2024-25 Denton ISD Benefit Guide by Higginbotham Public Sector

09/01/2024 - 08/31/2025

Benefit Contact Information

ISD

Higginbotham Public Sector (866) 914-5202 www.mybenefitshub.com/dentonisd

Cigna Group #3340946 (800) 244-6224 www.mycigna.com

Denton ISD Benefits Department (940) 369-0028 benefits@dentonisd.org PO Box 1951 1307 N Locust St Denton, TX. 76201 www.dentonisd.org/Domain/74

Blue Cross Blue Shield of Texas Group #369750 (800) 521-2227 www.bcbstx.com

Blue Cross Blue Shield of Texas HMO Gold Group #359485 HMO Platinum Group #359482 HSA HDHP Group #359458 (800) 521-2227 www.bcbstx.com

Blue Cross Blue Shield of Texas Group #VF029182 (800) 521-2227 www.bcbstx.com DISABILITY

The Hartford Group #G681062 (800) 523-2233 www.thehartford.com

Lincoln Financial Group Group #1040763 (800) 423-2765 www.lfg.com

FLEXIBLE SPENDING ACCOUNTS (FSA) EAP

Higginbotham (866) 419-3519 www.higginbotham.net

The Hartford (800) 964-3577 www.guidanceresources.com

Blue Cross Blue Shield of Texas Group #VF029182 (800) 521-2227 www.bcbstx.com

HEALTH SAVINGS ACCOUNT (HSA)

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

HOSPITAL INDEMNITY EMERGENCY MEDICAL TRANSPORTATION TELEHEALTH + BEHAVIORAL HEALTH

Cigna Group #HC110440 (800) 754-3207 www.cigna.com

MASA

Group #B2BDenton (800) 423-3226 claims@masaglobal.com

MDLive (888) 365-1663

www.MDLIVE.COM/FBSBH

www.mybenefitshub.com/dentonisd

CLICK LOGIN

Enter your Information

• Last Name

• Date of Birth

• Last Four (4) of Social Security Number

NOTE: THEbenefitsHUB uses this information to check behind the scenes to confirm your employment status.

Once confirmed, the Additional Security Verification page will list the contact options from your profile. Select either Text, Email, Call, or Ask Admin options to receive a code to complete the final verification step.

Enter the code that you receive and click Verify. You can now complete your benefits enrollment!

Annual Benefit Enrollment

Annual Enrollment

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

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

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

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

New Hire Enrollment

All new hire enrollment elections must be completed in the online enrollment system within the first 31 days of benefit eligible employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.

Q&A

Who do I contact with Questions?

For supplemental benefit questions, you can contact your Benefits department or you can call Higginbotham Public Sector at (866) 914-5202 or email benefits@dentonisd.org for assistance.

Where can I find forms?

For benefit summaries and claim forms, go to your benefit website: www.mybenefitshub.com/dentonisd. 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 Denton ISD benefit website: www.mybenefitshub. com/dentonisd. 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.

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 31 days of your qualifying event and meet with your Benefit Office to complete and sign the necessary paperwork in order to make a benefit election change. Benefit changes must be consistent with the qualifying event.

QUALIFYING EVENTS

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

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

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

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

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

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

Annual Benefit Enrollment

Employee Eligibility Requirements

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

Eligible employees must be actively at work on the plan effective date for new benefits to be effective, meaning you are physically capable of performing the functions of your job on the first day of work concurrent with the plan effective date. For example, if your 2024 benefits become effective on September 1, 2024, you must be actively-at-work on September 1, 2024 to be eligible for your new benefits.

Dependent Eligibility Requirements

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

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

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

FSA/HSA Limitations: Please note, in general, per IRS regulations, married couples may not enroll in both a Flexible Spending Account (FSA) and a Health Savings Account (HSA). If your spouse is covered under an FSA that reimburses for medical expenses then you and your spouse are not HSA eligible, even if you would not use your spouse’s FSA to reimburse your expenses. However, there are some exceptions to the general limitation regarding specific types of FSAs. To obtain more information on whether you can enroll in a specific type of FSA or HSA as a married couple, please reach out to the FSA and/or HSA provider prior to enrolling or reach out to your tax advisor for further guidance.

Potential Dependent Coverage Limitations: When enrolling for dependent coverage, please keep in mind that some benefits may not allow you to cover your eligible dependents if they are enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Higginbotham Public Sector, or contact the insurance carrier for additional information on dependent eligibility.

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 Benefit Administrator to request a continuation of coverage.

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.

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 None

Minimum Deductible

Maximum Contribution

Permissible Use Of Funds

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

$1,600 single (2024)

$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?

Yes

Portable? 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.

Basic Life and AD&D

ABOUT LIFE AND AD&D

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

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

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

Eligibility

All Active Full-Time Employees

Group Term Life Benefit: Employee $15,000

Guarantee Issue Amount - Employee $15,000

Group Term Life Age Reduction Schedule No Reduction

Waiver of Premium

Elimination Period: 6 Months; Duration: To Social Security Normal Retirement Age

Accelerated Death Benefit (ADB) Benefit: Up to 75% of the employee’s life insurance; Life expectancy: 12 months or less

Portability Feature (Life Coverage) Not Included Conversion Included

Beneficiary Resource Service

Travel Resource Services

Group AD&D Benefit:

AD&D Age Reduction Schedule

Loss

Loss of sight of

Loss of one hand and sight of one eye

Loss of one foot and sight of one eye

Includes grief, legal and financial counseling for beneficiaries, funeral planning; and online legal library, including templates to create a legal will and other legal documents.

Helps travelers with the unexpected that may take place while traveling. Services include emergency medical assistance, financial, legal and communication assistance and access to other critical services and resources available via the Internet.

Same as Basic Life

AD&D PRODUCT FEATURES INCLUDED:

S Seatbelt Benefit

S Airbag Benefit

S Repatriation Benefit

S Education Benefit

S Day Care Benefit

Loss of sight of one eye

Loss of one hand or one foot

Loss of speech or hearing

Loss of thumb and index finger of the same hand

Uniplegia

*Loss must occur within 365 days of accident.

Employee Assistance Program (EAP)

The Hartford

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/dentonisd

Compassionate solutions for common challenges.

From everyday issues like job pressures, relationships, retirement planning or the personal impact of grief, loss, or a disability, Ability Assist can be your resource for professional support. You and your family, including your spouse and dependents, can access Ability Assist.

Service Features

The service includes access to ComPsych HealthChampion℠ service and up to three face-to-face emotional or work-life counseling sessions per occurrence per year. This means you and your family members won’t have to share visits. Each individual can get counseling help for his/ her own unique needs. Legal and financial counseling are also available by telephone during business hours. HealthChampion offers unlimited access to services.

Ability Assist Counseling Services

Emotional or worklife counseling

Financial information and resources

Legal support and resources

It helps address stress, relationships, or other personal issues you or your family members may face. It is staffed by GuidanceExpertsSM—highly trained master’s and doctoral level clinicians—who listen to concerns and quickly make referrals to in-person counseling or other valuable resources. Situations may include:

• Job pressures.

• Relationship/marital conflicts.

• Stress, anxiety and depression.

• Work/school disagreements.

• Substance abuse.

• Child and elder care referral services.

Provides support for the complicated financial decisions you or your family members may face. Speak by phone with a Certified Public Accountant and Certified Financial Planners on various financial issues. Topics may include:

• Managing a budget.

• Retirement.

• Getting out of debt.

• Tax questions.

• Saving for college.

Offers assistance if legal uncertainties arise. Talk to an attorney by phone about important issues to you or your family members. If you require representation, you’ll be referred to a qualified attorney in your area with a 25% reduction in customary legal fees thereafter. Topics may include:

• Debt and bankruptcy.

• Guardianship.

• Buying a home.

• Power of attorney.

HealthChampionSM

• Divorce.

A service that supports you through all aspects of your health care issues by helping to ensure that you’re fully supported with employee assistance programs and/or work-life services. HealthChampion is staffed by both administrative and clinical experts who understand the nuances of any given health care concern. Situations may include:

• One-on-one review of your health concerns

• Preparation for upcoming doctor’s visits/lab work/tests/ surgeries

• Answers regarding diagnosis and treatment options

• Coordination with appropriate health care plan provider(s)

Extras that support and assist.

On the phone: Just one simple call. For access over the phone, simply call toll-free 1-800-96-HELP (1-800-964-3577)

Online: The point is simplicity. You’ll also have 24/7 access to GuidanceResources® Online (offered by ComPsych).1

• An easy-to-understand explanation of your benefits–what’s covered and what’s not

• Cost estimation for covered/non-covered treatment

• Guidance on claims and billing issues

• Fee/payment plan negotiation

This award-winning resource provides trusted information, resources, referrals and answers to everyday questions right from your desktop or the privacy of your home.

It includes:

• Chat sessions with professional moderators.

• Access to hundreds of personal health topics and resources for childcare, elder care, attorneys, or financial planners.

Visit www.guidanceresources.com to create your own personal username and password. If you’re a first-time user, you’ll be asked to provide the following information on the profile page:

1. In the Company/Organization field, use: hlf902

2. Then, create your own confidential username and password.

3. Finally, in the Company Name field at the bottom of the personalization page, use: ABILI

DENTON ISD EMPLOYEES MEDICARE NOTICE!

Your Prescription Drug Coverage and Medicare

Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Southwest Wholesale Nursery about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to enroll in a Medicare drug plan. If neither you nor any of your covered dependents are eligible for or have Medicare, this notice does not apply to you or the dependents, as the case may be. However, you should still keep a copy of this notice in the event you or a dependent should qualify for coverage under Medicare in the future. Please note, however, that later notices might supersede this notice.

1.Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage through a Medicare Prescription Drug Plan or a Medicare Advantage Plan that offers prescription drug coverage. All Medicare prescription drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.

2.Southwest Wholesale Nursery as determined that the prescription drug coverage offered by the Southwest Wholesale Nursery plan is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage pays and is considered Creditable Coverage. Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to enroll in a Medicare prescription drug plan, as long as you later enroll within specific time periods.

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.mybenefitshub.com/dentonisd

www.mybenefitshub.com/dentonisd

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 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/dentonisd

www.mybenefitshub.com/dentonisd

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

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

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/dentonisd

Hospital Care coverage provides a benefit when a Covered Person incurs a hospital stay resulting from a Covered Injury or Covered Illness.

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.

Benefit Waiting Period: None, unless otherwise stated. No benefits will be paid for a loss which occurs during the Benefit Waiting Period.

Chronic Condition Admission

Elimination Period. Limited to 1

Hospital Observation Stay

24 hour Elimination Period. Limited to 72 hours.

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 Admission

Limited to 1 day, 1 benefit per newborn child. This benefit is payable to the employee even if child coverage is not elected.

Newborn Nursery Care Stay

Limited to 30 days, 1 benefit per newborn child. This benefit is payable to the employee even if child coverage is not elected.

How do I submit a claim?

Complete the claim form with the link provided below: https://www.cigna.com/static/www-cigna-com/docs/individuals-families/member-resources/hospital-care-claim-form.pdf

Options for filing the Claim Form:

• Call (800) 754-3207 to speak with one of our dedicated customer service representatives.

• Email your scanned documents to: SuppHealthClaims@Cigna.com

Hospital Indemnity Cigna

Portability Feature: You, your spouse, and child(ren) can continue 100% of your coverage at the time your coverage ends. You must be covered under the policy and be under the age of 100 in order to continue your coverage. Rates may change and all coverage ends at age 100. Applies to United States Citizens and Permanent Resident Aliens residing in the United States

Benefit Amounts Payable: Benefits for all Covered Persons are payable at 100% of the Benefit Amounts shown, unless otherwise stated. Late applicants, if allowed under this plan, may be required to provide medical evidence of insurability.

Benefit-Specific Conditions, Exclusions & Limitations (Hospital Care):

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 Admission and 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.

Telehealth + Behavioral Health

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.mybenefitshub.com/dentonisd

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

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

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

• Are unable to see your primary care physician

When to Use MDLIVE:

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

• Sore throat

• Headache

• Stomachache

• Cold

• Flu

• Allergies

• Fever

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

MDLIVE Behavioral Health:

Managing stress or life changes can be overwhelming but it’s easier than ever to get help right in the comfort of your own home. Visit a counselor or psychiatrist by phone, secure video, or MDLIVE App.

• Talk to a licensed counselor or psychiatrist from your home, office, or on the go!

• Affordable, confidential online therapy for a variety of counseling needs.

• The MDLIVE app helps you stay connected with appointment reminders, important notifications and secure messaging.

Registration is Easy

• Online – www.mdlive.com/fbsbh

• Phone – (888) 365-1663

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

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

Telehealth

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/dentonisd

In-Network Reimbursement: For services provided by a BCBSTX contracting dentist, BCBSTX will reimburse the dentist according to a Fee Schedule or Discount Schedule.

Non-Network Reimbursement: For services provided by a non-contracting dentist, BCBSTX will reimburse according to the Maximum Allowable Charge. The dentist may balance bill up to their usual fees.

BlueCare Dental Network – Low Plan Program Basics

Oral Surgery Services: Surgical tooth extractions; Alveoloplasty and vestibuloplasty xcision of benign odontogenic tumor/cyst; Excision of bone tissue; Incision and drainage of an intraoral abscess (Bony impactions typically

under medical plan)

Surgical Periodontal Services: Gingivectomy or gingivoplasty and gingival flap procedures; Clinical crown lengthening; Osseous surgery; Osseous grafts; Soft tissue grafts/allografts; Distal or proximal wedge procedure

Major Restorative Services: Single crown restorations; Inlay/onlay restorations; Labial veneer restorations; Crowns placed over implants

Prosthodontic Services: Complete and removable partial dentures; Denture reline/rebase procedures; Fixed bridgework; Prosthetics placed over implants

Misc. Restorative & Prosthodontic Services: Prefabricated crowns; Recementations; Post and core, pin retention and crown/bridge repairs; Adjustments

Orthodontics (Deductible Not Waived): Orthodontic Diagnostic Procedures and Treatment Not Covered Not Covered

Dental

Diagnostic: Periodic oral evaluations; Problem focused oral evaluations; Comprehensive oral evaluations

Non-Surgical Periodontic Services: Periodontal scaling and root planing; Full-mouth debridement; Periodontal

Endodontic Services: Therapeutic pulpotomy and pulpal debridement; Root canal therapy; Apexification/recalcification

Major Restorative Services: Single crown restorations; Inlay/onlay restorations; Labial veneer restorations; Crowns placed over implants

Prosthodontic Services: Complete and removable partial dentures; Denture reline/rebase procedures; Fixed bridgework; Prosthetics placed over implants

Misc. Restorative & Prosthodontic Services: Prefabricated crowns; Recementations; Post and core, pin retention and crown/bridge repairs; Adjustments

Orthodontics (Deductible Not Waived): Orthodontic Diagnostic Procedures and Treatment

In-Network Reimbursement: For services provided by a BCBSTX contracting dentist, BCBSTX will reimburse the dentist according to a Fee Schedule or Discount Schedule.

Non-Network Reimbursement: For services provided by a non-network dentist, BCBSTX will reimburse according to the Maximum Reimbursable Charge. The MRC is calculated at the 90th percentile of all providers submitted amounts in the geographic area. The dentist may balance bill up to their usual fees.

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/dentonisd

DHMO PLAN

If you enroll in the DHMO plan, you must select a Primary Care Dentist (PCD) from the DHMO network directory to manage your care. Each eligible dependent may choose their own PCD. The Patient Charge Schedule applies only when covered dental services are performed by your network dentist. Not all Network Dentist perform all listed services and it is suggested to check with your Network Dentist in advance of receiving services. Dental services are unlimited; you pay fixed co-pays, there are no deductibles and there are no claim forms to file. There is no coverage for services provided without a referral from your PCD or if you seek care from out-of-network providers. Please refer to your benefit website for full details.

How do I find an In-network Dentist? Visit: https://hcpdirectory.cigna.com/ or call (800) 244-6224 to find an in-network dentist. Your network will be Cigna Dental Care DHMO.

Vision Insurance Blue Cross Blue Shield

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/dentonisd

Exam with dilation as necessary

Retinal Imaging

Frequency

Examination

Lenses or contact lenses

Frame

Exam options

Contact lens fit and follow up

Frames Any available frame at provider location

Standard Plastic Lenses

Single vision

Bifocal

Trifocal

Once every 12 months

Standard: $25 copay, paid in full fit and two follow up visits; Premium: $25 copay, 10% off retail price, then apply $50 allowance

$0 Copay/$125 Allowance/20% off

$20 copay

Lenticular $20 copay

Standard progressive lens $85 copay

Premium progressive lens See table below

Lens options UV treatment

Tint (solid and gradient)

Contact lenses (contact lens allowance includes materials only) Conventional

Disposable

Medically necessary

Lasik or PRK from U.S. Laser Network

Additional pairs benefit: Members also receive a 40% discount off complete pair eyeglass purchase and a 15% discount off conventional contact lenses once the funded benefit has been used.

Vision

Insurance

Blue Cross Blue Shield

Progressive price list*

• Standard progressive

• Premium progressives - Tier 1

• Premium progressives - Tier 2

• Premium progressives - Tier 3

• Premium progressives - Tier 4

• Anti-reflective coating price list*

• Standard anti-reflective coating

• Premium anti-reflective coatings - Tier 1

• Premium anti-reflective coatings - Tier 2

Member cost in-network

$85 copay

$105

$115

$130

$85 copay, 80% of charge less $120 Allowance

Member cost in-network

$45

$57

$68

• Premium anti-reflective coatings - Tier 3 80% of charge

• Other add-ons price list

• Photochromic (plastic)

Member cost in-network

$75

• Polarized 80% of charge

Exam with dilation as necessary

Retinal Imaging

Frequency

Examination

Lenses or contact lenses

Frame

Exam options

Contact lens fit and follow up

Frames - Any available frame at provider location

Standard Plastic Lenses

Single vision

Bifocal

Trifocal

Lenticular

Standard progressive lens

Premium progressive lens

Lens options

UV treatment

Tint (solid and gradient)

Standard plastic scratch coating

Standard polycarbonate – adults

$10 copay

$39

Once every 12 months

Standard: $25 copay, paid in full fit and two follow up visits; Premium: $25 copay, 10% off retail price, then apply $50 allowance Up to $40

$0 Copay/$150 Allowance/20% off

$20 copay

$85 copay

to $34

to $50

to $80

Up to $50

See table below Up to $50

$15

N/A

$15 N/A

$0 Up to $8

$0 Up to $20

Standard polycarbonate – kids under 19 $0 Up to $20

Standard anti-reflective coating

$45 N/A

Polarized 20% off retail price N/A

Photochromatic/transitions plastic

Premium anti-reflective

$0 Up to $38

See table below N/A

Contact lenses (contact lens allowance includes materials only)

Conventional

Disposable

Medically necessary

$0 copay/$150 Allowance/15% off balance Up to $100

$0 copay/$150 Allowance/Plus balance over $150 Up to $100

$0 copay, Paid in full Up to $210

Lasik or PRK from U.S. Laser Network 15% off retail price or 5% off promotional price N/A

Additional pairs benefit: Members also receive a 40% discount off complete pair eyeglass purchase and a 15% discount off conventional contact lenses once the funded benefit has been used. N/A

Progressive price list*

Member cost in-network

• Standard progressive $85 copay

• Premium progressives - Tier 1 $105

• Premium progressives - Tier 2 $115

• Premium progressives - Tier 3 $130

• Premium progressives - Tier 4 $85 copay, 80% of charge less $120 Allowance

• Anti-reflective coating price list*

Member cost in-network

• Standard anti-reflective coating $45

• Premium anti-reflective coatings - Tier 1 $57

• Premium anti-reflective coatings - Tier 2 $68

• Premium anti-reflective coatings - Tier 3 80% of charge

• Other add-ons price list

• Photochromic (plastic)

Member cost in-network

• Polarized 80% of charge

Disability Insurance The Hartford

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/dentonisd

What is Educator Disability Insurance?

Educator Disability insurance is a hybrid that combines features of short-term and long-term disability into one plan. Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. The plan gives you flexibility to be able to choose an amount of coverage and waiting period that suits your needs. We offer Educator Disability insurance for you to purchase through The Hartford.

If you need to file a claim, please contact The Hartford at (866) 278-2655 and provide Group# 681062.

Actively at Work: You must be at work with your Employer on your regularly scheduled workday. On that day, you must be performing for wage or profit all 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.

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

Benefit Amount: You may purchase coverage that will pay you a monthly flat dollar benefit in $100 increments between $200 and $8,000 that cannot exceed 66 2/3% of your current monthly earnings. Earnings are defined in The Hartford’s contract with your employer.

Elimination Period: You must be disabled for at least the number of days indicated by the elimination period that you select before you can receive a disability benefit payment. The elimination period that you select consists of

two numbers. The first number shows the number of days you must be disabled by an accident before your benefits can begin. The second number indicates the number of days you must be disabled by a sickness before your benefits can begin.

For those employees electing an elimination period of 30 days or less, if you are confined to a hospital for 24 hours or more due to a disability, the elimination period will be waived, and benefits will be payable from the first day of hospitalization.

Definition of Disability: Disability is defined as The Hartford’s contract with your employer. Typically, disability means that you cannot perform one or more of the essential duties of your occupation due to injury, sickness, pregnancy, or other medical conditions covered by the insurance, and as a result, your current monthly earnings are 80% or less of your pre-disability earnings. One you have been disabled for 24 months, you must be prevented from performing one or more essential duties of any occupation, and as a result, your monthly earnings are 66 2/3% or less of your pre-disability earnings.

Pre-Existing Condition Limitation: Your policy limits the benefits you can receive for a disability caused by a pre-existing condition. In general, if you were diagnosed or received care for a disabling condition within the 3 consecutive months just prior to the effective date of this policy, your benefit payment will be limited, unless: You have been insured under this policy for 12 months before your disability begins.

If your disability is a result of a pre-existing condition, we will pay benefits for a maximum of 4 weeks. for at least the number of days indicated by the elimination period that you select before you can receive a disability benefit

Disability Insurance

The Hartford

Benefit Integration: Your benefit may be reduced by other income you receive or are eligible to receive due to your disability, such as:

• Social Security Disability Insurance

• State Teacher Retirement Disability Plans

• Workers’ Compensation

• Other employer-based disability insurance coverage you may have

• Unemployment benefits

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

Your plan includes a minimum benefit of $100.

Maximum Benefit Duration: Benefit Duration is the maximum time for which we pay benefits for disability resulting from sickness or injury. Depending on the schedule selected and the age at which disability occurs, the maximum duration may vary. Please see the applicable schedules below based on your election of either the Gold Premium or Silver Select benefit options.

• Gold Premium Option: For the Gold benefit option –the table below applies to disabilities resulting from sickness or injury

• Silver Select Option: For the Silver benefit option – the table below applies to disabilities resulting from injury

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.mybenefitshub.com/dentonisd

Employee - Guaranteed coverage amounts

Spouse - Guaranteed coverage amount

Child(ren) - Guaranteed coverage amount

$10,000, $20,000, $30,000, $40,000 or $50,000

$10,000, $20,000, $30,000, $40,000 or $50,000 (up to 100% of the employee coverage amount)

$10,000, $20,000, or $25,000 (up to 100% of the employee coverage amount)

Critical Illness Insurance

Lincoln Financial Group

Life and AD&D

ABOUT LIFE AND AD&D

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

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

Life and AD&D

Denton Independent School District

Eligibility

You are eligible to enroll if you work the minimum number of hours per week by your employer, and you have satisfied any waiting period.

Supplemental Life and AD&D

Employee Benefit:

Spouse Benefit:

$10,000 to $500,000 in $10,000 increments

$5,000 to $250,000 in $5,000 increments (not to exceed 100% of the employee benefit)

Note: Spouse may not have coverage unless the employee has coverage. The Spouse amount may not exceed the amount for which the employee is eligible.

35%

Spouse

Emergency Medical Transport

ABOUT MEDICAL TRANSPORT

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

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

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 non-emergency air or ground transportation between medical facilities.

Repatriation/Recuperation

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

Should you need assistance with a claim contact MASA at (800) 6439023. You can find full benefit details at: www.mybenefitshub.com/dentonisd

DENTON PUBLIC SCHOOL FOUNDATION TEACHER-TO-TEACHER

EMPLOYEE GIVING

Thanks to contributions like yours and your co-workers, the DPSF Teacher2Teacher Employee Giving Campaign creates annual funding for Teacher Grants and Student Scholarships through monthly payroll deductions

$9,000 is set aside for 2 scholarships at each comprehensive high school and one at LaGrone Academy for DISD seniors going into education.

The remaining annual funds are used to provide Grants to Teachers for classroom enrichment.

Y You can see the impact of providing a grant or scholarship here - https://youtu be/ qZ7L7r3a8A

E Every dollar counts and no contribution is too small. THEbenefitsHUB online enrollment system offers you the opportunity to make your contribution during our annual open enrollment and will be payroll deducted each month

Thank you for choosing this way to support your fellow educators!

SICK LEAVE BANK (SLB) GUIDELINES AND HANDBOOK

PROPOSAL

PURPOSE AND DEFINITIONS:

A. Purpose

The Denton ISD Sick Leave Bank is a benefit that provides additional local leave days to employees and their immediate family member(s) who are experiencing an extended, catastrophic, incapacitating, personal illness or injury that forces them to exhaust all accumulated paid leave and to lose compensation from the District

B. Sick Leave Bank

The DISD Sick Leave Bank is a collective deposit of local leave days contributed by enrolled employees and subsequent contributions from members All days deposited into the bank become the property of the bank and are no longer available for use by the individual employee as accrued leave. The bank may be used by the individual member for his or her own qualifying condition and for that of an immediate family member, if the member donated the required amount of local leave days

C. Catastrophic Illness or Injury

A catastrophic illness or injury is a severe condition or combination of conditions affecting the mental or physical health of the employee or a member of the employee's immediate family that requires the services of a licensed practitioner for a prolonged period of time and that forces the employee to exhaust all leave time earned by that employee and to lose compensation from the District Such conditions typically require prolonged hospitalization or recovery or are expected to result in disability or death Conditions relating to pregnancy or childbirth shall be considered catastrophic if they meet the requirements of this paragraph.

This definition complies with the Internal Revenue Service (IRS) service requirements Routine or non-catastrophic illnesses or injuries, general pregnancy, and disabilities which qualify the member for Workers’ Compensation income benefits are excluded from the awardment of Sick Leave Bank days

D. Immediate Family

For the purposes of the Sick Leave Bank, “immediate family” is defined and aligned with the interpretation from the Department of Labor.

a Spouse

b. Child under the age 18, including biological, adopted, or foster child, a stepchild, a legal ward, or a child for whom the employee stands in loco parentis Children over the age of 18 must have a qualifying disability

c. Parent or other individual who stands in loco parentis to the employee.

A. Eligibility

Membership is voluntary and open to full and part-time regular employees For purposes of the bank, “regular employees” are defined as an employee who is in an allocated budgetary position (FTE) guaranteeing 20 hours or more per week Seasonal, substitute, or temporary positions are not eligible for membership in the bank.

B. Enrollment

1 Eligible employees have the opportunity to enroll in the Sick Leave Bank New personnel must enroll in membership during their New Hire Open Enrollment period for benefits and within thirty-one (31) calendar days of starting employment.

2 Existing employees will be extended the opportunity annually to join the Sick Leave Bank during the District’s Annual Open Enrollment period.

3. Enrollment in the bank is voluntary but requires a one-time donation of two (2) local leave days. An additional local leave day (1) may be donated for usage of the employee’s immediate family as defined above

CONTRIBUTION OF DAYS

A. Participation in the Sick Leave Bank

Participation in the Sick Leave Bank is voluntary but requires a one-time donation of two (2) local sick leave days. A third day may be donated for usage of the employee’s immediate family as defined above

B. Requesting Days from the Sick Leave Bank

1. To request days from the Sick Leave Bank, an employee must exhaust all paid leave, including local leave, state leave, accrued compensatory time, and vacation leave

2. The employee must be unable to perform the duties of their position and be on an approved consecutive federal or state leave of absence

C. Maximum Number of Sick Leave Banks Days Per School Year and Lifetime

1. The maximum number of Sick Leave Bank days that may be granted to a member of the Sick Leave Bank is 25 days per school calendar year (July 1 through June 30)

2. The lifetime maximum number of Sick Leave Bank days that may be granted to an employee is 75 days

D. School Year

For purposes of the Sick Leave Bank, the school year will be from July 1 through June 30. The days donated become the property of the DISD Sick Leave Bank Donations will remain in force and cannot be returned for any reason to the employee

E. Duration of Membership in Sick Leave Bank

Membership in the Bank will continue for the duration of employment Separation of the employee from DISD terminates membership in the Sick Leave Bank

F. Depletion of the Bank

Should the Bank be in danger of depletion and falls two times (2x) below the number of participating members, then all members must contribute one (1) extra day effective July 1 of the next fiscal year If it falls one (1x) below the number of members, then the employee must contribute two (2) days the next fiscal year.

G.

Withdrawal

of Membership from the Sick Leave Bank

The member may cancel membership at any time by using the proper form obtained from the Director of Benefits. The employee will not be eligible to use the Sick Leave Bank, as of the effective date, as indicated on the signature line of the withdrawal form The employee may not regain donated leave days upon cancellation of membership If the employee decides to rejoin the Bank, the employee must do so during an open enrollment period and again donate two (2) or three (3) leave days, as applicable.

H Termination of Sick Leave Bank Benefits

A member of the Sick Leave Bank is not eligible to use benefits of the Bank under the following conditions:

1 Termination of employment with Denton ISD

2. While being suspended without pay. Eligibility will also be terminated during suspension period.

3 A member ’s voluntary cancellation of Sick Leave Bank membership

4 Any abuse or misuse of the rules of the Sick Leave Bank

5. While on a non-medical leave of absence.

6 Death

H. Closure of the Bank

If the bank is depleted of leave without sufficient membership to sustain it, all membership and benefits will end Leave deposited will be forfeited by the members

The Denton ISD Sick Leave Bank committee through a majority vote will render a determination on all requests for the Sick Leave Bank The Sick Leave Bank committee will determine the number of days approved, up to 25, and reserves the right to approve, reject, or modify the days requested

A. Composition of Sick Leave Bank Committee

1 In an effort to maintain confidentiality and consistent determinations, the governing committee is comprised of employees from the following positions: Director of Benefits; Executive Director of Human Resources; Director of Human Resources-Auxiliary, Director of Health Services; and The Officers of the Teacher Communication Committee (TCC)

2 The Director of Benefits will communicate to the member whether the application was approved or not. The member will be notified if additional information is needed to make a decision.

3 Vacancies that occur on the committee during the school year will be filled by appointment by the Director of Benefits

4 The Director of Benefits shall serve as the bank administrator and advisor to the Sick Leave Bank Committee.

5. Decisions made by the committee may be appealed. The Level One Appeal must be filed with the District’s General Counsel, and the Level Two Appeal with the Superintendent.

PROCEDURES AND GUIDELINES

A. Process for Member to Request Sick Leave Bank Days

1. Sick Leave Bank days can be requested by the member or the member ’s designee after the member has exhausted all paid leave, including accrued compensatory time and vacation leave

2. The member must be on a consecutive, medical leave of absence under the Family and Medical Leave Act (FMLA) or Temporary Disability Leave (TDL) Sick leave days from the Bank may not be granted for Intermittent FMLA or for a period of disability when monies are paid to the member under the Texas Workers’ Compensation Act

3. The member must submit an application and physician’s statement to the Director of Benefits. All information related to the employees’ medical conditions are considered confidential and will be maintained as such

4 The medical certification or health care provider ’s statement must include: a Diagnosis and the nature of the illness or injury

b. Date of onset of the disabling illness or injury.

c Confirmation from the physician that the illness or injury is catastrophic in nature as defined by this policy This information includes but is not limited to, the type of treatment required, the duration of treatment, and the limits of the patient’s activity.

d Dates of hospitalization (if applicable)

e Dates of incapacity and inability to work

f. Anticipated date eligible to return to work full-time.

B. Exclusions

1 Elective absences, elective surgical or medical procedures, or procedures that could be scheduled without detriment to the member ’s health do not qualify for Sick Leave Bank Days.

2 Routine pregnancy is not categorized as a catastrophic illness or injury; however, serious complications arising from pregnancy or childbirth may be considered. These include but are not limited to, complications requiring a prolonged hospitalization and represent an increased risk to the life or function of a covered pregnant employee and/or the unborn infant

3 Labor and Delivery are not considered an emergency admission even though it may be an urgent admission. Delivery of a pregnancy by cesarean section, does not itself qualify a member for bank benefits Additionally, the period needed to recover from childbirth is not eligible for bank benefits

4 Mental disability that is not considered a “serious mental illness” as defined by Texas law

5. Disabilities that qualify the member for Workers’ Compensation income benefits.

C. Granting of Sick Leave Bank Days

1 Sick leave days from the Bank must be approved by the District’s Sick Leave Bank Committee A member will only be reimbursed for the amount of days actually docked. In no case will the granting of sick leave days from the Bank cause a member to receive more than his/her salary

2. Bank days will only be granted for absences from the member ’s scheduled work days. Holidays, vacation days, or other such days are not eligible for pay

3. Days from the bank will not be granted for a period of disability when monies are available to the member under the Workers’ Compensation Act

4 Reimbursement will be made in the member ’s regular payroll check

5. All unused sick leave days awarded by the Bank at the end of the fiscal year (June 30) will be carried over to the next fiscal year (July 1 through June 30)

6. If the employee is granted and uses two or more days from the Bank during the fiscal calendar year, then the district will deduct two (2) local days the following fiscal year (July 1) The additional two-day donation is required in order to continue membership in the Bank

D. Reporting and Record Keeping

1. The bank administrators will maintain records regarding the approval and denial of the Sick Leave Bank applications

2. The bank administrator is responsible for notifying the employee and payroll of the approval of bank days and the commencement of those days

3 For a balance of days used, employees can reach out to the bank administrator who in conjunction with the Payroll Department will provide this information

E. Guideline Changes

1. The Benefits Department is responsible for reviewing program guidelines and making recommendations for changes to the program

2. Any amended policies or procedures which could have an impact on the district will be submitted to the Superintendent or designees for approval

3 Upon approval of the Superintendent or designees, the changes will become effective with the next plan year

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 Denton 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 Denton 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.