2016 benefit guide cedar hill isd

EFFECTIVE:

09/01/2016 - 8/31/2017

BENEFIT GUIDE

www.mybenefitshub.com/cedarhillisd

CEDAR HILL ISD

1

Benefit Contact Information 3 How to Enroll 4-5 Annual Benefit Enrollment 6-11 1. Benefit Updates 6 2. Section 125 Cafeteria Plan Guidelines 7 3. Annual Enrollment 8 4. Eligibility Requirements 9 5. Helpful Definitions 10 6. HSA vs FSA Comparison 11 NBS Flexible Spending Account 12-15 TRS-ActiveCare Aetna 16-20 TRS Baylor Scott & White Medical 21-22 TRS Aetna and Scott & White Rate Sheet 23 MDLIVE Telehealth 24-25 APL MEDlink® 26-29 HSA Bank Health Savings Account 30-33 Cigna Dental 34-37 Superior Vision 38-39 The Hartford Long-Term Disability 40-43 Loyal American Cancer 44-47 AUL a One America Company Basic and Voluntary Life

48-51

One America EAP 52-53 Axis Global AD&D 54-55 Texas Life Permanent Life 58-59

Table of Contents

HOW TO ENROLL

PG. 4

YOUR BENEFIT UPDATES: WHAT’S NEW

PG. 6

YOUR BENEFITS PACKAGE

PG. 12

FLIP TO...

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Benefit Contact Information

BENEFIT ADMINISTRATORS HEALTH SAVINGS ACCOUNT CANCER COBRA (MEDICAL)

Financial Benefit Services (800) 583-6908 www.mybenefitshub.com/cedarhillisd

HSA Bank (800) 357-6246 www.hsabank.com

Group # 1630 Loyal American (800) 366-8354 www.loyalamerican.com

WellSystems (844) 752-5146

CEDAR HILL ISD ADMINISTRATOR

TELEHEALTH AD&D COBRA (DENTAL & VISION)

Kathy Shaw (972) 291-1581 [email protected]

MD Live (888) 632-2738 www.consultmdlive.com

VADD-50100-81 Axis Global (800) 583-6908 www.axisaccidentalhealth.com

National Benefit Services (800) 835-2362 www.nbsbenefits.com

TRS ACTIVECARE MEDICAL DENTAL VOLUNTARY LIFE

Aetna (800) 222-9205 www.trsactivecareaetna.com

Group # 3331960 CIGNA (800) 244-6224 www.mycigna.com

Group #G613168 AUL a OneAmerica Company (800) 583-6908 www.oneamerica.com

TRS HMO MEDICAL VISION INDIVIDUAL LIFE Scott and White (800) 321-7947 www.trs.swhp.org

Group # 29293 Superior Vision (800) 507-3800 www.superiorvision.com

Texas Life (800) 283-9233 www.texaslife.com

MEDICAL SUPPLEMENT DISABILITY FLEXIBLE SPENDING ACCOUNT

Group # 15301 APL MEDlink® (800) 256-8606 www.ampublic.com

Group # 395316 The Hartford (800) 583-6908 File a claim: (866) 278-2655 www.thehartford.com

National Benefit Services (800) 274-0503 www.nbsbenefits.com

Benefit Contact Information

3

!

How to Enroll

On Your Computer Access THEbenefitsHUB from your

computer, tablet or smartphone!

Our online benefit enrollment

platform provides a simple and

easy to navigate process. Enroll

at your own pace, whether at

home or at work.

www.mybenefitshub.com/

cedarhillisd delivers important

benefit information with 24/7

access, as well as detailed plan

information, rates and product

videos.

TEXT

“cedarhill”

TO

313131

On Your Device Enrolling in your benefits just got

a lot easier! Text “cedarhill” to

313131 to receive everything you

need to complete your

enrollment.

Avoid typing long URLs and scan

directly to your benefits website,

to access plan information,

benefit guide, benefit videos, and

more!

SCAN: TRY ME

4

GO www.mybenefitshub.com/cedarhillisd 1

2

Login Steps

3

Go to:

Click Login

Enter Username & Password

OR SCAN

All login credentials have been RESET to the default

described below:

Username:

The first six (6) characters of your last name, followed

by the first letter of your first name, followed by the

last four (4) digits of your Social Security Number.

If you have six (6) or less characters in your last name,

use your full last name, followed by the first letter of

your first name, followed by the last four (4) digits of

your Social Security Number.

Default Password:

Last Name* (lowercase, excluding punctuation)

followed by the last four (4) digits of your Social

Security Number.

Sample Password

l incola1234

l incoln1234

If you have trouble

logging in, click on the

“Login Help Video”

for assistance.

Click on “Enrollment Instructions” for more information about how to enroll.

Sample Username

LOGIN

Open Enrollment Tip

For your User ID: If you have less than six (6) characters in your last

name, use your full last name, followed by the first letter of your first

name, followed by the last four (4) digits of your Social Security Number.

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Financial Benefit Services (FBS) is the Third Party Administrator for the Cedar Hill ISD. FBS will conduct the annual enrollment and provide benefit support for the Cedar Hill ISD employees.

IMPORTANT! Per ACA Requirements, this is a mandatory

enrollment. All employees MUST login into THEbenefitsHUB to elect or decline benefits for the new plan effective 9/1/16.

UPDATE! Aetna remains the carrier for Medical Plans:

ActiveCare 1 HD, ActiveCare 2 and ActiveCare Select. All eligible employees, including active, contributing TRS members and employees regularly working 10 hours per week MUST either enroll for coverage or decline coverage in the Benefits HUB. For comprehensive TRS medical information, please visit the website, www.tractivecareaetna.com.

UPDATE! There is a slight increase in rates for The

Hartford Disability. Benefits and rates will remain the same for: Superior Vision, MDLive Telehealth, MDLive, Axis Global AD&D, National Benefit Services FSA accounts and Texas Permanent Life.

Health Care or Dependent Care FSA* participants— you

must re-elect a new contribution amount every year.

This benefit does not roll over. The 2016 FSA contribution limit is $2,550. If you are electing FSA for the first time, your debit card will arrive by the end of September. You can manually submit claims prior to receiving your cards. *Federal law prohibits anyone from having access to an FSA while making contributions to an HSA. This prohibition includes access to FSA rollover funds from the prior plan year.If you are planning to elect the HSA and have not spent all of the funds from your FSA by the end of this plan year (8/31/15), those funds will not be eligible for rollover.

Benefits and rates will remain the same for: Superior

Vision, Cigna Dental, MDLive Telehealth, Axis Global AD&D, National Benefit Services FSA accounts and Texas Permanent Life.

A Health Savings Account with HSA Bank. Tax-free savings

account available with high deductible insurance plans ONLY. Deposits are tax exempt, and available to pay for medical, dental or vision expenses. The HSA* annual contribution maximum is $3,350/individuals and $6,750/family. For individuals who are between 55-65, there is an additional catch-up provision of $1,000 that can be contributed annually.

Don’t Forget!

Login and complete your benefit enrollment from 07/18/2016 - 08/19/2016 On-site enrollment assistance will be available at the Benefits Office on July 19, 21, 26, 28 and

August 2, 4, 11, 18, and 19 from 8:00am - 4:30pm. Add dependents to the system—please bring dependent Social Security numbers and date of birth.

Benefit Updates - What’s New:

SUMMARY PAGES

Annual Benefit Enrollment

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SUMMARY PAGES

CHANGES IN STATUS (CIS):

QUALIFYING EVENTS

Marital Status A change in marital status includes marriage, death of a spouse, divorce or annulment (legal separation is not recognized in all states).

Change in Number of Tax Dependents

A change in number of dependents includes the following: birth, adoption and placement for adoption. You can add existing dependents not previously enrolled whenever a dependent gains eligibility as a result of a valid change in status event.

Change in Status of Employment Affecting

Coverage Eligibility

Change in employment status of the employee, or a spouse or dependent of the employee, that affects the individual's eligibility under an employer's plan includes commencement or termination of employment.

Gain/Loss of Dependents' Eligibility Status

An event that causes an employee's dependent to satisfy or cease to satisfy coverage requirements under an employer's plan may include change in age, student, marital, employment or tax dependent status.

Judgment/Decree/Order

If a judgment, decree, or order from a divorce, annulment or change in legal custody requires that you provide accident or health coverage for your dependent child (including a foster child who is your dependent), you may change your election to provide coverage for the dependent child. If the order requires that another individual (including your spouse and former spouse) covers the dependent child and provides coverage under that individual's plan, you may change your election to revoke coverage only for that dependent child and only if the other individual actually provides the coverage.

Eligibility for Government Programs

Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change.

A Cafeteria plan enables you to save money by using pre-tax dollars to pay for eligible group insurance premiums sponsored and offered by your employer. Enrollment is automatic unless you decline this benefit. Elections made during annual enrollment will become effective on the plan effective date and will remain in effect during the entire plan year.

Changes in benefit elections can occur only if you experience a qualifying event. You must present proof of a qualifying event to your Benefit Office within 31 days of your qualifying event and meet with your Benefit/HR Office to complete and sign the necessary paperwork in order to make a benefit election change. Benefit changes must be consistent with the qualifying event.

Section 125 Cafeteria Plan Guidelines

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Annual Enrollment

During your annual enrollment period, you have the opportunity

to review, change or continue benefit elections each year.

Changes are not permitted during the plan year (outside of

annual enrollment) unless a Section 125 qualifying event occurs.

Changes, additions or drops may be made only during the

annual enrollment period without a qualifying event.

Employees must review their personal information and verify

that dependents they wish to provide coverage for are

included in the dependent profile. Additionally, you must

notify your employer of any discrepancy in personal and/or

benefit information.

Employees must confirm on each benefit screen (medical,

dental, vision, etc.) that each dependent to be covered is

selected in order to be included in the coverage for that

particular benefit.

New Hire Enrollment

All new hire enrollment elections must be completed in the

online enrollment system within the first 31 days of benefit

eligibility employment. Failure to complete elections during this

timeframe will result in the forfeiture of coverage.

Q&A

Who do I contact with Questions?

For supplemental benefit questions, you can contact your

Benefits/HR department or you can call Financial Benefit Services

at 866-914-5202 for assistance.

Where can I find forms?

For benefit summaries and claim forms, go to your benefit

website:

www.mybenefitshub.com/cedarhillisd. Click on the benefit

plan you need information on (i.e., Dental) and you can find

the forms you need under the Benefits and Forms section.

How can I find a Network Provider?

For benefit summaries and claim forms, go to the Cedar Hill

ISD benefit website: www.mybenefitshub.com/cedarhillisd.

Click on the benefit plan you need information on (i.e.,

Dental) and you can find provider search links under the Quick

Links section.

When will I receive ID cards?

If the insurance carrier provides ID cards, you can expect to

receive those 3-4 weeks after your effective date. For most

dental and vision plans, you can login to the carrier website

and print a temporary ID card or simply give your provider the

insurance company’s phone number and they can call and

verify your coverage if you do not have an ID card at that

time. If you do not receive your ID card, you can call the

carrier’s customer service number to request another card.

SUMMARY PAGES

8

PLAN CARRIER MAXIMUM AGE

Medical Aetna 26

Medical Scott and White 26

Dental Cigna 26

Vision Superior Vision 26

Life AUL a OneAmerica Company 26

Cancer Loyal American 25

AD&D Axis Global 26

Individual Life Texas Life 19

Employee Eligibility Requirements

Supplemental Benefits: Eligible employees must work 30 or more

regularly scheduled hours each work week.

Eligible employees must be actively at work on the plan effective

date for new benefits to be effective, meaning you are physically

capable of performing the functions of your job on the first day of

work concurrent with the plan effective date. For example, if

your 2016 benefits become effective on September 1, 2016, you

must be actively-at-work on September 1, 2016 to be eligible for

your new benefits.

Dependent Eligibility Requirements

Dependent Eligibility: You can cover eligible dependent

children under a benefit that offers dependent coverage,

provided you participate in the same benefit, through the

maximum age listed below. Dependents cannot be double

covered by married spouses within Cedar Hill ISD or as both

employees and dependents.

If your dependent is disabled, coverage can continue past the maximum age under certain plans. If you have a disabled dependent who is reaching an ineligible age, you must provide a physician’s statement confirming your dependent’s disability. Contact your HR/Benefit Administrator to request a continuation of coverage.

SUMMARY PAGES

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Actively at Work You are performing your regular occupation for the employer

on a full-time basis, either at one of the employer’s usual

places of business or at some location to which the employer’s

business requires you to travel. If you will not be actively at

work beginning 9/1/2016 please notify your benefits

administrator.

Annual Enrollment The period during which existing employees are given the

opportunity to enroll in or change their current elections.

Annual Deductible The amount you pay each plan year before the plan begins to

pay covered expenses.

Calendar Year January 1st through December 31st

Co-insurance After any applicable deductible, your share of the cost of a

covered health care service, calculated as a percentage (for

example, 20%) of the allowed amount for the service.

Guaranteed Coverage The amount of coverage you can elect without answering any

medical questions or taking a health exam. Guaranteed

coverage is only available during initial eligibility period.

Actively-at-work and/or pre-existing condition exclusion

provisions do apply, as applicable by carrier.

In-Network Doctors, hospitals, optometrists, dentists and other providers

who have contracted with the plan as a network provider.

Out of Pocket Maximum The most an eligible or insured person can pay in co-insurance

for covered expenses.

Plan Year September 1st through August 31st

Pre-Existing Conditions Applies to any illness, injury or condition for which the

participant has been under the care of a health care provider,

taken prescriptions drugs or is under a health care provider’s

orders to take drugs, or received medical care or services

(including diagnostic and/or consultation services).

Helpful Definitions SUMMARY PAGES

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SUMMARY PAGES HSA vs. FSA

Health Savings Account (HSA) (IRC Sec. 223)

Flexible Spending Account (FSA) (IRC Sec. 125)

Description

Approved by Congress in 2003, HSAs are actual bank accounts in employee’s names that allow employees to save and pay for unreimbursed qualified medical expenses tax-free.

Allows employees to pay out-of-pocket expenses for copays, deductibles and certain services not covered by medical plan, tax-free. This also allows employees to pay for qualifying dependent care tax-free.

Employer Eligibility A qualified high deductible health plan. All employers

Contribution Source Employee and/or employer Employee and/or employer

Account Owner Individual Employer

Underlying Insurance Requirement

High deductible health plan None

Minimum Deductible $1,300 single (2016) $2,600 family (2016) N/A

Maximum Contribution $3,350 single (2016) $6,750 family (2016)

Varies per employer

Permissible Use Of Funds If used for non-qualified medical expenses, subject to current tax rate plus 20% penalty.

Reimbursement for qualified medical expenses (as defined in Sec. 213(d) of IRC).

Cash-Outs of Unused Amounts (if no medical expenses)

Permitted, but subject to current tax rate plus 20% penalty (penalty waived after age 65).

Not permitted

Year-to-year rollover of account balance?

Yes, will roll over to use for subsequent year’s health coverage.

No. Access to some funds can may be extended if your employer’s plan contains a 2 1/2 –month grace period or $500 rollover provision.

Does the account earn interest?

Yes No

Portable? Yes, portable year-to-year and between jobs.

No

FOR HSA INFORMATION

FLIP TO… PG. 30

FOR FSA INFORMATION

FLIP TO… PG. 12

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A Cafeteria Plan is designed to take advantage of Section 125 of the Internal Revenue Code. It allows you to pay certain qualified expenses on a pre-tax basis, thereby reducing your taxable income. You can set aside a pre-established amount of money per plan year in a Healthcare Flexible Spending Account (FSA). Funds allocated to a healthcare FSA must be used during the plan year or are forfeited unless your plan contains a $500 rollover or grace period provision.

Unlimited FSA (Non HSA Compatible) The funds in the unlimited healthcare FSA can be used to pay for eligible medical expenses like deductibles, co-payments, orthodontics, glasses and contacts.

About this Benefit

FSA (Flexible Spending Account)


NBS

This is a general overview of your plan benefits. If the terms of this outline differ from your policy, the policy will govern. Additional plan details on covered expenses, limitations and exclusions are included in the summary plan description located on the

Cedar Hill ISD Benefits Website: www.mybenefitshub.com/cedarhillisd 12

NBS Flexcard You may use the card to pay merchants or service providers that accept MasterCard® credit cards, so there is no need to pay cash up front, then wait for reimbursement. If you are participating in the Dependent Care portion, the money isn’t loaded to the card. You must file web or paper claims or enroll in continual reimbursement.

Current plan participants: KEEP YOUR CARDS! NBS debit cards are good for 3 years. If you throw away your cards, there is a $5.00 fee to replace them.

New Plan Participants NBS will mail out your new benefit cards to the address listed in THEbenefitsHUB. They will be sent in unmarked envelopes so please watch for them as they should arrive within 21 business days of effective date. NBS debit cards are good for 3 years.

FSA Annual Contribution Max: $2,550

Dependent Care Annual Max: $5,000

Account Information: Participant Account Web Access: www.participant.nbsbenefits.com Participants may call NBS and talk to a representative during regular business hours, Monday-Friday, 8 am to 7 pm Central Time. Participants can also obtain account information using the Automated Voice Response Unit, 24 hours a day, 7 days a week at (801) 838-7324 or toll free (800) 274-0503. For immediate access to your account information at any time, log on to the NBS website: www.NBSbenefits.com

Detailed claim history and processing status

Health care and dependent Care Account balances

Claim forms, Direct Deposit form, worksheets, etc.

Online Claim FAQs

For a list of sample expenses, please refer to the Cedar Hill ISD benefit website: www.mybenefitshub.com/cedarhillisd

NBS Contact Information:

8523 South Redwood Road West Jordan, UT 84088 Phone (800) 274‐0503 Fax (800) 478‐1528 Email: [email protected]

When Will I Receive My Flex Card? Expect Flex Cards to be delivered to the address listed in THEbenefitsHUB near the end of September. Don’t forget, Flex Cards Are Good For 3 Years!

FSA (Flexible Spending Account)

DID YOU KNOW? FSAs use tax-free funds to help pay for your Health Care Expenses.

NBS Prepaid MasterCard® Debit Card

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What is a Flexible Spending Account? A Flexible Spending Account allows you to save money by paying out-of-pocket health and/or dependent care related expenses with pre-tax dollars. Your contributions are deducted from your pay before taxes are withheld and your account is up fronted with an annual amount. Because you are taxed on a lower amount of pay, you pay less in taxes and you have more to spend.

How does a Flexible Spending Account Benefit Me? A Cafeteria plan enables you to save money on group insurance, health-related expenses, and dependent-care expenses. You may save as much as 35 percent on the cost of each benefit option! Eligible expenses must be incurred within the plan year and contributions are use-it-or- lose-it. Remember to retain all your receipts.

Health Care Expense Account Example Expenses:

Dependent Care Expense Account Example Expenses: Before and After School and/or Extended Day Programs

The actual care of the dependent in your home.

Preschool tuition.

The base costs for day camps or similar programs used as care for a qualifying individual.

What Can I Use My Flexible Spending Account On? For a full list of eligible expenses, please refer to www.mybenefitshub.com/cedarhillisd

What Happens If I Don’t Use All of My Funds by The End of the Plan Year (August 31st)? Eligible expenses must be incurred within the plan year +75 day grace period. Contributions are use-it-or- lose-it. Remember to retain all your receipts (including receipts for card swipes).

How Do I File A Claim? In most situations, you will be able to swipe your card however, in the event you lose your card or are waiting to receive one, you can visit www.mybenefitshub.com/cedarhillisd and complete the “Claim Form” to send to NBS or use the web or phone app to file online.

Hearing aids & batteries

Lab fees

Laser Surgery

Orthodontia Expenses

Physical exams

Pregnancy tests

Prescription drugs

Vaccinations

Vaporizers or humidifiers

Acupuncture

Body scans

Breast pumps

Chiropractor

Co-payments

Deductible

Diabetes Maintenance

Eye Exam & Glasses

Fertility treatment

First aid

FSA Frequently Asked Questions

How To Receive Your Dependent Care Reimbursement Faster.

A Direct Deposit form is available on the Benefits Website which will help you get reimbursed quicker!

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How the FSA Plan Works

You designate an annual election of pre-tax dollars to be deposited into your health and dependent-care spending accounts. Your total election is divided by the number of pay periods in the Plan year and deducted equally from each paycheck before taxes are calculated. By the end of the Plan year, your total election will be fully deposited. However, you may make a claim for eligible health FSA expenses as soon as they are incurred during the Plan year. Eligible claims will be paid up to your total annual election even if you have not yet contributed that amount to your account.

Get Your Money 1. Complete and sign a claim form (available on our website) or an online claim. 2. Attach documentation; such as an itemized bill or an Explanation of Benefits (EOB) statement from a health insurance provider. 3. Fax or mail signed form and documentation to NBS. 4. Receive your non-taxable reimbursement after your claim is processed either by check or direct deposit.

NBS Flexcard—FSA Pre-paid Benefit Card Your employer may sponsor the use of the NBS Flexcard, making access to your flex dollars easier than ever. You may use the card to pay merchants or service providers that accept credit cards, so there is no need to pay cash up front then wait for reimbursement.

Account Information Participants may call NBS and talk to a representative during our regular business hours, Monday–Friday, 7am to 6pm Mountain Time. Participants can also obtain account information using the Automated Voice Response Unit, 24 hours a day, 7 days a week at (801) 838-7324 or toll free (800) 274-0503. For immediate access to your account information at any time, log on to our website: www.NBSbenefits.com Information includes:

Detailed claim history and processing status

Health Care and Dependent Care account balances

Claim forms, worksheets, etc.

Online Claim Submission

Enrollment Considerations After the enrollment period ends, you may increase, decrease, or stop your contribution only when you experience a qualifying “change of status” (marriage status, employment change, dependent change). Be conservative in the total amount you elect to avoid forfeiting money that may be left in your account at the end of the year. Your employer may allow a short grace period after the Plan year ends for you to submit qualified claims for any unused funds.

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Major medical insurance is a type of health care coverage that provides benefits for a broad range of medical expenses that may be incurred either on an inpatient or outpatient basis.

About this Benefit

Medical


DID YOU KNOW?

TRS Aetna

More than 70% of adults across the United States are already being diagnosed with

a chronic disease.



2016-2017 TRS-ActiveCare Plan Highlights Effective September 1, 2016 through August 31, 2017 | In-Network Level of Benefits*

Type of Service ActiveCare 1-HD ActiveCare Select or ActiveCare Select Whole Health

(Baptist Health System and HealthTexas Medical Group; Baylor Scott & White Quality Alliance; Memorial Hermann

Accountable Care Network; Seton Health Alliance)

ActiveCare 2

Deductible (per plan year)

$2,500 employee only $5,000 family

$1,200 individual $3,600 family


Out-of-Pocket Maximum (per plan year; does include medical deductible/ any medical copays/coinsurance/any prescription drug deductible and applicable copays/coinsurance)

$6,550 individual $13,100 family (the individual out-of-pocket maximum only includes covered expenses incurred by that individual)



Coinsurance Plan pays (up to allowable amount) Participant pays (after deductible)

80% 20%

80% 20%

80% 20%

Office Visit Copay Participant pays

20% after deductible $30 copay for primary $60 copay for specialist

$30 copay for primary $50 copay for specialist

Diagnostic Lab Participant pays

20% after deductible Plan pays 100% (deductible waived) if performed at a Quest facility; 20% after deductible at other facility

Plan pays 100% (deductible waived) if performed at a Quest facility; 20% after deductible at other facility

Preventive Care See next page for a list of services

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

Teladoc® Physician Services $40 consultation fee (applies to 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 (preauthorization required) (facility charges) Participant pays

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)

Emergency Room (true emergency use) Participant pays

20% after deductible $150 copay plus 20% after deductible (copay waived if admitted)

$150 copay plus 20% after deductible (copay waived if admitted)

Outpatient Surgery Participant pays

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

$150 copay per visit plus 20% after deductible

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

$5,000 copay plus 20% after deductible

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

Prescription Drugs Drug deductible (per plan year)

Subject to plan year deductible $0 for generic drugs $200 per person for brand-name drugs

$0 for generic drugs $200 per person for brand-name drugs

Retail Short-Term (up to a 31-day supply) Participant pays • Generic copay • Brand copay (preferred list) • Brand copay (non-preferred list)

20% after deductible

$20 $40** 50% coinsurance**

$20 $40** $65**

Retail Maintenance (after first fill; up to a 31-day supply) Participant pays • Generic copay • Brand copay (preferred list) • Brand copay (non-preferred list)


$35 $60** 50% coinsurance**

$35 $60** $90**

Mail Order and Retail-Plus (up to a 90-day supply) Participant pays • Generic copay • Brand copay (preferred list) • Brand copay (non-preferred list)

20% after deductible $45 $105*** 50% coinsurance

$45 $105*** $180***

Specialty Drugs Participant pays

20% after deductible 20% coinsurance per fill $200 per fill (up to 31-day supply) $450 per fill (32- to 90-day supply)

A specialist is any physician other than family practitioner, internist, OB/GYN or pediatrician. *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 ActiveCare Select or 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. **If the patient obtains a brand-name drug when a generic equivalent is available, the patient will be responsible for the generic copayment plus the cost difference between the brand-name drug and the generic drug.

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TRS-ActiveCare Plans—Preventive Care

Preventive Care Services

Network Benefits When Using In-Network Providers

(Provider must bill services as “preventive care”)

ActiveCare 1-HD ActiveCare Select or ActiveCare Select

Whole Health (Baptist Health System and

HealthTexas Medical Group; Baylor Scott & White Quality Alliance;

Memorial Hermann Accountable Care Network; Seton Health

Alliance)

ActiveCare 2 Network

Evidence−based items or services that have in effect a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force (USPSTF) www. uspreventiveservicestaskforce.org/Page/Name/uspstf-a-andb- recommendations.

Immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC) with respect to the individual involved.

Evidence−informed preventive care and screenings provided for in the comprehensive guidelines supported by the Health Resources and Services Administration (HRSA) for infants, children and adolescents. Additional preventive care and screenings for women, not described above, as provided for in comprehensive guidelines supported by the HRSA www.hhs.gov/healthcare/factsand- features/fact-sheets/preventive-services-covered-underaca/ index.html#CoveredPreventiveServicesforAdults.

For purposes of this benefit, the current recommendations of the USPSTF regarding breast cancer screening and mammography and prevention will be considered the most current (other than those issued in or around November 2009).

The preventive care services described above may change as USPSTF, CDC and HRSA guidelines are modified.

Plan pays 100% (deductible waived; no copay required) Some 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 – 1 every year

age 35 and over Colonoscopy – 1 every 10 years

age 50 and over Prostate cancer screening – 1

per year age 50 and over Smoking cessation counseling – 8

visits per 12 months Healthy diet/obesity counseling

–unlimited to age 22; age 22 and over-26 visits per 12 months

Breastfeeding support – 6 lactation counseling visits per 12 months

Plan pays 100% (deductible waived; no copay required) Some 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 – 1 every year age 35 and over

Colonoscopy – 1 every 10 years age 50 and over

Prostate cancer screening –1 per year age 50 and over

Smoking cessation counseling –8 visits per 12 months

Healthy diet/obesity counseling – unlimited to age 22; age 22 and over-26 visits per 12 months

Breastfeeding support –6 lactation counseling visits per 12 months

Plan pays 100% (deductible waived) Some 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 – 1 every year age 35 and over

Colonoscopy – 1 every 10 years age 50 and over

Prostate cancer screening – 1 per year age 50 and over

Smoking cessation counseling – 8 visits per 12 months

Healthy diet/obesity counseling – unlimited to age 22; age 22 and over-26 visits per 12 months

Breastfeeding support – 6 lactation counseling visits per 12 months

(Examples of covered services included are: Routine annual physicals (one per year); immunizations; well-child care; breastfeeding support, services and supplies; cancer screening mammograms; bone density test; screening for prostate cancer and colorectal cancer (including routine colonoscopies); smoking cessation counseling services and healthy diet counseling; and obesity screening/counseling.

Examples of covered services for women with reproductive capacity are: Female sterilization procedures and specified FDA-approved contraception methods with a written prescription by a health care practitioner, including cervical caps, diaphragms, implantable contraceptives, intra-uterine devices, injectables, transdermal contraceptives and vaginal contraceptive devices. Prescription contraceptives for women are covered under the pharmacy benefits administered by Caremark.

To determine if a specific contraceptive drug or device is included in this benefit, contact Customer Service at 1-800-222-9205. The list may change as FDA guidelines are modified.

Annual Vision Examination (one per plan year; performed by an opthalmologist or optometrist using calibrated instruments) Participant pays

After deductible, plan pays 80%; participant pays 20%

$60 copay for specialist $50 copay for specialist

Annual Hearing Examination Participant pays

After deductible, plan pays 80%; participant pays 20%



Note: Covered services under this benefit must be billed by the provider as “preventive care.” If you receive preventive services from a non-network provider, you will be responsible for any applicable deductible and coinsurance under the ActiveCare 1-HD and ActiveCare 2. Non-network preventive care is not paid at 100%. There is no coverage for non-network services under the ActiveCare Select plan or ActiveCare Select Whole Health.

2016-2017 TRS-ActiveCare Plan Highlights Effective September 1, 2016 through August 31, 2017 | In-Network Level of Benefits*

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. 18

2016-2017 TRS-FirstCare Plan Highlights Plan Summary 2016 -2017

Medical Plan Year Deductible $500 Individual; $1,500 Family

Out-of-Pocket Maximum (includes medical & drug deductibles, copayments & coinsurance) $6,000 Individual: $12,000 Family

Annual Maximum Unlimited

Primary Care Provider (PCP) Office Visit

Includes routine lab/X-ray services, injectables, and supplies

Other services provided in a physician’s office are subject to additional deductible and copayments/coinsurance

$20 copayment

PCP Office Visit-Dependents, through age 19 $0 copayment

Specialist Office Visit

Includes routine lab/X-ray services

Other services provided in a physician’s office are subject to additional deductible and copayments/coinsurance

$60 copayment

Preventive Care Well-woman exam, immunizations, physicals, mammograms, colorectal cancer screening

No copayment

Surgical Procedures Performed in the Physician's Office 25% copayment1

Minor Emergency/Urgency Care Visit $75 copayment

Emergency Room $500 copayment1

Ambulance Air/Ground

25% copayment1

Inpatient Services Facility charges, physician services, surgical procedures, pre-admission testing, operating/recovery room, newborn delivery and nursery, ICU/coronary care units, laboratory tests/X-rays, rehabilitation facility, behavioral health (mental health/chemical dependency)

25% copayment1

Outpatient Services Facility charges, physician services, surgical procedures, observation unit

25% copayment1

MRI, CT Scan, PET Scan (Facility/Physician) $250 copayment1

Diagnostic Tests Sleep study; Stress test; EKG; Ultrasound; Cardiac imaging; Genetic testing; Non-preventive Colonoscopy (Facility/Physician)

25% copayment1

Home Health Care Limited to 60 visits per plan year 25% copayment1

Hospice Care 25% copayment1

Skilled Nursing Facility Limited to 30 days per plan year 25% copayment1

Accidental Dental Care 25% copayment1

Prosthetics 25% copayment1

Orthotics 25% copayment1

Spinal Manipulation Limited to 10 visits per year 25% copayment1

Durable Medical Equipment 25% copayment1

All Other Covered Services 25% copayment1

19

Prescription Drug Plan Year Deductible $100 Individual: $300 Family

Annual Maximum Unlimited

Participating Retail Pharmacy

Select Generic/ACA (Tier 1) deductible waived

Preferred Generic (Tier 2) deductible waived

Preferred Brand/Non-Preferred Generic (Tier 3)

Non-Preferred Brand/Non-Preferred Generic (Tier 4)

Specialty/Injectables (Tier 5)

Standard Drugs/30-day supply $0 per prescription

$15 per prescription $40 per prescription2

$100 per prescription2 20% per prescription2

Participating Mail Order Pharmacy

Select Generic/ACA (Tier 1) deductible waived

Preferred Generic (Tier 2) deductible waived

Preferred Brand/Non-Preferred Generic (Tier 3)

Non-Preferred Brand/Non-Preferred Generic (Tier 4)

Specialty/Injectables (Tier 5)

Maintenance Drugs/90-day supply $0 per prescription

$45 per prescription $120 per prescription2

$300 per prescription2

20% per prescription2

1Subject to medical deductible 2Subject to prescription drug deductible

Gross Monthly Cost for Coverage Effective September 1, 2016 - August 31, 2017

Coverage Category Total Cost - Active*

Employee only $472.50

Employee and spouse $1,180.50

Employee and child(ren) $748.50

Employee and family $1,190.50

*District and state fund are provided each month to active contributing TRS members to use toward the cost of TRS-ActiveCare coverage. State funding is subject to appropriation by the Texas Legislature. Please contact your Benefits Administrator to determine your net monthly cost for your coverage.

2016-2017 TRS-FirstCare Plan Highlights Plan Summary 2016 -2017

20

2016-2017 Scott & White Health Plan Highlights Summary of Benefits for TRS-ActiveCare

Home Health Services Copay

Home Health Care Visit $50 co-pay

Worldwide Emergency Care Copay

Nurse Advice Line 1-877-505-7947

Online Services No Charge — go to www.trs.swhp.org

After Hours Primary Care Clinics

$20 co-pay

Ambulance and Helicopter $40 copay and 20% of charges

after deductible

Emergency Room6 $150 copay and 20% of charges after deductible

Urgent Care Facility $55 copay

Prescription Drugs Copay

Annual Benefit Maximum Unlimited

Rx Deductible Does not apply to preferred generic drugs

$100

Ask an SWHP Pharmacy representative how to save money on your prescriptions.

Retail Quantity (Up to a 30-day

supply)

Maintenance Quantity

BSWH Pharmacies Only

(Up to a 90-day supply)

Preferred Generic7 $3 copay $6 copay

Preferred Brand 30% after Rx deductible

30% after Rx deductible

Non-preferred 50% after Rx deductible


Non-formulary Greater of $50 or


Not available

Mail Order 1-800-707-3477

1Including all services billed with office visit 2Does not apply to wellness or preventive visits 3Includes other services, treatments, or procedures received at time of office visit 4$750 maximum copay per admission and 20% after deductible 55 visits max per month, 35 max visit per year 6Copay waived if admitted within 24 hours 7If a brand name drug is dispensed when a generic is available, 50% copay applies

Specialty Medications (Up to a 30-day supply)

Copay


Fully Covered Health Care Services Copay

Preventive Services No Charge

Standard Lab and X-ray No Charge

Disease Management and Complex Case Management

No Charge

Well Child Care Annual Exams No Charge

Immunizations (age appropriate) No Charge

Plan Provisions Copay

Annual Deductible $1,000 Individual/ $3,000 Family

Annual out-of-pocket maximum (including medical and prescription co-pays and coinsurance)

$5,000 Individual/ $10,000 Family (includes combined Medical and RX

copays, deductibles and coinsurance)

Lifetime Paid Benefit Maximum None

Outpatient Services Copay

Primary Care1 $20 co-pay

(First Primary Care Visit for Illness $0 Copay2)

Specialty Care $50 co-pay

Other Outpatient Services 20% after deductible3

Diagnostic/Radiology Procedures 20% after deductible

Eye Exam (one annually) No Charge

Allergy Serum & Injections 20% after deductible

Outpatient Surgery $150 co-pay and 20% of charges after deductible

Maternity Care Copay

Prenatal Care No Charge

Inpatient Delivery $150 per day4 and 20% of charges after deductible

Inpatient Services Copay

Overnight hospital stay: includes all medical services including semi-private room or intensive care

$150 per day4 and 20% of charges after deductible

Diagnostic & Therapeutic Services Copay

Physical and Speech Therapy $50 copay

Manipulative Therapy5 20% without office visit $40 plus

20% with office visit

Equipment and Supplies Copay

Preferred Diabetic Supplies and Equipment

$3 copay; no deductible

Non-Preferred Diabetic Supplies and Equipment


Durable Medical Equipment/ Prosthetics


21

Cedar Hill ISD TRS Contributing Members 2016 - 2017 TRS Medical Rates

TRS-ActiveCare Plan 1- HD

TRS Monthly Premium

Cedar Hill ISD Contribution*

2016-2017 Employee Premium

Employee Only $341.00 $225.00 $116.00

Employee & Spouse $914.00 $225.00 $689.00

Employee & Child(ren) $615.00 $225.00 $390.00

Employee & Family $1,231.00 $225.00 $1,006.00

Deductible: Employee Only $2500 & Employee Family $5000 Max Out of Pocket: Employee Only $6550 & Employee Family $13,100

TRS-ActiveCare Select- Exclusive Provider

Organization

TRS Monthly Premium



Employee Only $484.00 $225.00 $259.00

Employee & Spouse $1,147.00 $225.00 $922.00


Employee & Family $1,361.00 $225.00 $1,136.00

Deductible: Employee Only $1200 Ded & Employee Family $3600 Ded Max Out of Pocket: Employee Only $6850 & Employee Family $13,700

TRS-ActiveCare 2 TRS

Monthly Premium Cedar Hill ISD Contribution*


Employee Only $645.00 $225.00 $420.00

Employee & Spouse $1,552.00 $225.00 $1,327.00

Employee & Child(ren) $1,042.00 $225.00 $817.00

Employee & Family $1,597.00 $225.00 $1,372.00

Deductible: Employee Only $1200 & Employee Family $3000 Max Out of Pocket: Employee Only $6850 & Employee Family $13,700

Scott and White HMO TRS



Employee Only $503.60 $225.00 $278.60

Employee & Spouse $1,135.62 $225.00 $910.62


Employee & Family $1,259.76 $225.00 $1,034.76

Deductible: Employee Only $1000 Ded & Employee Family $3000 Max Out of Pocket: Employee Only $5000 & Employee Family $10,000

AUXILIARY AND PARAPROFESSIONAL TRS MEMBERS: The district will contribute $241/ month All other TRS Members: The district will contribute $225.00 per month Non-TRS Members: No district contribution

22

Cedar Hill ISD TRS Auxiliary & Paraprofessional TRS Members 2016 - 2017 TRS Medical Rates

TRS-ActiveCare Plan 1- HD

TRS Monthly Premium


2016-2017 TRS Monthly Premium

Employee Only $341.00 $241.00 $100.00

Employee & Spouse $914.00 $241.00 $673.00


Employee & Family $1,231.00 $241.00 $990.00

Deductible: Employee Only $2500 & Employee Family $5000 ; Max Out of Pocket: Employee Only $6550 & Employee Family $13,100

TRS-ActiveCare Plan Select TRS



Employee Only $484.00 $241.00 $243.00

Employee & Spouse $1,147.00 $241.00 $906.00


Employee & Family $1,361.00 $241.00 $1,120.00

Exclusive Provider Organization -Employee Only $1200 Ded & Employee Family $3600 Ded; Max Out of Pocket $6850 Employee only & $13,700 Employee Family

TRS-ActiveCare Plan 2 TRS



Employee Only $645.00 $241.00 $404.00

Employee & Spouse $1,552.00 $241.00 $1,311.00

Employee & Child(ren) $1,042.00 $241.00 $801.00

Employee & Family $1,597.00 $241.00 $1,356.00

Deductible: Employee Only $1200 & Employee Family $3000 ; Max Out of Pocket: Employee Only $6850 & Employee Family $13,700

Scott and White HMO TRS



Employee Only $530.16 $241.00 $289.16

Employee & Spouse $1,192.82 $241.00 $951.82


Employee & Family $1,322.98 $241.00 $1,081.98

Deductible: Employee Only $1000 & Employee Family $3000 ; Max Out of Pocket Employee: Only $5000 & Employee Family $10,000

All other TRS Members: The district will contribute $225.00 per month Non-TRS Members: No district contribution

23

Telehealth provides 24/7/365 access to board-certified doctors via telephone consultations that can diagnose, recommend treatment and prescribe medication. Whether you are at home, traveling or at work, Telehealth makes care more convenient and accessible for non-emergency care when your primary care physician is not available.

About this Benefit

Telehealth YOUR BENEFITS PACKAGE

DID YOU KNOW?

75%

of all doctor, urgent care, and ER visits could be handled safely and effectively via

telehealth.

MDLIVE



Telehealth

When should I use MDLIVE? If you’re considering the ER or urgent care for a

non-emergency medical issue

Your primary care physician is not available

At home, traveling, or at work

24/7/365, even holidays!

What can be treated? Allergies

Asthma

Bronchitis

Cold and Flu

Ear Infections

Joint Aches and Pain

Respiratory Infection

Sinus Problems

And More!

Pediatric Care related to: Cold & Flu

Constipation

Ear Infection

Fever

Nausea & Vomiting

Pink Eye

And More!

Who are our doctors? MDLIVE has the nation’s largest network of telehealth doctors. On average, our doctors have 15 years of experience practicing medicine and are licensed in the state where patients are located. Their specialties include primary care, pediatrics, emergency medicine and family medicine. Our doctors are committed to providing convenient, quality care and are always ready to take your call.

Are children eligible? Yes. MDLIVE has local pediatricians on-call 24/7/365. Please note, a parent or guardian must be present during any interactions involving minors. We ask parents to establish a child record under their account. Parents must be present on each call for children 18 or younger.

How much does it cost? $0 Covers you, your spouse, and children up to age 26, with unlimited phone consultations.

Download the App Doctor visits are easier and more convenient with the MDLIVE App. Be prepared. Download today. www.mdlive.com/getapp

Access to a doctor anywhere: at home, at work, or on the go

Choose doctors from one of the nation's largest telehealth networks

Available 24/7 by video or phone

Private, secure and confidential visits

Connect instantly with MDLIVE Assist

Disclaimers: MDLIVE does not replace the primary care physician. MDLIVE operates subject to state regulation and may not be available in certain states. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services. For complete terms of use visit www.mdlive.com/pages/terms.html 010113

Call us at (888) 365-1663 or visit us at www.consultmdlive.com

Scan with your smartphone to get the app.

25

MEDlink® is designed to help supplement your Employer's major medical plan. This plan provides supplemental coverage to help offset out-of-pocket costs that you may experience due to deductibles, co-payments and coinsurance of your medical plan.

About this Benefit

MEDlink®IV YOUR

BENEFITS

DID YOU KNOW?

33%

of total healthcare costs are paid

out-of-pocket.


Cedar Hill ISD Benefits Website: www.mybenefitshub.com/cedarhillisd

AMERICAN PUBLIC LIFE

26

APSB-22354(TX) MGM/FBS Cedar Hill ISD

MEDlink® IV EnhancedLimited Benefit Group Medical Expense Supplemental InsuranceCedar Hill ISDTHE POLICY UNDER WHICH THIS CERTIFICATE IS ISSUED IS NOT A POLICY OF WORKERS’ COMPENSATION INSURANCE. THE EMPLOYER DOES NOT BECOME A SUBSCRIBER TO THE WORKERS’ COMPENSATION SYSTEM BY PURCHASING THE POLICY AND IF THE EMPLOYER IS A NON-SUBSCRIBER, THE EMPLOYEE LOSES THOSE BENEFITS WHICH WOULD OTHERWISE ACCRUE UNDER THE WORKERS’ COMPENSATION LAWS. THE EMPLOYER MUST COMPLY WITH THE WORKERS’ COMPENSATION LAW AS IT PERTAINS TO NON-SUBSCRIBERS AND THE REQUIRED NOTIFICATIONS THAT MUST BE FILED AND POSTED.

ENHANCED PLAN SUMMARY OF BENEFITS*

Base Policy Option 1

Maximum In-Hospital Benefits $2,500 per Covered Person per Confinement

In-Hospital Ambulance Benefit Up to $350 per trip for ground transportation or up to $1,000 per trip for air transportation where a Covered Person is Confined as an Inpatient. Limited to one trip per day.

In-Hospital Deductible $0 per Covered Person per Confinement

Outpatient Benefit Rider

Maximum Outpatient Benefits $500 per Covered Person per Occurrence for Covered Outpatient Services

Outpatient Ambulance Benefit Up to $350 per trip for ground transportation or up to $1,000 per trip for air transportation where a Covered Person resides less than 18 hours. Limited to one trip per day.

Outpatient Deductible $0 per Covered Person Per Occurrence

Covered Outpatient ServicesHospital Emergency Room Payable up to the Maximum Outpatient Benefit, subject to the Outpatient Benefit Deductible, as shown

above.

Urgent Care Facility Maximum of three Urgent Care visits per Covered Person per Calendar Year. Maximum of six Urgent Care visits per Calendar Year for all Covered Persons combined. Payable up to the Maximum Outpatient Benefit, subject to the Outpatient Benefit Deductible, as shown above.

Outpatient Surgery Outpatient Surgery in Hospital Outpatient Facility or Freestanding Outpatient Surgery Center. Payable up to the Maximum Outpatient Benefit, subject to the Outpatient Benefit Deductible, as shown above.

Diagnostic Testing Diagnostic Testing in a Hospital Outpatient Facility or MRI Facility. Payable up to the Maximum Outpatient Benefit, subject to the Outpatient Benefit Deductible, as shown above.

Outpatient Treatment for a Serious Mental Illness in a Hospital Outpatient Facility

Maximum of 60 days of treatment per Covered Person per Calendar Year. Payable up to the Maximum Outpatient Benefit, subject to the Outpatient Benefit Deductible, as shown above.

*Total premium includes the Plan selected and any applicable rider premium. Premiums are subject to increase with notice.The premium and amount of benefits vary dependent upon the Plan selected at time of application.

Option 1 Total Monthly Premiums by Plan*

Employee Employee & Spouse Employee & Child Employee & Family

Ages 18+ $33.90 $77.97 $57.63 $101.70

27

Important Policy Provisions EligibilityYou are eligible to be covered under this Policy/Certificate if you are Actively At Work, qualify for coverage as defined in the Master Application, are covered under your Employer’s Medical Plan and are under age 70 (if you work for an employer employing less than 20 employees). Your Eligible Dependents, as defined in the Policy/Certificate, are eligible for coverage if they are covered under the Employer’s Medical Plan. You must apply for insurance during the Initial Enrollment period or on the date the person first becomes eligible for coverage. If you do not apply during the Initial Enrollment period or on the date you become eligible for coverage, you may be subject to additional underwriting by APL. Evidence of coverage under your Employer’s Medical Plan is required.

When Coverage BeginsCoverage will begin on the requested Certificate Effective Date or the Certificate Effective Date assigned by us, upon approval of your application, if our underwriting rules are met, the premium has been paid and all persons to be insured are covered under your Employer’s Medical Plan and you are Actively At Work on the Certificate Effective Date. If you are not Actively At Work on the Certificate Effective Date due to disability, Injury, Sickness, temporary layoff, leave of absence or Family and Medical Leave of Absence, coverage begins on the date you return to Actively At Work.

Limitations & ExclusionsNo benefits will be payable for expenses incurred during any period the Covered Person does not have coverage under your Employer’s Medical Plan, except as provided in the Absence of the Insured’s Employer’s Medical Plan provision, described in the Policy.

A hospital is not an institution, or part thereof, used as: a place for rehabilitation, a place for rest or for the aged, a nursing or convalescent home, a long term nursing unit or geriatrics ward, or an extended care facility for the care of convalescent, rehabilitative or ambulatory patients.

Pre-Existing Condition LimitationNo benefits are payable during the Pre-Existing Condition Exclusion Period following the Covered Person’s Effective Date for any loss resulting from a Pre-Existing Condition. The Pre-Existing Condition Limitation will apply only if the Covered Person is subject to a Pre-Existing Condition Limitation under the Employer’s Medical Plan. Therefore, any Pre-Existing Condition Limitation applied to the Major Medical plan would, in effect, limit coverage under this plan.

ExclusionsNo benefits are payable for any loss resulting from or caused, whether directly or indirectly, by: s war or any act of war, whether declared or undeclared, or active service in the armed forces; (This exclusion includes Accident sustained or Sickness contracted while in the service of any military, naval or air force of any country engaged in war. If coverage is suspended for any Covered Person during a period of military service, APL will refund the pro-rata portion of any premium paid for any such Covered Person upon receipt of your written request) s an intentionally self-inflicted Injury or Sickness; s suicide or attempted suicide, while sane or insane; s rest care or rehabilitative care and treatment; s outpatient routine newborn care; s voluntary abortion except, with respect to you or your covered Eligible Dependent spouse: s where you or your Dependent spouse’s life would be endangered if the fetus were carried to term; or s where medical complications have arisen from abortion;

s pregnancy of an Eligible Dependent child; s participating in a riot, insurrection, rebellion, civil commotion, civil disobedience or unlawful assembly; (This does not include a loss which occurs while acting in a lawful manner within the scope of authority.) s committing, or attempting to commit, an illegal act that is defined as a felony; (Felony is as defined by the law of the jurisdiction in which the act takes place.) s participation in a contest of speed in power driven vehicles, parachuting or hang gliding; s air travel, except: s as a fare-paying passenger on a commercial airline on a regularly scheduled route; or s as a passenger for transportation only and not as a pilot or crew member; s being intoxicated or under the influence of any narcotic unless administered by a Physician or taken according to the Physician’s instructions; (Intoxication means that which is determined and defined by the laws and jurisdiction of the geographical area in which the event that caused the loss occurred.) s alcoholism or drug addiction; s sex changes; sexperimental treatment, drugs or surgery; s Accident or Sickness arising out of, and in the course of, any occupation for compensation, wage or profit; (This does not apply to those sole proprietors or partners not covered by Workers’ Compensation.) s dental or vision services, including treatment, surgery, extractions or x-rays, unless: s resulting from an Accident occurring while the Covered Person’s coverage is in force and if performed within 12 months of the date of such Accident; or s due to congenital disease or anomaly of a covered newborn child. s routine examinations, such as health exams, periodic check-ups or routine physicals, except when part of Inpatient routine newborn care; s elective cosmetic surgery; s drugs (prescription and non-prescription for use outside of a covered facility as defined in this Policy/Certificate or any attached rider); s sterilization and reversal of sterilization; s an expense that does not meet the definition of Covered Charges; s an expense or service that exceeds any of the Maximum Benefits, as shown in the Schedule of Benefits; or s any expense for which benefits are not payable under your Other Medical Plan.

Premium ChangesThe premium rates may be changed by APL at the first anniversary date of this Policy or any premium due date thereafter. No such increase in rates will be made unless 60 days prior notice is given to the Policyholder. Premiums will not increase during the initial 12 months of coverage.

Optionally RenewableThis Policy is renewable at the option of APL. The Policyholder or APL may terminate this Policy on any premium due date after the first anniversary following the Policy Effective Date, subject to 60 days written notice.

MEDlink® IV Enhanced Limited Benefit Group Medical Expense Supplemental Insurance

APSB-22354(TX) MGM/FBS Cedar Hill ISD28

Underwritten by American Public Life Insurance Company. This is a brief description of the coverage. For complete benefits, limitations, exclusions and other provisions, please refer to the certificate/policy and riders. This coverage does not replace Workers’ Compensation Insurance. This product is inappropriate for people who are eligible for Medicaid coverage. | This policy is considered an employee welfare benefit plan established and/or maintained by an association or employer intended to be covered by ERISA, and will be administered and enforced under ERISA. Group policies issued to governmental entities and municipalities may be exempt from ERISA guidelines. | Policy Form MEDlink® Series | Texas | Limited Benefit Group Medical Expense Supplemental Insurance | (10/14) | Cedar Hill ISD

APSB-22354(TX) MGM/FBS Cedar Hill ISD

2305 Lakeland Drive | Flowood, MS 39232ampublic.com | 800.256.8606

Termination of CertificateYour insurance coverage under this Certificate and any attached riders will end on the earliest of these dates: s the date the Policy terminates; s the end of the grace period if the premium remains unpaid; s the date you no longer qualify as an Insured; s the date you attain age 70 (if you work for an employer employing less than 20 employees); s the date your coverage under your Employer’s Medical Plan ends; or s the date of your death.Termination of CoverageYour insurance coverage under this Certificate and any attached riders for a Covered Person will end as follows: s the date the Policy terminates; s the date the Certificate terminates; s the end of the Certificate Month in which APL receives a written request from you to terminate the Covered Person’s coverage; s the date a Covered Person no longer qualifies as an Insured or Eligible Dependent; or s the date of the Covered Person’s death.

APL may end the coverage of any Covered Person who submits a fraudulent claim.

Cobra Continuation of CoverageThis plan may be continued in accordance with the Consolidated Omnibus Reconciliation Act of 1986.

MEDlink® IV Enhanced Limited Benefit Group Medical Expense Supplemental Insurance

29

A Health Savings Account is a tax-advantaged medical savings account available to employees who are enrolled in a high-deductible health plan. The funds contributed to the account are not subject to federal income tax at the time of deposit. Unlike a flexible spending account (FSA), funds roll over and accumulate year to year if not spent.

About this Benefit

HSA (Health Savings Account)


The interest earned in an HSA is tax free.

DID YOU KNOW?

Money withdrawn for medical spending never falls under taxable income.

HSA BANK



HSA Bank has teamed up with your employer to create an affordable health coverage option that helps you save on healthcare expenses. This plan is only available for those who are participating in the Active Care 1-HD medical plan. You may not enroll in the MEDlink® plan if you participate in the HSA. Depending on your district, you may or may not be able to participate in the FSA plan if you participate in HSA. Medicare, Medicaid, and Tricare participants are not eligible to participate in an HSA. You can use your Health Savings Account (HSA) to pay for a wide range of IRS-qualified medical expenses for yourself, your spouse or tax dependents. An IRS-qualified medical expense is defined as an expense that pays for healthcare services, equipment, or medications. Funds used to pay for IRS-qualified medical expenses are always tax-free.

What is an HSA? A tax-advantaged savings account that you use to pay for

eligible medical expenses as well as deductible, co-insurance, prescriptions, vision and dental care. Allows you to save while reducing your taxable income.

Unused funds that will roll over year to year. There’s no “use it or lose it” penalty.

A way to accumulate additional retirement savings. After age 65, funds can be withdrawn for any purpose without penalty.

Using Funds Debit Card

You may use the card to pay merchants or service providers that accept VISA credit cards, so there is no need to pay cash up front and wait for reimbursements.

You can make a withdrawal at any time. Reimbursements for qualified medical expenses are tax free. If you are disabled or reach age 65, you can receive non-medical distributions without penalty, but you must report the distributions as taxable income. You may also use your funds for a spouse or tax dependent not covered by your HDHP.

2016 Annual HSA Contribution Limits Individual: $3,350 Family: $6,750 Catch-Up Contributions: Accountholders who meet the qualifications noted below are eligible to make an HSA catch-up contribution of an additional $1,000.

Health Savings accountholder

Age 55 or older (regardless of when in the year an accountholder turns 55)

Not enrolled in Medicare (if an accountholder enrolls in Medicare mid-year, catch-up contributions should be prorated)

Authorized Signers who are 55 or older must have their own HSA in order to make the catch-up contribution Monthly Fee: Your account will be charged a monthly fee of $1.75, waived with an average daily balance at or above $3,000.

Examples of Qualified Medical Expenses Surgery

Braces

Contact lenses

Dentures

Eyeglasses

Vaccines For a list of sample expenses, please refer to the Cedar Hill ISD website at www.mybenefitshub.com/cedarhillisd

HSA Bank Contact Information 605 N. 8th Street, Ste 320 Sheboygan, WI 53081 Phone: 800-357-6246 www.hsabank.com

HSA (Health Savings Account)

31

A Health Savings Account (HSA) is an individually-owned, tax-advantaged account that you can use to pay for current or future IRS-qualified medical expenses. With an HSA, you’ll have the potential to build more savings for healthcare expenses or additional retirement savings through self-directed investment options1.

How an HSA works: You can contribute to your HSA via payroll deduction,

online banking transfer, or by sending a personal check to HSA Bank. Your employer or third parties, such as a spouse or parent, may contribute to your account as well.

You can pay for qualified medical expenses with your HSA Bank Debit Card directly to your medical provider or pay out-of-pocket. You can either choose to reimburse yourself or keep the funds in your HSA to grow your savings.

Unused funds will roll over year to year. After age 65, funds can be withdrawn for any purpose without penalty (subject to ordinary income taxes).

Check balances and account information via HSA Bank’s Internet Banking 24/7.

Are you eligible for an HSA? If you have a qualified High Deductible Health Plan (HDHP) - either through your employer, through your spouse, or one you’ve purchased on your own - chances are you can open an HSA. Additionally:

You cannot be covered by any other non-HSA-compatible health plan, including Medicare Parts A and B.

You cannot be covered by TriCare.

You cannot have accessed your VA medical benefits in the past 90 days (to contribute to an HSA).

You cannot be claimed as a dependent on another person’s tax return (unless it’s your spouse).

You must be covered by the qualified HDHP on the first day of the month.

When you open an account, HSA Bank will request certain information to verify your identity and to process your application.

What are the annual IRS contribution limits? Contributions made by all parties to an HSA cannot exceed the annual HSA limit set by the Internal Revenue Service (IRS). Anyone can contribute to your HSA, but only the accountholder and employer can receive tax deductions on those contributions. Combined annual contributions for the accountholder, employer, and third parties (i.e., parent, spouse, or anyone else) must not exceed these limits2.

2016 Annual HSA Contribution Limits Individual = $3,350 Family = $6,750

Catch-up Contributions Accountholders who meet these qualifications are eligible to make an HSA catch-up contribution of $1,000: Health Savings accountholder; age 55 or older (regardless of when in the year an accountholder turns 55); not enrolled in Medicare (if an accountholder enrolls in Medicare mid-year, catch-up contributions should be prorated). Authorized signers who are 55 or older must have their own HSA in order to make the catch-up contribution. According to IRS guidelines, each year you have until the tax filing deadline to contribute to your HSA (typically April 15 of the following year). Online contributions must be submitted by 2:00 p.m., Central Time, the business day before the tax filing deadline. Wire contributions must be received by noon, Central Time, on the tax filing deadline, and contribution forms with checks must be received by the tax filing deadline.

How can you benefit from tax savings? An HSA provides triple tax savings3. Here’s how:

Contributions to your HSA can be made with pre-tax dollars and any after-tax contributions that you make to your HSA are tax deductible.

HSA funds earn interest and investment earnings are tax free.

When used for IRS-qualified medical expenses, distributions are free from tax.

IRS-Qualified Medical Expenses You can use your HSA to pay for a wide range of IRS-qualified medical expenses for yourself, your spouse, or tax dependents. An IRS-qualified medical expense is defined as an expense that pays for healthcare services, equipment, or medications. Funds used to pay for IRS-qualified medical expenses are always tax-free. HSA funds can be used to reimburse yourself for past medical expenses if the expense was incurred after your HSA was established. While you do not need to submit any receipts to HSA Bank, you must save your bills and receipts for tax purposes.

How the HSA Plan Works

32

How the HSA Plan Works

Examples of IRS-Qualified Medical Expenses4:

For assistance, please contact the Client Assistance Center 800-357-6246 Monday – Friday, 7 a.m. – 9 p.m., and Saturday, 9 a.m. - 1 p.m., CT www.hsabank.com | 605 N. 8th Street, Ste. 320, Sheboygan, WI 53081 1 Investment accounts are not FDIC insured, may lose value and are not a deposit or other obligation of, or guarantee by the bank. Investment losses which are replaced are subject to the annual contribution limits of the HSA. 2 HSA funds contributed in excess of these limits are subject to penalty and tax unless the excess and earnings are withdrawn prior to the due date, including any extensions for filing Federal Tax returns. Accountholders should consult with a qualified tax advisor in connection with excess contribution removal. The Internal Revenue Service requires HSA Bank to report withdrawals that are considered refunds of excess contributions. In order for the withdrawal to be accurately reported, accountholders may not withdraw the excess directly. Instead, an excess contribution refund must be requested from HSA Bank and an Excess Contribution Removal Form completed. 3 Federal Tax savings are available no matter where you live and HSAs are taxable in AL, CA, and NJ. HSA Bank does not provide tax advice. Consult your tax professional for tax‐related questions. 4 This list is not comprehensive. It is provided to you with the understanding that HSA Bank is not engaged in rendering tax advice. The information provided is not intended to be used to avoid Federal tax penalties. For more detailed information, please refer to IRS Publication 502 titled, “Medical and Dental Expenses”. Publications can be ordered directly from the IRS by calling 1-800-TAXFORM. If tax advice is required, you should seek the services of a professional. 5 Insurance premiums only qualify as an IRS-qualified medical expense: while continuing coverage under COBRA; for qualified long-term care coverage; coverage while receiving unemployment compensation; for any healthcare coverage for those over age 65 including Medicare (except Medicare supplemental coverage).

Acupuncture Alcoholism treatment Ambulance services Annual physical examination Artificial limb or prosthesis Birth control pills (by prescription) Chiropractor Childbirth/delivery Convalescent home (for medical treatment only) Crutches Doctor’s fees Dental treatments (including x-rays, braces, dentures, fillings, oral surgery) Dermatologist Diagnostic services Disabled dependent care Drug addiction therapy Fertility enhancement (including in-vitro fertilization) Guide dog (or other service animal)

Gynecologist Hearing aids and batteries Hospital bills Insurance premiums5

Laboratory fees Lactation expenses Lodging (away from home for outpatient care) Nursing home Nursing services Obstetrician Osteopath Oxygen Pregnancy test kit Podiatrist Prescription drugs and medicines (over-the-counter drugs are not IRS- qualified medical expenses unless prescribed by a doctor) Prenatal care & postnatal treatments Psychiatrist Psychologist Smoking cessation programs

Special education tutoring Surgery Telephone or TV equipment to assist the hearing or vision impaired Therapy or counseling Medical transportation expenses Transplants Vaccines Vasectomy Vision care (including eyeglasses, contact lenses, lasik surgery) Weight loss programs (for a specific disease diagnosed by a physician – such as obesity, hypertension, or heart disease) Wheelchairs X-rays

33

Dental insurance is a coverage that helps defray the costs of dental care. It insures against the expense of routine care, treatment and dental disease.

About this Benefit

Dental YOUR BENEFITS PACKAGE

Good dental care may improve your overall health.

Also Women with gum disease may be at greater risk of giving birth to a preterm or low birth weight baby.

DID YOU KNOW?

CIGNA



Dental PPO - Low Option

Benefits Cigna Dental PPO - Low Option

In-Network Out-of-Network

Network Total Cigna DPPO Calendar Year Maximum (Class I, II, and III expenses)

Year 1: $1,000 Year 1: $1,000

Year 2: $1,250# Year 2: $1,250#

Year 3: $1,500+ Year 3: $1,500+

Year 4: $1,750^ Year 4 and beyond: $1,750^

Annual Deductible Individual Family

$50 per person $150 per family


Reimbursement Levels** Based on Reduced Contracted Fees

Based on Maximum Allowable Charge (In-

network fee level)

Plan Pays You Pay Plan Pays You Pay

Class I - Preventive & Diagnostic Care Oral Exams Routine Cleanings Bitewing X-rays Full Mouth X-rays Panoramic X-ray Emergency Care to Relieve Pain Fluoride Application Sealants Space Maintainers

100% No Charge 100% No Charge

Class II - Basic Restorative Care Fillings Brush Biopsies Anesthetics Denture Repairs Denture Relines, Rebases and Adjustments Repairs to Bridges, Crowns and Inlays Dentures Oral Surgery—Simple extractions

80%* 20%* 80%* 20%*

Class III - Major Restorative Care Crowns Root Canal Therapy Endodontics Osseous Surgery Periodontal Scaling and Root Planning Surgical Extractions of Impacted Teeth Oral Surgery—All except simple extractions Histopathologic Dentures Bridges Inlays/Onlays Prosthesis Over Implant

50%* 50%* 50%* 50%*

Class IV - Orthodontia Lifetime Maximum

50%* $1,000

Dependent children to

age 19

50%*

50%* $1,000


age 19

50%*

Monthly PPO Premiums

Tier Rate

EE Only $24.04

EE + 1 Dependent

$46.84

Family Coverage

$70.56

Missing Tooth Limitation – The amount payable is 50% of the amount otherwise payable until insured for 12 months; thereafter, considered a Class III expense. Pretreatment review is available on a voluntary basis when extensive dental work in excess of $500 is proposed. * Subject to annual deductible Dental Oral Health Integration Program (OHIP) - All dental customers = Clinical research shows an association between oral health and overall health. The Cigna Dental Oral Health Integration Program (OHIP)® is designed to provide enhanced dental coverage for customers with certain eligible medical conditions. Eligible conditions for the program include cardiovascular disease, cerebrovascular disease (stroke), diabetes, maternity, chronic kidney disease, organ transplants, and head and neck cancer radiation. The program provides:

100% coverage for certain dental procedures

guidance on behavioral issues related to oral health

discounts on prescription and non-prescription dental products For more information and to see the complete list of eligible conditions, go to www.mycigna.com or call customer service 24/7 at 1.800.CIGNA24. **For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Contracted Fee Schedule. For services provided by an out-of-network dentist, Cigna Dental will reimburse according to Reasonable and Customary Allowances but the dentist may balance bill up to their usual fees. # Increase contingent upon receiving Preventative Services in Plan Year 1 +Increase contingent upon receiving Preventive Services in Plan Years, 1 and 2 ^Increase contingent upon receiving Preventive Services in Plan Years 1, 2 and 3 35

Dental PPO - High Option

Monthly PPO Premiums

Tier Rate

EE Only $33.95

EE + 1 dependent

$67.16

Family $102.40

Missing Tooth Limitation – The amount payable is 50% of the amount otherwise payable until insured for 12 months; thereafter, considered a Class III expense. Pretreatment review is available on a voluntary basis when extensive dental work in excess of $500 is proposed. * Subject to annual deductible Dental Oral Health Integration Program (OHIP) - All dental customers = Clinical research shows an association between oral health and overall health. The Cigna Dental Oral Health Integration Program (OHIP)® is designed to provide enhanced dental coverage for customers with certain eligible medical conditions. Eligible conditions for the program include cardiovascular disease, cerebrovascular disease (stroke), diabetes, maternity, chronic kidney disease, organ transplants, and head and neck cancer radiation. The program provides: 100% coverage for certain dental procedures guidance on behavioral issues related to oral health discounts on prescription and non-prescription dental products For more information and to see the complete list of eligible conditions, go to www.mycigna.com or call customer service 24/7 at 1.800.CIGNA24. **For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Contracted Fee Schedule. For services provided by an out-of-network dentist, Cigna Dental will reimburse according to Reasonable and Customary Allowances but the dentist may balance bill up to their usual fees. # Increase contingent upon receiving Preventative Services in Plan Year 1 +Increase contingent upon receiving Preventive Services in Plan Years, 1 and 2 ^Increase contingent upon receiving Preventive Services in Plan Years 1, 2 and 3

Benefits Cigna Dental PPO - Low Option

In-Network Out-of-Network

Network Total Cigna DPPO Calendar Year Maximum (Class I, II, and III expenses)

Year 1: $1,000 Year: $1,000

Year 2: $1,250# Year 2: $1,250#

Year 3: $1,500+ Year 3: $1,500+

Year 4: $1,750^ Year 4 and beyond: $1,750^

Annual Deductible Individual Family



Reimbursement Levels** Based on Reduced Contracted Fees

90th percentile of Reasonable and Customary

Allowances

Plan Pays You Pay Plan Pays You Pay

Class I - Preventive & Diagnostic Care Oral Exams Routine Cleanings Bitewing X-rays Full Mouth X-rays Panoramic X-ray Emergency Care to Relieve Pain Fluoride Application Sealants Space Maintainers

100% No Charge 100% No Charge

Class II - Basic Restorative Care Fillings Brush Biopsies Anesthetics Denture Repairs Denture Relines, Rebases and Adjustments Repairs to Bridges, Crowns and Inlays Dentures Oral Surgery—Simple extractions

80%* 20%* 80%* 20%*

Class III - Major Restorative Care Crowns Root Canal Therapy Endodontics Osseous Surgery Periodontal Scaling and Root Planning Surgical Extractions of Impacted Teeth Oral Surgery—All except simple extractions Histopathologic Dentures Bridges Inlays/Onlays Prosthesis Over Implant

50%* 50%* 50%* 50%*

Class IV - Orthodontia Lifetime Maximum

50%* $1,000


age 19

50%*

50%* $1,000


age 19

50%*

36

Dental PPO - High and Low Options

Procedure Exclusions and Limitations Late Entrants Limit No overage except for Class I (as defined in these plans) for 12 months Exams 1 per 6-month period Prophylaxis (Cleanings) 1 routine prophy or perio maintenance procedure per 6-monyh consecutive period (routine prophy is Class I, perio prophy is Class II Fluoride Treatments 1 per consecutive 12 months for participants younger than age 14 Histopathologic Exams Payable if the biopsy is covered. No coverage for other diagnostic tests. X-Rays (routine) Bitewings: 1 set in any consecutive 12 month period. Limited to a maximum of 4 films per set X-Rays (non-routine) Full mouth or Panorex: 1 every 60 consecutive months Periapical x-rays 4 in 12 consecutive months if not performed in conjunction with an operative procedure Intraoral occlusal x-rays 2 in 12 consecutive months Models Not covered Fillings 1 per tooth per 12 consecutive months (applies to replacement of identical surface fillings only) No composite, white/tooth colored fillings on bicuspid or molar teeth Sealants 1 treatment per tooth per lifetime on unrestored permanent bicuspid or molar teeth under age 14 Minor Period (non-surgical) Root pling-1 per quadrant per 36 consecutive months Perio Surgery 1 per 36 consecutive months per area of the mouth (same service) Crowns and Inlays Replacement limited to 1 per 84 consecutive months. Benefits are based on the amount payable for non-precious metals. No porcelain or white/tooth-colored material on molar crowns or bridges. Replacement must be indicated by major decay. For participants less than ages 16, benefits for crowns an inlays are limited to resin or stainless steel. Stainless Steel & Resin 1 per 36 consecutive months for participants younger then age 16 Crowns Bridges Replacement limited to 1 per 84-consecutive months, if unserviceable and cannot be repaired. Benefits are based on the amount payable for non-precious metals. No porcelain or white/tooth-colored material on molar crowns or bridges Dentures and Partials Replacement limited to 1 per 84 consecutive months, if unserviceable and cannot be repaired Relines, Rebases Covered if more than 12 months after installation; 1 per 36 consecutive months Adjustments Covered if more than 12 months after installation; 1 per 12 consecutive months Repairs - Bridges Covered if more than 12 months after installation Repairs - Dentures Covered if more than 12 months after installation Endodontics Root canal re-treatment 1 per 24 consecutive months, if necessity demonstrated Prosthesis Over Implant 1 per 84 consecutive months if unserviceable and cannot be repaired. Benefits are based on the amount payable for nonprecious metals. No porcelain or white/tooth colored material on molar crowns or bridges Alternate Benefit When more than one covered Dental Service could provide suitable treatment based on common dental standards, Cigna HealthCare will determine the covered Dental Service on which payment will be based and the expenses that will be included as Covered Expenses

Benefit Exclusions Services performed primarily for cosmetic reasons Replacement of a lost or stolen appliance Replacement of a bridge or denture within five years following the

date of its original installation Replacement of a bridge or denture which can be made useable

according to accepted dental standards Procedures, appliances or restorations, other than full dentures, whose

main purpose is to change vertical dimension, diagnose or treat conditions of TMJ, stabilize periodontally involved teeth, or restore occlusion

Veneers of porcelain or acrylic materials on crowns or pontics on or replacing the upper and lower first, second and third molars

Bite registrations; precision or semi-precision attachments; splinting A surgical implant of any type Instruction for plaque control, oral hygiene and diet Dental services that do not meet common dental standards Services that are deemed to be medical services Services and supplies received from a hospital Charges which the person is not legally required to pay Charges made by a hospital which performs services for the U.S.

Government if the charges are directly related to a condition connected to a military service

Experimental or investigational procedures and treatments Any injury resulting from, or in the course of, any employment for

wage or profit Any sickness covered under any workers’ compensation or similar law Charges in excess of the reasonable and customary allowances To the extent that payment is unlawful where the person resides when

the expenses are incurred; Procedures performed by a Dentist who is a member of the covered

person’s family (covered person’s family is limited to a spouse, siblings, parents, children, grandparents, and the spouse’s siblings and parents);

For charges which would not have been made if the person had no insurance;

For charges for unnecessary care, treatment or surgery; To the extent that you or any of your Dependents is in any way paid or

entitled to payment for those expenses by or through a public

program, other than Medicaid; To the extent that benefits are paid or payable for those expenses

under the mandatory part of any auto insurance policy written to comply with a “no-fault” insurance law or an uninsured motorist insurance law. Cigna HealthCare will take into account any adjustment option chosen under such part by you or any one of your Dependents.

In addition, these benefits will be reduced so that the total payment will not be more than 100% of the charge made for the Dental Service if benefits are provided for that service under this plan and any medical expense plan or prepaid treatment program sponsored or made available by your Employer.

This benefit summary highlights some of the benefits available under the proposed plan. A complete description regarding the terms of coverage, exclusions and limitations, including legislated benefits, will be provided in your insurance certificate or plan description. Benefits are insured and/or administered by Connecticut General Life Insurance Company. "Cigna HealthCare" refers to various operating subsidiaries of Cigna Corporation. Products and services are provided by these subsidiaries and not by Cigna Corporation. These subsidiaries include Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, and HMO or service company subsidiaries of Cigna Health Corporation and Cigna Dental Health, Inc. DPPO insurance coverage is set forth on the following policy form numbers: AR: HP-POL77; CA: HP-POL57; CO: HP-POL78; CT: HP-POL58; DE: HP-POL79; FL: HP-POL60; ID: HPPOL82; IL: HP-POL62; KS: HP-POL84; LA: HP-POL86: MA: HP-POL 63; MI: HP-POL88; MO: HP- POL65; MS: HP-POL90; NC: HP-POL96; NE: HP-POL92; NH: HP-POL94; NM: HP-POL95; NV: HP-POL93; NY: HP-POL67; OH: HP-POL98; OK: HP-POL99; OR: HP-POL68; PA: HP-POL100; RI: HP-POL101; SC: HP-POL102; SD: HP-POL103; TN: HP-POL69; TX: HP-POL70; UT: HP-POL104; VA: HP-POL72; VT: HP-POL71; WA: POL-07/08; WI: HP-POL107; WV: HP-POL106; and WY: HP-POL108. “Cigna,” the “Tree of Life” logo and “Cigna Dental Care” are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Connecticut General Life Insurance Company (CGLIC), Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Connecticut, Inc., and Cigna Dental Health, Inc. and its subsidiaries. Cigna Dental PPO plans are underwritten or administered by CGLIC or CHLIC, with network management services provided by Cigna Dental Health, Inc. and certain of its subsidiaries. In Arizona and Louisiana, the insured Dental PPO plan offered by CGLIC is known as the “CG Dental PPO”. In Texas, the insured dental product offered by CGLIC and CHLIC is referred to as the Cigna Dental Choice Plan, and this plan utilizes the national Cigna Dental PPO network. Cigna Dental Care (DHMO) plans are underwritten or administered by Cigna Dental Health Plan of Arizona, Inc., Cigna Dental Health of California, Inc., Cigna Dental Health of Colorado, Inc., Cigna Dental Health of Delaware, Inc., Cigna Dental Health of Florida, Inc., a Prepaid Limited Health Services Organization licensed under Chapter 636, Florida Statutes, Cigna Dental Health of Kansas, Inc. (Kansas and Nebraska), Cigna Dental Health of Kentucky, Inc. (Kentucky and Illinois), Cigna Dental Health of Maryland, Inc., Cigna Dental Health of Missouri, Inc., Cigna Dental Health of New Jersey, Inc., Cigna Dental Health of North Carolina, Inc., Cigna Dental Health of Ohio, Inc., Cigna Dental Health of Pennsylvania, Inc., Cigna Dental Health of Texas, Inc., and Cigna Dental Health of Virginia, Inc. In other states, Cigna Dental Care plans are underwritten by CGLIC, CHLIC, or Cigna HealthCare of Connecticut, Inc. and administered by Cigna Dental Health, Inc. BSD46380 © 2015 Cigna

37

Vision insurance provides coverage for routine eye examinations and may cover all or part of the costs associated with contact lenses, eyeglasses and vision correction, depending on the plan.

About this Benefit

Vision YOUR BENEFITS PACKAGE

75%

DID YOU KNOW?

of U.S. residents between age 25 and 64 require some sort of vision

correction.

SUPERIOR VISION



Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements. 1Materials co-pay applies to lenses and frames only, not contact lenses ₂The specialty contact lens fitting is for new contact lens wearers and/or a member who wears toric, gas permeable, or multifocal lenses. ₃Covered to provider’s in-office standard retail lined trifocal amount; member pays difference between progressive and standard retail lined trifocal, plus applicable co-pay 4Contact lenses are in lieu of eyeglass lenses and frames benefit

Vision

Discount Features

Look for providers in the Provider Directory who accept discounts, as some do not; please verify their services and discounts (range from 10%-30%) prior to service as they vary. Discounts on Covered Materials Frames: 20% off amount over allowance Lens options: 20% off retail Progressives: 20% off amount over retail lined trifocal lens, including lens options The following options have out-of-pocket maximums5 on standard (not premium, brand, or progressive) plastic lenses. 5Discounts and maximums may vary by lens type. Please check with your

provider.

Maximum Member Out-of-Pocket

Single Vision Bifocal & Trifocal

Scratch coat $13 $13

Ultraviolet coat $15 $15

Tints, solid or gradients $25 $25

Anti-reflective coat $50 $50

Polycarbonate $40 20% off retail

High index 1.6 $55 20% off retail

Photochromics $80 20% off retail

Discounts on Non-Covered Exam and Materials Exams, frames, and prescription lenses: 30% off retail Lens options, contacts, other prescription materials: 20% off retail Disposable contact lenses: 10% off retail

Refractive Surgery Superior Vision has a nationwide network of refractive surgeons and leading LASIK networks who offer members a discount. These discounts range from 15%-50%, and are the best possible discounts available to Superior Vision. The Plan discount features are not insurance.

All allowances are retail; the member is responsible for paying the provider directly for all non-covered items and/or any amount over the allowances, minus available discounts. These are not covered by the plan.

Discounts are subject to change without notice.

Disclaimer: All final determinations of benefits, administrative duties, and definitions are governed by the Certificate of Insurance for your vision plan. Please check with your Human Resources department if you have any questions.

Co-Pays

Exam $10

Materials₁ $25

Contact Lens Fitting (standard & specialty)

$25

Services/Frequency

Exam 12 months

Frame 24 months

Contact Lens Fitting 12 months

Lenses 12 months

Contact Lenses 12 months

Benefits In-Network Out-of-Network

Exam (ophthalmologist) Covered in full Up to $42 retail

Exam (optometrist) Covered in full Up to $37 retail

Frames $125 retail allowance Up to $68 retail

Contact Lens Fitting (standard₂) Covered in full Not Covered

Contact Lens Fitting (specialty₂) $50 retail allowance Not Covered

Progressive Lens Upgrade See description3 Up to $61 retail

Contact Lenses4 $120 retail allowance Up to $100 retail

Lenses (standard) per pair

Single Vision Covered in full Up to $32 retail

Bifocal Covered in full Up to $46 retail

Trifocal Covered in full Up to $61 retail

Monthly Premiums

EE Only $7.34

EE + 1 dependent $14.26

EE + Family $20.96

39

About this Benefit

Disability YOUR BENEFITS PACKAGE

Just over 1 in 4 of today's 20 year-olds will become disabled before

they retire.

DID YOU KNOW?

34.6 months is the duration of the

average disability claim.

THE HARTFORD

Disability insurance protects one of your most valuable assets, your paycheck. This insurance will replace a portion of your income in the event that you become physically unable to work due to sickness or injury for an extended period of time.



Disability is designed to provide a monthly income to an individual that is disabled due to an accident or illness. There are different plans available with benefits becoming available from the 1st day of disability to as late as the 180th day. For specific details on how benefits are paid, refer to carrier brochure. Your disability coverage amount and premium can be accessed during your enrollment.

Pre-existing Conditions Your policy limits the benefits you can receive for a disability caused by a pre-existing condition. In general, if you were diagnosed or received care for a disabling condition within the 3 consecutive months just prior to the effective date of this policy, your benefit payment will be limited, unless: You have not received treatment for the disabling condition within 3 months, while insured under this policy, before the disability begins, or You have been insured under this policy for 12 months before your disability begins. You may also be covered if you have already satisfied the pre-existing condition requirement of your previous insurer. If your disability is a result of a pre-existing condition we will pay benefits for a maximum of 4 weeks.

Benefit Reductions Your benefit payments may be reduced by other income you receive or are eligible to receive due to your disability, such as: Social Security Disability Insurance (please see

www.mybenefitshub.com/cedarhillisd for exceptions) Workers' Compensation Other employer-based Insurance coverage you may have Unemployment benefits Settlements or judgments for income loss Retirement benefits that your employer fully or partially

pays for (such as a pension plan.) Your benefit payments will not be reduced by certain kinds of other income, such as: Retirement benefits if you were already receiving them

before you became disabled Retirement benefits that are funded by your after-tax

contributions Your personal savings, investment, IRAs or Keoghs Profit-sharing Most personal disability policies Social Security increases

Coverage goes into effect subject to the terms and conditions of the policy. You must satisfy the definition of Actively at Work with your employer on the day your coverage takes effect.

Exclusions You cannot receive Disability benefit payments for disabilities that are caused or contributed to by: War or act of war (declared or not) Military service for any country engaged in war or other

armed conflict

The commission of, or attempt to commit a felony An intentionally self-inflicted injury Any case where your being engaged in an illegal

occupation was a contributing cause to your disability You must be under the regular care of a physician to

receive benefits

Mental Illness, Alcoholism and Substance Abuse You can receive benefit payments for Long-Term

Disabilities resulting from mental illness, alcoholism and substance abuse for a total of 24 months for all disability periods during your lifetime.

Any period of time that you are confined in a hospital or other facility licensed to provide medical care for mental illness, alcoholism and substance abuse does not count toward the 24 month lifetime limit.

What other benefits are included in my disability coverage? Workplace Modification provides for reasonable

modifications made to a workplace to accommodate your disability and allow you to return to active full-time employment.

Survivor Benefit - If you die while receiving disability benefits, a benefit will be paid to your spouse or in equal shares to your surviving children under the age of 25, equal to three times the last monthly gross benefit.

Travel Assistance Program – Available 24/7, this program provides assistance to employees and their dependents who travel 100 miles from their home for 90 days or less. Services include pre-trip information, emergency medical assistance and emergency personal services.

The Hartford's Ability Assist service is included as a part of your group Long Term Disability (LTD) insurance program. You have access to Ability Assist services both prior to a disability and after you’ve been approved for an LTD claim and are receiving LTD benefits. Once you are covered you are eligible for services to provide assistance with child/elder care, substance abuse, family relationships and more. In addition, LTD claimants and their immediate family members receive confidential services to assist them with the unique emotional, financial and legal issues that may result from a disability. Ability Assist services are provided through ComPsych®, a leading provider of employee assistance and work/life services.

Waiver of Premium – Once your disability claim is approved and you have satisfied your elimination period, your coverage premiums will be waived.

Identity Theft Protection – An array of identity fraud support services to help victims restore their identity. Benefits include 24/7 access to an 800 number; direct contact with a certified caseworker who follows the case until it’s resolved; and a personalized fraud resolution kit with instructions and resources for ID theft victims.

Long Term Disability

41


For the Premium benefit option – the table below applies to disabilities resulting from injury or sickness:

Age Disabled Benefits Payable

Prior to Age 63 To Normal Retirement Age or 48 months if greater

Age 63 To Normal Retirement Age or 42 months if greater

Age 64 36 months

Age 65 30 months

Age 66 27 months

Age 67 24 months

Age 68 21 months

Age 69 and older 18 months

MONTHLY PREMIUMS

Accident / Sickness Elimination Period in Days

Annual Earnings Monthly Earnings Monthly Benefit 0 / 7 14 / 14 30 / 30 60 / 60 90 / 90 180 / 180

$3,600 $300 $200 $9.84 $7.84 $6.48 $4.44 $3.84 $2.96

$5,400 $450 $300 $14.76 $11.76 $9.72 $6.66 $5.76 $4.44

$7,200 $600 $400 $19.68 $15.68 $12.96 $8.88 $7.68 $5.92

$9,000 $750 $500 $24.60 $19.60 $16.20 $11.10 $9.60 $7.40

$10,800 $900 $600 $29.52 $23.52 $19.44 $13.32 $11.52 $8.88

$12,600 $1,050 $700 $34.44 $27.44 $22.68 $15.54 $13.44 $10.36

$14,400 $1,200 $800 $39.36 $31.36 $25.92 $17.76 $15.36 $11.84

$16,200 $1,350 $900 $44.28 $35.28 $29.16 $19.98 $17.28 $13.32

$18,000 $1,500 $1,000 $49.20 $39.20 $32.40 $22.20 $19.20 $14.80

$19,800 $1,650 $1,100 $54.12 $43.12 $35.64 $24.42 $21.12 $16.28

$21,600 $1,800 $1,200 $59.04 $47.04 $38.88 $26.64 $23.04 $17.76

$23,400 $1,950 $1,300 $63.96 $50.96 $42.12 $28.86 $24.96 $19.24

$25,200 $2,100 $1,400 $68.88 $54.88 $45.36 $31.08 $26.88 $20.72

$27,000 $2,250 $1,500 $73.80 $58.80 $48.60 $33.30 $28.80 $22.20

$28,800 $2,400 $1,600 $78.72 $62.72 $51.84 $35.52 $30.72 $23.68

$30,600 $2,550 $1,700 $83.64 $66.64 $55.08 $37.74 $32.64 $25.16

$32,400 $2,700 $1,800 $88.56 $70.56 $58.32 $39.96 $34.56 $26.64

$34,200 $2,850 $1,900 $93.48 $74.48 $61.56 $42.18 $36.48 $28.12

$36,000 $3,000 $2,000 $98.40 $78.40 $64.80 $44.40 $38.40 $29.60

$37,800 $3,150 $2,100 $103.32 $82.32 $68.04 $46.62 $40.32 $31.08

$39,600 $3,300 $2,200 $108.24 $86.24 $71.28 $48.84 $42.24 $32.56

$41,400 $3,450 $2,300 $113.16 $90.16 $74.52 $51.06 $44.16 $34.04

$43,200 $3,600 $2,400 $118.08 $94.08 $77.76 $53.28 $46.08 $35.52

$45,000 $3,750 $2,500 $123.00 $98.00 $81.00 $55.50 $48.00 $37.00

$46,800 $3,900 $2,600 $127.92 $101.92 $84.24 $57.72 $49.92 $38.48

$48,600 $4,050 $2,700 $132.84 $105.84 $87.48 $59.94 $51.84 $39.96

$50,400 $4,200 $2,800 $137.76 $109.76 $90.72 $62.16 $53.76 $41.44

$52,200 $4,350 $2,900 $142.68 $113.68 $93.96 $64.38 $55.68 $42.92

$54,000 $4,500 $3,000 $147.60 $117.60 $97.20 $66.60 $57.60 $44.40

$55,800 $4,650 $3,100 $152.52 $121.52 $100.44 $68.82 $59.52 $45.88

$57,600 $4,800 $3,200 $157.44 $125.44 $103.68 $71.04 $61.44 $47.36

$59,400 $4,950 $3,300 $162.36 $129.36 $106.92 $73.26 $63.36 $48.84

42


MONTHLY PREMIUMS

Accident / Sickness Elimination Period in Days

Annual Earnings Monthly Earnings Monthly Benefit 0 / 7 14 / 14 30 / 30 60 / 60 90 / 90 180 / 180

$61,200 $5,100 $3,400 $167.28 $133.28 $110.16 $75.48 $65.28 $50.32

$63,000 $5,250 $3,500 $172.20 $137.20 $113.40 $77.70 $67.20 $51.80

$64,800 $5,400 $3,600 $177.12 $141.12 $116.64 $79.92 $69.12 $53.28

$66,600 $5,550 $3,700 $182.04 $145.04 $119.88 $82.14 $71.04 $54.76

$68,400 $5,700 $3,800 $186.96 $148.96 $123.12 $84.36 $72.96 $56.24

$70,200 $5,850 $3,900 $191.88 $152.88 $126.36 $86.58 $74.88 $57.72

$72,000 $6,000 $4,000 $196.80 $156.80 $129.60 $88.80 $76.80 $59.20

$73,800 $6,150 $4,100 $201.72 $160.72 $132.84 $91.02 $78.72 $60.68

$75,600 $6,300 $4,200 $206.64 $164.64 $136.08 $93.24 $80.64 $62.16

$77,400 $6,450 $4,300 $211.56 $168.56 $139.32 $95.46 $82.56 $63.64

$79,200 $6,600 $4,400 $216.48 $172.48 $142.56 $97.68 $84.48 $65.12

$81,000 $6,750 $4,500 $221.40 $176.40 $145.80 $99.90 $86.40 $66.60

$82,800 $6,900 $4,600 $226.32 $180.32 $149.04 $102.12 $88.32 $68.08

$84,600 $7,050 $4,700 $231.24 $184.24 $152.28 $104.34 $90.24 $69.56

$86,400 $7,200 $4,800 $236.16 $188.16 $155.52 $106.56 $92.16 $71.04

$88,200 $7,350 $4,900 $241.08 $192.08 $158.76 $108.78 $94.08 $72.52

$90,000 $7,500 $5,000 $246.00 $196.00 $162.00 $111.00 $96.00 $74.00

$91,800 $7,650 $5,100 $250.92 $199.92 $165.24 $113.22 $97.92 $75.48

$93,600 $7,800 $5,200 $255.84 $203.84 $168.48 $115.44 $99.84 $76.96

$95,400 $7,950 $5,300 $260.76 $207.76 $171.72 $117.66 $101.76 $78.44

$97,200 $8,100 $5,400 $265.68 $211.68 $174.96 $119.88 $103.68 $79.92

$99,000 $8,250 $5,500 $270.60 $215.60 $178.20 $122.10 $105.60 $81.40

$100,800 $8,400 $5,600 $275.52 $219.52 $181.44 $124.32 $107.52 $82.88

$102,600 $8,550 $5,700 $280.44 $223.44 $184.68 $126.54 $109.44 $84.36

$104,400 $8,700 $5,800 $285.36 $227.36 $187.92 $128.76 $111.36 $85.84

$106,200 $8,850 $5,900 $290.28 $231.28 $191.16 $130.98 $113.28 $87.32

$108,000 $9,000 $6,000 $295.20 $235.20 $194.40 $133.20 $115.20 $88.80

$109,800 $9,150 $6,100 $300.12 $239.12 $197.64 $135.42 $117.12 $90.28

$111,600 $9,300 $6,200 $305.04 $243.04 $200.88 $137.64 $119.04 $91.76

$113,400 $9,450 $6,300 $309.96 $246.96 $204.12 $139.86 $120.96 $93.24

$115,200 $9,600 $6,400 $314.88 $250.88 $207.36 $142.08 $122.88 $94.72

$117,000 $9,750 $6,500 $319.80 $254.80 $210.60 $144.30 $124.80 $96.20

$118,800 $9,900 $6,600 $324.72 $258.72 $213.84 $146.52 $126.72 $97.68

$120,600 $10,050 $6,700 $329.64 $262.64 $217.08 $148.74 $128.64 $99.16

$122,400 $10,200 $6,800 $334.56 $266.56 $220.32 $150.96 $130.56 $100.64

$124,200 $10,350 $6,900 $339.48 $270.48 $223.56 $153.18 $132.48 $102.12

$126,000 $10,500 $7,000 $344.40 $274.40 $226.80 $155.40 $134.40 $103.60

$127,800 $10,650 $7,100 $349.32 $278.32 $230.04 $157.62 $136.32 $105.08

$129,600 $10,800 $7,200 $354.24 $282.24 $233.28 $159.84 $138.24 $106.56

$131,400 $10,950 $7,300 $359.16 $286.16 $236.52 $162.06 $140.16 $108.04

$133,200 $11,100 $7,400 $364.08 $290.08 $239.76 $164.28 $142.08 $109.52

$135,000 $11,250 $7,500 $369.00 $294.00 $243.00 $166.50 $144.00 $111.00

43

Cancer insurance offers you and your family supplemental insurance protection in the event you or a covered family member is diagnosed with cancer. It pays a benefit directly to you to help with expenses associated with cancer treatment.

About this Benefit

Cancer YOUR BENEFITS PACKAGE

Breast Cancer is the most commonly diagnosed cancer in women.

DID YOU KNOW?

If caught early, prostate cancer is one of the most treatable malignancies.

LOYAL AMERICAN



Cancer

ADDITIONAL BENEFIT AMOUNTS PLAN A

Maximum PLAN B

Maximum ANNUAL CANCER SCREENING BENEFIT RIDER (form LG-6041) A. Basic Benefit We will pay the expense incurred, but not to exceed the maximum benefit amount shown on the Certificate Schedule, once per calendar year per Insured Person for screening tests performed to determine whether Cancer exists in an Insured Person. Covered annual Cancer screening tests include but are not limited to: mammogram, pap smear, breast ultrasound, ThinPrep, biopsy, chest x-ray, thermography, colonoscopy, flexible sigmoidoscopy, hemocult stool specimen, PSA (blood test for prostate cancer), CEA (blood tests for colon cancer), CA125 (blood test for ovarian cancer), CA15-3 (blood test for breast cancer), serum protein electrophesis (blood test for myeloma).

B. Additional Benefit We will pay the expense incurred, but not to exceed two times the maximum benefit amount per calendar year as shown on the Certificate Schedule, for one additional invasive diagnostic procedure required as the result of an abnormal cancer screening test for which benefits are payable under the Basic Benefit above for an Insured Person. This additional benefit is payable regardless of the results of the additional diagnostic procedure. However, the amount payable will be reduced dollar for dollar for any amount payable under the Positive Diagnosis Benefit contained in the base Certificate.

$50 Per Calendar

Year

$100 Per Calendar

Year

$50 Per Calendar

Year

$100 Per Calendar

Year

FIRST OCCURRENCE BENEFIT RIDER (form LG-6043) If an Insured Person receives a positive diagnosis of Internal Cancer, We will pay the First Occurrence benefit amount shown on the Certificate Schedule. If the Insured Person receiving the positive diagnosis of Internal Cancer is a child under the age of 21, we will pay one and one-half times the First Occurrence benefit amount shown on the Certificate Schedule.

$1,000 Once per Lifetime $2,500

Once per Lifetime

$2,000 Once per Lifetime $3,000

Once per Lifetime

ANNUAL RADIATION, CHEMOTHERAPY, IMMUNOTHERAPY and EXPERIMENTAL TREATMENT BENEFIT RIDER (form LG-6045) We will pay the expense incurred, but not to exceed the maximum benefit amount shown on the Certificate Schedule, per calendar year per Insured Person for Radiation Treatment, Chemotherapy, Hormonal Therapy, Immunotherapy or Experimental Treatment. The Radiation Treatment, Chemotherapy, Hormonal Therapy, Immunotherapy or Experimental Treatment must be for the treatment of an Insured Person’s Cancer. The benefit amount shown on the Certificate Schedule is the maximum calendar year benefit available per Insured Person regardless of the number or types of Cancer treatments received in the same year.

$5,000 Per Calendar

Year

$20,000 Per Calendar

Year

SURGICAL BENEFIT RIDER (form LG-6048) Surgical Expense We will pay the Surgical Expense benefit for a surgical procedure for the treatment of an Insured Person’s Cancer (except Skin Cancer) according to the Surgical Schedule shown in this rider. However, in no event will the amount payable exceed the maximum Surgical Expense benefit shown on the Certificate Schedule, nor will it exceed the expense incurred.

$2,000

Procedure Maximum

$3,000

Procedure Maximum

Anesthesia Expense We will pay the anesthesia expense incurred, not to exceed 25% of the covered Surgical Expense benefit for the operation performed. This includes the services of an anesthesiologist or of an anesthetist under supervision of a physician for the purpose of administering anesthesia.

$500 Procedure Maximum

$750 Procedure Maximum

Breast Reconstruction With transverse rectus adominis myocutaneous flap (TRAM), single pedicle, including closure of donor site, with microvascular anastomosis (supercharging) is one of the surgical procedures listed in the Surgical Schedule. If this procedure is performed on an Insured Person as the result of a mastectomy for which We paid a Surgical Expense benefit for the treatment of Breast Cancer, We will pay the expense incurred not to exceed $900 per $1,000 of the Surgical Benefit issued.

Skin Cancer Surgery Expense We will pay the expense incurred, not to exceed the procedure amount listed in this rider ($125 to $750 depending on the procedure) when a surgical operation is performed on an Insured Person for treatment of a diagnosed Skin Cancer. This benefit is payable in lieu of any benefits for Surgical Expense and Anesthesia Expense which are not applicable to Skin Cancer.

$1,800

Procedure Maximum

Per Procedure

$2,700

Procedure Maximum

Per Procedure

DAILY HOSPITAL CONFINEMENT BENEFIT RIDER (form LG-6042) Confinements of 30 Days or Less We will pay the Daily Hospital Confinement benefit amount shown on the Certificate Schedule for each of the first 30 days in each period of hospital confinement during which an Insured Person is confined to a hospital, including a government or charity hospital, for the treatment of Cancer.

Confinements of 31 Days or More If an Insured Person is continuously confined to a hospital, including a government or charity hospital, for longer than 30 consecutive days for the treatment of Cancer, We will pay two times the Daily Hospital Confinement benefit amount shown on the Certificate Schedule. This benefit payment will begin on the 31st continuous day of such confinement and continue for each day of confinement until the Insured Person is discharged from the Hospital.

Benefits for an Insured Dependent Child under Age 21 The amount payable under this benefit will be double the Daily Hospital Confinement benefit shown on the Certificate Schedule if the Insured Person so confined is a dependent child under the age of 21.

$100

Per Day

$200 Per Day

$200/ $400

Per Day

$100

Per Day

$200 Per Day

$200/ $400

Per Day

45

Cancer

Additional Benefits Amounts SPECIFIED DISEASE BENEFIT RIDER (form LG-6052) If an Insured Person is first diagnosed with one or more covered Specified Diseases and is hospitalized for the definitive treatment of any covered Specified Disease, We will pay benefits according to the provisions of this rider.

Covers These 38 Specified Diseases

Addison’s Disease Lupus Erythematosus Rocky Mountain Spotted Fever

Amyotrophic Lateral Sclerosis Malaria Sickle Cell Anemia

Botulism Meningitis Tay-Sachs Disease

Bovine Spongiform Encephalopathy Multiple Sclerosis Tetanus

Budd-Chiari Syndrome Muscular Dystrophy Toxic Epidermal Necrolysis

Cystic Fibrosis Myasthenia Gravis Tuberculosis

Diptheria Neimann-Pick Disease Tularemia

Encephalitis Osteomyelitis Typhoid Fever

Epilepsy Poliomyelitis Undulant Fever

Hansen’s Disease Q Fever West Nile Virus

Histoplasmosis Rabies Whipple’s Disease

Legionnaire’s Disease Reye’s Syndrome Whooping Cough

Lyme Disease Rheumatic Fever

Benefits If an Insured Person is first diagnosed with one or more covered Specified Diseases and is hospitalized for the definitive treatment of any covered Specified Disease, We will pay benefits according to the provisions of this rider. An applicant may select 1, 2 or 3 units of coverage. Initial Hospitalization Benefit We will pay a benefit of $1,500 per unit of coverage selected when an Insured Person is confined to a hospital (for 12 or more hours, not applicable in SD) as a result of receiving treatment for a Specified Disease. This benefit is payable only once per period of confinement and once per calendar year for each Insured Person. Hospital Confinement Benefit We will pay a benefit of $300 per day per unit of coverage selected when an Insured Person is hospitalized during any continuous period of 30 days or less for the treatment of a covered Specified Disease. Benefits will double per day beginning with the 31st day of continuous confinement. If the hospital confinement follows a previously covered confinement, it will be deemed a continuation of the first confinement unless it is the result of an entirely different Specified Disease, or unless the confinements are separated by 30 days or more.

Monthly Rates

Employee

Single Parent

Family

Base Plan A $14.97 $18.76 $25.59

Base Plan B $28.23 $34.08 $47.28

46

Cancer

OPTIONAL BENEFITS YOU MAY SELECT FOR ADDITIONAL PREMIUM

HOSPITAL INTENSIVE CARE UNIT BENEFIT RIDER (form LG-6047)* Intensive Care Unit Benefit We will pay the daily Hospital Intensive Care Unit Benefit shown on the Certificate Schedule for an Insured Person’s confinement in an ICU for sickness or injury.

$500

Per Day

Double Intensive Care Unit Benefit We will pay double the daily Hospital Intensive Care Unit benefit amount shown on the Certificate Schedule for an Insured Person’s confinement in an ICU as a result of Cancer. We will also double this ICU benefit for only the initial ICU confinement resulting from an Insured Person’s travel related injury, provided that the ICU confinement begins within 24 hours of the accident causing the travel related injury. A travel related injury includes being struck by an automobile, bus, truck, van, motorcycle, train or airplane; or being involved in an accident where the Insured Person was the operator or passenger in or on such vehicle.

$1,000 Per Day

Step Down Unit Benefit We will pay one-half of the daily Hospital Intensive Care Unit benefit amount shown on the Certificate Schedule for an Insured Person’s confinement in a Step Down Unit for a sickness or injury.

$250

Per Day

*Additional Limitations and Exclusions for the Hospital Intensive Care Unit Benefit Rider If the rider is issued and coverage is in force, it will provide benefits if an Insured Person goes into a hospital Intensive Care Unit (including a Cardiac Intensive Care Unit or Neonatal Intensive Care Unit). Benefits start the first day of confinement in an ICU for sickness or injury. Any combination of benefits payable under this rider is limited to a maximum of 45 days per each period of confinement. ALL BENEFITS CONTAINED IN THIS HOSPITAL INTENSIVE CARE UNIT BENEFIT RIDER REDUCE BY ONE-HALF AT AGE 75. Benefits are not payable for any ICU or Step Down Unit confinement that results from intentional self-inflicted injury; or the Insured Person’s being intoxicated or under the influence of alcohol, drugs or any narcotics, unless administered on and according to the advice of a medical practitioner. THIS IS A LIMITED RIDER.

Monthly Rates

Employee

Single Parent

Family

Base Plan A + ICU $17.29 $21.96 $29.99

Base Plan B + ICU $30.55 $37.28 $51.68

47

Life insurance provides a cash death benefit to your beneficiary upon your death. Group term life is the most inexpensive way to purchase life insurance. You have the freedom to select an amount of life insurance coverage you need to help protect the well-being of your family. If you are covered, you may apply for coverage on your spouse and eligible dependent children.

About this Benefit

Basic & Voluntary Life YOUR BENEFITS PACKAGE

x 10

Experts recommend at least

your gross annual income in coverage when purchasing life insurance.

DID YOU KNOW?

AUL A ONEAMERICA COMPANY



AUL's Group Voluntary Term Life Insurance Terms and Definitions

Eligible Employees: Cedar Hill provides a $10,000 life insurance policy to all eligible employees at no cost. This benefit is available for employees who are actively at work on the effective date and working a minimum of 20 hours per week.

Flexible Choices: Since everyone's needs are different, this plan offers flexibility for you to choose a benefit amount that fits your needs and budget.

Guaranteed Issue Amounts: This is the most coverage you can purchase without having to answer any health questions. If you decline insurance coverage now and decide to enroll later, you will need to provide Evidence of Insurability.

Evidence of Insurability: Enrolling timely means you have enrolled during the initial enroll‐ment period when benefits were first offered by AUL, or as a newly hired employee within 31 days following completion of any applicable waiting period.

Timely Enrollment: If you elect a benefit amount over the Guaranteed Issue Amount shown above for you or your eligible dependents, or you do not enroll timely, you will need to submit a Statement of Insurability form for review. Based on health history, you and / or your de‐pendents will be approved or declined for insurance coverage by AUL.

Guaranteed Increase in Benefit: If eligible, this benefit allows you to increase your coverage every year as your life insurance needs change. You may be able to increase your benefit amount by $10,000 every year until you reach the guaranteed issue amount, without providing Evidence of Insurability. NOTE: If Evidence of Insurability is applied for and denied, please be aware Guaranteed Increase in Benefits will not be made avail‐able to you in the future.

Continuation of Coverage Options: Portability Should your coverage terminate for any reason, you may be eligi‐ble to take this term life insurance with you without providing Evidence of Insurability. You must apply within 31 days from the last day you are eligible. The Portability option is available until you reach age 70.

OR

Conversion Should your life insurance coverage, or a portion of it, cease for any reason, you may be eligible to convert your Group Term Cov‐erage to Individual Coverage without providing Evidence of Insur‐ability. You must apply within 31 days from the last day you are eligible. Accelerated Life Benefit: If diagnosed with a terminal illness and have less than 12 months to live, you may apply to receive 25%, 50% or 75% of your life insurance benefit to use for whatever you choose. Waiver of Premium: If approved, this benefit waives your and your dependents' insur‐ance premium in case you become totally disabled and are una‐ble to collect a paycheck. Reductions: Upon reaching certain ages, your original benefit amount will reduce to a percentage as shown in the following schedule.

This invitation to inquire allows eligible employees an opportuni‐ty to inquire further about AUL's group insurance and is limited to a brief description of any losses for which benefits are payable. The contract has exclusions, limitations reduction of benefits, and terms under which the contract may be continued in force or discontinued.

Basic & Voluntary Life

Employee Guaranteed Issue Amount $180,000

Spouse Guaranteed Issue Amount $50,000

Child Guaranteed Issue Amount $10,000

Age: 70 75 80 85 90

Reduces To: 65% 45% 30% 20% 15%

49

Voluntary Life

Monthly Payroll Deduction Illustration

About your benefit options:

You may select a minimum benefit of $10,000 up to a maximum amount of $500,000, in increments of $10,000, not to exceed 7 times your annual base salary only, rounded to the next higher $1,000.

Amounts requested above $180,000 for an Employee, $50,000 for a Spouse, or any amount not requested timely will require Evidence of Insurability.

Employee must select coverage to select any Dependent coverage.

Dependent coverage cannot exceed 50% of the Voluntary Term Life amount selected by the Employee.

EMPLOYEE ONLY OPTIONS (based on Employee's age as of 09/01)

Life Options

0-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+

$10,000 $.54 $.54 $.54 $.55 $.78 $1.05 $1.45 $2.75 $4.41 $6.95 $12.90 $26.20 $26.20

$20,000 $1.08 $1.08 $1.08 $1.10 $1.56 $2.10 $2.90 $5.50 $8.82 $13.90 $25.80 $52.40 $52.40

$30,000 $1.62 $1.62 $1.62 $1.65 $2.34 $3.15 $4.35 $8.25 $13.23 $20.85 $38.70 $78.60 $78.60

$40,000 $2.16 $2.16 $2.16 $2.20 $3.12 $4.20 $5.80 $11.00 $17.64 $27.80 $51.60 $104.80 $104.80

$50,000 $2.70 $2.70 $2.70 $2.75 $3.90 $5.25 $7.25 $13.75 $22.05 $34.75 $64.50 $131.00 $131.00

$70,000 $3.78 $3.78 $3.78 $3.85 $5.46 $7.35 $10.15 $19.25 $30.87 $48.65 $90.30 $183.40 $183.40

$90,000 $4.86 $4.86 $4.86 $4.95 $7.02 $9.45 $13.05 $24.75 $39.69 $62.55 $116.10 $235.80 $235.80

$100,000 $5.40 $5.40 $5.40 $5.50 $7.80 $10.50 $14.50 $27.50 $44.10 $69.50 $129.00 $262.00 $262.00

$150,000 $8.10 $8.10 $8.10 $8.25 $11.70 $15.75 $21.75 $41.25 $66.15 $104.25 $193.50 $393.00 $393.00

$180,000 $9.72 $9.72 $9.72 $9.90 $14.04 $18.90 $26.10 $49.50 $79.38 $125.10 $232.20 $471.60 $471.60

SPOUSE ONLY OPTIONS (based on Employee's Age as of 09/01

Life Options

0-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+

$5,000 $.27 $.27 $.27 $.28 $.39 $.53 $.73 $1.38 $2.21 $3.48 $6.45 $13.10 $13.10

$10,000 $.54 $.54 $.54 $.55 $.78 $1.05 $1.45 $2.75 $4.41 $6.95 $12.90 $26.20 $26.20

$15,000 $.81 $.81 $.81 $.83 $1.17 $1.58 $2.18 $4.13 $6.62 $10.43 $19.35 $39.30 $39.30

$20,000 $1.08 $1.08 $1.08 $1.10 $1.56 $2.10 $2.90 $5.50 $8.82 $13.90 $25.80 $52.40 $52.40

$25,000 $1.35 $1.35 $1.35 $1.38 $1.95 $2.63 $3.63 $6.88 $11.03 $17.38 $32.25 $65.50 $65.50

$30,000 $1.62 $1.62 $1.62 $1.65 $2.34 $3.15 $4.35 $8.25 $13.23 $20.85 $38.70 $78.60 $78.60

$35,000 $1.89 $1.89 $1.89 $1.93 $2.73 $3.68 $5.08 $9.63 $15.44 $24.33 $45.15 $91.70 $91.70

$40,000 $2.16 $2.16 $2.16 $2.20 $3.12 $4.20 $5.80 $11.00 $17.64 $27.80 $51.60 $104.80 $104.80

$45,000 $2.43 $2.43 $2.43 $2.48 $3.51 $4.73 $6.53 $12.38 $19.85 $31.28 $58.05 $117.90 $117.90

$50,000 $2.70 $2.70 $2.70 $2.75 $3.90 $5.25 $7.25 $13.75 $22.05 $34.75 $64.50 $131.00 $131.00

50

Voluntary Life

CHILD(REN) OPTIONS (Premium shown for Child(ren) reflects the cost for all eligible dependent children)

Child(ren) 6 months to age 26 Child(ren) live birth to 6 months Monthly Payroll Deduction Life

Amount

Option 1: $10,000 $1,000 $1.00

About Premiums: The premiums shown above may vary slightly due to rounding; actual premiums will be calculated by American United Life Insurance Company® (AUL), and may increase upon reaching certain age brackets, according to contract terms, and are subject to change.

51

An Employee Assistance Plan (EAP) is an employee benefit program offered to help employees manage personal and professional problems that might adversely impact their work performance, health, and well-being. Employee Assistance Plans generally include short-term counseling and referral services for employees and their household members. Your Employee Assistance Program benefit is provided to you by your employer.

About this Benefit

EAP (Employee Assistance Program) YOUR BENEFITS PACKAGE

DID YOU KNOW?

One America

38% of employees have missed life events because of bad work-life balance.



EAP 3 Visit Plan

What is an EAP? An EAP is a confidential worksite-based program designed to assist both employees and employers. An EAP provides assessment and referral — in person and over the phone— for personal matters. Each eligible employee1, along with each eligible employee’s dependents, is entitled to three visits (or sessions) free-of-charge per calendar year. Also, telephone intakes and information calls regarding EAP services are free and unlimited.

Assessment and referral services

Personal concerns Stress

Crisis

Psychiatric disorders

Medical problems

Work-related difficulties

Marital and family issues

Emotional concerns

Relationship issues

Life adjustments

Alcohol and drug problems

Financial Financial planning

Retirement planning

Investment strategies

Money management

Childcare Assess childcare needs and explore care options

Adoption resources

Referrals for an array of childcare arrangements, camps and schools

Online services Stress management course

Legal/financial library - Legal/financial articles - Sample legal documents

Smoking cessation program

Identity theft resources

Behavioral health library - Information on numerous life issues

Wellness information

Depression and substance abuse screenings

Eldercare Resources and referral for both public and private

eldercare facilities

Consultation on evaluation of facilities

Legal Consultation provided for an array of legal issues,

including family law, housing and real estate and estate planning

Simple will prepared at no cost

25 percent discount on

standard attorney hourly rate for services rendered beyond scope of EAP

Academic resources SAT and other testing resources

Tutors

College planning guides

Sources of financial assistance

Employee eligibility based upon contract terms. Contact your employer for EAPC’s eligibility requirements. All services must be arranged by EAPC who is wholly responsible for provision and administration of the EAP.

Pet services Referrals for breeders, kennels, veterinarians, etc.

Pet services guide

53

EAP 3 Visit Plan

Who is EAPC?

EAP services are provided through EAP Consultants, LLC (EAPC). EAPC is a private company with a diverse network of licensed professionals, including clinical providers and consultants. All EAP services are completely confidential pursuant to current US laws and regulations. EAPC’s services include access to highly experienced clinical providers that include licensed psychologists, clinical social workers, professional counselors, marriage and family therapists and alcohol and drug counselors. Consultants include attorneys, financial advisors and elder care and child care specialists. EAPC also offers online services to fit a wider array of needs. EAP professionals will help employees identify and clarify concerns and develop a plan of action to create solutions that work. If additional assistance is needed, EAPC will assist employees in finding resources that may be covered by their insurance and meet their financial capabilities. Note EAPC is neither affiliated nor under common control with OneAmerica or AUL, and AUL only markets EAPC products.

For detailed information, contact EAP Consultants, LLC at 1-800-869-0276. To confidentially request services online, visit the member access page at www.eapconsultants.com The password is OneAmericaEAP.

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3 Things to Know About Travel Assistance

Who is EAPC?

EAP American United Life Insurance Company® (AUL), a OneAmerica® company, realizes emergencies can happen when you are traveling away from home on business or for pleasure. When an emergency occurs, we How to utilize EA USA services understand you need help that is dependable and fast. With a phone call to Europ Assistance USA (EA USA)1, covered persons have access to worldwide 24-hour medical and transportation services. When traveling 100 or more miles away from home, EA will be there in the event of an emergency during a covered trip at no additional premium cost to the covered policyholder2.

Who is covered? A covered person is an individual who receives coverage under a covered policyholder’s AUL group life insurance contract and the individual’s spouse, domestic partner and children. The Travel Assistance benefit applies to covered persons who are traveling 100 miles or more away from home during a covered trip.

What is a covered trip? A covered trip is defined as a business or pleasure trip not more than 90 days in length and 100 or more miles away from home. EA USA offers and administers the program and services in most countries3 and can also provide pre-trip assistance services to help you prepare and plan ahead of time.

1. Call an EA USA representative. From the US/Canada: 1-866-294-2469 All other locations: +1 240 330 1509

2. Verify eligibility Provide the name of the covered policyholder’s employer in order to verify eligibility and a phone number where you may be reached. 1EA USA is neither affiliated nor under common control with OneAmerica or AUL, and AUL only markets the EA USA program. 2A covered person does not include an individual who has been approved for continuation of insurance or portability benefits, an individual insured under AUL’s 2+ Protector contract or an individual insured under AUL’s Voluntary Universal Life insurance contract. The program and services are not offered or available to individuals who are not covered persons and may be terminated or discontinued at any time. 3However, conditions and events such as force majeure, war, natural disasters or political instability may occur or exist that render assistance and services difficult or impossible in some areas. Therefore, availability of services cannot always be guaranteed or offered. 4Neither EA USA nor AUL shall have responsibility for the nature, content or quality of any medical advice or legal counsel given by any medical professional or attorney, nor shall EA USA or AUL be liable for the negligence or other wrongful acts or omissions of any healthcare or legal professionals providing direct services to covered persons. 5Eligibility must always first be verified by EA USA through the covered policyholder’s designated contract.

For a list of additional travel assistance services4, please refer to EA USA’s brochure5 or visit their website at www.europassistance-usa.com

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http://www/

Accidental Death & Dismemberment is life insurance coverage that pays a death benefit to the beneficiary, should death occur due to a covered accident. Dismemberment benefits are paid to you, according to the benefit level you select, if accidentally dismembered.

About this Benefit

AD&D YOUR BENEFITS PACKAGE

cause of accidental deaths in the US, followed by poisoning, falls,

drowning, and choking.

DID YOU KNOW?

#1

Motor vehicle crashes are the

Axis Global



AD&D

Principal Sum: Employee - $10,000 to $500,000 in $10,000 increments. Amounts over $250,000 may not exceed 10 times Base Earnings. Spouse – 60% of the employee’s benefit without child coverage, 50% of the employee’s benefit with child coverage. Spouse Maximum Principal Sum: $300,000. Child – 10% of the employee’s benefit with spouse coverage,

15% of the employee’s benefit without spouse coverage. Child(ren) Maximum Principal Sum: $30,000.

Eligibility: All active full time Employees of the Employer working 20 plus hours per week who are domiciled in the United States, its territories and protectorates, excluding temporary, lease or seasonal employees.

Core Benefits Accidental Death & Dismemberment Schedule of Benefits

Loss of Life 100% of the Principal Sum Loss of or Loss of use of Two or more Hands or Feet 100% of the Principal Sum Loss of Sight Both Eyes 100% of the Principal Sum Loss of One Hand or One Foot and Sight in One Eye 100% of the Principal Sum Loss of Speech and Hearing (both ears) 100% of the Principal Sum

Coma 1% of the Principal Sum for the first 11 months, 100% in the 12th Month

Loss of or Loss of use of One Hand or Foot 50% of the Principal Sum Loss of Sight in One Eye 50% of the Principal Sum

Loss of Speech 50% of the Principal Sum Loss of Hearing (both ears) 50% of the Principal Sum Loss of Thumb and Index Finger of the Same Hand 25% of the Principal Sum Loss of all Four Fingers of the Same Hand 25% of the Principal Sum Loss of all the Toes of the Same Foot 20% of the Principal Sum Quadriplegia (total paralysis of both upper and lower limbs) 100% of the Principal Sum Paraplegia (total paralysis of both lower limbs) 75% of the Principal Sum Hemiplegia (total paralysis of upper and lower limbs on one side of body 50% of the Principal Sum Uniplegia (total paralysis of one upper or lower limb) 25% of the Principal Sum Exposure and Disappearance Benefit Included

Additional Benefits Travel Assistance Services – You and your family have access to travel assistance services for emergencies that occur while traveling almost anywhere in the world, at least 100 miles from home. Comprehensive services are available locally in over 200 countries and through 35 assistance centers open 24/7, these comprehensive services offer support to help travelers in an emergency. Refer to the travel assurance flyer provided by your employer which includes information on the services available, as well as a wallet card with important contact information Your coverage includes Additional Benefits beyond the Principal Sum that can be paid if an Accidental Death Benefit is payable under the Policy. Certain other conditions may apply.

Special Education Benefits Surviving Dependent Child

Your Dependent Child attending school could qualify for an additional 5% of the Principal Sum, up to a maximum of $5,000 per year for up to 4 years

Spouse Retraining Benefit

Your surviving Spouse attending school could qualify for an additional 5% of the Principal Sum, up to a maximum of $5,000.

Seatbelt and Airbag Benefits If you were traveling in a private passenger vehicle and

properly wearing a seatbelt, you could qualify for an

additional 10% of the Principal Sum, up to a maximum of $50,000

If you were traveling in a private passenger vehicle equipped with a properly functioning airbag, you could qualify for an additional 5% of the Principal Sum, up to a maximum of $10,000.

Bereavement & Trauma If bereavement and trauma counseling is needed due to a

covered loss, you could qualify for 10 - $100 sessions with a maximum benefit of $1,000

Home Alteration and Vehicle Modification Benefit If you suffer a covered loss and require home alteration and

vehicle modification, you could qualify for an additional 10% of the Principal Sum, up to a maximum of $10,000

Medical Evacuation and Repatriation Benefits If a covered accident occurs while traveling that results in

the need for your emergency medical evacuation or a repatriation of your remains, you could qualify for an additional benefit of 100% of the Usual and Customary charges for such an expense.

COBRA

Reimburses COBRA Insurance Continuation expenses if you die in a covered accident and are survived by a spouse or dependent child(ren). You could qualify for 3% of the Principal Sum, up to a maximum of $3,000 per policy year for a maximum of 3 years.

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Individual life is a policy that provides a specified death benefit to your beneficiary at the time of death. The advantage of having an individual life insurance plan as opposed to a group supplemental term life plan is that this plan is guaranteed renewable, portable and typically premiums remain the same over the life of the policy.

About this Benefit

Individual Life YOUR BENEFITS PACKAGE

DID YOU KNOW?

TEXAS LIFE

1/3 of Americans would be financially impacted by the loss of the primary wage earner in just one month.



Individual Life

Life Insurance Highlights

Voluntary permanent life insurance can be an ideal complement to the group term and optional term your employer might provide. Designed to be in force when you die, this voluntary universal life product is yours to keep, even when you change jobs or retire, as long as you pay the necessary premium. Group and voluntary term, on the other hand, typically are not portable if you change jobs and, even if you can keep them after you retire, usually costs more and declines in death benefit. The policy, PureLife-plus, is underwritten by Texas Life Insurance Company, and it has these outstanding features:

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

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

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

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

Accelerated Death Benefit Rider. Should you be diagnosed as terminally ill with the expectation of death within 12 months (24 months in Illinois), you will have the option to receive 92% (84% in Illinois) of the death benefit, minus a $150 ($100 in Florida) administrative fee. This valuable living benefit gives you peace of mind knowing that, should you need it, you can take the large majority of your death benefit while still alive. (Conditions apply.)

You may apply for this permanent, portable coverage, not only for yourself, but also for your spouse, minor children and grandchildren. Like most life insurance policies, Texas Life policies contain certain exclusions, limitations, exceptions, reductions of benefits, waiting periods and terms for keeping them in force. Please contact a Texas Life representative for costs and complete details. 1Voluntary and Universal Whole Life Products, Eastbridge Consulting Group, October 2008

DID YOU KNOW? Those with no life insurance think it’s 3 times more expensive than it actually is.

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2016 benefit guide cedar hill isd

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