GEORGETOWN ISD BENEFIT OVERVIEW GUIDE

Transcription

1 GEORGETOWN ISD BENEFIT OVERVIEW GUIDE Plan Year: May 1, 2014 through August 31, 2015 Benefit Information Provided By: First Financial Group of America Austin Branch Office 2009 Ranch Road 620N, Ste # 123 Austin, TX

2 Table of Contents Introduction... 1 Online Enrollment Instructions... 2 Section 125 Cafeteria Plan Overview Medical Reimbursement Overview... 4 Dependent Care Reimbursement Overview... 4 Benefit Overview SUPPLEMENTAL INSURANCE AVAILABLE AFLAC Products Accident Insurance... 7 Cancer Insurance... 7 Hospital Indemnity Plan... 7 Hospital Intensive Care (ICU) Plan... 7 Critical Illness Plan... 8 Dental Insurance Disability Insurance Health Savings Account Life Insurance Group Life Insurance Permanent Life Insurance Term Life Insurance Long Term Care Insurance Vision Insurance Customer Service Numbers and Websites... 34

3 Introduction First Financial has been hired by Georgetown Independent School District to explain and enroll all benefit plans with the exception of the health plan. The following is a guide to supplemental insurance benefits that are offered to all fulltime eligible employees of Georgetown Independent School District. This description only outlines the coverages that are offered. For a full and complete understanding of the products, please read the product brochures and discuss any questions with the Insurance representatives. When reviewing the plans and premiums, remember that the cost will be deducted on a pre tax basis for most products. * The Life Insurance and Disability products should not be pre-taxed. The Plan Year for Georgetown ISD is May 1, 2014 through August 31, This guide contains a summary of the benefits offered by Georgetown 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. For a more detailed explanation of benefits you may contact First Financial Administrators at or visit the website listed below. Your Benefits Website: Visit for detailed information. 1 1

4 Online Enrollment Instructions How do I view my benefits? Conveniently view your benefits for the upcoming plan year at work or at home through our secure, online website. Where do I go to view my benefits? Go to What is my login and PIN? Your login is your social security number ( ). Your pin is the last four digits of your social security number and the last two numbers of your birth year (678977). Once you login you will see a Welcome presentation. Once finished Click Next, then:» Verify your personal information» Verify all dependent information (ssn/date of birth) **Very Important**» View employment information You will then see a brief presentation on each benefit available. Notify the Business Office/Payroll Department of any discrepancies. Useful Information to know» You must enroll in Medical Reimbursement & Dependent Care Reimbursement every year. (Flex plans do NOT automatically renew)» Write your PIN number down.» Contact First with any technical questions.» No changes will be allowed until annual enrollment (unless you have an IRS S125 approved event) 2 2

5 Section 125 Cafeteria Plan First Financial Administrators, Inc. As a district employee, you are eligible to participate in a Section 125 Flexible Benefit Plan. Enrollment opportunities are limited to the plan year dates for your district. Although coverage is voluntary (you may pick and choose), every employee is required to sign their Section 125 Benefit Election Form, even if they select no benefits or choose to keep current benefits the same. A Section 125 Flexible Benefit Plan allows you, the employee, to select from a list of available benefits that will meet your family s healthcare needs. Certain benefit premiums are deducted from your gross earnings before federal withholding taxes are figured. The amount you elect to have deducted pre-tax actually lowers your taxable income. By implementing this plan, your employer is helping you reduce your taxes and increase your take home pay. You cannot change your elections during the plan year except for certain specified changes in family status. Those changes include:» Marriage» Divorce» Death of a spouse/child» Birth or adoption of a child» Termination of spouse s employment You must notify your employer within 31 days of the qualifying event to make changes. Section 125 Plan Sample Paycheck 3 3

6 Flexible Spending Accounts - First Financial Group Flexible Spending Accounts are tax-favored accounts that allow participants to set aside money pretax for eligible Medical and Dependent Care costs. Flexible Spending Accounts (FSAs) allow an employee the opportunity to put some of his/her salary aside before taxes to pay for many common out-of-pocket expenses. Use-it-or-lose-it refers to an IRS requirement. If you do not spend all the money you have elected, it will be forfeited because it cannot be rolled over or refunded to you. Any money that you elect to set aside in a flexible spending account for a given Plan Year may be used only for eligible expenses you incur for services received during that Plan Year. So, it s very important that you plan carefully when deciding on how much to allot for your FSAs. You have the entire plan year to incur qualified expenses. You have 90 days after the plan year for reimbursement of expenses to be filed. Georgetown Independent School District has opted to change the Flexible Spending Account. You may carry over up to $500 of unused funds from your FSA at the end of the plan year to the following plan year. These funds may be used to pay for or reimburse medical expenses under the FSA incurred during the plan year to which it is carried over. You will no longer have the extra two and a half months to incur expenses. The first Plan Year for flexible spending is May 1, August 31, This will be a one time only four month plan year. The purpose of the four month plan year is to match up the supplemental plan year with the medical plan year. The next twelve month flexible spending period will be September 1, 2104 to August 31, Medical Reimbursement Your medical reimbursement account may be used to reimburse you for expenses that you incur for treatment of yourself, spouse and dependent children during your plan year. Eligible medical expenses include deductibles and coinsurance amounts under a group health plan, charges that are in excess of the amount reimbursed under a group health plan, and charges that are not covered under a group health plan such as certain corrective surgeries, vision care, dental care and hearing aids. Effective January 1, 2011, all over -the counter medications eligible for reimbursement must be accompanied by a doctor s prescription. Maximum contribution amount for 2014/2015 plan year is $2,500 ($ per month). Reminder If you or your spouse participate in a Qualified High Deductible Health Plan and contribute to a Health Savings Account, you are not eligible to enroll in Medical Reimbursement. FFA Benefits Card The FFA benefits card is available for Medical Reimbursement Flexible Spending Accounts. This card may be used in lieu of cash for any out of pocket medical expenses only. It is a signature debit card and does not require a pin for use. Cards are good for three years from the issue date as long as you participate each consecutive plan year. Cards can be issued to spouses and dependent children (ages 18 to 26) for no additional fee. Dependent Care Reimbursement This benefit allows you to pay for dependent care expenses with pre-tax dollars. The maximum amount for Dependent Care Reimbursement is $5,000 per plan year. Dependent daycare center expenses are eligible if the care is for your dependent under age 13 and for any other qualifying dependent (including adult dependents), who regularly spends at least 8 hours each day in your household. 4 4

7 Accident Insurance - AFLAC Benefits Overview The accident plan helps cover the expenses for emergency room costs, follow-up treatments, medical imaging, hospital confinement, and many other expenses associated with accidental injuries. This plan can help with medical expenses and living costs when you get hurt unexpectedly. Cancer Insurance - AFLAC Cancer insurance is designed to be a supplemental insurance that pays for many of the costs not covered by your major medical. This plan pays in addition to other coverage you may have. There are several option riders available such as spousal rider, critical illness rider and cobra rider, giving you the flexibility for the best coverage to meet your needs. Dental Insurance Ameritas Dental Ameritas Dental offers two different plans, depending on your needs. Both plans allow you to see the dentist of your choice. No waiting periods, not even for major services or orthodontics for children. Disability Income Insurance - American Fidelity Assurance Company This insurance is designed to protect your ability to earn an income. This plan will provide you with income (up to 70% of your salary) should you become disabled as a result of a covered accident or illness. The plan has various waiting periods you can select from depending on your own personal situation. Extra benefit: doctor bill benefit payable (if you are sick, miss a day of work, and go to a doctor) for out-of-pocket expenses up to $50 for illness and $150 for an accidental injury. Flexible Spending Plans - First Financial Administrators, Inc. Georgetown ISD allows employees to set aside up to $2,500 per year for unreimbursed medical expenses and/or up to $5,000 per year for dependent day care expenses on a pre-tax basis. Federal regulations effective January 1, 2011, will exclude over-the-counter medications from being eligible expenses. Health Savings Account - American Fidelity Health Svc. Administration A Health Savings Account is offered to Georgetown ISD employees through American Fidelity Health Services Administration. Please see your First Financial Representative for detailed plan information. 6 5

8 Intensive Care Insurance AFLAC This benefit pays for up to 15 days, when a covered person incurs a charge for confinement in a hospital Intensive Care Unit there is no lifetime maximum. Other benefits of this policy include a major organ transplant benefit, and an ambulance benefit. Life Insurance Group Term Life Insurance - UNUM Georgetown ISD offers Group Life insurance through UNUM. You may apply for coverage up to four times your annual salary. Additional coverage is also available for spouse and dependent children. Individual Life Insurance - Texas Life Georgetown ISD is offering its employees the opportunity to purchase individual permanent life insurance through Texas Life. These policies are portable at the same price and coverage. Cover- age can be purchased for dependents including spouses, children, and grandchildren. Coverage is guaranteed to age 121. Term Life Insurance - American Fidelity Assurance Term Life insurance is a policy that covers you during your earning years when you need it the most. You choose the term, 10, 20, or 30 years that you decide is best for you and your family. Long Term Care Insurance - LifeSecure Georgetown ISD is offering employees a Long Term Care plan through Lifesecure. This benefit will help protect your financial independence and preserve your freedom to choose how to live life on your terms and reduce the effects of long term care on your family. Major Medical Georgetown Independent School District offers the following choices for major medical benefits through TRS Active Care: Blue Cross Blue Shield (PPO Plans) Scott & White (HMO Plan) Medical GAP Insurance - AFLAC The Hospital Confinement Indemnity Plan helps with the out-of-pocket costs not covered by your health insurance. Benefits include: Wellness Benefit, Outpatient Surgical Benefit, Hospital Confinement Benefit, and Rehabilitation Unit Benefit. Vision Insurance Block Vision Block Vision is the vision provider for Georgetown ISD. There are two plans available, so that you 7 6

9 Georgetown ISD Benefits Overview and Monthly Premiums Accident Plan Pays cash benefits for any covered accidental injury on and off the job. Initial office visit benefit of $120, then $35 per follow-up, first day of hospital confinement pays $1,250, daily benefits of $250 thereafter. Injury benefits up to $12,500, plus a $60 wellness and more. Refer to brochure for full details of coverage/limitations and exclusions. Accident Plan Individual Emp. + Spouse 1 Parent Family 2 Parent Family Age $21.58 $30.55 $34.97 $45.50 Cancer Plan Pays cash benefits for diagnosis and treatment of cancer while coverage is in force. Benefits include $4,000 for diagnosis (with $500/year annual building benefit available as a rider), weekly radiation & chemotherapy, $200 daily hospital confinement, surgery, transportation & lodging, experimental treatment, $75 annual wellness and more. Refer to brochure for full details of coverage/limitations and exclusions. Cancer Care Individual Emp. + Spouse 1 Parent Family 2 Parent Family Age $31.72 $53.95 $31.72 $53.95 Hospital Indemnity Plan Pays $50 for ER/Physician (per visit) plus $25 (per visit) for Well Baby Care. 1 st day of hospital confinement triggers $1,650 then $150 per day each day thereafter for up to 180 days. Surgical and anesthesia benefits pay up to $1,500 plus prescription drug benefits. Excellent if planning to have children. Refer to brochure for full details of coverage/limitations and exclusions. Hospital Plan Individual Emp. + Spouse 1 Parent Family 2 Parent Family Age $44.68 $88.57 $67.86 $ Hospital Intensive Care (ICU) Plan Pays $700 daily cash benefits for days 1-7 in ICU, $1,200 per day days 8-15, $350 per day through day 30. Excellent if planning to have children this year or for basic catastrophic coverage. Refer to brochure for full details of coverage/limitations and exclusions. ICU Plan Individual Emp. + Spouse 1 Parent Family 2 Parent Family Age $10.40 $20.80 $20.41 $24.57 Age $11.31 $20.80 $20.41 $24.57 Age $13.65 $25.35 $22.36 $27.43 Age $15.47 $30.94 $28.86 $

10 Critical Illness Plan Pays a lump sum benefit of $5,000 to $50,000 ($20,000 guarantee-issue for GISD employees/$10,000 for spouse) for heart-attack, open heart surgeries, invasive heart procedures, renal failure, major human organ transplant, paralysis, severe burns, coma, loss of speech, sight and/or hearing and more. Also includes a $50 annual wellness benefit. Dependent children may be covered at no cost. Refer to brochure for full details of coverage/limitations and exclusions. $20,000 Benefit (non-tobacco) Individual $10,000 Benefit for Spouse (non-tobacco) Spouse Coverage adds additional: Age $12.74 Spouse Age $7.28 Age $19.54 Spouse Age $10.66 Age $39.14 Spouse Age $20.46 Age $64.44 Spouse Age $33.10 Age $ Spouse Age $51.74 Helpful Numbers: Aflac customer service: AFLAC ( ) Aflac claims fax: AFLAC ( ) Aflac claim forms are available at 8

11 Georgetown ISD Dental Highlight Sheet Low Plan: Dental Plan Summary Effective Date: 05/01/2014 Coinsurance Type 1 100% Type 2 50% Type 3 30% Deductible $25/Calendar Year Type 2 & 3 Waived Type 1 3 Family Maximum Maximum (per person) $750 per calendar year Allowance Contracted Fee Waiting Period None Sample Procedure Listing (Current Dental Terminology American Dental Association.) Type 1 Type 2 Type 3 Routine Exam Space Maintainers Onlays (1 in 6 months) Bitewing X-rays (1 in 12 months) Full Mouth/Panoramic X-rays (1 in 5 years) Periapical X-rays Cleaning (1 in 6 months) Fluoride for Children 13 and under (1 in 6 months) Sealants (age 14 and under) Restorative Amalgams Restorative Composites Simple Extractions Crowns (1 in 10 years per tooth) Crown Repair Endodontics (nonsurgical) Endodontics (surgical) Periodontics (nonsurgical) Periodontics (surgical) Denture Repair Prosthodontics (fixed bridge; removable complete/partial dentures) (1 in 10 years) Complex Extractions Anesthesia Monthly Rates Employee Only (EE) $19.96 EE + Spouse $39.12 EE + Children $41.20 EE + Spouse & Children $56.78 Ameritas Information We're Here to Help This plan was designed specifically for the associates of Georgetown ISD. At Ameritas Group, we do more than provide coverage - we make sure there's always a friendly voice to explain your benefits, listen to your concerns, and answer your questions. Our customer relations associates will be pleased to assist you 7 a.m. to midnight (Central Time) Monday through Thursday, and 7 a.m. to 6:30 p.m. on Friday. You can speak to them by calling toll-free: For plan information any time, access our automated voice response system or go online to ameritasgroup.com/member. Rx Savings Our valued plan members and their covered dependents (even their pets) can save on prescription medications through any Walmart or Sam's Club pharmacy across the nation. This Rx discount is offered at no additional cost, and it is not insurance. To receive the Walmart Rx discount, Ameritas plan members just need to visit us at ameritasgroup.com and sign into (or create) a secure member account where they can access and print an online-only Rx discount savings ID card. 9

12 Georgetown ISD Dental Highlight Sheet High Plan: Dental Plan Summary Effective Date: 05/01/2014 Coinsurance Type 1 100% Type 2 80% Type 3 50% Deductible $50/Calendar Year Type 2 & 3 Waived Type 1 3 Family Maximum Maximum (per person) $1,000 per calendar year Allowance 80th U&C Waiting Period None Orthodontia Summary - Child Only Coverage Allowance U&C Coinsurance 50% Lifetime Maximum (per person) $1,000 Waiting Period None Sample Procedure Listing (Current Dental Terminology American Dental Association.) Type 1 Type 2 Type 3 Routine Exam Space Maintainers Onlays (1 in 6 months) Restorative Amalgams Crowns Bitewing X-rays Restorative Composites (1 in 10 years per tooth) (1 in 12 months) Simple Extractions Crown Repair Full Mouth/Panoramic X-rays Endodontics (nonsurgical) (1 in 5 years) Endodontics (surgical) Periapical X-rays Periodontics (nonsurgical) Cleaning Periodontics (surgical) (1 in 6 months) Denture Repair Fluoride for Children 13 and under Implants (1 in 6 months) Prosthodontics (fixed bridge; removable Sealants (age 14 and under) complete/partial dentures) (1 in 10 years) Complex Extractions Anesthesia Monthly Rates Employee Only (EE) $42.80 EE + Spouse $83.40 EE + Children $85.04 EE + Spouse & Children $ Ameritas Information We're Here to Help This plan was designed specifically for the associates of Georgetown ISD. At Ameritas Group, we do more than provide coverage - we make sure there's always a friendly voice to explain your benefits, listen to your concerns, and answer your questions. Our customer relations associates will be pleased to assist you 7 a.m. to midnight (Central Time) Monday through Thursday, and 7 a.m. to 6:30 p.m. on Friday. You can speak to them by calling toll-free: For plan information any time, access our automated voice response system or go online to ameritasgroup.com/member. 10

13 AMERICAN FIDELITY ASSURANCE COMPANY S Long-Term Disability Income Insurance 7 Georgetown ISD 11

14 Disability Income Protection? IT S A FACT: Disability causes nearly 50% of all mortgage foreclosures each Disability 50% Death 2% year. 1 A Disability plan is a great source for providing the income protection you need. It basically works as insurance on your income: when you are unable to work due to a disability, you would receive benefits to help pay for life s necessities. American Fidelity s Long Term Disability Income Insurance may help you avoid becoming another disability statistic: Other 48% 70% of workers can only cover normal living expenses for six months or less if they lose their income. 2 Disabling injuries led to economic losses and lost quality of life valued at about $13,199 per person in Statistics beg to differ. On average, a disabling injury occurs every 1.2 seconds 4 and currently, the average long-term disability absence lasts 2.5 years. 5 But, the good news is that with a Long Term Disability Plan from American Fidelity, you can maintain the same quality of life you had before your disability. Plan benefits are paid directly to you and can be used however you d like! Don t Wait Any Longer Protect Your Paycheck Today with American Fidelity s Disability Income Insurance!

15 Benefits are paid directly to you, not to a doctor or your employer. Convenient payroll deduction. Benefit payments may be directly deposited into your bank account. Benefits paid due to a covered Accidental Injury or Sickness. Several benefit plan options are available. You choose the best plan for you! VALUABLE BENEFITS INCLUDE: Benefits Payable Year-Round Return To Work Benefit Donor Benefit Worksite Accommodation Benefit Evaluation Physician Expense Benefit Accidental Injury - $ Sickness - $50.00 Social Security Filing Assistance Hospital Confinement Benefit Waiver Of Premium Accidental Death Benefit BENEFITS BEGIN Plan I - On the 1st day of Disability due to a covered Accidental Injury and on the 4th day of Disability due to a covered Sickness. BENEFITS ARE PAYABLE Up to the period of time shown in the table below, based on your age as of the date of Disability due to a covered Accidental Injury or Sickness begins. Plan II - On the 15th day of Disability due to a covered Accidental Injury or Sickness. Plan III - On the 31st day of Disability due to a covered Accidental Injury or Sickness. Plan IV - On the 61st day of Disability due to a covered Accidental Injury or Sickness. Age Maximum Benefit Period Plan V - On the 91st day of Disability due to a covered Accidental Injury or Sickness. Plan VI - On the 151st day of Disability due to a covered Accidental Injury or Sickness. 9 13

16 Several benefit options are available to you. You may participate in the Plan under any one of the benefit levels outlined below, provided the Monthly Disability Benefit level selected does not exceed 70% of your regular monthly salary. Your monthly salary is defined as your annual compensation divided by 12. *Higher Monthly Disability Benefit amounts available, up to $7,500, based on your monthly salary. Monthly Salary Monthly Disability Benefit* MONTHLY PREMIUMS - PLAN I (1ST/4TH) Accidental Death Benefit Under & Over 10 14

17 You may participate in the Plan under any one of the benefit levels outlined below, provided the Monthly Disability Benefit level selected does not exceed 70% of your regular monthly salary. Your monthly salary is defined as your annual compensation divided by 12. *Higher Monthly Disability Benefit amounts available, up to $7,500, based on your monthly salary. Monthly Salary Monthly Disability Benefit* MONTHLY PREMIUMS - PLAN II (15TH) Accidental Death Benefit Under & Over 11 15

18 You may participate in the Plan under any one of the benefit levels outlined below, provided the Monthly Disability Benefit level selected does not exceed 70% of your regular monthly salary. Your monthly salary is defined as your annual compensation divided by 12. *Higher Monthly Disability Benefit amounts available, up to $7,500, based on your monthly salary. Monthly Salary Monthly Disability Benefit* MONTHLY PREMIUMS - PLAN III (31ST) Accidental Death Benefit Under & Over 12 16

19 You may participate in the Plan under any one of the benefit levels outlined below, provided the Monthly Disability Benefit level selected does not exceed 70% of your regular monthly salary. Your monthly salary is defined as your annual compensation divided by 12. *Higher Monthly Disability Benefit amounts available, up to $7,500, based on your monthly salary. Monthly Salary Monthly Disability Benefit* MONTHLY PREMIUMS - PLAN IV (61ST) Accidental Death Benefit Under & Over 13 17

20 You may participate in the Plan under any one of the benefit levels outlined below, provided the Monthly Disability Benefit level selected does not exceed 70% of your regular monthly salary. Your monthly salary is defined as your annual compensation divided by 12. *Higher Monthly Disability Benefit amounts available, up to $7,500, based on your monthly salary. Monthly Salary Monthly Disability Benefit* MONTHLY PREMIUMS - PLAN V (91ST) Accidental Death Benefit Under & Over 14 18

21 You may participate in the Plan under any one of the benefit levels outlined below, provided the Monthly Disability Benefit level selected does not exceed 70% of your regular monthly salary. Your monthly salary is defined as your annual compensation divided by 12. *Higher Monthly Disability Benefit amounts available, up to $7,500, based on your monthly salary. Monthly Salary Monthly Disability Benefit* MONTHLY PREMIUMS - PLAN VI (151ST) Accidental Death Benefit Under & Over 15 19

22 PHYSICIAN EXPENSE BENEFIT Accidental Injury - $ Sickness - $50.00 If you need personal treatment by a Physician due to an Accidental Injury or Sickness, the expense incurred for such treatment will be paid if a claim for no other benefit is made under the Policy; the expense is not for routine dental or eye care; and the expense is not more than the Physician s Expense Benefit amount shown above. This benefit will be paid for Sickness only if the expense is incurred during one full day of Disability during which you missed one full day of work; and you are personally seen and treated by a Physician. To be eligible for more than one payment for the same or related condition, you must have returned to Active Employment for at least 14 consecutive workdays. HOSPITAL CONFINEMENT BENEFIT If you are confined as a Patient in a Hospital due to an Accidental Injury or Sickness, a Hospital Confinement Benefit will be paid for each day you are charged room and board up to 60 days. The Hospital Confinement Benefit will be paid in lieu of any other benefit payable under the Policy. The amount payable is the Disability Benefit which will not be reduced by Deductible Sources of Income and will be pro rated based upon the number of days you are hospital confined. The Hospital confinement must be at least 18 continuous hours in duration. The Hospital Confinement Benefit will begin after your satisfaction of the elimination period. ACCIDENTAL DEATH BENEFIT The Accidental Death Benefit of $20, will be paid if you die as a direct result of an Accidental Injury and death occurs within 90 days after the date of the Accidental Injury. If you die and the Accidental Death Benefit applies, such benefit will be increased 1% for each full month that your Certificate was continuously in force just prior to death. The increase shall not be more than 60%. RETURN TO WORK INCENTIVE BENEFIT Disabled While Working: We will provide a Disability Payment if you are Disabled and your monthly Disability Earnings, if any, are less than 20% of your Monthly Compensation due to the same Sickness or Accidental Injury. If you are Disabled and your Disability Earnings are greater than 20% of your Monthly Compensation due to the same Sickness or Accidental Injury, we will figure your payment as follows: You will receive payments based on the percentage of Monthly Compensation you are losing due to your Disability computed as follows: (a) subtract your Disability Earnings from your Monthly Compensation; (b) divide the answer in item (a) by your Monthly Compensation. This is your percentage of lost earnings; and (c) multiply your Disability Payment by the answer in item (b). We will stop payments and your claim will end, if at any time you are no longer Disabled or if your Disability Earnings exceed 80% of your Monthly Compensation or at the end of 1 year, whichever comes first. The Elimination Period cannot be satisfied with days you are Disabled and working. DISABILITY EARNINGS means the gross monthly earnings you receive while Disabled and working. DONOR BENEFIT If you are disabled as a result of being an organ or tissue donor, we will pay your benefit as any other illness under the terms of your plan. WORKSITE ACCOMMODATION If worksite modifications may assist your return to work, we will evaluate your claim for appropriate action. DIRECT DEPOSIT DISABILITY BENEFITS In the event you choose the direct deposit option on an approved claim, we will deposit your benefits directly into your bank account at no additional cost. This can accelerate access to your benefits by several days. We also have a toll-free fax that allows you instant transmission of your claim forms to our benefits department. SOCIAL SECURITY FILING ASSISTANCE If we determine a Disabled Insured is a likely candidate for Social Security Disability benefits, we can assist you with the application and appeal process. WAIVER OF PREMIUM If you become Disabled due to a covered Accidental Injury or Sickness and are eligible to receive a Disability Payment, your insurance will be continued without payment of premium. Waiver of Premium will begin the first of the month following: (a) your satisfaction of the Elimination Period; or (b) 6 months of continuous Disability, whichever is later, provided premium has been paid from the beginning of Disability to the date Waiver of Premium begins. Waiver of Premium will continue until: (a) the end of your Disability; (b) the end of the Maximum Benefit Period; (c) the date you are no longer eligible to receive a Disability Payment; (d) the date the Policy terminates; or (e) the date your employment with the Policyholder or subscribing Employer unit ends, whichever first occurs. We will require proof on an annual basis that you remain Disabled during said period. MENTAL ILLNESS LIMITED BENEFIT If you are Disabled due to a Mental Illness, regardless of the cause, Disability Payments will be provided for the period of up to 2 years, not to exceed the Maximum Disability Period, as long as: (a) you are under the Regular and Appropriate Care of a Physician; and (b) you receive medical treatment (mental or medical examination alone will not be considered treatment) from either: (1) a registered specialist in psychiatry; (2) a Physician administering treatment on the advice of a registered specialist in psychiatry who certifies that such treatment is medically necessary; or (3) a Physician, if in our opinion, a specialist in psychiatry is not required to certify that such treatment is medically necessary. ALCOHOLISM AND DRUG ADDICTION LIMITED BENEFIT If you are Disabled due to alcoholism or drug addiction, a limited benefit of up to 15 days for each Disability will be paid. In no event will benefits be paid for more than 15 days of Disability in any 12-month period. If drug addiction is sustained at the hands of, or while under the Regular and Appropriate Care of a Physician in the course of treatment for Accidental Injury or Sickness, it will be covered the same as any other illness. DISABILITY Disability or Disabled for the first 12 months of Disability means that you are unable to perform the material and substantial duties of your Regular Occupation. After that, Disability means you are unable to perform the material and substantial duties of any Gainful Occupation for wage or profit for which you are reasonably qualified by training, education, or experience. HOSPITAL The term Hospital shall not include an institution used by you as a place for rehabilitation; a place for rest or for the aged; a nursing or convalescent home; a long-term nursing unit or geriatrics ward; or as an extended care facility for the care of convalescent, rehabilitative, or ambulatory patients

23 ELIGIBILITY All active full-time employees working 20 hours or more per week. Proof of good health may be required by us in order to be eligible for disability coverage. We will rely on answers given on your application to determine if coverage can be issued. Regardless of your health at the time of application, if coverage is approved and issued, claims incurred while coverage is in force will be subject to all terms of the Policy including any Pre-Existing Condition limitation. EFFECTIVE DATE OF COVERAGE Certificates will become effective the first of the month following the date we approve the application, providing you are on Active Employment and premium has been paid. ACTIVE EMPLOYMENT Active Employment means you are doing in the usual manner all of the regular duties of your employment on a full-time basis on a scheduled work day and these duties are being done at one of the places of business where you normally do such duties or at some location to which your employment sends you. You will be said to be on Active Employment on a day which is not a scheduled work day only if you are not Disabled and would be able to perform in the usual manner all the regular duties of your employment if it were a scheduled work day. DISABILITY PAYMENT Means your Disability Benefit minus Deductible Sources of Income. MINIMUM DISABILITY BENEFIT The Disability Payment payable will be no less than $ or 10% of the Monthly Disability Benefit, whichever is greater. IF YOU ARE DISABLED DUE TO A COVERED DISABILITY AND NOT WORKING Your Disability Payment will be calculated as follows: For the first 36 months Disability Payments are provided, the Disability Payment will be the lesser of: (a) your Disability Benefit; or (b) 70% of your Monthly Compensation less any Deductible Sources of Income you receive or are entitled to receive. After 36 months the Disability Payment will be the lesser of: (a) the Disability Benefit (as indicated on your application for coverage as approved by us) less any Deductible Sources of Income you receive or are entitled to receive; or (b) 70% of your Monthly Compensation less any Deductible Sources of Income you receive or are entitled to receive. DEDUCTIBLE SOURCES OF INCOME WILL INCLUDE (a) other group disability income; (b) governmental or other retirement system as a result of your Regular Occupation, whether due to disability, normal retirement or voluntary election of retirement benefits; (c) United States Social Security Act or similar plan or act, including any amounts due your dependent(s) on account of your Disability; (d) sick leave or other salary or wage continuance plans provided by the Employer which extend beyond 60 days from the date of Disability (Plans I, II, III, and IV), 90 days from the date of Disability (Plan V), or 150 days from the date of Disability (Plan VI); (e) State Disability; (f) unemployment compensation; and (g) workers compensation law, occupational disease law or any similar act or law. If we determine that you may qualify for benefits under items (b), (c), or (g) listed above, we may estimate the amount of benefits you may be entitled to receive. COST OF LIVING ADJUSTMENT The Disability Payment will not be reduced due to a cost of living increase if the increase from a Deductible Source of Income takes effect after the onset of Disability and while benefits are payable under the Policy. 17 PRE EXISTING CONDITION LIMITATION A limited benefit up to 1 month s Disability Benefit in any 12-month period will be payable for Disability due to a Pre-Existing Condition. This provision will not apply if you have gone treatment-free; incurred no expense; taken no medication; and received no diagnosis or advice from a Physician, for 12 consecutive months for such condition(s). Benefits will not be excluded for Disability due to a Pre-Existing Condition, which begins after you have been continuously covered under the policy for 24 months following your Effective Date of Coverage. Any increase in benefits will be subject to this Pre-Existing Condition limitation. A new Pre-Existing Condition period must be satisfied with respect to any increase applied for and approved by us. PRE-EXISTING CONDITION: The term Pre-Existing Condition means a disease, Accidental Injury, Sickness, physical condition or mental illness for which you had treatment; incurred expense; took medicine; received care or services including diagnostic testing or related measures; or received a diagnosis or advice from a Physician, during the 12-month period immediately before your Effective Date of coverage. The term Pre-Existing Condition will also include conditions which are related to such disease, Accidental Injury, Sickness, physical condition, or mental illness. EXCLUSIONS The Policy does not cover any loss, fatal or non-fatal, which results from: (a) intentionally self-inflicted injury while sane or insane; (b) an act of war, declared or undeclared; (c) Accidental Injury sustained or Sickness contracted while in the service of the armed forces of any country; (d) committing a felony; or (e) penal incarceration. We will not pay benefits for Disability or any other loss for any period for which you are incarcerated in a penal or correctional institution for a period of 30 consecutive days or longer. LEAVE OF ABSENCE Your coverage may be continued for up to 1 year during a Leave of Absence approved in writing by your Employer. TERMINATION OF INSURANCE Your insurance coverage will end on the earliest of these dates: (a) the date you do not meet the Eligibility requirements as defined in the Eligibility paragraph in this brochure; (b) the date you retire; (c) the date you cease to be on Active Employment, except as provided for under the Leave of Absence provision; (d) the end of the last period for which premium has been paid; or (e) the date the Policy is discontinued. If: (a) your coverage ends as a result of your termination of Active Employment; (b) such termination is caused by an Accidental Injury or Sickness for which Disability Benefits would be payable; and (c) Disability is established prior to the termination of Active Employment, then: Disability Benefits will be paid as if such termination had not occurred. Termination of the Policy will have no affect on Disability Payments which began before termination. We may end your coverage if you submit a fraudulent claim. 21

24 Use this worksheet to get a general estimate of how much Disability Income Protection insurance you need. However, you should consult with a financial advisor before buying any insurance products. MONTHLY INCOME Your Income Spouse/Other Income Total Monthly Income MONTHLY EXPENSES Mortgage/Rent Car Payment Utilities Loan/Credit Card Payments Insurance (Home, Auto, Health, Life, etc.) Food/Clothing Child Care/Education Other Expenses Total Monthly Expenses Are You Covered? $ $ $ $ $ $ $ $ $ $ $ $ 18 22

25 Health ServicesAdministration F I D E L I T Y Health Savings Accounts American Fidelity Health Services Administration, L.L.C. is proud to be a member of the American Fidelity family of companies. American Fidelity Assurance Company is a family-owned organization with a 50-year history of providing our customers with sound financial security solutions. We are proud of our association with one of the top-rated insurance companies in the nation 1. Our knowledgeable staff provides you with the support that you need. Our regulatory knowledge allows you the peace of mind that everyone deserves. Why choose American Fidelity Health Services Administration (AFHSA)? AFSHA has been an independent HSA provider since Our independence means that, unlike other HSA trustees integrated with the major medical plan changes to your medical plan insurer or administrator without the need to change HSA providers and affect your employees HSAs. Additionally, AFHSA gives consumers the opportunity to drive their health care decisions and provide the tools, resources and services valued by those taking advantage of what an HSA has to offer. Customer Service automated voice response system because we want to answer your questions personally. Our team of specialized representatives are dedicated to serving you and your employees. Our team of HSA professionals allows us to provide the best service possible. Our staff is committed to providing: Your employees can they call, which helps build lasting relationships. We strive to return s Advice on All Accounts Our staff regularly communicates with each other to know what is going on with our customers. If for some reason the person your employee contacts is unavailable, you can trust that any other team member will be able to help. Employee Education Educating your employees about how an HSA can work for them is important for successful implementation of a high deductible health plan paired with an HSA. We work with you on deciding what avenue is best for your employees. We can provide employee workshops, marketing materials, as well as talk with them via telephone or . We offer HSA educational information on our website, There is a slide show for Account Interest We offer a central approach where HSA funds are invested in FDIC-Insured interest-bearing accounts. The more that an employee saves in the HSA, the more interest earned. For current interest rates visit In addition, your employees will have access to the mutual fund investment offerings that cover a wide range of risk tolerances for balances above the $2,500 required in their cash account. A current listing of funds available can be viewed at 12 Our Commitment to Customer Service is to be available for your phone calls have an automated voice response system because we want to personally answer your employees questions and make sure that they truly understand what their HSA means for them. Because HSAs can be their situation. Our website offers an array of educational materials for you and your employees to browse. One of the most flyer. This flyer has commonly asked about items, in alphabetical order, for your employees to use as an easy reference guide. If they do not find what they are looking for, as always, we will be waiting for their call. Saving Today, Securing Tomorrow. 23

26 Centralized Offering of Basic Account and Investment Options Your employees will have access to mutual fund investment offerings that cover a wide range of risk tolerances. HSA and Tax Savings Section 125 plan along with a qualified high deductible health plan, making it a great fit for your American Fidelity family of companies serves as our plan custodian. InvesTrust specializes in safeguarding the funds as well as providing investment advice. Your employees will not need to establish a separate broker-dealer account when investment options are available via AFHSA. Other HSA providers charge fees for investments. Not only can there be per trade fees, but there can also be percentage of balance fees, deposit fees, transfer fees, and withdrawal fees. Our relationship with InvesTrust allows you to make investment decisions without trading or brokerage fees. Our relationship with InvesTrust also allows your employees free consultant services, regarding Investment Specialists. There are no hidden fees. There may be a fee associated with certain mutual funds and your employee will be notified prior to the investment taking place. When coupled with your Section 125 plan, the HSA By placing the HSA under your Section 125 plan, you are allowing your employees to payroll deduct deduction is typically preferred to depositing amounts directly into the HSA because it is more Enrollment We will work with you on how best to enroll your employees in the HSA during your open enrollment. Each employee will be required to complete an HSA Application/Custodial agreement. However, there are several things to consider when adding an HSA to your benefit offerings and we will work with you to help ensure your enrollment is as smooth as possible. Billing Send us your payroll deductions along with your payroll sheet and we ll take it from there. We want to make your employees funds available to them as soon as possible so we post the contributions the same day they are received, or by the second day at holders contributions on the same day. You can help prevent delays caused by inclement weather or misplaced mail by sending your contributions electronically rather than by paper check. Our strong relationship with InvesTrust allows additional benefits to our Customers. -Catherine Denwalt-Graham Chief Operating Officer 13 24

27 Account Access Since the HSA money is the employee s money, accessing those funds should be easy. We offer several ways for them to access their money. They can choose the way that best suits them! Debit Card doctor s office or pharmacy, to get immediate access to Online Account Distributions can be requested online either before or be received via check by mail or by direct deposit to an account chosen by your employee. Distribution Request Form A distribution form can be filled out and printed from our website. Once completed, your employee may via check or direct deposit. These three avenues give your employees different options when they are trying to decide when and how to access their HSA funds. Unlike traditional bank accounts, your employees will not need to order and keep track of checks. When they are ready to take a distribution from their account, it is quick and easy, just like it should be. Secured Website Our website, offers your employees a quick and easy way to navigate to administrative forms, quick reference guides, as well as allow them access to their secured online banking. The website offers different educational items including a slideshow for both you, the employer, and account holders. You can refer your employees to our website to go through the slide show to help them gain an understanding of what an HSA is. All account maintenance forms are available on our website in the Forms and Information section. Your employees can utilize this section of the website when they need to make a name or address change, a distribution request, or an investment funds transfer. Online banking offers an array of possibilities. The website s functionality helps your employees get the most out of their HSA by giving them the following items: Balance Information Get Year to Date balance information, current balance, etc. via direct deposit or check. Change direct deposit information. Not only can recent transactions be viewed on the home screen, 14 be viewed on the Account Activity page. 25 Your employees may upload receipts to their online account to avoid the possibility of damage or fading. They may even attach receipts to specific transactions so they know what reimbursements they have received. Our goal is to make HSA administration as easy as possible. We do this by having items that are simple to access right at your fingertips. Independence AFHSA will be your administrator regardless of which insurance provider you use. Like most employers, you If you coordinate your HSA with your health care provider, you will probably be required to change HSA providers as well. Why change HSA providers when your employees have built up savings? Changing HSA providers may require educating your employees on a number of things including: What to do with their HSA funds How to manage two HSAs How to transfer funds paperwork and signatures which means less work.

28 Limited Fees We handle the majority of the account administration through one monthly maintenance fee of $2.00. Certain non-routine activities such as manual distributions, stop payment fees, and researching fees may incur an additional fee if applicable. See for a full listing of miscellaneous fees. We do not allow accounts to be overdrawn. If the money is not there, the debit card transaction or the distribution request will be declined. With many banks, if the money is not there, they pay the charge for you but also charge an overdraft fee. Overdraft fees normally are charged on a per item basis, which can add up very quickly. On rare occasions, a vendor might process a force post causing the participant s HSA to have a negative balance. We do not charge a fee for this and work closely with the participant to resolve the issue. There are no trade fees specific to HSAs. Employees may choose to move their HSA funds to our wide variety of investment options as long as they retain a $2,500 minimum balance in a cash account. There is no limit on the amount of trading that they may do. Occasionally, there may be a fee associated with a specific mutual fund. There is no need to order checks, which may be lost or have to be re-ordered due to changing an address, phone number, etc. The HSA can be accessed online and unlimited distributions may be made free of charge. Employees may request a check to be mailed to them or they may receive direct deposit to an account of their choice. Having an HSA with AFHSA allows employees access to the knowledgeable staff that they demand, without charging a multitude of fees. About American Fidelity Health Services Administration: AFSHA has been an independent HSA provider since Our independence means that, unlike other HSA trustees integrated with the major medical changes to your medical plan insurer or administrator without the need to change HSA providers and affect your employees HSAs. Additionally, AFHSA gives consumers the opportunity to drive their health care decisions and provide the tools, resources and services valued by those taking advantage of what an HSA has to offer. Adept in the world of HSAs and their relationship customer personal attention and a wealth of options access and investment opportunities that fit your requirements make AF Health Services Administration the right choice. Administration is an affiliate of American Fidelity Assurance Company. A third-generation, familyowned organization, AFA provides insurance products and financial services to education employees, trade association members, and companies throughout the United States and across the globe. We share in their use of vigilant practices to provide steady progress through calculated growth and conservative investment practices. American Fidelity Company 1, one of the nation s leading insurance Fidelity Assurance Company is proud to count itself among Fortune 2 magazine s 100 Best Companies to Work For in America for the seventh straight year. We know that satisfied employees result in satisfied customers, which is an important foundation of American Fidelity s approach to business. AF Health Services Administration is dedicated to serving our customers and their investments with the respect they deserve. 1 SB Neither American Fidelity Health Services Administration nor American Fidelity Assurance Company are providing tax advice. Individuals with an interest in HSAs should contact their personal tax advisor.

29 Term Life Insurance Coverage Highlights Georgetown ISD Policy # Please read carefully the following description of your Unum Term Life insurance plan. Your Plan Eligibility Coverage Amounts All active full-time employees working at least 20 hours each week and their eligible spouses and children (up to age 19, or 25 if they are full-time students). Your Term Life coverage options are: Employee: Up to 4 times salary in increments of $10,000. Not to exceed $500,000. Spouse: Up to 50% of employee amount in increments of $5,000. Not to exceed $250,000. Benefits will be paid to the employee. Child: Up to 50% of employee coverage amount in increments of $2,000. Not to exceed $10,000. The maximum death benefit for a child between the ages of live birth and 6 months is $1000. Benefits will be paid to the employee. Note: In order to purchase Life coverage for your dependents, you must buy Life coverage for yourself. Coverage amount(s) will reduce at age 70 according to the following schedule: Employee: Spouse: Coverage may not be increased after a reduction. Insurance Amount Reduces to: lesser of $30,000 or 1x salary lesser of $15,000 or 50% of employee amount ADR