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BIRDVILLE ISD

2026-27 EMPLOYEE BENEFITS

Working Towards Wellness

A comprehensive guide to understanding your 2026-2027 employee benefits program

What’s Inside 3

Important Contacts

Eligibility

How to Enroll

Enrollment Frequently Asked Questions

Medical

11 Pharmacy 12 Preventive Care 13 Health Care Options 14 Health Savings Account 15 Flexible Spending Accounts 17 HSA and FSA Comparison

Welcome We are pleased to offer a full benefits program to you and your eligible dependents. Read this guide to know what benefits are available.

Availability of Medical Plan Benefits Information Coverage details for each medical plan offered are available in a Summary of Benefits and Coverage (also referred to as an SBC), which can be viewed at www.mybenefitshub.com/birdvilleisd.

18 Qualified HSA and FSA Expenses 19 Sick Leave Bank 20 Dental Coverage 22 Vision Coverage 23 Life and AD&D Insurance – For Employees / Basic

Your Benefits Are In Effect September 1, 2026

24 Life Insurance – Voluntary

through

25 AD&D Insurance – Voluntary

August 31, 2027

26 Educator Disability Insurance 27 Hospital Indemnity Insurance 28 Cancer Insurance

Flip to …

29 Critical Illness Insurance 30 Telehealth 31 Emergency Medical Transport

How to Enroll

Enrollment FAQ

Medical Coverage

33 Employee Assistance Program 34 Identity Theft Protection 34 Legal Assistance 35 Financial Planning 36 Glossary of Terms 40 Important Legal Notices

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Important Contacts Birdville ISD Benefits Office 817-547-5782 www.birdvilleschools.net

Birdville ISD Benefit Administrators Higginbotham Public Sector Employee Response Center 833-832-6632 https://web.mybenefitshub.com/birdvilleisd English and Spanish assistance provided

Medical Coverage TRS Medical BlueCross BlueShield 866-355-5999

Telemedicine Amazon One Medical 888-663-6331

Dental Coverage Cigna Group # 3347382 800-244-6224 www.cigna.com

Vision Coverage Superior Vision Group # 28488 800-507-3800

Basic and Voluntary Life and AD&D Lincoln Financial Group Basic Life Group # 00040276052 Voluntary Life Group # 00040276053 800-423-2765

Disability Chubb Group # 100000218 888-499-0425

Cancer Insurance American Public Life Group # 12906 800-256-8606

Critical Illness Insurance Lincoln Financial Group Group # 0000583053 800-423-2765

Hospital Indemnity Insurance The Hartford Group # 681612 866-547-4205

Medical Transport MASA Group # MKBISD 800-643-9023

Prescription Savings Clever RX Group # 1085 Member ID: 1621 800-873-1195

Health Savings Account EECU 817-882-0800

Employee Assistance Program Lincoln Financial Group 800-423-2765

Identity Theft Experian 855-797-0052

Legal Services LegalShield 800-654-7757

Financial Planning: 403(b)/457 Plans TCG 800-943-9179

Flexible Spending Accounts National Benefit Services 855-399-3035

Dependent Care Accounts National Benefit Services 855-399-3035

COBRA Dental and Vision National Benefit Services 800-274-0503

COBRA Medical TRS ActiveCare 833-682-8972

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Eligibility

OE: Open Enrollment QLE: Qualifying Life Event

Who is Eligible for Benefits New Hire

Employee

Dependent(s)

• A regular, full-time employee working an average of 20 hours or more per week

• Your legal spouse • Children under age 26 regardless of student, dependency, or marital status • Children age 26 or older 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

• Enroll within 30 days of date of hire

• During OE or for a QLE

• During OE or for a QLE • When covering dependents, you must enroll for and be on the same plans

• Medical: First of the month following date of hire • All other benefits: First of the month following 30 days of hire

• OE: Start of the plan year • QLE: Ask the Benefits Office

• Ask the Benefits Office

STATUS

Who is Eligible

When to Enroll When Coverage Starts

Maximum Dependent Eligibility Age by Plan

To Age 26

Medical/Dental/Vision/Life/ Accident/Hospital Indemnity/ Critical Illness

Qualifying Life Events You may only enroll for or make changes to coverage during the plan year if you are a new hire or if you have a QLE, such as:

Marriage

Birth

Divorce

Adoption/placement for adoption

Annulment Death of spouse

Change in benefits eligibility Death of child

FMLA, COBRA event, judgment, or decree

Gain or loss of benefits coverage

Becoming eligible for Medicare, Medicaid, TRICARE, or Marketplace coverage

Change in employment status affecting benefits

Receiving a Qualified Medical Child Support Order

You have 30 days from the event to notify the Benefits Office and complete your changes. You may need to provide documents to verify the change.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

How to Enroll Enrolling in benefits is simple through THEbenefitsHUB. 1.

Go to www.mybenefitshub.com/birdvilleisd or scan the QR code.

2. Click Login. 3. Enter your: Last name Date of birth Social Security number (last four digits only) 4. Once confirmed, the Additional Security Verification page will list contact options. Select either the Text, Email, Call, or Ask Admin option to receive a code for completing final verification. 5. Enter the code, and click Verify to begin your enrollment. 6. Review your personal information and verify covered dependents. Contact your employer with any discrepancies. 7.

After dependent information is confirmed, you may select the benefits shown. To make your selections, click the drop-down list next to the plan name. Once the desired coverage amount is selected, your contribution amount will be displayed. Click Save & Continue. Repeat for each benefit. You may be asked to provide evidence of insurability for certain benefits.

8. If enrolling in life insurance coverage, you must identify your beneficiary(ies).

Select your beneficiary designation. Click Sign & Continue. Review and confirm your information. Click Finished.

SCAN THE QR CODE TO ENROLL

Benefits Questions? Employee benefits can be complicated. The Higginbotham Public Sector benefits team is available to help you with the following:

Enrollment Benefits Eligibility Claims and Billing

Call or text 833-832-6632 Monday through Friday from 7:00 a.m. to 6:00 p.m. CT. If you leave a message after 3:00 p.m. CT, your call or text will be returned the next business day. You can also email birdvilleisd@hps.higginbotham.net. Bilingual representatives are available.

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 become effective on the plan effective date and will remain in effect during the entire plan year. Changes in benefit elections can occur only if you experience a QLE. You must present proof of the QLE to your Benefits Office within 30 days of the event. Meeting with the Benefits Office to complete and sign the necessary paperwork is also required to make benefit election changes effective. Changes must be consistent with the QLE. Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Enrollment Frequently Asked Questions What if I miss the enrollment deadline?

Where can I find benefits summaries and forms?

How can I find in-network providers?

Contact your Benefits Office for guidance if you miss a benefits enrollment deadline. Under normal circumstances, you may only enroll for or make changes to coverage during Open Enrollment, if you have a Qualifying Life Event, or if you are a new hire.

To access medical plan Summary of Benefits and Coverage (SBC) documents, plan documents for other coverages, and forms, go to the Benefit Information section at www.mybenefitshub.com/ birdvilleisd. Click on each benefit (e.g., medical, vision, etc.) for details.

Go to www.mybenefitshub.com/ birdvilleisd and click on the Provider Search link, where you will see all available plan provider searches.

Is there an age limit for dependents to be covered under my benefits? Yes. See the Eligibility page for details.

BENEFITS QUESTIONS? Call the Higginbotham Public Sector benefits team at 833-832-6632.

When will I get my ID cards? If the medical carrier provides ID cards and there is a plan change, new cards usually arrive within four weeks of your effective date. If there are no plan changes, a new card may not be issued. You may not need or receive an ID card for dental and vision plans. Simply share the carrier name and phone number with your health care provider to have benefits verified.

Important Limitations and Exclusions Information The following limitations and exclusions may apply when obtaining coverage as a married couple or for your dependents. Can I cover family members (a spouse and/or dependent) as dependents on my benefits if I and my spouse work for the same employer? Some benefits may not allow for this type of coverage if you both work for the same employer. Review the benefit plan documents, contact Higginbotham Public Sector, or contact the carrier for eligibility details.

Are there FSA and HSA limitations for married couples? Yes, generally. Married couples may not enroll in both a Health Care Flexible Spending Account (FSA) and a Health Savings Account (HSA) at the same time. If your spouse is covered under a Health Care FSA that reimburses for qualified health care expenses, then you and your spouse are not HSA-eligible – even if you do not use your spouse’s Health Care FSA to reimburse your expenses. However, there are some exceptions to the general limitation for other types of FSAs (e.g., Limited Purpose Health Care FSA; Dependent Care FSA). Contact the FSA and/or HSA administrator before you enroll, or consult your tax advisor for further guidance.

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 FSAs and an HSA as a married couple. You, the enrollee, shall hold harmless, defend, and indemnify Higginbotham Public Sector, LLC from any and all claims, actions, suits, charges, and judgments whatsoever that arise out of your enrollment in spouse and/or dependent coverage, including enrollment in FSAs and an HSA.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Medical Working Towards Health

Our medical plans protect you and your family from major financial hardship in the event of illness or injury. All TRS-Active participants may enroll in one of the following plans: TRS-ActiveCare Primary TRS-ActiveCare Primary+ TRS-ActiveCare HD

Medical Provider:

The TRS-ActiveCare 2 plan is closed to new enrollees, but you may continue in the plan if you are a currently enrolled participant.

TRS Region 11 Monthly Medical Rates Region 11

TRS MEDICAL

Job Class C1-CS, MT1-MT4 Total Monthly Premium

All other Job Classes

Employer Monthly Contribution

Employer Semi-monthly Contribution

Employee Monthly Cost

Employee Semimonthly Cost

ACTIVECARE PRIMARY Employee

$612.00

$252.00

$126.00

$312.00

$156.00

Employee and Spouse

$1,653.00

$1,293.00

$646.50

$1,353.00

$676.50

Employee and Child(ren)

$1,041.00

$681.00

$340.50

$741.00

$370.50

Employee and Family

$2,081.00

$1,721.00

$860.50

$1,781.00

$890.50

ACTIVECARE HD Employee

$630.00

$270.00

$135.00

$330.00

$165.00

Employee and Spouse

$1,701.00

$1,341.00

$670.50

$1,401.00

$700.50

Employee and Child(ren)

$1,071.00

$711.00

$355.50

$771.00

$385.50

Employee and Family

$2,142.00

$1,782.00

$891.00

$1,842.00

$921.00

Employee

$720.00

$360.00

$180.00

$420.00

$210.00

Employee and Spouse

$1,872.00

$1,512.00

$756.00

$1,572.00

$786.00

Employee and Child(ren)

$1,224.00

$864.00

$432.00

$924.00

$462.00

Employee and Family

$2,376.00

$2,016.00

$1,008.00

$2,076.00

$1,038.00

Employee

$1,013.00

$653.00

$326.50

$713.00

$356.50

Employee and Spouse

$2,402.00

$2,042.00

$1,021.00

$2,102.00

$1,051.00

Employee and Child(ren)

$1,507.00

$1,147.00

$573.50

$1,207.00

$603.50

Employee and Family

$2,841.00

$2,481.00

$1,240.50

$2,541.00

$1,270.50

ACTIVECARE PRIMARY+

ACTIVECARE 2

Examples of C1, C2, C3, C4, CS, MT1, MT2, MT3, and MT4 pay ranges include, but are not limited to, the following Job Classifications: Most Admin Assistants and Clerks, Bus Monitor, CN Specialist, CN Manager ES/MS, Custodian, all Educational Assistants, General Maintenance or Helper, Head Custodian ES/MS, lrrigator, Lead Caretaker/Groundskeeper/Night Custodian, Mail Delivery, all Receptionists, Security Guard, Switchboard Operator, Warehouse Delivery. Examples of all other pay ranges include, but are not limited to, the following Job Classifications: Admin Assistant to a Director or above, Accounts Payable Assistant, Assistant Principal, Bus Driver, CN Manager HS, Counselor, Head Custodian HS, Nurse, Principal, all Supervisors, Teacher.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

2026-27 TRS-ActiveCare Plan Highlights Sept. 1, 2026 – How to Calculate Your Monthly Premium

All TRS-ActiveCare participants have three plan options. TRS-ActiveCare Primary • Lowest premium of the three available plans • Copays for doctor visits before you meet your deductible • Statewide network • Primary Care Provider referrals required to see specialists • Not compatible with a Health Savings Account • No out-of-network coverage

Total Monthly Premium Your Employer Contribution

Plan Summary

Your Premium Ask your Benefits Administrator for your district’s specific premiums.

Monthly Premiums

Total Premium Employee Only

Being Healthy is Easy • $0 preventive services • One-on-one health coaches • Weight loss programs and nutrition • TRS Virtual Health • Member Rewards is even better. Now you’ll get a check when you use Member Rewards and choose low-cost, highquality doctors and facilities – up to $599* per tax year. • Airrosti Remote Recovery gives you inhome virtual physical therapy to relieve common aches and pains at no cost.*

Employer Contribution

Your Premium

$612

• Highest prem • Copays for ma • Lower deduct • Statewide net • Primary Care • Not compatib • No out-of-net

Total Premium $720

Employee and Spouse

$1,653

$1,872

Employee and Children

$1,041

$1,224

Employee and Family

$2,081

$2,376

Plan Features Type of Coverage Individual/Family Deductible Coinsurance Individual/Family Maximum Out of Pocket

In-Network Coverage Only $2,500/$5,000 You pay 30% after deductible $8,050/$16,100

PCP Required

Yes

Primary Care

$30 copay

Specialist

$70 copay

Urgent Care

$50 copay

Doctor Visits

* Eligibility rules may apply.

See the Annual Enrollment Guide for more details.

Mental Health You have in-office and virtual benefits: • TRS-ActiveCare Primary Plan: $30 copay for office visits or $0 with Teladoc • TRS-ActiveCare Primary+ Plan: $15 copay for office visits or $0 with Teladoc • TRS-ActiveCare HD Plan: 30% coinsurance after deductible or $42 with Teladoc • TRS-ActiveCare 2 Plan: $20 copay for office visits or $12 with Teladoc

Immediate Care Emergency Care

You pay 30% after deductible

TRS Virtual Health-RediMDTM

$0 per medical consultation

TRS Virtual Health-Teladoc®

$12 per medical consultation

Integrated with medical

$200 dedu

Prescription Drugs Drug Deductible Generics (31-Day Supply/90-Day Supply)

$15/$45 copay; $0 copay for certain generics

Preferred (Max does not apply if brand is selected and generic is available)

You pay 30% after deductible

Non-preferred

You pay 50% after deductible

Specialty (31-Day Max) Call 1-844-367-6108 to see if your specialty medication is covered by SaveOnSP.

You pay 30% after deductible; $0 if SaveOnSP eligible

Insulin Out-of-Pocket Costs

$25 copay for 31-day supply; $75 for 61- to 90-day supply

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

You pa You p

You pa

– Aug. 31, 2027

. Each includes a wide range of wellness benefits.

RS-ActiveCare Primary+

mium of the three available plans any services and drugs tible than the HD and Primary plans twork Provider referrals required to see specialists ble with a Health Savings Account twork coverage

Employer Contribution

Your Premium

This plan is closed to new enrollees. Current TRS-ActiveCare 2 participants can stay enrolled.

TRS-ActiveCare HD

TRS-ActiveCare 2

• Higher premium of the three available plans • Must meet your deductible before plan pays for non-preventive care • Nationwide network with out-of-network coverage • No requirement for Primary Care Providers or referrals • Compatible with a Health Savings Account

Employer Contribution

Total Premium

• Closed to new enrollees • Current enrollees can choose to stay in the plan • Lower deductible • Copays for many services and drugs • Nationwide network with out-of-network coverage • No requirement for Primary Care Providers or referrals

Your Premium

Employer Contribution

Total Premium

$630

$1,013

$1,701

$2,402

$1,071

$1,507

$2,142

$2,841

Your Premium

In-Network Coverage Only

In-Network

Out-of-Network

In-Network

Out-of-Network

$1,200/$2,400

$3,400/$6,800

$6,800/$13,600

$1,000/$3,000

$2,000/$6,000

You pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible

You pay 20% after deductible

You pay 40% after deductible

$6,900/$13,800

$8,300/$16,600

$20,500/$41,000

$7,900/$15,800

$23,700/$47,400

Yes

$15 copay

You pay 30% after deductible

You pay 50% after deductible

Tier 1: $20 copay Tier 2: $40 copay

You pay 40% after deductible

$70 copay

You pay 30% after deductible

You pay 50% after deductible

Tier 1: $55 copay Tier 2: $85 copay

You pay 40% after deductible

$50 copay

You pay 30% after deductible

You pay 50% after deductible

$50 copay

You pay 40% after deductible

You pay a $250 copay plus 20% after deductible

You pay 20% after deductible

You pay 30% after deductible

$0 per medical consultation

$30 per medical consultation

$0 per medical consultation

$42 per medical consultation

$12 per medical consultation

Integrated with medical

$200 brand deductible

$12 per medical consultation

uctible per participant (brand drugs only)

You pay 20% after deductible; $0 coinsurance for certain generics

$20/$45 copay

ay 25% after deductible ($100 max)/ pay 25% after deductible ($265 max)

$15/$45 copay

You pay 25% after deductible

You pay 25% after deductible ($40 min/$80 max)/ You pay 25% after deductible ($105 min/$210 max)

You pay 50% after deductible

You pay 50% after deductible ($100 min/$200 max)/ You pay 50% after deductible ($215 min/$430 max)

ay 20% after deductible ($500 max); $0 if SaveOnSP eligible

You pay 20% after deductible

You pay 30% after deductible ($200 min/$900 max); $0 if SaveOnSP eligible

$25 copay for 31-day supply; $75 for 61- to 90-day supply

You pay 25% after deductible

$25 copay for 31-day supply; $75 for 61- to 90-day supply

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Questions?

Call a Personal Health Guide at 1-866-355-5999 for help with medical services. Call Express Scripts® by Evernorth Pharmacy Benefit Services at 1-844-367-6108 for help with your pharmacy benefits.

Compare Prices for Common Medical Services Closed to new enrollees. Benefit

TRS-ActiveCare Primary

TRS-ActiveCare Primary+

In-Network Only

Office/Independent Lab: You pay $0

TRS-ActiveCare HD In-Network

Out-of-Network

In-Network

Out-of-Network

Office/Independent Lab: You pay $0 You pay 30% after deductible

Diagnostic Labs

TRS-ActiveCare 2

You pay 50% after deductible

You pay 40% after deductible

Outpatient: You pay 30% after deductible

Outpatient: You pay 20% after deductible

You pay 30% after deductible

You pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible

You pay 20% after deductible + $100 copay per procedure

You pay 40% after deductible + $100 copay per procedure

You pay 30% after deductible

You pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible

You pay 20% after deductible ($150 facility copay per incident)

You pay 40% after deductible ($150 facility copay per incident)

(like childbirth, complex joint replacement and cardiac surgery)

You pay 30% after deductible

You pay 20% after deductible

You pay 30% after deductible

You pay 50% after deductible ($500 facility per day maximum)

You pay 20% after deductible ($150 facility copay per day)

You pay 40% after deductible ($500 facility copay per incident)

Freestanding Emergency Room

You pay $500 copay + 30% after deductible

You pay $500 copay + 20% after deductible

You pay $500 copay + 30% after deductible

You pay $500 copay + 50% after deductible

You pay $500 copay + 20% after deductible

You pay $500 copay + 40% after deductible

Facility: You pay 30% after deductible

Facility: You pay 20% after deductible

Facility: You pay 20% after deductible ($150 facility copay per day)

Professional Services: You pay $5,000 copay + 30% after deductible

Professional Services: You pay $5,000 copay + 20% after deductible

Only covered if rendered at a BDC+ facility

Specialist: You pay $70 copay

You pay 30% after deductible

You pay 50% after deductible

PCP: $30 copay

PCP: $15 copay

Specialist: $70 copay

You pay 30% after deductible

You pay 50% after deductible

High-Tech Imaging (like CT Scan, Mammogram and MRI)

Outpatient (like colonoscopy, cataract surgery and steroid injections)

Inpatient

Bariatric Surgery

Annual Vision Exam (one per plan year)

Annual Hearing Exam (one per plan year)

Outpatient: You pay 20% after deductible

Not Covered

Only covered if rendered at a BDC+ facility

www.trs.texas.gov 04/01/2026 Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Not Covered

Tier 1 Specialist: $55 copay Tier 2 Specialist: $85 copay

Tier 1 PCP: $20 copay Tier 2 PCP: $40 copay Tier 1 Specialist: $55 copay Tier 2 Specialist: $85 copay

You pay 40% after deductible

Pharmacy Express Scripts TRS Pharmacy Benefits Manager As part of your TRS medical plan coverage, you also have pharmacy benefits coverage through Express Scripts, our pharmacy benefits manager (PBM). This pharmacy benefits coverage is available ONLY to those enrolled in one of the TRS-ActiveCare medical plans. Express Scripts helps you understand your pharmacy benefits and makes it convenient and affordable for you and your family to access the medications you need. New enrollees will be issued ID cards effective for the upcoming plan year. If you do not receive a card, or if yours is misplaced, you may download a temporary ID card. You can also contact the Express Scripts TRSActiveCare Customer Support team for assistance. Once your plan year deductible is met, you will pay the applicable copay or coinsurance for each prescription until your out-of-pocket maximum is reached. The Express Scripts website allows you to download a temporary ID card, check medication costs, and explore options for home delivery, specialty medications, and retail pharmacies. Please note that when utilizing prescription drug resources outside of Express Scripts, your prescription costs may not be applied toward your pharmacy coverage deductible or copays.

Questions? Visit https://cleverrx.com/birdvilleisd. Call the Clever RX Help Line at 800-873-1195.

Prescription Drug Discounts Aside from the pharmacy benefits coverage included with your TRS medical plan, standalone prescription drug discount programs (which are not insurance) may help to lower your prescription costs. These discount programs are available to anyone interested in saving money on prescriptions, and they do not require enrollment in a medical plan.

Lower Your Prescription Costs With Clever RX Don’t overpay for your prescriptions. Clever RX gives you access to discounts on thousands of medications, and it is accepted at most pharmacies nationwide. Best of all – you can get up to 80% off prescription drugs! Getting started is easy.

CONTACT EXPRESS SCRIPTS Visit https://www.express-scripts.com/ trsactivecare. Call 844-367-6108.

Download the free Clever RX app and enter these numbers. Group ID – 1085 Member ID – 1621 Enter your ZIP code to find local

2. pharmacies with the best prices. 3.

Click the voucher with the lowest price, closest location, and/or at your preferred pharmacy. Then present the voucher to the pharmacist when you pick up your prescription.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Having a doctor who knows you and your medical history is a key part of preventive care.

Preventive Care Your medical plan offers $0 preventive care for everyone. Preventive care is the care you receive to help prevent chronic illness or disease. It includes exams, lab work, screenings, immunizations, and counseling to prevent health problems, such as diabetes or heart disease.

Watch and learn more!

Preventive Care Coverage Includes Adults

Teens

Children

Cholesterol screening Blood pressure screening Colorectal cancer screening Lung cancer screening Hepatitis B screening Well visits Bone density screening Obesity screening Diabetes type 2 screening Depression screening Mammograms Cervical cancer screening Immunizations

Physical exam Blood tests for iron and cholesterol Anxiety screening Growth screening Hearing screening Hepatitis B screening Depression screening Alcohol, tobacco, and drug use assessments Tuberculosis screening Immunizations

Autism screening Blood screening Depression screening Developmental screening Hearing screening Obesity screening and counseling Hypothyroidism screening Behavioral assessments Well visits Immunizations

Frequently Asked Questions Why should I get preventive care?

Why did I get a bill for preventive care?

Preventive care is the fastest and best way to uncover potential risks and avoid chronic health conditions.

Diagnosis codes on the doctor’s bill must meet certain insurance company conditions for them to be processed as preventive and covered at 100%. If you have a medical complaint, or your doctor finds a specific medical issue during your preventive care doctor’s visit, a diagnosis code for that issue or complaint will be on your bill. As a result, the insurance company may process the bill for a specific medical condition, not preventive care. In this case, you must pay the copay or portion of your deductible.

Are all screenings, tests, and procedures covered under preventive care? No. Your doctor will be able to advise you as to the preventive care you need or should obtain, based on your medical and family history.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Health Care Options Becoming familiar with your options for medical care can save you time and money. Health Care Provider

Symptoms

Average Cost

Average Wait

Allergies Cough/cold/flu Rash Stomachache

2-5 minutes

Infections Sore and strep throat Vaccinations Minor injuries/sprains/ strains

15-20 minutes

Common infections Minor injuries Pregnancy tests Vaccinations

15 minutes

Sprains and strains Minor broken bones Small cuts that may require stitches Minor burns and infections

15-30 minutes

Chest pain Difficulty breathing Severe bleeding Blurred or sudden loss of vision Major broken bones

$$$$

4+ hours

Most major injuries except trauma Severe pain

$$$$$$

Minimal

NON-EMERGENCY CARE

Access to care via phone, online video, or mobile app whether you are at home, work, or traveling; medications can be prescribed TELEHEALTH

24 hours a day, 7 days a week

Generally, the best place for routine preventive care; established relationship; able to treat based on medical history DOCTOR’S OFFICE

Office hours vary

Usually lower out-of-pocket cost than urgent care; when you can’t see your doctor; located in stores and pharmacies RETAIL CLINIC

Hours vary based on store hours

When you need immediate attention; walk-in basis is usually accepted URGENT CARE

Generally includes evening, weekend and holiday hours

EMERGENCY CARE

Life-threatening or critical conditions; trauma treatment; multiple bills for doctor and facility HOSPITAL ER

24 hours a day, 7 days a week

Services do not include trauma care; can look similar to an urgent care center, but medical bills may be 10 times higher FREESTANDING ER

24 hours a day, 7 days a week

Note: Examples of symptoms are not inclusive of all health issues. Wait times described are only estimates. This information is not intended as medical advice. If you have questions, please call the phone number on the back of your medical ID card.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Health Savings Account

Watch and learn more!

Offset your HDHP health care costs, reduce your taxes, and get a long-term tax-advantaged savings account. A Health Savings Account (HSA) is like a personal savings account that allows you to pay for current or future health care expenses with pretax dollars or save the funds for retirement. The funds can also be used for your dependents, even if they are not covered by the HDHP. An HSA is always yours to keep, even if you change health plans or jobs.

HSA Administrator:

Two Ways To Use Your HSA USE IT NOW

INVEST OVER TIME

Pay for qualified out-ofpocket medical, dental, and vision expenses as they are incurred.

Invest and grow your HSA dollars tax-free. You can use the funds to pay for qualified expenses later.

Triple Tax Benefits

1. Tax-free contributions 2. Tax-free growth

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 (e.g., spouse’s health plan) Not enrolled in a Health Care Flexible Spending Account 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 *If you are age 65 or older but choose to delay Medicare, you can continue to contribute to your HSA. However, if you are automatically enrolled in premium-free Medicare Part A when you claim Social Security, your HSA eligibility ends immediately. Note: You may have an HSA at the financial institution of your choice, but only accounts opened through EECU are eligible for automatic payroll deductions.

How to Pay or Get Reimbursed Use your HSA debit card to pay for qualified expenses. Pay out-of-pocket and submit your receipts for reimbursement online or through the app.

Contributions You may contribute up to the IRS annual maximum.

2026 MAXIMUM HSA CONTRIBUTIONS

3. Tax-free withdrawals GET MORE INFORMATION OR SUBMIT RECEIPTS Visit https://www.eecu.org. Call 817-882-0800. Download the EECU app.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Individual

$4,400

Family

$8,750

If you are age 55 or older, you can contribute an extra $1,000.

Flexible Spending Accounts

Watch and learn more!

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).

Visit fsastore.com for an array of FSA-eligible products.

FSA Administrator:

Health Care FSA The Health Care FSA covers qualified medical, dental, and vision expenses for you and your eligible dependents. Eligible expenses include: Deductibles, copays, and coinsurance

Braces, glasses, and contacts Hearing aids and batteries

Prescription drugs If you enrolled in an HDHP and contribute to an HSA, you may not contribute to a Health Care FSA.

Working Towards Savings

IMPORTANT REMINDERS! 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 may offer some flexibility (e.g., more time via a grace period to incur expenses; or a limited amount of funds that can be carried over in to the next plan year). Because options vary by employer, it’s important to review your specific plan details or check with your employer for more information. 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.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

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.

Annual Maximum FSA Contributions 2026

Health Care FSA

Dependent Care FSA

Annual Maximum Contribution

$3,400

$7,500 (single parent filing head of household; or married filing jointly); $3,750 (married filing separately)

Run-out Period

90 days

No run-out period

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.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Get More Information or Submit Receipts Visit www.nbsbenefits.com. Call 855-399-3035. Fax 844-438-1496. Email service@nbsbenefits.com. Participant Portal: www.mynbsbenefits.com Mail: National Benefit Services, LLC P.O. Box 219393 Kansas City, MO 64121-9393

HSA and FSA Comparison 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. Health Savings Account

Flexible Spending Account*

Description

• Acts as a personal savings account. • Funds can be used to pay for current or future health care expenses with pretax dollars; or funds can be saved for retirement. • Funds can also be used for your dependents, even if they are not covered by the HDHP.

Health Care FSA – Use funds to pay qualified medical, dental, and vision expenses. Dependent Care FSA – Use funds to pay qualified dependent care expenses and services.

Contribution Source

Employee (You) and/or your employer

Account Owner

Employee (You)

Employer

Underlying Insurance Requirement

High Deductible Health Plan

None

Maximum Annual Contribution

2026 Individual – $4,400 Family – $8,750 Age 55+ Additional Catch-up – $1,000

2026 Health Care FSA – $3,400 Dependent Care FSA • $7,500 (Single parent filing head of household; or married filing jointly) • $3,750 (Married filing separately)

Permissible Use of Funds

• Pay for qualified out-of-pocket medical, dental, and vision expenses. • If used on nonqualified expenses prior to age 65, subject to income tax plus a 20% penalty.

See details in the Description section above.

Year-to-year rollover of account balance?

Yes. Funds roll over and can be used anytime or saved for future use.

Does the account earn interest?

Yes

Portable?

Yes. It is always yours to keep, even if you change jobs or medical plans.

Flip to … 14

HSA

FSA

* 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 may offer some flexibility (e.g., more time via a grace period to incur expenses; or a limited amount of funds that can be carried over in to the next plan year). Check with your employer for more details.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Qualified HSA and FSA Expenses The products and services listed below are examples of medical expenses eligible for payment from 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 complete details. Abdominal supports

Diagnostic fees

Orthopedic shoes

Acupuncture

Eyeglasses

Orthopedist

Ambulance

Gynecologist

Osteopath

Anesthetist

Healing services

Physician

Arch supports

Hearing aids and batteries

Postnatal treatments

Artificial limbs

Hospital bills

Prenatal care

Blood tests

Insulin treatment

Prescription medicines

Braces

Lab tests

Psychiatrist

Cardiographs

Metabolism tests

Therapy equipment

Chiropractor

Neurologist

Wheelchair

Crutches

Nursing

X-rays

Dental treatment

Obstetrician

Dentures

Operating room costs

Dermatologist

Ophthalmologist/Optician/Optometrist

* Excludes Dependent Care FSA.

Working Towards Savings

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Sick Leave Bank Purpose of the Sick Leave Bank (SLB) The purpose of the sick leave bank is to provide additional paid sick leave days for members of the bank who have exhausted all available paid leave because of a catastrophic injury or illness of the employee or immediate family member. The request for additional days may only be made when a member has exhausted all accumulated state, local, comp time, and vacation leave days.

What is the definition of catastrophic illness or injury? According to Board Policy DEC (local), a catastrophic illness or injury is a severe condition or combination of conditions affecting the mental or physical health of the employee that requires the services of a licensed practitioner for a prolonged period of time, and that forces the employee to exhaust all leave time earned by the employee and to lose compensation from the District.

How do I become a member of the Sick Leave Bank? In order to become a member of the sick leave bank, an employee must donate three days of local leave. These days are not refundable. This is a one-time donation.

How many days may I use from the Sick Leave Bank? The SLB may grant up to 30 days per school year with a lifetime maximum of 90 days.

Can SLB be used for maternity or family illnesses? The SLB may not be used for maternity unless for a complication resulting from pregnancy. SLB may be used to care for family illnesses meeting the definition of catastrophic.

Who will determine if I am granted days from the Sick Leave Bank? The SLB committee will determine whether the request for sick leave days is approved or denied based on the physician’s statement. All medical information is confidential. The name of the patient/employee will NOT be shared with the committee.

Once I’m a member of the Sick Leave Bank, will I ever have to donate more days? Members of the bank who, during the previous school year, found it necessary to use the benefits from the bank must donate three days or the actual number of days used, whichever is less, at the beginning of the next school year. Though unlikely, additional days may be needed if the bank runs low on days; please see the policy for more details. For additional information, review the Sick Leave Bank Guidelines or contact the Benefits Office at 817-547-5782 or benefitsweb@birdvilleschools.net.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Dental Coverage Our dental plans help you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work.

Find an In-Network Provider Visit: www.cigna.com. Call: 800-244-6224.

Dental Provider:

Network: Cigna Dental Choice

DHMO Plans If you enroll in a DHMO plan, you and all eligible dependents must select a primary care dentist (PCD) from the DHMO network directory to manage your care. Your initial PCD will be automatically assigned to you based on your ZIP code. You may change your PCD by contacting Cigna directly. Dental services are unlimited and have fixed copays. There are no deductibles or claim forms to file. Out-ofnetwork care is not covered.

Watch and learn more!

DPPO Plan Two levels of benefits are available with the DPPO plan: in-network and out-of-network. You may see 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 out-of-network provider.

Dental Benefits Summary Dental – Cigna High Plan

Low Plan

DHMO

Network Type

DPPO

DHMO

OON Reimbursement Type

MAC*

Charge Schedule

Total DPPO

Dental Care Access Plus

Annual Maximum Benefit per Member

$1,500

$1,000

N/A

Annual Deductible Amount • Individual • Family

$50 $150

N/A

$1,500

$1,050

N/A

Provider Network Dental Network Name Plan Features

Plan Annual Maximum Rollover or Increasing Maximum Threshold and Amount

HOW CAN I GET MY ID CARD? Visit www.cigna.com. Call 800-244-6224 and provide the group number 3347382.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Dental Coverage Dental – Cigna High Plan

Low Plan In-Network Reimbursement

DHMO 1

Reimbursement Percentages Class 1: Preventive/Diagnostic Care

100%

N/A

Class 2: Basic Restorative Care

80%

50%

N/A

Class 3: Major Restorative Care

50%

N/A

Class 3: Implants

Full

N/A

Class 4: Orthodontia Reimbursement Percentage

50%

Fee Schedule

Class 4: Orthodontia: Lifetime Maximum Amount

$1,500

N/A

Fee Schedule

Class 4: Orthodontia: Children Only or Adults & Child Coverage?

Children only

N/A

Child and Adult

Class 4: Orthodontia: To What Age are Children Covered?

Up to age 26

N/A

Up to age 26

Palliative Treatment

Basic

Please see Patient Charge Schedule (K1-09)

Oral Surgery: Simple Extractions

Basic

Please see Patient Charge Schedule (K1-09)

Oral Surgery: Surgical Extractions

Major

Please see Patient Charge Schedule (K1-09)

Periodontics Nonsurgical

Major

Please see Patient Charge Schedule (K1-09)

Periodontics Surgical

Major

Please see Patient Charge Schedule (K1-09)

Endodontics Nonsurgical

Major

Please see Patient Charge Schedule (K1-09)

Endodontics Surgical

Major

Please see Patient Charge Schedule (K1-09)

Orthodontia

Services Class

In-Network Reimbursement1 Plan Provisions Number of Dental Cleanings Available per Year

Up to 3

2 per Policy Year

Do Waiting Periods Apply for Any Preventive, Basic, Major, or Orthodontia Services?

Are Benefits Determined by Policy Year or Calendar Year?

Policy Year

Are Limitations for Late Entrants Included in the Policy?

Is a Missing Tooth Clause Included in the Policy?

Emergency Only

Employee Only

$44.14

$33.10

$11.84

Employee & Spouse

$86.10

$65.62

$21.52

Employee & Child(ren)

$98.68

$74.04

$31.22

Employee & Family

$142

$106.54

$45.04

Can Benefits Be Utilized Outside of the U.S.? Rates (Monthly)

You will be reimbursed up to the Maximum Allowable Charge (MAC) for services received from an out-of-network dentist. You are responsible for charges in excess of the MAC, so stay in-network to avoid balance billing. 1

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

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.

Find an In-Network Provider Visit www.superiorvision.com. Call 800-507-3800.

Vision Provider: Network: Superior Vision National Network

You may seek care from any vision provider, but the plan will pay the highest level of benefits when you see in-network providers.

Watch and learn more!

Vision Benefits Summary Vision Plan Exam (ophthalmologist)

In-network

Out-of-network

$10 copay

Up to $42

Exam (optometrist)

$10 copay

Up to $37

Frames1

$25 copay

Up to $68

Covered in full

Not covered

Contact lens fitting (standard2) Contact lens fitting (specialty2)

Monthly Rates Employee

$8.30

Employee and Spouse

$16.45

Employee and Child(ren)

$16.13

Employee and Family

$24.51

$50 retail allowance

Not covered

• Single vision

Covered in full

Up to $32 retail

Exam

$10

• Bifocal

Covered in full

Up to $46 retail

Materials

$25

• Trifocal

Covered in full

Up to $61 retail

• Progressive lens upgrade

See description3

Up to $61 retail

Contact lens fitting (standard)

$25

$120 retail allowance

Up to $100 retail

Lenses1 (standard) per pair

Contact lenses4

Copays

Services/Frequency Exam

12 months

Copays apply to in-network benefits; copays for out-of-network visits are deductible from reimbursements.

Frame

12 months

Contact lens fitting

12 months

¹ Materials copay applies to lenses and frames only, not contact lenses.

Lenses

12 months

² Standard contact lenses fittings applies to a current contact lenses user who wears disposable, daily wear or extended wear lenses only. Specialty contact lenses fitting applies to new contact wearers and/or a member who wears toric, gas permeable, or multi-focal lenses. ³Covered to provider’s in-office standard retail lined trifocal amount; members pay difference between progressive and standard retail lined trifocals, plus applicable copay. ⁴ Contact lenses are in lieu of eyeglass lenses and frames benefit.

WHERE CAN I GET MY ID CARD? Visit www.superiorvision.com. Call 800-507-3800. Group #28488.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Life and AD&D Insurance For Employees / Basic Life and Accidental Death and Dismemberment (AD&D) insurance are important to your financial security, especially if others depend on you for support or vice versa.

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Employee Basic Life and AD&D Eligible employees receive Basic Life and AD&D at no cost. You are automatically covered at $10,000 for each benefit. Coverage for each benefit reduces to $5,000 at age 70.

Life and AD&D Provider:

Designating a Beneficiary With Life insurance, you or your beneficiary(ies) can use the coverage to pay off debts such as credit cards, loans, and bills. 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).

A beneficiary is the person or entity you elect 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 anytime. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%).

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Life Insurance Watch and learn more!

Voluntary Life insurance is important to your financial security, especially if others depend on you for support or vice versa.

Voluntary Life Provider:

Voluntary Life If you need more coverage than Basic Life, you may buy Voluntary Life coverage for yourself and your dependent(s). If you do not elect Voluntary Life coverage when first eligible, or if you want to increase your benefit amount at a later date, you may need to show proof of good health. You must elect Voluntary Life coverage for yourself before covering your spouse and/or child(ren). Life Insurance Employee

• Increments of $10,000 up to $500,000 or 7x salary • New hire Guaranteed Issue $280,000

Spouse

• Increments of $5,000 up to $500,000 not to exceed 100% of employee election • New hire Guaranteed Issue $50,000

Child(ren)

• At least one day to age 26 - $10,000

With Life insurance, you or your beneficiary(ies) can use the coverage to pay off debts such as credit cards, loans, and bills.

Voluntary Life Rates

Designating a Beneficiary A beneficiary is the person or entity you elect 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 anytime. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%).

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Employee Age

Life Rates per $1,000

0-24

$0.040

25-29

$0.050

30-34

$0.070

35-39

$0.080

40-44

$0.110

45-49

$0.180

50-54

$0.320

55-59

$0.500

60-64

$0.750

65-69

$1.150

70+

$1.850

Child Coverage

$0.100

Spouse rate is based on employee’s age.

AD&D Insurance Watch and learn more!

Voluntary AD&D insurance is important to your financial security, especially if others depend on you for support or vice versa.

Voluntary AD&D Provider:

Voluntary AD&D If you need more coverage than Basic AD&D, you may buy Voluntary AD&D coverage for yourself and your dependent(s). If you do not elect Voluntary AD&D coverage when first eligible, or if you want to increase your benefit amount at a later date, you may need to show proof of good health. You must elect Voluntary AD&D coverage for yourself before covering your spouse and/or child(ren). Accidental Death and Dismemberment

With AD&D insurance, you or your beneficiary(ies) can use the coverage to pay off debts such as credit cards, loans, and bills.

Family

• You must enroll in Family AD&D coverage to elect Spouse or Child(ren) Family AD&D coverage. You may choose to cover your Dependent Spouse and Child(ren) under the Family AD&D plan. All eligible dependents will be covered. The Spouse and Child(ren) Family AD&D coverage is a percentage of the employee coverage amount and is based on the employee’s dependents. • Spouse Coverage with Child(ren): 100% of your coverage amount • Child(ren) Coverage with Spouse: 10% of your coverage amount for each dependent child • Spouse Coverage without Child(ren): 100% of your coverage amount • Child(ren) Coverage without Spouse: 10% of your coverage amount for each dependent child.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Educator Disability Insurance

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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.

File a Disability Claim Visit www.mybenefitshub.com/ birdvilleisd. Call 888-499-0425.

Disability Provider:

Educator Disability 14/141 days 30/301 days 90/90 days

Benefits Begin After Percentage of Earnings You Receive

You can choose between 40% or 60% of your monthly salary

Maximum Weekly Benefit

$1,000

Maximum Benefit Period

Social Security Normal Retirement Age

Pre-existing Condition Exclusion

3/121,2

RATES PER $100 OF MONTHLY BENEFIT

40%

60%

14/14

$1.96

$1.98

30/30

$1.37

$1.47

90/90

$0.93

$0.86

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. 1

Benefits may not be paid for any condition treated within three months prior to your effective date until you have been covered under this plan for 12 months. If your disability is a result of a pre-existing condition, benefits will be paid for a maximum of eight weeks. 2

Pre-Existing Condition Waiver The pre-existing condition limitation will be waived for the first eight weeks.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Are there pre-existing condition limitations? Yes. All plans include pre-existing 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.

Hospital Indemnity Insurance

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The Hospital Indemnity plans help you with the high cost of medical care by paying you a cash benefit when you have an inpatient hospital stay.

Hospital Indemnity Insurance Provider:

Unlike traditional insurance which pays a benefit to the hospital or doctor, these plans pay 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.

Hospital Indemnity Benefits Summary

Hospital Admission

Plan 1

Plan 2

$1,500

$2,500

Hospital Confinement

$150 per day up to 30 days

$250 per day up to 30 days

ICU Confinement

$300 per day up to 30 days

$500 per day up to 30 days

$21.14 $39.68 $38.50 $59.91

$35.24 $66.14 $64.17 $99.85

EMPLOYEE MONTHLY CONTRIBUTIONS Employee Employee and Spouse Employee and Child(ren) Employee and Family

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

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.

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Cancer Insurance Provider:

Cancer Insurance Benefits Summary Plan 1

Plan 2

Medical Imaging

$500 per year

Radiation and Chemotherapy Charges Per 12-month period

$15,000 per year

$20,000 per year

Internal Cancer – First Occurrence

$2,500

Diagnostic Testing - 1 test per calendar year

$50 per test

Follow-Up Diagnostic Testing - 1 test per calendar year

$100 per test

Bone Marrow Transplant - Maximum per lifetime

$6,000

$9,000

Stem Cell Transplant - Maximum per lifetime

$600

$900

$26.40 $47.70 $36.30 $47.70

$34.30 $61.10 $46.90 $61.10

EMPLOYEE MONTHLY CONTRIBUTIONS Employee Employee and Spouse Employee and Child(ren) Employee and Family

This summary does not include all covered services. Please refer to your certificate for a complete listing.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Critical Illness Insurance

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Critical Illness insurance helps pay the cost of non-medical expenses related to a covered critical illness.

Critical Illness Insurance Provider:

The plan provides a lump-sum benefit payment to you upon first and second diagnosis of any covered critical illness. The benefit can help cover expenses such as lost income, out-of-town treatments, special diets, daily living, and household upkeep costs. This coverage is portable. See the plan document for full details.

Critical Illness Insurance Benefits Summary Benefit Amount

COVERAGE Guaranteed coverage amounts

$10,000, $20,000 or $30,000 If this is your first opportunity to enroll for coverage, you can choose from the coverage amounts above

Guaranteed coverage amounts You can secure Critical Illness Insurance for your spouse when you choose coverage for yourself.

$10,000, $20,000 or $30,000 (up to 100% of the employee coverage amount) If this is your first opportunity to enroll for coverage, you can choose from the coverage amounts above for your spouse

Employee

Spouse

Dependent Children

Your dependent children automatically receive 50% of your coverage amount at no extra cost.

Guaranteed coverage amounts

RATES (MONTHLY) Employee Age Range (Attained Age)

$10,000

$20,000

$30,000

0-29

$2.71

$5.42

$8.13

30-39

$2.88

$5.76

$8.64

40-49

$5.16

$10.32

$15.48

50-59

$9.23

$18.46

$27.69

60-69

$14.21

$28.42

$42.63

70+

$43.27

$86.54

$129.81

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Telehealth This employer-paid telehealth program gives you and your family 24/7 access to boardcertified doctors via your mobile device or computer – from home, the office, or on the go. This benefit is provided to you at no cost.

Get More Information and Register Skip the trip to your doctor! Set up your account so you can get on-demand medical care. Visit www.onemedical.com/myhealth.

YOUR TELEHEALTH COPAY IS $0!*

Call 888-663-6331. Download the One Medical app.

Telehealth Provider:

Use code: BIRDXOM.

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 For minor conditions such as:

Sore throat Headache Stomachache Cold/flu Allergies Fever Urinary tract infections

Working towards Health

*Copay is $0 if you use Video Care (consultation) or Direct Message (email consultation) for free services.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Watch and learn more!

Do not use telehealth for serious or life-threatening emergencies.

Emergency Medical Transport MASA Medical Transport Solutions (MASA MTS) helps you prepare for the unexpected with affordable medical emergency air and ground transportation.

For More Information Visit www.masamts.com. Call 800-643-9023. Download the MASA Global app.

Emergency Medical Transport Provider:

If you or your family members need emergency medical transport, your insurance coverage and Medicare may not cover all of the costs. Following your medical crisis, MASA MTS will negotiate with your medical plan provider and cover your remaining balance on your medical transportation bills. Participation in this plan is voluntary.

Watch and learn more!

Emergency Medical Transport Rates Visit www.mybenefitshub.com/birdvilleisd for rates.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Emergency Medical Transport Emergency Medical Transport Benefits Summary EMERGENCY MEDICAL TRANSPORT – MASA SERVICES

Plans Emergent Plus Plan

Emergency Ground Ambulance Coverage

1

Emergency Air Ambulance Coverage

1

Hospital to Hospital Ambulance Coverage

1

Repatriation Near Home Coverage

1

Minor Return Transportation Coverage Pet Return Transportation Coverage Post Admission Continued Care Transportation Coverage Sick While Away From Home Expense Protection Patient Return Transportation Coverage Companion Emergency Transportation Coverage Hospital Visitor Transportation Coverage Mortal Remains Transportation Coverage Vehicle & RV Return Coverage Organ Retrieval Transportation Coverage Organ Recipient Transportation Coverage

RATES (MONTHLY) Employee and Family

$14

Coverage territories: 1

United States and Canada

Disclaimer: This material is for informational purposes only and does not provide any coverage. The benefits listed, and the descriptions thereof, do not guarantee coverage and do not represent the full terms and conditions applicable for usage and may only be offered in some memberships or policies. Premiums, benefits, and coverage vary depending on the plan selected. For a complete list of benefits, premiums, terms, conditions, and restrictions, please refer to the applicable member services agreement or policy for your state. For additional information and disclosures about MASA plans, visit: https://info.masaglobal.com/disclaimers.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Employee Assistance Program The Employee Assistance Program (EAP) helps you and family members cope with a variety of personal and work-related issues.

For 24/7 Support and More Information Visit www.lfg.com. Call 800-423-2765.

EAP Provider:

Support at Any Hour of the Day or Night!

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 issues

Substance abuse Financial and legal matters And more

The EAP also offers up to six face-to-face counseling sessions per person, per issue, per calendar year.

Working Towards Support

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Identity Theft Protection This plan helps to prevent or minimize the harm caused by identity theft when someone uses your personal information without permission.

To Learn More Visit www.experian.com. Call 855-797-0052.

Monitoring of credit files, financial accounts, and the dark web for fraudulent activity Alerts when suspicious activity is detected Identity restoration services Fraud resolution services

Identity Theft Provider:

EMPLOYEE MONTHLY CONTRIBUTIONS Employee

$7.50

Employee & Family

$14

Legal Assistance Legal services benefits include access to legal advice and representation on a wide variety of legal matters from traffic violations to creating a will. General advice and consultations for free or at reduced fees Will and estate planning Family law Traffic violations Contract disputes Real estate issues EMPLOYEE MONTHLY CONTRIBUTIONS Employee + Family LegalShield

$15.25

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

To Learn More Visit www.legalshield.com. Call 800-654-7757. For Member Services, call 888-807-0407.

Legal Provider:

Financial Planning 403(b) and 457 Retirement Plans A 403(b)/457 plan can be a powerful tool to help you reach your investment goals and be financially secure in retirement.

Retirement Plan Provider:

To Get Started Visit www.region10rams.org/403b. Enrollment assistance is available at www.ramsretirement.com/telewealth or by calling the Enrollment Hotline at 800-943-9179.

How the Plan Works You are eligible to participate in the plan if you are a fulltime employee, age 18 or older. You may contribute up to the IRS annual limits.

Vesting You are always 100% vested in your own contributions. The district does not make a contribution to 403(b)/457 plans.

457(b) Savings Plan

403(b) Savings Plan

Employer-sponsored plan with fiduciary oversight by HUB Investment Partners and a committee of Superintendents/CFOs. High-quality, low fee investment options. No commissions. No federal penalties to withdraw funds from account. Income tax still applies. Choose between target date funds, risk-based portfolios, or self-directed mutual funds.

Multi-vendor plan. You must research from a list of 50+ vendors and decide the best fit for you. Fees and investments vary per vendor. Commissions vary per vendor. 10% early withdrawal penalty (goes away at age 591/2 or age 55 if retired). Investment options vary by vendor, including fixed/variable annuities and mutual funds.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Glossary of Terms ACA (Affordable Care Act) – The ACA is comprehensive health care reform law enacted in March 2010. References to ACA at HPS typically involve reporting requirements, specifically, that obligate employers to report medical coverage for employees and to provide documents for employee tax preparation. HPS partners with ACA service providers to assist clients in meeting these requirements. Actively-at-work – This term refers to being at work as opposed to being on vacation, leave, or away from work for any other reason. Companywide or position-wide reporting dates (like summer breaks or winter breaks for teachers) do not apply here. ADL (Activities of Daily Living) – This is a concept related to eligibility for Long Term Care (LTC) benefits. There are six ADLs: bathing, dressing, toileting, transferring, eating, and continence. Most LTC plans require that the covered individual be unable to perform a certain number of these tasks to be eligible for benefits. Beneficiary – This is who will receive a benefit in the event of the insured’s death. A policy may have more than one beneficiary. Benefit Duration – This is the maximum period of time in which a claimant can receive benefits. Benefit Reduction – Some plans may include percentage reductions in benefit amounts when participants reach a certain age. Cafeteria/Section 125 Plan – This plan provides participants an opportunity to pay for qualified benefits on a pretax basis. Premiums for most medical, dental, vision, FSA, HSA, accident, and cancer plans are deducted on a pretax basis, which reduces participants’ taxable income. Certificate of Benefits (Certificate of Coverage) – The certificate serves as the primary official plan document for participants of group benefits, as they are not enrolled in an individual policy.

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COBRA – COBRA allows participants who lose their health benefits the right to continue group health benefits for limited periods of time under certain circumstances including voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals will have to pay the full premium (including any employer contribution applied when employed) up to 102% of the cost to the plan. Coverage is typically available for 18 months but can be extended in certain situations. Copay – Also known as a copayment, this is the fixed amount you pay for health care services received at the time of service. A copay typically goes toward your deductible. Coinsurance – After you have met your deductible, this is your share of the cost of a covered health care service, which is calculated as a percent of the allowed amount for the service. For example, your coinsurance is 20% (while the insurer pays the remaining 80%). Contingent Beneficiary – This is who will receive a benefit in the event of the beneficiary’s (aka the primary beneficiary) death. A policy may have more than one contingent beneficiary. Contingent Plans – Contingent plans make benefits available to participants only when another specific benefit has been elected. Examples of contingent plans include voluntary life for dependents (contingent on the election of employee voluntary life) and a Health Saving Account (contingent on the election of a High Deductible Health Plan). Continuation of Coverage – Many plans offered by HPS clients are continuable under COBRA or portability or conversion options. Standalone clients and cooperatives will have “continuation of coverage” documents that detail plan continuation availability. Conversion – Conversion is a benefit continuation option that transforms group coverage into individual coverage, separate from the group policy. This typically comes with much higher premiums.

Glossary of Terms Covered Expenses – These are health care expenses covered under your health plan. Deductible – This is the amount a participant must cover for health care services before the insurer will share costs and provide coinsurance. Dental Reimbursement Types – Various types of dental plans (except DHMO plans) will pay out-of-network benefits differently. MAC/MRC/NAP (Maximum Allowable Charge/ Maximum Reimbursable Charge/Network Access Plan): Participants will receive the same payouts (contracted fees) for services whether they go in or out of network; and they may be balance billed when going out of network. UCR/R&C(Usual, Customary, and Reasonable/ Reasonable & Customary): When going out of network, the plan will pay an amount determined by the usual cost charged for the service by dentists in a certain geographical area. Eligibility Waiting Period – This period is the amount of time new hires must wait before they are eligible for benefits. Most HPS clients will allow for new hires to be eligible the first of the month following (or coincident with) their date of hire. Elimination Period – Also known as a waiting period, this is the number of calendar days that participants in a Disability plan must be disabled before they are eligible to receive benefits. Employer Contribution – The amount of premium or financial contribution an employer provides to participants for insurance, spending accounts, or retirement. EOB (Explanation of Benefits) – This statement from your insurance carrier explains which procedures and services were provided, how much they cost, what portion of the claim was paid by the plan, and what portion of the claim is your responsibility. It also includes information on how you can appeal the insurer’s decision. These statements are also posted on the carrier’s website for your review.

EOI (Evidence of Insurability)/Statement of Health (SOH) – Some plans require an application or a “proof of good health” type of statement to obtain coverage. This is commonly referred to as EOI (Evidence of Insurability). Such applications or statements must be submitted electronically or by mail to the carrier for approval. Evergreen Clause – This clause, written into a client’s Cafeteria/Section 125 Plan, allows a client to roll over Flexible Spending Account elections into the new plan year. FMLA (Family and Medical Leave Act) – This act ensures employees have job-protected and unpaid leave for qualified medical and family reasons. FSA (Flexible Spending Account) – An option that allows participants to set aside pretax dollars to pay for qualified expenses (i.e., certain medical care or dependent care expenses) during a specific period (usually a 12-month period). Participants determine how much to contribute to their FSA at the beginning of the plan year. Most funds must be used by the end of the year, depending upon the type of FSA, as there is a limited carryover amount. Grace Period – As it pertains to FSAs, this is the period immediately following the end of the plan year during which participants can incur new claims to use their remaining FSA funds. Guaranteed Issue – Some plans may include Guaranteed Issue coverage to new enrollees without EOI. HDHP (High Deductible Health Plan) – A qualified health plan that combines lower monthly premiums in exchange for higher deductibles and out-of-pocket limits. These plans are often coupled with an HSA. HMO/DHMO (Health Maintenance Organization/ Dental Health Maintenance Organization) – Medical plans labeled as HMO plans have a specified network of providers, and benefits are generally not available outside of that network except in an emergency. DHMO plans follow this same model for dental coverage. HPS (Higginbotham Public Sector) – HPS is the insurance broker that represents your account.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Glossary of Terms HRA (Health Reimbursement Arrangement) – This is an employer-owned savings account to which the company deposits pretax dollars for each of its covered employees. Employees can then use the funds in their HRA to reimburse themselves for incurred qualified health care expenses. HSA (Health Savings Account) – This is an employeeowned savings account used to pay for eligible health care expenses with pretax dollars. Funds in the account do not have to be used within a specified time period. An HSA must be coupled with qualified HDHP. In-network – Doctors (e.g., a primary care physician or specialist), hospitals, and other providers that contract with your insurance company provide health care services at discounted rates. These providers are on an outlined list of health care practitioners. Inpatient – A person who is treated as a registered patient in a hospital or other health care facility. Medically Necessary – Services or supplies provided by a hospital, health care facility, or physician that meet the following criteria: (1) are appropriate for the symptoms and diagnosis and/or treatment of the condition, illness, disease, or injury; (2) serve to provide diagnosis or direct care and/or treatment of the condition, illness, disease, or injury; (3) are in accordance with standards of good medical practice; (4) are not primarily serving as convenience; and (5) are considered the most appropriate care available. Medicare – An insurance program administered by the federal government to provide health coverage to individuals age 65 or older, or who have certain disabilities or illnesses. Member – You and those covered become members when you enroll in a health plan. This includes eligible employees, their dependents, COBRA beneficiaries, and surviving spouses. Open Enrollment – Open Enrollment refers to the annual period during which employees may enroll in available benefits or make coverage changes without a Qualifying Life Event.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

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 Expense – Amount that you must pay toward the cost of health care services. This includes deductibles, copayments, and coinsurance. Out-of-pocket Maximum – Also known as an out-ofpocket limit, this is the most you pay during a policy or benefit period (usually a 12-month period) before your health insurance or plan begins to pay 100% of the allowed amount for covered services. PCP (Primary Care Physician) – A doctor who is selected to coordinate treatment under your health plan. This generally includes family practice physicians, general practitioners, internists, and pediatricians. Plan Year – A 12-month period of benefits coverage under a group health plan, which may or may not coincide with a calendar year. Plan Year Maximum – The maximum amount of benefit available to a participant for each plan year. Portability – Portability is a continuation option available that allows participants to continue group coverage beyond their employment. Premiums typically remain in line with active participants, but coverage depends on the continuation of the group policy. If the group policy terminates, portability will no longer be available. PPO (Preferred Provider Organization) – Health plans labeled as PPO refer to the network structure and plan availability. In-network PPO plan providers have agreed to offer services at a contracted rate, which means members generally pay less and get the highest level of benefits. Out-of-network services and providers are also available, but you may pay more for care and generally receive fewer benefits. Preventive Care – The care you receive to help prevent illness or disease. It also includes counseling to prevent health problems.

Glossary of Terms Pre-existing Condition – A pre-existing condition is a medical event, treatment, or diagnosis that occurs prior to the effective date of insurance coverage.

SSNRA (Social Security Normal Retirement Age) – This is the normal retirement age for an employee under the federal Social Security Act.

Pre-existing Condition Limitation – Some plans may limit benefits due to pre-existing conditions for a set period of time.

SSDI (Social Security Disability Insurance) – Disability benefits are available through Social Security as long as a participant is “insured” (has worked long enough and paid into Social Security) and has been defined as disabled by the federal government.

Premium – A reference to the cost (usually monthly) of insurance/benefits paid by the employer or employee. QLE (Qualifying Life Event) – These are events that allow changes to pretax benefits outside of Open Enrollment. Changes must typically be made within 30 or 31 days of the event. Examples of QLEs include marriage, birth, divorce, gain or loss of benefits coverage, and change in employment status affecting benefits. Rate Guarantee – Plan pricing can be under a rate guarantee for a certain amount of time, typically two to four years. The premium rates cannot be changed during this time. Renewal – When a plan’s rate guarantee expires, a rate renewal will be received from the carrier’s underwriter. This establishes new rates beyond the expiration of the rate guarantee. Clients can either accept the new rates, attempt to negotiate the renewal (usually assisted by HPS), or publish an RFP (Request for Proposal) to shop for a new carrier. Rollover – As it pertains to a Health Care FSA or Limited Purpose Health Care FSA, a client can establish a limit of $680 (for 2026) of unused funds that can be rolled over to the next plan year, provided the participant re-enrolls in the FSA plan.

THEbenefitsHUB – This is the benefits enrollment system used by HPS. Underwriting – This is the process of evaluating the risks of insuring an individual or group and establishing premium rates and coverage for the individual or group. Clients are subject to underwriting during RFPs and renewals, and their employees are subject to underwriting when submitting EOI statements for coverage. Usual, Customary and Reasonable (UCR) Allowance – This is the fee paid for covered services that is: (1) a similar amount to the fee charged by a health care provider to the majority of patients for the same procedure; (2) the customary fee paid to providers with similar training and expertise in a similar geographic area: and (3) reasonable in light of any unusual clinical circumstances. Waiver of Premium (WOP) – This is a feature in some insurance plans that allows premiums to be suspended for a participant for a period of disability

Run-out Period – Related to FSAs, this is a period immediately following the end of the plan year in which participants can submit claims incurred within the plan year. For new onboarding clients, this period can be managed by the current or new administrator. The current administrator may charge a fee. If the new administrator manages the run-out period, it will need a report of the FSA participants and their remaining FSA balances.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

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.

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.

Birdville ISD has determined that the prescription drug coverage offered by the Birdville 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. The HSA plan is not considered Creditable Coverage.

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: Birdville ISD Benefits 3124 Carson Street Haltom City, Texas 76117 817-547-5782

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 Birdville 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.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

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 Birdville 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 Birdville 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.

Call 1-800-MEDICARE (1-800-6334227). TTY users should call 877486-2048.

We are required to provide this Notice of Privacy Practices to you pursuant to HIPAA.

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.

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.

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).

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:

For more information about this notice or your current prescription drug coverage: Contact the Benefits Department at 817547-5782. 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.

September 1, 2026 Birdville ISD Benefits 3124 Carson Street Haltom City, Texas 76117 817-547-5782

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 Birdville ISD’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.

Your past, present, or future physical or mental health or condition;

The provision of health care to you; or

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: Birdville ISD Benefits 3124 Carson Street Haltom City, Texas 76117 817-547-5782 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;

provide you with certain rights with respect to your PHI;

provide you with a copy of this Notice of our legal duties and privacy practices with respect to your PHI; and

follow the terms of the Notice that is currently in effect.

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.

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Important Legal Notices 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.

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.

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.

Treatment Alternatives or HealthRelated 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.

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.

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.

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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 work-related injuries or illness.

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 lawenforcement official. 1.

in response to a court order, subpoena, warrant, summons, or similar process;

to identify or locate a suspect, fugitive, material witness, or missing person;

Public Health Risks. We may disclose your PHI for public health activities. These activities generally include the following:

about the victim of a crime if, under certain limited circumstances, we are unable to obtain the victim’s agreement;

about a death that we believe may be the result of criminal conduct; and

to prevent or control disease, injury, or disability;

about criminal conduct.

to report births and deaths;

to report child abuse or neglect;

to report reactions to medications or problems with products;

to notify people of recalls of products they may be using;

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;

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.

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

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. 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:

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Important Legal Notices 1.

You have been, or may be, subject to domestic violence, abuse, or neglect by such person; or

Treating such person as your personal representative could endanger you; and

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.

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;

was not created by us, unless the person or entity that created the information is no longer available to make the amendment;

is not part of the information that you would be permitted to inspect and copy; or

VIII. Your Rights

is already accurate and complete.

You have the following rights with respect to your PHI:

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 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

Right to an Accounting of Disclosures. You have the right to request an “accounting” of certain disclosures of

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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. 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.

Important Legal Notices 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)

Alabama – Medicaid Website: http://www.myalhipp.com/ Phone: 1-855-692-5447 Alaska – Medicaid

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.

The AK Health Insurance Premium Payment Program Website: http:// myakhipp.com/ Phone: 1-866-251-4861 Email: CustomerService@MyAKHIPP. com Medicaid Eligibility: https://health. alaska.gov/dpa/Pages/default.aspx

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.

Health Insurance Premium Payment (HIPP) Program Website: http://dhcs. ca.gov/hipp Phone: 916-445-8322 Fax: 916-440-5676 Email: hipp@dhcs.ca.gov

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 1-877KIDS 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.

Arkansas – Medicaid Website: http://myarhipp.com/ Phone: 1-855-MyARHIPP (855-6927447) California– Medicaid

Colorado – Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus (CHP+) Health First Colorado website: https:// www.healthfirstcolorado.com/ Health First Colorado Member Contact Center: 1-800-221-3943/State Relay 711 CHP+: https://hcpf.colorado.gov/childhealth-plan-plus CHP+ Customer Service: 1-800-3591991/State Relay 711 Health Insurance Buy-In Program (HIBI): https://www.mycohibi.com/ HIBI Customer Service: 1-855-6926442 Florida – Medicaid Website: https://www. flmedicaidtplrecovery.com/ flmedicaidtplrecovery.com/hipp/index. html Phone: 1-877-357-3268 Georgia – Medicaid GA HIPP Website: https://medicaid. georgia.gov/health-insurancepremium-payment-program-hipp Phone: 678-564-1162, Press 1 GA CHIPRA Website: https://medicaid. georgia.gov/programs/third-partyliability/childrens-health-insuranceprogram-reauthorization-act-2009chipra Phone: 678-564-1162, Press 2

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Important Legal Notices Indiana – Medicaid Health Insurance Premium Payment Program All other Medicaid Website: https://www.in.gov/medicaid/ http://www.in.gov/fssa/dfr/ Family and Social Services Administration Phone: 1-800-403-0864 Member Services Phone: 1-800-4574584 Iowa – Medicaid and CHIP (Hawki) Medicaid Website: https://hhs.iowa. gov/programs/welcome-iowamedicaid Medicaid Phone: 1-800-338-8366 Hawki Website: https://hhs.iowa.gov/ programs/welcome-iowa-medicaid/ iowa-health-link/hawki Hawki Phone: 1-800-257-8563 HIPP Website: https://hhs.iowa.gov/ programs/welcome-iowa-medicaid/ fee-service/hipp HIPP Phone: 1-888-346-9562 Kansas – Medicaid Website: https://www.kancare.ks.gov/ Phone: 1-800-792-4884 HIPP Phone: 1-800-967-4660 Kentucky – Medicaid Kentucky Integrated Health Insurance Premium Payment Program (KI-HIPP) Website: https://chfs.ky.gov/agencies/ dms/member/Pages/kihipp.aspx Phone: 1-855-459-6328 Email: KIHIPP.PROGRAM@ky.gov KCHIP Website: https://kynect.ky.gov Phone: 1-877-524-4718 Kentucky Medicaid Website: https:// chfs.ky.gov/agencies/dms

Maine – Medicaid Enrollment Website: https://www. mymaineconnection.gov/benefits/ s/?language=en_US Phone: 1-800-442-6003 TTY: Maine relay 711 Private Health Insurance Premium Webpage: https://www.maine.gov/ dhhs/ofi/applications-forms Phone: 1-800-977-6740 TTY: Maine Relay 711 Massachusetts – Medicaid and CHIP Website: https://www.mass.gov/ masshealth/pa Phone: 1-800-862-4840 TTY: 711 Email: masspremassistance@ accenture.com Minnesota – Medicaid Website: https://mn.gov/dhs/healthcare-coverage/ Phone: 1-800-657-3672 Missouri – Medicaid Website: http://www.dss.mo.gov/mhd/ participants/pages/hipp.htm Phone: 573-751-2005 Montana – Medicaid Website: https://dphhs.mt.gov/ MontanaHealthcarePrograms/HIPP Phone: 1-800-694-3084 Email: HHSHIPPProgram@mt.gov Nebraska – Medicaid Website: http://www. ACCESSNebraska.ne.gov Phone: 1-855-632-7633 Lincoln: 402-473-7000 Omaha: 402-595-1178

Louisiana – Medicaid

Nevada – Medicaid

Louisiana Medicaid Website: https:// www.ldh.la.gov/healthy-louisiana Medicaid Customer Service Line: 1-888-342-6207 Louisiana Medicaid email: healthy@ la.gov Louisiana Health Insurance Premium Program (LaHIPP) Website: https:// www.ldh.la.gov/lahipp LaHIPP phone: 1-877-697-6703 LaHIPP email: La.HIPP@la.gov LaHIPP fax: 1-888-716-9787 LaHIPP mailing address: 100 Crescent Centre Parkway, Suite 1000 Tucker, GA 30084

Medicaid Website: http://dhcfp.nv.gov Medicaid Phone: 1-800-992-0900 New Hampshire – Medicaid Website: https://www.dhhs.nh.gov/ programs-services/medicaid/healthinsurance-premium-program Phone: 603-271-5218 Toll free number for the HIPP program: 1-800-852-3345, ext. 15218 Email: DHHS.ThirdPartyLiabi@dhhs. nh.gov

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New Jersey – Medicaid and CHIP Medicaid Website: http://www.state. nj.us/humanservices/dmahs/clients/ medicaid/ Phone: 1-800-356-1561 CHIP Premium Assistance Phone: 609631-2392 CHIP Website: http://www. njfamilycare.org/index.html CHIP Phone: 1-800-701-0710 (TTY: 711) New York – Medicaid Website: https://www.health.ny.gov/ health_care/medicaid/ Phone: 1-800-541-2831 North Carolina – Medicaid Website: https://medicaid.ncdhhs.gov Phone: 919-855-4100 North Dakota – Medicaid Website: https://www.hhs.nd.gov/ healthcare Phone: 1-844-854-4825 Oklahoma – Medicaid and CHIP Website: http://www.insureoklahoma. org Phone: 1-888-365-3742 Oregon – Medicaid Website: https://healthcare.oregon. gov/Pages/index.aspx Phone: 1-800-699-9075 Pennsylvania – Medicaid and CHIP Website: https://www.pa.gov/en/ services/dhs/apply-for-medicaidhealth-insurance-premium-paymentprogram-hipp.html Phone: 1-800-692-7462 CHIP Website: https://www.dhs. pa.gov/chip/pages/chip.aspx CHIP Phone: 1-800-986-KIDS (5437) Rhode Island – Medicaid and CHIP Website: http://www.eohhs.ri.gov/ Phone: 1-855-697-4347 or 401-4620311 (Direct RIte Share Line) South Carolina – Medicaid Website: https://www.scdhhs.gov Phone: 1-888-549-0820 South Dakota – Medicaid Website: https://dss.sd.gov Phone: 1-888-828-0059

Important Legal Notices Texas – Medicaid Website: https://www.hhs.texas.gov/ services/financial/health-insurancepremium-payment-hipp-program Phone: 1-800-440-0493 Utah – Medicaid and CHIP Utah’s Premium Partnership for Health Insurance (UPP) Website: https:// medicaid.utah.gov/upp/ Email: upp@utah.gov Phone: 1-888-222-2542 Adult Expansion Website: https:// medicaid.utah.gov/expansion/ Utah Medicaid Buyout Program Website: https://medicaid.utah.gov/ buyout-program/ CHIP Website: https://chip.utah.gov/ Vermont– Medicaid Website: https://dvha.vermont.gov/ members/medicaid/hipp-program Phone: 1-800-250-8427 Virginia – Medicaid and CHIP Website: https://coverva.dmas.virginia. gov/learn/premium-assistance/famisselect https://coverva.dmas.virginia.gov/ learn/premium-assistance/healthinsurance-premium-payment-hippprograms Medicaid/CHIP Phone: 1-800-4325924 Washington – Medicaid Website: https://www.hca.wa.gov/ Phone: 1-800-562-3022 West Virginia – Medicaid and CHIP Website: https://dhhr.wv.gov/bms/ http://mywvhipp.com/ Medicaid Phone: 304-558-1700 CHIP Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447) Wisconsin – Medicaid and CHIP Website: https://www.dhs.wisconsin. gov/badgercareplus/p-10095.htm Phone: 1-800-362-3002 Wyoming – Medicaid Website: https://health.wyo.gov/ healthcarefin/medicaid/programs-andeligibility/ Phone: 1-800-251-1269

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 Birdville ISD group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Birdville ISD plan after you have left employment with the company. If you wish to elect COBRA coverage, contact your Benefits Department for the applicable deadlines to elect coverage and pay the initial premium. Plan Contact Information Birdville ISD Benefits 3124 Carson Street Haltom City, Texas 76117 817-547-5782

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 outof-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-ofnetwork 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-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 poststabilization 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-of-network providers cannot balance bill you, unless you give written consent and give up your protections.

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Important Legal Notices 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-ofnetwork 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 outof-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-ofnetwork services toward your deductible and out-of-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 employment-based 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

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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 employmentbased 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.

Important Legal Notices 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 1-800-3182596. TTY users can call 1-855-8894325.

What about Alternatives to Marketplace Health Insurance Coverage?

PART B: Information About Health Coverage Offered by Your Employer

If you or your family are eligible for coverage in an employment-based 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 employmentbased health plan.

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: Birdville ISD 5. Employer Address: 3124 Carson Street 6. Employer Phone Number: 817-547-5782 7. City: Haltom City 8. State: TX

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/ getting-medicaid-chip/ for more details.

10. Who can we contact at this job?: Benefits 11. Phone Number (if different from above): N/A 12. E-Mail Address: https://birdvilleschools.net

How Can I Get More Information? For more information about your coverage offered through your employment, please check your health plan’s summary plan description or contact Benefits. 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.

9. ZIP Code: 76117

As your employer, we offer a health plan to all eligible employees (see the Eligibility section of this guide). This coverage meets the minimum value standard, and the cost of this coverage to you is intended to be affordable, based on employee wages. Indexed annually; see https://www.irs.gov/pub/ irs-drop/rp-22-34.pdf for 2023. 1

An employer-sponsored or other employmentbased 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. 2

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Notes

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Notes

Visit www.mybenefitshub.com/birdvilleisd for full plan details.

Important Legal Notices

This brochure highlights the main features of the Birdville 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. Birdville ISD reserves the right to change or discontinue its employee benefits plans anytime.