2016 Benefit Guide Taylor ISD

EFFECTIVE:

09/01/2016 - 8/31/2017

BENEFIT GUIDE

www.mybenefitshub.com/taylorisd

TAYLOR ISD

1

Benefit Contact Information 3

How to Enroll 4-5

Annual Benefit Enrollment 6-11

1. Benefit Updates 6

2. Section 125 Cafeteria Plan Guidelines 7

3. Annual Enrollment 8

4. Eligibility Requirements 9

5. Helpful Definitions 10 6. HSA vs FSA Comparison 11

Century Healthcare Medical Gap 12-15

HSA Bank Health Savings Account 16-19

MDLIVE Telehealth 20-21

FBS LifeWorks EAP 22-23

CIGNA PPO Dental 24-28 CompBenefits Discount Dental 29

Superior Vision 30-31

UNUM Educator Disability 32-35

Loyal American Cancer 36-39 Loyal American Accident 40-43

Voya Critical Illness 44-45

OneAmerica Basic & VTL Life 46-51

Axis Voluntary AD&D 52-53

5Star Family Protection Plan Term Life Insurance with Long Term Care

54-57

ID Watchdog Identity Theft Protection 58-69

NBS Flexible Spending Accounts 60-63

Table of Contents

HOW TO ENROLL

PG. 4

YOUR BENEFIT UPDATES: WHAT’S NEW

PG. 6

YOUR BENEFITS PACKAGE

PG. 12

FLIP TO...

2

Benefit Contact Information

Benefit Contact Information TAYLOR ISD BENEFITS DENTAL ACCIDENT INDIVIDUAL LIFE

Financial Benefit Services (800) 583-6908 www.mybenefitshub.com/taylorisd

Cigna (800) 244-6224 www.mycigna.com

Loyal American (800) 366-8354

5 Star Life Insurance Company (866) 863-9753 www.5starlifeinsurance.com

TAYLOR ISD BENFITS OFFICE DENTAL -DISCOUNT PLAN HEALTH SAVINGS ACCOUNTS ID THEFT PROTECTION

(512) 352-6361 www.taylorisd.org

Humana Comp Benefits (800) 488-2801 www.mycompbenefits.com

HSA Bank (800) 357-6246 www.hsabank.com

ID Watchdog (800) 237-1521 www.idwatchdog.com

MEDICAL GAP VISION CRITICAL ILLNESS FLEXIBLE SPENDING ACCOUNTS

Century Healthcare (469) 305-4417 www.centuryhealthcare.com/

Superior Vision (800) 507-3800 www.superiorvision.com

Voya (888) 238-4840 www.voya.com

National Benefit Services (800) 274-0503 www.nbsbenefits.com

TELEHEALTH EDUCATOR DISABILITY BASIC LIFE & VTL LIFE COBRA (Dental, Vision, MEDlink, Medical Flex)

MDLIVE (888) 365-1663 www.consultmdlive.com

UNUM (800) 583-6908 www.unum.com

AUL a OneAmerica Company (800) 583-6908 www.oneamerica.com

National Benefit Services (800) 274-0503 option 4 Fax: (800) 478-1528 www.nbsbenefits.com

EMPLOYEE ASSISTANCE PLAN & WORK LIFE PROGRAM (EAP)

CANCER AD&D 403(B) INVESTMENTS

FBS LifeWorks (888) 456-1324 www.ceridian.com

Loyal American (800) 366-8354

Axis Global (866) 863-9753 www.axisaccidentalhealth.com

National Benefit Services (800) 274-0503 option 4 Fax: (800) 478-1528 www.nbsbenefits.com

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http://www.aetna.com/

!

How to Enroll

On Your Computer Access THEbenefitsHUB from your

computer, tablet or smartphone!

Our online benefit enrollment

platform provides a simple and

easy to navigate process. Enroll

at your own pace, whether at

home or at work.

www.mybenefitshub.com/

taylorisd delivers important

benefit information with 24/7

access, as well as detailed plan

information, rates and product

videos.

TEXT

“taylorisd”

TO

313131

On Your Device Enrolling in your benefits just got

a lot easier! Text “taylorisd” to

313131 to receive everything you

need to complete your

enrollment.

Avoid typing long URLs and scan

directly to your benefits website,

to access plan information,

benefit guide, benefit videos, and

more!

SCAN: TRY ME

4

GO www.mybenefitshub.com/taylorisd 1

2

Login Steps

3

Go to:

Click Login

Enter Username & Password

OR SCAN

All login credentials have been RESET to the default

described below:

Username:

The first six (6) characters of your last name, followed

by the first letter of your first name, followed by the

last four (4) digits of your Social Security Number.

If you have six (6) or less characters in your last name,

use your full last name, followed by the first letter of

your first name, followed by the last four (4) digits of

your Social Security Number.

Default Password:

Last Name* (lowercase, excluding punctuation)

followed by the last four (4) digits of your Social

Security Number.

Sample Password

l incola1234

l incoln1234

If you have trouble

logging in, click on the

“Login Help Video”

for assistance.

Click on “Enrollment Instructions” for more information about how to enroll.

Sample Username

LOGIN

Open Enrollment Tip

For your User ID: If you have less than six (6) characters in your last

name, use your full last name, followed by the first letter of your first

name, followed by the last four (4) digits of your Social Security Number.

5

Annual Enrollment

During your annual enrollment period, you have the opportunity

to review, change or continue benefit elections each year.

Changes are not permitted during the plan year (outside of

annual enrollment) unless a Section 125 qualifying event occurs.

Changes, additions or drops may be made only during the

annual enrollment period without a qualifying event.

Employees must review their personal information and verify

that dependents they wish to provide coverage for are

included in the dependent profile. Additionally, you must

notify your employer of any discrepancy in personal and/or

benefit information.

Employees must confirm on each benefit screen (medical,

dental, vision, etc.) that each dependent to be covered is

selected in order to be included in the coverage for that

particular benefit.

New Hire Enrollment

All new hire enrollment elections must be completed in the

online enrollment system within the first 31 days of benefit

eligibility employment. Failure to complete elections during this

timeframe will result in the forfeiture of coverage.

Q&A

Who do I contact with Questions?

For supplemental benefit questions, you can contact your

Benefits/HR department or you can call Financial Benefit Services

at 866-914-5202 for assistance.

Where can I find forms?

For benefit summaries and claim forms, go to your benefit

website:

www.mybenefitshub.com/taylorisd. Click on the benefit plan

you need information on (i.e., Dental) and you can find the

forms you need under the Benefits and Forms section.

How can I find a Network Provider?

For benefit summaries and claim forms, go to the Taylor ISD

benefit website: www.mybenefitshub.com/taylorisd. Click on

the benefit plan you need information on (i.e., Dental) and

you can find provider search links under the Quick Links

section.

When will I receive ID cards?

If the insurance carrier provides ID cards, you can expect to

receive those 3-4 weeks after your effective date. For most

dental and vision plans, you can login to the carrier website

and print a temporary ID card or simply give your provider the

insurance company’s phone number and they can call and

verify your coverage if you do not have an ID card at that

time. If you do not receive your ID card, you can call the

carrier’s customer service number to request another card.

SUMMARY PAGES

6

PLAN CARRIER MAXIMUM AGE CONTINUATION

Medical Aetna/First Care To 26 COBRA (Wellsystems)

Medical Supplement Gap Century Healthcare To 26 COBRA (NBS)

Dental Cigna Humana To 26 COBRA (NBS)

Vision Superior Vision To 26 COBRA (NBS)

Health Savings Account HSA To 26 Portable

Cancer Loyal American Unmarried To 25 Portable after 12 mos.

coverage*

Accident Loyal American Unmarried To 25 Portable*

Critical Illness Voya Unmarried To 26 Portable*

Voluntary Term Life AUL a OneAmerica Company Unmarried To 26 Port/Convert*

AD&D Axis Global

Individual Life w/LTC 5Star Issuable to age 23 Direct Pay*

Employee Assistance (EAP) Ceridian To 26 N/A

Identity Theft ID Watchdog To 26 N/A

Medical Flex National Benefit Services To 26 COBRA (NBS)

Dependent Flex

National Benefit Services

12 or younger or qualified individual unable to care for themselves & claimed as a dependent

on your taxes

N/A

Employee Eligibility Requirements

Supplemental Benefits: Eligible employees must work 20 or

more regularly scheduled hours each work week.

Eligible employees must be actively at work on the plan effective

date for new benefits to be effective, meaning you are physically

capable of performing the functions of your job on the first day

of work concurrent with the plan effective date. For example, if

your 2016 benefits become effective on September 1, 2016, you

must be actively-at-work on September 1, 2016 to be eligible for

your new benefits.

Dependent Eligibility Requirements

Dependent Eligibility: You can cover eligible dependent

children under a benefit that offers dependent coverage,

provided you participate in the same benefit, through the

maximum age listed below. Dependents cannot be double

covered by married spouses within Taylor ISD or as both

employees and dependents.

If your dependent is disabled, coverage can continue past the maximum age under certain plans. If you have a disabled dependent who is reaching an ineligible age, you must provide a physician’s statement confirming your dependent’s disability. Contact your HR/Benefit Administrator to request a continuation of coverage.

SUMMARY PAGES

*Contact carrier within 30 days of termination to be elibile for continuation

7

Benefit elections will become effective 9/1/2016(elections requiring evidence of insurability, such as life Insurance, may have a later effective date, if approved). After annual enrollment closes, benefit changes can only be made if you experience a qualifying event (and changes must be made within 30 days of event).

CRITICAL ILLNESS

The Allstate Heart & Stroke coverage will terminate 8/31/2016. Voya CI will now be available. Critical illness is a supplemental plan that provides a lump-sum benefit upon diagnosis of a covered condition or event. $5,000 in coverage is provided by Taylor ISD. Employees can purchase up to an additional $25,000 in coverage.

Reminder, If you currently participate in a Healthcare or

Dependent Care FSA, you MUST re-elect a new contribution amount every year to continue to participate.

5 STAR TERM LIFE TI WITH QUALITY OF LIFE RIDER

Current Texas Life policies will continue to be payroll deducted, but no new policies will be issued after 9/1/2016. 5 Star has a new policy available. This Guaranteed Issue individual life plan provides a death benefit to age 100 and includes a terminal illness benefit and Quality of Life rider. Employees do not need to apply in order to apply for eligible dependent spouse and children or grandchildren. This plan is portable, so you can keep it at retirement.

CUSTOMLINK This plan will replace the APL MEDLink. This plan will supplement your medical plan by helping pay for out-of-pocket expenses while confined in the hospital or as an outpatient. There are two plan options. One plan is HSA compatible with a $2,500 inpatient benefit and $1,300 employee deductible (2X for family), and the other is a traditional plan with a $2,500 inpatient benefit.

ID WATCHDOG

NEW! Identity theft protection monitors and alerts you to identity threats. Resolution services are included should your identity ever be compromised while you are covered.

Don’t Forget!

Login and complete your benefit enrollment from 7/11/2016—8/22/2016. Enrollment assistance is available by calling Financial Benefit Services at (800) 583-6908 to speak to

a representative. Update your profile information: home address, phone numbers, email. Update dependent social security numbers and student status for college aged children.

Benefit Updates - What’s New:

SUMMARY PAGES

Annual Benefit Enrollment

8

SUMMARY PAGES

CHANGES IN STATUS (CIS):

QUALIFYING EVENTS

Marital Status A change in marital status includes marriage, death of a spouse, divorce or annulment (legal separation is not recognized in all states).

Change in Number of Tax Dependents

A change in number of dependents includes the following: birth, adoption and placement for adoption. You can add existing dependents not previously enrolled whenever a dependent gains eligibility as a result of a valid change in status event.

Change in Status of Employment Affecting

Coverage Eligibility

Change in employment status of the employee, or a spouse or dependent of the employee, that affects the individual's eligibility under an employer's plan includes commencement or termination of employment.

Gain/Loss of Dependents' Eligibility Status

An event that causes an employee's dependent to satisfy or cease to satisfy coverage requirements under an employer's plan may include change in age, student, marital, employment or tax dependent status.

Judgment/Decree/Order

If a judgment, decree, or order from a divorce, annulment or change in legal custody requires that you provide accident or health coverage for your dependent child (including a foster child who is your dependent), you may change your election to provide coverage for the dependent child. If the order requires that another individual (including your spouse and former spouse) covers the dependent child and provides coverage under that individual's plan, you may change your election to revoke coverage only for that dependent child and only if the other individual actually provides the coverage.

Eligibility for Government Programs

Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change.

A Cafeteria plan enables you to save money by using pre-tax dollars to pay for eligible group insurance premiums sponsored and offered by your employer. Enrollment is automatic unless you decline this benefit. Elections made during annual enrollment will become effective on the plan effective date and will remain in effect during the entire plan year.

Changes in benefit elections can occur only if you experience a qualifying event. You must present proof of a qualifying event to your Benefit Office within 30 days of your qualifying event and meet with your Benefit/HR Office to complete and sign the necessary paperwork in order to make a benefit election change. Benefit changes must be consistent with the qualifying event.

Section 125 Cafeteria Plan Guidelines

9

Actively at Work You are performing your regular occupation for the employer

on a full-time basis, either at one of the employer’s usual

places of business or at some location to which the employer’s

business requires you to travel. If you will not be actively at

work beginning 9/1/2016 please notify your benefits

administrator.

Annual Enrollment The period during which existing employees are given the

opportunity to enroll in or change their current elections.

Annual Deductible The amount you pay each plan year before the plan begins to

pay covered expenses.

Calendar Year January 1st through December 31st

Co-insurance After any applicable deductible, your share of the cost of a

covered health care service, calculated as a percentage (for

example, 20%) of the allowed amount for the service.

Guaranteed Coverage The amount of coverage you can elect without answering any

medical questions or taking a health exam. Guaranteed

coverage is only available during initial eligibility period.

Actively-at-work and/or pre-existing condition exclusion

provisions do apply, as applicable by carrier.

In-Network Doctors, hospitals, optometrists, dentists and other providers

who have contracted with the plan as a network provider.

Out of Pocket Maximum The most an eligible or insured person can pay in co-insurance

for covered expenses.

Plan Year September 1st through August 31st

Pre-Existing Conditions Applies to any illness, injury or condition for which the

participant has been under the care of a health care provider,

taken prescriptions drugs or is under a health care provider’s

orders to take drugs, or received medical care or services

(including diagnostic and/or consultation services).

Helpful Definitions SUMMARY PAGES

10

SUMMARY PAGES HSA vs. FSA

Health Savings Account (HSA) (IRC Sec. 223)

Flexible Spending Account (FSA) (IRC Sec. 125)

Description

Approved by Congress in 2003, HSAs are actual bank accounts in employee’s names that allow employees to save and pay for unreimbursed qualified medical expenses tax-free.

Allows employees to pay out-of-pocket expenses for copays, deductibles and certain services not covered by medical plan, tax-free. This also allows employees to pay for qualifying dependent care tax-free.

Employer Eligibility A qualified high deductible health plan. All employers

Contribution Source Employee and/or employer Employee and/or employer

Account Owner Individual Employer

Underlying Insurance Requirement

High deductible health plan None

Minimum Deductible $1,300 single (2016) $2,600 family (2016) N/A

Maximum Contribution $3,350 single (2016) $6,750 family (2016)

Varies per employer

Permissible Use Of Funds If used for non-qualified medical expenses, subject to current tax rate plus 20% penalty.

Reimbursement for qualified medical expenses (as defined in Sec. 213(d) of IRC).

Cash-Outs of Unused Amounts (if no medical expenses)

Permitted, but subject to current tax rate plus 20% penalty (penalty waived after age 65).

Not permitted

Year-to-year rollover of account balance?

Yes, will roll over to use for subsequent year’s health coverage.

No. Access to some funds can may be extended if your employer’s plan contains a 2 1/2 –month grace period or $500 rollover provision.

Does the account earn interest?

Yes No

Portable? Yes, portable year-to-year and between jobs.

No

FOR HSA INFORMATION

FLIP TO… PG. 16

FOR FSA INFORMATION

FLIP TO… PG. 60

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A Gap Plan is designed to help supplement your Employer's major medical plan. This plan provides supplemental coverage to help offset out-of-pocket costs that you may experience due to deductibles, co-payments and coinsurance of your medical plan.

About this Benefit

Gap Plan YOUR BENEFITS PACKAGE

DID YOU KNOW?

33%

of total healthcare costs are paid out-of-pocket.

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the

Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd

CENTURY HEALTHCARE

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Custom Link - HSA Compatible

AGE BASED ON MONTHLY COST BY COVERAGE AMOUNT

Benefit Amount $2,500 IP / $1,250 OP

Under Age 40: Insured Only Insured & Spouse Insured & Child(ren) Insured & Family

$20.11 $36.19 $44.44 $60.53

Ages 40 – 49: Insured Only Insured & Spouse Insured & Child(ren) Insured & Family

$27.89 $50.19 $51.31 $73.62

Ages 50 & Above: Insured Only Insured & Spouse Insured & Child(ren) Insured & Family

$45.02 $81.03 $72.94

$108.95

Gap Plan Options The GAP Plans provide coverage for medically necessary eligible out-of- pocket expenses related to the insured’s major medical plan’s co-insurance and deductibles up to the maximum benefit selected, provided such expenses are the result of treatment for a covered injury or sickness.

INPATIENT HOSPITAL BENEFIT The benefit option offers a $2,500 In-Hospital benefit per covered person per calendar year. Note: This coverage may not cover 100% of out-of-pocket expenses. BENEFITS INCLUDE: Coverage for out-of-pocket expenses due to an inpatient hospital

confinement. Inpatient surgeries and physician in-hospital charges Emergency room treatment and ambulance for a covered injury or

sickness when it results in hospital confinement within 24 hours Routine Newborn Care Durable medical equipment (DME) when provided while confined in

a hospital

OUTPATIENT HOSPITAL BENEFIT The Outpatient Hospital benefit limit is 50% of the In-hospital benefit amount selected and two times the individual outpatient benefit for dependent coverage BENEFITS INCLUDE: Emergency room treatment and ambulance as long as the person is

NOT hospitalized within 24 hours of being transported to the hospital and ER treatment,

Outpatient surgery in an outpatient surgical facility, emergency facility or physician’s office

Diagnostic testing, x-rays, labs, MRI’s, and CT scans Outpatient radiation therapy or chemotherapy Physical therapy or chiropractic care Durable medical equipment (DME) The Outpatient Benefit does not cover a physician’s office visit charge. Deductible - In order for your GAP plan to be compatible with a Health Savings Account (HSA), it has a deductible amount of $1,300 that must be satisfied before any benefits are payable. When dependent coverage is elected, benefits are payable only after the entire family deductible has been satisfied by one or more insured persons. Please note that in order for a service to be covered under the GAP Plan, it needs to be covered under the major medical plan.

Gap Plan Pricing

Plan exclusions The Policy does not provide any benefits for the following: 1. any Expenses Incurred during any period the Insured Person does not have coverage under a Medical Plan; 2. any expenses which are not Medically Necessary; 3. war, declared or undeclared; 4. suicide or any attempt thereat, while sane or insane (in Colorado, Missouri or Montana, while sane); 5. any intentionally self-inflicted Injury or Sickness, while sane or insane (in Colorado, Missouri or Montana, while sane); 6. any loss while the Insured Person is in the service of the Armed Forces of any country. Orders to active military service for training purposes of two months or less will not constitute service in the Armed Forces. Upon notice to the Company of entering the Armed Forces, the Company will return to the Insured Person pro rata any premium paid, less any benefits paid, for any period during which the Insured Person is in such service; 7. any expense for which there is no legal obligation to pay, no charge is made or in the absence of coverage, no charge would be made; 8. drugs or medicines, except medicines prescribed and taken while Hospital Confined; 9. dental or vision services unless: a. resulting from an Injury occurring while the Insured Person’s coverage under the Policy is in force; or b. due to congenital disease or anomaly of a Dependent newborn child; 10. mental illness or functional or organic nervous disorders, regardless of the cause; 11. treatment of alcoholism, drug addiction or complications thereof; 12. any Injury that occurs while an Insured Person has been determined to be intoxicated: a. by judicial or administrative judgment or order; b. by evidence of an alcohol concentration in the Insured Person’s blood, breath or urine which equals or exceeds the limits set by applicable motor vehicle laws; or c. by other evidence demonstrating the Insured Person was under the influence of any alcohol, narcotic, barbiturate or hallucinatory drug, unless the same was administered on the advice of a Physician and was taken according to the prescribed dosage; and the use of such substance was a proximate cause of the Injury; 13. any treatment, services or supplies for Wellness Services. For this exclusion, “Wellness Services” means treatment, services or supplies provided for routine health care, including, but not limited to, routine health or check-up examinations, routine well child visits, mammograms and other charges incurred during the course of a routine physical examination or checkup; 14. Injury or Sickness for which compensation is payable under any Workers’ Compensation Law, any Occupational Disease Law or similar legislation, or if the Policyholder opts out of such requirements, any similar coverage purchased or self-funded by the Policyholder to cover work-related Injuries or Sicknesses; 15. any loss for which the Insured Person is not required to pay a Deductible, Copayment and/or Coinsurance under the Insured Person’s Medical Plan; 16. any expense for which benefits are excluded under the Insured Person’s Medical Plan; or 17. an Insured Person engaging in any act or occupation which is a violation of the law of the jurisdiction where the loss or cause of loss occurred. A violation of law includes both misdemeanor and felony violations.

Limitations Medical Plan. If the Insured Person did not have a Medical Plan on the Insured Person’s Effective Date under the Policy, the Company’s sole obligation will then be to refund all premiums paid for that Insured Person. This plan is underwritten by Fidelity Security Life Insurance Company arranged through Special Insurance Services, Inc

13

Custom Link Traditional Gap Plan

AGE BASED ON MONTHLY COST BY COVERAGE AMOUNT

Benefit Amount $2,500 IP / $1,250 OP

Under Age 40: Insured Only Insured & Spouse Insured & Child(ren) Insured & Family

$35.04 $63.07 $77.43

$105.46

Ages 40 – 49: Insured Only Insured & Spouse Insured & Child(ren) Insured & Family

$48.59 $87.46 $89.41

$128.28

Ages 50 & Above: Insured Only Insured & Spouse Insured & Child(ren) Insured & Family

$78.45

$141.21 $127.08 $189.84

Gap Plan Options The GAP Plans provide coverage for medically necessary eligible out-of- pocket expenses related to the insured’s major medical plan’s co-insurance and deductibles up to the maximum benefit selected, provided such expenses are the result of treatment for a covered injury or sickness.

INPATIENT HOSPITAL BENEFIT The benefit option offers a $2,500 In-Hospital benefit per covered person per calendar year. Note: This coverage may not cover 100% of out-of-pocket expenses. BENEFITS INCLUDE: Coverage for out-of-pocket expenses due to an inpatient hospital

confinement. Inpatient surgeries and physician in-hospital charges Emergency room treatment and ambulance for a covered injury or

sickness when it results in hospital confinement within 24 hours Routine Newborn Care Durable medical equipment (DME) when provided while confined in

a hospital

OUTPATIENT HOSPITAL BENEFIT The Outpatient Hospital benefit limit is 50% of the In-hospital benefit amount selected and two times the individual outpatient benefit for dependent coverage BENEFITS INCLUDE: Emergency room treatment and ambulance as long as the person is

NOT hospitalized within 24 hours of being transported to the hospital and ER treatment,

Outpatient surgery in an outpatient surgical facility, emergency facility or physician’s office

Diagnostic testing, x-rays, labs, MRI’s, and CT scans Outpatient radiation therapy or chemotherapy Physical therapy or chiropractic care Durable medical equipment (DME) The Outpatient Benefit does not cover a physician’s office visit charge. Please note that in order for a service to be covered under the GAP Plan, it needs to be covered under the major medical plan.

Gap Plan Pricing

Plan exclusions The Policy does not provide any benefits for the following: 1. any Expenses Incurred during any period the Insured Person does not have coverage under a Medical Plan; 2. any expenses which are not Medically Necessary; 3. war, declared or undeclared; 4. suicide or any attempt thereat, while sane or insane (in Colorado, Missouri or Montana, while sane); 5. any intentionally self-inflicted Injury or Sickness, while sane or insane (in Colorado, Missouri or Montana, while sane); 6. any loss while the Insured Person is in the service of the Armed Forces of any country. Orders to active military service for training purposes of two months or less will not constitute service in the Armed Forces. Upon notice to the Company of entering the Armed Forces, the Company will return to the Insured Person pro rata any premium paid, less any benefits paid, for any period during which the Insured Person is in such service; 7. any expense for which there is no legal obligation to pay, no charge is made or in the absence of coverage, no charge would be made; 8. drugs or medicines, except medicines prescribed and taken while Hospital Confined; 9. dental or vision services unless: a. resulting from an Injury occurring while the Insured Person’s coverage under the Policy is in force; or b. due to congenital disease or anomaly of a Dependent newborn child; 10. mental illness or functional or organic nervous disorders, regardless of the cause; 11. treatment of alcoholism, drug addiction or complications thereof; 12. any Injury that occurs while an Insured Person has been determined to be intoxicated: a. by judicial or administrative judgment or order; b. by evidence of an alcohol concentration in the Insured Person’s blood, breath or urine which equals or exceeds the limits set by applicable motor vehicle laws; or c. by other evidence demonstrating the Insured Person was under the influence of any alcohol, narcotic, barbiturate or hallucinatory drug, unless the same was administered on the advice of a Physician and was taken according to the prescribed dosage; and the use of such substance was a proximate cause of the Injury; 13. any treatment, services or supplies for Wellness Services. For this exclusion, “Wellness Services” means treatment, services or supplies provided for routine health care, including, but not limited to, routine health or check-up examinations, routine well child visits, mammograms and other charges incurred during the course of a routine physical examination or checkup; 14. Injury or Sickness for which compensation is payable under any Workers’

14

Custom Link Traditional Gap Plan

Compensation Law, any Occupational Disease Law or similar legislation, or if the Policyholder opts out of such requirements, any similar coverage purchased or self-funded by the Policyholder to cover work-related Injuries or Sicknesses; 15. any loss for which the Insured Person is not required to pay a Deductible, Copayment and/or Coinsurance under the Insured Person’s Medical Plan; 16. any expense for which benefits are excluded under the Insured Person’s Medical Plan; or 17. an Insured Person engaging in any act or occupation which is a violation of the law of the jurisdiction where the loss or cause of loss occurred. A violation of law includes both misdemeanor and felony violations.

Limitations Medical Plan. If the Insured Person did not have a Medical Plan on the Insured Person’s Effective Date under the Policy, the Company’s sole obligation will then be to refund all premiums paid for that Insured Person. This plan is underwritten by Fidelity Security Life Insurance Company arranged through Special Insurance Services, Inc.

15

A Health Savings Account is a tax-advantaged medical savings account available to employees who are enrolled in a high-deductible health plan. The funds contributed to the account are not subject to federal income tax at the time of deposit. Unlike a flexible spending account (FSA), funds roll over and accumulate year to year if not spent.

About this Benefit

HSA (Health Savings Account)


The interest earned in an HSA is tax free.

DID YOU KNOW?

Money withdrawn for medical spending never falls under taxable income.

HSA BANK


Taylor ISD Benefits Website: www.mybenefitshub.com/taylorisd 16

HSA Bank has teamed up with your employer to create an affordable health coverage option that helps you save on healthcare expenses. This plan is only available for those who are participating in the Active Care 1-HD medical plan. Depending on your district, you may or may not be able to participate in the FSA plan if you participate in HSA. Medicare, Medicaid, and Tricare participants are not eligible to participate in an HSA. You can use your Health Savings Account (HSA) to pay for a wide range of IRS-qualified medical expenses for yourself, your spouse or tax dependents. An IRS-qualified medical expense is defined as an expense that pays for healthcare services, equipment, or medications. Funds used to pay for IRS-qualified medical expenses are always tax-free.

What is an HSA? A tax-advantaged savings account that you use to pay for

eligible medical expenses as well as deductible, co-insurance, prescriptions, vision and dental care. Allows you to save while reducing your taxable income.

Unused funds that will roll over year to year. There’s no “use it or lose it” penalty.

A way to accumulate additional retirement savings. After age 65, funds can be withdrawn for any purpose without penalty.

Using Funds Debit Card

You may use the card to pay merchants or service providers that accept VISA credit cards, so there is no need to pay cash up front and wait for reimbursements.

You can make a withdrawal at any time. Reimbursements for qualified medical expenses are tax free. If you are disabled or reach age 65, you can receive non-medical distributions without penalty, but you must report the distributions as taxable income. You may also use your funds for a spouse or tax dependent not covered by your HDHP.

2016 Annual HSA Contribution Limits Individual: $3,350 Family: $6,750 Catch-Up Contributions: Accountholders who meet the qualifications noted below are eligible to make an HSA catch-up contribution of an additional $1,000.

Health Savings accountholder

Age 55 or older (regardless of when in the year an accountholder turns 55)

Not enrolled in Medicare (if an accountholder enrolls in Medicare mid-year, catch contributions should be prorated)

Authorized Signers who are 55 or older must have their own HSA in order to make the catch-up contribution Monthly Fee: Your account will be charged a monthly fee of $1.75, waived with an average daily balance at or above $3,000.

Examples of Qualified Medical Expenses Surgery

Braces

Contact lenses

Dentures

Eyeglasses

Vaccines For a list of sample expenses, please refer to the Taylor ISD website at www.mybenefitshub.com/taylorisd

HSA Bank Contact Information 605 N. 8th Street, Ste 320 Sheboygan, WI 53081 Phone: 800-357-6246 www.hsabank.com

HSA (Health Savings Account)

17

A Health Savings Account (HSA) is an individually-owned, tax-advantaged account that you can use to pay for current or future IRS-qualified medical expenses. With an HSA, you’ll have the potential to build more savings for healthcare expenses or additional retirement savings through self-directed investment options1.

How an HSA works: You can contribute to your HSA via payroll deduction,

online banking transfer, or by sending a personal check to HSA Bank. Your employer or third parties, such as a spouse or parent, may contribute to your account as well.

You can pay for qualified medical expenses with your HSA Bank Debit Card directly to your medical provider or pay out-of-pocket. You can either choose to reimburse yourself or keep the funds in your HSA to grow your savings.

Unused funds will roll over year to year. After age 65, funds can be withdrawn for any purpose without penalty (subject to ordinary income taxes).

Check balances and account information via HSA Bank’s Internet Banking 24/7.

Are you eligible for an HSA? If you have a qualified High Deductible Health Plan (HDHP) - either through your employer, through your spouse, or one you’ve purchased on your own - chances are you can open an HSA. Additionally:

You cannot be covered by any other non-HSA-compatible health plan, including Medicare Parts A and B.

You cannot be covered by TriCare.

You cannot have accessed your VA medical benefits in the past 90 days (to contribute to an HSA).

You cannot be claimed as a dependent on another person’s tax return (unless it’s your spouse).

You must be covered by the qualified HDHP on the first day of the month.

When you open an account, HSA Bank will request certain information to verify your identity and to process your application.

What are the annual IRS contribution limits? Contributions made by all parties to an HSA cannot exceed the annual HSA limit set by the Internal Revenue Service (IRS). Anyone can contribute to your HSA, but only the accountholder and employer can receive tax deductions on those contributions. Combined annual contributions for the accountholder, employer, and third parties (i.e., parent, spouse, or anyone else) must not exceed these limits2.

2016 Annual HSA Contribution Limits Individual = $3,350 Family = $6,750

Catch-up Contributions Accountholders who meet these qualifications are eligible to make an HSA catch-up contribution of $1,000: Health Savings accountholder; age 55 or older (regardless of when in the year an accountholder turns 55); not enrolled in Medicare (if an accountholder enrolls in Medicare mid-year, catch-up contributions should be prorated). Authorized signers who are 55 or older must have their own HSA in order to make the catch-up contribution. According to IRS guidelines, each year you have until the tax filing deadline to contribute to your HSA (typically April 15 of the following year). Online contributions must be submitted by 2:00 p.m., Central Time, the business day before the tax filing deadline. Wire contributions must be received by noon, Central Time, on the tax filing deadline, and contribution forms with checks must be received by the tax filing deadline.

How can you benefit from tax savings? An HSA provides triple tax savings3. Here’s how:

Contributions to your HSA can be made with pre-tax dollars and any after-tax contributions that you make to your HSA are tax deductible.

HSA funds earn interest and investment earnings are tax free.

When used for IRS-qualified medical expenses, distributions are free from tax.

IRS-Qualified Medical Expenses You can use your HSA to pay for a wide range of IRS-qualified medical expenses for yourself, your spouse, or tax dependents. An IRS-qualified medical expense is defined as an expense that pays for healthcare services, equipment, or medications. Funds used to pay for IRS-qualified medical expenses are always tax-free. HSA funds can be used to reimburse yourself for past medical expenses if the expense was incurred after your HSA was established. While you do not need to submit any receipts to HSA Bank, you must save your bills and receipts for tax purposes.

How the HSA Plan Works

18

How the HSA Plan Works

Examples of IRS-Qualified Medical Expenses4:

For assistance, please contact the Client Assistance Center 800-357-6246 Monday – Friday, 7 a.m. – 9 p.m., and Saturday, 9 a.m. - 1 p.m., CT www.hsabank.com | 605 N. 8th Street, Ste. 320, Sheboygan, WI 53081 1 Investment accounts are not FDIC insured, may lose value and are not a deposit or other obligation of, or guarantee by the bank. Investment losses which are replaced are subject to the annual contribution limits of the HSA. 2 HSA funds contributed in excess of these limits are subject to penalty and tax unless the excess and earnings are withdrawn prior to the due date, including any extensions for filing Federal Tax returns. Accountholders should consult with a qualified tax advisor in connection with excess contribution removal. The Internal Revenue Service requires HSA Bank to report withdrawals that are considered refunds of excess contributions. In order for the withdrawal to be accurately reported, accountholders may not withdraw the excess directly. Instead, an excess contribution refund must be requested from HSA Bank and an Excess Contribution Removal Form completed. 3 Federal Tax savings are available no matter where you live and HSAs are taxable in AL, CA, and NJ. HSA Bank does not provide tax advice. Consult your tax professional for tax‐related questions. 4 This list is not comprehensive. It is provided to you with the understanding that HSA Bank is not engaged in rendering tax advice. The information provided is not intended to be used to avoid Federal tax penalties. For more detailed information, please refer to IRS Publication 502 titled, “Medical and Dental Expenses”. Publications can be ordered directly from the IRS by calling 1-800-TAXFORM. If tax advice is required, you should seek the services of a professional. 5 Insurance premiums only qualify as an IRS-qualified medical expense: while continuing coverage under COBRA; for qualified long-term care coverage; coverage while receiving unemployment compensation; for any healthcare coverage for those over age 65 including Medicare (except Medicare supplemental coverage).

Acupuncture Alcoholism treatment Ambulance services Annual physical examination Artificial limb or prosthesis Birth control pills (by prescription) Chiropractor Childbirth/delivery Convalescent home (for medical treatment only) Crutches Doctor’s fees Dental treatments (including x-rays, braces, dentures, fillings, oral surgery) Dermatologist Diagnostic services Disabled dependent care Drug addiction therapy Fertility enhancement (including in-vitro fertilization) Guide dog (or other service animal)

Gynecologist Hearing aids and batteries Hospital bills Insurance premiums5

Laboratory fees Lactation expenses Lodging (away from home for outpatient care) Nursing home Nursing services Obstetrician Osteopath Oxygen Pregnancy test kit Podiatrist Prescription drugs and medicines (over-the-counter drugs are not IRS- qualified medical expenses unless prescribed by a doctor) Prenatal care & postnatal treatments Psychiatrist Psychologist Smoking cessation programs

Special education tutoring Surgery Telephone or TV equipment to assist the hearing or vision impaired Therapy or counseling Medical transportation expenses Transplants Vaccines Vasectomy Vision care (including eyeglasses, contact lenses, lasik surgery) Weight loss programs (for a specific disease diagnosed by a physician – such as obesity, hypertension, or heart disease) Wheelchairs X-rays

19

Telehealth provides 24/7/365 access to board-certified doctors via telephone consultations that can diagnose, recommend treatment and prescribe medication. Whether you are at home, traveling or at work, Telehealth makes care more convenient and accessible for non-emergency care when your primary care physician is not available.

About this Benefit

Telehealth YOUR BENEFITS PACKAGE

DID YOU KNOW?

75%

of all doctor, urgent care, and ER visits could be handled safely and effectively via

telehealth.

MDLIVE



Telehealth

When should I use MDLIVE? If you’re considering the ER or urgent care for a

non-emergency medical issue

Your primary care physician is not available

At home, traveling, or at work

24/7/365, even holidays!

What can be treated? Allergies

Asthma

Bronchitis

Cold and Flu

Ear Infections

Joint Aches and Pain

Respiratory Infection

Sinus Problems

And More!

Pediatric Care related to: Cold & Flu

Constipation

Ear Infection

Fever

Nausea & Vomiting

Pink Eye

And More!

Who are our doctors? MDLIVE has the nation’s largest network of telehealth doctors. On average, our doctors have 15 years of experience practicing medicine and are licensed in the state where patients are located. Their specialties include primary care, pediatrics, emergency medicine and family medicine. Our doctors are committed to providing convenient, quality care and are always ready to take your call.

Are children eligible? Yes. MDLIVE has local pediatricians on-call 24/7/365. Please note, a parent or guardian must be present during any interactions involving minors. We ask parents to establish a child record under their account. Parents must be present on each call for children 18 or younger.

How much does it cost?

Covers you, your spouse, and children up to age 26, with unlimited phone consultations.

Download the App Doctor visits are easier and more convenient with the MDLIVE App. Be prepared. Download today. www.mdlive.com/getapp

Access to a doctor anywhere: at home, at work, or on the go

Choose doctors from one of the nation's largest telehealth networks

Available 24/7 by video or phone

Private, secure and confidential visits

Connect instantly with MDLIVE Assist

Disclaimers: MDLIVE does not replace the primary care physician. MDLIVE operates subject to state regulation and may not be available in certain states. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services. For complete terms of use visit www.mdlive.com/pages/terms.html 010113

Call us at (888) 365-1663 or visit us at www.consultmdlive.com

Scan with your smartphone to get the app.

$0

21

An Employee Assistance Plan (EAP) is an employee benefit program offered to help employees manage personal and professional problems that might adversely impact their work performance, health, and well-being. Employee Assistance Plans generally include short-term counseling and referral services for employees and their household members. Your Employee Assistance Program benefit is provided to you by your employer.

About this Benefit

EAP (Employee Assistance Program)

DID YOU KNOW?

LIFEWORKS

38% of employees have missed life events because of bad work-life balance.




22

Employee Assistance Program (EAP)

TOPIC DESCRIPTION

Emotions and Stress

Relationship issues, depression and anxiety – even an online “calm room”

Parenting Parenting skills, adoption, talking with your teenager, help in finding child care

Midlife and Retirement

Financial considerations, work and career in midlife, relationships with adult children, growing as a couple

Addictive Behaviors

Drug and alcohol abuse, eating disorders, gambling

Education Applying to college, understanding financial aid and scholarships, advocating in the schools

Caring of older adults

Caregiver support, referrals to in-home and other services, and federally funded programs

Disability Special needs programs, advocacy and specific disabilities information

Everyday Issues Community resources and consumer information

Financial Issues

Credit management, budget analysis, 401(k) plan questions, basic estate planning, and questions about federal tax planning and preparation

Legal Issues

On-staff attorneys provide information and referrals for family matters, real estate, consumer credit and criminal matters. Also online program with forms, guides and simple wills.

Work

Special content for managers includes employee relations, interpersonal conflicts, performance issues, discrimination and workplace change. Also general support for co-worker relationships and stress.

TOOL DESCRIPTION

Online authorization Employees

Employees can obtain authorization for in-person sessions and choose a counselor right on the website

Resource locators Find child care, elder care, EAP counselors, public and private schools, and summer camps.

Interactive self- assessments

Employees get immediate feedback, descriptions of services available and links to relevant content all dynamically generated by their responses

Articles

More than 1,200 expert-reviewed articles covering the full range of EAP, work-life and wellness issues plus access to more than 4,000 health articles through the Health Library.

Audio podcasts

Monthly audio podcasts for employees and quarterly podcasts for managers featuring nationally recognized experts and Ceridian consultants.

Audio CDs

Financial calculators to help employees make savings and purchase decisions and health calculators to help them manage their health

Calculators Special needs programs, advocacy and specific disabilities information

Online seminars and workshops

Dozens of online sessions for easy access at anytime.

Monthly e-newsletter

Employees can subscribe to the monthly LifeWorks email newsletter, customized for each subscriber from a choice of eight topic areas.

Monthly web discussion

Hosted by experts on a variety of topics, these interactive discussions are open to all individuals.

With LifeWorks Integrated EAP and Work-life services, Taylor ISD employees and their families will have access to confidential assistance and support on a wide range of issues in the areas of life, health, family, work and money. EAP is employer-paid by Taylor ISD for employees and their dependents.

LifeWorks

888.456.1324 | WWW.CERIDIAN.COM

23

http://www.ceridian.com/

Dental insurance is a coverage that helps defray the costs of dental care. It insures against the expense of routine care, treatment and dental disease.

About this Benefit

Dental YOUR BENEFITS PACKAGE

Good dental care may improve your overall health.

Also Women with gum disease may be at greater risk of giving birth to a preterm or low birth weight baby.

DID YOU KNOW?

CIGNA



Dental PPO - Low Option

Benefits Cigna Dental PPO - Low Option

In-Network Out-of-Network

Network Total Cigna DPPO Contract Year Maximum (Class I, II, and III expenses)

$750 $750

Contract Deductible Individual Family

$50 per person $150 per family


Reimbursement Levels** Based on Reduced Contracted Fees

Based on Maximum Allowable Charge (In-

network fee level)

Plan Pays You Pay Plan Pays You Pay

Class I - Preventive & Diagnostic Care Oral Exams Routine Cleanings Full Mouth X-rays Bitewing X-rays Panoramic X-ray Emergency Care to Relieve Pain Fluoride Application Sealants Space Maintainers Histopathologic Exams

100% No Charge 100% No Charge

Class II - Basic Restorative Care Fillings Brush Biopsies Oral Surgery – Simple Extractions

80%* 20%* 80%* 20%*

Class III - Major Restorative Care Crowns/Bridges/Dentures Root Canal Therapy/Endodontics Osseous Surgery Periodontal Scaling and Root Planing Denture Repairs Denture Relines, Rebases and Adjustments Inlays/Onlays Prosthesis Over Implant Oral Surgery – all except simple extractions Anesthetics Surgical Extractions of Impacted Teeth Repairs to Bridges, Crowns and Inlays

50%* 50%* 50%* 50%*

Class IV - Orthodontia Lifetime Maximum

50%* $1,000

Dependent children to

age 19

50%*

50%* $1,000


age 19

50%*

Monthly PPO Premiums

Tier Rate

EE Only $26.39

EE + 1 Dependent $47.48

EE + 2 or more Dependents

$73.40

Dental Network Savings Program (DNSP): Using an out-of-network dental health care professional will cost you more than using in-network care. You may be able to save some money on out-of-pocket expenses if you use a dental health care professional that participates in Cigna’s Dental Network Savings Program. Missing Tooth Limitation – The amount payable is 50% of the amount otherwise payable until insured for 12 months; thereafter, considered a Class III expense. Pretreatment review is available on a voluntary basis when extensive dental work in excess of $200 is proposed. *Subject to annual deductible Dental Oral Health Integration Program (OHIP) - All dental customers = Clinical research shows an association between oral health and overall health. The Cigna Dental Oral Health Integration Program (OHIP)® is designed to provide enhanced dental coverage for customers with certain eligible medical conditions. Eligible conditions for the program include cardiovascular disease, cerebrovascular disease (stroke), diabetes, maternity, chronic kidney disease, organ transplants, and head and neck cancer radiation. The program provides:

100% coverage for certain dental procedures

guidance on behavioral issues related to oral health

discounts on prescription and non-prescription dental products For more information and to see the complete list of eligible conditions, go to www.mycigna.com or call customer service 24/7 at 1.800.CIGNA24. **For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Contracted Fee Schedule. For services provided by an out-of-network dentist, Cigna Dental will reimburse according to Reasonable and Customary Allowances but the dentist may balance bill up to their usual fees.

25

Dental PPO - High Option

Benefits Cigna Dental PPO - Low Option

In-Network Out-of-Network

Network Total Cigna DPPO Contract Year Maximum (Class I, II, and III expenses)

$1,000 $1,000

Contract Deductible Individual Family



Reimbursement Levels** Based on Reduced Contracted Fees

90th percentile of Reasonable and Customary

Allowances

Plan Pays You Pay Plan Pays You Pay

Class I - Preventive & Diagnostic Care Oral Exams Routine Cleanings Full Mouth X-rays Bitewing X-rays Panoramic X-ray Emergency Care to Relieve Pain Fluoride Application Sealants Space Maintainers Histopathologic Exams

100% No Charge 100% No Charge

Class II - Basic Restorative Care Fillings Brush Biopsies Oral Surgery – Simple Extractions

80%* 20%* 80%* 20%*

Class III - Major Restorative Care Crowns/Bridges/Dentures Root Canal Therapy/Endodontics Osseous Surgery Periodontal Scaling and Root Planing Denture Repairs Denture Relines, Rebases and Adjustments Inlays/Onlays Prosthesis Over Implant Oral Surgery – all except simple extractions Anesthetics Surgical Extractions of Impacted Teeth Repairs to Bridges, Crowns and Inlays

50%* 50%* 50%* 50%*

Class IV - Orthodontia Lifetime Maximum

50%* $1,000


age 19

50%*

50%* $1,000


age 19

50%*

Monthly PPO Premiums

Tier Rate

EE Only $37.95

EE + 1 Dependent $67.91

EE + 2 or more Dependents

$107.10

Dental Network Savings Program (DNSP): Using an out-of-network dental health care professional will cost you more than using in-network care. You may be able to save some money on out-of-pocket expenses if you use a dental health care professional that participates in Cigna’s Dental Network Savings Program. Missing Tooth Limitation – The amount payable is 50% of the amount otherwise payable until insured for 12 months; thereafter, considered a Class III expense. Pretreatment review is available on a voluntary basis when extensive dental work in excess of $200 is proposed. *Subject to annual deductible Dental Oral Health Integration Program (OHIP) - All dental customers = Clinical research shows an association between oral health and overall health. The Cigna Dental Oral Health Integration Program (OHIP)® is designed to provide enhanced dental coverage for customers with certain eligible medical conditions. Eligible conditions for the program include cardiovascular disease, cerebrovascular disease (stroke), diabetes, maternity, chronic kidney disease, organ transplants, and head and neck cancer radiation. The program provides:

100% coverage for certain dental procedures

guidance on behavioral issues related to oral health

discounts on prescription and non-prescription dental products For more information and to see the complete list of eligible conditions, go to www.mycigna.com or call customer service 24/7 at 1.800.CIGNA24. **For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Contracted Fee Schedule. For services provided by an out-of-network dentist, Cigna Dental will reimburse according to Reasonable and Customary Allowances but the dentist may balance bill up to their usual fees.

26

Dental PPO - High and Low Options

Procedure Exclusions and Limitations Late Entrants Limit 50% coverage on Class III and IV for 12 months

Exams Two per Calendar year

Prophylaxis (Cleanings) Two per Calendar year

Fluoride 1 per Calendar year for people under 19

Histopathologic Exams Various limits per Calendar year depending on specific test

X-Rays (routine) Bitewings: 2 per Calendar year

X-Rays (non-routine) Full mouth: 1 every 36 consecutive months., or Panorex: 1 every 36 consecutive months

Model Payable only when in conjunction with Ortho workup

Minor Perio (non-surgical) Various limitations depending on the service

Perio Surgery Various limitations depending on the service

Crowns and Inlays Replacement every 5 years

Bridges Replacement every 5 years

Dentures and Partials Replacement every 5 years

Relines, Rebases Covered if more than 6 months after installation

Adjustments Covered if more than 6 months after installation

Repairs - Bridges Reviewed if more than once

Repairs - Dentures Reviewed if more than once

Sealants Limited to posterior tooth. One treatment per tooth every three years up to age 14

Space Maintainers Limited to non-Orthodontic treatment

Prosthesis Over Implant 1 per 60 consecutive months if unserviceable and cannot be repaired. Benefits are based on the

amount payable for non- precious metals. No porcelain or white/tooth colored material on molar crowns or bridges

Alternate Benefit When more than one covered Dental Service could provide suitable treatment based on common dental standards, Cigna HealthCare will determine the covered Dental Service on which payment will be based and the expenses that will be included as Covered Expenses

Benefit Exclusions Services performed primarily for cosmetic reasons Replacement of a lost or stolen appliance Replacement of a bridge or denture within five years

following the date of its original installation Replacement of a bridge or denture which can be made

useable according to accepted dental standards Procedures, appliances or restorations, other than full

dentures, whose main purpose is to change vertical dimension, diagnose or treat conditions of TMJ, stabilize periodontally involved teeth, or restore occlusion

Veneers of porcelain or acrylic materials on crowns or

pontics on or replacing the upper and lower first, second

and third molars Bite registrations; precision or semi-precision

attachments; splinting Instruction for plaque control, oral hygiene and diet Dental services that do not meet common dental

standards Services that are deemed to be medical services Services and supplies received from a hospital Charges which the person is not legally required to pay Charges made by a hospital which performs services for

the U.S. Government if the charges are directly related to a condition connected to a military service

27

Experimental or investigational procedures and treatments

Any injury resulting from, or in the course of, any

employment for wage or profit Any sickness covered under any workers’

compensation or similar law Charges in excess of the reasonable and customary

allowances To the extent that payment is unlawful where the

person resides when the expenses are incurred; Procedures performed by a Dentist who is a member

of the covered person’s family (covered person’s family is limited to a spouse, siblings, parents, children, grandparents, and the spouse’s siblings and parents);

For charges which would not have been made if the

person had no insurance; For charges for unnecessary care, treatment or

surgery; To the extent that you or any of your Dependents is in

any way paid or entitled to payment for those expenses by or through a public program, other than Medicaid;

To the extent that benefits are paid or payable for

those expenses under the mandatory part of any auto insurance policy written to comply with a “no-fault” insurance law or an uninsured motorist insurance law. Cigna HealthCare will take into account any adjustment option chosen under such part by you or any one of your Dependents.

In addition, these benefits will be reduced so that the

total payment will not be more than 100% of the charge made for the Dental Service if benefits are provided for that service under this plan and any medical expense plan or prepaid treatment program sponsored or made available by your Employer.

This benefit summary highlights some of the benefits available under the proposed plan. A complete description regarding the terms of coverage, exclusions and limitations, including legislated benefits, will be provided in your insurance certificate or plan description. Benefits are insured and/or administered by Connecticut General Life Insurance Company. "Cigna HealthCare" refers to various operating subsidiaries of Cigna Corporation. Products and services are provided by these subsidiaries and not by Cigna Corporation. These subsidiaries include Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, and HMO or service company subsidiaries of Cigna Health Corporation and Cigna Dental Health, Inc.

High and Low Options

28

Texas Dental Plans, Inc./Group Plan

TDP brings simple, affordable choices. Texas Dental Plans (TDP) provide the additional security and con‐venience you need for the health options your traditional insur‐ance plan may not cover. Along with comprehensive dental cov‐erage, this TDP plan also includes vision and hearing benefits at no additional cost. Our special discount plans offer substantial savings and advantages to our members

Easy to use! Easy to save! Because we are not an insurance company or an HMO, our plan avoids high medical costs, annoying paperwork, and restrictions on procedures. Simply see the participating provider of your choice and pay the discounted fee at the time of service. Other advantages to our plans include no deductibles, no waiting peri‐ods, and no pre-existing condition limitations

Dedicated professionals. Currently, we have over 15,000 dental and vision providers in cities across the country, and the list continues to grow. You are free to choose from the large panel of providers and may change providers at any time without notifying our office. There are no limits on the number of visits and services. Pre-existing conditions are accepted!

Dental Up to 65% savings on dental services. Credentialed dentists in private practice. No claim forms or deductibles. Orthodontics and cosmetic dentistry included. No maximums per year. The number of conveniently located providers, low cost, and ease of use makes TDP preferable to other plans of its type. Simply see the participating dentist of your choice, pay the discounted fee at the time of treatment, and enjoy up to 65% savings! All dental services are discounted! After joining TDP, you will receive a list of dental procedures and discounted prices honored by general dentists. TDP specialists offer our mem‐bers a specified discount off the specialists’ usual and cus‐tomary rates. Remember, you do not need a referral to visit any of our specialists.

29

Vision insurance provides coverage for routine eye examinations and may cover all or part of the costs associated with contact lenses, eyeglasses and vision correction, depending on the plan.

About this Benefit

Vision YOUR BENEFITS PACKAGE

75%

DID YOU KNOW?

of U.S. residents between age 25 and 64 require some sort of vision

correction.

SUPERIOR VISION



Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements 1 Covered to provider’s in-office standard retail lined trifocal amount; member pays difference between progressive and standard retail lined trifocal, plus applicable co-pay 2 Contact lenses and related professional services (fitting, evaluation and follow-up) are covered in lieu of eyeglass lenses and frames benefit 3 Lasik Vision Correction is in lieu of eyewear benefit, subject to routine regulatory filings and certain exclusions and limitations

Vision

Discount Features

Non-Covered Eyewear Discount: Members may also receive a discount of 20% from a participating provider’s usual and customary fees for eyewear purchases which exceed the benefit coverage (except disposable contact lenses, for which no discount applies). This includes eyeglass frames which exceed the selected benefit coverage, specialty lenses (i.e. progressives) and lens “extras” such as tints and coatings. Eyewear purchased from a Walmart Vision Center does not qualify for this additional discount because of Walmart’s “Always Low Prices” policy.

Services/Frequency

Exam 12 months

Frame 12 months

Lenses 12 months

Contact Lenses 12 months

Benefits In-Network Out-of-Network

Exam Covered in full Up to $35 retail

Frames $150 retail allowance Up to $70 retail

Contact Lenses2 $200 retail allowance Up to $80 retail

Medically Necessary Contact Lenses Covered in full Up to $150 retail

Laser Vision Correction $300.00 allowance3

Lenses (standard) per pair

Single Vision Covered in full Up to $25 retail

Bifocal Covered in full Up to $40 retail

Trifocal Covered in full Up to $45 retail

Progressive See description1 Up to $45 retail

Lenticular Covered in full Up to $80 retail

Scratch coating Covered in full Not covered

Polycarbonate Covered in full Not covered

Anti-reflective coating Covered in full Not covered

UV coating Covered in full Not covered

Tint Covered in full Not covered

Monthly Premiums

EE Only $11.44

EE + Spouse $19.76

EE + Child(ren) $20.80

EE + Family $31.20

SuperiorVision.com Customer Service 800.507.3800

Co-Pays

Exam $5.00

Materials $0

The Plan discount features are not insurance. All allowances are retail; the member is responsible for paying the provider directly for all non-covered items and/or any amount over the allowances, minus available discounts. These are not covered by the plan. Discounts are subject to change with‐out notice. Disclaimer: All final determinations of benefits, administrative duties, and definitions are governed by the Certificate of Insurance for your vision plan. Please check with your Human Resources department if you have any questions

(Based on date of service)

31

About this Benefit

Educator Disability YOUR BENEFITS PACKAGE

Just over 1 in 4 of today's 20 year-olds will become disabled before

they retire.

DID YOU KNOW?

34.6 months is the duration of the

average disability claim.

UNUM

Disability insurance protects one of your most valuable assets, your paycheck. This insurance will replace a portion of your income in the event that you become physically unable to work due to sickness or injury for an extended period of time.



Educator Disability

Please read carefully the following description of your Unum Educator Select Income Protection Plan insurance.

Eligibility You are eligible for disability coverage if you are an active employee in the United States working a minimum of 20 hours per week. The date you are eligible for coverage is the later of: the plan effective date; or the day after you complete the waiting period.

Guarantee Issue Current Employees: Coverage is available to you without answering any medical questions or providing evidence of insurability. You may enroll on or before the enrollment deadline. After the initial enrollment period, you can apply only during an annual enrollment period. New Hires: Coverage is available to you without answering any medical questions or providing evidence of insurability. You may apply for coverage within 60 days after your eligibility date. If you do not apply within 60 days after your eligibility date, you can apply only during an annual enrollment period. Benefits will not be paid for disabilities caused by, contributed to by, or resulting from a pre-existing condition. You have a pre-existing condition if: you received medical treatment, consultation, care or services including diagnostic measures, or took prescribed drugs or medicines in the 3 months just prior to your effective date of coverage; and the disability begins in the first 12 months after your effective date of coverage.

Benefit Amount You may purchase a monthly benefit in $100 units, starting at a minimum of $200, up to 66 2/3% of your monthly earnings rounded to the nearest $100, but not to exceed a monthly maximum benefit of $8,000. Please see your Plan Administrator for the definition of monthly earnings.

Elimination Period The Elimination Period is the length of time of continuous disability, due to sickness or injury, which must be satisfied before you are eligible to receive benefits. You may choose an Elimination Period (injury/sickness) of 14/14, 30/30, 60/60, 90/90 or 180/180 days. If, because of your disability, you are hospital confined as an inpatient, benefits begin on the first day of inpatient confinement. Inpatient means that you are confined to a hospital room due to your sickness or injury for 23 or more consecutive hours. (Applies to Elimination Periods of 30 days or less.)

Benefit Duration Your duration of benefits is based on your age when the disability occurs. Plan: ADEA II: Your duration of benefits is based on the following table: Age at Disability Maximum Duration of Benefits Less than age 60 To age 65, but not less than 5 years Age 60 through 64 5 years Age 65 through 69 To age 70, but not less than 1 year Age 70 and over 1 year

Next Steps How to Apply/Effective Date of Coverage Current Employees: To apply for coverage, complete your enrollment form by the enrollment deadline. Your effective date of coverage is 9/01. New Hires: To apply for coverage, complete your enrollment form within 60 days of your eligibility date. Please see your Plan Administrator for your effective date. If you do not enroll during the initial enrollment period, you may apply only during an annual enrollment.

Delayed Effective Date of Coverage If you are absent from work due to injury, sickness, temporary layoff or leave of absence, your coverage will not take effect until you return to active employment. Please contact your Plan Administrator after you return to active employment for when your coverage will begin.

Questions If you should have any questions about your coverage or how to enroll, please contact your Plan Administrator. This plan highlight is a summary provided to help you understand your insurance coverage from Unum. Some provisions may vary or not be available in all states. Please refer to your certificate booklet for your complete plan description. If the terms of this plan highlight summary or your certificate differ from your policy, the policy will govern. For complete details of coverage, please refer to policy form number C.FP-1, et al. Underwritten by: Unum Life Insurance Company of America 2211 Congress Street, Portland, Maine 04122, www.unum.com ©2007 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.

33

Educator Disability

TAYLOR INDEPENDENT SCHOOL DISTRICT Costs below are based on a Monthly payroll deduction (Employer billing mode is based on 12 Payments per year)

Product: Educator Select Income Protection Plan

Plan A

ADEA II Duration of Benefits

Elimination Period (Days)

Injury (Days) 14* 30* 60 90 180

Sickness (Days) 14* 30* 60 90 180

Annual Earnings

Monthly Earnings

Maximum Monthly Benefit

3600 300 200 5.56 4.78 3.84 2.16 1.52

5400 450 300 8.34 7.17 5.76 3.24 2.28

7200 600 400 11.12 9.56 7.68 4.32 3.04

9000 750 500 13.90 11.95 9.60 5.40 3.80

10800 900 600 16.68 14.34 11.52 6.48 4.56

12600 1050 700 19.46 16.73 13.44 7.56 5.32

14400 1200 800 22.24 19.12 15.36 8.64 6.08

16200 1350 900 25.02 21.51 17.28 9.72 6.84

18000 1500 1000 27.80 23.90 19.20 10.80 7.60

19800 1650 1100 30.58 26.29 21.12 11.88 8.36

21600 1800 1200 33.36 28.68 23.04 12.96 9.12

23400 1950 1300 36.14 31.07 24.96 14.04 9.88

25200 2100 1400 38.92 33.46 26.88 15.12 10.64

27000 2250 1500 41.70 35.85 28.80 16.20 11.40

28800 2400 1600 44.48 38.24 30.72 17.28 12.16

30600 2550 1700 47.26 40.63 32.64 18.36 12.92

32400 2700 1800 50.04 43.02 34.56 19.44 13.68

34200 2850 1900 52.82 45.41 36.48 20.52 14.44

36000 3000 2000 55.60 47.80 38.40 21.60 15.20

37800 3150 2100 58.38 50.19 40.32 22.68 15.96

39600 3300 2200 61.16 52.58 42.24 23.76 16.72

41400 3450 2300 63.94 54.97 44.16 24.84 17.48

43200 3600 2400 66.72 57.36 46.08 25.92 18.24

45000 3750 2500 69.50 59.75 48.00 27.00 19.00

46800 3900 2600 72.28 62.14 49.92 28.08 19.76

48600 4050 2700 75.06 64.53 51.84 29.16 20.52

50400 4200 2800 77.84 66.92 53.76 30.24 21.28

52200 4350 2900 80.62 69.31 55.68 31.32 22.04

54000 4500 3000 83.40 71.70 57.60 32.40 22.80

55800 4650 3100 86.18 74.09 59.52 33.48 23.56

57600 4800 3200 88.96 76.48 61.44 34.56 24.32

59400 4950 3300 91.74 78.87 63.36 35.64 25.08

61200 5100 3400 94.52 81.26 65.28 36.72 25.84

63000 5250 3500 97.30 83.65 67.20 37.80 26.60

64800 5400 3600 100.08 86.04 69.12 38.88 27.36

66600 5550 3700 102.86 88.43 71.04 39.96 28.12

68400 5700 3800 105.64 90.82 72.96 41.04 28.88

70200 5850 3900 108.42 93.21 74.88 42.12 29.64

72000 6000 4000 111.20 95.60 76.80 43.20 30.40

73800 6150 4100 113.98 97.99 78.72 44.28 31.16

75600 6300 4200 116.76 100.38 80.64 45.36 31.92

77400 6450 4300 119.54 102.77 82.56 46.44 32.68

79200 6600 4400 122.32 105.16 84.48 47.52 33.44

81000 6750 4500 125.10 107.55 86.40 48.60 34.20

82800 6900 4600 127.88 109.94 88.32 49.68 34.96

84600 7050 4700 130.66 112.33 90.24 50.76 35.72

86400 7200 4800 133.44 114.72 92.16 51.84 36.48

88200 7350 4900 136.22 117.11 94.08 52.92 37.24

90000 7500 5000 139.00 119.50 96.00 54.00 38.00

91800 7650 5100 141.78 121.89 97.92 55.08 38.76

93600 7800 5200 144.56 124.28 99.84 56.16 39.52

34

Educator Disability

* If, because of your disability, you are hospital confined as an inpatient, benefits begin on the first day of inpatient confinement. Find your Annual/Monthly Earnings above to determine your Maximum Monthly Benefit. If your Annual/Monthly Earnings are not shown, use the next lower Annual/Monthly Earnings and corresponding Maximum Monthly Benefit. Or, you may refer to the Plan Highlights to calculate your Maximum Monthly Benefit based on your earnings.

TAYLOR INDEPENDENT SCHOOL DISTRICT Costs below are based on a Monthly payroll deduction (Employer billing mode is based on 12 Payments per year)

Product: Educator Select Income Protection Plan

Plan A

ADEA II Duration of Benefits

Elimination Period (Days)

Injury (Days) 14* 30* 60 90 180

Sickness (Days) 14* 30* 60 90 180

Annual Earnings

Monthly Earnings Maximum Monthly Benefit

95400 7950 5300 147.34 126.67 101.76 57.24 40.28

97200 8100 5400 150.12 129.06 103.68 58.32 41.04

99000 8250 5500 152.90 131.45 105.60 59.40 41.80

100800 8400 5600 155.68 133.84 107.52 60.48 42.56

102600 8550 5700 158.46 136.23 109.44 61.56 43.32

104400 8700 5800 161.24 138.62 111.36 62.64 44.08

106200 8850 5900 164.02 141.01 113.28 63.72 44.84

108000 9000 6000 166.80 143.40 115.20 64.80 45.60

109800 9150 6100 169.58 145.79 117.12 65.88 46.36

111600 9300 6200 172.36 148.18 119.04 66.96 47.12

113400 9450 6300 175.14 150.57 120.96 68.04 47.88

115200 9600 6400 177.92 152.96 122.88 69.12 48.64

117000 9750 6500 180.70 155.35 124.80 70.20 49.40

118800 9900 6600 183.48 157.74 126.72 71.28 50.16

120600 10050 6700 186.26 160.13 128.64 72.36 50.92

122400 10200 6800 189.04 162.52 130.56 73.44 51.68

124200 10350 6900 191.82 164.91 132.48 74.52 52.44

126000 10500 7000 194.60 167.30 134.40 75.60 53.20

127800 10650 7100 197.38 169.69 136.32 76.68 53.96

129600 10800 7200 200.16 172.08 138.24 77.76 54.72

131400 10950 7300 202.94 174.47 140.16 78.84 55.48

133200 11100 7400 205.72 176.86 142.08 79.92 56.24

135000 11250 7500 208.50 179.25 144.00 81.00 57.00

136800 11400 7600 211.28 181.64 145.92 82.08 57.76

138600 11550 7700 214.06 184.03 147.84 83.16 58.52

140400 11700 7800 216.84 186.42 149.76 84.24 59.28

142200 11850 7900 219.62 188.81 151.68 85.32 60.04

144000 12000 8000 222.40 191.20 153.60 86.40 60.80

35

Cancer insurance offers you and your family supplemental insurance protection in the event you or a covered family member is diagnosed with cancer. It pays a benefit directly to you to help with expenses associated with cancer treatment.

About this Benefit

Cancer YOUR BENEFITS PACKAGE

Breast Cancer is the most commonly diagnosed cancer in women.

DID YOU KNOW?

If caught early, prostate cancer is one of the most treatable malignancies.

LOYAL AMERICAN



Cancer

ADDITIONAL BENEFIT AMOUNTS PLAN A

Maximum PLAN B

Maximum ANNUAL CANCER SCREENING BENEFIT RIDER (form LG-6041) A. Basic Benefit We will pay the expense incurred, but not to exceed the maximum benefit amount shown on the Certificate Schedule, once per calendar year per Insured Person for screening tests performed to determine whether Cancer exists in an Insured Person. Covered annual Cancer screening tests include but are not limited to: mammogram, pap smear, breast ultrasound, ThinPrep, biopsy, chest x-ray, thermography, colonoscopy, flexible sigmoidoscopy, hemocult stool specimen, PSA (blood test for prostate cancer), CEA (blood tests for colon cancer), CA125 (blood test for ovarian cancer), CA15-3 (blood test for breast cancer), serum protein electrophesis (blood test for myeloma).

B. Additional Benefit We will pay the expense incurred, but not to exceed two times the maximum benefit amount per calendar year as shown on the Certificate Schedule, for one additional invasive diagnostic procedure required as the result of an abnormal cancer screening test for which benefits are payable under the Basic Benefit above for an Insured Person. This additional benefit is payable regardless of the results of the additional diagnostic procedure. However, the amount payable will be reduced dollar for dollar for any amount payable under the Positive Diagnosis Benefit contained in the base Certificate.

$50 Per Calendar

Year

$100 Per Calendar

Year

$50 Per Calendar

Year

$100 Per Calendar

Year

FIRST OCCURRENCE BENEFIT RIDER (form LG-6043) If an Insured Person receives a positive diagnosis of Internal Cancer, We will pay the First Occurrence benefit amount shown on the Certificate Schedule. If the Insured Person receiving the positive diagnosis of Internal Cancer is a child under the age of 21, we will pay one and one-half times the First Occurrence benefit amount shown on the Certificate Schedule.

$2,000 Once per Lifetime $3,000

Once per Lifetime

$500 Once per Lifetime

$750 Once per Lifetime

ANNUAL RADIATION, CHEMOTHERAPY, IMMUNOTHERAPY and EXPERIMENTAL TREATMENT BENEFIT RIDER (form LG-6045) We will pay the expense incurred, but not to exceed the maximum benefit amount shown on the Certificate Schedule, per calendar year per Insured Person for Radiation Treatment, Chemotherapy, Hormonal Therapy, Immunotherapy or Experimental Treatment. The Radiation Treatment, Chemotherapy, Hormonal Therapy, Immunotherapy or Experimental Treatment must be for the treatment of an Insured Person’s Cancer. The benefit amount shown on the Certificate Schedule is the maximum calendar year benefit available per Insured Person regardless of the number or types of Cancer treatments received in the same year.

$15,000 Per Calendar

Year

$5,000 Per Calendar

Year

SURGICAL BENEFIT RIDER (form LG-6048) Surgical Expense We will pay the Surgical Expense benefit for a surgical procedure for the treatment of an Insured Person’s Cancer (except Skin Cancer) according to the Surgical Schedule shown in this rider. However, in no event will the amount payable exceed the maximum Surgical Expense benefit shown on the Certificate Schedule, nor will it exceed the expense incurred.

$5,000

Procedure Maximum

$500

Procedure Maximum

Anesthesia Expense We will pay the anesthesia expense incurred, not to exceed 25% of the covered Surgical Expense benefit for the operation performed. This includes the services of an anesthesiologist or of an anesthetist under supervision of a physician for the purpose of administering anesthesia.

$1,250 Procedure Maximum

$125 Procedure Maximum

Breast Reconstruction With transverse rectus adominis myocutaneous flap (TRAM), single pedicle, including closure of donor site, with microvascular anastomosis (supercharging) is one of the surgical procedures listed in the Surgical Schedule. If this procedure is performed on an Insured Person as the result of a mastectomy for which We paid a Surgical Expense benefit for the treatment of Breast Cancer, We will pay the expense incurred not to exceed $900 per $1,000 of the Surgical Benefit issued.

Skin Cancer Surgery Expense We will pay the expense incurred, not to exceed the procedure amount listed in this rider ($125 to $750 depending on the procedure) when a surgical operation is performed on an Insured Person for treatment of a diagnosed Skin Cancer. This benefit is payable in lieu of any benefits for Surgical Expense and Anesthesia Expense which are not applicable to Skin Cancer.

$4,500

Procedure Maximum

Per Procedure

$450

Procedure Maximum

Per Procedure

DAILY HOSPITAL CONFINEMENT BENEFIT RIDER (form LG-6042) Confinements of 30 Days or Less We will pay the Daily Hospital Confinement benefit amount shown on the Certificate Schedule for each of the first 30 days in each period of hospital confinement during which an Insured Person is confined to a hospital, including a government or charity hospital, for the treatment of Cancer.

Confinements of 31 Days or More If an Insured Person is continuously confined to a hospital, including a government or charity hospital, for longer than 30 consecutive days for the treatment of Cancer, We will pay two times the Daily Hospital Confinement benefit amount shown on the Certificate Schedule. This benefit payment will begin on the 31st continuous day of such confinement and continue for each day of confinement until the Insured Person is discharged from the Hospital.

Benefits for an Insured Dependent Child under Age 21 The amount payable under this benefit will be double the Daily Hospital Confinement benefit shown on the Certificate Schedule if the Insured Person so confined is a dependent child under the age of 21.

$200

Per Day

$400 Per Day

$400/ $800

Per Day

$100

Per Day

$200 Per Day

$200/ $400

Per Day

37

Cancer

Additional Benefits Amounts SPECIFIED DISEASE BENEFIT RIDER (form LG-6052) If an Insured Person is first diagnosed with one or more covered Specified Diseases and is hospitalized for the definitive treatment of any covered Specified Disease, We will pay benefits according to the provisions of this rider.

Covers These 38 Specified Diseases

Addison’s Disease Lupus Erythematosus Rocky Mountain Spotted Fever

Amyotrophic Lateral Sclerosis Malaria Sickle Cell Anemia

Botulism Meningitis Tay-Sachs Disease

Bovine Spongiform Encephalopathy Multiple Sclerosis Tetanus

Budd-Chiari Syndrome Muscular Dystrophy Toxic Epidermal Necrolysis

Cystic Fibrosis Myasthenia Gravis Tuberculosis

Diptheria Neimann-Pick Disease Tularemia

Encephalitis Osteomyelitis Typhoid Fever

Epilepsy Poliomyelitis Undulant Fever

Hansen’s Disease Q Fever West Nile Virus

Histoplasmosis Rabies Whipple’s Disease

Legionnaire’s Disease Reye’s Syndrome Whooping Cough

Lyme Disease Rheumatic Fever

Benefits If an Insured Person is first diagnosed with one or more covered Specified Diseases and is hospitalized for the definitive treatment of any covered Specified Disease, We will pay benefits according to the provisions of this rider. An applicant may select 1, 2 or 3 units of coverage. Initial Hospitalization Benefit We will pay a benefit of $1,500 per unit of coverage selected when an Insured Person is confined to a hospital (for 12 or more hours, not applicable in SD) as a result of receiving treatment for a Specified Disease. This benefit is payable only once per period of confinement and once per calendar year for each Insured Person. Hospital Confinement Benefit We will pay a benefit of $300 per day per unit of coverage selected when an Insured Person is hospitalized during any continuous period of 30 days or less for the treatment of a covered Specified Disease. Benefits will double per day beginning with the 31st day of continuous confinement. If the hospital confinement follows a previously covered confinement, it will be deemed a continuation of the first confinement unless it is the result of an entirely different Specified Disease, or unless the confinements are separated by 30 days or more.

Monthly Rates Employee Single Parent Employee and

Spouse Family

Base Plan A $27.01 $32.67 $45.30 $45.30

Base Plan B $13.43 $17.07 $23.12 $23.12

38

Cancer

OPTIONAL BENEFITS YOU MAY SELECT FOR ADDITIONAL PREMIUM

HOSPITAL INTENSIVE CARE UNIT BENEFIT RIDER (form LG-6047) Intensive Care Unit Benefit We will pay the daily Hospital Intensive Care Unit Benefit shown on the Certificate Schedule for an Insured Person’s confinement in an ICU for sickness or injury.

$1,000 Per Day

Double Intensive Care Unit Benefit We will pay double the daily Hospital Intensive Care Unit benefit amount shown on the Certificate Schedule for an Insured Person’s confinement in an ICU as a result of Cancer. We will also double this ICU benefit for only the initial ICU confinement resulting from an Insured Person’s travel related injury, provided that the ICU confinement begins within 24 hours of the accident causing the travel related injury. A travel related injury includes being struck by an automobile, bus, truck, van, motorcycle, train or airplane; or being involved in an accident where the Insured Person was the operator or passenger in or on such vehicle.

$2,000 Per Day

Step Down Unit Benefit We will pay one-half of the daily Hospital Intensive Care Unit benefit amount shown on the Certificate Schedule for an Insured Person’s confinement in a Step Down Unit for a sickness or injury.

$500

Per Day

*Additional Limitations and Exclusions for the Hospital Intensive Care Unit Benefit Rider If the rider is issued and coverage is in force, it will provide benefits if an Insured Person goes into a hospital Intensive Care Unit (including a Cardiac Intensive Care Unit or Neonatal Intensive Care Unit). Benefits start the first day of confinement in an ICU for sickness or injury. Any combination of benefits payable under this rider is limited to a maximum of 45 days per each period of confinement. ALL BENEFITS CONTAINED IN THIS HOSPITAL INTENSIVE CARE UNIT BENEFIT RIDER REDUCE BY ONE-HALF AT AGE 75. Benefits are not payable for any ICU or Step Down Unit confinement that results from intentional self-inflicted injury; or the Insured Person’s being intoxicated or under the influence of alcohol, drugs or any narcotics, unless administered on and according to the advice of a medical practitioner. THIS IS A LIMITED RIDER.

Monthly Rates Employee Single Parent Employee and

Spouse Family

Base Plan A + ICU $31.66 $39.06 $54.10 $54.10

Base Plan B + ICU $18.08 $23.46 $31.92 $31.92

39

Accident insurance is designed to supplement your medical insurance coverage by covering indirect costs that can arise with a serious, or a not-so-serious, injury. Accident coverage is low cost protection available to you and your family without evidence of insurability.

About this Benefit

Accident YOUR BENEFITS PACKAGE

of disabling injuries suffered by American workers are not work related.

DID YOU KNOW?

36% of American workers report they always or usually live paycheck to paycheck.

2/3

LOYAL AMERICAN



Accident

Group #1575 Plan pays benefit amounts for covered medical expenses as a result of an accident, directly to you! Coverage is available for ages 18-64 and is portable, you can choose to keep your benefit even if you leave the district or retire.

This policy does not pay for losses resulting from sickness, only accident.

Always refer to your policy for detailed terms and conditions.

This policy is guaranteed renewable.

Summary of Benefits Plan A Plan B

Ambulance Ground Ambulance Benefit: Loyal American will pay this benefit if you require transportation by a licensed professional ambulance company to or from a hospital or between medical facilities within 90 days for injuries sustained after a covered accident. Payable once per accident.

$150 $75

Air Ambulance Benefit: Loyal American will pay this benefit if you require transportation by a license professional air ambulance company to or from a hospital or between medical facilities within 48 hours for injuries sustained after a covered accident. Payable once per accident.

$600 $300

Indemnity Benefits

Emergency Room Treatment Benefit: Loyal American will pay this benefit if you received hospital emergency room treatment within 72 hours of injuries sustained in a covered accident and for which charges are submitted.

Insured/Spouse: $150

Child: $75

Insured/Spouse: $75

Child: $40

Accident Follow-Up Treatment Benefit: Loyal American will pay this benefit for three additional treatments of injuries sustained in a covered accident over and above emergency treatment administered during the first 72 hours following the accident. Treatment must begin within 30 days of the covered accident and must be within the 6 month period following the covered accident.

$50 per visit

$25 per visit

Specific Sum Injuries Benefit: Loyal The specific indemnity amount as listed in the policy's Benefit Schedule will be paid according to the type of injury received in a covered accident. Loyal American will pay for dislocations (separated joint), burns, tendon (torn, ruptured, severed, ligaments, or rotator cuff), torn knee cartilage, eye injuries, lacerations, and fractures (broken bones).

Blood, Plasma, Platelets Benefit: Loyal American will pay this benefit if you require transfusion, administration, cross matching, typing and processing of blood, plasma or platelets when administered within 90 days for injuries sustained in a covered accident. Payable once per accident.

$100 $50

Hospital Benefits Initial Accident Hospitalization Benefit: Loyal American will pay this benefit if hospital confinement is required within six (6) months for injuries sustained in a covered accident. Payable once per accident.

$500 $250

Hospital Confinement Benefit: Loyal American will pay this benefit for a maximum of 180 days per confinement.* if you require confinement in a hospital or in a hospital intensive care unit– sub acute within six (6) months for injuries sustained in a covered accident.

$200 per day

$100 per day

Intensive Care

Hospital Intensive Care Unit Confinement Benefit: Loyal American will pay this benefit for a maximum of 15 days per confinement* if you are confined in a hospital intensive care unit within 30 days because of injuries received in a covered accident. *Confinements separated by less than 90 days will be considered as the same period of confinement.

$400 per day

$200 per day

41

Summary of Benefits Plan A Plan B

Physical Therapy

Physical Therapy Benefit: Loyal American will pay this benefit, not to exceed five treatments per accident, for services prescribed by a doctor and rendered by a licensed physical therapist. Physical therapy must be for injuries sustained in a covered accident and must start within 60 days after the accident. Treatment must be completed within 6 months after the accident.

$50 per treatment

$25 per treatment

Prostheses Benefit: Loyal American will pay this benefit if a doctor prescribes the use of a prosthetic device due to the loss of a hand, foot or sight of an eye in a covered accident. The prosthetic must be received within 1 year of the covered accident. This benefit is payable once per accident and is not payable for hearing aids, dental aids, false teeth or for cosmetic prosthesis (e.g. hair wigs). We will not pay for joint replacement (e.g. artificial hip or knee).

1 prosthetic device/artificial

limb: $100 More than 1:

$500

1 prosthetic device/artificial

limb: $50 More than 1:

$250

Appliance Benefit: Loyal American will pay this benefit if a doctor advises you to use a medical appliance as an aid to personal locomotion within 90 days as a result of injuries sustained in a covered accident. Benefits are payable for crutches, wheelchairs, braces, etc. Benefits are payable for crutches and wheelchairs once per accident.

$50 $25

Family Lodging & Transportation

Family Lodging Benefit: Loyal American will pay this benefit for a maximum of 30 days per accident, during the time you are confined in a hospital, for one motel/hotel room for a family member to accompany you if injuries sustained in a covered accident require hospital confinement, and if the hospital and motel/hotel are more than 100 miles from your residence.

$100 per day

$50 per day

Transportation Benefit: Loyal American will pay this benefit for a maximum of three trips per calendar year if you require special treatment and confinement in a hospital located more than 100 miles from your residence or site of the accident for injuries sustained in a covered accident.

$300 $150

Accidental Death

Accidental Death* Benefit: This policy will pay the following benefit for death if it is the result of injuries sustained in a covered accident. Death must occur within 90 days of a covered accident.

Common-Carrier: You must be a fare paying passenger on a common-carrier. Common-carrier vehicles are limited to commercial airplanes, trains, buses, trolleys, subways, ferries and boats that operate on a regular scheduled basis between predetermined points or cities. Taxies and privately chartered vehicles are not included.

Insured: $100,000 Spouse:

$50,000 Child: $15,000

Insured: $50,000 Spouse: $25,000

Child: $7,500

Other Accidents: Other Accidents are those not classified as common-carrier and are not specifically excluded in the limitations and exclusions section of the policy.


Child: $5,000


Child: $2,500

Dismemberment

Accidental Dismemberment* Benefit This policy will pay a percentage of the Accidental Death-Other Accidents Benefit for the selected plan.

Both arms and both legs 100% 100%

Two arms or legs 50% 50%

Sight of two eyes, hands, or feet 50% 50%

Sight of one eye, hand, foot, arm, or leg 20% 20%

One or more fingers and/or one or more toes 5% 5%

Accident

*Death or dismemberment must occur within 90 days of the accident. Only the highest single benefit will be paid for accidental dismemberment.

42

Accident

This is a limited benefit policy. This policy does not pay for losses resulting from sickness. RENEWABILITY CONDITIONS: The policy is guaranteed renewable. Premium rates may be changed on a class basis. A class may be defined by age, sex, occupation, premium payment method, issue state,elimination period, benefit period, etc. WHAT IS NOT COVERED BY THIS POLICY. We will not pay benefits for any injury as a result of you(r):

Operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven.

Engaging in hang gliding, bungee jumping, parachuting, sailgliding , parakiting, or hot-air ballooning.

Participating or attempting to participate in an illegal activity.

Riding in or driving any motor-driven vehicle in a race, stunt show, or speed test.

Intentionally causing a self-inflicted injury.

Having any sickness or declining process caused by a sickness, including physical or mental infirmity. We also will not pay benefits to diagnose or treat the sickness. Sickness means any disease or disorder that is not caused by an injury.

Practicing for or participating in any semi-professional or professional competitive athletic contest for which any type of compensation or remuneration is received.

Committing or trying to commit suicide, whether sane or insane.

Being in an accident which occurs more than 40 miles outside the territorial limits of the United States, Canada, Puerto Ri‐co,and Virgin Islands.

Involvement in any period of armed conflict, even if it is not declared. This brochure contains a summary of the Accident Insurance Policy form L-6020. Coverage as described in the brochure is pro‐vided only through the issuance of a policy. The policy should be consulted for full terms and conditions of coverage.

Payroll Deduction Rates – Available for Issue Ages 18 – 64

Plan A - Monthly Plan B - Monthly

Employee Only $12.70 $ 9.00

Employee & Spouse $19.50 $13.50

One Parent Family $20.40 $14.20

Family $27.20 $18.70

ACCIDENT EXPENSE INSURANCE POLICY (L-6020)

43

Critical illness insurance is designed to supplement your medical and disability coverage easing the financial impacts by covering some of your additional expenses. It provides a benefit payable directly to the insured upon diagnosis of a covered condition or event, like a heart attack or stroke.

About this Benefit

YOUR BENEFITS PACKAGE Critical Illness

Is the aggregate cost of a hospital stay for a heart

attack.

DID YOU KNOW?

$16,500



VOYA

44

Critical Illness

For what critical illnesses and conditions are benefits available? Critical illness insurance provides a benefit for the following illnesses and conditions. Benefits are paid at 100% of the Maximum Critical Illness Benefit unless otherwise stated. For a complete description of your benefits, along with applicable provisions, exclusions and limitations, see your certificate of insurance and any riders. BASE MODEL

Heart attack

Stroke

Coronary artery bypass (25%)

Coma

Major organ failure

Permanent paralysis

End stage renal (kidney) failure CANCER MODEL Cancer

Skin cancer (10%)

Carcinoma in situ (25%)

How much does Critical Illness Insurance cost? See chart for the premium amounts. Rate shown are guaranteed until August 31, 2018. Taylor ISD will provide the first $5,000 in employee coverage.

Limitations Benefits reduce 50% for the employee and/or covered spouse on the policy anniversary following the 70th birthday, however, premiums do not reduce as a result of this benefit change.

Employee Coverage Monthly Uni-Tobacco Rates

Attained Age

$5,000 $10,000 $15,000 $20,000 $25,000 $30,000

Under 30 $1.80 $3.60 $5.40 $7.20 $9.00 $10.80

30-39 $2.50 $5.00 $7.50 $10.00 $12.50 $15.00

40-49 $5.10 $10.20 $15.30 $20.40 $25.50 $30.60

50-59 $11.35 $22.70 $34.05 $45.40 $56.75 $68.10

60-64 $17.00 $34.00 $51.00 $68.00 $85.00 $102.00

65-69 $22.75 $45.50 $68.25 $91.00 $113.75 $136.50

70+ $30.90 $61.80 $92.70 $123.60 $154.50 $185.40

Spouse Coverage* Monthly Uni-Tobacco Rates

Coverage Amount

$5,000 $10,000 $15,000

Under 30 $2.50 $5.00 $7.50

30-39 $3.00 $6.00 $9.00

40-49 $6.10 $12.20 $18.30

50-59 $14.55 $29.10 $43.65

60-64 $22.15 $44.30 $66.45

65-69 $23.15 $46.30 $69.45

70+ $40.75 $81.50 $122.25

Children Coverage Monthly Rates Includes Wellness Benefit Rider

Coverage Amount Rate

$1,000 $0.15

$2,500 $.38

$5,000 $0.75

$10,000 $1.50

45

Life insurance provides a cash death benefit to your beneficiary upon your death. Group term life is the most inexpensive way to purchase life insurance. You have the freedom to select an amount of life insurance coverage you need to help protect the well-being of your family. If you are covered, you may apply for coverage on your spouse and eligible dependent children.

About this Benefit

Voluntary Life YOUR BENEFITS PACKAGE

x 10

Experts recommend at least

your gross annual income in coverage when purchasing life insurance.

DID YOU KNOW?

AUL A ONEAMERICA COMPANY



Group Term Life including matching AD&D Coverage Life and AD&D insurance coverage amount of $10,000 at no

cost to you

Waiver of premium benefit

Accelerated life benefit

Additional AD&D Benefits: Seat Belt, Air Bag, Repatriation, Child Higher Education, Child Care, Paralysis/Loss of Use, Severe Burns

Life and AD&D insurance reduces at age 65 to 65% of the original amount and again at age 70 to 50% of the original amount

AUL's Group Voluntary Term Life Insurance Terms and Definitions

Eligible Employees: This benefit is available for employees who are actively at work on the effective date and working a minimum of 20 hours per week.

Flexible Choices: Since everyone's needs are different, this plan offers flexibility for you to choose a benefit amount that fits your needs and budget.

Guaranteed Issue Amounts: This is the most coverage you can purchase without having to answer any health questions. If you decline insurance coverage now and decide to enroll later, you will need to provide Evidence of Insurability.

Timely Enrollment: Enrolling timely means you have enrolled during the initial enrollment period when benefits were first offered by AUL, or as a newly hired employee within 31 days following completion of any applicable waiting period.

Evidence of Insurability: If you elect a benefit amount over the Guaranteed Issue Amount shown above for you or your eligible dependents, or you do not enroll timely, you will need to submit a Statement of Insurability form for review. Based on health history, you and / or your dependents will be approved or declined for insurance coverage by AUL. If Evidence of Insurability is applied for and denied, please be aware Guaranteed Increase in Benefits will not be made available to you in the future.

Continuation of Coverage Options: Portability Should your coverage terminate for any reason, you may be eligible to take this term life insurance with you without providing Evidence of Insurability. You must apply within 31 days from the last day you are eligible. The Portability option is available until you reach age 70.

OR

Conversion Should your life insurance coverage, or a portion of it, cease for any reason, you may be eligible to convert your Group Term Coverage to Individual Coverage without providing Evidence of Insurability. You must apply within 31 days from the last day you are eligible. Accelerated Life Benefit: If diagnosed with a terminal illness and have less than 12 months to live, you may apply to receive 25%, 50% or 75% of your life insurance benefit to use for whatever you choose. Waiver of Premium: If approved, this benefit waives your and your dependents' insurance premium in case you become totally disabled and are unable to collect a paycheck. Reductions: Upon reaching certain ages, your original benefit amount will reduce to a percentage as shown in the following schedule.

This invitation to inquire allows eligible employees an opportunity to inquire further about AUL's group insurance and is limited to a brief description of any losses for which benefits are payable. The contract has exclusions, limitations reduction of benefits, and terms under which the contract may be continued in force or discontinued.

Voluntary Life

Age: 65 70

Reduces To: 65% 50%

Employee Guaranteed Issue Amount $150,000

Spouse Guaranteed Issue Amount $50,000

Child Guaranteed Issue Amount $10,000

47

Voluntary Life

EMPLOYEE ONLY OPTIONS (based on Employee's age as of 09/01)

Life & AD&D 0-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+

$10,000 $0.60 $0.60 $0.60 $0.80 $0.90 $1.00 $1.50 $2.40 $4.30 $6.60 $12.70 $20.60 $20.60

$20,000 $1.20 $1.20 $1.20 $1.60 $1.80 $2.00 $3.00 $4.80 $8.60 $13.20 $25.40 $41.20 $41.20

$30,000 $1.80 $1.80 $1.80 $2.40 $2.70 $3.00 $4.50 $7.20 $12.90 $19.80 $38.10 $61.80 $61.80

$40,000 $2.40 $2.40 $2.40 $3.20 $3.60 $4.00 $6.00 $9.60 $17.20 $26.40 $50.80 $82.40 $82.40

$50,000 $3.00 $3.00 $3.00 $4.00 $4.50 $5.00 $7.50 $12.00 $21.50 $33.00 $63.50 $103.00 $103.00

$60,000 $3.60 $3.60 $3.60 $4.80 $5.40 $6.00 $9.00 $14.40 $25.80 $39.60 $76.20 $123.60 $123.60

$70,000 $4.20 $4.20 $4.20 $5.60 $6.30 $7.00 $10.50 $16.80 $30.10 $46.20 $88.90 $144.20 $144.20

$80,000 $4.80 $4.80 $4.80 $6.40 $7.20 $8.00 $12.00 $19.20 $34.40 $52.80 $101.60 $164.80 $164.80

$90,000 $5.40 $5.40 $5.40 $7.20 $8.10 $9.00 $13.50 $21.60 $38.70 $59.40 $114.30 $185.40 $185.40

$100,000 $6.00 $6.00 $6.00 $8.00 $9.00 $10.00 $15.00 $24.00 $43.00 $66.00 $127.00 $206.00 $206.00

$110,000 $6.60 $6.60 $6.60 $8.80 $9.90 $11.00 $16.50 $26.40 $47.30 $72.60 $139.70 $226.60 $226.60

$120,000 $7.20 $7.20 $7.20 $9.60 $10.80 $12.00 $18.00 $28.80 $51.60 $79.20 $152.40 $247.20 $247.20

$130,000 $7.80 $7.80 $7.80 $10.40 $11.70 $13.00 $19.50 $31.20 $55.90 $85.80 $165.10 $267.80 $267.80

$140,000 $8.40 $8.40 $8.40 $11.20 $12.60 $14.00 $21.00 $33.60 $60.20 $92.40 $177.80 $288.40 $288.40

$150,000 $9.00 $9.00 $9.00 $12.00 $13.50 $15.00 $22.50 $36.00 $64.50 $99.00 $190.50 $309.00 $309.00

The amounts below require Statement of Insurability form

$160,000 $9.60 $9.60 $9.60 $12.80 $14.40 $16.00 $24.00 $38.40 $68.80 $105.60 $203.20 $329.60 $329.60

$170,000 $10.20 $10.20 $10.20 $13.60 $15.30 $17.00 $25.50 $40.80 $73.10 $112.20 $215.90 $350.20 $350.20

$180,000 $10.80 $10.80 $10.80 $14.40 $16.20 $18.00 $27.00 $43.20 $77.40 $118.80 $228.60 $370.80 $370.80

$190,000 $11.40 $11.40 $11.40 $15.20 $17.10 $19.00 $28.50 $45.60 $81.70 $125.40 $241.30 $391.40 $391.40

$200,000 $12.00 $12.00 $12.00 $16.00 $18.00 $20.00 $30.00 $48.00 $86.00 $132.00 $254.00 $412.00 $412.00

$210,000 $12.60 $12.60 $12.60 $16.80 $18.90 $21.00 $31.50 $50.40 $90.30 $138.60 $266.70 $432.60 $432.60

$220,000 $13.20 $13.20 $13.20 $17.60 $19.80 $22.00 $33.00 $52.80 $94.60 $145.20 $279.40 $453.20 $453.20

$230,000 $13.80 $13.80 $13.80 $18.40 $20.70 $23.00 $34.50 $55.20 $98.90 $151.80 $292.10 $473.80 $473.80

$240,000 $14.40 $14.40 $14.40 $19.20 $21.60 $24.00 $36.00 $57.60 $103.20 $158.40 $304.80 $494.40 $494.40

$250,000 $15.00 $15.00 $15.00 $20.00 $22.50 $25.00 $37.50 $60.00 $107.50 $165.00 $317.50 $515.00 $515.00

$260,000 $15.60 $15.60 $15.60 $20.80 $23.40 $26.00 $39.00 $62.40 $111.80 $171.60 $330.20 $535.60 $535.60

$270,000 $16.20 $16.20 $16.20 $21.60 $24.30 $27.00 $40.50 $64.80 $116.10 $178.20 $342.90 $556.20 $556.20

$280,000 $16.80 $16.80 $16.80 $22.40 $25.20 $28.00 $42.00 $67.20 $120.40 $184.80 $355.60 $576.80 $576.80

48

Voluntary Life

About Premiums: The premiums shown above may vary slightly due to rounding; actual premiums will be calculated by American United Life Insurance Company® (AUL), and may increase upon reaching certain age brackets, according to contract terms, and are subject to change.

EMPLOYEE ONLY OPTIONS (based on Employee's age as of 09/01)

Life & AD&D 0-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+

$290,000 $17.40 $17.40 $17.40 $23.20 $26.10 $29.00 $43.50 $69.60 $124.70 $191.40 $368.30 $597.40 $597.40

$300,000 $18.00 $18.00 $18.00 $24.00 $27.00 $30.00 $45.00 $72.00 $129.00 $198.00 $381.00 $618.00 $618.00

$310,000 $18.60 $18.60 $18.60 $24.80 $27.90 $31.00 $46.50 $74.40 $133.30 $204.60 $393.70 $638.60 $638.60

$320,000 $19.20 $19.20 $19.20 $25.60 $28.80 $32.00 $48.00 $76.80 $137.60 $211.20 $406.40 $659.20 $659.20

$330,000 $19.80 $19.80 $19.80 $26.40 $29.70 $33.00 $49.50 $79.20 $141.90 $217.80 $419.10 $679.80 $679.80

$340,000 $20.40 $20.40 $20.40 $27.20 $30.60 $34.00 $51.00 $81.60 $146.20 $224.40 $431.80 $700.40 $700.40

$350,000 $21.00 $21.00 $21.00 $28.00 $31.50 $35.00 $52.50 $84.00 $150.50 $231.00 $444.50 $721.00 $721.00

$360,000 $21.60 $21.60 $21.60 $28.80 $32.40 $36.00 $54.00 $86.40 $154.80 $237.60 $457.20 $741.60 $741.60

$370,000 $22.20 $22.20 $22.20 $29.60 $33.30 $37.00 $55.50 $88.80 $159.10 $244.20 $469.90 $762.20 $762.20

$380,000 $22.80 $22.80 $22.80 $30.40 $34.20 $38.00 $57.00 $91.20 $163.40 $250.80 $482.60 $782.80 $782.80

$390,000 $23.40 $23.40 $23.40 $31.20 $35.10 $39.00 $58.50 $93.60 $167.70 $257.40 $495.30 $803.40 $803.40

$400,000 $24.00 $24.00 $24.00 $32.00 $36.00 $40.00 $60.00 $96.00 $172.00 $264.00 $508.00 $824.00 $824.00

$410,000 $24.60 $24.60 $24.60 $32.80 $36.90 $41.00 $61.50 $98.40 $176.30 $270.60 $520.70 $844.60 $844.60

$420,000 $25.20 $25.20 $25.20 $33.60 $37.80 $42.00 $63.00 $100.80 $180.60 $277.20 $533.40 $865.20 $865.20

$430,000 $25.80 $25.80 $25.80 $34.40 $38.70 $43.00 $64.50 $103.20 $184.90 $283.80 $546.10 $885.80 $885.80

$440,000 $26.40 $26.40 $26.40 $35.20 $39.60 $44.00 $66.00 $105.60 $189.20 $290.40 $558.80 $906.40 $906.40

RATES CNTD.

49

Life and AD&D

SPOUSE ONLY OPTIONS Spouse premium based on EMPLOYEE'S age and amount of coverage chosen Spouse coverage amount cannot exceed

50% of employee amount

Life & AD&D 0-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+

$5,000 $0.30 $0.30 $0.30 $0.40 $0.45 $0.50 $0.75 $1.20 $2.15 $3.30 $6.35

$10,000 $0.60 $0.60 $0.60 $0.80 $0.90 $1.00 $1.50 $2.40 $4.30 $6.60 $12.70

$15,000 $0.90 $0.90 $0.90 $1.20 $1.35 $1.50 $2.25 $3.60 $6.45 $9.90 $19.05

$20,000 $1.20 $1.20 $1.20 $1.60 $1.80 $2.00 $3.00 $4.80 $8.60 $13.20 $25.40

$25,000 $1.50 $1.50 $1.50 $2.00 $2.25 $2.50 $3.75 $6.00 $10.75 $16.50 $31.75

$30,000 $1.80 $1.80 $1.80 $2.40 $2.70 $3.00 $4.50 $7.20 $12.90 $19.80 $38.10

$35,000 $2.10 $2.10 $2.10 $2.80 $3.15 $3.50 $5.25 $8.40 $15.05 $23.10 $44.45

$40,000 $2.40 $2.40 $2.40 $3.20 $3.60 $4.00 $6.00 $9.60 $17.20 $26.40 $50.80

$45,000 $2.70 $2.70 $2.70 $3.60 $4.05 $4.50 $6.75 $10.80 $19.35 $29.70 $57.15

$50,000 $3.00 $3.00 $3.00 $4.00 $4.50 $5.00 $7.50 $12.00 $21.50 $33.00 $63.50

The amounts below require Statement of Insurability form

$55,000 $3.30 $3.30 $3.30 $4.40 $4.95 $5.50 $8.25 $13.20 $23.65 $36.30 $69.85

$60,000 $3.60 $3.60 $3.60 $4.80 $5.40 $6.00 $9.00 $14.40 $25.80 $39.60 $76.20

$65,000 $3.90 $3.90 $3.90 $5.20 $5.85 $6.50 $9.75 $15.60 $27.95 $42.90 $82.55

$70,000 $4.20 $4.20 $4.20 $5.60 $6.30 $7.00 $10.50 $16.80 $30.10 $46.20 $88.90

$75,000 $4.50 $4.50 $4.50 $6.00 $6.75 $7.50 $11.25 $18.00 $32.25 $49.50 $95.25

$80,000 $4.80 $4.80 $4.80 $6.40 $7.20 $8.00 $12.00 $19.20 $34.40 $52.80 $101.60

$85,000 $5.10 $5.10 $5.10 $6.80 $7.65 $8.50 $12.75 $20.40 $36.55 $56.10 $107.95

$90,000 $5.40 $5.40 $5.40 $7.20 $8.10 $9.00 $13.50 $21.60 $38.70 $59.40 $114.30

$95,000 $5.70 $5.70 $5.70 $7.60 $8.55 $9.50 $14.25 $22.80 $40.85 $62.70 $120.65

$100,000 $6.00 $6.00 $6.00 $8.00 $9.00 $10.00 $15.00 $24.00 $43.00 $66.00 $127.00

$105,000 $6.30 $6.30 $6.30 $8.40 $9.45 $10.50 $15.75 $25.20 $45.15 $69.30 $133.35

$110,000 $6.60 $6.60 $6.60 $8.80 $9.90 $11.00 $16.50 $26.40 $47.30 $72.60 $139.70

$115,000 $6.90 $6.90 $6.90 $9.20 $10.35 $11.50 $17.25 $27.60 $49.45 $75.90 $146.05

$120,000 $7.20 $7.20 $7.20 $9.60 $10.80 $12.00 $18.00 $28.80 $51.60 $79.20 $152.40

$125,000 $7.50 $7.50 $7.50 $10.00 $11.25 $12.50 $18.75 $30.00 $53.75 $82.50 $158.75

$130,000 $7.80 $7.80 $7.80 $10.40 $11.70 $13.00 $19.50 $31.20 $55.90 $85.80 $165.10

$135,000 $8.10 $8.10 $8.10 $10.80 $12.15 $13.50 $20.25 $32.40 $58.05 $89.10 $171.45

$140,000 $8.40 $8.40 $8.40 $11.20 $12.60 $14.00 $21.00 $33.60 $60.20 $92.40 $177.80

$145,000 $8.70 $8.70 $8.70 $11.60 $13.05 $14.50 $21.75 $34.80 $62.35 $95.70 $184.15

50

CHILD(REN) OPTIONS

Child(ren) 6 months to age 26 Child(ren) live birth to 6 months Monthly Payroll Deduction Life Amount

Option 1: $10,000 $1,000 $2.00

Life and AD&D

About Premiums: The premiums shown above may vary slightly due to rounding; actual premiums will be calculated by American United Life Insurance Company® (AUL), and may increase upon reaching certain age brackets, according to contract terms, and are subject to change.

CNTD.

SPOUSE ONLY OPTIONS Spouse premium based on EMPLOYEE'S age and amount of coverage chosen Spouse coverage amount cannot exceed

50% of employee amount

Life & AD&D 0-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+

$150,000 $9.00 $9.00 $9.00 $12.00 $13.50 $15.00 $22.50 $36.00 $64.50 $99.00 $190.50

$155,000 $9.30 $9.30 $9.30 $12.40 $13.95 $15.50 $23.25 $37.20 $66.65 $102.30 $196.85

$160,000 $9.60 $9.60 $9.60 $12.80 $14.40 $16.00 $24.00 $38.40 $68.80 $105.60 $203.20

$165,000 $9.90 $9.90 $9.90 $13.20 $14.85 $16.50 $24.75 $39.60 $70.95 $108.90 $209.55

$170,000 $10.20 $10.20 $10.20 $13.60 $15.30 $17.00 $25.50 $40.80 $73.10 $112.20 $215.90

$175,000 $10.50 $10.50 $10.50 $14.00 $15.75 $17.50 $26.25 $42.00 $75.25 $115.50 $222.25

$180,000 $10.80 $10.80 $10.80 $14.40 $16.20 $18.00 $27.00 $43.20 $77.40 $118.80 $228.60

$185,000 $11.10 $11.10 $11.10 $14.80 $16.65 $18.50 $27.75 $44.40 $79.55 $122.10 $234.95

$190,000 $11.40 $11.40 $11.40 $15.20 $17.10 $19.00 $28.50 $45.60 $81.70 $125.40 $241.30

$195,000 $11.70 $11.70 $11.70 $15.60 $17.55 $19.50 $29.25 $46.80 $83.85 $128.70 $247.65

$200,000 $12.00 $12.00 $12.00 $16.00 $18.00 $20.00 $30.00 $48.00 $86.00 $132.00 $254.00

$205,000 $12.30 $12.30 $12.30 $16.40 $18.45 $20.50 $30.75 $49.20 $88.15 $135.30 $260.35

$210,000 $12.60 $12.60 $12.60 $16.80 $18.90 $21.00 $31.50 $50.40 $90.30 $138.60 $266.70

$215,000 $12.90 $12.90 $12.90 $17.20 $19.35 $21.50 $32.25 $51.60 $92.45 $141.90 $273.05

$220,000 $13.20 $13.20 $13.20 $17.60 $19.80 $22.00 $33.00 $52.80 $94.60 $145.20 $279.40

$225,000 $13.50 $13.50 $13.50 $18.00 $20.25 $22.50 $33.75 $54.00 $96.75 $148.50 $285.75

$230,000 $13.80 $13.80 $13.80 $18.40 $20.70 $23.00 $34.50 $55.20 $98.90 $151.80 $292.10

$235,000 $14.10 $14.10 $14.10 $18.80 $21.15 $23.50 $35.25 $56.40 $101.05 $155.10 $298.45

$240,000 $14.40 $14.40 $14.40 $19.20 $21.60 $24.00 $36.00 $57.60 $103.20 $158.40 $304.80

$245,000 $14.70 $14.70 $14.70 $19.60 $22.05 $24.50 $36.75 $58.80 $105.35 $161.70 $311.15

$250,000 $15.00 $15.00 $15.00 $20.00 $22.50 $25.00 $37.50 $60.00 $107.50 $165.00 $317.50

51

Accidental Death & Dismemberment is life insurance coverage that pays a death benefit to the beneficiary, should death occur due to a covered accident. Dismemberment benefits are paid to you, according to the benefit level you select, if accidentally dismembered.

About this Benefit

AD&D YOUR BENEFITS PACKAGE

cause of accidental deaths in the US, followed by poisoning, falls,

drowning, and choking.

DID YOU KNOW?

#1

Motor vehicle crashes are the

AXIS GLOBAL



AD&D

Principal Sum: Employee - $10,000 to $500,000 in $10,000 increments. Amounts over $250,000 may not exceed 10 times Base Earnings. Spouse – 60% of the employee’s benefit without child coverage, 50% of the employee’s benefit with child coverage. Spouse Maximum Principal Sum: $300,000. Child – 10% of the employee’s benefit with spouse coverage,

15% of the employee’s benefit without spouse coverage. Child(ren) Maximum Principal Sum: $30,000.

Eligibility: All active full time Employees of the Employer working 20 plus hours per week who are domiciled in the United States, its territories and protectorates, excluding temporary, lease or seasonal employees.

Core Benefits Accidental Death & Dismemberment Schedule of Benefits

Loss of Life 100% of the Principal Sum Loss of or Loss of use of Two or more Hands or Feet 100% of the Principal Sum Loss of Sight Both Eyes 100% of the Principal Sum Loss of One Hand or One Foot and Sight in One Eye 100% of the Principal Sum Loss of Speech and Hearing (both ears) 100% of the Principal Sum

Coma 1% of the Principal Sum for the first 11 months,

100% in the 12th Month Loss of or Loss of use of One Hand or Foot 50% of the Principal Sum Loss of Sight in One Eye 50% of the Principal Sum Loss of Speech 50% of the Principal Sum Loss of Hearing (both ears) 50% of the Principal Sum Loss of Thumb and Index Finger of the Same Hand 25% of the Principal Sum Loss of all Four Fingers of the Same Hand 25% of the Principal Sum Loss of all the Toes of the Same Foot 20% of the Principal Sum Quadriplegia (total paralysis of both upper and lower limbs) 100% of the Principal Sum Paraplegia (total paralysis of both lower limbs) 75% of the Principal Sum Hemiplegia (total paralysis of upper and lower limbs on one side of body 50% of the Principal Sum Uniplegia (total paralysis of one upper or lower limb) 25% of the Principal Sum Exposure and Disappearance Benefit Included

Additional Benefits Travel Assistance Services – You and your family have access to travel assistance services for emergencies that occur while traveling almost anywhere in the world, at least 100 miles from home. Comprehensive services are available locally in over 200 countries and through 35 assistance centers open 24/7, these comprehensive services offer support to help travelers in an emergency. Refer to the travel assurance flyer provided by your employer which includes information on the services available, as well as a wallet card with important contact information

Special Education Benefits Surviving Dependent Child

Your Dependent Child attending school could qualify for an additional 5% of the Principal Sum, up to a maximum of $5,000 per year for up to 4 years

Spouse Retraining Benefit

Your surviving Spouse attending school could qualify for an additional 5% of the Principal Sum, up to a maximum of $5,000.

Seatbelt and Airbag Benefits If you were traveling in a private passenger vehicle and

properly wearing a seatbelt, you could qualify for an

additional 10% of the Principal Sum, up to a maximum of $50,000

If you were traveling in a private passenger vehicle equipped with a properly functioning airbag, you could qualify for an additional 5% of the Principal Sum, up to a maximum of $10,000.

Bereavement & Trauma If bereavement and trauma counseling is needed due to a

covered loss, you could qualify for 10 - $100 sessions with a maximum benefit of $1,000

Home Alteration and Vehicle Modification Benefit If you suffer a covered loss and require home alteration

and vehicle modification, you could qualify for an additional 10% of the Principal Sum, up to a maximum of $10,000

Medical Evacuation and Repatriation Benefits If a covered accident occurs while traveling that results in

the need for your emergency medical evacuation or a repatriation of your remains, you could qualify for an additional benefit of 100% of the Usual and Customary charges for such an expense.

COBRA

Reimburses COBRA Insurance Continuation expenses if you die in a covered accident and are survived by a spouse or dependent child(ren). You could qualify for 3% of the Principal Sum, up to a maximum of $3,000 per policy year for a maximum of 3 years.

Rates: Employee Only: per employee, per month per $1,000 Principal Sum

$0.019/$1,000

Family Plan: per employee, per month per $1,000 Princi-pal Sum

$0.030/$1,000

53

Individual life is a policy that provides a specified death benefit to your beneficiary at the time of death. The advantage of having an individual life insurance plan as opposed to a group supplemental term life plan is that this plan is guaranteed renewable, portable and typically premiums remain the same over the life of the policy.

About this Benefit

Individual Life YOUR BENEFITS PACKAGE



5STAR

DID YOU KNOW?

1/3 of Americans would be financially impacted by the loss of the primary wage earner in just one month.

54

Term Life with Terminal Illness and Quality of Life Rider

The Family Protection Plan: Term Life Insurance with Terminal Illness Coverage to Age 100

Nearly 85% of Americans say most people need life insurance; unfortunately only 62% have coverage and a staggering 33% say they don’t have enough life insurance, including one-fourth who already have life insurance coverage.** Nobody wants to be a statistic - especially during a period of grief. That’s why 5Star Life Insurance Company developed its FPP policy - to ensure you and your loved ones are covered during a period of loss.

Affordability - With several options to choose from, select the coverage that best meets the needs of your family. Terminal Illness - This plan pays the insured 30% (25% in Connecticut and Michigan) of the policy coverage amount in a lump sum upon the occurrence of a terminal condition that will result in a limited life span of less than 12 months. Portability - You and your family continue coverage with no loss of benefits or increase in cost should you terminate employment after the first premium is paid. If this happens, we can simply bill you directly. Coverage can never be cancelled by the insurance company or your employer unless you stop paying premiums. Family Protection - Individual policies can be purchased on the employee, their spouse, children and grandchildren (ages newborn through 23). Quality of Life Benefit - Following a diagnosis of either a chronic illness or cognitive impairment, this rider accelerates a portion of the death benefit on a monthly basis – 4%; up to 75% of your benefit, and payable directly to you on a tax favored basis for the following:

Permanent inability to perform at least two of the six Activities of Daily Living (ADLs) without substantial assistance; or

Permanent severe cognitive impairment, such as dementia, Alzheimer’s disease and other forms of senility, requiring substantial supervision.

Convenience - Premiums are taken care of simply and easily through payroll deductions. Protection You Can Count On - Within 24 hours after receiving notice of an insured’s death, an emergency death benefit of the lesser of 50% of the coverage amount, or $10,000, will be mailed to the insured’s beneficiary, unless the death is within the two-year contestability period and/or under investigation. This product also contains no war or terrorism exclusions.

* Life insurance product underwritten by 5Star Life Insurance Company (a Baton Rouge, Louisiana company). Product may not be available in all states or territories. Request FPP insurance from Dell Perot, Post Office Box 83043, Lincoln, Nebraska 68501, (866) 863-9753.

DID YOU KNOW?

Protecting your financial well being is easier than you think. It’s like trading in a daily latte

for peace of mind.

$4.30 per day to start your morning with a

gourmet coffee OR

$1.75 per day to enrich your employee

benefits package

It’s less expensive than you think.

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Family Protection Plan - Terminal Illness

MONTHLY RATES GUARANTEED ISSUE RATES WITH QUALITY OF LIFE RIDER DEFINED BENEFIT

Age on App. Date

Employee Coverage Amounts Spouse Coverage Amounts

$10,000 $25,000 $50,000 $75,000 $100,000 $10,000 $20,000 $30,000

18-25 $7.56 $12.40 $20.46 $28.52 $36.58 $7.56 $10.78 $14.01

26 $7.58 $12.46 $20.58 $28.71 $36.83 $7.58 $10.83 $14.08

27 $7.65 $12.63 $20.92 $29.21 $37.50 $7.65 $10.97 $14.28

28 $7.74 $12.85 $21.38 $29.90 $38.42 $7.74 $11.15 $14.56

29 $7.88 $13.21 $22.08 $30.96 $39.83 $7.88 $11.43 $14.98

30 $8.07 $13.67 $23.00 $32.33 $41.67 $8.07 $11.80 $15.53

31 $8.27 $14.17 $24.00 $33.83 $43.67 $8.27 $12.20 $16.13

32 $8.49 $14.73 $25.13 $35.52 $45.92 $8.49 $12.65 $16.81

33 $8.73 $15.31 $26.29 $37.27 $48.25 $8.73 $13.12 $17.51

34 $9.00 $16.00 $27.67 $39.33 $51.00 $9.00 $13.67 $18.33

35 $9.30 $16.75 $29.17 $41.58 $54.00 $9.30 $14.27 $19.23

36 $9.64 $17.60 $30.88 $44.15 $57.42 $9.64 $14.95 $20.26

37 $10.02 $18.54 $32.75 $46.96 $61.17 $10.02 $15.70 $21.38

38 $10.41 $19.52 $34.71 $49.90 $65.08 $10.41 $16.48 $22.56

39 $10.84 $20.60 $36.88 $53.15 $69.42 $10.84 $17.35 $23.86

40 $11.31 $21.77 $39.21 $56.65 $74.08 $11.31 $18.28 $25.26

41 $11.83 $23.08 $41.83 $60.58 $79.33 $11.83 $19.33 $26.83

42 $12.41 $24.52 $44.71 $64.90 $85.08 $12.41 $20.48 $28.56

43 $13.00 $26.00 $47.67 $69.33 $91.00 $13.00 $21.67 $30.33

44 $13.63 $27.56 $50.79 $74.02 $97.25 $13.63 $22.92 $32.21

45 $14.28 $29.19 $54.04 $78.90 $103.75 $14.28 $24.22 $34.16

46 $14.97 $30.92 $57.50 $84.08 $110.67 $14.97 $25.60 $36.23

47 $15.69 $32.73 $61.13 $89.52 $117.92 $15.69 $27.05 $38.41

48 $16.43 $34.56 $64.79 $95.02 $125.25 $16.43 $28.52 $40.61

49 $17.22 $36.54 $68.75 $100.96 $133.17 $17.22 $30.10 $42.98

50 $18.08 $38.69 $73.04 $107.40 $141.75 $18.08 $31.82 $45.56

51 $19.04 $41.10 $77.88 $114.65 $151.42 $19.04 $33.75 $48.46

52 $20.16 $43.90 $83.46 $123.02 $162.58 $20.16 $35.98 $51.81

53 $21.40 $47.00 $89.67 $132.33 $175.00 $21.40 $38.47 $55.53

54 $22.79 $50.48 $96.63 $142.77 $188.92 $22.79 $41.25 $59.71

55 $24.27 $54.17 $104.00 $153.83 $203.67 $24.27 $44.20 $64.13

56 $25.93 $58.33 $112.33 $166.33 $220.33 $25.93 $47.53 $69.13

57 $27.66 $62.65 $120.96 $179.27 $237.58 $27.66 $50.98 $74.31

58 $29.42 $67.04 $129.75 $192.46 $255.17 $29.42 $54.50 $79.58

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Family Protection Plan - Terminal Illness

Quality of Life not available ages 66 - 70. Quality of Life benefits not available for children. Child life coverage available only on children and grandchildren of employee (age on application date: full term new born to 23 years). $4.98 monthly for $10,000 coverage and $9.97 monthly for $20,000 coverage.

MONTHLY RATES GUARANTEED ISSUE RATES WITH QUALITY OF LIFE RIDER DEFINED BENEFIT

Age on App. Date

Employee Coverage Amounts Spouse Coverage Amounts

$10,000 $25,000 $50,000 $75,000 $100,000 $10,000 $20,000 $30,000

59 $31.23 $71.56 $138.79 $206.02 $273.25 $31.23 $58.12 $85.01

60 $33.12 $76.29 $148.25 $220.21 $292.17 $33.12 $61.90 $90.68

61 $35.08 $81.19 $158.04 $234.90 $311.75 $35.08 $65.82 $96.56

62 $37.13 $86.31 $168.29 $250.27 $332.25 $37.13 $69.92 $102.71

63 $39.31 $91.77 $179.21 $266.65 $354.08 $39.31 $74.28 $109.26

64 $41.68 $97.71 $191.08 $284.46 $377.83 $41.68 $79.03 $116.38

65 $44.33 $104.33 $204.33 $304.33 $404.33 $44.33 $84.33 $124.33

66* $44.93 $105.81 $207.29 $308.77 $410.25 $44.93 $85.52 $126.11

67* $48.25 $114.13 $223.92 $333.71 $443.50 $48.25 $92.17 $136.08

68* $52.03 $123.58 $242.83 $362.08 $481.33 $52.03 $99.73 $147.43

69* $56.33 $134.31 $264.29 $394.27 $524.25 $56.33 $108.32 $160.31

70* $61.17 $146.42 $288.50 $430.58 $572.67 $61.17 $118.00 $174.83

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Identity theft protection monitors and alerts you to identity threats. Resolution services are included should your identity ever be compromised while you are covered.

About this Benefit

YOUR BENEFITS PACKAGE Identity Theft



ID WATCHDOG

An identity is stolen every

2 seconds,

and takes over

300 hours to resolve, causing an

average loss of $9,650.

DID YOU KNOW?

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CREDIT PROTECTION SERVICES Credit Monitoring, Report & Score(s)

Tri-bureau monitoring and TransUnion® report and score.

Monthly Credit Score Tracker Historical view of TransUnion scores.

Rapid Credit Alerts Credit alerts provided within minutes of detected activity change.

Credit Freeze Assistance with putting a security freeze on your credit report. Credentials are securely stored for easy access.

Fraud Alert Assistance & Reminders

Assistance with setting credit bureau fraud alerts and remind‐ers.

PROACTIVE IDENTITY MONITORING Public Records & NCOA Monitoring

We monitor the National Change of Address Registry and public records databases (over 37 billion consumer records). Direct network access enables us to detect potential fraud faster.

Payday Loan Monitoring We work directly with alternative credit bureaus that service the under-banked market. Our network monitors the largest database so we can alert faster.

Enhanced Non-Credit Loan Monitoring Our expanded fraud detection network includes monitoring of auto pawn, rent-to-own, sub-prime, and cell phone accounts. Protection is increased by scanning for these common trans‐actions that require minimal information to obtain.

High-Risk Application & Transaction Monitoring Real-time alerts cover new account applications such as finan‐cial and wireless. Real-time alerts inform you of critical trans‐actions including bank password resets, online healthcare, payroll account, or insurance records access. We catch poten‐tial identity theft up to 90 days sooner.

Cyber Monitoring Underground websites are scanned daily in search of personal information being sold. When detected in our scans, we send a compromised credentials alert.

Instant-On™ Monitoring Instant-On promptly activates all monitoring on the benefit effective date without any further action required by the em‐ployee.

ADVANCED TOOLS Breach Notification

Receive email notification of prominent data breaches.

Solicitation Reduction Opt in or out of the National Do Not Call Registry, pre-approved credit offers, junk mail, or email.

Lost Wallet Vault & Replacement Store your wallet contents in our secure digital vault. Lost Wallet Replacement will assist with cancelling and replacing contents from the Lost Wallet Vault.

2-Step Authentication To ensure your information is accurate and secure, we require a 2-step authentication process when logging in to and regis‐tering your account.

Identity Profifle Report Our report helps surface any pre-existing conditions going back 30 years or more.

Social Network Alerts Add alert customizations to Facebook, LinkedIn, Instagram, and Twitter accounts to stay on top of potential cyberbullying, cyber predators, and reputation-damaging items directed at you and your family. Our exclusive identity exposure report highlights PII published on social sites and calls out increased potential for identity theft.

Registered Sex O- ender Reporting & Alerts Run a report for a specific address showing location, photo ID, and the offense committed. Search for sex o enders in your area and receive alerts when new o enders move into your neighborhood. We track and report offenders who move from state to state who can be missed in an online state search. Real-time reporting is available for all ID Watchdog plans. Collect maximum information from one source to keep loved ones safe.

National Provider Identifier (NPI) Alerts We monitor the NPI database for activity that indicates poten‐tial fraud. We are the only vendor who monitors this database and provides alerts to physicians, pharmacists, and more if their credentials are compromised.

Password Manager Securely store and use login information and access it with a single master password. COMING IN 2016

ADVANCED CUSTOMER CARE CENTER Fully Managed Resolution Service

Dedicated CITRMS work with you to assess your identity theft situation and will manage your case until it is completely re‐stored.

$1M Expense Reimbursement Insurance The plan covers fi nancial damages incurred as a result of the theft.

Call Center Commitment to Excellence Real-time language support ensures clear communication with over 100 languages.

24/7 Call Center Reach an identity theft protection specialist when you need help.

Identity Theft

RATES

Single Family

$9.95 $17.95 1B + 3

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A Cafeteria Plan is designed to take advantage of Section 125 of the Internal Revenue Code. It allows you to pay certain qualified expenses on a pre-tax basis, thereby reducing your taxable income. You can set aside a pre-established amount of money per plan year in a Healthcare Flexible Spending Account (FSA). Funds allocated to a healthcare FSA must be used during the plan year or are forfeited unless your plan contains a $500 rollover or grace period provision.

Limited FSA (HSA Compatible) The funds in the limited healthcare FSA can be used to pay for eligible dental or vision expenses like orthodontics, glasses and contacts.

About this Benefit

FSA (Flexible Spending Account)


NBS



FOR HSA VS. FSA COMPARISON

FLIP TO… PG. 11

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NBS Flexcard You may use the card to pay merchants or service providers that accept MasterCard® credit cards, so there is no need to pay cash up front, then wait for reimbursement. If you are participating in the Dependent Care portion, the money isn’t loaded to the card. You must file web or paper claims or enroll in continual reimbursement.

Current plan participants: KEEP YOUR CARDS! NBS debit cards are good for 3 years. If you throw away your cards, there is a $5.00 fee to replace them.

New Plan Participants NBS will mail out your new benefit cards to the address listed in THEbenefitsHUB. They will be sent in unmarked envelopes so please watch for them as they should arrive within 21 business days of effective date. NBS debit cards are good for 3 years.

FSA Annual Contribution Max: $2,550

Dependent Care Annual Max: $5,000

Account Information: Participant Account Web Access: www.participant.nbsbenefits.com Participants may call NBS and talk to a representative during regular business hours, Monday-Friday, 8 am to 7 pm Central Time. Participants can also obtain account information using the Automated Voice Response Unit, 24 hours a day, 7 days a week at (801) 838-7324 or toll free (800) 274-0503. For immediate access to your account information at any time, log on to the NBS website: www.NBSbenefits.com Detailed claim history and processing status Health Care and Dependent Care account balances Health Care and Dependent Care account balances Claim forms, Direct Deposit form, worksheets, etc. Online claim FAQs

For a list of sample expenses, please refer to the Taylor ISD benefit website: www.mybenefitshub.com/taylorisd

NBS Contact Information:

8523 South Redwood Road West Jordan, UT 84088 Phone (800) 274‐0503 Fax (800) 478‐1528 Email: [email protected]

When Will I Receive My Flex Card? Expect Flex Cards to be delivered to the address listed in THEbenefitsHUB near the end of May. Don’t forget, Flex Cards Are Good For 3 Years!

FSA (Flexible Spending Account)

DID YOU KNOW? FSAs use tax-free funds to help pay for your Health Care Expenses?

NBS Prepaid MasterCard® Debit Card

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What is a Flexible Spending Account? A Flexible Spending Account allows you to save money by paying out-of-pocket health and/or dependent care related expenses with pre-tax dollars. Your contributions are deducted from your pay before taxes are withheld and your account is up fronted with an annual amount. Because you are taxed on a lower amount of pay, you pay less in taxes and you have more to spend.

How does a Flexible Spending Account Benefit Me? A Cafeteria plan enables you to save money on group insurance, health-related expenses, and dependent-care expenses. You may save as much as 35 percent on the cost of each benefit option! Eligible expenses must be incurred within the plan year and contributions are use-it-or- lose-it. Remember to retain all your receipts.

Health Care Expense Account Example Expenses:

Dependent Care Expense Account Example Expenses: Before and After School and/or Extended Day Programs

The actual care of the dependent in your home.

Preschool tuition.

The base costs for day camps or similar programs used as care for a qualifying individual.

What Can I Use My Flexible Spending Account On? For a full list of eligible expenses, please refer to www.mybenefitshub.com/taylorisd

What Happens If I Don’t Use All of My Funds by The End of the Plan Year (August 31st)? Eligible expenses must be incurred within the plan year +75 day grace period. Contributions are use-it-or- lose-it. Remember to retain all your receipts (including receipts for card swipes).

How Do I File A Claim? In most situations, you will be able to swipe your card however, in the event you lose your card or are waiting to receive one, you can visit www.mybenefitshub.com/taylorisd and complete the “Claim Form” to send to NBS or use the web or phone app to file online.

Hearing aids & batteries

Lab fees

Laser Surgery

Orthodontia Expenses

Physical exams

Pregnancy tests

Prescription drugs

Vaccinations

Vaporizers or humidifiers

Acupuncture

Body scans

Breast pumps

Chiropractor

Co-payments

Deductible

Diabetes Maintenance

Eye Exam & Glasses

Fertility treatment

First aid

FSA Frequently Asked Questions

How To Receive Your Dependent Care Reimbursement Faster.

A Direct Deposit form is available on the Benefits Website which will help you get reimbursed quicker!

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How the FSA Plan Works

You designate an annual election of pre-tax dollars to be deposited into your health and dependent-care spending accounts. Your total election is divided by the number of pay periods in the Plan year and deducted equally from each paycheck before taxes are calculated. By the end of the Plan year, your total election will be fully deposited. However, you may make a claim for eligible health FSA expenses as soon as they are incurred during the Plan year. Eligible claims will be paid up to your total annual election even if you have not yet contributed that amount to your account.

Get Your Money 1. Complete and sign a claim form (available on our website) or an online claim. 2. Attach documentation; such as an itemized bill or an Explanation of Benefits (EOB) statement from a health insurance provider. 3. Fax or mail signed form and documentation to NBS. 4. Receive your non-taxable reimbursement after your claim is processed either by check or direct deposit.

NBS Flexcard—FSA Pre-paid Benefit Card Your employer may sponsor the use of the NBS Flexcard, making access to your flex dollars easier than ever. You may use the card to pay merchants or service providers that accept credit cards, so there is no need to pay cash up front then wait for reimbursement.

Account Information Participants may call NBS and talk to a representative during our regular business hours, Monday–Friday, 7am to 6pm Mountain Time. Participants can also obtain account information using the Automated Voice Response Unit, 24 hours a day, 7 days a week at (801) 838-7324 or toll free (800) 274-0503. For immediate access to your account information at any time, log on to our website: www.NBSbenefits.com Information includes:

Detailed claim history and processing status

Health Care and Dependent Care account balances

Claim forms, worksheets, etc.

Online Claim Submission

Enrollment Considerations After the enrollment period ends, you may increase, decrease, or stop your contribution only when you experience a qualifying “change of status” (marriage status, employment change, dependent change). Be conservative in the total amount you elect to avoid forfeiting money that may be left in your account at the end of the year. Your employer may allow a short grace period after the Plan year ends for you to submit qualified claims for any unused funds.

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www.mybenefitshub.com/taylorisd

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Documents

2016 Benefit Guide Taylor ISD