We are pleased to offer a full benefits package to you and your eligible dependents. Read this guide to know what benefits are available to you. You may only enroll for or make changes to your benefits during Open Enrollment or when you have a Qualifying Life Event.
This Benefits Guide provides general information about the benefits available to you. For detailed plan provisions and coverage specifics, please refer to each plan’s Summary of Benefits available by accessing www.mybenefitshub.com/friscoisd
2026-2027 Important Contacts
Employee Response Center
Higginbotham Public Sector
833-953-7008
friscoisd@hps.higginbotham.net
Accident
Cigna
Group No. AI112293
800-754-3207
www.supphealthclaims.com
Cancer
Chubb
Policy No. 100000219
888-499-0425
cwbspecialmarketservice@chubb.com
COBRA (Medical)
bSwift
833-682-8972
COBRA (Dental and Vision)
National Benefit Services
800-274-0503
Critical Illness
Cigna
Group No. CI112211
800-754-3207
www.supphealthclaims.com
Dental
Cigna
Group No. 3339989
800-244-6224
www.cigna.com
Disability
Chubb
Policy No. 100000219
888-499-0425
cwbspecialmarketservice@chubb.com
Emergency Medical Transport
MASA
Group No. MKFRISC
800-423-3226
www.masamts.com
Employee Clinic
469-303-3036
wellness@friscoisd.org
Frisco ISD Benefits Office
469-633-6360
benefits@friscoisd.org
Frisco ISD CSR
Dalia Robledo
469-633-6373
robledod@friscoisd.org
Flexible Spending Accounts
National Benefit Services
855-399-3035
www.nbsbenefits.com
Health Savings Account
EECU
817-882-0800
www.eecu.org
Hospital Cash
Chubb
Policy No. 100000219
888-499-0425
cwbspecialmarketservice@chubb.com
ID Theft Protection
Aura Identity Guard
855-443-7748
https://my.aura.com
Individual Life
5Star Life Insurance Company
Policy No. 02484
866-863-9753
www.5starlifeinsurance.com
Legal Assistance
MetLife Legal Plans
Access Code 9310010
800-821-6400
www.members.legalplans.com
Life and AD&D (Basic and Voluntary)
Chubb
Policy No. 100000219
888-499-0425
cwbspecialmarketservice@chubb.com
Medical – TRS-Activecare
Blue Cross Blue Shield of Texas
866-355-5999
www.bcbstx.com/trsactivecare
Pet Insurance
MetLife
800-438-6388
www.metlifepetinsurance.com/friscoisd
Wellness
Frisco ISD
469-633-6379
wellness@friscoisd.org
https://sites.google.com/friscoisd.org/ fisdwellness/employee-clinic/onsite-clinic On personal devices, you must be logged in with your FISD email address under Google Chrome to open the wellness website.
Pharmacy
Express Scripts (Evernorth)
800-282-2881
www.express-scripts.com
Accredo Specialty Drugs 877-222-7336
Prescription Savings
Clever RX Group No. 1085
800-873-1195
https://cleverrx.com/friscoisd
Retirement Planning
TCG HUB International
800-943-9179
www.tcgservices.com
Finpath (Financial Wellness) 833-777-6545
www.finpathwellness.com
Telehealth
Recuro Health
855-6RECURO (673-2876) www.recurohealth.com
Vision
EyeMed Vision Care
Group No. VC-19 866-800-5457 www.eyemedvisioncare.com
How to Enroll
SSO Login Process
1
Go to www.mybenefitshub.com/friscoisd or scan the QR code below.
2 Click Login.
3 Click Login with Microsoft
4
Once confirmed, the Additional Security Verification page will list the contact options from your profile. Select either the Text, Email, Call, or Ask Admin options to receive a code to complete the final verification step.
5 Complete the verification steps.
6 Happy enrolling!
All Your Benefits – One Portal
Enrollment made easy with your smartphone or tablet. Scan the QR code to go to your benefit website for:
● Benefits resources
● Online enrollment
● Interactive tools
● And more!
* Standard message rates may apply.
What’s New
● FISD Employee Clinic:
GREAT NEWS! The FISD Employee Clinic will now see dependents up to the age of 26. Care is available both in-person and virtually. To ensure your family can access these services, verify your dependents are added to your profile in MyBenefitsHub.
● TRS-ActiveCare 2026-2027 Plan Update and Rates:
» Plan Details: The 2026-2027 TRS ActiveCare plan highlights and rates are now available. To view coverage details, visit TRS Plan Highlights and select Region 10
» Plan Rates: View the new monthly premiums here: 2026-2027 Medical Premiums
» Action Required: TRS now requires a Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN) for all enrolled spouses and dependent children over the age of one. Please ensure this information is updated in MyBenefitsHub to avoid termination of coverage.
● Health Savings Account (HSA):
You must enroll in the TRS ActiveCare-HD plan to enroll in an HSA. The HSA maximum is $4,400 for self-only and $8,750 for family coverage. You can contribute an additional amount of $1,000 if you are over the age of 55.
● Flexible Spending Account (FSA) and Dependent Care FSA Plans:
» Effective September 1, 2026, National Benefit Services (NBS) will be our carrier for the Flex and Dependent Care Spending Accounts
» FSA elections must be re-elected annually.
» The 2026 maximum FSA contribution amount increased to $3,400
» The Dependent Care FSA contribution maximum increased to $7,500 if filling jointly or Head of Household, and $3,750 if married filing separately.
» Both the FSA and Dependent Care FSA plans are use-it-or-lose it. You will NO LONGER be able to carry over any amount on the FSA plans.
● NEW Vision Offering:
We’re excited to introduce a new Enhanced Vision Plan alongside the current Base Plan. The Enhanced Plan offers greater value and lower out-of-pocket costs, especially if you wear glasses regularly or choose progressive/premium lenses.
» $0 copays for exams and standard lenses
» Higher frame allowance ($250 vs. $200 at PLUS Providers)
» Lower costs for progressive, anti-reflective, and premium lens upgrades
» Increased contact lens allowance
● NEW Function Health Offering:
District employees can now enroll in Function Health at a discounted rate. The plan offers comprehensive, affordable lab testing, evaluating over 160 biomarkers twice a year to provide deeper insights into health and disease markers compared to traditional physicals. The service includes clinician-reviewed results, nationwide testing locations, and is eligible for HSA/FSA funds. For more information, visit https://www.functionhealth.com/aep/higginbotham
● 5Star Individual Life:
Plans will once again be offered on a Guaranteed Issue regardless of health status.
Don’t Forget!
● Log in and complete your benefit enrollment from July 20 – August 13, 2026.
● Enrollment assistance is available by calling Higginbotham Public Sector at 833-953-7008
● REQUIRED! You must add the CORRECT Social Security number or ITIN for your spouse and dependent(s) in the online enrollment system. If you have questions, contact your Benefits Administrator.
Eligibility
Who is Eligible for Benefits
You are eligible for coverage if you are a regular, full-time employee. You may only enroll for coverage when:
New Hire
Who is Eligible
● A regular, full-time employee working an average of 20 hours per week
When to Enroll
● Enroll by the deadline given by Benefits Office
When Coverage Starts
● First day of work concurrent with the plan effective date
● You are a new hire
● It is Open Enrollment (OE)
● You have a Qualifying Life Event (QLE)
Employee
Who is Eligible
● A regular, full-time employee working an average of 20 hours per week
When to Enroll
● Enroll during OE or when you have a QLE
When Coverage Starts
● You must be actively at work on the plan effective date for new benefits to be effective
● QLE: Ask Benefits Office
Employees working 10 hours per week may enroll for medical coverage only at full cost.
See Important Limitations and Exclusions information on page 7.
Dependent(s)
Who is Eligible
● Your legal spouse
● Child(ren) under age 26, regardless of student, dependency, or marital status
● Child(ren) over age 26 who are fully dependent on you for support due to a mental or physical disability and who are indicated as such on your federal tax return
When to Enroll
● You must enroll the dependent(s) during OE or when you have a QLE
● When covering dependents, you must enroll for and be on the same plans
● Dependents cannot be double-covered by married spouses within the district as both employees and dependents
When Coverage Starts
● Based on OE or QLE effective dates
Eligibility
Employee Eligibility Requirements
Supplemental Benefits: Employees in a budgeted full-time equivalent (FTE) position guaranteeing 20 or more hours per week are eligible for all supplemental benefits.
Employees in positions guaranteeing at least 15 hours but fewer than 20 hours per week are eligible for dental and vision benefits only.
Eligible employees must be actively at work on the plan effective date for new benefits to be effective, meaning you are physically capable of performing the functions of your job on the first day of work concurrent with the plan effective date. For example, if your 2026 benefits become effective on September 1, 2026, you must be actively-at-work on September 1, 2026 to be eligible for your new benefits.
Dependent Eligibility Requirements
You can cover eligible dependent children under a benefit that offers dependent coverage, provided you participate in the same benefit, through the maximum age listed below. Dependents cannot be double covered by married spouses within the district as both employees and dependents.
Actively-at-Work
You are performing your regular occupation for the employer on a full-time basis, either at one of the employer’s usual places of business or at some location to which the employer’s business requires you to travel. If you will not be actively at work beginning September 1, 2026, please notify your benefits administrator.
Important Limitations and Exclusions
MAXIMUM DEPENDENT ELIGIBILITY AGE BY PLAN
To Age 26
Medical, Alternative Medical, Dental, Vision, Life/AD&D, Individual Life*, Cancer, Accident, and Critical Illness *Coverage may be applied for by age 26 but may be kept until age 121.
If your dependent is disabled, coverage may be able to continue past the maximum age under certain plans. If you have a disabled dependent who is reaching an ineligible age, you must provide a physician’s statement confirming your dependent’s disability. Contact your Benefits Office to request a continuation of coverage.
Employees who are not contributing TRS members and who are employed for 10 or more regularly scheduled hours per week are eligible to enroll in the TRS ActiveCare plan but are not eligible for the district contribution.
Please note, limits and exclusions may apply when obtaining coverage as a married couple or when obtaining coverage for dependents.
Potential Spouse Coverage Limitations: When enrolling in coverage, please keep in mind that some benefits may not allow you to cover your spouse as a dependent if your spouse is enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Higginbotham Public Sector, or contact the insurance carrier for additional information on spouse eligibility.
FSA/HSA Limitations: Please note, in general, per IRS regulations, married couples may not enroll in both a Flexible Spending Account (FSA) and a Health Savings Account (HSA). If your spouse is covered under an FSA that reimburses for medical expenses then you and your spouse are not HSA eligible, even if you would not use your spouse’s FSA to reimburse your expenses. However, there are some exceptions to the general limitation regarding specific types of FSAs. To obtain more information on whether you can enroll in a specific type of FSA or HSA as a married couple, please reach out to the FSA and/or HSA provider prior to enrolling or reach out to your tax advisor for further guidance.
Potential Dependent Coverage Limitations: When enrolling for dependent coverage, please keep in mind that some benefits may not allow you to cover your eligible dependents if they are enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Higginbotham Public Sector, or contact the insurance carrier for additional information on dependent eligibility.
Disclaimer: You acknowledge that you have read the limitations and exclusions that may apply to obtaining spouse and dependent coverage, including limitations and exclusions that may apply to enrollment in Flexible Spending Accounts and Health Savings Accounts as a married couple. You, the enrollee, shall hold harmless, defend, and indemnify Higginbotham Public Sector from any and all claims, actions, suits, charges, and judgments whatsoever that arise out of the enrollee’s enrollment in spouse and/or dependent coverage, including enrollment in Flexible Spending Accounts and Health Savings Accounts.
Section 125 Cafeteria Plan Guidelines
A Cafeteria plan enables you to save money by using pretax dollars to pay for eligible group insurance premiums sponsored and offered by your employer. Enrollment is automatic unless you decline this benefit. Elections made during annual enrollment will become effective on the plan effective date and will remain in effect during the entire plan year.
Changes to benefit elections are permitted only if you experience a Qualifying Life Event. You must submit proof of the qualifying event to the Benefits Office within 30 days of the event by completing a Benefit Change Form (available in the FISD Employee Portal).
While requests may be submitted within this 30-day period, coverage terminations will be effective no earlier than the end of the month in which the request is received and cannot be applied retroactively to prior months. All benefit changes must be consistent with the qualifying event.
Changes in Status (CIS) Qualifying Events
Marital Status
Change in Number of Tax Dependents
Change in Status of Employment Affecting Coverage Eligibility
Gain/Loss of Dependents’ Eligibility Status
Judgment/Decree/Order
Eligibility for Government Programs
You have 30 days after a Qualifying Life Event to make changes to your benefits. However, if you are ending coverage, it cannot be backdated to a prior month. Coverage will end no earlier than the end of the month in which your request is received.
A change in marital status includes marriage, death of a spouse, divorce, or annulment (legal separation is not recognized in all states).
A change in number of dependents includes the following: birth, adoption, and placement for adoption. You can add existing dependents not previously enrolled whenever a dependent gains eligibility as a result of a valid change in status event.
Change in employment status of the employee, or a spouse or dependent of the employee, that affects the individual’s eligibility under an employer’s plan includes commencement or termination of employment.
An event that causes an employee’s dependent to satisfy or cease to satisfy coverage requirements under an employer’s plan may include change in age, student, marital, employment, or tax dependent status.
If a judgment, decree, or order from a divorce, annulment, or change in legal custody requires that you provide accident or health coverage for your dependent child (including a foster child who is your dependent), you may change your election to provide coverage for the dependent child. If the order requires that another individual (including your spouse and former spouse) covers the dependent child and provides coverage under that individual’s plan, you may change your election to revoke coverage only for that dependent child and only if the other individual actually provides the coverage.
Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change.
Enrollment FAQ
Annual Enrollment
During your annual enrollment period, you have the opportunity to review, change or continue benefit elections each year. Changes are not permitted during the plan year (outside of annual enrollment) unless a Section 125 qualifying event occurs.
● Changes, additions, or drops may be made only during the annual enrollment period without a qualifying event.
● Review your personal information and verify that dependents you wish to provide coverage for are included in the dependent profile. Additionally, you must notify your employer of any discrepancy in personal and/or benefit information.
● Confirm on each benefit screen (medical, dental, vision, etc.) that each dependent to be covered is selected to be included in the coverage for that particular benefit.
● When selecting your benefits, please ensure your paycheck is sufficient to cover all payroll deductions. A change in financial circumstances does not constitute a Qualifying Life Event and does not permit mid-year benefit changes.
Q&A
Who do I contact with Questions?
For supplemental benefit questions, contact your Benefits Office or call Higginbotham Public Sector at 833953-7008
Where can I find forms?
For benefit summaries and claim forms, go to your benefit website: www. mybenefitshub.com/friscoisd. Click the benefit plan you need information on (i.e., Dental) and you can find the forms you need under the Benefits and Forms section.
How can I find a Network Provider?
For benefit summaries and claim forms, go to the Frisco ISD benefit website: www.mybenefitshub.com/friscoisd Click on the benefit plan you need information on (i.e., Dental) and you can find provider search links under the Quick Links section.
When will I receive ID cards?
If the insurance carrier provides ID cards, you can expect to receive those 3-4 weeks after your effective date. For most dental and vision plans, you can login to the carrier website and print a temporary ID card or simply give your provider the insurance company’s phone number and they can call to verify your coverage if you do not have an ID card at that time. If you do not receive your ID card, call the carrier’s customer service number to request another card.
If the insurance carrier provides ID cards, but there are no changes to the plan, you typically will not receive a new ID card each year.
New Hire Enrollment
All new hire enrollment elections must be completed in the online enrollment system within the first 30 days of benefit eligible employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.
What is Guaranteed Coverage?
The amount of coverage you can elect without answering any medical questions or taking a health exam. Guaranteed coverage is only available during initial eligibility period. Activelyat-work and/or pre-existing condition exclusion provisions do apply, as applicable by carrier.
What is a Pre-Existing Condition?
Applies to any illness, injury, or condition for which the participant has been under the care of a health care provider, taken prescriptions drugs or is under a health care provider’s orders to take drugs, or received medical care or services (including diagnostic and/or consultation services).
Medical Coverage
Our medical plans protects you and your family from major financial hardship in the event of illness or injury. You have a choice of three plans:
● TRS-ActiveCare Primary
● TRS-Activecare Primary+
● TRS-ActiveCare HD
Note: The TRS-ActiveCare 2 plan is closed to new enrollees. You may remain in the plan if you have existing coverage in it.
Both Primary and Primary+ offer $0 virtual mental health visits with in-network providers.
2 (closed to new enrollments)
Medical Coverage
Medical Benefits Summary
1 The amount you pay after the deductible is met.
2 $0 copay for certain generics.
3 $0 coinsurance for certain generics.
4 Max does not apply if brand is selected and generic is available.
Pharmacy Benefits
Evernorth is the pharmacy benefit manager for the TRS-Care Standard prescription drug plan. Express Scripts is part of Evernorth Health Services. Your pharmacy benefits include retail, mail order, and specialty prescription drugs.
Where to Get Prescriptions
Retail – Go to any pharmacy in the Evernorth retail network for short-term medications (up to a 30-day supply).
Mail Order – Fill long-term medications (90-day supply) at retailmaintenance pharmacies.
Specialty Drugs – Use Accredo for specialty drugs.
How to Save Money on Prescriptions
● Certain preventive generic drugs are available at no added cost. Ask your doctor about switching to a generic drug.
● Check the prescription drug list (formulary) to see if your plan covers your medication, if the drug is at no cost, and what options are available.
● If you get mail order medications via the Evernorth mail order pharmacy, you can split the payments for a 90-day supply into three payments over three months. Call Evernorth for details.
Prior Authorization
Some medications require you to get approval through a coverage review process before the plan will cover it. The coverage review process allows Evernorth to get more information about your specific course of treatment, including information that is not available on your original prescription.
TRS-ActiveCare Prescription Drug Plan Highlights
Find Your Best Option!
Access the Express Scripts website to compare different TRS plans and medication prices, and find pharmacies near you. Visit https://www. express-scripts.com/frontend/ commercial-open-enrollment/ teacherretirementsystemoftexas for details.
What is the SaveOnSP Copay Assistance Program?
The SaveOnSP is a copay assistance program that helps you save money and eliminates your member cost share for specialty medications. Formulary and prior authorization requirements still apply. The SaveOnSP Copay Assistance Program lets you get select specialty medication at no added cost. That means $0 out-of-pocket for any drug on your plan’s exclusive SaveOnSP Specialty Drug list when you fill your prescription with Accredo Specialty Pharmacy. Call SaveOnSP at 800-683-1074 for details.
Prescription Savings Program
Savings Outside of Medical Coverage
With Clever RX , you never have to overpay for prescriptions. When you use the Clever RX card or app, you get up to 80% off prescription drugs, discounts on thousands of medications, and usage at most pharmacies nationwide.
This is a prescription savings benefit and may be utilized even if you are not enrolled in a medical plan.
Download the App
Step 1
Download the free Clever RX app and enter these numbers during the onboarding process:
Group ID: 1085
Member ID: 1610
Step 2
BIN: 020529
PCN: CLEVR
Use your ZIP code to find a local pharmacy with the best price for your medication — up to 80% off!
Step 3
Click the voucher with the lowest price, closest location, and/or at your preferred pharmacy and show the voucher to the pharmacist.
Please note that if you are enrolled in an ActiveCare TRS plan, prescriptions purchased with the use of CleverRX will not count towards any medical deductibles.
Advanced Lab Tests and Health Screenings
New! Function Membership
Get a deeper understanding of your body and spot potential issues early.
Your benefit plan includes the opportunity for you and your family to enroll for a Function membership. Function empowers you to own your health through affordable access to advanced lab testing. A Function membership evaluates five times more biomarkers than the average physical, helping you gain a deeper understanding of what’s going on in your body, monitor for early indicators of disease, and track your health as it evolves.
The membership includes:
● Access to 100+ lab tests at the start of your membership.
● Access to an additional 60+ midyear follow-up tests to track your progress.
● Detailed clinician notes highlighting areas of focus.
● A targeted action plan to help improve your health.
● Results stored on one secure platform for easy access anytime.
How the Process Works
After signing up for Function, you will get an email and text message to schedule a convenient time and location for your lab visit. Tests take less than 30 minutes and are done at one of more than 2,000 partner lab locations nationwide. You will then get a detailed summary of your results and a targeted action plan to help you reach your health goals. All results are stored in one secure location for you to access anytime. You can retest in six months to see how you are progressing. Nonroutine tests (e.g., advanced MRI, early detection of multiple cancers, allergies, heavy metals, and more) may be added for an additional cost.
Advanced Lab Tests and Health Screenings
Test More. Know More.
Advanced testing across:
• Heart
• Immunity
• Metabolics
• Hormones
• Nutrients
• Heavy Metals
• Liver
• Kidneys
• Pancreas
• Prostate
• Sexual Health
• Electrolytes
• Thyroid
• Autoimmunity
• Urine
• Blood
The cost for an individual annual membership* is $335!
FSA/HSA Eligible
Funds from your Flexible Spending Account (FSA) or Health Savings Account (HSA) may be used to pay for your membership. Reimbursement is not guaranteed, so please contact your FSA/HSA provider in advance to confirm the terms of reimbursement. If you do not have an FSA or HSA, use a personal credit card.
*Function membership includes prepaid access to 160+ lab tests each year at a Quest Diagnostics site. Due to state regulations, members testing in New York and New Jersey will be charged an additional fee directly by Quest for each lab visit. We cannot accommodate lab testing in Hawaii or Rhode Island at this time. You can schedule lab testing in a neighboring state.
How To Enroll
Enroll anytime during the year.
You will pay the membership fee(s) directly to Function.
Knowing the difference between a Health Savings Account (HSA) and Flexible Spending Account (FSA) can help you choose the best option for you and your family.
Description
Employer
An HSA is an actual bank account in your name that allow you to save and pay for unreimbursed qualified medical expenses tax-free.
your
Underlying Insurance Requirement High Deductible Health Plan
Plan Minimum Deductible 2026
$1,650 single
$3,300 family
Maximum Contribution 2026 ● $4,400 single ● $8,750 family
● $1,000 age 55+ catch-up 2027 ● $4,500 single ● $9,000 family
● $1,000 age 55+ catch-up
An FSA allows you to pay out-of-pocket expenses tax-free for:
● copays, deductibles, and certain services not covered by medical plan ● qualifying dependent care
Permissible Use of Funds
Cash-Outs of Unused Amounts (if no medical expenses)
Year-to-year rollover of account balance?
Use any way you wish. If used for nonqualified medical expenses, funds are subject to the current tax rate plus a 20% penalty.
Reimbursement for qualified medical expenses as defined in Section 213(d) of the Internal Revenue Code.
Permitted, but subject to current tax rate plus 20% penalty (waived after age 65). Not permitted
Yes, it will roll over to use for subsequent year’s health coverage. No
Does the account earn interest? Yes No
Portable?
Yes, it is portable year-to-year and between jobs. No
Health Savings Account
A Health Savings Account is a personal savings account where the money can only be used for eligible medical expenses. Unlike a Flexible Spending Account, the money rolls over year to year but only those funds that have been deposited in your account can be used. Contributions to an HSA can only be used if you are also enrolled in a High Deductible Health Care Plan (HDHP). For full plan details, please visit your benefit website: http://www.mybenefitshub.com/friscoisd.
An HSA is more than a way to help you and your family cover health care costs – it is also a tax-exempt tool to supplement your retirement savings and cover health expenses during retirement. An HSA can provide the funds to help pay current health care expenses as well as future health care costs.
A type of personal savings account, an HSA is always yours even if you change health plans or jobs. The money in your HSA (including interest and investment earnings) grows tax-free and spends tax-free if used to pay for qualified medical expenses. There is no “use it or lose it” rule – you do not lose your money if you do not spend it in the calendar year – and there are no vesting requirements or forfeiture provisions. The account automatically rolls over year after year.
HSA Eligibility
You are eligible to open and contribute to an HSA if you are:
● Enrolled in an HSA-eligible HDHP not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan
● Not enrolled in a Heath Care FSA, nor should your spouse be contributing towards a Health Care FSA
● Not eligible to be claimed as a dependent on someone else’s tax return
● Not enrolled in Medicare, Medicaid, or TRICARE
● Not receiving Veterans Administration benefits
You can use the money in your HSA to pay for qualified medical expenses now or in the future. You can also use HSA funds to pay health care expenses for your dependents, even if they are not covered under your HDHP.
MAXIMUM HSA CONTRIBUTIONS
If you are age 55 or older, you can contribute an extra
Opening an HSA
If you meet the eligibility requirements, you may open an HSA administered by EECU. You will receive a debit card to manage your HSA account reimbursements. Keep in mind, available funds are limited to the balance in your HSA.
Important HSA Information
● Always ask your health care provider to file claims with your medical provider so network discounts can be applied. You can pay the provider with your HSA debit card based on the balance due after discount.
● You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.
● You may open an HSA at the financial institution of your choice, but only accounts opened through EECU are eligible for automatic payroll deduction.
Connect with EECU
● Online/Mobile: Sign-in for 24/7 account access to check your balance, pay bills and more.
● Call/Text: 817-882-0800 Monday through Friday from 8:00 a.m. to 7:00 p.m. CT, or Saturday 9:00 a.m. to 1:00 p.m. CT.
● Lost/Stolen Debit Card: Call the 24/7 debit card hotline at 800-333-9934
● Stop by a local EECU financial center: https://eecu.org/locations
Flexible Spending Accounts
Set aside pretax dollars from each paycheck to pay for certain IRS-approved health and dependent care expenses. We offer the following Flexible Spending Accounts (FSAs).
Health Care FSA
The Health Care FSA covers qualified medical, dental, and vision expenses for you or your eligible dependents. Eligible expenses include:
● Deductibles, copays, and coinsurance
● Prescription drugs
● Braces, glasses, and contacts
● Hearing aids and batteries
If you enrolled in an HDHP and contribute to an HSA, you may not contribute to a Health Care FSA.
Over-the-Counter Item Rule Reminder
Health care reform legislation requires that certain over-thecounter (OTC) items require a prescription to qualify as an eligible Health Care FSA expense. You only need to obtain a one-time prescription for the current plan year. You can continue to purchase your regular prescription medications with your FSA debit card. However, the FSA debit card may not be used for an OTC item, even when accompanied by a prescription.
Important Reminders!
Health Care FSAs are generally considered “use it or lose it” accounts, and unused remaining funds at the end of the plan year may be forfeited. Your employer offers some flexibility with a run-out period. This allows you to submit claims for expenses incurred between September 1 and August 31 for up to 60 days after the plan year ends. Any unused funds remaining after August 31 will be forfeited.
Planning the amount of your contributions carefully can help you make the most of your FSA and avoid losing unused funds. You cannot change your contribution election during the plan year unless you experience a Qualifying Life Event. Keep itemized receipts to verify debit card payments.
Flexible Spending Accounts
Dependent Care FSA
The Dependent Care FSA helps pay expenses associated with caring for children under age 13 and elder dependents so you or your spouse can work or attend school full-time.
Dependent Care FSA Guidelines
● To be eligible, you (and your spouse, if married) must be gainfully employed, looking for work, a full-time student, or incapable of self-care.
● You can use funds for daycare or babysitter expenses for your children under age 13, but only for the part of the year when the child is under 13.
● Only day camps – not overnight camps – can be considered for reimbursement.
● You can use funds for care of a spouse or dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self-care.
● The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.
● Dependent Care FSA claims may be submitted as incurred and will be paid as funds become available after monthly payroll contributions are deposited.
Note: Eligible expenses must be incurred by August 31. Claims for expenses incurred between September 1 and August 31 may be submitted for reimbursement up to 60 days after the plan year ends. Any unused funds remaining after August 31 will be forfeited.
Get More Information or Submit Receipts
● Visit www.nbsbenefits.com.
● Call 855-399-3035
● Fax 844-438-1496
● Email service@nbsbenefits.com
● Download the NBS app
● Participant Portal: www.mynbsbenefits.com
● Mail:
National Benefit Services, LLC P.O. Box 219393 Kansas City, MO 64121-9393
The full amount you elect for the plan year is available on the first day of coverage, regardless of payroll deductions made to date.
and deposited to your account at the end of each month. You may only be reimbursed up to the amount that has been deposited and is available in your account.
How to Access Funds/Pay or Get Reimbursed
Use your FSA debit card (excludes the Dependent Care FSA). OR Pay out-of-pocket, and submit your receipts for reimbursement.
Qualified HSA and FSA Expenses
The products and services listed below are examples of medical expenses eligible for payment under your Health Care FSA or HSA. This list is not all-inclusive; additional expenses may qualify, and the items listed are subject to change in accordance with IRS regulations. Please refer to IRS Publication 502 Medical and Dental Expenses at www.irs.gov for a complete description of eligible medical and dental expenses.
Abdominal supports
Acupuncture
Ambulance
Anesthetist
Arch supports
Artificial limbs
Blood tests
Braces
Cardiographs
Chiropractor
Crutches
Dental treatment
Dentures
Dermatologist
Diagnostic fees
Eyeglasses
Gynecologist
Healing services
Hearing aids and batteries
Hospital bills
Insulin treatment
Lab tests
Metabolism tests
Neurologist
Nursing
Obstetrician
Operating room costs
Ophthalmologist/Optician/Optometrist
Orthopedic shoes
Orthopedist
Osteopath
Physician
Postnatal treatments
Prenatal care
Prescription medicines
Psychiatrist
Therapy equipment
Wheelchair X-rays
Employee Clinic
The Frisco ISD Employee Clinic provides convenient onsite and virtual health care services for district employees and eligible dependents, including spouses and children ages 4-25. Employees receive acute care and musculoskeletal services at no cost, while dependents are seen for a $10 copay.
Services Include
● Allergies and asthma care
● Cold, flu, fever, and sore throat treatment
● Ear, eye, and sinus infections
● Skin rashes and minor injuries
● Sprains, strains, and musculoskeletal care
● Sports physicals
● Upper respiratory care, nausea, and more
Appointment Options
● In-person visits available Monday through Friday, 7:00 a.m.–6:00 p.m.
● Virtual care available 24/7, 365 days a year
● Clinic location: 6950 Stadium Lane Frisco, TX 75033
Dependents do not need FISD medical insurance to receive care but must be listed as a dependent in the FISD Benefits Portal before scheduling an appointment. Codes to access virtual care change monthly and can be found on the Wellness site accessed through the FISD Employee portal as well as Workvivo.
For More Information or to Schedule an Appointment
Visit the FISD Wellness Site at https://sites.google.com/friscoisd.org/ fisdwellness/employee-clinic/onsite-clinic
Call 469-303-3036
Email benefits@friscoisd.org.
Wellness Programs
Frisco ISD provides the following opportunities for you to engage and grow in your physical, social-emotional, and financial wellness.
Access the Wellness website via the FISD employee portal for details, events, and more.
Employee Clinic*
Get immediate access to health care through our onsite Employee Clinic or virtually, no matter if you are insured through the District or not. Spouses and children may also use the clinic for non-emergency services.
*Eligibility for this benefit is for employees that are in positions working 15+ hours a week, along with their spouses and children (ages 4-25) may be seen a the clinic. Temporary employees and substitutes are not eligible to use the Employee Clinic.
Physical Fitness*
Your fitness location options include the Frisco and McKinney YMCA locations, Frisco Athletic Center, BCBS Fitness program, Cigna virtual workouts, and a partial reimbursement for participating at the qualified facility of your choice.
*Full time employees are eligible for the fitness reimbursement program. Employees assigned to an allocated position, guaranteeing 20 hours or more hours per week are defined as full time.
Social-Emotional
ComPsych offers all Frisco ISD employees social and emotional support services at no cost. Get personal, confidential care through an extensive provider network for a variety of life challenges and mental health needs. Additional resources are available to you for self-help and discovery.
Financial Wellness
Frisco ISD offers free financial wellness resources to all employees via FinPath. You can schedule a personal visit with a financial expert, access articles and videos, and attend workshops at no cost.
Retirement planning services are also available to all employees at no cost. TCG advisors will work with you personally to set-up your retirement accounts (457b, 403b), discuss rollover options and investing, and create a retirement plan based on your goals.
BCBS Wellness Programs
Only available if you enrolled in TRS health coverage.
BCBS offers pregnancy planning and support, a total wellness program, a mental health guide, and musculoskeletal health support at no additional cost to you.
Additional Benefits
Employee Assistance Program
Employee assistance services are provided by Chubb and administered through ComPsych, a leading provider of employee assistance and work/life services. Services include 12 face-toface counseling sessions per issue per employee/family member per year and assistance with:
• Childcare
• Eldercare
• Substance abuse
• Family relationships
• And more
In addition, you and your immediate family members can receive confidential services to assist you with emotional, financial, and legal issues.
Travel Assistance Services
Available 24/7, this program provides assistance to you and your dependents who travel 100 miles from home for 90 days or less. Services include pre-trip information, emergency medical assistance, and emergency personal services.
Telehealth with Behavioral Health
Your benefit coverage offers access to quality telehealth and behavioral health services.
Medical Care
Connect anytime day or night with a board-certified doctor via your mobile device or computer for free or for the same or less cost than a visit to your regular physician. While telehealth does not replace your primary care physician, it is a convenient and cost-effective option when you need care and:
● Have a non-emergency issue and are considering an after hours health care clinic, urgent care clinic, or emergency room for treatment
● Are on a business trip, vacation, or away from home
● Are unable to see your primary care physician
When to Use Telehealth
Use telehealth for minor conditions such as:
• Sore throat
• Headache
• Stomach ache
• Cold
• Flu
• Allergies
• Fever
• Urinary tract infections
Do not use telehealth for serious or life-threatening emergencies. Telehealth is $12 per month for the whole family!
Behavioral Health
Managing stress or life changes can be overwhelming but it’s easier than ever to get help right in the comfort of your own home. Visit a counselor or psychiatrist by phone, secure video, or Recuro app
● Talk to a licensed counselor or psychiatrist from your home, office, or on the go!
● Affordable, confidential online therapy for a variety of counseling needs.
Registration is Easy
Register today so you are ready to use this valuable service when and where you need it. Visit www.recurohealth.com Call 855-6RECURO (673-2876)
Download the Recuro app
Age Restrictions
● No age restriction for Medical
● Age 10 and older for Behavioral Health
Emergency Transport Services
Did you know that a ground ambulance ride can cost more than $1,200 and an air ambulance ride can cost up to $70,000? If you or a family member is in need of an emergency medical transport, your insurance coverage and Medicare may not cover all of the costs. Consider buying emergency transport services to greatly reduce or completely cover the cost of emergency transportation. After your medical crisis, contact the medical transport carrier to negotiate with your medical plan provider and cover the balance on your medical transportation bills.
Coverage
● Emergency ground ambulance
● Emergency air ambulance
● Hospital to hospital ambulance
● Repatriation near home
For More Information
Visit www.masamts.com (Group
Dental Coverage
Our dental plans help you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work.
DPPO Plans
Two levels of benefits are available with the DPPO plans: innetwork and out-of-network. You may select any dental provider for care, but you will pay less and get the highest level of benefits with in-network providers. You could pay more if you use an outof-network provider.
DHMO Plan
If you enroll in the DHMO plan, you must select a Primary Care Dentist (PCD) from the DHMO network directory to manage your care. Each eligible dependent may choose their own PCD. With a DHMO, you get unlimited dental services, pay fixed copays, have no deductibles, and have no claim forms to file. NOTE: there is no coverage for services provided without a referral from your PCD or from out-of-network providers (except in a true emergency).
Dental Benefits Summary
1 For services provided by a non-network dentist, Cigna Dental will reimburse according to the Maximum Reimbursable Charge. The MRC is calculated at the 90th percentile of all provider submitted amounts in the geographic area. The dentist may balance bill up to their usual fees.
2 For services provided by a non-network dentist, Cigna Dental will reimburse according to the Maximum Allowable Charge. The dentist may balance bill up to their usual fees.
Vision Coverage
Our vision plan offers quality care to help preserve your health and eyesight. Regular exams can detect certain medical issues such as diabetes and high cholesterol, in addition to vision and eye problems. You may seek care from any vision provider, but the plan will pay the highest level of benefits when you see PLUS Providers or other EyeMed Insight in-network providers, which include Target Optical, Pearle Vision, LensCrafters, and thousands of independent providers.
Vision Benefits Summary
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Save more on exams and frames when you use a PLUS Provider. Look for the PLUS designation when searching for EyeMed Insight in-network providers.
Group Term Life vs. Individual Life
Knowing the difference between Group Term Life (Chubb) and Individual Life ( 5Star Family Protection Plan) can help you choose the best option for you and your family.
GROUP TERM LIFE (CHUBB)
INDIVIDUAL LIFE INSURANCE (5STAR)
Type of Plan
Dependent Coverage
Employee Coverage
Spouse Coverage
Child Coverage
Guaranteed Issue
Reduction Schedule
Yes – Available for spouse and children
Increments of $10,000 up to $500,000
Increments of $5,000 up to $500,000
$10,000
Employee: $400,000; Spouse $100,000; Child(ren)
$10,000
50% at age 70
Rate Changes Rates increase with age
Newly Eligible Employee and Dependents
Current Employees
Payroll Deduction
Age - Banded Pricing
AD&D Included
Accelerated Death Benefit for Long Term Care
Accelerated Death Benefit for Terminal Illness
Portable
Convertible
Additional Benefits
Coverage Changes
Stable Rates
You and your eligible dependents may select coverage up to the Guaranteed Issue amounts without answering health questions at Open Enrollment each year
At subsequent annual Open Enrollments, if you or your eligible dependents are currently enrolled in the plan, you may increase coverage up to the Guaranteed Issue amounts without answering health questions. All amounts over the Guaranteed Issue will require medical underwriting.
Yes
Yes, the cost goes up as you enter new age bands (every 5 years)
Yes
4% of Death Benefit per month up to 75% of Death Benefit, not to exceed $200,000. Available to employee and spouse only.
Get up to 75% of Death Benefit, not to exceed $500,000. Note: benefit is not the same as Long Term Care insurance.
Yes. Keep your coverage if your employment ends, you have reduced hours, or you retire. Your premiums remain the same as group rates.
Convert to an Individual Life policy; premiums increase.
Some plans include supplemental AD&D; Travel Assist America Global Emergency Services and wellness benefit included
May reduce/terminate if employment ends or plan changes
Rates increase in 5 - year age bands
Renewable Only while employed (or through limited portability options)
Individual Term Life to age 121 purchased through employment
Yes – Available for spouse and children. Employee coverage is not required to cover dependents.
Personalized level of coverage; policies can be stacked up to $150,000 face amount
Guaranteed Issue is offered to all eligible applicants regardless of health status. No doctor exams or physicals required.
Guaranteed Issue is offered, up to specified limits mentioned above, to all eligible applicants regardless of health status. No doctor exams or physicals required.
Yes
No, price locked for life if premiums are maintained
N/A
Up to 75% of your benefit and it is payable directly to you on a tax-favored basis for permanent inability to perform at least two of the six ADLs or permanent severe cognitive impairment
Pays 30% of the coverage amount (25% in CT and MI) in a lump sum upon when insured is diagnosed with a terminal condition and is expected to live less than 12 months (24 months in IL)
Yes, no loss of benefits or increase in cost and stays with you even if your job changes
Permanent policy allows for direct payment of premiums at termination of employment or retirement
Emphasizes stability: policy cannot be canceled as long as premiums are paid
Stays level — cannot be changed by company once in place
Rates stay the same for life
Yes, guaranteed renewable
Life and AD&D Insurance
Life insurance offers financial security, especially if others depend on you for support or vice versa. With Life insurance, you or your beneficiary(ies) can use the coverage to pay off debts such as credit cards, loans, and bills.
Accidental Death and Dismemberment (AD&D) coverage provides specific benefits if an accident causes bodily harm or loss (e.g., the loss of a hand, foot, or eye). If death occurs from an accident, 100% of the AD&D benefit would be paid to you or your beneficiary(ies).
Educator Group Term Life Insurance (Basic Term)
Basic Term Life and AD&D insurance are provided at no cost to you by Frisco ISD. You must be actively at work and in a budgeted allocated position of 20 hours or more per week to be eligible to enroll for coverage. You are automatically covered at $10,000*.
*Benefits will be reduced at age 70.
Watch and learn more!
Coverage Highlights
• Portable – Keep your coverage if you leave employment, reduce hours, or retire
• Convertible – Convert to an individual life policy.
• Accelerated Death Benefit for Long Term Care – 75% of death benefit
• Accelerated Death Benefit for Terminal Illness – Get up to 75% of death benefit, not to exceed $500,000. Note: this benefit is not the same as long-term care insurance.
• Air Bag Benefit – The lesser of 5% of AD&D benefit or $5,000
• Child Care Expense Benefit – 5% of employee’s AD&D benefit up to $12,000 per year for four years
• Child Education Expense Benefit –6% of AD&D benefit up to $6,000 for six years; maximum benefit $24,000
• Common Carrier Benefit – Included
• Elder Care Expense Benefit – The lesser of 1% of AD&D benefit or $500
• Exposure and Disappearance Benefit – Included
• Repatriation Expense Benefit –The lesser of $1,000 or the actual expense incurred
• Seatbelt Benefit – The lesser of 10% of AD&D benefit or $25,000
• Spouse Education Benefit – The lesser of 1% of AD&D benefit, $1,000, or the actual tuition expenses incurred
• Workplace Felonious Assault Benefit – 5% of AD&D benefit up to $10,000 Limitations and exclusions apply. See the plan documents for details.
Life and AD&D Insurance
Supplemental Term Life
Voluntary Term Life and AD&D Insurance is available to purchase for you and your family. You must be actively at work and in a budgeted allocated position of 20 hours or more per week to be eligible to enroll for coverage.
You and your eligible dependents may enroll in amounts up to $500,000 for employee and $500,000 for spouse without answering health questions. Amounts over the Guaranteed Issue will require medical underwriting. If you buy at least $10,000 of coverage during initial enrollment, you may buy up to the Guaranteed Issue $400,000 in subsequent re-enrollments without medical underwriting. Benefits will reduce 50% at age 70.
Supplemental AD&D
Supplemental AD&D coverage is separate and apart from your Basic and Supplemental Term Life insurance coverage. It provides benefits beyond your disability or life insurance for covered losses that are the result of an accidental injury or loss of life. The full amount of AD&D coverage you select is called the Full Amount and is equal to the benefit payable for the loss of life. Benefits for other losses — such as loss of sight, speech or hearing; coma; or paralysis — are payable as a predetermined percentage of the full amount.
Supplemental AD&D Coverage Amounts
Your Supplemental AD&D amount is equal to your Supplemental Term Life amount. You can also cover your dependent spouse and child(ren). Dependent coverage amounts will be equal to their Dependent Term Life coverage amounts.
Coverage Highlights
• Portable – Keep your coverage if you leave employment, reduce hours, or retire
• Convertible – Convert to an individual life policy
• Accelerated Death Benefit for Long Term Care – 4% of death benefit per month up to 75% of death benefit, not to exceed $200,000. Available to employee and spouse only.
• Accelerated Death Benefit for Terminal Illness – Get up to 75% of death benefit, not to exceed $500,000. Note: this benefit is not the same as long-term care insurance.
Spouse
• Increments of $10,000 up to $500,000
• Increments of $5,000 up to $500,000
• Employee Assistance Program – Six face-to-face visits
• Air Bag Benefit – The lesser of 5% of AD&D benefit or $5,000
• Child Care Expense Benefit – 5% of employee’s AD&D benefit up to $12,000 per year for four years
• Child Education Expense Benefit –6% of AD&D benefit up to $6,000 for six years; maximum benefit $24,000
• Common Carrier Benefit – Included
• Elder Care Expense Benefit – The lesser of 1% of AD&D benefit or $500
• Exposure and Disappearance Benefit – Included
• Repatriation Expense Benefit –The lesser of $1,000 or the actual expense incurred
• Seatbelt Benefit – The lesser of 10% of AD&D benefit or $25,000
• Spouse Education Benefit – The lesser of 1% of AD&D benefit, $1,000, or the actual tuition expenses incurred
• Workplace Felonious Assault Benefit – 5% of AD&D benefit up to $10,000
Limitations and exclusions apply. See the plan documents for details.
5STAR Individual Life Insurance
The Family Protection Plan Group Level Term Life Insurance from 5STAR Life Insurance helps protect your family.
You do not have to elect coverage for yourself. You may elect coverage for:
● Your spouse
● Your financially independent children and grandchildren (14 days to age 26).
Coverage lasts until age 121 for all insured, so your family can be protected into their retirement years as long as your premiums are paid. This coverage is portable, which means you may continue with no loss of benefits or increase in cost if you terminate employment after the first premium is paid. You will be billed directly.
Call 5Star Insurance at 866-914-5202
Buy When You Are Young!
Buying life insurance when you are younger allows you to take advantage of lower premium rates while you are generally healthy. This allows you to buy more insurance coverage for the future and still pay less than you would if you were older and trying to buy the same coverage amount. This is especially important if you have dependents who rely on your income, or you have debt that would need to be paid off.
Portable Coverage
Life moves fast so having a portable life insurance allows you to keep your coverage if you leave your school district. Keeping the coverage helps you ensure your family is protected even into your retirement years.
Terminal Illness Acceleration of Benefits
Coverage pays 30% (25% in CT and MI) of the coverage amount in a lump sum upon the occurrence of a terminal condition that will result in a limited life span of less than 12 months (24 months in IL).
Protection You Can Count On
Within one business day of notification, payment of 50% of coverage or $10,000 whichever is less is mailed to the beneficiary, unless the death is within the two-year contestability period and/or under investigation. This coverage has no war or terrorism exclusions.
• Convenient
• Easy payment through payroll deduction.
Quality of Life Benefit
Optional benefit that accelerates a portion of the death benefit on a monthly basis, up to 75% of your benefit, and is payable directly to you on a tax-favored basis for the following:
• Permanent inability to perform at least two of the six Activities of Daily Living (ADLs) without substantial assistance; or
• Permanent severe cognitive impairment, such as Alzheimer’s disease and other forms of senility, requiring substantial supervision.
Quality of Life
Many individuals who can’t take care of themselves require special accommodations to perform ADLs and would need to make modifications to continue to live at home with physical limitation. The proceeds from the Quality of Life benefit can be used for any purpose, including costs for in-facility care, home health care professionals, home modifications, and more.
About the Coverage
The Family Protection Plan offers a lump-sum cash benefit if you die before age 121. The initial death benefit is guaranteed to be level for at least the first 10 policy years. Afterward, the company intends to provide a nonguaranteed death benefit enhancement which will maintain the initial death benefit level until age 121. The company has the right to discontinue this enhancement. The death benefit enhancement cannot be discontinued on a particular insured due to a change in age, health, or employment status.
2026 Enrollment Plan Year
Guaranteed Issue is offered to all eligible applicants regardless of health status. No doctor exams or physicals.
• Employee: $150,000
• Spouse: $50,000
• Child: $10,000
Educator Disability Insurance
Educator Disability insurance combines features of short-term and long-term disability into one plan. Disability insurance protects part of your income if you are unable to work due to a covered accident, illness, or pregnancy. We offer Educator Disability insurance for you to purchase and allow you to choose the coverage amount and waiting period that best suits your needs.
EDUCATOR DISABILITY INSURANCE
Eligibility
Monthly Benefit Amount
Employees must be actively at work and in a budgeted allocated position of 20 hours or more per week
You can elect to purchase one of the following percentage of earnings as your benefit amount: 40%/50%/60%
Guaranteed Minimum Period The greater of 25% of monthly earnings or $100
Elimination Period –Injury/Sickness 14/141 30/30 1 60/60 90/90 Duration of Benefits Social Security Normal Retirement Age (SSNRA)
Pre-existing Condition Waiver2 The pre-existing condition limitation will be waived for the first 8 weeks
How to Choose a Plan
First choose your elimination period. The elimination period, sometimes referred to as the waiting period, is how long you are disabled and unable to work before your benefit will begin. This will be displayed as two numbers such as 14/14, 30/30, 60/60, 90/90, etc.
The first number indicates the number of days you must be disabled due to Injury and the second number indicates the number of days you must be disabled due to sickness.
When choosing your elimination period, ask yourself, “How long can I go without a paycheck?” Based on the answer to this question, choose your elimination period accordingly.
Important Note: Some plans will waive the elimination period if you choose 30/30 or less and you are confined as an inpatient to the hospital for a specific time period. Please review your plan details to see if this feature is available to you.
Next choose your benefit amount. This is the maximum amount of money you would receive from the carrier on a monthly basis once your disability claim is approved by the carrier.
When choosing your monthly benefit, ask yourself, “How much money do I need to be able to pay my monthly expenses?” Based on the answer to this question, choose your monthly benefit accordingly.
1 If your elimination period is 30 days or less and you are confined to a hospital for 24 hours or more, the elimination period will be waived, and benefits will be payable from the first day of hospitalization.
2 Pre-existing Condition Waiver: Benefits under this provision are payable for no more than eight weeks of benefit from the date of disability. After eight weeks, benefits are subject to a 3/12 pre-existing condition limitation.
Educator Disability Insurance
Educator Disability FAQ
What is disability insurance?
Disability insurance protects one of your most valuable assets: your paycheck. This insurance replaces part of your income if you are physically unable to work due to sickness or injury for an extended period of time. The Educator Disability plan is unique in that it includes both short- and long-term coverage in one convenient plan.
Does this plan have pre-existing condition limitations?
Yes. However, all plans will include preexisting condition limitations that could impact you if you are a first-time enrollee in your employer’s disability plan (including your initial new hire enrollment). Review the plan documents for full details.
Will I get all of my disability benefit?
Your disability benefit may be reduced by other income you receive or are eligible to receive due to your disability, such as:
● Social Security disability insurance
● State teacher retirement disability plans
● Workers’ compensation
● Other employer-based disability insurance coverage you may have
● Unemployment benefits
● Retirement benefits that your employer fully or partially pays for (such as a pension plan)
Educator Disability Insurance
Definitions and Provisions
Actively at Work
You must be at work with your employer on your regularly scheduled workday. On that day, you must be performing all of your regular duties in the usual way and for your usual number of hours. If school is not in session due to normal vacation or school break(s), actively at work shall mean you are able to report for work with your employer, performing all of the regular duties of your occupation in the usual way for your usual number of hours as if school was in session.
Enrollment
● Current Employees – Coverage is available to you without answering any medical questions or providing Evidence of Insurability. You may enroll on or before the enrollment deadline. After the initial enrollment period, you can apply only during an annual enrollment period.
● New Hires – Coverage is available to you without answering any medical questions or providing Evidence of Insurability. You may apply for coverage within 30 days of your hire date. If you do not apply within this timeframe, you can apply only during an annual enrollment period. Benefits may be subject to the pre-existing condition limitation.
Elimination Period
The elimination period is the length of time you must be continuously disabled before you can receive benefits. If you elect an elimination period of 30 days or less and you are confined to a hospital due to a disability, the elimination period will be waived, and benefits will be payable from the first day of hospitalization.
Continuity of Coverage
If you were insured under your district’s prior plan and not receiving benefits the day before this policy is effective, there will not be a loss in coverage and you will get credit for your prior carrier’s coverage.
Pre-existing Condition Waiver
Benefits under this provision are payable for no more than eight weeks of benefit from the date of disability. After 8 weeks, benefits are subject to a 3/12 pre-existing condition limitation.
Additional Plan Benefits
Survivor Benefit
In the event of your death, your beneficiary will receive a lump sum death benefit equal to three months of your gross disability payment.
Child/Family Member Care Expense Benefit
If you are disabled and participating in a vocational rehabilitation plan, you will be eligible for an additional expense benefit payment of $350 per child/family member not to exceed $1,000 per month.
Benefit Integration
● Your disability benefit will be reduced by deductible sources of income and any other earnings you have received while disabled.
● Your gross disability payment will be reduced immediately by items that may include: workers’ compensation, disability income, or other amounts you receive or are entitled to receive from sabbatical or assault leave plans and the amount of earnings you receive from an extended sick leave plan as described in Louisiana Revised Statutes or any other act or law with similar intent.
● After you have received monthly disability payments for 12 months, your gross disability payment will be reduced by additional deductible sources of income you receive or are entitled to receive under items that may include: state compulsory benefit laws; automobile liability insurance; legal judgments and settlements; certain retirement plans; salary continuation or sick leave plans; other group or association disability programs or insurance; and amounts you or your family receive or are entitled to receive from Social Security or similar governmental programs.
Education Expense Benefit
In addition to your monthly disability payment, you will receive a monthly education expense benefit in the amount of $200 for each eligible student, limited to a combined monthly maximum of $1,000.
Hospital Cash Plan
The Hospital Cash plan helps you with the high cost of medical care by paying you a cash benefit when you have an inpatient hospital stay. Unlike traditional insurance which pays a benefit to the hospital or doctor, this plan pays you directly. It is up to you how you want to use the cash benefit. These costs may include meals, travel, childcare or eldercare, deductibles, coinsurance, medication, or time away from work.
See the plan document for full details.
First Hospitalization Benefit
This benefit is payable for the first covered hospital confinement per certificate.
Hospital Admission Benefit
This benefit is for admission to a hospital or hospital sub-acute intensive care unit.
Hospital Confinement Benefit
This benefit is for confinement in hospital or hospital sub-acute intensive care unit.
Hospital Confinement ICU Benefit
This benefit is for confinement in a hospital intensive care unit.
Hospital ICU Admission Benefit
This benefit is for admission to a hospital intensive care unit.
Newborn Nursery Benefit
This benefit is payable for an insured newborn baby receiving newborn nursery care and who is not confined for treatment of a physical illness, infirmity, disease, or injury.
Rehabilitation Admission
This benefit is for admission to a rehabilitation unit as an inpatient.
Observation Unit
This benefit is for treatment in a hospital observation unit for a period of less than 20 hours.
Waiver of Premium Hospital Confinement
This benefit waives premium when the employee is confined for more than 30 continuous days.
Wellness Benefit
Employee Monthly Contributions
HOSPITAL CASH PLAN
• $500
• Maximum benefit per certificate: 1
• $1,500
• Maximum benefit per calendar year: 5
• $150 per day
• Maximum days per calendar year: 30
• $300 per day
• Maximum days per calendar year: 30
• $3,000
• Maximum benefit per calendar year: 2
• $500 per day
• Maximum days per confinement – normal delivery: 2
Maximum days per confinement – Cesarean delivery: 2
• $500
• Maximum benefit per calendar year: 3
• $500
• Maximum benefit per calendar year: 2
• $500
• Maximum benefit per certificate: 1
• $3,000
• Maximum benefit per calendar year: 5
• $200 per day
• Maximum days per calendar year: 30
• $400 per day
• Maximum days per calendar year: 30
• $6,000
• Maximum benefit per calendar year: 2
• $500 per day
• Maximum days per confinement – normal delivery: 2
Maximum days per confinement – Cesarean delivery: 2
• $500
• Maximum benefit per calendar year: 5
• $500
• Maximum benefit per calendar year: 2
• $50
• Maximum benefit per calendar year: 1
• $50
• Maximum benefit per calendar year: 1
Accident Insurance
Accident insurance provides affordable protection against a sudden, unforeseen accident. This plan helps offset the direct and indirect expenses resulting from an accident such as copayments, deductible, ambulance, physical therapy, childcare, rent, and other costs not covered by traditional health plans. See the plan document for full details.
ACCIDENT INSURANCE
Percentage Amount (unless otherwise indicated)
Initial and Emergency Care
• Emergency care treatment
• Physician office visit (includes urgent care)
• Diagnostic exam (X-ray or lab)
• Ground or water ambulance/air ambulance
Hospitalization Benefits
• Hospital admission
• Intensive care unit admission
• Hospital stay
• Intensive care unit stay
Fractures and Dislocations
• Per covered surgically-repaired fracture
• Per covered surgically-repaired dislocation
• Per covered non-surgically-repaired fracture
• Per covered non-surgically-repaired dislocation
• Chip-fracture (percent of fracture benefit)
Follow-Up Care
• Follow-up physician (or medical professional) office visit
• Follow-up physical therapy visit
Accidental Death & Dismemberment 1
Examples of benefits include (but are not limited to) payment for death from automobile accident; total and permanent loss of speech or hearing in both ears. Actual benefit amount paid depends on the type of covered loss. The Spouse and Child benefit is 50% and 25% respective of the benefit shown.
Wellness Treatment, Health Screening Test, and Preventive Care Benefit
$75
$50
1
Benefit paid for all covered persons is 100% of the benefit shown. Also includes COVID-19 immunizations, tests, and screenings. Virtual care accepted. $50
Organized and personal sports activity; limited to 10 per year.
Important Definitions and Policy Provisions
Covered Accident: A sudden, unforeseeable, external event that results, directly and independently of all other causes, in a covered injury or covered loss and occurs while the covered person is insured under this Policy; is not contributed to by disease, sickness, mental or bodily infirmity; and is not otherwise excluded under the terms of this policy.
Covered Injury: Any bodily harm that results directly and independently of all other causes from a covered accident.
Covered Person: An eligible person who is enrolled for coverage under this policy.
Covered Loss: A loss that is the result, directly and independently of other causes, from a covered accident suffered by the covered person within the applicable time period described in the policy.
Coverage Begins
Coverage begins on the later of the program’s effective date, the date you become eligible, or the first of the month following the date your completed enrollment form is received unless otherwise agreed upon by Cigna. Your coverage will not begin unless you are actively at work on the effective date. Coverage for all covered persons will not begin on the effective date if hospital, facility or home confined, disabled or receiving disability benefits or unable to perform activities of daily living.
Coverage Ends
Coverage ends on the earliest of the date you and your dependents are no longer eligible, the date the group policy is no longer in force, or the date for the last period for which required premiums are paid. For your dependent, coverage also ends when your coverage ends, when their premiums are not paid or when they are no longer eligible. (Under certain circumstances, your coverage may be continued. Be sure to read the provisions in your Certificate.)
30-Day Right To Examine Certificate
If a covered person is not satisfied with the Certificate for any reason, it may be returned within 30 days after receipt. Cigna will return any premium that has been paid and the Certificate will be void as if it had never been issued.
Critical Illness Insurance
Critical Illness insurance helps pay the cost of non-medical expenses related to a covered critical illness or cancer. The plan provides a lump sum benefit payment to you upon first and second diagnosis of any covered critical illness or cancer. The benefit can help cover expenses such as lost income, out-oftown treatments, special diets, daily living, and household upkeep costs. This coverage is portable.
See the plan document for full details. Refer to the enrollment system for rates.
CRITICAL ILLNESS INSURANCE
Coverage Conditions
Invasive cancer, heart attack, stroke, benign brain tumor, blindness, coma/ brain injury, end-stage renal (kidney) failure, major organ failure, paralysis, loss of hearing or speech, occupational hepatitis-B or hepatitis-C
Coverage Conditions
Advanced stage Alzheimer’s disease, Parkinson’s disease, ALS (a.k.a. Lou Gehrig’s disease), multiple sclerosis, mild stage Alzheimer’s disease, blindness, occupational hepatitis-HIV, loss of hearing or speech
Infectious Conditions
Bacterial meningitis, malaria, tuberculosis, necrotizing fasciitis, osteomyelitis, severe sepsis
Wellness Treatment, Health Screening Test, and Preventive Care Benefit*
The benefit amount shown will be paid regardless of the actual expenses incurred and is paid on a per day basis. Also includes COVID-19 immunization, test, and screenings. Virtual care accepted.
Additional Benefits
Hospital Indemnity – musculoskeletal, endocrine, heart and vascular or respiratory hospitalization admission only benefit pays when a covered person is confined to a hospital due to any covered condition
$50 – one per year
Hospital Admission: $3,000 per admission (Limited to 1 day, 1 benefit every 12 months)
The Spouse and Child benefit is 50% of the benefit, respectively
• Musculoskeletal Condition such as cervicalgia (neck pain), intervertebral disc disorders, gout, lumbago (back pain), osteoarthritis, rheumatoid arthritis, scoliosis, spinal stenosis, spondyloarthropathy (spinal arthritis), or spondylopathy (vertebral spine disease).
• Endocrine Condition such as Addison’s disease, Cushing disease or syndrome, central diabetes insipidus, diabetes mellitus (type 1, type 2), gestational diabetes, hyperthyroidism, hypothyroidism or polycystic ovarian syndrome.
• Heart and Vascular Condition such as arrhythmias (irregular heartbeat), primary cardiomyopathy (non-ischemic), peripheral vascular disease, or valvular heart disease (e.g., aortic stenosis, aortic regurgitation, etc.).
• Respiratory Condition such as asthma, chronic bronchitis, chronic obstructive pulmonary disease (COPD), or emphysema.
Cancer Insurance
Treatment for cancer is often lengthy and expensive. While your health insurance helps pay the medical expenses for cancer treatment, it does not cover the cost of non-medical expenses, such as out-of-town treatments, special diets, daily living, and household upkeep. In addition to these non-medical expenses, you are responsible for paying your health plan deductibles and/or coinsurance. Cancer insurance helps pay for these direct and indirect treatment costs so you can focus on your health.
See the plan document for full details.
CANCER INSURANCE
Diagnosis of Cancer
Hospital Confinement
Hospital Confinement ICU
• Employee or Spouse: $2,500 Child(ren): $3,750
• Waiting period: 0 days Benefit reduction: none
• $100 per day – days 1 through 30
• Additional days – $200
• Maximum days per confinement: 31
• $600 per day – days 1 through 30
• Additional days – $600
• Maximum days per confinement: 31
• Employee or Spouse: $2,500 Child(ren): $3,750
• Waiting period: 0 days Benefit reduction: none
• $200 per day – days 1 through 30
• Additional days – $400
• Maximum days per confinement: 31
• $600 per day – days 1 through 30
• Additional days – $600
• Maximum days per confinement: 31
Radiation Therapy, Chemotherapy, Immunotherapy Maximum per covered person per calendar year 12-month period: $10,000 Maximum per covered person per calendar year 12-month period: $20,000
Alternative Care
Medical Imaging
Air Ambulance
Ambulance
Blood, Plasma, and Platelets
Bone Marrow or Stem Cell Donation
Bone Marrow or Stem Cell Transplant
Hormonal Therapy
• $75 per visit
• Maximum visits per calendar year: 4
• $500 per imaging study
• Maximum studies per calendar year: 2
• $2,000 per trip
• Maximum trips per confinement: 2
• $200 per trip
• Maximum trips per confinement: 2
• $300 per transfusion
• Maximum transfusions per calendar year: 2
• $100 per confinement
• Lifetime maximum donations: 2
• First bone marrow transplant: $6,000
• Additional transplant: 50%
• Lifetime maximum transplant(s): 2
• First stem cell transplant: $600
• Additional transplant: 50%
• Lifetime maximum transplant(s): 2
• $50 per treatment
• Maximum treatments per calendar year: 12
• $75 per visit
• Maximum visits per calendar year: 4
• $500 per imaging study
• Maximum studies per calendar year: 2
• $2,000 per trip
• Maximum trips per confinement: 2
• $200 per trip
• Maximum trips per confinement: 2
• $300 per transfusion
• Maximum transfusions per calendar year: 2
• $100 per confinement
• Lifetime maximum donations: 2
• First bone marrow transplant: $9,000
• Additional transplant: 50%
• Lifetime maximum transplant(s): 2
• First stem cell transplant: $900
• Additional transplant: 50%
• Lifetime maximum transplant(s): 2
• $50 per treatment
• Maximum treatments per calendar year: 12
Cancer Insurance Benefits
Plan
Plan
First Cancer Benefit
$100 paid upon receipt of first covered claim for cancer; only one payment per covered person per certificate.
$100 paid upon receipt of first covered claim for cancer; only one payment per covered person per certificate.
Cancer Insurance
Counseling
Hair Piece
Medical Equipment
Non-Surgical Prosthesis
Recovery at Home
Therapy
Transportation and Lodging
• $75 per visit
• Maximum visits per calendar year: 6
• $150 per hair piece
• Lifetime maximum: 1
• $150 per piece of equipment
• Maximum pieces per calendar year: 2
• $100
• Lifetime maximum number of devices: 1
• $100 per day not to exceed the number of days confined
• Maximum days per calendar year: 15
• $25 per day of therapy
• Maximum days per calendar year: 40
• Transportation: $100 per trip
• Maximum trips per calendar year: 12
• Lodging: $50 per day
• Maximum days per calendar year: 100
• $50
• Maximum days of service, per covered person per calendar year: 1 day(s)
• Follow-up test benefit amount: $100
• Waiting period: 0 days
• $100 per test
Genetic Tumor Testing
Heritable Cancer Screening
Pharmacogenomic (PGX)
Screening Test
Heart Attack or Stroke Benefit
Heart Attack or Stroke
• Maximum tests per calendar year: 2
• $75
• Maximum tests per calendar year: 1
• $100 per test
• Maximum tests per calendar year: 2
• Employee or Spouse: $2,500
• Child(ren): $3,750
• Employee or Spouse Recurrence Benefit: $1,250
• Child(ren) Recurrence Benefit: $1,875
• Waiting period: 0 days
• Benefit reduction: none
• $75 per visit
• Maximum visits per calendar year: 6
• $150 per hair piece
• Lifetime maximum: 1
• $150 per piece of equipment
• Maximum pieces per calendar year: 2
• $200
• Lifetime maximum number of devices: 1
• $100 per day not to exceed the number of days confined
• Maximum days per calendar year: 15
• $25 per day of therapy
• Maximum days per calendar year: 40
• Transportation: $100 per trip
• Maximum trips per calendar year: 12
• Lodging: $50 per day
• Maximum days per calendar year: 100
• $50 • Maximum days of service, per covered person per calendar year: 1 day(s)
• Follow-up test benefit amount: $100
• Waiting period: 0 days
• $100 per test
• Maximum tests per calendar year: 2
• $75
• Maximum tests per calendar year: 1
• $100 per test
• Maximum tests per calendar year: 2
• Employee or Spouse: $2,500
• Child(ren): $3,750
• Employee or Spouse Recurrence Benefit: $1,250
• Child(ren) Recurrence Benefit: $1,875
• Waiting period: 0 days
• Benefit reduction: none
Cancer Insurance
Preventative Surgery
Reconstructive Surgery
•
•
• Breast TRAM flap: $2,000
• Breast reconstruction: $500
• Breast symmetry: $500
• Facial reconstruction: $500
• Breast TRAM flap: $2,000
• Breast reconstruction: $500
• Breast symmetry: $500
• Facial reconstruction: $500 Second and Third Opinion • $300
• $300
Legal Protection
At many points in your life, you may need legal assistance. Getting legal help can be a stressful and expensive process – many firms may charge up to $350 an hour. For these reasons, we offer a legal assistance plan to help you get the guidance you need. The cost for this service is $19.50 per month
Visit
Civil Lawsuits
Administrative hearings
Civil litigation defense
Consumer goods and services disputes
Incompetency defense
Pet liabilities
Small claims assistance
Money Matters
Debt collection defense
Identity theft defense
Creditor negotiations
Personal bankruptcy
Promissory notes
Tax audit representation
Tax collection defense
Download
Help for Personal Legal Matters
Consultation and document
review of your parents’ deeds and leases
Medicaid Medicare Notes
Nursing home agreements
Powers of Attorney
Prescription plans
Wills
Traffic ticket defense
Driving privileges restoration
DUI license suspension
Repossession
Attorney locator
Financial planning
Insurance resources
Law firm e-panel
Self-help legal documents
Home and Real Estate Estate Planning Family and Personal
Boundary and title disputes
Deeds
Eviction defense
Foreclosure
Home equity loans
Mortgages
Property tax assessments
Home refinancing
Home sale or purchase
Security deposit assistance
Tenant negotiations
Zoning applications
Codicils
Complex wills
Health care proxies
Living wills
Powers of Attorney (health care, financial, child care, immigration)
Revocable and irrevocable
trusts
Simple wills
Adoption
Affidavits
Conservatorship
Demand letters
Divorce – 20 hours
Support order enforcement or modification
Garnishment defense
Guardianship
Immigration assistance
Juvenile court defense
(including criminal matters)
Name change
Parental responsibility matters
Personal property protection
Prenuptial agreement
Domestic violence protection
Personal legal document
review
School hearings
ID Theft Protection
Identity theft is one of the fastest-growing crimes in the country. Millions of people have their identity stolen each year.
Protect yourself and restore your identity with two plan coverage options that include:
• Identity consultation and advice
• Identity and credit monitoring
• Social media monitoring
• Identity restoration • Threat and credit alerts • 24/7
Pet Insurance
Pet insurance is a financial safety net for your furry family. Get reimbursed for accidents and illnesses, and get a prompt response via the 24/7 pet health helpline. Flexible coverage options are available.
Covered Services
• Accidental injuries
• Illness
• Exam fees
• Surgeries
• Medications
• Ultrasounds
• Hospital stays
• X-rays and diagnostic tests
For More Information or to Enroll Today
Visit www.metlifepetinsurance.com/friscoisd
Call 800-438-6388
Coverage also includes:
● Hip dysplasia
● Hereditary conditions
● Congenital conditions
● Chronic conditions
● Alternative therapies
● Holistic care
● And more!
Retirement Plan
When you consistently save money throughout your career, it lays a secure foundation for your retirement years. Enroll in our 403(b) plan to help you reach your investment and retirement goals.
We offer two plans to help with your retirement goals:
● A 403(b) plan is a U.S. tax-advantaged retirement savings plan available for public education organizations.
● A 457(b) plan is a tax-deferred compensation plan provided for employees of certain tax-exempt, governmental organizations or public education institutions.
● A 401(a) plan is a Defined Contribution Plan that allows you to save and invest money for retirement with tax benefits.
Plan Comparison
What is a 403(b)?
A 403(b) plan is a retirement plan for certain employees of public schools, tax-exempt organizations, and ministers. Contributions are made under a Salary Reduction Agreement (SRA) with your employer. This agreement allows your employer to withhold money from your paycheck to be contributed directly into a 403(b) account for your benefit. Usually, you do not pay income tax on these contributions until you withdraw them from the account.
You have 35+ companies to choose from with a variety of investment types available (fixed annuity, fixed index annuity, variable annuity, investment advisory services, or mutual funds).
• Set up your 403b account with an approved vendor.
• Complete the Salary Reduction Agreement with TCG Administrators
There is an additional tax penalty on any funds withdrawn prior to retirement age.
What is a 457(b)?
The 457(b) plan is a type of deferred-compensation retirement plan that is available for governmental employers. The employer provides the plan and the employee defers compensation into it on a pre-tax basis. For the most part, the plan operates similarly to a 401(k) or 403(b) plan. The key difference is that there is no penalty for withdrawal before the age of 59½ (but subject to income tax).
Frisco ISD has selected one company to provide our employees with the 457(b) plan. TCG Administrators offers several investment options. Visit the website for a list of fees of service plan providers.
What is a 401(a)?
District employees can participate in a 403(b) or 457 plan. Employees who choose to participate in one or both of those optional retirement plans and who have achieved at least one year of service (as defined by TRS) with the District are eligible for the Teacher/Employee Recruitment and Retention Program (TERRP). Frisco ISD may provide a discretionary matching contribution to employees eligible for the TERRP, subject to the availability of excess revenue at the end of the preceding fiscal year. At the conclusion of each fiscal year, the District will assign excess unrestricted revenue, up to $1,000,000, to fund discretionary matching contributions to the TERRP.
• The District will match 25% of each eligible employee’s voluntary retirement plan contributions, up to 1% of the contributing employee’s base wages, in a 401(A) plan.
• If the total eligible match claims exceed the reserved amount, the Board may formally resolve to fully fund the match. Otherwise, each eligible employee will receive a proportionate share of the available matching pool based on their individual eligible match amount relative to the total. There is no guarantee that a match will be funded in any given year. Matching contributions, if any, will be calculated and deposited after the close of the preceding fiscal year.
How to Enroll
• Complete the Salary Reduction Agreement with TCG Administrators
Plan password for enrolling online:
• Enrolling for Pre-tax: fris403
• Enrolling for Roth: fri403xR
There is no penalty for early withdrawal (upon separation of service).
Access www.region10ams.org , click Login, and select your employer from the navigation bar. Under the 401(a) tab, click Login. The User ID is your Social Security number and the password is your date of birth.
Glossary of Terms
Actively-at-Work – You are performing your regular occupation for the employer on a full-time basis, either at one of the employer’s usual places of business or at some location to which the employer’s business requires you to travel. If you will not be actively at work beginning September 1, 2026 please notify your benefits administrator.
Beneficiary – Who will receive a benefit in the event of the insured’s death. A policy may have more than one beneficiary.
Annual Deductible – The amount you owe for health care services before your health insurance begins to pay its portion. For example, if your deductible is $1,000, your plan does not pay anything until you meet your $1,000 deductible for covered health care services. The deductible may not apply to all services, including preventive care.
Calendar Year – January 1 through December 31.
Coinsurance – Your share of the cost of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service, typically after you meet your deductible.
Copay – The fixed amount you pay for health care services received.
Employee Contribution – The amount you pay for your insurance coverage.
Employer Contribution – The amount your employer contributes to the cost of your benefits.
Explanation of Benefits (EOB) – A statement sent by your insurance carrier that explains which procedures and services were provided, how much they cost, what portion of the claim was paid by the plan, what portion of the claim is your responsibility, and information on how you can appeal the insurer’s decision. These statements are also posted on the carrier’s website for your review.
Flexible Spending Account (FSA) – An option that allows participants to set aside pretax dollars to pay for certain qualified expenses during a specific time period (usually a 12-month period).
Guaranteed Issue – The amount of coverage you can elect without answering any medical questions or taking a health exam. Guaranteed coverage is only available during initial eligibility period. Actively-at-work and/or pre-existing condition exclusion provisions do apply, as applicable by carrier.
Health Savings Account (HSA) – A personal savings account that allows you to pay for qualified medical expenses with pretax dollars.
High Deductible Health Plan (HDHP) – A medical plan with a higher deductible in exchange for a lower monthly premium. You must meet the annual deductible before any benefits are paid by the plan.
In-Network – Doctors, hospitals, and other providers that contract with your insurance company to provide health care services at discounted rates.
Out-of-Network – Doctors, hospitals, and other providers that are not contracted with your insurance company. If you choose an out-of-network provider, you may be responsible for costs over the amount allowed by your insurance carrier.
Out-of-Pocket Maximum – Also known as an out-of-pocket limit. The most you pay during a policy period (usually a 12-month period) before your health insurance or plan begins to pay 100% of the allowed amount. The limit does not include your premium, charges beyond the Reasonable and Customary (R&C) Allowance, or health care your plan does not cover. Check with your health insurance carrier to confirm what payments apply to the out-of-pocket maximum.
Plan Year – September 1 through August 31.
Prescription Medications – Medications prescribed by a doctor. Cost of these medications is determined by their assigned tier.
Preventive Care – The care you receive to prevent illness or disease. It also includes counseling to prevent health problems.
Reasonable and Customary (R&C) Allowance – Also known as an eligible expense or the Usual and Customary (U&C). The amount your insurance company will pay for a medical service in a geographic region based on what providers in the area usually charge for the same or similar medical service.
SSNRA – Social Security Normal Retirement Age.
Important Legal Notices
Women’s Health and Cancer Rights Act of 1998
In October 1998, Congress enacted the Women’s Health and Cancer Rights Act of 1998. This notice explains some important provisions of the Act. Please review this information carefully.
As specified in the Women’s Health and Cancer Rights Act, a plan participant or beneficiary who elects breast reconstruction in connection with a mastectomy is also entitled to the following benefits:
• All stages of reconstruction of the breast on which the mastectomy was performed;
• Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
• Prostheses and treatment of physical complications of the mastectomy, including lymphedema.
Health plans must determine the manner of coverage in consultation with the attending physician and the patient. Coverage for breast reconstruction and related services may be subject to deductibles and coinsurance amounts that are consistent with those that apply to other benefits under the plan.
Special Enrollment Rights
This notice is being provided to ensure that you understand your right to apply for group health insurance coverage. You should read this notice even if you plan to waive coverage at this time.
Loss of Other Coverage or Becoming Eligible for Medicaid or a state Children’s Health Insurance Program (CHIP)
If you are declining coverage for yourself or your dependents because of other health insurance or group health plan coverage, you may be able to later enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must enroll within 31 days after your or your dependents’ other coverage ends (or after the employer that sponsors that coverage stops contributing toward the other coverage).
If you or your dependents lose eligibility under a Medicaid plan or CHIP, or if you or your dependents become eligible for a subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents in this plan. You must provide notification within 60 days after you or your dependent is terminated from, or determined to be eligible for, such assistance.
Marriage, Birth or Adoption
If you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must enroll within 31 days after the marriage, birth, or placement for adoption.
For More Information or Assistance
To request special enrollment or obtain more information, contact: Frisco ISD Benefits Office 5515 Ohio Dr Frisco, TX 75035 469-633-6360
Your Prescription Drug Coverage and Medicare
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Frisco ISD and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to enroll in a Medicare drug plan. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
If neither you nor any of your covered dependents are eligible for or have Medicare, this notice does not apply to you or the dependents, as the case may be. However, you should still keep a copy of this notice in the event you or a dependent should qualify for coverage under Medicare in the future. Please note, however, that later notices might supersede this notice.
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage through a Medicare Prescription Drug Plan or a Medicare Advantage Plan that offers prescription drug coverage. All Medicare prescription drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
2. Frisco ISD has determined that the prescription drug coverage offered by the Frisco ISD medical plan is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage pays and is considered Creditable Coverage.
Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to enroll in a Medicare prescription drug plan, as long as you later enroll within specific time periods.
You can enroll in a Medicare prescription drug plan when you first become eligible for Medicare. If you decide to wait to enroll in a Medicare prescription drug plan, you may enroll later, during Medicare Part D’s annual enrollment period, which runs each year from October 15 through December 7 but as a general rule, if you delay your enrollment in Medicare Part D after first becoming eligible to enroll, you may have to pay a higher premium (a penalty).
You should compare your current coverage, including which drugs are covered at what cost, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. See the Plan’s summary plan description for a summary of the Plan’s prescription drug coverage. If you don’t have a copy, you can get one by contacting Frisco ISD at the phone number or address listed at the end of this section.
Important Legal Notices
If you choose to enroll in a Medicare prescription drug plan and cancel your current Frisco ISD prescription drug coverage, be aware that you and your dependents may not be able to get this coverage back. To regain coverage, you would have to re-enroll in the Plan, pursuant to the Plan’s eligibility and enrollment rules. You should review the Plan’s summary plan description to determine if and when you are allowed to add coverage.
If you cancel or lose your current coverage and do not have prescription drug coverage for 63 days or longer prior to enrolling in the Medicare prescription drug coverage, your monthly premium will be at least 1% per month greater for every month that you did not have coverage for as long as you have Medicare prescription drug coverage. For example, if nineteen months lapse without coverage, your premium will always be at least 19% higher than it would have been without the lapse in coverage.
For more information about this notice or your current prescription drug coverage:
Contact Benefits Office at 469-633-6360
NOTE: You will receive this notice annually and at other times in the future, such as before the next period you can enroll in Medicare prescription drug coverage and if this coverage changes. You may also request a copy.
For more information about your options under Medicare prescription drug coverage:
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You will get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. For more information about Medicare prescription drug coverage:
• Visit www.medicare.gov
• Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help.
• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 877-486-2048
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. Information about this extra help is available from the Social Security Administration (SSA) online at www.socialsecurity.gov, or you can call them at 800-772-1213. TTY users should call 800-325-0778
Remember: Keep this Creditable Coverage notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty).
September 1, 2026
Frisco ISD Benefits Office
5515 Ohio Dr Frisco, TX 75035
469-633-6360
Notice of HIPAA Privacy Practices
THIS NOTICE OF PRIVACY PRACTICES DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This Notice of Privacy Practices (the “Notice”) describes the legal obligations of Company’s Group Health Plan (the “Plan”) and your legal rights regarding your protected health information held by the Plan under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH Act). Among other things, this Notice describes how your protected health information may be used or disclosed to carry out treatment, payment, or health care operations, or for any other purposes that are permitted or required by law.
We are required to provide this Notice of Privacy Practices to you pursuant to HIPAA.
The HIPAA Privacy Rule protects only certain medical information known as “protected health information.” Generally, protected health information (PHI) is health information, including demographic information, collected from you or created or received by a health care provider, a health care clearinghouse, a health plan, or your employer on behalf of a group health plan, from which it is possible to individually identify you and that relates to:
1. Your past, present, or future physical or mental health or condition;
2. The provision of health care to you; or
3. The past, present, or future payment for the provision of health care to you.
I. Contact Information
If you have any questions about this Notice or about our privacy practices, and for any correspondence or requests related to the contents of this Notice, please contact: Frisco ISD
Benefits Office 5515 Ohio Dr Frisco, TX 75035 469-633-6360
II. Effective Date
This Notice is effective February 15, 2026.
III. Our Responsibilities
We are required by law to:
1. maintain the privacy of your PHI;
2. provide you with certain rights with respect to your PHI;
3. provide you with a copy of this Notice of our legal duties and privacy practices with respect to your PHI; and
4. follow the terms of the Notice that is currently in effect.
Important Legal Notices
We reserve the right to change the terms of this Notice and to make new provisions regarding your PHI that we maintain, as allowed or required by law. If we make any material change to this Notice, we will provide you with a copy of our revised Notice of Privacy Practices.
IV. How We May Use and Disclose Your PHI
Under the law, we may use or disclose your PHI under certain circumstances without your permission. The following categories describe the different ways that we may use and disclose your PHI. For each category of uses or disclosures we will explain what we mean and present some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories. Note that we will use and disclose PHI as described below unless otherwise prohibited or restricted by applicable state or other law, and that information can lose its protected status as PHI once re-disclosed by a recipient.
For Treatment. When and as appropriate, we may use or disclose medical information about you to facilitate medical treatment or services by health care providers. We may disclose medical information about you to providers, including doctors, nurses, technicians, medical students, or other hospital personnel who are involved in taking care of you. For example, we might disclose information about you with physicians who are treating you.
For Payment. We may use or disclose your protected health information to determine your eligibility for Plan benefits, to facilitate payment for the treatment and services you receive from health care providers, to determine benefit responsibility under the Plan, or to coordinate Plan coverage. For example, we may tell your health care provider about your medical history to determine whether a particular treatment is experimental, investigational, or medically necessary, or to determine whether the Plan will cover the treatment. We may also share your protected health information with a utilization review or pre-certification service provider. Likewise, we may share your protected health information with another entity to assist with the adjudication or subrogation of health claims or to another health plan to coordinate benefit payments.
For Health Care Operations. We may use and disclose your protected health information for other Plan operations. These uses and disclosures are necessary to run the Plan. For example, we may use medical information in connection with conducting quality assessment and improvement activities; underwriting, premium rating, and other activities relating to Plan coverage; submitting claims for stop-loss (or excess-loss) coverage; conducting or arranging for medical review, legal services, audit services, and fraud and abuse detection programs; business planning and development such as cost management; and business management and general Plan administrative activities. However, we will not use your genetic information for underwriting purposes.
Substance Use Disorder (SUD) Treatment Information. Some of your health information may be part of a SUD patient record and subject to additional protections under federal law (42 CFR Part 2) governing confidentiality of SUD patient records.
If we receive or maintain any information about you from a SUD treatment program that is covered by 42 CFR Part 2 (a “Part 2 Program”) through a general consent you provide to the Part 2 Program to use and disclose the SUD patient record for purposes of treatment, payment or health care operations, we may use and disclose your SUD patient record for treatment, payment and health care operations purposes as described in this Notice. If we receive or maintain your SUD patient record through specific consent you provide to us or another third party, we will use and disclose your SUD patient record only as expressly permitted by you in your consent as provided to us. In no event will we use or disclose your SUD patient record, or testimony that describes the information contained in your SUD patient record, in any civil, criminal, administrative, or legislative proceedings by any Federal, State, or local authority, against you, unless authorized by your consent or the order of a court after it provides you notice of the court order.
To Business Associates. We may contract with individuals or entities known as Business Associates to perform various functions on our behalf or to provide certain types of services. In order to perform these functions or to provide these services, Business Associates will receive, create, maintain, transmit, use, and/or disclose your PHI, but only after they agree in writing with us to implement appropriate safeguards regarding your PHI. For example, we may disclose your PHI to a Business Associate to process your claims for Plan benefits or to provide support services, such as utilization management, pharmacy benefit management, or subrogation, but only after the Business Associate enters into a Business Associate contract with us.
Treatment Alternatives or Health-Related Benefits and Services. We may use and disclose your protected health information to send you information about treatment alternatives or other health-related benefits and services that might be of interest to you.
As Required by Law. We will disclose your PHI when required to do so by federal, state, or local law. For example, we may disclose your PHI when required by national security laws or public health disclosure laws.
To Avert a Serious Threat to Health or Safety. We may use and disclose your PHI when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat. For example, we may disclose your PHI in a proceeding regarding the licensure of a physician.
To Plan Sponsors. For the purpose of administering the plan, we may disclose PHI to certain employees of the Employer. However, those employees will only use or disclose that information as necessary to perform plan administration functions or as otherwise required by HIPAA, unless you have authorized further disclosures. Your PHI cannot be used for employment purposes without your specific authorization.
Important Legal Notices
V. Special Situations
In addition to the above, the following categories describe other possible ways that we may use and disclose your PHI without your specific authorization. For each category of uses or disclosures, we will explain what we mean and present some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
Organ and Tissue Donation. If you are an organ donor, we may release your PHI after your death to organizations that handle organ procurement or organ, eye, or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
Military. If you are a member of the armed forces, we may release your PHI as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority.
Workers’ Compensation. We may release your PHI for workers’ compensation or similar programs, but only as authorized by, and to the extent necessary to comply with, laws relating to workers’ compensation and similar programs that provide benefits for workrelated injuries or illness.
Public Health Risks. We may disclose your PHI for public health activities. These activities generally include the following:
1. to prevent or control disease, injury, or disability;
2. to report births and deaths;
3. to report child abuse or neglect;
4. to report reactions to medications or problems with products;
5. to notify people of recalls of products they may be using;
6. to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
7. to notify the appropriate government authority if we believe that a patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree, or when required or authorized by law.
Health Oversight Activities. We may disclose your PHI to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. We may also disclose your PHI in response to a subpoena, discovery request, or other lawful process by someone involved in a legal dispute, but only if efforts have been made to tell you about the request or to obtain a court or administrative order protecting the information requested.
Law Enforcement. We may disclose your PHI if asked to do so by a law-enforcement official.
1. in response to a court order, subpoena, warrant, summons, or similar process;
2. to identify or locate a suspect, fugitive, material witness, or missing person;
3. about the victim of a crime if, under certain limited circumstances, we are unable to obtain the victim’s agreement;
4. about a death that we believe may be the result of criminal conduct; and
5. about criminal conduct.
Coroners, Medical Examiners, and Funeral Directors. We may release PHI to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients to funeral directors, as necessary to carry out their duties.
National Security and Intelligence Activities. We may release your PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Inmates. If you are an inmate of a correctional institution or are in the custody of a law-enforcement official, we may disclose your PHI to the correctional institution or law-enforcement official if necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
Research. We may disclose your PHI to researchers when:
1. The individual identifiers have been removed; or
2. When an institutional review board or privacy board has reviewed the research proposal and established protocols to ensure the privacy of the requested information and approves the research.
VI. Required Disclosures
The following is a description of disclosures of your PHI we are required to make.
Government Audits. We are required to disclose your PHI to the Secretary of the United States Department of Health and Human Services when the Secretary is investigating or determining our compliance with the HIPAA privacy rule.
Disclosures to You. When you request, we are required to disclose to you the portion of your PHI that contains medical records, billing records, and any other records used to make decisions regarding your health care benefits. We are also required, when requested, to provide you with an accounting of most disclosures of your PHI if the disclosure was for reasons other than for payment, treatment, or health care operations, and if the PHI was not disclosed pursuant to your individual authorization.
Important Legal Notices
VII. Other Disclosures
Personal Representatives. We will disclose your PHI to individuals authorized by you, or to an individual designated as your personal representative, attorney-in-fact, etc., so long as you provide us with a written notice/authorization and any supporting documents (i.e., power of attorney). Note: Under the HIPAA privacy rule, we do not have to disclose information to a personal representative if we have a reasonable belief that:
1. You have been, or may be, subject to domestic violence, abuse, or neglect by such person; or
2. Treating such person as your personal representative could endanger you; and
3. In the exercise of professional judgment, it is not in your best interest to treat the person as your personal representative.
Spouses and Other Family Members. With only limited exceptions, we will send all mail to the employee. This includes mail relating to the employee’s spouse and other family members who are covered under the Plan and includes mail with information on the use of Plan benefits by the employee’s spouse and other family members and information on the denial of any Plan benefits to the employee’s spouse and other family members. If a person covered under the Plan has requested Restrictions or Confidential Communications (see below under “Your Rights”), and if we have agreed to the request, we will send mail as provided by the request for Restrictions or Confidential Communications. Authorizations. Other uses or disclosures of your PHI not described above will only be made with your written authorization. For example, in general and subject to specific conditions, we will not use or disclose your psychiatric notes; we will not use or disclose your PHI for marketing; and we will not sell your PHI, unless you give us a written authorization. You may revoke written authorizations at any time, so long as the revocation is in writing. Once we receive your written revocation, it will only be effective for future uses and disclosures. It will not be effective for any information that may have been used or disclosed in reliance upon the written authorization and prior to receiving your written revocation.
VIII. Your Rights
You have the following rights with respect to your PHI:
Right to Inspect and Copy. You have the right to inspect and copy certain PHI that may be used to make decisions about your Plan benefits. If the information you request is maintained electronically, and you request an electronic copy, we will provide a copy in the electronic form and format you request, if the information can be readily produced in that form and format; if the information cannot be readily produced in that form and format, we will work with you to come to an agreement on form and format. If we cannot agree on an electronic form and format, we will provide you with a paper copy.
To inspect and copy your PHI, you must submit your request in writing. If you request a copy of the information, we may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request.
We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to your medical information, you may request that the denial be reviewed by submitting a written request.
Right to Amend. If you feel that the PHI we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the Plan.
To request an amendment, your request must be made in writing. In addition, you must provide a reason that supports your request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
1. is not part of the medical information kept by or for the Plan;
2. was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
3. is not part of the information that you would be permitted to inspect and copy; or
4. is already accurate and complete.
If we deny your request, you have the right to file a statement of disagreement with us and any future disclosures of the disputed information will include your statement.
Right to an Accounting of Disclosures. You have the right to request an “accounting” of certain disclosures of your PHI. The accounting will not include (1) disclosures for purposes of treatment, payment, or health care operations; (2) disclosures made to you; (3) disclosures made pursuant to your authorization; (4) disclosures made to friends or family in your presence or because of an emergency; (5) disclosures for national security purposes; and (6) disclosures incidental to otherwise permissible disclosures.
To request this list or accounting of disclosures, you must submit your request in writing. Your request must state the time period you want the accounting to cover, which may not be longer than six years before the date of the request. Your request should indicate in what form you want the list (for example, paper or electronic). The first list you request within a 12-month period will be provided free of charge. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right
to
Request Restrictions.
You have the right to request a restriction or limitation on your PHI that we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on your PHI that we disclose to someone who is involved in your care or the payment for your care, such as a family member or friend. For example, you could ask that we not use or disclose information about a surgery that you had.
Except as provided in the next paragraph, we are not required to agree to your request. However, if we do agree to the request, we will honor the restriction until you revoke it or we notify you.
Important Legal Notices
We will comply with any restriction request if (1) except as otherwise required by law, the disclosure is to a health plan for purposes of carrying out payment or health care operations (and is not for purposes of carrying out treatment); and (2) the PHI pertains solely to a health care item or service for which the health care provider involved has been paid in full by you or another person.
To request restrictions, you must make your request in writing. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both; and (3) to whom you want the limits to apply-for example, disclosures to your spouse.
Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you must make your request in writing. We will not ask you the reason for your request. Your request must specify how or where you wish to be contacted. We will accommodate all reasonable requests.
Right to Be Notified of a Breach. You have the right to be notified in the event that we (or a Business Associate) discover a breach of unsecured PHI.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
IX. Complaints
If you believe that your privacy rights have been violated, you may file a complaint with the Plan or with the Office for Civil Rights of the United States Department of Health and Human Services. To file a complaint with the Plan, contact the person listed in the Contact Information section of this Notice. All complaints must be submitted in writing.
You will not be penalized, or in any other way retaliated against, for filing a complaint with the Office for Civil Rights or with us.
Premium Assistance Under Medicaid
and the Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www. healthcare.gov
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow. gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employersponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444EBSA (3272)
If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of January 31, 2026. Contact your State for more information on eligibility.
Phone: 1-800-440-0493
To see if any other States have added a premium assistance program since January 31, 2026, or for more information on special enrollment rights, you can contact either:
U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272)
U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323 , Menu Option 4, Ext. 61565
Continuation of Coverage Rights Under COBRA
Under the Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), if you are covered under the Frisco ISD group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Frisco ISD plan after you have left employment with the company. If you wish to elect COBRA coverage, contact Benefits Office for the applicable deadlines to elect coverage and pay the initial premium.
Important Legal Notices
Frisco ISD Benefits Office
5515 Ohio Dr Frisco, TX 75035
469-633-6360
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that have not signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an innetwork facility but are unexpectedly treated by an out-of-network provider.
You are protected from balance billing for:
• Emergency services – If you have an emergency medical condition and get emergency services from an out-of- network provider or facility, the most the provider or facility may bill you is your plan’s in- network cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
• Certain services at an in-network hospital or ambulatory surgical center – When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-ofnetwork providers cannot balance bill you, unless you give written consent and give up your protections.
You are never required to give up your protections from balance billing. You also are not required to get care out-of-network. You can choose a provider or facility in your plan’s network.
When balance billing is not allowed, you also have the following protections:
• You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
• Your health plan generally must:
• Cover emergency services without requiring you to get approval for services in advance (prior authorization).
• Cover emergency services by out-of-network providers.
• Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
• Count any amount you pay for emergency services or outof-network services toward your deductible and out-ofpocket limit.
If you believe you have been wrongly billed, you may contact your insurance provider. Visit www.cms.gov/nosurprises for more information about your rights under federal law.
This brochure highlights the main features of the Frisco ISD employee benefits program. It does not include all plan rules, details, limitations, and exclusions. The terms of your benefit plans are governed by legal documents, including insurance contracts. Should there be an inconsistency between this brochure and the legal plan documents, the plan documents are the final authority. Frisco ISD reserves the right to change or discontinue its employee benefits plans at anytime.
