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Your BenefitsEffective January 2024Custodial

You must request a change to your benefitswithin 30 days of your life event (60 days forchanges involving Medicaid eligibility). Documentation may be required. Qualifying life events allow you to change yourcoverage during the year outside of OpenEnrollment. These include:marriage or divorce, birth or adoption, death of a covered dependent, and a change in eligibility through Medicare,Medicaid, or a spouse or parent's coverage. If you have a qualifying life event Open Enrollment is your one chance each year toreview your coverage options and make changes toyour benefits.Your choices are in effect from January –December of the following year unless you have aqualifying life event. At Open EnrollmentFor youYou are eligible for benefits as a full-timeemployee working at least 30 hours per week.Your Spouse or PartnerYour benefit plans are in effect January 1 – December31 each year. In general, there are three times you canmake benefit selections:Making benefit selectionsGetting startedEligibility Enrolling in coverageYour benefits begin on the first day of the monthfollowing your date of employment; this is youreffective date. Be sure to submit your selectionswithin your first 30 days of benefits eligibility. Your benefit selections will be in effect throughDecember 31. When you're first eligibleCovering your familyYou may also cover your eligible dependents whenyou elect coverage for yourself.Dependent children are eligible:Medical, dental and vision: until age 26regardless of student or marital statusChild life insurance: until age 26Your ChildrenYou may cover your legal spouse or domesticpartner.

Balance billingWhen you use an out-of-networkmedical or dental provider, theymay bill you the difference betweenwhat they charge and the amountyour insurance pays.Medical: balance billing is in additionto – and does not count towards –your out-of-pocket maximum.CoinsuranceAfter you’ve met your deductible,you’re sometimes responsible for apercentage of the cost of themedical care, dental care, orprescription medication youreceived. This percentage iscoinsurance.CopayA flat fee you pay each time youreceive a copay-eligible medical,dental, or vision service orprescription medication. DeductibleThe amount you’re responsible forpaying in care expenses before themedical or dental plan starts payingdeductible-eligible expenses.In-networkIn-network care is always yourlowest-cost option. Networks aregroups of medical, dental, andvision providers, pharmacies, andfacilities that agree to discount thecost of their care or service.Out-of-pocket maximumThe most you’ll pay for covered in-network medical care in a year. Thisincludes your deductible, anycoinsurance or copays, andprescription drugs. The out-of-pocket maximum does notinclude your premium (the amount youpay for coverage), non-coveredexpenses, or out-of-network carethat’s been balance billed.Primary care physicianA primary care physician (PCP) isyour main medical doctor – usually ageneral practitioner (GP), familydoctor, internist, OB/GYN, orpediatrician (for children).Referral/pre-authorizationSome specialty medical providersand services require a referral froma primary doctor. These may include- but are not limited to - cardiology,psychiatry, orthopedic surgeons,rheumatology, surgery, and imaging(CT or MRI).Have questions? Your advocate is here to help youwith all things benefits. See theircontact information on the nextpage.How to handle medicalbills (4:46)Annual NoticesWe’re required to tell you about certain rightsand responsibilities you have as an employee ofDanville School District 118. You can request a paper copy at no chargefrom: Kim Hoffman217-444-1053Download nowHelpful terms & resourcesWe've removed as much jargon as possible.Getting startedBut you’ll probably still encounter some terms as you enroll in and use yourbenefits, and we want you to be prepared!

Medical insuranceBlue Cross Blue Shield IL Group # 236865PPO Customer Service: 800-541-2767 24/7Nurseline: 800-299-0274 Pharmacy Program: 800-423-1973www.bcbsil.comHealth Reimbursement Account (HRA)ChardSnyder Benefit SolutionsPhone- 1-800-982-7715Fax- 513-459-9947www.chard-snyder.comLive Chat available 8am-5pm EST Mon-FriDental insuranceDeltaDentalGroup # 11561800-547-9515www.deltadental.comVision insuranceVSP Vision CareGroup # 12001821800-877-7195www.vsp.comLife insuranceDearborn NationalGroup #F014597Self-FundedContact Benefits217-444-1053Contact InformationGetting Started

In-network care BCS PPONetwork name:Blue Choice Select [BCS]Preferred Provider Organization [PPO]Annual Deductible (DED) $6,850 single$13,700 family$6,850 single$13,700 familyOut-of-pocket maximum$7,350 single $14,700 family $7,350 single $14,700 family Preventive carePrimary care visitSpecialist visitVirtual visit100% covered$50$75$25 (with MDLIVE)/ $50 with all other providers100% covered$50$75$25 (with MDLIVE)/ $50 with all other providersUrgent careEmergency room$75$400 copay waived if admitted$75$400 copay waived if admittedInpatient hospital careNo ChargeNo ChargePrescription drugsGeneric: PreferredGeneric Non-PreferredBrand: PreferredBrand: Non-PreferredSpecialty: PreferredSpecialty: Non-Preferred(Preferred | Non Preferred)$15 copay | $30 copay$15 copay | $30 copay$50 copay | $100 copay$100 copay | $200 copay$200 copay$300 copay (Preferred | Non Preferred)$15 copay | $30 copay$15 copay | $30 copay$50 copay | $100 copay$100 copay | $200 copay$200 copay$300 copay Your cost for coverageEmployee onlyEmployee + FamilyPer paycheck$20.00 $325.00Per paycheck$125.50$570.00See plan detailsSee plan detailsSee your plan details for out-of-network benefits.PPO Medical insuranceSelect from 2 medical options through Blue Cross Blue Shieldof IL.All plans cover in-network preventive care at 100%, prescriptiondrugs, and include an annual limit on your expenses. The differencesare: what you pay for the planwhat network

If you cover yourself onlyIf you cover dependentsDanville Schoolscontributes:$4,445$8,890Health ReimbursementArrangement (HRA)Health care dollars from Danville School District.The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Finalrates are dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract,and other notices contained in this document, applications, and other corresponding communications for additional information.ContributionsWhen you enroll in the HRA medical plan, Danville School District automatically setsaside money to help you and your covered dependents pay for qualifying health careexpenses.Pay for eligible health care expenses with an HRA - funded byDanville School District.Medical BCBS sends a monthly report of claims to BPC for processing and the provider ispaid directly by BPC.Your deductible or copay will be automatically deducted fromyour HRA allowance. HRA applies after the employee pays the first $500 of theDeductible. The HRA then pays out a 70/30 ratio until the deductible is met. Onceyour HRA is depleted, you will pay out of pocket.For more information on Chard-Snyder: Scan the QR code for website directions.

How a Health Reimbursement Account WorksChild Taylor breaks their arm.ExpensesAnnual physicals for entire family (Preventive - $0 costs)Annual OB/GYN exam (Preventive - $0 costs)Broken Arm costs (Emergency room costs)$0$0$6,000Jordan’s Out of Pocket Expenses$6,000Amount paid by HRA($3,500)Amount paid by Jordan ($1,000 deductiblethreshold + 30% co-insurance)$2,500You make all applicable copaymentsat the pharmacy and the doctor’sofficeThese payments do not apply toward yourdeductible; therefore you cannot use yourHRA to pay for these expenses. You can,however, use an FSA, if elected.You meet the deductible threshold$500 deductible threshold if enrolled inself-only coverage or $1,000 deductiblethreshold if enrolled in dependent orfamily coverage.Your deductible expenses are paidby your HRAOnce you meet the deductible threshold,the HRA will automatically pay 70% ofthe remaining deductible for self-onlycoverage and dependent or familycoverage.Your deductible expenses are paidby your HRA.The Danville School District HRA will fundup to $4,445 for self-only coverage and$8,890 for dependent or family coverageAfter that, you pay onlycoinsuranceOnce you have met your deductible, youshare in the cost of the expenses. This iscalled coinsurance and is capped innetwork at $500 for self-only coverage or$1,000 for dependent or family coverage.Example of How the Plan WorksJordan enrolls a family of three in the BCBS of IL medical plan. Danville School District contributes to an HRA fund of $8,890 for the2024 plan year, and the plan has a $13,700 annual in-network family deductible for the plan year. The HRA will begin to pay towardseligible expenses once the $1,000 family deductible threshold is met.Jordan may receive additional cash to helpcover his out of pocket expenses fromsupplemental health plans that areavailable with the optional Aflac programs.The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final rates are dependent on actual enrollment, insurance carrier or planrules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and other notices contained in this document, applications, and other corresponding communications for additional information.

Flexible Spending Accounts A flexible spending account (FSA) is an account in an employee’s name that reimburses the employee for qualified health care or dependent care expenses. It allows an employee to fund qualified expenses with pre-tax dollars deducted from the employee’s paychecks. The employee can receive cash reimbursement up to the total value of the account for covered expenses incurred during the benefit plan year and any applicable grace period. “Use-it-or-lose-it” Rule As required by the Internal Revenue Service (IRS), an FSA has a “use-it-or-lose-it” provision stating that any unused funds at the end of the plan year (plus any applicable grace period) will be forfeited. When electing an FSA during open enrollment, the employee must specify how much he or she would like to contribute to the FSA for the year. The goal is to choose an amount that will cover medical or dependent care expenses, but that is not so high that the money will be forfeited at the end of the year. The IRS allows employers to offer an extended deadline, or grace period, of 2 ½ months after the end of a plan year to use FSA funds. Thus, for a plan year ending Dec. 31, employees would have until March 15 to spend the funds in their FSAs. This provision is strictly optional; the employer must choose to implement it. Types of FSAs There are two different types of FSAs: health care accounts and dependent care accounts. An employee can elect to have both types of accounts and contribute separate pre-tax dollars to each. These accounts are kept separate; for instance, an employee could not be reimbursed for dependent care expenses from his or her health care account. Health Care Accounts A health care FSA reimburses employees for eligible medical expenses, up to the amount contributed for the plan year. A health care FSA offered through a cafeteria plan must limit the amount of salary reduction contributions that employees can make. For 2024, the limit is $3,200. A health care FSA only reimburses employees for money spent on medical care, as defined underSection 213(d) of the Tax Code. Section 213(d) of the Tax Code defines “medical care” to include amounts paid “for the diagnosis, cure, mitigation, treatment or prevention of disease, or for the purpose of affecting any structure or function of the body.” Examples of qualified medical expenses include deductibles and copayments for an individual’s health plan. Eye exams, eyeglasses, contact lenses, hearing exams, hearing aids, physical exams and smoking cessation programs are also covered. For a complete list of qualified medical expenses, visit the IRS website.

Many of the same general rules that apply to health care FSAs also apply to dependent care accounts, such as the “use it orlose it” rule. However, there are some other important differences between the two types of accounts. For dependent careaccounts: There is an annual limit as to how much an employee can contribute. This amount is $5,000, or, if lower, the maximumamount that can be excluded from the employee’s income under Section 129 of the Tax Code when the employee’selection is made; The money in a dependent care account is not available until it has been deposited by the employee; and Dependent care expenses cannot be reimbursed until they are actually incurred. This can be an issue when child carecenters “pre-bill” for services, and employees are required to pay in advance. For more information on FSA plan design and compliance, contact Danville School District today. This Benefits Insights is not intended to be exhaustive, nor should any discussion or opinions be construed as professional advice. © 2019-2020, 2023 Zywave,Inc. All rights reserved. Dependent Care Accounts The second type of FSA is a dependent care account. This account can be used to pay for care of dependent children under the age of 13 by a babysitter, day care center, or before- or after-school program. Care for a disabled spouse, parent or child over the age of 12 is also eligible for reimbursement.

* Not all plans provide this information.232640.0923Even on the go you can manage your ID cards and stay on top of claims activity, coverage informationand prescription refill reminders. It’s easy: Log into or create a BAM account at bcbsil.com.The updated Provider Finder platform has undergone intensive testing. Theresult is a better experience that will help you be a smarter consumer of healthcare. By going to bcbsil.com, you can login or create an account on Blue Access for MembersSM (BAMSM) and use Provider Finder to:•Find in-network providers, clinics, hospitals and pharmacies.•Search by specialty, ZIP code, language spoken, gender and more.•See clinical certifications and recognitions.•Compare quality awards for doctors, hospitals and more.•Read or add reviews for providers.•Estimate the out-of-pocket costs for more than 1,700 health careprocedures, treatments and tests.*•Find cost savings opportunities for prescription drugs using theMedication Finder tool.*Your Doctor Is In…Provider Finder® Provider Finder from Blue Cross and Blue Shield of Illinois is a fast, easy-to-usetool that improves yourexperience when you arelooking for in-network health care providers. It canalso help you manage yourout-of-pocket costs.Stay Connected with BCBSILIt’s now easier to find a provider and manage your health care expenses. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

Your health at your fingertips••••Find in-network doctors and hospitals.Once registered, view, print or download your member ID card.Review your benefits and dependent coverage.Covered dependents age 18 and over can have their own BAM accounts.Get information about the cost of procedures, find a doctor or request an ID card.You can do it all – simply and securely – on Blue Access for MembersSM (BAMSM).1.Go to bcbsil.com.2.Log in or sign up usingyour member ID card tocomplete your registration.With BAM, you can: Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation,a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield AssociationScan this QR code to visitbcbsil.com.Let’s get startedClick here for additional BCBS Perks and information on the Blue Card Program!

Reward Employeesand Realize Big SavingsMember Rewards is a comprehensive engagement andrewards program offered by Blue Cross and Blue Shield of Illinois (BCBSIL). It is administered by Zelis and guidesmembers to cost-effective options, helping achievemeasurable savings for both employers and employees.The Member Rewards program offers a cash reward to members when they shop for procedures or services, and select a low-cost, reward-eligible option. It uses the Provider Finder® tool, which helps members:•Compare costs and quality•Estimate out-of-pocket costs•Assist in making treatment decisions with their doctorsCall your BCBSIL Account Representative for more information about how Member Rewards can help your employees become smarter shoppers, earn rewards and lower their – and your – health care costs.Then, the member visits their chosenreward-eligible provider.Next, the member receives a cash rewardby check, which will be mailed to theirhome, after the claim is paid and theprovider is verified as reward-eligible.First, the member searches online viaProvider Finder to find and select a reward-eligible provider.Member Rewards offers an average savingsof $435 per claim.1How Does It Work?1 Based on Zelis SmartShopper data Jan. 2022 through Dec. 2022 for medical services. The cost estimates shown on Provider Finder® for various providers, facilities, and procedures are just estimates. Savings and reward amounts depend on the options members choose.MDX Medical, LLC, a Zelis company, is an independent company that has contracted with Blue Cross and Blue Shield of Illinois (BCBSIL) to administer the Member Rewards program for members with coverage through BCBSIL. Reward-eligible options and reward amounts are subject to change. Eligibility for rewards is subject to terms and conditions of the Member Rewards program. Amounts received through Member Rewards may be taxable. BCBSIL does not provide tax advice. Members that have primary coverage with Medicaid or Medicare are not eligible to receive incentive rewards under the Member Rewards program. BCBSIL makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them.245129.0923Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield AssociationGet Started Today! PPO & Blue Choice Select Plan Members Only

With Virtual Visits, the doctor is always in. Get 24/7 non-emergency care from a board-certified doctor by phone,online video or mobile app from the privacy and comfortof your own home. Don’t risk crowded waiting rooms,expensive urgent care or ER bills, or waiting weeks ormore to see a doctor, when you can speak with a VirtualVisits doctor within minutes.Virtual Visits, provided by Blue Cross andBlue Shield of Illinois (BCBSIL) and poweredby MDLIVE®, are a convenient alternative fortreatment of more than 80 health conditions,including:AllergiesCold/Flu FeverHeadachesNauseaSinus infectionsVirtual Visits with licensed behavioral healththerapists are available by appointment. Getvirtual care for:AnxietyDepressionStress managementAnd moreBlue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield AssociationCosts $25.00 and is accessible 24/7

The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Finalrates are dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract,and other notices contained in this document, applications, and other corresponding communications for additional information.Dental insuranceBoth plans cover in-network preventive care at 100%. Thedifferences are: what you pay for the plan, what you pay when you get care, the maximum amount Delta Dental will pay each year fordental care (annual maximum benefit), andwhether orthodontic care is covered.ToGo, a feature that allows you to carryover qualifiedunused portions of your annual maximum to the next year.Select from two dental options through Delta Dental.Base planHigh planNetwork name:Delta Dental PPODelta Dental PPOIn-networkOut-of-networkIn-networkOut-of-networkAnnual Deductible (DED)$50 per person $150 family max$50 per person $150 family max$25 per person $75 family max$50 per person $150 family maxAnnual maximum benefit$1,000 per person $1,000 per person $1,500 per person $1,500 per person Preventive care100% covered100% coveredBasic careDED then you pay40%DED then you pay40%DED then you pay20%DED then you pay20%Major careDED then you pay60%DED then you pay60%DED then you pay50%DED then you pay50%Orthodontic careCoverageLifetime max benefitN/A50% covered (child to age 19)$1,000 lifetime max benefitYour cost for coverageEmployee onlyEmployee + SpouseEmployee + Child(ren)Employee + FamilyPer paycheck$10.83$21.65$25.93$39.69Per paycheck$15.22$30.44$39.48$59.45See plan detailsSee plan detailsStay in-network to avoid balance billing (the difference between what an out-of-network provider charges and the amount your insurance pays).

The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Finalrates are dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract,and other notices contained in this document, applications, and other corresponding communications for additional information.Vision insuranceYour voluntary vision coverage is through VSP Vision Care.You'll get an annual exam with coverage for lenses andframes, or contacts in lieu of glasses.Vision PlanNetwork name:VSP Signature Network In-networkAnnual eye exam (every 12 months)$10 copayMaterials copay(lenses & frames)$25 copayLenses (every 12 months)Included in materials copayFrames(every 24 months)$200 allowance, 20% off balanceContact lenses(every 12 months)Elective: $130 allowanceMed. necessary: Included in material copayYour cost for coverageEmployee onlyEmployee + FamilyPer paycheck$0.00$6.25See plan detailsYour vision plan covers either glasses (lenses and frames) or contact lenses each year. If you receive contact lenses, they will be instead of your glasses benefit.How to find a provider?Go to www.VSP.com , click on ‘Find aProvider’, ‘enter your zip code and usethe Signature network

Basic lifeBasic AD&DDanville School District$25,000$25,000Danville School District 118 provides life and AD&D insurance at no cost to you.See plan detailsFor youFor your spouseFor your child(ren)Coverageincrements$10,000$5,000$1,000Coveragemaximum$500,000$150,000 Up to 50% ofemployee amount$10,000Guarantee Issue$100,000$25,000$10,000You may also purchase additional coverage for you, your spouse, and your eligiblechild(ren). Additional life and AD&D insuranceSee plan detailsLife insurance pays a benefit if you pass away while you're covered. Accidental Death and Dismemberment (AD&D) insurance offersadditional support if you pass away or are seriously injured due toan accident.Life and AD&DInsuranceWhat's AD&D?Accidental death anddismemberment (AD&D) insurancemay pay:your beneficiary if you passaway due to an accidentyou a partial benefit if you losespecified bodily functions(sight, limbs, etc.)Make sure to designate a beneficiary for your life insurance coverage to ensureyour family is cared for according to your wishes.The benefit plan information shown in this guide is illustrative only. To the extent the benefit plan information summarized herein differs from the underlyingplan details specified in the insurance documents that govern the terms and conditions of the plans of insurance described in this guide, the underlyinginsurance documents will govern in all cases.Basic life and AD&D insuranceSee plan details for more info. Voluntary Life amounts above theguarantee issue will require a Statement of Health.Financial peace of mind through Dearborn National.Guarantee IssueWhen you’re first eligible (a newhire), you can purchase lifeinsurance up to this limit withoutany medical questions required. Medical questions and approval willbe required for all future increaseand purchase requests.

You can print claim forms orfile a claim online. Please visit: www.aflac.comContact:Marvin Hartson217-276-5199Marvin_Harston@us.aflac.comThe AFLAC policies help with many out-of-pocketexpenses incurred during serious illness or accidentsand expenses such as deductibles, co-pays and otherout-of-pockets that are not covered by your majormedical insurance.AflacThe benefit plan information shown in this guide is illustrative only. To the extent the benefit plan information summarized herein differs from the underlyingplan details specified in the insurance documents that govern the terms and conditions of the plans of insurance described in this guide, the underlyinginsurance documents will govern in all cases.Features: AFLAC offers policies such as: Cancer, Accident,Dental, Specified Health Event, Hospital Intensive Care,Long Term Care and others.Guaranteed renewablePolicy benefits are paid regardless of any otherinsurance you may havePolicies pay cash benefits directly to you, unlessassignedPayroll rates are availableMost policies are available on a pre-tax basisAnnual election for AFLAC is once a year inOctober for January 1 renewal.For more information contact:American Family Life Assurance Company ofColumbus (Aflac)

LOCATION:Danville High School202 E. Fairchild StreetDanville, IL 61832HOURS:Monday — Friday7 a.m. — 4 p.m.SERVICES:School & Sports PhysicalsImmunizations/VaccinesCold, Cough, or Sore ThroatEaracheCOVID/Flu TestingBehavioral HealthPreventive CareDanville SchoolDistrict 118 &Appointments preferred,but not required.217.920.0168partner to offer healthcareservices for all district students,teachers, and staff.Meet your School-Based Health Center Provider: Ken’Niesha Hoskins, NPKen’Niesha is a board-certified nurse practitioner. She earned her master’s degree from Purdue Global University. Ken’Niesha is the provider for SIHFHealthcare at the Danville School-Based Health Center.“I believe I am God’s redeemed anointed disciple that’s called to providerelentless love and faith to my community. With relentless faith, barrierscan be broken in every aspect of my patient’s life. Relentless love is show-ing consistent compassion despite my patient’s background or economicstatus. I believe that there’s a Big God that can accomplish Big Dreams.My ultimate goal is to build lifelong relationships with my community toincrease health care outcomes.”sihf.org

2024 benefits