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YourBenefitsEffective July 1, 2024 - June 30, 2025

Making benefit selectionsGetting startedYou must request a change to your benefitswithin 30 days of your life event (60 days forchanges involving Medicaid eligibility). Documentation may be required.Your benefit plans are in effect July 1, 2024 – June 30, 2025. EligibilityEnrolling in coverageYour Spouse Open Enrollment is your one chance each year toreview your coverage options and make changes toyour benefits.Your elections are in effect from July - June of thefollowing year unless you have a qualifying lifeevent.Open EnrollmentQualifying life events allow you to change yourcoverage during the year outside of OpenEnrollment. These include:marriage or divorcebirth or adoptiondeath of a covered dependenta change in eligibility through Medicare,Medicaid, or a spouse or parent's coverageQualifying Life EventsYou may cover your eligible dependents when youelect coverage for yourself.Covering your familyDependent children are eligible until age 26regardless of student or marital status.You may cover your legal spouse.Your childrenHow to EnrollRead your materials and make sure youunderstand all of the options available.Complete enrollment or change forms to addor drop dependents, change plans, or waivecoverage.Enrollment or change forms are available fromHR or at the link below.Be prepared with dates of birth, social securitynumbers, and legal names of any dependentsyou live with to enroll in benefits.Remember to review your beneficiaries.Complete and submit your Evidence ofInsurability (EOI) form if your enrollmentrequires it.IneligibleEnroll now!Divorced or Legally separated spouseCommon law spouse, even if recognized byyour stateDomestic partners, unless your employer statesotherwiseFoster childrenSisters, brothers, parents or in-laws, etc.

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 inaddition to – and does not counttowards – your out-of-pocketmaximum.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 for 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 doesnot include your premium (theamount you pay for coverage), non-covered expenses, or out-of-network care that’s been balancebilled.Primary care physicianA primary care physician (PCP) isyour main medical doctor – usuallya general practitioner (GP), familydoctor, internist, OB/GYN, orpediatrician (for children).Referral/pre-authorizationSome specialty medical providersand services require a referral froma primary doctor. These mayinclude, but are not limited to,cardiology, psychiatry, orthopedicsurgeons, rheumatology, surgery,and imaging (CT or MRI).How to handle medicalbills (4:46)Helpful terms & resourcesGetting startedWe've removed as much jargon as possible.But you’ll probably still encounter some terms as you enroll in and use your benefits, and wewant you to be prepared!

MedicalRxBlueCross BlueShieldCustomer Service:800-382-2000DentalHealthPartnersCustomer Service:952-883-5000Life & AD&DLong-Term DisabilityEmployee Assistance ProgramThe HartfordCustomer Service:800-523-2233EAP Phone:800-964-3577VEBA AccountFlexible Spending AccountOneBridgeCustomer Service:1-888-865-1628View Your NoticesContact informationGetting startedClient PortalPlease contact your HR and Benefits team with anyquestions!benefits@isd200.orgAndrea Seleski651-480-7007Annual NoticesWe’re required to tell you about certainrights and responsibilities you have as anemployee of Hastings Public SchoolsClient PortalClient PortalClient PortalEAP Portal

In-Network BenefitsNon-High Deductible Plan (Comp Basic)*High Deductible Plan (VEBA)Plan Year Deductible$250 per person$500 family max$1,700 per person$3,400 family maxOut-of-Pocket Maximum$3,000 per person$6,000 family max$1,700 per person$3,400 family maxOffice VisitsPrimary Care, Specialist, Urgent Care$25 CopayDeductible then 100%ProceduresInpatient, OutpatientDeductible then 100%Deductible then 100%Emergency Room(Waived if Admitted)$50 CopayDeductible then 100%Prescription drugsGenericBrandNon-FormularySpecialty $10 Copay$20 Copay$35 CopayUp to $35 CopayDeductible then 100%Deductible then 100%Not CoveredDeductible then 100%Medical insuranceFind an In-Network Provider Here:Aware NetworkThe 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.Refer to the carrier benefits summary for the exact benefit levels associated withyour plan.Select a Medical option provided by BlueCross BlueShield. Please refer to your plan documents for full out-of-network benefits.*Out of Network coverage not available on the Non-High Deductible PlanSee plan detailsSee plan detailsMedsYourWay Prescription DrugsHow to Transfer a MaxorPlusMail Order PrescriptionBCBS 2024 MemberResource Guide

Connection to your passion, the reason you get out of bed every day.PurposeFeeling connected to where you live, work and play through activities such as volunteering and mentoring.CommunitySocial & EmotionalHealthy, supportive relationships with family, friends, and mostimportantly, yourself. Effectively managing feelings and emotions andpracticing healthy ways to manage stress and adapt to challenges.PhysicalHaving good health and the energy to perform your job and also enjoy life outside of work, such as spendingtime with family and friends, or participating in activities you enjoy. Think of physical wellbeing as nutrition,staying hydrated, getting rest, avoiding illness through vaccines, preventive screenings, and following doctors’orders.The ability to effectively understand and plan for day-to-day expenses, short-term, and long-term goals likepaying back student loans, saving for a house, sending children to college, retirement, or caring for agingfamily members.FinancialAccess your Ability AssistProgram now!24/7/365 access to care. 800-964-3577www.guidanceresources.comThe 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.The recipe to living wellWellness BenefitsThere are five ingredients to wellbeing — each is just as important as the others:Ability Assist ProgramYou encounter more than just health concerns throughout your life. Managelife’s curveballs with a confidential and complimentary program designed toprovide counseling, support, and resources for a variety of personal issueslike stress and anxiety, relationship struggles, substance abuse, eldercare,financial worries, and much more!See plan details

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.Highlights A VEBA is offered exclusively to enrollees of the High Deductible (VEBA) medical plan.Your employer sets up this account for you and puts money into it. As soon as your employer funds theaccount, the money belongs to you.You are not able to contribute to VEBA, this is done by your employer.Because the money isn’t part of your wages, you won’t pay taxes on it. You can use this money to help pay your health care costs at medical facilities.Once retired, you can use VEBA funds to pay for health insurance premiums like COBRA or Medicare.Savings PlansA voluntary employee beneficiary account (VEBA) is a unique, tax-free health care savings plan fundedentirely by your employer. You can use it to pay for qualified medical expenses now or in the future, plus itcan be used to pay health insurance premiums when you retire.Health and dependent care expenses can add up. Paying with tax-free fundscan help. Enroll in one or more flexible spending accounts depending on yourneeds.Pay for qualifying expenses with tax-free money using yourFlexible Spending Account through OneBridge.Eligible expenses2024 maximum FSAcontribution$3,200Annual rollover amount$640See plan detailsHealth care expensesPay for eligible medical, prescription, dental, andvision expenses.Health care FSA2024 maximum contribution$5,000Married filing separately? You can contribute up to $2,500 per person.Pay for eligible child or disabled adult care while youwork or attend school.Dependent care FSAOnly the amount you’ve actually contributed isavailable for use at any one time.Estimate carefully! Unused funds will be forfeited atthe end of the year per IRS regulations.Flexible Spending Account (FSA)VEBA

Stay in-network to avoid balance billing (the difference between what an out-of-network provider charges and the amount your insurance pays). In-Network ServicesHealthPartners BenefitsDeductible NoneAnnual maximum benefit$1,700 Per PersonDiagnostic & Preventive CareCleanings, X-rays, Exams, Fluoride, Sealants100% CoveredBasic CareSimple Extractions, Fillings,Endodontics, Periodontics, Complex Oral SurgeryDeductible then 100%Special CareRestorative Crowns and onlaysDeductible then 100%ProstheticsDentures, BridgesDental ImplantsDeductible then 80%Deductible then 50%Orthodontic Services*For dependents age 18 and under50% up to $1,000 Lifetime MaximumFind an In-Network Provider Here:Network DirectorySee plan detailsDental insuranceThe 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.You'll get in-network preventive care at 100% along withcoverage for basic and major dental services.Your dental coverage is through HealthPartners.*12 Month waiting period applies for new enrollees.Please refer to your plan documents for full out-of-network benefits.HealthPartners Open Enrollment Guide:HP Guide

EmployeeSpouseDependent Life(Spouse: $5,000Child(ren): $2,500)Election Increments$5,000$5,000Family UnitCoverage Amount Maximum$300,000 not to exceed 6xAnnual Earnings$50,000 up to 50% ofEmployee AmountGuarantee Issue$150,000$15,000Employer Paid Basic Life & AD&D InsuranceLong Term Disability insuranceYou may also purchase additional coverage for you, yourspouse, and your eligible child(ren). Voluntary Life InsuranceLife insurance pays a benefit if you pass away while you're covered. Accidental Death andDismemberment (AD&D) insurance offers additional support if you pass away or are seriouslyinjured due to an accident.Financial peace of mind through The Hartford.Life and AD&D & DisabilityInsuranceThe district offers basic life and AD&D coverage. Please refer to your employment contractfor plan details.Make sure to designate a beneficiary for your life insurance coverage to ensure your family iscared 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.The district offers long term disability coverage at 66.67% of your pre-disability earnings. Please refer to your plan documents for full benefitdetails.Long-Term Disability coverage insures your paycheck, replacing a portion ofyour income if you’re unable to work due to a covered illness or injury. It canprovide lasting income protection if you remain unable to work for a longerperiod of time.

Life and AD&D & DisabilityInsurance RatesThe 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.Coverage TierBased on Employee AgeEmployee / Spouse Voluntary LifeRates per $1,000 of benefit per monthUnder 25$.0625-29$.0630-34$.0835-39$.1040-44$.1345-49$.2050-54$.3155-59$.5660-64$.7865-69$1.9570-74$2.0675-120$2.06Coverage TierDependent LifeFamily Unit$2.065

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.Carrier ResourcesThe district offers a handful of non-traditional benefitsthrough your insurance carriers to support you and your familyas you juggle life’s demands.See plan detailsBeneficiary AssistOffered through The HartfordBeneficiary Assist provides you, your eligiblebeneficiaries and immediate family members withunlimited 24/7 phone access to support including mentalhealth, Legal advice, Financial advice, and more.See plan detailsBlue365Offered through BlueCross BlueShieldWith Blue365, you get great deals on products andservices that complement your health. Save on personalcare, fitness gear, hearing and vision, healthy meal kits and more. See plan detailsFuneral ConciergeOffered through The HartfordThis service helps you make confident, informeddecisions, understand your options, and stay withinbudget at a difficult time. See plan detailsHinge HealthOffered through BlueCross BlueShieldHinge Health is a digital exercise therapy program youcan do anywhere, anytime through a convenient app.You’ll be matched with a personal physical therapist andget everything you need to get started,See plan detailsBlue Care AdvisorOffered through BlueCross BlueShieldBlue Care Advisor connects you to everythingyou need to easily manage your healthcare,meet your goals and live healthier.See plan detailsEstate GuidanceOffered through The HartfordThis free service helps you create a simple, legally bindingwill online, saving you the time and expense of a privatelegal consultation.See plan detailsTravel Assist & ID TheftOffered through The HartfordWhether you're traveling for business or pleasure, TravelAssistance services are available when you're more than100 miles from home for 90 days or less.

2024 Benefits