2022-23 Texarkana ISD Benefit Guide

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2022 - 2023 Plan Year

TEXARKANA ISD

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

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

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10 12-17 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. 12

YOUR BENEFITS


Benefit Contact Information TEXARKANA ISD BENEFITS

TRS ACTIVECARE MEDICAL

TELEHEALTH

Financial Benefit Services (800) 583-6908 www.mybenefitshub.com/texarkanaisd

BCBSTX (866) 355-5999 www.bcbstx.com/trsactivecare

MDLive (888) 365-1663 www.mdlive.com

LIFE AND AD&D

DENTAL

VISION

Lincoln Financial Group (800) 423-2765 www.lfg.com

Lincoln Financial Group (800) 423-2765 www.lfg.com

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

CANCER

DISABILITY

FLEXIBLE SPENDING ACCOUNT (FSA)

APL (800) 256-8606 www.ampublic.com

Lincoln Financial Group (800) 423-2765 www.lfg.com

Higginbotham (866) 419-3519 www.higginbotham.net

HEALTH SAVINGS ACCOUNT (HSA)

HOSPITAL INDEMNITY

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

The Hartford Group #VHI-681609 www.thehartford.com

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All Your Benefits One App Employee benefits made easy through the FBS Benefits App! Text “FBS TXRK” 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 #: FBSTXRK

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Text

“FBS TXRK”

to (800) 583-6908 OR SCAN


How to Log In 1

www.mybenefitshub.com/texarkanaisd

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

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

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

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

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

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

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

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

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


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 31 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 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

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 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. 8

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 prescription drugs or is under a health care provider’s orders to take drugs, or received medical care or services (including diagnostic and/or consultation services).


Annual Benefit Enrollment

SUMMARY PAGES

Employee Eligibility Requirements

Dependent Eligibility Requirements

Supplemental Benefits: Eligible employees must work 20 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

CARRIER

MAXIMUM AGE

Medical

Blue Cross Blue Shield

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Dental

Cigna

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Vision

Superior Vision

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Cancer

APL

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Voluntary Life

UNUM

26

Hospital Indemnity

The Hartford

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Telehealth

MDLIVE

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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. 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 taxfree.

Employer Eligibility

A qualified high deductible health plan.

All employers

Contribution Source

Employee and/or employer

Employee and/or employer

Account Owner

Individual

Employer

Underlying Insurance Requirement

High deductible health plan

None

Minimum Deductible

$1,400 single (2022) $2,800 family (2022)

N/A

Maximum Contribution

$3,650 single (2022) $7,300 family (2022)

$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 Not permitted 65).

Description

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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PG. 30

FLIP TO FOR FSA INFORMATION

PG. 28


Notes

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Medical Insurance

EMPLOYEE BENEFITS

TRS ABOUT MEDICAL Major medical insurance is a type of health care coverage that provides benefits for a broad range of medical expenses that may be incurred either on an inpatient or outpatient basis.

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

Monthly Premium

District Contribution

Employee Cost

TRS ActiveCare HD Employee Only Employee & Spouse Employee & Child(ren) Employee & Family

$418.00

$242.00

$176.00

$1,176.00

$242.00

$934.00

$750.00

$242.00

$508.00

$1,407.00

$242.00

$1,165.00

TRS ActiveCare 2 Employee Only

$1,013.00

$242.00

$771.00

Employee & Spouse

$2,402.00

$242.00

$2,160.00

Employee & Child(ren)

$1,507.00

$242.00

$1,265.00

Employee & Family

$2,841.00

$242.00

$2,599.00

TRS ActiveCare Primary Employee Only Employee & Spouse Employee & Child(ren) Employee & Family

$406.00

$242.00

$164.00

$1,144.00

$242.00

$902.00

$730.00

$242.00

$488.00

$1,370.00

$242.00

$1,128.00

TRS ActiveCare Primary+ Employee Only Employee & Spouse Employee & Child(ren) Employee & Family

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$510.00

$242.00

$268.00

$1,246.00

$242.00

$1,004.00

$820.00

$242.00

$578.00

$1,567.00

$242.00

$1,325.00


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Telehealth

EMPLOYEE BENEFITS

MDLive 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/texarkanaisd

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.

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/fbs • 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 Employee and Family

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$10.00 $10.00


Life and AD&D

EMPLOYEE BENEFITS

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

Basic Life

Voluntary Group Life w/AD&D - per $1,000 in coverage Age Employee Spouse < 20 $0.04 $0.04 AT A GLANCE: 20-29 $0.04 $0.04 • A cash benefit of one times basic annual earnings, rounded to the next higher $1,000 30-34 $0.05 $0.05 ($160,000 maximum) to your loved ones in the event of your death, plus a matching cash 35-39 $0.08 $0.08 benefit if you die in an accident 40-44 $0.10 $0.10 • A cash benefit to you if you suffer a covered loss in an accident, such as losing a limb or your 45-49 $0.15 $0.15 eyesight 50-54 $0.23 $0.23 • Accident Plus - If you suffer an AD&D loss in an accident, you may also receive benefits for the 55-59 $0.42 $0.42 following on top of your core AD&D benefits: coma, plegia, education, child care, spouse 60-64 $0.58 $0.58 training, and more. 65-69 $1.05 $1.05 • LifeKeys® services, which provide access to counseling, financial, and legal support 70 + $1.70 $1.70 • TravelConnect® services, which give you and your family access to emergency medical Spouse rates based on Employee's assistance when you're on a trip 100+ miles from home age. Think about what your loved ones may face after you’re gone. Term life insurance can help them in so many ways, like covering everyday expenses, paying off debt, and protecting savings. AD&D provides even more coverage if you die or suffer a covered loss in an accident.

You also have the option to increase your cash benefit by securing additional coverage at affordable group rates. See the enclosed life insurance information for details.

Voluntary Group Life - Child(ren) $1,000 in coverage

ADDITIONAL DETAILS

0-26 $0.13 Conversion: You can convert your group term life coverage to an individual life insurance policy without providing evidence of insurability if you lose coverage due to leaving your job or for another reason outlined in the plan contract. AD&D benefits cannot be converted. Continuation of Coverage: You may be able to continue your coverage if you leave your job for any reason other than sickness, injury, or retirement. Benefit Reduction: Coverage amounts begin to reduce at age 75 and benefits terminate at retirement. See the plan certificate for details. For complete benefit descriptions, limitations, and exclusions, refer to the certificate of coverage.

Voluntary Term Life with AD&D The Lincoln Term Life and AD&D Insurance Plan: • Provides a cash benefit to your loved ones in the event of your death • Provides an additional cash benefit to your loved ones if you die – or to you if you lose a limb or your eyesight – in a covered accident

• •

Includes LifeKeys services, which provide access to counseling, financial and legal support services Also includes TravelConnect services, which give you and your family access to emergency medical assistance when you’re on a trip 100+ miles from home. 19


Life and AD&D

EMPLOYEE BENEFITS

Lincoln Financial Group Voluntary Term Life with AD&D Continued Employee Guaranteed coverage amount during initial offering or approved special enrollment period Newly hired employee guaranteed coverage amount Continuing employee guaranteed coverage annual increase amount Maximum coverage amount Minimum coverage amount AD&D coverage amount Spouse Guaranteed coverage amount during initial offering or approved special enrollment period Newly hired employee guaranteed coverage amount Continuing employee guaranteed coverage annual increase amount Maximum coverage amount Minimum coverage amount AD&D coverage amount Dependent Children Day 1 to age 26 guaranteed coverage amount

$250,000 $250,000 Up to $40,000 7 times your annual salary ($750,000 maximum in increments of $10,000) $10,000 Equal to the life insurance amount chosen $50,000 $50,000 Up to $20,000 100% of the employee coverage amount ($250,000 maximum in increments of $5,000) $5,000 Equal to the life insurance amount chosen $10,000

What your benefits cover Spouse Coverage - You can secure term life and AD&D insurance for your spouse if you select coverage for yourself. Guaranteed Life and AD&D Insurance Coverage Amount Guaranteed Life and AD&D Insurance Coverage Amount • Initial Open Enrollment: When you are first offered this • Initial Open Enrollment: When you are first offered this coverage, you can choose a coverage amount up to coverage, you can choose a coverage amount up to 100% of $250,000 without providing evidence of insurability. your coverage amount ($50,000 maximum) for your spouse without providing evidence of insurability. • Annual Limited Enrollment: If you are a continuing employee, you can increase your coverage amount up to • Annual Limited Enrollment: If you are a continuing employee, $40,000 without providing evidence of insurability. If you you can increase the coverage amount for your spouse up to submitted evidence of insurability in the past and were $20,000 without providing evidence of insurability. If you declined for medical reasons, you may be required to submitted evidence of insurability in the past and were declined submit evidence of insurability. for medical reasons, you may be required to submit evidence of insurability. • If you decline this coverage now and wish to enroll later, evidence of insurability may be required and may be at • If you decline this coverage now and wish to enroll later, your own expense. evidence of insurability may be required and may be at your Maximum Life Insurance Coverage Amount own expense. • You can choose a coverage amount up to 7 times your Maximum Life Insurance Coverage Amount annual salary ($750,000 maximum) with evidence of • You can choose a coverage amount up to 100% of your insurability. See the Evidence of Insurability page for coverage amount ($250,000 maximum) for your spouse with details. evidence of insurability. • Your coverage amount will reduce by 50% when you reach • Coverage amounts are reduced by 50% when an employee age 75. reaches age 75. Dependent Children Coverage - You can secure term life insurance for your dependent children when you choose coverage for yourself. Guaranteed Life Insurance Coverage Options: $10,000 Employee Coverage

Additional Plan Benefits Accelerated Death Benefit Premium Waiver Conversion Portability Seat Belt & Airbag Common Carrier 20

Included Included Included Included Included with AD&D Included with AD&D


Dental Insurance

EMPLOYEE BENEFITS

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

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

The Lincoln DentalConnect PPO Plans: • Cover many preventative, basic and major dental care services • Allow you to choose any dentist you wish, though can lower your out-of -pocket costs by selecting a contracting dentist • Don’t make you and your loved ones wait six months between routine cleanings • High Plan covers orthodontic treatment for children The Lincoln DentalConnect PPO Plan:

Policy Deductible

Dental Low Plan Employee Only $24.80 Employee and Spouse $56.77 Employee and Child(ren) $61.72 Employee and Family $90.30

Low Plan Contracting Non-Contracting Dentists Dentists Individual: $50 Family: $150 Waived for: Preventive

Individual: $50 Family: $150 Waived for: Preventive

High Plan $28.19 $64.51 $70.12 $102.63

High Plan Contracting Non-Contracting Dentists Dentists Individual: $50 Family: $150 Waived for: Preventive

Individual: $50 Family: $150 Waived for: Preventive

Deductibles are combined for basic and major Contracting Dentists’ services. Deductibles are combined for basic and major NonContracting Dentists’ services. Annual Maximum $500 $500 $1,000 $1,000 Annual Maximums are combined for preventive, basic, and major services. Lifetime Orthodontic Max N/A N/A $1,000 $1,000 Orthodontic Coverage N/A Available for dependent children. There are no benefit waiting There are no benefit waiting Waiting Period periods for any service types periods for any service types Services Preventative Services – routine oral exams, bitewing x-rays, 100% 100% 100% 100% routine cleanings, fluoride treatments, sealants and more* No Deductible No Deductible No Deductible No Deductible Basic Services – Problem focused exams, consultations, injections of antibiotics, fillings, simple extractions, surgical extractions periodontal surgery and more*

80% 80% 80% 80% After Deductible After Deductible After Deductible After Deductible

Major Services – Bridges, full and partial dentures, dental reline and rebase services, crowns, inlays, onlays and relative services, implants and implant related servcies

50% 50% 50% 50% After Deductible After Deductible After Deductible After Deductible

Orthodontics – Orthodontic exames, x-rays, extractions, appliances and more*

N/A

N/A

50% 50% After Deductible After Deductible

*Refer to the certificate of coverage for a full list of covered services. 21


Dental Insurance

EMPLOYEE BENEFITS

Lincoln Financial Group Contracting Dentists

Non-Contracting Dentists

Contracting Dentists/Non-Contracting Dentists To find a contracting dentist near you, visit www.LincolnFinancial.com/FindADentist. This plan lets you choose any dentist you wish. However, your out-of-pocket costs are likely to be lower when you choose a contracting dentist. For example, if you need a crown…

… you pay a deductible (if applicable), then 50% of the usual …you pay a deductible (if and customary fee, which is the applicable), then 50% of the maximum expense covered by the remaining discounted fee for PPO plan. You are responsible for the members. This is known as a PPO difference between the usual and contracted fee. customary fee and the dentist’s billed charge.

Visit LincolnFinancial.com/FindADentist where you can search by: • Location • Dentist name or office name • Distance you are willing to travel • Specialty, language and more Your search will automatically provide up to 100 dentists that most closely match your criteria. If your search does not locate the dentist you prefer, you can nominate one – just click the Nominate a Dentist link and complete the online form.

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Vision Insurance Superior Vision

EMPLOYEE BENEFITS

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/texarkanaisd

Lens Add-Ons Your Cost Anti-scratch coating $15 You can request your vision id card by contacting Superior Vision Ultraviolet coating $12 directly at 800-507-3800. You can also go to Tints – solids / gradient $15 / $18 www.superiorvision.com and register/login to access your account Polycarobonate lenses $40 by clicking on “Members” at the top of the page. You can also Blue light filtering $15 download the Superior Vision mobile app on your smart phone. Digital Single Vision $30 Progressive lenses Vision Rates (standard/premium/ultra/ $55 / $110 / $150 / $225 Employee Only $7.68 ultimate) Employee and Spouse $15.18 Anti-reflective coating Employee and Child(ren) $14.88 (standard/premium/ultra/ $50 / $70 / $85 /$120 ultimate) Employee and Family $22.62 Polarized lenses $75 Copays Frequency Plastic photochromatic lenses $80 Exam $10 Exam 12 months Hi-index (1.67 / 1.75) $80 / $120 Contact lens fitting Overage Discounts Amount copay (standard and $25 Frame 24 months Frames 20% off amount over allowance specialty) Convention contacts 20% off amount over allowance Specialty in-network Disposable contacts 10% off amount over allowance $50 Contact lens fitting 12 months allowance Non-Covered Services Amount Frames, in-network $125 Eyeglass lenses 12 months Discounts Materials $25 Contact lenses 12 months Exams, frames, prescription 30% off retail Contacts, in lieu of lenses $150 glasses Contacts, misc options 20% off retail Disposable contact lenses 10% off retail Out-of-Network Retinal imaging $39 cost Lenses (per pair) In-Network Charge Reimbursement Additional Out-of-Network Amount Single Vision Covered in-full Up to $32 Reimbursements Bifocal Covered in-full Up to $46 Eye exam (MD) Up to $42 Trifocal Covered in-full Up to $61 Eye exam (OD) Up to $37 Progressives See description* Up to $61 Frame Up to $70 Contact lens fitting *Covered to provider’s in-office standard retail lined trifocal amount; member Not covered (standard/specialty) pays difference between progressive and standard retail lined trifocal, plus applicable co-pay Contact lenses UP to $105

How to Print your Vision ID Card:

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Cancer Insurance

EMPLOYEE BENEFITS

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

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

THIS 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. Benefits Radiation Therapy/Chemotherapy/ Immunotherapy Benefit Hormone Therapy Benefit Surgical Schedule Benefit Anesthesia Benefit Hospital Confinement Benefit US Government/Charity Hospital/HMO Outpatient Hospital or Ambulatory Surgical Center Benefit Drugs & Medicine Benefit - Inpatient Drugs & Medicine Benefit - Outpatient Transportation & Outpatient Lodging Benefit Family Member Transportation & Lodging Benefit Blood, Plasma & Platelets Benefit Bone Marrow/Stem Cell Transplant Experimental Treatment Benefit Attending Physician Benefit Surgical Prosthesis Benefit Hair Prosthesis Benefit Dread Disease Benefit Hospice Care Benefit Inpatient Special Nursing Services Ambulance Ground Benefit Ambulance Air Benefit Extended Care Benefit Home Health Care Benefit 24

Cancer Low

High Low - w/ ICU High - w/ICU

Employee Only

$12.50 $27.10

$15.50

$30.10

Employee and Spouse

$22.10 $47.20

$28.40

$53.50

Employee and Child(ren) $17.30 $37.10 $22.10 $47.20 Employee and Family

$21.50

$41.30

$28.40

$53.50

SUMMARY OF BENEFITS Level 1 Plan $500 per calendar month of treatment

Level 2 Plan $1,500 per calendar month of treatment

$50 per treatment, up to 12 per calendar year $50 per treatment, up to 12 per calendar year $1,600 max per operation; $15 per surgical unit $4,800 max per operation; $45 per surgical unit 25% of the amount paid for covered surgery 25% of the amount paid for covered surgery $100 per day 1-90 days; $100 per day, 91+ days in lieu $300 per day 1-90 days; $300 per day, 91+ days in lieu of other benefits of other benefits $100 per day in lieu of most other benefits $300 per day in lieu of most other benefits $200 per day of surgery

$600 per day of surgery

$150 per confinement $150 per confinement $50 per prescription, up to $50 per cal month $50 per prescription, up to $150 per cal month $0.50 per mile per round trip $0.50 per mile per round trip $100 per day, up to 100 days per calendar year $100 per day, up to 100 days per calendar year $0.50 per mile per round trip $0.50 per mile per round trip $100 per day, up to 100 days per calendar year $100 per day, up to 100 days per calendar year $150 per day, up to $7,500 per calendar year $250 per day, up to $12,500 per calendar year Autologous - $500 per calendar year Autologous - $1,500 per calendar year Non-Autologous - $1,500 per calendar year Non-Autologous - $4,500 per calendar year Pays as any non-experimental benefit Pays as any non-experimental benefit $30 per day of confinement $50 per day of confinement $1,000 per device (includes surgical fee); max 1 device $3,000 per device (includes surgical fee); max 1 device per site, 2 lifetime max per site, 2 lifetime max $50 per hair prosthetic, 2 lifetime max $50 per hair prosthetic, 2 lifetime max $100 per day, 1-90 days of hospital confinement $300 per day, 1-90 days of hospital confinement $50 per day, $9,000 lifetime max $100 per day, $18,000 lifetime max $150 per day of confinement $150 per day of confinement $200 per ground trip $200 per ground trip $2,000 per air trip; up to 2 trips per hospital $2,000 per air trip; up to 2 trips per hospital confinement (any combination of ground/air) confinement (any combination of ground/air) $100 per day $300 per day $100 per day $300 per day


Cancer Insurance

EMPLOYEE BENEFITS

APL Benefits Second & Third Surgical Opinions Waiver of Premium Physical/Speech Therapy Benefit Riders Diagnostic Testing Benefit Rider Critical Illness Rider: Heart Attack/Stroke Optional Benefit Rider Intensive Care Unit Rider

SUMMARY OF BENEFITS CONTINUED Level 1 Plan Level 2 Plan $300 per diagnosis; additional $300 if third opinion re- $300 per diagnosis; additional $300 if third opinion quired required Premium waived after 90 days of primary insured con- Premium waived after 90 days of primary insured continuous total disability due to cancer tinuous total disability due to cancer $25 per visit, up to 4 visits per calendar month, $25 per visit, up to 4 visits per calendar month, $1,000 lifetime max $1,000 lifetime max $50; 1 person, per calendar year $2,500 lump sum benefit

$50; 1 person, per calendar year $2,500 lump sum benefit

$600 up to a max of 30 days per confinement

$600 up to a max of 30 days per confinement

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 which is primarily a place for alcoholics or drug addicts; the aged; a nursing, rest or convalescent nursing home; a mental institution or sanitarium; a facility contracted for or operated by the United States Government for treatment of members or ex-members of the armed forces (unless You are legally required to pay for services rendered in the absence of insurance); or, a long-term nursing unit or geriatrics ward.

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 30day period following the covered person’s effective date of coverage. 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 precancerous 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. 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 ten- month 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.

25


Disability Insurance

EMPLOYEE BENEFITS

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

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

Texarkana Independent School District provides this valuable benefit at no cost to you. Full-Time Employees

Long Term Disability Insurance Keep getting a check when you’re hurt or sick. You always have bills to pay, even when you can’t get to work due to injury, illness, or surgery. Long-term disability insurance helps you make ends meet during this difficult time.

ADDITIONAL DETAILS Coverage Period for Your Occupation: 36 months. After this initial period, you may be eligible to continue receiving benefits if your disability prohibits you from performing any employment for which you are reasonably suited through your training, education, and experience. In this case, your benefits may be extended through the end of your maximum coverage period (benefit duration).

Pre-existing Condition: If you have a medical condition that begins before your coverage takes effect, and you receive treatment for this condition within the 3 months leading up to your coverage start date, you may not be eligible for AT A GLANCE: benefits for that condition until you have been covered by • A cash benefit of 60% of your monthly salary (up to $5,000) starting 180 days after you are out of work and the plan for 12 months. continuing up to age 65 if the disability occurs at age For complete benefit descriptions, limitations, and 59 or before, 5 years if the disability occurs at age 60 exclusions, refer to the certificate of coverage. to 64, up to age 70 if the disability occurs at age 65 to 69, and 1 year if the disability occurs at age 70 or after This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not SM • EmployeeConnect services, which give you and your modify those provisions or the insurance in any way. This is not a binding family confidential access to counselors as well as contract. A certificate of coverage will be made available to you that describes the benefits in greater detail. Refer to your certificate for your maximum benefit personal, legal, and financial assistance. Program amounts. Should there be a difference between this summary and the contract, Services include: the contract will govern. • Unlimited, 24/7 access to information and referrals EmployeeConnectSM services are provided by ComPsych® Corporation, Chicago, IL. ComPsych® is a registered trademark of ComPsych® Corporation. ComPsych® • In-person help for short-term issues; up to four is not a Lincoln Financial Group® company. Coverage is subject to actual contract sessions with a counselor per person, per issue, language. Each independent company is solely responsible for its own obligations. Insurance products (policy series GL3001) are issued by The Lincoln per year. National Life Insurance Company (Fort Wayne, IN), which does not solicit • One free consultation with a network attorney business in New York, nor is it licensed to do so. Product availability and/or (with subsequent meetings at a reduced fee) features may vary by state. Limitations and exclusions apply. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. • Online tools, tutorials, videos and much more

Affiliates are separately responsible for their own financial and contractual obligations. Limitations and exclusions apply. Benefits Overview | The Lincoln National Life Insurance Company GP-ERPD-FLI001-TX - ©2019 Lincoln National Corporation - LCN-1821793-061517 -Q1.0

26


Disability Insurance

EMPLOYEE BENEFITS

Lincoln Financial Group Full-Time Employees

Short Term Disability Insurance Benefits At-A-Glance: Option One

Benefits At-A-Glance: Option Two

The Lincoln Short-term Disability Insurance Plan: • Provides a cash benefit when you are out of work for up to 24 weeks due to injury, illness, surgery, or recovery from childbirth • Provides a partial cash benefit if you can only do part of your job or work part time • Features group rates for Texarkana ISD employees • Offers a fast, no-hassle claims process

The Lincoln Short-term Disability Insurance Plan: • Provides a cash benefit when you are out of work for up to 24 weeks due to injury, illness, surgery, or recovery from childbirth • Provides a partial cash benefit if you can only do part of your job or work part time • Features group rates for Texarkana ISD employees • Offers a fast, no-hassle claims process

Short-term Disability 66.67% of your weekly salary, limited to $1,500 per week Sickness elimination period 14 days Accident elimination period 14 days Maximum coverage period 24 weeks

Short-term Disability 66.67% of your weekly salary, limited to $1,500 per week Sickness elimination period 30 days Accident elimination period 30 days Maximum coverage period 24 weeks

Weekly benefit amount

Weekly benefit amount

Sickness Elimination Period You must be out of work for 14 days due to an illness before you can collect disability benefits. You can begin collecting benefits on day 15. Accident Elimination Period You must be out of work for 14 days due to an accidental injury before you can collect disability benefits. You can begin collecting benefits on day 15. Pre-existing Condition If you have a medical condition that begins before your coverage takes effect, and you receive treatment for this condition within the 3 months leading up to your coverage start date, you may not be eligible for benefits for that condition until you have been covered by the plan for 12 months. Benefits Integration Your short-term disability benefits can coordinate with income from other sources, such as continued income or sick pay from your employer, during your disability. This allows you to receive up to 100% of your pre-disability income.

Sickness Elimination Period You must be out of work for 30 days due to an illness before you can collect disability benefits. You can begin collecting benefits on day 31. Accident Elimination Period You must be out of work for 30 days due to an accidental injury before you can collect disability benefits. You can begin collecting benefits on day 31. First Day Hospitalization The elimination period is reduced if you are hospitalized due to an illness or accidental injury. You can begin collecting benefits on the first day of hospitalization. Pre-existing Condition If you have a medical condition that begins before your coverage takes effect, and you receive treatment for this condition within the 3 months leading up to your coverage start date, you may not be eligible for benefits for that condition until you have been covered by the plan for 12 months. Benefits Integration Your short-term disability benefits can coordinate with income from other sources, such as continued income or sick pay from your employer, during your disability. This allows you to receive up to 100% of your pre-disability income.

Additional Plan Benefits 5% Rehabilitation Assistance Premium Waiver

Included Included

Open Enrollment

Additional Plan Benefits

When you are first offered this coverage (and during approved open enrollment periods), you can take advantage of this important coverage with no health examination.

5% Rehabilitation Assistance Premium Waiver

Voluntary Short Term Disability Premium

When you are first offered this coverage (and during approved open enrollment periods), you can take advantage of this important coverage with no health examination.

Here’s how little you pay with group rates. $ Your estimated monthly premium is determined by multiplying your weekly salary amount (up to $2,250) by the X premium rate of 0.04400. If your weekly salary exceeds $2,250, multiply $2,250 by =$ 0.04400.

weekly salary 0.04400 premium rate monthly premium

Included Included

Open Enrollment

Voluntary Short Term Disability Premium Here’s how little you pay with group rates.

Your estimated monthly premium is determined by multiplying your weekly salary amount (up to $2,250) by the premium rate of 0.04400. If your weekly salary exceeds $2,250, multiply $2,250 by 0.04400.

$ weekly salary

X

0.03507 premium rate

=$ monthly premium

For benefit exclusions and reductions, please visit your benefit website: www.mybenefitshub.com/texarkanaisd 27


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/texarkanaisd

Health Care FSA The Health Care FSA covers qualified medical, dental and vision expenses for you or your eligible dependents. You may contribute up to $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).

Higginbotham Benefits Debit Card The Higginbotham Benefits Debit Card gives you immediate access to funds in your Health Care FSA when you make a purchase without needing to file a claim for reimbursement. If you use the debit card to pay anything other than a copay amount, you will need to submit an itemized receipt or an Explanation of Benefits (EOB). If you do not submit your receipts, you will receive a request for substantiation. You will have 60 days to submit your receipts after receiving the request for substantiation before your debit card is suspended. Check the expiration date on your card to see when you should order a replacement card(s).

Dependent Care FSA The Dependent Care FSA helps pay for expenses associated with caring for elder or child dependents so you or your spouse can work or attend school full time. You can use the account to pay for day care or baby sitter expenses for your children under age 13 and qualifying older dependents, such as dependent parents. Reimbursement from your 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 hours a day in your home and is mentally or physically incapable of self-care. The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.

Important FSA Rules • • • •

The maximum per plan year you can contribute to a Health Care FSA is $2,850. The maximum per plan year you can contribute to a Dependent Care FSA is $5,000 when filing jointly or head of household and $2,500 when married filing separately. You cannot change your election during the year unless you experience a Qualifying Life Event. You can continue to file claims incurred during the plan year for another 90 days (up until November 30th) Your Health Care FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care expenses. 28


Flexible Spending Account (FSA) Higginbotham

EMPLOYEE BENEFITS

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

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

Register on the Higginbotham Portal Visit https://flexservices.higginbotham.net and click Register. Follow the instructions and scroll down to enter your information. • Enter your Employee ID, which is your Social Security number with no dashes or spaces. • Follow the prompts to navigate the site. • If you have any questions or concerns, contact Higginbotham: • Phone – 866-419-3519 • Email – flexclaims@higginbotham.net • Fax – 866-419-351

Higginbotham Flex Mobile App 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. • View Accounts – Includes detailed account and balance information • Card Activity – Account information • Snap Claim – 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 (FSA) Individual

$2,850.00

Dependent Care

$5,000.00

29


Health Savings Account (HSA)

EMPLOYEE BENEFITS

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

A Health Savings Account (HSA) is more than a way to help you and your family cover health care costs – it is also a tax-exempt tool to supplement your retirement savings and cover health expenses during retirement. An HSA can provide the funds to help pay current health care expenses as well as future health care costs. A type of personal savings account, an HSA is always yours even if you change health plans or jobs. The money in your HSA (including interest and investment earnings) grows tax-free and spends taxfree 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 • 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 30

Individual Family

Health Savings Account (HSA) $2,850.00 $5,000.00

You decide whether to use the money in your account to pay for qualified expenses or let it grow for future use. If you are 55 or older, you may make a yearly catch-up contribution of up to $1,000 to your HSA. If you turn 55 at any time during the plan year, you are eligible to make the catch-up contribution for the entire plan year.

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

Important HSA Information •

• •

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

How to Use your HSA • •

• •

Online/Mobile: Sign-in for 24/7 account access to check your balance, pay bills and more. Call/Text: (817) 882-0800. EECU’s dedicated member service representatives are available to assist you with any questions. Their hours of operation are Monday through Friday from 8:00 a.m. to 7:00 p.m. CT, Saturday 9:00 a.m. – 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

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

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

BENEFIT HIGHLIGHTS Hospital indemnity (HI) insurance pays a cash benefit if you or an insured dependent (spouse or child) are confined in a hospital for a covered illness or injury. Even with the best primary health insurance plan, out-of-pocket costs from a hospital stay can add up. The benefits are paid in lump sum amounts to you, and can help offset expenses that primary health insurance doesn’t cover (like deductibles, co-insurance amounts or co- pays), or benefits can be used for any non-medical expenses (like housing costs, groceries, car expenses, etc.). To learn more about Hospital Indemnity insurance, visit thehartford.com/employeebenefits

COVERAGE INFORMATION You have a choice of two hospital indemnity plans, which allows you the flexibility to enroll for the coverage that best meets your needs. Benefit amounts are based on the plan in effect for you or an insured dependent at the time the covered event occurs. Unless otherwise noted, the benefit amounts payable under each plan are the same for you and your dependent(s). PLAN INFORMATION Coverage Type Covered Events HSA Compatible BENEFITS HOSPITAL CARE First Day Hospital Confinement Up to 1 day per year Daily Hospital Confinement (Day 2+) Up to 30 days per year Daily ICU Confinement (Day 1+) Up to 30 days per year VALUE ADDED SERVICES Ability Assist® EAP4 – 24/7/365 access to help for financial, legal or emotional issues HealthChampionSM5 – Administrative & clinical support following serious illness or injury

Hospital Indemnity Plan 1 Employee Only $14.44 Employee and Spouse $26.09 Employee and Child(ren) $26.59 Employee and Family $40.25

Plan 2 $28.88 $52.19 $53.17 $80.51

OPTION 1 On and off-job (24 hour) Illness and injury Yes OPTION 1

OPTION 2 On and off-job (24 hour) Illness and injury Yes OPTION 2

$1,000 $100 $200 PLAN 1

$2,000 $200 $400 PLAN 3

Included

Included

Included

Included

ASKED & ANSWERED IS THIS COVERAGE HSA COMPATIBLE? If you (or any dependent(s)) currently participate in a Health Saving Account (HSA) or if you plan to do so in the future, you should be aware that the IRS limits the types of supplemental insurance you may have in addition to a HSA, while still maintaining the taxexempt status of the HSA. Both HSA compatible and non-HSA compatible plans are available to you, as indicated in the Plan Information section. If you have or 31


Hospital Indemnity The Hartford plan to open an HSA, please consult your tax and legal advisors to determine which supplemental benefits may be purchased by employees with an HSA. WHO IS ELIGIBLE? You are eligible for this insurance if you are an active full-time employee who works at least 20 hours per week on a regularly scheduled basis. Your spouse and child(ren) are also eligible for coverage. Any child(ren) must be under age 26. 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.

EMPLOYEE BENEFITS and Accident Insurance Company. Home Office is Hartford, CT. 5962h NS 08/16 © 2016 The Hartford Financial Services Group, Inc. All rights reserved. This Benefit Highlights document 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 document and the policy, the terms of the policy apply. Benefits are subject to state availability. Policy terms and conditions vary by state. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy as issued to the policyholder. Hospital does not include: convalescent homes, or convalescent, rest or nursing facilities; facilities affording primarily custodial, educational or rehabilitory care; or facilities primarily for care of the aged/elderly, persons with substance abuse issues/ disorders or mental/nervous disorders. Confinement means the assignment to a bed in a medical facility for a period of at least 20 consecutive hours. Required hours may vary by state. The Hartford compensates both internal and external producers, as well as others, for the sale and service of our products. For additional information regarding Hartford’s compensation practices, please review our website http://thehartford.com/group-benefits-producercompensation. Hospital Income Plan Form Series includes GBD-2800, GBD-2900, or state equivalent.

WHEN CAN I ENROLL? You may enroll during any scheduled enrollment period, or within LIMITATIONS & EXCLUSIONS 31 days of the date you have a change in family status. This insurance coverage includes certain limitations and exclusions. The certificate details all provisions, limitations, and WHEN DOES THIS INSURANCE BEGIN? exclusions for this insurance coverage. A copy of the certificate Insurance will become effective in accordance with the terms of can be obtained from your employer. the certificate (usually the first day of the month following the GROUP HOSPITAL INDEMNITY INSURANCE date you elect coverage). You must be actively at work with your employer on the day your LIMITATIONS AND EXCLUSIONS coverage takes effect. Your spouse and child(ren) must be The benefits payable are based on the insurance in effect on the performing normal activities and not be confined (at home or in a date of the covered event, subject to the definitions, limitations, hospital/care facility). exclusions and other provisions of the policy. WHEN DOES THIS INSURANCE END? This insurance will end when you or your dependents no longer satisfy the applicable eligibility conditions, premium is unpaid, you are no longer actively working, you leave your employer, or the coverage is no longer offered. CAN I KEEP THIS INSURANCE IF I LEAVE MY EMPLOYER OR AM NO LONGER A MEMBER OF THIS GROUP? Yes, you can take this coverage with you. Coverage may be continued for you and your dependent(s) under a group portability policy. Your spouse may also continue insurance in certain circumstances. The specific terms and qualifying events for portability are described in the certificate. 1“Hospital Adjusted Expenses per Inpatient Day.” Kaiser Family Foundation. 2015. Web. 2 Mar. 2017. 2For Hospital Care benefits, when an insured is eligible for more than one benefit in a single day, only the highest benefit will be paid. 3Rates and/or benefits may be changed. 4HealthChampionSM and Ability Assist® services are provided 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. Prepare. Protect. Prevail. With The Hartford. ® The Hartford® is The Hartford Financial Services Group, Inc. and its subsidiaries, including issuing companies Hartford Life Insurance Company and Hartford Life 32

You and your dependent(s) must be citizens or legal residents of the United States, its territories and protectorates. Other Hospital Indemnity Policy Limitation (Over-insurance Limitation): If an employee is insured under any other hospital indemnity policy underwritten by The Hartford, any claim for benefit is only payable under the one policy elected by the employee (or beneficiary or estate, in the event of death). We will return the amount of premium paid for any other policy that is declined by the employee retroactive to the later of: the last date any benefit was paid for any covered person under the other policy the effective date of insurance for the employee under the other policy


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

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