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Madison County Schools Benefits Guide

2027

Effective January 1st, 2027 Summary for Review Purposes Only

The Madison County School System offers a comprehensive and valuable benefits program to all eligible employees. Our benefits package is designed to provide security and assistance during a time of need. Please become familiar with the various options and select the best coverage for the upcoming plan year.

MADISON COUNTY SCHOOL SYSTEM

INSIDE THIS GUIDE Eligibility..................................................... 1 Enrollment & Benefits Portal................... 2 Take Action Reminders............................ 3 Campus Benefits Service Hub................. 4 Employee Assistance Program................ 5 Disability Insurance................................... 6 Basic Life Insurance.................................. 7 Life Insurance 101..................................... 8 Voluntary Term Life Insurance................ 9 Permanent Life Insurance........................ 10 Vision Insurance ....................................... 11 Dental Insurance....................................... 12-13 Critical Illness Insurance........................... 14 Hospital Indemnity Insurance.................. 15 Cancer Insurance....................................... 16 Wellness Incentives................................... 17 Accident Insurance.................................... 18 MedCare Complete................................... 19 Flexible Spending Accounts.................... 20-21 Legal Plan................................................... 22 Additional Resources .............................. 23 SHBP........................................................... 24-25

CONTACTS: Kristin Brock Payroll / Benefits Phone: 706.795.2191 ext 1024 Email: kbrock@madison.k12.ga.us Dee Reynolds Human Resources - Classified Employee Specialist Phone: 706.795.2191 ext 1032 Email: dreynolds@madison.k12.ga.us Rika Rowland Human Resources Director Phone: 706.795.2191 ext 1022 Email: rika.rowland@madison.k12.ga.us Susan Sarna Human Resources - Secretary Phone: 706.795.2191 ext. 1026 Email: ssarna@madison.k12.ga.us

Need Help? Start Here: mybenefits@campusbenefits.com 1.866.433.7661, opt 5

Eligibility • •

Generally, full-time employees working 20 or more hours per week are eligible to enroll in the various benefits described throughout the guide. (Certain rules may apply per benefit). Specific plan eligibility is listed on the top of each page. Specific employee and dependent eligibility rules are governed by each plan’s policy document/certificate, which is available on your employee benefits website, or by contacting Campus Benefits.

When Do Benefits Begin •

The effective date of coverage for benefits depends on your hire date. Typically, benefits will begin the first of the month following 30 days of employment. For all benefits, you must be actively at work on the effective date of coverage.

Changes • • • •

Employee benefit elections are allowed as a new hire and during the scheduled open enrollment period. The selected benefits will remain in effect throughout the plan year. A qualifying life event allows eligible changes to benefit elections throughout the plan year. All qualifying life events must be submitted within 30 days of the event date. A qualifying life event is a change in your situation such as getting married, having a baby, or losing health coverage.

Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

Benefits Guide 2027

Version #09232026

ENROLLMENT & BENEFITS PORTAL Scheduled Open Enrollment • •

Open Enrollment Dates: October - November You must re-enroll in the Flexible Spending Account each year. Plan Year: January 1 - December 31

•

New Hire Enrollment •

New hires: Benefits enrollment must take place within 30 days of hire date. Please go to MadisonCountyBenefits.com to begin your enrollment.

Review your benefits portal at: MadisonCountyBenefits.com

1 2 3

MadisonCountyBenefits.com Select “Campus Connect” to login Enter Login Information 1. Enter your username 2. Enter your password 3. Click “LOGIN” 4. Click on the “Start Benefits” button to begin the enrollment process

FAQ’S What is my username? • Work email address OR • Email address you provided to HR when hired OR • Email address you used to previously change your username What is my password? To create or reset a forgotten password follow the steps on the login page using tips below. • • •

Password must be at least 6 characters It must contain a symbol and a number Using uppercase, numbers and symbols greatly improves security

Company Identifier: MCSD18 New User Registration 1. On Login page click on “Register as a new user” and enter information below • • • • •

First Name Last Name Company Identifier: MCSD18 PIN: Last 4 Digits of SSN Birthdate

2. Click “Next” 3. Username: Work email address or one you have provided to HR when you were hired 4. Password: Must be at least 6 characters and contain a symbol and a number 5. Click on “Register” 6. On the next page, it will show your selected Username. Click on “Login” 7. Enter Username and Password 8. Click “Start Benefits” to begin the enrollment

Benefits Guide 2027

IMPORTANT REMINDERS - TAKE ACTION • • • • •

Eligibility for benefits enrollment must take place within 30 days of your hire date. Remember: Please review and/or update beneficiaries annually for all benefits including, Basic Life, Voluntary Term Life & AD&D and Permanent Life policies. Important: Review and Understand Guaranteed Issue Options (New Hires). Life Events - You are required to submit any life event changes for you and eligible dependents within 30 days of an event. This Guide - This guide is presented for illustrative purposes only and is not intended to offer insurance advice. It is important you review each benefit’s summary plan description (SPD) and other carrier materials before making any selections.

There are two separate benefit enrollments: 1. Campus Benefits Voluntary Benefits 2. State Health Benefit Plan Medical Insurance

*Benefits enrollment must take place within 30 days of hire date

How to Enroll in Campus Benefits Voluntary Benefits

How to Enroll in State Health Benefit Medical Plan

1. Visit www.madisoncountybenefits.com

2. Select the “Enroll” tab or the

2. Select the “State Health” tab

“Campus Connect” tab 3. Follow the on-screen instructions OR

3. Select “SHBP Enrollment Link” (refer to the SHBP section of this guide for additional

4. Contact Campus Benefits at 1.866.433.7661, opt 5

details) OR 4. Contact SHBP at 1.800.610.1863

•

Plan year is 1/1 - 12/31

•

Scheduled open enrollment occurs in the Fall

•

Plan year is 1/1 - 12/31

(October - November)

•

Annual open enrollment occurs in the Fall (October - November)

Benefits Guide 2027

SERVICE HUB/ SUPPORT CENTER Campus Benefits is your dedicated advocate for all your voluntary benefits. When to contact the Campus Benefits Service Hub • Portability/Conversion • Claims • Benefits Education • Card Requests • Evidence of Insurability • Benefit Questions • Qualified Life Event • COBRA Information Changes

The Campus Benefits team understands the claims process and leverages the necessary carrier relationships to expedite the paperwork efficiently to ensure claims are not delayed due to improper paperwork completion.

How to File a Claim: 1. Contact Campus Benefits via phone or email 2. Work with Campus Benefits’ claims specialist to complete the necessary paperwork • Employee Portion • Physician Portion • Employer Portion 3. Submit the necessary paperwork to Campus Benefits via the secure upload • Secure upload located at www.madisoncountybenefits.com/contact-campus Frequently Asked Questions (FAQs): Q: When must a qualifying life event change be made? A: Please notify Campus Benefits within 30 days of the life event date. All SHBP life events must be made directly through the SHBP website. Q: Am I required to contact Campus Benefits to file a claim? A: No. However, in our experience the number one reason for claim denial or delay is due to incomplete or inaccurate paperwork. By working with Campus Benefits’ claim specialist, we can advocate on your behalf. Q: How can I access the group dental card or vision card quickly? A: Group dental and vision plan information is available at: www.madisoncountybenefits.com

Phone: 1.866.433.7661, opt 5 Email: mybenefits@campusbenefits.com Website: www.madisoncountybenefits.com 4

Benefits Guide 2027

EMPLOYEE ASSISTANCE PROGRAMS What is an EAP? Programs offered to Madison County School System’s employees to provide guidance with personal issues, planning for life events or simply managing daily life which can affect your work, health and family. Mutual of Omaha EAP Eligibility: Eligible Madison County School System’s employees, their household members and children up to age 26 • Coverage through Mutual of Omaha • Provides support, resources, and information for personal and work-life challenges • Receive up to four sessions per issue • CALL 1.800.316.2796 or visit mutualofomaha.com/eap

Confidential Counseling • •

Helps employees address stress, relationship and other personal issues for you and your family Sessions with highly trained master’s and doctoral level clinicians • Stress anxiety and depression • Job pressures • Grief and loss • Relationship/marital conflicts • Substance abuse • Problems with children

Work-Life Solutions

Work-Life Specialists will do the research for you, providing qualified referrals and customized resources for: • Child and elder care • College planning • Moving and relocation • Pet care • Making major purchases • Home repair

Financial Information and Resources

Speak by phone with a Certified Public Accountants and Certified Financial Planners on a wide range of financial issues, including: • Getting out of debt • Retirement planning • Credit card or loan problems • Estate planning • Tax questions • Saving for college

Online Resources • •

Timely articles, HelpSheets, tutorials, streaming videos and self-assessments Child care, elder care, attorney and financial planner searches

Plan Rates Coverage provided at no cost to you.

Benefits Guide 2027

DISABILITY INSURANCE What is Disability Insurance? A type of coverage that replaces a portion of your income if injury or illness prevents you from working. It provides financial security for you and any loved ones who may depend on your ability to earn a paycheck. You may also hear disability insurance referred to as disability income insurance or income protection. Eligibility: Eligible full-time employees working 20 or more hours per week • Coverage through Mutual of Omaha • Employee must be actively at work on the effective date • No health questions - Every Year at Open Enrollment! (Pre-existing condition will See apply for new participants) important • Participants can begin the required disability paperwork up to 3-4 weeks before claims going out on disability information on • STD pays in-addition to sick leave and paid parental leave. Sick leave (if the Service available) must be used in conjunction with disability benefit. Paid Parental Hub page. Leave can be used within 12 months but cannot exceed FMLA. • LTD benefits do not pay in-addition to sick leave. Must exhaust all sick leave prior to using benefit. Short-Term Disability Quick Summary Elimination Period

Benefits begin on the 15th day of an injury or illness

Benefit Duration

Covers accidents and sicknesses up to 11 weeks

Benefit Percentage (weekly)

60% of your gross weekly salary

Maximum Benefit Amount Weekly

$1,250

Pre-Existing Condition Limitation (New Enrollees Only)

3/6 Illness or injury for which you received treatment the 3 months prior to your effective date will not be covered for the first 6 months. Long-Term Disability Quick Summary

Elimination Period

Benefits begin on the 91st day of an injury or illness

Benefit Duration

Covers accidents and sicknesses up to Social Security normal age of retirement (Please note exclusions or limitations may apply, see plan certificate for details)

Benefit Percentage (monthly)

60% of your gross monthly salary

Maximum Benefit Amount Monthly

$6,000

Pre-Existing Condition Limitation (New Enrollees Only)

6/12 Illness or injury for which you received treatment the 6 months prior to your effective date will not be covered for the first 12 months Plan Rates

Short-Term Disability

$0.75 per $10 of Weekly Benefit

Long-Term Disability

$0.27 per $100 of Covered Payroll

Benefits Guide 2027

BASIC LIFE INSURANCE What is Basic Life Insurance? A financial and family protection plan paid for by Madison County School System which provides a lump-sum payment, known as a death benefit, to a beneficiary upon the death of the insured. Eligibility: Eligible full-time employees working 20 or more hours per week • Coverage through Mutual of Omaha • Must be actively at work on the effective date Basic Life Insurance Quick Summary All Eligible Employees

$20,000

Additional Plan Features: Employee Assistance Program, Child Care Benefit, Higher Education Benefit, Repatriation Age Reduction

None

Conversion

Included (Rate will increase)

Plan Rates Coverage paid for by Madison County School System at no cost to you.

Benefits Guide 2027

LIFE INSURANCE 101 The need for life insurance depends on each individual life situation. If loved ones are financially dependent on you, then buying life insurance coverage can absolutely be worth it. Even if you don’t have financial dependents yet, life insurance can be a valuable solution for making death easier on a family (at least financially.) There are two voluntary life insurance options offered through your employer: Term Life Insurance and Permanent Life Insurance. Below is an overview of the differences.

Term Life and Permanent Life work best used in conjunction with one another. Term Life can protect your family in your younger working years and Permanent Life can protect your family in your retirement years. TERM LIFE INSURANCE Term Life insurance is illustrated on the bell curve below. The term life offered is a group policy which allows you to get more benefit for less premium. • Term life insurance is for the unexpected death • Includes an Accidental Death & Dismemberment Benefit • Term life insurance is flexible and allows changes to your benefit amount each year depending on life changes. For example, as you get married and have children the need for term insurance often increases. As you near retirement, the need for term life insurance often decreases. • Coverage is portable at retirement or if you leave the employer (premium will increase) • Premiums are based on age and increase as you get older

PERMANENT LIFE INSURANCE Permanent Life Insurance is illustrated above along the bottom of the graph with a straight blue arrow. • Permanent life insurance offers a stable premium along the lifetime of the policy • Permanent life offers a level premium and is meant to take into retirement • Permanent life is an issue age policy based on the age when the policy is issued • This is an individual plan you can take with you regardless of where you work 8

Benefits Guide 2027

VOLUNTARY TERM LIFE & AD&D INSURANCE What is Voluntary Term Life Insurance and AD&D? A financial protection plan which provides a cash benefit to a beneficiary upon the death of the insured. Proceeds can be used to replace lost potential income during working years and help ensure your family’s financial goals will still be met; goals like paying off mortgage, keeping a business running, and paying for college. AD&D coverage is included as a part of life insurance benefits, and will pay out a lump-sum death benefit in the event you or a covered loved one die accidentally or pass away later as the direct result of an accident. This plan also has a dismemberment benefit which provides an additional lump sum payment if an insured becomes dismembered in an accident. Eligibility: Eligible full-time employees working 20 or more hours per week, spouse & children up to age 26 • Coverage through Mutual of Omaha • Must be actively at work on the effective date • If electing Voluntary Term Life outside of initial enrollment period, health questions will be required • Employee must elect coverage on themselves in order to cover spouse and/or children Term Life and AD&D Quick Summary

Employee Life and AD&D Rates Age

LIFE AMOUNT Employee

In increments of $10,000 up to the lesser of $500,000

Spouse

Increments of $5,000 up to $250,000, not to exceed employee amount (terms when employee turns age 80)

Child(ren)

$5,000 or $10,000

Child > 6 months

$1,000

Dependent coverage may not exceed employee coverage amounts ACCIDENTAL DEATH & DISMEMBERMENT AMOUNT (INCLUDED) Employee, Spouse & Child(ren)

Per $10,000

0-29

$0.88

30-34

$1.01

35-39

$1.24

40-44

$1.62

45-49

$2.26

50-54

$3.45

55-59

$5.70

60-64

$7.38

65-69

$12.96

70+

$39.06

Matches the Life Amount

Spouse Life and AD&D Rates

GUARANTEED ISSUE - FIRST TIME ELIGIBLE/NEW HIRE

Age

Per $5,000

Employee

$250,000

0-34

$0.64

Spouse

$50,000

35-39

$0.74

$10,000

40-44

$1.01

45-49

$1.56

50-54

$2.51

55-59

$3.61

60-64

$5.56

65-69

$9.17

70+

$48.24

Child(ren) GUARANTEED INCREASE IN BENEFIT Age Reduction

Employee: If enrolled, can increase by $20,000 up to guaranteed issue amount. Spouse: If enrolled, can increase by $10,000 up to guaranteed issue amount. 50% at age 80 (Based on employee age)

Portability Provision

Included (Rate will increase)

Conversion

Included (Rate will increase)

Accelerated Life Benefit Waiver of Premium

80% of Life Benefit Included

Coverage based on Employee Age / Spouse volume

Child(ren) Life and AD&D Rates $5,000

$1.11

$10,000

$2.21

Benefits Guide 2027

PERMANENT LIFE INSURANCE What is Permanent Life Insurance? Coverage that provides lifelong protection and the ability to maintain a level premium. Eligibility: Eligible full-time employees working 20 or more hours per week, spouse & children up to age 26 • Coverage through UNUM • Must be actively at work on the effective date • Permanent Life offers the flexibility to meet a variety of personal needs while allowing employees the choice of benefit premium amounts which fit their paycheck and lifestyle • Underwriting may be required. Coverage is not guaranteed • Keep your coverage, at the same cost, even if you retire or change employers Permanent Life Quick Summary PLAN MAXIMUMS Employee

$2,000 - $200,000

Spouse

$2,000 - 35,000

Child

$5,000 - $50,000 (increments of $5,000) GUARANTEED ISSUE (INITIAL ENROLLMENT/NEW HIRE)

Employee

$35,000 (Ages 15-50) / $25,000 (Ages 51-80)

Spouse

$10,000

Child

$25,000 OTHER FEATURES Guaranteed Premium Guaranteed Death Benefit Guaranteed Interest rate of 4.5% Living Benefit Option Rider - 100% of the benefit amount if you are terminally ill

Plan Rates Cost of coverage is based on the level of benefit you choose and your age. Please consult with a Campus Benefits Counselor or log into the enrollment system for rate details.

Benefits Guide 2027

VISION INSURANCE What is Vision Insurance? A health and wellness plan designed to reduce your costs for routine preventive eye care including eye exams and prescription eyewear (eyeglasses and contact lenses). Eligibility: Eligible full-time employees working 20 or more hours per week, spouse & children up to age 26 • Coverage through MetLife • To locate an in-network provider, please visit metlife.com/members/MetLife/FindAProvider/ • Network (Superior Vision) • The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety. Vision Benefits Quick Summary Eye Exam

$10 Copay

Fit and Follow-Up

Standard: $25 Copay, Specialty: $50 allowance after $25 Copay $175 allowance plus 20% off balance. Additional $25 allowance at select providers.

Frames

(20% off balance excludes Costco, Walmart and Sam’s Club.) $175 allowance plus 20% off balance of conventional lenses

Elective Contacts

& 10% off disposable lenses

Progressive Lenses

*Covered in Full (Standard, Premium, Ultra, and Ultimate)

Single/Bifocal/Trifocal/Lenticular Lenses

$25 Copay

Medically Necessary Contacts

Covered in full

Lasik

20% - 35% off national average

Frequencies

Exams, Frames, and Lens or Contact Lenses every 12 months Each member chooses one of the following: 2 pairs of eyeglasses OR 1 pair of eyeglasses & contact allowance OR Double the contact allowance

Additional Info (Allowance must be purchased on two separate invoices)

*Covered in Full Features

UV Coating, Solid Tint, Scratch Resistant Coating, Polycarbonate Lenses, Photochromic, Anti-Reflective Coating, High-Index (1.67/1.74) *Please visit www.madisoncountybenefits.com/vision for Out-of-Network allowances and additional information on your vision plan.

Rates

One Plan

Employee

$18.02

Employee + One

$30.39

Employee + Family

$34.23

Superior Vision Madison County School District

5946558

Group Name

Group Number

Providers: 1.877.638.3379 Members: 1.800.438.6388 This card is not a guarantee of coverage or eligibility.

*Click on id card for more information and printable version (electronic guide) Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

Benefits Guide 2027

DENTAL INSURANCE What is Dental Insurance? A health and wellness plan designed to pay a portion of dental costs associated with preventive, basic, some major dental care, as well as orthodontia services.

Eligibility: Eligible full-time employees working 20 or more hours per week, spouse & dependent children up to age 26 • Coverage through MetLife • In-Network provider Directory: www.providers.online.metlife.com (Network: PDP Plus) • Orthodontia available for employees, spouses, and children up to age 26 (only on Middle and High plans) • Exams and cleanings are allowed 2 times each calendar year and do not have to be separated by 6 months • No waiting periods or late entrant penalties • The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety.

High

Middle

Low

90 UCR

In-Network Only

90 UCR

Preventive

100%

Basic

80%

90%

80%

Major

50%

60%

$1,000 per person, per calendar year

$2,000 per person, per calendar year

$500 per person, per calendar year

UCR

Annual Maximum

Preventive services do not apply to annual max Coinsurance

50%

N/A

Ortho Lifetime Maximum (Adults & Children)

$1,000

$1,500

N/A

Deductible

$50 per person/$150 per family max (waived for preventive)

Preventive (A)

High Plan

Middle Plan

Low Plan

Basic (B)

Routine Exam (2/12 months) Bitewing X-Rays (1/12 months) Cleaning (2/12 Months) Fluoride for Children (18 & under)

Benefits Guide 2027

Restorative Amalgams Restorative Composites Crown Repair Periodontics (nonsurgical) Denture Repair Anesthesia Restorative Amalgams Restorative Composites Endodontics Periodontics Denture Repair Simple Extractions Complex Extractions Anesthesia

Major (C) Onlays Crowns Endodontics Periodontics (surgical) Implants Prosthodontics Simple Extractions Complex Extractions Onlays Crowns/Crown Repair Implants Prosthodontics

Restorative Amalgams Restorative Composites Crown Repair Periodontics (nonsurgical) Denture Repair Anesthesia Endodontics

DENTAL INSURANCE ADDITIONAL RESOURCES

DENTAL PLAN

Dental insurance pays a portion of the costs associated with dental care. Tips for utilizing your benefit

Look for participating dentists online at metlife.com.

Go to metlife.com/mybenefits or download the MetLife Mobile App. Find providers, view claims and more. Group name: Madison County School District

*The Middle Plan is the only innetwork only plans. Utilizing an in-network dentist will reduce your out-of pocket costs.

Your dentist can request a pre-treatment estimate for any service that is more the $300 to help you manage your cost and care

• In-network discounts apply even after you reach your plan’s annual maximum, reducing your out-of-pocket expense.

PDP Plus Madison County School District

5946558

Group Name

Group Number

Providers: 1.877.638.3379 Members: 1.800.438.6388 This card is not a guarantee of coverage or eligibility.

*Click on id card for more information and printable version (electronic guide)

High Plan

Middle Plan (In-Network Only)

Low Plan

Employee Only

$63.15

$54.98

$40.38

Employee + Dependent

$111.97

$97.44

$74.74

Employee + Family

$171.52

$149.18

$114.13

Benefits Guide 2027

CRITICAL ILLNESS INSURANCE What is Critical Illness Insurance? A health and wellness plan in which you receive a lump sum cash payment if diagnosed with one of the specific illnesses on the predetermined list of critical illnesses. Eligibility: Eligible full-time employees working 20 or more hours per week, spouse & dependent children up to age 26 • Coverage through MetLife • Must be actively at work on the effective date • Elect Critical Illness with or without Cancer Coverage based on your individual needs • Attained Age - Rates will increase as you age • No health questions- Every Year! (Pre-existing condition will apply for new participants) • The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety. CI Only

CI w/Cancer

Employee

Critical Illness Benefits Quick Summary

$10,000 or $20,000

Spouse

100% of EE Amount

Dependent Children

100% of EE Amount

Pays % of Face Amount

Heart Attack (Myocardial Infarction)

100%

Stroke

100%

Major Organ Failure

100%

End Stage Renal Failure (Kidney)

100%

Alzheimer’s Disease

100%

Coronary Artery Bypass Graft Surgery

100%

Full Cancer Benefit

None

100%

Partial Cancer Benefit

None

25%

COVERED SPECIFIED CRITICAL ILLNESSES

25% - 1 payment for each condition per lifetime

22 Additional Covered Conditions

GUARANTEED ISSUE (Up to Age 70) WELLNESS INCENTIVE TOTAL BENEFIT PRE-EXISTING CONDITION

Addison’s disease (adrenal hypofunction); amyotrophic lateral sclerosis (Lou Gehrig’s disease); cerebrospinal meningitis (bacterial); cerebral palsy; cystic fibrosis; diphtheria; encephalitis; Huntington’s disease (Huntington’s chorea); Legionnaire’s disease; malaria; multiple sclerosis (definitive diagnosis); muscular dystrophy; myasthenia gravis; necrotizing fasciitis; osteomyelitis; poliomyelitis; rabies; sickle cell anemia (excluding sickle cell trait); systemic lupus erythematosus (SLE); systemic sclerosis (scleroderma); tetanus; and tuberculosis

$20,000

$50 - (See Wellness Incentives Page) 3 times the amount of your initial benefit 3/6

Any Illness or injury for which you received treatment the 3 months prior to your effective date will not be covered for the first 6 months.

Plan Rates Cost of coverage is based on the level of benefit you choose and your age. Please consult with a Campus Benefits Counselor or log into the enrollment system for rate details. 14

Benefits Guide 2027

HOSPITAL INDEMNITY INSURANCE What is Hospital Indemnity Insurance? Supplemental coverage that helps offset costs associated with hospital stays, whether for planned or unplanned reasons. Payments made directly to you and benefits do not offset with medical insurance.

Eligibility: Eligible full-time employees working 20+hours/week, spouse and dependent children up to age 26 • Coverage provided by MetLife • No health questions – Every Year! (No pre-existing condition limitation) • No waiting period and no age reduction of benefits • Keep your coverage even if you retire or change employers • The chart below is a sample of covered services. Please see Plan Certificate for a detailed listing of services in their entirety which can be found on your new benefits website.

Hospital Indemnity Quick Summary

High Plan

Low Plan

Hospital Admission

$1,000

$500

ICU Supplemental Admission

$1,000

$500

Admission Benefit (4 times per calendar year - separated by 90 days) Confinement

$200

$100

ICU Supplemental Confinement

$200

$100

Confinement Benefit (365 days per calendar year) Confinement Benefit for Newborn Nursery Care (2 days per confinement) Wellness Incentive

$50

$25

$50 - (See Wellness Incentives Page)

Low Plan Rates

High Plan Rates Employee Employee + Spouse Employee + Child(ren) Employee + Family

$23.71 $43.72 $35.66 $55.67

Employee Employee + Spouse Employee + Child(ren) Employee + Family

$14.13 $26.23 $21.49 $33.59

Benefits Guide 2027

CANCER INSURANCE What is Cancer Insurance? Cancer insurance is a form of supplemental insurance meant to offset cancer related expenses so you can focus on recovery. • • • • • • •

Eligibility: Eligible full-time employees working 20 or more hours per week, spouse & children up to age 26 Coverage through Guardian No age reduction on benefits Payments made directly to you and do not offset with medical insurance No health questions - Every Year! (Pre-existing condition will apply for new participants) Must be cancer free for 5 years if previously diagnosed with cancer Keep your coverage even if you retire or change employers The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety. Cancer Plan Quick Summary

Premier (High Plan)

Advantage (Low Plan)

HOSPITAL AND RELATED BENEFITS - DAILY BENEFIT Initial Diagnosis Benefit Amount

$5,000

(must be first time diagnosis) Initial Diagnosis Waiting Period

$2,500 30 days

Premier (High Plan)

Hospital Confinement

$400

$300

ICU Confinement

$600

$400

Private Duty Nursing Expenses (daily)

$150

$100

Employee

Hospice

$100

$50

$30.60

$15,000

$10,000

Employee + Spouse $56.91

Up to $10,000

Up to $5,000

$200

$100

RADIATION,CHEMOTHERAPY & RELATED BENEFITS Radiation Therapy Chemotherapy (every 12 months) Blood/Plasma/Platelets (every 12 months) Medical Imaging (2 per year)

SURGERY AND RELATED BENEFITS Surgery (inpatient or outpatient) Anesthesia (% of surgery) Ambulatory Surgical Center

up to $5,500

up to $4,125

25%

Monthly Rates

Employee + Child(ren) $34.91 Employee + Family $61.23

$350/day

$250/day

Breast TRAM $3,000 Breast reconstruction $700 Breast Symmetry $350 Facial reconstruction $700

Breast TRAM Flap $2,000 Breast reconstruction $500 Breast Symmetry $250 Facial reconstruction $500

Surgical Benefit

$5,500

$4,125

Second Opinion

$300

$200

1. Bone Marrow

$10,000

$7,500

2. Stem Cell

$2,500

$1,500

3. Donor Benefit

$1,500

$1,000

Employee + Spouse $34.93

$250

$200

Employee + Child(ren) $21.55

Transportation (local or non-local)

$0.50 per mile ($1,500 round trip)

$0.50 per mile ($1,000 round trip)

Outpatient or Family Lodging (daily)

$100

$75

Reconstructive Surgery

Bone Marrow /Stem Cell

Advantage (Low Plan) Monthly Rates Employee $18.82

MISCELLANEOUS BENEFITS Air Ambulance (per confinement/2 trip limit)

Ambulance (per confinement)

Physical or Speech Therapy (Daily)

$50

$200 per day / $2,400 per month

$100 per day / $1,000 per month

Prosthetic

$300 - $6,000

$200 - $4,000

Skin Cancer

Biopsy Only: $100 Reconstructive Surgery: $250 Excision of a skin cancer: $375 Excision of a skin cancer with flap or graft: $600

Experimental Treatment

Wellness Incentive (see Wellness Incentives page)

$75

$50

Waiting Period (Initial Diagnosis)

30 Days

Pre-Existing Condition Limitation

12/12= Any illness or injury for which you received treatment. The 12 months prior to your effective date will not be covered for first 12 months.

Benefits Guide 2027

Employee + Family $37.66

WELLNESS INCENTIVES

GET REWARDED FOR PREVENTIVE CARE What are Wellness Incentives? An annual reimbursement for covered members who complete one of the eligible screening procedures on your critical illness, hospital indemnity and/or cancer insurance plans. Eligibility: You, spouse and dependents who are covered on the critical illness, hospital indemnity or cancer plans How it works: • If you or a covered dependent get one of the eligible screenings, you can file a wellness claim • Once approved, you will receive a check for the wellness benefit amount • The wellness incentive can be filed annually as long as your critical illness and cancer plans are in force Available Wellness Incentives

Low Plan

Critical Illness and Hospital Indemnity - MetLife

High Plan $50

Cancer Plan - Guardian

$50

State Health Benefit Plan

See the SHBP for details more details

$75

What Qualifies as Wellness? Critical Illness and Hospital Indemnity - MetLife May Include, but not limited to: (Please refer to the benefits website for additional wellness incentives and claims information) • Annual physical exam • Biopsies for cancer • Blood test to determine total cholesterol/triglycerides • Bone marrow testing • Breast MRI, ultrasound, sonogram • Cancer antigen 15-3 and 125 blood test for breast cancer (CA 15-3)/ ovarian cancer (CA 125) • Carcinoembryonic antigen blood test for colon cancer (CEA) • Carotid doppler • Chest x-rays • Clinical testicular exam • Colonoscopy; Digital rectal exam (DRE) • Doppler screening for cancer • Doppler screening for peripheral vascular disease • Echocardiogram; Electrocardiogram (EKG) • Endoscopy • Fasting blood glucose/plasma test • Flexible sigmoidoscopy • Hemoccult stool specimen • Hemoglobin A1C • Human papillomavirus (HPV) vaccination • Lipid panel • Mammogram • Oral cancer screening • Pap smears or thin prep pap test • Prostate-specific antigen (PSA) test • Serum cholesterol test to determine LDL or HDL • Serum protein electrophoresis • Skin Exam; Skin cancer biopsy; screening • Stress test on bicycle or treadmill • Successful completion of smoking cessation program • Tests for sexually transmitted infections (STIs) • Thermography • Two hour post-load plasma glucose test • Ultrasounds for cancer detection • Ultrasound screening of the abdominal aorta for abdominal aortic aneurysms • Virtual colonoscopy

Cancer - Guardian • • • • • • • • • • • • • • • • • • •

Bone marrow testing BRCA testing Breast ultrasound Breast MRI CA 15-3 (blood test for breast cancer) CA125 (blood test for ovarian cancer) CEA (blood test for colon cancer) Chest x-ray Colonoscopy/Virtual Colonoscopy CT scans /MRI scans Flexible sigmoidoscopy Hemoccult stool analysis Mammography Pap smear /ThinPrep pap test PSA (blood test for prostate cancer) Serum protein electrophoresis (blood test for myeloma) Testicular ultrasound Thermograph

How to submit a wellness claim? • •

Call 1.800.GET.MET8. (800.438.6388) File your Health Screening Benefit online through the MyBenefits portal at www.metlife.com/mybenefits or by mail with a paper claim form. Important Note: Must use Madison County School District when registering on the MetLife MyBenefits site.

•

Log on to guardianlife.com and select “My Account/Login” to register or access your account.

Additional wellness information and claim forms can be found on your employee benefits website, madisoncountybenefits.com

Benefits Guide 2027

ACCIDENT INSURANCE What is Accident Insurance? This coverage is designed to help offset medical and out-of-pocket costs associated with unforeseen accidents. Payments made directly to you and benefits do not offset with medical insurance. Eligibility: Eligible full-time employees working 20 + hours per week, spouse & dependent children up to age 26 • Coverage through MetLife • No health questions - Every Year! • Keep your coverage even if you retire or change employers • The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety. Accident Plan Quick Summary

High Plan

Low Plan

High Plan Rates

INJURIES Fractures

$100-$6,000

$50-$3,000

Dislocations

$100-$6,000

$50-$3,000

Second and Third Degree Burns

$100-$10,000

$50-$5,000

$400

$200

$50-$400

$25-$200

$300

$200

Concussions Cuts/Lacerations Eye injuries

MEDICAL SERVICES & TREATMENT Ambulance

$300-$1,000

$200-$750

Emergency Care

$50-$100

$25-$50

Non-Emergency Care

$50

$25

Physician Follow-Up

$75

$50

Therapy Services (including physical therapy)

$25

$15

Medical Testing Benefit

$200

$100

Medical Appliances

$100-$1,000

$50-$500

Inpatient Surgery

$200-$2,000

$100-$1,000

Hospital Coverage (Accident) Admission

$1,000 (nonICU)-$2,000 (ICU) per accident

$500 (nonICU)-$1,000 (ICU) per accident

Confinement

$200 a day (nonICU)-$400 (ICU) up to 31 days

$100 a day (nonICU)-$200 (ICU) up to 31 days

Inpatient Rehab

$200 a day up to 15 days

$100 a day up to 15 days

Age Reduction

Employee $10.89 Employee + Spouse $22.99 Employee + Child(ren) $22.38 Employee + Family $27.53 Low Plan Rates Employee $5.70 Employee + Spouse $11.98 Employee + Child(ren) $11.75 Employee + Family $14.71

25% at age 65; 50% at age 70

Includes Accidental Death and Dismemberment Benefit. See policy certificate for details. 18

Benefits Guide 2027

MEDCARECOMPLETE

THE SMART WAY TO REDUCE YOUR HEALTHCARE COSTS THE SMART WAY TO REDUCE YOUR HEALTHCARE COSTS What is MedCareComplete? Provides a bundle of services constructed to save you time, money, and hassle while simplifying your life. Eligibility: Eligible full-time employees working 20 or more hours per week, spouse & unmarried children up to age 26 • This is a supplemental benefit and does not replace health insurance • Register @ MCC: medcarecomplete.com/members to access the full range of benefits • Register @ 1800MD: 1800md.com or 800.388.8785 to access telemedicine benefits

Included with the MedCareComplete Membership: Medical Bill Negotiator

Restoration Expert

Medication Management

Identity Loss Expense Reimbursement

Telemedicine

Social Media Tracking

Medical & ID Theft Monitoring

Sex Offender Alerts

Medical Bill Negotiator A medical bill advocate will identify and appeal common billing errors and overcharges on your behalf. Advocates provide continuous support throughout the appeal that typically results in an average savings of 40% on 80% of the bills reviewed.

Telemedicine Get 24/7/365 on-demand telephone access to Board-certified physicians for diagnosis, and prescriptions for common and acute illnesses. There are no copays and no limit to how many times you can utilize this feature.

Individual Rate

Family Rate

$10.50 Per Month

$12.50 Per Month

NO COPAY

Acute Illnesses include but are not limited to the following: Asthma Fever Headache Infections

Migraines Rashes Bacterial Infections Diarrhea

Heartburn Sinus Conditions Urinary Tract Infections

Bronchitis Ear Infection Gout Joint Aches

Pink Eye Sore Throat Cold & Flu Nausea & Vomiting

Medical & ID Theft Protection Service monitors the internet for instances of your personal health and financial information to protect you from becoming a victim of identity theft. The security of your personal health information (PHI) can have a large impact on the medical care you receive. Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

Benefits Guide 2027

FLEXIBLE SPENDING ACCOUNTS What are Medical Flexible Spending Accounts (FSAs)? A pre-tax benefit account used to pay for out-of-pocket healthcare costs such as deductibles, co-pays, prescribed medication, and other medical costs. What are Dependent Care Accounts? A pre-tax benefit account used to pay for dependent care services such as preschool, summer day camp, before or after school programs, and child or elder daycare. Eligibility: Eligible full-time employees working 20 or more hours per week, spouse & children up to age 26; children under age 13 are eligible for Dependent Care and up to age 26 for Medical FSA • Coverage through Medcom • Plan year is from January 1 - December 31 • Dependent Care funds used for daycare and available for tax dependent adults for adult care • Only family status changes will allow you to alter your annual election. The altered election must be consistent with the status change • Married and not filing jointly participants limited to $3,750 deferral for Dependent Care • Transfer of funds between Dependent Care and un-reimbursed Medical are prohibited • For a full list of eligible expenses, please go to www.medcom.net FSA Benefits Quick Summary MEDICAL FSA ACCOUNT Minimum Contribution

$300 annually

Maximum Contribution

$3,400 annually

Carryover Maximum*- Maximum participants can carry over if re-electing the plan

$680

Total elected amount is available at the beginning of the plan year

All receipts should be kept to submit if verification is requested DEPENDENT CARE ACCOUNT Minimum Contribution

$300 annually

Maximum Contribution

$7,500 annually

Carryover Maximum

None Amount is available as it is payroll deducted PLAN RULES

RUNOUT PERIOD - Time to turn in receipts for services rendered during the plan year.

Admin Fee Fee Per Participant Per Month (One fee even if electing both Medical FSA and Dependent Care)

Benefits Guide 2027

$3.50

30 Days

IMPORTANT NOTE: Dependent Care FSA is for eligible expenses related to the care of your child, disabled spouse, elderly parent, or other dependent who is physically or mentally unable or disabled for self-care (i.e. day care, adult day care). Medical expenses for your dependent are not eligible for reimbursement under the Dependent Care account.

HELPFUL FSA RESOURCES What is covered under Medical FSA Accounts? • Medical coinsurance and deductible FSA Eligibility List • Doctor’s office visit copays www.fsastore.com/fsa-eligibility-list • Emergency Room costs FSA Calculator • Dental copays and out-of-pocket costs (estimates how much you can save with an FSA) www.fsastore.com/fsa-calculator • Vision copays and out-of-pocket costs • Contacts and Glasses • Prescriptions • Please see the full eligibility list for other covered expenses Who is covered under a Dependent Care Account? • Children under age 13 (including stepchildren, grandchildren, adopted or foster children, and children related to you who are eligible for a tax exemption on your federal tax return) • Tax dependents residing with you and incapable of self-care (this could include your spouse, a child age 13 and over, and elderly parents) The CARES Act permanently reinstates over-the counter products, and adds menstrual care products for the first time, as eligible expenses for your FSA funds WITHOUT A PRESCRIPTION! Eligible items for purchase without a prescription now include, but are not limited to: • Pain relief medications, e.g., acetaminophen, ibuprofen, naproxen sodium • Cold & flu medications • Allergy medications • Acne treatments • Eye drops • Stomach & digestive aids • Pads, tampons and menstrual sponges • Sleep aids • Children’s pain relievers, allergy medicines, and digestive aids

In the App Store go to: MedCom Mobile Online Portal and Access to information: www.medcom.wealthcareportal.com IMPORTANT NOTE: Dependent Care FSA is for eligible expenses related to the care of your child, disabled spouse, elderly parent, or other dependent who is physically or mentally unable for self-care (i.e. day care, adult day care) or is disabled. Medical expenses for your dependent are not eligible for reimbursement under the Dependent Care account. Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

Benefits Guide 2027

LEGAL PLAN What is Legal Plan? A plan which provides valuable legal and financial educational resources for a variety of life events and needs. Eligibility: Eligible full-time employees working 20+ hours/week, spouse and dependent children (up to age 26) • • • •

Coverage through MetLife Elder Care extends to parents and in-laws Visit www.legalplans.com/why-enroll or call 800.821.6400 for additional information Non-Members & Members create an account and select Employer for plan information (creating an account doesn’t enroll you in plans) • High Plan: For non-covered matters that are not otherwise excluded, your plan provides four hours of network attorney time and services per year • Plan Certificate available on your Employee Benefits Website (www.madisoncountybenefits.com) Low Plan Quick Summary Money Matters

• • • • •

Identity Theft Defense Negotiations with Creditors Promissory Notes Debt Collection Defense Tax Collection Defense

• • • • •

Identity Theft Defense Negotiations with Creditors Promissory Notes Debt Collection Defense Tax Collection Defense

• • • •

Personal Bankruptcy LifeStages Identity Management Tax Audit Representation Financial Education Workshops Tax Preparation & Filing

Deeds Mortgages Foreclosure Tenant Negotiations Eviction Defense Security Deposit Assistance

• • • • • •

Deeds Mortgages Foreclosure Tenant Negotiations Eviction Defense Security Deposit Assistance

•

Home & Real Estate

• • • • • •

• • • •

Sale or Purchase (Primary or Vacation Home) Refinancing & Home Equity Property Tax Assessments Boundary & Title Disputes Zoning Applications

• • • • •

Simple and Complex Wills Healthcare Proxies Living Wills Codicils Powers of Attorney (Healthcare, Financial, Childcare, Immigration)

• • • • •

Simple and Complex Wills Healthcare Proxies Living Wills Codicils Powers of Attorney (Healthcare, Financial, Childcare, Immigration)

•

Revocable & Irrevocable Trusts

• • • •

Guardianship Conservatorship Name Change Review of ANY Personal Legal Document School Hearings Demand Letters Affidavits Personal Property Issues Garnishment Defense Domestic Violence Protection

• • • •

Guardianship Conservatorship Name Change Review of ANY Personal Legal Document School Hearings Demand Letters Affidavits Personal Property Issues Garnishment Defense Domestic Violence Protection

•

Juvenile Court Defense (Including Criminal Matters) Parental Responsibility Matters Review of Immigration Documents Prenuptial Agreement Adoption Caregiving Support (Family First)

Disputes over Consumer Goods & Services Administrative Hearings Incompetency Defense

•

Estate Planning

Family & Personal

Civil Lawsuits

Elder Care Issues

Vehicle & Driving

High Plan Quick Summary

• • • • • • • • •

• • • • • •

• •

Disputes over Consumer Goods & Services Administrative Hearings Incompetency Defense

•

• • • • •

• • •

Civil Litigation Defense & Mediation Small Claims Assistance Pet Liabilities

Consultation & Document review for issues related to your (or Spouse’s) parents: • Medicare • Medicaid • Prescription Plans • Nursing Home Agreements • Leases • Promissory Notes • Deeds • Wills • Power of Attorney

Consultation & Document review for issues related to your (or Spouse’s) parents: • Medicare • Medicaid • Prescription Plans • Nursing Home Agreements Low Plan High Plan • Leases • Promissory Notes • Deeds $8.00 $19.50 • Wills • Power of Attorney

• • • •

Benefits Guide 2027

Repossession Defense of Traffic Tickets Driving Privileges Restoration License Suspension due to DUI

Per Month

Repossession Defense of Traffic Tickets Driving Privileges Restoration License Suspension due to DUI

Per Month

NO COPAY

ADDITIONAL RESOURCES Additional Benefits to Support Your Wellbeing and Peace of Mind As part of your Mutual of Omaha benefits package, you have access to additional services such as a hearing discount program, identity theft assistance, travel assistance and will preparation services. Must be enrolled in Voluntary Term Life benefits to access resources. Hearing Discount Program

Enjoy savings and support through Amplifon Hearing Health Care. • Variety of industry leading brands’ hearing aids to choose from • 60-day risk free trial with money back guarantee • 3 year warranty for loss, repairs or damage • Follow up care, battery supplies and financing options available • Family and friends receive a discount • Call Amplifon at 1-888-534-1747 to speak with a Patient Care Advocate who will connect you with a provider near you • To learn more visit www.amplifonusa.com/mutualofomaha

Identity Theft Assistance

Receive essential identity protection and recovery help through AXA Assistance. • Education and awareness to reduce risk of identity theft • Guidance on recognizing and responding to fraud • Recovery support if personal information is stolen, including steps to restore your identity and contacts for financial institutions and credit bureaus • Call AXA Assistance at 1-800-856-9947

Worldwide Travel Assistance

Feel secure knowing you and your family are covered while traveling more than 100 miles from home. • 24/7 emergency support for medical referrals, legal help and translation services • Pre-trip planning support including passport/visa requirement, health advisories, and currency exchange rates • Assistance with lost baggage, emergency cash, emergency messages between you and others, vehicle return and document replacement (credit card, passport, tickets) • Call World Travel Assistance at 1-800-856-9947 (within the U.S.) or 312-935-3658 (outside of the U.S.)

Will Preparation Services

Create important legal documents at no cost through Epoq, Inc. • Easy online platform to prepare: living will and trust, power of attorney, healthcare directive, pourover will, last will and testament • Print and share instantly and update as needed for major life changes • Make the document legally binding (check with your state for requirements) • To learn more visit www.willprepservices.com and use code MUTUALWILLS to register

Please visit www.madisoncountybenefits.com for more information.

Benefits Guide 2027

STATE HEALTH BENEFIT PLAN Eligibility: Please review the SHBP Decision Guide for plan eligibility rules. • • • •

Coverage through Anthem (BCBS of GA) or United Healthcare All qualifying life events must be submitted via the SHBP Portal Notice: Madison County School System offers eligible employees health insurance through the Georgia State Health Benefit Plan. During the scheduled open enrollment, employees have the opportunity to review all available options and make elections for the upcoming Plan Year Kaiser Permanente is only available in the Atlanta Metro area.

SHBP Enrollment Portal:

SHBP Wellness Portal:

www.myshbpga.adp.com

www.bewellshbp.com

How to Enroll:

SHBP Decision Guide:

1. Go to www.myshbpga.adp.com 2. Enter your Username and Password and click Login. If you need assistance, click on “Forgot User ID?” or “Forgot Your Password?”. 3. If you have not registered, click “Register Here”. 4. Your registration code is SHBP-GA.

This Guide provides a brief explanation about each health benefit option, a benefit comparison guide, and a list of things to consider before making plan decisions. Access the decision guide at www.shbp.georgia.gov

SHBP Phone Number: 1.800.610.1863 SHBP 2027 Wellness Incentives Overview: ****The table below is a high-level overview, for official details and plan information please review the SHBP Decision Guide.

Anthem HMO MyIncentive Account (MIA)

Anthem Health Reimbursement Arrangement (HRA)

UHC HMO & HDHP Health Incentive Account (HIA)

Who’s Eligible

Up to

Member

480 credits

Spouse

480 credits

Bonus credits for member

N/A

$250 Reward Card (covered member & spouse)

Potential Total credits/dollars

960 credits

1,460 credits

Plan Option

Please review the Active Decision Guide for full incentive program details and requirements. Anthem: Members enrolled in an Anthem HRA Plan Option will receive SHBP-funded base credits at the beginning of the Plan Year. The amount funded will be based on your elected coverage tier. If you enroll in a HRA during the Plan Year, these credits will be prorated based on the elected coverage tier and the months remaining in the current Plan Year. *KP: Members enrolled in the KP Regional HMO Plan Option and their covered spouses will each receive a $500 reward card after they each satisfy KP’s Wellness Program requirements. **UnitedHealthcare: Members and their covered spouses enrolled in an UnitedHealthcare Plan Option can each earn a 240 well-being incentive credit match with a maximum combined up to 480 well-being incentive credits matched by UnitedHealthcare for completing wellness requirements under the plan. After credits are added to your HIA, any remaining credits will rollover to the next plan year. Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes Benefits Guide 2027 24 and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

2027 SHBP PLANS & PRICING The table below is a high-level overview, for official details and plan information please review the SHBP Decision Guide. Plan Designs for 2027 Anthem Gold Plan HRA In Out

Anthem Silver Plan HRA In Out

Anthem Bronze Plan HRA In Out

You

$1,500

$3,000

$2,000

$4,000

$2,500

You + Spouse

$2,250

$4,500

$3,000

$6,000

$3,750

You + Child(ren)

$2,250

$4,500

$3,000

$6,000

$3,750

You + Family

$3,000

$6,000

$4,000

$8,000

$5,000

Anthem HMO In

UHC HMO In

$5,000

$1,300

$3,500

$7,000

$7,500

$1,950

$7,000

$14,000

$7,500

$1,950

$7,000

$14,000

$10,000

$2,600

$7,000

$14,000

UHC HDHP Out

Kaiser HMO* In

Deductible

Medical OOPM (Out of Pocket Maximum) You

$4,000

$8,000

$5,000

$10,000

$6,000

$12,000

$4,000

$6,450

$12,900

$6,350

You + Spouse

$6,000

$12,000

$7,500

$15,000

$9,000

$18,000

$6,500

$12,900

$25,800

$12,700

You + Child(ren)

$6,000

$12,000

$7,500

$15,000

$9,000

$18,000

$6,500

$12,900

$25,800

$12,700

You + Family

$8,000

$16,000

$10,000

$20,000

$12,000

$24,000

$9,000

$12,900

$25,800

$12,700

Coinsurance (Plan Pays. Some outof-network services not covered)

85%

60%

80%

60%

75%

60%

70%

50%

100%

80%

HRA (Health Reimbursement Arrangement) Credits You

N/A

You + Spouse

N/A

You + Child(ren)

*See decision guide and summary plan documents for details

You + Family Medical ER

Coins after ded

$200 copay

Coins after ded

$200 copay

Urgent Care

Coins after ded

$35 copay

Coins after ded

$35 copay

PCP Visit

Coins after ded

$35 copay

Coins after ded

$35 copay

Specialist Visit

Coins after ded

$45 copay

Coins after ded

$45 copay

Preventative

100%

N/A

100%

N/A

100%

Retail Rx (Not subject to deductible on HRA plans) Tier 1

15%, Min $5, Max $10

$5 copay

Coins after ded

$20 copay

Tier 2

25%, Min $55, Max $85

$55 copay

Coins after ded

$50 copay

Tier 3

25%, Min $85, Max $130

$95 copay

Coins after ded

$80 copay

Tier 1

15%, Min $12.50 Max $25

$12.50 copay

Coins after ded

$50 copay

Tier 2

25%, Min $137.50, Max $212.50

$137.50 copay

Coins after ded

$125 copay

Tier 3

25%, Min $212.50, Max $325

$237.50 copay

Coins after ded

$200 copay

Monthly Premiums

Anthem Gold Plan HRA

Anthem Silver Plan HRA

Anthem Bronze Plan

Anthem HMO

UHC HMO

UHC HDHP

Kaiser HMO*

Mail Order Rx

Employee

$227.19

$153.17

$94.16

$189.29

$232.70

$83.76

$189.29

Employee + CH

$415.51

$289.67

$189.35

$351.08

$424.87

$171.67

$351.08

Employee + SP

$565.89

$410.44

$286.52

$486.30

$577.46

$264.68

$486.30

Family

$754.21

$546.94

$381.71

$648.09

$769.63

$352.59

$648.09

*Kaiser Permanente is available in the Metro Atlanta Service Area and Athens-Clarke, in-network only. There is an $80 tobacco surcharge added to all rates. Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

Benefits Guide 2027

• • • •

The Service Hub Helps With: Portability/Conversion Benefits Education Evidence of Insurability Qualified Life Event Changes

The 2027 Benefits Enrollment Guide is provided for illustrative purposes only. Actual benefits, eligibility, services, premiums, claims processes and all other features and plan designs for coverage offered is governed exclusively by the insurance contract and associated Summary Plan Description (SPD). In case of discrepancies between this document and the insurance contract and SPD, the contract and SPD will prevail. We reserve the right to change, modify, revise, amend or terminate these plan offerings at any time. Updates, changes, and notices are available for review at madisoncountybenefits.com or by contacting HR or the email above. These should be reviewed fully prior to electing any benefits. Disclosures: All required SPD, legal and plan Disclosures are posted on the Benefit Website. For a written copy please contact Campus Benefits at 866-433-7661, opt. 5.

• • • •

Claims Card Requests Benefit Questions COBRA Information