USD 290 Benefit Guide

FY 2023-2024 BENEFIT GUIDE BENEFIT GUIDE Ottawa USD #290 Ottawa USD is dedicated to offering a comprehensive and valuable benefits package for you and your family. This guide will provide an overview of the various benefits offered by Ottawa USD, allowing you to determine the options that best suit your and your family's needs. If you have questions about any of the benefits mentioned in this guide, please don’t hesitate to reach out to Benefits Direct. Table of Contents Our Benefits Partner..................................................................................................................................3 Enrollment FAQ ...........................................................................................................................................4 New Employee Benefits Eligibility...................................................................................................5 Carrier Contact Information.................................................................................................................6 Health Insurance..........................................................................................................................................7 Health Savings Account.........................................................................................................................12 Medical Transport.......................................................................................................................................14 Dental Insurance.........................................................................................................................................15 Vision Insurance...........................................................................................................................................18 Flexible Spending Account..................................................................................................................20 Dependent Care Reimbursement Account ............................................................................22 Basic Life and AD&D.................................................................................................................................23 Voluntary Life Insurance.......................................................................................................................24 Short-Term Disability..............................................................................................................................27 Cancer Insurance......................................................................................................................................28 Accident Insurance..................................................................................................................................29 Critical Illness Insurance ......................................................................................................................31 Hospital Indemnity Insurance..........................................................................................................35 Universal Life Insurance........................................................................................................................37  Identity Theft................................................................................................................................................39 Pre-Paid Legal.............................................................................................................................................41 PICK THE BEST BENEFIT FOR YOU AND YOUR FAMILY OUR BENEFITS PARTNER Telephone:(833)703-9078  Email: CustomerSupport@AmerilifeBenefits.com Website: https://benefits-direct.com/ottawa290/  The information in this Enrollment Guide is presented for illustrative purposes and is based on information provided by the employer. The text contained in this guide was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the guide and actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about the guide, please contact us. For help or assistance, we are always just a phone call or email away! For over 50 years, Benefits Direct has serviced the insurance needs of companies, employees, and retirees. Our objective at Benefits Direct is to be recognized as the best, in each and every area in which we do business, and to provide our best advice, products, and services. We continue to be sensitive to our clients’ needs and make the satisfaction of those needs our most important job. We inform our clients of developments in our constantly changing marketplace. Service is our main priority each and every day. Our administrative office staff and field professionals are well-trained, experienced, competent, and courteous.   Benefits Direct strives to provide cost-effective programs for a diverse group of businesses, professionals, educators, and individuals. Our mission is to effectively meet each client’s financial and insurance goals through our firm’s relationship with major carriers. When to Enroll How to Enroll This is an active enrollment year which means ALL employees MUST enroll even if they wish to waive all products.  Option 1: Online Self-Enrollment: Please visit the benefits portal at  https://benefits-direct.com/ottawa290/ • Explore the portal and its pages to learn more about the benefits offered to you! • Click on “How to Enroll” in the menu bar • Follow the instructions in the self-enroll section and complete your enrollment Option 2: Benefits Counselor Call Center Enrollment: • Please visit the benefits portal at  https://benefits-direct.com/ottawa290/ • Explore the portal and its pages to learn more about the benefits offered to you! • Click on “How to Enroll” in the menu bar • Click the link to book an appointment Open Enrollment Dates: July 24th– August 11th Please set your appointment BEFORE August 1st to ensure counselor availability Who is eligible? If you are a benefits eligible employee at Ottawa USD, you are eligible to enroll in the benefits outlined in this guide. Medical benefits eligible employees are those who work 30 or more hours per week. In addition, your legal dependents are eligible for supplemental benefits. Unless you experience a life-changing qualifying event, you cannot make changes to your benefits until the next open enrollment period. Qualifying events include things such as: Marriage, divorce, or legal separation Birth or adoption of a child Change in child’s dependent status Death of a spouse, child, or other qualified dependent Change in employment status or a change in coverage under another employer-sponsored plan Making Changes ENROLLMENT FAQ New Employee Benefits Eligibility Benefits eligible employees are qualified to register for the benefits outlined in this benefit guide. New hires and their qualified dependents must complete enrollment within 30 days of their date of hire. Your dependents may be added provided they satisfy the criteria of being an eligible dependent. Eligible children are covered until the conclusion of the month in which they reach the age of 26, regardless of their student, marital, or employment condition. However, the spouse and/or child(ren) of your dependent child(ren) are not eligible.  What is Open Enrollment? Open Enrollment refers to a designated period during which all benefits eligible employees have the future opportunity to: Modify their existing benefits Add new benefits Choose to enroll or waive benefits as necessary. Remember, as a new employee, you have 30 days from your date of hire to enroll in benefits. If you miss this deadline, you will have to wait for the next Open Enrollment Period to make any further decisions regarding your benefits.  Benefits Portal The benefits portal houses all the necessary information about the benefits we offer, which include: Comprehensive descriptions of the benefits we provide Procedures for enrolling in the benefits we offer Access to a benefits counselor for inquiries or enrollment support Remember to bookmark the benefits portal and keep your login credentials secure for future access to your benefits information. Get Started Today! Please take some time to review the contents of our Benefits Guide so that you can take full advantage of the fantastic benefits we have made available to you. Should you have any queries or concerns regarding this information, please don't hesitate to contact our support team at (833)703-9078. Medical Carrier Name: BCBS of KS Website: https://www.bcbsks.com/ Phone: 1-866-343-5744 Health Savings Accounts Carrier Name: Further Website: https://hellofurther.com/ Phone: 1-800-859-2144 Medical Transport  Carrier Name: MASA Website: https://www.masamts.com/ Phone: (877) 503-0585 Dental Carrier Name: Delta Dental  Website: https://deltadentalks.com/ Phone: 1-800-234-3375  Vision Carrier Name: VSP  Website: https://www.vsp.com/ Phone: 1-800-877-7195 Flexible Spending Account Flex Made Easy Website: www.flexmadeeasy.com Phone: (855) 615-3679 Dependent Care Reimbursement Account Flex Made Easy Website: www.flexmadeeasy.com Phone: (855) 615-3679 Basic Life  Carrier Name: AdvanceLife Website: https://www.advanceinsurance.com/ Phone: 1-800-530-5989 Voluntary Life  Carrier Name: OneAmerica Website: https://www.oneamerica.com/ Phone: 1-800-553-5318    If you have any questions regarding your benefits, please review your benefit portal here https://benefits-direct.com/ottawa290/ or reach out to the appropriate carrier listed below. Short-Term Disability Carrier Name: OneAmerica Website: https://www.oneamerica.com/ Phone: 1-800-553-5318 Cancer Carrier Name: Prosperity Website: https://benefits-direct.com/ottawa290/cancer/ Phone: 1-844-801-6238 Accident Carrier Name: Prosperity Website: https://benefits-direct.com/ottawa290/accident/ Phone: 1-844-801-6238  Critical Illness Carrier Name: Prosperity Website: benefits-direct.com/ottawa290/critical-illness/ Phone: 1-844-801-6238  Hospital Indemnity Carrier Name: Reliance Standard Website: https://www.reliancematrix.com/ Phone: 1-800-351-7500  Permanent Life with Long Term Care Carrier Name: Trustmark Website: https://www.trustmarkbenefits.com/ Phone: 847-615-1500  ID Protection Carrier Name; ID Force Website: https://secure.identityforce.com/ Phone: 1-877-807-5119 Legal Protection Carrier Name: MetLife Legal Website: https://www.legalplans.com/ Phone: 1-800-821-6400  CARRIER CONTACT INFORMATION Provider: BCBS of KS Eligibility:  Employee must work 30 hours or more per week to qualify for enrollment. Questions? MEDICAL INSURANCE You can call BCBS of KS directly at 1-866-343-5744 As a benefits eligible employee of Ottawa USD, you have the choice between four medical plan options through BCBS of KS. BCBS of KS works to empower their members and help them live active and rewarding lives. You can cover yourself and eligible dependents with a health plan through your employer. Eligible child(ren) can be covered until they turn 26 years old. MEDICAL INSURANCE Deductible Member Pays Non-Network Option A $1500 Individual /$3000 Two Persons/$4500 Three or more Persons $2,000/$4,000 Option B $2000 Individual /$4000 Two Persons/$6000 Three or more Persons 50% / 50% Option C $2500 Individual /$5000 Two Persons/$7500 Three or more Persons $8,000/$16,000 Option D $5000 Individual /$10,000 Two or more Persons $10,000/$20,000 Coinsurance Member Pays Option A,B,C 20% of allowed amounts after deductible has been met 70% after deductible Option D 0% of allowed amount after deductible has been met 70% after deductible Coinsurance Max Member Pays 70% after deductible Option A $1000 Individual /$2000 Two Persons/$3000 Three or more Persons Option B $1500 Individual /$3000 Two Persons/$4500 Three or more Persons Option C $2000 Individual /$4000 Two Persons/$6000 Three or more Persons Option D N/A 70% after deductible Annual Out-of-Pocket Max Member Pays Includes Copays, deductible, and coinsurance $6350 Individual/ $12700 two or more persons 50% after deductible Doctor's Office Visits Member Pays 50% after deductible Option A, B & C $35/$70 office visit copay 50% after deductible Option D Deductible/Coinsurance 50% after deductible Preventative Care Paid at 100% of allowable charge. Prescription Drugs & Mail Order In-Network Non-Network Option A, B & C ResultsRx BlueRx Card Durable Medical Equipment Generic $15 per 30 days, *ESN $30 per 31-90 Days 50% after deductible Urgent Care Facility Preferred Brand - $50 per 30 days, *ESN $100 per 31-60 days, $150 per 61-90 days 70% after deductible Chiropractic Care (26 Visits per year) Non-Preferred Brand - $75 per 30 days, *ESN $150 per 31-60 days, $225 per 61-90 days 70% after deductible Ambulance Mail Order 2.5 Times Co-pays 80% after deductible Behavioral/Mental/Substance Abuse Inpatient Services Preferred Specialty - 25% up to $250 per 30 days, Prime Therapeutics Exclusive Specialty Network 50% after deductible Behavioral/Mental/Substance Abuse Outpatient Services Non-Preferred Specialty - 25% to $1,000 per 30 days, Prime Therapeutics Exclusive Specialty Network 70% after deductible Option D ResultsRx BlueRx Card, AFTER Deductible Generic $15 per 30 days, *ESN $30 per 31-90 Days Preferred Brand - $50 per 30 days, *ESN $100 per 31-60 days, $150 per 61-90 days Non-Preferred Brand - $75 per 30 days, *ESN $150 per 31-60 days, $225 per 61-90 days Mail Order 2.5 Times Co-pays Preferred Specialty - 25% up to $250 per 30 days, Prime Therapeutics Exclusive Specialty Network Non-Preferred Specialty - 25% to $1000 per 30 days, Prime Therapeutics Exclusive Specialty Network*ESN (Extended Supply Network Pharmacy) MEDICAL INSURANCE MEDICAL INSURANCE Medical Services Member Pays Non-Network Emergency Medical Transport Subject to deductible/coinsurance $6,000/$12,000 Inpatient Surgery Physician/Surgical Subject to deductible/coinsurance 60% / 40% Inpatient Facility Fee Subject to deductible/coinsurance $4,000 / $8,000 Outpatient Surgery Physician/Surgical Subject to deductible/coinsurance $10,000/$20,000 Outpatient Lab and Radiology Option A, B & C Pays at 100% to a combined maximum of $300 for each covered person, each benefit period then subject to deductible/coinsurance Outpatient Lab and Radiology Option D Subject to deductible/coinsurance Emergency Room Option A, B & C $250 copay then subject to deductible/coinsurance Emergency Room Option D Subject to deductible/coinsurance Accidental Injury Services Subject to deductible/coinsurance Recovery/Special Needs Member Pays Outpatient Rehab Subject to deductible/coinsurance 70% after deductible Hospice Subject to deductible/coinsurance 60% after deductible Home Care Subject to deductible/coinsurance 60% after deductible Mental Health Member Pays 60% after deductible Inpatient Services (Requires pre-admission certification from New Directions Behavioral Health at 1-800-952-5906) Subject to deductible/coinsurance 60% after deductible Outpatient Servcies Option A, B & C $35 office visit copay 60% after deductible Outpatient Services Option D Subject to deductible/coinsurance 60% after deductible Other Maximum Lifetime Benefit Unlimited 60% after deductible Eligible Dependents Up to age 26 60% after deductible *Please note these pages are a brief overview of coverage. It does not list all benefits, nor does it list exclusions and limitations. Please refer to your benefit portal for more information. Option C $2,500/$5,000/$7,500 Deductible Plan Employee Only Employee & Spouse Employee & Child Children Option C $205 $739 $721 Employee & Family $1260 Option B $2,000/$4,000/$6,000 Deductible Plan Employee Only Employee & Spouse Employee & Child Children Option B $251 $822 $801 Employee & Family $1639 Option A $1,500/$3,000/$4500 Deductible Plan Employee Only Employee & Spouse Employee & Child Children Option A $354 $1006 $983 Employee & Family $1639 MEDICAL INSURANCE Option D $5,000/$10,000 Deductible Plan Employee Only Employee & Spouse Employee & Child Children Option D $55 $471 $462 Employee & Family $884 HEALTH SAVINGS ACCOUNT Tax Year Individual Coverage Limits Family Coverage Limits 2022 $3,650 $7,300 2023 $3,850 $7,750 2024 $4,150 $8,300 Contribution Limits Please keep in mind that the federal government sets limits on how much you can contribute to an HSA in a tax calendar year. The table below displays the current HSA contribution limits. Current contribution information can be found on the U.S. Department of Treasury website at treas.gov. Provider: Flex Made Easy Eligibility:  Medical HDHP Plan D Enrollees are the only employees eligible for an HSA Overview:  A Health Savings Account (HSA) is a savings account that offers tax benefits and can be used to pay for medical expenses. Discounts apply for In-Network providers. There are several benefits of an HSA, including: Your payroll contributions are made with pretax dollars, which may help lower your tax bill. The funds in your account do not expire at the end of the year. You can keep them as long as you want to. The funds in your account are yours to keep even if you change jobs. Using the account is easy. Most HSAs will issue a debit card to you. If you use the debit card to immediately pay for your eligible medical expenses, you won't have to go through a reimbursement process. Health care costs have escalated at a rapid rate over the past decade. The combination of a lower monthly premium payment and an HSA account--designed to help people pay for health care expenses with significant tax savings--is an ideal way to save and pay for health care needs now and in the future. In a traditional health plan, the insurer sets limits for what is covered under the premium. The HSA, in contrast, can be used for a wide range of expenses, limited only by legislation and IRS guidelines. However, it is your responsibility to: • Ensure that you use your funds for eligible expenses. • Retain documentation (receipts, prescriptions, etc) about your purchases. These will be necessary in the event that you are audited by the IRS. More flexibility and control Medical HDHP Plan Option D Enrollees are the only employees eligible for an HSA Why an HSA? A health savings account (HSA) is a tax-advantaged savings account that you can use for medical expenses. It is paired with a qualifying health insurance plan; typically, a high deductible health plan (HDHP). Provider: Delta Dental of KS DENTAL INSURANCE Delta Dental Insurance Employee Only Employee & Spouse Employee & Child Dental Insurance $33.33 $76.61 $79.81 Employee & Family $119.87 Overview:  Dental insurance not only helps preserve your smile, but also covers the cost of dental treatments and typically includes routine checkups, cleanings, and X-rays. Research indicates that oral health issues like gum disease can have an impact on other parts of the body, including the heart. By getting regular dental care, you can safeguard your overall well-being. Eligibility:  Employee must work 20 hours or more per week to qualify for enrollment. Employee Monthly Premium Benefit % Paid Diagnostic & Preventive (Not subject to deductible) Delta Dental PPO 100% Diagnostic: Includes the following procedures necessary to evaluate existing dental conditions and the dental care required: • Oral Evaluations – 2 times each contract year • Bitewing x rays – 2 times each contract year for dependents under age 18 and once each 12 months for adults age 18 and over • Fill mouth or panoramic x-rays – once every 5 years 100% Preventive: Provides for the following • Routine Cleanings • Topical Fluoride • Space Maintainers – for Dependent Children under age 14 and only for early loss of baby molars • Sealants – once each tooth per lifetime for dependent children under age 16 when applied only to adult molars with no decay or filings on the chewing surface and intact Basic (subject to deductible) 80% Ancillary: Provides for one emergency/limited exam per Contract Year by the Dentist for the relief of pain. 80% Oral Surgery: Provides for removal of teeth including pre and post-operative care, preparation of the mouth for dentures, removal of the vertical band of thin tissue that connects the tongue to the bottom of the mouth, removal of the tissue that attaches the lips to the gum above the top front two teeth, removal of tissue that connects the gums to the insides of the cheeks, and removal of apiece of tissue from a lesion and sent to the lab for testing. 80% Regular Restorative: Provides silver fillings; resin (white) fillings on all teeth; and stainless-steel crowns for Dependents under age 12. 80% Endodontics: Includes root canal treatments. When covered, payment for the initial root canal therapy is limited to one per lifetime, per tooth; payment for the re-treatment of a root canal is limited to once per 24 months, per tooth. 80% Periodontics: a. Includes procedures for the treatment of diseases of the gums and bones. Periodontal cleaning, including evaluation, is counted toward the frequency limitation for regular cleanings.  b. Surgical periodontal procedures/ Maximum & Deductible Information Maximum Benefit per person The Maximum Benefit for all Covered Services for each Enrollee in any one Contract Year is One Thousand Five Hundred Dollars ($1,500.00). The Maximum Benefit for covered orthodontics procedures for each Enrollee is One Thousand Dollars ($1,000.00) during such Enrollee's lifetime. Payment for Orthodontic Services shall be included in determining the Maximum Benefit for each Contract Year. *Orthodontic Services are not a Covered Service if the Enrollee is a new hire rehire or added to the group dental program due to a qualifying event with Orthodontic Services already in progress. Deductible Limitations Coverage for Diagnostic and Preventive Services are not subject to the Deductible. For all other Covered Services, the Contract Year Deductible is: $50x3. Eligible Children Children are eligible for coverage to age 26. Please note this is a brief overview of coverage. It does not list all benefits, nor does it list exclusions and limitations. Please refer to your Evidence of Coverage or Summary Plan Description for list of benefit limitations and exclusions. DENTAL INSURANCE Benefit % Paid Services Major (subject to deductible) Delta Dental PPO 50% Special Restorative When teeth cannot be restored with a filling, provides for individual crowns. 50% Prosthodontics a. Includes bridges, partial and complete dentures 50% b. Repairs and adjustments of bridges and dentures Orthodontics (subject to deductible) 50% Orthodontics (Braces): Includes orthodontic appliances and treatment, interceptive and corrective, for Dependent Children under age 19. Employee Monthly Premium Eligibility:  Employee must work 20 hours or more per week to qualify for enrollment. VISION INSURANCE Provider: VSP Overview: Driving to work, reading the news, and watching television are all common daily activities, but your ability to perform them is heavily dependent on the health of your eyes and vision. Vision insurance can assist in preserving your vision and identifying various health issues. Full Vision Plan Employee Only Employee & Spouse Employee & Child Employee Cost $15.10 $26.35 $27.61 Employee & Family $39.93 Benefit Description Wellness Exam Focuses on your eyes and overall health Essential Medical Eye Care Retinal Screening for members with diabetes Additional exams and services beyond routine care to treat immediate issues Coordination with your medical coverage may apply. Ask VSP for details Prescription Glasses Frame $170 featured frame allowance $50 Every 24 months $150 frame allowance 12 Months 20% savings on amount over $80 allowance for Walmart/Sam's Club Out-Of-Network $0 Lenses Single Vision, Lined Bifocal, lined Trifocal Up to $34 $35 Every 12 months Exam (OD) Impact-resistant lenses for dependent children Up to $26 N/A Frames Depedent children covered until end of month they reach 26 years of age Not Covered $150 Retail Allowance Lens Enhancements Covered in Full Not Covered $0 Every 12 months Contact Lens Fitting (Specialty) $50 Retail Allowance Not Covered $50 Retail Allowance Covered Contact Lenses (in addition to glasses) Annual Supply of Contacts Every 12 months Single Vision Contact lens exam (fitting adn evaluation) Up to $29 $80 Copay Frequency $20 Every 12 Months N/A $0 Per screening $20 per exam Available as needed VISION INSURANCE *Please note this is a brief overview of coverage. It does not list all benefits, nor does it list exclusions and limitations. Please refer to your Evidence of Coverage or Summary Plan Description for list of benefit limitations and exclusions. Eligibility:  Employee must work 20 hours or more per week to qualify for enrollment. HOW DO I ENROLL? You can enroll during Open Enrollment. Even if you signed up last year, you must re-enroll for 2023.  FLEXIBLE SPENDING ACCOUNTS Provider: Flex Made Easy Flexible Spending Account Healthcare and Limited Purpose FSA Min/Max per Employee $100 $3,050 Overview: Paying for health care can be stressful. That's why your employer offers an employer-sponsored flexible spending account (FSA). FSA savings example: Bob and Jane’s combined gross income is $30,000. They have two children and file their income taxes jointly. Since Bob and Jane expect to spend $2,000 in adult orthodontia and $3,300 for day care next plan year, they decide to direct a total of $5,300 into their FSAs. WHAT ARE THE BENEFITS OF AN FSA? It saves you money. The plans allow you to put aside money  tax-free that can be used for qualified medical expenses. It is a tax-saver. Since your taxable income is decreased by your  contributions, you will pay less in taxes. It is flexible. You can use your FSA funds at any time, even if it is the  beginning of the year. You cannot stockpile money in your FSA. If you do not use it, you lose it. You should only contribute the amount of money you expect to pay out-of-pocket that plan year. FLEXIBLE SPENDING ACCOUNTS Without FSAs With FSA Gross Income $30,000 $30,000 FSA Contributions 0 -5,000 Gross Income $30,000 $25,000 Estimated taxes Federal tax -$2,550 -$1776 State tax -$900 -$750 FICA tax -$2,295 -$1913 After-tax earnings $24,255 $20,314 Eligible out-of-pocket expenses Medical and dependent care expenses -$5,000 $0 Remaning spendable income $19,255 $20,561 Spendable income increase $1,306 Dependent Care Reimbursement Account Dependent Care Reimbursement Account Min/Max per household $100 $5,000 Min/Max if filing separate $100 $2,500 Provider: Flex Made Easy OVERVIEW: A dependent care reimbursement account is a convenient financial tool that enables employees to save money on eligible childcare expenses. By setting aside a portion of their pre-tax income into this account, employees can reduce their taxable income and increase their take-home pay. Eligibility:  Employee must work 20 hours or more per week to qualify for enrollment. Basic Life Up to age 65 Life Benefit $35,000 Age 65-69 Life Benefit $22,750 Ages 70-74 Life Benefit $14,000 Ages 75+ Life Benefit $8,750 Ottawa USD offers Basic Life insurance through Advance Life to protect your family. Think about your personal circumstances. Are you the sole provider for your household? What other expenses do you expect in the future (for example, college tuition for your child)? Depending on your needs, you may want to consider buying life insurance. You can buy basic life insurance for both you and your dependents. Overview: Eligibility:  Employee must work 20 hours or more per week to qualify for enrollment. Provider: Advance Life BASIC LIFE INSURANCE Eligibility:  Employee must work 20 hours or more per week to qualify for enrollment. Example of Employee Monthly Premium 40 Year Old Employee with $100,00 Coverage Employee Only $17.00 56 Year old Employee/Spouse with $50,000 Coverage Employee, Spouse (both age 56) $70.70 Provider: One America VOLUNTARY LIFE INSURANCE Overview:  If you are the primary breadwinner for your household, and have future expenses to consider such as your child's college tuition, it may be worth considering purchasing life insurance. This will provide financial security for your loved ones in the event of your unexpected death. VOLUNTARY LIFE INSURANCE Employee Voluntary Life, AD&D, Dependent Voluntary Life, and AD&D plan design Description Copay Frequency Employee Voluntary Life and AD&D Eligible Employees All Benefits Eligible Employees working a minimum of 20 hours per week Effective Date October 1, 2023 Waiting Period For the month coincident with or next following date of employment Benefit Amount Increments of $10,000 Maximum Benefit $500,000 or 5X Annual Earnings Minumim Benefit $10,000 Guaranteed Issue Amount $150,000 (Initial elgibility period only) Spouse Voluntary Life and AD&D Spouse Benefit Amount Increments of $5,000 Spouse Maximum Benefit $500,000 or 5X Annual Earnings Minumim Benefit $5,000 Spouse Guaranteed Issue Amount $30,000 (Initial elgibility period only) Max % of Employee Coverage 100% Spouse Termination Age N/A Compulsory AD&D Coverage Yes Child Voluntary Life and AD&D Child Guaranteed Issue Amount $10,000 Full Child Benefit Begins 6 Months Child Benefit by age Birth to 6 months, $2,000 Child Eligibility Unmarried dependent up to age 26 Max % of emplyee coverage 100% Compulsory AD&D Coverage Yes Rate per $10,000 $1.37 *Employee must elect Voluntary Life to elect Spouse or Child Voluntary Life/AD&D Age Band Employee Rate per $1,000 Spouse Rate per $1,000 Under 30 $0.07 $0.133 30-34 $0.09 $0.143 35-39 $0.11 $0.170 40-44 $0.17 $0.248 45-49 $0.27 $0.361 50-54 $0.41 $0.566 55-59 $0.58 $0.834 60-64 $0.74 $1.063 65-70 $1.16 $1.650 70+ $2.99 Terms at age 70 VOLUNTARY LIFE INSURANCE Employee Monthly Premium Employee Monthly Premium Provider: OneAmerica Overview:  It's a fact that bills need to be paid, even when you are unable to work due to an injury, illness or surgery. Disability income benefits are designed to provide a replacement of lost income in the event that you become disabled from a non-work-related injury or sickness. It will help you safeguard your assets and maintain some level of earnings. Short Term Disability Option # Elimination Period Duration Rate per $100 Option 1 0/7 26 Weeks $9.80 Option 2 14/14 24 Weeks $7.50 Option 3 30/30 22 Weeks $4.50 No pre-existing limitations. Employee only coverage Max Benefit 70% or $1750 Eligibility:  Employee must work 20 hours or more per week to qualify for enrollment. SHORT-TERM DISABILITY Provider: Prosperity Overview:  Our cancer voluntary coverage provides cash benefits when it is most needed! When you enroll in the plan, you will be eligible for benefits upon a positive diagnosis of an internal cancer. This can bring peace of mind to you and your loved ones, as you will have protection in place to help avoid financial strain from paying for day-to-day living expenses or incurring debt Employee Monthly Premium Cancer Insurance Low Employee Only Employee & Spouse Employee & Child Plan #1 $35.03 $54.58 $39.25 Employee & Family $58.84 Eligibility:  Employee must work 20 hours or more per week to qualify for enrollment. Cancer Insurance High Employee Only Employee & Spouse Employee & Child Plan #2 $39.57 $61.62 $44.25 Employee & Family $66.31 CANCER INSURANCE Eligibility:  Employee must work 20 hours or more per week to qualify for enrollment. Employee Monthly Premium ACCIDENT INSURANCE Provider: Prosperity Accident Insurance High Employee Only Employee & Spouse Employee & Child Accident Plan $18.17 $29.59 $38.61 Employee & Family $50.76 Overview:  The plan provides financial assistance by giving cash benefits for initial care, specific injuries, treatment, facility care, and follow-up care visits. These benefits are paid directly to you, which can help cover deductibles, co-insurance, or other expenses incurred. Accident Insurance Low Employee Only Employee & Spouse Employee & Child Accident Plan $13.35 $21.70 $29.37 Employee & Family $38.31 broken bones dislocated joints burns bandages, stitches and cuts surgery and anesthesia ACCIDENT INSURANCE emergency room visits, x-rays and imaging emergency dental work ambulance rides wheelchairs, crutches, and other supplies Accident insurance helps you pay for those unexpected costs by  providing you cash benefits for things such as:        Additionally, the accident coverage includes accidental death and dismemberment benefits. Any of the benefits you receive from the policy are paid directly to you and can help you cover deductibles, co-insurance, or whatever expenses you may choose to spend it on. Best of all, your benefits will be paid to you regardless of any other insurance coverage you may have. To see more plan details & compare the plans please visit your benefit portal https://benefits-direct.com/ottawa290/ Overview:  With a critical illness plan, you'll receive a benefit after a serious illness or a condition such as a heart attack, stroke, or coronary artery bypass graft. In most cases, benefits payments are made directly to you, giving you more control during a difficult time when options may feel limited. Example of Employee Monthly Premium 40 Year Old Employee w/ $40,000 Coverage Employee Only $29.00 56 Year old Employee w/ $20,000 Coverage Employee, Spouse (both age 56) $50.40 Provider: Prosperity CRITICAL ILLNESS INSURANCE Eligibility:  Employee must work 20 hours or more per week to qualify for enrollment. Base Coverage Benefit Covered Critical Illness / Benefit Amount Percentage Heart Attack - 100% Stroke - 100% Coronary Artery Bypass Graft - 100% Major Organ Transplant - 100% Kidney Failure - 100% Coma - 100% Severe Burns - 100% Motor Neuron Disease/ALS - 100% Advanced Alzheimer's Disease - 100%  Paralysis - 100% Employee: $5,000 - $50,000 Spouse: 50% of the Named Insured Amount Children: 25% of the Named Insured Amount WHY DO I NEED CRITICAL ILLNESS COVERAGE? A critical illness plan can assist you with a variety of expenses so you can focus on getting better. You can spend the benefits however you want, on direct or indirect costs associated with the illness: Make your mortgage payments Hire extra help for around the house, such as in-home caregivers Help cover medical bills as well as therapy and training not covered by your primary health insurance Pay for travel to treatment facilities away from home - and for family visit. You elect an initial benefit amount between $10,000 - $40,000 and SunLife will pay the initial benefit amount when a covered person is diagnosed with a covered Critical Illness while the coverage is in force. To see more details please visit your benefit portal. In addition to the physical and emotional effects, people who are diagnosed with a serious condition may see a costly impact on their expenses. CRITICAL ILLNESS INSURANCE Please note this is a brief overview of coverage. It does not list all benefits, nor does it list exclusions and limitations. Please refer to your Evidence of Coverage or Summary Plan Description for list of benefit limitations and exclusions. Employee Critical Illness Coverage Amount <30 30-39 40-49 $10,000 $2.97 $5.47 $10.79 $20,000 $5.51 $10.32 $20.61 $30,000 $8.05 $15.17 $30.43 $60.16 $100 $132.71 $188.52 $242.09 $315.98 $40,000 $10.59 $20.02 $40.26 $79.79 $132.82 $176.38 $250.74 $322.17 $420.69 $50,000 $13.13 $24.87 $50.08 $99.42 $165.64 $220.05 $312.96 $402.24 $525.39 50-59 60-64 65-69 70-74 75-79 80+ $20.91 $34.36 $45.36 $64.07 $81.93 $106.56 $40.53 $67.18 $89.04 $126.29 $162.01 $211.27 CRITICAL ILLNESS INSURANCE Monthly Premium by Benefit Amount Employee/Spouse Critical Illness Coverage Amount <30 30-39 40-49 $10,000 $4.45 $8.12 $15.91 $20,000 $8.09 $15.08 $30 $30,000 $11.74 $22.03 $44.09 $86.89 $144.19 $191.22 $271.34 $348.21 $454.24 $40,000 $15.38 $28.99 $28.19 $115.06 $191.29 $253.90 $360.63 $463.12 $604.50 $50,000 $19.02 $35.95 $72.28 $143.23 $238.39 $316.59 $449.93 $578.04 $754.76 50-59 60-64 65-69 70-74 75-79 80+ $30.56 $49.98 $65.85 $92.75 $118.37 $153.72 $58.72 $97.08 $128.54 $182.05 $233.29 $303.98 Single Parent Family Coverage Amount <30 30-39 40-49 $10,000 $3.17 $5.67 $10.99 $20,000 $5.85 $10.66 $20.95 $30,000 $8.53 $15.64 $30.91 $60.64 $100.47 $133.19 $188.99 $242.56 $316.45 $40,000 $11.20 $20.63 $40.87 $80.40 $133.43 $177 $251.35 $322.78 $421.30 $50,000 $13.88 $25.62 $50.83 $100.17 $166.39 $220.81 $313.71 $403 $526.15 50-59 60-64 65-69 70-74 75-79 80+ $21.11 $34.56 $45.57 $64.27 $82.13 $106.76 $40.87 $67.52 $89.38 $126.63 $162.34 $211.61 Two Parent Family Coverage Amount <30 30-39 40-49 $10,000 $4.65 $8.32 $16.11 $20,000 $8.43 $15.41 $30.34 $30,000 $12.21 $22.51 $44.57 $87.37 $144.66 $191.70 $271.82 $348.68 $454.71 $40,000 $15.99 $29.61 $58.80 $115.67 $191.90 $254.52 $361.25 $463.73 $605.11 $50,000 $19.77 $36.70 $73.03 $143.98 $239.14 $317.34 $450.68 $578.79 $755.51 50-59 60-64 65-69 70-74 75-79 80+ $30.76 $50.18 $66.05 $92.95 $118.57 $153.92 $59.06 $97.42 $128.87 $182.38 $233.63 $304.32 Monthly Premium by Benefit Amount CRITICAL ILLNESS INSURANCE Eligibility:  Employee must work 20 hours or more per week to qualify for enrollment. HOSPITAL INDEMNITY Employee Monthly Premium Employee Only Employee & Spouse Employee & Children HI Plan 1 $11.46 $24.19 $17.19 Employee & Family $29.92 Overview:  Voluntary hospital indemnity insurance offers a set of fixed, lump-sum daily benefits to help cover expenses related to a hospital stay, such as room and board. You must be admitted and hospitalized at least 20 hours for benefit payment. The benefit is paid directly to the policyholder. Provider: Reliance Standard Benefit Details Hospital Room & Board Benefits Hospital Confinement (180 Daily Benefits per Coverage Year) $100/day Hospital Critical Care Unit Benefits (Paid in addition to Room & Board Benefit) ICU Confinement (30 Daily Benefits per coverage year) $100/day Hospital Admission Benefit One Daily Benefits per Coverage Year $500 Covered Conditions Newborn Care Included Complications of Pregnancy Included Mental/Nervous Included Substance Abuse Included Sickness and Accidents 24 hour coverage Pre-Existing Condition Limitation Not Included Waiting Period Not Included HOSPITAL INDEMNITY Provider: Trustmark ULE Eligibility:  Employee must work 20 hours or more per week to qualify for enrollment. PERMANENT LIFE WITH LTC Overview: Protection for finances and loved ones can bring peace of mind and allow you to focus on spending time with those you care about. Permanent life insurance can provide financial support for families in the event of an emergency or unexpected death, helping them maintain their standard of living. The death benefit can secure a family's future, and the cash value can be borrowed against in case of emergencies during the policyholder's lifetime. PERMANENT LIFE WITH LTC Sample Rates - Defined Benefit Issue Age $25,000 Universal Life $25,000 Universal Life Events Monthly Premium Monthly Premium 30 From $5.06 - $6.27 From $3.49 - $4.59 40 From $7.42 - $9.44 From $5.05 - $6.71 50 From $11.92 - $15.44 From $7.84 - $10.71 Trustmark Universal Life Events (ULE) Insurance provides two important coverage's when you need them most.  1. Financial Security After a loss Protecting your loved ones is one of life’s greatest responsibilities. When a family loses someone, in addition to grief, survivors may suddenly be faced with costly expenses and debts, and even a loss of income. Universal LifeEvents can help. ULE provides a higher death benefit when your needs and responsibilities are the greatest. You can choose a plan and benefit amount that provides the right protection for you.   ULE insurance can mean those left behind are still able to pursue their own dreams, and help ensure that the ending of one story won’t stop the beginning of another.  2. Long-Term Care At any point in your life you may need long-term care services which could cost hundreds of dollars per day.  Universal LifeEvents includes a long-term care (LTC) benefit that can help pay for these services at any age. This benefit remains at the same level throughout your life, so the full amount is always available when you most need it. IDENTITY PROTECTION Eligibility:  Employee must work 20 hours or more per week to qualify for enrollment. Overview:  Your identity is important, so make sure you have the protection you need for your privacy and security! With the growing number of fraud and scams, it's more important than ever to take steps to safeguard what you've worked for. Your company understands the increasing risks of having sensitive personal information exposed, which is why it has included IdentityForce as part of its employee benefits. IdentityForce provides top-notch identity theft protection plans that proactively monitor, alert, and assist you in resolving any identity theft issues that may arise.   Employee Only $9.50 Family $17.50 Provider: ID Force Employee Monthly Premium ID THEFT IMPACT IDENTITY PROTECTION WHY NOW You don't want to deal with a lifetime of damage that could result from identity theft. You most likely even know someone who has already been a victim of identity theft themselves, or you at least know someone who has had their good name compromised. Security incidents, scams, and fraud continue to grow. As our world becomes increasingly digitized, and virtual, it’s even more important to have IdentityForce in your corner.   We not only proactively monitor the Dark Web, credit reports, and real-time fraud issues, but we will help you fix any compromises to your personal information. All without the hassle of making phone calls, completing paperwork, and all the heavy lifting needed to make sure your identity is restored. Our identities have become more than just a name, birthdate, and social security number. Today it includes voice signatures and fingerprints, personal property records, health records, and even social media data. All of these details can be capitalized on by criminals to commit identity fraud, whether used directly in forms of synthetic identity theft, or used in social engineering attempts to extract money or personal details that provide additional opportunities for identity crimes. Employee Only $18.75 Family $18.75 Provider: MetLaw Employee Monthly Premium Eligibility:  Employee must work 20 hours or more per week to qualify for enrollment. Overview:  MetLaw offers coverage for you, your spouse, and dependents. It includes unlimited telephone and office consultations with an attorney of your choice for various personal legal matters. Additionally, it provides e-Services such as an attorney locator, an e-panel of law firms, a law guide, free downloadable legal documents, financial planning resources, insurance information, and work-life resources. LEGAL PROTECTION Real Estate Matters  • Sale, Purchase or Refinancing of your Primary, Second or Vacation Home • Eviction and Tenant Problems (Primary Residence - Tenant only) • Home Equity Loans for your Primary, Second or Vacation Home • Zoning Applications • Boundary or Title Disputes • Property Tax Assessment • Security Deposit Assistance (For Tenant) Document Preparation • Affidavits • Deeds • Demand Letters • Mortgages • Promissory Notes   Traffic Offenses • Defense of Traffic Tickets (excludes DUI) • Driving Privileges Restoration (Includes License Suspension due  to DUI)  Personal Property Protection • Consultations and Document Review for Personal Property Issues • Assistance for disputes over goods and services LEGAL PROTECTION Estate Planning Documents • Simple and Complex Wills • Trusts (Revocable and Irrevocable) • Powers of Attorney (Healthcare, Financial, Childcare) • Healthcare Proxies • Living Wills • Codicils Document Review • Any Personal Legal Documents Family Law • Prenuptial Agreement • Protection from Domestic Violence • Adoption and Legitimization • Guardianship or Conservatorship • Name Change Immigration Assistance • Advice and Consultation • Review of Immigration Documents • Preparation of Affidavits and Powers of Attorney Elder Law Matters • Consultations and Document Review for issues related to your parents including Medicare, Medicaid, Prescription Plans, Nursing Home Agreements, leases, notes, deeds, wills and powers of attorney as these affect the participant Financial Matters  • Negotiations with Creditors • Debt Collection Defense • **LifeStages – Identity Management Services • Identity Theft Defense • Personal Bankruptcy • Tax Audit Representation (Municipal, State or Federal) • Foreclosure Defense • Tax Collection Defense  Juvenile Matters • Juvenile Court Defense, including Criminal Matters • Parental Responsibility Matters  Defense of Civil Lawsuits  • Administrative Hearings • Civil Litigation Defense • Incompetency Defense • School Hearings • Pet Liabilities  Consumer Protection • Disputes over Consumer Goods and Services • Small Claims Assistance  Family Matters™ • Available for an additional fee  • Separate plan for parents of participants for Estate Planning Documents • Easy Enrollment - online or by phone