TABLE OF CONTENTS. Open Enrollment Information...1. Introduction to Section 125 Cafeteria Plan...3. Section 125 F.A.Q...4

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1 TABLE OF CONTENTS TOPIC PAGE Open Enrollment Information...1 Introduction to Section 125 Cafeteria Plan...3 Section 125 F.A.Q....4 Customer Service Numbers....6 Medical (Aetna)...8 Medical HMO (Aetna)...12 Medical HSA 14 Dental (Safeguard)...16 Dental (MPX)...17 Vision (Superior)...18 Disability (Standard)...19 Universal Life (Trustmark)...26 Group Term Life (Unum Provident)...30 Cancer (Allstate)...32 AD & D (Reliance Standard)...34 Legal (Family Legal Protection Plan).. 36 Flex Smartflex Card / 403(b)...42

2 Open Enrollment Information Each year, Conroe ISD employees have the opportunity to review, change, or continue their current medical and/or voluntary benefits. Employees may enroll July 1, 2007 through July 31, It is recommended that you keep this booklet after completing enrollment for future reference. All employees will need to complete the online enrollment even if they do not have any coverages with the district. Corrections, changes, additions, or drops may only be made during the open enrollment period. Employees must review his/her employee profile and verify that any dependents to be provided coverage in any benefit selected are included in the profile. Employees must confirm on the individual benefit screens (dental, vision, etc.) that each dependent to be covered for each particular benefit is listed in order to be included in this coverage. When: Open Enrollment Period July 1 July 31, 2007 You may choose to attend one of the general information meetings to gain information on medical and voluntary benefits for the plan year effective September 1, Option 1: Meet with a representative How to Schedule an appointment 1. Log on to Your username is a combination of the first letter of your first name, first letter of your last name, and last four digits of your social security. Example: John Doe with a social of would be JD6789 Your password is your birth date in YYYYMMDD Example if born July 4, 2001, your password will be Provide the date, time, and location that you prefer 3. Provide your name and telephone number. Option 2: Online enrollment This method can be used for any enrollment option: First time enrollment, making no changes, or dropping existing benefits. Employees participating in the Flexible Spending Account must re-enroll in this benefit annually. Making no changes assumes that you are willing to accept any applicable rate increases to benefits experiencing a rate change or benefits dropping. It is recommended that if you desire to make changes to your benefits that you schedule an appointment to meet with an enroller. 1. Go to the enrollment website at: Follow the instructions to complete your enrollment. Conroe ISD employees will have computer access to complete the on-line enrollment at each of the 4 high schools. Enrollment representatives will be available at each location should you have questions.

3 Enrollment Schedule Date Day Time Location July 9-28 th Monday through Friday 7:30 a.m.- 4:30 p.m. Conroe High School Caney Creek High School Oak Ridge High School The Woodlands High School July 9 th ** Monday 9:00 a.m. *Aetna will attend Conroe High School Caney Creek High School Oak Ridge High School The Woodlands High School July 16 th** Monday 9:00 a.m. & 3:30 p.m. *Aetna will attend Conroe High School Oak Ridge High School Caney Creek High The Woodlands High School July 23 rd** Monday 9:00 a.m.. *Aetna will attend Conroe High School The Woodlands High School July 21st Saturday 7:30 a.m.- 4:30 p.m. The Woodlands High School July 28 th Saturday 7:30 a.m.- 4:30 p.m. Conroe High School * Aetna representatives will be at the high schools on these dates and times to provide information about health coverage. ** Optional benefits Information meeting

4 INTRODUCTION TO SECTION 125/CAFETERIA PLAN The Section 125/Cafeteria Plan Benefit refers to Section 125 of the Internal Revenue Code of Simply put, the Cafeteria Plan allows you to deduct certain benefit premiums from your gross earnings, before federal withholding taxes are figured. The amount you elect to have deducted pre-tax actually lowers your taxable income. Please review the following sample paycheck, for an illustration of how participating in the Cafeteria plan could work for you. The benefit plan year is September 1, 2007 through August 31, There are two very important issues to keep in mind regarding your cafeteria plan. Although all coverage is voluntary, every employee is required to complete an online election, even if no benefits are selected, or if you wish to keep your current benefits the same. Any pre-tax elections made during open enrollment will become effective September 1, 2007 and remain in effect and cannot be changed during the plan year unless you have one of the following changes in family status: Marriage/Divorce Birth/Adoption/Death Change in spouse s employment Change in eligibility status of a dependent Qualify for Medicare TOLL-FREE HELP LINE AVAILABLE In an effort to give you a faster response to questions concerning your benefits, there is a toll-free number to call. If you have questions concerning how your benefits work, how to file a claim, or if you need other policy information, you can call TOLL- FREE (800)

5 SECTION 125 Frequently Asked Questions Q. What is a Section 125 Plan? A. It is an employer sponsored benefit plan which allows an employee to select from a list of available benefits, those benefits needed by the employee. Q. What does this benefit program mean to me? A. This program means that expenditures for items such as medical insurance, dental insurance, cancer insurance, critical illness insurance, vision insurance, dependent care costs, and some medical expenses not covered by insurance, can be paid with pre-tax dollars. The bottom line is that you may have more dollars available to purchase other benefits you may need, or increase your takehome pay. Q. What happens if the tax laws change next year? A. No one can predict what future changes may occur in the tax laws. This Section 125 Plan has been set up in accordance with current laws and regulations. If the laws change, appropriate steps will be taken to bring this plan into compliance with any new rules. Q. How do I enroll in the Section 125 Plan? A. A Representative from First Financial will meet with you to complete an election form. This election form must be completed and signed by each employee, whether or not you wish to elect to participate in the benefit portion of the plan or if you wish your benefit to remain unchanged. Q. Must I make my election before the effective date of the Plan? A. Yes, you must make your benefit election prior to the beginning of the plan year (effective date), or prior to becoming eligible to participate in the Plan. Q. Can I make changes in my election during the plan year? A. The only time tax law regulations will allow you to make a change is if there is a change in family status affecting your need for a benefit. Your change in payroll deductions must also be consistent with that change in family status. Some examples of status change are marriage, divorce, the death of a spouse or child, the birth or adoption of a child, or a change in the employment status of you or your spouse.

6 Q. Who do I contact if I have a question regarding my benefits? A. You may always feel free to call First Financial at (800) or if you have a specific question pertaining to coverage or claims you may also contact the provider directly. Q. What is a qualified medical expense for reimbursement under this plan? A. Most medical expenses not reimbursed by any other source or an insurance plan, such as deductibles and co-insurance, any items not covered by insurance, such as vision care, dental costs and routine physicals, are qualified medical expenses. These expenses may be either for you or your dependents. Some cosmetic surgery procedures do not qualify for reimbursement. Q. How can I get money from my reimbursement accounts? A. You may access First Financial s website ( to obtain paper voucher for submission of any expenses incurred during the month. This voucher must be accompanied by your receipts containing required dependent care provider information. This voucher will be processed by the plan record keeper and you will be sent a check to reimburse you for your expenses. The medical expense reimbursement check will be for the expenses claimed up to the maximum benefit amount you elected for the year. The dependent care expense check will be for the expense you claimed up to the amount you have in your account. Please submit to First Financial Administrators, P.O. Box , Houston, TX or fax to Q. What happens if I don t incur enough expenses to get back the money deposited in my reimbursement accounts? A. Any expense dollars not used for expenses is forfeited. This is what is known as the use it or lose it provision of Section 125. It is very important to be conservative and accurate in estimating your expenses for the plan year. First Financial will remind you periodically of the balance in your account. You also have up to 90 days to file for expenses incurred during the previous plan year or within 90 days after termination to file for expenses incurred prior to termination. Q. Can I use the tax credit for medical expense deduction on my income tax return? A. No. Expenses reimbursed under this plan may not be used when calculating your medical expense deduction. Q. What is the maximum monthly amount I can have deducted from my check (pre-tax) for dependent care? What is the maximum for medical reimbursement? A. $ per month is the maximum for medical reimbursement. The maximum for dependent care is $ per month.

7 Customer Service Contacts First Financial Administrators Aetna 457 Tax Sheltered Annuities B Claim forms: HMO Group no. SI HSA Behavioral Health Mail Order Prescriptions Alternate Plan (CBCA) or Dental Vision Disability Safeguard Dental MedPayExpress (MPX) Dental Reimbursement P. O. Box 2108 Lake Charles, LA Superior Vision The Standard Disability Insurance

8 Cancer Allstate Cancer Life Insurance Universal Life Trustmark Group Term Life Unum Provident Long Term Disability Accidental Death &Dismemberment Legal Reliance Standard Legal Access Plan Flexible Spending Accounts Dependent Care Reimbursement Medical Reimbursement

UMPHYSICIANS 2018 OPEN ENROLLMENT FREQUENTLY ASKED QUESTIONS

UMPHYSICIANS 2018 OPEN ENROLLMENT FREQUENTLY ASKED QUESTIONS Open Enrollment What is Open Enrollment? Open enrollment refers to the specific time each year when you are eligible to enroll in or change