Benefit Contact Information
LOVEJOY ISD BENEFITS
Higginbotham Public Sector (469) 385-4685 www.mybenefitshub.com/lovejoyisd
LOVEJOY ISD BENEFITS OFFICE
Terri Martin Benefits Specialist 469-742-8013 terri_martin@lovejoyisd.net
HEALTH SAVINGS ACCOUNT
EECU (817) 882-0800 www.eecu.org
NY Life Insurance Group #LK963740 (800) 362-4462 myNYLGBS.com
Blue Cross Blue Shield
866-355-5999 www.bcbstx.com/trsactivecare
MDLIVE (888) 365-1663 www.mdlive.com/fbs
PHARMACY (ACTIVECARE ONLY) VISION
Express Scripts (844) 238-8084
https://www.express-scripts.com/ trsactivecare
MetLife (800) 438-6388 Group # 5383775 https://www.metlife.com/mybenefits
NY Life Insurance Life Group # FLX965387 (800) 244-6224 nyl.com/customer-forms
MetLife Network Davis Vision (833) 393-5433
Group #5383775 metlife.com/vision
Chubb (888) 499-0425
Group ID: 100000045 educatorclaims@chubb.com
THEFT
ID Watchdog (866) 513-1518 www.idwatchdog.com HOSPITAL CASH PLAN
Chubb Group #100000045 (888) 499-0425 educatorclaims@chubb.com
Chubb Group # 100000045 (888) 499-0425 educatorclaims@chubb.com
FLEXIBLE SPENDING ACCOUNT (FSA) EMPLOYEE ASSISTANCE PROGRAM (EAP)
National Benefit Services Group ID NBS367463 (855) 399-3035 www.nbsbenefits.com
NYL /Guidance Resources
800-344-9752
Web ID NYLGBS www.guidanceresources.com
SAVINGS
Clever RX Group ID 1085 (800) 873-1195 https://cleverrx.com/lovejoyisd
1 www.mybenefitshub.com/lovejoyisd
2
3
4
Enter your Information
• Last Name
• Date of Birth
• Last Four (4) of Social Security Number
NOTE: THEbenefitsHUB uses this information to check behind the scenes to confirm your employment status. CLICK LOGIN
Once confirmed, the Additional Security Verification page will list the contact options from your profile. Select either Text, Email, Call, or Ask Admin options to receive a code to complete the final verification step.
5
Enter the code that you receive and click Verify. You can now complete your benefits enrollment!
Annual Benefit Enrollment
Annual Enrollment
During your annual enrollment period, you have the opportunity to review, change or continue benefit elections each year. Changes are not permitted during the plan year (outside of annual enrollment) unless a Section 125 qualifying event occurs.
• Changes, additions or drops may be made only during the annual enrollment period without a qualifying event.
• Employees must review their personal information and verify that dependents they wish to provide coverage for are included in the dependent profile. Additionally, you must notify your employer of any discrepancy in personal and/or benefit information.
• Employees must confirm on each benefit screen (medical, dental, vision, etc.) that each dependent to be covered is selected in order to be included in the coverage for that particular benefit.
New Hire Enrollment
All new hire enrollment elections must be completed in the online enrollment system within the first 30 days of benefit 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 Office or you can call Higginbotham Public Sector at (866) 914-5202 for assistance.
Where can I find forms?
For benefit summaries and claim forms, go to your benefit website: www.mybenefitshub.com/lovejoyisd 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 Lovejoy ISD benefit website: www.mybenefitshub.com/lovejoyisd. 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.
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 Benefits Office within 30 days of your qualifying event and meet with your Benefits Office to complete and sign the necessary paperwork in order to make a benefit election change. Benefit changes must be consistent with the qualifying event.
QUALIFYING EVENTS
A change in marital status includes marriage, death of a spouse, divorce or annulment (legal separation is not recognized in all states).
A change in number of dependents includes the following: birth, adoption and placement for adoption. You can add existing dependents not previously enrolled whenever a dependent gains eligibility as a result of a valid change in status event.
Change in employment status of the employee, or a spouse or dependent of the employee, that affects the individual’s eligibility under an employer’s plan includes commencement or termination of employment.
An event that causes an employee’s dependent to satisfy or cease to satisfy coverage requirements under an employer’s plan may include change in age, student, marital, employment or tax dependent status.
If a judgment, decree, or order from a divorce, annulment or change in legal custody requires that you provide accident or health coverage for your dependent child (including a foster child who is your dependent), you may change your election to provide coverage for the dependent child. If the order requires that another individual (including your spouse and former spouse) covers the dependent child and provides coverage under that individual’s plan, you may change your election to revoke coverage only for that dependent child and only if the other individual actually provides the coverage.
Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change.
Annual Benefit Enrollment
Employee Eligibility Requirements
Supplemental Benefits: Eligible employees must work 15 or more regularly scheduled hours each work week.
Eligible employees must be actively at work on the plan effective date for new benefits to be effective, meaning you are physically capable of performing the functions of your job on the first day of work concurrent with the plan effective date. For example, if your 2024 benefits become effective on September 1, 2024, you must be actively-at-work on September 1, 2024 to be eligible for your new benefits.
Dependent Eligibility Requirements
Dependent Eligibility: You can cover eligible dependent children under a benefit that offers dependent coverage, provided you participate in the same benefit, through the maximum age listed below. Dependents cannot be double covered by married spouses within the district as both employees and dependents.
Please note, limits and exclusions may apply when obtaining coverage as a married couple or when obtaining coverage for dependents.
Potential Spouse Coverage Limitations: When enrolling in coverage, please keep in mind that some benefits may not allow you to cover your spouse as a dependent if your spouse is enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Higginbotham Public Sector, or contact the insurance carrier for additional information on spouse eligibility.
FSA/HSA Limitations: Please note, in general, per IRS regulations, married couples may not enroll in both a Flexible Spending Account (FSA) and a Health Savings Account (HSA). If your spouse is covered under an FSA that reimburses for medical expenses then you and your spouse are not HSA eligible, even if you would not use your spouse’s FSA to reimburse your expenses. However, there are some exceptions to the general limitation regarding specific types of FSAs. To obtain more information on whether you can enroll in a specific type of FSA or HSA as a married couple, please reach out to the FSA and/or HSA provider prior to enrolling or reach out to your tax advisor for further guidance.
Potential Dependent Coverage Limitations: When enrolling for dependent coverage, please keep in mind that some benefits may not allow you to cover your eligible dependents if they are enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Higginbotham Public Sector, or contact the insurance carrier for additional information on dependent eligibility.
Disclaimer: You acknowledge that you have read the limitations and exclusions that may apply to obtaining spouse and dependent coverage, including limitations and exclusions that may apply to enrollment in Flexible Spending Accounts and Health Savings Accounts as a married couple. You, the enrollee, shall hold harmless, defend, and indemnify Higginbotham Public Sector from any and all claims, actions, suits, charges, and judgments whatsoever that arise out of the enrollee’s enrollment in spouse and/or dependent coverage, including enrollment in Flexible Spending Accounts and Health Savings Accounts.
If your dependent is disabled, coverage may be able to continue past the maximum age under certain plans. If you have a disabled dependent who is reaching an ineligible age, you must provide a physician’s statement confirming your dependent’s disability. Contact your Benefit Office to request a continuation of coverage.
Description
Health
Savings Account (HSA)
(IRC Sec. 223)
Approved by Congress in 2003, HSAs are actual bank accounts in employee’s names that allow employees to save and pay for unreimbursed qualified medical expenses tax-free.
Flexible Spending Account (FSA)
(IRC Sec. 125)
Allows employees to pay out-of-pocket expenses for copays, deductibles and certain services not covered by medical plan, taxfree. This also allows employees to pay for qualifying dependent care tax-free.
Employer Eligibility A qualified high deductible health plan. All employers
Contribution Source Employee and/or employer
Account Owner Individual
Underlying Insurance Requirement High deductible health plan
Minimum Deductible
Maximum Contribution
Permissible Use Of Funds
Cash-Outs of Unused Amounts (if no medical expenses)
Year-to-year rollover of account balance?
Does the account earn interest?
Portable?
$1,600 single (2024)
$3,200 family (2024)
$4,150 single (2024)
$8,300 family (2024)
55+ catch up +$1,000
Employees may use funds any way they wish. If used for non-qualified medical expenses, subject to current tax rate plus 20% penalty.
Employee and/or employer
Employer
None
N/A
$3,200 (2024)
Reimbursement for qualified medical expenses (as defined in Sec. 213(d) of IRC).
Permitted, but subject to current tax rate plus 20% penalty (penalty waived after age 65). Not permitted
Yes, will roll over to use for subsequent year’s health coverage.
Yes
Most plans require that you use your funds by 8/31/2024. Your plan allows an additional 75 days from 8/31 to spend your remaining funds.
No
Yes, portable year-to-year and between jobs. No
PR E SCRIPTI O NS AGAIN
NOW TH A T’S CL EVE R.
Download your Clever RX card or Clever RX App to unlock exclusive savings.
Present your Clever RX App or Clever RX card to your pharmacist.
FREE to use. Save up to 80% off prescription drugs and beat copay prices.
100% FREE to use
Unlock discounts on thousands of medications Accepted at most pharmacies nationwide ST AR T SA VI NG TOD AY
Save up to 80% off prescription drugs – often beats the average copay
ST EP 1:
Download the FREE Clever RX App. From your App Store search for "Clever RX" and hit download. Make sure you enter in Group ID and in Member ID during the on-boarding process. This will unlock exclusive savings for you and your family!
ST EP 2 :
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.
ST EP 3 :
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.
ST EP 4:
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.
NOW TH A T IS N O T ONLY CL EVER, I T IS CL EVE R RX
DID Y OU KNOW?
Over 7 0% of peopl e c an benefi t fro m a pre sc rip ti on sav ing s c ard due t o high dedu ct ible heal t h plan s, high c opa ys , and being unde r in s ured or u ni ns ur ed
Ov er 3 0 % of pre sc rip t ion s ne ver ge t filled due t o high co sts .
4 0% of t he t op t en most prescribed d rugs ha v e in cr ea s ed in cost b y o v e r 1 00 %
Dental
1. “In-Network Benefits” refers to benefits provided under this plan for covered dental services that are provided by a
provided under this plan for covered dental services that are not provided by a participating dentist.
“Out-of-Network
2. Negotiated fees refer to the fees that participating dentists have agreed to accept as payment in full for covered services, subject to any copayments, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change.
3. Applies to Type B and C services only.
4. Out-of-network benefits are payable for services rendered by a dentist who is not a participating provider. The Reasonable and Customary charge is based on the lowest of:
• the dentist’s actual charge (the ‘Actual Charge’),
• the dentist’s usual charge for the same or similar services (the ‘Usual Charge’) or
• the usual charge of most dentists in the same geographic area for the same or similar services as determined by MetLife (the ‘Customary Charge’). For your plan, the Customary Charge is based on the 90th percentile. Services must be necessary in terms of generally accepted dental standards.
2.
3.
4.
services (the ‘Usual Charge’) or
• the usual charge of most dentists in the same geographic area for the
Charge is based on the 90th percentile.
(the ‘Customary Charge’). For your
the
Dental Insurance MetLife
Type A - Preventive How Many / How Often
Oral Examinations 2 in 12 months
Full Mouth X-rays 1 in 36 months
Bitewing X-rays (Adult/Child) 1 in a year
Prophylaxis - Cleanings 2 in 12 months
Topical Fluoride Applications
2 in 12 months - Children to age 16
Sealants 1 in 36 months - Children to age 16
Space Maintainers No limit - Children up to age 16
Type B - Basic Restorative How Many / How Often
Amalgam and Composite Fillings
Oral Surgery (Simple Extractions)
Oral Surgery (Surgical Extractions)
Other Oral Surgery
Emergency Palliative Treatment
General Anesthesia
Consultations
limit - Children up to age 16
Type C - Major Restorative How Many / How Often Crowns/Inlays/Onlays
1 per tooth in 60 months
Prefabricated Crowns 1 per tooth in 60 months
Repairs 1 in 12 months
Endodontics Root Canal 1 per tooth per lifetime
Periodontal Surgery 1 in 36 months per quadrant
Periodontal Scaling & Root Planing 1 in 24 months per quadrant
Periodontal Maintenance 2 in 1 year, includes 2 cleanings
Bridges 1 in 60 months
Dentures 1 in 60 months
Implant Services 1 service per tooth in 60 months - 1 repair per 12 months
Harmful Habits Appliances
*Alternate Benefits: Where two or more professionally acceptable dental treatments for a dental condition exist, reimbursement is based on the least costly treatment alternative. If you and your dentist have agreed on a treatment that is more costly than the treatment upon which the plan benefit is based, you will be responsible for any additional payment responsibility. To avoid any misunderstandings, we suggest you discuss treatment options with your dentist before services are rendered, and obtain a pretreatment estimate of benefits prior to receiving certain high cost services such as crowns, bridges or dentures.
DHMO Direct Referral Dental Plan* MET290: Your policy benefit provides a SCHEDULE OF BENEFITS which lists each Covered Service available to You and Your Dependents under your dental plan. You and Your Dependent’s costs may include Co-Payments for a Covered Service. Please refer to www.mybenefitshub.com/lovejoyisd under the Dental DHMO section to review the procedure amounts and copay schedules. No ID card is necessary, and you will be assigned a network dentist before services are rendered. Please call 1-800-880-1800 for benefit questions and support.
*Care under this plan is provided through a network of Selected General Dentists. Your Selected General Dentist is responsible for determining when the services of a Specialty Care Dentist are needed and facilitating any necessary referral. You and Your Dependents will be advised of the name, address, and telephone number of the Specialty Care Dentist in Your or Your Dependent’s Service Area.
Missed Appointments: If You or Your Dependents need to cancel or reschedule an appointment, please notify the Selected General Dental Office as far in advance as possible. This will allow the Selected General Dental Office to accommodate another person in need of attention. If You or Your Dependents fail to do this in a timely fashion, You or Your Dependents may be charged a missed appointment fee.
Vision Insurance MetLife Network Davis 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/lovejoyisd
With your Vision Preferred Provider Organization Plan, you can:
• Go to any licensed Davis vision provider and receive coverage. Just remember your benefit dollars go further when you stay in network.
• Choose from a large network of ophthalmologists, optometrists and opticians, from private practices to retailers like Costco® Optical, Walmart, Sam’s Club and Visionworks.
In-network benefits
There are no claims for you to file when you go to an in-network Davis vision provider. Simply pay any copays or member out of pocket amount (MOOP) and, if applicable, any amount over your frame/contact allowance at the time of service
Eye
Exam
• Once every 12 months
• Eye health exam, dilation, prescription and refraction for glasses: Covered in full after $10 copay.
• Retinal imaging: Up to a $40 copay on routine retinal screening when performed by a private practice.
Frame
• Once every 12 months
• Allowance: $150 after $15 eyewear copay1 You will receive an additional 20% savings on the amount that you pay over your allowance.
• Exclusive Collection Frame Copay (in lieu of Allowance) Fashion / Designer / Premier: Covered in full / Covered in full / Covered in full. Participating private practice providers typically do not display the Collection but are contractually required to maintain a comparable selection (in both quantity and quality) of frames that would be covered, with no additional member out-of-pocket expense. Special lens designs, materials, powers and frames may require additional cost. Collection is available at most participating independent provider offices. Collection is subject to change.
Standard Corrective Lenses
• Once every 12 months
• Single vision, lined bifocal, lined trifocal, lenticular: Covered in full after $15 eyewear copay1
Standard Lens Enhancements2
• Once every 12 months
• Standard Polycarbonate (child up to age 18)3, Progressive Standard: Covered in full after $15 eyewear copay1
• Progressive Premium/Custom, Standard Polycarbonate (adult)3, UV coating, Scratch- resistant coatings, Solid or Gradient Tints, Anti-reflective, Photochromic, Blue Light filtering, Digital Single Vision, Polarized, High Index (1.67 / 1.74): Your cost will be limited to a member out of pocket amount (MOOP) that MetLife has negotiated for you. These amounts may be viewed after enrollment at www.metlife. com/mybenefits
Contact Lenses (instead of eyeglasses)4
• Once every 12 months
• Contact fitting and evaluation: 15% discount.
• Elective lenses: $150 allowance.
• Necessary lenses: Covered in full
• Conventional contacts: You will receive an additional 15% savings on the amount that you pay over your allowance.
• Disposable contacts: You will receive an additional 15% savings on the amount that you pay over your allowance.
1 Materials co-pay applies to lenses and frames only, not contact lenses.
2 The above list highlights some of the most popular lens enhancements and is not a complete listing.
3 Polycarbonate lenses are covered for dependent children, monocular patients, and patients with prescriptions +/- 6.00 diopters or greater.
4 Not all providers participate in vision program discounts, including the member out-of-pocket features. Call your provider prior to scheduling an appointment to confirm if the discount and member out-of-pocket features are offered at that location. Discounts and member out-of-pocket are not insurance and subject to change without notice.
Vision Insurance MetLife Network Davis Vision
In-network value added features:
Additional savings on lens enhancements:5 Average 20- 25% savings over retail on all lens enhancements not otherwise covered under the Davis Vision Insurance program.
Additional savings on glasses and sunglasses:5 Members may receive 50% off of additional complete pairs of eyeglasses and sunglasses at Visionworks or 30% off at other participating providers on the same transaction. Otherwise, a 20% discount off the provider’s usual and customary rate may be available.
Additional savings on frames:5 20% off any amount over your frames allowance.
Additional savings on contacts:5 15% off any amount over your contact lens allowance. 15% discount on additional contacts beyond your covered amount.
Free one-year breakage warranty: All eyeglasses come with a breakage warrenty for repair or replacement of the frame and/or lenses for a period of one year from the date of delivery. The one-year breakage warranty applies to all plan-covered eyeglasses (ie., all spectacle lenses, Davis Vision Exclusive Collection frames and national retailer frames, where our Exclusive Collection is not displayed). Warranty does not apply to Glasses.com.
Hearing discounts:5 A National Hearing Network of hearing care professionals, featuring Your Hearing Network, offers Davis Vision members discounts on services, hearing aids and accessories. These discounts should be verified prior to service.
5 These features may not be available in all states and with all in-network vision providers. Discounts are not available at Walmart and Sam’s Club. Please check with your in-network vision provider.
We’re here to help
Find a Davis Vision provider at: www.metlife.com/vision and select Davis Vision by MetLife’. For general questions, go to www.metlife.com/mybenefits or call 1-833-EYE-LIFE (1-833-393-5433).
Cancer Insurance Chubb
ABOUT CANCER
Cancer insurance offers you and your family supplemental insurance protection in the event you or a covered family member is diagnosed with cancer. It pays a benefit directly to you to help with expenses associated with cancer treatment.
For full plan details, please visit your benefit website: www.mybenefitshub.com/lovejoyisd
Diagnosis of Cancer Benefit
Medical Imaging Benefit
$5,000
$7,500 child(ren)
Waiting Period 0 days Benefit Reduction: None
$500 per Imaging Study
$10,000
$15,000 child(ren)
Waiting Period 0 days Benefit Reduction: None
$500
Attending Physician Benefit
Hospital Confinement Benefit
Hospital Confinement ICU Benefit
Hospital Confinement Sub- Acute Intensive Care Unit Benefit
Family Care Benefit
Prescription Drug Inpatient Benefit
U.S. Government or Charity Hospital Benefit
$50 per Visit
Maximum Visits per Confinement: 2 Maximum Visits per Calendar Year: 4
$100 Per Day – Days 1 through 30
Additional Days: $200
Maximum Days per Confinement: 31
$200 Per Day – Days 1 through 30
Additional Days: $200
Maximum Days per Confinement: 31
$100 Per Day – Days 1 through 30
Additional Days: $100
Maximum Days per Confinement: 31
Childcare: $100 per Day per Child
Maximum Days per Calendar Year: 30
Adult Day Care or Home Healthcare: $100 per Day
Maximum Days per Calendar Year: 30
Per Confinement: $150
Maximum Confinements per Calendar Year 6
Days 1 through 30:
$100
Additional Days: $200
Maximum Days per Confinement: 15
$50 per Visit
Maximum Visits per Confinement: 2
Maximum Visits per Calendar Year: 4
$100 Per Day – Days 1 through 30
Additional Days: $200
Maximum Days per Confinement: 31
$200 Per Day – Days 1 through 30
Additional Days: $200
Maximum Days per Confinement: 31
$100 Per Day – Days 1 through 30
Additional Days: $100
Maximum Days per Confinement: 31
Childcare: $100 per Day per Child
Maximum Days per Calendar Year: 30
Adult Day Care or Home Healthcare: $100 per Day
Maximum Days per Calendar Year: 30
Per Confinement: $150
Maximum Confinements per Calendar Year 6
Days 1 through 30:
$100
Additional Days: $200
Maximum Days per Confinement: 15
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.
Awarded Best in Class Identity Protection Service Provider for Consumers
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.
Javelin Strategy & Research, "2023 Identity Fraud Study: The Butterfly Effect", Mar 2023. Refer to your employer or ID Watchdog for family plan eligibility.
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
Dark Web Monitoring
Data Breach Notifications
High-Risk Transactions Monitoring
Subprime Loan Monitoring
Public Records Monitoring
USPS Change of Address Monitoring
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
Identity Theft Insurance
•Up to $1M Stolen Funds Reimbursement
-Checking and savings accounts
-401k/HSA/ESOP accounts
•Home Title Fraud NEW
•Cyber Extortion
•Professional Identity Fraud
•Deceased Family Member Fraud
Subprime Loan Block
within the monitored lending network
Annually
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)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. (2)The monitored network does not cover all businesses or transactions. (3)For 1B Family Plan, applicable for enrolled family members only. (4)Monitoring from TransUnion and Experian will take several days to begin. (5)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. (6)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). (7)The Integrated Fraud Alert feature is made available to consumers by Equifax Information Services LLC and fulfilled on its behalf by Identity Rehab Corporation. (8)May be subject to delay or change. To review ID Watchdog Terms & Conditions, go to idwatchdog.com/terms.
Disability Insurance
New York Life
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/lovejoyisd
SUMMARY OF BENEFITS
If you had an unexpected illness or injury and were unable to work, how long would you be able to pay your bills and take care of your family? Disability insurance pays a portion of your salary if you’re unable to work due to a covered disability.
By purchasing coverage through your employer, you also benefit from cost-effective group rates and convenient payroll deduction.
Eligibility: If you are an active employee working at least 15 hours per week, you will be eligible immediately.
Guaranteed Issue*:
Initial Enrollment: If you are eligible on or before the policy’s effective date, you may enroll for coverage during the Initial Enrollment without submitting any evidence of good health.
New Hires: If you were hired after the policy’s effective date, you may elect coverage once eligible without submitting any evidence of good health.
Annual Enrollment: During annual enrollment, you may enroll for the first time or make coverage changes, if already participating, without submitting any evidence of good health.
*The Pre-Existing Condition Limitation, as outlined in the Benefit Reductions, Conditions, Limitations and Exclusions section, will apply.
Select from Five (5) Options: Accident/Sickness
Option 1: 0 days/7 days
Option 2: 14 days/14 days
Option 3: 30 days/30 days
Option 4: 60 days/60 days
Option 5: 90 days/90 days
Please refer to the “Maximum Benefit Period” Schedules below for more details
Monthly Cost of Coverage:
Life Insurance
New York Life
ABOUT LIFE INSURANCE
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/lovejoyisd
Employer-Paid Basic Life
Who Is Eligible For Coverage?
You: All active, Full-time Employees of the Employer working a minimum of 15 hours per week. You will be eligible for coverage the first of the month following date of hire.
Available Coverage:
Employee:
• Benefit Amount
• Maximum
• Guaranteed Issue Amount
$15,000
$15,000
$15,000
Guaranteed Issue means that you may be able to purchase coverage without medical exams or health questions. See “Guaranteed Issue” below for more information.
Additional Features:
Extended Death Benefit with Waiver of Premium – The extended death benefit continues your coverage without payment of premium, before you’re eligible to qualify for Waiver of Premium, if you are continuously Disabled for 9 months prior to age 60. “Disabled” means, because of injury or sickness, you are unable to perform all the material duties of your regular occupation, or you are receiving disability benefits under a program sponsored by your Employer. Regular Occupation means the occupation you routinely performed at the time your Disability began. We/the insurance company will consider the duties of your occupations as those that are normally performed in the general labor market in the national economy. If you qualify for this benefit and have insured your spouse or children, the insurance company will also extend their coverage if applicable.
Waiver of Premium – If you become Disabled prior to age 60, and you remain Disabled continuously for a 9 month period and thereafter, you won’t need to pay premiums for your life insurance coverage, provided we/the Insurance Company determine(s) you are Disabled. “Disabled” for this coverage means, because of injury or sickness, you are unable to perform the material duties of your regular occupation, or are receiving disability benefits under a program sponsored by your employer, for the first 12 months after your Disability began. Thereafter, you
must be unable to perform the material duties of any occupation that you are or may reasonably become qualified based on your education, training or experience. If you qualify for this coverage and have insured your spouse or children, the insurance company will also waive their premium if applicable.
Accelerated Death Benefit – Terminal Illness – if two unaffiliated doctors diagnose you as terminally ill while the coverage is active, with a life expectancy of 12 months or less, the benefit for Terminal Illness provides up to:
• Employee: 80% of your Term Life Insurance coverage amount or $8,000, whichever is less.
Conversion – To convert, you must apply for the conversion policy and pay the first premium payment within 31 days after your group coverage ends.
Guaranteed Issue: If you are a new hire and you apply within 31 days after you are eligible to elect coverage for yourself, you are entitled to choose any coverage offered up to the Guaranteed Issue Amount, without providing proof of good health. If you apply for an amount of coverage greater than the Guaranteed Issue Amount, coverage in excess of the Guaranteed Issue Amount will not be issued until the insurance company approves acceptable proof of good health. If you apply for coverage for yourself more than 31 days from the date you become eligible to elect coverage under this plan, the Guaranteed Issue Amount will not apply, unless Guaranteed Issue has been approved by your employer for a specific period of time. Coverage will not be issued until the insurance company approves acceptable proof of good health.
Important Definitions and Policy Provisions:
Benefit Reduction Schedule - If you are still employed, your benefits will reduce to 65% at age 65 and 50% at age 70.
Limitations - The Accelerated Death Benefit is payable only once. Using this benefit reduces the life insurance death benefit. The amount payable under the Accelerated Death Benefit may be reduced by the amount of other benefits already paid to the insured under the policy. See your certificate for further details.
Voluntary Group Life
Employee-Paid Voluntary Life
Who Is Eligible For Coverage?
You: All active, Full-time Employees of the Employer working a minimum of 15 hours per week. You will be eligible for coverage the first of the month following date of hire.
Your Spouse: Up to age 70, as long as you apply for and are approved for coverage yourself.
Your Child(ren): Birth to 26, or age 26 if a full-time student, as long as you apply for and are approved for coverage yourself.
Accelerated Death Benefit – Terminal Illness – if two unaffiliated doctors diagnose you or your spouse as terminally ill while the coverage is active, with a life expectancy of 12 months or less, the benefit for Terminal Illness provides up to:
• Employee: 80% of your Term Life Insurance coverage amount or $250,000, whichever is less.
• Spouse: 80% of your Term Life Insurance coverage amount or $250,000, whichever is less.
Portability – If your employment is terminated, you can continue your life insurance on a direct-bill basis. Coverage may also be continued for your spouse/children. Premiums will increase at this time. Coverage can be continued to age 70, unless the insurance company terminates portability for all insured persons.
Refer to your certificate for details.
Conversion – To convert, you must apply for the conversion policy and pay the first premium payment within 31 days after your group coverage ends.
Guaranteed Issue means that you may be able to purchase coverage without medical exams or health questions. See “Guaranteed Issue” below for more information.
Additional Features:
Extended Death Benefit with Waiver of Premium – The extended death benefit continues your coverage without payment of premium, before you’re eligible to qualify for Waiver of Premium, if you are continuously Disabled for 9 months prior to age 60. “Disabled” means, because of injury or sickness, you are unable to perform all the material duties of your regular occupation, or you are receiving disability benefits under a program sponsored by your Employer. Regular Occupation means the occupation you routinely performed at the time your Disability began. We/the insurance company will consider the duties of your occupations as those that are normally performed in the general labor market in the national economy. If you qualify for this benefit and have insured your spouse or children, the insurance company will also extend their coverage if applicable.
Waiver of Premium – If you become Disabled prior to age 60, and you remain Disabled continuously for a 9 month period and thereafter, you won’t need to pay premiums for your life insurance coverage, provided we/the Insurance Company determine(s) you are Disabled. “Disabled” for this coverage means, because of injury or sickness, you are unable to perform the material duties of your regular occupation, or are receiving disability benefits under a program sponsored by your employer, for the first 12 months after your Disability began. Thereafter, you must be unable to perform the material duties of any occupation that you are or may reasonably become qualified based on your education, training or experience. If you qualify for this coverage and have insured your spouse or children, the insurance company will also waive their premium if applicable.
Spouse rates based on
AD&D Insurance
New York Life
ABOUT AD&D INSURANCE
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/lovejoyisd
Employee-Paid Accidental Death & Dismemberment Insurance
Who Can Elect Coverage?
You: All active, full-time Employees of the Employer working a minimum of 15 hours per week. You will be eligible for coverage the first of the month following date of hire.
Your Spouse: Up to age 70, as long as you apply for and are approved for coverage yourself.
Your Child(ren): Birth to 26, as long as you apply for and are approved for coverage yourself.
Benefit Details:
If, within 365 days of a Covered Accident, bodily injuries result in:
Loss of life; Total paralysis of both upper and lower limbs; Loss of two or more hands or feet; Loss of sight in both eyes; or Loss of speech and hearing (both ears)
Total paralysis of both lower limbs or both upper limbs
Total paralysis of upper and lower limbs on one side of the body; Loss of one hand, one foot, sight in one eye, speech, or hearing in both ears; or Severance and Reattachment of one hand or foot
Total paralysis of one upper or one lower limb; Loss of all four fingers of the same hand; or Loss of thumb and index finger of the same hand
Loss of all toes of the same foot
For Comas – You will receive 1% of the full benefit amount each month, for up to a maximum of 11 months, if you or an insured family member are in a coma for 30 days or more as a result of a Covered Accident. If the covered person is still in a coma after 11 months, or dies, the full benefit amount will be paid.
Your Monthly Cost of Coverage:
• Employee Cost Per $10,000 units = $.30
• Spouse Cost Per $5,000 units = $.15
• Child’s Cost Per $1,000 units = $.04
Actual per pay period premiums may differ slightly due to rounding. Benefits will reduce on age (see Benefits Reduction Schedule for details). Rates may be subject to change in the future.
How to Calculate Your Monthly Cost of Coverage:
Step 1: Find the above Monthly rate.
Step 2: Multiply this rate by your desired coverage amount, in units. Reference the information above to find the appropriate unit amounts for employee and/or dependents.
Step 3: The result is the Monthly cost.
Benefit Reductions, Exclusions and Limitations
Benefit Reduction Schedule: If you are still employed, your benefits will reduce to 65% at age 65 and 50% at age 70. Your premiums will also reduce to match your benefits.
Limitations – For multiple covered losses, benefits are paid for the single largest benefit available. For loss of life, the benefit amount shown will be reduced by the amount of any dismemberment benefits that were previously paid or payable.
Exclusions - Please refer to plan certificate for a full list of exclusions.
“ ” ’
returns); (b) your taxable compensation; (c) your spouse’s actual or deemed earned income.
“Register” in the top right corner, and follow the
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/lovejoyisd
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.
Employee Assistance Program (EAP)
New York Life
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/lovejoyisd
Life: just when you think you’ve got it figured out, along comes a challenge. Whether your needs are big or small, New York Life Group Benefit Solutions is there for you with our Employee Assistance & Wellness Support program1. It can help you and your family find solutions and restore your peace of mind. This is just another example of how we are committed to Putting Benefits To Work For PeopleSM.
Our suite of value-add resources includes:
Employee Assistance Program1
Are you feeling overwhelmed by the demands of balancing work and family life? Maybe you have questions about a legal or financial concern. You and your family members now have access to various counseling services including legal, financial, and work-life balance assistance. All counseling calls are answered by a Master’s or PhD-level counselor who will collect some general information and will discuss your needs. The Employee Assistance Program provides a maximum of three sessions, per issue, per year.
Guidance Resources®1
When you need information quickly to help handle life’s challenges, you can visit guidanceresources.com for resources and tools on topics such as health and wellness, legal regulations, family and relationships, work and education, money and investments, and home and auto. You will also have access to articles, podcasts, videos, slideshows, on-demand trainings and “Ask the Expert” which provides personal responses to your questions.
Well-being Coaching1
Sometimes you may need help with personal challenges and physical issues that can be overwhelming. To help you achieve your goals, you will have access to a certified coach who will work with you, one on one, to address health and well-being issues such as burnout, time management and coping with stress. You have access to five sessions per year. All sessions are conducted telephonically.
Family Source®1
Managing the everyday concerns of home, work and family can be difficult. To help resolve those concerns, you have access to family care service specialists that provide customized research, educational materials and prescreened referrals for childcare, adoption, elder care, education, and pet care.
Contact Info:
Employee Assistance and Wellness Support 24/7
Phone: (800) 344-9752
Website: guidanceresources.com
Hospital Cash CHUBB
ABOUT HOSPITAL INDEMNITY
This is an affordable supplemental plan that pays you should you be inpatient hospital confined. This plan complements your health insurance by helping you pay for costs left unpaid by your health insurance.
For full plan details, please visit your benefit website: www.mybenefitshub.com/lovejoyisd
Newborn Nursery - This benefit is payable for an insured newborn baby receiving newborn nursery care and who is not confined for treatment of a physical illness, infirmity, disease or injury. • $500
Observation Unit - This benefit is for treatment in a hospital observation unit for a period of less than 20 hours.
$500
Maximum Days Per Calendar Year: 2
Maximum Days Per Calendar Year: 2
Maximum Days Per Calendar Year: 2
This is a summary of the benefits offered under this plan. Please refer to the Certificate located on the employee website www.mybenefitshubcom/lovejoyisd under the Hospital Indemnity Section for details.
Critical Illness Insurance CHUBB
ABOUT CRITICAL ILLNESS
Critical illness insurance can be used towards medical or other expenses. It provides a lump sum benefit payable directly to the insured upon diagnosis of a covered condition or event, like a heart attack or stroke. The money can also be used for non-medical costs related to the illness, including transportation, child care, etc.
For full plan details, please visit your benefit website: www.mybenefitshub.com/lovejoyisd
No benefit will be paid for a date of diagnosis that occurs prior to the coverage effective date. Covered individuals must be treatment free from cancer for 12 months prior to diagnosis date and in complete remission. There is no pre-existing condition limitation. All amounts are Guaranteed Issue- no medical questions are required for coverage to be issued.
Benefits are payable for a subsequent diagnosis of Benign Brain Tumor, Cancer, Coma, Coronary Artery Obstruction, Heart Attack, Major Organ Failure, Severe Burns, Stroke, or Sudden Cardiac Arrest.
Critical Illness Insurance
Questions?
Contact the Higginbotham Public Sector Careline at (833) 453-1680.
Please refer to your Certificate of Insurance at https://www.mybenefitshub.com/lovejoyisd for a complete listing of available benefits, limitations, and exclusions.
HOW TO FILE YOUR CRITICAL ILLNESS CLAIM
SIGN and DATE the claim form on the website, then submit using one of the methods shown below. The Authorization to Obtain and Disclose Information must be completed and signed. The Attending Physician’s Statement must be completed and signed by the Attending Physician and submitted. Attach a copy of the pathology report or operative report along with all itemized bills related to condition.
Mail To:
Chubb Workplace Benefits
Claim Department PO Box 6700
Scranton, PA 18505-0700
Email to: educatorclaims@chubb.com
Fax to: 312-351-7114
If you have any questions about the claim process or how to complete this form, please call 888-499-0425.
PAYROLL DEDUCTION
Your donation matters! The Foundation for Lovejoy Schools champions a wide range of educational initiatives including:
• Classroom Grants and Enhancements
• Safety Marshal Salaries & Equipment
• Holiday Bonuses for Teachers and Staff
• Professional Development
• New Teacher Classroom Support
FREE TICKETS TO OUR SIGNATURE EVENT, DENIM & DIAMONDS GALA AND LIVE AUCTION WITH:
$10/month donation- One free ticket
$20/month donation- Two free tickets
259 Country Club Road
Allen, Texas 75002
(469) 742-8000 - (469) 742-8001 (fax)
Catastrophic Sick Leave Bank
What Is The Lovejoy ISD Catastrophic Sick Leave Bank?
The Lovejoy ISD Catastrophic Sick Leave Bank is a voluntary employee benefit program developed to provide up to 45 paid days to members who have suffered a catastrophic illness or injury.
Open Enrollment
Employees may join the Catastrophic Sick Leave Bank during the annual open enrollment period, or if a new employee, during the first 30 calendar days from hire date.
Who Is Eligible?
All full time Lovejoy ISD employees working at least 21 hours or more per week and eligible for leave benefits may become a member of the Sick Leave Bank.
How To Enroll
To become a member of the Bank, an employee must contribute two days from his/her accrued or anticipated local leave for the current calendar year. New employees have the first 30 calendar days from their hire date to join the bank.
The two contributed days will be acquired within the first 60 days of employment from the member ’s local leave record and become the property of the Lovejoy ISD Catastrophic Sick Leave Bank. Existing employees who wish to join the Bank must do so during the district’s annual open enrollment.
Membership
The effective date of membership will be the 9/1 date of the year in which the employee signed up during open enrollment. All Sick
Leave days donated remain in the Bank and cannot be returned even upon cancellation of membership.
Membership continues from year to year, without any additional contributions, unless:
● The member uses one or more days from the Bank during the year; OR
● A member decides to cancel his/her membership in the Bank; OR
● A member terminates employment with the District; OR
● The days paid to members during the school year cause the number of days remaining in the bank to fall below two times the number of members. Then, depending on the need, current members will give an additional day to replenish the Bank. (If a current member is unable to donate the emergency request due to that member ’s leave being exhausted, the member ’s ability to use the sick leave bank is not affected.)
Qualifying For Catastrophic Sick Leave Bank Days
A member may request days from the Catastrophic Sick Leave Bank only after he/she has exhausted all accumulated state and local leave days, plus the 10 extended sick leave days. Catastrophic Sick Leave Bank days can be granted only for working day absences and will not be granted for holidays, vacation days, or other such days for which the member is not paid. A member may receive days from the Bank ONLY after the two day membership donation has been contributed. Anyone who joins the sick leave bank with a pre-existing, diagnosed condition or illness for which they
Catastrophic Sick Leave Bank
have received treatment within the last 90 days, shall not be allowed to utilize the sick leave bank for an illness resulting from or related to that specific condition until the member has been treatment free for 90 days or has been a member of the sick leave bank for one full year(365 days).
Days from the Bank are granted only for a catastrophic illness or injury that necessitates an extended in-patient hospital stay of 3 days or more and an absence from work based on the Catastrophic Sick Leave Bank guidelines.
The application for Catastrophic Sick Leave Bank days must be requested from the Human Resources office as early as possible, but no later than 30 work days from the date the employee returns to work.
A member who suffers a catastrophic illness or injury may initially apply for up to 30 days from the Bank. If the employee is unable to return to work after the initial 30 days are exhausted, he/she may apply for up to 15 additional days.
Use Of Catastrophic Sick Leave Bank for Immediate Family
The Bank may be used for members whose immediate family has suffered a catastrophic illness or injury that necessitates an extended in-patient hospital stay of 3 days or more. Immediate family is defined in Board Policy DEC (Local).
The maximum number of Catastrophic Sick Leave Bank days that may be granted to an employee during the year (July 1 through June 30) is 45 days.
What Is Considered Catastrophic?
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. Complications resulting from pregnancy shall be treated the same as any other condition. Such conditions typically require at least 3 days of extended in-patient hospitalization or is expected to result in disability or death.
Determination of “catastrophic” is based upon the physician’s statement with diagnosis, and any complications, in accordance with the Catastrophic Sick Leave Bank guidelines. A few examples of conditions that may be considered catastrophic are:
● Inpatient hospitalization due to major non-elective surgery or injury (proof of room & board charges will be required)
● Organ transplant
● Cancer with chemotherapy treatment
Exclusions include normal pregnancy and/or post-natal care; elective or routine surgery; outpatient procedures; mental disability that is not considered a “serious mental illness” as defined by Texas law; and workers’ compensation income eligibility.
When an employee has suffered a catastrophic illness or injury, the member may submit from the Benefit Specialist a request for days from the Bank. This request will include the “Application for Catastrophic Sick Leave Bank Days” and the “Catastrophic Sick Leave Bank Physician’s Statement”. A copy of inpatient room and board charges will also be required. Applications will be processed by the Benefits Specialist and reviewed by the Sick Leave Bank Executive Officer.
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+).
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
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 Lovejoy 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 Lovejoy 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.