Annual Benefit Enrollment

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1 9/01/2015-8/31/2016 Annual Benefit Enrollment Irving ISD Enrollment is from 07/20/2015 through 08/31/2015 Benefit Updates - What s New: TRS is now offering an HMO plan, Scott & White Health Voluntary Term Life/AD&D by Cigna offers new hires the Plan (SWHP) Under SWHP you must use providers who option to elect life insurance up to the Guarantee Issue belong to the SWHP network. For more information visit (GI) amount of $250,000 for themselves and $50,000 for or call (800) their spouse. Employees that currently have a life election below the GI can increase their coverage $10K - $50K All employees will be required to login and re-elect or during enrollment up to the GI without an application. re-decline medical and other elections that are Employees that did not elect term life last year can elect contingent on being enrolled in medical (ex. HSA, up to $10,000 without health questions asked. MEDlink ). These elections will not automatically roll to the plan year. All other supplemental elections Benefit elections will become effective 9/1/2015. In order from the plan year (ex. dental, vision) will roll to to receive a medical card by Sept 1, you must enroll in the plan year. benefits by August 13th. Elections requiring Evidence of Insurability, such as Life Insurance, may have a later The IRS maximum for FSA Health Care reimbursement is effective date, if approved. After 8/31/15, benefit changes now $2,550 annually or $ per month. Your FSA can only be made if you experience a qualifying event and includes a 90 day run-out period and a 75 day grace any changes must be made within 30 days of event. period at the end of the plan year. American Public Life Cancer Insurance is enrolled on a The new HSA annual maximums for 2015 contributions Guarantee issue (GI) basis with no health questions asked. are $3,350 for individual and $6,650 for family. Don t Forget! Login and complete your benefit enrollment from 7/20/2015 8/31/2015. ENROLLMENT ASSISTANCE: Call Financial Benefit Services at to speak to a representative. Asistencia de inscripción está disponible llamando al Financial Benefit Services para hablar con un representante. Update your profile information: home address, phone numbers, and . Update dependent social security numbers and student status for college aged children. Irving ISD Employee Benefits HUB: Benefit Information Access / Online Enrollment Access / FBS Contact Information

2 Benefit Summary Flexible Spending Accounts (FSA) Tax-sheltered flexible spending accounts allow an individual to set aside pre-tax dollars to pay for future health care and dependent care expenses. Please remember to keep your receipts if you use your Flex Card. 1) Eligible expenses must be incurred within the plan year. Contributions are use it or lose it. 2) The annual maximum for medical reimbursement is $2,550 annually or $ per month. 3) The annual maximum for dependent care reimbursement is $5,000 if you are married or $2,500 if single. 4) You may not participate in both the Health Savings Account and the Medical Reimbursement FSA. Run-Out Period: Your FSA includes a 90 day run-out period after the plan year ends. During this time period, you may file claims for expenses incurred during the plan year. When the run-out period is over, you forfeit any unused funds. Example: On August 31, your plan year ends, but your plan includes a 90-day run-out period. You have until 11/30 to submit claims for expenses incurred from Sept 1 to Aug 31 of the previous plan year. Grace Period: Your FSA also includes a 75 day grace period. This feature creates a grace period that immediately follows the end of the plan year. During this time frame, you may incur expenses and use the funds remaining in your account toward eligible FSA expenses. The grace period begins on the first day immediately following the last day of the plan year, and in most cases, ends two months and 15 days later. The grace period ensures that you have the opportunity to maximize your FSA funds and avoid forfeiting money through the IRS use-it-or-lose-it rule. Example: Your plan year ends August 31; the grace period is two months and 15 days. Beginning Sept 1 through Nov 15 of the following year, you can incur expenses and get reimbursed by using the remaining funds left in your FSA from the prior plan year. Health Savings Account by HSA Bank An HSA is a tax free savings account available to employees enrolled in a high deductible health plan (HDHP). Deposited funds are tax deductible and are used to pay for medical expenses. 1) The annual contribution maximum for 2015 is $3,350 for individual and $6,650 for family. 2) For individuals who are between the ages of 55 and over, there is an additional catch-up provision of $1,000 that can be contributed annually. 3) This plan is only available for those who are participating in Active Care 1-HD. 4) You are not eligible to contribute to an HSA if you are currently enrolled in Medicare. 5) You may not enroll in the Medical Reimbursement FSA or the MEDlink plan if you participate in the Health Savings Account. MEDlink by American Public Life This plan provides supplemental coverage to help offset out-of-pocket costs from deductibles and coinsurance of your employer s medical plan. Plan includes an in-hospital benefit, out-patient benefit, and a physician benefit. This policy has limitations and exclusions. You may not enroll in the MEDlink plan if you participate in a Health Savings Account. Telehealth by Teladoc This plan allows employees of and their household members to call in to a licensed network doctors who will diagnose common conditions, recommend treatment plans, and prescribe non-controlled medications when appropriate. This is only an outline of benefits. If the terms of this benefit summary differ from your policy, the policy will govern.

3 Benefit Summary Dental Insurance by Cigna Two PPO options and a DHMO option are available. 1) PPO Options: The PPO plans allow you the freedom to choose your dentist. Each plan covers preventive at 100%. Type I services are paid at 100%, Type II services are paid at 80% and Type III services are paid at 50%. Orthodontics are covered only for children to age 19, with a $1,000 lifetime maximum. No Waiting Periods. - There is a $1,500 annual maximum on the High plan and $750 annual maximum on the Low plan. - The Low Option is a MAC plan which means that if you visit an out-of-network provider you may be responsible for some of the costs. 2) DHMO: The DHMO plan requires you to visit an in-network provider. No annual maximums or waiting periods. All services are paid per the plan schedule and co-pay amount so plan participants always know the out-of-pocket costs. Employees must choose a dentist upon enrollment in the DHMO plan. Disability Protection by Unum This plan provides a monthly income to an individual that is disabled due to an accident or illness. There are different plans options with benefits becoming available from the 1st day of disability to as late as the 60th day. Eligible employees can enroll or increase coverage for up to a $8,000 monthly benefits, not exceeding 66 2/3% of your annual salary. Plan rates are based on age. Vision Insurance by Superior Vision Members pay a co-pay for in-network benefits. Exams, lenses, and frames (within plan allowances) are covered in-network once every 12 months. Out-of-network vision services are reimbursed up to a certain dollar amount. Exam co-pay is $10.00 and materials co-pay is $ Cancer Insurance by American Public Life Plan allows enrollment on a Guarantee Issue basis (no health questions asked). However, this plan has a 12-month pre-existing condition exclusion. Cancer insurance is designed to be a supplement and pays for many costs not covered by your major medical plan. This plan has 2 options available: 1) High Option Plan: $1,000/month Radiation/Chemo benefit, $200/day Hospital Confinement benefit, and includes a lump sum Critical Illness benefit. 2) Low Option Plan: $500/month Radiation/Chemo benefit and $100/day Hospital Confinement benefit. Term Life/AD&D Insurance by Cigna Irving ISD provides eligible employees with $12,000 of Base Life/ AD&D coverage as an employer paid benefit. Voluntary Term Life/AD&D is available as an age-banded rate plan that allows benefits up to $500,000 for the employee (based on salary). New hires can elect up to $250,000 or 5X salary in coverage with no health questions asked. In addition, spouses of new employees can enroll up to $50,000 with no health questions asked. Employees that currently have a life election below $250,000 can increase their coverage $10,000 - $50,000 during enrollment up to $250K without health questions asked. Employees that currently do not have a life election can elect $10,000 worth of coverage without an application. Child(ren) Life benefits are available up to a maximum of $10,000. Legal Club of America This plan provides free and discounted legal care, tax preparation, and financial education. Benefits also include identity theft protection and counseling/personal consultation services. This is only an outline of benefits. If the terms of this benefit summary differ from your policy, the policy will govern.

4 Irving ISD Plan Year September 1, August 31, 2016 TRS ActiveCare Medical Insurance Tier ActiveCare 1-HD ActiveCare Select ActiveCare 2 Employee Only $0 $132 $273 Employee + Spouse $573 $781 $1,137 Employee + Children $274 $421 $651 Employee + Family $890 $990 $1,180 Employee Only $0 $66 $ Employee + Spouse $ $ $ Employee + Children $137 $ $ Employee + Family $445 $495 $590 Employee Only $0 $88 $182 Employee + Spouse $382 $ $758 Employee + Children $ $ $434 Employee + Family $ $660 $787 Scott & White HMO Employee Only $ $81.30 $ Employee + Spouse $ $ $ Employee + Children $ $ $ Employee + Family $ $ $ Employee and Family Split Rates TRS ActiveCare 1 - HD TRS ActiveCare Select TRS Active Care 2 Employee + Family $ $ $ Employee works for Irving ISD and their spouse works at another school offering TRS AcitveCare Medical. Employee and Family Pooled Rates ` Employee + Family $ $ $ Both employee and their spouse works for Irving ISD. Cigna Dental Insurance High PPO Calendar year maximum of: $1,500 per insured person. Tier Employee Only $29.78 $14.89 $19.85 Employee + Spouse $51.00 $25.50 $34.00 Employee + Children $70.98 $35.49 $47.32 Employee + Family $99.90 $49.95 $66.60 Low MAC Plan Calendar year maximum of: $750 per insured person. Tier Employee Only $20.88 $10.44 $13.92 Employee + Spouse $35.78 $17.89 $23.85 Employee + Children $49.80 $24.90 $33.20 Employee + Family $70.06 $35.03 $46.71 DHMO Participant must choose an in-network primary care dentist. Tier Employee Only $13.79 $6.90 $9.19 Employee + Spouse $27.58 $13.79 $18.39 Employee + Children $35.31 $17.66 $23.54 Employee + Family $38.76 $19.38 $25.84

5 Unum Long-Term Disability Insurance Guarantee Issue open enrollment every year. Superior Vision $125 frame allowance and $130 contact lens allowance. Waiver of elimination period upon hospital Exam/Lenses/Contacts: 12 months and Frames 24 months. confinement with 30/30 elimination or less. Employee Only $7.98 Pregnancy covered same as any illness. Employee + Spouse $15.76 Can elect up to 66 2/3% of salary to a max of $8,000. Employee + Children $15.44 Plan A Ages (Pays to Age 65) Employee + Family $23.50 Elimination Period Rates p/$500 0/7 $14.50 Cigna Voluntary Life Insurance 14/14 $10.95 Employee Guarantee Issue: $250,00 or 5x Salary 30/30 $6.85 Spouse Guarantee Issue: $50,000 60/60 $3.95 Child Guarantee Issue: $10,000 Employee Rates p/$10,000 Spouse Rates p/$5,000 American Public Life Cancer Under 30 $0.40 Under 30 $0.20 Two base plan Options with different benefit amounts $ $ Month Pre-existing condition limitation $ $0.30 Intensive Care Unit Rider $ $0.50 Low Option Rates: $ $0.80 Individual $ $ $ Parent Family $ $ $2.40 Family $ $ $3.45 Low Option w/icu Rider Rates: $ $5.80 Individual $ $ N/A 1 Parent Family $ $ N/A Family $ $ N/A High Option Rates: Child Rates Individual $27.40 Per $5,000 $ Parent Family $38.50 Family $49.20 Cigna Voluntary AD&D High Option w/icu Rider Rates: Cost per $10,000 Individual $30.70 Employee Only $ Parent Family $43.00 Employee + Spouse $0.25 Family $56.10 Employee + Children $0.28 Employee + Family $0.32 NBS Flexible Spending Accounts Healthcare Reimbursement Maximum: $2,550 Dependent Care Reimbursement Maximum: $2,500 American Public Life MEDlink Two Plan Options: $1,500 and $2,500 or $5,000 (Dependent Care Maximum is based on Tier $1,500 $2,500 Marital Status) Employee Only $32.67 $38.29 Employee + Spouse $75.59 $88.49 HSA Bank Health Savings Accounts Employee + Children $59.08 $68.62 Individual Maximum $3,350 Employee + Family $ $ Family Maximum $6,650 Legal Club of America Legal Benefits Teladoc Telehealth Full Family Coverage is available at no cost for Legal Services, Tax Preparation, Financial Services, ID Theft, and Counseling. employees that enroll in ActiveCare 1-HD or Rates waive medical. Family $14.00 Online benefit information at Toll Free Assistance (866)