Coldspring Oakhurst CISD - Edl · PDF file · 2016-08-23Houston, TX . Please visit www ... Group Cancer Allstate 800-521-3535 ... See reverse side for a list of services

Coldspring Oakhurst CISD

2016 — 2017 Benefit Summary

Plan Year is September 1, 2016 to August 31, 2017

OPEN ENROLLMENT AUGUST 16 TO AUGUST 22, 2016

Benefit Information Provided By: John Brick, Sr. Account Administrator

First Financial Group of America Cell Phone: 832-859-5865

11811 North Freeway, Ste 900 Houston, TX 77060

Please visit www.benefits.ffga.com/coldspringoakhurstcisd for additional plan details and rates.

Important Details to Know This Year ACA RULES Due to Federal Regulations under the Affordable Care Act (ACA), ALL EMPLOYEES must enroll in or decline coverage for themselves and their dependents in the TRS Medical Plan. Changes for the 2016/17 plan year Aetna Medical – Rate increase and benefit changes on select plans. Please be sure to visit the Coldspring Oakhurst CISD Employee Benefits Center or contact John Brick at 832-859-5865 for additional information on all of the products available.

Contacts

BENEFIT CONTACTS NAME PHONE WEB ADDRESS

Payroll Coordinator Kim Jeter 936-653-1113 [email protected]

Sr. Account Administrator John Brick 832-859-5865 [email protected]

BENEFIT VENDOR PHONE WEBSITE Flexible Spending & Dependent Care First Financial 800-523-8422 www.ffga.com

Health Savings Accounts American Fidelity 866-326-3600 www.afhsa.com

Medical Aetna 800-222-9205 www.trsactivecareaetna.com

Gap Insurance American Fidelity 800-654-8489 www.americanfidelity.com

Accident, Disability and Term Life Unum 800-275-8686 www.unum.com

Group Cancer Allstate 800-521-3535 www.allstateatwork.com

Permanent Life Texas Life 800-283-9233 www.texaslife.com

Dental Ameritas 800-487-5553 www.ameritas.com

Vision Superior 800-507-3800 www.supervision.com

TeleHealth My Health Pass 855-212-6020 www.myhealthpass.com

Legal Plan Identity Theft Legal Club 866-434-3572 www.legalclub.com

Legal Plan Lost Credit Card Legal Club 888-490-0382 www.legalclub.com

Legal Plan Referrals Legal Club 800-305-6816 www.legalclub.com

USEFUL INFORMATION TO KNOW

• You must enroll in Medical Reimbursement, Dependent Care Reimbursement and Health Savings Account (HSA) every year. These benefits DO NOT automatically renew.

• Write your PIN number down. • Contact First Financial # 800-523-8422 with any technical questions. • No changes will be permitted until annual enrollment, unless you have an IRS S125 qualified

event.

http://www.benefits.ffga.com/coldspringoakhurstcisd

mailto:[email protected]

mailto:[email protected]

http://www.ffga.com/

http://www.americanfidelity.com/

http://www.allstateatwork.com/

http://www.texaslife.com/

http://www.ameritas.com/

http://www.myhealthpass.com/

http://www.legalclub.com/



2016 – 2017 TRS-ActiveCare Plan Highlights

TRS-0042 Plan Highlights_V11

Effective September 1, 2016 through August 31, 2017 | In-Network Level of Benefits*

Type of Service ActiveCare 1-HD ActiveCare Select or ActiveCare Select Whole Health(Baptist Health System and HealthTexas Medical Group; Baylor Scott & White Quality Alliance; Memorial Hermann Accountable Care Network; Seton Health Alliance)

ActiveCare 2

Deductible (per plan year)

$2,500 employee only$5,000 family

$1,200 individual$3,600 family


Out-of-Pocket Maximum (per plan year; does include medical deductible/any medical copays/coinsurance/any prescription drug deductible and applicable copays/coinsurance)

$6,550 individual$13,100 family (the individual out-of-pocket maximum only includes covered expenses incurred by that individual)



Coinsurance Plan pays (up to allowable amount)Participant pays (after deductible)

80%20%

80%20%

80%20%

Office Visit Copay Participant pays

20% after deductible $30 copay for primary$60 copay for specialist

$30 copay for primary$50 copay for specialist

Diagnostic LabParticipant pays

20% after deductible Plan pays 100% (deductible waived) if performed at a Quest facility; 20% after deductible at other facility

Plan pays 100% (deductible waived) if performed at a Quest facility; 20% after deductible at other facility

Preventive CareSee reverse side for a list of services

Plan pays 100% Plan pays 100% Plan pays 100%

Teladoc® Physician Services $40 consultation fee (applies to deductible and out-of-pocket maximum)

Plan pays 100% Plan pays 100%

High-Tech Radiology (CT scan, MRI, nuclear medicine) Participant pays

20% after deductible $100 copay plus 20% after deductible $100 copay plus 20% after deductible

Inpatient Hospital (preauthorization required) (facility charges)Participant pays

20% after deductible $150 copay per day plus 20% after deductible ($750 maximum copay per admission)

$150 copay per day plus 20% after deductible($750 maximum copay per admission; $2,250 maximum copay per plan year)

Emergency Room (true emergency use)Participant pays

20% after deductible $150 copay plus 20% after deductible (copay waived if admitted)

$150 copay plus 20% after deductible (copay waived if admitted)

Outpatient SurgeryParticipant pays

20% after deductible $150 copay per visit plus 20% after deductible

$150 copay per visit plus 20% after deductible

Bariatric SurgeryPhysician charges (only covered if performed at an IOQ facility)Participant pays

$5,000 copay plus 20% after deductible Not covered $5,000 copay (does not apply to out-of-pocket maximum) plus 20% after deductible

Prescription Drugs Drug deductible (per plan year)

Subject to plan year deductible $0 for generic drugs$200 per person for brand-name drugs

$0 for generic drugs$200 per person for brand-name drugs

Retail Short-Term (up to a 31-day supply)Participant pays• Generic copay• Brand copay (preferred list)• Brand copay (non-preferred list)

20% after deductible

$20$40**50% coinsurance**

$20$40**$65**

Retail Maintenance (after first fill; up to a 31-day supply)Participant pays• Generic copay• Brand copay (preferred list)• Brand copay (non-preferred list)



$35$60**$90**

Mail Order and Retail-Plus (up to a 90-day supply)Participant pays• Generic copay• Brand copay (preferred list)• Brand copay (non-preferred list)



$45$105**$180**

Specialty DrugsParticipant pays

20% after deductible 20% coinsurance per fill $200 per fill (up to 31-day supply)$450 per fill (32- to 90-day supply)

A specialist is any physician other than family practitioner, internist, OB/GYN or pediatrician. *Illustrates benefits when in-network providers are used. For some plans non-network benefits are also available; there is no coverage for non-network benefits under the ActiveCare Select or ActiveCare Select Whole Health Plan; see Enrollment Guide for more information. Non-contracting providers may bill for amounts exceeding the allowable amount for covered services. Participants will be responsible for this balance bill amount, which maybe considerable. **If the patient obtains a brand-name drug when a generic equivalent is available, the patient will be responsible for the generic copayment plus the cost difference between the brand-name drug and the generic drug.

TRS-ActiveCare Plans – Preventive Care

Preventive Care Services

In-Network BenefitsWhen Using In-Network Providers

(Provider must bill services as “preventive care”)

ActiveCare 1-HD ActiveCare Select or ActiveCare Select

Whole Health(Baptist Health System and

HealthTexas Medical Group; Baylor Scott & White Quality Alliance;

Memorial Hermann Accountable Care Network; Seton Health Alliance)

ActiveCare 2 Network

Evidence−based items or services that have in effect a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force (USPSTF) http://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations.Immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC) with respect to the individual involved.Evidence−informed preventive care and screenings provided for in the comprehensive guidelines supported by the Health Resources and Services Administration (HRSA) for infants, children and adolescents. Additional preventive care and screenings for women, not described above, as provided for in comprehensive guidelines supported by the HRSA http://www.hhs.gov/healthcare/facts-and-features/fact-sheets/preventive-services-covered-under-aca/index.html#CoveredPreventiveServicesforAdults.For purposes of this benefit, the current recommendations of the USPSTF regarding breast cancer screening and mammography and prevention will be considered the most current (other than those issued in or around November 2009).The preventive care services described above may change as USPSTF, CDC and HRSA guidelines are modified.

Plan pays 100% (deductible waived)

Some examples of preventive care frequency and services:• Routine physicals – annually age

12 and over• Well-child care – unlimited up to

age 12• Well woman exam & pap smear –

annually age 18 and over• Mammograms – 1 every year age

35 and over• Colonoscopy – 1 every 10 years

age 50 and over• Prostate cancer screening –

1 per year age 50 and over• Smoking cessation counseling –

8 visits per 12 months• Healthy diet/obesity counseling –

unlimited to age 22; age 22 and over-26 visits per 12 months

• Breastfeeding support – 6 lactation counseling visits per 12 months

Plan pays 100% (deductible waived; no copay required)











Plan pays 100% (deductible waived; no copay required)











Examples of covered services included are:Routine annual physicals (one per year); immunizations; well-child care; breastfeeding support, services and supplies; cancer screening mammograms; bone density test; screening for prostate cancer and colorectal cancer (including routine colonoscopies); smoking cessation counseling services and healthy diet counseling; and obesity screening/counseling.Examples of covered services for women with reproductive capacity are:Female sterilization procedures and specified FDA-approved contraception methods with a written prescription by a health care practitioner, including cervical caps, diaphragms, implantable contraceptives, intra-uterine devices, injectables, transdermal contraceptives and vaginal contraceptive devices. Prescription contraceptives for women are covered under the pharmacy benefits administered by Caremark. To determine if a specific contraceptive drug or device is included in this benefit, contact Customer Service at 1-800-222-9205. The list may change as FDA guidelines are modified.

Annual Vision Examination (one per plan year; performed by an opthalmologist or optometrist using calibrated instruments)Participant pays

After deductible, plan pays 80%; participant pays 20%

$60 copay for specialist $50 copay for specialist

Annual Hearing ExaminationParticipant pays

After deductible, plan pays 80%; participant pays 20%



2016 – 2017 TRS-ActiveCare Plan Highlights

Note: Covered services under this benefit must be billed by the provider as “preventive care.” If you receive preventive services from a non-network provider, you will be responsible for any applicable deductible and coinsurance under the ActiveCare 1-HD and ActiveCare 2. Non-network preventive care is not paid at 100%. There is no coverage for non-network services under the ActiveCare Select plan or ActiveCare Select Whole Health.

TRS-ActiveCare is administered by Aetna Life Insurance Company. Aetna provides claims payment services only and does not assume any financial risk or obligation with respect to claims. Prescription drug benefits are administered by Caremark.

2016-2017 TRS-ActiveCare POS II Rates and Benefit Changes

Changes Effective September 1, 2016

TRS-ActiveCare 1-HD Premium Changes Coverage Tier 2015-2016 Premiums 2016-2017 Premiums

Employee Only $341.00 $341.00

Employee & Spouse $914.00 $914.00

Employee & Child(ren) $615.00 $615.00

Employee & Family $1,231.00 $1,231.00

TRS-ActiveCare 1-HD Benefit Changes Benefit 2015-2016 Plan Year 2016-2017 Plan Year

Deductible Individual - $2,500 Family - $5,000

No changes

Out-of-Pocket Maximum Individual - $6,450 Family - $12,900

Individual - $6,550 Family - $13,100

TRS-ActiveCare Select Premium Changes Coverage Tier 2015-2016 Premiums 2016-2017 Premiums


Employee & Spouse $1,122.00 $1,147.00

Employee & Child(ren) $762.00 $779.00

Employee & Family $1,331.00 $1,361.00

Gross monthly premiums before state and district contributions


TRS-ActiveCare Select Benefit Changes Benefit 2015-2016 Plan Year 2016-2017 Plan Year


No changes



Retail Maintenance (after 1st fill, up to 31-day supply)

Generic Preferred Brand Non-Preferred Brand

$25 copay $50 copay

50% coinsurance

$35 copay $60 copay

50% coinsurance

TRS-ActiveCare 2 Premium Changes Coverage Tier 2015-2016 Premiums 2016-2017 Premiums


Employee & Spouse $1,478.00 $1,552.00

Employee & Child(ren) $992.00 $1,042.00

Employee & Family $1,521.00 $1,597.00

TRS-ActiveCare 2 Benefit Changes Benefit 2015-2016 Plan Year 2016-2017 Plan Year


No changes



Retail Maintenance (after 1st fill, up to 31-day supply)

Generic Preferred Brand Non-Preferred Brand

$25 copay $50 copay $80 copay

$35 copay $60 copay $90 copay


Coldspring Oakhurst CISD Benefits Book Plan Year September 1, 2016 to August 31, 2017

Visit the Employee Benefits Center (EBC) at www.benefits.ffga.com/coldspringoakhurstcisd

SECTION 125 CAFETERIA PLAN RULES

TWO IMPORTANT ISSUES TO KEEP IN MIND

1. You must make an election each plan year to continue your eligibility for Flexible Spending Accounts (FSAs).

2. You cannot change your benefit elections for the plan year unless the benefits office receives

notification in writing within 31days of the status change. If the Benefits Office is not notified within 31 days of the status change, no benefit change can be made until the next annual Open Enrollment.

IRS specified changes in family status include:

• Marriage or divorce • Birth, adoption or death of a spouse or child • Change in a spouse’s or dependent’s employment status • Change in eligibility status of a dependent • Substantial increase in a benefit premium • Becoming Medicare eligible • Spousal Open Enrollment (not all plans allow this)

SECTION 125 FAQ’S Q. Can I use the tax credit for medical expense deduction on my income tax return? A. No. Expenses reimbursed under this plan may not be used when calculating your medical expense

deduction. Q. What is the maximum monthly amount I can have deducted from my check (pre-tax) for medical

reimbursement? A. $208.33 per month is the maximum for medical reimbursement. Q. If my spouse has a Health Saving account (HSA), can I enroll in a Flexible spending plan (FSA)? A. No. Due to IRS regulations you would not be eligible to enroll in a Flexible Spending plan (FSA).

Section 125 Flexible Benefit Plan allows you, the employee to select from a list of available benefits that will meet your family’s benefits needs. Certain benefit premiums are deducted from your gross earnings before federal tax with-holding taxes are calculated. The amount you elect to have deducted “pre-tax” actually lowers your taxable income. By implementing this plan, your employer is helping you reduce your taxes

and increase your take home pay.

BENEFITS UNDER SECTION 125: Medical Insurance Dental Insurance Vision Insurance Critical Illness Insurance Accident Plan Flexible Spending Account (FSA)




SECTION 125 FAQ’S CONT’D Q. What happens if I don’t incur enough expenses to get back the money deposited in my Reimbursement account? A. Any expense dollars not used for expenses is forfeited. This is what is known as the “use it or lose it”

provision of the Section 125. It is very important to be conservative and accurate in estimating your expenses for the plan year. You will be reminded periodically (based on activity) of the balance in your account. You also have up to 90 days to file for expenses incurred during the previous plan year or within 90 days after termination to file for expenses incurred prior to termination.

FLEXIBLE SPENDING ACCOUNT (FSA) – MEDICAL Medical Flexible Spending Accounts (FSA) allow you to set aside pre-tax payroll deductions each pay check to pay for out of pocket medical, dental and vision expenses for you and your family. During open enrollment you will estimate the amount you think you will need during the year. This amount will be taken out of each paycheck. Your full annual election will be available to you at the beginning of the plan year. The maximum you can set aside each year is $2,550. With a Medical FSA you can set aside part of your pay on a pre-tax basis to pay for eligible medical expenses such as:

• Prescriptions • Co-payments • Deductibles • Dental Expenses • Glasses/Contacts

REMEMBER: If you don’t use it, you lose it! You MUST re-enroll every year.

FF Flex Mobile App you can:

• Submit Claims • View Account Balance & History • See Claim Status • View Alerts • Upload Receipts and Documentation

The FF Flex Mobile App is available for Apple or Android devices on the App StoreSM or the Google

Play Store.




FSA Store www.ffga.com/fsaextras

First Financial has partnered with the FSA Store to bring you an easy to use online store to better understand and manage your Flexible Spending Account (FSA). Shop at the FSA Store for eligible items from bandages to wheel chairs and thousands of products in between, browse or search for eligible products and services using the FSA Eligibility List, and visit the FSA Learning Center to help find answers to questions you may have about your FSA.

FLEXIBLE SPENDING ACCOUNT (FSA) – DEPENDENT CARE This is a plan that allows for a tax savings on day care expenses for children under the age of 13 and for dependent adults unable to care for themselves. The employee estimates an annual election for the amount of expenses to be incurred. The annual election amount is deducted in equal amounts from each paycheck, before taxes are calculated, and then set aside in a special account for the employee. As expenses are incurred, the employee submits a claim and the money is reimbursed to the employee from the employee’s account as the monies come in from each paycheck. The IRS does not allow the Dependent Care Account (DCA) to be pre-funded. Where accepted, the debit card may be used for payment of dependent care expenses. Please see the summary plan description located on the enrollment website for more information. Note: Any money not claimed by the employee within ninety days after the end of the plan year is forfeited. The maximum annual election amount is $5,000 per household. If you are married and filing separately, each spouse may only elect up to $2,500.

AMERICAN FIDELITY HEALTH SAVINGS ACCOUNT (HSA) A Health Savings Account (HSA) is an individually owned savings account that allows you to set aside money for health care tax-free whenever you select an HSA qualified High Deducible Health Plan (HDHP). Money left in the account can accumulate interest tax-free and money used to pay for qualified medical expenses can be distributed tax-free. Through your employer’s Section 125 Plan, you can contribute pre-tax amounts up to the yearly maximum allowed.

HIGHLIGHTS

• HSA contributions receive tax-favored treatment. (Pre-tax if made through a Section 125 Plan or tax deductible if made directly to the HSA) - Earned interest may be tax-free

• Interest earned is applied to your account starting with first dollar contribution • Distributions are not taxed when funds are used for qualified medical expenses • You decide when and how to use your money • No “use or lose” requirement meaning whatever deposits you make each year may be left on

deposit to earn interest and to be available to pay for medical expenses in future years • You may pay for qualified medical expenses for yourself, your spouse, and your tax dependents

regardless of whether or not they are on your health plan • No matter where you go, your account follows you. Even if you change jobs, change medical

coverage, become unemployed, move to another state, or change your marital status, your HSA goes with you. You own it!




AMERICAN FIDELITY HEALTH SAVINGS ACCOUNT (HSA) CONT’D

CONTRIBUTIONS

If you are eligible to make contributions, you may contribute up to the annual maximum amount allowed by law in any given tax year. The IRS establishes the maximum amounts on an annual basis. The 2016 maximum allowable is $3,350 for an individual or $6,650 for a family. If you HDHP is effective other than January 1 and you wish to make the maximum annual contribution, you must meet certain requirements. Please visit www.afhsa.com for those requirements and additional information.

If you are age 55 or older, you are eligible to make an annual catch-up contribution of $1,000. HSAs are owned by one individual, so if you and your spouse are covered under the family HDHP and both of you are age 55 or older, you as the owner of the account may make the catch up contribution. Your spouse would be required to establish his or her own HSA to make catch-up contributions.

QUALIFIED MEDICAL EXPENSES

There are many expenses that qualify for tax-free distributions. For a listing, you can refer to the HSA Eligible Expenses listed on www.afhsa.com. If you use funds for any expenses that are not qualified medical expenses, then the funds distributed are subject to income tax and a 20% additional tax penalty and must be reported on your income tax return.

AMERITAS DENTAL Oral care can be a significant financial expense. Having dental insurance can help cover the costs and help keep your family’s smiles healthy. Deductible waived for Type 1 service, $50 deductible for Type 2 & 3 services. Plan pays $1,500 maximum benefit per calendar year (per person). SAMPLE PROCEDURE LISTING

Type 1

• Routine Exam (2 per benefit period) • Bitewing X-rays (1 per benefit period) • Full Mouth/Panoramic X-rays (1 in 5 years) • Cleaning (2 per benefit period) • Fluoride for Children 13 and under (1 per benefit period) • Sealants (age 13 and under)

Type 2

• Space Maintainers • Restorative Amalgams • Restorative Composites (anterior and posterior teeth) • Simple Extractives • Anesthesia


http://www.afhsa.com/

http://www.afhsa.com/



AMERITAS DENTAL CONT’D

Type 3 • Onlays • Crowns (1 in 8 years per tooth) • Crown Repair • Endodontics (nonsurgical) • Endodontics (surgical) • Periodontics (nonsurgical) • Periodontics (surgical) • Denture Repair • Prosthodontics (fixed bridge, removable complete/partial dentures) (1in 8 years) • Complex Extractions

SUPERIOR VISION Vision Insurance is a way to help cover expenses incurred for eye care services from optometrists and ophthalmologists. Regular eye exams can offer more than just measuring your eye sight! They can identify serious eye diseases early, allowing time for treatment. Most people don’t realize that eye exams can also reveal early signs of serious illnesses like diabetes, heart disease and high blood pressure. Vision Insurance can help pay for:

• Eye exams • Eyeglasses • Contact lenses • Eye surgeries

Superior Vision - Monthly Coverage Tier Employee Contribution ($)

Employee Only $7.26

Employee & Spouse $12.34

Employee & Child(ren) $13.07

Family $19.61

Ameritas Dental – Monthly Rates

Coverage Tier Employee Contribution

Employee Only $33.52

Employee + 1 $67.08

Employee + 2 or more Dependents $96.00




UNUM TERM DISABILITY While most people insure their lives and other material assets like homes and automobiles, many overlook the need to protect one of their most valuable assets-their ability to work and earn a living. When disability strikes, your ability to earn an income becomes interrupted however, your monthly bills continue. Would you be adequately prepared to cover present and future financial obligations if you were to fall sick or become disabled and not able to work? 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 Coverage is available to you without answering any medical questions or providing evidence of insurability. You may enroll on or before the enrollment deadline of 9/1/12016. After the initial enrollment period, you can apply only during an annual enrollment period. 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. For rates and more information about your disability plan offering, please contact your FFGA Agent, John Brick at 832-859-5865.




ALLSTATE GROUP CANCER A cancer diagnosis can be devastating, both personally and financially. It is likely that your major medical coverage will not cover all of the costs associated with a cancer diagnosis. Supplementing your major medical with cancer insurance may help you pay for related expenses, such as:

• Copays and deductibles • Specialists • Experimental treatment • Specialty hospitals • Travel expenses • Help at home • Child care expenses

With cancer insurance, benefits are paid to you, so you choose how to spend them. The Allstate Group Cancer Insurance provides a Guaranteed Issue for new hires who enroll within 31 days of their date of hire.

Allstate Group Cancer Monthly Premiums

Employee Only Employee + Spouse Employee + Children Family

Option 1 – Low $16.12 $25.85 $22.26 $31.96

Option 2 – High $40.11 $62.37 $57.07 $76.31

TEXAS LIFE PERMANENT LIFE INSURANCE Voluntary permanent life insurance can be an ideal complement to the group term and optional term your employer might provide. Designed to be in force when you die, this voluntary universal life product is yours to keep, even when you change jobs or retire. You may also apply for this coverage for yourself, your spouse and minor children and grandchildren.

Please visit the website below or contact John Brick at 832-859-5865 for premiums and additional information.

HIGHLIGHTS • Portable – you can take it with you when

you leave the district • Coverage to age 121 • Coverage for child(ren) & grandchild(ren)

$25,000 - $50,000 • $300,00 coverage only 3 questions




UNUM GROUP TERM LIFE – Term life insurance provides affordable coverage for a specific amount of time. Most people buy it during their working years, so if they die, their death benefit can help loved ones manage their financial needs. Unum’s term life plans offer other important features, too – like guaranteed coverage, family options, and additional payments for covered accident-related claims and early payoffs for terminal illness. The Unum Group Term Life and AD&D insurance allows employees to purchase up to 5 times their salary in increments of $5,000, not to exceed $500,000. An employee may purchase up to 100% of employee amount in increments of $5,000 not to exceed $100,000. Benefits will be paid to the employee. An employee may also purchase child coverage, flat amount: $1,000, $2,000, $4,000, $5,000 or $10,000 up to 100% of employee coverage amount, not to exceed $10,000. The maximum death benefit for a child between the ages of live birth and 6 months is $1,000. Benefits will be paid to the employee. USEFUL INFORMATION TO KNOW In order to purchase Life coverage for your spouse and/or child, you must purchase Life coverage for yourself

You may purchase AD&D coverage for yourself regardless of whether you purchase Life coverage In order to purchase AD&D coverage for your spouse and/or child you must purchase AD&D coverage for yourself. New employees and their dependents, within 31 days of hire, may apply for Life coverage up to the Guarantee Issue amount of $150,000 for yourself and any amount of coverage up to $25,000 for your spouse. Any Life insurance coverage over the Guarantee Issue amount(s) will be subject to Evidence of Insurability. If you and your eligible dependents do not enroll within 31 days of your eligibility date, you can apply for coverage only during an annual enrollment period and will be required to furnish Evidence of Insurability for the entire amount of coverage.

Please contact your FFGA Representative John Brick at 832-859-5865 for additional information and premium rates.




UNUM ACCIDENT Accident Insurance is a way to protect you and your family from the unexpected expenses of an accident. Not only can the policy assist with hospital stays and medical exams but, travel costs as well. With benefits paid directly to you, you can determine where to spend the money. It’s comforting to know that an accident insurance policy can be there through all the stages of your care, from initial treatment to follow-up care. Accident coverage may provide a benefit for costs associated with:

• Concussions • Lacerations • Broken Teeth • Emergency Room Visits • Ambulance, Ground or Air • Intensive Care Unit

AMERICAN FIDELITY GAP INSURANCE Rising health care costs can be a financial concern. When faced with a hospital expense, how would you manage to pay your share, including the deductible and co-pays? The Hospital GAP PLAN® Choice™ can help! The Inpatient Hospital Benefit pays the difference between the actual hospital expenses you incur as an inpatient and the amount your primary medical plan covers. Benefit amounts available range from $1,000 to $7,500. Your reimbursement cannot exceed the benefit amount you initially select under this plan. The Outpatient Benefit pays the difference between the actual outpatient expenses incurred and the amount paid by your primary medical plan.

Please contact your FFGA Representative John Brick at 832-859-5865 for additional information and premium rates.

Unum Accident Monthly Premium

Employee $12.31

Employee + Spouse $19.72

Employee + Children $24.40

Employee + Family $31.81




LEGAL CLUB OF AMERICA IDENTITY THEFT SOLUTIONS Unexpected legal questions arise every day and with a pre-paid legal plan, you can have access to a quality law firm for a low monthly fee. From letters written on your behalf to document review, speeding tickets to will preparation and more, attorneys are on hand to provide legal advice – no matter how traumatic or how trivial it may seem. With a pre-paid legal plan you will be protected and empowered to worry less and live more. ELIGIBILITY Membership includes the member’s spouse or domestic partner, dependent children who are under the age of 25 and any dependent individuals living in the plan member’s home such as a parent or grandparent. Monitoring and Insurance is limited only to the member. PREMIUM Monthly Premium = $10.00

MYHEALTHPASS TELE-MEDICINE – Get treated without leaving your home or office. My HealthPass members get access to a national network of U.S. board-certified doctors and pediatricians, 24 hours a day/7 days a week via phone, video or online. WHEN SHOULD YOU USE YOUR MYHEALTHPASS BENEFITS?

• After your physician’s normal hours of operation • If you are on vacation, business trip or away from home • If you need a short-term prescription refilled • If you would like guidance on the type of specialist you should see of if you have a health related

question • If you are thinking about visiting the emergency room for a non-emergency medical issue

WHEN IS IT NOT APPROPRIATE?

• For medical emergencies • To treat a complicated or chronic disease • For long-term, DEA-controlled anti-psychotic, or non-therapeutic drugs • As a substitute for your PCP


First Financial Group of America11811 North Freeway, Suite 900

Houston, TX 77060(800) 523-8422(281) 847-8422

Documents

Coldspring Oakhurst CISD - Edl · PDF file · 2016-08-23Houston, TX . Please visit www ... Group Cancer Allstate 800-521-3535 ... See reverse side for a list of services