2024-25 Brazosport ISD Benefit Guide by Higginbotham Public Sector

09/01/2024 - 08/31/2025

Benefit Contact Information

BENEFIT ADMINISTRATORS

Higginbotham Public Sector (833) 453-1680 www.mybenefitshub.com/brazosportisd

UnitedHealthcare (866) 556-8298 www.UHC.com

Gulf Coast Educators Federal Credit Union (281) 487-9333 https://www.gcefcu.org FLEXIBLE SPENDING

Higginbotham (866) 419-3519 Flexclaims@higginbotham.net

Next Level Prime (833) 957-6200 nextlevelurgentcare.com Cigna Group #HC961361 (800) 754-3207 www.cigna.com DENTAL

UnitedHealthcare (866) 556-8298 www.UHC.com

UnitedHealthcare (866) 556-8298 www.UHC.com CANCER

MetLife/Baybridge Administrators (800) 845-7519 https://www.bbadmin.com/

EMERGENCY TRANSPORTATION

MASA (800) 423-3226 www.masamts.com

UnitedHealthcare (866) 556-8298 www.UHC.com

5Star (866) 863-9753 https://www.5starlifeinsurance.com ID AND LEGAL SHIELD

LegalShield (800) 654-7757 www.legalshield.com

Pet’s Best Group #BISDPETS (888) 984-8700 www.petsbest.com

UnitedHealthcare (877) 660-3806 liveandworkwell.com

www.mybenefitshub.com/brazosportisd

CLICK LOGIN

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.

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.

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/ brazosportisd. 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

Brazosport ISD benefit website: www.mybenefitshub.com/brazosportisd. 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 pre-existing 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).

Don’t Forget!

• Login and complete your benefit enrollment from 7/15/2024 - 8/16/2024

• Enrollment assistance is available by calling Higginbotham Public Sector at (866) 914-5202.

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

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

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

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

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

Flexible Spending Account (FSA) (IRC Sec. 125)

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

Employer Eligibility A qualified high deductible health plan All employers

Contribution Source Employee and/or employer

Account Owner Individual

Underlying Insurance Requirement High deductible health plan

Minimum Deductible

Maximum Contribution

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?

$1,600 single (2024)

$3,200 family (2024)

$4,150 single (2024)

$8,300 family (2024)

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

Employee and/or employer

Employer

None

N/A

$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.

Yes

No. Access to some funds may be extended. Brazosport’s plan contains a 75 day grace period.

Portable? Yes, portable year-to-year and between jobs. No

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/brazosportisd

United Healthcare Medical plan coverage details

Deductible, then Plan pays

Deductible, then Plan pays 70%

Deductible, then Plan pays 80%

Deductible,

Health Savings Account (HSA) Gulf Coast Educators Federal Credit Union

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/brazosportisd

Health Savings Account (HSA)

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

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

HSA Eligibility

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

• Enrolled in an HSA-eligible HDHP.

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

• Not enrolled in a Health Care Flexible Spending Account

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

• Not enrolled in Medicare or TRICARE

• Not receiving Veterans Administration benefits

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

Maximum Contributions

Your HSA contributions may not exceed the annual maximum amount established by the Internal Revenue Service. The annual contribution maximum for 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 Gulf Coast Educators Federal Credit Union 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 Gulf Coast Educators Federal Credit Union are eligible for automatic payroll deduction.

Flexible Spending Account (FSA)

Higginbotham

ABOUT FSA

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

For full plan details, please visit your benefit website: www.mybene itshub.com/sampleisd

www.mybenefitshub.com/brazosportisd

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

You may have the option to enroll in both a HSA and FSA, however doing so will make your FSA a "Limited" FSA, which means it will only be available for dental and vision expenses. All medical expenses would need to be processed through your HSA.

Higginbotham Benefits Debit Card

The Higginbotham Benefits Debit Card gives you immediate access to funds in your Health Care FSA when you make a purchase without needing to file a claim for reimbursement. If you use the debit card to pay anything other than a copay amount, you will need to submit an itemized receipt or an Explanation of Benefits (EOB).

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

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 $640 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

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

Welcome to Next Level PRIME

To take full advantage of your PRIME membership, download the Next Level Urgent Care App by scanning the QR code below or searching in the App Store.

Press the orange Next Level PRIME button on the app or call 833-957-6200 to get connected to a Care Navigator. Email navigator@nextlevelurgentcare.com

Scan the QR code or go to the App store and download the Next Level Urgent Care App.

Next Level PRIME is looking forward to helping you and your dependents achieve a healthy lifestyle and improved health.

As a PRIME member, you can access all Next Level Urgent Care locations for your primary care and urgent care needs 7 days a week, and access to virtual care 24/7. This added wellness and healthcare benefit is at no additional cost to you.

Common Services Offered for PRIME Members:

Primary Care

§ Annual physicals

§ Well Woman Exams

§ Well Child Exams

§ Vaccinations

§ Diabetes

§ Hypertension

§ Thyroid Conditions

§ Covid Testing (Rapid,PCR)

§ Depression & Anxiety

§ Chronic Diseases

§ Preventive Screenings

§ Blood Draws

§ Specialist Referrals

Urgent Care

§ Upper Respiratory Infections

§ Urinary Tract Infections

§ X-ray for Acute Injury

§ Sprains, Strains, Splints & Casts for Broken Bones

§ Gastroenteritis

§ IV fluids for Dehydration

§ Stitches for Lacerations

§ Abscesses

§ Pink Eye

§ Rashes

§ Headaches

§ Back Pain

§ Ear infections

Hospital Indemnity Cigna

ABOUT HOSPITAL INDEMNITY

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

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

Hospital Care Coverage

The Hospital Indemnity Plan provided through Cigna helps with the high cost of medical care by paying you a set amount when you have an inpatient hospital stay. Unlike traditional insurance, which pays a benefit to the hospital or doctor, this plan pays you directly based on the care or treatment you receive. You then decide how to use your funds, perhaps to reimburse yourself for your deductible or coinsurance or to cover household costs or even travel and lodging expenses related to your hospitalization. Pre-existing conditions are waived, however see the plan summaries on your benefits website for exclusions.

Dental Insurance

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/brazosportisd

High Dental Plan

UnitedHealthcare Insurance Company (30100)®

Restorations (Amalgams or Composite)

Emergency Treatment/General Services

Simple Extractions Oral Surgery (incl. surgical extractions)

PREVENTIVE

MAJOR SERVICES

Inlays/Onlays/Crowns

and Removable Prosthetics

Partial Dentures (Bridges)

Low Dental Plan

Prophylaxis (Cleaning)

(Preventive)

BASIC SERVICES

Restorations (Amalgams or Composite)

Emergency Treatment/General Services

Simple Extractions

Oral

and Limitations section for benefit guidelines. MAJOR SERVICES

(incl. surgical

Inlays/Onlays/Crowns

Dentures and Removable Prosthetics

Fixed Partial Dentures (Bridges)

Exclusions and Limitations section for benefit guidelines.

Vision Insurance UnitedHealthcare

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/brazosportisd

Vision Benefit Summary - Low Plan

Customer Service and Provider Locator: (800) 638-3120 myuhcvision.com

UnitedHealthcare Vision has been trusted for more than 50 years to deliver affordable, innovative vision care solutions to the nation’s leading employers through experienced, customer-focused people and the nation’s most accessible, diversified vision care network.

Comprehensive Exam(s) Once every 12 months

Eyeglass Lenses Once every 12 months

Frames Once every 12 months

Contact Lenses instead of Eyeglasses Once every 12 months

Copays

Exam(s)

Eyeglasses (lenses and frame)

Contact lenses instead of Eyeglasses

$10.00

$0.00

Frame Benefit - for frames that exceed the allowance, an additional 30% discount may be applied to the overage¹

Private Practice Provider

Retail Chain Provider

$150.00 retail frame allowance

Lens Options - this list highlights the discounted cost on our most popular lens options. Exact pricing may vary; confirm cost with your provider prior to purchase.

Standard Scratch Coating

Scratch Warranty

Tint

UV Coating

Photochromic

Anti-Reflective Tier I

Anti-Reflective Tier II

Anti-Reflective Tier III

Anti-Reflective Tier IV

Roll and Polish Edges

$10

$14

$16

$67

$30

$50

$75

$95

$13

Services

Tier I

Tier II

Tier III

Tier IV

Tier V

Index (<1.66)

Index (1.66-1.73)

Polycarbonate for Adults

Polycarbonate for Dependent

Children

$33

Contact Lens Benefit² - Formulary contact lenses refer to contact lenses available on our formulary contact list. Contact lenses not on this list are referred to as Non-Formulary. A copy of the list can be found at myuhcvision.com Formulary contact lenses

The fitting/evaluation fees, contact lenses, and up to two follow-up visits are covered in full after copay.

Non-Formulary contact lenses

An allowance is applied toward the purchase of contact lenses outside the Formulary. The allowance is for materials. No portion will be applied to the fitting and evaluation. Contact lens copay is waived.

If you choose disposable contacts, up to 6 boxes are included when obtained from an in-network provider.

$150.00

Necessary contact lenses³ Covered in full after copay (if applicable).

Vision Benefit Summary - High Plan

Frequency

Comprehensive

with Materials

Eyeglass Lenses Once every 12 months

Contact Lenses

Eyeglasses (lenses and frame) $ 0.00

Contact lenses instead of Eyeglasses $ 0.00

Frame Benefit - for frames that exceed the allowance, an additional 30% discount may be applied to the overage¹

Private Practice Provider $ 250.00 retail frame allowance

Retail Chain Provider $ 250.00 retail frame allowance

Lens Options - this list highlights the discounted cost on our most popular lens options. Exact pricing may vary; confirm cost with your provider prior to purchase. Standard Scratch Coating

Tier I

Anti-Reflective Tier II

Anti-Reflective Tier III

Anti-Reflective Tier IV

Roll and Polish Edges

Progressive Tier I

Progressive Tier II

Progressive Tier III

Progressive Tier IV

Progressive Tier V

$50

$75

$95

$13

$55

$100

$150

$200

$250

In-Network Services

Formulary contact lenses

The fitting/evaluation fees, contact lenses, and up to two follow-up visits are covered in full after copay.

Non-Formulary contact lenses

If you choose disposable contacts, up to 10 boxes are included when obtained from an in-network provider.

$250.00

Necessary contact lenses³ Covered in full after copay (if applicable).

Disability Insurance

ABOUT DISABILITY

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

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

Help prepare for the unexpected with income protection through UnitedHealthcare. Your ability to earn an income is your biggest asset. Long-Term Disability Insurance pays you a benefit while you are temporarily unable to work due to a sickness or injury. It provides income protection so you can focus on your health rather than worrying about paying your bills and expenses.

Your Long-Term Disability plan highlights:

Eligibility: All Active Full Time Employees working a minimum of 20 Hours per week. Coverage amount is a percentage of your monthly earnings just prior to becoming disabled. 60% of your Monthly Earnings to a maximum of $10,000.00 per month.

Maximum Benefit Period is the total length of time you can receive disability benefits under this plan; provided you continue to meet the definition of disability as defined by your policy.

The duration or length of time your benefit will be paid can be reduced based on your age in the chart.

Benefits begin after you complete the Elimination Period: a period of time you must be disabled before benefits are payable.

Pre-Existing Condition is a disease or physical condition for which treatment has been received within a defined period of time immediately prior to becoming covered under the plan.

If your plan includes a Pre-Existing Condition provision it is displayed as two time periods. (e.g. 3/12)

• Look Back Period: Number of months prior to the effective date where we look for received treatment or a diagnosis by a physician.

• Exclusion Period: Number of months following the effective date where if you become disabled due to a pre-existing condition, then benefits for the disability are excluded.

Age 65 w/Reducing Benefit Duration

Age 69 and over

90 days

Look Back period: 3 months Exclusion period: 12 months

Disability Insurance

Lump Sum Survivor Benefit: an additional benefit payable to your family if you die while you are disabled and receiving benefits under this plan.

Minimum Monthly Benefit: the minimum monthly benefit amount payable for a qualifying disability after deducting other sources of income.

Short-term Disability Plan Highlights

Effective Date

Eligibility

Voluntary STD Benefit

Elimination Period

3 months of the gross disability payment.

Greater of $100 or 10% of gross monthly benefit

Benefit Duration

Lump Sum Survivor Benefit

Offsets

Other limitations to enrollment

September 1, 2024

All Active Full Time and Part Time Employees electing the 15 day plan working a minimum of 20 Hours per week.

60.0% of your weekly Earnings to a maximum of $2,500 per week.

Minimum Benefit: $25

Earnings are defined in the UnitedHealthcare contract with your employer.

Short Term Disability Insurance benefit begins on the 15th day after your accident or 15th day of sickness.

The Elimination Period will be waived and benefits will begin immediately if You are Hospital Confined because of Your Disability

Up to 11 weeks

Lesser of $3,000 or 3 weeks Gross

As described later in this summary, your weekly Short Term Disability benefit may be reduced by other income you receive.

If you enroll during this enrollment period, your coverage is provided to you on a guaranteed basis - no medical information is required. If you enroll after this enrollment period, (or any time after you first become eligible), evidence of insurability will be required for all coverage amounts. Subject to any preexisting condition limitations.

You must be Actively at Work with your employer on the day your coverage takes effect.

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.

Important Details

This Summary of Benefits sheet is an overview of the Short Term Disability Insurance being offered and is provided for illustrative purposes only and is not a contract. It in no way changes or affects the policy as actually issued. Only the insurance policy issued to the policyholder (your employer) can fully describe all of the provisions, terms, conditions, limitations and exclusions of your insurance coverage. In the event of any difference between the Summary of Benefits sheet and the insurance policy, the terms of the insurance policy apply.

Once a group policy is issued to your employer, a certificate of coverage will be available to explain your benefits in detail.

Exclusions:

You cannot receive Short Term Disability Insurance benefit payments for disabilities that are caused or contributed to by*:

• War or act of war (declared or not)

• The commission of, or attempt to commit a felony

• An intentionally self-inflicted injury

• Any case where your being engaged in an illegal occupation was a contributing cause to your disability

• Sickness or injury for which Workers’ Compensation benefits are paid, or may be paid, if duly claimed

• Any injury sustained as a result of doing any work for pay or profit for another employer

You must be under the regular care of a physician to receive benefits.*

Your benefit payments will be reduced by other income you receive or are eligible to receive due to your disability, including but not limited to*:

• Social Security Disability Insurance

• Workers’ Compensation

• Other employer-based insurance coverage you may have

• Unemployment benefits

• Settlements or judgments for income loss

• Retirement benefits that your employer fully or partially pays for (such as a pension plan)

• Employer’s sick leave or salary continuation plan.

• Loss of time or lost wages from no-fault motor vehicle insurance plan.

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.

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

Cancer Insurance

Treatment for cancer is often lengthy and expensive. While your health insurance helps pay the medical expenses for cancer treatment, it does not cover the cost of non-medical expenses, such as out-of-town treatments, special diets, daily living and household upkeep. In addition to these non-medical expenses, you are responsible for paying your health plan deductibles and/ or coinsurance. Cancer insurance through MetLife helps pay for these direct and indirect treatment costs so you can focus on your health. This plan is administered by Bay Bridge Administrators . This plan is offered on a guarantee issue basis for the employee, spouse and dependents. Please see the Outline of Coverage on your employee benefits website for a complete list of plan benefits

$325 per day for any confinement, $650 per day if related to cancer or specified disease $325 per day for any confinement, $650 per day if related to cancer or specified disease

in situ is not considered internal cancer

Critical Illness Insurance

ABOUT CRITICAL ILLNESS

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

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

Brazosport Independent School District (TX)

Summary of Benefits: Critical Illness

Plan

Effective Date: 09/01/2024

Help protect yourself from costly medical expenses with UnitedHealthcare. Critical Illness Protection Plan helps protect employees from costly expenses associated with the diagnosis of a serious illness. All benefits are paid directly to the insured and can be used towards any expense.

Your Critical Illness Protection Plan highlights: Eligibility: All Active Full Time Employees working a minimum of 20 hours per week. Employee must purchase coverage in order to purchase dependent coverage. Dependent children are covered to age 26.

Critical Illness Insurance

** Not eligible for the Reoccurrence benefit

Organ Failure (Liver, Lung, Pancreas, Small Bowel)

Syndrome

Muscular Dystrophy

Sickle Cell Anemia

Spina Bifida

This benefit summary is an overview of your Insurance. Once a group policy is issued to your employer, a Certificate of Coverage will be available to explain your benefits in detail. In the event of a conflict between this benefit summary and your Certificate of Coverage, the Certificate of Coverage will control.

Accident Insurance UnitedHealthcare

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/brazosportisd

This is not a comprehensive overview of benefits. Please review www.mybenefitshub.com/brazosportisd for full benefit details.

Help protect yourself from the unexpected cost of an accident with UnitedHealthcare. The Accident Protection Plan helps protect employees from costly expenses associated with an accident. All

are

directly to the insured and can be used towards any expense.

Your Accident Protection Plan highlights: Class

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.

Life and AD&D

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/brazosportisd

Effective Date September 1, 2024

All Other Active Full Time Employees working a minimum of 20 hours per week.

Guarantee Issue Limit: $20,000 Employee Supplemental Life and AD&D Benefit Increments of $10,000, to a maximum of $500,000, not to exceed 7 times Annual Earnings. Guarantee Issue Limit: $200,000

Spouse Supplemental Life and AD&D

If you elect Supplemental Life and AD&D Insurance for yourself, you may choose to purchase Spouse Supplemental Life and AD&D Insurance:

• Increments of $5,000, to a maximum of $250,000 not to exceed 100.0% of Employee amount.

• Guarantee Issue Limit: $50,000

• You may not elect coverage for your Spouse if they are already covered as an Employee under this policy.

If you elect Supplemental Life and AD&D Insurance for yourself, you may choose to purchase Child(ren)* Supplemental Life and AD&D Insurance:

• Increments of $1,000, to a maximum of $10,000 not to exceed 100.0% of Employee amount for each child.

• Guarantee Issue Limit: $10,000

Note: Paid benefit is limited to $1,000 for a child age 0 to 14 days, and $1,000 for a child age 14 days to 6 months.

Spouse Supplemental

at age 70

Coverage terminates at employee’s retirement

age 70

Coverage terminates at employee’s retirement

True Open Enrollment for September 1, 2024: A one-time exception has been made to allow an Actively at Work employee, including an employee not currently enrolled for Supplemental Life coverage, to elect an amount of Supplemental Life coverage without providing proof of good health as follows:

For employees insured under the Supplemental Life plan on August 31, 2024:

• Employees insured under the Supplemental Life plan are eligible to increase their Supplemental Life coverage without providing proof of good health, not to exceed the Guaranteed Issue limit. All requests must be received by September 30, 2024

For employees who are not insured under the Supplemental Life plan on August 31, 2024:

• Employees not insured under the Supplemental Life plan are eligible to enroll for coverage without providing proof of good health not to exceed the Guaranteed Issue limit. All requests must be received by September 30, 2024

Spouse: Note: These amounts are prior to any age reduction being taken.

Life and AD&D UnitedHealthcare

Evidence of Insurability Requirements

Child(ren) - You may elect up to the Guarantee Issue limit.

Late Entrant (did not enroll within 31 days of eligibility): For Employee and Spouse coverage, evidence of good health/insurability is required for any requested amount.

This Summary of Benefits sheet is an overview of the Life Insurance being offered and is provided for illustrative purposes only and is not a contract. It in no way changes or affects the policy as actually issued. Only the insurance policy issued to the policyholder (your employer) can fully describe all of the provisions, terms, conditions, limitations and exclusions of your insurance coverage. In the event of any difference between the Summary of Benefits sheet and the insurance policy, the terms of the insurance policy apply.

Once a group policy is issued to your employer, a certificate of coverage will be available to explain your benefits in detail.

You must be Actively at Work with your employer on the day your coverage takes effect.

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.

Annual Earnings are defined in UnitedHealthcare’s contract with your employer.

Supplemental Life Insurance can be purchased without Supplemental AD&D Insurance, however you cannot purchase Supplemental AD&D Insurance without Supplemental Life Insurance. If you do elect

Supplemental AD&D Insurance, the amount elected must not exceed the amount of Supplemental Life elected and approved.

This applies to you, your Spouse and your Dependent Child(ren).

Eligible Child(ren) are covered To age 26.

Benefit Reduction Examples:

• 65% at age 65, 50% at age 70: Coverage reduces to 65% of the face amount at age 65; to 50% of the original amount at age 70.

• 65% at age 65, 45% at age 70, 25% at age 75: Coverage reduces to 65% of the face amount at age 65; to 45% of the original amount at age 70; to 25% of the original amount at age 75.

Exclusions:

AD&D Insurance does not cover losses caused by or contributed by: Disease, bodily or mental infirmity, suicide or intentionally self-inflicted injury, commission of an assault or felony, war, use of any drug unless prescribed by physician, driving while intoxicated, engaging in any hazardous activities, or travel in a private aircraft.*

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

As is standard with most term life Insurance, this Insurance coverage includes certain limitations and exclusions: Death by suicide 2 Years*. Eligibility: All Other Active Full Time Employees working a minimum of 20 hours per week.

Family Protection Plan

Group Term Life Insurance to age 121 with Quality of Life

Make a smart choice to help protect your loved ones and your future.

Life doesn’t come with a lesson plan

Help protect your family with the Family Protection Plan Group Level Term Life Insurance to age 121. You can get coverage for your spouse even if you don’t elect coverage on yourself. And you can cover your ﬁnancially dependent children and grandchildren (14 days to 26 years old). The coverage lasts until age 121 for all insured,* so no matter what the future brings, your family is protected.

Why buy life insurance when you’re young?

Buying life insurance when you’re younger allows you to take advantage of lower premium rates while you’re generally healthy, which allows you to purchase more insurance coverage for the future. This is especially important if you have dependents who rely on your income, or you have debt that would need to be paid off.

Portable

Coverage continues with no loss of beneﬁts or increase in cost if you terminate employment after the ﬁrst premium is paid. We simply bill you directly.

Why is portability important?

Life moves fast so having a portable life insurance allows you to keep your coverage if you leave your school district. Keeping the coverage helps you ensure your family is protected even into your retirement years.

44% of American households would encounter significant financial difficulties within six months if they lost the primary family wage earner. 28% would reach this point in one month or less.

Family Protection Plan

Group Term

Terminal illness acceleration of beneﬁts

Coverage pays 30% (25% in CT and MI) of the coverage amount in a lump sum upon the occurrence of a terminal condition that will result in a limited life span of less than 12 months (24 months in IL).

Protection you can count on

Within one business day of notiﬁcation, payment of 50% of coverage or $10,000 whichever is less is mailed to the beneﬁciary, unless the death is within the two-year contestability period and/or under investigation. This coverage has no war or terrorism exclusions.

Convenient

Easy payment through payroll deduction.

Quality of Life beneﬁt

Optional benefit that accelerates a portion of the death benefit on a monthly basis, up to 75% of your benefit, and is payable directly to you on a tax favored basis* for the following:

•Permanent inability to perform at least two of the six Activities of Daily Living (ADLs) without substantial assistance; or

•Permanent severe cognitive impairment, such as dementia, Alzheimer’s disease and other forms of senility, requiring substantial supervision.

How does Quality of Life help?

Many individuals who can’t take care of themselves require special accommodations to perform ADLs and would need to make modifications to continue to live at home with physical limitation. The proceeds from the Quality of Life benefit can be used for any purpose, including costs for infacility care, home healthcare professionals, home modifications, and more.

2024 Enrollment Plan Year

Guaranteed Issue is offered to all eligible applicants regardless of health status. No Doctor exams or physicals.

Employee: $100,000 | Spouse: $30,000 | Child: $10,000

Enroll to provide peace of mind for your family

To do an initial enrollment or if you have questions please call our customer service at 866-914-5202. Monday - Friday | 8:00 am-6:00 pm CST

About the coverage

The Family Protection Plan offers a lump-sum cash benefit if you die before age 121. The initial death benefit is guaranteed to be level for at least the first ten policy years. Afterward, the company intends to provide a nonguaranteed death benefit enhancement which will maintain the initial death benefit level until age 121. The company has the right to discontinue this enhancement. The death benefit enhancement cannot be discontinued on a particular insured due to a change in age, health, or employment status.

Identity Theft LegalShield

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.

ABOUT LEGAL SERVICES

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

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

Identity Shield and Legal Shield

IDShield

Identity theft is one of the fastest-growing crimes in the country. Millions of people have their identity stolen each year. Protect yourself and restore your identity with coverage from LegalShield. Benefits include:

• Identity consultation and advice

• Licensed private investigators

• Identity and credit monitoring

LegalShield

• Social media monitoring

• Identity restoration

• Threat and credit alerts

• 24/7 emergency ID protection access

• Mobile app

The average cost of a lawyer is anywhere between $250 to $350 per hour1. Your employer knows that obtaining legal help can be a stressful and expensive process. That’s why they’re offering you a solution with a legal assistance plan!

This benefit offers you legal help at a fixed and affordable rate. This isn’t a benefit just for when you need legal representation in court. It’s something that you can rely on whenever you come across a major life event that you need a little help with. Most legal assistance plans can help you out when you are:

• Getting married

• Buying or selling a home

• Dealing with identity theft

• Starting a family

• Sending the kids off to college

• … and more!

By eliminating the stress of finding legal aide, it’ll make every situation you’re facing easier to deal with.

1How Much Do Lawyers Cost: Fees Broken Down By State (2023) (contractscounsel.com)

Pet Insurance

ABOUT PET INSURANCE

You love your pet and consider them a member of your family. Pet insurance provides pet parents resources to keep your pet safe and healthy while avoiding financial crisis due to unexpected pet medical emergencies.

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

Pet insurance reimburses you for vet bills when your pet is sick or injured, to help take the financial worry out of vet visits.

With Pet’s Best you get:

9 Fast claims processing and payment

9 Optional direct deposit and direct vet pay options

9 No networks – use any veterinarian in the U.S. including specialty and emergency clinics

9 Exclusive employee discounts

9 Optional coverage for routine care

9 Access to a 24/7 pet helpline powered by whiskerDocs

Coverage is for dogs and cats only, and your cost will be based on the breed and age of your pet. There are various levels of coverage available, and you may learn more about this coverage by reviewing the plan information on your benefits website.

See Benefits Website for Plan Information and Site to Register. This Plan Will Not Be Deducted Through Payroll.

If you are interested in pet insurance you may enroll in coverage at: www.petsbest.com/BISDPETS Call 888.984.8700 and be sure to reference discount code BISDPETS

Pet insurance will not be payroll deducted by Brazosport ISD, rather if you enroll, you will set up payment via bank draft or credit/debit card.

Your well-being is what matters most

Medical issues can take a toll on your work and home life. To help you through difficult times, the UnitedHealthcare Member Assistance Program (MAP) provides you and your family personal and confidential support, 24 hours a day, 7 days a week.

The help you may need, at no extra cost

• Unlimited phone access to master’s-level specialists – 24/7

• Up to 3 referrals for face-to-face counseling sessions – Our national network includes 218,000 clinicians¹ *

• Help dial down possible symptoms of stress, anxiety and depression –Sanvello® is an app that offers techniques and coping tools, community support and guided journeys

• One legal consultation for 30 minutes – Meet with an attorney by phone or in person, and you can retain an attorney for ongoing services at a 25% discounted rate**

• A 30- to 60-minute financial consultation – Discuss estate taxes and other financial matters with credentialed financial professionals

• Access to liveandworkwell.com – Easily, securely find a provider and work-life resources, confidentially connect to expert guidance and explore thousands of articles

Maintaining your privacy and confidentiality is of the utmost importance. All records, referrals and evaluations are kept private and confidential in accordance with federal and state laws.

Call 1-877-660-3806, TTY 711. Translators are available for non-English speakers. Visit liveandworkwell.com. Enter anonymously using access code FP3EAP.

Join Sanvello

Go to liveandworkwell.com and select the Sanvello tile to get started.

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 Brazosport 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 Brazosport 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.