HSSD Benefits Guide 2024

2024 Employee Benefit Guide

Table of Contents A Message to Our Employees

3

Vision Insurance

14

Benefits for You & Your Family

4

Short-Term Disability Insurance

15

Medical Insurance

5

Long-Term Disability Insurance

15

Pharmacy Coverage

6

Life Insurance

16

Health Savings Account (HSA)

7

Voluntary Accident & Critical Illness Insurance

17

Health Reimbursement Account

8

Wisconsin Retirement System

18

Flexible Spending Account

9

Wisconsin Deferred Compensation (WDC) 457

19

Prevea Onsite Health & Wellness Center

10

WEA Member Benefits

21

Prevea Employee Assistance Program (EAP)

11

HSSD Supplemental Retirement 403(b)

21

Making Informed Choices When Choosing Care

12

Paid Leave Benefits

21

Dental Insurance

13

Important Contacts

22

This brochure summarizes the benefit plans that are available to Howard-Suamico School District eligible employees and their dependents. Official plan documents, policies and certificates of insurance contain the details, conditions, maximum benefit levels and restrictions on benefits.

These documents govern your benefits program. If there is any conflict, the official documents prevail. These documents are available upon request through the Human Resources Department. Information provided in this brochure is not a guarantee of benefits.

2

A Message to Our Employees

Hello, Howard-Suamico School District (HSSD) is committed to supporting your personal health and well being. Providing meaningful insurance coverage is part of our larger total compensation strategy to ensure that you have the support necessary to bring the best version of yourself to school every day. After all, when you are feeling good, students and colleagues directly benefit from your positive time, energy and attention.

Although we remain challenged by rising inflation and escalating healthcare costs, almost 80 percent of HSSD respondents on the annual employee engagement survey indicated agreement that their benefits are competitive with similar jobs found elsewhere.

That said, we believe there are always creative ways to get better.

In her book, The Gifts of Imperfection, Brené Brown says, “Healthy striving is self-focused: How can I improve?" Let’s respond together by learning how to maximize these important resources. Therefore, I invite you to review this new Benefit Guide to learn more about our comprehensive insurance for you and your dependents. Our Organizational Development Team is ready to support and assist your efforts as we move forward together.

In Good Health,

Damian LaCroix Superintendent of Schools

3

Benefits for You & Your Family Howard-Suamico School District is pleased to announce our 2024 benefits program, which is designed to help you stay healthy, feel secure, and maintain a work/life balance. Offering a competitive benefits package is just one way we strive to provide our employees with a rewarding workplace employment experience. Please read the information provided in this guide carefully. For full details about our plans, please refer to the summary plan descriptions on the Staff Portal.

Who is Eligible?

Employees who meet the following weekly hour requirements are eligible for benefits: Weekly Hours

Benefits Available

30+ Hours Per Week:

Medical with Health Savings and Health Reimbursement Account Dental Insurance Access to the Prevea Onsite Health & Wellness Center when enrolled in the medical plan

24+ Hours Per Week:

Life Insurance Voluntary Accident and Critical Illness Insurance Long-Term and Short-Term Disability Insurance Wisconsin Retirement System Other Retirement Options: WEA 403(b) or WDC 457

20+ Hours Per Week:

Vision Flexible Spending Accounts

Less than 20 Hours Per Week:

Prevea Employee Assistance Program

When are you Eligible?

For newly eligible employees, coverage is effective on the 1st of the month following your 1st day of employment or transfer into a benefit eligible role. Life Insurance is effective on the 1st of the month following 30 days of employment or transfer into a benefit eligible role.

Annual Open Enrollment You may make changes to your benefit elections during annual open enrollment each year. Those changes take effect every January 1.

Changing Coverage During the Year You may make benefit changes within 30 days of a qualified event.

Qualified events include marriage, divorce, legal separation, birth or adoption of a child, change in child’s dependent status, death of spouse or dependent, or change in spouse’s benefits or employment status. Employee is responsible for notifying Mary Pliner at maryplin@hssdschools.org of any changes within 30 days of the qualifying event.

Note: Employees are also responsible for verifying their payroll deductions and reporting any discrepancies to our Organizational Development or Payroll Departments. For all benefits listed within this guide, see Summary of Benefits for full policy details including limits and exclusions. Visit the Staff Portal to review summary plan descriptions.

4

Medical Insurance WCA Group Health Trust / UMR Generally, you must pay all the costs from providers up to the deductible amount before this plan begins to pay.

Out of network benefits are not available except for emergency care.

WCA Group Health Trust HSSD Medical Plan Coverage

In-Network Benefits

Out-of-Network Benefits

Individual

$3,000

N/A

Family

$6,000

N/A

0%

N/A

Individual

$6,850

N/A

Family

$13,700

N/A

Primary Care

100% after deductible

Not Covered

Specialty Care

100% after deductible

Not Covered

Adult Periodic Exams

100%

Not Covered

Well-Child Care

100%

Not Covered

X-ray and Lab tests

100% after deductible

Not Covered

Complex Radiology

100% after deductible

Not Covered

Urgent Care Facility

100% after deductible

Not Covered

$250 copay, 100% after deductible

$250 copay, 100% after deductible

100% after deductible

Not Covered

Inpatient

100% after deductible

Not Covered

Outpatient

100% after deductible

Not Covered

Inpatient

100% after deductible

Not Covered

Outpatient

100% after deductible

Not Covered

100% after deductible

Not Covered

Annual Deductible

Coinsurance Maximum Out-of-Pocket*

Physician Office Visit

Preventative Care

Diagnostic Services

Emergency Room Facility Charges Outpatient Facility and Surgical Charges Mental Health

Substance Abuse

Other Services Chiropractic

HSSD Medical Premiums Employee Contributions (24 Pay Periods)

Employee Contributions (20 Pay Periods)

7% Premium Contribution

7% Premium Contribution

Employee Only

$27.03

Employee Only

$32.44

Employee + Family

$61.84

Employee + Family

$74.20

12% Premium Contribution

12% Premium Contribution

Employee Only

$46.34

Employee Only

$55.60

Employee + Family

$106.01

Employee + Family

$127.21

Cash In Lieu of Medical Insurance If you are eligible to receive Medical Insurance, you have the option to decline medical insurance through Howard-Suamico School District’s group medical plan and receive $6,000 annually in lieu of medical insurance.

5

HSSD Pharmacy Coverage

WCA Group Health Trust HSSD Pharmacy Coverage

In-Network Benefits

Out-of-Network Benefits

Retail (up to a 90 day supply)

100% after deductible

Not Covered

Specialty Drugs * (up to a 30 day supply)

100% after deductible

Not Covered

Mail Order (up to a 90 day supply)

100% after deductible

Not Covered

*Specialty prescriptions can only be obtained through a CVS Pharmacy or by CVS Caremark mail order to a maximum 30-day supply.

6

Health Savings Account (HSA) When you are enrolled in a Qualified High Deductible Health Plan (QHDHP) and meet the eligibility requirements, the IRS allows you to open and contribute to a Health Savings Account (HSA).

What is a Health Savings Account (HSA)?

A HSA is a tax-sheltered bank account that you own, to pay for eligible health care expenses for you and/or your eligible dependents, for current or future healthcare expenses. The HSA is yours to keep, even if you change jobs or medical plans.

There is no “use it or lose it” rule; your balance carries over year to year.

Plus, you get extra tax advantages with a HSA because: Money you deposit into a HSA is exempt from federal income taxes.

Interest in your account grows tax free; and you don’t pay income taxes on withdrawals used to pay for eligible healthcare expenses. (If you withdraw funds for non-eligible expenses, taxes and penalties apply.)

You also have a choice of investment options which earn competitive interest rates so your unused funds grow over time.

Are you eligible to open a Health Savings Account (HSA)?

Although you may be able to enroll in the Qualified High Deductible Health Plan, not everyone is eligible to open and contribute to a HSA. You must meet these requirements to open a HSA: You must be enrolled in a Qualified High Deductible Health Plan (QHDHP).

You must not be covered by another non-QHDHP health plan, such as a spouse’s PPO plan.

You must not be enrolled in Medicare.

You must not be in the TRICARE or TRICARE for Life military benefits program.

You must not have received Veterans Administration (VA) benefits within the past three months.

You cannot be claimed as a dependent on another person’s tax return.

You cannot be covered by a traditional health care flexible spending account (FSA). This includes your spouse’s FSA. (Enrollment in a limited purpose health care FSA is allowed).

2024 HSA Contributions You are able to contribute to your Health Savings Account on a pre-tax basis through payroll deductions up to the IRS statutory maximums. The IRS has established the following maximum HSA contributions for the 2024 tax year: $4,150 Individual $8,300 Family If you are age 55 and over, you may contribute an extra $1,000 catch up contribution.

HSSD Health Savings Account Annual Contributions Coverage

Contribution

Employee Only

$1,500

Employee + Family

$3,000

7

Health Reimbursement Account Employee Benefit Corporation (EBC) What is a Health Reimbursement Account?

A health reimbursement account or arrangement (HRA) is true to its name. Howard-Suamico School District will fund the account so you can be reimbursed for eligible expenses applied to the medical plan deductible.

How does the Howard-Suamico School District's Health Reimbursement Account work?

The Howard-Suamico School District will set the HRA up for you. It’s a different arrangement than a flexible spending account or health savings account, where you can contribute money.

For the 2024 Benefit Plan year, the Howard-Suamico School District will be funding the HRA: $750 when enrolled on the single plan, and $1,500 when enrolled on the family plan. The HRA dollars are intended for the plan year and they do not carry over.

Employee Benefits Corporation (EBC) will be the HRA administrator. Employees will automatically be reimbursed by EBC when they incur additional deductible expenses above $1,600 on the single plan and $3,200 on the family plan.

Employees are required to cover the FIRST $1,600 for single coverage $3,200 for family coverage Health Reimbursement Account (HRA) covers the NEXT $750 for single coverage $1,500 for family coverage

HSSD Health Reimbursement Account Annual Contributions Coverage Employee Only

$750

Employee + Family

$1,500

Employee Only Coverage

$3,000

Deductible $2,350 - $3,000

Family Coverage

$6,000

Deductible $4,700 - $6,000

$3,000 - $2,250 = $750 Employee Responsibility

$6,000 - $4,500 = $1,500 Employee Responsibility

Deductible $1,601 - $2,350

Deductible $3,201 - $4,700

$750 HSSD HRA Reimbursement

$1,500 HSSD HRA Reimbursement

Deductible $1 - $1,600

Deductible $1 - $3,200

$1,500 HSSD HSA Contribution $0

Contribution

$3,000 HSSD HSA Contribution $0

The above examples are when seeing in-network providers.

8

Flexible Spending Account Employee Benefit Corporation (EBC) The Limited Flexible Spending Account (FSA) plan with Employee Benefits Corporation (EBC) allows you to set aside pre-tax dollars to cover qualified expenses you would normally pay out of your pocket with post-tax dollars. You pay no federal or state income taxes on the money you place in a FSA. How a FSA works: Choose a specific amount of money to contribute each pay period, pre-tax, to one or both accounts during the year.

The amount is automatically deducted from your pay at the same level each pay period.

As you incur eligible expenses, you may use your flexible spending debit card to pay at the point of service OR submit the appropriate paperwork to be reimbursed by the plan.

Important rules to keep in mind: The IRS has a strict “use it or lose it” rule. If you do not use the full amount in your limited-purpose FSA, you will lose it.

You cannot change your contribution amount during the year unless you experience a qualifying life event.

You cannot transfer funds from one FSA to another.

Please plan your limited-purpose FSA contributions carefully, as any funds not used by the end of the year will be forfeited.

Limited Care FSA A limited-purpose health flexible spending account (referred to as a limited-purpose FSA) is much like a typical, general-purpose health FSA; however, under a limited-purpose FSA, eligible expenses are limited to qualifying dental and vision expenses. If contributing to a HSA, this is the only FSA available to you. The annual maximum amount you may contribute to a limited purpose FSA is $3,200.

Dependent Care FSA A Dependent Care FSA allows you to pay for child or elder care expenses using tax-free dollars. These expenses must be incurred while you are employed and must be for the care of a qualified dependent.

Unlike the Health Care FSA, Dependent Care FSA funds are not available to you day one. These funds must accumulate before you can reimburse yourself, and you can only be reimbursed up to the amount you have in the account at any given time.

Examples of Eligible Dependent Care Expenses: Pre-School Charges Before and After School Care Day Care Centers Summer Day Camps

The annual maximum amount you may contribute to the Dependent Care FSA is $5,000 (or $2,500 if married or filing separately) per calendar year.

Dependent Care election amounts can be changed during the year as cost changes.

Flex Debit Card

The Flex Debit Card allows you to pay for your healthcare needs on the spot at qualified locations without having to wait for a reimbursement check. The card can be used at hospitals, physician offices, dental offices, vision service providers and pharmacies. Copies of receipts for some expenses still need to be submitted.

Flex Debit Card Advantage Payment comes directly from your Health Care FSA account, which reduces your out-of-pocket expense Limits the need to submit claim forms and wait for reimbursement FSA plan year is January 1st through December 31st Any changes in election (other than January 1) can only happen if there is a family status change (marriage, divorce, birth or death). In order for the employee’s child to claim to be paid, the child must be a dependent of the employee by the IRS. Maximum Annual Election Health Care FSA

$3,050

Dependent Care FSA

$5,000

9

Prevea Onsite Health & Wellness Center The Howard-Suamico School District partners with Prevea Health to offer an onsite employer clinic located in Bay Port High School. All employees and dependents on the health insurance plan are welcomed and encouraged to use the onsite clinic.

10

Prevea Employee Assistance Program

You're not alone.

Help is just a call away.

11

Making Informed Choices When Choosing Care The Howard-Suamico School District, in partnership with Prevea Health, offers employees and their insured family members healthcare options at low cost. The chart below is intended to help you identify the right setting for your specific needs.

Type of Care

HSSD Onsite Health & Wellness Center

Prevea Partnered Health

Prevea Partnered Health Urgent Care

Prevea EAP

Teladoc Virtual Care

Retail Clinic

Your Doctor’s Office

Urgent Care

Emergency Room

Common Services

Approximate Wait Time

Cost Level

Primary Care Physicals Lab services Minor treatments Coughs, colds, flu

Physical Therapy Personal injury consultation Muscle/Joint pain Strengthening Post-surgery therapy

Same Day or next day availability

$5

Primary Care Physicals Lab services Minor treatments Cold, cough, flu

Physical Therapy Personal injury consultation Muscle/Joint pain Strengthening Post-surgery therapy

Same Day or next day availability

$15

Allergies Bites and stings Colds, cough, flu Earaches Minor infections

Injuries Musculoskeletal care Sore throat Minor lacerations Rashes

20 – 30 Minutes

$15

Behavioral Health Mental Health Crisis

Stress Anxiety Relationships Financial Concerns

Same day for crisis events 5 days for non-crisis

FREE

Rashes & Bug Bites Minor Injury Cold, cough, flu Bronchitis

Sinus problems Allergies Dermatology Behavioral health

Medical Care: 20 Minutes Dermatology: 30 Minutes Behavioral Health: 4 Hours

FREE

Cold, cough, flu Sinus infection Allergies Vaccinations/Screenings

Headaches Sore throat Minor sprain Minor burn

15 Minutes

$50 +

Preventative services Vaccinations Disease management

Medical problems or symptoms that are not an immediate, serious threat to your health or life

1 Week or More

$150 +

Sprains or strains Mild asthma attack Minor infections Minor injury

Medical problems or symptoms that are not an immediate, serious threat to your health or life

20 – 30 Minutes

$150 +

Sudden change in vision Sudden trouble talking Large open wounds Major burn

Severe head injury Heavy bleeding Chest pain Major broken bone

3–12 Hours Estimated wait time for non-critical cases

$1,200 +

12

Dental Insurance Healthy teeth and gums are important in maintaining your overall health and well-being. Howard-Suamico School District will continue to offer two dental programs. Members are required to pay the difference between the plan payment and the provider’s actual fee for covered services. Therefore, the out-of-pocket expenses may be lower if services are provided by a Participating Provider. The chart below is a brief outline of the plans. Please refer to the summary plan descriptions for complete plan details.

Delta Dental of Wisconsin

Coverage

CarePlus Dental

In-Network Benefits

Out-of-Network Benefits

In-Network

Individual

$0

$0

$0

Family

$0

$0

$0

Per Person/Family

$1,200

$1,200

$1,700

Preventative Oral Exams Cleanings X-Rays

100%

100%

100%

Basic Crowns Inlays Onlays

80%

80%

100%

50%

50%

100% 100% 75%

50%

50%

50%

Adults (and covered full-time Students, if Eligible)

Full-Time Students Only up to age 24

Full-Time Students Only up to age 24

Adults and Dependents up to age 26

Dependent Child(ren)

Covered up to age 19

Covered up to age 19

Covered up to age 26

Lifetime Maximum

$1,500

$1,500

$2,000

Annual Deductible

Annual Maximum

Major Prosthetics Partial Dentures and Complete Dentures Implants Orthodontia Benefit Percentage

HSSD Dental Premiums Employee Contributions (24 Pay Periods)

Employee Contributions (20 Pay Periods)

Delta Dental

Care Plus

Delta Dental

Care Plus

Employee Only

$2.62

$2.05

Employee Only

$3.36

$2.45

Employee + Family

$7.32

$5.52

Employee + Family

$8.78

$6.62

To identify an in-network provider for Delta Dental, go to www.deltadentalwi.com Children can remain on the Delta Dental plan if they are full-time students until age 24 and to age 19 if not enrolled in college.

If you see a non-PPO dentist, you will be responsible for any charges over the Reasonable and Customary amount.

To identify an in-network provider for Care Plus Dental, go to www.careplusdentalplans.com Dental Associates locations are the only in-network providers for the Care Plus plan.

13

Vision Insurance

Superior Vision Eye care can be an important benefit for you and your family, which is why we provide vision insurance through Superior Vision.

Superior Vision Plans Coverage

Examination Standard Lenses Single Bifocal Trifocal Frames Contact Lenses (In lieu of glasses) Medically Required LASIK Correction

Platinum with Eye Exam Plan

Platinum without Eye Exam Plan

Frequency

In-Network Benefits

Out-of-Network Benefits

Frequency

In-Network Benefits

Out-of-Network Benefits

12 months

Not Covered

Not Covered

12 months

Covered in Full

Up to $35

12 months

No Charge

Reimbursement up to $25 up to $40 up to $45

12 months

No Charge

Reimbursement up to $25 up to $40 up to $45

12 months

$150 Allowance

Reimbursement up to $70

12 months

$150 Allowance

Reimbursement up to $70

12 months

$150 Allowance

Reimbursement up to $125

12 months

$150 Allowance

Reimbursement up to $125

12 months

Covered in Full

Reimbursement up to $150

12 months

Covered in Full

Reimbursement up to $150

12 months

$200 Allowance

12 months

$200 Allowance

*One eye exam per year is covered under the medical plan for eligible employees.

HSSD Vision Premiums Employee Contributions (24 Pay Periods) Platinum w/o Exam

Platinum with Exam

Employee Only

$3.98

$5.57

Limited Family

$7.96

Employee + Family

$10.53

Employee Contributions (20 Pay Periods) Platinum w/o Exam

Platinum with Exam

Employee Only

$4.78

$6.68

$11.13

Limited Family

$9.95

$13.35

$14.72

Employee + Family

$12.63

$17.66

To identify an in-network provider go to www.superiorvision.com

14

Short-Term Disability Insurance Mutual of Omaha Howard-Suamico School District offers Short-Term Disability in the event you become disabled from a non-work-related injury or sickness, including pregnancy. Short-Term Disability benefits are provided as a source of income.

Short-Term Disability Benefit Begins

1st Day of Disability Due to Accidental Injury 8th Day of Disability Due to Sickness including Pregnancy

Benefit Duration

Up to 9 weeks

Percentage of Income Replaced

60% of your Weekly Income

Maximum Benefit

$800 Per Week

Rate

$.56 Per $10 of Weekly Benefit

Weekly Benefit Amount & Cost per pay period calculation example: $50,000 (your annual earnings/salary) x 60% = $30,000 / 52 = $576.92 (weekly benefit amount) / 10 * $.56 (rate at $.56 per $10 of weekly benefit) = $32.30 / 2 = $16.15 semi-monthly premium

Long-Term Disability Insurance Mutual of Omaha Howard-Suamico School District offers long-term income protection through Mutual of Omaha and pays for the cost of this benefit on your behalf. Long-term Disability provides income protection in the event you become disabled from a non-work-related injury or sickness for an extended period of time.

Long-Term Disability Elimination Period

60 Calendar Days of Disability Caused by Sickness or Injury

Benefit Duration

To Social Security Normal Retirement Age

Percentage of Income Replaced

60% of your Monthly Income

Maximum Benefit

$8,000 Per Month 15

Group Life Insurance The Minnesota Life Insurance Company The life Insurance program offers employees coverage up to five times your annual earnings. You may elect additional units of coverage, beyond basic, for a monthly premium cost to you. Coverage options include: Basic Plan (1x annual salary) is paid for by the Board of Education.

Supplemental Plan provides coverage equal to your earnings for the previous year, rounded up to the next $1,000.

Additional Plan provides up to three units of coverage. Each unit of coverage equals your earnings for the previous year, rounded up to the next $1,000. You may choose up to three units of additional coverage.

Spouse & Dependent Plan provides coverage for your spouse and all dependent(s). If you elect one unit of coverage, your spouse will have $10,000 in coverage and each dependent (regardless of number) will have $5,000 in coverage. If you elect two units, your spouse will have $20,000 in coverage and each dependent will have $10,000 in coverage. Each unit of insurance is $1.60 per month.

Sample Calculation: Lucy is 42 and earned $ 53,200 last year. The life insurance benefit rounds up to the next $1,000, which is $54,000.

Lucy would take 54 x .08 = $4.32 to determine what her cost is for 1 additional unit of life insurance.

If adding more than 1 unit she multiplies the cost by the number units she is adding.

2022 Monthly Employee Premium Rates per $1,000 of Insurance Insured Employee’s Attained Age

Rate

Under 30

$.05

30-34

$.06

35-39

$.07

40-44

$.08

45-49

$.12

50-54

$.22

55-59

$.39

60-64

$.49

65-69

$.57

When an active employee reaches age 70: Basic coverage continues at a reduced level without further premiums Supplemental coverage ceases Additional coverage will continue until the employee cancels coverage, stops paying premiums or ends employment Additional coverage rates for employees age 70 and older are listed below Insured Employee’s Attained Age

Monthly Rate per $10 of Weekly Benefit

70

$1.00

71

$1.15

72

$1.25

73

$1.45

74

$1.60

75

$1.80

76

$1.95

77

$2.06

16

Voluntary Accident and Critical Illness Insurance Mutual of Omaha

Accident and Injury Insurance No one plans to have an accident. But, it can happen at any moment throughout the day, whether at work or at play. Most major medical insurance plans only pay a portion of the bills. Our policy can help pick up where other insurance leaves off and provide cash to cover the expenses. Our accident coverage helps offer peace of mind when an accidental injury occurs.

Critical Illness Insurance The signs pointing to a critical illness are not always clear and may not be preventable, but our coverage can help offer financial protection in the event you are diagnosed. Mutual of Omaha Insurance Company group voluntary critical illness coverage provides a lump-sum cash benefit to help you cover the out-of-pocket expenses associated with a critical illness.

Review the tables on the following pages to see premiums for Voluntary Accident and Critical Illness Insurance.

17

Voluntary Accident Insurance Voluntary Accident Coverage Catastrophic Benefits Principal Sum Employee/Spouse/Child

$25,000 / $10,000 / $5,000

Basic Accidental Death

100%

Accidental Death Common Carrier

300%

Dismemberment and Paralysis

25% - 100%

Reasonable Modifications

Up to 10%

Coma

50%

Initial Care and Transportation Benefits ER Treatment

$200

Urgent Care

$125

Initial Physician Office Visit

$100

Ground Ambulance

$300

Air Ambulance

$1,500

Major Injuries Factures: Closed

$200 - $3,000

Fractures: Open

$400 - $6,000

Dislocations: Closed

$225 - $4,500

Dislocations: Open

$450 - $9,000

Burns

$250 - $15,000

Skin Grafts

25% of Burn Benefit

Lacerations

$50 - $800

Dental Crown or Filling Repair

$300

Extraction

$100

Hospital Admission

$1,500

Daily Confinement (Up to 365 Days)

$300 per Day

ICU Confinement (Up to 15 Days)

$600 per Day

Rehab, Facility Confinement (Up to 30 Days)

$150 per Day

Surgeries

$150 - $2,000

X-Ray

$75

Diagnostic Exam

$300

Follow Up Care Physician Follow Up (Up to 6 per Accident)

$75

Therapy Services (Up to 6 per Accident)

$25

Medical Device

$100

Prosthetic Device (Up to 2 per Accident)

$750

Transportation (Up to 3 Trips for Accident)

$300 per Trip

Lodging (Up to 30 Nights per Accident)

$125 per Night

Childcare (Up to 30 Days per Accident)

$20 per Day

HSSD Voluntary Accident Premiums Employee Rates (24 Pay Periods) Employee Only Employee + Spouse Employee + Child(ren) Employee + Family

$2.86 $4.75 $6.62 $8.51

Employee Rates (20 Pay Periods) Employee Only $3.43 Employee + Spouse $5.70 Employee + Child(ren) $7.94 Employee + Family $10.21

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Voluntary Critical Illness Insurance Voluntary Critical Illness Plan Features and Benefits

Employee $10,000

Spouse 100% of EE Benefit to $10,000

Benefit Maximum

25% of EE Benefit to $5,000

Benefit Increment

$10,000

$10,000

25% of EE Benefit to $5,000

Benefit Minimum

$10,000

$10,000

25% of EE Benefit to $5,000

Guaranteed Issue*

$10,000

$10,000

$3,000

50% at Age 70

50% at Age 70

N/A

$75

$75

$75

Age Reduction Annual Wellness Screening Benefit Separation Period

Child

3 Months Between Different Categories

Additional Occurrence Waiting Period

12 Months Between Diagnosis

Maximum Benefit

400% per Condition

Recurrence Waiting Period

12 Months

Recurrence Maximum

100% of Initial Diagnosis Benefit, 1 Time per Applicable Condition

Pre-Existing Condition Limitation

12/12

Covered Conditions

Benefit as % of Principal Sum

Heart Attack

100%

Stroke

100%

Coronary Artery Bypass

25%

Major Organ Failure

100%

End Stage Renal Failure

100%

Benign Brain Tumor

25%

Type 1 Diabetes

100%

Cancer (Invasive)

100%

HSSD Voluntary Critical Illness Premiums Employee Rates (24 Pay Periods)

Employee Rates (20 Pay Periods)

Age Band $10,000 Benefit

Age Band $10,000 Benefit

Under 25

$1.40

Under 25

$1.68

25-29

$1.79

25-29

$2.15

30-34

$2.08

30-34

$2.50

35-39

$2.68

35-39

$3.22

40-44

$3.19

40-44

$3.83

45-49

$3.77

45-49

$4.52

50-54

$5.75

50-54

$6.90

55-59

$5.67

55-59

$6.80

60-64

$11.39

60-64

$13.67

65-99

$19.86

65-99

$23.83

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Retirement Wisconsin Retirement System Benefits are administered by the Department of Employee Trust Funds (ETF). If you work a minimum of 4.8 hours per day, you will automatically be enrolled. The District and you will each contribute 6.9% of your gross income to the Wisconsin Retirement System (WRS). Unless you elect to participate in the Variable Trust Fund, 100% of your contributions will be deposited in the Core fund. See chart below for participation standards.

Variable Trust Fund If you elect this option, 50% of the funds contributed by you and the District will be placed in a variable rate (primarily in common stocks). Those participating must be prepared for the possibility that poor stock market performance could result in investment losses. You can only enroll once and opt out once.

WRS Participation Standards: Initially Employed Before 7/1/2011

Initially Employed On or After 7/1/2011

Must be expected to work: At least ⅓ of full time for at least one year

Must be expected to work: At least ⅔ of full time for at least one year

440 Hours

880 Hours

For more information, please see the Wisconsin Retirement System Handbook or visit: https://etf.wi.gov/retirement/wrs-retirement-benefit Wisconsin Deferred Compensation (WDC) 457 Deferred compensation programs allow eligible employees to save and invest before-tax and/or after-tax (Roth) dollars through voluntary paycheck contributions, supplementing any existing retirement/pension benefits. Visit www.wdc457.org for more information.

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HSSD Supplemental Retirement WEA Member Benefits 403(b) As an eligible public school employee, the 403(b) retirement plan, sometimes referred to as a tax-sheltered annuity (TSA), is a salary deferral plan that allows you to contribute to your retirement through a payroll deduction. This is similar to a 401(k) plan offered in the private sector. Voluntary contributions can be made on a before-tax and/or after-tax (Roth) basis. Visit www.weabenefits.com for more information.

Annual Contribution Amount Administrators

$3,000

Teachers, Student Services & Coordinators

$2,000

Support Staff: Supervisors, Managers & Coordinators

$2,000

Support Staff: Specialists, Technicians, Custodians, Secretaries, Student Advocates & School Nutrition Supervisors

$1,500

Support Staff: Aides & School Nutrition

$1,000 *Employees are 100% vested in all District contributions.

Supplemental Retirement Qualifications: Employees must work a minimum of 30 hours per week in order to be eligible for this benefit.

Employer contributions will be made in March each year. This amount is prorated based on FTE. Employee must be an active employee of the Howard-Suamico School District on the date of the contribution in order to receive it.

All employer contributions made prior to an employee’s death will become immediately vested upon their death.

Paid Leave Benefits Paid Time Off, Vacation and Bereavement Leave The Howard-Suamico School District believes in providing employees flexibility to support a healthy work/life balance. Eligible employees receive Paid Time Off (PTO), Vacation (full-year only) and Bereavement leave annually. Leave benefits are prorated based on employment start date and the length of hours the employee works each day. PTO and Vacation may be used for any reason, however, there are guidelines in place for requesting time off. Please refer to your Employee Handbook for specific details.

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Important Contacts BENEFIT

CARRIER

CONTACT INFORMATION

Medical PPO

WCA Group Health Trust/UMR

(800)207-3172 www.umr.com Group Number: 76-440252

Prevea Onsite Health & Wellness Clinic

Prevea Health

(833)576-0684 https://www.hssdschools.org/staff/clinic-information

Prevea Partnered Health Program

Prevea Health

www.Prevea.com/PartneredHealth

Employee Assistance Program

Prevea Health

(920)272-1200 Green Bay (920)458-5557 Sheboygan

Dental PPO

Delta Dental of Wisconsin Inc.

(800)236-3712 www.deltadentalwi.com Group Number: 99007

Managed Dental Care

Care-Plus Dental Plans, Inc.

(800)318-7007 www.careplusdentalplans.com also known as Dental Associates Group Number: PPD309

Vision

Versant Health

(800)507-3800 www.superiorvision.com Group Number: 14490101

Short Term Disability (STD) Long Term Disability (LTD) Accident & Voluntary Critical Illness

Mutual of Omaha Insurance Company

(800)369-3809 www.mutualofomaha.com Group Number: G000BP42

Health Reimbursement Account (HRA) Flexible Spending Accounts: Limited Purpose FSA Dependent Care FSA

Employee Benefits Corporation

(800)346-2126 https://www.ebcflex.com

Wisconsin Department of Employee Trust Funds

(877)533-5020 https://etf.wi.gov Number: 69-036-4384-000

403(b) Retirement Investment Options

WEA Member Benefits

(800)279-4030 www.weabenefits.com Unit ID: 0335.0 HSSD Representative: Theron Wahlberg

403(b) Retirement Investment Options

Wisconsin Deferred Compensation

(877) 457-9327 www.wdc457.org Group ID: 98971-01

USI Benefit Resource Center Benefit Questions 10:00 a.m. – 8:00 p.m. (CST)

USI

(855)874-0742 Email: BRCMT@usi.com

Wisconsin Retirement System

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