PLAN YEAR: September 1, 2019 - August 31, 2020

Humble isd

What’s inside?• EMPLOYEE BENEFITS CENTER• HOW TO ENROLL• SECTION125 PLAN INFORMATION• FLEXIBLE SPENDING ACCOUNTS• AVAILABLE RESOURCES• BENEFITS AT A GLANCE• CONTACT INFORMATION

EMPLOYEE BENEFITs CENTERVISIT YOUR MYHUMBLE ACCOUNT

valerie clinkscalesAccounT MANAGER

EMAIL: VALERIE.CLINKSCALES@FFGA.COM

CELL: 713-254-1273

11811 North Freeway, Ste. 900 Houston, TX 77060 Office: 800-523-8422 ext 7634

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 your Account Manager or First Financial Administrators at 1-800-523-8422 or visit https://www.benefitsolver.com

table of contents

BENEFITS ENROLLMENT ASSISTANCE DATES AND LOCATIONS..........................................i

ADDRESS LOCATIONS....................................................................................................ii

EMPLOYEE BENEFITS CENTER.........................................................................................1

OPTIONS OF ENROLLING...............................................................................................2

SECTION 125 PLAN INFORMATION AND RATES................................................................3

HEALTH SAVINGS ACCOUNTS, FLEXIBLE SPENDING ACCOUNTS, AND DEPENDENT CARE...4

RESOURCES FOR FSA MANAGEMENT..............................................................................5

TRS ACTIVE CARE MEDICAL INFORMATION AND RATES.....................................................6

HOSPITAL INDEMNITY....................................................................................................7

DENTAL PLANS..............................................................................................................7

VISION PLAN.................................................................................................................9

DISABILITY INSURANCE..................................................................................................9

CANCER INSURANCE....................................................................................................10

CRITICAL ILLNESS..........................................................................................................11

ACCIDENT INSURANCE.................................................................................................11

LIFE INSURANCE...........................................................................................................12

EAP.............................................................................................................................12

LEGAL PLAN.................................................................................................................13

TELEMEDICINE.............................................................................................................13

ID THEFT PROTECTION..................................................................................................12

RETIREMENT OPTIONS..................................................................................................14

HOW TO ENROLL.........................................................................................................16

FREQUENTLY ASKED QUESTIONS................................................................................. 17

Employee benefits center NEW employee benefits center - your guide to your benefits!

We’ve created a custom site just for you! Find detailed information about current and upcoming benefits, voluntary product offerings and employer programs, Section 125 & Flexible spending Information, important contact numbers and links, and downloadable forms and brochures.

To enroll online, login to your MyHumble account and click on the BenefitSolver link. You can also access BenefitSolver from the District Benefits website. Use your

computer username and password to login.

1

Section 125 Plan Information and rules A Section 125 Plan provides a tax-saving way to pay for eligible medical or dependent care expenses. The funds are automatically deducted from your paycheck on a pre-tax basis.

Here’s How It WorksA Section 125 Plan reduces your taxes and increases your spendable income by allowing you to deduct the cost of eligible benefits from your earnings before tax. Plus, the plan is available to you at no cost, and you’re already eligible. All you have to do is enroll.

Is It Right for Me? The savings you may experience with a Section 125 Plan are outlined below. By utilizing the Section 125 Plan, you would have $70 more every month to apply toward insurance benefits or other needs. That’s a savings of $840 a year!

3

section 125 plan information and rules

3

irslexible Spending Accounts

irs Medical FSAFSA Plan Year is: September 1, 2019 - august 31, 2020FSA MAX: The maximum you can set aside each year is $2,700

IRS Medical Flexible Spending Accounts (FSA) allow you to set aside pre-tax payroll deductions each paycheck to pay for out of pocket medical, dental and vision expenses for you and your family. During open enrollment you will estimate the amount you think you will need during the year. This amount will be taken out of each paycheck. Your full annual election will be available to you at the beginning of the plan year.

Please note: If you don't use it, you will lose it!

IRS DEPENDENT CARE FSAWith an IRS Dependent Care Flexible Spending Account (FSA), you can set aside part of your pay on a pre-tax basis to pay for eligible dependent care expenses, such as: • Day Care Centers• Before/After School Care• Mothers-Day-Out Program• Nursery Schools• Babysitters• Nanny• Au Pair• Day Camps

This account allows you to pay for day care expenses for your qualifying dependent/child with pre-tax dollars while you (and your spouse) are working, seeking employment, and/or attending school as a full time student (for at least five months of the year). Eligible dependents must be claimed as an exemption on your tax return. For full plan details, view the FSA Booklet available on the Reference Center.

You may allocate up to $5,000 per tax year for reimbursement of dependent day care services.

($2,500 if you are married and file a separate tax return).

HEALTH SAVINGS ACCOUNTSWhat is a Health Savings Account (HSA)?HSAs were created to help control healthcare costs. They provide a savings vehicle that allows you to set aside money to pay for higher deductibles associated with lower monthly premium High Deductible Health Plans (HDHP). The money you save in monthly insurance premiums may be for eligible medical expenses you incur in the future. Your HSA balance rolls over from year-to-year earning interest along the way. The account is portable. Upon retirement or separation of service, you take the HSA with you because it’s your money and your account.

Key Advantages of an HSA»No end-of-year forfeiture of funds»Portable account»Provides an excellent savings vehicle for healthcare expenses»No monthly account fees»Free statements when you opt in for electronic delivery»The money you put into the account is deducted from your paycheck before tax»The interest and earnings you make on the account grow tax free»Distributions for eligible medical expenses are tax free

FACTS: »Money is not available up front»You cannot have both Flex and HSA for Medical

use»You MUST re-enroll every year, even if the

amount is the same as last year.

HSA Plan Year is: September 1, 2019 - august 31, 2020 HSA MAX: The maximum you can set aside each year is

$3,500 for self only and $7,000 for family

4

IRS FLEXIBLE SPENDING ACCOUNTS

IMPORTANT: If you are switching from an FSA to an HSA this plan year, you must exhaust your FSA by 08/31/2019 or the HSA account won’t be opened and you must wait until the 2020-2021 plan year

Please note: If you don't use it, you will lose it! You MUST re-enroll every year, even if the amount is the same as last year. Monies are also not fronted, they are available only as you have them deducted from your paychecks

RESOURCES FOR FSA MANAGEMENT

FLEXIBLE BENEFITS CARD The Flex Benefits Card is available to all employees that participate in Medical FSA and or a Dependent Care 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.

FF FLEX Mobile AppWith the FF Flex Mobile App you can submit claims, view account balance & history, see claim status, view alerts, upload receipts and documentation and more! The FF Flex Mobile App is available for Apple® or AndroidTM devices on the App StoreSM or the Google Play StoreTM.

FF onlineAccess your account online by visiting https://ffa.wealthcareportal.com

Your Employer ID Number is FFA1016 and the mobile app setup can begin on or after 9/1/2018, when the plan year begins. Also, you will receive your Flex Benefits MasterCard in the mail. You must have either your Employer ID Number or your Flex Benefits MasterCard number to register your account .

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 FSA. Visit http://www.ffga.com/fsaextras for more details & special deals!

• Shop at FSA Store for eligible items from bandages to wheel chairs and thousands of products inbetween

• Browse or search for eligible products and services using the FSA Eligibility List• Visit the FSA Learning Center to help find answers to questions you may have about your FSA

5

RESOURCES FOR FSA MANAGEMENT

Visit your myhumble account for rates and benefit information

Medical- TRS ActiveCareAetna is the plan administrator for the TRSActive Care plans. First Financial Group of America enrolls this product for your district however any product questions or concerns need to be directed to Aetna or your district benefit administrator.

Aetna offers: • A variety of plan and network options to suit your individual needs• A Health Concierge available by phone for answers and guidance on care and benefits• Online services and mobile apps for easy access to health information and tools, wherever you

travel

TRS/Active Care 1 HD Employee Rate (Monthly) District Contribution TRS Total

Employee Only $52.00 $326.00 $378.00

Employee + Child(ren) $371.00 $351.00 $722.00 Employee + Spouse $680.00 $386.00 $1,066.00

Employee + Family $1,014.00 $401.00 $1,415.00

TRS/Active Care Select Employee Rate (Monthly) District Contribution TRS Total

Employee Only $205.00 $351.00 $556.00

Employee + Child(ren) $551.00 $351.00 $902.00 Employee + Spouse $981.00 $386.00 $1,367.00

Employee + Family $1,317.00 $401.00 $1,493.00 The Select Plan requires utilization of the Memorial Hermann network or Kelsey Seybold network. Network access is based

on your residence zip code. You will not be able to change to the other network until the next plan year. This plan does not cover out-of-network services except for emergencies.

TRS/Active Care 2 Employee Rate (Monthly) District Contribution TRS Total

Employee Only $501.00 $351.00 $852.00

Employee + Child(ren) $916.00 $351.00 $1,267.00 Employee + Spouse $1,634.00 $386.00 $2,020.00

Employee + Family $1,988.00 $401.00 $2,389.00

To get the best view of Aetna resources and plan information, visit www.trsactivecareaetna.com. Please reviews your Aetna medical plan to take advantage of all it offers for your health and well-being.

Benefits at a Glance

IMPORTANT: The TRS ActiveCare2 plan will be closed to any new enrollments.Only those employees currently on the plan will be able to keep it. Once

ActiveCare2 has been dropped, the plan cannot be re-elected.

6

Benef

its at a Glance

In-NetworkDeductible

$2,750.00

$5,500.00$5,500.00

$5,500.00

In-NetworkDeductible$1,200.00

$3,600.00 $3,600.00

$3,600.00

In-NetworkDeductible

$1,000.00

$3,000.00 $3,000.00

$3,000.00

Out-of-NetworkDeductible

$5,500.00

$11,000.00 $11,000.00

$11,000.00

Out-of-NetworkDeductible

Does not cover

Does not coverDoes not cover

Does not cover

Out-of-NetworkDeductible$2,000.00

$6,000.00 $6,000.00

$6,000.00

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

TRS-ActiveCare 2

NOTE: If you’re currently enrolled in TRS-ActiveCare 2, you can remain in this plan. However, as of Sept. 1, 2018, TRS-ActiveCare 2 is closed to new enrollees.

Deductible(per plan year)In-Network $2,750 employee only/$5,500 family $1,200 individual/$3,600 family $1,000 individual/$3,000 familyOut-of-Network $5,500 employee only/$11,000 family Not applicable. This plan does not cover out-

of-network services except for emergencies.$2,000 individual/$6,000 family

Out-of-Pocket Maximum (per plan year; medical and prescription drug deductibles, copays, and coinsurance count toward the out-of-pocket maximum)

The individual out-of-pocket maximum only includes covered expenses incurred by that individual.

In-Network $6,750 individual/$13,500 family $7,900 individual/$15,800 family $7,900 individual/$15,800 familyOut-of-Network $20,250 individual/$40,500 family Not applicable. This plan does not cover out-

of-network services except for emergencies.$23,700 individual/$47,400 family

CoinsuranceIn-Network Participant pays (after deductible) 20% 20% 20%Out-of-Network Participant pays (after deductible)

40% of allowed amount unless otherwise noted

Not applicable. This plan does not cover out-of-network services except for emergencies.

40% of allowed amount unless otherwise noted

Office Visit Copay Participant pays

20% after deductible $30 copay for primary$70 copay for specialist

$30 copay for primary$70 copay for specialist

Diagnostic LabParticipant pays

20% after deductible 20% after deductible 20% after deductible

Preventive CareSee below for examples

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

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

Plan pays 100% Plan pays 100%

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

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

Inpatient Hospital Facility Charges Only (preauthorization required)In-Network 20% after deductible $150 copay per day plus 20% after

deductible ($750 maximum copay per admission)

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

Out-of-Network Plan pays up to $500 per day cap of covered charges after deductible; you pay the excess over the $500 per day cap

Not applicable. This plan does not cover out-of-network services except for emergencies.

Plan pays up to $500 per day cap of covered charges after deductible; you pay the excess of over the $500 per day cap

Urgent Care 20% after deductible $50 copay per visit $50 copay per visit

Freestanding Emergency RoomParticipant pays

$500 copay per visit plus 20% after deductible

$500 copay per visit plus 20% after deductible

$500 copay per visit plus 20% after deductible

Emergency Room (true emergency use) Participant pays

20% after deductible $250 copay plus 20% after deductible (copay waived if admitted)

$250 copay plus 20% after deductible (copay waived if admitted)

Outpatient SurgeryParticipant pays

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

$150 copay per visit plus 20% after deductible

Bariatric Surgery(only covered if performed at an IOQ facility)Physician charges; Participant pays

$5,000 copay (does apply to out-of-pocket maximum) plus 20% after deductible

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

Annual Vision Examination (one per plan year; performed by an ophthalmologist or optometrist) Participant pays

20% after deductible $70 copay for specialist $70 copay for specialist

Annual Hearing ExaminationParticipant pays

20% after deductible $30 copay for primary$70 copay for specialist

$30 copay for primary$70 copay for specialist

2019-20 TRS-ActiveCare Plan HighlightsEffective Sept. 1, 2019 through Aug. 31, 2020 | In-Network Level of Benefits1

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

Preventive CareSome examples of preventive care frequency and services:• Routine physicals – annually age 12 and over • Well-child care – unlimited up to age 12 • Well woman exam & pap smear – annually age 18 and over• Mammograms – one every year age 35 and over • Colonoscopy – one every 10 years age 50 and over • Prostate cancer screening – one per year age 50 and over• Smoking cessation counseling – eight visits per 12 months • Healthy diet/obesity counseling – unlimited to

age 22; age 22 and over – 26 visits per 12 months• Breastfeeding support – six lactation counseling visits

per 12 monthsNote: Covered services under this benefit must be billed by the provider as “preventive care.” Non-network preventive care is not paid at 100%. If you receive preventive services from a non-network provider, you will be responsible for any applicable deductible and coinsurance under the TRS-ActiveCare 1-HD and TRS-ActiveCare 2. There is no coverage for non-network services under the TRS-ActiveCare Select plan or TRS-ActiveCare Select Whole Health. For more information, please view the Benefits Booklet at www.trsactivecareaetna.com.

2019-20 TRS-ActiveCare Plan Highlights

* If you are not eligible for the state/district subsidy, you will pay the full monthly premium. Please contact your Benefits Administrator for your monthly premium.** The premium after state, $75 and district, $150 contribution is the maximum you may pay per month. Ask your Benefits Administrator for your monthly cost.

(This is the amount you will owe each month after all available subsidies are applied to your premium.) *** Completed by your benefits administrator. The state/district contribution may be greater than $225.

Monthly PremiumsTRS-ActiveCare Monthly Premium

TRS-ActiveCare 1-HD TRS-ActiveCare Select/ ActiveCare Select Whole Health

TRS-ActiveCare 2

Full monthly premium*

Premium with min. state/district contribution**

Your monthly premium***

Full monthly premium*

Premium with min. state/district contribution**

Your monthly premium***

Full monthly premium*

Premium with min. state/district contribution**

Your monthly premium***

Individual $378 $153 $556 $331 $852 $627

+Spouse $1,066 $841 $1,367 $1,142 $2,020 $1,795

+Children $722 $497 $902 $677 $1,267 $1,042

+Family $1,415 $1,190 $1,718 $1,493 $2,389 $2,164

Prescription Coverage

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

TRS-ActiveCare 2

NOTE: If you’re currently enrolled in TRS-ActiveCare 2, you can remain in this plan. However, as of Sept. 1, 2018, TRS-ActiveCare 2 is closed to new enrollees.

Drug Deductible (per person, per plan year)

Must meet plan-year deductible before plan pays.2

$0 generic; $200 brand $0 generic; $200 brand

Short-Term Supply at a Retail Location (up to a 31-day supply)Tier 1 – Generic 20% coinsurance after deductible,

except for certain generic preventive drugs that are covered at 100%.2

$15 copay $20 copay

Tier 2 – Preferred Brand 25% coinsurance after deductible3 25% coinsurance (min. $404; max. $80)3 25% coinsurance (min. $404; max. $80)3

Tier 3 – Non-Preferred Brand 50% coinsurance after deductible3 50% coinsurance3 50% coinsurance (min. $1004; max. $200)3

Extended-Day Supply at Mail Order or Retail-Plus Pharmacy Location (60- to 90-day supply)5

Tier 1 – Generic 20% coinsurance after deductible $45 copay $45 copayTier 2 – Preferred Brand 25% coinsurance after deductible3 25% coinsurance (min. $1054; max. $210)3 25% coinsurance (min. $1054; max. $210)3

Tier 3 – Non-Preferred Brand 50% coinsurance after deductible3 50% coinsurance3 50% coinsurance (min. $2154; max. $430)3

Specialty Medications (up to a 31-day supply)

Specialty Medications 20% coinsurance after deductible 20% coinsurance 20% coinsurance (min. $2004; max. $900)Short-Term Supply of a Maintenance Medication at Retail Location up to a 31-day supplyThe second time a participant fills a short-term supply of a maintenance medication at a retail pharmacy, they will be charged the coinsurance and copays in the rows below. Participants can save more over the plan year by filling a larger day supply of a maintenance medication through mail order or at a Retail-Plus location.

Tier 1 – Generic 20% coinsurance after deductible $30 copay $35 copayTier 2 – Preferred Brand 25% coinsurance after deductible3 25% coinsurance (min. $604; max. $120)3 25% coinsurance (min. $604; max. $120)3

Tier 3 – Non-Preferred Brand 50% coinsurance after deductible3 50% coinsurance3 50% coinsurance (min. $1054; max. $210)3

What is a maintenance medication? Maintenance medications are prescriptions commonly used to treat conditions that are considered chronic or long-term. These conditions usually require regular, daily use of medicines. Examples of maintenance drugs are those used to treat high blood pressure, heart disease, asthma and diabetes.When does the convenience fee apply? For example, if you are covered under TRS-ActiveCare Select, the first time you fill a 31-day supply of a generic maintenance drug at a retail pharmacy you will pay $15, then you will pay $30 each month that you fill a 31-day supply of that generic maintenance drug at a retail pharmacy. A 90-day supply of that same generic maintenance medication would cost $45, and you would save $180 over the year by filling a 90-day supply.

A specialist is any physician other than family practitioner, internist, OB/GYN or pediatrician. 1 Illustrates benefits when in-network providers are used. For some plans non-network benefits are also available; there is no coverage for non-network benefits under the TRS-ActiveCare Select or TRS-ActiveCare Select Whole Health Plan; see Enrollment Guide for more information. Non-contracting providers may bill for amounts exceeding the allowable amount for covered services. Participants will be responsible for this balance bill amount, which maybe considerable.

2 For TRS-ActiveCare 1-HD, certain generic preventive drugs are covered at 100%. Participants do not have to meet the deductible ($2,750 – individual, $5,500 – family) and they pay nothing out of pocket for these drugs. Find the list of drugs at info.caremark.com/trsactivecare.

3 If a participant obtains a brand-name drug when a generic equivalent is available, they are responsible for the generic copay plus the cost difference between the brand-name drug and the generic drug.

4 If the cost of the drug is less than the minimum, you will pay the cost of the drug. 5 Participants can fill 32-day to 90-day supply through mail order.

TRSAC-0097 (4/19)

hospital indemnity – guardianHow will you prepare for out-of-pocket expenses from hospital and doctor bills? Most insurance will only cover a portion of your overall medical expenses. The hospital indemnity plan is designed to help cover your out-of-pocket expenses due to an inpatient hospital stay and assists with deductibles and expenses not covered by your major medical plan. Benefits are paid directly to you so you can use the funds to pay for your needs at your discretion. Coverage is available for spouses and eligible children. Additional information is available in the Reference Center on your myhumble account, or meet with your First Financial Account Manager to enroll in coverage that fits your need.

• Guardian helps protect you and your familyfrom unexpected expenses

• Evidence of Insurability is not required withGuardian

• The Plan is portable• Cash benefits are paid directly to you• Employees & Spouses age 69 and under may

enroll and coverage continues as long asemployee is actively at work

• Children covered from birth to age 26

Hospital Indemnity (monthly rates)

HSA Compliant

Employee + Spouse$40.43

Employee + Child(ren)$73.77

Employee + Family$64.00 $97.34

Non-HSA Compliant

Employee Only PremierAdvantage

$20.16$36.19$31.10$47.13

Coverage Tier

• Both plans cover sickness and injury on and offthe job

• Plan 1 offers additional coverage for ER, Urgentcare facility treatment, Diagnostic Tests andoutpatient surgical category 1 & 2

• $2000 hospital admission benefit

Dental DHMO – cignaThe Cigna Dental DHMO plan allows you to choose a primary care dentist from the CIGNA DHMO – Houston, TX network. A list of the participating providers can be found at www.mycigna.com. All enrolled employees will receive a dental DHMO card. You must select a dentist during open enrollment or one will be assigned to you that is closest to your home.

CIGNA DHMO PLAN FEATURES

Cigna DHMO – Monthly Rates

Coverage Tier Premium Employee Only $14.06 Employee + Spouse $28.13 Employee + Child(ren) $27.71 Employee + Family $41.21

7

• No Deductibles• No Annual Max Allowances• No Claim Forms• Network general dentist you choose will manage your overall dental care

o Network pediatric dentists are available for children under age 7

Dental PPO – cigna Receiving regular dental care can not only catch minor problems before they become major and expensive to treat - it may even help improve your overall health. This dental plan includes Cigna Dental Wellness Plus. When you or your family members receive any preventive care in one plan year, the annual dollar maximum will increase in the following year. When you or your family members remain enrolled in the plan and continue to receive preventive care, the annual dollar maximum will increase in the following year, until it reaches a peak level.CIGNA Base PLAN FEATURES

• Plan Year Maximum – Maximum range is determined upon preventive care services used duringthe particular plan year

• Annual Deductible – In/Out of Network = Individual $50/PP and $150/Family• Preventive Care covered at 100% – Cleanings, fluoride, sealants, bitewing X-rays, full mouth X-

rays and more• Basic Care covered at 80% – Tooth-colored fillings (called resin or composite) and silver-colored

fillings (called amalgam) root canals, extractions• Base Plan covers Major Services at 50% – Crowns, bridges and dentures (including those placed

over implants), oral surgery, treatment for gum disease, specialty care (with an approvedreferral) and more

• Orthodontia services are covered at 50% up to $1000 lifetime max (children and adults)

Cigna Base Plan – Monthly Rates

Coverage Tier Premium Employee Only $32.60 Employee + Spouse $65.20 Employee + Child(ren) $64.11 Employee + Family $95.62

CIGNA DENTAL High PLAN FEATURE

• Plan Year Maximum – Maximum range is determined upon preventive care services used during theparticular plan year

• Annual Deductible – In/Out of Network = Individual $50/PP and $150/Family• Preventive Care covered at 100% – Cleanings, fluoride, sealants, bitewing X-rays, full mouth X-rays and

more• Basic Care covered at 80% – Tooth-colored fillings (called resin or composite) and silver-colored fillings

(called amalgam) root canals, oral surgery, extractions• Major Services on the High Plan are covered at 70%, – Crowns, bridges and dentures (including those

placed over implants), treatment for gum disease, specialty care (with an approved referral) and more• Orthodontia services are covered at 50% up to $1000 lifetime max (children and adults)

Cigna High Plan – Monthly Rates

Coverage Tier Premium Employee Only $40.35 Employee + Spouse $79.35 Employee + Child(ren) $80.70 Employee + Family $118.36 8

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

• Two plan options are now available with the high plan increasing the frame allowance to $150and the contact lenses allowance to $175

• The new plan high plan will now cover tinting, ultraviolet coating and photochromic lenses• Extensive provider network – please go to www.superiorvision.com “National Network” and search

by your zip code radius. Or you can call 1-800-507-3800

Disability – AMERICAN FIDELITYAmerican Fidelity’s Long-Term Disability Insurance offers a variety of plan features and benefit amounts to meet the needs of each employee. The benefit is paid directly to you and helps provide financial peace of mind so you can focus on getting better and returning to work. You will have 3 factors that determine your rates:

• Options for Waiting period in calendar days of 7, 14, 30 include hospital waiver, other options of60, 90 and 150 days of disability are available. The waiting period is how long you have to waituntil the disability coverage would begin. Ex: if you chose a 14 day wait the disability coveragewould begin on the 15th day until the doctor says you can come back to work (up to the limitationsof the policy)

• Amount of coverage will vary depending on what percentage of your salary you choose. You havethe option to choose 50% of your covered salary or 66 2/3% of your covered salary, for up to$7,500 of your covered salary

• You have two options. One plan pays for an injury or a sickness to your Social Security NormalRetirement Age (SSNRA). The second plan pays for an injury up to your SSNRA and a sickness up to5 years

• New enrollees are subject to a pre-existing limitation for anything being treated, should betreated, or you are taking medications for 3 months prior to the effective date will not be coveredfor the first 12 months Existing employees are grandfathered in at their current coverage or canchange to the new plan(s) without having a pre-existing IF they have been on their current plansfor 12 months or longer

• Your disability coverage offers a $150 Physician Expense Benefit payable for an injury if no otherclaim is made.

• On new coverage under this plan, you must be a work for one full day for coverage to start afterthe plan year begins

Superior Vision – Monthly Rates

Coverage Tier Low Plan *NEW* High Plan

Employee Only $ 7.40 $10.42

Employee + Spouse $15.40 $21.68

Employee + Child(ren) $16.00 $22.53

Employee + Family $20.50 $28.86

9

CANCER INSURANCE - GUARDIAN If cancer touches someone in your family, this plan may help ease the impact on your finances. Benefit payments are made directly to you, allowing you to pay for expenses like copayments, hospital stays, and house and car payments. Highlights include:

• Convenient payroll deductions• If currently on the group cancer plan for 12 months or longer, you will not be subject to a pre-

existing condition limitation. If you are not currently on the cancer plan or have not met the 12months, you can still receive the guarantee issue but you will have the pre-existing conditionlimitation for the first 12 months of the policy only. Please see an Account Manager for details.

• Plan is portable• Waiver of Premium - if you become disabled due to cancer for 90 days, premiums will be waived

thereinafter so long as you continue to be disabled.

• Radiation/Chemotherapy treatments are actual cost covered up to $100 per day• Experimental treatments are covered at $100 per day• Hospital Confinement is covered at $100 per day, first 30 days• Ambulance benefits are covered at $500 per trip, with a limit of 2 trips per hospital confinement• Hospice is covered at $ 100 per day

Advantage Plan Features:

Advantage Plan Monthly Premium CU benefitCoverage Rates

Employee Only

Employee + Spouse

Employee + Child(ren)

Employee + Family

• Radiation/Chemotherapy treatments are actual cost covered up to $400 per day• Experimental treatments are covered at $300 per day• Hospital Intensive Care $400/day first 30 days, $600/day for 31st day thereafter• Hospital Confinement is covered at $200 per day, first 30 days• Ambulance benefits are covered at $500 per trip, with a limit of 2 trips per hospital confinement• Hospice is covered at $ 100 per day• The Premier plan includes an Intensive Care Unit (ICU) rider that will pay $500 daily, up to 45 days, if

you are confined to the ICU for ANY reason other than cancer

Premier Plan Monthly PremiumCoverage Rates

Employee Only Employee + Spouse

Employee + Child(ren) Employee + Family

Premier Plan Features:

$12.90

$20.30

$15.20

$22.60

$24.36

$39.10

$27.54$42.28

10

Critical Illness Insurance - MetLife If you experience an event such as a heart attack or stroke, Critical Illness Insurance may help. It pays a lump sum amount to help with expenses that may not be covered by major medical insurance – house payments, everyday expenses, lost income, and more. Highlights include:

• Plan pays a lump-sum benefit amount of $10,000,$20,000 or $30,000, offered guaranteedissue for employees and their spouse. Children are eligible for 25% of the employee benefitamount

• Pre-existing conditions will not be covered for six months, except for heart attack or stroke• Guaranteed Issue for all employees, spouse and children• Recurrence Benefit will apply to certain illness• Rates for all plans are listed in your Employee Benefits Center

Covered Illnesses • Heart Attack

• Major Organ Transplant• Alzheimer’s Disease

• Coronary Artery Bypass Graft

Accident Insurance - CHUBB This plan is designed to help you cope with the costs associated with accidental injuries. Despite having health insurance, out-of-pocket costs may add up quickly when you factor in expenses like ER visits, physical therapy, and medical imaging, co-payments and deductibles. Highlights of the plan include:

Accident Insurance

Monthly Rates

Coverage Tier

Employee Only

Employee + Spouse

Employee + Child(ren)

Employee + Family

$10.27

$17.50

$17.81

$24.02

• Plan is fully portable even if you leave youremployer

• Guaranteed issue - no medical history isrequired

• Guaranteed renewable - your coveragecannot be cancelled as long as yourpremiums are paid

• HSA compatible• Date of application coverage - coverage is

effective as soon as your application issigned

Coverage Amount

• Kidney Failure

• 22 Other Conditions - Partial Benefit

11

*Specific Rates according to benefit election are available online or by sitting with a representative on site*

• Stroke

GROUP Term LIFE – StandardHumble ISD provides Group Basic Life and Accidental Death and Dismemberment Insurance paid by the District in the amount of $10,000. Group life insurance allows you to purchase affordable life insurance on yourself and your spouse. This year only employee guaranteed issue amount is 6 times your salary or $300,000. Spouse guaranteed issue amount is $50,000. Evidence of Insurability form is required if electing more than the guarantee issue amounts. This is term insurance, available as long as you are employed by the district. The maximum election for child life is $10,000.

This year, during annual enrollment, employees currently enrolled in Additional Life or Spouse Life may increase their benefit up to the Guarantee Issue ($300,000 for employee and $50,000 for spouse) without submitting an EOI. New hires may apply for amounts up to the Guarantee Issue without EOI within 31 days from date of eligibility.

Employees enrolling in the coverage after the first 31 days of their employment, will be subject to insurability and must complete a health questionnaire prior to coverage being issued.

ELIGIBILITY:Definition of a Member – Active employee of Humble ISD and regularly working at least 20 hours each week. You are not a member if you are a temporary or seasonal employee, a full-time member of the armed-forces, a leased employee or an independent contractor.

Waiting Period – If you are already a member on the date the group policy is effective, you are eligible on that date. If you become a member after the group policy effective date, you are eligible on the first day of the month that follows the date you become a member. On new coverage under this plan, you must be at work for one full day for coverage to start after the plan year begins.

EAP - StandardEmployee assistance is a District paid program available to all employees. The EAP is available 24/7 to provide crisis support to all employees and their household members. The EAP provides up to 6 face to face counseling session per issue. Take advantage of this District sponsored benefit when you or someone in your household needs help getting through a difficult time.

EAP services can help with:

• Depression, grief, loss and emotional well-being• Family, marital and other relationship issues• Life improvement and goal-setting• Addictions such as alcohol and drug abuse• Stress or anxiety with work or family• Financial and legal concerns• Identity theft and fraud resolution• Online will preparationContact EAP by calling 877-851-1631

12

ID THEFT PROTECTION – iLock360 Protect yourself and your family from the fastest growing crime in the US: Identity Theft. A low monthly cost provides protection by scouring the dark web for any compromised accounts and restores your identity with 24/7/365 support. This protection saves you money and time by relying on a service to handle all the details involved if your identity is stolen. Highlights include:

Telemedicine - WEllvia Telemedicine allows you and your family access to a licensed healthcare professional, via phone, 24/7. The product provides convenience and immediate consultation on your medical issue so you can get back to your daily life. Saves travel and wait time to and from conventional medical facilities. Our Board-Certified doctors diagnose, recommend treatment and prescribe medication via phone or video from anywhere. When to Use WellVia: 70% of primary care visits can be handled over the phone. 40% of urgent care doctor visits can be handled over the phone.Great for:

• Acid Reflux Cold & Flu• Sore throat• Allergies• Sinus Infections• Asthma

• Nausea• Upper Respiratory

Infections• Bronchitis• Rashes• and more...

This is an employer paid benefit free to all full-time, eligible employees of

Humble ISD

Coverage Plan (monthly rates) Basic Plus Premium

Employee Only FREE $8.00 $15.00

Employee + Spouse n/a $15.00 $22.00

Employee + Child(ren) n/a $13.00 $20.00

Employee + Family n/a $20.00 $27.00

13

LEGAL – MetLaw/Hyatt Legal Pre-paid legal provides access to a variety of legal services for you and your family at an affordable monthly cost. Simply call an 800 number to access legal counsel and advice from qualified lawyers. T his product provides peace of mind in today’s litigious environment. Highlights include:

• Plan covers many legal services including, but not limited to, Family Law, Estate Law, Civil Lawsuits,Traffic Matters, Real Estate Law, Law for Money Matters and Law for Elder Care issues

• The plan can provide security for you and your family, with benefits of the preparation of Living Trusts,Living Wills, Powers of Attorney and Will and Codicils

• Plan includes preparation and review of Affidavits, Deeds, Demand Letters, Document Reviews, ElderLaw Matters, Mortgages and Promissory Notes

• Other benefits of the plan are Adoption and Legitimization, Guardianship, Name Change, PrenuptialAgreement, protection from Domestic Violence, Juvenile Court of Defense, Debt Collection defenseand Tax Audit Representation

• Identity Theft Defense is included with attorney consultations• Letter preparation, a checklist and an online library of all necessary recovery forms and documents to

resolve and restore your name are also available

MetLaw/Hyatt Legal Plan – Monthly Premium Employee + Family $16.50

• All employees eligible are given the Basic Identity Theft Protection for free! Pleaseregister your account on line once you receive your email

• Personal email address required to sign up for this program• Monitors your identity 24/7/365• Coverage options available for your spouse and children in both the plus and

premium plans• Plan can protect individual or family

How to enroll in your benefits:

1.

2.

4.

The next screen contains text regarding the upcoming changes and important benefits dates. Please read the text and click START ENROLLMENT at the bottom of the page to proceed.

3.

5.

You will need to go through each benefit to select I WANT COVERAGE or WAIVE COVERAGE. At the bottom of each benefit page you will click NEXT once you have selected your choice

6.

After you have completed all the benefits you will be directedto the"Review Enrollment" page. Here, you can make a change to a benefit selection if you wish to do so. Click EDIT to the right of the benefit if you want to change and elect differentcoverage.

When you have finished reviewing and are satisfied with your enrollment choices, click APPROVE at the bottom of the "Review Enrollment" page. The next, and last screen is the Confirmation page, click I AGREE to complete your enrollment.

ONLINE ENROLLMENT starting July 9 -August 22 To enroll online, login to your MyHumble account and click on the BenefitSolver link. You can also access BenefitSolver from the District Benefits website. Use your computer username and password to login.

Click START HERE to begin the enrollment process. If you would like more information you may go to the REFERENCE CENTER to get more details on the available plans. You can view provider directories for the dental and vision plans if you would like to see the available network providers as well as brochures on each of the benefits available. Just click the benefit tab you would like to view.

16

Frequently Asked Questions

17

What is Guaranteed Issue (GI)?Also referred to as Guaranteed Acceptance, or GA, means that you can't be turned down for health reasons. Guaranteed Issue is typically offered during initial enrollment for benefits.

What is a "pre-existing condition"?A pre-existing condition is a disease or physical condition for which symptoms existed or medical advice or treatment was recommended or received prior to the effective date of coverage.

What is a deductible? A deductible is what you must pay for your health care before your insurance pays its part. Most plans have deductibles, which start over when your “PLAN YEAR” starts over. For example, if your plan has a $1,000 deductible and you have surgery that costs $5,000, you’ll pay $1,000 before your insurer helps you cover your bills.

What is a co-pay? A copay is a small, fixed amount—often $15 or $20—that you pay for covered services like a prescription or a doctor’s visit. Some health plans also apply coinsurance to certain services. With it, you pay a percentage of the total cost of care. For example, if you have a 20% coinsurance, and your doctor's appointment costs $300, you'd pay $60. That's if you've met your deductible.

What does out-of-pocket maximum mean? Your out-of-pocket maximum is the most you have to pay each year toward your medical services or prescription drugs before your insurance pays for all your care. This amount does not include what you pay in premiums. The Affordable Care Act limits the out-of-pocket maximums.

What does EOB mean? After you’ve visited your doctor or had a procedure in a hospital, you’ll receive an explanation of benefits (EOB) form explaining how much of the charges your insurance will pay. The EOB isn’t a bill itself, but it can tell you what your doctor may charge you. Look for the words “due from patient” to see how much you may owe after your insurance pays.

Before you get certain tests or procedures, do you need permission from your health insurance plan?If your doctor says you need a test or procedure, your health plan may have to give permission if it's to be covered by insurance. Giving that permission is called preauthorization. Your plan's overview of benefits lists what care needs to be preauthorized. If you don't get it when it's required, your health plan won't pay its part of the costs.

IMPORTANT: If are switching from an FSA to an HSA this plan year, you must exhaust your FSA by 08/31/2019 or the HSA account won’t be opened and you must wait until the 2020-2021 plan year

IMPORTANT CONTACTS

Benefit Vendor Phone Website Medical TRS Active Care Aetna 800-222-9205 www.trsactivecareaetna.com

Dental PPO/DHMO

Cigna 800-244-6224 www.cigna.com

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

Flexible Spending FFGA 866-853-3539 flex@ffga.com

Hospital Indeminity Guardian 888-482-7342 www.guardianlife.com

Disability AFA 800-654-8489 www.americanfidelity.com

Critical Insurance MetLife 800-438-6388 www.metlife.com

Accident Insurance Chubb www2.Chubb.com

Legal MetLaw 800-821-6400 info.legalplans.com

Telemedicine WellVia 855-935-5842 www.wellviasolutions.com

Valerie clinkscales, ACCOUNT MANAGER 11811 NORTH FREEWAY, STE. 900, HOUSTON, TX 77060

OFFICE: 800-523-8422 | CELL:713-254-1273 | EMAIL: Valerie.Clinkscales@ffga.com

Important Contacts

Cancer Insurance Guardian

18

IID Theft Protection iLock360 855-287-8888 www.iLock360.com

Retirement Options TSA Consulting Group 888-796-3786 www.tsacg.com

888-482-7342 www.guardianlife.com

800-490-1322

Group Term Life Standard 800-628-8600 www.standard.com

EAP Standard 877-851-1631 www.standard.com

Health Savings FFGA 866-853-3539 ffa.wealthcareportal.com