2023-24 Prosper ISD Benefit Guide

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2023 - 2024 Plan Year PROSPER ISD BENEFIT GUIDE EFFECTIVE: 09/01/2023 - 8/31/2024
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WWW.MYBENEFITSHUB.COM/PROSPERISD
HOW TO ENROLL PG. 4 How to Enroll 4-5 Annual Benefit Enrollment 6-11 1. Benefit Updates 6 2. Section 125 Cafeteria Plan Guidelines 7 3. Annual Enrollment 8 4. Eligibility Requirements 9 5. Helpful Definitions 10 6. Health Savings Account (HSA) vs. Flexible Spending Account (FSA) 11 Medical 12-18 Health Savings Account (HSA) 19 Hospital Indemnity 20-21 Critical Illness 22-23 Accident Insurance 24-25 Dental 26-27 Vision 28 Disability 29-30 Cancer 31 Life and AD&D 32-33 Identity Theft 34 Emergency Medical Transportation 35 Flexible Spending Account (FSA) 36-37 Employee Assistance Program (EAP) 38 2
Table of Contents FLIP TO... SUMMARY PAGES PG. 6 YOUR BENEFITS PG. 12

Benefit Contact Information

BENEFIT ADMINISTRATORS TRS ACTIVECARE MEDICAL

Financial Benefit Services (866) 914-5202

www.mybenefitshub.com/prosperisd

BCBSTX (866) 355-5999

www.bcbstx.com/trsactivecare

TRS HMO MEDICAL PROSPER ISD BENEFITS

Scott & White HMO (844) 633-5325

www.trs.swhp.org

Benefits Department

(469) 219-2000

Benefits@prosper-isd.net

PHARMACY MANAGER FOR ACTIVE CARE PLANS ONLY

Express Scripts (844) 238-8084

https://www.express-scripts.com/ trsactivecare

HEALTH SAVINGS ACCOUNT (HSA)

EECU (800) 333-9934

www.eecu.org

HOSPITAL INDEMNITY DENTAL VISION

The Hartford Group #872784 (866) 547-4205

www.thehartford.com/claims

Lincoln Financial Group (See Benefit Highlights for Group #’s) DPPO: (800) 423-2765

www.lfg.com

Superior Vision Group #322100 (800) 507-3800

www.superiorvision.com

DISABILITY CANCER LIFE AND AD&D

The Hartford Group #872784

866-547-9124

www.thehartford.com

IDENTITY THEFT

ID Watchdog

(800) 774-3772

www.idwatchdog.com

American Public Life Group #24842 (800) 256-8606

www.ampublic.com

EMERGENCY MEDICAL TRANSPORTATION

MASA Group #B2BPROISD

(800) 643 9023

claims@masaglobal.com

www.masamts.com

EMPLOYEE ASSISTANCE PROGRAM (EAP) CRITICAL ILLNESS

Deer Oaks EAP Services

(866) 827-2400

www.deeroakseap.com

The Hartford Group # 872784

(866) 547-4205

benefitsclaims.thehartford.com

The Hartford Group #872784 (888) 563-1124

www.thehartford.com

FLEXIBLE SPENDING ACCOUNT (FSA)

Higginbotham

(866) 419-3519

https://flexservices.higginbotham.net/

ACCIDENT PLAN

The Hartford Group #872784

(866) 547-4205

benefitsclaims.thehartford.com

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Employee benefits made easy through the FBS Benefits App! All Your BenefitsOne App OR SCAN Text “FBS PISD” to (800) 583-6908 App Group #: FBSPISD Text “FBS PISD” to (800) 583-6908 and get access to everything you need to complete your benefits enrollment: • Benefit Resources • Online Enrollment • Interactive Tools • And more! 4

How to Log In

1 www.mybenefitshub.com/prosperisd

2

3 ENTER USERNAME & PASSWORD

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

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

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

CLICK LOGIN
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Annual Benefit Enrollment

Benefit Updates - What’s New:

TRS

New Pharmacy Benefits Manager Active Care Plans Only Express Scripts!

• Questions regarding coverage can be addressed at https://www.expresssscripts.com/trsactivecare or by calling (844) 238-8084.

• CVS cards valid through August 31st

• HMO Plans are not impacted by this change.

Other Changes in the Active Care Plans

• Primary Plus Plan: Family Deductible is now $2,400 instead of $3,600.

• Primary Plus Plan PCP for Mental Health Copays are now $15.00.

• Primary and Primary Plus Plans now offer Teladoc virtual Mental Health visits for a $0 copay.

• Primary Plan the Individual out of pocket is now $7,500 and $15,000 for Family

Changes for Supplemental Benefits

Dental - No DHMO Dental Plan will be offered this plan year.

• You must log into the Benefit’s HUB to elect a PPO Dental Plan if you were enrolled in a DHMO plan prior. We did not elect an alternate plan for you.

New Accident Plan! The Hartford

• Offering Accident Coverage by providing a cash payment for each covered injury.

• $75 Health Screening Benefit

• Robust X Ray payouts

• Physical Therapy 10 Visits Included

• Chiropractic -10 Visits

New Disability Carrier! The Hartford

• Pre-Existing Conditions will receive a maximum benefit of 6 weeks.

• If you choose an Elimination Period of 30 days or less and you are confined to a hospital for 24 hours or more due to a disability, the elimination period is waived and benefits are payable from the first day of hospitalization.

• Telephonic claims

• Ability Assist 3 face to face counseling sessions and unlimited phone counseling.

New Critical Illness Plan! The Hartford

• Wellness Benefit $75

• Pays a lump sum benefit based on a schedule of illness.

• Pre-existing limitation is anything 12 months prior to the plan date.

Don’t Forget!

• Login and complete your benefit enrollment from 07/17/2023 - 08/07/2023

• Enrollment assistance is available by calling Financial Benefit Services at (866) 914-5202.

• Update your information: home address, phone numbers, email, and beneficiaries.

◊ Update your address here: https://forms.prosper-isd.net/Forms/AddressChange

• REQUIRED!! Due to the Affordable Care Act (ACA) reporting requirements, you must add your dependent’s CORRECT social security numbers in the online enrollment system. If you have questions, please contact your Benefits Administrator.

SUMMARY PAGES
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Annual Benefit Enrollment

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 benefit elections can occur only if you experience a qualifying event. You must present proof of a qualifying event to your Benefit Office within 30 days of your qualifying event and meet with your Benefit/HR Office to complete and sign the necessary paperwork in order to make a benefit election change. Benefit changes must be consistent with the qualifying event.

CHANGES IN STATUS (CIS): QUALIFYING EVENTS

Marital Status

Change in Number of Tax Dependents

Change in Status of Employment Affecting Coverage Eligibility

Gain/Loss of Dependents’ Eligibility Status

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

An event that causes an employee’s dependent to satisfy or cease to satisfy coverage requirements 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

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

SUMMARY PAGES
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Annual Benefit Enrollment

Annual Enrollment

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

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

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

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

New Hire Enrollment

All new hire enrollment elections must be completed in the online enrollment system within the first 30 days of benefit 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 call Financial Benefit Services at 866-914-5202 for assistance.

Where can I find forms?

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

SUMMARY PAGES
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Annual Benefit Enrollment

Employee Eligibility Requirements

Supplemental Benefits: Eligible full-time employees must work 20 or more regularly scheduled hours each work week.

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.

Dependent Eligibility Requirements

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.

Medical To age 26

Dental To age 26

Vision To age 26

Cancer To age 26

Life To age 26

AD&D To age 25

Identity Theft To age 26

HSA 26 (benefits terminate at the end of the plan year following the birthday)

FSA 26 (benefits terminate at the end of the plan year following the birthday)

Medical Transportation To age 26 (including disabled children)

Hospital Indemnity To age 26

EAP To age 26

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

Potential Spouse Coverage Limitations: When enrolling in coverage, please keep in mind that some benefits may not allow you to cover your spouse as a dependent if your spouse is enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Financial Benefit Services, or contact the insurance carrier for additional information on spouse eligibility.

FSA/HSA Limitations: Please note, in general, per IRS regulations, married couples may not enroll in both a Flexible Spending Account (FSA) and a Health Savings Account (HSA). If your spouse is covered under an FSA that reimburses for medical expenses then you and your spouse are not HSA eligible, even if you would not use your spouse’s FSA to reimburse your expenses. However, there are some exceptions to the general limitation regarding specific types of FSAs. To obtain more information on whether you can enroll in a specific type of FSA or HSA as a married couple, please reach out to the FSA and/or HSA provider prior to enrolling or reach out to your tax advisor for further guidance.

Potential Dependent Coverage Limitations: When enrolling for dependent coverage, please keep in mind that some benefits may not allow you to cover your eligible dependents if they are enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Financial Benefit Services, or contact the insurance carrier for additional information on dependent eligibility.

Disclaimer: You acknowledge that you have read the limitations and exclusions that may apply to obtaining spouse and dependent coverage, including limitations and exclusions that may apply to enrollment in Flexible Spending Accounts and Health Savings Accounts as a married couple. You, the enrollee, shall hold harmless, defend, and indemnify Financial Benefit Services, LLC from any and all claims, actions, suits, charges, and judgments whatsoever that arise out of the enrollee’s enrollment in spouse and/or dependent coverage, including enrollment in Flexible Spending Accounts and Health Savings Accounts.

If your dependent is disabled, coverage may be able to continue past the maximum age under certain plans. If you have a disabled dependent who is reaching an ineligible age, you must provide a physician’s statement confirming your dependent’s disability. Contact your HR/Benefit Administrator to request a continuation of coverage.

SUMMARY PAGES
PLAN MAXIMUM AGE
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Helpful Definitions

Actively-at-Work

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.

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.

In-Network

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

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).

SUMMARY
PAGES
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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

Employees may use funds any way they wish. If used for non-qualified medical expenses, subject to current tax rate plus 20% penalty.

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

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

213(d) of IRC).

FLIP TO FOR HSA INFORMATION FLIP TO FOR FSA INFORMATION PG. 19 PG. 38 SUMMARY PAGES HSA vs. FSA
A
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
Eligibility
qualified high deductible health plan
Reimbursement
Permitted,
Not
Yes,
for qualified medical expenses (as defined in Sec.
Cash-Outs of Unused Amounts (if no medical expenses)
permitted Year-to-year rollover of account balance?
Does the account earn interest? Yes No Portable? Yes, portable year-to-year and between jobs. No 11
No. Access to some funds may be extended with a $500 rollover provision under the guidelines of the IRS.

Medical Insurance

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/prosperisd

TRS Monthly Premium District Contribution Employee Cost TRS ActiveCare HD Employee Only $462.00 $351.00 $111.00 Employee & Spouse $1,248.00 $351.00 $897.00 Employee & Child(ren) $786.00 $351.00 $435.00 Employee & Family $1,571.00 $351.00 $1,220.00 TRS ActiveCare 2 Employee Only $1,013.00 $500.00 $513.00 Employee & Spouse $2,402.00 $500.00 $1,902.00 Employee & Child(ren) $1,507.00 $500.00 $1,007.00 Employee & Family $2,841.00 $500.00 $2,341.00 TRS ActiveCare Primary Employee Only $450.00 $351.00 $99.00 Employee & Spouse $1,215.00 $351.00 $864.00 Employee & Child(ren) $765.00 $351.00 $414.00 Employee & Family $1,530.00 $351.00 $1,179.00 TRS ActiveCare Primary+ Employee Only $529.00 $433.00 $96.00 Employee & Spouse $1,376.00 $433.00 $943.00 Employee & Child(ren) $900.00 $433.00 $467.00 Employee & Family $1,746.00 $433.00 $1,313.00 Scott and White HMO Employee Only $569.76 $433.00 $136.76 Employee & Spouse $1,432.42 $433.00 $999.42 Employee & Child(ren) $916.49 $433.00 $483.49 Employee & Family $1,648.78 $433.00 $1,215.78 EMPLOYEE
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BENEFITS

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 speci ed 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 maximum, the plan pays 100% of allowable charges for covered services.

762373.0523
You bet your boots big things happen here, including TRS-ActiveCare’s large network of doctors and hospitals.
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Monthly Premiums Employee Only $450 $ $529 Employee and Spouse $1,215 $ $1,376 Employee and Children $765 $ $900 Employee and Family $1,530 $ $1,746 Total Premium Total Premium Your Premium How to Calculate Your Monthly Premium Total Monthly Premium Your District and State Contributions Your Premium Ask your Bene ts Administrator for your district’s speci c premiums. All TRS-ActiveCare participants have three plan options. TRS-ActiveCare Primary TRS-ActiveCare Plan Summary • 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 • Lower deductible than • Copays for many services • Higher premium • Statewide network • PCP referrals required • Not compatible with • No out-of-network Wellness Bene ts at No Extra Cost* Being healthy is easy with: • $0 preventive care • 24/7 customer service • One-on-one health coaches • Weight loss programs • Nutrition programs • OviaTM pregnancy support • TRS Virtual Health • Mental health bene ts • And much more! *Available for all plans. See the bene ts guide for more details. Immediate Care Urgent Care $50 copay 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 $12 2023-24 TRS-ActiveCare Plan Highlights Sept. 1, 2023 –New Rx Bene ts! • Express Scripts is your new pharmacy bene ts manager! CVS pharmacies and most of your preferred pharmacies and medication are still included. • Certain specialty drugs are still $0 through SaveOnSP. Doctor Visits Primary Care $30 copay Specialist $70 copay Plan Features Type of Coverage In-Network Coverage Only In-Network Individual/Family Deductible $2,500/$5,000 Coinsurance You pay 30% after deductible You Individual/Family Maximum Out of Pocket $7,500/$15,000 Network Statewide Network PCP Required Yes Prescription Drugs Drug Deductible Integrated with medical $200 deductible Generics (31-Day Supply/90-Day Supply)$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 You Insulin Out-of-Pocket Costs$25 copay for 31-day supply; $75 for 61-90 day supply$25 copay for 31-day 14
This plan is closed and not accepting new enrollees. If you’re currently enrolled in TRS-ActiveCare 2, you can remain in this plan. $ $462 $ $ $1,248 $ $ $786 $ $ $1,571 $ Premium Total Premium Your Premium Your Premium Total Premium Your Premium $1,013 $ $2,402 $ $1,507 $ $2,841 $
a wide
of wellness bene ts. 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 TRS-ActiveCare Primary+ TRS-ActiveCare HD than the HD and Primary plans services and drugs required to see specialists with a Health Savings Account (HSA) coverage • 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 $50 copay You pay 30% after deductibleYou pay 50% after deductible You pay 20% after deductible You pay 30% after deductible $0 per medical consultation $30 per medical consultation $12 per medical consultation $42 per medical consultation $50 copay You pay 40% after deductible You pay a $250 copay plus 20% after deductible $0 per medical consultation $12 per medical consultation Aug. 31, 2024 $15 copay You pay 30% after deductibleYou pay 50% after deductible $70 copay You pay 30% after deductibleYou pay 50% after deductible $30 copay You pay 40% after deductible $70 copay You pay 40% after deductible In-Network Coverage Only In-Network Out-of-Network $1,200/$2,400 $3,000/$6,000 $5,500/$11,000 You pay 20% after deductible You pay 30% after deductibleYou pay 50% after deductible $6,900/$13,800 $7,500/$15,000 $20,250/$40,500 Statewide Network Nationwide Network Yes No In-Network Out-of-Network $1,000/$3,000 $2,000/$6,000 You pay 20% after deductibleYou pay 40% after deductible $7,900/$15,800 $23,700/$47,400 Nationwide Network No deductible per participant (brand drugs only) Integrated with medical $15/$45 copay You pay 20% after deductible; $0 coinsurance for certain generics You pay 25% after deductible You pay 25% after deductible You pay 50% after deductible You pay 50% after deductible $0 if SaveOnSP eligible; You pay 30% after deductible You pay 20% after deductible 31-day supply; $75 for 61-90 day supply You pay 25% after deductible $200 brand deductible $20/$45 copay You pay 25% after deductible ($40 min/$80 max)/ You pay 25% after deductible ($105 min/$210 max) 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
Each includes
range

What’s New and What’s Changing

• Individual maximum-out-of-pocket decreased by $650. Previous amount was $8,150 and is now $7,500.

• Family maximum-out-of-pocket decreased by $1,300. Previous amount was $16,300 and is now $15,000.

• 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.

• 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.

• No changes.

• This plan is still closed to new enrollees.

2022-23 Total Premium New 2023-24 Total Premium Change in Dollar Amount TRS-ActiveCare Primary Employee Only $410 $450 $40 Employee and Spouse $1,157 $1,215 $58 Employee and Children $738 $765 $27 Employee and Family $1,384 $1,530 $146 TRS-ActiveCare HD 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 TRS-ActiveCare Primary+ 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 TRS-ActiveCare 2 (closed to new enrollees) Employee Only $1,013 $1,013 $0 Employee and Spouse $2,402 $2,402 $0 Employee and Children $1,507 $1,507 $0 Employee and Family $2,841 $2,841 $0 Key Plan Changes At a Glance Primary HD Primary+ Premiums Lowest Lower Higher Deductible Mid-range High Low Copays Yes No Yes NetworkStatewide network Nationwide network Statewide network PCP Required? Yes No Yes HSA-eligible? No Yes No Effective: Sept. 1, 2023
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.
16

Compare Prices for Common Medical Services

*Pre-certi cation for genetic and specialty testing may apply. Contact a PHG

with questions.

Bene t TRS-ActiveCare Primary TRS-ActiveCare Primary+ TRS-ActiveCare HD TRS-ActiveCare 2 In-Network OnlyIn-Network OnlyIn-NetworkOut-of-NetworkIn-NetworkOut-of-Network Diagnostic Labs* Of ce/Indpendent Lab: You pay $0 Of ce/Indpendent Lab: You pay $0 You pay 30% after deductible You pay 50% after deductible Of ce/Indpendent Lab: You pay $0 You pay 40% after deductible Outpatient: You pay 30% after deductible Outpatient: You pay 20% 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 Bariatric Surgery Facility: You pay 30% after deductible Facility: You pay 20% after deductible Not CoveredNot Covered Facility: You pay 20% after deductible ($150 facility copay per day) Not Covered Professional Services: You pay $5,000 copay + 30% after deductible Professional Services: You pay $5,000 copay + 20% after deductible Professional Services: You pay $5,000 copay + 20% after deductible 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 copayYou 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
www.trs.texas.gov
at 1-866-355-5999
Call a Personal Health Guide (PHG) any time 24/7 to help you nd the best price for a medical service. Reach them at 1-866-355-5999 REMEMBER: Revised 05/30/23 17

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

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.

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

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

Remember that when you choose an HMO, you’re choosing a regional network. REMEMBER: www.trs.texas.gov Total Monthly Premiums Total PremiumYour PremiumTotal PremiumYour PremiumTotal PremiumYour Premium Employee Only$569.76$ N/A$ N/A$ Employee and Spouse$1,432.42$ N/A$ N/A$ Employee and Children$916.49$ N/A$ N/A$ Employee and Family$1,648.78$ N/A$ N/A$ Central and North Texas Baylor Scott & White Health Plan Brought to you by TRS-ActiveCare Blue Essentials - South Texas HMO Brought to you by TRS-ActiveCare Blue Essentials - West Texas HMO Brought to you by TRS-ActiveCare
Prescription Drugs Drug Deductible $200 (excl. generics) N/A N/A Days Supply30-day supply/90-day supply N/A N/A Generics $14/$35 copay N/A N/A Preferred BrandYou pay 35% after deductible N/A N/A Non-preferred BrandYou pay 50% after deductible N/A N/A SpecialtyYou pay 35% after deductible N/A N/A Immediate Care Urgent Care $40 copay N/A N/A Emergency Care$500 copay after deductible N/A N/A Doctor Visits Primary Care $20 copay N/A N/A Specialist $70 copay N/A N/A Plan Features Type of CoverageIn-Network Coverage Only N/A N/A Individual/Family Deductible $2,400/$4,800 N/A N/A CoinsuranceYou pay 25% after deductible N/A N/A Individual/Family Maximum Out of Pocket $8,150/$16,300 N/A N/A
Revised 05/30/23 Cameron, Eastland, Ector, Fisher, Floyd, Gaines, Garza, $14/$35 copay N/A N/A Emergency Care$500 copay after deductible 18

Health Savings Account (HSA)

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/prosperisd

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.

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

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

• 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.

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. 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

EECU EMPLOYEE BENEFITS 19

Hospital Indemnity 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/prosperisd

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. It also provides additional daily benefits for related services. 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 nonmedical expenses (like housing costs, groceries, car expenses, etc.).

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 current financial protection 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). There is no limitation for pre-existing conditions. You and your dependents must be citizens or legal residents of the United States.

PLAN INFORMATION OPTION 1 OPTION 2 Coverage Type On and off-job (24 hour) Covered Events Illness and injury Illness and injury HSA Compatible Yes Yes BENEFITS OPTION 1 OPTION 2 HOSPITAL CARE First Day Hospital Confinement Up to 1 day per year $1,100 $2,200 Daily Hospital Confinement (Day 2+) Up to 30 days per year $100 $100 Daily ICU Confinement (Day 2+) Up to 10 days per year $150 $150 FAMILY CARE OPTION 1 OPTION 2 Health Screening Up to 1 day $50 $50 VALUE ADDED SERVICES OPTION 1 OPTION 2 Ability Assist® EAP – 24/7/365 access to
for
issues Included Included HealthChampionSM – Administrative & clinical support following serious illness or injury Included Included ADDITIONAL PLAN FEATURES COVERAGE ENROLLED IN ADDITIONAL SERVICES AVAILABLE Hospital Indemnity Ability Assist® Counseling Services Health ChampionSM Hospital Indemnity Monthly Premium Option 1 Option 2 Employee $14.28 $25.25 Employee + Spouse $25.48 $44.87 Employee + Child(ren) $26.52 $46.33 Family $39.74 $69.45
help
financial, legal or emotional
EMPLOYEE
20
BENEFITS

Hospital Indemnity The Hartford

WHAT IS ABILITY ASSIST COUNSELING SERVICES?

Ability Assist® Counseling Services provides access to Master’s- and PhD-degreed clinicians for 24/7 assistance if you’re enrolled in coverage. This includes 3 face-to-face visits per occurrence per year for emotional concerns and unlimited phone consultations for financial, legal, and work-life concerns.

For more information on Ability Assist® Counseling Services:

Call 1-800-964-3577

Visit www.guidanceresources.com

Company name: Abili Company ID: HLF90

WHAT IS HEALTHCHAMPION?

HealthChampionSM offers unlimited access to benefit specialists and nurses for administrative and clinical support to address medical care and health insurance claims concerns if you’re enrolled in coverage. Service includes: guidance on health insurance claims and billing support, explanation of benefits, cost estimates and fee negotiation, information related to conditions and available treatments, and support to help prepare for medical visits.

For more information on HealthChampionSM Services

Call 1-800-964-3577

Visit www.guidanceresources.com

Company name: Abili Company ID: HLF902

LIMITATIONS & EXCLUSIONS

Exclusions. This insurance does not provide benefits for any loss that results from or is caused by:

• Suicide or attempted suicide, whether sane or insane, or intentional self-infliction

• Voluntary intoxication (as defined by the law of the jurisdiction in which the illness or injury occurred) or while under the influence of any narcotic, drug or controlled substance, unless administered by or taken according to the instruction of a physician or medical professional

• Voluntary intoxication through use of poison, gas or fumes, whether by ingestion, injection, inhalation or absorption

• Voluntary commission of or attempt to commit a felony, voluntary participation in illegal activities (except for misdemeanor violations), voluntary participation in a riot, or voluntary engagement in an illegal occupation

• Incarceration or imprisonment following conviction for a crime

• Travel in or descent from any vehicle or device for aviation or aerial navigation, except as a fare-paying passenger in a commercial aircraft (other than a charter airline) on a regularly scheduled passenger flight or while traveling on business of the policyholder

• Ride in or on any motor vehicle or aircraft engaged in acrobatic tricks/stunts (for motor vehicles), acrobatic/stunt flying (for aircraft), endurance tests, off- road activities (for motor vehicles), or racing

• Participation in any organized sport in a professional or semi-professional capacity

• Participation in abseiling, base jumping, Bossaball, bouldering, bungee jumping, cave diving, cliff jumping, free climbing, freediving, freerunning, hang gliding, ice climbing, Jai Alai, jet powered flight, kite surfing, kiteboarding, luging, missed climbing, mountain biking, mountain boarding, mountain climbing, mountaineering, parachuting, paragliding, parakiting, paramotoring, parasailing, Parkour, proximity flying, rock climbing, sail gliding, sandboarding, scuba diving, sepak takraw, slacklining, ski jumping, skydiving, sky surfing, speed flying, speed riding, train surfing, tricking, wingsuit flying, or other similar extreme sports or high risk activities

• Travel or activity outside the United States or Canada

• Active duty service or training in the military (naval force, air force or National Guard/Reserves or equivalent) for service/training extending beyond 31 days of any state, country or international organization, unless specifically allowed by a provision of the certificate

• Involvement in any declared or undeclared war or act of war (not including acts of terrorism), while serving in the military or an auxiliary unit attached to the military, or working in an area of war whether voluntarily or as required by an employer

EMPLOYEE BENEFITS 21

Critical Illness Insurance

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/prosperisd

COVERAGE ELECTION & AMOUNT(S)

To be insured under the Policy an Employee must elect coverage for themself and any Dependent(s). The Employee is required to pay a premium for the coverage selected. Payment of premium does not guarantee eligibility for coverage.

Any amount of insurance for a Spouse/Partner or Dependent Child(ren) will be rounded to the next higher multiple of $1,000, if not already an even multiple of $1,000. All Coverage Amount(s) are Guaranteed Issue.

Benefits & Features

Without Impairment (including Transient Ischemic Attack (TIA)) •

COVERAGE AMOUNTS Employee Coverage Amount Choice of $10,000 to $40,000 in increments of $10,000 Spouse Coverage Amount 50% of your coverage amount Child(ren) Coverage Amount 50% of your coverage amount at no cost. Must be under age 26 and elected as a covered member during enrollment. COVERED ILLNESSES Initial Occurrence Benefit Amount: Reoccurrence Benefit Amount: CANCER & BENIGN TUMOR CATEGORY Cancer (Invasive) 100% 100% Carcinoma in Situ (Non-Invasive) 25% 100% Skin Cancer $250 None Bone Marrow Failure 50% None Benign Brain or Spinal Cord (Intradural) Tumor – Advanced Diagnosis 100% None HEART & VASCULAR CATEGORY Heart Attack • ST-Segment Elevation Myocardial Infarction (STEMI) • Non-ST Segment Elevation Myocardial Infarction (NSTEMI) 100% 25% 100% 100% Sudden Cardiac Arrest 100% None Coronary Artery Disease • Minor Diagnosis
Major Diagnosis 10% 100% 100% 100% Stroke
Stroke
Mild Stroke
Moderate Stroke
Severe Stroke 10% 25% 50% 100% 100% 100% 100% 100% Abdominal Aortic Aneurysm or Thoracic Aortic Aneurysm – Major Diagnosis 100% 100% MAJOR ORGAN CATEGORY Major Organ Failure 100% 100% End Stage Renal Disease (ESRD) 100% None
22
The Hartford EMPLOYEE BENEFITS

Critical Illness Insurance The Hartford EMPLOYEE BENEFITS

Critical Illnesses included in the Child Conditions Category must be Diagnosed during Childhood, with the exception of Type 1 Diabetes which may be Diagnosed during Childhood or Adolescence.

You may be able to continue insurance for You and Your Dependent(s) in certain circumstances when You are no longer Actively at Work, with payment of premium and subject to certain conditions. The available continuation option(s) are described in the Certificate.

Extended Continuation

Ability Assist® EAP1

HealthChampionSM1

You or an insured Spouse/Partner, in certain circumstances, may continue coverage under the Policy when insurance would otherwise end under the Termination of Coverage provision, with payment of premium and subject to certain conditions. This provision is fully described in the Certificate.

24/7/365 access to help for financial, legal, or emotional issues

Administrative and clinical support following serious illness or injury

1. ONLINE CLAIMS

• Visit the Supplemental Insurance Claims Portal at TheHartford.com/benefits/myclaim.

• Register for access if you have not done so already. (Please note: We must have current eligibility from your benefits administrator for you and any dependents to be eligible to register on the portal.)

• Log in to the portal.

• Click on “Complete Your Claim Form Online” under the Quick Links section.

• Follow the prompts to complete and submit a claim.

2. FILE A CLAIM OVER THE PHONE

(Applicable to Health Screening Benefit/Accident Protection Benefit Only)

• File your claim by calling 866-547-4205.

• Available Monday through Friday, 8:00 a.m. - 6:00 p.m. EST.

• SUBMIT A CLAIM VIA MAIL OR FAX

• Download a claim form at TheHartford.com/benefits/myclaim.

• Complete the form and mail or fax it to: The Hartford Supplemental Insurance Benefit Department

P.O. Box 99906

Grapevine, TX 76099

Fax Number: 469-417-1952

For assistance filing your claim, call 866-547-4205.

NOTE: Go to www.mybenefitshub.com/prosperisd under the Criical Illness Section for a full rate schedule.

COVERED ILLNESSES Initial Occurrence Benefit Amount: Reoccurrence Benefit Amount: NEUROLOGICAL CONDITIONS CATEGORY Dementia – Advanced Diagnosis 100% None Parkinson’s Disease – Advanced Diagnosis 100% None Amyotrophic Lateral Sclerosis (ALS) – Advanced Diagnosis 100% None Multiple Sclerosis (MS) – Advanced Diagnosis 100% None Huntington’s Disease (HD) – Advanced Diagnosis 100% None INFECTIOUS CONDITIONS CATEGORY Other Chronic/Progressive Condition – Advanced Diagnosis 50% None Severe Infectious Disease – Major Diagnosis 25% None FUNCTIONAL LOSS & CATASTROPHIC CONDITIONS CATEGORY Coma 100% 100% Loss of Hearing 100% None Loss of Sight 100% None Loss of Speech 100% None Permanent Paralysis 100% None Severe Burn – Greater than 36% of Total Body Surface Area 100% None CHILD CONDITIONS CATEGORY Cerebral Palsy – Advanced Diagnosis 100% None Congenital Heart Defect 100% None Congenital Metabolic Disorder 100% None Genetic Disorder 100% None Structural Congenital Defect 100% None Type 1 Diabetes 25% None
Benefit: Benefit Amount: Benefit Maximum: Health Screening $75 Once per Policy Year FEATURES
of Coverage
Continuation
Monthly Rates per $10,000 Age2 Employee3 Employee and Child <25 $4.30 $4.30 25-29 $5.10 $5.10 30-34 $6.30 $6.30 35-39 $7.80 $7.80 40-44 $10.20 $10.20 45-49 $14.60 $14.60 50-54 $18.60 $18.60 Age2 Employee and Spouse Employee and Family <25 $5.75 $5.75 25-29 $7.05 $7.05 30-34 $8.70 $8.70 35-39 $10.90 $10.90 40-44 $14.45 $14.45 45-49 $20.95 $20.95 50-54 $27.70 $27.70
23

Accident Insurance The Hartford 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/prosperisd

COVERAGE INFORMATION

You have a choice of two accident plans, which allows you the flexibility to enroll for the coverage that best meets your needs. This insurance provides benefits when injuries, medical treatment and/or services occur as the result of a covered accident. Unless otherwise noted, the benefit amounts payable under each plan are the same for you and your dependent(s).

PLAN INFORMATION LOW PLAN HIGH PLAN Coverage Type On and off-job (24 hour) On and off-job (24 hour) BENEFITS LOW PLAN HIGH PLAN EMERGENCY, HOSPITAL & TREATMENT CARE Accident Follow-Up Up to 3 visits per accident $100 $150 Acupuncture/Chiropractic Care/PT Up to 10 visits each per accident Up to $75 Up to $100 Ambulance – Air Once per accident $2,000 $2,500 Ambulance – Ground Once per accident $750 $1,000 Blood/Plasma/Platelets Once per accident $300 $400 Child Care Up to 30 days per accident while insured is confined $35 $50 Daily Hospital Confinement Up to 365 days per lifetime $400 $600 Daily ICU Confinement Up to 30 days per accident $600 $800 Diagnostic Exam Once per accident $300 $400 Emergency Dental Once per accident Up to $450 Up to $600 Emergency Room Once per accident $200 $250 Health Screening Benefit Once per year for each covered person $75 $75 Hospital Admission Once per accident $1,500 $2,000 Initial Physician Office Visit Once per accident $100 $150 Lodging Up to 30 nights per lifetime $150 $175 Medical Appliance Once per accident $200 $300 Rehabilitation Facility Up to 15 days per lifetime $300 $450 Transportation Up to 3 trips per accident $600 $800 Urgent Care Once per accident $150 $200 X-ray Once per accident $150 $200
Monthly Accident Premiums LOW PLAN HIGH PLAN Employee Only $9.94 $13.74 Employee and Spouse $15.65 $21.65 Employee and Child(ren) $16.54 $22.92 Employee and Family $26.05 $36.07 24

Accident Insurance The Hartford

The claim form is online at https://benefitsclaims.thehartford.com/. If you need assistance completing this form, contact 1-866-547-4205. In addition, they can help you understand how to submit the claim successfully and provide guidance on supporting documents that may be required.

BENEFITS LOW PLAN HIGH PLAN SPECIFIED INJURY & SURGERY Abdominal/Thoracic Surgery Once per accident $3,000 $4,000 Arthroscopic Surgery Once per accident $500 $750 Burn Once per accident Up to $15,000 Up to $20,000 Burn – Skin Graft Once per accident for third degree burn(s) 50% of burn benefit 50% of burn benefit Concussion Up to 3 per year $200 $250 Dislocation Once per joint per lifetime Up to $8,000 Up to $12,000 Eye Injury Once per accident Up to $750 Up to $1,000 Fracture Once per bone per accident Up to $10,000 Up to $12,000 Hernia Repair Once per accident $400 $600 Joint Replacement Once per accident $4,000 $6,000 Knee Cartilage Once per accident Up to $2,000 Up to $3,000 Laceration Once per accident Up to $1,000 Up to $1,500 Ruptured Disc Once per accident $2,000 $3,000 Tendon/Ligament/Rotator Cuff Once per accident Up to $2,000 Up to $3,000 CATASTROPHIC Accidental Death Within 90 days; Spouse @ 50% and child @ 25% $75,000 $100,000 Common Carrier Death Within 90 days $150,000 $300,000 Coma Once per accident Up to $15,000 Up to $20,000 Dismemberment Once per accident Up to $75,000 Up to $100,000 Home Health Care Up to 30 days per accident $75 $100 Paralysis Once per accident Up to $75,000 Up to $100,000 Prosthesis Once per accident Up to $3,000 Up to $4,000 FEATURES Ability Assist® EAP2 – 24/7/365 access to help for financial, legal or emotional issues Included Included HealthChampionSM3 – Administrative & clinical support following serious illness or injury Included Included
Claims
EMPLOYEE BENEFITS
25

Dental Insurance Lincoln Financial Group EMPLOYEE BENEFITS

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/prosperisd

The Lincoln DentalConnect® PPO Plans:

• Cover many preventive, basic, and major dental care services

• Also cover orthodontic treatment for children

• Let you choose any dentist you wish, though you can lower your out-of-pocket costs by selecting a contracting dentist

• Do not make you and your loved ones wait six months between routine cleanings

Calendar (Annual) Deductible

Individual: $50 Family: $150 Waived for Preventive

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 Non-Contracting Dentists’ services.

*Orthodontic Coverage is available for dependent children.

Waiting Period

Visit LincolnFinancial.com/FindADentist

You can search by:

• Location

• Dentist name or office name

• Distance you are willing to travel

• Specialty, language and more

There are no benefit waiting periods for any service types

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.

DPPO Benefit Highlights High DPPO Group #00001D040883 Low DPPO Group #00001D040882 Standard DPPO Group #00001D041861
Plan Year Maximum $1,500 $1,000 $500 Lifetime Orthodontic Max $1,000* N/A N/A
Dental Monthly Premium High DPPO Low DPPO Standard DPPO Employee Only $47.10 $32.89 $20.93 Employee and Spouse $97.78 $66.84 $40.75 Employee and Child(ren) $104.86 $80.05 $46.06 Employee and Family $165.94 $126.92 $72.78
26

Dental Insurance Lincoln Financial Group

DPPO Plan Coverage High DPPO Group #00001D040883 Low DPPO Group #00001D040882 Standard DPPO Group #00001D041861 In-Network Out-ofNetwork In-Network Out-ofNetwork In-Network Out-ofNetwork Preventive Services* 100% No Deductible 100% No Deductible 100% No Deductible 100% No Deductible 80% No Deductible 80% No Deductible Basic Services* 80% After Deductible 80% After Deductible 80% After Deductible 80% After Deductible 50% After Deductible 50% After Deductible Major Services* 50% After Deductible 50% After Deductible 50% After Deductible 50% After Deductible 50% After Deductible 50% After Deductible Orthodontics* 50% 50% No Coverage No Coverage No Coverage No Coverage
*Services included in each category vary by plan. Refer to your benefit website for a full list of details for each plan.
EMPLOYEE BENEFITS 27

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/prosperisd

How to Print your Vision ID Card:

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

Need

Need

Discount Features

Non-Covered Eyewear Discount: Members may also receive a discount of 20% from a participating provider’s usual and customary fees for eyewear purchases which exceed the benefit coverage (except disposable contact lenses, for which no discount applies). This includes eyeglass frames which exceed the selected benefit coverage, specialty lenses (i.e. progressives) and lens “extras” such as tints and coatings. Eyewear purchased from a Walmart Vision Center does not qualify for this additional discount because of Walmart’s “Always Low Prices” policy.

to search an in-network provider?
800-507-3800 or Visit https://superiorvision.com/locator/ to locate a provider.
Call
Help?
800-507-3800 Customer Service, log in online at www.SuperiorVision.com, or create an account on the app. Copays Services/frequency Vision Monthly Premiums Exam $10 Exam 12 months Employee $7.72 Materials $25 Frame 12 months Employee + Spouse $13.06 Lenses 12 months Employee + Child(ren) $13.84 Contact lenses 12 months Family $20.74 Benefits: Superior Select Southwest National network In-network Out-of-network Exam Covered in full Up to $35 retail Frames $125 retail allowance Up to $70 retail Lenses
Single Vision Covered in full Up to $25 retail Bifocal Covered in full Up to $40 retail Trifocal Covered in full Up to $45 retail Progressive See description Up to $45 retail Lenticular Covered in full Up to $80 retail Contact Lenses $150 retail allowance Up to $80 retail Medically Necessary Contact Lenses Covered in full Up to $150 retail Lasik Vision Correction $200 allowance
Call
(standard) per pair
28

Disability Insurance The Hartford EMPLOYEE BENEFITS

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/prosperisd

What is Disability Insurance?

Disability Insurance pays you a portion of your earnings if you cannot work because of a disabling illness or injury. You can purchase Disability Insurance through your employer. This highlight sheet is an overview of your Disability Insurance. Once a group policy is issued to your employer; a certificate of insurance will be available to explain your coverage in detail. Actively at Work: You must be at work with your Employer on your regularly scheduled workday. On that day, you must be performing for wage or profit all of your regular duties in the usual way and for your usual number of hours. If school is not in session due to normal vacation or school break(s), Actively at Work shall mean you are able to report for work with your Employer, performing all the regular duties of Your Occupation in the usual way for your usual number of hours as if school was in session.

Coverage Amount: You may purchase coverage that will pay you a monthly flat dollar benefit in $100 increments between $200 and $7,500 that cannot exceed 66 2/3% of your current monthly earnings.

Elimination Period: You must be disabled for at least the number of days indicated by the elimination period that you select before you can receive a disability benefit payment. The elimination period that you select consists of two numbers. The first number shows the number of days you must be disabled by an accident before your benefits can begin. The second number indicates the number of days you must be disabled by a sickness before your benefits can begin. For those employees electing an elimination period of 30 days or less, if you are confined to a hospital for 24 hours or more due to a disability, the elimination period will be waived, and benefits will be payable from the first day of hospitalization.

Definition of Disability: Disability is defined as The Hartford’s contract with your employer. Typically, disability means that you cannot perform one or more of the essential duties of your occupation due to injury, sickness, pregnancy or other medical conditions covered by the insurance, and as a result, your current

monthly earnings are 80% or less of your pre-disability earnings. Once you have been disabled for 24 months, you must be prevented from performing one or more essential duties of any occupation, and as a result, your monthly earnings are 66 2/3% or less of your pre-disability earnings.

Pre-Existing Condition Limitation: Your policy limits the benefits you can receive for a disability caused by a pre-existing condition. In general, if you were diagnosed or received care for a disabling condition within the 3 consecutive months just prior to the effective date of this policy, your benefit payment will be limited, unless: You have not received treatment for the disabling condition within 3 months, while insured under this policy, before the disability begins, or You have been insured under this policy for 12 months before your disability begins.

If your disability is a result of a pre-existing condition, we will pay benefits for a maximum of 6 weeks.

Maximum Benefit Duration: Benefit Duration is the maximum time for which we pay benefits for disability resulting from sickness or injury. Depending on the age at which disability occurs, the maximum duration may vary. Please see the applicable schedule below based on the Premium benefit option. Premium Option: For the Premium benefit option – the table below applies to disabilities resulting from sickness or injury.

Age Disabled Maximum Benefit Duration

Prior to 60 To Age 65

Age 60 -64 60 Months

Age 65 -67 To age 70

Age 68 and over 24 months

Benefit Integration: For the first 6 months your benefit may be reduced by other income due to your disability such as a leave of absence, less the cost of paying a substitute teacher if required to do so, or income received from your Employer’s assault leave plan or similar leave of absence plan resulting from you being physically assaulted while acting in your official capacity.

29

Disability Insurance The Hartford EMPLOYEE BENEFITS

After 6 months, your benefit may be reduced by other income you receive or are eligible to receive due to your disability, such as:

• Social Security Disability Insurance

• State Teacher Retirement Disability Plans

• Other employer-based disability insurance coverage you may have

• Unemployment benefits

• Retirement benefits that your employer fully or partially pays for (such as a pension plan)

Your plan includes a minimum benefit of 25% of your elected benefit.

Added value services include Ability Assist Counseling Services with three face-to-face counseling sessions per occurrence per year. Call 800-964-3577 or register at: www.guidanceresource.com Company code HLF902 Company

Name ABILI. Other services include Funeral Concierge Services, Estate Guidance Will Services and Beneficiary Counseling Services.

How to file a claim: Claims are now processed telephonically by calling 866-547-9124. Just refer to policy number 872784 and follow these easy steps:

1. If your absence is scheduled, call 30 days prior and if unscheduled, please call as soon as possible.

2. Have your information ready

• Name address other key information

• Name of department and last day full day of active work

• The nature of your claim or leave request.

• Your treating physicians name, address, and fax numbers

With your information handy, you will be assisted by a member who will take your information, answer your questions, and file your claim.

Disability Monthly Premium Elimination Period per $200 in Benefit 0/7 $8.57 14/14 $6.84 30/30 $5.64 60/60 $3.86 90/90 $3.34 180/180 $2.58 30

Cancer Insurance

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/prosperisd

THIS IS ONLY A SUMMARY OF BENEFITS. PLEASE REFER TO THE CERTIFICATE OF COVERAGE FOR LIMITATIONS AND EXCLUSIONS TO DETERMINE ACTUAL COVERAGES. GO TO WWW.MYBENEFITSHUB.COM/PROSPERISD UNDER THE CANCER SECTION FOR COMPLETE DETAILS.

Cancer Monthly Premium Employee $21.88 Employee + Spouse $35.50 Employee + Child(ren) $27.24 Family $37.96 Summary of Benefits Plan 1 Cancer Treatment Policy Benefits Level 4 Radiation Therapy, Chemotherapy, Immunotherapy - Maximum per 12-month period $20,000 Hormone Therapy - Maximum of 12 treatments per calendar year $50 per treatment Experimental Treatment paid in same manner and under the same maximums as any other benefit Surgical Rider Benefits Surgical $30 unit dollar amount Max $3,000 per operation Anesthesia 25% of amount paid for covered surgery Bone Marrow Transplant - Maximum per lifetime $6,000 Stem Cell Transplant - Maximum per lifetime $600 Prosthesis - Surgical Implantation/Non-Surgical
per lifetime $1,000 / $100 Internal Cancer First Occurrence Rider Benefits Level 2 Lump Sum Benefit - Maximum 1 per Covered Person per lifetime $5,000 Lump Sum for Eligible Dependent Children - Maximum 1 per Covered Person per lifetime $7,500 Hospital Intensive Care Unit Rider Benefits Intensive Care Unit $600 per day Step Down Unit - Maximum of 45 days per Confinement for any combination of Intensive Care Unit or Step Down Unit $300 per day
(not Hair Piece) 1 device per site,
APL EMPLOYEE
31
BENEFITS

Life and AD&D The Hartford

ABOUT LIFE AND AD&D

Group term life is the most inexpensive way to purchase life insurance. You have the freedom to select an amount of life insurance coverage you need to help protect the well-being of your family.

Accidental Death & Dismemberment is life insurance coverage that pays a death benefit to the beneficiary, should death occur due to a covered accident. Dismemberment benefits are paid to you, according to the benefit level you select, if accidentally dismembered.

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

The Group Term Life and Accidental Death and Dismemberment (AD&D) insurance available through your employer gives extra protection that you and your family may need. Life and AD&D insurance offers financial protection by providing you coverage in case of an untimely death or an accident that destroys your income- earning ability. Life benefits are disbursed to your beneficiaries in a lump sum in the event of your death.

APPLICANT BASIC COVERAGE

Reductions at age 65 and 70

Employee Benefit: $10,000

AD&D: Included

Spouse Not Included

Child(ren) Not Included

Note: Basic Life is Employer Paid

Life Insurance Coverage Information

SUPPLEMENTAL COVERAGE

Benefit: Increments of $10,000

Maximum: the lesser of 5x earnings or $500,000

Benefit: Increments of $10,000

Maximum: the lesser of 100% of your supplemental coverage or $250,000

Benefit: Increments of $5,000 Maximum: $10,000

Group Voluntary Accidental Death & Dismemberment (AD&D) insurance pays your beneficiary a death benefit if you die due to a covered accident or pays you if you are unexpectedly injured in a covered accident. The benefits are paid in lump sum amounts to you (or your beneficiary) and can be used to pay for health care expenses not covered by your major medical insurance, help replace income lost while not working, funeral expenses, or however you choose. Acci-dental death benefits are paid in addition to any life insurance.

Accidental Death and Dismemberment (AD&D)

APPLICANT AD&D COVERAGE

Employee Benefit2: Increments of $10,000

Maximum: the lesser of 5x earnings or $500,000

Coverage Information

Your dependent(s) will be covered at a percentage of your coverage amount.

Dependent(s)

Covered accidents or death can occur up to 365 days after the accident. The total benefit for all losses due to the same accident will not exceed 100% of your coverage amount.

COVERAGE TIER SPOUSE PERCENTAGE CHILD(REN) PERCENTAGE Spouse 50% 0% Child(ren) 0% 15% Spouse & Child(ren) 40% 10% AD&D BENEFITS – PERCENT OF COVERAGE AMOUNT PER ACCIDENT
LOSS FROM ACCIDENT BASIC COVERAGE VOLUNTARY COVERAGE Life 100% 100% Both Hands or Both Feet or Sight of Both Eyes 100% 100%
EMPLOYEE BENEFITS
32

Life and AD&D The Hartford

EMPLOYEE BENEFITS

ADDITIONAL SERVICES

If you are enrolled in insurance coverage with The Hartford, you may also be eligible to receive additional services at no cost to you. These services help with challenges that come before and after a claim. Be sure to read the information provided below; The Hartford wants to be there when you need us.

COVERAGE ENROLLED IN

Life & Accidental Death and Dismemberment

LIMITS AND EXCLUSIONS

ADDITIONAL SERVICES AVAILABLE

• Beneficiary Assist® Counseling Services

• EstateGuidance® Will Services

• Funeral Planning and Concierge Services

• Travel Assistance Services with ID Theft Protection and Assistance Refer to your benefit website for details on these additional services.

This insurance coverage includes certain limitations and exclusions. The certificate details all provisions, limitations, and exclusions for this insurance coverage. A copy of the certificate can be obtained at www.mybenefitshub.com/prosperisd com under the Basic Life and Voluntary Life Sections.

Spouse rates are based on Employee’s age and cannot exceed 100% of the employees supplemental life amount.

Voluntary Group Life - per $10,000 in coverage Monthly Premium Age Employee Spouse <24 $0.40 $0.50 25-29 $0.50 $0.60 30-34 $0.65 $0.80 35-39 $0.70 $0.90 40-44 $0.80 $1.00 45-49 $1.20 $1.50 50-54 $1.80 $2.30 55-59 $3.40 $4.20 60-64 $5.20 $6.50 65-69 $12.50 $12.50 70+ $20.30 $20.30
Voluntary Group Life - Child(ren) Monthly Premium Age $5,000 $10,000 0-26 $1.00 $2.00 AD&D (per $10,000) Monthly Premium Employee Only $0.20 Family $0.40
FROM ACCIDENT (cont’d) BASIC COVERAGE VOLUNTARY COVERAGE One Hand and One Foot 100% 100% Speech and Hearing in Both Ears 100% 100% Either Hand or Foot and Sight of One Eye 100% 100% Movement of Both Upper and Lower Limbs (Quadriplegia) 100% 100% Movement of Both Lower Limbs (Paraplegia) 75% 75% Movement of Three Limbs (Triplegia) 75% 75% Movement of the Upper and Lower Limbs of One Side of the Body (Hemiplegia) 50% 50% Either Hand or Foot 50% 50% Sight of One Eye 50% 50% Speech or Hearing in Both Ears 50% 50% Movement of One Limb (Uniplegia) 25% 25% Thumb and Index Finger of Either Hand 25% 25% Your benefit will be reduced
35% at
and
Reductions will be
LOSS
by
age 65
50% at age 70.
applied to the original amount.
33

Identity Theft ID Watchdog

ABOUT IDENTITY THEFT PROTECTION

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

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

ID Watchdog is everywhere you can’t be — monitoring credit reports, social media, transaction records, public records and more — to help you better protect your identity. And don’t worry, we’re always here for you. In fact, our U.S.-based customer care team is available 24/7/365 at 866.513.1518.

UNIQUE FEATURES INCLUDED IN ALL ID WATCHDOG PLANS

Monitor & Detect

• Dark Web Monitoring*

• High-Risk Transactions Monitoring*

• Subprime Loan Monitoring*

• Public Records Monitorin*

• USPS Change of Address Monitoring

• Identity Profile Report

Manage & Alert

• Child Credit Lock | 1 Bureau*

• Financial Accounts Monitoring

• Social Network Alerts*

• Registered Sex Offender Reporting*

• Customizable Alert Options

• Breach Alert Emails

• Mobile App

Support & Restore

• Identity Theft Resolution Specialists (Resolution for Pre-existing Conditions)*

• 24/7/365 U.S.-based Customer Care Center

• Lost Wallet Vault & Assistance

• Deceased Family Member Fraud Remediation

• Fraud Alert & Credit Freeze Assistance

*Helps better protect children

1 Bureau = Equifax® | Applies to the 1B plan and includes monthly monitoring

Multi-Bureau = Equifax, TransUnion® | Applies to the Platinum Plan to lock your credit report to avoid fraud

3 Bureau = Equifax, Experian®, TransUnion | Applies to the Platinum Plan and allows monitoring for all 3 credit bureaus listed

Please refer to the website, www.mybenefitshub.com/prosperisd for more details.

Identity Theft Monthly Premium 1B Platinum Employee $7.95 $11.95 Employee and Family $14.95 $22.95
34
EMPLOYEE BENEFITS

Emergency Medical Transport

ABOUT MEDICAL TRANSPORT

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

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

A MASA MTS Membership provides the ultimate peace of mind at an affordable rate for emergency ground and air transportation service within the United States and Canada, regardless of whether the provider is in or out of a given group healthcare benefits network. If a member has a high deductible health plan that is compatible with a health savings account, benefits will become available under the MASA membership for expenses incurred for medical care (as defined under Internal Revenue Code (“IRC”) section 213 (d)) once a member satisfies the applicable statutory minimum deductible under IRC section 223(c) for high-deductible health plan coverage that is compatible with a health savings account.

Emergent Air Transportation In the event of a serious medical emergency, Members have access to emergency air transportation into a medical facility or between medical facilities.

Emergent Ground Transportation In the event of a serious medical emergency, Members have access to emergency ground transportation into a medical facility or between medical facilities.

Non-Emergency Inter-Facility Transportation In the event that a member is in stable condition in a medical facility but requires a heightened level of care that is not available at their current medical facility, Members have access to nonemergency air or ground transportation between medical facilities.

Repatriation/Recuperation Suppose you or a family member is hospitalized more than 100-miles from your home. In that case, you have benefit coverage for air or ground medical transportation into a medical facility closer to your home for recuperation.

Should you need assistance with a claim contact MASA at 800-643-9023. You can find full benefit details www.mybenefitshub.com/prosperisd

MASA EMPLOYEE BENEFITS Emergency Medical Transport Monthly Premium Employee and Family $14.00 35

Flexible Spending Account (FSA) Higginbotham

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 $570 rollover or grace period provision).

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

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).

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.

EMPLOYEE
36
BENEFITS

Flexible Spending Account (FSA) Higginbotham

Important FSA Rules

• The maximum per plan year you can contribute to a Health Care FSA is $3,050. 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 after August 31st

• Your Health Care FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care expenses.

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 – 866-419-3516

EMPLOYEE BENEFITS 37

Employee Assistance Program (EAP)

Deer Oaks

ABOUT EAP

An Employee Assistance Program (EAP) is a program that assists you in resolving problems such as finding child or elder care, relationship challenges, financial or legal problems, etc. This program is provided by your employer at no cost to you.

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

EMPLOYEE ASSITANCE PROGRAM AT NO COST TO YOU!

The Deer Oaks Employee Assistance Program (EAP) is a free service provided for you, your dependents, and household members by your employer. This program offers a wide variety of counseling, referral, and consultation services, which are all designed to assist you and your family in resolving work and life issues to live happier, healthier, more balanced lives. From stress, addiction, and change management, to locating childcare facilities, legal assistance, and financial challenges, our qualified professionals are here to help. These services are completely confidential and can be easily accessed 24/7, offering you aroundthe-clock assistance for all of life’s challenges.

Program Access: You may access the EAP by calling the tollfree Helpline number, using our iConnectYou App, or instant messaging with a work-life consultant through our online instant messaging system.

Telephonic Assessments & Support: In-the-moment telephonic support and crisis intervention are available 24/7 along with intake and clinical assessments.

Short-term Counseling: Counseling sessions with a qualified counselor to assist with issues such as stress, anxiety, grief, marital/family challenges, relationship issues, addiction, etc. Counseling is available via structured telephonic sessions, video, and in-person at local provider offices.

Referrals & Community Resources: Our team provides referrals to local community resources, member health plans, support groups, legal resources, and child/elder care/daily living resources.

Advantage Legal Assist: Free 30 minute telephonic or in-person consultation with a plan attorney; 25% discount on hourly attorney fees if representation is required; unlimited online access to a wealth of educational legal resources, links, tools and forms; and interactive online Simple Will preparation.

Advantage Financial Assist: Unlimited telephonic consultation with an Accredited Financial Counselor qualified to advise on a range of financial issues such as bankruptcy prevention, debt reduction, financial planning, and identity theft; supporting educational materials available; unlimited online access to a wealth of educational financial resources, links, tools and forms (i.e. tax guides, financial calculators, etc.).

Alternate Modes of Support: Your EAP offers support alternatives in addition to traditional short-term counseling including telephonic life coaching, AWARE stress reduction sessions, and virtual group counseling. During your call with one of our counselors, ask if these programs would be right for you.

Work-life Services: Our work-life consultants are available to assist you with a wide range of daily living resources such as locating pet sitters, event planners, home repair, tutors, travel planning, and moving services. Simply call the Helpline for resource and referral information.

Child & Elder Care Referrals: Our child and elder care specialists can help you with your search for licensed child and elder care facilities in your area. They will discuss your needs, provide guidance, resources, and qualified referral packets. Searchable databases and other resources are also available on the Deer Oaks member website.

Take the High Road Ride Reimbursement Program: Deer Oaks reimburses members for their cab, Lyft and Uber fares in the event that they are incapacitated due to impairment by a substance or extreme emotional condition. This service is available once per year per participant, with a maximum reimbursement of $45.00 (excludes tips).

Contact Us:

Toll-Free: (888) 993-7650

Website: www.deeroakseap.com

Email: eap@deeroaks.com

EMPLOYEE BENEFITS 38
Notes 39

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 Prosper 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 Prosper 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.

2023
- 2024 Plan Year WWW.MYBENEFITSHUB.COM/PROSPERISD
40
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