Benefit Contact Information
COLORADO SPRINGS CHARTER ACADEMY BENEFITS
Higginbotham Public Sector (833) 453-1680 www.mybenefitshub.com/ cscharteracademy
United Health Care (855) 828-7715
www.welcometouhc.com
HEALTH SAVINGS ACCOUNT (HSA) HOSPITAL CASH
Optum (800) 791-9361 customercare@optum.com
Chubb Group #100000250 (888) 499-0425
educatorclaims@chubb.com
Recuro Health (855) 673-2876 www.recurohealth.com
DENTAL
MetLife (800) 275-4638 www.metlife.com/dental Network: PDP Plus VISION DISABILITY ACCIDENT
MetLife (800) 275-4638
www.metlife.com/vision Network: VSP Choice
CRITICAL ILLNESS
Chubb Group #100000250 (888) 499-0425
educatorclaims@chubb.com
FLEXIBLE SPENDING ACCOUNT (FSA)
Higginbotham (866) 419-3519
https://flexservices.higginbotham.net/ Flexclaims@higginbotham.net
Lincoln Financial Group
Group #1213109 (800) 423-2756 www.lfg.com
Lincoln Financial Group Group #1213109 (800) 423-2756 custservsupportteam@lfg.com
Chubb Group #100000250 (888) 499-0425
educatorclaims@chubb.com
5Star Life Insurance Company (866) 863-9753 www.5starlifeinsurance.com
Don’t Forget!
• Login and complete your benefit enrollment from 05/02/2025 - 05/31/2025
• Enrollment assistance is available by calling Higginbotham Public Sector at (866) 914-5202.
• Update your information: home address, phone numbers, email, and beneficiaries.
• 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.
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 Office 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/ cscharteracademy. 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 Colorado Springs Charter Academy benefit website: www.mybenefitshub.com/cscharteracademy. 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.
What is 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.
What is a 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).
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 Benefits 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.
Telehealth Recuro Health
ABOUT TELEHEALTH
Telehealth provides 24/7/365 access to board-certified doctors via telephone or video consultations that can diagnose, recommend treatment and prescribe medication. Telehealth makes care more convenient and accessible for non-emergency care when your primary care physician is not available.
For full plan details, please visit your benefit website: www.mybenefitshub.com/cscharteracademy
Alongside your medical coverage is access to quality telehealth services through Recuro. Connect anytime day or night with a board-certified doctor via your mobile device or computer. While Recuro 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 Telehealth:
At a cost that is the same or less than a visit to your physician, use telehealth services for minor conditions such as:
• Sore throat
• Headache
• Stomachache
• Cold
• Flu
• Allergies
• Fever
• Urinary tract infections
Do not use telemedicine for serious or life-threatening emergencies.
Recuro Behavioral Health
Psychiatry
Therapy and Counseling Health Risk Assessment
Risk Stratification Integrated Prescriptions
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 Recuro 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.
Behavioral Health and Psychiatry is only available for dependents 14 and up
Registration is Easy Register with Recuro so you are ready to use this valuable service when and where you need it.
• Online – www.recurohealth.com
• Phone – 1.855.6RECURO
• Mobile – download the Recuro mobile app to your smartphone or mobile device
Hospital Indemnity Chubb
Choose from 1 of 2 plans
Waiver of Premium for Hospital Confinement
This benefit waives premium when the employee or spouse is confined for more than 30 continuous days.
Exclusions and Limitations*
Included
Included
We will not pay for any Covered Accident or Covered Sickness that is caused by, or occurs as a result of 1) committing or attempting to commit suicide or intentionally injuring oneself; 2) war or serving in any of the armed forces or its auxiliary units; 3) participating in an illegal occupation or attempting to commit or actually committing a felony; 4) sky diving, hang gliding, parachuting, bungee jumping, parasailing, or scuba diving; 5) being intoxicated or being under the influence or any narcotic or other prescription drug unless taken in accordance with Physician’s instructions 6) alcoholism; 7) cosmetic surgery, except for reconstructive surgery needed as the result of an Injury or Sickness or is related to or results from a congenital disease or anomaly of a covered Dependent Child; 8) services related to sterilization, reversal of a vasectomy or tubal ligation, in vitro fertilization, and diagnostic treatment of infertility or other related problems.
A Physician cannot be You or a member of Your Immediate Family, Your business or professional partner, or any person who has a financial affiliation or business interest with You.
*If the employee waives medical coverage, the district will pay the $23.66 employee cost for Plan 2, and if the employee elects any other tier on Plan 2, the $23.66 will be credited toward the employee’s coverage.
Questions?
Contact the FBS Benefits CareLine via the QR code or (833) 453-1680
*Please refer to your Certificate of Insurance at www.mybenefitshub.com/cscharteracademy for a complete listing of available benefits, limitations and exclusions. Underwritten by ACE Property & Casualty Company, a Chubb company. This information is a brief description of the important benefits and features of the insurance plan. It is not an insurance contract. This is a supplement to health insurance and is not a substitute for Major Medical or other minimal essential coverage. Hospital indemnity coverage provides a benefit for covered loss; neither the product name nor benefits payable are intended to provide reimbursement for medical expenses incurred by a covered person or to result in any payment in excess of loss.
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/cscharteracademy
Dental Coverage
Our dental plans help you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work.
DPPO Plan
Two levels of benefits are available with the DPPO plan: in-network and out-of-network. You may select any dental provider for care, but you will pay less and get the highest level of benefits with in-network providers. You could pay more if you use an out-of-network provider.
Find an In-Network Provider Visit www.metlife.com/dental Call (800) 275-4638
Disability Insurance Lincoln Financial Group
ABOUT DISABILITY
Disability insurance protects one of your most valuable assets, your paycheck. This insurance will replace a portion of your income in the event that you become physically unable to work due to sickness or injury for an extended period of time.
For full plan details, please visit your benefit website: www.mybenefitshub.com/cscharteracademy
Short Term Disability Insurance can pay you a weekly benefit if you have a covered disability that keeps you from working. Short-Term Disability Benefit Overview-Please see plan documents for details.
Disability Insurance Lincoln Financial Group
Long Term Disability Insurance can replace part of your income if a disability keeps you out of work for a long period of time.
Long-Term Disability Benefit Overview- please see plan documents for details.
Long-Term Disability Benefits
Elimination Period
Maximum Benefit Period
of $100 or 10% of Benefit
of Age 65 or SSNRA
Pre-Existing Conditions* Subject to a 3/12 pre-existing limitation
Definition of Earnings
Return to Work Incentive
Annual Earnings Excluding Overtime, Bonuses, & Commission
of Age 65 or SSNRA
Maximum Benefit Period Benefits for a disabled employee are payable to the employee’s Social Security Normal Retirement Age or the Maximum Benefit Period listed on plan documents. All employees must be actively at work on policy’s effective date. Please see plan documents for plan details, definitions and limitations.
Disability Insurance
Lincoln Financial Group
Traditional LTD and STD Disability - Definitions
What is disability insurance? 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.
Pre-Existing Condition Limitations - Please note that all plans will include pre-existing condition limitations that could impact you if you are a first-time enrollee in your employer’s disability plan. This includes during your initial new hire enrollment. Please review your plan details to find more information about pre-existing condition limitations.
How do I choose which plan to enroll in during my open enrollment?
You will enroll in Long Term and Short Term Disability on two separate pages during your open enrollment walkthrough. Generally your short term coverage and long term coverage work together so that once your short term coverage ends, at that time your long term coverage would begin if you are still disabled and approved to remain on your claim. In other words, your short term coverage may continue for up to 12 weeks and your long term coverage begins the 13th week.
Your short term coverage will generally be a weekly benefit. This is the maximum amount of money you will receive from the carrier on a weekly basis once your disability claim is approved by the carrier. This is generally a flat percentage of your salary.
Your long term coverage will generally be a monthly benefit. This is the maximum amount of money you will receive from the carrier on a monthly basis once your disability claim is approved by the carrier. This is generally a flat percentage of your salary.
Accident Insurance Chubb
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/cscharteracademy
You do everything you can to stay active and healthy, but accidents happen every day. An injury that hurts an arm or a leg can hurt your finances too. Chubb Accident pays cash benefits directly to you regardless of any other coverage you have. Benefits can be used to help cover health plan gaps for out-of-pocket expenses like deductibles, copays, and coinsurance.
Choose from 1 of 2 plans
Accident Insurance
Two
Exclusions and Limitations*
No benefits will be paid for services rendered by a member of the immediate family of a covered person. No benefits will be paid for an injury that is caused by, contributed to, or occurs as a result of: 1) being intoxicated, or under the influence of alcohol, narcotic or other prescription drug unless taken in accordance with Physician’s instructions; 2) participating in an illegal activity or attempting to commit or committing a felony; 3) committing or attempting to commit suicide or intentionally injuring oneself; 4) having dental treatment except for such care or treatment due to injury to sound natural teeth within twelve (12) months of the covered accident; 5) war, or serving in any of the armed forces or its auxiliary units; 6) participation in any contest using a motorized vehicle. No benefits will be payable for sickness or infection including physical or mental condition that is not caused solely by or as a direct result of a Covered Accident.
Questions?
Contact
*Please refer to your Certificate of Insurance at www.mybenefitshub.com/ cscharteracademy for a complete listing of available benefits, limitations and exclusions. Underwritten by ACE Property & Casualty Company, a Chubb company.
This information is a brief description of the important benefits and features of the insurance plan. It is not an insurance contract. This is an accident only policy and does not pay benefits for loss from sickness.
Critical Illness Insurance Chubb
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/cscharteracademy
Available Coverage Choices
Employee
Spouse
$10,000; $20,000; or $30,000
$10,000; $20,000; or $30,000
Child coverage Included in the employee amount
No benefits will be paid for a date of diagnosis that occurs prior to the coverage effective date. Covered individuals must be treatment free from cancer for 12 months prior to diagnosis date and in complete remission. There is no pre-existing conditions limitation. All amounts are Guaranteed Issue — no medical questions are required for coverage to be issued.
Sample list of Benefits, refer to plan documents for full list.
Sudden
Skin
- Payable once per insured per year
Occupational Package
Pays 100% of the face amount; benefits payable for HIV or Hepatitis B, C, or D, MRSA, Rabies, Tetanus, or Tuberculosis contracted on the job.
Childhood Conditions
Pays 100% of the dependent child face amount; Provides benefits for childhood conditions (Autism Spectrum Disorder; Cerebral Palsy; Congenital Birth Defects; Heart, Lung, Cleft Lip, Palate, etc; Cystic Fibrosis; Down Syndrome; Gaucher Disease; Muscular Dystrophy; Type 1 Diabetes).
Critical Illness Insurance
Benefits are payable for a subsequent diagnosis of Aneurysm – Cerebral or Aortic, Benign Brain Tumor, Cancer, Coma, Coronary Artery Obstruction, Heart Attack, Major Organ Failure, Severe Burns, Stroke, and Sudden Cardiac Arrest.
Wellness benefit – payable once per insured per year.
Sample Rates, refer to plan documents for full list of rates.
No benefits will be paid for losses that are caused by, contributed, or occur as a result of a Covered Person’s: 1) injuring oneself intentionally or committing or attempting to commit suicide; 2) committing or attempting to commit a felony or engaging in an illegal occupation or activity.
A Physician cannot be You or a member of Your Immediate Family, Your business or professional partner, or any person who has a financial affiliation or business with you.
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/cscharteracademy
Life and AD&D Insurance
Life and Accidental Death and Dismemberment (AD&D) insurance is important to your financial security, especially if others depend on you for support or vice versa. With Life insurance, you or your beneficiary(ies) can use the coverage to pay off debts such as credit cards, loans, and bills. AD&D coverage provides specific benefits if an accident causes bodily harm or loss (e.g., the loss of a hand, foot, or eye). If death occurs from an accident, 100% of the AD&D benefit would be paid to you or your beneficiary(ies).
Basic Term Life and AD&D
Basic Term Life and AD&D insurance are provided at no cost to you. You are automatically covered at $15,000 for each benefit.
Supplemental Term Life
If you need more coverage than Basic Term Life and AD&D, you may buy Supplemental Term Life for yourself and your dependent(s). If you do not elect Supplemental Term Life insurance when first eligible, or if you want to increase your benefit amount at a later date, you may need to show proof of good health (Evidence of Insurability).
Supplemental AD&D
Supplemental AD&D coverage is separate and apart from your Basic and Supplemental Term Life insurance coverage. It provides benefits beyond your disability or life insurance for covered losses that are the result of an accidental injury or loss of life. The full amount of AD&D coverage you select is called the Full Amount and is equal to the benefit payable for the loss of life. Benefits for other losses — such as loss of sight, speech, or hearing; coma; or paralysis — are payable as a predetermined percentage of the full amount.
Supplemental AD&D Coverage Amounts
Your Supplemental AD&D amount is equal to your Supplemental Term Life amount. You can also cover your dependent spouse and child(ren). Dependent coverage amounts will be equal to their Dependent Term Life coverage amounts.
Supplemental Coverage Highlights
• Portable – keep your supplemental coverage if you leave your current employer
• Convertible – convert your group term life insurance benefits to an individual whole life policy if your coverage ends
• Accelerated Benefits Option – get up to 80% of your life insurance benefit if you (or your spouse) are terminally ill and have less than 24 months to live. Note: this benefit is not the same as long term care insurance.
Some limitations and exclusions apply. See the plan documents for details.
Designating a Beneficiary
A beneficiary is the person or entity you elect to receive the death benefits of your Life and AD&D insurance policies. You can name more than one beneficiary, and you can change beneficiaries at any time. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%). The total must add up to 100%.
Life and AD&D
Lincoln Financial Group
Voluntary Life/AD&D Rates
Spouse
Child(ren)
• Increments of $10,000 up to 5 times salary up to $500,000
• New hire Guaranteed Issue $100,00
• Increments of $10,000 up to $250,000 not to exceed 50% of your election
• New hire Guaranteed Issue $xx
• 1 month to age 26 - Increments of $20,000 up to $20,000
• Guaranteed Issue $20,000
OE GI is approved for existing employees not previously enrolled.
• Employee – $20,000
• Spouse – $10,000
Existing employees previously enrolled:
• Employees – $20,000 auto increase
• Spouse – $10,000 auto increase
Flexible Spending Account (FSA)
Higginbotham
Flexible Account 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 y our p aycheck ever y plan ye ar, b ased o n your employer’s annual plan limit. This money is use-it-or-lose-it with a 30 day grace period.
For full plan details, please visit your benefit website: www.mybenefitshub.com/sampleisd
www.mybenefitshub.com/cscharteracademy
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 $3,300 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 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).
Important FSA Rules
• The maximum per plan year you can contribute to a Health Care FSA is $3,300.
• Elections are evergreen and will roll from one plan year to the next unless changes are made during Open Enrollment.
• You cannot change your election during the year unless you experience a Qualifying Life Event.
• In most cases, you can continue to file claims incurred during the plan year for another 30 days after the plan year ends.
• Your Health Care FSA debit card can be used for health care expenses only.
• Review your employer's Summary Plan Document for full details. FSA rules vary by employer.
• The money in your FSA is use-it-or-lose-it within the plan year, a 30 day grace period is offered
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.
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 Colorado Springs Charter Academy 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 Colorado Springs Charter Academy 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.
