DEKALB INDEPENDENT SCHOOL DISTRICT

DEKALB ISD

101 Maple Street

DeKalb, Texas 75559

(903) 667-2566

www.dekalbisd.net

2018-2019 PLAN YEAR

EMPLOYEE BENEFITS GUIDE

DEKALB INDEPENDENT

SCHOOL DISTRICT

Benefit Website

Contact Information 1-2

General Information 3

Things You Should Know 4

Online Enrollment Information 5

Section 125 / Cafeteria Plan 6

Medical Plans 16 -17

Dental Insurance 22

Vision Insurance 43

Longterm Disability Insurance 23-30

Voluntary Life Insurance 31-33

Accident Insurance 38-42

Cancer Insurance 35-37

TASC Card 8

Permanent Life 34

Notes 44

Flexible Spending Account 7

Investment Information 12

TABLE OF CONTENTS

Benefit Rate Information 13 - 15

Medical Gap Plan 18-21

Health Savings Account 9-11

CONTACT INFORMATION

U.S. Employee Benefits

Services Group (USEBSG)

Jack Dickerson

1106 Ridge Road, Suite A

Rockwall, TX 75087

(877) 730-7780 / Cell (956) 346-1522

www.usebsg.comThe Standard – Disability

Claims & Administration Offices

P. O. Box 2800

Portland, OR 97208

(800) 368-1135/F (888) 878-3686

www.standard.com

TRS ActiveCare - Aetna

Customer Service (800) 222-9205

www.trsactivecareaetna.com

24-Hour Nurse Information Line

(800) 556-1555

Beginning Right Maternity

Management Program

(800) 272-3531

Caremark Prescription Benefits

(800) 222-9205

www.caremark.com/trsactivecare

Texas Life – Permanent Life

P.O. Box 830

Waco, TX 76703-0830

(800) 283-9233

www.texaslife.com

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Med Gap – Benefit Connect

Special Insurance Services

2740 Dallas Parkway

Plano, Texas 75093

(800) 767-6811 or (972) 788-0699

Fax (972) 960-0377 or (972) 991-3936

[email protected]

www.specialinc.com

Meritain Health, Inc. –Dental

P.O. Box 27267 Minneapolis,

MN 55427-0267

(800) 925-2272

Allstate – Cancer

P.O. Box 43067

Jacksonville, Florida 32203-3067

(800) 348-4489 Fax (866) 424-8482 www.AllstateBenefits.com

Lincoln Financial – Dental & Life

P.O. Box 2609

Omaha, NE 68103-2609

(800) 487-1485/F (877) 668-5331

www.lincoln4benefits.com

InRoll Online Benefit Enrollment

Assistance

Group ID: DEKALB ISD

Default password: dekalbisd

(877) 730-7780

www.in-roll.com

U.S. Employee Benefits Services

Group (USEBSG) is the nation’s

leading independent provider and

administrator of employer-

sponsored benefits and retirement

plans in the school district

marketplace.

We serve over 400 ISDs in Texas

and are endorsed by TACS. Our

focus is on developing

comprehensive programs

providing affordable solutions for

DeKalb Independent School

District benefits, online enrollment

and retirement plan needs. We

have 25 years of experience and

over 1,000,000 clients across the

nation.

CONTACT INFORMATION

TASC Flex System – Customer Service

2302 International Lane

Madison, WI 53704-3140

(800) 422-4661

www.tasconline.com

VSP

PO Box 742788

Los Angeles, CA 90074

(800) 216-6248

www.vsp.com

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DEKALB ISD EMPLOYEE

BENEFITS

101 Maple Street

Dekalb, Texas 75559

(903) 667-8566

www.dekalbisd.net

This booklet is designed to

highlight your benefits. It is not a

summary plan description (SPD).

Official plan and insurance

documents actually govern your

rights and benefits under each

plan. For more details about your

benefits, including covered

expenses, exclusions and

limitations please refer to the

individual SPDs.

Combine Insurance – Accident

Group # BKRC0043

Sandy Tarpley 817-821-0063

www.combinedinsurance.com

HSA Bank

PO Box 939

Sheboygan, WI 53082-0939

(800) 357-6246

www.hsabank.com

If any discrepancy exists between this booklet and

the official documents, the official documents (SPD) will prevail.

DeKalb Independent School District

offers a wide range of benefits to eligible

employees and their family members. All

new or newly eligible employees will

either go online or come to the Benefits

Office to enroll.

You will be required to provide the name,

date of birth and social security number

for any dependents (this includes

spouse) that are listed. You will not be

allowed to enroll without all the required

information, this includes social security

number.

As a new or newly eligible employee you

will only have 31 days from your date of

employment (start date) to enroll in

benefits.

In the event that you do not enroll by the

31st day, your next window of opportunity

to enroll in benefits will be during annual

open enrollment.

The plan options and coverage levels

you select for the 2018-2019 plan year

will remain in effect from September 1,

2018 through August 31, 2019.

After the initial enrollment period, you can

only add or change coverage during the

year if you have a Qualified Family

Status Change/Special Enrollment event

such as: Marriage, Divorce, Birth or

adoption, Death, Court Order (child(ren)

coverage only), Spouse gains or loses

employment.

You must submit all the required

documentation and make your plan

changes within 31 days from the date

of the event.

AUTOMATIC COVERAGE FOR

CERTAIN BENEFITS

As a TRS contributing member and a

DeKalb ISD employee, you will receive a

basic life insurance policy provided by

the district at no cost to you. Please

ensure you have a beneficiary on file

with In-Roll for this policy.

To sign up for benefits log in to our

enrollment system, In-Roll, at www.in-

roll.com or contact the Benefits

Office at (806) 669-4700.

Certain benefits are Guarantee Issue to

new employees, meaning you will not be

denied and you will not have to answer

medical questions. If you enroll later,

you may be expected to answer medical

questions and coverage could be

denied.

When logging into In-Roll, remember:

❖ To verify all personal information

for all participants.

❖ To add all dependents that will be

covered.

❖ Accept or waive coverage for

yourself and all dependents under

each benefit section.

❖ Print your completed confirmation

sheet an retain a copy for your

records.

GENERAL INFORMATION

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THINGS YOU SHOULD KNOW

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1. CAFETERIA PLAN ENROLLMENT

This year’s medical enrollment is mandatory as the district must maintain Affordable Care Act and

Cafeteria Plan (Section 125) compliance. All eligible employees are required re-enroll in medical

and voluntary benefits for the 2018/2019 Cafeteria Plan Year. Employees are encouraged to review

dependent and spouse information to confirm that the enrollment system has correct social security

numbers. Employees not participating in the Cafeteria plan must participate in the enrollment to

either select or decline benefits.

Employees who do not participate in DeKalb ISD’s Cafeteria Benefit Plan are required to enter

dependent and spouse information into the system with their benefit declination.

2. PLAN ADDITIONS AND CHANGES

The district has added H S A Bank allowing employees with TRS Active Care HD1 to setup H S A

Accounts via payroll deduction. Certain restrictions apply to H S A Accounts. To participate you

must elect Active Care HD1. If you elect H S A, you may not select Medical Gap coverage and or

an FSA account Additional changes for the 2018/2019 Plan Year Include: TRS Medical Rates have

increased and enrollment in Active Care 2 is limited to those enrolled in Active Care 2 during the

17/18 plan year. Also increases in Medical Gap Rates and VSP Vision. Voluntary life has changed

to Lincoln.

3. IMPORTANT DATES

This year’s Employee Benefit Open Enrollment begins with a pre-online enrollment period on

Tuesday, August 1st. Benefit counselors will be at the administration building to provide enrollment

assistance on Tuesday, August 7 and Wednesday August 8. Benefit Booklets will be available at the

administration building.

4. DEKALB ISD BENEFIT WEBSITE

The district benefit website is located at::http://dekalbisdbenefitportal.com. The site provides

complete Cafeteria Benefit Plan information with brochures and claim forms for all products and

services.

5. 403B NOTICE

You have the opportunity to save for retirement by participating in the School District’s 403(b) plan

(“Plan”). A brief, 3-minute video presentation explaining what a 403(b) plan is, and how to contribute

can be reached at http://www.403bwhyme.com/.. Registration is required to view the video. If there

are any questions, you may contact The OMNI Group at 877-544-6664.

http://www.403bwhyme.com/

ONLINE ENROLLMENT INFORMATION

USERNAME AND SECURE PASSWORD

User Name - Your user name will be the

first initial of the legal first name on record

with DeKalb ISD, followed by your entire last

name, followed by the last 4 digits of your

SS#.

(Ex: employee name - Robert Smith, SS#

123-45-6789; User Name will be:

rsmith6789)

Default Password - Your default password

for the initial log in will be dekalbisd

(case sensitive)

All Passwords have been reset to the

Default Password for the open enrollment.

Be sure to change your password to

something that is easy to remember, yet

secure, as you will be the only one with

access to it. Once you have successfully

changed your password you will be directed

to a Welcome Page.

WELCOME PAGE

Please read the Welcome Page and

“Things You Should Know”. Important

information and notices are posted to

inform and assist you in your enrollment.

CONFIRMATION STATEMENT

Once you have completed your enrollment,

you will see a “Confirmation Statement”.

This page shows you the benefit selections

made, the cost of these benefits, and

dependents entered into the system. Click

the “Print and Save” button at the bottom of

this page to create a printable version of

this document.

Once the printable version appears, click

file/print to print a copy for your records.

Note: If you have a valid email address in

the system, you can also request to have a

copy of your Confirmation Statement

emailed to you.

If the option to email a statement

does not appear, return to the Verify

Information screen and make sure

you have a valid email address entered

in InRoll. After this document prints,

click the Exit link at the top of the page

to close your enrollment site.

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WHAT IS A CAFETERIA PLAN?

Cafeteria plans, also known as Section 125

plans (the IRS code that covers them), and

flexible spending plans allow you to deduct

certain amounts for benefits from your gross

earnings before federal withholding taxes are

figured.

Similar to a cafeteria where individuals select

their food of choice, employees may choose

benefits of their choice. These plans become

more useful as diversity within our workforce

continues to grow. For example, the benefit

needs of young families may differ greatly

from those of a single person.

RULES REGARDING THE DeKalb ISD

SECTION 125 / CAFETERIA PLAN:

All employees must sign their Benefits

Election Form every plan year, regardless of

whether they are making changes or carry

NO benefits. This may be done on-line or by

visiting with a benefits agent. Benefits

elections will remain in effect for the plan

year and cannot be revoked or changed

unless one of the following family status

changes:

❖Marriage

❖ Divorce

❖ Birth

❖ Adoption

❖ Death

❖ Termination or change in

spouse’s employment

❖ Change in eligibility status of

a dependent

It is also possible to change you medical

coverage if there is a substantial increase

in the premium and you have like coverage

elsewhere.

SECTION 125 / CAFETERIA PLAN

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Employee salary reductions to a medical Flex Spending Account (FSA) are limited to $2,650 per Plan Year, indexed for inflation. Check with your employer for your Plan’s maximum annual election amount.

Putting money in a FSA is smart and safe. DeKalb ISD has provided you with a plan which allows a 2.5 month Grace Period and a 45 day Run-Out Period

FLEXIBLE SPENDING ACCOUNT

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TASC CARD

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HSA BANK WEBSITE

Certain restrictions apply to Health Saving Accounts. To participate you must elect Active Care HD1. If you elect H S A, you may not select Medical Gap coverage and or an FSA account.

Health Savings Account

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HSA BANK WEBSITE

Certain restrictions apply to H S A Accounts. To participate you must elect Active Care HD1. If you elect H S A, you may not select Medical Gap coverage and or an FSA account.

H


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HSA BANK WEBSITE

For information on discount pricing visit www.hsabank.com

Certain restrictions apply to H S A Accounts. To participate you must elect Active Care HD1. If you elect H S A, you may not select Medical Gap coverage and or an FSA account.


WHAT IS A 403(B) AND/OR A 457 PLAN?

A 403(b) plan is a retirement savings plan

available for public education organizations. It has

tax treatment similar to a 401(k) plan. Employee

salary deferrals into a 403(b) plan are made

before income tax is paid and allowed to grow tax-

deferred until the money is taxed as income when

withdrawn from the plan. 403(b) plans are also

referred to as a tax-sheltered annuity.

The 457 plan is a type of deferred-compensation

retirement plan that is available for governmental

employers.

The employer provides the plan and the employee

defers compensation into it on

a pre-tax basis. For the most part the plan

operates similarly to a 401(k) or 403(b)

plan most people are familiar with. The

key difference is that there is no penalty

for withdrawal before the age of 59½

(but subject to income tax).

WHY DO I NEED MORE THAN TRS

RETIREMENT?

You have other options to help close the gap

between your current income and what your

retirement income will be.

The 3 main options include but are not limited to a:

❖ 403(b) - Tax Sheltered Annuity

❖ 403(b)(7) - Mutual Fund

❖ 457 - Deferred Compensation Plan

www.403bwhyme.com

The OMNI Group (877) 544-6664

Your contributions to these accounts can be

payroll deducted on a pre-tax basis allowing

your taxable income to be lower based on

your contribution. Each of these accounts

offer fixed and variable investment options

for you to select from. A fixed investment

sets your rate

of return and remains consistent throughout

your investing years. A variable investment

allows for some volatility, meaning that

when the market is up, your investment

should be on the increase; when the market

is down, your investment is likely to go

down. Since each type of account comes

with different tax rules, you will want to be

sure you are aware of the difference with

them.

Ultimately TRS is not going to provide you

with the income or lifestyle you are used to

having during your working

years. Consider one of these options to

help close that shortfall.

INVESTMENT INFORMATION

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2018-2019 BENEFIT RATE INFORMATION

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TRS-ActiveCare HD-1Hourly Monthly

Rate

Professional Monthly

Rate

Employee Only $67.00 $142.00

Employee and Spouse $735.00 $810.00

Employee and Children $401.00 $476.00

Family $1,074.00 $1,149.00

TRS-ActiveCare Select


Employee and Spouse $1,027.00 $1,102.00


Family $1,368.00 $1,443.00

TRS-ActiveCare 2


Employee and Spouse $1,555.00 $1,630.00


Family $1,894.00 $1,969.00

Medical Insurance – TRS-ActiveCare

Premiums are Net of Employer Contribution - $300 for hourly and $225 for professional eligible employee

Age

Employee Only

Employee + Spouse

Employee + Child

Family

$65.05

$69.58

$98.44

$1,500 Inpatient and $1,500 Outpatient Annual Benefit

Under 40 40-49 50 & Above

$74.37

$136.65

$128.15

$188.80

$26.89

$49.44

$64.64

$86.57

$35.41

Medical Gap Insurance - Benefit Connect


Disability Insurance – The Standard

Insurance for your paycheck in the event of an accident or illness.

Option A $1,000 Monthly Benefit – Rates

0-7 Day Elimination Period$38.40

14 Day Elimination Period$33.80





Option B $1,000 Monthly Benefit – Rates

0-7 Day Elimination Period$36.00






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Please see agent or enroll online at www.in-roll.com for additional information.

Guarantee issue $100,000 Employee, $30,000 Spouse & $10,000 Child Non Medical Maximums

Up to 5X Annual Earnings or $500,000 Maximum Coverage

Permanent Life Insurance – Texas LifePermanent Life to Age 121. Express Issue (no medical) for coverage

up to $150K for Ages 17-49 and $75K for Age 50-65

Employees may select Voluntary Term and/or Permanent Life Insurance. Premiums are calculated in

the enrollment system

Supplemental Term - Voluntary Term Life Insurance – Lincoln Financial


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Cancer Insurance – Allstate

Rates include $2,000 Initial Diagnosis and $100 Annual Wellness benefit

Monthly Rate

Employee $23.33

Employee & Spouse $36.15

Employee & Children $32.51

Family $49.55

Accident Insurance – Combined

Pays over and above major medical insurance, directly to the participant.

Monthly Rate

Employee Only $16.60

Employee and Spouse $30.36

Employee and Children $32.08

Family $45.84

Tier Option Monthly Rate

Employee Only $9.00

Employee + One $14.40

Employee + Children $14.69

Employee + Family $23.69

Vision Insurance – VSP$10 Office Copay - Exam every 12 months, $25 Materials Copay. Lenses every 12 months. Frames every 24

months.

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Meet Alex, your benefits

counselor!www.myalex.

com/trsactivecare

MEDICAL PLANS

http://www.myalex/

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MEDICAL PLANS

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MEDICAL GAP PLAN

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MEDICAL GAP PLAN

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MEDICAL GAP PLAN

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MEDICAL GAP PLAN

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DENTAL INSURANCE

TO ENROLL IN DENTAL, PLEASE SEESTACY SHIFFLETT – PAYROLL OFFICE

LONGTERM DISABILITY INSURANCE

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VOLUNTARY LIFE INSURANCE

VOLUNTARY SUPPLEMENTAL LIFE INSURANCE

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VOLUNTARY SUPPLEMENTAL LIFE INSURANCE

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PERMANENT LIFE INSURANCE

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CANCER INSURANCE

CANCER INSURANCE

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CANCER INSURANCE

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ACCIDENT INSURANCE

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ACCIDENT INSURANCE

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ACCIDENT INSURANCE

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ACCIDENT INSURANCE

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ACCIDENT INSURANCE

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VISION INSURANCE

Tier Option Monthly Rate

Employee Only $9.00

Employee + One $14.40

Employee + Children $14.69

Employee + Family $23.69

Vision Insurance – VSP$10 Office Copay - Exam every 12 months, $25 Materials Copay. Lenses every 12 months. Frames every 24

months.

NOTES:

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U.S. Employee Benefits Services Group Jack Dickerson

1106 Ridge Road Suite ARockwall, Texas 75087

(877) 730-7780 / Fax (972) 722-0901www.usebsg.com

DEKALB INDEPENDENT SCHOOL DISTRICT

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