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THPRDBenefits GuideEffective January 2024

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 changesto your 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.Your Spouse or PartnerYour benefit plans are in effect January 1 –December 31 each year. In general, there arethree times you can make benefit selections:Making benefit selectionsGetting startedEligibility Enrolling in coverageYour benefits begin on the first day of the monthfollowing date of hire. Be sure to submit yourselections within your first 30 days of benefitseligibility. Your benefit selections will be in effect throughDecember 31. When you're first eligibleCovering your familyYou may also cover your eligible dependentswhen you elect coverage for yourself.Dependent children are eligible:Medical, dental and vision: until age 26regardless of student or marital statusChild life insurance: until age 21, or 26 if afull-time studentYour ChildrenYou may cover your legal spouse or domesticpartner.ENROLL NOW

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 amountyou pay for coverage), non-coveredexpenses, or out-of-network carethat’s been balance billed.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).Have questions? Your advocate is here to help youwith all things benefits. See theircontact information on the nextpage.How to handlemedical bills (4:46)Annual NoticesWe’re required to tell you about certainrights and responsibilities you have as anemployee of THPRD. You can request a paper copy at nocharge from:Benefits Teambenefits@thprd.orgDownload 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 insurance(vision included)Kaiser PermanenteGroup #: 17068800-464-4000 | Kaiser WebsiteDental insuranceModaGroup #: 10008140503-265-2965 | Moda WebsiteLife and AD&D insuranceUnumGroup #: 447424800-275-8686 | Unum WebsiteDisability insurance& Long term careUnumGroup #: 447424Flex Benefits(FSA, DCA, Transit)PacificSource AdministratorsGroup #: P00249800-422-7038 | PSA WebsiteHealth Reimbursement Arrangement (HRA)PacificSource AdministratorsGroup #: P00249Employee Assistance Program (EAP)Canopy800-433-2320 | Canopy EAP WebsitePet InsurancePetPartnersGroup #: GPPI-00061866-774-1113 | PetPartners WebsiteStudent Loan Repayment &529 College SavingsBenefitEd844-358-5707 | BenefitEd WebsiteIAP & 457 Plan retirementsavingsMission Square800-669-7400 | MissionSquare WebsiteAlison BeckerClient Service Specialist, OneDigitalalison.becker@onedigital.comGio ArellanoBenefits Technician | HR, THPRDbenefits@thprd.orgContact Information & EnrollmentYou have advocates ready to help you with claims, coveragequestions, and more!Getting started

In-network careHSA-Qualified PlanHMO PlanDual Choice PPO PlanNetworkIn Network OnlyIn Network OnlyIn Network Select Providers*Annual Deductible (DED)Out-of-pocket maximum$1,600 per person / $3,200 family$3,500 per person / $7,000 family$250 per person / $500 family$1,150 per person / $3,450 family$250 per person / $750 family$2,500 per person / $7,500 familyPre-tax account availabilityHealth Savings Account (HSA)Health care FSAHealth care FSAPreventive carePrimary care visitSpecialist visitVirtual visit100% covered20% after Deductible**20% after Deductible$0 after Deductible100% covered$15**$15$0100% covered$30; Enhanced Benefit $15**$30; Enhanced Benefit $15$0Urgent careEmergency roomInpatient hospital care20% after Deductible20% after Deductible20% after Deductible$15$200 After Deductible (waived ifadmitted)10% After Deductible$30; Enhanced Benefit $15$200 After Deductible (waived ifadmitted)10% After DeductiblePrescription drugsGeneric Preferred brand Non-preferred brandSpecialty(30 days)$10 copay after Deductible$20 copay after Deductible$40 copay after Deductible$100 copay after Deductible(30 days)$10$20$40$100(30 days)$10$20$40$100VisionAnnual eye examEyewear allowance20% after Deductible$400, once every 24 Months$10 Exam$400, once every 24 Months$30 Exam; Enhanced Benefit $15$400, once every 24 MonthsYour cost for coverageEmployee onlyEmployee + SpouseEmployee + Child(ren)Employee + FamilyPer pay period$ 0$ 0$ 0$ 0Per pay period$ 17.61$ 41.24$ 17.61$ 41.24Per pay period$ 84.57$ 198.03$ 84.57$ 198.03See plan detailsThe 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.Medical insuranceAll plans cover in-network preventive care at 100%, prescriptiondrugs, and include an annual limit on your expenses. The differencesare: what you pay for the plan, what you pay when you get care, how out-of-network care is covered, andyour annual maximum cost for care (out-of-pocket maximum).Select from three medical options through Kaiser.*For the Dual Choice PPO plan, please see your benefit summary for out-of-network benefits.** $5 copay for first 3 visits. First 3 visits defined as any combination of in-person of telemedicine services for primary care (non-specialty), outpatient mental health,naturopathic medicine, or outpatient substance use disorder services.Available to full-time employees on the 1st of the month followingdate of hire.

Additional perksThe 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.There's more to love with these extra benefits. As a Kaiser member, you have access to valueadd programs such as ClassPass, ChooseHealthy,and even free self-care app subscriptions! Access member discounts at kp.orgMental Wellbeing & Behavioral Health CareGinger, Calm, & MyStrength - Free access to chat-based coaching and self-guided mindfulness & meditation appsAdvice Nurse, Primary Care Physician - visit kp.org/appointments or call 1.800.813.2000CHP Active & HealthyDiscounts on active & healthy activities:Gym memberships, classes, & equipmentSporting eventsVitamins & supplementsAlternative CareVirtual CareReceive care in real time via tablet, smartphone, computer, or phoneTeleHealth - Video & telephonic visits with a providerE-Vists - Receive care within 1 hour via emailCare EssentialsConvenient Care Centers located in the Hawthorne & Pearl DistrictsHealthy ResourcesOnline Wellness Tools, Healthy Lifestyle Programs, Health Classes, & Personal Wellness CoachingPortland Clinic - Contracted Partner in all plansCall 1.503.223.3113Kaiser Value Adds & DiscountsKaiser value adds & discounts are available for medically enrolled members.See page 5 for waiting period information.

HSA-Qualified PlanHMO PlanDual Choice PPO Plan$0 copay AfterDeductible$0 copay$0 copay (in-network)Access quality care in the convenience of your own home, on yourlunch break, or on the way to your child’s soccer game! Whether it's a nagging cough, middle-of-the-night fever, or asuspicious-looking mole or rash — telehealth through Kaiser is herewhen you need it. Connect with a board-certified physician 24 hours aday, 7 days a week.Your cost per visit depends on your medical plan:Telehealth: virtual health care that fits your scheduleTotal wellbeing:caring for all ofyouSupport for your health, finances, and life.There are five ingredients to wellbeing — each is just as important as theothers:The recipe to living wellConnection 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.CommunityThe 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.Social & EmotionalHealthy, supportive relationships with family, friends, and most importantly, yourself. Effectively managingfeelings and emotions and practicing healthy ways to manage stress and adapt to challengesPhysicalHaving good health and the energy to perform your job life outside of work, such as spending time with familyand 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 membersFinancialKaiser Telehealth is available for medically enrolled members. See page 5 forwaiting period information.

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 insuranceModa Premier PPO DentalNetwork name:Premier NetworkIn-networkOut-of-networkAnnual Deductible$0$0Annual maximum benefit$2,500 per individual $2,500 per individual Preventive careCovered at 100%Covered at 100%Basic careCovered at 100%Covered at 100%Major careCovered at 60%Covered at 60%Orthodontic careCovered at 50%$3,000 Lifetime Maximum per individualYour cost for coverageEmployee onlyEmployee + SpouseEmployee + Child(ren)Employee + FamiyPer pay period$ 0$ 0$ 0$ 0See plan detailsYou'll get in-network preventive care at 100% along withcoverage for basic and major dental services.Orthodontic care is covered.Your dental coverage is through Moda.Stay in-network to avoid balance billing (the difference between what an out-of-network provider charges and the amount your insurance pays). Learn about dental care categoriesAvailable to full-time employees on the 1st of the month followingdate of hire.

Basic lifeBasic AD&DTHPRD provides$100,000 (non-represented employees)$50,000 (bargaining unit employees)Matches LifeTHPRD 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$2,000Coveragemaximum5x your annualearnings up to$500,000Your (employee)coverage amount up to $150,000$10,000Medical question limit$100,000$50,000Does not applyYou may also purchase additional coverage for you, your spouse, and youreligible child(ren). Additional life and AD&D insuranceLife insurance pays a benefit if you pass away while you'recovered. Accidental Death and Dismemberment (AD&D) insurance offersadditional support if you pass away or are seriously injured dueto an accident.Financial peace of mind through Unum.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.Medical question limitWhen you’re first eligible (a newhire), you can purchase lifeinsurance up to this limit withoutany medical questions required. Medical questions and approvalwill be required for all futureincrease and purchase requests.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 insuranceAvailable to full-time employees on the 1st of the month followingdate of hire.

Long-term disability coverage can provide lasting income protection if youremain unable to work. THPRD provides this coverage at no cost to you.Long-term disabilitySee plan detailsPre-existing conditionlimitations If you make a disability claim withinthe first year of being covered, checkyour plan details to see how pre-existing condition limitations mightimpact your coverage.Benefits beginAfter 60 days of inability to work (once short-termdisability ends)Coverage amount66.67% of your income up to $12,500 per monthPayments may continueUntil your Social Security Normal Retirement Age if youremain unable to work.Wish you knew moreabout finances? Nowyou can - at no cost!Disability insurance& Long term careThe 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.Protect your paycheck with disability insurancethrough Unum.Disability coverage insures your paycheck, replacing a portionof your income if you’re unable to work due to a covered illnessor injury.Base PlanBenefit Duration: 3 YearsMonthly Facility Benefit: $2,000Monthly Home Benefit: 50% of Facility BenefitBuy-Up PlanBenefit Duration: 6 YearsMonthly Facility Benefit: $2,500 - $6,000Monthly Home Benefit: 50% of Facility BenefitIs a Family Member optionavailable?YesLong term care (LTC) is available for assistance with activities of dailyliving. LTC can help cover the costs of that care when you have a chronicmedical condition, disability or disorder.Long term care (LTC)Available to full-time employees on the 1st of the month followingdate of hire.

Flexible SpendingAccounts (FSAs)Pay for eligible child or disabled adult care while youwork or attend school.Dependent care FSA2024 maximum contribution$5,000Married filing separately: contribute up to $2,500 per person.Only 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.Pay for eligible transit and parking expenses related towork.Transit and parking FSA2024 Monthly maximum contribution$315Enrollment and contribution elections are made on amonthly basis, not annual.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.Pay for eligible medical, prescription, dental, and visionexpenses.See plan detailsHealth care FSAHealth, dependent care, and transit expenses can add up.Paying with tax-free funds can help. Enroll in one or moreflexible spending accounts (FSAs) depending on your needs.Pay for qualifying expenses with tax-free money usingyour Flexible Spending Account through PacificSource.Eligible expenses2024 maximum contribution$3,200Maximum rollover amount$640Enrolled in an HDHP plan and eligible for HSA contributions? You’re not eligible for a health care FSA; you cancontribute to a limited purpose FSA instead.Available to full-time employees on the 1st of the month followingdate of hire.

THPRD contributes:$300HealthReimbursementArrangement (HRA)Health care dollars from THPRD.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, THPRD automatically sets aside moneyto help you and your covered dependents pay for qualifying health care expenses.Unused funds at the end of the year will not roll into the next year’s allowance. Your funds are non-transferable and areforfeited if your employment with THPRD terminates for any reason.Unused funds and morePay for eligible health care expenses with an HRA - funded by THPRD.You can use your HRA dollars for medical, prescription, dental, and vision expensesfor you and your covered dependents.Eligible expensesUsing your fundsMedical and prescriptionYour deductible or copay will be automatically deducted from your HRA allowancefirst. Once your HRA is depleted, you may either pay out of pocket or use healthcare FSA funds.Dental and visionYou can use your HRA debit card at the provider's office, or pay out of pocket andfile for reimbursement. Be sure to keep your itemized receipt!See plan detailsAvailable to full-time employees on the 1st of the month followingdate of hire.

If you coveryourself onlyIf you coverdependentsTHPRDcontributes up to:$1,600$3,200You may alsocontribute:$2,550$5,1002024 IRS maximumcontribution $4,150$8,300Learn how HSAs canhelp you save fortoday and tomorrow.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.Health SavingsAccount (HSA)55 or older? You can contribute an extra $1,000 peryear in catch-up contributions.THPRD contributes to your Health Savings Account(HSA) when you elect the HDHP medical plan and meetIRS eligibility requirements. You may also contribute tax-free funds to save forcurrent and future health expenses:Contributions HSA funds Using your moneySpend your HSA balance on health care expenses(medical, prescription, dental, and vision) for youand your tax dependents, ORLet your balance grow for retirement.The money in your HSA is always yours and availablefor qualified health care expenses - even if you changejobs or health plans. Before retirement, any funds usedfor non-healthcare expenses are subject to taxpenalties. Keep your receipts!Growing your money + tax savingsHSA dollars go in tax-free, grow tax-free, and come outtax-free when you use them for qualified healthexpenses. You may also be able to invest part of yourbalance once it meets a certain level.In retirementAt age 65, you can withdraw the funds in your HSA forany use (not just health care!) without tax penalties. EligibilityIn order to make – or receive – contributions to aHealth Savings Account (HSA), you must:be enrolled in a qualified High Deductible HealthPlan (HDHP),not be covered under any other non-HDHP healthcoverage, including a full health care FSA throughyour spouse,not be anyone else’s tax dependent, and not be eligible for or enrolled in Medicare A or B,Tricare, or VA benefits.An HSA through Bank of America is paired with aHigh Deductible Health Plan (HDHP).Save pre-tax money for health care expenses – or retirement!Available to full-time employees on the 1st of the month followingdate of hire.

24/7/365 access to care. 800-433-2320 Canopy EAP WebsiteSee plan detailsEAP features:Confidential. No one at THPRD will ever know you called or what wasdiscussed.Available 24/7/365. Life doesn't happen during office hours. The EAPis here when you need them.Family care is included. Anyone living in your home is eligible for EAPservices at no cost.Face-to-face visits. When needed, each person can receive up to 6face-to-face (or virtual) visits with a licensed counselor per issue peryear. At no cost. Additional visits - if needed - will go through yourhealth insurance.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.Our Employee Assistance Plan (EAP) is a confidential service with accessto guidance and resources at no cost for: mental health concerns (including substance abuse or addiction),adoption, parenting, or caregiving needs,financial or legal support,familial relationships and friendships,coping with day-to-day challenges, andso much more.Essentially, if it's part of your life, our EAP is here for you.Access support online, through live chat, or over the phone. 24/7/365.Everyone needs support sometimes (even superheroes)EmployeeAssistanceProgram (EAP)Care for your mind – and your life – with supportthrough Providence.Confidential care designed for all that life brings.Canopy EAP OrientationVideo (1:12)Canopy EAP MentalHealth Referral Video(1:30)Available to all employees on the date of hire.

See plan detailsProtect your furry best friend with PetPartners PetInsurance. You'll get access to licensed veterinarians forroutine care, emergencies, lab tests and wellness visits.You can enroll one pet at no cost, with the option topurchase coverage for additional pets.Pet insurancePet insurance reimburses you for the cost of accidentsand illnesses throughout your pet’s life.Additional benefitsThe 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.Educational AidMileage ReimbursementReimbursement for mileage at the rate establishedby the IRS when an employee uses his/ her own carin the furthering of District business.Fifty percent (50%) of the cost of tuition at a Stateof Oregon college for optional course work thatdemonstrates direct application to the currentposition or the next logical promotional step.Available to full-time employees on the date of hire.Available to full-time employees hereafter completing ofthe probationary period.BenefitEdTHPRD can help you pay down student loans through theStudent Loan Repayment and 529 College Savings PlanProgram with BenefitEd. You will receive an email toenroll into the program prior to becoming eligible. Training & ConferencesOne hundred percent (100%) reimbursement oftuition, books and fees for any course of trainingprogram prescribed by the District.Available to full-time employees on the date of hire.Public Service Loan ForgivenessProgramIf you are employed by a government or not-for-profitorganization, you may be able to receive loan forgivenessunder the Public Service Loan Forgiveness Program. Learnmore here.Available to full-time employees after 10 years or 120consecutive payments.See plan detailsAvailable to full-time employees on the 1st of the month followingdate of hire.Available to full-time employees on the 1st of the month followingdate of hire.

See plan detailsLearn how investingand saving actuallyworks - and can workfor you.Retirement savingsplanThe 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.Set your future self up for financial stability with aretirement plan through MissionSquare.The key to saving for retirement is to start early and stay committed.Making the choice to invest in yourself by contributing to your employersponsored retirement plan is a decision that may have a big impact onyour ability to retire confidently.THPRD offers a hybrid pension plan (not PERS) that provides for both adefined benefit pension plan at age 65 of 1.5% x years of service xaverage monthly salary paid by the employer and a defined contributionplan that is funded by a mandatory 6% employee contribution thatemployees are immediately vested in. Employees hired after July 1, 2010are automatically enrolled in THPRD’s Tier II Pension Plan.457(b) Deferred Compensation PlanEmployees can choose to defer contributions from their salary into the457(b) plan on a pre-tax or Roth basis. The Roth option allows for after-taxdeferrals and therefore tax-free distributions in retirement. The 457(b) actsand feels much like a 401(k) plan where employees have the option toinvest their money for retirement, however there is never a 10% penaltyfor withdrawals, no matter what age you separate from service. The IRS limits for investing in 2024 are $22,500 for anyone under the ageof 50, $30,000 for anyone over the age of 50, and $45,000 for anyonewithin three years of normal retirement age.If an employee has outside qualified retirement assets, they can choose toroll them into the 457(b) plan. All contributions an employee makes arealways 100% vested.Pension PlanAvailable to full-time employees after observing a six (6) month waiting periodAvailable to full-time employees on the date of hire