Annual Employee Benefit Enrollment

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The Humble ISDEmployee Benefit Program
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Enrollment Forms must be completed within 30 days
of your date of hire

• Coverage will go into effect following the first
  months premium payment.
• (example September deductions pay for October
  coverage)

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Effective 9-1-02

• The State will fund an additional 83 per
  employee, per month (paid in equal payments of
  41.67 per check), for your choice of

• 1. Pay health insurance premium

• 2. Buy supplemental insurance (dental, etc.)

• 3. Take the money as a salary increase

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Annual Benefit Review Process

• Everyone should receive

• HISD Benefit Plan Explanation with attachments

Which provides information about plans offered,
enrollment periods and required notification of
COBRA rights and an explanation of TRS funding

• a Benefit Plan Enrollment Form

• the TRS election form

Everyone must complete the TRS election form
and the Benefit Plan Enrollment Form.
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Health Insurance Options9-1-02

• Participate in Comprehensive Health Plan

• Traditional Health PPO

• HISD - EPO

• Opt for no health option

• Hospital Confinement/Dental Plan

• Waive participation in health insurance- you
  may participate in other supplemental
  coverage such as dental and receive the
  additional TRS 83.34 per month.

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HISD - EPO Plan

• An Exclusive Provider Organization (EPO) is
  simply a self-funded HMO.

• It relies on the Kelsey-Seybold network of
  providers for necessary health care.

• No referrals are necessary to see specialist
  within the Kelsey network.

• No coverage for health care outside the network.

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Kelsey-Seybold - Location Map
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Traditional Health PPO

• Allows you to choose your provider, either in the
  network or out of the network.
• Has a network of independent physicians and
  hospitals throughout the greater Houston area and
  the plan pays a higher benefit if you use
  someone in the network.
• Allows you to go outside the network and will
  still pay benefits.

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-Traditional Health HISD PPO
Non-PPO EPO
Deductible 50
200 none Co-Insurance 85
65 n/a Out-Of Pocket Max. 2,000
5,000 n/a Physician Office Visit Co-Pay
subject to deductible 20
co-insurance Lab Work/Radiology
20 Hospital Admission
100
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PRESCRIPTION PROGRAMS Traditional
HISD PPO EPO Retail Annual
Deductible 25 n/a Generic 10 5
Formulary 20 15 Non-Formulary 50
n/a Mail-Order
Generic 20 10 Formulary 40 40
Non-Formulary 60 n/a
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Monthly Employee Health Insurance Costs
Reminders Rates will be further reduced by the
TRS 83.34 monthly funding, if you choose to use
the funds in this manner.
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Example

• TRS Funds
• Less Health Insurance Premiums
• Less Dental Insurance Premiums
• Balance Remaining to be received as additional pay

• - 83.34

• - 40.00

• - 30.00

• 13.34

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Optional Coverages Available

• Additional Life Insurance - up to 1 x annual
  salary.

• Short-Term Disability - with a 30 or 60 day
  waiting period, pays 2/3 lost wages

• Dental Insurance

• Optical Insurance through VSP

• (consult the newsletter for details on plan
  benefits and premiums)

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Forms that must be completed

• HISD Benefit Plan Enrollment Form.

• TRS Election Form.

• If you are planning to participate in any one of
  the following plans, you must complete the plan
  enrollment form

• Traditional Health PPO

• HISD - Exclusive Provider Organization (EPO)

• Dental Plan

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Reminders

• Forms must be completed within thirty days of
  your date of hire

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Reminders
For most employees, premium deductions effect
your September payroll checks.Coverage goes into
effect October 1st.
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Reminders

• For an earlier coverage date (i.e. September 1st)
• you may pre-pay your share of the required
  premium by personal check.
• Simply make your check payable to Humble ISD and
  turn in with your enrollment form.

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Welcome to the district.

• Should you require additional information about
  our benefit programs, you may
• visit our website
• www.humble.k12.tx.us/employee_benefits.htm
• or phone us at 281-641-8050

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