Benefit Contact Information
Higginbotham Public Sector (833) 453-1680 www.wtxebc.com
Clever RX Group #1085 (800) 873-1195 www.partner.cleverrx/wtxebc
EECU (817) 882-0800 www.eecu.org
HOSPITAL CASH TELEHEALTH DENTAL
CHUBB
Group # 100000137
Claims Assistance: (888) 499-0425 mybenefitsconnect.chubb.com
Superior Vision Group #28790 (800) 507-3800 www.superiorvision.com
The Hartford Group #VAC-715266 (866) 547-4205 www.thehartford.com
MD Live Group ID: FBS (888) 365-1663 www.mdlive.com/fbs
UNUM (800) 858-6843 www.unum.com
CHUBB Group # 100000137 Claims Assistance: (888) 499-0425 mybenefitsconnect.chubb.com
Lincoln Financial Group (800) 423-2765 https://www.lfg.com
CHUBB
Claims Assistance: (888) 499-0425 mybenefitsconnect.chubb.com
UNUM (866) 679-3054 www.unum.com INDIVIDUAL
5Star Life Insurance Company (866) 863-9753 www.5starlifeinsurance.com
Higginbotham (866) 419-3519
https://flexservices.higginbotham.net/ Flexclaims@higginbotham.net
For DeLeon ISD & Big Springs ISD only
Experian (866)-617-1894 www.experian.com
NBS (855) 399-3035 www.nbsbenefits.com
MASA (800) 423-3226
www.masamts.com
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Enter your Information
• Last Name
• Date of Birth
• Last Four (4) of Social Security Number
NOTE: THEbenefitsHUB uses this information to check behind the scenes to confirm your employment status.
Once confirmed, the Additional Security Verification page will list the contact options from your profile. Select either Text, Email, Call, or Ask Admin options to receive a code to complete the final verification step.
Enter the code that you receive and click Verify. You can now complete your benefits enrollment!
Annual Benefit Enrollment
Annual Enrollment
During your annual enrollment period, you have the opportunity to review, change or continue benefit elections each year. Changes are not permitted during the plan year (outside of annual enrollment) unless a Section 125 qualifying event occurs.
• Changes, additions or drops may be made only during the annual enrollment period without a qualifying event.
• Employees must review their personal information and verify that dependents they wish to provide coverage for are included in the dependent profile. Additionally, you must notify your employer of any discrepancy in personal and/or benefit information.
• Employees must confirm on each benefit screen (medical, dental, vision, etc.) that each dependent to be covered is selected in order to be included in the coverage for that particular benefit.
New Hire Enrollment
All new hire enrollment elections must be completed in the online enrollment system within the first 30 days of benefit eligibility employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.
Q&A
Who do I contact with Questions?
For supplemental benefit questions, you can contact your Benefit 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.wtxebc.com. 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 your benefit website: www.wtxebc.com. 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 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).
Annual Benefit Enrollment
Section 125 Cafeteria Plan Guidelines
A Cafeteria plan enables you to save money by using pre-tax dollars to pay for eligible group insurance premiums sponsored and offered by your employer. Enrollment is automatic unless you decline this benefit. Elections made during annual enrollment will become effective on the plan effective date and will remain in effect during the entire plan year.
CHANGES IN STATUS (CIS):
Marital Status
Change in Number of Tax Dependents
Change in Status of Employment Affecting Coverage Eligibility
Gain/Loss of Dependents’ Eligibility Status
Judgment/ Decree/Order
Eligibility for Government Programs
Changes in benefit elections can occur only if you experience a qualifying event. You must present proof of a qualifying event to your Benefit Office within 31 days of your qualifying event and meet with your Benefit Office to complete and sign the necessary paperwork in order to make a benefit election change. Benefit changes must be consistent with the qualifying event.
QUALIFYING EVENTS
A change in marital status includes marriage, death of a spouse, divorce or annulment (legal separation is not recognized in all states).
A change in number of dependents includes the following: birth, adoption and placement for adoption. You can add existing dependents not previously enrolled whenever a dependent gains eligibility as a result of a valid change in status event.
Change in employment status of the employee, or a spouse or dependent of the employee, that affects the individual’s eligibility under an employer’s plan includes commencement or termination of employment.
An event that causes an employee’s dependent to satisfy or cease to satisfy coverage requirements under an employer’s plan may include change in age, student, marital, employment or tax dependent status.
If a judgment, decree, or order from a divorce, annulment or change in legal custody requires that you provide accident or health coverage for your dependent child (including a foster child who is your dependent), you may change your election to provide coverage for the dependent child. If the order requires that another individual (including your spouse and former spouse) covers the dependent child and provides coverage under that individual’s plan, you may change your election to revoke coverage only for that dependent child and only if the other individual actually provides the coverage.
Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change.
Annual Benefit Enrollment
Employee Eligibility Requirements
Supplemental Benefits: Eligible employees must work 20 or more regularly scheduled hours each work week. Eligible employees must be actively at work on the plan effective date for new benefits to be effective, meaning you are physically capable of performing the functions of your job on the first day of work concurrent with the plan effective date. For example, if your 2024 benefits become effective on September 1, 2024, you must be actively-at-work on September 1, 2024 to be eligible for your new benefits.
Dependent Eligibility Requirements
Dependent Eligibility: You can cover eligible dependent
PLAN MAXIMUM AGE
Accident Through 25
Cancer Through 25
Critical Illness Through 25
Dental Through 25
Dependent Flex
12 or younger or qualified individual unable to care for themselves & claimed as a dependent on your taxes
Individual Life Issue through 23; Keep to 121
Healthcare FSA Through 25 or IRS Tax Dependent
Health Savings Account IRS Tax Dependent
Identity Theft Through 25
Medical Supplement Through 25
Telehealth Through 25
Vision Through 25
Life and AD&D Through 25
Medical Transportation Through 25
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 Benefit Office to request a continuation of coverage.
Description
Health Savings Account (HSA) (IRC Sec. 223)
Approved by Congress in 2003, HSAs are actual bank accounts in employee’s names that allow employees to save and pay for unreimbursed qualified medical expenses tax-free.
Flexible Spending Account (FSA) (IRC Sec. 125)
Allows employees to pay out-of-pocket expenses for copays, deductibles and certain services not covered by medical plan, taxfree. This also allows employees to pay for qualifying dependent care tax- free.
Employer Eligibility A qualified high deductible health plan All employers
Contribution Source Employee and/or employer Employee and/or employer
Account Owner Individual
Underlying
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.
$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.
No. Access to some funds may be extended if your employer’s plan contains a 2 1/2 –month grace period or $610 rollover provision.
Yes No
Yes, portable year-to-year and between jobs. No
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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.wtxebc.com
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 Cash
It’s not easy to pay hospital bills, especially if you have a high deductible medical plan. Chubb Hospital Cash pays money directly to you if you are hospitalized so you can focus on your recovery. And since the cash goes directly to you, there are no restrictions on how you use your money. average three-day hospitalization cost.¹
$30,000
5.4 days
Choose from 1 of 2 plans
First Hospitalization Benefit
This benefit is payable for the first covered hospital confinement per certificate.
Hospital Admission Benefit
This benefit is for admission to a hospital or hospital sub-acute intensive care unit.
Hospital Admission ICU Benefit
This benefit is for admission to a hospital intensive care unit.
Hospital Confinement Benefit
This benefit is for confinement in hospital or hospital sub-acute intensive care unit.
Hospital Confinement ICU Benefit
The benefit for confinement in a hospital intensive care unit.
Newborn Nursery
This benefit is payable for an insured newborn baby receiving newborn nursery care and who is not confined for treatment of a physical illness, infirmity, disease or injury.
• $500
• Maximum Benefit Per Certificate: 1
• $1,500
• Maximum Benefit Per Calendar Year: 3
• $3,000
• Maximum Benefit Per Calendar Year: 3
• $100 Per Day
• Maximum Days Per Calendar Year: 30
• $200 Per Day
• Maximum Days Per Calendar Year: 30
• $500 Per Day
• Maximum Days per Confinement - Normal Delivery: 2
• Maximum Days per Confinement - Caesarean Section: 2
• $1,000
• Maximum Benefit Per Certificate: 1
• $3,000
• Maximum Benefit Per Calendar Year: 5
• $6,000
• Maximum Benefit Per Calendar Year: 5
• $200 Per Day
• Maximum Days Per Calendar Year: 30
• $400 Per Day
• Maximum Days Per Calendar Year: 30
• $500 Per Day
• Maximum Days per Confinement - Normal Delivery: 2
• Maximum Days per Confinement - Caesarean Section: 2
Observation Unit
This benefit is for treatment in a hospital observation unit for a period of less than 20 hours.
Rehabilitation Unit Admission Benefit
This benefit is for admission to a rehabilitation unit as an inpatient.
Rehabilitation Unit Confinement Benefit
This benefit is for confinement in a rehabilitation unit.
Family Care Benefit
This benefit helps pay for childcare when an insured is confined in a hospital or rehabilitation unit.
Medical Travel Benefit
This benefit helps pay for travel expenses when an insured must travel at least 50 miles from their residence to receive special treatment or confinement in a hospital.
Waiver of Premium Hospital Confinement
This benefit waives premium when the employee is confined for more than 30 continuous days.
Questions?
.
• $500
• Maximum Days Per Calendar Year: 2
• $500
• Maximum Benefit Per Calendar Year: 3
• $200 Per Day
• Payable per day for days 2 through 11
• Maximum Days Per Calendar Year: 10
• Childcare Benefit Per Day: $200
• Maximum Days per Calendar Year: 10
• Per Day – 50 or more miles: $100
• Maximum Days Per Calendar Year: 4
• $500
• Maximum Days Per Calendar Year: 2
• $500
• Maximum Benefit Per Calendar Year: 5
• $400 Per Day
• Payable per day for days 2 through 11
• Maximum Days Per Calendar Year: 10
• Childcare Benefit Per Day: $200
• Maximum Days per Calendar Year: 10
• Per Day – 50 or more miles: $100
• Maximum Days Per Calendar Year: 4
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
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.wtxebc.com
The Lincoln DentalConnect® PPO Plans:
• Cover many preventive, basic, and major dental care services
• Also cover orthodontic treatment for children
• Feature group rates for WTXEBC employees
• Let you choose any dentist you wish, though you can lower your out-of-pocket costs by selecting a contracting dentist
• Do not make you and your loved ones wait six months between routine cleanings
Some plans may not be offered at every district within WTXEBC. Check your district benefit website for details.
Calendar (Annual)
Deductible
Individual: $50
Family: $150
Waived for Preventive
Individual: $50
Family: $150
Waived for Preventive
Deductibles are combined for basic and major Contracting Dentists’ services. Deductibles are combined for basic and major Non-Contracting Dentists’ services.
Waiting
Visit LincolnFinancial.com/FindADentist
You can search by:
• Location
• Dentist name or office name
• Distance you are willing to travel
• Specialty, language and more
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 llink and complete the online form.
Dental Insurance Lincoln Financial Group
Some plans may not be offered at every district within WTXEBC. Check your district benefit website for details.
Routine oral exams
Bitewing X-rays
Full-mouth or panoramic X-rays
Other dental X-rays - including periapical films
Routine cleanings
Fluoride treatments
Space maintainers for children
Palliative treatment - including emergency relief of dental pain
Sealants
Problem focused exams
Injections of antibiotics and other therapeutic medications
Fillings
Simple extractions
anesthesia and I.V. sedation
Consultations
Prefabricated stainless steel and resin crowns
Surgical extractions
Oral surgery
Biopsy and examination of oral tissue - including brush biopsy
Prosthetic repair and recementation services
Endodontics - including root canal treatment
Orthodontic exams
To find a contracting dentist near you, visit www.LincolnFinancial.com/FindADentist. This plan lets you choose any dentist you wish. However, your out-ofpocket 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.
… you pay a deductible (if applicable), then the remaining balance between the maximum allowable change and the dentist’s billed charge. You are responsible for the difference between the maximum allowable charge and the dentist’s billed charge.
MAC Option *Out of network reimbursement on this plan is based on the in-network fee schedule. This can mean more cost is incurred to you as the employee if you select this plan and see a dentist that is out of network. To find a in network dentist please visit to www.LincolnFinancial.com
Vision Insurance Superior Vision
ABOUT VISION
Vision insurance provides coverage for routine eye examinations and can help with covering some of the costs for eyeglass frames, lenses or contact lenses.
For full plan details, please visit your benefit website: www.wtxebc.com
How to Print your Vision ID Card:
You can request your vision id card by contacting Superior Vision directly at 800-507-3800. You can also go to www.superiorvision.com and register/login to access your account by clicking on “Members” at the top of the page. You can also download the Superior Vision mobile app on your smart phone.
Vision Insurance Superior Vision
Discount Features
Look for providers in the provider directory who accept discounts, as some do not; please verify their services and discounts (range from 10%-40%) prior to service as they vary.
Discounts on covered materials
Progressives:
off
off amount over retail lined trifocal lens, including lens options
Discounts on non-covered exam, services and materials
Exams, frames, and prescription lenses:
Disposable contact lenses:
Maximum member out-of-pocket
The following options have out-of-pocket maximums5 on standard (not premium, brand, or progressive) lenses.
5. Discounts and maximums may vary by lens type. Please check with your provider.
Refractive Surgery
Superior Vision has a nationwide network of independent refractive surgeons and partnerships with leading LASIK networks who offer members a discount. These discounts range from 5%-50%, and are the best possible discounts available to Superior Vision.
Disclaimer: All final determinations of benefits, administrative duties, and definitions are governed by the Certificate of Insurance for your vision plan. Please check with your Benefit Office if you have any questions.
Voluntary Disability Insurance
How does it work?
This coverage provides a monthly benefit if you have a covered illness or injury and you can’t work for a few months or even longer.
You’re generally considered disabled if you’re unable to do important parts of your job and your income suffers as a result.
Why is this coverage so valuable?
You can use the money however you choose. It can help you pay for your rent or mortgage, groceries, out-of-pocket medical expenses and more.
Consider your expenses
Voluntary Disability Insurance can replace part of your income if a disability keeps yo out of work for a long period of time
What else is included?
Survivor Benefit
If you die while you’ve been disabled and receiving benefits for at least 180 days, your family could get a benefit equal to 3 months of your gross disability payment.
Waiver of premium
If you’re disabled and receiving benefit payments, Unum waives your cost until you return to work.
Worldwide emergency travel assistance
One phone call gets you and your family immediate help anywhere in the world, as long as you’re traveling 100 or more miles from home. However, a spouse traveling on business for his or her employer is not covered.
You are eligible for coverage if you are an active employee in the United States working a minimum of 20 hours per week.
Choose to cover 30%, 40%, 50%, 60% or 70% of your monthly income, up to a maximum payment of $8,000.
*See the Legal Disclosures for more information. You*
The monthly benefit may be reduced or offset by other sources of income.
This plan does not cover pre-existing conditions. See the disclosure section to learn more.
Elimination period (EP) Options:
Option 1: 7 days/ 7 days first day hospital
Option 2: 14 days/14 days first day hospital
Option 3: 30 days/30 days first day hospital
Option 4: 60 days/60 days
Option 5: 90 days/90 days
This is the number of days that must pass after a covered accident or illness before you can begin to receive benefits.
If, because of your disability, you are hospital confined as an inpatient, benefits begin on the first day of inpatient confinement. Inpatient means that you are confined to a hospital room due to your sickness or injury for 23 or more consecutive hours. Your admission and discharge dates and l time must be 23 or more consecutive hours apart. (Applies to Elimination Periods of 30 days or less)
Benefit duration (BD)
This is the maximum length of time you can receive benefits while you’re disabled. You can receive benefits up to the Social Security (SS) normal retirement age. If you become disabled after your normal retirement age, check with your employer for the maximum length of time applicable to you.
Since our founding in 1848, Unum has been a leader in the
employee benefits business.
Innovation, integrity and an unwavering commitment to our customers has helped us become a global leader in financial protection benefits.
Exclusions and limitations
Active employee
You are considered in active employment, if on the day you apply for coverage, you are being paid regularly by your employer for the required minimum hours each week and you are performing the material and substantial duties of your regular occupation.
Delayed effective date of coverage
Insurance coverage will be delayed if you are not an active employee because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective.
Benefit duration (BD)
The duration of your benefit payments is based on your age when your disability occurs. Your Long Term Disability benefits are payable while you continue to meet the definition of disability. Please refer to your plan document for the duration of benefits under this policy.
Definition of disability
You are considered disabled when Unum determines that:
• You are limited from performing the material and substantial duties of your regular occupation due to sickness or injury; and
• You have a 20% or more loss of indexed monthly earnings due to the same sickness or injury
After 24 months, you are considered disabled when Unum determines that due to the same sickness or injury, you are unable to perform the duties of any gainful occupation for which you are reasonably fitted by education, training or experience.
You must be under the regular care of a physician in order to be considered disabled.
The loss of a professional or occupational license or certification does not, in itself, constitute disability.
“Substantial and material acts” means the important tasks, functions and operations that are generally required by employers from those engaged in your usual occupation and that cannot be reasonably omitted or modified.
Unless the policy specifies otherwise, as part of the disability claims evaluation process, Unum will evaluate your occupation based on how it is normally performed in the national economy, not how work is performed for a specific employer, at a specific location or in a specific region.
Pre-existing conditions
You have a pre-existing condition if:
• You received medical treatment, consultation, care or services including diagnostic measures for the condition, or took prescribed drugs or medicines for it in the 3 months just prior to your effective date of coverage; and
• The disability begins in the first 12 months after your effective date of coverage.
• For Disabilities due to a pre-existing condition, the maximum period of payment is 4 weeks. After 4 weeks, the benefit is subject to the 3/12 pre-existing condition provision. Please refer to the policy for a detailed description of this provision
Deductible sources of income
Your disability benefit may be reduced by deductible sources of income and any earnings you have while you are disabled, including such items as group disability benefits or other amounts you receive or are entitled to receive:
• Workers’ compensation or similar occupational benefit laws, including a temporary disability benefit under a workers’ compensation law
• State compulsory benefit laws
• Automobile liability insurance policy
• No fault motor vehicle plan
• Third-party settlements
• Other group insurance plans
• A group plan sponsored by your employer
• Governmental retirement system
• Salary continuation or sick leave plans, if applicable
• Retirement payments
• Social Security or similar governmental programs
Exclusions and limitations
Benefits will not be paid for disabilities caused by, contributed to by, or resulting from:
• Intentionally self-inflicted injuries;
• Active participation in a riot;
• War, declared or undeclared or any act of war;
• Commission of a crime for which you have been convicted;
• Loss of professional license, occupational license or certification; or
• Pre-existing conditions (See the disclosure section to learn more).
The loss of a professional or occupational license does not, in itself, constitute disability.
Unum will not pay a benefit for any period of disability during which you are incarcerated. The lifetime cumulative maximum benefit for all disabilities due to mental illness is 24 months. Only 24 months of benefits will be paid for any combination of such disabilities even if the disabilities are not continuous and/or are not related. Payments can continue beyond 24 months only if you are confined to a hospital or institution as a result of the disability.
Termination of coverage
Your coverage under the policy ends on the earliest of the following:
• The date the policy or plan is cancelledThe date you no longer are in an eligible group
• The date your eligible group is no longer covered
• The last day of the period for which you made any required contributions
• The last day you are in active employment except as provided under the covered layoff or leave of absence provision.
Unum will provide coverage for a payable claim that occurs while you are covered under the policy or plan. Unum’s LTD contracts standardly include a provision called the Social Security Claimant Advocacy Program. With this feature, claimants can receive expert advice and assistance from us regarding their Social Security Disability claim during the application and appeal process. Social Security advocacy services are provided by GENEX Services, LLC or Brown & Brown Absence Services Group. Referral to one of our advocacy partners is determined by Unum.
Worldwide emergency travel assistance services, provided by Assist America, Inc., are available with select Unum insurance offerings. Terms and availability of service are subject to change and prior notification requirements. Services are not valid after coverage terminates. Please contact your Unum representative for details.
This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. For complete details of coverage and availability, please refer to Policy Form
C.FP-1 et al. or contact your Unum representative.
Underwritten by:
Unum Life Insurance Company of America, Portland, Maine
© 2022 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.
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.wtxebc.com
A cancer diagnosis and treatment can be an emotionally and physically difficult time. Chubb is there to help support you by providing cash benefits paid directly to you. Benefits are paid if you are diagnosed with cancer but also help cover many other cancer-related services such as doctor’s visits, treatments, specialty care, and recovery. However, there are no restrictions on how to use these cash benefits—so you can use them as you see fit.
Choose the right level of coverage during the enrollment period to better protect your family.
Cash benefits for every step of the way
First cancer benefit Not included
Employee or spouse: $5,000
Child(ren): $7,500
Diagnosis of cancer
Hospital confinement
Hospital confinement ICU
Radiation therapy, chemotherapy, immunotherapy
Waiting period: 0 days
Benefit reduction: none
$100 per day – days 1 through 30
Additional days: $100
Maximum days per confinement: 31
$200 per day – days 1 through 30
Additional days: $200
Maximum days per confinement: 31
Maximum per covered person per calendar year 12-month period: $10,000
Alternative care Not included
Medical imaging Not included
Skin cancer initial diagnosis Not included
Attending physician Not included
Hospital confinement sub-acute ICU Not included
$100 paid upon receipt of first covered claim for cancer; only one payment per covered person per certificate per calendar year
Employee or spouse: $10,000
Child(ren): $15,000
Waiting period: 0 days
Benefit reduction: none
$200 per day – days 1 through 30
Additional days: $200
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 12-month period: $20,000
$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
Cancer Insurance CHUBB
Accident Insurance The Hartford
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.wtxebc.com
With Accident insurance, you’ll receive payment(s) associated with a covered injury and related services. You can use the payment in any way you choose –from expenses not covered by your major medical plan to day-to-day costs of living such as the mortgage or your utility bills. You have a choice of two accident plans, which allows you the flexibility to enroll for the coverage that best meets your needs. This insurance provides benefits when injuries, medical treatment and/or services occur as the result of a
accident. Unless otherwise noted, the benefit amounts payable under each plan are the same for you and your dependent(s).
Accident Insurance
Organized Amateur Sports Injury Enhancement Benefit
Ability Assist® EAP2 – 24/7/365 access to help for financial, legal or emotional issues
HealthChampionSM3 – Administrative & clinical support following serious illness or injury
WHO IS ELIGIBLE?
You are eligible for this insurance if you are an active full-time employee who works at least 20 hours per week on a regularly scheduled basis. Your spouse and child(ren) are also eligible for coverage. Any child(ren) must be under age 26.
CAN I INSURE MY DOMESTIC OR CIVIL UNION PARTNER?
Yes. Any reference to “spouse” in this document includes your domestic partner, civil union partner or equivalent, as recognized and allowed by applicable law.
AM I GUARANTEED COVERAGE?
This insurance is guaranteed issue coverage – it is available without having to provide information about your or your family’s health. All you have to do is elect the coverage to become insured.
Premiums will be automatically paid through payroll deduction, as authorized by you during the enrollment process. This ensures you don’t have to worry about writing a check or missing a payment.
WHEN CAN I ENROLL?
You may enroll during any scheduled enrollment period or within 31 days of the date you have a change in family status.
WHEN DOES THIS INSURANCE BEGIN?
Insurance will become effective in accordance with the terms of the certificate (usually the first day of the month following the date you elect coverage). You must be actively at work with your employer on the day your coverage takes effect. Your spouse and child(ren) must be performing normal activities and not be confined (at home or in a hospital/care facility), unless already insured with the prior carrier.
WHEN DOES THIS INSURANCE END?
This insurance will end when you or your dependents no longer satisfy the applicable eligibility conditions, premium is unpaid, you are no longer actively working, you leave your employer, or the coverage is no longer offered.
CAN I KEEP THIS INSURANCE IF I LEAVE MY EMPLOYER OR AM NO LONGER A MEMBER OF
THIS GROUP?
Yes, you can take this coverage with you. Coverage may be continued for you and your dependent(s) under a group portability policy. Your spouse may also continue insurance in certain circumstances. The specific terms and qualifying events for portability are described in the certificate.
Critical Illness
Heart attacks and strokes happen every day and often unexpectedly. They don’t give you time to prepare and can take a serious toll on both your physical and inancial well-being. Chubb Critical Illness pays cash bene its directly to you that you can use to help with your bills, your mortgage, your rent, your childcare—you name it—so you can focus on recovery.
Every 40 seconds
1 in 3
Americans don’t have enough money readily available to cover an unexpected $400 expense.²
Available coverage choices
Employee
Spouse
$10,000; $20,000; $30,000; or $40,000 face amounts
$10,000; $20,000; $30,000; or $40,000 face amounts
Child Included in the employee rate
No benefits will be paid for a date of diagnosis that occurs prior to the coverage effective date. There is no pre-existing conditions limitation. All amounts are Guaranteed Issue — no medical questions are required for coverage to be issued.
Critical Illness benefits
of sight, speech, or hearing
Miscellaneous Disease Rider + COVID-19
The Miscellaneous Disease Rider is payable once per covered condition.
Covered Conditions include: Addison’s disease; cerebrospinal meningistis; diptheria; Hungtington’s chorea; Legionnaire’s disease; malaria; myasthenia gravis; meningitis; necrotizing fasciitis; osteomyelitis; polio; rabies; sclerodema; systematic lupus; tetanus; tuberculosis.
COVID-19 means a disease resulting in a positive COVID-19 diagnostic screening and 5 consecutive days of hospital confinement.
Occupational package
Pays 100% of the face amount; Benefits payable for HIV or hepatitis B, C, or D, MRSA, rabies, tetanus, or tuberculosis contracted on the job.
Childhood conditions
Pays 100% of the dependent child face amount; Provides benefits for childhood conditions (autism spectrum disorder, cerebral palsy, congenital birth defects: heart, lung, cleft lip, palate, etc., cystic fibrosis, Down’s syndrome, Gaucher disease, muscular dystrophy, type 1 diabetes).
Recurrence Benefit
Benefits are payable for a subsequent diagnosis of benign brain tumor; coma; coronary artery obstruction; heart attack; major organ failure; stroke; or sudden cardiac arrest.
Advocacy package
Diabetes Benefit
Diabetes Diagnosis Benefit
Pays a benefit once for covered person’s diabetes diagnosis. $500
Additional benefits
Waiver of Premium
Waives premium while the Insured is totally disabled.
Wellness Benefit - Payable once per insured per year
Term Life and Accidental Death & Dismemberment (AD&D) Insurance
How does it work?
You choose the amount of coverage that’s right for you, and you keep coverage for a set period of time, or “term.” If you die during that term, the money can help your family pay for basic living expenses, final arrangements, tuition and more.
AD&D Insurance is also available, which pays a benefit if you survive an accident but have certain serious injuries. It pays an additional amount if you die from a covered accident.
Why is this coverage so valuable?
There will be an open enrollment period for the 2024 enrollment. Evidence of insurability will not be required during this open enrollment period for late applicants, unless you and your dependents applies for an amount of life insurance, if any, over the amount in the Life Insurance “BENEFITS AT A GLANCE ” page. The effective date of insurance for the employees and dependents who enroll in the plan during the open enrollment period will b e 9/1/2024
What else is included?
A ‘Living’ Benefit If you are diagnosed with a terminal illness with less than 12 months to live, you can request 50% of your life insurance benefit (up to $750,000) while you are still living. This amount will be taken out of the death benefit, and may be taxable. These benefit payments may adversely affect the recipient’s eligibility for Medicaid or other government benefits or entitlements, and may be taxable. Recipients should consult their tax attorney or advisor before utilizing living benefit payments.
Waiver of premium Your cost may be waived if you are totally disabled for a period of time.
Portability You may be able to keep coverage if you leave the company, retire or change the number of hours you work.
Employees or dependents who have a sickness or injury having a material effect on life expectancy at the time their group coverage ends are not eligible for portability.
Who can get Term Life coverage?
Who can get Term Life coverage?
If you are actively at work at least 20 hours per week, you may apply for coverage for:
If you are work 20 week, you apply for coverage for:
You: Choose from $10,000 to $500,000 in $10,000 increments, up to 7 times your earnings. You can get up to $230,000. This is the amount of coverage you can qualify for with no medical underwriting.
You: Choose from $10,000 to $500,000 in $10,000 increments, up to 7 times your earnings. You can get up to $230,000. This is the amount of coverage you can qualify for with no medical underwriting.
Your spouse: Get up to $500,000 of coverage in $10,000 increments. Spouse coverage cannot exceed 100% of the coverage amount you purchase for yourself.
Your Get up to $500,000 of coverage in $10,000 spouse: increments. Spouse coverage cannot exceed 100% of the coverage amount you purchase for yourself.
Your spouse can get up to $50,000 with no medical underwriting, if eligible (see delayed effective date).
Your spouse can get up to $50,000 with no medical underwriting, if eligible (see delayed effective date).
Your children: Get up to $10,000 of coverage in $5,000 increments if eligible (see delayed effective date). One policy covers all of your children until their 26th birthday.
Your Get up to $10,000 of coverage in $5,000 children: increments if eligible (see delayed effective date). One policy covers all of your children until their 26th birthday.
The maximum benefit for children from live birth to 14 days is $1,000. The maximum benefit for children 14 days to 6 months is $2,000.
Who can get Accidental Death & Dismemberment (AD&D) coverage?
The maximum benefit for children from live birth to 14 days is $1,000. The maximum benefit for children 14 days to 6 months is $2,000.
You: Get up to $500,000 of AD&D coverage for yourself in $10,000 increments to a maximum of 10 times your earnings.
Your spouse: Get up to 50% to a maximum of $250,000 of AD&D coverage for your spouse, if eligible (see delayed effective date).
Your children: Get up to 10% to a maximum of $50,000 of coverage for your children if eligible (see delayed effective date). The maximum benefit for children from live birth to 14 days is $1,000. The maximum benefit for children 14 days to 6 months is $2,000
No medical underwriting is required for AD&D coverage.
How
Calculate your costs
1. Enter the coverage amount you want.
2. Divide by the amount shown.
3. Multiply by the rate. Use the rate table (at right) to find the rate based on age. (Choose the age you will be when your coverage becomes effective. See your plan administrator for your plan effective date. To determine your spouse rate, choose the age the spouse will be when coverage becomes effective. See your plan administrator for your plan effective date.)
4. Enter your cost.
1. Enter the AD&D coverage amount you want.
2. Divide by the amount shown.
3. Multiply by the rate. Use the AD&D rate table (at right) to find the rate.
4. Enter your cost.
Exclusions and limitations
Actively at work
Eligible employees must be actively at work to apply for coverage. Being actively at work means on the day the employee applies for coverage, the individual must be working at one of his/her company’s business locations; or the individual must be working at a location where he/she is required to represent the company. If applying for coverage on a day that is not a scheduled workday, the employee will be considered actively at work as of his/her last scheduled workday. Employees are not considered actively at work if they are on a leave of absence or lay off.
An unmarried handicapped dependent child who becomes handicapped prior to the child’s attainment age of 26 may be eligible for benefits. Please see your plan administrator for details on eligibility. Employees must be U.S. citizens or legally authorized to work in the U.S. to receive coverage. Employees must be actively employed in the United States with the Employer to receive coverage. Employees must be insured under the plan for spouses and dependents to be eligible for coverage.
Exclusions and limitations
Life insurance benefits will not be paid for deaths caused by suicide occurring within 24 months after the effective date of coverage. The same applies for increased or additional benefits.
AD&D specific exclusions and limitations:
Accidental death and dismemberment benefits will not be paid for losses caused by, contributed to by, or resulting from:
• Disease of the body; diagnostic, medical or surgical treatment or mental disorder as set forth in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM)
• Suicide, self-destruction while sane, intentionally self-inflicted injury while sane or self-inflicted injury while insane
• War, declared or undeclared, or any act of war
• Active participation in a riot
• Committing or attempting to commit a crime under state or federal law
• The voluntary use of any prescription or non-prescription drug, poison, fume or other chemical substance unless used according to the prescription or direction of your or your dependent’s doctor. This exclusion does not apply to you or your dependent if the chemical substance is ethanol.
• Intoxication – ‘Being intoxicated’ means your or your dependent’s blood alcohol level equals or exceeds the legal limit for operating a motor vehicle in the state or jurisdiction where the accident occurred.
Delayed effective date of coverage
Insurance coverage will be delayed if you are not an active employee because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective.
Delayed Effective Date: if your spouse or child has a serious injury, sickness, or disorder, or is confined, their coverage may not take effect. Payment of premium does not guarantee coverage. Please refer to your policy contract or see your plan administrator for an explanation of the delayed effective date provision that applies to your plan.
Age Reduction
Coverage amounts for Life and AD&D Insurance for you and your dependents will reduce to 65% of the original amount when you reach age 65, and will reduce to 50% of the original amount when you reach age 70. Coverage may not be increased after a reduction.
Termination of coverage
Your coverage and your dependents’ coverage under the policy ends on the earliest of:
• The date the policy or plan is cancelled
• The date you no longer are in an eligible group
• The date your eligible group is no longer covered
• The last day of the period for which you made any required contributions
• The last day you are actively employed (unless coverage is continued due to a covered layoff, leave of absence, injury or sickness), as described in the certificate of coverage In addition, coverage for any one dependent will end on the earliest of:
• The date your coverage under a plan ends
• The date your dependent ceases to be an eligible dependent
• For a spouse, the date of a divorce or annulment
• For dependents, the date of your death
Unum will provide coverage for a payable claim that occurs while you and your dependents are covered under the policy or plan.
This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. For complete details of coverage and availability, please refer to Policy Form C.FP-1 et al or contact your Unum representative.
Life Planning Financial & Legal Resources services, provided by HealthAdvocate, are available with select Unum insurance offerings. Terms and availability of service are subject to change. Service provider does not provide legal advice; please consult your attorney for guidance. Services are not valid after coverage terminates. Please contact your Unum representative for details. Unum complies with state civil union and domestic partner laws when applicable.
Underwritten by:
Unum Life Insurance Company of America, Portland, Maine
© 2022 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.
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
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.
Identity Theft + Financial Wellness
Experian
ABOUT Identity Theft
As identity theft and fraud continue to increase, an evolving suite of products helps you monitor any potential threats to your identity and alerts you if there are any areas of concern. You will also have access to a full financial wellness platform and proactive digital privacy tools that can help you keep passwords and other personal information private and secure while surfing the web.
For full plan details, please visit your benefit website: www.wtxebc.com
Experian
Stay prepared with MASA® AccessSM
Comprehensive coverage and care for emergency transport.
Our Emergent Plus membership plan includes:
Emergency Ground Ambulance Coverage1
Your out-of-pocket expenses for your emergency ground transportation to a medical facility are covered with MASA.
Emergency Air Ambulance Coverage1
Your out-of-pocket expenses for your emergency air transportation to a medical facility are covered with MASA.
Hospital to Hospital Ambulance Coverage1
When specialized care is required but not available at the initial emergency facility, your out-of-pocket expenses for the ground or air ambulance transfer to the nearest appropriate medical facility are covered with MASA.
Repatriation Near Home Coverage1
Should you need continued care and your care provider has approved moving you to a hospital nearer to your home, MASA coordinates and covers the expense for ambulance transportation to the approved medical facility.
Did you know?
51.3 million emergency responses occur each year
MASA protects families against uncovered costs for emergency transportation and provides connections with care services.
Source: NEMSIS, National EMS Data Report, 2023
About MASA
MASA is coverage and care you can count on to protect you from the unexpected. With us, there is no “out-of-network” ambulance. Just send us the bill when it arrives and we’ll work to ensure charges are covered. Plus, we’ll be there for you beyond your initial ride, with expert coordination services on call to manage complex transport needs during or after your emergency — such as transferring you and your loved ones home safely.
Protect yourself, your family, and your family’s financial future with MASA.
Flexible Spending Account (FSA)
ABOUT FSA
A Flexible Spending Account allows you to pay for eligible healthcare expenses with a pre-loaded debit card. You choose the amount to set aside from your paycheck every plan year, based on your employer’s annual plan limit. This money is use it or lose it within the plan year (unless your plan contains a $610 rollover or grace period provision).
For full plan details, please visit your benefit website: www.wtxebc.com
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 enrolled in a High Deductible Health Plan (HDHP) and contribute to a Health Savings Account (HSA).
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.
• 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 $570 in your Health Care FSA into the next plan year. The carry-over rule does not apply to your Dependent Care FSA.
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.
FSAstore.com
FSAstore.com offers thousands of FSA-eligible products and services to purchase using your FSA Debit Card or any major credit card. Competitive pricing and free shipping on orders over $50 can save you up to 40% using your FSA pretax dollars. Shop directly at FSAstore.com or have your physician submit prescriptions (when required). The FSAstore.com Services Channel allows you to search a database of more than 300,000 health care providers for nearby eligible services, such as acupuncture and chiropractic care. The FSAstore.com Learning Center focuses on answering common questions and keeping you informed about changes to your FSA benefits.
Some plans vary by district within WTXEBC. Check your district benefit website for details.
WTXEBC Mobile App Login Group #’s
Use your District’s group # to login to the Benefits app.
District GROUP #
Abernathy ISD WTXA
Adrian ISD WTXB
Amherst ISD WTXC
Anthony ISD WTXD
Anton ISD WTXE
Archer City ISD WTXF
Balmorhea ISD WTXG
Benjamin ISD WTXI
Big Spring ISD FBSBSISD
Blackwell CISD WTXJ
Blanket ISD WTXK
Booker ISD WTXL
Borger ISD WTXM
Bovina ISD WTXN
Brookesmith ISD WTXP
Bryson ISD WTXQ
Canadian ISD WTXR
Channing ISD WTXS
Cherokee ISD WTXT
Childress ISD WTXU
City View ISD WTXV
Clarendon CISD WTXW
Coahoma ISD WTXX
Cotton Center ISD WTXY
Crane ISD WTXBA
Crosbyton Consolidated ISD WTXZ
Crowell ISD WTXAA
Culberson County -Allamoore ISD WTXAB
Dalhart ISD WTXAC
Darrouzett ISD WTXAD
DeLeon ISD WTXBL
Dumas ISD WTXAF
Eden CISD WTXAG
El Paso Education Initiative Inc WTXAH
El Paso Leadership Academy WTXAI
Electra ISD WTXAJ
District GROUP #
Farwell ISD WTXAK
Floydada ISD WTXAL
Follett ISD WTXAM
Forsan ISD WTXAO
Fort Elliott CISD WTXAP
Fort Stockton ISD WTXAQ
Friona ISD WTXAR
Garden City -Glasscock County ISD WTXAS
Grady ISD WTXAT
Grandfalls-Royalty ISD WTXBD
Grandview -Hopkins ISD WTXAU
Greenwood ISD WTXBF
Groom ISD WTXAV
Gruver ISD WTXAW
Gustine ISD WTXBG
Guthrie CSD WTXAX
Hale Center ISD WTXAY
Happy ISD WTXAZ
Harrold ISD WTXAZZ4
Hart ISD WTXHA
Hartley ISD WTXAAA
Hedley ISD WTXABB
Henrietta ISD WTXACC
Hereford ISD WTXBE
Highland Park ISD WTXADD
Holliday ISD WTXAEE
Idalou ISD WTXAFF
Jacksboro ISD WTXAGG
Jayton ISD WTXAHH
Jim Ned CISD WTXAII
Kelton ISD WTXAJJ
Klondike ISD WTXAKK
Kress ISD WTXALL
Lazbuddie ISD WTXAMM
Lefors ISD WTXANN
Lockney ISD WTXAOO
WTXEBC Mobile App Login Group #’s
Use your District’s group # to login to the Benefits app.
District
Loop ISD
Lorenzo ISD
May ISD
McLean ISD
Meadow ISD
Memphis ISD
Menard ISD
Miami ISD
Midland Academy Charter School
Monahans-Wickett-Pyote ISD
Montague ISD
Morton ISD
Munday CISD
Nazareth ISD
New Home ISD
Newcastle ISD
Nocona ISD
Northside ISD
O'Donnell ISD
Olfen ISD
Olton ISD
Paducah ISD
Paint Rock ISD
Panhandle ISD
Panther Creek CISD
Pathway Academy
Patton Springs ISD
Petersburg ISD
Petrolia ISD
Plains ISD
Post ISD
Prairie Valley ISD
Pringle-Morse CISD
PSPartners
Quanah ISD
Ralls ISD
GROUP #
WTXAPP
WTXAQQ
WTXARR
WTXASS
WTXATT
WTXAUU
WTXAVV
WTXAWW
WTXAXX
WTXAYY
WTXAZZ
WTXAAA1
WTXABB1
WTXACC1
WTXADD1
WTXAEE1
WTXAFF1
WTXAGG1
WTXAHH1
WTXAII1
WTXAJJ1
WTXAKK1
WTXALL1
WTXAMM1
WTXANN1
WTXBH
WTXAOO1
WTXAPP1
WTXAQQ1
WTXARR1
WTXASS1
WTXATT1
WTXAUU1
WTXBA
WTXAVV1
WTXAWW1
District GROUP #
Rankin ISD
WTXAXX1
RISE Academy WTXAYY1
River Road ISD WTXAZZ1
Robert Lee ISD WTXAAA2
Roosevelt ISD WTXABB2
Saint Jo ISD WTXADD2
San Vicente ISD WTXBI
Sands CISD WTXAEE2
Sanford-Fritch ISD WTXAFF2
Santa Anna ISD WTXAGG2
Seagraves ISD WTXAHH2
Shamrock ISD WTXAII2
Sierra Blanca ISD WTXAJJ2
Smyer ISD WTXAHH3
Southland ISD WTXAKK2
Spring Creek ISD WTXALL2
Springlake-Earth ISD WTXAFF3
Sudan ISD WTXAMM2
Sunray ISD WTXANN2
Sweetwater ISD WTXAOO2
Tahoka ISD WTXAPP2
Texline ISD WTXAQQ2
The Betty M. Condra School WTXBK
Throckmorton ISD WTXARR2
Tulia ISD WTXASS2
Turkey-Quitaque ISD WTXATT2
Valentine ISD WTXAUU2
Vega ISD WTXAVV2
Water Valley ISD WTXAWW2
Wellington ISD WTXAXX2
Wheeler ISD WTXAZZ2
White Deer ISD WTXAAA3
Whitharral ISD WTXABB3
Wildorado ISD WTXAZZ3
Wilson ISD WTXACC3
Windthorst ISD WTXADD3
Zephyr ISD WTXAEE3
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 WTXEBC 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 WTXEBC 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.