If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, a federal law gives you more choices about your prescription drug coverage. Please see page 26 for more details.
WELCOME
On behalf of the TCA Board of Trustees and Head of School Dr. Jeff Williams, we are pleased to offer you a comprehensive benefits package intended to promote your well-being and financial health. This guide is your opportunity to learn more about all of the benefits that are now available to you and your eligible dependents beginning January 1, 2026.
To get the best value from your health care plan, please take the time to evaluate your coverage options and determine which plans best meet your health care and financial needs. By being a wise consumer, you can support your health and maximize your health care dollars.
Each year during Open Enrollment, you have the opportunity to make changes to your benefit plans. The health care enrollment decisions you make this year will remain in effect through December 31, 2026. You may make changes to your health care benefit elections only when you have a Qualifying Life Event. After such an event, you can make changes to your health care coverage within 30 days; otherwise, you cannot make changes to your benefits coverage until the next Open Enrollment period.
We hope each of you has a great year!
Philippians 4:19 “And my God will meet all your needs according to the riches of his glory in Christ Jesus.”
Julie H. Brown Director of Human Resources – General Counsel
ELIGIBILITY
You are eligible for benefits if you are a full-time employee working an average of 30 hours per week. You may also enroll eligible dependents for benefits coverage. The cost to you for dependent coverage will vary depending on the number of dependents you enroll and the particular plans you choose. When covering dependents, you must select the same plans for your dependents as you select for yourself.
Eligible dependents include:
A Your legal spouse
A Children under the age of 26, regardless of student, dependency, or marital status
A Children over the age of 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
Qualifying Life Events
Once you elect your benefit options, they remain in effect for the entire plan year until the following Open Enrollment. You may only change coverage during the plan year if you have a Qualifying Life Event, and you must do so within 30 days of the event.
Qualifying Life Events Include
A Marriage or divorce
A Birth, adoption, or placement for adoption of an eligible child
A Death of your spouse or child
A Change in your spouse’s employment status that affects benefits eligibility
A Change in your child’s eligibility for benefits
A Significant change in benefit plan coverage for you, your spouse, or child
A FMLA leave, COBRA event, court judgment or decree
A Becoming eligible for Medicare, Medicaid, or TRICARE
A Receiving a Qualified Medical Child Support Order
If you have a Qualifying Life Event and want to request a midyear change, you must notify Human Resources and complete your election changes within 30 days following the event. Be prepared to provide documentation supporting the Qualifying Life Event.
ONLINE ENROLLMENT INSTRUCTIONS
1. Go to www.paycomdfw.com and log in. Select 2026 Benefits Enrollment from the bell icon in the top right of your screen.
2. Please read the reminders and choose Continue Enrollment
3. The first screen provides your contact information. Please make sure it is correct and make any necessary edits. Select Next to continue.
4. On the next screen, you will be asked if you want to enroll in the same plans as last year. Choose yes or no. You can also review/add/edit any dependents you want to enroll in a plan. To add dependents, select Add and enter the applicable information. You can also edit the dependent information by selecting the pencil icon or delete the dependent altogether by selecting the trash can icon.
5. Once finished, select Save and Next to continue.
6. Next, you will be guided through the enrollment process for each of your available benefit plans. Each benefit screen will have two checkboxes: one to enroll and one to decline. You can review the details of each plan by clicking on Plan Documents.
7. Check the box to enroll or decline coverage for each plan. Once finished, select Enroll or Decline at the bottom of the screen. Continue through the enrollment process by choosing whether you would like to enroll or decline coverage in each of the available plans.
8. As you progress through the enrollment process, you can keep track of which benefits you have selected or declined from the Progress box on the right side of the screen. Green checkmarks mean you have enrolled, and the cost per pay period will be in the column to the right of the plan name. A red “X” means you selected to decline the plan. You can make edits to a benefit by clicking the benefit name.
9. Once you have made a selection for each plan, you will be brought to the Summary screen to View Detailed Enrollment. This will give you a snapshot of the plans in which you have elected to enroll.
10. Once you have reviewed your 2026 benefit selections in the Progress box on the right, select Finalize
11. You will then be brought to the Sign and Submit screen. Once you are ready to submit your enrollment, click Sign and Submit.
12. If you want a printed confirmation of your enrollment, click Benefits, then Current Benefits and then View Confirmation
Congratulations! Your enrollment is now complete. The following screen will provide a recap of your elections, including who is covered under each plan and your named beneficiaries.
If you have any questions about your benefits or need help enrolling, please call Jen Bailey at ext. 2924
MEDICAL COVERAGE
The medical plan options through Blue Cross Blue Shield of Texas (BCBSTX) protect you and your family from major financial hardship in the event of illness or injury. You have a choice of two plans:
A Blue Essentials HMO Plan – This plan is an HMO.
A BlueChoice HDHP/HSA Plan – This plan is a High Deductible Health Plan.
Health Maintenance Organization (HMO)
With an HMO plan, you must seek care from in-network providers in the BCBSTX HMO network. The selection of a primary care physician is required, and you need a referral to see a specialist. Always confirm that your doctor and all specialists are in-network before seeking care.
High Deductible Health Plan (HDHP)
An HDHP allows you to see any provider when you need care, but you will pay less for care when you go to in-network providers. In exchange for a lower per-paycheck cost for medical benefits, you must satisfy a higher plan deductible that applies to almost all health care expenses, including prescription drugs. If you enroll in the HDHP, you may be eligible to open a Health Savings Account (see page 9).
Find
a Network Provider
Visit www.bcbstx.com or call 800-521-2227
Blue Access for Members
Blue Access for Members (BAM) is the secure BCBSTX member website where you can:
A Check claim status or history
A Confirm dependent eligibility
A Print Explanation of Benefits (EOB) forms
A Locate in-network providers
A Print or request an ID card
To get started, log in at www.bcbstx.com and use the information on your BCBSTX ID card to complete the registration process.
Mobile App
The BCBSTX mobile app can help you stay organized and in control of your health anytime, anywhere. Log in from your mobile device to access your BAM account and:
A Track account balances and deductibles
A Access ID card information
A Find doctors, dentists, and pharmacies
Text BCBSTX to 33633 or search your mobile device’s app store to download.
Member Rewards
Register for Member Rewards and receive rewards for making good health care decisions, such as seeking care from preferred providers. Log in to BAM and click on the Doctors & Hospitals tab under Provider Finder.
MEDICAL COVERAGE
Medical Benefits Summary
1
BCBSTX RESOURCES
The following programs are available to you with your BCBSTX medical coverage at no additional cost.
Hinge Health
If you suffer from constant back and joint pain, Hinge Health can help without drugs or surgery. Get personal therapy, unlimited support, a computer tablet, and wearable sensors — all for free! Average results show 60% pain reduction and two out of three surgeries avoided. Remote care may be done in the comfort of your own home. Treatment begins with a 12-week intensive phase, followed by an ongoing program that builds on what you have learned. To be eligible for this program, you must:
A Be covered under a BCBSTX medical plan (includes spouse and children)
A Be age 18+
A Have a chronic musculoskeletal claim in the last three months
A Be contacted by Hinge Health to sign up based on your medical claim; self-referrals will not be accepted
Learn more and apply at www.hingehealth.com/bcbstx
Omada
If you are at risk for diabetes and/or high blood pressure, Omada helps you change the habits that put you most at risk for developing a chronic condition. A virtual care team will work with you to create a program to reduce your risk and build healthy habits. You will receive weekly support and connect with a small group of peers, all from the comfort of your own home. These features are all covered as part of your BCBSTX benefits:
A 24/7 access to digital support and help
A Weekly classes on healthy habits (food, activity, sleep, and stress)
A Smart devices to track and manage your condition
Visit www.omadahealth.com/bcbstx to apply for Omada online. If you qualify for the program, Omada will send you an email with more information. However, if you have any health claims that show you may be at risk for diabetes or high blood pressure, Omada will reach out to you directly. For more information, visit www.omadahealth.com/bcbstx
Wondr
Wondr is a 100% digital weight loss program that teaches you how to eat your favorite foods and still lose weight, have energy, stress less, and sleep better. Wondr is not a diet plan. There are no points, plans, or calories to count. It teaches you skills to know how and when you eat and improve your long-term health. To be eligible for the Wondr program, you must:
A Be covered under a BCBSTX medical plan (includes spouse and children)
A Be age 18 or older
A Have a body mass index (BMI) over 25
If you or your covered dependents meet this eligibility, you may learn more and enroll at https://wondrhealth.com/bcbstx
When your application is accepted, you will get an email and program details. Once enrolled, download the Wondr app to your mobile device.
Livongo
Available at no cost to you, Livongo offers digital solution programs to help you manage chronic diabetes and hypertension. Participation is FREE and available to you and your family members to help manage type 1 and type 2 diabetes by using:
A Livongo’s advanced blood glucose meter – Manage your blood glucose readings safely and securely. Receive immediate feedback once your blood sugar is processed, especially if your blood sugar is out of range. An additional feature enables you to alert loved ones in real time (using a cellular connection) when your blood glucose is too high or too low.
A Unlimited strips and lancets at NO COST – When your supply runs out, Livongo will ship more supplies to your home or office.
A Real-time tips and support from certified diabetes educators (CDEs) – The Livongo meter can help you connect with CDEs should you have an out-of-range glucose reading or if you just need some quick tips on diabetes management. CDEs are available 24/7.
Participation in Livongo is Easy!
A App – Text GO TXHEALTH to 85240
A Online – Visit https://get.livongo.com/txhealth/register
A Phone – Call 800-945-4355
BCBSTX RESOURCES
Well onTarget
Well onTarget provides the support you need to make healthy choices. Access personalized tools and resources on the secure Well onTarget website, including:
A Self-management programs
A Health resources and information
A Tools and trackers
A Health assessments
Visit www.wellontarget.com to access the Well onTarget member portal. If you have already registered on BAM, you will use the same login information. If not, you can register on this site. Customer Service is available at 877-806-9380
Nurseline
Call 800-581-0368 for immediate access to registered nurses who can answer general health questions, make appointments with your doctor and help determine where to go for immediate or emergency health care services. You can also access an audio library of more than 1,000 health-related topics in both English and Spanish.
Blue365
Blue365 can help you save money on health and wellness products and services not covered by insurance. There are no claims to file and you do not need a referral or preauthorization. Sign up for Blue365 at www.blue365deals.com/bcbstx to receive weekly featured deals by email. Discounts include:
A Davis Vision | LasikPlus – Eyewear and LASIK
A TruHearing | Beltone – Hearing aids and tests
A Philips Sonicare – Oral care products
A Dental Solutions – Dental discount card
A Jenny Craig | Sunbasket – Weight loss and nutrition
A Reebok | SKECHERS – Work footwear
Maternity and Family Benefits
If you are pregnant or are planning to get pregnant, your BCBSTX health plan offers tools from Ovia Health and Well onTarget to help you prepare for parenthood. Call 888-421-7781 for details.
Ovia Health
Ovia Health’s suite of maternity and family apps support you by tracking your cycle, pregnancy, and your baby’s growth.
A Ovia Fertility – Track your cycle and predict when you are more likely to get pregnant.
A Ovia Pregnancy – Monitor your pregnancy and your baby’s growth.
A Ovia Parenting – Keep up with your baby’s growth and milestones from birth to three years old.
Well onTarget
Well onTarget offers online, self-guided courses about pregnancy. Topics include healthy foods, body changes, and labor.
HEALTH SAVINGS ACCOUNT
If you enroll in the HDHP medical plan, you may be eligible to open a Health Savings Account (HSA). An HSA is a personal savings account which you can use to pay qualified out-ofpocket medical expenses with pretax dollars. You own and control the money in your HSA. The money in your account (including interest and investment earnings) grows tax-free, and as long as the funds are used to pay for qualified medical expenses, they are spent tax-free.
Your HSA has no “use-it-or-lose-it” rule — you do not lose your money if you do not spend it in the calendar year — and there are no vesting requirements or forfeiture provisions. The account will automatically roll over year-after-year. Since it is an individual account, the balance is yours to keep if you change health plans or jobs.
HSA Eligibility
You are eligible to open and contribute to an HSA if you are:
A Enrolled in an HSA-eligible HDHP
A Not covered by another non-HDHP, such as your spouse’s health plan or a Health Care Flexible Spending Account
A Not eligible to be claimed as a dependent on someone else’s tax return
A Not enrolled in Medicare or TRICARE
A Not receiving Veterans Administration benefits
You can use the money in your HSA to pay for qualified medical expenses now or in the future. Your HSA can be used for your expenses and those of your spouse and tax-eligible dependents, even if they are not covered by the HDHP.
Maximum Contributions
Your contributions to your HSA, when combined with TCA’s contributions, may not exceed the annual maximum amount established by the Internal Revenue Service. The annual contribution maximum is based on the coverage option you elect.
Contributions from TCA
TCA will contribute $1,000 for individual (employee only) coverage or $2,000 for family (employee plus dependent) coverage during the 2026 plan year to each eligible HSA participant. You must be actively employed to receive the HSA contributions.
Employees age 55 or older are allowed to make an additional annual catch-up contribution of up to $1,000.
Opening an HSA
Once you enroll in the HDHP medical plan, you may be eligible to enroll in the HSA administered by North Dallas Bank & Trust You will receive a debit card from North Dallas Bank & Trust for managing your HSA account reimbursements. Funds available for reimbursement are limited to the balance in your HSA. Visit www.ndbt.com to view your account information.
You, NOT your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.
Please note: You may open an HSA at any financial institution of your choice. However, HSA contributions from TCA will only be made to North Dallas Bank & Trust.
HEALTH REIMBURSEMENT ARRANGEMENT
A Health Reimbursement Arrangement (HRA) is an employerfunded health benefit plan that reimburses employees for out-of-pocket medical expenses. Our HRA — administered by Higginbotham — allows us to make contributions to your account and provide reimbursement for eligible medical expenses that apply to your in-network deductible and out-ofpocket maximum.
Eligible Medical Expenses
A You can use your HRA to pay for medical care expenses covered by the health plan (e.g., doctor’s visits, diagnostic tests, prescription drugs, and more)
A Any combination of deductible, coinsurance, or copayment expenses
Using Your HRA
TCA offers an HRA to help offset your deductible and out-ofpocket costs. This tax-free benefit is completely funded by TCA. You and your dependents must be covered by one of TCA’s BCBSTX medical plans to be eligible for the HRA.
A Employee Only – Based on a $5,000 plan year innetwork deductible and $6,000 in-network out-of-pocket maximum, the following reimbursement schedule applies:
You are responsible for paying the first $3,000 (HSA employer contribution is $1,000).
TCA will reimburse you OR your provider up to the final $3,000.
A
Employee
+ Dependent
– Based on a $10,000 plan year in-network deductible and $12,000 in-network out-of-pocket maximum, the following reimbursement schedule applies:
You are responsible for paying the first $5,500 (HSA employer contribution is $2,000).
TCA will reimburse you OR your provider up to the final $6,500; if only one family member claims the HRA, the HRA reimbursement can be up to $3,250.
How the HRA Works for You
TELEMEDICINE
Your medical coverage offers telemedicine services through MDLIVE. Connect anytime day or night with a board-certified doctor via your mobile device or computer for free or for the same or lower cost than a visit to your regular physician.
While telemedicine does not replace your primary care physician, it is a convenient and cost-effective option when you need care and:
A Have a non-emergency issue and are considering an after-hours health care clinic, urgent care clinic, or emergency room for treatment
A Are on a business trip, vacation, or away from home
A Are unable to see your primary care physician
Registration is Easy
Register with MDLIVE so you are ready to use this valuable service when and where you need it.
A Online – www.mdlive.com/bcbstx
A Phone – 888-680-8646
A Text - BCBSTX to 635-483
A Mobile – Download the mobile app to your smartphone or mobile device
When to Use MDLIVE
Use telemedicine services for minor conditions such as:
Sore throat
Headache
Stomachache
Cold and flu Allergies
Fever
Urinary tract infections
Do not use telemedicine for serious or life-threatening emergencies.
URGENT CARE CENTERS
When you need convenient and affordable treatment for common illnesses but your doctor’s office is not open or you need to be seen quickly, urgent care centers and retail clinics provide simple, non-emergency services to walk-in patients.
The nurse practitioners and physician assistants who staff the clinics are certified, licensed health care professionals and are qualified to:
A Diagnose and treat common injuries and minor illnesses
A Prescribe or order medicine
A Give most vaccinations
Did you know?
The cost of treating MOST common medical conditions can be up to five times greater in an emergency room than in a physician’s office or an urgent care center. If you are experiencing a situation requiring prompt medical attention that is not life-threatening, you may receive faster care at a retail clinic, urgent care center, or by scheduling a same-day appointment with your primary care physician, if available.
Your out-of-pocket costs are much lower in a non-emergency setting:
Illnesses Treated at Urgent Care Centers
HEALTH CARE OPTIONS
Becoming familiar with your options for medical care can save you time and money.
Non-Emergency Care
Access to care via phone, online video, or mobile app whether you are home, work, or traveling; medications can be prescribed
24 hours a day, 7 days a week
TELEMEDICINE
DOCTOR’S OFFICE
Generally, the best place for routine preventive care; established relationship; able to treat based on medical history
Office hours vary
Usually lower out-of-pocket cost than urgent care; when you can’t see your doctor; located in stores and pharmacies
Hours vary based on store hours
When you need immediate attention; walk-in basis is usually accepted
Generally includes evening, weekend and holiday hours
Allergies
Cough/cold/flu
Rash
Stomachache
Infections
Sore and strep throat Vaccinations Minor injuries, sprains, and strains
Life-threatening or critical conditions; trauma treatment; multiple bills for doctor and facility 24 hours a day, 7 days a week
Common infections Minor injuries
Pregnancy tests
Vaccinations
Services do not include trauma care; can look similar to an urgent care center, but medical bills may be 10 times higher 24 hours a day, 7 days a week
Sprains and strains
Minor broken bones
Small cuts that may require stitches
Minor burns and infections
15-30 minutes
Chest pain
Difficulty breathing
Severe bleeding
Blurred or sudden loss
Major broken bones
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.
HEALTH CARE OPTIONS
Health Care Settings
Convenient Care Clinics (e.g., CVS Minute Clinic)
A Typically located in malls or retail stores
A Treat the most minor of cases
A Services available to patients 18 months of age or older
Urgent Care Centers (e.g., CareNow, Concentra Urgent Care, MedSpring Urgent Care)
A Open seven days a week and typically 10-12 hours per day
A Do not offer 24/7/365 service from an emergency medicine physician
A Staffed by a combination of physicians, physician assistants and nurse practitioners
A Must accept walk-in patients during business hours
A Must have diagnostic equipment on-site, including an X-ray machine and blood-drawing equipment
A Multiple exam rooms
A Able to perform minor medical procedures and treat a broad spectrum of diseases
A Must have a licensed physician operating as the medical director
A Do not charge a facility fee
Traditional Emergency Room (attached to a hospital)
A Intended to provide fast, life- or limb-saving care
A Open 24/7/365
A Equipped to handle emergencies of all kinds
A Receives patients by ambulance
Freestanding Emergency Rooms (e.g., First Choice ER, Highland Park ER, Physicians ER)
A Not attached to a hospital
A Cannot handle true emergencies. For example, patients who arrive at a freestanding ER on their own and require immediate surgery or cardiac procedures must be rushed by ambulance to the nearest hospital, potentially losing valuable time and delaying treatment, which can sometimes have serious consequences.
A Do not receive patients by ambulance
A Bill patients just like hospital ERs
PAY LESS FOR PRESCRIPTIONS
Pharmacies and discount drug programs usually charge different prices for the same prescription drug and can vary by more than $100.
GoodRx is a free service that offers comparison pricing as well as coupons and discounts. Visit www.goodrx.com for more information.
NOTE: Your cost for using GoodRx will not apply toward your deductible or out-of-pocket maximum.
VOLUNTARY DENTAL COVERAGE
Our dental plan through United Concordia helps you maintain good dental health through affordable options for preventive care, including regular checkups and other dental work. Premium contributions for your dental plan will be deducted from your paycheck on a pretax basis.
DPPO Plan
Two levels of benefits are available with the DPPO plan: in-network and outof-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.
Dental Benefits Summary
Class II – Basic Restorative 4 Fillings, extractions, repairs of crowns, inlays, onlays, bridges, oral surgery
Class III – Major Restorative 4 Bridges, dentures, endodontics, periodontics, inlays, onlays, crowns
Orthodontia Children to age 19
1 Members (subscribers or covered dependents) with certain medical conditions must sign up for the Smile for Health program through MyDentalBenefits on www.UnitedConcordia.com
2 Reimbursement is based on our schedule of maximum allowable charges (MACs). In-network dentists agree to accept our allowances as payment in full for covered services. Out-of-network dentists may bill the member for any difference between our allowance and their fee (also known as balance billing). United Concordia Dental’s standard exclusions and limitations apply.
3 United Concordia creates out-of-network charges utilizing FAIR Health data supplemented with our charge data as appropriate. We then calculate the out-of-network charge at the 90th percentile of such data. Outof-network dentists may bill the member for any difference between our allowance and their fee.
4 Dependent children covered to age 26.
5 Preventive Incentive - Class I services do not count toward your annual program maximum.
Create a MyDentalBenefits account MyDentalBenefits is the online hub where you can check coverage details, see claims and payments, print extra ID cards, and more. Visit www.UnitedConcordia.com/GetMDB and have your member ID or Social Security number handy.
Maximize Your Dental Plan
A Download the United Concordia Dental app to access your MyDentalBenefits information from your smartphone or tablet. You can log in with the same user ID and password.
A Make brushing fun for kids with the Chomper Chums app. Children love brushing alongside their favorite Chomper Chum, and a built-in timer ensures they brush, floss, and rinse for a full two minutes.
A
Sign up for monthly email tips that will help you understand your dental plan and keep your mouth healthy. Sign up for emails when you create your MyDentalBenefits account.
VOLUNTARY 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 an in-network provider.
is provided through BCBSTX utilizing the EyeMed network of providers.
DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT
You may voluntarily elect to set aside pretax dollars from each pay period to pay for dependent care expenses in order for you to be able to work. Through the Dependent Care Flexible Spending Account (DCFSA), you can pay for daycare or babysitter expenses for your children under age 13 and for qualifying older dependents, such as dependent parents. To be eligible, you must be a single parent or you and your spouse must be employed outside the home, disabled, or a full-time student. The dependent care provider cannot be your child under age 19 or anyone who is your dependent for income tax purposes.
A Overnight camps are not eligible for reimbursement (only day camps can be considered).
A If your child turns 13 midyear, you may only request reimbursement for the part of the year when the child is under age 13.
A You may request reimbursement for care of a spouse or dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self-care.
REMINDER
The DCFSA includes a grace period of 2½ months after the plan year ends to incur claims. This means you will have until March 15, 2027 to incur claims. You will then have an additional two months (until May 15, 2027) to submit claims.
Plan Year Contribution Limits
Reimbursement is limited to the total amount deposited in your account at that time.
$7,500 (single parent filing head of household; or married filing jointly)
$3,750 (married filing separately)
LIFE AND AD&D INSURANCE
Life and Accidental Death and Dismemberment (AD&D) insurance through BCBSTX are 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). Life and AD&D benefits reduce by 35% of the original amount at age 65 and further reduce by 50% of the original amount at age 70.
Basic Life and AD&D
TCA provides Basic Life and AD&D insurance through BCBSTX at no cost to you. You are automatically covered at two times your annual earnings to a maximum of $250,000.
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 and AD&D
If you need more coverage than Basic Life and AD&D, you may buy Voluntary Life and AD&D for yourself and your dependent(s). If you do not elect Voluntary Life and AD&D insurance when first eligible, or if you want to increase your benefit amount at a later date, you may need to show proof of good health. You must elect Voluntary Life and AD&D coverage for yourself before covering your spouse and/or child(ren).
Employee
Spouse
Child(ren)
Increments of $10,000 up to $500,000 Guaranteed Issue $150,000
Increments of $5,000 up to $250,000 not to exceed 50% of employee amount
Guaranteed Issue $25,000
Birth to 14 days - $0
15 days to 6 months- $100
6 months to age 26- $10,000
See Paycom for rates.
Evidence of Insurability
If you or your dependent needs to provide Evidence of Insurability (EOI), you must visit https://eoi. groupadmins.hcsc.net/key/VF027903:TX .
Note: The link will not work on handheld devices such as cell phones or tablets. Google Chrome is the recommended browser. The link is not compatible with Microsoft Internet Explorer.
DISABILITY INSURANCE
Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. We offer Short Term Disability (STD) for you to purchase and Long Term Disability (LTD) insurance at no cost to you.
Short Term Disability Insurance
STD coverage Colonial Life 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 jobrelated injury or illness. If a medical condition is job-related, it is considered under workers’ compensation, not STD. Benefits may not be paid for any condition treated within the 12 months prior to your effective date until you have been covered under this plan for 12 months.
See Paycom for benefit options and rates.
Long Term Disability Insurance
LTD can be one of the most important financial benefits. It provides income protection in the event of a long-term sickness or injury. LTD from BCBSTX covers 60% of your base annual earnings to a $6,000 monthly maximum. The benefit begins after 90 days of disability and payments will last for as long as you are disabled or until you reach your Social Security Normal Retirement Age, whichever is sooner. A qualifying disability can occur on or off the job.
Long Term Disability
1 Benefits may not be paid for any condition treated within the three months prior to your effective date until you have been covered under this plan for 12 months.
Trinity Christian Academy pays 100% of your LTD!
SUPPLEMENTAL BENEFITS
You and your eligible family members have the opportunity to enroll in additional coverage that complements our traditional health care programs. Health insurance covers medical bills, but if you have an emergency, you may face unexpected out-ofpocket costs such as deductibles, coinsurance, travel expenses, and non-medical related expenses. These voluntary plans are offered through Colonial Life and are portable.
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, deductibles, ambulance, physical therapy, and other costs not covered by traditional health plans.
There are four plans from which to choose – Economy, Basic, Preferred, and Premier – each with its own level of benefits to fit your budget and needs.
*Percentage of benefit paid for dismemberment is dependent on type of loss.
Paycom for
SUPPLEMENTAL BENEFITS
Hospital Indemnity Insurance
Hospital Indemnity insurance helps you with the high cost of medical care by paying you a set amount when you have an inpatient hospital stay. Unlike traditional insurance, which pays a benefit to the hospital or doctor, this plan pays you directly based on the care or treatment that you receive. These costs may include meals and transportation, childcare, or time away from work due to a medical issue that requires hospitalization.
HOSPITAL INDEMNITY INSURANCE
Critical Illness Insurance
Critical Illness insurance helps pay the cost of non-medical expenses related to a covered critical illness or cancer. The plan provides a lump sum benefit payment to you upon 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.
Coverage amounts will depend on the specific level of coverage you elect.
CRITICAL ILLNESS
Full Coverage
Benign brain tumor; coma/brain injury; end-stage renal failure; heart attack; major organ failure; invasive cancer; loss of sight, speech, or hearing; major burns; paralysis; stroke
Child Conditions
Cleft lip or palate; cystic fibrosis; Down syndrome; spina bifida; and more
Partial
Coronary artery bypass; non-invasive cancer, and more
RETIREMENT PLANS
A consistent savings plan throughout your career is the foundation for security during your retirement years. TCA offers two retirement plan options.
Employer-funded Plan – 100% TCA Funded
TCA will make contributions to the employer-funded plan in an amount to be determined each year by TCA. This contribution is discretionary and is a percentage of compensation to all participants for the school year. Eligible employees are added to the plan on August 1 after completing the minimum service requirements.
For questions concerning eligibility or participation in the plan, please contact the TCA Business Office.
403(b) Plan – 100% Employee-funded
A 403(b) plan can be a powerful tool in promoting financial security in retirement. TCA’s 403(b) plan through The Standard is designed to help you reach your investment goals.
To participate, you must be scheduled to work at least 20 hours per week with a total of 1,000 hours per fiscal year. The plan allows for immediate entry for eligible employees.
Enrollment
Log in to your employee self-service portal in Paycom and select the 403(b) plan to enroll. The amount you choose to contribute from your paycheck can be updated here throughout the year.
Please contact the TCA Business Office for distribution or other information.
Investment Options
You may direct your contributions to any of the investments offered within the TCA 403(b) plan. Changes to your investments can be made directly through The Standard by calling 800-858-5420
IDENTITY THEFT PROTECTION
TCA knows how important identity theft protection is in today’s world. That is why we are offering LifeLock Identity Theft Protection. You will be able to enroll in early November, and the coverage will begin on January 1, 2026. Once enrolled, you will receive an email from LifeLock with instructions on how to take full advantage of your membership.
Plan Options
The following two plans are available:
A LifeLock Benefit Elite Plus – This plan helps protect your identity and your nest egg. Elite Plus protection helps detect potential fraud and notifies you through email, text, phone, or mobile apps.
A LifeLock Benefit Elite Premium – In addition to the above, the Elite Premium plan helps protect your 403(b) and other investment accounts from fraudulent withdrawals and balance transfers. It also includes enhanced services including bank account applications and takeover alerts, one bureau annual credit score and report, monthly credit score tracking and three-bureau annual credit monitoring.
LifeLock protection includes reimbursement for stolen funds, coverage for personal expenses up to $1 million, and coverage for lawyers and experts (if needed) to help resolve your case.
ADDITIONAL BENEFITS
Included with your BCBSTX coverage are the following programs available to you and your eligible dependents at no cost.
Beneficiary Resource Services
Beneficiary Resource Services, offered through Morneau Shepell, combines family wellness and security at the most difficult times.
Services for you and your family include:
A Online Will Preparation – Creating a will is an important investment in your future. In just minutes, you can create a personalized will with this program that keeps your information safe and secure.
Visit www.beneficiaryresource.com and enter the username: beneficiary. Answer a few simple questions and then download or print any documents instantly.
A Online Funeral Planning – A funeral planning guide is available to download. There are also calculators to estimate and compare funeral expenses, along with information on funeral requirements and various religious customs.
Services for your beneficiaries and their families:
A Unlimited phone contact is available for up to one year with a grief counselor, legal advisor, or financial planner.
A There are up to five face-to-face working sessions available. These can be split between the different counselors depending on need.
A Morneau Shepell maintains a comprehensive directory of qualified and accessible counselors. Counselors will initiate follow-up calls when necessary for up to one full year from the date of initial contact.
For more information, call 800-769-9187
DearbornCares
DearbornCares provides an advance payment of the Life insurance benefit up to $50,000 to help beneficiaries cover immediate expenses, such as funeral costs and medical bills. For more information visit www.dearbornnational.com.
College Planning Program
SimpliCollege provides straightforward tools and guidance to help you manage the college planning process more effectively. Visit https://simplicollege.com to learn more.
A Clear steps for planning and preparing for college
A Strategies to help reduce overall college expenses
A Guidance on grants, scholarships, and financial aid
A Support with financial aid appeals
A Resources to help you make informed, confident decisions.
Disability Resource Services
The following services are available to you if you are enrolled in our LTD plan:
A Three face-to-face sessions to address behavioral issues.
A 24/7 unlimited telephone counseling with highly qualified counselors to identify concerns, assess needs, and referral to a specialist to help resolve the issue.
A Web-based services through GuidanceResources, a secure website where you can access self-assessments, content on personal health, and tools to help with personal, relationship, legal, health, and financial concerns. Go to www.guidanceresources.com. Use Company ID DISRES when prompted.
For further information, call 866-899-1363
ADDITIONAL BENEFITS
Office Supply Discount
As a BCBSTX ancillary insurance customer, you’re eligible for a 10% discount on most of your office supplies at any Office Depot and OfficeMax store. You will need to present the store purchasing card, which you’ll find below.
You can also use the discount online; simply create a unique user ID and password. There’s no need to use the store purchasing card online because the 10% discount has already been applied.
Visit https://community.officedepot.com/ GPOHome?id=84143306
Travel Resource Services
Assist America offers around-the-clock emergency and information services that can help you access emergency assistance when you are traveling 100 or more miles away from home.
Medical Emergency Assistance
A Medical referral
A Medical monitoring
A Emergency medical evacuation
A Foreign hospital admission assistance
A Medical repatriation
A Prescription assistance
Travel Emergency Assistance
A Compassionate visit
A Care of minor children
A Evacuation transport for family members
A Return of mortal remains
A Return of vehicle
A Legal and interpreter referrals
A Pre-trip information
Contact Assist America
A Call: 800-872-1414 (Toll Free within the U.S.); +1-609-986-1234 (outside the U.S.) A Email: medservices@assistamerica.com Your Assist America Reference Number is: 01-AA-TRS-12201
EMPLOYEE BENEFIT COST WORKSHEET
IMPORTANT CONTACTS
IMPORTANT NOTICES
Women’s Health and Cancer Rights Act of 1998
In October 1998, Congress enacted the Women’s Health and Cancer Rights Act of 1998. This notice explains some important provisions of the Act. Please review this information carefully.
As specified in the Women’s Health and Cancer Rights Act, a plan participant or beneficiary who elects breast reconstruction in connection with a mastectomy is also entitled to the following benefits:
All stages of reconstruction of the breast on which the mastectomy was performed;
Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
Prostheses and treatment of physical complications of the mastectomy, including lymphedema.
Health plans must determine the manner of coverage in consultation with the attending physician and the patient. Coverage for breast reconstruction and related services may be subject to deductibles and coinsurance amounts that are consistent with those that apply to other benefits under the plan.
Special Enrollment Rights
This notice is being provided to ensure that you understand your right to apply for group health insurance coverage. You should read this notice even if you plan to waive coverage at this time.
Loss of Other Coverage or Becoming Eligible for Medicaid or a state Children’s Health Insurance Program (CHIP)
If you are declining coverage for yourself or your dependents because of other health insurance or group health plan coverage, you may be able to later enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must enroll within 31 days after your or your dependents’ other coverage ends (or after the employer that sponsors that coverage stops contributing toward the other coverage).
If you or your dependents lose eligibility under a Medicaid plan or CHIP, or if you or your dependents become eligible for a subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents in this plan. You must provide notification within 60 days after you or your dependent is terminated from, or determined to be eligible for, such assistance.
Marriage, Birth or Adoption
If you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must enroll within 31 days after the marriage, birth, or placement for adoption.
For More Information or Assistance
To request special enrollment or obtain more information, contact: Trinity Christian Academy Human Resources 17001 Addison Road Addison, TX 75001 972-931-8325
Your Prescription Drug Coverage and Medicare
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Trinity Christian Academy and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to enroll in a Medicare drug plan. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
If neither you nor any of your covered dependents are eligible for or have Medicare, this notice does not apply to you or the dependents, as the case may be. However, you should still keep a copy of this notice in the event you or a dependent should qualify for coverage under Medicare in the future. Please note, however, that later notices might supersede this notice.
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage through a Medicare Prescription Drug Plan or a Medicare Advantage Plan that offers prescription drug coverage. All Medicare prescription drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
2. Trinity Christian Academy has determined that the prescription drug coverage offered by the Trinity Christian Academy medical plan is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage pays and is considered Creditable Coverage.
Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to enroll in a Medicare prescription drug plan, as long as you later enroll within specific time periods.
You can enroll in a Medicare prescription drug plan when you first become eligible for Medicare. If you decide to wait to enroll in a Medicare prescription drug plan, you may enroll later, during Medicare Part D’s annual enrollment period, which runs each year from October 15 through December 7 but as a general rule, if you delay your enrollment in Medicare Part D after first becoming eligible to enroll, you may have to pay a higher premium (a penalty).
IMPORTANT NOTICES
You should compare your current coverage, including which drugs are covered at what cost, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. See the Plan’s summary plan description for a summary of the Plan’s prescription drug coverage. If you don’t have a copy, you can get one by contacting Company at the phone number or address listed at the end of this section.
If you choose to enroll in a Medicare prescription drug plan and cancel your current Company prescription drug coverage, be aware that you and your dependents may not be able to get this coverage back. To regain coverage, you would have to re-enroll in the Plan, pursuant to the Plan’s eligibility and enrollment rules. You should review the Plan’s summary plan description to determine if and when you are allowed to add coverage.
If you cancel or lose your current coverage and do not have prescription drug coverage for 63 days or longer prior to enrolling in the Medicare prescription drug coverage, your monthly premium will be at least 1% per month greater for every month that you did not have coverage for as long as you have Medicare prescription drug coverage. For example, if nineteen months lapse without coverage, your premium will always be at least 19% higher than it would have been without the lapse in coverage. For more information about this notice or your current prescription drug coverage:
Contact the Human Resources Department at 972-931-8325
NOTE: You will receive this notice annually and at other times in the future, such as before the next period you can enroll in Medicare prescription drug coverage and if this coverage changes. You may also request a copy.
For more information about your options under Medicare prescription drug coverage:
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You will get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. For more information about Medicare prescription drug coverage:
Visit www.medicare.gov
Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help.
Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 877-486-2048
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. Information about this extra help is available from the Social Security Administration (SSA) online at www. socialsecurity.gov, or you can call them at 800-772-1213. TTY users should call 800-325-0778.
Remember: Keep this Creditable Coverage notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty).
January 1, 2026
Trinity Christian Academy Human Resources 17001 Addison Road Addison, TX 75001
972-931-8325
Notice of HIPAA Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) imposes numerous requirements on employer health plans concerning the use and disclosure of individual health information. This information known as protected health information (PHI), includes virtually all individually identifiable health information held by a health plan – whether received in writing, in an electronic medium or as oral communication. This notice describes the privacy practices of the Employee Benefits Plan (referred to in this notice as the Plan), sponsored by Trinity Christian Academy, hereinafter referred to as the plan sponsor.
The Plan is required by law to maintain the privacy of your health information and to provide you with this notice of the Plan’s legal duties and privacy practices with respect to your health information. It is important to note that these rules apply to the Plan, not the plan sponsor as an employer.
You have the right to inspect and copy protected health information which is maintained by and for the Plan for enrollment, payment, claims and case management. If you feel that protected health information about you is incorrect or incomplete, you may ask the Human Resources Department to amend the information. For a full copy of the Notice of Privacy Practices describing how protected health information about you may be used and disclosed and how you can get access to the information, contact the Human Resources Department.
Complaints: If you believe your privacy rights have been violated, you may complain to the Plan and to the Secretary of Health and Human Services. You will not be retaliated against for filing a complaint. To file a complaint, please contact the Privacy Officer.
Trinity Christian Academy Human Resources
17001 Addison Road
Addison, TX 75001
972-931-8325
Conclusion
PHI use and disclosure by the Plan is regulated by a federal law known as HIPAA (the Health Insurance Portability and Accountability Act). You may find these rules at 45 Code of Federal Regulations Parts 160 and 164. The Plan intends to comply with these regulations. This Notice attempts to summarize the regulations. The regulations will supersede any discrepancy between the information in this Notice and the regulations.
IMPORTANT NOTICES
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan. If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).
If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of January 31, 2026. Contact your State for more information on eligibility.
Texas – Medicaid
Website: https://www.hhs.texas.gov/services/financial/healthinsurance-premium-payment-hipp-program Phone: 1-800-440-0493
To see if any other States have added a premium assistance program since January 31, 2026, or for more information on special enrollment rights, you can contact either:
U.S. Department of Labor
Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272)
U.S. Department of Health and Human Services
Centers for Medicare & Medicaid Services www.cms.hhs.gov
1-877-267-2323 , Menu Option 4, Ext. 61565
Continuation of Coverage Rights Under COBRA
Under the Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), if you are covered under the Company group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Company plan after you have left employment with the company. If you wish to elect COBRA coverage, contact your Human Resources Department for the applicable deadlines to elect coverage and pay the initial premium.
Continuation of Coverage Rights Under COBRA
Under the Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), if you are covered under the Trinity Christian Academy group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Trinity Christian Academy plan after you have left employment with the company. If you wish to elect COBRA coverage, contact your Human Resources Department for the applicable deadlines to elect coverage and pay the initial premium.
Plan Contact Information
Trinity Christian Academy Human Resources 17001 Addison Road Addison, TX 75001 972-931-8325
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/ or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that have not signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in- network facility but are unexpectedly treated by an out-of-network provider.
IMPORTANT NOTICES
You are protected from balance billing for:
Emergency services – If you have an emergency medical condition and get emergency services from an out-of- network provider or facility, the most the provider or facility may bill you is your plan’s in- network cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Certain services at an in-network hospital or ambulatory surgical center – When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be outof-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-of-network providers cannot balance bill you, unless you give written consent and give up your protections.
You are never required to give up your protections from balance billing. You also are not required to get care out-of-network. You can choose a provider or facility in your plan’s network.
When balance billing is not allowed, you also have the following protections:
You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay outof-network providers and facilities directly.
Your health plan generally must:
Cover emergency services without requiring you to get approval for services in advance (prior authorization).
Cover emergency services by out-of-network providers.
Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
Count any amount you pay for emergency services or out-ofnetwork services toward your deductible and out-of-pocket limit.
If you believe you have been wrongly billed, you may contact your insurance provider. Visit www.cms.gov/nosurprises for more information about your rights under federal law.
New Health Insurance Marketplace Coverage Options and Your Health Coverage
PART A: General Information
Even if you are offered health coverage through your employment, you may have other coverage options through the Health Insurance Marketplace (“Marketplace”). To assist you as you evaluate options for you and your family, this notice provides some basic information about the Health Insurance Marketplace.
What is the Health Insurance Marketplace?
The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers “onestop shopping” to find and compare private health insurance options in your geographic area.
Can I Save Money on my Health Insurance Premiums in the Marketplace?
You may qualify to save money and lower your monthly premium and other out-of-pocket costs, but only if your employer does not offer coverage, or offers coverage that is not considered affordable for you and doesn’t meet certain minimum value standards (discussed below). The savings on your premium that you’re eligible for depends on your household income. You may also be eligible for a tax credit that lowers your costs.
Does Employment-Based Health Coverage Affect Eligibility for Premium Savings through the Marketplace?
Yes. If you have an offer of health coverage from your employer that is considered affordable for you and meets certain minimum value standards, you will not be eligible for a tax credit, or advance payment of the tax credit, for your Marketplace coverage and may wish to enroll in your employment-based health plan. However, you may be eligible for a tax credit, and advance payments of the credit that lowers your monthly premium, or a reduction in certain cost-sharing, if your employer does not offer coverage to you at all or does not offer coverage that is considered affordable for you or meet minimum value standards. If your share of the premium cost of all plans offered to you through your employment is more than 9.12%1 of your annual household income, or if the coverage through your employment does not meet the “minimum value” standard set by the Affordable Care Act, you may be eligible for a tax credit, and advance payment of the credit, if you do not enroll in the employment-based health coverage. For family members of the employee, coverage is considered affordable if the employee’s cost of premiums for the lowest-cost plan that would cover all family members does not exceed 9.12% of the employee’s household income.1, 2
IMPORTANT NOTICES
Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered through your employment, then you may lose access to whatever the employer contributes to the employment-based coverage. Also, this employer contribution -as well as your employee contribution to employment-based coverageis generally excluded from income for federal and state income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis. In addition, note that if the health coverage offered through your employment does not meet the affordability or minimum value standards, but you accept that coverage anyway, you will not be eligible for a tax credit. You should consider all of these factors in determining whether to purchase a health plan through the Marketplace.
When Can I Enroll in Health Insurance Coverage through the Marketplace?
You can enroll in a Marketplace health insurance plan during the annual Marketplace Open Enrollment Period. Open Enrollment varies by state but generally starts November 1 and continues through at least December 15.
Outside the annual Open Enrollment Period, you can sign up for health insurance if you qualify for a Special Enrollment Period. In general, you qualify for a Special Enrollment Period if you’ve had certain qualifying life events, such as getting married, having a baby, adopting a child, or losing eligibility for other health coverage. Depending on your Special Enrollment Period type, you may have 60 days before or 60 days following the qualifying life event to enroll in a Marketplace plan. There is also a Marketplace Special Enrollment Period for individuals and their families who lose eligibility for Medicaid or Children’s Health Insurance Program (CHIP) coverage on or after March 31, 2023, through July 31, 2024. Since the onset of the nationwide COVID-19 public health emergency, state Medicaid and CHIP agencies generally have not terminated the enrollment of any Medicaid or CHIP beneficiary who was enrolled on or after March 18, 2020, through March 31, 2023. As state Medicaid and CHIP agencies resume regular eligibility and enrollment practices, many individuals may no longer be eligible for Medicaid or CHIP coverage starting as early as March 31, 2023. The U.S. Department of Health and Human Services is offering a temporary Marketplace Special Enrollment period to allow these individuals to enroll in Marketplace coverage.
Marketplace-eligible individuals who live in states served by HealthCare. gov and either- submit a new application or update an existing application on HealthCare.gov between March 31, 2023 and July 31, 2024, and attest to a termination date of Medicaid or CHIP coverage within the same time period, are eligible for a 60-day Special Enrollment Period. That means that if you lose Medicaid or CHIP coverage between March 31, 2023, and July 31, 2024, you may be able to enroll in Marketplace coverage within 60 days of when you lost Medicaid or CHIP coverage. In addition, if you or your family members are enrolled in Medicaid or CHIP coverage, it is important to make sure that your contact information is up to date to make sure you get any information about changes to your eligibility. To learn more, visit www.HealthCare. gov or call the Marketplace Call Center at 1-800-318-2596. TTY users can call 1-855-889-4325
What about Alternatives to Marketplace Health Insurance Coverage?
If you or your family are eligible for coverage in an employment-based health plan (such as an employer-sponsored health plan), you or your family may also be eligible for a Special Enrollment Period to enroll in that health plan in certain circumstances, including if you or your dependents were enrolled in Medicaid or CHIP coverage and lost that coverage. Generally, you have 60 days after the loss of Medicaid or CHIP coverage to enroll in an employment-based health plan, but if you and your family lost eligibility for Medicaid or CHIP coverage between March 31, 2023 and July 10, 2023, you can request this special enrollment in the employment-based health plan through September 8, 2023. Confirm the deadline with your employer or your employment-based health plan. Alternatively, you can enroll in Medicaid or CHIP coverage at any time by filling out an application through the Marketplace or applying directly through your state Medicaid agency. Visit https://www.healthcare. gov/medicaid-chip/getting-medicaid-chip/ for more details.
How Can I Get More Information?
The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit www.HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area.
PART B: Information About Health Coverage Offered by Your Employer
This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application.
3. Employer Name: Trinity Christian Academy
5. Employer Address: 17001 Addison Road
7. City: Addison
4. Employer Identification Number (EIN): 75-1324332
6. Employer Phone Number: 972-447-4666
8. State: TX 9. ZIP Code: 75001
10. Who can we contact at this job? Julie Brown
11. Phone Number (if different from above): 972-447-4666
12. E-Mail Address: jbrown@trinitychristian.org
You are not eligible for health insurance coverage through this employer. You and your family may be able to obtain health coverage through the Marketplace, with a new kind of tax credit that lowers your monthly premiums and with assistance for out-of-pocket costs.
1 Indexed annually; see https://www.irs.gov/pub/irs-drop/rp-22-34.pdf for 2023.
2 An employer-sponsored or other employment-based health plan meets the “minimum value standard” if the plan’s share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs. For purposes of eligibility for the premium tax credit, to meet the “minimum value standard,” the health plan must also provide substantial coverage of both inpatient hospital services and physician services.
This brochure highlights the main features of the Trinity Christian Academy 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. Trinity Christian Academy reserves the right to change or discontinue its employee benefit plans at anytime.