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Happy, Healthy and Well

2019 Employee Benefits | January 1 - December 31

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We will continue to provide electronic enrollment through Employee Navigator. Employee Navigator provides you

the ability to make benefit elections and changes online during annual open enrollment and new hire enrollment.

Accessible 24 hours a day, information about all of your employee benefits election options, including premiums,

carrier contact information, benefit summaries and so much more!

What’s changing in 2019?

• Dental frequencies: The frequencies for diagnostic and preventive services will be changed from once every

six months to two times per contract year. This allows more flexibility for the member when scheduling ap-

pointments for routine care!

• Dental network: Adding Delta Dental PPO network (along with the current Delta Dental Premier network), al-

lowing you more choice. Through the Delta Dental PPO network, dentists agree to a lower fee table and pa-

tients usually receive a higher level of benefits or lower out-of-pocket costs when choosing a PPO dentist.

• Life/AD&D open enrollment opportunity: Mutual of Omaha has approved a one-time open enrollment for

voluntary term life and accidental death & dismemberment (AD&D) for employees only (this does not apply to

spouse and/or child(ren). Which means if you have previously waived coverage for life/AD&D you may apply

during open enrollment for coverage up to the guarantee issue amount and not be subject to evidence of in-

surability.

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This guide offers you a quick reference and overview of benefits; we compiled this summary so you can see

which benefits may be best for you and your family. It is your responsibility to read and review this guide,

get informed and ask questions! Take the time to attend an information session and take advantage of our

enrollment help sessions. Then complete enrollment online through Employee Navigator.

Information Sessions:

• Tuesday, October 2nd at 4:30 - 5:30 PM, Andover Central High School Library

• Tuesday, October 2nd at 5:30 - 6:30 PM, Andover Central High School Commons (vendor booth breakout)

• Tuesday, October 2nd 6:30 - 7:30 PM, Andover Central High School Library

Enrollment Help Sessions:

• Tuesday, October 9th at 7:00 - 11:00 AM, Andover Middle School Library

• Tuesday, October 9th at 2:00 - 6:00 PM, Prairie Creek Elementary Library

• Wednesday, October 10th at 7:00 - 11:00 AM, Wheatland Elementary Library

• Wednesday, October 10th at 2:00 - 6:00 PM, Andover Central Middle School, Room 200

• Monday, October 15th at 7:00 AM - 6:00 PM, District Office Board Room (Extended Help Session)

The open enrollment window starts on Tuesday, October 2nd and ends at midnight on Sunday, October 21st. You are responsible for completing online enrollment through Employee Navigator by midnight on Sunday, October 21st. If you miss the deadline, you will not be enrolled in the benefit unless due to a qualifying event as listed below or upon the next annual enrollment period. Qualifying events as defined by law:

After your initial eligibility date and other than the annual open enrollment period, you may only change your bene-

fit elections and covered dependents within 30 days following a qualifying event such as:

• Birth or adoption of a child

• Marriage, legal separation, annulment, or divorce

• Death of spouse and/or dependent

• Dependent’s loss of eligibility

• Termination or loss of coverage due to a reduction in hours

Complete enrollment through Employee Navigator. The

open enrollment window starts on Tuesday, October 2nd

and ends at midnight on Sunday, October 21st.

Employee Benefits Coordinator, Julie Rogers (316) 218-4675 or rogersj@usd385.org

WHO DO I CONTACT WITH BENEFIT QUESTIONS?

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Instructions for online enrollment through Employee Navigator

How to create an Employee Navigator account:

• Open the following URL https://www.employeenavigator.com in your web browser

• You have now accessed Employee Navigator’s homepage

• Click the link for “Login” at the top right corner of the page

• You will be redirected to the Employee Navigator Login portal

• Then click the link “Register as a new user”

• Registration page will pop up

• Enter your first and last name

• Enter your Company Identifier number: AndoverUSD

• Enter the last four digits of SSN

• Enter your birth date (mm/dd/yyyy)

• Then click “Next”

• Enter all the marked fields to complete the registration process

How to Access the Employee Navigator Login Portal:

• Open the following URL https://www.employeenavigator.com in your web browser

• You have now accessed Employee Navigator’s homepage

• Click the link for “Login” at the top right corner of the page

• You will be redirected to the Employee Navigator Login portal

• Enter your username and password and click ‘Log In’

• Once you have signed in, you can choose to log out at any time

Click on one of the links below (or copy the links to your web browser) for assistance on the following:

Creating an employee account: https://www.youtube.com/watch?v=RlyuY_rdhsE

Enrolling in benefits: https://www.youtube.com/watch?v=0vFCbg3yFZo

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Who is Eligible?

Employees - First of the month following the first 30 days of employment.

Dependents - As an employee eligible to enroll in the group insurance plans, you may elect certain options for your dependents. Eligible dependents include:

• Your legal spouse

• Your dependent child or step child up to age 26

• Any child placed with you for adoption or for whom you have legal guardianship

• Any unmarried, disabled child of any age who resides with you, medically certified as disabled prior to his/her 26th birthday and primarily dependent upon you for support

• Any eligible child for whom health care coverage is required through a Qualified Medical Child Support Order (QMCSO) or other court or administrative order – even if the child does not reside with you

Healthcare Reform Exchanges:

• If you are eligible for benefits at Andover Public Schools and buy coverage through a Federal or State Ex-change — you and your family will not qualify for a subsidy through the Exchange.

• Federal and State Medicaid programs offer low cost or free medical coverage to individuals and families with limited incomes. Your eligibility will depend on your state, income, and family size. For more info visit: www.healthcare.gov.

IMPORTANT NOTE:

For 9, 10, & 11 month employees for all benefits elected, you will be required to remain on the plan during the summer months and you will pre-pay for these months of coverage through payroll deduction. District contributions for single, employee plus child(ren) or spouse and family coverage will not be available to em-ployees during months when they are not scheduled to work.

For classified employees taking the $120-month salary in lieu of health insurance, please note that due to the health care reform, proof of group health insurance will be required during open enrollment in order for your salary in lieu payments to continue.

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medical

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Medical Coverage Option 1 Option 2 Option 3 Option 4

Network | Benefit Period BlueChoice | January 1 - December 31

Deductible

(Individual | Family) $1,500 | $3,000 $3,000 | $6,000 $5,000 | $10,000 $3,000 | $6,000

Coinsurance

(Plan | Member) 80% | 20% 80% | 20% 80% | 20% 80% | 20%

Coinsurance Out-of-Pocket

(Individual | Family) $1,000 | $3,000 $1,000 | $3,000 $1,000 | $2,000 $1,900 | $3,800

Maximum Out-of-Pocket

(Individual | Family) $6,350 | $12,700 $6,350 | $12,700 $6,350 | $12,700 $6,350 | $12,700

HSA Qualified Plan No No No Yes

Referrals Required No No No No

Office Visit

(Primary | Specialist) $30 | $60 $30 | $60 $35 | $65 20% after Deductible

Telehealth (Amwell) Visit $30 $30 $35 20% after Deductible

Preventive Care Covered 100%, no Deductible

Urgent Care $75, then 20% $75, then 20% $75, then 20% 20% after Deductible

Emergency Room $100, then 20% $100, then 20% $100, then 20% 20% after Deductible

Outpatient Diagnostic Lab 20% after Deductible 20% after Deductible 20% after Deductible 20% after Deductible

Outpatient Diagnostic X-Ray 20% after Deductible 20% after Deductible 20% after Deductible 20% after Deductible

Routine Vision Exam

1 visit every 12 months 20% after Deductible Covered 100% no Deductible

Drug (Rx) Coverage Option 1 Rx Option 2 Rx Option 3 Rx Option 4 Rx

Rx Deductible

(Individual | Family) $200 | $600 $200 | $600 $200 | $600

Medical Deductible

Applies

Generic Tier 1

(Retail | Mail Order) $20 | $50 $20 | $50 $20 | $50

$10 after Deductible |

$25 after Deductible

Preferred Brand Tier 2

(Individual | Family)

$40 after Deductible |

$100 after Deductible

$40 after Deductible |

$100 after Deductible

$40 after Deductible |

$100 after Deductible

$25 after Deductible |

$62.50 after Deductible

Non-Preferred Brand Tier 3

(Individual | Family)

$70 after Deductible |

$175 after Deductible

$70 after Deductible |

$175 after Deductible

$70 after Deductible |

$175 after Deductible

$50 after Deductible |

$125 after Deductible

Specialty

(Retail Only)

20% up to

$80 after Deductible

20% up to

$80 after Deductible

20% up to

$80 after Deductible 20% after Deductible

Below is a summary of in-network medical and prescription services through Blue Cross Blue Shield of Kansas (BCBSKS). This

summary assumes eligible services are provided by contracting providers. If you receive services from a non-contracting pro-

vider, the benefits will be substantially less. See the plan document for more information.

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Enrollment Tier Total Premium Employer Contribution

(What the District Pays)

Employee Contribution

(What YOU Pay)

Op

tio

n 1

$1

,50

0 D

ed

.

Employee Only $525.97 $430.00 $95.97

Employee + Spouse $1,129.78 $530.00 $599.78

Employee + Child(ren) $1,105.06 $530.00 $575.06

Employee + Family $1,706.77 $630.00 $1,076.77

Op

tio

n 2

$3

,00

0 D

ed

.

Employee Only $485.47 $430.00 $55.47

Employee + Spouse $1,043.00 $530.00 $513.00

Employee + Child(ren) $1,020.38 $530.00 $490.38

Employee + Family $1,576.33 $630.00 $946.33

Op

tio

n 3

$5

,00

0 D

ed

.

Employee Only $450.76 $430.00 $20.76

Employee + Spouse $967.78 $530.00 $437.78

Employee + Child(ren) $947.80 $530.00 $417.80

Employee + Family $1,464.30 $630.00 $834.30

Op

tio

n 4

(HSA

)

$3

,00

0 D

ed

.

Employee Only $453.39 $430.00 $23.39

Employee + Spouse $974.10 $530.00 $444.10

Employee + Child(ren) $955.69 $530.00 $425.69

Employee + Family $1,475.87 $630.00 $845.87

REMINDER:

For 9, 10, & 11 month employees for all benefits elected, you will be required to remain on the plan dur-ing the summer months and you will pre-pay for these months of coverage through payroll deduction. District contributions for single, employee plus child(ren) or spouse and family coverage will not be avail-able to employees during months when they are not scheduled to work.

For classified employees taking the $120-month salary in lieu of health insurance, please note that due to the health care reform, proof of group health insurance will be required during open enrollment in order for your salary in lieu payments to continue.

Medical Monthly Cost January 1, 2019 - December 31, 2019

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It is important for you to verify each of your medical providers are “contracting providers” prior to each

service. Your out-of-pocket cost will be substantially lower if you receive services from contracting providers.

Find a Doctor:

1. Go to www.bcbsks.com

2. Click “Find a Doctor/Hospital” on the top right of the screen.

3. Either login to your BlueAccess account (details below) or click on the link to enter the first characters on your ID card.

4. The results will default to location Topeka, KS so be sure to change your location if necessary.

How to find other network services:

Follow the same steps located to the left and

narrow your search by any of the following:

• Urgent Care

• Behavioral Healthcare

• Find a Hospital

• Find and Compare Procedural Costs

Sign up for BlueAccess visit www.bcbsks.com

BlueAccess is an online service that allows you to view your

information quickly and securely. All you need to get started is your

member ID Card for access to the following, and more!

• Verify benefits, including eligibility and deductible/coinsurance information

• Check medical, behavioral health, and prescription drug claims

• View the formulary drug list and find a pharmacy near you

• Change your mailing address or request an ID card

• Find your latest Explanation of Benefits (EOBs)

• Locate an in-network provider near you

• Access your Health Risk Assessment

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Medication Search

You and your doctor can search for a drug, find out if it’s covered and see what tier it falls under. You can also see if there are alternatives that cost less. Make sure your doctor knows that you pay more for higher tiered drugs, which are the brand name and specialty drugs. You will generally always pay less if you ask for your prescription to be filled as a generic. He or she can consider this before writing a prescription, you just have to mention it.

Find Drugs (Formulary) - Members

Benefits are subject to your specific plan you enroll in. To get the best results, specific to your coverage, login to your BlueAccess account and click on Rx Drugs. If you do not have a BlueAccess account, sign up today by visiting www.bcbsks.com or you can call Customer Service at 1-800-432-3990.

AllianceRx Walgreens Prime Home Delivery

Our BlueRx Mail program through AllianceRx Walgreens Prime offers home delivery with the highest stand-

ards of quality, safety and service for your prescription drug needs.

Step 1: For each long-term medication prescribed for you, ask your doc-

tor to write TWO prescriptions:

• One to be filled at a participating local pharmacy for imme-diate use.

• One for the maximum-days supply (90 days) your prescrip-tion benefit program allows to be filled at Walgreens Mail Service Pharmacy.

Step 2:

Complete (in black ink) the Walgreens Mail Service Registration & Prescription Order Form.

Step 3:

Mail to Walgreens Mail Service Pharmacy:

• Your completed Walgreens Mail Service Registration & Pre-scription Order Form.

• Your original doctor-signed maximum-day supply prescrip-tion*

• The appropriate payment*

* You may submit more than one long-term prescription and payment in one order.

If you have questions, call BCBSKS customer service toll-free at -800-432-3990.

Prescription Refill Options You can get medication refills by internet, phone or mail. Remember to order three weeks before your current pre-scription is due to run out. Walgreens Mail Service pro-vides the following convenient refill methods: Option 1: Refill by Internet

• Log on to Walgreens.com/PrimeMail. You will be able to view medicines available to refill.

• Follow the website instructions to complete your refill order; you will need to have your prescription number and credit card information ready to enter.

Option 2: Refill by Phone

• Dial AllianceRx’s Walgreens Prime automated refill line at 877-357-7463.

• Have your prescription number and credit card infor-mation available; follow the system prompts to com-plete your refill order.

Option 3: Refill by Mail

• Use the order form that was included in your previous fill. Fill out all information completely and send appro-priate payment.

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1. Who can have an HSA? The individual must be:

a. covered by a HDHP (only Option #4);

b. not covered under other health insurance;

c. not enrolled in Medicare; and

d. not another person's dependent.

2. Where can I open an HSA? Many banks and credit unions offer HSAs.

3. When do I see the tax savings? When you do your taxes at the end of the year, it will be an “above the line” deduction, therefore your taxable income is reduced by the amount you contributed to your HSA.

4. If I switch jobs, do I lose my money? No. The money in your HSA is yours. Whatever money you contribute to your HSA is yours, just like if you had a bank sav-ings account. If you do not use all your HSA money during the year, it will roll over to the next year.

5. How much can I contribute to my HSA account? In 2019, with single coverage, you can contribute $3,500 and $7,000 if two or more are insured. Age 55+ can contribute an additional $1,000. Limits apply.

6. What are some examples of HSA qualifying expens-es? HSA qualifying expenses include doctor office visits, prescription drugs, eye exams, glasses, contact lenses, chiropractors, laser eye surgery and birth‐control prescriptions, to name a few. There are many more eligible items you can pay for with HSA money. You can get a list of covered expenses at www.irs.gov

7. What happens if I lose my health insurance? You may continue to use your HSA money to pay for eligi-ble expenses, even if you do not have a qualifying health insurance plan, but you cannot keep contrib-uting money to your HSA.

8. Can I use my HSA money to pay for my premiums? HSA money can pay for health insurance premiums if you are collecting Federal or State unemployment benefits or are paying COBRA premiums.

9. What if I need medical care in another country? You

can use your HSA money for the same medical ex-

penses anywhere in the world.

10. Can I withdraw my HSA money if I need to? Yes, but

the withdrawal is taxable and you will pay a 20% pen-

alty for non‐qualifying withdrawals.

11. When I die, do I lose my HSA money? No. You can name a beneficiary to receive your HSA money.

12. How much does it cost to set up an HSA? This depends on the bank or credit union you choose. Most usually have a one time set up fee, monthly fee, debit card fees, printed check fees, and overdraft fees. Shop around for the lowest fees.

13. Can my HSA be used for dependents not covered by the health insurance? Generally, yes. Qualified medical ex-penses include unreimbursed medical expenses of the account holder, his or her spouse, or dependents, even if they are not insured by a qualified HDHP.

14. Do I need to keep any records when I use my HSA? Alt-hough some financial institutions track the use of the HSA for you, it is a good idea to keep your own records. It is your responsibility to track the use of your HSA ac-count and you may be required to show proof of your expenditures to the IRS. We recommend you designate a place to store all your receipts so they are available when you need them.

15. What if I do not use all of the money in my HSA account by the end of the year? All the money deposited in your HSA, but not spent during the year, rolls over to the next year. HSA’s do not have a “use or lose it” provision. You have the option of accumulating money in your HSA to pay for future eligible expenses and never pay taxes on the money.

16. May I use payroll deduction to deposit money into my HSA? Yes, but it will not be a pre‐tax deduction. It is your responsibility to remember to claim these deposits on your income tax return.

17. Can I deposit additional money into my HSA account without going through payroll? Yes, you can make de-posits directly to your HSA. It is your responsibility to remember to claim these direct deposits on your income tax return.

18. Will my bank notify me if I have exceeded my allowable contribution amount? No, it is your sole responsibility to keep track of the amounts deposited and spent from

Please Note:

By selecting the HDHP and Health Savings Account

(HSA) you may not participate in the Flexible

Spending Account (FSA).

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Amwell Telehealth

Telehealth is a fast, convenient way to see a doctor virtually. Members with Blue Cross and Blue Shield of Kansas (BCBSKS) coverage can have a live visit on their computer or mobile device with a doctor at a time that works for them.

Blue Cross provides telehealth services through Amwell®. With Amwell, members register for FREE, and the cost per visit is less than an emergency room, urgent care, or even an in-office doctor visit. It's easy-to-use, affordable, private and secure.

Disease Management Our disease management programs are designed to help improve quality of life and overall health. Our registered nurses will help by providing one-on-one support, coaching and education via telephone calls to members who have any of these chronic health conditions:

• Asthma

• Chronic obstructive pulmonary disease (COPD)/chronic bronchitis/emphysema

• Diabetes

• Heart disease

• High blood pressure

• High cholesterol

Our disease management programs emphasize educating members about their health conditions and working with them to take a more active role in their health care. With the help of a registered nurse, enrolled members will receive education, tools and one-on-one support to help:

• Gain an improved understanding of their chronic condition

• Recognize the value of making healthier choices

• Strengthen and improve health care team relationships

• Feel empowered to make informed health decisions

Our free disease management programs are available for members, ages 18 and older, who have BCBSKS as their primary carrier. For more information call 1-800-520-3137 between 8:00 a.m. and 4:30 p.m., Monday through Friday.

Newsletters View current and archived issues of member newsletters, Healthy You and Healthy Living.

• In addition, BCBSKS also offers BlueNews, a free e-Newsletter that is sent periodically with details of what’s new on our website and other information about products and services that may be of interest to you.

Consumer Transparency Tools Blue Cross and Blue Shield of Kansas members have access to tools to help them search for urgent care, review and compare doctors and estimate costs for health care services.

Access these tools by using our provider directory and cost tool. To receive personalized results, log in with your name, ID number, group number and birth date. After logging in, you'll find access to these tools: • Cost Estimator tool - By using data from the Blue Cross

Blue Shield Association National Consumer Cost Tool (NCCT), members are able to compare providers and prices to find the best value care.

• Patient Review of Physicians - Members have the ability to read and write reviews of physicians and professional providers nationwide.

• Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS) - HCAHPS is a national, standardized patient satisfaction survey for hospitals run by the Centers for Medicare & Medicaid Services (CMS). Results from these surveys, as well as reviews from other Blue Cross Blue Shield members, are shown to members to help evaluate providers based upon prior patient experience and satisfaction.

BlueAccess BlueAccess gives you secure, 24-hour access to all of your Blue Cross member information. All you need to get started is your member ID card.

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dental

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We are excited to continue offering our dental benefits through Delta Dental of Kansas as a way to keep

your health and wellness a priority. You are free to go to any dentist of your choice; however, there may

be a difference in the amount of payment if the dentist is not a Delta Dental participating dentist. It is to

your advantage to choose a Delta Dental PPO or Delta Dental Premier dentist.

Go to www.deltadentalks.com to access the following:

• Locate a participating dentist

• Check plan information

• Check claim status

• Print an ID card

Contact customer service at (316) 264-4511 or toll-free at (800) 234-3375

Dental Coverage In-network Benefit Overview

Network Delta Dental Premier and PPO Network

Benefit Period Calendar Year

Deductible (Individual | Family) $50 | $150

Deductible Applies To Type II & III

Maximum Benefit(s) Per Person $1,500

Type I - Diagnostic & Preventive Services Covered 100%, no Deductible

Type II - Basic Services 20% after Deductible

Type III - Major Services 50% after Deductible

Dependent Child Age Limit 26

Enrollment Tier Monthly Cost

Employee Only $32.86

Employee + Spouse $65.01

Employee + Child(ren) $64.82

Employee + Familiy $109.95

Monthly Dental Cost January 1, 2018 - December 31, 2018

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vision

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A clear view of your benefits helps you steer toward success, personally and professionally, and carrying

vision coverage protects one of your most important senses, your sight. We will continue offering two

vision plans through Surency, you can decide which plan best fits you and your family’s needs!

Option 1 - Comprehensive Plan In-network Benefit Overview

Network Access

Frequency Once per Calendar Year

Eye Exam Copay $10

Contact Lens Fit & Follow-up $0

Frames $130 Allowance

Standard Plastic Lenses Copay $25

Lens Options

Standard Polycarbonate

(Adult | Dependent under 19) $40 | $0

UV Coating $15

Tint (Solid & Gradient) $15

Standard Scratch-resistance $15

Standard Anti-reflective Coating $45

Standard Progressive (Add-on to Bifocal) $65

Premium Progressive (Add-on to Bifocal) $65 + 80% of Retail less $120

Other add-ons and Services 20% off Retail Price

Contact Lenses

Contact lens allowance includes materials only. Allowance not available if eyeglass lenses are elected.

Conventional $130 Allowance, 15% off Balance Over $130

Disposable $130 Allowance

Option 2 - Materials Only Plan In-network Benefit Overview

Network Access

Frequency Once per Calendar Year

Frames, Lenses & Options Package $200 Allowance for Frame, Lenses & Lens Options

Contact Lenses in lieu of $200 Allowance (Declining Balance Allowed)

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Option 1 - Comprehensive Plan

Enrollment Tier Monthly Cost

Employee Only $9.60

Employee + Spouse $20.17

Employee + Child(ren) $17.29

Employee + Family $32.34

Option 2 - Materials Only Plan

Enrollment Tier Monthly Cost

Employee Only $8.84

Employee + Spouse $18.54

Employee + Child(ren) $15.90

Employee + Family $30.91

LOCATE A SURENCY VISION NET-

WORK PROVIDER

Go to www.surency.com to locate a participating vision provider.

Be sure to click on the Access Network.

Call Surency Vision at (866) 818-8805 or access their FAQ page to

see answers to common member questions.

Monthly Vision Cost January 1, 2019 - December 31, 2019

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finances

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Voluntary Life Insurance: Help protect what matters - you, your family and your future. We understand

you’ve worked hard to get where you are today. Ensuring your loved ones can maintain financial stabil-

ity if an unexpected death should occur is something to consider when planning for the future.

Voluntary Term Life Insurance

& Accidental Death and

Dismemberment (AD&D)

Benefits Overview

Eligibility Requirement Actively working a minimum of 30 hours per week

Dependent Eligibility

Requirement

To be eligible for coverage, your dependents must be able to perform normal activities, and

not be confined (at home, in a hospital, or in any other care facility), and any child(ren) must

be under age 21, or 25 if a full time student. In order for your spouse and/or children to be

eligible for coverage, you must elect coverage for yourself.

AD&D Benefit Amount Same as the life amount elected.

Age Reduction Schedules

Insurance benefits and guarantee issue amounts are subject to age reductions:

• At age 70, amounts reduce to 65%

• At age 75, amounts reduce to 45%

• At age 80, amounts reduce to 30%

• At age 85, amounts reduce to 20%

• At age 90, amounts reduce to 15%

Spouse coverage terminates when you reach age 70

Hearing Discount Program

The hearing discount program provides you and your family discounted hearing products,

including hearing aids and batteries.

Call 1-888-534-1747 or visit www.amplifonusa.com/mutualofomaha to learn more.

Will Prep

We work with Willing to offer employees discounted online will preparation tools. In just a

few clicks you can complete a customized plan to protect your family and property (valid in

all 50 states). To get started visit www.willing.com/mutualofomaha

Coverage Guidelines

Minimum Guarantee Issue Maximum

For You $10,000 5 times annual salary, up to

$200,000

5 times annual salary, up to

$500,000

Spouse $5,000 100% of employee’s benefit,

up to $50,000

50% of employee’s benefit,

up to $100,000

Children $2,000 100% of employee’s benefit 50% of employee’s benefit,

up to $10,000

Current Enrolled Employees:

You may elect to increase insurance coverage by $10,000 up to the guaranteed issue amount at each open enrollment peri-

od without having to complete evidence of insurability. This applies for employee only, not for spouse and/or child(ren).

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Voluntary Short-Term Disability Benefits Overview

Eligibility Requirement Actively working a minimum of 30 hours per week

Elimination Period (Injury | Illness) 15th Day | 15th Day

Weekly Benefit 60% pre-tax weekly earnings

Maximum Benefit Period Up to 24 weeks

Maximum Weekly Benefit $1,000

Minimum Weekly Benefit None

Definition of Disability

Disability and disabled mean that because of an injury or illness, a significant

change in your mental or functional abilities has occurred, for which you are pre-

vented from performing at least one of the material duties of your regular job and

are unable to generate current earnings which exceed 99% of your weekly earn-

ings from your regular job. You can be totally or partially disabled during the elimi-

nation period.

Definition of Weekly Earnings

Weekly earnings for salaried employees is the gross annual salary in effect immedi-

ately prior to the date disability begins, divided by 52. Weekly earnings for hourly

employees is the hourly rate of pay multiplied by the average number of hours

worked per week during the 12 month period immediately prior to the date disa-

bility begins. If employed for part of the prior 12 month period, weekly earnings is

the hourly rate of pay multiplied by the average number of hours worked.

Pre-Existing Condition Exclusion

A pre-existing condition means any injury or sickness for which you received medi-

cal treatment, advice or consultation, care or services, including diagnostic

measures, or had drugs or medicines prescribed or taken in the 3 months prior to

the day you become insured under the policy. We will not provide benefits for any

disability caused by, attributable to, or resulting from a pre-existing condition

which begins in the first 6 months after you are continuously insured under the

policy.

Hearing Discount Program

The hearing discount program provides you and your family discounted hearing

products, including hearing aids and batteries. Call 1-888-534-1747 or visit

www.amplifonusa.com/mutualofomaha to learn more.

Voluntary Short-Term Disability: How would you pay your bills if you were sick or injured temporarily? Even

a short illness or injury could seriously impact your paycheck. Sick time will get you by while it lasts, but what

happens when your sick days run out? A short-term disability policy provides you with cash benefits when

you need it.

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Employee benefits that put more money in your pocket! Are you making the most of your employee benefits package?

We are continuing our partnership with Discovery Benefits for our Flexible Spending Account (FSA) and Dependent Care ad-

ministration to give you the opportunity to save on health care costs. Take a moment to review the options available.

Make sure you take the time to inform yourself on how these benefit offerings work. The links below will take you to im-

portant information to help you confidently navigate what is best for you and your family in the upcoming benefit year.

Account Login: Order additional debit cards (at no cost), file a claim, upload receipts, check account bal-

ances, enroll in direct deposit, find a form, pay the provider, etc.

FSA Calculator: Take the guesswork out of FSA contributions.

Eligible Expenses: Find out what expenses are eligible, you may be surprised!

FSA Store: A true place where you can shop and save.

Common Questions: Because you’re not the only one who has them.

Employee Videos: Looking for FSA 101? Click this link.

Mobile App: This FREE mobile app gives you the power to manage your benefits anytime, anywhere.

Discovery Benefits (FSA & Dependent Care) Benefit Overview

Benefit Period January 1 - December 31

FSA Maximum Contribution $2,650

Dependent Care Maximum Contribution $5,000

Eligibility Requirement 30 hours per week

Do I have to be enrolled in the district’s

medical plan to participate?

No. The IRS states no law prohibiting an employee from participating in a Flexible

Spending Account if they are not enrolled in their company’s health insurance.

Do I have to enroll/re-enroll every year? Yes. You are required to enroll/re-enroll annually; if you do not elect to enroll

then you will not be able to participate for the upcoming benefit year.

What if I have leftover funds at the end of

the benefit period?

We allow a “grace period” after the end of the benefit period, which permits a

participant to incur expenses and pay for them from their FSA funds.

What is the length of the grace period? 2 & 1/2 months for both Medical FSA and Dependent Care FSA

When and why do I need to substantiate

Benefits Debit Card transactions?

Due to IRS regulations, certain Benefits Debit Card transactions need to be sub-

stantiated. Substantiating means validating the transaction to ensure the card

was used for IRS approved items/services within the allowed time frame.

STILL HAVE QUESTIONS? Call (866) 451-3399 M-F from 6 AM - 9 PM CST

Prefer not to call? No problem! Go to www.discoverybenefits.com/contact

and choose from live chat, email, fax, or mail.

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supplementary

23

You can win the battle against a critical illness, but can you handle the added costs? Our group critical

illness plan through Aflac helps prepare you for the added costs of battling a specific critical illness.

Aflac Critical Illness Plan Benefit Overview

Illnesses 100% Covered Cancer, Heart Attack, Stroke, Major Organ Transplant, Reneal Failure

Annual Wellness Benefit $50 per Calendar Year for Employee and Covered Spouse

Monthly Premiums

Non-Tobacco Users Tobacco Users

Age Bands Employee

$10,000

Spouse

$5,000

Employee

$10,000

Spouse

$5,000

Ages 18-29 $5.45 $3.60 $7.95 $4.85

Ages 30-39 $8.55 $5.15 $13.45 $7.60

Ages 40-49 $15.55 $8.65 $30.75 $16.25

Ages 50-59 $26.68 $14.22 $51.75 $26.75

Ages 60-69 $41.75 $21.75 $81.75 $41.75

Do you know how much a trip to the emergency room could cost you? You don’t budget for accidents if

you’re like most people. Our accident insurance plan through Aflac provides 24 hour benefits to help

cover the costs of unexpected medical bills.

Aflac Accident Plan Benefit Overview

Annual Wellness Benefit $60 per Calendar Year for Employee and Covered Spouse and/or

Child(ren)

Hospital Benefits Refer to Brochure on Employee Navigator for Details

AD&D Refer to Brochure on Employee Navigator for Details

Major Injuries Refer to Brochure on Employee Navigator for Details

Specific Injuries Refer to Brochure on Employee Navigator for Details

Additional Benefits Refer to Brochure on Employee Navigator for Details

Monthly Premiums

Employee $16.21

Employee + Spouse $23.19

Employee + Child(ren) $30.90

Employee + Family $37.88

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Does your major medical insurance cover all of your bills? Even a small trip to the hospital can have a

major impact on your finances. Our Hospital Indemnity HSA-compatible plan can help cover expenses

and protect your savings.

Aflac Hospital Indemnity Plan Benefit Overview

Hospital Admission $1,000

Hospital Confinement $250 per Day

(Up to 180 days per confinement)

Hospital Intensive Care $250 per Day

(30 day maximum for any one period of confinement)

Monthly Premiums

Employee $23.70

Employee + Spouse $46.60

Employee + Child(ren) $33.70

Employee + Family $56.65

WE’VE GOT YOU

UNDER OUR WING.

Questions? Curiosity? Need help filing a claim? No

problem! Our dedicated Aflac representative is here to

assist. Contact Saida Sosa today!

Saida_Sosa@us.aflac.com or by phone at (316) 554-4990

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The LegalShield Membership Includes Services:

1. Legal Advice - Unlimited legal issues, personal, business & pre-existing

2. Letters/calls made on your behalf

3. Contracts and documents reviewed (up to 10 pages)

4. Attorneys prepare your Will, your Living Will and your Health Care Power of Attorney

5. Moving Traffic Violations

6. Trial defense including Pre-Trial & Trial Representation (on the job, criminal, or civil)

7. 25% Preferred Member Discount (Divorce, Bankruptcy, Criminal Charges, Other Matters,)

8. 24/7/365 Emergency Access (limited matters)

9. Online Legal forms

10. Member Perks (shopping discounts)

Individual or Family Monthly Cost:

$15.95 The IDShield Membership Includes Services:

1. Full Service Restoration - Complete identity recovery services by Kroll Licensed Private Investigators and our $5 million

service guarantee ensure that if your identity is stolen, it will be restored to its pre-theft status.

2. Privacy Monitoring – Monitoring your name, SSN, date of birth, email address (up to 10), phone numbers (up to 10),

driver license & passport numbers, and medical ID numbers (up to 10) provides you with comprehensive identity pro-

tection service that leaves nothing to chance.

3. Security Monitoring – SSN, credit cards (up to 10), and bank account (up to 10) monitoring, sex offender search, finan-

cial activity alerts and quarterly credit score tracking.

4. Consultation – Your identity protection plan includes 24/7/365 live support for covered emergencies, unlimited coun-

seling, identity alerts, data breach notifications and lost wallet protection.

Individual or Family Monthly Cost:

Individual $8.95 | Family $18.95

Both Services (LegalShield & IDShield Combined) Monthly Cost:

Individual: $24.90

Familiy: $30.90

Bob Pilcher bobpilcher58@gmail.com

Employee Group Benefits & Security Specialist

(620) 965-2545 office | (316) 215-5100 mobile

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403(b) & 457(b) Retirement Plans

Will you have enough money when you want to retire? It is important to start saving now.

Brought to you by the Omni Group, USD 385 has adopted a 403(b) Plan that meets the regulations of Section 403(b) of the Inter-nal Revenue Service code. The 403(b) Plan allows employees to contribute money on a pre-tax basis to approved investment companies for retirement. You may start, stop, or change coverage elected throughout the year. Omni provides a Participant Website at www.omni403b.com.The website features step by step instructions to guide you through all of the features and options. Note: Elections are offered through the Omni website link; this plan will not be provided through the Online Employee Navigator. Omni makes it easy for you to:

• Obtain vendor contact information

• Make changes to the amount of your deferral elections

• Make changes to your vendor(s)

• Request vouchers for hardship withdrawals

• Request vouchers for contract exchanges

The website is available 24 hours a day, 7 days a week.

If you do not have Internet access, have questions regarding the website or want to make a request, contact Omni Customer Service, or you may contact the District Business Office.

Omni Customer Service:

Customer Service (877) 544-6664, from 7:30 a.m. to 8 p.m. Eastern Time, Monday through Friday. For prompt assistance, please have your social security number and date of birth available.

457(b) Retirement Plan USD 385 has adopted a 457(b) plan. Vendors are: Fidelity Investments and Waddell & Reed.

Approved 403(b) Plan Vendor List

American Century Services, LLC (800) 345-3533 Lincoln National (877) 275-5462

American Fidelity Assurance Company (800) 662-1113 National Life Group (LSW) (800) 732-8939

Ameriprise Financial Services, Inc. (800) 297-2012 Voya Financial (Reliastar) (855) 663-8692

Aspire Financial Services, Inc. (866) 634-5873 MetLife (800) 638-5433

AXA Equitable (800) 628-6673 Midland National Life Insurance (866) 270-9564

Fidelity Management Trust Co. (800) 544-4774 North American Company for Life &

Health (800) 800-3656

Franklin Templeton Investments (800) 632-2301 Oppenheimer Funds (800) 835-7305

Great American Financial Resources Inc. (800) 854-3649 Security Benefit Group of Companies (800) 888-2461

Horace Mann Companies (800) 999-1030 Vanguard (800)523-1036

27

KPERS - Kansas law requires that all eligible employees must become members. As an active member you contribute a per-centage of your gross earnings.

KPERS 1 Benefits Members hired before July 1, 2009

Contribution Amount: As a KPERS 1 member you contribute 6% of your income (5% for 2014 and 4% for 2013 and before). Kansas law does not allow you to borrow from your contributions.

Earning Interest: If you became a member before July 1, 1993, your contributions earn 8% interest. On or after July 1, 1993, your contributions earn 4% interest. Source: http://www.kpers.org/active/kpers1.html

KPERS 2 Benefits Members hired July 1, 2009 through December 31, 2014

Contribution Amount: As a KPERS 2 member you contribute 6% of your income. Kansas law does not allow you to borrow from your contributions.

Earning Interest: Your contributions earn 4% interest. Source: http://www.kpers.org/active/kpers2.html

KPERS 3 Benefits Members hired January 1, 2015 and after

Contribution Amount: As a KPERS 3 member you contribute 6% of your income. Kansas law does not allow you to borrow from your contributions.

Earning Interest: Your contributions earn 4% interest annually (paid quarterly). There is also a possibility of additional interest, depending on KPERS' investment returns.

Your Retirement Credits: You earn retirement credits while working. They are based on a percentage of your pay and the number of years you’ve worked. You receive these credits quarterly and your annual credit rate increases the longer you work. They can only be used at retirement.

Years You've Worked Annual Credit Rate

< 5 years 3% of your pay

5-11 years 4% of your pay

12-23 years 5% of your pay

24+ years 6% of your pay

Source: http://www.kpers.org/active/kpers3.html

Basic Life and Death Benefits for Active Members: You have basic group life insurance equal to 150 percent of your annual salary. Your employer pays for the cost of this benefit. The Retirement System also returns your contributions and interest if you die. You can name different beneficiaries for these benefits.

Long Term Disability Benefits for Active Members: If you become disabled, you may qualify for a disability benefit based on 60 percent of your annual salary. You must be disabled for 180 days and no longer receive employer compensation. You must apply for Social Security benefits and complete any appeal process.

Job Related Death Benefit: If you die from an on-the-job accident, your spouse will receive a monthly benefit based on 50 percent of your final average salary, less any Workers’ Compensation. The Retirement System also returns your contributions and interest if you die. You can name different beneficiaries for these benefits.

Optional Group Life Insurance (OGLI) for Active Members, Spouse and Children: This is an addition to the coverage that is already provided to you just by being a KPERS member. The cost of the life insurance is paid by the employee. As of January 2016, your employer will offer member, spouse, and child OLGI coverage.

Contact information: (888) 275-5737 | Fax (785) 296-6638 | Email kpers@kpers.org | Website: www.kpers.org

Coverage Amount Cost to Employee Participant Who is Eligible?

$10,000 $1/month – Covers all children in family Children up to age 26

$20,000 $2/month Children up to age 26

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miscellaneous

29

For nearly 40 years, EMPAC has provided assistance, counseling, and education to employees and their

families to help them live healthy, balanced lives. This benefit, provided by your employer, provides the

following for you, your spouse/significant other, and dependents living in your home:

• 24/7 telephone access to a counselor

• Up to 3 in-person counseling sessions per issue for each household member per year at no cost to

the employee (limit 2 issues per year). This could be regarding stress management, marriage issues,

parenting issues, alcohol or drug issues, grief, self-esteem, work/life balance, divorce recovery,

school issues, etc.

• Web based resources on our website for self-help on a variety of topics.

• Training on a variety of subjects at our Wichita office, via our webinar library, and on site at your loca-

tion.

• Newsletters for employees and supervisors Referrals to partners addressing other issues such as:

Legal consultation with an attorney. (Up to 30 minutes via phone or in person, with discounts

for attorney fees if, after the free consultation, the situation requires hiring an attorney).

Money Management – Help with personal financial. (Budgeting, debt reduction, savings strate-

gies, etc.)

If you have further questions, or need to schedule a confidential counseling session, please call us

at: 316.265.9922 or 800.234.0630

Benefit Overview for

Andover Public Schools USD 385

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The Foundation for Andover Schools

The Foundation for Andover Schools, formerly the Andover Advantage Foundation, is a 501(c)3 non profit fundraising partner of USD 385. Contributions to the Foundation through employee payroll deduction are tax-deductible and 100% of your donation goes toward the funding of teacher grants. Since inception in 1997, the Foundation has awarded over $1 million to more than one thousand teacher grants.

Andover Education Association (AEA)

The association is the bargaining unit for teachers of USD 385 and protects the rights of educators and sup-port personnel. Also, the AEA and the KNEA provide $1 million in liability insurance. AEA membership is han-dled annually by the Association at the beginning of the year. The district will provide payroll deductions for the member dues at the direction of the Association. If you have any questions regarding association mem-bership, please contact Gina Miller at 316-218-4610 or millerg@usd385.org

United Way

United Way of the Plains is a local, volunteer-driven organization. United Way brings the community together to address critical issues such as care for the elderly, youth at risk, disaster relief and more.

Direct Deposit

Direct deposit is required for all employees. Employees that do not have a bank account will be issued a pay card (debit card) for payroll purposes. Sign up for this service can be completed at the district office.

Leave

The district offers all employees who qualify, leave days. See your Classified Handbook or Negotiated Agree-ment for more information.

Notices

Reference our “Notices Packet” located in Employee Navigator for the most up to date benefit notices.

31

Medical/Rx: BlueCross BlueShield of Kansas (BCBSKS)

Phone: 1-800-432-3990 Website: www.bcbsks.com

• Call when need to order a new ID card

• Call for list of in-network providers

• Call for questions regarding billing

• Call for questions regarding deductibles and coverage

Don’t forget to sign up for BlueAccess!

• Find in-network doctors

• Pull up medical ID card

• Find Urgent Care facilities fast and easily

• Check the status of claims

• Manage personal health records

Dental: Delta Dental

Phone: 316-264-4511 / 1-800-234-3375 Website: www.deltadentalks.com

Download the Delta Dental mobile app!

• View your ID card

• Find a dentist

• Check claims and coverage

Vision: Surency

Phone: 1-866-8805 Website: www.surency.com

Download the Surency Vision mobile app!

• Find a doctor

• Check your eligibility or claim status

• Access your mobile ID card

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Life/AD&D and Short-Term Disability: Mutual of Omaha

Phone: 1-800-775-8805 / 1-800-877-5176

Website: www.mutualofomaha.com

Medical FSA & Dependent Care FSA: Discovery Benefits

Phone: 1-866-451-3399

Website: www.discoverybenefits.com

Aflac

Phone: 1‐800‐594‐0880

Email: Saida_Sosa@us.aflac.com

Website: www.aflac.com

Legal Shield

Phone: 620‐965‐2545

Mobile: 316‐215‐5100

E‐mail: bobpilcher58@gmail.com

Website: www.bobpilcher.com

Employee Assistance Program: EMPAC

Phone: 316-265-9922 / 800-234-0630

Address: 300 W Douglas Ave, Suite 930 Wichita, KS 67202

Website: www.empac-eap.com

IMA

Phone: 316-266-6322

E‐mail: Megan.Larsen@imacorp.com

Website: www.imacorp.com

33

This Benefit Guide was prepared by IMA, Inc. Please consult your certificates/policies for complete plan provisions and limitations. 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 were taken from various summary plan descriptions and plan information. While every effort was taken to

accurately report your plans, discrepancies, or errors are always possible. In case of discrepancy between the Guide and the actual plan

documents the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Ac-

countability Act of 1996. If you have any questions about your Guide, contact Human Resources