Harrison School District Two Benefits

1. Harrison School District TwoBenefits Welcome to Harrison School District Two. If you have questions or need assistance, call Sherie Shupe the Insurance Risk Manager at 719-579-2011 or by e-mail at sshupe@hsd2.org. The fax number is 719-579-2138.

2. CRITICAL INFORMATION • The Benefits guidebook is located at: http://www.hsd2.org/departments/finance/benefit-guidebook • IMPORTANT NOTE: This PowerPoint is designed to be informational only. Actual benefits may vary and are subject to the official plan documents. Changes to these documents may occur at any time.  In the event of a conflict between this information and the certificates of coverage, plan documents, SPDs, contracts or policies - the certificates of coverage, plan documents, SPDs, contracts and policies shall govern. Certificates of coverage are located on the Benefits web page, click Summary Plans for access or contact the District Benefits Office (719) 579-2011 for more information. • If you don’t enroll in medical insurance with Harrison, we need proof that you have insurance elsewhere or a written statement that you currently do not have medical insurance. Please either hand deliver, fax (719-579-2138) or scan and e-mail to us. DO NOT SEND THROUGH THE COURIER!

3. CRITICAL INFORMATION • Eligibility – If you are hired in a benefit eligible position, you are eligible the 1st of the month following the second month of employment (i.e. hired in August-eligible October 1; hired in September-eligible November 1, etc.) • Premiums are deducted from your paycheck the month prior to the month that coverage is for, i.e., October’s premiums will be deducted from September’s paycheck. The only exception to this is for flexible spending accounts. They are deducted the month OF (i.e. October’s contribution is deducted in October.) • It is your responsibility to check your pay stubs EVERY month to make sure they are correct – including the deductions!

4. CRITICAL INFORMATION (continued) • Initial eligibility period – You must enroll within 31 days of eligibility. If your enrollment form is received after payroll the deadline, it could result in double or triple premiums being deducted on your next paycheck. • Eligible Dependents; it’s your responsibility to notify us of ineligible dependents for COBRA. No premiums will be refunded if you fail to notify us with 31 days of a dependent losing their eligibility status and it changes the coverage level and premium amount deducted. The District requires proof your dependents are your eligible dependents. This information is listed in the Critical Information section of the guidebook. • You cannot pickup or drop insurance anytime you want – only during the initial eligibility period (explained above), annual open enrollment (always held in April/May), or if you have a qualifying event.

5. QUALIFYING EVENTS • No changes to elections allowed unless Open Enrollment or Qualifying Event: Please visit the webpage to see a list of qualifying events and the details surrounding qualifying events (www.hsd2.org, Departments, Finance, Highlight Benefits Tab, Guidebook, Critical Information). • The life and disability plans are not subject to the same Qualifying Event guidelines, so if you have questions on these plans, please contact us. • Qualifying Event changes are governed by the IRS, Department of Labor, and the Centers for Medicaid/Medicare and must be completed on the e-portal (instructions on the benefits webpage within 31 calendar days or the change will not be allowed.) • Dissatisfaction with a plan and financial hardship are not qualifying events, so choose carefully.

6. IMPORTANT INFORMATION • All of our plans are unbundled – you do not have to enroll in medical to get dental, etc; HOWEVER you as the employee must be enrolled to cover dependents. • The only plans that “stack” are Anthem Life (which means you must buy the Basic life to purchase optional employee or dependent life). Information on these plans is located on the benefits web page. • Our medical plans do not require primary care physicians, they do not require referrals to see a specialist, they do not have pre-existing condition limitations, and they do not have lifetime maximums.

7. PREMIUMS AND LEAVES OF ABSENCE • The premiums for the medical, dental, and vision plans are available on-line under the Guidebook. • Please note that there are Full-time and Part-time premiums. Full-time vs. part-time is defined under the “Critical Information” tab of the guidebook. • If you need to take a leave of absence, you must complete the leave of absence paperwork and submit it to Human Capital. • Leave of absence – depending on whether eligible under Family Medical Leave Act (FMLA) or not and depending on the length of the leave, you may be responsible for the whole premium and/or only have the option to continue medical, dental and/or vision insurance through COBRA.

8. ANTHEM BLUE CROSS & BLUE SHIELDMEDICAL INSURANCE • Descriptions of the two plans offered are available on the benefits web page. • Compare the provisions of the plans carefully before making your selection to choose the plan that best fits your needs. • www.anthem.comis the web site for Anthem Blue Cross and Blue Shield • It is the employee’s responsibility to make sure all services utilized are in-network, otherwise additional costs could be incurred. There are several notices on the benefits web page that go into more detail on this, specifically related to laboratory services. These notices can be found at http://www.hsd2.org/departments/finance/important-notices

9. ANTHEM (continued) • Penalties can apply for receiving non-network services that require pre-certification and pre-certification not obtained. • Cards are only issued to employees and spouses only, sharing the same randomly issued ID number. To obtain a separate card for a dependent child(ren), call Anthem at 1-800-542-9402. • It is recommended that you log-on to Anthem’s site and create a user name and password for yourself so you have access to your information should your card be lost/stolen. You can use your ID number if you’ve received your card or social security number to create this sign-on, once we’ve enrolled you in their system • No sign-on is required to search for participating providers

10. DELTA DENTAL OF COLORADODENTAL INSURANCE • Descriptions of the two plans offered are available on the benefits web page. • Compare the provisions of the plans carefully before making your selection to choose the plan that best fits your needs. • www.deltadentalco.com is the web site for Delta Dental. To search for a dentist by name visit Delta’s national web site at www.deltadental.com. • No ID cards will be issued – follow instructions on Benefits webpage http://www.hsd2.org/departments/finance/dental-benefits to register and then you’ll see the option to “print ID card”.

11. DELTA DENTAL (continued) • No sign-on is required to search for participating providers. • If you enroll in the EPO plan, CONFIRM participating dentists by calling Delta or verify on Delta’s web page as there are no out-of-network benefits. Using an out-of-network dentist on this plan will result in you being responsible for the entire cost. • The EPO plan does not guarantee out of state coverage unless it is a dental emergency, so if you have dependents that live outside of Colorado, there may not be coverage for dental services.

12. VISION SERVICE PLAN(VSP)VISION INSURANCE • A description of the plan offered is available on the benefits web page. • www.vsp.com is the web site for Vision Service Plan. • No ID cards will be issued. Your social security number is your ID number. You can go to any eye doctor you wish; however if they are not contracted with VSP it will cost you more out of your pocket. • Provide the eye doctor’s office with your social security number, they look you up in VSP’s system and you’re all set. • DO NOT GIVE THEM YOUR ANTHEM ID CARD. There is a provision on our medical plan that allows an eye exam once every 24 months, but there is no coverage for glasses or contacts. If you choose to use your medical plan for the eye exam, you will be subject to the co-pays on our medical plan for that service.

13. SECTION 125 FLEXIBLE SPENDING ACCOUNTSAND AMERICAN FIDELITY ASSURANCE • 3 Options to Participate: • Section 125 Pre-Tax Premium Deduction plan: • If you enroll in medical, dental, and/or vision and the premium is deducted on a pre-tax basis. TAKE NOTE, the Default setting on the e-portal is pre-tax. If you want after-tax YOU MUST CHANGE IT. • You are required annually to complete Section 125 enrollment either via AFEnroll or by meeting with an American Fidelity representative or your premiums will be converted to an “after-tax” basis. • Section 125 unreimbursed medical account (minimum monthly contribution is $25, maximum monthly contribution is $208.33 – these are IRS limits). These are additional monies taken from your paycheck on a pre-tax basis to reimburse yourself for qualified expenses not covered by your insurance.

14. SECTION 125 & AMERICAN FIDELITY (continued) • Section 125 dependent daycare account (minimum monthly contribution is $25, maximum monthly contribution is $416.66, annual maximum is $5,000 – these are IRS limits). • American Fidelity offers additional products such as: Critical Illness, Cancer, Accident, and Life insurance. There is a link to American Fidelity’s web page on the benefits web page under American Fidelity Voluntary Insurance Products. • To enroll in one of the above products, you must do so through an American Fidelity Representative. You can contact American Fidelity at (800) 365-9247.

15. Anthem Life/AD&D Plans • THESE ARE THE ONLY PRODUCTS YOU CANNOT ENROLL IN VIA THE E-PORTAL. YOU MUST PHYSICALLY PRINT THE FORM FROM THE FINANCE FORM PAGE. ONCE COMPLETED THE FORM MUST BE RETURNED TO THE BENEFITS OFFICE VIA HAND DELIVERY, FAX OR SCAN AND E-MAIL. DO NOT SEND IN THE COURIER! • If you enroll in the Basic Life/AD&D, the District will pay 50% of premium on your behalf. The policy is for 1 x Base Annual Salary, rounded to the next higher $1,000. The policy amount premium will change automatically if your salary changes (subject to the limits/restrictions on the plan listed in the additional information available on the web page). • You must enroll in the basic life to be able to enroll in additional optional employee life or dependent life.

16. Anthem Life/AD&D (continued) • If you elect the Basic Life, you are also eligible to enroll in the optional employee life. The plan offers coverage in increments of $10,000 up to $200,000 for the employee. YOU MAY SELECT ANY AMOUNT THAT DOES NOT EXCEED 5X YOUR ANNUAL SALARY. If you elect an amount that exceeds the amount you’re allowed, the benefits office will reduce it to the next available amount. • They only guarantee issue policies from $10,000 to $150,000. If you elect (and are eligible to elect) an amount from $160,000 to $200,000 you will be required to complete an Evidence of Insurability form. • If you elect the Basic Life and a minimum of $10,000 optional life, you are also eligible to enroll in the optional dependent child life. The plan is a $10,000 policy on each child under age 26. The cost is $2.00/month regardless of the number of children.

17. Anthem Life/AD&D (continued) • If you elect the Basic Life and a minimum of $20,000 optional life, you are also eligible to enroll in the optional spouse life. The plan offers coverage in increments of $10,000 up to $100,000 for the employee’s spouse. YOU MAY SELECT ANY AMOUNT THAT DOES NOT EXCEED MORE THAN 1/2 YOUR OPTIONAL EMPLOYEE COVERAGE AMOUNT. If you elect an amount that exceeds the amount you’re allowed, the benefits office will reduce it to the next available amount. • They only guarantee issue policies from $10,000 to $50,000. If you elect (and are eligible to elect) an amount from $60,000 to $100,000 your spouse will be required to complete an Evidence of Insurability form. • Qualifying Events are completely different on these plans. Contact the benefits office for additional information.

18. Anthem Disability Plans (Short-Term and Long-Term) • If you enroll in the Long Term Disability plan, the District will pay 50% of premium on your behalf. Upon approval & verification of illness/injury, the plan pays 60 % of base monthly earnings after 90 days of disability. Maximum monthly benefit is $7,000. • If you enroll in the Short Term Disability, upon approval & verification of illness/injury, the plan pays 60% of base weekly earnings on the 8th day of injury, 8th day of illness, for a maximum of 13 weeks, (i.e. maternity, mental health, etc.). Maximum weekly benefit is $1,000.

19. Disability Plans (Short-Term and Long-Term) • Pre-existing conditions apply on both disability plans. Additional information on both these plans is located on the benefits web page. • These plans are offered on a guarantee issue basis during your initial eligibility period ONLY. All plans are subject to medical underwriting outside of original offering period. (See additional information on benefits web page.) • Qualifying Event guidelines do not apply to these plans.

20. WORKERS’ COMPENSATION & SAFETY • If you are injured on the job you are required by state law and District policy to complete an “Accident Report” form (located with school nurse or on-line EVEN IF YOU ARE NOT GOING TO TREAT FOR THE INJURY. • District policy requires it to be fax to the benefit’s office within 24 hours of injury, BUT WE PREFER THE SAME DAY AS INJURY IF POSSIBLE. • The benefits office must provide authorization for treatment of injury. • You must see the designated medical provider (DMP) if injury occurs during the regular business hours of one of our providers (Integrity Urgent Care, Concentra or HealthQuest). If you are a military dependent, DO NOT use a military doctor, hospital or facility for work related injury care.

21. WORKERS’ COMPENSATION & SAFETY (con’t) • You may go to the Emergency Room (Penrose or Memorial NOT THE MILITARY HOSPITALS) if none of the designated medical providers (DMP) are open; HOWEVER, you’ll still have to see one of the DMP’s the very next business day. • Integrity has evening and weekend hours. • The addresses and phone numbers for the designated medical providers are located on the benefits web page under Workers’ Compensation or by following this link: http://www.hsd2.org/departments/finance/workers-comp

22. Use common sense and be aware of where you are. DO NOT STAND ON CHAIRS, TABLES, COUNTER TOPS, ETC. Ask the custodian to get you a step ladder or ask for help. • Don’t lift things that are too heavy for you, watch for uneven and slick surfaces, wear proper footwear for the weather, use proper safety equipment. • BE CAREFUL! Do everything possible to avoid an injury to yourself, co-workers, and our students. • Failing to adhere to the safety guidelines provided to you in the District Safety Guidebook could result in a Worker’s Compensation injury being marked as a “safety violation” and could reduce your benefits by as much as 50%.