BRYAN INDEPENDENT SCHOOL DISTRICT EMPLOYEE BENEFIT HANDBOOK 2016 PLAN YEAR

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1 BRYAN INDEPENDENT SCHOOL DISTRICT EMPLOYEE BENEFIT HANDBOOK 2016 PLAN YEAR BENEFIT PLANS CAFETERIA PLAN INFORMATION ONLINE ENROLLMENT PROCEDURES 1

2 TABLE OF CONTENTS Medical Plans Pages 3 16 Dental Plans Pages Vision Plans Pages Life Insurance Pages 20; Disability Insurance Pages 20; Cancer Plan Page 29 Heart Plan Page 29 Employee Assistance Plan Page 29 Section 125 Plan Information Page 30 Flexible Spending Account Information Pages Health Savings Account Information Page (b) Plan Information Page Plan Information Page 35 Online Enrollment Information Page 35 Provider Contact Information Page 36 Notice of Privacy Practices Pages LifeLock Benefit Solutions Pages Affordable Care Act Notice to Employees Pages

3 MEDICAL and DENTAL PLANS There are four different BISD medical/dental plans with different levels of coverage available to each eligible employee (Silver, Gold, Platinum, and the Health Savings Account). Employees must choose one of the medical/dental plans offered. ELIGBILITY FOR COVERAGE An employee who works twenty (20) hours a week is eligible for benefits unless the employee is a bus driver. A bus driver is eligible for benefits if they work sixteen (16) hours a week. The district s contribution to employee healthcare premiums is determined annually by the Board of Trustees. PLAN YEAR January 1 December 31. ENROLLMENT PERIODS New Employees Within 31 calendar days of the first day of work. If the 31st day is a Saturday or Sunday the enrollment must be submitted the following Monday. Annual re enrollment The annual re enrollment occurs each November. announced and are subject to change with staff notification. Dates are Changes in Dependent Coverage This change must be made within 31 calendar days of a major change such as marriage, divorce, or birth of a child and is effective on the first of the month following the date of enrollment (except for newborn children, coverage is effective the date of birth provided an enrollment form is submitted within 31 calendar days of the event). The employee is responsible for this enrollment within 31 calendar days of the event. Enrollment is requested through InRoll as a Change of Family Status. COVERAGE BEGINS Coverage will be effective the 1st of the month following the date of employment provided timely enrollment is completed. COVERAGE ENDS For an employee who works less than a 12 month contract, termination will be handled in accordance with HB973. The employee's termination will either be effective at the end of the summer, August 31, or the date when other coverage becomes effective. It may be different from the eligibility date. A 12 month employee's coverage will be terminated the end of the month following the resignation. PREMIUM BEGINS First day of coverage PREMIUM ENDS Last day of coverage 3

4 2016 MEDICAL AND PRESCRIPTION DRUG RATES PLANS OFFERED SILVER PLAN 4

5 SILVER PLAN cont'd 5

6 GOLD PLAN 6

7 GOLD PLAN cont'd 7

8 GOLD PLAN cont'd 8

9 GOLD PLAN cont'd PLATINUM PLAN 9

10 PLATINUM PLAN cont'd 10

11 PLATINUM PLAN cont'd 11

12 PLATINUM PLAN cont'd 12

13 HSA/HD PLAN 13

14 HSA/HD PLAN cont'd 14

15 HSA/HD PLAN cont'd 15

16 HSA/HD PLAN cont'd 2016 DENTAL PLAN RATES 16

17 PLANS OFFERED SILVER PLAN 17

18 GOLD PLAN 18

19 PLATINUM PLAN 19

20 VISION PLAN An employee who works twenty (20) hours a week is eligible for the vision plan unless the employee is a bus driver. A bus driver is eligible for the vision plan if they work sixteen (16) hours a week. The vision plan offers an economical way to purchase eye examinations, eyeglasses and contact lenses from member doctors. Copayments for eye examinations and allowances for purchase of frames, lenses and contact lenses are available through this plan. Additional services requested may result in additional charges. A list of providers can be viewed by going to and clicking on the provider locator searching by either a Member or Future Member. You can also call United Healthcare at for provider location and for customer service. For a summary plan description please refer to pages of this handbook. GROUP LIFE AND AD&D INSURANCE An employee who works twenty (20) hours a week is eligible for life and AD&D benefits unless the employee is a bus driver. A bus driver is eligible for life and AD&D benefits if they work sixteen (16) hours a week. Currently the District provides each eligible employee with $20,000 of term life insurance and accidental death and dismemberment insurance. An option is available that allows employees to purchase additional amounts of group term life insurance on themselves and their family members. An employee must have coverage on themselves, to obtain coverage on their dependents. For a summary plan description please refer to pages of this handbook. DISABILITY INCOME INSURANCE An employee who works twenty (20) hours a week is eligible for disability income insurance unless the employee is a bus driver. A bus driver is eligible for disability income insurance if they work sixteen (16) hours a week. Disability income insurance provides income replacement if you experience a covered illness, injury or pregnancy. The monthly benefit payments can help with the bills, like your mortgage or rent, that continue even when you can't work expenses health insurance won t cover. For a summary plan description please refer to pages of this handbook or 20

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29 CANCER/HEART PLAN This Plan may be elected in addition to your medical coverage; it allows you to elect additional cancer care, intensive care coverage, heart and stroke coverage. This coverage plan is offered to provide additional benefits for medical claims that are historically more expensive than for other claims. For a complete summary of benefits on all plans please go to EMPLOYEE ASSISTANCE PLAN Deer Oaks offers a Comprehensive Employee Assistance Program, Work/Life, and Health and Wellness Services to public and private employer groups throughout North America. For more information please go to or call

30 SECTION 125 CAFETERIA PLAN The Cafeteria Plan allows for tax savings when the cost of certain insurance coverage is deducted from gross salary. Reducing gross salary reduces the amount of earnings on which federal income taxes are calculated and deducted. As a result, the amount of taxes that the employee is required to pay and to have withheld from his/her paycheck is reduced. Certain restrictions involving changing benefits during the plan year apply. Benefits eligible under Section 125 are medical plans, dental plans, vision plans, cancer insurance, heart plans, life insurance, flexible spending accounts, health savings accounts, medical reimbursement, and dependent care. A benefit cannot be changed during a plan year unless there is a qualifying event recognized by the IRS. See the Blue Cross Blue Shield Plan Booklet for a list of these qualifying events. DEPENDENT CARE EXPENSES 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 amounts 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 are reimbursed to the employee from the employee s account. Any money not claimed 2 ½ months after the end of the plan year is forfeited. MEDICAL REIMBURSEMENT PLAN This is a plan that allows for a tax savings on most medical, dental and vision expenses not covered by insurance. Non covered expenses apply to all family members even if not covered by a particular insurance plan. Most over the counter medicine and drugs are no longer eligible under the plan. The employee estimates an annual election based on the amount of non covered expenses to be incurred. The annual election 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 debit card will be issued to you to pay for most expenses incurred. Where a debit card may not be accepted, the employee submits a claim and the money is reimbursed by check to the employee from the employee s account. Not all expenses are eligible for reimbursement. Any money not claimed 2 ½ months after the end of the plan year is forfeited. 30

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34 HEALTH SAVINGS ACCOUNT A Health Savings Account (HSA) is a savings product that allows individuals to pay for current qualified medical expenses and save toward future medical expenses on a tax free basis. To qualify for an HSA, you must first be enrolled in a qualified High Deductible Health Plan (HDHP). 403(b) PLAN INFORMATION Third Party Administrator (TPA) Change Bryan Independent School District has contracted with TSA Consulting Group, Inc (TSACG) to provide 403(b) plan administration services. TSACG, based in Fort Walton Beach, Florida, is an independent TPA and is not affiliated with an investment provider nor do they market investment products. Who is TSACG? TSACG provides a variety of services to public education employers that relate to the compliance and administration of 403(b) and 457 retirement plans. The Internal Revenue Service issued regulations regarding 403(b) plans which significantly increase the administrative and reporting responsibilities of plan sponsors (your employer). These requirements include making the plan sponsor responsible for the review and approval process of any transaction made to any account that is a part of the sponsored 403(b) plan. In response to these requirements, your employer contracted with TSACG. On behalf of your employer, TSACG will be responsible for the approval process of transactions such as Distributions, Enrollment, Exchanges, Transfers, 403(b) Loans, and Rollovers. Upon reviewing submitted paperwork to ensure that the transaction complies with IRS regulations, TSACG will forward approved paperwork to your authorized investment product provider who will complete the transaction by disbursing funds directly to you or directly to an account specified by you. The goal of TSACG is to efficiently facilitate the process for you, your employer, and your investment product provider. We have listed on the following pages the steps for enrolling in the plan, as well as steps required for approval of transactions that you may wish to have processed. Carefully reviewing this information and submitting the correct, completed documentation will help ensure that your request will be processed as quickly as possible. If you have questions while preparing documentation, a TSACG representative can be reached at ext. 2. Information is also available by visiting our Web site, Please note that TSACG is not an investment product provider, and we cannot give investment advice. For questions regarding your investments, please contact your investment product provider or financial advisor. 34

35 457 PLAN INFORMATION The 457 plan is a district sponsored voluntary retirement savings plan that allows an employee to save money for retirement on a tax deferred basis. Your district has chosen the Region 10 Plan to offer which has low cost investment options. The plan contains most of the same features of the 403(b) plan, but is different in one unique way. Distributions from the 457 Deferred Compensation Plan are not subject to the 10% IRS excise tax for early withdrawal. For more information you can go to or call them toll free at ONLINE ENROLLMENT Online Enrollment Login Instructions URL Address: roll.com Your login ID is your first initial, last name, and the last four digits of your social. Login Example: Example Login for Beverly Jones User Name: bjonesxxxx (xxxx represents the last 4 digits of your social security #) Password: bryanisd (After initial login you will be prompted to change it. The new password must contain at least one number.) After logging in you will be directed to a welcome page. At the bottom of the welcome page click the link entitled click here to begin your enrollment. At that point you will be guided step by step through the enrollment process. If you finish your enrollment and would like to go back to change a prior benefit, you can click the link attached to the benefit name on the left side of the enrollment screen. Once you have finished your enrollment you will be prompted to print a confirmation statement. You may retain this statement for a record of your benefits for the upcoming year. 35

36 The Following companies provide benefits for Bryan ISD: MEDICAL & PRESCRIPTION Blue Cross Blue Shield DENTAL Blue Cross Blue Shield VISION United Healthcare MEDICAL REIMBURSEMENT PLAN NTA Life DEPENDENT CARE PLAN NTA Life GROUP & OPTIONAL LIFE Sun Life Insurance usa.com CANCER CARE PLAN NTA Life HEART CARE PLAN NTA Life DISABILITY PLAN The Standard COBRA Blue Cross Blue Shield EMPLOYEE ASSISTANCE PLAN Deer Oaks EAP (b) PLAN TSA Consulting PLAN JEM Plan Administrators (800) Specific information for any of the above benefits or companies, please contact Employee Benefits at

37 NOTICE OF PRIVACY PRACTICES Bryan Independent School District Group Benefit Risk Pool THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. The Bryan Independent School District Group Benefits Risk Pool (the Plan ) is required by law to take reasonable steps to ensure the privacy of your personally identifiable health information and to inform you about: - the Plan s uses and disclosures of Protected Health Information (PHI); - your privacy rights with respect to your PHI; - the Plan s duties with respect to your PHI; - your right to file a complaint with the Plan and to the Secretary of the U.S. Department of Health and Human Services; and - the person or office to contact for further information about the Plan's privacy practices. The term Protected Health Information (PHI) includes all individually identifiable health information transmitted or maintained by the Plan, regardless of form (oral, written, electronic). NOTICE OF PHI USES AND DISCLOSURES Upon your request, the Plan is required to give you access to certain PHI in order to inspect and copy it. Use and disclosure of your PHI may be required by the Secretary of the Department of Health and Human Services to investigate or determine the Plan s compliance with the privacy regulations. Uses and disclosures to carry out treatment, payment and health care operations The Plan and its business associates will use PHI without your consent, authorization or opportunity to agree or object to carry out treatment, payment and healthcare operations. The Plan also will disclose PHI to the Plan Sponsor for purposes related to treatment, payment and health care operations. The Plan Sponsor has amended its plan documents to protect your PHI as required by federal law. Treatment is the provision, coordination or management of health care and related services. It also includes but is not limited to consultations and referrals between one or more of your providers. For example, the Plan may disclose to a treating orthodontist the name of your treating dentist so that the orthodontist may ask for your dental x-rays from the treating dentist. Payment includes but is not limited to actions to make coverage determinations and payment (including billing, claims management, subrogation, plan reimbursement, reviews for medical necessity and appropriateness of care and utilization review and preauthorization). For example, the Plan may tell a doctor whether you are eligible for coverage or what percentage of the bill will be paid by the Plan. Health care operations include but are not limited to quality assessment and improvement, reviewing competence or qualifications of health care professionals, underwriting, premium rating and other insurance activities relating to creating or renewing insurance contracts. It also includes disease management, case management, conducting or arranging for medical review, legal services and auditing functions including fraud planning and development, business management and general administrative activities. For example, the Plan may use information about your claims to refer you to a disease management program, project future benefit costs or audit the accuracy of its claims processing functions. Uses and disclosures that require your written authorization Your written authorization generally will be obtained before the Plan will use or disclose psycho-therapy notes about you from your psychotherapist. Psychotherapy notes are separately filed notes about your conversation with your mental health professional during a counseling session. They do not include summary information about your mental health treatment. The Plan may use and disclose such notes when needed by the Plan to defend against litigation filed by you. Uses and disclosure that require that you be given an opportunity to agree or disagree prior to the use or release Use and disclosure of your PHI is allowed without your consent, authorization or request under the following circumstances: - the information is directly relevant to the family or friend s involvement with your care or payment for that care; and - You have either agreed to the disclosure or have been given an opportunity to object and have not objected. Uses and disclosures for which consent, authorization or opportunity to object is not required 37

38 Use and disclosure of your PHI is allowed with your consent, authorization or request under the following circumstances: - When required by law. - When permitted for purposes of public health activities, including when necessary to report product defects, to permit product recalls and to conduct post-marketing surveillance. PHI may also be used or disclosed if you have been exposed to a communicable disease or are at risk of spreading a disease or condition, if authorized by law. - When authorized by law to report information about abuse, neglect or domestic violence to public authorities if there exist a reasonable belief that you may be a victim of abuse, neglect or domestic violence. In such case, the Plan will promptly inform you that such disclosure has been or will be made unless that notice would cause a risk of serious harm. For the purpose of reporting child abuse or neglect, it is not necessary to inform the minor that such a disclosure has been or will be made. Disclosure may generally be made to the minor s parents or other representatives although there may be circumstances under federal or state law when the parents or other representatives may not be given access to the minor s PHI. - The Plan may disclose your PHI to a public health oversight agency for oversight activities authorized by law. This includes uses or disclosures in civil, administrative or criminal investigations; inspections; licensure or disciplinary actions (for example, to investigate complaints against providers); and other activities necessary for appropriate oversight of government benefit programs (for example, to investigate Medicare or Medicaid fraud). - The Plan may disclose your PHI when required for judicial or administrative proceedings. For example, your PHI may be disclosed in response to a subpoena or discovery request provided certain conditions are met. One of those conditions is that satisfactory assurances must be given to the Plan that the requesting party had made a good faith attempt to provide written notice to you, and the notice provided sufficient information about the proceeding to permit you to raise an objection and no objections were raised or were resolved in favor of disclosure by the court or tribunal. - When required for law enforcement purposes (for example, to report certain types of wounds). - For law enforcement purposes, including for the purpose of identifying or locating a suspect, fugitive, material witness or missing person. Also, when disclosing information about an individual who is or is suspected to be a victim of a crime but only if the individual agrees to the disclosure or the covered entity is unable to obtain the individual s agreement because of emergency circumstances. Furthermore, the law enforcement official must represent that the information is not intended to be used against the individual, the immediate law enforcement activity would be materially and adversely affected by waiting to obtain the individual s agreement and disclosure is in the best interest of the individual as determined by the exercise of the Plan s best judgment. - When required to be given to a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death or other duties as authorized by law. Also, disclosure is permitted to funeral directors, consistent with applicable law, as necessary to carry out their duties with respect to the descendant. - The Plan may use or disclose PHI for research, subject to conditions. - When consistent with applicable law and standards of ethical conduct if the Plan, in good faith, believes the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public and the disclosure is to a person reasonably able to prevent or lessen the threat, including the target of the threat. - When authorized by and to the extent necessary to comply with workers compensation or other similar programs established by law. Except as otherwise indicated in this notice, uses and disclosures will be made only with your written authorization subject to your right to revoke such authorization. RIGHTS OF INDIVIDUALS Right to Request Restrictions on PHI Uses and Disclosures You may request the Plan to restrict uses and disclosures of you PHI to carry out treatment, payment or health care operations, or to restrict uses and disclosures to family members, relatives, friends or other persons identified by you who are involved in your care or payment for your care. However, the Plan is not required to agree to your request. The Plan will accommodate reasonable request to receive communication of PHI by alternative means or at alternative locations. 38

39 You or your personal representative will be required to complete a form to request restrictions and disclosures of your PHI. Such requests should be made to the following officer: Mr. Ronnie O Neal, Manager, Benefits and Risk Management, 101 North Texas Avenue, Bryan, Texas 77803, Right to Inspect and Copy PHI You have a right to inspect and obtain a copy of your PHI contained in a designated record set, for as long as the Plan maintains the PHI. Protected Health Information (PHI) includes all individually identifiable health information transmitted or maintained by the Plan, regardless of form. Designated Record Set includes the medical records and billing records about individuals maintained by or for a covered health care provider; enrollment, payment, billing claims adjudication and case or medical management record systems maintained by or for a health plan; or other information use in whole or in part by or for the covered entity to make decisions about individuals. Information used for quality control or peer review analyses and not used to make decision about individuals is not in the designated record set. The requested information will be provided within 30 days if the information is maintained on site or within 60 days if the information is maintained offsite. A single 30-day extension is allowed if the Plan is unable to comply with the deadline. You or your personal representative will be required to complete a form to request access to the PHI in you designated record set. Requests for access to PHI should be made to the following officer: Mr. Ronnie O Neal, Director, Benefits and Risk Management, 101 North Texas Avenue, Bryan, Texas 77803, If access is denied, you or your personal representative will be provided with a written denial setting forth the basis for the denial, a description of how you may exercise those review rights and a description of how you may complain to the Secretary of the U.S. Department of Health and Human Services. Right to Amend PHI You have the right to request the Plan to amend your PHI or a record about you in a designated record set for as long as the PHI is maintained in the designated record set. The Plan has 60 days after the request is made to act on the request. A single 30-day extension is allowed if the Plan is unable to comply with the deadline. If the request is denied in whole or part, the Plan must provide you with a written denial that explains the basis for the denial. You or your personal representative may then submit a written statement disagreeing with the denial and have that statement included with any future disclosures of your PHI. Requests for amendment of PHI in a designation record set should be made to the following officer: Mr. Ronnie O Neal, 101 North Texas Avenue, Bryan, Texas 77803, You or your personal representative will be required to complete a form to request amendment of the PHI in your designation record set. The Right to Receive an Accounting of PHI Disclosures At your request, the Plan will also provider you with an accounting of disclosures by the Plan of your PHI during the six years prior to the date of your request. However, such accounting need not include PHI disclosures made: (1) to carry out treatment, payment or health care operations; (2) to individuals about their own PHI; (3) prior to compliance date; or (4) based on your written authorization. If the accounting cannot be provided with 60 days, an additional 30 days is allowed if the individual is given a written statement of the reasons for the delay and the date by which the accounting will be provided. If you request more than one accounting within a 12- month period, the Plan will charge a reasonable, costbased fee for each subsequent accounting. The Right to Receive a Paper Copy of This Notice Upon Request To obtain a paper copy of this Notice contact the following officer: Mr. Ronnie O Neal, Director, Benefits and Risk Management, 101 North Texas Avenue, Bryan, Texas 77803, A Note About Personal Representatives You may exercise your rights through a personal representative. Your personal representative will be required to produce evidence of his/her authority to act on you behalf before that person will be given access to your PHI or allowed to take any action for you. Proof of such authority may take one of the following forms: - a power of attorney for health care purposes, notarized by a notary public; - a court order of appointment of the person as the conservator or guardian o the individual; or - an individual who is the parent of a minor child. 39

40 The Plan retains discretion to deny access to your PHI to a personal representative to provide protection to those vulnerable people who depend on others to exercise their rights under these rules and who may be subject to abuse or neglect. This also applies to personal representatives of minors. THE PLAN S DUTIES The Plan is required by law to maintain the privacy of PHI and to provide individuals (participants and beneficiaries) with notice of its legal duties and private privacy practices. This notice is effective beginning April 14, 2003 and the Plan is required to comply with the terms of this notice. However, the Plan reserves the right to change its privacy practices and to apply the changes to any PHI received or maintained by the Plan prior to that date. If a privacy practice is changed, a revised version of this notice will be provided for whom the Plan still maintains PHI. Any revised version of this notice will be distributed within 60 days of the effective date of any material change to the uses or disclosures, the individual s rights, the duties of the Plan or other privacy practices stated in this notice. Minimum Necessary Standard When using or disclosing PHI or when requesting PHI from another covered entity, the Plan will make reasonable efforts not to use, disclose or request more than the minimum amount of PHI necessary to accomplish the intended purpose of the use, disclosure or request, taking into consideration practical and technological limitations. However, the minimum necessary standard will not apply in the following situations: - disclosures to or requests by a health care provider for treatment. - Uses or disclosures to or requests by a health care provider for treatment; - Uses or disclosures made to the individual; - Disclosures made to the Secretary of the U.S. Department of Health and Human Services; - Uses or disclosures that are required by law; and - Uses or disclosures that are required for the Plan s compliance with legal regulations. In addition, the Plan may use or disclose summary health information to the plan sponsor for obtaining premium bids or modifying, amending or terminating the group health plan, which summarizes the claims history, claims expenses or type of claims experiences by individuals for whom a plan sponsor has provided health benefits under a group health plan; and from which identifying information has been deleted in accordance with HIPPA. YOUR RIGHT TO FILE A COMPLAINT WITH THE PLAN OR THE HHS SECRETARY If you believe that your privacy rights have been violated, you may complain to the Plan in care of the following officer: Mr. Ronnie O Neal, 101 North Texas Avenue, Bryan, Texas 77803, , ronnie.oneal@bryanisd.org You may file a complaint with the Secretary of the U.S. Department of Health and Human Services, Hubert H. Humphrey Building, 200 Independence Avenue S.W., Washington D.C The Plan will not retaliate against you for filing a complaint. WHOM TO CONTACT AT THE PLAN FOR MORE INFORMATION If you have any questions regarding this notice or the subjects addressed in it, you may contact the following officer: Mr. Ronnie O Neal, 101 North Texas Avenue, Bryan, Texas 77803, , ronnie.oneal@bryanisd.org. CONCLUSION PHI use and disclosure by the Plan is regulated by a federal law known as HIPPA (the Health Insurance Portability and Accountability Act). You may find these rules at 45 Code of Federal Regulations Parts 160 and 164. This notice attempts to summarize the regulations. The regulations will supersede any discrepancy between the information in this notice and the regulations. This notice does not apply to information that has been de-identified. De-identified information is information that does not identify an individual and with respect to which there is no reasonable basis to believe that the information can be used to identify an individual is not individually identifiable health information. 40

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43 Notice to Employees: Requirements of the Affordable Care Act As of January 1, 2014, the Affordable Care Act (ACA) requires you to have health insurance for yourself and your dependents. Some people are exempt from this requirement. To learn how to apply for an exemption see Questions and Answers on the Individual Shared Responsibility Provision, and Answers on the Individual Shared Responsibility Provision. If you do not have health insurance and you are not exempt, you may be subject to a penalty (see if someone doesnt have health coverage in 2014). The penalty takes effect on the first day of the 2014 plan year (September 1, 2014). Enrollment in the Bryan ISD Group Benefit Risk Pool satisfies the requirement to have health insurance. The Blue Cross Blue Shield Benefit Booklet explains who is eligible to enroll in the Bryan ISD Group Benefit Risk Pool. Enrollment in another plan, such as through a spouse, parent, or association, also satisfies the requirement to have health insurance if the plan provides minimum essential coverage. As an alternative to Bryan ISD Group Benefit Risk Pool or another health insurance program, you may enroll in insurance through the Health Insurance Marketplace. In Texas, the Marketplace is a federal government program that will offer one stop shopping to find and compare private health insurance options. Most individuals are eligible to enroll in insurance through the Marketplace. The Marketplace will begin enrollment in October 2013 for coverage beginning in January For information on the Marketplace, see You may be eligible for a premium tax credit or other assistance toward insurance obtained through the Marketplace, depending on your household income. More information on the premium tax credit and other cost sharing provisions is available at Please note that the district will not contribute to premium costs if you enroll in insurance through the Marketplace. Also, you will lose the benefit of paying the premium with pre tax income if you purchase insurance through the Marketplace. You must decide whether to enroll in the Bryan ISD Group Benefit Risk Pook during open enrollment for 2014, if you are eligible. You may not delay the decision until the Marketplace is operational. If you decide not to enroll in the Bryan ISD Group Benefit Risk Pool during open enrollment in October 2015, you will not be able to enroll again until the 2017 plan year unless you experience a special enrollment event. On the other hand, if you decide to enroll, the district s section 125 plan (cafeteria plan) does not permit you to drop insurance before the end of the plan year. Additional information. If you have questions or concerns about the health insurance offered through the district, please contact the Bryan ISD Employee Benefit Office. Questions about the Marketplace and how the Affordable Care Act impacts you as an individual should be addressed to or your personal attorney. 43

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