BENEFITS GUIDE
NAVARRO Independent School District
2022-23
NAVARRO Independent School District
2022-23 ENROLLMENT INFORMATION
Know Your Benefits! Below is a summary of benefits offered through NISD.
• Medical (Blue Cross/Blue Shield, Scott & White) – TRS manages the healthcare plan for Navarro ISD. Please call 800.222.9205 for questions related to health insurance or prescription benefits.
• Hospital Indemnity (MetLife) – 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 BCBS Health Plans only. For questions please contact Teladoc directly at 1-855TELADOC (835-2362).
• Dental (MetLife) – Coverage for preventive, basic, major, and ortho services. Please note that the waiting period for major services and orthodontic services will notapplyifyouenrollduringopenenrollment Remember that deductibles annual maximums reset on January 1.
• Vision (Superior) – 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. For more information, including a list of providers visit www.superiorvision.com.
• Disability (The Standard) – Long term income protection that is designed to provide up to 66 2/3% 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 NISD.
• Group Life (Lincoln) – Group term life insurance that ends when you terminate employment with NISD. 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 (Guardian) – Pays benefits for internal cancer diagnosis. Includes an annual cancer screening benefit.
• Accident (MetLife) – Pays benefits for off the job accidents and related treatments. Includes a physical/ wellness exam reimbursement.
• Flexible Spending (TASC) – Make sure to spend/claim the money in your current reimbursement account by 8/31/2022. FSA funds for the 2022-23 plan year will be available on 9/1/2022.
• OMNI Retirement Plans – NISD offers tax advantaged retirement plans designed to help supplement your TRS retirement benefits. Visit www.omni403b.com for more information.
More Important Information
Covering Dependents?
To include dependents on any of your coverages through NISD 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:
• 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 Alicia Boswell immediately at (830) 372-1930. Discrepancies must be communicated within 30 days from the effective date of the policy.
Benefit Related Documents
For contact information, claim forms, benefits guides and more, please visit the Navarro ISD benefits website at www.mybenefitshub.com/navarroisd.
TABLE OF CONTENTS
2022-23 Important Information
Table of Contents
Health Insurance - TRS ActiveCare
Phone: 8663555999
Website: www.bcbstx.com/trsactivecare
Flexible Spending Accounts - TASC
Dental - MetLife
Phone: Website: Phone: Website:
Vision - Superior
Disability - The Standard
800.487.5553 www.metlife.com
Phone: Website: Phone: 800.368.1135
800.422.4661 www.tasconline.com www.superiorvision.com
800.507.3800
Permament Life Insurance - Texas Life
Website: www.standard.com Phone: Website: www.texaslife.com
800.283.9233
Group Life Insurance - Lincoln Financial
Phone: Website:
800.423.2765 www.lincolnfinancial.com
Accident - MetLife
Phone: Website: Phone: Website: 888.600.1600 www.guardiananytime.com
800.438.6388 www.metlife.com/mybenefits
Cancer - Guardian This guide contains a summary of the benefits offered by Navarro ISD. If there is a conflict between the terms of this outline of benefits and the actual contracts, the terms of the contracts will prevail.
Contact Information
TABLE OF CONTENTS
Hospital Indemnity - MetLife
Phone: 800.438.6388
Website: www.metlife.com
Critical Illness - MetLife
Phone: 800.438.6388
Website: www.metlife.com
Retirement Plan Information - The Omni Group
Phone: Website:
877.544.6664
www.omni403b.com
ADDITIONAL CONTACT INFORMATION
U.S. Employee Benefits Services Group
Phone: Website: Rusty Freeman:
888.836.5100
www.mybenefitshub.com/navarroisd
rfreeman@usebsg.com
Email: This guide contains a summary of the benefits offered by Navarro ISD. If there is a conflict between the terms of this outline of benefits and the actual contracts, the terms of the contracts will prevail.
Contact Information
LOCAL HEALTH CARE. TEXAS-SIZED BENEFITS. TRS-ActiveCare Plan Highlights 2022-23
From the North Texas plains to the Gulf Coast, TRS-ActiveCare is where you live and work. We have more Texas doctors than any other plan and more ways to make your health plan yours.
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.
758436.0322
All TRS-ActiveCare participants have three plan options . Each includes a wide range of wellness benefits. This plan is closed and not accepting new enrollees. If you’re currently enrolled in TRS-ActiveCare 2, you can remain in this plan. 2022-23 TRS-ActiveCare Plan Highlights Sept. 1, 2022 –Aug. 31, 2023 TRS-ActiveCare 2 • 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 PCPs or referrals TRS-ActiveCare Primary TRS-ActiveCare Primary+ TRS-ActiveCare HD Plan Summary • Lowest premium of all three plans • Copays for doctor visits before you meet your deductible • Statewide network • Primary Care Provider (PCP) referrals required to see specialists • Not compatible with a Health Savings Account (HSA) • No out-of-network coverage • Lower deductible than the HD and Primary plans • Copays for many ser vices and drugs • Higher premium • Statewide network • PCP referrals required to see specialists • Not compatible with a Health Savings Account (HSA) • No out-of-network coverage • Compatible with a Health Savings Account (HSA) • Nationwide network with out-of-network coverage • No requirement for PCPs or referrals • Must meet your deductible before plan pays for non-preventive care Things to Know • TRS’s Texas-sized purchasing power enables access to broad networks without county boundaries. • Specialty drug insurance means you’re covered, no matter what life throws a t you. Monthly Premiums Employee Only $346 $ $434 $ $357 $ Employee and Spouse $976 $ $1,062 $ $1,005 $ Employee and Children $ 622 $ $699 $ $641 $ Employee and Family $1,168 $ $1,336 $ $1,202 $ Total Premium Total Premium Total Premium Your Premium Your Premium Your Premium Total Premium Your Premium $1,013 $ $2,402 $ $1,507 $ $2,841 $ How to Calculate Your Monthly Premium Total Monthly Premium Your District and State Contributions Your Premium Ask your Benefits Administrator for your district’s specific premiums. Wellness Benefits at No Extra Cost* Being healthy is easy with: •$0 preventive care •24/7 customer service •One-on-one health coaches •Weight loss programs •Nutrition programs •Ovia TM pregnancy support • TRS Virtual Health •Mental health benefits •And much more! * Available for all plans. See the benefits guide for more details. Plan Features Type of Coverage In-Network Coverage Only In-Network Coverage Only In-Network Out-of-Network Individual/Family Deductible $2,500/$5,000 $1,200/$3,600 $3,000/$6,000 $5,500/$11,000 Coinsurance You pay 30% after deductible You pay 20% after deductible You pay 30% after deductibleYou pay 50% after deductible Individual/Family Maximum Out of Pocket $8,150/$16,300 $6,900/$13,800 $7,050/$14,100 $20,250/$40,500 Network Statewide Network Statewide Network Nationwide Network PCP Required Yes Yes No In-Network Out-of-Network $1,000/$3,000 $2,000/$6,000 You pay 20% after deductibleYou pay 40% after deductible $7,900/$15,800 $23,700/$47,400 Nationwide Network No Doctor Visits Primary Care $30 copay $30 copay You pay 30% after deductibleYou pay 50% after deductible Specialist $70 copay $70 copay You pay 30% after deductibleYou pay 50% after deductible $30 copay You pay 40% after deductible $70 copay You pay 40% after deductible Immediate Care Urgent Care $50 copay $50 copay You pay 30% after deductibleYou pay 50% after deductible Emergency Care You pay 30% after deductible You pay 20% after deductible You pay 30% after deductible TRS Virtual HealthRediMD (TM) $0 per medical consultation $0 per medical consultation $30 per medical consultation TRS Virtual HealthTeladoc ® $12 per medical consultation $12 per medical consultation $42 per medical consultation $50 copay You pay 40% after deductible You pay a $250 copay plus 20% after deductible $0 per medical consultation $12 per medical consultation Prescription Drugs Drug Deductible Integrated with medical $200 brand deductible Integrated with medical Generics (30-Day Supply/90-Day Supply)$15/$45 copay; $0 copay for certain generics $15/$45 copay You pay 20% after deductible; $0 coinsurance for certain generics Preferred Brand You pay 30% after deductible You pay 25% after deductible You pay 25% after deductible Non-preferred Brand You pay 50% after deductible You pay 50% after deductible You pay 50% after deductible Specialty $0 if PrudentRx eligible; You pay 30% after deductible $0 if PrudentRx 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 $200 brand deductible $20/$45 copay You pay 25% after deductible ($40 min/$80 max)/ You pay 25% after deductible ($105 min/$210 max) You pay 50% after deductible ($100 min/$200 max)/ You pay 50% after deductible ($215 min/$430 max) $0 if PrudentRx 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 day supply $ 96 $ 726 $ 372 $ 918 $ 184 $ 812 $ 449 $ 1086 $ 107 $ 755 $ 391 $ 952
What’s New and What’s Changing
This table shows you the changes between 2021-22 statewide premium price and this year’s 2022-23 regional price for your Education Service Center.
• Member Rewards was expanded to include lab services a t Labcorp and Quest Diagnostics
• Copay for Teladoc ® rose from $0 to $12
• Maximum out of pocket for insulin capped at $25/31-day supply; $75/61-90 day supply
• In-network maximum rose by $50/individual; $100/families
• The Member Rewards program, including for lab ser vices at Labcorp and Quest Diagnostics, is now available for HD participants
Rewards are paid through a limited-purpose Health Care Account (HCA) and can be used toward dental and vision expenses
• Consult fee for Teladoc rose from $30 to $42
• Member Rewards was expanded to include lab services
Labcorp and Quest Diagnostics
• Copay for Teladoc rose from $0 to $12
• Maximum out of pocket for insulin capped at $25/31-day supply; $75/61-90 day supply
• Copay for Teladoc rose from $0 to $12
• Maximum out of pocket for insulin capped at $25/31-day supply; $75/61-90 day supply
• This plan is still closed to new enrollees
Effective: Sept. 1, 2022
At a Glance Primary HD Primary+ Premiums Lowest Lower Higher Deductible Mid-range High Low Copays Yes No Yes NetworkStatewide network Nationwide network Statewide network PCP Required? Yes No Yes HSA-eligible? No Yes No
2021-22 Total Premium New 2022-23 Total Premium Change in Dollar Amount TRS-ActiveCare Primary Employee Only $417 $346 ($71) Employee and Spouse $1,176 $976 ($200) Employee and Children $751 $622 ($129) Employee and Family $1,405 $1,168 ($237) TRS-ActiveCare HD Employee Only $429 $357 ($72) Employee and Spouse $1,209 $1,005 ($204) Employee and Children $772 $641 ($131) Employee and Family $1,445 $1,202 ($243) TRS-ActiveCare Primary+ Employee Only $542 $434 ($108) Employee and Spouse $1,334 $1,062 ($272) Employee and Children $879 $699 ($180) Employee and Family $1,675 $1,336 ($339) TRS-ActiveCare 2 (closed to new enrollees) Employee Only $1,013 $1,013 $0 Employee and Spouse $2,402 $2,402 $0 Employee and Children $1,507 $1,507 $0 Employee and Family $2,841 $2,841 $0
Key Plan Changes
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REMEMBER:
Compare Prices for Common Medical Services
Log into Blue Access for MembersSM at www.bcbstx.com/trsactivecare to use the cost estimator tool. This will help you find the best prices through different providers.
*Pre-certification for genetic and specialty testing may apply. Contact a Personal Health Guide at 1-866-355-5999 with questions.
www.trs.texas.gov
Revised 05/03/2022
Benefit TRS-ActiveCare Primary TRS-ActiveCare Primary+ TRS-ActiveCare HD TRS-ActiveCare 2 In-Network OnlyIn-Network OnlyIn-NetworkOut-of-NetworkIn-NetworkOut-of-Network Diagnostic Labs* Office/Indpendent Lab: You pay $0 Office/Indpendent Lab: You pay $0 You pay 30% after deductible You pay 50% after deductible Office/Indpendent Lab: You pay $0 You pay 40% after deductible Outpatient: You pay 30% after deductible Outpatient: You pay 20% 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 per day maximum) 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 Bariatric Surgery Facility: You pay 30% after deductible Facility: You pay 20% after deductible Not CoveredNot Covered Facility: You pay 20% after deductible ($150 facility copay per day) Not Covered 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 Only covered if rendered at a BDC+ facility Annual Vision Exam (one per plan year; performed by an ophthalmologist or optometrist) You pay $70 copayYou 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 $30 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
Advantages of a Flexible Spending Account (FSA)
A valuable pre-tax benefit with innovative services!
FlexSystem FSA increases your take-home pay by reducing your taxable income. A Flexible Spending Account (FSA) allows you to save up to 30% on your eligible healthcare and/or dependent care expenses every year by using pre-tax dollars.
Consider how much you spend on healthcare and/or dependent care expenses for you and your qualified dependents in one year:
•prescription drugs/medications.
•medical/dental office visit co-pays.
•eye exams and prescription glasses/lenses.
•vaccinations.
•daycare tuition.
Why not reduce these expenses by using pre-tax dollars instead of after-tax dollars? With rising healthcare costs, every penny counts! By using pre-tax dollars, you are taxed on a lower gross salary, thereby saving money that would otherwise be spent on federal, state and FICA taxes, and thereby you increase your take home pay!
Employee salary reductions to a medical Flexible Spending Account (FSA) are limited to $2,850 per Plan Year, indexed for inflation. Check with your employer for your Plan’s maximum annual election amount.
Putting money in an FSA is smart and safe! If you have medical FSA funds leftover at the end of the Plan Year and your employer has elected Carryover, you may carryover up to $500 from year to year with no cost or penalty.
How FlexSystem Works
Pre-Tax Savings Example
FlexSystem FSA is offered through your employer and is adminstered by TASC. When you choose to enroll in a FlexSystem FSA Healthcare and/or Dependent Care, you choose the dollar amount you want to contribute to each account based on your estimated expenses for the upcoming Plan Year. Your contributions will be deducted in equal amounts from each paycheck, pre-tax, throughout the Plan Year. The more you contribute to these accounts, the more you save by paying less in taxes!
Your total Healthcare FSA annual contribution amount is available immediately at the start of the Plan Year; Dependent Care FSA funds are available up to the current account balance only.
Reimbursements and the TASC Card
As you incur eligible expenses, simply swipe your TASC Card. The card automatically pays for and substantiates most eligible expenses at the point of purchase. If you do not use the TASC Card to pay for an eligible expense, simply submit a request for reimbursement via the MyTASC Mobile App, online Request for Reimbursement Wizard in MyTASC, text message, fax, or mail. Your reimbursement is deposited in your MyCash account. You can access your MyCash funds in three ways: (1) swipe your TASC Card at any merchant that accepts major credit cards, (2) withdraw at an ATM using your TASC Card (with PIN), or (3)transfer to a personal bank account from MyCash Manager within MyTASC.
TASC • 2302 International Lane • Madison, WI 53704-3140 • 800-422-4661 • Fax: 608-245-3623 • www.tasconline.com FX-4245-020514
FlexSystem Healthcare FSA
FlexSystem Dependent Care FSA
Without FSA With FSA Gross Monthly Pay: $3,500 $3,500 Pre-Tax Contributions Medical/Dental Premiums $0 -$125 Medical Expenses $0 -$75 Dependent Care Expenses $0 -$400 TOTAL: $0 -$600 Taxable Monthly Income $3,500 $2,900 Taxes (federal, state, FICA): -$968 -$802 Out-of-pocket Expenses: -$600 $0 Monthly Take-home Pay: $1,932 $2,098 Net Increase in Take-Home Pay = $166/mo! For illustration only. Actual dollar amounts may vary.
FSA Eligible Expenses
FlexSystem FSA funds may only be used for eligible expenses under your healthcare FSA and/or dependent care FSA. Some eligible expenses include:
• Medical care services
• Dental care services
• Vision care expenses
• Prescriptions
• Certain over-the-counter medications
• Daycare tuition
More detailed lists can be found at www.irs.gov in IRS Publications 502 & 503. Please note insurance premiums are NOT eligible for reimbursement.
Multiple Methods for Account Management
You may use any of the following self-service options to access your FlexSystem accounts and TASC Card transactions:
• MyTASC Online: www.tasconline.com
• MyCash Manager: within MyTASC at www.tasconline.com
• MyTASC Mobile App: free download at www.tasconline.com/mobile
• MyTASC Text Messaging: elect through your MyTASC account online
Important Considerations
FSA Funds do not Rollover:
It is important to be conservative in making elections because any unused funds left in your FSA at the close of the Plan Year are not refundable to you. (The only exception to this rule is for the Healthcare FSA where funds may carryover to the next Plan Year’s healthcare FSA (up to $500) when elected by your employer.) You are urged to take precautionary steps, such as tracking account balances on the FlexSystem website and/or using the Interactive Voice Response System, to avoid having funds remaining in your account at year-end.
Changing Elections
During the Plan Year:
You may change your FSA elections during the Plan year only if you experience a change of status such as:
• a marriage or divorce
• birth or adoption of a child, or
• a change in employment status
Refer to the Change of Election Form (available from your employer) for a complete list of circumstances acceptable for changing elections mid-year.
Online enrollment and account management. Online tax-savings calculator to help determine how much to contribute. Convenient pre-tax payroll deductions. Benefits debit card for eligible purchases.
Mobile app for account access on the go.
Multiple self-service tools. Fast reimbursements.
33 million Americans save up to 30% every year by participating in an FSA.
2009 Nielson Consumer Research
Sign up for FlexSystem and keep more money in your pocket!
Dental
Metropolitan Life Insurance Company
Plan Design for: Navarro ISD
Network: PDP Plus
The Preferred Dentist Program was designed to help you get the dental care you need and help lower your costs. You get benefits for a wide range of covered services — both in and out of the network. The goal is to deliver affordable protection for a healthier smile and a healthier you.
Orthodontia Lifetime MaximumOrtho applies to Child Only Child to age 19 $1000 per Person $1000 per Person Dependent Age: Eligible for benefits until the day that he or she turns 26.
1. "In-Network Benefits" refers to benefits provided under this plan for covered dental services that are provided by a participating dentist. "Out-of-Network Benefits" refers to benefits provided under this plan for covered dental services that are not provided by a participating dentist.
2. Negotiated fees refer to the fees that participating dentists have agreed to accept as payment in full for covered services, subject to any copayments, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change.
3. Applies to Type B and C services only.
4. Out-of-network benefits are payable for services rendered by a dentist who is not a participating provider. The Reasonable and Customary charge is based on the lowest of:
• the dentist’s actual charge (the 'Actual Charge'),
• the dentist’s usual charge for the same or similar services (the 'Usual Charge') or
• the usual charge of most dentists in the same geographic area for the same or similar services as determined by MetLife (the 'Customary Charge'). For your plan, the Customary Charge is based on the 90th percentile. Services must be necessary in terms of generally accepted dental standards.
Coverage Type: In-Network1 % of Negotiated Fee2 Out-of-Network1 % of R&C Fee4 Type A - Preventive 100% 100% Type B - Basic Restorative 80% 80% Type C - Major Restorative 50% 50% Type D - Orthodontia 50% 50% Deductible3 Individual $50 $50 Family $150 $150 Annual Maximum Benefit: Per Individual $1250 $1250
IMPORTANT RATE INFORMATION Monthly Premium Payment Employee $23.66 Employee + 1 Dependent $48.64 Employee + 2 or more Dependents $80.96
Understanding Your Dental Benefits Plan
The Preferred Dentist Program is designed to provide the dental coverage you need with the features you want. Like the freedom to visit the dentist of your choice – in or out of the network. .
If you receive in-network services, you will be responsible for any applicable deductibles, cost sharing, negotiated charges after benefit maximums are met, and costs for non-covered services. If you receive out-of-network services, you will be responsible for any applicable deductibles, cost sharing, charges in excess of the benefit maximum, charges in excess of the negotiated fee schedule amount or R&C Fee, and charges for non-covered services.
• Plan benefits for in-network covered services are based on a percentage of the Negotiated fee – the Fee that participating dentists have agreed to accept as payment in full for covered services, subject to any deductibles, copayments, cost sharing and benefit maximums. Negotiated fees are subject to change.
• Plan benefits for out-of-network services are based on a percentage of the Reasonable and Customary (R&C) charge. If you choose a dentist who does not participate in the network, your out-of-pocket expenses may be greater.
Once you’re enrolled you may take advantage of online self-service capabilities with MyBenefits.
• Check the status of your claims
• Locate a participating dentist
• Access MetLife’s Oral Health Library
• Elect to view your Explanation of Benefits online
To register, just go to www.metlife.com/mybenefits and follow the easy registration instructions.
IMPORTANT ENROLLMENT INFORMATION
You may only enroll for Dental Expense Benefits within 31 days of your Personal Benefits Eligibility Date, or if you have a Qualifying Event or during the Plan's Annual Open Enrollment Period.
Qualifying Event: Request to be covered, or to change your coverage, upon a Qualifying Event If there is a Qualifying Event you may request to be covered, or to change your coverage, only within 31 days of a Qualifying Event. Such a request will not be a late request. Except for marriage or the birth or adoption of a child, you must give us proof of prior dental coverage under your spouse's plan if you are requesting coverage under this Plan because of a loss of the prior dental coverage. If you make a request to be covered under this Plan or request a change(s)in coverage under this Plan within thirty-one days of a Qualifying Event, your coverage or the change(s) in coverage will become effective on the first day of the month following the date of your request, subject to the Active Work Requirement, and provided that the change in coverage is consistent with your new family status.
Cancellation/Termination of Benefits:
Coverage is provided under a group insurance policy (Policy form GPN99) issued by Metropolitan Life Insurance Company. Subject to the terms of the group policy, rates are effective for one year from your plan's effective date. Once coverage is issued, the terms of the group policy permit Metropolitan Life Insurance Company to change rates during the year in certain circumstances. Coverage terminates when your full-time employment ceases, when your dental contributions cease or upon termination of the group policy by the Policyholder. The group policy may also terminate if participation requirements are not met, or on the date of the employee’s death, if the Policyholder fails to perform any obligations under the policy, or at MetLife's option. The dependent's coverage terminates when a dependent ceases to be a dependent. There is a 30-day limit for the following services that are in progress: Completion of a prosthetic device, crown or root canal therapy after individual termination of coverage.
Vision Plan Benefits for Navarro ISD
Co-Pays Monthly Premiums Services/Frequency
Benefits through Superior Select Southwest Network
Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements
1 If premium progressive lenses are selected, members receive an allowance based on the provider's charges for standard progressive lenses
2 Contact lenses and related professional services (fitting, evaluation and follow-up) are covered in lieu of eyeglass lenses and frames benefit
3 Lasik Vision Correction is in lieu of eyewear benefit, subject to routine regulatory filings and certain exclusions and limitations
Discount Features
Non-Covered Eyewear Discount: Members may also receive a discount of 20% from a participating provider’s usual and customary fees for eyewear purchases which exceed the benefit coverage (except disposable contact lenses, for which no discount applies). This includes eyeglass frames which exceed the selected benefit coverage, specialty lenses (i.e. progressives) and lens “extras” such as tints and coatings. Eyewear purchased from a Walmart Vision Center does not qualify for this additional discount because of Walmart’s “Always Low Prices” policy.
The Plan discount features are not insurance.
All allowances are retail; the member is responsible for paying the provider directly for all non-covered items and/or any amount over the allowances, minus available discounts. These are not covered by the plan.
Discounts are subject to change without notice.
Disclaimer: All final determinations of benefits, administrative duties, and definitions are governed by the Certificate of Insurance for your vision plan. Please check with your Human Resources department if you have any questions.
Superior Vision of Texas P.O. Box 967 Rancho Cordova, CA 95741 800.507.3800 SuperiorVision.com 0617-BSv2/TX
Exam $10 Emp. only $8.16 Exam 12 months Materials $20 Emp. + 1 dependent $15.86 Frame 12 months Emp. + family $27.66 Lenses 12 months Contact Lenses 12 months (Based on date of service)
In-Network Out-of-Network Exam Covered in full Up to $35 retail Frames $130 retail allowance Up to $70 retail Lenses (standard) per pair Single Vision Covered in full Up to $25 retail Bifocal Covered in full Up to $40 retail Trifocal Covered in full Up to $45 retail Progressive1 Covered in full Up to $40 retail Scratch Resistant Coating Covered in full Up to $25 retail Ultraviolet Coating Covered in full Up to $20 retail Lenticular Covered in full Up to $80 retail Contact Lenses2 $175 retail allowance Up to $80 retail Medically Necessary Contact Lenses Covered in full Up to $150 retail Lasik Vision Correction3 $200 retail allowance
SuperiorVision.com Customer Service 800.507.3800
Disability Insurance - The Standard
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 Navarro ISD. 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 Navarro ISD and The Standard.
Eligibility
To become insured, you must be:
• A regular employee of Navarro ISD, excluding temporary or seasonal employees, full-time members of the armed forces, leased employees or independent contractors
• Actively at work at least 20 hours each week
• A citizen or resident of the United States or Canada
Employee Coverage Effective Date
Please contact your human resources representative for more information regarding the following requirements that must be satisfied for your insurance to become effective. You must satisfy:
• Eligibility requirements
• An eligibility waiting period (check with your human resources representative)
• An evidence of insurability requirement, if applicable
• An active work requirement. This means that if you are not actively at work on the day before the scheduled effective date of insurance, your insurance will not become effective until the day after you complete one full day of active work as an eligible employee.
Benefit Amount
You may select a monthly benefit amount in $100 increments from $200 to $8,000; based on the tables and guidelines presented in the Rates section of these Coverage Highlights. The monthly benefit amount must not exceed 66 2/3 percent of your monthly earnings.
Benefits are payable for non-occupational disabilities only. Occupational disabilities are not covered.
Plan Maximum Monthly Benefit: 66 2/3 percent of predisability earnings
Plan Minimum Monthly Benefit: 25 percent of your LTD benefit before reduction by deductible income
Disability Insurance - The Standard
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:
Options 1-6: Maximum Benefit Period To Age 65 for Sickness and 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:
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.
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.
Option Accidental Injury Other Disability Maximum Benefit Period 1 0 days 7 days To age 65 for Sickness and to age 65 for Accident 2 14 days 14 days To age 65 for Sickness and to age 65 for Accident 3 30 days 30 days To age 65 for Sickness and to age 65 for Accident 4 60 days 60 days To age 65 for Sickness and to age 65 for Accident 5 90 days 90 days To age 65 for Sickness and to age 65 for Accident 6 180 days 180 days To age 65 for Sickness and to age 65 for Accident
Age Maximum Benefit Period 62 3 years 6 months 63 3 years 64 2 years 6 months 65 2 years 66 1 year 9 months 67 1 year 6 months 68 1 year 3 months 69+ 1 year
Disability Insurance - The Standard
Other LTD Features
• Employee Assistance Program (EAP) – This program offers support, guidance and resources that can help an employee resolve personal issues and meet life’s challenges.
• Family Care Expense Adjustment – Disabled employees faced with the added expense of family care when returning to work may receive combined income from LTD benefits and work earnings in excess of 100 percent of indexed predisability earnings during the first 12 months immediately after a disabled employee’s return to work.
• Special Dismemberment Provision – If an employee suffers a lost as a result of an accident, the employee will be considered disabled for the applicable Minimum Benefit Period and can extend beyond the end of the Maximum Benefit Period
• Reasonable Accommodation Expense Benefit – Subject to The Standard’s prior approval, this benefit allows us to pay up to $25,000 of an employer’s expenses toward work-site modifications that result in a disabled employee’s return to work.
• Survivor Benefit – A Survivor Benefit may also be payable. This benefit can help to address a family’s financial need in the event of the employee’s death.
• Return to Work (RTW) Incentive – The Standard’s RTW Incentive is one of the most comprehensive in the employee benefits history. For the first 12 months after returning to work, the employee’s LTD benefit will not be reduced by work earnings until work earnings plus the LTD benefit exceed 100 percent of predisability earnings. After that period, only 50 percent of work earnings are deducted.
• Rehabilitation Plan Provision – Subject to The Standard’s prior approval, rehabilitation incentives may include training and education expense, family (child and elder) care expenses, and job-related and job search expenses.
When Benefits End
LTD benefits end automatically on the earliest of:
• The date you are no longer disabled
• The date your maximum benefit period ends
• The date you die
• The date benefits become payable under any other LTD plan under which you become insured through employment during a period of temporary recovery
• The date you fail to provide proof of continued disability and entitlement to benefits
Disability Insurance - The Standard
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.
Disability Insurance - The Standard
Annual Earnings Monthly Earnings Monthly Disability Benefit Accident/Sickness Benefit Waiting Period Cost Per Month 0-7 14-14 30-30 60-60 90-90 180-180 3,600 300 200 7.68 6.76 5.74 3.72 3.22 2.36 5,400 450 300 11.52 10.14 8.61 5.58 4.83 3.54 7,200 600 400 15.36 13.52 11.48 7.44 6.44 4.72 9,000 750 500 19.20 16.90 14.35 9.30 8.05 5.90 10,800 900 600 23.04 20.28 17.22 11.16 9.66 7.08 12,600 1,050 700 26.88 23.66 20.09 13.02 11.27 8.26 14,400 1,200 800 30.72 27.04 22.96 14.88 12.88 9.44 16,200 1,350 900 34.56 30.42 25.83 16.74 14.49 10.62 18,000 1,500 1,000 38.40 33.80 28.70 18.60 16.10 11.80 19,800 1,650 1,100 42.24 37.18 31.57 20.46 17.71 12.98 21,600 1,800 1,200 46.08 40.56 34.44 22.32 19.32 14.16 23,400 1,950 1,300 49.92 43.94 37.31 24.18 20.93 15.34 25,200 2,100 1,400 53.76 47.32 40.18 26.04 22.54 16.52 27,000 2,250 1,500 57.60 50.70 43.05 27.90 24.15 17.70 28,800 2,400 1,600 61.44 54.08 45.92 29.76 25.76 18.88 30,600 2,550 1,700 65.28 57.46 48.79 31.62 27.37 20.06 32,400 2,700 1,800 69.12 60.84 51.66 33.48 28.98 21.24 34,200 2,850 1,900 72.96 64.22 54.53 35.34 30.59 22.42 36,000 3,000 2,000 76.80 67.60 57.40 37.20 32.20 23.60 37,800 3,150 2,100 80.64 70.98 60.27 39.06 33.81 24.78 39,600 3,300 2,200 84.48 74.36 63.14 40.92 35.42 25.96 41,400 3,450 2,300 88.32 77.74 66.01 42.78 37.03 27.14 43,200 3,600 2,400 92.16 81.12 68.88 44.64 38.64 28.32 45,000 3,750 2,500 96.00 84.50 71.75 46.50 40.25 29.50 46,800 3,900 2,600 99.84 87.88 74.62 48.36 41.86 30.68 48,600 4,050 2,700 103.68 91.26 77.49 50.22 43.47 31.86 50,400 4,200 2,800 107.52 94.64 80.36 52.08 45.08 33.04 52,200 4,350 2,900 111.36 98.02 83.23 53.94 46.69 34.22 54,000 4,500 3,000 115.20 101.40 86.10 55.80 48.30 35.40 55,800 4,650 3,100 119.04 104.78 88.97 57.66 49.91 36.58 57,600 4,800 3,200 122.88 108.16 91.84 59.52 51.52 37.76 59,400 4,950 3,300 126.72 111.54 94.71 61.38 53.13 38.94 61,200 5,100 3,400 130.56 114.92 97.58 63.24 54.74 40.12 63,000 5,250 3,500 134.40 118.30 100.45 65.10 56.35 41.30
Option 1-6
Disability Insurance - The Standard
Option 1-6 (Continued)
Annual Earnings Monthly Earnings Monthly Disability Benefit Accident/Sickness Benefit Waiting Period Cost Per Month 0-7 14-14 30-30 60-60 90-90 180-180 64,800 5,400 3,600 138.24 121.68 103.32 66.96 57.96 42.48 66,600 5,550 3,700 142.08 125.06 106.19 68.82 59.57 43.66 68,400 5,700 3,800 145.92 128.44 109.06 70.68 61.18 44.84 70,200 5,850 3,900 149.76 131.82 111.93 72.54 62.79 46.02 72,000 6,000 4,000 153.60 135.20 114.80 74.40 64.40 47.20 73,800 6,150 4,100 157.44 138.58 117.67 76.26 66.01 48.38 75,600 6,300 4,200 161.28 141.96 120.54 78.12 67.62 49.56 77,400 6,450 4,300 165.12 145.34 123.41 79.98 69.23 50.74 79,200 6,600 4,400 168.96 148.72 126.28 81.84 70.84 51.92 81,000 6,750 4,500 172.80 152.10 129.15 83.70 72.45 53.10 82,800 6,900 4,600 176.64 155.48 132.02 85.56 74.06 54.28 84,600 7,050 4,700 180.48 158.86 134.89 87.42 75.67 55.46 86,400 7,200 4,800 184.32 162.24 137.76 89.28 77.28 56.64 88,200 7,350 4,900 188.16 165.62 140.63 91.14 78.89 57.82 90,000 7,500 5,000 192.00 169.00 143.50 93.00 80.50 59.00 91,800 7,650 5,100 195.84 172.38 146.37 94.86 82.11 60.18 93,600 7,800 5,200 199.68 175.76 149.24 96.72 83.72 61.36 95,400 7,950 5,300 203.52 179.14 152.11 98.58 85.33 62.54 97,200 8,100 5,400 207.36 182.52 154.98 100.44 86.94 63.72 99,000 8,250 5,500 211.20 185.90 157.85 102.30 88.55 64.90 100,800 8,400 5,600 215.04 189.28 160.72 104.16 90.16 66.08 102,600 8,550 5,700 218.88 192.66 163.59 106.02 91.77 67.26 104,400 8,700 5,800 222.72 196.04 166.46 107.88 93.38 68.44 106,200 8,850 5,900 226.56 199.42 169.33 109.74 94.99 69.62 108,000 9,000 6,000 230.40 202.80 172.20 111.60 96.60 70.80 109,800 9,150 6,100 234.24 206.18 175.07 113.46 98.21 71.98 111,600 9,300 6,200 238.08 209.56 177.94 115.32 99.82 73.16 113,400 9,450 6,300 241.92 212.94 180.81 117.18 101.43 74.34 115,200 9,600 6,400 245.76 216.32 183.68 119.04 103.04 75.52 117,000 9,750 6,500 249.60 219.70 186.55 120.90 104.65 76.70 118,800 9,900 6,600 253.44 223.08 189.42 122.76 106.26 77.88 120,600 10,050 6,700 257.28 226.46 192.29 124.62 107.87 79.06 122,400 10,200 6,800 261.12 229.84 195.16 126.48 109.48 80.24 124,200 10,350 6,900 264.96 233.22 198.03 128.34 111.09 81.42
Permanent Life Insurance Texas Life
FlexiblePremiumLifeInsurance toAge121 PolicyForm
Voluntary permanent life insurance can be an ideal complement to the group term and optional term your employer might provide. Designed to be in force when you die, this voluntary universal life product is yours to keep, even when you change jobs or retire, as long as you pay the necessary premium. Group and voluntary term, on the other hand, typically are not portable if you change jobs and, even if you can keep them after you retire, usually costs more and declines in death benefit.
The policy,purelife-plus,is underwritten byTexas Life Insurance Company,and it has these outstanding features:
• High Death Benefit. With one of the highest death benefits available at the worksite,1 purelife-plus gives your loved ones peace of mind,knowing there will be significant life insurance in force should you die prematurely.
• Minimal Cash Value. Designed to provide high death benefit, purelife-plus does not compete with the cash accumulation in your employer-sponsored retirement plans.
• Long Guarantees. Enjoy the assurance of a policy that has a guaranteed death benefit to age 121 and level premium that guarantees coverage for a significant period of time (after the guaranteed period, premiums may go down, stay the same, or go up).
• RefundofPremium.Uniquein themarketplace,purelife-plusoffersyouarefundof10years’premium,should you surrender the policy if the premium you pay when you buy the policy ever increases. (Conditions apply.)
• AcceleratedDeathBenefitRider.Shouldyoubediagnosedasterminallyillwiththeexpectationofdeathwithin 12 months (24 months in Illinois),you will have the option to receive 92% (84% in Illinois) 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.)
You may apply for this permanent, portable coverage, not only for yourself,but also for your spouse,minor children and grandchildren.
Like most life insurance policies, Texas Life policies contain certain exclusions, limitations, exceptions, reductions of benefits, waiting periods and terms for keeping them in force. Please contact a Texas Life representative for costs and complete details.
1 Voluntary and Universal Whole Life Products, Eastbridge Consulting Group, October 2008
See the purelife-plus brochure for details.
PRFNG-NI-1010M055-C 1040 (Expires 0612) Not for use in WA.
PureLife-plusispermanentlifeinsurancetoAttainedAge121thatcanneverbecancelledaslongasyoupaythenecessarypremiums.Afterthe GuaranteedPeriod,thepremiumscanbelower,thesame,orhigherthantheTablePremium.Seethebrochureunder”PermanentCoverage”.
monthlypremiums
GUARANTEED MonthlyPremiumsforLifeInsuranceFaceAmountsShown PERIOD IncludesAddedCostfor AgetoWhich Issue AccidentalDeathBenefit(Ages17-59) Coverageis Age Guaranteedat Issue $10,000 $15,000 $25,000 $40,000 $50,000 $75,000 $100,000 $125,000 $150,000 TablePremium 15D-10 7.75 75 11-16 8.00 70 17-20 10.00 15.10 18.50 27.00 35.50 44.00 52.50 66 21 10.25 15.50 19.00 27.75 36.50 45.25 54.00 66 22 10.25 15.50 19.00 27.75 36.50 45.25 54.00 65 23-25 10.50 15.90 19.50 28.50 37.50 46.50 55.50 63 26 10.75 16.30 20.00 29.25 38.50 47.75 57.00 63 27 11.00 16.70 20.50 30.00 39.50 49.00 58.50 63 28 11.00 16.70 20.50 30.00 39.50 49.00 58.50 62 29 11.25 17.10 21.00 30.75 40.50 50.25 60.00 62 30-31 11.50 17.50 21.50 31.50 41.50 51.50 61.50 60 32 12.00 18.30 22.50 33.00 43.50 54.00 64.50 61 33 12.50 19.10 23.50 34.50 45.50 56.50 67.50 62 34 13.00 19.90 24.50 36.00 47.50 59.00 70.50 62 35 8.85 13.75 21.10 26.00 38.25 50.50 62.75 75.00 64 36 9.15 14.25 21.90 27.00 39.75 52.50 65.25 78.00 64 37 9.45 14.75 22.70 28.00 41.25 54.50 67.75 81.00 64 38 9.90 15.50 23.90 29.50 43.50 57.50 71.50 85.50 65 39 10.50 16.50 25.50 31.50 46.50 61.50 76.50 91.50 66 40 7.90 11.10 17.50 27.10 33.50 49.50 65.50 81.50 97.50 67 41 8.40 11.85 18.75 29.10 36.00 53.25 70.50 87.75 105.00 68 42 9.10 12.90 20.50 31.90 39.50 58.50 77.50 96.50 115.50 70 43 9.80 13.95 22.25 34.70 43.00 63.75 84.50 105.25 126.00 72 44 10.50 15.00 24.00 37.50 46.50 69.00 91.50 114.00 136.50 73 45 11.30 16.20 26.00 40.70 50.50 75.00 99.50 124.00 148.50 74 46 12.10 17.40 28.00 43.90 54.50 81.00 107.50 134.00 160.50 75 47 12.80 18.45 29.75 46.70 58.00 86.25 114.50 142.75 171.00 76 48 13.60 19.65 31.75 49.90 62.00 92.25 122.50 152.75 183.00 77 49 14.50 21.00 34.00 53.50 66.50 99.00 131.50 164.00 196.50 78 50 15.60 22.65 36.75 57.90 72.00 107.25 79 51 16.90 24.60 40.00 63.10 78.50 117.00 80 52 18.50 27.00 44.00 69.50 86.50 129.00 82 53 20.10 29.40 48.00 75.90 94.50 141.00 83 54 21.70 31.80 52.00 82.30 102.50 153.00 85 55 23.10 33.90 55.50 87.90 109.50 163.50 86 56 24.10 35.40 58.00 91.90 114.50 171.00 85 57 24.80 36.45 59.75 94.70 118.00 176.25 84 58 25.60 37.65 61.75 97.90 122.00 182.25 84 59 26.60 39.15 64.25 101.90 127.00 189.75 84 60 27.30 40.20 66.00 104.70 130.50 195.00 84 61 29.60 43.65 71.75 113.90 142.00 212.25 85 62 32.40 47.85 78.75 125.10 156.00 233.25 87 63 35.50 52.50 86.50 137.50 171.50 256.50 89 64 39.60 58.65 96.75 153.90 192.00 287.25 93 65 42.50 63.00 104.00 165.50 206.50 309.00 94 66 45.30 95 67 47.80 96 68 50.40 96 69 53.20 96 70 56.20 95
Non-Tobacco
PureLife-plus StandardRiskTablePremiums Non-Tobacco ExpressIssue
PureLife2010-C4AAB5ACD9CM
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 $10,000 to your loved ones in the event of your death, plus a matching cash benefit if you die in an accident
• A cash benefit to you if you suffer a covered loss in an accident, suchas losing a limb or your eyesight
• LifeKeys® services, which provide access to counseling, financial, and legalsupport
• TravelConnectSM services, which give you and your family access to emergency medical help when you’re traveling
You also have the option to increase your cash benefit by securing additional coverage at affordable group rates. See the enclosed life insurance information for details.
ADDITIONAL DETAILS
Conversion: You can convert your group term life coverage to an individual life insurance policy without providing evidence of insurability if you lose coverage due to leaving your job or for another reason outlined in the plan contract. AD&D benefits cannot be converted.
Benefit Reduction: Coverage amounts begin to reduce at age 65 and benefits terminate at retirement. See the plan certificate for details.
For complete benefit descriptions, limitations, and exclusions, refer to the certificate of coverage. This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater detail. Refer to your certificate for your maximum benefit amounts. Should there be a difference between this summary and the contract, the contract will govern.
EmployeeConnectSM and LifeKeys® services are provided by ComPsych® Corporation, Chicago, IL. ComPsych®, EstateGuidance® and GuidanceResources® are registered trademarks of ComPsych® Corporation. TravelConnectSM services are provided by UnitedHealthcare Global, Baltimore, MD. ComPsych® and UnitedHealthcare Global are not Lincoln Financial Group® companies. Coverage is subject to actual contract language. Each independent company is solely responsible for its own obligations.
Insurance products (policy series GL1101) are issued by The Lincoln National Life Insurance Company (Fort Wayne, IN), which does not solicit business in New York, nor is it licensed to do so. Product availability and/or features may vary by state. Limitations and exclusions apply. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Affiliates are separately responsible for their own financial and contractual obligations. Limitations and exclusions apply.
Employer-Paid BenefitsOverview | The Lincoln National Life Insurance Company GP-ERPD-FLI001-TX ©2017 Lincoln National Corporation -LCN-1821793-061517 -Q 1.0
Navarro Independent School District provides this valuable benefit at no cost to you.
P
The Lincoln Term Life Insurance Plan:
• Provides a cash benefit to your loved ones in the event of your death
• Features group rates for Navarro Independent School District employees
• Includes LifeKeys® services, which provide access to counseling, financial, and legal support services
• Also includes TravelConnectSM services, which give you and your family access to emergency medical help when you’re traveling
Now Available to Navarro Independent School District: Life insurance with affordable group rates
rovide for your loved ones.
And yourself.
Life goes on, even after you’re gone. Now you can help ensure the life you started and the people you started it with go on without you. Here’s how this important coverage works.
• If you die, the loved ones you designate receive a cash benefit through your term life insurance. You can secure up to $150,000 in guaranteed coverage without providing evidence of insurability (documentation of your health history, which can include a statement from a physician or a medical examination). Or, you can get up to 5 times your annual salary ($500,000 maximum) by providing evidence of insurability.
Coverage is also available for a spouse and dependent children. A complete Summary of Benefits is included on the next few pages.
Here are some expenses to consider.
When deciding how much coverage you may need, keep in mind the types of expenses your loved ones could face. For example:
• Everyday expenses such as the rent/mortgage, groceries, utilities, and medical costs
• Debt such as a home loan, car loan, credit cards, and student loans
• Future expenses such as education, retirement, weddings, and travel Here’s how little you pay with group rates.
• A 40-year-old employee can get $150,000 of life insurance for just $19.50 per pay period without providing evidence of insurability.
• The employee’s spouse and dependent children can be covered, as well, for just a little more.
See the Summary of Benefits for coverage amounts and monthly premiums.
money is due at enrollment. Your premium simply comes out of your paycheck.
No
Life Insurance Summary of Benefits
Prepared for: Navarro Independent School District
Group rates for Navarro Independent School District employees make life insurance more affordable than ever. This plan provides coverage for you, a spouse, and dependent children. Additional benefits and services of the plan are outlined below.
Yourpremium comes out of your paycheck, so no money is due now.
Coverage for You
You can secure term life insurance if you are an active Navarro Independent School District employee In the event of your death, a cash benefit is paid to the beneficiary/beneficiaries you name. If you do not name a beneficiary, or that person dies before you, the cash benefit may go to your estate. See the plan contract for additional details.
Term Life Insurance | Employee
Guaranteed coverage amount $150,000
Maximum coverage amount 5 times your annual salary ($500,000 maximum)
Minimum coverage amount $10,000
Guaranteed Life Insurance Coverage Amount
You can choose a coverage amount up to $150,000 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 5 times your annual salary ($500,000 maximum) with evidence of insurability. See the Evidence of Insurability page for details.
• Coverage amounts are reduced when an employee reaches age 65
• For complete plan details, please see yourcontract.
Life Insurance Summary of Benefits LFE-ENRO-BRC001-TX
Group Rates for You
The estimated monthly premium for life insurance is determined by multiplying the desired amount of coverage (in increments of $10,000) by the employee age-range premium rate.
$ X ___________ = $ coverage amount premium rate monthly premium
Note: Rates are subject to change and can vary over time.
Life Insurance Summary of Benefits
LFE-ENRO-BRC001-TX
|Monthly Premiums for Select Life Insurance Coverage Amounts Employee AgeRange $10,000 $20,000 $50,000 $60,000 $150,000 $500,000 0-24 $0.50 $1.00 $2.50 $3.00 $7.50 $25.00 25-29 $0.50 $1.00 $2.50 $3.00 $7.50 $25.00 30-34 $0.70 $1.40 $3.50 $4.20 $10.50 $35.00 35-39 $0.80 $1.60 $4.00 $4.80 $12.00 $40.00 40-44 $1.30 $2.60 $6.50 $7.80 $19.50 $65.00 45-49 $2.00 $4.00 $10.00 $12.00 $30.00 $100.00 50-54 $2.60 $5.20 $13.00 $15.60 $39.00 $130.00 55-59 $4.10 $8.20 $20.50 $24.60 $61.50 $205.00 60-64 $5.90 $11.80 $29.50 $35.40 $88.50 $295.00 Employee AgeRange $6,500 $13,000 $32,500 $39,000 $97,500 $325,000 65 -69 $5.59 $11.18 $27.95 $33.54 $83.85 $279.50 Employee AgeRange $4,000 $8,000 $20,000 $24,000 $60,000 $200,000 70 -74 $4.44 $8.88 $22.20 $26.64 $66.67 $222.00 Employee AgeRange $2,500 $5,000 $12,500 $15,000 $37,500 $125,000 75 -79 $3.73 $7.45 $18.63 $22.35 $55.88 $186.25 Employee AgeRange $1,000 $2,000 $5,000 $6,000 $15,000 $50,000 80 -99 $1.49 $2.98 $7.45 $8.94 $22.35 $74.50
Employee
Coverage for Your Spouse
You can secure term life insurance for your spouse if you select coverage for yourself.
Term Life Insurance | Spouse
Guaranteed coverage amount $30,000
Maximum coverage amount 50% of the employee coverage amount ($250,000 maximum)
Minimum coverage amount $5,000
Guaranteed Life Insurance Coverage Amount
You can choose a coverage amount up to 50% of your coverage amount ($30,000 maximum) for your spouse 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 $10,000 during the next limited open enrollment period.
Maximum Life Insurance Coverage Amount
You can choose a coverage amount up to 50% of your coverage amount ($250,000 maximum) for your spouse with evidence of insurability.
Coverage amounts are reduced when an employee reaches age 65.
For complete plan details, please see your contract.
Group Rates for Your Spouse
The estimated monthly premium for life insurance is determined by multiplying the desired amount of coverage (in increments of $5,000) by the employee age-range premium rate. $ X ___________ = $
Life Insurance Summary of Benefits LFE-ENRO-BRC001-TX
coverage amount premium rate monthly premium
Coverage for Your Dependent Children
You can secure term life insurance for your dependent children when you choose coverage for yourself. For children age 14 days to 6 months, the maximum coverage amount is $250. Newborn children younger than the ages shown below are not eligible for coverage.
Group
for Your Dependent Children
One affordable monthly premium covers all of your dependent children 6 months to age 26.
Note: You must be an active Navarro Independent School District employee to select coverage for a spouse and/or dependent children. To be eligible for coverage, a spouse or dependent child cannot be confined to a health care facility or unable to perform the typical activities of a healthy person of the same age and gender. Newborn children younger than the ages shown above are not eligible for coverage.
Life Insurance Summary of Benefits LFE-ENRO-BRC001-TX Spouse |Monthly Premiums for Select Life Insurance Coverage Amounts Employee AgeRange $10,000 $20,000 $50,000 $60,000 $150,000 $500,000 0-24 $0.50 $1.00 $2.50 $3.00 $7.50 $25.00 25-29 $0.50 $1.00 $2.50 $3.00 $7.50 $25.00 30-34 $0.70 $1.40 $3.50 $4.20 $10.50 $35.00 35-39 $0.80 $1.60 $4.00 $4.80 $12.00 $40.00 40-44 $1.30 $2.60 $6.50 $7.80 $19.50 $65.00 45-49 $2.00 $4.00 $10.00 $12.00 $30.00 $100.00 50-54 $2.60 $5.20 $13.00 $15.60 $39.00 $130.00 55-59 $4.10 $8.20 $20.50 $24.60 $61.50 $205.00 60-64 $5.90 $11.80 $29.50 $35.40 $88.50 $295.00 Employee AgeRange $6,500 $13,000 $32,500 $39,000 $97,500 $325,000 65 -69 $5.59 $11.18 $27.95 $33.54 $83.85 $279.50
Term Life Insurance | Dependent Children 6 months to age 26 Guaranteed coverage amount $10,000 Term Life Insurance | Dependent Children Age 14 Days to 6 months Guaranteed coverage amount $250 Dependent Children Monthly Premium for Life Insurance Coverage Coverage Amount Monthly Premium $5,000 $0.90 $10,000 $1.80
Rates
Accident Insurance Plan Summary
ACCIDENT INSURANCE BENEFITS
With MetLife, you’ll have a comprehensive plan which provides payments in addition to any other insurance payments you may receive1 Here are just some of the covered events/services2
Covered Benefits – All benefits must relate to injuries sustained in an accident.
ADF# AI664.14
BENEFIT AMOUNTS BENEFIT BENEFIT LIMITS EMPLOYEE SPOUSE CHILD ACCIDENTAL DEATH BENEFITS CATEGORY Basic Accidental Death N/A $40,000 $20,000 $10,000 Accidental Death Common Carrier $200,000 $100,000 $50,000 ACCIDENTAL DISMEMBERMENT/FUNCTIONAL LOSS/PARALYSIS BENEFITS CATEGORY Basic Dismemberment/Functional Loss Benefit Loss of one finger or one toe N/A $2,000 $1,000 $500 Loss of one arm or one leg $20,000 $10,000 $5,000 Loss of one hand or one foot $20,000 $10,000 $5,000 Loss of two or more fingers or toes $4,000 $2,000 $1,000 Loss of sight in one eye $20,000 $10,000 $5,000 Loss of hearing in one ear $20,000 $10,000 $5,000 Catastrophic Dismemberment/Functional Loss Benefit Loss of both arms or both legs or one arm and one leg N/A $40,000 $20,000 $5,000 Loss of both hands or both feet or one hand and one foot $40,000 $20,000 $5,000 Loss of sight in both eyes $40,000 $20,000 $5,000 Loss of hearing in both ears $40,000 $20,000 $5,000 Loss of ability to speak $40,000 $20,000 $5,000 Paralysis Benefit Two Limbs (paraplegia or hemiplegia) N/A $15,000 $15,000 $15,000 Four Limbs (quadriplegia) $30,000 $30,000 $30,000
If more than one bone is fractured, the amount we will pay for all fractures combined will be no more than 2 times the highest Fracture Benefit.
If more than one bone is fractured, the amount we will pay for all fractures combined will be no more than 2 times the highest Fracture Benefit.
BENEFIT BENEFIT LIMITS EMPLOYEE SPOUSE CHILD ACCIDENTAL INJURY BENEFITS
Fracture Benefit (Closed) Face or Nose
BENEFIT AMOUNTS
CATEGORY
(except mandible or maxilla)
$600 $300 $150 Skull Fracture - depressed (except bones of face or nose) $3,800 $1,900 $950 Skull Fracture - non depressed (except bones of face or nose) $1,900 $950 $475 Lower Jaw, Mandible (except alveolar process) $800 $400 $200 Upper Jaw, Maxilla (except alveolar process) $1,000 $500 $250 Upper Arm between Elbow and Shoulder (humerus) $2,200 $1,100 $550 Shoulder Blade (scapula), Collarbone (clavicle, sternum) $2,200 $1,100 $550 Forearm (radius and/or ulna), Hand, Wrist (except fingers) $1,600 $800 $400 Rib $600 $300 $150 Finger, Toe $280 $140 $70 Vertebrae, Body of (excluding vertebral processes) $1,500 $750 $375 Vertebral Process $500 $250 $125 Pelvis (includes ilium, ischium, pubis, acetabulum except coccyx) $4,000 $2,000 $1,000 Hip, Thigh (femur) $4,000 $2,000 $1,000 Coccyx $280 $140 $70 Leg (tibia and/or fibula) $2,200 $1,100 $550 Kneecap (patella) $1,600 $800 $400 Ankle $1,600 $800 $400 Foot (except toes) $1,400 $700 $350 Chip Fracture 25% 25% 25% Fracture Benefit (Open) Face or Nose (except mandible or maxilla)
$1,200 $600 $300 Skull Fracture - depressed (except bones of face or nose) $7,600 $3,800 $1,900 Skull Fracture - non depressed (except bones of face or nose) $3,800 $1,900 $950 Lower Jaw, Mandible (except alveolar process ) $1,600 $800 $400 Upper Jaw, Maxilla (except alveolar process) $2,000 $1,000 $500 Upper Arm between Elbow and Shoulder (humerus) $4,400 $2,200 $1,100 Shoulder Blade (scapula), Collarbone (clavicle, sternum) $4,400 $2,200 $1,100 Forearm (radius and/or ulna), Hand, Wrist (except fingers) $3,200 $1,600 $800 Rib $1,200 $600 $300
Fracture Benefit (Open)
If more than one bone is fractured, the amount we will pay for all fractures combined will be no more than 2 times the highest Fracture Benefit.
If more than one joint is dislocated, the amount we will pay for all dislocations combined will be no more than 2 times the highest Dislocation Benefit.
If more than one joint is dislocated, the amount we will pay for all dislocations combined will be no more than 2 times the highest Dislocation Benefit.
Finger, Toe
$560 $280 $140 Vertebrae, Body of
processes) $3,000 $1,500 $750 Vertebral Process $1,000 $500 $250 Pelvis (includes
coccyx) $8,000 $4,000 $2,000 Hip, Thigh (femur) $8,000 $4,000 $2,000 Coccyx $560 $280 $140 Leg (tibia and/or fibula) $4,400 $2,200 $1,100 Kneecap (patella) $3,200 $1,600 $800 Ankle $3,200 $1,600 $800 Foot (except toes) $2,800 $1,400 $700 Chip Fracture 25% 25% 25% Dislocation Benefit (Closed) Lower Jaw
(excluding vertebral
ilium, ischium, pubis, acetabulum except
$750 $375 $190 Collarbone (sternoclavicular) $600 $300 $150 Collarbone (acromioclavicular and separation) $600 $300 $150 Shoulder (glenohumeral) $800 $400 $200 Rib $750 $375 $190 Elbow $1,200 $600 $300 Wrist $1,400 $700 $350 Bone or Bones of the Hand (other than fingers) $600 $300 $150 Hip $4,000 $2,000 $1,000 Knee (except patella) $1,600 $800 $400 Ankle - Bone or bones of the Foot (other than toes) $1,600 $800 $400 One Toe or Finger $120 $60 $30 Partial Dislocation 25% 25% 25% Dislocation Benefit (Open) Lower Jaw
$1,500 $750 $380 Collarbone (sternoclavicular) $1,200 $600 $300 Collarbone (acromioclavicular and separation) $1,200 $600 $300 Shoulder (glenohumeral) $1,600 $800 $400 Rib $1,500 $750 $380 Elbow $2,400 $1,200 $600 Wrist $2,800 $1,400 $700 Bone or Bones of the Hand (other than fingers) $1,200 $600 $300 Hip $8,000 $4,000 $2,000 Knee (except patella) $3,200 $1,600 $800 Ankle - Bone or bones of the Foot (other than toes) $3,200 $1,600 $800 One Toe or Finger $240 $120 $60 Partial Dislocation 25% 25% 25%
Burn Benefit 2nd Degree w/ less than 10% of surface skin burnt 1 time per accident; Unlimited time(s) per calendar year $75 $75 $75 2nd Degree 10-25% surface skin burnt $150 $150 $150 2nd Degree 25-35% surface skin burnt $500 $500 $500 2nd Degree 35% or more of surface skin burnt $1,000 $1,000 $1,000 3rd Degree w/ less than 10% of surface skin burnt $1,000 $1,000 $1,000 3rd Degree 10-25% surface skin burnt $1,500 $1,500 $1,500 3rd Degree 25-35% surface skin burnt $5,000 $5,000 $5,000 3rd Degree 35% or more of surface skin burnt $10,000 $10,000 $10,000 Concussion Benefit Concussion 1 time(s) per calendar year $300 $300 $300 Coma Benefit Coma 1 time(s) per accident; Unlimited time(s) per calendar year $20,000 $20,000 $20,000 Laceration Benefit Without repair by stiches 1 time per accident; 3 time(s) per calendar year $50 $50 $50 Repaired by stiches but less than 2 inches long $75 $75 $75 Repaired by stiches and 2-6 inches long $200 $200 $200 Repaired by stiches and over 6 inches long $400 $400 $400 Broken Tooth Benefit Crown 1 time(s) per accident; 3 time(s) per calendar year (applies to all procedures) $200 $200 $200 Extraction 1 time(s) per accident; 3 time(s) per calendar year (applies to all procedures) $100 $100 $100 Filling 1 time(s) per accident; 3 time(s) per calendar year (applies to all procedures) $25 $25 $25 Eye Injury Benefit Eye Injury 1 time(s) per accident; 2 time(s) per calendar year $200 $200 $200 BENEFIT AMOUNTS BENEFIT BENEFIT LIMITS EMPLOYEE SPOUSE CHILD MEDICAL TREATMENT AND SERVICES BENEFITS CATEGORY Ground Ambulance Benefit Ground Ambulance 1 time(s) per accident; 2 time(s) per calendar year $200 $200 $200 Air Ambulance Benefit Air Ambulance 1 time(s) per accident; 2 time(s) per calendar year $600 $600 $600
Emergency Care Benefit Emergency Room 1 time per accident (combined with Non-Emergency Initial Care Benefit) $200 $200 $200 Physician’s Office $100 $100 $100 Urgent Care $75 $75 $75 Non-Emergency Initial Care Benefit Non-Emergency Initial Care 1 time per accident (combined with Emergency Care Benefit) $75 $75 $75 Medical Testing Benefit Medical Testing (MRI/MR, Ultrasound, NCV, CT/CAT, EEG) 1 time(s) per accident; 2 time(s) per calendar year $100 $100 $100 Medical Testing (X-rays) $200 $200 $200 Physician Follow-Up Benefit Physician Follow-Up Visit 2 time(s) per accident; 6 time(s) per calendar year $75 $75 $75 Transportation Benefit Transportation 1 time(s) per accident; 2 time(s) per calendar year $800 $800 $800 Therapy Services Benefit Cognitive Behavioral Therapy 10 time(s) per accident; 15 time(s) per calendar year $60 $60 $60 Occupational Therapy $60 $60 $60 Physical Therapy $60 $60 $60 Respiratory therapy $60 $60 $60 Speech Therapy $60 $60 $60 Vocational Therapy $60 $60 $60 Pain Benefit Pain Management (for Epidural Anesthesia) 1 time(s) per accident; Unlimited time(s) per calendar year $200 $200 $200 Prosthetic Device Benefit One Device Only 1 time(s) per accident; Unlimited time(s) per calendar year $1,000 $1,000 $1,000 More than One Device $2,000 $2,000 $2,000 Medical Appliance Benefit Brace $75 $75 $75 Cane $75 $75 $75 Crutches $75 $75 $75 Walker - expected use < 1yr $150 $150 $150 Walker - expected use >=1 yr $300 $300 $300 Walking Boot $75 $75 $75 Wheel chair or motorized scooter - expected use < 1yr $200 $200 $200 Wheel chair or motorized scooter - expected use >=1yr $750 $750 $750 Other medical device used for Mobility $75 $75 $75
Medical Appliance Benefit Limit (for all appliances combined per accident) $750 $750 $750 Modification Benefit Modification 1 time(s) per accident; Unlimited time(s) per calendar year $1,000 $1,000 $1,000 Blood/ Plasma/ Platelets Benefit Blood/Plasma/Platelets 1 time(s) per accident; Unlimited time(s) per calendar year $600 $600 $600 Surgery Benefits Surgical Repair – Cranial 1 time(s) per accident; 2 time(s) per calendar year $1,500 $1,500 $1,500 Surgical Repair – Hernia $150 $150 $150 Surgical Repair – Ruptured Disc $1,000 $1,000 $1,000 Surgical Repair – Skin Graft Benefit 50% 50% 50% Surgical Repair – Torn Cartilage in Knee $750 $750 $750 Surgical Repair – Torn tendon/ligament/rotator cuff - one $1,000 $1,000 $1,000 Surgical Repair – Torn tendon/ligament/rotator cuff - two or more $2,000 $2,000 $2,000 Surgical Repair – Thoracic Cavity or Abdominal Pelvic Cavity $2,000 $2,000 $2,000 Exploratory Surgery (for any Surgery Benefit procedure) $150 $150 $150 Other Outpatient Surgery Benefit Other Outpatient Surgery Benefit 1 time(s) per accident; 2 time(s) per calendar year $300 $300 $300 BENEFIT AMOUNTS BENEFIT BENEFIT LIMITS EMPLOYEE SPOUSE CHILD ACCIDENT – HOSPITAL BENEFITS CATEGORY Hospital Admission Benefit Admission 1 time per accident; Unlimited times per calendar year $1,000 $1,000 $1,000 ICU Supplemental Admission (paid in addition to Admission) $1,000 $1,000 $1,000 Hospital Confinement Benefit Confinement 15 days per accident. Payable after the first day of admission. ICU Supplemental Confinement will pay an additional benefit for 15 of those days. $200 $200 $200 ICU Supplemental Confinement (paid in addition to Confinement) $200 $200 $200 Inpatient Rehabilitation Benefit Inpatient Rehabilitation 15 days per accident; 30 days per calendar year $200 $200 $200
Notes Regarding Certain Benefits:
Accidental Death Benefits Category: The benefit amount will be reduced by the amount of any Accidental Dismemberment/Functional Loss/Paralysis Benefits and Modification Benefit paid for Injuries sustained by the Covered Person in the same Accident for which the Accidental Death Benefit is being paid.
Accidental Death Common Carrier Benefit: “Common Carrier”: refers to airplanes, trains, buses, trolleys, subways and boats. Certain conditions apply. See your Disclosure Statement or Outline of Coverage/Disclosure Document for specific details.
Lodging Benefit: The lodging benefit is not available in all states. It provides a benefit for a companion accompanying a covered insured while hospitalized, provided that lodging is at least 50 miles from the insured’s primary residence.
Please contact MetLife for detailed definitions and state variations of covered benefits.
BENEFIT PAYMENT EXAMPLE
Kathy’s daughter, Molly, plays soccer on the varsity high school team. During a recent game, she collided with an opposing player, was knocked unconscious and taken to the local emergency room by ambulance for treatment. The ER doctor diagnosed a concussion and a broken tooth. He ordered a CT scan to check for facial fractures too, since Molly’s face was very swollen. Molly was released to her primary care physician for follow-up treatment, and her dentist repaired her broken tooth with a crown. Depending on her health insurance, Kathy’s out -of-pocket costs could run into hundreds of dollars to cover expenses like insurance co-payments and deductibles. MetLife Group Accident Insurance payments can be used to help cover these unexpected costs.
INSURANCE RATES
MetLife offers competitive group rates and convenien t payroll deduction so you don’t have to worry about writing a check or missing a payment! Your employee rates are outlined below.
BENEFIT AMOUNTS BENEFIT BENEFIT LIMITS EMPLOYEE SPOUSE CHILD OTHER BENEFITS CATEGORY Health Screening Benefit 1 time(s) per calendar year $200 $200 $200 Lodging Benefit 15 day(s) per calendar year $200 $200 $200
Proposed Rates Type Monthly (12) Employee Only $13.84 Employee + Spouse $25.48 Employee + Children $27.34 Employee + Spouse and Children $34.14 Covered Event3 Benefit Amount Ambulance (ground) $200 Emergency Care $200 Physician Follow-Up ($75 x2) $150 Medical Testing $200 Concussion $300 Broken Tooth (repaired by crown) $200 Benefits paid by MetLife Group Accident Insurance $1,250
GroupNumber: 00575749
ACancerinsuranceplanthroughGuardianprovides:
•Lump-sumcashpaymentsforcertainprocedures,screeningsandtreatmentsrelatedtoacoveredcancerdiagnosis,inaddition towhateveryourmedicalplancovers
•Paymentsaremadedirectlytoyouandcanbeusedforanypurpose
•Abilitytotakethecoveragewithyouifyouchangejobsorretire
•Affordablegrouprates
AboutYourBenefits:
INITIALDIAGNOSISBENEFIT- BenefitispaidwhenyouarediagnosedwithInternalcancerforthefirsttimewhileinsuredunderthisPlan.
BenefitWaitingPeriod- Aspecifiedperiodoftimeafteryour effectivedateduringwhichtheInitialDiagnosisbenefitswillnotbe payable.
CANCERSCREENING
BenefitAmount
RADIATIONTHERAPYORCHEMOTHERAPY
Benefit
Pre-ExistingConditionsLimitation: Apre-existingcondition includesanyconditionforwhichyou,inthespecifiedtimeperiodprior tocoverageinthisplan,consultedwithaphysician,received treatment,ortookprescribeddrugs.
$50;$50forFollow-Upscreening$50;$50forFollow-Upscreening
Scheduleamountsuptoa$10,000 benefityearmaximum.
3monthsprior/6months treatmentfree/12monthsafter.
Scheduleamountsuptoa$15,000 benefityearmaximum.
3monthsprior/6months treatmentfree/12monthsafter.
Child(ren)AgeLimits Childrenagebirthto26yearsChildrenagebirthto26years
FEATURES
AirAmbulance
$1,500/trip,limit2tripsper hospitalconfinement
$2,000/trip,limit2tripsper hospitalconfinement
AlternativeCare NoBenefit $50/visitupto20visits
Ambulance
Anesthesia
$200/trip,limit2tripsperhospital confinement
25%ofsurgerybenefit
$250/trip,limit2tripsperhospital confinement
25%ofsurgerybenefit
Anti-Nausea $50/dayupto$150permonth$50/dayupto$250permonth
AttendingPhysician $25/daywhilehospitalconfined. Limit75visits. $25/daywhilehospitalconfined. Limit75visits.
Blood/Plasma/Platelets
$100/dayupto$5,000peryear$200/dayupto$10,000peryear
BenefitinformationillustratedwithinthismaterialreflectstheplancoveredbyGuardianasof06/01/2020
AllEligibleEmployeesBenefitSummary
TheGuardian LifeInsuranceCompanyofAmerica,NewYork,NY
CancerBenefitSummary
NAVARROISD
CANCER
DETAILS Option1:AdvantagePlanOption2:PremierPlan YourMonthlypremium $22.88 $35.03 YouandSpouse $35.47 $54.39 YouandChild(ren) $32.60 $50.37 You,SpouseandChild(ren) $45.19 $69.73
COVERAGE-
BenefitAmount(s) Employee$2,500 Spouse$2,500 Child$2,500 Employee$5,000 Spouse$5,000 Child$5,000
30Days 30Days
Included Included
3
BoneMarrow/StemCell
BoneMarrow:$7,500
StemCell:$1,500
50%benefitfor2ndtransplant. $1,000benefitifadonor
BoneMarrow:$10,000
StemCell:$2,500
50%benefitfor2ndtransplant. $1,500benefitifadonor
ExperimentalTreatment $100/dayupto$1,000/month$200/dayupto$2,400/month
ExtendedCareFacility/SkilledNursingcare $100/dayupto90daysperyear$150/dayupto90daysperyear
GovernmentorCharityHospital $300perdayinlieuofallother benefits $400perdayinlieuofallother benefits
HomeHealthCare $50/visitupto30visitsperyear$100/visitupto30visitsperyear
HormoneTherapy $25/treatmentupto12treatments peryear $50/treatmentupto12treatments peryear
Hospice $50/dayupto100days/lifetime$100/dayupto100days/lifetime
HospitalConfinement $300/dayforfirst30days; $600/dayfor31stdaythereafter perconfinement
ICUConfinement
Immunotherapy
$400/dayforfirst30days; $600/dayfor31stdaythereafter perconfinement
$400/dayforfirst30days; $800/dayfor31stdaythereafter perconfinement
$600/dayforfirst30days; $800/dayfor31stdaythereafter perconfinement
$500permonth,$2,500lifetime max $500permonth,$2500lifetime max
$100/dayupto30daysperyear$150/dayupto30daysperyear MedicalImaging $100/imageupto2peryear$200/imageupto2peryear
InpatientSpecialNursing
Outpatientandfamilymemberlodging-Lodgingmustbemorethan 50milesfromyourhome.
OutpatientorAmbulatorySurgicalCenter
$75/day,upto90daysperyear$100/day,upto90daysperyear
$250/day,3daysperprocedure$350/day,3daysperprocedure
PhysicalorSpeechTherapy $25/visitupto4visitspermonth, $400lifetimemax
SurgicallyImplanted:$2,000/device, $4,000lifetimemax
Prosthetic
ReconstructiveSurgery
ReproductiveBenefit
Non-Surgically:$200/device,$400 lifetimemax
BreastTRAMFlap$2,000
Breastreconstruction$500
BreastSymmetry$250
Facialreconstruction$500
$50/visitupto4visitspermonth, $1,000lifetimemax
SurgicallyImplanted:$3,000/device, $6,000lifetimemax
Non-Surgically:$300/device,$600 lifetimemax
BreastTRAM$3,000
Breastreconstruction$700
BreastSymmetry$350 Facialreconstruction$700
NoBenefit$1,500eggharvesting,$500eggor spermstorage,$2,000lifetimemax
SecondSurgicalOpinion $200/surgeryprocedure $300/surgeryprocedure
BiopsyOnly:$100
BiopsyOnly:$100
SkinCancer
ReconstructiveSurgery:$250 Excisionofaskincancer:$375 Excisionofaskincancerwithflap orgraft:$600
ReconstructiveSurgery:$250 Excisionofaskincancer:$375 Excisionofaskincancerwithflap orgraft:$600
SurgicalBenefit
WaiverofPremium-Ifyoubecomedisabledduetocancerthatis diagnosedaftertheemployee'seffectivedate,andyouremain disabledfor90days,wewillwaivethepremiumdueaftersuch90 daysforaslongasyouremaindisabled.
UNDERSTANDINGYOURBENEFITS:
$0.50/mileupto$1,000perround trip/equalbenefitforcompanion
Scheduleamountupto$4,125Scheduleamountupto$5,500 Transportation/CompanionTransportation-Benefitispaidifyou havetotravelmorethan50milesonewaytoreceivetreatmentfor internalcancer.
$0.50/mileupto$1,500perround trip/equalbenefitforcompanion
Included Included
• AlternativeCare – Benefit ispaidforpalliativecare(bio-feedbackorhypnosis)orlifestylebenefitssuchasvisitstoan accreditedpractitionerforsmokingcessation,yoga,meditation,relaxationtechniquesandnutritionalcounseling.
AllEligibleEmployeesBenefitSummary TheGuardianLifeInsuranceCompanyofAmerica,NewYork,NY
Option1:AdvantagePlanOption2:PremierPlan
FEATURES(Cont.)
4
UNDERSTANDINGYOURBENEFITS(Cont.):
• Cancer –Cancermeansyouhavebeendiagnosedwithadiseasemanifestedbythepresenceofamalignanttumor characterizedbytheuncontrolledgrowthandspreadofmalignantcellsinanypartofthebody.Thisincludesleukemia, Hodgkin'sdisease,lymphoma,sarcoma,malignanttumorsandmelanoma.Cancerincludescarcinomasin-situ(inthenaturalor normalplace,confinedtothesiteoforigin,withouthavinginvadedneighboringtissue).Pre-malignantconditionsorconditions withmalignantpotential,suchasmyelodyplasticandmyeloproliferativedisorders,carcinoid,leukoplakia,hyperplasia,actinic keratosis,polycythemia,andnonmalignantmelanoma,molesorsimilardiseasesorlesionswillnotbeconsideredcancer. CancermustbediagnosedwhileinsuredundertheGuardiancancerplan.
• ExperimentalTreatment –Benefitswillbepaidforexperimentaltreatmentprescribedbyadoctorforthepurposeof destroyingorchangingabnormaltissue.AlltreatmentmustbeNCIlistedasviableexperimentaltreatmentforInternal Cancer.
ManageYourBenefits:
Gotowww.GuardianAnytime.comtoaccesssecureinformation aboutyourGuardianbenefits.Youron-lineaccountwillbeset upwithin30daysafteryourplaneffectivedate.
LIMITATIONSANDEXCLUSIONS:
ASUMMARYOFCANCERLIMITATIONSANDEXCLUSIONS:
Conditional Issueunderwritingisrequiredonthoseenrollingoutsideofthe initialenrollmentperiodorannualopenenrollmentperiod.
Thisplanwillnotpaybenefitsfor:Servicesortreatmentnotincludedinthe Features.Servicesortreatmentprovidedbyafamilymember.Servicesor treatmentrenderedforhospitalconfinementoutsidetheUnitedStates.Any cancerdiagnosedsolelyoutsideoftheUnitedStates.Servicesortreatment providedprimarilyforcosmeticpurposes.Servicesortreatmentfor premalignantconditions.Servicesortreatmentforconditionswithmalignant potential.Servicesortreatmentfornon-cancersicknesses.
NeedAssistance?
CalltheGuardianHelpline(888)600-1600,weekdays,8:00AM to8:30PM,EST.RefertoyourmemberID(socialsecurity number)andyourplannumber:00575749
Cancercausedby,contributedtoby,orresultingfrom:participatinginafelony, riotorinsurrection;intentionallycausingaself-inflictedinjury;committingor attemptingtocommitsuicidewhilesaneorinsane;acoveredperson’smentalor emotionaldisorder,alcoholismordrugaddiction;engaginginanyillegalactivity; orservinginthearmedforcesoranyauxiliaryunitofthearmedforcesofany country.
IfCancerinsurancepremiumispaidforonapretaxbasis,thebenefitmaybetaxable. Pleasecontactyourtaxorlegaladvisorregardingthetaxtreatmentofyourpolicy benefits.
Thisdocumentisasummaryofthemajorfeaturesofthereferencedinsurancecoverage. Itisintendedforillustrativepurposesonlyanddoesnotconstitute acontract.Theinsuranceplandocuments,includingthepolicyandcertificate,comprisethecontractforcoverage.Thefullplandescription,includingthe benefitsandallterms,limitationsandexclusionsthatapplywillbecontainedinyourinsurancecertificate.Theplandocumentsarethefinalarbiterof coverage.Coveragetermsmayvarybystateandactualsoldplan.Thepremiumamountsreflectedinthissummaryareanapproximation;ifthereisa discrepancybetweenthisamountandthepremiumactuallybilled,thelatterprevails.
AllEligibleEmployeesBenefitSummary
TheGuardianLifeInsuranceCompanyofAmerica,NewYork,NY
Contract#GP-1-CAN-IC-125
MetLife Hospital Indemnity Insurance Plan Summary
HOSPITAL INDEMNITY INSURANCE BENEFITS
With MetLife, you’ll have a choice of two comprehensive plans which provide payments in addition to any other insurance payments you may receive. Here are just some of the covered benefits/services, when an accident or illness puts you in the hospital.1
Admission must occur within 180 days after the accident
Confinement must occur within 180 days after the accident
Inpatient Rehab stay must occur immediately following hospital confinement and occur within 365 days of accident
$500 per accident (non-ICU) $1,000 per accident (ICU)
$100 a day (non-ICU) for up to 31 days
$200 a day (ICU) for up to 31 days
$100 a day, up to 15 days per accident and 30 days per calendar year
$1,000 per accident (non-ICU) $2,000 per accident (ICU)
$200 a day (non-ICU) for up to 31 days
$400 a day (ICU) for up to 31 days
$200 a day, up to 15 days per accident and 30 days per calendar year
$100 a day (non-ICU) for up to 31 days
$200 a day (ICU) for up to 31 days
Other Benefits Lodging4 benefit provided for a companion accompanying a covered insured while hospitalized
$200 a day (non-ICU) for up to 31 days
$400 a day (ICU) for up to 31 days
Navarro Independent School District
Benefit Type2 Low Plan MetLife Hospital Indemnity Insurance Pays YOU High Plan MetLife Hospital Indemnity Insurance Pays YOU Hospital Coverage (Accident)
Admission Payable1xpercalendar year
$1,000
$2,000
Hospital Coverage (Sickness)3
$500 (non-ICU)
(ICU) $1,000 (non-ICU)
(ICU) Confinement Paidpersickness
$100 per night up to 30 night per calendar year $200 per night up to 30 nights per calendar year
HI681.14
ADF#
QUESTIONS & ANSWERS
Who is eligible to enroll for this Hospital Indemnity coverage?
You are eligible to enroll yourself and your eligible family members7. You need to enroll during your Enrollment Period and be actively at work for your coverage to be effective. Dependents to be enrolled may not be subject to a medical restriction as set forth in the Certificate. Some states require the insured to have medical coverage.
How do I pay for my Hospital Indemnity coverage?
Premiums will be conveniently paid through payroll deduction, so you don’t have to worry about writing a check or missing a payment.
What happens if my employment status changes? Can I take my coverage with me?
Yes, you can take your coverage with you. You will need to continue to pay your premiums to keep your coverage in force. Your coverage will only end if you stop paying your premium or if your employer offers you similar coverage with a different insurance carrier. 8
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 8:00 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 8 p.m., EST and talk with a benefits consultant.
1 Hospital does not include certain facilities such as nursing homes, convalescent care or extended care facilities. See your Disclosure Statement or Outline of Coverage/Disclosure Document for full details.
2 Covered services/treatments must be the result of an accident or sickness as defined in the group policy/certificate. See your Disclosure Statement or Outline of Coverage/Disclosure Document for more details.
3 There is a preexisting condition exclusion for covered sicknesses See your Disclosure Statement or Outline of Coverage/Disclosure Document for more details.
4 The lodging benefit is not available in all states. It provides a benefit for a companion accompanying a covered insured while hospitalized, provided that lodging is at least 50 miles from the insured’s primary residence.
5 The Health Screening Benefit is not available in all states.
6 Benefit amount is based on a sample MetLife plan design. Plan design and plan benefits may vary.
7 Coverage is guaranteed provided (1) the employee is actively at work and (2) dependents to be covered are not subject to medical restrictions as set forth 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.
8 Eligibility for portability through the Continuation of Insurance with Premium Payment provision may be subject to certain eligibility requirements and limitations. For more information, contact your MetLife representative.
METLIFE'S HOSPITAL INDEMNITY INSURANCE IS A LIMITED BENEFIT GROUP INSURANCE POLICY. The policy is not intended to be a substitute for medical coverage and certain states may require the insured to have medical coverage to enroll for the coverage. The policy or its provisions may vary or be unavailable in some states. There is a preexisting condition limitation for hospital sickness benefits. MetLife’s Hospital Indemnity Insurance may be subject to benefit reductions that begin at age 65. Like most group accident and health insurance policies, policies offered by MetLife may contain certain exclusions, limitations and terms for keeping them in force. For complete details of coverage and availability, please refer to the group policy form GPNP12AX or GPNP13-HI or contact MetLife. Benefits are underwritten by Metropolitan Life Insurance Company, New York, New York. In certain states, availability of MetLife’s Group Hospital Indemnity Insurance is pending regulatory approval.
L0217490584[exp0418][All States] © 2017 METLIFE, INC.
MetLife Critical Illness Insurance Plan Summary
COVERAGE OPTIONS
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%
Please refer to the table below for the percentage benefit amount for each Covered Condition.
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
Navarro Independent School District
Critical Illness Insurance Eligible Individual Initial Benefit Requirements Employee $15,000 or $30,000 Coverage is guaranteed provided you are actively at work.3 Spouse/Domestic Partner1 50% 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 Dependent Child(ren)2 50% of the employee’s Initial Benefit 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
Covered Conditions Initial Benefit Recurrence Benefit Full Benefit Cancer5 100% of Initial Benefit 50% of Benefit Amount Partial Benefit Cancer5 25% of Initial Benefit 12.5% of Benefit Amount Heart Attack 100% of Initial Benefit 50% of Benefit Amount Stroke6 100% of Initial Benefit 50% of Benefit Amount Coronary Artery Bypass Graft7 100% of Initial Benefit 50% of Benefit Amount 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
Example of Initial & Recurrence Benefit Payments
The example below illustrates an employee who elected an Initial Benefit of $15,000 and has a Total Benefit of 3 times the Initial Benefit Amount or $45,000.
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 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.
*The Health Screening Benefit amount depends upon the Initial Benefit Amount selected. Employees would receive a $50 benefit with the $15,000 initial benefit amount or a $100 benefit with the $30,000 Initial Benefit Amount.
QUESTIONS & ANSWERS
How do I enroll?
Enroll for coverage at mybenefits.metlife.com/NavvaroISD.
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 9/1/2019
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 8:00 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 8 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.
2 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
Illness – Covered Condition Payment Total Benefit Remaining Heart Attack – first diagnosis Initial Benefit payment of $15,000 or 100% $30,000 Heart Attack – second diagnosis, two years later Recurrence Benefit payment of $15,000 or 100% $15,000 Kidney Failure – first diagnosis, three years later Initial Benefit payment of $15,000 or 100% $0
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.
7 In NJ sitused cases, the Covered Condition is Coronary Artery Disease.
8 Please review the Outline of Coverage for specific information about Alzheimer’s disease.
9 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 The Health Screening Benefit is not available in all states. See your certificate for any applicable waiting periods. There is a separate mammogram benefit for MT residents and for cases sitused in CA and MT.
11 Eligibility for portability through the Continuation of Insurance with Premium Payment provision may be subject to certain eligibility requirements and limitations. For more information, contact your MetLife representative.
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 may vary by state. In most plans, there is a preexisting condition exclusion. In most states, after a covered condition occurs there is a benefit suspension period during which most plans do not pay recurrence benefits. Attained Age rates are based on 5-year age bands and will increase when a Covered Person reaches a new age band. 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 GPNP09-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.
Metropolitan Life Insurance Company, New York, NY 10166.
L1216486089[exp0218][All States]
NW 3.5 AA OHIV
Navarro Independent School District
403(b) UNIVERSAL AVAILABILITY NOTICE
The Opportunity.
You have the opportunity to save for retirement by participating in the Navarro ISD's 403(b) plan (“Plan”). We recommend that all employees view a brief, 3-minute video presentation explaining what a 403(b) plan is, and how to contribute.
The video can be reached at www.403bwhyme.com
If there are any questions, you may contact The OMNI Group at 877-544-6664.
How Can I Participate?
You can participate in the Plan with pre-tax contributions by completing and submitting a Salary Reduction Agreement (“SRA”) online at http://www.omni403b.com/, or by submitting a completed SRA form, which can be found on the same website, to The OMNI Group either by facsimile to (585) 672-6194 or by mail at 1099 Jay St., Bldg F, Rochester, NY, 14611 (“OMNI”).
How Much Can I Contribute Annually?
You may contribute up to $20,500 in 2022 this amount is subject to change annually. If you have at least 15 years of service with your employer or you are at least 50 years old, you may also be able to make additional catch-up contributions. For appropriate limits for your particular circumstances, please contact OMNI’s Customer Care Center at 1-877-544-6664.
What If I Already Have An Account?
If you are already contributing to the Plan, and you want to change your contribution amount or service provider, simply complete and submit a new SRA. See directions above for on-line and paper submission options.
What If I Do Not Want To Contribute?
If you do not want to take advantage of this program, simply submit an SRA with the option “I do not wish to participate at this time” selected. See directions above for on-line and paper submission options.
How can I get more information?
You can access further information at www.omni403b.com or www.403bwhyme.com.
