2026-2027 Lewisville ISD Employee Benefits Guide

26 27 EMPLOYEE BENEFITS GUIDE for a healthy you

Welcome We are pleased to offer a full benefits program to you and your eligible dependents. Read this guide to know what benefits are available.

Availability of Medical Plan Benefits Information Coverage details for each medical plan offered are available in a Summary of Benefits and Coverage (also referred to as an SBC), which can be viewed at www.mybenefitshub.com/lewisvilleisd.

Your Benefits Are in Effect September 1, 2026 through August 31, 2027

Contents Important Contacts............................... .3

Flexible Spending Accounts..............15

Educator Disability Insurance......... .26

Eligibility.................................................. .4

HSA and FSA Comparison.................17

Hospital Cash...................................... .30

How to Enroll...........................................5

Qualified HSA and FSA Expenses.................................................18

Critical Illness Insurance................... .31

Enrollment Frequently Asked Questions................................................ .6

Dental Coverage...................................19

Medical.................................................... .7

Vision Coverage................................. .20

Pharmacy..................................................11

Life and AD&D Insurance................. .22

Preventive Care.....................................12

Life Insurance...................................... .23

Health Care Options............................13

AD&D Insurance...................................24

Health Savings Account......................14

Permanent Life Insurance................ .25

Telehealth + Behavioral Health........33 Emergency Medical Transport.........34 Legal Assistance................................ .35 Sick Leave Bank................................. .36 Investment Services.......................... .38 Glossary of Terms.............................. .39

FLIP TO …

HOW TO ENROLL

5

ENROLLMENT FAQ

6

MEDICAL COVERAGE

7

2

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Important Contacts Benefits Call Center

Higginbotham Public Sector 833-982-2477 Email: lewisvilleisd@hps.higginbotham.net

Medical

TRS ActiveCare BCBSTX 866-355-5999 www.bcbstx.com/trsactivecare

TRS Virtual Health

RediMD 855-942-4900 www.rediMD.com/trsactivecare Registration Code: trsactivecare Teladoc 855-835-2362 www.member.teladoc.com/ trsactivecare

Pharmacy

Cigna Healthcare 800-244-6224 www.mycigna.com Group #3346815 Network – Total DPPO

Vision Coverage

Critical Illness

Flexible Spending Accounts (Health Care and Dependent Care Reimbursement)

Hospital Cash

EECU 817-882-0800 www.eecu.org

National Benefit Services (NBS) 855-399-3035 www.nbsbenefits.com

Telehealth with Behavioral Health Recuro Health 855-673-2876 www.recurohealth.com

Cigna Healthcare 800-754-3207 www.mycigna.com Group #CI961740

Chubb 888-499-0425 https://mybenefitsconnect.chubb.com Group #100000044

Legal Services

LegalEase 800-248-9000 www.legaleaseplan.com/lisd Group #9000789

Emergency Medical Transportation

Permanent Life

Express Scripts by Evernorth 844-367-6108 www.express-scripts.com/trsactivecare

Dental Coverage

Health Savings Account (HSA)

Texas Life 800-283-9233 www.texaslife.com

MASA MTS 800-423-3226 www.masamts.com Group #B2BLEWIS

Life and AD&D

Chubb 888-499-0425 Group #100000044

Investment Services 403(b) and 457(b)

Disability

New York Life 888-842-4462 www.newyorklife.com Group #SLH100028

TCG Administrators 800-943-9179 www.tcgservices.com TeleWealth virtual meeting: www.tcgservices.com/telewealth

EyeMed 866-939-3633 www.eyemed.com Network – Insight

COBRA Dental and Vision

COBRA TRS ActiveCare Medical

National Benefit Services 800-274-0503 www.nbsbenefits.com

bswift 833-682-8972

3

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Eligibility

OE: Open Enrollment QLE: Qualifying Life Event

Who is Eligible for Benefits NEW HIRE

EMPLOYEE

DEPENDENT(S)

Who is Eligible

Who is Eligible

Who is Eligible

• For medical eligibility, active

contributing TRS members or substitute teachers* working 10 or more regularly scheduled hours per week. For all other benefits, employees working 15 or more regularly scheduled hours per week.

When to Enroll

• For medical eligibility, active

contributing TRS members or substitute teachers* working 10 or more regularly scheduled hours per week. For all other benefits, employees working 15 or more regularly scheduled hours per week.

When to Enroll

• Within 30 days of your start date

• Open Enrollment (OE) or when you have a Qualifying Life Event (QLE)

When Coverage Starts

When Coverage Starts

• First day of the month following

• OE: Start of the plan year • QLE: Dependent on QLE details

employment start date

• You can cover eligible dependents

under a benefit that offers dependent coverage, provided you participate in the same benefit; dependent children can be covered through the maximum age listed in the chart below.

• If your dependent is disabled,

coverage may be able to continue past the maximum age under certain plans. You must provide a physician’s statement confirming your dependent’s disability. Contact the LISD Benefits Department to request a continuation of coverage.

* Substitute teachers do not receive the district medical premium contribution.

MAXIMUM DEPENDENT ELIGIBILITY AGE BY PLAN TO AGE 26

IRS DEPENDENT

Medical/Dental/Vision/Life and AD&D/Permanent Life/ Hospital Cash/Critical Illness/Emergency Medical Transport

Health Savings Account/ Flexible Spending Account

Qualifying Life Events (QLE) You may only enroll for or make changes to coverage outside of Open Enrollment if you are a new hire or if you have a QLE, such as:

Marriage

Birth

Divorce

Adoption/placement for adoption

Annulment

FMLA, COBRA event, judgment, or decree

Gain or loss of benefits coverage

Becoming eligible for Medicare, Medicaid, or TRICARE

Change in employment status affecting benefits

Receiving a Qualified Medical Child Support Order

Death of dependent

You must complete a Benefit Change Form and provide requested proof of the QLE to the Benefits Department within 31 days of the event. Go to https://benefits.lisd.net for more information.

4

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

How to Enroll Enrolling in benefits is simple through THEbenefitsHUB.

Log in to THEbenefitsHUB

• THEbenefitsHUB system is accessed through the LISD Learning Hub. • Log in to the LISD Learning Hub (Lhub) through the Staff page, www.lisd.net/staff, then click on the blue “Benefits Hub” icon.

• For step-by-step log in instructions, go to https://benefits.lisd.net. If you have issues with logging in, contact the LISD Benefits Department via email, benefits@lisd.net, or call 469-948-8104.

Enrollment for Existing Employees 1. System Acknowledgments: Read and click I acknowledge for each acknowledgment. Click Save and Continue at the bottom of the page.

2. Select the Enroll in Benefits tile.

3. Personal Information and Dependents: Review your personal information and verify covered dependents. Contact the Benefits Department with any discrepancies at 469-948-8104 or email benefits@lisd.net.

4. Benefits: Read each benefit screen to enroll or waive the product (medical, dental, vision, etc.). You must confirm on each screen that each dependent to be covered is selected in order to be included in the coverage for that particular benefit. Once your elections are made, click Sign and Continue at the bottom of each screen to complete that benefit enrollment. You may use the “back” button during the session to make changes. Once you click Sign and Continue, you are enrolled in the benefit. You may make changes to your elections through the end of the Open Enrollment period.

5. You may be asked to provide Evidence of Insurability (EOI) for certain benefits. This may be done during your enrollment session.

6. Beneficiaries: Step 1 – Add or edit your beneficiaries and click Sign and Continue. Step 2 – Enter the percentage of benefit you would like to designate for each beneficiary. Some designations are mandatory and cannot be changed. (Beneficiaries can be edited at any time throughout the year.) Click Finished.

7. Consolidated Enrollment Form: After completing the enrollment walkthrough, the “Consolidated Enrollment Form” page will appear with “Congratulations!” and a green check mark displayed. Review the information carefully for accuracy. Use the “back” button to make changes or log out if you are finished.

8. Making changes: You may log in at anytime to make changes to your benefits during the Open Enrollment period. Remember, as soon as you click Save and Continue you are enrolled in the benefit, whether you finish the walkthrough or not.

5

Benefits Questions?

Employee benefits can be complicated. The Higginbotham Public Sector benefits team is available to help you with the following:

• Enrollment • Benefits • Eligibility • Claims Call or text 833-982-2477 Monday through Friday from 7:00 a.m. to 6:00 p.m. CT. If you leave a message after 3:00 p.m. CT, your call or text will be returned the next business day. You can also email lewisvilleisd@hps. higginbotham.net.

Bilingual representatives are available.

SECTION 125 CAFETERIA PLAN GUIDELINES A cafeteria plan enables you to save money by using pretax dollars to pay for eligible group insurance premiums sponsored and offered by your employer.

Elections made during annual enrollment become effective on the plan effective date and will remain in effect during the entire plan year.

Changes in benefit elections can occur only if you experience a QLE. You must present proof of the QLE to your Benefits Department within 31 days of the event and complete and sign the Benefit Change Form. Changes must be consistent with the QLE.

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Enrollment Frequently Asked Questions Is there an age limit for dependents to be covered under my benefits?

When will I get my ID cards?

BCBS provides ID cards if there is a plan change or a new enrollment. New cards usually arrive within four weeks of your effective date. If there are no plan changes, a new card will not be issued.

Yes. See the Eligibility page for details.

Where can I find benefits summaries and forms?

To access medical plan Summary of Benefits and Coverage (SBC) documents, plan documents for other coverages, and forms, go to the Benefit Information section at www.mybenefitshub.com/lewisvilleisd. Click on each benefit (e.g., medical, vision, etc.) for details.

You may not need or receive an ID card for dental and vision plans. Simply share the carrier name and phone number with your health care provider to have benefits verified.

How can I find in-network providers?

Go to www.mybenefitshub.com/lewisvilleisd and click on the Provider Search link, where you will see all available plan provider searches.

Benefits Questions?

Call the Higginbotham Public Sector Benefits team at 833-982-2477.

Can I cover family members (a spouse and/or dependent) as dependents on my benefits if my spouse and I work for the same employer?

Some benefits may not allow for this type of coverage if you both work for the same employer. Review the benefit plan documents, contact Higginbotham Public Sector, or contact the carrier for eligibility details.

Are there FSA and HSA limitations for married couples?

Yes, generally. Married couples may not enroll in both a Health Care Flexible Spending Account (FSA) and a Health Savings Account (HSA) at the same time. If your spouse is covered under a Health Care FSA that reimburses for qualified health care expenses, then you and your spouse are not HSA-eligible – even if you do not use your spouse’s Health Care FSA to reimburse your expenses. However, there are some exceptions to the general limitation for other types of FSAs (e.g., Limited Purpose Health Care FSA; Dependent Care FSA). Contact the FSA and/or HSA administrator before you enroll, or consult your tax advisor for further guidance.

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 FSAs and an HSA as a married couple. You, the enrollee, shall hold harmless, defend, and indemnify Higginbotham Public Sector, LLC from any and all claims, actions, suits, charges, and judgments whatsoever that arise out of your enrollment in spouse and/or dependent coverage, including enrollment in FSAs and an HSA.

6

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Medical Our medical plans protect you and your family from major financial hardship in the event of illness or injury.

All TRS-ActiveCare participants may enroll in one of the following plans:

• TRS-ActiveCare Primary • TRS-ActiveCare Primary+ • TRS-ActiveCare HD The TRS-ActiveCare 2 plan is closed to new enrollments, but you may continue in the plan if you are a currently enrolled participant.

TRS Region 11 Monthly Medical Rates TRS MEDICAL

REGION 11 TOTAL MONTHLY PREMIUM

EMPLOYER CONTRIBUTION

EMPLOYEE MONTHLY COST

Employee

$612.00

$400.00

$212.00

Employee and Spouse

$1,653.00

$400.00

$1,253.00

Employee and Child(ren)

$1,041.00

$400.00

$641.00

Employee and Family

$2,081.00

$400.00

$1,681.00

Employee

$720.00

$400.00

$320.00

Employee and Spouse

$1,872.00

$400.00

$1,472.00

Employee and Child(ren)

$1,224.00

$400.00

$824.00

Employee and Family

$2,376.00

$400.00

$1,976.00

$630.00

$400.00

$230.00

Employee and Spouse

$1,701.00

$400.00

$1,301.00

Employee and Child(ren)

$1,071.00

$400.00

$671.00

Employee and Family

$2,142.00

$400.00

$1,742.00

Employee

$1,013.00

$400.00

$613.00

Employee and Spouse

$2,402.00

$400.00

$2,002.00

Employee and Child(ren)

$1,507.00

$400.00

$1,107.00

Employee and Family

$2,841.00

$400.00

$2,441.00

ACTIVECARE PRIMARY

ACTIVECARE PRIMARY+

ACTIVECARE HD Employee

ACTIVECARE 2

7

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

2026-27 TRS-ActiveCare Plan Highlights Sept. 1, 2026 – A How to Calculate Your Monthly Premium

All TRS-ActiveCare participants have three plan options. E TRS-ActiveCare Primary • Lowest premium of the three available plans • Copays for doctor visits before you meet your deductible • Statewide network • Primary Care Provider referrals required to see specialists • Not compatible with a Health Savings Account • No out-of-network coverage

Total Monthly Premium Your Employer Contribution

TRS

Plan Summary

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

Monthly Premiums

Being Healthy is Easy • $0 preventive services • One-on-one health coaches • Weight loss programs and nutrition • TRS Virtual Health • Member Rewards is even better. Now you’ll get a check when you use Member Rewards and choose low-cost, highquality doctors and facilities – up to $599* per tax year.

• Airrosti Remote Recovery gives you inhome virtual physical therapy to relieve common aches and pains at no cost.*

Total Premium

Employer Contribution

Your Premium

• Highest premium • Copays for many • Lower deductible • Statewide netwo • Primary Care Pro • Not compatible w • No out-of-netwo

Total Premium

Employee Only

$612

$400

$212

$720

Employee and Spouse

$1,653

$400

$1,253

$1,872

Employee and Children

$1,041

$400

$641

$1,224

Employee and Family

$2,081

$400

$1,681

$2,376

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

In-Network Coverage Only

I

$2,500/$5,000 You pay 30% after deductible

Yo

$8,050/$16,100

PCP Required

Yes

Primary Care

$30 copay

Specialist

$70 copay

Doctor Visits

* Eligibility rules may apply.

See the Annual Enrollment Guide for more details.

Mental Health

Immediate Care Urgent Care

You pay 30% after deductible

You

TRS Virtual Health-RediMDTM

$0 per medical consultation

$0

TRS Virtual Health-Teladoc

$12 per medical consultation

$12

Integrated with medical

$200 deduct

®

You have in-office and virtual benefits: • TRS-ActiveCare Primary Plan: $30 copay for office visits or $0 with Teladoc • TRS-ActiveCare Primary+ Plan: $15 copay for office visits or $0 with Teladoc • TRS-ActiveCare HD Plan: 30% coinsurance after deductible or $42 with Teladoc • TRS-ActiveCare 2 Plan: $20 copay for office visits or $12 with Teladoc

$50 copay

Emergency Care

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

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

Preferred (Max does not apply if brand is selected and generic is available)

You pay 30% after deductible

You pay You pay

Non-preferred

You pay 50% after deductible

Yo

Specialty (31-Day Max) Call 1-844-367-6108 to see if your specialty medication is covered by SaveOnSP.

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

You pay

Insulin Out-of-Pocket Costs

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

$2 $7

8

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Aug. 31, 2027

Each includes a wide range of wellness benefits.

S-ActiveCare Primary+

TRS-ActiveCare HD

m of the three available plans y services and drugs e than the HD and Primary plans ork ovider referrals required to see specialists with a Health Savings Account ork coverage

Employer Contribution

This plan is closed to new enrollees. Current TRS-ActiveCare 2 participants can stay enrolled.

Your Premium

TRS-ActiveCare 2

• Higher premium of the three available plans • Must meet your deductible before plan pays for non-preventive care • Nationwide network with out-of-network coverage • No requirement for Primary Care Providers or referrals • Compatible with a Health Savings Account

Total Premium

Employer Contribution

• Closed to new enrollees • Current enrollees can choose to stay in the plan • Lower deductible • Copays for many services and drugs • Nationwide network with out-of-network coverage • No requirement for Primary Care Providers or referrals

Your Premium

Total Premium

Employer Contribution

Your Premium

$400

$320

$630

$400

$230

$1,013

$400

$613

$400

$1,472

$1,701

$400

$1,301

$2,402

$400

$2,002

$400

$824

$1,071

$400

$671

$1,507

$400

$1,107

$400

$1,976

$2,142

$400

$1,742

$2,841

$400

$2,441

In-Network Coverage Only

In-Network

Out-of-Network

In-Network

$1,200/$2,400

$3,400/$6,800

$6,800/$13,600

$1,000/$3,000

$2,000/$6,000

ou pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible

You pay 20% after deductible

You pay 40% after deductible

$6,900/$13,800

$8,300/$16,600

$20,500/$41,000

$7,900/$15,800

Yes

Out-of-Network

$23,700/$47,400

No

No

$15 copay

You pay 30% after deductible

You pay 50% after deductible

Tier 1: $20 copay Tier 2: $40 copay

You pay 40% after deductible

$70 copay

You pay 30% after deductible

You pay 50% after deductible

Tier 1: $55 copay Tier 2: $85 copay

You pay 40% after deductible

$50 copay

You pay 30% after deductible

You pay 50% after deductible

$50 copay

You pay 40% after deductible

You pay a $250 copay plus 20% after deductible

u pay 20% after deductible

You pay 30% after deductible

0 per medical consultation

$30 per medical consultation

$0 per medical consultation

$42 per medical consultation

$12 per medical consultation

Integrated with medical

$200 brand deductible

2 per medical consultation

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

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

$20/$45 copay

25% after deductible ($100 max)/ 25% after deductible ($265 max)

You pay 25% after deductible

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

ou pay 50% after deductible

You pay 50% after deductible

You pay 50% after deductible ($100 min/$200 max)/ You pay 50% after deductible ($215 min/$430 max)

20% after deductible ($500 max); $0 if SaveOnSP eligible

You pay 20% after deductible

You pay 30% after deductible ($200 min/$900 max); $0 if SaveOnSP eligible

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

You pay 25% after deductible

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

9

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Questions?

Call a Personal Health Guide at 1-866-355-5999 for help with medical services.

Call Express Scripts® by Evernorth Pharmacy Benefit Services at 1-844-367-6108 for help with your pharmacy benefits.

Compare Prices for Common Medical Services Closed to new enrollees.

Benefit

TRS-ActiveCare Primary

TRS-ActiveCare Primary+

In-Network Only

In-Network Only

Office/Independent Lab: You pay $0

Office/Independent Lab: You pay $0

TRS-ActiveCare HD In-Network

Out-of-Network

In-Network

Out-of-Network

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

Diagnostic Labs

TRS-ActiveCare 2

You pay 50% after deductible

You pay 40% after deductible

Outpatient: You pay 30% after deductible

Outpatient: You pay 20% after deductible

You pay 30% after deductible

You pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible

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

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

You pay 30% after deductible

You pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible

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

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

(like childbirth, complex joint replacement and cardiac surgery)

You pay 30% after deductible

You pay 20% after deductible

You pay 30% after deductible

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

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

You pay 40% after deductible ($500 facility copay per incident)

Freestanding Emergency Room

You pay $500 copay + 30% after deductible

You pay $500 copay + 20% after deductible

You pay $500 copay + 30% after deductible

You pay $500 copay + 50% after deductible

You pay $500 copay + 20% after deductible

You pay $500 copay + 40% after deductible

Facility: You pay 30% after deductible

Facility: You pay 20% after deductible

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

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

Only covered if rendered at a BDC+ facility

Only covered if rendered at a BDC+ facility

Specialist: You pay $70 copay

Specialist: You pay $70 copay

You pay 30% after deductible

You pay 50% after deductible

PCP: $30 copay

PCP: $15 copay

Specialist: $70 copay

Specialist: $70 copay

You pay 30% after deductible

You pay 50% after deductible

High-Tech Imaging (like CT Scan, Mammogram and MRI)

Outpatient (like colonoscopy, cataract surgery and steroid injections)

Inpatient

Bariatric Surgery

Annual Vision Exam (one per plan year)

Annual Hearing Exam (one per plan year)

Outpatient: You pay 20% after deductible

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

Not Covered

Not Covered

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

Not Covered

Only covered if rendered at a BDC+ facility Tier 1 Specialist: $55 copay Tier 2 Specialist: $85 copay

Tier 1 PCP: $20 copay Tier 2 PCP: $40 copay Tier 1 Specialist: $55 copay Tier 2 Specialist: $85 copay

www.trs.texas.gov 04/01/2026

10

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

You pay 40% after deductible

You pay 40% after deductible

Pharmacy Express Scripts TRS Pharmacy Benefits Manager As part of your TRS medical plan coverage, you also have pharmacy benefits coverage through Express Scripts, our pharmacy benefits manager (PBM). This pharmacy benefits coverage is available ONLY to those enrolled in one of the TRS-ActiveCare medical plans.

Express Scripts helps you understand your pharmacy benefits and makes it convenient and affordable for you and your family to access the medications you need. New enrollees will be issued ID cards effective for the upcoming plan year. If you do not receive a card, or if yours is misplaced, you may download a temporary ID card. You can also contact the Express Scripts TRS-ActiveCare Customer Support team for assistance.

Contact Express Scripts Visit www.express-scripts.com/trsactivecare Call 844-367-6108

Once your plan year deductible is met, you will pay the applicable copay or coinsurance for each prescription until your out-of-pocket maximum is reached. The Express Scripts website allows you to download a temporary ID card, check medication costs, and explore options for home delivery, specialty medications, and retail pharmacies.

Check medication prices, see what pharmacies are in-network, and find out what medications are covered by your plan.

Please note that when utilizing prescription drug resources outside of Express Scripts, your prescription costs may not be applied toward your pharmacy coverage deductible or copays.

11

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Preventive Care Your medical plan offers $0 preventive care for everyone. Preventive care is the care you receive to help prevent chronic illness or disease. It includes exams, lab work, screenings, immunizations, and counseling to prevent health problems, such as diabetes or heart disease.

Having a doctor who knows you and your medical history is a key part of preventive care.

Preventive Care Coverage May Include ADULTS

TEENS

CHILDREN

Cholesterol screening

Physical exam

Autism screening

Blood pressure screening

Blood tests for iron and cholesterol

Blood screening

Colorectal cancer screening

Anxiety screening

Depression screening

Lung cancer screening

Growth screening

Developmental screening

Hepatitis B screening

Hearing screening

Hearing screening

Well visits

Hepatitis B screening

Obesity screening and counseling

Bone density screening

Depression screening

Hypothyroidism screening

Obesity screening

Alcohol, tobacco, and drug use assessments

Behavioral assessments

Tuberculosis screening

Immunizations

Diabetes type 2 screening Depression screening Mammograms

Immunizations

Well visits

Cervical cancer screening Immunizations

Frequently Asked Questions Why should I get preventive care?

Preventive care is the fastest and best way to uncover potential risks and avoid chronic health conditions.

Are all screenings, tests, and procedures covered under preventive care?

No. Your doctor will be able to advise you as to the preventive care you need or should obtain, based on your medical and family history.

Why did I get a bill for preventive care?

Diagnosis codes on the doctor’s bill must meet certain insurance company conditions for them to be processed as preventive and covered at 100%. If you have a medical complaint, or your doctor finds a specific medical issue during your preventive care doctor’s visit, a diagnosis code for that issue or complaint will be on your bill. As a result, the insurance company may process the bill for a specific medical condition, not preventive care. In this case, you must pay the copay or portion of your deductible.

12

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Health Care Options Becoming familiar with your options for medical care can save you time and money.

HEALTH CARE PROVIDER

SYMPTOMS

AVERAGE COST

AVERAGE WAIT

$

2-5 minutes

$

15-20 minutes

$

15 minutes

$$

15-30 minutes

$$$$

4+ hours

$$$$$$

Minimal

NON-EMERGENCY CARE

Telehealth

Access to care via phone, online video, or mobile app whether you are at home, work, or traveling; medications can be prescribed

Cough/cold/flu

24 hours a day, 7 days a week

Stomachache

Generally, the best place for routine preventive care; established relationship; able to treat based on medical history

Doctor’s Office

Retail Clinic

Urgent Care

Office hours vary

Allergies Rash

Infections Sore and strep throat Vaccinations Minor injuries/sprains/strains

Usually lower out-of-pocket cost than urgent care; when you can’t see your doctor; located in stores and pharmacies

Common infections

Hours vary based on store hours

Vaccinations

When you need immediate attention; walk-in basis is usually accepted

Sprains and strains

Generally includes evening, weekend and holiday hours

Minor injuries Pregnancy tests

Minor broken bones Small cuts that may require stitches Minor burns and infections

EMERGENCY CARE Chest pain Life-threatening or critical conditions; trauma treatment; multiple bills for doctor and facility

Hospital ER

24 hours a day, 7 days a week

Severe bleeding Blurred or sudden loss of vision Major broken bones

Services do not include trauma care; can look similar to an urgent care center, but medical bills may be 10 times higher

Freestanding ER

Difficulty breathing

24 hours a day, 7 days a week

Most major injuries except trauma Severe pain

Note: Examples of symptoms are not inclusive of all health issues. Wait times described are only estimates. This information is not intended as medical advice. If you have questions, please call the phone number on the back of your medical ID card.

13

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Health Savings Account Offset your High Deductible Health Plan (HDHP) health care costs, reduce your taxes, and get a long-term tax-advantaged savings account.

A Health Savings Account (HSA) is like a personal savings account that allows you to pay for current or future health care expenses with pretax dollars or save the funds for retirement. The funds can also be used for your dependents, even if they are not covered by the HDHP. An HSA is always yours to keep, even if you change health plans or jobs.

Watch and learn more!

HSA Eligibility

Two Ways To Use Your HSA

You are eligible to open and contribute to an HSA if you are:

Use it Now

Invest Over Time

Pay for qualified out-ofpocket medical, dental, and vision expenses as they are incurred.

Invest and grow your HSA dollars tax-free. You can use the funds to pay for qualified expenses later.

• Enrolled in an HSA-eligible HDHP • Not covered by another plan that is not a qualified HDHP (e.g., 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 Note: You may have an HSA at the financial institution of your choice, but only accounts opened through EECU are eligible for automatic payroll deductions.

Triple Tax Savings

How to Pay or Get Reimbursed

Tax-free contributions

• Use your HSA debit card to pay for qualified expenses.

• Pay out-of-pocket and submit your receipts for reimbursement online or through the app.

Tax-free growth

Annual Maximum HSA Contributions You may contribute up to the IRS annual maximum.

Tax-free withdrawals

MAXIMUM CONTRIBUTION Individual

$4,4001

Family

$8,7501

1

If you are age 55 or older, you can contribute an extra $1,000.

Get More Information or Submit Receipts Visit www.eecu.org Call 817-882-0800

14

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Flexible Spending Accounts Set aside pretax dollars from each paycheck to pay for certain IRS-approved health and dependent care expenses. We offer the following Flexible Spending Accounts (FSAs).

Health Care FSA

Important Reminders!

The Health Care FSA covers qualified medical, dental, and vision expenses for you and your eligible dependents. This benefit is funded up-front, so you will have access to your whole annual election on the first day of the plan year. Eligible expenses include:

FSAs are generally considered “use it or lose it” accounts, and unused remaining funds at the end of the plan year may be forfeited. Your employer may offer some flexibility (e.g., more time via a grace period to incur expenses; or a limited amount of funds that can be carried over in to the next plan year). Because options vary by employer, it’s important to review your specific plan details or check with your employer for more information.

• Deductibles, copays, and coinsurance • Prescription drugs • Braces, glasses, and contacts • Hearing aids and batteries If you enrolled in an High Deductible Health Plan and contribute to an HSA, you may not contribute to a Health Care FSA.

Planning the amount of your contributions carefully can help you make the most of your FSA and avoid losing unused funds. You cannot change your contribution election during the plan year. Keep itemized receipts to verify debit card payments.

How to Access Funds/Pay or Get Reimbursed Use your FSA debit card (excludes the Dependent Care FSA).

OR Pay out-of-pocket, and submit your receipts for reimbursement.

Get More Information or Submit Receipts Visit www.nbsbenefits.com Call 855-399-3035 Fax 844-438-1496 Email service@nbsbenefits.com Participant Portal: www.mynbsbenefits.com

15

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Flexible Spending Accounts Dependent Care FSA The Dependent Care FSA helps pay expenses associated with caring for children under age 13 and elder dependents so you or your spouse can work or attend school full-time.

Dependent Care FSA Guidelines

• 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.

• You can use funds for daycare or babysitter expenses for your children under age 13, but only for the part of the year when the child is under 13.

• Only day camps – not overnight camps – can be considered for reimbursement.

• You can use funds 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.

How to Access Funds/Pay or Get Reimbursed

• The dependent care provider cannot be your child

Pay out-of-pocket, and submit your receipts for reimbursement.

under age 19 or anyone claimed as a dependent on your income taxes.

• Dependent Care FSA claims may be submitted as

incurred and will be paid as funds become available after monthly payroll contributions are deposited.

Annual Maximum FSA Contributions You may contribute up to the IRS annual maximum.

MAXIMUM CONTRIBUTION Health Care FSA

$3,400 $7,500 – Single filing head of household or married filing jointly $3,750 – Married filing separately

Dependent Care FSA

Watch and learn more!

Visit fsastore.com for an array of FSA-eligible products.

16

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

HSA and FSA Comparison Knowing the difference between a Health Savings Account (HSA) and Flexible Spending Account (FSA) can help you choose the best option for you and your family. Each benefit allows you to save taxes because the amount you elect is set aside on a pre-tax basis.

HEALTH SAVINGS ACCOUNT

FLEXIBLE SPENDING ACCOUNT

IRC SEC. 223

Description

IRC SEC. 125

• Acts as a personal savings account.

• Funds can be used to pay for current or future

• An employer-sponsored plan that lets you set

•

•

health care expenses with pretax dollars; or funds can be saved for retirement.

Funds can also be used for your dependents, even if they are not covered by the HDHP.

aside pre-tax money from your paycheck to pay for eligible out-of-pocket health care or dependent care expenses.

Generally, a “use it or lose it” account.1

Contribution Source

Employee (You)

Employee (You)

Account Owner

Employee (You)

Employer

Underlying Insurance Requirement

High Deductible Health Plan (HDHP)

None

Maximum Annual Contribution

Individual – $4,400 Family – $8,750 Age 55+ Additional Catch-up – $1,000

Health Care FSA $3,400 Dependent Care FSA $7,500 (Single parent filing head of household; or married filing jointly) $3,750 (Married filing separately)

Permissible Use of Funds

• Pay for qualified out-of-pocket medical, dental, and vision expenses.

• If used on nonqualified expenses prior to age 65, subject to income tax plus a 20% penalty.

• • •

Health Care FSA - Pay for qualified medical, dental, and vision expenses.

Dependent Care FSA - Pay for qualified dependent care expenses and services.

Year-to-year rollover of account balance?

Yes. Funds roll over and can be used anytime or saved for future use.

No. After end of plan year, allows a 75-day grace period to incur new expenses and a 90-day runout period to file claims.1

Does the account earn interest?

Yes

No

Portable?

Yes. It is always yours to keep, even if you change jobs or medical plans.

No

1 FSAs are generally considered “use it or lose it” accounts, and unused remaining funds at the end of the plan year may be forfeited. Your employer may offer some flexibility (e.g., more time to incur expenses). Check the full plan details for more information.

FLIP TO...

14

HSA

17

15

FSA

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Qualified HSA and FSA Expenses

The products and services listed below are examples of medical expenses eligible for payment from your Health Care FSA or HSA.* This list is not all-inclusive; additional expenses may qualify, and the items listed are subject to change in accordance with IRS regulations. Please refer to IRS Publication 502 Medical and Dental Expenses at www.irs.gov for complete details.

Abdominal supports

Dermatologist

Operating room costs

Acupuncture

Diagnostic fees

Ophthalmologist/Optician/Optometrist

Ambulance

Eyeglasses

Orthopedic shoes

Anesthetist

Gynecologist

Orthopedist

Arch supports

Healing services

Osteopath

Artificial limbs

Hearing aids and batteries

Physician

Blood tests

Hospital bills

Postnatal treatments

Braces

Insulin treatment

Prenatal care

Cardiographs

Lab tests

Prescription medicines

Chiropractor

Metabolism tests

Psychiatrist

Crutches

Neurologist

Therapy equipment

Dental treatment

Nursing

Wheelchair

Dentures

Obstetrician

X-rays

* Excludes Dependent Care FSA.

18

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Dental Coverage Our dental plans help you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work.

Dental PPO Plans Two levels of benefits are available with the DPPO plans: in-network and out-of-network.

You may see 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.

Watch and learn more!

Dental Benefits Summary CIGNA DENTAL CHOICE DENTAL PPO HIGH PLAN1

LOW PLAN1

IN-NETWORK

IN-NETWORK

Plan Annual Maximum

$1,500

$1,000

Annual Deductible – Individual / Family

$50/$150

$0/$0

Class 1 (Preventative/Diagnostic Care) – Reimbursement Percentage

100%

50%

Class 2 (Basic Restorative Care) – Reimbursement Percentage

80%

50%

Class 3 (Major Restorative Care) – Reimbursement Percentage

50%

50%

Class 4 (Orthodontia) – Reimbursement Percentage / Lifetime Max

50% / $1,500

Not covered

Class 4 (Orthodontia) – Children Only or Adults and Child Coverage

Children and Adults

N/A

50% / $1,500

50% / $1,000

50%

50%

Endodontics Non-Surgical

Basic

Basic

Endodontics Surgical

Basic

Basic

Periodontics Non-Surgical

Basic

Major

Periodontics Surgical

Basic

Major

Oral Surgery

Basic

Major

Class 3 (Implants) – Full, Partial or No Coverage Class 3 (Dentures) – Fixed Partial, Removable Partial & Removable Full or No Coverage

SERVICES

PLAN PROVISIONS Please Detail the Missing Tooth Clause

No Limitation (teeth missing prior to the effective date of coverage are covered)

Dental Cleanings Available per Year

2

1

Reimbursement up to a Maximum Allowable Charge (MAC) for services received from an out-of-network dentist. You are responsible for charges in excess of the MAC.

EMPLOYEE MONTHLY CONTRIBUTIONS HIGH PLAN

LOW PLAN

Employee

$40.44

$21.28

Employee and Spouse

$80.90

$42.54

Employee and Child(ren)

$82.53

$43.41

Employee and Family

$122.98

$64.69

19

Find an In-Network Provider Visit www.cigna.com Network: Total DPPO Group #3346815 Call 800-244-6224

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Vision Coverage Our vision plan offers 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.

The plan will pay the highest level of benefits when you see in-network providers.

PLUS providers offer more savings that add value on top of existing benefits.

A welcome packet with two ID Cards will be mailed to you.

Watch and learn more!

Vision Benefits Summary VISION – EYEMED BENEFIT FREQUENCY (PER PLAN YEAR) Exam

Once per Plan Year

Frames

Once per Plan Year (in lieu of contacts)

Lenses

Once per Plan Year (in lieu of contacts)

Contact Lenses

Once per Plan Year (in lieu of frames and lenses)

IN-NETWORK YOU PAY

OUT-OF-NETWORK REIMBURSEMENT

$10 copay; $0 copay at PLUS provider

Up to $40 reimbursement

SERVICES Exam Retinal Imaging

Up to $39

Not covered

Standard Contact Lens Fitting

$0 copay

Up to $40 reimbursement

Frame Allowance

$0 copay, 20% off balance over $130 allowance; 20% off balance over $180 allowance at PLUS provider

Up to $65 reimbursement

Materials Copay

See below

See below

Are Single Vision Lenses Covered in Full?

$25 copay

Up to $30 reimbursement

$25 copay

Up to $50 reimbursement

Inclusive of $25 copay Standard: $90 copay Premium Tier I – V: $110 – $250 copay

Up to $50 reimbursement

MATERIALS (PER PAIR)

Are Bifocal Lenses Covered in Full?

Progressive Lenses by Tier Standard Premium

• •

In-network Discounts

Find an In-Network Provider

• 40% off complete additional pair of eyeglasses • 20% off non-prescription sunglasses and accessories

Visit www.eyemed.com Network: Insight Call 866-939-3633

20

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

VISION – EYEMED IN-NETWORK YOU PAY

OUT-OF-NETWORK REIMBURSEMENT

Adult and Children

Up to $20 reimbursement

$0 copay

Up to $20 reimbursement

Anti-reflective Coating Standard Premium

Standard: $45 Premium: Tier 1 – $57; Tier 2 – $68; Tier 3 – $85

Not covered

Scratch-resistant Coating

$0 copay

Up to $8 reimbursement

$15/$15 copay

Up to $8 reimbursement

LENS ENHANCEMENTS Are Standard Polycarbonate Lenses Covered in Full?

Standard Polycarbonate Lenses

• •

UV Treatment/Tint

CONTACTS AND LASIK Are Contacts in Lieu of Glasses?

Yes

Conventional Contact Lens Allowance Medically Necessary Contact Lens Allowance LASIK Benefit

$0 copay; 15% off balance over $130 allowance

Up to $65 reimbursement

$0 copay; paid-in-full

Up to $300 reimbursement

15% off retail price or 5% off promotional price for LASIK or PRK from US Laser Network

Not covered

PLAN PROVISIONS Are Benefits Determined by Policy Year, Service Year, or Calendar Year?

Plan Year

Can Benefits Be Utilized Outside of the U.S.?

No

EMPLOYEE MONTHLY CONTRIBUTIONS Employee

$6.98

Employee and Spouse

$13.10

Employee and Child(ren)

$13.72

Employee and Family

$21.18

21

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Life and AD&D Insurance BASIC – EMPLOYER-PAID LIFE AND AD&D Life and Accidental Death and Dismemberment (AD&D) insurance are important to your financial security, especially if others depend on you for support.

Employee Basic Life and AD&D

With Life insurance, 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 your beneficiary(ies).

Eligible employees receive Basic Life and AD&D at no cost. You are automatically covered at $15,000* for each benefit. *Reduces to $9,750 at age 70.

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 anytime. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%).

22

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Watch and learn more!

Life Insurance VOLUNTARY – EMPLOYEE, SPOUSE, CHILDREN Life 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. Life coverage amounts reduce to 65% at age 70.

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 anytime. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%).

Voluntary Life If you need more coverage than Basic Life, you may buy Voluntary Life coverage for yourself and your dependent(s). If you do not elect Voluntary Life coverage 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. You must elect Voluntary Life coverage for yourself before covering your spouse and/or child(ren).

VOLUNTARY LIFE INSURANCE

• Up to 7 times employee annual earnings up to a maximum of $750,000 in $10,000 increments • New hire Guaranteed Issue $350,000 • Increments of $5,000 up to $250,000 maximum (not to exceed 100% of employee amount) • New hire Guaranteed Issue $50,000 • Increments of $2,000 up to $10,000 • Live birth to six months – $100 • Six months to age 26 – $2,000 to $10,000 in $2,000 increments • New hire Guaranteed Issue $10,000

Employee

Spouse

Child(ren)

MONTHLY VOLUNTARY LIFE RATES

Voluntary Coverage Highlights Portable – keep your supplemental coverage if you leave your current employer Convertible – convert your group term life insurance benefits to an individual life policy if your coverage ends Accelerated Death Benefit for Terminal Illness – 50% of Death Benefit not to exceed $500,000 Accelerated Death Benefit for Long Term Care – 4% of Death Benefit per month up to 75% of Death Benefit not to exceed $200,000 Some limitations and exclusions apply, so see the plan documents for details.

AGE

EMPLOYEE RATE PER $10,000

SPOUSE1 RATE PER $5,000

<29

$0.360

$0.180

30-34

$0.450

$0.225

35-39

$0.640

$0.320

40-44

$1.000

$0.500

45-49

$1.730

$0.865

50-54

$3.000

$1.500

55-59

$4.280

$2.140

60-64

$5.100

$2.550

65-69

$9.110

$4.555

70-74

$15.580

$7.790

75+

$31.240

$15.620

CHILD(REN) PER $2,000 To age 26 1

Spouse rate is based on employee’s age.

Watch and learn more!

23

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

$0.200

AD&D Insurance VOLUNTARY 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 AD&D insurance, you or your beneficiary(ies) can use the coverage to pay off debts such as credit cards, loans, and bills. AD&D pays a death benefit to the beneficiary should the death occur due to a covered accident and provides specific benefits if an accident causes bodily harm or loss (e.g., the loss of hand, foot, or eye). AD&D coverage amounts reduce to 65% at age 70.

Voluntary AD&D

Watch and learn more!

VOLUNTARY AD&D INSURANCE

• Up to 7 times employee annual earnings

If you need more coverage than Basic AD&D, you may buy Voluntary AD&D coverage for yourself and your dependent(s). If you do not elect Voluntary AD&D coverage 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. You must elect Voluntary AD&D coverage for yourself before covering your spouse and/or child(ren).

up to a maximum of $750,000 in $10,000 increments New hire Guaranteed Issue $350,000

Employee

• • Increments of $5,000 up to $250,000

maximum (not to exceed 100% of employee amount) New hire Guaranteed Issue $50,000

Spouse

• • Increments of $2,000 up to $10,000 • Live birth to six months – $100 • Six months to age 26 – $2,000 to $10,000 in $2,000 increments • New hire Guaranteed Issue $10,000

Child(ren)

Designating a Beneficiary

MONTHLY VOLUNTARY AD&D RATES

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 anytime. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%).

1

24

EMPLOYEE

SPOUSE1

CHILD(REN)

$0.30 per $10,000

$0.15 per $5,000

$0.06 per $2,000

Spouse rate is based on employee’s age.

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Permanent Life Insurance Permanent Life insurance is a type life insurance 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.

For More Information

Help protect your family with the PureLife-plus Plan from Texas Life Insurance Company. This permanent universal life insurance plan offers level premiums and a level death benefit to age 121, as long as there is no lapse in premium payments.

Plan Highlights • Family Coverage:

Visit www.texaslife.com Call 800-283-9233

• Convenient Payment: Your premium can be payrolldeducted.

» Employee: issue ages 17-70.

• Easy to Qualify for Coverage: Just answer three

» Spouse: issue ages 17-60.

questions with no medical exam required. During the last six months, has the proposed insured:

» Children: issue ages 15 days to 26 years. » Grandchildren: issue ages 15 days to 18 years.

1. Been actively at work on a full-time basis and

Children must reside with the applicant to be eligible for coverage. Employees do not have to participate in order to apply for coverage on eligible dependents.

performing usual duties?

2. Been absent from work due to illness or medical

• Portability: If you change jobs or retire, and continue to

treatment for more than five consecutive working days?

pay your premium, your coverage continues with no loss of benefits and no premium increase.

3. Been disabled or received tests, treatment, or care

• Accelerated Death Benefit: With the optional Terminal

of any kind in a hospital or nursing home; or received chemotherapy, hormonal therapy for cancer, radiation, dialysis treatment; or received treatment for alcohol or drug abuse?

Illness Rider, you may receive an accelerated portion of your death benefit – up to 92% – should you be diagnosed as terminally ill with a life expectancy of 12 months or less.

25

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Educator Disability Insurance Educator Disability insurance combines features of short-term and long-term disability into one plan. Disability insurance protects part of your income if you are unable to work due to a covered accident, illness, or pregnancy. We offer Educator Disability insurance for you to purchase and allow you to choose the coverage amount and waiting period that best suits your needs.

EDUCATOR DISABILITY INSURANCE AVAILABLE COVERAGE GROSS MONTHLY BENEFIT Units of $100, minimum amount of $200 1

MAXIMUM GROSS MONTHLY BENEFIT

BENEFIT WAITING PERIOD ACCIDENT/SICKNESS

MAXIMUM BENEFIT PERIOD

Lesser of 70% of your monthly covered earnings or $8,000

Option 1: 14/14 days1 Option 2: 30/30 days1 Option 3: 60/60 days Option 4: 90/90 days

Refer to the How Long Benefits Last section for more details.

Benefit Waiting Period will end on the date in inpatient hospital admission if the date is before the time period specified.

Family Survivor Benefit Additional Feature If you die while receiving benefits, New York Life will pay a survivor benefit to your lawful spouse, eligible children, or estate. The plan will pay a single lump sum equal to three months of benefits.

MONTHLY RATES PER $100 BENEFIT SELECT PLAN Accident in Days

14

30

60

90

Sickness in Days

14

30

60

90

$2.42

$2.08

$1.35

$1.16

All Ages

PREMIUM PLAN Accident in Days

14

30

60

90

Sickness in Days

14

30

60

90

$2.74

$2.32

$1.50

$1.30

All Ages

26

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Educator Disability Insurance Important Definitions and Policy Provisions:

File a Disability Claim

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 60% or more of your indexed earnings. We will require proof of earnings and continued disability.

Visit www.newyorklife.com Group #SLH100028 Call 888-842-4462

Covered Earnings – “Covered Earnings” means your wages or salary, not including bonuses, commissions, overtime pay, and other extra compensation.

When Benefits Begin – You must be continuously disabled for your elected benefit waiting period before benefits will be payable for a covered disability.

How Long Benefits Last – 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 according to one of the following schedules, depending on your age at the time you become disabled and the plan you select.

MAXIMUM BENEFIT PERIOD SCHEDULE SELECT PLAN AGE AT DISABILITY

AGE 62 OR YOUNGER

63

64

65

66

67

68

69+

Duration of Payments for Accident (months)

To age 65 or the date the 42nd monthly benefit is payable, if later.

36

30

24

21

18

15

12

AGE AT DISABILITY

AGE 62 OR YOUNGER

63

64

65

66

67

68

69+

Duration of Payments for Sickness (months)

The date the 60th Monthly Benefit is payable

Your 70th Birthday or the date the 12th Monthly Benefit is payable, if later.

The date the 12th Monthly Benefit is payable, if later.

PREMIUM PLAN AGE AT DISABILITY

AGE 62 OR YOUNGER

63

64

65

66

67

68

69+

Duration of Payments for Accident (months)

To age 65 or the date the 42nd monthly benefit is payable, if later.

36

30

24

21

18

15

12

AGE AT DISABILITY

AGE 62 OR YOUNGER

63

64

65

66

67

68

69+

Duration of Payments for Sickness (months)

To age 65 or the date the 42nd monthly benefit is payable, if later.

36

30

24

21

18

15

12

When Coverage Takes Effect – 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 if required, or the date you authorize any necessary payroll deductions if applicable. 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 proof of good health, your coverage takes effect on the date New York Life agrees, in writing, to cover you.

27

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Educator Disability Insurance Benefit Reductions, Conditions, Limitations and Exclusions 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 may 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, sick leave, 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. Note: Some of the other income benefits, as defined in the group policy, will not be considered until after disability benefits are payable for 12 months.

Earnings While Disabled – During the first 24 months that benefits are payable, benefits will be reduced if benefits plus income from employment exceeds 100% of pre-disability covered earnings. After that, benefits will be reduced by 50% of earnings from employment.

Limited Benefit Period – Disabilities caused by or contributed to by any one or more of the following conditions are subject to a lifetime limit of 24 months for outpatient treatment: anxiety-disorders, delusional (paranoid) or depressive disorders, eating disorders, mental illness, somatoform disorders (including psychosomatic illnesses) or substance abuse. Benefits are payable during periods of hospital confinement for these conditions for hospitalizations lasting more than 14 consecutive days that occur before the 24-month lifetime outpatient limit is exhausted.

Pre-existing Condition Waiver The insurance company will waive the pre-existing condition limitation for the first four weeks of disability even if you have a pre-existing condition. The disability benefits as shown in the schedule of benefits will continue beyond four weeks only if the pre-existing condition limitation does not apply.

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 three months just prior to the most recent effective date of insurance. Benefits are not payable for any disability resulting from a pre-existing 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 pre-existing condition limitation will apply to any added benefits or increases in benefits.

Termination of Disability Benefits – Your benefits will terminate when your disability ceases, when your benefit duration period is exceeded, or on the following events: the date you earn from any occupation more than the percentage of indexed earnings, or the date you fail to cooperate with us in a rehabilitation plan, or transitional work arrangement, or the administration of the claim.

28

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Educator Disability Insurance How do I choose which plan to enroll in during my open enrollment?

1. First, choose your elimination period and plan type (Select or Premium). The elimination period, sometimes referred to as the waiting period, is how long you are disabled and unable to work before your benefit will begin. This will be displayed as two numbers such as 14/14, 30/30, 60/60, or 90/90.

The first number indicates the number of days you must be disabled due to Injury and the second number indicates the number of days you must be disabled due to Sickness.

When choosing your elimination period, ask yourself, “How long can I go without a paycheck?” Based on the answer to this question, choose your elimination period accordingly.

Important Note: Some plans will waive the elimination period if you choose 30/30 or less and you are confined as an inpatient to the hospital for a specific time period. Please review your plan details to see if this feature is available to you.

2. Next, choose your benefit amount. This is the maximum amount of money you would receive from the carrier on a monthly basis once your disability claim is approved by the carrier (based on a percentage of your salary).

When choosing your monthly benefit, ask yourself, “How much money do I need to be able to pay my monthly expenses?” Based on the answer to this question, choose your monthly benefit accordingly.

Choose your Monthly Benefit amount from the drop down box.

Choose your desired elimination period and plan type.

29

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Hospital Cash The Hospital Cash plan pays if you are confined as an in-patient at a hospital.

Unlike traditional insurance which pays a benefit to the hospital or doctor, this plan pays you directly. It is up to you how you want to use the cash benefit. These costs may include meals, travel, childcare or eldercare, deductibles, coinsurance, medication, or time away from work.

Watch and learn more!

Hospital Cash Benefits Summary HOSPITAL CASH BENEFITS Hospital Admission

$1,000, up to 5 per calendar year

Hospital Confinement

$100 per day up to 30 days

Intensive Care Unit Admission

$2,000, up to 5 per calendar year

Intensive Care Unit Confinement

$200 per day up to 30 days

Newborn Nursery

$500 per day, 2 days maximum for normal or Cesarean section delivery

Observation Unit (Treatment less than 20 hours)

$500 per day, up to 2 days per calendar year

Wellness Benefit

$50, one per calendar year, per covered member

EMPLOYEE MONTHLY CONTRIBUTIONS Employee

$17.44

Employee and Spouse

$33.09

Employee and Child(ren)

$26.78

Employee and Family

$42.43

30

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Critical Illness Insurance Critical Illness insurance helps pay the cost of medical or other expenses related to a covered critical illness.

The plan provides a lump sum benefit payment to you upon first and second diagnosis of any covered critical illness or cancer. The benefit can help cover expenses such as lost income, out-of-town treatments, special diets, daily living, and household upkeep costs.

Watch and learn more!

Critical Illness Insurance Benefits Summary What are the Critical Illness coverage costs? Employee contribution rates are based on benefit amount elected, coverage tier, and employee age. See plan document for more details.

CRITICAL ILLNESS BENEFIT AMOUNT

GUARANTEED ISSUE AMOUNT

Employee

$10,000, $20,000, $30,000

Up to $30,000

Spouse

100% of employee amount

Up to $30,000

Children

100% of employee amount, including childhood conditions

All Guaranteed Issue

INITIAL BENEFIT AMOUNT %

RECURRENCE % OF INITIAL BENEFIT AMOUNT

COVERED CONDITIONS CANCER CONDITIONS Skin Cancer*

$250 one time per lifetime

Invasive Cancer

100%

100%

Carcinoma in Situ

25%

25%

Heart Attack

100%

100%

Stroke

100%

100%

Coronary Artery Disease

100%

100%

Advanced Stage Alzheimer’s Disease

25%

Not available

Amyotrophic Lateral Sclerosis (ALS)

25%

Not available

Parkinson’s Disease

25%

Not available

Multiple Sclerosis

25%

Not available

Mid-Stage Alzheimer’s Disease

25%

Not available

Huntington’s Disease

25%

Not available

Myasthenia Gravis

25%

25%

Bacterial Meningitis

25%

25%

Malaria

25%

25%

Tuberculosis

25%

25%

Necrotizing Fasciitis

25%

25%

Osteomyelitis

25%

25%

VASCULAR CONDITIONS

NERVOUS SYSTEM CONDITIONS

INFECTIOUS CONDITIONS

31

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Critical Illness Insurance CHILDHOOD CONDITIONS Cerebral Palsy

25%

Not Available

Cystic Fibrosis

25%

Not Available

Muscular Dystrophy

25%

Not Available

Poliomyelitis

25%

Not Available

Benign Brain Tumor

100%

100%

Blindness

100%

Not Available

OTHER SPECIFIC CONDITIONS

Coma

25%

25%

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%

FOR QUESTIONS 25%

Systemic Sclerosis

25%

CALL 800-244-6224.

GROUP #602825.

ADDITIONAL BENEFITS Health Screening Benefit

$50 paid for completing health screening. Limited to one per year per covered person.

Hospital Indemnity Pays when a newborn child of employee is confined to hospital in NICU, payable if child coverage not elected.

25% of employee benefit amount limited to one benefit per newborn child

For Questions Call 800-244-6224 Group #C1961740

32

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Telehealth + Behavioral Health This voluntary telehealth program gives you 24/7 access to board-certified doctors, licensed counselors, and psychiatrists via your mobile device or computer – from home, the office, or on the go. Whether you need medical care or support navigating stress and life changes, confidential help is at your fingertips. It is a standalone program that is NOT tied to your medical plan coverage.

While telehealth with behavioral health does not replace your primary care physician, counselor, or psychiatrist, it is a convenient and cost-effective option when you need care and:

• Have a non-emergency issue and are considering

an after-hours health 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, counselor, or psychiatrist

When to Use Telehealth For minor conditions such as:

• Sore throat • Headache • Stomachache • Cold/flu

• Allergies • Fever • Urinary tract infections • Behavioral health

Get More Information and Register Skip the trip to your doctor! Set up your account so you can get on-demand medical care.

TELEHEALTH + BEHAVIORAL HEALTH

Visit www.recurohealth.com

EMPLOYEE MONTHLY CONTRIBUTIONS Employee and Family

$13.00

Call 855-673-2876 Download the Recuro app

Your telehealth + behavioral health copay is $0!

Watch and learn more!

33

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Emergency Medical Transport MASA Medical Transport Solutions (MASA MTS) helps you prepare for the unexpected with affordable medical emergency air and ground transportation.

If you or your family members need emergency medical transport, your insurance coverage and Medicare may not cover all of the costs. Following your medical crisis, MASA MTS will negotiate with your medical plan provider and cover your remaining balance on your medical transportation bills. If a member has a High Deductible Health Plan, benefits for incurred expenses will be available once plan deductible is met.

Emergency Medical Transport Benefits Summary EMERGENCY MEDICAL TRANSPORT – MASA SERVICES

EMERGENT PLUS PLAN

Emergency Ground Ambulance Coverage

✓1

Emergency Air Ambulance Coverage

✓1

Hospital to Hospital Ambulance Coverage

✓1

Repatriation Near Home Coverage

✓1

EMPLOYEE MONTHLY CONTRIBUTIONS Employee and Family

$14.00

Coverage territories: 1

United States and Canada

Disclaimer: This material is for informational purposes only and does not provide any coverage. The benefits listed, and the descriptions thereof, do not guarantee coverage and do not represent the full terms and conditions applicable for usage and may only be offered in some memberships or policies. Premiums, benefits, and coverage vary depending on the plan selected. For a complete list of benefits, premiums, terms, conditions, and restrictions, please refer to the applicable member services agreement or policy for your state. For additional information and disclosures about MASA plans, visit: https://info.masaglobal.com/disclaimers.

For More Information Visit www.masamts.com Group #B2BLEWIS Call 800-643-9023 Download the MASA Global app

34

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Watch and learn more!

Legal Assistance Legal services benefits include access to legal advice and representation on a wide variety of legal matters from traffic violations to creating a will.

Coverage Highlights

• Access to a national network of attorneys with

To Learn More

exceptional experience that are matched to meet your needs.

Visit www.legaleaseplan.com/lisd Group #9000789

• Concierge help navigating common individual or family legal issues.

Call 800-248-9000

• Home and residential legal issues (buying, selling, disputes, etc.).

Reference Lewisville ISD

• Auto and traffic issues (tickets, serious traffic matters, Lemon Law litigation, etc.).

• Estate planning and wills.

• Financial and consumer issues (debt collection

EMPLOYEE MONTHLY CONTRIBUTION

defense,bankruptcy, tax audit, student loan refinancing, etc.).

Employee and Family

• Family issues (separation, divorce, guardianship, adoptions, elder law, etc.).

• General issues (civil litigation defense, document review, misdemeanor defense, etc.).

35

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

$15.18

Sick Leave Bank The purpose of the Sick Leave Bank is to provide additional paid sick leave days to members of the Bank in the event of extended illness, surgery, or a disability due to an injury when the member is unable to perform the duties of his/her position. Benefits are for personal illness/injury of the member, and for serious illness, injury, or death of family members (as defined within the bereavement and critical care benefits).

For full plan details, please visit benefits.lisd.net.

Lewisville ISD Sick Leave Bank Rules

Application Process

Membership Eligibility

The Application for Sick Leave Bank Days must be submitted to the Benefits Department of the Lewisville ISD. If the member is too ill to complete the application, his or her building or area administrator may begin the process on the member’s behalf. The deadline for submitting the application to the Employee Services/Benefits Department is 60 days from the first date of absence pertaining to the SLB request.

Each illness or injury must be applied for separately and each must meet the criteria for approval of benefits on its own merits. This may not apply, however in certain circumstances such as recurring absences due to the same illness. See Guidelines for Benefits. The SLB Board will make the final determination of the eligibility of the member’s request for days from the SLB. If all criteria are met, the SLB Board will approve a maximum number of days (up to 25) that the member may withdraw from the Bank. In no circumstance may the member withdraw any days that exceed his or her actual absence for the period covered by the approved application. The SLB Board tries to meet at regular intervals to assure that any decision will be made prior to the cutoff date for payroll determination. If the cutoff date is missed on an individual applicant, the Payroll Department will make corrections on the next payroll check as supplemental pay. You may determine the cutoff date for your position by checking with Payroll or your administrator. The Payroll Department will not be able to issue special checks.

Eligibility is limited to all full-time employees of the Lewisville Independent School District. Full-time shall be defined as thirty or more hours of duty per week. Eligibility for membership begins on the first official workday for eligible personnel. An employee must be able to earn at least one local personal leave day from the beginning of his/her employment to the end of that SLB year to be eligible for membership. Application for membership must be made during the enrollment period or within thirty-one (31) days of employment or eligibility for membership.

Sick Leave Bank Enrollment

• Existing employees

» Sick Leave Bank enrollment will be conducted during the benefits Open Enrollment period.

• New hires

» New employees will indicate their Sick Leave Bank election through the on-line benefits system. » New employees that fail to make an election within 31 days of their hire date will not be allowed to join the Sick Leave Bank until the following plan year.

Existing members who have not received awarded SLB days in 2025-2026 are not required to donate a local day for 2026-2027.

Applicants who wish to discuss their situation may contact:

• The Benefits Department for questions regarding SLB Board meetings

• Payroll Department for questions on pay and leave balances

• SLB Board Members for questions on SLB Board activities and responsibilities

No individual is authorized to make SLB or application decisions.

Sick Leave Bank Calendar Year The sick bank calendar year is from July 1st through June 30th for all staff.

36

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Sick Leave Bank Absences at the Beginning of the Sick Leave Bank Year

Withdrawal of Days Only bank members in good standing are eligible to withdraw days. Days will be awarded only after the member has exhausted all accumulated state and local leave. The Sick Leave Bank may provide a member with benefits for serious illnesses and injuries. A member may apply for days after ten (10) consecutive days of absence for reasons of personal illness or injury. A member may apply for days for planned absences such as surgery or hospitalization in advance if it is anticipated that the absence will exceed ten (10) days. There is no 10-day waiting period for critical care or bereavement leave. A member may apply for these immediately. The ten (10) consecutive days of absence provision is modified to include school holidays for employees that elect to postpone their medical treatment/ care to a school holiday but who are unable to postpone the medical treatment/care to the summer months. The days during the holiday period that an employee would have been absent had the employee not postponed their medical treatment/care will count toward satisfying the 10-day absent rule. The ten (10) day consecutive absence requirement is waived for employees who have a minimum of 10 absences due to a serious long-term illness/injury but whose absences are not consecutive. Benefit days are retroactive to the first day of eligible absence once all other eligibility criteria are met. No benefit days will be granted unless an actual absence from normal duty occurs. No benefit days will be granted for elective absences, elective surgical or medical procedures, or procedures that could be safely and reasonably postponed to extended school breaks. If the member dies before all approved absences are used, the unused days revert to the bank. There are no survivor benefits under any circumstance.

Employees that are on leave of absence at the beginning of the Sick Leave Bank year will not be paid for any days awarded from the Sick Leave Bank until the employee has returned to work for a minimum of 18 days. The employee may apply for and be awarded Sick Leave Bank days for the absences at the beginning of the Sick Leave Bank year, but the employee will not be paid for these days until they have returned to work for a minimum of 18 work days.

Contribution of Days For employees who elect to join the SLB, one local personal leave day will automatically be subtracted from the employee’s personal leave balance. It becomes the permanent property of the bank and cannot be returned.

Each deposit remains the property of the bank, even in the event of termination, resignation. Unused bank days carry over to the next SLB year. If a member uses any days from the bank during a bank year, the employee will be required to become a member the next bank year whether or not the employee wishes to enroll. One (1) day will be subtracted from the employee’s personal leave balance during the member’s next year of employment. If, as of March 1 the number of unused bank days is equal to or greater than three (3) times the number of current members then employees who continue their membership the following year do not have to donate a local personal day (provided that the employee did not use any days from the bank during the current bank year).

37

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Investment Services A 403(b) plan is a U.S. tax-advantaged retirement savings plan available for public education organizations.

A 457(b) plan is a tax-deferred compensation plan provided for employees of certain tax-exempt, governmental organizations or public education institutions.

FEATURE

What is a 403(b)?

What we offer

A 403(b) plan is a special type of employer-sponsored retirement plan designed for eligible public education, religious, and other tax-exempt organizations. Saving with a 403(b) plan gives you the ability to defer a portion of your paycheck and invest funds in a portfolio of your choosing.

By participating, you can take advantage of tax savings, reduce your retirement income gap, and get one step closer to achieving financial independence. To establish a 403(b) account, you must first select an investment provider from a list of approved vendors and then elect contributions on a pre-tax or Roth basis.

Contribution maximum limits (can contribute to both plans)

What is a 457(b)?

A Section 457(b) plan is a special type of employersponsored retirement plan that certain governmental employers and other tax-exempt organizations can establish for their employees. Your employer offers the RAMS 457(b) plan as a way to help you save for life beyond your full-time working years. Contributing regularly to a 457(b) can help give you the power and confidence to retire with more in your pocket to cover housing, health care, vacations, bills, and other expenses upon retirement.

Contact TCG to open or change an account anytime during the year.

457(b)

Pre-tax, Post-tax (Roth)

Pre-tax, Post-tax

• $24,500 • $8,000 additional

• $24,500 • $8,000 additional

•

•

catch-up contribution (ages 50-59 and 64+) $11,250 additional catch-up contribution (ages 60-63 in 2026) 10%

None

Investment options

Fixed/Variable interest annuities or mutual funds/ custodial accounts

Managed allocations or self-directed mutual funds

Investment committee/advisor oversight

No

Yes, managed by TCG Advisors

Funds can be requested upon: Age 59 Age 55 and/ or leaving an employer Disability Death Financial hardship

Funds can be requested upon: Age 59 Separation from employer Disability Death Unforeseeable emergency

• • • • •

Qualified for the following causes: Medical care Foreclosure/ eviction Tuition payment Buying a home Funeral costs Home repair costs Disaster relief

Must be an unforeseen Emergency. The following criteria must be met: Medical expenses Funeral expenses Foreclosure/ eviction Certain hurricanes and natural disasters

Distribution restrictions

To Enroll and Get More Information Visit www.tcgservices.com Loans

• • • • • • • • • • • •

• • • •

Permitted; loans from all qualified plans limited to the lesser of 50,000 or 50% of vested account balance.

Call 800-943-9179

38

catch-up contribution (ages 50-59 and 64+) $11,250 additional catch-up contribution (ages 60-63 in 2026)

Early withdrawal penalty tax

Financial Hardship/ Unforeseeable Emergency Distributions

Visit www.tcgservices.com/telewealth to book a virtual meeting.

403(b)

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Glossary of Terms Copay – Also known as a copayment, this is the fixed amount you pay for health care services received at the time of service. A copay typically goes toward your deductible.

Actively-at-work – This term refers to being at work as opposed to being on vacation, leave, or away from work for any other reason. Company-wide or position-wide reporting dates (like summer breaks or winter breaks for teachers) do not apply here.

Coinsurance – After you have met your deductible, this is your share of the cost of a covered health care service, which is calculated as a percent of the allowed amount for the service. For example, your coinsurance is 20% (while the insurer pays the remaining 80%).

ADL (Activities of Daily Living) – This is a concept related to eligibility for Long Term Care (LTC) benefits. There are six ADLs: bathing, dressing, toileting, transferring, eating, and continence. Most LTC plans require that the covered individual be unable to perform a certain number of these tasks to be eligible for benefits.

Contingent Beneficiary – This is who will receive a benefit in the event of the beneficiary’s (aka the primary beneficiary) death. A policy may have more than one contingent beneficiary.

Beneficiary – This is who will receive a benefit in the event of the insured’s death. A policy may have more than one beneficiary.

Contingent Plans – Contingent plans make benefits available to participants only when another specific benefit has been elected. Examples of contingent plans include voluntary life for dependents (contingent on the election of employee voluntary life) and a Health Saving Account (contingent on the election of a High Deductible Health Plan).

Benefit Duration – This is the maximum period of time in which a claimant can receive benefits.

Benefit Reduction – Some plans may include percentage reductions in benefit amounts when participants reach a certain age.

Cafeteria/Section 125 Plan – This plan provides participants an opportunity to pay for qualified benefits on a pretax basis. Premiums for most medical, dental, vision, FSA, and HSA plans are deducted on a pretax basis, which reduces participants’ taxable income.

Conversion – Conversion is a benefit continuation option that transforms group coverage into individual coverage, separate from the group policy. This typically comes with much higher premiums.

Covered Expenses – These are health care expenses covered under your health plan.

Certificate of Benefits (Certificate of Coverage) – The certificate serves as the primary official plan document for participants of group benefits, as they are not enrolled in an individual policy.

Deductible – This is the amount a participant must cover for health care services before the insurer will share costs and provide coinsurance.

COBRA – COBRA allows participants who lose their health benefits the right to continue group health benefits for limited periods of time under certain circumstances including voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals will have to pay the full premium (including any employer contribution applied when employed) up to 102% of the cost to the plan.

Coverage is typically available for 18 months but can be extended in certain situations.

Eligibility Waiting Period – This period is the amount of time new hires must wait before they are eligible for benefits.

Elimination Period – Also known as a waiting period, this is the number of calendar days that participants in a Disability plan must be disabled before they are eligible to receive benefits.

39

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Glossary of Terms Employer Contribution – The amount of premium or financial contribution an employer provides to participants for medical insurance.

EOB (Explanation of Benefits) – This statement from your insurance carrier explains which procedures and services were provided, how much they cost, what portion of the claim was paid by the plan, and what portion of the claim is your responsibility. It also includes information on how you can appeal the insurer’s decision. These statements are also posted on the carrier’s website for your review.

EOI (Evidence of Insurability)/Statement of Health (SOH) – Some plans require an application or a “proof of good health” type of statement to obtain coverage. This is commonly referred to as EOI (Evidence of Insurability). Such applications or statements must be submitted electronically or by mail to the carrier for approval.

HSA (Health Savings Account) – This is an employee owned savings account used to pay for eligible health care expenses with pretax dollars. Funds in the account do not have to be used within a specified time period.

An HSA must be coupled with qualified High Deductible Health Plan.

In-network – Doctors (e.g., a primary care physician or specialist), hospitals, and other providers that contract with your insurance company provide health care services at discounted rates. These providers are on an outlined list of health care practitioners.

Inpatient – A person who is treated as a registered patient in a hospital or other health care facility.

Medically Necessary – Services or supplies provided by a hospital, health care facility, or physician that meet the following criteria: (1) are appropriate for the symptoms and diagnosis and/or treatment of the condition, illness, disease, or injury; (2) serve to provide diagnosis or direct care and/ or treatment of the condition, illness, disease, or injury; (3) are in accordance with standards of good medical practice; (4) are not primarily serving as convenience; and (5) are considered the most appropriate care available.

FMLA (Family and Medical Leave Act) – This act ensures employees have job-protected and unpaid leave for qualified medical and family reasons.

FSA (Flexible Spending Account) – An option that allows participants to set aside pretax dollars to pay for qualified expenses (i.e., certain medical care or dependent care expenses) during a specific period (usually a 12-month period). Participants determine how much to contribute to their FSA at the beginning of the plan year. Most funds must be used by the end of the year, depending upon the type of FSA, as there is a limited carryover amount.

Medicare – An insurance program administered by the federal government to provide health coverage to individuals age 65 or older, or who have certain disabilities or illnesses.

Member – You and those covered become members when you enroll in a health plan. This includes eligible employees, their dependents, COBRA beneficiaries, and surviving spouses.

Grace Period – As it pertains to FSAs, this is the period immediately following the end of the plan year during which participants can incur new expenses to use their remaining FSA funds.

Open Enrollment – Open Enrollment refers to the annual period during which employees may enroll in available benefits or make coverage changes without a Qualifying Life Event.

Guaranteed Issue – Some plans may include Guaranteed Issue coverage to new enrollees without EOI. HPS (Higginbotham Public Sector) – HPS is the insurance broker that represents your account.

40

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Glossary of Terms Pre-existing Condition Limitation – Some plans may limit benefits due to pre-existing conditions for a set period of time.

Out-of-network – Doctors, hospitals, and other providers that are not contracted with your insurance company. If you choose an out-of-network provider, you may be responsible for costs over the amount allowed by your insurance carrier.

Premium – A reference to the cost (usually monthly) of insurance/benefits paid by the employer or employee.

Out-of-pocket Expense – Amount that you must pay toward the cost of health care services. This includes deductibles, copayments, and coinsurance.

QLE (Qualifying Life Event) – These are events that allow changes to pretax benefits outside of Open Enrollment.

Changes must typically be made within 30 or 31 days of the event. Examples of QLEs include marriage, birth, divorce, gain or loss of benefits coverage, and change in employment status affecting benefits.

Out-of-pocket Maximum – Also known as an out-ofpocket limit, this is the most you pay during a policy or benefit period (usually a 12-month period) before your health insurance or plan begins to pay 100% of the allowed amount for covered services.

Run-out Period – Related to FSAs, this is a period immediately following the end of the plan year in which participants can submit claims incurred within the plan year.

PCP (Primary Care Physician) – A doctor who is selected to coordinate treatment under your health plan. This generally includes family practice physicians, general practitioners, internists, and pediatricians.

THEbenefitsHUB – This is the benefits enrollment system used by HPS.

Plan Year – A 12-month period of benefits coverage under a group health plan, which may or may not coincide with a calendar year.

Plan Year Maximum – The maximum amount of benefit available to a participant for each plan year.

Portability – Portability is a continuation option available that allows participants to continue group coverage beyond their employment. Premiums typically remain in line with active participants, but coverage depends on the continuation of the group policy. If the group policy terminates, portability will no longer be available.

Preventive Care – The care you receive to help prevent illness or disease. It also includes counseling to prevent health problems.

Pre-existing Condition – A pre-existing condition is a medical event, treatment, or diagnosis that occurs prior to the effective date of insurance coverage.

41

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Notes

42

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

Notes

43

Visit www.mybenefitshub.com/lewisvilleisd for full plan details.

This brochure highlights the main features of the Lewisville ISD employee benefits program.

It does not include all plan rules, details, limitations, and exclusions. The terms of your benefit plans are governed by legal documents, including insurance contracts. Should there be an inconsistency between this brochure and the legal plan documents, the plan documents are the final authority. Lewisville ISD reserves the right to change or discontinue its employee benefits plans anytime.