2024-25 Tyler ISD Benefit Guide

Page 1

09/01/2024 - 08/31/2025 WWW.MYBENEFITSHUB.COM/TYLERISD

TYLER ISD BENEFIT GUIDE
2024 - 2025 Plan Year 1
EFFECTIVE:
Table of Contents FLIP TO... SUMMARY PAGES PG. 6 YOUR BENEFITS PG. 12 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 12-15 Health Savings Account (HSA) 16 Flexible Spending Account (FSA) 17-18 Hospital Indemnity 19-20 Emergency Medical Transportation 21 Telehealth 22 Dental 23 Vision 24 Disability 25-26 Cancer 27 Accident 28-29 Critical Illness 30-31 Life and AD&D 32-33 Identity Theft 34 Employee Assistance Program (EAP) 35 2

Benefit Contact Information

Higginbotham Public Sector (800) 583-6908 www.mybenefitshub.com/tylerisd

Tyler ISD

Kendra Martin (972) 685-1311 ksmartin@higginbotham.com

Amanda Parish Benefits Facilitator (903) 262-1081 EECU (800) 333-9934 www.eecu.org

Cigna

Group # HC962302 (800) 754-3207

SuppHealthClaims@Cigna.com

MetLife

Group # 241558 (800) 942-0854 www.metlife.com/mybenefits

Chubb Group # TY20240213v1 (888) 499-0425 educatorclaims@chubb.com

Lincoln Financial Group

Basic & AD&D

Group # 00010270893 VTL Group # 000400270894 LifeClaims@lfg.com

MASA

Group # MKTYTISD (800) 643-9023 claims@masaglobal.com

MetLife Group # 241558 (833) 393-5433 www.metlife.com/mybenefits

Cigna Group # AI960493 (800) 754-3207 SuppHealthClaims@Cigna.com

Identity Guard (855) 443-7748 customercare@identityguard.com

John Ledebur (972) 977-4722 jledebur@higginbotham.com

National Benefit Services Employer ID NBS651616 (855) 399-3035 my.nbsbenefits.com

MDLIVE (888) 365-1663 www.mdlive.com/fbsbh

New York Life Group # SLH-100002 (800) 842-4462 myNYLGBS.com

Cigna Group # CI960493 (800) 754-3207 SuppHealthClaims@Cigna.com

Lincoln Financial Group (888) 682 4824 GuidanceResources.com

Username: LFG Support Password LFGSupport1

SUPPLEMENTAL BENEFITS ACCOUNT EXECUTIVE BENEFIT CONSULTANT
MEDICAL HEALTH SAVINGS ACCOUNT (HSA) FLEXIBLE SPENDING ACCOUNT (FSA)
HOSPITIAL INDEMNITY EMERGENCY MEDICAL TRANSPORT TELEHEALTH
DENTAL VISION DISABILITY
CANCER ACCIDENT CRITICAL ILLNESS
LIFE AND AD&D IDENTITY THEFT EMPLOYEE ASSSISTANCE PROGRAM (EAP)
3
Employee benefits made easy through the HPS Benefits App! All Your BenefitsOne App OR SCAN Text “BENEFITS” to (214) 851-0569 App Group #: FBSTYLER Text “BENEFITS” to (214) 851-0569 and get access to everything you need to complete your benefits enrollment: • Benefit Resources • Online Enrollment • Interactive Tools • And more! 4
SSO LogIn Process CLICK LOGIN CLICK LOGIN WITH MICROSOFT 4 5 6 Enter your work e-mail address. Complete the verification steps as outlined by your employer. Happy Enrolling! 2 3 5
1 www.mybenefitshub.com/tylerisd

Annual Benefit Enrollment

Benefit Updates - What’s New:

MEDICAL - NEW CARRIER TRS

• Medical Plans are with TRS and will not rollover to the new plan year. You must log into THEbenefitsHUB and enroll in medical if you want that coverage.

• Your last Medical deduction is in July which will be used to pay your August premium.

• TRS offers 3 Active Care Plans including a High Deductible Plan.

• PCP’s are required for the Active Care Primary and Primary Plus plans so use this link: https://www.bcbstx. com/trsactivecare/doctors-and-hospitals to locate your 10 digit code for your primary care doctor.

• There will be only one medical contribution per family for each plan according to TRS guidelines. The employer contribution amounts have increased from $225 and are as follows:

$375 Employee or Employee + Child

$425 Employee + Spouse or Employee + Family

PRESCRIPTION DRUGS – EXPRESS SCRIPTS

• Express Scripts manages the Active Care plans use this link: Open Enrollment - Pharmacy Benefit Plans (expressscripts.com) to lookup preferred formulary and drug exclusions.

• Specialty drugs are managed by SaveOnSP and you must have prior approval. Benefits vary according to the Active Care Plan you choose.

EMPLOYER PAID LIFE INSURANCE CHANGES

Your Your Employer paid Basic Life is now $10K regardless if you elect medical or decline. Only available for employees that work a minimum of 15 hours. Excludes temporary employees. Don’t forget to assign a beneficiary as you complete your enrollment.

Don’t Forget!

FLEX AND DEPENDENT CARE SHORT PLAN YEAR

• The 10/1/2024 plan year will be based on 11 months of contributions instead of 12 months making this a short plan year, so an increase in your monthly amount might need to be considered.

• Your Flex and Dependent Care benefits will roll-over so you must log in to opt out of these plans for the new plan year.

• Your new Flex contribution amount for the 24-25 plan year is $3,200 and dependent care will remain at $5,000

DENTAL RATE INCREASE!

• There is a 5% increase on all Dental rates due to the cost of rising care. Please note this change as you review your payroll for the 9/1/2024.

CANCER PLAN– NEW CARRIER CHUBB

Enhanced benefits include:

• Attending Physician Benefit

• Increased Hospital Confinement Benefits

• ICU Coverage

• Family Day Care Benefit

• Hospice Care

• Home health Care

• Bone marrow and Stem Cell Transplants

• Heritable Cancer Screening

• Prosthesis Benefits

• $50 Wellness Benefit

• Continuity Of Coverage Subject to the terms of the certificate.

MDLIVE NEW FAMILY RATE - $16 MONTHLY EMPLOYEE ONLY RATE - $12.00 MONTHLY

• Plan Offers Unlimited non-emergency Medical and Behavioral visits regardless if you are enrolled in medical coverage. This plan is not intended to replace the virtual care options already offered under your TRS Medical Plan.

• Login and complete your benefit enrollment from 05/13/2024 - 06/08/2024

• Enrollment assistance is available by calling Higginbotham Public Sector at (866) 914-5202.

• Update your information: home address, phone numbers, email, and utilizing the district’s Employee Self Service Section.

• 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
6

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 STATUS (CIS):

Marital Status

Change in Number of Tax Dependents

Change in Status of Employment Affecting Coverage Eligibility

Gain/Loss of Dependents’ Eligibility Status

Judgment/ Decree/Order

Eligibility for Government Programs

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

QUALIFYING EVENTS

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

A change in number of dependents includes the following: birth, adoption and placement for 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.

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.

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

SUMMARY PAGES
7

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 eligibility employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.

Q&A

Who do I contact with Questions?

For supplemental benefit questions, you can contact your Benefits/HR department or you can call Higginbotham Public Sector 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/tylerisd

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 Tyler ISD benefit website: www.mybenefitshub.com/tylerisd. 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
8

Annual Benefit Enrollment

Employee Eligibility Requirements

Medical and Supplemental Benefits: Eligible employees must work 15 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 2024 benefits become effective on September 1, 2024, you must be actively-at-work on September 1, 2024 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.

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 Higginbotham Public Sector, 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 Higginbotham Public Sector, or contact the insurance carrier for additional information on dependent eligibility.

Theft

age 26

To age 26

To age 26

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 Higginbotham Public Sector 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 Medical To age 26 Telehealth To age 26 Dental To age 26 Vision To age 26 Cancer To age 26 Accident To age 26 Critical Illness To age 26 Voluntary Life To age 26 Medical Transport To
Hospital Indemnity
Monitoring
Identity
9

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 09/1/2024 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 prescriptions drugs or is under a health care provider’s orders to take drugs, or received medical care or services (including diagnostic and/or consultation services).

SUMMARY PAGES
10

Description

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

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.

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

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

Account Owner Individual

Underlying Insurance Requirement High deductible health plan

Minimum Deductible

Maximum Contribution

Permissible Use Of Funds

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

Year-to-year rollover of account balance?

$3,200 single (2024)

Employee and/or employer

Employer

None

$6,400 family (2024) N/A

$4,150 single (2024)

$8,300 family (2024) 55+ catch up +$1,000

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

$3,050 (2023)

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

Permitted, but subject to current tax rate plus 20% penalty (penalty waived after age 65). Not permitted

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

Access to some funds may be extended to 75 days due to the grace period or $640 rollover provision.

Does the account earn interest? Yes No

Portable?

Yes, portable year-to-year and between jobs. No

FLIP TO FOR HSA INFORMATION FLIP TO FOR FSA INFORMATION PG. 16 PG. 17 SUMMARY PAGES HSA vs. FSA
11

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/tylerisd

ABOUT MEDICAL
TRS EMPLOYEE BENEFITS Monthly Premium District Contribution Employee Cost TRS ActiveCare HD Employee Only $484.00 $375.00 $109.00 Employee & Spouse $1,307.00 $425.00 $882.00 Employee & Child(ren) $823.00 $375.00 $448.00 Employee & Family $1,646.00 $425.00 $1,221.00 TRS ActiveCare Primary Employee Only $469.00 $375.00 $94.00 Employee & Spouse $1,267.00 $425.00 $842.00 Employee & Child(ren) $798.00 $375.00 $423.00 Employee & Family $1,595.00 $425.00 $1,170.00 TRS ActiveCare Primary+ Employee Only $551.00 $375.00 $176.00 Employee & Spouse $1,433.00 $425.00 $1,008.00 Employee & Child(ren) $937.00 $375.00 $562.00 Employee & Family $1,819.00 $425.00 $1,394.00 12
Medical Insurance
13
14
15

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/tylerisd

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 HDHP (High Deductible Health Plan) Not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan

• Not enrolled in a Health Care Flexible Spending Account, nor should your spouse be contributing towards a Health Care Flexible Spending Account

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

• Not enrolled in Medicare or TRICARE

• Not receiving Veterans Administration benefits

You can use the money in your HSA to pay for qualified medical expenses now or in the future. You can also use HSA funds to pay health care expenses for your dependents, even if they are not covered under your HDHP.

Maximum Contributions

Your HSA contributions may not exceed the annual maximum amount established by the Internal Revenue Service. The annual contribution maximum for 2024 is based on the coverage option you elect:

• Individual – $4,150

• Family (filing jointly) – $8,300

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

Opening an HSA

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

Important HSA Information

• Always ask your health care provider to file claims with your medical provider so network discounts can be applied. You can pay the provider with your HSA debit card based on the balance due after discount.

• You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.

• You may open an HSA at the financial institution of your choice, but only accounts opened through EECU are eligible for automatic payroll deduction and company contributions.

How To Use Your HSA

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

• Call/Text: (817) 882-0800 EECU’s dedicated member service representatives are available to assist you with any questions. Their hours of operation are Monday through Friday from 8:00 a.m. to 7:00 p.m. CT, Saturday 9:00 a.m. 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: www.eecu.org/ locations

EECU EMPLOYEE BENEFITS
16

Flexible Spending Account (FSA)

National Benefit Services (NBS)

ABOUT FSA

A Flexible Spending Account (FSA) lets you set aside a portion of your paycheck—before taxes—into an account to help you pay for medical, dental, vision, and dependent care expenses. An FSA is a planning tool with great tax benefits. With an FSA, you must use the account balance in full before the end of the plan year or it will be forfeited. *

For full plan details, please refer to your Summary Plan Description (SPD) and visit the NBS Participant Portal: mynbsbenefits.com

There are three types of Flexible Spending Accounts you may be able to choose from. Make sure you understand the purpose of each account before you make your elections!

Health Flexible Spending Account (FSA)

The Health FSA allows you to pay for medical, dental, and vision expenses for yourself and your eligible dependents. For plan years that start in 2024, you may contribute up to $3,200.00 to your Health FSA. This benefit is funded up-front, so you will have access to your whole annual election on the first day of the plan year. You can use your NBS Smart Debit Card to pay for expenses or pay out of pocket and submit claims for reimbursement.

Some examples of common eligible expenses are co-pays and deductibles, orthodontia, eyeglasses, prescription medicines, menstrual care products, over-the-counter medicines, chiropractor, hearing aids, monitoring devices (blood pressure, cholesterol), physical therapy, laser eye surgery, and many more. Complete lists of eligible and non-eligible expenses can be found in IRS Publication 502

*The FSA is a “use-it-or-lose-it” benefit, so plan carefully to ensure you don’t forfeit funds. Your employer may offer you a grace period or rollover option. Refer to your Summary Plan Description (SPD) for more information.

Limited-Purpose Flexible Spending Account (LFSA)

If you contribute to a Health Savings Account, you cannot participate in the Health FSA. However, your employer may offer you the option to participate in a Limited Health Flexible Spending Account (LFSA). The LFSA is similar to the Health FSA but is designed to be paired with a Health Savings Account. The LFSA will allow you to be reimbursed for out-of-pocket dental and vision expenses incurred by you and your dependents.

NBS Smart Debit Card

If you participate in the FSA or LFSA benefits, you will receive a card in the mail. You can use this card to pay for eligible expenses, thus avoiding out-of-pocket expenses and submitting claim forms. Please make sure you keep any bills, receipts, statements, and/or explanations of benefits (EOBs) corresponding to your card purchases. You may be asked to substantiate your purchase to show it was an eligible expense.

EMPLOYEE BENEFITS
17

Flexible Spending Account (FSA)

National Benefit Services (NBS)

Dependent Care FSA aka Dependent Care Assistance Program (DCAP)

The Dependent Care Flexible Spending Account (DCAP) enables you to pay for out-of-pocket, work-related dependent daycare expenses using pre-tax funds. Please see your Summary Plan Description (SPD) for the definition of eligible dependent. Generally, your reimbursement may not exceed the lesser of: (a) $5,000 (if you are married filing a joint return or you are head of a household) or $2,500 (if you are married filing separate returns); (b) your taxable compensation; (c) your spouse’s actual or deemed earned income.

Examples of eligible expenses:

¾ Before and after school/extended day programs

¾ Daycare in your home or elsewhere

¾ Base cost of day camps or similar programs

Examples of ineligible expenses:

¾ Schooling for a child in kindergarten or above

¾ Babysitter while you go to the movies or dinner

¾ Cost of overnight camps

DCAPs are not funded up-front like Health FSAs. You will gain access to your contributions only after they are deducted from your paycheck. You may choose to be reimbursed automatically each pay period by filling out and submitting the Continual Reimbursement form at the beginning of the plan year. Alternatively, you can choose to submit individual claims for reimbursement. Some employers may allow you to use your NBS Smart Debit card to pay your dependent care provider.

Review your Summary Plan Description (SPD)

Your Summary Plan Description (SPD) will give you important information about these benefits that is specific to your employer’s plan. Please read your SPD so you understand your spending deadline, deadline to submit claims, whether you have a grace period and if so, when it ends, whether you have the option to carryover some remaining FSA funds and if so, how much, which qualifying life events may allow you to change your elections outside of open enrollment, and more.

NBS Participant Portal and Mobile App

To get the most out of your benefits, register for our participant portal and/or download our mobile app. On the portal and app, you can submit claims, pay providers, check your balance, set up direct deposit, order cards for your dependents and replacement cards, review transactions and spending deadlines, manage your alerts, and more.

To register, visit http://mynbsbenefits.com/, click “Register” in the top right corner, and follow the prompts. Your employee ID is your SSN.

NBS Service Center

Our dedicated service center is available to help with any of your individual needs, including accessing your account, questions about your benefits, and requesting new debit cards.

Phone: 855-399-3035, option 2

Fax: (844) 438-1496

Email: service@nbsbenefits.com

Hours of Operation:

7:00 a.m. - 7:00 p.m. CT Mon - Fri

Scan to access the NBS portal!

EMPLOYEE BENEFITS
18

Hospital Indemnity Cigna

ABOUT HOSPITAL INDEMNITY

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

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

Even with the best primary health insurance plan, out-of-pocket costs from a hospital stay can add up. Cigna’s Hospital Care plan pays a scheduled benefit if you or an insured dependent (spouse or child) are confined in a hospital for a covered illness or injury.

The benefits are paid to you, and can help offset expenses that primary health insurance doesn’t cover (like deductibles, co-insurance amounts or co-pays), or benefits can be used for any non-medical expenses (like housing costs, groceries, car expenses, etc.).

Plan Highlights

• No Pre-existing Limitations!

• HSA Compatible Claims

Options for filing Claims

Call : (800)754-3207 to speak with a representative

Online: Visit SuppHealthClaims.com

Email: Send your scanned documents to: SuppHealthClaims@Cigna.com

Available Coverage:

The benefit amounts shown in this summary will be paid regardless of the actual expenses incurred and are paid on a per day basis unless otherwise specified. Benefits are only payable when all policy terms and conditions are met. Please read all the information in the plan summary document on the benefit website to understand limitations and conditions.

Hospitalization

Hospital Admission

No Elimination Period. Limited to 1 day, 1 benefit(s) every 90 days.

Hospital Chronic Condition Admission

No Elimination Period. Limited to 1 day, 1 benefit(s) every 90 days.

Hospital Stay

No Elimination Period. Limited to 30 days, 1 benefit(s) every 90 days.

Hospital Intensive Care Unit (ICU) Stay

No Elimination Period. Limited to 30 days, 1 benefit(s) every 90 days.

Hospital Observation Stay

24 hour Elimination Period. Limited to 72 hours.

Newborn Nursery Care Admission

Limited to 1 day, 1 benefit per newborn child. This benefit is payable to the employee even if child coverage is not elected.

Newborn Nursery Care Stay*

Limited to 30 days, 1 benefit per newborn child. This benefit is payable to the employee even if child coverage is not elected.

per day

per 4-hour period

per day

per day

Benefits Plan 1 Plan 2
$1,000 $3,000
$50 $100
$100 per
$200 per day
day
$200
$400
per day
$500
$500 $500
$100
$100
EMPLOYEE BENEFITS 19

Hospital Indemnity Cigna

Additional Information:

• Hospital Admission: Must be admitted as an Inpatient due to a Covered Injury or Covered Illness. Excludes: treatment in an emergency room, provided on an outpatient basis, or for re-admission for the same Covered Injury or Covered Illness (including chronic conditions).

• Hospital Chronic Condition Admission: Must be admitted as an Inpatient due to a covered chronic condition and treatment for the covered chronic condition must be provided by a specialist in that field of medicine. Excludes: treatment in an emergency room, provided on an outpatient basis, or for re-admission for the same Covered Injury or Covered Illness (including chronic conditions).

• Hospital Stay: Must be admitted as an Inpatient and confined to the Hospital, due to a Covered Injury or Covered Illness, at the direction and under the care of a physician. If also eligible for the ICU Stay Benefit, only 1 benefit will be paid for the same Covered Injury or Covered Illness, whichever is greater. Hospital stays within 90 days for the same or a related Covered Injury or Covered Illness is considered one Hospital Stay.

• Intensive Care Unit (ICU) Stay: Must be admitted as an Inpatient and confined in an ICU of a Hospital, due to a Covered Injury or Covered Illness, at the direction and under the care of a physician. If also eligible for the Hospital Stay Benefit, only 1 benefit will be paid for the same Covered Injury or Covered Illness, whichever is greater. ICU stays within 90 days for the same or a related Covered Injury or Covered Illness is considered one ICU Stay.

• Hospital Observation Stay: Must be receiving treatment for a Covered Injury or Covered Illness in a Hospital, including an observation room, or ambulatory surgical center, for more than 24 hours, on a non-Inpatient basis and a charge must be incurred. This benefit is not payable if a benefit is payable under the Hospital Stay Benefit or Hospital Intensive Care Unit Stay Benefit.

• Newborn Nursery Care Admission and Newborn Nursery Care Stay: Must be admitted as an Inpatient and confined in a Hospital immediately following birth at the direction and under the care of a physician.

Hospital Indemnity

EMPLOYEE BENEFITS
Plan 1 Plan 2 Employee $12.87 $25.42 Employee + Spouse $24.09 $47.87 Employee + Child(ren) $22.47 $44.52 Family $36.12 $71.81 20

Emergency Medical Transport MASA

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/tylerisd

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 highdeductible 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.

Inter-

Transportation

Disclaimer: 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.

Plan Features Emergency Plus Membership Platinum Membership Emergency Air Transportation x x Emergent Ground Transportation x x Non-Emergency
Facility
x x Repatriation/
x x Escort
x Visitor
x Return
x Mortal
Transportation x Minor Return x Organ
Recipient
x Vehicle
x Pet Return x Worldwide Coverage x Emergency Medical Transportation Emergent Plus Platinum Employee Only $14.00 $24.50 Employee & Family $14.00 $32.50
Transportation
Recuperation
Transportation
Transportation
Remains
Retrieval/Organ
Transportation
Return
EMPLOYEE BENEFITS 21

Telehealth

ABOUT TELEHEALTH

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

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

Alongside your medical coverage is access to quality telehealth services through MDLIVE. Connect anytime day or night with a board-certified doctor via your mobile device or computer. While MDLIVE does not replace your primary care physician, it is a convenient and cost-effective option when you need care and:

• Have a non-emergency issue and are considering a convenience care clinic, urgent care clinic or emergency room for treatment

• Are on a business trip, vacation or away from home

• Are unable to see your primary care physician

When to Use MDLIVE:

At a cost that is the same or less than a visit to your physician, use telehealth services for minor conditions such as:

• Sore throat

• Headache

• Stomach ache

• Cold

• Flu

• Allergies

• Fever

• Urinary tract infections Do not use telemedicine for serious or life-threatening emergencies.

MDLIVE Behavioral Health:

Managing stress or life changes can be overwhelming but it’s easier than ever to get help right in the comfort of your own home. Visit a counselor or psychiatrist by phone, secure video, or MDLIVE App.

• Talk to a licensed counselor or psychiatrist from your home, office, or on the go!

• Affordable, confidential online therapy for a variety of counseling needs.

• The MDLIVE app helps you stay connected with appointment reminders, important notifications and secure messaging.

Registration is Easy

Register with MDLIVE so you are ready to use this valuable service when and where you need it.

• Online – www.mdlive.com/fbsbh

• Phone – 888-365-1663

• Mobile – download the MDLIVE mobile app to your smartphone or mobile device

• Select –“MDLIVE as a benefit” and “FBS” as your Employer/Organization when registering your account.

MDLive EMPLOYEE BENEFITS Telehealth Employee Only $12.00 Employee + Family $16.00 22

Dental Insurance

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/tylerisd

How do I request a new ID Card?

You can request your dental id card by contacting MetLife directly at 800-942-0854. You can also go to www.metlife.com and register/login to access your account.

How do I find an in-network Dentist?

• Go to metlife.com

• Select “Find a Dentist”

• Select PDP Plus next to “Choose a network”

1. “In-Network Benefits” refers to benefits provided under this plan for covered dental services that are provided by a participating dentist. “Out-of-Network Benefits” refers to benefits provided under this plan for covered dental services that are not provided by a participating dentist.

2. Negotiated fees refer to the fees that participating dentists have agreed to accept as payment in full for covered services, subject to any copay- ments, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change.

* Reimbursement for out-of-network services is based on the lesser of the dentist’s actual fee or the Maximum Allowable Charge (MAC) . The out- of-network Maximum Allowable Charge is a scheduled amount determined by MetLife.

**R&C fee refers to the Reasonable and Customary (R&C) charge, which is based on the lowest of (1) the dentist’s actual charge, (2) the dentist’s usual charge for the same or similar services, or (3) the charge of most dentists in the same geographic area for the same or similar services as determined by MetLife.

† Applies only to Type B & C Services.

• Orthodontia included for adults. Available for dependent children up to age 26.

Coverage Type: In-Netowrk1 %of PDP Fee2 Out-of-Netowrk1 %of R&C Fee4 Type A - Preventive 100% 100% Type B - Basic Restorative 80% 80% Type C - Major Restorative 50% 50% Type D - Orthodontia 50% 50% Deductible3 Individual $50 $50 Family $150 $150 Annual Maximum Benefit: Per Individual $1500 $1500 Ortodontia Lifetime Maximum Up to dependent age limit $1000 per Person $1000 per Person
EMPLOYEE BENEFITS Dental Employee Only $32.52 Employee + Dependent $65.66 Employee + Family $95.62 23
MetLife

Vision Insurance MetLife

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/tylerisd

We’re Here to Help

• Find a Vision provider at www.metlife.com/vision

• Download a claim form at www.metlife.com/mybenefits

• For general questions, go to www.metlife.com/mybenefits or call 1-833-EYE-LIFE (1-833-393-5433)

• These plans use the Superior Network

High Plan

Eye Exam - Once every 12 months

• Eye health exam, dilation, prescription, and refraction for glasses: Covered in full after a $5 copay.

• Retinal imaging: Up to a $39 copay on routine retinal screening when performed by a private practice.

Frame - Once every 12 months

• Allowance: $150

• You will receive an additional 20% savings on the amount that you pay over your allowance.

Standard Corrective Lenses - Once every 12 months

• Single vision, lined bifocal, lined trifocal, lenticular: Covered in full after $5 eyewear copay.

Standard Lens Enhancements - Once every 12 months

• Standard Polycarbonate (child up to age 18): Covered in full. Progressive lenses, Standard Polycarbonate (adult), UVcoating, Scratch-resistant coatings, Tints, Anti-reflective, Photochromic, Blue Light filtering, Digital Single Vision, Polarized, High Index (1.67 / 1.74): Your cost will be limited to a member out of pocket amount (MOOP) that MetLife has negotiated for you. These amounts may be viewed after enrollment at metlife.com/mybenefits

Contact Lenses (instead of eyeglasses) - Once every 12 months

• Contact lens fitting (standard): Covered in full after $25 copay.

• Contact lens fitting (premium): $50 retail allowance after $25 copay.

• Elective lenses: $150 allowance

• Necessary lenses: Covered in full.

Low Plan

Eye Exam - Once every 12 months

• Eye health exam, dilation, prescription, and refraction for glasses: Covered in full after a $5 copay.

• Retinal imaging: Up to a $39 copay on routine retinal screening when performed by a private practice.

Frame - Once every 12 months

• Allowance: $150

• You will receive an additional 20% savings on the amount that you pay over your allowance.

Standard Corrective Lenses - Once every 12 months

• Single vision, lined bifocal, lined trifocal, lenticular: Covered in full after $5 eyewear copay.

Standard Lens Enhancements - Once every 12 months

• Standard Polycarbonate (child up to age 18): Covered in full. Progressive lenses, Standard Polycarbonate (adult), UV coating, Scratch-resistant coatings, Tints, Anti-reflective, Photochromic, Blue Light filtering, Digital Single Vision, Polarized, High Index (1.67 / 1.74): Your cost will be limited to a member out of pocket amount (MOOP) that MetLife has negotiated for you. These amounts may be viewed after enrollment at metlife.com/mybenefits

Contact Lenses (instead of eyeglasses) - Once every 12 months

• Contact lens fitting (standard): Covered in full after $25 copay.

• Contact lens fitting (premium): $50 retail allowance after $25 copay.

• Elective lenses: $150 allowance

• Necessary lenses: Covered in full.

Vision High Plan Low Plan Employee Only $9.98 $7.70 Employee and Spouse $17.02 $13.12 Employee and Family $24.98 $19.26
EMPLOYEE BENEFITS Please note: The High Plan allows dual allowances for Frames and Lenses or Contacts and or one of each. This applies only to in-network providers. 24

Disability Insurance

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/tylerisd

What is Educator Disability Insurance?

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

Definition of Disability: “Disability” or “Disabled” means that, solely because of a covered injury or sickness, you are unable to perform the material duties of your regular occupation/regular job and you are unable to earn 80% or more of your indexed earnings from working in your regular occupation/regular job. After benefits have been payable for 24 months, you are considered disabled if solely due to your injury or sickness, you are unable to perform the material duties of any occupation for which you are (or may reasonably become) qualified by education, training or experience, and you are unable to earn 80% or more of your indexed earnings. We will require proof of earnings and continued disability.

Pre-Existing Condition Limitation: Benefits are not payable for medical conditions for which you incurred expenses, took prescription drugs, received medical treatment, care or services (including diagnostic measures), during the 3 months just prior to the most recent effective date of insurance. Benefits are not payable for any disability resulting from a preexisting condition unless the disability occurs after you have been insured under this plan for at least 12 months after your most recent effective date of insurance.

The Insurance Company will waive the Pre-Existing Condition Limitation for the first four weeks of Disability even if the Employee has a Pre-Existing Condition. The Disability Benefits as shown in the Schedule of Benefits will continue beyond 4 weeks only if the Pre-Existing Condition Limitation does not apply.

Maximum Benefit Duration: Once you qualify for benefits under this plan, you continue to receive them until the end of the benefit or until you no longer qualify for benefits, whichever occurs first. Should you remain Disabled, your benefits continue based on a schedule. See your benefit website at www.mybenefitshub.com/tylerisd for full details.

Eligibility: All active, Full-time Employees of the Employer who are citizens or permanent resident aliens of the United States working a minimum of 15 hours per week. You will be eligible for coverage the first of the month on or after 30 days of active service.

Effective Date: Your coverage takes effect on the later of the policy’s effective date, the date you become eligible, the date we receive your completed enrollment form, or the date you authorize any necessary payroll deductions. If you’re not actively at work on the date your coverage would otherwise take effect, your coverage will take effect on the date you return to work. If you have to submit evidence of good health, your coverage takes effect on the date we agree, in writing, to cover you.

EMPLOYEE BENEFITS 25
New York Life

Disability Insurance

New York Life

Effects of Other Income Benefits: This plan is structured to prevent your total benefits and post-disability earnings from equaling or exceeding pre-disability earnings. Therefore, we reduce this plan’s benefits by Other Income Benefits payable to you, your dependents, or a qualified third party on behalf of you or your dependents. Disability benefits will be reduced by amounts received through Social Security disability benefits payable to you, your dependents, or a qualified third party on behalf of you or your dependents. Your disability benefits will not be reduced by any Social Security disability benefits you are not receiving as long as you cooperate fully in efforts to obtain them and agree to repay any overpayment when and if you do receive them. Disability benefits will also be reduced by amounts received through other government programs, employer’s sabbatical leave, employer’s assault leave plan, employer funded retirement benefits, workers’ compensation, franchise/group insurance, auto no-fault, and damages for wage loss. For details, see your outline of coverage, policy certificate, or your employer’s summary plan description.

Choose the plan and elimination period best for your situation. Remember the elimination period is the number of days of your disability that are NOT covered. Only plans with elimination periods 30 days or less waive the elimination period during a 24 hospital stay.

Please refer to the “Maximum Benefit Period” Schedules on your benefit website for full details.

EMPLOYEE BENEFITS
Gross Monthly Benefit Maximum Gross Monthly Benefit Benefit Waiting Period Maximum Benefit Period
You can choose between 30%, 40%, 60% or 65% of your monthly covered earnings. $7,500 Select from Six Options: Accident Sickness 0 days/7 days 14 days/14 days 30 days/30 days 60 days/60 days 90 days/90 days 180 days/180 days
Monthly Rates by Type of Plan (Per $100 Benefit) Premium Duration Accident SSNRA Sickness SSNRA Benefit Waiting Period Days Accident 0 30 60 180 Sickness 7 30 60 180 30% $4.05 $2.43 $1.93 $1.10 40% $4.52 $2.71 $2.15 $1.22 60% $4.77 $2.86 $2.27 $1.29 65% $4.86 $2.92 $2.31 $1.31 26

Cancer Insurance CHUBB

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/tylerisd

Cancer Insurance

This Cancer Insurance covers all active employees working 15 hours per week.

First Cancer Benefit

Alternative Care Benefit

Diagnosis of Cancer Benefit

Medical Imaging Benefit

Skin Cancer Initial Diagnosis Benefit

Attending Physician Benefit

Hospital Confinement Benefit

Hospital Confinement ICU Benefit

Hospital Confinement Sub-Acute

Intensive Care Unit Benefit

Family Care Benefit

$100

Plan 1

paid upon receipt of first covered claim for Cancer; only one payment per Covered Person per Certificate per Calendar Year

$75 per visit

Maximum Visits per Calendar Year: 4

$5,000

Waiting Period 0 days

Benefit Reduction: None

$500 per Imaging Study

Maximum Studies per Calendar Year: 2

$100 per Diagnosis

Lifetime Maximum: 1

$50 per Visit

Maximum Visits per Confinement: 2

Maximum Visits per Calendar Year: 4

$100 Per Day – Days 1 through 30

Additional Days: $200

Maximum Days per Confinement: 31

$600 Per Day – Days 1 through 30

Additional Days: $600

Maximum Days per Confinement: 31

$300 Per Day – Days 1 through 30

Additional Days: $300

Maximum Days per Confinement: 31

Childcare: $100 per Day per Child

Maximum Days per Calendar Year: 30

Adult Day Care or Home Healthcare:

$100 per Day

Maximum Days per Calendar Year: 30

Plan 2

$100

paid upon receipt of first covered claim for Cancer; only one payment per Covered Person per Certificate per Calendar Year

$75 per visit

Maximum Visits per Calendar Year: 4

$10,000

Waiting Period 0 days

Benefit Reduction: None

$500 per Imaging Study

Maximum Studies per Calendar Year: 2

$100 per Diagnosis

Lifetime Maximum: 1

$50 per Visit

Maximum Visits per Confinement: 2

Maximum Visits per Calendar Year: 4

$300 Per Day – Days 1 through 30

Additional Days: $600

Maximum Days per Confinement: 31

$600 Per Day – Days 1 through 30

Additional Days: $600

Maximum Days per Confinement: 31

$300 Per Day – Days 1 through 30

Additional Days: $300

Maximum Days per Confinement: 31

Childcare: $100 per Day per Child

Maximum Days per Calendar Year: 30

Adult Day Care or Home Healthcare: $100 per Day

Maximum Days per Calendar Year: 30

EMPLOYEE BENEFITS
27

Cancer Insurance CHUBB

Prescription Drug Inpatient Benefit

Private Full-Time Nursing Services Benefit

U.S. Government or Charity Hospital Benefit

Family Member Transportation and Lodging Benefit

Home Health Care Benefit

Hospice Care Benefit

Skilled Nursing Care Facility Benefit

Per Confinement: $150

Maximum Confinements per Calendar Year 6

$150 per Day

Maximum Days per Confinement: 5

Days 1 through 30: $100

Additional Days: $200

Maximum Days per Confinement: 15

Family Transportation: $100 per Trip

Maximum Trips per Calendar Year: 12

Family Lodging: $100 per Day

Maximum Days per Calendar Year: 100

$100 per Day not to exceed the number of days confined

Maximum Days per Calendar Year: 30

$100 per Day

$300 per Day

Maximum Days per Calendar Year: 30

Per Confinement: $150

Maximum Confinements per Calendar Year 6

$150 per Day

Maximum Days per Confinement: 5

Days 1 through 30: $300

Additional Days: $600

Maximum Days per Confinement: 15

Family Transportation: $100 per Trip

Maximum Trips per Calendar Year: 12

Family Lodging: $100 per Day

Maximum Days per Calendar Year: 100

$300 per Day not to exceed the number of days confined Maximum Days per Calendar Year: 30

$300 per Day

$300 per Day

Maximum Days per Calendar Year: 30

EMPLOYEE BENEFITS Plan 1 Plan 2
Specialty Care Benefits Plan 1 Plan 2
Cancer Monthly Premiums Plan 1 Plan 2 Employee Only $16.96 $28.66 Employee + Spouse $32.60 $54.98 Employee + Child(ren) $21.44 $36.78 Family $38.18 $60.80 28

Accident Insurance Cigna

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/tylerisd

Office Visit – Includes urgent care, Virtual Care accepted. Limited to 1 per

INITIAL CARE AND EMERGENCY CARE Plan 1 Plan 2 Emergency Care Treatment - Limited to 1 per accident. $200 $400 Physician
$100 $200 Diagnostic Exam
lab)
per accident. $50 $100 Ground / Water Ambulance (to nearest hospital) $400 $500 Air Ambulance - Limited 1 per accident. $1,600 $2,000 HOSPITALIZATION Plan 1 Plan 2 Hospital Admission - Limited to 1 per accident. $1,000 $1,500 Hospital Stay - Limited to 365 days, 1 stay per accident. $200 per day $300 per day Intensive Care Unit Stay - Limited to 365 days, 1 stay per accident. $400 per day $600 per day Accident Plan 1 Plan 2 Employee $8.40 $14.55 Employee + Spouse $14.30 $24.81 Employee + Child(ren) $14.54 $25.25 Family $19.62 $34.07 You can
additional claim
Benefit Amount FRACTURES Plan 1 Plan 2 Non-Surgical Surgical Non-Surgical Surgical Skull $4,000 $8,000 $5,000 $10,000 Hip or Thigh $4,000 $8,000 $5,000 $10,000 Vertebrae or Pelvis $4,000 $8,000 $5,000 $10,000 Upper Arm $1,000 $2,000 $1,500 $3,000 Shoulder or Collarbone $1,000 $2,000 $1,500 $3,000 Leg $1,000 $2,000 $1,500 $3,000 Ankle $800 $1,600 $1,000 $2,000 Kneecap $800 $1,600 $1,000 $2,000 Lower Arm $800 $1,600 $1,000 $2,000 Foot $800 $1,600 $1,000 $2,000 Hand or Wrist $800 $1,600 $1,000 $2,000 Upper Jaw $600 $1,200 $800 $1,600 Lower Jaw $600 $1,200 $800 $1,600 Bones of Face or Nose $600 $1,200 $800 $1,600 Vertebral Processes $600 $1,200 $800 $1,600
accident.
(x-ray or
- Limited 1
find
forms and materials at www.mybenefitshub.com/tylerisd
EMPLOYEE BENEFITS 29

Accident Insurance Cigna

Online: Visit SuppHealthClaims.com

Email: Send your scanned documents to: SuppHealthClaims@Cigna.com

EMPLOYEE BENEFITS Benefit Amount FRACTURES (cont’d) Plan 1 Plan 2 Non-Surgical Surgical Non-Surgical Surgical Rib - More than 1 rib fracture pays 2 times the Benefit Amount $200 $400 $300 $600 Coccyx $4,000 $8,000 $5,000 $10,000 Finger - More than 1 finger pays 2 times the Benefit Amount $100 $200 $150 $300 Toe - More than 1 toe fracture pays 2 times the Benefit Amount $100 $200 $150 $300 Sternum $100 $200 $150 $300 Heel $100 $200 $150 $300 Chip Fracture 25% of closed fracture benefit N/A 25% of closed fracture benefit N/A Multiple Fractures 200% of the single fracture benefit for multiple fractures to the same bone N/A 200% of the single fracture benefit for multiple fractures to the same bone N/A DISLOCATIONS Plan 1 Plan 2 Non-Surgical Surgical Non-Surgical Surgical Hip Joint $3,000 $6,000 $3,000 $6,000 Knee Joint $3,000 $6,000 $3,000 $6,000 Bones of Foot $3,000 $6,000 $3,000 $6,000 Ankle $1,000 $2,000 $1,500 $3,000 Wrist $800 $1,600 $1,000 $2,000 Elbow $600 $1,200 $800 $1,600 Shoulder $400 $800 $600 $1,200 Hand $400 $800 $600 $1,200 Collarbone $400 $800 $600 $1,200 Lower Jaw $400 $800 $600 $1,200 Finger or Toe $100 $200 $150 $300 Benefit Type Plan 1 Plan 2 Loss of Life $25,000 $50,000 Automobile Accidental Death $25,000 $50,000 Common Carrier Accidental Death $75,000 $100,000 Sight in Both Eyes $20,000 $30,000 Both Hands or Arms $20,000 $30,000 Both Feet or Legs $20,000 $30,000 Speech and Hearing in Both Ears $20,000 $30,000 Speech or Hearing in Both Ears $10,000 $15,000 One Hand or Arm and One Foot or Leg $10,000 $15,000 One Hand, Arm, Foot, Leg, or Sight in one Eye $10,000 $15,000 Finger $1,000 $2,000 Toe $1,000 $2,000 Options
for filing Claims:
Call: 1-800-754-3207 to speak with a representative
30

Critical Illness Insurance Cigna

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/tylerisd

Who Can Elect Coverage:

You: All active, Employees of the Employer who are regularly working a minimum of 15 hours per week who are United States citizens or permanent resident aliens regularly working in the United States. You will be eligible to elect coverage on the first of the month after 30 days from date of hire or Active Service. Your Spouse:* Up to age 100, as long as you apply for and are approved for coverage yourself. Your Child(ren): Birth to age 26; 26+ if disabled, as long as you apply for and are approved for coverage yourself.

Available Coverage:

The benefit amounts shown will be paid regardless of the actual expenses incurred. The benefit descriptions are a summary only. There are terms, conditions, state variations, exclusions and limitations applicable to these benefits. Please read all of th e information in this Summary and your Certificate of Insurance for more information. All Covered Critical Illness Conditions must be due to disease or sickness.

Benefit Amount Guaranteed Issue Amount Employee $5,000, $10,000, $15,000, $20,000, $30,000 Up to $30,000 Spouse $5,000, $10,000, $15,000 Up to $15,000 Children $5,000 All guaranteed issue Covered Conditions Initial Benefit Amount % Recurrence % of Initial Benefit Amount Vascular Conditions Heart Attack 100% 100% Stroke 100% 100% Coronary Artery Disease 25% 25% Nervous System Conditions Advanced Alzheimer's Disease 25% Not Available Amyotrophic Lateral Sclerosis (ALS) 25% Not Available Parkinson's Disease 25% Not Available Multiple Sclerosis 25% Not Available Childhood Conditions* Cerebral Palsy 100% Not Available Cystic Fibrosis 100% 100% Muscular Dystrophy 100% 100% Poliomyelitis 100% Not Available Other Specified Conditions Benign Brain Tumor 100% 100% Blindness 100% Not Available Coma 25% 25%
EMPLOYEE BENEFITS 31

Critical Illness Insurance

Cigna

For Childhood Conditions please refer to the beginning of the Available Coverage section above for details on how much coverage is available for covered children. Health Screening

Test Benefit

Examples includes (but are not limited to) mammography, and certain blood tests. The benefit amount shown will be paid regardless of the actual expenses incurred and is paid on a per day basis. Virtual Care accepted.

Benefit for a diagnosis made after the effective date of coverage for each Covered Condition shown above. The amount payable per Covered Condition is the Initial Benefit Amount multiplied by the applicable percentage shown. Each Covered Condition will be payable one time per Covered Person, subject to the Maximum Lifetime Limit. A 90 days separation period between the dates of diagnosis is required.* Recurrence Benefit

Maximum Lifetime Limit

Benefit for the diagnosis of a subsequent and same Covered Condition for which an Initial Critical Illness Benefit has been paid, payable after a 6 month separation period from diagnosis of a previous Covered Condition, subject to the Maximum Lifetime Limit.

The maximum benefit payable per Covered Person is the lesser of 5 times the elected Benefit Amount or $150,000.

Portability Feature: You can continue 100% of coverage for all Covered Persons at the time Your coverage ends. You must be covered under the policy and be under the age of 100 in order to continue your coverage. Rates may change and all coverage ends at age 100. Applies to United States Citizens and Permanent Resident Aliens residing in the United States.

Guaranteed Issue: If you are a new hire you are not required to provide proof of good health if you enroll during your employer’s eligibility waiting period and you choose an amount of coverage up to and including the Guaranteed Issue Amount. If you apply for an amount of coverage greater than the Guaranteed Issue Amount, coverage in excess of the Guaranteed Issue Amount will not be issued until the insurance company approves acceptable proof of good health. Guaranteed Issue coverage may be available at other specified periods of time. Your employer will notify you when these periods of time are available. Your Spouse must be age 18 or older to apply if evidence of insurability is required.

To file a claim:

Call: 800. 754.3207

Fax: 860.730.6460

Email scanned documents to: accidentinjury/criticalillness@Cigna.com

Claim Forms are located at: Cigna.com/customer-forms

EMPLOYEE BENEFITS Covered Conditions Initial Benefit Amount % Recurrence % of Initial Benefit Amount Other Specified Conditions End-Stage Renal (Kidney) Disease 100% 100% Major Organ Failure 100% 100% Paralysis 100% 100% Loss of Hearing 100% Not Available Loss of Speech 100% Not Available Systemic Lupus 25% 25% Systemic Sclerosis 25% 25%
Benefit Amount
$50 1 per year Benefits Initial Critical Illness Benefit
Critical Illness Critical Illness Age Employee Spouse Child(ren) $5,000 $10,000 $15,000 $20,000 $30,000 $5,000 $10,000 $15,000 $2.14 <29 $2.73 $3.47 $4.21 $4.95 $6.43 $2.30 $3.11 $3.92 30 to 39 $3.10 $4.21 $5.32 $6.43 $8.65 $2.88 $4.27 $5.66 40 to 49 $3.96 $5.93 $7.90 $9.87 $13.81 $4.16 $6.83 $9.50 50 to 59 $5.78 $9.58 $13.37 $17.17 $24.76 $7.02 $12.55 $18.08 60 to 69 $8.30 $14.61 $20.92 $27.23 $39.85 $10.21 $18.93 $27.65 70 to 79 $14.99 $28.00 $41.00 $54.01 $80.02 $16.89 $32.29 $47.69 80 to 89 $33.15 $64.32 $95.48 $126.65 $188.98 $41.49 $81.50 $121.50 90+ $33.15 $64.32 $95.48 $126.65 $188.98 $41.49 $81.50 $121.50
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Life and AD&D

Lincoln Financial Group

ABOUT LIFE AND AD&D

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

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

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

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

Safeguard the most important people in your life.

Consider what your loved ones may face after you’re gone. Term life insurance can help them in many ways, like covering everyday expenses, paying off debt, and protecting savings. Accidental death and dismemberment (AD&D) insurance provides additional benefits if you die or suffer a covered loss in an accident, such as losing a limb or your eyesight.

At a glance:

• A cash benefit of $10,00 to your loved ones in the event of your death, plus an additional cash benefit if you die in an accident.

• AD&D Plus: If you suffer an AD&D-covered loss in an accident, you may also receive benefits for the following in addition to your core AD&D benefits: coma, plegia, education, childcare, spouse [OR domestic partner] training. Additional conditions are outlined in your policy.

• Includes LifeKeys® services, which provide access to counseling, financial, and legal support services.

• TravelConnect® services, which give you and your family access to emergency medical assistance when you’re on a trip 100+ miles from home.

You also have the option to increase your cash benefit by securing additional coverage at affordable group rates. Under the Voluntary Life Section, refer to the voluntary section on your employee portal, www.mybenefitshub.com/tylerisd.

Additional details

Continuation of coverage for ceasing active work: You may be able to continue your coverage if you leave your job for reasons including, but not limited to, Family and Medical Leave, layoff, leave of absence, leave of absence due to disability, sabbatical leave, or temporary reduction in hours.

Waiver of premium: This provision relieves you from paying premiums during a specified time of disability.

Continuation of coverage: You may be able to continue your coverage if you leave your job for any reason other than sickness, injury, or retirement.

Accelerated death benefit: This enables you to receive a portion of your policy death benefit while living. To qualify, a medical professional must diagnose you with a terminal illness with a life expectancy of fewer than 12 months.

Conversion: You may be able to convert your group term life coverage to an individual life insurance policy if your coverage decreases or you lose coverage due to leaving your job or for other reasons outlined in the plan contract.

Benefit reduction: Your employee Life/AD&D coverage amount will reduce by 50% when you reach 70. Benefits end when you retire.

REMINDER: Please review your beneficiary(ies) to ensure they are up to date. It’s good practice to review and, if necessary, update your beneficiary(ies) annually. A complete list of benefit exclusions is available under the policy certificate located on the employee site: www.mybenefitshub.com/tylerisd

EMPLOYEE BENEFITS
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Identity Theft Aura | Identity Guard

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/tylerisd

E-mail solicitation/junk mail prevention

Robo-call/robo-text protection

Safe browsing extension

Have you wondered:

• How do I know if my information has been comprised?

• What do I do if my personal information has been stolen?

• Can I protect myself and my family on social media?

• Can I protect my children from identity theft?

Aura Identity Guard protects you and your family against cybercrime.

COMPREHENSIVE IDENTITY PROTECTION

• $1M in insurance protection1 from financial losses and legal fees

• 24/7 expert guidance, if a threat is detected

• Protect your loved ones for one low price with our family plan

• Around-the-clock scan of billions of online resources

• Reduce exposure to cybertheft

• Be alerted within seconds of possible cyberthreats POWERFUL FINANCIAL TOOLS

• Keep an eye on your spending and get alerted to suspicious transactions

• Access to your credit report and real-time alerts to changes that impact your credit

• Complete protection and monitoring of online accounts and passwords

How to file a Claim:

Customer Service Concierge: customercare@identityguard.com or (855) 443-7748

Safe browsing: anti-ransomware & anti-malware

VPN / WiFi security

COMPREHENSIVE IDENTITY PROTECTION

$1 Million insurance with stolen funds reimbursement

401(k) & HSA reimbursement

Address monitoring

Auto-on monitoring

Compromised credentials scan

Court records monitoring

Criminal record monitoring

Cyberbullying monitoring

Dark web monitoring

Data broker list monitoring/removal

Device/cookie tracking protection

Fictitious identity monitoring

Home title monitoring

Human-sourced intelligence

Medical ID monitoring

Social media monitoring

Social security and ID authentication monitoring

FINANCIAL FRAUD PROTECTION

Bank account transaction monitoring

Credit card monitoring

Debit card monitoring

Financial accounts monitoring

High-risk transaction monitoring

Lost wallet protection

Online accounts monitoring

POWERFUL FINANCIAL TOOLS

Annual credit report

Credit bureau monitoring

Credit report lock

Credit score tracker

Monthly credit score

Near real-time alerts

Security freeze assistance

Student loan activity alerts

CUSTOMER CARE

End-to-end remediation

Mobile App

Online identity dashboard

U.S.-based customer care

SPEED
LARGEST BREADTH
ALERTS
FASTEST
AND
OF
Identity Guard Employee Only $9.94 Employee and Family $18.50 PROACTIVE DEAVICE & PRIVACY PROTECTION Ultimate Plan Anti-adware  Anti-virus 
Up to 3-Bureau
Up to 3-Bureau
1-Bureau
EMPLOYEE BENEFITS 34

Employee Assistance Program (EAP) Lincoln Financial Group | LifeKeys

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/tylerisd

No matter how well you plan, unexpected challenges arise. When they do, help and support are nearby— thanks to LifeKeys® services from Lincoln Financial Group.

LifeKeys services include:

Discounts on shopping and entertainment : GuidanceResources® includes 24/7 online access to the Working Advantage discount network. You can save up to 60% on a variety of products and services, including electronics, health and fitness, Broadway shows, and much more. Discounts are also available in the GuidanceNow mobile app, available in the Apple App Store and on Google Play.

Help with important life matters: You’ll find support tools and advice on a wide range of topics, including legal, financial, family, and career, on GuidanceResources online. Stay in the know on matters that impact your personal and professional life.

Protection against identity theft: Identity theft is widespread, and everyone is vulnerable. LifeKeys includes an online resource for information that can help you recognize and prevent identity theft — and restore your good name should your identity be compromised.

Online will preparation: Creating a will allows you to make vital decisions ahead of time, including naming a guardian for your children or designating who will receive your property and assets after you pass away. Without a will, state officials will distribute your estate. EstateGuidance® offers a secure, efficient way to create and execute a will so you can rest easy knowing you’ve planned ahead for your family.

Guidance and support for your beneficiaries: LifeKeys is a comprehensive program that offers resources to help your loved ones address a range of common concerns should they experience a loss. Services include grief counseling, financial and legal advice, and support when coping with the challenges of day -to-day life.

Your life and accidental death and dismemberment (AD&D) insurance policies include access to a wide range of services

to help you and your loved ones navigate life’s most important matters.

Help, guidance, and support for beneficiaries following a loss

The emotional impact of losing a loved one can be deep and long -lasting. All too often, financial or legal issues can add to the stress. LifeKeys services can be a welcome resource for your beneficiaries.

Your beneficiaries will have access to six in-person sessions for grief counseling, legal or financial information, and unlimited phone counseling. Services are available for up to one year after a loss.

Grief counseling — advice, information, and referrals on:

• Coping with loss

• Stress, anxiety, and depression

• Memorial planning information

• Concerns about family, including children and teens

Legal support — access to legal information on:

• Estate and probate law

• Real estate transactions

• Social Security survivor and child benefits

• Important documents for beneficiaries

Financial services — online resources and advice from financial specialists on:

• Estate planning

• Bankruptcy

• Budgeting

• Investments

• Overcoming debt

Help with everyday life — comprehensive information on:

• Finding child care or elder care

• Financing a home

• Moving and relocation

• Making major purchases

Access LifeKeys services. Visit GuidanceResources.com, download the GuidanceNow mobile app, or call 888-628-4824.

Username LFGSupport

Password LFGSupport1

EMPLOYEE BENEFITS 35

2024 - 2025 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 Sample 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 Sample 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.

WW W.MY BENEFITS HUB.COM/TYLERISD
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