2019-2020 Benefits Booklet

2019-2020 Benefits Booklet (Print Version - PDF)

2019-2020 Employee Benefits Guide - Grand Prairie ISD
You take care of them. We'll take care of you. 

Grand Prairie ISD (GPISD) will be utilizing BCG's services for our benefit communication and enrollment. Benefit Counselors will provide you with a detailed explanation of your entire benefit program. They will review your benefits with you on an individual, confidential basis. They will also be able to discuss any personal situations you may have that could potentially impact your benefit decision.

Each year, we strive to offer comprehensive benefit plans to our employees. In the following pages, you will find a summary of our benefit plans for the 2019-2020 plan year (9/1/2019-8/31/2020). Please read this Benefits Guidebook carefully as you prepare to make your elections for the upcoming plan year.

About this Benefits Guidebook

This Benefits Guidebook describes the highlights of Grand Prairie ISD’s benefits program in non-technical language. Included in this Benefits Guidebook is important information about each of the benefit plans offered to you and your family. It includes the benefits paid by Grand Prairie ISD as well as voluntary products which you can customize to meet your individual needs.

Please remember that these general descriptions are not intended to provide all the details of requirements of these benefits. The official Plan Documents will prevail if any inconsistencies are found between the Benefit Guidebook and the official Plan Documents. You should be aware that any and all elements of Grand Prairie ISD’s benefits program may be modified in the future, at any time, to meet Internal Revenue Service rules, or otherwise as decided by Grand Prairie ISD.

Questions

Questions about enrolling in benefits? Contact the Benefits Call center provided by BCG at 888-284-2470 8am-5pm CST M-F.

Questions about your claims or coverage that you are participating in? Contact the plan provider(s): Please see page 32 for contact information.

Questions about your paycheck deductions or other inquiries: Contact the GPISD Payroll and Benefits Team at insurancequestions@gpisd.org or 972-237-5501.


ELIGIBILITY

Employee Eligibility Group insurance coverage is available to all full time (20 or more hours per week) employees. The insurance plan year is from September 1 through August 31 of each year.

Effective Date of Coverage In order for your coverage to take effect, you must call in to the Benefits Service Center for coverage for yourself and any eligible dependents within 31 days of your date of hire. Your coverage will become effective on the 1st day of the month following your date of hire.

Eligible Dependents If you apply for coverage, you may include your dependents. You must ensure that only family members who meet the following requirements are enrolled in the GPISD insurance and health care benefit programs. Eligible dependents include one or more of the following:

  • Your legal spouse
  • A child under the limiting age of 26
  • A child of any age who is medically certified as disabled and dependent on the parent for supportand maintenance.
    Child means: 
  • Your natural child; or
  • Your legally adopted child, including a child for whom the participant is a party in a suit inwhich the adoption of the child is sought; or
  • Your stepchild; or
  • A child of your child who is your dependent for federal income tax purposes at the timeapplication of coverage of the child of your child is made; or
  • A child for who a Participant has received a court order requiring that Participant to havefinancial responsibility for providing health insurance; or
  • A child not listed above:
    • Whose primary residence is your household; and
    • To who you are legal guardian or related by blood or marriage; and
    • Who is dependent upon you for more than one-half of his support as defined by theInternal Revenue Code of the United States.

Status Changes

Important Information Regarding Status Changes

  • You pay for some of your benefits on a pre-tax basis. As a result, the Internal Revenue Servicewill not allow an employee to change his/her elections during the year unless you experience a qualifying life event.
    Qualifying life events include:
    • Marriage, divorce or legal separation
    • Birth or adoption of a child
    • Gain or loss of coverage through employee’s spouse’s employer
    • Gain or loss of spouse’s job
    • Employee’s child gaining or losing eligibility status; and/or
    • Death of a dependent, spouse, or child
  • You must change your coverage within 31 calendar days from the date of the qualifying event.
  • You must ensure the change in coverage is consistent with the status change. For example, ifyou get married, you have 31 calendar days to enroll the new spouse or drop coverage if youwill be added to your spouse’s plan.

MEDICAL SERVICES 

GPISD offers several medical plan options to meet the healthcare needs of your family. These options include not only different benefit levels and plan designs but different network options as well.

The network options are:

  1. Aetna Broad Network – This network is Aetna’s largest network and includes most healthcare providers in the DFW area and nationally.
  2. THA Care Plus Network – This network while smaller than the Aetna Broad Networkincludes over 2000 primary care doctors, over 8200 specialist, 48 hospitals, over 1500behavioral health providers and 50 behavioral health facilities, all in the DFW area.

The Benefit Plan Options are:

  1. THA Care Plus $1500 Deductible Plan – This plan utilizes the THA Care Plus NetworkONLY, and is designed to provide a plan for those who prefer lower deductibles, lowerCo-Pays and a lower maximum out of pocket.
  2. Low $3500 Deductible Plan – This plan is designed to provide lower premium cost butwill have a higher deductible, Co-Pays and maximum out of pocket. At time ofenrollment you may choose either the Aetna Broad Network or the THA Care PlusNetwork.
  3. HSA $4000 Deductible Plan – This plan is designed to conform to IRS rules regarding aHigh Deductible Health Plan, and will allow you to contribute to a Health SavingsAccount (HSA), and it has the lowest premium price point. At time of enrollment youmay choose either the Aetna Broad Network or the THA Care Plus Network.

So, at time of enrollment you have three choices to make:

  1. Choose the Network Option that works for you.
  2. Choose the Benefit Plan Option that works for you.
  3. Choose who you would like to cover…just you, your spouse and/or your children

Medical - Aetna

Benefit  THA Care Plus $1,500 Plan   
  In-Network  Out-of-Network 
Deductible (per calendar year)     
Individual  $1,500  $4,000 
Family  $4,000  $12,000 
Out of Pocket Maximum (per calendar year)     
Individual  $4,500  $19,000 
Family  $9,000  $38,000 
Member Coinsurance  10%  50% 
Preventative Care  Covered 100%; deductible waived  50% after deductible 
Office Visits to PCP  $20 copay; deductible waived  50% after deductible 
Specialist Office Visits  $30 copay; deductible waived  50% after deductible 
Diagnostic Procedures  Covered 100%; deductible waived 10% after deductible  50% afterdeductible 50% afterdeductible 
Non-Complex X-ray & Laboratory Complex Imaging 
Emergency Medical Care     
Urgent Care Provider  $30 copay; deductible waived  50% after deductible 
Emergency Room  10% after $50 copay  Same as in-network care 
Emergency Use of Ambulance  10%; after deductible  Same as in-network care 
Hospital Care
Inpatient Coverage
Outpatient Surgery 
10% after deductible  50% after deductible 
Inpatient Mental Health Services  10% after deductible  50% after deductible 
Other Services
Home Health Care
Infusion Therapy 
Covered 100%; deductible waived 10%; deductible waived  50% after deductible 
Prescription Drug     
Out of Pocket Maximum (per calendar year)     
Individual  $1,000  none
Family $2,000 none
Retail (30 day supply)     
Generic  $5 copay 20% of submitted cost after copay
Preferred Brand Name  $45 copay  20% of submitted cost after copay
Non-Preferred Generic/Brand Name  $65 copay  20% of submitted cost after copay
Mail Order (31-90 day supply)     
Generic  $12.50 copay  Not Applicable
Preferred Brand Name  $112.50 copay  Not Applicable
Non-Preferred Generic/Brand Name $162.50 copay  Not Applicable
Value Plus Specialty     
Preferred Specialty  $45 copay  Not Applicable
Non-Preferred Specialty  $60 copay  Not Applicable

 

$1,500 THA Care Plus Monthly Rates 
Coverage Tier  Deduction Amount 
Employee Only  $387.31 
Employee + Spouse  $1,271.72 
Employee + Child(ren)  $1,002.18 
Family  $1,847.37 

 

 

Benefit  Low Plan 
  In-Network  Out-of-Network 
Deductible (per calendar year)     
Individual  $3,500  $7,000 
Family  $10,500  $21,000 
Out of Pocket Maximum (per calendar year)     
Individual  $5,600  $17,000 
Family  $11,200  $51,000 
Member Coinsurance  30%  50% 
Preventative Care  Covered 100%; deductible waived  50% after deductible 
Office Visits to PCP  $45 copay; deductible waived  50% after deductible 
Specialist Office Visits  $45 copay; deductible waived  50% after deductible 
Diagnostic Procedures  Covered 100%; deductible waived 30% after deductible  50% after deductible 
Non-Complex X-ray & Laboratory Complex Imaging  50% after deductible 
Emergency Medical Care     
Urgent Care Provider  $45 copay; deductible waived  50% after deductible 
Emergency Room  30% after deductible  Same as in-network care 
Emergency Use of Ambulance  30% after deductible  Same as in-network care 
Hospital Care    50% after deductible 
Inpatient Coverage Outpatient Surgery  30% after deductible  50% after deductible 
Inpatient Mental Health Services  30% after deductible  50% after deductible 
Other Services      
Home Health Care Covered 100%; deductible waived  50% after deductible 
Infusion Therapy  30% after deductible 50% after deductible 
Prescription Drug     
Out of Pocket Maximum     
(per calendar Year)     
Individual  $1,000  None 
Family  $2,000  None 
Retail (30 day supply)     
Generic  $15 copay  20% of submitted cost after copay 
Preferred Brand Name  $45 copay  20% of submitted cost after copay 
Non-Preferred Generic/Brand Name  $65 copay  20% of submitted cost after copay 
Mail Order (31-90 day supply)     
Generic  $45 copay  Not Applicable 
Preferred Brand Name  $135 copay  Not Applicable 
Non-Preferred Brand Name  $195 copay  Not Applicable 
Value Plus Specialty    Not Applicable Not Applicable 
Preferred Specialty  $45 
Non-Preferred Specialty  $65 

 

  Low Plan Option Monthly Rates 
Coverage Tier  Broad Network  Care Plus Network 
Employee Only  $405.57  $97.07 
Employee + Spouse  $1,320.84  $638.66 
Employee + Child(ren)  $1,043.22  $474.37 
Family  $1,913.87  $989.55 


Medical: 
Aetna - HSA

Benefit  HSA 
  In-Network  Out-of-Network 
Embedded Deductible (per calendar year)     
Individual  $4,000  $6,000 
Family  $12,000  $18,000 
Out of Pocket Maximum (per calendar year)     
Individual  $6,600  $10,000 
Family  $13,200  $30,000 
Member Coinsurance  20%  40% 
Preventative Care  Covered 100%; deductible waived  40% after deductible 
Office Visits to PCP  20% after deductible  40% after deductible 
Specialist Office Visits  20% after deductible  40% after deductible 
Diagnostic Procedures  20% after deductible  40% after deductible 
Non-Complex X-ray & Laboratory Complex Imaging 
Emergency Medical Care     
Urgent Care Provider  20% after deductible  40% after deductible 
Emergency Room  Same as in-network care 
Emergency Use of Ambulance  Same as in-network care   
Hospital Care
Inpatient Coverage Outpatient Surgery 
20% after deductible  40% after deductible 
Inpatient Mental Health Services  20% after deductible  40% after deductible 
Other Services
Home Health Care
Infusion Therapy 
20% after deductible  40% after deductible 
Prescription Drug  (After Deductible)  (After Deductible) 
Retail (30 day supply) Generic  $15 copay  40% of submitted cost; after applicable copay 
Preferred Brand Name  $45 copay   
Non-Preferred Generic/Brand Name  $65 copay   
Mail Order (31-90 day supply)     
Generic  $45 copay   Not Applicable
Preferred Brand Name  $135 copay   Not Applicable
Non-Preferred Generic/Brand Name  $195 copay   Not Applicable

 

  HSA Option Monthly Rates 
Coverage Tier  Broad Network  Care Plus Network 
Employee Only  $345.12  $61.31 
Employee + Spouse  $1185.17  $559.56 
Employee + Child(ren)  $931.76  $408.42 
Family  $1,732.76  $882.39 

 

Hospital Indemnity Plan - Aetna

This is not a health insurance medical plan.

This benefit is available to those employees who do not elect a medical plan (or who are covered under another medical plan) at no cost to the employee. Dependents are not eligible for this benefit. Inpatient Hospital daily benefit allowance is $100 per day per period of Bed-Patient confinement up to 365 days. Benefits are not payable for out-patient procedures. Employees can waive if they have other coverage (i.e. Medicare, Tricare, Medicaid).

Hospital Indemnity Rates

Coverage Tier

Monthly

Employee Only

$0.00

 

Gap Insurance - Beazley
*You cannot enroll in this plan if you are making a contribution to a Health Savings Account (HSA).

What is Supplemental Medical (Gap) Insurance?

Even with your major medical insurance, you may have certain expenses that are not covered. For example, you may need to meet a deductible before your health insurance kicks in. Or you may need to cover co-pays and co-insurance out of your own pocket. As such, you may be concerned about those expenses taking a bite out of your budget.

Supplemental Medical (Gap) insurance covers eligible out-of-pocket medical expenses you incur in inpatient and outpatient settings (as defined by the policy).

Note: Supplemental Medical (Gap) does NOT replace your health insurance. But it can help fill gaps and offset medical expenses that you may have.

What does the Supplemental Medical (Gap) plan cover?

Supplemental Medical (Gap) Plan for Grand Prairie ISD

Plan Features

Description

Inpatient benefit

$2,500 benefit amount

Reimburses eligible out-of-pocket expenses incurred during inpatient hospitalization, up to the annual benefit maximum.

Outpatient benefit

$1,500 benefit amount

Reimburses eligible out-of-pocket expenses performed in these select outpatient settings, up to the annual benefit maximum:

•Treatment in a hospital ER (but not admitted to inpatient).•Surgery in a hospital outpatient facility or freestanding surgery center orPhysician’s Office/Urgent Care facility•Radiological diagnostic testing in a hospital outpatient or MRI facility orPhysician’s Office/Urgent Care facility.•Chemotherapy or radiation therapy in a licensed facility

 

Guarantee issue

You are eligible for this coverage (regardless of your health status). You do not have to answer medical questions to qualify for coverage.

Dependent coverage

You may also opt for coverage for your spouse or child(ren), as long as they participate in your employer’s underlying major medical plan. Your family maximum will be two times the individual benefit amounts stated above.

Gap Plan Rates

Coverage Tier

Monthly

Employee Only

$42.00

Employee + Spouse

$81.50

Employee + Child(ren)

$82.00

Family

$115.00


FINANCIAL FUTURE

Accident Insurance - 24 hour coverage - Chubb

You do everything you can to keep your family safe, but accidents do happen. It’s comforting to know you have help to manage the medical costs associated with accidental injuries, both on and off the job. Accident Insurance provides you with additional coverage to help cover medical expenses and living costs when you get hurt unexpectedly. In addition, Accident Insurance provides a wellness benefit of $50 per insured person per calendar year. Sports package included—Benefits are 25% higher when the accident is due to organized sports.*

Benefit

24 Hour Accident Plan

Accidental Death Benefit Rider

Employee

$50,000

Spouse as % of employee

$50,000

Children as % of employee

$10,000

Catastrophic Death

Employee

$150,000

Spouse

$100,000

Children

$50,000

Ambulance Ground

$250

Ambulance Air

$2,500

Appliance

$120

Lacerations

Up to $625

Second- and Third-Degree Burns

Up to $12,500

Physical Therapy (Maximum 10 visits)

$35 per visit

Concussion

$150

Dislocation

Up to $6,000

Herniated Disc

$937.50

Emergency Room Treatment

$150

Coma

$10,000

Eye Injury

$375

Fractures

Up to $7,700

Surgery

Up to $1,875

Physician Follow-Up (Maximum 2 visits)

$35 per visit

Hospital Admission (per accident)

$1,000

Hospital Confinement (per day up to 365 days)

$300

Hospital ICU Admission (per accident)

$1,500

Hospital ICU Confinement (per day up to 15 days)

$600

Wellness Benefit (per person, per year)

$50

*Up to $1,000 per person, per year

Critial Illness Insurance - Chubb

You have responsibilities - to yourself and to your family. Critical Illness with Cancer Insurance protects you and your family in the event of a serious illness or other medical condition with coverage that is portable (meaning you can take it with you, if you leave!) In addition, Critical Illness with Cancer Insurance provides a wellness

ben-efit of $100 per covered person per calendar year.

Depending on the diagnosis you receive, your benefit payment may be 100% or 25% of your selected benefit amount. Payments are made directly to the employee, and can be applied to claims, household bills, or other expenses as needed.

Benefit Critical Illness/Cancer

Coverage Amounts

Benefit Amount

Employee (Guaranteed Issue - $30,000) Spouse (Guaranteed Issue - $15,000) Child

$5,000 to $50,000

$5,000 to $30,000

25% of employee amount

Benefit

Heart Attack Stroke

Major Organ Failure End Stage Renal Failure Cancer

Coma

Permanent Paralysis Blindness

Benign Brain Tumor Occupational HIV

100%

Coronary Artery Bypass Surgery Carcinoma In Situ

25%

Wellness Benefit

$100

Rates are based on age and amount of coverage elected. Please speak to a Benefits Counselor for personalized rates.


HEALTH AND WELL BEING

Dental - MetLife

MetLife gives you the freedom to choose whether you would like to visit a participating dentist or an out-of- network dentist. There are considerable cost savings when using a dentist who is in the MetLife Network. The following is a brief summary of the major plan provisions.

Benefit High Plan PPO Low Plan PPO

Deductible (Per person. Applies to class A, B and C services)

$15 per person

$15 per person

Plan Year Maximum (per calendar year. Includes class A, B, and C services)

$2,250

$1,500

Type 1 - Preventative Services

Waiting Period: None

Routine Exams: 2 per 12 months

Bite-wing X-rays: 1 per 12 months

Full Mouth/Panoramic X-rays: 1 per 60 months Periapical X-rays

Cleaning: 2 per 12 months

Fluoride to age 13: 1 per 12 months

100%

100%

Type 2 - Basic Services

Waiting Period: None Simple Extractions

Periodontics (surgical and non-surgical) Endodontics (surgical and non-surgical) Restorative Amalgams

Restorative Composites (anterior and posterior teeth) Sealants to age 16

Space Maintainers

80%

80%

Type 3 - Major Services

Waiting Period: None Implants

Crowns (1 in 10 years per tooth) Crown and Denture Repair

Prosthodontic: fixed bridge, removable complete/partial dentures (1 in 10 years)

Complex Extractions Anesthesia

50%

50%

Orthodontics (dependent child to age 19 only) Waiting Period: None

50%

Lifetime Maximum:

$2,000

50%

Lifetime Maximum:

$1,500

Out of Network Claims Reimbursement

90th UCR

Negotiated Fee

 

Monthly Dental Plan Rates     
Coverage Tier High Plan Low Plan
Employee Only  $40.37  $29.25 
Employee + Spouse  $80.73  $61.50 
Employee + Child(ren)  $84.77  $64.57 
Family  $121.09  $92.27 

Vision - MetLife / VSP

Your vision health is an important part of complete wellness. MetLife is pleased to present your vision benefits which are designed to give you and your covered family members the care, value and service to help maintain good vision and overall health.

Benefit

Benefit

Low Plan In-Network

Low Plan Out of Network

High Plan In-Network

High Plan Out of Network

Exam

$10 copay

$45 allowance

$0

$45 allowance

Standard Plastic Lenses Single Vision

Bifocal Trifocal Lenticular

Progressive

$10

$10

$10

$10

Up to $55 copay

$30 allowance

$50 allowance

$65 allowance

$100 allowance

$50 allowance

$0

$0

$0

$0

Up to $55 copay

$30 allowance

$50 allowance

$65 allowance

$100 allowance

$50 allowance

Contact Lenses

Elective

Medically Necessary

$130 allowance Covered in full

$105 allowance

$210 allowance

$180 allowance1 Covered in full

$105 allowance1

$210 allowance

Frames

Up to $130 allowance

$70 allowance

$180 allowance1

$70 allowance1

Frequencies

12/12/24

12/12/24

12/12/12

12/12/12

*Contact lenses are in lieu of eyeglasses and frames—Low plan only

Coverage TierMonthly Rates     
  Low Plan  High Plan 
Employee Only  $6.27  $13.85 
Employee + Spouse  $10.99  $24.28 
Employee + Child(ren)  $11.19  $24.72 
Family  $18.32  $40.47 

Supplemental Rider Benefit Information

In-Network

Out-of-Network

Diabetic Eyecare Plus (High plan only)

Provides additional coverage for members who have diagnosed with type 1 or type 2 diabetes and have specific ophthalmological conditions. It also provides benefits for those with glaucoma and age-related macular degeneration (AMD). In addition, members who have diabetes but don’t show signs of diabetic eye disease are eligible to receive preventive retinal screenings. Not available to retail chains including Costco.

Exam: Covered in full after $20 copay

Other Ophthalmological services: Covered in full

Diabetic Eyecare Plus Program:

-Exam and otherophthalmologicalservices-The lesserof the provider’s fee

or 80% of theMedicare allowable.

Second Paid Glasses/Contacts1 (High plan only)

This benefit gives you additional eyewear coverage. You can get:

-Two pairs of prescription eyeglasses, or

-One pair of prescription eyeglasses and an allowance toward contact lenses, or

-Double your contact lens allowance

*Benefit provides for two (2) complete order for eyewear. Eyewear purchases must be separate; allowancescannot be combined for single eyewear purchase

Same OON benefit as primary plan

 


MEDICAL SERVICES

 Health Savings Account (HSA) - Proficient Benefit Solutions (PBS)

Now, more than ever, healthcare dollars need to go further. With a Health Savings Account (HSA), you’ll pay less in taxes and increase your take-home pay. So enroll in an HSA and keep more of the money you’ve earned. That’s real savings, real simple.

What is a Health Savings Account (HSA)?

An HSAworks with a high deductible heath plan(HDHP), an dallows you to use before-tax dollars to eimburse yourself for eligible out- of-pocket health expenses for you, your spouse and your dependents, which in turn saves you on taxes and increases your spendable income.

How it works

Anyonecan deposit money into your HSA account, up to an annual individual or family limit* set by the IRS. When you enroll, an account will be created for you at a sponsor bank. You’ll be given access to a secure, easy-to-use web portal where you can track your account balance, view your investment accounts and submit requests for reimbursements.

In addition, you’ll receive a convenient benefit card to make it easy to access the money in your HSA. The card contains thevalue of yourHSAaccount andyou can use it to payfor eligibles ervicesand products. When you use the card, payments are automatically withdrawn from your account, so there are no out- of-pocket costs and you won’t have to submit receipts to verify the purchase. Just swipe the card and go. It’s that easy! Please note: the IRS requires that you retain documentation for your eligible expenses.

*IRS limits for 2019 and 2020
Individual | $3,500 (2019) & $3,550 (2020)
Family | $7,000 (2019) & $7,100 (2020)

Benefits to You:

  • An HSA is yours. Funds in your HSA accountstaywith you, even if you change jobs.
  • Contribute tax free. An HSA reduces your taxable income.The money is tax free both when you put it in and when you take it out to cover qualified health expenses.
  • Grow funds tax free. An HSA grows with you. If you maintain a minimum balance of $2,000 your additional funds may be invested in mutual funds yielding tax-free earnings.
  • Spend tax free. Withdrawals used for eligible expenses are tax free.
  • Funds can be withdrawn any time for health expenses.
  • After age 65, the funds can be used for any purpose, without penalty

You can use your HSA dollars and card to pay for:

  • Routine Healthcare: office visits, X-rays, lab work
  • Hospital Expenses: room and board, surgery
  • Medications: prescriptionand over-the-counter(OTC) drugswhen prescribed by aphysician
  • Dental Care: cleanings, fillings, crowns
  • Vision Care: eye exams, glasses, contacts
  • Copays and Coinsurance (the portions of healthcarebills paid by you)
  • Eligible OTC Items* such as: first aid dressings andsupplies – bandages, rubbing alcohol
  • Contact Lens Solution/Supplies
  • Diagnostic Products such as: thermometers, bloodpressure monitors, cholesterol testing
  • Insulin and Diabetic Testing Supplies

*The list of eligible OTC items changed per the PatientProtection and Affordable Care Act of 2010. Contact yourplan administrator for more information or visitwww.irs.gov for details.

The amount you save in taxes with a Health Savings Account will vary depending on the amount you set aside in the account, your annual earnings, whether or not you pay Social Security taxes, the number of exemptions and deductions you claim on your tax return, your tax bracket and your state and local tax regulations. Check with your tax advisor for information on you participation will affect your tax savings.

This brochure highlights some of the benefits of a Card. If there is a discrepancy between this material and your official plan document, the plan document will govern. WEX Health reserves the right to amend or modify the services at any time.

Flexible Spending Account (FSA) - Proficient Benefits Solution (PBS)
You are not eligible to contribute to a Health Savings Account (HSA) if you are enrolled in a medical FSA or if you have any rollover dollars from a medical FSA from a prior plan year.

 

Using a Flexible Spending Account (FSA) is great way to stretch your benefit dollars. You use before-tax dollars in your FSA to reimburse yourself for eligible out-of-pocket health (Healthcare FSA) and dependent care (Dependent Care FSA) expenses. That means you can enjoy tax savings and increased take-home pay—all with the convenience of a benefits card. Plus you can rollover $500 from your Health FSA from one year to the next, reducing your risk of losing dollars at the end of the plan year.

How much can I contribute?

With an FSA, you elect to have your annual contribution (up to $2700* for a Healthcare FSA and $5,000* for a Dependent CareFSA) deducted from your paycheck each pay period, in equal installments throughout the year, until you reach the yearly maximum you have specified. The amount of your pay that goes into an FSA will not count as taxable income, so you will have immediate tax savings. FSA dollars can be used during the plan year to pay for qualified expenses and services.

  • A Healthcare FSA allows reimbursement ofqualifyingout-of-pocket health expenses.
  • A Dependent Care FSA allows reimbursement ofdependent care expenses, such as daycare) incurred byeligible dependents.

*The entire elected Healthcare FSA contribution amount is frontloaded to the benefits card and available for immediate use. The elected Dependent Care contribution amount is loadedeach pay period.

ACCESSING MY FSA:

With all FSA account types, you’ll receive access to a secure, easy-to-use web portal where you can track your account balance, view your claims history and submit requests for reimbursements.

In addition, you’ll receive a convenient benefits card to make it easy to pay for eligible services and products. When you use the card, payments are automatically withdrawn from your account. Just swipe the card and go. Most expenses can be validated through the card transaction but you may be prompted to provide a copy of the itemized receipt for certain transactions in accordance to IRS regulations. When required, itemized receipts can be easily uploaded to either the consumer portal online or, through the mobile app.

WITH AN FSA YOU CAN:
An FSA is a great way to pay for expenses with pre-tax dollars.

  • Enjoy significant tax savings with pre-tax contributions and tax-free reimbursements forqualified plan expenses
  • Quickly and easily access funds using the prepaid benefits card at point of sale, or request to have funds directly deposited to your bank account via online or mobile app
  • Reduce filing hassles and paperwork by using your prepaid benefits card
  • Enjoy secure access to accounts using a convenient Consumer Portal available 24/7/365
  • Manage your FSA “on the go” with an easy-to-use mobile app
  • File claims easily online (when required) and let the system determine approval based on eligibility and availability of funds
  • Stay up to date on balances and action required with automated email alert and convenient portal an dmobile home page messages
  • Get one---click answers to benefits questions
  • Use it or Roll It Over. Up to $500 of your unused Healthcare FSA balance can be carried over into the next plan year instead of you “losing it” - making enrollment in an FSA much less risky. This gives you more flexibility to spend your FSA money when you need it. You can use it for necessary out-of-pocket healthcare expenses, rather than feeling pressured to engage in last minute and potentially unnecessary spending at the end of the year.

FINPATH - A TCG SOLUTION

A free, personalizedfinancial wellness program just for you.

The FinPath online Financial Education platform includes:

  • Wellness Score Analyzer - Take an assessment to determine your personal areas for improvement.
  • FinPath University Courses - Participate in online financial classes taught by investment advisors.
  • Support from Wellness Coaches - Get direct access to a coach who will answer any specific questions.

Make progress on your path to improved personal finances. Register for free today a www.finpathwellness.com.


HEALTH AND WELLBEING

Basic Term Life with Accidental Death & Dismemberment (AD&D) Insurance
can provide money for your family if you die or are diagnosed with a terminal illness.

How does it work?

You keep coverage for a set period of time, or "term". If you die during that term, the money can help your family pay for basic living expenses, final arrangements, tuition, and more.

AD&D insurance is also available, which can pay a benefit if you survive and accident but have certain serious injuries. It can pay an additional amount if you die from a covered accident.

Provided by your employer
Your employer is offering you this coverage at no cost to you.

An Accelerated Benefit
Terminally ill members may withdraw up to 75% of their Life benefit to a maximum of $750,000 (when Basic Life and any additional life are combined).

Waiver of Premium
Your cost may be waived if you are totally disabled for a period of time.

The Family Benefit Package includes:
Tuition reimbursement Career adjustment Child care benefit

Travel Assistance


The Life Services Toolkit
Helps beneficiaries cope with grief and loss

Who can get Basic Term Life coverage?

If you are actively at work at least 20 hours, you can receive coverage for:

You - You can receive a benefit amount of $20,000

Who can get Basic Accidental Death & Dismemberment (AD&D) coverage?

 You - You can receive an AD&D amount of $20,000

No questions or health exams required for Basic Life & AD&D coverage.

For more information about this plan and about exclusions and limitations please speak with a Benefits Counselor.

Term Life Insurance can provide money for your family if you die or are diagnosed with a terminal illness.

How does it work?
Life insurance helps employees’ loved ones get through a difficult time and can help pay for important things, like living expenses or college tuition.
Guaranteed Issue*

Employee: $250,000

Spouse: $50,000

Child: Full Benefit

Additional Benefits

  • An accelerated Benefit is included for employees— terminally ill members may withdraw up to 75% of their Life benefit to a maximum of $750,000 (when Basic Life and any Additional Life are combined).
  • Life Insurance for dependents continues automatically, without premium payment, for five months after the death of the insured member.
  • Dependents coverage includes child(ren) from live birth though age 25.

Conditions

  • Maximum additional Life benefit is 5 times annual earnings.
  • Member must be enrolled in Additional Life to enroll in the Spouse Life plan
  • Member must be enrolled in Additional Life to enroll in the Child Life plan

Who can get Term Life coverage?
If you are actively at work at least 20 hours per week, you may apply for coverage for:

You Maximum Benefit Amount: $500,000
Minimum Benefit Amount: $10,000
Guarantee Issue Amount: $250,000
Benefit Schedule: Increments of $10,000
Your
Spouse
Maximum Benefit Amount: $100,000*
Minimum Benefit Amount: $5,000
Guarantee Issue Amount: $50,000
Benefit Schedule: Increments of $5,000
*Spouse can’t exceed 100% of the member’s enrolled benefit for Additional Life.
Your
Children
Maximum Benefit Amount: $10,000*
Minimum Benefit Amount: $1,000
Guarantee Issue Amount: full amount
Benefit Schedule: Increments of $1,000
*Child life can’t exceed 100% of member’s enrolled benefit for Additional Life.

*For 9/1/19, all members may increase their benefit amount orapply for up to 5 increments of $10,000 ($50,000 total), not toexceed the guarantee issue amount, without providingevidence of insurability (EOI).

*After your initial enrollment period, during open enrollment, you may increase your benefit amount by or apply for one or two increments of $10,000 ($20,000 total), not to exceed the guarantee issue amount, without providing evidence of insurability. During the Annual Enrollment period, evidence of insurability is required for those whose evidence of insurability was not approved by us during any prior period of eligibility.

Term Life Insurance

Calculate your costs
1. Enter the Term Life coverage amount youwant.†
2. Divide by the amount shown.
3. Multiply by the rate. Use the Term Life rate table (at right) to find the rate based on age. (To get your age, subtract your birth year from 2019. To determine your spouse rate, subtract the employee birth year from 2019 and use the rate for the appropriate age band.)
4. Enter your monthly cost.

Term Life

1

2

3

4

Employee

$____,000

÷  1,000 = $_____

X $_____

= $_____

Spouse

$____,000

÷  1,000 = $_____

X $_____

= $_____

Child

$____,000

÷  1,000 = $_____

X $_____

= $_____

Total cost

 

Term Life monthly rate for employee
Age Per $1,000 of coverage
Cost
15-24 $0.045
25-29 $0.054
30-34 $0.071
35-39 $0.080
40-44 $0.089
45-49 $0.134
50-54 $0.206
55-59 $0.385
60-64 $0.590
65-69 $1.136
70-74 $1.842
75+ $1.842

 

Spouse monthly rate
Age Per $1,000 of coverage
Cost
15-24 $0.045
25-29 $0.054
30-34 $0.071
35-39 $0.080
40-44 $0.089
45-49 $0.134
50-54 $0.206
55-59 $0.385
60-64 $0.590
65-69 $1.136
70-74 $1.842
75+ $1.842
Child monthly rate

$0.123 per $1,000 of coverage

Billed amount may vary slightly.

† If you apply for coverage above the guaranteed issue amount, you will be asked health-related questions which may affect your ability to get the larger coverage amount. In order to purchase coverage for your dependents, you must buy coverage for yourself. Coverage amounts cannot exceed 100% of your coverage amounts.


For more information about this plan and about exclusions and limitations please speak with a Benefits Counselor.


HEALTH AND WELLBEING

CHUBB Lifetime Benefit Term

Chubb's LifeTime Benefit Term (LBT) innovative design provides lifetime guarantees at a fraction of the cost of whole life insurance. It’s term insurance that lasts a lifetime. And with LBT’s flexibility, death benefits can be taken early and doubled or even tripled to supplement the cost of Long Term Care. Solutions address differing employee needs for permanent life insurance and peace of mind for a lifetime, and are available for employees, their spouse, and children. The options include the industry’s most comprehensive Living Benefits package.

Product Features:

  • Valuable life insurance protection through age 120!
  • LifeTime Benefit Term life insurance up to $225,000 for eligibleactively at work employees.
  • Life base insurance premiums are guaranteed never to increase through age 100.
  • No medical exams required. Issuance of coverage dependsupon answers to a few health questions.
  • Provides paid-up death benefit values after only ten years, so if you decide to stop paying premiums at some time in the future,you are guaranteed paid-up coverage of a reduced amount.
  • Flexible! You have the option to: Continue your coverage at the same premium; or Elect paid-up insurance coverage of areduced amount after 10 years with no further premiumpayments—Guaranteed!
  • Fully portable – you own it and take it with you when you leave your employment.
  • Spouse and child coverage is available.

Please speak with a benefits counselor for personalized rates.

Voluntary Long-Term Disability

Texas Educators LTD (Employee Paid)

We understand the unique needs of those who work in education, and we have created Texas Educators
LTD insurance to meet those requirements. The Standard’s Texas Educators LTD insurance can replace a portion of your salary if you become ill or injured and can’t work. It can help you cover your expenses and protect your finances at a time when you’re not getting a paycheck and have extra medical bills.

  • Employee Benefit: You may purchase a monthly benefit in $100 units, starting at a minimum of
    $200, up to 66 2/3% of your monthly earnings rounded to the nearest $100, but not to exceed amonthly maximum benefit of $8,000. Please see your Plan Administrator for the definition of monthlyearnings.
  • Definition of Disability: You are disabled when The Standard determines that:
    • you are limited from performing the material and substantial duties of your regular occupation dueto your sickness or injury; and
    • you have a 20% or more loss in your indexed monthly earnings due to the same sickness or injury;and
    • during the elimination period, you are unable to perform any of the material and substantial dutiesof your regular occupation.
      After 24 months of payments, you are disabled when The Standard determines that due to the same sickness or injury, you are unable to perform the duties of any gainful occupation for which you are reasonably fitted by education, training or experience.

You must be under the regular care of a physician in order to be considered disabled.

  • Elimination Period: The Elimination Period is the length of time of continuous disability, due tosickness or injury, which must be satisfied before you are eligible to receive benefits.
    You may choose an Elimination Period (injury days/sickness days) of 0/7, 14/14, 30/30,60/60, 90/90, or 180/180 days.
  Elimination Period (days)
Injury (days) 0* 14* 30* 60 90 180
Sickness (days) 7* 14* 30* 60 90 180
             
  Monthly Rate per Increment of $100
  3.9 3.5 2.96 1.92 1.66 1.24

*If, because of your disability, you are hospital confined as an inpatient, benefits begin on the first day of in patient confinement.

  • Pre-existing Condition Exclusion1: Benefits will not be paid for disabilities caused by, contributedto by, or resulting from a pre-existing condition. You have a pre-existing condition if:
    • you received medical treatment, consultation, care or services including diagnostic measures*,or took prescribed drugs or medicines in the 3 months just prior to your effective date ofcoverage; and the disability begins in the first 12 months after your effective date of coverage.
  • Benefit Integration: Your disability benefit will be reduced by deductible sources of income and anyearnings you have while disabled.

*Pre-existing Exclusion will not apply for the first 90 days of disability 1Waived for those previously enrolled

Voluntary Long-Term Disability

  • Duration of Benefits: The duration of your benefit payments is based on your age when yourdisability occurs. Your LTD benefits are payable for the period during which you continue to meetthe definition of disability. If your disability occurs before age 62, benefits could be payable up tothe Social Security Normal Retirement Age. If your disability occurs at or after age 62, yourbenefits would be paid according to the benefit duration schedule.
Age at Disability Maximum Duration of Benefits
Less than Age 62 To Social Security Normal Retirement Age
Age 62 60 months
Age 63 48 months
Age 64 42 months
Age 65 36 months
Age 66 30 months
Age 67 24 months
Age 68 18 months

 

Year of Birth Social Security Normal Retirement Age
1937 or before 65 years
1938 65 years 2 months
1939 65 years 4 months
1940 65 years 6 months
1941 65 years 8 months
1942 65 years 10 months
1943-1954 66 years
1955 66 years 2 months
1956 66 years 4 months
1957 66 years 6 months
1958 66 years 8 months
1959 66 years 10 months
1960 and after 67 years
  • Survivor Benefit: Your eligible survivor will receive a lump sum benefit equal to 3 months of your gross disability payment. This benefit will be paid if, on the date of your death, your disability had continued for 180 or more consecutive days, and you were receiving or were entitled to receive payments under the plan. You may receive your survivor benefit prior to your death if you are receiving monthly payments and your physician certifies in writing that you have been diagnosed as terminally ill and your life expectancy has been reduced to less than 12 months.

Group LTD Standard Plan Features Include:

  • Rehabilitation and Return to Work Assistance Program - Provides a rehabilitation and return to work assistance benefit for disabled employees who are receiving LTD payments, and who are medically able to participate. The Standard will determine eligibility for this program.

SafetyNetsplus provides 4 Benefits For You and Your Immediate Family
All For $16.95 Per Month + New This Year - Free Student Loan Analysis
Powered by GotZoom!

TELADOC

Feel better now! 24/7 access to a doctor is only a call or click away—anytime, anywhere with a $0 visit fee. With Teladoc, you can talk to a doctor by phone, onlinevideo or mobileapp to get a diagnosis, treatment options and prescription if medically necessary. Save time and money by avoiding crowded waiting rooms in the doctor’s office, urgent care clinic or ER. Simply use your phone, computer, smartphone or tablet to reques ta visit with a U.S. physician licensed in your state. Teladoc doctors respond on average within 10 minutes to treat non emergency medical issues such as the following:

cold & flu symptoms constipation urinary tract infection
sinus problems allergies respiratory diarrhea
gastroenteritis infection pharyngitis bronchitis
pink eye   rash & other skin eruptions

Disclaimers:

©2019 Teladoc, Inc. All rights reserved. Teladoc and the Teladoc logo are registered trademarks of Teladoc, Inc. and may not be used without written permission. Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc operates subject to state regulation and may not be available in certain states. Teladoc does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse.

Available with no age restrictions.


LifeLock

Criminals can open new accounts, get payday loans, and even file tax returns in your name. There's a new victim every 2 seconds*, so don't wait to get identity theft protection.

  • Studies show individuals who receive a data breach notification are over 4 times more likely to become victims*
  • Credit monitoring only shows changes to credit AFTER they are reported to the credit bureaus, and damage has been done
  • LifeLock works proactively using advanced technology to monitor over a trillion data points to help detect suspicious uses of your identity information.
  • LifeLock Identity Alert® System** patented system alerts you via text, phone or email anytime LifeLock detects fraudulent use of your Social Security number, name, address or date of birth in applications for credit and service.
  • Dark Web Monitoring LifeLock patrols over 10,000 criminal websites and notifies you if they find your data
  • Lost Wallet Protection quickly cancels or replaces credit/debit cards from a lost or stolen wallet, infiltrates and patrols black market websites for the illegal selling or trading of your personal information
  • USPS Address Change Verification notifies you of any change of address associates with your personal information
  • Live member support provides U.S. based Member Service Agents 24/7/365 to assist you.

*Identity Fraud Studies, Javelin Strategy & Research
**LifeLock does not monitor all transactions at all businesses.
LifeLock membership Includes 3 adult memberships available to member, spouse, domestic partner, adult children, elder parents, & membership for up to 5 dependent children under the age of 18.

This plan is NOT insurance


Save time, money and stress. Protect yourself and your family with the SafetyNets plus package of benefits.

Family Legal Protection Plan
7 out of 10 families had a need for an attorney in the past year.
This plan is so much more than just an online do-it-yourself legal plan. Members have access to face-to-face or phone consultations with licensed network attorneys and so much more. There are no caps or limitations to how many times members can utilize the plan for new legal matters.

Four great ways to save:
1. No-Cost Services
2. Exclusive Flat Fee Services
3. Low Hourly Plan Discount Rate Services
4. Discounted Contingency Fees

No-Cost services including:

  • Free Simple Will with free annual updates
  • Free Living Will substitution for Free Simple Will
  • One-on-one consultations for new legal matters
  • Unlimited phone consultations (for each new legal matter)
  • Phone calls made and letters written on your behalf
  • Attorney review of legal documents (6 page max per new matter)
  • Helpful advice on representing yourself in small claims court
  • Assistance in solving your problems with government programs

Available to member, spouse or domestic partner, unmarried dependent children up to age 23. Also available to member and spouse’s elder parents, step parents, adoptive parents and grandparents, even if not residing in member’s household.


Roadside Assistance service is available 24 hours a day, 365 days a year to assist members when owned or leased vehicles are disabled as a result of unavoidable circumstances. Members will only have to pay for any
non-covered expenses or covered costs in excess of the 15 miles towing per occurrence maximum (up to $80 retail value). Coverage is extended to the member, spouse, and dependent children up to 21 years of age permanently residing at registered address when driving any vehicles that they own (or lease for 12 months or longer). Limit 1 service within 72 hours and maximum of five services per year.

  • Towing up to 15 miles
  • Battery jump start
  • Flat Tire changing to your spare
  • Lock out Assistance
  • Fluid Delivery - gas, oil, water

Reduce your Student Loan Debt by 65%
Educators and Public Service employees enjoy special status with the Department of Education (DOE) and are eligible for the best available student loan repayment and loan forgiveness programs. $350 Million of additional DOE funding became available in Mar. 2018 (first come, first serve)

  • #1 provider of Federal student loan relief with a 7 year track record of performance and customer satisfaction
  • The link to your enrollment page will be provided in the SafetyNets plus Welcome Packet you will receive prior to your effective date
  • Average student debt reduction of 65%
  • All administrative details are managed by GotZoom for the employee
  • GotZoom monitors DOE programs and reviews the employee's status annually to find any additional debt reduction options
  • Employee's loan analysis and Benefits Summary are free (no obligation)
  • Service fees apply only after the employee has reviewed and approved repayment/forgiveness programs
  • Application Fee: $407; Monthly Fee: $32.95

Disclosures: This plan is NOT insurance. This discount card program contains a 30-day cancellation period. This plan is not insurance coverage and does not meet the minimum creditable coverage requirements under the Affordable Care Act.

SafetyNets plus is provided by National Benefit Plans, Ltd

11550 IH 10 West, Suite 193. • San Antonio, TX 78230 • (800) 787-3988


EMPLOYEE ASSISTANCE PROGRAM

There are times in life when you might need a little help coping or figuring out what to do. Take advantage of the Employee Assistance Program1 (EAP) which includes WorkLife Services and is available to you and your family in connection with your group insurance from Standard Insurance Company (The Standard). It’s confidential — information will be released only with your permission or as required by law.

With EAP, assistance is immediate, personal and available when you need it.

Connection to Resources, Support and Guidance
You, your dependents (including children to age 26) 2 and all household members can contact master’s-degreed clinicians 24/7 by phone, online, live chat, email and text. There’s even a mobile EAP app. Receive referrals to support groups, a network counselor, community resources or your health plan. If necessary, you’ll be connected to emergency services.


Your program includes up to three face-to-face assessment and counseling sessions per issue. 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 preparation

WorkLife Services
WorkLife Services are included with the Employee Assistance Program. Get help with referrals for important needs like education, adoption, travel, daily living and care for your pet, child or elderly love done.

Online Resources
Visit workhealthlife.com/Standard3 to explore a wealth of information online, including videos, guides, articles, webinars, resources, self-assessments
and calculators.

Contact EAP
888.293.6948
TDD: 800.327.1833
24 hours a day, seven days a week
workhealthlife.com/Standard3

NOTE: It’s a violation of your company’s contract to share this information with individuals who are not eligible for this service.

h1eTEAP service is provided through an arrangement with Morneau Shepell, which is not affiliated with The Standard. Morneau Shepell is solely responsible for providing and administering the included service. EAP is not an insurance product and is provided to groups of 10–2,499 lives. This service is only available while insured under The Standard’s group policy.

n2dIividual EAP counseling sessions area available to eligible participants 16 years and older; family sessions are available for eligible members 12 years and older, and their parent or guardian. Children under the age of 12 will not receive individual counseling sessions.

The Standard is a marketing name for StanCorp Financial Group, Inc. and subsidiaries. Insurance products are offered by Standard Insurance Company of Portland, Oregon in all states except New York. Product features and availability vary by state and are solely the responsibility of Standard Insurance Company.


PERSONAL SERVICES

Legal Updates and Notices

Model Language for Notice of Opportunity to Enroll in Connection with
Extension of Dependent Coverage to Age 26

The interim final regulations extending dependent coverage to age 26 provide
transitional relief for a child whose coverage ended, or who was denied coverage (or was not eligible for coverage) under a group health plan or health insurance coverage because, under the terms of the plan or coverage, the availability of dependent coverage of children ended before the attainment of age 26. The regulation requires a plan or issuer to give such a child an opportunity to enroll that continues for at least 30 days (including written notice of the opportunity to enroll), regardless of whether the plan or coverage offers an open enrollment period and regardless of when any open enrollment period might otherwise occur. This enrollment opportunity (including the written notice) must be provided no later than the first day of the first plan year beginning on or after September 23, 2010. The notice may be included with other enrollment materials that a plan distributes, provided the statement is prominent. Enrollment must be effective as of the first day of the first plan year beginning on or after September 23, 2010.


The following model language can be used to satisfy the notice requirement:

Individuals whose coverage ended, or who were denied coverage (or were not
eligible for coverage), because the availability of dependent coverage of children ended before attainment of age 26 are eligible to enroll in Grand Prairie ISD group health plans. Individuals may request enrollment for such children for 30 days from the date of notice. Enrollment will be effective retroactively to September 1, 2019 beginning on or after September 23, 2010. For more information, contact your Payroll/Benefits Department.

Premium Assistance Under Medicaid and the Childrens' Health Insurance Program (CHIP)

If you or you children are eligible for Medicaid for CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid for CHIP, you won’t be eligible for those premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.

If you or your depends are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial
1-877-KIDS now or www.insurekidsnow.gov to find out how to apply. If you qualify, ask you state if it has a program that might help you pay the premiums for an employer-sponsored plan.

If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).

If you live in Texas you may be eligible for assistance paying your employer health plan premiums. The following contact information is current as of July 31, 2014. If you do not reside in Texas, You should contact your State for further information on eligibility.

Texas- Medicaid
Website: https://www.gethipptexas.com/
Phone: 1-800-440-0493

For more information on special enrollment rights, contact either:

U.S Department of Labor U.S. Department of Health and Human Services
Employee Benefits Security Administration Centers for Medicare & Medicaid Services
www.dol.gov.ebsa www.cms.hhs.gov
1-800-444-EBSA (3272) 1-877-267-2323, Menu Option 4, Ext. 61565

Womens' Health and Cancer Rights Act (WHCRA) Notice
Do you know that your plan, as required by the Women’s Health and Cancer Rights Act of 1998, provides benefits for mastectomy-related services including all stages of reconstruction and surgery to achieve symmetry between the breast, prostheses, and complications resulting from a
mastectomy, including lymphedema? Call your plan administrator at 972-237-5511 for more information.

Newborns’ and Mothers’ Health Protection Act
Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother’s or newborn’s attending
provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).

Important Notice from Grand Prairie ISD about your Prescription Drug Coverage and Individual Medicare Part D
Grand Prairie ISD has determined that the prescription drug coverage offered by Grand Prairie ISD is, on average, for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher
premium (a penalty) if you later decide to join a Medicare drug plan.

However, if you are enrolled under one of the HSA (Health Savings Account) plans your should strongly consider enrolling in an individual Medicare Part D plan, when you are first eligible. If you enroll later, you will face a significant Medicare Part D premium penalty. Prescription Drug coverage provided under the HSA plans are not considered to be creditable prescription coverage.

HIPPA Special Enrollment Rights
Loss of other coverage—If you are declining or have declined enrollment for yourself or your dependents (including your spouse) because of other health insurance coverage, you may in the future be able to enroll yourself or your dependents in this plan, provided that you request enrollment within 30 days after your other coverage ends.

Health Insurance Portability and Accountability Act
Grand Prairie ISD is in accordance with HIPPA, protects your Protected Health Information (PHI). Grand Prairie ISD discuss your PHI with medical providers and third-party administrators when necessary to administer the plan that provides your medical and dental benefits or as mandated by law.

Continuations Required by Federal Law for your and your Dependents (COBRA)
Federal Law enables you or your dependent to continue health insurance if coverage would cease due to a reduction of your work hours or your termination of employment (other than for gross misconduct). Federal law also enables your dependents(s) to continue health insurance if their coverage ceases due to your death, divorce, legal separation, or with respect to dependent children, failure to continue to qualify as a dependent. Continuation must be elected in accordance with the rules of your employer's group health plan(s) and is subject to federal law, regulations and interpretations.

HIPPA Privacy Notice Update
HIPPA requires Grand Prairie ISD notify you that a Privacy Notice is available from the Human Resources Department.

Mental Health Parity and Addiction Equity Act (MHPAEA)
The Mental Health Parity and Addiction Act of 2008 general requires group health plans and health insurance issuers to ensure that financial requirements (such as co-pays and deductibles) and treatment limitations (such as annual visit limits) applicable to mental health or substance use disorder benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical/surgical benefits.

Genetic Information Nondiscrimination Act (GINA)
The Genetic Information Nondiscrimination Act of 2008 protects employees against discrimination based on their genetic information. Unless otherwise permitted, your employer may not request or require any genetic information from you or your family members.

GINA prohibits employers and other entities covered by GINA Title II from requesting or requiring genetic information of an individual or family member of the individual, except as specifically allowed by this law.
comply with this law, we are asking that you not provide any genetic information when responding to this request for medical information.

Women’s Health and Cancer Rights Act
If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women's Health and Cancer Rights Act of 1998 (WHCRA). The Women's Health and Cancer Rights Act requires group health plans and their insurance companies and HMOs to provide certain benefits for mastectomy patients who elect breast reconstruction. For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for:

  • All stages of reconstruction of the breast on which the mastectomy was performed;
  • Surgery and reconstruction of the other breast to produce a symmetrical appearance;
  • Prostheses; and
  • Treatment of physical complications of the mastectomy, including lymphedema.
    Breast reconstruction benefits are subject to deductibles and co-insurance limitations that are consistent with those establishes for other benefits under the plan.

Contact Page

Plan Group Number Website Contact
Medical - Aetna 285711 www.texashealthaetna.com 800-309-2386
Hospital Indemnity - Aetna 285711 www.texashealthaetna.com 800-309-2386
Gap - Beazley YD9002 www.beazleybenefits.com 855-805-9176
Dental - MetLife 0166568 www.metlife.com/mybenefits 800-942-0854
Vision - MetLife/VSP 0166568 www.metlife.com/mybenefits 855-638-3931
Group Life - The Standard Voluntary
Life - The Standard
Disability - The Standard
EAP - The Standard
165930 www.standard.com 855-757-4717
855-757-4717
88-293-6948
855-757-4717
Accident - CHUBB
Critical Illness - Cancer - CHUBB
TBD www.chubbworkplacebenefits.com 866-324-8222
866-324-8222
403 (b) – Financial Pathway N/A www.financialpathway.com 833-777-6545
HSA - Proficient Benefits Solutions (PBS)
FSA - Proficient Benefits Solutions (PBS)
COBRA Administration
Grand Prairie ISD www.proficientbenefits.com 888-659-8151
Permanent Life Insurance - CHUBB TBD www.chubbworkplacebenefis.com 866-324-8222
       
Safety-Nets Plus 15111 www.safetynetsplus.com 800-787-3988
866-611-7043-
Roadside
BCG-Benefits Service Center Benefits Call Center www.bcgenrolls.com 888-284-2470

 

Staff Member Email Phone
GPISD Payroll/Benefits
Pat Wade pat.wade@gpisd.org 972-237-5513
Darlene Jennings debra.jennings@gpisd.org 972-237-5511
Karla Silvas karla.silvas@gpisd.org 972-237-5507
Brown & Brown    
Kelli Cobarrubias
Account Executive
kcobarrubias@alamoinsgrp.com 210-524-7142
Greg Coldewey
Account Executive
gcoldewey@alamoinsgrp.com

210-524-7109



Notes

Grand Prairie Independent School District

2602 South Belt Line Road

Grand Prairie, TX 75052

www.gpisd.org