BENEFITS 102

A Deeper Dive Into Your

DCPS & KEHP Benefits

Plan design, premiums, wellness rewards, and optional coverage for teachers and staff

2026 Plan Year • Human Resources & Benefits Team

What We'll Cover

KEHP Health Insurance

The four plan options, premiums & HRAs

Pharmacy & Wellness

Prescription coverage, wellness rewards, the LivingWell Promise

Support Programs

Telehealth, diabetes, maternity & mental health

DCPS Optional Benefits

Guardian Dental, Avesis vision, life, disability, accident, cancer & critical illness

Enrollment & Deadlines

How to enroll, qualifying events, and who to call

Open Discussion

Remaining time for your questions

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Objectives: Benefits Breakdown

KEHP Health Plan

Medical, dental and vision plan options administered by the Kentucky Employees' Health Plan, the same for every KEHP member statewide.

DCPS Optional Benefits

Dental, vision, life, disability, accident, critical illness, hospital indemnity, and cancer coverage offered through Guardian, Avesis & The Standard.

Two Enrollments

KEHP: (State Insurance) Completed in KHRIS.

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DCPS Optional Benefits: (District Specific Insurance) Completed in Employee Navigator

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Open Enrollment, Qualifying Events and New Hire Enrollment

Ways to change your benefits: During annual Open Enrollment, within 30 days of a qualifying life event (like marriage, birth, or loss of other coverage), or 30 days during New Hire Enrollment.

SECTION THREE

SECTION TWO

SECTION ONE

KEHP Health Insurance

Plan options, premiums, additional resources and HRAs

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SECTION ONE

KEHP HEALTH INSURANCE (pg 7 & 8 of KEHP Guide Book)

Four Plans, Four Ways to Balance Cost & Coverage

LivingWell

CDHP

Reasonable premium, good value

• For most services, once you meet the Deductible, the plan will pay 80% of covered expenses and you will pay a 20% Co-insurance.

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• HRA: $500 single / $1,000 family

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• Good for low & high utilizers

LivingWell

PPO

Co-pays, higher premium

• $25-$50 Co-pays apply to doctor’s office visits, allergy serum, allergy shots, urgent care centers, specialist, and prescriptions.

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• Most expenses are subject to the Deductible and then covered at 75%.

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• Separate medical & Rx Max OOP

LivingWell

Basic CDHP

Lower premium, basic coverage

• For most services, once you meet the Deductible, you will pay 30% Co-insurance until the out of pocket max is reached

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• HRA: $250 single / $500 family

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• Good for lighter healthcare needs

LivingWell

HDHP

Catastrophic-style, lowest premium

• HDHP does not have separate single and family Deductibles accumulating simultaneously; one Deductible will apply

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• HSA-compatible (HSA not via KEHP)

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• HRA funds and Carrum Health is not available under the HDHP

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There is no one-size-fits-all or “best” health plan. Your hand-out includes a diagram that helps you identify “What Matters Most To You” so you can narrow down which plan may be the best fit for your healthcare needs.

Deductibles & Max Out-of-Pocket (In-Network)

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Visit DCPS Benefits Website for the complete benefits grid in the KEHP Benefit Guide Book

https://dcps.io/BenefitsWebsite

KEHP HEALTH INSURANCE (pg 9 of KEHP Guide Book)

HEALTH WAIVERS (pg 15 & 16 of KEHP Guide Book)

Don’t Need Health Insurance?

Declining health insurance during enrollment means you may still get employer HRA funds

Waiver General Purpose HRA

• For employees who waive KEHP and have other employer-sponsored group health coverage
• Employer funded $175/month, up to $2,100/year funded Jan 1 & Jul 1
• Balance can be used on medical, dental & vision out-of-pocket costs
• Must re-enroll every Open Enrollment in KHRIS to keep the funds and carryover.

Waiver Limited Purpose HRA

• For employees with government-sponsored coverage (Medicare, Medicaid, TRICARE)
• Employer funded $175/month, up to $2,100/year — funded Jan 1 & Jul 1
• Dental and vision expenses only — not a replacement for dental/vision insurance
• Must re-enroll every Open Enrollment in KHRIS to keep the funds and carryover.

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Clarification: Waiving Health Insurance means

You are choosing not to enroll in a health insurance plan through KEHP because you are covered elsewhere

Anthem Dental and Vision (pg 28 & 29 of KEHP Guide Book)

KEHP Anthem Dental and Anthem Vision

Anthem Dental

• Bronze, Silver and Gold plan options available
• Only Gold plan covers Orthodontia for children under 18
• No out-of-pocket cost for most preventative and diagnostic services

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Important Note: Anthem Dental only pays benefits for services received from in-network providers. If you see an out-of-network dentist, Anthem Dental will pay $0, and you will be responsible for the full cost.

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Anthem Vision

• Bronze, Silver and Gold plan options available
• $10 co-pay for all tiers
• Covered routine Eye Exams annually along with allowances toward lenses, contact lenses, and frames (based on tier)
• $150-175 Allowance on disposable lenses based on tier

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Important Note: Dental and vision plans offered through Anthem and the DCPS Optional Guardian/Avesis plans are separate benefits.

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Before enrolling, make sure you understand which plan you want so you don't accidentally enroll in two plans and pay unnecessary premiums.

PHARMACY BENEFITS (pg 13 & 14 of KEHP Guide Book)

Prescription Coverage & Value Benefits

CVS/Caremark manages pharmacy benefits, but you can use any in-network pharmacy — not just CVS.

CVS Caremark

LivingWell PPO plan - offers a fixed Co-pay (or

prescription drugs. Also has a separate Deductible for prescriptions

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CDHP, Basic CDHP & HDHP - Pay only Co-insurance. Deductible is combined with medical.

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Value Benefits

Diabetes, COPD, asthma & hypertension.

Reduced co-pay/co-insurance with NO Deductible on maintenance drugs & supplies (inhalers, monitors, pumps), regardless of plan choice.

Insulin capped at $30 max for a 30-day supply.

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CVS/Caremark has a Check Drug and Cost Coverage tool that is helpful in comparing the cost of drugs at nearby pharmacies. The lower the cost of the drug, the less you will pay in Co-insurance. Sign in at Caremark.com, select Plan & Benefits, and choose Check Drug and Cost Coverage.

CVS Caremark 866-601-9634

$ Money Saver! $

FLEXIBLE SPENDING ACCOUNTS (pg 17 & 18 of KEHP Guide Book)

Pre-Tax Savings — Must Actively Enroll Each Year

Healthcare FSA

• Employee-funded through payroll deductions

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• You choose how much to contribute from each paycheck

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• Contribute $120 - $3,300/year, pre-tax
• Carries over up to $660 into the next year
• Funds available in full on Jan 1, on a HealthEquity card
• 90-day run-out period (through Mar 31, 2027)

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Child & Adult Daycare FSA

• Employee-funded through payroll deductions

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• You choose how much to contribute from each paycheck - Minimum amount is $120 per year. Maximum amount per year is based on your tax filing status.
• Covers daycare, preschool, summer camp, before/after-school & elder daycare
• Does NOT carry over — use it or lose it by Dec 31, 2026

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$ Money Saver! $

WELLNESS INCENTIVES (pg 19-24 of KEHP Guide Book)

Earn Real Premium Discounts & Cash

LivingWell Promise

Complete the Castlight Health Assessment between Jan 1 - Jul 1, 2026 to earn $480/year ($40/month) off next years premium.

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*New Hires will not be required to complete The LivingWell Promise their first year.

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Wellness Rewards

Earn up to $200 for preventive exams, screenings, dental screenings, and step challenges through Castlight.

SmartShopper

Shop around for MRIs, surgeries, colonoscopies & more — earn cash incentives from $25 to $850 for choosing lower-cost, in-network locations.

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TELEHEALTH & EVERYDAY SUPPORT (pg 19-24 of KEHP Guide Book)

Free or Low-Cost Ways to Get Care Fast

LiveHealth Online

$0 video visits for medical & behavioral health, 24/7 from your phone or computer.

24/7 NurseLine

Talk to a registered nurse anytime, day or night, about symptoms, care options & more.

Carrum Health

Bundled surgical care (cancer, joint, spine, heart, bariatric) at $0 cost to you.

Note: Carrum Health is not available under the LivingWell HDHP.

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SPECIALTY SUPPORT PROGRAMS (pg 19-24 of KEHP Guide Book)

Targeted Help, No Extra Cost

Diabetes: Lark & Diabetic Self Management Education & Support

Free diabetes prevention coaching (Lark) and self-management education for those already diagnosed (DSMES).

Maternity: Building Healthy Families

Personalized pregnancy & parenting support through Sydney Health, plus lactation support via LiveHealth Online.

Joint & Back Pain: Hinge Health

Virtual exercise therapy for back, knee, hip, neck & shoulder pain

Mental Health

RethinkCare (parenting), LiveHealth Online Behavioral Health ($0 visits), Learn to Live, and the 24/7 Behavioral Health Resource Line.

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DCPS Optional Benefits

Dental, Vision, Life, Disability, and Voluntary protection plans available to Daviess County Public School employees only

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SECTION TWO

GUARDIAN DENTAL INSURANCE (pg 6 of DCPS Optional Benefits Guide Book)

Low Plan vs. High Plan

Visit DCPS Benefits Website for DCPS Optional Benefits Guide Book

https://dcps.io/BenefitsWebsite

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Important Note: Dental and vision plans offered through Anthem and the DCPS Optional Guardian/Avesis plans are separate benefits.

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Before enrolling, make sure you understand which plan you want so you don't accidentally enroll in two plans and pay unnecessary premiums.

• Low plan covers all preventative care 100% and basic needs at 60% for In-network dentist
• High plan covers major care (dentures, root canal, crowns) at 50% for In-network dentist
• Guardian will still pay out a percentage of out-of-network dentist where as Anthem Dental will pay $0
• Dental Maximum Rollover- Save unused claim dollars for when you need them most on the High plan

AVESIS VISION INSURANCE (pg 8-10 of DCPS Optional Benefits Guide)

Annual Exams, Frames & Contacts

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Important Note: Dental and vision plans offered through Anthem and the DCPS Optional Guardian/Avesis plans are separate benefits.

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Before enrolling, make sure you understand which plan you want so you don't accidentally enroll in two plans and pay unnecessary premiums.

• Single plan option available
• Coverage includes annual eye exams, prescription lenses, frames, and contact lenses
• $0 Copay and $10 Materials Co-pay for in-network providers
• Low premium with good value
• $200 Allowance on elective lenses

GUARDIAN LIFE INSURANCE (pg 11 of DCPS Optional Benefits Guide Book)

Basic Coverage + Optional Supplemental

Basic Life & AD&D

• 100% employer-paid
• 1x annual salary, up to $150,000
• Reduces at ages 70, 75 & 80
• Ends at separation or retirement unless converted

Supplemental Life & AD&D

Employee: $10,000 increments up to $500,000

Spouse: $5,000 increments up to $250,000

Child (14 days-26): $5,000 or $10,000

New Hire Guarantee Issue: $250,000 employee / $60,000 spouse / $10,000 child — no health questions

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*Watch for EOI requirements to gain coverage

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VOLUNTARY DISABILITY INSURANCE (pg 13 of DCPS Optional Benefits Guide Book)

Protecting Your Paycheck

Benefit Choice: Choose a weekly (STD, $50-$1,000) or monthly (LTD, $250-$5,000) benefit up to 60% of salary.

New Hire Guarantee Issue: Up to 60% of salary, no EOI needed

Pre-Existing Condition: 3 month look back for STD and 6 month look back for LTD

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VOLUNTARY PROTECTION PLANS or GAP INSURANCE (pg 14-17 of DCPS Optional Benefits Guide Book)

Extra Cash When the Unexpected Happens

Accident Plan

Pays YOU cash for ER visits, fractures, dislocations & more.

Employee $19.66/mo • Family $44.68/mo

Critical Illness

Lump sum ($10k-$50k) upon diagnosis of cancer, heart attack, stroke & more.

New Hire GI: $30k employee / $15k spouse (to age 70)

Hospital Indemnity

Pay outs for hospital admission & ICU confinement, no pre-existing condition limits.

Employee $19.17/mo • Family $43.16/mo

The Standard Group Cancer

Diagnosis, treatment & hospital confinement benefits, plus an annual wellness benefit.

Employee $20.18-$25.70/mo • Family $34.44-$44.34/mo

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SECTION THREE

Enrollment & Deadlines

How and when to make your elections

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OPEN ENROLLMENT

Two Systems, Two Purposes

KEHP Health Insurance

• Enroll/change via KHRIS.ky.gov during Open Enrollment (Oct Annually) or within 30 days of hire
• Waiver HRA & Healthcare FSA require active re-enrollment every year

DCPS Optional Benefits

• Enroll online at Employeenavigator.com or call 1-463-900-5384
• New hires: 30 days from date of hire
• Guarantee Issue amounts available for new hires — no health questions (EOI) needed on amounts up to the GI limit

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DCPS hosts multiple In-Person Open Enrollment Assistance opportunities, watch for announcements and flyers. Don’t wait until the deadline if you need help.

QUALIFYING LIFE EVENTS (pg 27 of KEHP Benefits Guide Book)

Changing Coverage Outside Open Enrollment

Under IRS Section 125 rules, you can only change benefit elections during Open Enrollment, new-hire enrollment, or after a Qualifying Event.

Marriage or Divorce

Birth or Adoption

Death of a Dependent

Loss of Other Coverage

Spouse's Different Open Enrollment Period

Court Order Requiring Coverage

You must act within 30 days of the event

KEHP: Log into KHRIS and submit a Qualifying Event yourself or submit the Employee Benefits Enrollment Change Form with documentation to Coty Vance or HR

DCPS Optional Benefits: Contact Coty Vance, submit a Life Event in Employee Navigator yourself or call the Steele Benefits Call Center at 1-463-900-5384 with documentation.

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Ways To Stay In The Know

We are here to provide information, resources, and support but it is still your responsibility to review your benefits, understand your coverage, and stay informed throughout the year. Even completing just one or two of these steps puts you ahead and helps you take a more active role in managing your benefits.

Utilize The DCPS Benefits Website

Watch for DCPS Insider (Benefits Corner)

Read all Benefits Emails and Mailed Material

Log into KHRIS and Employee Navigator and Review Your Benefit Elections Annually

Keep Contact Information Up to Date By Submitting in Records/Powerschools

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Ask Questions Before Deadlines

Use Your School's Benefit Liaison as a Resource for Technical Questions

Attend Benefits Resource Events or Training Sessions

Key Contacts & Resources

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Questions?

ask us anything about your KEHP or DCPS Optional Benefits.