This guide highlights your benefits. Official plan and insurance documents govern your rights and benefits under each plan. For more details about your benefits, including covered expenses, exclusions, and limitations, please refer to the individual summary plan descriptions (SPDs), plan document, or certificate of coverage for each plan. If any discrepancy exists between this guide and the official documents, the official documents will prevail.
BENEFITS YOU CAN COUNT ON
The Langley School is committed to providing employees with a benefits package that is both comprehensive and competitive. Our benefits offer health coverage and a degree of financial security to our employees and their families. This guide provides a general overview of your benefit choices and enrollment information to help you select the coverage that is right for you.
ELIGIBILITY
To be eligible for most benefits, including medical, dental, and vision, employees must fall into one of the following categories: instructional (those employees who have signed a contract that runs from August 15 through August 14); 11-month exempt or non-exempt (those employees whose employment generally runs over a period of 11 months during the current school year as specified in the employment letter); or 12-month exempt or non-exempt (those employees who have signed a contract that runs from July 1 through June 30), and work a minimum of 30 hours per week.
Your dependents are also eligible based on the following guidelines:
• Your spouse/domestic partner
• Your dependent children up to age 26 regardless of marital or student status for medical, dental, vision, and voluntary life
• Your unmarried children of any age who are incapable of supporting themselves due to a mental or physical disability and who are dependent on you
MAKING CHANGES DURING THE YEAR
Choose your benefits carefully. Medical, dental, vision and flexible spending contributions are made on a pre-tax basis and IRS regulations state that you have to experience a qualifying life event in order to make changes during the plan year.
Qualifying life events include but are not limited to:
• Marriage or divorce
• Death of your spouse/partner or dependent
• Birth or adoption of a child
• Your spouse/partner terminating or obtaining new employment (that affects eligibility for coverage)
• You or your spouse/partner switching employment status from full-time to part-time or vice versa (that affects eligibility for coverage)
• Significant cost or coverage changes
• Your dependent no longer qualifies as an eligible dependent
You must notify and submit any applicable forms and/or documentation to Human Resources within 30* calendar days of the event. Human Resources will review your request and determine whether the change you are requesting is allowed. Only benefit changes which are consistent with the qualifying life event are permitted.
As a benefits eligible employee, you have the once-a-year opportunity to enroll in or make changes to your benefit plans during our annual enrollment period unless you experience a qualifying life event.
Our benefits plan year runs from September 1, 2024 - December 31, 2025
Some benefits are provided to you at no cost by The Langley School. The cost of other benefits is shared by you and The Langley School. Additional benefits, such as voluntary life, are paid by you at discounted group rates.
Having benefit options available means you can build your benefits to meet your needs and your lifestyle.
PAYROLL DEDUCTIONS
Medical / Prescription
Dental
Vision
Basic Life and AD&D
Short-Term Disability
Long-Term Disability
The Langley School & You
The Langley School & You
The Langley School & You
The Langley School
The Langley School
The Langley School
Voluntary Life and AD&D You
Life Assistance Program (LAP) The Langley School
Flexible Spending Accounts (FSA) You
Pet Insurance You
Legal & ID Theft You
Payroll deductions for the medical, dental and vision plan options effective 9/1/2024 - 12/31/2025
Employee Cost Per Pay Period
Employee Cost Per Pay Period
HEALTH CARE PLAN INFORMATION
IN-NETWORK ADVANTAGE
Consider your health care options highlighted in this guide. Some plans give you the freedom to use any healthcare provider of your choice. However, when you use an in-network provider, the percentage you pay out-of-pocket will be based on a negotiated fee, which is usually lower than the actual charges. If you use a provider who is outside of the network, you may be responsible for paying the difference between your insurance carrier’s allowable charges and what the provider charges. This is called balance billing. Allowable charges are set by the insurance carrier and are the amounts that are generally considered reasonable based on what most providers charge for a particular service in a geographic area.
COPAYMENTS AND COINSURANCE
A copayment (copay) is the fixed dollar amount you pay for certain in-network services. In some cases, you may be responsible for the deductible or coinsurance after the copay is made.
Coinsurance is the percentage of covered expenses shared by the employee and the plan. For example, if you pay 20% of an in-network covered charge, the plan pays 80%. In some cases, coinsurance is paid after the member meets a deductible.
ANNUAL DEDUCTIBLE
Your annual deductible is the amount of money you must first pay before your plan begins paying for services covered by coinsurance. Some services, such as office visits, may require copays and may not apply to the deductible.
• Your annual medical deductible is on a calendar year basis
• Your annual dental deductible is on a calendar year basis
After you meet your deductible, the plan pays for a percentage of eligible expenses (coinsurance) until you meet your out-of-pocket maximum. If you receive services from an out-of-network provider, you may have a larger deductible and the plan may pay a lower percentage of coinsurance. Refer to your health care plan summaries for more information.
OUT-OF-POCKET MAXIMUM
Some plans feature an out-of-pocket maximum, which limits the amount you will pay for eligible health care expenses. Once you reach that maximum, the plan begins to pay 100% of eligible expenses. There may be separate in- and out-of-network out-of-pocket maximums. All copays, deductibles and coinsurance accrue to the out-ofpocket maximums.
• Your annual out-of-pocket maximum is on a calendar year basis
MEDICAL BENEFITS: PREVENTIVE CARE SERVICES
Preventive care is covered in-network at 100% (no deductible or copay) for those services that are generally linked to designated routine wellness exams and screenings. Examples of preventive care services include:
• Annual routine physicals, immunizations (subject to age frequency / limitations)
• Cholesterol screening
• Mammograms, pap smears, pelvic exams
• PSA (Prostate Specific Antigen) exams
There may be limits on how often you can receive preventive care treatments and services. You should ask your health care provider whether your visit is considered preventive or non-preventive care. Please refer to https:// www.healthcare.gov/coverage/preventive-care-benefits/ for a list of eligible preventive services.
MEDICAL BENEFITS
Providing comprehensive and quality medical coverage at a reasonable cost is a challenge for all employers. The Langley School meets this challenge by providing employees with Cigna’s High Deductible HSA eligible and $500 deductible $25/$50 copay plans that include prescription drug coverage. The information below is a summary of medical coverage only. Please contact Cigna or Human Resources for plan summaries detailing coverage information, limitations, and exclusions. Any deductibles, copays, and coinsurance percentages shown in the chart below are amounts for which you are responsible.
In-Network Prescription Drug
MEDICAL BENEFITS
Providing The information below is a summary of medical coverage only. Please contact Cigna or Human Resources for plan summaries detailing coverage information, limitations, and exclusions. Any deductibles, copays, and coinsurance percentages shown in the chart below are amounts for which you are responsible.
In-Network Prescription Drug
Pharmacy Out-of-Pocket Maximum is combined with medical. There is no prescription deductible.
Retail: Up to a 30-day supply
Home Delivery & Preferred Pharmacies: Up to a 90-day supply
Providing The information below is a summary of medical coverage only. Please contact Cigna or Human Resources for plan summaries detailing coverage information, limitations, and exclusions. Any deductibles, copays, and coinsurance percentages shown in the chart below are amounts for which you are responsible.
In-Network Prescription Drug
Pharmacy Out-of-Pocket Maximum is combined with medical. There is no prescription deductible.
Retail: Up to a 30-day supply
Home Delivery & Preferred Pharmacies: Up to a 90-day supply
Precertification is a review to determine if a medical service requested by a doctor or other health care professional will be covered under an individual’s health care plan before that service occurs.
When certain elective procedures or services are scheduled, the provider is required to have it pre-certified through Cigna in advance. If your physician is in-network with Cigna, it’s the network physician’s office responsibility to have the service pre-certified. If the doctor is not in the Cigna network, and the plan covers out-of-network services, the individual is responsible for getting precertification – not the doctor.
It is also important to understand what services have this requirement in advance of it being performed. Confirm with the physician’s office prior to your service date that this step has taken place to avoid delays or non-payments.
Some examples of services that require provider precertification
• INPATIENT HOSPITALIZATION
• OUTPATIENT SURGERY / PROCEDURES
• OUTPATIENT PAIN MANAGEMENT / TESTING
• ADVANCED RADIOLOGY (MRI/CT SCAN)
Approvals – Cigna reviews precertification requests against established criteria for that procedure. If the information provided to Cigna meets the clinical criteria, the doctor will receive an approval and an appointment can be scheduled.
Expected authorization turnaround time for high-tech radiology services (assuming all necessary clinical information has been submitted by the doctor) is approximately 2 to 3 business days for routine requests.
HEALTH SAVINGS ACCOUNT (HSA)
HSA BANK
866.494.2111
| MYCIGNA.COM
WHAT IS AN HSA PLAN?
A tax advantaged health plan that provides coverage for current medical/pharmacy expenses and allows the option to save for future health expenses. This plan combines a qualified medical plan (medical/pharmacy coverage) with a Health Savings bank account. Money deposited into the HSA is generally not taxable. HSA balances are not lost at year-end (like an FSA) and the balance can be taken with you if/when you leave The Langley School.
AM I ELIGIBLE TO PARTICIPATE?
Since HSA plans have special tax advantages, the IRS defines specific rules on participation. In order to be eligible, you:
• Must be enrolled in a qualified HSA high deductible medical plan (Cigna’s High Deductible Health Plan is a qualified medical plan)
• Cannot have any other health coverage
• Cannot be covered by spouse’s medical or pharmacy plan
• Cannot be covered through Medicare Part A or Part B
• Cannot be covered through a general-purpose Flexible Spending Account (FSA) plan (either Employer’s or Spouse’s)
• Cannot be claimed as a dependent on another person’s tax return
MAXIMUM HSA CONTRIBUTIONS
Because HSAs offer special tax advantages, the IRS puts limits on the maximum amount that can be contributed to the account. This includes both Langley’s contributions and your contributions.
Limits
$4,150 individual coverage
$8,300 family coverage
To make the maximum contribution you must:
Maximum Limits
$4,300 individual coverage
$8,550 family coverage
Age 55 or older: Maximum contribution increases by $1,000 (considered a “catch-up” contribution)
• Meet all eligibility requirements for HSA contribution on January 1
• Remain qualified through the full plan year
LANGLEY HSA CONTRIBUTION
Langley School matches your contribution up to: $50 per month for employee only up to $600 annually and $100 per month for employees with dependents up to $1,000 annually. Langley allows you to change your contribution once per month. However, you must contribute in order to earn the match from Langley.
HSA GUIDELINES
The IRS determines what a “qualified health expense” is and therefore what HSA money can be used for. Qualified health expenses include:
• Expenses eligible under your medical plan
• Expenses incurred after the HSA account is established
• Other expenses typically covered through an FSA: Medical, pharmacy, vision and dental. See comprehensive list on HSABank.com
HSA BANK
How does it work when you need care?
1. You will get a debit card by mail to pay for doctor visits and prescriptions. You must activate the debit card to use it. You will also need to show your health plan ID card when you go to the doctor or pick up a prescription.
2. You can contribute tax-free money to the account, up to a certain amount each year.
3. If there’s money in the HSA, you can use the debit card to pay for health care costs. 2024 Maximum
MEDICAL SERVICES
24/7 HEALTH INFORMATION / NURSE LINE | CIGNA
800.CIGNA.24 (OR USE THE PHONE NUMBER ON THE BACK OF YOUR ID CARD)
Call to talk with a clinician at no extra cost, 24 hours a day, 365 days a year. When you have a high fever, bad cough, or an allergic reaction, you may not be sure where to go for care. A Health Information Line clinician will ask you a few questions about your symptoms. The clinician can give you information to help you decide to go to urgent care, see your doctor, go to the emergency room, or care for yourself at home.
Cigna's Health Information Line is personal and confidential. Instead of worrying and waiting, call and speak directly with a medical professional. We're here with support and guidance for any non-emergency situation, even when your doctor's office is closed. In an emergency, always dial 911 or visit the nearest hospital. Note that this service is only available in the US.
You can also call the Health Information Line to listen to podcasts on dozens of health and wellness topics. CIGNA TELEHEALTH CONNECTION
Cigna provides access to telehealth services as part of your medical plan through MDLIVE. Register today so you’ll be ready to use the telehealth service when and where you need it within the United States**.
This program lets you connect with a board-certified doctor by phone or secure, online video chat if you are traveling** or when you are unable to see your Primary Care Provider (PCP). It’s available anytime, 24 hours a day, 7 days a week, 365 days a year. With Cigna Telehealth you have access to the care you need - including most prescriptions* - for a wide range of minor acute conditions including sore throat, headache, stomachache, fever, cold and flu, allergies, rash, acne, UTI and more.
MDLIVE is only available for medical visits. For covered services related to mental health and substance abuse, you have access to the CIGNA Behavioral Health network of providers. Telehealth visits with Cigna Behavioral Health network providers cost the same as an in-office visit.
• Go to myCigna.com to search for a video telehealth specialist
• Call to make an appointment with your selected provider
EXAMPLES OF NON-EMERGENCY SITUATIONS THAT MAY BE APPROPRIATE FOR TELEHEALTH
GINGER - MENTAL HEALTH PROGRAM | GINGER.COM/CIGNA | HELP@GINGER.COM
Ginger offers confidential mental healthcare through behavioral health coaching via text-based chats, self-guided learning activities and content, and, if needed, video-based therapy and psychiatry. Support is available anytime (24/7/365), anywhere for a variety of mental health challenges you may be struggling withall from the privacy of your smartphone. Coaches can help with any issue you’re struggling with such as stress, anxiety, depression, issues with work, relationships, sleep and more.
To get started:
Download the Ginger emotional support app from your smartphone. Follow the instructions sent to your email. Enter your: First name, last name, DOB and your Member ID # to verify your eligibility. Then, answer a few simple questions, and you’re ready to get started! Choose to schedule an appointment with your coach at a time that works best for you, or chat right away.
RECOVERYONE | CIGNA | RECOVERYONE.COM/CIGNASELECT
RecoveryOne is an online physical therapy program that’s included in your health plan benefits. If you have nagging injuries, muscle aches, or joint pain access RecoveryOne when you want , from the comfort and safety of home. There’s no added cost to you or your covered dependents (ages 18+) to use it. With RecoveryOne for Cigna, you get:
• Customized recovery plans to meet your needs
• A multimedia app that guides you through your exercises
• Video, voice, and chat conversations with your support team
• Weekly check-ins with a certified health coach to help keep you on track
CIGNA ONE GUIDE® | CIGNA | 888.806.5094
Cigna One Guide® service provides personalized assistance to help you:
• Resolve health care issues
• Get the most out of your plan
• Find in-network doctors, hospitals and other providers
• Get cost estimates
• Understand your bills
Call or access the Cigna One Guide support tool by downloading the myCigna App.
CIGNA LIFESTYLE MANAGEMENT PROGRAMS
If weight, tobacco or stress is affecting your ability to live an active life, a health advocate can provide you with personalized support to help you.
• Weight management: Learn to manage your weight using a non-diet approach that helps you build confidence, change habits, eat healthier and become more active.
• Quit tobacco: Develop a personal quit plan to become and remain tobacco-free.
• Reduce stress: Understand the sources of your stress, and learn to use coping techniques to better manage stress both on and off the job.
Use an online or telephone coaching program or both for the support you need.
CIGNA DIABETES PREVENTION PROGRAM
The Cigna Diabetes Prevention Program in collaboration with Omada provides digital support focused on reducing the risk of type 2 diabetes and heart disease through healthy weight loss, nutrition, sleep and exercise. Personalized tools at no extra cost to you:
• Digital enabled scale
• Omada professional health coach
• Social support group
• Interactive online training lessons on healthy eating, physical activity, sleep and stress
DENTAL BENEFITS
800.244.6224 | MYCIGNA.COM | GROUP NUMBER: 0633565
Dental coverage is a key component of your overall health and wellness. The Langley School offers you access to a dental plan through Cigna which covers four main types of expenses: Preventive and Diagnostic Services, Basic Services, Major Services, and Orthodontia.
• Preventive and Diagnostic Services: Routine exams and cleanings, x-rays, sealants and fluoride treatments (age restrictions and frequency applies)
• Basic Services: Fillings and extractions, root canals, oral surgery, and periodontics
• Major Services: Crowns, bridgework, implants anddentures
• Orthodontia: Included for adults and children (to age 19)
Children are covered for Preventive, Basic and Major Services to age 26. Orthodontics are covered for children up to age 19.
When you choose a participating, in-network provider, you will have lower out-of-pocket costs, will not be subject to balance billing, and your claims will be submitted to insurance by the dentist on your behalf.
VISION BENEFITS
INCOME PROTECTION
BASIC LIFE AND AD&D INSURANCE
The Langley School provides you with basic life insurance and accidental death and dismemberment (AD&D) coverage administered by Cigna / NY Life with a benefit of one times your annual salary up to a maximum of $200,000. The AD&D coverage matches the life benefit. Refer to the benefit summary for the benefit reduction schedule for basic life.
VOLUNTARY LIFE & AD&D INSURANCE
You have the option to elect additional life and AD&D insurance with Cigna / NY Life for yourself, your spouse, and your children. The accidental death and dismemberment (AD&D) coverage matches the voluntary life amount. Coverage must be elected within 30 days of your date of hire or medical evidence of insurability will be required. Guaranteed Issue is available during your initial eligibility period or one time open enrollment for September 2023. Refer to the plan summaries for low-cost, age-related rates and the benefit reduction schedule.
Notes: To purchase coverage for either your spouse or child(ren), you must enroll in employee coverage. You pay 100% of the cost for this coverage. Life and Accidental Death and Dismemberment amounts must match.
For Yourself
In increments of $10,000 to a maximum $250,000 or 5x your annual earnings.
For Your Spouse
In increments of $5,000 to a maximum of 50% of employee election up to $125,000
For Your Children
In increments of $5,000 from $5,000 to a maximum $15,000
Child coverage:
Birth to 6 months: $1,000 6 month to 26 years: $5,000-$15,000
Employee Guarantee Issue amount:
$100,000
SHORT-TERM DISABILITY
Spouse/Partner Guarantee Issue amount: $30,000
All amounts guaranteed
Short-term disability (STD) coverage is provided through Cigna / NY Life. STD insurance pays a monthly benefit in the event you cannot work because of more than 5 days of disability. Benefits provide you with 60% of your weekly salary up to a $1,000 weekly maximum. Payments continue up to 60 days. The Langley School pays for these benefits. STD benefits are taxable.
LONG-TERM DISABILITY
Long-term disability (LTD) coverage is also paid for by The Langley School and provided through Cigna / NY Life. LTD insurance pays a monthly benefit in the event you cannot work because of 60 days of disability. Benefits provide you with 60% of your monthly salary up to a $12,000 monthly maximum. Payments continue as long as you are disabled until your social security normal retirement age.
The Langley School will continue to pay the premium for this coverage. We will automatically change the plan to be taxable on the premiums and the benefits will be tax free. You may opt out of this once a year at Open Enrollment, giving you the opportunity to switch from taxable or non-taxable.
VALUE ADDED SERVICES
LIFE ASSISTANCE PROGRAM (LAP) | 800.538.3543
From health and wellness support to help with life’s everyday needs and challenges, the Life Assistance Program can help with life challenges from personal, work and family, caregiving, bereavement, legal, financial to pet care issues, just to name a few. This program also helps you avoid the impact of unscheduled absences and lost productivity to your business. You’ll have access to unlimited 24/7 Toll-Free assistance including but not limited to:
• Information, resources, and referrals on family matters, such as child and elder care
• Legal information and referrals for situations requiring expertise in family law, and estate planning
• Guidance with financial matters, including household budgeting, and short- and long-term planning
• Up to three sessions with a counselor per person, per issue, per year
HEALTH ADVOCACY SERVICES |
866.799.2725
Health Advocacy Services offers you expert assistance with a wide range of healthcare and health insurance issues. This service is available to you, your spouse, dependents, parents and parents-in-law to get the answers you need, when you need them, 24/7, at no additional cost to you.
MY SECURE ADVANTAGE PROGRAM |
888.724.2262
This is a full-service financial wellness program that can help support the financial health of your household at no additional cost to you. All you’ll need to give is your name, city, state, zip code and the name of your employer (The Langley School). My Secure Advantage Program includes:
Money Coaching:
• Free 30-minute consultation with a certified financial expert before you decide to participate in Money Coaching
• Individuals and couples can work with a designated Money Coach for 30 days, paid for by Cigna
• Your Money Coach can help you handle a wide range of financial challenge, including but not limited to: Basic money management, getting out of debt, saving for college or retirement, purchasing a home, marriage or divorce, loss of income, death in the family, and more
• Through an easy-to-use online portal, you can communicate with your Coach, view educational webinars and access a library of financial tools, forms and tips
What’s more, individuals who would like to continue working with their money coach beyond the NYL GBSpaid 30-day coaching period may do so on a self-pay basis of $39.95 per month.
If you don’t participate in Money Coaching you can get a 25% discount on tax planning and preparation.
Identity theft prevention and will preparation:
• Identity theft services including a fraud resolution kit and consultation with a Fraud Resolution Specialist for victims of identity theft or to learn how to better protect oneself from identity theft
• Online resources to create and execute state-specific wills, powers of attorney and a variety of other important legal documents
• Free 30-minute legal consultation with a licensed practicing attorney to obtain legal advice or review legal documents, and a 25% discount off of standard fixed or hourly attorney’s fees
VALUE ADDED SERVICES
Assistance for domestic or international travel
An emergency can be much more difficult to deal with when traveling, whether it is on the other side of the world, or only a couple of hours away from home. In the event that an unfortunate situation arises – injury, illness, arrest, death, lost or stolen items – New York Life Group Benefit Solutions (NYL GBS) Secure Travel is just a phone call away, 24/7/365!
NYL GBS Secure Travel provides pre-trip planning, assistance while traveling and emergency medical transportation benefits for covered persons traveling 100 miles or more from home. Services include, but not limited to:
Pre-Trip Planning
• Immunization requirements & Visa and passport requirements
• Foreign exchange rates
• Travel advisories and weather conditions
Traveling Assistance
• 24-hour multilingual assistance and referral to interpretation and translation services
• Referrals to physicians, dentists, medical facilities and legal assistance providers
• Arrangements for payment of medical expenses up to $10,000 if required prior to treatment
• Assistance with lost or stolen items, including luggage and prescription replacement services
Emergency Assistance
• Emergency evacuation and repatriation, when medically necessary; arrange and cover the cost of
FLEXIBLE SPENDING ACCOUNTS
PRIMEPAY
877.769.3539 | PRIMEPAY.COM
Flexible Spending Accounts (FSAs) help you save money by allowing you to pay for certain types of health care and dependent care expenses on a pre-tax basis. You decide how much money to put aside annually in one or both FSAs. This annual amount is then deducted evenly from each pay period and deposited into your FSA. When you incur an eligible expense, you can be reimbursed once you submit a claim and that claim is approved. You will be reimbursed through PrimePay.
GENERAL PURPOSE HEALTHCARE ACCOUNT
This year Langley School will have a short FSA plan year that runs from September 1, 2024 through December 31, 2024. Starting January 1, 2025 and going forward, Langley will run the FSA plan year from January to December. In November 2024, you will have an opportunity to make FSA elections for the January to December 2025 plan year.
For benefits-eligible employees, this is your opportunity to enroll in the FSA. To have FSA coverage for the short plan year and then for the new January to December 2025 plan year, you must enroll at each open enrollment in ADP Workforce Now.
The chart below shows the pro-rated amounts for the short FSA plan year. For this short plan year, the IRS will allow employees to rollover $640 of unused funds into the next FSA plan year of 1-1-2025 to 12-31-2025.
ACCOUNT
General Purpose Healthcare FSA
9-1-2024 TO 12-31-2024 PLAN YEAR CONTRIBUTION LIMITS
*NoteligibleifenrolledintheHSA $1,066.67 maximum Dependent Care FSA
GENERAL PURPOSE HEALTHCARE ACCOUNT
Coverage includes all qualified dependents, including spouse. Eligible expenses include all qualified 213(d) medical expenses not reimbursed by other insurance, including vision expenses, dental expenses, and overthe counter medicines and medical supplies.
Coverage includes dependents thru age 12; disabled/elder tax dependents (regardless of age). Eligible expenses include day care centers, providers of care outside of the home, provider who comes to your home, before/after school care, and summer day camps. Expenses for a child in nursery school, pre-school, or similar programs for children below the level of kindergarten are eligible. Expenses to attend kindergarten or a higher grade, summer school, overnight camps, and tutoring are not eligible expenses.
The Langley School’s Legal Resources program offers you an opportunity to enroll in the Legal Resources® legal plan as part of your benefits. As a Legal Resources Member, you’ll have immediate and ongoing access to comprehensive legal coverage, services, and expertise that will easily save you money. Legal Resources has been providing comprehensive legal services and representation for members and their families for over 20 years. The cost per pay check for the Legal Resources benefit is $9.50. For additional information, as well as the enrollment form for Legal Resources, please reach out to Human Resources.
The Langley School offers you identity theft protection through Legal Resources’ Identity Theft Protection. Identity theft is a serious crime and occurs when your personal information is stolen and used without your knowledge to commit fraud or other crimes. Identity theft not only costs you time and money, but it can negatively impact your credit.
Common ways ID Theft Occurs:
• Dumpster Diving – they rummage through your trash looking for bills or other paper with personal information included
• Skimming – they steal credit/debit card numbers by using a special storage device when processing your card
• Phishing – they pretend to be financial institutions or companies and send spam or pop-up message to get you to reveal your personal information
• Changing your Address – they divert your bills to another location by completing a “change of address” form
Theft Protection monitors your personal information and alerts you if there are any changes; it helps you to know and improve your credit score, protect your personal information on-line and keep your keystrokes, pin numbers, and credit card information safe. You can choose to enroll in the Identity Theft Protection Gold or Platinum plan.
Gold Plan
Individual plan: $4.98 per pay
Family plan: $9.95 per pay
Platinum Plan
Individual plan: $8.48 per pay
Family plan: $16.95 per pay
For additional information on these benefits please reach out directly to Human Resources.
IRA
The Langley School offers a ROTH IRA option through TIAA, to its investment portfolio. The Roth IRA allows the individual to save for retirement with money that has already been taxed. When one retires, upon meeting plan requirements, withdrawals are typically tax-free.
If you would like to enroll and contribute to the Roth IRA, please contact Nadia Boga.
PET INSURANCE
PET BENEFIT PLANS FROM PET BENEFIT SOLUTIONS | 800.891.2565
The Langley School offers you access to pet benefits through Pet Benefit Solutions. You can choose to enroll in one, two, or all three plans.
VETERINARY DISCOUNT PLAN | PET ASSURE | 888.789.7387
Pet Assure Veterinary Discount Plan will save you hundreds on your pets’ healthcare care every year by giving you access to quality veterinary care at a discounted rate. As a member, you receive an instant 25% discount on all in-house medical services at participating veterinarians, including savings on wellness, sick and emergency care. There are no exclusions based on type, breed, age, or health of your pets. All pets are eligible for Pet Assure, and even pre-existing and hereditary conditions are covered. Do you have multiple pets? No problem, each one can be enrolled, there is no per pet price, just one low rate per family. Pet Assure can be used as an alternative or complement to pet insurance. A list of participating veterinarians is on MyLangley.
Pet Assure Perks:
• 25% discount on all in-house medical services by network veterinarians
• Can be used an UNLIMITED number of times
• Includes 24/7 lost pet recovery service from ThePetTag
• Enroll today by reaching out directly to Human Resources for the group rate ($4.25 per pay / $8.50 per month) and enrollment instructions.
• You can find participating vets by visiting: www.petbenefits.com/search
PRODUCT & PRESCRIPTION DISCOUNT PLAN | PETPLUS (DOGS & CATS ARE ELIGIBLE)
The PetPlus Product and Prescription Discount Plan provides you with members-only pricing (up to 40% off) and free shipping on everything your pet needs! Shop for your pet’s food, treats, toys, prescriptions, preventatives, and more at PetCareRx.com. Human-grade prescriptions can be picked up same-day at over 60,000 Caremark pharmacies like CVS, Walgreens and Walmart. PetPlus also includes 24/7 Pet Telehealth, which provides live support from a US-based veterinarian on your pet’s health, from the comfort of your home. Enroll any dog or cat, no exclusions, and start saving on your pets’ products and prescriptions with PetPlus! The premium for PetPlus is $4.50 per month, $2.25 per pay period for a single pet; and $8.50 a month and $4.25 per pay period for an unlimited family plan.
PET HEALTH INSURANCE | PETS BEST
TO OBTAIN A QUOTE PLEASE VISIT: WWW.PETBENEFITS.COM/PB/LANGLEY
Pets Best Pet Health Insurance offers a comprehensive pet health insurance plan with 90% reimbursement on accidents, illnesses, surgeries, emergencies, exam fees and more. You can visit any veterinarian. Employees enjoy low deductibles, no annual limit and discount rates. Pets Best has fast claims processing and payment. You can also add routine care coverage for wellness visits, dental cleanings and preventatives. It’s easy to get a quote – you just need your pet’s breed, age and zip code. All plans include a 24/7 pet help line. To generate your pet’s custom quote visit: petbenefits.com/land/Langley Pet insurance is administered by Pets Best Insurance Services, LLC and is underwritten by American Pet Insurance Company, a New York insurance company. Please visit www.americanpetinsurance.com to review all available pet health insurance products. Terms and conditions apply. See policy for details.
ANNUAL NOTICES
Langley School plans are partially arranged by Langley Schools and governed by its plan rules and documents. ERISA and various other state and federal laws require that employers provide disclosure and annual notices to their plan participants. Langley Schools distributes annual notices to new-hires, and each year during open enrollment. You may also request a copy by contacting your HR department.
The following are a list of Annual Notices:
• Medicare Part D Notice of Creditable Coverage: Plans are required to provide each covered participant and dependent a Certificate of Creditable Coverage to qualify for enrollment in Medicare Part D prescription drug coverage when qualified without a penalty.
• HIPAA Notice of Privacy Practices: This notice is intended to inform employees of the privacy practices followed by Q2 Impact. group health plan. It also explains the federal privacy rights afforded to you and the members of your family as plan participants covered under a group plan.
• Women's Health and Cancer Rights Act (WHCRA): This act contains important protections for breast cancer patients who choose breast reconstruction with a mastectomy.
• Newborns’ and Mothers’ Health Protection Act: This act affects the amount of time a mother and her newborn child are covered for a hospital stay following childbirth.
• Special Enrollment Rights: Plan participants are entitled to certain special enrollment rights outside of Langley Schools open enrollment period. This notice provides information on special enrollment periods for loss of prior coverage or the addition of a new dependent.
• Medicaid & Children’s Health Insurance Program: Some states offer premium assistance programs for those who are eligible for health coverage from their employers, but are unable to afford the premiums. This notice provides information on how to determine if your state offers a premium assistance program.
• Summary of Benefits and Coverage (SBC): Health insurance issuers and group health plans are required to provide you with an easy-to-understand summary about your health plan’s benefits and coverage.
The Affordable Care Act (ACA)’s penalty for not having health coverage (known as the individual mandate) has been eliminated. However, if you are a taxpayer in California, Massachusetts, New Jersey, Rhode Island, or the District of Columbia, you will be required to have health coverage (unless you qualify for an exemption) or pay the penalty for the 2024 tax year – these states have an individual mandate requirement.
You may consider these options below to satisfy this requirement:
• Enroll in a medical plan offered by Q2 Impact. or another group medical plan meeting the requirements for minimum essential coverage;
• Purchase coverage through a health insurance marketplace;
• Enroll in coverage through a government-sponsored program if eligible. If you choose to purchase coverage through the marketplace, because Q2 Impact. medical plans are considered affordable and meet minimum value under the Affordable Care Act, you may not be eligible for a subsidy, and you may not see lower premiums or out-of-pocket costs through the marketplace. In addition, employer contributions to your medical benefits will be lost, and your portion of medical premiums will no longer be paid via payroll deductions on a pre-tax basis.
YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What Is “Balance Billing” (Sometimes Called “Surprise Billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
You Are Protected From Balance Billing For:
Emergency Services
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these poststabilization services.
Certain Services at an In-network Hospital or Ambulatory Surgical Center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-ofnetwork. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.
You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of -network. You can choose a provider or facility in your plan’s network.
What When Balance Billing Isn’t Allowed, You Also Have the Following Protections:
• You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
• Your health plan generally must:
• Cover emergency services without requiring you to get approval for services in advance (prior authorization).
• Cover emergency services by out-of-network providers.
• Base what you owe the provider or facility (cost-sharing) on what it would pay an in network provider or facility and show that amount in your explanation of benefits.
• Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
Visit https://www.cms.gov/nosurprises for more information about your rights under federal law.
What Happens to Your Current Coverage If You Decide to Join a Medicare Drug Plan?
If you decide to join a Medicare drug plan, your current The Langley School coverage will not be affected. If you drop your coverage with The Langley School and enroll in a Medicare prescription drug plan, you may not be able to get this coverage back later. You should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of Medicare prescription drug coverage in your area.
When Will You Pay a Higher Premium (Penalty) to Join a Medicare Drug Plan?
You should also know that if you drop or lose your current coverage with The Langley School and don’t join a Medicare drug plan within 63 continuous days after you current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go 19 months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following November to join.
For More Information About this Notice or Your Current Prescription Drug Coverage
To obtain more information about this notice or your current prescription drug coverage, contact Human Resources. You’ll get this notice each year. You may receive this notice at other times in the future such as before the next period you can enroll in Medicare prescription drug coverage, and if this coverage changes. You may request a copy of this notice at any time.
For More Information About Your Options Under Medicare Prescription Drug Coverage
More detailed information about Medicare plans that offer prescription drug coverage is in the Medicare & You handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.
For more information about Medicare prescription drug coverage:
• Visit www.medicare.gov
• Call your State Health Insurance Assistance Program (see your copy of the Medicare & You handbook for their telephone number) for personalized help
• Call 1-800-Medicare (1-800-633-4227)
TTY users should call 1-877- 486-2048
Remember: Keep this notice. If you enroll in one of the Medicare-approved plans offering prescription drug coverage, you may need to provide a copy of this notice when applying for the coverage to show that you are not required to pay a higher premium amount.
