Mason ISD Benefits Book

D S I N O AS

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YOUR HEALTH YOUR FAMILY YOUR LIFE

BENEFITS

2022 ENROLLMENT GUIDE Employee Bene it

Services Group

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245 LANDA ST NEW BRAUNFELS, TX 78130 PHONE (830) 606-5100

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Know Your Benefits! Below is a summary of benefits offered through 0ISD. •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

• 6XSHULRU 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.

• +DUWIRUG Disability - Plan provides a monthly income to an individual that is disabled due to an accident or illness. This plan provides a week benemt for pre-exisWLng condiUJo ns for all new enrollees or increase in coverage.

• 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 0ISD.

• /LQFROQ Group Life - Group term life insurance that ends when you terminate employment with 0ISD. Coverage is also available for their spouses and dependent children.

• $3/ Cancer - Pays benefits for internal cancer diagnosis. Includes an annual cancer screening benefit. *XDUDQWHHG ,VVXH IRU DOO HPSOR\HHV 3UH H[LVWLQJ FRQGLWLRQV PD\ DSSO\

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ÄÙʽ½Ã Äã & YÝ INTRODUCTION

MID-YEAR CHANGES

ProvidŝŶŐ great beneĮt choices to you and your family is just ŽŶĞ ŽĨ ƚŚĞ ŵĂŶLJ ǁĂLJƐ /^ ůŽŽŬƐ ĂŌĞƌ ƚŚĞ ŚĞĂůƚŚ ĂŶĚ ĮŶĂŶcial welfare of the people who make our district work so well. KƵƌ ŐŽĂů Ăƚ /^ ŝƐ ƚŽ ƉƌŽǀŝĚĞ LJŽƵ ǁŝƚŚ ĂŶ ĂƌƌĂLJ ŽĨ ďĞŶĞĮƚ ŽƉƟŽŶƐ ƚŚĂƚ ǁŝůů ŵĞĞƚ LJŽƵƌ ƉĞƌƐŽŶĂů ŶĞĞĚƐ ĂƐ ƉĂƌƚ ŽĨ LJŽƵƌ ƚŽƚĂů ĐŽŵƉĞŶƐĂƟŽŶ ĂŶĚ ƌĞǁĂƌĚƐ͘

dŚĞ ďĞŶĞĮƚƐ LJŽƵ ĐŚŽŽƐĞ ǁŝůů ƌĞŵĂŝŶ ŝŶ ĞīĞĐƚ ƚŚƌŽƵŐŚŽƵƚ ƚŚĞ ƉůĂŶ LJĞĂƌ ;ĨƌŽŵ ^ĞƉƚĞŵďĞƌ ϭ Ͳ ƵŐƵƐƚ ϯϭͿ͘ zŽƵ ŵĂLJ ŽŶůLJ ĂĚĚ or cancel coverage during the year if you have a qualifying change in the family or employment status that causes you to ŐĂŝŶ Žƌ ůŽƐĞ ĞůŝŐŝďŝůŝƚLJ ĨŽƌ ďĞŶĞĮƚƐ͘ YƵĂůŝĨLJŝŶŐ ĐŚĂŶŐĞƐ ŵĂLJ include: • ĐŚĂŶŐĞ ŝŶ LJŽƵƌ ůĞŐĂů ŵĂƌŝƚĂů ƐƚĂƚƵƐ • ĐŚĂŶŐĞ ŝŶ LJŽƵƌ ŶƵŵďĞƌ ŽĨ ĚĞƉĞŶĚĞŶƚƐ ĂƐ Ă ƌĞƐƵůƚ ŽĨ ďŝƌƚŚ͕ ĂĚŽƉƟŽŶ͕ ůĞŐĂů ĐƵƐƚŽĚLJ͕ Žƌ ŝĨ LJŽƵƌ ĚĞƉĞŶĚĞŶƚ ĐŚŝůĚ ƐĂƟƐĮĞƐ Žƌ ĐĞĂƐĞƐ ƚŽ ƐĂƟƐĨLJ ĞůŝŐŝďŝůŝƚLJ ƌĞƋƵŝƌĞŵĞŶƚƐ ĨŽƌ ĐŽǀĞƌĂŐĞ͕ Žƌ ƚŚĞ ĚĞĂƚŚ ŽĨ Ă ĚĞƉĞŶĚĞŶƚ ĐŚŝůĚ Žƌ ƐƉŽƵƐĞ • ĐŚĂŶŐĞ ŝŶ ĞŵƉůŽLJŵĞŶƚ ƐƚĂƚƵƐ ĨŽƌ LJŽƵ Žƌ LJŽƵƌ ƐƉŽƵƐĞ • Loss or gain of eligibility for other insurance (including ,/W Θ DĞĚŝĐĂŝĚͿ

HOW DO I ENROLL? Visit ǁǁǁ͘ŵLJďĞŶĞĮƚƐŚƵď͘ĐŽŵͬŵĂƐŽŶŝƐĚ h^ ZE D ͗ ŶƚĞƌ ƚŚĞ ĮƌƐƚ ϲ ůĞƩĞƌƐ ŽĨ LJŽƵƌ ůĂƐƚ ŶĂŵĞ͕ ĨŽůůŽǁĞĚ ďLJ ƚŚĞ ĮƌƐƚ ůĞƩĞƌ ŽĨ LJŽƵƌ ĮƌƐƚ ŶĂŵĞ͕ ĂŶĚ ƚŚĞŶ ƚŚĞ last 4 digits of your SSN. (EX: John Sanderson SSN: dždždžͲdždžͲϭϮϯϰ h^ ZE D ͗ ƐĂŶĚĞƌũϭϮϯϰͿ W ^^tKZ ͗ Complete last name (excluding any special ĐŚĂƌĂĐƚĞƌƐ Žƌ ƐƉĂĐĞƐͿ ĨŽůůŽǁĞĚ ďLJ ƚŚĞ ůĂƐƚ ϰ ĚŝŐŝƚƐ ŽĨ LJŽƵƌ ^^E͘ ; dž͗ ƐĂŶĚĞƌƐŽŶϭϮϯϰͿ

zŽƵ ŵƵƐƚ ŶŽƟĨLJ ƚŚĞ D ^KE /^ ĞŶĞĨŝƚ KĸĐĞ ŽĨ ƚŚĞ ƌĞƋƵĞƐƚĞĚ ĐŚĂŶŐĞ ǁŝƚŚŝŶ ϯϬ ĐĂůĞŶĚĂƌ ĚĂLJƐ ŽĨ ƚŚĞ ĐŚĂŶŐĞ ŝŶ ƐƚĂƚƵƐ͘ dŚĞƌĞ ĂƌĞ ŶŽ ĞdžĐĞƉƟŽŶƐ ƚŽ ƚŚŝƐ ƌƵůĞ͘

WHO IS ELIGIBLE? WHEN WILL I RECEIVE ID CARDS?

• zŽƵ ĂƌĞ ĞůŝŐŝďůĞ ƚŽ ĞŶƌŽůů ŝŶ ƚŚĞ D/^ ĞŶĞĮƚƐ WƌŽŐƌĂŵ ŝĨ LJŽƵ ĂƌĞ Ă ƌĞŐƵůĂƌ ĞŵƉůŽLJĞĞ ǁŽƌŬŝŶŐ Ăƚ ůĞĂƐƚ ϭϱ ŚŽƵƌƐ ƉĞƌ ǁĞĞŬ ŝŶ Ă ƉĞƌŵĂŶĞŶƚ ƉŽƐŝƟŽŶ͘ • ůů ŽƚŚĞƌ ĞŵƉůŽLJĞĞ͕ ƚŽ ŝŶĐůƵĚĞ ƐƵďƐƟƚƵƚĞƐ͕ ǁŚŽ ǁŽƌŬ ůĞƐƐ ƚŚĂŶ ϭϱ ŚŽƵƌƐ ƉĞƌ ǁĞĞŬ͕ ĂƌĞ ĞůŝŐŝďůĞ ƚŽ ĞŶƌŽůů ŝŶ ŵĞĚŝĐĂů insurance at full cost.

Everyone enrolled in Medical will receive a new Medical Card. ŶƌŽůůĞĚ ƉĂƌƟĐŝƉĂŶƚ ǁŝůů ƌĞĐĞŝǀĞ ĞŶƚĂů͕ ,^ ĂŶĚ &^ ĐĂƌĚƐ ƉƌŝŽƌ ƚŽ ƚŚĞ ĞīĞĐtiǀĞ ĚĂƚĞ ŽĨ ƚŚĞ ŶĞǁ ĐŽǀĞƌĂŐĞ͘ &Žƌ ŵŽƐƚ ƉůĂŶƐ͕ LJŽƵ ĐĂŶ ůŽŐŝŶ ƚŽ ƚŚĞ ĐĂƌƌŝĞƌ ǁĞďƐŝƚĞ ĂŶĚ ƉƌŝŶƚ Ă ƚĞŵƉŽrary ID card or give your provider the insurance company’s phone number to call and verify your coverage if you do not have an ID card at the time of service.

WHO IS AN ELIGIBLE DEPENDENT? • zŽƵƌ ůĞŐĂů ƐƉŽƵƐĞ • ŚŝůĚƌĞŶ ƵŶĚĞƌ ƚŚĞ ĂŐĞ ŽĨ Ϯϲ͕ LJŽƵƌƐ KZ LJŽƵƌ ƐƉŽƵƐĞ͛Ɛ • Dependent children of any age who are disabled • Children under your legal guardianship

WHO DO I CONTACT WITH QUESTIONS? &Žƌ ƋƵĞƐƟŽŶƐ͕ LJŽƵ ĐĂŶ ĐŽŶƚĂĐƚ LJŽƵƌ dW

tŚĞŶ ĂĚĚŝŶŐ ĚĞƉĞŶĚĞŶƚƐ ĨŽƌ ƚŚĞ ĮƌƐƚ ƟŵĞ͕ ƉůĞĂƐĞ ƉƌŽǀŝĚĞ͕ ĚĂƚĞ ŽĨ ďŝƌƚŚ͕ ŐĞŶĚĞƌ ĂŶĚ ƐŽĐŝĂů ƐĞĐƵƌŝƚLJ ŶƵŵďĞƌ͘

^ŚĞƌƌLJ ^ŬŝĚŵŽƌĞ KĸĐĞ͗ ;ϴϯϬͿ ϲϬϲͲϱϭϬϬ Email: ƐƐŬŝĚŵŽƌĞ@ƵƐĞďƐŐ.ĐŽŵ

NEW HIRE ENROLLMENT KŶůŝŶĞ ďĞŶĞĮƚ ĞŶƌŽůůŵĞŶƚ ŵƵƐƚ ďĞ ĐŽŵƉůĞƚĞĚ ǁŝƚŚŝŶ ϯϬ ĚĂLJƐ ŽĨ LJŽƵƌ ƐƚĂƌƚ ĚĂƚĞ͘ ůĞĐƚĞĚ ďĞŶĞĮƚƐ ǁŝůů ƚĂŬĞ ĞīĞĐƚ ŽŶ ƚŚĞ ϭƐƚ of the following month.

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ŶƌŽůůŵĞŶƚ /ŶƐƚƌƵĐƚŝŽŶƐ ĨŽƌ d, ďĞŶĞĨŝƚƐ,h Site Access͗ To access your employer online enrollment site, d, ďĞŶĞĨŝƚƐ,h , you can ůŽŐŝŶ ƚŽ ƚŚĞ ĨŽůůŽǁŝŶŐ ǁebsite ǁǁǁ͘ŵLJďĞŶĞĨŝƚƐŚƵď͘ĐŽŵͬŵĂƐŽŶŝƐĚ͘

hƐĞƌŶĂŵĞ͗ dŚĞ ĨŝƌƐƚ Ɛŝdž ;ϲͿ ĐŚĂƌĂĐƚĞƌƐ ŽĨ LJŽƵƌ ůĂƐƚ ŶĂŵĞ͕ ĨŽůůŽǁĞĚ ďLJ ƚŚĞ ĨŝƌƐƚ ůĞƚƚĞƌ ŽĨ LJŽƵƌ ĨŝƌƐƚ ŶĂŵĞ͕ ĨŽůůŽǁĞĚ ďLJ ƚŚĞ ůĂƐƚ ĨŽƵƌ ;ϰͿ ĚŝŐŝƚƐ ŽĨ LJŽƵƌ ^^E͗ džĂŵƉůĞ͗ mployee Eame Ͳ Robert Smith, SS# 123-45-6789

User Name: smithƌ6789

Default Password͗ ŽŵƉůĞƚĞ >ĂƐƚ EĂŵĞ ; džĐůƵĚŝŶŐ WƵŶĐƚƵĂƚŝŽŶͿ ĨŽůůŽǁ ďLJ ƚŚĞ ůĂƐƚ ĨŽƵƌ ;ϰͿ ĚŝŐŝƚƐ ĨŽƌ LJŽƵƌ ^^E Password ZĞƐĞƚ͗ ŵƉůŽLJĞĞƐ ǁŝůů ƉƌŽŵƉƚĞĚ ƚŽ ƵƉĚĂƚĞ ƚŚĞ password once you enter the site.

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CONTACT INFORMATION 202 -202 If you should have any questions regarding your supplemental benefits, please contac US Employee Benefits at 830-606-5100. For questions regarding TRS, please contact the district or TRS directly.

TABLE OF CONTENTS

DENTAL - Lincoln Financial .................................................................................... PAGE(S) 7-14 Phone: 1-800-423-2765 Website: www.lfg.com

VISION - Superior Vision ............................................................................................. PAGE(S) 15 Phone: 1-800-507-3800 Website: www.superiorvision.com

DISABILITY - The Hartford .................................................................................... PAGE(S) 16-19 Phone: 1-800-523-2233 Website: www.thehartford.com

INDIVIDUAL LIFE INSURANCE - Texas Life Insurance ....................................... PAGE(S) 20-23 Phone: 1-800-283-9233 Website: www.texaslife.com

VOLUNTARY LIFE AND AD&D INSURANCE - /LQFROQ )LQDQFLDO.......................... PAGE(S) 24-26 Phone: 1-8 - Website: www.OIJ.com

CANCER - American Public Life ........................................................................... PAGE(S) 27-30 Phone: 1-800-256-8606 Website: www.ampublic.com

CRITICAL ILLNESS - The Hartford ....................................................................... PAGE(S) 35-36 Phone: 1-800-523-2233 Website: www.thehartford.com

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CONTACT INFORMATION 202 -202

HOSPITAL INDEMNITY - The Hartford .................................................................. PAGE(S) 37-40 Phone: 1-800-523-2233 Website: www.thehartford.com

MEDICAL TRANSPORTATION - MASA ................................................................. PAGE(S) 41-42 Phone: 1-800-423-3226 Website: www.masamts.com

TELEMEDICINE - 1.800MD .................................................................................... PAGE(S) 43-44 Phone: 1-800-530-8666 Website: www.1800MD.com

IDENTITY THEFT PROTECTION - ID Watchdog ................................................... PAGE(S) 45-46 Phone: 1-866-513-1518 Website: www.idwatchdog.com

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All Full-Time Employees Electing the High Plan of Mason ISD Benefits At-A-Glance

Dental Insurance

High Option The Lincoln DentalConnect® PPO Plan: x Covers many preventive, basic, and major dental care services x Also covers orthodontic treatment for children x Features group coverage for Mason ISD employees x Allows you to choose any dentist you wish, though you can lower your out-of-pocket costs by selecting a contracting dentist x Does not make you and your loved ones wait six months between routine cleanings

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

$1,500

$1,500

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): $800 ●Rollover Amount: $350 per calendar year ●Rollover Amount with Preferred Provider: $500 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

There are no benefit waiting periods for any service types

Visit LincolnFinancial.com/FindADentist You can search by: ●Location ●Dentist name or office name ●Distance you are willing to travel ●Specialty, language and more Your search will automatically provide up to 100 dentists that most closely match your criteria. If your search does not locate the dentist you prefer, you can nominate one—just click the Nominate a Dentist link and complete the online form.

The Lincoln National Life Insurance Company 7

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 Other dental X-rays (including periapical films) Routine cleanings Fluoride treatments Space maintainers for children Sealants Palliative treatment (including emergency relief of dental pain) Basic Services Problem focused exams Injections of antibiotics and other therapeutic medications Fillings Simple extractions General anesthesia and I.V. sedation Major Services Consultations Prefabricated stainless steel and resin crowns Surgical extractions Oral surgery Biopsy and examination of oral tissue (including brush biopsy) 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-ofpocket costs are likely to be lower when you choose a contracting dentist. For example, if you need a crown…

Dental Coverage | At-A-Glance | High Option DTL-ENRO-BRC001-TX 8

50%

Benefit Exclusions

With the Lincoln Dental Mobile App

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

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

Lincoln DentalConnect® Online Health Center x Determine the average cost of a dental procedure x Have your questions answered by a licensed dentist x Learn all about dental health for children, from baby’s first tooth to dental emergencies x 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.

• Unmarried dependent children, up to age 26.

x 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. x 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. x 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. x 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. x Certain conditions, such as age and frequency limitations, may impact your coverage. See the summary plan description for details. x This plan includes continuation of coverage for employees with dental coverage from a previous employer. The member is required to complete the Continuity of Coverage form located on www.lfg.com. The form must be provided to us prior to the effective date to be eligible for continuation of coverage.

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

Questions? Call 800-423-2765 and mention Group ID: WTXMASOISD. This is not intended as a complete description of the coverage offered. Controlling provisions are provided in the summary plan description, and this summary does not modify coverage. A summary plan description will be made available to you that describes the benefits in greater detail.

Refer to your summary plan description for your maximum benefit amounts.

Lincoln DentalConnect® health center Web content is provided by go2dental.com, Santa Clara, CA. Go2dental.com is not a Lincoln Financial Group® company. Coverage is subject to actual summary plan description language. Each independent company is solely responsible for its own obligations.

The Lincoln National Life Insurance Company (Fort Wayne, IN), does not conduct business in New York, nor is it licensed to do so. In New York, business is conducted by Lincoln Life & Annuity Company of New York (Syracuse NY). Both are Lincoln Financial Group Companies.

©2020 Lincoln National Corporation LCN-2012491-013118 R 1.0 – Group ID: WTXMASOISD

Dental Coverage | At-A-Glance | High Option DTL-ENRO-BRC001-TX 9

Dental Rate Here’s how little you pay with grouprates.

As a Mason ISD employee, you can take advantage of this dental coverage for less than $1.11 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

$33.21

Employee & spouse

$63.49

Employee & child/children

$80.85

Employee & family

$111.22

The Lincoln National Life Insurance Company Please see prior page for product information.

Dental Coverage | Rate Calculation | High Option DTL-ENRO-BRC001-TX 10

All Full-Time Employees Electing the Low Plan of Mason ISD Benefits At-A-Glance

Dental Insurance

Low Option The Lincoln DentalConnect® PPO Plan: x Covers many preventive, basic, and major dental care services x Also covers orthodontic treatment for children x Features group coverage for Mason ISD employees x Allows you to choose any dentist you wish, though you can lower your out-of-pocket costs by selecting a contracting dentist x Does not make you and your loved ones wait six months between routine cleanings

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

$1,500

$1,500

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): $800 ●Rollover Amount: $350 per calendar year ●Rollover Amount with Preferred Provider: $500 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

There are no benefit waiting periods for any service types

Visit LincolnFinancial.com/FindADentist You can search by: ●Location ●Dentist name or office name ●Distance you are willing to travel ●Specialty, language and more Your search will automatically provide up to 100 dentists that most closely match your criteria. If your search does not locate the dentist you prefer, you can nominate one—just click the Nominate a Dentist link and complete the online form.

The Lincoln National Life Insurance Company 11

Contracting Dentists

Non-Contracting Dentists

90% No Deductible

90% No Deductible

Contracting Dentists

Non-Contracting Dentists

50% After Deductible

50% 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 Other dental X-rays (including periapical films) Routine cleanings Fluoride treatments Space maintainers for children Sealants Palliative treatment (including emergency relief of dental pain) Basic Services Problem focused exams Injections of antibiotics and other therapeutic medications Fillings Simple extractions General anesthesia and I.V. sedation Major Services Consultations Prefabricated stainless steel and resin crowns Surgical extractions Oral surgery Biopsy and examination of oral tissue (including brush biopsy) 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-ofpocket costs are likely to be lower when you choose a contracting dentist. For example, if you need a crown…

Dental Coverage | At-A-Glance | Low Option DTL-ENRO-BRC001-TX 12

50%

Benefit Exclusions

With the Lincoln Dental Mobile App

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

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

Lincoln DentalConnect® Online Health Center x Determine the average cost of a dental procedure x Have your questions answered by a licensed dentist x Learn all about dental health for children, from baby’s first tooth to dental emergencies x 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.

• Unmarried dependent children, up to age 26.

x 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. x 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. x 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. x 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. x Certain conditions, such as age and frequency limitations, may impact your coverage. See the summary plan description for details. x This plan includes continuation of coverage for employees with dental coverage from a previous employer. The member is required to complete the Continuity of Coverage form located on www.lfg.com. The form must be provided to us prior to the effective date to be eligible for continuation of coverage.

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

Questions? Call 800-423-2765 and mention Group ID: WTXMASOISD. This is not intended as a complete description of the coverage offered. Controlling provisions are provided in the summary plan description, and this summary does not modify coverage. A summary plan description will be made available to you that describes the benefits in greater detail.

Refer to your summary plan description for your maximum benefit amounts.

Lincoln DentalConnect® health center Web content is provided by go2dental.com, Santa Clara, CA. Go2dental.com is not a Lincoln Financial Group® company. Coverage is subject to actual summary plan description language. Each independent company is solely responsible for its own obligations.

The Lincoln National Life Insurance Company (Fort Wayne, IN), does not conduct business in New York, nor is it licensed to do so. In New York, business is conducted by Lincoln Life & Annuity Company of New York (Syracuse NY). Both are Lincoln Financial Group Companies.

©2020 Lincoln National Corporation LCN-2012491-013118 R 1.0 – Group ID: WTXMASOISD

Dental Coverage | At-A-Glance | Low Option DTL-ENRO-BRC001-TX 13

Dental Rate Here’s how little you pay with grouprates.

As a Mason ISD employee, you can take advantage of this dental coverage for less than $0.64 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

$19.14

Employee & spouse

$36.66

Employee & child/children

$46.51

Employee & family

$64.13

The Lincoln National Life Insurance Company Please see prior page for product information.

Dental Coverage | Rate Calculation | Low Option DTL-ENRO-BRC001-TX 14

Vision plan benefits for Mason ISD Copays

Services/frequency

Monthly premiums

Exam

$10

Emp. only

$7.80

Exam

12 months

Materials1

$25

12 months

$0

$15.46 $15.17

Frame

Contact lens fitting

Emp. + spouse Emp. + child(ren)

Contact lens fitting

12 months

Emp. + family

$22.95

Lenses

12 months

(standard & specialty)

Contact lenses

12 months

(based on date of service)

Benefits through Superior National network Exam (ophthalmologist) Exam (optometrist) Frames Contact lens fitting (standard2) Contact lens fitting (specialty2) Lenses (standard) per pair Single vision Bifocal Trifocal Progressives lens upgrade Factory scratch coat Contact lenses4

In-network

Out-of-network

Covered in full Covered in full $125 retail allowance Covered in full $50 retail allowance

Up to $42 retail Up to $37 retail Up to $68 retail Not covered Not covered

Covered in full Covered in full Covered in full See description3 Covered in full $120 retail allowance

Up to $32 retail Up to $46 retail Up to $61 retail Up to $61 retail Not covered Up to $100 retail

Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements 1 Materials co-pay applies to lenses and frames only, not contact lenses 2 Standard contact lens fitting applies to a current contact lens user who wears disposable, daily wear, or extended wear lenses only. Specialty contact lens fitting applies to new contact wearers and/or a member who wear toric, gas permeable, or multi-focal lenses.

3 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.

4 Contact lenses are in lieu of eyeglass lenses and frames benefit

Discount features

superiorvision.com

Look for providers in the provider directory who accept discounts, as some do not; please verify their services and discounts (range from 10%-30%) prior to service as they vary.

(800) 507-3800

Discounts on covered materials Frames: Lens options: Progressives:

20% off amount over allowance 20% off retail Discounts on non-covered exam, services and materials 20% off amount over retail lined trifocal Exams, frames, and prescription lenses: 30% off retail lens, including lens options Lens options, contacts, miscellaneous options: 20% off retail Specialty contact lens fit: 10% off retail, then apply allowance Disposable contact lenses: 10% off retail Retinal imaging: $39 maximum out-of-pocket Maximum member out-of-pocket The following options have out-of-pocket maximums5 on standard (not premium, brand, or progressive) lenses.

LASIK Scratch coat Ultraviolet coat Tints, solid or gradients Anti-reflective coat Polycarbonate High index 1.6 Photochromics 5

Single vision $13 $15 $25 $50 $40 $55 $80

Bifocal & trifocal $13 $15 $25 $50 20% off retail 20% off retail 20% off retail

Discounts and maximums may vary by lens type. Please check with your provider

Laser vision correction (LASIK) is a procedure that can reduce or eliminate your dependency on glasses or contact lenses. This corrective service is available to you and your eligible dependents at a special discount (20-50%) with your Superior Vision plan.

Contact QualSight LASIK at (877) 201-3602 for more information.

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 Services, Inc. P.O. Box 967 Rancho Cordova, CA 95741 (800) 507-3800 superiorvision.com The Superior Vision Plan is underwritten by National Guardian Life Insurance Company. National Guardian Life Insurance Company is not affiliated with The Guardian Life Insurance Company of America, AKA The Guardian or Guardian Life 15 NVIGRP 5-07 0420-BSv2/TX

BENEFIT HIGHLIGHTS FOR:

Mason Independent School District

EDUCATOR DISABILITY INSURANCE OVERVIEW What is Educator Disability Income Insurance?

Educator Disability insurance combines the features of a short-term and long-term disability plan into one policy. The coverage pays you a portion of your earnings if you cannot work because of a disabling illness or injury. The plan gives you the flexibility to choose a level of coverage to suit your need.

You have the opportunity to purchase Disability Insurance through your employer. This highlight sheet is an overview of your Disability Insurance. Once a group policy is issued to your employer, a certificate of insurance will be available to explain your coverage in detail.

Why do I need Disability Insurance Coverage?

More than half of all personal bankruptcies and mortgage foreclosures are a consequence of disability1 1

Facts from LIMRA, 2016 Disability Insurance Awareness Month

The average worker faces a 1 in 3 chance of suffering a job loss lasting 90 days or more due to a disability2 2Facts from LIMRA, 2016 Disability Insurance Awareness Month

Only 50% of American adults indicate they have enough savings to cover three months of living expenses in the event they’re not earning any income3 3Federal Reserve, Report on the Economic Well-Being of U.S. Households in 2018

ELIGIBILITY AND ENROLLMENT Eligibility

1

You are eligible if you are an active employee who works at least 17.5 hours per week on a regularly scheduled basis.

Enrollment

You can enroll in coverage within 31 days of your date of hire or during your annual enrollment period.

Effective Date

Coverage goes into effect subject to the terms and conditions of the policy. You must satisfy the definition of Actively at Work with your employer on the day your coverage takes effect.

Actively at Work

You must be at work with your Employer on your regularly scheduled workday. On that day, you must be performing for wage or profit all of your regular duties in the usual way and for your usual number of hours. If school is not in session due to normal vacation or school break(s), Actively at Work shall mean you are able to report for work with your Employer, performing all of the regular duties of Your Occupation in the usual way for your usual number of hours as if school was in session.

16

FEATURES OF THE PLAN Benefit Amount

You may purchase coverage that will pay you a monthly flat dollar benefit in $100 increments between $200 and $8,000 that cannot exceed 66 2/3% of your current monthly earnings.

Earnings are defined in The Hartford’s contract with your employer.

Elimination Period

You must be disabled for at least the number of days indicated by the elimination period that you select before you can receive a Disability benefit payment. The elimination period that you select consists of two numbers. The first number shows the number of days you must be disabled by an accident before your benefits can begin. The second number indicates the number of days you must be disabled by a sickness before your benefits can begin.

For those employees electing an elimination period of 30 days or less, if your are confined to a hospital for 24 hours or more due to a disability, the elimination period will be waived, and benefits will be payable from the first day of hospitalization.

Maximum Benefit Duration

Benefit Duration is the maximum time for which we pay benefits for disability resulting from sickness or injury. Depending on the schedule selected and the age at which disability occurs, the maximum duration may vary. Please see the applicable schedules below based on your election of either the Premium or Select benefit option.

Premium Option: For the Premium benefit option – the table below applies to disabilities resulting from sickness or injury.

Select Option: For the Select benefit option – the table below applies to disabilities resulting from injury.

Age Disabled Prior to 63 Age 63 Age 64 Age 65 Age 66 Age 67 Age 68 Age 69 and older

Maximum Benefit Duration To Normal Retirement Age or 48 months if greater To Normal Retirement Age or 42 months if greater 36 months 30 months 27 months 24 months 21 months 18 months

Select Option: For the Select benefit option – the table below applies to disabilities resulting from sickness.

Age Disabled Prior to 68 Age 68-69 Age 70 and older Mental Illness, Alcoholism and Substance Abuse: Duration

Maximum Benefit Duration 24 Months To Age 70, but not less than 12 months 12 Months

You can receive benefit payments for Long-Term Disabilities resulting from mental illness, alcoholism and substance abuse for a total of 24 months for all disability periods during your lifetime.

Any period of time that you are confined in a hospital or other facility licensed to provide medical care for mental illness, alcoholism and substance abuse does not count toward the 24 month lifetime limit.

2

17

Partial Disability

Partial Disability is covered provided you have at least a 20% loss of earnings and duties of your job.

Other Important Benefits

Survivor Benefit - If you die while receiving disability benefits, a benefit will be paid to your spouse or child under age 25, equal to three times your last monthly gross benefit.

The Hartford's Ability Assist service is included as a part of your group Long Term Disability (LTD) insurance program. You have access to Ability Assist services both prior to a disability and after you’ve been approved for an LTD claim and are receiving LTD benefits. Once you are covered you are eligible for services to provide assistance with child/elder care, substance abuse, family relationships and more. In addition, LTD claimants and their immediate family members receive confidential services to assist them with the unique emotional, financial and legal issues that may result from a disability. Ability Assist services are provided through ComPsych®, a leading provider of employee assistance and work/life services.

Travel Assistance Program – Available 24/7, this program provides assistance to employees and their dependents who travel 100 miles from their home for 90 days or less. Services include pre-trip information, emergency medical assistance and emergency personal services.

Identity Theft Protection – An array of identity fraud support services to help victims restore their identity. Benefits include 24/7 access to an 800 number; direct contact with a certified caseworker who follows the case until it’s resolved; and a personalized fraud resolution kit with instructions and resources for ID theft victims.

Workplace Modification provides for reasonable modifications made to a workplace to accommodate your disability and allow you to return to active full-time employment.

PROVISIONS OF THE PLAN Definition of Disability

Disability is defined as The Hartford’s contract with your employer. Typically, disability means that you cannot perform one or more of the essential duties of your occupation due to injury, sickness, pregnancy or other medical conditions covered by the insurance, and as a result, your current monthly earnings are 80% or less of your pre-disability earnings.

Once you have been disabled for 24 months, you must be prevented from performing one or more essential duties of any occupation, and as a result, your monthly earnings are 66 2/3% or less of your pre-disability earnings.

Pre-Existing Condition Limitation

Your policy limits the benefits you can receive for a disability caused by a pre-existing condition.

In general, if you were diagnosed or received care for a disabling condition within the 3 consecutive months just prior to the effective date of this policy, your benefit payment will be limited, unless you have been insured under this policy for 12 months before your disability begins.

If your disability is a result of a pre-existing condition, we will pay benefits for a maximum of 4 weeks.

3

18

Continuity of Coverage

If you were insured under your district’s prior plan and not receiving benefits the day before this policy is effective, there will not be a loss in coverage and you will get credit for your prior carrier’s coverage.

Recurrent Disability

What happens if I Recover but become Disabled again?

Periods of Recovery during the Elimination Period will not interrupt the Elimination Period, if the number of days You return to work as an Active Employee are less than one-half (1/2) the number of days of Your Elimination Period.

Any day within such period of Recovery, will not count toward the Elimination Period.

Benefit Integration

Your benefit may be reduced by other income you receive or are eligible to receive due to your disability, such as: • • • • • •

Social Security Disability Insurance State Teacher Retirement Disability Plans Workers’ Compensation Other employer-based disability insurance coverage you may have Unemployment benefits Retirement benefits that your employer fully or partially pays for (such as a pension plan)

Your plan includes a minimum benefit of 10% of your elected benefit or $100.

General Exclusions

You cannot receive Disability benefit payments for disabilities that are caused or contributed to by: • • • • • •

Termination Provisions

War or act of war (declared or not) Military service for any country engaged in war or other armed conflict The commission of, or attempt to commit a felony An intentionally self-inflicted injury Any case where your being engaged in an illegal occupation was a contributing cause to your disability You must be under the regular care of a physician to receive benefits

Your coverage under the plan will end if: • • • • •

The group plan ends or is discontinued You voluntarily stop your coverage You are no longer eligible for coverage You do not make the required premium payment Your active employment stops, except as stated in the continuation provision in the policy

The Hartford® is The Hartford Financial Services Group, Inc. and its subsidiaries, including underwriting company Hartford Life and Accident Insurance Company.

Home Office is Hartford, CT. All benefits are subject to the terms and conditions of the policy. Policies underwritten by the underwriting company listed above detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in force or discontinued. This Benefit Highlights Sheet explains the general purpose of the insurance described, but in no way changes or affects the policy as actually issued. In the event of a discrepancy between this Benefit Highlights Sheet and the policy, the terms of the policy apply. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy as issued to the policyholder. Benefits are subject to state availability. © 2020 The Hartford.

4

19

life insurance highlights For the employee

purelife-plus

Voluntary permanent life insurance can be an ideal complement to the group term and optional term life insurance 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 life insurance may be portable if you change jobs, but even if you can keep them after you retire, they usually cost more and decline in death benefit.

The contract, 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, knowing there will be life insurance in force when you die.

•

Refund of Premium. Unique in the marketplace, purelife-plus offers you a refund of 10 years’ premium, should you surrender the contract if the premium you pay when you buy the contract 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)

21M066-C R0222 2009 (exp0523)

20

Additional Features •

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. Enjoy the assurance of a contract that has a guaranteed death benefit to age 121 and level premium that guarantees coverage for a significant period of time (after the guaranteed period, premiums may go down, stay the same, or go up). 2

You may apply for this permanent coverage, not only for yourself, but also for your spouse, children and grandchildren.3

3

QUICK QUESTIONS

You can qualify by answering just 3 questions – no exams or needles.

DURING THE LAST SIX MONTHS, HAS THE PROPOSED INSURED: 1

Been actively at work on a full time basis, performing usual duties?

2

Been absent from work due to illness or medical treatment for a period of more than 5 consecutive working days?

3

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, dialysis treatment, or treatment for alcohol or drug abuse?

PureLife-plus is a Flexible Premium Adjustable Life Insurance to Age 121. As with most life insurance products, Texas Life contracts and riders contain certain exclusions, limitations, exceptions, reductions of benefits, waiting periods and terms for keeping them in force. Please contact a Texas Life representative or see the Purelife-plus brochure for costs and complete details. Contract Form ICC18-PRFNG-NI-18, Form Series PRFNG-NI-18 or PRFNG-NI-20-OHIO. 1

Voluntary Whole and Universal Life Products, Eastbridge Consulting Group, December 2018 Guarantees are subject to product terms, limitations, exclusions, and the insurer’s claims paying ability and financial strength 3 Coverage not available on children in WA or on grandchildren in WA or MD. In MD, children must reside with the applicant to be eligible for coverage.

2

21M066-C R0222 2009 (exp0523)

21

Mason 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 $30,000 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, suchas losing a limb or your eyesight • Accident Plus - If you suffer an AD&D loss in an accident, you may also receive benefits for the following on top of your core AD&D benefits: coma, plegia, education, childcare, spouse training, and more.

• LifeKeys® services, which provide access to counseling, financial, and legalsupport • TravelConnect® services, which give you and your family access to emergency medical assistance when you're on a trip 100+ miles from home You also have the option to increase your cash benefit by securing additional coverage at affordable group rates.

See the enclosed life insurance information for details.

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.

Continuation of Coverage: You may be able to continue your coverage if you leave your job for any reason other than sickness, injury, or retirement.

Benefit Reduction: Coverage amounts begin to reduce at age 65 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

Benefits Overview | The Lincoln National Life Insurance Company

22 GP-ERPD-FLI001-TX - ©2022 Lincoln National Corporation - LCN-1821793-061517-Q1.0

Full-Time Employees of Mason Independent School District Benefits At-A-Glance Voluntary Term Life Insurance

Employee

loved ones in the event of your

Guaranteed coverage amount during initial offering or approved special enrollment period Newly hired employee guaranteed coverage amount Continuing employee guaranteed coverage annual increase amount

death

Maximum coverage amount

The Lincoln Term Life Insurance Plan: • Provides a cash benefit to your

• Features group rates for Mason ISD employees • Includes LifeKeys® services, which provide access to counseling, financial, and legal support services • Also includes TravelConnect®

Choice of $10,000 or $20,000

$200,000 Choice of $10,000 or $20,000 7 times your annual salary ($500,000 maximum in increments of $10,000) $10,000

Minimum coverage amount

Spouse Guaranteed coverage amount during initial offering or approved special enrollment period Newly hired employee guaranteed coverage amount Continuing employee guaranteed coverage annual increase amount

Choice of $10,000 or $20,000 $50,000 Choice of $10,000 or $20,000 100% of the employee coverage amount ($100,000 maximum in increments of $10,000) $10,000

Maximum coverage amount

services, which give you and your family access to

Minimum coverage amount

emergency medical assistance

Dependent Children

when you’re on a trip 100+

6 months to age 26 guaranteed coverage amount

$10,000

14 days to 6 months

$2,000

Day 1 to 14 days

$1,000

miles from home

The Lincoln National Life Insurance Company 1 23

What your benefits cover Employee Coverage

Guaranteed Life Insurance Coverage Amount • Initial Offering or Approval Special Enrollment: You can choose a coverage amount up to $20,000 without providing evidence of insurability. x 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. x Newly hired guarantee issue amount: When you are first offered this coverage, you can choose a coverage amount up to $200,000 without providing evidence of insurability. x If you decline this coverage now and wish to enroll later, evidence of insurability may be required and may be at your own expense.

x 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 7 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 35% when you reach age 65 and an additional 15% of the original amount when you reach age 70.

Spouse Coverage - You can secure term life insurance for your spouse if you select coverage for yourself.

Guaranteed Life Insurance Coverage Amount • Initial Offering or Approval Special Enrollment: You can choose a coverage amount up to $20,000 without providing evidence of insurability. x Annual Limited Enrollment: If you are a continuing employee, you can increase the coverage amount for your spouse 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. x Newly hired guarantee issue amount: When you are first offered this coverage, you can choose a coverage amount up to $50,000 without providing evidence of insurability. x If you decline this coverage now and wish to enroll later, evidence of insurability may be required and may be at your own expense.

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

Maximum Life Insurance Coverage Amount x

You can choose a coverage amount up to 100% of your coverage amount ($100,000 maximum) for your spouse 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.

Voluntary Life Insurance Benefits At-A-Glance LFE-ENRO-BRC001-TX

2 24

Additional Plan Benefits Accelerated Death Benefit

Included

Premium Waiver

Included

Conversion

Included

Portability

Included

Benefit Exclusions Like any insurance, this term life insurance policy does have exclusions. A suicide exclusion may apply. A complete list of benefit exclusions is included in the policy. State variations apply.

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. TravelConnect® travel assistance services are provided by On Call International, Salem NH. On Call International must coordinate and provide all arrangements in order for eligible services to be covered.

ComPsych® and On Call International are not Lincoln Financial Group companies and Lincoln Financial Group does not administer these Services.

Each independent company is solely responsible for its own obligations. Coverage is subject to contract language that contains specific terms, conditions, and limitations.

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.

©2019 Lincoln National Corporation LCN-2016746-020518 R 1.0 – Group ID: WTXMASOISD

Voluntary Life Insurance Benefits At-A-Glance LFE-ENRO-BRC001-TX 25

3

Full-Time Employees of Mason Independent School District Benefits At-A-Glance

Voluntary AD&D Insurance

The Lincoln AD&D Insurance Plan:

Employee Maximum coverage amount

10 times your annual salary ($500,000 maximum) in $10,000 increments

loved ones if you die in an

Minimum coverage amount

$10,000

accident

Your employee AD&D coverage amount will reduce by 35% when you reach age 65, and an additional 15% of the original amount when you reach age 70.

Benefits end when you retire.

• Provides a cash benefit to your

• Provides a cash benefit to you if you suffer a covered loss in

Spouse

an accident • Features group rates for Mason ISD employees • Includes LifeKeys® services,

Maximum coverage amount

50% of the employee coverage amount ($250,000 maximum) in $5,000 increments

Minimum coverage amount

$5,000

which provide access to

You can secure AD&D insurance for your spouse if you select coverage for yourself.

counseling, financial, and legal

Benefits end when you retire.

support • Also includes TravelConnectSM

Dependent Children

services, which give you and

6 months to age 26 Maximum coverage amount

$25,000

your family access to

Minimum coverage amount

$25,000

Day 1 to 14 days Maximum coverage amount

$1,000

when you’re on a trip 100+ miles from home

Day 14 to age 6 months

$2,000

emergency medical assistance

You can secure AD&D insurance for your dependent children when you choose coverage for yourself.

The Lincoln National Life Insurance Company 1 26

Benefit Exclusions

Additional Plan Benefits Safe Driver Benefit

Included

Education Benefit

Included

Spouse Training Benefit

Included

Felonious Assault

Included

Child Care Benefit

Included

Coma Benefit

Included

Common Disaster Benefit

Included

Exposure Benefit

Included

Disappearance Benefit

Included

Common Carrier Benefit

Included

Like any insurance, this AD&D insurance policy does have exclusions. Benefits will not be paid if death results from suicide, or death/dismemberment occurs while: x Intentionally inflicting or attempting to inflict injury to one’s self x Participating in a war, act of war, or riot x Serving on full-time active duty in the armed forces of any state or country (this does not include duty of 30 days or less training in the Reserves or National Guard) x Flying on any non-commercial airplane or aircraft, such as a hot air balloon or glider (see the contract for details and exceptions) x Flying on a commercial airline or aircraft as a pilot or crewmember x Committing or attempting to commit a felony x Deliberately inhaling gas (such as carbon monoxide) or using drugs other than those taken as prescribed by a licensed physician x Driving while intoxicated, impaired, or under the influence of drugs

Note: See the policy for details and specific requirements for each of these benefits

In addition, this 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.

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. TravelConnect® travel assistance services are provided by On Call International, Salem NH. On Call International must coordinate and provide all arrangements in order for eligible services to be covered.

ComPsych® and On Call International are not Lincoln Financial Group companies and Lincoln Financial Group does not administer these Services.

Each independent company is solely responsible for its own obligations. Coverage is subject to contract language that contains specific terms, conditions, and limitations.

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.

©2020 Lincoln National Corporation - LCN-2016756-020518-07 – R1.0 – Group ID: WTXMASOISD

Voluntary AD&D Insurance At-A-Glance LFE-ADD-BRC001-TX

2

27

Voluntary Accidental Death & Dismemberment Insurance Here’s how little you pay with group rates.

Monthly Premium Calculation for You The estimated monthly premium for AD&D insurance is determined by multiplying the desired amount of coverage (in increments of $10,000) by the premium rate. See table at right for select coverage amounts.

= $_______________

$____________ X 0.0000400 coverage amount

premium rate

Coverage Amount $10,000 $100,000

Monthly Premium $0.40 $4.00

$250,000 $500,000

$10.00 $20.00

Coverage Amount $10,000 $50,000 $100,000 $250,000

Monthly Premium $0.70 $3.50 $7.00 $17.50

Coverage Amount $25,000

Monthly Premium $1.75

monthly premium

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

Monthly Premium Calculation for Your Spouse The estimated monthly premium for AD&D insurance is determined by multiplying the desired amount of coverage (in increments of $5,000) by the premium rate. See table at right for select coverage amounts.

$____________ X coverage amount

0.0000700 = $_______________ premium rate monthly premium

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

Monthly Premium Calculation for Your Dependent Children The estimated monthly premium for AD&D insurance is determined by multiplying the desired amount of coverage (in increments of $25,000) by the premium rate. See table at right for select coverage amounts.

$__________ X 0.0000700 coverage amount

= $_______________

premium rate

monthly premium

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

Note: You must be an active Mason Independent School District employee to select coverage for a spouse and/or dependent children. To be eligible for coverage, a spouse 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.

The Lincoln National Life Insurance Company

Please see prior page for product information.

Voluntary AD&D Insurance At-A-Glance LFE-ADD-BRC001-TX

3

28

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

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

$10,000

$30,000

$60,000

$100,000

$200,000

$500,000

$0.54 $0.54 $0.72 $0.81 $0.99

$1.62 $1.62 $2.16 $2.43 $2.97

$3.24 $3.24 $4.32 $4.86 $5.94

$5.40 $5.40 $7.20 $8.10 $9.90

$10.80 $10.80 $14.40 $16.20 $19.80

$27.00 $27.00 $36.00 $40.50 $49.50

$1.53 $2.88 $4.95 $7.92

$4.59 $8.64 $14.85 $23.76

$9.18 $17.28 $29.70 $47.52

$15.30 $28.80 $49.50 $79.20

$30.60 $57.60 $99.00 $158.40

$76.50 $144.00 $247.50 $396.00

$6,500

$19,500

$39,000

$65,000

$130,000

$325,000

$7.18

$21.53

$43.06

$71.76

$143.52

$358.80

$5,000

$15,000

$30,000

$50,000

$100,000

$250,000

$9.27

$27.81

$55.62

$92.70

$185.40

$463.50

$5,000

$15,000

$30,000

$50,000

$100,000

$250,000

$9.27

$27.81

$55.62

$92.70

$185.40

$463.50

$5,000

$15,000

$30,000

$50,000

$100,000

$250,000

$9.27

$27.81

$55.62

$92.70

$185.40

$463.50

Spouse | Monthly Premiums for Select Life 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

$10,000

$50,000

$80,000

$100,000

$200,000

$250,000

$0.54 $0.54 $0.72 $0.81 $0.99 $1.53 $2.88 $4.95 $7.92 $11.04

$2.70 $2.70 $3.60 $4.05 $4.95 $7.65 $14.40 $24.75 $39.60 $55.20

$4.32 $4.32 $5.76 $6.48 $7.92 $12.24 $23.04 $39.60 $63.36 $88.32

$5.40 $5.40 $7.20 $8.10 $9.90 $15.30 $28.80 $49.50 $79.20 $110.40

$10.80 $10.80 $14.40 $16.20 $19.80 $30.60 $57.60 $99.00 $158.40 $220.80

$13.50 $13.50 $18.00 $20.25 $24.75 $38.25 $72.00 $123.75 $198.00 $276.00

The Lincoln National Life Insurance Company

Please see prior page for product information.

Voluntary Life Insurance At-A-Glance LFE-ENRO-BRC001-TX

4 29

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

Monthly Premium $2.00

Group Rates for Your Dependent Children One affordable monthly premium covers all of your eligible dependent children.

Note: You must be an active Mason Independent School District employee to select coverage for a spouse and/or dependent children. To be eligible for coverage, a spouse 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.

The Lincoln National Life Insurance Company

Please see prior page for product information.

Voluntary Life Insurance At-A-Glance LFE-ENRO-BRC001-TX 30

5

Limited Benefit

Cancer Indemnity Insurance

Summary of Benefit

Plan 1 Level 1

Level 1 Diagnostic Testing 1 test per calendar year

$50 per test $100 per test

Follow Up Diagnostic Testing 1 test per calendar year

$500 per test 1 test per calendar year

Medical Imaging

Level 1 Surgical

$30 unit dollar amount Max $3,000 per operation

Anesthesia

25% of amount paid for covered surgery $6,000

Bone Marrow Transplant Maximum per lifetime Stem Cell Transplant Maximum per lifetime

$600

Prosthesis Surgical Implantation/Non Surgical (not Hair Piece) 1 device per site, per lifetime

$1,000/$100

Level 1 Hospital Confinement Per day of Hospital Confinement (1 30 days) Per day for Eligible Dependent Children (1 30 days) Per day of Hospital Confinement (31+ days) Per day for Eligible Dependent Children (31+ days) Outpatient Facility Per day surgery is performed

$100 $200 $100 $200 $200

Attending Physician Per day of Hospital Confinement

$30

Dread Disease Per day of Hospital Confinement (1 30 days / 31+ days)

$100/$100

Extended Care Facility Up to the same number of Hospital Confinement Days

$100 per day

Donor

$100 per day

Home Health Care Up to the same number of Hospital Confinement Days

$100 per day

Hospice Care Up to maximum of 365 days per lifetime US Government, Charity Hospital or HMO Per day of Hospital Confinement (1 30 days / 31+ days)

$100 per day $100/$100 Level 1 Not Included

Cancer Treatment Center Evaluation or Consultation 1 per lifetime

Evaluation or Consultation Travel and Lodging 1 per lifetime

Not Included $300 / $300 $150 per confinement $50 per prescription $150

Second / Third Surgical Opinion per diagnosis of cancer Drugs and Medicine Inpatient / Outpatient (maximum $150 per month) Hair Piece (Wig) 1 per lifetime Transportation Maximum 12 trips per calendar year for all modes of transportation combined Travel by bus, plane or train

actual coach fare or $0.40 per mile $0.40 per mile $50 per day

Travel by car Lodging up to a maximum of 100 days per calendar year Family Transportation Maximum 12 trips per calendar year for all modes of transportation combined Travel by bus, plane or train Travel by car Family Lodging up to a maximum of 100 days per calendar year Blood, Plasma and Platelets

actual coach fare or $0.40 per mile $0.40 per mile $50 per day $300 per day

Ambulance Ground/Air Maximum of 2 trips per Hospital Confinement for all modes of transportation combined Inpatient Special Nursing Services per day of Hospital Confinement

$200 / $2,000 per trip $150 per day

31

GC14 Limited Benefit

Cancer Indemnity Insurance Level 1

Outpatient Special Nursing Services Up to same number of Hospital Confinement days

$150 per day

Medical Equipment Maximum of 1 benefit per calendar year

Not Included

Physical, Occupational, Speech, Audio Therapy & Psychotherapy / Maximum per calendar year

$25 per visit / $1,000

Waiver of Premium

Waive Premium

Level 1 Lump Sum Benefit Maximum 1 per Covered Person per lifetime

$2,500

Lump Sum for Eligible Dependent Children Maximum 1 per Covered Person per lifetime

$3,750

Level 1 Intensive Care Unit

$600 per day

Step Down Unit Maximum of 45 days per Confinement for any combination of Intensive Care Unit or Step Down Unit

$300 per day

Total Monthly Premiums by Plan** Issue Ages

Individual

Individual & Spouse

1 Parent Family

2 Parent Family

Plan 1

Plan 1

Plan 1

Plan 1

18

$19.80

$41.70

$25.78

$47.62

Total premium includes the Plan selected and any applicable rider premium. Premiums are subject to increase with notice.

The premium and amount of benefits vary dependent upon the Plan selected at time of application.

32

33

34

Accident Insurance Supplemental Limited Benefit Accident Expense Insurance (A-3)

THIS IS NOT A POLICY OF WORKERS’ COMPENSATION INSURANCE. THE EMPLOYER DOES NOT BECOME A SUBSCRIBER TO THE WORKERS’ COMPENSATION SYSTEM BY PURCHASING THIS POLICY, AND IF THE EMPLOYER IS A NON-SUBSCRIBER, THE EMPLOYER LOSES THOSE BENEFITS WHICH WOULD OTHERWISE ACCRUE UNDER THE WORKERS’ COMPENSATION LAWS. THE EMPLOYER MUST COMPLY WITH THE WORKERS’ COMPENSATION LAW AS IT PERTAINS TO NON-SUBSCRIBERS AND THE REQUIRED NOTIFICATIONS THAT MUST BE FILED AND POSTED.

APSB-21402(TX)-0219 Mason ISD 35

Summary of Benefits Benefit Description

Level 1 - 1 Unit

Level 2 - 2 Units

Level 3 - 3 Units

Level 4 - 4 Units

$5,000

$10,000

$15,000

$20,000

actual charges up to $500

actual charges up to $1,000

actual charges up to $1,500

actual charges up to $2,000

Daily Hospital Confinement Benefit

$75 per day

$150 per day

$225 per day

$300 per day

Air and Ground Ambulance Benefit

actual charges up to $1,250

actual charges up to $2,500

actual charges up to $3,750

actual charges up to $5,000

Accidental Dismemberment Benefit - per unit Single Finger or toe Multiple fingers or toes Single hand, arm, foot or leg Multiple hands, arms, feet or legs

$500 $500 $2,500 $5,000

$1,000 $1,000 $5,000 $10,000

$1,500 $1,500 $7,500 $15,000

$2,000 $2,000 $10,000 $20,000

Accidental Loss of Sight Benefit - per unit Loss of Sight in one eye Loss of Sight in both eyes

$2,500 $5,000

$5,000 $10,000

$7,500 $15,000

$10,000 $20,000

$100 upon admission

$100 upon admission

$100 upon admission

$100 upon admission

$150 per day

$150 per day

$150 per day

$150 per day

Accidental Death - per unit Medical Expense Accidental Injury Benefit per unit

Hospital Admission Benefit Accident Only - Intensive Care Benefit

Accidental Dismemberment Benefit

Policy Benefit Highlights

Pays an indemnity benefit, as shown below, for an Insured Person if an Accidental Bodily Injury results in Loss of finger, toe, hand, arm, foot, leg or sight.

Medical Expense Accidental Injury Benefit Pays actual charges up to the benefit selected for an Insured Person when medical treatment is required as a result of an Accidental Bodily Injury. For medical treatment received on an out-patient basis, Covered Expenses include physician charges, surgery, x-rays, radiation of fractures or other emergency first-aid expenses incurred in a physician’s office, clinic, out-patient hospital facility or ambulatory surgical center.

If Covered Expenses are incurred at a Hospital emergency room, a $50 deductible will apply for each Accidental Injury. For medical treatment received by the Insured Person confined in a Hospital as a resident bed patient, Covered Expenses include physician charges, hospital room and medically necessary hospital billed services and supplies.

Single Finger or Toe Multiple Fingers or Toes Single Hand, Arm, Foot or Leg Multiple Hand, Arm, Foot or Leg

$500 Per Unit $500 Per Unit $2,500 Per Unit $5,000 Per Unit

Accidental Loss of Sight Benefit Pays an indemnity benefit, as shown below, for an Insured person if an Accidental Bodily Injury results in the Loss of Sight in one eye. Pays double the indemnity benefit, as shown below, for an Insured Person if an Accidental Bodily Injury results in the Loss of Sight in both eyes.

Air and Ground Ambulance Benefit

Loss of Sight in one eye Loss of Sight in both eyes

$2,500 Per Unit $5,000 Per Unit

Pays actual charges up to the benefit selected for an Insured Person that requires emergency air or ground ambulance transportation, to or from a Hospital, for covered treatment as a result of an Accidental Bodily Injury.

Optional Benefits

Daily Hospital Confinement Benefit

Pays a per unit admission benefit for an Insured Person upon admission to a hospital due to a covered Accidental Injury.

Hospital Admission Benefit

Pays a daily benefit each day an Insured Person is Hospital confined as the result of an Accidental Bodily Injury. The maximum benefit period for this benefit is 30 days per covered accident.

Accident Only – Intensive Care Benefit Pays a daily benefit for an Insured Person when confined in an Intensive Care Unit as a result of Accidental Bodily Injury.

Accidental Death Pays an indemnity benefit for an Insured Person when an Accidental Bodily Injury results in the loss of life.

Limitations and Exclusions

Injury or Accidental Injury or Accidental Bodily Injury means physical damage to an Insured Person, sustained on or after the Effective Date, and while this Policy is in force, which is the direct cause of the loss, independent of disease, bodily infirmity or any other cause. All injuries sustained in any one accident and all complications arising therefrom and recurrence and complication shall be deemed to be a single “Injury.”

Eligibility This policy will be issued to only those persons who meet American Public Life Insurance Company's insurability requirements. Persons not meeting APL's insurability requirements will be excluded from coverage by an endorsement attached to the policy. An eligible family member is your legal spouse or your dependent child (by blood or adoption) or stepchild under the age of 26.

36

(11) Injury sustained or sickness which first manifests itself while on full-time duty in the armed forces; (Upon notice, We will refund the proportion of unearned premium while in such forces.)

(12) Injury incurred while engaging in an illegal occupation; (13) Injury incurred while attempting to commit a felony or an assault; (14) Injury to a covered person while practicing for or being a part of organized or competitive rodeo, sky diving, hang gliding, parachuting or scuba diving; (15) driving in any race or speed test or while testing an automobile or any vehicle on any racetrack or speedway; (16) hernia, carpal tunnel syndrome or any complication therefrom;

Base Policy and Optional Benefits No benefits are payable for a pre-existing condition. Pre-existing condition means an Injury that pertains solely to an Accidental Bodily Injury which resulted from an accident sustained before the Effective Date of coverage. Pre-Existing Conditions specifically named or described as permanently excluded in any part of this contract are never covered.

A Hospital is not an institution which is primarily a place for alcoholics or drug addicts; the aged; a nursing, rest or convalescent nursing home; a mental institution or sanitarium; a facility contracted for or operated by the United States Government for treatment of members or exmembers of the armed forces (unless You are legally required to pay for services rendered in the absence of insurance); or, a long-term nursing unit or geriatrics ward.

If You are entitled to benefits under this Policy as a result of sprained or lame back, or any intervertebral disk conditions, such benefits shall be payable for a maximum period of time, not exceeding in the aggregate three (3) months for any Injury.

Medical Expense Accidental Injury Benefit Guaranteed Renewable

Expenses must commence within 60 days of the covered accident. The maximum benefit amount payable for any one accident for the Insured Person shall not exceed the Medical Expense Benefit.

You have the right to renew this Policy until the first premium due date on or after Your 69th birthday, if you pay the correct premium when due or within the Grace Period. When an Insured’s coverage terminates at age 70, coverage for other Insured Persons, if any, shall continue under this Policy. We have the right to change premium rates by class.

Air and Ground Ambulance Benefit Emergency transportation must occur within 21 calendar days of the accident causing such Injury.

Daily Hospital Confinement Benefit The maximum benefit period for this benefit is 30 days per covered accident.

Accidental Death Accidental Death must result within 90 days of the covered accident causing the injury.

Accidental Dismemberment Benefit The total amount payable for all Losses resulting from the same accident will not exceed the Maximum Dismemberment Benefit of $5,000 cumulative per unit, per Accident. Loss must be within 90 days of the accident causing such Injury.

Hospital Admission Benefit The maximum benefit is 4 units.

Accident Only – Intensive Care Benefit The maximum benefit is 4 units. The maximum benefit period for this benefit is up to 30 days for any one accident.

Exclusions Benefits otherwise provided by this Policy will not be payable for services or expenses or any such Loss resulting from or in connection with: (1) sickness, illness or bodily infirmity; (2) suicide, attempted suicide or intentional self-inflicted Injury, whether sane or insane; (3) dental care or treatment unless due to accidental Injury to natural teeth; (4) war or any act of war (whether declared or undeclared) or participating in a riot or felony; (5) alcoholism or drug addiction; (6) travel or flight in or descent from any aircraft or device which can fly above the earth’s surface in any capacity other than as a fare paying passenger on a regularly scheduled airline; (7) Injury originating prior to the effective date of the Policy; (8) Injury occurring while intoxicated (Intoxication means that which is determined and defined by the laws and jurisdiction of the geographical area in which the loss or cause of loss is incurred.); (9) Voluntary inhalation of gas or fumes or taking of poison or asphyxiation; (10) Voluntary ingestion or injection of any drug, narcotic or sedative, unless administered on the advice and taken in such doses as prescribed by a Physician; 37

Supplemental Limited Benefit Accident Expense Insurance A-3 Monthly Premiums* Individual

Individual & Spouse

One Parent Family

2 Parent Family

Level 1 - 1 Unit

$11.70

$20.70

$22.70

$31.70

Level 2 - 2 Units

$18.00

$31.10

$36.40

$49.50

Level 3 - 3 Units

$22.40

$40.20

$46.70

$64.50

Level 4 - 4 Units

$25.40

$46.20

$53.50

$74.30

2305 Lakeland Drive | Flowood, MS 39232 ampublic.com | 800.256.8606 *The premium and amount of benefits may vary dependent upon the plan selected at time of application. Policy and additional benefits were choosen by your employer.

Premiums are subject to increase with notice.

Underwritten by American Public Life Insurance Company. This is a brief description of the coverage. For complete benefits and other provisions, please refer to the policy/ certificate/rider(s). This coverage does not replace Workers’ Compensation Insurance. This product is inappropriate for people who are eligible for Medicaid coverage. | Policy Form A-3 series | Texas | Supplemental Limited Benefit Accident Expense Insurance | Employee Brochure | (02/19)

38

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65% of American cancer survivors did not have sufficient income to cover out--of-pockett expenses for cancer treatment and other incurred debts related d to o 1 the e illness.

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&29(5$*( ,1)250$7,21 %HQH¿W DPRXQWV IRU FRYHUHG LOOQHVVHV DUH EDVHG RQ WKH FRYHUDJH DPRXQW LQ HIIHFW IRU \RX RU DQ LQVXUHG GHSHQGHQW DW WKH WLPH RI GLDJQRVLV

&29(5$*( $02817 (PSOR\HH &RYHUDJH $PRXQW 6SRXVH &RYHUDJH $PRXQW &KLOG UHQ &RYHUDJH $PRXQW

&29(5(' ,//1(66(6

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%(1(),7 $028176

COVERAGE &$1&(5 &21INFORMATION ',7,216

If C1 ≠ Core/Buy-Up and CI19 = No, then display: [Benefit amounts for covered illnesses are based on the coverage amount in effect for %HQLJQ %UDLQ 7XPRU ,QYDVLYH &DQFHU RI FRYHUDJH DPRXQW you at the time of diagnosis.]

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event occurs. If HI11 = Yes, then display: [Unless otherwise noted, the benefit amounts payable under each plan are the same for you )($785(6 3/$1 and your dependent(s).] $ELOLW\ $VVLVW ($3 ± DFFHVV WR KHOS IRU ¿QDQFLDO OHJDO RU HPRWLRQDO LVVXHV ,QFOXGHG ,QFOXGHG If (HI1 = Low Plan or HI1 = Medium Plan or HI1 = High Plan or HI1a = Low Plan or HI1a = Medium Plan or HI1a = High Plan or HI1b = 6 0

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First Day Hospital Confinement

Up to 1 day per year

$500

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44

FOR EMPLOYEES Emergencies can happen to anyone, anytime, and anywhere! heere!

No matter what, MASA MTS has you covered!

What is Covered?

BENEFIT

EMERGENT $9/Mo ȋε ͛͘ά ơȌ

Emergency Air Medical Transport

✓ ȋ Ǥ Ǥ Ȍ

Emergency Ground Ambulance Transport

✓ ȋ Ǥ Ǥ Ȍ

THE TRUTH….

Americans today ơ that their medical coverage will pay for all costs associated with emergency or critical care transport. The reality is that a majority of Americans are only partially covered for these high costs. ơ Dz and Customary Charges” leaving you with the remainder of the bill.

You face the possibility that your medical coverage will deny the claim leaving you responsible for the ENTIRE bill.

Typically, health insurance policies will not get you back home when traveling, leaving you exposed to transportation costs that can exceed $100,000.

With MASA, you will have ZERO out of pocket expenses for any emergent air or ground transport, REGARDLESS who transports you!

We provide medical emergency transportation solutions AND cover your out of pocket medical transport cost when your insurance falls short.

“All I had to do was send the bill which was never paid by Medicare and TriCare for Life --- and the rest is history.

When MASA received that bill, it was paid and all amounts Ƥ Ǥdz ǦǦǦ ǡ ͚͙͘͝

MASA MTS for Employees Ensures…

• NO health questions

Only MASA MTS for Employees can provide you with complete protection.

• NO age limits • NO claim forms • NO deductibles

• NO provider/insurance network limitations • NO dollar limits on emergency transport costs

45

͚Ȁ͙Ȁ͚͙͘͟

Any Ground. Any Air. Anywhere.

PLATINUM MEMBERSHIP BENEFITS Emergency Air Medical Transportation

Should a member suffer serious life or limb threatening emergency that requires immediate transport by fixed wing or helicopter air ambulance of that member to the nearest most appropriate medical facility capable of providing required emergency medical treatments, also referred to as “golden hour transports”, MASA MTS will cover the out-of-pocket expenses resulting from that transport. (U.S. and Canada Only)

Emergency Ground Transportation

Should a member suffer a life or limb emergency requiring emergent ground transport from the site of serious illness or injury, or from a transferring medical facility that is unable to provide services required, to the nearest most appropriate medical facility capable of attending to the member’s medical needs MASA MTS will cover the out-of-pocket expenses resulting from that transport. (U.S. and Canada Only)

Non-Emergent Air Transportation

Should a member suffer a serious illness or injury resulting in hospitalization and if the member is in need of specialized treatment not available locally but such transportation is not immediately needed for life or limb saving treatment and such transportation can be arranged by MASA, then MASA MTS will coordinate transport to the nearest appropriate medical facility capable of providing such specialized treatment.

(Worldwide Coverage)

Organ Retrieval**

MASA MTS will provide air transportation of an organ to be used in an organ transplant. (U.S. Only)

Organ Recipient Transportation** Recuperation / Repatriation Return Transportation Escort Transportation

MASA MTS will fly a member to the commercial airport nearest the medical facility where an organ transplant is scheduled to happen. (U.S. Only) If a member is hospitalized while away from home, MASA MTS will fly them back to a hospital closer to home to recuperate in familiar surroundings. (Worldwide Coverage) MASA MTS will arrange transport on a commercial carrier to a commercial airport closest to member’s residence after being discharged from a hospitalization of at least 24 hours. (Worldwide Coverage) If a member requires emergency air transport, MASA MTS will fly the member's spouse, family member or friend to accompany them in the air. (Worldwide Coverage)

Visitor Transport

If a member is hospitalized while away from his/her home for more than 7 days, the member may select a family member to visit them during confinement. MASA MTS will provide round trip, common carrier air transportation for the person selected. (Basic Coverage Area Only*)

Minor Children / Grandchildren Return

When minor children or grandchildren are left unattended as a result of a member using MASA MTS air ambulance service, MASA MTS will provide one-way common carrier air transport for return of the children to the commercial airport nearest the place of residence of the children. (Basic Coverage Only*)

Vehicle Return

MASA MTS will return vehicles such as cars, vans, RVs or trucks owned or rented by the member when illness, injury or death requires use of the air ambulance services provided by MASA MTS. The vehicle will be carried to the member's place of residence or rental vehicles will be returned to the nearest rental company office or agent. (Basic Coverage Area Only*)

Mortal Remains Transport

In the event a member dies while away from his/her place of residence, MASA Dd^ will return his/her remains to the commercial airport nearest his/her residence. (Worldwide Coverage)

Pet Return

MASA MTS will return the Member’s dog, cat or smaller animal, should the Member be flown to a hospital near their residence on an air ambulance arranged by the MASA MTS. (Basic Coverage Area Only*)

*Basic Coverage Area includes U.S., Canada, Mexico, and Caribbean (excluding Cuba). **One (1) year waiting period if pre-existing condition requiring transplant.

There is a 90 day waiting period on pre-existing conditions. This clause is WAIVED for emergent ground and air transports -- Dependents are covered up until age 26.

46

OVERVIEW

QUALITY CARE WHEN YOU NEED IT MOST .QQMKPI HQT ECTG VJCV ƓVU [QWT UEJGFWNG! /& QHHGTU TGNKCDNG SWCNKV[ JGCNVJ ECTG CV [QWT ƓPIGTVKRU YKVJ C TGOCTMCDNG TGRWVCVKQP 1.800MD is a fast, convenient alternative to waiting days for an appointment or spending hours sitting in the FQEVQTũU QHƓEG WTIGPV ECTG QT '4 9JGVJGT KV KU C O HTQO [QWT VQFFNGTũU TQQO QT R O HTQO [QWT DWUKPGUU trip destination, our telehealth solutions save you time and money while providing peace of mind.

WHY CHOOSE 1.800MD? SAVES MONEY Visits to the emergency room or urgent care are costly prices to pay when many visits can be handled by calling 1.800MD. As a low-cost alternative 1.800MD physicians treat many common conditions via phone or video consultations, reducing unnecessary doctor’s visits and saving you money.

CONVENIENCE AND QUALITY CARE

CUTTING EDGE TECHNOLOGY

SUPPORT

With more than a decade of experience, 1.800MD provides individuals, families, employers and groups with best of class medical care 24/7/365. #XCKNCDNG CP[ VKOG FC[ QT PKIJV QWT DQCTF EGTVKƓGF RJ[UKEKCPU are equipped to diagnose, recommend treatment and RTGUETKDG OGFKECVKQPU YJKNG KP VJG EQOHQTV QH [QWT JQOG QHƓEG QT DWUKPGUU VTKR FGUVKPCVKQP

Independently owned, 1.800MD focuses on customer satisfaction. 1WT OGODGT service representatives are CXCKNCDNG CP[ VKOG VQ CUUKUV [QW or answer any questions you may have.

1.800MD’s website and mobile app are extensions of our customer service commitment.

They provide consumers with access to fast, convenient access to health care. Individual UGEWTG OGODGT RQTVCNU EQPVCKP information and tools to help make informed health care decisions.

ACTIVATE ACCOUNT HOW DOES 1. Activate your account online at www.1800md.com QT D[ ECNNKPI 1.800.530.8666. Once activated, you will IT WORK? PGGF VQ UGVWR [QWT OGODGT RTQƓNG CPF EQORNGVG [QWT GNGEVTQPKE JGCNVJ TGEQTF 2. REQUEST A CONSULT

Login to your account online or call OGODGT UGTXKEGU CV 1.800.530.8666 VQ TGSWGUV C EQPUWNV CP[VKOG

3. RECEIVE CARE

Receive diagnosis and treatment, giving you quality care and peace of mind where ever you are.

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1.800.530.8666 www.1800MD.com 43

Quality Care When You Need It Most Frequently Asked QuesƟons Q: What is 1.800MD? A: With more than a decade of experience, 1.800MD is focused on providing individuals, families, employers and groups with convenient medical care, anywhere in the United States* at any me. You can rest assured that 1.800MD’s personalized telehealth solu ons are unparalleled.

How does 1.800MD improve quality of care?

A: 1.800MD provides fast, convenient care for minor medical ma ers from the flu to allergies to urinary tract infec ons.

With one of the largest networks of telemedicine physicians in the na on, 1.800MD’s board-cer fied physicians are equipped to diagnose, recommend treatment and prescribe medica ons from the comfort of your home, office or travel des na on (within the United States, subject to state regula ons) 24/7/365.

Q: How does 1.800MD reduce health care costs?

A: 1.800MD saves you money by diagnosing and trea ng common ailments through our telehealth solu ons, thus reducing unnecessary doctor’s office and emergency room visits. Data shows up to 70 percent of all urgent care and emergency room visits are unneeded, costly and can be handled with a 1.800MD telephone or video consulta on.

Q: What about the doctors?

A: 1.800MD has one of the largest networks of telemedicine physicians in the na on to ensure convenient care anywhere. A thorough review of medical licensure, training, educa on, work and malprac ce history is performed every two years by a na onal third-party creden aling agency in accordance with the Na onal Commi ee for Quality Assurance and the U liza on Review Accredita on Commi ee guidelines. With an average of 15 years of internal medicine, family prac ce or pediatrics experience, you can rest assured each physician is properly licensed in your state, board-cer fied and verified by the Na onal Physician Data Base and the American Medical Associa on.

Q: Is there a minimum age requirement?

A: There is no minimum age to consult with a 1.800MD physician. However, the pa ent must have the ability to communicate his or her condi on to the doctor to ensure the physician can properly diagnose and treat.

Q: I have a pre-exisƟng condiƟon. Will 1.800MD sƟll accept me?

A: Absolutely! 1.800MD is not insurance. We do not deny access to quality care because of pre-exis ng condi ons.

Q: Can I get a consultaƟon aŌer hours or on weekends?

A: Yes. 1.800MD is available 24 hours a day, seven days a week and 365 days a year.

Q: How are prescripƟons filled?

A: If a 1.800MD physician recommends medica on as part of your treatment plan, the prescrip on will be digitally sent to the local pharmacy of your choice.

Q: Are there any limitaƟons as to what can be prescribed?

A: Yes. While a 1.800MD physician can prescribe appropriate medica ons to treat your condi on such as an bio cs, an histamines and maintenance medicines, our physicians do not prescribe lifestyle drugs, medica ons regulated by the Drug Enforcement Agency or those that pose a poten al for abuse or addic on.

For all other quesƟons, please contact us at 1 (800) 530-8666.

Offered through U.S. Employee Benefits Services Group 44

IDENTITY THEFT PROTECTION

Because There’s Only One You. Your identity is important — it’s what makes you, you. You’ve spent a lifetime building your name and financial reputation. Let us help you better protect it. And, we’ll even go one step further and help you better protect the identities of your family.

Easy & Affordable Identity Protection With ID Watchdog®, you have an easy and affordable way to help better protect and monitor the identities of you and your family. You’ll be alerted to potentially suspicious activity and enjoy the peace of mind that comes with the support of dedicated resolution specialists.

And, a customer care team that’s available any time, every day.

1 in 18 consumers were victims of identity theft in 2018.1

WHY CHOOSE ID WATCHDOG

Credit Lock With our online and in-app feature, lock your Equifax® credit report2 — and your child’s Equifax credit report — to help provide additional protection against unauthorized access to your credit.

More for Families Our family plan helps you better protect your loved ones, with each adult getting their own account with all plan features.

And, we offer more features that help protect minors than any other provider.

ID Watchdog Is Here for You ID Watchdog is everywhere you can’t be — monitoring credit reports, social media, transaction records, public records and more — to help you better protect your identity. And don’t worry, we’re always here for you. In fact, our U.S.-based customer care team is available 24/7/365 at 866.513.1518.

Dedicated Resolution Specialists If you become a victim, you don’t have to face it alone. One of our certified resolution specialists will fully manage the case for you until your identity is restored.

See our unique features and pricing and take a step to help better protect your identity today.

(Features and pricing tables on reverse.)

A Leader in Detection & Prevention for 3 years running

1

2019 Identity Fraud Study, Javelin Research, March 2019 Locking your Equifax credit report will prevent access to it by certain third parties. Locking your Equifax credit report will not prevent access to your credit report at any other credit reporting agency. Entities that may still have access to your Equifax credit report include: companies like ID Watchdog, which provide you with access to your credit report or credit score, or monitor your credit report as part of a subscription or similar service; companies that provide you with a copy of your credit report or credit score, upon your request; federal, state and local government agencies and courts in certain circumstances; companies using the information in connection with the underwriting of insurance, or for employment, tenant or background screening purposes; companies that have a current account or relationship with you, and collection agencies acting on behalf of those whom you owe; companies that authenticate a consumer’s identity for purposes other than granting credit, or for investigating or preventing actual or potential fraud; and companies that wish to make pre-approved offers of credit or insurance to you. To opt out of such pre-approved offers, visit www.optoutprescreen.com

2

45

IDENTITY THEFT PROTECTION ID WATCHDOG®

The Powerful Features You Want — All at an Affordable Price

1B

PLAN FEATURES

Monitor & Detect

Manage & Alert

Support & Restore

• Credit Report & VantageScore® Credit Score 1 Bureau Monthly

• Credit Report Lock3 | 1 Bureau

• Identity Theft Resolution Specialists (Resolution for Pre-existing Conditions)

• Child Credit Lock4 | 1 Bureau • Financial Accounts Monitoring

• Credit Score Tracker 1 Bureau Monthly • Credit Report Monitoring | 1 Bureau • Dark Web Monitoring1 • High-Risk Transactions Monitoring2

• Social Network Alerts

• 24/7/365 U.S.-based Customer Care Center

• Registered Sex Offender Reporting

• Up to $1M Identity Theft Insurance5

• Customizable Alert Options

• Lost Wallet Vault & Assistance

• Breach Alert Emails

• Deceased Family Member Fraud Remediation

• Subprime Loan Monitoring2

• Mobile App

• Public Records Monitoring

• National Provider ID Alerts

• Fraud Alert & Credit Freeze Assistance

• USPS Change of Address Monitoring • Identity Profile Report Helps better protect children

1 Bureau = Equifax®

What You Need to Know The credit scores provided are based on the VantageScore 3.0 model. Any one-bureau VantageScore uses Equifax data. Third parties use many different types of credit scores and are likely to use a different type of credit score to assess your creditworthiness.

SPECIAL EMPLOYEE PRICING

PER MONTH

Employee

$ɒȜǒŇ

Take steps to help better protect your identity.

(Includes 1 child <18)

Employee + Family

Enroll in this valuable benefit today.

$ǵŗȜǒŇ

1

Dark Web Monitoring scans thousands of internet sites where consumers’ personal information is suspected of being bought and sold, and is constantly adding new sites to those it searches. However, the internet addresses of these suspected internet trading sites are not published and frequently change, so there is no guarantee that ID Watchdog is able to locate and search every possible internet site where consumers’ personal information is at risk of being traded.

2 The monitored network does not cover all businesses or transactions.

3 Locking your Equifax credit report will prevent access to it by certain third parties. Locking your Equifax credit report will not prevent access to your credit report at any other credit reporting agency. Entities that may still have access to your Equifax credit report include: companies like ID Watchdog, which provide you with access to your credit report or credit score, or monitor your credit report as part of a subscription or similar service; companies that provide you with a copy of your credit report or credit score, upon your request; federal, state, and local government agencies and courts in certain circumstances; companies using the information in connection with the underwriting of insurance, or for employment, tenant or background screening purposes; companies that have a current account or relationship with you, and collection agencies acting on behalf of those whom you owe; companies that authenticate a consumer’s identity for purposes other than granting credit, or for investigating or preventing actual or potential fraud; and companies that wish to make pre-approved offers of credit or insurance to you. To opt out of such pre-approved offers, visit www.optoutprescreen.com.

4 Locking your child’s Equifax credit report helps prevent access to it by lenders and creditors. It will not prevent access to your child’s credit report at any other credit reporting agency.

5 The Identity Theft Insurance is underwritten and administered by American Bankers Insurance Company of Florida, an Assurant company. Please refer to the actual policies for terms, conditions, and exclusions of coverage. Coverage may not be available in all jurisdictions. Review the Summary of Benefits (www.idwatchdog.com/ terms/insurance).

© 2019 ID Watchdog. Other product and company names are property of their respective owners. EE79376CG0819

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