2024 Employee Benefit Guide

2024 E mployee B enefits G uide

H elping Y ou B ecome a B etter Y ou .

Non - Discrimination Disclosure

It is the policy of the School District of Clayton not to discriminate on the basis of race, color, religion, sex, national origin, ancestry, disability, age, genetic information or any other characteristic protected by law, in its programs or employment practices as required by Title VI and VII of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975 and Title II of the Americans with Disabilities Act of 1990. Behavior that is not unlawful or does not rise to the level of illegal discrimination, harassment or retaliation might still be unacceptable for the workplace or the educational environment. Demeaning or otherwise harmful actions are prohibited, particularly if directed at personal characteristics. Accordingly, the District prohibits discrimination, harassment or retaliation on the basis of socioeconomic level, sexual orientation, perceived sexual orientation or gender identity. Inquiries or concerns regarding civil rights compliance should be directed to Robyn Wiens, the Title XI/Non - Discrimination Coordinator. Inquiries related to the District ’ s student programs should be directed to Robyn Wiens, Assistant Superintendent of Student Services, School District of Clayton, #2 Mark Twain Circle, Clayton, Missouri, 63105 or by phone at (314) 854 - 6023. Inquiries or concerns regarding civil rights compliance by school districts should be directed to the local school district Title IX/ N on - D iscrimination C oordinator. Inquiries and complaints may also be directed to the Kansas City Office, Office for Civil Rights, US Department of Education, 8930 Ward Parkway, Suite 2037, Kansas City, MO 64114; (816) 268 - 0550; TDD (877) 521 - 2172.

School District of Clayton

#2 Mark Twain Circle

Clayton, Missouri 63105

(314) 854 - 6000

The purpose of this booklet is to describe the highlights of your benefit program. Your specific rights to benefits under the Plans are governed solely, and in every respect, by the official Plan documents and insurance contracts, and not by this booklet. If there is any discrepancy between the description of the Plans as described in this material and official Plan documents, the language of the official plan documents shall govern.

Contact Information & Table of Contents

CONTACTS The School District of Clayton in partnership with the following carriers, strives to meet your benefit needs. If you have any questions regarding your benefits, please contact the corresponding carrier listed below or call the Business Office at 314 - 854 - 6024.

TABLE OF CONTENTS

INTRODUCTION

Non - Discrimination Disclosure ………………… . 1 Understanding Your Plan Options .................... 3

Medical

Anthem Group Number: W60496

Eligibility ........................................................... 4

anthem.com 800.490.6145

Frequently Asked Questions ............................ 4

Dental

HEALTH AND WELFARE

Guardian Dental Group Number: 00025763 guardiananytime.com 888.600.1600 Cigna DHMO Group Number: 10050105 Cigna.com 800.244.6224

Medical Plans ................................................... 5

Medical Plan Network Options .……………….. 6

Health Savings Account (HSA) ........................ 7 Flexible Spending Account (FSA) … ... ………… 9 Dental Insurance. ............................................ 10 Vision Insurance ............................................ 12 Anthem Health & Wellness ............................. 13

Vision

EyeMed Group Number: 1018839

eyemed.com 866.939.3633

Care Options ……………………..……………...15

LIFE AND DISABILITY

Basic Life/AD&D, Voluntary Life/AD&D, & LTD Equitable Group Number: 04320

Basic Life and Accidental Death &

ebcustomerservice@equitable.com 866.274.9887 Option 3, then Option 8

Dismemberment (AD&D) ............................... 17

Voluntary Life and Accidental Death &

Voluntary Worksite Benefits Trustmark

Dismemberment (AD&D) ............................... 17

www.trustmarkbenefits.com 800.918.8877

Long - Term Disability ...................................... 18

SUPPLEMENTAL BENEFITS

Employee Assistance Program (EAP) PAS

Voluntary Worksite Policies ............................ 19

paseap.com 800.356.0845 Company ID: Clayton Schools

Employee Assistance Program ………………. 20

ENROLLMENT

Flexible Spending Account CBIZ Flex myplans.cbiz.com 800.815.3023 Fax: 800.584.4185 CSD Retirement Trust—AIG Shane Hurst 314 - 439 - 4850 Shane.hurst@aig.com

How to Enroll .................................................. 21

Mobile App ..................................................... 22

Important Benefit Information ......................... 23

FOR YOUR INFORMATION

Important Notices ........................................... 24

Glossary of Terms .......................................... 29

CBIZ Consultant Eric File

efile@cbiz.com 314.692.5848

INTRODUCTION

Understanding Your Plan Options

When the School District of Clayton reviews our employee benefits options, we focus not only on providing quality medical plans but also on controlling the cost and financial risk for employees. We are proud to offer a broad benefits package to eligible, full - time employees. The complete benefits package is briefly summarized in this booklet. T he School District of Clayton provides some benefits at no premium cost to you. Based upon your benefit selections, you may share the premium cost. In addition, there are voluntary benefits with reasonable group rates that you can purchase through the School District of Clayton with payroll deductions.

Benefits Offered

◼ Three medical plans administered by Anthem: a Base Plan, Buy - Up Plan, and a Qualified High Deductible Health Plan (QHDHP). If you select the QHDHP, the District contributes $125 per month from the allotment into your Health Savings Ac- count. ◼ Each medical plan offers a choice of either a Blue Access Choice full network which includes the BJC provider network or the Blue Preferred Select narrow network which does not include the BJC provider network. The District offers several plans at no premium cost to the employee. Additionally, the District subsidizes the spouse/dependent premiums of medical plans.

◼ Two dental plans - one is offered through Guardian Dental PPO and the other through Cigna DHMO.

◼

Vision plan through EyeMed.

◼ Basic Life / AD&D and Supplemental Life / AD&D offered through Equitable.

◼ Long - Term Disability offered through Equitable.

◼ Worksite products to include Critical Illness, Accident and Universal Life with Long - Term Care offered through Trustmark.

◼ The District provides eligible employees an allotment to help pay for the employee premium for medical, dental and vision plans. The 202 4 total allotment is $84 8.54 per month per eligible employee ($800 medical, $41.72 dental, $6.82 vision).

◼ The District offers an $1,800 stipend to any employee who elects to waive medical coverage. The stipend is divided equally over the course of the plan year on each pay date. You must be eligible for the medical insurance and prove you are covered elsewhere. A signed waiver is required and the stipend is paid as taxable income.

What ’ s Inside? This brochure provides an overview of your benefit options. If you have any questions after you enroll, please call the carriers directly or log on to their websites.

Eligibility

The Board defines a benefit eligible, full - time employee as a staff member the District reasonably expects to work an average of 30 hours or more per week. Eligible employees who are hired on a full - time basis, and the letter of employment or contract start date is the first day of the month, are eligible for coverage on th at date. All other full - time new-hires are eligible for coverage on the first day of the following month.

WHO CAN YOU ADD TO YOUR PLAN:

Eligible:

Ineligible:

■

Your legal spouse

A common law spouse/domestic partner

■

■ Your or your spouse ’ s child who is under age 26 ■ Legally adopted child or a child placed for adoption ■ Child for which you or your spouse is the legal guardian ■ A disabled child who is unmarried and over age 25 ■ A child for whom health care coverage is required through a Qualified Medical Child Support Order or other court order

Divorced or legally separated spouse

■

Foster children

■ Sisters, brothers, parents, in - laws, grandchildren, etc.

Frequently Asked Questions

ARE CHANGES TO MY PLAN ALLOWED DURING THE YEAR?

Generally, you may only enroll in the plan, or make changes to your benefit selections, during the open enrollment period or when you are first hired. However, you may make changes/enroll during the plan year if you experience a Qualifying Life Event (QLE). As with a new enrollee, you must have your paperwork turned in within 30 days of the qualifying life event or you will have to wait until the next annual open enrollment period. Premiums and enrollment eligibility may change; see the Business Office for details. EXAMPLES OF QUALIFYING EVENTS :

■

You have a baby or adopt a child

Death of an insured member

■

Gain or loss of Medicaid entitlement

You become eligible for Medicare

■ You or your spouse take an unpaid leave of absence ■

You get married, divorced, or legally separated (with court order)

■ Your dependents or you lose health coverage because of loss of eligibility or loss of employer contributions

HEALTH AND WELFARE

Medical Plans

Below is a summary of the three medical plan options available beginning January 1, 202 4 . It is to your advantage to use in - network providers . If you go out - of - network, you will be responsible for any amount exceeding Anthem ’ s negotiated discounts plus any deductible and co - insurance associated with your procedure.

The in - network benefits for each plan are illustrated side - by - side below so that you can compare them. Please refer to the Anthem Benefit Summaries for out - of - network - benefits associated with each of these options and more detailed information.

Plan Designs - Administered by Anthem

Qualified High Deductible Health Plan*

Features

Base Plan

Buy - Up Plan

In-Network Deductible (per calendar year) (Individual / Family)

$3, 200 / $6, 4 00 (Embedded)

$750/$1,500

$300/$600

Deductible is Calendar Year

Out - of - Pocket Maximum (per calendar year) (includes deductibles & copays - RX copays do not apply for Base and High Plans) (Individual / Family)

$3,500/$7,000

$3,000/$6,000

$4,000/$8,000

Coinsurance (the amount the plan pays)

80%

90%

Office Visits (Preventive— 100% in - network)

$30 Primary Care Physician $60 Specialist

$25 Primary Care Physician $50 Specialist

Deductible & Coinsurance

LiveHealth Online

$30 Copay

$25 Copay

$49 Copay after deductible

Inpatient Hospital

Deductible & Coinsurance

Outpatient Surgery

Deductible & Coinsurance

Lab, X - Ray and Diagnostic

Deductible & Coinsurance

Urgent Care

$50 Copay

$50 Co - Pay

Deductible & Coinsurance

Emergency Room

$300 Copay

$200 Co - Pay

Deductible & Coinsurance

Prescription Drug ( Carelon Rx) Retail Pharmacy Mail Order Pharmacy

$10 / $40 / $70 / $150 2 Copays

Deductible & Coinsurance Deductible & Coinsurance

$10 / $40 / $70 / $150 2 Copays

*If you elect to enroll in the Qualified High Deductible Health Plan (QHDHP), you are required to enroll in the Health Savings Account. The District requires $125 per month from the benefit allocation to be deposited into your Health Savings Account. The School District of Clayton offers employees the ability to choose between two network options for each medical plan .

◼ Full Network —This network includes all the hospitals and affiliated physicians in the Anthem network. This is the Anthem Blue Access Choice network.

◼ Narrow Network (No BJC) - The narrow network plans have a lower premium (approximately 6% lower), but as a trade - off, your choice of providers is limited. This network excludes all BJC hospitals and affiliated physicians. This is the Anthem Blue Preferred network.

Medical Plan Network Options

Medical Plan Network Options It is important to know your network, and the providers in it, to avoid high er out - of - pocket costs due to being out - of - network. ◼ You might consider a narrow network if you are healthy. The lower premium may balance out the smaller net- work if you usually only visit your doctor for regular health exams. Narrow networks can be enough if you don ’ t see a lot of specialists or need many medical tests. ◼ You might need a larger network if you or a family member needs a lot of care. If you have a chronic health problem like diabetes or heart disease, a narrow network could limit your choices. If you leave your network, your out - of - pocket costs could add up quickly. Be sure to study each network with care to make sure you are able to visit your regular providers. Search the plan ’ s list of providers (available online) by your zip code. See if your provider or how many other providers are close to where you live and work. Below is a sample list of hospitals that are not included in the narrow network:

Alton Memorial

Northwest Healthcare

All Barnes - Jewish Hospitals

Parkland Health Center

Christian Hospital

Progress West Hospital Rehab Institute of St. Louis

Goldfarb School of Nursing

Memorial Hospital East & Belleville

St. Louis Children ’ s Hospital

Missouri Baptist Medical Center & Sullivan

Washington University

This is not a complete list of excluded providers. Be sure to check with your provider to confirm which network they are affiliated with. This also applies to urgent care, outpatient and imaging centers. A complete list of providers can be found on the Anthem website. If you enroll in the narrow network option, you will be required to sign a document stating you understand the provisions of this plan and that if you go to a BJC provider in this option for a non - emergency visit, the cost will be subject to your out - of - network benefits. If you choose to “ waive ” the medical coverage, you will receive a monthly opt out allocation of $150 . In order to receive this allocation, you must return the “ waiver form ” to the Business Office. This form is available on the Benefit Allocation page on the enrollment website.

Employee Share of Medical Premiums (Monthly)

Coverage Type

Base Plan

Buy - Up Plan

QHDHP

Narrow Network

Narrow Network $ 117 .00 $6 96 .00 $ 531 .00 $1,1 84 .00

Narrow Network

Full Network

$1 65. 00

Employee

$0.00

$4 72 .00 $ 328 .00 $8 72 .00

$ 384 .00 $2 4 8.00 $7 48 .00

$ 240. 00 $1 20 .00 $54 4 .00

$ 173 .00 $6 0 .00 $4 47 .00

Employee/Spouse

$785.00

$ 612 .00

Employee/Children

$1, 309 .00

Family

Health Savings Account (HSA)

What is an HSA?

A savings account set up by either you or your company where you can either direct pre - tax payroll deductions or deposit money to be used by you to pay for current or future medical expenses for you and/or your dependents. Once money goes into the account, it's yours to spend on eligible healthcare costs. The HSA is held in your name, just like a personal checking or savings account.

Why would I want an HSA?

Because you fund the HSA with pre - tax funds, you are using tax - free funds for healthcare expenses you would normally pay for out - of - pocket using after - tax dollars. HSA contributions do NOT count toward your taxable income for federal taxes.

What Rules Must I Follow?

■ You must be covered under a Q ualified High Deductible Health Plan (QHDHP) in order to establish an HSA.

■ You cannot establish an HSA if your spouse has a medical flexible spending account (FSA) through their employer.

■ You cannot set up an HSA if you have insurance coverage under another plan, for example your spouse ’ s employer, unless that secondary coverage is also a qualified high deductible health plan.

■ You cannot be enrolled in Medicare or Tricare.

■ You cannot be claimed as a dependent under someone else ’ s tax return.

What is the Difference Between a Qualified High Deductible Health Plan and a Traditional PPO Plan?

In a QHDHP, all services received, with the exception of preventive office visits, are applied to the deductible and coinsurance first. This would include office visits that are not preventive, emergency room visits, and prescription drugs. You will, however, still have the opportunity to benefit from the discounts associated with using a network physician or facility. If you or your family have high prescription drug costs, you may want to consider the Base plan over the QHDP to help cover those expenses.

What Else Do I Need to Know?

■ The IRS sets HSA contribution limits yearly, which are listed under “ Total Annual Maximum Contribution ” in the table below. You cannot put more than this amount in the account in a calendar year; you can put less.

■ HSA contributions from your paycheck are tax - free, grow tax - free, and are paid out as tax - free as long as you utilize the fu nds for approved services (medical, dental, vision and OTC medically-necessary items).

202 4 Total Annual Maximum Contribution

$ 4,150 $ 8,300

Employee

Employee + Family

■ Unspent contributions roll over from year to year and can be taken with you if you leave your current job.

■ If you use the HSA for non - qualified expenses, that money becomes taxable and subject to a 20% excise tax penalty (like in an IRA account). ■ Once you turn 65, become disabled and/or qualify for Medicare, you can use the account for other than eligible medical purposes without paying the 20% penalty, but you will pay income taxes. ■ The savings account can be established with your employer, so you can take advantage of payroll deductions on a pre - tax basis. ■ The $1,500 employer contribution is not front - loaded and will be evenly allocated over each pay period throughout the benefit year and will be prorated based on calendar date of hire for a new enrollment or qualifying life event plan change.

Health Savings Account (HSA) cont ’ d.

Generally, you can put enough in your HSA to cover most of your deductible .

The Qualified High Deductible Health Plan helps you pay for healthcare AFTER you meet the deductible. The annual contribution limit is based on IRS rules. In general, the total amount that goes in your account each year cannot be more than the IRS annual contribution limit. If you are age 55 or older, you are allowed to make an extra $1,000 catch - up contribution each year. You can spend only the money that is actually in your HSA. If your healthcare expenses are more than your HSA balance, you need to pay the remaining cost another way, such as cash or personal check. You can request reimbursement after you have accumulated more money.

Facts and tips Your account can grow over time... Since the money always belongs to you, even if you leave The School District of Clayton, any unspent funds carry over from year to year, so you never have to worry about losing your money. That means if you do not use a lot of healthcare services now, your HSA funds will be there if you need them in the future – even after retirement. HSA ’ s are also an investment opportunity … With an HSA, your account can grow tax - free in an interest - bearing savings account, a money market account, a wide variety of mutual funds – or all three. Of course, your funds are always available if you need them for qualified healthcare expenses.

You can use your HSA for your spouse and dependents – even if they are not covered by your High Deductible Health Plan.

You can use HSA funds for IRS - approved items such as …

Physical & speech therapy

Orthodontia, cleanings & fillings

Dental services

Doctor ’ s office visits

Eye exams & eyeglasses

Laser eye surgery

Hearing aids

Chiropractic expenses

Contact lenses & solution

Prescription drugs

More information about approved items, plus additional details about the HSA, is available on the IRS Website at irs.gov .

Every time you use your HSA, save your receipt in case the IRS asks you to prove your claim was for a qualified expense. If you use HSA funds for a non - qualified expense, you will pay taxes and a penalty on the ineligible amount.

Flexible Spending Accounts (FSA)

Any amount contributed to your FSA account but not spent or used by December 31, 202 4 is lost to the account holder. Money in your FSA does NOT roll over and must be used by December 31, 202 4 . You will have 90 days after 12/31/2 4 to turn in all receipts for medical expenses incurred in 202 4.

Administered by CBIZ Flex , Flexible Spending Accounts (FSA) allow an employee to set aside a portion of earnings to pay for qualified expenses as established in the cafeteria plan. Money deducted from an employee's pay into an FSA is not subject to payroll taxes, resulting in substantial payroll tax savings. Open enrollment allows you the opportunity to enroll in and/or increase your election amounts for your Flexible Spending Account. Therefore, now is the time to gauge how much you utilize your benefits and how much money you spend in deductibles and copayments each year so that you can properly enroll in the FSA . Please note, you must set up an ACH Direct Debit through CBIZ for reimbursement. Medical Reimbursement FSA This account allows employees the opportunity to pay for eligible medical, dental, and vision expenses that are not paid in full through insurance coverage. Many members use this account for deductible amounts, copayments, eyeglasses, over the counter medications with a physician ’ s prescription, root canals, etc. You may contribute a maximum of $ 3,050 during 202 4 , measured January 1 through December 31. You cannot contribute to an FSA if you are enrolled in the QHDHP. Dependent Care Reimbursement FSA May be used to set aside pre - tax dollars that are used to pay for daycare expenses for a child under age 13 or the care of a disabled spouse or dependent of any age. You and your spouse must both work or be full - time students to qualify. You are allowed to contribute a maximum of $5,000 during 202 4 to the Dependent Care FSA if you are married and filing a joint tax return or are filing a single head of household tax return. Married couples filing separate returns are allowed to claim a maximum of $2,500 each. In most cases, there is substantially more tax savings with this plan than there is with the “ tax credit ” that you get when doing your tax return. It is best to discuss your options with your tax advisor if you have any concerns. Employees may participate in a Health Savings Account (HSA) along with a Dependent Care FSA.

Facts and tips Tracking your health care deductibles can help you make better decisions at open enrollment time when considering a Medical Reimbursement FSA. Know the following:

◼

The total amount of your deductibles

◼ What expenses don ’ t count towards your deductible ◼ How often you actually meet your deductible ◼ Medical exams or services you ’ ll need during the year

Below is a partial list of eligible expenses that can be reim- bursed from a Medical Reimbursement Account. Other out - of - pocket expenses may qualify.

Alcoholism treatment

Laboratory fees

Artificial limbs

Licensed osteopaths

Ambulance

Licensed practical nurses

Braces

Orthodontia

Chiropractors

Orthopedic shoes

Coinsurance and copay- ments

Obstetrical expenses

Contact lens solution

Oxygen

Contraceptives

Prescription drugs

Crutches

Podiatrists

Deductible amounts

Prescribed vitamin Supplements (medically necessary)

Dental expenses

Psychiatric care

Dentures

Psychologist expenses

Dermatologists

Routine physical

Diagnostic expenses

Seeing - eye dog expenses

Eyeglasses, including exam fee Handicapped care and sup- port

Smoking cessation programs

Sterilization and reversals

Nutrition counseling

Substance abuse treatment

Hearing devices and batter- ies

Surgical expenses

Hospital bills

Dental Insurance—Guardian Dental PPO

To find a participating dentist, visit www.guardiananytime.com . The list of available dentists is not guaranteed and it is advisable to ask your dentist if they are currently participating or accepting new patients. Although the Guardian Dental plan allows you the freedom to visit any licensed dentist, you will save more on your out - of - pocket costs when you visit a Guardian PPO dentist. The Guardian Platinum network also provides cost saving features and is the next best option. Ask your dentist if they are a Guardian Platinum or Gold/Silver provider to choose the plan that ’ s right for you. The dentist you choose could affect your cost.

Plan Design - Administered by Guardian Dental

Facts and tips You are always free to select the dentist of your choice. However, if you choose a dentist who does not participate in the Guardian program, your out - of - pocket expenses may be greater, since you will be responsible to pay for any difference between the dentist's fee and your plan's payment for the approved service. If you receive services from a participating dentist, you are only responsible for the difference between the in - network fee for the service provided and your plan's payment for the approved service. Please note: any plan deductibles must be met before benefits are paid.

Features

Platinum

Gold/Silver

Non Contracted

Deductible (Calendar Year) (Individual / Family)

$50 / $150

Type I - Preventive Care: (Exams, Cleanings, X - rays) Type II - Basic Procedures: (Fillings, Extractions) Type III —Major Procedures: (Caps, Crowns, Bridges, Dentures)

100% (No Ded.)

80%

90%

60%

50%

Endodontics:

90%

80%

Periodontics:

90%

80%

Type IV —Orthodontia: (dependent children under age 19)

50% to $2,000 Lifetime Maximum

Maximum Benefits/Year

$2,000

◼ Certain services may have frequency and/or age limitations. The limits are described in the Guardian Dental Certificate of Coverage or you can contact Guardian Customer service for specific details.

Monthly Dental Employee Cost Coverage Type

The amounts shown are the employee share of premium after the district $ 41.72 monthly dental benefit allotment.

Employee

$ 41.72 $ 60.02 $ 101.79

Employee/Spouse

Employee/Children

Family

Dental Insurance—Cigna DHMO

Following is a sample schedule of the Cigna DHMO patient charge schedule:

CODE

PROCEDURE

PATIENT PAYS

Facts and tips

D1110

Adult Cleaning

No Charge

D0270

Bitewings

No Charge

◼ You are responsible for a $5 office visit fee per patient, per office visit. ◼ You have to be on the dentist ’ s roster in order to receive treatment. ◼ Check the Patient Charge Schedule K1 - V9 before receiving services to know your responsibility.

D0330

Panoramic X - Ray

No Charge

D2330

Composite - Surface

No Charge

D2140

Amalgam - 1 surface

No Charge

D2752

Crown - Porcelain

$425

D6794

Crown - Titanium

$460

◼ The Patient Charge Schedule K1 - V9 is located

D3310

Root Canal - Anterior

$210

in the EMB Resource page, or you can contact the Business Office for a copy.

D3320

Root Canal - Bicuspid

$245

D3330

Root Canal - Molar

$335

◼ If a procedure is not shown in the schedule, it is not covered .

D4210

Gingivectomy 4 per Quad

$180

D5110

Full Upper Denture

$625

D5120

Full Lower Denture

$625

Implant supported porcelain/ ceramic crown

D6065

$790

Monthly Dental Employee Cost

Ortho

24 - Month Treatment Fee

$2,040

Allotment Balance

Coverage Type

($ 14.38 )

Employee

The amounts shown are the employee share of premium after the district $ 41.72 monthly dental benefit allotment.

$ 6.19 $ 8.98 $ 35.12

Employee & Spouse

Employee & Child(ren)

Employees cannot opt out of a dental or vision plan.

Employee & Family

Vision Insurance—EyeMed

The District provides vision insurance for employees at no cost. You may elect coverage for your spouse and/or children; however, you will be responsible for the premium to cover your dependents. Please notice out - of - network services only provide a reimbursement benefit. You will have to pay for services first then file a claim with EyeMed.

Facts and tips

Plan Design - Administered by EyeMed

Frequency of Service:

Exam: Every 12 months Lenses: Every 12 months Frames: Every 24 months

Coverage Type

In - Network

Out - of - Network

Examination Co - Pay

Up to $35 Reimbursement

$0 Co - Pay

◼

Contact lens allowance is for lenses. In - network providers are contracted to charge no more than $40 for the standard contact lens fit and follow up exam. UCR refers to Usual, Customary and Reasonable charges. To determine the UCR, EyeMed takes the procedural charge of area providers and calculates an average. Charges above this average become your responsibility.

Lenses: Single Bifocal Trifocal

$5 Copay; then: $0 Copay $0 Copay $0 Copay

Allowance $35 $45 $60

$50 Wholesale Allowance $125 to $150 Retail

$35 Retail Allowance

◼

Frame

Contact Lenses: Necessary Elective

UCR $130 Allowance

$250 Allowance $130 Allowance

You will receive a monthly benefit allotment of $6.82 from which your vision cost will be deducted.

Monthly Vision Employee Cost

Coverage Type

Employee

Employee & Spouse

$6.14

Employee & Child(ren)

$6.82

Employee & Family

$13.24

The amounts shown above are the employee contributions after the $6.82 monthly vision benefit allotment

Anthem Health & Wellness Resources

As an Anthem member, you have access to health and wellness tools that can change the way you think about healthcare and how you use your benefits. They were designed with YOU in mind, so you can use them when and where you want to.

SYNDEY—Anthem ’ s newest app is simple, smart and all about YOU. With Sydney you can find everything you need to know about your Anthem benefits—personalized and all in one place. Sydney makes it easier to get things done, so you can spend more time focused on your health.

myStrength—is a free online and mobile program that supports emotional health and well - being. The pro- gram ’ s tools and resources are available to help you manage addiction, depression, anxiety, sleep problems, chronic pain and stress. To access myStrength, visit anthem.com/mystrengthMO. After you are registered online, you can download the myStrength app for easy access wherever you are.

MyHealth Advantage connects your claims, doctor reports, personal health history and other information for a bigger picture of your health. If we see things you can act on to help improve your health or save money, you ’ ll get a MyHealth Note—a confidential health summary that includes money - saving tips, prescription drug up- dates, reminders for checkups, tests and exams, list of recent claims and general health tips. The program can help you keep health issues from developing or becoming serious. And that means lower health care costs down the road. MyHealth Notes can also be accessed through the Sydney app. LiveHealth Online. Visit a doctor 24/7 to get expert advice, a treatment plan and prescriptions if needed. Whether you have a medical issue, allergy concern or need behavioral health services, LiveHealth Online can help. It ’ s free to sign up, there are no monthly fees. Simply sign up or log in, select a doctor and feel better fast. Sign up at livehealthonline.com or download the app by searching LiveHealth Online in the App Store or Plan Store. LiveHealth Online can also be accessed through the Sydney app. LiveHealth Online Psychology. You can get help for conditions such as stress; anxiety; depression; family or relationship issues; grief; panic attacks; stress from coping with a sickness. ConditionCare. Get the added support you may need if you have asthma, diabetes, heart disease, chronic obstructive pulmonary disease or heart failure. A nurse coach can answer questions about your health and help you reach your goals based on your doctor ’ s plan. You can work with dietitians, health educators, phar- macists and social workers to reach those goals and feel your best. After you select your plan, you can sign up for ConditionCare by calling 866 - 962 - 1069.

24/7 NurseLine. Registered nurses can answer your health questions wherever you are—anytime, day or night by calling 800 - 337 - 4770.

Future Mom. Moms - to - be get personalized support and guidance from registered nurses to help them have a healthy pregnancy, a safe delivery and a health baby. After you select your plan, you can sign up for Future Moms by calling 800 - 828 - 5891.

Anthem.com—Health and Wellness Resources. Anthem ’ s online wellness health support is your one - stop shop for health and wellness resources. The programs help you achieve your health goals by providing a per- sonalized action plan, plus access to both Anthem and WebMD health improvement programs. To access the online wellness help support, visit anthem.com and select Health and Wellness Center under the Care tab.

Anthem Health & Wellness Resources (con ’ t)

Get Started with Sydney.

To download the app:

◼ On your Apple device, open App Store. On your Android device, open Play Store.

◼ Enter Sydney into the search bar and select Download.

Once downloaded, the Sydney logo will appear on your device.

Already using the Anthem app? It ’ s easy to make the switch. Simply download the Sydney app and log in with your Anthem username and password.

Care Options

While we recommend that you seek routine medical care from your primary care physician whenever possible, there are alternatives available to you. Services may vary, so it ’ s a good idea to visit the care provider ’ s website. Be sure to check that the facility is in - network by calling the toll - free number on the back of your medical ID card, or by visiting anthem.com . . PRIMARY CARE - For routine, primary/preventive care, or non - urgent treatment, we recommend going to your doctor ’ s office for medical care. Your doctor knows you and your health history, and has access to your medical records. You may also pay the least amount out - of - pocket when you receive care in your doctor ’ s office. VIRTUAL VISITS - Lets you see and talk to a doctor from your mobile device or computer without an appointment, anytime and anywhere! Anthem ’ s LiveHealth Online brings you care from the comfort and convenience of your home or wherever you are. CONVENIENCE CARE - Sometimes, you may not be able to get to your doctor ’ s office, and your condition is not urgent or an emergency. In these situations, you may want to consider a Convenience Care Center that can be an alternative to seeing your doctor. Convenience Care Centers are conveniently located often in malls or some retail stores, and offer services without the need to schedule an appointment. Services at a Convenience Care Center may be provided at a lower out - of - pocket cost than an urgent care center visit and are subject to primary care physician office visit copays and/or deductible/coinsurance. Services at a Convenience Care Center are generally available to patients 18 months of age or older. Services that are available may vary per center. We do, however, recommend that you seek routine medical care from your primary care physician whenever possible.

Facts and tips You have options when it comes to you or your loved ones ’ care. This list only provides examples and is not intended as an exclusive list. If you believe you or your loved one is experiencing an emergency medical condition, you should go to the nearest emergency room or call 911, even if your symptoms are not described here.

• Routine, primary/ preventive care • Non - urgent treatment

Primary Care

• Cold/flu • Diarrhea • Fever

• Rash • Sinus

Virtual Visits

Problems

• Common infection (ear infections, pink eye, strep throat) • Flu shots • Pregnancy tests

Convenience Care

• Sprains • Small cuts • Strains • Sore throats

• Minor

infections • Vaccinations • Screenings

Urgent Care

To find an in - network Convenience Care Center near you, visit Anthem ’ s website at anthem.com .

• Heavy

• Spinal

bleeding

injuries • Difficulty breathing • Major burns

URGENT CARE - Sometimes you may need medical care fast, but a trip to the emergency room may not be necessary. Of course, during office hours, you may be able to go to your doctor for any urgently needed service; however, if you require urgent care outside your doctor ’ s regular office hours or you are unable to be seen by your doctor immediately, you may consider going to an urgent care center. At an urgent care center, you can generally be treated for many minor medical problems faster than at an emergency room. We do however, recommend that you seek routine medical care from your primary care physician whenever possible.

• Large open

Emergency Room

wounds

• Chest pain

Care Options cont ’ d.

Services that are available for urgent care may vary per center. If you choose to use an urgent care center, please make sure it is in - network by calling the toll - free number on the back of your medical ID card or visiting Anthem ’ s website at anthem.com .

LAB SERVICES - Both Quest and LabCorp are Anthem preferred labs.

EMERGENCY ROOM - If you think you or your loved one may be experiencing an emergency medical condition, you should go to the nearest emergency room or call 911. An emergency medical condition is any condition (including severe pain), which you believe that without immediate medical care may result in: ■ Serious jeopardy to you or your loved one ’ s health, including the health of a pregnant woman or her unborn child ■ Serious impairment to you or your loved one ’ s bodily functions ■ Serious dysfunction of any of you or your loved one ’ s bodily organ or part

If you obtain care at an emergency room, you will likely pay more out - of - pocket than if you were treated at your doctor ’ s office, a Convenience Care Center or Urgent Care facility.

PRESCRIPTION BENEFITS - Most prescriptions are filled right away when you take them to the pharmacy. However, some drugs need to be reviewed by Anthem and approved before they are covered. This process, called prior authorization , helps ensure drugs are used as recommended by the FDA. Prior authorization focuses mainly on drugs that may have:

■ Risk of serious side effects or dangerous drug interactions ■

Better alternatives that may cost you less

■

■ Restrictions for use with very specific conditions

High potential for incorrect use or abuse

Prior authorization may require you to take an additional step when you are prescribed certain medications, but the long - term gain is lower out - of - pocket prescription costs for you and reduced claims expense for The School District of Clayton and potentially lower future renewal increases. Some prescription drugs are covered only if the physician obtains prior authorization from Anthem. In addition, coverage for some drugs is provided in limited quantities and duration.

This is only a brief summary of benefits. The Certificate, issued when coverage is approved for the group, contains program details, and will, in all cases, have control over any information in this summary. The certificate is available upon request.

PREVENTIVE CARE - Certain preventive services will be covered without charging a deductible, copayment, or coinsurance when these services are provided by a network provider. The types of preventive services covered are defined by federal law and can vary based on your age, gender, and health status. There may be services you had in the past that will now be covered as preventive at no cost to you. The preventive services included in this provision are described at healthcare.gov. WOMEN ’ S PREVENTIVE CARE COVERAGE - Your health plan will provide first dollar coverage for certain women ’ s preventive coverage without any cost sharing requirements (copayment, coinsurance or deductible), when delivered by in - network providers. This includes 100% coverage for FDA - approved tier 1 contraceptive methods for women when filled at an in - network pharmacy.

LIFE AND DISABILITY

Basic Life and Accidental Death & Dismemberment (AD&D)

Administered by Equitable, the District provides Basic Life and Accidental Death & Dismemberment coverage to all eligible employees. This coverage is provided by the District at no cost to you. In the event of your death, your beneficiary will receive $50,000. The AD&D benefit is equal to your basic group life insurance in case of death.

Voluntary Life and Accidental Death & Dismemberment (AD&D)

Administered by Equitable, the District offers eligible employees the option to purchase voluntary life insurance for yourself, your spouse, and/or your dependent child(ren). Any amount in excess of the guaranteed issue limit requires completion of an Evidence of Insurability form. If voluntary life is not purchased when first eligible, an evidence of insurability form will need to be completed and coverage will not be effective until approved by Equitable. Coverage will go into effect once Equitable approves your application. Employees will have 30 days after election to file appropriate paperwork; otherwise the request will be dropped.

EMPLOYEE COVERAGE

Employees may elect coverage in increments of $10,000 up to the lesser of $500,000 or 5 times your salary. Guaranteed Issue amount is $200,000 without evidence of insurability.

SPOUSE COVERAGE

Spousal coverage is available in $5,000 increments not to exceed 50% of the employee amount up to a maximum of $200,000. Guaranteed issue amount is $25,000 without evidence of insurability.

FACTS & TIPS

CHILDREN

Sign up for this coverage when you are first hired and you will not have to answer any health questions and risk being turned down for coverage.

Coverage is available for your children up to age 26 whether they are a full - time student or not. You can elect coverage of $10,000. The amount you select is for each child you cover. The cost is based upon the family unit and not each child.

Guarantee issue does not apply to child coverage.

Monthly Voluntary Life Employee Rate Age Band Rate Per $1,000

Voluntary AD&D must match your elected Voluntary Life coverage. Example: if you elect $100,000 of Voluntary Life insurance, your elected Voluntary AD&D coverage must also be $100,000.

Under Age 30

$ .033

30 - 34

$ .038

35 - 39

$ .049

Monthly Voluntary AD&D Employee Rate

40 - 44

$ .073

Rate per $1,000 of Coverage

Rate Per $1,000

45 - 49

$ .115

Single

$.017

50 - 54

$ .180

Spouse

$.017

55 - 59

$ .275

Child(ren)

$.049

60 - 64

$ .388

Amount of coverage must match your elected Voluntary Life coverage.

65 - 69

$ .691

70+

$1.149

Child

$ .240

*The premium calculation is based upon the life and AD&D rate for an employee age 45.

$50,000 Elected Coverage

÷ 1,000 =

$.132 Rate

$ 6.60

HOW TO CALCULATE VOLUNTARY LIFE / AD&D PREMIUM

Units

Per Month

* See Note

Long - Term Disability

Administered by Equitable

The School District of Clayton provides you with Long - Term Disability (LTD) protection. This benefit protects your income to age 65 if you are totally disabled. Following are some key components of the plan:

◼

180 day waiting period before benefits begin.

◼ 66 2/3% salary reimbursement to $12,500 per month maximum.

◼ Benefits are payable for 3 years if you are unable to perform your occupation. Benefits are available to age 65 if your are totally disabled and unable to perform any occupation.

SUPPLEMENTAL BENEFITS

Voluntary Worksite Policies—Trustmark

Administered by Trustmark —three supplemental benefit options are offered to you on a voluntary basis. These benefit plans are offered only during the enrollment process. If you elect any of these worksite benefit programs, premiums will be deducted from your paycheck.

Critical Illness insurance pays a cash benefit if you are faced with a covered critical illness like cancer, heart attack or stroke.

We know that everyone has different needs and ways of coping with a critical illness. That is why you can choose how to spend or save your cash benefit. It can be used for expenses beyond direct medical costs, including:

◼ Paying for child care or help around the house

◼

Travel costs to see a specialist

◼

Medical treatment and doctor visits

◼

Copays and deductibles

◼

Prescription drug costs

Accidental Injury insurance gives you a cash benefit for covered accidents. You can use it to help pay for expenses associated with a covered injury.

Accidents happen and can affect your financial health. Trustmark wants to help you and your family be more protected from out - of - pocket expenses like copays or hospitalization costs. The payments you receive for covered accidents can be used however you wish and are not limited to direct medical costs. For example, you can use the money to help pay for things like:

◼

Rehabilitation and therapy expenses

◼

Cover unexpected expenses

Universal Life Insurance with Long Term Care

◼ With this coverage you will receive permanent life insurance protection. Long - Term Care benefits and life insurance are combined. You will also benefit from a higher death benefit during the working years and a higher living benefit for long term care.

Did you Know? When you experience a major health event, supplemental insurance policies help pay for many expenses that aren ’ t covered by your primary health insurance.

Employee Assistance Program (EAP)

Administered by Personal Assistance Services (PAS) EAP services are confidential assistance for you and your eligible dependents. It provides short - term, confidential counseling in dealing with family and relationship issues, substance abuse, stress and anxiety, communication issues, and emotional concerns. The EAP also provides the below services to help you balance work and home life. PAS specializes in providing professional counseling services through highly qualified, licensed behavioral health practitioners. Their professionals answer calls 24 hours a day, seven days a week. When you call EAP at 314.842.6223 or 1.800.356.0845, please provide Company ID Clayton Schools. A representative will answer any questions you have and set up an appointment for you. Or you may text EAP/PAS at 314 - 451 - 5727. Please visit the PAS website for additional information at paseap.com.

■ Marital/relationship concerns

■ Job stress

■ Emotional health and wellness

■ Parenting challenges

■ Legal concerns

■ Substance abuse

■ Financial planning

■ Child care resources and referral

■ Tobacco cessation

■ Budget/debt problems

■ Education and college planning

■ Healthy eating and exercise

■ Identity theft

■ Elder care planning and management

■ Household management

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