Marble Falls ISD Benefits Guide

2024-2025 Benefits Guide

1111 Employee Benefits E Services Group.

Rusty Freeman & Associates LLC 245 Landa Street New Braunfels, TX 78130 Phone: (830) 606-5100 www.usebsg.com

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Marble Falls Independent School District Love and Inspire

Support Contacts Danielle Hinson Director of Human Resources Office: (830) 693-4357 Email: dhinson@mfisd.txed.net Tracy Hamel

Randi Freeman

Senior Account Manager

Account Manager Office: (830) 606-5100

Email: thamel@usebsg.com

Rmfreeman@usebsg.com

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

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Table of Content Important Information

Page

Medical – TRS Activecare

4-6 7-10

Dental – Ameritas Group

11-13

Vision – Ameritas Group Disability – The Standard

14-15 16-17 18-23

Group & Vol Life – Lincoln Financial

24-34

Permanent Life – Texas Life Accident – Lincoln Financial

35 36-43

Hospital Indemnity - Lincoln Financial

44-47

Cancer – Transamerica Critical Illness – MetLife

48-55 56-58

Flexible Spending Account - NBS

59-62

Health Savings Account – NBS

63-70

EAP - BDA

Retirement Plans – The Omni Group

71

Benefit Contacts Benefit

Phone

Website

TRS ACTIVECARE – MEDICAL

1-800-523-2233

WWW.BCBSTX.COM/TRSACTIVECARE

AMERITAS GROUP – DENTAL

1-800-507-3800

AMERITAS – VISION

1-800-507-3800

WWW.AMERITASGROUP.COM WWW.AMERITASGROUP.COM

THE STANDARD - EAP

1-888-293-6948

WWW.WORKHEALTHLIFE.COM/STANDARD3

THE STANDARD – DISABILITY

1-800-368-1135

WWW.STANDARD.COM

TEXAS LIFE – PERMANENT LIFE LINCOLN – GROUP LIFE

1-800-283-9233

WWW.TEXASLIFE.COM

1-800-423-2765

WWW.LINCOLNFINANCIAL.COM WWW.METLIFE.COM

LINCOLN – HOSPITAL INDEMNITY

1-800-438-6388 1-800-521-3535

TRANSAMERICA – CANCER

1-888-763-7474

WWW.TRANSAMERICABENEFITS.COM

METLIFE – CRITICAL ILLNESS

1-800-438-6388

WWW.METLIFE.COM

NBS – FLEXIBLE SPENDING ACCOUNT NBS- HEALTH SAVINGS ACCOUNT

1-800-274-0503

WWW.NBSNENEFITS.COM

1-800-274-0503

WWW.NBSBENEFITS.COM

THE OMNI GROUP – RETIREMENT PLAN

1-877-544-6664

WWW.OMNI403B.COM

LINCOLN – ACCIDENT

WWW.LINCOLNFINANCIAL.COM

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OPEN ENROLLMENT INFORMATION The 20Ϯ3-2024 Section 125 Cafeteria Plan year begins 09/01/20Ϯ4 and ends 08/31/2025. All benefits elected during the annual open enrollment will be effective 09/01/20Ϯ4.

Know Your Benefits! Below is a summary of benefits offered through MFISD. x

x x

x

x

x x x x x x x x

Medical ( ^, Scott & White) - Health Insurance is provided by TRS ActiveCare. Please visit www.ďĐďƐƚdž͘trsactiveͬďĂ.com for questions related to health insurance or prescription benefits.

Hospital Indemnity (Allstate) – Benefits are paid directly to the insured to help with out of pocket expenses related to a hospital confinement. Maternity benefits are included.

TeleMedicine – TelaDoc, Access to physicians for non-emergency treatment/prescriptions is currently available with TRS Aetna Health Plans only. For questions please contact Teladoc directly at 1-855TELADOC (835-2362).

Dental (Ameritas) – Coverage for preventive, basic, major, and ortho services. The plan does not contain waiting periods. Remember that annual maximums reset on September 1st and that you will not receive a card. Temporary cards are available for print on the MFISD benefits website.

Vision ( ŵĞƌŝƚĂƐ) – Plans 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. For more information, including a list of providers visit ǁǁǁ͘ĂŵĞƌŝƚĂƐ͘ĐŽŵ͘ Disability (The Standard) – Long term income protection that is designed to provide up to 70% of your gross income.

Permanent Life (Texas Life) – Portable, permanent life insurance available for employees, their spouses and dependents. Employees can keep the coverage upon termination or retirement from MFISD. Group Life (Lincoln) – Group term life insurance that ends when you terminate employment with MFISD. Coverage is also available for spouses and dependent children.

Critical Illness (MetLife) – Critical Illness pays a lump sum benefit if the insured is diagnosed with a covered critical illness.

Cancer (Transamerica) – Pays benefits for internal cancer diagnosis. Includes an annual cancer screening benefit.

Accident (Lincoln Financial) – Pays benefits for off the job accidents and related treatments. Includes a physical/wellness exam reimbursement.

Flexible Spending Changing to NBS) –Make sure to spend/claim the money in your current reimbursement account by August 31, 20Ϯ4. Visit www͘ƵďĂ.tasconline.com to check account balances.

OMNI Retirement Plans – MFISD offers tax advantaged retirement plans designed to help supplement your TRS retirement benefits. Visit www.omni403b.com for more information.

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Click the "Log In" button located at the top right-hand corner of the page.

Fill in your last name, date of birth (DOB), and the last four digits of your Social Security Number (SSN). Click the "Log In" button.

Authentication Code: You will receive an authentication code on your cell phone.

Enter this code in the provided field and press "Log In" again.

Acknowledge Notifications: Go through all the acknowledgments as prompted.

Once logged in, start your 2024-2025 benefit enrollment.

Follow the instructions to select your benefits plan by plan.

For any assistance, please contact the Marble Falls ISD benefits department.

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More Important Information Covering Dependents?

To include dependents on any of your coverages through MFISD you must provide the dependents name, date of birth, and social security number.

Making Changes During Year Choose your benefits carefully. Several of the employee benefits plan contributions are made on a pre-tax basis and per IRS regulations, contribution amounts cannot be changed unless you experience a qualified life event.

Qualifying life events include: x x x x x

Marriage, divorce, legal separation; Death of spouse or dependent; Birth or adoption of a child; Changes in employment for spouse or dependents; Significant cost or coverage changes;

You must submit your benefit change requests and include required documentation within 30 days of the event.

Also note that per the IRS, only changes consistent with the life event are allowed.

New Employees New employees must enroll within 30 days of their hire date. If employees fail to enroll within the 30 days, all benefits will be waived.

Except for health insurance, plans will be effective on the first of the month following the date of hire. Health Insurance can be effective the date of hire or the first of the month following date of hire. Please be aware that if you choose date of hire as effective date for health insurance, you will be charged for the entire month.

Very Important Please carefully review your paycheck(s) to ensure all deductions are correct. If you find a discrepancy in your paycheck, please contact U.S. Employee Benefits immediately at (888) 836-5100. Discrepancies must be communicated within 30 days from the effective date of the policy.

Benefit tĞďƐŝƚĞ For contact information, claim forms, benefits guides and more please visit͗

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TRS-ActiveCare has more doctors and hospitals than the hill country has hills.

TRS-ActiveCare Plan Highlights 2024-25 Learn the Terms.

•P remium: The monthly amount you pay for health care coverage.

•D eductible: The annual amount for medical expenses you’re responsible to pay before your plan begins to pay.

•C opay: The set amount you pay for a covered service at the time you receive it. The amount can vary based on the service.

• Coinsurance: The portion you’re required to pay for services after you meet your deductible. It’s often a specified percentage of the costs; e.g., you pay 20% while the health care plan pays 80%.

• Out-of-Pocket Maximum: The maximum amount you pay each year for medical costs. After reaching the out-of-pocket maximum, the plan pays 100% of allowable charges for covered services.

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765394.0424

2024-25 TRS-ActiveCare Plan Highlights Sept. 1, 2024 – Aug. 31, 2025 How to Calculate Your Monthly Premium

All TRS-ActiveCare participants have three plan options. Each includes a wide range of wellness benefits.

TRS-ActiveCare Primary • Lowest premium of all three plans • Copays for doctor visits before you meet your deductible • Statewide network • Primary Care Provider referrals required to see specialists • Not compatible with a Health Savings Account • No out-of-network coverage

Total Monthly Premium Your Employer Contribution

TRS-ActiveCare Primary+

Plan Summary

Your Premium Ask your Benefits Administrator for your district’s specific premiums.

Being healthy is easy with: • $0 preventive care • 24/7 customer service • One-on-one health coaches

TRS-ActiveCare HD

• Lower deductible than the HD and Primary plans • Copays for many services and drugs • Higher premium • Statewide network • Primary Care Provider referrals required to see specialists • Not compatible with a Health Savings Account • No out-of-network coverage

TRS-ActiveCare 2

• Compatible with a Health Savings Account • Nationwide network with out-of-network coverage • No requirement for Primary Care Providers or referrals • Must meet your deductible before plan pays for non-preventive care

• Closed to new enrollees • Current enrollees can choose to stay in plan • Lower deductible • Copays for many services and drugs • Nationwide network with out-of-network coverage • No requirement for Primary Care Providers or referrals

Total Premium

Employer Contribution

Your Premium

Total Premium

Employer Contribution

Your Premium

Total Premium

Employer Contribution

Your Premium

Total Premium

Employer Contribution

Your Premium

Employee Only

$445

$445

$0

$522

$445

$77

$460

$445

$15

$1,013

$445

$568

Employee and Spouse

$1,202

$445

$757

$1,358

$445

$913

$1,242

$445

$2,402

$445

$1,957

$757

$445

$312

$888

$445

$443

$797

Employee and Children

$782

$445

$337

$1,507

$445

$1,062

$445

$1,278

$1,564

$445

$1,119

$2,841

$445

$2,396

Monthly Premiums

Wellness Benefits at No Extra Cost*

This plan is closed and not accepting new enrollees. If you’re currently enrolled in TRS-ActiveCare 2, you can remain in this plan.

Employee and Family

$1,513

$445

$1,068

$1,723

Plan Features Type of Coverage Individual/Family Deductible Coinsurance Individual/Family Maximum Out of Pocket

In-Network Coverage Only

In-Network

Out-of-Network

In-Network

$2,500/$5,000

$1,200/$2,400

$3,200/$6,400

$6,400/$12,800

$1,000/$3,000

Out-of-Network $2,000/$6,000 You pay 40% after deductible $23,700/$47,400

You pay 30% after deductible

You pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible

You pay 20% after deductible

$8,050/$16,100

$6,900/$13,800

$8,050/$16,100

$20,250/$40,500

$7,900/$15,800

Statewide Network

Statewide Network

Nationwide Network

Nationwide Network

PCP Required

Yes

Yes

No

No

Primary Care

$30 copay

$15 copay

You pay 30% after deductible

You pay 50% after deductible

$30 copay

You pay 40% after deductible

Specialist

$70 copay

$70 copay

You pay 30% after deductible

You pay 50% after deductible

$70 copay

You pay 40% after deductible

Urgent Care

$50 copay

$50 copay

You pay 30% after deductible

You pay 50% after deductible

$50 copay

You pay 40% after deductible

Network

• Weight loss programs

In-Network Coverage Only

• Nutrition programs • OviaTM pregnancy support

Doctor Visits

• TRS Virtual Health • Mental health benefits • And much more! * Available for all plans.

See the benefits guide for more details.

Immediate Care Emergency Care

You pay 30% after deductible

You pay 20% after deductible

You pay 30% after deductible

You pay a $250 copay plus 20% after deductible

TRS Virtual Health‑RediMDTM

$0 per medical consultation

$0 per medical consultation

$30 per medical consultation

$0 per medical consultation

TRS Virtual Health‑Teladoc

$12 per medical consultation

$12 per medical consultation

$42 per medical consultation

$12 per medical consultation

Integrated with medical

$200 deductible per participant (brand drugs only)

Integrated with medical

$200 brand deductible

$15/$45 copay; $0 copay for certain generics

$15/$45 copay

You pay 20% after deductible; $0 coinsurance for certain generics

$20/$45 copay

®

Primary Plans & Mental Health • Both Primary and Primary+ offer $0 virtual mental health visits with any in-network provider.

Prescription Drugs Drug Deductible Generics (31-Day Supply/90-Day Supply) Preferred (Max does not apply if brand is selected and generic is available)

You pay 30% after deductible

You pay 25% after deductible ($100 max)/ You pay 25% after deductible ($265 max)

You pay 25% after deductible

You pay 25% after deductible ($40 min/$80 max)/ You pay 25% after deductible ($105 min/$210 max)

Non-preferred

You pay 50% after deductible

You pay 50% after deductible

You pay 50% after deductible

You pay 50% after deductible ($100 min/$200 max)/ You pay 50% after deductible ($215 min/$430 max)

Specialty (31-Day Max)

$0 if SaveOnSP eligible; You pay 30% after deductible

$0 if SaveOnSP eligible; You pay 30% after deductible

You pay 20% after deductible

Insulin Out-of-Pocket Costs

$25 copay for 31-day supply; $75 for 61-90 day supply

$25 copay for 31-day supply; $75 for 61-90 day supply

You pay 25% after deductible

$0 if SaveOnSP eligible; You pay 30% after deductible ($200 min/$900 max)/ No 90-day supply of specialty medications $25 copay for 31-day supply; $75 for 61-90 day8supply

Compare Prices for Common Medical Services

REMEMBER: Benefit

Call a Personal Health Guide 24/7 to help you find the best price for a medical service.

Reach them at 1-866-355-5999.

TRS-ActiveCare Primary

TRS-ActiveCare Primary+

In-Network Only

In-Network Only

Office/Indpendent Lab: You pay $0

Office/Indpendent Lab: You pay $0

TRS-ActiveCare HD In-Network

In-Network

Out-of-Network

Office/Indpendent Lab: You pay $0 You pay 30% after deductible

Diagnostic Labs**

Out-of-Network

TRS-ActiveCare 2

You pay 50% after deductible

You pay 40% after deductible

Outpatient: You pay 30% after deductible

Outpatient: You pay 20% after deductible

High-Tech Radiology

You pay 30% after deductible

You pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible

You pay 20% after deductible + $100 copay per procedure

You pay 40% after deductible + $100 copay per procedure

Outpatient Costs

You pay 30% after deductible

You pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible

You pay 20% after deductible ($150 facility copay per incident)

You pay 40% after deductible ($150 facility copay per incident)

Inpatient Hospital Costs

You pay 30% after deductible

You pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible ($500 facility per day maximum)

You pay 20% after deductible ($150 facility copay per day)

You pay 40% after deductible ($500 facility copay per incident)

Freestanding Emergency Room

You pay $500 copay + 30% after deductible

You pay $500 copay + 20% after deductible

You pay $500 copay + 30% after deductible

You pay $500 copay + 50% after deductible

You pay $500 copay + 20% after deductible

You pay $500 copay + 40% after deductible

Facility: You pay 30% after deductible

Facility: You pay 20% after deductible

Facility: You pay 20% after deductible ($150 facility copay per day)

Professional Services: You pay $5,000 copay + 30% after deductible

Professional Services: You pay $5,000 copay + 20% after deductible

Professional Services: You pay $5,000 copay + 20% after deductible

Only covered if rendered at a BDC+ facility

Only covered if rendered at a BDC+ facility

Annual Vision Exam (one per plan year; performed by an ophthalmologist or optometrist)

You pay $70 copay

You pay $70 copay

You pay 30% after deductible

You pay 50% after deductible

You pay $70 copay

You pay 40% after deductible

Annual Hearing Exam (one per plan year)

$30 PCP copay $70 specialist copay

$15 PCP copay $70 specialist copay

You pay 30% after deductible

You pay 50% after deductible

$30 PCP copay $70 specialist copay

You pay 40% after deductible

Bariatric Surgery

Outpatient: You pay 20% after deductible

Not Covered

Not Covered

Not Covered

Only covered if rendered at a BDC+ facility

**Pre-certification for genetic and specialty testing may apply. Contact a PHG at 1-866-355-5999 with questions.

www.trs.texas.gov Revised 04/30/24

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2024-25 Health Maintenance Organization Plans and Premiums for Select Regions of the State

REMEMBER:

When you choose an HMO, you’re choosing a regional network.

TRS contracts with HMOs in certain regions to bring participants in those areas additional options.

HMOs set their own rates and premiums. They’re fully insured products who pay their own claims.

Total Monthly Premiums

Blue Essentials - South Texas HMOSM

Blue Essentials - West Texas HMOSM

Brought to you by TRS-ActiveCare

Brought to you by TRS-ActiveCare

You can choose this plan if you live in one of these counties: Cameron, Hildalgo, Starr, Willacy

You can choose this plan if you live in one of these counties: Andrews, Armstrong, Bailey, Borden, Brewster, Briscoe, Callahan, Carson, Castro, Childress, Cochran, Coke, Coleman, Collingsworth, Comanche, Concho, Cottle, Crane, Crockett, Crosby, Dallam, Dawson, Deaf Smith, Dickens, Donley, Eastland, Ector, Fisher, Floyd, Gaines, Garza, Glasscock, Gray, Hale, Hall, Hansford, Hartley, Haskell, Hemphill, Hockley, Howard, Hutchinson, Irion, Jones, Kent, Kimble, King, Knox, Lamb, Lipscomb, Llano, Loving, Lubbock, Lynn, Martin, Mason, McCulloch, Menard, Midland, Mitchell, Moore, Motley, Nolan, Ochiltree, Oldham, Parmer, Pecos, Potter, Randall, Reagan, Reeves, Roberts, Runnels, San Saba, Schleicher, Scurry, Shackelford, Sherman, Stephens, Sterling, Stonewall, Sutton, Swisher, Taylor, Terry, Throckmorton, Tom Green, Upton, Ward, Wheeler, Winkler, Yoakum

Total Premium

Employer Contribution

Your Premium

Total Premium

Employer Contribution

Your Premium

Employee Only

-

-

-

$1,011.20

-

-

Employee and Spouse

-

-

-

$2,462.32

-

-

Employee and Children

-

-

-

$1,593.00

-

-

Employee and Family

-

-

-

$2,614.90

-

-

Plan Features Type of Coverage

N/A

In-Network Coverage Only

Individual/Family Deductible

N/A

$950/$2,850

Coinsurance

N/A

You pay 25% after deductible

Individual/Family Maximum Out of Pocket

N/A

$7,450/$14,900

Primary Care

N/A

$20 copay

Specialist

N/A

$70 copay

Doctor Visits

Immediate Care Urgent Care

N/A

$50 copay

Emergency Care

N/A

$500 copay before deductible + 25% after deductible

Drug Deductible

N/A

$150

Days Supply

N/A

30-Day Supply/90-Day Supply

Prescription Drugs

Generics

N/A

$5/$12.50 copay; $0 for certain generics

Preferred Brand

N/A

You pay 30% after deductible

Non-preferred Brand

N/A

You pay 50% after deductible

Specialty

N/A

You pay 15%/25% after deductible (preferred/non-preferred)

www.trs.texas.gov Revised 04/30/24

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z z

DŽŶƚŚůLJ ZĂƚĞƐ ŵƉůŽLJĞĞ KŶůLJ ; Ϳ н ϭ ĞƉĞŶĚĞŶƚ н Ϯ Žƌ ŵŽƌĞ ĞƉĞŶĚĞŶƚƐ

KŶůĂLJƐ ƌŽǁŶƐ ;ϭ ŝŶ ϴ LJĞĂƌƐ ƉĞƌ ƚŽŽƚŚͿ ƌŽǁŶ ZĞƉĂŝƌ ŶĚŽĚŽŶƚŝĐƐ ;ŶŽŶƐƵƌŐŝĐĂůͿ ŶĚŽĚŽŶƚŝĐƐ ;ƐƵƌŐŝĐĂůͿ WĞƌŝŽĚŽŶƚŝĐƐ ;ŶŽŶƐƵƌŐŝĐĂůͿ WĞƌŝŽĚŽŶƚŝĐƐ ;ƐƵƌŐŝĐĂůͿ ĞŶƚƵƌĞ ZĞƉĂŝƌ /ŵƉůĂŶƚƐ WƌŽƐƚŚŽĚŽŶƚŝĐƐ ;ĨŝdžĞĚ ďƌŝĚŐĞ͖ ƌĞŵŽǀĂďůĞ ĐŽŵƉůĞƚĞͬƉĂƌƚŝĂů ĚĞŶƚƵƌĞƐͿ ;ϭ ŝŶ ϴ LJĞĂƌƐͿ ŽŵƉůĞdž džƚƌĂĐƚŝŽŶƐ ŶĞƐƚŚĞƐŝĂ

ΨϯϮ͘ϵϲ Ψϲϳ͘ϰϰ ΨϭϭϮ͘Ϯϴ

ŵĞƌŝƚĂƐ /ŶĨŽƌŵĂƚŝŽŶ tĞΖƌĞ ,ĞƌĞ ƚŽ ,ĞůƉ dŚŝƐ ƉůĂŶ ǁĂƐ ĚĞƐŝŐŶĞĚ ƐƉĞĐŝĨŝĐĂůůLJ ĨŽƌ ƚŚĞ ĂƐƐŽĐŝĂƚĞƐ ŽĨ D Z > & >>^ /E W E Ed ^ ,KK> /^dZ/ d͘ ƚ ŵĞƌŝƚĂƐ 'ƌŽƵƉ͕ ǁĞ ĚŽ ŵŽƌĞ ƚŚĂŶ ƉƌŽǀŝĚĞ ĐŽǀĞƌĂŐĞ Ͳ ǁĞ ŵĂŬĞ ƐƵƌĞ ƚŚĞƌĞΖƐ ĂůǁĂLJƐ Ă ĨƌŝĞŶĚůLJ ǀŽŝĐĞ ƚŽ ĞdžƉůĂŝŶ LJŽƵƌ ďĞŶĞĨŝƚƐ͕ ůŝƐƚĞŶ ƚŽ LJŽƵƌ ĐŽŶĐĞƌŶƐ͕ ĂŶĚ ĂŶƐǁĞƌ LJŽƵƌ ƋƵĞƐƚŝŽŶƐ͘ KƵƌ ĐƵƐƚŽŵĞƌ ƌĞůĂƚŝŽŶƐ ĂƐƐŽĐŝĂƚĞƐ ǁŝůů ďĞ ƉůĞĂƐĞĚ ƚŽ ĂƐƐŝƐƚ LJŽƵ ϳ Ă͘ŵ͘ ƚŽ ŵŝĚŶŝŐŚƚ ; ĞŶƚƌĂů dŝŵĞͿ DŽŶĚĂLJ ƚŚƌŽƵŐŚ dŚƵƌƐĚĂLJ͕ ĂŶĚ ϳ Ă͘ŵ͘ ƚŽ ϲ͗ϯϬ Ɖ͘ŵ͘ ŽŶ &ƌŝĚĂLJ͘ zŽƵ ĐĂŶ ƐƉĞĂŬ ƚŽ ƚŚĞŵ ďLJ ĐĂůůŝŶŐ ƚŽůůͲĨƌĞĞ͗ ϴϬϬͲϰϴϳͲϱϱϱϯ͘ &Žƌ ƉůĂŶ ŝŶĨŽƌŵĂƚŝŽŶ ĂŶLJ ƚŝŵĞ͕ ĂĐĐĞƐƐ ŽƵƌ ĂƵƚŽŵĂƚĞĚ ǀŽŝĐĞ ƌĞƐƉŽŶƐĞ ƐLJƐƚĞŵ Žƌ ŐŽ ŽŶůŝŶĞ ƚŽ ĂŵĞƌŝƚĂƐ͘ĐŽŵ͘

11

D Z > & >>^ /E W E Ed ^ ,KK> /^dZ/ d ĞŶƚĂů ,ŝŐŚůŝŐŚƚ ^ŚĞĞƚ Zdž ^ĂǀŝŶŐƐ KƵƌ ǀĂůƵĞĚ ƉůĂŶ ŵĞŵďĞƌƐ ĂŶĚ ƚŚĞŝƌ ĐŽǀĞƌĞĚ ĚĞƉĞŶĚĞŶƚƐ ĐĂŶ ƐĂǀĞ ŽŶ ƉƌĞƐĐƌŝƉƚŝŽŶ ŵĞĚŝĐĂƚŝŽŶƐ Ăƚ ŽǀĞƌ ϲϬ͕ϬϬϬ ƉŚĂƌŵĂĐŝĞƐ ĂĐƌŽƐƐ ƚŚĞ ŶĂƚŝŽŶ ŝŶĐůƵĚŝŶŐ s^͕ tĂůŐƌĞĞŶƐ͕ ZŝƚĞ ŝĚ ĂŶĚ tĂůŵĂƌƚ͘ dŚŝƐ Zdž ĚŝƐĐŽƵŶƚ ŝƐ ŽĨĨĞƌĞĚ Ăƚ ŶŽ ĂĚĚŝƚŝŽŶĂů ĐŽƐƚ͕ ĂŶĚ ŝƚ ŝƐ ŶŽƚ ŝŶƐƵƌĂŶĐĞ͘ dŽ ƌĞĐĞŝǀĞ ƚŚŝƐ Zdž ĚŝƐĐŽƵŶƚ͕ ŵĞƌŝƚĂƐ ƉůĂŶ ŵĞŵďĞƌƐ ũƵƐƚ ŶĞĞĚ ƚŽ ǀŝƐŝƚ ƵƐ Ăƚ ĂŵĞƌŝƚĂƐ͘ĐŽŵ ĂŶĚ ƐŝŐŶ ŝŶƚŽ ;Žƌ ĐƌĞĂƚĞͿ Ă ƐĞĐƵƌĞ ŵĞŵďĞƌ ĂĐĐŽƵŶƚ ǁŚĞƌĞ ƚŚĞLJ ĐĂŶ ĂĐĐĞƐƐ ĂŶĚ ƉƌŝŶƚ ĂŶ ŽŶůŝŶĞͲŽŶůLJ Zdž ĚŝƐĐŽƵŶƚ ƐĂǀŝŶŐƐ / ĐĂƌĚ͘

LJĞǁĞĂƌ ^ĂǀŝŶŐƐ ŵĞƌŝƚĂƐ ƉůĂŶ ŵĞŵďĞƌƐ ŵĂLJ ƌĞĐĞŝǀĞ ƵƉ ƚŽ ϭϱй ŽĨĨ ĞLJĞǁĞĂƌ ĨƌĂŵĞƐ ĂŶĚ ůĞŶƐĞƐ ƉƵƌĐŚĂƐĞĚ Ăƚ ĂŶLJ tĂůŵĂƌƚ sŝƐŝŽŶ ĞŶƚĞƌ ŶĂƚŝŽŶǁŝĚĞ͘ DĞŵďĞƌƐ ŵĂLJ ĂůƐŽ ďƌŝŶŐ ŝŶ ƚŚĞŝƌ ĐƵƌƌĞŶƚ ǀŝƐŝŽŶ ƉƌĞƐĐƌŝƉƚŝŽŶ ĨƌŽŵ ĂŶLJ ǀŝƐŝŽŶ ĐĂƌĞ ƉƌŽǀŝĚĞƌ ĂŶĚ ƉƵƌĐŚĂƐĞ ĞLJĞǁĞĂƌ Ăƚ tĂůŵĂƌƚ͘ dŚŝƐ ƐĂǀŝŶŐƐ ĂƌƌĂŶŐĞŵĞŶƚ ŝƐ ŶŽƚ ŝŶƐƵƌĂŶĐĞ͗ ŝƚ ŝƐ ĂǀĂŝůĂďůĞ ƚŽ ŵĞŵďĞƌƐ Ăƚ ŶŽ ĂĚĚŝƚŝŽŶĂů ĐŽƐƚ ƚŽ ƚŚĞŝƌ ƉůĂŶ ƉƌĞŵŝƵŵ͘ dŽ ƌĞĐĞŝǀĞ ƚŚĞ ĞLJĞǁĞĂƌ ƐĂǀŝŶŐƐ ŝĚĞŶƚŝĨŝĐĂƚŝŽŶ ĐĂƌĚ͕ ŵĞƌŝƚĂƐ ƉůĂŶ ŵĞŵďĞƌƐ ĐĂŶ ǀŝƐŝƚ ĂŵĞƌŝƚĂƐ͘ĐŽŵ ĂŶĚ ƐŝŐŶͲŝŶ ;Žƌ ĐƌĞĂƚĞͿ Ă ƐĞĐƵƌĞ ŵĞŵďĞƌ ĂĐĐŽƵŶƚ͘ DĞŵďĞƌƐ ŵƵƐƚ ƉƌĞƐĞŶƚ ƚŚĞ ŵĞƌŝƚĂƐ LJĞǁĞĂƌ ^ĂǀŝŶŐƐ ĂƌĚ Ăƚ ƚŝŵĞ ŽĨ ƉƵƌĐŚĂƐĞ ƚŽ ƌĞĐĞŝǀĞ ƚŚĞ ĚŝƐĐŽƵŶƚ͘

ĞŶƚĂů ZĞǁĂƌĚƐΠ dŚŝƐ ĚĞŶƚĂů ƉůĂŶ ŝŶĐůƵĚĞƐ Ă ǀĂůƵĂďůĞ ĨĞĂƚƵƌĞ ƚŚĂƚ ĂůůŽǁƐ ƋƵĂůŝĨLJŝŶŐ ƉůĂŶ ŵĞŵďĞƌƐ ƚŽ ĐĂƌƌLJŽǀĞƌ ƉĂƌƚ ŽĨ ƚŚĞŝƌ ƵŶƵƐĞĚ ĂŶŶƵĂů ŵĂdžŝŵƵŵ͘ ŵĞŵďĞƌ ĞĂƌŶƐ ĚĞŶƚĂů ƌĞǁĂƌĚƐ ďLJ ƐƵďŵŝƚƚŝŶŐ Ăƚ ůĞĂƐƚ ŽŶĞ ĐůĂŝŵ ĨŽƌ ĚĞŶƚĂů ĞdžƉĞŶƐĞƐ ŝŶĐƵƌƌĞĚ ĚƵƌŝŶŐ ƚŚĞ ďĞŶĞĨŝƚ LJĞĂƌ͕ ǁŚŝůĞ ƐƚĂLJŝŶŐ Ăƚ Žƌ ƵŶĚĞƌ ƚŚĞ ƚŚƌĞƐŚŽůĚ ĂŵŽƵŶƚ ĨŽƌ ďĞŶĞĨŝƚƐ ƌĞĐĞŝǀĞĚ ĨŽƌ ƚŚĂƚ LJĞĂƌ͘ ŵƉůŽLJĞĞƐ ĂŶĚ ƚŚĞŝƌ ĐŽǀĞƌĞĚ ĚĞƉĞŶĚĞŶƚƐ ŵĂLJ ĂĐĐƵŵƵůĂƚĞ ƌĞǁĂƌĚƐ ƵƉ ƚŽ ƚŚĞ ƐƚĂƚĞĚ ŵĂdžŝŵƵŵ ĐĂƌƌLJŽǀĞƌ ĂŵŽƵŶƚ͕ ĂŶĚ ƚŚĞŶ ƵƐĞ ƚŚŽƐĞ ƌĞǁĂƌĚƐ ĨŽƌ ĂŶLJ ĐŽǀĞƌĞĚ ĚĞŶƚĂů ƉƌŽĐĞĚƵƌĞƐ ƐƵďũĞĐƚ ƚŽ ĂƉƉůŝĐĂďůĞ ĐŽŝŶƐƵƌĂŶĐĞ ĂŶĚ ƉůĂŶ ƉƌŽǀŝƐŝŽŶƐ͘ /Ĩ Ă ƉůĂŶ ŵĞŵďĞƌ ĚŽĞƐŶΖƚ ƐƵďŵŝƚ Ă ĚĞŶƚĂů ĐůĂŝŵ ĚƵƌŝŶŐ Ă ďĞŶĞĨŝƚ LJĞĂƌ͕ Ăůů ĂĐĐƵŵƵůĂƚĞĚ ƌĞǁĂƌĚƐ ĂƌĞ ůŽƐƚ͘ Ƶƚ ŚĞ Žƌ ƐŚĞ ĐĂŶ ďĞŐŝŶ ĞĂƌŶŝŶŐ ƌĞǁĂƌĚƐ ĂŐĂŝŶ ƚŚĞ ǀĞƌLJ ŶĞdžƚ LJĞĂƌ͘ ĞŶĞĨŝƚ dŚƌĞƐŚŽůĚ

ΨϱϬϬ

ĞŶƚĂů ďĞŶĞĨŝƚƐ ƌĞĐĞŝǀĞĚ ĨŽƌ ƚŚĞ LJĞĂƌ ĐĂŶŶŽƚ ĞdžĐĞĞĚ ƚŚŝƐ ĂŵŽƵŶƚ

ŶŶƵĂů ĂƌƌLJŽǀĞƌ ŵŽƵŶƚ

ΨϮϱϬ

ĞŶƚĂů ZĞǁĂƌĚƐ ĂŵŽƵŶƚ ŝƐ ĂĚĚĞĚ ƚŽ ƚŚĞ ĨŽůůŽǁŝŶŐ LJĞĂƌΖƐ ŵĂdžŝŵƵŵ

DĂdžŝŵƵŵ ĂƌƌLJŽǀĞƌ

Ψϭ͕ϬϬϬ

DĂdžŝŵƵŵ ƉŽƐƐŝďůĞ ĂĐĐƵŵƵůĂƚŝŽŶ ĨŽƌ ĞŶƚĂů ZĞǁĂƌĚƐ

KƌƚŚŽĚŽŶƚŝĂ tĂŝƚŝŶŐ WĞƌŝŽĚ Ͳ ŶĞǁ ĞŶƌŽůůĞĞƐ ŽŶůLJ dŚĞ ŐƌŽƵƉ ŽĨ ŝŶŝƚŝĂů ĞŵƉůŽLJĞĞƐ ǁŚŽ ĞŶƌŽůů ŝŶ ƚŚŝƐ ƉůĂŶ ŚĂǀĞ ŶŽ ǁĂŝƚŝŶŐ ƉĞƌŝŽĚ ĨŽƌ ŽƌƚŚŽĚŽŶƚŝĂ ďĞŶĞĨŝƚƐ͘ ŶLJŽŶĞ ŚŝƌĞĚ ĂĨƚĞƌ ƚŚĞ ŝŶŝƚŝĂů ƉůĂŶ ĞŶƌŽůůŵĞŶƚ ǁŝůů ŚĂǀĞ Ă ϭϮͲŵŽŶƚŚ ǁĂŝƚŝŶŐ ƉĞƌŝŽĚ͕ ĂĨƚĞƌ ƚŚĞLJ ĞŶƌŽůů ŝŶ ƚŚŝƐ ĚĞŶƚĂů ƉůĂŶ͕ ďĞĨŽƌĞ ƚŚĞLJ ĂƌĞ ĞůŝŐŝďůĞ ƚŽ ƌĞĐĞŝǀĞ ŽƌƚŚŽĚŽŶƚŝĂ ďĞŶĞĨŝƚƐ͘

ĞŶƚĂů EĞƚǁŽƌŬ /ŶĨŽƌŵĂƚŝŽŶ dŽ ĨŝŶĚ Ă ƉƌŽǀŝĚĞƌ͕ ǀŝƐŝƚ ĂŵĞƌŝƚĂƐ͘ĐŽŵ ĂŶĚ ƐĞůĞĐƚ &/E WZKs/ Z͕ ƚŚĞŶ Ed >͘ ŶƚĞƌ LJŽƵƌ ĐƌŝƚĞƌŝĂ ƚŽ ƐĞĂƌĐŚ ďLJ ůŽĐĂƚŝŽŶ Žƌ ĨŽƌ Ă ƐƉĞĐŝĨŝĐ ĚĞŶƚŝƐƚ Žƌ ƉƌĂĐƚŝĐĞ͘ ĂůŝĨŽƌŶŝĂ ZĞƐŝĚĞŶƚƐ͗ tŚĞŶ ƉƌŽŵƉƚĞĚ ƚŽ ƐĞůĞĐƚ LJŽƵƌ ŶĞƚǁŽƌŬ͕ ĐŚŽŽƐĞ ƚŚĞ ŵĞƌŝƚĂƐ EĞƚǁŽƌŬ ĨŽƵŶĚ ŽŶ LJŽƵƌ / ĂƌĚ Žƌ ĐŽŶƚĂĐƚ ƵƐƚŽŵĞƌ ŽŶŶĞĐƚŝŽŶƐ Ăƚ ϴϬϬͲϰϴϳͲϱϱϱϯ͘

ĞŶƚĂů EĞƚǁŽƌŬ /Ŷ dĞdžĂƐ͕ ŽƵƌ ŶĞƚǁŽƌŬ ĂŶĚ ƉůĂŶƐ ĂƌĞ ƌĞĨĞƌƌĞĚ ƚŽ ĂƐ ƚŚĞ ŵĞƌŝƚĂƐ ĞŶƚĂů EĞƚǁŽƌŬ͘

WƌĞƚƌĞĂƚŵĞŶƚ tŚŝůĞ ǁĞ ĚŽŶΖƚ ƌĞƋƵŝƌĞ Ă ƉƌĞƚƌĞĂƚŵĞŶƚ ĂƵƚŚŽƌŝnjĂƚŝŽŶ ĨŽƌŵ ĨŽƌ ĂŶLJ ƉƌŽĐĞĚƵƌĞ͕ ǁĞ ƌĞĐŽŵŵĞŶĚ ƚŚĞŵ ĨŽƌ ĂŶLJ ĚĞŶƚĂů ǁŽƌŬ LJŽƵ ĐŽŶƐŝĚĞƌ ĞdžƉĞŶƐŝǀĞ͘ Ɛ Ă ƐŵĂƌƚ ĐŽŶƐƵŵĞƌ͕ ŝƚΖƐ ďĞƐƚ ĨŽƌ LJŽƵ ƚŽ ŬŶŽǁ LJŽƵƌ ƐŚĂƌĞ ŽĨ ƚŚĞ ĐŽƐƚ ƵƉ ĨƌŽŶƚ͘ ^ŝŵƉůLJ ĂƐŬ LJŽƵƌ ĚĞŶƚŝƐƚ ƚŽ ƐƵďŵŝƚ ƚŚĞ ŝŶĨŽƌŵĂƚŝŽŶ ĨŽƌ Ă ƉƌĞƚƌĞĂƚŵĞŶƚ ĞƐƚŝŵĂƚĞ ƚŽ ŽƵƌ ĐƵƐƚŽŵĞƌ ƌĞůĂƚŝŽŶƐ ĚĞƉĂƌƚŵĞŶƚ͘ tĞΖůů ŝŶĨŽƌŵ ďŽƚŚ LJŽƵ ĂŶĚ LJŽƵƌ ĚĞŶƚŝƐƚ ŽĨ ƚŚĞ ĞdžĂĐƚ ĂŵŽƵŶƚ LJŽƵƌ ŝŶƐƵƌĂŶĐĞ ǁŝůů ĐŽǀĞƌ ĂŶĚ ƚŚĞ ĂŵŽƵŶƚ ƚŚĂƚ LJŽƵ ǁŝůů ďĞ ƌĞƐƉŽŶƐŝďůĞ ĨŽƌ͘ dŚĂƚ ǁĂLJ͕ ƚŚĞƌĞ ǁŽŶΖƚ ďĞ ĂŶLJ ƐƵƌƉƌŝƐĞƐ ŽŶĐĞ ƚŚĞ ǁŽƌŬ ŚĂƐ ďĞĞŶ ĐŽŵƉůĞƚĞĚ͘

KƉĞŶ ŶƌŽůůŵĞŶƚ /Ĩ Ă ŵĞŵďĞƌ ĚŽĞƐ ŶŽƚ ĞůĞĐƚ ƚŽ ƉĂƌƚŝĐŝƉĂƚĞ ǁŚĞŶ ŝŶŝƚŝĂůůLJ ĞůŝŐŝďůĞ͕ ƚŚĞ ŵĞŵďĞƌ ŵĂLJ ĞůĞĐƚ ƚŽ ƉĂƌƚŝĐŝƉĂƚĞ Ăƚ ƚŚĞ ƉŽůŝĐLJŚŽůĚĞƌΖƐ ŶĞdžƚ ĞŶƌŽůůŵĞŶƚ ƉĞƌŝŽĚ͘ dŚŝƐ ĞŶƌŽůůŵĞŶƚ ƉĞƌŝŽĚ ǁŝůů ďĞ ŚĞůĚ ĞĂĐŚ LJĞĂƌ ĂŶĚ ƚŚŽƐĞ ǁŚŽ ĞůĞĐƚ ƚŽ ƉĂƌƚŝĐŝƉĂƚĞ ŝŶ ƚŚŝƐ ƉŽůŝĐLJ Ăƚ ƚŚĂƚ ƚŝŵĞ ǁŝůů ŚĂǀĞ ƚŚĞŝƌ ŝŶƐƵƌĂŶĐĞ ďĞĐŽŵĞ ĞĨĨĞĐƚŝǀĞ ŽŶ ^ĞƉƚĞŵďĞƌ ϭ͘

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D Z > & >>^ /E W E Ed ^ ,KK> /^dZ/ d ĞŶƚĂů ,ŝŐŚůŝŐŚƚ ^ŚĞĞƚ >ĂƚĞ ŶƚƌĂŶƚ WƌŽǀŝƐŝŽŶ tĞ ƐƚƌŽŶŐůLJ ĞŶĐŽƵƌĂŐĞ LJŽƵ ƚŽ ƐŝŐŶ ƵƉ ĨŽƌ ĐŽǀĞƌĂŐĞ ǁŚĞŶ LJŽƵ ĂƌĞ ŝŶŝƚŝĂůůLJ ĞůŝŐŝďůĞ͘ /Ĩ LJŽƵ ĐŚŽŽƐĞ ŶŽƚ ƚŽ ƐŝŐŶ ƵƉ ĚƵƌŝŶŐ ƚŚŝƐ ŝŶŝƚŝĂů ĞŶƌŽůůŵĞŶƚ ƉĞƌŝŽĚ͕ LJŽƵ ǁŝůů ďĞĐŽŵĞ Ă ůĂƚĞ ĞŶƚƌĂŶƚ͘ >ĂƚĞ ĞŶƚƌĂŶƚƐ ǁŝůů ďĞ ĞůŝŐŝďůĞ ĨŽƌ ŽŶůLJ ĞdžĂŵƐ͕ ĐůĞĂŶŝŶŐƐ͕ ĂŶĚ ĨůƵŽƌŝĚĞ ĂƉƉůŝĐĂƚŝŽŶƐ ĨŽƌ ƚŚĞ ĨŝƌƐƚ ϭϮ ŵŽŶƚŚƐ ƚŚĞLJ ĂƌĞ ĐŽǀĞƌĞĚ͘

^ĞĐƚŝŽŶ ϭϮϱ dŚŝƐ ƉůĂŶ ŝƐ ƉƌŽǀŝĚĞĚ ĂƐ ƉĂƌƚ ŽĨ ƚŚĞ WŽůŝĐLJŚŽůĚĞƌΖƐ ^ĞĐƚŝŽŶ ϭϮϱ WůĂŶ͘ ĂĐŚ ĞŵƉůŽLJĞĞ ŚĂƐ ƚŚĞ ŽƉƚŝŽŶ ƵŶĚĞƌ ƚŚĞ ^ĞĐƚŝŽŶ ϭϮϱ WůĂŶ ŽĨ ƉĂƌƚŝĐŝƉĂƚŝŶŐ Žƌ ŶŽƚ ƉĂƌƚŝĐŝƉĂƚŝŶŐ ŝŶ ƚŚŝƐ ƉůĂŶ͘ /Ĩ ĂŶ ĞŵƉůŽLJĞĞ ĚŽĞƐ ŶŽƚ ĞůĞĐƚ ƚŽ ƉĂƌƚŝĐŝƉĂƚĞ ǁŚĞŶ ŝŶŝƚŝĂůůLJ ĞůŝŐŝďůĞ͕ ŚĞͬƐŚĞ ŵĂLJ ĞůĞĐƚ ƚŽ ƉĂƌƚŝĐŝƉĂƚĞ Ăƚ ƚŚĞ WŽůŝĐLJŚŽůĚĞƌΖƐ ŶĞdžƚ ŶŶƵĂů ůĞĐƚŝŽŶ WĞƌŝŽĚ͘

ĞŶƚĂů ŽƐƚ ƐƚŝŵĂƚŽƌ ǀĞƌ ǁŽŶĚĞƌ ǁŚĂƚ Ă ĚĞŶƚĂů ƉƌŽĐĞĚƵƌĞ ƵƐƵĂůůLJ ĐŽƐƚƐ͍ dŚĞ ĂŶƐǁĞƌ ĐĂŶ ďĞ ĨŽƵŶĚ ƵƐŝŶŐ ƚŚĞ ŵĞƌŝƚĂƐ ŐƌŽƵƉ ĚŝǀŝƐŝŽŶ͛Ɛ ĞŶƚĂů ŽƐƚ ƐƚŝŵĂƚŽƌ ƚŽŽů ůŽĐĂƚĞĚ ŝŶ ŽƵƌ ^ĞĐƵƌĞ DĞŵďĞƌ ĐĐŽƵŶƚ ƉŽƌƚĂů͘ DĞŵďĞƌƐ ĐĂŶ ƐĞĂƌĐŚ ďLJ /W ŽĚĞ ĨŽƌ Ă ƐƉĞĐŝĨŝĐ ĚĞŶƚĂů ƉƌŽĐĞĚƵƌĞ ĂŶĚ ƐĞĞ ĨĞĞ ƌĂŶŐĞ ĞƐƚŝŵĂƚĞƐ ĨŽƌ ŽƵƚͲŽĨͲŶĞƚǁŽƌŬ ŐĞŶĞƌĂů ĚĞŶƚŝƐƚƐ ŝŶ ƚŚĂƚ ĂƌĞĂ͘ KĨ ĐŽƵƌƐĞ͕ ǁĞ ĂůǁĂLJƐ ƐƵŐŐĞƐƚ ƚŚĂƚ ŵĞŵďĞƌƐ ƉĂƌƚŶĞƌ ǁŝƚŚ ƚŚĞŝƌ ĚĞŶƚŝƐƚƐ͕ ƐŽ ƚŚĞLJ ŬŶŽǁ ǁŚĂƚ͛Ɛ ŝŶǀŽůǀĞĚ ŝŶ ĂŶLJ ƌĞĐŽŵŵĞŶĚĞĚ ƚƌĞĂƚŵĞŶƚ ƉůĂŶ͘ dŚĞ ĞƐƚŝŵĂƚŽƌ ƚŽŽů ŝƐ ƉŽǁĞƌĞĚ ďLJ 'ŽϮ ĞŶƚĂů ĂŶĚ ƵƐĞƐ & /Z ,ĞĂůƚŚ ĚĂƚĂ ƚŚĂƚ ŝƐ ƵƉĚĂƚĞĚ ĂŶŶƵĂůůLJ͘ WůĞĂƐĞ ŶŽƚĞ͕ ĐŽƐƚ ĞƐƚŝŵĂƚĞƐ ĚŽ ŶŽƚ ƌĞĨůĞĐƚ ĚŝƐĐŽƵŶƚĞĚ ƌĂƚĞƐ ĂǀĂŝůĂďůĞ ƚŚƌŽƵŐŚ ƉƌŽǀŝĚĞƌ ŶĞƚǁŽƌŬƐ͕ ĂŶĚ ƚŚĞ ĞƐƚŝŵĂƚŽƌ ĚŽĞƐ ŶŽƚ ŝŶĐůƵĚĞ ŽƌƚŚŽĚŽŶƚŝĐ ĞƐƚŝŵĂƚĞƐ Ăƚ ƚŚŝƐ ƚŝŵĞ͘ /Ŷ ĂĚĚŝƚŝŽŶ͕ ǁŚĞŶ ŵĞŵďĞƌƐ ĂƌĞ ŝŶ ƚŚĞŝƌ ^ĞĐƵƌĞ DĞŵďĞƌ ĐĐŽƵŶƚ͕ ƚŚĞLJ ĐĂŶ͗ z 'Ž ƉĂƉĞƌůĞƐƐ ǁŝƚŚ ĞůĞĐƚƌŽŶŝĐ džƉůĂŶĂƚŝŽŶ ŽĨ ĞŶĞĨŝƚƐ ƐƚĂƚĞŵĞŶƚƐ ĂŶĚ ƌĞĚƵĐĞ ƚŚĞ ĐůƵƚƚĞƌ ŝŶ ƚŚĞŝƌ ŵĂŝůďŽdžĞƐ z sŝĞǁ ƚŚĞŝƌ ĐĞƌƚŝĨŝĐĂƚĞ ŽĨ ŝŶƐƵƌĂŶĐĞ ĂŶĚ ƐƉĞĐŝĨŝĐ ƉůĂŶ ďĞŶĞĨŝƚƐ ŝŶĨŽƌŵĂƚŝŽŶ z ĐĐĞƐƐ ǀĂůƵĞͲĂĚĚĞĚ ĞdžƚƌĂƐ ůŝŬĞ ƚŚĞ Zdž ĚŝƐĐŽƵŶƚ / ĐĂƌĚ

tŽƌůĚǁŝĚĞ ^ƵƉƉŽƌƚ tŚĞŶ ŽƵƌ ŵĞŵďĞƌƐ ƚƌĂǀĞů ĂďƌŽĂĚ͕ ƚŚĞLJ͛ůů ŚĂǀĞ ƉĞĂĐĞ ŽĨ ŵŝŶĚ ŬŶŽǁŝŶŐ ƚŚĂƚ ƐŚŽƵůĚ Ă ĚĞŶƚĂů Žƌ ǀŝƐŝŽŶ ŶĞĞĚ ĂƌŝƐĞ͕ ŚĞůƉ ŝƐ ũƵƐƚ Ă ƉŚŽŶĞ ĐĂůů ĂǁĂLJ͘ dŚƌŽƵŐŚ y ƐƐŝƐƚĂŶĐĞ͕ ŵĞƌŝƚĂƐ ŽĨĨĞƌƐ ŝƚƐ ĚĞŶƚĂů ĂŶĚ ǀŝƐŝŽŶ ƉůĂŶ ŵĞŵďĞƌƐ ϮϰͲŚŽƵƌ ĂĐĐĞƐƐ ƚŽ ĚĞŶƚĂů Žƌ ǀŝƐŝŽŶ ƉƌŽǀŝĚĞƌ ƌĞĨĞƌƌĂůƐ ǁŚĞŶ ƚƌĂǀĞůŝŶŐ ŽƵƚƐŝĚĞ ƚŚĞ h͘^͘ /ŵŵĞĚŝĂƚĞůLJ ĂĨƚĞƌ Ă ĐĂůů ŝƐ ŵĂĚĞ ƚŽ y ͕ ĂŶ ĂƐƐŝƐƚĂŶĐĞ ĐŽŽƌĚŝŶĂƚŽƌ ĂƐƐĞƐƐĞƐ ƚŚĞ ƐŝƚƵĂƚŝŽŶ͕ ƉƌŽǀŝĚĞƐ ĐƌĞĚŝďůĞ ƉƌŽǀŝĚĞƌ ƌĞĨĞƌƌĂůƐ ĂŶĚ ĐĂŶ ĞǀĞŶ ĂƐƐŝƐƚ ǁŝƚŚ ŵĂŬŝŶŐ ƚŚĞ ĂƉƉŽŝŶƚŵĞŶƚ͘ tŝƚŚŝŶ ϰϴ ŚŽƵƌƐ ĨŽůůŽǁŝŶŐ ƚŚĞ ĂƉƉŽŝŶƚŵĞŶƚ͕ ƚŚĞ ĐŽŽƌĚŝŶĂƚŽƌ ĐĂůůƐ ƚŚĞ ŵĞŵďĞƌ ƚŽ ĨŝŶĚ ŽƵƚ ŝĨ ĂĚĚŝƚŝŽŶĂů ĂƐƐŝƐƚĂŶĐĞ ŝƐ ŶĞĞĚĞĚ͘ /Ĩ Ăůů ŝƐ ǁĞůů͕ ƚŚĞ ĐĂƐĞ ŝƐ ĐůŽƐĞĚ͘ dŚĞŶ͕ ƚŚĞ ƉůĂŶ ŵĞŵďĞƌ ŵĂLJ ƐƵďŵŝƚ Ă ĐůĂŝŵ ƚŽ ŵĞƌŝƚĂƐ ĨŽƌ ƌĞŝŵďƵƌƐĞŵĞŶƚ ĐŽŶƐŝĚĞƌĂƚŝŽŶ ďĂƐĞĚ ŽŶ ĂƉƉůŝĐĂďůĞ ƉůĂŶ ďĞŶĞĨŝƚƐ͘ ŽŶƚĂĐƚ y ƐƐŝƐƚĂŶĐĞ h^ ƚŽůů ĨƌĞĞ ďLJ ĐĂůůŝŶŐ ϴϲϲͲϲϲϮͲϮϳϯϭ͕ Žƌ ĐĂůů ĐŽůůĞĐƚ ĨƌŽŵ ĂŶLJǁŚĞƌĞ ŝŶ ƚŚĞ ǁŽƌůĚ ďLJ ĚŝĂůŝŶŐ ϭͲϯϭϮͲ ϵϯϱͲϯϳϮϳ͘

>ĂŶŐƵĂŐĞ ^ĞƌǀŝĐĞƐ tĞ ƌĞĐŽŐŶŝnjĞ ƚŚĞ ŝŵƉŽƌƚĂŶĐĞ ŽĨ ĐŽŵŵƵŶŝĐĂƚŝŶŐ ǁŝƚŚ ŽƵƌ ŐƌŽǁŝŶŐ ŶƵŵďĞƌ ŽĨ ŵƵůƚŝůŝŶŐƵĂů ĐƵƐƚŽŵĞƌƐ͘ dŚĂƚ ŝƐ ǁŚLJ ǁĞ ŽĨĨĞƌ Ă ůĂŶŐƵĂŐĞ ĂƐƐŝƐƚĂŶĐĞ ƉƌŽŐƌĂŵ ƚŚĂƚ ŐŝǀĞƐ LJŽƵ ĂĐĐĞƐƐ ƚŽ͗ ^ƉĂŶŝƐŚͲƐƉĞĂŬŝŶŐ ĐůĂŝŵƐ ĐŽŶƚĂĐƚ ĐĞŶƚĞƌ ƌĞƉƌĞƐĞŶƚĂƚŝǀĞƐ͕ ƚĞůĞƉŚŽŶĞ ŝŶƚĞƌƉƌĞƚĂƚŝŽŶ ƐĞƌǀŝĐĞƐ ŝŶ Ă ǁŝĚĞ ƌĂŶŐĞ ŽĨ ůĂŶŐƵĂŐĞƐ͕ ŽŶůŝŶĞ ĚĞŶƚĂů ŶĞƚǁŽƌŬ ƉƌŽǀŝĚĞƌ ƐĞĂƌĐŚ ŝŶ ^ƉĂŶŝƐŚ ĂŶĚ Ă ǀĂƌŝĞƚLJ ŽĨ ^ƉĂŶŝƐŚ ĚŽĐƵŵĞŶƚƐ ƐƵĐŚ ĂƐ ĞŶƌŽůůŵĞŶƚ ĨŽƌŵƐ͕ ĐůĂŝŵ ĨŽƌŵƐ ĂŶĚ ĐĞƌƚŝĨŝĐĂƚĞƐ ŽĨ ŝŶƐƵƌĂŶĐĞ͘ dŚŝƐ ĚŽĐƵŵĞŶƚ ŝƐ Ă ŚŝŐŚůŝŐŚƚ ŽĨ ƉůĂŶ ďĞŶĞĨŝƚƐ ƉƌŽǀŝĚĞĚ ďLJ ŵĞƌŝƚĂƐ >ŝĨĞ /ŶƐƵƌĂŶĐĞ ŽƌƉ͘ ĂƐ ƐĞůĞĐƚĞĚ ďLJ LJŽƵƌ ĞŵƉůŽLJĞƌ͘ /ƚ ŝƐ ŶŽƚ Ă ĐĞƌƚŝĨŝĐĂƚĞ ŽĨ ŝŶƐƵƌĂŶĐĞ ĂŶĚ ĚŽĞƐ ŶŽƚ ŝŶĐůƵĚĞ ĞdžĐůƵƐŝŽŶƐ ĂŶĚ ůŝŵŝƚĂƚŝŽŶƐ͘ &Žƌ ĞdžĐůƵƐŝŽŶƐ ĂŶĚ ůŝŵŝƚĂƚŝŽŶƐ͕ Žƌ Ă ĐŽŵƉůĞƚĞ ůŝƐƚ ŽĨ ĐŽǀĞƌĞĚ ƉƌŽĐĞĚƵƌĞƐ͕ ĐŽŶƚĂĐƚ LJŽƵƌ ďĞŶĞĨŝƚƐ ĂĚŵŝŶŝƐƚƌĂƚŽƌ͘

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MARBLE FALLS INDEPENDENT SCHOOL DISTRICT Eye Care Highlight Sheet Low Plan: Focus® Plan Summary

Effective Date: 9/1/2022 Out of Network

VSP Choice Network + Affiliates Deductibles

Annual Eye Exam Lenses (per pair) Single Vision Bifocal Trifocal Lenticular Progressive Contacts Fit & Follow Up Exams

$15 Exam $15 Eye Glass Lenses or Frames* Covered in full

$15 Exam $15 Eye Glass Lenses or Frames Up to $45

Covered in full Covered in full Covered in full Covered in full See lens options

Up to $30 Up to $50 Up to $65 Up to $100 NA

Member cost up to $60

No benefit

Up to $150 Covered in full $150**

Up to $120 Up to $210 Up to $70

Elective Medically Necessary Frame Allowance Frequencies (months) Exam/Lens/Frame

12/12/12 Based on plan year *Deductible applies to a complete pair of glasses or to frames, whichever is selected. **The Costco and Walmart allowance will be the wholesale equivalent.

12/12/12 Based on plan year

Lens Options (member cost)*

Progressive Lenses Std. Polycarbonate Solid Plastic Dye

VSP Choice Network + Affiliates (Other than Costco) Covered in Full Covered in full for dependent children $33 adults $15 (except Pink I & II) $17 $31-$82

Out of Network Up to Lined Bifocal allowance.

No benefit No benefit

Plastic Gradient Dye Photochromatic Lenses (Glass & Plastic) Scratch Resistant Coating $17-$33 Anti-Reflective Coating $43-$85 Ultraviolet Coating $16 *Lens Option member costs vary by prescription, option chosen and retail locations.

Monthly Rates Employee Only (EE) EE + Spouse EE + Children EE + Spouse & Children Additional Focus® Choice Network Features Contact Lenses Elective

No benefit No benefit No benefit No benefit No benefit

$8.64 $16.40 $17.28 $25.40

Allowance can be applied to disposables, but the dollar amount must be used all at once (provider will order 3 or 6 month supply). Applies when contacts are chosen in lieu of glasses. For plans without a separate contact fitting & evaluation (which includes follow up contact lens exams), the cost of the fitting and evaluation is deducted from the allowance.

Additional Glasses

20% off additional complete pairs of prescription glasses and/or prescription sunglasses.*

Frame Discount

VSP offers 20% off any amount above the retail allowance.*

Laser VisionCare

VSP offers an average discount of 15% off or 5% off a promotional offer for LASIK Custom LASIK and PRK. The maximum out-of-pocket per eye for members is $1,800 for LASIK and $2,300 for custom LASIK using Wavefront technology, and $1,500 for PRK. In order to receive the benefit, a VSP provider must coordinate the procedure.

Low Vision

With prior authorization, 75% of approved amount (up to $1,000 is covered every two years).

Based on applicable laws, reduced costs may vary by doctor location.

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MARBLE FALLS INDEPENDENT SCHOOL DISTRICT Eye Care Highlight Sheet High Plan : Focus® Plan Summary

Effective Date: 9/1/2022 Out of Network

VSP Choice Network + Affiliates Deductibles

Annual Eye Exam Lenses (per pair) Single Vision Bifocal Trifocal Lenticular Progressive Contacts Fit & Follow Up Exams

$0 Exam $0 Eye Glass Lenses or Frames* Covered in full

$0 Exam $0 Eye Glass Lenses or Frames Up to $45

Covered in full Covered in full Covered in full Covered in full See lens options

Up to $30 Up to $50 Up to $65 Up to $100 NA

Member cost up to $60

No benefit

Up to $250 Covered in full $175**

Up to $145 Up to $210 Up to $70

Elective Medically Necessary Frame Allowance Frequencies (months) Exam/Lens/Frame

12/12/12 Based on plan year *Deductible applies to a complete pair of glasses or to frames, whichever is selected. **The Costco and Walmart allowance will be the wholesale equivalent.

12/12/12 Based on plan year

Lens Options (member cost)*

Progressive Lenses Std. Polycarbonate Solid Plastic Dye

VSP Choice Network + Affiliates (Other than Costco) Covered in Full Covered in Full $15 (except Pink I & II) $17 $31-$82

Out of Network Up to Lined Bifocal allowance.

No benefit No benefit

Plastic Gradient Dye Photochromatic Lenses (Glass & Plastic) Scratch Resistant Coating Covered in Full Anti-Reflective Coating $43-$85 Ultraviolet Coating Covered in Full *Lens Option member costs vary by prescription, option chosen and retail locations.

Monthly Rates Employee Only (EE) EE + Spouse EE + Children EE + Spouse & Children Additional Focus® Choice Network Features Contact Lenses Elective

No benefit No benefit No benefit No benefit No benefit

$12.96 $24.64 $25.92 $38.12

Allowance can be applied to disposables, but the dollar amount must be used all at once (provider will order 3 or 6 month supply). Applies when contacts are chosen in lieu of glasses. For plans without a separate contact fitting & evaluation (which includes follow up contact lens exams), the cost of the fitting and evaluation is deducted from the allowance.

Additional Glasses

20% off additional complete pairs of prescription glasses and/or prescription sunglasses.*

Frame Discount

VSP offers 20% off any amount above the retail allowance.*

Laser VisionCare

VSP offers an average discount of 15% off or 5% off a promotional offer for LASIK Custom LASIK and PRK. The maximum out-of-pocket per eye for members is $1,800 for LASIK and $2,300 for custom LASIK using Wavefront technology, and $1,500 for PRK. In order to receive the benefit, a VSP provider must coordinate the procedure.

Low Vision

With prior authorization, 75% of approved amount (up to $1,000 is covered every two years).

Based on applicable laws, reduced costs may vary by doctor location.

15

WůĂŶ ƉƌŽǀŝĚĞĚ ďLJ D&/^ Ăƚ EK K^d ƚŽ Ăůů ďĞŶĞĨŝƚ ĞůŝŐŝďůĞ ĞŵƉůŽLJĞĞƐ͘

A helping hand when you need it.

Rely on the support, guidance and resources of your Employee Assistance Program.

Standard Insurance Company

16

There are times in life when you might need a little help coping or figuring out what to do. Take advantage of the Employee Assistance Program1 (EAP) which includes WorkLife Services and is available to you and your family in connection with your group insurance from Standard Insurance Company (The Standard). It’s confidential — information will be released only with your permission or as required by law.

Connection to Resources, Support and Guidance You, your dependents (including children to age 26)2 and all household members can contact master’s-degreed clinicians 24/7 by phone, online, live chat, email and text. There’s even a mobile EAP app. Receive referrals to support groups, a network counselor, community resources or your health plan. If necessary, you’ll be connected to emergency services.

With EAP, assistance is immediate, personal and available when you need it.

Your program includes up to three face-to-face assessment and counseling sessions per issue. EAP services can help with: Depression, grief, loss and emotional well-being Family, marital and other relationship issues Life improvement and goal-setting Addictions such as alcohol and drug abuse

Contact EAP

Stress or anxiety with work or family

888.293.6948 TDD: 800.327.1833 24 hours a day, seven days a week

Financial and legal concerns

workhealthlife.com/Standard3

Identity theft and fraud resolution Online will preparation

WorkLife Services NOTE: It’s a violation of your company’s contract to share this information with individuals who are not eligible for this service.

WorkLife Services are included with the Employee Assistance Program. Get help with referrals for important needs like education, adoption, travel, daily living and care for your pet, child or elderly loved one.

Online Resources Visit workhealthlife.com/Standard3 to explore a wealth of information online, including videos, guides, articles, webinars, resources, self-assessments and calculators.

1 The EAP service is provided through an arrangement with Morneau Shepell, which is not affiliated with The Standard. Morneau Shepell is solely responsible for providing and administering the included service. EAP is not an insurance product and is provided to groups of 10–2,499 lives. This service is only available while insured under The Standard’s group policy.

2 Individual EAP counseling sessions area available to eligible participants 16 years and older; family sessions are available for eligible members 12 years and older, and their parent or guardian. Children under the age of 12 will not receive individual counseling sessions.

The Standard is a marketing name for StanCorp Financial Group, Inc. and subsidiaries. Insurance products are offered by Standard Insurance Company of Portland, Oregon in all states except New York. Product features and availability vary by state and are solely the responsibility of Standard Insurance Company.

Standard Insurance Company 1100 SW Sixth Avenue Portland, OR 97204

standard.com Employee Assistance Program-3 SI 17201 (7/17) EE

17

'LVDELOLW\ ,QVXUDQFH 7KH 6WDQGDUG Voluntary Long Term Disability Insurance Standard Insurance Company has developed this document to provide you with information about the optional insurance coverage you may select through the Marble Falls Independent School District. Written in non-technical language, this is not intended as a complete description of the coverage. If you have additional questions, please check with your human resources representative.

Employer Plan Effective Date A minimum number of eligible employees must apply and qualify for the proposed plan before Voluntary LTD coverage can become effective. This level of participation has been agreed upon by the Marble Falls Independent School District and The Standard.

Eligibility To become insured, you must be: x A regular employee of the Marble Falls Independent School District, excluding temporary or seasonal employees, full-time members of the armed forces, leased employees or independent contractors x Actively at work at least 20 hours each week x A citizen or resident of the United States or Canada

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

Benefit Amount You may select a monthly benefit amount in $100 increments from $200 to $7,500; based on the tables and guidelines presented in the Rates section of these Coverage Highlights. The monthly benefit amount must not exceed 70 percent of your monthly earnings.

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

Plan Maximum Monthly Benefit: 70 percent of predisability earnings Plan Minimum Monthly Benefit: 25 percent of your LTD benefit before reduction by deductible income

18

Benefit Waiting Period and Maximum Benefit Period The benefit waiting period is the period of time that you must be continuously disabled before benefits become payable. Benefits are not payable during the benefit waiting period. The maximum benefit period is the period for which benefits are payable. The benefit waiting period and maximum benefit period associated with your plan options are shown below: Option 1 2 3 4 5 6

Accidental Injury 0 days 14 days 30 days 60 days 90 days 180 days

Other Disability 3 days 14 days 30 days 60 days 90 days 180 days

Maximum Benefit Period To Age 65 for Accident and 3 Years for Sickness

Options 1-6: Maximum Benefit Period of 3 years for Sickness If you become disabled before age 64, LTD benefits may continue during disability for 3 years. If you become disabled at age 64 or older, the benefit duration is determined by your age when disability begins: Age 64 65 66 67 68 69+

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

Options 1-6: Maximum Benefit Period To Age 65 for Accident If you become disabled before age 62, LTD benefits may continue during disability until you reach age 65. If you become disabled at age 62 or older, the benefit duration is determined by your age when disability begins: Age 62 63 64 65 66 67 68 69+

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

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

19

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

Preexisting Condition Period: The 90-day period just before your insurance becomes effective Exclusion Period: 12 months

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

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

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

Other LTD Features x Employee Assistance Program (EAP) – This program offers support, guidance and resources that can help an employee resolve personal issues and meet life’s challenges. x Family Care Expense Adjustment – Disabled employees faced with the added expense of family care when returning to work may receive combined income from LTD benefits and work earnings in excess of 100 percent of indexed predisability earnings during the first 12 months immediately after a disabled employee’s return to work. x Special Dismemberment Provision – If an employee suffers a lost as a result of an accident, the employee will be considered disabled for the applicable Minimum Benefit Period and can extend beyond the end of the Maximum Benefit Period x Reasonable Accommodation Expense Benefit – Subject to The Standard’s prior approval, this benefit allows us to pay up to $25,000 of an employer’s expenses toward work-site modifications that result in a disabled employee’s return to work. x Survivor Benefit – A Survivor Benefit may also be payable. This benefit can help to address a family’s financial need in the event of the employee’s death. x Return to Work (RTW) Incentive – The Standard’s RTW Incentive is one of the most comprehensive in the employee benefits history. For the first 12 months after returning to work, the employee’s LTD benefit will not be reduced by work earnings until work earnings plus the LTD benefit exceed 100 percent of predisability earnings. After that period, only 50 percent of work earnings are deducted. x Rehabilitation Plan Provision – Subject to The Standard’s prior approval, rehabilitation incentives may include training and education expense, family (child and elder) care expenses, and job-related and job search expenses.

When Benefits End LTD benefits end automatically on the earliest of: x The date you are no longer disabled x The date your maximum benefit period ends x The date you die x The date benefits become payable under any other LTD plan under which you become insured through employment during a period of temporary recovery x The date you fail to provide proof of continued disability and entitlement to benefits 20

Rates Employees can select a monthly LTD benefit ranging from a minimum of $200 to a maximum amount based on how much they earn. Referencing the appropriate attached charts, follow these steps to find the monthly cost for your desired level of monthly LTD benefit and benefit waiting period: 1. Find the maximum LTD benefit by locating the amount of your earnings in either the Annual Earnings or Monthly Earnings column. The LTD benefit amount shown associated with these earnings is the maximum amount you can receive. If your earnings fall between two amounts, you must select the lower amount.

2. Select the desired monthly LTD benefit between the minimum of $200 and the determined maximum amount, making sure not to exceed the maximum for your earnings.

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

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

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

21

Annual Monthly Earnings Earnings

Accident/Sickness Benefit Waiting Period Cost Per Month

Monthly Disability Benefit

0/3

14/14

30/30

60/60

90/90

180/180

3,600

300

200

7.58

4.69

3.91

2.97

2.48

1.85

5,400

450

300

11.37

7.04

5.86

4.46

3.73

2.78

7,200

600

400

15.16

9.39

7.81

5.94

4.97

3.71

9,000

750

500

18.96

11.73

9.77

7.43

6.21

4.64

10,800

900

600

22.75

14.08

11.72

8.91

7.45

5.56

12,600

1,050

700

26.54

16.43

13.68

10.40

8.69

6.49

14,400

1,200

800

30.33

18.77

15.63

11.88

9.94

7.42

16,200

1,350

900

34.12

21.12

17.58

13.37

11.18

8.34

18,000

1,500

1,000

37.91

23.47

19.54

14.85

12.42

9.27

19,800

1,650

1,100

41.70

25.82

21.49

16.34

13.66

10.20

21,600

1,800

1,200

45.49

28.16

23.44

17.82

14.90

11.12

23,400

1,950

1,300

49.28

30.51

25.40

19.31

16.15

12.05

25,200

2,100

1,400

53.07

32.86

27.35

20.79

17.39

12.98

27,000

2,250

1,500

56.87

35.20

29.31

22.28

18.63

13.91

28,800

2,400

1,600

60.66

37.55

31.26

23.76

19.87

14.83

30,600

2,550

1,700

64.45

39.90

33.21

25.25

21.11

15.76

32,400

2,700

1,800

68.24

42.24

35.17

26.73

22.36

16.69

34,200

2,850

1,900

72.03

44.59

37.12

28.22

23.60

17.61

36,000

3,000

2,000

75.82

46.94

39.07

29.70

24.84

18.54

37,800

3,150

2,100

79.61

49.28

41.03

31.19

26.08

19.47

39,600

3,300

2,200

83.40

51.63

42.98

32.67

27.32

20.39

41,400

3,450

2,300

87.19

53.98

44.94

34.16

28.57

21.32

43,200

3,600

2,400

90.98

56.32

46.89

35.64

29.81

22.25

45,000

3,750

2,500

94.78

58.67

48.84

37.13

31.05

23.18

46,800

3,900

2,600

98.57

61.02

50.80

38.61

32.29

24.10

48,600

4,050

2,700

102.36

63.36

52.75

40.10

33.53

25.03

50,400

4,200

2,800

106.15

65.71

54.70

41.58

34.78

25.96

52,200

4,350

2,900

109.94

68.06

56.66

43.07

36.02

26.88

54,000

4,500

3,000

113.73

70.41

58.61

44.55

37.26

27.81

55,800

4,650

3,100

117.52

72.75

60.57

46.04

38.50

28.74

57,600

4,800

3,200

121.31

75.10

62.52

47.52

39.74

29.66

59,400

4,950

3,300

125.10

77.45

64.47

49.01

40.99

30.59

61,200

5,100

3,400

128.89

79.79

66.43

50.49

42.23

31.52

63,000

5,250

3,500

132.69

82.14

68.38

51.98

43.47

32.45

64,800

5,400

3,600

136.48

84.49

70.33

53.46

44.71

33.37

66,600

5,550

3,700

140.27

86.83

72.29

54.95

45.95

34.30

68,400

5,700

3,800

144.06

89.18

74.24

56.43

47.20

35.23

70,200

5,850

3,900

147.85

91.53

76.20

57.92

48.44

36.15

72,000

6,000

4,000

151.64

93.87

78.15

59.40

49.68

37.08

22

Annual Monthly Earnings Earnings

Accident/Sickness Benefit Waiting Period Cost Per Month

Monthly Disability Benefit

0/3

14/14

30/30

60/60

90/90

180/180

96.22

80.10

60.89

50.92

38.01

73,800

6,150

4,100

155.43

75,600

6,300

4,200

159.22

98.57

82.06

62.37

52.16

38.93

77,400

6,450

4,300

163.01

100.91

84.01

63.86

53.41

39.86

79,200

6,600

4,400

166.81

103.26

85.96

65.34

54.65

40.79

81,000

6,750

4,500

170.60

105.61

87.92

66.83

55.89

41.72

82,800

6,900

4,600

174.39

107.95

89.87

68.31

57.13

42.64

84,600

7,050

4,700

178.18

110.30

91.82

69.80

58.37

43.57

86,400

7,200

4,800

181.97

112.65

93.78

71.28

59.62

44.50

88,200

7,350

4,900

185.76

115.00

95.73

72.77

60.86

45.42

90,000

7,500

5,000

189.55

117.34

97.69

74.25

62.10

46.35

91,800

7,650

5,100

193.34

119.69

99.64

75.74

63.34

47.28

93,600

7,800

5,200

197.13

122.04

101.59

77.22

64.58

48.20

95,400

7,950

5,300

200.92

124.38

103.55

78.71

65.83

49.13

97,200

8,100

5,400

204.72

126.73

105.50

80.19

67.07

50.06

99,000

8,250

5,500

208.51

129.08

107.45

81.68

68.31

50.99

100,800

8,400

5,600

212.30

131.42

109.41

83.16

69.55

51.91

102,600

8,550

5,700

216.09

133.77

111.36

84.65

70.79

52.84

104,400

8,700

5,800

219.88

136.12

113.32

86.13

72.04

53.77

106,200

8,850

5,900

223.67

138.46

115.27

87.62

73.28

54.69

108,000

9,000

6,000

227.46

140.81

117.22

89.10

74.52

55.62

109,800

9,150

6,100

231.25

143.16

119.18

90.59

75.76

56.55

111,600

9,300

6,200

235.04

145.50

121.13

92.07

77.00

57.47

113,400

9,450

6,300

238.83

147.85

123.08

93.56

78.25

58.40

115,200

9,600

6,400

242.63

150.20

125.04

95.04

79.49

59.33

117,000

9,750

6,500

246.42

152.54

126.99

96.53

80.73

60.26

118,800

9,900

6,600

250.21

154.89

128.95

98.01

81.97

61.18

120,600

10,050

6,700

254.00

157.24

130.90

99.50

83.21

62.11

122,400

10,200

6,800

257.79

159.59

132.85

100.98

84.46

63.04

124,200

10,350

6,900

261.58

161.93

134.81

102.47

85.70

63.96

126,000

10,500

7,000

265.37

164.28

136.76

103.95

86.94

64.89

127,800

10,650

7,100

269.16

166.63

138.71

105.44

88.18

65.82

129,600

10,800

7,200

272.95

168.97

140.67

106.92

89.42

66.74

131,400

10,950

7,300

276.74

171.32

142.62

108.41

90.67

67.67

133,200

11,100

7,400

280.54

173.67

144.58

109.89

91.91

68.60

135,000

11,250

7,500

284.33

176.01

146.53

111.38

93.15

69.53

136,800

11,400

7,600

288.12

178.36

148.48

112.86

94.39

70.45

138,600

11,550

7,700

291.91

180.71

150.44

114.35

95.63

71.38

140,400

11,700

7,800

295.70

183.05

152.39

115.83

96.88

72.31

142,200

11,850

7,900

299.49

185.40

154.34

117.32

98.12

73.23

144,000

12,000

8,000

303.28

187.75

156.30

118.80

99.36

74.16

23

Marble Falls Independent School District

Life/AD&D insurance What is it?

Life and accidental death and dismemberment (AD&D) insurance provide cash benefits in the unfortunate event that you or a covered family member passes away or suffers a traumatic injury.

Why is this coverage valuable?

Life and AD&D insurance can offer reassurance that you, or the people you love, will have access to money to help cover expenses during a challenging time.

Your life insurance and AD&D coverage Life/AD&D Eligibility description Contribution

All full-time employees Your employer pays the cost of your coverage.

Employee life insurance coverage amount AD&D coverage amount Evidence of insurability (EOI): A health statement requiring you to answer a few medical history questions.

Benefit reductions

$10,000 Your AD&D coverage is equal to the life benefit amount.

Health statement may be required.

50% reduction at age 70. Benefits end when you retire.

Conversion: Allows you to continue coverage after your group plan has terminated.

Yes, with restrictions. See certificate of benefits.

LifeKeys® services: Access to counseling, financial, and legal support services.

Included

TravelConnect® services: Access to emergency medical assistance for you and your family when you’re on a trip 100 or more miles from home.

Included

Benefit exclusions Like any insurance, this life and AD&D insurance policy does have exclusions. Benefits won’t be paid if death or dismemberment occurs as the result of: ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪

War, declared or undeclared, or any act of war Intentionally self-inflicted injuries, while sane or insane Suicide, or suicide attempt, while sane or insane Active participation in a riot Committing or attempting to commit a felony Disease, bodily or mental illness, or medical or surgical treatment thereof Infections Controlled substances voluntarily taken, ingested, or injected, unless prescribed or administered by a physician Serving on full-time active duty in the armed forces of any country or international authority The presence of alcohol in the covered person’s blood, which raises the presumption that the covered person was under the influence of alcohol and contributed to the cause of the accident

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

24

6448858

Life/AD&D insurance

Reminder: Please review your beneficiary(ies) to ensure they’re up to date. It’s good practice to review, and if necessary update, your beneficiary(ies) annually.

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 policy, the policy will govern.

LifeKeys® services are provided by ComPsych® Corporation, Chicago, IL. ComPsych® is not a Lincoln Financial Group® company. Coverage is subject to actual contract language. Each independent company is solely responsible for its own obligations (except in Vermont).

State limitations apply. Beneficiary grief counseling is the only benefit available to a beneficiary(ies) of policies issued in the state of New York. Online will prep is the only benefit available to insured employee and dependents of policies issued in the state of Washington.

©2024 Lincoln National Corporation LincolnFinancial.com Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates.

Affiliates are separately responsible for their own financial and contractual obligations.

LCN-6448858-030124 PDF 5/24 Z01 Order code: GP-LADEP-FLI001

TravelConnect® services are provided by On Call International, Salem, NH. On Call International is not a Lincoln Financial Group® company and Lincoln Financial Group does not administer these services. Each independent company is solely responsible for its own obligations.

On Call International must coordinate and provide all arrangements in order for eligible services to be covered.

Coverage is subject to contract language that contains specific terms, conditions, and limitations, which can be found in the program description.

The TravelConnect® program is not available to insured employees and dependents of policies issued in the state of New York and Washington. Access only program available to insured employees and dependents of policies issued in the state of Missouri and Texas. Benefits provided under the Access only program exclude payment for paid services.

Not available in New York and Washington.

Insurance products 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. In New York, insurance products are issued by Lincoln Life & Annuity Company of New York, Syracuse, NY. Both are Lincoln Financial Group® companies. Product availability and/or features may vary by state. Limitations and exclusions apply.

25

Group Benefits

Because life doesn’t always go as planned No matter how well you plan, unexpected challenges arise. When they do, help and support are nearby thanks to LifeKeys® services from Lincoln.

LifeKeys services include: Discounts on shopping and entertainment GuidanceResources® Online includes access to the Working Advantage discount network, available 24 hours a day, seven days a week. Save up to 60% on a variety of products and services, including electronics, health and fitness, Broadway shows, and much more.

Discounts are also available in the GuidanceNowSM mobile app, available in the Apple and Google app stores.

Help with important life matters You’ll find support tools and advice on a wide range of topics, including legal, financial, family, and career, on GuidanceResources Online. Stay informed on matters that impact your personal and professional life.

Protection against identity theft Identity theft is widespread, and everyone is vulnerable. LifeKeys includes online resources for information to help you recognize and prevent identity theft and restore your good name should your identity be compromised.

Online will preparation Creating a will allows you to make vital decisions ahead of time, including naming a guardian for your children or designating who’ll receive your property and assets after you pass away. Without a will, state officials will distribute your estate. EstateGuidance® offers a secure, efficient way to create and execute a will so you can rest easy knowing you’ve planned ahead for your family.

Guidance and support for your beneficiaries LifeKeys is a comprehensive program that offers resources to help your loved ones address a range of common concerns should they experience a loss. Services include grief counseling, financial and legal advice, and support when coping with the challenges of day-to-day life.

Services are detailed on Page 2.

LFE-LKEYE-FLI001_Z05

26

Your life and accidental death and dismemberment (AD&D) insurance policies include access to a variety of services to help you and your loved ones navigate life’s most important matters.

Help, guidance, and support for beneficiaries following a loss The emotional impact of losing a loved one can be deep and long-lasting. All too often, financial or legal issues can add to the stress. LifeKeys services can be a welcome resource for your beneficiaries.

Your beneficiaries will have access to six in-person sessions for grief counseling, legal or financial information, and unlimited phone counseling. Services are available for up to one year after a loss.

Grief counseling — advice, information, and referrals on: Coping with loss

Memorial planning information

Stress, anxiety, and depression

Concerns about family, including children and teens

Legal support — access to legal information on: Estate and probate law

Social Security survivor and child benefits

Real estate transactions

Important documents for beneficiaries

Financial services — online resources and advice from financial specialists on: Estate planning

Bankruptcy

Budgeting

Investments

Overcoming debt Help with everyday life — comprehensive information on: Finding child or elder care

Moving and relocation

Financing a home

Making major purchases

To access LifeKeys services, visit GuidanceResources.com, download the GuidanceNowSM mobile app, or call 855-891-3684.

First-time users enter web ID: LifeKeys ©2023 Lincoln National Corporation

Download the app today!

LincolnFinancial.com Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates.

Affiliates are separately responsible for their own financial and contractual obligations.

LCN-3985132-121521 MAP 12/23 Z05 Order code: LFE-LKEYE-FLI001

LifeKeys® services are provided by ComPsych® Corporation, Chicago, IL. ComPsych® is not a Lincoln Financial Group® company. Coverage is subject to actual contract language. Each independent company is solely responsible for its own obligations (except in Vermont). GuidanceResources® is a trademark of ComPsych® Corporation.

Google Play and the Google Play logo are trademarks of Google LLC. App Store is a service mark of Apple Inc., registered in the U.S. and other countries.

State limitations apply. Beneficiary grief counseling is the only benefit available to a beneficiary(ies) of policies issued in the state of New York. Online will prep is the only benefit available to insured employee and dependents of policies issued in the state of Washington.

27

Group Benefits

Because life doesn’t always go as planned No matter how well you plan, unexpected challenges arise. When they do, help and support are nearby thanks to LifeKeys® services from Lincoln.

LifeKeys services include: Discounts on shopping and entertainment GuidanceResources® Online includes access to the Working Advantage discount network, available 24 hours a day, seven days a week. Save up to 60% on a variety of products and services, including electronics, health and fitness, Broadway shows, and much more.

Discounts are also available in the GuidanceNowSM mobile app, available in the Apple and Google app stores.

Help with important life matters You’ll find support tools and advice on a wide range of topics, including legal, financial, family, and career, on GuidanceResources Online. Stay informed on matters that impact your personal and professional life.

Protection against identity theft Identity theft is widespread, and everyone is vulnerable. LifeKeys includes online resources for information to help you recognize and prevent identity theft and restore your good name should your identity be compromised.

Online will preparation Creating a will allows you to make vital decisions ahead of time, including naming a guardian for your children or designating who’ll receive your property and assets after you pass away. Without a will, state officials will distribute your estate. EstateGuidance® offers a secure, efficient way to create and execute a will so you can rest easy knowing you’ve planned ahead for your family.

Guidance and support for your beneficiaries LifeKeys is a comprehensive program that offers resources to help your loved ones address a range of common concerns should they experience a loss. Services include grief counseling, financial and legal advice, and support when coping with the challenges of day-to-day life.

Services are detailed on Page 2.

LFE-LKEYE-FLI001_Z05

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Your life and accidental death and dismemberment (AD&D) insurance policies include access to a variety of services to help you and your loved ones navigate life’s most important matters.

Help, guidance, and support for beneficiaries following a loss The emotional impact of losing a loved one can be deep and long-lasting. All too often, financial or legal issues can add to the stress. LifeKeys services can be a welcome resource for your beneficiaries.

Your beneficiaries will have access to six in-person sessions for grief counseling, legal or financial information, and unlimited phone counseling. Services are available for up to one year after a loss.

Grief counseling — advice, information, and referrals on: Coping with loss

Memorial planning information

Stress, anxiety, and depression

Concerns about family, including children and teens

Legal support — access to legal information on: Estate and probate law

Social Security survivor and child benefits

Real estate transactions

Important documents for beneficiaries

Financial services — online resources and advice from financial specialists on: Estate planning

Bankruptcy

Budgeting

Investments

Overcoming debt Help with everyday life — comprehensive information on: Finding child or elder care

Moving and relocation

Financing a home

Making major purchases

To access LifeKeys services, visit GuidanceResources.com, download the GuidanceNowSM mobile app, or call 855-891-3684.

First-time users enter web ID: LifeKeys ©2023 Lincoln National Corporation

Download the app today!

LincolnFinancial.com Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates.

Affiliates are separately responsible for their own financial and contractual obligations.

LCN-3985132-121521 MAP 12/23 Z05 Order code: LFE-LKEYE-FLI001

LifeKeys® services are provided by ComPsych® Corporation, Chicago, IL. ComPsych® is not a Lincoln Financial Group® company. Coverage is subject to actual contract language. Each independent company is solely responsible for its own obligations (except in Vermont). GuidanceResources® is a trademark of ComPsych® Corporation.

Google Play and the Google Play logo are trademarks of Google LLC. App Store is a service mark of Apple Inc., registered in the U.S. and other countries.

State limitations apply. Beneficiary grief counseling is the only benefit available to a beneficiary(ies) of policies issued in the state of New York. Online will prep is the only benefit available to insured employee and dependents of policies issued in the state of Washington.

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Marble Falls Independent School District Benefits At-A-Glance All full-time employees Employee Life and AD&D

Voluntary Life and AD&D Insurance

Coverage Options

Increments of $10,000

Maximum coverage amount

This amount may not exceed five times Basic Annual Earnings (rounded up to the nearest $10,000) or $500,000

The Lincoln Term Life and AD&D Insurance Plan:

Minimum coverage amount

$10,000

Guaranteed Life coverage amount

$100,000

Voluntary AD&D coverage amount

Equal to the life insurance amount chosen

• Provides a cash benefit to your loved ones in the event of your death or if you die in an accident • Provides a cash benefit to you if you suffer a covered loss in an accident, such as losing a limb or your eyesight • Features group rates for employees • Includes LifeKeys® services, which provide access to counseling, financial, and legal support services • Also includes TravelConnect® services, which give you and your family access to emergency medical assistance when you’re on a trip 100+ miles from home

Your coverage amount will reduce by 50% when you reach age 70. Benefits end when you retire.

Spouse or Domestic Partner Life and AD&D The amount of Dependent Life Insurance coverage cannot be greater than 50% of the Employee Benefit.

Coverage Options

Increments of $5,000

Maximum coverage amount

This amount may not exceed 50% of your benefit (rounded up to the nearest $5,000) or $250,000

Minimum coverage amount

$5,000

Guaranteed Life coverage amount

$25,000

Voluntary AD&D coverage amount

Equal to the life insurance amount chosen

Spouse or Domestic Partner Life and AD&D benefits end when you reach age 70.

Dependent Child(ren) Life At least 14 days but under six months

$250

At least six months but under 26 years

$10,000

Lincoln Financial Group 30

What your benefits cover Employee Coverage

Guaranteed Life Insurance Coverage Amount • Initial Open Enrollment: When you are first offered this coverage, you can choose a coverage amount up to $100,000 without providing evidence of insurability.

• Specified Open Enrollment: If you are a continuing employee, you can increase your coverage amount by two levels without providing evidence of insurability. If you submitted evidence of insurability in the past and were declined or withdrawn, you may be required to submit evidence of insurability.

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

Maximum Insurance Coverage Amount • You can choose a coverage amount up to five times Annual Earnings or $500,000. Evidence of Insurability may be required for voluntary life coverage. See the Evidence of Insurability page for details.

Spouse or Domestic Partner Coverage - You can secure term life insurance for your spouse or domestic partner if you select coverage for yourself.

Guaranteed Life Insurance Coverage Amount • Initial Open Enrollment: When you are first offered this coverage, you can choose a coverage amount up to $25,000 for your spouse or domestic partner without providing evidence of insurability.

• Specified Open Enrollment: If you are a continuing employee, you can increase the coverage amount for your spouse or domestic partner by two levels without providing evidence of insurability. If you submitted evidence of insurability in the past and were declined or withdrawn, you may be required to submit evidence of insurability.

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

Maximum Insurance Coverage Amount • You can choose a coverage amount up to 50% of your benefit or $250,000 for your spouse or domestic partner. Evidence of Insurability may be required.

Dependent Child(ren) Coverage - You can secure term life insurance for your dependent children when you choose coverage for yourself.

Guaranteed Life Insurance Coverage Options: • You can choose a coverage amount up to $250 if at least 14 days but under six months, $10,000 if at least six months but under 26 years for your child(ren).

Life Insurance Benefits At-A-Glance GP-OPVL-FLI001

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Additional Plan Benefits Included with Life Coverage Waiver of Premium

Included

Portability

Included

Accelerated Death Benefit

Included

Conversion

Included

REMINDER: Please review your beneficiary(ies) to ensure they are up to date. It’s good practice to review, and if necessary update, your beneficiary(ies) annually.

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® is not a Lincoln Financial Group® company. Coverage is subject to actual contract language. Each independent company is solely responsible for its own obligations. EstateGuidance® and GuidanceResources® Online are trademarks of ComPsych® Corporation.

State limitations apply. Beneficiary Grief counseling is the only benefit available to a beneficiary(ies) of policies issued in the state of New York. Online will prep is the only benefit available to insured employee and dependents of policies issued in the state of Washington.

TravelConnect® services are provided by On Call International, Salem, NH. On Call International is not a Lincoln Financial Group® company and Lincoln Financial Group does not administer these services. Each independent company is solely responsible for its own obligations. On Call International must coordinate and provide all arrangements in order for eligible services to be covered. Coverage is subject to contract language that contains specific terms, conditions, and limitations, which can be found in the program description.

The TravelConnect® program is not available to insured employees and dependents of policies issued in the state of New York and Washington. Access only program available to insured employees and dependents of policies issued in the state of Missouri and Texas. Benefits provided under the Access Only program exclude payment for paid services.

Not for use in New York or Washington.

Group insurance products and services described herein 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. In New York, insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group® companies. Product availability and/or features may vary by state. Limitations and exclusions apply. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Affiliates are separately responsible for their own financial and contractual obligations.

©2022 Lincoln National Corporation LCN-4232117-012522 GP-OVLAD-FLI001_Z01

Life Insurance Benefits At-A-Glance

32

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

For life insurance, a suicide exclusion may apply.

For AD&D, benefits will not be paid if death results from suicide, or death/dismemberment occurs while: • • • • • • •

Inflicting or attempting to inflict injury to one’s self Participating in a riot or as a result of war or act of war Serving as a member of the military, including the Reserves and National Guard Committing or attempting to commit a felony Deliberately inhaling gas (such as carbon monoxide) or using drugs other than those prescribed by a physician and administered as prescribed Flying in a non-commercial airplane or aircraft, such as a balloon or glider Driving while intoxicated

In addition, the AD&D insurance policy does not cover sickness or disease, including the medical and surgical treatment of a disease.

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

Questions? Call 800-423-2765 and mention Group ID: MARBLEFALL.

REMINDER: Please review your beneficiary(ies) to ensure they are up to date. It’s good practice to review, and if necessary update, your beneficiary(ies) annually.

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® is not a Lincoln Financial Group® company. Coverage is subject to actual contract language. Each independent company is solely responsible for its own obligations. EstateGuidance® and GuidanceResources® Online are trademarks of ComPsych® Corporation.

State limitations apply. Beneficiary Grief counseling is the only benefit available to a beneficiary(ies) of policies issued in the state of New York. Online will prep is the only benefit available to insured employee and dependents of policies issued in the state of Washington.

TravelConnect® services are provided by On Call International, Salem, NH. On Call International is not a Lincoln Financial Group® company and Lincoln Financial Group does not administer these services. Each independent company is solely responsible for its own obligations. On Call International must coordinate and provide all arrangements in order for eligible services to be covered. Coverage is subject to contract language that contains specific terms, conditions, and limitations, which can be found in the program description.

The TravelConnect® program is not available to insured employees and dependents of policies issued in the state of New York and Washington. Access only program available to insured employees and dependents of policies issued in the state of Missouri and Texas. Benefits provided under the Access Only program exclude payment for paid services.

Not for use in New York or Washington.

Group insurance products and services described herein 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. In New York, insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group® companies. Product availability and/or features may vary by state. Limitations and exclusions apply. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Affiliates are separately responsible for their own financial and contractual obligations.

©2022 Lincoln National Corporation LCN-4232117-012522 GP-OVLAD-FLI001_Z01

Life Insurance Benefits At-A-Glance

33

Monthly Voluntary Life Insurance Premium Calculate Your Premium.

Group Life and AD&D Rates for You Employee Age Range 0 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65 - 69 70 - 74 75 +

Group Life and AD&D Rates for Your Spouse or Domestic Partner

Life and AD&D Premium Rate $0.080 $0.090 $0.110

Employee Age Range 0 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65 - 69

$0.130 $0.180 $0.280 $0.440 $0.700 $0.870 $1.490 $2.400 $3.670

Life and AD&D Premium Rate $0.080 $0.090 $0.110

Group Life Rates for your Dependent Child(ren) Child(ren) Life Premium Rate, per $1,000 $0.100

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

$0.130 $0.180 $0.280 $0.440 $0.700 $0.870 $1.490

Note: To be eligible for coverage, a spouse or domestic partner or dependent child cannot be confined on the date the increase or addition is to take effect, it will take effect when the confinement ends.

Calculate Your Cost Use the appropriate rate provided in the tables above to calculate your cost based on the amount of coverage you select. The following example calculates the monthly cost for a 36-year-old employee who would like to purchase $100,000 in employee voluntary term life and AD&D insurance coverage.

Calculation Example Step 1 Step 2 Step 3 Step 4

Using the table above, enter the rate that corresponds with your age.

Enter the desired coverage amount in dollars.

Enter the desired coverage amount in increments of $1,000. To calculate, divide the coverage amount by $1,000.

Calculate the monthly cost. Multiply Step 1 by Step 3.

Example

You

Spouse

$0.130 $100,000 100 $13.00

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

Please see prior page for product information.

Life Insurance Premium Calculation 34

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All Full-Time Employees at Marble Falls Independent School District

Benefits At-A-Glance

Accident Insurance

Lincoln Accident Insurance Plan: • Provides cash benefits if you or a covered family member is accidentally injured • Features group rates for employees • Benefits are focused on the family, safety, and accident prevention

Emergency treatment

Your cash benefit

Ambulance

$400

Air ambulance

$1,500

Emergency care/treatment

$200

Initial care visit

$100

Major diagnostic exam

$250

X-ray

$150

Fractures*

Your cash benefit

Ankle

$1,000

Arm (shoulder to elbow)

$800

Arm (elbow to wrist)

$700

Coccyx

$300

Collarbone

$1,200

Elbow

$250

Bones of the face

$750

Fingers

$125

Foot (except toes)

$675

Hand (except fingers)

$675

Hip

$2,500

Jaw upper

$825

Jaw lower

$625

Kneecap

$650

Leg (hip to knee)

$1,300

Leg (knee to ankle)

$1,300

Nose

$575

Pelvis

$1,425

Rib

$350

Shoulder blade

$725

Skull depressed

$2,000

Skull non-depressed

$1,000

Sternum

$325

Toes

$125 36

Fractures*

Your cash benefit

Vertebral Body

$1,275

Vertebral process

$700

Wrist

$850

Surgical treatment surgery

Two times nonsurgical benefit

Chip fracture

25% of fracture benefit

*Fracture benefits listed are nonsurgical. Treatment for the fracture must occur within 90 days of the accident.

The combined maximum of all fractures is two times the highest fracture payable.

No money is due at enrollment. Your premium simply comes out of your paycheck.

Dislocations *

Your cash benefit

Ankle

$625

Collarbone (acromio and separation)

$475

Collarbone (sternoclavicular)

$675

Elbow

$475

Fingers

$100

Foot (except toes)

$625

Hand (except fingers)

$475

Hip

$2,000

Lower jaw

$475

Knee (except kneecap)

$1,175

Shoulder

$1,500

Toes

$100

Wrist

$475

Surgical treatment

Two times nonsurgical benefit

Partial dislocation

25% of dislocation benefit

*Dislocation benefits listed are nonsurgical. Treatment for the dislocation must occur within 90 days of the accident. The combined maximum of all dislocations is two times the highest dislocation payable.

Group Accident Insurance | Benefits At-A-Glance EED-ACC-FLI001_Z01

37

Specific Injuries

Your Cash Benefit

Blood, plasma, platelets, and other non-blood substitute IV solutions 2nd degree burns: Based upon surface area burned

$250 $100-$950

3rd degree burns: Based upon surface area burned

$875-$10,000

Skin grafts

25% of burn benefit

Concussion

$200

Dental crown

$300

Dental extraction

$100

Eye (surgical repair)

$300

Eye (removal of foreign object)

$200

Laceration: Based upon the need for and length of sutures

$75-$750

Severe traumatic brain injury

$5,000

Surgical benefits:* Arthroscopic

$400

Cranial

$1,500

Hernia

$150

Other surgery under conscious sedation

$150

Other surgery under general anesthesia

$300

Repair of knee cartilage

$1,000

Repair of ligaments, tendons, rotator cuff

$1,000

Repair of ruptured disc

$1,000

Open abdominal or thoracic

$1,500

*Benefits will be paid up to two times the highest surgical benefit payable for all surgeries.

Group Accident Insurance | Benefits At-A-Glance EED-ACC-FLI001_Z01

38

Hospitalization and ongoing care

Your cash benefit

Accident hospital admission

$500

Accident hospital daily confinement

$100

Accident intensive care admission

$1,000

Accident intensive care daily confinement

$200

Physical, occupational, and chiropractic therapy (up to 10 sessions)

$50

Physician follow-up visits (up to six visits)

$125

Alternative care/rehab facility daily confinement

$100

Epidural/cortisone pain management (up to one injection)

$50

Medical mobility devices

$100

Wheelchair (expected use one year or more)

$300

Wheelchair (expected use less than one year)

$100

Prosthesis (per limb)

$500

Recovery assistance

Your cash benefit

Family care

$300

Companion lodging (100+ miles from home)

$250 per day

Transportation (100+ miles from home)

$500 per trip

Group Accident Insurance | Benefits At-A-Glance EED-ACC-FLI001_Z01

39

Accidental Death & Dismemberment benefit Accidental death Your death Your spouse or life partner Your child Common carrier death Your death Your spouse or life partner Your child A common carrier is any land, air, or water conveyance licensed to transport passengers for hire.

Transportation of remains (100+ miles)

Your cash benefit $50,000 $25,000 $12,500 $100,000 $50,000 $25,000

Loss of hand, foot, arm, leg, eye, or hearing in one ear

$12,500 10% of accidental death and dismemberment benefit 10% of accidental death and dismemberment benefit 10% of accidental death and dismemberment benefit $12,500

Loss of finger, thumb, toe

$1,625

Loss of sight in both eyes

$32,500

Loss of hearing in both ears

$32,500

Loss of speech

$32,500

Loss of both arms

$32,500

Loss of both legs

$32,500

Loss of arm and leg

$32,500

Paraplegia

$32,500

Hemiplegia

$32,500

Loss of both arms and both legs

$32,500

Quadriplegia Education: This benefit is paid if an insured person dies within 365 days of a covered accident and is survived by one or more full-time students.

$32,500

Safe driver: Seat belt Safe driver: Air bag Safe driver: Helmet

The education benefit is payable for each full-time student.

Spouse training: This benefit is paid if a covered employee or dependent spouse dies within 365 days of a covered accident, and the surviving spouse is enrolled as a student.

The spouse training benefit covers students enrolled in any school that retrains or refreshes skills needed for employment within 365 days from the date of death.

Modification to home/auto: This benefit is payable for modifications to make the principal residence accessible or the vehicle ridable if the insured suffers a severe loss.

10% of accidental death benefit

10% of accidental death benefit

$3,500

This benefit is payable once per person within 365 days of the accident.

Group Accident Insurance | Benefits At-A-Glance EED-ACC-FLI001_Z01

40

Health Assessment/Wellness Benefit You receive a cash benefit every year you and any of your covered family members complete a single covered assessment test.

Your cash benefit Level: $100

Additional plan benefits Portability

Included

Child Sports Injury Benefit

Included

This is not intended as a complete description of the insurance coverage offered. While benefit amounts stated in this summary are specific to your coverage, other items may summarize our standard product features and not the specific features of your coverage. 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 policy 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 policy, the policy will govern.

Benefits may vary by state, have limits on the number of services provided, or limit the time frame in which the services must be rendered. See your certificate booklet or policy for more information.

Insurance products are issued by The Lincoln National Life Insurance Company (Fort Wayne, IN), which does not solicit business in New York, nor is licensed to do so. Product availability and/or features may vary by state. Limitations and exclusions apply.

©2021 Lincoln National Corporation LCN-3881347-102221 EED-ACC-FLI001_Z01

Group Accident Insurance | Benefits At-A-Glance

41

Benefit exclusions Accident insurance covers many injuries that result from a covered event. The policy exclusions are: 1. Disease, physical or mental infirmity, sickness, or medical or surgical treatment of these 2. Suicide, attempted suicide, or any intentionally self-inflicted injury, while sane or insane 3. Voluntary intake or use by any means of any drugs, poison, gas, or fumes, voluntary use of controlled substance, voluntary intake or use by any means of any drug, except when: a. Prescribed or administered by a physician, and b. Taken in accordance with the physician’s instructions 4. Committing or attempting to commit a felony, participation in a felony, voluntary participation in a felony, voluntary committing or attempting to commit a felony 5. War or any act of war, declared or undeclared, war or any act of war other than terrorism, declared or undeclared, war or any act of war, declared or undeclared while serving in the military or an auxiliary unit attached to the military or working in an area of war, whether voluntarily or as required by an employer 6. Participation in a riot, insurrection, or rebellion of any kind 7. Military duty, including the Reserves or National Guard 8. Travel or flight in or on any aircraft, except: a. As a fare-paying passenger on a regularly scheduled commercial flight; or b. As a passenger, pilot, or crew member in the group policyholder’s aircraft while flying for the group policyholder’s business, provided: i. The aircraft has a valid U.S. airworthiness certificate or foreign equivalent; and ii. The pilot has a valid pilot’s certificate with a nonstudent rating authorizing him to fly the aircraft 9. Driving a vehicle while intoxicated, as defined by the jurisdiction where the accident occurred. For accidental death and dismemberment only, benefits are not payable for any loss sustained or contracted in consequence of your or your insured dependent being intoxicated or under the influence of any narcotic; operating a motor vehicle while intoxicated, as defined by the law of the state in which the accident occurred, if it is a felony 10. Cosmetic or elective surgery, physician determination of cosmetic or elective surgery, cosmetic surgery, surgery to improve appearance, cosmetic or elective surgery when it is to improve appearance rather than restore function or correct a deformity resulting from an injury 11. Being incarcerated in any type of penal or detention facility, injury sustained while confined to jail, workhouse, or other corrections facility when it is due to an act of the facility and law enforcement is liable 12. Under the influence of narcotics, unless prescribed and taken in accordance with the prescription by a physician 13. Participating in, practicing for, or officiating any semi-professional or professional sport 14. Riding in or driving in any motor driven vehicle for race, stunt show, or speed test 15. An injury sustained while residing outside the U.S., U.S. territories, Canada, or Mexico for more than 12 months 16. Bungee cord jumping, mountaineering, or base jumping 17. Skydiving, parachuting, or jumping from any aircraft for recreational purposes This is an incomplete list of benefit exclusions. A complete list is included in the policy. State variations apply.

Questions? Call 800-423-2765 and mention ID MARBLEFALL.

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Accident insurance premium Here’s how little you pay with group rates As an employee, you can take advantage of this accident insurance plan. Plus, you can add loved ones to the plan for just a little more.

Coverage

Monthly premium

Employee only

$9.86

Employee & spouse

$16.32

Employee & child/children

$18.25

Employee & family (spouse and child/children)

$24.57

Note: The premiums for this coverage will not change due to your age. The premium for employee & child/children and employee & family coverage includes all children.

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

Group Accident Insurance | Benefits At-A-Glance EED-ACC-FLI001_Z01

43

All Full-Time Employees of Marble Falls Independent School District

Benefits at a glance If you or a covered family member have to go to the hospital for an accident or injury, hospital indemnity insurance provides a lump-sum cash benefit to help you take care of unexpected expenses — anything from deductibles to child care to everyday bills. Because you’re selecting this coverage through your company, you can take advantage of group rates. You don’t have to answer medical questions to receive coverage; this is guaranteed coverage.

Core hospital benefits Hospital admission For the initial day of admission to a hospital for treatment of a sickness/an injury Hospital confinement For each day of confinement in a hospital as a result of a sickness/an injury Hospital intensive care unit (ICU) admission For the initial day of admission to an ICU for treatment as the result of a sickness/an injury Hospital ICU confinement For each full or partial day of confinement in an ICU as a result of a sickness/an injury Complications of pregnancy

Plan benefit $1,000 per day up to one day per calendar year

$200 per day up to 30 days per calendar year starting on 2nd day of confinement

$2,000 per day up to one day per calendar year

$400 per day up to 30 days per calendar year starting the 2nd day of confinement

Included

▪ Admission or Admitted means accepted for inpatient services in a hospital or intensive care unit for a period of more than 20 hours.

▪ If admitted to a hospital or ICU within 90 days after being discharged from a preceding stay for the same or related cause, the subsequent admission will be considered part of the first admission.

▪ If both hospital and ICU admission or hospital and ICU confinement become payable for the same day, only the Hospital ICU Admission benefit will be paid Additional confinement benefits

Plan benefit

Newborn care $100 per day up to two days per calendar year For each day of confinement to a hospital for routine post-natal care following birth ▪ If a newborn baby is confined for treatment of an illness, infirmity, disease, or injury, we will pay the Hospital or ICU confinement benefit instead of the Newborn care benefit.

Health assessment/wellness benefit

Your cash benefit

Health assessment benefit Receive a cash benefit every year you and any of your covered family members complete a single covered exam, screening, or immunization.

Level: $50, one test per 12-month assessment period

Hospital indemnity insurance| Benefits at a glance

44

Enhanced benefits Hospital NICU admission Increases the hospital ICU admission benefit for a newborn child

Hospital NICU confinement Increases the hospital ICU confinement benefit for a newborn child

Plan benefit percentage

25%

25%

Additional plan benefit(s) Portability if you leave your employer

Included

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

Hospital indemnity insurance| Benefits at a glance

45

Benefit exclusions General exclusions The policy covers only sicknesses and injuries that occur while insurance is in force. No indemnities will be paid for a sickness or injury that occurs before the effective date of the insurance. Benefits are not payable for any loss caused or contributed to by: 1. Suicide, attempted suicide, or any intentionally self-inflicted injury, while sane or insane* 2. Voluntary intake or use by any means of any drugs, poison, gas, or fumes, except when:

a. Prescribed or administered by a physician b. Taken in accordance with the physician’s instructions 3. Committing or attempting to commit a felony 4. War or any act of war, declared or undeclared 5. Participation in a riot, insurrection, or rebellion of any kind 6. Participation in an act of terrorism 7. Military duty, including the Reserves or National Guard 8. Travel or flight in or on any aircraft, except as a fare-paying passenger on a regularly scheduled commercial flight, or as a passenger, pilot, or crew member in the group policyholder's aircraft while flying for group policyholder business, provided: a. The aircraft has a valid U.S. airworthiness certificate (or foreign equivalent) b. The pilot has a valid pilot's certificate with a non-student rating authorizing them to fly the aircraft 9. Driving a vehicle while intoxicated, as defined by the jurisdiction where the accident occurred 10. Cosmetic surgery, unless the treatment is the result of a covered event 11. Treatment for dental care or dental procedures, unless the treatment is the result of a covered event 12. Treatment of a mental illness* 13. Treatment of alcoholism, drug addiction, chemical dependency, or complications thereof* 14. Treatment through experimental procedures 15. Travel outside the United States and its possessions for the sole purpose of receiving medical care or treatment 16. Participating in, practicing for, or officiating any semi-professional or professional sport 17. Riding in or driving in any motor driven vehicle for race, stunt show, or speed test 18. Being incarcerated in any type of penal or detention facility 19. Scuba diving 20. Mountaineering or spelunking 21. Bungee cord jumping, hang gliding, sail gliding, parasailing, parakiting, kitesurfing, base jumping, or any similar activities 22. Skydiving, parachuting, jumping, or falling from any aircraft for recreational purposes 23. Residing outside the United States, U.S. Territories, Canada, or Mexico for more than 12 months 24. Injury arising out of or during employment for wage or profit *Exceptions to the exclusions are accepted when substance abuse and mental disorder benefits are selected. This is a partial list of benefit exclusions. A complete list is included in the policy. State variations apply.

Questions? Call 800-423-2765 and mention ID: MARBLEFALL.

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46

Hospital indemnity insurance premium Affordable group rates – Monthly premiums As an employee, you can take advantage of this accident insurance plan. Plus, you can add loved ones to the plan for just a little more.

Premium Employee only

$19.51

Employee + spouse

$41.65

Employee + child(ren)

$30.03

Family

$54.42

Please see prior pages for product information.

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.

Some benefits have limits on the number of services provided or limit the time frame in which the services must be rendered. See your certificate booklet or policy for more information. This insurance product does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. Insurance products 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. Limitations and exclusions apply.

Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Affiliates are separately responsible for their own financial and contractual obligations.

©2023 Lincoln National Corporation LCN-6015745-101123 GP-HSP1P-FLI001_Z02

Hospital indemnity insurance| Benefits at a glance

47

CancerSelect® Plus Cancer-only indemnity insurance | Underwritten by Transamerica Life Insurance Company

Nancy watched as a co-worker battled lung cancer. Everyone rallied around him for support, but he still faced major financial strain due to missed work and high deductibles. Knowing her pack-a-day habit and family history, Nancy doesn’t worry if she’ll get cancer, but when. And when the time comes, she’s afraid medical insurance might not be enough.

Product highlights • Pays benefits directly to you • Spouse and dependent benefits available

Good medical insurance helps, but is it enough?

While some individuals diagnosed with cancer have meaningful and adequate health insurance to pay for most of the cost of treatment, privately insured workers face the prospect of crippling out-of-pocket costs.

If cancer is the disease you worry about most, you’re not alone.

• Payroll-deducted premiums • Easy enrollment process

Contact information

If you or one of your family members were to be diagnosed with cancer, would you want to face those chances? Now there’s a way you can add more benefits for you and your family.

With this supplemental benefit your employer is making available, you’ll not only have more resources to cope with any future diagnosis of cancer, but you’ll also have wellness benefits to help you detect cancer early when it’s most treatable.

VISIT

transamericabenefits.com CUSTOMER SERVICE

1-888-763-7474

Valuable benefits for your life.

Review the attached benefits and costs for the insurance policy your employer has designed for your consideration. It’s a long list of benefits, but they’re all important. As you read through the list of all the ways this supplemental insurance pays, think about how you could possibly pay for all these costs on your own. Fighting cancer can be challenging both financially and emotionally, and the more resources you have, the better prepared you and your family will be.

Monthly Premium

Individual

Single Parent Family

Family

Plan Option 1

$13.73

$15.62

$24.54

$22.47

$25.76

$40.70

Monthly Premium Plan Option 2

Up-to-date information regarding our compensation practices can be found in the Disclosures section of our website: tebcs.com This is a brief summary of CancerSelect Plus, cancer-only insurance. Policy form series CPCAN200 and CCCAN200. Forms and numbers may vary.

Insurance may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate and riders for complete details.

23217_CCP01C0916

48

Product Details Hospital Benefits Hospital Confinement

Extended Benefits

Plan Option 1 1.00 Units

Plan Option 2 1.00 Units

$100

$100

per day of covered confinement

$200

per day; begins on day 91 of continuous confinement; in lieu of all other benefits (except surgery and anesthesia)

$200

Policy Pays

Attending Physician

$20

$20

per day while hospital confined; one visit per 24-hour period

Inpatient Drugs and Medicines

$15

$15

per day while hospital confined

$100

per day while hospital confined; must be authorized by the attending physician; cannot be hospital staff or a family member

$100

for service by a licensed ambulance service for transportation to a hospital; admittance required

$100

per day; up to the number of days for the prior hospital stay; admittance must be within 14 days of hospital discharge

$100

per day of covered confinement; in lieu of all other benefits

$100

$100

per day of hospice care; 100-day lifetime maximum; not payable while hospital confined

Plan Option 1 1.00 Units

Plan Option 2 2.00 Units

Private Duty Nurse

$100

Ambulance

$100

Extended Care Facility Government or Charity Hospital

Hospice Care

Surgery Benefits

$100

$100

Inpatient

$1,000

$2,000

Outpatient

$1,500

$3,000

25%

25%

Surgery

Anesthesia

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Policy Pays maximum benefit; actual benefit is determined by the surgery schedule in the contract; for multiple procedures in same incision only the highest benefit is paid; for multiple procedures in separate incisions will pay highest benefit and then 50% for each lesser procedure of covered surgery benefit

Transamerica Life Insurance Company 49

Product Details

Prosthesis

$1,000

maximum benefit; pays actual charges per device requiring implantation

$50

$100

maximum benefit; pays actual charges for wig to cover hair loss from cancer treatment

$120

$240

$500

Hair Prosthesis Breast Cancer – simple or total mastectomy Breast Cancer – Reconstructive radical mastectomy Surgery Cancers of the male or female genitalia Cancer of the head, neck, or oral cancers Second Surgical Opinion

$170

$340

$170

$340

$250

$500

$100

$200

when surgery is prescribed; excludes skin cancer maximum per day; pays actual charges for outpatient surgery at an ambulatory surgical center

Ambulatory Surgical Center

$150

$300

One removal

$75

$150

Per additional removal

$35

$70

Plan Option 1 1.00 Units

Plan Option 2 2.00 Units

Skin Cancer

Radiation and Chemotherapy Benefits

for reconstructive surgery within 2 years of the initial cancer removal; excludes skin cancer and malignant melanoma; benefit not payable if paid under any other provision of the policy

Radiation and Chemotherapy

$5,000

QT0000152682-01

Transamerica Life Insurance Company

$10,000

for removal of skin cancer (skin cancer does not include malignant melanoma or mycosis fungoides)

Policy Pays maximum benefit per 12-month period; pays actual charges

50

Product Details

Associated Radiation & Chemo Expenses Blood, Plasma, Blood Components, Bone Marrow and Stem Cell Transplant

Associated Blood & Plasma Expenses

$250

$5,000

$250

$500

$10,000

maximum benefit per 12-month period; pays actual charges for treatment consultations and planning, adjunctive therapy, radiation management, chemotherapy administration, physical exams, checkups, and laboratory or diagnostic tests; transportation and lodging are not included as associated expenses maximum benefit per 12-month period; pays actual charges

$500

maximum benefit per 12-month period; pays actual charges for administration of blood, plasma and blood components, transfusions, processing and procurement, or cross-matching, treatment consultations and planning, physical exams, checkups, and laboratory or diagnostic tests; transportation and lodging are not included as associated expenses

$10,000

maximum benefit per 12-month period; pays actual charges for drugs or chemical substances approved by the FDA for experimental use on humans or surgery or therapy endorsed by either the NCI or ACS for experimental studies received in the US or its territories

New or Experimental Treatment

$5,000

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Transamerica Life Insurance Company 51

Product Details Wellness & Non-Medical Benefits

Plan Option 1 1.00 Units

Plan Option 2 2.00 Units

$100

per calendar year for cancer screening tests: mammogram pap smear flexible sigmoidoscopy prostate-specific antigen test chest x-ray hemocult stool specimen ultrasound CEA CA125 biopsy thermography colonoscopy serum protein electrophoresis bone marrow testing blood screening

$100

per calendar year for MRI scan used as diagnostic tool for breast cancer

Annual Cancer Screening $50 Magnetic Resonance Imaging (MRI) Scan

Non-Local Transportation

Family Member Lodging

$50

Included

$50

Policy Pays

Included

round-trip charges or private vehicle allowance, up to 750 miles at $0.40 per mile, when required non-local hospital confinement is more than 50 miles from residence for a covered person and an adult immediate family member during confinement; payable once per confinement

$100

per day (maximum 50 days per 12 month period) for lodging expenses for an adult immediate family member when non-local hospital confinement is required

Outpatient Lodging

$50

$100

per day (maximum 50 days per 12 month period) for lodging expenses for a covered person to receive radiation or chemotherapy on an outpatient basis if not available locally

Physical Therapy & Speech Therapy

$25

$50

per treatment; limit one treatment per day

QT0000152682-01

Transamerica Life Insurance Company 52

Product Details

At-Home Nursing

$50

$100

per day, up to the number of days of the prior hospital stay when admitted within 14 days of hospital discharge waives premium for total disability due to cancer after 60 consecutive days of total disability; total disability must begin prior to the covered person's 70th birthday

Waiver of Premium

Included

Included

Cancer Maintenance Therapy Benefit

Plan Option 1 1.00 Units

Plan Option 2 1.00 Units

Cancer Suppressive Therapy Hematological Drugs Anti-Nausea Drugs Motility Agents

First Occurrence Rider (Rider Form Series CROCC100, 200 or 300)

$1,000

$1,000

Plan Option 1 2.00 Units

Plan Option 2 3.00 Units

Policy Pays

maximum benefit per 12-month period; pays actual charges

Policy Pays pays a one-time, lump-sum benefit when a covered person is initially diagnosed with cancer (except skin cancer), based on a microscopic examination of fixed tissue or preparations from the hemic system.

Clinical diagnosis is accepted under certain conditions.

Initial Diagnosis Benefit

$2,000

$3,000

Intensive Care Rider (Rider Form Series CRICU100, 200 or 300)

Plan Option 1 2.00 Units

Plan Option 2 2.00 Units

$200

$200

per day of confinement in an ICU such as a cardiac care unit, burn unit, or neonatal unit

$100

per day of confinement in a step-down unit for progressive, sub-acute or intermediate care

Maximum of 45 days per covered confinement

Intensive Care Unit

Step-Down Unit

$100

Policy Pays

maximum benefit; pays actual charges; per period of ICU confinement for transportation between medical facilities by a licensed professional ambulance service; benefit is not payable if paid under Ambulance Benefit $400 $400 the base contract provision Actual charges means the amount actually paid by or on behalf of the insured and accepted by the provider as payment in full for services provided.

QT0000152682-01

Transamerica Life Insurance Company 53

Limitations and Exclusions We provide benefits only for cancer as defined herein, which is positively diagnosed while coverage is in force. It does not provide benefits for any other illness or disease.

We may reduce or deny a claim or void coverage for loss incurred by a covered person: During the first 2 years from the effective date of such coverage for any misstatements in the application which would have materially affected our acceptance of the risk; At any time for fraudulent misstatements in the application.

We will only pay for loss as a direct result of cancer. Proof of positive diagnosis must be submitted to us for each new claim. We will not pay for any other disease or incapacity that has been caused, complicated, worsened or affected by, or as a result of cancer, except as specifically covered under the contract.

If a covered hospital confinement is due to more than one covered condition, benefits will be payable as though the confinement or expense were due to one condition. If a hospital confinement or expense is also due to a disease or condition that is not covered, benefits will be payable only for the part of the hospital confinement or expense due to the covered disease or condition.

Under no condition will we pay any benefits for losses or medical expenses incurred prior to the effective date.

Pre-Existing Condition Limitation - No benefits are provided during the first 12 months for pre-existing conditions for which the covered person has been diagnosed, treated, or for which the covered person has incurred expense or has taken medication within 12 months prior to the effective date of such person's policy. Pre-existing condition also includes a condition that manifests itself in a way that would cause an ordinarily prudent person to seek medical advice, diagnosis, care or treatment.

Total Disability means the inability to perform all of the material and substantial duties of the employee's regular occupation. Total Disability will be considered to exist when under the regular care and attendance of a physician for the necessary treatment of cancer. After the first two years of Total Disability, the employee will continue to be considered Totally Disabled if unable to engage in any employment or occupation for which he or she is or becomes qualified by reason of education, training, or experience. On or after age 65, Total Disability will mean that a physician has certified that the employee is unable to perform two or more Activities of Daily Living (continence, transferring, dressing, toileting, eating and bathing) without direct personal assistance as a result of cancer.

12-Month Benefit Period - The initial 12-Month Benefit Period is the 12-month period beginning on the date of positive diagnosis. Subsequent 12-Month Benefit Periods begin on the same month and day as the immediately preceding 12-Month Benefit Period; however, if the covered person incurs no covered loss during the 3 months after the end of any 12-Month Benefit Period, the next 12-Month Benefit Period will begin on the next date a covered loss is incurred. Benefit Periods are determined separately for each covered person.

First Occurrence Rider Benefits are not payable: For cancer diagnosed prior to the Effective Date of this Rider; For any other illness or disease other than internal Cancer; For Skin Cancer or any Cancer excluded from coverage by name or specific description.

Intensive Care Rider We will only pay one daily indemnity benefit per day. We will not pay any benefits for loss resulting from: Specifically excluded diseases or conditions in the Contract or in this Rider; An attempted suicide while sane or insane or an intentionally self-inflicted injury; Any act of war either declared or undeclared; Alcoholism or drug addiction; Mental or nervous disorders; An overdose of drugs, narcotics, hallucinogens, unless administered on the advice of a Physician; Intoxication, or being under the influence of any intoxicant or narcotic, unless administered on the advice of a Physician; Injury received while engaging in an illegal occupation or activity.

QT0000152682-01

Transamerica Life Insurance Company 54

Limitations and Exclusions Termination of Insurance Employee insurance will terminate on the earliest of: The date of the employee's death; The date on which the employee ceases to be eligible for insurance; The last date for which premium payment has been made to us; The last date on which employment terminates; The date the group master policy terminates; or The date the employee sends us a written notice to cancel insurance.

Dependent insurance will terminate on the earliest of: The date the employee's insurance terminates; The last date for which premium payment has been made to us; The date the dependent no longer meets the definition of dependent; The date the group master policy is modified so as to exclude dependent insurance; or The date the employee sends us a written notice to cancel dependent insurance.

We will have the right to terminate the insurance of any insured person who submits a fraudulent claim under the policy.

Portability Option If an employee loses eligibility for this insurance for any reason other than nonpayment of premiums, insurance can be continued by paying the premiums directly to us within 31 days after termination. We will bill the employee directly once we receive notification to continue insurance.

Other Insurance with Us An individual can only have one cancer policy or certificate with us. If a person already has cancer insurance with us, such person is not eligible to apply for this insurance.

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Transamerica Life Insurance Company 55

MetLife Critical Illness Insurance Plan Summary COVERAGE OPTIONS Critical Illness Insurance Eligible Individual

Initial Benefit

Requirements

$10,000 or $20,000

Coverage is guaranteed provided you are actively at work.3

Spouse/Domestic Partner1

100% of the employee’s Initial Benefit

Dependent Child(ren)2

100% of the employee’s Initial Benefit

Coverage is guaranteed provided the employee is actively at work and the spouse/domestic partner is not subject to a medical restriction as set forth on the enrollment form and in the Certificate.3 Coverage is guaranteed provided the employee is actively at work and the dependent is not subject to a medical restriction as set forth on the enrollment form and in the Certificate.3

Employee

BENEFIT PAYMENT Your Initial Benefit provides a lump-sum payment upon the first diagnosis of a Covered Condition. Your plan pays a Recurrence Benefit4 equal to the Initial Benefit for the following Covered Conditions: Heart Attack, Stroke, Coronary Artery Bypass Graft, Full Benefit Cancer and Partial Benefit Cancer. A Recurrence Benefit is only available if an Initial Benefit has been paid for the Covered Condition.

There is a Benefit Suspension Period between Recurrences.

The maximum amount that you can receive through your Critical Illness Insurance plan is called the Total Benefit and is 3 times the amount of your Initial Benefit. This means that you can receive multiple Initial Benefit and Recurrence Benefit payments until you reach the maximum of 300% or $30,000 or $60,000.

Please refer to the table below for the percentage benefit amount for each Covered Condition.

Covered Conditions

Initial Benefit

Recurrence Benefit

100% of Initial Benefit

100% of Initial Benefit

25% of Initial Benefit

25% of Initial Benefit

Heart Attack

100% of Initial Benefit

100% of Initial Benefit

Stroke6

100% of Initial Benefit

100% of Initial Benefit

Coronary Artery Bypass Graft

100% of Initial Benefit

100% of Initial Benefit

Kidney Failure

100% of Initial Benefit

Not applicable

Alzheimer’s Disease8

100% of Initial Benefit

Not applicable

Major Organ Transplant Benefit

100% of Initial Benefit

Not applicable

22 Listed Conditions

25% of Initial Benefit

Not applicable

Full Benefit Cancer5 Partial Benefit Cancer

5

7

22 Listed Conditions MetLife Critical Illness Insurance will pay 25% of the Initial Benefit Amount for each of the 22 Listed Conditions until the Total Benefit Amount is reached. A Covered Person may only receive one payment for each Listed Condition in his/her lifetime. The Listed Conditions are Addison’s disease (adrenal hypofunction); amyotrophic lateral sclerosis (Lou Gehrig’s disease); cerebrospinal meningitis (bacterial); cerebral palsy; cystic fibrosis; diphtheria; encephalitis; Huntington’s disease (Huntington’s chorea); Legionnaire’s disease; malaria; multiple sclerosis (definitive diagnosis); muscular dystrophy; myasthenia gravis; necrotizing fasciitis; osteomyelitis; poliomyelitis; rabies; sickle cell anemia (excluding sickle cell trait); systemic lupus erythematosus (SLE); systemic sclerosis (scleroderma); tetanus; and tuberculosis.

ADF# CI660.14

56

Example of Initial & Recurrence Benefit Payments The example below illustrates an employee who elected an Initial Benefit of $30,000 and has a Total Benefit of 3 times the Initial Benefit Amount or $60,000.

Illness – Covered Condition

Payment

Total Benefit Remaining

Heart Attack – first diagnosis

Initial Benefit payment of $10,000 or 100%

$20,000

Heart Attack – second diagnosis, two years later

Recurrence Benefit payment of $10,000 or 100%

$10,000

Kidney Failure – first diagnosis, three years later

Initial Benefit payment of $10,000 or 100%

$0

SUPPLEMENTAL BENEFITS MetLife provides coverage for the Supplemental Benefits listed below. This coverage would be in addition to the Total Benefit Amount payable for the previously mentioned Covered Conditions.

Health Screening Benefit10 After your coverage has been in effect for thirty days, MetLife will provide an annual benefit* of $50 or $100 per calendar year for taking one of the eligible screening/prevention measures. MetLife will pay only one health screening benefit per covered person per calendar year. For a complete list of eligible screening/prevention measures, please refer to the Disclosure Statement/Outline of Coverage. *The Health Screening Benefit amount depends upon the Initial Benefit Amount selected. Employees would receive a $50 benefit with the $10,000 initial benefit amount or a $100 benefit with the $60,000 Initial Benefit Amount.

INSURANCE RATES MetLife offers competitive group rates and convenient payroll deduction so you don’t have to worry about writing a check or missing a payment! Your employee rates are outlined below.

Monthly Premium/$1,000 of Coverage:

Attained Age <25

Employee Only $0.42

Employee + Spouse

Employee + Children

Employee + Spouse / Children

$0..84

$0.94

$1.36

25–29

$0.44

$0.93

$0.96

$1.45

30–34

$0.61

$1.28

$1.13

$1.80

35–39

$0.84

$1.83

$1.36

$2.35

40–44

$1.26

$2.80

$1.78

$3.32

45–49

$1.88

$4.22

$2.40

$4.74

50–54

$2.66

$6.12

$3.18

$6.64

55–59

$3.66

$8.68

$4.18

$9.20

60–64

$5.27

$12.76

$5.79

$13.28

65–69

$7.89

$19.20

$8.41

$19.72

70+

$12.31

$29.04

$12.83

$29.56

57

QUESTIONS & ANSWERS Who is eligible to enroll?

Regular active full-time employees who are actively at work along with their spouse/domestic partner and dependent children can enroll for MetLife Critical Illness Insurance coverage.3 How do I pay for coverage?

Coverage is paid through convenient payroll deduction.

What is the coverage effective date?

The coverage effective date is 09/01/ If I Leave the Company, Can I Keep My Coverage? 11 Under certain circumstances, you can take your coverage with you if you leave. You must make a request in writing within a specified period after you leave your employer. You must also continue to pay premiums to keep the coverage in force.

Who do I call for assistance?

Contact a MetLife Customer Service Representative at 1 800- GET-MET8 (1-800-438-6388), Monday through Friday from 8:00 a.m. to 11:00 p.m., EST. Individuals with a TTY may call 1-800-855-2880.

Please call MetLife directly at 1-855-JOIN-MET (1-855-564-6638), Monday through Friday from 8:00 a.m. to 11 p.m., EST and talk with a benefits consultant.

Footnotes: 1

Coverage for Domestic Partners, civil union partners and reciprocal beneficiaries varies by state. Please contact MetLife for more information.

Dependent Child coverage varies by state. Please contact MetLife for more information.

3 Coverage is guaranteed provided (1) the employee is actively at work and (2) dependents are not subject to medical restrictions as set forth on the enrollment form and in the Certificate. Some states require the insured to have medical coverage. Additional restrictions apply to dependents serving in the armed forces or living overseas.

Coverage is guaranteed provided (1) the employee is performing all of the usual and customary duties of your job at the employer's place of business or at an alternate place approved by your employer (2) dependents are not subject to medical restrictions as set forth on the enrollment form and in the Certificate. Some states require the insured to have medical coverage. Additional restrictions apply to dependents serving in the armed forces or living overseas.

4 We will not pay a Recurrence Benefit for a Covered Condition that Recurs during a Benefit Suspension Period. We will not pay a Recurrence Benefit for either a Full Benefit Cancer or a Partial Benefit Cancer unless the Covered Person has not had symptoms of or been treated for the Full Benefit Cancer or Partial Benefit Cancer for which we paid an Initial Benefit during the Benefit Suspension Period.

5 Please review the Disclosure Statement or Outline of Coverage/Disclosure Document for specific information about cancer benefits. Not all types of cancer are covered. Some cancers are covered at less than the Initial Benefit Amount. For NH-sitused cases and NH residents, there is an initial benefit of $100 for All Other Cancers.

6 In certain states, the covered condition is Severe Stroke.

8 Please review the Outline of Coverage for specific information about Alzheimer’s Disease.

The Occupational HIV benefit is not available with all plans or in all states. Please review the Disclosure Statement or Outline of Coverage/Disclosure Document for specific information about the Occupational HIV benefit if it is available to you.

10 In most states there is a 30 day waiting period for the Health Screening Benefit. There is no waiting period for MD sitused cases. The Health Screening Benefit is not available to NH sitused cases or NH residents. There is a separate mammogram benefit for MT residents and for cases sitused in CA and MT. 11 See your certificate for details.

2

METLIFE’S CRITICAL ILLNESS INSURANCE (CII) IS A LIMITED BENEFIT GROUP INSURANCE POLICY. Like most group accident and health insurance policies, MetLife’s CII policies contain certain exclusions, limitations and terms for keeping them in force. Product features and availability vary by state. There is a preexisting condition exclusion. There is a Benefit Suspension Period between Recurrences. Attained Age rates are based on 5-year age bands and will increase when a Covered Person reaches a new age band. Rates are subject to change. A more detailed description of the benefits, limitations, and exclusions can be found in the applicable Disclosure Statement or Outline of Coverage/Disclosure Document available at time of enrollment. For complete details of coverage and availability, please refer to the group policy form GPNP07-CI or GPNP10-CI, or contact MetLife for more information. Benefits are underwritten by Metropolitan Life Insurance Company, New York, New York.

MetLife's Critical Illness Insurance is not intended to be a substitute for Medical Coverage providing benefits for medical treatment, including hospital, surgical and medical expenses. MetLife's Critical Illness Insurance does not provide reimbursement for such expenses.

L0515424452[exp0716][All States] Metropolitan Life Insurance Company, New York, NY 10166.

PEANUTS © 2015 Peanuts Worldwide, LLC

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Offering you cost savings and well-being with a Flexible Spending Account (FSA)

59

1

Signing up for a Flexible Spending Account (FSA) puts more money in your pocket.

You can pay less in taxes and reduce your medical expenses simply by signing up for an FSA! A Flexible Spending Account (FSA) lets you set aside a portion of your paycheck—before taxes— into an account to help you pay for medical expenses. An FSA is a planning tool with great tax benefits. With an FSA, you must use the account balance in full before the end of the plan year or it will be forfeited.

A Flexible Spending Account (FSA): Two Types of FSAs. To take advantage of a health FSA, start by choosing an annual election amount. This amount will be available on day one of your plan year for eligible medical expenses. Payroll deductions will then be made throughout the plan year to fund your account. A dependent care FSA works differently than a health FSA. Dependent care FSA money only becomes available as it is contributed, and can only be used to pay expenses for the care of your dependents while you work. Both are pre-tax benefits your employer offers through a cafeteria plan. Choose one or both — whichever is right for you.

Reduces your taxable income. Your FSA contributions are deducted from your paycheck by your employer before taxes are withheld. These deductions lower your taxable income, which can save you money on income taxes.

Enrollment Consideration. After the enrollment period ends, you may increase, decrease or stop your contribution only when you experience a qualifying “change in status” event (e.g. marriage, divorce, employment change, dependent change). Be conservative in the total amount you elect to avoid forfeiting money at the end of the plan year.

What if I don’t use it all? You must use the account balance in full before the end of the plan year or it will be forfeited. This is known as the “use it or lose it” rule. Your employer may offer a grace period or a rollover to help if you miss the mark a little bit. Check your Summary Plan Description for specifics on your employer's plan, and make sure to plan carefully when you enroll.

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

Account access is easy Get account information from our easy-to-use online portal and mobile app. You can submit claims online, and see your account balance, contributions, and account history in real time.

Eligible Expenses Expenses can be reimbursed from your health FSA if the expenses are for the diagnosis, cure, mitigation, treatment or prevention of disease and for treatments affecting any part or function of the body. The expenses must be primarily to alleviate or prevent a physical or mental defect or illness. Expenses solely for cosmetic reasons generally are not considered expenses for medical care. Also, expenses that are merely beneficial to your general health are not eligible.

The following list shows common examples of qualified medical expenses. Complete lists of eligible and non-eligible expenses can be found in IRS Publication 502, which can be ordered from the IRS by calling 1-800-TAX-FORM (1-800-829-3676) or by visiting www.irs.gov.

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Healthcare Expense Account

Sample Expenses

Medical Expenses •

Acupuncture

•

Fertility treatment

•

Physical exams

•

Addiction programs

•

First aid (e.g., bandages, gauze)

•

Pregnancy tests

•

Adoption (medical expenses for baby birth)

•

Hearing aids & batteries

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Prescription medicines or drugs

•

Alternative healer fees

•

Hypnosis (for treatment of illness)

•

Ambulance

Incontinence products (e.g., Depends, Serene)

Psychiatrist/psychologist (for mental illness)

•

•

•

Physical therapy

•

Body scans

•

Joint support bandages and hosiery

•

Speech therapy

•

Breast pumps

•

Lab fees

•

Vaccinations

•

Care for mentally handicapped

•

Menstrual Products*

•

Vaporizers or humidifiers

•

Chiropractor

•

•

•

Copayments

Monitoring device (blood pressure, cholesterol)

Weight loss program fees (if prescribed by physician)

•

Crutches

•

•

Wheelchair

•

Diabetes (insulin, glucose monitor)

•

Eye patches

Non-prescription medicines or drugs (vitamins/supplements without a prescription are not eligible)*

*After January 1, 2020

Dental Expenses

Vision Expenses

•

Artificial teeth

•

Dentures

•

Braille - books & magazines

•

Eyeglasses

•

Copayments

•

Orthodontia expenses

•

Contact lenses

•

Laser surgery

•

Deductible

•

Preventative care at dentist office

•

Contact lens solutions

•

Office fees

•

Dental work

•

Bridges, crown, etc.

•

Eye exams

•

Guide dog and upkeep/ other animal aid

Items that generally do not qualify for reimbursement •

•

Personal hygiene (e.g., deodorant, soap, body powder, sanitary products.

Does not include menstrual products)

•

Exercise equipment**

•

•

Haircare (e.g., hair color, shampoo, conditioner, brushes, hair loss products)

Nutritional and dietary supplements (e.g., bars, milkshakes, power drinks, Pedialyte)**

•

Health club or fitness program fees**

Skin care (e.g., moisturizing lotion, lip balm)

•

Sleep aids (e.g., snoring strips)**

•

Vitamins**

•

Weight reduction aids (e.g., Slimfast, appetite suppressant)**

Addiction products**

•

Cosmetic surgery**

•

•

Cosmetics (e.g., makeup, lipstick, cotton swabs, cotton balls, baby oil)

•

Homeopathic supplement or herbs**

•

Counseling (e.g., marriage/family)

•

Household or domestic help

•

Dental care - routine (e.g., toothpaste, toothbrushes, dental floss, antibacterial mouthwashes, fluoride rinses, teeth whitening/bleaching)**

•

Laser hair removal

•

Massage therapy**

**Portions of these expenses may be eligible for reimbursement if they are recommended by a licensed medical professional as medically necessary for treatment of a specific medical condition.

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Welcome to your

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Thank you for opening a Health Savings Account (HSA) administered by National Benefit Services (NBS). We are here to help you and your family understand how to take full advantage of your HSA. Our goal is to provide you with an affordable, convenient and worryfree approach to begin saving for your medical expenses. Our convenient web portal provides easy to follow tutorials that will simplify managing your HSA. Additionally, we provide access to our team of financial wellness professionals. Your account has been opened - so let’s get started!

The fundamentals An HSA enables you to save, invest and spend funds for qualified medical expenses tax-free. Until they are spent, funds roll over from year to year and can even be invested tax-free.

What’s next?

This Welcome Kit provides an overview of how your HSA works, including: how to access your account online, ways to contribute and use your funds, how to maximize your contributions and utilize on-line tools and resources.

In addition, you will also receive these additional materials

Now that your account is open, you can begin making deposits and use your account to pay for qualified medical expenses.

Read through this guide for helpful hints and guidance on how to take control of your healthcare costs and begin saving for your future medical expenses.

shortly:

A welcome letter by mail or email with your account number.

A welcome email with instructions for logging into our online portal and links to other valuable resources.

Your NBS Smart Card (within 10 business days).

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Contributing funds lowers your taxable income and allows you to build a nest egg for future healthcare expenses. Contributions to your HSA may be made by you, your employer or anyone else.

Contribution methods You can contribute money to your account in several convenient ways including:

1

pre-tax through your employer’s cafeteria plan.

3

Electronic Funds Transfer – Within the NBS portal you can schedule one-time or ongoing EFTs from other

financial institutions. They are fast and easy!

2

may transfer the funds to your new HSA. Required

forms are available within the NBS portal. You can even transfer an IRA.

4

Direct Deposit – Your HSA acts just like a personal

savings account. If your employer offers direct deposit, you can give them your HSA account information to begin contributing via direct deposit.

Investing your HSA dollars is easy!

•

An array of mutual funds, and an interest-bearing account, give you competitive investment choices.

•

HSA contributions can be automatically swept into investment accounts when they meet the necessary cash account balance; no need to manually move funds between accounts.

•

HSA deposits are held by PNC Bank and are insured by FDIC.

National Benefit Services

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Maximizing your contributions As you decide how much to contribute, it’s important to

you are covered under an HDHP on the first day of the last

note that contributing the maximum allowable amount helps you to get the most from your HSA. At the very least,

month of your tax year (December 1 for most taxpayers) and remain in an HDHP for the following 12 months. See

you’ll want to contribute enough to cover anticipated

IRS publication 969 for details. Contributions are allowed

healthcare expenses. Because your balance rolls over

until April 15th for the previous calendar year. Additionally,

year to year, there is no penalty for contributing more than you’re able to use in one year. The tax advantages of an

if you are 55 or older, you are allowed to make an annual $1,000 catch-up contribution.

HSA make it a powerful long-term savings vehicle.

Keep in mind that HSA contribution limits, established The maximum annual contribution can be made even if you

by the IRS, may change each year and you must not over

become HSA eligible after your tax year begins, as long as

contribute to avoid adverse tax consequences.

2023 Contribution Limit

2024 Contribution Limit

Catch-up Contribution

Single

$ 3,850

$4,150

$1,000

Family

$7,750

$8,300

$1,000

*Participants age 55 or older may make additional contributions above the set HSA maximum. Catch-up contributions can be made any time during the year in which the HSA participant turns 55.

HSA Welcome Guide 66

HSA funds can be used to pay for qualified medical expenses, such as: •

Medical

•

Prescription

•

Dental

•

Medical Equipment

•

Vision

•

Chiropractic

Go to my.nbsbenefits.com and use the Eligible HSA Expense tool to see which types of expenses are qualified.

You can also go to www.irs.gov and download Publication 502. Generally, qualified medical expenses are those expenses directly related to the treatment or prevention of physical or mental illness.

To make it easier for our participants, NBS has partnered with HSAStore, an online store whose entire inventory is HSA eligible. They have the largest selection of HSA eligible products and services on the web.

You’ll find a banner for the HSAStore on the landing page of the online portal.

If you use HSA funds for medical expenses that are not qualified, they will be included in your taxable income.

HSA withdrawals made for non-qualified expenses are subject to ordinary income tax and may also be subject to IRS penalties. State taxes vary so please consult your tax advisor.

Pay for qualified expenses •

Use your NBS Smart Card where accepted, such as the pharmacy or doctor’s office.

•

Write your Smart Card number on medical bills to have your HSA funds directed to the expense.

•

Use our web portal’s online bill pay feature to pay for a healthcare expense or to reimburse yourself for an out-of-pocket medical expense.

Keep good records of your expenses Keep track of your expenses and payments by using the NBS portal to see balances, view transactions, create reports and upload receipts. Be sure to keep receipts for all of your medical expenses for at least three years for tax-reporting purposes – there’s even a place in the NBS portal to keep them! If you use your HSA funds for non-qualified medical expenses, and are under the age of 65, you may incur a 20% penalty and owe income taxes on the amount used. After the age of 65, HSA funds can be used for any expense with no penalty, but you may still owe income taxes on those funds. Qualified medical expenses are always tax-free.

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National Benefit Services

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Whatever your circumstances are, an HSA is a powerful tool to manage your healthcare expenses – now and in the future. You’ve taken the first step by opening your HSA and here’s how to make it work best for you.

Cover your current expenses At minimum, you should contribute enough to cover the cost of your health plan’s annual deductible and other anticipated healthcare expenses. That way you’ve planned ahead to pay for all of your out-of-pocket expenses tax free.

Plan for the unexpected Some healthcare expenses are unanticipated and can be expensive.

Increasing your HSA contributions as much as possible will prepare you for the unexpected.

Save for the future The most powerful use of an HSA is to save for your biggest retirement expense – healthcare. Once you meet minimum account balance requirements, your HSA savings can be invested in a variety of mutual funds. Retiring with a well-funded HSA will provide security and peace of mind.

HSAWelcome WelcomeGuide Guide 68 HSA

Make the most of your HSA

Recordkeeping for tax purposes

•

Contribute the maximum to your HSA.

You will be responsible for retaining your monthly account

•

Manage your healthcare expenses wisely.

•

Learn about and practice healthcare consumerism.

statements and all receipts for qualified medical expenses.

Online statements are available for 18 months. Statements

•

Invest unused HSA funds and make your money work harder for you.

•

Take good care of yourself and your family – a healthy lifestyle makes a big difference.

Note: Your NBS HSA is triple tax-advantaged. You can fund

are generated at the end of each calendar month so please access your account regularly. Consult your tax advisor to determine how HSAs are treated for state tax purposes for the state in which you file your taxes.

At year end of each year, PNC Bank will send you the following:

your HSA with pre-tax or tax-deductible contributions. You can spend tax-free with your HSA. Balances grow tax-free

•

and withdrawals are also tax-free, as long as the money is

•

used for IRS-qualified medical expenses.

1099 SA – Received by January 31 and shows your annual distributions 5498 SA – Received by May 31 and shows your annual contributions

If you have questions regarding these forms, contact NBS at 855-399-3035 and we will be happy to answer any questions you may have.

Visit hsa.nbsbenefits.com for more info on HSA’s or call one of our Benefit Specialists at 855-399-3035. Your benefits administrator will also be able to provide you information about your HSA.

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National Benefit Services

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When you’re on the go, save time and hassle with the NBS Mobile App. Submit claims, check your balances, view transactions, and submit documentation using your device’s camera.

Easy and convenient •

Designed to work just as other iOS and Android apps, making it easy to learn and use.

•

Shares user authentication with the NBS portal.

Registered users can download the app and log in immediately to gain access to their benefit accounts, with no need to register their phone or your account.

It’s secure No sensitive account information is ever stored on your mobile device and secure encryption is used to protect all transmissions.

Mobile app features The NBS mobile app supports a wide variety of features, empowering you to more proactively manage your account.

•

View account balances

•

View claims

•

View reimbursement history

•

Submit claims

•

Submit documentation using your device’s camera

•

Pay providers

•

Setup a variety of SMS alerts

•

Edit your personal information

•

View contribution details

•

View plan information

•

View calendar deadlines

•

Contact a service representative

•

View Smart Card information

HSA Welco Welcome meGuide Gu70 ide HSA

Marble Falls Independent School District ARE YOU AWARE OF YOUR 403(b) BENEFIT? THE OPPORTUNITY You have the opportunity to save for retirement by participating in your Employer’s 403(b) retirement plan. A 403(b) plan is a retirement plan for certain employees of public schools, tax-exempt organizations and ministries. We recommend that all employees visit our education page which can be found here: www.omni403b.com/Employees/Education WHY SAVE WITH 403(b)?

1. You do not pay income tax on allowable contributions until you begin making withdrawals from the plan, usually after your retirement.

2. Pre-tax investment gains in the plan are not taxed until distribution and eligible ROTH investment gains are tax free.

3. Generally, retirement assets can be carried from one employer to another.

Future retirement savings value assuming 6% growth Monthly Contributions

5 Year

15 Years

20 Years

$50

$3,489

$14,541

$23,102

$200

$13,954

$58,164

$92,408

$500

$34,885

$145,409

$231,020

New accounts may be opened with the following approved service providers.

• American Century Services LLC • American Funds Service Company • American United Life Ins Co 1 • Aspire Financial Services • Equitable (formerly AXA) • Fiduciary Trust Intl-Franklin Templeton • GWN/Employee Deposit Acct • Horace Mann Life Ins. Co. • Invesco OppenheimerFunds • Midland National Life Ins. Co. • National Life Group (LSW) • PlanMember Services Corp.

• RBFCU Retirement Program • ROTH - Equitable (formerly AXA) • Security Benefit • Sentinel Group Funds, Inc. • TransAmerica • Vanguard Fiduciary Trust Co.

HOW CAN I PARTICIPATE? Prior to contributing you must open an account with an investment provider authorized in the Plan, a list of which is available on the right.

You may then complete a Salary Reduction Agreement (SRA) online at: www.omni403b.com/SRA If you are already contributing to your Employer’s Plan and you want to change your contribution amount or investment provider, simply complete and submit a new SRA. Once we are in receipt of the newly completed SRA, we will notify your employer to begin contributions.

HOW MUCH CAN I CONTRIBUTE ANNUALLY? In 2024, you may contribute up to $23,000 if you are 49 years of age or below and up to $30,500 if you are 50 years of age and over. You may also be entitled to additional catch-up provisions like the 15 Year Service Catch-up. Please contact OMNI’s Customer Care Center at 877.544.6664 for further details.

15 Yr. Contribution Limits Combined Limit Maximum Service Age 49 Age 50 Age 49 Age 50 Employer Catch-up & below & above Contributions & below & above (if eligible) $23,000

$30,500

$3,000

$69,000

$69,000

$76,500

LOOKING FOR HELP? Click the link below for an investment professional to reach out to you.

Marble Falls Independent School District Plan Detail Page

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1111 Employee Benefits lt;J Services Group.

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