Benefit Contact Information
Higginbotham Public Sector (800) 583-6908 www.mybenefitshub.com/texarkanaisd BCBSTX (866) 355-5999 www.bcbstx.com/trsactivecare
Lincoln Financial Group (800) 423-2765 www.lfg.com
APL Group #: 13311 (800) 256-8606 www.ampublic.com
EECU (817) 882-0800 www.eecu.org
Clever RX (800) 974-3135 www.cleverrx.com
Lincoln Financial Group Group #: 00001D041925 (800) 423-2765 www.lfg.com
Lincoln Financial Group (800) 423-2765 www.lfg.com
(888) 365-1663 www.mdlive.com/FBS
Superior Vision Group #: 28882 (800) 507-3800 www.superiorvision.com
Higginbotham (866) 419-3519 www.higginbotham.net
Lincoln Financial Group (800) 423-2765 www.lfg.com
Lincoln Financial Group (800) 423-2765
www.lfg.com
1 www.mybenefitshub.com/texarkanaisd
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CLICK LOGIN
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Enter your Information
• Last Name
• Date of Birth
• Last Four (4) of Social Security Number
NOTE: THEbenefitsHUB uses this information to check behind the scenes to confirm your employment status.
Once confirmed, the Additional Security Verification page will list the contact options from your profile. Select either Text, Email, Call, or Ask Admin options to receive a code to complete the final verification step.
Enter the code that you receive and click Verify. You can now complete your benefits enrollment!
Annual Benefit Enrollment
Annual Enrollment
During your annual enrollment period, you have the opportunity to review, change or continue benefit elections each year. Changes are not permitted during the plan year (outside of annual enrollment) unless a Section 125 qualifying event occurs.
• Changes, additions or drops may be made only during the annual enrollment period without a qualifying event.
• Employees must review their personal information and verify that dependents they wish to provide coverage for are included in the dependent profile. Additionally, you must notify your employer of any discrepancy in personal and/or benefit information.
• Employees must confirm on each benefit screen (medical, dental, vision, etc.) that each dependent to be covered is selected in order to be included in the coverage for that particular benefit.
New Hire Enrollment
All new hire enrollment elections must be completed in the online enrollment system within the first 31 days of benefit eligible employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.
Q&A
Who do I contact with Questions?
For supplemental benefit questions, you can contact your Benefits 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/ texarkanaisd. 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 Texarkana ISD benefit website: www.mybenefitshub.com/texarkanaisd. 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.
What is Guaranteed Coverage?
The amount of coverage you can elect without answering any medical questions or taking a health exam. Guaranteed coverage is only available during initial eligibility period. Actively-at-work and/or preexisting condition exclusion provisions do apply, as applicable by carrier.
What is a Pre-Existing Conditions?
Applies to any illness, injury or condition for which the participant has been under the care of a health care provider, taken prescription drugs or is under a health care provider’s orders to take drugs, or received medical care or services (including diagnostic and/or consultation services).
Annual Benefit Enrollment
Section 125 Cafeteria Plan Guidelines
A Cafeteria plan enables you to save money by using 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 Dependent’s Eligibility Status
Judgment/ Decree/Order
Eligibility for Government Programs
Changes in benefit elections can occur only if you experience a qualifying event. You must present proof of a qualifying event to your Benefit Office within 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.
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.
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 Benefits Office to request a continuation of coverage.
Description
Health Savings Account (HSA)
(IRC Sec. 223)
Approved by Congress in 2003, HSAs are actual bank accounts in employees’ names that allow employees to save and pay for unreimbursed qualified medical expenses tax-free.
Employer Eligibility A qualified high deductible health plan
Contribution Source Employee and/or employer
Account Owner Individual
Underlying Insurance
Requirement
Minimum Deductible
Maximum Contribution
High deductible health plan
$1,600 single (2024)
$3,200 family (2024)
$4,150 single (2024)
$8,300 family (2024) 55+ catch up +$1,000
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?
Employees may use funds any way they wish. If used for non-qualified medical expenses, subject to current tax rate plus 20% penalty.
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.
All employers
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
Yes, portable year-to-year and between jobs.
No. Access to some funds may be extended if your employer’s plan contains a 2 1/2-month grace period or $500 rollover provision.
No
No
Medical Insurance
Major medical insurance is a type of health care coverage that provides benefits for a broad range of medical expenses that may be incurred either on an inpatient or outpatient basis.
For full plan details, please visit your benefit website: www.mybenefitshub.com/texarkanaisd
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.
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.
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/texarkanaisd
Basic Life
Think about what your loved ones may face after you’re gone. Term life insurance can help them in so many ways, like covering everyday expenses, paying off debt, and protecting savings. AD&D provides even more coverage if you die or suffer a covered loss in an accident.
AT A GLANCE:
• A cash benefit of one times basic annual earnings, rounded to the next higher $1,000 ($160,000 maximum) to your loved ones in the event of your death, plus a matching cash benefit if you die in an accident
• A cash benefit to you if you suffer a covered loss in an accident, such as losing a limb or your eyesight
• Accident Plus - If you suffer an AD&D loss in an accident, you may also receive benefits for the following on top of your core AD&D benefits: coma, plegia, education, child care, spouse training, and more.
• LifeKeys® services, which provide access to counseling, financial, and legal support
• TravelConnect® services, which give you and your family access to emergency medical assistance when you're on a trip 100+ miles from home
You also have the option to increase your cash benefit by securing additional coverage at affordable group rates. See the enclosed life insurance information for details.
ADDITIONAL DETAILS
Conversion: You can convert your group term life coverage to an individual life insurance policy without providing evidence of insurability if you lose coverage due to leaving your job or for another reason outlined in the plan contract. AD&D benefits cannot be converted.
Continuation of Coverage: You may be able to continue your coverage if you leave your job for any reason other than sickness, injury, or retirement.
Benefit Reduction: Coverage amounts begin to reduce at age 75 and benefits terminate at retirement. See the plan certificate for details.
For complete benefit descriptions, limitations, and exclusions, refer to the certificate of coverage.
Voluntary Term Life with AD&D
The Lincoln Term Life and AD&D Insurance Plan:
• Provides a cash benefit to your loved ones in the event of your death
• Provides an additional cash benefit to your loved ones if you die – or to you if you lose a limb or your eyesight – in a covered accident
• Includes LifeKeys services, which provide access to counseling, financial and legal support services
• Also includes TravelConnect services, which give you and your family access to emergency medical assistance when you’re on a trip 100+ miles from home
Voluntary
Life and AD&D Lincoln Financial Group
Voluntary Term Life with AD&D Continued
Guaranteed Life and AD&D Insurance Coverage Amount
• Initial Open Enrollment: When you are first offered this coverage, you can choose a coverage amount up to $250,000 without providing evidence of insurability.
• Annual Limited Enrollment: If you are a continuing employee, you can increase your coverage amount up to $40,000 without providing evidence of insurability. If you submitted evidence of insurability in the past and were declined for medical reasons, you may be required to submit evidence of insurability.
• If you decline this coverage now and wish to enroll later, evidence of insurability may be required and may be at your own expense. Maximum Life Insurance Coverage Amount
• You can choose a coverage amount up to 7 times your annual salary ($750,000 maximum) with evidence of insurability. See the Evidence of Insurability page for details.
• Your coverage amount will reduce by 50% when you reach age 75. Guaranteed Life and AD&D Insurance Coverage Amount
• Initial Open Enrollment: When you are first offered this coverage, you can choose a coverage amount up to 100% of your coverage amount ($50,000 maximum) for your spouse without providing evidence of insurability.
• Annual Limited Enrollment: If you are a continuing employee, you can increase the coverage amount for your spouse up to $20,000 without providing evidence of insurability. If you submitted evidence of insurability in the past and were declined for medical reasons, you may be required to submit evidence of insurability.
• If you decline this coverage now and wish to enroll later, evidence of insurability may be required and may be at your own expense.
Maximum Life Insurance Coverage Amount
• You can choose a coverage amount up to 100% of your coverage amount ($250,000 maximum) for your spouse with evidence of insurability.
• Coverage amounts are reduced by 50% when an employee reaches age 75.
Dental Insurance Lincoln Financial Group
ABOUT DENTAL
Dental insurance is a coverage that helps defray the costs of dental care. It insures against the expense of routine care, dental treatment and disease.
For full plan details, please visit your benefit website: www.mybenefitshub.com/texarkanaisd
The Lincoln DentalConnect PPO Plans:
• Cover many preventative, basic and major dental care services
• Allow you to choose any dentist you wish, though can lower your out-of-pocket costs by selecting a contracting dentist
• Don’t make you and your loved ones wait six months between routine cleanings
• High Plan covers orthodontic treatment for children
Major Services – Bridges, full and partial dentures, dental reline and rebase services, crowns, inlays, onlays and relative services, implants and implant related services
Orthodontics – Orthodontic exams, x-rays, extractions, appliances and more*
*Refer to the certificate of coverage for a full list of covered services.
Dental Insurance
Lincoln Financial Group
Contracting Dentists/Non-Contracting Dentists
To find a contracting dentist near you, visit www.LincolnFinancial.com/FindADentist
This plan lets you choose any dentist you wish. However, your out-of-pocket costs are likely to be lower when you choose a contracting dentist. For example, if you need a crown…
…you pay a deductible (if applicable), then 50% of the remaining discounted fee for PPO members. This is known as a PPO contracted fee.
Visit LincolnFinancial.com/FindADentist where you can search by:
• Location
• Dentist name or office name
• Distance you are willing to travel
• Specialty, language and more
… you pay a deductible (if applicable), then 50% of the usual and customary fee, which is the maximum expense covered by the plan. You are responsible for the difference between the usual and customary fee and the dentist’s billed charge.
Your search will automatically provide up to 100 dentists that most closely match your criteria. If your search does not locate the dentist you prefer, you can nominate one – just click the Nominate a Dentist link and complete the online form.
Vision Insurance
Superior Vision
ABOUT VISION
Vision insurance helps cover the cost of care for maintaining healthy vision. Similar to an annual checkup at your family doctor, routine eyecare is necessary to ensure that your eyes are healthy and to check for any signs of eye conditions or diseases . Most plans cover your routine eye exam with a copay and provide an allowance for Frames or Contact Lenses.
www.mybenefitshub.com/texarkanaisd
For full plan details, please visit your benefit website: www.mybenefitshub.com/texarkanaisd
Superior Vision Customer Service 1-800-507-3800
An overview of your vision benefits
• In-network benefits available through network eye care professionals.
• Find an in-network eye care professional at superiorvision.com. Call your eye doctor to verify network participation.
• Obtain a vision exam with either an MD or OD.
• Flexibility to use different eye care professionals for exam and for eyewear.
• Access your benefits through our mobile app – Display member ID card – view your member ID card in full screen or save to wallet .
Our network is built to support you.
• We manage one of the largest eye care professional networks in the country .
• The network includes 50 of the top 50 national retailers. Examples include:
• In-network online retail Providers :
Additional discounts
Members may also receive additional discounts, including 20% off lens upgrades and 30% off additional pairs of glasses.*
Access to LASIK discounts
A LASIK discount is available to all covered members. Our Discounted LASIK services are administered by QualSight. Visit lasik.sv.qualsight.com to learn more.
Access to hearing aid discounts
Members save up to 40% on brand name hearing aids and have access to a nationwide network of licensed hearing professionals through Your Hearing Network.
*Discounts are provided by participating locations. Verify if their eye care professional participates in the discount featur e before receiving service.
Group Cancer Insurance
American Public Life (APL)
HELP COVER COSTS ASSOCIATED WITH THE DETECTION AND TREATMENT OF CANCER
Even the best major medical insurance may not cover all the out-ofpocket costs related to cancer treatment. APL’s Cancer Insurance* may help cover some of the expenses related to the treatment of covered cancer, daily living expenses and routine cancer screenings to help with early detection.
For full plan details, please visit your benefit website: www.mybenefitshub.com/sampleisd
www.mybenefitshub.com/texarkanaisd
Why buy cancer insurance?
IMAGINE
You or a loved one is diagnosed with cancer Travel for the best treatment Expenses for care Missed work X X X
The 5-year relative survival rate for all cancers diagnosed is 69% 1
per year
11 of 12 cancer drugs approved by the FDA in 2012 were priced at more than $100,000 per year. 2
Group Cancer Insurance
American Public Life (APL)
If you or a family member are diagnosed with cancer, APL’s Cancer Insurance may help cover the costs associated with the detection and treatment of cancer and help you be more financially prepared.
How it works
CHOOSE the benefit options that best protect you and your family.
RECEIVE treatment for a covered benefit.
FILE your claim online or mail it in.
Benefits may help pay expenses related to cancer and routine screenings
With Cancer Insurance, you may be covered for:
Radiation Therapy, Chemotherapy, Immunotherapy
Experimental Treatments
Prescriptions
Transportation Benefits and more Plus, plan options are available to cover you, your spouse or your child(ren).
Your plan may include the following options
• Surgical Benefit Rider provides: Anesthesia, Skin Cancer, Reconstructive Surgery, Bone Marrow and Stem Cell Transplant benefits and more
• Patient Care Benefit Rider provides: Hospital Confinement, Outpatient Facility, Extended Care Facility, Donor Benefits, Home Health Care, Hospice benefits and more
• Miscellaneous Benefit Rider offers: Second/Third surgical opinion, drugs and medicine, patient and family transportation, blood, plasma and platelets and more
• Internal Cancer First Occurrence Optional Benefit Rider
• Heart Attack/Stroke Optional Rider
• ICU Optional Rider
A Hospital is a place that is not an institution, or part thereof, used as a place for rehabilitation, a place for rest or for the aged, a nursing or convalescent home, a longterm nursing unit of geriatrics ward, or an extended care facility for the care of convalescent, rehabilitative or ambulatory patients.
If the cancer insurance premium is paid on a pre-tax basis, the benefit may be taxable. Please contact your tax or legal advisor regarding tax treatment of your policy benefits.
Underwritten by American Public Life Insurance Company. This is a brief description of the coverage. This product contains Limitations, Exclusions and Waiting Periods. For complete benefits and other provisions, please refer to your policy/certificate. This coverage does not replace Workers’ Compensation Insurance. This product is inappropriate for people who are eligible for Medicaid coverage. This policy is considered an employee welfare benefit plan established and/or maintained by an association or employer intended to be covered by ERISA, and will be administered and enforced under ERISA. Group policies issued to governmental entities and municipalities may be exempt from ERISA guidelines. Policy Form GC14APL Series | Policy Form GC-3 series
*This Cancer Policy provides limited benefits.
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/texarkanaisd
Texarkana Independent School District provides this valuable benefit at no cost to you.
Full-Time Employees
Long-Term Disability Insurance
Keep getting a check when you’re hurt or sick. You always have bills to pay, even when you can’t get to work due to injury, illness, or surgery. Long-term disability insurance helps you make ends meet during this difficult time.
AT A GLANCE:
• A cash benefit of 60% of your monthly salary (up to $5,000) starting 180 days after you are out of work and continuing up to age 65 if the disability occurs at age 59 or before, 5 years if the disability occurs at age 60 to 64, up to age 70 if the disability occurs at age 65 to 69, and 1 year if the disability occurs at age 70 or after
• EmployeeConnectSM services, which give you and your family confidential access to counselors as well as personal, legal, and financial assistance. Program Services include:
• Unlimited, 24/7 access to information and referrals
• In-person help for short-term issues; up to four sessions with a counselor per person, per issue, per year.
• One free consultation with a network attorney (with subsequent meetings at a reduced fee)
• Online tools, tutorials, videos and much more
ADDITIONAL DETAILS
Coverage Period for Your Occupation: 36 months. After this initial period, you may be eligible to continue receiving benefits if your disability prohibits you from performing any employment for which you are reasonably suited through your training, education, and experience. In this case, your benefits may be extended through the end of your maximum coverage period (benefit duration).
Pre-existing Condition: If you have a medical condition that begins before your coverage takes effect, and you receive treatment for this condition within the 3 months leading up to your coverage start date, you may not be eligible for benefits for that condition until you have been covered by the plan for 12 months.
For complete benefit descriptions, limitations, and exclusions, refer to the certificate of coverage.
This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater detail. Refer to your certificate for your maximum benefit amounts. Should there be a difference between this summary and the contract, the contract will govern.
EmployeeConnectSM services are provided by ComPsych® Corporation, Chicago, IL. ComPsych® is a registered trademark of ComPsych® Corporation. ComPsych® is not a Lincoln Financial Group® company. Coverage is subject to actual contract language. Each independent company is solely responsible for its own obligations. Insurance products (policy series GL3001) are issued by The Lincoln National Life Insurance Company (Fort Wayne, IN), which does not solicit business in New York, nor is it licensed to do so. Product availability and/or features may vary by state. Limitations and exclusions apply. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Affiliates are separately responsible for their own financial and contractual obligations. Limitations and exclusions apply.
Benefits Overview | The Lincoln National Life Insurance Company GP-ERPD-FLI001-TX - ©2019 Lincoln National Corporation - LCN-1821793061517-Q1.0
Disability Insurance Lincoln Financial Group
Full-Time
Employees
Short-Term Disability Insurance
Benefits At-A-Glance: Option One
The Lincoln Short-term Disability Insurance Plan:
• Provides a cash benefit when you are out of work for up to 24 weeks due to injury, illness, surgery, or recovery from childbirth
• Provides a partial cash benefit if you can only do part of your job or work part-time
• Features group rates for Texarkana ISD employees
• Offers a fast, no-hassle claims process
Weekly benefit amount
Short-term Disability
66.67% of your weekly salary, limited to $1,500 per week
Sickness elimination period 14 days
Accident elimination period 14 days
Maximum coverage period 24 weeks
Sickness Elimination Period
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.
Accident Elimination Period
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.
Pre-existing Condition
If you have a medical condition that begins before your coverage takes effect, and you receive treatment for this condition within the 3 months leading up to your coverage start date, you may not be eligible for benefits for that condition until you have been covered by the plan for 12 months.
Benefits Integration
Your short-term disability benefits can coordinate with income from other sources, such as continued income or sick pay from your employer, during your disability.
This allows you to receive up to 100% of your pre-disability income.
Additional Plan Benefits
5% Rehabilitation Assistance
Premium Waiver Included Included
Open Enrollment
When you are first offered this coverage (and during approved open enrollment periods), you can take advantage of this important coverage with no health examination.
Voluntary Short Term Disability Premium
Here’s how little you pay with group rates. Your estimated monthly premium is determined by multiplying your weekly salary amount (up to $2,250) by the premium rate of 0.04400. If your weekly salary exceeds $2,250, multiply $2,250 by 0.04400.
Benefits At-A-Glance: Option Two
The Lincoln Short-term Disability Insurance Plan:
• Provides a cash benefit when you are out of work for up to 24 weeks due to injury, illness, surgery, or recovery from childbirth
• Provides a partial cash benefit if you can only do part of your job or work part-time
• Features group rates for Texarkana ISD employees
• Offers a fast, no-hassle claims process
Weekly benefit amount
Short-term Disability
66.67% of your weekly salary, limited to $1,500 per week
Sickness elimination period 30 days
Accident elimination period 30 days
Maximum coverage period 24 weeks
Sickness Elimination Period
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
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.
First Day Hospitalization
The elimination period is reduced if you are hospitalized due to an illness or accidental injury. You can begin collecting benefits on the first day of hospitalization.
Pre-existing
Condition
If you have a medical condition that begins before your coverage takes effect, and you receive treatment for this condition within the 3 months leading up to your coverage start date, you may not be eligible for benefits for that condition until you have been covered by the plan for 12 months.
Benefits Integration
Your short-term disability benefits can coordinate with income from other sources, such as continued income or sick pay from your employer, during your disability.
This allows you to receive up to 100% of your pre-disability income.
Additional Plan Benefits
5% Rehabilitation Assistance
Premium Waiver Included Included
Open Enrollment
When you are first offered this coverage (and during approved open enrollment periods), you can take advantage of this important coverage with no health examination.
Voluntary Short Term Disability Premium
Here’s how little you pay with group rates.
Your estimated monthly premium is determined by multiplying your weekly salary amount (up to $2,250) by the premium rate of 0.04400. If your weekly salary exceeds $2,250, multiply $2,250 by 0.04400.
Flexible Spending Account (FSA)
Higginbotham
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/texarkanaisd
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 have the option to enroll in both a HSA and FSA, however doing so will make your FSA a "Limited" FSA, which means it will only be available for dental and vision expenses. All medical expenses would need to be processed through your HSA.
Higginbotham Benefits Debit Card
The Higginbotham Benefits Debit Card gives you immediate access to funds in your Health Care FSA when you make a purchase without needing to file a claim for reimbursement. If you use the debit card to pay anything other than a copay amount, you will need to submit an itemized receipt or an Explanation of Benefits (EOB).
Dependent Care FSA
The Dependent Care FSA helps pay for expenses associated with caring for elder or child dependents so you or your spouse can work or attend school full time. You can use the account to pay for day care or baby sitter expenses for your children under age 13 and qualifying older dependents, such as dependent parents. Reimbursement from your Depend ent Care FSA is limited to the total amount deposited in your account at that time. To be eligible, you must be a single parent or you and your spouse must be employed outside the home, disabled or a full-time student.
Things to Consider Regarding the Dependent Care FSA
• Overnight camps are not eligible for reimbursement (only day camps can be considered).
• If your child turns 13 midyear, you may only request reimbursement for the part of the year when the child is under age 13.
• You may request reimbursement for care of a spouse or dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self-care.
• The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.
Flexible Spending Accounts
Higginbotham
Important FSA Rules
• The maximum per plan year you can contribute to a Health Care FSA is $3,200. The maximum per plan year you can contribute to a Dependent Care FSA is $5,000 when filing jointly or head of household and $2,500 when married filing separately.
• You cannot change your election during the year unless you experience a Qualifying Life Event.
• In most cases, you can continue to file claims incurred during the plan year for another 90 days after the plan year ends.
• Your Health Care FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care expenses.
• The IRS has amended the “use it or lose it rule” to allow you to carry-over up to $640 in your Health Care FSA into the next plan year for eligible employers The carry-over rule does not apply to your Dependent Care FSA.
• 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
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).
www.mybenefitshub.com/texarkanaisd
For full plan details, please visit your benefit website: www.mybenefitshub.com/texarkanaisd
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/texarkanaisd
Benefits at a glance
If you or a covered family member have to go to the hospital for an accident or injury, hospital indemnity insurance provides a lumpsum cash benefit to help you take care of unexpected expenses — anything from deductibles to child care to everyday bills. Because you’re selecting this coverage through your company, you can take advantage of group rates. You don’t have to answer medical questions to receive coverage; this is guaranteed issue coverage.
Core
hospital
benefits Low Plan High Plan
Hospital admission
For the initial day of admission to a hospital for treatment of a sickness/an injury
Hospital confinement
For each day of confinement in a hospital as a result of a sickness/an injury
Hospital intensive care unit (ICU) admission
For the initial day of admission to an ICU for treatment as the result of a sickness/an injury
Hospital ICU confinement
For each full or partial day of confinement in an ICU as a result of a sickness/an injury
Complications of pregnancy
$1,000 per day for 1 day per calendar year $2,000 per day for 1 day per calendar year
$100 per day up to 30 days per calendar year starting on day one of confinement
$2,000 per day for 1 day per calendar year
$200 per day up to 30 days per calendar year starting on day one of confinement
Included
$200 per day up to 30 days per calendar year starting on day one of confinement
$4,000 per day for 1 day per calendar year
$400 per day up to 30 days per calendar year starting on day one of confinement
Included
• Admission or Admitted means accepted for inpatient services in a hospital or intensive care unit for a period of more than 20 hours.
• If admitted to a hospital or ICU within 90 days after being discharged from a preceding stay for the same or related cause, the subsequent admission will be considered part of the first admission.
• If both hospital and ICU admission or hospital and ICU confinement become payable for the same day, only the Hospital ICU Admission benefit will be paid.
Additional confinement benefits
Newborn care
For each day of confinement to a hospital for routine post-natal care following birth
$100 per day up to 2 days per calendar year
$200 per day up to 2 days per calendar year
• If a newborn baby is confined for treatment of an illness, infirmity, disease, or injury, we will pay the Hospital or ICU confinement benefit instead of the Newborn care benefit.
Hospital Indemnity Lincoln Financial Group
Additional plan benefit(s)
Continuation of coverage due to approved leave
Portability if you leave your employer
Benefit exclusions
General exclusions
Included
Included
The policy covers only sicknesses and injuries that occur while insurance is in force. No indemnities will be paid for a sickness or injury that occurs before the effective date of the insurance. Benefits are not payable for any loss caused or contributed to by:
1. Suicide, attempted suicide, or any intentionally self-inflicted injury while sane or insane*
2. Voluntary intake or use by any means of any drugs, poison, gas, or fumes, except when:
a. Prescribed or administered by a physician
b. Taken in accordance with the physician’s instructions
3. Committing or attempting to commit a felony
4. War or any act of war, declared or undeclared
5. Participation in a riot, insurrection, or rebellion of any kind
6. Participation in an act of terrorism
7. Military duty, including the Reserves or National Guard
8. Travel or flight in or on any aircraft, except as a fare-paying passenger on a regularly scheduled commercial flight, or as a passenger, pilot, or crew member in the group policyholder's aircraft while flying for group policyholder business, provided:
a. The aircraft has a valid U.S. airworthiness certificate (or foreign equivalent)
b. The pilot has a valid pilot's certificate with a non-student rating authorizing them to fly the aircraft
9. Driving a vehicle while intoxicated, as defined by the jurisdiction where the accident occurred
10. Cosmetic surgery, unless the treatment is the result of a covered event
11. Treatment for dental care or dental procedures, unless the treatment is the result of a covered event
12. Treatment of a mental illness*
13. Treatment of alcoholism, drug addiction, chemical dependency, or complications thereof*
14. Treatment through experimental procedures
15. Travel outside the United States and its possessions for the sole purpose of receiving medical care or treatment
16. Participating in, practicing for, or officiating any semi-professional or professional sport
17. Riding in or driving in any motor driven vehicle for race, stunt show, or speed test
18. Being incarcerated in any type of penal or detention facility
19. Scuba diving
20. Mountaineering or spelunking
21. Bungee cord jumping, hang gliding, sail gliding, parasailing, parakiting, kitesurfing, base jumping, or any similar activities
22. Skydiving, parachuting, jumping, or falling from any aircraft for recreational purposes
23. Residing outside the United States, U.S. Territories, Canada, or Mexico for more than 12 months
24. Injury arising out of or during employment for wage or profit
* Exceptions to the exclusions are accepted when substance abuse and mental disorder benefits are selected. This is a partial list of benefit exclusions. A complete list is included in the policy. State variations apply.
Critical Illness Insurance Lincoln Financial Group
ABOUT CRITICAL ILLNESS
Critical illness insurance can be used towards medical or other expenses. It provides a lump sum benefit payable directly to the insured upon diagnosis of a covered condition or event, like a heart attack or stroke. The money can also be used for non-medical costs related to the illness, including transportation, child care, etc.
For full plan details, please visit your benefit website: www.mybenefitshub.com/texarkanaisd
The Lincoln Critical Illness Insurance Plan:
• Provides cash benefits if you or a covered family member is diagnosed with a critical illness or event
• Benefits are paid in addition to what is covered under your health insurance
• Features group rates for employees
• Includes access to a personal health advocate who can assist you in managing health care services for you and your entire family
• There are no waiting periods or overall plan maximums
Critical Illness Insurance | Employee
Guaranteed coverage amounts
Critical Illness Insurance | Spouse
Coverage for your dependent children
Noninvasive cancer (in situ)
Skin Cancer (other than melanoma)
$10,000, $20,000, $30,000 or $40,000
$10,000, $20,000, $30,000 or $40,000 (up to 100% of the employee coverage amount)
Your dependent children automatically receive 50% of your coverage amount at no extra cost.
Loss of sight, hearing and/or speech
Critical Illness Insurance
Lincoln Financial Group
You receive a cash benefit every year you and any of your covered family members complete a single covered exam or screening
Note: See the policy for details and specific requirements for each of these benefit options.
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DID Y OU KNOW?
Ov er 3 0 % of
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 Texarkana 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 Texarkana 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.