Benefit Contact Information
Higginbotham Public Sector (800) 583-6908 www.mybenefitshub.com/brownfieldisd
BCBSTX (866) 355-5999 www.bcbstx.com/trsactivecare
BCBSTX: Blue Essentials HMO (888) 378-1633 https://www.bcbstx.com/trshmo
Clever RX
Group # 1085 (800) 873-1195
partner.cleverrx.com/brownfieldisd
MDLive (888) 398-4347 www.mdlive.com/fbs
Unum
Short-Term Disability Plan #474769
Long-Term Disability Plan #474768 (800) 858-6843 www.unum.com
Unum (800) 635-5597 www.unum.com
Chubb (888) 499-0425 mybenefitsconnect.chubb.com
Lincoln Financial Group Group # 1197993 (800) 423-2765
www.lfg.com
Cigna
Group #3343634 (800) 224-6224 www.cigna.com
Chubb (888) 499-0425 mybenefitsconnect.chubb.com
Eyemed (844) 225-3107 www.eyemed.com
Lincoln Financial Group (800) 423-2765 www.lfg.com
Texas Life (800) 283-9233 www.texaslife.com
IDWatchdog (800) 774-3772 www.idwatchdog.com
MASA (800) 423-3226 www.masamts.com
HSA Bank (800) 357-6246 www.hsabank.com
Higginbotham (866) 419-3519 www.higginbotham.net
Mobile Enrollment
Enrollment made easy with your smartphone or tablet.
Text “BENEFITS” to (214) 831- 4213 to opt into important text message * enrollment reminders. Scan the QR code to go to your benefit website for:
• Benefit Resources
• Online Enrollment
• Interactive Tools
• And more!
1 www.mybenefitshub.com/brownfieldisd
2
3
4
Enter your Information
• Last Name
• Date of Birth
• Last Four (4) of Social Security Number
NOTE: THEbenefitsHUB uses this information to check behind the scenes to confirm your employment status. CLICK LOGIN
Once confirmed, the Additional Security Verification page will list the contact options from your profile. Select either Text, Email, Call, or Ask Admin options to receive a code to complete the final verification step.
5
Enter the code that you receive and click Verify. You can now complete your benefits enrollment!
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 31 days of benefit eligible employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.
Q&A
Who do I contact with Questions?
For benefit questions, you can contact your Benefits 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/ brownfieldisd. 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 Brownfield ISD benefit website: www.mybenefitshub.com/brownfieldisd. 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 log in 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).
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 31 days of your qualifying event and meet with your Benefit Office to complete and sign the necessary paperwork in order to make a benefit election change. Benefit changes must be consistent with the qualifying event.
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.
Annual Benefit Enrollment
Employee Eligibility Requirements
Supplemental Benefits: Eligible employees must work 20 or more regularly scheduled hours each work week. Eligible employees must be actively-at-work on the plan effective date for new benefits to be effective, meaning you are physically capable of performing the functions of your job on the first day of work concurrent with the plan effective date. For example, if your 2025 benefits become effective on September 1, 2025, you must be actively-at-work on September 1, 2025 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.
Actively-at-Work
You are performing your regular occupation for the employer on a full-time basis, either at one of the employer’s usual places of business or at some location to which the employer’s business requires you to travel. If you will not be actively at work beginning 9/1/2025 please notify your benefits administrator.
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.
Unmarried To 26
Accident To 26
Life and AD&D Unmarried To 26
Critical Illness To 26
Medical Flex To 26
Dependent Flex 12 or younger or qualified individual unable to care for themselves & claimed as a dependent on your taxes
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.
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 Benefit office to request a continuation of coverage.
Description
Employer
Minimum Deductible
Maximum Contribution
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.
Permissible Use Of Funds
$1,650 single (2025)
$3,500 family (2025)
$4,300 single (2025)
$8,550 family (2025) 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.
$3,300 (2025)
Reimbursement for qualified medical expenses (as defined in Sec. 213(d) of IRC).
Cash-Outs of Unused Amounts (if no medical expenses) Permitted, but subject to current tax rate plus 20% penalty (penalty waived after age 65). Not permitted
Year-to-year rollover of account balance? Yes, will roll over to use for subsequent year’s health coverage.
Does the account earn interest?
No. Access to some funds may be extended if your employer’s plan contains a 2 1/2-month grace period.
Yes No
Portable? Yes, portable year-to-year and between jobs. No
For full plan details, please visit your benefit website: www.mybenefitshub.com/brownfieldisd
LEARN THE TERMS
• PREMIUM: The monthly amount you pay for health care coverage.
• DEDUCTIBLE: The annual amount for medical expenses you’re responsible to pay before your plan begins to pay.
• COPAY: The set amount you pay for a covered service at the time you receive it. The amount can vary based on the service.
• COINSURANCE: The portion you’re required to pay for services after you meet your deductible. It’s often a specifed percentage of the costs; e.g., you pay 20% while the health care plan pays 80%.
• OUT-OF-POCKET MAXIMUM: The maximum amount you pay each year for medical costs. After reaching the out-of-pocket maximum, the plan pays 100% of allowable charges for covered services.
2025-26 TRS-ActiveCare Plan
Compare Prices for Common Medical Services
REMEMBER:
When you choose an HMO, you’re choosing a regional network.
TRS contracts with HMOs in certain regions to bring participants in those areas additional options. HMOs set their own rates and premiums. They’re fully insured products who pay their own claims.
Blue Essentials - South Texas HMOSM Brought to you by TRS-ActiveCare
You can choose this plan if you live in one of these counties: Cameron, Hildalgo, Starr, Willacy
Blue Essentials - West Texas HMOSM Brought to you by TRS-ActiveCare
You can choose this plan if you live in one of these counties: Andrews, Armstrong, Bailey, Borden, Brewster, Briscoe, Callahan, Carson, Castro, Childress, Cochran, Coke, Coleman, Collingsworth, Comanche, Concho, Cottle, Crane, Crockett, Crosby, Dallam, Dawson, Deaf Smith, Dickens, Donley, Eastland, Ector, Fisher, Floyd, Gaines, Garza, Glasscock, Gray, Hale, Hall, Hansford, Hartley, Haskell, Hemphill, Hockley, Howard, Hutchinson, Irion, Jones, Kent, Kimble, King, Knox, Lamb, Lipscomb, Llano, Loving, Lubbock, Lynn, Martin, Mason, McCulloch, Menard, Midland, Mitchell, Moore, Motley, Nolan, Ochiltree, Oldham, Parmer, Pecos, Potter, Randall, Reagan, Reeves, Roberts, Runnels, San Saba, Schleicher, Scurry, Shackelford, Sherman, Stephens, Sterling, Stonewall, Sutton, Swisher, Taylor, Terry, Throckmorton, Tom Green, Upton, Ward, Wheeler, Winkler, Yoakum
Prescription Savings Clever RX
ABOUT MEDICAL SUPPLEMENT
A prescription savings card is a free program that allows individuals to save money on prescription medications. Th discount cards can be used at participating pharmacies and offer discounts on both branded and generic medications.
For full plan details, please visit your benefit website: www.mybenefitshub.com/brownfieldisd
Clever RX Benefits
With Clever RX, you never have to overpay for prescriptions. When you use the Clever RX card or app, you get up to 80% off prescription drugs, discounts on thousands of medications and usage at most pharmacies nationwide.
Step 1
Download the free Clever RX app and enter these numbers during the onboarding process:
• Group ID 1085
• Member ID 1726
Step 2
Use your ZIP code to find a local pharmacy with the best price for your medication — up to 80% off!
Step 3
Click the voucher with the lowest price, closest location, and/or at your preferred pharmacy and show the voucher to the pharmacist.
Questions?
Call Clever RX Customer Service at (800) 873-1195
Basic Life and AD&D
Chubb
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/brownfieldisd
Benefit Summary
Employer Term Life and AD&D Insurance is provided by your employer for all full-time employees enrolling in medical coverage. Employees must be actively at work for at least 30 hours per week. There is no premium paid by you for this life insurance.
You
$10,000
at age 65
at age 70
Employer Term Life and AD&D Insurance is provided by your employer for all full-time employees waiving medical coverage. Employees must be actively at work for at least 30 hours per week. There is no premium paid by you for this life insurance.
at age 65 50% at age
The AD&D plan provides additional protection for you and your dependents in the event of an accidental bodily injury resulting in death or dismemberment. In addition to standard dismemberment coverage, the following benefit provisions are included:
• Air Bag Benefit – The lesser of 5% of AD&D benefit or $5,000
• Child Care Expense Benefit – 5% of employee’s AD&D benefit up to $12,000 per year for 4 years
• Child Education Expense Benefit – 6% of employee’s AD&D benefit up to $6,000 for 6 years; maximum benefit of $24,000
• Common Carrier Benefit – Included
• Elder Care Expense Benefit – The lesser of 1% of AD&D benefit or $500
• Exposure and Disappearance Benefit – Included
• Repatriation Expense Benefit – The lesser of $1,000 or the actual expense incurred
• Seatbelt Benefit – The lesser of 10% of AD&D benefit or $25,000
• Spouse Education Benefit – The lesser of 1% of AD&D benefit, $1,000, or the actual tuition expenses incurred
• Workplace Felonious Assault Benefit – 5% of AD&D benefit up to $10,000
Hospital Indemnity Lincoln Financial Group
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/brownfieldisd
Benefits at a glance
If you or a covered family member have to go to the hospital for an accident or injury, hospital indemnity insurance provides a lump-sum cash benefit to help you take care of unexpected expenses — anything from deductibles to child care to everyday bills. Because you’re selecting this coverage through your company, you can take advantage of group rates. You don’t have to answer medical questions to receive coverage; this is guarantee issue coverage.
Core hospital benefits
Hospital admission
For the initial day of admission to a hospital for treatment of a sickness/an injury
Hospital confinement
For each day of confinement in a hospital as a result of a sickness/an injury
Hospital intensive care unit (ICU) admission
For the initial day of admission to an ICU for treatment as the result of a sickness/an injury
Hospital ICU confinement
For each full or partial day of confinement in an ICU as a result of a sickness/an injury
Plan 1
$1,500 per day up to three days per calendar year
$100 per day up to 30 days per calendar year starting on the second day of confinement
$1,500 per day up to one day per calendar year
$200 per day up to 15 days per calendar year starting on the second day of confinement
Plan 2
$3,000 per day up to three days per calendar year
$200 per day up to 30 days per calendar year starting on the second day of confinement
$3,000 per day up to one day per calendar year
$400 per day up to 15 days per calendar year starting on the second day of confinement
Complications of pregnancy Included Included
• Admission or Admitted means accepted for inpatient services in a hospital or intensive care unit for a period of more than 20 hours.
• If admitted to a hospital or ICU within 90 days after being discharged from a preceding stay for the same or related cause, the subsequent admission will be considered part of the first admission.
• If both hospital and ICU admission or hospital and ICU confinement become payable for the same day, only the Hospital ICU Admission benefit will be paid.
Hospital Indemnity Lincoln Financial Group
For each day of confinement to a hospital for routine post-natal care following birth
For each day examined or treated in an emergency room for an emergency medical condition that results from an injury
plan benefit(s)
Portability if you leave your employer Included
Note: See the policy for details and specific requirements for each of these benefits.
Questions?
Call 800-423-2765 and mention ID: 1197993. Hospital indemnity insurance premium
Affordable group rates – Monthly premiums
As an employee, you can take advantage of this accident insurance plan. Plus, you can add loved
to the
for just a little more.
Telehealth
MDLIVE
ABOUT TELEHEALTH
Telehealth provides 24/7/365 access to board-certified doctors via telephone or video consultations that can diagnose, recommend treatment and prescribe medication. Telehealth makes care more convenient and accessible for non-emergency care when your primary care physician is not available.
For full plan details, please visit your benefit website: www.mybenefitshub.com/brownfieldisd
Alongside your medical coverage is access to quality telehealth services through MDLIVE. Connect anytime day or night with a board-certified doctor via your mobile device or computer. While MDLIVE does not replace your primary care physician, it is a convenient and cost-effective option when you need care and:
• Have a non-emergency issue and are considering a convenience care clinic, urgent care clinic or emergency room for treatment
• Are on a business trip, vacation or away from home
• Are unable to see your primary care physician
When to Use MDLIVE:
At a cost that is the same or less than a visit to your physician, use telehealth services for minor conditions such as:
• Sore throat
• Headache
• Stomachache
• Cold
• Flu
• Allergies
• Fever
• Urinary tract infections
Do not use telemedicine for serious or life-threatening emergencies.
Registration is Easy
Register with MDLIVE so you are ready to use this valuable service when and where you need it.
• Online – www.mdlive.com/fbs
• Phone – 888-365-1663
• Mobile – download the MDLIVE mobile app to your smartphone or mobile device
• Select – MDLIVE as a benefit and FBS as your Employer/ Organization when registering your account.
Dental Insurance Cigna
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/brownfieldisd
Dental Coverage
Our dental plan helps you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work. Premium contributions are deducted from your paycheck on a pretax basis. Coverage is provided through Cigna Dental.
DPPO Plan
Two levels of benefits are available with the DPPO plan: in-network and out-of-network. You may select the dental provider of your choice, but your level of coverage may vary based on the provider you see for services. You could pay more if you use an out-ofnetwork provider.
Dental Insurance Cigna
Minor Periodontics
Major Periodontics
Root Canal Therapy / Endodontics
Relines, Rebases, and Adjustments
Crowns/Inlays/Onlays
Stainless Steep/Resin Crowns
Dentures
Bridges
Additional Member Responsibility in excess of Coinsurance
the difference between Billed Charges and the plan reimbursement
In Texas, the insured dental product offered by CGLIC and CHLIC is referred to as the Cigna Dental Choice Plan, and this plan utilizes the national Cigna Dental PPO network.
How to Find a Dentist
Visit https://hcpdirectory.cigna.com/ or call (800) 244-6224 to find an in-network dentist.
How to Request a New ID Card
You can request your dental id card by contacting Cigna directly at (800) 244-6224.
You can also go to www.mycigna.com and register/login to access your account. In addition, you can download the “MyCigna” app on your smartphone and access your id card right there on your phone.
In-Network Reimbursement: For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Fee Schedule or Discount Schedule.
Non-Network Reimbursement: For services provided by a non-network dentist, Cigna Dental will reimburse according to the Maximum Reimbursable Charge. The dentist may balance bill up to their usual fees.
Vision Insurance
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/brownfieldisd
Our vision plan provides quality care to help preserve your health and eyesight. Regular exams can detect certain medical issues such as diabetes and high cholesterol, in addition to vision and eye problems. You may seek care from any vision provider, but the plan will pay the highest level of benefits when you see in-network providers.
Find an In-Network Provider
Visit: www.eyemed.com
Disability Insurance Unum
ABOUT DISABILITY
Disability insurance protects one of your most valuable assets, your paycheck. This insurance will replace a portion of your income in the event that you become physically unable to work due to sickness or injury for an extended period of time.
For full plan details, please visit your benefit website: www.mybenefitshub.com/brownfieldisd
Long Term Disability Insurance can replace part of your income if a disability keeps you out of work for a long period of time that keeps you from working.
How does it work?
This coverage provides a monthly benefit if you have a covered illness or injury and you can’t work for a few months — or even longer.
You’re generally considered disabled if you’re unable to do important parts of your job — and your income suffers as a result.
Why is this coverage so valuable?
You can use the money however you choose. It can help you pay for your rent or mortgage, groceries, out-of-pocket medical expenses and more.
You are eligible for coverage if you are an active employee in the United States working a minimum of 20 hours per week.
You*
Choose to cover 45%, 55% or 65% of your monthly income, up to a maximum payment of $8,000. The monthly benefit may be reduced or offset by other sources of income.
*See the Legal Disclosures for more information.
What else is included?
Survivor Benefit
If you die while you’ve been disabled and receiving benefits for at least 180 days, your family could get a benefit equal to 3 months of your gross disability payment.
Waiver of premium
If you’re disabled and receiving benefit payments, Unum waives your cost until you return to work.
Work-life balance Employee Assistance Program
Get access to professional help for a range of personal and workrelated issues, including counselor referrals, financial planning
and legal support.
Worldwide emergency travel assistance
One phone call gets you and your family immediate help anywhere in the world, as long as you’re traveling 100 or more miles from home. However, a spouse traveling on business for his or her employer is not covered.
This plan does not cover pre-existing conditions. See the disclosure section to learn more.
If you didn’t get coverage when you were first eligible, you’ll have to answer health questions now. If you‘re newly eligible, you may not have to answer health questions. If you already have coverage, you can increase it up to the maximum available. You may have to answer health questions. New coverage may be subject to pre-existing condition limitations.
Elimination period (EP)
Choose your elimination period 90 or 180 days. This is the number of days that must pass after a covered accident or illness before you can begin to receive benefits.
Benefit duration (BD)
This is the maximum length of time you can receive benefits while you’re disabled. You can receive benefits up to the Social Security (SS) normal retirement age. If you become disabled after your normal retirement age, check with your employer for the maximum length of time applicable to you.
Disability Insurance Unum
Short Term Disability Insurance pays you a weekly benefit if you have a covered disability that keeps you from working.
How does it work?
If a covered illness or injury keeps you from working, Short Term Disability Insurance replaces part of your income while you recover. As long as you remain disabled, you can receive payments for up to 13 weeks.
You’re generally considered disabled if you’re unable to do important parts of your job — and your income suffers as a result.
Why is this coverage so valuable?
You can use the money however you choose. It can help you pay for your rent or mortgage, groceries, out-of-pocket medical expenses and more.
What else is included?
First Day Hospital benefit
The First Day Hospital option (also known as Inpatient Hospital Benefit) waives the elimination periods for insureds confined in a hospital due to their disability. You*
You are eligible for coverage if you are an active employee in the United States working a minimum of 20 hours per week.
Cover 45%, 55% or 65% of your weekly income to a maximum benefit of $2,000 per week. The weekly benefit may be reduced or offset by other sources of income.
*See the Legal Disclosures for more information.
If you didn’t get coverage when you were first eligible, you’ll have to answer health questions now. If you‘re newly eligible, you may not have to answer health questions. If you already have coverage, you can increase it up to the maximum available. You may have to answer health questions. New coverage may be subject to pre-existing condition limitations.
This plan does not cover pre-existing conditions. See the disclosure section to learn more.
Elimination period (EP)
This is the number of days that must pass between your first day of a covered disability and the day you can begin to receive your disability benefits.
Choose: 0/7, 14/14 or 30/30
Each plan option comes with a specific elimination period. The first number is the number of days for accidents. The second number is for illnesses.
Benefit duration (BD)
The maximum number of weeks you can receive benefits while you’re disabled. You have a 13 week benefit duration.
Disability Insurance
Unum
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.
Cancer Insurance
ABOUT CANCER
Cancer insurance offers you and your family supplemental insurance protection in the event you or a covered family member is diagnosed with cancer. It pays a benefit directly to you to help with expenses associated with cancer treatment.
For full plan details, please visit your benefit website: www.mybenefitshub.com/brownfieldisd
First cancer benefit
Diagnosis of cancer
Hospital confinement
Hospital confinement ICU
Radiation therapy, chemotherapy, immunotherapy
Alternative care
Medical imaging
Skin cancer initial diagnosis
Attending physician
Hospital confinement sub-acute ICU
Family care
Prescription drug in-patient
Private full-time nursing services
U.S. government or charity hospital
Family member transportation and lodging
Home health care
Hospice care
Skilled nursing care facility
Air ambulance
Ambulance
Blood, plasma, and platelets
$100 paid upon receipt of first covered claim for cancer; only one payment per covered person per certificate per calendar year
$5,000 employee or spouse
$7,500 child(ren)
Waiting period: 0 days
Benefit reduction: none
$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
Maximum per covered person per calendar year per 12-month period: $15,000
$100 paid upon receipt of first covered claim for cancer; only one payment per covered person per certificate per calendar year
$10,000 employee or spouse
$15,000 child(ren)
Waiting period: 0 days
Benefit reduction: none
$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
Maximum per covered person per calendar year per 12-month period: $20,000
$75 per visit; Maximum visits per calendar year: 4 $75 per visit; Maximum visits per calendar year: 4
$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:
$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
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
$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:
$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
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 $300 per day; Maximum days per calendar year: 30
$2,000 per trip; Maximum trips per confinement: 2 $2,000 per trip; Maximum trips per confinement: 2
$200 per trip; Maximum trips per confinement: 2 $200 per trip; Maximum trips per confinement: 2
$300 per transfusion; Maximum transfusions per calendar year: 2
$300 per transfusion; Maximum transfusions per calendar year: 2
Cancer Insurance Chubb
Bone marrow or stem cell donation
Bone marrow or stem cell transplant
Hormonal therapy
Counseling
Hair piece
Medical equipment
Non-surgical prosthesis
Recovery at home
Therapy
Transportation and lodging
Cancer wellness
Genetic tumor testing
Heritable cancer screening
Pharmacogenomic (PGX) screening test
Heart attack or stroke
Hospital confinement for specified disease
Surgical Treatment Benefits
Waiting period
$300 per confinement; Lifetime maximum donations: 2
First bone marrow transplant: $6,000
Additional transplant: 50%.
Lifetime maximum transplant(s): 2
First stem cell transplant: $600
Additional transplant: 50%.
Lifetime maximum transplant(s): 2
$50 per treatment; Maximum treatments per calendar year: 12
$50 per visit; Maximum visits per calendar year: 6
$150 per hair piece
Lifetime maximum: 1
$150 per piece of equipment
Maximum pieces per calendar year: 2
$100; Lifetime maximum number of devices: 1
$150 per day not to exceed the number of days confined
Maximum days per calendar year: 15
$25 per day of therapy
Maximum days per calendar year: 40
Transportation: $100 per trip Maximum trips per calendar year: 12 Lodging: $100 per day
Maximum days per calendar year: 100
$50; Maximum days of service, per covered person per calendar year: 1 day(s)
Follow-up test benefit amount: $100
Waiting period: 0 days
$50 per test; Maximum tests per calendar year: 2
$50; Maximum tests per calendar year: 1
$300 per confinement; Lifetime maximum donations: 2
First bone marrow transplant: $12,000
Additional transplant: 50%.
Lifetime maximum transplant(s): 2
First stem cell transplant: $1,200
Additional transplant: 50%.
Lifetime maximum transplant(s): 2
$50 per treatment; Maximum treatments per calendar year: 12
$50 per visit; Maximum visits per calendar year: 6
$150 per hair piece
Lifetime maximum: 1
$150 per piece of equipment
Maximum pieces per calendar year: 2
$300; Lifetime maximum number of devices: 1
$150 per day not to exceed the number of days confined
Maximum days per calendar year: 15
$25 per day of therapy
Maximum days per calendar year: 40
Transportation: $100 per trip Maximum trips per calendar year: 12 Lodging: $100 per day
Maximum days per calendar year: 100
$50; Maximum days of service, per covered person per calendar year: 1 day(s)
Follow-up test benefit amount: $100
Waiting period: 0 days
$50 per test; Maximum tests per calendar year: 2
$50; Maximum tests per calendar year: 1
$50 per test; Maximum tests per calendar year: 2 $50 per test; Maximum tests per calendar year: 2
$5,000 employee or spouse
$7,500 child(ren)
Recurrence benefit: $2,500 employee or spouse
$3,750 child(ren)
Waiting period: 0 days Benefit reduction: none
$100 per day – days 1 through 30
Additional days: $200
Maximum days per confinement: 31
$10,000 employee or spouse
$15,000 child(ren)
Recurrence benefit: $5,000 employee or spouse
$7,500 child(ren)
Waiting period: 0 days Benefit reduction: none
$300 per day – days 1 through 30
Additional days: $600
Maximum days per confinement: 31
0 days 0 days
Surgery Up to $3,000 Up to $6,000
Anesthesia
Outpatient surgery facility service
Preventative surgery
Reconstructive surgery
Second and third opinion
Skin cancer surgery
Surgical prosthesis
General anesthesia: 25% of surgery benefit
Maximum benefits per calendar year: 2
$150; Lifetime maximum: 1
Breast TRAM flap: $2,000
Breast reconstruction: $500
Breast symmetry: $500
Facial reconstruction: $500
$300; Maximum benefits per calendar year: 2
$1,000 per device; Lifetime maximum benefit amount: $1,000
General anesthesia: 25% of surgery benefit
Maximum benefits per calendar year: 2
$150; Lifetime maximum: 1
Breast TRAM flap: $2,000
Breast reconstruction: $500
Breast symmetry: $500
Facial reconstruction: $500
per device; Lifetime maximum benefit amount: $3,000
Accident Insurance Lincoln Financial Group
ABOUT ACCIDENT
Do you have kids playing sports, are you a weekend warrior, or maybe you’re 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/brownfieldisd
Accident Insurance
Lincoln Financial Group
Blood, plasma, platelets, and other nonblood substitute IV solutions
2nd -degree burns: Based upon surface area burned
3rd -degree burns: Based upon surface area burned
Skin grafts
Concussion
Dental crown
Dental extraction
occupational, and chiropractic therapy (up to 10 sessions)
Physician follow-up visits (up to six visits)
$65 $80
Alternative care/rehab facility daily confinement/rehabilitative confinement $200 $300
Epidural/cortisone pain management (up to
Critical Illness Insurance Unum
ABOUT CRITICAL ILLNESS
Critical Illness insurance helps pay the cost of non-medical expenses related to a covered critical illness or cancer. The plan provides a lump sum benefit payment to you upon the diagnosis of any covered critical illness or cancer. It helps cover expenses such as lost income, out-of-town treatments, special diets, daily living, and household upkeep costs. This coverage is portable.
For full plan details, please visit your benefit website: www.mybenefitshub.com/brownfieldisd
Critical Illness
• Heart attack
• Stroke
• Major organ failure
• End-stage kidney failure
Cancer Conditions
Choose $10,000, $20,000 or $30,000 of coverage with no medical underwriting to qualify if you apply during this enrollment.
• Sudden cardiac arrest
• Coronary artery disease:
• Major (50%): Coronary artery bypass graft or valve replacement
• Minor (10%): Balloon angioplasty or stent placement
• Invasive cancer — all breast cancer is considered invasive
• Non-invasive cancer (25%)
• Skin cancer — $500
Progressive Diseases
• Amyotrophic Lateral Sclerosis (ALS)
• Dementia, including Alzheimer’s disease
• Multiple Sclerosis (MS)
• Parkinson’s disease
Supplemental Conditions
• Loss of sight, hearing or speech
• Benign brain tumor
• Coma
• Permanent Paralysis
Children
• Functional loss
• Huntington’s Disease
• Lupus
• Muscular Dystrophy
• Occupational HIV, Hepatitis B, C or D
• Occupational PTSD Paid at 25%
• Infectious Diseases
• Myasthenia Gravis
• Systemic Sclerosis (Scleroderma)
• Addison’s Disease
• Pulmonary Embolism
• Transient Ischemic Attack (TIA)
• Bone Marrow/Stem Cell
Children from live birth to age 26 are automatically covered at no extra cost. Their coverage amount is 50% of yours. They are covered for all the same illnesses plus these specific childhood conditions: cerebral palsy, cleft lip or palate, cystic fibrosis, Down syndrome, spina bifida, type 1 diabetes, sickle cell anemia and congenital heart disease. The diagnosis must occur after the child’s coverage effective date.
Wellness
One per covered person per calendar year $50
Voluntary Life and AD&D Chubb
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/brownfieldisd
Newly eligible employees and dependents: You and your eligible dependents may elect coverage up to the guaranteed issue amounts without answering health questions. Elections over the guaranteed issue amounts will require medical underwriting. Current employees: At subsequent annual enrollments if you or your eligible dependents are currently enrolled in the plan, you may increase your coverage up to the guaranteed issue amounts without answering health questions. All amounts over the guaranteed issue will require medical underwriting.
Please note that if you or your dependents did not elect coverage when first eligible, then you are considered a late entrant. Late entrants will be medically underwritten and will have to answer health questions for any amount of coverage elected.
1 Spouse rate is based on Employee Age
Permanent Life Insurance
Texas Life Insurance Company
Texas Life Insurance Company
ABOUT PERMANENT LIFE INSURANCE
Permanent life insurance is a type of life insurance policy that provides coverage for the insured’s entire lifetime, as long as the premiums are paid. It complements term life insurance, which covers the insured for a specified period of time. Permanent life insurance is the coverage you can keep when your employment ends.
For full plan details, please visit your benefit website: www.mybenefitshub.com/sampleisd
www.mybenefitshub.com/brownfieldisd
Voluntary permanent life insurance can be an ideal complement to the group term and voluntary term life insurance your employer might provide. This voluntary permanent universal life product is yours to keep, even when you change jobs or retire, as long as you pay the necessary premium. Group and voluntary term life insurance may be portable if you change jobs, but even if you can keep them after you retire, they usually cost more and decline in death benefit.
The contract, PureLife-plus, is underwritten by Texas Life Insurance Company, and it has the following features:
• HIGH DEATH BENEFIT. Written on a minimal cash-value Universal Life frame, PureLife-plus features one of the highest death benefits per payroll-deducted dollar offered at the worksite.1
• REFUND OF PREMIUM. Unique in the workplace, PureLife-plus offers you a refund of 10 years’ premium, should you surrender the contract if initial specified premium paid for ever increases. (Conditions apply.)
• ACCELERATED DEATH BENEFIT DUE TO TERMINAL ILLNESS RIDER. Should you be diagnosed as terminally ill with the expectation of death within 12 months, you will have the option to receive 92% of the death benefit, minus a $150 ($100 in Florida) administrative fee. Included with your contract at no additional cost, this valuable living benefit helps give you peace of mind knowing that, should you need it, you can take the large majority of your death benefit while still alive. (Conditions apply.) (Form ICC07-ULABR-07 or Form Series ULABR-07)
• MINIMAL CASH VALUE. Designed to provide a high death benefit at a reasonable premium, PureLife-plus helps provide peace of mind for you and your beneficiaries while freeing investment dollars to be directed toward such tax-favored retirement plans as 403(b), 457 and 401(k).
• LONG GUARANTEES. Enjoy the assurance of a contract that has a guaranteed death benefit to age 121 and level premium that guarantees coverage for a significant period of time (after the guaranteed period, premiums may go down, stay the same, or go up).2
1 Voluntary Whole and Universal Life Products, Eastbridge Consulting Group, March 2022
2 As long as you pay the necessary premium. Guarantees are subject to product terms, limitations, exclusions, and the insurer’s claims paying ability and financial strength. 45 years average for all ages based on our actuarial review.
Permanent Life Insurance
Texas Life Insurance Company
Texas Life Insurance Company
WHO CAN APPLY FOR COVERAGE?
Actively at work employees at issue ages 17-70 are eligible. Spouses, issue age 17-60, children ages 15 days to 26 years, and grandchildren ages 15 days to 18 years are eligible to apply for this coverage as well3. Employees do not have to participate in order to apply for coverage on eligible dependents.
SAMPLE RATES
You can qualify by answering just 3 questions4 –no exams or needles.
During the last six months, has the proposed insured:
Been actively at work on a full time basis, performing usual duties?
Been absent from work due to illness or medical treatment for a period of more than 5 consecutive working days?
Been disabled or received tests, treatment or care of any kind in a hospital or nursing home or received chemotherapy, hormonal therapy for cancer, radiation, dialysis treatment, or treatment for alcohol or drug abuse?
3 Coverage not available on children in WA or on grandchildren in WA or MD. In MD, children must reside with the applicant to be eligible for coverage.
4 Issuance of coverage will depend on the answer to these questions.
Important Note: Texas Life does not offer legal or financial advice. Contact an attorney and a financial advisor in your state for legal and financial information on wills, estates and trusts.
PureLife-plus is a Flexible Premium Adjustable Life Insurance to Age 121. As with most life insurance products, Texas Life contracts and riders contain certain exclusions, limitations, exceptions, reductions of benefits, waiting periods and terms for keeping them in force. Please contact a Texas Life representative or see the Purelife-plus brochure for costs and complete details. Contract Form ICC18-PRFNG-NI-18, Form Series PRFNG-NI-18 or PRFNGNI-20-OHIO.
Emergency Medical Transport
ABOUT MEDICAL TRANSPORT
Medical Transport covers emergency transportation to and from appropriate medical facilities by covering the out-of-pocket costs that are not covered by insurance. It can include emergency transportation via ground ambulance, air ambulance and helicopter, depending on the plan.
For full plan details, please visit your benefit website: www.mybenefitshub.com/brownfieldisd
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. After the group health plan pays its portion, MASA MTS works with providers to deliver our members’ $0 in out-of-pocket costs for emergency transport.
Emergent Air Transportation In the event of a serious medical emergency, Members have access to emergency air transportation into a medical facility or between medical facilities.
Emergent Ground Transportation In the event of a serious medical emergency, Members have access to emergency ground transportation into a medical facility or between medical facilities.
Non-Emergency Inter-Facility Transportation In the event that a member is in stable condition in a medical facility but requires a heightened level of care that is not available at their current medical facility, Members have access to nonemergency air or ground transportation between medical facilities.
Repatriation/Recuperation Suppose you or a family member is hospitalized more than 100-miles from your home. In that case, you have benefit coverage for air or ground medical transportation into a medical facility closer to your home for recuperation.
Should you need assistance with a claim contact MASA at (800) 643-9023. You can find full benefit details at www.mybenefitshub.com/brownfieldisd
Non-Emergency Inter-Facility Transportation
Repatriation/Recuperation
Escort Transportation
Visitor Transportation
Return Transportation
Mortal Remains Transportation
Minor Return
Organ Retrieval/Organ Recipient Transportation
Vehicle Return
Pet Return
Coverage
Identity Theft IDWatchdog
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/brownfieldisd
Identity Theft Protection
Millions of people have their identity stolen each year. Protect yourself and restore your identity with coverage that includes:
• Identity consultation and advice
• Licensed private investigators
• Identity and credit monitoring
• Social media monitoring
• Identity restoration
• Threat and credit alerts
• 24/7 emergency ID protection access
• Mobile app
Health Savings Account (HSA) HSA Bank
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/brownfieldisd
A Health Savings Account (HSA) is a tax-exempt tool to supplement your retirement savings and to cover current and future health costs.
An HSA is a type of personal savings account that 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 current or future 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.
You Decide How To Use Your HSA Funds
Use it Now
• Make annual HSA contributions.
• Pay for eligible medical costs.
• Keep HSA funds in cash. Let it Grow
• Make annual HSA contributions.
• Pay for medical costs with other funds.
• Invest HSA funds.
If you are age 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.
Important HSA Information
• Have your in-network doctor file your claims and use your HSA debit card to pay any balance due.
• You must keep ALL your records and receipts for HSA reimbursements in case of an IRS audit.
• Only HSA accounts opened through our plan administrator are eligible for automatic payroll deduction.
HSA Eligibility
You are eligible to open and contribute to an HSA if you are:
• Enrolled in an HSA-eligible HDHP
• Not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan
• Not enrolled in a Health Care Flexible Spending Account
• Not eligible to be claimed as a dependent on someone else’s tax return
• Not enrolled in Medicare, Medicaid, or TRICARE
• Not receiving Veterans Administration benefits
Maximum HSA Contributions
• $4,300 – Individual
• $8,550 – Family
HSA contributions are tax-deductible and grow taxdeferred. Withdrawals for qualifying medical expenses are tax-free.
HSA Contacts
• Register for an account at http://www.hsabank.com
• Call (800) 357-6246
Flexible Spending Account (FSA) Higginbotham
ABOUT
FSA
A Flexible Spending Account allows you to pay for eligible healthcare expenses with a pre-loaded debit card. You choose the amount to set aside from your paycheck every plan year, based on your employer’s annual plan limit. This money is use it or lose it within the plan year (unless your plan contains a $500 rollover or grace period provision).
For full plan details, please visit your benefit website: www.mybenefitshub.com/brownfieldisd
Health Care FSA
The Health Care FSA covers qualified medical, dental, and vision expenses for you or your eligible dependents. Eligible expenses include:
• Dental and vision expenses
• Medical deductibles and coinsurance
• Prescription copays
• Hearing aids and batteries
You may not contribute to a Health Care FSA if you enrolled in a High Deductible Health Plan (HDHP) and contribute to a Health Savings Account (HSA).
How the Health Care and Limited Purpose FSAs Work
You can access the funds in your Health Care or Limited Purpose FSA two different ways:
Use your FSA debit card to pay for qualified expenses, doctor visits, and prescription copays.
Pay out-of-pocket and submit your receipts for reimbursement:
• Fax – 866-419-3516
• Email – flexclaims@higginbotham.net
• Online – flexservices.higginbotham.net
• Phone – 866-419-3519
Dependent Care FSA
The Dependent Care FSA helps pay for expenses associated with caring for elder or child dependents so you or your spouse can work or attend school full-time. You can use the account to pay for daycare or babysitter expenses for your children under age 13 and qualifying older dependents, such as dependent parents. Reimbursement from your Dependent Care FSA is limited to the total amount deposited in your account at that time. To be eligible, you (and your spouse, if married) must be gainfully employed, looking for work, a full-time student, or incapable of self-care.
Dependent Care FSA Considerations
• Overnight camps are not eligible for reimbursement (only day camps can be considered).
• If your child turns 13 midyear, you may only request reimbursement for the part of the year when the child is under age 13.
• You may request reimbursement for care of a spouse or dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self-care.
• The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.
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 Brownfield 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 Brownfield 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.