to Basic Life.
Voluntary Life and AD&D
You may purchase additional Life insurance for you and your eligible dependents.
If you decline Voluntary Life when first eligible and wish to elect later, Evidence of Insurability (EOI) – proof of good health – may be required before coverage is approved. You must be covered to obtain coverage for your dependents. Porting and conversion options are available upon termination. Please see plan documents for details and limitations. Benefits reduce by 50% at employee age of 75.
• Increments of $10,000 not to exceed
• New Hire Guarantee Issue $350,000
• Open Enrollment Guarantee Issue $350,000
• AD&D Coverage included equal to Voluntary Life Election
• Increments of $5,000 up to 100% of employee amount, not to exceed $500,000
• New Hire Guarantee Issue $50,000
• Open Enrollment Guarantee $50,000
• AD&D Coverage included equal to Spouse Voluntary Life Election Child(ren)
• 6 months to age 26 - $20,000 Voluntary Life Benefit
Designating a Beneficiary
A beneficiary is the person or entity you designate to receive the death benefits of your life policies. You can name more than one beneficiary and you can change beneficiaries at any time. If you name more than one beneficiary, you must identify the share for each.
Permanent Life Insurance Texas Life Insurance Company
Permanent Life Insurance Texas Life Insurance Company
ABOUT PERMANENT LIFE INSURANCE
Permanent life insurance is a type of life insurance policy that provides coverage for the insured’s entire lifetime, as long as the premiums are paid. It complements term life insurance, which covers the insured for a specified period of time. Permanent life insurance is the coverage you can keep when your employment ends.
For full plan details, please visit your benefit website: www.mybenefitshub.com/sampleisd
www.mybenefitshub.com/allenisd
Voluntary permanent life insurance can be an ideal complement to the group term and voluntary term life insurance your employer might provide. This voluntary permanent 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 life insurance may be portable if you change jobs, but even if you can keep them after you retire, they usually cost more and decline in death benefit.
The contract, PureLife-plus, is underwritten by Texas Life Insurance Company, and it has the following features:
• HIGH DEATH BENEFIT. Written on a minimal cash-value Universal Life frame, PureLife-plus features one of the highest death benefits per payroll-deducted dollar offered at the worksite.1
• REFUND OF PREMIUM. Unique in the workplace, PureLife-plus offers you a refund of 10 years’ premium, should you surrender the contract if initial specified premium paid for ever increases. (Conditions apply.)
• ACCELERATED DEATH BENEFIT DUE TO TERMINAL ILLNESS RIDER. Should you be diagnosed as terminally ill with the expectation of death within 12 months, you will have the option to receive 92% of the death benefit, minus a $150 ($100 in Florida) administrative fee. Included with your contract at no additional cost, this valuable living benefit helps give 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.) (Form ICC07-ULABR-07 or Form Series ULABR-07)
• MINIMAL CASH VALUE. Designed to provide a high death benefit at a reasonable premium, PureLife-plus helps provide 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. Enjoy the assurance of a contract that has a guaranteed death benefit to age 121 and level premium that guarantees coverage for a significant period of time (after the guaranteed period, premiums may go down, stay the same, or go up).2
1 Voluntary Whole and Universal Life Products, Eastbridge Consulting Group, March 2022
2 As long as you pay the necessary premium. Guarantees are subject to product terms, limitations, exclusions, and the insurer’s claims paying ability and financial strength. 45 years average for all ages based on our actuarial review.
Permanent Life Insurance
Texas Life Insurance Company
Permanent Life Insurance Texas Life Insurance Company
WHO CAN APPLY FOR COVERAGE?
Actively at work employees at issue ages 17-70 are eligible. Spouses, issue age 17-60, children ages 15 days to 26 years, and grandchildren ages 15 days to 18 years are eligible to apply for this coverage as well3. Employees do not have to participate in order to apply for coverage on eligible dependents.
SAMPLE RATES
You can qualify by answering just 3 questions4 –no exams or needles.
During the last six months, has the proposed insured:
Been actively at work on a full time basis, performing usual duties?
Been absent from work due to illness or medical treatment for a period of more than 5 consecutive working days?
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, dialysis treatment, or treatment for alcohol or drug abuse?
3 Coverage not available on children in WA or on grandchildren in WA or MD. In MD, children must reside with the applicant to be eligible for coverage.
4 Issuance of coverage will depend on the answer to these questions.
Important Note: Texas Life does not offer legal or financial advice. Contact an attorney and a financial advisor in your state for legal and financial information on wills, estates and trusts.
PureLife-plus is a Flexible Premium Adjustable Life Insurance to Age 121. As with most life insurance products, Texas Life contracts and riders contain certain exclusions, limitations, exceptions, reductions of benefits, waiting periods and terms for keeping them in force. Please contact a Texas Life representative or see the Purelife-plus brochure for costs and complete details. Contract Form ICC18-PRFNG-NI-18, Form Series PRFNG-NI-18 or PRFNGNI-20-OHIO.
24M003-C 1001 (exp0426)
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.
For full plan details, please visit your benefit website: www.mybene itshub.com/sampleisd
www.mybenefitshub.com/allenisd
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 $3,200 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
Higginbotham Benefits Debit Card
The Higginbotham Benefits Debit Card gives you immediate access to funds in your Health Care FSA when you make a purchase without needing to file a claim for reimbursement. If you use the debit card to pay anything other than a copay amount, you will need to submit an itemized receipt or an Explanation of Benefits (EOB).
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 Depend ent Care FSA is limited to the total amount deposited in your account at that time. To be eligible, you must be a single parent or you and your spouse must be employed outside the home, disabled or a full-time student.
Things to Consider Regarding the Dependent Care FSA
• Overnight camps are not eligible for reimbursement (only day camps can be considered).
• If your child turns 13 midyear, you may only request reimbursement for the part of the year when the child is under age 13.
• You may request reimbursement for care of a spouse or dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self-care.
• The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.
Flexible Spending Accounts
Flexible Spending Accounts
Higginbotham
Higginbotham
Important FSA Rules
• The maximum per plan year you can contribute to a Health Care FSA is $3,200. 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.
• In most cases, you can continue to file claims incurred during the plan year for another 90 days after the plan year ends.
• 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 for eligible employers The carry-over rule does not apply to your Dependent Care FSA.
• Review your employer's Summary Plan Document for full details. FSA rules vary by employer.
Over-the-Counter Item Rule Reminder
Health care reform legislation requires that certain over-the-counter (OTC) items require a prescription to qualify as an eligible Health Care FSA expense. You will only need to obtain a one-time prescription for the current plan year. You can continue to purchase your regular prescription medications with your FSA debit card. However, the FSA debit card may not be used as payment for an OTC item, even when accompanied by a prescription.
Higginbotham Portal
The Higginbotham Portal provides information and resources to help you manage your FSAs.
• Access plan documents, letters and notices, forms, account balances, contributions and other plan information
• Update your personal information
• Utilize Section 125 tax calculators
• Look up qualified expenses
• Submit claims
• Request a new or replacement Benefits Debit Card
Register on the Higginbotham Portal
Visit https://flexservices.higginbotham.net and click Register. Follow the instructions and scroll down to enter your information.
• Enter your Employee ID, which is your Social Security number with no dashes or spaces.
• Follow the prompts to navigate the site.
• If you have any questions or concerns, contact Higginbotham:
∗ Phone – 866-419-3519
∗ Questions – flexsupport@higginbotham.net
∗ Fax – 866-419-3516
∗ Claims- flexclaims@higginbotham.net
Legal and Identity Services LegalShield & IDShield
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/allenisd
New and enhanced options in 2024 for Legal and Identity services for you and your family. Please review plan summary for plan details.
Highlights of Offerings Include:
• Monthly Credit Score Tracker
• Full-service Identity Restoration
• Reputation Management Services
• Monitored Information
• Online Privacy and Reputation Management
• Alerts
• Unlimited Consultation
• 24/7 Assistance
• Mobile App
• Estate Planning • Probate
• Moving Traffic Violations
• Real Estate Contracts
• Contractor Disputes
• Deeds
• Adoption
• Bankruptcy
• 24/7 Emergency Legal Access
• Mobile App
• Dedicated network of Provider Law Firms
Stay prepared with MASA® AccessSM
Comprehensive coverage and care for emergency transport.
Our Emergent Plus membership plan includes:
Emergency Ground Ambulance Coverage1
Your out-of-pocket expenses for your emergency ground transportation to a medical facility are covered with MASA.
Emergency Air Ambulance Coverage1
Your out-of-pocket expenses for your emergency air transportation to a medical facility are covered with MASA.
Hospital to Hospital Ambulance Coverage1
When specialized care is required but not available at the initial emergency facility, your out-of-pocket expenses for the ground or air ambulance transfer to the nearest appropriate medical facility are covered with MASA.
Repatriation Near Home Coverage1
Should you need continued care and your care provider has approved moving you to a hospital nearer to your home, MASA coordinates and covers the expense for ambulance transportation to the approved medical facility.
Did you know?
51.3 million emergency responses occur each year
MASA protects families against uncovered costs for emergency transportation and provides connections with care services.
Source: NEMSIS, National EMS Data Report, 2023
About MASA
MASA is coverage and care you can count on to protect you from the unexpected. With us, there is no “out-of-network” ambulance. Just send us the bill when it arrives and we’ll work to ensure charges are covered. Plus, we’ll be there for you beyond your initial ride, with expert coordination services on call to manage complex transport needs during or after your emergency — such as transferring you and your loved ones home safely.
Protect yourself, your family, and your family’s financial future with MASA.
Stay prepared with MASA®
protects families against out-of-pocket costs for emergency transportation and provides connections with care. Gain peace of mind and shield your finances knowing there’s a MASA plan best suited for your needs.
Employee Assistance Program (EAP) Guidance Resources
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/allenisd
Employee Assistance Program
Allen ISD provides an Employee Assistance Program (EAP) to help you and family members cope with a variety of personal or work-related issues. As part of your Basic Life coverage professional, confidential services are available to help you and your loved ones improve your quality of life.
• In-person guidance
◦ Up to 5 sessions with a counselor per person per year
◦ Network Lawyers include one 30-minute consultation per issue and 25% off subsequent meetings.
• Unlimited 24/7 assistance
◦ Telephonic
◦ Mobile App
◦ Online
• Online resources include:
◦ Expert advice
◦ Support tools
◦ Videos
◦ Financial Calculators
◦ Budgeting worksheets
◦ And much more!
Call 888-628-4824 or visit GuidanceResources.com for support at any hour of the day or night.
Username: LFGSupport
Password: LFGSupport1
Download the Guidance Now mobile app.
2024 - 2025 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 Allen 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 Allen 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.