2022-23 Joshua ISD Benefit Guide

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2022 - 2023 Plan Year

JOSHUA ISD

BENEFIT GUIDE EFFECTIVE: 09/01/2022 - 8/31/2023 WWW.MYBENEFITSHUB.COM/JOSHUAISD

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Table of Contents How to Enroll Annual Benefit Enrollment 1. Section 125 Cafeteria Plan Guidelines 2. Annual Enrollment 3. Eligibility Requirements 4. Helpful Definitions 5. Health Savings Account (HSA) vs. Flexible Spending Account (FSA) Medical Health Savings Account (HSA) Hospital Indemnity Telehealth Dental Vision Identity Theft Disability Cancer Critical Illness Life and AD&D Individual Life Emergency Medical Transportation Flexible Spending Account (FSA)

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10 11-12 13-14 15-16 17 18-19 20-21 22 23-24 25 26-27 28-29 30-31 32

PG. 4

HOW TO ENROLL

PG. 6

SUMMARY PAGES

PG. 11

YOUR BENEFITS

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Benefit Contact Information JOSHUA ISD BENEFITS

MEDICAL

HEALTH SAVINGS ACCOUNT (HSA)

Financial Benefit Services (469) 385-4685 www.mybenefitshub.com/joshuaisd

Texas Schools Health Benefits Program (TSHBP) (888) 803-0081 All Plans: www.tshbp.org Pharmacy Benefits: SouthernScripts Group #50000 https://tshbp.info/DrugPham

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

HOSPTAL INDEMNITY

TELEHEALTH

DENTAL

Cigna Group #HC961005 (800) 754-3207 www.cigna.com

MDLive (888) 365-1663 https://www.mdlive.com/fbs

Cigna Group #3334575 (800) 244-6224 www.mycigna.com

VISION

IDENTITY THEFT

DISABILTY

Superior Vision Group #322750 (800) 507-3800 www.superiorvision.com

iLock360 (855) 287-8888 www.ilock360.com

UNUM Group #124509001 (866) 679-3054 www.unum.com

CANCER

CRITICAL ILLNESS

LIFE AND AD&D

American Public Life Group #18186 (800) 256-8606 www.ampublic.com

The Hartford Group #884447 (860) 547-5000 www.thehartford.com

The Hartford Group #884447 (860) 547-5000 www.thehartford.com

INDIVIDUAL LIFE

EMERGENCY MEDICAL TRANSPORT FLEXIBLE SPENDING ACCOUNT (FSA)

5Star Life Insurance Company Group #2283 (866) 863-9753 https://5starlifeinsurance.com

MASA Group #MKJOSH (800) 423-3226 https://www.masamts.com/

Higginbotham (866) 419-3519 https://flexservices.higginbotham.net

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All Your Benefits One App Employee benefits made easy through the FBS Benefits App! Text “FBS JOSHUAISD” to (800) 583-6908 and get access to everything you need to complete your

benefits enrollment: •

Benefit Resources

Online Enrollment

Interactive Tools

And more!

App Group #: FBSJOSHUAISD

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Text

“FBS JOSHUAISD”

to (800) 583-6908 OR SCAN


How to Log In 1

www.mybenefitshub.com/joshuaisd

2

CLICK LOGIN

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ENTER USERNAME & PASSWORD Your Username Is: Your email in THEbenefitsHUB. (Typically your work email) Your Password Is: Four (4) digits of your birth year followed by the last four (4) digits of your Social Security Number If you have previously logged in, you will use the password that you created, NOT the password format listed above.

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Annual Benefit Enrollment

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): Marital Status

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 30 days of your qualifying event and meet with 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 A change in marital status includes marriage, death of a spouse, divorce or annulment (legal separation is not recognized in all states).

A change in number of dependents includes the following: birth, adoption and placement for Change in Number of adoption. You can add existing dependents not previously enrolled whenever a dependent Tax Dependents gains eligibility as a result of a valid change in status event. Change in Status of Change in employment status of the employee, or a spouse or dependent of the employee, Employment Affecting that affects the individual's eligibility under an employer's plan includes commencement or Coverage Eligibility termination of employment. Gain/Loss of Dependents' Eligibility Status

Judgment/Decree/ Order

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

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

Eligibility for Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change. Government Programs

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Annual Benefit Enrollment

SUMMARY PAGES

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

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

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

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

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

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

Where can I find forms? For benefit summaries and claim forms, go to your benefit website: www.mybenefitshub.com/ joshuaisd. Click the benefit plan you need information on (i.e., Dental) and you can find the forms you need under the Benefits and Forms section. How can I find a Network Provider? For benefit summaries and claim forms, go to the Joshua ISD benefit website: www.mybenefitshub.com/joshuaisd. Click on the benefit plan you need information on (i.e., Dental) and you can find provider search links under the Quick Links section.

When will I receive ID cards? If the insurance carrier provides ID cards, you can expect to receive those 3-4 weeks after your effective date. For most dental and vision plans, you can 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 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.

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Annual Benefit Enrollment

SUMMARY PAGES

Employee Eligibility Requirements

Dependent Eligibility Requirements

Supplemental Benefits: Eligible employees must work 16 or more regularly scheduled hours each work week.

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

Eligible employees must be actively at work on the plan effective date for new benefits to be effective, meaning you are physically capable of performing the functions of your job on the first day of work concurrent with the plan effective date. For example, if your 2022 benefits become effective on September 1, 2022, you must be actively-at-work on September 1, 2022 to be eligible for your new benefits.

PLAN

MAXIMUM AGE

Basic Life

N/A

Cancer

26

Dental

26

Disability

N/A

Health Savings Account

IRS Dependent covered on your HDHP

Medical

26

Hospital Indemnity

26

Medical Flex

IRS Dependent

Telehealth

26

Vision

26

Voluntary Life

26

Individual Life

24

Critical Illness

26

Medical Transportation

26

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

Potential Spouse Coverage Limitations: When enrolling in coverage, please keep in mind that some benefits may not allow you to cover your spouse as a dependent if your spouse is enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Financial Benefit Services, or contact the insurance carrier for additional information on spouse eligibility. FSA/HSA Limitations: Please note, in general, per IRS regulations, married couples may not enroll in both a Flexible Spending Account (FSA) and a Health Savings Account (HSA). If your spouse is covered under an FSA that reimburses for medical expenses then you and your spouse are not HSA eligible, even if you would not use your spouse's FSA to reimburse your expenses. However, there are some exceptions to the general limitation regarding specific types of FSAs. To obtain more information on whether you can enroll in a specific type of FSA or HSA as a married couple, please reach out to the FSA and/or HSA provider prior to enrolling or reach out to your tax advisor for further guidance. Potential Dependent Coverage Limitations: When enrolling for dependent coverage, please keep in mind that some benefits may not allow you to cover your eligible dependents if they are enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact 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.

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SUMMARY PAGES

Helpful Definitions Actively-at-Work

In-Network

You are performing your regular occupation for the employer on a full-time basis, either at one of the employer’s usual places of business or at some location to which the employer’s business requires you to travel. If you will not be actively at work beginning 9/1/2022 please notify your benefits administrator.

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

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

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

Calendar Year

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

Plan Year September 1st through August 31st

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

January 1st through December 31st

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

Guaranteed Coverage The amount of coverage you can elect without answering any medical questions or taking a health exam. Guaranteed coverage is only available during initial eligibility period. Actively-at-work and/or preexisting condition exclusion provisions do apply, as applicable by carrier. 9


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.

Employer Eligibility

A qualified high deductible health plan.

All employers

Contribution Source Account Owner Underlying Insurance Requirement

Employee and/or employer Individual

Employee and/or employer Employer

High deductible health plan

None

Description

Minimum Deductible Maximum Contribution

$1,400 single (2022) $2,800 family (2022) $3,650 single (2022) $7,300 family (2022)

N/A $2,850 (2022)

Permissible Use Of Funds

Employees may use funds any way they wish. 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 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

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FLIP TO FOR FSA INFORMATION

PG. 33


Medical Insurance Texas Schools Health Benefits Program

EMPLOYEE BENEFITS

ABOUT TSHBP The TSHBP is proud to offer a variety of plans and benefits to meet your school district’s needs. All plans are designed so members can easily navigate through their health medical needs.

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

Directed Care Highlights

Aetna Network Highlights

The TSHBP Directed Care Plans utilize a national network to provide physician and ancillary services access to all members. Enrolled school districts will access the HealthSmart practitioner and ancillary only network to gain access to over 478,000 providers in over 1,222,000 unique locations across the United States, Please note, hospitals are excluded from the PPO networks. All hospital and other medical facility-based services are accessed via an assigned Care Coordinator.

You want a network that is comprehensive, is easy to use and can help you save on costs. Look no further. You can now find support through our Aetna Signature Administrators® preferred provider organization network. Discover provider options and reduced costs.

TSHBP members will experience the lowest out-of-pocket costs for physician and ancillary medical services when utilizing network providers. HealthSmart Network Solutions’ Physician and Ancillary Only Primary PPO contains approximately 478,000 contracted providers in over 1,222,000 unique locations across the country. It is easy to look up providers in your area by looking up providers in your area by clicking on the link below. Your searches can be saved to your computer or sent to your email. https://tshbp.info/HSNetwork

Access the MyTSHBP Digital Wallet for easy access to all your benefit resources.

With our network, you now have access to over 1.2 million participating doctors, 8,700 hospitals, and strong, negotiated discounts. We know quality care is important. So we make sure our doctors successfully complete our credentialing requirements. Our credentialing process meets industry standards, as well as state and federal requirements. You’ll also have access to over 600 Institutes of Excellence™ facilities and Institutes of Quality® facilities. We measure these publicly recognized institutes by clinical performance, outcomes and efficiency. Then, we pass this guidance along to you—so you can choose the best facility. No one likes changing doctors every year. We make it easier, so you don’t have to. Our local network teams work with doctors and hospitals to promote effective member care and better customer satisfaction. As a result, the turnover in our network is remarkably low, year after year. Ready to search our network? Just visit http://aetna.com/asa

PPO Deductible Credits With the Aetna PPO plans, if you choose to utilize the services of a Care Coordinator for a procedure or admission to a facility, you will receive a $500 credit toward your deductible1. If you have already met your deductible, the $500 credit will apply to your out-of-pocket maximum! 1

On the HDHP plan, a member must meet a minimum of $1,400 of the deductible accumulation before receiving the credit to comply with HSA requirements. 11


Medical Insurance

EMPLOYEE BENEFITS

Texas Schools Health Benefits Program DIRECTED CARE PLANS

AETNA NETWORK PLANS

High Deductible

CoPay

Aetna HD

Aetna Signature

Directed Care Plan • Use CC for Hospital/ Surgical Services • Compatible with an HSA • Lowest HD Premium Plan • Out-of-Network Benefits In-Network

Directed Care Plan • Use CC for Hospital/ Surgical Services • Co-payments for Services • Reduce Out-of-Pocket • Out-of-Network Benefits In-Network

Traditional PPO Plan • Compatible with an HSA • Network for all physician and hospital services

Traditional PPO Plan • Lowest Deductible Plan • Brand Drug Deductible • Network for all physician and hospital services

In-Network

In-Network

$3,000/$9,000

$0 Deductible

$3,000/$6,000

$2,000/$4,000

None - Plan Pays 100% after deductible $3,000/$9,000

None - Plan Pays 100% after out-of-pocket is met $3,500/$10,500

You pay 30% after deductible $7,000/$14,000

You pay 25% after deductible $7,500/$15,000

HealthSmart

HealthSmart

Aetna

Aetna

PCP Required

No

No

No

No

PCP Referral to Specialist

No

No

No

No

Yes - $0 copay Deductible, then Plan pays 100% Deductible, then Plan pays 100% $30 per consultation

Yes - $0 copay

Yes - $0 copay You pay 30% after deductible You pay 30% after deductible $30 per consultation

Yes - $0 Copay

PLAN SUMMARY

Plan Features Individual/Family Deductible Coinsurance Ind/Fam Out of Pocket National Network

Doctor Visits Preventive Care Primary Care

Specialist Virtual Health

$35 copay

$35 copay $0 per consultation

$30 copay

$70 copay $0 per consultation

Care Facilities Deductible, then Plan pays 100% Deductible, then Plan pays 100% Deductible, then Plan pays 100%

$500 copay

Integrated with medical 30-Day Supply / 90-Day Supply

No deductible 30-Day Supply / 90-Day Supply

Deductible, then Plan pays 100%

$0 at selected pharmacies; others $10/$20 copay

Deductible, then Plan pays 100% Deductible, then Plan pays 100%

$35 copay or 50% copay (max $100) $70 copay or 50% copay (max $200)

Limited - PAP Required

Limited - PAP Required

Employee Cost (District Contribution of $300) Employee Only

$71.00

$113.00

$129.00

$177.00

Employee/Spouse

$715.00

$855.00

$909.00

$949.00

Employee/Child

$394.00

$485.00

$472.00

$511.00

$1,030.00

$1,225.00

$1,145.00

$1,232.00

Urgent Care Emergency Care Outpatient Surgery

$50 copay

$500 copay

You pay 30% after deductible You pay 30% after deductible You pay 30% after deductible

$50 copay You pay $500 copay + 25% after deductible You pay 25% after deductible

Prescriptions Drug Deductible Days Supply

Generics Preferred Brand Non-preferred Brand Specialty

Employee/Family 12

Integrated with medical 30-Day Supply / 90-Day Supply You pay 20% after deductible; $0 for certain generics You pay 25% after deductible You pay 50% after deductible Full Coverage - PAP Required

$500 brand deductible 30-Day Supply / 90-Day Supply

$15/$45 copay You pay 25% after deductible You pay 50% after deductible Full Coverage - PAP Required


Health Savings Account (HSA) EECU

EMPLOYEE BENEFITS

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

A Health Savings Account (HSA) is more than a way to help you and your family cover health care costs; it is a tax-exempt tool to supplement your retirement savings and cover health expenses during retirement. An HSA can provide the funds to help pay current health care expenses as well as future health care costs. A type of personal savings account, an HSA is always yours even if you change health plans or jobs. The money in your HSA (including interest and investment earnings) grows tax-free and spends tax-free if used to pay for qualified medical expenses. There is no “use it or lose it” rule — you do not lose your money if you do not spend it in the calendar year — and there are no vesting requirements or forfeiture provisions. The account automatically rolls over year after year.

HSA Eligibility You are eligible to open and contribute to an HSA if you are: • Enrolled in an HSA-eligible HDHP (TSHBP HD or Aetna High Deductible) • Not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan • Not enrolled in a Health Care Flexible Spending Account, nor should your spouse be contributing towards a Health Care Flexible Spending Account • Not eligible to be claimed as a dependent on someone else’s tax return • Not enrolled in Medicare or TRICARE • Not receiving Veterans Administration benefits You can use the money in your HSA to pay for qualified medical expenses now or in the future. You can also use HSA funds to pay health care expenses for your dependents, even if they are not covered under your HDHP.

Maximum Contributions Your HSA contributions may not exceed the annual maximum amount established by the Internal Revenue Service. The annual contribution maximum for 2022 is based on the coverage option you elect: • Individual – $3,650 • Family (filing jointly) – $7,300 You decide whether to use the money in your account to pay for qualified expenses or let it grow for future use. If you are 55 or older, you may make a yearly catch-up contribution of up to $1,000 to your HSA. If you turn 55 at any time during the plan year, you are eligible to make the catch-up contribution for the entire plan year.

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Health Savings Account (HSA) EECU

EMPLOYEE BENEFITS

Opening an HSA If you meet the eligibility requirements, you may open an HSA administered by EECU. You will receive a debit card to manage your HSA account reimbursements. Keep in mind, available funds are limited to the balance in your HSA.

Important HSA Information • • •

Always ask your health care provider to file claims with your medical provider so network discounts can be applied. You can pay the provider with your HSA debit card based on the balance due after discount. You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit. You may open an HSA at the financial institution of your choice, but only accounts opened through EECU are eligible for automatic payroll deduction and company contributions.

How to Use your HSA • •

• •

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Online/Mobile: Sign-in for 24/7 account access to check your balance, pay bills and more. Call/Text: (817) 882-0800. EECU’s dedicated member service representatives are available to assist you with any questions. Their hours of operation are Monday through Friday from 8:00 a.m. to 7:00 p.m. CT, Saturday 9:00 a.m. – 1:00 p.m. CT and closed on Sunday. Lost/Stolen Debit Card: Call the 24/7 debit card hotline at (800) 333-9934 Stop by a local EECU financial center for in-person assistance; find EECU locations & service hours a www.eecu.org/ locations.


Hospital Indemnity

EMPLOYEE BENEFITS

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

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

Who Can Elect Coverage: • You: All active, Full-time Employees of the Employer who are regularly working in the United States a minimum of 20 hours per week and regularly residing in the United States who are United States citizens or permanent resident aliens and their Spouse and Dependent Children who are United States citizens or permanent resident aliens and are residing in the United States. You will be eligible for coverage on the first of the month coinciding with or next following date of hire or Active Service. • Your Spouse:* Up to age 100, as long as you apply for and are approved for coverage yourself. • Your Child(ren): Birth to age 26; 26+ if disabled, as long as you apply for and are approved for coverage yourself. Available Coverage: The benefit amounts shown in this summary will be paid regardless of the actual expenses incurred and are paid on a per day basis unless otherwise specified. Benefits are only payable when all policy terms and conditions are met. Please read all the information in this summary to understand the terms, conditions, state variations, exclusions, and limitations applicable to these benefits. See your Certificate of Insurance for more information. Benefit Waiting Period:* None, unless otherwise stated. No benefits will be paid for a loss which occurs during the Benefit Waiting Period. Hospitalization Benefits Hospital Admission No Elimination Period. Limited to 1 day, 1 benefit(s) every 90 days. Hospital Chronic Condition Admission No Elimination Period. Limited to 1 day, 1 benefit(s) every 90 days. Hospital Stay No Elimination Period. Limited to 30 days, 1 benefit(s) every 90 days. Hospital Intensive Care Unit (ICU) Stay No Elimination Period. Limited to 30 days, 1 benefit(s) every 90 days. Hospital Observation Stay 24 hour Elimination Period. Limited to 72 hours. Newborn Nursery Care Stay* Limited to 30 days, 1 benefit per newborn child. This benefit is payable to the employee even if child coverage is not elected.

Plan 1

Plan 2

Plan 3

$500

$1,000

$2,000

$50

$100

$150

$100

$100

$200

$200

$200

$250

$500 per 24-hour period $100

$100

$200 per 24-hour period $200

Portability Feature:* You, your spouse, and child(ren) can continue 100% of your coverage at the time your coverage ends. You must be covered under the policy and be under the age of 100 in order to continue your coverage. Rates may change and all coverage ends at age 100. Applies to United States Citizens and Permanent Resident Aliens residing in the United States. 15


Hospital Indemnity Cigna

EMPLOYEE BENEFITS

including pregnancy and complications of pregnancy that results in a covered loss. A Covered Illness includes medically-necessary quarantine in a Hospital in conjunction Hospital Admission: Must be admitted as an Inpatient due with medically-necessary preventive treatment due to an to a Covered Injury or Covered Illness. Excludes: treatment identifiable exposure to a life-threatening contagious and in an emergency room, provided on an outpatient basis, or infectious disease. for re-admission for the same Covered Injury or Covered Illness (including chronic conditions). Covered Injury: Any bodily harm that results in a covered loss. Hospital Chronic Condition Admission: Must be admitted as an Inpatient due to a covered chronic condition and Covered Person: An eligible person, as defined in the treatment for a covered chronic condition must be Schedule of Benefits, who is enrolled and for whom provided by a specialist in that field of medicine. Excludes: Evidence of Insurability, where required, has been treatment in an emergency room, provided on an accepted by Us, required premium has been paid when outpatient basis, or for re-admission for the same Covered due, and coverage under this Policy remains in force. Injury or Covered Illness (including chronic conditions). Elimination Period: The continuous period of time that must Hospital Stay: Must be admitted as an Inpatient and be satisfied before a benefit shown in the Schedule of confined to the Hospital, due to a Covered Injury or Benefits is payable. An Elimination Period may be satisfied Covered Illness, at the direction and under the care of a during the Policy’s Benefit Waiting Period. physician. If also eligible for the ICU Stay Benefit, only 1 benefit will be paid for the same Covered Injury or Covered Hospital:* An institution that is licensed as a hospital Illness, whichever is greater. Hospital stays within 90 days pursuant to applicable law; primarily and continuously for the same or a related Covered Injury or Covered Illness engaged in providing medical care and treatment to sick and injured persons; managed under the supervision of a is considered one Hospital Stay. staff of physicians; provides 24-hour nursing services by or Intensive Care Unit (ICU) Stay: Must be admitted as an under the supervision of a graduate registered Nurse Inpatient and confined in an ICU of a Hospital, due to a (R.N.); and has medical, diagnostic and treatment facilities Covered Injury or Covered Illness, at the direction and with major surgical facilities on its premises, or available to under the care of a physician. If also eligible for the it on a prearranged basis. The term Hospital does not Hospital Stay Benefit, only 1 benefit will be paid for the include a clinic or facility for: (1) rehabilitation, same Covered Injury or Covered Illness, whichever is convalescent, custodial, educational, hospice, or skilled greater. ICU stays within 90 days for the same or a related nursing care; (2) the aged, drug addiction or alcoholism; or Covered Injury or Covered Illness is considered one ICU (3) a facility primarily or solely providing psychiatric stay. services to mentally ill patients. The term Hospital also does not include a unit of a Hospital for rehabilitation, Hospital Observation Stay: Must be receiving treatment for convalescent, custodial, educational, hospice, or skilled a Covered Injury or Covered Illness in a Hospital, including nursing care. an observation room, or ambulatory surgical center, for more than 24 hours on a non-inpatient basis and a charge Hospital Indemnity must be incurred. This benefit is not payable if a benefit is Plan 1 Plan 2 Plan 3 payable under the Hospital Stay Benefit or Hospital Intensive Care Unit Stay Benefit. Employee $0.00 $7.10 $22.10 Employee + Spouse $6.40 $18.35 $45.30 Newborn Nursery Care Admission and Newborn Nursery Employee + Child(ren) $6.70 $17.56 $41.12 Care Stay: Must be admitted as an Inpatient and confined in a hospital immediately following birth at the direction and Family $13.75 $31.80 $72.34 under the care of a physician.

Benefit-Specific Conditions, Exclusions & Limitations (Hospital Care):

Important Definitions: Covered Illness: A physical or mental disease or disorder 16


Telehealth

EMPLOYEE BENEFITS

MDLive with Behavioral Health ABOUT TELEHEALTH Telehealth provides 24/7/365 access to board-certified doctors via telephone or video consultations that can diagnose, recommend treatment and prescribe medication. Telehealth makes care more convenient and accessible for non-emergency care when your primary care physician is not available.

For full plan details, please visit your benefit website: www.mybenefitshub.com/joshuaisd Alongside your medical coverage is access to quality telehealth services through MDLIVE. Connect anytime day or night with a board-certified doctor via your mobile device or computer. While MDLIVE does not replace your primary care physician, it is a convenient and cost-effective option when you need care and: • Have a non-emergency issue and are considering a convenience care clinic, urgent care clinic or emergency room for treatment • Are on a business trip, vacation or away from home • Are unable to see your primary care physician

When to Use MDLIVE: At a cost that is the same or less than a visit to your physician, use telehealth services for minor conditions such as: • Sore throat • Headache • Stomachache • Cold • Flu • Allergies • Fever • Urinary tract infections Do not use telemedicine for serious or life-threatening emergencies.

MDLIVE Behavioral Health: Managing stress or life changes can be overwhelming but it’s easier than ever to get help right in the comfort of your own home. Visit a counselor or psychiatrist by phone, secure video, or MDLIVE App. • Talk to a licensed counselor or psychiatrist from your home, office, or on the go! • Affordable, confidential online therapy for a variety of counseling needs. • The MDLIVE app helps you stay connected with appointment reminders, important notifications and secure messaging.

Registration is Easy • • • • •

Register with MDLIVE so you are ready to use this valuable service when and where you need it. Online – www.mdlive.com/fbsbh Phone – 888-365-1663 Mobile – download the MDLIVE mobile app to your smartphone or mobile device Select –“MDLIVE as a benefit” and “FBS” as your Employer/Organization when registering your account.

Telehealth Employee and Family

Paid fully by Joshua ISD

17


Dental Insurance

EMPLOYEE BENEFITS

Cigna ABOUT DENTAL Dental insurance is a coverage that helps defray the costs of dental care. It insures against the expense of routine care, dental treatment and disease.

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

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

How to Find a Dentist Visit https:// hcpdirectory.cigna.com/ or call 800-244-6224 to find an innetwork dentist. Your network will be Total Cigna DPPO. How to Request a New ID Card You can request your dental id card by contacting Cigna directly at 800-244-6224. You can also go to www.mycigna.com and register/login to access your account. In addition, you can download the “MyCigna” app on your smartphone and access your id card right there on your phone.

DENTAL - HIGH PLAN Network Options Reimbursement Levels Policy Year Benefits Maximum Applies to: Class I, II & III expenses Policy Year Deductible Individual Family Benefit Highlights Class I: Diagnostic & Preventive Oral Evaluations Prophylaxis: routine cleanings X-rays: routine X-rays: non-routine Fluoride Application Sealants: per tooth Space Maintainers: non-orthodontic Emergency Care to Relieve Pain

See Non-Network Reimbursement

$1,000

$1,000

$50 $150

$50 $150

Out-of-Network:

Maximum Reimbursable Charge

Plan Pays

You Pay

Plan Pays

You Pay

100% No Deductible

No Charge

100% No Deductible

No Charge

80% After Deductible

20% After Deductible

80% After Deductible

20% After Deductible

50% After Deductible

50% After Deductible

50% After Deductible

50% After Deductible

50% No Deductible

50% No Deductible

50% No Deductible

50% No Deductible

Class II: Basic Restorative Restorative: fillings Endodontics: minor and major Periodontics: minor and major Oral Surgery: minor and major Anesthesia: general and IV sedation Repairs: dentures

Class III: Major Restorative Inlays and Onlays Prosthesis Over Implant Crowns: prefabricated stainless steel / resin Crowns: permanent cast and porcelain Bridges and Dentures Repairs: bridges, crowns and inlays Denture Relines, Rebases and Adjustments

Class IV: Orthodontia Coverage for Dependent Children to age 19 Lifetime Benefits Maximum: $1,500

Benefit Plan Provisions: In-Network Reimbursement Non-Network Reimbursement

18

In-Network: Total Cigna DPPO Network Based on Contracted Fees

For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Fee Schedule or Discount Schedule. For services provided by a non-network dentist, Cigna Dental will reimburse according to the Maximum Reimbursable Charge. The MRC is calculated at the 90th percentile of all provider submitted amounts in the geographic area. The dentist may balance bill up to their usual fees.


Dental

EMPLOYEE BENEFITS

Cigna DENTAL - LOW PLAN Network Options Reimbursement Levels Policy Year Benefits Maximum Applies to: Class I, II & III expenses Policy Year Deductible Individual Family Benefit Highlights Class I: Diagnostic & Preventive Oral Evaluations Prophylaxis: routine cleanings X-rays: routine X-rays: non-routine Fluoride Application Sealants: per tooth Space Maintainers: non-orthodontic Emergency Care to Relieve Pain

In-Network: Total Cigna DPPO Network Based on Contracted Fees

See Non-Network Reimbursement

$1,000

$1,000

$50 $150

$50 $150

Out-of-Network:

Maximum Allowable Charge

Plan Pays

You Pay

Plan Pays

You Pay

100% No Deductible

No Charge

100% No Deductible

No Charge

60% After Deductible

40% After Deductible

80% After Deductible

20% After Deductible

Not Covered

100% of your Dentist’s usual fees

Not Covered

100% of your Dentist’s usual fees

Class II: Basic Restorative Restorative: fillings Endodontics: minor and major Periodontics: minor and major Oral Surgery: minor and major Anesthesia: general and IV sedation Repairs: dentures

Class III: Major Restorative Inlays and Onlays Prosthesis Over Implant Crowns: prefabricated stainless steel / resin Crowns: permanent cast and porcelain Bridges and Dentures Repairs: bridges, crowns and inlays Denture Relines, Rebases and Adjustments

Benefit Plan Provisions: In-Network Reimbursement

For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Fee Schedule or Discount Schedule. For services provided by a non-network dentist, Cigna Dental will reimburse according to the Maximum Reimbursable Charge. The MRC is calculated at the 90th percentile of all provider submitted amounts in the geographic area. The dentist may balance bill up to their usual fees.

Non-Network Reimbursement

Dental Rates Employee Only Employee & Spouse Employee & Child(ren) Employee & Family

High $33.52 $73.35 $80.72 $107.58

Low $29.61 $64.78 $71.28 $95.05

19


Vision Insurance

EMPLOYEE BENEFITS

Superior Vision ABOUT VISION Vision insurance provides coverage for routine eye examinations and can help with covering some of the costs for eyeglass frames, lenses or contact lenses.

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

How to Print your Vision ID Card: You can request your vision id card by contacting Superior Vision directly at 800-507-3800. You can also go to www.superiorvision.com and register/login to access your account by clicking on “Members” at the top of the page. You can also download the Superior Vision mobile app on your smart phone.

Copays Exam Materials1

$10 $25

Services/frequency Exam 12 months Frame 24 months Lenses 12 months Contact lenses 12 months

Monthly Premiums Employee Only Employee & Spouse Employee & Child(ren) Employee & Family

$9.99 $17.04 $18.02 $27.03

(based on date of service)

Benefits through Superior Select Southwest network

In-network

Out-of-network

Covered in full

Up to $35 retail

$150 retail allowance

Up to $70 retail

Single vision

Covered in full

Up to $25 retail

Bifocal

Covered in full

Up to $40 retail

Trifocal

Covered in full

Exam (ophthalmologist) Frames Lenses (standard) per pair

Progressives lens upgrade 4

Contact lenses Medically necessary contact lenses

Up to $45 retail 3

See description

Up to $45 retail

$120 retail allowance Covered in full

Up to $80 retail Up to $150 retail

Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements 1. Materials co-pay applies to lenses and frames only, not contact lenses 2. Standard contact lens fitting applies to a current contact lens user who wears disposable, daily wear, or extended wear lenses only. Specialty contact lens fitting applies to new contact wearers and/or a member who wear toric, gas permeable, or multi-focal lenses. 3. Covered to provider’s in-office standard retail lined trifocal amount; member pays difference between progressive and standard retail lined trifocal, plus applicable co-pay. 4. Contact lenses are in lieu of eyeglass lenses and frames benefit

20


Vision Insurance

EMPLOYEE BENEFITS

Superior Vision Discount Features

Look for providers in the provider directory who accept discounts, as some do not; please verify their services and discounts (range from 10%-30%) prior to service as they vary. Discounts on covered materials Frames:

20% off amount over allowance

Conventional Contacts

20% off amount over allowance

Disposable Contact

20% off amount over allowance

Discounts on non-covered exam, services and materials Exams, frames, and prescription lenses:

30% off retail

Contacts, miscellaneous options:

20% off retail

Disposable contact lenses:

10% off retail

Retinal imaging:

$39 maximum out-of-pocket 6

Maximum member out-of-pocket

The following options have out-of-pocket maximums5 on standard (not premium, brand, or progressive) lenses. Scratch coat

$15

Ultraviolet coat

$12

Tints, solid

$15

Tints, gradient

$18

Polycarbonate

$40

Blue light filtering

$15

Digital single vision

$30

Progressive lenses: Standard/Premium/Ultra/Ultimate

$55 / $110 / $150 / $225

Anti-reflective coating: Standard/Premium/Ultra/Ultimate

$50 / $70 / $85 / $120

Polarized lenses

$75

Plastic photochromic lenses

$80

High Index (1.67 / 1.74)

$80 / $120

6. Discounts and maximums may vary by lens type. Please check with your provider. Discounts are subject to change without notice.

Refractive Surgery

Hearing discounts

Superior Vision has a nationwide network of independent refractive surgeons and partnerships with leading LASIK networks who offer members a discount. These discounts range from 10%-50%, and are the best possible discounts available to Superior Vision.

A National Hearing Network of hearing care professionals, featuring Your Hearing Network, offers Superior Vision members discounts on services, hearing aids and accessories. These discounts should be verified prior to service. 21


Identity Theft

EMPLOYEE BENEFITS

iLock360 ABOUT IDENTITY THEFT PROTECTION Identity theft protection monitors and alerts you to identity threats. Resolution services are included should your identity ever be compromised while you are covered.

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

HAVE YOU EVER? Been a victim of a data breach? • Data breaches increased by 133% in 2018. • 1 in 3 notifed breach victims experience fraud.

FULL-SERVICE IDENTITY RESTORATION. Rest assured that iLOCK360 will work on your behalf to restore your identity. Our experts can complete all restoration activities for you, and we can even help you with pre-existing conditions.

PEACE OF MIND. 56% of victims have to take time off work Known someone that has been a victim of identity theft? to resolve an identity theft case on their own. With ID theft is the fastest growing crime, occurring once every 2 iLOCK360, you have experienced professionals in your seconds corner to restore your identity, so you can spend your time doing what you do best. Been concerned about your childrens’ and loved ones' identities being stolen? Identity Theft Child identity theft is projected to affect 25% of kids before turning 18. Employee $6.95 Employee & Family $13.95 Had your credit impacted by financial fraud? If a criminal gains access to your personal information, they can open new accounts in your name that you may not learn of until the damage is done.

HOW iLOCK360 HELPS DEFEND Your personal information is monitored 24/7/365 PROTECT Alerts inform you of potential threats for immediate action RESTORE iLOCK360 does the work to restore your identity

22


Disability Insurance

EMPLOYEE BENEFITS

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

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

What is Educator Disability Insurance? Educator Disability insurance is a hybrid that combines features of short-term and long-term disability into one plan. Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. The plan gives you flexibility to be able to choose an amount of coverage and waiting period that suits your needs. We offer Educator Disability insurance for you to purchase through UNUM.

Elimination Period: The Elimination Period is the length of time of continuous disability, due to sickness or injury, which must be satisfied before you are eligible to receive benefits. You may choose an Elimination Period (injury/sickness) of 0/7, 14/14, 30/30, 60/60, 90/90 or 180/180 days.

If, because of your disability, you are hospital confined as an inpatient, benefits begin on the first day of inpatient confinement. Inpatient means that you are confined to a If you need to file a claim, please contact UNUM at 800-858- hospital room due to your sickness or injury for 23 or more 6843. consecutive hours. (Applies to Elimination Periods of 30 days or less.) Benefit Amount: You may purchase a monthly benefit in $100 units, starting at a minimum of $200, up to 66 2/3% Definition of Disability: You are disabled when Unum of your monthly earnings rounded to the nearest $100, but determines that: not to exceed a monthly maximum benefit of $7,500. • you are limited from performing the material and Please see your Plan Administrator for the definition of substantial duties of your regular occupation due to monthly earnings. your sickness or injury; • you have a 20% or more loss in indexed monthly The total benefit payable to you on a monthly basis earnings due to the same sickness or injury; and (including all benefits provided under this plan) will not • during the elimination period you are unable to exceed 100% of your monthly earnings unless the excess perform any of the material and substantial duties of amount is payable as a Cost of Living Adjustment. However, your regular occupation. if you are participating in Unum’s Rehabilitation and Return to Work Assistance program, the total benefit payable to After benefits have been paid for 24 months, you are you on a monthly basis (including all benefits provided disabled when Unum determines that due to the same under this plan) will not exceed 110% of your monthly sickness or injury, you are unable to perform the duties of earnings (unless the excess amount is payable as a Cost of any gainful occupation for which you are reasonably fitted Living Adjustment). by education, training or experience. You must be under the regular care of a physician in order to be considered Eligibility: You are eligible for disability coverage if you are disabled. an active employee in the United States working a minimum of 20 hours per week. The date you are eligible Pre-Existing Condition Limitation: Benefits will not be paid for coverage is the later of: the plan effective date; or the for disabilities caused by, contributed to by, or resulting day after you complete the waiting period. from a pre-existing condition. You have a pre-existing 23


Disability Insurance UNUM condition if: • you received medical treatment, consultation, care or services including diagnostic measures, or took prescribed drugs or medicines in the 3 months just prior to your effective date of coverage; and • the disability begins in the first 12 months after your effective date of coverage. Maximum Benefit Duration: Your duration of benefits is based on your age when the disability occurs. Your duration of benefits is based on the following tables: For disabilities due to injury: Age at Disability

Maximum Duration of Benefits

Less than age 60

To age 65, but not less than 5 years

Age 60-64

5 years

Age 65-69

To age 70, but not less than 1 year

Age 70 and over

1 year

For disabilities due to sickness: Age at Disability

Maximum Duration of Benefits

Less than age 65

5 years

Age 65 through 68

To age 70, but not less than 1 year

Age 69 and over

1 year

Age 70 and over

1 year

Disability

24

Elimination Period

Monthly Benefit per $100

0/7

$4.02

14/14

$3.18

30/30

$2.66

60/60

$1.81

90/90 180/180

$1.57 $1.21

EMPLOYEE BENEFITS


Cancer Insurance

EMPLOYEE BENEFITS

APL ABOUT CANCER INSURANCE Cancer insurance offers you and your family supplemental insurance protection in the event you or a covered family member is diagnosed with cancer. It pays a benefit directly to you to help with expenses associated with cancer treatment.

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

Treatment for cancer is often lengthy and expensive. While your health insurance helps pay the medical expenses for cancer treatment, it does not cover the cost of non-medical expenses, such as out-of-town treatments, special diets, daily living and household upkeep. In addition to these nonmedical expenses, you are responsible for paying your health plan deductibles and/or coinsurance. Cancer insurance through American Public Life helps pay for these direct and indirect treatment costs so you can focus on your health.

Cancer Plan Monthly Premiums PLAN 1

PLAN 2

Employee Only Employee & Spouse Employee & Child(ren)

$19.80

$33.80

$41.70

$70.78

$25.78

$43.16

Employee & Family

$47.62

$80.18

Should you need to file a claim contact APL at 800-256-8606 or online at www.ampublic.com. You can find additional claim forms and materials at www.mybenefitshub.com/joshuaisd. Internal Cancer First Occurrence* Cancer Screening Rider Benefits Diagnostic Testing- 1 test per calendar year Follow Up-Diagnostic Testing- 1 test per calendar year Medical Imaging- per calendar year Cancer Treatment Policy benefits Radiation and Chemotherapy, Immunotherapy Maximum Per 12month period Hormone Therapy- Maximum of 12 treatments per calendar year Surgical Rider Benefits Surgical Anesthesia Bone Marrow Transplant-Maximum per lifetime Stem Cell Transplant- Maximum per lifetime Miscellaneous Care Rider Benefits Hair Piece (Wig)- 1 per lifetime Blood, Plasma &Platelets Ambulance- Ground /Air-Maximum of 2 trips per Hospital Confinement for all modes of transportation combined Heart Attack/Stroke First Occurrence Rider Benefits Lump Sum Benefit- Maximum per 1 covered person per lifetime Hospital Intensive Care Unit Rider Benefits Intensive Care Unit *Carcinoma in situ is not considered internal cancer

Plan 1 $2,500

Plan 2 $5,000

$50 per test $50 per test $100 per test $100 per test $500 per test/1 per calendar year Plan 1 Plan 2 $10,000

$20,000

$50 per treatment $50 per treatment Plan 1 Plan 2 $30 unit dollar amount Max $60 unit dollar amount Max $3,000 per operation $6,000 per operation 25% of amount paid for covered surgery $6,000 $12,000 $600 $600 Plan 1 Plan 2 $150 $150 $300 per day $300 per day $200/$2000 per trip

$200/$2000 per trip

Plan 1 $2,500 Plan 1 $600 per day

Plan 2 $2,500 Plan 2 $600 per day

Pre-Existing Condition Exclusion: Review the Plan Summary page that can be found at www.mybenefitshub.com/joshuaisd for full details. 25


Critical Illness Insurance The Hartford

EMPLOYEE BENEFITS

ABOUT CRITICAL ILLNESS Critical illness insurance can be used towards medical or other expenses. It provides a lump sum benefit payable directly to the insured upon diagnosis of a covered condition or event, like a heart attack or stroke. The money can also be used for non-medical costs related to the illness, including transportation, child care, etc.

For full plan details, please visit your benefit website: www.mybenefitshub.com/joshuaisd COVERAGE INFORMATION Benefit amounts for covered illnesses are based on the coverage amount in effect for you or an insured dependent at the time of diagnosis. COVERAGE AMOUNTS Employee Coverage Amount Spouse Coverage Amount Child(ren) Coverage Amount

$10,000; $20,000; or $30,000 Greater of $5,000 or 50% of your coverage amount $5,000

COVERED ILLNESSES CANCER CONDITIONS

BENEFIT AMOUNTS

Benign Brain Tumor*; Invasive Cancer* Non-invasive Cancer VASCULAR CONDITIONS Heart Attack*; Heart Transplant*; Stroke* Aneurysm; Angioplasty/Stent; Coronary Artery Bypass Graft OTHER SPECIFIED CONDITIONS Coma*; End Stage Renal Failure; Loss of Hearing; Loss of Speech; Loss of Vision; Major Organ Transplant*; Paralysis Bone Marrow Transplant ADDITIONAL BENEFITS Recurrence – Pays a benefit for a subsequent diagnosis of conditions marked with an asterisk (*) Health Screening Benefit FEATURES Coverage Maximum – Primary Insured & Spouse Coverage Maximum – Child (ren)

100% of coverage amount 25% of coverage amount

26

100% of coverage amount 25% of coverage amount

100% of coverage amount

25% of coverage amount BENEFIT AMOUNTS 100% of original benefit amount

$50 one time DETAILS 500% of coverage amount 300% of coverage amount

ASKED & ANSWERED WHO IS ELIGIBLE? You are eligible for this insurance if you are an active full-time employee who works at least 20 hours per week on a regularly scheduled basis and are less than age 80. Your spouse and child(ren) are also eligible for coverage. Any child(ren) must be under age 25. AM I GUARANTEED COVERAGE? This insurance is guaranteed issue coverage – it is available without having to provide information about your or your family’s health. All you have to do is elect the coverage to become insured. WHEN CAN I ENROLL? You may enroll during any scheduled enrollment period, within 31 days of the date you have a change in family status, or within 31 days of the completion of any eligibility waiting period established by your employer. WHEN DOES THIS INSURANCE BEGIN? The initial effective date of this coverage is September 1, 2018. Subject to any eligibility waiting period established by your employer, if you enroll for coverage prior to this date, insurance will become effective on this date. If you enroll for coverage after this date, insurance will become effective in accordance with the terms of the certificate (usually the first day of the month following the date you elect coverage). You must be actively at work with your employer on the day your coverage takes effect. Your spouse and child(ren) must be performing normal activities and not be confined (at home or in a hospital/care facility). WHEN DOES THIS INSURANCE END? This insurance will end when you or your dependent(s) no longer satisfy the applicable eligibility conditions, or when you reach the age of 80, premium is unpaid, you are no longer actively working, you leave your employer, or the coverage is no longer offered. CAN I KEEP THIS INSURANCE IF I LEAVE MY EMPLOYER OR AM NO


Critical Illness

EMPLOYEE BENEFITS

The Hartford

LONGER A MEMBER OF THIS GROUP? Yes, you can take this coverage with you. Coverage may be continued for you and your dependent(s) under a group portability policy. Your spouse may also continue insurance in certain circumstances. Pre-Existing Condition Limitation. We will not pay a benefit or any increase in benefits for any critical illness for a pre-existing condition, unless at the time of a positive diagnosis a covered person has been continuously insured under the policy or any prior group plan for 12 months. Pre-existing condition, as used in this limitation, means any critical illness for which medical care is received within the 12 month period prior to the effective date of insurance for a covered person or prior to the effective date of any increase in coverage for a covered person, under the policy or any prior group plan. Exclusions. This insurance does not provide benefits for any loss that results from or is caused by: • Suicide, attempted suicide or intentionally self-inflicted injury, whether sane or insane • War or act of war, declared or undeclared • A covered person's participation in a felony, riot or insurrection • A covered person's engaging in any illegal occupation • A covered person's service in the armed forces or units auxiliary to them General Limitations. Benefits under the policy are not payable for any covered illness: • Diagnosed prior to the effective date of insurance for a covered person (except for newborn children) • Diagnosed during an applicable benefit separation period • For which a covered person has already received a benefit payment under the policy, unless the covered illness is included in a recurrence provision For which a covered person has already received a benefit payment under the recurrence provision In addition, benefits are not payable for any critical illness not included as a covered illness in your certificate.

Critical Illness with Wellness Rider Age

Employee

Employee and Spouse

Employee and Child(ren)

Employee and Family

$10,000 18-29 30-39 40-49 50-59 60-69 70-79

$3.66 $5.11 $10.18 $19.55 $37.77 $66.60

$5.92 $8.11 $15.92 $30.47 $58.57 $102.58

$6.07 $7.04 $11.85 $21.14 $39.35 $68.18

$8.72 $10.35 $17.86 $32.33 $60.40 $104.41

$8.79 $11.17 $20.95 $39.57 $76.00 $133.66

$12.81 $16.53 $31.63 $60.56 $116.73 $204.74

$11.52 $15.30 $30.05 $58.00 $112.65 $199.13

$16.90 $22.71 $45.40 $88.80 $173.05 $305.07

$20,000 18-29 30-39 40-49 50-59 60-69 70-79

$6.39 $9.24 $19.29 $37.98 $74.42 $132.08

$10.01 $14.29 $29.69 $58.70 $114.89 $202.90 $30,000

18-29 30-39 40-49 50-59 60-69 70-79

$9.11 $13.37 $28.39 $56.41 $111.07 $197.56

$14.09 $20.47 $43.46 $86.94 $171.21 $303.23

27


Life and AD&D

EMPLOYEE BENEFITS

The Hartford ABOUT LIFE AND AD&D Group term life is the most inexpensive way to purchase life insurance. You have the freedom to select an amount of life insurance coverage you need to help protect the well-being of your family. Accidental Death & Dismemberment is life insurance coverage that pays a death benefit to the beneficiary, should death occur due to a covered accident. Dismemberment benefits are paid to you, according to the benefit level you select, if accidentally dismembered. For full plan details, please visit your benefit website: www.mybenefitshub.com/joshuaisd

newly eligible and elect an amount that exceeds the guaranteed issue amount of $200,000, you will need to provide evidence of insurability that is satisfactory to The • Applicant: Employee Only Hartford before the excess can become effective. If you • Coverage: $10,000 with AD&D included enroll after your annual or initial enrollment period, evidence of insurability will be required for all coverage WHO IS ELIGIBLE? You are eligible if you are an active full time employee who amounts. works at least 20 hours per week on a regularly scheduled If you enroll during your annual enrollment period or are basis. newly eligible and elect an amount that exceeds the guaranteed issue amount of $50,000, your spouse will BASIC LIFE AND AD&D PREMIUMS need to provide evidence of insurability that is satisfactory Your employer pays 100% of the premium for your to The Hartford before the excess can become effective. If coverage. you enroll after your annual or initial enrollment period, VOLUNTARY LIFE COVERAGE INFORMATION evidence of insurability will be required for all coverage amounts. This insurance is guaranteed issue coverage – it is Employee: Benefit: Increments of $10,000 available without having to provide information about your Maximum: $500,000 child(ren)’s health. Spouse: Benefit2: Increments of $10,000. Maximum: the lesser of 100% of your VOLUNTARY AD&D COVERAGE INFORMATION supplemental coverage or $500,000 You (the primary insured) may enroll for one of the Child(ren): Live Birth to 6 months - $1,000 following AD&D coverage amounts: increments of $10,000. 6 months to 26 - $10,000 The maximum amount you can elect is the lesser of 10 x WHO IS ELIGIBLE? earnings or $500,000. You are eligible if you are an active full time employee who works at least 20 hours per week on a regularly scheduled You may also enroll your dependent(s) for AD&D coverage. Your dependent(s) will be covered at a percentage of your basis. coverage amount Your spouse and child(ren) are also eligible for coverage. Any child(ren) must be under age 26. SPOUSE CHILD(REN)

BASIC LIFE AND AD&D COVERAGE INFORMATION

CAN I INSURE MY DOMESTIC OR CIVIL UNION PARTNER? Yes. Any reference to “spouse” in this document includes your domestic partner, civil union partner or equivalent, as recognized and allowed by applicable law. AM I GUARANTEED COVERAGE? If you enroll during your annual enrollment period or are 28

COVERAGE TIER

Spouse Child(ren) Spouse & Child(ren)

PERCENTAGE 50% 0% 50%

PERCENTAGE 0% 10% 10%


Life and AD&D

EMPLOYEE BENEFITS

The Hartford AD&D BENEFITS PERCENT OF COVERAGE AMOUNT PER ACCIDENT Covered accidents or death can occur up to 365 days after the accident. The total benefit for all losses due to the same accident will not exceed 100% of your coverage amount. COVERAGE LOSS FROM ACCIDENT AMOUNT Life 100% Both Hands or Both Feet or Sight of Both Eyes 100% One Hand and One Foot 100% Speech and Hearing in Both Ears 100% Either Hand or Foot and Sight of One Eye 100% Movement of Both Upper and Lower Limbs 100% (Quadriplegia) Movement of Both Lower Limbs (Paraplegia) 75% Movement of Three Limbs (Triplegia) 75% Movement of the Upper and Lower Limbs of 50% One Side of the Body (Hemiplegia) Either Hand or Foot 50% Sight of One Eye 50% Speech or Hearing in Both Ears 50% Movement of One Limb (Uniplegia) 25% Thumb and Index Finger of Either Hand 25%

Group Life (per $10,000) Employee Age

Employee and Spouse

18-29

$0.50

30-34

$0.70

35-39

$0.80

40-44

$0.80

45-49

$1.40

50-54

$2.20

55-59

$4.30

60-64

$6.60

65-69

$12.70

70-74

$20.60

75+

$32.20

Spouse rates based on Employee's age. Child Group Life (AGE 0-26) $10,000.00

$1.80

AD&D (per $10,000) Employee Only

$0.20

Employee and Family

$0.40

29


Individual Life Insurance

EMPLOYEE BENEFITS

5Star ABOUT INDIVIDUAL LIFE Individual insurance is a policy that covers a single person and is intended to meet the financial needs of the beneficiary, in the event of the insured’s death. This coverage is portable and can continue after you leave employment or retire.

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

Enhanced coverage options for employees. Easy and flexible enrollment for employers. The 5Star Life Insurance Company’s Family Protection Plan offers both Individual and Group products with Terminal Illness coverage to age 121, making it easy to provide the right benefit for you and your employees. CUSTOMIZABLE With several options to choose from, employees select the coverage that best meets the needs of their families.

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

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

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

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 Find full details and rates at www.mybenefitshub.com/ that will result in a limited life span of less than 12 months joshuaisd. (24 months in IL). Should you need to file a claim, contact 5Star directly at (866) 863-9753. PORTABLE Coverage continues with no loss of benefits or increase in cost if employment terminates after the first premium is paid. We simply bill the employee directly. CONVENIENCE Easy payments through payroll deduction. FAMILY PROTECTION Coverage is available for spouses and financially dependent children, even if the employee doesn’t elect coverage on themselves. *Financially dependent children 14 days to 23 years old.

PROTECTION TO 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.

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*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.


Individual Life Insurance 5Star Age on Eff. Date 18-25 26 27 28 29 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*

$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 $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 $48.50 $49.13 $52.62 $56.58 $61.09 $66.18

MONTHLY RATES WITH QUALITY OF LIFE RIDER DEFINED BENEFIT Employee Coverage Amounts $20,000 $30,000 $40,000 $50,000 $75,000 $100,000 $13.28 $16.68 $20.07 $23.46 $31.94 $40.42 $13.34 $16.75 $20.16 $23.59 $32.13 $40.66 $13.46 $16.96 $20.44 $23.92 $32.62 $41.34 $13.66 $17.26 $20.84 $24.42 $33.37 $42.34 $13.95 $17.68 $21.40 $25.13 $34.44 $43.75 $14.35 $18.28 $22.20 $26.12 $35.94 $45.75 $14.76 $18.90 $23.04 $27.16 $37.50 $47.84 $15.23 $19.61 $23.97 $28.34 $39.25 $50.17 $15.72 $20.33 $24.93 $29.55 $41.06 $52.58 $16.30 $21.20 $26.10 $31.00 $43.26 $55.50 $16.93 $22.16 $27.37 $32.59 $45.63 $58.67 $17.65 $23.23 $28.80 $34.37 $48.31 $62.25 $18.44 $24.40 $30.36 $36.34 $51.25 $66.16 $19.25 $25.63 $32.00 $38.38 $54.32 $70.25 $20.17 $27.00 $33.83 $40.67 $57.76 $74.83 $21.15 $28.48 $35.80 $43.13 $61.44 $79.75 $22.25 $30.13 $38.00 $45.87 $65.57 $85.25 $23.46 $31.96 $40.44 $48.92 $70.12 $91.34 $24.70 $33.81 $42.90 $52.00 $74.75 $97.50 $26.02 $35.78 $45.53 $55.30 $79.69 $104.08 $27.37 $37.80 $48.23 $58.67 $84.75 $110.83 $28.83 $40.00 $51.17 $62.33 $90.26 $118.17 $30.35 $42.28 $54.20 $66.13 $95.94 $125.75 $31.88 $44.58 $57.27 $69.96 $101.69 $133.42 $33.55 $47.08 $60.60 $74.13 $107.94 $141.75 $35.36 $49.81 $64.24 $78.67 $114.75 $150.84 $37.39 $52.83 $68.26 $83.71 $122.32 $160.91 $39.74 $56.35 $72.96 $89.59 $131.13 $172.66 $42.33 $60.26 $78.17 $96.09 $140.87 $185.67 $45.27 $64.65 $84.03 $103.42 $151.88 $200.33 $48.37 $69.31 $90.23 $111.17 $163.50 $215.83 $51.87 $74.56 $97.23 $119.92 $176.63 $233.33 $55.49 $79.98 $104.46 $128.96 $190.19 $251.41 $59.19 $85.53 $111.86 $138.21 $204.06 $269.91 $62.97 $91.21 $119.43 $147.67 $218.25 $288.83 $66.94 $97.15 $127.36 $157.59 $233.13 $308.66 $71.05 $103.33 $135.60 $167.88 $248.57 $329.25 $75.37 $109.80 $144.23 $178.67 $264.75 $350.83 $79.95 $116.68 $153.40 $190.13 $281.94 $373.75 $84.93 $124.16 $163.37 $202.59 $300.62 $398.67 $90.50 $132.51 $174.50 $216.50 $321.50 $426.50 $91.75 $134.38 $177.00 $219.63 $326.19 $432.75 $98.73 $144.85 $190.97 $237.08 $352.38 $467.67 $106.67 $156.75 $206.83 $256.92 $382.13 $507.33 $115.68 $170.28 $224.87 $279.46 $415.94 $552.42 $125.85 $185.53 $245.20 $304.88 $454.06 $603.25

EMPLOYEE BENEFITS

$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 $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 $531.50 $539.31 $582.96 $632.54 $688.90 $752.44

$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 $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 $636.51 $645.88 $698.25 $757.75 $825.38 $901.63 31


Emergency Medical Transport MASA

EMPLOYEE BENEFITS

ABOUT MEDICAL TRANSPORT Medical Transport covers emergency transportation to and from appropriate medical facilities by covering the out-of-pocket costs that are not covered by insurance. It can include emergency transportation via ground ambulance, air ambulance and helicopter, depending on the plan.

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

A MASA MTS Membership provides the ultimate peace of mind at an affordable rate for emergency ground and air transportation service within the United States and Canada, regardless of whether the provider is in or out of a given group healthcare benefits network. After the group health plan pays its portion, MASA MTS works with providers to deliver our members’ $0 in out-of-pocket costs for emergency transport. Emergent Air Transportation In the event of a serious medical emergency, Members have access to emergency air transportation into a medical facility or between medical facilities. Emergent Ground Transportation In the event of a serious medical emergency, Members have access to emergency ground transportation into a medical facility or between medical facilities.

Non-Emergency Inter-Facility Transportation In the event that a member is in stable condition in a medical facility but requires a heightened level of care that is not available at their current medical facility, Members have access to nonemergency air or ground transportation between medical facilities. Repatriation/Recuperation Suppose you or a family member is hospitalized more than 100-miles from your home. In that case, you have benefit coverage for air or ground medical transportation into a medical facility closer to your home for recuperation. Should you need assistance with a claim contact MASA at 800-643-9023. You can find full benefit details www.mybenefitshub.com/joshuaisd. Emergency Transportation Employee and Family

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$14.00


Flexible Spending Account (FSA) Higginbotham

EMPLOYEE BENEFITS

ABOUT FSA A Flexible Spending Account allows you to pay for eligible healthcare expenses with a pre-loaded debit card. You choose the amount to set aside from your paycheck every plan year, based on your employer’s annual plan limit. This money is use it or lose it within the plan year (unless your plan contains a $500 rollover or grace period provision).

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

Health Care FSA The Health Care FSA covers qualified medical, dental and vision expenses for you or your eligible dependents. You may contribute up to $2,850 annually to a Health Care FSA and you are entitled to the full election from day one of your plan year. Eligible expenses include: • Dental and vision expenses • Medical deductibles and coinsurance • Prescription copays • Hearing aids and batteries You may not contribute to a Health Care FSA if you enrolled in a High Deductible Health Plan (HDHP) and contribute to a Health Savings Account (HSA).

such as dependent parents. Reimbursement from your Dependent Care FSA is limited to the total amount deposited in your account at that time. To be eligible, you must be a single parent or you and your spouse must be employed outside the home, disabled or a full-time student.

Things to Consider Regarding the Dependent Care FSA • Overnight camps are not eligible for reimbursement (only day camps can be considered). • If your child turns 13 midyear, you may only request reimbursement for the part of the year when the child is under age 13. • You may request reimbursement for care of a spouse or dependent of any age who spends at least eight Higginbotham Benefits Debit Card hours a day in your home and is mentally or physically The Higginbotham Benefits Debit Card gives you immediate incapable of self-care. access to funds in your Health Care FSA when you make a • The dependent care provider cannot be your child purchase without needing to file a claim for under age 19 or anyone claimed as a dependent on reimbursement. If you use the debit card to pay anything your income taxes. other than a copay amount, you will need to submit an itemized receipt or an Explanation of Benefits (EOB). If you Important FSA Rules do not submit your receipts, you will receive a request for • The maximum per plan year you can contribute to a substantiation. You will have 60 days to submit your Health Care FSA is $2,850. The maximum per plan year receipts after receiving the request for substantiation you can contribute to a Dependent Care FSA is $5,000 before your debit card is suspended. Check the expiration when filing jointly or head of household and $2,500 date on your card to see when you should order a when married filing separately. replacement card(s). • You cannot change your election during the year unless you experience a Qualifying Life Event. Dependent Care FSA • You can continue to file claims incurred during the plan The Dependent Care FSA helps pay for expenses associated year for another 90days from August 31st. with caring for elder or child dependents so you or your • Your Health Care FSA debit card can be used for health spouse can work or attend school full time. You can use the care expenses only. It cannot be used to pay for account to pay for day care or baby sitter expenses for your dependent care expenses. children under age 13 and qualifying older dependents, 33


Flexible Spending Account (FSA) Higginbotham

EMPLOYEE BENEFITS

Over-the-Counter Item Rule Reminder

Higginbotham Flex Mobile App

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

Easily access your Health Care FSA on your smartphone or tablet with the Higginbotham mobile app. Search for Higginbotham in your mobile device’s app store and download as you would any other app.

Higginbotham Portal The Higginbotham Portal provides information and resources to help you manage your FSAs. • Access plan documents, letters and notices, forms, account balances, contributions and other plan information • Update your personal information • Utilize Section 125 tax calculators • Look up qualified expenses • Submit claims • Request a new or replacement Benefits Debit Card

Register on the Higginbotham Portal Visit https://flexservices.higginbotham.net and click Register. Follow the instructions and scroll down to enter your information. • Enter your Employee ID, which is your Social Security number with no dashes or spaces. • Follow the prompts to navigate the site. • If you have any questions or concerns, contact Higginbotham:  Phone – 866-419-3519  Email – flexclaims@higginbotham.net  Fax – 866-419-3516

View Accounts – Includes detailed account and balance information Card Activity – Account information SnapClaim – File a claim and upload receipt photos directly from your smartphone Manage Subscriptions – Set up email notifications to keep up-to-date on all account and Health Care FSA debit card activity Log in using the same username and password you use to log in to the Higginbotham Portal. Note: You must register on the Higginbotham Portal in order to use the mobile app.

FSAstore.Com FSAstore.com offers thousands of FSA-eligible products and services to purchase using your Higginbotham Benefits Debit Card or any major credit card. Competitive pricing and free shipping on orders over $50 can save you up to 40% using your FSA pretax dollars. Shop directly at FSAstore.com or have your physician submit prescriptions (when required). The FSAstore.com Services Channel allows you to search a database of more than 300,000 health care providers for nearby eligible services, such as acupuncture and chiropractic care. The FSAstore.com Learning Center focuses on answering common questions and keeping you informed about changes to your FSA benefits.

Flexible Spending Accounts Account Type

Health Care FSA

Dependent Care FSA 34

Eligible Expenses

Annual Contribution Limits

Benefit

Most medical, dental and vision care expenses Saves on eligible that are not covered by your health plan (such expenses not covered by as copayments, coinsurance, deductibles, $2,850 insurance, reduces your eyeglasses and doctor-prescribed over-thetaxable income counter medications) Dependent care expenses (such as day care, $5,000 single Reduces your taxable after-school programs or elder care programs) $2,500 if married and filing so you and your spouse can work or attend income separate tax returns school full-time


Notes

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2022 - 2023 Plan Year

Enrollment Guide General Disclaimer: This summary of benefits for employees is meant only as a brief description of some of the programs for which employees may be eligible. This summary does not include specific plan details. You must refer to the specific plan documentation for specific plan details such as coverage expenses, limitations, exclusions, and other plan terms, which can be found at the Joshua ISD Benefits Website. This summary does not replace or amend the underlying plan documentation. In the event of a discrepancy between this summary and the plan documentation the plan documentation governs. All plans and benefits described in this summary may be discontinued, increased, decreased, or altered at any time with or without notice. Rate Sheet General Disclaimer: The rate information provided in this guide is subject to change at any time by your employer and/or the plan provider. The rate information included herein, does not guarantee coverage or change or otherwise interpret the terms of the specific plan documentation, available at the Joshua ISD Benefits Website, which may include additional exclusions and limitations and may require an application for coverage to determine eligibility for the health benefit plan. To the extent the information provided in this summary is inconsistent with the specific plan documentation, the provisions of the specific plan documentation will govern in all cases.

WWW.MYBENEFITSHUB.COM/JOSHUAISD 36