2024-25 Palacios ISD Benefit Guide

Page 1


Benefit Contact Information

Higginbotham Public Sector (833) 453-1680

www.mybenefitshub.com/palaciosisd

Cigna (800) 244-6224

BCBSTX (866) 355-5999 www.bcbstx.com/trsactivecare

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

IDWatchdog (800) 774-3772

www.idwatchdog.com

Higginbotham (866) 419-3519

www.higginbotham.net Flexclaims@higginbotham.net

Lincoln Financial Group

Long-Term Disability Plan #10255651 Short-Term Disability Plan #10255648 (800) 423-2765 www.lfg.com

5Star Life Insurance (866) 863-9753 www.5starlifeinsurance.com

Cigna Group #3337069 (800) 244-6224

www.cigna.com

MetLife Group #5959277 (800) 438-6388

www.metlife.com

United Health Care Group #305114 (866) 556-8298 www.uhc.com

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

Lincoln Financial Group (800) 423-2765

www.lfg.com

MDLIVE (888) 365-1663

www.mdlive.com/fbs

Unum Group #474112 (800) 635-5597

www.unum.com

TCG (800) 943-9179 www.tcgservices.com

MASA Group #B2BPALISD (800) 423-3226

www.masamts.com

1

2

3

www.mybenefitshub.com/palaciosisd

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

Benefit Updates - What’s New:

NEW Voluntary Benefits:

• Cancer - Now offered through Chubb. Enhanced benefits including first diagnosis benefit, additional wellness benefits, and heart attack/stroke coverage.

• Vision - Now offered through Cigna. $10 copy for annual exam; $25 copay for materials.

IRS HAS ESTABLISHED NEW CONTRIBUTION LIMITS FOR FSA AND HSA!

• FSA - $3,200

• HSA - $4,150 Individual, $8,300 Family. Those age 55+ can contribute an additional $1,000.

Don’t Forget!

• Login and complete your benefit enrollment from 07/08/2024 - 08/14/2024

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

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

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

Annual Benefit Enrollment

Annual Enrollment

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

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

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

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

New Hire Enrollment

All new hire enrollment elections must be completed in the online enrollment system within the first 30 days of benefit eligibility employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.

Q&A

Who do I contact with Questions?

For supplemental benefit questions, you can contact your Benefits Office or you can call Higginbotham Public Sector at (866) 914-5202 for assistance.

Where can I find forms?

For benefit summaries and claim forms, go to your benefit website: www.mybenefitshub.com/palaciosisd 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 Palacios ISD benefit website: www.mybenefitshub.com/palaciosisd. 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 Benefits Office to complete and sign the necessary paperwork in order to make a benefit election change. Benefit changes must be consistent with the qualifying event.

QUALIFYING EVENTS

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

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

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

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

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

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

Annual Benefit Enrollment

Employee Eligibility Requirements

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

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

Dependent Eligibility Requirements

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

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

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

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

To age 26

To age 26

Emergency Medical

Transportation To age 26

Individual Life To Age 26

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

Disclaimer: You acknowledge that you have read the limitations and exclusions that may apply to obtaining spouse and dependent coverage, including limitations and exclusions that may apply to enrollment in Flexible Spending Accounts and Health Savings Accounts as a married couple. You, the enrollee, shall hold harmless, defend, and indemnify Higginbotham Public Sector from any and all claims, actions, suits, charges, and judgments whatsoever that arise out of the enrollee’s enrollment in spouse and/or dependent coverage, including enrollment in Flexible Spending Accounts and Health Savings Accounts.

If your dependent is disabled, coverage may be able to continue past the maximum age under certain plans. If you have a disabled dependent who is reaching an ineligible age, you must provide a physician’s statement confirming your dependent’s disability. Contact your Benefits Office to request a continuation of coverage.

Helpful Definitions

Actively-at-Work

You are performing your regular occupation for the employer on a full-time basis, either at one of the employer’s usual places of business or at some location to which the employer’s business requires you to travel. If you will not be actively at work beginning 9/1/2024 please notify your benefits administrator.

Annual Enrollment

The period during which existing employees are given the opportunity to enroll in or change their current elections.

Annual Deductible

The amount you pay each plan year before the plan begins to pay covered expenses.

Calendar Year

January 1st through December 31st

Co-insurance

After any applicable deductible, your share of the cost of a covered health care service, calculated as a percentage (for example, 20%) of the allowed amount for the service.

Guaranteed Coverage

The amount of coverage you can elect without answering any medical questions or taking a health exam. Guaranteed coverage is only available during initial eligibility period. Actively-at-work and/or preexisting condition exclusion provisions do apply, as applicable by carrier.

In-Network

Doctors, hospitals, optometrists, dentists and other providers who have contracted with the plan as a network provider.

Out-of-Pocket Maximum

The most an eligible or insured person can pay in coinsurance for covered expenses.

Plan Year

September 1st through August 31st

Pre-Existing Conditions

Applies to any illness, injury or condition for which the participant has been under the care of a health care provider, taken prescriptions drugs or is under a health care provider’s orders to take drugs, or received medical care or services (including diagnostic and/or consultation services).

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

$570 Rollover - Remaining funds of $570 or less will be rolled forward to the next plan year. Amounts above $570 will be forfeited.

No

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

Medical Insurance

ABOUT MEDICAL

Major medical insurance is a type of health care coverage that provides benefits for a broad range of medical expenses that may be incurred either on an inpatient or outpatient basis.

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

Learn the Terms.

• Premium: The monthly amount you pay for health care coverage.

• Deductible: The annual amount for medical expenses you’re responsible to pay before your plan begins to pay.

• Copay: The set amount you pay for a covered service at the time you receive it. The amount can vary based on the service.

• Coinsurance: The portion you’re required to pay for services after you meet your deductible. It’s often a specified percentage of the costs; e.g., you pay 20% while the health care plan pays 80%.

• Out-of-Pocket Maximum: The maximum amount you pay each year for medical costs. After reaching the out-of-pocket maximum, the plan pays 100% of allowable charges for covered services.

Health Savings Account (HSA) EECU

ABOUT HSA

A Health Savings Account (HSA) is a personal savings account where the money can only be used for eligible medical expenses. Unlike a flexible spending account (FSA), the money rolls over year to year however only those funds that have been deposited in your account can be used. Contributions to a Health Savings Account can only be used if you are also enrolled in a High Deductible Health Care Plan (HDHP). For full plan details, please visit your benefit website: www.mybeneitshub.com/sampleisd

www.mybenefitshub.com/palaciosisd

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.

Hospital Indemnity Lincoln Financial Group

ABOUT HOSPITAL INDEMNITY

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

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

confinement - For each day of confinement in a hospital as a result of an accident

Hospital ICU confinement - For each full or partial day of confinement in an ICU as a result of an accident $400 per day for 30 days per calendar year starting the 1st day of confinement $200 per day for 30 days per calendar year starting the 1st day of confinement

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

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

care - For each day of confinement to a hospital for routine post-natal care following birth

On-demand care for illness and injuries is

part of your health plan.

MDLIVE. Anytime. Anywhere.

Getting sick is always a hassle. When you need care fast, talk to a board-certified MDLIVE doctor in minutes. Get reliable care from the comfort of home instead of an urgent care clinic or crowded ER. MDLIVE is open nights, weekends, and holidays. No surprise costs.

Convenient and reliable care.

MDLIVE doctors have an average of 15 years of experience and can be reached 24/7 by phone or video.

Affordable alternative to urgent care clinics and the ER. MDLIVE treats 80+ common conditions like flu, sinus infections, pink eye, ear pain, and UTIs (Females, 18+). By talking to a doctor at home, you can avoid long waits and exposure to other sick people. Prescriptions.

Your MDLIVE doctor can order prescriptions1 to the pharmacy of your choice. MDLIVE can also share notes with your local doctor upon request.

MDLIVE cares for more than 80 common, non-emergency conditions, including:

• Pink Eye

• Sinus Problems

• Cough

• Ear Pain

• Headache

• Prescriptions

• Sore Throat

• UTI (Females, 18+)

• Yeast Infections

• And more

1Prescriptions are available at the physician’s discretion when medically necessary. A renewal of an existing prescription can also be provided when your regular physician is unavailable, depending on the type of medication.

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/palaciosisd

Our dental plan helps you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work. Premium contributions are deducted from your paycheck on a pretax basis. Coverage is provided through Cigna Dental

How to Find a Dentist

Visit https://hcpdirectory.cigna.com/ or call 800-244-6224 to find an in-network dentist. Your network will be Total Cigna DPPO.

How to Request a New ID Card

You can request your dental id card by contacting Cigna directly at 800-244-6224. You can also go to www.mycigna.com and register/login to access your account. In addition, you can download the “MyCigna” app on your smartphone and access your id card right there on your phone.

Cigna Dental Choice Plan

Dental Insurance Cigna

Highlights

Class I: Diagnostic & Preventive Oral Evaluations

Prophylaxis: routine cleanings

X-rays: routine

X-rays: non-routine

Fluoride Application

Sealants: per tooth

Space Maintainers: non-orthodontic

Class II: Basic Restorative Restorative: fillings

Endodontics: minor and major Periodontics: minor and major Oral Surgery: simple extractions only Emergency Care to Relieve Pain

Class III: Major Restorative Inlays and Onlays

Prosthesis Over Implant Crowns: prefabricated stainless steel / resin Crowns: permanent cast and porcelain Bridges and Dentures

Oral Surgery: all except simple extractions Anesthesia: general and IV sedation Repairs: Bridges, Crowns and Inlays Repairs: Dentures

Denture Relines, Rebases and Adjustments s

IV: Orthodontia

Vision Insurance Cigna

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/palaciosisd

Summary of Benefits

Cigna Health and Life Insurance Company

Cigna Vision serviced by EyeMed Palacios ISD

C1 PPO Comprehensive Plan

Welcome to Cigna Vision Schedule of Vision Coverage Effective Date: September 1, 2024

Exam and Professional Services:

Standard Eyeglass Lenses Allowances: Frequency*: one pair per 12 month

Lenses:

Single Vision

Lined Bifocal Lined Trifocal

Lens Enhancements / Options:

Oversize lenses

Rose #1 and #2 Solid Tints

Polycarbonate Lenses <19 years of age

Standard Polycarbonate Lenses

Standard Progressives

Plastic Dye Tints

Photochromic – Glass or Plastic

Scratch Coating

Standard Ultraviolet (UV) Coating

Standard Anti-Reflective (AR) Coating

Hi-Index Lenses

All other lens options, including Premium Tiers

Contact Lenses Retail Allowance:

Vision Insurance Cigna

Retail Allowance Frequency*: one per 12 month

* Your Frequency Period begins on January 1 (Calendar year basis)

Definitions:

Copay: the amount you pay towards your exam and/or materials, lenses and/or frames. Coinsurance: the percentage of charges Cigna will pay. Customer is financially responsible for the balance. Allowance: the maximum amount Cigna will pay. Customer is financially responsible for any amount over the allowance.

In-Network Coverage Includes**:

• One vision and eye health evaluation including but not limited to eye health examination, dilation, refraction, and prescription for glasses;

• One pair of standard prescription plastic or glass lenses, all ranges of prescriptions (powers and prisms) including Oversize, Rose #1 or #2 Solid Tint and Polycarbonate lenses < 19 years of age.

| 20% savings on all additional lens enhancements/ option you choose for your lenses, not shown on the Schedule of Vision Coverage above.

• One pair of Elective conventional contact lenses or a single purchase of a supply of disposable contact lenses – in lieu of lenses and frame benefit, (may not receive contact lenses and frames in same benefit year).

• Coverage for Therapeutic contact lenses will be provided when visual acuity cannot be corrected to 20/70 in the better eye with eyeglasses and the fitting of the contact lenses would obtain this level of visual acuity; and in certain cases of anisometropia, keratoconus, or aphakis; as determined and documented by your Vision eye care professional. Contact lenses fitted for other therapeutic purposes or the narrowing of visual fields due to high minus or plus correction will be covered in accordance with the Elective contact lens coverage shown on the Schedule of Vision Coverage.

• One frame for prescription lenses – frame of choice covered up to retail plan allowance, plus a 20% savings on amount that exceeds frame allowance;

** Coverage may vary at participating discount retail and membership club optical locations, please contact Customer Service for specific coverage information.

*** Provider participation is 100% voluntary; please check with your Eye Care Professional for any offered discounts.

What’s Not Covered:

• Orthoptic or vision training and any associated supplemental testing

• Medical or surgical treatment of the eyes

• Any eye examination, or any corrective eyewear, required by an employer as a condition of employment

• Any injury or illness when paid or payable by Workers’ Compensation or similar law, or which is work-related

• Charges in excess of the usual and customary charge for the Service or Materials

• Charges incurred after the policy ends or the insured’s coverage under the policy ends, except as stated in the policy

• Experimental or non-conventional treatment or device

• Magnification or low vision aids not shown as covered in the Schedule of Vision Coverage

• Any non-prescription (minimum Rx required) eyeglasses, includes frame, lenses, or contact lenses

• Spectacle lens treatments, “add-ons”, or lens coatings not shown as covered in the Schedule of Vision Coverage

• Prescription sunglasses lens “add-ons”, or lens coatings not shown as covered in the Schedule of Vision Coverage

• Two pair of glasses, in lieu of bifocals or trifocals

• Safety glasses or lenses required for employment not shown as covered in the Schedule of Vision Coverage

• VDT (video display terminal)/computer eyeglass benefit

• Claims submitted and received in excess of twelve (12) months from the original Date of Service

How to use your Cigna Vision Benefits

1. Finding a doctor

There are three ways to find a quality eye doctor in your area:

1. Log into myCigna.com, under ”Coverage”, select Vision page. Click on Visit Cigna Vision. Then select “Find a Cigna Vision Network Eye Care Professional” to search the Cigna Vision – serviced by EyeMed Directory.

2. Don’t have access to myCigna.com? Go to Cigna.com, top of the page select “Find A Doctor, Dentist or Facility”, click on Cigna Vision serviced by EyeMed Directory, from the Additional Directories drop down listing.

3. Prefer the phone? Call the toll-free number found on your Cigna insurance card and talk with a Cigna Vision customer service representative.

2. Schedule an appointment

Identify yourself as a Cigna Vision customer when scheduling an appointment. Present your Cigna Vision serviced by EyeMed information at the time of your appointment, which will quickly assist the doctor’s office with accessing your plan details and verifying your eligibility.

Accident Insurance

ABOUT ACCIDENT

Do you have kids playing sports, are you a weekend warrior, or maybe accident-prone? Accident plans are designed to help pay for medical costs associated with accidents and benefits are paid directly to you.

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

Accident Insurance Plan Summary

You’ll have a choice of two comprehensive plans which provide payments in addition to any other insurance payments you may receive. Here are just some of the covered events/services.

Accident Insurance

Accidental Death

Employee receives 100% of amount shown, spouse receives 50% and children receive 20% of amount shown.

Dismemberment, Loss & Paralysis

Other Benefits

Lodging6 - Pays for lodging for companion up to 30 nights per calendar year

Health Screening Benefit (Wellness)7 benefit provided if the covered insured takes one of the covered screening/prevention tests

QUESTIONS & ANSWERS

Who is eligible to enroll for this accident coverage?

$250 - $10,000 per injury

$100 per night, up to 31 nights

1x per calendar year

$500 - $50,000 per injury

$200 per night, up to 31 nights $50

1x per calendar year

You are eligible to enroll yourself and your eligible family members!9 You need to enroll during your Enrollment Period and be actively at work for your coverage to be effective.

How do I pay for my accident coverage?

Premiums will be conveniently paid through payroll deduction, so you don’t have to worry about writing a check or missing a payment.

What happens if my employment status changes? Can I take my coverage with me?

Yes, you can take your coverage with you.10 You will need to continue to pay your premiums to keep your coverage in force. Your coverage will only end if you stop paying your premium or if your employer offers you similar coverage with a different insurance carrier.

Who do I call for assistance?

Contact a MetLife Customer Service Representative at 1 800-GET-MET8 (1-800-438-6388), Monday through Friday from 8:00 a.m. to 8:00 p.m., EST.

Disability Insurance Lincoln Financial Group

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/palaciosisd

The Lincoln Short-term Disability Insurance Plan:

• Provides a cash benefit when you are out of work for up to 9 or 11 weeks due to injury, illness, surgery, or recovery from childbirth

• Features group rates for employees

• Provides a partial cash benefit if you can only do part of your job or work part time

• Offers a fast, no-hassle claims process

Sickness Elimination Period:

• Option 1: You must be out of work for 14 days due to an illness before you can collect disability benefits. You can begin collecting benefits on day 15.

• Option 2: You must be out of work for 30 days due to an illness before you can collect disability benefits. You can begin collecting benefits on day 31.

Accident Elimination Period:

• Option 1: You must be out of work for 14 days due to an accidental injury before you can collect disability benefits. You can begin collecting benefits on day 15.

• Option 2: You must be out of work for 30 days due to an accidental injury before you can collect disability benefits. You can begin collecting benefits on day 31.

Recurrent Disability Benefits: If you become disabled for the same condition within 14 days following your prior disability, your benefits will continue under the same claim.

60% of your weekly salary, limited to $1,000 per week 60% of your weekly salary, limited to $1,000 per week

Disability Insurance Lincoln Financial Group

The

Lincoln

Long-term Disability Insurance Plan:

• Provides a cash benefit after you are out of work for 90 days or more due to injury, illness, or surgery

• Starts with a “core plan” that is paid for by Palacios Independent School District

• Offers a simple “buy-up” option that lets you enhance your benefit at affordable group rates

• Features group rates for eligible employees

• Includes EmployeeConnectSM services, which give you and your family confidential access to counselors as well as personal, legal, and financial assistance

Core Plan (paid by Palacios Independent School District)

Monthly benefit amount

Elimination period

40% of your monthly salary, limited to $5,000 per month

90 days

Coverage period for your occupation 24 months

Maximum coverage period

Up to age 65 or Social Security Normal Retirement Age (SSNRA), whichever is later

“Buy-Up” Option (paid by you through payroll deduction)

Monthly benefit amount

Elimination period

66.67% of your monthly salary, limited to $5,000 per month

90 days

Coverage period for your occupation 24 months

Maximum coverage period

Elimination Period

Up to age 65 or Social Security Normal Retirement Age (SSNRA), whichever is later

• This is the number of days you must be disabled before you can collect disability benefits.

• The elimination period can be met through either total disability (out of work entirely) or partial disability (working with a reduced schedule or performing different types of duties.)

Coverage Period for Your Occupation

• This is the coverage period for the trade or profession in which you were employed at the time of your disability (also known as your own occupation).

• You may be eligible to continue receiving benefits if your disability prohibits you from any employment for which you are reasonably suited through your training, education, and experience. In this case, your benefits may extend through the end of your maximum coverage period (benefit duration).

Maximum Coverage Period

• This is the total amount of time you may be eligible to collect disability benefits (also known as the benefit duration).

• Benefits are limited to 24 months for mental illness; 24 months for substance abuse. See contract for detail on other specified illnesses.

Disability Insurance

Lincoln Financial Group

Traditional LTD and STD Disability - Definitions

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

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

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

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

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

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

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/palaciosisd

First cancer benefit

Diagnosis of cancer

Hospital confinement

Hospital confinement ICU

Radiation therapy, chemotherapy, immunotherapy

Alternative care

Medical imaging

Skin cancer initial diagnosis

Attending physician

Hospital confinement sub-acute ICU

$100 paid upon receipt of first covered claim for cancer; only one payment per covered person per certificate per calendar year

$5,000 employee or spouse

$7,500 child(ren)

Waiting period: 0 days

Benefit reduction: none

$300 per day – days 1 through 30

Additional days: $600

Maximum days per confinement: 31

$600 per day – days 1 through 30

Additional days: $600

Maximum days per confinement: 31

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

$75 per visit

Maximum visits per calendar year: 4

$500 per imaging study

Maximum studies per calendar year: 2

$100 per diagnosis

Lifetime maximum: 1

$50 per visit

Maximum visits per confinement: 2

Maximum visits per calendar year: 4

$300 per day – days 1 through 30

Additional days: $300

Maximum days per confinement: 31

Childcare: $100 per day per child

Maximum days per calendar year: 30

Family care

Prescription drug in-patient

Adult day care or home healthcare:

$100 per day

Maximum days per calendar year: 30

Per confinement: $150

Maximum confinements per calendar year: 6

$100 paid upon receipt of first covered claim for cancer; only one payment per covered person per certificate per calendar year

$10,000 employee or spouse

$15,000 child(ren)

Waiting period: 0 days

Benefit reduction: none

$300 per day – days 1 through 30

Additional days: $600

Maximum days per confinement: 31

$600 per day – days 1 through 30

Additional days: $600

Maximum days per confinement: 31

Maximum per covered person per calendar year per 12-month period: $15,000

$75 per visit

Maximum visits per calendar year: 4

$500 per imaging study

Maximum studies per calendar year: 2

$100 per diagnosis

Lifetime maximum: 1

$50 per visit

Maximum visits per confinement: 2

Maximum visits per calendar year: 4

$300 per day – days 1 through 30

Additional days: $300

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

Cancer Insurance CHUBB

Private full-time nursing services

Renewability

Portability

$150 per day

Maximum days per confinement: 5

$150 per day

Maximum days per confinement: 5

Conditionally Renewable Coverage is automatically renewed as long as the insured is an eligible employee, premiums are paid as due, and the policy is in force.

Portability Employees can keep their coverage if they change jobs or retire while the policy is in-force.

Continuity of coverage Included

Pre-existing conditions limitation

A condition for which a covered person received medical advice or treatment within the 12 months preceding the certificate effective date.

Waiver of premium Included

If the certificate replaced another cancer indemnity certificate or individual policy, your coverage under the certificate shall not limit or exclude coverage for a pre-existing condition or waiting period that would have been covered under the policy being replaced.

Continuity of coverage

Definition of cancer

Definition of cancer

Benefits payable for a pre-existing condition or during the waiting period will be the lesser of the benefits that would have been payable under the terms of the prior coverage if it had remained in force; or the benefits payable under the certificate.

Time periods applicable to pre-existing conditions and waiting periods will be waived to the extent that similar limitations or exclusions were satisfied under the coverage being replaced.

Continuity of coverage is only extended to the benefits provided under the certificate. The certificate may not include all the benefits provided under the prior coverage.

Cancer means carcinoma in situ, leukemia, or a malignant tumor characterized by uncontrolled cell growth and invasion or spread of malignant cells to distant tissue. Cancer is also defined as cancer which meets the diagnosis criteria of malignancy established by the American Board of Pathology after a study of the histocytologic architecture or pattern of the suspect tumor, tissue, or specimen. Carcinoma in situ means a malignant tumor which is typically classified as Stage 0 cancer, where the tumor cells still lie within the tissue of the site of origin without having invaded neighboring tissue.

The following are not considered cancer: Pre-malignant conditions or conditions with malignant potential; non-invasive basal cell carcinoma of the skin; non-invasive squamous cell carcinoma of the skin; or melanoma diagnosed as Clark’s Level I or II or Breslow less than .75mm.

Plan descriptions Refer to the Certificate of Coverage for details specific to each plan.

Critical Illness Insurance Unum

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/palaciosisd

How does it work?

If you’re diagnosed with an illness that is covered by this insurance, you can receive a lump sum benefit payment. You can use the money however you want.

Why is this coverage so valuable?

• The money can help you pay out-of-pocket medical expenses, like co-pays and deductibles.

• You can use this coverage more than once. Even after you receive a payout for one illness, you’re still covered for the remaining conditions and for the reoccurrence of any critical illness with the exception of skin cancer. Even after you receive a payout for one illness, you’re still covered for the remaining conditions. Diagnoses must be at least 180 days apart or the conditions can’t be related to each other.

What’s covered?

Critical illnesses

• Heart attack

• Stroke

• Major organ failure

• End-stage kidney failure

Progressive diseases

• Amyotrophic Lateral Sclerosis (ALS)

• Dementia, including Alzheimer’s disease

• Multiple Sclerosis (MS)

• Parkinson’s disease

• Functional loss

• Coronary artery disease Major (50%): Coronary artery bypass graft or valve replacement Minor (10%): Balloon angioplasty or stent placement

• Supplemental conditions

• Loss of sight, hearing, or speech

• Benign brain tumor

• Coma

• Permanent Paralysis

• Occupational HIV, Hepatitis B, C, or D

• Infectious Diseases (15%)

Critical Illness Insurance Unum

Why should I buy coverage now?

• It’s more affordable when you buy it through your employer and the premiums are conveniently deducted from your paycheck

• If you apply during your initial enrollment, you can get coverage without a health exam or medical questions.

• Coverage is portable. You may take the coverage with you if you leave the company or retire. You’ll be billed at home.

Who can get coverage

You Choose $10,000, $10,000 or $30,000 of coverage with no medical questions if you apply during this enrollment.

Your spouse

Your children

Spouses can get 100% of the employee coverage amount as long as you have purchased coverage for yourself.

Children from live birth to age 26 are automatically covered at no extra cost. Their coverage amount is 100% of yours. They are covered for all the same illnesses plus these specific childhood conditions: cerebral palsy, cleft lip or palate, cystic fibrosis, Down syndrome, and spina bifida. The diagnosis must occur after the child’s coverage effective date.

Be Well Benefit

Every year, each family member who has Critical Illness coverage can also receive $50 for getting a covered Be Well Benefit screening test, such as:

• Annual exams by a physician (including sports physicals) for adults, and well-child visits

• Screenings for cancer, including pap smear, colonoscopy

• Cardiovascular function screenings

• Screenings for cholesterol and diabetes

• Imaging studies, including chest X-ray, mammography

• Immunizations including HPV, MMR, tetanus, influenza

Life and AD&D Lincoln Financial Group

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/palaciosisd

Am I eligible?

How much company paid Basic Life and AD&D do I have?

How much Employee Supplemental Life and AD&D can I purchase?

You are eligible if you are an active, full-time Employee who works at least 20 hours per week on a regularly scheduled basis.

Your employer provides, at no cost to you, Employee Basic Life and AD&D Insurance in an amount equal to 2 times your Annual Earnings, rounded to the next higher $1,000, to a maximum of $100,000. Annual Earnings are defined in UnitedHealthcare’s contract with your employer.

You can purchase Supplemental Life and AD&D Insurance in increments of $10,000, $10,000 minimum to a $500,000 maximum. However, coverage cannot exceed 5 times your Annual Earnings. Annual Earnings are defined in UnitedHealthcare’s contract with your employer.

How much Spouse Supplemental Life and AD&D can I purchase?

How much Child(ren) Supplemental Life and AD&D can I purchase?

If you elect Employee Supplemental Life and AD&D Insurance for yourself, you may choose to purchase Spouse Supplemental Life and AD&D Insurance in increments of $5,000, $5,000 minimum to a maximum of $250,000. However, coverage cannot exceed 50% of the employee’s Supplemental Life and AD&D amount. You may not elect coverage for your Spouse if they are already covered as an Employee under this policy.

If you elect Supplemental Life and AD&D Insurance for yourself, you may choose to purchase Child(ren)* Supplemental Life and AD&D Insurance in increments of $1,000, $1,000 minimum to a maximum of $10,000 for each child. However, coverage cannot exceed 50% of the employee’s Supplemental Life and AD&D amount.

Note: Paid benefit is limited to $500 for a child age live birth to 6 months.

*Eligible Child(ren) are from live birth to age 26. What is the highest amount of Supplemental Life I can buy without filling out a medical questionnaire? (Guarantee Issue Limit)

New Hire:

Employee - You may elect up to $130,000. Amounts greater will require evidence of good health/insurability. Spouse - You may elect up to $50,000. Amounts greater will require evidence of good health/insurability.

Child(ren) - You may elect up to $10,000.

Spouse rates based on Employee’s age.

Life and AD&D Lincoln Financial Group

continued Annual Enrollment

Employee - If you are enrolled in coverage, you may increase your amount by one increment level of $10,000 up to $130,000. Amounts greater will require evidence of good health/insurability.

Spouse - If your Spouse has never been denied* spouse coverage, you may increase that coverage by one incremental of $5,000 up to $50,000. Amounts greater will require evidence of good health/insurability.

Late Entrant (did not enroll within 31 days of initial eligibility):

For Employee and Spouse coverage, evidence of good health/insurability is required for any requested amount.

What does AD&D provide me?

Accidental Death & Dismemberment (AD&D) provides benefits due to certain injuries or death from an accident.* The covered injuries or death can occur up to 365 days after the accident. The AD&D Insurance pays certain percentages of the benefit amount based on the injury sustained. Refer to the certificate of coverage for the complete AD&D Benefit schedule. Coverage includes 10% additional benefit for use of Seatbelt only or Seatbelt and Air Bag for loss of life. Your total benefit for all losses due to the same accident will not be more than 100% of the amount of coverage provided to you.

*Some state variations may apply.

What is a beneficiary? Your beneficiary is a person (or persons) or legal entity (entities) who receives a benefit payment if you die while you are covered under the policy. You, as the employee, must select your beneficiary when you complete your enrollment application; your selection is legally binding. You are automatically the beneficiary for any Spouse or Child(ren) coverage.

Are any resources available for beneficiaries?

Are there other limitations to enrollment?

Does my coverage reduce as I get older?

Do I still pay my Life Insurance premiums if I become disabled?

What is Accelerated Death Benefit?

Can I keep my Life coverage if I leave my employer?

Beneficiary Services: Provides beneficiaries with services for grief consultation, financial/legal assistance and referral to community resources. For more information, call 866-302-4480. See below for more details.

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

This coverage, like most group benefit insurance, requires that a certain percentage of eligible employees participate. If that group participation minimum is not met, the insurance coverage that you have elected may not be in effect.

Yes, Employee Basic Life and AD&D and Supplemental Life and AD&D coverage reduces to 67% of the face amount at age 70; to 45% of the original amount at age 75.

Spouse Supplemental Life and AD&D coverage reduces the same as the employee’s. All coverage terminates upon employee’s retirement.

If you become totally disabled before age 60 and your disability lasts for at least 9 months, your Employee Supplemental Life Insurance premium may be waived.

If you are diagnosed as terminally ill with a 12 month or less life expectancy, you may receive payment of a portion of your Life Insurance. The remaining amount of your Life Insurance would be paid to your beneficiary when you die.

Yes, subject to the contract, you have the option of:

• Converting your group Life coverage to your own individual policy (policies).

• If you leave your employer, Portability is an option that allows you to continue your Supplemental Life Insurance coverage. To be eligible, you must terminate your employment prior to age 70. This option allows you to continue all or a portion of your Life Insurance coverage under a separate Portability term policy. Portability is subject to a minimum of $5,000 and a maximum of $500,000 and does include coverage for your Spouse and Children. You must elect portability for your own coverage in order to elect portability for your Spouse and or Children. To elect Portability, you must apply and pay the premium within 30 days of the termination of your Life Insurance.

Dependent Spouse Portability is subject to a maximum of $250,000. Dependent Child Portability is subject to a maximum of $10,000.

Family Protection Plan

Group Term Life Insurance to age 121 with Quality of Life

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

Life doesn’t come with a lesson plan

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

Why buy life insurance when you’re young?

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

Portable

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

Why is portability important?

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

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

Family Protection Plan

Group Term Life Insurance to age 121 with Quality of Life underwritten by 5Star Life Insurance Company

Terminal illness acceleration of benefits

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

Protection you can count on

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

Convenient

Easy payment through payroll deduction.

Quality of Life benefit

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

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

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

How does Quality of Life help?

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

2024 Enrollment Plan Year

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

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

Enroll to provide peace of mind for your family

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

About the coverage

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

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

If you become a victim, you don’t have to face it alone. One of our certified resolution specialists will personally manage the case for you until your identity is restored.

Our family plan helps you better protect your loved ones with personalized accounts for adult family members, family alert sharing, and exclusive features for children.

Powerful Features Included in Both ID Watchdog Plans

Financial Accounts Monitoring

Social Accounts Monitoring

Registered Sex Offender Reporting

Blocked Inquiry Alerts | 1 Bureau

Customizable Alert Options

National Provider ID Alerts

Integrated Fraud Alerts

With a fraud alert, potential lenders are encouraged to take extra steps to verify your identity before extending credit.

Dark Web Monitoring

Data Breach Notifications

High-Risk Transactions Monitoring

Subprime Loan Monitoring

Public Records Monitoring

USPS Change of Address Monitoring

Telecom & Utility Alerts | 1 Bureau

Credit Score Tracker | 1 Bureau

Personalized Identity Restoration

including Pre-Existing Conditions

Online Resolution Tracker

Lost Wallet Vault & Assistance

Deceased Family Member Fraud

Remediation (Family Plan only)

Credit Freeze Assistance

Solicitation Reduction

Help better protect children with Equifax Child Credit Lock & Equifax Child Credit Monitoring PLUS features marked with this icon

Plan-Specific Features

Credit Report Monitoring

Credit Report(s) & VantageScore Credit Score(s)

Credit Report Lock

Subprime Loan Block

within the monitored lending network

Personal VPN and Password Manager

Device Security & Online Privacy

Personal Data Scans & Removal

Essentials

to $1 Million Up to $1M Stolen Funds Reimbursement - Checking and savings accounts

to $1 Million Up to $1M Stolen Funds Reimbursement - Checking and savings accounts

Platinum, Platinum Plus

Plus only

Plus only

Essentials Up to $2 Million Up to $2M Stolen Funds Reimbursement - Checking and savings accounts -401k/HSA/ESOP accounts

Home Title Fraud NEW

Cyber Extortion

Professional Identity Fraud

Deceased Family Member Fraud

Bureau = Equifax | Multi-Bureau = Equifax, TransUnion | 3 Bureau = Equifax, Experian , TransUnion ® ® ®

What You Need to Know

The credit scores provided are based on the VantageScore 3.0 model. For three-bureau VantageScore credit scores, data from Equifax, Experian, and TransUnion are used respectively. Any one-bureau VantageScore uses Equifax data. Third parties use many different types of credit scores and are likely to use a different type of credit score to assess your creditworthiness.

(1)The Integrated Fraud Alert feature is made available to consumers by Equifax Information Services LLC and fulfilled on its behalf by Identity Rehab Corporation. (2)There is no guarantee that ID Watchdog is able to locate and scan all deep and dark websites where consumers' personal information is at risk of being traded. (3)The monitored network does not cover all businesses or transactions. (4)For low Family Plans, applicable for enrolled family members only. (5)Monitoring from Equifax will begin on your plan start date. TransUnion and Experian will take several days to begin after you create an online account. (6)Locking your Equifax or TransUnion credit report will prevent access to it by certain third parties. Locking your Equifax or TransUnion credit report will not prevent access to your credit report at any other credit reporting agency. Entities that may still have access to your Equifax or TransUnion credit report include: companies like ID Watchdog and TransUnion Interactive, Inc. which provide you with access to your credit report or credit score, or monitor your credit report as part of a subscription or similar service; companies that provide you with a copy of your credit report or credit score, upon your request; federal, state, and local government agencies and courts in certain circumstances; companies using the information in connection with the underwriting of insurance, or for employment, tenant or background screening purposes; companies that have a current account or relationship with you, and collection agencies acting on behalf of those whom you owe; companies that authenticate a consumer’s identity for purposes other than granting credit, or for investigating or preventing actual or potential fraud; and companies that wish to make pre approved offers of credit or insurance to you. To opt out of preapproved offers, visit www.optoutprescreen.com.

(7)Available for simultaneous use on up to 6 devices. (8)Equip up to 5 devices; 10 with a Family Plan. (10)May be subject to delay or change. To review ID Watchdog Terms & Conditions, go to idwatchdog.com/terms. (9)The Identity Theft Insurance is underwritten and administered by American Bankers Insurance Company of Florida, an Assurant company. Please refer to the actual policies for terms, conditions, and exclusions of coverage. Coverage may not be available in all jurisdictions. Review the Summary of Benefits (www.idwatchdog.com/terms/insurance).

Flexible Spending Account (FSA)

ABOUT FSA

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

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

www.mybenefitshub.com/palaciosisd

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

Flexible Spending Accounts

Higginbotham

Higginbotham

Important FSA Rules

• The maximum per plan year you can contribute to a Health Care FSA is $3,200. The maximum per plan year you can contribute to a Dependent Care FSA is $5,000 when filing jointly or head of household and $2,500 when married filing separately.

• You cannot change your election during the year unless you experience a Qualifying Life Event.

• In most cases, you can continue to file claims incurred during the plan year for another 90 days after the plan year ends.

• Your Health Care FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care expenses.

• Review your employer's Summary Plan Document for full details. FSA rules vary by employer.

Over-the-Counter Item Rule Reminder

Health care reform legislation requires that certain over-the-counter (OTC) items require a prescription to qualify as an eligible Health Care FSA expense. You will only need to obtain a one-time prescription for the current plan year. You can continue to purchase your regular prescription medications with your FSA debit card. However, the FSA debit card may not be used as payment for an OTC item, even when accompanied by a prescription.

Higginbotham Portal

The Higginbotham Portal provides information and resources to help you manage your FSAs.

• Access plan documents, letters and notices, forms, account balances, contributions and other plan information

• Update your personal information

• Utilize Section 125 tax calculators

• Look up qualified expenses

• Submit claims

• Request a new or replacement Benefits Debit Card

Register on the Higginbotham Portal

Visit https://flexservices.higginbotham.net and click Register. Follow the instructions and scroll down to enter your information.

• Enter your Employee ID, which is your Social Security number with no dashes or spaces.

• Follow the prompts to navigate the site.

• If you have any questions or concerns, contact Higginbotham:

∗ Phone – 866-419-3519

∗ Questions – flexsupport@higginbotham.net

∗ Fax – 866-419-3516

∗ Claims- flexclaims@higginbotham.net

Stay prepared with MASA® AccessSM

Comprehensive coverage and care for emergency transport.

Our Emergent Plus membership plan includes:

Emergency Ground Ambulance Coverage1

Your out-of-pocket expenses for your emergency ground transportation to a medical facility are covered with MASA.

Emergency Air Ambulance Coverage1

Your out-of-pocket expenses for your emergency air transportation to a medical facility are covered with MASA.

Hospital to Hospital Ambulance Coverage1

When specialized care is required but not available at the initial emergency facility, your out-of-pocket expenses for the ground or air ambulance transfer to the nearest appropriate medical facility are covered with MASA.

Repatriation Near Home Coverage1

Should you need continued care and your care provider has approved moving you to a hospital nearer to your home, MASA coordinates and covers the expense for ambulance transportation to the approved medical facility.

Did you know?

51.3 million emergency responses occur each year

MASA protects families against uncovered costs for emergency transportation and provides connections with care services.

Source: NEMSIS, National EMS Data Report, 2023

About MASA

MASA is coverage and care you can count on to protect you from the unexpected. With us, there is no “out-of-network” ambulance. Just send us the bill when it arrives and we’ll work to ensure charges are covered. Plus, we’ll be there for you beyond your initial ride, with expert coordination services on call to manage complex transport needs during or after your emergency — such as transferring you and your loved ones home safely.

Protect yourself, your family, and your family’s financial future with MASA.

Stay prepared with MASA®

protects families against out-of-pocket costs for emergency transportation and provides connections with care. Gain peace of mind and shield your finances knowing there’s a MASA plan best suited for your needs.

Retirement Plans

ABOUT RETIREMENT PLANS

A 403(b) plan is a U.S. tax-advantaged retirement savings plan available for public education organizations.

A 457(b) plan is a tax-deferred compensation plan provided for employees of certain tax-exempt, governmental organizations or public education institutions.

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

Contribution maximum limits (can contribute to both plans)

Retirement Contributions Tax Credit

Early withdrawal penalty tax

Investment options

Investment committee/advisor oversight

2024: $23,000; $30,000 age 50+

Up to $1,000

Distribution restrictions

Financial Hardship/Unforeseeable

Emergency Distributions

Loans

Required minimum distributions

2024: $23,000; $30,000 age 50+

($2,000 if filing jointly) Up to $1,000 ($2,000 if filing jointly)

None

Managed allocations or self-directed mutual funds.

Yes, managed by TCG Advisors and Investment Advisory Committee (comprised of superintendents & CFO’s).

Funds can be requested upon:

• Age 59

• Separation from employer

• Disability

• Death

• Unforeseeable emergency

Must be an unforeseeable Emergency. Can include the following criteria is met:

• Medical expenses

• Funeral expenses

• Foreclosure/eviction

• Certain hurricanes and natural disasters

Permitted; loans from all qualified plans limited to the lesser of 50,000 or 50% of vested account balance.

RMD rules apply at age 72 or later, severance from service, or after death.

10%

Fixed/Variable interest annuities or mutual funds/custodial accounts

No

Funds can be requested upon:

• Age 59

• Age 55 and/or leaving employer

• Disability

• Death

• Financial hardship

Qualified for the following causes:

• Medical care

• Foreclosure/eviction

• Tuition payment

• Buying a home

• Funeral costs

• Home repair costs

• Disaster relief

Permitted; loans from all qualified plans limited to the lesser of $50,000 or 50% of vested account balance.

RMD rules apply at age 72 or later, severance from service, or after death

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 Palacios 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 Palacios 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.

Turn static files into dynamic content formats.

Create a flipbook
Issuu converts static files into: digital portfolios, online yearbooks, online catalogs, digital photo albums and more. Sign up and create your flipbook.