2023-24 McKinney ISD Benefit Guide

2023 - 2024 Plan Year

MCKINNEY ISD

BENEFIT GUIDE EFFECTIVE: 09/01/2023 - 8/31/2024 WWW.MYBENEFITSHUB.COM/MCKINNEYISD

1

Table of Contents How to Enroll

4-5

Annual Benefit Enrollment

6-11

1. Section 125 Cafeteria Plan Guidelines

7

2. Annual Enrollment

7

3. Eligibility Requirements

8

4. Helpful Definitions

9

5. Health Savings Account (HSA) vs. Flexible Spending Account (FSA)

10

Medical Health Savings Account (HSA) Flexible Spending Account (FSA)

2

FLIP TO...

12-18 19 20-21

Hospital Indemnity

22

Dental

23

Vision

24-25

Disability

26-27

Accident

28

Critical Illness

29-30

Life and AD&D

31-32

PG. 4

HOW TO ENROLL

PG. 6

SUMMARY PAGES

PG. 12

YOUR BENEFITS

Benefit Contact Information MCKINNEY ISD BENEFITS ADMINISTRATOR Financial Benefit Services Amanda Wallace (469) 385-4685 (469) 302‐4029 www.mybenefitshub.com/mckinneyisd benefits@mckinneyisd.net MCKINNEY ISD BENEFITS

FLEXIBLE SPENDING ACCOUNT (FSA) National Benefit Services (800) 274-0503 www.nbsbenefits.com

TRS ACTIVECARE MEDICAL

TRS HMO MEDICAL

HOSPITAL INDEMNITY

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

Scott & White HMO (844) 633-5325 www.trs.swhp.org

Unum Group #R0747188 (866) 679-3054 www.unum.com

DENTAL

VISION

CRITICAL ILLNESS

Delta Dental Group #04370 (800) 521-2651 www.deltadental.com

Avesis High Plan #10771-1205-01 Low Plan #10771-1205 (800) 522-0258 www.avesis.com

Unum Group #473073 (866) 679-3054 www.unum.com

LIFE AND AD&D

DISABILITY

ACCIDENT

Unum Group #148506 (866) 679-3054 www.unum.com

Unum Group #125328 (866) 679-3054 www.unum.com

Unum Group #R0747188 (866) 679-3054 www.unum.com

HEALTH SAVINGS ACCOUNT EECU (800) 333-9934 www.eecu.org

3

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

Text “FBS MCKINNEY” to (800) 583-6908

• Benefit Resources • Online Enrollment • Interactive Tools • And more!

App Group #: FBSMCKINNEY

4

OR SCAN

How to Log In 1

www.mybenefitshub.com/mckinneyisd

2

CLICK LOGIN

3

ENTER USERNAME & PASSWORD Your login credentials will be the same as your McKinney ISD login.

Username: Employee ID Password: district password If you do not know your username and password please contact the Help Desk at (469) 302-4048 or Email support@mckinneyisd.net

5

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):

QUALIFYING EVENTS

Marital Status

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

Change in Number of Tax Dependents

A change in number of dependents includes the following: birth, adoption and placement for adoption. You can add existing dependents not previously enrolled whenever a dependent gains eligibility as a result of a valid change in status event.

Change in Status of Employment Affecting Coverage Eligibility

Change in employment status of the employee, or a spouse or dependent of the employee, that affects the individual’s eligibility under an employer’s plan includes commencement or termination of employment.

Gain/Loss of Dependents’ Eligibility Status

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.

Judgment/ Decree/Order

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 Government Programs

6

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 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.

Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change.

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.

Where can I find forms?

For benefit summaries and claim forms, go to your benefit website: www.mybenefitshub.com/ mckinneyisd. 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 McKinney ISD benefit website: www.mybenefitshub.com/mckinneyisd. 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.

All new hire enrollment elections must be completed in the online enrollment system within the first 30 days If you do not receive your ID card, you can call the carrier’s customer service number to request another of benefit eligible employment. Failure to complete card. elections during this timeframe will result in the •

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

forfeiture of coverage.

Q&A Who do I contact with Questions?

For supplemental benefit questions, you can contact your Benefit Office or you can call Financial Benefit Services at (866) 914-5202 for assistance.

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.

7

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 2023 benefits become effective on September 1, 2023, you must be actively-at-work on September 1, 2023 to be eligible for your new benefits.

PLAN

MAXIMUM AGE

Medical

To 26

Dental

To 26

Vision

To 26

FSA

To 26

Life and AD&D

To 26

Accident

Unmarried to 26

Hospital Indemnity

Unmarried to 26

Critical Illness

Unmarried to 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 Benefit Office to request a continuation of coverage.

8

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 9/1/2023 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

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).

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)

Description

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, taxfree. This also allows employees to pay for qualifying dependent care tax-­free.

Employer Eligibility

A qualified high deductible health plan.

All employers

Contribution Source

Employee and/or employer

Employee and/or employer

Account Owner

Individual

Employer

Underlying Insurance Requirement

High deductible health plan

None

Minimum Deductible

$1,500 single (2023) $3,000 family (2023)

N/A

Maximum Contribution

$3,850 single (2023) $7,750 family (2023) 55+ catch up +$1,000

$3,050 (2023)

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).

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

10

PG. 19

FLIP TO

FOR FSA INFORMATION

PG. 20

Notes

11

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/mckinneyisd

Eligible employees must work 10 or more regularly scheduled hours each work week.

Monthly Premium

District Contribution

Employee Cost

TRS ActiveCare HD Employee Only

$462.00

$306.00

$156.00

Employee and Spouse

$1,248.00

$306.00

$942.00

Employee and Child(ren)

$786.00

$306.00

$480.00

Employee and Family

$1,571.00

$306.00

$1,265.00

TRS ActiveCare 2 Employee Only

$1,013.00

$306.00

$707.00

Employee and Spouse

$2,402.00

$306.00

$2,096.00

Employee and Child(ren)

$1,507.00

$306.00

$1,201.00

Employee and Family

$2,841.00

$306.00

$2,535.00

TRS ActiveCare Primary Employee Only

$450.00

$306.00

$144.00

Employee and Spouse

$1,215.00

$306.00

$909.00

Employee and Child(ren)

$765.00

$306.00

$459.00

Employee and Family

$1,530.00

$306.00

$1,224.00

TRS ActiveCare Primary+ Employee Only

$529.00

$306.00

$223.00

Employee and Spouse

$1,376.00

$306.00

$1,070.00

Employee and Child(ren)

$900.00

$306.00

$594.00

Employee and Family

$1,746.00

$306.00

$1,440.00

Central and North Texas Baylor Scott and White HMO

12

Employee Only

$569.76

$306.00

$263.76

Employee and Spouse

$1,432.42

$306.00

$1,126.42

Employee and Child(ren)

$916.49

$306.00

$610.49

Employee and Family

$1,648.78

$306.00

$1,342.78

You bet your boots big things happen here, including TRS-ActiveCare’s large network of doctors and hospitals.

TRS-ActiveCare Plan Highlights 2023-24 Learn the Terms.

• Premium: The monthly amount you pay for health care coverage.

• Deductible: The annual amount for medical expenses you’re responsible to pay before your plan begins to pay its portion.

• Copay: The set amount you pay for a covered service at the time you receive it. The amount can vary by the type of service.

• Coinsurance: The portion you’re required to pay for services after you meet your deductible. It’s often a specified percentage of the costs; i.e. you pay 20% while the health care plan pays 80%.

• Out-of-Pocket Maximum: The maximum amount you pay each year for medical costs. After reaching the out-of-pocket 13 maximum, the plan pays 100% of allowable charges for covered services.

762373.0523

2023-24 TRS-ActiveCare Plan Highlights Sept. 1, 2023 – How to Calculate Your Monthly Premium

All TRS-ActiveCare participants have three plan options. E TRS-ActiveCare Primary

Total Monthly Premium Your District and State Contributions

• Lowest premium of all three plans • Copays for doctor visits before you meet your deductible • Statewide network • Primary Care Provider (PCP) referrals required to see specialists • Not compatible with a Health Savings Account (HSA) • No out-of-network coverage

Plan Summary

Your Premium

TRS-

• Lower deductible t • Copays for many s • Higher premium • Statewide network • PCP referrals requi • Not compatible wit • No out-of-network

Ask your Benefits Administrator for your district’s specific premiums.

Monthly Premiums

Wellness Benefits at No Extra Cost* Being healthy is easy with:

• One-on-one health coaches

Your Premium

Total Premi

Employee Only

$450

$

$529

Employee and Spouse

$1,215

$

$1,376

Employee and Children

$765

$

$900

Employee and Family

$1,530

$

$1,746

Plan Features

• $0 preventive care • 24/7 customer service

Total Premium

Type of Coverage Individual/Family Deductible Coinsurance

In-Network Coverage Only You pay 30% after deductible

Individual/Family Maximum Out of Pocket

$7,500/$15,000

Network

Statewide Network

• Weight loss programs

In

$2,500/$5,000

PCP Required

Yes

Primary Care

$30 copay

Specialist

$70 copay

Urgent Care

$50 copay

You

• Nutrition programs • OviaTM pregnancy support

Doctor Visits

• TRS Virtual Health • Mental health benefits • And much more! *Available for all plans.

See the benefits guide for more details.

Immediate Care Emergency Care

You pay 30% after deductible

You

TRS Virtual Health-RediMD (TM)

$0 per medical consultation

$0

TRS Virtual Health-Teladoc

$12 per medical consultation

$1

®

New Rx Benefits!

Prescription Drugs Drug Deductible Generics (31-Day Supply/90-Day Supply)

• Express Scripts is your new pharmacy benefits manager! CVS pharmacies and most of your preferred pharmacies and medication are still included.

• Certain specialty drugs are still $0 through SaveOnSP. 14

Integrated with medical

$200 deducti

$15/$45 copay; $0 copay for certain generics

Preferred

You pay 30% after deductible

You

Non-preferred

You pay 50% after deductible

You

Specialty (31-Day Max)

$0 if SaveOnSP eligible; You pay 30% after deductible

Insulin Out-of-Pocket Costs

$25 copay for 31-day supply; $75 for 61-90 day supply

You

$25 copay for 3

Aug. 31, 2024

Each includes a wide range of wellness benefits.

-ActiveCare Primary+

TRS-ActiveCare HD

than the HD and Primary plans services and drugs

• Compatible with a Health Savings Account (HSA) • Nationwide network with out-of-network coverage • No requirement for PCPs or referrals • Must meet your deductible before plan pays for non-preventive care

k ired to see specialists th a Health Savings Account (HSA) coverage

ium

Your Premium

Total Premium

Your Premium

This plan is closed and not accepting new enrollees. If you’re currently enrolled in TRS-ActiveCare 2, you can remain in this plan.

TRS-ActiveCare 2 • Closed to new enrollees • Current enrollees can choose to stay in plan • Lower deductible • Copays for many services and drugs • Nationwide network with out-of-network coverage • No requirement for PCPs or referrals

Total Premium

Your Premium

$

$462

$

$1,013

$

$

$1,248

$

$2,402

$

$

$786

$

$1,507

$

$

$1,571

$

$2,841

$

n-Network Coverage Only

In-Network

Out-of-Network

$1,200/$2,400

$3,000/$6,000

$5,500/$11,000

$1,000/$3,000

$2,000/$6,000 You pay 40% after deductible $23,700/$47,400

In-Network

Out-of-Network

u pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible

You pay 20% after deductible

$6,900/$13,800

$7,500/$15,000

$20,250/$40,500

$7,900/$15,800

Statewide Network

Nationwide Network

Nationwide Network

Yes

No

No

$15 copay

You pay 30% after deductible

You pay 50% after deductible

$30 copay

You pay 40% after deductible

$70 copay

You pay 30% after deductible

You pay 50% after deductible

$70 copay

You pay 40% after deductible

$50 copay

You pay 30% after deductible

You pay 50% after deductible

$50 copay

You pay 40% after deductible

You pay a $250 copay plus 20% after deductible

u pay 20% after deductible

You pay 30% after deductible

0 per medical consultation

$30 per medical consultation

$0 per medical consultation

$42 per medical consultation

$12 per medical consultation

Integrated with medical

$200 brand deductible

12 per medical consultation

ible per participant (brand drugs only) $15/$45 copay

You pay 20% after deductible; $0 coinsurance for certain generics

$20/$45 copay

u pay 25% after deductible

You pay 25% after deductible

u pay 50% after deductible

You pay 50% after deductible

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

$0 if SaveOnSP eligible; u pay 30% after deductible

You pay 20% after deductible

31-day supply; $75 for 61-90 day supply

You pay 25% after deductible

You pay 50% after deductible ($100 min/$200 max)/ You pay 50% after deductible ($215 min/$430 max) $0 if SaveOnSP eligible; You pay 30% after deductible ($200 min/$900 max)/ No 90-day supply of specialty medications $25 copay for 31-day supply; $75 for 61-90 day supply

15

What’s New and What’s Changing This table shows you the changes between 2022-23 statewide premium price and this year’s 2023-24 regional price for your Education Service Center.

2022-23 Total Premium

TRS-ActiveCare Primary

TRS-ActiveCare HD

TRS-ActiveCare Primary+

TRS-ActiveCare 2 (closed to new enrollees)

New 2023-24 Total Premium

Change in Dollar Amount

Key Plan Changes

Employee Only

$410

$450

$40

Employee and Spouse

$1,157

$1,215

$58

• Individual maximum-out-of-pocket decreased by $650.

Previous amount was $8,150 and is now $7,500.

Employee and Children

$738

$765

$27

Employee and Family

$1,384

$1,530

$146

• Family maximum-out-of-pocket decreased by $1,300.

Previous amount was $16,300 and is now $15,000.

Employee Only

$422

$462

$40

Employee and Spouse

$1,187

$1,248

$61

Employee and Children

$757

$786

$29

Employee and Family

$1,419

$1,571

$152

• Individual maximum-out-of-pocket increased by $450 to match IRS guidelines. Previous amount was $7,050 and is now $7,500.

• Family maximum-out-of-pocket increased by $900 to match IRS guidelines. Previous amount was $14,100 and is now $15,000.

These changes apply only to in-network amounts.

Employee Only

$515

$529

$14

Employee and Spouse

$1,259

$1,376

$117

Employee and Children

$829

$900

$71

Employee and Family

$1,584

$1,746

$162

Employee Only

$1,013

$1,013

$0

Employee and Spouse

$2,402

$2,402

$0

• No changes.

Employee and Children

$1,507

$1,507

$0

• This plan is still closed to new enrollees.

Employee and Family

$2,841

$2,841

$0

• Family deductible decreased by $1,200.

Previous amount was $3,600 and is now $2,400.

• Primary care provider copay decreased from $30 to $15.

At a Glance

16

Primary

HD

Primary+

Premiums

Lowest

Lower

Higher

Deductible

Mid-range

High

Low

Copays

Yes

No

Yes

Network

Statewide network

Nationwide network

Statewide network

PCP Required?

Yes

No

Yes

HSA-eligible?

No

Yes

No

Effective: Sept. 1, 2023

Compare Prices for Common Medical Services

REMEMBER: Benefit

Call a Personal Health Guide (PHG) any time 24/7 to help you find the best price for a medical service. Reach them at 1-866-355-5999.

TRS-ActiveCare Primary

TRS-ActiveCare Primary+

In-Network Only

In-Network Only

Office/Indpendent Lab: You pay $0

Office/Indpendent Lab: You pay $0

TRS-ActiveCare HD In-Network

In-Network

Out-of-Network

Office/Indpendent Lab: You pay $0 You pay 30% after deductible

Diagnostic Labs*

Out-of-Network

TRS-ActiveCare 2

You pay 40% after deductible

You pay 50% after deductible

Outpatient: You pay 30% after deductible

Outpatient: You pay 20% after deductible

High-Tech Radiology

You pay 30% after deductible

You pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible

You pay 20% after deductible + $100 copay per procedure

You pay 40% after deductible + $100 copay per procedure

Outpatient Costs

You pay 30% after deductible

You pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible

You pay 20% after deductible ($150 facility copay per incident)

You pay 40% after deductible ($150 facility copay per incident)

Inpatient Hospital Costs

You pay 30% after deductible

You pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible ($500 facility per day maximum)

You pay 20% after deductible ($150 facility copay per day)

You pay 40% after deductible ($500 facility per day maximum)

Freestanding Emergency Room

You pay $500 copay + 30% after deductible

You pay $500 copay + 20% after deductible

You pay $500 copay + 30% after deductible

You pay $500 copay + 50% after deductible

You pay $500 copay + 20% after deductible

You pay $500 copay + 40% after deductible

Facility: You pay 30% after deductible

Facility: You pay 20% after deductible

Facility: You pay 20% after deductible ($150 facility copay per day)

Professional Services: Professional Services: You pay $5,000 You pay $5,000 copay + 20% after copay + 30% after deductible deductible

Professional Services: You pay $5,000 copay + 20% after deductible

Bariatric Surgery

Outpatient: You pay 20% after deductible

Not Covered

Not Covered

Not Covered

Only covered if rendered at a BDC+ facility

Only covered if rendered at a BDC+ facility

Only covered if rendered at a BDC+ facility

Annual Vision Exam (one per plan year; performed by an ophthalmologist or optometrist)

You pay $70 copay

You pay $70 copay

You pay 30% after deductible

You pay 50% after deductible

You pay $70 copay

You pay 40% after deductible

Annual Hearing Exam (one per plan year)

$30 PCP copay $70 specialist copay

$30 PCP copay $70 specialist copay

You pay 30% after deductible

You pay 50% after deductible

$30 PCP copay $70 specialist copay

You pay 40% after deductible

*Pre-certification for genetic and specialty testing may apply. Contact a PHG at 1-866-355-5999 with questions.

www.trs.texas.gov Revised 05/30/23

17

2023-24 Health Maintenance Organization (HMO) Plans and Premiums for Select Regions of the State

REMEMBER:

Remember that when you choose an HMO, you’re choosing a regional network.

TRS contracts with HMOs in certain regions to bring participants in those areas additional options.

HMOs set their own rates and premiums. They’re fully insured products who pay their own claims.

Total Monthly Premiums

Central and North Texas Baylor Scott & White Health Plan

Blue Essentials - South Texas HMO

Brought to you by TRS-ActiveCare

Brought to you by TRS-ActiveCare

You can choose this plan if you live in one of these counties: Austin, Bastrop, Bell, Blanco, Bosque, Brazos, Burleson, Burnet, Caldwell, Collin, Coryell, Dallas, Denton, Ellis, Erath, Falls, Freestone, Grimes, Hamilton, Hays, Hill, Hood, Houston, Johnson, Lampasas, Lee, Leon, Limestone, Madison, McLennan, Milam, Mills, Navarro, Robertson, Rockwall, Somervell, Tarrant, Travis, Walker, Waller, Washington, Williamson

You can choose this plan if you live in one of these counties: Cameron, Hildalgo, Starr, Willacy

Total Premium

Your Premium

Total Premium

Your Premium

Blue Essentials - West Texas HMO Brought to you by TRS-ActiveCare You can choose this plan if you live in one of these counties: Andrews, Armstrong, Bailey, Borden, Brewster, Briscoe, Callahan, Carson, Castro, Childress, Cochran, Coke, Coleman, Collingsworth, Comanche, Concho, Cottle, Crane, Crockett, Crosby, Dallam, Dawson, Deaf Smith, Dickens, Donley, Eastland, Ector, Fisher, Floyd, Gaines, Garza, Glasscock, Gray, Hale, Hall, Hansford, Hartley, Haskell, Hemphill, Hockley, Howard, Hutchinson, Irion, Jones, Kent, Kimble, King, Knox, Lamb, Lipscomb, Llano, Loving, Lubbock, Lynn, Martin, Mason, McCulloch, Menard, Midland, Mitchell, Moore, Motley, Nolan, Ochiltree, Oldham, Parmer, Pecos, Potter, Randall, Reagan, Reeves, Roberts, Runnels, San Saba, Schleicher, Scurry, Shackelford, Sherman, Stephens, Sterling, Stonewall, Sutton, Swisher, Taylor, Terry, Throckmorton, Tom Green, Upton, Ward, Wheeler, Winkler, Yoakum Total Premium

Your Premium

Employee Only

$553.45 $569.76

$

N/A

$

N/A

$

Employee and Spouse

$1,390.74 $1,432.42

$

N/A

$

N/A

$

Employee and Children

$889.98 $916.49

$

N/A

$

N/A

$

Employee and Family

$1,600.72 $1,648.78

$

N/A

$

N/A

$

Plan Features Type of Coverage Individual/Family Deductible Coinsurance Individual/Family Maximum Out of Pocket

In-Network Coverage Only

N/A

N/A

$2,400/$4,800

N/A

N/A

You pay 25% after deductible

N/A

N/A

$8,150/$16,300

N/A

N/A

Doctor Visits Primary Care

$20 copay

N/A

N/A

Specialist

$70 copay

N/A

N/A

$45 $40 copay

N/A

N/A

$500 copay after deductible

N/A

N/A

Immediate Care Urgent Care Emergency Care

Prescription Drugs Drug Deductible

$200 (excl. generics)

N/A

N/A

Days Supply

30-day supply/90-day supply

N/A

N/A

$14/$35 copay

N/A

N/A

Preferred Brand

Generics

You pay 35% after deductible

N/A

N/A

Non-preferred Brand

You pay 50% after deductible

N/A

N/A

Specialty

You pay 35% after deductible

N/A

N/A

www.trs.texas.gov Revised 18 05/30/23

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/mckinneyisd

A Health Savings Account (HSA) is more than a way to help you and your family cover health care costs – it is also a tax-exempt tool to supplement your retirement savings and cover health expenses during retirement. An HSA can provide the funds to help pay current health care expenses as well as future health care costs.

A type of personal savings account, an HSA is always yours even if you change health plans or jobs. The money in your HSA (including interest and investment earnings) grows tax-free and spends tax-free if used to pay for qualified medical expenses.

There is no “use it or lose it” rule — you do not lose your money if you do not spend it in the calendar year — and there are no vesting requirements or forfeiture provisions. The account automatically rolls over year after year.

HSA Eligibility You are eligible to open and contribute to an HSA if you are: • Enrolled in an HSA-eligible High Deductible Health Plan (HDHP) • Not enrolled in Medicare or TRICARE • If you enroll in an HSA and FSA, the FSA becomes a Limited Purpose FSA and may only be used for Dental and Vision, not medical expenses.

• Not eligible to be claimed as a dependent on someone else’s tax return 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 by the HDHP.

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.

Qualified Expenses

You can use your HSA for a wide range of qualified expenses, such as doctor’s visits, prescription drugs, lab work, medical equipment, contacts lenses, dental work, physical therapy… the list goes on! Refer to IRS Publication 502 for comprehensive guidelines.

Important HSA Information • •

• • • •

Maximum Contributions

Your HSA contributions may not exceed the annual maximum amount established by the Internal Revenue Service. The annual contribution maximum for 2023 is based on the coverage option you elect: • Individual – $3,850 • Family (filing jointly) – $7,750

• •

You will receive a debit card to manage your Health Savings Account. Keep in mind, available funds are limited to the balance in your HSA. 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.

Online/Mobile: Sign-in for 24/7 account access to check your balance, pay bills and more.

Call/Text: (817) 882-0800 EECU’s dedicated member service representatives are available to assist you with any questions.

Their hours of operation are Monday through Friday from 8:00 a.m. to 7:00 p.m. CT, Saturday 9:00 a.m. to 1:00 p.m. CT and closed on Sunday.

Lost/Stolen Debit Card: Call the 24/7 debit card hotline at (800) 333-9934.

Stop by a local EECU financial center for in-person assistance; find locations & service hours at www.eecu.org/locations.

19

Flexible Spending Account (FSA) NBS

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.

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

Health Care FSA

The Health Care FSA covers qualified medical, dental and vision expenses for you or your eligible dependents. You may contribute up to $3,050 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).

How the Health Care FSAs Work

You can access the funds in your Health Care FSA two different ways: • Use your NBS Debit Card to pay for qualified expenses, doctor visits and prescription copays.

• Pay out-of-pocket and submit your receipts for reimbursement: ◊ Fax – (844) 438-1496 ◊ Email – service@nbsbenefits.com ◊ Online – my.nbsbenefits.com ◊ Call for Account Balance: (855) 399-3035 ◊ Lost or Stolen Debit Cards Replacement Fee $5.00 (taken from account balance) ◊ Mail: PO Box 6980 West Jordan, UT 84084

Contact NBS • • • •

Hours of Operation: 6:00 AM – 6:00 PM MST, Mon-Fri Phone: (800) 274-0503 Email: service@nbsbenefits.com Mail: PO Box 6980 West Jordan, UT 84084

Dependent Care FSA

This account 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.

20

Flexible Spending Account (FSA) NBS

EMPLOYEE BENEFITS

General Plan Information

Plan Year End……………………………... August 31st Run-out Period…………………………… 90 Days Maximum Medical Limit…………….. Current IRS limit $3,050

See Code Section 125(i)(2) or current enrollment information

Maximum Dependent Care Limit.. $5,000 Health FSA Carryover………………….. Up to $500 following the Plan run-out Amounts exceeding $500 will be forfeited

Deadlines to Use Funds Health FSA…………………………………. November 29 following Plan Year End DCAP………………………………………….. November 29 following Plan Year End FSA Mid-year termination………….. 90 days following termination date DCAP Mid-year termination……….. 90 days following termination date

Over-the-Counter (OTC) Item Rule

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

FSAstore.Com

FSAstore.com offers thousands of FSA-eligible products and services to purchase using your FSA Debit Card or any major credit card. Competitive pricing and free shipping on orders over $50 can save you up to 40% using your FSA pretax dollars. Shop directly at www.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.

21

Hospital Indemnity

EMPLOYEE BENEFITS

Unum

ABOUT HOSPITAL INDEMNITY This is an affordable supplemental plan that pays you should you be in­ patient 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/mckinneyisd

How does it work?

Hospital Insurance helps covered employees and their families cope with the financial impacts of a hospitalization. You can receive benefits when you’re admitted to the hospital for a covered accident, illness or childbirth based on the schedule below: Benefit

Description

Coverage

Hospital Admission

Payable for a maximum of 1 day per year

$1,000

ICU Admission

Payable for a maximum of 1 day per year

$1,000

Hospital Indemnity Monthly Rates Employee Only Employee and Spouse Employee and Child(ren) Employee and Family

$12.38 $22.42 $17.54 $27.58

Pre-existing Condition defined by the carrier.

We will not pay benefits for a claim when the Covered Loss occurs in the first 12 months following an Insured’s Coverage Effective Date and the Covered Loss is caused by, contributed to by, or resulting from any of the following: • a Pre-existing Condition; or complications arising from treatment or surgery for, or medications taken for, a Pre-existing Condition.

• An Insured has a Pre-existing Condition if, within the 12 months just prior to their Coverage Effective Date, they have a a disease or physical condition whether diagnosed or not, for which: • medical treatment, consultation, care or services, or diagnostic measures were received or recommended to be received during that period; or • drugs or medications were taken, or prescribed to be taken during that period; or • symptoms existed.

• Pre-existing Condition requirements are not applicable to: • Children who are newly acquired after your Coverage Effective Date.

The Pre-existing Condition provision applies to any Insured’s initial coverage and any increases in coverage. Coverage Effective Date refers to the date any initial coverage or increases in coverage become effective.

Be Well Benefit Every year, each family member who has Hospital coverage can also receive $50 for getting a covered Be Well screening test, such as: • Annual exams by a physician include sports physicals, wellchild visits, dental and vision exams • Screenings for cancer, including pap smear, colonoscopy • Cardiovascular function screenings • Screenings for cholesterol and diabetes • Imaging studies, including chest X-ray, mammography • Immunizations including HPV, MMR, tetanus, influenza

22

Dental Insurance

EMPLOYEE BENEFITS

Delta Dental 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/mckinneyisd

Need to Contact the Carrier?

Delta Dental Insurance Company 1130 Sanctuary Parkway, Suite 600 Alpharetta, GA 30009

Customer Service deltadentalins.com/enrollees (800) 521-2651

Eligibility Deductibles Deductibles waived for Diagnostic & Preventive (D & P) and Orthodontics?

Maximums D & P counts toward maximum?

Waiting Period(s) Benefits and Covered Services* Diagnostic & Preventive Services (D&P) Exams, cleanings, x-rays and sealants Basic Services Fillings Endodontics (root canals) Covered Under Basic Services Periodontics (gum treatment) Covered Under Basic Services Oral Surgery Covered Under Basic Services Major Services Crowns, inlays, onlays and cast restorations Prosthodontics Bridges and dentures Orthodontic Benefits Dependent children Orthodontic Maximums

Dental Monthly Rates Employee Only Employee and 1 Dependent Employee and 2 or more Dependents

$45.77 $81.00 $104.48

Plan Benefit Highlights Primary enrollee, spouse, and eligible dependent children to age 26 $50 per person / $150 per family each plan year Yes $1,500 per person each plan year Yes Basic Benefits Major Benefits None None Delta Dental DPO dentists**

Prosthodontics Orthodontics None None Non-Delta Dental DPO dentists**

100%

100%

80%

80%

80%

80%

80%

80%

80%

80%

50%

50%

50%

50%

50%

50%

$1,500 Lifetime

$1,500 Lifetime

* Limitations or waiting periods may apply for some benefits; some services may be excluded from your plan. Reimbursement is based on Delta Dental maximum contract allowances and not necessarily each dentist’s submitted fees. ** Reimbursement is based on DPO contracted fees for DPO dentists, Premier contracted fees for Premier dentists and program allowance for non-Delta Dental dentists.

23

Vision Insurance

EMPLOYEE BENEFITS

Avesis

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/mckinneyisd

Reliable & Dependable

Avēsis is a national leader in providing exceptional vision care benefits for millions of commercial members throughout the country. The Avēsis Vision care products give our members an easy-to-use wellness benefit that provides excellent value and protection.

Here’s How It Works

When you need to see an eye care professional, simply visit www.avesis.com or contact Avēsis’ Customer Service Monday through Friday, 7:00 AM to 8:00 PM (EST) at (800) 828-9341 to receive a listing of providers in your area.

1. Select a provider 2. Make an appointment 3. Visit provider for service 4. Pay any copays or additional expenses

Vision Monthly Rates High Employee Only $11.13 Employee and Spouse $19.75 Employee and Child(ren) $22.93 Employee and Family $29.08

Low $7.38 $12.88 $15.18 $18.82

How can we help you?

Avēsis website: www.avesis.com Customer Service: (800) 828-9341 7:00 AM - 8:00 PM EST LASIK Provider: (877) 712-2010

High Plan

Low Plan

Vision Care Services

In-Network Member Cost

Out-of-Network Reimbursement

In-Network Member Cost

Out-of-Network Reimbursement

Vision Examination (Includes Refraction)

Covered in full after $10 copay

Up to $35

Covered in full after $10 copay

Up to $35

Contact Lens Fit and Follow-up Standard Contact Lens Fitting Custom Contact Lens Fitting Materials*

Up to $50 member out-of­-pocket maximum Up to $75 member out-of­-pocket maximum

N/A

out-of-pocket maximum: Up to $50

N/A

N/A

Up to $75

N/A

$20 copay

$20 copay

(Materials copay applies to frame or spectacle lenses, if applicable.)

(Materials copay applies to frame or spectacle lenses, if applicable.)

Frame Allowance

(Up to 20% discount above frame allowance.)

24

$150 allowance

Up to $50

$150 allowance

Up to $50

Vision Insurance

EMPLOYEE BENEFITS

Avesis

High Plan Vision Care Services

Low Plan

In-Network Member Cost

Out-of-Network Reimbursement

In-Network Member Cost

Out-of-Network Reimbursement

Single Vision

Covered in full after $20 copay

Up to $25

Covered in full after $20 copay

Up to $25

Bifocal

Covered in full after $20 copay

Up to $40

Covered in full after $20 copay

Up to $40

Trifocal

Covered in full after $20 copay

Up to $50

Covered in full after $20 copay

Up to $50

Lenticular

Covered in full after $20 copay

Up to $80

Covered in full after $20 copay

Up to $80

Covered in full

Up to $10

$40/$44

N/A

Standard Scratch-Resistant Coating

Covered in full

Up to $5

$17

N/A

Ultra-Violet Screening

Covered in full

Up to $6

$15

N/A

Solid or Gradient Tint

Covered in full

Up to $4

$17

N/A

Standard Anti-Reflective Coating

Covered in full

Up to $24

$45

N/A

Level 1 Progressives

Covered in full

Up to $40

$75

Up to $40

Level 2 Progressives

Covered in full

Up to $48

$110

Up to $40

All Other Progressives

$140 allowance + 20% discount

Up to $48

$50 allowance + 20% discount

Up to $40

$70/$80

N/A

$70/$80

N/A

Polarized

$75

N/A

$75

N/A

PGX/PBX

$40

N/A

$40

N/A

Up to 20% discount

N/A

Up to 20% discount

N/A

Standard Spectacle Lenses

Preferred Pricing Options Polycarbonate (Single Vision/Multi-Focal)

Transitions® (Single Vision/Multi­ Focal)

Other Lens Options

Contact Lenses† (in lieu of frame and spectacle lenses) Elective

$150 allowance

Up to $128

$150 allowance

Up to $128

Medically Necessary

Covered in full

Up to $250

Covered in full

Up to $250

Onetime/lifetime $150 allowance Provider discount up to 25%

Onetime/lifetime $150 allowance

Onetime/lifetime $150 allowance Provider discount up to 25%

Onetime/lifetime $150 allowance

Refractive Laser Surgery

Frequency Eye Examination

Once every 12 months

Lenses or Contact Lenses

Once every 12 months

Frame

Once every 12 months

* Discounts are not insured benefits. † Prior authorization is required for medically necessary contacts. *At participating Walmart/Sam’s locations, retail pricing for your plan is $82. At participating Costco locations, retail pricing is $84.99.

25

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/mckinneyisd

Eligibility

You are eligible for disability coverage if you are an active employee in the United States working a minimum of 20 hours per week. The date you are eligible for coverage is the later of: the plan effective date; or the day after you complete the waiting period.

•

Survivor Benefit: Unum will pay your eligible survivor a lump sum benefits equal to 3 months of your gross disability payment.

•

Dependent Care Expense Benefit: If you are disabled and participating in Unum’s Rehabilitation and Return to Work Assistance program, Unum will pay a Dependent Care Expense $350 per month per dependent, to a maximum of $1,000 per month for all dependent care expenses combined.

•

Education Benefit: If you are disabled and receiving monthly disability benefits, you may receive an additional monthly Education Benefit of $200 for each child who is an eligible student.

•

Medical Treatment Benefit: A Medical Treatment Benefit will be paid when you receive treatment by a doctor as a result of a sickness or injury, provided no other benefits are payable under the plan as a result of the condition for which the treatment was rendered.

Benefit Amount You may purchase a monthly benefit in $100 units, starting at a minimum of $200, up to 66.7% of your monthly earnings rounded to the nearest $100, but not to exceed a monthly maximum benefit of $8,000.

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 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 hospital room due to your sickness or injury for 23 or more consecutive hours. (Applies to Elimination Periods of 30 days or less.)

Benefit Duration

Your duration of benefits is based on your age when the disability occurs.

Age at Disability Less than age 60 Age 60 through 64 Age 65 through 69 Age 70 and over

Additional Benefits •

26

Maximum Duration of Benefits To age 65, but not less than 5 years 5 years To age 70, but not less than 1 year 1 year

Work/Life Balance Employee Assistance Program: Worklife balance is a comprehensive resource providing access to professional assistance for a wide range of personal and work-related issues.

Other Important Provisions

Pre-Existing Condition Exclusion: Benefits will not be paid for disabilities caused by, contributed to by, or resulting from a preexisting condition. You have a pre-existing 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.

• After benefits have been paid for 24 months, you are disabled when Unum determines that due to the same sickness or injury, you are • unable to perform the duties of any gainful occupation for which you are reasonably fitted by education, training, or experience.

• You must be under the regular care of a physician to be considered disabled.

Disability Insurance Unum

EMPLOYEE BENEFITS

Benefit Integration: Your disability benefit will be reduced by deductible sources of income and any earnings you have while disabled.

After you have received monthly disability payments for 12 months, your gross disability payment will be reduced by such items as additional deductible sources of income you receive or are entitled to receive under state compulsory benefit laws.

Mental Illness/Self-Reported Symptoms

The lifetime cumulative maximum benefit period for all disabilities due to mental illness and disabilities based primarily on self-reported symptoms is 24 months. Only 24 months of benefits will be paid for any combination of such disabilities even if the disabilities are not continuous and/or are not related.

Payments would continue beyond 24 months only if you are confined to a hospital or institution because of the disability.

Limitations apply.

How to file a claim and Other Important Resources To file a claim online: https://www.unum.com/employees/file-a-claim To check the status of a claim: https://unum.com/claims (800) 858-6843 M-F 8:00 - 8:00 / EST Disability Monthly Rates Elimination Period

per $100 in benefit

14/14

$3.73

30/30

$3.05

60/60

$2.04

90/90

$1.75

180/180

$1.31

27

Accident Insurance Unum

EMPLOYEE BENEFITS

ABOUT ACCIDENT Do you have kids playing sports, are you a weekend warrior, or maybe accident prone? Accident plans are designed to help pay for medical costs associated with accidents and benefits are paid directly to you.

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

How does it work?

Accident Insurance can pay a set benefit amount based on the type of injury you have and the type of treatment you need. It covers accidents that occur on and off the job. And it includes a range of incidents, from common injuries to more serious events. In addition, it covers loss of life for you and your family as well as dismemberment for loss of limb. Included are benefits for Hospitalization, ER Room, Ambulance and Urgent Care in a Physician’s Office.

What’s Included?

Be Well Benefit Every year, each family member who has Accident coverage can also receive $50 for getting a covered Be Well screening test, such as: • Annual exams by a physician include sports physicals, well-child visits, dental and vision exams • Screenings for cancer, including pap smear, colonoscopy • Cardiovascular function screenings • Screenings for cholesterol and diabetes • Imaging studies, including chest X-ray, mammography • Immunizations including HPV, MMR, tetanus, influenza

How do I file a Claim?

You can call (800) 635-5597 or go online: https://www.unum.com/employees/file-a-claim For full coverage details and limitations and exclusions, please go to: www.mybenefitshub.com/mckinneyisd under the Accident Section of the employee benefits portal.

Accident Monthly Rates Employee Only

$13.24

Employee and Spouse

$23.36

Employee and Child(ren)

$29.82

Employee and Family

$39.94

28

Critical Illness Insurance Unum

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/mckinneyisd Critical Illness insurance provides financial protection by paying a lump sum benefit if you are diagnosed with a covered critical illness.

This is a overview of coverage and does not provide all the conditions and terms of the plan. Please refer to the district website www.mybenefitshub.com/mckinneyisd under the Critical Illness section for complete details.

How to file a claim: Call (800) 635-5597 or online at https://www.unum.com/employees/file-a-claim Who is eligible for this coverage?

All employees in active employment in the United States working at least 20 hours per week and their eligible spouses and children (up to age 26 regardless of student or marital status).

What are the Critical Illness The following coverage amounts are available. coverage amounts?

For you: Select one of the following $10,000, $20,000 or $30,000 For your Spouse and Children: 100% of employee coverage amount Can I be denied coverage?

Coverage is guarantee issue.

When is coverage effective?

Please see your Plan Administrator for your effective date of coverage. Insurance coverage will be delayed if you are not in active employment because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective.

What critical illness conditions are Covered Conditions* % of Coverage Amount Critical Illnesses covered?

Coronary Artery Disease (major) 50% Coronary Artery Disease (minor) 10% End Stage Renal (Kidney) Failure 100% Heart Attack (Myocardial Infarction) 100% Major Organ Failure Requiring Transplant 100% Stroke 100% Supplemental Critical Illnesses Benign Brain Tumor 100% Coma 100% Loss of Hearing 100% Loss of Sight 100% Loss of Speech 100% Infectious Disease 25% Occupational Human Immunodeficiency Virus (HIV) or Hepatitis 100% Permanent Paralysis 100% Progressive Diseases Amyotrophic Lateral Sclerosis (ALS) 100% Dementia (including Alzheimer’s Disease) 100% Functional Loss 100% Multiple Sclerosis (MS) 100% Parkinson’s Disease 100% 29

Critical Illness Insurance Unum

EMPLOYEE BENEFITS

What critical illness conditions are Additional Critical Illnesses for your Children covered? (cont’d) Cerebral Palsy 100% Cleft Lip or Palate 100% Cystic Fibrosis 100% Down Syndrome 100% Spina Bifida 100% * Please refer to the policy for complete definitions of covered conditions.

Covered Condition Benefit The covered condition benefit is payable once per covered condition per insured.

Unum will pay a covered condition benefit for a different covered condition if: • the new covered condition is medically unrelated to the first covered condition; or • the dates of diagnosis are separated by more than 180 days.

Reoccurring Condition Benefit We will pay the reoccurring condition benefit for the diagnosis of the same covered condition if the covered condition benefit was previously paid and the new date of diagnosis is more than 180 days after the prior date of diagnosis. The benefit amount for any reoccurring condition benefit is 100% of the percentage of coverage amount for that condition. The following Covered Conditions are eligible for a reoccurring condition benefit: • Benign Brain Tumor • Heart Attack (Myocardial Infarction) • Coma • Invasive Cancer (includes all Breast Cancer) • Coronary Artery Disease (Major) • Major Organ Failure Requiring Transplant • Coronary Artery Disease (Minor) • Non-Invasive Cancer • End Stage Renal (Kidney) Failure • Stroke Are wellness screenings covered? Each insured is eligible to receive one Be Well Benefit per calendar year.

Be Well Benefit If the employee’s Critical Illness The Be Well Benefit Amount for you, your Coverage Amount is: spouse and your children is: $10,000 $50 $20,000 $75 $30,000 $100 Be Well Screenings include tests for the following: cholesterol and diabetes, cancer and cardiovascular function. They also include imaging studies, immunizations and annual examinations by a Physician. See certificate for details.

Critical Illness Monthly Rates Employee Employee Employee Spouse Spouse Spouse Age $10,000 $20,000 $30,000 $10,000 $20,000 $30,000 > 25 $3.52 $7.05 $10.57 $3.52 $7.05 $10.57 25-29 $4.42 $8.85 $13.27 $4.42 $8.85 $13.27 30-34 $5.62 $11.25 $16.87 $5.62 $11.25 $16.87 35-39 $7.42 $14.85 $22.27 $7.42 $14.85 $22.27 40-44 $9.72 $19.45 $29.17 $9.72 $19.45 $29.17 45-49 $12.72 $25.45 $38.17 $12.72 $25.45 $38.17 50-54 $16.02 $32.05 $48.07 $16.02 $32.05 $48.07 55-59 $21.52 $43.05 $64.57 $21.52 $43.05 $64.57 60-64 $29.72 $59.45 $89.17 $29.72 $59.45 $89.17 65-69 $42.82 $85.65 $128.47 $42.82 $85.65 $128.47 70-74 $66.72 $133.45 $200.17 $66.72 $133.45 $200.17 75-79 $98.42 $196.85 $295.27 $98.42 $196.85 $295.27 80-84 $143.62 $287.25 $430.87 $143.62 $287.25 $430.87 85+ $231.42 $462.85 $694.27 $231.42 $462.85 $694.27

30

Life and AD&D

EMPLOYEE BENEFITS

Unum

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/mckinneyisd

Basic Life and AD&D

Who is eligible for this coverage?

All actively employed employees working at least 20 hours each week for your employer in the U.S. What is the coverage amount?

Your employer is providing you with $5,000 of Term Life insurance. You will also receive $5,000 of Accidental Death and Dismemberment insurance.

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

If you retire, reduce your hours or leave your employer, you can continue coverage at the group rate. Portability is not available for people who have a medical condition that could shorten their life expectancy — but they may be able to convert their term life policy to an individual life insurance policy.

What does my AD&D insurance pay for?

The full benefit amount is paid for loss of: • Life • Both hands or both feet or sight of both eyes • One hand and one foot • One hand and the sight of one eye • Speech and hearing Do my life insurance benefits decrease with age?

Coverage amounts will reduce according to the following schedule: Age: Insurance amount reduces to: 65 65% of original amount 70 50% of original amount 75 30% of original amount Coverage may not be increased after a reduction.

Voluntary Life and AD&D

Who is eligible for this coverage?

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

What are the coverage amounts?

Employee: up to 5 times salary in increments of $10,000; not to exceed $500,000.

Spouse: up to 100% of employee amount in increments of $5,000; not to exceed $500,000.

Child: up to 100% of employee coverage amount in increments of $2,000; not to exceed $10,000. The maximum death benefit for a child between the ages of live birth and six months is $1,000.

What are the AD&D coverage amounts?

Employee: up to 5 times salary in increments of $10,000; not to exceed $500,000.

Spouse: up to 100% of employee amount in increments of $5,000; not to exceed $500,000.

Child: up to 100% of employee coverage amount in increments of $2,000; not to exceed $10,000. The maximum death benefit for a child between the ages of live birth and six months is $1,000.

Do my life insurance benefits decrease with age?

Coverage amounts will reduce according to the following schedule: Age: Insurance amount reduces to: 70 65% of original amount 75 50% of original amount Coverage may not be increased after a reduction.

31

Life and AD&D Unum

What does my AD&D insurance pay for?

The full benefit amount is paid for loss of: • life; • both hands or both feet or sight of both eyes; • one hand and one foot; • one hand or one foot and the sight of one eye; • speech and hearing.

Other losses may be covered as well. Please contact your plan administrator.

Can I be denied coverage?

Current Employees: If you and your eligible dependents are enrolled in the plan and wish to increase your life insurance coverage, you may apply on or before the enrollment deadline for any amount of additional coverage up to the plan max for yourself and any amount of additional coverage up to $50,000 for your spouse. Any life insurance coverage over the guaranteed amount(s) will be subject to answers to health questions.

If you and your eligible dependents are not currently enrolled in the plan, you may apply for coverage on or before the enrollment deadline and will be required to answer health questions for any amount of coverage.

New Employees: To apply for coverage, complete your enrollment within 31 days of your eligibility period. If you apply for coverage after 31 days, or if you choose coverage over the amount you are guaranteed, you will need to complete a medical questionnaire which you can get from your plan administrator. You may also be required to take certain medical tests at Unum’s expense.

Are there any life insurance exclusions or limitations?

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

Will my premiums be waived if I’m disabled?

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

32

EMPLOYEE BENEFITS

Term Life Monthly Rates (Per $1,000) Age Employee or Spouse <25 $0.019 25-29 $0.019 30-34 $0.028 35-39 $0.048 40-44 $0.057 45-49 $0.085 50-54 $0.143 55-59 $0.247 60-64 $0.323 65-69 $0.599 70-74 $0.960 75+ $0.960 Child life monthly rate is $0.26 per $1,000.

One life premium covers all children.

Spouse rates based on Employee’s Age AD&D Monthly Rate Chart (Per $1,000) Employee $0.02 Spouse $0.02 Child $0.02 This is a brief overview of this benefit. All conditions and limitations can be found on your benefit website, www.mybenefitshub.com/mckinneyisd, under the Life Insurance and AD&D sections.

Notes

33

Notes

34

Notes

35

2023 - 2024 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 McKinney 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 McKinney 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/MCKINNEYISD 36