Benefit Contact Information
Higginbotham Public Sector (866) 914-5202
www.mybenefitshub.com/crandallisd
Cigna
Group #HC110566 (800) 754-3207
www.cigna.com
EMPLOYEE ASSISTANCE PROGRAM (EAP)
ComPsych Group Code: ONEAMERICA3 (855) 387-9727 www.guidanceresources.com
OneAmerica Group #G00615860 (855) 517-6365 www.oneamerica.com
IDENTITY
ID Watchdog (800) 774-3772 www.idwatchdog.com
BCBSTX (866) 355-5999 www.bcbstx.com/trsactivecare MDLIVE (888) 365-1663 www.mdlive.com/fbsbh
Superior Vision Group #308730 (800) 507-3800
www.superiorvision.com
MASA
Group #BCBCRANISD (800) 643-9023 www.masamts.com
American Public Life Group #18219 (800) 256-8606 www.ampublic.com
Clever RX Group #1085 (800) 974-3135 www.cleverrx.com
Cigna Group #3334771 (800) 244-6224
www.mycigna.com
Higginbotham (866) 419-3519 https://flexservices.higginbotham. net/
One America Group # 615860 (800) 858-3829 https://www.oneamerica.com/
EECU (817) 882-0800
www.eecu.org
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www.mybenefitshub.com/crandallisd
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CLICK LOGIN
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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/HR department 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/crandallisd.
How can I find a Network Provider? For benefit summaries and claim forms, go to the Crandall ISD benefit website: www.mybenefitshub.com/crandallisd. Click on the benefit plan you need information on (i.e., Dental) and you can find provider search links under the Quick Links section.
When will I receive ID cards? If the insurance carrier provides ID cards, you can expect to receive those 3-4 weeks after your effective date. For most dental and vision plans, you can login to the carrier website and print a temporary ID card or simply give your provider the insurance company’s phone number and they can call and verify your coverage if you do not have an ID card at that time. If you do not receive your ID card, you can call the carrier’s customer service number to request another card. If the insurance carrier provides ID cards, but there are no changes to the plan, you typically will not receive a new ID card each year.
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 prescription drugs or is under a health care provider’s orders to take drugs, or received medical care or services (including diagnostic and/ or consultation services).
Annual Benefit Enrollment
Section 125 Cafeteria Plan Guidelines
A Cafeteria plan enables you to save money by using pretax 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 Dependent’s 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 Benefit/HR Office to complete and sign the necessary paperwork in order to make a benefit election change. Benefit changes must be consistent with the qualifying event.
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 15 or more regularly scheduled hours each work week.
Eligible employees must be actively at work on the plan effective date for new benefits to be effective, meaning you are physically capable of performing the functions of your job on the first day of work concurrent with the plan effective date. For example, if your 2025 benefits become effective on September 1, 2025, you must be actively-at-work on September 1, 2025 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.
birthday) Telehealth To Age 26
Transportation To age 26
Life To age 26
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, LLC from any and all claims, actions, suits, charges, and judgments whatsoever that arise out of the enrollee’s enrollment in spouse and/or dependent coverage, including enrollment in Flexible Spending Accounts and Health Savings Accounts.
If your dependent is disabled, coverage may be able to continue past the maximum age under certain plans. If you have a disabled dependent who is reaching an ineligible age, you must provide a physician’s statement confirming your dependent’s disability. Contact your Benefits Administrator 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
$1,600 single (2024)
Employee and/or employer
Employer
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).
Cash-Outs of Unused Amounts (if no medical expenses) 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
Yes, portable year-to-year and between jobs.
No. Access to some funds may be extended if your employer’s plan contains a 2 1/2-month grace period or $500 rollover provision.
No
No
Medical Insurance
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/crandallisd
your
Learn the Terms.
• Premium: The monthly amount you pay for health care coverage.
• Deductible: The annual amount for medical expenses you’re responsible to pay before your plan begins to pay.
• Copay: The set amount you pay for a covered service at the time you receive it. The amount can vary based on the service.
• Coinsurance: The portion you’re required to pay for services after you meet your deductible. It’s often a specified percentage of the costs; e.g., you pay 20% while the health care plan pays 80%.
• Out-of-Pocket Maximum: The maximum amount you pay each year for medical costs. After reaching the out-of-pocket maximum, the plan pays 100% of allowable charges for covered services.
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Find where you can save on your medication. Using your zip code, when you search for your medication Clever RX checks which pharmacies near you offer the lowest price. Savings can be up to 80% compared to what you're currently paying.
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Click the voucher with the lowest price, closest location, and/or at your preferred pharmacy. Click "share" to text yourself the voucher for easy access when you are ready to use it. Show the voucher on your screen to the pharmacist when you pick up your medication.
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Share the Clever RX App. Click "Share" on the bottom of the Clever RX App to send your friends, family, and anyone else you want to help receive instant discounts on their prescription medication. Over 70% of people can benefit from a prescription savings card.
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Life and AD&D OneAmerica
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/crandallisd
What you need to know about your Basic Life and AD&D Benefits
Guaranteed Issue: Employee: $10,000
Accidental Death and Dismemberment (AD&D): Additional life insurance benefits may be payable in the event of an accident which results in death or dismemberment as defined in the contract. Additional AD&D benefits include seat belt, air bag, repatriation, child higher education, child care, paralysis/loss of use, severe burns, disappearance, and exposure.
Accelerated Life Benefit: If diagnosed with a terminal illness and have less than 12 months to live, you may apply to receive 25%, 50% or 75% of your life insurance benefit to use for whatever you choose.
Basic Employee Life and AD&D Coverage
Your Life and AD&D insurance coverage amount is $10,000. Coverage is provided at no cost to you.
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/crandallisd
Summary of Benefits
Even with the best primary health insurance plan, out-of-pocket costs from a hospital stay can add up. Cigna’s Hospital Care plan pays a scheduled benefit if you or an insured dependent (spouse or child) are confined in a hospital for a covered illness or injury.
The benefits are paid to you and can help offset expenses that primary health insurance doesn’t cover (like deductibles, co-insurance amounts or co-pays), or benefits can be used for any non-medical expenses (like housing costs, groceries, car expenses, etc.).
Plan Highlights
• No Pre-existing Limitations!
• HSA Compatible
Claims
Call 800-754-3207 or email hospitalcare@cigna.com to file a claim. Group number on page 3 of this guide.
Available Coverage: The benefit amounts shown in this summary will be paid regardless of the actual expenses incurred and are paid on a per day basis unless otherwise specified. Benefits are only payable when all policy terms and conditions are met. Please read all the information in this summary to understand the terms, conditions, state variations, exclusions, and limitations applicable to these benefits. See your Certificate of Insurance for more information.
Hospital Chronic Condition Admission
No Elimination Period. Limited to 1 day, 1 benefit(s) every 180 days.
Hospital Stay
No Elimination Period. Limited to 30 days, 1 benefit(s) every 90 days. $150 per day
Hospital Intensive Care Unit (ICU) Stay
per day
No Elimination Period. Limited to 30 days, 1 benefit(s) every 90 days. $300 per day $300 per day
Hospital Observation Stay
24-hour Elimination Period. Limited to 72 hours. $500 per day $1,000 per day
Newborn Nursery Care Admission
Limited to 1 day, 1 benefit per newborn child. This benefit is payable to the employee even if child coverage is not elected.
Hospital Indemnity Cigna
Additional Information:
Hospital Admission: Must be admitted as an Inpatient due to a Covered Injury or Covered Illness. Excludes: treatment in an emergency room, provided on an outpatient basis, or for re-admission for the same Covered Injury or Covered Illness (including chronic conditions).
Hospital Chronic Condition Admission: Must be admitted as an Inpatient due to a covered chronic condition and treatment for a covered chronic condition must be provided by a specialist in that field of medicine. Excludes: treatment in an emergency room, provided on an outpatient basis, or for re-admission for the same Covered Injury or Covered Illness (including chronic conditions).
Hospital Stay: Must be admitted as an Inpatient and confined to the Hospital, due to a Covered Injury or Covered Illness, at the direction and under the care of a physician. If also eligible for the ICU Stay Benefit, only 1 benefit will be paid for the same Covered Injury or Covered Illness, whichever is greater. Hospital stays within 90 days for the same or a related Covered Injury or Covered Illness is considered one Hospital Stay.
Intensive Care Unit (ICU) Stay: Must be admitted as an Inpatient and confined in an ICU of a Hospital, due to a Covered Injury or Covered Illness, at the direction and under the care of a physician. If also eligible for the Hospital Stay Benefit, only 1 benefit will be paid for the same Covered Injury or Covered Illness, whichever is greater. ICU stays within 90 days for the same or a related Covered Injury or Covered Illness is considered one ICU stay.
Hospital Observation Stay: Must be receiving treatment for a Covered Injury or Covered Illness in a Hospital, including an observation room, or ambulatory surgical center, for more than 24 hours on a non-inpatient basis and a charge must be incurred. This benefit is not payable if a benefit is payable under the Hospital Stay Benefit or Hospital Intensive Care Unit Stay Benefit.
Newborn Nursery Care Stay: Must be admitted as an Inpatient and confined in a hospital immediately following birth at the direction and under the care of a physician.
Your benefits include reliable 24/7 health care by phone or video. Our national network of board-certified doctors provides personalized care for hundreds of medical and mental health needs. No surprise costs. No hassle. Just create an account to enroll.
URGENT CARE
On-demand care for illness and injuries.
Talk to a board-certified doctor in just minutes when you need care fast, including prescriptions.
Reliable and affordable alternative to urgent care clinics for more than 80 common, non-emergency conditions like flu, sinus infections, ear pain, and UTIs (Females, 18+).
MENTAL HEALTH
Talk therapy and psychiatry from the privacy of home.1
Licensed therapists and board-certified psychiatrists.
Schedule your appointment in as little as five days with after-hours and flexible sessions available. Meet Sophie, your personal assistant Text FBSBH to 635483 to create an account.
STEP 2: REQUEST AN APPOINTMENT.
Have an urgent care appointment right away, or schedule a time that works for you.
STEP 3: FEEL BETTER FASTER.
Get a diagnosis, treatment plan, and prescriptions, when appropriate, sent right to your preferred pharmacy.1
Employee Assistance Program (EAP) ComPsych
ABOUT EAP
An Employee Assistance Program (EAP) is a program that assists you in resolving problems such as finding child or elder care, relationship challenges, financial or legal problems, etc. This program is provided by your employer at no cost to you.
For full plan details, please visit your benefit website: www.mybenefitshub.com/crandallisd
Personal issues, planning for life events or simply managing daily life can affect your work, health and family. Your GuidanceResources program provides support, resources and information for personal and work-life issues. The program is company-sponsored, confidential and provided at no charge to you and your dependents. This flyer explains how GuidanceResources can help you and your family deal with everyday challenges.
Confidential Counseling 3 Session Plan
This no-cost counseling service helps you address stress, relationship and other personal issues you and your family may face. It is staffed by GuidanceConsultantsSM —highly trained master’s and doctoral level clinicians who will listen to your concerns and quickly refer you to in-person counseling (up to 3 sessions per issue per year) and other resources for:
• Stress, anxiety and depression
• Relationship/marital conflicts
• Problems with children
• Job pressures
• Grief and loss
• Substance abuse
Financial Information and Resources Discover your best options. Speak by phone with our Certified Public Accountants and Certified Financial Planners on a wide range of financial issues, including:
• Getting out of debt
• Credit card or loan problems
• Tax questions
• Retirement planning
• Estate planning
• Saving for college
Legal Support and Resources Expert info when you need it. Talk to our attorneys by phone. If you require representation, we’ll refer you to a qualified attorney in your area for a free 30-minute consultation with a 25% reduction in customary legal fees thereafter. Call about:
• Divorce and family law
• Debt and bankruptcy
• Landlord/tenant issues
• Real estate transactions
• Civil and criminal actions
• Contracts
Work-Life Solutions Delegate your “to-do” list.
Our Work-Life specialists will do the research for you, providing qualified referrals and customized resources for:
• Child and elder care
• Moving and relocation
• Making major purchase
• College planning
• Pet care
• Home repair
GuidanceResources® Online Knowledge at your fingertips. GuidanceResources Online is your one stop for expert information on the issues that matter most to you...relationships, work, school, children, wellness, legal, financial, free time and more.
• Timely articles, HelpSheetsSM , tutorials, streaming videos and self-assessments
• “Ask the Expert” personal responses to your questions
• Child care, elder care, attorney and financial planner searches
Free Online Will Preparation Get peace of mind. EstateGuidance® lets you quickly and easily write a will on your computer. Just go to www.guidanceresources.com and click on the EstateGuidance link. Follow the prompts to create and download your will at no cost. Online support and instructions for executing and filing your will are included. You can:
• Name an executor to manage your estate
• Choose a guardian for your children
• Specify your wishes for your property
• Provide funeral and burial instructions
CALL ANYTIME
Your ComPsych® GuidanceResources® Program TDD: 800.697.0353
Online: www.guidanceresources.com
Your company Web ID: ONEAMERICA3
Health Savings Account (HSA)
ABOUT HSA
A Health Savings Account (HSA) is a personal savings account where the money can only be used for eligible medical expenses. Unlike a flexible spending account (FSA), the money rolls over year to year however only those funds that have been deposited in your account can be used. Contributions to a Health Savings Account can only be used if you are also enrolled in a High Deductible Health Care Plan (HDHP). For full plan details, please visit your benefit website: www.mybeneitshub.com/sampleisd
www.mybenefitshub.com/crandallisd
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.
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/crandallisd
Network Options
Highlights
Class I: Diagnostic & Preventive Oral Evaluations, Prophylaxis: routine cleanings, X-rays: routine, X-rays: nonroutine, Fluoride Application, Sealants: per tooth, Space Maintainers: non-orthodontic
Class II: Basic Restorative Restorative: fillings, Endodontics: minor and major, Periodontics: minor and major, Oral Surgery: minor and major, Anesthesia: general and IV sedation, Emergency Care to Relieve Pain
Class III: Major Restorative Inlays and Onlays, Prosthesis Over Implant, Crowns: prefabricated stainless steel/resin, Crowns: permanent cast and porcelain, Bridges and Dentures, Denture Relines, Rebases and Adjustments, Repairs: Bridges, Crowns and Inlays, Repairs: Dentures
Class IV: Orthodontia Coverage for Dependent Children to age 19
Cigna Dental Choice Plan
Dental Insurance Cigna
Benefit Plan Provisions:
In-Network Reimbursement
Non-Network Reimbursement
Cross Accumulation
Calendar Year Benefits Maximum
Calendar Year Deductible
Pretreatment Review
Alternate Benefit Provision
Oral Health Integration Program (OHIP)
For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Fee Schedule or Discount Schedule.
For services provided by a non-network dentist, Cigna Dental will reimburse according to the Maximum Reimbursable Charge. The MRC is calculated at the 90th percentile of all provider charges in the geographic area. The dentist may balance bill up to their usual fees.
All deductibles, plan maximums, and service specific maximums cross accumulate between in and out of network. Benefit frequency limitations are based on the date of service and cross accumulate between in and out of network.
The plan will only pay for covered charges up to the yearly Benefits Maximum, when applicable. Benefit-specific Maximums may also apply.
This is the amount you must pay before the plan begins to pay for covered charges, when applicable. Benefit-specific deductibles may also apply.
Pretreatment review is available on a voluntary basis when dental work in excess of $200 is proposed.
When more than one covered Dental Service could provide suitable treatment based on common dental standards, Cigna HealthCare will determine the covered Dental Service on which payment will be based and the expenses that will be included as Covered Expenses.
Cigna Dental Oral Health Integration Program offers enhanced dental coverage for customers with the following medical conditions: diabetes, heart disease, stroke, maternity, head and neck cancer radiation, organ transplants and chronic kidney disease. There’s no additional charge for the program, those who qualify get reimbursed 100% of coinsurance for certain related dental procedures. Eligible customers can also receive guidance on behavioral issues related to oral health and discounts on prescription and non-prescription dental products. Reimbursements under this program are not subject to the plan deductible, but will be applied to and are subject to the plan annual maximum. Discounts on certain prescription and non-prescription dental products are available through Cigna Home Delivery Pharmacy only, and you are required to pay the entire discounted charge. For more information including how to enroll in this program and a complete list of program terms and eligible medical conditions, go to www.mycigna.com or call customer service 24/7 at 1.800.CIGNA24.
Timely Filing
Out of network claims submitted to Cigna after 365 days from date of service will be denied.
Please refer to the employee portal at www.mybenefitshub.com/crandallisd under the Dental section for complete policy details, limits, and exclusions. This document provides a summary only. It is not a contract.
Vision Insurance Superior Vision
ABOUT VISION
Vision insurance provides coverage for routine eye examinations and can help with covering some of the costs for eyeglass frames, lenses or contact lenses.
For full plan details, please visit your benefit website: www.mybenefitshub.com/crandallisd
Necessary Contact Lenses
Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements
1. Covered to provider’s in-office standard retail lined trifocal amount; member pays difference between progressive and standard retail lined trifocal, plus applicable co-pay
2. Contact lenses and related professional services (fitting, evaluation and follow-up) are covered in lieu of eyeglass lenses and frames benefit
3. Lasik Vision Correction is in lieu of eyewear benefit, subject to routine regulatory filings and certain exclusions and limitations
Discount features
Non-Covered Eyewear Discount: Members may also receive a discount of 20% from a participating provider’s usual and customary fees for eyewear purchases which exceed the benefit coverage (except disposable contact lenses, for which no discount applies). This includes eyeglass frames which exceed the selected benefit coverage, specialty lenses (i.e. progressives) and lens “extras” such as tints and coatings. Eyewear purchased from a Walmart Vision Center does not qualify for this additional discount because of Walmart’s “Always Low Prices” policy.
Need Help?
Call 800-507-3800 Customer Service.
Log In online at www.SuperiorVision.com or create an account on the mobile app.
Need to find an in-network provider?
Use this link: https://www.superiorvision.com/member/locate_provider?a=1
This is a summary of benefits so please refer to the employee portal www.mybenefitshub.com/crandallisd for complete details and exclusions.
Disability Insurance OneAmerica
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/crandallisd
What you need to know about your Group Educator Disability Benefits:
• Elimination Period: This is a period of consecutive days of disability before benefits may become payable under the contract.
• Maximum Benefit Duration: This is the length of time that you may be paid benefits if continuously disabled as outlined in the contract.
• Pre-Existing Condition Period: Certain disabilities are not covered if the cause of the disability is traceable to a condition existing prior to your effective date of coverage.
• Group Educator Disability Option
• You may select a benefit percentage of 66.67% of your earnings, up to a maximum monthly benefit of $7,500.
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For full benefit details, claim instructions, Added Value Benefits, limits and exclusions, visit your benefit website: www.mybenefitshub.com/crandallisd
Group Cancer Insurance
American Public Life (APL)
HELP COVER COSTS ASSOCIATED WITH THE DETECTION AND TREATMENT OF CANCER
Even the best major medical insurance may not cover all the out-ofpocket costs related to cancer treatment. APL’s Cancer Insurance* may help cover some of the expenses related to the treatment of covered cancer, daily living expenses and routine cancer screenings to help with early detection.
For full plan details, please visit your benefit website: www.mybenefitshub.com/sampleisd
www.mybenefitshub.com/crandallisd
Why buy cancer insurance
IMAGINE
You or a loved one is diagnosed with cancer Travel for the best treatment Expenses for care Missed work X X X
? The 5-year relative survival rate for all cancers diagnosed is 69% 1
11 of 12 cancer drugs approved by the FDA in 2012 were priced at more than $100,000 per year. 2
Group Cancer Insurance
American Public Life (APL)
If you or a family member are diagnosed with cancer, APL’s Cancer Insurance may help cover the costs associated with the detection and treatment of cancer and help you be more financially prepared.
How it works
CHOOSE the benefit options that best protect you and your family.
RECEIVE treatment for a covered benefit.
FILE your claim online or mail it in.
Benefits may help pay expenses related to cancer and routine screenings
With Cancer Insurance, you may be covered for:
Radiation Therapy, Chemotherapy, Immunotherapy
Experimental Treatments
Prescriptions
Transportation Benefits and more Plus, plan options are available to cover you, your spouse or your child(ren).
Your plan may include the following options
• Surgical Benefit Rider provides: Anesthesia, Skin Cancer, Reconstructive Surgery, Bone Marrow and Stem Cell Transplant benefits and more
• Patient Care Benefit Rider provides: Hospital Confinement, Outpatient Facility, Extended Care Facility, Donor Benefits, Home Health Care, Hospice benefits and more
• Miscellaneous Benefit Rider offers: Second/Third surgical opinion, drugs and medicine, patient and family transportation, blood, plasma and platelets and more
• Internal Cancer First Occurrence Optional Benefit Rider
• Heart Attack/Stroke Optional Rider
• ICU Optional Rider
A Hospital is a place that is not an institution, or part thereof, used as a place for rehabilitation, a place for rest or for the aged, a nursing or convalescent home, a longterm nursing unit of geriatrics ward, or an extended care facility for the care of convalescent, rehabilitative or ambulatory patients.
If the cancer insurance premium is paid on a pre-tax basis, the benefit may be taxable. Please contact your tax or legal advisor regarding tax treatment of your policy benefits.
Underwritten by American Public Life Insurance Company. This is a brief description of the coverage. This product contains Limitations, Exclusions and Waiting Periods. For complete benefits and other provisions, please refer to your policy/certificate. This coverage does not replace Workers’ Compensation Insurance. This product is inappropriate for people who are eligible for Medicaid coverage. This policy is considered an employee welfare benefit plan established and/or maintained by an association or employer intended to be covered by ERISA, and will be administered and enforced under ERISA. Group policies issued to governmental entities and municipalities may be exempt from ERISA guidelines. Policy Form GC14APL Series | Policy Form GC-3 series
*This Cancer Policy provides limited benefits.
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/crandallisd
What
you
need to know about
your
Voluntary Term Life and AD&D Benefits
Flexible Options:
• Employee: $10,000 to $500,000, in $10,000 increments
• Spouse: $10,000 to $500,000, in $5,000 increments, not to exceed 100% of the employee’s amount
Guaranteed Issue:
• Employee: $150,000
• Spouse: $50,000
• Child: $10,000
Dependent Life Coverage: Optional dependent life coverage is available to eligible employees. You must select employee coverage in order to cover your spouse and/or child(ren).
Accidental Death and Dismemberment (AD&D):
You must select Life coverage in order to select any AD&D coverage. Additional life insurance benefits may be payable in the event of an accident which results in death or dismemberment as defined in the contract.
Spouse rates based on Employee’s age
Accelerated Life Benefit: If diagnosed with a terminal illness and have less than 12 months to live, you may apply to receive 25%, 50% or 75% of your life insurance benefit to use for whatever you choose.
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.
Flexible Spending Account (FSA)
ABOUT FSA
A Flexible Spending Account allows you to pay for eligible healthcare expenses with a pre-loaded debit card. You choose the amount to set aside from your paycheck every plan year, based on your employer’s annual plan limit. This money is use it or lose it within the plan year.
For full plan details, please visit your benefit website: www.mybenefitshub.com/sampleisd
www.mybenefitshub.com/crandallisd
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 not contribute to a Health Care FSA if you contribute to a Health Savings Account (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.
• Review your employer's Summary Plan Document for full details. FSA rules vary by employer.
Over-the-Counter Item Rule Reminder
Health care reform legislation requires that certain over-the-counter (OTC) items require a prescription to qualify as an eligible Health Care FSA expense. You will only need to obtain a one-time prescription for the current plan year. You can continue to purchase your regular prescription medications with your FSA debit card. However, the FSA debit card may not be used as payment for an OTC item, even when accompanied by a prescription.
Higginbotham Portal
The Higginbotham Portal provides information and resources to help you manage your FSAs.
• Access plan documents, letters and notices, forms, account balances, contributions and other plan information
• Update your personal information
• Utilize Section 125 tax calculators
• Look up qualified expenses
• Submit claims
• Request a new or replacement Benefits Debit Card
Register on the Higginbotham Portal
Visit https://flexservices.higginbotham.net and click Register. Follow the instructions and scroll down to enter your information.
• Enter your Employee ID, which is your Social Security number with no dashes or spaces.
• Follow the prompts to navigate the site.
• If you have any questions or concerns, contact Higginbotham:
∗ Phone – 866-419-3519
∗ Questions – flexsupport@higginbotham.net
∗ Fax – 866-419-3516
∗ Claims- flexclaims@higginbotham.net
Sick Leave Bank
Crandall ISD
ABOUT SICK LEAVE BANK
This is a brief overview of the district’s policy. Full Disclosure and content is available on the employee benefits portal.
For full plan details, please visit your benefit website: www.mybenefitshub.com/crandallisd
I. PURPOSE: The Crandall ISD Sick Leave Bank will provide additional sick leave days to members of the bank in the event of catastrophic illness, surgery, or temporary disability due to an injury or under The Family Medical Leave Act programs. Days may be requested from the bank only after the member has exhausted all accumulated state and local sick leave, personal business, and extended leave days.
II. ELIGIBILITY: All regularly employed personnel are eligible to participate. Participation is voluntary but is required in order to be eligible to apply for the Crandall ISD Sick Leave Bank.
III. ENROLLMENT: Open enrollment to the bank shall begin from the beginning of each school year through September 30th. New employees hired during a school year may enroll in bank within 30 days of employment. Those employees who elect not to enroll in the bank shall not be permitted to enroll until the following annual open enrollment period. Employees will be required to elect to enroll in the bank annually.
IV. CONTRIBUTION: Any employee who is eligible to enroll in the Crandall ISD Sick Leave Bank may do so by donating 1 day of his or her accrued local sick leave days. Any member, however, using 10 days or more from the bank must donate one local sick leave days at the beginning of the next school year to be reinstated in Crandall ISD Sick Leave Bank. The days donated will be subtracted from the members’ total local sick days. All donations will remain in force and cannot be returned even upon cancellation of membership. In order to maintain the sick leave bank the contribution of additional days may become necessary up to a maximum of 2 days per year, per member.
V. RULES AND PROCUDURES: Should there be a catastrophic illness or injury of the member, or of a person in the member’s immediate family (as defined in the policy), necessitating the need for additional days after all accumulate state and local sick leave, personal, and extended leave days (if applicable) have been used, the member may submit a request for days from the bank. Requests should be made through the Benefits Specialist. All required forms must be completed at the time of the request.
No one is immune to identity theft.
Better Protect What Matters Most.
Identity theft can affect anyone—from infants to seniors. Each generation has habits that savvy criminals know how to exploit—resulting in over $43 billion lost to identity fraud in the U.S. in 2022. Take action with award-winning ID Watchdog identity theft protection.
Greater Peace of Mind
With ID Watchdog as an employee benefit, you have a more convenient and affordable way to help better protect and monitor your identity. You’ll be alerted to potentially suspicious activity and enjoy greater peace of mind knowing you don't have to face identity theft alone.
Why Choose ID Watchdog?
We scour billions of data points— public records, transaction records, social media and more—to search for signs of potential identity theft.
We've got you covered with lock features for added control over your credit report(s) to help keep identity thieves from opening new accounts in your name.
Best in
If you become a victim, you don’t have to face it alone. One of our certified resolution specialists will personally manage the case for you until your identity is restored.
Our family plan helps you better protect your loved ones with personalized accounts for adult family members, family alert sharing, and exclusive features for children.
Powerful Features Included in Both ID Watchdog Plans
Financial Accounts Monitoring
Social Accounts Monitoring
Registered Sex Offender Reporting
Blocked Inquiry Alerts | 1 Bureau
Customizable Alert Options
National Provider ID Alerts
Integrated Fraud Alerts
With a fraud alert, potential lenders are encouraged to take extra steps to verify your identity before extending credit.
Dark Web Monitoring
Data Breach Notifications
High-Risk Transactions Monitoring
Subprime Loan Monitoring
Public Records Monitoring
USPS Change of Address Monitoring
Telecom & Utility Alerts | 1 Bureau
Credit Score Tracker | 1 Bureau
Personalized Identity Restoration
including Pre-Existing Conditions
Online Resolution Tracker
Lost Wallet Vault & Assistance
Deceased Family Member Fraud
Remediation (Family Plan only)
Credit Freeze Assistance
Solicitation Reduction
Help better protect children with Equifax Child Credit Lock & Equifax Child Credit Monitoring PLUS features marked with this icon
Plan-Specific Features
Credit Report Monitoring
Credit Report(s) & VantageScore Credit Score(s)
Credit Report Lock
Subprime Loan Block
within the monitored lending network
Personal VPN and Password Manager
Device Security & Online Privacy
Personal Data Scans & Removal
to $1 Million Up to $1M Stolen Funds Reimbursement -
Essentials
to $1 Million Up to $1M Stolen Funds Reimbursement -
and savings accounts
Essentials Up to $2 Million Up to $2M Stolen Funds Reimbursement - Checking and savings accounts -401k/HSA/ESOP accounts
Home Title Fraud NEW Cyber Extortion
Professional Identity Fraud Deceased Family Member Fraud
What You Need to Know
The credit scores provided are based on the VantageScore 3.0 model. For three-bureau VantageScore credit scores, data from Equifax, Experian, and TransUnion are used respectively. Any one-bureau VantageScore uses Equifax data. Third parties use many different types of credit scores and are likely to use a different type of credit score to assess your creditworthiness.
(1)The Integrated Fraud Alert feature is made available to consumers by Equifax Information Services LLC and fulfilled on its behalf by Identity Rehab Corporation. (2)There is no guarantee that ID Watchdog is able to locate and scan all deep and dark websites where consumers' personal information is at risk of being traded. (3)The monitored network does not cover all businesses or transactions. (4)For low Family Plans, applicable for enrolled family members only. (5)Monitoring from Equifax will begin on your plan start date. TransUnion and Experian will take several days to begin after you create an online account. (6)Locking your Equifax or TransUnion credit report will prevent access to it by certain third parties. Locking your Equifax or TransUnion credit report will not prevent access to your credit report at any other credit reporting agency. Entities that may still have access to your Equifax or TransUnion credit report include: companies like ID Watchdog and TransUnion Interactive, Inc. which provide you with access to your credit report or credit score, or monitor your credit report as part of a subscription or similar service; companies that provide you with a copy of your credit report or credit score, upon your request; federal, state, and local government agencies and courts in certain circumstances; companies using the information in connection with the underwriting of insurance, or for employment, tenant or background screening purposes; companies that have a current account or relationship with you, and collection agencies acting on behalf of those whom you owe; companies that authenticate a consumer’s identity for purposes other than granting credit, or for investigating or preventing actual or potential fraud; and companies that wish to make pre approved offers of credit or insurance to you. To opt out of preapproved offers, visit www.optoutprescreen.com.
(7)Available for simultaneous use on up to 6 devices. (8)Equip up to 5 devices; 10 with a Family Plan. (10)May be subject to delay or change. To review ID Watchdog Terms & Conditions, go to idwatchdog.com/terms. (9)The Identity Theft Insurance is underwritten and administered by American Bankers Insurance Company of Florida, an Assurant company. Please refer to the actual policies for terms, conditions, and exclusions of coverage. Coverage may not be available in all jurisdictions. Review the Summary of Benefits (www.idwatchdog.com/terms/insurance).
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 Crandall 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 Crandall 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.