dilley isd EMPLOYEE BENEFITs CENTER
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1 PLAN YEAR: September 1, 2018 August 31, 2019 dilley isd What s inside? EMPLOYEE BENEFITS CENTER HOW TO ENROLL S125 PLAN INFORMATION FLEXIBLE SPENDING ACCOUNTS AVAILABLE RESOURCES BENEFITS AT A GLANCE CONTACT INFORMATION EMPLOYEE BENEFITs CENTER CHUCK EGLI, ACCOUNT MANAGER 2009 RANCH RD 620 N STE 123, AUSTIN TX OFFICE: CHUCK.EGLI@FFGA.COM
2 This guide contains a summary of the benefits offered by your employer. If there is a conflict between the terms of this outline of benefits and the actual contracts, the terms of the contracts will prevail. For a more detailed explanation of benefits you may contact your Account Manager or First Financial Administrators at or visit
3 Employee benefits center NEW employee benefits center - your guide to your benefits! We ve created a custom site just for you! Find detailed information about current and upcoming benefits, voluntary product offerings and employer programs, Section 125 & Flex Information, important contact numbers and links, and downloadable forms and brochures.
4 Section 125 Plan Information and rules A Section 125 Plan provides a tax-saving way to pay for eligible medical or dependent care expenses. The funds are automatically deducted from your paycheck on a pre-tax basis. Here s How It Works A Section 125 Plan reduces your taxes and increases your spendable income by allowing you to deduct the cost of eligible benefits from your earnings before tax. Plus, the plan is available to you at no cost, and you re already eligible. All you have to do is enroll. Is It Right for Me? The savings you may experience with a Section 125 Plan are outlined below. By utilizing the Section 125 Plan, you would have $70 more every month to apply toward insurance benefits or other needs. That s a savings of $840 a year!
5 Flexible Spending Accounts Medical FSA Medical Flexible Spending Accounts (FSA) allow you to set aside pre-tax payroll deductions each paycheck to pay for out of pocket medical, dental and vision expenses for you and your family. During open enrollment you will estimate the amount you think you will need during the year. This amount will be taken out of each paycheck. Your full annual election will be available to you at the beginning of the plan year. Your employer has chosen the $500 Roll-Over Option for your plan. This option allows you the opportunity to roll over $500 of unclaimed Medical FSA funds into the following plan year. Any amount in excess of $500 will be forfeited under the use-it-or-lose-it rule. FSA Plan Year is: SEPTEMBER 1, 2018 AUGUST 31, 2019 FSA MAX: The maximum you can set aside each year is $2,650. DEPENDENT CARE FSA With a Dependent Care Flexible Spending Account (FSA), you can set aside part of your pay on a pre-tax basis to pay for eligible dependent care expenses, such as: Day Care Centers Before/After School Care Mothers-Day-Out Program Nursery Schools Babysitters Nanny Au Pair/Day Camps You may allocate up to $5,000 per tax year for reimbursement of dependent day care services. ($2,500 if you are married and file a separate tax return). This account allows you to pay for day care expenses for your qualifying dependent/child with pre-tax dollars while you (and your spouse) are working, seeking employment, and/or attending school as a full time student (for at least five months of the year). Eligible dependents must be claimed as an exemption on your tax return. For full plan details, view the FSA Booklet available on the Employee Benefit Center.
6 RESOURCES FOR FSA MANAGEMENT FLEXIBLE BENEFITS CARD The Flex Benefits Card is available to all employees that participate in Medical FSA and or a Dependent Care FSA. The Benefits Flex Card gives you immediate access to your money at the point of purchase. Cards are available for participating employees, their spouse and eligible dependents that are at least 18 years old. The IRS requires validation of most transactions. You must submit receipts for validation of expenses when requested. If you fail to substantiate by providing a receipt to First Financial within 60 days of the purchase or date of service your card will be suspended until the necessary receipt or explanation of benefits from your insurance provider is received. FF FLEX MOBILE APP With the FF Flex Mobile App you can submit claims, view account balance & history, see claim status, view alerts, upload receipts and documentation and more! The FF Flex Mobile App is available for Apple or Android TM devices on the App Store SM or the Google Play Store TM. Your Employer ID Number is FFA850. You must have this number or your Flex Benefits Card number to register your account on the FF Flex Mobile App. FSA STORE First Financial has partnered with the FSA Store to bring you an easy to use online store to better understand and manage your FSA. Visit for more details & special deals! Shop at FSA Store for eligible items from bandages to wheel chairs and thousands of products in between Browse or search for eligible products and services using the FSA Eligibility List Visit the FSA Learning Center to help find answers to questions you may have about your FSA
7 Benefits at a Glance Visit for rates and benefit information. Disability American Fidelity Disability insurance pays a cash benefit and is designed to help protect you if you can t work due to a covered injury or sickness. It pays a monthly benefit amount based on a percentage of your gross income, so you may continue to pay for everyday living expenses. CANCER INSURANCE Allstate If cancer touches someone in your family, this plan may help ease the impact on your finances. Benefit payments are made directly to you, allowing you to pay for expenses like copayments, hospital stays, and house and car payments. Accident Insurance - allstate Accidents are inevitable. Even though you can t always prepare for unforeseen events, you can plan ahead. Accident Insurance is designed to help cover some of the expenses that can result from a covered accident, and benefit payments are made directly to you. Critical Illness Insurance American fidelity *** new *** If you experience an event such as a heart attack or stroke, Critical Illness Insurance may help. It pays a lump sum amount to help with expenses that may not be covered by major medical insurance house payments, everyday expenses, lost income, and more. Dental - humana Oral care can be a significant financial expense. Having dental insurance can help cover the costs. Help keep your family's smiles healthy with dental insurance.
8 Benefits at a Glance Visit for rates and benefit information. Vision superior Vision insurance is a way to help cover expenses incurred for eye care services from eye care professionals such as optometrists and ophthalmologists. Regular eye exams can offer more than just measuring your eye sight! They can identify serious eye diseases early, allowing time for treatment. Most people don't realize that eye exams can also reveal the early signs of serious illnesses like diabetes, heart disease and high blood pressure. Permanent, Portable Life Insurance texas life Ensuring your family is financially covered in the event of a loss is an important way of showing them you care about their needs. Life Insurance can help. Portable, Individual Life Insurance policies may help your family in the event of your death. The application process is simple. You only have to answer three health questions, and there are no medical exams required. GROUP LIFE - dearborn Group life insurance allows you to purchase affordable life insurance on yourself, spouse and dependent children. This is term insurance, available as long as you are employed by district. Employees enrolling in the coverage after the first 31 days of their employment will be subject to insurability and must complete a health questionnaire prior to coverage being issued. Term Life Insurance American fidelity Life insurance is an important purchase to make. It is impossible for life insurance to emotionally compensate for a loss, but it may help ease the financial obligations left to your loved ones such as your mortgage, college tuition, other debts, and daily living expenses. Term Life Insurance offers protection during your peak earning years when you have financial responsibilities such as paying a mortgage or supporting your family whole Life Insurance American fidelity *** new *** A whole life insurance product that provides a guaranteed level death benefit, guaranteed cash value, and guaranteed level premiums up to age 121.
9 SGB0174A Humana Dental Preventive Plus 14 TEXAS Calendar-year deductible (excludes orthodontia services) Calendar-year annual maximum (excludes orthodontia services) Preventive services Routine oral examinations (2 per year) Bitewing x-rays (2 films under age 10, up to 4 films ages 10 and older) Routine cleanings (2 per year) Fluoride treatment (1 per year, through age 14) Sealants (permanent molars, through age 14) Space maintainers (primary teeth, through age 14) Oral Cancer Screening (1 per year, ages 40 and older) Basic services Emergency care for pain relief Amalgam fillings (1 per tooth every 2 years, composite for anterior/front teeth) Composite fillings (1 per tooth every 2 years, molar teeth) Oral surgery (routine extractions) If you use an IN-NETWORK dentist Individual $50 Family $150 Dilley ISD If you use an OUT-OF-NETWORK dentist Individual $50 Family $150 Deductible applies to all services excluding preventive services. $1, % no deductible 100% no deductible 80% after deductible 80% after deductible More Value Basic services Stainless steel crowns Harmful habit appliances for children Major services Crowns Inlays and onlays Bridges Dentures Denture relines/rebases Denture repair and adjustments Implants Periodontics (gums) Endodontics (root canals) Orthodontia services Adult and child orthodontia These services are not covered under this plan. Members may receive a discount on non-covered services and may contact their participating provider to determine if any discounts are available on non-covered services. Non-participating dentists can bill you for charges above the amount covered by your HumanaDental plan. To ensure you do not receive additional charges, visit a participating PPO Network dentist. Members and their families benefit from negotiated discounts on covered services by choosing dentists in our network. If a member visits a participating network dentist, the member will not receive a bill for charges more than the negotiated fee for covered services. If a member sees an out-of-network dentist, coinsurance will apply to the maximum allowable charge of one or more network providers in your geographic area. Out-of-network dentists may bill you for charges above the amount covered by your dental plan Humana.com Page 1 of 5
10 Humana Dental Preventive Plus 14 Waiting periods Employer-sponsored funding: 10+ enrolled employees Enrollment type Preventive Basic Major Orthodontia Initial enrollment, open enrollment No No Not available Not available and timely add-on Late applicant 1 No 12 months Not available Not available 1 Late applicants not allowed with open enrollment option. Monthly rates* (12 deductions per year) Employee $13.57 Employee + 1: $32.33 Family: $54.26 * This is not a substitute for a quote. Rates must be approved by HumanaDental underwriting Humana.com Page 2 of 5
11 SGB0174A Humana Dental Traditional Plus 14 TEXAS Calendar-year deductible (excludes orthodontia services) Calendar-year annual maximum (excludes orthodontia services) Preventive services Routine oral examinations (2 per year) Bitewing x-rays (2 films under age 10, up to 4 films ages 10 and older) Routine cleanings (2 per year) Fluoride treatment (1 per year, through age 14) Sealants (permanent molars, through age 14) Space maintainers (primary teeth, through age 14) Oral Cancer Screening (1 per year, ages 40 and older) Basic services Emergency care for pain relief Amalgam fillings (1 per tooth every 2 years, composite for anterior/front teeth) Composite fillings (1 per tooth every 2 years, molar teeth) Oral surgery (tooth extractions including impacted teeth) Stainless steel crowns Harmful habit appliances for children (1 per lifetime, through age 14) Major services Crowns (1 per tooth every 5 years) Inlays/onlays (1 per tooth every 5 years) Bridges (1 per tooth every 5 years) Dentures (1 per tooth ever 5 years) Denture relines/rebases (1 every 3 years, following 6 months of denture use) Denture repair and adjustments (following 6 months of denture use) Implants (1 every 5 years limited to crowns, bridges, and dentures. Coverage limited to equivalent cost of a non-implant service. Implant placement itself is not covered) Periodontics (periodontal cleanings 4 per year, scaling/root planing and surgery 1 per quadrant every 3 years) Endodontics (root canals 1 per tooth per lifetime and 1 re-treatment) Orthodontia services If you use an IN-NETWORK dentist Individual $50 Family $150 Dilley ISD If you use an OUT-OF-NETWORK dentist Individual $50 Family $150 Deductible applies to all services excluding preventive services. $1,000 After you reach the annual maximum amount, you will receive 30 percent coinsurance on preventive, basic, and major services for the rest of the year (excludes orthodontia.) 100% no deductible 100% no deductible 80% after deductible 80% after deductible 50% after deductible 50% after deductible Adult/child orthodontia. Plan pays 50 percent (no deductible) of the covered orthodontia services, up to: $1,000 lifetime orthodontia maximum Humana.com Page 1 of 5
12 Humana Dental Traditional Plus 14 Non-participating dentists can bill you for charges above the amount covered by your HumanaDental plan. To ensure you do not receive additional charges, visit a participating PPO Network dentist. Members and their families benefit from negotiated discounts on covered services by choosing dentists in our network. If a member visits a participating network dentist, the member will not receive a bill for charges more than the negotiated fee for covered services. If a member sees an out-of-network dentist, coinsurance will apply to the usual and customary charge. Out-of-network dentists may bill you for charges above the amount covered by your dental plan. Waiting periods Employer-sponsored funding: 10+ enrolled employees Enrollment type Preventive Basic Major Orthodontia Initial enrollment, open enrollment No No No No and timely add-on Late applicant 1, 2 No 12 months 12 months 12 months 1 Late applicants not allowed with open enrollment option. 2 Waiting periods do not apply to endodontic or periodontic services unless a late applicant. Monthly rates* (12 deductions per year) Employee $26.84 Employee + 1: $53.54 Family: $87.44 * This is not a substitute for a quote. Rates must be approved by HumanaDental underwriting Humana.com Page 2 of 5
13 Vision Plan Benefits for Dilley ISD Co-Pays Monthly Premiums Services/Frequency Exam $10 Emp. only $6.67 Exam 12 months Materials 1 $25 Emp. + spouse $13.25 Frame 12 months Contact Lens Fitting $25 Emp. + child(ren) $12.97 Contact Lens Fitting 12 months (standard & specialty) Emp. + family $19.74 Lenses 12 months Benefits through Superior National Network Contact Lenses (Based on date of service) In-Network Out-of-Network Exam (Ophthalmologist) Covered in full Up to $42 retail Exam (Optometrist) Covered in full Up to $37 retail Frames $125 retail allowance Up to $50 retail Contact Lens Fitting (standard 2 ) Covered in full Not covered Contact Lens Fitting (specialty 2 ) $50 retail allowance Not covered Lenses (standard) per pair Single Vision Covered in full Up to $26 retail Bifocal Covered in full Up to $34 retail Trifocal Covered in full Up to $50 retail Progressive lens upgrade See description 3 Up to $50 retail Contact Lenses 4 $120 retail allowance Up to $100 retail 12 months Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements 1 Materials co-pay applies to lenses and frames only, not contact lenses 2 See your benefits materials for definitions of standard and specialty contact lens fittings 3 Covered to provider s in-office standard retail lined trifocal amount; member pays difference between progressive and standard retail lined trifocal, plus applicable co-pay. 4 Contact lenses are in lieu of eyeglass lenses and frames benefit Discount Features Look for providers in the Provider Directory who accept discounts, as some do not; please verify their services and discounts (range from 10%-30%) prior to service as they vary. Discounts on Covered Materials Frames: Lens options: Progressives: 20% off amount over allowance 20% off retail 20% off amount over standard progressive retail The following options have out-of-pocket maximums 5 on standard (not premium, brand, or progressive) lenses. Maximum Member Out-of-Pocket Single Vision Bifocal & Trifocal Scratch coat $13 $13 Ultraviolet coat $15 $15 Tints, solid or gradients $25 $25 Anti-reflective coat $50 $50 Polycarbonate $40 20% off retail High index 1.6 $55 20% off retail Photochromics $80 20% off retail Discounts on Non-Covered Exam and Materials Exams, frames, and prescription lenses: Lens options, contacts, other prescription materials: Disposable contact lenses:. 30% off retail 20% off retail 10% off retail 5 Discounts and maximums may vary by lens type. Please check with your provider. SuperiorVision.com Customer Service Refractive Surgery Superior Vision has a nationwide network of refractive surgeons and leading LASIK networks who offer members a discount. These discounts range from 15%-50%, and are the best possible discounts available to Superior Vision. 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 Services, Inc. P.O. Box 967 Rancho Cordova, CA SuperiorVision.com The Superior Vision Plan is underwritten by National Guardian Life Insurance Company. National Guardian Life Insurance Company is not affiliated with The Guardian Life Insurance Company of America, AKA The Guardian or Guardian Life NVIGRP BSv2/TX
14 Benefits at a Glance Visit for rates and benefit information. RETIREMENT OPTIONS First Financial offers a variety of options to help supplement your future income and help achieve your financial goals Which One Is Right for Me? A 403(b) Plan allows you to reduce your federal taxable income by the amount you choose to contribute. A 457(b) Plan is a deferred compensation plan that allows eligible employees to save for retirement by deferring compensation with pre-tax dollars. With a Traditional IRA, contributions may be tax deductible, and earnings grow tax-deferred. With a Roth IRA, contributions are made with after-tax dollars, and it offers the possibility of withdrawing account earnings on a tax-free basis.
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16 IMPORTANT CONTACTS Chuck egli, ACCOUNT MANAGER OFFICE: Benefit Vendor Phone Website Medical TRS ActiveCare Aetna Dental Humana Vision Superior Disability American Fidelity Accident Allstate Cancer Allstate Critical Illness American Fidelity Life Texas Life Group Life Dearborn Whole Life American Fidelity HSA (Health Savings Account) Medical FSA and Dependent Care American Fidelity Afhsa.americanfidelity.com First Financial
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