2022 BENEFITS INFORMATION GUIDE - Understanding your Options - Pflugerville ... (2024)

2022 BENEFITSINFORMATION GUIDE Understanding your Options

HELLO!Welcome to your 2022 Benefits Information Guide.At Pflugerville ISD, we understand the importance of a well-rounded benefits program and are dedicated toproviding you with unique benefits that meet the needs of you and your family. We are proud to offer a rangeof plans that help protect you in the case of illness or injury. This Benefits Information Guide is acomprehensive tool to help you become familiar with the plans and programs that you and your family canenroll in for the plan year.Enclosed you will find: • Step by step instructions on how to enroll • Summary information about each medical, dental, vision, life, disability and worksite benefit option • Information on additional benefits such as flexible spending, health savings account and the employee assistance program (EAP) • Directory and contact information, in case you have questionsAnd much more!We’re here to help!If you have any questions at all,please contact the PfISD Benefits Department.(512) 594-0026benefits@pfisd.net

GETTING STARTED 4 4 EnrollmentMEDICAL 7 7 Medical 9 Prescription Drug Coverage 10 Medical Plan Summaries 12 Premiums 13 Virtual VisitsTAX SAVINGS 14 14 Health Savings Account (HSA) 16 Flexible Spending AccountDENTAL & VISION 17 17 Dental Plan 18 Vision Plan 19 PremiumsLIFE & DISABILITY 20 20 Voluntary Life & AD&D 21 Voluntary DisabilityWORK/LIFE 22 22 Voluntary Worksite Benefits 25 Identity Protection & Employee Assistance ProgramRATES 26 26 Rates by planADDITIONAL RESOURCES 30 30 Member Support 31 Leave and Absences 32 Directory & Resources

ENROLLMENT GETTING STARTEDWho can Enroll?If you are an employee regularly working a minimum of 30 hours per week, you are eligible to participate in the benefitsprogram. Eligible employees may also choose to enroll family members, including a legal spouse/ registered domesticpartner (as legally defined under state and local law) (hereinafter referred to as “registered domestic partner”) and/oreligible children.When Does Coverage Begin?The coverage plan year is January 1, 2022 to December 31, 2022. For new hires, coverage begins on the first day of themonth following your date of hire. If you miss the enrollment deadline, you may not enroll in a benefit plan unless you have a change in TIP status during the plan year. Please review details on IRS qualified change in status events for more information.HOW DO I ENROLL?TBXTo enroll, simply follow these steps:• Visit https://tbx.benselect.com.• Under User ID, enter your employee ID Number with three zeros before the number – example 000801001 or Social Security Number with no dashes. Do not use an e in front of your ID number.• Under Personal ID Number (PIN), enter the last 4 digits of you Social Security Number and the last 2 digits of your birth year.• Follow the steps displayed on the site and click “Next” to move on to the next section.• Once you’ve completed all your elections on your benefits, you’ll be taken to a “Review/Sign Forms” screen. Click “Sign Form” after you have reviewed all of the forms to confirm all of your elections.4. PFLUGERVILLE ISD 2022 Benefits Information Guide

WHAT IF MY NEEDS CHANGE DURING THE YEAR?You are permitted to make changes to your benefits outside of the open enrollment period if you have a qualified change in GETTING STARTEDstatus as defined by the IRS. Generally, you may add or remove dependents from your benefits, as well as add, drop, orchange coverage if you submit your request for change within 60 days of the qualified event. Changes in benefit electionsmust correlate with your qualifying event. For example, if you have a child, you may add them as a dependent on yourmedical plan, but you would be unable to remove any previously elected coverages for your spouse until the next enrollment.Change in status examples include:• Marriage, divorce or legal separation.• Birth or adoption of a child.• Death of a dependent.• You or your spouse’s/ registered domestic partner’s loss or gain of coverage through our organization or another employer.• You gain or lose eligibility for Medicaid, Medicare or state health insurance programs• You have a change in employment status where you have a reduction in hours to an average below 30 hours of service per week, but continue to be eligible for benefits, and you intend to enroll in another plan. The plan must provide Minimum Essential Coverage that is effective no later than the first day of the second month following the date of revocation of your employer sponsored coverage.DO I HAVE TO ENROLL?You may elect to “waive” medical coverage if you have access to coverage through another plan. It is important to note thatif coverage is waived, the next opportunity to enroll in our group benefit plans will be during open enrollment for an effectivedate of January 1, 2022, or if a qualifying status change has occurred.5. Pflugerville ISD 2022 Benefit Information Guide

YOUR HEALTH NO SE QUEDE SIN LA INFORMACIÓN DE SUS BENEFICIOS: ¡LLÉVELA A TODAS PARTES!¡Descargue hoy la aplicación PfISD Insider! Recibirá un correo electrónico de Ingaged-No-Reply@pfisd.net en breve, asegúrese de 6. PFLUGERVILLE ISD 2022 Benefits Information Guide registrarse y descargar la aplicación.

MEDICALWhat are my Options? YOUR HEALTHUse the chart below to help compare medical plan providers and determine which would be the best for you and your family. BLUECROSS BLUESHIELD HEALTHCARE HIGHWAYS (BCBS) (HCH) HCH Sync BlueChoice PPO You must see a network provider. Out-of- You must see a network provider. Out-of- network services will not be covered. Network network services will not be covered. Limited local network of providers. Network Broad national network of providers. Network providers are found in Texas and Oklahoma providers are found throughout the US. only. Medical benefits will be provided through Medical benefits will be provided through BlueCross BlueShield of Texas. Healthcare Highways. Medical benefits Services covered by BCBS medical plans are Services covered by HCH medical plans are consistent with services covered by HCH. This consistent with services covered by BCBS. includes any visit limits. This includes any visit limits. Prescription drugs will be covered by Express Prescription drugs will be covered by Express Prescription benefits Scripts. Scripts. Claims Process Usually providers will submit claims Usually providers will submit claims To find a provider online: • Visit www.bcbstx.com To find a provider online: • Click on Find Care, then Find a Doctor • Visit www.healthcarehighways.com or Hospital • Click Find a Provider in the top right • Select Search as a Guest corner • Search where you would like care • Select the HCH Sync – TX network Find a Provider • Select the Blue Choice PPO under • Search for a doctor or facility by Plans to show In Network options name or specialty • Then browse by category or search for a name or specialty You can also find a provider by calling 833- You can also find a provider by calling 972- 841-6703 766-6900 or the number on the back of your membership ID cardPFLUGERVILLE ISD 2022 Benefits Information Guide 7.

MEDICALWhat are my Options? YOUR HEALTHThe health plans provided to you by Pflugerville ISD are EPO Plans. EPO stands for Exclusive Provider Organization. Thismeans that when you select one of the plans, you must access health care services from doctors, hospitals, and other careproviders who are within the plan’s network. Costs will not be covered when utilizing care outside of the plan’s network. EPO EPO HDHP + HSA BlueCross Blue Shield or BlueCross Blue Shield or Healthcare Highways Healthcare Highways No referral required Seeing a Primary Care No referral required You will pay the full cost of the office visit Physician (PCP) or a You will pay your copay for routine office visits until you meet your deductible. Then you will Specialist until you meet your maximum out of pocket. pay 30% of the cost until you meet your maximum out of pocket. You will pay the full cost of your prescription until you meet your deductible. Then you will Prescription benefits You will pay a copay for covered drugs. pay 30% of the cost until you meet your maximum out of pocket. You will pay the full cost until you meet your You will pay the full cost until you meet your Inpatient Services and deductible. Then you will pay 20%-30% of the deductible. Then you will pay 30% of the cost Outpatient Surgery cost until you meet your maximum out of until you meet your maximum out of pocket. pocket. Claims Process Usually providers will submit claims Usually providers will submit claims Compatible with a Health Savings Account No Yes (HSA) Compatible with a Yes, compatible with a Health FSA, Limited Only compatible with a Limited Purpose FSA Flexible Spending Purpose FSA, and Dependent Care FSA and a Dependent Care FSA Account (FSA) • This plan requires that you see a • This plan requires that you see a doctor in a specific network to doctor in a specific network to receive coverage. receive coverage. Other Important Tips • Out-of-Network services will not be • Out-of-Network services will not be covered. covered. • Emergencies covered worldwide. • Emergencies covered worldwide.Please note the above examples are used for general illustrative purposes only. Please consult with your Benefits Office formore specific information as it relates to your specific plan. For a detailed view of your medical plan summaries, visitwww.pfisd.net/benefits.8. PFLUGERVILLE ISD 2022 Benefits Information Guide

PRESCRIPTION DRUG COVERAGEMany FDA-approved prescription medications are covered through the benefits program. Important information regarding yourprescription drug coverage is outlined below: YOUR HEALTHExpress Scripts Prescription Drug Plan• The Express Scripts plan covers 4 different tiers of drugs: generic, preferred brand-name, non-preferred brand name, and specialty.• The Low and High plans prescription drug plans require copay depending on the drug’s tier. The HDHP plan requires a flat coinsurance after the deductible has been met.• Generic prescriptions offer the greatest value compared to other drugs that treat the same conditions and are often the lowest cost. Generic drugs are required by the FDA to contain the same active ingredients as their brand-name counterparts.• Preferred brand-name drugs have a moderate copayment. Some drugs may also have a generic equivalent.• Non-preferred brand-name drugs have a higher copayment compared to the lower tiers, as they are higher cost drugs. Some drugs on this list may have a generic or preferred brand-name counterpart.• Specialty drugs are used to treat complex, chronic conditions, and may require special storage or close monitoring.For a current version of the prescription drug list, go to www.express-scripts.com.WHY PAY MORE?There are a few ways you can save money when using the Prescription Drug Plan. Visit pfisd.mydrugcosts.com to find out more waysto save.PFLUGERVILLE ISD 2022 Benefits Information Guide 9.

PLAN HIGHLIGHTS BCBS HIGH PLAN HCH LOW PLAN BCBS LOW PLAN In-Network Only In-Network Only In-Network Only YOUR HEALTH Annual Plan Year Deductible Individual $1,500 $2,000 $2,600 Family $3,000 $4,000 $5,200 Maximum Plan Year Out-of-pocket (1) Individual $5,000 $5,500 $6,500 Family $10,000 $11,000 $13,000 Professional Services Primary Care Physician (PCP) $35 $20 $40 Specialist $50 $35 $55 Virtual Visits No Charge No Charge No Charge Preventive Care Exam No Charge No Charge No Charge Diagnostic X-ray and Lab No Charge No Charge No Charge Complex Diagnostics (MRI/CT Scan) 80% after deductible 80% after deductible 70% after deductible Therapy, including Physical, $35 / $55 $35 $40 / $55 Occupational and Speech Hospital Services Inpatient 80% after deductible 80% after deductible 70% after deductible Outpatient Surgery 80% after deductible 80% after deductible 70% after deductible Emergency Room $400 + 20% coinsurance $400 + 20% coinsurance $500 + 30% coinsurance Urgent Care $50 $35 $55 Maternity Care Physician Services (prenatal or $35 $20 $40 postnatal) Hospital Services 80% after deductible 80% after deductible 70% after deductible Mental Health & Substance Abuse Inpatient 80% after deductible 80% after deductible 70% after deductible Outpatient $35 $20 $40 Retail Prescription Drugs (30-day supply) Generic $15 $15 $15 Preferred Brand $40 $40 $50 Non-preferred Brand $65 $65 $75 10% copay capped at 10% copay capped at 10% copay capped at Specialty $2,500 $2,500 $2,500 Mail Order Prescription Drugs 3x Retail 3x Retail 3x Retail (90-day supply) Monthly Employee Premiums BCBS High Plan HCH Low Plan BCBS Low Plan Employee Only $185 $63 $80 Employee and Spouse/Domestic $730 $560 $600 Partner Employee and Child(ren) $570 $390 $410 Employee and Family $1,120 $870 $940(1) Out-of-pocket maximum is based on the maximum allowable charge the carrier allows.The above information is a summary only. Please refer to your Evidence of Coverage for complete details of Plan benefits, limitations and exclusions.10. PFLUGERVILLE ISD 2022 Benefits Information Guide

PLAN HIGHLIGHTS BCBS HD PLAN HCH HD PLAN YOUR HEALTH In-Network Only In-Network Only Annual Plan Year Deductible Individual $2,800 $3,300 Family $5,600 $6,600 Maximum Plan Year Out-of-pocket (1) Individual $6,750 $6,750 Family $13,500 $13,500 Professional Services Primary Care Physician (PCP) 70% after deductible 70% after deductible Specialist 70% after deductible 70% after deductible Virtual Visits No charge after deductible No charge after deductible Preventive Care Exam No Charge No Charge Diagnostic X-ray and Lab 70% after deductible 70% after deductible Complex Diagnostics (MRI/CT Scan) 70% after deductible 70% after deductible Therapy, including Physical, Occupational 70% after deductible 70% after deductible and Speech Hospital Services Inpatient 70% after deductible 70% after deductible Outpatient Surgery 70% after deductible 70% after deductible Emergency Room 70% after deductible 70% after deductible Urgent Care 70% after deductible 70% after deductible Maternity Care Physician Services (prenatal or postnatal) 70% after deductible 70% after deductible Hospital Services 70% after deductible 70% after deductible Mental Health & Substance Abuse Inpatient 70% after deductible 70% after deductible Outpatient 70% after deductible 70% after deductible Retail Prescription Drugs (30-day supply) Generic 70% after deductible 70% after deductible Preferred Brand 70% after deductible 70% after deductible Non-preferred Brand 70% after deductible 70% after deductible Specialty 70% after deductible 70% after deductible Mail Order Prescription Drugs 70% after deductible 70% after deductible (90-day supply) Monthly Employee Premiums BCBS HD Plan HCH HD Plan Employee Only $50 $0 Employee and Spouse/Domestic Partner $540 $440 Employee and Child(ren) $370 $282 Employee and Family $850 $722(1) Out-of-pocket maximum is based on the maximum allowable charge the carrier allows.The above information is a summary only. Please refer to your Evidence of Coverage for complete details of Plan benefits, limitations and exclusions.PFLUGERVILLE ISD 2022 Benefits Information Guide 11.

MEDICAL PREMIUMS COVERAGE LEVEL PAYROLL DEDUCTION YOUR HEALTH Monthly BCBS High Plan Employee Only $185 Employee and Spouse/Domestic Partner $730 Employee and Child(ren) $570 Employee and Family $1,120 HCH Low Plan Employee Only $63 Employee and Spouse/Domestic Partner $560 Employee and Child(ren) $390 Employee and Family $870 BCBS Low Plan Employee Only $80 Employee and Spouse/Domestic Partner $600 Employee and Child(ren) $410 Employee and Family $940 BCBS HD Plan Employee Only $50 Employee and Spouse/Domestic Partner $540 Employee and Child(ren) $370 Employee and Family $850 HCH HD Plan Employee Only $0 Employee and Spouse/Domestic Partner $440 Employee and Child(ren) $282 Employee and Family $722Note: Whichever plan you choose, you will be receiving new ID cards in the mail closer to the new plan year.12. PFLUGERVILLE ISD 2022 Benefits Information Guide

VIRTUAL VISITSWith MDLIVE, the doctor is always in. Get 24/7 non-emergency care from a board-certified doctor by phone, online YOUR HEALTHvideo or mobile app from the privacy and comfort of your own home.Don’t risk crowded waiting rooms, expensive urgent care or ER bills, or waiting weeks to see a doctor, when you canspeak with a Virtual Visits doctor within minutes. They can even send a prescription to your local pharmacy.Virtual Visits powered by MDLIVE and provided by BlueCross BlueShield and Healthcare Highways, are a convenientalternative for treatment of more than 80 health conditions including: • Allergies • Cold/Flu • Fever • Headaches • Sinus Infections • NauseaVirtual Visits with licensed behavioral health therapists are available by appointment. Get virtual care for: • Anxiety • Depression • Stress managementHow Virtual Visits Work • Connect Access where mobile app, online video or telephone service is available • Interact Real-time consultation with an independently contracted, board-certified doctor or therapist • Diagnose – Prescriptions sent to a pharmacy of your choice when appropriateBlueCross BlueShield and Healthcare Highways both provide Virtual Visits through MDLIVE however, setting up anaccount for each carrier is completed differently. Once you have selected your medical plan please refer to the accountinformation below for the corresponding carrier. ACTIVATE YOUR BCBS MDLIVE ACCOUNT ACTIVATE YOUR HCH MDLIVE ACCOUNT Call MDLIVE at 888-680-8646 Go to www.mdlive.com/bcbstx Call MDLIVE at 855-848-8813 Text BCBSTX to 635-483 Go to www.mdlive.com/hch Download the MDLIVE app Download the MDLIVE appPFLUGERVILLE ISD 2022 Benefits Information Guide 13.

HEALTH SAVINGS ACCOUNT (HSA)What is it? TAX SAVINGSBy enrolling in the BCBS HD or HCH HD health plan, you will have access to a Health Savings Account (HSA), which providestax advantages and can be used to pay for qualified health care expenses, such as your deductible and other out-of-pocketexpenses.What are the benefits?Administered by Optum Bank, an HSA accumulates funds that can be used to pay current and future health care costs.• You can contribute to your HSA on a pre- tax basis, for federal tax purposes, or you can contribute on a post-tax basis and take the deduction on your tax return.• HSA funds can grow on a tax-free basis, subject to state law.• A HSA reduces your taxable income and may allow you to make tax-free withdrawals from the account when paying for qualified health care expenses (tax regulations vary by state).• Because you own the HSA, there are no “Use it or Lose it” provisions, so unused HSA funds roll over from year-to-year, and can be used to reimburse future eligible out-of-pocket expenses.• Pflugerville ISD automatically contributes $25 per month ($300 annually) to your HSA regardless of whether you contribute or not. If you choose to contribute funds, PfISD will match your contribution dollar for dollar up to $600 annually or $50 per month.• Because you own the HSA, the money in your account is yours to keep if you leave the District.How do I qualify for an HSA?The IRS has guidelines regarding who qualifies for an HSA. You are considered eligible if:• You are covered under a qualified medical plan.• You are not enrolled in non-qualified health insurance outside of Pflugerville ISD’s HDHP EPO plan.• You are not enrolled in Medicare.• You are not claimed as a dependent on someone else’s tax return.• You are not enrolled in a general Health Care Flexible Spending Account (Health FSA) or general Health Reimbursem*nt Arrangement (HRA).How can I access my account?Once the HSA is activated, you can manage your account at any time by visiting www.optumbank.com. If questions ariseregarding account activation, contact Optum Bank or visit www.optumbank.com. Consult your tax advisor for taxationinformation or advice. You can also access your HSA by visiting myuhc.com and clicking on the “Manage Your HealthSavings Account (HSA) link.14. PFLUGERVILLE ISD 2022 Benefits Information Guide

A few rules you need to know:• In 2022, the maximum contribution limit is $3,650 for individuals and $7,300 for families, which includes employee and employer contributions combined. TAX SAVINGS• It’s important to monitor your contributions to avoid going over the IRS limit, as contributions in excess of the IRS limit are subject to standard income tax rates, plus a 6% excise tax.• There is a 20% penalty for using HSA funds on non-qualified health care expenses if you are under age 65. For more details about what are considered qualified health care expenses, visit www.irs.gov/publications/p502.• You may not be able to contribute to your HSA if you are entitled to Medicare. However, funds accumulated before Medicare entitlement may be used to reimburse your qualified medical expenses.• You may not contribute to your HSA if you are covered under any medical benefits plan which is not an HSA-qualified high deductible medical plan (e.g., a spouse’s non-HDHP medical plan, a general purpose Health Care FSA, or Medicare). However, you may be covered by a Limited Purpose Health Care FSA.• Typically, the maximum amount an employee is eligible to contribute to an HSA per calendar year is based upon a pro- rata portion of the number of months an employee is eligible to contribute to an HSA. For example, an employee would normally be able to contribute 4/12 of the maximum annual limit in his/her first year of enrollment into the HSA plan, if the employee first joins the HSA plan on September 1. However, an employee is allowed to contribute the maximum annual amount, regardless of the number of months he/she was eligible to contribute to an HSA in the first year, if he/she is eligible to contribute to an HSA on December 1 of the first year and continues to be eligible to contribute to an HSA until December 31 of the following year (i.e., for the entire subsequent year). How do I manage my HSA? TIP • The most convenient way to pay for qualified expenses is to utilize the debit card • You can also use your own cash or a personal credit card and reimburse yourself through your online HSA account • It is recommended that you keep receipts of HSA purchases, should you ever be audited by the IRS • View the status of your claims and check your HSA balance at www.optumbank.comPFLUGERVILLE ISD 2022 Benefit Information Guide 15.

FLEXIBLE SPENDING ACCOUNTS (FSA)A flexible spending account lets you use pre-tax dollars to cover eligible health care and dependent care expenses. Startingin 2022, Pflugerville ISD will be offering this benefit through iSolved (formerly Infinisource). Here are a number of different TAX SAVINGStypes of FSAs that help to reduce your taxable income when paying for eligible expenses for yourself, your spouse andeligible dependents, as outlined below: FSA TYPE DETAIL • Can reimburse for eligible health care expenses not covered by your Health Care FSA medical, dental and vision insurance • Maximum contribution for 2021 is $2,750* • Option for employees enrolled in a Health Savings Account (HSA) eligible plan Limited Purpose FSA • Use this FSA to reimburse for eligible preventive care, dental and vision expenses • Maximum contribution for 2021 is $2,750* • Can be used to pay for qualified child care and/or caregivers for a disabled family member in the household who is unable to care for Dependent Care FSA themselves • Maximum contribution for 2021 is $5,000 or $2,500 if married and filing separately**The 2022 limits have not been published by the IRS. This will be updated when the limits are released.What are the benefits? • Your taxable income is reduced and your spendable income increases! • Save money while keeping you and your family healthyHow do I use it?You must enroll in the FSA program within 30 days of your hire date or during annual open enrollment. At this time, you mustestablish an annual contribution amount within the maximum limit. Once enrolled, you will have online access to view yourFSA balance, check on a reimbursem*nt status and more. Visit https://www.isolvedbenefitservices.com to access iSolved’sonline portal.A few rules you need to know: • You will not be able to make updates to your FSA elections during the year unless you have a qualifying event, so it is important to estimate your expenses and choose the amount you want to contribute carefully. • Although the plan year runs from January 1, 2022 through December 31, 2022, the plan allows an annual run out period through March, 30, 2022, allowing you to seek reimbursem*nt for any expenses incurred during the plan year (from January 1, 2022 to December 31, 2022)16. PFLUGERVILLE ISD 2022 Benefits Information Guide

DENTAL PLANYour Dental PPO Plan YOUR HEALTHThis year, you and your eligible dependents have the opportunity to enroll in a Dental Preferred Provider Organization (PPO)plan offered by MetLife.Using the PlanThe Dental PPO plan is designed to give you the freedom to receive dental care from any licensed dentist of your choice.You’ll receive the highest level of benefit from the plan if you select an in-network PPO dentist versus an out-of-networkdentist who has not agreed to provide services at the negotiated rate. Additionally, no claim forms are required when usingin-network PPO dentists.Please note Metlife does not provide identification cards. At the provider’s office, your social security number will serve asyour identification.To view a complete plan summary, visit www.pfisd.net/benefits. PLAN HIGHLIGHTS METLIFE DENTAL PPO High Low Calendar Year Deductible Individual $50 $50 Family $150 $150 Annual Maximum $2,000 $1,250 Preventive 100% 100% Basic Services 80% 80% Major Services 50% Not Covered Orthodontia Services 50% Not Covered Adult Not Covered Not Covered Child up to age 26 Covered Not Covered Lifetime Maximum $1,500 Not Covered Out-of-Network Reimbursem*nt 80th percentile 80th percentileThe above information is a summary only. Please refer to your Evidence of Coverage for complete details of Plan benefits, limitations and exclusions. Find your Favorite Dentist TIP When using a Dental PPO plan, you can receive services from dental providers both in and out of your insurance network. However, you’ll receive better coverage when you use an in-network dentist. To determine whether your dentist is in or out of your insurance network, go to www.metlife.com and search the PDP Plus network, or call Metlife at 800-942-0854.Crean Lutheran High School 2021 Benefit Information Guide 17.

VISION PLANYour Vision Plan YOUR HEALTHVision coverage is offered by United Healthcare as a Preferred Provider Organization (PPO) plan.Using the PlanAs with a traditional PPO, you may take advantage of the highest level of benefit by receiving services from in-network visionproviders and doctors. You will only be responsible for a copayment at the time of your service. However, if you receiveservices from an out-of-network doctor, you pay all expenses at the time of service and submit a claim for reimbursem*nt upto the allowed amount.Please note UHC Vision does not provide identification cards. At the provider’s office, your social security number will serveas your identification.To view a complete plan summary, visit www.pfisd.net/benefits.To find an in network provider, please go to www.myuhcvision.com. PLAN HIGHLIGHTS UHC VISION PPO In-Network Out-of-Network Reimbursem*nt Exam – Once every plan year $10 N/A Lenses – Every 12 months $25 See Below Single 100% after copay Up to $40 Bifocal 100% after copay Up to $60 Trifocal 100% after copay Up to $80 Frames – Every 24 months $150 allowance + 30% off Up to $45 Contacts – Every 12 months, in lieu of lenses & frames Medically Necessary 100% Up to $210 Cosmetic $150 + 15% off Up to $150The above information is a summary only. Please refer to your Evidence of Coverage for complete details of Plan benefits, limitations and exclusions. Five Tips for Superior Vision TIP Don’t take your eyes for granted! The following pointers can help you keep your vision strong: • Eat lots of leafy greens and dark berries. • Get regular eye exams. • Give your eyes a rest from staring into the computer screen. • Wear sunglasses to protect your eyes from bright light. • Wear safety eyewear whenever necessary.18. PFLUGERVILLE ISD 2022 Benefits Information Guide

DENTAL PREMIUMS LIFE AND DISABILITYCOVERAGE LEVEL PAYROLL DEDUCTION MonthlyMetlife Dental Plans Low Plan High PlanEmployee Only $22.52 $41.32Employee and Spouse/Domestic Partner $45.66 $91.78Employee and Child(ren) $38.06 $83.26Employee and Family $58.40 $118.44VISION PREMIUMSCOVERAGE LEVEL PAYROLL DEDUCTION MonthlyUHC Vision PlanEmployee Only $6.04Employee and Spouse/Domestic Partner $10.86Employee and Child(ren) $11.50Employee and Family $17.22Pflugerville ISD 2022 Benefits Information Guide 19.

VOLUNTARY LIFE AND AD&DProtect your loved ones YOUR HEALTHIn the event of your death, Life Insurance will provide your family members or other beneficiaries with financial protectionand security. Additionally, if your death is a result of an accident or if you become dismembered, your Accidental Death &Dismemberment (AD&D) coverage may apply.Your coverageAll full time employees have a $10,000 basic life and AD&D benefit that is paid by the district. You may choose to purchaseadditional voluntary coverage for yourself and your dependents:• Employee Voluntary Life insurance can be elected in $10k increments up to 5x salary or $500,000 max. The guarantee issue amount is $200,000*. Elections over this amount require Evidence of Insurability**.• Spouse Voluntary Life insurance can be elected in $5k increments up to $100,000, not to exceed the employee election. The guarantee issue amount is $50,000. Elections over this amount require Evidence of Insurability*. The rate is based on Employee age.• Child Voluntary Life insurance can be elected in the amount of $10,000 and cannot exceed 100% of the employee’s life benefit.At 65, the benefit amount will reduce to 65% of the original election for employee and spouse.* New hire enrollments can elect up to the guarantee issue amount without providing Evidence of Insurability. Newenrollments or increases in volume to existing enrollments will require completion of the Evidence of Insurability form.**The Evidence of Insurability form can be found at www.standard.com/mybenefits/mhs_ho.html or contact the Benefitsoffice. Required! Are Your Beneficiaries Up to Date? TIP Beneficiaries are individuals or entities that you select to receive benefits from your policy. • You can change your beneficiary designation at any time. • You may designate a sole beneficiary or multiple beneficiaries to receive payment in the percent allocated. • To select or change your beneficiary, contact the Benefits Office.20. PFLUGERVILLE ISD 2022 Benefits Information Guide

VOLUNTARY DISABILITYAdded income protection WORK/LIFEShould you experience a non-work related illness or injury that prevents you from working, disability coverage acts asincome replacement to protect important assets and help you continue with some level of earnings.Your coverageIf you want to change your existing policy during open enrollment, you can increase your benefit level up to $300 per monthup to the maximum allowed or go down a level on your benefit waiting period.The benefits outlined below are provided on a voluntary basis by The Standard:• You can elect the following elimination periods (Accident/ Illness): o 0/3 days o 14/14 days o 30/30 days o 60/60 days o 90/90 days o 180/180 days• You can elect the minimum benefit amount of $200 up to the lesser of $8,000 or two-thirds of your earnings.• The maximum benefit period is 3 years for illness, or to age 65 for accident.*For pre-existing conditions, benefits are only available for the first 90 days of disability. A pre-existing condition is anycondition, for which you have received treatment or care within 90 days of becoming effective. After 12 months ofcontinuous coverage, the condition is no longer considered pre-existing. Disability Facts and Figures TIP • One in every 7 people will become disabled for five years or more in their lifetime. • 30% of people use disability coverage. • Nearly half (46%) of all foreclosures are caused by financial hardship due to a disability. Source: www.affordableinsuranceprotection.com/disability_factsPflugerville ISD 2022 Benefits Information Guide 21.

VOLUNTARY WORKSITE BENEFITSBridging the GapShould you experience an injury or illness, Accident, Critical Illness, and Hospital Indemnity policies can assist insupplementing your other insurance coverage and help offset out-of-pocket medical expenses. These policies are designed RATESto enhance your underlying medical coverage, not replace it. A Whole Life policy is guaranteed financial security in the eventof your death. To view a complete plan summary, visit www.pfisd.net/benefits. YOUR PLANS COVERAGE OVERVIEW Accident • Accident insurance is designed to help cover deductible gaps and daily living expenses with a cash benefit for unexpected injuries . • Benefits are paid out for things like urgent care visits, emergency room treatment, hospital admission and confinement, ambulance, and x-rays. • You can choose from a good, better, or best plan option. • You can also receive benefits for getting a wellness check-up. Critical Illness • Critical illness insurance can pay for costs not covered by traditional insurance. This type of insurance policy compensates policyholders with a lump sum payment after getting diagnosed with a specific illness, such as a heart attack, cancer, or a stroke. • You can purchase a benefit of $10,000, $15,000, or $25,000 for yourself, as well as coverage for your spouse, domestic partner and dependent children. • You can also receive benefits for getting a wellness check-up. Hospital Indemnity • Hospital Indemnity insurance, is a plan that pays you benefits when you are admitted or confined to a hospital, whether for planned or unplanned reasons, or for other medical services. • Cigna will pay $500, $1000, $1,500 a day depending on which plan you select. • You can also receive benefits for getting a wellness check-up. Whole Life • Whole life insurance is a permanent policy offered by Chubb, which gives you guaranteed protection for your loved ones that lasts a lifetime. • With whole life insurance, unlike term, you earn guaranteed cash value of up to $150,000, which you can use however you want. • The Chubb policy also includes a benefit for Long Term Care, in which you can access your benefit while you are living for home health care, assisted living, or nursing home care. Allstate Identity Protection • The identity protection benefit with Allstate protects a wide array of identity threats including credit reports, dark web monitoring, financial transactions, and social media interactions. This benefit provides piece of mind while navigating the technological world we live in today. • In the event of fraud, Allstate’s $1 million Identity theft insurance policy with reimburse you. • The plan features include checking your identity health score, monitoring your TransUnion credit score and report fraud, receiving real time financial and identity alerts, and the ability to protect yourself as well as your family.22. PFLUGERVILLE ISD 2022 Benefits Information Guide

ACCIDENT & CRITICAL ILLNESS BUNDLEPLAN HIGHLIGHTS GOOD BUNDLE BETTER BUNDLE BEST BUNDLE WORK/LIFEAccident Emergency Room Treatment $100 $200 $300 Physician Office Visit $50 $100 $150 Diagnostic Exam $10 $50 $50 Ambulance (Ground/Air) $200 / $800 $300 / $1,200 $400 / $1,600 Hospital Admission $500 $1,000 $1,500 Hospital Stay $100 $200 $300 Intensive Care Unit Stay $200 $400 $600 Fractures and Dislocations $50 - $4,000 $100 - $8,000 $150 - $10,000 Follow Up Physician Office Visit $50 $75 $125 Follow Up Physical Therapy Visit $25 $50 $75 Lacerations $50 - $400 $100 - $600 $150 - $800 Concussion $200 $400 $600 Coma $5,000 $10,000 $15,000 Accidental Death* $25,000 - $75,000 $50,000 - $100,000 $75,000 - $100,000 Accidental Dismemberment* $1,000 - $20,000 $2,000 - $30,000 $3,000 - $40,000 Wellness Benefit $50 $75 $100Critical Illness Employee Benefit Amount $10,000 $15,000 $25,000 Spouse Benefit Amount $5,000 $7,500 $12,500 Child Benefit Amount $5,000 $7,500 $12,500 Maximum Lifetime Limit 5x benefit amount Covered Conditions: Benefit / Recurrence Invasive Cancer 100% / 100% Carcinoma in Situ 25% / 25% Heart Attack 100% / 100% Stroke 100% / 100% Coronary Artery Disease 25% / 25% Advance Alzheimer’s Disease 25% / Not Available Amyotrophic Lateral Sclerosis 25% / Not Available Parkinson’s Disease 25% / Not Available Multiple Sclerosis 25% / Not Available Benign Brain Tumor 100% / 100% Blindness 100% / Not Available Coma 100% / 25% End Stage Renal Disease 100% / 100% Major Organ Failure 100% / 100% Paralysis 100% / 100% Loss of Hearing 100% / Not Available Loss of Speech 100% / Not Available Systemic Lupus 25% / 25% Systemic Sclerosis 25% / 25% Skin Cancer $250 per lifetime Second Opinion Cancer $500 per lifetime Wellness Benefit $100 *Amounts shown are for employee coverage. Spouse and Child benefit are 50% and 25% of the benefit shown, respectively. Pflugerville ISD 2022 Benefits Information Guide 23.

HOSPITAL INDEMNITYPLAN HIGHLIGHTS LOW PLAN MID PLAN HIGH PLANHospital Indemnity RATESHospital Admission* $500 $1,000 $1,500Hospital Stay** $100 per day; 30 days max $200 per day; 30 days max $200 per day; 30 days maxHospital ICU Stay** $200 per day; 30 days max $400 per day; 30 days max $400 per day; 30 days maxHospital Chronic Condition $50 per day; 1 day max $100 per day; 1 day max $100 per day; 1 day maxAdmission**Hospital Observation Stay*** $100 per 24-hour period $200 per 24-hour period $200 per 24-hour periodWellness Benefit $50 $50 $50 * Benefit limited to once every 365 days ** Benefit limited to once every 90 days *** 24 hour elimination period applies; limited to 72 hours Hospital Indemnity Low Mid High Employee Only $12.82 $23.12 $28.74 Employee and Spouse/Domestic Partner $23.12 $42.02 $52.18 Employee and Child(ren) $23.94 $41.98 $51.26 Employee and Family $34.24 $60.88 $74.72 WHOLE LIFE WITH LONG TERM CAREPLAN HIGHLIGHTSWhole Life Details Employee Coverage Amount Up to $100,000 Spouse Coverage Amount Up to $100,000 Child Coverage Amount Up to $25,000 Accelerated Death Benefits for 50% of benefit Terminal Illness Accelerated Death Benefits for 4% of benefit payable each month for 25 months Member must be unable to perform 2 out of 6 activities of daily living Long Term Care (LTC)* or be cognitively impaired and be receiving long term care services Extension of Benefits** Extends the Accelerated Death Benefit for LTC up to an additional 50 months Restores your coverage by 50% (up to $50,000) if benefits were reduced Death Benefit Restoration with accelerated death benefit for long term care * Available to employees aged 19-79 and spouses aged 19-70 at time of enrollment ** Available to employees aged 71-80 at time of enrollment 24. PFLUGERVILLE ISD 2022 Benefits Information Guide

ALLSTATE IDENTITY PROTECTIONPLAN HIGHLIGHTSIdentity Protection Details Pro Plan Pro Plus Plan WORK/LIFE Insurance Protection Minimum $1 million Identity Restoration Benefit Included Lost Wallet Protection Included IP Address Monitoring Included Credit Monitoring and Bank Account Activity Alerts Included Tri-Bureau Monitoring Not Included Included Social Media Monitoring Not Included Included 401(k) and HSA Stolen Funds Reimbursem*nt Not Included Included Rates Per Person / Month $4.00 $6.00 Per Family / Month $10.00 $14.00 The above information is a summary only. Please refer to your plan document for complete details of plan benefits, limitations and exclusions. EMPLOYEE ASSISTANCE PROGRAM (EAP) Pflugerville ISD understands that you and your family members might experience a variety of personal or work-related challenges. Through the Optum EAP, you have access to resources, information, and counseling that are fully confidential and no cost to you. PROGRAM COMPONENT COVERAGE DETAILS Who Can Utilize All employees, dependents of employees, and members of your household Topics May Include • Childcare • Eldercare • Legal services • Identity theft • Marital, relationship or family problems • Bereavement or grief counseling • Substance abuse and recovery • Financial support • Consumer information Number of Sessions 3 face-to-face sessions per year per member per incident How to Access: TIP • By Phone: 866-248-4094 • Online: www.liveandworkwell.com • Website password: pfisd Pflugerville ISD 2022 Benefits Information Guide 25.

COST BREAKDOWNVOLUNTARY DISABILITY Elimination Period Benefit Amount Monthly Cost per $100 0 accident/ 3 illness $200 - $8,000 or 66.6% of earnings $2.80 14 accident/ 14 illness $200 - $8,000 or 66.6% of earnings $2.19 RATES 30 accident/ 30 illness $200 - $8,000 or 66.6% of earnings $1.61 60 accident/ 60 illness $200 - $8,000 or 66.6% of earnings $1.40 90 accident/ 90 illness $200 - $8,000 or 66.6% of earnings $1.24 180 accident/ 180 illness $200 - $8,000 or 66.6% of earnings $1.17Calculating your Disability Cost: X ÷ 100 = Rate Benefit Amount Monthly RateVOLUNTARY LIFE/AD&D Vol u n t ary Li f e Rat es Age E m pl oyee Spou s e

COST BREAKDOWNACCIDENT & CRITICAL ILLNESS BUNDLE Employee and Good Plan Employee Employee and Spouse Employee and Family Child(ren) Age Non-Tobacco Tobacco Non-Tobacco Tobacco Non-Tobacco Tobacco Non-Tobacco Tobacco RATES

COST BREAKDOWNWHOLE LIFE WITH LONG TERM CAREEmployee & Spouse Rates: $25,000 $50,000 $75,000 $100,000 RATES Age Non-Smoker Smoker Non-Smoker Smoker Non-Smoker Smoker Non-Smoker Smoker 19 N/A $14.50 $22.75 $29.00 $34.12 $43.50 $45.50 $58.00 20 N/A $14.50 $22.75 $29.00 $34.12 $43.50 $45.50 $58.00 21 N/A $14.85 $23.17 $29.71 $34.75 $44.56 $46.33 $59.41 22 N/A $15.21 $23.58 $30.42 $35.37 $45.62 $47.16 $60.83 23 N/A $15.60 $24.04 $31.21 $36.06 $46.81 $48.08 $62.41 24 N/A $16.04 $24.54 $32.08 $36.81 $48.12 $49.08 $64.16 25 N/A $16.46 $25.04 $32.92 $37.56 $49.37 $50.08 $65.83 26 N/A $17.08 $25.92 $34.17 $38.87 $51.25 $51.83 $68.33 27 $13.44 $17.75 $26.87 $35.50 $40.31 $53.25 $53.75 $71.00 28 $13.94 $18.40 $27.87 $36.79 $41.81 $55.19 $55.75 $73.58 29 $14.44 $19.04 $28.87 $38.08 $43.31 $57.12 $57.75 $76.16 30 $14.94 $19.71 $29.87 $39.42 $44.81 $59.12 $59.75 $78.83 31 $15.57 $20.60 $31.15 $41.20 $46.72 $61.80 $62.30 $82.40 32 $16.27 $21.57 $32.55 $43.15 $48.82 $64.72 $65.10 $86.30 33 $16.95 $22.49 $33.91 $44.97 $50.86 $67.46 $67.81 $89.95 34 $17.67 $23.48 $35.35 $46.96 $53.02 $70.45 $70.70 $93.93 35 $18.50 $24.48 $37.00 $48.96 $55.50 $73.43 $74.00 $97.91 36 $19.49 $25.67 $38.98 $51.35 $58.47 $77.02 $77.96 $102.70 37 $20.52 $26.99 $41.05 $53.99 $61.57 $80.98 $82.10 $107.98 38 $21.60 $28.32 $43.20 $56.63 $64.80 $84.95 $86.40 $113.26 39 $22.78 $29.87 $45.56 $59.73 $68.33 $89.60 $91.11 $119.46 40 $23.96 $31.33 $47.91 $62.66 $71.87 $94.00 $95.83 $125.33 41 $25.25 $33.27 $50.51 $66.55 $75.76 $99.82 $101.01 $133.09 42 $26.61 $35.32 $53.22 $70.64 $79.83 $105.96 $106.45 $141.28 43 $28.01 $37.43 $56.02 $74.86 $84.03 $112.28 $112.05 $149.71 44 $29.49 $39.64 $58.99 $79.28 $88.48 $118.92 $117.98 $158.56 45 $31.06 $42.08 $62.12 $84.16 $93.18 $126.24 $124.25 $168.33 46 $33.13 $44.92 $66.26 $89.84 $99.38 $134.76 $132.51 $179.68 47 $35.34 $47.99 $70.68 $95.97 $106.02 $143.96 $141.36 $191.94 48 $37.70 $51.22 $75.40 $102.44 $113.10 $153.66 $150.79 $204.88 49 $40.14 $54.60 $80.28 $109.20 $120.42 $163.79 $160.56 $218.39 50 $42.85 $58.23 $85.70 $116.45 $128.56 $174.68 $171.41 $232.91 51 $45.43 $62.00 $90.85 $124.00 $136.28 $186.01 $181.71 $248.01 52 $48.15 $66.05 $96.30 $132.09 $144.44 $198.14 $192.59 $264.19 53 $50.97 $70.22 $101.95 $140.44 $152.92 $210.65 $203.89 $280.87 54 $53.99 $74.58 $107.97 $149.15 $161.96 $223.73 $215.94 $298.30 55 $57.12 $79.14 $114.25 $158.29 $171.37 $237.43 $228.49 $316.57 56 $61.78 $85.35 $123.56 $170.71 $185.34 $256.06 $247.12 $341.42 57 $66.75 $92.00 $133.50 $184.01 $200.25 $276.01 $267.01 $368.02 58 $71.99 $98.86 $143.99 $197.73 $215.98 $296.59 $287.97 $395.45 59 $77.46 $106.14 $154.93 $212.27 $232.39 $318.41 $309.85 $424.5528. PFLUGERVILLE ISD 2022 Benefits Information Guide

COST BREAKDOWNWHOLE LIFE WITH LONG TERM CARE (CONTINUED)Employee & Spouse Rates (continued): $25,000 $50,000 $75,000 $100,000 RATES Age Non-Smoker Smoker Non-Smoker Smoker Non-Smoker Smoker Non-Smoker Smoker 60 $83.25 $113.72 $166.49 $227.45 $249.74 $341.17 $332.99 $454.90 61 $90.63 $123.63 $181.26 $247.27 $271.89 $370.90 $362.52 $494.53 62 $98.26 $133.85 $196.53 $267.71 $294.79 $401.56 $393.05 $535.41 63 $106.40 $144.78 $212.79 $289.56 $319.19 $434.35 $425.58 $579.13 64 $114.84 $155.98 $229.68 $311.96 $344.52 $467.94 $459.36 $623.93 65 $123.75 $167.85 $247.49 $335.69 $371.24 $503.54 $494.98 $671.39 66 $137.84 $186.79 $275.69 $373.59 $413.53 $560.38 $551.38 $747.17 67 $152.61 $206.65 $305.22 $413.31 $457.83 $619.96 $610.44 $826.62 68 $168.15 $227.56 $336.29 $455.12 $504.44 $682.67 $672.59 $910.23 69 $184.52 $249.61 $369.04 $499.21 $553.55 $748.82 $738.07 $998.43 70 $201.91 $272.95 $403.82 $545.89 $605.73 $818.84 $807.63 $1,091.79 71 $202.98 $284.55 $243.58 $341.46 $324.77 $455.28 $405.97 $569.09 72 $225.66 $318.69 $270.79 $382.42 $361.06 $509.90 $451.32 $637.37 73 $249.69 $355.04 $299.63 $426.04 $399.51 $568.06 $499.39 $710.07 74 $275.10 $393.66 $330.12 $472.39 $440.16 $629.85 $550.20 $787.31 75 $302.13 $434.98 $362.56 $521.98 $483.41 $695.97 $604.27 $869.97 76 $340.51 $490.85 $408.61 $589.02 $544.82 $785.36 $681.02 $981.69 77 $380.78 $549.88 $456.94 $659.85 $609.26 $879.80 $761.57 $1,099.76 78 $423.20 $612.37 $507.84 $734.84 $677.13 $979.79 $846.41 $1,224.73 79 $467.81 $678.56 $561.37 $814.28 $748.50 $1,085.70 $935.62 $1,357.13 80 $515.04 $748.99 $618.05 $898.79 $824.07 $1,198.39 $1,030.08 $1,497.98Child(ren) Rates: $5,000 $2.09 $10,000 $4.18 $15,000 $6.27 $20,000 $8.36 $25,000 $10.46Pflugerville ISD 2022 Benefits Information Guide 29.

MEMBER SUPPORTUnderstanding your employee benefits options can be confusing and complicated. The Benefits Service Center through RESOURCESMarsh & McLennan Agency provides answers and information at your fingertips.You’re Not AlonePlan options, copays and deductibles…Planning for you and your family’s health and welfare needs can be an overwhelming task. The Benefits Service Center isyour resource for guidance when navigating your benefits plan, from open enrollment to handling life’s many changes.Just a Call or Click AwayBilingual member support is available Monday through Friday, 8:00 a.m. – 5:00 p.m. Central Time (6:00 pm during OE).• Toll-free: (855) 550-9885• PIN: 1083• Email: PflugervilleISD@MarshMMA.comDedicated Benefits ResourceAs a company-sponsored benefit, the Benefits Service Center gives you unlimited direct access to insurance professionalswho are dedicated to knowing our plan options inside and out. Whether you’re a new employee looking for information onhow to continue your coverage, or your insurance needs are changing, you’re bound to have questions on your plan optionsand programs. The Benefits Service Center can assist with: TIP • General benefit questions • Finding a network provider or facility • Reviewing bills • Assistance with claims Contact PfISD Benefits and Leave Office for: • Verification of eligibility • Processing qualifying life events • Available 8:00 a.m. - 5:00 p.m. • Phone: (512) 924-0026 • Email: benefits@pfisd.net30. PFLUGERVILLE ISD 2022 Benefits Information Guide

LEAVE AND ABSENCESThe district offers employees paid and unpaid leaves of absence in times of personal need. Employees who expect to beabsent for an extended period of more than five (5) days should contact the Leave Department for information aboutapplicable leave benefits, payment of insurance premiums, and requirements for communicating with the district. Please RESOURCESrefer to the employee handbook and policies DEC (Local), DEC (Legal), and DECA (Legal) for a full explanation of PfISD Leaveand Absence information. Paid LeaveLocal Sick Leave – 5 days o Earned at a rate of ½ day per 18 days worked o Employees receive 5 days maximum per year o Leave is recorded in ¼ day, ½ day, and whole days o All absences require supervisor approval o May only be used for an employee or family member illness o Leave is prorated for employees who start after the official beginning date of their position or separate before their last duty day o End of year balance rolls over to the next year o Eligible for reimbursem*nt upon retirement for employees who meet the requirementsState Personal Leave – 5 days o Employees receive 5 days maximum per year o Recorded in ¼ day, ½ day, and whole days o All absences require supervisor approval o May be used for a personal absence or illness o State Personal absences must be requested one week in advance and receive approval o State personal leave shall not exceed three consecutive workdays o Leave is prorated for employees who start after the official beginning date of their position or separate before their last duty day o End of year balance rolls over to the next year o Transferable to other Texas school districts*Extended Sick Leave– up to 3 days in a given school year, maximum of 9 days during course of employment uponapproval. (Must be requested by the employee).*Catastrophic Leave– up to 60 days during course of employment upon approval. (Must be requested by the employee).*Employees must meet the eligibility requirements.Non-Contract (Vacation) Days o Only employees who work 226 or more days are eligible for non-contract days. o Non-exempt employees can carry a maximum of 10 non-contract days over to the next school year. o Exempt employees can carry an unlimited amount of non-contract days, however upon resignation will only be paid for 10 days. o Days must be approved by supervisor in advance. Days are allocated according to the present year calendar and vary from year to year.Pflugerville ISD 2022 Benefits Information Guide 31.

Unpaid Leave*Family Medical Leave – up to 12 work weeks/26 work weeks for Military related injuries. o Contact the Leave Office for paperwork. RESOURCES o Employee must be employed by the district for one year and worked a minimum of 1,250 hours to be eligible. o Leave runs concurrent with district paid leave and Temporary Disability Leave. Leave becomes unpaid once leave is exhausted.*State Temporary Disability Leave – up to180 calendar days. o Contact the Leave Office for paperwork. o For qualified employees only (employees whose position requires them to hold a certificate through SBEC). o Runs concurrent with district paid leave and Family Medical Leave. Leave becomes unpaid once leave is exhausted. o May not be taken intermittent. o For personal illness only.*Local Temporary Disability Leave– up to 45 calendar days. o Contact the Leave Office for paperwork. o For employees who are not eligible for state temporary disability leave with 30 days of continuous employment. o Runs concurrent with district paid leave. Leave becomes unpaid once leave is exhausted. o May not be taken intermittent. o For personal illness only.*Employees must meet the eligibility requirementsBereavement– up to 5 days per occurrence o Employees must use their state or local leave. o Leave shall not exceed 5 workdays per occurrence. o Employees with no accumulated leave will be docked their daily rate of pay.PfISD Leave Departmentleave@pfisd.net, 512-594-0026, Fax: 512-594-003132. PFLUGERVILLE ISD 2022 Benefits Information Guide

RESOURCESPflugerville ISD 2022 Benefits Information Guide 33.

RESOURCES34. PFLUGERVILLE ISD 2022 Benefits Information Guide

DIRECTORY & RESOURCES GROUP /INFORMATION REGARDING POLICY # CONTACT INFORMATION RESOURCESEnrollment & Eligibility• Benefits Office 512-594-0026 benefits@pfisd.net• Enrollment Vendor: TBX 855-482-9669 www.tbx.benselect.comMedical CoverageBlueCross BlueShield• Low, High EPO 323154 877-262-3037 www.bcbstx.com• HDHP EPOHealthcare Highways• Low EPO HCH1008 833-841-6703 www.healthcarehighways.com• HDHP EPODental CoverageMetLife 159299 800-942-0854 www.metlife.comVision CoverageUHC 915287 800-638-3120 www.myuhcvision.comLife, AD&D and DisabilityThe Standard• Voluntary Life / AD&D 649561 800-628-8600 www.standard.com• Disability 800-368-1135PharmacyExpress Scripts 1-800-334-8134 www.express-scripts.comHealth Savings AccountOptumBank 866-234-8913 www.optumbank.comFlexible Spending AccountiSolved 866-370-3040 www.isolvedbenefitservices.comEmployee Assistance Program www.liveandworkwell.comOptum 866-248-4094 Code: pfisdAccidentCigna AI961211 800-754-3207 www.cigna.comCritical IllnessCigna CI961164 800-754-3207 www.cigna.comHospital IndemnityCigna HC960547 800-754-3207 www.cigna.comWhole LifeChubb 855-241-9891 www.chubb.comIdentity ProtectionAllstate 1-800-789-2720 www.infoarmor.comRetirement Plan AdviserTCG Group Holdings 1-800-943-9179 www.tcgservices.com Pflugerville ISD 2022 Benefits Information Guide 35.

RESOURCES36. PFLUGERVILLE ISD 2022 Benefits Information Guide