Kemp ISD 2023-2024 Benefit Guide

EMPLOYEE BENEFIT GUIDE

Rusty Freeman & Associates, LLC U.S. Employee Benefits Services Group 245 Landa Street New Braunfels, Texas 78130 (830) 606-5100

www.mybenefitshub.com/kempisd

Support Contacts Cathy Gunn

Kim Marshall

Employee Benefits Office

Business Office Specialist

Office: (903) 498-1400 ext. 6012

Office: (903) 498-1400 ext. 6015

Email: cathy.gunn@kempisd.org

Email: kim.marshall@kempisd.org Tracy Hamel

Senior Account Manager Office: (830) 606-5100 Email: thamel@usebsg.com Marlene Freeman Senior Account Manager Office: (830) 606-5100 Email: mfreeman@usebsg.com

Table of Content Page Enrollment Information & Instructions

4-5

Medical Transportation - MASA

6-7

Accident - MetLife

8-13

Critical Illness - Unum

14-20

Cancer – Colonial Life

21-24

Disability – The Standard

25-32

Dental - Lincoln

33-38

Vision – Superior

39

Basic (District Paid) Life - Lincoln

40

Voluntary Life - Lincoln

41-45

Texas Life - Permanent Life

46-48

Health Savings Account – HSABank

49-50

Flexible Spending Account - FSA

51-54

Benefit Contacts Benefit

Phone

Website

HEALTH SAVING ACCT (HSABANK)

1-800-357-6246 WWW.HSABANK.COM

THE STANDARD - DISABILITY

1-800-368-1135 WWW.STANDARD.COM

TEXAS LIFE – PERMANENT LIFE

1-800-283-9233 WWW.TEXASLIFE.COM

METLIFE – ACCIDENT

1-800-638-5433 WWW.METLIFE.COM

CANCER – COLONIAL LIFE

1-800-325-4368 WWW.COLONIALLIFE.COM

LINCOLN – GROUP LIFE

1-800-423-2765 WWW.LINCOLNFINANCIAL.COM

LINCOLN – VOLUNTARY LIFE

1-800-423-2765 WWW.LINCOLNFINANCIAL.COM

UNUM – CRITICAL ILLNESS

1-866-679-3054 WWW.UNUM.COM

LINCOLN – DENTAL

1-800-423-2765 WWW.LINCOLNFINANCIAL.COM

SUPERIOR – VISION

1-800-507-3800 WWW.SUPERIORVISION.COM

MASA – MEDICAL TRANSPORT

1-954-334-8261 WWW.MASAMTS.COM

NBS – FLEXIBLE SPENDING ACCOUNT

1-800-274-0503 WWW.NBSBENEFITS.COM

Enrollment Instructions for THEbenefitsHUB Site Access: To access your employer online enrollment site, THEbenefitsHUB, you can login to the following website

www.mybenefitshub.com/kempisd

245 Landa Street New Braunfels, Texas 78130 Phone: (830) 606-5100 4

2023-2024 Enrollment Information

The 2023-2024 Section 125 Cafeteria Plan year begins 9/01/2023 and ends 8/31/2024. All benefits elected during the annual open enrollment will be effective 09/01/2023 Know Your Benefits! Below is the summary of benefits offered by KISD! Medical Transport - MASA provides emergency transportation for ground, emergency air, and non-emergency hospital to hospital transportation anywhere in the US/Canada.

Standard Disability – Plan includes both short and long term disability coverage. Plan is designed to protect up to 66 2/3% of your gross KISD income.

Texas Life Permanent Life – Portable, permanent life insurance available for employees, their spouses and dependents.

Employees can keep the coverage upon termination or retirement from KISD. Colonial Cancer – Benefits become payable to the employee once certain procedures have been conducted and/or diagnosis has been made.

Wellfleet Accident (NEW) – Pays benefits for off the job accidents and related treatments. **$200 Wellness Benefit Lincoln Group & Voluntary Life – Group Life Insurance that ends when employment is terminated from KISD. Coverage is also available for spouse and children.

UNUM Critical Illness – Guaranteed issue and pays a lump sum benefit if the insured is diagnosed with a covered critical illness. ** Wellness Benefit - $50 Lincoln Dental – Coverage for preventive, basic, major, and orthodontia services. High and a Low plan available.

Superior Vision – Plan includes coverage for eye exams materials (such as frames and lenses) and discounts for laser vision correction. The plan has a defined network of providers. Out of network benefits are available on a reimbursement basis only.

Health Savings Account - Participants in the TRS-ActiveCare 1HD health plan are eligible to contribute to a health savings account. A health savings account (HSA) provides tax benefits when used to pay for eligible out-of-pocket medical, dental, and vision expenses.

NBS Flexible Spending – Make sure to spend/claim the money in your current reimbursement account by August 31, 2023. Visit www.nbsbenefits.com to check account balances or request information.

5

The Ultimate Peace of Mind for Employees and Their Families

The Harrison’s Story •

Jim and his family were at a local festival when his daughter, Sara, suddenly began experiencing horrible abdominal and back pain, after a fall from earlier in the day.

•

His wife, Heather, called 911 and Sara was transported to a local hospital, when it was decided that she needed to be flown to another hospital.

•

Upon arrival, Sara underwent multiple procedures and her condition was stabilized.

•

After further testing, it was discovered that Sara needed additional specialized treatment at another hospital requiring transport on a non-emergent basis.

Based on a true story. Names were changed to protect identities in compliance with HIPAA.

And then, the Bills came!

As a MASA Member

If a Non-MASA Member

Sara would pay*

If In-Network**

If Out-of-Network**

911 Ground Ambulance Cost: $1,800

$0

$300

$1,600

Emergent Air Ambulance Cost: $45,000

$0

$4,000

$30,000

Non-Emergent Air Transport† Cost: $20,000

$0

$20,000

$20,000

Total Out-of-Pocket Cost

$0

$24,300

$51,600

*Benefit is dependent on Membership Enrolled. **Out-of-pocket dollars vary dependent on provider, distance, health plan design, current status of deductible and out-of pocket max. These figures are an example of the costs one may incur. † More and more health plans are not covering interfacility transports on a non-emergent basis.

Any Ground. Any Air. Anywhere.TM No matter how comprehensive your local in-network coverage may be, you still have significant exposure to out-of-network emergency transportation. Moreover, when you and your family travel outside your area, there is an 80% chance of being picked up by an out-of-network provider.

A MASA Membership prepares you for the unexpected. ONLY MASA MTS provides you with: • Coverage ANYWHERE in all 50 states and Canada whether at home or away • Coverage for BOTH emergent ground ambulance and air ambulance transport REGARDLESS of the provider • Non-emergent transport services, which are frequently covered inadequately by your insurance, if at all For more information, please contact your local MASA MTS representative or visit www.masamts.com 6

FLYER_COMP_B2B

EMERGENCY TRANSPORTATION COSTS

HOW MASA IS DIFFERENT Across the US there are thousands of ground ambulance providers and hundreds of air ambulance carriers. ONLY MASA offers comprehensive coverage since MASA is a PAYER and not a PROVIDER!

MASA MTS is here to protect its members and their families from the shortcomings of health insurance coverage by providing them with comprehensive financial protection for lifesaving emergency transportation services, both at home and away fromhome.

ONLY MASA provides over 1.6 million members with coverage for BOTH ground ambulance and air ambulance transport, REGARDLESS of which provider transports them.

Many American employers and employees believe that their health insurance policies cover most, if notall ambulance expenses.

The truth is, they DO NOT!

Members are covered ANYWHERE in all 50 states and Canada!

Even after insurance payments for emergency transportation, you could receive a bill up to $5,000 for ground ambulance and as high as $70,000 for air ambulance. The financial burdens for medical transportation costs are very real.

Any Ground. Any Air. Anywhere.™

OUR BENEFITS Benefit*

Additionally, MASA provides a repatriation benefit: if a member is hospitalized more than 100 miles from home, MASA can arrangeand pay to have them transported to a hospital closer to their place of residence.

Emergent Plus $14/mo.

Emergent Ground Transportation

U.S./Canada

Emergent Air Transportation

U.S./Canada

Non-Emergent Air Transportation

U.S./Canada

Repatriation

U.S./Canada

A MASA Membership prepares you for the unexpected and gives you the peace of mind to access vital emergency medical transportation no matter where you live, for a minimal monthly fee.

• One low fee for the entire family • NO deductibles • NO health questions • Easy claims process

For more information, pleasecontact Your Broker or MASA Representative 7 * Please refer to the MSA for a detailed explanation of benefits and eligibility,

EVERY FAMILY DESERVES A MASA MEMBERSHIP

Accident Insurance

8

Schedule of Benefits & Features • • • •

Unlimited lifetime maximum benefit with no age-related benefit reductions Benefits paid based on the schedule of benefits provided for each covered accident Waiver of Premium: Premium is waived following a 60-day period of disability due to a covered accident for as long as the covered person remains disabled.

Portability is included.

ACCIDENT PLAN BENEFITS

Custom Accident

Emergency and Initial Accident Treatment Benefits Ambulance Ground Air Water Emergency Room Treatment Urgent Care Major Diagnostic Imaging X-ray

$200.00 $600.00 $600.00 $200.00 $75.00 $200.00 $75.00

Hospital Benefits Hospital Admission Hospital Confinement Maximum per accident Intensive Care Admission ICU Confinement Maximum per accident Observation Unit

$1,000.00 $200.00 365 days $1,000.00 $200.00 365 days $100.00

Specific Injury Benefit Fractures Closed/Non-Surgical Treatment Skull (except Bones of Face or Nose) Depressed

$4,000.00

Hip, Thigh (Femur) Vertebrae, Body of (excluding Vertebral Process)

$4,000.00 $4,000.00

Pelvis Leg (Tibia and/or Fibula) Upper Arm (Humerus) Shoulder Blade Collarbone Upper Jaw, Maxilla (except Alveolar Process)

$4,000.00

$4,000.00 $3,000.00 $3,000.00 $3,000.00 $2,500.00

AI-2 9

MP0000822785

Lower Jaw, Mandible (except Alveolar Process)

$2,500.00

Vertebral Process Forearm (Ulna and/or Radius) Hand, Wrist (except Fingers) Kneecap Foot (except Toes) Ankle Rib Coccyx Finger, Toe Enhancement for Open/Surgical Reduction Chip Fractures Dislocations Closed/Non-Surgical Treatment Hip Knee (other than Kneecap) Shoulder Kneecap Ankle bone or bones of the foot Elbow Wrist Bone or bones of the hand Jawbone Collarbone One toe or finger Enhancement for Open/Surgical Reduction Partial Dislocations Lacerations No Repair Repair - up to 2 inches Repair - over 2 inches, up to 6 inches Repair - over 6 inches Burns 2nd Degree Burns At least 1%, but less than 20% of skin surface 20% or greater of skin surface 3rd Degree Burns Less than 5% of skin surface At least 5%, but less than 20% of skin surface 20% or greater of skin surface Skin Graft Due to Burns (% of applicable Burn benefit)

$1,600.00 $1,600.00 $1,600.00 $1,600.00 $1,600.00 $1,600.00 $300.00 $300.00 $300.00 2X 25%

10

$4,000.00 $2,250.00 $2,250.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $300.00 2X 25% $50.00 $50.00 $200.00 $400.00

$100.00 $500.00 $500.00 $5,000.00 $10,000.00 50%

Not due to Burns At least 1%, but less than 20% of skin surface 20% or greater of skin surface Concussion and Other Brain Injuries Dental Benefit Eye Injury Benefit

$100.00 $200.00 $300.00 $250.00 $200.00

Surgery Benefits Outpatient Surgery Benefit Facilities other than Physician Office or Emergency Room Physician Office or Emergency Room Internal Injuries Surgical Benefits Open Abdominal & Thoracic Hernia Exploratory without Repair Tendon/Ligament/Rotator Cuff Surgical Benefit Single Multiple Exploratory without Repair Torn Knee Cartilage Surgery Benefit Torn with Surgical Repair Exploratory without Repair Diagnosis only with no surgery or repair Ruptured Disc with Surgical Repair Anesthesia Benefit General Anesthesia Epidural or Regional Anesthesia

$300.00 $300.00 $2,000.00 $200.00 $150.00 $700.00 $1,050.00 $150.00 $600.00 $150.00 $100.00 $600.00 $200.00 $200.00

Medical Benefits Blood, Plasma & Platelets Benefit Prosthetic Device Benefit One only Two or more Appliances Pain Management Benefit

$500.00 $1,000.00 $2,000.00 $300.00 $200.00

Follow-Up Care and Transportation Benefits Physician Office Visit Maximum number of visits Therapy Services Benefit (Occupational, Physical, Speech Therapy) Maximum number of visits Rehabilitation Unit Confinement Maximum number of days

11

$75.00 4 $60.00 12 $200.00 90

Residence/Vehicle Modification Benefit Transportation (minimum of 100 miles from residence, up to 3 round trips) Lodging Maximum number of days

$1,000.00 $.60/mile $200.00 30

Accidental Death Benefits Accidental Death Employee Spouse Child(ren) Common Carrier Accidental Death Employee Spouse Child(ren) Organ Donor Benefit

$40,000.00 $20,000.00 $20,000.00 $200,000.00 $100,000.00 $100,000.00 $5,000.00

Accidental Dismemberment Benefits Dismemberment Loss of Both Hands, or Loss of Both Feet, or Loss of One Hand and One Foot Loss of One Hand or Loss of One Foot Partial Dismemberment Loss of One or More Fingers or Toes Partial Amputation of Finger or Toe

$40,000.00 $20,000.00 $600.00 $200.00

Catastrophic Benefits Catastrophic Loss Loss of Sight in both eyes or Hearing in both ears Loss of Speech or Sight in one eye or Hearing in one ear Coma Paralysis Paraplegia Quadriplegia

$20,000.00 $5,000.00 $20,000.00 $15,000.00 $30,000.00

Riders Health Screening Benefit Rider: Number of payments per year, per covered person.

$200.00 1

Monthly Rates Custom Accident

Employee Only

Employee & Spouse

Employee & Child(ren)

Family

$14.00

$24.00

$29.00

$39.00

12

EXCLUSIONS* In addition to any benefit-specific exclusion, benefits will not be paid for any loss which, directly or indirectly, in whole or in part, is caused by or results from any of the following unless coverage is specifically provided for by name in this Certificate: 1.

An injury incurred while working for pay or profit;

2.

Intentionally self-inflicted injury, suicide, or any attempt or threat while sane or insane;

3.

Participating in war or any act of war whether declared or undeclared;

4.

Commission or attempt to commit a felony;

5.

Commission of or active participation in a riot, insurrection, or terrorist activity;

6.

Engaging in an illegal activity or occupation;

7.

Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the earth’s surface,including any travel beyond the earth’s atmosphere except a fare-paying passenger on a regularly scheduled commercial or charter airline;

8.

Practicing for or participating in any semi-professional or professional competitive athletic contest, including officiating or coaching, for which the covered person receives any compensation or remuneration;

9.

Sickness, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;

10.

Voluntary ingestion or inhalation of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a physician and taken in accordance with the prescribed dosage;

11.

Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant including any prescribed drug for which the covered person has been provided a written warning against operating a vehicle while taking it. Under the influence of alcohol, for purposes of this exclusion, means intoxicated, as defined by the law of the State in which the covered accident occurred;

12.

Care that is not recommended and approved by a physician.

13

Kemp Independent School District Critical Illness Plan Highlights Policy Number 474643 Critical Illness insurance provides financial protection by paying a lump sum benefit if you are diagnosed with a covered critical illness.

Who is eligible for this coverage?

All employees in active employment in the United States working at least 20 hours per week and their eligible spouses and children (up to age 26 regardless of student or marital status).

What are the Critical Illness coverage amounts?

The following coverage amounts are available.

For you:

Select one of the following $10,000, $15,000 or $20,000

For your Spouse: 100% of employee coverage amount For your Children: 50% of employee coverage amount Can I be denied coverage?

Coverage is guarantee issue.

When is coverage effective?

Please see your Plan Administrator for your effective date of coverage.

What critical illness conditions are covered?

Covered Conditions*

Insurance coverage will be delayed if you are not in active employment because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective.

Critical Illnesses Coronary Artery Disease (major) Coronary Artery Disease (minor) End Stage Renal (Kidney) Failure Heart Attack (Myocardial Infarction) Major Organ Failure Requiring Transplant Stroke Cancer Invasive Cancer (including all Breast Cancer) Non-Invasive Cancer Skin Cancer Supplemental Critical Illnesses Benign Brain Tumor Coma Loss of Hearing Loss of Sight Loss of Speech Infectious Disease Occupational Human Immunodeficiency Virus (HIV) or Hepatitis Permanent Paralysis

14

Percentage of Coverage Amount 50% 10% 100% 100% 100% 100% 100% 25% $500 100% 100% 100% 100% 100% 25% 100% 100%

Progressive Diseases Amyotrophic Lateral Sclerosis (ALS) Dementia (including Alzheimer’s Disease) Functional Loss Multiple Sclerosis (MS) Parkinson’s Disease

100% 100% 100% 100% 100%

Additional Critical Illnesses for your Children Cerebral Palsy 100% Cleft Lip or Palate 100% Cystic Fibrosis 100% Down Syndrome 100% Spina Bifida 100% *Please refer to the policy for complete definitions of covered conditions.

Covered Condition Benefit The covered condition benefit is payable once per covered condition per insured.

Unum will pay a covered condition benefit for a different covered condition if: - the new covered condition is medically unrelated to the first covered condition; or - the dates of diagnosis are separated by more than 180 days.

Reoccurring Condition Benefit We will pay the reoccurring condition benefit for the diagnosis of the same covered condition if the covered condition benefit was previously paid and the new date of diagnosis is more than 180 days after the prior date of diagnosis.

The benefit amount for any reoccurring condition benefit is 100% of the percentage of coverage amount for that condition.

The following Covered Conditions are eligible for a reoccurring condition benefit: Benign Brain Tumor Coma Coronary Artery Disease (Major) Coronary Artery Disease (Minor) End Stage Renal (Kidney) Failure

Heart Attack (Myocardial Infarction) Invasive Cancer (includes all Breast Cancer) Major Organ Failure Requiring Transplant Non-Invasive Cancer Stroke

Are wellness Each insured is eligible to receive one Be Well Benefit per calendar year. screenings covered?

Be Well Benefit For you, your spouse and your children: $50 If the employee’s Critical Illness Coverage Amount is: $10,000 $15,000 $20,000

The Be Well Benefit Amount for you, your spouse and your children is: $50 $50 $50

Be Well Screenings include tests for the following: cholesterol and diabetes, cancer and cardiovascular function. They also include imaging studies, immunizations and annual examinations by a Physician. See certificate for details.

15

How much does the coverage cost?

Option 1 Monthly Critical Illness Cost $10,000 EE, $10,000 SP, $50 Be Well Benefit Age Employee Cost Spouse Cost Less than age 25 $3.88 $3.88 25-29 $4.88 $4.88 30-34 $6.08 $6.08 35-39 $8.08 $8.08 40-44 $10.58 $10.58 45-49 $13.88 $13.88 50-54 $17.68 $17.68 55-59 $23.78 $23.78 60-64 $33.18 $33.18 65-69 $47.88 $47.88 70-74 $74.08 $74.08 75-79 $108.68 $108.68 80-84 $157.68 $157.68 85 or over $253.38 $253.38 Option 2 Monthly Critical Illness Cost $15,000 EE, $15,000 SP, $50 Be Well Benefit Age Employee Cost Spouse Cost Less than age 25 $4.88 $4.88 25-29 $6.38 $6.38 30-34 $8.18 $8.18 35-39 $11.18 $11.18 40-44 $14.93 $14.93 45-49 $19.88 $19.88 50-54 $25.58 $25.58 55-59 $34.73 $34.73 60-64 $48.83 $48.83 65-69 $70.88 $70.88 70-74 $110.18 $110.18 75-79 $162.08 $162.08 80-84 $235.58 $235.58 85 or over $379.13 $379.13

16

Option 3 Monthly Critical Illness Cost $20,000 EE, $20,000 SP, $50 Be Well Benefit Age Employee Cost Spouse Cost Less than age 25 $5.88 $5.88 25-29 $7.88 $7.88 30-34 $10.28 $10.28 35-39 $14.28 $14.28 40-44 $19.28 $19.28 45-49 $25.88 $25.88 50-54 $33.48 $33.48 55-59 $45.68 $45.68 60-64 $64.48 $64.48 65-69 $93.88 $93.88 70-74 $146.28 $146.28 75-79 $215.48 $215.48 80-84 $313.48 $313.48 85 or over $504.88 $504.88 Your rate is based on your insurance age, which is your age immediately prior to and including the anniversary/effective date.

Spouse rate is based on your Spouse’s insurance age, which is their age immediately prior to and including the anniversary/effective date.

Critical Illness benefits do not decrease due to age.

Do my critical illness insurance benefits decrease with age?

Are there any exclusions or limitations?

We will not pay benefits for a claim that is caused by, contributed to by, or occurs as a result of any of the following: - committing or attempting to commit a felony; - being engaged in an illegal occupation or activity; - injuring oneself intentionally or attempting or committing suicide, whether sane or not; - active participation in a riot, insurrection, or terrorist activity. This does not include civil commotion or disorder, injury as an innocent bystander, or Injury for self-defense; - participating in war or any act of war, whether declared or undeclared; - combat or training for combat while serving in the armed forces of any nation or authority, including the National Guard, or similar government organizations; - voluntary use of or treatment for voluntary use of any prescription or nonprescription drug, alcohol, poison, fume, or other chemical substance unless taken as prescribed or directed by the Insured’s Physician; - being intoxicated; and - a Date of Diagnosis that occurs while an Insured is legally incarcerated in a penal or correctional institution.

Additionally, no benefits will be paid for a Date of Diagnosis that occurs prior to the coverage effective date.

17

Pre-existing Conditions We will not pay benefits for a claim when the covered loss occurs in the first 12 months following an insured’s coverage effective date and the covered loss is caused by, contributed to by, or occurs as a result of any of the following: - a pre-existing condition; or - complications arising from treatment or surgery for, or medications taken for, a pre-existing condition.

An insured has a pre-existing condition if, within the 3 months just prior to their coverage effective date, they have an injury or sickness, whether diagnosed or not, for which: - medical treatment, consultation, care or services, or diagnostic measures were received or recommended to be received during that period; - drugs or medications were taken, or prescribed to be taken during that period; or - symptoms existed.

Pre-existing Condition requirements are not applicable to children who are newly acquired after your Coverage Effective Date.

The pre-existing condition provision applies to any Insured’s initial coverage and any increases in coverage. Coverage effective date refers to the date any initial coverage or increases in coverage become effective.

Is the coverage portable (can I keep it if I leave my employer)?

If your employment with your employer ends or you are no longer in an eligible group you can apply for ported coverage and pay the first premium within 31 days to continue coverage for yourself, your spouse and your children.

When does my coverage end?

If you choose to cancel coverage, it will end on the first of the month following the date you provide notification to your employer.

If your spouse’s coverage ends as a result of your death, divorce or annulment, your spouse may elect to continue spouse and children coverage, as long as premium is paid as required.

Otherwise, coverage ends on the earliest of: - the date the policy is cancelled by your employer; - the date you no longer are in an eligible group; - the date your eligible group is no longer covered; - the date of your death - the last day of the period any required contributions are made; - the last day you are in active employment.

If you choose to cancel your Spouse’s coverage, it will end on the first of the month following the date you provide notification to your employer.

Otherwise, your spouse’s coverage will end on the earliest of: - the date your coverage ends; - the date your spouse is no longer eligible for coverage; - the date your spouse no longer meets the definition of a spouse; - the date of your spouse’s death; or - the date of divorce or annulment.

18

Your children’s coverage will end on the earliest of: - the date your coverage ends; - the date your children are no longer eligible for coverage; or - the date your children no longer meet the definition of children.

The limited benefits provided are a supplement to major medical coverage and are not a substitute for major medical coverage or other minimal essential coverage as required by federal law. Lack of minimal essential coverage may result in an additional tax payment being due.

This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. For complete details of coverage and availability, please refer to Policy Form GCIP16-1 et al or contact your Unum representative. © 2018 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.

Underwritten by Unum Insurance Company, Portland, Maine AE-1226

FOR EMPLOYEES

19

Kemp Independent School District

Learn more about your annual Be Well Benefit

Your Unum plan pays a Be Well Benefit for one Be Well screening each year.

It’s easy to file a claim.

You can receive a benefit for tests that are performed after your initial coverage date. Follow these simple steps:

With Unum’s Be Well Benefit, you and other covered family members can receive a valuable incentive for important tests and screenings. Many of these tests are routinely performed, so it’s easy to take advantage of this benefit.

Your Critical Illness Be Well benefit is $50.

File your claim by mail or over the phone.

Simply call 1-800-635-5597 to learn more.

Be Well screenings • Annual exams by a

physician including sports physicals and well-child visits • Cancer screenings including pap smear, colonoscopy • Cardiovascular function screenings

• Cholesterol and

diabetes screenings • Imaging studies, including chest X-ray, mammography • Immunizations including HPV, MMR, tetanus, influenza

You will need to provide the following: • First and last names of the employee and claimant (the employee might not be the claimant) • Employee’s Social Security number or policy number • Name and date of the test • Name of physician and the facility where the test was performed.

Each year, you can earn a valuable incentive just for taking care of your health. And so can each of your covered family members.

For more information, please contact your HR representative.

Unum will pay Be Well benefits for all eligible policies according to policy terms.

THESE POLICIES OFFER LIMITED BENEFITS The policies or their provisions may vary or be unavailable in some states. The policies have exclusions and limitations which may affect any benefits payable. See the actual policy or your Unum representative for specific provisions and details of availability.

Underwritten by: Unum Insurance Company, Portland, Maine; In New York, underwritten by: Provident Life and Casualty Insurance Company, Chattanooga, Tennessee unum.com © 2020 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.

EN-1911-BeWell (1-20) FOR EMPLOYEES

20

Nearly everyone has experienced or knows somebody who has experienced a cancer diagnosis in their family.

The good news is that cancer screenings and cancer-fighting technologies have gotten a lot better in recent years.

However, with advanced technology come high costs. Major medical health insurance is a great start, but even with this essential safety net, cancer sufferers can still be hit with unexpected medical and non-medical expenses.

Cancer coverage from Colonial Life offers the protection you need to concentrate on what is most important — your care.

Features of Colonial Life’s Cancer Insurance: 1. Pays benefits to help with the cost of cancer screening and cancer treatment.

Group Cancer 1000 With Additional Benefits

2. Provides benefits to help pay for the indirect costs associated with cancer, such as: l Loss of wages or salary l Deductibles and coinsurance l Travel expenses to and from treatment centers l Lodging and meals l Child care 3. Pays regardless of any other insurance you have with other insurance companies.

4. Provides a cancer screening benefit that you can use even if you are never diagnosed with cancer.

5. Benefits paid directly to you unless you specify otherwise.

6. Flexible coverage options for employees and their families.

21

This is a brief description of some available benefits.

Treatment Benefits (In-or Outpatient) Radiation/Chemotherapy Antinausea Medication l Blood/Plasma/Platelets/Immunoglobulins l Experimental Treatment l Hair Prosthesis/External Breast/Voice Box Prosthesis l Supportive/Protective Care Drugs and Colony Stimulating Factors l Bone Marrow Stem Cell Transplant l Peripheral Stem Cell Transplant l l

We will pay benefits if one of the following routine cancer screening tests is performed or if cancer is diagnosed while your coverage is in force.

Cancer Screening Benefit Tests

Surgery Benefits

This benefit is payable once per calendar year per covered person.

Surgery Procedures (including skin cancer) l Anesthesia (including skin cancer) l Second Medical Opinion l Reconstructive Surgery l Prosthesis/Artificial Limb l Outpatient Surgical Center l

Pap Smear ThinPrep Pap Test1 l CA125 (Blood test for ovarian cancer) l Mammography l Breast Ultrasound l CA 15-3 (Blood test for breast cancer) l PSA (Blood test for prostate cancer) l Chest X-ray l Biopsy of Skin Lesion l Colonoscopy l Virtual Colonoscopy l Hemoccult Stool Analysis l Flexible Sigmoidoscopy l CEA (Blood test for colon cancer) l Bone Marrow Aspiration/Biopsy l Thermography l Serum Protein Electrophoresis (Blood test for Myeloma) l l

Transportation/Lodging Benefits l

l

Lodging

Extended Care Benefits l Skilled Nursing Care Facility l

Hospice

l Home Health Care Service

Waiver of Premium

To file a claim for a covered cancer screening/wellness test, it is not necessary to complete a claim form. Call our toll-free Customer Service number, 1.800.325.4368, with the medical information Group Cancer 1000 With Additional Benefits

Transportation

l Transportation for Companion

Inpatient Benefits l Hospital and Hospital Intensive Care Unit

Confinement Ambulance l Private Full-Time Nursing Services l Attending Physician l

THIS IS A CANCER ONLY POLICY. This policy has exclusions and limitations. For cost and complete details of the coverage, see your Colonial Life benefits counselor. Coverage may vary by state and may not be available in all states. Applicable to policy form GCAN-MP and certificate form GCAN-C (including state abbreviations where used, for example GCAN-C-TX.) ThinPrep is a registered trademark of Cytyc Corporation.

1

Level 2 with $2,000 Initial Diagnosis Benefit & Specified Disease

Level 4 with $2,000 Initial Diagnosis Benefit & Specified Disease

$13.50

$26.70

$22.45

$44.30

Employee

Colonial Life 1200 Colonial Life Boulevard Columbia, South Carolina 29210 coloniallife.com

Family 22

Group Cancer Insurance— Initial Diagnosis of Cancer Rider

The diagnosis of internal cancer can be an upsetting time. You do not need to add financial worry to what is already a very difficult situation. When you add an Initial Diagnosis of Cancer rider to your group cancer insurance coverage, you add a little more financial protection at the point you or an insured family member is diagnosed with internal cancer—a time before many medical costs are incurred.

Rider Benefits This rider pays a lump sum benefit for the initial diagnosis of internal (not skin) cancer. Use the benefit any way you choose, such as to help pay for deductibles and coinsurance on your major medical insurance or settle any outstanding debts.

Group Cancer 1000— Initial Diagnosis of Cancer Rider

Rider Features l

Guaranteed renewable as long as your cancer insurance policy is in force.

l

Covers the same family members as your cancer insurance policy.

l

Pays benefits regardless of any other insurance you have with other insurance companies.

l

Pays benefits directly to you, unless you specify otherwise.

This rider has exclusions and limitations. For cost and complete details of the coverage, see your Colonial Life benefits counselor. Coverage may vary by state and may not be available in all states. Applicable to rider form R-GCAN-Indx (including state abbreviations where used - for example: R-GCAN-Indx-TX).

Colonial Life 1200 Colonial Life Boulevard Columbia, South Carolina 29210 coloniallife.com

©2011 Colonial Life & Accident Insurance Company.

Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand.

23

Colonial Life and Making benefits count are registered service marks of Colonial Life & Accident Insurance Company.

62614-3

Group Cancer Insurance— Specified Disease Rider

When you add this rider to your group cancer insurance coverage, you add valuable coverage related to the following specified diseases.

Specified Diseases

• Adrenal Hypofunction (Addison’s Disease) • Botulism • Bubonic Plague • Cerebral Palsy • Cholera • Cystic Fibrosis • Diphtheria • Encephalitis (including Encephalitis contracted from West Nile Virus) • Huntington’s Chorea • Legionnaires’ Disease

• Lou Gehrig’s Disease (Amyotrophic Lateral Sclerosis) • Lyme Disease • Malaria • Meningitis (bacterial) • Multiple Sclerosis • Muscular Dystrophy • Myasthenia Gravis • Necrotizing Fasciitis • Osteomyelitis • Poliomyelitis • Rabies • Reye’s Syndrome

• Scleroderma • Scarlet Fever • Sickle Cell Anemia • Systemic Lupus • Tetanus • Toxic Epidermal Necrolysis • Toxic Shock Syndrome • Tuberculosis (Mycobacterial) • Tularemia • Typhoid Fever • Variant Creutzfeldt-Jakob Disease (Mad Cow Disease) • Yellow Fever

Rider Benefits l

l

Group Cancer 1000— Specified Disease Rider

l

Hospital Confinement –We will pay this benefit if you incur charges for and are confined to a hospital for treatment of one of the specified diseases listed above.

Ambulance – We will pay this benefit if you incur charges for and use a professional ambulance to transport you, on the advice of a doctor, to or from a hospital where you are confined as an inpatient for the treatment of a specified disease listed above. Limit 2 one way trips per confinement.

Attending Physician– We will pay this benefit if you incur charges for and use the services of an attending physician while confined to a hospital for the treatment of a specified disease listed above.

Rider Features l

Covers the same family members as your cancer insurance coverage.

l

Pays benefits regardless of any other insurance you have with other insurance companies.

l

Pays benefits directly to you, unless you specify otherwise.

This rider has exclusions and limitations. For cost and complete details of the coverage, see your Colonial Life benefits counselor. Coverage may vary by state and may not be available in all states. Applicable to Rider form R-GCAN-SpDis (including state abbreviation where used - for example: R-GCAN-SpDis-TX).

Colonial Life 1200 Colonial Life Boulevard Columbia, South Carolina 29210 coloniallife.com

© 2011 Colonial Life & Accident Insurance Company Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand.

24

62613-3

Kemp Independent School District

Voluntary Long Term Disability Insurance Standard Insurance Company has developed this document to provide you with information about the optional insurance coverage you may select through the Kemp Independent School District. Written in non-technical language, this is not intended as a complete description of the coverage. If you have additional questions, please check with your human resources representative.

Employer Plan Effective Date

The group policy effective date is September 1, 2021.

Eligibility To become insured, you must be: • A regular employee of the Kemp Independent School District, excluding temporary or seasonal employees, fulltime members of the armed forces, leased employees or independent contractors • Actively at work at least 15 hours each week • A citizen or resident of the United States or Canada

Employee Coverage Effective Date Please contact your human resources representative for more information regarding the following requirements that must be satisfied for your insurance to become effective. You must satisfy: • Eligibility requirements • An eligibility waiting period of 0 days • An evidence of insurability requirement, if applicable • An active work requirement. This means that if you are not actively at work on the day before the scheduled effective date of insurance, your insurance will not become effective until the day after you complete one full day of active work as an eligible employee.

Benefit Amount You may select a monthly benefit amount in $100 increments from $300 to $8,000; based on the tables and guidelines presented in the Rates section of these Coverage Highlights. The monthly benefit amount must not exceed 66 2/3 percent of your monthly earnings.

Benefits are payable for non-occupational disabilities only. Occupational disabilities are not covered.

Plan Maximum Monthly Benefit: 66 2/3 percent of predisability earnings Plan Minimum Monthly Benefit: 10 percent of your LTD benefit before reduction by deductible income

25

Benefit Waiting Period and Maximum Benefit Period The benefit waiting period is the period of time that you must be continuously disabled before benefits become payable. Benefits are not payable during the benefit waiting period. The maximum benefit period is the period for which benefits are payable. The benefit waiting period and maximum benefit period associated with your plan options are shown below: Option 1 2 3 4

Accidental Injury 7 days 14 days 30 days 90 days

Other Disability 7 days 14 days 30 days 90 days

Maximum Benefit Period 3 Years for Sickness & To SSNRA for Accident 3 Years for Sickness & To SSNRA for Accident 3 Years for Sickness & To SSNRA for Accident 3 Years for Sickness & To SSNRA for Accident

Options 1-4: Maximum Benefit Period of 3 years for Sickness If you become disabled before age 64, LTD benefits may continue during disability for 3 years. If you become disabled at age 64 or older, the benefit duration is determined by your age when disability begins: Age 64 65 66 67 68 69+

Maximum Benefit Period 2 years 6 months 2 years 1 year 9 months 1 year 6 months 1 year 3 months 1 year

Options 1-4: Maximum Benefit Period of To SSNRA for Accident If you become disabled before age 62, LTD benefits may continue during disability until you reach age 65 or to the Social Security Normal Retirement Age (SSNRA) or 3 years 6 months, whichever is longest. If you become disabled at age 62 or older, the benefit duration is determined by your age when disability begins: Age 62 63 64 65 66 67 68 69+

Maximum Benefit Period To SSNRA, or 3 years 6 months, whichever is longer To SSNRA, or 3 years, whichever is longer To SSNRA, or 2 years 6 months, whichever is longer 2 years 1 year 9 months 1 year 6 months 1 year 3 months 1 year

First Day Hospital Benefit With this benefit, if an insured employee is admitted as a hospital inpatient for at least four hours during the benefit waiting period, the benefit waiting period will be satisfied. Benefits become payable on the date of hospitalization; the maximum benefit period also begins on that date. This feature is included only on LTD plans with benefit waiting periods of 30 days or less.

Preexisting Condition Limitation A detailed description of the preexisting condition limitation is included in the Group Policy. If you have questions, please check with your human resources representative.

Preexisting Condition Period: The 180-day period just before your insurance becomes effective.

Exclusion Period: 12 months

26

Preexisting Condition Waiver The Standard may pay benefits for up to 90 days even if you have a preexisting condition. After 90 days, The Standard will continue benefits only if the preexisting condition exclusion does not apply.

Own Occupation Period For the plan’s definition of disability, as described in your brochure, the own occupation period is the first 24 months for which LTD benefits are paid.

Any Occupation Period The any occupation period begins at the end of the own occupation period and continues until the end of the maximum benefit period.

Other LTD Features • Employee Assistance Program (EAP) – This program offers support, guidance and resources that can help an employee resolve personal issues and meet life’s challenges.

• Family Care Expense Adjustment – Disabled employees faced with the added expense of family care when returning to work may receive combined income from LTD benefits and work earnings in excess of 100 percent of indexed predisability earnings during the first 12 months immediately after a disabled employee’s return to work.

• Special Dismemberment Provision – If an employee suffers a lost as a result of an accident, the employee will be considered disabled for the applicable Minimum Benefit Period and can extend beyond the end of the Maximum Benefit Period • Reasonable Accommodation Expense Benefit – Subject to The Standard’s prior approval, this benefit allows us to pay up to $25,000 of an employer’s expenses toward work-site modifications that result in a disabled employee’s return to work.

• Survivor Benefit – A Survivor Benefit may also be payable. This benefit can help to address a family’s financial need in the event of the employee’s death.

• Return to Work (RTW) Incentive – The Standard’s RTW Incentive is one of the most comprehensive in the employee benefits history. For the first 12 months after returning to work, the employee’s LTD benefit will not be reduced by work earnings until work earnings plus the LTD benefit exceed 100 percent of predisability earnings. After that period, only 50 percent of work earnings are deducted.

• Rehabilitation Plan Provision – Subject to The Standard’s prior approval, rehabilitation incentives may include training and education expense, family (child and elder) care expenses, and job-related and job search expenses.

When Benefits End LTD benefits end automatically on the earliest of: • The date you are no longer disabled • The date your maximum benefit period ends • The date you die • The date benefits become payable under any other LTD plan under which you become insured through employment during a period of temporary recovery • The date you fail to provide proof of continued disability and entitlement to benefits

27

Rates Employees can select a monthly LTD benefit ranging from a minimum of $300 to a maximum amount based on how much they earn. Referencing the appropriate attached charts, follow these steps to find the monthly cost for your desired level of monthly LTD benefit and benefit waiting period: 1. Find the maximum LTD benefit by locating the amount of your earnings in either the Annual Earnings or Monthly Earnings column. The LTD benefit amount shown associated with these earnings is the maximum amount you can receive. If your earnings fall between two amounts, you must select the lower amount.

2. Select the desired monthly LTD benefit between the minimum of $300 and the determined maximum amount, making sure not to exceed the maximum for your earnings.

3. In the same row, select the desired benefit waiting period to see the monthly cost for that selection.

If you have questions regarding how to determine your monthly LTD benefit, the benefit waiting period, or the premium payment of your desired benefit, please contact your human resources representative.

Group Insurance Certificate If you become insured, you will receive a group insurance certificate containing a detailed description of the insurance coverage. The information presented above is controlled by the group policy and does not modify it in any way. The controlling provisions are in the group policy issued by Standard Insurance Company.

28

Accident 7/ Sickness 7 If your gross annual salary is at least:

You are eligible for a maximum monthly benefit of:

Monthly Premium

If your gross annual salary is at least:

You are eligible for a maximum monthly benefit of:

Monthly Premium

$5,400 $7,200 $9,000 $10,800 $12,600 $14,400 $16,200 $18,000 $19,800 $21,600 $23,400 $25,200 $27,000 $28,800 $30,600 $32,400 $34,200 $36,000 $37,800 $39,600 $41,400 $43,200 $45,000 $46,800 $48,600 $50,400 $52,200 $54,000 $55,800 $57,600 $59,400 $61,200 $63,000 $64,800 $66,600 $68,400 $70,200 $72,000 $73,800

$300 $400 $500 $600 $700 $800 $900 $1,000 $1,100 $1,200 $1,300 $1,400 $1,500 $1,600 $1,700 $1,800 $1,900 $2,000 $2,100 $2,200 $2,300 $2,400 $2,500 $2,600 $2,700 $2,800 $2,900 $3,000 $3,100 $3,200 $3,300 $3,400 $3,500 $3,600 $3,700 $3,800 $3,900 $4,000 $4,100

$9.80 $13.02 $16.00 $18.86 $21.98 $24.56 $27.64 $30.26 $33.34 $36.66 $39.78 $42.84 $45.38 $48.48 $50.50 $52.54 $55.48 $58.42 $61.32 $64.24 $67.16 $70.10 $73.00 $75.94 $78.84 $81.78 $84.86 $92.88 $100.44 $103.68 $106.92 $110.16 $113.40 $116.64 $119.88 $123.12 $126.36 $129.60 $132.84

$75,600 $77,400 $79,200 $81,000 $82,800 $84,600 $86,400 $88,200 $90,000 $91,800 $93,600 $95,400 $97,200 $99,000 $100,800 $102,600 $104,400 $106,200 $108,000 $109,800 $111,600 $114,400 $115,200 $117,000 $118,800 $120,600 $122,400 $124,200 $126,000 $127,800 $129,600 $131,400 $133,200 $135,000 $136,800 $138,600 $140,400 $142,200 $144,000

$4,200 $4,300 $4,400 $4,500 $4,600 $4,700 $4,800 $4,900 $5,000 $5,100 $5,200 $5,300 $5,400 $5,500 $5,600 $5,700 $5,800 $5,900 $6,000 $6,100 $6,200 $6,300 $6,400 $6,500 $6,600 $6,700 $6,800 $6,900 $7,000 $7,100 $7,200 $7,300 $7,400 $7,500 $7,600 $7,700 $7,800 $7,900 $8,000

$136.08 $139.32 $142.56 $145.80 $149.04 $152.28 $155.52 $158.76 $162.00 $165.24 $168.48 $171.72 $174.96 $178.20 $181.44 $184.68 $187.92 $191.16 $194.40 $197.69 $201.03 $204.43 $207.88 $211.39 $214.97 $218.60 $222.29 $226.05 $229.87 $233.75 $237.70 $241.72 $245.80 $249.96 $245.18 $258.48 $262.84 $267.29 $271.80

29

Accident 14/ Sickness 14 If your gross annual salary is at least:

You are eligible for a maximum monthly benefit of:

Monthly Premium

If your gross annual salary is at least:

You are eligible for a maximum monthly benefit of:

Monthly Premium

$5,400 $7,200 $9,000 $10,800 $12,600 $14,400 $16,200 $18,000 $19,800 $21,600 $23,400 $25,200 $27,000 $28,800 $30,600 $32,400 $34,200 $36,000 $37,800 $39,600 $41,400 $43,200 $45,000 $46,800 $48,600 $50,400 $52,200 $54,000 $55,800 $57,600 $59,400 $61,200 $63,000 $64,800 $66,600 $68,400 $70,200 $72,000 $73,800

$300 $400 $500 $600 $700 $800 $900 $1,000 $1,100 $1,200 $1,300 $1,400 $1,500 $1,600 $1,700 $1,800 $1,900 $2,000 $2,100 $2,200 $2,300 $2,400 $2,500 $2,600 $2,700 $2,800 $2,900 $3,000 $3,100 $3,200 $3,300 $3,400 $3,500 $3,600 $3,700 $3,800 $3,900 $4,000 $4,100

$6.84 $9.12 $11.40 $13.70 $15.98 $18.26 $20.54 $22.82 $25.10 $27.38 $29.66 $31.96 $34.24 $36.52 $38.80 $41.08 $43.36 $45.64 $47.94 $50.22 $52.50 $54.78 $57.06 $59.34 $61.62 $63.90 $66.20 $68.48 $70.68 $72.96 $75.24 $77.52 $79.80 $82.08 $84.36 $86.64 $88.92 $91.20 $93.48

$75,600 $77,400 $79,200 $81,000 $82,800 $84,600 $86,400 $88,200 $90,000 $91,800 $93,600 $95,400 $97,200 $99,000 $100,800 $102,600 $104,400 $106,200 $108,000 $109,800 $111,600 $114,400 $115,200 $117,000 $118,800 $120,600 $122,400 $124,200 $126,000 $127,800 $129,600 $131,400 $133,200 $135,000 $136,800 $138,600 $140,400 $142,200 $144,000

$4,200 $4,300 $4,400 $4,500 $4,600 $4,700 $4,800 $4,900 $5,000 $5,100 $5,200 $5,300 $5,400 $5,500 $5,600 $5,700 $5,800 $5,900 $6,000 $6,100 $6,200 $6,300 $6,400 $6,500 $6,600 $6,700 $6,800 $6,900 $7,000 $7,100 $7,200 $7,300 $7,400 $7,500 $7,600 $7,700 $7,800 $7,900 $8,000

$95.76 $98.04 $100.32 $102.60 $104.88 $107.16 $109.44 $111.72 $114.00 $116.28 $118.56 $120.84 $123.12 $125.40 $127.68 $129.96 $132.24 $134.52 $136.80 $139.11 $141.46 $143.85 $146.28 $148.76 $151.27 $153.83 $156.43 $159.07 $161.76 $164.49 $167.27 $170.10 $172.97 $175.90 $178.87 $181.89 $184.97 $188.09 $191.27

30

Accident 30 / Sickness 30 If your gross annual salary is at least:

You are eligible for a maximum monthly benefit of:

Monthly Premium

If your gross annual salary is at least:

You are eligible for a maximum monthly benefit of:

Monthly Premium

$5,400 $7,200 $9,000 $10,800 $12,600 $14,400 $16,200 $18,000 $19,800 $21,600 $23,400 $25,200 $27,000 $28,800 $30,600 $32,400 $34,200 $36,000 $37,800 $39,600 $41,400 $43,200 $45,000 $46,800 $48,600 $50,400 $52,200 $54,000 $55,800 $57,600 $59,400 $61,200 $63,000 $64,800 $66,600 $68,400 $70,200 $72,000 $73,800

$300 $400 $500 $600 $700 $800 $900 $1,000 $1,100 $1,200 $1,300 $1,400 $1,500 $1,600 $1,700 $1,800 $1,900 $2,000 $2,100 $2,200 $2,300 $2,400 $2,500 $2,600 $2,700 $2,800 $2,900 $3,000 $3,100 $3,200 $3,300 $3,400 $3,500 $3,600 $3,700 $3,800 $3,900 $4,000 $4,100

$5.02 $6.70 $8.36 $10.04 $11.72 $13.38 $15.06 $16.74 $18.40 $20.08 $21.76 $23.12 $25.10 $26.78 $28.46 $30.12 $31.80 $33.48 $35.14 $36.82 $38.50 $40.16 $41.84 $43.52 $45.20 $46.86 $48.54 $50.22 $51.46 $53.12 $54.78 $56.44 $58.10 $59.76 $61.42 $63.08 $64.74 $66.40 $68.08

$75,600 $77,400 $79,200 $81,000 $82,800 $84,600 $86,400 $88,200 $90,000 $91,800 $93,600 $95,400 $97,200 $99,000 $100,800 $102,600 $104,400 $106,200 $108,000 $109,800 $111,600 $114,400 $115,200 $117,000 $118,800 $120,600 $122,400 $124,200 $126,000 $127,800 $129,600 $131,400 $133,200 $135,000 $136,800 $138,600 $140,400 $142,200 $144,000

$4,200 $4,300 $4,400 $4,500 $4,600 $4,700 $4,800 $4,900 $5,000 $5,100 $5,200 $5,300 $5,400 $5,500 $5,600 $5,700 $5,800 $5,900 $6,000 $6,100 $6,200 $6,300 $6,400 $6,500 $6,600 $6,700 $6,800 $6,900 $7,000 $7,100 $7,200 $7,300 $7,400 $7,500 $7,600 $7,700 $7,800 $7,900 $8,000

$69.72 $71.38 $73.04 $74.70 $76.36 $78.02 $79.68 $81.34 $83.00 $84.66 $86.32 $87.98 $89.64 $91.30 $92.96 $94.62 $96.28 $97.94 $99.60 $101.28 $102.99 $104.74 $106.51 $108.31 $110.14 $112.00 $113.89 $115.81 $117.77 $119.76 $121.79 $123.84 $125.94 $128.07 $130.23 $132.43 $134.66 $136.94 $139.26

31

Accident 90 / sickness 90 If your gross annual salary is at least:

You are eligible for a maximum monthly benefit of:

Monthly Premium

If your gross annual salary is at least:

You are eligible for a maximum monthly benefit of:

Monthly Premium

$5,400 $7,200 $9,000 $10,800 $12,600 $14,400 $16,200 $18,000 $19,800 $21,600 $23,400 $25,200 $27,000 $28,800 $30,600 $32,400 $34,200 $36,000 $37,800 $39,600 $41,400 $43,200 $45,000 $46,800 $48,600 $50,400 $52,200 $54,000 $55,800 $57,600 $59,400 $61,200 $63,000 $64,800 $66,600 $68,400 $70,200 $72,000 $73,800

$300 $400 $500 $600 $700 $800 $900 $1,000 $1,100 $1,200 $1,300 $1,400 $1,500 $1,600 $1,700 $1,800 $1,900 $2,000 $2,100 $2,200 $2,300 $2,400 $2,500 $2,600 $2,700 $2,800 $2,900 $3,000 $3,100 $3,200 $3,300 $3,400 $3,500 $3,600 $3,700 $3,800 $3,900 $4,000 $4,100

$3.84 $5.12 $6.40 $7.68 $8.96 $10.24 $11.52 $12.80 $14.08 $15.36 $16.64 $17.92 $19.20 $20.48 $21.76 $23.04 $24.32 $25.60 $26.88 $28.16 $29.40 $30.72 $32.00 $33.28 $34.56 $35.84 $37.12 $38.40 $39.68 $40.96 $42.24 $43.52 $44.80 $46.08 $47.36 $48.64 $49.92 $51.20 $52.48

$75,600 $77,400 $79,200 $81,000 $82,800 $84,600 $86,400 $88,200 $90,000 $91,800 $93,600 $95,400 $97,200 $99,000 $100,800 $102,600 $104,400 $106,200 $108,000 $109,800 $111,600 $114,400 $115,200 $117,000 $118,800 $120,600 $122,400 $124,200 $126,000 $127,800 $129,600 $131,400 $133,200 $135,000 $136,800 $138,600 $140,400 $142,200 $144,000

$4,200 $4,300 $4,400 $4,500 $4,600 $4,700 $4,800 $4,900 $5,000 $5,100 $5,200 $5,300 $5,400 $5,500 $5,600 $5,700 $5,800 $5,900 $6,000 $6,100 $6,200 $6,300 $6,400 $6,500 $6,600 $6,700 $6,800 $6,900 $7,000 $7,100 $7,200 $7,300 $7,400 $7,500 $7,600 $7,700 $7,800 $7,900 $8,000

$53.76 $55.04 $56.32 $57.60 $58.88 $60.16 $61.44 $62.72 $64.00 $65.28 $66.56 $67.84 $69.12 $70.40 $71.68 $72.96 $74.24 $75.52 $76.80 $78.10 $79.42 $80.76 $82.12 $83.51 $84.92 $86.36 $87.82 $89.30 $90.81 $92.35 $93.91 $95.50 $97.11 $98.75 $100.42 $102.12 $103.81 $105.60 $107.38

32

Full-Time Employees Electing the High Plan of Kemp Independent School District Benefits At-A-Glance Dental Insurance

High Option The Lincoln DentalConnect® PPO Plan: • Covers many preventive, basic, and major dental care services • Also covers orthodontic treatment for children • Features group coverage for Kemp Independent School District employees • Allows you to choose any dentist you wish, though you can lower your out-of-pocket costs by selecting a contracting dentist

Calendar (Annual) Deductible

Contracting Dentists

Non-Contracting Dentists

Individual: $50 Family: $150 Waived for: Preventive

Individual: $50 Family: $150 Waived for: Preventive

Deductibles are combined for basic and major Contracting Dentists’ services. Deductibles are combined for basic and major Non-Contracting Dentists’ services.

Annual Maximum

$1,250

$1,250

MaxRewards® lets you and your covered family members roll a portion of unused dental benefits from one year into the next. So you have extra benefit dollars available when you need them most. ●Eligible Range (claim threshold): $500 ●Rollover Amount: $250 per calendar year ●Rollover Amount with Preferred Provider: $350 per calendar year ●Maximum Rollover Account Balance: $1,250 Lifetime Orthodontic Max

$1,000

$1,000

Orthodontic Coverage is available for dependent children.

Waiting Period

This plan includes an additional waiting period if you do not enroll within the defined timeframe when it is first offered to you or within an annual open enrollment period. ●12 months for basic services

• Does not make you and your loved ones wait six months between routine cleanings

●12 months for major services ●12 months for orthodontic services

33

Contracting Dentists

Non-Contracting Dentists

100% No Deductible

100% No Deductible

Contracting Dentists

Non-Contracting Dentists

80% After Deductible

80% After Deductible

Contracting Dentists

Non-Contracting Dentists

50% After Deductible

50% After Deductible

Orthodontics

Contracting Dentists

Non-Contracting Dentists

Orthodontic exams X-rays Extractions Study models Appliances

50%

Contracting Dentists/Non-Contracting Dentists

Contracting Dentists

Non-Contracting Dentists

…you pay a deductible (if applicable), then 50% of the remaining discounted fee for PPO members. This is known as a PPO contracted fee.

… you pay a deductible (if applicable), then 50% of the usual and customary fee, which is the maximum expense covered by the plan.

You are responsible for the difference between the usual and customary fee and the dentist’s billed charge.

Preventive Services Routine oral exams Bitewing X-rays Full-mouth or panoramic X-rays Routine cleanings Fluoride treatments Space maintainers for children Sealants Basic Services Other dental X-rays (including periapical films) Problem focused exams Consultations Palliative treatment (including emergency relief of dental pain) Injections of antibiotics and other therapeutic medications Fillings Prefabricated stainless steel and resin crowns Simple extractions Surgical extractions Oral surgery Biopsy and examination of oral tissue (including brush biopsy) Major Services General anesthesia and I.V. sedation Prosthetic repair and recementation services Endodontics (including root canal treatment) Periodontal maintenance procedures Non-surgical periodontal therapy Periodontal surgery Bridges Full and partial dentures Denture reline and rebase services Crowns, inlays, onlays and related services Build-ups/post & core Implants Implant related services

To find a contracting dentist near you, visit www.LincolnFinancial.com/FindADentist.

This plan lets you choose any dentist you wish. However, your out-of-pocket costs are likely to be lower when you choose a contracting dentist. For example, if you need a crown…

34

50%

With the Lincoln Dental Mobile App • Find a network dentist near you in minutes • Have an ID card on your phone • Customize the app to get details of your plan • Find out how much your plan covers for checkups and other services • Keep track of your claims

Lincoln DentalConnect® Online Health Center • Determine the average cost of a dental procedure • Have your questions answered by a licensed dentist • Learn all about dental health for children, from baby’s first tooth to dental emergencies • Evaluate your risk for oral cancer, periodontal disease and tooth decay

Covered Family Members When you choose coverage for yourself, you can also provide coverage for: • Your spouse or domestic partner.

Benefit Exclusions Like any coverage, this dental coverage does have some exclusions.

• The plan does not cover services started before coverage begins or after it ends. Benefits are limited to appropriate and necessary procedures listed in the summary plan description. Benefits are not payable for duplication of services. Covered expenses will not exceed the summary plan description’s usual and customary allowances.

• Plan benefits are not payable for a condition that is covered under Workers’ Compensation or a similar law; that occurs during the course of employment or military service or involvement in an illegal occupation, felony, or riot; or that results from a self-inflicted injury.

• The plan does not cover an orthodontia treatment plan started before coverage begins unless the member was receiving orthodontia benefits from the employer’s previous group dental summary plan description. In this case, Lincoln Financial will continue orthodontia benefits until the combined benefit paid by both policies is equal to this summary plan description’s lifetime orthodontia maximum. Plan benefits are not payable if the orthodontic appliance was installed after the age of 19.

• In certain situations, there may be more than one method of treating a dental condition. This summary plan description includes an alternative benefits provision that may reduce benefits to the lowestcost, generally effective, and necessary form of treatment.

• Certain conditions, such as age and frequency limitations, may impact your coverage. See the summary plan description for details.

A complete list of benefit exclusions is included in the summary plan description.

• Unmarried dependent children, up to age 26.

Dental Rate

Here’s how little you pay with group rates.

As a Kemp Independent School District employee, you can take advantage of this dental coverage for less than $1.10 a day.

Plus, you can add loved ones to the plan for just a little more.

Your estimated cost is itemized below.

Coverage

Monthly Rate

Employee only

$32.94

Employee & spouse/domestic partner

$67.50

Employee & child/children

$65.34

Employee & family

$100.44 35

Full-Time Employees Electing the Low Plan of Kemp Independent School District Benefits At-A-Glance Dental Insurance

Low Option The Lincoln DentalConnect® PPO Plan: • Covers many preventive and basic dental care services • Features group coverage for Kemp Independent School District employees

Calendar (Annual) Deductible

Contracting Dentists

Non-Contracting Dentists

Individual: $100 Family: $300 Waived for: Preventive

Individual: $100 Family: $300 Waived for: Preventive and Major

Deductibles are combined for basic and major Contracting Dentists’ services. Deductibles are combined for basic Annual Maximum

$1,000

$1,000

Annual Maximums are combined for preventive, basic, and major services.

Waiting Period

This plan includes an additional waiting period if you do not enroll within the defined timeframe when it is first offered to you or within an annual open enrollment period. ●12 months for basic services

• Allows you to choose any dentist you wish, though you can lower your out-of-pocket costs by selecting a contracting dentist • Does not make you and your loved ones wait six months between routine cleanings

36

Preventive Services Routine oral exams Bitewing X-rays Full-mouth or panoramic X-rays Routine cleanings Fluoride treatments Space maintainers for children Sealants Basic Services Other dental X-rays (including periapical films) Problem focused exams Consultations Palliative treatment (including emergency relief of dental pain) Injections of antibiotics and other therapeutic medications Fillings Prefabricated stainless steel and resin crowns Simple extractions Surgical extractions Oral surgery Biopsy and examination of oral tissue (including brush biopsy) General anesthesia and I.V. sedation Prosthetic repair and recementation services Endodontics (including root canal treatment) Periodontal maintenance procedures Non-surgical periodontal therapy Periodontal surgery Contracting Dentists/Non-Contracting Dentists

Contracting Dentists

Non-Contracting Dentists

100% No Deductible

100% No Deductible

Contracting Dentists

Non-Contracting Dentists

80% After Deductible

80% After Deductible

Contracting Dentists

Non-Contracting Dentists

… you pay a deductible (if applicable), then 20% of the …you pay a deductible (if usual and customary fee, applicable), then 20% of the which is the maximum remaining discounted fee expense covered by the plan. for PPO members. This is You are responsible for the known as a PPO difference between the usual contracted fee. and customary fee and the dentist’s billed charge.

To find a contracting dentist near you, visit www.LincolnFinancial.com/FindADentist.

This plan lets you choose any dentist you wish. However, your out-of-pocket costs are likely to be lower when you choose a contracting dentist. For example, if you need a filling…

37

With the Lincoln Dental Mobile App • Find a network dentist near you in minutes • Have an ID card on your phone • Customize the app to get details of your plan • Find out how much your plan covers for checkups and other services • Keep track of your claims

Lincoln DentalConnect® Online Health Center • Determine the average cost of a dental procedure • Have your questions answered by a licensed dentist • Learn all about dental health for children, from baby’s first tooth to dental emergencies • Evaluate your risk for oral cancer, periodontal disease and tooth decay

Benefit Exclusions Like any coverage, this dental coverage does have some exclusions.

• The plan does not cover services started before coverage begins or after it ends. Benefits are limited to appropriate and necessary procedures listed in the summary plan description. Benefits are not payable for duplication of services. Covered expenses will not exceed the summary plan description’s usual and customary allowances.

• Plan benefits are not payable for a condition that is covered under Workers’ Compensation or a similar law; that occurs during the course of employment or military service or involvement in an illegal occupation, felony, or riot; or that results from a self-inflicted injury.

• In certain situations, there may be more than one method of treating a dental condition. This summary plan description includes an alternative benefits provision that may reduce benefits to the lowestcost, generally effective, and necessary form of treatment.

• Certain conditions, such as age and frequency limitations, may impact your coverage. See the summary plan description for details.

A complete list of benefit exclusions is included in the summary plan description.

Covered Family Members When you choose coverage for yourself, you can also provide coverage for: • Your spouse or domestic partner.

• Unmarried dependent children, up to age 26.

Dental Rate

Here’s how little you pay with group rates.

As a Kemp Independent School District employee, you can take advantage of this dental coverage for less than $0.95 a day.

Plus, you can add loved ones to the plan for just a little more.

Your estimated cost is itemized below.

Coverage

Monthly Rate

Employee only

$28.62

Employee & spouse/domestic partner

$57.78

Employee & child/children

$55.62

Employee & family

$85.86 38

Vision Plan Benefits for Kemp ISD Co-Pays

Exam Materials

$10 $25

Monthly Premiums

Services/Frequency

Emp. only $7.51 Emp. + 1 dependent $12.80 Emp. + family $18.82

Exam Frame Lenses Contact Lenses

12 months 12 months 12 months 12 months

(Based on date of service)

Benefits through Superior Select Southwest Network Exam Frames Lenses (standard) per pair Single Vision Bifocal Trifocal Progressive Lenticular Contact Lenses2 Medically Necessary Contact Lenses

In-Network

Out-of-Network

Covered in full Covered in full Covered in full 1 See description Covered in full $125 retail allowance Covered in full

Up to $25 retail Up to $40 retail Up to $45 retail Up to $45 retail Up to $80 retail Up to $65 retail Up to $125 retail

Covered in full $100 retail allowance

Up to $35 retail Up to $55 retail

Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements 1 Covered to provider’s in-office standard retail lined trifocal amount; member pays difference between progressive and standard retail lined trifocal, plus applicable co-pay 2 Contact lenses and related professional services (fitting, evaluation and follow-up) are covered in lieu of eyeglass lenses and frames benefit

Discount Features Non-Covered Eyewear Discount: Members may also receive a discount of 20% from a participating provider’s usual and customary fees for eyewear purchases which exceed the benefit coverage (except disposable contact lenses, for which no discount applies). This includes eyeglass frames which exceed the selected benefit coverage, specialty lenses (i.e. progressives) and lens “extras” such as tints and coatings. Eyewear purchased from a Walmart Vision Center does not qualify for this additional discount because of Walmart’s “Always Low Prices” policy.

SuperiorVision.com Customer Service 800.507.3800

.

The Plan discount features are not insurance.

All allowances are retail; the member is responsible for paying the provider directly for all non-covered items and/or any amount over the allowances, minus available discounts. These are not covered by the plan.

Discounts are subject to change without notice.

Disclaimer: All final determinations of benefits, administrative duties, and definitions are governed by the Certificate of Insurance for your vision plan.

Please check with your Human Resources department if you have any questions

Superior Vision of Texas P.O. Box 967 Rancho Cordova, CA 95741 800.507.3800 SuperiorVision.com 0417-BSv2/TX

39

Kemp Independent School District provides this valuable benefit at no cost to you.

Full-Time Employees

Term Life and AD&D Insurance Safeguard the most important people in your life.

Think about what your loved ones may face after you’re gone. Term life insurance can help them in so many ways, like covering everyday expenses, paying off debt, and protecting savings. AD&D provides even more coverage if you die or suffer a covered loss in an accident.

AT A GLANCE: • A cash benefit of $15,000 to your loved ones in the event of your death, plus a matching cash benefit if you die in an accident • A cash benefit to you if you suffer a covered loss in an accident, such as losing a limb or your eyesight • LifeKeys® services, which provide access to counseling, financial, and legal support • TravelConnect® services, which give you and your family access to emergency medical assistance when you're on a trip 100+ miles from home ADDITIONAL DETAILS Conversion: You can convert your group term life coverage to an individual life insurance policy without providing evidence of insurability if you lose coverage due to leaving your job or for another reason outlined in the plan contract. AD&D benefits cannot be converted.

Benefit Reduction: Coverage amounts begin to reduce at age 70 and benefits terminate at retirement. See the plan certificate for details.

For complete benefit descriptions, limitations, and exclusions, refer to the certificate of coverage.

This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater detail. Refer to your certificate for your maximum benefit amounts. Should there be a difference between this summary and the contract, the contract will govern.

LifeKeys® services are provided by ComPsych® Corporation, Chicago, IL. ComPsych®, EstateGuidance® and GuidanceResources® are registered trademarks of ComPsych® Corporation. TravelConnect® services are provided by On Call International, Salem, NH. ComPsych® and On Call International are not Lincoln Financial Group® companies. Coverage is subject to actual contract language. Each independent company is solely responsible for its own obligations.

Insurance products (policy series GL1101) are issued by The Lincoln National Life Insurance Company (Fort Wayne, IN), which does not solicit business in New York, nor is it licensed to do so. Product availability and/or features may vary by state. Limitations and exclusions apply. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Affiliates are separately responsible for their own financial and contractual obligations. Limitations and exclusions apply.

40

Full-Time Employees of Kemp Independent School District Benefits At-A-Glance Voluntary Term Life and AD&D Insurance

The Lincoln Term Life and AD&D Insurance Plan: • Provides a cash benefit to your loved ones in the event of your death • Provides an additional cash benefit to your loved ones if you die — or to you if you lose a limb or your eyesight — in a covered accident • Features group rates for Kemp Independent School District employees • Includes LifeKeys® services, which provide access to counseling, financial, and legal

Employee Newly hired employee guaranteed coverage amount Continuing employee guaranteed coverage annual increase amount Maximum coverage amount Minimum coverage amount AD&D coverage amount

$150,000 Choice of $10,000 or $20,000 5 times your annual salary ($500,000 maximum in increments of $10,000) $10,000 Equal to the life insurance amount chosen

Spouse / Domestic Partner Newly hired employee guaranteed coverage amount Continuing employee guaranteed coverage annual increase amount Maximum coverage amount Minimum coverage amount AD&D coverage amount

$30,000 Choice of $5,000 or $10,000 50% of the employee coverage amount ($250,000 maximum in increments of $5,000) $5,000 Equal to the life insurance amount chosen

Dependent Children 6 months to age 26 guaranteed coverage amount Age 14 days to 6 months guaranteed coverage amount

support services • Also includes TravelConnect® services, which give you and your family access to emergency medical assistance when you’re on a trip 100+ miles from home 41

$10,000 $250

What your benefits cover Employee Coverage

Guaranteed Life and AD&D Insurance Coverage Amount • Initial Open Enrollment: When you are first offered this coverage, you can choose a coverage amount up to $150,000 without providing evidence of insurability.

• Annual Limited Enrollment: If you are a continuing employee, you can increase your coverage amount by $10,000 or $20,000 without providing evidence of insurability . If you submitted evidence of insurability in the past and were declined for medical reasons, you may be required to submit evidence of insurability.

• If you decline this coverage now and wish to enroll later, evidence of insurability may be required and may be at your own expense.

• You can increase this amount by up to $20,000 during the next limited open enrollment period.

Maximum Life Insurance Coverage Amount • You can choose a coverage amount up to 5 times your annual salary ($500,000 maximum) with evidence of insurability.

See the Evidence of Insurability page for details.

• Your coverage amount will reduce by 50% when you reach age 70 Spouse / Domestic Partner Coverage - You can secure term life and AD&D insurance for your spouse / domestic partner if you select coverage for yourself.

Guaranteed Life and AD&D Insurance Coverage Amount • Initial Open Enrollment: When you are first offered this coverage, you can choose a coverage amount up to 50% of your coverage amount ($30,000 maximum) for your spouse / domestic partner without providing evidence of insurability.

• Annual Limited Enrollment: If you are a continuing employee, you can increase the coverage amount for your spouse / domestic partner by $5,000 or $10,000 without providing evidence of insurability. If you submitted evidence of insurability in the past and were declined for medical reasons, you may be required to submit evidence of insurability.

• If you decline this coverage now and wish to enroll later, evidence of insurability may be required and may be at your own expense.

• You can increase this amount by up to $10,000 during the next limited open enrollment period.

Maximum Life Insurance Coverage Amount • You can choose a coverage amount up to 50% of your coverage amount ($250,000 maximum) for your spouse / domestic partner with evidence of insurability.

Dependent Children Coverage - You can secure term life insurance for your dependent children when you choose coverage for yourself.

Guaranteed Life Insurance Coverage Options: $10,000

42

Additional Plan Benefits Accelerated Death Benefit

Included

Premium Waiver

Included

Conversion

Included

Portability

Included

Seat Belt & Airbag

Included with AD&D

Common Carrier

Included with AD&D

Benefit Exclusions Like any insurance, this term life and AD&D insurance policy does have exclusions.

For life insurance, a suicide exclusion may apply.

For AD&D, benefits will not be paid if death results from suicide, or death/dismemberment occurs while: • Inflicting or attempting to inflict injury to one’s self • Participating in a riot or as a result of war or act of war • Serving as a member of the military, including the Reserves and National Guard • Committing or attempting to commit a felony • Deliberately inhaling gas (such as carbon monoxide) or using drugs other than those prescribed by a physician and administered as prescribed • Flying in a non-commercial airplane or aircraft, such as a balloon or glider • Driving while intoxicated (with a blood alcohol level of .08 grams or more per 100 milliliters of blood) In addition, the AD&D insurance policy does not cover sickness or disease, including the medical and surgical treatment of a disease.

A complete list of benefit exclusions is included in the policy. State variations apply.

43

Monthly Voluntary Life and AD&D Insurance Premium Here’s how little you pay with group rates.

0 - 24 25 - 29 30 - 34 35 - 39 40 - 44

Life & AD&D Premium Rate Factor 0.0000800 0.0000900 0.0001100 0.0001300 0.0001800

45 - 49 50 - 54 55 - 59 60 - 64 65 - 69 70 - 74 75 - 79 80 - 99

0.0002800 0.0004400 0.0007000 0.0008700 0.0014900 0.0024000 0.0036700 0.0036700

Employee Age Range

Group Rates for You The estimated monthly premium for life and AD&D insurance is determined by multiplying the desired amount of coverage (in increments of $10,000) by the employee age-range premium factor.

$____________ X coverage amount

___________ = $_______________ premium factor monthly premium

Note: Rates are subject to change and can vary over time.

Employee |Monthly Premiums for Select Life and AD&D Insurance Amounts Employee Age Range 0 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65 - 69 Employee Age Range 70 - 74 Employee Age Range 75 - 79 Employee Age Range 80 - 99

$10,000

$20,000

$30,000

$50,000

$60,000

$100,000

$150,000

$300,000

$500,000

$0.80 $0.90 $1.10 $1.30

$1.60 $1.80 $2.20 $2.60

$2.40 $2.70 $3.30 $3.90

$4.00 $4.50 $5.50 $6.50

$4.80 $5.40 $6.60 $7.80

$8.00 $9.00 $11.00 $13.00

$12.00 $13.50 $16.50 $19.50

$24.00 $27.00 $33.00 $39.00

$40.00 $45.00 $55.00 $65.00

$1.80 $2.80 $4.40 $7.00 $8.70 $14.90

$3.60 $5.60 $8.80 $14.00 $17.40 $29.80

$5.40 $8.40 $13.20 $21.00 $26.10 $44.70

$9.00 $14.00 $22.00 $35.00 $43.50 $74.50

$10.80 $16.80 $26.40 $42.00 $52.20 $89.40

$18.00 $28.00 $44.00 $70.00 $87.00 $149.00

$27.00 $42.00 $66.00 $105.00 $130.50 $223.50

$54.00 $84.00 $132.00 $210.00 $261.00 $447.00

$90.00 $140.00 $220.00 $350.00 $435.00 $745.00

$5,000

$10,000

$15,000

$25,000

$30,000

$50,000

$75,000

$150,000

$250,000

$12.00

$24.00

$36.00

$60.00

$72.00

$120.00

$180.00

$360.00

$600.00

$5,000

$10,000

$15,000

$25,000

$30,000

$50,000

$75,000

$150,000

$250,000

$18.35

$36.70

$55.05

$91.75

$110.10

$183.50

$275.25

$550.50

$917.50

$5,000

$10,000

$15,000

$25,000

$30,000

$50,000

$75,000

$150,000

$250,000

$18.35

$36.70

$55.05

$91.75

$110.10

$183.50

$275.25

$550.50

$917.50

44

0 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59

Life & AD&D Premium Rate Factor 0.0000800 0.0000900 0.0001100 0.0001300 0.0001800 0.0002800 0.0004400 0.0007000

60 - 64 65 - 69

0.0008700 0.0014900

Employee Age Range

Group Rates for Your Spouse / Domestic Partner

The estimated monthly premium for life and AD&D insurance is determined by multiplying the desired amount of coverage (in increments of $5,000) by the employee age-range premium factor.

$____________ X coverage amount

___________ = $_______________ premium factor monthly premium

Note: Rates are subject to change and can vary over time.

Spouse / Domestic Partner | Monthly Premiums for Select Life & AD&D Insurance Coverage Amounts Employee Age Range 0 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65 - 69

$5,000

$15,000

$25,000

$30,000

$50,000

$60,000

$75,000

$150,000

$250,000

$0.40 $0.45 $0.55 $0.65 $0.90 $1.40 $2.20 $3.50 $4.35 $7.45

$1.20 $1.35 $1.65 $1.95 $2.70 $4.20 $6.60 $10.50 $13.05 $22.35

$2.00 $2.25 $2.75 $3.25 $4.50 $7.00 $11.00 $17.50 $21.75 $37.25

$2.40 $2.70 $3.30 $3.90 $5.40 $8.40 $13.20 $21.00 $26.10 $44.70

$4.00 $4.50 $5.50 $6.50 $9.00 $14.00 $22.00 $35.00 $43.50 $74.50

$4.80 $5.40 $6.60 $7.80 $10.80 $16.80 $26.40 $42.00 $52.20 $89.40

$6.00 $6.75 $8.25 $9.75 $13.50 $21.00 $33.00 $52.50 $65.25 $111.75

$12.00 $13.50 $16.50 $19.50 $27.00 $42.00 $66.00 $105.00 $130.50 $223.50

$20.00 $22.50 $27.50 $32.50 $45.00 $70.00 $110.00 $175.00 $217.50 $372.50

Dependent Children Monthly Premium for Life Insurance Coverage Coverage Amount $10,000

Monthly Premium $1.00

Group Rates for Your Dependent Children

One affordable monthly premium covers all of your eligible dependent children.

Note: You must be an active Kemp Independent School District employee to select coverage for a spouse / domestic partner and/or dependent children. To be eligible for coverage, a spouse / domestic partner or dependent child cannot be confined to a health care facility or unable to perform the typical activities of a healthy person of the same age and gender.

45

Life Insurance Highlights

purelife-plus

For the employee Flexible Premium Life Insurance to Age 121 Policy Form PRFNG-NI-10

Voluntary permanent life insurance can be an ideal complement to the group term and optional term your employer might provide. This voluntary universal life product is yours to keep, even when you change jobs or retire, as long as you pay the necessary premium. Group and voluntary term, on the other hand, typically are not portable if you change jobs and, even if you can keep them after you retire, usually cost more and decline in death benefit.

The policy, purelife-plus, is underwritten by Texas Life Insurance Company, and it has the following features: •

High Death Benefit. With one of the highest death benefits available at the worksite,1 purelife-plus gives your loved ones peace of mind.

•

Minimal Cash Value. Designed to provide a high death benefit at a reasonable premium, purelife-plus provides peace of mind for you and your beneficiaries while freeing investment dollars to be directed toward such tax-favored retirement plans as 403(b), 457 and 401(k).

•

Long Guarantees.2 Enjoy the assurance of a policy that has a guaranteed death benefit to age 121 and level premium that guarantees coverage for a significant period of time.3

•

Refund of Premium. Unique in the marketplace, purelife-plus offers you a refund of 10 years’ premium, should you surrender the policy if the premium you pay when you buy the policy ever increases. (Conditions apply.)

•

Accelerated Death Benefit Due to Terminal Illness Rider. Should you be diagnosed as terminally ill with the expectation of death within 12 months, you will have the option to receive 92% of the death benefit, minus a $150 ($100 in Florida) administrative fee. This valuable living benefit gives you peace of mind knowing that, should you need it, you can take the large majority of your death benefit while still alive. (Conditions apply.) (Form ICC07-ULABR-07 or Form Series ULABR-07) You may apply for this permanent, portable coverage, not only for yourself, but also for your spouse, children and grandchildren by answering just 3 questions: 4 During the last six months, has the proposed insured: a. Been actively at work on a full time basis, performing usual duties? b. Been absent from work due to illness or medical treatment for a period of more than five consecutive working days? c. Been disabled or received tests, treatment or care of any kind in a hospital or nursing home or received chemotherapy, hormonal therapy for cancer, radiation therapy, dialysis treatment, or treatment for alcohol or drug abuse?

Like most life insurance policies, Texas Life policies contain certain exclusions, limitations, exceptions, and terms for keeping them in force. Please contact a Texas Life representative for costs and complete details.

Voluntary Whole and Universal Life Products, Eastbridge Consulting Group, December 2015 2 Guarantees are subject to product terms, exclusions and limitations and the insurer’s claims-paying ability and financial strength.

3 After the guaranteed period, premiums may go down, stay the same, or go up.

4 Texas Life complies with all state laws regarding marriages, domestic and civil union partnerships, and legally recognized familial relationships. Accordingly, we will treat each party to a civil union or domestic partnership that is recognized and valid under applicable state law as a spouse. Coverage not available on children and grandchildren in Washington.

1

See the purelife-plus brochure for details.

Texas Life is licensed to do business in the District of Columbia and every state but New York.

18M007-C 1006 (exp1219)

46

purelife-plus is not available in NJ, NY or PA.

monthly p r e m i u m s PureLife-plus — Standard Risk Table Premiums — Non-Tobacco — Express Issue GUARANTEED

Monthly Premiums for Life Insurance Face Amounts Shown

PERIOD

Age to Which

cco

Issue Age

10.05 10.35 10.80 11.25 12.00 12.75 13.80 15.00 16.05 17.10 18.15 19.35 20.40 21.45 22.80 24.30 26.10 28.05 29.55 31.05 32.70 34.20 36.00 37.65 39.45 41.70 43.65 46.05 48.45 51.00 53.85

$25,000 9.25 9.50 9.75 10.00 10.25 10.25 10.50 10.75 11.00 11.50 11.75 12.00 12.25 13.00 13.50 14.25 15.25 15.75 16.50 17.25 18.50 19.75 21.50 23.50 25.25 27.00 28.75 30.75 32.50 34.25 36.50 39.00 42.00 45.25 47.75 50.25 53.00 55.50 58.50 61.25 64.25 68.00 71.25 75.25 79.25 83.50 88.25

$40,000

$50,000

$75,000

$100,000

$125,000

$150,000

15.05 15.45 15.85 16.25 17.05 17.45 17.85 18.25 19.45 20.25 21.45 23.05 23.85 25.05 26.25 28.25 30.25 33.05 36.25 39.05 41.85 44.65 47.85 50.65 53.45 57.05 61.05 65.85 71.05 75.05 79.05 83.45 87.45 92.25 96.65 101.45 107.45 112.65 119.05 125.45 132.25 139.85

18.25 18.75 19.25 19.75 20.75 21.25 21.75 22.25 23.75 24.75 26.25 28.25 29.25 30.75 32.25 34.75 37.25 40.75 44.75 48.25 51.75 55.25 59.25 62.75 66.25 70.75 75.75 81.75 88.25 93.25 98.25 103.75 108.75 114.75 120.25 126.25 133.75 140.25 148.25 156.25 164.75 174.25

26.25 27.00 27.75 28.50 30.00 30.75 31.50 32.25 34.50 36.00 38.25 41.25 42.75 45.00 47.25 51.00 54.75 60.00 66.00 71.25 76.50 81.75 87.75 93.00 98.25 105.00 112.50 121.50 131.25 138.75 146.25 154.50 162.00 171.00 179.25 188.25 199.50 209.25 221.25 233.25 246.00 260.25

34.25 35.25 36.25 37.25 39.25 40.25 41.25 42.25 45.25 47.25 50.25 54.25 56.25 59.25 62.25 67.25 72.25 79.25 87.25 94.25 101.25 108.25 116.25 123.25 130.25 139.25

42.25 43.50 44.75 46.00 48.50 49.75 51.00 52.25 56.00 58.50 62.25 67.25 69.75 73.50 77.25 83.50 89.75 98.50 108.50 117.25 126.00 134.75 144.75 153.50 162.25 173.50

50.25 51.75 53.25 54.75 57.75 59.25 60.75 62.25 66.75 69.75 74.25 80.25 83.25 87.75 92.25 99.75 107.25 117.75 129.75 140.25 150.75 161.25 173.25 183.75 194.25 207.75

oba

9.25 9.95 10.75 11.45 12.15 12.85 13.65 14.35 15.05 15.95 16.95 18.15 19.45 20.45 21.45 22.55 23.55 24.75 25.85 27.05 28.55 29.85 31.45 33.05 34.75 36.65 38.75 41.05 43.55 46.05 48.65

$15,000

n-T

$10,000

No

(ALB) 15D-1 2-4 5-8 9-10 11-16 17-20 21-22 23 24-25 26 27-28 29 30-31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70

Coverage is Guaranteed at Table Premium 81 80 79 79 77 75 74 75 74 75 74 74 73 74 74 75 76 76 77 77 78 79 80 81 82 83 83 84 84 85 85 86 87 88 88 88 89 89 89 89 89 90 90 90 90 90 90 90 91 91 91 91

PureLife-plus is permanent life insurance to Attained Age 121 that can never be cancelled as long as you pay the necessary premiums. After the Guaranteed Period, the premiums can be lower, the same, or higher than the Table Premium. See the brochure under ”Permanent Coverage”.

Form: 21M013-ICC EXP-A-M-1LO

47

monthly p r e m i u m s PureLife-plus — Standard Risk Table Premiums — Tobacco — Express Issue GUARANTEED

Monthly Premiums for Life Insurance Face Amounts Shown

PERIOD

Age to Which Issue

Coverage is

Age

Guaranteed at

14.15 15.05 16.15 17.55 18.25 19.25 20.05 21.05 21.95 23.25 24.35 25.45 27.05 28.45 29.75 31.15 32.75 34.35 36.05 37.75 39.55 41.85 44.05 46.25 48.45 50.85 53.45 56.25 59.15 62.25 65.55

$25,000

$40,000

$50,000

$75,000

$100,000

$125,000

$150,000

15.30 15.75 16.80 17.25 18.45 20.10 21.45 23.10 25.20 26.25 27.75 28.95 30.45 31.80 33.75 35.40 37.05 39.45 41.55 43.50 45.60 48.00 50.40 52.95 55.50 58.20 61.65 64.95 68.25 71.55 75.15

15.25 16.00 16.75 17.25 17.75 18.25 18.50 21.00 21.75 22.00 22.25 24.00 24.75 26.50 27.25 29.25 32.00 34.25 37.00 40.50 42.25 44.75 46.75 49.25 51.50 54.75 57.50 60.25 64.25 67.75 71.00 74.50 78.50 82.50 86.75 91.00 95.50 101.25 106.75 112.25 117.75 123.75

23.05 24.25 25.45 26.25 27.05 27.85 28.25 32.25 33.45 33.85 34.25 37.05 38.25 41.05 42.25 45.45 49.85 53.45 57.85 63.45 66.25 70.25 73.45 77.45 81.05 86.25 90.65 95.05 101.45 107.05 112.25 117.85 124.25 130.65 137.45 144.25 151.45 160.65 169.45 178.25 187.05 196.65

28.25 29.75 31.25 32.25 33.25 34.25 34.75 39.75 41.25 41.75 42.25 45.75 47.25 50.75 52.25 56.25 61.75 66.25 71.75 78.75 82.25 87.25 91.25 96.25 100.75 107.25 112.75 118.25 126.25 133.25 139.75 146.75 154.75 162.75 171.25 179.75 188.75 200.25 211.25 222.25 233.25 245.25

41.25 43.50 45.75 47.25 48.75 50.25 51.00 58.50 60.75 61.50 62.25 67.50 69.75 75.00 77.25 83.25 91.50 98.25 106.50 117.00 122.25 129.75 135.75 143.25 150.00 159.75 168.00 176.25 188.25 198.75 208.50 219.00 231.00 243.00 255.75 268.50 282.00 299.25 315.75 332.25 348.75 366.75

54.25 57.25 60.25 62.25 64.25 66.25 67.25 77.25 80.25 81.25 82.25 89.25 92.25 99.25 102.25 110.25 121.25 130.25 141.25 155.25 162.25 172.25 180.25 190.25 199.25 212.25

67.25 71.00 74.75 77.25 79.75 82.25 83.50 96.00 99.75 101.00 102.25 111.00 114.75 123.50 127.25 137.25 151.00 162.25 176.00 193.50 202.25 214.75 224.75 237.25 248.50 264.75

80.25 84.75 89.25 92.25 95.25 98.25 99.75 114.75 119.25 120.75 122.25 132.75 137.25 147.75 152.25 164.25 180.75 194.25 210.75 231.75 242.25 257.25 269.25 284.25 297.75 317.25

o

$15,000

acc

$10,000

Tob

(ALB) 15D-1 2-4 5-8 9-10 11-16 17-20 21-22 23 24-25 26 27-28 29 30-31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70

Table Premium 81 80 79 79 77 71 71 72 71 72 71 71 72 72 72 71 72 72 73 73 74 76 77 78 80 80 81 81 82 82 83 83 83 84 85 85 85 85 86 86 86 86 86 87 87 87 87 88 88 88 88 89

PureLife-plus is permanent life insurance to Attained Age 121 that can never be cancelled as long as you pay the necessary premiums. After the Guaranteed Period, the premiums can be lower, the same, or higher than the Table Premium. See the brochure under ”Permanent Coverage”.

Form: 21M013-ICC EXP-A-M-1LO

48

Health Savings Accounts Maximize your savings

A Health Savings Account, or HSA, is a tax-advantaged savings account you can use for healthcare expenses. Along with saving you money on taxes, HSAs can help you grow your nest egg for retirement.

How an HSA works:

What’s covered?

• Contribute to your HSA by payroll deduction, online banking transfer or personal check.

You can use your HSA funds to pay for any IRS-qualified medical expenses, like doctor visits, hospital fees, prescriptions, dental exams, vision appointments, over-the-counter medications and more.

• P ay for qualified medical expenses for yourself, your spouse and your dependents. Both current and past expenses are covered if they’re from after you opened your HSA.

Visit hsabank.com/QME for a full list.

• U se your HSA Bank Health Benefits Debit Card to pay directly, or pay out of pocket for reimbursement or to grow your HSA funds.

Am I eligible for an HSA? You’re most likely eligible to open an HSA if:

• R oll over any unused funds year to year. It’s your money — for life.

• Y ou have a qualified high-deductible health plan (HDHP).

• Y ou’re not covered by any other non-HSA-compatible health plan, like Medicare Parts A and B.

• I nvest your HSA funds and potentially grow your savings.¹

• Y ou’re not covered by TriCare.

• N o one (other than your spouse) claims you as a dependent on their tax return.

49

How much can I contribute?

The IRS limits how much you can contribute to your HSA every year. This includes contributions from your employer, spouse, parents and anyone else.2

2023

Maximum contribution limit

2024

SINGLE PLAN

FAMILY PLAN

$3,850

$7,750

Maximum contribution limit

SINGLE PLAN

FAMILY PLAN

$4,150

$8,300

Catch-up contributions You may be eligible to make a $1,000 HSA catch-up contribution if you’re: • O ver 55.

• A n HSA accountholder.

• N ot enrolled in Medicare (if you enroll mid-year, annual contributions are prorated).

Triple tax savings A huge way that HSAs can benefit you is they let you save on taxes in three ways.

1

You don’t pay federal taxes on contributions to your HSA.3

2

Earnings from interest and investments are tax-free.

3

Distributions are tax free when used for qualified medical expenses.

¹ Investment accounts are not FDIC insured, may lose value and are not a deposit or other obligation of, or guarantee by the bank. Investment losses which are replaced are subject to the annual contribution limits of the HSA. 2 HSA contributions in excess of IRS limits are subject to penalty and tax unless the excess and earnings are withdrawn prior to the tax filing deadline as explained in IRS Publication 969.

3 F ederal tax savings are available regardless of your state. State tax laws may vary. Consult a tax professional for more information.

Visit www.hsabank.com or call the number on the back of your debit card for more information. © 2022 HSA Bank. HSA Bank is a division of Webster Bank, N.A., Member FDIC. Plan Administrative Services and Benefit Services are administered by Webster Servicing LLC. HSA_Overview_050522

50

-$3,000

$21,000

-$6,300

$14,700 $0

$14,700

Total Pre-tax Contributions

Taxable Income after FSA

Income Taxes

After-tax Income

After-tax Health and Welfare Expenses

Take-home Pay

$900

$1,500

Dependent Care FSA

You Saved

$1,500

$24,000

Health FSA

Annual Taxable Income

FSA

$0

$13,800

-$3,000

$16,800

-$7,200

$24,000

$0

$0

$0

$24,000

No FSA

How Much Can I Save with an FSA?

FSA Trifold, Print Version- FSAStore.indd 1

51

Salt Lake City, UT - Headquarters Dallas, TX | San Diego, CA | Honolulu, HI 800-274-0503 fsa@nbsbenefits.com

Visit fsa.nbsbenefits.com for more info or call one of our Benefit Specialists at 800-274-0503

Help Make Medical Costs Painless.

9/5/2019 1:46:27 PM

What is a Flexible Spending Account (FSA)?

A cafeteria plan enables you to save money on group insurance, healthcare expenses, and dependent care expenses. Your contributions are deducted from your paycheck by your employer before taxes are withheld. These deductions lower your taxable income which can save you up to 35% on income taxes!

What is a Cafeteria Plan?

Both are pre-tax benefits your employer offers through a cafeteria plan. Choose one or both — whichever is right for you.

A dependent care FSA works differently than a health FSA. Money only becomes available as it is contributed and can only be used for dependent care expenses.

Payroll deductions will then be made throughout the plan year to fund your account.

Psychiatrist/Psychologist

To take advantage of a health FSA, start by choosing an annual election amount. This amount will be available on day one of your plan year for eligible medical expenses.

Be conservative in the total amount you elect to avoid forfeiting money at the end of the plan year.

After the enrollment period ends, you may increase, decrease, or stop your contribution only when you experience a qualifying “change of status” (e.g. marriage, divorce, employment change, dependent change).

Enrollment Consideration

Prescribed OTC Medication

Shop FSA Store at fsastore.com/nbs

Get $10 off using code NBS1819.

9/5/2019 1:46:32 PM

From baby care to pain relief, shop the largest selection of guaranteed FSA-eligible products with zero guesswork at FSA Store. Is your health need FSA-eligible? Find out using our comprehensive Eligibility List.

Life’s not always flexible, but your money can be.

Get account information from our easy-to-use online portal and mobile app. See your account balance, contributions and account history in real time.

Laser Eye Surgery Eyeglasses, Contact Lenses, Lens Solution

Account access is easy

Our convenient NBS Smart Card allows you to avoid out-of-pocket expenses, cumbersome claim forms and reimbursement delays. You may also utilize the “pay a provider” option on our web portal.

Spending is easy

How to Spend

Eye Exams

Dental Work/Orthodontia

Vaccinations

Lab Fees

First-Aid Supplies

Chiropractor

Physical Therapy

Prescription Drugs

Medical/Dental/Vision Copays and Deductibles

Partial List of Eligible Expenses:

Two Types of FSAs

Flexible Spending Account (FSA)

FSA Trifold, Print Version- FSAStore.indd 2

52

What is a Dependent Care Assistance Program (DCAP)?

The Dependent Care Assistance Program (DCAP) allows you to use tax-free dollars to pay for child day care or elder day care expenses that you incur because you and your spouse are both gainfully employed.

To participate, determine the annual amount that you want to deduct from your paycheck before taxes.

The maximum amount you can elect depends on your federal tax filing status ($5,000 if you are married and filing a joint return or if you are a single parent, $2,500 if you are married but filing separately).

Your annual amount will be divided by the number of pay periods in the plan year and that amount will be deducted from each paycheck.

Who is an eligible dependent?

You can use the DCAP for expenses incurred for: • Your qualifying child who is age twelve or younger for whom you claim a dependency exemption on your income tax return.

•

Your qualifying relative (e.g. a child over twelve, your parent, a spouse’s parent) who is physically or mentally incapable of caring for himself or herself and has the same principal place of abode as you for more than half of the year.

•

Your spouse who is physically or mentally incapable of caring for himself or herself and has the same principal place of abode as you for more than half of the year.

Special Rule for Parents Who Are Divorced, Separated, or Living Apart Only the custodial parent can claim expenses from the DCAP. The custodial parent is generally the parent with whom the child resides for the greater number of nights during the calendar year.

Additionally, the custodial parent cannot be reimbursed from the DCAP for child-care expenses while the child lives with the non-custodial parent because such expenses are not incurred to enable the custodial parent to be gainfully employed.

What are eligible expenses for the DCAP? The expenses which are eligible for reimbursement must have been incurred during the plan year and in connection with you and your spouse to remain gainfully employed.

Examples of eligible expenses: •

Before and After School and/or Extended Day Programs

•

Daycare in your home or elsewhere so long as the dependent regularly spends at least 8 hours a day in your home.

•

Base cost of day camps or similar programs.

Examples of ineligible expenses: •

Schooling for a child in kindergarten or above

•

Babysitter while you go to the movies or out to eat

•

Cost of overnight camps

Salt Lake City, UT - Headquarters | Dallas, TX | San Diego, CA | Honolulu, HI (800) 274-0503 | service@nbsbenefits.com | www.nbsbenefits.com 53

What does it mean to be “gainfully employed”?

This means that you are working and earning an income (i.e. not doing volunteer work). You are not considered gainfully employed during paid vacation time or sick days. Gainful employment is determined on a daily basis.

If you are married, then your spouse would also need to be gainfully employed for your day care expenses to be eligible for reimbursement.

You are also considered gainfully employed if you are unemployed but actively looking for work, you are self-employed, you are physically or mentally not capable of self-care, or you are a full-time student (must attend for the number of hours that the school considers full-time, must have been a student for some part of each of 5 calendar months during the year, cannot be attending school only at night, does not include on-the-job training courses or correspondence schools).

What are some other important IRS regulations?

•

You cannot be reimbursed for dependent care expenses that were paid to (1) one of your dependents, (2) your spouse, or (3) one of your children who is under the age of nineteen.

•

In the event that you use a day care center that cares for more than six children, the center must be licensed.

•

You must provide the day care provider’s Social Security Number/Tax Identification Number (EIN) on form 2441 when you file your taxes.

What are some other important IRS regulations?

The IRS allows you to take a tax credit for your dependent care expenses. The tax credit may provide you with a greater benefit than the DCAP if you are in a lower tax bracket. To determine whether the tax credit or the DCAP is best for you, you will need to review your individual tax circumstances.

You cannot use the same expenses for both the tax credit and the DCAP, however, you may be able to coordinate the federal dependent care tax credit with participation in the DCAP for expenses not reimbursed through DCAP.

For more information, please call

1(800) 274-0503

Salt Lake City, UT - Headquarters Dallas, TX | San Diego, CA | Honolulu, HI www.nbsbenefits.com 800-274-0503 service@nbsbenefits.com

54

Notes