1. TCA - East Texas coop 2019-20 Benefits
Benefit Plan Information

2. Things to Remember
Benefits will become effective September 1st and will remain in effect until August 31,
You must enroll or decline coverage on you AND your eligible dependents (even if you aren’t taking coverage).
You can only change your benefits during Open Enrollment unless you experience an IRS defined Qualifying Event.

4. 2019-20 New TCA Benefit Offerings
Flexible Spending Accounts
Health Savings Account
Hospital Indemnity Plan
Employee Life (No health questions up to Guarantee Issue Amount, $250,000)
Emergency Medical Transportation Plan
Critical Illness Plan
Identity Theft Protection Plan
Accident Plan
Telehealth Plan

5. ACTIVECARE 1-hd: Why should you elect this plan?
TCA Offers Higher Employer Contributions
Plus TCA Offers Additional Employer Paid Benefits if you Elect AC1-HD Medical Plan

6. TRS Medical Overview Member Services: 1-800-223-8778
Monday–Friday, 7 a.m.–6 p.m. Automated information available day or night, seven days a week ​​
TRS-Care General Questions: ​ ​ (TRS Health & Insurance Benefits Eligibility and Enrollment) Monday – Friday, 7 a.m.-6 p.m.
Medical elections must be made by August 8th to receive new medical card by September 1st.
Remember: Meet Deductible first, then insurance will kick in to 80/20 up to Out-Of-Pocket Max. Only then will the plan pay 100% of costs. Co-pays do not apply to deductible.
In-network Preventative Services are paid 100%

7. Helping with out-of-pocket costs
HSA: A tax-sheltered medical savings account to help pay toward eligible medical expenses. Must be enrolled in the ActiveCare 1-HD medical plan to be eligible to enroll in a health savings account! 2019 Annual Contributions Maximums Employee Only: Up to $3,500/Family: Up to $7,000/Age 55+ additional $1,000 catch-up contribution
Funds are available for use only as they are contributed
Funds roll over from year to year
You will receive a debit card
No monthly service fees
Telehealth: A cost saving benefit allowing you to obtain a diagnosis and prescription over the phone, 24/7/365 (including holidays) for non-emergent care. One low cost covers the entire family.
FSA: Use pre-tax dollars to help pay toward eligible medical expenses.
Contribute up to $2,700 Annually
Use it or lose it (TCA offers a $500 roll-over).

8. Accident Coverage for Accidental Injuries.
Pays actual charges up to specified benefit amount for: physicians treatment surgery, x-rays reductions of fractures and dislocations, and/or other emergency treatment expenses.
Ambulance benefit, Hospital Confinement, and AD&D benefit also available.
Coverage for accidents that happen on and off the job (24 hours)
Gold and Platinum plan options available

9. New! Hospital Indemnity
Replacing anyone currently enrolled in GAP
3 Options: $1,500/ $3,000/ $5,000
Not contingent on being enrolled in any Medical plan and works with HSA.
In-patient only with daily hospital benefit

10. Disability
Disability insurance pays a portion of your salary if you are unable to work due to a covered disability. When reviewing these coverages, consider how long you can personally go without receiving a paycheck.
Short-Term Disability – Benefits are available in $50 increments from $100 to $1000, up to 60% of salary.
Long-Term Disability % Employer Paid Benefit for all eligible full time employees

11. Employee Assistance Program (EAP) No cost to you!

12. Group life insurance Voluntary Life Employee Paid: UNUM
Employee Guarantee Issue up to $250,000, no health questions!
Up to $50,000 GI for Spouses, and up to $10,000 for Dependents (to age 26)
Rates are age banded. This means they can increase as you age.
Benefits reduce to 65% at 65; 50% at age 70
Basic Life Employer Paid: UNUM
All eligible employees will receive at least $10,000 Basic Life Insurance*.
This benefit is paid to your beneficiary should you pass away while employed with the district

13. Dental- New Rates High Plan
$1500 Calendar Year Maximum; $100 Annual Increase with Preventive Care
100% Preventive & Diagnostic 80% Basic Restorative Care 50% Major Restorative Care
50% Ortho Available for Dependents to age 26 ($1,000 Ortho max)
$50 Deductible for Basic and Major Restorative Care
Low Plan
$1000 Calendar Year Maximum; $100 Annual Increase with Preventative Care
100% Preventive & Diagnostic 50% Basic Restorative Care 50% Major Restorative Care
No Orthodontia on the Low Plan
$50 Deductible for Basic and Major Restorative Care
Must stay in-network!

14. Vision $10 Copay for Exam/$25 Copay for Materials Exam every 12 months
Lenses every 12 month
Frames every 12 months
$130 Frame Allowance
Contacts covered in lieu of glasses/$150 Allowance for contacts
New Warby Parker retailers
Lens Options: Single Vision, Bifocal, Trifocal, Lenticular, Scratch-Coating, Poly-CarbonateProgressive

15. Critical Illness + Cancer
Current Critical Illness enrollees will be moved into equal benefit. New Attained Age pricing.
Benefits from $10,000 up to $30,000 in 5k increments
Same portal as Medical and Hospital Indemnity to file claims
Now will cover invasive Cancer, Carcinoma in Situ (non-invasive), and Skin Cancer
Heart Attack, Stroke, Coronary Artery Condition Requiring Bypass Surgery, Major Organ Failure, End-Stage Renal Failure, Paralysis, Loss of Sight, Loss of Hearing, Occupational HIV, Coma, Benign Brain Tumor, Third-Degree Burns, Alzheimer, Parkinson, Lupus, Multiple Sclerosis, Muscular Dystrophy

16. Cancer $50 Annual Wellness Benefit
First Occurrence $2,500, $5,000, $7,000
Daily Radiation, Chemo, Immunotherapy And Experimental Treatment Benefit Rider Surgical expense
Breast reconstruction
38 additional diseases Encephalitis, West Nile, Rabies, Lyme, ALS, MS, Sickle Cell Anemia
ICU $500/day any reason, $1000/day cancer
FYI:
12 Month waiting period for Pre-existing Conditions
Guaranteed Issue
Fully Portable
Benefit pays directly to you

17. Emergency Transport/ Identity Theft
MASA
No Network limitations
No dollar limits on ER Transport costs
Emergency Helicopter Transport
Emergency Ground Ambulance
Platinum plan offers Mortal remains transport, return transport, organ retrieval, vehicle return, etc.
One low cost covers entire family on either plan
ID Watchdog
Identity Theft benefit that conducts monthly ID Advanced Monitoring.
Credit report monitoring Full ID Restoration
Sexual Offender monitoring
1B plan monitors 1 Credit Bureau
Platinum plan monitors all 3 Credit Bureaus and provides annual credit report and scores

18. WANT TO LEARN MORE? WWW.ETXEBC.COM

19. * * Please note all phone calls are recorded