BENEFITS
ESSENTIALS
2026 Employee Benefits Overview
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
Important Notice
EACS has made every attempt to ensure the accuracy of the information described in this enrollment guide. Any discrepancy between this guide and the insurance contracts or other legal documents that govern the plans of benefits described in this enrollment guide will be resolved according to the insurance contracts and legal documents. EACS reserves the right to amend or discontinue the benefits described in this enrollment guide in the future, as well as change how eligible employees and EACS share plan costs at any time. This enrollment guide creates neither an employment agreement of any kind nor a guarantee of continued employment with EACS.
TABLE OF CONTENTS
3 | Welcome |
4 | Eligibility |
5 | Medical & RX Benefits |
8 | PHP |
15 | Medical Plan - EPO 3 TIER |
17 | Wellbridge Surgical |
18 | One-Imaging |
19 | CVS/Caremark and Prudent RX- Specialty Drugs |
23 | Health Savings Account (HSA) |
24 | Flexible Spending Accounts |
26 | Dental Benefits |
27 | Vision Benefits |
28 | Income Protection Benefits |
32 | Additional Benefits |
38 | Wellness Credit |
39 | Key Contacts |
40 | Required Notices |
2
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
OPEN ENROLLMENT is from November 12th to November 21st
You play an important role in our success. That’s why we strive to provide you with a benefits program that rewards you for the hard work and dedication you put forth every day.
Our comprehensive and competitive benefits program is an important component of your total compensation package. This guide provides valuable information to help you better manage your health and your financial security.
During open enrollment, you have the opportunity to review your coverage needs, consider the benefit plans available to you, and select benefits that will provide the most value to you.
Open Enrollment for 2026 coverage – your one chance to make changes to your benefits¹ – begins November 12th and will remain open until November 21st. The benefits you choose will become effective on January 1, 2026 – December 31, 2026.
You must participate in Open Enrollment if you wish to do any or all of the following:
* You won’t be automatically enrolled in any FSAs – you need to make an election to participate each year.
Review this guide to choose which benefits are right for you. If after reading this guide you need more information, please contact Human Resources at 260-446-0100 ext. 1025.
WELCOME
1 You can change your coverage during the year if you experience a “Qualified Status Change,” including but not limited to marriage, domestic partnership, divorce, birth or adoption of a child or death of spouse or child.
3
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
ELIGIBILITY
Full-time employees (working a minimum of 30 hours per week) and their eligible dependents can participate in EACS benefits. Eligible dependents include:
PROOF OF DEPENDENT ELIGIBILITY
You may be required to provide proof of eligibility for your dependents. Note that attempting to enroll an ineligible dependent could lead to discipline and possible termination of employment. If your dependent becomes ineligible for coverage during the year, you must contact Human Resources at 260-446-0100 ext. 1025. Failure to provide notification may lead to discipline and possible termination of employment.
Coinsurance | The percentage you pay for the cost of covered health care services after you’ve met your deductible. |
Copayment (Copay) | A fixed amount (for example, $30) you pay for a covered health care service, usually when you receive the service (as specified by your plan). |
Deductible | The amount you pay in a plan year before your health plan begins to pay benefits. |
Health Savings Account (HSA) | A bank account that lets you put money aside, tax-free, to save and pay for qualified health care expenses. The Internal Revenue Service (IRS) limits who can open and put money into an HSA. |
Network | A group of doctors, hospitals, labs, and other providers that your health insurance contracts so you can make visits at a pre-negotiated (and often discounted) rate. |
Out-of-Pocket Maximum | The cap on your out-of-pocket costs for the plan year. Once you’ve reached this amount, your plan will cover 100% of your qualified medical expenses for the plan year. |
Premium | The amount of money that’s paid for your health insurance every month. EACS pays a portion of this amount, and you pay the rest. |
Enrolling in Benefits If you're eligible for EACS benefits, you can enroll by visiting https://rds.eacs.k12.in.us/RDSEmployeeAccess Once you've accessed the page, follow these steps:
Pencil -click the pencil to check the appropriate boxes for each dependent. Trash can - allows you to delete dependents
|
BENEFITS TERMS
Before reviewing your benefit choices for this year, here’s a refresher on some key health insurance vocabulary that will help you better understand your options.
4
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
MEDICAL & PRESCRIPTION
DRUG BENEFITS
You have the opportunity to enroll in 1 of 3 medical plans through PHP-TPA. Each plan offers in- and out-of-network coverage, but you will pay less for services when you see in-network providers.
HDHP Benefit Change effective 1/1/2026- new deductible limits as required by the IRS.
MEDICAL PLAN SUMMARY – HDHP H.S.A. EPO Plan #1
Refer to Summary Plan document for complete benefit information.
2026 Benefit Grid Key Features | HDHP – H.S.A. Option 1 EPO* | ||
Tier 1: EPO Facilities / PPO Providers | Tier 2: Signature Care Facilities | Tier 3: Non-Preferred Providers | |
Calendar Year Deductible�Individual / Family | $3,400 / $6,800 | $4,400 / $8,800 | $6,400 / $13,400 |
Out-of-Pocket Maximum (includes deductible)�Individual / Family | $3,400 / $6,800 | $6,400 / $13,400 | Unlimited |
Coinsurance (portion you pay) | 0% after deductible | 10% after deductible | 30% after deductible |
Preventive Care | Covered at 100% | Covered at 100% | Covered at 50% |
Physician Services | 0% after deductible | 10% after deductible | 30% after deductible |
Urgent Care Copay | 0% after deductible | 10% after deductible | 30% after deductible |
Emergency Room | 0% after deductible | 0% after deductible | 0% after deductible |
Hospitalization | 0% after deductible | 10% after deductible | 30% after deductible |
Lab and X-Ray Services | 0% after deductible | 10% after deductible | 30% after deductible |
Chiropractor Visits | 0% after deductible – Max 25 visits per year | 10% after deductible – Max 25 visits per year | 30% after deductible – Max 25 visits per year |
Prescription Drugs | |||
Calendar Year Prescription Drug Deductible | Member pays 100% until Deductible and Max Out of Pocket is met. | Member pays 100% until Deductible and Max Out of Pocket is met. | Not Covered |
RETAIL PRESCRIPTIONS (30-DAY SUPPLY) | |||
Generic | 0% after deductible | 0% after deductible | Not Covered |
Preferred Brand | 0% after deductible | 0% after deductible | Not Covered |
Non-preferred Brand | 0% after deductible | 0% after deductible | Not Covered |
Specialty | 0% after deductible | 0% after deductible | Not Covered |
5
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
MEDICAL & PRESCRIPTION
DRUG BENEFITS
You have the opportunity to enroll in 1 of 3 medical plans through PHP-TPA. Each plan offers in- and out-of-network coverage, but you will pay less for services when you see in-network providers.
HDHP Benefit Change effective 1/1/2026- new deductible limits as required by the IRS.
MEDICAL PLAN SUMMARY – HDHP H.S.A. EPO Plan #2
Refer to Summary Plan document for complete benefit information.
2026 Benefit Grid Key Features | HDHP – H.S.A. Option 2 EPO* | ||
Tier 1: EPO Facilities / PPO Providers | Tier 2: Signature Care Facilities | Tier 3: Non-Preferred Providers | |
Calendar Year Deductible�Individual / Family | $3,400 / $6,800 | $4,400 / $8,800 | $6,400 / $13,400 |
Out-of-Pocket Maximum (includes deductible)�Individual / Family | $5,400 / $10,800 | $8,400 / $13,800 | Unlimited |
Coinsurance (portion you pay) | 20% after deductible | 30% after deductible | 50% after deductible |
Preventive Care | Covered at 100% | Covered at 100% | Covered at 50% |
Physician Services | 20% after deductible | 30% after deductible | 50% after deductible |
Urgent Care Copay | 20% after deductible | 30% after deductible | 50% after deductible |
Emergency Room | 20% after deductible | 20% after deductible | 20% after deductible |
Hospitalization | 20% after deductible | 30% after deductible | 50% after deductible |
Lab and X-Ray Services | 20% after deductible | 30% after deductible | 50% after deductible |
Chiropractor Visits | 20% after deductible – Max 25 visits per year | 30% after deductible – Max 25 visits per year | 50% after deductible – Max 25 visits per year |
Prescription Drugs | |||
Calendar Year Prescription Drug Deductible | Member pays 100% until Deductible and Max Out of Pocket is met. | Member pays 100% until Deductible and Max Out of Pocket is met. | Not Covered |
RETAIL PRESCRIPTIONS (30-DAY SUPPLY) | |||
Generic | 20% after deductible | 20% after deductible | Not Covered |
Preferred Brand | 20% after deductible | 20% after deductible | Not Covered |
Non-preferred Brand | 20% after deductible | 20% after deductible | Not Covered |
Specialty | 30% after deductible | 30% after deductible | Not Covered |
6
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
MEDICAL & PRESCRIPTION
DRUG BENEFITS
You have the opportunity to enroll in 1 of 3 medical plans through PHP-TPA. Each plan offers in- and out-of-network coverage, but you will pay less for services when you see in-network providers.
MEDICAL PLAN SUMMARY – Traditional EPO Plan #3
Refer to Summary Plan document for complete benefit information.
2026 Benefit Grid Key Features | Traditional EPO* | ||
Tier 1: EPO Facilities / PPO Providers | Tier 2: Signature Care Facilities | Tier 3: Non-Preferred Providers | |
Calendar Year Deductible�Individual / Family | $1,000 / $2,000 | $2,000 / $4,000 | $5,000 / $10,000 |
Out-of-Pocket Maximum (includes deductible)�Individual / Family | $2,000 / $4,000 | $5,000 / $10,000 | Unlimited |
Coinsurance (portion you pay) | 20% | 30% | 50% |
Preventive Care | Covered at 100% | Covered at 100% | Covered at 50% |
Physician Services | Deductible + 20% coinsurance | Deductible + 30% coinsurance | Deductible + 50% coinsurance |
Urgent Care Copay | Deductible + 20% coinsurance | Deductible + 30% coinsurance | Deductible + 50% coinsurance |
Emergency Room | Deductible + 20% coinsurance | Deductible + 20% coinsurance | Deductible + 20% coinsurance |
Hospitalization | Deductible + 20% coinsurance | Deductible + 30% coinsurance | Deductible + 50% coinsurance |
Lab and X-Ray Services | Deductible + 20% coinsurance | Deductible + 30% coinsurance | Deductible + 50% coinsurance |
Chiropractor Visits | Deductible + 20% coinsurance – Max 25 visits per calendar year | Deductible + 30% coinsurance – Max 25 visits per year | Deductible + 50% coinsurance – Max 25 visits per year |
Prescription Drugs | |||
Calendar Year Prescription Drug max out of pocket not to exceed Individual / Family | $4,600 / $9,200 | ||
RETAIL PRESCRIPTIONS (30-DAY SUPPLY) | |||
Generic | 30% to $75 per Rx | 30% to $75 per Rx | Not Covered |
Preferred Brand | 40% to $100 per Rx | 40% to $100 per Rx | Not Covered |
Non-preferred Brand | 60% to $125 per Rx | 60% to $125 per Rx | Not Covered |
Specialty | 30% per Rx | 30% per Rx | Not Covered |
7
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
MEDICAL PLAN – PHP (TPA)
PHP-TPA Services
What you should do for 1/1/2026:
8
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
PHP Member Portal
9
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
PHP Member App
10
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
PHP After-Hours Rx Hotline
11
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
PHP BenefitHub
12
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
PHP Active & Fit Direct
13
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
PHP TruHearing
14
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
MEDICAL PLAN – WHY EPO TIER #1 ?
15
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
MEDICAL PLAN – Find an EPO Tier #1 Hospital
Reminder: all Lutheran Health Physicians and Fort Wayne Orthopedics providers no longer participate in Signature Care.
For more information on in-network options, contact Signature Care customer service at 260-266-5510 or 800-666-4449.
Hours
Monday - Friday
8am – 4:30pm
Or visit https://www.parkview.com/employer-solutions/signature-care/for-members/provider-search
Women’s Health Advantage- Office Visits only
16
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
*If you are on the HDHP, you must meet your deductible first.
DISCOVER
17
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
ONE IMAGING- Medical Imaging
18
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
PRESCRIPTION - DRUG BENEFITS
19
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
PRESCRIPTION - DRUG BENEFITS
RxSavingsPlus Program
20
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
PRESCRIPTION - DRUG BENEFITS
PrudentRX can be reached at 1-800-578-4403 to address any questions regarding the program
21
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
PRESCRIPTION - DRUG DISCOUNTS FOR EMPLOYEES NOT ENROLLED ON HEALTH PLAN
22
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
HEALTH SAVINGS ACCOUNT (HSA)
1 Certain states do not treat HSA contributions or distribution as tax-free (e.g., California and New Jersey). Consult your tax advisor to understand how HSA participation may impact you and your family members from a tax perspective.
If you’re enrolling in a High Deductible Health Plan (HDHP) such as HDHP Plan 1 or HDHP Plan 2, you are eligible to open a Health Savings Account (HSA) to pay for expenses on a pre-tax basis, such as eligible medical, dental and/or vision expenses.
ELIGIBILITY REQUIREMENTS
ADVANTAGES OF AN HSA
Important: HSAs involve very complex rules, including limitations on eligibility, contributions and expense reimbursement. Federal and state tax penalties may be assessed upon you if these requirements are not met. You should talk to a tax advisor about your personal circumstances with respect to the HSA rules. Another helpful resource is IRS Publication 969 (https://www.irs.gov/publications/p969/ar02.html).
Each year, the IRS sets limits on how much you can contribute to an HSA. Maximum employee contributions for 2026 are as follows:
23
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
Use-It or Lose-It
FLEXIBLE SPENDING ACCOUNTS (FSAs)
Flexible Spending Accounts (FSAs) allow you to set aside money from your paycheck to pay Health Care and Dependent Care expenses with tax-free dollars. When you contribute to FSAs, your pre-tax contributions reduce your taxable income. Our FSA is administered with Health Equity.
Account | What it can be used for: | Most you can �contribute in 2026: |
Health Care FSA | To pay medical, dental, vision, and hearing expenses not covered by your health care plans, such as deductibles, coinsurance and copayments. NOTE: If you contribute to an HSA, you cannot participate in the Health Care FSA. | $3,400 |
Dependent Care FSA | Dependent care expenses such as day care and after school programs for children under age 13, or elder care expenses, so you and your spouse can work or attend school full time | $7,500, or $3,750 if married and filing �separate tax returns |
HOW THE FSAs WORK:
24
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
25
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
DENTAL BENEFITS
EACS offers dental coverage through PHP-TPA.
Key Features | Dental Plan with Orthodontics | Dental Plan – No Orthodontics (Non-Teachers Only) |
Calendar Year Deductible (Individual / Family) | $25 / $50 | $25 / $50 |
Preventive Services (no deductible) Exams, Cleanings, X-rays, Fluoride, Space Maintainers, Sealants | 20% of cost after Deductible | 20% of cost after Deductible |
Restorative & Prosthodontics Fillings, Extractions, Inlays, Onlays, Crowns, Oral Surgery, Endodontics, Periodontics, Bridgework and Dentures | 20% of cost after Deductible | 20% of cost after Deductible |
Orthodontics (children up to age 19) Diagnostic, Surgical therapy & Appliance therapy | 20% of cost after Deductible | N/A |
Orthodontics Lifetime Maximum | $2,000 | N/A |
Annual Calendar Year Maximum | $2,000 | $2,000 |
DENTAL PLAN SUMMARY
Orthodontia for Teachers includes employees and dependents. Teachers are not offered a non-orthodontia option. Orthodontia for Non-Teachers, dependent children only.
Refer to Summary Plan Document for complete benefit Information.
26
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
VISION BENEFITS
You and your dependents have access to vision coverage through PHP-TPA.
VISION PLAN SUMMARY
Key Features | In-Network | Frequency |
Exam | $65 | One exam per 12-month period |
Lenses | Single - $75 Bifocal - $90 Tri-Focal - $100 Lenticular - $75 | One exam per 12-month period |
Frames | $125 | One exam per 24-month period |
Contact Lenses | Elective or Soft - $320 (per set) | One exam per 12-month period |
Refer to Summary Plan document for complete benefit information.
27
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
EACS BENEFITS
In addition to health benefits, EACS also offers eligible employees income protection benefits with Guardian . These benefits are intended to provide financial assistance for you and your beneficiaries in the event of disability, accident, or death.
EACS offers the following benefits:
BASIC LIFE AND AD&D
EACS provides you with Basic Life and AD&D insurance at no cost to you. If your death is the result of an accident, you will receive an additional Accidental Death & Dismemberment (AD&D) benefit. If you lose a limb or your eyesight as the result of an accident, the AD&D plan will pay a percentage of your AD&D benefit amount.
Refer to Summary Plan Document for complete benefit information.
Please ensure your beneficiaries are up to date. If you would like to make a change, please contact your Human Resources department.
28
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
INCOME PROTECTION BENEFITS
VOLUNTARY LIFE AND AD&D
You have the option to supplement your company-paid coverage by purchasing additional Life and AD&D insurance for yourself, your spouse and your children. You are required to purchase coverage for yourself in order to enroll your family members.
Key Features | |
Employee Benefit | $10,000 increment up to $500,000 Guarantee Issue: $200,000 |
Spouse Benefit | $5,000 increment up to $250,000 *not to exceed 100% of Employee's amount Guarantee Issue: $30,000 |
Child Benefit | $2,500 increment up to $10,000 *not to exceed 10% of Employee's amount Guarantee Issue: $10,000 |
Infant Benefit | $500 |
Guarantee Issue | If you sign up during your initial eligibility, you are not required to complete a health statement as long as you do not exceed Guarantee Issue amount. |
29
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
INCOME PROTECTION BENEFITS
Disability
Short Term Disability
EACS offers Voluntary Short-Term Disability (STD) paid by you through Guardian.
Key Features | Short-Term Disability |
Benefits Begin | On 30th day of your illness or injury |
Benefits Payable | $100, $125, $150, $175, $200, $225, $250, $275, $300, $325, $350, $375, $400, $500, $550, $600, $700,$800, $900, $1,000 |
Percentage of Income Replaced | Up to 60% of your salary |
Duration of Benefit | 9 weeks |
Guarantee Issue – when elected during initial enrollment period | Up to $1,000 |
Evidence Of Insurability | Health Statement may be required |
Pre-Existing Condition – Includes any condition /symptom prior to coverage in plan in which you consulted with a physician received treatment or took a prescribed drug. | 3 months look back from date coverage begins; 12 months after 2-week limitation |
30
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
INCOME PROTECTION BENEFITS
Disability
Maximum Benefit Period – The Employee’s Maximum Benefit Period is the period shown below or the Employee’s Normal Retirement Age under the 1983 amendments to the Federal Social Security Act, whichever is longer.
Age at Disability | Maximum Benefit Period | ORO | Year of Birth | Normal Retirement Age |
61 or less | To age 65 |
| 1937 or before | Age 65 |
62 | 42 Months |
| 1938 | Age 65 and 2 months |
63 | 36 Months |
| 1939 | Age 65 and 4 months |
64 | 30 Months |
| 1940 | Age 65 and 6 months |
65 | 24 Months |
| 1941 | Age 65 and 8 months |
66 | 21 Months |
| 1942 | Age 65 and 10 months |
67 | 18 months |
| 1943 through 1954 | Age 66 |
68 | 15 Months |
| 1955 | Age 66 and 2 months |
69 or more | 12 Months |
| 1956 | Age 66 and 4 months |
|
|
| 1957 | Age 66 and 6 months |
|
|
| 1958 | Age 66 and 8 months |
|
|
| 1959 | Age 66 and 10 months |
|
|
| 1960 and after | Age 67 |
Long-Term Disability | All Eligible Superintendents | All Eligible Administrators | All Eligible Clerical, Nurse, Paraprofessional, Food Services | All Eligible Custodial, Carpenters, Electricians | All Eligible Teachers |
Benefits Begin | 91 days | 91 days | 91 days | 91 days | 91 days |
Benefits Payable | Up to $7,250 | Up to $5,000 | Up to $3,500 | Up to $2,500 | Up to $3,500 |
Percentage of Income Replaced | Not to exceed 60% | Not to exceed 60% | Not to exceed 60% | Not to exceed 60% | Not to exceed 60% |
Duration of Benefit | Social Security normal retirement age, includes Lifetime Rider if ADL disabled | Social Security normal retirement age, includes Lifetime Rider if ADL disabled | Social Security normal retirement age, includes Lifetime Rider if ADL disabled | Social Security normal retirement age, includes Lifetime Rider if ADL disabled | Social Security normal retirement age, includes Lifetime Rider if ADL disabled |
Pre-Existing Condition | 3 months prior, 12 months after Exclusion, Continuity of Coverage | 3 months prior, 12 months after Exclusion, Continuity of Coverage | 3 months prior, 12 months after Exclusion, Continuity of Coverage | 3 months prior, 12 months after Exclusion, Continuity of Coverage | 3 months prior, 12 months after Exclusion, Continuity of Coverage |
Long Term Disability
EACS provides Long-Term Disability at no cost to you through Guardian.
31
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
ADDITONAL BENEFITS
CRITICAL ILLNESS
Critical Illness Insurance if purchased by employee pays a benefit if you are diagnosed with a serious illness covered by the plan. The benefit is paid to you and can be used to pay medical costs or living expenses such as childcare or mortgage payments.
Key Features | |
Employee Benefit | $5,000 increment up to $25,000 Guarantee Issue: $25,000 |
Spouse Benefit | $5,000 increment up to $25,000 *not to exceed 100% of Employee's amount Guarantee Issue: $25,000 |
Child Benefit | 25% of Employee benefit |
Covered Conditions | First Occurrence | Second Occurrence |
Cancer | ||
Invasive Cancer: | 100% | 100% |
Carcinoma In Situ | 30% | 0% |
Benign Brain Tumor | 75% | 0% |
Skin Cancer | $250 per Lifetime | Not Covered |
Vascular | ||
Heart Attack | 100% | 100% |
Stroke | 100% | 100% |
Heart Failure | 100% | 100% |
Coronary Arteriosclerosis | 30% | 0% |
Wellness Benefit – per year | $50 | N/A |
32
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
ADDITONAL BENEFITS
CRITICAL ILLNESS
Critical Illness Insurance pays a benefit if you are diagnosed with a serious illness covered by the plan. The benefit is paid to you and can be used to pay medical costs or living expenses such as childcare or mortgage payments.
Covered Conditions | First Occurrence | Second Occurrence |
Other | ||
Organ Failure | 100% | 100% |
Kidney Failure | 100% | 100% |
Group 2 Covered Conditions | First Occurrence of these additional illnesses:
| |
Group 3 Childhood Covered Conditions | 100% of Child Benefit for the First Occurrence of Cerebral Palsy, Cleft lip/palate, Club Foot, Cystic Fibrosis, Down's Syndrome, Muscular Dystrophy, Spina Bifida, and Type 1 Diabetes. | |
33
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
ADDITONAL BENEFITS
ACCIDENT INSURANCE
Accident Insurance helps cover the cost of emergency medical care, physical therapy and other unexpected expenses that result from an accidental injury.
Key Features | |
Accidental Death and Dismemberment | |
Death Benefit | Employee: $50,000 Spouse: $25,000 Child: $10,000 |
Catastrophic Loss | Quadriplegia: 100% of AD&D Loss of speech and hearing (both ears): 100% of AD&D Loss of cognitive function: 100% of AD&D Hemiplegia:50% of AD&D Paraplegia:50% of AD&D |
Common Carrier | 200% of AD&D |
Common Disaster | 200% of Spouse AD&D benefit |
Dismemberment | |
Hand, Foot, Sight | Single: 50% of AD&D benefit Multiple: 100% of AD&D benefit |
Thumb/Index Finger Same Hand, Four Fingers Same Hand, All Toes Same Foot | 25% of AD&D benefit |
Seatbelts and Airbags | Seatbelts: $10,000 or Seatbelts & Airbags: $15,000 |
Reasonable Accommodation to Home or Vehicle | $2,500 |
Wellness Benefit | Provides a $75 per year benefit for completing certain routine wellness screenings or procedures (refer to Plan Highlights section for example procedures). |
Portability | Included without Evidence |
Child(ren) Age Limits | Birth to 26 years subject to state limitations |
Air Ambulance | $1,000 |
Ambulance | $200 |
Blood/Plasma/Platelets | $300 |
Burns (2nd Degree/3rd Degree) | 9 sq inches to 18 sq inches: $0 / $2,500 18 sq inches to 35 sq inches: $1,250 / $5,000 Over 35 sq inches: $3,750 / $15,000 |
Burn – Skin Graft | 50% of burn benefit |
Child Organized Sport | 25% increase to child benefits |
Chiropractic Visits | $50 per visit up to 6 visits |
Coma | $7,500 |
Concussion Baseline Study | $25 |
Concussions | $150 |
34
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
ADDITONAL BENEFITS
ACCIDENT INSURANCE
Accident Insurance helps cover the cost of emergency medical care, physical therapy and other unexpected expenses that result from an accidental injury.
Key Features | |
Diagnostic Exam (Major) | $200 |
Dislocations | Schedule up to $6,000 |
Doctor Follow-Up Visits | $100 up to 6 treatments |
Emergency Dental Work | $300/Crown $75/Extraction |
Emergency Room Treatment | $200 |
Epidural Anesthesia Pain Management | $100, 2 times per accident |
Eye Injury | $300 |
Family Care | $20/day up to 30 days |
Fractures | Schedule up to $10,000 |
Gun Shot Wound | $750 |
Hospital Admission | $1,000 |
Hospital Confinement | $250/day – up to 1 year |
Hospital ICU Admission | $2,000 |
Hospital ICU Confinement | $500/day – up to 15 days |
Initial Doctor's Office/Urgent Care Facility Treatment | $125 |
Joint Replacement (hip/knee/shoulder) | $2,500/$1,250/$1,250 |
Knee Cartilage | $500 |
Laceration | Schedule up to $600 |
Lodging | $150/day, up to 30 days for companion hotel stay |
Medical Appliance | Schedule up to $300 |
Outpatient Therapies | $35/day up to 10 days |
Post-Traumatic Stress Disorder | $400 |
Prosthetic Device/Artificial Limb | 1: $750 2 or more: $1,500 |
Rehabilitation Unit Confinement | $100/day up to 15 days |
Ruptured Disc with Surgical Repair | $750 |
Surgery (Cranial, Open Abdominal, Thoracic) | Schedule up to $1,500 Hernia:$300 |
Surgery – Exploratory or Arthroscopic | $150 |
Tendon/Ligament/Rotator Cuff | 1: $500 2 or more: $1,000 |
Transportation | $0.50 per mile, limited to $500/round trip, up to 3 times per accident |
Traumatic Brain Injury | $4,000 |
X-Ray | $40 |
35
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
ADDITONAL BENEFITS
HOSPITALIZATION
Hospital Indemnity Insurance provides a cash payment if you or a covered family member are admitted to the hospital. As an eligible employee, you may elect to purchases this coverage
Key Features | |
Hospital/ICU Admission | $1500 / $1500 per admission to a max of 2 admissions per year, per insured |
Hospital/ICU Confinement | $200 per day to a max of 30 days per year, per insured |
Health Screenings | $50 per day of screening to a max of 1 day per year, per insured |
Treatment of Normal Pregnancy | Normal pregnancy is included with no 9-month limitation. |
Pre-Existing Condition | Not Applicable |
Refer to your Guardian Certificate of Coverage for complete information about your benefits.
36
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
ADDITONAL BENEFITS
EMPLOYEE ASSISTANCE PROGRAM #1
East Allen County Schools employee Assistance program provided by Parkview. Employee Assistance provides help when you need it and provides 4 free sessions.
For more information or to make an appointment call 260-266-8060 or 800-721-8809
After-hours Crisis Line: 260-446-1867
EMPLOYEE ASSISTANCE PROGRAM #2
37
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
EACS Employees enrolled in a medical plan can save on their medical premium contributions by participating in the 2026 Wellness Rewards Program. Participants who fulfill the 2026 Wellness requirements by the deadline of December 31st, 2026, will receive a $200 Wellness Premium Credit in 2026. Your results are protected by Federal Law and will remain confidential. The District will only be notified of your participation if you have completed all required actions within the program. Failure to participate does not render you ineligible for medical plan coverage. If you have questions, please contact Parkviewworkplacewellness@parkview.com.
Wellness Rewards Timeframe:
January 1, 2026 – December 31st, 2026
Participant Eligibility:
Who can participate in 2026? An employee enrolled in a medical plan offered by East Allen County Schools. Each of the four (4) steps must be completed to earn the Wellness Premium Credit.
Participant Required Actions:
Step 1: TO BE COMPLETED BY NOVEMBER 1ST, 2026!
Complete a wellness screening which includes total cholesterol, LDL cholesterol, HDL cholesterol, fasting glucose, triglycerides, height, weight, waist circumference and blood pressure. Participate in an EACS On-site Wellness Screening OR download a Healthcare Provider Verification Form for completion by your healthcare provider and submit to Parkviewworkplacewellness@parkview.com
Step 2: TO BE COMPLETED BY NOVERMBER 1ST, 2026
Submit a Non-Tobacco User Affidavit or complete an approved tobacco cessation course. Complete one (1) of the following options below:
Step 3:
Complete an Online Health Assessment by December 31st, 2026. Your Online Health Assessment will be sent to you via email after participating in an EACS On-site Wellness Screening or after submitting your Healthcare Provider Verification Screening Form.
Step 4:
Earn 8 Activity Points by December 31st, 2026. Activity Points are designed to reward and encourage your involvement in enhancing your healthy lifestyle! Of the several opportunities listed, choose the opportunities that work for you.
WELLNESS PREMIUM CREDIT
�
38
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
KEY CONTACTS
For Questions About | Carrier | Phone Number | Website/Email |
Medical & Prescription Drug | PHP-TPA /260-436-9495 | Contact: Jennifer Rose 260-446-0100 Ext 1025 | |
Dental | PHP-TPA /260-436-9495 | Contact: Jennifer Rose 260-446-0100 Ext 1025 | |
Vision | PHP-TPA /260-436-9495 | Contact: Jennifer Rose 260-446-0100 Ext 1025 | |
FSA/DCAP | PHP-TPA /260-436-9495 | Contact: Jennifer Rose 260-446-0100 Ext 1025 | |
Life and AD&D Insurance | Guardian | 888-600-1600 | |
Short-Term Disability (STD) | Guardian | 888-600-1600 | |
Long-Term Disability (LTD) | Guardian | 888-600-1600 | |
Critical Illness | Guardian | 888-600-1600 | |
Accident | Guardian | 888-600-1600 | |
Hospital Indemnity | Guardian | 888-600-1600 | |
Employee Assistance Program | Parkview Health/Guardian | 260-266-8060/800-386-7055 | worklife.uprisehealth.com |
For Questions About | | Phone Number | |
Human Resources | Jennifer Rose | 260-446-0100 ext. 1025 | |
EPIC Insurance Midwest | Kaitlyn Sandiford Client Manager | 812-478-6023 |
39
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
COMPLIANCE NOTICES
Women’s Health and Cancer Rights Act (WHCRA) Enrollment Notice: Your Rights After a Mastectomy
If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient for:
These benefits will be provided subject to the same deductible and coinsurance applicable to other medical and surgical benefits provided under this plan. Therefore, the deductible and coinsurance you will be subject to depends on your medical plan. If you would like more information on WHCRA benefits, call your plan Administrator.
HIPAA Notice of Special Enrollment Rights
If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance coverage, you may in the future be able to enroll yourself or your dependents in this plan, if you or your dependents lose eligibility for that other coverage (or if the employer stops contributions towards you or your dependents’ other coverage). However, you must request enrollment within 30 days after you or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage).
In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption.
To request special enrollment or obtain more information, contact your director of Human Resources with appropriate or required documentation of the change in which you are submitting. Please know that you may be asked to complete the carrier specific change form, for the change you are currently requesting.
Wellness Program Disclosure
Your health plan is committed to helping you achieve your best health. Rewards for participating in a wellness program are available to all employees. If you think you might be unable to meet a standard for a reward under this wellness program, you might qualify for an opportunity to earn the same reward by different means. Contact your plan administrator or Human Resources Director and we will work with you (and, if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status.
40
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
Michelle’s Law
Notice of Extended Coverage to Participants Covered Under a Group Health Plan
Federal legislation known as “Michelle's Law” generally extends eligibility for group health benefit plan coverage to a dependent child who is enrolled in an institution of higher education at the beginning of a medically necessary leave of absence if the leave normally would cause the dependent child to lose eligibility for coverage under the plan due to loss of student status. The extension of eligibility protects eligibility of a sick or injured dependent child for up to one year.
The Company (the “Plan”) currently permits an employee to continue a child’s coverage until the end of the month a child turns 26 without any restrictions. Michelle's Law requires the Plan to allow extended eligibility in some cases for a dependent child who would lose eligibility for Plan coverage due to loss of full-time student status.
There are two definitions that are important for purposes of determining whether the Michelle's Law extension of eligibility applies to a particular child:
For the Michelle’s Law extension of eligibility to apply, a dependent child’s treating physician must provide written certification of medical necessity (i.e., certification that the dependent child suffers from a serious illness or injury that necessitates the leave of absence or other enrollment change that would otherwise cause loss of eligibility).
If a dependent child qualifies for the Michelle's Law extension of eligibility, the Plan will treat the dependent child as eligible for coverage until the earlier of:
A dependent child on a medically necessary leave of absence is entitled to receive the same Plan benefits as other dependent children covered under the Plan. Further, any change to Plan coverage that occurs during the Michelle’s Law extension of eligibility will apply to the dependent child to the same extent as it applies to other dependent children covered under the Plan.
COMPLIANCE NOTICES
41
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
42
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
43
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
44
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
SHORT-TERM DISABILITY (STD)
After you have been disabled for 30 days, LTD benefits begin and you receive 60% of your income, up to a maximum of $6,000 per month. Benefits continue until you are no longer disabled or until you reach Social Security Normal Retirement Age, whichever comes first. Your LTD benefits will be offset by any other disability payments you may receive, such as Social Security or Workers’ Compensation. Benefit provided by Guardian Life Insurance Administrators.
45
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
SHORT-TERM DISABILITY (STD)
After you have been disabled for 30 days, LTD benefits begin and you receive 60% of your income, up to a maximum of $6,000 per month. Benefits continue until you are no longer disabled or until you reach Social Security Normal Retirement Age, whichever comes first. Your LTD benefits will be offset by any other disability payments you may receive, such as Social Security or Workers’ Compensation. Benefit provided by Guardian Life Insurance Administrators.
46
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
47
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
48
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
49
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
50
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
51
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
Model General Notice of COBRA Continuation Coverage Rights
(For use by single-employer group health plans)
** Continuation Coverage Rights Under COBRA**
Introduction
You're getting this notice because you recently gained coverage under a group health plan (the Plan). This notice has important information about your right to COBRA continuation coverage, which is a temporary extension of coverage under the Plan. This notice explains COBRA continuation coverage, when it may become available to you and your family, and what you need to do to protect your right to get it. When you become eligible for COBRA, you may also become eligible for other coverage options that may cost less than COBRA continuation coverage.
The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you and other members of your family when group health coverage would otherwise end. For more information about your rights and obligations under the Plan and under federal law, you should review the Plan's Summary Plan Description or contact the Plan Administrator.
You may have other options available to you when you lose group health coverage. For example, you may be eligible to buy an individual plan through the Health Insurance Marketplace. By enrolling in coverage through the Marketplace, you may qualify for lower costs on your monthly premiums and lower out-of-pocket costs. Additionally, you may qualify for a 30-day special enrollment period for another group health plan for which you are eligible (such as a spouse's plan), even if that plan generally doesn't accept late enrollees.
What is COBRA continuation coverage?
COBRA continuation coverage is a continuation of Plan coverage when it would otherwise end because of a life event. This is also called a "qualifying event." Specific qualifying events are listed later in this notice. After a qualifying event, COBRA continuation coverage must be offered to each person who is a "qualified beneficiary." You, your spouse, and your dependent children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event. Under the Plan, qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage.
If you 're an employee, you’ll become a qualified beneficiary if you lose your coverage under the Plan because of the following qualifying events:
If you're the spouse of an employee, you'll become a qualified beneficiary if you lose your coverage under the Plan because of the following qualifying events:
Your dependent children will become qualified beneficiaries if they lose coverage under the Plan because of the following qualifying events:
52
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
Model General Notice of COBRA Continuation Coverage Rights
(For use by single-employer group health plans)
** Continuation Coverage Rights Under COBRA**
When is COBRA continuation coverage available?
The Plan will offer COBRA continuation coverage to qualified beneficiaries only after the Plan Administrator has been notified that a qualifying event has occurred. The employer must notify the Plan Administrator of the following qualifying events:
For all other qualifying events ( divorce or legal separation of the employee and spouse or a dependent child's losing eligibility for coverage as a dependent child), you must notify the Plan Administrator within 30 days after the qualifying event occurs.
How is COBRA continuation coverage provided?
Once the Plan Administrator receives notice that a qualifying event has occurred, COBRA continuation coverage will be offered to each of the qualified beneficiaries. Each qualified beneficiary will have an independent right to elect COBRA continuation coverage. Covered employees may elect COBRA continuation coverage on behalf of their spouses, and parents may elect COBRA continuation coverage on behalf of their children.
COBRA continuation coverage is a temporary continuation of coverage that generally lasts for 18 months due to employment termination or reduction of hours of work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit a beneficiary to receive a maximum of 36 months of coverage.
There are also ways in which this 18-month period of COBRA continuation coverage can be extended:
Disability extension of 18-month period of COBRA continuation coverage
If you or anyone in your family covered under the Plan is determined by Social Security to be disabled and you notify the Plan Administrator in a timely fashion, you and your entire family may be entitled to get up to an additional 11 months of COBRA continuation coverage, for a maximum of 29 months. The disability would have to have started at some time before the 60th day of COBRA continuation coverage and must last at least until the end of the 18-month period of COBRA continuation coverage.
Second qualifying event extension of 18-month period of continuation coverage
If your family experiences another qualifying event during the 18 months of COBRA continuation coverage, the spouse and dependent children in your family can get up to 18 additional months of CO BRA continuation coverage, for a maximum of 3 6 months, if the Plan is properly notified about the second qualifying event. This extension may be available to the spouse and any dependent children getting COBRA continuation coverage if the employee or former employee dies; becomes entitled to Medicare benefits (under Part A, Part B, or both); gets divorced or legally separated; or if the dependent child stops being eligible under the Plan as a dependent child. This extension is only available if the second qualifying event would have caused the spouse or dependent child to lose coverage under the Plan had the first qualifying event not occurred.
53
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
Model General Notice of COBRA Continuation Coverage Rights
(For use by single-employer group health plans)
** Continuation Coverage Rights Under COBRA**
Are there other coverage options besides COBRA Continuation Coverage?
Yes. Instead of enrolling in COBRA continuation coverage, there may be other coverage options for you and your family through the Health Insurance Marketplace, Medicare, Medicaid, Children's Health Insurance Prom-am (CHIP), or other group health plan coverage options (such as a spouse's plan) through what is called a "special enrollment period." Some of these options may cost less than COBRA continuation coverage. You can learn more about many of these options at
Can I enroll in Medicare instead of COBRA continuation coverage after my group health plan coverage ends?
In general, if you don't enroll in Medicare Part A or B when you are first eligible because you are still employed, after the Medicare initial enrollment period, you have an 8-month special enrollment period1 to sign up for Medicare Part A or B, beginning on the earlier of
If you don't enroll in Medicare and elect COBRA continuation coverage instead, you may have to pay a Part B late enrollment penalty and you may have a gap in coverage if you decide you want Part B later. If you elect COBRA continuation coverage and later enroll in Medicare Part A or B before the COBRA continuation coverage ends, the Plan may terminate your continuation coverage. However, if Medicare Part A or B is effective on or before the date of the COBRA election, COBRA coverage may not be discontinued on account of Medicare entitlement, even if you enroll in the other part of Medicare after the date of the election of COBRA coverage.
If you are enrolled in both COBRA continuation coverage and Medicare, Medicare will generally pay first (primary payer) and COBRA continuation coverage will pay second. Certain plans may pay as if secondary to Medicare, even if you are not enrolled in Medicare.
For more information visit
If you have questions
Questions concerning your Plan or your COBRA continuation coverage rights should be addressed to the contact or contacts identified below. For more information about your rights under the Employee Retirement Income Security Act (ERISA), including COBRA, the Patient Protection and Affordable Care Act, and other laws affecting group health plans, contact the nearest Regional or District Office of the U.S. Department of Labor's Employee Benefits Security Administration (EBSA) in your area or visit . (Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA's website.) For more information about the Marketplace, visit
Keep your Plan informed of address changes
To protect your family's rights, let the Plan Administrator know about any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator.
54
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
55
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
56
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
57
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
58
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
59
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
60
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
61
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for:
Prepared By
Whether your client provides their own imagery or you just need additional options, customizing the templates with different photos or icons is easy.
While we’ve designed pages with imagery that has broad appeal, we’ve set up additional master pages with placeholder images. Apply one of these master layouts instead and simply click the placeholder icon to add a custom image.
Visit the EPIC intranet for curated libraries if you need additional imagery for: