Taliaferro County - Benefits Guide 2027 VIEW ONLY by campusleadership

Benefits Guide 2027 Effective January 1st, 2027 Summary for Review Purposes Only

Table of Contents 3

Eligibility & Important Notes

Qualified Life Events & Preventive Care

Service Hub/Support Center

Voluntary Benefits Claim Instructions

Employee Assistance Program

Mutual of Omaha Additional Resources

9-10

Enrollment in Benefits - Take Action

Health Insurance 101

12-13

Medical Plan (State Health Benefit Plan)

14-16

Dental Plan

Vision Plan

Need help? Start Here:

Get the most out of your Dental and Vision Plans

Disability Plans

mybenefits@campusbenefits.com 866.433.7661, opt. 5

Life Insurance 101

Basic Life and AD&D Plan

Voluntary Term Life and AD&D Plan

Permanent Life Insurance

Hospital Indemnity Plan

Accident Plan

Critical Illness w/Cancer Plan

Wellness Incentives

28-29

Taliaferro County School District offers a comprehensive and valuable benefits program to all eligible employees. Our benefits package is designed to provide security and assistance during a time of need. Please become familiar with the various options and select the best coverage for the upcoming plan year.

Taliaferro County School District Contact: Egypt Thomas 706-986-0396 ethomas@taliaferro.k12.ga.us

FSA and Helpful FSA Resources

Legal Plan

MedCareComplete

Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

Eligibility Benefits Eligible Employees: Generally, full-time employees working 20 or more hours a week are eligible to enroll in the various benefits described throughout the guide. (Certain rules may apply per benefit) Eligible family members may be enrolled under certain plans when elected by the employee. 49% employees are eligible for Basic Life and AD&D, MedCareComplete, and Flexible Spending Accounts Board Members are eligible for basic Life and AD&D, dental, vision, and Medcarecomplete. Eligible family members include: Your legally married spouse Your unmarried children who are your natural children, stepchildren, adopted children, or children of whom you have legal custody (age restrictions may apply) up to the age of 26. Disabled children age 26 or older who meet certain criteria may continue on your coverage.

Waiving Coverage Employees who choose to waive/decline any benefits for themselves or their dependents will not be eligible to enroll until open enrollment for each plan without a Qualifying Life Event. Additional Rules: Specific employee and dependent eligibility rules are governed by each plan’s policy document/certificate; available on the employee benefits website, or by contacting Campus Benefits. Employees must be actively at work on effective date.

When Do Benefits Begin? The effective date of coverage for benefits depends on your hire date. Benefits begin first of the month following 30 days for all benefits. For all benefits, employees must be actively at work on the effective date of coverage. New hires must complete enrollment within 30 days of hire date, prior to effective date of coverage. Supporting documentation is required to be submitted to process qualifying life events.

When Do Benefits End? Upon termination of employment, the benefits end date may vary by benefit, but typically end at the end of the month after your last payroll deduction. However, Flexible Spending Accounts end at the end of the month of your last payroll deduction. Please consult with a Campus Benefits advisor on your specific end date for portability options for any current coverages.

Important Notes: This guide is presented for illustrative purposes only and is not intended to offer insurance advice. It is important to review each benefit’s summary plan description (SPD) and other carrier materials before making any selections. Remember: Review the plan options and/or update beneficiaries annually for all benefits including Basic Life and Voluntary Term Life & AD&D. Carefully review your plan options and consider which ones best meet your needs. Make elections during the assigned enrollment period to receive coverage for the upcoming plan year. Enrollment requires dependent information, including Social Security numbers and dates of birth.

When can I change my benefits? Employee benefit elections are allowed as a new hire and during the annual open enrollment period. The selected benefits will remain in effect throughout the plan year. Plan year is from January 1st to December 31st. Qualifying Life Events: Each year during open enrollment, you will have the opportunity to make changes to your benefit elections for yourself and your covered dependents. Outside of open enrollment, you must experience a qualifying event that satisfies federal regulations outlined below: Marriage, legal separation or divorce Birth or adoption of a child Death of a covered dependent Loss or gain of other coverage (e.g. spouse loses job-based coverage) Change in employment status (e.g. full-time to part-time or vice versa) Change in dependent eligibility (e.g. child turns 26 and ages out of coverage) Relocation that affects coverage options (e.g. moving out of a plan’s service area) Court order requiring coverage for a dependent (e.g. through legal guardianship or custody) Entitlement to Medicare IMPORTANT NOTE: Campus Benefits must be notified of any qualifying life events within 30 days. You will need to submit supporting documentation to process your life event. Please keep any records of the above occurrences.

Wellness and Health Management: Preventive Care Understanding the full value of covered benefits allows you to maintain good health and build healthy habits. Through State Health Benefit Plan (SHBP), preventive services recommended by the U.S. Preventive Services Task Force are covered at 100% under the Affordable Care Act (i.e. Health Care Reform) when using in-network providers.

Which Preventive Care Services are Covered? Routine Physical Exam Well Woman Visits Routine Bone Density Test Routine Gynecological Exam Obesity Screening and Counseling Routine Prostate Test Routine Mammograms Smoking Cessation Health Counseling for STDs and HIV Screening and Counseling for Domestic Violence

Well Baby and Child Care Immunizations Routine Breast Exam Screening for Gestational Diabetes Routine Colonoscopy Routine Lab Procedures Routine Pap Smear Health Education/Counseling Services Testing for HPV and HIV See SHBP page for additional details

Service Hub/Support Center Claim Instructions What can Campus Benefits help you with? Portability/Conversion Benefits Education Evidence of Insurability Qualified Life Event Changes

Claims Card Requests Benefit Questions COBRA Information

Campus Benefits is your dedicated advocate for all your voluntary benefits. Common Questions Am I required to contact Campus Benefits to file a claim? No. However, in our experience, the number one reason for claim denial or delay is due to incomplete or inaccurate paperwork. By working with a Campus Benefits’ claim specialist, we can advocate on your behalf. How can I access my dental card or vision card quickly? Your group dental and vision information is available at www.taliaferrocountyschoolbenefits.com Voluntary Term Life Part 1: Employer Completes Part 2: Employee Completes Sign authorization to release personal information Supply death certificate (employees can submit claim form before obtaining death certificate to get the process started)

Disability Section 1: Employee Completes Sign authorization to release personal information Sign authorization to release personal information to employer For direct deposit, complete electronic transfer form Provide voided check copy Section 2: Employer Completes Section 3: Physician Completes

The Campus Benefits team understands the claims process and leverages the necessary carrier relationships to expedite the paperwork efficiently to ensure claims are not delayed due to improper paperwork completion. Phone: 866.433.7661, Opt 5 Email: mybenefits@campusbenefits.com Website: www.taliaferrocountyschoolbenefits.com REMINDER: Make sure your physician completes their portion if needed. Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

Voluntary Benefits Claim Instructions Required for all voluntary benefits claims: UB-04 form for Hospital Visits: Request a UB-04 (CMS-1450) from the hospital billing department. This provides details of hospital services and charges and can help ensure all eligible benefits are considered. Explanation of Benefits (EOBs) from your health insurance

Hospital Indemnity

Accident

Admission & discharge dates, including room type (ICU and/or Non-ICU) Diagnosis, treatment details/records and discharge papers Auto-accident claims: Police report and if applicable, toxicology or blood-screening results.

Medical documentation showing the patient’s name, dates of service, diagnosis, and treatment or procedure Itemized medical bills and ER discharge papers If hospitalized, include admission/discharge dates and room type (ICU or non-ICU). Auto-accident claims: Police report and, if applicable, toxicology or blood-screening results

Critical Illness w/Cancer Medical records supporting the condition, such as doctors’ notes, test results, and other relevant treatment records Proof of diagnosis, such as a pathology report or other supporting medical evidence Applicable hospital records, such as admission and discharge summaries Any additional documentation supporting the diagnosis or condition

How to Submit Your Claim: Step 1 - Request claim forms from Campus Benefits or pull from benefits website Step 2 - Collect all applicable documentation (see above) Step 3 - Upload securely through the benefits portal: (www.taliaferrocountyschoolbenefits.com/contact-campus) Step 4 - Campus Benefits will review, confirm and submit to the carriers REMINDER: Make sure your physician completes their portion if needed.

Employee Assistance Program (EAP) What is an EAP? This is a program offered to Taliaferro County School District employees to provide guidance with personal issues, planning for life events or simply managing daily life which can affect your work, health and family. Coverage through Mutual of Omaha Available for all Taliaferro County School District employees, their household members and dependent children up to age 26 Provides support, resources, and information for personal and work-life challenges Visit the Employee Assistance Program website to view timely articles and resources on a variety of financial, well-being, behavioral and mental health topics CALL 1-800-316-2796 or visit www.mutualofomaha.com/eap

EAP can help with:

EAP Benefits 24/7 Access Reach an EAP professional anytime, day or night.

Emotional well-being Stress, anxiety, depression and more Family and relationships Communication, parenting, marriage and more

3 face-to-face sessions* Up to three sessions per issue, per calendar year with a counselor.

Legal and financial matters Legal guidance, financial tools and resources

Legal assistance & financial resources Online will preparation Legal library and online forms Financial tools and resources

Healthy lifestyles Wellness and overall well-being Work and life transitions Career changes, burnout, retirement and more

Additional resources Resources for substance use and other addictions. Dependent and elder care resources Online resources Educational articles, handouts and resources via www.mutualofomaha.com/eap

Important Notes: *Face-to-face visits can also be used toward legal consultations. *California Residents: Knox-Keene Statute limits no more than three face-to-face sessions per six-month period.

See the Additional Resources page for additional resources provided free of charge to all benefits eligible employees.

EAP Plan Rates Coverage paid for by Taliaferro County School District at no cost to you. Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

Mutual of Omaha

Additional Resources

Additional Benefits to Support Your Wellbeing and Peace of Mind As part of your Mutual of Omaha benefits package, you have access to additional services such as a hearing discount program, identity theft assistance, travel assistance, and will preparation services. Available to all benefit eligible employees, no enrollment requirement.

Hearing Discount Program

Worldwide Travel Assistance

Enjoy savings and support through Amplifon Hearing Health Care. Variety of industry leading brands’ hearing aids to choose from 60-day risk free trial with money back guarantee 3 year warranty for loss, repairs or damage Follow up care, battery supplies and financing options available Family and friends receive a discount Call Amplifon at 1-888-534-1747 to speak with a Patient Care Advocate who will connect you with a provider near you To learn more, visit: www.amplifonusa.com/mutualofomaha

Feel secure knowing you and your family are covered while traveling more than 100 miles from home. 24/7 emergency support for medical referrals, legal help and translation services Pre-trip planning support including passport/visa requirement, health advisories, and currency exchange rates Assistance with lost baggage, emergency cash, emergency messages between you and others, vehicle return and document replacement (credit card, passport, tickets) Call World Travel Assistance at 1-800-856-9947 (within the U.S.) or 312-935-3658 (outside of the U.S.)

Identity Theft Assistance

Will Preparation Services

Receive essential identity protection and recovery help through AXA Assistance. Education and awareness to reduce risk of identity theft Guidance on recognizing and responding to fraud Recovery support if personal information is stolen, including steps to restore your identity and contacts for financial institutions and credit bureaus Call AXA Assistance at 1-800-856-9947

Create important legal documents at no cost through Epoq, Inc. Easy online platform to prepare living will and trust, power of attorney, healthcare directive, pour-over will, last will and testament Print and share instantly and update as needed for major life changes Make the document legally binding (check with your state for requirements) To learn more, visit www.willprepservices.com and use code MUTUALWILLS to register

Please visit www.taliaferrocountyschoolbenefits.com for more information.

Enrollment in Benefits - Take Action There are two separate benefit enrollments: 1. Campus Benefits (Dental, Vision, Life, Disability etc.) 2. State Health Benefit Plan (Medical)

Campus Benefits Enrollment

Step 1: Visit www.taliaferrocountyschoolbenefits.com Step 2: Click Enroll/Login tab and complete your enrollment Need help? Click Campus Connect tab to send in questions OR call 1.866.433.7661, opt. 5

New User Registration 1. Register as a new user and enter: First Name Last Name Company Identifier: TCS2026 PIN: Last 4 Digits of SSN Birthdate 2.Click Next 3. Create login credentials (see FAQ) 4. Click Register then Login 5. Enter Username and Password 6. Click Start Benefits to begin enrollment

Important Notes: Plan Year is 1/1 - 12/31 Annual open enrollment occurs in the fall (October/November)

Still Need Help? Contact Campus Benefits Email: mybenefits@campusbenefits.com Call: 1.866.433.7661, opt. 5

Frequently Asked Questions What is my username?

The default username is your work email or the email on file with HR, unless it has changed.

What is my password?

Create or reset your password on the login page. It must be at least 6 characters and include a number and symbol. Using uppercase, numbers, and symbols greatly improves security.

Enrollment in Benefits - Take Action There are two separate benefit enrollments: 1. Campus Benefits (Dental, Vision, Life, Disability etc.) 2. State Health Benefit Plan (Medical)

State Health Enrollment

Step 1: Visit www.taliaferrocountyschoolbenefits.com Step 2: Click State Health Benefit Plan Step 3: Click SHBP Enrollment Link

Need help? Refer to the SHBP section of the guide for additional details OR call SHBP at 1.800.610.1863.

Compare Plan Options: Health Maintenance Organization (HMO) Allows you to receive covered medical services from in-network providers only (except for emergency care). It is important to verify your current provider is in-network when selecting an HMO Plan Option. Plan pays 100% of covered services provided by in-network providers that are properly coded as “preventive care.” There are co-pays with this plan for certain services and certain services are subject to a deductible and coinsurance.

Health Reimbursement Account (HRA) The HRA provides first-dollar coverage for eligible medical and pharmacy expenses and is funded by SHBP. When going to the doctor, you will not pay a co-pay. Instead, you pay the applicable deductible and coinsurance. Plan pays 100% of covered services provided by in-network providers that are properly coded as “preventive care”. You must meet separate in-network and out-of-network deductibles and out-of-pocket maximums.

High Deductible Health Plan (HDHP) The HDHP offers in-network and out-of-network benefits and provides access to one of the largest network of providers statewide and on a national basis across the United States. In addition to a lower monthly premium, you can open a Health Savings Account (HSA) that allows you to save money tax deferred to help offset your plan costs. Plan pays 100% of covered services provided by in-network providers that are properly coded as “preventive care.”

The Georgia State Health Benefit Plan (SHBP) provides annual legal and prescription drug coverage disclosure notices, as well as forms for disclosing or authorizing the release of protected health information. Visit https://shbp.georgia.gov/legal-notices to review the following notices. Please review these notices in their entirety.

Federal Patient Protection and Affordable Care Act Notices HIPAA Special Enrollment Notice Women’s Health and Cancer Rights Act of 1998 Newborns’ and Mothers’ Health Protection Act of 1996 Health Insurance Portability and Accountability Act Notice of Information Privacy Practices

Centers for Medicare & Medicaid Services Medicare Part D Credible Coverage Notice Summaries of Benefits and Coverage Georgia Law Section 33-30-13 Notice

Health Insurance 101 Before enrolling, take a moment to review these key terms to better understand and navigate the benefits options with confidence. See your specific plan summary for additional details.

In-Network vs. Out-of-Network In-Network providers have contracts with health plans to offer services at discounted rates. Out-of-Network providers are not contracted and rates are higher. Explanation of Benefits (EOB) A statement from the insurance provider showing what was billed, what the plan paid, and what you may still owe. An EOB is not a bill. Summary of Benefits and Coverage (SBC) A standardized overview of what the plan covers, costs, and examples of how the plan would pay for common medical situations. Qualifying Life Event (QLE) Qualified life change that allows midyear benefit changes. Reasonable & Customary Typical cost for services in your area.

Premium Amount you pay for coverage, which is separate from the deductible and out-of-pocket maximum. Copayment A fixed amount you pay for services that counts towards your out-ofpocket maximum, not the deductible. Deductible Amount paid for covered services before your insurance plan starts to pay on your behalf. Coinsurance The percentage you pay for covered costs after meeting the deductible. Out-of-Pocket Maximum (OOPM) The highest amount paid annually for covered services. Afterwards, the plan pays 100% (with minimal exceptions). Preventive Care Routine services like check-ups, immunizations, and screenings for adults and children.

Medical Plan (State Health Benefit Plans) Taliaferro County School District offers all eligible employees health insurance through the Georgia State Health Benefit Plan. During the annual open enrollment, employees have the opportunity to review all available options and make elections for the upcoming plan year. Coverage through Anthem/BCBS of GA, United Healthcare, or Kaiser Permanente* All qualifying life events must be submitted directly to State Health Benefit Plan via the SHBP Portal Kaiser Permanente* is available in the Metro Atlanta Service Area and Athens-Clarke, in-network only Transferring from another school district: You will not be able to make changes until the next open enrollment period, unless it is a qualifying life event The information provided is an overview; please see the SHBP summary plan descriptions on the benefits website for detailed listing of services in their entirety.

SHBP Enrollment Portal:

SHBP Wellness Portal:

How to Enroll:

SHBP Decision Guide:

www.shbp.georgia.gov/enrollment-portal

www.bewellshbp.com

Go to website above Enter your Username and Password and click Login. If you need assistance, click on “Forgot User ID?” or “Forgot Your Password?”. If you have not registered, click “Register Here”. Your registration code is SHBP-GA.

This Guide provides a brief explanation about each health benefit option, a benefit comparison guide, and a list of things to consider before making plan decisions. Access the decision guide at www.shbp.georgia.gov/enrollment/decision-guides

SHBP Phone Number: 1.800.610.1863 Wellness Credits (Due by November 30th)

Anthem HMO MyIncentive Account (MIA)

Anthem Health Reimbursement Arrangement (HRA)

Kaiser Permanente (KP) Regional HMO

UHC HMO & HDHP Health Incentive Account (HIA)

Member

Up to 480 Credits

$500*

Up to 480 Credits

Spouse

Up to 480 Credits

$500*

Up to 480 Credits

Reward Card credits for member/spouse

N/A

$250 Reward Card (covered member & spouse)

Potential Total credits/dollars

960 credits

$1,000*

1,460 credits

Please review the Active Decision Guide for full incentive program details and requirements. Anthem: members enrolled in an Anthem HRA Plan Option will receive SHBP-funded base credits at the beginning of the Plan Year. The amount funded will be based on your elected coverage tier. If you enroll in an HRA during the Plan Year, these credits will be prorated based on the elected coverage tier and the months remaining in the current Plan Year. *KP: members enrolled in the KP Regional HMO Plan Option and their covered spouses will each receive a $500 Mastercard reward card after they each satisfy KP’s Wellness Program requirements. **UnitedHealthcare: Spouses enrolled in an UnitedHealthcare Plan Option can now earn a 240 well-being incentive credit match. This means members and their covered spouses enrolled in an UnitedHealthcare Plan Option can each earn a 240 well-being incentive credit match with a maximum combined up to 480 well-being incentive credits matched by UnitedHealthcare for completing wellness requirements under the plan. After credits are added to your HIA, any remaining credits will roll over each plan year. Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request 12 documents before electing coverage.

Medical Plan (State Health Benefit Plans) The table below is a high level overview, for official details and plan information please review the SHBP Decision Guide. Anthem HRA Gold Plan

Anthem HRA Silver Plan

Anthem HRA Bronze Plan

Out

You

$1,500

$3,000

$2,000

$4,000

You + Spouse

$2,250

$4,500

$3,000

You + Child(ren)

$2,250

$4,500

You + Family

$3,000

$6,000

Plan

Anthem HMO

UHC HMO

Out

$2,500

$5,000

$1,300

$3,500

$7,000

$6,000

$3,750

$7,500

$1,950

$7,000

$14,000

$3,000

$6,000

$3,750

$7,500

$1,950

$7,000

$14,000

$4,000

$8,000

$5,000

$10,000

$2,600

$7,000

$14,000

UHC HDHP

Kaiser HMO*

Deductible

Medical Out of Pocket Maximum (OOPM) You

$4,000

$8,000

$5,000

$10,000

$6,000

$12,000

$4,000

$6,450

$12,900

$6,350

You + Spouse

$6,000

$12,000

$7,500

$15,000

$9,000

$18,000

$6,500

$12,900

$25,800

$12,700

You + Child(ren)

$6,000

$12,000

$7,500

$15,000

$9,000

$18,000

$6,500

$12,900

$25,800

$12,700

You + Family

$8,000

$16,000

$10,000

$20,000

$12,000

$24,000

$9,000

$12,900

$25,800

$12,700

Coinsurance (Plan pays. Some out-ofnetwork services not covered)

85%

60%

80%

60%

75%

60%

80%

70%

50%

100%

Health Reimbursement Arrangement Credits (HRA) You

$400

$200

$100

You + Spouse

$600

$300

$150

You + Child(ren)

$600

$300

$150

You + Family

$800

$400

$200

N/A

$200 Copay $200 Copay

Urgent Care and PCP Visit

Coinsurance after deductible

Specialist Visit Preventive

100%

N/A

100%

N/A

100%

N/A

$35 Copay

$45 Copay

100%

$200 Copay Coinsurance after deductible

$35 Copay $45 Copay

100%

N/A

100%

Retail Rx (Not subject to deductible on HRA Plans) Tier 1

15%, Min $5, Max $10

$5 Copay

Tier 2

25%, Min $55, Max $85

$55 Copay

Tier 3

25%, Min $85, Max $130

$95 Copay

Coinsurance after deductible

$20 Copay $50 Copay $80 Copay

Mail Order Rx Tier 1

15%, min $12.50, Max $25

$12.50 Copay

Tier 2

25%, Min $137.50, max $212.50

$137.50 Copay

Tier 3

25%, Min $212.50, max $325

$237.50 Copay

Monthly Premiums

Anthem HRA Gold Plan

Anthem HRA Silver Plan

Employee

$227.19

EE + CH

$415.51

EE + SP Family

$50 Copay

Coinsurance after deductible

$125 Copay

UHC HDHP

Kaiser HMO*

$200 Copay

Anthem HRA Bronze Plan

Anthem HMO

UHC HMO

$153.17

$94.16

$189.29

$232.70

$83.76

$189.29

$289.67

$189.35

$351.08

$424.87

$171.67

$351.08

$565.89

$410.44

$286.52

$486.30

$577.46

$264.68

$486.30

$754.21

$546.94

$381.71

$648.09

$769.63

$352.59

$648.09

Kaiser Permanente* is available in the Metro Atlanta Service Area and Athens-Clarke, in-network only. There is an $80 tobacco surcharge added to all rates. Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

Dental Plan

What is Dental Insurance? This is a health and wellness plan designed to pay a portion of dental costs associated with preventive, basic, some major dental care, as well as orthodontia.

Coverage through Mutual of Omaha Provider directory: www.mutualofomaha.com/dental (Network: Mutually Preferred) Claims must be submitted within 90 days of date of service Orthodontics available only for dependent children up to age 26 (subject to takeover provision/lifetime max) The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety. Quick Summary

One Plan

Class I: Preventive

100%

Class II: Basic

80%

Class III: Major

50%

Orthodontia

50% (no ortho deductible) Plan Benefits

Orthodontia Lifetime Maximum (Per covered person)

$1,000

Calendar Year Maximum (Per covered person)

$1,500

Calendar Year Deductible

$50 / $150 Family Max (Waived for Type I/Preventive)

Out-of-Network Coverage

80th UCR

Waiting Period

None

Dental Plan Rates Employee

$33.58

Employee + Spouse

$66.12

Employee + Child(ren)

$80.60

Employee + Family

$118.84

*Click here for more information and printable version of the ID Card (electronic guide)

Dental Plan Have major dental work coming up? Avoid a surprise bill by exploring costs of dental services in your Mutual of Omaha dental account.

Tip: Submit a pre-treatment estimate to stay ahead of your expenses.

Quick Summary

Preventive

Basic

Major

Exams: 2 services in a 12 month period Full Mouth Series/Panoramic X-ray: 1 service in a 36 month period Fluoride: 1 service in a 12 month period for dependent children to age 16 Cleaning: 2 services in a 12 month period Brush Biopsy/Cancer Screen: 2 services in a 12 month period

Bitewing X-rays: 4 films in a 12 month period Other X-rays Sealants: For dependent children to age 16 Space Maintainers: For dependent children to age 14 Palliative Treatment: Emergency minor procedure Periodontal Maintenance: 2 services in a 12 month period Fillings: Amalgam and composite/resin fillings Stainless Steel Crowns: For dependent children to age 16 Simple Extractions General Anesthesia or I.V. Sedation Surgical Extractions Oral Surgery Endodontics Non-Surgical Periodontics Surgical Periodontics Dentures (Full or Partial) Repair of Full or Partial Dentures Bridges Repair of Bridges Cast Crowns, Inlays, Onlays, Labial Veneers Repair of Cast Crowns, Inlays, Onlays, Labial Veneers

Dental Providers Sample of In-Network Dental Providers within a 35 mile radius (not a complete list)

*Choosing in-network dental providers helps you get the most value and savings from your plan benefits.* Current providers list as of 10/6/2026. Providers are subject to change. Refer to the In-Network Provider Directory for a full list of providers. Provider Directory: www.mutualofomaha.com/dental Network: Mutually Preferred <15 Mile radius ANDREW LEE TAM (OCONEE VALLEY HEALTHCARE INC) 803 S MAIN ST, GREENSBORO, GA 30642 (706) 454-5114 LAKESIDE PEDIATRIC DENTISTRY LLC 1050 PARKSIDE CMNS STE 103 GREENSBORO, GA 30642 (706) 454-2222 LETISHA EDWARDS 1050 PARKSIDE CMNS STE 103 GREENSBORO, GA 30642 (706) 454-2222 GEORGIA DENTAL ALLIANCE OF GREENSBORO 1000 COWLES CLINIC WAY STE W-200 GREENSBORO, GA 30642 (706) 454-5114 RUSSELL MARSON 1041 PARKSIDE CMNS STE 104 GREENSBORO, GA 30642 (706) 545-0044 LAKE OCONEE SMILE CENTER 1050 PARKSIDE CMNS STE 103 GREENSBORO, GA 30642 (706) 454-2222 <25 Mile radius BRET DANIEL FREEDMAN 1690 EATONTON RD, MADISON, GA 30650 (706) 342-7272 PAGETT WHETZEL FAMILY AND COSMETIC DENTISTRY 1880 BETHANY RD STE A, MADISON, GA 30650 (706) 342-3636 LINDSEY FAMILY DENTAL 480 HANCOCK ST, MADISON, GA 30650 (706) 342-2155 CHARLES J. SCHERER 2151 EATONTON RD BLDG D MADISON, GA 30650 (706) 752-1910

ORTHODONTIC CARE OF GA 1690 EATONTON RD, MADISON, GA 30650 (706) 342-7272 WILLIAM A. BEHRNDT 126 FAIRPLAY ST, RUTLEDGE, GA 30663 (706) 557-7374 WILLIE TRANARD OLIVER 122 W MARION ST, EATONTON, GA 31024 (706) 623-0318 ORTHODONTIC CARE OF GA 1690 EATONTON RD, MADISON, GA 30650 (706) 342-7272 <35 Mile radius REDWOOD DENTAL OF GEORGIA 1289 CEDAR SHOALS DR, ATHENS, GA 30605 (706) 353-7018 ADVANCED ATHENS DENTISTRY ATHENS 1155 CEDAR SHOALS DR, ATHENS, GA 30605 (706) 546-8720 FAMILY ORTHODONTICS LLC 1610 MARS HILL RD STE B WATKINSVILLE, GA 30677 (770) 417-3546 ATHENS DENTISTRY FOR CHILDREN 2470 DANIELS BRIDGE RD STE 231 ATHENS, GA 30606 (706) 549-0108 ASPEN DENTAL 1805 EPPS BRIDGE PKWY STE 101 ATHENS, GA 30606 (478) 387-7015 DENTISTRY FOR CHILDREN OF GEORGIA LLC 1795 RESURGENCE DR STE 101 WATKINSVILLE, GA 30677 (770) 692-1000 MCRAE FAMILY DENTISTRY 995 BAXTER ST, ATHENS, GA 30606 (706) 546-8480

Vision Plan What is Vision Insurance? A health and wellness plan designed to reduce your costs for routine preventive eye care including eye exams and prescription eyewear (eyeglasses and contact lenses). Coverage through Mutual of Omaha Provider directory: www.mutualofomaha.com/vision (Network: EyeMed Insight) Claims must be submitted within 90 days of date of service The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety.

Quick Summary

One Plan

Vision Plan Per Pay Period Rates

Exam

$0 Copay

Employee

$7.80

Standard Contact Lens Fit & Follow-Up

Up to $40 Copay

Frames (See highlight sheet for details)

$0 Copay, $130 allowance plus 20% off balance over allowance

Employee + Spouse

$16.84

Employee + Child(ren)

$13.65

Single Vision, Bifocal & Trifocal, Lenticular Lenses

$0 Copay

Employee + Family

$22.68

Standard Progressive Lenses

$65 Copay

Additional Lens Options UV Treatment

$15 Copay

Standard Scratch Coating

$15 Copay

Polycarbonate Lenses

Adults & Children: $40 Copay

Tint

$15 Copay

Standard Anti-Reflective Coating

$45 Copay

Photochromic - Transitions

$75 Copay

Contact Lenses Elective Conventional Contacts

$0 Copay, $130 allowance plus 15% off balance over allowance

Elective Disposable Contacts

$0 Copay, $130 allowance

Medically Necessary

$0 Copay; paid in full

*Click here for more information and printable version ID card (electronic guide)

Frequencies Exams, Lenses, Contact Lenses and Frames

Every 12 Months (Based on date of service)

Are there any additional discounts beyond what is covered by the plan? - Yes! 40 percent off additional complete pairs of glasses 20 percent off any remaining frame balance 15 percent off any remaining conventional contact lens balance 20 percent off non-covered items, including non-prescription sunglasses, accessories and lens cleaner 15 percent off the standard price or 5 percent off any promotional price of LASIK or PRK services Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

Get the most out of your Dental and Vision Plans Dental and vision plans help pay a portion of costs associated with care and provide options to get the most out of these benefits. Tips for utilizing your Dental Benefits Look for participating dentist online at www.mutualofomaha.com/dental Go to www.mutualofomaha.com to *Your plan allows you to visit any find providers, view claims and more. general dentist or specialist. Group name: Taliaferro County However, you usually save more with School District a participating dentist.

Your dentist can request a pretreatment estimate for any service that is more than $300 to help you manage your cost and care

*In-Network discounts apply even after you reach your plan’s annual maximum, reducing your out-of-pocket expense. Tips for utilizing your Vision Benefits Track your claims and plan usage by registering for a Mutual of Omaha You can price shop your lens & frame account (if enrolled in both dental Look for participating vision providers providers. Take your prescription and vision, you will utilize the same online at from your out-of-network provider to user name and password. www.mutualofomaha.com/vision an in-network provider to receive the Visit www.mutualofomaha.com, Network: EyeMed Insight most benefit from your vision plan. select Sign In and select Employee Portal. Enter in credentials or sign up for an account. *While your plan allows you to visit any licensed vision provider, remember your benefits go further when you go in-network.

Dental Wellness Center Access these tools by visiting www.mutualofomaha.com/dental and selecting Dental Wellness Center under Resources.

Cost Estimator

Risk Assessments

Ask a Dentist

Use Mutual of Omaha’s estimator to find out what dental procedures may cost before your next visit.

Take a quiz to see if you are at a higher risk for certain oral conditions.

Email a dentist your dental related questions. It's free and a dentist will respond within 48 hours.

Disability Plans What is Disability Insurance? Disability insurance replaces a portion of your income if injury or illness prevents you from working, providing financial security for you and your dependents. Coverage through Mutual of Omaha (Employee must be actively at work on the effective date.) Short-Term Disability: Annual enrollment, no health questions every year. Long-Term Disability: If electing outside of initial enrollment, Evidence of Insurability (EOI) would be required. The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety. Quick Summary

Short-Term Disability

Long-Term Disability

Elimination Period

Benefits begin after being out of work due to an injury or illness for 7 days.

Benefits begin after you have been out of work due to an injury or illness for 90 calendar days

Benefit Duration

Covers accidents and illnesses up to 12 weeks

Covers accidents and sicknesses up to Social Security Normal Age of Retirement (Please note exclusions or limitations may apply; see plan certificate for details)

Benefit Percentage (weekly)

60% of your gross weekly salary

60% of your gross monthly salary

Maximum Benefit Amount

$1,500 (weekly benefit)

$6,000 (monthly benefit)

Leave Offset Rules

Does not offset for Paid Parental Leave but will offset for Sick Leave. Will offset with Sick Leave and any outside Employee can start/stop sick leave to income (Social Security, Military pension, match elimination period, must be retirement, etc.) decided at the beginning of leave.

Pre-Existing Condition Limitation

Short-Term Disability: 3/6 - Any sickness or injury for which you received medical treatment, consultation, care, or services during the specified months (3 months) prior to your coverage effective date. A disability arising from any such sickness or injury will be covered only if it begins after you have performed your regular occupation on a full-time basis for the specified months (6 months) following the coverage effective date. (Waived during initial enrollment and for new hires if enrolling during new hire enrollment)

Long-Term Disability: 3/12 - Any sickness or injury for which you received medical treatment, consultation, care, or services during the specified months (3 months) prior to your coverage effective date. A disability arising from any such sickness or injury will be covered only if it begins after you have performed your regular occupation on a full-time basis for the specified months (12 months) following the coverage effective date. (Applies to new enrollees only)

Disability Plan Rates Cost of coverage is based on your age and salary. Please consult with a Campus Benefits Counselor or log into the enrollment system for rate details. Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents 19 posted on your employer’s benefits website or request documents before electing coverage.

Life Insurance 101 Term Life and Permanent Life work best used in conjunction with one another. Term Life can protect your family in your younger working years and Permanent Life can protect your family in your retirement years. The need for life insurance depends on each individual life situation. If loved ones are financially dependent on you, then buying life insurance coverage can absolutely be worth it. Even if you don’t have financial dependents yet, life insurance can be a valuable solution for making loss easier financially for a family. There are two voluntary life insurance options offered through your employer: Term Life Insurance and Permanent Life Insurance.

Quick Reference

Term Life Insurance

Permanent Life Insurance

Available Plans

Employer Paid Basic Life and AD&D Voluntary Life and AD&D

Whole Life

Coverage Duration

Protection during your working years

Lifelong protection as long as premiums are paid

Initial Cost

Lower initial cost, premium increases as you age.

Higher initial cost, premiums stay the same for the life of the policy

Benefit Flexibility

Highly flexible, benefit amounts can be changed annually based on life changes (e.g. marriage, children, nearing retirement)

Benefit amount is typically fixed at issue. Add additional plans to increase coverage

Purpose

For the unexpected death during your working years to protect your family

Long-term security, intended to take into retirement and provide foundational coverage

Cash Value

No cash value accumulation

Builds cash value, see policy for details

Portability

Portable at retirement or leaving employer, but Fully portable at the same cost at retirement or premiums will increase leaving employer

Basic Life and AD&D Plan What is Basic Life and AD&D Insurance? A financial protection plan paid by Taliaferro County School District, which provides a lump-sum payment, known as a death benefit, to a beneficiary upon the death of employee. Coverage through Mutual of Omaha Premiums paid by Taliaferro County School District Upon termination or retirement, continuation of coverage may apply The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety. Quick Summary

Basic Life and AD&D

Benefit Amounts

Employee: $10,000 (AD&D matches Life amounts)

Additional AD&D Benefits

Seat Belt Benefit, Airbag, Common Carrier (see policy documents for details)

Age Reduction

To 65% at age 65, 50% at age 70

Conversion

Included

Accelerated Life Benefit

80% of the amount of the life insurance benefit is available to you if terminally ill, not to exceed $8,000.

Employee Assistance Program (EAP)

Included, please see EAP page for more information

Portability

Portable at retirement or leaving employer, paid by employee

Keep your beneficiary information up to date Review your beneficiaries regularly. Life changes such as marriage, divorce, the birth or adoption of a child, or the death of a loved one may mean your current beneficiary designations no longer reflect your wishes. Don't forget your other accounts. In addition to your employerprovided Basic Life and AD&D coverage, review the beneficiaries on other life insurance policies, retirement accounts, HSAs, and other financial accounts. A will may not override a beneficiary designation. Benefits and account balances are generally paid according to the beneficiary information on file, making it important to keep your designations current. Take a few minutes to review your information. Keeping your beneficiary designations up to date can help ensure your benefits are distributed according to your wishes and make things easier for those you leave behind. Basic Life and AD&D Plan Rates Coverage is provided by Taliaferro County School District at no cost to you. Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

Voluntary Term Life and AD&D Plan What is Term Life Insurance? A life and AD&D insurance plan provides financial protection by paying a lump-sum benefit to your beneficiary in the event of your death or accidental dismemberment, helping replace lost income and support your family’s financial goals. Coverage through Mutual of Omaha Only covered employees may elect dependent coverage; Dependent coverage may not exceed employee coverage amounts. Evidence of Insurability (EOI) may be required if electing outside of initial enrollment or above guaranteed issue amounts. The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety.

Quick Summary

Voluntary Term Life and Accidental Death & Dismemberment (AD&D)

Employee Benefit

Increments of $5,000 up to $300,000 Guaranteed Issue: $100,000

Spouse Benefit

Increments of $5,000 up to $150,000 (100% of Employee Election) Guaranteed Issue: $30,000 (Spouse coverage terms when employee reaches age 80)

Child(ren) Benefit

$5,000 increments up to $20,000 Guaranteed Issue: 100% of employee’s benefit

AD&D Amount

Match Life Amount

Age Reduction

Benefit reduces to 50% at age 75 Reduction is based on employee’s age. Spouse coverage terminates when employee reaches age 80.

Portability & Conversion

Included

Accelerated Life Benefit

80% of the amount of the life insurance benefit is available to you if terminally ill, not to exceed $240,000.

Guaranteed Increase in Benefit for future enrollments

Employee: If enrolled, can increase by $10,000 up to the Guaranteed Issue amount. Spouse: If enrolled, can increase by $5,000 up to the Guaranteed Issue amount.

Additional Benefits

Seat Belt, Airbag, Repatriation, Common Carrier Benefit (See certificate for details)

Dual Coverage (if both If employee and spouse are both employed by Taliaferro County School District, they cannot cover each employee and spouse other or double cover their dependents. Please contact Campus Benefits if you have questions regarding work at Taliaferro County coverage. School District)

Voluntary Life and AD&D Plan Rates Cost of coverage is based on the level of benefit you choose and your age. Spouse rate based on employee’s age. Please consult with a Campus Benefits Counselor or log into the enrollment system for rate details.

Permanent Life What is Permanent Life Insurance? Coverage that provides lifelong protection, and the ability to maintain level premium, while allowing employees the choice of benefit and premium amounts to fit family needs. Coverage through Colonial Life (Whole Life Plus) Underwriting may be required. Coverage is not guaranteed. Must be actively at work on the effective date Permanent offers the flexibility to meet a variety of personal needs while allowing employees the choice of benefit and premium amounts which fit their paychecks and life styles Keep your coverage at the same cost even if you retire or change employers Dependent Child(ren): Ages 0 - 17 are eligible for coverage. Full-time dependent students ages 18 - 26 are issued adult plans and the tobacco question is required on the application.

Quick Summary

Whole Life

Plan Maximums

Employee (issue ages 18 - 79) $5,000 - $500,000

Spouse (issue ages 18 - 79) $5,000 - $500,000

Child (issue ages 0 - 17) $10,000 - $500,000

Guaranteed Issue (New Hire or First Time Eligible)

Up to $200,000 (ages 18 - 49) Up to $75,000 (ages 50 - 79)

Simplified Issue (answer questions in system)

$10,000 to $25,000 (ages 0 - 17)

Additional Features

Guaranteed Interest rate of 4.5% Build Cash Value Level Premiums deducted from your paycheck Accelerated Death Benefit - 12 months or less (75% w/max of $150,000) Accidental Death Rider Waiver of Premium

Portability

Employees can port the coverage at the same cost.

Permanent Life Rates Cost of coverage is based on the level of benefit you choose and your age. Please consult with a Campus Benefits Counselor or log into the enrollment system for rate details.

Hospital Indemnity Plan What is Hospital Indemnity Insurance? Supplemental coverage that helps offset costs associated with hospital stays, whether for planned or unplanned reasons. Payments are made directly to you and benefits do not offset with medical insurance. Coverage through Mutual of Omaha Employee must be actively at work on the effective date. Dependent children are covered up to age 26. Routine childbirth and complications from pregnancy are covered No Health Questions Every Year! The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety. Quick Summary

Plan Details

Coverage

24-Hour (On and Off the Job)

Pre-existing condition limitation

None

Age Reduction

None

Portability

Included, prior to age 70

Plan Benefits First Day Hospital Confinement (1 admission per policy year)

$1,000 per admission Additional $1,000 for ICU Admission (not payable on the same day)

Daily Hospital and ICU Confinement

$200 per day (Max combined total of 180 days per policy year)

Daily Newborn Nursey Care Confinement

$75 per day, up to 2 days per policy year

Mental/Nervous Disorder Facility

$1,000 per admission (1 per policy year) $100 per day (Max 30 days per policy year, limited to 180 days lifetime)

Substance Abuse Facility

$1,000 per admission (1 per policy year) $100 per day (Max 30 days per policy year, limited to 180 days lifetime)

Express Benefit

$100 per hospital admission

Health Screening Benefit

$50 (1 per covered person, per calendar year)

Please see plan hightlight sheets for additional details, located on your benefits website.

Hospital Indemnity Plan Monthly Rates

Employee

$22.18

Employee + Spouse

$42.48

Employee + Child(ren)

$37.29

Employee + Family

$56.41

Why Does Hospital Indemnity Insurance Matter? If you’re admitted to the hospital for a planned or unexpected stay, Hospital Indemnity Insurance helps provide financial support by paying a lumpsum benefit directly to you, not providers, to help cover your expenses. Claims must be filed with the carrier for reimbursement.

Accident Plan What is Accident Insurance? Accident insurance provides direct payments to help cover medical and out-ofpocket costs from unexpected accidents, without offsetting your medical insurance. Coverage through Mutual of Omaha Employee must be actively at work on the effective date No health questions - Every Year! Payments made directly to you and benefits do not offset with medical coverage The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety. Quick Summary

Plan Details

Coverage

24-Hour Coverage (On and Off-the-Job)

Age Reduction

50% at age 70 for Catastrophic Benefits only

Pre-Existing Condition Limitation/Waiting Period

None

Portability

Included, prior to age 70 Plan Benefits

Emergency Room Services

$300

Express Benefit

$100 (paid upon notification of injury due to an accident)

Urgent Care

$225

Initial Hospital Admission

$1,500

Daily Hospital Confinement

$300 (pays daily up to 365 days)

Intensive Care

$600 (pays daily up to 30 days)

Fractures, Dislocations, Burns, and Lacerations Up to $20,000 (Amounts vary according to type of injury and severity) Physician Follow-Up Office Visit

$150 (Max 6 per accident)

Health Screening Benefit

$50 (1 per covered person, per calendar year)

Please see plan highlight sheets for additional details, located on your benefits website.

Accident Plan Monthly Rates Employee

$10.18

Employee + Spouse

$18.44

Employee + Child(ren)

$19.80

Employee + Family

$23.68

Accidents can happen anytime, Accident Insurance helps provide financial protection by: Helping offset out-of-pocket costs like deductibles, copays, and out-of-network care Giving you flexibility to use funds for everyday needs such as childcare, transportation, or other unexpected expenses

Critical Illness w/Cancer Plan What is Critical Illness Insurance? A health and wellness plan in which you receive a lump sum cash payment if diagnosed with one of the specific illnesses on the predetermined list of critical illnesses. Coverage through Mutual of Omaha Employee must be actively at work on the effective date. No health questions - Every Year! Attained Rates - rates will increase as you age (rates based on your age on your effective date) Payments made directly to you and benefits do not offset with medical coverage. The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety. Quick Summary

CI w/Cancer No Age Reduction/Pre-Existing Condition Limitation/Waiting Period

Portability

Included, prior to age 70

Subsequent Benefit

30 Days - Once an Initial Benefit has been paid for a Critical Illness for an Insured Person, a benefit for the diagnosis of a different Critical Illness is payable if the dates of diagnosis are separated by 30 days or more.

Reoccurrence Benefit

90 days – Once an Initial Benefit has been paid for a Critical Illness for an Insured Person, a benefit for a reoccurrence of the same diagnosis is payable if the dates of diagnosis are separated by 90 days or more.

Policy Benefit Maximum

1000% – The total amount of benefits payable for each insured person is subject to a benefit maximum of 1000% of the Critical Illness Principal Sum in effect for the insured person.

Plan Benefits Employee

$5,000 increments up to $20,000 (Guaranteed Issue: $20,000)

Spouse

$5,000 increments up to $20,000 (Guaranteed Issue: $20,000) (Max 100% of Employee Amount)

Children

Up to 50% of Employee Amount (no additional cost to Employee cost)

Health Screening Benefit

$50 (1 per covered person, per calendar year)

What does it cover? Critical illnesses includes coverage for: Autoimmune Disorders Cancers & Benign Tumor Diagnoses Childhood Conditions (only for children) Vascular & Pulmonary Conditions (Heart Attack) Neurological Movement Disorders Neurological Brain & Skull Conditions (Stroke) Organ Conditions (End State Renal Failure) Infectious Conditions Functional Loss (Coma) *See highlight sheet for full list and details

Why should I consider it? Critical illness insurance is an affordable way to supplement and pay for additional expenses that your health insurance doesn’t cover. The policy typically provides payments for the first and second time you’re diagnosed with a covered illness. Plus, critical illness insurance is portable and payments are made directly to you. Critical Illness w/Cancer Plan Rates Cost of coverage is based on the level of benefit you choose and your age. Spouse rate based on employee’s age. Children are automatically included in employee premium, no additional cost. Please consult with a Campus Benefits Counselor or log into the enrollment system for rate details.

Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents 26 posted on your employer’s benefits website or request documents before electing coverage.

Wellness Incentives What are Wellness Incentives? This is an annual reimbursement for covered members who complete one of the eligible screening procedures on an elected plan. Available Wellness Incentives

One Plan

Mutual of Omaha - Accident, Critical Illness & Hospital Indemnity

$50/per covered person per year

Examples of Eligible Screenings: Mutual of Omaha Accident, Critical Illness & Hospital Indemnity (Policy #G000CY83) Bone marrow testing CA 15-3 (blood test for breast cancer) Cancer Testing/Screening/Biopsy Colonoscopy Chest x-ray Dental/Hearing/Physician Annual Exam Diabetes Health Screening Mammography Mental Health Evaluation Pap smear Substance Abuse Screening How to submit a claim: Call 800.775.8805 Fax completed documents to 404.997.1898 Email completed documents to submitgrpacc@mutualofomaha.com Mail completed documents to: 3300 Mutual of Omaha Plaza, Omaha, NE 68175 Visit www.mutualofomaha.com/support/forms *Some of these benefits are only available on select accident plans. Please refer to your certificate of coverage for benefits covered under your policy.

IMPORTANT NOTE: This is not a complete list. Visit your employee benefits website at www.taliaferrocountyschoolbenefits.com or review the carrier documents for all eligible screenings. Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

FSA What is a Flexible Spending Account? It’s a pre-tax benefit account used to pay for out-of-pocket healthcare costs such as deductibles, copays, prescribed medications, and doctor visits. What are Dependent Care Accounts? This is a pre-tax account used to pay for dependent care services such as daycare, before or after school programs, and elder care. Coverage through Consolidated Admin Services Plan year is from January 1 - December 31. Employees must re-elect each year. Only family status changes will allow you to change your annual election. The altered election must be consistent with the status change. Transfer of funds between Dependent Care and Medical Care are prohibited Married and not filing jointly participants limited to $3,750 deferral for Dependent Care Full list of eligible FSA expenses is on the website: www.taliaferrocountyschoolbenefits.com FSA Quick Summary Medical FSA Minimum Contribution

$300 annually

Maximum Contribution

$3,400 annually

Carryover Maximum* (Maximum participants can carry over if re-electing the plan)

$680

Total elected amount is available at the beginning of the plan year All receipts should be kept to submit if verification is requested *Carryover funds are only available if re-electing the plan for the next year Dependent Care FSA Minimum Contribution

$300 annually

Maximum Contribution

$7,500

Carryover Maximum

None

Amount is only available as it is payroll deductible Plan Rules 30 days from plan end date (turn in reimbursement form with receipts for services rendered during the plan year)

RUNOUT PERIOD

Monthly Admin Fee

Fee Per Participant Per Month (One fee even if electing both Medical FSA and Dependent Care)

$2.00

Replacement Card Fee

N/A

IMPORTANT NOTE: Dependent Care FSA is for eligible expenses related to the care of your child, disabled spouse, elderly parent, or other dependent who is physically or mentally unable of or disabled for self-care (i.e. day care, adult day care). Medical expenses for your dependent are not eligible for reimbursement under the Dependent Care.

Helpful FSA Resources FSA Eligibility List: www.fsastore.com/fsa-eligibility-list

FSA Calculator www.fsastore.com/fsa-calculator

Medical FSA Account Covers:

Dependent Care Account Covers:

Medical coinsurance and deductible Doctor’s office visit copays Emergency Room costs Dental copays and out-of-pocket costs Vision copays and out-of-pocket costs Contacts and glasses Prescriptions Please see the full eligibility list for other covered expenses.

Children ages 12 and under (including stepchildren, grandchildren, adopted or foster children, and children related to you who are eligible for a tax exemption on your federal tax return) Tax dependents residing with you and incapable of self-care (this could include your spouse, a child age 13 and over, and elderly parents)

Eligible items for purchase without a prescription now include, but are not limited to: Pain relief medications, e.g., acetaminophen, ibuprofen, naproxen sodium Cold & flu medications Allergy medications Acne treatments

Access CAS at your fingertips

Eye drops Stomach & digestive aids Pads, tampons and menstrual sponges Sleep aids Children’s pain relievers, allergy medicines, and digestive aids

Download the app: Consolidated Admin Services

Visit the website: www.consolidatedadmin.com

The CARES Act permanently reinstates over-the counter products, and adds menstrual care products for the first time, as eligible expenses for your FSA funds WITHOUT A PRESCRIPTION Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

Legal Plan What is a Legal Plan? A plan which provides valuable legal and financial educational resources for a variety of life events and needs. Coverage through MetLife Visit www.legalplans.com/why-enroll or call 800.821.6400 for additional information Non-Members & Members create an account and select Employer for plan information (creating an account doesn’t enroll you in plans) Elder care extends to parents and in-laws Additional plan information available on your Employee Benefits Website (www.taliaferrocountyschoolbenefits.com) The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety.

Plan Highlights

Consult with attorneys in person, by phone, email or online

Choose a network attorney or request reimbursement for an out-of-network attorney

Examples of Covered Legal Services: Money Matters Identity theft and tax collection defense Home & Real Estate Deeds, foreclosure, mortgages, tenant matters Estate Planning Wills, living wills, powers of attorney Family & Personal Guardianship and name changes Civil Lawsuits Small claims and consumer disputes Elder-Care Issues Consultations and document review for parents Traffic Matters Defense of traffic ticket (DUI not covered) IIMPORTANT NOTE: This is not a complete list. Visit your employee benefits website at www.taliaferrocountyschoolbenefits.com or review the carrier documents.

Unlimited legal assistance for covered matters

No waiting periods, copays, deductible or claim forms for network services

Additional High Plan Benefits 4 hours of attorney time for non-covered items Bankruptcy and tax-audit representation Home purchases, refinancing and property-tax matters Trusts, adoption, immigration and prenuptial agreements Tax preparation and caregiving support 1. Find an attorney Visit members.legalplans.com, or call 800-821-6400 to get matched with the right attorney and receive the case number. 2. Make an appointment Call the attorney you select, provide the case number and schdule a time to talk or meet. 3. Easy from start to finish No copays, deductible, claim forms with an in-network attorney for a covered matter.

Legal Monthly Plan Rates Low Plan

$8.00

High Plan

$19.50

MedCareComplete What is MedCareComplete? A bundle of services constructed to save you time, money, and hassle while simplifying your life. This is a supplemental benefit and does not replace health insurance Register at MCC: Medcarecomplete.com/members to access the full range of benefits Phone number: 1-866-610-3619 Register at 1800MD: 1800md.com or 800.388.8785 to access telemedicine benefits This is supplemental coverage and does not replace health insurance The information below is a sample of covered services. Please see the plan documents on your Employee Benefits Website for a detailed listing of services in their entirety.

24/7/365 Telemedicine Speak with a Board-certified physician by phone for help with common and acute illnesses. No copay or usage limits. Asthma Fever/Cold & Flu Headache/Migraines Infections/Rashes Sore Throat/Sinus Conditions

Heartburn/Gout Bacterial Infections Urinary Tract Infections Pink Eye Nausea & Vomiting

Legal Plan Monthly Rates Individual

Family

$10.50

$12.50 NO COPAY

IIMPORTANT NOTE: This is not a complete list. Visit your employee benefits website at www.taliaferrocountyschoolbenefits.com or review the carrier documents.

Additional Services: Medical Bill Negotiator Identifies errors and overcharges on medical bills. Of submitted bills, 80% achieve an average savings of 40%.

Medical & ID Theft Monitoring Provides high-risk transaction alerts when personal information may have been compromised online.

Medication Management Home delivery is available for members and their families managing chronic conditions and taking more than four maintenance medications daily.

Compare & Save Networks Offers access to a nationwide network of more than 59,000 pharmacies, along with discounts on prescriptions, dental, vision, hearing and other wellness services.

Restoration Expert An identity-theft specialist assesses the situation and helps manage the resolution process.

Social Media Tracking Sends alerts about potential damaging online content directed towards you or a family member, includes cyberbullying and predators.

Expense Reimbursement Provides a $25,000 insurance policy for eligible expenses from identity theft.

Sex Offender Alerts Get notified when a registered sex offender moves within five miles of an identified address.

The Service Hub Helps With: Portability/Conversion Benefits Education Evidence of Insurability Qualified Life Event Changes

Claims Card Requests Benefit Questions COBRA Information

Phone: 866-433-7661, opt. 5 Email: mybenefits@campusbenefits.com Benefit Website: www.taliaferrocountyschoolbenefits.com

The 2027 Benefits Guide is provided for illustrative purposes only. Actual benefits, services, premiums, claims processes and all other features and plan designs for coverage offered is governed exclusively by the insurance contract and associated Summary Plan Description (SPD). In case of discrepancies between this document and the insurance contract and SPD, the contract and SPD will prevail. We reserve the right to change, modify, revise, amend or terminate these plan offerings at any time. Updates, changes, and notices are available for review at www.taliaferrocountyschoolbenefits.com or by contacting HR or the email above. These should be reviewed fully prior to electing any benefits. Disclosures: All required SPD, legal and plan Disclosures are posted on the Benefit Website. For a written copy please contact Campus Benefits at 866-433-7661, opt. 5.