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ARLINGTON ISD

BENEFIT GUIDE EFFECTIVE: 09/01/2021 - 8/31/2022 WWW.MYAISDBENEFITS.NET 1


Table of Contents Contact Information How to Enroll Annual Benefit Enrollment 1. Benefit Updates 2. Section 125 Cafeteria Plan Guidelines 3. Annual Enrollment 4. Eligibility Requirements 5. Helpful Definitions 6. Health Savings Account (HSA) vs. Flexible Spending Account (FSA) TRS ActiveCare Primary and HD TRS ActiveCare Primary+ and 2 TRS Scott & White HMO Medical Plan TRS ActiveCare Medical Rates without Wellness Program Incentive TRS ActiveCare Medical Rates with Wellness Program Incentive Wellness Program TRS Teladoc Plan | MDLive Telehealth Plan Metlife Hospital Indemnity Plan Healthcare Savings Account (HSA) Dental Plans and Rates Vision Plan and Rates Disability Plan Cancer Plan and Rates Group Life and AD&D Individual Life Insurance Long Term Care Insurance Identity Theft Protection Plan and Rates Pet Insurance MetLaw Hyatt Legal Services Catastrophic Sick Leave Bank Medical & Dependent Care Reimbursement Accounts Employee Assistance Program Retirement Planning 2

3 4-5 6-11 6 7 8 9 10 11 12 13 14 16 17 18-21 22-23 24-27 28-29 30-31 32-35 36-39 40-43 44-49 50-53 54-57 58-61 62-63 64-65 66-67 68-71 72-75 76-77

FLIP TO...

PG. 4

HOW TO ENROLL

PG. 6

SUMMARY PAGES

PG. 12

YOUR BENEFITS


Program

Vendor

Phone Number

Website/Email

ARLINGTON ISD BENEFITS OFFICE STAFF Jola Khan

Director of Compensation and Benefits

(682) 867-7700

hrbenefits@aisd.net

Otti Armant

HR Specialist-Benefits and Wellness

(682) 867-7480

hrbenefits@aisd.net

Linda Scott

FBS Client Services Representative

(682) 867-7364

hrbenefits@aisd.net

Office Fax (682) 867-4651

Website www.myaisdbenefits.net

INSURANCE PLANS PHONE NUMBERS 2021-2022 TRS ActiveCare Medical

BCBS

(866) 355-5999

www.bcbstx.com/trsactivecare

Caremark

(866) 355-5999

www2.caremark.com/trsactivecare/

Baylor Scott & White

(844) 216-4150

https://trs.swhp.org/

Go365

(800) 592-3009

www.Go365.com

BCBS

(855) 835-2362

www.teladoc.com/TRSActiveCare

MDLive

(888) 365-1663

www.consultmdlive.com

EECU

(817) 882-0800

www.eecu.org

Hospital Indemnity

Metlife

(800) 438-6388

www.metlife.com

Dental

CIGNA

(800) 244-6224

www.cigna.com

Vision

Davis Vision

(800) 999-5431

www.davisvision.com

Disability

The Hartford

(866) 278-2655

www.thehartford.com

American Public Life

(800) 256-8606

www.ampublic.com

Group Life and AD&D

Unum

(800) 421-0344

www.unum.com

Individual Life

5 Star

(866) 863-9753

www.5starlifeinsurance.com

Long Term Care

Unum

(800) 227-4165

www.unum.com

Pet Insurance

Metlife

(800) 438-6388

www.petinsurance.com/myaisdbenefits

MetLaw Hyatt Legal Plan

MetLaw

(800) 821-6400

www.legalplans.com

Identity Theft Protection

ID Watchdog

(800) 970-5182

www.idwatchdog.com

National Benefit Services

(800) 274-0503

www.nbsbenefits.com

The Hartford

(800) 964-3577

www.guidanceresources.com

Teacher Retirement Systems

(800) 223-8778

www. trs.state.tx.us

403(b)

National Benefits Services

(800) 274-0503

www.nbsbenefits.com

457(b)

Redwood Financial

(817) 332-7995

www.redwoodfp.com

Financial Benefit Services

(800) 583-6908

www.fbsbenefits.com

TRS ActiveCare Pharmacy Baylor Scott & White HMO Medical and Pharmacy

Wellness Program TRS Teladoc MDLive Telehealth Healthcare Savings Account (HSA)

Cancer

Medical & Dependent Care Reimbursement Accounts Employee Assistance Retirement

Benefits Third Party Administrator

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MOBILE APP DOWNLOAD Enrollment made simple through the new FBS Benefits App! Text “FBS AISD” to (800) 583-6908

and get access to everything you need to complete your benefits

“FBS AISD” to (800) 583-6908

enrollment: •

Enrollment Resources

Online Support

Interactive Tools

And more!

App Group #: FBSAISD

4

Text

OR SCAN


How to Log In

1 BENEFIT INFO

INTERACTIVE TOOLS

2 3

www.myaisdbenefits.net

CLICK LOGIN

ENTER USERNAME & PASSWORD All login credentials have been RESET to the default described below:

Username: The first six (6) characters of your last name, followed by the first letter of your first name, followed by the last four (4) digits of your Social Security Number.

ONLINE SUPPORT

If you have less than six (6) characters in your last name, use your full last name, followed by the first letter of your first name, followed by the last four (4) digits of your Social Security Number.

Default Password: Last Name (lowercase, excluding punctuation) followed by the last four (4) digits of your Social Security Number.

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Annual Benefit Enrollment: What’s New IMPORTANT INFORMATION FOR THE NEW BENEFIT PLAN YEAR SEPTEMBER 1, 2021– AUGUST 31, 2022 TRS Medical Plans: What’s New • AISD contributes an additional $31 per month per employee toward the cost of medical premiums. • Premiums are increasing slightly for all TRS ActiveCare plans • Premiums are decreasing for the Baylor Scott & White HMO Medical Plan • There are no benefit changes to TRS ActiveCare Primary, Primary+, or ActiveCare Plan 2 • Deductibles, In and Out‐of Network Coinsurance and Maximum Out of Pocket amounts are increasing for theActiveCare HD Plan • Deductibles, Prescription drug deductible, Prescription Drug Copay for 30‐day/90‐day supply, and Inpatient Cost Sharing amounts are increasing for the Baylor Scott & White HMO plan Dental • The premiums for the Cigna PPO High plan are increasing slightly Vision • A new enhanced Vision plan will be offered to AISD employees • The enhanced plan has a $0 examination co‐pay and a frame allowance of up to $175 • The basic vision plan that AISD offers will still be available • Premiums for the basic vision plan are increasing slightly

SUMMARY PAGES

The maximum annual contribution for the medical Flexible Spending Account has changed to $2,750 employee coverage and $5,500 family coverage If you elect a Health Savings Account and elect a Flexible Spending Account, the Flexible Spending Account then becomes a Limited Flexible Spending Account and can only be used for dental and vision expenses

Basic Life Insurance and AD&D • The vendor for basic life insurance and AD&D is changing from Symetra to Unum Voluntary Group Life Insurance and AD&D • The vendor for group life insurance and AD&D is changing from Symetra to Unum Voluntary Employee Life and AD&D • You can elect increments of $10,000 up to a maximum benefit of $500,000 • An employee can elect up to $400,000 without having to complete Evidence of Insurability • During Open Enrollment you can elect up to $400,000 without having to complete Evidence of Insurability • No Evidence of Insurability is required for AD&D

Voluntary Spouse Life • You must elect Voluntary Employee Life to elect Voluntary Spouse Life • You can elect increments of $5,000 up to a maximum benefit of $60,000 • An employee can elect up to $60,000 without having to complete Evidence of Insurability • During Open Enrollment, you can elect up to $60,000 without having to Wellness Program complete Evidence of Insurability • The AISD Wellness Program will still be available to all eligible employees • The AISD Wellness vendor has changed from Virgin Pulse to Go365 Voluntary Child Life • Members are elibible for a $51 monthly reduction on their medical • You must elect Voluntary Employee Life to elect Voluntary Child Life premiums if they choose to participate, are enrolled in a TRS medical • You can elect increments of $1,000 up to a maximum benefit of $10,000 plan, and reach Go365 Silver Status (5000 points) before July 31, 2022 • An employee can elect up to $10,000 without having to complete • The $51 medical premium reduction is only available to TRS ActiveCare Evidence of Insurability medical plan participants Health Saving Account (EECU) • You MUST be enrolled in ActiveCare HD to participate in an HSA • The contribution amount that you made in the 2020‐2021 plan year will roll over to the 2021‐2022 plan year • The maximum annual contribution for the Health Savings Account has changed to $3,600 employee coverage and $7,200 family coverage Flexible Spending Account (FSA) • You MUST re‐elect your FSA contribution amount. If you do not go into the system and make an election, you will not have an FSA Account in the 2021‐2022 plan year

• • •

Things to Remember • Declining Medical Coverage – If you are declining the TRS ActiveCare Medical Plans for yourself or any of your dependents for the first time, you are required to complete the “Declination Process.” This can be done online at www.myaisdbenefits.net • Updating Beneficiary Information – You can change your beneficiary information anytime, however, Annual Open Enrollment is a good time to ensure your life insurance beneficiaries are correct in the Benefits System

Login and complete your supplemental benefit enrollment from 7/19/2021 to 8/16/2021 Update your profile information: home address, phone numbers, email. Important: Per the Affordable Care Act (ACA) reporting requirements, to ensure that the information you enter into the benefits system matches the IRS database, please confirm that your dependents' name, date of birth, and social security number appear exactly as they do on your dependents' social security card. 6


SUMMARY PAGES

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):

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. Contact your Benefit/HR 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

Marital Status

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

Change in Number of Tax Dependents

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 Status of Employment Affecting Coverage Eligibility

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 Gain/Loss of Dependents' under an employer's plan may include change in age, student, marital, employment or tax dependent Eligibility Status 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 Judgment/Decree/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. Eligibility for Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change. Government Programs

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SUMMARY PAGES

Annual Enrollment During your annual enrollment period, you have the opportunity

Where can I find forms?

to review, change or continue benefit elections each year.

Click on the benefit plan you need information on (i.e.,

Changes are not permitted during the plan year (outside of

Dental) and you can find forms you need under the Benefits

annual enrollment) unless a Section 125 qualifying event occurs.

and Forms section.

Changes, additions or drops may be made only during the

How can I find a Network Provider?

annual enrollment period without a qualifying event.

For benefit summaries and claim forms, go to the Arlington ISD benefit website: www.myaisdbenefits.net. Click on your

• Employees must review their personal information and verify

school district, then click on the benefit plan you need

that dependents they wish to provide coverage for are

information on (i.e., Dental) and you can find provider search

included in the dependent profile. Additionally, you must

links under the Quick Links section.

notify your employer of any discrepancy in personal and/or benefit information.

When will I receive ID cards? If the insurance carrier provides ID cards, you can expect to

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.

receive those 3-4 weeks after your effective date. For most dental and vision plans, you can login to the carrier website and print a temporary ID card or simply give your provider the insurance company’s phone number and they can call and verify your coverage if you do not have an ID card at that time. If you do not receive your ID card, you can call the

New Hire Enrollment All new hire enrollment elections must be completed in the online enrollment system within the first 31 days of benefit eligibility employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.

Q&A Who do I contact with Questions? For supplemental benefit questions, you can contact your Benefits/HR department or you can call Financial Benefit Services at 866-914-5202 for assistance.

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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.


SUMMARY PAGES

Employee Eligibility Requirements

Dependent Eligibility Requirements

Supplemental Benefits: Eligible employees must work 20 or more

Dependent Eligibility: You can cover eligible dependent

regularly scheduled hours each work week.

children under a benefit that offers dependent coverage,

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

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.

your 2021 benefits become effective on September 1, 2021, you must be actively-at-work on September 1, 2021 to be eligible for your new benefits. MAXIMUM AGE

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

American Public Life

Through 26

Dental

Cigna

Through 26

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 Financial Benefit Services, or contact the insurance carrier for additional information on spouse eligibility.

Dependent Flex

National Benefit Services

Healthcare FSA

National Benefit Services

Health Savings Account

EECU

IRS Tax Dependent

Hospital Indemnity Plan

MetLife

Through 26

Individual Life

5 Star

Through 23

Telehealth

MDLIVE

Through 26

Vision

Davis

Through 26

Voluntary Life

UNUM

Through 26

PLAN

CARRIER

Cancer

12 or younger or qualified individual unable to care for themselves & claimed as a dependent on your taxes

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.

Through 26 or 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 IRS Tax coverage as an employee under the same employer. Review the applicable plan documents, contact Dependent Financial Benefit Services, 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 Financial Benefit Services, LLC 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 HR/ Benefit Administrator to request a continuation of coverage. 9


SUMMARY PAGES

Helpful Definitions Actively-at-Work

In-Network

You are performing your regular occupation for the employer

Doctors, hospitals, optometrists, dentists and other providers

on a full-time basis, either at one of the employer’s usual

who have contracted with the plan as a network provider.

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 please notify your benefits administrator.

Out-of-Pocket Maximum The most an eligible or insured person can pay in co-insurance for covered expenses.

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

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

Plan Year September 1st through August 31st

Pre-Existing Conditions Applies to any illness, injury or condition for which the participant has been under the care of a health care provider, taken prescriptions drugs or is under a health care provider’s

Calendar Year

orders to take drugs, or received medical care or services

January 1st through December 31st

(including diagnostic and/or consultation services).

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

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

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SUMMARY PAGES

HSA vs. FSA Health Savings Account (HSA) (IRC Sec. 223)

Flexible Spending Account (FSA) (IRC Sec. 125)

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.

Allows employees to pay out-of-pocket expenses for copays, deductibles and certain services not covered by medical plan, tax-free. This also allows employees to pay for qualifying dependent care tax-free.

Employee Eligibility

A qualified high deductible health plan.

All employees

Contribution Source Account Owner Underlying Insurance Requirement

Employee Employee

Employee Employer

High deductible health plan

None

Description

Minimum Deductible Maximum Contribution

$1,400 single (2021) $2,800 family (2021) $3,600 single (2021) $7,200 family (2021)

N/A $2,750 single, $5,500 household

Permissible Use Of Funds

If used for non-qualified medical expenses, subject to current tax rate plus 20% penalty.

Reimbursement for qualified medical expenses (as defined in Sec. 213(d) of IRC).

Cash-Outs of Unused Amounts (if no medical expenses)

Permitted, but subject to current tax rate plus 20% penalty (penalty waived after age 65).

Not permitted

Year-to-year rollover of account balance?

Yes, will roll over to use for subsequent year’s health coverage.

No. Access to some funds can may be extended if your employer’s plan contains a 2 1/2 –month grace period or $500 rollover provision.

Does the account earn interest?

Yes

No

Portable?

Yes, portable year-to-year and between jobs.

No

FLIP TO FOR HSA INFORMATION

PG. 28

FLIP TO FOR FSA INFORMATION

PG. 68 11


TRS ActiveCare Primary and HD A list of Network Physicians can be found at www.bcbstx.com/trsactivecare. Benefits

TRS ActiveCare Primary

ActiveCare HD

PLAN FEATURES Type of Coverage

In-Network Coverage only

In -Network

Out-of-Network Coverage

Individual/Family Deductible (per plan year)

$2,500 Individual/ $5,000 family

$3,000 Individual/ $6,000 family

$5,500 individual/ $11,100 family

Individual/Family Maximum Out of Pocket

$8,150 individual/ $16,300 family

$7,000 individual/ $14,000 family

$20,250 individual/ $40,500 family

You pay 30% after deductible

You pay 30% after deductible

You pay 50% after deductible

Coinsurance Network Primary Care Provider (PCP) Required

Statewide Network

Nationwide Network

Yes

No

DOCTORS VISITS Primary Care

$30 copay

You pay 30% after deductible

You pay 50% after deductible

Specialist

$70 copay

You pay 30% after deductible

You pay 50% after deductible

TRS Virtual Health (Teledoc)

$0 per consultation

$30 per consultation

IMMEDIATE CARE Urgent Care

$50 copay

You pay 30% after deductible

You pay 50% after deductible

You pay 30% after deductible

You pay 20% after deductible

Drug Deductible

Integrated with Medical

Integrated with Medical

Generics (30-Day Supply/ 90 Day Supply)

Certain Rxs $0; $15/$45

You pay 20% after deductible

Preferred Brand

You pay 30% after deductible

You pay 25% after deductible

Non-preferred Brand

You pay 50% after deductible

You pay 50% after deductible

Specialty

You pay 30% after deductible

You pay 20% after deductible

Emergency Care PRESCRIPTION DRUGS

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TRS ActiveCare Primary+ and ActiveCare 2 A list of Network Physicians can be found at www.bcbstx.com/trsactivecare. Benefits

TRS ActiveCare Primary+ (formerly Select)

ActiveCare 2

PLAN FEATURES Type of Coverage

In-Network Coverage only

In -Network

Out-of-Network Coverage

Individual/Family Deductible (per plan year)

$1,200 Individual/ $3,600 family

$1,000 Individual/ $3,000 family

$2,000 individual/ $6,000 family

Individual/Family Maximum Out of Pocket

$6,900 individual/ $13,800 family

$7,900 individual/ $15,800 family

$23,700 individual/ $47,400 family

You pay 20% after deductible

You pay 20% after deductible

You pay 40% after deductible

Coinsurance Network Primary Care Provider (PCP) Required

Statewide Network

Nationwide Network

Yes

No

DOCTORS VISITS Primary Care

$30 copay

You pay $30 copay

You pay 40% after deductible

Specialist

$70 copay

You pay $70 copay

You pay 40% after deductible

TRS Virtual Health (Teledoc)

$0 per consultation

$0 per consultation

IMMEDIATE CARE Urgent Care

$50 copay

$50 copay

You pay 40% after deductible

You pay 20% after deductible

You pay $250 copay plus 20% after deductible

$200 brand deductible

$200 brand deductible

Generics (30-Day Supply/ 90 Day Supply)

$15/$45 copay

$20/$45 copay

Preferred Brand

You pay 25% after deductible

You pay 25% after deductible ($40 min/$80 max) You pay 25% after deductible ($105 min/$210 max)

Non-preferred Brand

You pay 50% after deductible

You pay 50% after deductible ($100 min $200 max) You pay 50% after deductible ($215 min/$430 max)

Specialty

You pay 20% after deductible

You pay 20% after deductible ($200 min/$900 max) No 90-Day Supply of Specialty Medications

Emergency Care PRESCRIPTION DRUGS Drug Deductible

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TRS Baylor Scott & White HMO Please change this to read A list of Baylor Scott & White HMO Network Physicians can be found at https://trs.swhp.org/. Benefits

TRS Baylor Scott & White HMO

PLAN FEATURES Type of Coverage Individual/Family Deductible (per plan year) Individual/Family Maximum Out of Pocket Coinsurance

Network

Primary Care Provider (PCP) Required

In-Network Coverage only $1,150 Individual/$3,450 family

$7,450 individual / $14,900 family You pay 20% after deductible You can choose this plan if you live in one these counties: Austin, Bastrop, Bell, Blanco, Bosque, Brazos, Burleson, Burnet, Caldwell, Collin, Coryell, Dallas, Denton, Ellis, Erath, Falls, Freestone, Grimes, Hamilton, Hays, Hill, Hood, Houston, Johnson, Lampasas, Lee, Leon, Limestone, Madison, McLennan, Milam, Mills, Navarro, Robertson, Rockwall, Somervell, Tarrant, Travis, Walker, Waller, Washington, Williamson Yes

DOCTORS VISITS Primary Care

$20 copay

Specialist

$70 copay

Baylor Scott & White HMO Virtual Health (Teledoc)

$0 copay

IMMEDIATE CARE Urgent Care Emergency Care

$50 copay $500 copay after deductible

PRESCRIPTION DRUGS Drug Deductible Generics (30-Day Supply/90 Day Supply)

$250 (excluding generics) $10/$25.00 copay

Preferred Brand

You pay 30% after deductible

Non-preferred Brand

You pay 50% after deductible

Specialty

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You pay 15%/25% after deductible (preferred/ nonpreferred)


NOTES

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TRS Medical Rates 2021-2022 TRS ActiveCare Health Insurance Premiums Without Wellness Program Incentive 12 Pay—Administrators and Professionals

Employee Only Employee + Spouse Employee + Children Family

TRS ActiveCare Primary

TRS ActiveCare HD

TRS ActiveCare Primary+

TRS ActiveCare 2

Baylor Scott & White HMO

$151.00 $910.00 $485.00 $1,139.00

$163.00 $943.00 $506.00 $1,179.00

$276.00 $1,068.00 $613.00 $1,409.00

$747.00 $2,136.00 $1,241.00 $2,575.00

$276.48 $1,096.70 $606.16 $1,302.42

12 Pay—Para-Professionals

Employee Only Employee + Spouse Employee + Children Family

TRS ActiveCare Primary

TRS ActiveCare HD

TRS ActiveCare Primary+

TRS ActiveCare 2

Baylor Scott & White HMO

$136.00 $895.00 $470.00 $1,124.00

$148.00 $928.00 $491.00 $1,164.00

$261.00 $1,053.00 $598.00 $1,394.00

$732.00 $2,121.00 $1,226.00 $2,560.00

$261.47 $1,081.70 $591.16 $1,287.42

18 Pay

Employee Only Employee + Spouse Employee + Children Family

TRS ActiveCare Primary $90.67 $596.67 $313.33 $749.33

TRS ActiveCare HD $98.67 $618.67 $327.33 $776.00

TRS ActiveCare Primary+ $174.00 $702.00 $398.67 $929.33

TRS ActiveCare 2 $488.00 $1.414.00 $817.33 $1,706.67

Baylor Scott & White HMO $174.31 $721.13 $394.11 $858.28

26 Pay

Employee Only Employee + Spouse Employee + Children Family

TRS ActiveCare Primary

TRS ActiveCare HD

TRS ActiveCare Primary+

TRS ActiveCare 2

Baylor Scott & White HMO

$62.77 $413.08 $216.92 $518.77

$68.31 $428.31 $226.62 $537.23

$120.46 $486.00 $276.00 $643.38

$337.85 $978.92 $565.85 $1,181.54

$120.68 $499.25 $272.84 $594.19

AISD contributes the following each month to employees participating in a medical plan: • $266 per month for Professional employees • $281 per month for all Para-Professional and Auxiliary employees

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TRS Medical Rates 2021-2022 TRS ActiveCare Health Insurance Premiums With Wellness Program Incentive 12 Pay—Administrators and Professionals

Employee Only Employee + Spouse Employee + Children Family

TRS ActiveCare Primary

TRS ActiveCare HD

TRS ActiveCare Primary+

TRS ActiveCare 2

Baylor Scott & White HMO

$100.00 $859.00 $434.00 $1,088.00

$112.00 $892.00 $455.00 $1,128.00

$225.00 $1,017.00 $562.00 $1,358.00

$696.00 $2,085.00 $1,190.00 $2,524.00

$225.48 $1,045.70 $555.16 $1,251.42

12 Pay—Para-Professionals

Employee Only Employee + Spouse Employee + Children Family

TRS ActiveCare Primary

TRS ActiveCare HD

TRS ActiveCare Primary+

TRS ActiveCare 2

Baylor Scott & White HMO

$85.00 $844.00 $419.00 $1,073.00

$97.00 $877.00 $440.00 $1,113.00

$210.00 $1,002.00 $547.00 $1,343.00

$681.00 $2,070.00 $1,175.00 $2,509.00

$210.47 $1,030.70 $540.16 $1,236.42

18 Pay

Employee Only Employee + Spouse Employee + Children Family

TRS ActiveCare Primary $56.67 $562.67 $279.33 $715.33

TRS ActiveCare HD $64.67 $584.67 $293.33 $742.00

TRS ActiveCare Primary+ $140.00 $668.00 $364.67 $895.33

TRS ActiveCare 2 $454.00 $1,380.00 $783.33 $1,672.67

Baylor Scott & White HMO $140.31 $687.13 $360.11 $824.28

26 Pay

Employee Only Employee + Spouse Employee + Children Family

TRS ActiveCare Primary

TRS ActiveCare HD

TRS ActiveCare Primary+

TRS ActiveCare 2

Baylor Scott & White HMO

$39.23 $389.54 $193.38 $495.23

$44.77 $404.77 $203.08 $513.69

$96.92 $462.46 $252.46 $619.85

$314.31 $955.38 $542.31 $1,158.00

$97.14 $475.71 $249.30 $570.66

AISD contributes the following each month to employees participating in a medical plan: • $266 per month for Professional employees • $281 per month for all Para-Professional and Auxiliary employees

17


GO365

Wellness

About this Benefit Wellness programs include activities such as company-sponsored exercise, weight-loss competitions, educational seminars, tobaccocessation programs and health screenings that are designed to help employees eat better, lose weight and improve their overall physical health.

YOUR BENEFITS PACKAGE

70% fewer sick days for employees participating in wellness programs than those opting out.

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 18 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


2021-2022 Arlington ISD Wellness Program The Arlington Independent School District wellness program is a vital part of our overall benefits program. AISD has partnered with Go365 to bring you the latest health and wellness tools and educational programs to help you live better and achieve your health goals.

Wellness Incentive Reward

The AISD wellness program is run on a point system. You will be eligible for a $51 monthly reduction on your medical premiums if you choose to participate, are enrolled in a TRS medical plan, and reach Go365 SILVER STATUS (5000 points) on or before July 31, 2022.

EARNING POINTS in Go365

Take the stairs. Keep your blood pressure in check. Eat more salads. There are lots of things you can do to get healthier. With Go365®, you can earn Points for doing them. The more Go365 activities you complete, the more Points you earn and the higher your Go365 Status.

10,000 PTS

Three ways to get started

Complete the Go365 Health Assessment Get a biometric screening Log a verified workout Start here

Blue

5,000 PTS

8,000 PTS

and move up

Platinum Bronze

Silver

Gold

How to register for Go365

Access Go365 Mobile App from the App Store or Google Play or register online at Go365.com. For questions about registration contact Go365 customer service: 800.592.3009

Unlock activities to earn more Points and move up to a higher Status

Recommended activities

These personalized activities are created just for you, based on your Health Assessment. Recommended activities are things like losing weight or exercising more that are designed to jump-start your health, and they’re worth more Points!

Go365 is not an insurance product. This is a general description of services which are subject to change. Please refer to Customer Support for more information. This document is intended to provide a high-level overview of the primary Go365 account holder’s Points earning potential. Recommended activities are not medical advice. Consult your physician. We are committed to helping you achieve your best health. If you think you might be unable to meet a standard for a Go365 reward, you might qualify for an opportunity to earn the same reward by different means. Contact Go365’s Customer Care team by signing in to Go365.com and using the secure live chat feature on the bottom right of the screen or by calling the number on the back of your member ID card, 800.592.3009. 19


Activities and Points Points listed are per program year unless stated otherwise.

Education Activity

Points



Health Assessment Take your full Go365 Health Assessment online or on the App and earn Points for completing it for the first time each program year.



OR Health Assessment sections

500

50

>> Get Active >> Eat Better >> Reduce Stress >> Live Well >> Know Your Health >> Introduce Yourself 200 bonus Points when you complete all six sections

Bonus Points         

First Step Health Assessment bonus 500 once/lifetime Fast Start Health Assessment bonus 250 75 each (up to 300/program year) Calculators CPR certification 125 First-aid certification 125 Update/confirm contact Information 50 Monthly Go365.com, Humana.com or Go365 App sign-in 10 (up to 120/program year) First time Go365 App sign-in 50 once/lifetime Available for Go365 members with Humana medical coverage only. Accept online statements 50 once/lifetime

Prevention Activity

Points

Health screening Dental exam  Vision exam  Flu shot  Nicotine test ** Biometric screening completion *

 

   

400 per eligible screening 200 per exam (up to 400/program year) 200 200 400

Body mass index (BMI) Blood pressure Blood glucose Total cholesterol

800 400 400 400

Maximum Points for Health Assessment completion per program year is 500. Fast Start bonus awarded for full Health Assessment completion within the first 90 days of your program year. *Subject to certain requirements and will appear as a recommended activity if they are applicable to you. **Cost associated with nicotine tests are the responsibility of the Go365 member. Nicotine tests are not associated with biometric screenings.

20

WEB AND APP

|

APP ONLY

|

WEB ONLY


Activities and Points Points listed are per program year unless stated otherwise.

Healthy living Activity Blood donation Nicotine test (in-range results)  Virtual well-being coaching ongoing interactions  

Points 50 each (up to 300/ program year) 400 10 weekly (up to 520/program year)



Weekly log

10 weekly



Sleep diary

25 weekly (up to 150/ program year)



Daily health quiz



Fitness habit Biometric screening (in-range results) Body mass index ≥ 18.5 and < 25, or BMI ≥ 25 and < 30, with a waist circumference < 40” for males and < 35” for females Blood pressure(systolic and diastolic) < 130/85 mm Hg Blood glucose < 100 mg/dL or A1c < 6.5% Total cholesterol < 200 mg/dL or an HDL ≥ 40 mg/dL for males and ≥ 50/mg/dL for females

   

2 daily up to 25 per month

800 400 400 400

Fitness Activity     

Daily verified workout types up to 50/day Steps* 1 Point per 1,000 steps Heart Rate (HR)* 5 Points for every 15 minutes above 60% of maximum HR Calories* 5 Points per 100 calories if burn rate exceeds 200 calories/hour Participating fitness facility or digital fitness connection* 10 per daily visit Photo proof of home or gym workout* 10 points per workout Bonus Points

Exceeded 50 weekly workout Points  Exceeded 100 weekly workout Points  First lifetime verified workout  Sports leagues Challenges Sponsored Challenges are set up by employers or Go365. Member-created Challenges are set up by members. 

 

  

Points

50 100

only one bonus awarded per week 500 350 Points per league team (up to 1,400/program year) up to 200/month total for all Challenge-related activities

Participate in a Member-created Challenge

100

Participate in a Sponsored Challenge Athletic events (running, walking, cross-country skiing, cycling, triathlon)

100 up to 3,000/program year

Level 1 (example: 5K) Level 2 (example: 10K) Level 3 (example: half-marathon)

250 350 500

*Calculating daily workout Points: Each day, Go365 will look at Points earned across all workout types and award the category with the highest value for that day. Points are awarded for one workout type per day. Week is defined as Sunday–Saturday. Maximum of 50 daily workout Points can be awarded. 21 WEB AND APP

|

APP ONLY

|

WEB ONLY


TELEDOC | MDLIVE

Telehealth

About this Benefit Telehealth provides 24/7/365 access to boardcertified doctors via telephone consultations that can diagnose, recommend treatment and prescribe medication. Whether you are at home, traveling or at work, Telehealth makes care more convenient and accessible for non-emergency care when your primary care physician is not available.

YOUR BENEFITS PACKAGE

75%

of all doctor, urgent care, and ER visits could be handled safely and effectively via telehealth.

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 22 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


Telehealth TRS ActiveCare Teledoc Plan

MDLIVE Telehealth Plan

Teladoc services are included with the TRS ActiveCare Medical Plans.

AISD is offering an additional Telehealth Plan administered by MDLive.

Teladoc is an added benefit that gives you 24/7 telephone access Unlike the TRS Teladoc plan, you do not have to be enrolled in to a national network of U.S. board-certified doctors. any of the TRS Medical Plans to utilize this benefit. MDLive voluntary telehealth plan will allow employees to cover Call Teladoc from anywhere - home, work, or on the road - and themselves and dependents for $10 per month. let the doctor come to you! Teladoc doctors diagnose nonemergency medical problems, recommend treatment, and can even call in a prescription to your pharmacy of choice when necessary.

Medical Plan Enrollment Required

What Can Be Treated

Co-Pay

Are family members covered

Quality

• • • • • • • • • •

Teladoc

MDLive

YES

NO

Respiratory infections Ear Infections Urinary tract infections Allergies Colds and Flu Sore Throat Pink Eye Asthma Bronchitis Joint Aches and Pain And More!

$30 consultation fee (waived if enrolled in ActiveCare Primary, Primary + and ActiveCare 2)

• • • • • • • • • •

Respiratory infections Ear Infections Urinary tract infections Allergies Colds and Flu Sore Throat Pink Eye Asthma Bronchitis Joint Aches and Pain And More! $0 per consultation

Family members are covered only if they are enrolled as a dependent under the employee’s medical plan

Family members are covered if enrolled in the MDlive plan (no medical plan enrollment needed)

Are U.S. board-certified in internal medicine, family practice, emergency medicine or pediatrics

Are U.S. board-certified in internal medicine, family practice, emergency medicine or pediatrics

23


MetLife YOUR BENEFITS PACKAGE

Hospital Indemnity

About this Benefit Hospital Confinement Indemnity Insurance pays a daily benefit if you have a covered stay in a hospital*, critical care unit and rehabilitation facility. The benefit amount is determined based on the type of facility and the number of days you stay. Hospital Confinement Indemnity Insurance is a limited benefit policy. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.

The median hospital costs per stay have steadily grown to over $10,000.

$8,800

9,600

10,400

2003

2008

2012

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 24 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


MetLife Hospital Indemnity HOSPITAL INDEMNITY INSURANCE | Plan Summary Coverage to help pay for expenses such as hospitalization expenses that may not be covered under your medical plan. Enrollment Period: 7/19/2021 to 8/16/2021

Hospital Indemnity Insurance Benefits With MetLife, you’ll have a choice of two comprehensive plans (called the “Low Plan” and the “High Plan”) which provide lump sum cash payments in addition to any other payments you may receive from your medical plan. Here are just some of the covered benefits/services, when an accident or illness puts you in the hospital.A

Covered BenefitsB Please contact MetLife for detailed definitions and state variations of covered benefits.

HOSPITAL BENEFITS Subcategory

Admission Benefit

Confinement Benefit

Benefit Limits (Applies to Subcategory)

Benefit

Low Plan

High Plan

1 time(s) per plan year

Admission

$1,000

$2,000

1 time(s) per plan year

ICU Supplemental Admission (Benefit paid concurrently with the Admission benefit when a Covered Person is admitted to ICU)

$500

$1,000

Confinement⁴

$100

$200

ICU Supplemental Confinement (Benefit paid concurrently with the Confinement benefit when a Covered Person is admitted to ICU)

$100

$200

15 days per plan year ICU Supplemental Confinement will pay an additional benefit for 15 of those days

Confinement Benefit for Newborn Nursery Care

2 day(s) per confinement

Confinement Benefit for Newborn Nursery Care5

$25

$50

Inpatient Rehabilitation Benefit*

15 days per plan year

Inpatient Rehabilitation (For Injury Only)

$100

$200

$50

$50

OTHER BENEFITS Health Screening Benefit

1 time(s) per plan year per covered person

Health Screening

*Any benefit(s) marked with an asterisk requires a prior Hospital Admission or Confinement. 4 If the Admission Benefit is payable for a Confinement, the Confinement Benefit will begin to be payable the day after Admission. 5 Payable for the period of newborn confinement for a newborn child who is not sick or injured.

25


MetLife Hospital Indemnity BENEFIT PAYMENT EXAMPLE FOR HIGH PLAN Susan has chest pains at home, and after contacting her doctor, she is instructed to head to her local hospital. Upon arrival, the doctor examines Susan and advises that she requires immediate admission to the Intensive Care Unit for further evaluation and treatment. After two days in the Intensive Care Unit, Susan moves to a standard room and spends two additional days recovering in the hospital. Susan was released to her primary care physician for follow-up treatment and observation. Her primary doctor is now keeping a close watch over Susan’s overall health. Depending on her health insurance, Susan’s out-of-pocket costs could run into hundreds of dollars to cover expenses like insurance co-payments and deductibles. MetLife Group Hospital Indemnity Insurance payments can be used to help cover these unexpected costs or in any other way Susan sees fit.

Covered Benefit

High Benefit Amount

Regular Hospital Admission (1x)

$2,000

ICU Supplemental Admission (1x)

$1,000

Regular Hospital Confinement (3 total days)

$600

ICU Supplemental Confinement (1 day)

$200

Benefits paid by MetLife Group Hospital Indemnity Insurance

$2,800

Benefit amount is based on a sample MetLife plan design. Plan design and plan benefits may vary.

QUESTIONS & ANSWERS Q. Who is eligible to enroll for this Hospital Indemnity coverage? A. You are eligible to enroll yourself and your eligible family members. C You need to enroll during your Enrollment Period and be actively at work for your coverage to be effective. Dependents to be enrolled may not be subject to a medical restriction as set forth in the Certificate. Some states require the insured to have medical coverage. Q. How do I pay for my Hospital Indemnity coverage? A. Premiums will be paid through payroll deduction, so you don’t have to worry about writing a check or missing a payment. Q. What happens if my employment status changes? Can I take my coverage with me? A. Yes, you can take your coverage with you. You will need to continue to pay your premiums to keep your coverage in force. Your coverage will only end if you stop paying your premium or if your employer cancels the group policy and offers you similar coverage with a different insurance carrier. D Q. What is the coverage effective date? A. The coverage effective date is 09/01/2021.

Q. Who do I call for assistance? A. Please call MetLife directly at 1-800-GET-MET8 (1-800-438-6388) and talk with a benefits consultant. Or visit our website: www.mybenefits.metlife.com

26


MetLife Hospital Indemnity A Hospital does not include certain facilities such as nursing homes, convalescent care or extended care facilities. See your Disclosure Statement or Outline of Coverage/Disclosure Document for full details. B Covered services/treatments must be the result of an accident or sickness as defined in the group policy/certificate. See your Disclosure Statement or Outline of Coverage/Disclosure Document for more details. C Coverage is guaranteed provided (1) the employee is actively at work and (2) dependents to be covered are not subject to medical restrictions as set forth in the Certificate. Some states require the insured to have medical coverage. D Eligibility for portability through the Continuation of Insurance with Premium Payment provision may be subject to certain eligibility requirements and limitations. For more information, contact your MetLife representative.

METLIFE'S HOSPITAL INDEMNITY INSURANCE IS A LIMITED BENEFIT GROUP INSURANCE POLICY. The policy is not intended to be a substitute for medical coverage and certain states may require the insured to have medical coverage to enroll for the coverage. The policy or its provisions may vary or be unavailable in some states. Prior hospital confinement may be required to receive certain benefits. There may be a preexisting condition limitation for hospital sickness benefits. MetLife’s Hospital Indemnity Insurance may be subject to benefit reductions that begin at age 65. Like most group accident and health insurance policies, policies offered by MetLife may contain certain exclusions, limitations and terms for keeping them in force. For complete details of coverage and availability, please refer to the group policy form GPNP12-AX, GPNP13-HI, GPNP16-HI or GPNP12-AX-PASG, or contact MetLife. Benefits are underwritten by Metropolitan Life Insurance Company, New York, New York. In certain states, availability of MetLife’s Group Hospital Indemnity Insurance is pending regulatory approval. Hospital does not include certain facilities such as nursing homes, convalescent care or extended care facilities. See MetLife's Disclosure Statement or Outline of Coverage/Disclosure Document for full details.

27


EECU

HSA (Health Savings Account)

About this Benefit A Health Savings Account is a tax-advantaged medical savings account available to employees who are enrolled in a high-deductible health plan. The funds contributed to the account are not subject to federal income tax at the time of deposit. Unlike a flexible spending account (FSA), funds roll over and accumulate year to year if not spent.

YOUR BENEFITS PACKAGE

The interest earned in an HSA is tax free.

Money withdrawn for medical spending never falls under taxable income.

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included This is a general overview of your plan benefits.inIfthe thesummary terms of plan this outline differlocated from your policy, the policy will govern. Additional plan description on the 28 details on covered expenses,Frisco limitations and exclusions included in the summary plan description located on the ISD Benefits Website:are www.mybenefitshub.com/friscoisd Arlington ISD Benefits Website: www.myaisdbenefits.net


HSA (Health Savings Account) What is an HSA?

How to Use Your Funds

Health Savings Account (HSA) enables you to save for and conveniently pay for qualified healthcare expenses, while you earn tax-free interest and pay no monthly service fees. Opening a Health Savings Account provides both immediate and long term benefits. The money in your HSA is always yours, even if you change jobs, switch your health plan, become unemployed or retire. Your unused HSA balance rolls over from year to year. And best of all, HSAs have tax-free deposits, tax-free earnings and tax-free withdrawals. And after age 65, you can withdraw funds from your HSA penalty-free for any purpose*.

HSA Debit Card – use your EECU HSA Mastercard® debit card to pay healthcare providers at point-of-sale or by following the instructions provided on a bill from a medical provider.

Online Bill Pay – sign up, at eecu.org, and use EECU’s free online banking and bill pay to make payments to medical providers directly from your HSA. Online Transfers – use EECU’s online banking or mobile app; reimburse yourself for out-of-pocket expenses by making a transfer from your HSA to your personal checking or savings account. Check – optional HSA checks can be ordered upon request for a fee. You can use these checks to pay healthcare providers and suppliers.

EECU HSA Benefits •

Save money tax-free for healthcare expenses – contributions are not subject to federal income taxes and can be made by • you, your employer or a third party* • No monthly service fee – so you can save more and earn more • Earn competitive dividends on your entire balance – Save your receipts – for all qualified medical expenses. compounded daily and paid monthly from deposit to EECU does not verify eligibility. You are responsible for withdrawal making sure payments are for qualified medical expenses. • Conveniently pay for qualified healthcare expenses – with a free, no annual fee EECU HSA Debit Mastercard® or via EECU’s free online bill pay. (HSA checks are also available How To Manage Your Account upon request, for a nominal fee**) • Online - check your balance, pay healthcare providers and • Free online, mobile and branch access – allows you to arrange deposits; sign-up for online banking at actively manage your account however you prefer www.eecu.org. • Comprehensive service and support – to assist you in • Mobile - EECU’s mobile app allows you to manage your optimizing your healthcare saving and spending account on the go; download “EECU Mobile Banking” in • Federally insured – to at least $250,000 by NCUA Apple’s App Store and Google Play. • Contact Member Service – call 817-882-0800 for help with 2021 Annual HSA Contribution Limits your HSA questions or transactions. You can also chat with Individual: $3,600 us online at eecu.org or use our secure email. Member Family: $7,200 Service is available Monday through Friday from 8:00am – Catch-Up Contributions: Accountholders who meet the 7:00pm CT, Saturdays from 9am – 1pm CT and closed on qualifications noted below are eligible to make an HSA Sunday. catch-up contribution of an additional $1,000. • Account Statements – monthly account statements show all • Health Savings accountholder your account activity for that period. You can receive free • Age 55 or older (regardless of when in the year an online statements or printed statements. accountholder turns 55) * Contributions, investment earnings, and distributions are tax free for federal tax purposes if • Not enrolled in Medicare (if an accountholder enrolls in used to pay for qualified medical expenses, and may or may not be subject to state taxation. Medicare mid-year, catch-up contributions should be A list of Eligible Medical Expenses can be found in IRS Publication 502, http://www.irs.gov/ pub/irs-pdf/p502.pdf. As described in IRS publication 969, http://www.irs.gov/pub/irs-pdf/ prorated) p969.pdf, certain over-the-counter medications (when prescribed by a doctor) are Authorized Signers who are 55 or older must have their own considered eligible medical expenses for HSA purposes. If an individual is 65 or older, there is no penalty to withdraw HSA funds. However, income taxes will apply if the distribution is not HSA in order to make the catch-up contribution used for qualified medical expenses. For more information consult a tax adviser or your state department of revenue. All contributions and distributions are your responsibility and must be within IRS regulatory limits. ** Call 817-882-0800 or stop-by an EECU branch to order standard checks at no charge (excludes shipping and handling) or order custom checks - prices vary.

29


CIGNA

Dental

YOUR BENEFITS PACKAGE

About this Benefit Dental insurance is a coverage that helps defray the costs of dental care. It insures against the expense of routine care, treatment and dental disease.

Good dental care may improve your overall health. Also Women with gum disease may be at greater risk of giving birth to a preterm or low birth weight baby.

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 30 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


Dental PPO and DHMO Dental PPO Plans

DHMO Plan

The Dental PPO Plans allow you to visit any dental provider. However, when you use a CIGNA network dentist you usually pay less out of your pocket because the network dentists have agreed to charge pre-negotiated reduced fees. If you visit a dentist outside the network, you may be responsible for additional fees.

The DHMO plan provides dental care through a network of dentists who charge set fees for their services. You must use a CIGNA network dentist to receive coverage. You will be required to select a DHMO Dental provider within the CIGNA network. For a list of participating providers go to www.cigna.com.

These summaries only show a few of the covered procedures. Please visit www.myaisdbenefits.net to obtain a complete summary.

Benefits Plan Year Maximum (Class I, II and III Expenses) Plan Year Deductible (Applies to Classes II III and IV only)

CIGNA PPO High Plan

CIGNA PPO Low Plan

CIGNA DHMO Plan

$2,000

$750

NONE

$50 per person $150 per family Plan Pays:

Class I-Preventive and Diagnostic Care Oral Exams, Routine Cleanings, X-Rays Class II-Basic Restorative Care Fillings, Extractions, Periodontal Scaling Class III-Major Restorative Care Surgical Extractions., Crowns, Dentures Class IVOrthodontia

100%

80%*

50%*

No Charge*

20%*

50%*

Plan Pays:

80%

50%*

50%*

NONE

$1,000 Lifetime maximum

50%*

CIGNA PPO High

CIGNA PPO Low

CIGNA DHMO

Employee Only

$34.41

$21.84

$16.48

Employee + Children

$78.73

$49.59

$29.85

Employee + Spouse

$69.56

$43.82

$28.52

Family

$110.81

$69.69

$40.07

You Pay:

20%

50%*

50%*

18 Pay

CIGNA PPO High

CIGNA PPO Low

CIGNA DHMO

Employee Only

$22.94

$14.56

$10.99

$10-$135 See DHMO Patient Charge Schedule for exact costs

Employee + Children

$52.49

$33.06

$19.90

Employee + Spouse

$46.37

$29.21

$19.01

$115-$550 See DHMO Patient Charge Schedule for exact costs

Family

$73.87

$46.46

$26.71

$5.00

Only covers Dependent and No Orthodontia dependent children Adult coverage coverage to age 19 available 50%*

*In‐Network *Subject to annual deductible

You Pay:

$50 per person $150 per family

12 Pay

Not 100% Covered

$375-$400 See DHMO Patient Charge Schedule for exact cost

26 Pay CIGNA PPO High

CIGNA PPO Low

CIGNA DHMO

Employee Only

$15.88

$10.08

$7.61

Employee + Children

$36.34

$22.89

$13.78

Employee + Spouse

$32.10

$20.22

$13.16

Family

$51.14

$32.16

$18.49

NOTE: The Dental PPO deductibles and maximums are now based on the AISD Plan year (September—August) instead of a calendar year

31


DAVIS

Vision

YOUR BENEFITS PACKAGE

About this Benefit Vision insurance provides coverage for routine eye examinations and may cover all or part of the costs associated with contact lenses, eyeglasses and vision correction, depending on the plan.

75% of U.S. residents between age 25 and 64 require some sort of vision correction.

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 32 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


Vision New Enhanced Vision Plan Available to AISD starting 9/1/21

Arlington Independent School District your basic and enhanced vision plan Frequency Benefits will refresh every September 1 Exam: Lenses & lens upgrades: Frame: Contacts, evaluation & fitting:

September 1 September 1 September 1 September 1

Sign up during open enrollment

BASIC

(NEW) ENHANCED

Exams & Services

Exams & Services

Eye Exam copay: $10 Contacts evaluation, fitting & follow-up: Conventional lens Covered in full Specialty lens $60 allowance Plus 15% savings2

Eye Exam copay: $0 Contacts evaluation, fitting & follow-up: Conventional lens Covered in full Specialty lens $60 allowance Plus 15% savings2

Lenses

Lenses

Lens copay:

$10

Frame Allowance: Other locations Visionworks1

Lens copay:

$0

Frame $150 Covered in full +Additional 20% off any overage.2

Allowance: Other locations Visionworks1

$175 Covered in full +Additional 20% off any overage.2

or The Exclusive Collection copay: Fashion Covered in full Designer Covered in full Premier Covered in full

or The Exclusive Collection copay: Fashion Covered in full Designer Covered in full Premier Covered in full

Contacts3 in lieu of glasses

Contacts3 in lieu of glasses

Allowance: $150 +Additional 20% off any overage.2 or The Exclusive Collection of Contact Lenses:4 Covered in full

Allowance: $150 +Additional 20% off any overage.2 or The Exclusive Collection of Contact Lenses:4 Covered in full

Find a network provider... Enter your client code in the “Member Sign In” section of our website at davisvision.com/member to locate a provider near you including Visionworks.

Using your client code Log in using your client code (listed above) at davisvision.com/member to find a list of in-network providers near you and access your benefit information. Free breakage warranty Your glasses are covered with our FREE one-year breakage warranty. Some limitations apply. The Exclusive Collection The Exclusive Collection of frames is available at nearly 9,000 locations across the U.S. Log in to browse frames, and find a Collection near you.

33


Vision Options &Upgrades Lens options

Basic

(NEW) Enhanced

Clear plastic single-vision, bifocal, trifocal or lenticular lenses (any RX)

$0

$0

Polycarbonate Lenses (Children / Adults)

$0 or $30

$0 or $30

High-Index Lenses 1.67

$55

$55

High-Index Lenses 1.74

$120

$120

Polarized Lenses

$75

$75

$50 / $90 / $140 / $175

$0 / $90 / $140 / $175

(Standard / Premium / Ultra / Ultimate)

$35 / $48 / $60 / $85

$0 / $48 / $60 / $85

Ultraviolet Coating

$12

$0

Tinting of Plastic Lenses (Solid / Gradient)

$0

$0

Plastic Photochromic Lenses (Transitions® Signature™)

$65

$0

Scratch-Resistant Coating

$0

$0

Premium Scratch-Resistant Coating

$30

$30

Digital Single Vision Lenses

$30

$30

Scratch-Protection Plan (Single-Vision | Multifocal)

$20 | $40

$20 | $40

Trivex Lenses

$50

$50

Blue Light Filtering

$15

$15

Progressive Lenses (Standard / Premium / Ultra / Ultimate)

Anti-Reflective (AR) Coating

Additional savings Retinal imaging (Member charge) Additional pairs of eyeglasses

$39 30% discount2

BASIC Employee rates

(NEW) ENHANCED

Monthly

Annually

Employee rates

Monthly

Annually

Employee

$9.36

$112.32

Employee

$14.89

$178.68

Employee + Spouse

$15.32

$183.84

Employee + Spouse

$24.37

$292.44

Employee + Child(ren)

$14.97

$179.64

Employee + Child(ren)

$23.81

$285.72

Employee + Family

$24.66

$295.92

Employee + Family

$39.23

$470.76

Out-of-network benefits You may receive services from an out-of-network provider, although you will receive the greatest value and maximize your benefit dollars if you select a provider who participates in the network.

Out-of-network reimbursement schedule (up to) Eye Examination: $45 Trifocal Lenses: $65 Frame: $70 Lenticular Lenses: $100 Single-Vision Lenses: $30 Elective Contact Lenses: $105 Bifocal / Progressive Visually Required Contacts: $225 Lenses: $50

1. Excludes Maui Jim® eyewear. 2. Some limitations apply to additional discounts; discounts not applicable at all in-network providers. 3. Contact lens coverage varies by product selection. Visually Required contacts are covered in full with prior approval. 4. The Davis Vision Exclusive Collection of Contact Lenses is available at participating providers. Evaluation, fitting and follow-up care for Collection contacts are covered in full. Davis Vision has done its best to accurately reflect plan coverage herein. If differences exist between this document and the plan contract, the contract will prevail.

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35


THE HARTFORD YOUR BENEFITS PACKAGE

Disability

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

Just over 1 in 4 of today's 20 year -olds will become disabled before they retire.

34.6 months is the duration of the average disability claim.

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 36 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


Disability Insurance BENEFIT HIGHLIGHTS FOR: ARLINGTON INDEPENDENT SCHOOL DISTRICT POLICY # 681065

EDUCATOR DISABILITY INSURANCE OVERVIEW What is Educator Disability Income Insurance? Educator Disability insurance combines the features of a short‐ term and long‐term disability plan into one policy. The coverage pays you a portion of your earnings if you cannot work because of a disabling illness or injury. The plan gives you the flexibility to choose a level of coverage to suit your need. You have the opportunity to purchase Disability Insurance through your employer. This highlight sheet is an overview of your Disability Insurance. Once a group policy is issued to your employer, a certificate of insurance will be available to explain your coverage in detail. Why do I need Disability Insurance Coverage? More than half of all personal bankruptcies and mortgage foreclosures are a consequence of disability1 1

Facts from LIMRA, 2016 Disability Insurance Awareness Month

The average worker faces a 1 in 3 chance of suffering a job loss lasting 90 days or more due to a disability2 2

Facts from LIMRA, 2016 Disability Insurance Awareness Month

Only 50% of American adults indicate they have enough savings to cover three months of living expenses in the event they’re not earning any income3 3

Federal Reserve, Report on the Economic Well‐Being of U.S. Households in 2018

ELIGIBILITY AND ENROLLMENT Eligibility You are eligible if you are an active employee who works at least 20 hours per week on a regularly scheduled basis. Enrollment You can enroll in coverage within 31 days of your date of hire or during your annual enrollment period. Effective Date Coverage goes into effect subject to the terms and conditions of the policy. You must satisfy the definition of Actively at Work with your employer on the day your coverage takes effect.

Actively at Work You must be at work with your Employer on your regularly scheduled workday. On that day, you must be performing for wage or profit all of your regular duties in the usual way and for your usual number of hours. If school is not in session due to normal vacation or school break(s), Actively at Work shall mean you are able to report for work with your Employer, performing all of the regular duties of Your Occupation in the usual way for your usual number of hours as if school was in session.

FEATURES OF THE PLAN Benefit Amount You may purchase coverage that will pay you a monthly benefit of 30%, 40%, 50% or 60% of your monthly income, to a

maximum monthly benefit of $8,000. Earnings are defined in The Hartford’s contract with your employer. Elimination Period You must be disabled for at least the number of days indicated by the elimination period that you select before you can receive a Disability benefit payment. The elimination period that you select consists of two numbers. The first number shows the number of days you must be disabled by an accident before your benefits can begin. The second number indicates the number of days you must be disabled by a sickness before your benefits can begin. For those employees electing an elimination period of 30 days or less, if your are confined to a hospital for 24 hours or more due to a disability, the elimination period will be waived, and benefits will be payable from the first day of hospitalization. Maximum Benefit Duration Benefit Duration is the maximum time for which we pay benefits for disability resulting from sickness or injury. Depending on the age at which disability occurs, the maximum duration may vary. Please see the applicable schedule below based on the Premium benefit option. Premium Option: For the Premium benefit option – the table below applies to disabilities resulting from sickness or injury. Age Disabled Prior to 63 Age 63 Age 64 Age 65 Age 66 Age 67 Age 68 Age 69 and older

Maximum Benefit Duration To Normal Retirement Age or 48 months if greater To Normal Retirement Age or 42 months if greater 36 months 30 months 27 months 24 months 21 months 18 months

Mental Illness, Alcoholism and Substance Abuse: Duration You can receive benefit payments for Long‐Term Disabilities resulting from mental illness, alcoholism and substance abuse for a total of 24 months for all disability periods during your lifetime. Any period of time that you are confined in a hospital or other facility licensed to provide medical care for mental illness, alcoholism and substance abuse does not count toward the 24 month lifetime limit. Partial Disability Partial Disability is covered provided you have at least a 20% loss of earnings and duties of your job. Other Important Benefits Survivor Benefit ‐ If you die while receiving disability benefits, a benefit will be paid to your spouse or child under age 25, equal to three times your last monthly gross benefit. The Hartford's Ability Assist service is included as a part of your group Long Term Disability (LTD) insurance program. You have access to Ability Assist services both prior to a disability and after you’ve been approved for an LTD claim and are receiving LTD benefits. Once you are covered you are eligible 37


Disability Insurance for services to provide assistance with child/elder care, substance abuse, family relationships and more. In addition, LTD claimants and their immediate family members receive confidential services to assist them with the unique emotional, financial and legal issues that may result from a disability. Ability Assist services are provided through ComPsych®, a leading provider of employee assistance and work/life services. Travel Assistance Program – Available 24/7, this program provides assistance to employees and their dependents who travel 100 miles from their home for 90 days or less. Services include pre‐trip information, emergency medical assistance and emergency personal services.

Identity Theft Protection – An array of identity fraud support services to help victims restore their identity. Benefits include 24/7 access to an 800 number; direct contact with a certified caseworker who follows the case until it’s resolved; and a personalized fraud resolution kit with instructions and resources for ID theft victims. Workplace Modification provides for reasonable modifications made to a workplace to accommodate your disability and allow you to return to active full‐time employment.

PROVISIONS OF THE PLAN Definition of Disability Disability is defined as The Hartford’s contract with your employer. Typically, disability means that you cannot perform one or more of the essential duties of your occupation due to injury, sickness, pregnancy or other medical conditions covered by the insurance, and as a result, your current monthly earnings are 80% or less of your pre‐disability earnings. One you have been disabled for 24 months, you must be prevented from performing one or more essential duties of any occupation, and as a result, your monthly earnings are 60% or less of your pre‐disability earnings. Pre‐Existing Condition Limitation Your policy limits the benefits you can receive for a disability caused by a pre‐existing condition. In general, if you were diagnosed or received care for a disabling condition within the 3 consecutive months just prior to the effective date of this policy, your benefit payment will be limited, unless: You have been insured under this policy for 12 months before your disability begins. If your disability is a result of a pre‐existing condition, we will pay benefits for a maximum of 4 weeks. Continuity of Coverage If you were insured under your district’s prior plan and not receiving benefits the day before this policy is effective, there will not be a loss in coverage and you will get credit for your prior carrier’s coverage.

38

Recurrent Disability What happens if I Recover but become Disabled again? Periods of Recovery during the Elimination Period will not interrupt the Elimination Period, if the number of days You return to work as an Active Employee are less than one‐half (1/2) the number of days of Your Elimination Period. Any day within such period of Recovery, will not count toward the Elimination Period. Benefit Integration Your benefit may be reduced by other income you receive or are eligible to receive due to your disability, such as: • Social Security Disability Insurance • State Teacher Retirement Disability Plans • Workers’ Compensation • Other employer‐based disability insurance coverage you may have • Unemployment benefits • Retirement benefits that your employer fully or partially pays for (such as a pension plan) • Your plan includes a minimum benefit the greater of 10% of your elected benefit or $100. General Exclusions You cannot receive Disability benefit payments for disabilities that are caused or contributed to by: • War or act of war (declared or not) • Military service for any country engaged in war or other armed conflict • The commission of, or attempt to commit a felony • An intentionally self‐inflicted injury • Any case where your being engaged in an illegal occupation was a contributing cause to your disability • You must be under the regular care of a physician to receive benefits Termination Provisions Your coverage under the plan will end if: • The group plan ends or is discontinued • You voluntarily stop your coverage • You are no longer eligible for coverage • You do not make the required premium payment • Your active employment stops, except as stated in the continuation provision in the policy The Hartford® is The Hartford Financial Services Group, Inc. and its subsidiaries, including underwriting company Hartford Life and Accident Insurance Company. Home Office is Hartford, CT. All benefits are subject to the terms and conditions of the policy. Policies underwritten by the underwriting company listed above detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in force or discontinued. This Benefit Highlights Sheet explains the general purpose of the insurance described, but in no way changes or affects the policy as actually issued. In the event of a discrepancy between this Benefit Highlights Sheet and the policy, the terms of the policy apply. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy as issued to the policyholder. Benefits are subject to state availability. © 2020 The Hartford.


39


APL

Cancer

About this Benefit 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.

YOUR BENEFITS PACKAGE

Breast Cancer is the most commonly diagnosed cancer in women.

If caught early, prostate cancer is one of the most treatable malignancies.

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 40 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


GC3 Limited Benefit Group Cancer Indemnity Insurance Arlington ISD Group #13040 THE POLICY UNDER WHICH THIS CERTIFICATE IS ISSUED IS NOT A POLICY OF WORKERS’ COMPENSATION INSURANCE. THE EMPLOYER DOES NOT BECOME A SUBSCRIBER TO THE WORKERS’ COMPENSATION SYSTEM BY PURCHASING THE POLICY AND IF THE EMPLOYER IS A NON-SUBSCRIBER, THE EMPLOYEE LOSES THOSE BENEFITS WHICH WOULD OTHERWISE ACCRUE UNDER THE WORKERS’ COMPENSATION LAWS. THE EMPLOYER MUST COMPLY WITH THE WORKERS’ COMPENSATION LAW AS IT PERTAINS TO NON-SUBSCRIBERS AND THE REQUIRED NOTIFICATIONS THAT MUST BE FILED AND POSTED.

Summary of Benefits* Benefits

Level 1 Base Plan

Level 2 Base Plan

Radiation Therapy/Chemotherapy/ Immunotherapy Benefit

$500 per calendar month of treatment

$1,500 per calendar month of treatment

Hormone Therapy Benefit

$50 per treatment, up to 12 per calendar year

$50 per treatment, up to 12 per calendar year

Surgical Schedule Benefit

$1,600 max per operation; $15 per surgical unit

$4,800 max per operation; $45 per surgical unit

Anesthesia Benefit

25% of the amount paid for covered surgery

25% of the amount paid for covered surgery

Hospital Confinement Benefit

$100 per day 1-90 days; $100 per day, 91+ days in lieu of other benefits

$300 per day 1-90 days; $300 per day, 91+ days in lieu of other benefits

US Government/Charity Hospital/HMO

$100 per day in lieu of most other benefits

$300 per day in lieu of most other benefits

Outpatient Hospital or Ambulatory Surgical Center Benefit

$200 per day of surgery

$600 per day of surgery

Drugs & Medicine Benefit - Inpatient

$150 per confinement

$150 per confinement

Drugs & Medicine Benefit - Outpatient

$50 per prescription, up to $50 per cal month

$50 per prescription, up to $150 per cal month

Transportation & Outpatient Lodging Benefit

$0.50 per mile per round trip $100 per day, up to 100 days per calendar year

$0.50 per mile per round trip $100 per day, up to 100 days per calendar year

Family Member Transportation & Lodging Benefit

$0.50 per mile per round trip $100 per day, up to 100 days per calendar year

$0.50 per mile per round trip $100 per day, up to 100 days per calendar year

Blood, Plasma & Platelets Benefit

$150 per day, up to $7,500 per calendar year

$250 per day, up to $12,500 per calendar year

Bone Marrow/Stem Cell Transplant

Autologous - $500 per calendar year Non-Autologous - $1,500 per calendar year

Autologous - $1,500 per calendar year Non-Autologous - $4,500 per calendar year

Experimental Treatment Benefit

Pays as any non-experimental benefit

Pays as any non-experimental benefit

Attending Physician Benefit

$30 per day of confinement

$50 per day of confinement

Surgical Prosthesis Benefit

$1,000 per device (includes surgical fee); max 1 device per site, 2 lifetime max

$3,000 per device (includes surgical fee); max 1 device per site, 2 lifetime max

Hair Prosthesis Benefit

$50 per hair prosthetic, 2 lifetime max

$50 per hair prosthetic, 2 lifetime max

Dread Disease Benefit

$100 per day, 1-90 days of hospital confinement

$300 per day, 1-90 days of hospital confinement

Hospice Care Benefit

$50 per day, $9,000 lifetime max

$100 per day, $18,000 lifetime max

Inpatient Special Nursing Services

$150 per day of confinement

$150 per day of confinement

Ambulance Ground Benefit

$200 per ground trip

$200 per ground trip

Ambulance Air Benefit

$2,000 per air trip; up to 2 trips per hospital confinement (any combination of ground/air)

$2,000 per air trip; up to 2 trips per hospital confinement (any combination of ground/air)

Extended Care Benefit

$100 per day

$300 per day

Home Health Care Benefit

$100 per day

$300 per day

Second & Third Surgical Opinions

$300 per diagnosis; additional $300 if third opinion required

$300 per diagnosis; additional $300 if third opinion required

Waiver of Premium

Premium waived after 90 days of primary insured continuous total disability due to cancer

Premium waived after 90 days of primary insured continuous total disability due to cancer

Physical/Speech Therapy Benefit

$25 per visit, up to 4 visits per calendar month, $1,000 lifetime max

$25 per visit, up to 4 visits per calendar month, $1,000 lifetime max

Diagnostic Testing Benefit Rider

$50; 1 person, per calendar year

$50; 1 person, per calendar year

Critical Illness Rider: Cancer

$2,500 lump sum benefit

$2,500 lump sum benefit

Up to $400 max of 30 days per ICU confinement; $100 ambulance per ICU admission

Up to $600 max of 30 days per ICU confinement; $100 ambulance per ICU admission

Riders

Optional Benefit Rider Intensive Care Unit Rider Monthly Premium**

Level 1

Level 1 + ICU Rider

Level 2

Level 2 + ICU Rider

Individual

$13.20

$15.20

$27.80

$30.80

One Parent

$18.40

$21.20

$38.20

$42.40

$23.60

$27.80

$48.70

$55.00

Two Parent

*Premium and amount of benefits provided vary dependent upon the level selected at time of application. **Total premium includes the policy and riders of the option selected.

APSB-22356(TX) MGM/FBS Arlington ISD-0315

41


GC3 Limited Benefit Group Cancer Indemnity Insurance Eligibility

This policy/certificate will be issued only to those persons who meet American Public Life Insurance Company’s insurability requirements. The policy/certificate and the Internal Cancer coverage under the Critical Illness Rider will not be issued to anyone who has been diagnosed or treated for Cancer in the previous ten years. The Heart Attack or Stroke coverage under the Critical Illness Rider will not be issued to anyone who has been diagnosed or treated for any heart or stroke related conditions. The Hospital Intensive Care Unit Rider will not cover heart conditions for a period of two years following the Effective Date of coverage for anyone who has been diagnosed or treated for any heart related condition prior to the 30th day following the Covered Person’s Effective Date of coverage. If You are working either under contract to or as a Full-Time Employee for the Policyholder, or You are a member in or employed by the association, You are eligible for insurance provided You qualify for coverage as defined in the Master Application. You must apply for insurance within thirty (30) days of the Policy Effective Date or the date that You become eligible for coverage. If You do not apply within thirty (30) days of the Policy Effective Date or the date You become eligible for coverage, You may be subject to additional underwriting by Us.

Base Policy

All diagnosis of cancer must be positively diagnosed by a legally licensed doctor of medicine certified by the American Board of Pathology or American Board of Osteopathic Pathology. This policy/certificate pays only for loss resulting from definitive cancer treatment including direct extension, metastatic spread or recurrence. Proof must be submitted to support each claim. This policy/certificate also covers other conditions or diseases directly caused by cancer or the treatment of cancer. No benefits are payable for any covered person for any loss incurred during the first year of this policy/certificate as a result of a Pre-Existing Condition. A PreExisting Condition is a specified disease for which, within 12 months prior to the covered person’s effective date of coverage, medical advice, consultation or treatment, including prescribed medications, was recommended by or received from a member of the medical profession, or for which symptoms manifested in such a manner as would cause an ordinarily prudent person to seek diagnosis, medical advice or treatment. Pre-Existing Conditions specifically named or described as excluded in any part of this contract are never covered. This policy/certificate contains a 30-day waiting period during which no benefits will be paid under this policy/certificate. If any covered person has a specified disease diagnosed before the end of the 30-day period immediately following the covered person’s effective date, coverage for that person will apply only to loss that is incurred after one year from the effective date of such person’s coverage. If any covered person is diagnosed as having a specified disease during the 30-day period immediately following the effective date, you may elect to void the policy/certificate from the beginning and receive a full refund of premium. All benefits payable only up to the maximum amount listed in the schedule of benefits in the policy/certificate. A Hospital is not an institution, or part thereof, used as: a hospice unit, including any bed designated as a hospice or a swing bed; a convalescent home; a rest or nursing facility; a rehabilitative facility; an extended-care facility; a skilled nursing facility; or a facility primarily affording custodial, educational care, or care or treatment for persons suffering from mental diseases or disorders, or care for the aged, or drug or alcohol addiction.

Diagnostic Testing Benefit Rider

We will pay the indemnity amount for one generally medically recognized internal cancer screening test per covered person per calendar year. Screening test include, but limited to: mammogram; breast ultrasound; breast thermography; breast cancer blood test (CA15-3); colon cancer blood test (CEA); prostate-specific antigen blood test (PSA); flexible sigmoidoscopy; colonoscopy; virtual colonoscopy; ovarian cancer blood test (CA-125); pap smear (lab test required); chest x-ray; hemocult stool specimen; serum protein electrophoresis (blood test for myeloma); thin prep pap test. Screening tests payable under this benefit will only be paid under this benefit. Benefits will only be paid for tests performed after the 30-day period following the covered person’s effective date of coverage. 42 APSB-22356(TX) MGM/FBS

Arlington ISD-0315

Critical Illness Rider

Benefits will only be paid for a covered critical illness as shown on the policy/ certificate schedule page in the policy. No benefits will be provided for any loss caused by or resulting from: intentionally self-inflicted bodily injury, suicide or attempted suicide, whether sane or insane; or alcoholism or drug addiction; or any act of war, declared or undeclared , or any act related to war; or military service for any country at war; or a pre-existing condition; or a covered critical illness when the date of diagnosis occurs during the waiting period; or participation in any activity or event while intoxicated or under the influence of any narcotic unless administered by a physician or taken according to the physician’s instructions; or participation in, or attempting to participate in a felony, riot or insurrection (a felony is as defined by the law of the jurisdiction in which the activity takes place). Internal cancer does not include: other conditions that may be considered pre-cancerous or having malignant potential such as: acquired immune deficiency syndrome (AIDS); or actinic keratosis; or myelodysplastic and non-malignant myeloproliferative disorders; or aplastic anemia; or atypia; or non-malignant monoclonal gamopathy; or Leukoplakia; or Hyperplasia; or Carcinold; or Polycythemia; or carcinoma in situ or any skin cancer other than invasive malignant melanoma into the dermis or deeper. For a pre-existing condition no benefits are payable. Pre-Existing Condition, as used in this rider means any sickness or condition for which prior to the Effective Date of coverage, medical advice, consultation or treatment, including prescribed medications, was recommended by or received from a member of the medical profession, or for which symptoms manifested in such a manner as would cause an ordinarily prudent person to seek diagnosis, medical advice or treatment.

Hospital Intensive Care Unit Rider

No benefits will be provided during the first two years of this rider for hospital intensive care unit confinement caused by any heart condition when any heart condition was diagnosed or treated prior to the 30th day following the covered person’s effective date of this rider. The heart condition causing the confinement need not be the same condition diagnosed or treated prior to the effective date. No benefits will be provided if the loss results from: attempted suicide, whether sane or insane; or intentional self-injury; or alcoholism or drug addiction; or any act of war, declared or undeclared, or any act related to war; or military service for a country at war. No benefits will be paid for confinements in units such as surgical recovery rooms, progressive care, burn units, intermediate care, private monitored rooms, observation units, telemetry units or psychiatric units not involving intensive medical care; or other facilities which do not meet the standards for intensive care unit as defined in the rider. For a newborn child born within the tenmonth period following the effective date of this rider, no benefits will be provided for hospital intensive care unit confinement that begins within the first 30 days following the birth of such child.


GC3 Limited Benefit Group Cancer Indemnity Insurance Conditionally Renewable

This policy/certificate is conditionally renewable. This means that We have the right to terminate your policy/certificate on any premium due date after the first Policyholder’s Anniversary Date. We must give the Policyholder at least 60 days written notice prior to cancellation. We cannot cancel Your coverage because of a change in Your age or health. We can change Your premiums if We change premiums for all similar Certificates issued to the Policyholder. We must give the Policyholder at least 60 days written notice before We change Your premiums.

Continuation Rider Continuation

Coverage is continued when the Insured (You) cease employment with the employer through whom You originally became insured under the Policy. You will have the option to continue this Certificate (including any Riders, if applicable) by paying the premiums directly to Us at Our home office. Premiums must be paid within thirty-one (31) days after employment with your employer terminates. Premium rates required under this Continuation provision will be the same rates as those charged under the Employer’s Policy as if You had continued employment. We will bill You for these premiums after You notify Us to continue this coverage. Coverage will continue until the earlier of: (1) the Policy under which You originally became insured ends; or (2) You stop paying premiums under this option (subject to the terms of the Grace Period).

Termination of Coverage

Your Insurance coverage will end on the earliest of these dates: (a) the date You no longer qualify as an Insured; (b) the last day of the period for which a premium has been paid, subject to the Grace Period; (c) the date the Policy terminates (See Conversion provision); (d) the date You retire; (e) the date You cease employment, or terminate Your contract with the employer through whom You originally became insured under the Policy (See Conversion provision); or (f) the date We receive Your written request for termination. Termination of Dependent(s) Insurance coverage on Your Dependent(s) will end on the earliest of these dates: (a) the date the coverage under the Certificate terminates; (b) the date the Dependent no longer meets the definition of Dependent, as defined in the Policy/Certificate (See Conversion provision); (c) the date We receive Your written request for termination.

Termination of Rider Coverage

This rider terminates: (a) when Your coverage terminates under the Policy/ Certificate to which this Rider is attached; or, (b) when any premium for this rider is not paid before the end of the Grace Period; or, (c) when You give Us a written request to do so. Coverage on a Dependent terminates under this rider when such person ceases to meet the definition of Dependent, as defined in the Policy.

Conversion

If the Employer’s Policy is terminated, this Certificate will terminate. Upon termination of the Employer’s Policy, the employee (You) will be entitled to convert to an individual policy of insurance issued by Us without evidence of insurability provided the required premiums have been paid on your behalf and You notified Us in writing within thirty-one (31) days of the Employer’s Policy termination. Premiums for the individual policy of insurance will be figured from the premium rate table in effect on the date of conversion. Subject to the terms of this provision, a covered child who ceases to be eligible may convert to an individual policy of insurance and a covered spouse who ceases to be eligible for coverage because of divorce or annulment may convert to an individual policy. Terms of this provision include: (1) Application for the individual policy and payment of the first premium must be made within 60 days after coverage ceases under the Policy/Certificate. Premiums will be figured from the premium rate table in effect on the date of conversion. (2) The individual policy will be issued without proof of insurability. It will provide benefits that most nearly approximates those of the Policy/Certificate. (3) The individual policy will take effect the day after coverage ceases under the Policy/Certificate. However, no benefits will be payable under the individual policy for any loss for which benefits are payable under the Policy/Certificate. (4) The Pre-Existing Condition Limitation and Time Limit on Certain Defenses provisions for the individual policy will be figured from the Covered Person’s Effective Date of coverage under the Policy/ Certificate. (5) Any benefit maximums will be figured from the Effective Date of the Policy/Certificate. This rider is subject to all the provisions of the Policy and Certificate to which it is attached that are not in conflict with this rider.

2305 Lakeland Drive | Flowood, MS 39232 ampublic.com | 800.256.8606

Underwritten by American Public Life Insurance Company. This is a brief description of the coverage. For complete benefits, limitations, exclusions and other provisions, please refer to the policy/certificate/ riders. This coverage does not replace Workers’ Compensation Insurance. This product is inappropriate for people who are eligible for Medicaid coverage. | This policy is considered an employee welfare benefit plan established and/or maintained by an association or employer intended to be covered by ERISA, and will be administered and enforced under ERISA. Group policies issued to governmental entities and municipalities may be exempt from ERISA guidelines. | Policy Form GC-3 Series | Texas | Limited Benefit Group Cancer Indemnity Insurance Policy | (11/14) | Arlington ISD

43

APSB-22356(TX) MGM/FBS Arlington ISD-0315


UNUM

Life and AD&D

YOUR BENEFITS PACKAGE

About this Benefit Group term life is the most inexpensive way to purchase life insurance. You have the freedom to select an amount of life insurance coverage you need to help protect the well-being of your family. Accidental Death & Dismemberment is life insurance coverage that pays a death benefit to the beneficiary, should death occur due to a covered accident. Dismemberment benefits are paid to you, according to the benefit level you select, if accidentally dismembered.

Motor vehicle crashes are the

#1

cause of accidental deaths in the US, followed by poisoning, falls, drowning, and choking.

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 44 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


Basic Life and AD&D Arlington Independent School District Life and AD&D Insurance Plan Highlights Who is eligible for this coverage?

All full-time employees working at least 20 hours each week for your employer in the U.S.

What is the coverage amount?

Life Coverage: Your employer is providing you with $10,000. AD&D Coverage: Your employer is providing you with $10,000.

Is it portable (can I keep it if I leave my employer)?

If you retire, reduce your hours or leave your employer, you can take this coverage with you according to the terms outlined in the contract*.

Life Planning Financial & This personalized financial counseling service provides expert, objective financial counseling to survivors Legal Resources and terminally ill employees at no cost to you. This service is also extended to you upon the death or terminal illness of your covered spouse. The financial consultants are master level consultants. They will help develop strategies needed to protect resources, preserve current lifestyles and build future security. At no time will the consultants offer or sell any product or service. When is coverage effective?1.

Your coverage will become effective the first of the month following the date you become eligible. Insurance coverage will be delayed if you are not in active employment because of an injury, sickness, temporary layoff or leave of absence on the date that insurance would otherwise become effective.

Accelerated Benefit

If you become terminally ill and are not expected to live beyond a certain time period as stated in your certificate booklet, you may request up to 75% of your life insurance amount up to $500,000 without fees or present value adjustments. A doctor must certify your condition in order to qualify for this benefit. Upon your death, the remaining benefit will be paid to your designated beneficiary (ies).

Waiver of Premium

If you become disabled (as defined by your plan) and are no longer able to work, your premium payments will be waived during the period of disability after a 9 month waiting period.

Retained Asset Account

Benefits of $10,000 or more are paid through the Unum Retained Asset Account. This interest bearing account will be established in the beneficiary’s name. He or she can then write a draft for the full amount or for $250 or more, as needed.

Additional AD&D Benefits Education Benefit: If you or your insured spouse die within 365 days of an accident, an additional benefit is paid to your dependent child(ren). Your child(ren) must be a full-time student beyond grade 12. (Not available in Illinois or New York) Seat Belt/Air Bag Benefit: If you or your insured dependent(s) die in a car accident and are wearing a properly fastened seat belt and/or are in a seat with an air bag, an amount will be paid in addition to the AD&D benefit. What does my AD&D insurance pay for?

The full benefit amount is paid for loss of: Life Both hands or both feet or sight of both eyes One hand and one foot One hand and the sight of one eye Speech and hearing

Do my life insurance benefits decrease with age?

Coverage amounts will reduce according to the following schedule: Age: 70 75 80

Insurance amount reduces to: 35% of original amount 55% of original amount 70% of the original amount

Coverage may not be increased after a reduction. 45


Basic Life and AD&D Does this plan include help with work-life balance?

Yes. Our work-life balance employee assistance program (EAP) provides professional advice for a wide range of personal and work-related issues. The service is available to you and your family members 24 hours a day, 365 days a year. It provides resources to help you find solutions to everyday issues — such as financing a car or selecting child care — as well as more serious problems, such as alcohol or drug addiction, divorce or relationship problems. There is no additional charge for using the program, and you do not have to have filed a claim or be receiving benefits to use the program.

What else is included with this policy?

Worldwide emergency travel assistance is included with this long term disability plan. Emergency travel assistance is available to you, your spouse* and your dependent children when you travel to any foreign country, including Canada or Mexico. It is also available anywhere in the United States when you travel just 100 or more miles from home. * A spouse traveling on business for his or her employer is not covered by the program.

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.

Please refer to the policy for Exclusions and Limitations 1.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. *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. The Work-life balance employee assistance program and Life Planning Financial & Legal Resources services, are provided by HealthAdvocate, is 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. 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. Unum complies with state civil union and domestic partner laws when applicable. Underwritten by Unum Life Insurance Company of America, Portland, Maine © 2021 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. CE-540701-1 (5-21) FOR EMPLOYEES

46


Voluntary Life and AD&D Arlington Independent School District VoluntaryLife and AD&D Insurance Plan Highlights Who is eligible for this coverage?

All full-time employees working at least 20 hours each week for your employer in the U.S. and their eligible spouses and children to age 26.

What are the Life coverage amounts?

Employee: up to $500,000 in increments of $10,000; not to exceed $500,000. Spouse: up to 100% of employee amount in increments of $5,000; not to exceed $500,000. Child: $10,000. The maximum death benefit for a child between the ages of live birth and six months is $1,000.

What are the AD&D coverage amounts?

Employee: up to $500,000 in increments of $10,000; not to exceed $500,000. Spouse: up to 100% of employee amount in increments of $5,000; not to exceed $500,000. Child: $10,000. The maximum death benefit for a child between the ages of live birth and six months is $1,000. Note: You may purchase AD&D coverage for yourself regardless of whether you purchase term life coverage. In order to purchase life and AD&D coverage for your dependents, you must buy coverage for yourself.

Can I be denied coverage?

If you and your eligible dependents enroll before the enrollment deadline, you may apply for any amount of coverage up to $400,000 for yourself and any amount of coverage up to $60,000 for your spouse, without answering any medical questions. If you want coverage over the amount you are guaranteed, you will need to provide answers to health questions. In addition, if you and your eligible dependents do not enroll during this enrollment period, you will have to wait for a future annual enrollment period to apply — and then you will need to answer health questions for the entire amount of coverage you apply for. New employees: To apply for coverage, complete your enrollment within 31 days of your eligibility period. If you apply for coverage after 31 days, or if you choose coverage over the amount you are guaranteed, you will need to complete a medical questionnaire which you can get from your plan administrator. You may also be required to take certain medical tests at Unum’s expense. Insurance coverage over the guaranteed amount(s) will be subject to answers to health questions.

Why buy now?

As long as you buy $10,000 of life coverage now, you can buy more coverage later – up to $400,000 without answering any medical questions.

How do I apply?

Please see your plan administrator.

When is coverage effective?1.

Please see your plan administrator for your effective date. Insurance coverage will be delayed if you are not in active employment because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective. For your dependent spouse and children, insurance coverage will be delayed if that dependent is totally disabled on the date that insurance would otherwise be effective. Totally disabled means that as a result of an injury, sickness or disorder, your dependent spouse and children: are confined in a hospital or similar institution or are confined at home under the care of a physician for a sickness or injury. Exception: Infants are insured from live birth.

47


Voluntary Life and AD&D How much does the coverage cost?

Term Life Age band Employee monthly rate per $1,000 Spouse monthly rate per $1,000 <25 $0.026 $0.026 25-29 $0.033 $0.033 30-34 $0.041 $0.041 35-39 $0.056 $0.056 40-44 $0.078 $0.078 45-49 $0.124 $0.124 50-54 $0.190 $0.190 55-59 $0.293 $0.293 60-64 $0.367 $0.367 65-69 $0.522 $0.522 70-74 $1.119 $1.119 75+ $1.739 $1.739 Child life monthly rate is $0.80 for $10,000. One life premium covers all children. AD&D rate chart AD&D cost Employee Per $1,000 Spouse Per $1,000 Child $10,000

Monthly Cost $0.016 $0.030 $0.300

Your rate is based on your insurance age, which is your age immediately prior to and including the anniversary/effective date. Spouse rate is based on your insurance age, which is your age immediately prior to and including the anniversary/effective date.

Accelerated Benefit

If you become terminally ill and are not expected to live beyond a certain time period as stated in your certificate booklet, you may request up to 75% of your life insurance amount up to $500,000 without fees or present value adjustments. A doctor must certify your condition in order to qualify for this benefit. Upon your death, the remaining benefitwill be paid to your designated beneficiary(ies).

Retained Asset Account

Benefits of $10,000 or more are paid through the Unum Retained Asset Account. This interest bearing account will be established in the beneficiary’s name. He or she can thenwrite a draft for the full amount or for $250 or more, as needed.

Do my life insurance benefits decrease with age?

Coverage amounts will reduce according to the following schedule: Age: 70 75 80

Insurance amount reduces to: 35% of original amount 55% of original amount 70% of the original amount

Coverage may not be increased after a reduction. Is the coverage portable If you retire, reduce your hours or leave your employer, you can continue coverage for yourself your (can I keep it if I leave my spouse and your dependent children at the group rate. Portability is not available for people who have a employer)? medical condition that could shorten their life expectancy — but they may be able to convert their term life policy to an individual life insurance policy. Life Planning Financial & This personalized financial counseling service provides expert, objective financial counseling to survivors Legal Resources and terminally ill employees at no cost to you. This service is also extended to you upon the death or terminal illness of your covered spouse. The financial consultants are master level consultants. They will help develop strategies needed to protect resources, preserve current lifestyles and build future security. At no time will the consultants offer or sell any product or service.

48


Voluntary Life and AD&D Are there any life insurance exclusions or limitations?2.

Life insurance benefits will not be paid for deaths caused by suicide within the first 24 months after the date your coverage becomes effective. If you increase or add coverage, these enhancements will not be paid for deaths caused by suicide within the first 24 months after you make these changes.

Will my premiums be waived if I’m disabled?

If you become disabled (as defined by your plan) and are no longer able to work, your life premium payments will be waived until your disability period ends.

What does my AD&D insurance pay for?

The full benefit amount is paid for loss of: • life; • both hands or both feet or sight of both eyes; • one hand and one foot; • one hand or one foot and the sight of one eye; • speech and hearing. Other losses may be covered as well. Please contact your plan administrator.

Are there any AD&D Accidental death and dismemberment benefits will not be paid for losses caused by, contributed to by, or exclusions or limitations? 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 you 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. When does my coverage end?

You and your dependents’ coverage under the Summary of Benefits 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 in active employment unless continued due to a covered layoff or leave of absence or due to an 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 dependent coverage, 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. 1.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. Underwritten by: Unum Life Insurance Company of America, Portland, ME. © 2021 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. Unum complies with state civil union and domestic partner laws when applicable. CE-540705-1 (5-21) FOR EMPLOYEES

49


5STAR

Individual Life

About this Benefit Individual life is a policy that provides a specified death benefit to your beneficiary at the time of death. The advantage of having an individual life insurance plan as opposed to a group supplemental term life plan is that this plan is guaranteed renewable, portable and typically premiums remain the same over the life of the policy.

YOUR BENEFITS PACKAGE

Experts recommend at least

x 10 your gross annual income in coverage when purchasing life insurance.

This50is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


Term Life with Terminal Illness and Quality of Life Rider Family Protection Plan with Terminal Illness Term Life Insurance to age 100 Prepare for the future. Protect your loved ones. CUSTOMIZABLE With several options to choose from, select the coverage that best meets the needs of your family. TERMINAL ILLNESS ACCELERATION OF BENEFITS Coverage that 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). 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.

Nearly

85%

of people said they thought most people need life insurance.

Yet only

59%

said that they have coverage themselves.

And

33%

wish their spouse or partner had more life insurance.*

FAMILY PROTECTION You can get coverage for your spouse and financially dependent children 14 days through 23 years old, even if you don’t elect coverage on yourself. No matter what the future brings, you and your family are protected. CONVENIENT Easy payment through payroll deduction. QUALITY OF LIFE 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. 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. Underwritten by 5Star Life Insurance Company (a Lincoln, Nebraska company); Administered by NTT Data at 777 Research Drive, Lincoln, NE 68521 FPPi product available in all states and some U.S. Territories except: CA, DE, FL, NY, ND. SD. Quality of Life rider not available in CA. FPPg product available in all states and some U.S. Territories except: CA, DE, FL, NY, ND. SD, VI FPPi/gQOLFlyerR1119 FPPduoQOL_MKT_FLYER_1119

51


Family Protection Plan - Terminal Illness MONTHLY RATES WITH QUALITY OF LIFE RIDER DEFINED BENEFIT

18-25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46

$10,000 $9.90 $9.91 $9.98 $10.08 $10.23 $10.43 $10.64 $10.87 $11.11 $11.40 $11.72 $12.08 $12.46 $12.88 $13.33 $13.83 $14.38 $14.98 $15.60 $16.26 $16.93 $17.67

$20,000 $13.28 $13.34 $13.46 $13.66 $13.95 $14.35 $14.76 $15.23 $15.72 $16.30 $16.93 $17.65 $18.44 $19.25 $20.17 $21.15 $22.25 $23.46 $24.70 $26.02 $27.37 $28.83

$30,000 $16.68 $16.75 $16.96 $17.26 $17.68 $18.28 $18.90 $19.61 $20.33 $21.20 $22.16 $23.23 $24.40 $25.63 $27.00 $28.48 $30.13 $31.96 $33.81 $35.78 $37.80 $40.00

Employee Coverage Amounts $40,000 $50,000 $75,000 $20.07 $23.46 $31.94 $20.16 $23.59 $32.13 $20.44 $23.92 $32.62 $20.84 $24.42 $33.37 $21.40 $25.13 $34.44 $22.20 $26.12 $35.94 $23.04 $27.16 $37.50 $23.97 $28.34 $39.25 $24.93 $29.55 $41.06 $26.10 $31.00 $43.26 $27.37 $32.59 $45.63 $28.80 $34.37 $48.31 $30.36 $36.34 $51.25 $32.00 $38.38 $54.32 $33.83 $40.67 $57.76 $35.80 $43.13 $61.44 $38.00 $45.87 $65.57 $40.44 $48.92 $70.12 $42.90 $52.00 $74.75 $45.53 $55.30 $79.69 $48.23 $58.67 $84.75 $51.17 $62.33 $90.26

47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64

$18.43 $19.19 $20.02 $20.93 $21.94 $23.11 $24.42 $25.88 $27.44 $29.19 $30.99 $32.84 $34.74 $36.71 $38.77 $40.93 $43.22 $45.72

$30.35 $31.88 $33.55 $35.36 $37.39 $39.74 $42.33 $45.27 $48.37 $51.87 $55.49 $59.19 $62.97 $66.94 $71.05 $75.37 $79.95 $84.93

$42.28 $44.58 $47.08 $49.81 $52.83 $56.35 $60.26 $64.65 $69.31 $74.56 $79.98 $85.53 $91.21 $97.15 $103.33 $109.80 $116.68 $124.16

$54.20 $57.27 $60.60 $64.24 $68.26 $72.96 $78.17 $84.03 $90.23 $97.23 $104.46 $111.86 $119.43 $127.36 $135.60 $144.23 $153.40 $163.37

$66.13 $69.96 $74.13 $78.67 $83.71 $89.59 $96.09 $103.42 $111.17 $119.92 $128.96 $138.21 $147.67 $157.59 $167.88 $178.67 $190.13 $202.59

$95.94 $101.69 $107.94 $114.75 $122.32 $131.13 $140.87 $151.88 $163.50 $176.63 $190.19 $204.06 $218.25 $233.13 $248.57 $264.75 $281.94 $300.62

$125.75 $133.42 $141.75 $150.84 $160.91 $172.66 $185.67 $200.33 $215.83 $233.33 $251.41 $269.91 $288.83 $308.66 $329.25 $350.83 $373.75 $398.67

$155.56 $165.15 $175.57 $186.92 $199.52 $214.21 $230.46 $248.80 $268.17 $290.04 $312.64 $335.77 $359.42 $384.21 $409.94 $436.92 $465.56 $496.71

$185.38 $196.88 $209.38 $223.01 $238.13 $255.75 $275.26 $297.25 $320.51 $346.76 $373.88 $401.63 $430.01 $459.75 $490.63 $523.00 $557.38 $594.76

65

$48.50

$90.50

$132.51

$174.50

$216.50

$321.50

$426.50

$531.50

$636.51

Age on Eff. Date

52

$100,000 $40.42 $40.66 $41.34 $42.34 $43.75 $45.75 $47.84 $50.17 $52.58 $55.50 $58.67 $62.25 $66.16 $70.25 $74.83 $79.75 $85.25 $91.34 $97.50 $104.08 $110.83 $118.17

$125,000 $48.89 $49.21 $50.04 $51.29 $53.07 $55.56 $58.16 $61.09 $64.11 $67.75 $71.71 $76.18 $81.09 $86.19 $91.92 $98.06 $104.94 $112.54 $120.25 $128.48 $136.92 $146.09

$150,000 $57.38 $57.75 $58.76 $60.26 $62.38 $65.38 $68.50 $72.01 $75.63 $80.00 $84.76 $90.13 $96.00 $102.13 $109.00 $116.38 $124.63 $133.76 $143.01 $152.88 $163.00 $174.00


Family Protection Plan - Terminal Illness MONTHLY RATES WITH QUALITY OF LIFE RIDER DEFINED BENEFIT Age on Eff. Date 66* 67* 68* 69* 70*

$10,000 $49.13 $52.62 $56.58 $61.09 $66.18

$20,000 $91.75 $98.73 $106.67 $115.68 $125.85

$30,000 $134.38 $144.85 $156.75 $170.28 $185.53

Employee Coverage Amounts $40,000 $50,000 $75,000 $177.00 $219.63 $326.19 $190.97 $237.08 $352.38 $206.83 $256.92 $382.13 $224.87 $279.46 $415.94 $245.20 $304.88 $454.06

$100,000 $432.75 $467.67 $507.33 $552.42 $603.25

$125,000 $539.31 $582.96 $632.54 $688.90 $752.44

$150,000 $645.88 $698.25 $757.75 $825.38 $901.63

*Quality of Life not available ages 66 - 70. Quality of Life benefits not available for children. Child life coverage available only on children and grandchildren of employee (age on application date: 14 days through 23 years).$7.15 monthly for $10,000 coverage per child.

FPPiDBQOLMonthlyRates

9/18 53


UNUM

Long Term Care

YOUR BENEFITS PACKAGE

About this Benefit Long Term Care insurance is designed to help create a safety net if you are no longer able to care for yourself. If you suffer from an eligible prolonged illness, disability or cognitive disorder, long term care insurance will provide financial support.

60% of Americans do not have a “rainy day” fund to cover three months of unanticipated financial emergencies.

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 54 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


Long Term Care Who controls your future? Be prepared with long term care insurance from Unum. Your life, your choice There are plenty of decisions to make for retirement… • Fishing or golf? • Motor home or long-awaited cruise? • A house at the beach — or close to the grandchildren? Long term care insurance may help you avoid a far more difficult decision: whether to exhaust your savings or liquidate your assets to pay for a period of long term care. This policy may help you be prepared for the financial realities and help you maintain control of some important decisions, such as: • Who would take care of me? • Where can I choose to receive care? • Would I be a burden on my children if my savings couldn’t cover my care?

What is long term care? Whether it’s due to a motorcycle accident or a serious illness, it is the type of care you may need if you couldn’t independently perform the basic activities of daily living: bathing, dressing, using toilet, transferring from one location to another, continence and eating, or if you suffered sever cognitive impairment from a condition such as Alzheimer’s disease.

Who’s at risk? Long term care insurance is not just for the elderly.

• • •

40% of people currently receiving long term care are working-age adults 18 to 64 years old.1 About 70% of individuals over age 65 will require some type of long term care services during their lifetime.2 By 2020, 12 million people are projected to need long term care.3

How does this coverage help? Here are some examples of how you may use a long term care benefit of $3,000 per month, based on the national averages for care:4 Home health: Home health aide: $18.50/hour

$24,050/year* - $36,000 annual benefit = $11,950 left for out-of-pocket medical/prescription costs

Assisted living: Assisted living cost: $2,825.25/month

$33,903/year - $36,000 annual benefit = $2,097 left for out-of-pocket

Private nursing home: Private nursing home cost: $203.31/day

$74,208.15/year - $36,00 annual benefit = $38,208.15 of cost of care is paid out of pocket

*Based on receiving care five hours a day/five days a week at $18.50/hour. For illustrative purposes only.

How to apply Your benefit enrollment is coming soon. To learn more, watch for information from you employer. 55


Long Term Care Get the coverage you need Won’t my other insurance pay for long term care? Unfortunately, no. • Medical insurance and Medicare are designed to pay for specific care for acute conditions — not for long term help with daily living. • Medicaid is available only after most financial resources are gone, except for certain exempt and unavailable assets. Only long term care insurance may cover those costs and allow you to maintain as much of your assets as possible. Do I need to be in a nursing home to use my LTC insurance? All Unum plans include a home health option. This allows you to use your benefit to pay for an aide to come you your home, so you can remain in your residence as long as possible. For an extra premium, some plans allow you to pay a family member or friend to take care of you. Why buy now? People often buy long term care insurance at an early age, because the younger you are, the more affordable the rates. 1 In fact, 63% of the people who buy group LTC insurance are under age 55.5 Why buy coverage at work? 1. You may get more affordable rates when you buy this coverage through your employer and you may extend you coverage to your parents and spouse. 2. Depending on your plan, you may be able to pay your premiums through convenient payroll deduction. 3. Your employer has selected coverage from Unum, the leading provider of group LTC insurance for employees in the U.S.6 Additional help for caregivers Even if you don’t need long term care in the immediate future, you may be a caregiver for someone you love. Your plan includes LTC Connect® service, which gives you access to counselors who can help you find long term care providers in your area, a support group, or other assistance you may need. This service also provides discounts for medical equipment such as walkers, hearing aids, wheelchairs, and other related needs. A senior insurance counseling program is provided by the Area Agency on Aging under the authority of the Texas Health and Human Services Commission: Health Information Counseling and Advocacy Program (HICAP) 701 W. 51st W-352, Austin, Texas, 78751 1-800-252-9240 The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent or insurance company. 1,2,3 U.S. Department of Health and Human Services, “National Clearinghouse for Long Term Care Information,” updated October 2008. Available at http:// www.longtermcare.gov/LTC/Main_Site/Understanding_Long_Term_Care/Basics/Basics.aspx, cited November 17,2009. 4 Genworth Financial, “2009 Cost of Care Study,” April 2009. 5 American Association for Long Term Care Insurance, “2008 LTCI Sourcebook,” February 2008. 6 LIMRA, 2008 Group LTC Report, 2009. Based on inforce cases. Excluding Federal and California-specific Group LTC plans, Unum also ranks first in number of employees enrolled. Nursing home care based on 24 hour care for one year. Assisted living based on 12 months care. Home care based on five hours of care per day, five days per week for Non-Medicaid Certified home health aide services. 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 GLTC04 or contact your Unum representative. Underwritten by: Unum Life Insurance Company of America, Portland, ME unum.com © 2020 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. For employee information EN-1168-TX (5-10) 56


Long Term Care

Monthly Rates

AGE 18-30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80

Plan 3

Plan 1

Plan 2

Long Term Care Facility Prof Home-Comm Care 75% $2,000 Facility Benefit 3 Year Duration

Long Term Care Facility Prof Home-Comm Care 75% $3,000 Facility Benefit 4 Year Duration

Long Term Care Facility Prof Home-Comm Care 75% Simple Inflation $4,000 Facility Benefit 4 Year Duration

7.20 7.60 7.80 8.20 8.60 9.00 9.60 10.00 10.60 11.20 11.60 12.20 12.60 13.20 13.80 14.40 15.00 15.60 16.60 17.80 19.00 20.60 22.20 23.40 25.00 26.60 28.40 30.20 32.40 35.00 38.00 41.40 45.20 48.60 52.40 58.00 62.00 68.80 74.60 80.60 87.40 96.00 106.20 117.40 129.80 147.20 164.40 184.80 204.00 225.60 247.80

12.30 12.90 13.50 14.10 14.70 15.30 16.20 17.10 18.00 18.90 19.80 20.70 21.30 22.20 23.40 24.30 25.50 26.40 28.20 30.30 32.40 34.80 37.50 39.90 42.30 45.30 48.00 51.00 55.20 59.40 64.50 70.50 76.80 82.80 88.80 98.40 105.30 117.00 126.60 136.80 148.50 162.90 180.60 199.20 220.20 249.60 278.70 313.50 345.90 382.50 420.00

39.60 41.60 43.60 46.00 48.40 50.80 53.60 56.40 59.20 62.40 65.60 68.40 70.80 74.00 76.80 80.00 83.60 86.40 92.00 98.00 104.40 112.00 120.40 126.80 133.60 141.20 148.40 156.00 166.00 177.20 190.00 204.40 219.20 232.00 244.40 261.20 275.20 301.20 321.20 341.20 365.20 393.60 428.40 464.40 504.00 544.00 596.80 658.40 713.20 773.20 832.40

57


ID WATCHDOG

Identity Theft

YOUR BENEFITS PACKAGE

About this Benefit Identity theft protection monitors and alerts you to identity threats. Resolution services are included should your identity ever be compromised while you are covered.

An identity is stolen every 2 seconds, and takes over

300 hours

to resolve, causing an average loss of $9,650.

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 58 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


Identity Theft IDENTITY THEFT PROTECTION Better protect what matters most. You’ve spent a lifetime building your name and financial reputation. Now more than ever, it is important to better protect your identity—and your family’s identities—as fraudsters take advantage of the pandemic to trick victims into giving up personal and financial information.

Easy & Affordable Identity Protection With ID Watchdog®, you have an easy and affordable way to help better protect and monitor the identities of you and your family. You’ll be alerted to potentially suspicious activity and enjoy the peace of mind that comes with the support of dedicated resolution specialists. And, a customer care team that’s available any time, every day. WHY CHOOSE ID WATCHDOG Greater Protection & Control We've got you covered with alerts on identity-related vulnerabilities and lock features for added control over your credit report(s).

More for Families Our family plan helps you better protect your loved ones, with each adult getting their own personalized account. And, we offer more features that help protect minors than any other provider.

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

ID Watchdog Is Here for You Our US-based customer care team is available 24/7/365 at 866.513.1518. Take a step to help better protect your identity today.

The Powerful Features You Want at an Affordable Price FEATURES INCLUDED IN BOTH ID WATCHDOG PLANS CONTROL & MANAGE • Blocked Inquiry Alerts • Child Credit Lock | 1 Bureau* • Financial Accounts Monitoring • Social Account Monitoring* • Registered Sex Offender Reporting* • Customizable Alert Options • National Provider ID Alerts

MONITOR & DETECT • Child Credit Monitoring | 1 Bureau • Dark Web Monitoring1 • High-Risk Transactions Monitoring2 • Subprime Loan Monitoring2 • Public Records Monitoring • USPS Change of Address Monitoring • Identity Profile Report

SUPPORT & RESTORE • Identity Theft Resolution Specialists with Resolution for Pre-Existing Conditions • Online Resolution Tracker • Lost Wallet Vault & Assistance • Deceased • Family Member Fraud Remediation • Credit Freeze Assistance • Breach Alert Emails • Mobile App

*Helps better protect children | 1 Bureau = Equifax® | Multi-Bureau = Equifax, TransUnion® | 3 Bureau = Equifax, Experian®, TransUnion

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

ID WATCHDOG® 1B

ID WATCHDOG® PLATINUM

1 Bureau

3 Bureau

Credit Report(s)4 & VantageScore Credit Score(s)

1 Bureau Monthly

1 Bureau Daily & 3 Bureau Annually

Credit Score Tracker

1 Bureau Monthly

1 Bureau Daily

1 Bureau

Multi-Bureau

Up to $1M

Up to $1M

-

-

-

-

Employee

$7.95/month

$11.95/month

Employee + Family

$14.95/month

$22.95/month

Credit Report Monitoring

3

Credit Report Lock5 Identity Theft Insurance

6

401K/HSA Stolen Funds Reimbursement6 2

Subprime Loan Block * within the monitored lending network

Social Account Takeover Alerts* Integrated Fraud Alerts

7

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

Enroll in this valuable benefit today. 1 Dark Web Monitoring scans thousands of internet sites where consumers’ personal information is suspected of being bought and sold, and is constantly adding new sites to those it searches. However, the internet addresses of these suspected internet trading sites are not published and frequently change, so there is no guarantee that ID Watchdog is able to locate and search every possible internet site where consumers’ personal information is at risk of being traded. 2 The monitored network does not cover all businesses or transactions. 3 Locking your child’s Equifax credit report helps prevent access to it by lenders and creditors. It will not prevent access to your child’s credit report at any other credit reporting agency. 4 Under certain circumstances, access to your Equifax Credit Report may not be available as certain consumer credit files maintained by Equifax contain credit histories, multiple trade accounts, and/or an extraordinary number of inquiries of a nature that prevents or delays the delivery of your Equifax Credit Report. If a remedy for the failure is not available, the product subscription will be cancelled and a full refund will be made. 5 Monitoring from TransUnion® and Experian® will take several days to begin. 6 Locking your Equifax or TransUnion credit report will prevent access to it by certain third parties. Locking your Equifax or TransUnion credit report will not prevent access to your credit report at any other credit reporting agency. Entities that may still have access to your Equifax or TransUnion credit report include: companies like ID Watchdog and TransUnion Interactive, Inc. which provide you with access to your credit report or credit score, or monitor your credit report as part of a subscription or similar service; companies that provide you with a copy of your credit report or credit score, upon your request; federal, state, and local government agencies and courts in certain circumstances; companies using the information in connection with the underwriting of insurance, or for employment, tenant or background screening purposes; companies that have a current account or relationship with you, and collection agencies acting on behalf of those whom you owe; companies that authenticate a consumer’s identity for purposes other than granting credit, or for investigating or preventing actual or potential fraud; and companies that wish to make pre-approved offers of credit or insurance to you. To opt out of pre-approved offers, visit www.optoutprescreen.com. 7 The Identity Theft Insurance is underwritten and administered by American Bankers Insurance Company of Florida, an Assurant company. Please refer to the actual policies for terms, conditions, and exclusions of coverage. Coverage may not be available in all jurisdictions. Review the Summary of Benefits (www.idwatchdog.com/ terms/insurance). © 2019 ID Watchdog. Other product and company names are property of their respective owners. EE79376CG0819

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Identity Theft

61


METLIFE

Pet Insurance

YOUR BENEFITS PACKAGE

About this Benefit Pet insurance is a tool to help pet parents avoid a financial crisis due to unexpected veterinary expenses from accidents and illnesses.

1 in 3 pets may need urgent vet care every year

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 62 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


Pet Insurance My Pet Protection® from Nationwide® Now with options to meet every budget. Our popular My Pet Protection pet insurance plans now feature more choices and more flexibility: • Get cash back on eligible vet bills—Choose from three levels of reimbursement: 90%, 70% or 50%* • Available exclusively for employees—These plans aren’t available to the general public • Same price for pets of all ages—Your rate won’t go up because your pet had a birthday • Use any vet, anywhere—No networks, no pre-approvals • Optional wellness coverage available—Includes spay/neuter, dental cleaning, exams, vaccinations and more

Choose the reimbursement level that fits your needs Problems such as upset stomach are among the most common reasons dogs and cats go to the vet. The average cost for this kind of visit is $424. Here’s how My Pet Protection would cover the bill.*

90%

70%

50%

Reimbursement

Reimbursement

Reimbursement

Choose the level of coverage that fits your needs Get 90%, 70% or 50% reimbursement on these vet bills and more.* Accidents, including poisonings and allergic reactions Injuries, including cuts, sprains and broken bones Common illnesses, including ear infections, vomiting and diarrhea Serious/chronic illnesses, including cancer and diabetes Hereditary and congenital conditions Surgeries and hospitalization X-rays, MRIs and CT scans Prescription medications and therapeutic diets Wellness exams Dental cleaning Vaccinations Spay/neuter

reimbursement

reimbursement

reimbursement

You pay: $43 Nationwide pays: $381

You pay: $128 Nationwide pays: $396

You pay: $212 Nationwide pays: $212

Examples reflect reimbursement after $250 annual deductible has been fulfilled.

Get more—enjoy these extras when you protect your pet with a Nationwide pet insurance policy ®

Unlimited, 24/7 access to a veterinary professional ($150 value).

Fast, convenient electronic claim payments.

Multiple-pet discounts available.†

Mobile claims with the VitusVet App.

Access to our award -winning magazine, The Companion.

Discounts on handpicked pet products and services.

Get a fast, no-obligation quote today at www.petinsurance.com/myaisdbenefits To enroll your bird, rabbit, reptile or other exotic pet, call 877-738-7874.

Flea and tick prevention Heartworm testing and prevention Routine blood tests

✓ ✓

✓ ✓

✓ ✓ ✓ ✓ ✓ ✓ ✓

Both plans feature a $250 annual deductible and have a maximum annual benefit of $7,500. Pre-existing conditions are not covered. Any illness or injury a pet had prior to start of policy will be considered pre-existing.*

How to use your pet insurance plan 1. 2. 3.

Visit any vet, anywhere. Submit claim. Get reimbursed.

*Some exclusions may apply. Certain coverages may be subject to pre-existing exclusion. See policy documents for a complete list of exclusions. Reimbursement options may not be available in all states. †Pet owners receive a 5% multiple-pet discount by insuring two to three pets or a 10% discount on each policy for four or more pets. Insurance terms, definitions and explanations are intended for informational purposes only and do not in any way replace or modify the definitions and information contained in individual insurance contracts, policies or declaration pages, which are controlling. Such terms and availability may vary by state and exclusions may apply. Underwritten by Veterinary Pet Insurance Company (CA), Columbus, OH, an AM Best A+ rated company (2018); National Casualty Company (all other states), Columbus, OH, an AM Best A+ rated company (2018). Agency of Record: DVM Insurance Agency. Nationwide, the Nationwide N and Eagle, and Nationwide is on your side are service marks of Nationwide Mutual Insurance Company. ©2019 Nationwide. 19GRP5915 19GRMPP907050 63


METLAW YOUR BENEFITS PACKAGE

Legal Services

About this Benefit Having an affordable, qualified lawyer on your side can be an invaluable asset. Legal plans provide valuable benefits that cover the most common legal needs you may encounter - like creating a standard will, living will, healthcare power of attorney or buying a home. This plan also provides access to quality law firms for advice, consultation and representation.

55% of American adults do not have a will or other estate plan in place.

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 64 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


Legal Services Smart. Simple. Affordable.® •

$16.50 per month—covers you, your spouse and dependents.

Telephone and office consultations for an unlimited number of personal legal matters with an attorney of your choice

E-Services—Attorney locator, law firm e-panel, law guide, free, downloadable legal documents, financial planning, insurance and work/life resources Estate Planning Documents

• Simple and Complex Wills • Trusts (Revocable and

Document Review • Any Personal Legal Documents

Irrevocable)

• Preparation of Affidavits and

Financial, Childcare)

Powers of Attorney

Family Law • Prenuptial Agreement • Protection from Domestic Violence

• Adoption and Legalization • Guardianship or Conservatorship • Name Change Document Preparation • • • • •

Affidavits

Traffic Offenses* • Defense of Traffic Tickets (excludes DUI)

Deeds Demand Letters

• Advice and Consultation • Review of Immigration Documents

• Powers of Attorney (Healthcare, • Healthcare Proxies • Living Wills • Codicils

Immigration Assistance

• Driving Privilege Restoration

Mortgages

Real Estate Matters • Sale, Purchase or Refinancing of Your Primary, Second or Vacation Home

• Eviction and Tenant Problems (Primary Residence)

• Home Equity Loans for Your

Elder Law Matters

Primary, Second or Vacation Home

• Consultations and Document

Review for issues related to your • parents including Medicare, • Medicaid, Prescription Plans, • Nursing Home Agreements, • leases, notes, deeds, wills and powers of attorney as these affect the participant

Personal Property Protection • Consultations and Document Review for Personal Property Issues

(Includes License Suspension due • Assistance for disputes over to DUI) goods and services

Promissory Notes

Zoning Applications Boundary or Title Disputes Property Tax Assessment Security Deposit Assistance (For Tenant)

Financial Matters • • • •

Negotiations with Creditors

Debt Collection Defense Identity Theft Defense **LifeStages - Identity Management Services

• Personal Bankruptcy • Tax Audit Representation (Municipal, State or Federal)

• Foreclosure Defense • Tax Collection Defense) Juvenile Matters • Juvenile Court Defense, including • Criminal Matters • • Parental Responsibility Matters • • •

Defense of Civil Lawsuits Administrative Hearings Civil Litigation Defense

Incompetency Defense School Hearings Pet Liabilities

Consumer Protection

Family Matters™***

• Disputes over Consumer Goods • Available for an additional fee and Services • Separate plan for parents of • Small Claims Assistance participants for Estate Planning Documents

• Easy Enrollment - online or by phone

For More Information: Visit our website info.legalplans.com and enter access code: Legal or call our Client Service Center at 1-800821-6400 Monday - Friday from 8 a.m. - 7 p.m. (Eastern Time). Group legal plans and Family Matters provided by Hyatt Legal Plans, Inc., a MetLife company, Cleveland, Ohio. In certain states, group legal plans and Family Matters provided through insurance coverage underwritten by Metropolitan Property and Casualty Insurance Company and Affiliates, Warwick, Rhode Island. Please contact Hyatt Legal Plans for complete details on covered services including trials. No service, including advice and consultations, will be provided for: 1) employment-related matters, including company or statutory benefits; 2) matters involving the employer, MetLife® and affiliates, and plan attorneys; 3) matters in which there is a conflict of interest between the employee and spouse or dependents in which case services are excluded for the spouse and dependents; 4) appeals and class actions; 5) farm and business matters, including rental issues when the participant is the landlord; 6) patent, trademark and copyright matters; 7) costs and fines; 8) frivolous or unethical matters; 9) matters for which an attorney-client relationship exists prior to the participant becoming eligible for plan benefits. For all other personal legal matters, an advice and consultation benefit is provided. Additional representation is also included for certain matters listed above under Legal Representation. *Not available in all states. ** This benefit provides the Participant with access to LifeStages Identity Management Services provided by IDT911, LLC. IDT911 is not a corporate affiliate of Hyatt Legal Plans. ***For Family Matters, different terms and exclusions apply. ML3 L0715430950[exp0916][All States][DC,PR]

65


BANK

Catastrophic Sick Leave Bank

About this Benefit Catastrophic Sick Leave Banks is a voluntary employee benefit program developed to provide up to 75 additional paid days to members who have suffered a catastrophic illness or injury.

YOUR BENEFITS PACKAGE

34.6

months Is the average group long-term disability claim .

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 66 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


Catastrophic Sick Leave Bank

The purpose of the Catastrophic Sick Leave Bank is to provide additional paid leave days to members of the Bank who experience a catastrophic illness or injury and have exhausted all paid leave days. The request for additional days may only be made when a member has exhausted all accumulated state, local and vacation leave days.

To become a member of the Bank, employees make a one-time donation of three (3) local leave days. Once you have contributed your three days you cannot request to have them refunded.

Bank days can only be used for employees for their own catastrophic illness and must be approved by the Committee.

A catastrophic illness or injury is defined as a severe condition or combination of conditions affecting the mental or physical health of an employee that requires the services of a licensed practitioner for a prolonged period of time and that causes an employee to exhaust all leave time earned and lose compensation from the District.

You can join the Sick Leave Bank during the open enrollment period or, if you are a new employee, during the first 31 calendar days of employment.

Enrollment is conducted online at www.myaisdbenefits.net through the employee benefits portal.

67


NBS

FSA (Flexible Spending Account)

YOUR BENEFITS PACKAGE

About this Benefit A Cafeteria Plan is designed to take advantage of Section 125 of the Internal Revenue Code. It allows you to pay certain qualified expenses on a pre-tax basis, thereby reducing your taxable income. You can set aside a pre-established amount of money per plan year in a Healthcare Flexible Spending Account (FSA). Funds allocated to a healthcare FSA must be used during the plan year or are forfeited unless your plan contains a $500 rollover or grace period provision.

Unlimited FSA (Non HSA Compatible) The funds in the unlimited healthcare FSA can be used to pay for eligible medical expenses like deductibles, co-payments, orthodontics, glasses and contacts.

FLIP TO… FOR HSA VS. FSA COMPARISON

PG. 11

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 68 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


FSA (Flexible Spending Account) How do I receive reimbursements? During the course of the plan year, you may submit requests for reimbursement of expenses you have incurred. Expenses are Congratulations! considered "incurred" when the service is performed, not Your employer has established a "flexible benefits plan" to help necessarily when it is paid for. You can get submit a claim online you pay for your out-of-pocket health and daycare expenses. at: my.nbsbeneits.com One of the most important features of the plan is that the Please note: Policies other than company sponsored policies (i.e. benefits being offered are paid for with a portion of your pay spouse’s or dependents’ individual policies) may not be paid before federal income or social security taxes are withheld. This through the flexible beneits plan. Furthermore, qualified longmeans that you will pay less tax and have more money to spend term care insurance plans may not be paid through the flexible and save. However, if you receive a reimbursement for an benefits plan. expense under the plan, you cannot claim a federal income tax NBS Benefits Card credit or deduction on your return. Your employer may Health Flexible spending account: sponsor the use of the The health flexible spending account (FSA) enables you to pay NBS Benefits Card, for expenses allowed under Section 105 and 213(d) of the making access to your Internal Revenue Code which are not covered by our insured flex dollars easier than medical plan. ever. You may use the The most that you can contribute to your Health FSA each plan card to pay merchants year is set by the IRS. This amount can be adjusted for increases or service providers in cost-of-living in accordance with Code Section 125(i)(2). that accept credit cards such as hospitals and pharmacies, so there is no need to pay cash up front then wait for Premium expense plan: reimbursement. A premium expense portion of the plan allows you to use preOrthodontic expenses that are paid fully up-front at the time of tax dollars to pay for specific premiums under various insurance initial service are reimbursable in full after the initial service has programs we offer you. been performed and payment has been made. Ongoing orthodontia payments are reimbursable only as they are paid. Dependent care Flexible spending account: The dependent care flexible spending account (DCFSA) enables Account Information you to pay for out-of-pocket, work-related dependent daycare Participants may call NBS and talk to a representative during our costs. Please see the Summary Plan Description for the regular business hours, Monday-Friday, 7 a.m. to 7 p.m. Central definition of an eligible dependent. The law places limits on the Time. Participants can also obtain account information using the amount of money that can be paid to you in a calendar year. Automated Voice Response Unit, 24 hours a day, 7 days a week Generally, your reimbursement may not exceed the lesser of: at (385) 988-6423 or toll free at (800) 274-0503. For immediate (a) $5,000 (if you are married filing a joint return or you are access to your account information at any time, log on to our head of a household) or $2,500 (if you are married filing website at my.nbsbenefits.com or download the NBS Mobile separate returns); (b) your taxable compensation; (c) your App. spouse's actual or deemed earned income. Also, in order to have the reimbursements made to you and be What can I save with an FSA? excluded from your income, you must provide a statement from FSA No FSA the service provider including the name, address and, in most cases, the taxpayer identification number of the service Annual taxable income $24,000 $24,000 provider as well as the amount of such expense and proof that Health FSA $1,500 $0 the expense has been incurred. Dependent care FSA $1,500 $0 Determining contributions Total pre-tax contributions -$3,000 $0 Before each plan year begins, you will select the benefits you want and how much contributions should go toward each Taxable income after FSA $21,000 $24,000 benefit. It is very important that you make these choices Income taxes -$6,300 -$7,200 carefully based on what you expect to spend on each covered benefit or expense during the plan year. After-tax income $14,700 $16,800 Generally, you cannot change the elections you have made after After-tax health and welfare expenses $0 -$3,000 the beginning of the plan year. However, there are certain limited situations when you can change your elections if you Take-home pay $14,700 $13,800 have a "change in status". Please refer to your Summary Plan You saved $900 $0 Description for a change in status listing.

Plan Highlights Flexible Spending Plans

69


FSA (Flexible Spending Account) NBS Mobile App When you're on the go, save time and hassle with the NBS Mobile App. Submit claims, check your balances, view transactions, and submit documentation using your device's camera.

Easy and convenient •

Designed to work just as other iOS and Android apps which makes it easy to learn and use. Shares user authentication with the NBS portal. Registered users can download the app and log in immediately to gain access to their benefit accounts, with no need to register their phone or your account.

It's secure •

No sensitive account information is ever stored on your mobile device and secure encryption is used to protect all transmissions.

Mobile app features The NBS mobile app supports a wide variety of features, empowering you to proactively manage your account. • View account balances • View claims • View reimbursement history • Submit claims • Submit documentation using your device's camera • Pay providers • Setup a variety of SMS alerts • Edit your personal information • View contribution details • View plan information • View calendar deadlines • Contact a service representative • View Benefits Card information

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FSA (Flexible Spending Account) Sample Expenses Medical expenses • • • • • • • •

• • •

Acupuncture Addiction programs Adoption (medical expenses for baby birth) Alternative healer fees Ambulance Body scans Breast pumps Care for mentally handicapped Chiropractor Copayments Crutches

Dental expenses • • • • • • •

Artificial teeth Copayments Deductible Dental work Dentures Orthodontia expenses Preventative care at dentist office Bridges, crowns, etc.

Vision expenses • • • • • • • •

Braille - books & magazines Contact lenses Contact lens solutions Eye exams Eye glasses Laser surgery Office fees Guide dog and upkeep/other animal aid

Diabetes (insulin, glucose monitor) Eye patches Fertility treatment First aid (i.e. bandages, gauze) Hearing aids & batteries Hypnosis (for treatment of illness) Incontinence products (i.e. Depends, Serene) Joint support bandages and hosiery Lab fees Monitoring device (blood pressure, cholesterol)

• • • • • • • •

• •

Physical exams Pregnancy tests Prescription drugs Psychiatrist/psychologist (for mental illness) Physical therapy Speech therapy Vaccinations Vaporizers or humidifiers Weight loss program fees (if prescribed by physician) Wheelchair

• • • • • • • •

• •

Items that generally do not qualify for reimbursement • • • • • •

• • • • • •

• • •

Personal hygiene (deodorant, soap, body powder, sanitary products) Addiction products Allergy relief (oral meds, nasal spray) Antacids and heartburn relief Anti-itch and hydrocortisone creams Athlete's foot treatment Arthritis pain relieving creams Cold medicines (i.e. syrups, drops, tablets) Cosmetic surgery Cosmetics (i.e. makeup, lipstick, cotton swabs, cotton balls, baby oil) Counseling (i.e. marriage/family) Dental care - routine (i.e. toothpaste, toothbrushes, dental floss, anti-bacterial mouthwashes, fluoride rinses, teeth whitening/ bleaching) Exercise equipment Fever & pain reducers (i.e. Aspirin, Tylenol) Hair care (i.e. hair color, shampoo, conditioner, brushes, hair loss

• • • • • • •

• • • • • •

• •

products) Health club or fitness program fees Homeopathic supplement or herbs Household or domestic help Laser hair removal Laxatives Massage therapy Motion sickness medication Nutritional and dietary supplements (i.e. bars, milkshakes, power drinks, Pedialyte) Skin care (i.e. sun block, moisturizing lotion, lip balm) Sleep aids (i.e. oral meds, snoring strips) Smoking cessation relief (i.e. patches, gum) Stomach & digestive relief (i.e. Pepto- Bismol, Imodium) Tooth and mouth pain relief (Orajel, Anbesol) Vitamins Wart removal medication Weight reduction aids (i.e. Slimfast, appetite suppressant

These expenses may be eligible if they are prescribed by a physician (if medically necessary for a specific condition).

71


THE HARTFORD

EAP (Employee Assistance Program)

About this Benefit An Employee Assistance Plan (EAP) is an employee benefit program offered to help employees manage personal and professional problems that might adversely impact their work performance, health, and well-being. Employee Assistance Plans generally include short-term counseling and referral services for employees and their household members. Your Employee Assistance Program benefit is provided to you by your employer.

38%

YOUR BENEFITS PACKAGE

of employees have missed life events because of bad worklife balance.

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 72 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


Employee Assistance Program Ability Assist® Counseling Services For employees covered under The Hartford’s Disability insurance, Critical Illness insurance or Leave Management Services.

GETTING SUPPORT SHOULD BE EASY. Life presents complex challenges. If the unexpected happens, you want to know that you and your family have simple solutions to help you cope with the stress and life changes that may result. That’s why the Hartford’s Ability Assist Counseling Services, offered by ComPsych®,¹ can play such an important role. Our straightforward approach takes the complexity out of benefits when life throws you a curve.

COMPASSIONATE SOLUTIONS FOR COMMON CHALLENGES. From the everyday issues like job pressures, relationships, retirement planning or personal impact of grief, loss, or a disability, Ability Assist can be your resource for professional support. You and your family, including spouse and dependents, can access Ability Assist, at any time, as long as you are covered under The Hartford’s Disability insurance, Critical Illness insurance or Leave Management Services.

ABILITY ASSIST COUNSELING SERVICES Emotional or Work-Life Counseling

Financial Information and Resources

Legal Support and Resources

Health ChampionSM

Helps address stress, relationship or other personal issues you or your family members may face. It’s staffed by GuidanceExperts℠ – highly trained master’s and doctoral level clinicians – who listen to concerns and quickly make referrals to in-person counseling or other valuable resources. Situations may include: • Job pressures. • Substance abuse. • Work/school disagreements. • Stress, anxiety and depression. • Relationship/marital conflicts. • Child and elder care referral services. Provides support for the complicated financial decisions you or your family members may face. Speak by phone with a Certified Public Accountant and Certified Financial Planner ™ Professionals on a wide range of financial issues. Topics may include: • Managing a budget. • Retirement. • Getting out of debt. • Tax questions. • Saving for college. Offers assistance if legal uncertainties arise. Talk to an attorney by phone about the issues that are important to you or your family members. If you require representation, you’ll be referred to a qualified attorney in your area with a 25% reduction in customary legal fees thereafter. Topics may include: • Debt and bankruptcy. • Guardianship. • Buying a home. • Power of attorney. • Divorce. A service that supports you through all aspects of your health care issues by helping to ensure that you’re fully supported with employee assistance programs and/or work-life services. HealthChampion is staffed by both administrative and clinical experts who understand the nuances of any given health care concern. Situations may include: • One-on-one review of your health concerns • An easy-to-understand explanation of your benefits– what’s covered and what’s not • Preparation for upcoming doctor’s visits/lab work/tests/ • Cost estimation for covered/non-covered treatment surgeries • Answers regarding diagnosis and treatment options • Guidance on claims and billing issues • Coordination with appropriate health care plan • Fee/payment plan negotiation provider(s)

SERVICE FEATURES The service includes up to three face-to-face emotional or work-life counseling sessions per occurrence per year. This means you and your family members won’t have to share visits. Each individual can get counseling help for his/her own unique needs. Legal and financial counseling are also available by telephone during business hours. HealthChampion℠ offers unlimited access to services.2

GETTING IN TOUCH IS EASY. On the phone: Just one simple call. For access over the phone, simply call toll-free 1-800-96-HELPS (1-800-964-3577). Online: The point is simplicity. You’ll also have 24/7 access to GuidanceResources® Online (offered by ComPsych).1 This resource provides trusted information, resources, referrals and answers to everyday questions right from your desktop or the privacy of your home. It includes: • Chat sessions with professional moderators. • Access to hundreds of personal health topics and resources for child care, elder care, attorneys or financial planners.

Visit WWW.GUIDANCERESOURCES.COM to create your own personal username and password. If you’re a first-time user, you’ll be asked to provide the following information on the profile page: 1. In the Company/Organization field, use: HLF902 2. Then, create your own confidential user name and password. 3. Finally, in the Company Name field at the bottom of personalization page, use: ABILI A CASE IN POINT.3 “The initial counselor I spoke with was so comforting and easy to communicate with. She put me right at ease and empowered me to follow through with the program. She was wonderful.” – Hartford Customer, Ability Assist User Visit us at THEHARTFORD.COM/EMPLOYEEBENEFITS The Hartford® is The Hartford Financial Services Group, Inc. and its subsidiaries including issuing companies Hartford Life Insurance Company and Hartford Life and Accident Insurance Company. Home Office is Hartford, CT. 1 Ability Assist®, The GuidanceResources® Program, and HealthChampionSM services are offered through The Hartford by ComPsych®. ComPsych is not affiliated with The Hartford and is not a provider of insurance services. The Hartford is not responsible and assumes no liability for the goods and services provided by ComPsych. ComPsych and GuidanceResources are registered trademarks and HealthChampion is a service mark of ComPsych Corporation. 2 HealthChampionSM specialists are only available during business hours. Inquiries outside of this time frame can either request a call-back the next day or schedule an appointment. 3 This case illustration is fictitious and for illustrative purposes only. 4264 06/15 Printed in U.S.A. © 2015 The Hartford Financial Services Group, Inc. All rights reserved.

73


Travel Assistance and ID Theft Protection Services EVEN THE BEST PLANNED TRIPS CAN BE FULL OF SURPRISES. The best laid travel plans can go awry, leaving you vulnerable and, possibly, unable to communicate your needs. When the unexpected happens far from home, it’s important to know whom to call for assistance.

services.4

SERVICES FROM HERE TO THERE. Travel Assistance begins even before you embark, with pre-trip information, and continues throughout your trip. See the list of services in the chart on the back of this page.

If you are covered under a Hartford Group Policy, you and your IDENTITY THEFT ASSISTANCE, TOO. Identity theft, America’s fast growing crime, victimizes almost family have access to Travel Assistance Services provided by 1 10 million American consumers each year5. Europ Assistance Europ Assistance USA. USA helps protect you and your family from its consequences With a local presence in 200 countries and territories around 24/7,2 at home and when you travel. the world, and numerous 24/7 assistance centers, they are In addition to prevention education, this service provides available to help you anytime, anywhere. advice and help with administrative tasks resulting from identity theft. GOOD TO GO: MULTILINGUAL ASSISTANCE 24/7. Whether you’re traveling for business or pleasure, Travel Assistance services are available when you’re more than 100 miles from home for 90 days or less.2,3 As long as you contact Europ Assistance USA at the time of need, you could be approved for up to $1 million in covered

TRAVEL ASSISTANCE AND ID THEFT PROTECTION SERVICES EMERGENCY MEDICAL ASSISTANCE6

PRE-TRIP INFORMATION

EMERGENCY PERSONAL SERVICES7

IDENTITY THEFT ASSISTANCE

• • • • • • • • •

• Visa and passport

• Medication and eyeglass

• Prevention Services

Medical referrals Medical monitoring Medical evacuation Repatriation Traveling companion assistance Dependent children assistance Visit by a family member or friend Emergency medical payments Return of mortal remains

requirements • Inoculation and immunization requirements • Foreign exchange rates • Embassy and consular referrals

• • • •

prescription assistance Emergency travel arrangements9 Emergency cash9 Locating lost items Bail advancement

 Education  Identity Theft Resolution Kit • Detection Services

 Fraud alert to three credit

bureaus • Resolution Guidance and Assistance

 Credit information review  ID Theft Affidavit Assistance  Card replacement

• Personal Services

 Translation  Emergency cash advance*

 Cash advance available when theft occurs 100 miles or more from your primary residence. Must be secured by a valid credit card

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Travel Assistance and ID Theft Protection Services CASE ILLUSTRATION: HELP A WORLD AWAY.8 As a Human Resource Professional, Tammy had always been on the coordinating end of travel services helping her company’s employees; but when her daughter was hurt while traveling with her school group in Italy, she suddenly found herself in a different position. Using the travel assistance medical referral, medical monitoring, and repatriation services from Europ Assistance USA, Tammy’s daughter was able to receive immediate medical treatment and was evacuated within 48 hours. The Europ Assistance USA Case Manager helped Tammy through some of the most stressful days she’s experienced as a mother and provided care for her daughter when she couldn’t.

What to have ready: Your employer’s name, a phone number where you can be reached, nature of the problem, Travel Assistance Identification Number and your company policy number, which can be Have a serious medical emergency? Please obtain emergency medical services first (contact the local “911”), and then contact Europ Assistance USA to alert them to your situation. Travel Assistance Identification Number:

The Hartford® is The Hartford Financial Services Group, Inc. and its subsidiaries including issuing companies Hartford Life Insurance Company and Hartford Life and Accident Insurance Company. Home office is Hartford, CT. 1 Travel Assistance and Identity Theft services are provided by Europ Assistance USA Europ Assistance USA is not affiliated with The Hartford and is not a provider of insurance services. Europ Assistance USA may modify or terminate all or any part of the service at any time without prior notice. None of the benefits provided to you by Europ Assistance USA as a part of the Travel Assistance and Identity Theft service are insurance. This brochure, the Travel Assistance and Identity Theft service Terms and Conditions of Use, and the Identity Theft Resolution Kit constitute your benefit materials and contain the terms, conditions, and limitations relating to your benefits. These services may not be used for business or commercial purposes or by any person other than the individual insured under The Hartford’s group insurance policy . The Hartford is not responsible and assumes no liability for the goods and services described in these materials. 2 Coverage includes spouse (or domestic partner) and dependent children under age 26. 3 Services are available in every country of the world. Depending on the current political situation in the country to which you are traveling, EA may experience difficulties providing assistance, which may result in delays or even the inability to render certain services. It is your responsibility to inquire, prior to departure, whether assistance service is available in the countries where you are traveling. 4 The Combined Single Limit (CSL), or amount of money available to the insured under a Hartford Group policy the Travel Assistance Program, is $1 million. One service or a combination of the services may exceed the CSL. The insured is responsible for payment of any expenses that exceed the CSL. Note: Certain Accidental Death and Dismemberment programs may offer different CSLs. Please consult with your Human Resources Manager for more details. 5 www.transunion.com/personal-credit/identity-theft-and-fraud/identity-theft-facts.page, viewed on 6/25/15. 6 In a medical emergency, Europ Assistance USA pays for assistance as described herein, but you are personally responsible for paying your medical/hospital expenses. 7 Europ Assistance USA provides the described personal services to you in an emergency, but you are personally responsible for the cost of air fare not approved as medically necessary by the attending physician; food, hotel and car expenses; and attorney fees. Emergency cash advances and bail advancement require your personal satisfactory guarantee of reimbursement provided through a valid credit card. 8 This case illustration is fictitious and for illustrative purposes only. 9 Emergency cash is charged as a cash advance, and emergency airline tickets are charged as a purchase to your credit card account and are all subject to that account’s finance rates. DISCLAIMER: Service Exclusions and Limitations: Europ Assistance USA (EA) services are eligible for payment or reimbursement by EA only if EA was contacted at the time of the services and arranged and/or preapproved the services. Certain terms, conditions and exclusions apply; for further information refer to the Web site listed or call EA at the number provided.

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NBS - 403(b) | Redwood Financial - 457

Retirement Planning

YOUR BENEFITS PACKAGE

About this Benefit A 403(b) plan is a U.S. tax-advantaged retirement savings plan available for public education organizations. A 457(b) plan is a tax-deferred compensation plan provided for employees of certain tax-exempt, governmental organizations or public education institutions.

38% of Americans don’t actively save for retirement at all.

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan 76 details on covered expenses, limitations and exclusions are included in the summary plan description located on the Arlington ISD Benefits Website: www.myaisdbenefits.net


Retirement Planning-403(B) Important Benefit Information about your 403(b) Retirement Plan What is a 403(b) plan? A 403(b) plan, also known as a Tax‐Sheltered Annuity (TSA) plan, is a tax‐deferred retirement plan for employees of certain tax‐ exempt, governmental organizations or public education institutions. An employer may sponsor a 403(b) plan to provide a benefit to its employees of the opportunity to save for retirement on a tax‐deferred basis. 403(b) plans were created to encourage long‐term savings, so depending on your plan, distributions are available only when you reach age 59 ½, leave you job or upon death or disability. Keep in mind, distributions before age 59 ½ might be subject to restrictions and a 10% federal penalty for early withdrawals. Why contribute to a 403(b) plan? Participating in your plan can provide a number of benefits, including the following: Lower Taxes Today The 403(b) contributions you make are on a pre‐tax basis. This means that you are taxed on a lower amount of income. For example, if your federal marginal income tax rate is 25%, and if you contribute $100 a month to a 403(b) plan, you have reduced your federal income taxes by nearly $25. In effect, your $100 contribution costs you only $75. The tax savings can grow with the size of your 403(b) contribution.

Tax‐deferred Growth In your 403(b) plan, interest and earnings accrue tax‐deferred. This means that your interest will grow tax‐free until the time of your withdrawal. The compounding interest on your 403(b) plan can allow your account to grow more quickly than saving in a taxable account where interest and earnings are generally taxed each year. Taking the Initiative Contributing to a 403(b) retirement plan can help you take control of your future retirement needs. Other sources of retirement income, including state pension plans and, if applicable, Social Security, often do not adequately replace a person’s salary upon retirement. A 403(b) plan can be a great way to provide you with additional income at retirement. Possible Tax Credits If you make contributions to the plan, you may be able to receive a tax credit, which could reduce your overall federal income tax paid for the year. How do I get more information? To obtain additional information about participation, and about the savings products made available under the plan, contact your benefits department.

457(b) Summary Plan Description PLAN TYPE 457(b)

PLAN ADMINISTRATOR Redwood Financial

EXCLUDED EMPLOYEES None

FIRST TIME USERNAME Social Security Number

FIRST TIME PASSWORD Date of Birth

PLAN EFFECTIVE DATE Per Plan Document

CONTRIBUTION TAX TREATMENT Pre-Tax

ONTRIBUTION SOURCES Employee Only

ROTH 457(b) Available

CONTRIBUTION LIMIT $19,500/yr

CATCH-UP PROVISION $6,500 *Must be over age 50*

SELF ENROLLMENT Available

ROLLOVERS INTO PLAN Available from another Qualified Plan

ROLLOVERS OUT OF PLAN Available to Qualified Plan upon meeting qualifying event. LOANS Available. Minimum loan amount= $1,000. Maximum loans outstanding= 1

GRANDFATHERED PRODUCTS None

ADMINISTRATIVE FEES $ per participant per month. Paid by the Participant.

OTHER PARTICIPANT FEES FPS Record Keeper- $38/yr FPS Custodian- .15% of assets Redwood Education & Comm.- .50% of assets Managed Portfolios (Optional) .80% of assets

DISTRUBUTIONS Available under following conditions: • Separation of Service • Death • Disability • Retirement BENEFICIARIES Designated at enrollment.

For more information, please contact Redwood Financial: 817.332.7995

UNFORESEEABLE EMERGENCY Available as defined by the IRS for 457(b) plans.

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WWW.MYAISDBENEFITS.NET 80

Profile for FBS

2021-22 Arlington ISD Benefit Guide  

2021-22 Arlington ISD Benefit Guide  

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