Employee Benefits Guide
If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, a federal law gives you more choices about your prescription drug coverage. Please see page 24 for more details.
Welcome
We are pleased to offer you a comprehensive benefits package intended to protect your well-being and financial health. This guide is your opportunity to learn more about all of the benefits that are now available to you and your eligible dependents beginning January 1, 2026.
To get the best value from your benefits offerings, please take the time to evaluate your coverage options and determine which plans best meet your and your family’s health care and financial needs. By being a wise consumer, you can support your health and maximize your health care dollars.
Each year during Open Enrollment, you have the opportunity to make changes to your benefit plans. The enrollment decisions you make this year will remain in effect through December 31, 2026. After Open Enrollment, you may make changes to your benefit elections only when you have a Qualifying Life Event. You will have 31 days to make your benefit elections and submit supporting documentation to Human Resources. Changes will be effective on the day of the event and must be consistent with your Qualifying Life Event. If you do not make your changes during the 31-day period, your changes cannot be made until the next Open Enrollment period.
Availability of Summary Health Information
Liberty Christian School offers you three medical plan options. To help you make an informed decision, a Summary of Benefits and Coverage (SBC) for each plan is available by contacting Human Resources or visiting https://libertychristian.myschoolapp.com/app/ faculty#resourceboarddetail/4360 under the Human Resources page.
Eligibility
You are eligible for benefits if you are a regular, full-time employee working an average of 30 hours per week or more. Your coverage is effective on the date you become an eligible employee. You may also enroll eligible dependents for benefits coverage. Your cost for dependent coverage will vary depending on the number of dependents you enroll in the plan and the particular plans you choose. When covering dependents, you must select the same plans for your dependents as you select for yourself.
Eligible Dependents Include
Your legal spouse
Children under the age of 26, regardless of student, dependency, or marital status
Children over the age of 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
Qualifying Life Events
Once you elect your benefit options, they remain in effect for the entire plan year until the following Open Enrollment. You may only change coverage during the plan year if you have a Qualifying Life Event, and you must do so within 31 days of the event.
Qualifying Life Events Include
Marriage, divorce, legal separation, or annulment
Birth, adoption, or placement for adoption of an eligible child
Death of your spouse or child
Change in your spouse’s employment status that affects benefits eligibility
Change in your child’s eligibility for benefits
Significant change in benefit plan coverage for you, your spouse, or child
FMLA leave, COBRA event, court judgment, or decree
Becoming eligible for Medicare, Medicaid, or TRICARE
Receiving a Qualified Medical Child Support Order
If you have a Qualifying Life Event and want to request a midyear change, you must notify Human Resources and complete your election changes within 31 days following the event. Be prepared to provide documentation to support the Qualifying Life Event.
When Coverage Ends for Separating Employees
Medical, Dental, and Vision insurance continue through the end of the month in which you separate from Liberty. Basic Life and Voluntary Life and Accidental Death and Dismemberment coverage end on the last day you work.
Health Care and Dependent Care Flexible Spending Accounts coverage ends on your date of separation from Liberty.
Employee Monthly Contributions
Definitions
Calendar and Plan Year
January 1 through December 31 of each year.
Coinsurance
Coinsurance is your share of the costs of covered health care service, calculated as a percentage (for example, 20%) of the allowed amount for the service. You pay coinsurance plus any deductibles you owe. Coinsurance is not the same as a copayment (copay).
Copayment
A copayment (copay) is a fixed amount (for example, $15) you pay for a covered health care service, usually when you receive a service. You will pay a copay or the allowed amount, whichever is lower. The amount can vary by the type of covered health care service. Please see the specific common medical event to see if a copay applies and how much you have to pay.
Deductible
The deductible is the amount you have to pay for covered health care services (common medical event) before your health plan begins to pay. The deductible may not apply to all services. You may have more than one type of deductible.
Guaranteed Issue
The amount of coverage pre-approved by the insurance carrier regardless of health status.
Health Maintenance Organization (HMO)
A network of health care providers contracted to provide medical services to covered employees and dependents at negotiated rates. Some HMOs require you to select a primary care provider to coordinate your care. You must use in-network providers to receive covered services, except in true emergencies.
In-Network Benefits
The benefits applicable for the covered services by an innetwork provider.
Medical Emergency
A sudden, serious, unexpected, and acute onset of an illness or injury when a delay in treatment would cause irreversible deterioration resulting in a threat to your life or body part.
Open Enrollment
The period during which employees are given the opportunity to enroll or change their current coverage elections.
Out-of-Network Benefits
The benefits applicable for the covered services by a provider not in your plan’s network.
Out-of-Pocket Limit
The most you pay during a policy year before your health plan begins to pay 100%. Once you reach the out-of-pocket limit, your health plan will pay for all covered services. This does not include any amounts over the amount allowed when you see an out-of-network provider.
Preferred Provider Organization (PPO)
A network of health care providers contracted to provide medical services to covered employees and dependents at negotiated rates. You may seek care from either an in-network or out-of-network provider, but in-network care is covered at a higher benefit level. You are responsible for a greater portion of the cost when using an out-of-network provider.
Usual and Customary Rates
Out-of-network health plan expenses are considered for reimbursement at Usual and Customary (U&C) rates. U&C rates are the prevailing charges for certain services by similar providers in the same geographic area. Charges above U&C are not covered by the plan and are your responsibility.
Medical
The medical plan options through UnitedHealthcare (UHC) protect you and your family from major financial hardship in the event of illness or injury. You have a choice of three plans:
EIW3 HMO Plan – using the Navigate network.
EI3W Plan – using the NexusACO OAP network.
EI1S PROformance Plan – using the Choice Plus network.
Preferred Provider Organization (PPO)
The PPO plans allow you the freedom to see any provider when you need care. When you use in-network providers, you receive benefits at a discounted network cost. You may pay more for services if you use out-of-network providers.
Health Maintenance Organization (HMO)
With an HMO, you must seek care from in-network providers in the Navigate network. The selection of a primary care provider is required, and you need a referral to see a specialist. Always confirm that your doctor and all specialists are in-network before seeking care. The HMO offers cost savings benefits as long as you use in-network providers for your care (except in true emergencies).
Find a Provider
Visit www.myuhc.com
Call 866-801-4409
Download the UnitedHealthcare app.
UHC Member Website and App
The UHC member website at www.myuhc.com and the UnitedHealthcare app give you access to resources, answers, and customer support.
Search for in-network doctors
Refill prescriptions
Access your plan ID cards
Check your benefits and coverage
View your claims
Get virtual care
UHC May Call You
A UHC nurse or advocate may contact you to provide extra support. They can help you schedule appointments, enroll in programs, manage prescriptions, and answer questions.
You may be contacted if you are:
Recovering from a hospital stay: to review aftercare instructions and medications
Managing a health condition: such as cancer, asthma, diabetes, heart failure, or kidney issues
Expecting a baby: to provide guidance and support from a maternity nurse
Medical Plans Summary
1 The amount you pay after the deductible is met
Telemedicine
Included with your medical coverage is access to quality telemedicine services through UHC 24/7 Virtual Visits
Choose from an Amwell, Doctor On Demand, or Teladoc Health network provider and pay $0 per visit. All three Virtual Visits provider networks are covered under your health plan benefits. Connect anytime day or night with a boardcertified doctor via your mobile device or computer. While telemedicine 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 a convenient care clinic, urgent care clinic, or emergency room for treatment
Are on a business trip, vacation, or away from home
Your primary care physician is unavailable
When To Use Telemedicine
At a cost that is the same or lower than a visit to your physician, use telemedicine services for minor conditions such as:
Sore throat
Headache
Nausea
Cold
Flu
Allergies
Fever
Urinary tract infections
Do not use telemedicine for serious or life-threatening emergencies.
Registration is Easy
1. For Virtual Visits access or to find out more, download the Amwell, Doctor On Demand or Teladoc Health mobile apps today.
2. Locate your member ID number on your health plan ID card.
3. Have your credit card ready to cover any costs not covered by your health plan.
4. Choose a pharmacy that is open in case you are given a prescription.
24/7 Virtual Visits Cost $0 copay (in-network)
UHC Wellness Resources
The following programs and services are available to you at no additional charge as a UHC member.
UHC Rewards
Earn up to $300 with UHC Rewards for a variety of activities, including tracking your steps or sleep.
Get a biometric screening
Get an annual checkup
Connect a tracker
Take a health survey
Register for UHC Rewards
$50
$25
$25
$15
1. Download the UnitedHealthcare app or sign up at www.myuhc.com
2. Select UHC Rewards.
3. Activate UHC Rewards.
4. Choose reward activities and start earning.
Gym Discount
One Pass Select offers a low-cost nationwide gym membership – including digital fitness. Get access to gyms, studios, online workouts, and even grocery delivery with one monthly membership.
There are no long-term contracts or annual gym registration fees.
You can change your subscription or add family members (ages 18+) anytime.
All tiers Classic or above come with grocery and home essentials delivery at no extra cost.
Membership Options*
*There is an enrollment fee of $10 for the digital membership and a $29 enrollment fee for any other membership level.
Find a Gym Near You
Go to www.onepassselect.com to find a gym near you. Gym partners include Anytime Fitness, Crunch, LA Fitness, Life Time, Orangetheory, and CrossFit.
Use your UHC Rewards dollars towards your One Pass Select subscription.
UHC Wellness Resources
Weight Loss Program
Real Appeal is a free online weight loss program that provides personal coaching to help you and eligible family members lose weight and keep it off. On average, participants lose 10 pounds after attending just four online sessions.
One-on-one Coaching
Get help staying on track to reach your goals with online, coach-led group sessions.
$0 Out-of-pocket
Real Appeal is offered at no additional cost as part of your health plan benefits.
Success Kit
Get scales, recipes, fitness equipment, and more delivered to your door.
Learn more and start today at https://success.realappeal. com
Smoking Cessation Program
Quit For Life offers coaching and support to quit tobacco at no additional cost. Each coach-guided step of the program is designed to give you the confidence you need to quit for good as you progress.
Nicotine replacement therapy with patches or gum that can help you manage cravings and double your chance of quitting for good
24/7 access to coaches, tools, and support to help you quit smoking, chewing, vaping, or however you use tobacco or nicotine
Real-life tips and coach support to build your personalized Quit Plan, with recommended daily goals, articles, and videos
One-on-one access to coaches via phone, chat, or text plus coach-led group video sessions so you’ll get guidance at every step
A mobile app and access to Text A Coach for resources, encouragement, and reminders
To get started, go to https://quitnow.net
UHC Mental Health Resources
If you are enrolled in a UnitedHealthcare medical plan, you have behavioral health resources to help support your mental and emotional well-being.
Self Care from AbleTo
Access on-demand digital tools created by clinicians to help you manage stress, anxiety, and low mood. You receive personalized techniques, coping strategies, and guided exercises.
Visit www.ableto.com/begin and have your health plan ID card ready.
Employee Assistance Program
The UHC Employee Assistance Program offers three free sessions by phone or in-person for short-term support and advice on issues like:
Stress, anxiety, and depression
Various personal challenges
Work/life balance
Legal and financial support
Call 888-887-4114 for 24/7 phone support or to schedule an in-person counseling session.
UHC Behavioral Health Providers
UHC offers virtual and in-person support with licensed therapists for long-term support on issues including:
Bipolar and neuro-development disorders
Compulsive habits and eating disorders
Substance abuse
Medication management
Visit www.myuhc.com/mh-recommendations to find support or call the number on your medical ID card.
Calm Health App
The Calm Health app is designed to support your mental health and well-being at your own pace. The app starts with a short mental health screening so it can suggest a tailored program of content and tools created by psychologists to help you meditate, improve focus, move mindfully, and feel calm. You can set your own pace and track your progress along the way.
Download the Calm Health app to get started. You first need to sign into your account at www.myuhc.com or on the UnitedHealthcare app
Dental
Our dental plan helps you maintain good oral health through affordable options for preventive care, including regular checkups, and other dental work. Premium contributions for dental will be deducted from your paycheck on a pretax basis. Coverage is provided by UHC
PPO Plan
Two levels of benefits are available with the PPO plan: innetwork and out-of-network. You have the flexibility to select the dental provider of your choice, but your level of coverage may vary based on the provider you see for services. Staying in-network and going to a contracted PPO provider will provide you with the highest level of benefits and the deepest discounts your plan offers.
Dental Plan Summary
1 Payment for covered services received from an out-of-network dentist is based on the 90th percentile of Usual,
Vision
Our vision plan provides quality care to help preserve your health and eyesight. In addition to identifying vision and eye problems, regular exams can detect certain medical issues such as diabetes and high cholesterol. You may seek care from any licensed optometrist, ophthalmologist or optician, but plan benefits are better if you use an in-network provider. Premium contributions are deducted from your paycheck on a pretax basis. Coverage is provided through UHC using the UnitedHealthcare Vision Network.
Vision Plan Summary
How to Find a Vision Provider Visit www.myuhcvision.com. Call 800-638-3120
Download the UnitedHealthcare app
FREQUENCY
Save Big with Warby Parker
Pay only your plan copay for most frames and lenses. Enjoy high-quality designs, antireflective lenses, and polarized sun options. Visit https://warbyparker.com/united
Life and AD&D Insurance
Life insurance is an important part of your financial security, especially if others depend on you for support. Accidental Death and Dismemberment (AD&D) insurance helps protect you and your family from the unforeseen financial hardship of a serious accident that causes death or dismemberment.
AD&D insurance provides you specified benefits for a covered accidental bodily injury that directly causes dismemberment (e.g., the loss of a hand, foot or eye). In the event that death occurs from an accident, 100% of the AD&D benefit would be payable to your beneficiary(ies).
Basic Life and AD&D
Basic Life and AD&D insurance are provided by Liberty Christian School at no cost to you through UHC. You are automatically covered at $25,000. Benefits reduce to 65% at age 65 and to 50% at age 70.
Designating a Beneficiary
A beneficiary is the person or entity you designate to receive the death benefits of your Life and AD&D insurance policies. You can name more than one beneficiary, and you can change beneficiaries at anytime. If you name more than one beneficiary, you must identify the share for each.
Voluntary Life and AD&D
You may purchase additional Life and AD&D insurance for you and your eligible dependents. If you decline Voluntary Life and AD&D insurance when first eligible or if you elect coverage and wish to increase your benefit amount at a later date, Evidence of Insurability (EOI) – proof of good health – may be required before coverage is approved. You can submit your EOI online at www.myuhcfp.com, use the electronic or paper form provided by your employer, or request a form by calling 1-866-615-8727 (option 3, then 1).
You must elect Voluntary Life and AD&D insurance for yourself in order to elect coverage for your spouse or children. Your spouse can elect up to 50% of the coverage amount you elect for yourself. Coverage is provided through UHC. If you leave Liberty Christian School, you may be able to take the insurance with you at your cost.
Flexible Spending Accounts
A great way to plan ahead and save money over the course of a year is to participate in our Flexible Spending Account (FSA) programs. FSAs allow you to pay for certain health, dental, vision, and dependent care expenses with pretax dollars that reduce your taxable income and save you money.
There are two kinds of accounts — one for health care expenses and another for dependent care expenses. When you enroll, you must decide how much to set aside from your paycheck for each account. Be sure to estimate your expenses conservatively as the IRS requires that you use the money in your account during the FSA plan year, which is January 1 – December 31, 2026. You will have until March 15, 2027 to spend the funds in your account. Our FSAs are administered by Higginbotham.
Health Care FSA
You may voluntarily elect to set aside from each paycheck pretax dollars that can then be used to pay for out-ofpocket medical, prescription and eligible over-the-counter drugs, dental, vision and hearing expenses. A complete list of qualified expenses can be found in Publication 502 on the IRS website. When you incur the expense, you will be reimbursed the full amount at that time. You can contribute up to $3,400 in the 2026 plan year. You cannot contribute to a Health Care FSA if you have a Health Savings Account (HSA). Higginbotham will issue you a debit card to pay for eligible expenses.
How the Health Care FSA Works
When you incur a medical, dental, vision or hearing expense, you will be reimbursed the full amount of the expense at that time (up to your annual election amount). You are entitled to the full election amount from day one of your plan year.
When you incur a qualified health care expense, you can choose one of two reimbursement methods:
Use your FSA debit card to pay doctor visit and prescription copays. Your FSA will be charged for the amount, and you will not need to submit a request for reimbursement.
You can pay out-of-pocket and then submit your receipts:
» Fax – 866-419-3516
» Email – flexclaims@higginbotham.net
» Online – https://flexservices.higginbotham.net
Health Care FSA coverage ends on the date you terminate or retire. You may continue for a limited period of time through COBRA.
FSA Debit Card
The FSA debit card is a quick and easy way to pay for qualified expenses from your Health Care FSA. The debit card links directly to your FSA which gives you immediate access to funds when you are making a purchase. You do not need to file a claim for reimbursement.
If you have any questions or concerns, contact Higginbotham:
Phone – 866-419-3519
Email – flexclaims@higginbotham.net
Fax – 866-419-3516
Reminder: You cannot use your Health Care FSA debit card for dependent care expenses.
Note: If you use the debit card to pay anything other than medical copays, pharmacy or vision expenses, you will need to submit an itemized receipt or an Explanation of Benefits. If you do not submit your receipts, Liberty will begin the process of collecting unsubstantiated debit charges. You will have 60 days to submit your receipts after receiving the request for substantiation before your debit card is suspended.
Dependent Care FSA
The Dependent Care FSA helps pay for expenses associated with caring for elder or child dependents in order for you or your spouse to work or attend school full-time. The dependent child must be under age 13 and claimed as a dependent on your federal income tax return, or a disabled dependent of any age incapable of caring for himself or herself and who spends at least eight hours a day in your home.
Reimbursement from your Dependent Care FSA is limited to the total amount that is deposited in your account at that time. In order to be reimbursed, you must provide the tax identification or Social Security number of the party providing care, and that provider cannot be anyone considered your dependent for income tax purposes.
Other Things to Consider Regarding the Dependent Care FSA
Overnight camps are not eligible for reimbursement (only day camps can be considered).
If your child turns 13 midyear, you may only request reimbursement for the part of the year when the child is under age 13.
You may request reimbursement 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.
Reminder: Your plan includes a 75-day grace period which applies to your Health Care FSA and Dependent Care FSA. During this period, you may incur eligible FSA expenses and use the funds remaining in your account to cover those charges.
Important FSA Rules
The maximum per plan year you can contribute to a Health Care FSA is $3,400. The maximum per plan year you can contribute to a Dependent Care FSA is $7,500 when filing jointly or head of household and $3,750 when married and filing separately.
You cannot change your election during the year unless you experience a Qualifying Life Event.
You can continue to file claims incurred during the plan year until March 31, 2027.
Your Health Care FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care expenses.
The IRS has amended the “use it or lose it” rule to allow you to carry over up to $680 in your Health Care FSA into the next plan year. The carryover rule does not apply to your Dependent Care FSA.
Higginbotham Portal
The Higginbotham Portal provides information and resources to help you manage your FSAs.
Access plan documents, letters and notices, forms, account balances, contributions and other plan information
Update your personal information
Look up qualified expenses
Submit claims
Register on the Higginbotham Portal
Visit https://flexservices.higginbotham.net and click Register. Follow the instructions and scroll down to enter your information.
Enter your Employee ID, which is your Social Security number with no dashes or spaces.
Follow the prompts to navigate the site.
If you have any questions or concerns, contact Higginbotham:
» Phone – 866-419-3519
» Email – flexclaims@higginbotham.net
» Fax – 866-419-3516
Health Reimbursement Arrangement
A Health Reimbursement Arrangement (HRA) is a Liberty Christian School-funded health care account from which you can be reimbursed tax-free for qualified medical expenses up to a fixed dollar amount per year. The HRA will reimburse 50% of your in-network deductible. You must provide a copy of your Explanation of Benefits (EOB) to apply for HRA reimbursement. This benefit is offered to employees only and requires participation in our UHC medical plans. It does not apply to dependents.
When you elect coverage under any of the three UHC medical plans, Liberty Christian School will establish an HRA in your name and contribute as follows to the account. You can use the funds in your HRA to cover the second half of your Employee Only in-network deductible. You are responsible for paying for the first half of the deductible and amounts due to your medical provider.
EIW3 HMO Plan: Up to $3,500
EI3W Nexus ACO Plan: Up to $1,000
EI1S PROformance Plan: Up to $1,000
Please note: The HRA runs concurrent with the medical plan which has a calendar year deductible. All HRA claims must be submitted by March 31, 2027.
Eligible Medical Expenses
You can use your HRA to pay for qualified medical expenses that apply toward your in-network deductible such as:
Diagnostic tests
Inpatient hospital care
Outpatient surgery
Submitting a Claim
Submit your claim and UHC EOB to Higginbotham via fax at 866-419-3516 or email to flexclaims@ higginbotham.net after 50% of your deductible has been met. If you have questions or need further information, call Higginbotham at 866-419-3519.
Employee Assistance Program
The Employee Assistance Program (EAP) from UHC helps you and family members cope with a variety of personal and work-related issues. This program provides confidential counseling and support services at little or no cost to you to help with:
Relationships
Work-life balance
Stress and anxiety
Will preparation and estate resolution
Grief and loss
Childcare and eldercare resources
Substance abuse
Get More Information
Call 888-887-4114 or visit www.myuhc.com for support at any hour of the day or night.
Additional Benefits
The following benefits are available to you from UHC at no additional cost
Beneficiary Services
Beneficiaries have access to 24/7 support at 866-302-4480 for grief counseling, financial and legal guidance, and referrals to community resources. Services include two complimentary grief sessions, consultations with financial specialists, legal support through a national attorney network, and a Beneficiary Kit with helpful information.
Wealth Management Account
Life claim payments over $5,000 are automatically deposited into an FDIC-insured OptumBank Wealth Management Account. Beneficiaries receive an interest-earning account with easy access to funds through a debit card or checkbook.
Retirement Plan
You have the choice of two retirement plan options administered by Empower Retirement Services:
Traditional 401(k) – Contributions deducted before taxes
Roth 401(k) – Contributions deducted after taxes
401(k) Plan
The 401(k) plan is a retirement savings plan designed to allow eligible employees to supplement existing retirement and pension benefits by saving and investing pretax dollars through a voluntary salary contribution. Your contributions are deducted pretax on the traditional 401(k), and your contributions and any earnings are tax deferred until money is withdrawn. Your contributions to the Roth 401(k) are made after taxes, and your contributions and earnings are not taxed when withdrawn. Penalties may be assessed if money is withdrawn prior to age 59½.
Eligibility Requirements
The 401(k) plan is available to full-time and part-time employees. You must meet the following criteria to enroll:
Be age 21 or older
Have completed six months of service
Eligible employees may enroll the first day of each month.
Certain employees are not eligible to participate in the 401(k) plan. For a list of ineligible employees, please log in to myLiberty, click on the HR page and view the Liberty Christian School 401(k) Summary Plan Description.
Enrollment
You will be automatically enrolled in the traditional 401(k) plan at 6% unless you select a different amount or sign a waiver on or after 30 days from your participation date.
2026 Contribution Limits
Combined maximum limit of 90% (1% minimum) of your compensation or $24,500, whichever is lower for all retirement contributions
Participants age 50 or older in 2026 may make an additional catch-up contribution:
» 50-59 – $8,000
» 60-63 – $11,250
» 64 and older – $8,000
Employer Contributions
Liberty Christian School may contribute a discretionary match to your retirement plan. This contribution will only apply to your deferrals that do not exceed a dollar amount or a percentage of included compensation that is determined by Liberty Christian School.
Safe Harbor Matching Contribution
Your plan provides for a Safe Harbor employer matching contribution — 100% of your elective deferrals that do not exceed 1% of your compensation — plus 50% of your elective deferrals that exceed 1% of your compensation but do not exceed 6% of your compensation.
Profit Sharing
Each year, Liberty Christian School may make a discretionary profit sharing contribution to your account.
Vesting Schedule
Vesting refers to the percentage of your account you are entitled to receive upon the occurrence of distributable events. Your contributions and any earnings are always 100% vested (including rollovers from previous employers).
The employer match/profit sharing contribution is immediately 100% vested.
Safe Harbor contributions and earnings are always 100% vested.
401(k) Frequently Asked Questions
Can I change my contribution percentage?
Can I change from a Roth IRA to a traditional IRA and vice versa?
Can I add or change my beneficiaries?
Yes, the above actions can be completed one of two ways:
Visit the Empower Retirement website at www.empower-retirement.com
Call Empower Retirement at 855-756-4738.
Note: For information only. This section is not part of Open Enrollment.
Investment Options
A wide array of core investment options is available through your plan. Each option is explained in further detail in your plan’s fund sheets. Once you have enrolled, investment option information is also available through the website at www.empower-retirement.com or by calling KeyTalk at 800-338-4015. The website and KeyTalk are available to you 24 hours a day, seven days a week.
Deferrals, Transfers and Allocation Changes
Use your Personal Identification Number (PIN) and username to access the website, or you can use your Social Security number and PIN to access KeyTalk. You can move all or a portion of your existing balances among investment options (subject to plan rules) and change how your payroll contributions are invested.
Rollovers
Only plan administrator-approved balances from an eligible governmental 457(b), 401(k), 403(b) or 401(a) plan, or an Individual Retirement Account (IRA) may be rolled over to the plan. Some plans may only allow rollovers from other 401(k) plans.
Withdrawals
Qualifying distribution events are as follows:
Retirement
Permanent disability
Financial hardship (as defined by the IRS code and your plan’s provisions)
Severance of employment (as defined by the IRS code provisions)
Attainment of age 59½
Death (your beneficiary receives your benefits)
Ordinary income tax will apply to each distribution. Distributions received prior to age 59½ may also be assessed a 10% early withdrawal federal tax penalty. Refer to your Summary Plan Description for more information about distributions.
Plan Fees
Distribution Fees
There is a benefit distribution fee of $50.
Investment Option Fees
Each option has an investment management fee that varies by investment. These fees are deducted by each investment option’s management company before the daily price or performance is calculated. Fees pay for trading of securities within the investment options and other management expenses.
Funds may impose redemption fees on certain transfers, redemptions or exchanges. Asset allocation funds are generally subject to a fund operating expense at the fund level, as well as prorated fund operating expenses of each underlying fund in which they invest. For more information, please refer to the fund prospectus and/or disclosure document. Funds are subject to the risks of the underlying funds.
There may be a record keeping or administrative fee for investing in certain investment options. Please contact your Empower Retirement Services representative for more information about any potential investment option fees.
Loans
Your plan allows you to borrow the lesser of $50,000 or 50% of your total vested account balance. The minimum loan amount is $1,000, and you have up to five years to repay your loan — up to 20 years if the money is used to purchase your primary residence. There is a $100 origination fee for each loan that is deducted from the loan proceeds, plus an ongoing annual $50 fee, deducted from your account at $12.50 each quarter. You may have only one outstanding loan at a time.
How Can I Get More Information?
Visit the website at www.empower-retirement.com or call KeyTalk toll free at 855-756-4738 for more information. The website provides information regarding your plan, as well as financial education information, financial calculators and other tools to help you manage your account.
Paid Time Off Benefits
Important 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:
Liberty Christian School Human Resources 1301 US 377 Argyle, TX 76226 940-294-2087
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 Liberty Christian School 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. Liberty Christian School has determined that the prescription drug coverage offered by the Liberty Christian School 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 Liberty Christian School at the phone number or address listed at the end of this section.
If you choose to enroll in a Medicare prescription drug plan and cancel your current Liberty Christian School 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 the Human Resources Department at 940-2942087
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).
January 1, 2026
Liberty Christian School
Human Resources 1301 US 377 Argyle, TX 76226 940-294-2087
Notice of HIPAA Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Effective Date of Notice: September 23, 2013
Liberty Christian School’s Plan is required by law to take reasonable steps to ensure the privacy of your personally identifiable health information and to inform you about:
1. the Plan’s uses and disclosures of Protected Health Information (PHI);
2. your privacy rights with respect to your PHI;
3. the Plan’s duties with respect to your PHI;
4. your right to file a complaint with the Plan and to the Secretary of the U.S. Department of Health and Human Services; and
5. the person or office to contact for further information about the Plan’s privacy practices.
The term “Protected Health Information” (PHI) includes all individually identifiable health information transmitted or maintained by the Plan, regardless of form (oral, written, electronic).
Section 1 – Notice of PHI Uses and Disclosures
Required
PHI Uses and Disclosures
Upon your request, the Plan is required to give you access to your PHI in order to inspect and copy it.
Use and disclosure of your PHI may be required by the Secretary of the Department of Health and Human Services to investigate or determine the Plan’s compliance with the privacy regulations.
Uses and disclosures to carry out treatment, payment and health care operations.
The Plan and its business associates will use PHI without your authorization to carry out treatment, payment and health care operations. The Plan and its business associates (and any health insurers providing benefits to Plan participants) may also disclose the following to the Plan’s Board of Trustees: (1) PHI for purposes related to Plan administration (payment and health care operations); (2) summary health information for purposes of health or stop loss insurance underwriting or for purposes of modifying the Plan; and (3) enrollment information (whether an individual is eligible for benefits under the Plan). The Trustees have amended the Plan to protect your PHI as required by federal law.
Treatment is the provision, coordination or management of health care and related services. It also includes but is not limited to consultations and referrals between one or more of your providers.
For example, the Plan may disclose to a treating physician the name of your treating radiologist so that the physician may ask for your X-rays from the treating radiologist.
Payment includes but is not limited to actions to make coverage determinations and payment (including billing, claims processing, subrogation, reviews for medical necessity and appropriateness of care, utilization review and preauthorizations).
For example, the Plan may tell a treating doctor whether you are eligible for coverage or what percentage of the bill will be paid by the Plan.
Health care operations include but are not limited to quality assessment and improvement, reviewing competence or qualifications of health care professionals, underwriting, premium rating and other insurance activities relating to creating or renewing insurance contracts. It also includes case management, conducting or arranging for medical review, legal services and auditing functions including fraud and abuse compliance programs, business planning and development, business management and general administrative activities. However, no genetic information can be used or disclosed for underwriting purposes.
For example, the Plan may use information to project future benefit costs or audit the accuracy of its claims processing functions.
Uses and disclosures that require that you be given an opportunity to agree or disagree prior to the use or release.
Unless you object, the Plan may provide relevant portions of your protected health information to a family member, friend or other person you indicate is involved in your health care or in helping you receive payment for your health care. Also, if you are not capable of agreeing or objecting to these disclosures because of, for instance, an emergency situation, the Plan will disclose protected health information (as the Plan determines) in your best interest. After the emergency, the Plan will give you the opportunity to object to future disclosures to family and friends.
Uses and disclosures for which your consent, authorization or opportunity to object is not required.
The Plan is allowed to use and disclose your PHI without your authorization under the following circumstances:
1. For treatment, payment and health care operations.
2. Enrollment information can be provided to the Trustees.
3. Summary health information can be provided to the Trustees for the purposes designated above.
4. When required by law.
5. When permitted for purposes of public health activities, including when necessary to report product defects and to permit product recalls. PHI may also be disclosed if you have been exposed to a communicable disease or are at risk of spreading a disease or condition, if required by law.
6. When required by law to report information about abuse, neglect or domestic violence to public authorities if there exists a reasonable belief that you may be a victim of abuse, neglect or domestic violence. In which case, the Plan will promptly inform you that such a disclosure has been or will be made unless that notice would cause a risk of serious harm. For the purpose of reporting child abuse or neglect, it is not necessary to inform the minor that such a disclosure has been or will be made. Disclosure may generally be made to the minor’s parents or other representatives although there may be circumstances under federal or state law when the parents or other representatives may not be given access to the minor’s PHI.
7. The Plan may disclose your PHI to a public health oversight agency for oversight activities required by law. This includes uses or disclosures in civil, administrative or criminal investigations; inspections; licensure or disciplinary actions (for example, to investigate complaints against providers); and other activities necessary for appropriate oversight of government benefit programs (for example, to investigate Medicare or Medicaid fraud).
8. The Plan may disclose your PHI when required for judicial or administrative proceedings. For example, your PHI may be disclosed in response to a subpoena or discovery request.
9. When required for law enforcement purposes, including for the purpose of identifying or locating a suspect, fugitive, material witness or missing person. Also, when disclosing information about an individual who is or is suspected to be a victim of a crime but only if the individual agrees to the disclosure or the Plan is unable to obtain the individual’s agreement because of emergency circumstances. Furthermore, the law enforcement official must represent that the information is not intended to be used against the individual, the immediate law enforcement activity would be materially and adversely affected by waiting to obtain the individual’s agreement and disclosure is in the best interest of the individual as determined by the exercise of the Plan’s best judgment.
10. When required to be given to a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death or other duties as authorized by law. Also, disclosure is permitted to funeral directors, consistent with applicable law, as necessary to carry out their duties with respect to the decedent.
11. When consistent with applicable law and standards of ethical conduct if the Plan, in good faith, believes the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public and the disclosure is to a person reasonably able to prevent or lessen the threat, including the target of the threat.
12. When authorized by and to the extent necessary to comply with workers’ compensation or other similar programs established by law.
Except as otherwise indicated in this notice, uses and disclosures will be made only with your written authorization subject to your right to revoke such authorization.
Uses and disclosures that require your written authorization.
Other uses or disclosures of your protected health information not described above will only be made with your written authorization. For example, in general and subject to specific conditions, the Plan will not use or disclose your psychiatric notes; the Plan will not use or disclose your protected health information for marketing; and the Plan will not sell your protected health information, unless you provide a written authorization to do so. You may revoke written authorizations at any time, so long as the revocation is in writing. Once the Plan receives 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.
Section 2 – Rights of Individuals
Right to Request Restrictions on Uses and Disclosures of PHI
You may request the Plan to restrict the uses and disclosures of your PHI. However, the Plan is not required to agree to your request (except that the Plan must comply with your request to restrict a disclosure of your confidential information for payment or health care operations if you paid for the services to which the information relates in full, out of pocket).
You or your personal representative will be required to submit a written request to exercise this right. Such requests should be made to the Plan’s Privacy Official.
Right to Request Confidential Communications
The Plan will accommodate reasonable requests to receive communications of PHI by alternative means or at alternative locations if necessary to prevent a disclosure that could endanger you.
You or your personal representative will be required to submit a written request to exercise this right.
Such requests should be made to the Plan’s Privacy Official.
Right to Inspect and Copy PHI
You have a right to inspect and obtain a copy of your PHI contained in a “designated record set,” for as long as the Plan maintains the PHI. If the information you request is in an electronic designated record set, you may request that these records be transmitted electronically to yourself or a designated individual.
Protected Health Information (PHI)
Includes all individually identifiable health information transmitted or maintained by the Plan, regardless of form.
Designated Record Set
Includes the medical records and billing records about individuals maintained by or for a covered health care provider; enrollment, payment, billing, claims adjudication and case or medical management record systems maintained by or for the Plan; or other information used in whole or in part by or for the Plan to make decisions about individuals. Information used for quality control or peer review analyses and not used to make decisions about individuals is not in the designated record set.
The requested information will be provided within 30 days if the information is maintained on site or within 60 days if the information is maintained off site. A single 30-day extension is allowed if the Plan is unable to comply with the deadline.
You or your personal representative will be required to submit a written request to request access to the PHI in your designated record set. Such requests should be made to the Plan’s Privacy Official.
If access is denied, you or your personal representative will be provided with a written denial, setting forth the basis for the denial, a description of how you may appeal the Plan’s decision and a description of how you may complain to the Secretary of the U.S. Department of Health and Human Services.
The Plan may charge a reasonable, cost-based fee for copying records at your request.
Right to Amend PHI
You have the right to request the Plan to amend your PHI or a record about you in your designated record set for as long as the PHI is maintained in the designated record set.
The Plan has 60 days after the request is made to act on the request. A single 30-day extension is allowed if the Plan is unable to comply with the deadline. If the request is denied in whole or part, the Plan must provide you with a written denial that explains the basis for the denial. You or your personal representative may then submit a written statement disagreeing with the denial and have that statement included with any future disclosures of your PHI.
Such requests should be made to the Plan’s Privacy Official.
You or your personal representative will be required to submit a written request to request amendment of the PHI in your designated record set.
Right to Receive an Accounting of PHI Disclosures
At your request, the Plan will also provide you an accounting of disclosures by the Plan of your PHI during the six years prior to the date of your request. However, such accounting will not include PHI disclosures made: (1) to carry out treatment, payment or health care operations; (2) to individuals about their own PHI; (3) pursuant to your authorization; (4) prior to April 14, 2003; and (5) where otherwise permissible under the law and the Plan’s privacy practices. In addition, the Plan need not account for certain incidental disclosures.
If the accounting cannot be provided within 60 days, an additional 30 days is allowed if the individual is given a written statement of the reasons for the delay and the date by which the accounting will be provided.
If you request more than one accounting within a 12-month period, the Plan will charge a reasonable, cost-based fee for each subsequent accounting.
Such requests should be made to the Plan’s Privacy Official.
Right to Receive a Paper Copy of This Notice Upon Request
You have the right to obtain a paper copy of this Notice. Such requests should be made to the Plan’s Privacy Official.
A Note About Personal Representatives
You may exercise your rights through a personal representative. Your personal representative will be required to produce evidence of his/her authority to act on your behalf before that person will be given access to your PHI or allowed to take any action for you. Proof of such authority may take one of the following forms:
1. a power of attorney for health care purposes;
2. a court order of appointment of the person as the conservator or guardian of the individual; or
3. an individual who is the parent of an unemancipated minor child may generally act as the child’s personal representative (subject to state law).
The Plan retains discretion to deny access to your PHI by a personal representative to provide protection to those vulnerable people who depend on others to exercise their rights under these rules and who may be subject to abuse or neglect.
Section 3 – The Plan’s Duties
The Plan is required by law to maintain the privacy of PHI and to provide individuals (participants and beneficiaries) with notice of the Plan’s legal duties and privacy practices. This Notice is effective September 23, 2013, and the Plan is required to comply with the terms of this Notice. However, the Plan reserves the right to change its privacy practices and to apply the changes to any PHI received or maintained by the Plan prior to that date. If a privacy practice is changed, a revised version of this Notice will be provided to all participants for whom the Plan still maintains PHI. The revised Notice will be distributed in the same manner as the initial Notice was provided or in any other permissible manner.
If the revised version of this Notice is posted, you will also receive a copy of the Notice or information about any material change and how to receive a copy of the Notice in the Plan’s next annual mailing. Otherwise, the revised version of this Notice will be distributed within 60 days of the effective date of any material change to the Plan’s policies regarding the uses or disclosures of PHI, the individual’s privacy rights, the duties of the Plan or other privacy practices stated in this Notice.
Minimum Necessary Standard
When using or disclosing PHI or when requesting PHI from another covered entity, the Plan will make reasonable efforts not to use, disclose or request more than the minimum amount of PHI necessary to accomplish the intended purpose of the use, disclosure or request, taking into consideration practical and technological limitations. When required by law, the Plan will restrict disclosures to the limited data set, or otherwise as necessary, to the minimum necessary information to accomplish the intended purpose.
However, the minimum necessary standard will not apply in the following situations:
1. disclosures to or requests by a health care provider for treatment;
2. uses or disclosures made to the individual;
3. disclosures made to the Secretary of the U.S. Department of Health and Human Services;
4. uses or disclosures that are required by law; and
5. uses or disclosures that are required for the Plan’s compliance with legal regulations.
De-Identified Information
This notice does not apply to information that has been deidentified. De-identified information is information that does not identify an individual and with respect to which there is no reasonable basis to believe that the information can be used to identify an individual.
Summary Health Information
The Plan may disclose “summary health information” to the Trustees for obtaining insurance premium bids or modifying, amending or terminating the Plan. “Summary health information” summarizes the claims history, claims expenses or type of claims experienced by participants and excludes identifying information in accordance with HIPAA.
Notification of Breach
The Plan is required by law to maintain the privacy of participants’ PHI and to provide individuals with notice of its legal duties and privacy practices. In the event of a breach of unsecured PHI, the Plan will notify affected individuals of the breach.
Section 4 – Your Right to File a Complaint With the Plan or the HHS Secretary
If you believe that your privacy rights have been violated, you may complain to the Plan. Such complaints should be made to the Plan’s Privacy Official.
You may file a complaint with the Secretary of the U.S. Department of Health and Human Services, Hubert H. Humphrey Building, 200 Independence Avenue SW, Washington, D.C. 20201. The Plan will not retaliate against you for filing a complaint.
Section 5 – Whom to Contact at the Plan for More Information
If you have any questions regarding this notice or the subjects addressed in it, you may contact the Plan’s Privacy Official. Such questions should be directed to the Plan’s Privacy Official at:
Liberty Christian School Human Resources 1301 US 377 Argyle, TX 76226 940-294-2087
Conclusion
PHI use and disclosure by the Plan is regulated by a federal law known as HIPAA (the Health Insurance Portability and Accountability Act). You may find these rules at 45 Code of Federal Regulations Parts 160 and 164. The Plan intends to comply with these regulations. This Notice attempts to summarize the regulations. The regulations will supersede any discrepancy between the information in this Notice and the regulations.
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 employer-sponsored 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 1-866-444-EBSA (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.
Texas – Medicaid
Website: https://www.hhs.texas.gov/services/financial/healthinsurance-premium-payment-hipp-program
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, 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 Liberty Christian School group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Liberty Christian School plan after you have left employment with the company. If you wish to elect COBRA coverage, contact your Human Resources Department for the applicable deadlines to elect coverage and pay the initial premium.
Plan Contact Information
Liberty Christian School Human Resources 1301 US 377 Argyle, TX 76226 940-294-2087
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-ofnetwork 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-ofpocket 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 in-network 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-ofnetwork 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 innetwork 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-ofnetwork. 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 out-of-network services toward your deductible and outof-pocket 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.
New Health Insurance Marketplace Coverage Options and Your Health Coverage
PART A: General Information
Even if you are offered health coverage through your employment, you may have other coverage options through the Health Insurance Marketplace (“Marketplace”). To assist you as you evaluate options for you and your family, this notice provides some basic information about the Health Insurance Marketplace.
What is the Health Insurance Marketplace?
The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers “one-stop shopping” to find and compare private health insurance options in your geographic area.
Can I Save Money on my Health Insurance Premiums
in the Marketplace?
You may qualify to save money and lower your monthly premium and other out-of-pocket costs, but only if your employer does not offer coverage, or offers coverage that is not considered affordable for you and doesn’t meet certain minimum value standards (discussed below). The savings on your premium that you’re eligible for depends on your household income. You may also be eligible for a tax credit that lowers your costs.
Does
Employment-Based Health
Coverage
Affect Eligibility for Premium Savings through the Marketplace?
Yes. If you have an offer of health coverage from your employer that is considered affordable for you and meets certain minimum value standards, you will not be eligible for a tax credit, or advance payment of the tax credit, for your Marketplace coverage and may wish to enroll in your employment-based health plan. However, you may be eligible for a tax credit, and advance payments of the credit that lowers your monthly premium, or a reduction in certain cost-sharing, if your employer does not offer coverage to you at all or does not offer coverage that is considered affordable for you or meet minimum value standards. If your share of the premium cost of all plans offered to you through your employment is more than 9.12%1 of your annual household income, or if the coverage through your employment does not meet the “minimum value” standard set by the Affordable Care Act, you may be eligible for a tax credit, and advance payment of the credit, if you do not enroll in the employmentbased health coverage. For family members of the employee, coverage is considered affordable if the employee’s cost of premiums for the lowest-cost plan that would cover all family members does not exceed 9.12% of the employee’s household income.1, 2
Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered through your employment, then you may lose access to whatever the employer contributes to the employment-based coverage. Also, this employer contribution -as well as your employee contribution to employment-based coverage- is generally excluded from income for federal and state income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis. In addition, note that if the health coverage offered through your employment does not meet the affordability or minimum value standards, but you accept that coverage anyway, you will not be eligible for a tax credit. You should consider all of these factors in determining whether to purchase a health plan through the Marketplace.
When Can I Enroll in Health Insurance Coverage through the Marketplace?
You can enroll in a Marketplace health insurance plan during the annual Marketplace Open Enrollment Period. Open Enrollment varies by state but generally starts November 1 and continues through at least December 15.
Outside the annual Open Enrollment Period, you can sign up for health insurance if you qualify for a Special Enrollment Period. In general, you qualify for a Special Enrollment Period if you’ve had certain qualifying life events, such as getting married, having a baby, adopting a child, or losing eligibility for other health coverage. Depending on your Special Enrollment Period type, you may have 60 days before or 60 days following the qualifying life event to enroll in a Marketplace plan.
There is also a Marketplace Special Enrollment Period for individuals and their families who lose eligibility for Medicaid or Children’s Health Insurance Program (CHIP) coverage on or after March 31, 2023, through July 31, 2024. Since the onset of the nationwide COVID-19 public health emergency, state Medicaid and CHIP agencies generally have not terminated the enrollment of any Medicaid or CHIP beneficiary who was enrolled on or after March 18, 2020, through March 31, 2023. As state Medicaid and CHIP agencies resume regular eligibility and enrollment practices, many individuals may no longer be eligible for Medicaid or CHIP coverage starting as early as March 31, 2023. The U.S. Department of Health and Human Services is offering a temporary Marketplace Special Enrollment period to allow these individuals to enroll in Marketplace coverage.
Marketplace-eligible individuals who live in states served by HealthCare.gov and either- submit a new application or update an existing application on HealthCare.gov between March 31, 2023 and July 31, 2024, and attest to a termination date of Medicaid or CHIP coverage within the same time period, are eligible for a 60-day Special Enrollment Period. That means that if you lose Medicaid or CHIP coverage between March 31, 2023, and July 31, 2024, you may be able to enroll in Marketplace coverage within 60 days of when you lost Medicaid or CHIP coverage. In addition, if you or your family members are enrolled in Medicaid or CHIP coverage, it is important to make sure that your contact information is up to date to make sure you get any information about changes to your eligibility. To learn more, visit www.HealthCare.gov or call the Marketplace Call Center at 1-800-318-2596. TTY users can call 1-855-889-4325
What about Alternatives to Marketplace Health Insurance Coverage?
If you or your family are eligible for coverage in an employmentbased health plan (such as an employer-sponsored health plan), you or your family may also be eligible for a Special Enrollment Period to enroll in that health plan in certain circumstances, including if you or your dependents were enrolled in Medicaid or CHIP coverage and lost that coverage. Generally, you have 60 days after the loss of Medicaid or CHIP coverage to enroll in an employment-based health plan, but if you and your family lost eligibility for Medicaid or CHIP coverage between March 31, 2023 and July 10, 2023, you can request this special enrollment in the employment-based health plan through September 8, 2023. Confirm the deadline with your employer or your employment-based health plan.
Alternatively, you can enroll in Medicaid or CHIP coverage at any time by filling out an application through the Marketplace or applying directly through your state Medicaid agency. Visit https://www.healthcare.gov/medicaid-chip/gettingmedicaid-chip/ for more details.
How Can I Get More Information?
The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit www.HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area.
PART B: Information About Health Coverage Offered by Your Employer
This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application.
3. Employer Name: Liberty Christian School
5. Employer Address: 1301 US 377
7. City: Argyle
4. Employer Identification Number (EIN): 75-2316143
6. Employer Phone Number: 940-294-2133
8. State: TX 9. ZIP Code: 76226
10. Who can we contact at this job?: Meg Mitchell
11. Phone Number (if different from above): 940-294-2087
12. E-Mail Address: meg.mitchell@mylcs.com
You are not eligible for health insurance coverage through this employer. You and your family may be able to obtain health coverage through the Marketplace, with a new kind of tax credit that lowers your monthly premiums and with assistance for out-of-pocket costs.
1 Indexed annually; see https://www.irs.gov/pub/irs-drop/rp-22-34.pdf for 2023.
2 An employer-sponsored or other employment-based health plan meets the “minimum value standard” if the plan’s share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs. For purposes of eligibility for the premium tax credit, to meet the “minimum value standard,” the health plan must also provide substantial coverage of both inpatient hospital services and physician services.
Important Contacts
This brochure highlights the main features of the Liberty Christian School 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. Liberty Christian School reserves the right to change or discontinue its employee benefit plans at anytime.