2026-2027 CITY OF TERELL Working EMPLOYEE Towards BENEFITS Wellness
A comprehensive guide to understanding your 2026-2027 employee benefits program
What’s Inside
What’s Inside 2 Welcome 3 Important Contacts 4 How to Enroll 5 Enrollment FAQ 6 Eligibility 7 Qualifying life events 8 Medical (ABA) 9 Additional Medical Assistance 10 Telemedicine 11 Flexible Spending Account 12 Dental Coverage 13 Vision Coverage 14 Life & AD&D 15 Permanent Life Insurance 16 Disability 17 Short-term Disability 18 Long-term Disability 19 Hospital Indemnity 20 Accident Insurance 21 Critical Insurance 22 Cancer Insurance 23 Legal & Identity theft protection 24 Emergency Medical Transport 25 Advance Lab test screening 27 Glossary 28 Notes
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Visit www.mybenefitshub.com/cityofterrell for full plan details.
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/cityofterrell
Your Benefits Are In Effect October 1, 2026, through
September 30, 2027
Flip to … 4
How to Enroll
5
Enrollment FAQ
8
Medical Coverage
Important Contacts ❖ City of Terrell Benefits Administrators Higginbotham Public Sector 833-856-5161 www.mybenefitshub.com/cityofterrell
❖ Director of Human Resources Sue Pfleging 972-551-6600 Ext 4053 spfleging@terrelltx.gov
❖ HR Generalist Erika Riley 972-551-6600 Ext 4052 eriley@terrelltx.gov
❖ Dental / Vision / Life AD&D / Disability
❖ Accident / Critical Illness
cityofterrell@hps.higginbotham.net ❖ Medical Assured Benefits Administrators 800-247-7114 www.abadmin.com ❖ Prescription Savings Clever RX 800-873-1195 www.cleverrx.com
The Standard
Aflac Group Insurance 800-992-3522
800-368-1135 www.standard.com
www.aflacgroupinsurance.com
❖ Flexible Spending Accounts (FSA) National Benefit Services (NBS) (855)399-3035
❖ Individual Life 5 Star 866-863-9753 www.5starlifeinsurance.com
❖ Telehealth Recuro 855-673-2876 www.recurohealth.com
www.nbsbenefits.com ❖ Cancer / Hospital Indemnity
❖ Medical Transport Solutions MASA 800-423-3226 www.masamts.com
CHUBB 888-499-0425 CWBspecialmarketservice@Chubb.com
❖ Legal Services Legal Shield 800-654-7757 www.legalshield.com
3 Visit www.mybenefitshub.com/cityofterrell for full plan details.
Mobile Enrollment Employee benefits made easy with your smartphone or tablet!
Scan the QR code to visit your benefit website for: • Benefits resources
• Interactive tools
• Online enrollment
• And more!
How to Enroll LOGIN PROCESS
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Go to www.mybenefitshub.com/cityofterrell Or scan the QR code on the top right-hand corner.
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Click Login. Enter your information: • Last name
3
• Date of birth • Last four digits of your Social Security number Note: THEbenefitsHUB uses this information to check behind the scenes to confirm your employment status.
4
Once confirmed, the Additional Security Verification page will list the contact options from your profile. Select either the Text, Email, Call, or Ask Admin options to receive a code to complete the final verification step.
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Enter the code that you receive and click Verify to begin your benefits enrollment.
4 Visit www.mybenefitshub.com/cityofterrell for full plan details.
Enrollment FAQ What if I miss the enrollment deadline?
When will I get my ID cards?
You may only enroll for or change your benefits during Open Enrollment or if you have a Qualifying Life Event.
If the medical carrier provides ID cards and there is a plan change, new cards usually arrive within four weeks of your effective date. If there are no plan changes, a new card may not be issued.
Is there an age limit for dependents to be covered under my benefits? You may cover dependents up to age 26 on most benefit plans, but there are exceptions. See the Eligibility section for more details. Where do I find benefit summaries and forms?
You may not need a card for dental and vision plans. Simply give your provider the insurance company’s name and phone number to verify benefits. You can also print a temporary card by visiting the insurance company’s website or mobile app.
Access https://mybenefitshub.com/cityofterrell and click on the benefit plan you need (i.e., Dental).
Benefit questions?
How do I find an in-network provider?
Access https://mybenefitshub.com/cityofterrell and click on the benefit plan for the provider you need to find.
Call 833-856-5161 Email cityofterrell@hps.higginbotham.net
Important Limitations and Exclusions Information The following limitations and exclusions may apply when obtaining coverage as a married couple or for your dependents. Can I cover my family — a spouse or a dependent — as dependents on my benefits if we work for the same employer? Some benefits may not allow you to do this if you work for the same employer. Review the applicable plan documents, contact Higginbotham Public Sector, or contact the insurance carrier for spouse and dependent eligibility.
Are there FSA/HSA limitations for married couples? Yes, generally. 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 for specific types of FSAs. Contact the FSA and/or HSA provider before you enroll or reach out to 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 may apply to enrollment in Flexible Spending Accounts and a Health Savings Account 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 an FSA and HSA.
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Eligibility Who is Eligible for Benefits You are eligible for coverage if you are a regular, full-time employee. You may only enroll for coverage when: • You are a new hire • It is Open Enrollment (OE)
• You have a Qualifying Life Event (QLE) See Important Exclusions and Limitations for details.
New Hire
Employee
Dependent(s)
Who is Eligible
Who is Eligible
Who is Eligible
• A regular, full-time employee working an average of 30 hours per week
• A regular, full-time employee working an average of 30 hours per week
• Your legal spouse
When to Enroll
When to Enroll
• Enroll by the deadline given by Human Resources
• Enroll during OE or when you have a QLE
When Coverage Starts
When Coverage Starts
• First of the Month following the date of hire
• You must be actively at work on the plan effective date for new benefits to be effective • QLE: Ask Human Resources
MAXIMUM DEPENDENT ELIGIBILITY AGE BY PLAN Plan
To Age
Medical, Telemedicine, Dental, Vision
To age 26
Life and AD&D
To age 26
Individual Life
To age 26
Accident
To age 26
Cancer
To age 26
Critical Illness
To age 26
Hospital Indemnity
To age 26
Legal assistance
To age 26
• Child(ren) under age 26, regardless of student, dependency, or marital status
• Child(ren) over age 26 who are fully dependent on you for support due to a mental or physical disability and who are indicated as such on your federal tax return
When to Enroll • You must enroll the dependent(s) during OE or when you have a QLE • When covering dependents, you must enroll for and be on the same plans • Dependents cannot be double-covered by married spouses within the same employer, as both employees and dependents.
When Coverage Starts • Based on OE or QLE effective dates
About Your Coverage Effective Date You must be Actively at Work on the date your coverage becomes effective. Your coverage must be in effect for your spouse’s and eligible children’s coverage to take effect. See plan documents for specific details.
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Qualifying Life Events You may only change coverage during the plan year if you have a Qualifying Life Event, such as:
Marriage
Birth
Divorce
Adoption
Legal separation Annulment
Undergoing FMLA, COBRA event, court judgment, or decree
Placement for adoption
Becoming eligible for Medicare, Medicaid, or TRICARE
Change in benefits eligibility Death
Receiving a Qualified Medical Child Support Order
You have 31 days from the event to notify your Human Resources department and complete your changes. You may need to provide documents to verify the change.
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Gain or loss of benefits coverage Change in employment status affecting benefits
Significant change in cost of spouse’s coverage
Medical Coverage ABA $2000 PPO Plan In-Network Calendar Year Deductible • Individual • Family • Coinsurance
$2,000 $6,000 80%
Out-of-Pocket Maximum Includes deductible • Individual • Family
$4,500 $7,000
**United Healthcare Network
You Pay
Preventive Care
No Charge; de ductibl e does no t a pply
Telemedicine
Inc luded
Primary Care Physician
$25 Cop ay
PCP Visit Copay- Dependent children under age 19
$0 Cop ay
Specialist
$40 Co pay
Diagnostic Test (X-ray, Blood Work)
0% co ins uran ce afte r ded ucti ble
Complex Imaging CT/PET sc an, MRI
20% Coi nsur anc e after deduc tibl e
Urgent Care
$40 Cop ay; ded ucti ble do es no t apply
Emergency Room
$300 copa y per vi si t; deduc tibl e does not appl y
Chiropractor Care In-network PT/ Speech Therapy In Network
$40 Co pay pe r v isi t (2 0 Vis it an nual l imit ) $25 Co pay P er V is it ( 30 ther apy vis its per y ear )
Prescription Drugs – Generic
Reta il $ 10 ( 30 -day Supply) Mail Order $20 (90-day Supply)
Prescription Drugs – Preferred Brand
Retail $20 (30-Day Supply) Mai l O rder $40 ( 90-day Supp ly)
Non-Preferred Brand
Retai l $30 ( 30-Day Suppl y) Mai l O rder $60 ( 90-day Supp ly)
Not Covered
Prescription Drugs – Specialty
City contribution
Monthly Total Cost
EE Monthly Premium
Employee Only
$959.30
$959.30
$0.00
Employee and Spouse
$2110.44
$1698.12
$412.32
Employee and Child(ren)
$1726.73
$1434.99
$291.74
Employee and Family
$2877.89
$2192.13
$685.76
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Employee Premium Per Check $0.00 $206.16 $145.87 $342.88
Additional Medical Assistance Your medical plan offers benefits for retail and mail order prescription drugs. Use in-network pharmacies to get your plan’s highest level of benefits. Both the medical and drug deductible and out-of-pocket expenses are the same. All benefits — including prescription drug benefits — apply to the plan’s overall deductible and outof-pocket maximum. Keep your prescription drug costs down:
• Fill your prescriptions at an in-network pharmacy
ZERO
• Ask your doctor if a generic drug is an option
•
• Use mail order for maintenance drugs
• Use the plan’s specialty pharmacy service for specialty drugs
• •
Your employer partners with ZERO to provide you and your dependents with options! Hundreds of medical services and procedures that always cost you $0. Chat Live: www.zero.health Call: (855) 816-0001
Diathrive Health
Need More Details? Visit www.verus-rx.com Call (80 0)838 - 000 7
• • • • •
Free and unlimited Insulin pen needles! Glucose testing supplies Diabetes education Clinical support from their health advisors Questions? Call Diathrive customer support today at (866) 878-7477
•
Support@diathrive.com
Clever RX Benefit • 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. • Download the app, use the zip code to find the pharmacy with the best prices. • Group: 1085 Member ID: 6572 • Questions? Call Customer Service at (800)873-1195.
9 Visit www.mybenefitshub.com/cityofterrell for full plan details.
Telemedicine Your benefit coverage offers access to quality telehealth services. Connect anytime day or night with a board-certified doctor via your mobile device or computer for free or for the same or less cost than a visit to your regular physician.
Registration is Easy Register today so you are ready to use this valuable service when and where you need it. Visit www.recurohealth.com
While telemedicine does not replace your primary care physician, it is a convenient and cost-effective option when you need care and:
Call 855 - 673 - 287 6 Download the app to your mobile device.
• Have a non-emergency issue and are considering an after-hours health care clinic, urgent care clinic, or emergency room for treatment
When to Use Telemedicine
• Are on a business trip, vacation, or away from home
Use telemedicine for minor conditions such as:
• Are unable to see your primary care physician
• Sore throat
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• Headache
• Mental health issues
• Stomachache
• Allergies
• Cold
• Fever
• Flu
• Urinary tract infections
Do not use telemedicine for serious or life-threatening emergencies.
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Flexible Spending Accounts
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).
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Visit fsastore.com for an array of FSA-eligible products.
FSA Administrator:
Health Care FSA The Health Care FSA covers qualified medical, dental, and vision expenses for you and your eligible dependents. Eligible expenses include: * *
Deductibles, copays, and coinsurance
*
Braces, glasses, and contacts
*
Hearing aids and batteries
Prescription drugs
IMPORTANT REMINDERS!
2026 Annual Maximum FSA contributions Healthcare FSA
Dependent Care FSA
Annual Max Contribution
$3,400
$7,500 Single parent filing head of household or married filling jointly; $3,750 (Married filling separately)
Run- Out Period
90 days
Time given to turn in claims for services during
Grace Period
75 Days
Time given to incur additional health and dep care claims after the plan year
Working Towards Savings 11
Visit www.mybenefitshub.com/cityofterrell for full plan details.
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.
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 unless you experience a Qualifying Life Event. Keep itemized receipts to verify debit card payments.
Dental Coverage Our dental plan helps you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work.
DPPO Plan Two levels of benefits are available with the DPPO plan: in-network and out-of-network. You may select any dental provider for care, but you will pay less and get the highest level of benefits with in-network providers. You could pay more if you use an out-of-network provider.
Dental Benefits Summary THE STANDARD-DENTAL PLAN In-Network Calendar Year Deductible • Individual • Family Calendar Year Benefit Maximum Per Individual
$50 $150
$2,000
You Pay Preventive Services optional list of ser vices Basic Services optional list of ser vices
80%
Major Services optional list of ser vices
50%
Orthodontia Childr en O nly
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100%
50% $1,000 lifetime maximum
Employee Monthly Rates Employee Only
$0.00
Find an In-Network Provider
Employee and Spouse
$19.06
Visit: www.stan d ar d.com
Employee and Child(ren)
$24.60
Employee and Family
$43.64
Call: 800 - 547 - 951 5
12 Visit www.mybenefitshub.com/cityofterrell 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. You may seek care from any vision provider, but the plan will pay the highest level of benefits when you see in-netw ork providers.
Vision Benefits Summary VISION PLAN
Exam Lenses • Single vision • Lined bifocals • Lined trifocals • Stand ard progressiv e • Polycar bonate lenses
Frames Contacts In lieu of frames and lenses • Standar d contact l ens fitting allowance
• Specialty contact lens fitting allowance
• Medic ally neces sar y
In-Network You Pay
Out-ofNetwork Reimburseme nt
$10 copay
Up to $45
Cov ered in ful l Cov ered in ful l $55 copay Chi ldr en covered in full
Up to $3 0 Up to $5 0 Up to $6 5 N/A N/A
Up to $180 allowance
Up to $70
Up t o $1 80 al lo wanc e
Up to $10 5
P art ic ipa nt c os ts up to $ 60
N/A
Par tici pant cos ts up to $60
N/A
Cov ered in F ull
N/A
Find an In-Network Provider
Benefit Frequency Exam
O nc e eve ry 12 months
Lenses
O nc e eve ry 12 months
Frames
O nc e eve ry 12 months
Contacts
O nc e eve ry 12 months
Visit www.Standard.com
Call (80 0)547 - 951 5
Employee Monthly Rates Employee Only
$6.20
Employee and Spouse
$12.95
Employee and Child(ren)
$14.24
Employee and Family
$20.71
Watch and learn more!
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Life and AD&D Insurance Group term life is the least expensive w ay to buy life insurance. Life and Accidental Death and Dismemberment (AD&D) insurance is important to your financial security, especially if others depend on you for support or vice versa. With Life insurance, you or your beneficiary(ies) can use the coverage to pay off debts such as credit cards, loans, and bills.
AD&D coverage provides specific benefits if an accident causes bodily harm or loss (e.g., the loss of a hand, foot, or eye). If death occurs from an accident, 100% of the AD&D benefit would be paid to you or your beneficiary(ies).
Basic Life and AD&D Basic Life and AD&D insurance are provided at no cost to you. You are automatically covered up to 1 times your Basic annual earnings to a maximum of $200,000. **Benefits are reduced 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 at anytime. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%).
A full plan summary is available on your benefits website.
Voluntary Life Insurance You may purchase additional Life and AD&D insurance for you and your eligible dependents. If you decline Voluntary Life and AD&D insurance when first eligible or if you elect coverage and wish to increase your benefit amount at a later date, Evidence of Insurability (EOI) – proof of good health – may be required before coverage is approved. You must elect Voluntary Life and AD&D coverage for yourself to elect coverage for your spouse or children. If you leave the company, you may be able to take the insurance with you. VOLUNTARY LIFE PER $10,000 Employee
• Increments of $10,000 not to exceed $500,000 • Guaranteed Issue: $200,000
Spouse
• Increments of $5,000 up to 100% of the 100% of the employee’s amount • Guaranteed Issue: $30,000
Child(ren)
• $1000-$10,000 in increments of $1000
Voluntary Life Rates per $1,000 Age
Employee and Spouse
<29
$0.12
30-34
$0.12
35-39
$0.14
40-44
$0.20
45-49
$0.32
50-54
$0.44
55-59
$0.76
60-64
$1.20
65+
$1.70
Voluntary Life Rates for Child(ren) per $10,000 $10,000
14 Visit www.mybenefitshub.com/cityofterrell for full plan details.
$1.70
Individual Life Insurance The Family Protection Plan Group Level Term Life Insurance from 5STAR Life Insurance helps protect your family.
Buy When You Are Young! Buying life insurance when you are younger allows you to take advantage of lower premium rates while you are generally healthy. This allows you to buy more insurance coverage for the future and still pay less than you would if you were older and trying to buy the same coverage amount. This is especially important if you have dependents who rely on your income, or you have debt that would need to be paid off.
You do not have to elect coverage for yourself. You may elect coverage for: • Your spouse • Your financially independent children and grandchildren (14 days to age 26). Coverage lasts until age 121 for all insured, so your family can be protected into their retirement years as long as your premiums are paid. This coverage is portable, which means you may continue with no loss of benefits or increase in cost if you terminate employment after the first premium is paid. You will simply be billed directly.
File a Claim Contact 5Star directly at 866-863-9753
Individual Life Advantages • • • • •
Customizable for you and your family Terminal Illness Acceleration of Benefits Portable Family Protection Quality of Life Benefit Acceleration (not available for children or at ages 66-70)
Watch and learn more!
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Disability Insurance Traditional disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. Disability coverage pays a percentage of your monthly salary for a covered disability or injury that prevents you from working for an extended period of time. Benefits begin after an elimination period and continue while you are disabled up to a maximum benefit period. Full plan summaries and rates are available on your benefits website.
Short Term Disability FAQ
Long Term Disability FAQ
Short Term Disability (STD) benefits can be beneficial if you find yourself unable to work for a short period due to a non-work-related injury or illness. STD insurance provides cash benefits based on a percentage of your pre-disability earnings, paid weekly during your time on a disability claim. You have the flexibility to use these funds as you wish.
How can Long Term Disability (LTD) benefits help me?
How is STD different than Workers’ Compensation?
When do disability benefits begin?
Workers’ Compensation applies to a job-related injury or illness. STD benefits may apply if you are unable to work due to pregnancy or non-work-related illness or injury.
The start of your disability insurance depends on the specifics of your policy and your disability. LTD usually begins after a pre-determined waiting period (such as 90 to 180 days from the onset of the disability).
Will I get all of my disability benefit?
Will I get all of my disability benefit?
Your disability benefit may be reduced by other income you receive or are eligible to receive due to your disability. Some of these income sources may include Social Security disability insurance, Workers’ Compensation, unemployment benefits, etc. Some limitations and exclusions may apply so read your plan documents for details.
You will get a percentage of your income – typically 60%. However, your disability benefit may be reduced by other income you receive or are eligible to receive due to your disability, such as unemployment benefits. Some limitations and exclusions may apply so read your plan documents or contact Human Resources for details.
Disability insurance pays cash benefits for covered injuries and illness if you are not able to work for an extended period of time due to a chronic injury or illness. It provides a percentage of pre-disability earnings when you are out on a disability claim. You can use the money however you see fit.
How long will the disability benefit last?
How do I apply for Short Term Disability?
Refer to your specific policy for term limits. Some policies pay benefits until age 65, while others have a fixed number of years.
Contact your Human Resources department to begin STD benefits.
What else is included with my disability coverage? Your policy includes worldwide emergency travel assistance if you or a family member needs help anywhere in the world. See plan documents for details.
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Short Term Disability Insurance Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. We provide Short Term Disability (STD) for you to purchase.
Voluntary Short-Term Disability
Short Term Disability FAQ
Voluntary STD coverage pays a percentage of your weekly salary if you are temporarily disabled and unable to work due to an illness, pregnancy or non-work related injury. STD benefits are not payable if the disability is due to a job- related injury or illness. If a medical condition is jobrelated, it is considered Workers’ Compensation, not STD.
How can STD benefits help me? STD insurance pays cash benefits for covered injuries and illness if you are not able to work for a short period of time due to a non-work-related injury or illness. It provides a percentage of pre-disability earnings on a weekly basis when you are out on a disability claim. You can use the money however you see fit.
VOLUNTARY SHORT TERM DISABILITY Benefits Begin
0/7
Percentage of Earnings You Receive
60%
Maximum Weekly Benefit
$1500
Maximum Benefit Period
90 da ys
Pre-existing Condition Exclusion
None
How is STD different than Workers’ Compensation? Workers’ Compensation applies to a job-related injury or illness. STD benefits may apply if you are unable to work due to pregnancy or non-work-related illness or injury.
Will I get all of my disability benefit?
Rates per $10 of Weekly Benefit
Your disability benefit may be reduced by other income you receive or are eligible to receive due to your disability. Some of these income sources may include Social Security disability insurance, Workers’ Compensation, unemployment benefits, etc. Some limitations and exclusions may apply so read your plan documents for details.
Age <40
$0.42
40-49
$0.40
50-54
$0.48
55-59
$0.54
60-69
$0.70
70+
$0.28
How do I apply for Short Term Disability? Contact your Human Resources department to begin STD benefits.
Watch and learn more!
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Long Term Disability Insurance Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. We provide Long Term Disability (LTD) at no cost to you.
Long Term Disability FAQ How can LTD benefits help me? LTD insurance pays cash benefits for covered injuries and illness if you are not able to work for an extended period of time due to a chronic injury or illness. It provides a percentage of pre-disability earnings on a monthly basis when you are out on a disability claim. You can use the money however you see fit.
Long Term Disability LTD insurance pays a percentage of your monthly salary for a covered disability or injury that prevents you from working for more than 90 days. Benefits begin at the end of an elimination period and continue while you are disabled up to maximum benefit period.
When do LTD benefits begin? The start of your LTD insurance depends on the specifics of your policy and your disability. LTD usually begins after a pre-determined waiting period (such as 90 to 180 days from the onset of the disability).
LONG TERM DISABILITY Benefits Begin
90 day
Percentage of Earnings You Receive
60%
Maximum Monthly Benefit
$10,000
Pre-existing Condition Employer Assistance Program
Will I get all of my disability benefit? You will get a percentage of your income – typically 60%. However, your disability benefit may be reduced by other income you receive or are eligible to receive due to your disability, such as unemployment benefits. Some limitations and exclusions may apply so read your plan documents or contact Human Resources for details.
3/12
3 face-to-face/ unlimited telephonic EAP
How long will the LTD benefits last? Refer to your specific LTD policy for term limits. Some policies pay benefits until age 65, while others have a fixed number of years.
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Hospital Indemnity Insurance Th e Hospi tal Ind em ni ty pl an he lp s y ou wi th th e hi gh cost of m edi ca l car e b y pa yi ng you a cash be ne fit wh e n you ha ve a n in patien t hospital stay. Unli ke tradi ti onal in su rance wh ich pa y s a be ne fit to th e hospital o r do cto r, this pl an pa y s you directl y. It is u p to you h o w you wa nt to use th e cash be nefi t. Th es e c os ts m ay in cl ud e meals, travel, ch ild ca re o r el de rcare , de du cti ble s, coi nsura nce, med icati on , o r time aw ay from wo rk. Se e th e pl an d ocu men t for full details.
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CHUBB - HOSPITAL INDEMNITY INSURANCE
Plan 1
Plan 2
Hospital Admission
$1,000
$2,000
Hospital Confinement
$ 10 0 per day up to 30 day s
$ 2 00 per day up to 30 day s
ICU Confinement
$ 2 00 per day up to 30 day s
$ 4 00 per day up to 30 day s
Employee Only
$14.78
$24.88
Employee and Spouse
$32.78
$50.98
Employee and Child(ren)
$27.26
$47.30
Employee and Family
$45.26
$73.78
Employee Contributions
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Accident Insurance Accident insurance provides affordable protection against a sudden, unforeseen accident. The Accident plan helps offset the direct and indirect expenses resulting from an accident such as copayments, deductible, ambulance, physical therapy, childcare, rent, and other costs not covered by traditional health plans. See the plan document for full details. AFLAC - ACCIDENT INSURANCE Low Plan Ambulance • G round • Air Emergency Room/ x-rays/ without X-rays
Admission • Hospital • ICU Confinement • Hospital – up to 365
Specific Sum Injuries (See plan summary for more detail)
$ 400 $1,200
$2 50 -$2 00 $1,250 $400 per day 30 d ays Max
$ 3 00 per day (Employee & Spouse)
$1 00 -$ 20 ,00 0
$100,000 Employee, Spouse Accidental Death Benefit
$10,000 Children
Gunshot Wound Rider
$5,000 Employee
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Employee Rate Employee Only
$23.72
Employee and Spouse
$37.55
Employee and Child(ren)
$46.32
Employee and Family
$60.15
20 Visit www.mybenefitshub.com/cityofterrell for full plan details.
Critical Illness Insurance Critical Illness in su rance he lp s pa y th e cost of n on -med ica l exp en se s related to a cove re d cri tica l illne ss o r can ce r. Th e pl an pro v id es a l um p su m be nefit p ayme n t to you u po n first a nd se con d di agn osi s of an y cove re d cri tica l illness o r can ce r. Th e be ne fit ca n he lp cove r ex p en se s su ch as lo st i ncome , ou t-of- to wn trea tme nts, sp ecial di ets, dai ly livi ng, a nd ho use hol d u pk e ep costs. This cover ag e is po rta bl e. Se e th e pl an d ocu men t for full details.
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CRITICAL ILLNESS INSURANCE Employee
Incr ements of $5 ,00 0 up to $ 25 ,00 0
Spouse
E l ig i bl e fo r 1 0 0% of the empl oyee’s amount
Children
5 0% of emplo yee amount
First Occurrence Benefit Full Coverage Cancer (Internal or invasive), Heart attack, Stroke, Major organ transplant, Kidney failure, Bone Marrow Transplant, Sudden cardiac arrest, Coronary Artery Bypass Surgery, Coma, Paralysis, Type 1 Diabetes, Loss of sight, hearing or speech,
1 00 % of benefit amount
Partial Coverage Non -invasive can cer , Insured placed on a transplant list for a major organ transplant
2 5% of benefit amount
Childhood Diseases Cereb ral palsy, cleft lip/palate, cy stic fibrosis, Dow n Sy ndrome , Cleft Palate *Chi ldhood autism Disorder
5 0% of benefit amount
Access the benefits website at www.mybenefitshub.com/cityofterrell for rates.
21 Visit www.mybenefitshub.com/cityofterrell for full plan details.
$3,000
Cancer Insurance Treatment for cancer is often lengthy and expensive. For More Information While your health insurance helps pay the medical Email expenses for cancer treatment, it does not cover the cost www.CWBspecialMarketservice@chubb.com of non-medical expenses, such as out-of-town treatments, special diets, daily living, and household upkeep. In addition to these non- medical expenses, you are Call (88 8) 49 9- 042 5 responsible for paying your health plan deductibles and/or coinsurance. Cancer insurance helps pay for these direct and indirect treatment costs so you can focus on your health. CHUBB - CANCER INSURANCE Low Plan Medical Imaging Radiation and Chemotherapy
First Cancer Benefit
$500/ Imaging Study (2 per c alendar y ear) $20,000 Max per person in a 12 -month period $100 paid upon receipt of the first c overed claim for Cancer; only one payment per certificate
Employee Contributions Employee Only
$31.86
Employee and Spouse
$55.70
Employee and Child(ren)
$31.86
Employee and Family
$55.70
22 Visit www.mybenefitshub.com/cityofterrell for full plan details.
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Legal and ID Theft Protection Legal Protection At many points in your life, you may need legal assistance. Getting legal help can be a stressful and expensive process – many firms may charge up to $350 an hour. For these reasons, your employer offers a legal assistance plan to help you get the guidance you need.
For More Information
This plan offers legal help at a fixed and affordable rate to assist with these types of issues: • Family (adoption, juvenile court, prenuptial agreements)
• Financial (bankruptcy, affidavits, tax audits) • Home (title disputes, deeds, foreclosures, mortgages)
Visit www.legalshield.com
• Auto (traffic violations, injuries, driver’s license restoration)
Call (88 8) 80 7- 040 7
• General (document review, consultations, wills, estates)
• And more
EMPLOYEE MONTHLY CONTRIBUTIONS Employee Employee and Family
Legal Shield
IDShield
Legal Shield + IDShield
N/A
$12.95
N/A
$18.95
$18.95
$28.90
Identity Theft Protection Identity theft is one of the fastest-growing crimes in the country. Millions of people have their identity stolen each year. Protect yourself and restore your identity with coverage that includes:
For More Information
• Identity consultation and advice
• Threat and credit alerts
• Licensed private investigators
• 24/7 emergency ID protection access
Visit www.legalshield.com.
• Mobile app
Call (888)807-0407.
• Identity and credit monitoring • Social media monitoring
Download the IDShield and/or LegalShield apps.
• Identity restoration
23 Visit www.mybenefitshub.com/cityofterrell for full plan details.
Emergency Medical Transport
Emergency Medical Transport MASA Medical Transport Solutions (MASA MTS) helps you prepare for the unexpected with affordable medical emergency air and ground transportation.
For More Information Visit www.masamts.com. Call 800-643-9023. Download the M AS A Global app.
Emergency Medical Transport Provider:
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. Participation in this plan is voluntary.
Watch and learn more!
Emergency Medical Transport Rates Visit www.mybenefitshub.com/cityofterrell for rates.
Visit www.mybenefitshub.com/cityofterrell for full plan details.
24
Advanced Lab Tests and Health Screenings
Advanced Lab Tests and Health Screenings New! Function Membership Get a deeper understanding of your body and spot potential issues early. Your benefit plan includes the opportunity for you and your family to enroll for a Function membership. Function empowers you to own your health through affordable access to advanced lab testing. A Function membership evaluates five times more biomarkers than the average physical, helping you gain a deeper understanding of what’s going on in your body, monitor for early indicators of disease, and track your health as it evolves. The membership includes: * * * * *
Access to 100+ lab tests at the start of your membership. Access to an additional 60 + midyear follow-up tests to track your progress. Detailed clinician notes highlighting areas of focus. A targeted action plan to help improve your health. Results stored on one secure platform for easy access anytime.
Carrier:
H OW THE PROCESS WORK S After signing up for Function, you will get an email and text message to schedule a convenient time and location for your lab visit. Tests take less than 30 minutes and are done at one of more than 2,000 partner lab locations nationwide. You will then get a detailed summary of your results and a targeted action plan to help you reach your health goals. All results are stored in one secure location for you to access anytime. You can retest in six months to see how you are progressing. Nonroutine tests (e.g., advanced MRI, early detection of multiple cancers, allergies, heavy metals, and more) may be added for an additional cost.
Visit www.mybenefitshub.com/xxxxxxxx for full plan details.
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Advanced Lab Tests and Health Screenings
Advanced Lab Tests and Health Screenings Test More. Know More. Advanced testing across: *
Heart
*
Heavy Metals
*
Sexual Health
*
Immunity
*
Liver
*
Electrolytes
*
Metabolics
*
Kidneys
*
Thyroid
*
Hormones
*
Pancreas
*
Autoimmunity
*
Nutrients
*
Prostate
*
Urine
*
Blood
The cost for an individual annual membership* is $335! FSA/HSA ELIGIBLE Funds from your Flexible Spending Account (FSA) or Health Savings Account (HSA) may be used to pay for your membership. Reimbursement is not guaranteed, so please contact your FSA/HSA provider in advance to confirm the terms of reimbursement. If you do not have an FSA or HSA, use a personal credit card. Our company will contribute $X toward the cost of your Function membership. The balance of the cost will be paid by you either by a personal credit card or a Flexible Spending Account (FSA) or Health Savings Account (HSA). *Function membership includes prepaid ac cess to 160+ lab tests each year at a Quest Diagnostics site. Due to state regulations, members testing in New York and New Jersey will be charged an additional fee directly by Quest for each lab visit. We cannot accommodate lab testing in Hawaii or Rhode Island at this time. You can schedule lab testing in a neighboring state.
How to Enroll Enroll anytime during the year. You will pay the membership fee(s) directly to Function. Visit https://www.functionhealth.com/aep/higginbotham.
26
Visit www.mybenefitshub.com/cityofterrell for full plan details.
Glossary of Terms 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. Annual Deductible – The amount you owe for health care services before your health insurance begins to pay its portion. For example, if your deductible is $1,000, your plan does not pay anything until you meet your $1,000 deductible for covered health care services. The deductible may not apply to all services, including preventive care. Annual Enrollment – The period during which existing employees are given the opportunity to enroll in or change their current elections. Beneficiary – Who will receive a benefit in the event of the insured’s death. A policy may have more than one beneficiary.
Calendar Year – January 1 through December 31. Coinsurance – Your share of the cost of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service, typically after you meet your deductible.
Copay – The fixed amount you pay for health care services received. Explanation of Benefits (EOB) – A statement sent by your insurance carrier that explains which procedures and services were provided, how much they cost, what portion of the claim was paid by the plan, what portion of the claim is your responsibility, and information on how you can appeal the insurer’s decision. These statements are also posted on the carrier’s website for your review.
Guaranteed Issue – 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. Health Savings Account (HSA) – A personal savings account that allows you to pay for qualified medical expenses with pretax dollars. In-Network – Doctors, hospitals, and other providers that contract with your insurance company to provide health care services at discounted rates.
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. Out-of-Pocket Maximum – The most an eligible or insured person can pay in coinsurance for covered expenses. Plan Year – September 1 through August 31.
Pre-Existing Conditions – Applies to any illness, injury or condition for which the participant has been under the care of a health care provider, taken prescription drugs or is under a health care provider’s orders to take drugs, or received medical care or services (including diagnostic and/or consultation services). Preventive Care – The care you receive to prevent illness or disease. It also includes counseling to prevent health problems. SSNRA – Social Security Normal Retirement Age.
Flexible Spending Account (FSA) – An option that allows participants to set aside pretax dollars to pay for certain qualified expenses during a specific time period (usually a 12-month period).
27 Visit www.mybenefitshub.com/cityofterrell for full plan details.
Notes
28 Visit www.mybenefitshub.com/cityofterrell for full plan details.
Notes
29 Visit www.mybenefitshub.com/cityofterrell for full plan details.
This brochure highli ghts the mai n features of the Ci ty of Terrel l employee benefits program. It does not include all plan rul es, details, lim itations, and exclusi ons. The terms of yo ur benefi t plans are governed by legal docum ents, includi ng insuran ce contracts. Sh ould there be an inconsi stency between this brochure and the legal plan documents, the plan docum ents are the final authority. Ci ty of Terrel l reserves the right to chang e or disconti nue its em ployee benefits plans at anytime.
Visit www.mybenefitshub.com/cityofterrell for full plan details.