Hurst Euless Bedford I.S.D.
Employee Benefits
2015 - 2016
Presented By: Karen Rose
HEB ISD Risk & Benefits Coordinator
Contacts in the Benefit Office
Karen Rose
• Risk & Benefits Coordinator
• karenrose@hebisd.edu
Maria Ortiz
• Benefits Secretary
• mariaortiz@hebisd.edu
• Ext. 2056 or 817-399-2056
2
Open Enrollment
Open Enrollment
• Enrollment Dates:
July 20, 2015 – August 21, 2015
• Effective Date of Changes:
September 1, 2015
Enroll Online
www.in-roll.com
• Your default login is your first initial of
your first name followed by your last
name and the last 4 digits of your
social security number
• Example: John Doe SSN 123-456789
• Login ID: jdoe6789
• Your default password is the word
“hebisd”
Purpose of this Meeting

Discuss all available benefits

Highlight and explain the changes

If you don’t want to hear the presentation and
you don’t have any questions, you may go
ahead and head to the lab for assistance with
the enrollment.

If you have questions, please stay for the
presentation.
Summary of Changes for the 2015-2016
School Year
Health Insurance
• Premium Increase
• Out of Pocket Maximum Increase
• New HMO Plan
Rate Increase
• Dental PPO High & Low Plans
• GAP Insurance
New Prepaid Legal Plan
Life Insurance – ability to increase amount
Cancer Insurance – guarantee issue on Low Plan
HEB ISD
BENEFITS
GUIDE
Please visit the Benefits web page for
plan documents and more details on
each benefit.
5
Section 125/Family Status Change

Benefits can only be changed during the middle of the
plan year if you have a family status change AND you
notify us within 30 days from the date the family status
change occurred.

Marriage

Divorce

Death

Birth/Adoption

Loss of employment/benefits

Dependent lost eligibility
8
Sick Leave Bank
Paper Enrollment Form must be
completed if you want to enroll in
the Sick Leave Bank plan.
Purpose

The purpose of the sick leave bank is
to provide additional paid sick leave
days for members of the bank who
have exhausted all available paid
leave (sick, personal, old state,
vacation, etc) because of the
catastrophic injury or illness of the
employee or the employee’s
immediate family member.
Sick Leave Bank Summary
Membership –
contribute 3 days of
local leave (one time
contribution)
Must exhaust all available
paid leave (sick, personal,
old state days, vacation,
etc) before you can request
days from the sick leave
bank
Sick leave bank days
available to use for:
• Employee, spouse
child’s illness/injury
• Parent receiving
hospice or end-of-life
care
Maximum # of days that can be used:
• employee’s illness – 30 days per school year
• spouse or child’s illness – 30 days per school year; 60 days lifetime maximum
• parent – 10 days per school year; 20 lifetime maximum
Sick Leave Bank Continued

Catastrophic illness/injury – Serious
in nature (not a passing disorder or
temporary ailment)

Examples: cancer, heart disease,
multiple sclerosis, car accident with
life threatening injuries, etc.

Illness/Injury must require that you
will miss at least 20 work days

Sick Leave Bank Committee will
approve/deny requests

Not Covered:
 Any procedure that could be
scheduled, without detriment
to the employee’s health, at a
time more compatible with the
member’s work responsibilities
are not covered

Example of Procedures Not
Covered: maternity, knee
surgery, hysterectomy, etc.
9
Employee Assistance
Program (EAP)
The Standard
bda – Bensinger, DuPont & Assoc.
What is an EAP?

An employee assistance program is a
program which confidentially helps you in a
time of need at no cost to you. The purpose
of the program is to tackle your problems
before these problems start to negatively
affect your health and work performance.
The program offers a variety of services
ranging from family, health, and stress
management to legal and financial
counseling.
Who is Eligible to Receive Services
Spouse (Married
or Divorced)
Any household
member, regardless
of age or
relationship, residing
in employee’s
home
Employee
Children and
Grandchildren (age 26 or
under)
Significant
Other /
Partner
The EAP Services Can Help With:
Child care &
elder care
Alcohol &
drug abuse
Life
improvement
Difficulties in
relationships
Stress &
anxiety with
work or family
Depression
Goal-setting
Emotional
well-being
Grief & loss
Identity theft
& fraud
resolution
Online will
preparation
Financial &
legal
concerns
3 Sessions per incident or
problem for assessment
& counseling at no cost
to the employee. Each
member of the
employee’s household is
eligible for this service.
11
Health Insurance
4 HEALTH PLAN OPTIONS


AETNA

ActiveCare 1HD

ActiveCare Select

ActiveCare 2
SCOTT & WHITE

HMO
See Health
Insurance
Enrollment Guide
online for more
details
Affordable Care Act (ACA)

As of January 1, 2014, the Affordable Care Act (ACA)
requires you to have health insurance for yourself and
your dependents.

You may have to pay a penalty if you cannot provide
proof to the IRS that you had health insurance.

You can visit www.healthcare.gov to see the plans that
are available through the Marketplace
ActiveCare 1HD Changes
ActiveCare Select Changes
ActiveCare 2 Changes
New HMO Plan

Scott & White

In order to enroll in the HMO plan, you must
work or reside in the HMO service plan area
which includes: Denton, Collin, Tarrant,
Dallas, and Rockwall counties.

You must see a doctor that is in the network
or the plan will not pay any benefits! There
are NO OUT OF NETWORK Benefits!!! Make
sure you review the list of providers in the
network before you enroll in this plan!

No primary care physician (PCP) required

Referrals typically not needed to see a
specialist
Scott & White Service Area
Plan Overview
(Network Level of Benefits)
ActiveCare
1-HD
$2,500 employee only
$5,000 employee & spouse;
Deductible
employee & children;
employee & family
Maximum Out of
Pocket
(includes medical &
prescription deductibles,
copays and coinsurance)
Coinsurance
Office Visit Copay
$6,450 employee only
$12,900 employee & spouse;
employee & children;
employee & family
80% Plan pays
20% Participant pays
20% after deductible
ActiveCare
Select
$1,200 individual
$3,600 family
$6,600 individual
$13,200 family
80% Plan pays
20% Participant pays
$30 for primary
$60 for specialist
Scott & White
HMO
ActiveCare
2
$800 individual
$2,400 family
$1,000 individual
$3,000 family
$5,000 individual
$10,000 family
(Excludes Deductible)
80% Plan pays
20% Participant pays
$6,600 individual
$13,200 family
80% Plan pays
20% Participant pays
$20 for primary
$50 for specialist
Primary means care provided by family practitioners, internists, OB/GYNs and pediatricians.
$30 for primary
$50 for specialist
Preventive Benefits
(Network Level of Benefits)
Preventive Care Clarification
Services
Preventive Care
ActiveCare
1-HD
ActiveCare
Select
Scott & White
HMO
ActiveCare
2
Plan pays 100%
(deductible waived)
Plan pays 100%
(no copay required)
Plan pays 100%
(no copay required)
Plan pays 100%
(no copay required)
• Must be billed by provider as “preventive care”
Plan Overview
(Network Level of Benefits)
Benefits (continued)
Services
Diagnostic Lab
High-tech
Radiology
(CT scan, MRI,
nuclear medicine)
Outpatient Surgery
ActiveCare 1-HD
20% after deductible
ActiveCare Select
Quest Facility
Plan pays 100%
(deductible waived)
Scott & White HMO
20% after deductible
ActiveCare 2
Quest Facility
Plan pays 100%
(deductible waived)
Other Facility
20% after deductible
Other Facility
20% after deductible
20% after deductible
$100 copay per
service, plus 20%
after deductible
20% after deductible
$100 copay per
service, plus 20%
after deductible
20% after deductible
$150 copay
per visit, plus 20%
after deductible
$150 copay
per visit, plus 20%
after deductible
$150 copay
per visit, plus 20%
after deductible
Plan Overview
(Network Level of Benefits)
Benefits (continued)
Services
Emergency Room
(true emergency use)
ActiveCare
1-HD
20% after
deductible
Inpatient Hospital
(facility charges)
Preauthorization required
20% after
deductible
ActiveCare Select
Scott & White HMO
ActiveCare 2
$150 copay, plus 20%
after deductible
$150 copay, plus 20%
after deductible
$150 copay, plus 20% after
deductible
(copay waived if admitted)
(copay waived if admitted)
(copay waived if admitted)
$150 copay per day, plus
20% after deductible
$150 copay per day, plus
20% after deductible
$150 copay per day, plus
20% after deductible
($750 max copay per admission)
($750 max copay per admission)
($750 max copay per admission)
Important Notes
ActiveCare 1-HD
ActiveCare Select Scott & White HMO
You must pay all of your
deductible before
insurance will pay any
benefits.
You must see a
provider in network
or insurance will not
pay any benefits
You must see a
provider in network or
insurance will not pay
any benefits
Deductible is waived for
preventive visits!
NO out of network
benefits!
NO out of network
benefits!
ActiveCare 2
Prescription
Drug Benefits
Prescription Drug Benefits
Features
Drug Deductible
(per person, per plan year)
ActiveCare 1-HD
ActiveCare Select
Scott & White HMO
ActiveCare 2
Subject to
plan year
deductible
$200 per person
(excludes generics)
$100 per person
(excludes generics)
$200 per person
(excludes generics)
Retail Short-Term
(up to 31-day supply)
and
Retail
Short Term
Retail
Maintenance
Retail
Short Term
Retail
Maintenance
Retail
Short Term
Retail
Maintenance
Generic
$20
$25
$3
$6
$20
$25
Preferred Brand
$40
$50
30%
30%
$40
$50
Non-Preferred Brand
50%
50%
50%
50%
$65
$80
Retail Maintenance
(after first fill)
Mail Order and Retail-Plus
(up to 90-day supply)
20% coinsurance
after deductible
Mail Order and Retail-Plus
Mail Order and Retail-Plus
Mail Order and Retail-Plus
Generic
$45
$6
$45
Preferred Brand
$105
30%
$105
Non-Preferred Brand
50%
50%
$180
$200 per fill (up to 31-day
20% coinsurance per fill
Tier I – 10%
Tier II – 20%
Tier III – 30%
Tier IV – 50%
Specialty Medications
$450 per
supply)
fill (32-day to 90-day
supply)
Monthly Premiums
ActiveCare
1-HD
ActiveCare
Select
New Plan
Scott & White
HMO
ActiveCare
2
Current
New
Current
New
Current
New
Current
New
Employee Only
$100
$116
$225
$248
n/a
$278.60
$330
$389
Employee & Spouse
$625
$689
$819
$897
n/a
$910.62
$1,062
$1,253
Employee & Children
$347
$390
$484
$537
n/a
$573.30
$650
$767
Employee & Family
$920
$1,006
$1,013
$1,106
n/a
$1,034.76
$1,098
$1,296
17
Total Out of Pocket Amounts
(In Network for Employee Only)
ActiveCare
1 - HD
ActiveCare
Select
$2,500
$1,200
$800
$1,000
$0
$200
$100
$200
$3,950
$5,200
$5,000
$5,400
$6,450
$6,600
$5,900
$6,600
Annual Premium
$1,392
$2,976
$3,343
$4,668
Total Premium, Medical &
Prescription Expenses
$7,842
$9,576
$9,243
$11,268
Deductible (Medical)
Deductible (Prescription)
Maximum Out of Pocket (co-ins &
copays)
Subtotal Medical & Prescription
Costs
Scott & White ActiveCare
HMO
2
1HD vs. 2 = $3,276 savings in annual premiums
Employee & Spouse
Deductible (Medical)
Deductible (Prescription)
Maximum Out of Pocket (co-ins & copays)
Subtotal Medical & Prescription Costs
Annual Premium
Total Premium, Medical & Prescription Expenses
ActiveCare 1 - HD
$5,000
$0
$7,900
$12,900
$8,268
$21,168
ActiveCare Select Scott & White HMO
$2,400
$1,600
$400
$200
$10,400
$10,000
$13,200
$11,800
$10,764
$10,927
$23,964
$22,727
ActiveCare 2
$2,000
$400
$10,800
$13,200
$15,036
$28,236
Employee & Child(ren) - Assumes 2 children
Deductible (Medical)
Deductible (Prescription)
Maximum Out of Pocket (co-ins & copays)
Subtotal Medical & Prescription Costs
Annual Premium
Total Premium, Medical & Prescription Expenses
ActiveCare 1 - HD
$5,000
$0
$7,900
$12,900
$4,680
$17,580
ActiveCare Select Scott & White HMO
$3,600
$2,400
$600
$300
$9,000
$10,000
$13,200
$12,700
$6,444
$6,880
$19,644
$19,580
ActiveCare 2
$3,000
$600
$9,600
$13,200
$9,204
$22,404
Employee & Family - Assumes 4 family members
Deductible (Medical)
Deductible (Prescription)
Maximum Out of Pocket (co-ins & copays)
Subtotal Medical & Prescription Costs
Annual Premium
Total Premium, Medical & Prescription Expenses
ActiveCare 1 - HD
$5,000
$0
$7,900
$12,900
$12,072
$24,972
ActiveCare Select Scott & White HMO
$3,600
$2,400
$800
$400
$8,800
$10,000
$13,200
$12,800
$13,272
$12,417
$26,472
$25,217
ActiveCare 2
$3,000
$800
$9,400
$13,200
$15,552
$28,752
18
Application to Split Premium

Married couples working for different
participating entities may “pool” funds
OR

Married couples both working for HEB ISD

Family coverage and all want the same plan

Requires an Application to Split Premium form
to be completed by both employees and both
employers

No application needed if the couple both
work for HEB ISD
Split Premiums For Family Coverage
Employee & Family
Standard Funding
Employee Only Premium
Employee & Child(ren) Premium
TRS ActiveCare 1 -HD
$116.00
$390.00
$506.00
TRS ActiveCare Select
$248.00
$537.00
$785.00
Scott & White HMO TRS ActiveCare 2
$278.60
$389.00
$573.30
$767.00
$851.90
$1,156.00
Pooling Funds
Employee & Family Total Premium
HEB Contribution for Employee A
HEB Contribution for Employee B
Total Premium due
TRS ActiveCare 1-HD
$1,231.00
-$225.00
-$225.00
$781.00
÷2
$390.50
TRS ActiveCare Select
$1,331.00
-$225.00
-$225.00
$881.00
÷2
$440.50
Scott & White HMO TRS ActiveCare 2
$1,259.76
$1,521.00
-$225.00
-$225.00
-$225.00
-$225.00
$809.76
$1,071.00
÷2
÷2
$404.88
$535.50
Each employee pays
Monthly Savings or (additional cost)
Annual Savings or (additional cost)
($275.00)
($3,300.00)
($96.00)
($1,152.00)
$42.14
$505.68
$85.00
$1,020.00
How to Search
for Providers

TRS ActiveCare 1HD, Select or 2
www.trsactivecareaetna.com

Scott & White HMO
www.trs.swhp.org
DocFind
No
If you choose
ActiveCare
Select, you will
not see the
correct list!!!
Yes
ActiveCare
Select – you
must choose
the Baylor Scott
& White Quality
Alliance (DFW
Region) option!
List of Hospitals in Select & HMO Plans

Hospitals:






Baylor Medical Center (Grapevine, Irving, Trophy Club, etc.)
Baylor Emergency Medical Center (Colleyville, Keller,
Out of Network
Mansfield, etc.)
Hospitals:
Baylor All Saints – Ft. Worth
Harris Methodist – HEB
North Hills Hospital
Cook Children’s Medical Center
Children’s Medical Center
Urgent Care Facilities:


Concentra
Cook Children’s – Hurst, Ft. Worth, Southlake
Out of Network
Urgent Care
Facilities: Carenow
List Primary Care Providers within 10 miles of
HEB ISD in Select & HMO Plans
HMO Plan
Select Plan
Provider
City
Colleyville Family Medicine
Colleyville
Dr. Mohammad Uddin
Colleyville
Randall Hayes
Euless
Baylor Family Medicine @ Riverside
Grand Prairie
Provider
City
Colleyville Family Medicine
Colleyville
Dr. Eileen O’Brien
Colleyville
Dr. Mohammad Uddin
Colleyville
Baylor Family Medicine @ Grapevine
Grapevine
Baylor Family Medicine @ Riverside
Grand Prairie
Carlos Bazaldua
Grapevine
Baylor Family Medicine @ Grapevine
Grapevine
Donald Frusher
Hurst
Baylor Family Practice @ Keller
Keller
Family Medicine Clinic
Hurst
Southlake Family Medicine
Southlake
Baylor Family Practice @ Keller
Keller
North Country Family Practice
Southlake
Southlake Family Medicine
Southlake
North Country Family Practice
Southlake
14
What is Teladoc?

Available only to those on TRS ActiveCare!! Not available for the
HMO Plan!!

Teladoc’s board-certified doctors can resolve many of your
medical issues, 24/7/365, via phone or online video consults from
wherever you happen to be.
Imagine this…You wake up one morning with sudden cold-like symptoms:
stuffy nose, cough, congestion. You have trouble getting an appointment
with your existing doctor and you don’t want to miss time at work by sitting
in an urgent care or ER waiting room…so what do you do?
You contact Teladoc…
Step 1: Contact
Teladoc – online or
by phone
•Request a phone or
online video consult
with doctor (avg. call
back time is 16 minutes
or you can schedule a
time for the doctor to
call you back)
Step 3: Resolve
your issue
Step 2: Talk with
a doctor
•The doctor will
recommend the right
treatment and write
a prescription if
necessary
Step 4: Settle up
• ActiveCare 2 – no
charge
• Select - no charge
• 1HD - $40 fee
What Issues can Teladoc handle?
Non emergency
medical issues
Common list of short
term prescriptions
• Cold & flu symptoms
• Bronchitis
• Allergies
• Poison ivy
• Pink eye
• Urinary tract infection
• Respiratory infection
• Sinus problems
• Ear infection
• & more!
• Amoxicillin™
• Azithromycin™
• Bactrim DS™
• Augmentin™
• Cipro™
• Tessalon Perles™
• Flonase Nasal Spray™
• Pyridium™
• Prednisone™
• Diflucan™
19
GAP Insurance
SPECIAL INSURANCE
SERVICES (SIS)
Gap Insurance
Gap insurance helps with out of pocket expenses one might
incur due to a large deductible or high maximum out of
pocket amounts.
You must be covered under a GROUP health plan in order to
be eligible to enroll in the Gap plan.
2 Benefits: $1500 Inpatient & $1500 Outpatient
Note: This plan will only reimburse you
the amount the insurance carrier
shows you owed to the provider.
Benefits
Inpatient Hospital Benefit
• $1,500 per covered person per plan year
Outpatient Benefit
• $1,500 per person per sickness/injury
• Maximum of 3 occurrences per family per plan year
• All expenses related to the treatment of the same or related sickness/injury will
accrue toward the outpatient benefit
How to file a claim:
• Give your provider the Gap ID Card or
• File a claim with SIS for reimbursement
Gap – Definition of Outpatient Services
ER
Durable medical
equipment
The outpatient benefit does
not cover a physician’s
office visit charge.
Chiropractic care
Outpatient Surgery
Diagnostic testing (i.e.. Xrays, lab work, MRI, CT scans,
etc.)
Physical
therapy
Outpatient radiation/chemotherapy
Gap - Premiums
Under Age 40
Ages 40 - 49
Ages 50 & Above
Old
New
Old
New
Old
New
Employee Only
$25.98
$26.89
$34.21
$35.41
$71.85
$74.37
Employee & Spouse
$47.76
$49.44
$62.85
$65.05
$132.02
$136.65
Employee & Children
$62.45
$64.64
$67.22
$69.58
$123.81
$128.15
Employee & Family
$83.64
$86.57
$95.11
$98.44
$182.41
$188.80
20
Dental Insurance
LINCOLN FINANCIAL
Lincoln Financial Dental PPO & DHMO
DHMO
PPO High
PPO Low
Preventive
$5 Office Fee
Plan Pays 100%
Plan Pays 100%
Basic
Fixed Co-Pays
Plan Pays 80%
Plan Pays 70%
(see pg 23)
Deductible Applies
Deductible Applies
Major
Fixed Co-Pays
Plan Pays 50%
Plan Pays 50%
(see pg 23)
Deductible Applies
Deductible Applies
Orthodontics
Fixed Co-Pays
Out of Network
Deductible Per Calendar Year
Annual Maximum Benefit
(Maximum amount the insurance will pay per
person per calendar year)
Plans Pays 50%
(see pg 23)
up to $1,000
Not Covered
You must choose an in
network provider (see page 21-22)
Yes
Yes
None
$50 Per Person
$150 Family
$25 Per Person
$75 Family
None
$1,000
$750
None;
25
PPO Plans MaxRewards

Both PPO Plans offer MaxRewards maximum rollover feature which will
allow covered members to roll over a portion of their unused annual
maximum into a MaxRewards Account Balance.
MaxRewards
PPO High
PPO Low
Eligible Range (Claim Threshold)
$1 - $600
$1 - $300
Rollover Amount
Rollover Amount with Preferred
Provider
Maximum Rollover Account
Balance
$250 per year $150 per year
$350 per year $200 per year
$1,000
$750
Dental Premiums
DHMO
PPO High
PPO Low
No Rate
Increase
Old
New
Old
New
Employee Only
$13.91
$33.95
$38.00
$22.31
$25.00
Employee + 1
$26.42
$67.40
$75.50
$45.98
$51.50
Employee + Family
$41.72
$102.42
$114.50
$62.36
$69.50
26
Vision Plan
SUPERIOR VISION
Vision Plan
In Network Benefits
Examination (Once Every Plan Year)
$10 copay
Material Copay (lenses & frames only, not contact lenses)
$25 copay
Contact Lens Evaluation & Fitting
(Once Every Plan Year)
(specialty)
Frames (Once Every Two Plan Years)
Contact Lenses
$0 (standard)
$50 retail allowance
(Once Every Plan Year)
Lenses (Once Every Plan Year)
•Single Vision, Bifocal, Trifocal Lenticular
•Standard Scratch Coating
$130 Allowance
(20% discount off balance)
Up to $150
(Covered 100% if Medically
Necessary)
Covered in Full
*Discounts on other types of
specialty lenses
Premiums
Employee Only
$6.10
Employee + 1
$11.84
Family
$17.39
27
Disability
Insurance
THE STANDARD
The Standard Disability
Disability
Income
Replaces a portion of your income when you are sick
or injured and cannot work
Maximum
Benefit
Amount up to 2/3rds of your monthly earnings
Benefit Waiting
Period 0/7, 14,
30, 60, 90, 180
days –
The period of time that you must be continuously
disabled before benefits become payable. Benefits
are not payable during the benefit waiting period!
Disability Pre-Existing Conditions
Preexisting
Condition
Exclusion:
Any condition you
had 90 days prior to
the effective date of
your insurance will be
considered preexisting.
Preexisting
Condition
Waiver:
If you move up more than $300, you will be
subject to pre-ex, but they will still pay you the
higher benefits for 90 days because of the preexisting condition waiver.
For the first 90 days
of disability, The
Standard will pay
full benefits even if
you have a preexisting condition
If you move down more
than 1 elimination period
and up more than $300;
The Standard will apply
continuity of care and pay
you what you had last
year!
No Preexisting
issues if:
You can move up
$300
You can move down
1 elimination period
Bottom line: if you have a
pre-existing condition,
please contact the benefits
office before you make any
changes!!
Monthly
Annual Monthly Disability
Earnings Earnings Benefit
3,600
5,400
7,200
9,000
10,800
12,600
14,400
16,200
18,000
19,800
21,600
23,400
25,200
27,000
28,800
30,600
32,400
34,200
36,000
37,800
39,600
41,400
43,200
45,000
46,800
300
450
600
750
900
1,050
1,200
1,350
1,500
1,650
1,800
1,950
2,100
2,250
2,400
2,550
2,700
2,850
3,000
3,150
3,300
3,450
3,600
3,750
3,900
200
300
400
500
600
700
800
900
1,000
1,100
1,200
1,300
1,400
1,500
1,600
1,700
1,800
1,900
2,000
2,100
2,200
2,300
2,400
2,500
2,600
Accident/Sickness Benefit Waiting Period
Cost Per Month
1800-7
14-14
30-30
60-60
90-90
180
9.74
14.61
19.48
24.35
29.22
34.09
38.96
43.83
48.70
53.57
58.44
63.31
68.18
73.05
77.92
82.79
87.66
92.53
97.40
102.27
107.14
112.01
116.88
121.75
126.62
7.78
11.67
15.56
19.45
23.34
27.23
31.12
35.01
38.90
42.79
46.68
50.57
54.46
58.35
62.24
66.13
70.02
73.91
77.80
81.69
85.58
89.47
93.36
97.25
101.14
6.42
9.63
12.84
16.05
19.26
22.47
25.68
28.89
32.10
35.31
38.52
41.73
44.94
48.15
51.36
54.57
57.78
60.99
64.20
67.41
70.62
73.83
77.04
80.25
83.46
4.38
6.57
8.76
10.95
13.14
15.33
17.52
19.71
21.90
24.09
26.28
28.47
30.66
32.85
35.04
37.23
39.42
41.61
43.80
45.99
48.18
50.37
52.56
54.75
56.94
3.80
5.70
7.60
9.50
11.40
13.30
15.20
17.10
19.00
20.90
22.80
24.70
26.60
28.50
30.40
32.30
34.20
36.10
38.00
39.90
41.80
43.70
45.60
47.50
49.40
2.94
4.41
5.88
7.35
8.82
10.29
11.76
13.23
14.70
16.17
17.64
19.11
20.58
22.05
23.52
24.99
26.46
27.93
29.40
30.87
32.34
33.81
35.28
36.75
38.22
28
If you choose a
waiting period of 30
days or less, your
waiting period is
waived if you are
admitted as an
inpatient in the
hospital.
32
Cancer Plan
ALLSTATE
Cancer Insurance Changes

During this open enrollment period, you may enroll in
the Low Plan on a Guarantee Issue basis


NO Health Questions Asked!
Pre-Existing Condition – Allstate will not pay benefits for
a pre-existing condition during the 1st 12 months if you
are currently under treatment
Allstate
Pays actual doctor
charges for Cancer related
treatment
•Surgery, Radiation,
Chemotherapy, Transportation,
Lodging, etc.
Also covers 29 other
specified diseases such as:
•Lou Gehrig’s Disease, Muscular
Dystrophy, Multiple Sclerosis,
Tuberculosis, Sickle Cell Anemia,
Bacterial Meningitis, Lyme
Disease, Cystic Fibrosis, etc.
Pays benefits directly to
you
Policy is portable, which
means if you leave the
district you can keep the
plan at the same rate.
Allstate Cancer Insurance
Benefits
High Option
Low Option
Radiation/Chemotherapy
$20,000
$10,000
Cancer Initial Diagnosis (1st Occurrence)
$5,000
$2,000
Hospital Confinement
$200 per day
ICU
Wellness Benefit
Medical Imaging
$600
$100 per calendar year
$1,000
$500
New or Experimental Treatment
$5000
Surgery
Premiums
Up to $3000
High Option
Low Option
Employee Only
$40.33
$26.41
Employee & Child(ren)
$57.55
$37.28
Employee & Spouse
$63.24
$41.87
Employee & Family
$80.44
$52.72
38
Group Term
Life Insurance
LINCOLN
FINANCIAL
Term Life Insurance Changes
Opportunity to increase
or elect additional life
insurance with no health
questions asked:
• Employee - $20,000
• Spouse - $10,000
If you have ever been declined or withdrew an application with Lincoln Financial, you must
answer health questions.
Term Life Insurance
Term Life Insurance for
Employee
Term Life insurance for spouse
and/or child(ren)
• Age Banded Rates – every 5 years
when you are bumped to the next
age bracket, your rates will increase
• Employee must choose term life
insurance in order to choose term
life insurance for spouse or child
• Spouse’s rates are based on the
employee’s age
• Spouse’s coverage not to exceed ½
of employee’s coverage
40
Term Life Insurance Premiums
Spouse Premiums
Employee Premiums
Child (ren) Premiums


$5,000 per child - $.60 per month
$10,000 per child - $1.20 per month
42
Accidental Death &
Dismemberment
Life Insurance
AD&D Life Plan
Accidental Death & Dismemberment

Insurance that is payable in case death is ruled an
accident
Employee Only
Family Coverage
Insurance Schedules

Examples:
50% for spouse w/no children
1 to 10 Times Salary 40% for spouse w/children.
10% for children
Maximum Benefit
$500,000
$500,000
Employee Contribution
100%
100%
Rate per $1,000
$.024
$.033
Employee Only Coverage
$100,000 = $2.40
$500,000 = $12.00
Family Coverage
$100,000 = $3.30
$500,000 = $16.50
45
New
PrePaid Legal
Insurance
LEGALEASE
What is PrePaid Legal?
LegalEASE offers employees a customized legal assistance plan that provides support
and protection from unexpected personal (not business related) legal issues.
The plan
matches you up
with an attorney
There are no
deductibles
Benefits cover
the attorney’s
time
Other costs, such
as filing fees, are
not covered
Top 10 Legal Issues
Divorce
Child Custody Battles
Child Support Order Modifications
Will & Trust Drafting
Real Estate
Vehicle-Related Issues
Juvenile & School Issues
Guardianship
Bankruptcy
Landlord & Tenant Disputes
47
Plan Benefits
Consumer
•Small Claims
Court
Representation
•Document
Preparation
•Promissory
Note
•Simple
Affidavit
Estate Planning
& Wills
•Simple Will
•Living Will
•Health Care
Power of
Attorney
•Living Trust
•Probate of
Small Estate
Premiums
Family
Home
•Divorce
•Name Change
•Adoption
•Guardianship
•Purchase of
Primary
Residence
•Sale of Primary
Residence
•Refinancing
Individual
$16.91
Family
$18.88
Criminal
•Traffic Defense
•Misdemeanor
Defense
Other
•Civil Litigation
Defense
•Foreclosure
•Tax Audit
•Financial
Planning &
Coaching
•Office
Consultation
•Telephone
Advice
49
Health Savings
Accounts (HSA)
HSA BANK
What is a Health Savings Account
(HSA)?

An HSA, is a taxadvantaged
account that you
put money into to
pay for current or
future healthcare
expenses
Tax free contributions
Unused funds roll over from year to year. There’s no “use it or lose
it” penalty
Money in your account is invested
Money in your account is accessible as it is contributed. You do not
have access upfront to all the money you are supposed to contribute to
the account for the entire year like a Flexible Spending Account
Eligibility
You must be covered
by a qualified high
deductible health
plan (HDHP) –
ActiveCare 1HD
You cannot be
enrolled in the GAP
Plan
You cannot be
enrolled in Medicare
You cannot be
enrolled in a Flexible
Spending Account
(FSA)
You cannot be
claimed as a
dependent on
someone else's tax
return
You cannot be
covered by other
health insurance
Maximum Contributions per Year
Individual Coverage
Family Coverage
Funding your HSA:

Payroll deductions

Online transfers

Personal check
Age Under 55
$3,350
$6,650
Age 55+
$4,350
$7,650
Eligible Medical Expenses
Expenses applied
to your health plan
deductible
Note: You do not
have to submit any
receipts to HSA
Bank, save your bills
and receipts for tax
purposes!
Dental Care
Prescription drugs
and medicines
Vision Care
How to Use Your HSA
Sign up for free internet banking
How to access your funds:
• You can reimburse yourself for an expense paid
out-of-pocket or pay directly from your HSA
account:
• Debit Card
• Checks – order checks from HSA bank for a fee
• Online Transfers
• Manual withdraw form - processing fee
52
Flexible Spending Plan
TASC
Medical Reimbursement
Employee can pay for out-ofpocket medical expenses with
before tax dollars
• File claims for reimbursement
• Use the debit card that is provided
Deductibles, co-insurance, copays, vision care, dental
procedures, etc.
You must use it or lose it!!
Plan year is September 1st
through August 31st. You must
re-enroll every year.
Funds are front loaded (you
have access to all the money
on September 1st)
Maximum per year is $2,400 or
$200 per month
55
Dependent Day Care
Reimbursement Plan
Dependent Day Care Reimbursement Plan
The plan allows you to set aside money on
a pre-tax basis that you can use to cover
certain costs associated with providing
your dependent(s) with day care while you
and your spouse are at work.
If you choose this plan you
cannot claim the Federal Tax
Credit.
Any dependent under the age of
13 or any other dependent such
as a parent or spouse can be
covered
Maximum contribution is $5,000
per year. You must use it or lose it.
Debit Card is provided and/or
you can file claims for
reimbursement.
57
Retirement
Planning
Plan Administrators
403(b) Plan
457 Plan
The Omni Group
877-544-6664
www.omni403b.com
RAMS / JEM
800-943-9179
www.region10rams.org
What is a 403b or 457?
What is a 403(b)?
A 403(b) plan is a retirement savings plan
available for public education organizations. It has
tax treatment similar to a 401(k) plan. Employee
salary deferrals into a 403(b) plan are made
before income tax is paid an allowed to grow taxdeferred until the money is taxed as income when
withdrawn from the plan. 403(b) plans are also
referred to as tax-sheltered annuity.
Maximum Contributions for 2015:
Annual Maximum - $18,000
Over age 50 Catch-up - $6,000
What is a 457?
The 457 plan is a type of deferred-compensation
retirement plan that is available for governmental
employers. The employer provides the plan and
the employee defers compensation into it on a
pre-tax basis. For the most part the plan operates
similarly to a 401(k) or 403(b) plan. The key
difference is that there is no penalty for
withdrawal before the age of 59½ (but
subject to income tax).
Maximum Contributions for 2015:
Annual Maximum - $18,000
Over age 50 Catch-up - $6,000
Investment Options
403(b) Plan
You have 20 + companies to
choose from with a variety of
investment options available –
Please visit www.trs.state.tx.us
and select 403b Certification and
click on View 403(b) Products List to see
the list of fees charged by each
company/product.
457 Plan
HEB ISD has selected 1 company
to provide our employees with the
457 plan. RAMS/JEM offers
several investment options
How to Enroll
Enrollment or changes may be made anytime during the year
403(b) Plan
How to Enroll:
Step 1: Set up your 403b
account with an
approved vendor
Step 2: Complete the
Salary Reduction
Agreement with The
Omni Group
457 Plan
How to Enroll:
Complete the Salary
Reduction Agreement with
RAMS / JEM
63
Online Enrollment

July 20, 2015 – August 21, 2015
Effective Date of Changes: September 1, 2015

Visit www.in-roll.com

Your default login is your first initial of your first name followed by your last name and

the last 4 digits of your Social Security Number.
Example: John Doe SSN 123-45-6789 – Login ID: jdoe6789

Your default password is the word “hebisd”
It is your responsibility to check your paycheck stub in September to make
sure the correct amount is being deducted. Please contact the Benefits
Office promptly in the event of any error or discrepancy with these
deductions.
Confirmation Statement
Review your confirmation statement to
make sure everything looks correct.
You may print or email the confirmation
then click on “Complete Enrollment”
Questions?
Questions
Give
away Door Prizes