employeebenefits - West Ada School District · Diagnostic Lab / X-Ray Services Covered 100% for the first $100, then Minor (In Office) Major 80 / 20 AD 80 / 20 AD 60 / 40 AD 60

January 1, 2016 through December 31, 2016

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WEST ADA SCHOOL DISTRICT HR CONTACT AND MORETON & COMPANY ACCOUNT MANAGER INFORMATION

West Ada School DistrictKesha Lee, Benefits Manager208-350-5087 [email protected] Carrithers, HR Clerk 208-350-5090 [email protected] Wasson, HR Clerk208-350-5026 [email protected] Lindbloom, HR Clerk208-350-5088 [email protected]

Laurie McCormick, HR Clerk208-350-5168 [email protected] Ada School District Department number: 208-350-4431West Ada School District Department Fax number: 208-350-5961

Moreton & Company - Account ManagerPatty Gillin208-321-2028 [email protected] Free: 800-341-6789 www.moreton.com

BENEFIT CARRIER CONTACT INFORMATION

Blue Cross of Idaho - Medical Group #: 10021204208-331-7347 / 800-627-1188 www.bcidaho.com

CVS Caremark: Mail Order PharmacyBenefit Manager: 855-839-5205

ComPsych - Employee Assistance Program WASD Web ID: WASD855-247-0206 www.guidanceresources.com

Flores and Associates - Cafeteria Plan, Medical / Dependent Care Flex704-335-8211 / 800-532-3327 www.flores247.com

Willamette Dental - Dental Policy #: Z1390/ID209855-433-6825 [email protected]

Delta Dental - Dental Group #: 3906208-489-3580 / 800-356-7586 www.deltadentalid.com

VSP (through LifeMap) - Vision 800-794-5390 www.LifeMapCo.com

LifeMap Assurance Company - Life Group #: ID 03904IClaims: 800-286-1129 www.LifeMapCo.com

Standard Insurance Co. - Disability Group #: 641768503-321-7000 / 800-368-2859 www.standard.com

AFLAC - Supplemental Insurance Group #: 89236 & 0GM99800-992-3522 www.aflac.com

American Fidelity - Supplemental Insurance800-654-8489 www.americanfidelity.com

TSA Consulting Group - 403(b) Plan888-796-3786 www.tsacg.com

P.E.R.S.I. - Supplemental Life & Retirement Plan208-334-3365 / 800-451-8228 www.persi.idaho.gov

NC PERS Group Decreasing Term Life Insurance - HealthSmart Benefit Solutions, Inc.

800-525-8056 www.NCPERSVoluntaryLife.com/persi

WELCOME!To help educate you on the many benefits West Ada School District offers, please review the following 2016 benefit materials. If you have any questions about your benefits, we are here to help!

HUMAN RESOURCES Please contact Human Resources for any benefit related questions including benefit coverage, contributions, enrollment, benefit change forms, notification for changes in status, provider directories, and general carrier information.

SOCIAL SECURITY NUMBERSFederal law requires you to provide a valid Social Security Number for each person to be covered by any medical plan sponsored by your employer (yourself, your spouse, and all dependent children).

MEDICARE PART DIf you have Medicare or will become eligible for Medicare in the next 12 months, Federal law gives you more choices about your prescription drug coverage. See Human Resources for more information.

IRS REGULATIONSFailure to meet IRS Deadlines will affect your insurance coverage! IRS regulations govern how and when an employee may make cafeteria plan elections and changes to those elections. These rules require that employers enforce firm deadlines with respect to employee benefit enrollment forms and the related cafeteria plan elections. This means that we cannot accept forms turned in after open enrollment ends. Furthermore, if you experience a qualifying event allowing you to add, drop, or modify your coverage and related cafeteria plan election mid-year, we must be notified of such event. The required forms generally must be completed within 30 days of such event, or you cannot make the change. In addition, please be aware that with the exception of the birth, adoption, or placement for adoption of a child, any cafeteria plan election, changes can only be implemented prospectively, i.e., on the first paycheck or period of coverage following our receipt of the form. Therefore, if you are making a change based on a qualifying event other than a new child, and you want changes implemented as of the date of the event, you must inform us of the change and turn in your form in advance or as soon after the event as possible. If you do not enroll on time, you will not receive coverage or be able to change your elections mid-year unless you have a special enrollment opportunity.

© Moreton & Company 2015The benefits illustrated are in summary form only. They should not be construed as complete in and of themselves. They are only for comparison. In the case of a discrepancy,

the plan documents apply. Please refer to the formal plan documents for a complete description of benefits, limitations, and exclusions.

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enrollmentguidelines

2016HIPAA PRIVACY NOTICEThe Health Insurance Portability and Accountability Act (HIPAA) requires employers to adhere to strict privacy guidelines and establishes employees’ rights with regard to their personal health information. If you have any questions regarding this federal regulation, please speak with your Moreton & Company Representative or contact Human Resources.

WHY IS OPEN ENROLLMENT SO IMPORTANT?Benefits open enrollment for West Ada School District is held each year. Employees should understand that the pre-tax payment for applicable benefits are done through the Cafeteria Plan (premium only plan) and will remain in effect and cannot be revoked or changed during the plan year. Employees must notify Human Resources of any change of status as soon as possible, but in no event more than 30 days of the event. Once the enrollment period has ended, employees may not make or change benefit elections. If employees believe they can make or change an election due to a change in employment or family status, they generally have 30 days to complete and return a new enrollment form.

WHO IS ELIGIBLE TO PARTICIPATE IN THE BENEFITS PLAN?• For medical benefits:

· Classified employees must work 20+ hours and Administration and Certified employees must work 30+ hours per week. · For all other benefits: Classified employees, Administration and Certified employees must work 20+ hours per week,

• Employees will be eligible to receive: · Medical benefits on the first day of the month following 60 days from the first day of work (provided forms are properly submitted); · Voluntary benefits on the first day of the month following 30 days from the first day of work (provided forms are properly submitted);

• Employees may obtain coverage for dependents; see your Human Resources Department for the definition of dependent;• Employees hired after the plan year begins will select their coverage choices for the remainder of that plan year at the time of eligibility. All the necessary

enrollment and change forms are available through the Human Resources Department.

IS IT POSSIBLE TO MAKE CHANGES DURING THE YEAR?After the enrollment deadline, your election is generally irrevocable, meaning you cannot add, modify, or drop coverage for the plan year. You may have a special enrollment right allowing coverage changes for certain losses of coverage eligibility under another plan or if you gain a new spouse or dependent. You also may be entitled, or required, to change your election if you, your spouse, or dependents experience one of the Qualifying Change events below. However, you must contact Human Resources to determine if our plan and if your circumstances allow such a change. If so, you must complete and return a change form to Human Resources generally within 30 days.

QUALIFYING CHANGES (30 DAYS UNLESS OTHERWISE STATED BELOW) • Marriage, Divorce, or legal separation; or change in number of dependents; • Change in employment status of employee, spouse, or dependent that causes loss of eligibility; • Dependent ceases to satisfy eligibility requirements; • Change in residence that causes loss of eligibility; • Significant changes in company benefit plan(s) including cost change, significant coverage curtailment, additional or significant improvement of company

offered benefits; • Change in coverage under another employer plan (including mandatory or optional change initiated by your spouse’s employer or a change initiated by your spouse); • Loss of coverage from government plans / programs or educational institution; • COBRA qualifying event (termination / reduction of hours, employee death, divorce / legal separation, ceasing to be a dependent); • Other changes resulting from a judgment, decree, or order; Medicare or Medicaid entitlement; or FMLA leave of absence; • Loss of CHIP or Medicaid eligibility; Gaining CHIP or Medicaid subsidy eligibility (60 Days).

GLOSSARY OF TERMS

Co-pay: Typically refers to a dollar amount a member pays for services.Deductible: Amount that must be paid by the member prior to the benefits offered and are indicated with AD (After Deductible).Coinsurance: Typically refers to the percentage of a member's share of covered costs, after any deductible has been satisfied.Out of Pocket Maximum (OOPM): The maximum amount members pay for covered in-network essential health benefit expenses during the benefit year including Co-Pays, Coinsurance, and Deductibles.

PPO (Preferred Provider Organization): This type of Plan utilizes Network and Non-Network Benefits.Network (In-Network): Providers who have agreed to accept Contracted rates from an Insurance Carrier.Non-Network (Out-of-Network): Any Non-Contracted Providers. The services from these Providers are subject to balance billing meaning members can be billed for the difference between the Insurance Carrier's fee schedule and the billed charges.

Note: This publication is only a partial summary of benefits and is provided for informational purposes only. It does not describe all elements of the summarized programs. For complete information regarding the benefits, plan provisions, limitations and exclusions, and for a description of claims procedures, refer to the formal benefit documents that will be provided to you after enrollment. In the event of a discrepancy or conflict between the information contained in this publication and the official benefit plan provisions, the official plan documents and insurance contracts will govern. Copies of these documents are available for your review from your Human Resources Department. No rights shall accrue to you and/or your dependents because of any statement, error, or omission in this publication.

3The benefits illustrated are in summary form only. They should not be construed as complete in and of themselves. They are only for comparison. In the case of a discrepancy,

the plan documents apply. Please refer to the formal plan documents for a complete description of benefits, limitations, and exclusions.med

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16 Blue Cross of IdahoWest Ada School District offers the following medical plan:

PREFERRED BLUE

Network Non Network *

Deductible PCY$500 Individual / $1,000 Family

If any family member reaches the individual deductible then the deductible is satisfied for that family member. If any combination of family members reach the family deductible, then the deductible is satisfied for the entire family..

Out of Pocket Maximum (Includes Most Services) $5,000 Individual / $10,000 Family $6,500 Individual / $13,000 Family

Coinsurance (Carrier Pays / Member Pays) 80% / 20% AD 60% / 40% AD

Office VisitsPrimary CarePreventive † **Specialists or Secondary Care ProviderChiropractic

$20 Co-pay ¥ (Per Visit)Covered 100%

$20 Co-pay (Per Visit)80 / 20 AD

60 / 40 AD60 / 40 AD60 / 40 AD50 / 50 AD

Prescriptions (Generic Required) Generic Prescriptions / Brand Name PrescriptionsOut of Pocket Maximum (Separate)PharmacyMail Order ‡

$1,500 Per Individual / $3,000 Per Family$10 Co-pay, then 20% / $20 Co-pay, then 20%

$10 Co-pay / $20 Co-pay

$1,500 Per Individual / $3,000 Per Family$10 Co-pay, then 20% / $20 Co-pay, then 20%

None

Diagnostic Lab / X-Ray Services Covered 100% for the first $100, thenMinor (In Office)Major

80 / 20 AD80 / 20 AD

60 / 40 AD60 / 40 AD

Hospital ServicesOutpatientInpatientMaternity

80 / 20 AD80 / 20 AD80 / 20 AD

60 / 40 AD60 / 40 AD60 / 40 AD

Emergency ServicesUrgent CareEmergency Room (Co-pay waived if Admitted)Ambulance

$20 Co-pay (Per Visit) ¥$200 Co-pay, then 80 / 20 AD

80 / 20 AD

60 / 40 AD$200 Co-pay, then 60 / 40 AD

60 / 40 AD

Mental Health ServicesInpatientOutpatientOutpatient - Office

80 / 20 AD80 / 20 AD (Per Visit)

$20 Co-pay

60 / 40 AD60 / 40 AD60 / 40 AD

EMPLOYEE MONTHLY RATES Rates based on 1.0 FTE. Employees with other FTE classifications, contact the HR office for rate information

Employee (EE)EE + SpouseEE + ChildEE + ChildrenEE + Spouse + ChildEE + Spouse + Children

$25.00$736.94$143.58$271.21$855.52$983.15

AD: After Deductible PCY: Per Calendar Year FTE: Full Time Equivalency

¥: Unity Health office visit requires no co-payment ‡: 90 day supply or 100 unit doses, whichever is less

† Maximum Allowable of specifically listed services

* Member will be responsible for amounts billed by non-participating providers in excess of eligible medical expense amount.

** Please refer to your provided Blue Cross of Idaho materials for a full list of covered preventative services and limitations.

Please Note: Some benefits require Pre-Authorization and / or Limitations may apply, please refer to your provided Blue Cross of Idaho materials for additional information.

To find a provider or for a complete description of benefits, limitations, and exclusions, consult your Benefit's Summary, available from Human Resources or at www.bcidaho.com.

The benefits illustrated are in summary form only. They should not be construed as complete in and of themselves. They are only for comparison. In the case of a discrepancy,the plan documents apply. Please refer to the formal plan documents for a complete description of benefits, limitations, and exclusions. 4

preventivecare 2016

2016 Preventive Care BenefitsApplies to all non-grandfathered individual and group plans with effective dates on or after January 1, 2014. Highlights of your preventive care benefits:• You pay nothing; no coinsurance, co-payment or deductible, for covered preventive care services when you visit in-network providers.• Preventive care benefits for services from out-of-network providers subject to deductible and coinsurance.

COVERED PREVENTIVE CARE SERVICES In-Network Out-of-Network

Specifically Listed Services Annual adult physical examinations; routine or scheduled wellbaby and well-child examinations; Bone Density; Chemistry Panels; Cholesterol Screening; Colorectal Cancer Screening (Colonoscopy, Sigmoidoscopy, Fecal Occult Blood Test); Complete Blood Count (CBC); Diabetes Screening; Pap Test; PSA Test; Rubella; Screening EKG; Screening Mammogram; Thyroid Stimulating Hormone (TSH); Transmittable Diseases Screening (Chlamydia, Gonorrhea, HIV, Syphilis, Tuberculosis (TB)); Urinalysis (UA); Aortic Aneurysm Ultrasound; Alcohol Misuse Assessment; Genetic Counseling for High Risk Family History of Breast or Ovarian Cancer; Newborn Metabolic Screening (PKU, Thyroxine, Sickle Cell); Health Risk Assessment for Depression; Newborn Hearing Test; Lipid Disorder Screening; Smoking Cessation Counseling Visit; Dietary Counseling (Limited to 3 Visits Per Member, Per Benefit Period); Preventive Lead Screening; Urine Culture for Pregnant Women; Hepatitis B Virus Screening for Pregnant Women; Iron Deficiency Screening for Pregnant Women; Rh (D) Incompatibility Screening for Pregnant Women.

The specifically listed Preventive Care Services may be adjusted accordingly to coincide with federal government changes, updates, and revisions.

Members pay nothing of the allowed amount

for specifically listed preventive care services per person, per benefit period. No co-payment, deductible

or coinsurance required.

Members pay coinsurance after

meeting deductible.

WOMEN’S PREVENTIVE HEALTH SERVICES(Applies to group and individual plan members unless otherwise noted.) In-Network Out-of-Network

Well-woman visits (for recommended age-appropriate preventive services); gestational diabetes screening; interpersonal and domestic violence screening and counseling; human papillomavirus testing; sexually transmitted infections screening; human immune-deficiency virus screening; breast-feeding support, supplies, and counseling.

Members pay nothing of the allowed amount

for specifically listed preventive care services per person, per benefit period.

No co-payment, deductible, or coinsurance required

Members paycoinsurance after

meeting deductible.

Prescribed Contraceptives (Grandfathered groups may purchase benefit for an added premium.)Blue Cross of Idaho pays 100% for Women’s Preventive Prescription Drugs and devices as specifically listed on the Blue Cross of Idaho website, bcidaho.com; Deductible does not apply. The day supply allowed shall not exceed a 90-day supply at one (1) time, as applicable to the specific contraceptive drug or supply.

Prescribed Contraceptive ServicesIncludes diaphragms, intrauterine devices (IUDs), implantables, injections, and tubal ligation

Blue Cross of Idaho may cover services not specifically listed when medically necessary.

Blue Cross of Idaho may cover services not specifically listed when medically necessary. Members pay deductible and coinsurance

Members pay deductible and coinsurance

IMMUNIZATIONS In-Network Out-of-Network

Accellular Pertussis, Diphtheria, Hemophilus Influenza B, Hepatitis B, Influenza, Measles, Mumps, Pneumococcal (pneumonia), Poliomyelitis (polio), Rotavirus, Rubella, Tetanus, Varicella (Chicken Pox), Hepatitis A, Meningococcal, Human papillomavirus (HPV) and Zoster.All Immunizations are limited to the extent recommended by the Advisory Committee on Immunization Practices (ACIP) and may be adjusted accordingly to coincide with federal government changes, updates, and revisions.

Members pay nothing for specifically listed immunizations.No co-payment, deductible, or coinsurance required.

Other immunizations not specifically listed may be covered when Medically Necessary and approved by the BCI Pharmacy and Therapeutics Committee.



Please Note: Your provider must bill these services as preventive/wellness services. The specifically listed preventive care services may be adjusted accordingly to coincide with federal government changes, updates, and revisions.

The descriptions above are general in nature, to allow for an overall view of Blue Cross of Idaho’s preventive care coverage. For complete descriptions of your policy and policy changes, please read your contract and contract amendment language.

The benefits illustrated are in summary form only. They should not be construed as complete in and of themselves. They are only for comparison. In the case of a discrepancy,the plan documents apply. Please refer to the formal plan documents for a complete description of benefits, limitations, and exclusions.5em

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16 ComPsychEmployee Assistance Program - 100% Employer Paid

ACCESSING SERVICESYou and your family members can access ComPsych by phone or Internet twenty-four hours a day, seven days a week. For phone access, simply call toll-free 855-247-0206. Internet access is at www.guidanceresources.com. The West Ada School District's Web ID is: WASD

COUNSELING SERVICESComPsych GuidanceConsultantsSM are available to help you with a variety of concerns, including:Marital and Family Conflicts • Grief and Loss • Drug and Alcohol Abuse • Anxiety and Stress • Eating Disorders • Physical or Emotional Abuse

When you call, a ComPsych GuidanceConsultant will listen to your concerns and help schedule an appointment for you with a professional in your area. During your scheduled appointment, an experienced EAP counselor will discuss your situation and help you develop a solution-focused plan of action. You are eligible for up to 6 free counseling sessions per problem per year. If you need additional counseling, ComPsych will work with you to find a provider that suits your needs and your medical benefit plan.

FINANCIALCONNECT® FINANCIAL SERVICESThe FinancialConnect program offers you unlimited telephone access to certified public accountants, certified financial planners, and other financial professionals who are trained and experienced in handling personal financial issues and can offer consulting on issues such as family budgeting, credit problems, tax questions, investment options, money management and retirement programs.

LEGALCONNECT® LEGAL SERVICESThe LegalConnect program provides you with unlimited telephone consultation with attorneys who are trained and dedicated to providing legal information and assistance to clients with such issues as divorce, bankruptcy, family law, real estate purchases and wills.

If you need legal representation or extended assistance that cannot be provided by phone, LegalConnect professionals can provide referrals to local attorneys. You or your family member will receive a free 30-minute consultation and, thereafter, a 25% reduction in fees for representation if you choose one of ComPsych’s network attorneys.

FAMILYSOURCE® WORK-LIFE PROGRAMSComPsych FamilySource Guidance Specialists offer practical advice through telephonic consultation, accurate and timely referral information, and educational literature. Specialists are available to provide assistance on issues such as:

• Finding and evaluating quality daycare and eldercare• Moving and relocation

• Planning a vacation, wedding, or other major event• Understanding programs such as Medicare and Medicaid.

Callers receive detailed resource packages containing accurate referral information on community resources, available openings in programs, and guidelines for evaluating in order to make the selection that is best for you.

ComPsych will follow-up to make sure you have received all the information necessary to meet your specific needs.

GUIDANCERESOURCES ONLINEGuidanceResources Online is a comprehensive interactive service that provides you with instant guidance, information and helpful tools.

At GuidanceResources Online, you can:• Obtain information about personal, emotional, and life issues• Read HelpsheetsSM on your topic• Review frequently asked questions

• Purchase expert-endorsed products and services to support your issue or lifestyle need

• Get book recommendations

Call 1-855-247-0206Visit www.guidanceresources.com


reimbursem

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Flores & AssociatesJanuary 1, 2016 through December 31, 2016Reimbursement accounts enable you to pay certain qualified expenses using tax-free dollars. Depending on your personal tax rate, this can save you 10% to 30% or more on medical, dental, vision, and/or dependent care out-of-pocket costs.

THE FOLLOWING ACCOUNTS MAY BE AVAILABLE TO YOU:FLEXIBLE SPENDING ACCOUNT (FSA)This account allows you to set aside up to $2,550 in pretax dollars to pay most out-of-pocket medical, dental or vision care expenses, including: Medical and Dental Deductibles and Co-payments, Eye Glasses, Dental, and Orthodontic work not covered by insurance. As of January 1, 2015, under the Affordable Care Act, the maximum amount that can be contributed to a Flexible Spending Account is $2,550 per year.

DEPENDENT CARE ASSISTANCE PLAN (DCAP)This account lets you set aside up to $5,000 in pre-tax dollars to pay for eligible dependent care expenses so you (and if married, your spouse) can work.

THE ADVANTAGES There are some significant advantages to using the above reimbursement type accounts. Income directed to a reimbursement account is tax free. When you pay less in taxes, you receive more spendable income. The accounts can save you 10% to 30% or even more, depending on your personal tax rate. Convenient payroll deductions help assure that you will have money avail-able for out-of-pocket health and/or dependent care expenses.

HOW IT WORKS During annual enrollment, you decide how much you want to deposit into your reimbursement account(s). That amount is deducted evenly during the calendar year from your paycheck before taxes are taken out. When you have an expense that qualifies, you pay the bill, submit a claim, and you are reimbursed with tax-free dollars from your account. For example:

JOHN'S EXPENSESLENSES & FRAMES $280ORTHODONTIA + $1,000CO-PAYS + $120ANTICIPATED SURGERY + $1,150TOTAL FOR THE YEAR = $2,550

John's Situation WITHOUT the AccountJOHN'S ANNUAL EARNINGS $30,000TAXES (25%) - $7,500NET PAY $22,500EXPENSES (AFTER TAXES) - $2,550TAKE HOME PAY = $19,950

John's Situation WITH the AccountJOHN'S ANNUAL EARNINGS $30,000EXPENSES (BEFORE TAXES) - $2,550TAXABLE PAY $27,450TAXES (25%) - $6,863TAKE HOME PAY = $20,587John's take home pay increases $637 by using the reimbursement account.

ELIGIBILITY You will be eligible to participate in the account(s) on the first day of the month following your first pay check. Following are additional guidelines for determining eligible expenses:• Expenses are for services received during the calendar year (Jan. 1 to Dec. 31).• Expenses are not covered by any health care plan in which you are enrolled.• The IRS would otherwise let you deduct the expenses on your income taxes.

THE DEPENDENT CARE ASSISTANCE PLAN With the Dependent Care account you can set aside tax-free income to pay for qualified dependent care expenses, such as day care, that you normally pay with after-tax dollars. You must meet the following criteria in order to set up this account:• You and your spouse both work;• You are a single head of household; or• Your spouse is disabled or a full-time student.

Qualified dependents include children under 13 and/or dependents who are physically or mentally handicapped and the expense must be incurred to allow you to work. If your spouse is unemployed or doing volunteer work you cannot set up a reimbursement account. Each calendar year the IRS allows you to contribute the following amounts, depending on your family status:• If you are single, the lesser of your earned income or $5,000• If you are married, you can contribute the lowest of:

• Your (or your spouse’s) earned income. • $5,000 if filing jointly, or $2,500 if filing separately.

ROLLOVER OPTION If you don’t use all the pre-tax dollars you deposited in your FSA account during the plan year, you may roll-over up to $500 into the next plan year. (The roll-over amount does not count toward the $2,550 yearly maximum FSA contribution limit.) Any remaining unused balance at the end of the plan year will be forfeited. If you do not use all of the pre-tax dollars you deposited in your DCAP account, you will forfeit any balance in the account at the end of the plan year. You have until March 31, 2016 to submit claims for expenses incurred during that plan year

ONCE ENROLLED, YOU MAY NOT CHANGE Once you have designated how much you want to contribute on an annual basis to one or both of your reimbursement accounts, you cannot stop or change your contributions unless you have a qualifying Change Event as defined and limited by the IRS. See Qualifying Change rules earlier in this guide.

REIMBURSEMENTSTo claim reimbursements, fill out a claim form and attach any supporting information. For health care this will include receipts of the amount you paid and the date(s) on which you or a dependent received services. For dependent care this may include any contracts, letters, or receipts. You may send this information to Flores & Associates via email, fax, or standard mail.

Email: www.flores247.comFax: 800-726-9982Mailing Address: PO Box 31397 Charlotte, NC 28231

The benefits illustrated are in summary form only. They should not be construed as complete in and of themselves. They are only for comparison. In the case of a discrepancy,the plan documents apply. Please refer to the formal plan documents for a complete description of benefits, limitations, and exclusions.7

Delta Dental West Ada School District offers the following dental plans:

OPTION 1 PPO PASSIVE PLAN

PPO Network Premier Network*

Deductible PCY $50 Single

Maximum Annual Benefit - Dental $1,500

Coinsurance Carrier Pays / Member Pays - See Amounts Below

Preventive & Diagnostic Services NO WAITING PERIODExams, Cleanings, Fluoride, X-Rays Covered 100%

Basic Services NO WAITING PERIODFillings, Oral Surgery 80 / 20 AD

Major Services 12 MONTH WAITING PERIOD FOR LATE ENROLLEESBridges, Crowns, Nonsurgical Periodontics or Dentures 50 / 50 AD

Endodontic & Periodontic Services Covered under Basic Services

Maximum Lifetime Benefit - Orthodontia None

Orthodontic Services (All Ages) Discounts Available, please refer to your carrier provided material

EMPLOYEE MONTHLY RATES

Employee (EE)EE + 1 DependentEE + 2 or More Dependents

$35.82$72.49

$123.64

AD: After Deductible

PCY: Per Calendar Year

* Member will be responsible for amounts billed by non-participating providers in excess of eligible dental expense amount.

Value-Added Orthodontic Discount Program: If West Ada School District covered adults and children obtain orthodontia services from a Delta Dental of Idaho Discount Program orthodontist then they will receive the orthodontia services at a reduced fee schedule cost based on the number of months in treatment.

Number of Treatment Months and Fee Schedule:12 to 17 months - $3,80018 to 24 months - $4,20025+ months - $4,600

For additional information, call Delta Dental of Idaho at 208-489-3580 or email [email protected].

To find a provider or for a complete description of benefits, limitations, and exclusions, consult your Benefit's Summary, available from Human Resources or at www.deltadentalid.com.

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Willamette Dental West Ada School District offers the following dental plans:

OPTION 2 WILLAMETTE PROVIDERS ONLY

PPO Network Premier Network*

Deductible None

Maximum Annual Benefit - Dental None

Preventive & Diagnostic Services NO WAITING PERIODExams, Cleanings, Fluoride, X-Rays $15 Co-pay, then Covered 100%

Basic Services NO WAITING PERIODFillings, Non-Surgical Extractions $15 Co-pay, then Covered 100%

Major Services NO WAITING PERIODBridges, Crowns, Oral Surgery $15 Co-pay, then Covered 100%

Maximum Lifetime Benefit - Orthodontia None

Orthodontic Services ** (All Ages)$150 Co-pay / $1,500 Co-pay Initial Exam, Study Models & X-rays, Comprehensive Ortho Services

Specialists $30 Co-pay

Emergency Office Visits $15 Co-pay

EMPLOYEE MONTHLY RATES

Employee (EE)EE + 1 dependentEE + 2 or more dependents

$49.10$95.80

$171.90

* Member will be responsible for amounts billed by non-participating providers in excess of eligible dental expense amount.

** $150 Co-pay for pre-orthodontic services, including initial orthodontic exam, study models and x-rays. $1,500 Co-pay for comprehensive orthodontic services. The $150 pre-orthodontic services co-pay will be applied to the $1,500 co-pay. Services connected with orthodontic treatment,such as general office visits and emergency office visits, are still subject to the co-pay specific to the service.

To Find a Provider, please visit www.WillametteDental.com.

For a complete description of benefits, limitations, and exclusions, consult your Benefit's Summary, available from Human Resources or at www.WillametteDental.com.

dentalplans 2016

The benefits illustrated are in summary form only. They should not be construed as complete in and of themselves. They are only for comparison. In the case of a discrepancy,the plan documents apply. Please refer to the formal plan documents for a complete description of benefits, limitations, and exclusions.9vi

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16 Vision Service Plan (VSP) Through LifeMapWest Ada School District offers the following vision plan:

Your Coverage from a VSP DoctorExam (Covered in Full) Every 12 MonthsPrescription Glasses

Lenses (Covered in Full) -Single vision, lined bifocal and lined trifocal lenses.Polycarbonate lenses for dependent children.

Frames**Frame of your choice covered up to $130.00. Plus, 20% off amount over allowance.

Every 12 Months

Every 24 Months

Contact Lenses (In Lieu of Lenses and Frames) - When you choose contacts instead of glasses, your $130.00 allowance applies to the cost of your contacts and the contact lens exam (fitting and evaluation). This exam is in addition to your vision exam to ensure proper fit of contacts. If you choose contact lenses you will be eligible for a frame 12 months from the date the contact lenses were obtained. Current soft contact lens wearers may qualify for a special contact lens program that includes a contact lens evaluation and initial supply of replacement lenses. Learn more from your doctor or visit www.vsp.com

Every 12 Months

Extra Discounts and SavingsLaser Vision Correction DiscountsPrescription Glasses - Up to 20% savings on lens extras such as scratch resistant and anti-reflective coatings and progressives 20% off additional prescription glasses and sunglasses *Contacts * - 15% off cost of Contact Lens Exam (Fitting and Evaluation)

Your DeductiblesExam $10.00Prescription Glasses** $25.00Contacts $0.00

* Available from the same VSP doctor who provided your eye exam within the last 12 months

** Deductible applies to complete pair of glasses or to frames, whichever is selected

Out-of-Network Reimbursement AmountsExam Up to $45.00Lenses -

Single VisionLined BifocalLined Trifocal

Up to $30.00Up to $50.00Up to $65.00

Frames Up to $70.00Contacts Up to $105.00

Dollar for dollar you get the best value from your VSP benefit when you visit a VSP network doctor. If you decide not to see a VSP doctor, co-pays still apply. You'll also receive a lesser benefit and typically pay more out-of-pocket. You are required to pay the provider in full at the time of your appointment and submit a claim to VSP for partial reimbursement. If you decide to see a provider not in the VSP network, call us first at 800-794-5390.

An Eyecare Plan with you in mindAre you really seeing your best? Or are you simply used to the view? With good vision, your experiences are clearer. Sharper. Brighter. Besides helping you see better, routine eye exams can detect a number of serious health conditions such as glaucoma, cataracts, and diabetes. Even cancer. Plus, eye exams for kids can spot problems that can impact learning and development.

New patients are always welcomeVSP network doctors are located right where you need them - close to work, home, and shopping centers. They provide exceptional care and offer a wide selection of frames and contact lenses to choose from - all at one convenient location. Their commitment to care and service grows with you and your family for a lifetime of care.

No ID cards. No claim forms. Easy as 1, 2, 3.1. Find a VSP network doctor at www.vsp.com or call 800-877-7195.2. Make an appointment and tell the doctor you are a VSP member.3. Your doctor and VSP will handle the rest.

Visit www.vsp.com todayWhat's important to you? Do you need an evening appointment? Interested in a doctor who focuses on sports eyewear or children? Want an online savings statement after you visit a VSP doctor? Searching for information on conditions of the eye? Visit www.vsp.com You'll like what you see.

EMPLOYEE MONTHLY RATESEmployee (EE)EE + SpouseEE + Child(ren)Family

$6.23$12.45$13.34$21.32


LifeMap Assurance CompanyBasic Life, AD&D - Employee Premium 100% Employer Paid (Dependent Coverage 100% Employee Paid)Each eligible employee can receive basic life insurance for themselves and their eligible dependents. Benefits reduce to 65% at age 65 and 50% at age 70. AD&D benefits match this reduction schedule. Life and AD&D benefits terminate upon retirement. Retirees may continue basic life insurance benefits by contacting the Human Resources Department and completing the required retiree basic life insurance enrollment form. Basic Term Life insurance includes waiver of premium coverage. The waiver of premium does not apply to any AD&D benefits.

BENEFITS CLASS 1 - ADMINISTRATORS CLASS 2 - ALL OTHER STAFF

Life Insurance - Employee $100,000 $50,000

Accidental Death & Dismemberment (AD&D) - Employee Only Up to the Principal Sum of $100,000 Up to the Principal Sum of $50,000

Seatbelt Benefit - Employee Only (Paid for a death resulting from an auto accident while properly wearing a seatbelt)

$10,000 $10,000

Voluntary Life InsuranceSpouse ($0.40 Per Month)Child(ren) - Live birth to age 26 ($0.40 Per Month)

$1,000$1,000

$1,000$1,000

Please see Certificate of Coverage summary for more detailed benefit information.

LifeMap Assurance CompanyEmployee and Dependent Voluntary Supplemental Life - 100% Employee PaidSupplemental Group Term Life Insurance is available on a voluntary basis. This coverage is in addition to the company provided amounts and the premiums are 100% employee paid through payroll deduction. Coverage is available only to employees eligible for benefits and covered under the basic Group Term Life Insurance provided by West Ada School District.

Employees may select the lessor of $300,000 to a maximum of 7× salary in increments of $10,000. Spouse coverage may be equal to but not exceed the 100% Employee's Supplemental Coverage amount up to $300,000 in increments of $10,000. Unmarried, dependent children under the age of 26 are eligible for up to $10,000 of coverage.

If an employee purchases an amount of $10,000 or greater during their initial enrollment, they can always increase coverage up to the guaranteed issue amount during future annual open enrollment periods without answering medical questions. For insurance amounts over the guaranteed issue amount or late enrollment each applicant must complete a Statement of Health Form. Insurance will become effective on the first of the month following underwriting approval by LifeMap. Supplemental Life benefits will reduce to 65% at the insured's age 65, to 50% at age 70. Benefits terminate upon retirement. Supplemental Life offers a Right of Conversion. Enrollment forms are available from Human Resources.

The waiver of premium does not apply to any AD&D benefits. Please see Certificate of Coverage summary for more detailed benefit information.

ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) BENEFITS *Employee Up to the Principal Sum of $300,000, in increments of $10,000Spouse Up to $300,000 in increments of $10,000Children Up to $10,000 in increments of $2,000Termination of AD&D Coverage When the insured employee is no longer eligible or retires

* This AD&D plan is offered as an automatic, matching benefit to the Life Insurance. AD&D rates are included in the illustration above.

ESTIMATED PREMIUM CALCULATIONS

÷ 1,000 = × = × 12 = ÷ 12 =

Desired Amount ofEmployee Coverage

Number of 1,000's

Rate from Table

EstimatedMonthly Premium **

Number of Pay Periods

Estimated PremiumPer Pay Period **

** The premiums calculated are estimates ONLY. Please refer to your LifeMap plan documents for full premium breakdowns.

lifeinsuranceplans 2016

MONTHLY RATES PER $1,000 OF COVERAGEAge Rate

Under 30 $0.0830 to 34 $0.1035 to 39 $0.1140 to 44 $0.1345 to 49 $0.2150 to 54 $0.3155 to 59 $0.5360 to 64 $0.6865 to 69 $1.0070 to 74 $1.7475 to 79 $3.22

MonthlyDependent Life

$0.26 per $2,000 increment(Regardless of number of children)

NEW HIRE GUARANTEED ISSUEEmployee $300,000 Spouse $50,000 Dependent Child(ren) All amounts

The benefits illustrated are in summary form only. They should not be construed as complete in and of themselves. They are only for comparison. In the case of a discrepancy,the plan documents apply. Please refer to the formal plan documents for a complete description of benefits, limitations, and exclusions.11lif

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2016 National Conference on Public Employee Retirement Systems (NCPERS)

Voluntary Group Life Insurance - 100% Employee PaidSIMPLE-AFFORDABLE-PAYROLL DEDUCTED – An NCPERS supplemental survivor's benefit and insurance plan is available to enhance the financial security of PERSI members. It is voluntary and administered through payroll deduction.

Simple - For a flat monthly cost, a member can further guarantee the financial security of survivors, even after retirement!Affordable - $16 monthly buys this great value, coordinated with the members pension survivor benefit. Payroll Deducted - The cost will be deducted from the member's paycheck.

FACTS ABOUT THE PLAN – • All active employees at time of enrollment of participating employers may enroll. Employees must be "actively at work."• The plan will pay a benefit in addition to other insurance plans.• The plan is completely voluntary, and can be terminated at any time.• If you cease to be a member you can convert your Group Decreasing Term Life Insurance to a Prudential individual life policy within 31 days

following termination of insurance. Dependent term life coverage can also be converted if you cease to be a member or you die.• Benefit checks of $5,000 or more are deposited in a special interest bearing checking account, on which the beneficiary can write checks

immediately after the claim is approved.

WANT TO PARTICIPATE? If you want to participate, here are the simple steps you need to take:

1. Contact your employer. If your employer has agreed to participate in the PERSI / NCPERS plan by authorizing payroll deductions, you may enroll during the next open enrollment period. Open enrollments are held each year from September 1st through November 30th. New employees may enroll immediately, within 90 days of hire.

2. Employers whose employees are members of PERSI may participate in the life insurance program simply by authorizing the payroll deduction. A special open enrollment period may be held for such employees not previously eligible for coverage.

ELIGIBILITY FOR MEMBERS – All actively employed members of PERSI are eligible for this insurance if their current employer has adopted the plan.• Eligible dependents are your spouse or domestic partner ($16 plan only) and unmarried children 14 days to 21 years old.• Dependent children are your legally adopted children, step-children and foster children who depend on you for support.• Dependents in military service are not eligible. There are no medical exams or health requirements.

HealthSmart Benefit Solutions, Inc.Address: 10303 East Dry Creek Road, Suite 200, Englewood, CO 80112 | Phone: 800-525-8056 | Email: [email protected] | Fax: 303-804-9490


Standard Insurance CompanyShort-Term Disability - 100% Employer PaidShort Term Disability (STD) Insurance replaces a percentage of your income on a weekly basis in the event that you are unable to work due to an accident or illness. Please see Certificate of Coverage summary, provided by The Standard, for more detailed benefit information.

BENEFITS CLASS 2 CLASSIFIED MEMBERS

Weekly Benefit 66 2/3 of the first $1,500 of pre-disability earnings reduced by deductible income.

Maximum Benefit Period 60 days minus the length of the Benefit Waiting Period

Elimination / Waiting Period InjuryPhysical Disease, Pregnancy, Mental Disorder

None5 days

Maternity Covered as any other Sickness (See Certificate for more Details)

Definition of Earnings

Your Pre-disability Earnings means your "daily rate" of earnings from your Employer in effect on your last full day of Active Work times 5 and includes:1. Contributions you make through a salary reduction agreement, 2. an executive non-qualified deferred compensation arrangement or 3. amounts contributed to your fringe benefits according to a salary reduction agreement under an IRC Section 125 plan

Pre-Existing Condition Restrictions None

Voluntary Short-Term Disability - Shared Cost with EmployerWest Ada School District will contribute $12 monthly to Administrators and Certified Staff STD premium. Short Term Disability (STD) Insurance replaces a percentage of your income on a weekly basis in the event that you are unable to work due to an accident or illness. Please see Certificate of Coverage summary, provided by The Standard, for more detailed benefit information.

BENEFITS CLASS 1 ADMINISTRATORS & CERTIFIED STAFF

Weekly Benefit 66 2/3 of the first $3,000 of pre-disability earnings reduced by deductible income

Maximum Benefit Period 60 days minus the length of the Benefit Waiting Period

Elimination / Waiting Period InjuryPhysical Disease, Pregnancy, Mental Disorder

None5 days

Maternity Covered as any other Sickness (See Certificate for more Details)

Definition of Earnings

Your Pre-disability Earnings means your "daily rate" of earnings from your Employer in effect on your last full day of Active Work times 5 and includes:1. Contributions you make through a salary reduction agreement, 2. an executive non-qualified deferred compensation arrangement or 3. amounts contributed to your fringe benefits according to a salary reduction agreement under an IRC Section 125 plan

Pre-Existing Condition Restrictions None


× 0.30 = ÷ 100 =Monthly Income Rate Estimated Premium Per month **

** The premiums calculated are estimates ONLY. Please refer to your Standard Insurance Company plan documents for full premium breakdowns.

2016 RATES

$0.30 per $10 of Weekly Benefit

disabilityinsuranceplans 2016

The benefits illustrated are in summary form only. They should not be construed as complete in and of themselves. They are only for comparison. In the case of a discrepancy,the plan documents apply. Please refer to the formal plan documents for a complete description of benefits, limitations, and exclusions.13di

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16 Standard Insurance CompanyVoluntary Long-Term Disability - 100% Employee PaidLong Term Disability (LTD) Insurance replaces a percentage of your income on a monthly basis in the event that you are unable to work due to an accident or illness. Please see Certificate of Coverage summary, provided by The Standard, for more detailed benefit information.

BENEFITS

Monthly Benefit 60% of first $10,000 or monthly earnings

Maximum Benefit Period Determined by your age when Disability begins. Please refer to carrier materials.

Elimination / Waiting Period 60 Days

Definition of DisabilityOwn Occupation Definition You are Disabled from your Own Occupation if, as a result of Physical Disease, Injury, Pregnancy or Mental Disorder:

The first 24 months for which LTD Benefits are paid. Own Occupation means any employment, business, trade, profession, calling or vocation that involves Material Duties of the same general character as the occupation you are regularly performing for your Employer when Disability begins.

Any Occupation Definition You are Disabled from all occupations if, as a result of Physical Disease, Injury, Pregnancy or Mental Disorder, you are unable to perform with reasonable continuity the Material Duties of Any Occupation.Any Occupation means any occupation or employment which you are able to perform, whether due to education, training, or experience, which is available at one or more locations in the national economy and in which you can be expected to earn at least 60% of your Indexed Pre-disability Earnings within twelve months following your return to work, regardless of whether you are working in that or any other occupation.

Mental & Health / Substance Abuse Payment limited to 24 months during your entire lifetime

Definition of Earnings Your Pre-disability Earnings will be based on your earnings in effect on your last full day of Active Work.Any subsequent change in your earnings after that last full day of Active Work will not affect your Pre-disability Earnings.Pre-disability Earnings means your monthly rate of earnings from your Employer, including:

1. Contributions you make through a salary reduction agreement with your Employer to:a. An Internal Revenue Code (IRC) Section 401(k), 403(b), 408(k), 408(p), or 457 deferred compensation arrangement; orb. An executive non-qualified deferred compensation arrangement.

2. Amounts contributed to your fringe benefits according to a salary reduction agreement under an IRC Section 125 plan.

If you are paid on an annual contract basis, your monthly rate of earnings is one-twelfth (1 / 12th) of your annual contract salary.If you are paid hourly (non-exempt), your monthly rate of earnings is your average monthly earnings over the preceding 12 months, or over the period of employment with the Employer if less than 12 months.

Pre-Existing Condition Restrictions Continuously insured under the group policy for 12 months; and actively at work for a least one full day after the end of that 12 months.


× ÷ 100 =Monthly Income Age Rate Estimated Premium Per month **

** The premiums calculated are estimates ONLY. Please refer to your Standard Insurance Company plan documents for full premium breakdowns.

RATES PER $100 OF COVERAGE

Age Monthly Rate

29 & Under $0.158

30 to 34 $0.202

35 to 39 $0.308

40 to 44 $0.422

45 to 49 $0.590

50 to 54 $0.845

55 to 59 $1.038

60 to 64 $1.074

65 & Over $1.162


retirementprogram

2016

Public Employee Retirement Systems of Idaho (PERSI)

These benefits generally are NOT sponsored or endorsed by your employer including for purposes of Federal and State law, so Federal ERISA law is inapplicable.

PERSI Retirement PlanYou become a PERSI member when you go to work in an eligible position with a PERSI employer. When you earn 60 months of service credit you will be vested to receive a lifetime benefit at retirement. The 60-month vesting period (5 months for elected and some appointed officials) does not have to be with the same PERSI employer. So unless you leave public employment altogether, changing jobs should not affect your PERSI membership.

Base Plan BenefitsEnrollment in the PERSI Base Plan (pension) is mandatory. Both you and your employer make contributions to PERSI: Employee contributes 6.79% and Employer contributes 11.32%. Your contributions are credited to your personal account, while employer contributions are pooled in a trust to cover benefits. The actual value of your benefit exceeds your contributions. When you retire as a vested member, PERSI will pay you every month for as long as you live - and if you select a retirement option with survivor benefits, your Contingent Annuitant will receive a benefit for life after your death.

Portability of FundsYour Base Plan contributions are always yours. If you leave a PERSI employer, but keep your Base Plan money in PERSI and later work for another PERSI-covered employer, you retain the service credit earned in your previous job. All service credit you earn while working for a PERSI employer is automatically combined into a single account for you.

The Choice 401(k) PlanThe Choice 401(k) Plan is an optional defined contribution retirement savings plan available to active members. Unlike the Base Plan, participation in The Choice 401(k) Plan is completely voluntary. It allows you to contribute a portion of your salary on a tax-deferred basis via payroll deduction. This means your contributions come out of your paycheck before taxes, thereby reducing the amount of taxes you pay during the year. The Choice 401(k) Plan includes a loan provision where members may take a loan for any reason as long as they have a balance of $2,000 or more in their account, excluding any gain sharing amounts.

The Choice 401(k) Plan has 12 investment options. One of the most popular is the PERSI Total Return Fund (TRF), which mirrors the Base Plan investments. The TRF is the default investment fund. Your contributions are automatically invested in the TRF unless you elect otherwise. The TRF has no investment manager fee; however, fees are associated with the other 11 investment options. Unlike the Base Plan, you manage your Choice 401(k) Plan funds. In most cases, you may change deferral amounts and investments at any time. No fee is charged for making changes to your account. PERSI pays the record keeping fees for active members.

Money from other qualified retirement plans, such as a 401(a), 457, pre-tax IRA, 403(a) or 403(b), or another 401(k) account, can be rolled over to The Choice 401(k) Plan at PERSI. After-tax contributions cannot be rolled into The Choice Plan.

For More InformationTo learn more about PERSI, or for more detailed information about your retirement options and benefits, visit the PERSI Website at: www.persi.idaho.gov. You may also contact the PERSI Answer Center Monday thru Friday between 7:30 am and 5:30 pm (Mountain Time) by calling 208-334-3365 in the Boise area, or toll free 800-451-8228 from other parts of the state. Your Human Resources Department and/or payroll personnel will gladly assist you as well.

The benefits illustrated are in summary form only. They should not be construed as complete in and of themselves. They are only for comparison. In the case of a discrepancy,the plan documents apply. Please refer to the formal plan documents for a complete description of benefits, limitations, and exclusions.15ad

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16 TSA Consulting Group403(b) Plan - 100% Employee Contribution

These benefits generally are NOT sponsored or endorsed by your employer including for purposes of Federal and State law, so Federal ERISA law is inapplicable.

The 403(b) Plan is a valuable retirement savings option available through West Ada School District.

Plan administrative services for the 403(b) are provided by TSA Consulting Group, Inc. (TSACG). Visit the TSACG website (tsacg.com) for information about enrollment in the Plan, investment product providers available, distributions, enrollment, exchanges or transfers, 403(b) loan and roll overs.

All employees with the exception of private contractors, school board members and student workers are eligible to participate in the 403(b) plan immediately upon employment. Employees may make voluntary elective deferrals to the 403(b) plan. Participants are fully vested in their contributions and earnings at all times.

Employees who wish to enroll in the Supplemental 403(b) Retirement Plan must first select the provider and investment product best suited for their 403(b) account. Upon establishment of the account with the selected provider, a "Salary Reduction Agreement"(SRA) form and any disclosure forms must be completed and submitted to West Ada School District. This form authorizes the District to withhold 403(b) contributions from your pay and send those funds to the Investment Provider on your behalf. A SRA must be completed to start, stop or modify contributions to a 403(b) account.

Upon enrollment, participants designate a portion of their salary that they wish to contribute to their 403(b) account up to their maximum annual contribution amount on a pre-tax basis, thus reducing the participant's taxable income. Salary deferral contribution to the participant's 403(b) account are made from income paid through West Ada School District's payroll system. Taxes on contributions and any earnings are deferred until the participant withdraws their funds.

Participants in defined contribution plans are responsible for determining which, if any, investment vehicles best serve their retirement objectives. The 403(b) Plan assets are invested solely in accordance with the participant's instructions. The participant should periodically review whether his/her objectives are being met, and make changes as appropriate. Careful planning with a tax advisor or financial planner may help to ensure that the supplemental retirement savings plan meets your needs.

TSACG monitors 403(b) plan contributions and notifies the employer in the event of an excess contribution.


additionalretirementprogram

2016

TSA and Retirement Vendor ListingAdditional Deductions - Voluntary Contact vendor excluding PERSI

TAX SHELTERED ANNUITIES (TSA) 403(b) PRE-TAX

AMERICAN FIDELITY ASSURANCEAddress: 621 W Mallon Ave, Suite 301, Spokane WA 99201Kimberly Edwards: 509-279-2540 | Email: [email protected] site: http://www.af-group.com/index.shtml

HORACE MANN ANNUITY CO.Address: 1111 S Orchard Ste 204, Boise ID 83705Michael Sallee: 208-385-0609 | Email: [email protected] site: http://www.horacemann.com

RELIASTAR LIFE INS CO. ("ING") Address: 6154 N Meeker PI Ste 175, Boise ID 83713Scott Gull: 208-685-0101

WADDELL 8, REED - Boise Office Address: 225 N 9th St Ste 420, Boise ID 83702Mike Fuhriman: 208-338-0771Web site: http://www.waddell.com

SECURITY BENEFIT GROUPAddress: 1900 N. Lakes Place, Ste. 102, Meridian, ID 83646Chad Majors: 208-376-6949 | Email: [email protected]

OPPENHEIMER FUNDS SERVICESAddress: PO Box 5270, Denver CO 80217-5270Phone: 800-835-7305 | Fax: 303-768-1500Web site: http://www.oppenheimerfunds.com

VALICAddress: 430 Ryman St Ste 102, Missoula MT 598021-800-892-5558 Ext. 89009John Rutter, Financial Advisor: 208-954-6954Web site: http://www.valic.com

ASPIREAddress: 1759 W. Broadway, PMB 260, Idaho Falls, ID 83402Jim Hancock: 208-522-4961 | Email: [email protected] site: http://proinvestmentcoach.com

401(k) THRU PERSI

PERSI CHOICE * 401(k) optional programAddress: PO Box 83720, Boise ID 83720-0078208-334-3365Web site: http://www.persi.state.id.us/Choice.htm (Please see Web site for eligibility requirements and details)

457 - DEFERRED COMPENSATION


VALICAddress: 430 Ryman St Ste 102, Missoula MT 598021-800-892-5558 Ext. 89009John Rutter, Financial Advisor: 208-954-6954Web site: http://www.valic.com/

ROTH 403(b) - AFTER TAX


The benefits illustrated are in summary form only. They should not be construed as complete in and of themselves. They are only for comparison. In the case of a discrepancy,the plan documents apply. Please refer to the formal plan documents for a complete description of benefits, limitations, and exclusions.17w

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2016 AFLAC

Voluntary Supplemental Coverage - 100% Employee PaidThese benefits generally are NOT sponsored or endorsed by your employer including for purposes of Federal and State law, so Federal ERISA law is inapplicable.

Good Insurance is an important asset not only for good health but also for your financial wellbeing. Being proactive now can help prevent financial hardships in your future. You can supplement your major medical insurance with Aflac polices that provide cash insurance for daily living and out of pocket expenses that major medical insurance does not cover.

There is a wide range of plans available that can fit most budgets, needs or concerns, such as:• Cancer (considered to be the leading cause of medical bankruptcy)• Hospital - in & out patient, ER; surgeries, Dr. visits, diagnostic testing• Intensive care• Accident (can also include some disability for your working spouse)• Critical Illness- heart attach/stroke, end stage renal failure & more• Life, whole, term, juvenile, supplemental dental

Aflac usually processes claims within 4 working days*, so while you are focusing on your health, they focus on getting you cash as quickly as possible. For more information or claims assistance, please contact:

Gerri SchoonderwoerdPhone: 208-459-0658 | Fax: 208-453-2756 | Email: [email protected]

* West Ada School District Aflac members are now eligible for Aflac's One Day Pay program. Most properly documented, individual claims submitted through Aflac SmartClaim by 3 pm ET are eligible for the One Day Pay program. Visit aflac.com/mypolicy or contact Gerri Schoonderwoerd to learn more.

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Notes

Documents

employeebenefits - West Ada School District · Diagnostic Lab / X-Ray Services Covered 100% for the first $100, then Minor (In Office) Major 80 / 20 AD 80 / 20 AD 60 / 40 AD 60