Mason ISD Benefits Guide 2023-2024

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

Medical Insurance- TRS has been added to the benefits hub for your convenience to enroll in all benefits in one location.

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

Disability - Plan provides a monthly income to an individual that is disabled due to an accident or illness. This plan provides a week bene t for pre-exis ng condi o ns for all new enrollees or increase in coverage.

Texas Life Permanent Life - Portable, permanent life insurance available for employees, their spouses, and dependents. Employees can keep the coverage upon termination or retirement from ISD.

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

Cancer - Pays benefits for internal cancer diagnosis. Includes an annual cancer screening benefit.

INTRODUCTION

Provid great bene t choices to you and your family is justcial welfare of the people who make our district work so well.

HOW DO I ENROLL?

Visit last 4 digits of your SSN. (EX: John Sanderson SSN: Complete last name (excluding any special

WHO IS ELIGIBLE?

insurance at full cost.

WHO IS AN ELIGIBLE DEPENDENT?

Dependent children of any age who are disabled

Children under your legal guardianship

MID-YEAR CHANGES

or cancel coverage during the year if you have a qualifying change in the family or employment status that causes you to include:

Loss or gain of eligibility for other insurance (including

WHEN WILL I RECEIVE ID CARDS?

Everyone enrolled in Medical will receive a new Medical Card. ti -

rary ID card or give your provider the insurance company’s phone number to call and verify your coverage if you do not have an ID card at the time of service.

WHO DO I CONTACT WITH QUESTIONS?

of the following month.

Enrollment Instructions for THEbenefitsHUB

Site Access: To access your employer online enrollment site, THEbenefitsHUB, you can login to the following website www.mybenefitshub.com/masonisd

Username: The first six (6) characters of your last name, followed by the first letter of your first name, followed by the last four (4) digits of your SSN:

Example: Employee Name - Robert Smith, SS# 123-45-6789 User Name: smithr6789

Default Password: Complete Last Name (Excluding Punctuation) follow by the last four (4) digits for your SSN

Password Reset: Employees will prompted to update the password once you enter the site. 245 Landa Street New Braunfels, Texas 78130 Phone: (830) 606-5100

TRS-ActiveCare’s network has more doctors and hospitals than you can round up.

TRS-ActiveCare Plan Highlights 2023-24

Learn the Terms.

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

• Deductible: The annual amount for medical expenses you’re responsible to pay before your plan begins to pay its portion.

• Copay: The set amount you pay for a covered service at the time you receive it. The amount can vary by the type of 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; i.e. 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.

2023-24 TRS-ActiveCare Plan Highlights

New

•Certain specialty drugs are still $0 through SaveOnSP.

Compare Prices for Common Medical Services

*Pre-certification for genetic and specialty testing may apply. Contact a PHG

questions.

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.

You can choose this plan if you live in one of these counties: Austin, Bastrop, Bell, Blanco, Bosque, Brazos, Burleson, Burnet, Caldwell, Collin, Coryell, Dallas, Denton, Ellis, Erath, Falls, Freestone, Grimes, Hamilton, Hays, Hill, Hood, Houston, Johnson, Lampasas, Lee, Leon, Limestone, Madison, McLennan, Milam, Mills, Navarro, Robertson, Rockwall, Somervell, Tarrant, Travis, Walker, Waller, Washington, Williamson

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

All Full-Time Employees Electing the High Planof Mason

ISD

Benefits At-A-Glance

Dental Insurance

High Option

The Lincoln

DentalConnect®PPO

Plan:

Covers many preventive, basic, and majordental care services

Also covers orthodontic treatment for children

Features group coveragefor Mason ISDemployees

Allowsyou to choose any dentist you wish, though you can lower your out-of-pocket costs by selecting a contracting dentist

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

Calendar (Annual)

Deductible

Contracting Dentists

Individual: $50

Family: $150

Waived for: Preventive

Non-Contracting Dentists

Individual: $50

Family: $150

Waived for: Preventive

Deductibles are combined for basicand majorContracting Dentists’ services. Deductibles are combined for basicand majorNon-Contracting Dentists’services.

Annual Maximum $1,500 $1,500

MaxRewards® lets you and your covered family members roll a portion of unused dental benefits from one year into the next. So you have extra benefit dollars available when you need them most.

●Eligible Range (claim threshold): $800

●Rollover Amount: $350per calendar year

●Rollover Amount with Preferred Provi der: $500per calendar year

●Maximum Rollover Account Balance: $1,250

Lifetime Orthodontic Max $1,000 $1,000

Orthodontic Coverage is available for dependent children.

Waiting Period There are no benefit waiting periods for any service types

Visit LincolnFinancial.com/FindADentist

You can search by:

●Location

●Dentist name or office name

●Distance you are willing to travel

●Specialty, language and more

Your search will automatically provide up to 100 dentists that most closely match your criteria. If your search does not locate the dentist you prefer, you can nominate one—just click the Nominate a Dentist link and complete the online form.

Routine oral exams

Bitewing X-rays

Full-mouth or panoramic X-rays

Other dental X-rays (including periapical films)

children Sealants

(including emergency relief of dental pain)

Problem focused exams

Injections of antibiotics and other therapeutic medications

Consultations

Prefabricated stainless steel and resin crowns

Surgical extractions

Oral surgery

Biopsy and examination of oral tissue (includ ing brush biopsy)

Prosthetic repair and recementation services

Endodontics (including root canal treatment)

Periodontal maintenance procedures

Non-surgical periodontal therapy

Periodontal surgery

Bridges

Full and partial dentures

Denture reline and rebase services

Crowns, inlays, onlays and related services

Build-ups/post & core Implants & implant related services

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

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

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

… you pay a deductible (if applicable), then 50% of the usual and customary fee, which is the maximum expense covered by the plan. You are responsible for the difference between the usual and customary fee and the dentist’s billed charge.

With the Lincoln Dental Mobile App

Find a network dentist near you in minutes

Have an ID card on your phone

Customize the app to get details of your plan

Find out how much your plan covers for checkups and other services

Keep track of your claims

Lincoln DentalConnect® Online Health Center

Determine the average cost of a dental procedure

Have your questions answered by a licensed dentist

Learn all about dental health for children, from baby’s first tooth to dental emergencies

Evaluate your risk for oral cancer, periodontal disease and tooth decay

Covered Family Members

When you choose coverage for yourself, you can also provide coverage for:

• Your spouse.

• Unmarried dependent children, up to age 26.

Benefit Exclusions

Like any coverage, this dental coverage doeshave some exclusions. The plan does not cover services started before coverage begins or after it ends. Benefits are limited to appropriate and necessary procedures listed in the summary plan description.Benefits are not payable for duplication of services. Covered expenses will not exceed the summary plan description’susual and customary allowances. Plan benefits are not payable for a condition that is covered under Workers’ Compensation or a similar law; that occurs during the courseof employment or military service or involvement in an illegal occupation, felony, or riot; or that results from a self-inflicted injury. The plan does not cover an orthodontia treatment plan started before coveragebegins unless the member was receiving orthodontia benefits from the employer’s previous group dental summary plan description. In this case, Lincoln Financial will continue orthodontia benefits until the combined benefit paid by both policies is equal tothis summary plan description’slifetime orthodontia maximum. Plan benefits are not payable if the orthodontic appliance was installed after the age of 19. In certain situations, there may be more than one method of treating a dental condition. This summary plan description includes an alternative benefits provision that may reduce benefits to the lowestcost, generally effective, and necessary form of treatment. Certain conditions, such as age and frequency limitations, may impact your coverage. See the summary plan description for details. This plan includes continuation of coverage for employees with dental coverage from a previous employer. The member is required to complete the Continuity of Coverage form located on www.lfg.com. The form must be providedto us prior to the effective date to be eligible for continuation of coverage.

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

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

This is not intended as a complete description of the coverage offered. Controlling provisions are provided in the summary plan description,and this summary does not modify coverage. A summary plan descriptionwill be made available to you that describes the benefits in greater detail. Refer to your summary plan descriptionfor your maximum benefit amounts.

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

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

Dental Rate

Here’s how little you pay with grouprates.

As aMason ISDemployee, you can take advantage of this dental coveragefor less than $1.11a day. Plus, you can add loved ones to the plan for just a little more.

Your estimated cost is itemizedbelow.

The Lincoln National Life Insurance Company

Please see prior page for product information.

All Full-Time Employees Electing the Low Planof Mason

ISD

Benefits At-A-Glance

Dental Insurance

Low Option

The Lincoln

DentalConnect®PPO

Plan:

Covers many preventive, basic, and majordental care services

Also covers orthodontic treatment for children

Features group coveragefor Mason ISDemployees

Allowsyou to choose any dentist you wish, though you can lower your out-of-pocket costs by selecting a contracting dentist

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

Calendar (Annual)

Deductible

Contracting Dentists

Individual: $50

Family: $150

Waived for: Preventive

Non-Contracting Dentists

Individual: $50

Family: $150

Waived for: Preventive

Deductibles are combined for basicand majorContracting Dentists’ services. Deductibles are combined for basicand majorNon-Contracting Dentists’services.

Annual Maximum $1,500 $1,500

MaxRewards® lets you and your covered family members roll a portion of unused dental benefits from one year into the next. So you have extra benefit dollars available when you need them most.

●Eligible Range (claim threshold): $800

●Rollover Amount: $350per calendar year

●Rollover Amount with Preferred Provi der: $500per calendar year

●Maximum Rollover Account Balance: $1,250

Lifetime Orthodontic Max $1,000 $1,000

Orthodontic Coverage is available for dependent children.

Waiting Period There are no benefit waiting periods for any service types

Visit LincolnFinancial.com/FindADentist

You can search by:

●Location

●Dentist name or office name

●Distance you are willing to travel

●Specialty, language and more

Your search will automatically provide up to 100 dentists that most closely match your criteria. If your search does not locate the dentist you prefer, you can nominate one—just click the Nominate a Dentist link and complete the online form.

Routine oral exams

Bitewing X-rays

Full-mouth or panoramic X-rays

Other dental X-rays (including periapical films)

emergency relief of dental pain)

Problem focused exams

Injections of antibiotics and other therapeutic medications

Consultations

Prefabricated stainless steel and resin crowns

Surgical extractions

Oral surgery

Biopsy and examination of oral tissue (includ ing brush biopsy)

Prosthetic repair and recementation services

Endodontics (including root canal treatment)

Periodontal maintenance procedures

Non-surgical periodontal therapy

Periodontal surgery

Bridges

Full and partial dentures

Denture reline and rebase services

Crowns, inlays, onlays and related services

Build-ups/post & core Implants & implant related services

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

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

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

… you pay a deductible (if applicable), then 50% of the usual and customary fee, which is the maximum expense covered by the plan. You are responsible for the difference between the usual and customary fee and the dentist’s billed charge.

With the Lincoln Dental Mobile App

Find a network dentist near you in minutes

Have an ID card on your phone

Customize the app to get details of your plan

Find out how much your plan covers for checkups and other services

Keep track of your claims

Lincoln DentalConnect® Online Health Center

Determine the average cost of a dental procedure

Have your questions answered by a licensed dentist

Learn all about dental health for children, from baby’s first tooth to dental emergencies

Evaluate your risk for oral cancer, periodontal disease and tooth decay

Covered Family Members

When you choose coverage for yourself, you can also provide coverage for:

• Your spouse.

• Unmarried dependent children, up to age 26.

Benefit Exclusions

Like any coverage, this dental coverage doeshave some exclusions. The plan does not cover services started before coverage begins or after it ends. Benefits are limited to appropriate and necessary procedures listed in the summary plan description.Benefits are not payable for duplication of services. Covered expenses will not exceed the summary plan description’susual and customary allowances. Plan benefits are not payable for a condition that is covered under Workers’ Compensation or a similar law; that occurs during the courseof employment or military service or involvement in an illegal occupation, felony, or riot; or that results from a self-inflicted injury. The plan does not cover an orthodontia treatment plan started before coverage begins unless the member was receiving orthodontia benefits from the employer’s previous group dental summary plan description. In this case, Lincoln Financial will continue orthodontia benefits until the combined benefit paid by both policies is equal to this summary plan description’slifetime orthodontia maximum. Plan benefits are not payable if the orthodontic appliance was installed after the age of 19. In certain situations, there may be more than one method of treating a dental condition. This summary plan description includes an alternative benefits provision that may reduce benefits to the lowestcost, generally effective, and necessary form of treatment. Certain conditions, such as age and frequency limitations, may impact your coverage. See the summary plan description for details. This plan includes continuation of coverage for employees with dental coverage from a previous employer. The member is required to complete the Continuity of Coverage form located on www.lfg.com. The form must be providedto us prior to the effective date to be eligible for continuation of coverage.

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

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

This is not intended as a complete description of the coverage offered. Controlling provisions are provided in the summary plan description,and this summary does not modify coverage. A summary plan descriptionwill be made available to you that describes the benefits in greater detail. Refer to your summary plan descriptionfor your maximum benefit amounts.

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

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

Dental Rate

Here’s how little you pay with grouprates.

As aMason ISDemployee, you can take advantage of this dental coveragefor less than $0.64a day. Plus, you can add loved ones to the plan for just a little more.

Your estimated cost is itemizedbelow.

The Lincoln National Life Insurance Company

Please see prior page for product information.

plan benefits for Mason ISD

Benefits through Superior National network

Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements

1 Materials co-pay applies to lenses and frames only, not contact lenses

2 Standard contact lens fitting applies to a current contact lens user who wears disposable, daily wear, or extended wear lenses only. Specialty contact lens fitting applies to new contact wearers and/or a member who wear toric, gas permeable, or multi-focal lenses.

3 Covered to provider’s in-office standard retail lined trifocal amount; member pays difference between progressive and standard retail lined trifocal, plus applicable co-pay.

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

Discount features

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

Discounts on covered materials

Frames: 20% off amount over allowance

Lens options: 20% off retail

Progressives: 20% off amount over retail lined trifocal lens, including lens options

Specialty contact lens fit: 10% off retail, then apply allowance

Maximum member out-of-pocket

The following options have out-of-pocket maximums5 on standard (not premium, brand, or progressive) lenses.

Single vision Bifocal & trifocal

Scratch coat $13 $13

Ultraviolet coat $15 $15

Tints, solid or gradients $25 $25

Anti-reflective coat $50 $50

Polycarbonate $40

High index 1.6 $55

20% off retail

20% off retail

Photochromics $80 20% off retail

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

Discounts on non-covered exam, services and materials

Exams, frames, and prescription lenses: 30% off retail

Lens options, contacts, miscellaneous options: 20% off retail

Disposable contact lenses: 10% off retail

Retinal imaging: $39 maximum out-of-pocket

LASIK

Laser vision correction (LASIK) is a procedure that can reduce or eliminate your dependency on glasses or contact lenses. This corrective service is available to you and your eligible dependents at a special discount (20-50%) with your Superior Vision plan. Contact QualSight LASIK at (877) 201-3602 for more information.

The Plan discount features are not insurance.

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

Discounts are subject to change without notice.

Disclaimer: All final determinations of benefits, administrative duties, anddefinitions are governed by the Certificate of Insurance for your vision plan. Please check with your Human Resources department if you have any questions.

BENEFIT HIGHLIGHTS FOR:

Mason Independent School District

EDUCATOR DISABILITY INSURANCE OVERVIEW

What is Educator Disability Income Insurance?

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

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

Why do I need Disability Insurance Coverage?

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

1 Facts from LIMRA, 2016 Disability Insurance Awareness Month

The average worker faces a 1 in 3 chance of suffering a job loss lasting 90 days or more due to a disability2

2Facts from LIMRA, 2016 Disability Insurance Awareness Month

Only 50% of American a dults indicate they have enough savings to cover three months of living expenses in the event they’re not earning any income 3

3Federal Reserve, Report on the Economic Well-Being of U.S. Households in 2018

ELIGIBILITY AND ENROLLMENT

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

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

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

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

FEATURES OF THE PLAN

Benefit Amount You may purchase coverage that will pay you a monthly flat dollar benefit in $100 increments between $200 and $8,000 that cannot exceed 66 2/3% of your current monthly earnings. Earnings are defined in The Hartford ’s contract with your employer.

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

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

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

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

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

Mental Illness, Alcoholism and Substance Abuse: Duration

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

Prior to 68 24 Months

Age 68-69 To Age 70, but not less than 12 months

Age 70 and older 12 Months

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

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

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

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

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

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

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

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

PROVISIONS OF THE PLAN

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

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

Pre-Existing Condition Limitation

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

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

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

Recurrent Disability What happens if I Recover but become Disabled again?

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

Benefit Integration

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

•Social Security Disability Insurance

•State Teacher Retirement Disability Plans

•Workers’ Compensation

•Other employer-based disability insurance coverage you may have

•Unemployment benefits

•Retirement benefits that your employer fully or partially pays for (such as a pension plan)

Your plan includes a minimum benefit of 10%ofyour elected benefitor $100.

General Exclusions

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

•War or act of war (declared or not)

•Military service for any country engaged in war or other armed conflict

•The commission of, or attempt to commit a felony

•An intentionally self-inflicted injury

•Any case where your being engaged in an illegal occupation was a contributing cause to your disability

•You must be under the regular care of a physician to receive benefits

Termination Provisions

Your coverage under the plan will end if:

•The group plan ends or is discontinued

•You voluntarily stop your coverage

•You are no longer eligible for coverage

•You do not make the required premium payment

•Your active employment stops, except as stated in the continuation provision in the policy

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

life insurance highlights

For the employee purelife-plus

Voluntary permanent life insurance can be an ideal complement to the group term and optional term life insurance your employer might provide. This voluntary universal life product is yours to keep, even when you change jobs or retire, as long as you pay the necessary premium. Group and voluntary term life insurance may be portable if you change jobs, but even if you can keep them after you retire, they usually cost more and decline in death benefit.

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

•HighDeathBenefit. With one of the highest death benefits available at the worksite,1 purelife-plus gives your loved ones peace of mind, knowing there will be life insurance in force when you die.

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

•AcceleratedDeathBenefitDuetoTerminalIllnessRider. Should you be diagnosed as terminally ill with the expectation of death within 12 months, you will have the option to receive 92% of the death benefit, minus a $150 ($100 in Florida) administrative fee. This valuable living benefit gives you peace of mind knowing that, should you need it, you can take the large majority of your death benefit while still alive. (Conditions apply.) (Form ICC07-ULABR-07 or Form Series ULABR-07)

AdditionalFeatures

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

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

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

QUICK QUESTIONS 3

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

DURING THE LAST SIX MONTHS, HAS THE PROPOSED INSURED:

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

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

Been disabled or received tests, treatment or care of any kind in a hospital or nursing home or received chemotherapy, hormonal therapy for cancer, radiation, dialysis treatment, or treatment for alcohol or drug abuse?

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

1 Voluntary Whole and Universal Life Products, Eastbridge Consulting Group, December 2018

2 Guarantees are subject to product terms, limitations, exclusions, and the insurer’s claims paying ability and financial strength

3 Coverage not available on children in WA or on grandchildren in WA or MD. In MD, children must reside with the applicant to be eligible for coverage.

PureLife-plusispermanentlifeinsurancetoAttainedAge121thatcanneverbecancelledaslongasyoupaythenecessarypremiums.Afterthe GuaranteedPeriod,thepremiumscanbelower,thesame,orhigherthantheTablePremium.Seethebrochureunder”PermanentCoverage”.

PureLife-plusispermanentlifeinsurancetoAttainedAge121thatcanneverbecancelledaslongasyoupaythenecessarypremiums.Afterthe GuaranteedPeriod,thepremiumscanbelower,thesame,orhigherthantheTablePremium.Seethebrochureunder”PermanentCoverage”.

Full-Time Employees

Term Lifeand AD&DInsurance

Safeguard the most important people in your life.

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

AT A GLANCE:

• A cash benefit of $30,000toyourlovedonesintheeventofyourdeath,plusa matching cash benefit if you die in anaccident

• Acash benefit to you if you suffer a covered loss in an accident, suchas losing a limb or your eyesight

• Accident Plus -If you suffer an AD&D loss in an accident, you may also receive benefits for the following on top of your core AD&D benefits: coma, plegia, education, childcare, spouse training, and more.

• LifeKeys® services, which provide access to counseling, financial, and legalsupport

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

You also have the option to increase your cash benefit by securing additional coverage at affordable group rates. See the enclosed life insurance information for details.

ADDITIONAL DETAILS

Conversion: You can convert your group term life coverage to an individual life insurance policy without providing evidence of insurability if you lose coverage due to leaving your job or for another reason outlined in the plan contract. AD&D benefits cannot be conve rted.

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

Benefit Reduction: Coverage amounts begin to reduce at age 65 and benefits terminate at retirement. See the plan certificate for details.

For complete benefit descriptions, limitations, and exclusions, refer to the certificate of coverage. This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provid ed 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®servicesareprovidedbyComPsych®Corporation,Chicago,IL.ComPsych®,EstateGuidance®andGuidanceResources®are registered trademarks of ComPsych® Corporation. TravelConnect® services are provided by On Call International, Salem, NH. ComPsych® and On Call Internationalare not Lincoln Financial Group® companies. Coverage is subject to actual contract language. Each independent company is solely responsible for its own obligations.

Insurance products (policy series GL1101) are issued by The Lincoln National Life Insurance Company (Fort Wayne, IN), which does not solicit business in New York, noris it licensed to do so. Product availability and/or features may vary by state. Limitations and exclusions apply. Lincoln Financial Group is

Mason Independent School Districtprovides this valuable benefitat no cost to you.

Voluntary TermLife Insurance

The Lincoln Term Life Insurance Plan:

• Provides a cash benefit to your loved ones in the event of your death

• Features group rates for Mason ISDemployees

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

Full-Time Employeesof Mason Independent School District

Benefits At-A-Glance

Employee

Guaranteed coverage amount during initial offering or approved special enrollment period

Choice of $10,000 or $20,000

Newly hired employeeguaranteed coverage amount $200,000

Continuing employeeguaranteed coverage annual increase amount

Maximum coverage amount

Choice of $10,000 or $20,000

7times your annual salary ($500,000 maximumin increments of $10,000)

Minimum coverage amount $10,000

Spouse

Guaranteed coverage amount during initial offering or approved special enrollment period

Choice of $10,000 or $20,000

Newly hired employeeguaranteed coverage amount $50,000

Continuing employeeguaranteed coverage annual increase amount

Maximum coverage amount

Choice of $10,000 or $20,000

100%of the employee coverage amount ($100,000maximumin increments of $10,000)

Minimum coverage amount $10,000

Dependent Children

6 months to age 26guaranteed

What your benefits cover

Employee Coverage

Guaranteed Life Insurance Coverage Amount

• Initial Offering or Approval Special Enrollment: You can choose a coverage amount up to $20,000 without providing evidence of insurability.

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

Newly hired guarantee issue amount: When you are first offered this coverage, you can choose a coverage amount up to $200,000 without providing evidence of insurability.

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

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

Maximum Life Insurance Coverage Amount

• You can choose a coverage amount up to 7 times your annual salary ($500,000 maximum) with evidence of insurability. See the Evidence of Insurability page for details.

• Your coverage amount will reduce by 35% when you reach age 65 and an additional 15% of the original amount when you reach age 70.

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

Guaranteed Life Insurance Coverage Amount

• Initial Offering or Approval Special Enrollment: You can choose a coverage amount up to $20,000 without providing evidence of insurability.

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

Newly hired guarantee issue amount: When you are first offered this coverage, you can choose a coverage amount up to $50,000 without providing evidence of insurability.

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

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

Maximum Life Insurance Coverage Amount

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

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

Guaranteed Life Insurance Coverage Options: $10,000.

Additional Plan Benefits

Benefit Exclusions

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

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

LifeKeys® services are provided by ComPsych® Corporation, Chicago, IL. TravelConnect® travel assistance services are provided by On Call International, Salem NH. On Call International must coordinate and provide all arrangements in order for eligible services to be covered. ComPsych® and On Call International are not Lincoln Financial Group companies and Lincoln Financial Group does not administerthese Services. Each independent company is solely responsible for its own obligations. Coverage is subject to contract language that contains specific terms, conditions, and limitations.

Insurance products (policy series GL1101) are issued by The Lincoln National Life Insurance Company (Fort Wayne, IN), whichdoes not solicit business in New York, nor is it licensed to do so. Product availability and/or features may vary by state. Limitations and exclusions apply.

Voluntary AD&D Insurance

The Lincoln AD&D Insurance Plan:

• Provides a cash benefit to your loved ones if you die in an accident

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

• Features group rates for Mason ISDemployees

• Includes LifeKeys® services, which provide access to counseling, financial, and legal support

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

Full-Time Employeesof Mason Independent School District

Benefits At-A-Glance

Employee

Maximum coverage amount

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

Minimum coverage amount $10,000

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

Spouse

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

Minimum coverage amount $5,000

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

Benefits end when you retire

Dependent Children

6 months to age 26 Maximum coverage amount $25,000

Minimum coverage amount $25,000

Day 1 to 14 days Maximum coverage amount

Day 14 to age 6 months

$1,000 $2,000

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

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

Benefit Exclusions

Like any insurance, this AD&D insurance policy does have exclusions. Benefits will not be paid if death results from suicide, or death/dismemberment occurs while:

Intentionally inflicting or attempting to inflict injury to one’s self

Participating in a war, act of war, or riot

Serving on full-time active duty in the armed forces of any state or country (this does not include duty of 30 days or less training in the Reserves or National Guard)

Flying on any non-commercial airplane or aircraft, such as a hot air balloon or glider (see the contract for details and exceptions)

Flying on a commercial airline or aircraft as a pilot or crewmember

Committing or attempting to commit a felony

Deliberately inhaling gas (such as carbon monoxide) or using drugs other than those taken as prescribed by a licensed physician

Driving while intoxicated, impaired, or under the influence of drugs

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

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

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

LifeKeys® services are provided by ComPsych® Corporation, Chicago, IL. TravelConnect® travel assistance services are provided by On Call International, Salem NH. On Call International must coordinate an d provideall arrangements in order for eligible services to be covered. ComPsych® and On Call International are not Lincoln Financial Group companies and Lincoln Financial Group does not administerthese Services. Each independent company is solely responsible for its own obligations. Coverage is subject to contract language that contains specific terms, conditions, and limitations.

Insurance products (policy series GL1101) are issued by The Lincoln National Life Insurance Company (Fort Wayne, IN), which does not solicit business in New York, nor is it licensed to do so. Product availability and/or features may vary by state. Limitations and exclusions apply.

©2020 LincolnNationalCorporation -LCN-2016756-020518-07–R1.0 –Group ID: WTXMASOISD

Voluntary Accidental Death & DismembermentInsurance

Here’s how little you pay with grouprates.

MonthlyPremium Calculation for You

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

$____________ X 0.0000400 = $ coverage

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

MonthlyPremium Calculation for Your Spouse

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

$____________ X 0.0000700 = $

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

MonthlyPremium Calculation for Your Dependent Children

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

$__________ X 0.0000700 = $

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

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

The Lincoln National Life Insurance Company

Please see prior page for product information. Voluntary AD&D

MonthlyVoluntary Life Insurance Premium

Here’s how little you pay with grouprates.

Spouse|

The Lincoln National Life Insurance Company

Please see prior page for product information.

LFE-ENRO-BRC001-TX

Voluntary Life Insurance At-A-Glance

Group

for Your Dependent Children

One affordable monthlypremium covers all of youreligible dependent children.

Note: You must be an active Mason Independent School Districtemployee to select coverage for a spouseand/or dependent children. To be eligible for coverage, a spouseor dependent child cannot be confined to a health care facility or unable to perform thetypical activities of a healthy person of the same age and gender.

Accident Insurance

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

APSB-21402(TX)-0219

Mason ISD

SummaryofBenefit

DiagnosticTesting 1testpercalendaryear

Follow UpDiagnosticTesting 1testpercalendaryear

MedicalImaging

Surgical Anesthesia

BoneMarrowTransplant Maximumperlifetime

StemCellTransplant Maximumperlifetime

Prosthesis SurgicalImplantation/Non Surgical(notHairPiece)1devicepersite,perlifetime

HospitalConfinement

PerdayofHospitalConfinement(1 30days)

PerdayforEligibleDependentChildren(1 30days)

PerdayofHospitalConfinement(31+days)

Per dayforEligibleDependentChildren(31+days)

OutpatientFacility Perdaysurgeryisperformed

AttendingPhysician PerdayofHospitalConfinement

DreadDisease PerdayofHospitalConfinement(1 30days/31+days)

ExtendedCareFacility UptothesamenumberofHospitalConfinementDays

Donor

HomeHealthCare UptothesamenumberofHospitalConfinementDays

HospiceCare Uptomaximumof365daysperlifetime

USGovernment,CharityHospitalorHMO

Perdayof HospitalConfinement(1 30days/31+days)

CancerTreatmentCenterEvaluationorConsultation 1perlifetime

EvaluationorConsultationTravelandLodging 1perlifetime

Second/ThirdSurgicalOpinion perdiagnosisofcancer $300/$300

DrugsandMedicine Inpatient/Outpatient(maximum$150permonth)

Transportation Maximum12tripspercalendaryearforallmodesoftransportationcombined

Travelbybus,planeortrain

Travelbycar

Lodging uptoamaximumof100dayspercalendaryear

Travelbybus,planeortrain

Travelbycar

Family Lodging uptoamaximumof 100dayspercalendar year

$150perconfinement

actualcoachfareor

actualcoachfareor

InpatientSpecialNursingServices perdayofHospitalConfinement $200/$2,000pertrip $150perday Level 1 Not Included Not Included $0.40 per mile $0.40 per mile $50 per day $0.40 per mile $0.40 per mile $50 per day 39

TotalpremiumincludesthePlanselectedandanyapplicableriderpremium.Premiumsaresubjecttoincreasewithnotice. ThepremiumandamountofbenefitsvarydependentuponthePlanselectedattimeofapplication.

Summary of Benefits

Policy Benefit Highlights

Medical Expense Accidental Injury Benefit

Pays actual charges up to the benefit selected for an Insured Person when medical treatment is required as a result of an Accidental Bodily Injury. For medical treatment received on an out-patient basis, Covered Expenses include physician charges, surgery, x-rays, radiation of fractures or other emergency first-aid expenses incurred in a physician’s office, clinic, out-patient hospital facility or ambulatory surgical center. If Covered Expenses are incurred at a Hospital emergency room, a $50 deductible will apply for each Accidental Injury. For medical treatment received by the Insured Person confined in a Hospital as a resident bed patient, Covered Expenses include physician charges, hospital room and medically necessary hospital billed services and supplies.

Air and Ground Ambulance Benefit

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

Daily Hospital Confinement Benefit

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

Accidental Death

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

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

Accidental Dismemberment Benefit

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

Single Finger or Toe $500 Per Unit

Multiple Fingers or Toes $500 Per Unit

Single Hand, Arm, Foot or Leg $2,500 Per Unit

Multiple Hand, Arm, Foot or Leg $5,000 Per Unit

Accidental Loss of Sight Benefit

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

Loss of Sight in one eye $2,500 Per Unit

Loss of Sight in both eyes $5,000 Per Unit

Optional Benefits

Hospital Admission Benefit

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

Accident Only – Intensive Care Benefit

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

Limitations and Exclusions

Eligibility

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

Base Policy and Optional Benefits

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

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

Medical Expense Accidental Injury Benefit

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

Air and Ground Ambulance Benefit

Emergency transportation must occur within 21 calendar days of the accident causing such Injury.

Daily Hospital Confinement Benefit

The maximum benefit period for this benefit is 30 days per covered accident.

Accidental Death

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

Accidental Dismemberment Benefit

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

Hospital Admission Benefit

The maximum benefit is 4 units.

Accident

Only – Intensive Care Benefit

The maximum benefit is 4 units. The maximum benefit period for this benefit is up to 30 days for any one accident.

Exclusions

Benefits otherwise provided by this Policy will not be payable for services or expenses or any such Loss resulting from or in connection with:

(1)sickness, illness or bodily infirmity;

(2)suicide, attempted suicide or intentional self-inflicted Injury, whether sane or insane;

(3)dental care or treatment unless due to accidental Injury to natural teeth;

(4)war or any act of war (whether declared or undeclared) or participating in a riot or felony;

(5)alcoholism or drug addiction;

(6)travel or flight in or descent from any aircraft or device which can fly above the earth’s surface in any capacity other than as a fare paying passenger on a regularly scheduled airline;

(7)Injury originating prior to the effective date of the Policy;

(8) Injury occurring while intoxicated (Intoxication means that which is determined and defined by the laws and jurisdiction of the geographical area in which the loss or cause of loss is incurred.);

(9) Voluntary inhalation of gas or fumes or taking of poison or asphyxiation;

(10)Voluntary ingestion or injection of any drug, narcotic or sedative, unless administered on the advice and taken in such doses as prescribed by a Physician;

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

(12) Injury incurred while engaging in an illegal occupation;

(13) Injury incurred while attempting to commit a felony or an assault;

(14)Injury to a covered person while practicing for or being a part of organized or competitive rodeo, sky diving, hang gliding, parachuting or scuba diving;

(15) driving in any race or speed test or while testing an automobile or any vehicle on any racetrack or speedway;

(16) hernia, carpal tunnel syndrome or any complication therefrom;

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

Guaranteed Renewable

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

*The premium and amount of benefits may vary dependent upon the plan selected at time of application. Policy and additional benefits were choosen by your employer. Premiums are subject to increase with notice.

Underwritten by American Public Life Insurance Company. This is a brief description of the coverage. For complete benefits and other provisions, please refer to the policy/ certificate/rider(s). This coverage does not replace Workers’ Compensation Insurance. This product is inappropriate for people who are eligible for Medicaid coverage. |

65% ofAmerican cancer survivorsdid not have sufficient income to cover o out-of-pocket t expenses for cancer treatment and other incurred debts related d to o the e illness.1

COVERAGE INFORMATION

If C1 ≠ Core/Buy-Upand CI19 = No, then display: [Benefit amounts for covered illnesses are based on the coverage amount in effect for you at the time of diagnosis.]

If C1 ≠ Core/Buy-Upand CI19 = Yes, then display: [Benefit amounts for covered illnesses are based on the coverage amount in effect for you or an insured dependentat the time of diagnosis.]

If C1 = Core/Buy-Upand CI19 = No, then display: [Your employer will automatically enroll you for coverage under the Core Plan (if eligible). You also have the option to elect additional coverage under the Buy-Up Plan. This choice allows you the flexibility to enroll for the coverage that best meets your current financial protection needs. Benefit amounts for covered illnesses are based on the coverage amount ineffect for you at the time of diagnosis.]

If C1 = Core/Buy-Upand CI19 = Yes, then display: [Your employer will automatically enroll you for coverage under the Core Plan (if eligible). You also have the option to elect additional coverage for you and coverage for your dependents under the Buy-Up Plan. This choice allows you the flexibility to enroll for the coverage that best meets your current financial protection needs. Benefitamounts for covered illnesses are based on the coverage amount in effect for you or an insured dependentat the time of diagnosis.]

BENEFITS & FEATURES

If (CI1 = Employer Paid and CI4 = Standard Plan) or (CI1 =Voluntary and CI4 = Standard Plan), then display: [

COVERAGE AMOUNTS

GG3 Coverage Amount

Display coverage amounts checked between CI22 and CI31

Single amount format: $X,XXX

Two amounts format: $X,XXX or $X,XXX

More than two amounts format: $X,XXX; $X,XXX; or $X,XXX

If CI19 = Yes, then display row Spouse Coverage Amount 50% of your coverage amount

COVERAGE INFORMATION

If HI2>1, then display: [You have a choice of If HI2 = 2, then display: [two] If HI2 = 3, then display: [three] If HI2 = 4, then display: [four] hospital indemnity plans, which allows you the flexibility to enroll for the coverage that best meets your current financial protection needs.] Benefit amounts are based on the plan in effect for you If HI11 = Yes, then display: [or an insured dependent] at the time the covered event occurs. If HI11 = Yes, then display: [Unless otherwise noted, the benefit amounts payable under each plan are the same for you and your dependent(s).]

If(HI1 = Low Plan orHI1 = Medium Plan or HI1 = High Planor HI1a = Low Plan orHI1a =Medium Plan or HI1a = High Plan or HI1b = Low Plan or HI1b = Medium Plan or HI1b = High Plan or HI1c = Low Plan or HI1c = Medium Plan or HI1c = High Plan) and (HI1 Base Plan andHI1 Custom Plan and HI1a Base Plan andHI1a Custom Plan and HI1b Base Plan andHI1b Custom Plan and HI1c Base Plan andHI1c Custom Plan), then display table

Try to keep each row to one line of text if possible – adjust columns if needed as long as they stay consistent throughout each section as shown here

PLAN INFORMATION

If HI2 = 1, then delete HI159 column name and merge cell with column header to left HI159

If

=

OF

[FIT ALL FOOTER TEXT FROM G1 TO PAGE # ON ONE LINE IF POSSIBLE; IF CLASS NAM TOO LO

No matter what, MASA MTS has you covered!

THE TRUTH….

What is Covered?

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

Americans today suffer from a false sense of security that their medical coverage will pay for all costs associated with emergency or critical care transport. The reality is that a majority of Americans are only partially covered for these high costs.

Most healthcare policies will only pay based off of the “Usual and Customary Charges” leaving you with the remainder of the bill.

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

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

“All I had to do was send the bill which was never paid by TriCare for Life --- and the rest is history. When MASA received that bill, it was paid and all amounts owed satisfied.” --- MASA Member, 2015

• NO health questions

• NO age limits

• NO claim forms

• NO deductibles

• NO provider network limitations

• NO dollar limits on emergency transport costs

Emergency Air Medical Transportation

Emergency Ground Transportation

Any Ground. Any Air. Anywhere.

PLATINUM MEMBERSHIP BENEFITS

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

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

Non-EmergentAir

Transportation

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

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

Organ Recipient Transportation** MASA MTS will fly a member to the commercial airport nearest the medical facility where an organ transplant is scheduled to happen. (U.S. Only)

Recuperation / Repatriation

Return Transportation

Escort Transportation

Visitor Transport

Minor Children / Grandchildren Return

Vehicle Return

Mortal Remains Transport

Pet Return

If a member is hospitalized while away from home, MASA MTS will fly them back to a hospital closer to home to recuperate in familiar surroundings. (Worldwide Coverage)

MASA MTS will arrange transport on a commercial carrier to a commercial airport closest to member’s residence after being discharged from a hospitalization of at least 24 hours. (Worldwide Coverage)

If a member requires emergency air transport, MASA MTS will fly the member's spouse, family member or friend to accompany them in the air. (Worldwide Coverage)

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

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

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

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

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

*Basic Coverage Area includes U.S., Canada, Mexico, and Caribbean (excluding Cuba).

**One (1) year waiting period if pre-existing condition requiring transplant.

There is a 90 day waiting period on pre-existing conditions. This clause is WAIVED for emergent ground and air transports

-Dependents are covered up until age 26.

HOW IT WORKS

What is 1.800MD?

1.800MD is a national telehealth company specializing in convenient, quality medical care. With board-certified physicians in all 50 states*, those in need can obtain diagnosis,  treatment and a prescription, when necessary, through the convenience of a telephone and digital communications.

*Subjecttostateregulations.

I have a pre-existing condition. Will 1.800MD still accept me?

Absolutely! 1.800MD is not insurance. We do not deny access to quality care because of pre-existing conditions.

Can I get a consultation after hours or on weekends?

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

CONVENIENCE

Talk to a doctor any time, day or night, on the weekend or when traveling away from home. No inconvenience or hassle of traveling to the doctor’s office, urgent care or ER and waiting to be seen.

SAVES MONEY

1.800MD  reduces unnecessary doctor’s office and emergency room visits. Up to 70 percent of all urgent care and emergency room visits are unneeded, costly and can be handled with a 1.800MD telephone or video consultation.

QUALITY CARE

With an average of 15 years of internal medicine, family practice or pediatrics experience, you can rest assured each physician is properly licensed in your state, board-certified and verified by the National Physician Data Base and the American Medical Association.

CONTINUITY OF CARE

Real-time access to medical records, and the ability to send them to your primary care physi-cian or other providers.

WELLNESS AND PREVENTATIVE HEALTH TOOLS

The 1.800MD member portal contains information and tools to help you make informed health care decisions.

E-PRESCRIPTIONS

If a 1.800MD physician recommends medication as part of your treatment plan, the prescription will be digitally sent to the local pharmacy of your choice.

Is your identity leading a double life?

OVER 15 MILLION IDENTITIES WERE STOLEN IN 2013.

You may already be a victim of identity theft without knowing it. Now what?

Victims may discover the problem when they are denied credit or employment, are contacted by police, or receive unknown bills.

» Identity theft victims su er an average loss of over $6,000 and spend 300 hours repairing the damage on their own.

» e value is in the identity, not the bank account.

Armed with your personal information, thieves can:

» Drain your savings and retirement accounts.

» Open credit cards or loans in your name.

» Commit tax fraud in your name.

» Use your name when arrested for a crime.

Millions of identities face a greater risk for ID theft because they have been stolen from major outlets including:

» e Home Depot ® 56+ million

» Target ® 40 million

» Medical Centers/Hospitals 6.8 million

» Google Gmail™ Accounts 5 million

» JP Morgan Chase Bank 76 million

TOTAL IDENTITY PROTECTION

Instant Identity Monitoring™

We monitor identities in real time to identify potential fraud instantly —as it is occurring—even failed attempts. New accounts can be detected at the instant of application. We also monitor and alert on high-risk transactions like password resets, fund transfers, and more!

Internet Monitoring

Sophisticated algorithms spider the Internet black market, phishing sites, command and control networks, compromised machines, forums, and chat rooms to determine if personal data has been compromised.

National Provider ID Monitoring

ID Watchdog is the ONLY ID eft Protection vendor to o er Physician NPI Monitoring. is emerging threat involves “ghost practices” submitting high-dollar Medicare and Medicaid claims in a physician’s name, costing thousands to resolve.

Payday Loan Monitoring

ID Watchdog works directly with alternative credit bureaus that service the underbanked to expand the monitoring of payday loans.

Enhanced Non-Credit Loan Monitoring

Working with our alternative credit bureau partners, ID Watchdog is the first and only ID eft Protection provider to expand its fraud detection network to include monitoring of auto pawn, buy-here-pay-here auto, rent-to-own transactions, sub-prime utility and cell phone accounts, and sub-prime collections.

Public Records & NCOA Monitoring

We monitor the National Change of Address Registry and public records databases with more than 11.6 billion consumer records in an attempt to identify identity theft.

Instant-On Fullfillment™

Utilizing our deferred authentication technology ID Watchdog is the only vendor to activate ALL of your monitoring on day 1 without any additional action, ensuring you are protected the day your benefi ts start.

Lost Wallet Protection & Monitoring

A secure digital vault to store wallet contents, and, in the event a wallet is lost or stolen, assistance with cancelling and replacing its content.

Fraud Alert Assistance & Reminders

Assistance with setting credit bureau fraud alerts, and reminders when the fraud alerts expire— securing your credit file to help prevent ID theft.

Concierge-Level Identity Resolution

A dedicated Certified Identity eft Risk Management (CITRMS) professional will work with you to assess your identity theft situation and move forward with a fully managed resolution.

Expense Reimbursement Insurance

$1M in expense reimbursement insurance, providing protection from the financial damages of identity theft including lost wages, travel expenses, fraudulent fund transfers and legal defense.

Solicitation Reduction

ID Watchdog enables you to opt in or out of the National Do Not Call Registry, Pre-Approved Credit O ers, and Junk Mail or Email.

Identity Profile Report

ID Watchdog creates this report to surface any pre-existing conditions going back 30 years or more.

100% Resolution Guarantee:

ID Watchdog will not stop working on an employee’s case until their identity is completely restored to its pre-theft level. ID Watchdog has never failed to restore an identity.

ID Watchdog o ers di erent levels of identity theft protection to fit your needs. We o er the best value and guarantee 100% resolution services should you become a victim.

EECU Health Savings Account

Enclosed

Getting Started

you need

Step

1: Log In for Online Account Access

Step 2: Activate Your Debit Card

Learn how to make contributions, payments and manage your account.

you’re

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57

Making It Convenient

Here’s How To Contribute

Payroll Deductions – your HSA contributions can be deducted from your paycheck on a pre-tax basis. For more information, please contact your employer.

Online Contribution – use our online banking Transfer tool to contribute to your account. Simply log in at eecu.org, then hover over “Move Money” in the top menu, then select the type of transfer from an EECU or external checking or savings account to your HSA. (All contributions are classified as current year contributions unless directed otherwise.)

Check – use EECU’s mobile deposit feature to deposit a check from your mobile device. You can also stop by an EECU financial center or one of our 5,000 shared financial centers to make a check deposit. Transfer / Rollover – to make a transfer complete our Direct Transfer form and send it to your other HSA provider; and, for a rollover, withdraw your HSA funds from your other HSA and deposit them into your EECU HSA. See FAQs for details on Transfers & Rollovers.

Here’s How To Make Payments

HSA Debit Card – use your EECU HSA Mastercard® debit card to pay healthcare providers at point-of-sale after you receive a bill.

Online Bill Pay – use EECU’s free online banking and bill pay to make payments to medical providers directly from your HSA.

Online Transfers – use EECU’s online banking or mobile app to reimburse yourself for out-of-pocket expenses by making a transfer from your HSA to your personal checking or savings account. Check – optional HSA checks can be ordered upon request for a fee2. You can use these checks to pay healthcare providers and suppliers.

Here’s How To Manage Your Account

Online - check your balance, pay healthcare providers and arrange deposits. Mobile - EECU’s mobile app allows you to manage your account on the go; download “EECU Mobile Banking” in Apple’s App Store and Google Play.

Contact Member Service – call (817) 882-0800. Our dedicated member service representatives are available to assist you with any questions. Our hours of operation are Monday through Friday from 8:00 a.m. to 7:00 p.m. CT, Saturday 9:00 a.m. – 1:00 p.m. CT and closed on Sunday. If your debit card is lost or stolen, call our 24-hour debit card hotline at (800) 333-9934.

Account Statements – monthly account statements show all your account activity for that period. You can receive free online statements or printed statements. You will also receive an IRS 1099 form and a 5498-SA form if you had any contributions or distributions (withdrawals) during the year.

Thank you for choosing EECU for your Health Savings Account.

For more information about HSAs, visit www.eecu.org/HSA, call one of our Member Service Representatives at (817) 882-0800 or stop by a local EECU financial center.

Your Benefits Administrator will also be able to provide you information about your HSA.

1 A list of Eligible Medical Expenses be found in IRS Publication 502, http://www.irs.gov/pub/irs-pdf/p502.pdf. As described in IRS publication 969, http://www.irs.gov/pub/irs-pdf/p969.pdf, over-the-counter medications (when prescribed by a doctor) are considered Eligible Medical Expenses for HSA purposes.

2 Call 817-882-0800 or stop by a financial center to order Standard checks at no charge, excludes shipping & handling or order custom checks, prices vary.

HSA Spending

What is a qualified medical expense?

Qualified medical expenses are defined by the Internal Revenue Service and are listed in IRS publication 502. They include expenses that pay for healthcare services, equipment or medications.

Examples of IRS-qualified medical expenses1:

Acupuncture

Alcoholism treatment

Ambulance

Breast reconstruction surgery (mastectomy-related)

Chiropractor

Contact lenses

Dental treatment (X-rays, fillings, braces, extractions, etc.)

Diagnostic devices (such as blood sugar test kits for diabetics)

Doctor’s office (including physicians, surgeons, specialists or other medical practitioners) visits and procedures

Drug addiction treatment

Eyeglasses and exams (for medical reasons)

Eye surgery (such as laser eye surgery or radical keratotomy)

Hearing aids (and batteries for use)

Hospital services

Laboratory fees

Nursing home

Operations/surgery (excluding unnecessary cosmetic surgery)

Osteopath

Physical Therapy

Prescription Drugs

Psychiatric care

Speech Therapy

Stop-smoking programs (including nicotine gum or patches)

Vasectomy

Weight-loss program (to treat a specific disease diagnosed by a physician)

This list is not comprehensive. For a detailed listing, please refer to https://www.irs.gov/pub/irs-pdf/p502.pdf, titled “Medical and Dental Expenses.”

How much can I contribute annually to an HSA?

Internal Revenue Service contribution limits are:

2022

• Individual coverage: $3,650

• Family coverage: $7,300

2023

• Individual coverage: $3,850

• Family coverage: $7,750

And, accountholders age 55 and over can make a HSA catch-up contribution: $1,000

Flexible Spending Account (FSA)

Partial List of Eligible Expenses:

Medical/Dental/Vision Copays and Deductibles

Prescription Drugs

Physical Therapy

Chiropractor

First-Aid Supplies

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. Money only becomes available as it is contributed and can only be used for dependent care expenses.

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

What is a Cafeteria Plan?

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

How to Spend

Spending is easy

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

Lab Fees

Psychiatrist/Psychologist

Vaccinations

Dental Work/Orthodontia

Eye Exams

Laser Eye Surgery

Eyeglasses, Contact Lenses, Lens Solution

Prescribed OTC Medication

Account access is easy

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

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

Enrollment Consideration

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

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

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

Get $10 off using code NBS1819.

Shop FSA Store at fsastore.com/nbs