ABILENE ISD BENEFIT SUMMARY FOR NEW HIRES. Table of Contents PLAN YEAR IS SEPTEMBER 1, 2017 TO AUGUST 31, 2018

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1 Table of Contents Contacts... 2 Plan Rules... 2 Medical... 3 Medical Bridge Plan... 4 Dental Plan... 4 Vision Plan... 4 Critical Illness Plan... 5 Cancer Plan... 5 Educator Disability Plan... 5 Accident Insurance Plan... 6 Individual Life Insurance... 6 Basic Term Life, with AD&D and Supplemental Group Term Life... 6 Group Term Life Insurance... 7 Identity Theft Protection (b) Retirement Savings Plan (b) Retirement Savings Plan... 8 Flexible Spending Accounts (FSA)... 8 Frequently Asked Questions... 9 Enrollment Navigation Newly hired employees, within 31 days of hire, can enroll for Medical Benefits Supplemental Benefits Flexible Spending Account (FSA) Supplemental Retirement Plans ALL BENEFITS are payroll-deducted and effective the first month after your date of hire. For more important details on any of your benefit plans, please see the benefit website or call First Financial Group of America at Recommended browser: PC Internet Explorer or Chrome Mac Safari or Chrome ABILENE ISD BENEFIT SUMMARY FOR NEW HIRES PLAN YEAR IS SEPTEMBER 1, 2017 TO AUGUST 31, 2018 KEY ITEMS IMPORTANT INFORMATION TO KNOW THIS YEAR TCG and First Financial Administrators, Inc. have formed a business alliance to better service school district customers. TCG Services is still the administrator over the retirement plans, 457 and 403(b). First Financial Administrators, Inc. will be the new Section 125 & FSA Administrator for Please note some contact information has changed. LIFE INSURANCE BY COMBINED INSURANCE employee, spouse, and children Guaranteed Issue available THIS YEAR with a long-term care rider for employee and spouse and no medical history required. Some limitations apply, please see a Benefits Advisor. CRITICAL ILLNESS PLAN BY ALLSTATE Guaranteed Issue THIS YEAR for the entire family and no medical history required; covers lump sum payment for heart attacks, strokes, Alzheimer s disease, and other illnesses. Pre-existing conditions will apply, please see a Benefits Advisor ALLSTATE CANCER PLAN Guaranteed Issue for new employees within 31 days of hire only coverage is for employee, spouse, and dependent child(ren). Pre-existing conditions will apply for the first 12 months of the policy. MEDICAL FLEXIBLE SPENDING ACCOUNT (FSA) You must ENROLL every year in the FSA "use-it-or-lose-it" account even if the amount is the same as last year; $2,600 maximum. All employees will need to enroll online to confirm their benefit needs for the upcoming plan year. Employees need to add their personal and phone number when enrolling. All New Hires must list dependents (including spouse and children under age 26) in the Dependent Section. Include SSN s, birthdates, and address if it different from yours. This is required by TRS. If your dependents lose other coverage during the school year, you will not be allowed to add them to your insurance unless they are listed as dependents during your New Hire Enrollment period. ABILENE NHS 7/17 Your company key is abilene (case sensitive)

2 Contacts Benefit VENDOR PHONE WEBSITE Medical TRS ActiveCare Aetna Medical First Care HMO Mail order prescriptions CVS/CareMark DEPENDENT ELIGIBILITY AGE To age 26 whether a tax dependent or not To age 26 whether a tax dependent or not To age 26 whether a tax dependent or not Medical Bridge Plan Colonial To age 26 Dental Insurance - PPO Plans MetLife To age 26 Vision Insurance Superior Vision To age 26 Educator Disability Sun Life N/A Accident Insurance Allstate To age 26 Individual Life Insurance Combined Life/Fidelity Basic Term Life and Group Optional Term Life Hartford To age 26 Voluntary Group Term Life Sun Life To age 26 Identity Theft Protection ilock To age 18 Critical Illness Allstate To age 26 Cancer Allstate To age 26 To age 25 to apply covers to age 26 Flexible Spending Account (FSA) Medical Expense or Dependent Care FFGA Customer Service FFGA Fax flex@ffga.com First_Financial_Receipts@Alegeus.com N/A 457(b) Retirement Plan TCG Administrators N/A 403(b) Retirement Plan TCG Administrators N/A Section 125 Cafeteria Plan Rules The 125 Cafeteria Plan allows you to deduct certain benefit premiums from your gross earnings, before federal withholding taxes are calculated. The amount you elect to have deducted pretax lowers your taxable income. TWO IMPORTANT ISSUES TO KEEP IN MIND You must make an election each plan year to continue your eligibility for cafeteria plan benefits. A benefit cannot be changed during the plan year unless you have a qualified family status change. These changes include, but are not limited to, Marriage or divorce Birth, adoption, or death of a spouse or child Change in a spouse s or dependent s employment status Change in eligibility status of a dependent Substantial increase in a benefit premium Becoming Medicare eligible Spousal Open Enrollment (not all plans allow this) Eligible Benefits Under Section 125 Medical Insurance Dental Insurance Vision Insurance Gap/Medical Bridge Insurance Critical Illness Insurance Cancer Insurance Accident Insurance Flexible Spending Accounts (FSA) 2

3 Medical Medical coverage is available to all eligible employees and their eligible dependents to age 26. Employees who have questions on the medical insurance can refer to documents and comparison charts in the Reference Center on the benefits enrollment website at or contact TRS Aetna directly at or First Care HMO at TRS ActiveCare Plan 1-HD Total Premium AISD Contribution (semimonthly) Employee Only $ $ $0.00 $0.00 Employee + Spouse $ $ $ $ Employee + Child(ren) $ $ $ $ Employee + Family $1, $ $ $ Family Pooling Premium (if spouse is an educator at AISD) Split Premium Election (if spouse works for another TRS medical district) $1, $ $ $ $ $ $ $ TRS ActiveCare 2 Total Premium AISD Contribution (semimonthly) Employee Only $ $ $ $ Employee + Spouse $1, $ $1, $ Employee + Child(ren) $1, $ $ $ Employee + Family $2, $ $1, $ Family Pooling Premium (if spouse is an educator at AISD) Split Premium Election (if spouse works for another TRS medical district) $2, $ $1, $ $1, $ $ $ TRS ActiveCare Select Plan Total Premium AISD Contribution (semimonthly) Employee Only $ $ $ $52.00 Employee + Spouse $1, $ $ $ Employee + Child(ren) $ $ $ $ Employee + Family $1, $ $1, $ Family Pooling Premium (if spouse is an educator at AISD) Split Premium Election (if spouse works for another TRS medical district) $1, $ $ $ $ $ $ $ TRS First Care HMO Total Premium AISD Contribution (semimonthly) Employee Only $ $ $ $52.41 Employee + Spouse $1, $ $ $ Employee + Child(ren) $ $ $ $ Employee + Family $1, $ $ $ Family Pooling Premium (if spouse is an educator at AISD) Split Premium Election (if spouse works for another TRS medical district) $1, $ $ $ $ $ $ $

4 Medical Bridge Plan (GAP) by Colonial Even with a comprehensive health plan that covers expenses, there is a chance you could still have to pay for deductibles, copayments, and co-insurance. This plan can offer added financial protection for out-of-pocket costs related to a covered accident or a covered sickness. GI Plan is Guaranteed Issue; pre-existing conditions apply Rates vary depending on employee s age visit (click LOGIN and follow prompts) for rate charts In-Patient/Hospital Benefit: Pays $1,500 per person, per year Out-Patient Surgical Benefit: Pays $1,500 per person, per year Any pre-existing condition that has been treated, received medical advice or testing, or taking medication within the previous 12 months of the effective date, will not be paid for the first 12 months of the policy Dental PPO Plan by MetLife Visiting the dentist can help you and your family keep a great smile as well as maintaining good health. These plans are designed to help you keep your teeth in the best shape possible. Here s how they work: The Low Plan is a MAC plan a plan that requires you to see an in-network dentist; if you use an out-of-network dentist, you will pay more using the Low Plan because it only pays based on the maximum allowable charge The High Plan is a 90th percentile plan that pays at a higher percentage when you visit out-of-network dentists and gives you freedom to choose any in- or out-of-network dentist Annual deductible of $50 per individual, $150 per family Annual maximum of $1,750 per person for High Plan; $1,500 per person for Low Plan (this is the most the dental insurance will pay per calendar year) Preventative care (e.g., cleaning and exam) is paid at 100%; basic services are covered at 80%; major services are covered at 50% Orthodontia lifetime maximum of $1,000 for either Plan for employees, spouse or eligible dependents to age 26 Vision Plan by Superior Vision Dental Plan (semi-monthly rates) Low Plan High Plan Employee Only $15.07 $23.17 Employee + Spouse $31.35 $48.17 Employee + Children $29.29 $45.00 Employee + Family $36.43 $55.97 Keeping up with routine eye exams is extremely important regardless how perfect your vision might be. On top of providing you with prescriptions for glasses or contacts, your eye doctor can check you for diseases or infections. This plan is designed to help you and your family s vision stay as healthy as possible. Highlights include Richer benefits with in-network provider $10 co-pay for eye exam $20 co-pay for eyeglasses or contacts $150 frame allowance OR $150 contact lens allowance This plan allows for new frames every 12 months New enrollees will receive their ID card via USPS Vision Plan (semi-monthly rates) Employee Only $3.64 Employee + One $6.72 Employee + Family $9.96 4

5 Critical Illness Plan by Allstate Receiving news that you ve been diagnosed with a critical illness can impact your financial and emotional stability. Paying for treatment can be costly and your savings may not cover everything. These plans are designed to help you through the illness. Highlights include GI GI Plan is Guaranteed Issue; pre-existing conditions apply Low and High plans available to meet your needs Critical Illness Plan You choose lump-sum benefit amount of $10,000 or (semi-monthly rates) Low Plan High Plan $20,000 Employee Only $9.66 $17.33 Dependent s coverage is 50% of employee s coverage New coverage is subject to pre-existing conditions Employee + Spouse $14.60 $25.93 Wellness benefit pays you $100 to complete exams for qualified conditions Employee + Children $9.78 $17.57 Any pre-existing condition that has been treated, received medical advice or Employee + Family $14.72 $26.18 testing, or taking medication within the previous 12 months of the effective date, will not be paid for the first 12 months of the policy In Categories 1 and 2, this plan pays up to 100% of the basic lump-sum benefit amount Category 1 heart attack (100%), heart transplant (100%), stroke (100%), By-pass surgery (25%) Category 2 major organ transplant (100%), end-stage renal failure (100%) paralysis (100%), Alzheimer s (25%) Recurrence Benefit (25%) is paid if diagnosed more than once with same critical illness as long as more than 18 months have passed between each diagnosis Cancer Plan by Allstate Dependents covered up to age 26 (must be tax dependent) If you are suddenly diagnosed with cancer, it might present a challenge to your family s financial and emotional stability. This plan can help provide financial security as you undergo treatment and are not able to work. Benefits include Plans pay directly to offset expenses related to the treatment of cancer and other specified diseases like Lupus, Cystic Fibrosis, Lyme Disease, etc. Plans pay based upon a schedule of benefits Cancer Premiums Low Plan Low Plan pays $3,000, High Plan pays $5,000 upon initial (semi-monthly Low Plan High Plan Plus rates) cancer diagnosis Wellness benefit: $50 on Low Plan, $100 on High Plan Plus Plans offer an Intensive Care Unit (ICU) rider benefit New Hires only (within 31 days of hire) and their dependents who apply for coverage during this open enrollment will be guaranteed coverage. A pre-existing condition is a disease or physical condition for which symptoms existed or medical advice or treatment was recommended or received within the twelve-month period prior to the effective date of coverage. The cancer plan does not pay for any loss due to a pre-existing condition during the first 12 months of coverage. Educator Disability Plan by Sun Life High Plan Plus Employee $8.82 $9.36 $13.02 $14.64 Family $14.84 $15.94 $21.98 $25.28 Having disability insurance can help protect your income in the event you become sick, injured, or pregnant, and the doctor says you re unable to work. This plan can help provide financial security for you and your family so you can focus on recovering. Here is how it works: GI Guaranteed Issue coverage for everyone; pre-existing condition limitations only apply on new levels of coverage elected or for any enhancements to the plan In the event that you become sick, injured, or pregnant, and are unable to work, disability insurance can step in to help take the place of your missing paycheck Your monthly benefit will pay up to 70% of your salary in $100 increments to a maximum of $8,000 per month The plan will pay up to age 65 for accidents or illness, if you are unable to return to work; the cost depends on your age, the amount of coverage selected, and on how quickly you want benefits to begin ELIMINATION PERIOD allows you to select the number of days that you must be disabled before benefits are available. Options are 14 days, 30 days, 60 days, 90 days or 180 days for absences due to covered injuries and sickness Plan includes a Hospital Waiver meaning if you have been admitted to a hospital as an inpatient for 24 hours or more, the elimination period will be waived and begin payment immediately for anyone who has chosen the 14-day or 30-day elimination periods A pre-existing condition is any condition for which advice or treatment was received in the 180 days prior to the effective date of coverage; pre-existing conditions will not be covered until after 12 months of continuous coverage 5

6 Accident Insurance Plan by Allstate This plan is designed to help you cope with the costs associated with unexpected accidents. Despite having health insurance, out-ofpocket costs may add up quickly when you factor in expenses like co-payments and deductibles. Highlights of the plan include GI NEW Guaranteed issue for all employees High and low plan to fit your budget and needs Helps pay high deductibles on medical expenses from accident Coverage includes but is not limited to fractured or broken bones, x-rays, diagnostic exams, third degree burns, concussions, broken teeth, emergency room treatment, ambulance, hospital confinement Pays directly to the employee, based on the schedule of benefits Plan (semi-monthly rates) Low Plan High Plan Employee Only $5.51 $8.34 Employee + Spouse $8.16 $12.39 Employee + Children $11.08 $16.72 Employee + Family $13.85 $20.90 Individual Life Insurance by Combined Insurance Dependents coverage can be elected up to age 25; covered up to age 26 FOR NEW HIRES ONLY, within 31 days of hire, every eligible new employee, up to age 70, will be GUARANTEED up to $150,000 of total coverage without having to provide evidence of insurability; approval of any additional coverage over $150,000 is subject to health and underwriting guidelines set by the insurance company. GI Coverage available for employee, spouse, and child(ren) Child term rider for dependent child(ren) available for age 15 days old to 25 years old Child(ren) who age out of the Plan are eligible to convert the policy to an unattached, portable policy Children are guarantee issue this year up to $25,000 and spouse (up to age 60) has a limited guarantee issue of $25,000 THIS YEAR ONLY See FAQs page for definition of guaranteed issue Detailed rate chart at Highlights Portable Coverage up to age 120 Rates are guaranteed up to age 100 Rider for child(ren) Long-Term Care (LTC pays up to 4% of death benefit up to 25 months) Basic Term Life, with AD&D and Supplemental Group Term Life by Hartford Although no dollar amount can ever be placed on the value of your life, this insurance plan can provide stability and protection to your loved ones after you are gone. Here s how this plan works: District provides $10,000 to benefit-eligible employees for basic life and $5,000 of AD&D insurance at no cost for employee Coverage available for spouse and child(ren) ONLY if you have Hartford supplemental coverage for yourself If an employee has less than 3x salary in coverage, they may elect a 1x salary bump to a maximum of $250,000 of coverage without evidence of insurability This policy has age-banded rates for employees. The policy will age the insured as of their age on September 1 of each year and rates will be based on your age-band for that plan year. New Hires (within 31 days of hire) Guaranteed issue GI Employee coverage: up to 3x annual salary to a maximum of $250,000 of coverage Dependent coverage: spouse coverage is $2,000; child(ren) coverage is $1,000 6

7 Voluntary Group Term Life Insurance by Sun Life Dependent coverage can only be carried on one employee if both work for the district Although no dollar amount can ever be placed on the value of your life, this insurance plan can provide stability and protection to your loved ones after you are gone. Here s how this plan works: Coverage available for spouse and child(ren) ONLY if you have coverage for yourself For amounts of coverage still in underwriting after September 1, 2017, the effective date of coverage will be the first day of the month following the date of approval by underwriting New Hires (within 31 days of hire) Guaranteed issue up to limits below Employee: Up to $150,000 of coverage GI Spouse: Up to $50,000 of coverage, cannot exceed 50% of employee coverage Children: Up to $10,000 of coverage Identity Theft Protection by ilock360 Dependents covered up to age 18 (must be a tax dependent) Your identity may be your most important asset. It defines who you are, determines how much you can borrow and can be a deciding factor in employment. These factors are why your identity is a target for online criminals. In 2015, identity fraud affected 13.1 million consumers costing a total of $15 billion. Last year, 20% of all fraud losses were due to new account fraud meaning that fraudsters were opening new accounts under stolen identities, going beyond the usual credit card fraud many consumers anticipate. Keep your identity protected with ilock360 s comprehensive identity protection. Here s how it works: All employees eligible for identity theft protection coverage Monitors your identity 24/7/365 Personal address required to sign up for this program Plan can protect individual or family ilock360 (semimonthly rates) Plus Premium Employee Only $4.00 $7.50 Employee + Spouse $7.50 $11.00 Employee + Children $6.50 $10.00 Employee + Family $10.00 $13.50 Service Plus Premium CyberAlert SM monitors: One social security number Two phone numbers Five credit/debit cards Two addresses Two medical ID numbers Five bank accounts Social Security number trace Change of address Sex offender alerts Payday loan Court/criminal records Full service restoration and lost wallet $1M insurance Daily monitoring of one credit bureau (TransUnion) Daily monitoring of three credit bureaus (TransUnion, Equifax, Experian) ScoreTracker adults children 7

8 457(b) Retirement Savings Plan Section 457(b) Deferred Compensation Plan refers to Section 457(b) of the Internal Revenue Code of This is a district-sponsored voluntary retirement savings plan that allows an employee to save money for retirement on a tax-deferred basis. This plan allows you to start, stop, increase or decrease contributions at any time. The plan contains most of the same features of the 403(b) plan, but is particularly different in one unique way: distributions from the 457(b) Deferred Compensation Plan are not subject to the 10% excise tax for early withdrawal. In 2017, you can contribute 100% of your includible compensation up to $18,000, whichever is less. If you are age 50 or older, you can contribute up to an additional $6,000 for a total of $24,000 for the year. TCG Administrators (formerly JEM Resource Partners) is the plan administrator; you can elect salary deductions at Your initial password to enroll online is abile457 (case sensitive). All investing involves risk. Past performance is not a guarantee of future returns. 403(b) Retirement Savings Plan A 403(b) is a retirement savings plan generally offered by public schools and other tax-exempt organizations that allows employees to make contributions on a pretax basis. Most plans allow you to start, stop, increase or decrease contributions at any time. The employer determines the investment providers and employees must open an account with one of those providers to contribute. TCG Administrators (formerly JEM Resource Partners) is the plan administrator; you can elect salary deductions at Your initial password to enroll online is abile403 (case sensitive). All investing involves risk. Past performance is not a guarantee of future returns. Flexible Spending Account (FSA) Medical This plan allows for tax savings on most medical, dental, and vision expenses not covered by insurance. Noncovered expenses apply to all dependent family members even if not covered by a particular insurance plan. The employee estimates an annual election based upon the amount of non-covered expenses expected to be incurred. The maximum election amount for 2017 is $2,600 this amount is deducted in equal amounts from each paycheck, before taxes are calculated, and then set aside for the employee in a special account. A MasterCard debit card will be issued to you to pay for most expenses incurred. Please consult your employee benefits office or visit ( for a list of eligible expenses. REMEMBER: If you don't use it, you lose it! You MUST re-enroll every year. Flexible Spending Account (FSA) Dependent Care This is a plan that allows for a tax savings on day care expenses for children under the age of 13 and for dependent adults unable to care for themselves. The employee estimates an annual election for the amount of expenses to be incurred. The annual election amount is deducted in equal parts from each paycheck, before taxes are calculated, and then set aside in a special account for the employee. As expenses are incurred the employee submits a claim and the money is reimbursed to the employee from the employee s account as the monies come in from each paycheck. The IRS does not allow the Dependent Care Account (DCA) to be prefunded. Where accepted, the debit card may be used for payment of dependent care expenses. Please see the summary plan description located on the enrollment website for more information. Note: Any money not claimed by the employee within ninety days (90) after the end of the plan year is forfeited. The maximum annual election amount is $5,000 per household. If you are married and filing separately, each spouse may only elect up to $2,500. Please consult your employee benefits office or visit for a list of eligible expenses. REMEMBER: You MUST re-enroll every year. 8

9 Frequently Asked Questions What is Guaranteed Issue (GI)? Also referred to as Guaranteed Acceptance, or GA, means that you can t be turned down for health reasons. Guaranteed Issue is typically offered during initial enrollment for benefits. What is a "pre-existing condition"? A pre-existing condition is a disease or physical condition for which symptoms existed or medical advice or treatment was recommended or received prior to the effective date of coverage. What is a deductible? A deductible is what you must pay for your health care before your insurance pays its part. Most plans have deductibles, which start over when your PLAN YEAR starts over. For example, if your plan has a $1,000 deductible and you have surgery that costs $5,000, you ll pay $1,000 before your insurer helps you cover your bills. What is a co-pay? A copay is a small, fixed amount often $15 or $20 that you pay for covered services like a prescription or a doctor s visit. Some health plans also apply coinsurance to certain services. With it, you pay a percentage of the total cost of care. For example, if you have a 20% coinsurance, and your doctor's appointment costs $300, you'd pay $60. That's if you've met your deductible. What is out-of-pocket maximum mean? Your out-of-pocket maximum is the most you have to pay each year toward your medical services or prescription drugs before your insurance pays for all your care. This amount does not include what you pay in premiums. The Affordable Care Act limits the out-ofpocket maximums. In 2016, for one adult, it can be no more than $6,850, and for a family, it can be no more than $13,700. What does EOB mean? After you ve visited your doctor or had a procedure in a hospital, you ll receive an explanation of benefits (EOB) form explaining how much of the charges your insurance will pay. The EOB isn t a bill itself, but it can tell you what your doctor may charge you. Look for the words due from patient to see how much you may owe after your insurance pays. Before you get certain tests or procedures, do you need permission from your health insurance plan? If your doctor says you need a test or procedure, your health plan may have to give permission if it's to be covered by insurance. Giving that permission is called preauthorization. Your plan's overview of benefits lists what care needs to be preauthorized. If you don't get it when it's required, your health plan won't pay its part of the costs. Dependent Care Accounts If I contribute to a Dependent Care Account, can I also write-off my daycare expenses on my taxes? No, you may not. If you use the Dependent Care Account, you save money up-front on your taxes. Your per-paycheck deductions are taken out of your paycheck before you pay taxes on your income. Thus, your taxable income is less, and you pay less in taxes. What kinds of care does this cover? Before-school and after-school care Expenses for preschool/nursery school Extended day programs Au pair services (amounts paid for the actual care of the dependent) Baby sitter (in or out of the home) Nanny services (amounts paid for the actual care of the dependent) Summer day camp for your qualifying child under the age of 13 Elder day care for a qualifying individual Can I use the dependent care account to fund elder care for my mother/father/spouse? Yes, you may use your Dependent Care account to fund care for individuals who qualify as your dependent child under the age of 13 who lives with you for more than half the year (and for whom you are the custodial parent in cases of divorce) your spouse, or other tax dependent, who is incapable of self-care and lives with you for more than half the year. 9

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