2024-25 CBEBC Benefit Guide (Alt. Medical) by Higginbotham Public Sector

09/01/2024 - 08/31/2025

Benefit Contact Information

Higginbotham Public Sector (833) 453-1680 www.cbebc.com

National Benefit Services (855) 399-3035

www.nbsbenefits.com

Lincoln Financial Group (800) 423-2765 www.lfg.com

United HealthCare (888) 679-8925 www.whyuhc.com/dentalppo

Texas Republic Life (512) 330-0099 www.texasrepubliclife.com

CHUBB (888) 499-0425 educatorclaims@chubb.com

Experian (855) 797-0052 https://experian.myfinancialexpert.com/ login

Clever RX (800) 873-1195 https://cleverrx.com

MD Live (888) 365-1663 www.consultmdlive.com

Eyetopia (800) 662-8264 www.eyetopia.org

EECU (817) 882-0800 www.eecu.org

MASA Group #MCKBEBC (800) 423-3226 www.masamts.com

CHUBB (888) 499-0425 educatorclaims@chubb.com

Lincoln Financial Group (800) 423-2765 www.lfg.com

CHUBB (888) 499-0425 www.chubb.com

Lincoln Financial Group (800) 423-2765 www.lfg.com

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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.cbebc.com. 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 CBEBC benefit website: www.cbebc.com. 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.

Don’t Forget!

• Login and complete your benefit enrollment from 07/08/2024 - 08/23/2024 (Dates vary by district)

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

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

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

Annual Benefit Enrollment

Section 125 Cafeteria Plan Guidelines

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

CHANGES IN 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.

Spouse Eligibility: Legal spouse or common-law marriage

Child Eligibility: Tax dependent

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

Accident To age 26

Cancer To age 26

Critical Illness To age 26

Dental To age 26

Identity Theft To age 26

Individual Life To age 26

Hospital Indemnity To age 26

Telehealth To age 26

Vision To age 26

Voluntary Life and AD&D To age 26

Emergency Transportation To age 26

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 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)

$1,600 single (2024)

None

$3,200 family (2024) N/A

$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.

$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

Year-to-year rollover of account balance? Yes, will roll over to use for subsequent year’s health coverage.

Does the account earn interest?

Portable?

Yes

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

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

Medical Insurance

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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.cbebc.com

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

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.

Flexible Spending Accounts

National Benefit Services (NBS)

returns); (b) your taxable compensation; (c) your spouse’s actual or deemed earned income.

“Register” in the top right corner, and follow the

ABOUT TELEHEALTH

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

For full plan details, please visit your benefit website: www.cbebc.com

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

• Have a non-emergency issue and are considering a convenience care clinic, urgent care clinic or emergency room for treatment

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

• Are unable to see your primary care physician

When to Use MDLIVE:

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

• Sore throat

• Headache

• Stomach ache

• Cold

• Flu

• Allergies

• Fever

• Urinary tract infections Do not use telemedicine for serious or life-threatening emergencies.

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

• Online – www.mdlive.com/fbs

• Phone – (888) 365-1663

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

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

Check with your district to see if your employer offers this benefit at no cost to you and your family.

Emergency Medical Transport MASA

ABOUT MEDICAL TRANSPORT

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

For full plan details, please visit your benefit website: www.cbebc.com

A MASA MTS Membership provides the ultimate peace of mind at an affordable rate for emergency ground and air transportation service within the United States and Canada, regardless of whether the provider is in or out of a given group healthcare benefits network. If a member has a high deductible health plan that is compatible with a health savings account, benefits will become available under the MASA membership for expenses incurred for medical care (as defined under Internal Revenue Code (“IRC”) section 213 (d)) once a member satisfies the applicable statutory minimum deductible under IRC section 223(c) for high-deductible health plan coverage that is compatible with a health savings account.

Emergent Air Transportation

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

Emergent Ground Transportation

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

Non-Emergency Inter-Facility Transportation

In the event that a member is in stable condition in a medical facility but requires a heightened level of care that is not available at their current medical facility, Members have access to nonemergency air or ground transportation between medical facilities.

Repatriation/Recuperation

Suppose you or a family member is hospitalized more than 100-miles from your home. In that case, you have benefit coverage for air or ground medical transportation into a medical facility closer to your home for recuperation.

Should you need assistance with a claim contact MASA at (800)643-9023. You can find full benefit details at: www.cbebc.com.

Dental Insurance Lincoln Financial Group

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.

Lincoln Financial Group offered to most employers. United HealthCare dental (following pages) offered to employers with the United HealthCare medical plan.

For full plan details, please visit your benefit website: www.cbebc.com

Plans Effective 09/01/2024:

• Plan cover many preventive, basic, and major dental care services. (See Below)

• Both plans allow you to choose any dentist you wish, though you can lower your out-of-pocket costs by selecting a contracting dentist.

• Does not make you and your dependents wait six months between routine cleanings.

• More information available to you at www.lfg.com

Deductibles are combined for basic and major Contracting Dentists’ services. Deductibles are combined for basic and major Non-Contracting Dentists’ services.

for

and major

Orthodontic Coverage is available for dependent children to age 19.

Waiting Period There are no benefit waiting periods for any service types

You can also go to www.lfg.com and register/login to access your account and Downloand the Lincoln Dental Mobile App.

• Find a network dentist near you in minutes

• Have an ID card on your phone

• Customize the app to get details of your plan

• Find out how much your plan covers for checkups and other services

• Keep track of your claims

You can request your dental ID card by contacting Lincoln Financial Dental directly at (800) 423-2765.

UnitedHealthcare Insurance Company (30100)®

Voluntary Options PPO 30 / covered dental services

Radiographs Lab and Other Diagnostic Tests

PREVENTIVE SERVICES

Prophylaxis (Cleaning)

Fluoride Treatment (Preventive)

Sealants

Emergency Treatment/General Services

General Services - Adjunctive Emergency Treatment

BASIC SERVICES

Restorations, Amalgams or Composite (Anterior & Posterior)

Emergency Treatment/General Services

General Services - Adjunctive Occlusal Guard

General Services - Adjunctive Other Simple Extractions

Oral Surgery (incl. surgical extractions) Periodontics

Endodontics

MAJOR SERVICES

Space Maintainers

Emergency Treatment/General Services

General Services - Adjunctive Anesthesia

Inlays/Onlays/Crowns

Dentures and Removable Prosthetics

Fixed Partial Dentures (Bridges) Implants

ORTHODONTIC SERVICES

Diagnose or correct misalignment of the teeth or bite

# This plan includes a roll-over maximum benefit. Some of the unused portion of your annual maximum may be available in future periods.

* Your dental plan provides that where two or more professionally acceptable dental treatments for a dental condition exist, your plan bases reimbursement on the least costly treatment alternative. If you and your dentist agreed on a treatment which is more costly than the treatment on which the plan benefit is based, you will be responsible for the difference between the fee for service rendered and the fee covered by the plan. In addition, a pre-treatment estimate is recommended for any service estimated to cost over $500; please consult your dentist.

**The network percentage of benefits is based on the discounted fees negotiated with the provider.

***The non-network percentage of benefits is based on the usual and customary fees in the geographic areas in which the expenses are incurred.

Veneers are only covered when a filling cannot restore a tooth. For a complete description and coverage levels for Veneers, please refer to your Certificate of Coverage. Cone Beams are limited to combined captured and interpretation treatment codes only. For a complete description and coverage levels for Cone Beams, please refer to your Certificate of Coverage.

In accordance with the Illinois state requirement, a partner in a Civil Union is included in the definition of Dependent. For a complete description of Dependent Coverage, please refer to your Certificate of Coverage.

The Prenatal Dental Care (not available in WA) and Oral Cancer Screening programs are covered under this plan.

The material contained in the above table is for informational purposes only and is not an offer of coverage. Please note that the above table provides only a brief, general description of coverage and does not constitute a contract. For a complete listing of your coverage, including exclusions and limitations relating to your coverage, please refer to your Certificate of Coverage or contact your benefits administrator. If differences exist between this Summary of Benefits and your Certificate of Coverage/benefits administrator, the certificate/benefits administrator will govern. All terms and conditions of coverage are subject to applicable state and federal laws. State mandates regarding benefit levels and age limitations may supersede plan design features.

UnitedHealthcare Dental Options PPO Plan is either underwritten or provided by: United HealthCare Insurance Company, Hartford, Connecticut; United HealthCare Insurance Company of New York, Hauppauge, New York; Unimerica Insurance Company, Milwaukee, Wisconsin; Unimerica Life Insurance Company of New York, New York, New York or United HealthCare Services, Inc.

Radiographs Lab and Other Diagnostic Tests

PREVENTIVE SERVICES

Prophylaxis (Cleaning)

Fluoride Treatment (Preventive) Sealants

Emergency Treatment/General Services

General Services - Adjunctive Emergency Treatment

BASIC SERVICES

Restorations, Amalgams or Composite (Anterior & Posterior)

Emergency Treatment/General Services

General Services - Adjunctive Occlusal Guard

General Services - Adjunctive Other Simple Extractions

Oral Surgery (incl. surgical extractions) Periodontics

Endodontics

MAJOR SERVICES

Space Maintainers

Emergency Treatment/General Services

General Services - Adjunctive Anesthesia

Inlays/Onlays/Crowns

Dentures and Removable Prosthetics

Fixed Partial Dentures (Bridges) Implants

ORTHODONTIC SERVICES

Diagnose or correct misalignment of the teeth or bite

# This plan includes a roll-over maximum benefit. Some of the unused portion of your annual maximum may be available in future periods.

**The network percentage of benefits is based on the discounted fees negotiated with the provider.

***The non-network percentage of benefits is based on the usual and customary fees in the geographic areas in which the expenses are incurred.

The Prenatal Dental Care (not available in WA) and Oral Cancer Screening programs are covered under this plan.

Vision Insurance

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.cbebc.com

Eyetopia Benefits - Low Plan

Eyetopia provides two vision benefits each eligibility period. You may have the opportunity to maximize your Eyetopia benefits by coordinating benefits with your Health Insurance coverage.

BENEFIT ONE2 (choose either one of the following 2 options every 12 months):

1. Refractive Exam. One routine Vision Exam.

2. Coverage towards a medical eye exam copay or other services or materials.2

BENEFIT TWO (choose only one of the following Vision Correction Options): Eyetopia provides you with 3 options for correcting your vision every 12 months.3

1. Prescription Lenses4 CR-39 plastic single vision, bifocal, trifocal lenses.

• CR-39 plastic Progressive (no-line multi-focal) lenses that retail for up to $199. N/A

• CR-39 plastic Progressive (no-line multi-focal) lenses that retail for more than $199.

•

• Polycarbonate

for child dependents (under age 26)

• Basic Coating (Ultraviolet Protection & Scratch Resistant Coating)

• Mid-Level Anti-Reflective Coatings that retail up to $99.

• Premium Anti-Reflective Coatings that retail for $100 or more copay not to exceed: N/A

• Premium blue light blocking lenses or premium blue light blocking anti-reflective coating.

• Photochromatic or Polarized Lenses

• Medically necessary spectacles for Aniseikonia or Amblyopia.5

• Anti-Fatigue lenses. Covered $20.00

• Frame: The member may select any frame on display and is responsible for any amount exceeding the allowance.

2. Contact Lens Option: In lieu of spectacles. Allowance to be applied toward prescription contact lenses.

• This allowance can be applied toward the contact lens fitting fee and all other charges including follow-up visits and contact lenses.6

• Medically necessary contact lenses - $145.00 evaluation allowance and $400.00 contact lens allowance.7

3. Refractive Surgery Option 8 In lieu of spectacles or contact lenses. A $350.00 per eye allowance with contracted surgeons or a $75.00 per eye allowance with non-contracted surgeons toward the fees for refractive surgery care for the following procedures: LASIK, PRK, ICL or RLE. The member pays any amount exceeding the per eye allowance.

Vision Insurance Eyetopia

Eyetopia Benefits - High Plan

Eyetopia provides two vision benefits each eligibility period. You may have the opportunity to maximize your Eyetopia benefits by coordinating benefits with your Health Insurance coverage.

BENEFIT ONE2 (choose either one of the following 2 options every 12 months):

1. Refractive Exam. One routine vision exam.

2. Coverage toward medical eye exam co-pay or other services or materials.2

BENEFIT TWO (choose only 1 of the following Vision Correction Options) Eyetopia provides you with 3 options for correcting your vision every 12 months.3

1. Prescription Lenses3,4

Single Vision, Bi-focal or Tri-focal lenses

• Progressive (no line multifocal) lenses that retail for up to $219.

• Progressive (no line multifocal) lenses that retail for more than $219.

• Lens Materials: polycarbonate, Trivex®, 1.60 or 1.67 index plastic.

• Basic Coating (ultraviolet protection and scratch resistant coating)

• Mid-Level Anti-Reflective Coatings that retail up to $99.

• Premium Anti-Reflective Coatings that retail for $100 or more.

• Premium blue light blocking lenses or premium blue light blocking anti-reflective coating. N/A

• Tint (Solid and Gradient) N/A

• Photochromic or polarized lens upgrade

• Medically necessary spectacles for Aniseikonia or Amblyopia.5

• Anti-Fatigue lenses.

• Frame: The member may select any frame on display and is responsible for any amount exceeding the allowance.

2. Contact Lens Option in lieu of spectacles. Allowance to be applied toward prescription contact lenses.

• This allowance can be applied toward the contact lens fitting fee and all other charges including follow-up visits and contact lenses.6

• Medically necessary contact lenses - $300.00 evaluation allowance and $400.00 contact lens allowance.7

3. Refractive Surgery Option8 in lieu of spectacles or contact lenses. A $500.00 per eye allowance with contracted surgeons or a $150.00 per eye allowance with non-contracted surgeons toward the fees for refractive surgery care for the following procedures: LASIK, PRK, ICL or RLE. The member pays any amount exceeding the per eye allowance.

4. Hearing Aid Option 9 If you do not use any other benefit options you can elect to apply your benefit toward hearing aids. Please see the attached Eartopia benefit forms. The benefit increases each year for 3 years if not used.

and Child(ren)

Educator Group Term Life Insurance

Benefit Summary

Life insurance is an important part of your employee benefits package. Chubb Term Life and Accidental Death and Dismemberment (AD&D) insurance provides the protection your family needs if something were to happen to you. Your family can receive cash benefits paid directly to them that they can use to help cover expenses like mortgage payments, credit card debt, childcare, college tuition, and other household expenses.

Voluntary Term Life and AD&D Insurance is made available for purchase by you and your family. Employees must be actively at work for at least 20 hours per week.

Life Insurance/AD&D

For

You

$10,000 increments up to a maximum of the lesser of 7 x annual salary or $500,000

For Your Spouse

$5,000 increments up to a maximum of $500,000 not to exceed 100% of employee amount

For Your Dependent Children

Live birth to 6 months: $100 6 months to age 26: $10,000

Reduction Schedule

50% at age 70

Additional Plan Benefits

Guaranteed Issue

Employee: $250,000 Spouse: $75,000 Child: $10,000

Newly eligible employees and dependents: You and your eligible dependents may elect coverage up to the guaranteed issue amounts without answering health questions. Elections over the guaranteed issue amounts will require medical underwriting.

Current employees: At subsequent annual enrollments if you or your eligible dependents are currently enrolled in the plan, you may increase your coverage up to the guaranteed issue amounts without answering health questions. All amounts over the guaranteed issue will require medical underwriting.

*Please note that if you or your dependents did not elect coverage when first eligible, then you are considered a late entrant. Late entrants will be medically underwritten and will have to answer health questions for any amount of coverage elected.

The AD&D plan provides additional protection for you and your dependents in the event of an accidental bodily injury resulting in death or dismemberment. In addition to standard dismemberment coverage, the following benefit provisions are included:

• Air Bag Benefit – The lesser of 5% of AD&D benefit or $5,000

• Child Care Expense Benefit – 5% of employee’s AD&D Benefit up to $12,000 per year for 4 years

• Child Education Expense Benefit – 6% of employee’s AD&D Benefit up to $6,000 for 6 years; maximum benefit of $24,000

• Common Carrier Benefit – Included

• Elder Care Benefit – The lesser of 1% of AD&D Benefit or $500

• Exposure and Disappearance Benefit– Included

• Repatriation Expense Benefit – The lesser of $1,000 or the actual expense incurred

• Seatbelt Benefit – The lesser of 10% of AD&D benefit or $25,000

• Spouse Education Benefit – The lesser of 1% of AD&D Benefit, $1,000, or the actual tuition expenses incurred

• Workplace Felonious Assault Benefit – 5% of AD&D benefit up to $10,000

Portability

You can elect portable coverage, at group rates, if you terminate employment, reduce hours or retire from the employer.

Conversion When your group coverage ends, you may convert your coverage to an individual life policy without providing evidence of insurability.

Monthly Costs for Voluntary Term Life/AD&D Insurance

You have the option to purchase Supplemental Term life Insurance. Listed below are the monthly rates.

Child Life monthly rate is $1.60 per $10,000. One premium covers all children.

Employee AD&D monthly rate is $0.30 per $10,000.

Spouse AD&D monthly rate is $0.15 per $5,000.

Child AD&D monthly rate is $0.30 per $10,000.

Term Life Exclusions*

No benefits will be paid for losses that are caused by, contributed to, or result from: 1) suicide, while sane or insane, occurring within 24 months after a Covered Person’s initial effective date of coverage; and 2) suicide, while sane or insane, occurring within two years after the date any increases in or additional coverage applied for becomes effective for a Covered Person.

AD&D Exclusions*

No benefits will be paid for any loss caused or contributed to by: 1) attempted suicide; 2) intentionally self-inflicted harm; 3) travel if Insured is other than passenger; 4) war; 5) active participation in a riot, insurrection, or terrorist activity; 6) committing or attempting to commit a felony; 7) voluntary intake or use by any means of any drug, unless taken in accordance with instructions; 8) any poison, gas or fumes, unless a direct result of an occupational accident; 9) being intoxicated; 10) bungee jumping; 11) participation in an illegal occupation/activity; 12) rock or mountain climbing; and 13) aeronautics.

*Please refer to your Certificate of Insurance at https://cbebc.com for a complete listing of available benefits, limitations and exclusions. Underwritten by ACE Property & Casualty Company, a Chubb company. Contact the FBS Benefits CareLine via the QR code or (833) 453-1680

Educator Income Protection Plan

Disabilities may occur more often than you think. If you can’t earn a paycheck due to disability, your savings might not be enough to cover household expenses plus healthcare and recovery costs that can continue for months.

The Educator Income Protection Plan from Chubb is coverage that pays you cash benefits if you cannot work. The plan gives you the flexibility to choose the right level of coverage to suit your needs and provides a robust set of benefits to help you through a difficult time.

Benefits and Features Summary

Eligibility

Monthly Benefit Amount

Guaranteed Minimum Benefit

Elimination Period – Injury/Sickness

Employees actively at work for at least 20 hours per week

$200 to $10,000 available in $100 increments up to a maximum of 66 2/3% of the employee’s monthly earnings

Lesser of 10% gross disability payment or $100

You can elect one of the following elimination periods under this plan:

*1st day hospital included

Duration of Benefits Social Security Normal Retirement Age

Pre-Existing Condition Waiver*

Travel Assistance Services

During the initial enrollment period the pre-existing condition limitation will be waived for the first 8 weeks

Provides assistance to you and your dependents who travel 100 miles from their home

Definitions and Provisions

Actively at Work

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

Enrollment - Current Employees

Coverage is available to you without answering any medical questions or providing evidence of insurability. You may enroll on or before the enrollment deadline. After the initial enrollment period, you can apply only during an annual enrollment period. New Hires: Coverage is available to you without answering any medical questions or providing evidence of insurability. You may apply for coverage within 60 days after your eligibility date. If you do not apply within 60 days after your eligibility date, you can apply only during an annual enrollment period. Benefits may be subject to the pre-existing condition limitation.

Elimination Period

The elimination period is the length of time you must be continuously disabled before you can receive benefits. If you elect an elimination period of 30 days or less, if you are confined to a hospital due to a disability, the elimination period will be waived, and benefits will be payable from the first day of hospitalization.

Continuity of Coverage

If you were insured under your district’s prior plan and not receiving benefits the day before this policy is effective, there will not be a loss in coverage and you will get credit for your prior carrier’s coverage.

Pre-existing Condition Waiver

Benefits under this provision are payable for no more than 8 weeks of benefit from the date of disability. After 8 weeks, benefits are subject to a 3/12 pre-existing condition limitation. This applies to new hires and/or newly eligible employees only.

Benefit Integration

Your disability benefit will be reduced by deductible sources of income and any other earnings you have received while disabled. Your gross disability payment will be reduced immediately by items that may include: workers compensation, disability income or other amounts you receive or are entitled to receive from sabbatical or assault leave plans and the amount of earnings you receive from an extended sick leave plan as described in Louisiana Revised Statutes or any other act or law with similar intent. After you have received monthly disability payments for 12 months, your gross disability payment will be reduced by additional deductible sources of income you receive or are entitled to receive under items that may include: state compulsory benefit laws; automobile liability insurance; legal judgments and settlements; certain retirement plans; salary continuation or sick leave plans; other group or association disability programs or insurance; and amounts you or your family receive or are entitled to receive from social security or similar governmental programs.

Benefit Duration

Additional Plan Benefits

Travel Assistance Services

Available 24/7, this program provides assistance to you and your dependents who travel 100 miles from their home for 90 days or less. Services include pre-trip information, emergency medical assistance and emergency personal services.

Education Expense Benefit2

In addition to your monthly disability payment, you will receive a monthly education expense benefit in the amount of $200 for each eligible student, limited to a combined monthly maximum of $1,000.

1180 day waiting period

2 90 day waiting period

Exclusions and Limitations‡

Survivor Benefit1

In the event of your death, your beneficiary will receive a lump sum death benefit equal to three months of your gross disability payment.

Child/Family Member Care Expense Benefit2

If you are disabled and participating in a vocational rehabilitation plan, you will be eligible for an additional expense benefit payment of $350 per child/family member not to exceed $1,000 per month.

Pre-existing Condition Limitation – You have a pre-existing condition if you received medical treatment, consultation, care or services including diagnostic measures, or took prescribed drugs or medicines 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. Late entrants and participants increasing coverage will be subject to a 3/12 pre-existing condition limitation.

Benefits will not be paid for disabilities caused by, contributed to by, or resulting from: 1) commission or attempt to commit a felony; 2) intentionally self-inflicted harm; 3) active participation in a riot, insurrection or terrorist activity; 4) war; 5) incarceration; 6) loss of professional or occupational license, or certification.

Maximum Period of Payment for all disabilities due to mental illness is 24 months for each disability. Maximum Period of Payment for all disabilities due to alcoholism or drug abuse is 24 months for each disability.

Rates

*If you are confined to a hospital due to a disability, the elimination period will be waived, and benefits will be payable from the first day of hospitalization.

Questions?

Contact the FBS Benefits CareLine via the QR code or (833) 453-1680.

‡ Please refer to your Certificate of Insurance at https://cbebc.com for

Disability Lincoln Financial Group

Traditional disability benefit options may not be applicable for all groups.

Traditional LTD and STD Disability - Definitions

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

Pre-Existing Condition Limitations - Please note that all plans will include pre-existing condition limitations that could impact you if you are a first-time enrollee in your employer’s disability plan. This includes during your initial new hire enrollment. Please review your plan details to find more information about pre-existing condition limitations.

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

You will enroll in Long Term and Short Term Disability on two separate pages during your open enrollment walkthrough. Generally your short term coverage and long term coverage work together so that once your short term coverage ends, at that time your long term coverage would begin if you are still disabled and approved to remain on your claim. In other words, your short term coverage may continue for up to 12 weeks and your long term coverage begins the 13th week.

Your short term coverage will generally be a weekly benefit. This is the maximum amount of money you will receive from the carrier on a weekly basis once your disability claim is approved by the carrier. This is generally a flat percentage of your salary.

Your long term coverage will generally be a monthly benefit. This is the maximum amount of money you will receive from the carrier on a monthly basis once your disability claim is approved by the carrier. This is generally a flat percentage of your salary.

Accident Insurance CHUBB

ABOUT ACCIDENT

Do you have kids playing sports, are you a weekend warrior, or maybe you’re 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.cbebc.com

Cash Benefits Paid in Addition to Any Other Coverage

You Have

You do everything you can to stay active and healthy, but accidents happen every day, including sports-related accidents. An injury that hurts an arm or a leg can hurt your finances too. That’s where Chubb Accident can help. Chubb Accident pays cash benefits directly to you regardless of any other coverage you have. Benefits are designed to cover health plan gaps for out-ofpocket expenses like deductibles, copays, and coinsurance. Let Chubb Accident help take care of your bills so you can take care of yourself and your family.

Per

ICU Confinement

Per

Rehabilitation Confinement

Per day, up to 30 days

Follow-up

Per visit, up to three visits

Lodging

For treatment 100 miles or more away; per night, up to 30 nights

Major Diagnostic Exam (CT, MRI, etc.)

Physical, Occupational, or Speech

Therapy

Per visit, up to 10 visits

Prosthetics

Surgery: Abdominal, Cranial, & Thoracic

Tendon, Ligament or Rotator Cuff

Surgery

Transportation

up to three trips

2nd/3rd Degree, up to Skin Graft

Accident Insurance CHUBB

Injuries (cont’d)

Fractures, up to Herniated Disc

Knee Cartilage (Torn) Surgery

Lacerations

Loss of Hands, Feet or Sight, up to Loss of Fingers or Toes, up to Paralysis

Two limbs

Four limbs

Traumatic Brain Injury

First Accident (Once per policy)

Family Care

For each child in a child care center: Per day, up to 30 days

Joint Replacement

Elbow

Hip Knee

Shoulder

Outpatient Physician Treatment & Preventative Care Benefit

Sports Package Benefit

Increases total benefit by 25% when accident is due to participation in organized sports. Up to $1,000 per person per

Cash benefits when you need them most — Cancer Insurance from Chubb

A cancer diagnosis and treatment can be an emotionally and physically difficult time. Chubb is there to help support you by providing cash benefits paid directly to you. Benefits are paid if you are diagnosed with cancer, but also help cover many other cancer-related services such as doctor’s visits, treatments, specialty care, and recovery. However, there are no restrictions on how to use these cash benefits so you can use them as you see fit.

Choose the right level of coverage during the enrollment period to better protect your family.

Cash benefits for every step of the way

First cancer benefit

Diagnosis of cancer

Hospital confinement

Hospital confinement ICU

Radiation therapy, chemotherapy, immunotherapy

$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)

Waiting period: 0 days

Benefit reduction: none

$100 per day – days 1 through 30

Additional days: $100

Maximum days per confinement: 31

$200 per day – days 1 through 30

Additional days: $200

Maximum days per confinement: 31

Maximum per covered person per calendar year 12-month period: $10,000

$75 per visit

$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)

Waiting period: 0 days

Benefit reduction: none

$200 per day – days 1 through 30

Additional days: $200

Maximum days per confinement: 31

$400 per day – days 1 through 30

Additional days: $400

Maximum days per confinement: 31

Maximum per covered person per calendar year 12-month period: $20,000

Maximum visits per calendar year: 4 $75 per visit

Maximum visits per calendar year: 4 Medical imaging

Skin cancer initial diagnosis

$500 per imaging study

Maximum studies per calendar year: 2

$100 per diagnosis

Lifetime maximum: 1

$500 per imaging study

Maximum studies per calendar year: 2

$100 per diagnosis

Lifetime maximum: 1

Attending physician

Hospital confinement sub-acute ICU

Family care

$30 per visit

Minimum visits per confinement: 2

Maximum visits per calendar year: 4

$100 per day – days 1 through 30

Additional days: $200

Maximum days per confinement: 31

Childcare: $100 per day per child

Maximum days per calendar year: 30

Adult day care or home healthcare: $100 per day

Maximum days per calendar year: 30

Prescription drug in-patient Per confinement: $150

$50 per visit

Minimum visits per confinement: 2

Maximum visits per calendar year: 4

$100 per day – days 1 through 30

Additional days: $200

Maximum days per confinement: 31

Childcare: $100 per day per child

Maximum days per calendar year: 30

Adult day care or home healthcare: $100 per day

Maximum days per calendar year: 30

Maximum confinements per calendar year: 6 Per confinement: $150

Maximum confinements per calendar year: 6 Private full-time nursing services

$150 per day

Maximum days per confinement: 5 $150 per day Maximum days per confinement: 5

U.S. government or charity hospital Days 1 through 30: $100

Additional days: $100

Maximum days per confinement: 15 Days 1 through 30: $300

Additional days: $600

Maximum days per confinement: 15

Critical Illness Insurance

Lincoln Financial Group

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.cbebc.com

The Critical Illness Insurance Plan:

• Provides cash benefits if you or a covered family member is diagnosed with a critical illness or event

• Benefits are paid in addition to what is covered under your health insurance

• Features group rates for employees

• Includes access to a personal health advocate who can assist you in managing healthcare services for you and your entire family

• There are no waiting periods or overall plan maximums

Coverage for you

Guaranteed coverage amounts

• You can choose from the coverage amount

Maximum coverage amount

• You can choose from the coverage amount of $40,000 (in increments of $5,000).

Coverage for your spouse

You can secure Critical Illness Insurance for your spouse when you choose coverage for yourself.

of the employee coverage amount up to $40,000 maximum in increments of $5,000

Minimum coverage amount $5,000

Guaranteed coverage amount

• You can choose from the coverage amount up to $40,000 for your spouse

Maximum coverage amount

• You can choose a coverage amount up to 100% of your coverage amount ($40,000 maximum) for your spouse

Coverage for your dependent children

Your dependent children automatically receive 50% of your coverage amount at no extra cost.

Critical Illness Insurance Lincoln Financial Group

organ failure (heart, lung, liver, pancreas, or intestine)

Hospital Indemnity

Lincoln Financial Group

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.cbebc.com

Benefits at a glance

If you or a covered family member have to go to the hospital for an accident or injury, hospital indemnity insurance provides a lump-sum cash benefit to help you take care of unexpected expenses — anything from deductibles to childcare to everyday bills. Because you’re selecting this coverage through your company, you can take advantage of group rates. You don’t have to answer medical questions to receive coverage; this is guaranteed coverage.

admission - For the initial day of admission to a hospital for treatment of a sickness/ an injury. per day for one day per calendar year

Hospital confinement - For each day of confinement in a hospital as a result of a sickness/an injury. per day for 30 days per calendar year starting on the first day of confinement

Hospital intensive care unit (ICU) admission - For the initial day of admission to an ICU for treatment as the result of a sickness/an injury. per day for one day per calendar year

Hospital ICU confinement - For each full or partial day of confinement in an ICU as a result of a sickness/an injury. per day for 30 days per calendar year starting the first day of confinement

of pregnancy

• If admitted to a hospital or ICU within 90 days after being discharged from a preceding stay for the same or related cause, the subsequent admission will be considered part of the first admission.

• If both hospital and ICU admission or hospital and ICU confinement become payable for the same day, only the larger of the two benefits will be paid. If the amount of the benefits is the same, only one will be paid.

Newborn care - For each day of confinement to a hospital for routine post-natal care following birth. per day for two days per calendar year

• If a newborn baby is confined for treatment of an illness, infirmity, disease, or injury, we will pay the Hospital or ICU confinement benefit instead of the Newborn care benefit.

Hospital Indemity Insurance Monthly

Premiums

As an employee, you can take advantage of this accident insurance plan. Plus, you can add loved ones to the plan for just a little more.

Questions? Call (800) 423-2765 and mention ID: CBEC

Identity Theft Experian

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.cbebc.com

My Financial Expert: Elite Plan

Financial Wellness & Identity Protection

Achieve your credit & financial goals sooner with unique insights With features like Digital Financial Management you will have tools to help manage your finances and credit profile in a single experience.

Digital Financial Management

360° view of financial accounts

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

Exclusive credit insights

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

Industry leading monitoring & alerts

Consistent monitoring of your Experian® credit report and VantageScore* can help you better understand your current credit profile and personal finances. Financial Alerts will notify you, via push notifications and emails, when certain financial events are detected.

Features to assist you with:

• Budgeting & cashflow

• Tracking spending

• Investments & net worth

Identity protection for the whole family

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

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

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

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

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

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

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

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

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

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

CBEBC Mobile App Login Group #’s

Use your District’s group # to login to the Benefits app.

District

Academy of Accelerated Learning

Agua Dulce ISD

Banquete ISD

Beeville ISD

Ben Bolt-Palito Blanco ISD

Benavides ISD

Bloomington ISD

Brooks County ISD

Cuero ISD

Dr M L Garza Gonzales

Charter

Driscoll ISD

Ezzell ISD

Freer ISD

Hallettsville ISD

Horizon Montessori Public Schools

Ingleside ISD

Kenedy ISD

London ISD

Lyford CISD

Lytle ISD

GROUP #

CBEBCAU

CBEBCA

CBEBCB

CBEBCC

CBEBCD

CBEBCE

CBEBCF

CBEBCAJ

CBEBCH

CBEBCI

CBEBCJ

CBEBCK

CBEBCAN

CBEBCL

CBEBCAM

CBEBCM

CBEBCN

CBEBCO

CBEBCQ

CBEBCAS

District

Meyersville ISD

Monte Alto ISD

Odem-Edroy ISD

Odyssey Academy Inc.

Orange Grove ISD

Pettus ISD

Port Aransas ISD

Ramirez CSD

Refugio ISD

Ricardo ISD

Riviera ISD

San Diego ISD

San Perlita ISD

Santa Gertrudis ISD

Sinton ISD

Skidmore-Tynan ISD

St. Marys Academy Charter School

Taft ISD

Webb CISD

West Side Helping Hands

GROUP #

CBEBCR

CBEBCAL

CBEBCS

CBEBCT

CBEBCU

CBEBCV

CBEBCW

CBEBCX

CBEBCY

CBEBCZ

CBEBCAA

CBEBCAB

CBEBCAC

CBEBCAD

CBEBCAE

CBEBCAF

CBEBCAG

CBEBCAH

CBEBCAT

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 CBEBC 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 CBEBC 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.