corsicana isd benefit summary 2016 isd... · corsicana isd benefit guide plan year: september 1,...

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CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America 1200 W. Walnut Hill Ln, Suite 3400 Irving, TX 77060 800-883-0007

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Page 1: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

CORSICANA ISD BENEFIT GUIDE

Plan Year: September 1, 2016 – August 31, 2017

Information Provided By: First Financial Group of America

1200 W. Walnut Hill Ln, Suite 3400 Irving, TX 77060

800-883-0007

Page 2: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

Attention Corsicana ISD: It’s time to enroll! It’s that time again. FFGA reps will be in the district May 9th - 16th to help you with all of your supplemental benefit needs. FFGA and Corsicana ISD are always working hard to bring you competitive and cost effective benefits. There are several changes this year to your benefit offering so please take a few minutes to review the information attached prior to enrollment.

What’s New this Year??? As you know, out of pocket Medical costs continue to rise putting more and more liability on you to cover the costs when you need your insurance the most. The two new benefits listed below are a great way to help you supplement your medical insurance and cover those high deductibles, out of pocket maximums and costs not covered by medical insurance.

2 New Benefits from AFLAC 1) AFLAC –Critical Illness (will replace Humana CI) 2) AFLAC – Hospital Indemnity

Video Links: Critical Illness http://www.aflac.com/videos/ciM/

Hospital Indemnity http://www.aflac.com/videos/hiC1/

For all benefit information, please visit http://benefits.ffga.com/corsicanaisd

***All employees need to meet with an FFGA representative or enroll online. Online enrollment instructions are on the benefits website.

***Medical Insurance will be enrolled online July 18th – August 19th

Ryan Hancock, Account Manager First Financial Group of America [email protected]

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Page 3: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

TABLE OF CONTENTS PAGE

WHAT’S NEW 1

TABLE OF CONTENTS 2

BENEFIT OVERVIEW 3

HOW TO ENROLL 4

SECTION 125 INFORMATIOM 5

FLEXIBLE SPENDING ACCOUNT DETAILS 6

CRITICAL ILLNESS INSURANCE 8

HOSPITAL INDEMNITY INSURANCE 15

DISABILITY INSURANCE 22

ACCIDENT INSURANCE 31

VISION INSURANCE 40

DENTAL INSURANCE 42

CANCER INSURANCE 45

LEGAL SHIELD 48

ASSURANT TERM LIFE INSURANCE 50

TEXAS LIFE PERMANENT LIFE INSURANCE 55

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Page 4: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

Overview

Corsicana Independent School District and First Financial Group of America would like to take this opportunity to present to you the information for the upcoming plan year. This information has been created to bring forth a brief overview of your choices as well as offer you a reference guide when questions may arise regarding your insurance plans.

Please take the time to look over the information contained in this booklet to familiarize yourself with the benefits that are provided to you as an employee.

Open Enrollment will be May 9 –May 16. All employees must review plan options and make any necessary changes to your supplementary elections under the Cafeteria Plan. This is the only time you can make changes to your supplemental insurance, unless there is a qualified family status change during the year.

Your plan year is September 1 through August 31. Payroll deductions for your benefits will begin in September.

This guide contains a summary of the benefits offered by your employer. If there is a conflict between the terms of this

outline of benefits and the actual contracts, the terms of the contracts will prevail. For a more detailed explanation of

benefits you may contact First Financial Administrators at 1-800-523-8422 or visit the website listed below.

For detailed information your benefits website is:

http://benefits.ffga.com/corsicanaisd

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Online Enrollment Instructions

How do I enroll my benefits prior to open enrollment? Conveniently, you can view your benefits, enroll or make any necessary changes for the upcoming plan year at work or at home using our secure, online website.

Where do I go to enroll in my benefits? Go to https://ffga.benselect.com/enroll.

What is my login and PIN? Your login is your social security number (123456789). Your pin is the last four digits of your social security number and the last two numbers of your birth year (678977). Once you login you will see a Welcome presentation. Once finished Click “Next,” then:

Verify your personal information

Verify all dependent information (ssn/date of birth) **Very Important**

View employment information You will then see a brief presentation on each benefit available. Notify the Business Office/Payroll Department of any discrepancies.

Useful Information to know Contact First Financial at

855-523-8422 with any technical questions.

No changes will be allowed until the annual open enrollment period (unless you have an IRS S125 approved event).

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Section 125 Cafeteria Plan First Financial Administrators, Inc.

As a district employee, you are eligible to participate in a Section 125 Flexible Plan. Enrollment opportunities are limited to the plan year dates for your district. A Section 125 Flexible Plan allows you, the employee, to select from a list of available benefits that will meet your family’s healthcare needs. Certain premiums are deducted from your gross earnings before federal withholding taxes are figured. 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. You cannot change your elections during the plan year except for certain specified changes in family status. Those changes include:

Marriage

Divorce

Death of a spouse/child

Birth or adoption of a child

Termination of spouse’s employment

You must notify your employer within 31 days of the qualifying event to make changes.

Section 125 Plan Sample Paycheck The example below shows how a married employee claiming 1 exemption can reduce their taxable income

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Flexible Spending Accounts (FSAs) Flexible Spending Accounts (FSAs) are tax-favored accounts that allow participants to set aside money pretax for eligible Medical and Dependent Care costs. FSAs allow an employee the opportunity to put some of his/her salary aside before taxes to pay for many common out-of-pocket expenses. Use-it-or-lose-it-Rule: Money remaining in your FSA account(s) will not be returned to you at the end of the plan year. Any amount remaining after the end of the runoff will be forfeited. Because of the use-it-or-lose-it rule, it is important for you to carefully estimate your out-of-pocket health and dependent care expenses for the upcoming plan year. Your employer has chosen the $500 Roll-Over Option for your plan. This option allows you the opportunity to roll over $500 of unclaimed Medical FSA funds into the following plan year. Any amount in excess of $500 will be forfeited under the use-it-or-lose-it rule.

Medical FSA Your Medical FSA may be used to reimburse you for expenses that you incur for treatment of yourself, spouse and dependent children during your plan year. Eligible medical expenses include deductibles and coinsurance amounts under a group health plan, charges that are in excess of the amount reimbursed under a group health plan, and charges that are not covered under a group health plan such as certain corrective surgeries, vision care, dental care and hearing aids. Effective January 1, 2011, all over -the counter medications eligible for reimbursement must be accompanied by a doctor’s prescription. Maximum contribution amount for 2016/2017 plan year is 2,550 ($212.50 per month). Reminder – If you or your spouse participate in a Qualified High Deductible Health Plan and contribute to a Health Savings Account, you are not eligible to enroll in Medical Reimbursement.

Dependent Care Reimbursement A Dependent Care FSA allows you to pay for daycare expenses for your qualified dependent/child with pre-tax dollars while you (and your spouse) are working, seeking employment, or attending school as a full- time student for at least 4 months during the year. Eligible dependents must be claimed as an exemption on your tax return. These dependents can include step-children, grandchildren, adopted children or foster children. Under IRS regulations, eligible dependents are further defined as: under age 13 and/or physically or mentally unable to care for themselves, such as a disabled spouse, disabled child, or elderly parents that live with you. The IRS allows employees to contribute up to $5,000 annually to a Dependent Care FSA.

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Flex Benefits Card The Flex Benefits Card is available to all employees that participate in Medical Reimbursement FSA. The Benefits Flex Card gives you immediate access to your money at the point of purchase. Cards are available for participating employees, their spouse and eligible dependents that are at least 18 years old. The IRS requires validation of most transactions. You must submit receipts for validation of expenses when requested. If you fail to substantiate by providing a receipt to First Financial within 60 days of the purchase or date of service your card will be suspended until the necessary receipt or explanation of benefits from your insurance provider is received.

FF Flex Mobile App The FF Flex Mobile App is available for Apple® or AndroidTM devices on the App StoreSM or the Google Play StoreTM. With the FF Flex Mobile App you can:

Submit Claims

View Account Balance & History

See Claim Status

View Alerts

Upload Receipts and Documentation Download & register your app today!

FSA Store 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 FSA Store for eligible items from bandages to vitamins 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. www.ffga.com/fsaextras

FFA818 is the mobile app number

for Corsicana ISD

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AFLAC Critical Illness

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Page 10: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

Aflac Group Critical Illness AdvantageINSURANCE – PLAN INCLUDES BENEFITS FOR CANCER AND HEALTH SCREENING

We help take care of your expenses while you take care of yourself.

IV (9/15)AGC150049

THIS IS NOT A MEDICARE SUPPLEMENT PLAN. If you are eligible for Medicare, review the Guide to Health Insurance for People with Medicare, which is available from the company.

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AFLAC GROUP CRITICAL ILLNESS ADVANTAGE CIG

Aflac can help ease the financial stress of surviving a critical illness.

Chances are you may know someone who’s been diagnosed with a critical

illness. You can’t help notice the difference in the person’s life—both physically

and emotionally. What’s not so obvious is the impact a critical illness may have on

someone’s personal finances.

That’s because while a major medical plan may pay for a good portion of the

costs associated with a critical illness, there are a lot of expenses that may not be

covered. And, during recovery, having to worry about out-of-pocket expenses is the

last thing anyone needs.

That’s the benefit of an Aflac Group Critical Illness plan.

It can help with the treatment costs of covered critical illnesses, such as a heart

attack or stroke.

More importantly, the plan helps you focus on recuperation instead of the

distraction of out-of-pocket costs. With the Critical Illness plan, you receive cash

benefits directly (unless otherwise assigned)—giving you the flexibility to help pay

bills related to treatment or to help with everyday living expenses.

Understanding the facts can help you decide if the Aflac group Critical Illness plan makes sense for you.

AN ESTIMATED83.6MILLION $108.9BILLION

AMERICAN ADULTS–GREATER THAN 1 IN 3–HAVE ONE OR MORE TYPES OF CARDIOVASCULAR DISEASE (CVD).1

THE AMOUNT OF MONEY CORONARY HEART DISEASE COST THE UNITED STATES. THIS TOTAL INCLUDES THE COST OF HEALTH CARE SERVICES, MEDICATIONS AND LOST PRODUCTIVITY.2

FACT NO. 1 FACT NO. 2

1 American Heart Association/American Stroke Association 2013 Statistical Fact Sheet2 Centers for Disease Control and Prevention Heart Disease Fact Sheet 2015

Coverage underwritten by Continental American Insurance Company (CAIC)A proud member of the Aflac family of insurers 10

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CIG For over 60 years, Aflac has been dedicated to helping provide individuals and families peace of mind and financial security when they’ve needed it most. The Aflac Group Critical Illness plan is just another innovative way to help make sure you’re well protected under our wing.

Here’s why the Aflac Group Critical Illness plan may be right for you.

How it works

Amount payable based on $30,000 First Occurrence Benefit.

Aflac Group Critical Illness

Advantage coverage is selected.

You experience chest pains

and numbness in the left arm.

You visit the emergency

room.

A physician determines

that you have had suffered a heart attack.

Aflac Group Critical Illness Advantage pays a First Occurrence Benefit of

$30,000

The Aflac Group Critical Illness plan benefits include:

• Critical Illness Benefit payable for:

– Cancer

– Heart Attack (Myocardial Infarction)

– Stroke

– Kidney Failure (End-Stage Renal Failure)

– Major Organ Transplant

– Bone Marrow Transplant (Stem Cell Transplant)

– Sudden Cardiac Arrest

– Coronary Artery Bypass Surgery

– Non-Invasive Cancer

– Skin Cancer

• Health Screening Benefit

Features:

• Benefits are paid directly to you, unless you choose otherwise.

• Coverage is available for you, your spouse, and dependent children.

• Coverage may be continued (with certain stipulations). That means you can take it with you if you change jobsor retire.

• Fast claims payment. Most claims are processed in about four days.

But it doesn’t stop there. Having group critical illness insurance from Aflac means that you may have added financial resources to help with medical costs or ongoing living expenses.

For more information, ask your insurance agent/producer, call 1.800.433.3036, or visit aflacgroupinsurance.com.11

Page 13: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

COVERED CRITICAL ILLNESSES:

CANCER (Internal or Invasive) 100%

HEART ATTACK (Myocardial Infarction) 100%

STROKE (Ischemic or Hemorrhagic) 100%

MAJOR ORGAN TRANSPLANT 100%

KIDNEY FAILURE (End-Stage Renal Failure) 100%

BONE MARROW TRANSPLANT (Stem Cell Transplant) 100%

SUDDEN CARDIAC ARREST 100%

BURNS* 100%

COMA** 100%

PARALYSIS** 100%

LOSS OF SIGHT / HEARING / SPEECH** 100%

NON-INVASIVE CANCER 25%

CORONARY ARTERY BYPASS SURGERY 25%

INITIAL DIAGNOSISWe will pay a lump sum benefit upon initial diagnosis of a covered critical illness when such diagnoses is caused by or solely attributed to an underlying disease. Employee benefit amount available is $30,000. Spouse coverage is also available in a benefit amount of $15,000. Cancer diagnoses are subject to the cancer diagnosis limitation. Benefits will be based on the face amount in effect on the critical illness date of diagnosis.

ADDITIONAL DIAGNOSISWe will pay benefits for each different critical illness after the first when the two dates of diagnoses are separated by at least 6 consecutive months, and the new critical illness is not contributed to or caused by a critical illness for which benefits have been paid. Cancer diagnoses are subject to the cancer diagnosis limitation.

REOCCURRENCEWe will pay benefits for the same critical illness after the first when the two dates of diagnoses are separated by at least 6 consecutive months, and the new critical illness is not contributed to or caused by a critical illness for which benefits have been paid. Cancer diagnoses are subject to the cancer diagnosis limitation.

CHILD COVERAGE AT NO ADDITIONAL COSTEach dependent child is covered at 50 percent of the primary insured’s benefit amount at no additional charge. Children-only coverage is not available.

SKIN CANCER BENEFITWe will pay $250 for the diagnosis of skin cancer. We will pay this benefit once per calendar year.

Benefits Overview

*This benefit is only payable for burns due to, caused by, and attributed to, a covered accident.**These benefits are payable for loss due to a covered underlying disease or a covered accident.12

Page 14: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

• Blood test for triglycerides • Bone marrow testing • Breast ultrasound • CA 15-3 (blood test for breast cancer) • CA 125 (blood test for ovarian cancer) • CEA (blood test for colon cancer) • Chest X-ray • Colonoscopy • DNA stool analysis • Fasting blood glucose test • Flexible sigmoidoscopy

• Hemocult stool analysis • Mammography • Pap smear • PSA (blood test for prostate cancer) • Serum cholesterol test to determine level of of HDL

and LDL • Serum protein electrophoresis (blood test for

myeloma) • Spiral CT screening for lung cancer • Stress test on a bicycle or treadmill • Thermography

The plan has limitations and exclusions that may affect benefits payable. This brochure is for illustrative purposes only. Refer to your certificate for complete details, definitions, limitations, and exclusions.

WAIVER OF PREMIUMIf you become totally disabled due to a covered critical illness prior to age 65, after 90 continuous days of total disability, we will waive premiums for you and any of your covered dependents. As long as you remain totally disabled, premiums will be waived up to 24 months, subject to the terms of the plan.

SUCCESSOR INSURED BENEFITIf spouse coverage is in force at the time of the primary insured’s death, the surviving spouse may elect to continue coverage. Coverage would continue at the existing spouse face amount and would also include any dependent child coverage in force at the time.

HEALTH SCREENING BENEFIT (Employee and Spouse only)We will pay $100 for health screening tests performed while an insured’s coverage is in force. We will pay this benefit once per calendar year.

This benefit is only payable for health screening tests performed as the result of preventive care, including tests and diagnostic procedures ordered in connection with routine examinations. This benefit is payable for the covered employee and spouse. This benefit is not paid for dependent children.

COVERED HEALTH SCREENING TESTS INCLUDE:

OPTIONAL BENEFITS RIDER

BENIGN BRAIN TUMOR 100%

ADVANCED ALZHEIMER’S DISEASE 25%

ADVANCED PARKINSON’S DISEASE 25%

These benefits will be paid based on the face amount in effect on the critical illness date of diagnosis. We will pay the optional benefit if the insured is diagnosed with one of the conditions listed in the rider schedule if the date of diagnosis is while the rider is in force.

PROGRESSIVE DISEASES RIDER

AMYOTROPHIC LATERAL SCLEROSIS (ALS or Lou Gehrig’s Disease) 100%

SUSTAINED MULTIPLE SCLEROSIS 100%

This benefit is paid based on your selected Progressive Disease Benefit amount. We will pay the benefit shown upon diagnosis of one of the covered diseases if the date of diagnosis is while the rider is in force.

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0 1 2 3 4 5 6 7 8 9 10

1 1 1 1 NONTOBACCO - Employee 1 1 1 1 1

Issue Age $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000 $50,000

18-29 5.56$ 8.09$ 10.63$ 13.17$ 15.70$ 18.24$ 20.78$ 23.31$ 25.85$ 28.39$ 30-39 7.16$ 11.30$ 15.44$ 19.58$ 23.72$ 27.86$ 32.00$ 36.14$ 40.28$ 44.42$ 40-49 11.10$ 19.19$ 27.27$ 35.36$ 43.44$ 51.52$ 59.61$ 67.69$ 75.78$ 83.86$ 50-59 17.93$ 32.84$ 47.74$ 62.65$ 77.56$ 92.47$ 107.38$ 122.29$ 137.19$ 152.10$ 60-69 27.71$ 52.39$ 77.08$ 101.76$ 126.45$ 151.14$ 175.82$ 200.51$ 225.20$ 249.88$

1 1 1 1 NONTOBACCO - Spouse 1 1 1 1

Issue Age $5,000 $7,500 $10,000 $12,500 $15,000 $17,500 $20,000 $22,500 $25,000

18-29 5.56$ 6.83$ 8.09$ 9.36$ 10.63$ 11.90$ 13.17$ 14.44$ 15.70$ 30-39 7.16$ 9.23$ 11.30$ 13.37$ 15.44$ 17.51$ 19.58$ 21.65$ 23.72$ 40-49 11.10$ 15.15$ 19.19$ 23.23$ 27.27$ 31.31$ 35.36$ 39.40$ 43.44$ 50-59 17.93$ 25.38$ 32.84$ 40.29$ 47.74$ 55.20$ 62.65$ 70.11$ 77.56$ 60-69 27.71$ 40.05$ 52.39$ 64.74$ 77.08$ 89.42$ 101.76$ 114.11$ 126.45$

1 1 1 1 TOBACCO - Employee 1 1 1 1 1

Issue Age $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000 $50,000

18-29 6.59$ 10.16$ 13.73$ 17.30$ 20.88$ 24.45$ 28.02$ 31.59$ 35.16$ 38.73$ 30-39 9.49$ 15.95$ 22.42$ 28.88$ 35.35$ 41.81$ 48.28$ 54.74$ 61.21$ 67.67$ 40-49 15.74$ 28.46$ 41.18$ 53.90$ 66.62$ 79.34$ 92.05$ 104.77$ 117.49$ 130.21$ 50-59 27.09$ 51.17$ 75.24$ 99.31$ 123.39$ 147.46$ 171.53$ 195.61$ 219.68$ 243.75$ 60-69 41.55$ 80.07$ 118.60$ 157.13$ 195.65$ 234.18$ 272.71$ 311.24$ 349.76$ 388.29$

1 1 1 1 TOBACCO - Spouse 1 1 1 1

Issue Age $5,000 $7,500 $10,000 $12,500 $15,000 $17,500 $20,000 $22,500 $25,000

18-29 6.59$ 8.38$ 10.16$ 11.95$ 13.73$ 15.52$ 17.30$ 19.09$ 20.88$ 30-39 9.49$ 12.72$ 15.95$ 19.18$ 22.42$ 25.65$ 28.88$ 32.11$ 35.35$ 40-49 15.74$ 22.10$ 28.46$ 34.82$ 41.18$ 47.54$ 53.90$ 60.26$ 66.62$ 50-59 27.09$ 39.13$ 51.17$ 63.20$ 75.24$ 87.28$ 99.31$ 111.35$ 123.39$ 60-69 41.55$ 60.81$ 80.07$ 99.34$ 118.60$ 137.86$ 157.13$ 176.39$ 195.65$

Base Plan: Riders: Provisions: Group Attributes:

-With Cancer Benefit -Optional Benefits Rider (BTAP) -No Pre-Existing Condition Limitation -Situs State: TX

-$100 Health Screening Benefit -Progressive Diseases Rider -Add'l Separation Waiting Period: 6 Months -Eligible Lives: 850

-$250 Skin Cancer Benefit -Re-Separation Waiting Period: 6 Months

-With Additional Benefits -Benefit Reduction at Age 70

(Loss of Sight, Speech, Hearing) -Standard Portability

(Coma, Burns, Paralysis) -Rate Guarantee: 2 Years

Please Note: Premiums shown are accurate as of publication. They are subject to change.

Published: Mar-16 Series C21000

Group Critical Illness Advantage

CI21000-160303-134457-F3zii3Fw-037Yj4H-02202

Corsicana ISD - Monthly (12pp/yr) Rates

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AFLAC Hospital Indemnity

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IV (2/16)AG80075M R1

Aflac Group Hospital Indemnity INSURANCE

Even a small trip to the hospital can have a major impact on your finances.

Here’s a way to help make your visit a little more affordable.

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Page 18: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

The plan that can help with expenses and protect your savings.

Does your major medical insurance cover all of your bills?

Even a minor trip to the hospital can present you with unexpected expenses and medical bills. And even with major medical insurance, your plan may only pay a portion of your entire stay.

That’s how the Aflac Group Hospital Indemnity plan can help.

It provides financial assistance to enhance your current coverage. So you may be able to avoid dipping into savings or having to borrow to address out-of-pocket-expenses major medical insurance was never intended to cover. Like transportation and meals for family members, help with child care, or time away from work, for instance.

The Aflac Group Hospital Indemnity plan benefits include the following:

• Hospital Confinement Benefit

• Hospital Admission Benefit

• Hospital Intensive Care Benefit

• Intermediate Intensive Care Step-Down Unit

AFLAC GROUP HOSPITAL INDEMNITY HIG

Policy Series C80000

How it works

The plan has limitations and exclusions that may affect benefits payable. This brochure is for illustrative purposes only. Refer to your certificate for complete details, definitions, limitations, and exclusions.

The Aflac Group

Hospital Indemnity plan is selected.

The insured has a high fever and

goes to the emergency

room.

The physician admits the insured into the hospital.

The insured is released after two

days.

The Aflac Group Hospital Indemnity plan pays

$1,300Amount payable was generated based on benefit amounts for: Hospital Admission ($1,000), and Hospital Confinement ($150 per day).

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BENEFIT AMOUNT

HOSPITAL ADMISSION BENEFIT per confinement (once per covered sickness or accident per calendar year for each insured)Payable when an insured is admitted to a hospital and confined as an in-patient because of a covered accidental injury or covered sickness. We will not pay benefits for confinement to an observation unit, or for emergency room treatment or outpatient treatment.

$1,000

HOSPITAL CONFINEMENT per day (maximum of 31 days per confinement for each covered sickness or accident for each insured)Payable for each day that an insured is confined to a hospital as an in-patient as the result of a covered accidental injury or covered sickness. If we pay benefits for confinement and the insured becomes confined again within six months because of the same or related condition, we will treat this confinement as the same period of confinement. This benefit is payable for only one hospital confinement at a time even if caused by more than one covered accidental injury, more than one covered sickness, or a covered accidental injury and a covered sickness.

$150

HOSPITAL INTENSIVE CARE BENEFIT per day (maximum of 10 days per confinement for each covered sickness or accident for each insured) Payable for each day when an insured is confined in a Hospital Intensive Care Unit because of a covered accidental injury or covered sickness. We will pay benefits for only one confinement in a Hospital's Intensive Care Unit at a time. Once benefits are paid, if an insured becomes confined to a Hospital's Intensive Care Unit again within six months because of the same or related condition, we will treat this confinement as the same period of confinement.

This benefit is payable in addition to the Hospital Confinement Benefit.

$150

INTERMEDIATE INTENSIVE CARE STEP-DOWN UNIT per day (maximum of 10 days per confinement for each covered sickness or accident for each insured)Payable for each day when an insured is confined in an Intermediate Intensive Care Step-Down Unit because of a covered accidental injury or covered sickness. We will pay benefits for only one confinement in an Intermediate Intensive Care Step-Down Unit at a time.

Once benefits are paid, if an insured becomes confined to a Hospital's Intermediate Intensive Care Step-Down Unit again within six months because of the same or related condition, we will treat this confinement as the same period of confinement.

This benefit is payable in addition to the Hospital Confinement Benefit.

$75

Benefits Overview

LIMITATIONS AND EXCLUSIONSEXCLUSIONSWe will not pay for loss due to:

• War – voluntarily participating in war, any act of war, or military conflicts, declared or undeclared, or voluntarily participating or serving in the military, armed forces, or an auxiliary unit thereto, or contracting with any country or international authority. (We will return the prorated premium for any period not covered by the certificate when the insured is in such service.) War also includes voluntary participation in an insurrection, riot, civil commotion or civil state of belligerence. War does not include acts of terrorism.

• Suicide – committing or attempting to commit suicide, while sane or insane. • Self-Inflicted Injuries – injuring or attempting to injure oneself intentionally. • Racing – riding in or driving any motor-driven vehicle in a race, stunt show or speed

test in a professional or semi-professional capacity. • Illegal Occupation – voluntarily participating in, committing, or attempting to commit

a felony or illegal act or activity, or voluntarily working at, or being engaged in, an illegal occupation or job.

• Sports – participating in any organized sport in a professional or semi-professional capacity.

• Custodial Care – this is non-medical care that helps individuals with the basic tasks of everyday life, the preparation of special diets, and the self-administration of medication which does not require the constant attention of medical personnel.

• Treatment for being overweight, gastric bypass or stapling, intestinal bypass, and any related procedures, including any resulting complications.

• Services performed by a family member. • Services related to sex or gender change, sterilization, in vitro fertilization, vasectomy

or reversal of a vasectomy, or tubal ligation. • Elective Abortion – an abortion for any reason other than to preserve the life of the

person upon whom the abortion is performed. • Dental Services or Treatment. • Cosmetic Surgery, except when due to:

− Reconstructive surgery, when the service is related to or follows surgery resulting from a Covered Accidental Injury or a Covered Sickness, or is related to or results from a congenital disease or anomaly of a covered dependent child.

− Congenital defects in newborns.

HIG

In order to receive benefits for accidental injuries due to a covered accident, an insured must be admitted within six months of the date of the covered accident.

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Page 20: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

Continental American Insurance Company (CAIC ), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. CAIC is not licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands.

Continental American Insurance Company • Columbia, South Carolina

The certificate to which this sales material pertains is written only in English; the certificate prevails if interpretation of this material varies. This brochure is a brief description of coverage and is not a contract. Benefits, terms, and conditions may vary by state.

This brochure is subject to the terms, conditions, and limitations of Policy Series C80000.

TERMS YOU NEED TO KNOWA Covered Accident is an accident that occurs on or after an insured’s effective date while coverage is in force, and that is not specifically excluded by the plan.Dependent means your spouse or dependent children, as defined in the applicable rider, who have been accepted for coverage. Spouse is your legal wife, husband, or partner in a legally recognized union. Refer to your certificate for details. Dependent Children are your or your spouse’s natural children, step-children, grandchildren who are in your legal custody and residing with you, foster children, children subject to legal guardianship, legally adopted children, or children placed for adoption. Newborn children are automatically covered from the moment of birth for 60 days. Newly adopted children are automatically covered for 60 days also. See certificate for details. Dependent children must be younger than age 26, however this limit will not apply to any insured dependent child who is incapable of self-sustaining employment due to mental or physical handicap and is chiefly dependent on a parent for support and maintenance. Doctor is a person who is duly qualified as a practitioner of the healing arts acting within the scope of his license, and: is licensed to practice medicine; prescribe and administer drugs; or to perform surgery, or is a duly qualified medical practitioner according to the laws and regulations in the state in which treatment is made.A Doctor does not include you or any of your Family Members. For the purposes of this definition, Family Member includes your spouse as well as the following members of your immediate family: son, daughter, mother, father, sister, or brother.A Hospital is not a nursing home; an extended care facility; a skilled nursing facility; a rest home or home for the aged; a rehabilitation facility; a facility for the treatment of

alcoholism or drug addiction; an assisted living facility; or any facility not meeting the definition of a Hospital as defined in the certificate.A Hospital Intensive Care Unit is not any of the following step-down units: a progressive care unit; a sub-acute intensive care unit; an intermediate care unit; a private monitored room; a surgical recovery room; an observation unit; or any facility not meeting the definition of a Hospital Intensive Care Unit as defined in the certificateSickness means an illness, infection, disease, or any other abnormal physical condition or pregnancy that is not caused solely by, or the result of, any injury. A Covered Sickness is one that is not excluded by name, specific description, or any other provision in this plan. For a benefit to be payable, loss arising from the covered sickness must occur while the applicable insured’s coverage is in force.Treatment is the consultation, care, or services provided by a doctor. This includes receiving any diagnostic measures and taking prescribed drugs and medicines. Treatment does not include telemedicine services.You May Continue Your CoverageYour coverage may be continued with certain stipulations. See certificate for details.Termination of CoverageYour insurance may terminate when the plan is terminated; the 31st day after the premium due date if the premium has not been paid; or the date you no longer belong to an eligible class. If your coverage terminates, we will provide benefits for valid claims that arose while your coverage was in force.

NOTICESIf this coverage will replace any existing individual policy, please be aware that it may be in your best interest to maintain your individual guaranteed-renewable policy.

Continental American Insurance Company is not aware of whether you receive benefits from Medicare, Medicaid, or a state variation. If you or your dependents are subject to Medicare, Medicaid, or a state variation, any and all benefits under this plan could be assigned. This means that you may not receive any of the benefits in the plan. As a result, you should please check the coverage in all health insurance policies you already have or may have before you buy this insurance to verify the absence of any assignments or liens.

Notice to Consumer: The coverages provided by Continental American Insurance Company (CAIC) represent supplemental benefits only. They do not constitute comprehensive health insurance coverage and do not satisfy the requirement of minimum essential coverage under the Affordable Care Act. CAIC coverage is not intended to replace or be issued in lieu of major medical coverage. It is designed to supplement a major medical program.

19

Page 21: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

AFLAC GROUP HOSPITAL INDEMNITY INSURANCEPolicy Series C80000 HIG

AG80075HSB R1 I V (2 /16 )

For a complete list of limitations and exclusions please refer to the brochure.

Continental American Insurance Company (CAIC), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. CAIC is not licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands.

COVERED HEALTH SCREENING TESTS INCLUDE, BUT ARE NOT LIMITED TO:

• Blood test for triglycerides • Bone marrow testing • Breast ultrasound • CA 15-3 (blood test for breast cancer) • CA 125 (blood test for ovarian cancer) • CEA (blood test for colon cancer) • Chest X-ray • Colonoscopy • DNA stool analysis • Fasting blood glucose test • Flexible sigmoidoscopy • Non-diagnostic vascular screening • Immunization

• Hemoccult stool analysis • Mammography • Pap smear • PSA (blood test for prostate cancer) • Serum cholesterol test to determine level of

of HDL and LDL • Serum protein electrophoresis (blood test

for myeloma) • Spiral CT screening for lung cancer • Stress test on a bicycle or treadmill • Thermography • Urinalysis • Vision screening

The Health Screening Benefit is payable once per calendar year for health screening tests performed as the result of preventive care, including tests and diagnostic procedures ordered in connection with routine examinations.

This benefit is payable for each insured.

H E A L T H S C R E E N I N G B E N E F I T / $50 P E R C A L E N D A R Y E A R

Residents of Massachusetts are not eligible for the Health Screening Benefit.

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Page 22: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

$24.50

$44.90

$36.60

$57.00

Hospitalization Category:$1,000

$150

$150

$75

$50

Provisions: Group Attributes:Waiver of Pre-existing Conditions Exclusion Situs State: TX

Waiver of Pregnancy Exclusion Group Size: 850

Waiver of Mental and Emotional Disorders Exclusion

No Issue Age or Termination Age Limitations

Rate Guarantee: 2 years

Portability: Standard

Please note: Premiums shown are accurate as of publication. They are subject to change.

Published: Apr-16 Series C80000 - TX HI80000-160419-170123-028T2AhY-5Pxv75fB-16772 Product Code: HI160419-170123

Employee

Employee & Dependent Spouse

Employee & Dependent Child(ren)

Family

RatesCoverage

Corsicana - Monthly (12pp/yr)

Group Hospital Indemnity

Hospital Admission

Hospital Confinement

Hospital Intensive Care Unit

Health Screening Benefit

Intermediate I.C. Step-Down Unit

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Page 23: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

AFA

Disability

22

Page 24: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

Enhanced Disability Income Plan

Coverage Options · Benefits Paid Directly to You · Excellent Customer Service · Learn More » »

LONG-TERM DISABILITYIncome Insurance

First Financial Capital Corporation P.O. Box 670329 • Houston, TX 77267-0329

Local (281) 847-8422 | Toll Free (800) 523-8422 www.ffga.com

Marketed by:

Underwritten by: American Fidelity Assurance Company

Underwritten and administered by:

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Page 25: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

Disabilities Happen. Are You Prepared?What would you do if you experienced a disability today and your paycheck suddenly stopped? Nearly 70% of American employees live paycheck to paycheck1, staying current on bill payments, but not preparing for the loss of that valuable income.

“I’ll use my sick leave or savings.”

68%

68% of American employees live from paycheck to paycheck.1

1/3 of Americans entering the work force today will become disabled before they retire.2

“I don’t have a significant risk of being disabled.”

Ready To Learn More?Contact your First Financial Account Representative for more details or to schedule a one-on-one appointment.

Think It Couldn’t Happen to You?

Know The Facts:

1 Reuters. “More than two-thirds in U.S. live paycheck to paycheck: survey,” September 19, 2012. 2”Chances of Disability: Overview.” Council for Disability Awareness. 2010. Web. 24 Mar. 2011

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Page 26: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

Find the plan that’s best for you! 1. Locate your current salary and review the monthly benefit offered based on your income.2. Review Elimination Period and Premium columns to choose the one that best fits your needs.3. See your First Financial Representative to enroll in your plan!

SALARY BENEFIT ELIMINATION PERIOD/MONTHLY PREMIUM

Annual Salary Monthly Salary*

Monthly Disability Benefit**

Accidental Death

Benefit

14 day Elimination

Period

30 day Elimination

Period

60 day Elimination

Period

90 day Elimination

Period

150 day Elimination

Period

$3,432.00 - $5,147.99 $286.00 - $428.99 $200.00 $20,000.00 $7.28 $5.80 $4.92 $4.16 $3.12

$5,148.00 - $6,863.99 $429.00 - $571.99 $300.00 $20,000.00 $10.92 $8.70 $7.38 $6.24 $4.68

$6,864.00 - $8,579.99 $572.00 - $714.99 $400.00 $20,000.00 $14.56 $11.60 $9.84 $8.32 $6.24

$8,580.00 - $10,295.99 $715.00 - $857.99 $500.00 $20,000.00 $18.20 $14.50 $12.30 $10.40 $7.80

$10,296.00 - $11,999.99 $858.00 - $999.99 $600.00 $20,000.00 $21.84 $17.40 $14.76 $12.48 $9.36

$12,000.00 - $13,715.99 $1,000.00 - $1,142.99 $700.00 $20,000.00 $25.48 $20.30 $17.22 $14.56 $10.92

$13,716.00 - $15,431.99 $1,143.00 - $1,285.99 $800.00 $20,000.00 $29.12 $23.20 $19.68 $16.64 $12.48

$15,432.00 - $17,147.99 $1,286.00 - $1,428.99 $900.00 $20,000.00 $32.76 $26.10 $22.14 $18.72 $14.04

$17,148.00 - $18,863.99 $1,429.00 - $1,571.99 $1,000.00 $20,000.00 $36.40 $29.00 $24.60 $20.80 $15.60

$18,864.00 - $20,579.99 $1,572.00 - $1,714.99 $1,100.00 $20,000.00 $40.04 $31.90 $27.06 $22.88 $17.16

$20,580.00 - $22,295.99 $1,715.00 - $1,857.99 $1,200.00 $20,000.00 $43.68 $34.80 $29.52 $24.96 $18.72

$22,296.00 - $23,999.99 $1,858.00 - $1,999.99 $1,300.00 $20,000.00 $47.32 $37.70 $31.98 $27.04 $20.28

$24,000.00 - $25,715.99 $2,000.00 - $2,142.99 $1,400.00 $20,000.00 $50.96 $40.60 $34.44 $29.12 $21.84

$25,716.00 - $27,431.99 $2,143.00 - $2,285.99 $1,500.00 $20,000.00 $54.60 $43.50 $36.90 $31.20 $23.40

$27,432.00 - $29,147.99 $2,286.00 - $2,428.99 $1,600.00 $20,000.00 $58.24 $46.40 $39.36 $33.28 $24.96

$29,148.00 - $30,863.99 $2,429.00 - $2,571.99 $1,700.00 $20,000.00 $61.88 $49.30 $41.82 $35.36 $26.52

$30,864.00 - $32,579.99 $2,572.00 - $2,714.99 $1,800.00 $20,000.00 $65.52 $52.20 $44.28 $37.44 $28.08

$32,580.00 - $34,295.99 $2,715.00 - $2,857.99 $1,900.00 $20,000.00 $69.16 $55.10 $46.74 $39.52 $29.64

$34,296.00 - $35,999.99 $2,858.00 - $2,999.99 $2,000.00 $20,000.00 $72.80 $58.00 $49.20 $41.60 $31.20

$36,000.00 - $37,715.99 $3,000.00 - $3,142.99 $2,100.00 $20,000.00 $76.44 $60.90 $51.66 $43.68 $32.76

$37,716.00 - $39,431.99 $3,143.00 - $3,285.99 $2,200.00 $20,000.00 $80.08 $63.80 $54.12 $45.76 $34.32

$39,432.00 - $41,147.99 $3,286.00 - $3,428.99 $2,300.00 $20,000.00 $83.72 $66.70 $56.58 $47.84 $35.88

$41,148.00 - $42,863.99 $3,429.00 - $3,571.99 $2,400.00 $20,000.00 $87.36 $69.60 $59.04 $49.92 $37.44

$42,864.00 - $44,579.99 $3,572.00 - $3,714.99 $2,500.00 $20,000.00 $91.00 $72.50 $61.50 $52.00 $39.00

$44,580.00 - $46,295.99 $3,715.00 - $3,857.99 $2,600.00 $20,000.00 $94.64 $75.40 $63.96 $54.08 $40.56

$46,296.00 - $47,999.99 $3,858.00 - $3,999.99 $2,700.00 $20,000.00 $98.28 $78.30 $66.42 $56.16 $42.12

$48,000.00 - $49,715.99 $4,000.00 - $4,142.99 $2,800.00 $20,000.00 $101.92 $81.20 $68.88 $58.24 $43.68

$49,716.00 - $51,431.99 $4,143.00 - $4,285.99 $2,900.00 $20,000.00 $105.56 $84.10 $71.34 $60.32 $45.24

$51,432.00 - $53,147.99 $4,286.00 - $4,428.99 $3,000.00 $20,000.00 $109.20 $87.00 $73.80 $62.40 $46.80

$53,148.00 - $54,863.99 $4,429.00 - $4,571.99 $3,100.00 $20,000.00 $112.84 $89.90 $76.26 $64.48 $48.36

$54,864.00 - $56,579.99 $4,572.00 - $4,714.99 $3,200.00 $20,000.00 $116.48 $92.80 $78.72 $66.56 $49.92

$56,580.00 - $58,295.99 $4,715.00 - $4,857.99 $3,300.00 $20,000.00 $120.12 $95.70 $81.18 $68.64 $51.48

$58,296.00 - $59,999.99 $4,858.00 - $4,999.99 $3,400.00 $20,000.00 $123.76 $98.60 $83.64 $70.72 $53.04

$60,000.00 - $61,715.99 $5,000.00 - $5,142.99 $3,500.00 $20,000.00 $127.40 $101.50 $86.10 $72.80 $54.60

$61,716.00 - $63,431.99 $5,143.00 - $5,285.99 $3,600.00 $20,000.00 $131.04 $104.40 $88.56 $74.88 $56.16

$63,432.00 - $65,147.99 $5,286.00 - $5,428.99 $3,700.00 $20,000.00 $134.68 $107.30 $91.02 $76.96 $57.72

$65,148.00 - $66,863.99 $5,429.00 - $5,571.99 $3,800.00 $20,000.00 $138.32 $110.20 $93.48 $79.04 $59.28

$66,864.00 - $68,579.99 $5,572.00 - $5,714.99 $3,900.00 $20,000.00 $141.96 $113.10 $95.94 $81.12 $60.84

$68,580.00 - $70,295.99 $5,715.00 - $5,857.99 $4,000.00 $20,000.00 $145.60 $116.00 $98.40 $83.20 $62.40

* Higher benefit amounts available up to a maximum Monthly Disability Benefit of $7,500. Ask your First Financial Representative for details.** Not to exceed 70% of your covered monthly compensation.

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Page 27: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

ACCIDENTAL DEATH BENEFITA lump sum of $20,000.00 will be paid if you die as the direct result of an Injury and death occurs within 90 days after the Injury.

The benefit will be increased 1% for each full month that your Certificate was continuously in force just prior to death. The total increase shall not be more than 60% of the benefit amount.

DIRECT DEPOSIT DISABILITY BENEFITSIn the event you choose the direct deposit option on an approved claim, we will deposit your benefits directly into your bank account at no additional cost. This can accelerate access to your benefits by several days. We also have a toll-free fax that allows you instant transmission of your claim forms to our Benefits Department.

DONOR BENEFITIf you are Disabled as a result of being an organ or tissue donor, we will pay your benefit as any other Sickness under the terms of the plan.

FAMILY CARE BENEFITIf you are Disabled and Working, qualify to receive a Disability Payment from us, and have one or more eligible family members, you may be eligible to receive a Family Care Benefit. This may include payment for the care of an eligible family member by a licensed childcare provider or licensed caregiver who is not related to you by blood or marriage. We will provide a Family Care Benefit for expenses incurred of up to 25% of your monthly Disability Benefit provided the total of your Disability Earnings, the gross Disability Benefit, and the Family Care Benefit do not exceed 100% of your Monthly Compensation. Payment of the Family Care Benefit will end on the earlier of the following: the date you no longer incur Family Member expenses; or the date you no longer qualify as Disabled and Working; or the date Disabled and Working benefits have been paid for a total of 24 months.

HOSPITAL CONFINEMENT BENEFITThe Hospital Confinement Benefit will not begin until the elimination period has been satisfied and will pay up to 60 days. The Hospital Confinement Benefit will be paid each day the insured is confined as a patient in a Hospital due to an Injury or Sickness. The amount payable is one times the Disability Benefit which will be pro-rated on a daily basis. This benefit is not reduced by Deductible Sources of Income. The Hospital Confinement must be at least 18 hours of continuous duration.

PHYSICIAN EXPENSE BENEFIT

» Injury - $150.00 per Injury

» Sickness - $50.00

If you need personal treatment by a Physician due to an Injury or Sickness, we will pay the amount shown above provided no other claim has been paid under the Policy. This benefit will be paid for Sickness only if the treatment is received during one full day of Disability during which you missed one full day of work. To be eligible for more than one payment for

the same or related condition due to Sickness, you must have returned to Active Employment for at least 14 consecutive scheduled workdays. You are not required to miss one full day of work in order to receive the Injury benefit.

PORTABILITY CONVERSIONThe Conversion Plan will be a separate group plan with a 30 day elimination period and 2 year benefit period. Certain other qualifications may apply. A brochure is available for this plan upon request after termination.

RETURN TO WORK INCENTIVE BENEFIT: DISABLED WHILE WORKINGWe will provide a Disability Payment if you are Disabled and your monthly Disability Earnings, if any, are less than 20% of your Monthly Compensation due to the same Disability.

If you are Disabled and your Disability Earnings are greater than 20% of your Monthly Compensation due to the same Disability, we will figure your payment as follows:

During the first 24 months of payments while Disabled and Working:

» Your Disability Payment will not be reduced as long as the Disability Earnings plus the gross Disability Benefit does not exceed 80% of your Monthly Compensation.

» If the Disability Earnings plus the gross Disability Benefit exceeds 80% of your Monthly Compensation, the Disability Payment will be reduced by the amount exceeding 80% of your Monthly Compensation.

After 24 months of payments, while Disabled and Working, you will receive payments based on the percentage of Monthly Compensation you are losing due to Lost Earnings based on your Disability.

We will stop payments and your claim will end, if at any time you are no longer Disabled or if your Disability Earnings exceed 80% of your Monthly Compensation. The Elimination Period cannot be satisfied with days you are Disabled and Working.

SOCIAL SECURITY FILING ASSISTANCEIf we determine you are a likely candidate for Social Security Disability benefits, we can assist you with the application and appeal process.

SPECIAL CONDITIONS LIMITED BENEFITThe Special Conditions Limited Benefit provides a benefit up to 2 years, due to Special Conditions if you are disabled and under the regular and appropriate care of your physician. Special Conditions means: Chronic Fatigue Syndrome; Fibromyalgia; Any disease, disorder, accident or injury of the neck or back not resulting in hemiplegia, paraplegia or quadriplegia; Environmental allergic illness including, but not limited to sick building syndrome and multiple chemical sensitivity; and Self-reported symptoms. Self-reported symptoms are symptoms that the insured tells their physician that are not verifiable using tests, procedures or clinical examinations. Examples include: headaches, pain, fatigue, stiffness, soreness, ringing in ears, dizziness, numbness, or loss of energy.

Plan Features

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Page 28: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

SUCCESSIVE DISABILITIESDisabilities which result from the same or related causes will be considered one period of Disability unless the Disabilities are separated by your return to Active Employment or any other gainful occupation for at least 3 consecutive months.

WAIVER OF PREMIUMNo premium payments are required while you are receiving payments under the plan after Disability Payments have been received under the plan for 180 consecutive days. We will require proof on an annual basis that you remain Disabled during this time.

WORKSITE ACCOMMODATIONAs part of our claims evaluation process, if worksite modifications may assist your return to work, we will evaluate your claim for appropriate action.

Important Policy ProvisionsELIGIBILITYAll permanent employees in subscribing group working 20 hours or more per week. Proof of good health may be required by us in order to be eligible for disability coverage. We will rely on answers given on your application to determine if coverage can be issued. Regardless of your health at the time of application, if coverage is approved and issued, claims incurred while coverage is in force will be subject to all terms of the Policy including any Pre-Existing Condition limitation.

WHEN COVERAGE BEGINSCertificates will become effective on the requested effective date following the date we approve the application, providing you are on Active Employment and premium has been paid.

IF YOU ARE DISABLED DUE TO A COVERED DISABILITY AND NOT WORKINGYour Disability Payment will be the Disability Benefit described in the Benefit Schedule less any Deductible Sources of Income you receive or are entitled to receive. No Disability Payment will be provided for any period in which you are not under the regular and appropriate care of a physician.

OFFSETS WITH OTHER SOURCES OF INCOME Deductible Sources of Income include:

» Other group disability income.

» Governmental or other retirement system, whether due to Disability, normal retirement or voluntary election of retirement benefits.

» United States Social Security Act or similar plan or act, including any amounts due your dependent(s) on account of your Disability.

» State Disability.

» Unemployment compensation.

» Sick leave or other salary or wage continuance plans provided by the Employer which extend beyond 60 (14, 30, 60 day Elimination Periods), 90 (on 90 day Elimination Period) and 150 (on 150 day Elimination Period) calendar days from the Date of Disability.

We reserve the right to estimate these Deductible Sources of Income that you may receive as defined in your Certificate.

MINIMUM DISABILITY BENEFITThe minimum Monthly Disability Benefit is 10% of the Monthly Disability Benefit or $100.00, whichever is greater.

INCREASE OF INCOME DUE TO COST OF LIVING ADJUSTMENTSThe Disability Payment will not be reduced due to a cost of living increase if the increase from a Deductible Source of Income takes effect after the onset of Disability and while benefits are payable under the Policy.

MENTAL ILLNESS LIMITED BENEFITIf you are Disabled due to a mental illness, regardless of the cause, Disability Payments will be provided for up to 2 years, not to exceed the Maximum Disability Period.

ALCOHOLISM AND DRUG ADDICTION LIMITED BENEFIT If you are disabled due to alcoholism or drug addiction, a limited benefit of up to 15 days for each Disability will be paid. Benefits will not be paid beyond the Maximum Benefit Period. If drug addiction is sustained at the hands of, or while under the regular and appropriate care of a physician in the course of treatment for Injury or Sickness, it will be covered the same as any other Sickness.

PRE-EXISTING CONDITION LIMITATIONA limited benefit up to 1 month’s Disability Benefit will be payable for Disability caused by or resulting from a Pre-Existing Condition. This provision will not apply if you have:

» gone treatment-free;

» incurred no expense;

» taken no medication; and

» received no diagnosis or advice from a Physician,

for 12 consecutive months for such condition(s).

This limitation will not apply to a Disability resulting from a Pre-Existing Condition that begins after you have been continuously covered under the Policy for 24 months.

Any increase in benefits will be subject to this Pre-Existing Condition limitation. A new Pre-Existing Condition period must be satisfied with respect to any increase applied for and approved by us.

EXCLUSIONSThe Policy does not cover any loss, fatal or non-fatal, resulting from:

» Intentionally self-inflicted injury while sane or insane.

» An act of war, declared or undeclared.

» Injury sustained or Sickness contracted while in the service of the armed forces of any country.27

Page 29: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

» Committing a felony.

» Penal incarceration. We will not pay benefits for Disability or any other loss during any period for which you are incarcerated in a penal or correctional institution for a period of 30 consecutive days or longer.

» Injury or Sickness arising out of and in the course of any occupation for wage or profit or for which you are entitled to Workers’ Compensation*.

*The term “entitled to Workers’ Compensation” shall also include Workers’ Compensation claim settlements that occur via compromise and release. Further, no benefits will be paid under this Policy for any period during which you are entitled to Workers’ Compensation benefits.

LEAVE OF ABSENCEYour coverage may be continued for up to 1 year during a Leave of Absence approved in writing by your Employer.

TERMINATION OF INSURANCEYour insurance coverage will end on the earliest of these dates:

» the date you do not meet the Eligibility requirements as defined in the Eligibility paragraph in this brochure;

» the date you retire;

» the date you cease to be on Active Employment, except as provided for under the Leave of Absence provision;

» the end of the last period for which premium has been paid;

» the date the Policy is discontinued; or

» the date your employment terminates.If:

» your coverage ends as a result of your termination of Active Employment;

» such termination is caused by an Injury or Sickness for which Disability Benefits would be payable; and

» Disability is established prior to the termination of Active Employment,

then:

Disability Benefits will be paid as if such termination had not occurred.

Termination of the Policy will have no affect on Disability Payments which began before termination. We may end your coverage if you submit a fraudulent claim. Your coverage can be terminated or premiums may be increased on any premium due date with 31 days advance notice.

DEFINITIONSACTIVE EMPLOYMENT: Means you are doing in the usual manner all of the regular duties of your employment on a full-time basis on a scheduled work day and these duties are being done at one of the places of business where you normally do such duties or at some location to which your employment sends you. You will be said to be on Active Employment on a day which is not a scheduled work day only if you are not Disabled and would be able to perform in the usual manner all the regular duties of your employment if it were a scheduled work day.

DISABILITY: Disability or Disabled for the first 12 months of Disability means that you are unable to perform the material and substantial duties of your Regular Occupation. After that, Disability means you are unable to perform the material and substantial duties of any Gainful Occupation for wage or profit for which you are reasonably qualified by training, education, or experience.

DISABILITY EARNINGS: Means the gross monthly earnings you receive while Disabled and Working.

DISABILITY PAYMENT: Means your Disability Benefit minus Deductible Sources of Income.

ELIGIBLE FAMILY MEMBERS: With regards to the Family Care Benefit, this means your child (natural, step, or adopted) living in your household and under age 13; or your family member who is:

» living in your household;

» dependent upon you for support; and

» in need of supervision or assistance due to physical or mental incapacity.

HOSPITAL: The term “Hospital” shall not include an institution used by you as:

» a place for rehabilitation;

» a place for rest or for the aged;

» a nursing or convalescent home;

» a long-term nursing unit or geriatrics ward; or

» as an extended care facility for the care of convalescent, rehabilitative, or ambulatory patients.

LOST EARNINGS: Means the percentage of Monthly Compensation you are losing due to your Disability while Disabled and Working. This is computed as follows:

» subtract your Disability Earnings from your Monthly Compensation;

» divide this answer by your Monthly Compensation. This will be your percentage of lost earnings. Multiply your Disability payment by your percentage of lost earnings.

MONTHLY COMPENSATION: Means for contracted employees, one-twelfth (1/12) of your contract salary through your Employer; or for non-contracted employees, one-twelfth (1/12) of your annual salary through your Employer, in effect on the date Disability began. It excludes any additional compensation including but not limited to, overtime pay, weekend or summer work compensation, bus or other allowances, bonuses or district-funded fringe benefits. If you become Disabled while on an approved leave of absence, we will use your gross Monthly Compensation from your Employer in effect just prior to the date your absence began.

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Marketed by: First Financial Group of AmericaPRE-EXISTING CONDITION: The term “Pre-Existing Condition” means a disease, Injury, Sickness, physical condition or mental illness for which you:

» had treatment;

» incurred expense;

» took medication;

» received care or services including diagnostic testing or related measures; or

» received a diagnosis or advice from a Physician,

during the 12-month period immediately before your Effective Date of coverage. The term Pre-Existing Condition will also include conditions which are related to such disease, Injury, Sickness, physical condition, or mental illness.

ELIMINATION PERIODPeriod of time you must be disabled before benefit payments begin.

BENEFITS BEGIN Benefits begin on the following days, upon satisfying any required elimination period.

14 Day Elimination Period: Benefits begin on the 15th day of Disability due to a covered Injury or Sickness. 30 Day Elimination Period: Benefits begin on the 31st day of Disability due to a covered Injury or Sickness. 60 Day Elimination Period: Benefits begin on the 61st day of Disability due to a covered Injury or Sickness. 90 Day Elimination Period: Benefits begin on the 91st day of Disability due to a covered Injury or Sickness. 150 Day Elimination Period: Benefits begin on the 151st day of Disability due to a covered Injury or Sickness.

BENEFITS ARE PAYABLE

Up to the period of time shown in the table below, based on your age as of the date Disability due to a covered Injury or Sickness begins.

If you reside in a state other than your employer’s state of domicile, where required by law, policy provisions and benefits may vary.

Age Maximum Benefit Period Less than age 60 To Social Security Normal Retirement Age (SSNRA)*

60 60 months, or to SSNRA*, whichever is greater

61 48 months, or to SSNRA*, whichever is greater

62 42 months, or to SSNRA*, whichever is greater

63 36 months, or to SSNRA*, whichever is greater

64 30 months, or to SSNRA*, whichever is greater

65 24 months, or to SSNRA*, whichever is greater

66 21 months, or to SSNRA*, whichever is greater

67 18 months, or to SSNRA*, whichever is greater

68 15 months, or to SSNRA*, whichever is greater

Age 69 or older 12 months, or to SSNRA*, whichever is greater

*Age at which you are entitled to unreduced Social Security benefits based on current Social Security Amendments.

Disability Income Insurance Can Help! Ask Your First Financial Account

Representative For More Details.

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SB-29298(FF)(ENHANCED)-0316 G-120-TX-100-060; MCH#1309; 014405-8, 014406-9, 014407-10, 014408-11, 014410-12

PLAN HIGHLIGHTS

Please review the full benefit definition of each section above under “Plan Features” inside this brochure for plan details, limitations and exclusions.

» Effective DateYour Effective Date is different than the date you sign your application. Your Effective Date of coverage is the date shown on your certificate. Please be sure to view your group certificate to understand when your coverage begins upon approval of application it can either be mailed to you or you can receive an email with a link to view securely online.

» Hospital Confinement Benefit Pays an immediate benefit each day you are confined to a hospital for an injury or sickness, and will not begin until the elimination period has been satisfied. Benefit will pay up to 60 days.

» Limitations and ExclusionsThis policy has limitations and/or exclusions to select benefits during certain situations, including self inflicted injury, an act of war, injuries contracted not to cover any loss, fatal or non-fatal, resulting from while serving in the armed forces, while committing a felony or during penal incarceration, or an injury or sickness in which you are entitled to Workers’ Compensation.

» Physicians Expense BenefitReceive a benefit if you receive treatment by a Physician due to a covered Injury.

» Pre-Existing Means a disease, Injury, Sickness, physical condition or mental illness that received medical advice or treatment prior to enrollment in a new disability insurance plan.

» OffsetsIf applicable, your disability benefit will be reduced by deductible sources of Income that include, but are not limited to:

» Salary Increases Your Monthly Disability Benefit does not automatically increase if you have an increase in pay! It is important to notify your Account Manager when applying for a new, higher benefit that is aligned with your current income.

» Waiver of PremiumPremiums may be waived while you are disabled based on the length of your disability and the plan selected.

• other group disability income benefits;• government or retirement system benefits; • Social Security benefits (if applicable in your

state), including any amounts due to your dependent(s) on account of your disability;

» Sick leave or other salary or wage continuance plans provided by the Employer which extend beyond 60 (14, 30, 60 day Elimination Periods), 90 (on 90 day Elimination Period) and 150 (on 150 day Elimination Period) calendar days from the Date of Disability.

9000 Cameron ParkwayOklahoma City, Oklahoma 73114

800-654-8489www.americanfidelity.com

Underwritten and administered by:Sign up for online secured access to view and print your

policies at americanfidelity.com. American Fidelity’s Online Service Center provides you convenient,

secure 24/7 access to your detailed certificate. We understand your privacy is important so we will not use your e-mail address for

solicitation purposes.

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AFA

Accident

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»

»

»

»

»

»

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2000 N. Classen Boulevard • Oklahoma City, Oklahoma 73106 • 800-654-8489 • www.americanfidelity.com

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Superior

Vision

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Vision Plan Benefits for Corsicana ISD

Co-Pays Monthly Premiums Services/Frequency

Exam $10 Emp. only $7.43 Exam 12 months

Materials $25 Emp. + spouse $12.65 Frame 24 months

Emp. + child(ren) $13.35 Lenses 12 months

Emp. + family $20.07 Contact Lenses 12 months

(Based on date of service)

Benefits In-Network Out-of-Network

Exam Covered in full Up to $35 retail Frames $125 retail allowance Up to $70 retail Lenses (standard) per pair

Single Vision Covered in full Up to $25 retail Bifocal Covered in full Up to $40 retail Trifocal Covered in full Up to $45 retail Progressive See description1 Up to $45 retail Lenticular Covered in full Up to $80 retail

Contact Lenses2 $150 retail allowance Up to $80 retail Medically Necessary Contact Lenses Covered in full Up to $150 retail Lasik Vision Correction $200 allowance3

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

Discount Features

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

.

The Plan discount features are not insurance. All allowances are retail; the member is responsible for paying the provider directly for all non-covered items and/or any amount over the allowances, minus available discounts. These are not covered by the plan. Discounts are subject to change without notice. Disclaimer: All final determinations of benefits, administrative duties, and definitions are governed by the Certificate of Insurance for your vision plan. Please check with your Human Resources department if you have any questions

SuperiorVision.com Customer Service

800.507.3800

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Ameritas

Dental

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FFGA TEXAS STATE SCHOOL PLAN

CORSICANA ISD Dental Highlight Sheet

Plan 1: Dental Plan Summary Policy # 36814 Effective Date: 9/1/2016

Plan Benefit

Type 1 100% Type 2 80% Type 3 50%

Deductible $5/visit Type 1

$50 Calendar Year Type 2,3

No Family Maximum

Maximum (per person) $1,000 per calendar year

Allowance Ameritas U&C

Dental Rewards® Included

Waiting Period Type 3 – 6 months

Orthodontia Summary - Child Only Coverage

Allowance U&C

Plan Benefit 50%

Lifetime Maximum (per person) $1,000

Waiting Period 6 months

Sample Procedure Listing (Current Dental Terminology © American Dental Association.)

Type 1 Type 2 Type 3

� 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)

� Space Maintainers

� Restorative Amalgams

� Restorative Composites

� Simple Extractions

� Onlays

� Crowns

(1 in 8 years per tooth)

� Crown Repair

� Endodontics (nonsurgical)

� Endodontics (surgical)

� Periodontics (nonsurgical)

� Periodontics (surgical)

� Denture Repair

� Implants

� Prosthodontics (fixed bridge; removable

complete/partial dentures)

(1 in 8 years)

� Complex Extractions

� Anesthesia

Monthly Rates

Employee Only (EE) $29.96

EE + Spouse $63.88

EE + Children $70.12

EE + Spouse & Children $103.96

Ameritas Information

We're Here to Help This plan was designed specifically for the associates of CORSICANA ISD. At Ameritas Group, we do more than provide coverage - we make sure there's always a friendly voice to explain your benefits, listen to your concerns, and answer your questions. Our customer relations associates will be pleased to assist you 7 a.m. to midnight (Central Time) Monday through Thursday, and 7 a.m. to 6:30 p.m. on Friday. You can speak to them by calling toll-free: 800-487-5553. For plan information any time, access our automated voice response system or go online to ameritas.com.

Dental Health Scorecard

How would you rate your dental health? In 2016, you can receive your Dental Health Report Card by signing into your secure member account online. Your assessment is based on claims submitted. The report card also offers suggestions if you strive to improve your dental health. Ameritas members can access the personalized report card by going to ameritas.com, click Account Access in the top right corner and choose the Dental/Vision/Hearing drop down. Select the Secure Member Account link and sign in to see your report.

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FFGA TEXAS STATE SCHOOL PLAN

CORSICANA ISD Dental Highlight Sheet

Rx Savings

Our valued plan members and their covered dependents (even their pets) can save on prescription medications through any Walmart or Sam's Club pharmacy across the nation. This Rx discount is offered at no additional cost, and it is not insurance. To receive the Walmart Rx discount, Ameritas plan members just need to visit us at ameritas.com and sign into (or create) a secure member account where they can access and print an online-only Rx discount savings ID card.

Eyewear Savings

Ameritas plan members may receive up to 15% off eyewear frames and lenses purchased at any Walmart Vision Center nationwide. Members may also bring in their current vision prescription from any vision care provider and purchase eyewear at Walmart. This savings arrangement is not insurance: it is available to members at no additional cost to their plan premium. To receive the eyewear savings identification card, Ameritas plan members can visit ameritas.com and sign-in (or create) a secure member account. Members must present the Ameritas Eyewear Savings Card at time of purchase to receive the discount.

Dental Rewards®

This dental plan includes a valuable feature that allows qualifying plan members to carryover part of their unused annual maximum. A member earns dental rewards by submitting at least one claim for dental expenses incurred during the benefit year, while staying at or under the threshold amount for benefits received for that year. Employees and their covered dependents may accumulate rewards up to the stated maximum carryover amount, and then use those rewards for any covered dental procedures subject to applicable coinsurance and plan provisions. If a plan member doesn't submit a dental claim during a benefit year, all accumulated rewards are lost. But he or she can begin earning rewards again the very next year.

Benefit Threshold $500 Dental benefits received for the year cannot exceed this amount

Annual Carryover Amount $250 Dental Rewards amount is added to the following year's maximum

Maximum Carryover $1,000 Maximum possible accumulation for Dental Rewards

Dental Network Information

To find a provider, visit ameritas.com and select FIND A PROVIDER, then DENTAL. Enter your criteria to search by location or for a specific dentist or practice. California Residents: When prompted to select your network, choose the Ameritas Network found on your ID Card or contact Customer Connections at 800-487-5553.

Pretreatment

While we don't require a pretreatment authorization form for any procedure, we recommend them for any dental work you consider expensive. As a smart consumer, it's best for you to know your share of the cost up front. Simply ask your dentist to submit the information for a pretreatment estimate to our customer relations department. We'll inform both you and your dentist of the exact amount your insurance will cover and the amount that you will be responsible for. That way, there won't be any surprises once the work has been completed.

Open Enrollment

If a member does not elect to participate when initially eligible, the member may elect to participate at the policyholder's next enrollment period. This enrollment period will be held each year and those who elect to participate in this policy at that time will have their insurance become effective on September 1.

Late Entrant Provision

We strongly encourage you to sign up for coverage when you are initially eligible. If you choose not to sign up during this initial enrollment period, you will become a late entrant. Late entrants will be eligible for only exams, cleanings, and fluoride applications for the first 12 months they are covered.

Section 125

This plan is provided as part of the Policyholder's Section 125 Plan. Each employee has the option under the Section 125 Plan of participating or not participating in this plan. If an employee does not elect to participate when initially eligible, he/she may elect to participate at the Policyholder's next Annual Election Period.

Language Services

We recognize the importance of communicating with our growing number of multilingual customers. That is why we offer a language assistance program that gives you access to: Spanish-speaking claims contact center representatives, telephone interpretation services in a wide range of languages, online dental network provider search in Spanish and a variety of Spanish documents such as enrollment forms, claim forms and certificates of insurance.

This document is a highlight of plan benefits provided by Ameritas Life Insurance Corp. as selected by your employer. It is not a certificate of insurance and does not include exclusions and limitations. For exclusions and limitations, or a complete list of covered procedures, contact your benefits administrator.

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Allstate

Cancer

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benefits and amounts

¹ Yearly

$0 $0.40/Mile $0.40/Mile

$0 $0.40/Mile $0.40/Mile

Physical or Speech Therapy (daily) $50 $50

New or Experimental Treatment (every 12 months) $5,000 $5,000

$100

Prosthesis (per amputation) $2,000 $2,000

$200

Waiver of Premium (primary insured only) Yes Yes

Hair Prosthesis (every 2 years)

Group Voluntary Cancer (Texas)

$25 $25

$50 $50Nonsurgical External Breast Prosthesis

$0 $0

Cancer Initial Diagnosis (one-time benefit) $2,000 $2,000

Intensive Care - Intensive Care Confinement (daily) $0 $200

$200

OPTIONAL BENEFITS $0 $0

Step-Down Confinement (daily) $0

Anti-Nausea Benefit (yearly)

Air/Surface Ambulance $0

#N/A #N/A #N/A

HOSPITAL AND RELATED BENEFITS OPTION 1 OPTION 2

Continuous Hospital Confinement (daily) $200 $200

Government or Charity Hospital (daily) $200 $200

Private Duty Nursing Services (daily) $200 $200

Extended Care Facility (daily) $200 $200

At Home Nursing (daily) $200 $200

Freestanding Hospice Care Center (daily) or $200 $200

Hospice Care Team (per visit) $200 $200

RADIATION, CHEMOTHERAPY, AND RELATED BENEFITS $0 $0 $0 $0

Radiation/Chemotherapy for Cancer (every 12 months) $10,000 $15,000

Blood, Plasma, and Platelets (every 12 months) $10,000 $15,000

Hematological Drugs (yearly) $200 $300

Medical Imaging (yearly) $500 $750

SURGERY AND RELATED BENEFITS $0 $0 $0 $0

Surgery (maximum, depending on surgery) $4,500 $4,500

Anesthesia (% of Surgery Benefit) 25% 25%

Ambulatory Surgical Center (daily) $750 $750

Second Opinion $600 $600

Bone Marrow or Stem Cell Transplant - Autologous¹ $1,500 $1,500

Non-autologous¹ $3,750 $3,750

Non-autologous for Leukemia¹ $7,500 $7,500

MISCELLANEOUS BENEFITS $0 $0 $0 $0

Inpatient Drugs and Medicine (daily) $25 $25

Physician’s Attendance (daily) $50 $50

Ambulance (per confinement) $100 $100

Non-Local Transportation (per trip or mile) Coach Fare or Coach Fare or

Actual Charges

#N/A #N/A #N/A #N/A #N/A

Wellness (yearly) $50 $50

Family Member Lodging (daily) and $50 $50

Transportation (per trip or mile) Coach Fare or Coach Fare or

Outpatient Lodging (daily, $2,000 max/12 months) $50 $50

#N/A #N/A

#N/A #N/A #N/A #N/A #N/A

#N/A #N/A #N/A #N/A #N/A

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Group Voluntary Cancer (Texas)

Premiums – Monthly

In addition to cancer, benefits (unless noted specifically for cancer) are also payable for: Muscular Dystrophy, Amyotrophic

Lateral Sclerosis (Lou Gehrig's Disease), Poliomyelitis, Multiple Sclerosis, Encephalitis, Rabies, Tetanus, Tuberculosis,

Osteomyelitis, Diphtheria, Scarlet Fever, Cerebrospinal Meningitis (bacterial), Brucellosis, Sickle Cell Anemia, Thalassemia,

Rocky Mountain Spotted Fever, Legionnaires' Disease (confirmation by culture or sputum), Addison's Disease, Hansen's

Disease, Tularemia, Hepatitis (Chronic B or Chronic C with liver failure or Hepatoma), Typhoid Fever, Myasthenia Gravis,

Reye's Syndrome, Primary Sclerosing Cholangitis (Walter Payton's Liver Disease), Lyme Disease, Systemic Lupus Erythematosus,

Cystic Fibrosis, Primary Biliary Cirrhosis.

EE=Employee and F = Family

Option 2

2 Units Hospital Benefits, 6 Units Radiation &

Chemotherapy Benefits, 3 Units Surgery Benefits, 1 Unit

Miscellaneous Benefits, 2 Units Wellness Benefit, 2 Units

Intensive Care Benefits, 2 Units Cancer Initial Diagnosis.

Option 3

1 Unit Hospital Benefits, 2 Units Radiation &

Chemotherapy Benefits, 1 Unit Surgery Benefits, 1 Unit

Miscellaneous Benefits.

PLAN DESIGN

Option 1

2 Units Hospital Benefits, 4 Units Radiation &

Chemotherapy Benefits, 3 Units Surgery Benefits, 1 Unit

Miscellaneous Benefits, 2 Units Wellness Benefit, 2 Units

Cancer Initial Diagnosis.

N/A

$30.30

This Quote Expires on 5/12/2016

N/A

$23.76

EE

$50.87

$39.70

F

N/A N/A

Option 4

N/A N/A N/A N/A1 Unit Hospital Benefits, 2 Units Radiation &

Chemotherapy Benefits, 1 Unit Surgery Benefits, 1 Unit

Miscellaneous Benefits.

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Legal

Shield

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HAVE YOU EVER?

THE IDSHIELDSM MEMBERSHIP INCLUDES:

This is a general overview and is for illustrative purposes only. Plans

and services vary from state to state. See a plan contract for your state of

residence for complete terms, coverage, amounts, conditions and exclusions.

WHAT IS LEGALSHIELD? LegalShield was founded in 1972, with the mission to make equal justice under law a reality for all North Americans. The 3.5 million individuals enrolled as LegalShield members throughout the United States and Canada can talk to a lawyer on any personal legal matter, no matter how trivial or traumatic, all without worrying about high hourly costs. LegalShield has provided identity theft protection since 2003 with Kroll Advisory Solutions, the world’s leading company in ID Theft consulting and restoration. We have safeguarded over 1 million members, provided more than 200,000 identity consultations, and helped restore nearly 10,000 individual identities.

¨ Needed your Will prepared or updated

¨ Been overcharged for a repair or paid an unfair bill

¨ Had trouble with a warranty or defective product

¨ Signed a contract

¨ Received a moving traffic violation

¨ Had concerns regarding child support

Privacy Monitoring Monitoring your name, SSN, date of birth, email address (up to 10), phone numbers (up to 10), driver license & passport numbers, and medical ID numbers (up to 10) provides you with comprehensive identity protection service that leaves nothing to chance.

Security Monitoring SSN, credit cards (up to 10), and bank account (up to 10) monitoring, sex offender search, financial activity alerts and quarterly credit score tracking keep you secure from every angle. With the family plan, Minor Identity Protection is included and provides monitoring for up to 8 children under the age of 18.

Consultation Your identity protection plan includes 24/7/365 live support for covered emergencies, unlimited counseling, identity alerts, data breach notifications and lost wallet protection.

Full Service Restoration Complete identity recovery services by Kroll Licensed Private Investigators and our $5 million service guarantee ensure that if your identity is stolen, it will be restored to its pre-theft status.

IDShield plans are available at individual or family rates. A family rate covers the member, member’s spouse and up to 8 dependents up to the age of 18

¨ Worried about being a victim of Identity theft

¨ Been concerned about your child’s identity

¨ Lost your wallet

¨ Worried about entering personal information on-line ¨ Feared the security of your medical information

¨ Been pursued by a collection agency

For more information, please call your independent associate:

THE LEGALSHIELD® MEMBERSHIP INCLUDES:

P Personal Legal advice on unlimited issues

P Letters/ calls made on your behalf

P Contracts & documents reviewed (up to 15 pages)

P Residential Loan Document Assistance

P Lawyers prepare your Will, your Living Will and your Health Care Power of Attorney

P Moving Traffic Violations (available 15 days after enrollment)

P IRS Audit Assistance

P Trial Defense (if named defendant/ respondent in a covered civil action suit)

P Uncontested Divorce, Separation, Adoption and/or Name Change Representation (available 90 days after enrollment)

P 25% Preferred Member Discount (Bankruptcy, Criminal Charges, DUI, Other Matters, etc.)

P 24/7 Emergency Access for covered situations

LegalShield legal plans cover the member; member’s spouse; never married

dependent children under 26 living at home; dependent children under age

18 for whom the member is legal guardian; never married, dependent children

up to age 26 if a full-time college student; and physically or mentally disabled

dependent children. An individual rate is available for those enrollees who are

not married, do not have a domestic partner and do not have minor children

or dependents. No family benefits are available to individual plan members.

Ask your Independent Associate for details.

FFGA 2016 - TX

Jason Lavender 512-740-3322 [email protected]

Individual $18.95

$8.95

$27.90

Family $18.95

$18.95

$33.90

THE IDSHIELDSM MEMBERSHIP INCLUDES:

Privacy Monitoring Monitoring your name, SSN, date of birth, email address (up to 10), phone numbers (up to 10), driver license & passport numbers, and medical ID numbers (up to 10) provides you with comprehensive identity protection service that leaves nothing to chance.

Security Monitoring SSN, credit cards (up to 10), and bank account (up to 10) monitoring, sex offender search, financial activity alerts and quarterly credit score tracking keep you secure from every angle. With the family plan, Minor Identity Protection is included and provides monitoring for up to 8 children under the age of 18.

Consultation Your identity protection plan includes 24/7/365 live support for covered emergencies, unlimited counseling, identity alerts, data breach notifications and lost wallet protection.

Full Service Restoration Complete identity recovery services by Kroll Licensed Private Investigators and our $5 million service guarantee ensure that if your identity is stolen, it will be restored to its pre-theft status.

IDShield plans are available at individual or family rates. A family rate covers the member, member’s spouse and up to 8 dependents up to the age of 18

THE LEGALSHIELD® MEMBERSHIP INCLUDES:

P Personal Legal advice on unlimited issues

P Letters/ calls made on your behalf

P Contracts & documents reviewed (up to 15 pages)

P Residential Loan Document Assistance

P Lawyers prepare your Will, your Living Will and your Health Care Power of Attorney

P Moving Traffic Violations (available 15 days after enrollment)

P IRS Audit Assistance

P Trial Defense (if named defendant/ respondent in a covered civil action suit)

P Uncontested Divorce, Separation, Adoption and/or Name Change Representation (available 90 days after enrollment)

P 25% Preferred Member Discount (Bankruptcy, Criminal Charges, DUI, Other Matters, etc.)

P 24/7 Emergency Access for covered situations

LegalShield legal plans cover the member; member’s spouse; never married

dependent children under 26 living at home; dependent children under age

18 for whom the member is legal guardian; never married, dependent children

up to age 26 if a full-time college student; and physically or mentally disabled

dependent children. An individual rate is available for those enrollees who are

not married, do not have a domestic partner and do not have minor children

or dependents. No family benefits are available to individual plan members.

Ask your Independent Associate for details.

M onthly

ID Shield

C ombined

LegalShield

Payroll D eduction

49

Page 51: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

Assurant

Term Life

50

Page 52: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

51

Page 53: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

52

Page 54: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

T 512.454.7685 800.788.2638 F 512.454.9042

Assu

rant E

mp

loyee B

en

efits is the b

rand

nam

e used

for in

suran

ce pro

du

cts un

derw

ritten an

d issu

ed b

y Un

ion

Secu

rity Insu

rance C

om

pan

y.

Vo

lun

tary Life M

on

thly P

remiu

m D

edu

ction

Sch

edu

les Fo

r: Corsicana Independent S

chool District

Em

plo

yee Life P

remiu

ms

Prem

iums are based on the em

ployee's age on each policy anniversary B

enefit in

A

ge

000’s

<20

20-24 25-29

30-34 35-39

40-44 45-49

50-54 55-59

60-64 65-69

70-74 75+

$20

1.04 1.04

1.60 1.60

2.14 3.24

4.34 6.92

9.12 20.72

33.28 56.68

208.00

$30 1.59

1.59 2.40

2.40 3.21

4.86 6.51

10.38 13.68

31.08 49.92

85.02 312.00

$40 2.12

2.12 3.20

3.20 4.28

6.48 8.68

13.84 18.24

41.44 66.56

216.32 416.00

$50 2.65

2.65 4.00

4.00 5.35

8.10 10.85

17.30 22.80

51.80 83.20

141.70 520.00

$60 3.18

3.18 4.80

4.80 6.42

9.72 13.02

20.76 27.36

62.16 99.84

170.04 624.00

$70 3.71

3.71 5.60

5.60 7.49

11.34 15.19

24.22 31.92

72.52 116.48

198.38 728.00

$80 4.24

4.24 6.40

6.40 8.56

12.96 17.36

27.68 36.48

82.88 133.12

226.72 832.00

$90 4.77

4.77 7.20

7.20 9.63

14.58 19.53

31.14 41.04

93.24 149.76

255.06 936.00

$100 5.30

5.30 8.00

8.00 10.70

16.20 21.70

34.60 45.60

103.60 166.40

283.40 1040.00

$110 5.83

5.83 8.80

8.80 11.77

17.82 23.87

38.06 50.16

113.96 183.04

311.74 1144.00

$120 6.36

6.36 9.60

9.60 12.84

19.44 26.04

41.52 54.72

124.32 199.68

340.08 1248.00

$130 6.89

6.89 10.40

10.40 13.91

21.06 28.21

44.98 59.28

134.68 216.32

368.42 1352.00

$140 7.42

7.42 11.20

11.20 14.98

22.68 30.38

48.44 63.84

145.04 232.96

396.76 1456.00

$150 7.95

7.95 12.00

12.00 16.05

24.04 32.55

51.90 68.40

155.40 249.60

425.10 1560.00

$160 8.48

8.48 12.80

12.80 17.12

25.92 34.72

55.36 72.96

165.76 266.16

453.44 1664.00

$170 9.01

9.01 13.60

13.60 18.19

27.54 36.89

58.82 77.52

176.12 282.88

481.78 1768.00

$180 9.54

9.54 14.40

14.40 19.26

29.16 39.06

62.28 82.08

186.48 299.52

510.12 1872.00

$190 10.07

10.07 15.20

15.20 20.33

30.78 41.23

65.74 86.64

196.84 316.16

538.46 1976.00

$200 10.60

10.60 16.00

16.00 21.40

32.40 43.40

69.20 91.20

207.20 332.80

566.80 2080.00

$210 11.13

11.13 16.80

16.80 22.47

34.02 45.57

72.66 95.76

217.56 349.44

595.14 2184.00

$220 11.66

11.66 17.60

17.60 23.54

35.64 47.74

76.12 100.32

227.92 366.08

623.48 2288.00

$230 12.19

12.19 18.40

18.40 24.61

37.26 49.91

79.58 104.88

238.28 385.72

651.38 2392.00

$240 12.72

12.72 19.20

19.20 25.68

38.88 52.08

83.04 109.44

248.64 399.36

680.16 2496.00

$250 13.25

13.25 20.00

20.00 26.75

40.50 54.25

86.50 114.00

259.00 416.00

708.50 2600.00

$260 13.78

13.78 20.80

20.80 27.82

42.12 56.42

89.96 118.56

269.36 432.64

736.84 2704.00

$270 14.31

14.31 21.60

21.60 28.89

43.74 58.59

93.42 123.12

279.72 449.28

765.18 2808.00

$280 14.84

14.84 22.40

22.40 29.96

45.36 60.76

96.88 127.68

290.08 465.92

793.52 2912.00

$290 15.37

15.37 23.20

23.20 31.03

46.98 62.93

100.34 132.24

300.44 482.56

821.86 3016.00

$300 15.90

15.90 24.00

24.00 32.10

48.60 168.90

103.80 136.80

310.80 499.20

850.20 3120.00

$350 18.55

18.55 28.00

28.00 65.45

56.70 75.95

121.10 159.60

362.60 582.40

991.90 3640.00

$400 21.20

21.20 32.00

32.00 42.80

64.80 86.80

138.40 182.40

414.40 665.60

1133.60 4130.00

$450 23.85

23.85 36.00

36.00 48.15

62.90 97.65

155.70 360.90

466.20 748.80

1275.30 4680.00

$500 26.50

26.50 40.00

40.00 53.50

81.00 108.50

186.00 228.00

518.00 832.00

1417.00 5200.00

For p

remium

s for benefit amounts not illustrated in this chart, please contact your P

lan A

dministrator.

53

Page 55: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

T 512.454.7685 800.788.2638 F 512.454.9042

Sp

ou

se Life P

remiu

ms

Prem

iums are based on the em

ployee's age on each policy anniversary

Ben

efit in

Ag

e

000’s

<20

20-24 25-29

30-34 35-39

40-44 45-49

50-54 55-59

60-64 65-69

70-74 75+

$5 0.27

0.27 0.40

0.40 0.54

0.81 1.09

1.73 2.28

5.18 8.32

14.17 52.00

$10 0.53

0.53 0.80

0.80 1.07

1.62 2.17

3.46 4.56

10.36 16.64

28.34 104.00

$15 0.80

0.80 1.20

1.20 1.61

2.43 3.26

5.19 6.84

15.54 24.96

42.51 156.00

$20 1.06

1.06 1.60

1.60 2.14

3.24 4.34

6.92 9.12

20.72 33.28

56.68 208.00

$25 1.33

1.33 2.00

2.00 2.68

4.05 5.43

8.65 11.40

25.90 41.60

70.85 260.00

$30 1.59

1.59 2.40

2.40 3.21

4.86 6.51

10.38 13.68

31.08 49.92

85.02 312.00

$35 1.86

1.86 2.80

2.80 3.75

5.67 7.60

12.11 15.96

36.26 58.24

99.19 364.00

$40 2.12

2.12 3.20

3.20 4.28

6.48 8.68

13.84 59.69

41.44 66.56

113.36 416.00

$45 2.39

2.39 3.60

3.60 4.82

7.29 9.77

15.57 20.52

46.62 74.88

127.53 468.00

$50 2.65

2.65 4.00

4.00 5.35

8.10 10.85

17.30 22.80

51.80 83.20

141.70 520.00

$60 3.18

3.18 4.80

4.80 6.42

9.72 13.02

20.76 27.36

62.16 99.84

170.04 624.00

$70 3.71

3.71 5.60

5.60 7.49

11.34 15.19

24.22 31.92

72.52 116.48

198.38 728.00

$80 4.24

4.24 6.40

6.40 8.56

12.96 17.36

27.68 36.48

82.88 133.12

226.68 832.00

$90 4.77

4.77 7.20

7.20 9.63

14.58 19.53

31.14 41.04

93.24 149.76

255.06 936.00

$100 5.30

5.30 8.00

8.00 10.70

16.20 21.70

34.60 45.60

103.60 166.40

283.40 1040.00

$110 5.83

5.83 8.80

8.80 11.77

17.82 23.87

38.06 50.16

113.96 183.04

311.74 1144.00

$120 6.36

6.36 9.60

9.60 12.84

19.44 26.04

41.52 54.72

124.32 199.68

340.08 1248.00

$130 6.89

6.89 10.40

10.40 13.91

49.27 28.21

44.98 59.28

134.68 216.28

368.42 1352.00

$140 7.42

7.42 11.20

11.20 14.98

22.68 30.38

48.44 63.84

145.04 232.96

396.76 1456.00

$150 7.95

7.95 12.00

12.00 16.40

24.30 32.55

51.90 68.40

155.40 249.60

425.10 1560.00

$160 8.48

8.48 12.80

12.80 17.12

25.92 34.72

55.36 72.96

165.76 266.24

453.44 1664.00

$170 9.01

9.01 13.60

13.60 18.19

27.54 36.89

58.82 77.52

176.12 282.88

481.78 1768.00

$180 9.54

9.54 14.40

14.40 19.26

29.16 39.06

62.28 82.08

186.48 299.52

510.12 1872.00

$190 10.07

10.07 15.20

15.20 20.33

30.78 41.23

65.74 86.64

196.84 316.16

538.46 1976.00

$200 10.60

10.60 16.00

16.00 21.40

32.40 43.40

69.20 91.20

207.20 332.80

656.80 2079.20

$210 11.13

11.13 16.80

16.80 22.47

34.02 45.66

72.66 95.76

217.56 349.44

595.14 2184.00

$220 11.66

11.66 17.60

17.60 23.54

35.64 47.74

76.12 100.32

227.92 366.08

623.48 2288.00

$230 12.19

12.19 18.40

18.40 24.61

37.26 49.91

79.58 104.88

238.28 382.72

651.82 2392.00

$240 12.72

12.72 19.20

19.20 25.68

38.88 52.08

83.04 109.44

248.64 399.36

680.16 2496.00

$250 13.25

13.25 20.00

20.00 26.75

40.50 54.25

93.00 114.00

259.00 416.00

708.50 2600.00

Ch

ild A

mo

un

t $1,000

$5,000 $10,000

Ch

ild L

ife an

d A

D&

D P

rem

ium

0.21

1.04 2.08

54

Page 56: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

Texas

Life

55

Page 57: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

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, as long as you pay the necessary premium. Group and voluntary term, on the other hand, typically are not portable if you change jobs and, even if you can keep them after you retire, usually costs more and declines in death benefit.

The policy, purelife-plus, is underwritten by Texas Life Insurance Company, and it has these outstanding features:

High Death Benefit.• With one of the highest death benefits available at the worksite,1 purelife-plus gives your loved ones peace of mind, knowing there will be significant life insurance in force should you die prematurely.

Minimal Cash Value.• Designed to provide high death benefit, purelife-plus does not compete with the cash accumulation in your employer-sponsored retirement plans.

Long Guarantees.• 2 Enjoy the assurance of a policy that has a guaranteed death benefit to age 121 and level premium that guarantees coverage for a significant period of time (after the guaranteed period, premiums may go down, stay the same, or go up).

Refund of Premium.• Unique in the marketplace, purelife-plus offers you a refund of 10 years’ premium, should you surrender the policy if the premium you pay when you buy the policy ever increases. (Conditions apply.)

Accelerated Death Benefit Rider. • Should you be diagnosed as terminally ill with the expectation of death within 12 months (24 months in Illinois), you will have the option to receive 92% (84% in Illinois) of the death benefit, minus a $150 ($100 in Florida) administrative fee. This valuable living benefit gives you peace of mind

knowing that, should you need it, you can take the large majority of your death benefit while still alive. (Conditions apply.) (Form ICC07-ULABR-07 or ULABR-07)

You may apply for this permanent, portable coverage, not only for yourself, but also for your spouse, minor children and grandchildren.3

Flexible Premium Life Insurance to Age 121Policy Form PRFNG-NI-10

See the purelife-plus brochure for details.

1 Voluntary and Universal Whole Life Products, Eastbridge Consulting Group, October 2012

2 Guarantees are subject to product terms, exclusions and limitations and the insurer’s claims-paying ability and financial strength.

3 Policies not available for children and grandchildren in Washington.

Life Insurance HighlightsFor the employee

purelife-plus

Like most life insurance policies, Texas Life policies contain certain exclusions, limita-tions, exceptions, reductions of benefits, waiting periods and terms for keeping them

in force. Please contact a Texas Life representative for costs and complete details.

14M034-C 1025 (exp0316) purelife-plus is not available in NJ, NY or PA.56

Page 58: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

Non

-Tob

acco

monthly p r em i um s

PureLife-plus — Standard Risk Table Premiums — Non-Tobacco — Express IssueGUARANTEED

Monthly Premiums for Life Insurance Face Amounts Shown PERIOD

Includes Added Cost for Age to Which

Issue Accidental Death Benefit (Ages 17-59) Coverage is

Age Guaranteed at

(ALB) $10,000 $25,000 $50,000 $75,000 $100,000 $150,000 $200,000 $250,000 $300,000 Table Premium

15D-10 7.75 14.00 75

11-16 8.00 14.50 70

17-20 10.00 18.50 27.00 35.50 52.50 69.50 86.50 103.50 66

21 10.25 19.00 27.75 36.50 54.00 71.50 89.00 106.50 66

22 10.25 19.00 27.75 36.50 54.00 71.50 89.00 106.50 65

23-25 10.50 19.50 28.50 37.50 55.50 73.50 91.50 109.50 63

26 10.75 20.00 29.25 38.50 57.00 75.50 94.00 112.50 63

27 11.00 20.50 30.00 39.50 58.50 77.50 96.50 115.50 63

28 11.00 20.50 30.00 39.50 58.50 77.50 96.50 115.50 62

29 11.25 21.00 30.75 40.50 60.00 79.50 99.00 118.50 62

30-31 11.50 21.50 31.50 41.50 61.50 81.50 101.50 121.50 60

32 12.00 22.50 33.00 43.50 64.50 85.50 106.50 127.50 61

33 12.50 23.50 34.50 45.50 67.50 89.50 111.50 133.50 62

34 13.00 24.50 36.00 47.50 70.50 93.50 116.50 139.50 62

35 13.75 26.00 38.25 50.50 75.00 99.50 124.00 148.50 64

36 14.25 27.00 39.75 52.50 78.00 103.50 129.00 154.50 64

37 14.75 28.00 41.25 54.50 81.00 107.50 134.00 160.50 64

38 15.50 29.50 43.50 57.50 85.50 113.50 141.50 169.50 65

39 16.50 31.50 46.50 61.50 91.50 121.50 151.50 181.50 66

40 7.90 17.50 33.50 49.50 65.50 97.50 129.50 161.50 193.50 67

41 8.40 18.75 36.00 53.25 70.50 105.00 139.50 174.00 208.50 68

42 9.10 20.50 39.50 58.50 77.50 115.50 153.50 191.50 229.50 70

43 9.80 22.25 43.00 63.75 84.50 126.00 167.50 209.00 250.50 72

44 10.50 24.00 46.50 69.00 91.50 136.50 181.50 226.50 271.50 73

45 11.30 26.00 50.50 75.00 99.50 148.50 197.50 246.50 295.50 74

46 12.10 28.00 54.50 81.00 107.50 160.50 213.50 266.50 319.50 75

47 12.80 29.75 58.00 86.25 114.50 171.00 227.50 284.00 340.50 76

48 13.60 31.75 62.00 92.25 122.50 183.00 243.50 304.00 364.50 77

49 14.50 34.00 66.50 99.00 131.50 196.50 261.50 326.50 391.50 78

50 15.60 36.75 72.00 107.25 142.50 79

51 16.90 40.00 78.50 117.00 155.50 80

52 18.50 44.00 86.50 129.00 171.50 82

53 20.10 48.00 94.50 141.00 187.50 83

54 21.70 52.00 102.50 153.00 203.50 85

55 23.10 55.50 109.50 163.50 217.50 86

56 24.10 58.00 114.50 171.00 227.50 85

57 24.80 59.75 118.00 176.25 234.50 84

58 25.60 61.75 122.00 182.25 242.50 84

59 26.60 64.25 127.00 189.75 252.50 84

60 27.30 66.00 130.50 195.00 259.50 84

61 29.60 71.75 142.00 212.25 282.50 85

62 32.40 78.75 156.00 233.25 310.50 87

63 35.50 86.50 171.50 256.50 341.50 89

64 39.60 96.75 192.00 287.25 382.50 93

65 42.50 104.00 206.50 309.00 411.50 94

66 45.30 95

67 47.80 96

68 50.40 96

69 53.20 96

70 56.20 95

PureLife-plus is permanent life insurance to Attained Age 121 that can never be cancelled as long as you pay the necessary premiums. After the

Guaranteed Period, the premiums can be lower, the same, or higher than the Table Premium. See the brochure under ”Permanent Coverage”.

Form: 10M014-AZrplt EXP-K-M-1AD R 05-01-15 57

Page 59: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

Tob

acco

monthly p r em i um s

PureLife-plus — Standard Risk Table Premiums — Tobacco — Express IssueGUARANTEED

Monthly Premiums for Life Insurance Face Amounts Shown PERIOD

Includes Added Cost for Age to Which

Issue Accidental Death Benefit (Ages 17-59) Coverage is

Age Guaranteed at

(ALB) $10,000 $25,000 $50,000 $75,000 $100,000 $150,000 $200,000 $250,000 $300,000 Table Premium

15D-10

11-16

17-20 14.25 27.00 39.75 52.50 78.00 103.50 129.00 154.50 66

21 14.75 28.00 41.25 54.50 81.00 107.50 134.00 160.50 66

22 14.75 28.00 41.25 54.50 81.00 107.50 134.00 160.50 65

23-25 15.50 29.50 43.50 57.50 85.50 113.50 141.50 169.50 63

26 15.75 30.00 44.25 58.50 87.00 115.50 144.00 172.50 63

27 16.00 30.50 45.00 59.50 88.50 117.50 146.50 175.50 63

28 16.25 31.00 45.75 60.50 90.00 119.50 149.00 178.50 62

29 16.50 31.50 46.50 61.50 91.50 121.50 151.50 181.50 62

30-31 18.50 35.50 52.50 69.50 103.50 137.50 171.50 205.50 60

32 19.00 36.50 54.00 71.50 106.50 141.50 176.50 211.50 61

33 19.25 37.00 54.75 72.50 108.00 143.50 179.00 214.50 62

34 19.50 37.50 55.50 73.50 109.50 145.50 181.50 217.50 62

35 20.75 40.00 59.25 78.50 117.00 155.50 194.00 232.50 64

36 21.50 41.50 61.50 81.50 121.50 161.50 201.50 241.50 64

37 22.75 44.00 65.25 86.50 129.00 171.50 214.00 256.50 64

38 23.50 45.50 67.50 89.50 133.50 177.50 221.50 265.50 65

39 25.00 48.50 72.00 95.50 142.50 189.50 236.50 283.50 66

40 11.80 27.25 53.00 78.75 104.50 156.00 207.50 259.00 310.50 67

41 12.50 29.00 56.50 84.00 111.50 166.50 221.50 276.50 331.50 68

42 13.40 31.25 61.00 90.75 120.50 180.00 239.50 299.00 358.50 70

43 14.80 34.75 68.00 101.25 134.50 201.00 267.50 334.00 400.50 72

44 15.60 36.75 72.00 107.25 142.50 213.00 283.50 354.00 424.50 73

45 16.70 39.50 77.50 115.50 153.50 229.50 305.50 381.50 457.50 74

46 17.70 42.00 82.50 123.00 163.50 244.50 325.50 406.50 487.50 75

47 18.70 44.50 87.50 130.50 173.50 259.50 345.50 431.50 517.50 76

48 19.70 47.00 92.50 138.00 183.50 274.50 365.50 456.50 547.50 77

49 21.30 51.00 100.50 150.00 199.50 298.50 397.50 496.50 595.50 78

50 22.40 53.75 106.00 158.25 210.50 79

51 24.10 58.00 114.50 171.00 227.50 80

52 26.20 63.25 125.00 186.75 248.50 82

53 27.90 67.50 133.50 199.50 265.50 83

54 30.00 72.75 144.00 215.25 286.50 85

55 31.50 76.50 151.50 226.50 301.50 86

56 32.80 79.75 158.00 236.25 314.50 85

57 33.80 82.25 163.00 243.75 324.50 84

58 35.60 86.75 172.00 257.25 342.50 84

59 37.10 90.50 179.50 268.50 357.50 84

60 38.10 93.00 184.50 276.00 367.50 84

61 40.70 99.50 197.50 295.50 393.50 85

62 44.00 107.75 214.00 320.25 426.50 87

63 47.40 116.25 231.00 345.75 460.50 89

64 51.10 125.50 249.50 373.50 497.50 93

65 53.60 131.75 262.00 392.25 522.50 94

66 56.40 95

67 59.20 96

68 62.30 96

69 65.50 96

70 69.00 95

PureLife-plus is permanent life insurance to Attained Age 121 that can never be cancelled as long as you pay the necessary premiums. After the

Guaranteed Period, the premiums can be lower, the same, or higher than the Table Premium. See the brochure under ”Permanent Coverage”.

Form: 10M014-AZrplt EXP-K-M-1AD R 05-01-15 58

Page 60: Corsicana ISD Benefit Summary 2016 ISD... · CORSICANA ISD BENEFIT GUIDE Plan Year: September 1, 2016 – August 31, 2017 Information Provided By: First Financial Group of America

Corsicana ISD 2200 W 4th Avenue

Corsicana, TX 75110

(903) 874-7441

www.cisd.org

First Financial Administrators, Inc.

Supplemental and Retirement Benefits

1200 W. Walnut Hill Lane, Suite 3400

Irving, TX 75038

Ryan Hancock, Account Manager

[email protected]

Customer Service: [email protected]

469-417-0505 • 1-800-883-0007 office • 469-417-0509 fax

Flexible Spending Accounts

P.O. Box 670329

Houston, TX 77267-0329

1-866-853-3539 • 1-800-298-7785 fax

www.ffga.com

American Fidelity

Assurance Company Disability and Accident

1-800-654-8489

www.americanfidelity.com

Ameritas Dental

Dental Insurance

1-800-487-5553

www.ameritasgroup.com

Superior Vision

Vision Insurance

1-800-883-5747

www.superiorvision.com

Allstate

Cancer Insurance

(800) 521-3535

www.allstatework.com

AFLAC

Critical and Hospital Indemnity Insurance

1-800-433-3036

www.aflac.com

Texas Life Insurance Company

Permanent Life Insurance

1-800-283-9233

www.texaslife.com

Assurant

Group Life Insurance

1-800-788-2638

www.assurantemployeebenefits.com