Employee Benet GuideEFFECTIVE 0/01/201 - 0/31/201

www.mybenefitshub.com/pecos-barstow-toyahisd

Pecos-Barstow-Toyah Independent School District

Table of Contents

1 Contact Information

2 Online Benefit Enrollment

3 Benefit Updates

4-7 Benefit Summary

8 MDLIVE Telehealth

9-10 APL Medlink Medical Supplement

11-15 APL Accident Plan

16-18 CIGNA Dental

Benefit Contact Information

Refer to this list when you need to contact one of your benefit providers. For general information please contact your Benefits Department, Financial Benefit Services or log on to www.mybenefitshub.com/pecos-barstow-toyahisd

19 Superior Vision

20-28 UNUM Long Term Disability

29-35 Loyal American Cancer

36-40 Allstate Heart & Stroke

41-44 The Hartford Life & AD&D

45-48 Trustmark Universal Life

49-52 NBS Flexible Spending Accounts

Benefit Vendor Phone Number Website

Pecos-Barstow-Toyah ISD Benefit Website

Financial Benefit Services (800) 583-6908 www.mybenefitshub.com/pecos-barstow-toyahisd

Telehealth MDLIVE (888) 365-1663 www.consultmdlive.com

Medical Supplement - Medlink American Public Life (800) 256-8606 www.ampublic.com

Dental CIGNA (800) 244-6224 www.cigna.com

Vision Superior Vision (800) 507-3800 www.superiorvision.com

Disability UNUM (800) 583-6908 www.mybenefitshub.com/pecos-barstow-toyahisd

Cancer Loyal American (800) 366-8354 www.mybenefitshub.com/pecos-barstow-toyahisd

Accident American Public Life (800) 256-8606 www.ampublic.com

Heart & Stroke Allstate (800) 348-4489 www.mybenefitshub.com/pecos-barstow-toyahisd

Voluntary Group Life and AD&D The Hartford (800) 583-6908 www.mybenefitshub.com/pecos-barstow-toyahisd

Universal Life with Long Term Care Trustmark (866) 914-5202 www.trustmarkinsurance.com

Flexible Spending Accounts National Benefit Services (800) 274-0503 www.nbsbenefits.com

COBRA (dental, vision, medical FSA)Retirement 403b & 457

National Benefit Services (800) 274-0503 www.nbsbenefits.com

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Cl

Passwords

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2 Click the Login button to begin your Online Enrollment

*If you have trouble logging in, Click on the Login Help Video for assistance.

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All passwords have been RESET to the default described below:

Online Benefit Enrollment

Username: The first Six (6) characters of your last name, followed by the first letter of your first name, followed by the last four (4) digits of your Social Security Number.

Default Password: Last Name* (lowercase, excluding punctuation) followed by the last four (4) digits of your Social Security Number.

Example:

Example:

Enrollment Instructions

Click on Enrollment Instructions for more information about how to

enroll .

George Washington 000-00-1234 John Smith 000-00-4321

Username: washing1234 Password: washington1234 Username: smithj4321 Password: smith4321

Passwords

For benefit information and to enroll go to: www.mybenefitshub.com/pecos-barstow-toyahisd

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2

4

Passwords

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2/01/2015 - 1/31/2016

Pecos-Barstow-Toyah ISD Employee Benefits HUB:

www.mybenefitshub.com/pecos-barstow-toyahisd

www.mybenefitshub.com/pecos-barstow-toyahisd

PBT ISD Annual Medical Enrollment

Open 8/01/2015 - 8/31/2015

Annual Benefit Enrollment

Login and complete your benefit enrollment from 08/01/2015 - 08/31/2015 Enrollment assistance is available by calling Financial Benefit Services at (866) 914-5202 between 10am 7 pm (Spanish speaking representatives will be available) Update your profile information: home address, phone numbers, email, beneficiaries REQUIRED: Provide correct dependent social security numbers

Dont Forget!

Whats New for September 2015: Benefit elections will become effective 9/1/2015 (elections requiring evidence of insurability, such as life Insurance, may have a later effective date, if approved). After annual enrollment closes, benefit changes can only be made if you experience a qualifying event (and changes must be made within 30 days of event). Online Benefit Access: www.mybenefitshub.com/pecos-barstow-toyahisd You have access to benefit information 24/7 on the employee benefit website provided. You can review and print the consolidated enrollment form or benefit guide, download claim forms and plan summaries, link to

carrier websites and provider searches.

Due to new federal ACA Regulations, every employee (including active contributing members and employees working 10 hours/week) is required to log in and complete the enrollment process, even if declining benefits. Health Insurance elections will not roll over. If you do not log in and enroll, you will not have this benefit in the 2015/16 plan year. For complete TRS medical information, visit the TRS website at www.trsactivecareaetna.com or call 800.222.9205 or www.trsactivecareaetna.com 800.884.4901

Flex Spending: New hires enrolling in a HealthCare or Dependent Care FSA, please remember the flex plan year ends 1/31/2016 with 75 day grace period. Please choose your 5 month contributions wisely. Funds are use it or lose it. New participants will receive medical flex card in late Sept. Funds are available thru web or paper claim mid Sept. Employees who currently participate in a Healthcare FSA (flexible spending account), please KEEP your card. You will be able to log-in thru the THEBenefits HUB or use the smart phone app to view your balances and card swipes. Vision: Generic Superior Vision card available on your Benefit Website. Network Providers- Superior National. Telehealth: MDLIVE is the new telehealth carrier effective 2/1/2015 . This is the same employer-paid benefit for all eligible employees. Telephone consultation for diagnosis & treatment for common conditions. Plan covers employee, spouse and all unmarried dependents under the age of 26 years. No Cards are mailed, but they are available on the Benefit Website in the Welcome Kit for your convenience.

Benefit Summary www.mybenefitshub.com/pecos-barstow-toyahsisd

This is only an outline of benefits. If the terms of this benefit summary differ from your policy, the policy will govern.

Telehealth - MDLIVE This Employer Paid plan provides you and your family with around-the-clock access to U.S-based, licensed physicians for telephone consultations. Its easy to connect with a doctor in real-time for treatment or diagnosis of common non-emergency conditions. MEDlink Insurance - American Public Life (APL) This supplemental coverage helps offset out-of-pocket costs you experience due to deductible & coinsurance for an in-patient hospital stay. The available plan options are based on enrollment in your employers medical plan & includes $1,500 or $2,500 inpatient hospital benefit option This plan also pays a $200 outpatient benefit and a $25.00 Physician Outpatient Benefit. You are not eligible for MEDlink if any of the following apply: employees (or dependents) who arent covered under your employers medical plan, anyone covered by TRS-Care (retiree plan), Medicare, Medicaid, or Medical Savings Accounts, employees who have an HSA that is being actively funded, non-residents of the US, employees not actively at work on the plan effective date. Dental Insurance - CIGNA This is a PPO dental plan with the freedom to chose any dentist. In-network benefits are 100% for preventive, 80% for Basic, 50% for Major services and 50% Orthodontia with a Lifetime maximum of $1,000 for dependent children to age 19. Out-of-Network charges are paid based on usual, reasonable and customary fees. There is a $50 deductible for Basic and Major services per person, to a maximum of $150. Calendar year plan maximums per insured are: Year 1 -$1,250; Year 2 - $1,350; Year 3 -$1,450 and Year 4 -$1550. Vision Insurance - Superior Vision Members pay a copay for in-network benefits. Out-of-network vision services are reimbursed up to a certain dollar amount for covered expenses. The in-network exam co-pay is $10.00, the materials copay is $25.00 and the contact lenses fitting exam copay is $25.00. Exams, lenses & frames (within plan allowance) are covered in-network with a co-pay, once every 12 months. Long-Term Disability Insurance - UNUM This insurance is designed to provide a monthly income to an individual who is disabled due to an accident or illness. There are different plans available with benefits becoming available from the 1st day of disability to as late as the 180th day. Benefits can be payable to age 65 if disability occurs prior to age 65. All new or increases in coverage are subject to pre-existing condition exclusions. Cancer Insurance - Loyal American Cancer insurance is designed to be a supplement & pays for many costs not covered by your medical insurance. There are 3 plan options available, with Guaranteed Issue and no medical questions. Some plan benefit are: cancer screening tests, first occurrence, chemotherapy/radiation and surgical benefits. All new or increases in coverage are subject to pre-existing condition exclusions. Accident Insurance -American Public Life (APL) This Plan pays a benefit amount for covered accidental injuries. This plan has an ambulance, hospital and physician expense benefit for covered accidents. Coverage is issuable for ages 18-64 and is portable, you can choose to keep your benefit even if you leave the district or retire until age 70. Voluntary Group Term Life & AD&D Insurance - The Hartford This portable plan is an affordable way to purchase additional life insurance. Employees must enroll in order to enroll dependents. Employees can enroll for up to a max of 5 times salary not to exceed $500,000 and $250,000 on their spouse and $10,000 on each eligible dependent child under age 26. New coverage in excess of 10k for employee and 5k for spouse is subject to underwriting and Evidence of Insurability form is required. New employees can enroll for up to $150,000 on themselves, $50,000 on their spouse and $10,000 on their children on a Guarantee Issue Basis (No Health Questions Asked) as long as the election is made within 31 days of hire date. For new or increases in coverage to take effect, employees must be actively at work and spouse/child cannot be disabled. Universal Life with Long Term Care Insurance - Trustmark Plan offers Permanent Life Insurance designed to match your needs throughout your lifetime. It pays higher death benefit during working years when expenses are high and you need maximum protection. Then, at age 70 when financial needs are lower, the death benefit reduces. However, the Living Benefit for Long Term Care (LTC) never reduces. That means you will have maximum protection during your retirement when you are more than likely to need it. Your LTC Benefit helps supplement the cost of home healthcare, assisted living, adult day care and nursing home care. (Speak to an Enroller for an application, paper application required.) Heart & Stroke Insurance - Allstate Plan pays you benefits that can be used for non-medical expenses that health insurance might not cover. No benefits are payable during the first year of coverage for a pre-existing condition. Plan is portable, you can choose to keep your benefit if you leave the district. Paper application required. Healthcare & Dependent Care Flexible Spending Account by National Benefit Services Tax-sheltered flexible spending accounts allow an individual to set aside dollars to pay for future healthcare & dependent care expenses. Eligible expenses must be incurred within the plan year 2/1/20151/31/2016 & 75 day grace period. Contributions are use-it-or- lose-it. The healthcare reimbursement maximum is $2,400/plan year. The dependent care reimbursement maximum is $5,000 married or $2,500 for married individuals filing separately. Remember to keep all your receipts!

Current Healthcare FSA Participants: Do not discard your NBS Flex Card. Your new Flex funds will be loaded on your current NBS Flex Card. Please allow up to 14 days following February 1, 2015 for your funds to be available.

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During your annual enrollment period, you have the opportunity to review, change or continue benefit elections each year. Changes are not permitted during the plan year (outside of annual enrollment) unless a Section 125 qualifying event occurs.

Changes, additions or drops may be made only during the annual enrollment period without a qualifying event.

Employees must review their personal information and verify that dependents they wish to provide coverage for are included in the dependent profile. Additionally, you must notify your employer of any discrepancy in personal and/or benefit information.

Employees must confirm on each benefit screen (dental, vision, etc.) that each dependent to be covered is selected in order to be included in the coverage for that particular benefit.

Annual Enrollment

New Hire Enrollment

All new hire enrollment elections must be completed in the online enrollment system within the first 31 days of benefit eligibility employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.

Q&A

Who do I contact with Questions? For supplemental benefit questions, you can contact your Benefits/HR department or you can call Financial Benefit Services at 866-914-5202 for assistance.

Where can I find forms? For benefit summaries and claim forms, go to the Pecos-Barstow-Toyah ISD benefit website: www.mybenefitshub.com/pecos-barstow-toyahisd Click on the benefit plan you need information on (i.e., Dental) and you can find the forms you need under the Benefits and Forms section.

How can I find a Network Provider? For benefit summaries and claim forms, go to the PBT ISD benefit website: www.mybenefitshub.com/pecos-barstow-toyahisd Click on the benefit plan you need information on (i.e., Dental) and you can find provider search links under the Quick Links section.

When will I receive ID cards? If the insurance carrier provides ID cards, you can expect to receive those 3-4 weeks after your effective date. For most dental and vision plans, you can login to the carrier website and print a temporary ID card or simply give your provider the insurance companys phone number and they can call and verify your coverage if you do not have an ID card at that time. If you do not receive your ID card, you can call the carriers customer service number to request another card.

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Plan Carrier Child Maximum Age

Dental Cigna Through 25

Vision Superior Vision Through 25

Cancer Loyal American Through 24

Accident American Public Life Through 25

Heart & Stroke Allstate Through 25

Telehealth MDLIVE Through 25

Voluntary Life & AD&D

The Hartford Through 24, IRS dependent

Medical Gap Plan American Public Life Through 25

Healthcare FSA & HSA

National Benefit Services IRS Tax Dependent

Dependent Flex National Benefit Services 12 or younger or qualified individual

unable to care for themselves & claimed as a dependent on your taxes

Dependent Eligibility: You can cover eligible dependent children under a benefit that offers dependent coverage, provided you participate in the same benefit, through the maximum age listed below. Dependents cannot be double covered by married spouses within the PBT ISD or as employees and dependents.

If your dependent is disabled, coverage can continue past the maximum age under certain plans. If you have a disabled dependent who is reaching an ineligible age, you may need to provide documentation confirming your dependents disability. Contact your HR/Benefit Administrator for more information .

Dependent Eligibility Requirements

Supplemental Benefits: Eligible employees must work 20 or more regularly scheduled hours each work week.

Eligible employees must be actively at work on the plan effective date for new benefits to be effective, meaning you are physically capable of performing the functions of your job on the first day of work concurrent with the plan effective date. For example, if your 2015 benefits become effective on February 1, 2015, you must be actively-at-work on February 1, 2015 to be eligible for your new benefits.

Employee Eligibility Requirements

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This is a general overview of your plan benefits. Additional details on covered expenses, limitations and exclusions are included in the

summary plan description located on the PBT ISD Benefits Website: www.mybenefitshub.com/pecos-barstow-toyahisd

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Changes In Status (CIS): Qualifying Events

Marital Status A change in marital status includes marriage, death of a spouse, divorce or annulment (legal separation is not recognized in all states).

Change in Number of Tax Dependents

A change in number of dependents includes the following: birth, adoption and placement for adoption. You can add existing dependents not previously enrolled whenever a dependent gains eligibility as a result of a valid change in status event.

Change in Status of Employment Affecting

Coverage Eligibility

Change in employment status of the employee, or a spouse or dependent of the employee, that affects the individual's eligibility under an employer's plan includes commencement or termination of employment.

Gain/Loss of Dependents' Eligibility Status

An event that causes an employee's dependent to satisfy or cease to satisfy coverage requirements under an employer's plan may include change in age, student, marital, employment or tax dependent status.

Judgment/Decree/Order

If a judgment, decree, or order from a divorce, annulment or change in legal custody requires that you provide accident or health coverage for your dependent child ( including a foster child who is your dependent), you may change your election to provide coverage for the dependent child. If the order requires that another individual (including your spouse and former spouse) covers the dependent child and provides coverage under that individual's plan, you may change your election to revoke coverage only for that dependent child and only if the other individual actually provides the coverage.

Eligibility for Government Programs

Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change.

Section 125 Cafeteria Plan Guidelines

A Cafeteria plan enables you to save money by using pre-tax dollars to pay for eligible group insurance premiums sponsored and offered by your employer. Enrollment is automatic unless you decline this benefit. Elections made during annual enrollment will become effective on the plan effective date and will remain in effect during the entire plan year. Changes in benefit elections can occur only if you experience qualifying event. You must present proof of a qualifying event to your Benefit Office within 30 days of your qualifying event and meet with your Benefit/HR Office to complete and sign the necessary paperwork in order to make a benefit election change. Benefit changes must be consistent with the qualifying event .

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Call us at (888) 365-1663 or visit us at consultmdlive.com

Who are our providers? Are children eligible?

Our providers practice primary care,pediatrics, family and emergency medicine, and have incorporated MDLIVE into their practice to provide convenient access to qualitycare.

Yes. MDLIVE has local pediatricianson-call 24/7/365.However, a parent or guardian must be present during registration and any consultations involvingminors.

24/7/365 on-demand access toaffordable, quality healthcare.Anytime, Anywhere.

MDLIVE offers 24/7/365 on-demand access to anational network of board-certified doctors andpediatricians that can diagnose, recommendtreatment, and prescribe medication. Getthe care you need, when you need it.

What can be treated?

AllergiesAsthmaBronchitisCold and FluEar InfectionsJoint Aches and PainRespiratory InfectionSinus ProblemsAnd More!

Disclaimers: MDLIVE does not replace the primary care physician. MDLIVE operates subject to state regulation and may not be available in certain states. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services. For complete terms of use visit www.mdlive.com/pages/terms.html 010113

When should I use MDLIVE?If youre considering the ER or urgent care for a non-emergencymedical issueYour primary care physician is not availableAt home, traveling, or at work24/7/365, even holidays!

Pediatric Care related to:

Cold & FluConstipationEar InfectionFeverNausea & VomitingPink EyeAnd More!

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APSB-22330(TX) MGM/FBS Pecos Barstow Toyah ISD

MEDlink Limited Benefit Medical Expense Supplemental InsurancePecos Barstow Toyah ISD Group #14986 / #15841

THE POLICY UNDER WHICH THIS CERTIFICATE IS ISSUED IS NOT A POLICY OF WORKERS COMPENSATION INSURANCE. THE EMPLOYER DOES NOT BECOME A SUBSCRIBER TO THE WORKERS COMPENSATION SYSTEM BY PURCHASING THE POLICY AND IF THE EMPLOYER IS A NON-SUBSCRIBER, THE EMPLOYEE LOSES THOSE BENEFITS WHICH WOULD OTHERWISE ACCRUE UNDER THE WORKERS COMPENSATION LAWS. THE EMPLOYER MUST COMPLY WITH THE WORKERS COMPENSATION LAW AS IT PERTAINS TO NON-SUBSCRIBERS AND THE REQUIRED NOTIFICATIONS THAT MUST BE FILED AND POSTED.

*Total premium includes the Plan selected and any applicable rider premium. Premiums are subject to increase with notice.The premium and amount of benefits vary dependent upon the Plan selected at time of application.

LimitationsEligibilityThis policy will be issued to those persons who meet American Public Life Insurance Companys insurability requirements. Evidence of insurability acceptable to us may be required. If our underwriting rules are met, you are on active service, you are covered under your Employers Medical Plan and premium has been paid, your insurance will take effect on the requested Effective Date or the Effective Date assigned by us upon approval of your written application, whichever is later.

Covered Charges mean those charges that are incurred by a Covered Person because of an Accident or Sickness; are for necessary treatment, services and medical supplies and recommended by a Physician; are not more than any dollar limit set forth in the Schedule; are incurred while insured under the Policy, subject to any Extension of Benefits; and are not excluded under the Policy.

A Hospital is not any institution used as a place for rehabilitation; a place for rest, or for the aged; a nursing or convalescent home; a long term nursing unit or geriatrics ward; or an extended care facility for the care of convalescent, rehabilitative or ambulatory patients.

In-Hospital BenefitBenefits payable are limited to any out-of-pocket deductible amount; any out-of-pocket co-payment or coinsurance amounts the Covered Person actually incurs after your Employers Medical Plan has paid; any out-of-pocket amount the Covered Person actually incurs for surgery performed by a Physician after the your Employers Medical Plan has paid; and the Maximum

In-Hospital Benefit shown in the Policy Schedule. The Covered Person must be an Inpatient and covered by your Employers Medical Plan when the Covered Charges are incurred.

Outpatient BenefitsTreatment is for the same or related conditions, unless separated by a period of 90 consecutive days. After 90 consecutive days, a new Outpatient Benefit will be payable. The Covered Person must be covered by your Employers Medical Plan when the Covered Charges are incurred.

Physician Outpatient Treatment BenefitBenefit maximum of $125 per family per Calendar Year. The Covered Person must be covered by your Employers Medical Plan when the Covered Charges are incurred. The Covered Person must not be an Inpatient when the Covered Charges are incurred.

PremiumsThe premium rates may be changed by Us. If the rates are changed, We will give You at least 31 days advance written notice. If a change in benefits increases Our liability, premium rates may be changed on the date Our liability is increased.

This plan may be continued in accordance with the Consolidated Omnibus Reconciliation Act of 1986.

Summary of BenefitsBenefit Description Option 1 Option 2

In-Hospital Benefit - Maximum In-Hospital Benefit $1,500 per confinement $2,500 per confinement

Outpatient Benefit up to $200 per treatment up to $200 per treatment

Physician Outpatient Treatment Benefit $25 per treatment; $125 max per family per Calendar Year

$25 per treatment; $125 max per family per Calendar Year

Option 2 Total Monthly Premiums by Plan*

Issue Ages 17-54

Issue Ages 55-59

Issue Ages 60-69

Employee $28.00 $44.50 $68.50

Employee & Spouse $51.50 $81.50 $122.50

1 Parent Family $45.50 $62.00 $86.00

2 Parent Family $69.00 $99.00 $140.00

Option 1 Total Monthly Premiums by Plan*

Issue Ages 17-54

Issue Ages 55-59

Issue Ages 60-69

Employee $21.50 $32.00 $49.00

Employee & Spouse $39.50 $59.00 $88.00

1 Parent Family $36.50 $47.00 $64.00

2 Parent Family $54.50 $74.00 $103.00

Option 1 Total 9-Pay Premiums by Plan*

Issue Ages 17-54

Issue Ages 55-59

Issue Ages 60-69

Employee $28.67 $42.67 $65.33

Employee & Spouse $52.67 $78.67 $117.33

1 Parent Family $48.67 $62.67 $85.33

2 Parent Family $72.67 $98.67 $137.33

Option 2 Total 9-Pay Premiums by Plan*

Issue Ages 17-54

Issue Ages 55-59

Issue Ages 60-69

Employee $37.33 $59.33 $91.33

Employee & Spouse $68.67 $108.67 $163.33

1 Parent Family $60.67 $82.67 $114.67

2 Parent Family $92.00 $132.00 $186.67

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This is a brief description of the coverage. For actual benefits, limitations, exclusions and other provisions, please refer to the policy and riders. This coverage does not replace Workers Compensation Insurance. This product is inappropriate for people who are eligible for Medicaid coverage. | This policy is considered an employee welfare benefit plan established and/or maintained by an association or employer intended to be covered by ERISA, and will be administered and enforced under ERISA. Group policies issued to governmental entities and municipalities may be exempt from ERISA guidelines. Policy Form MEDlink Series | Texas | Limited Benefit Medical Expense Supplemental Insurance | (10/14) | Pecos Barstow Toyah ISD

Underwritten by:

2305 Lakeland Drive | Flowood, MS | 39232ampublic.com | 800.256.8606

ExclusionsWe will pay no benefits for any expenses incurred during any period the Covered Person does not have coverage under your Employers Medical Plan, except as provided in the Absence of your Employers Medical Plan provision or which result from:(a) suicide or any attempt, thereof, while sane or insane; (b) any intentionally self-inflicted injury or Sickness;(c) rest care or rehabilitative care and treatment;(d) routine newborn care, including routine nursery charges;(e) voluntary abortion except, with respect to You or Your covered

Dependent spouse: (1) where Your or Your Dependent spouses life would be

endangered if the fetus were carried to term; or (2) where medical complications have arisen from abortion;(f) pregnancy of a Dependent child;(g) participation in a riot, civil commotion, civil disobedience, or

unlawful assembly. This does not include a loss which occurs while acting in a lawful manner within the scope of authority;

(h) commission of a felony;(i) participation in a contest of speed in power driven vehicles,

parachuting, or hang gliding;(j) air travel, except: (1) as a fare-paying passenger on a commercial airline on a

regularly scheduled route; or (2) as a passenger for transportation only and not as a pilot or

crew member;(k) intoxication; (Whether or not a person is intoxicated is determined

and defined by the laws and jurisdiction of the geographical area in which the loss occurred.)

(l) alcoholism or drug use, unless such drugs were taken on the advice of a Physician and taken as prescribed;

(m) sex changes;(n) experimental treatment, drugs, or surgery;(o) an act of war, whether declared or undeclared, or while performing

police duty as a member of any military or naval organization; (This exclusion includes Accident sustained or Sickness contracted while in the service of any military, naval, or air force of any country engaged in war. We will refund the pro rata unearned premium for any such period the Covered Person is not covered.)

(p) Accident or Sickness arising out of and in the course of any occupation for compensation, wage or profit; (This does not apply to those sole proprietors or partners not covered by Workers Compensation.)

(q) mental illness or functional or organic nervous disorders, regardless of the cause;

(r) dental or vision services, including treatment, surgery, extractions, or x-rays, unless:

(1) resulting from an Accident occurring while the Covered Persons coverage is in force and if performed within 12 months of the date of such Accident; or

(2) due to congenital disease or anomaly of a covered newborn child.

(s) routine examinations, such as health exams, periodic check-ups, or routine physicals;

(t) any expense for which benefits are not payable under the Covered Persons your Employers Medical Plan; or

(u) air or ground ambulance.

Termination of Coverage Your Insurance coverage will end on the earliest of these dates: the date You no longer qualify as an Insured; the end of the last period for which premium has been paid; the date the Policy is discontinued; the date You retire; if You work for an employer employing less than 20 employees on a typical work day in the preceding Calendar Year, the date You attain age 70; the date You cease to be on Active Service; the date Your coverage under your Employers Medical Plan ends; or the date You cease employment with the employer through whom You originally became insured under the Policy.

Insurance coverage on a Dependent will end on the earliest of these dates: the date Your coverage terminates; the end of the last period for which premium has been paid; the date the Dependent no longer meets the definition of Dependent; the date the Dependents coverage under your Employers Medical Plan ends; or the date the Policy is modified so as to exclude Dependent coverage.

We may end the coverage of any Covered Person who submits a fraudulent claim.

We may end the coverage of a Subscribing Unit if fewer persons are insured than the Policyholders application requires.

APSB-22330(TX) MGM/FBS Pecos Barstow Toyah ISD Page 10

Form A-3B Revised (10/06) Gen/D.C./ID/NC/TN/WV

Supplemental

Accident Insurance

Because Life is full of surprises

American Public Life Insurance Company EZ2DOBIZWITHTM

Form A-3B Revised (10/06) Gen/D.C./ID/NC/TN/WVPage 11

ACCIDENTS HAPPEN -ITS A SIMPLE FACT OF LIFE

BUT THEY DONT HAVE TO CATCH YOU UNPREPARED

With added security coverage, you can rest assured that youre protected if a covered accident happens to threaten your nancial security, or the security of your family. So give yourself and your family the protection and peace of mind you need. Wouldnt this be the perfect time to add this valuable protection?

ITS A LEVEL OF PROTECTION OTHER COVERAGE PLANS SIMPLY CANT MATCH

Added Security Coverage pays regardless

of any other medical coverage

It protects you 24 hours a day on or off the job

Issue ages, 18-64

Its guaranteed renewable up to age 70

Family members receive full benets

Benets are paid directly to you

There is no limit on the number of accidents covered

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Pecos-Barstow-Toyah Independent School DistrictA3 - Accident Expense Policy

Benefits 1 Unit 2 Units 3 Units 4 Units

Accidental Injury Benefit - We will pay the actual charges per accident (not to exceed maximum benefits for units selected) for physicians treatment, surgery, x-rays, reduction of fractures and dislocations or other emergency treatment expenses. In no case will the benefit exceed actual charges. There is a $50 deductible for emergency room expenses, per occurrence, regardless of the number of units.

$500 $1,000 $1,500 $2,000

Ambulance Benefit - We will pay the actual charges (not to exceed maximum benefits for units selected) for emergency transportation for covered treatment (ground or air).

Hospital Confinement - We will pay the daily hospital benefit, based upon the number of units selected, when a covered insured is confined to a hospital due to accident or injury. This benefit begins the first day of confinement and pays up to 30 days per any one injury.

Hospital Admission Benefit - We will pay for the benefit shown, based upon the number of units selected, upon admission to a hospital due to a covered accident.

Accident Only Intensive Care Benefit: We will pay the daily benefit shown, based on the number of units selected, for intensive care confinement as a result of accidental bodily injury, subject to a maximum benefit period of 30 days. This benefit pays $150 daily per unit. A maximum of four units may be purchased.

Accidental Death Benefit* - We will pay the benefit shown for accidental death which results within 90 days of injury, based upon the number of units selected.

$1,250

$75

$100

$150

$5,000

$2,500

$150

$100

$150

$10,000

$3,750

$225

$100

$150

$15,000

$5,000

$300

$100

$150

$20,000

Dismemberment* - We will pay the following benefit, based upon the number of units selected, for dismemberment which results within 90 days of injury (dismemberment benefits are subject to a $5,000 per unit cumulative maximum). Single Finger or toe Multiple fingers or toes Single Hand, Arm, Foot or Leg Multiple Hands, Arms, Feet or Legs

$250 $500

$2,500 $5,000

$500 $1,000 $5,000 $10,000

$750 $1,500 $7,500

$15,000

$1,000 $2,000 $10,000 $20,000

Loss of Sight Benefit - We will pay the benefit, based upon the number of units selected, shown for the loss of sight due to accidental injury. Loss of sight in one eye Loss of sight in both eyes

$2,500 $5,000

$5,000 $10,000

$7,500 $15,000

$10,000 $20,000

Premiums: Individual Individual and Spouse Individual and Children Family (2 Parents and children)

$11.70 $20.70 $22.70 $31.70

$18.00 $31.10 $36.40 $49.50

$22.40 $40.20 $46.70 $64.50

$25.40 $46.20 $53.50 $74.30

Page 13

DEFINITIONS

INJURY or ACCIDENTAL INJURY or ACCIDENTAL BODILY INJURY means physical damage to an Insured Person, sustained on or after the Effective Date, and while this Policy is in force, which is the direct cause of the loss, independent of disease, bodily inrmity or any other cause. All injuries sustained in any one accident and all complications arising therefrom and recurrence and complication shall be deemed to be a single Injury.

DISABILITY means Your inability, as a result of covered Accidental Injury, to perform the substantial and material duties of Your occupation and You are not gainfully employed.

EXCLUSIONS AND LIMITATION

Benets otherwise provided by this policy will not be payable for services or expenses or any such loss resulting from or in connection with:

1. sickness, illness or bodily inrmity; except as covered by the Sickness Disability Rider;

2. suicide, attempted suicide or intentional self-inicted injury, whether sane or insane;

3. dental care or treatment due to accidental injury to natural teeth;

4. war or any act of war (whether declared or undeclared) or participating in a riot or felony;

5. alcoholism or drug addiction;

6. travel or ight in or descent from any aircraft or device which can y above the earths surface in any capacity other than as a fare-paying passenger on a regularly scheduled airline;

7. injury originating prior to the effective date of the policy;

8. injury occurring while intoxicated (intoxication means that which is determined and dened by the laws and jurisdiction of the geographical area in which the loss or cause of loss is incurred);

9. voluntary inhalation of gas or fumes or taking of poison or asphyxiation;

10. voluntary ingestion or injection of any drug, narcotic or sedative, unless administered on the advice and taken in such doses as prescribed by a physician;

11. injury sustained or sickness which manifests itself while on full-time duty in the armed forces. Upon notice, the company will refund the proportion of unearned premium while in such forces;

12. injury incurred while engaged in an illegal occupation;

13. injury incurred while attempting to commit a felony or an assault;

14. mental or emotional disorders;

15. injury to a covered person while practicing for or being a part of organized or competitive rodeo, sky diving, hang gliding parachuting or scuba diving;

16. driving in any race or speed test or while testing an automobile or any vehicle on any racetrack or speedway;

17. charges incurred outside the U.S. if an insured traveled to the location for the purpose of receiving medical services, drugs or supplies;

18. hernia, carpal tunnel syndrome or any complication therefrom;

19. any bacterial infection (except pyogenic infections which shall occur with and through an accidental cut or wound).

If you are entitled to benets under this policy, as a result of sprained or lame back, or any intervertebral disk conditions, such benets shall be payable for a maximum period of time, not exceeding in the aggregate three (3) months for any injury.

These exclusions and limitations are not applicable for all states. Please refer to your policy or outline for applicable exclusions and limitations.

Page 14

American Public Life Insurance Company P.O. Box 925 Jackson, Mississippi 39205800-256-8606 800-256-6736 (Sales Department) www.ampublic.com

A m e m b e r o f t h e A m e r i c a n F i d e l i t y G r o u p

American Public LifeInsurance Company

This brochure does not constitute the full contract and is intended to provide basic information about American Public Life Insurance Companys Form A-3B Supplemental Accident product. For specic details, please consult an actual policy and its provisions.

This coverage should be viewed as a supplement to other health insurance. This is not the insurance contract, and only the actual policy provisions will apply. It is therefore important that you read your policy carefully. All products are not available in all states.

In West Virginia: 18, and 19 above are changed and read as follows:18. hernia, within six (6) months after the Effective Date;19. carpal tunnel syndrome or any complication therefrom;20. any bacterial infection (except pyogenic infections which shall occur with and through an accidental cut or wound).

In Idaho: Exclusions and Limitations 1. sickness, illness or bodily inrmity; 2. suicide, attempted suicide or intentional self-inicted Injury, whether sane or insane; 3. dental care or treatment due to accidental Injury to natural teeth; 4. war or any act of war (whether declared or undeclared) or participating in a riot or felony; 5. alcoholism or drug addiction; 6. participation in any form of ight aviation other than as a fare-paying passenger in a licensed, passenger-carrying aircraft; 7. a Pre-existing Condition incurred within 12 months following the effective date of coverage; 8. Injury occurring while intoxicated or under the inuence of any narcotic, unless administered on the advice and taken in such doses as prescribed by a Physician; 9. Injury sustained or sickness which rst manifests itself while on full-time duty in the armed forces. Upon notice, We will refund

the proportion of unearned premium while in such forces.10. Injury incurred while engaging in an illegal occupation;11. Injury incurred while attempting to commit a felony;12. mental or emotional disorders;13. Injury to a covered person while participating as a professional as a part of organized or competitive rodeo, sky diving, hang gliding, parachuting or scuba diving;14. driving as a professional in any race or speed test or while testing an automobile or any vehicle on any racetrack or

speedway;15. charges incurred outside the U.S., if an Insured traveled to the location for the purpose of receiving medical services, drugs or

supplies;

Page 15

Cigna Dental Benefit Summary

Pecos-Barstow-Toyah ISD

Account #3335679 Receiving regular dental care can not only catch minor problems before they become major and expensive to treat - it may even help improve your overall health. Gum disease is increasingly being linked to complications for pre-term birth, heart disease, stroke, diabetes, osteoporosis and other health issues. Thats why this dental plan includes Cigna Dental WellnessPlusSM features. When you or your family members receive any preventive care in one plan year, the annual dollar maximum will increase in the following plan year. When you or your family members remain enrolled in the plan and continue to receive preventive care, the annual dollar maximum will increase in the following plan year, until it reaches the level specified below. Please refer to your plan materials for additional information on this plan feature.

Benefits Cigna Dental PPO In-Network Out-of-Network

Network Total Cigna DPPO Calendar Year Maximum (Class I, II and III expenses)

Year 1: $1,250 Year 2: $1,350#

Year 1: $1,250 Year 2: $1,350#

Year 3: $1,450+ Year 4 and beyond: $1,550^ Year 3: $1,450+ Year 4 and beyond: $1,550^ Annual Deductible Individual

Family

$50 per person

$150 per family

$50 per person

$150 per family

Reimbursement Levels** Based on Reduced Contracted Fees 90th percentile of Reasonable and Customary Allowances

Plan Pays You Pay Plan Pays You Pay

Class I - Preventive & Diagnostic Care Oral Exams

Routine Cleanings

Bitewing X-rays

Full Mouth X-rays

Panoramic X-ray

Fluoride Application

Sealants

Space Maintainers

100% No Charge 100% No Charge

Class II - Basic Restorative Care Fillings

Emergency Care to Relieve Pain

Surgical Extractions of Impacted

Teeth Brush Biopsies

Oral Surgery - all except simple extractions

Anesthetics

Oral Surgery Simple Extractions

80%* 20%* 80%* 20%*

Class III - Major Restorative Care Crowns

Root Canal Therapy/Endodontics

Osseous Surgery

Periodontal Scaling and Root Planing

Histopathologic Exams

Denture Repairs

Denture Relines, Rebases and

Adjustments Repairs to Bridges,

Crowns and Inlays Dentures

Bridges

Inlays/Onlays

Prosthesis Over Implant

50%* 50%* 50%* 50%*

Class IV - Orthodontia Lifetime Maximum

50%* $1,000

Dependent children to

age 19

50%* 50%* $1,000

Dependent children to

age 19

50%*

EE Only $ 25.69 EE + Spouse $ 54.54 EE + Child(ren) $ 57.33 Family Coverage $ 83.91

Page 16

Important Notes Missing Tooth Limitation The amount payable is 50% of the amount otherwise payable until insured for 24 months; thereafter, considered a Class III expense. Pretreatment review is available on a voluntary basis when extensive dental work in excess of $200 is proposed.

* Subject to annual deductible

Dental Oral Health Integration Program (OHIP)- All dental customers= Clinical research shows an association between oral health and overall health. The Cigna

Dental Oral Health Integration Program (OHIP) is designed to provide enhanced dental coverage for customers with certain eligible medical conditions. Eligible

conditions for the program include cardiovascular disease, cerebrovascular disease (stroke), diabetes, maternity, chronic kidney disease, organ transplants, and head and

neck cancer radiation. The program provides:

100% coverage for certain dental procedures

guidance on behavioral issues related to oral health

discounts on prescription and non-prescription dental products

For more information and to see the complete list of eligible conditions, go to www.mycigna.com or call customer service 24/7 at 1.800.CIGNA24.

**For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Contracted Fee Schedule. For services provided

by an out-of-network dentist, Cigna Dental will reimburse according to Reasonable and Customary Allowances but the dentist may balance bill up to their usual fees.

#Increase contingent upon receiving Preventive Services in Plan Year 1

+Increase contingent upon receiving Preventive Services in Plan Years 1 and 2

^Increase contingent upon receiving Preventive Services in Plan Years 1, 2 and 3

Cigna Dental PPO Exclusions and Limitations

Procedure Exclusions and Limitations Late Entrants Limit 50% coverage on Class III and IV for 24 months

Exams Two per Calendar year Prophylaxis (Cleanings) Two per Calendar year Fluoride 1 per Calendar year for people under 19 Histopathologic Exams Various limits per Calendar year depending on specific test X-Rays (routine) Bitewings: 2 per Calendar year X-Rays (non-routine) Full mouth: 1 every 36 consecutive months., Panorex: 1 every 36 consecutive months Model Payable only when in conjunction with Ortho workup Minor Perio (non-surgical) Various limitations depending on the service Perio Surgery Various limitations depending on the service Crowns and Inlays Replacement every 5 years Bridges Replacement every 5 years Dentures and Partials Replacement every 5 years Relines, Rebases Covered if more than 6 months after installation Adjustments Covered if more than 6 months after installation Repairs - Bridges Reviewed if more than once Repairs - Dentures Reviewed if more than once Sealants Limited to posterior teeth. One treatment per tooth every three years up to age 14 Space Maintainers Limited to non-Orthodontic treatment Prosthesis Over Implant 1 per 60 consecutive months if unserviceable and cannot be repaired. Benefits are based on the amount payable for non-

precious metals. No porcelain or white/tooth colored material on molar crowns or bridges Alternate Benefit When more than one covered Dental Service could provide suitable treatment based on common dental standards, Cigna

HealthCare will determine the covered Dental Service on which payment will be based and the expenses that will be included as Covered Expenses

Benefit Exclusions:

Services performed primarily for cosmetic reasons Replacement of a lost or stolen appliance Replacement of a bridge or denture within five years following the date of its original installation Replacement of a bridge or denture which can be made useable according to accepted dental standards Procedures, appliances or restorations, other than full dentures, whose main purpose is to change vertical dimension, diagnose or treat conditions of TMJ, stabilize

periodontally involved teeth, or restore occlusion

Veneers of porcelain or acrylic materials on crowns or pontics on or replacing the upper and lower first, second and third molars Bite registrations; precision or semi-precision attachments; splinting A surgical implant of any type Instruction for plaque control, oral hygiene and diet Dental services that do not meet common dental standards Services that are deemed to be medical services Services and supplies received from a hospital Charges which the person is not legally required to pay Charges made by a hospital which performs services for the U.S. Government if the charges are directly related to a condition connected to a military service Experimental or investigational procedures and treatments Any injury resulting from, or in the course of, any employment for wage or profit Any sickness covered under any workers compensation or similar law Charges in excess of the reasonable and customary allowances To the extent that payment is unlawful where the person resides when the expenses are incurred; Procedures performed by a Dentist who is a member of the covered persons family (covered persons family is limited to a spouse, siblings, parents, children,

grandparents, and the spouses siblings and parents);

For charges which would not have been made if the person had no insurance; For charges for unnecessary care, treatment or surgery; To the extent that you or any of your Dependents is in any way paid or entitled to payment for those expenses by or through a public program, other than

Medicaid;

To the extent that benefits are paid or payable for those expenses under the mandatory part of any auto insurance policy written to comply with a no-fault insurance law or an uninsured motorist insurance law. Cigna HealthCare will take into account any adjustment option chosen under such part by you or any one of

your Dependents.

In addition, these benefits will be reduced so that the total payment will not be more than 100% of the charge made for the Dental Service if benefits are provided for that service under this plan and any medical expense plan or prepaid treatment program sponsored or made available by your Employer.

Page 17

c31631Line

c31631Line

This benefit summary highlights some of the benefits available under the proposed plan. A complete description regarding the terms of coverage, exclusions and limitations, including legislated benefits, will be provided in your insurance certificate or plan description. Benefits are insured and/or administered by Connecticut General Life Insurance Company. "Cigna HealthCare" refers to various operating subsidiaries of Cigna Corporation. Products and services are provided by these subsidiaries and not by Cigna Corporation. These subsidiaries include Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, and HMO or service company subsidiaries of Cigna Health Corporation and Cigna Dental Health, Inc.

DPPO insurance coverage is set forth on the following policy form numbers: AR: HP-POL77; CA: HP-POL57; CO: HP-POL78; CT: HP-POL58; DE: HP-POL79; FL: HP-POL60; ID: HP-POL82; IL: HP-POL62; KS: HP-POL84; LA: HP-POL86: MA: HP-POL 63; MI: HP-POL88; MO: HP- POL65; MS: HP-POL90; NC: HP-

POL96; NE: HP-POL92; NH: HP-POL94; NM: HP-POL95; NV: HP-POL93; NY: HP-POL67; OH: HP-POL98; OK: HP-POL99; OR: HP-POL68; PA: HP-POL100;

RI: HP-POL101; SC: HP-POL102; SD: HP-POL103; TN: HP-POL69; TX: HP-POL70; UT: HP-POL104; VA: HP-POL72; VT: HP-POL71; WA: POL-07/08; WI: HP-POL107; WV: HP-POL106; and WY: HP-POL108.

Cigna, the Tree of Life logo and Cigna Dental Care are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its

operating subsidiaries. All products and services are provided by or through such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries

include Connecticut General Life Insurance Company (CGLIC), Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Connecticut, Inc., and Cigna

Dental Health, Inc. and its subsidiaries. Cigna Dental PPO plans are underwritten or administered by CGLIC or CHLIC, with network management services provided by

Cigna Dental Health, Inc. and certain of its subsidiaries. In Arizona and Louisiana, the insured Dental PPO plan offered by CGLIC is known as the CG Dental PPO. In

Texas, the insured dental product offered by CGLIC and CHLIC is referred to as the Cigna Dental Choice Plan, and this plan utilizes the national Cigna Dental PPO

network. Cigna Dental Care (DHMO) plans are underwritten or administered by Cigna Dental Health Plan of Arizona, Inc., Cigna Dental Health of California, Inc.,

Cigna Dental Health of Colorado, Inc., Cigna Dental Health of Delaware, Inc., Cigna Dental Health of Florida, Inc., a Prepaid Limited Health Services Organization

licensed under Chapter 636, Florida Statutes, Cigna Dental Health of Kansas, Inc. (Kansas and Nebraska), Cigna Dental Health of Kentucky, Inc. (Kentucky and

Illinois), Cigna Dental Health of Maryland, Inc., Cigna Dental Health of Missouri, Inc., Cigna Dental Health of New Jersey, Inc., Cigna Dental Health of North Carolina,

Inc., Cigna Dental Health of Ohio, Inc., Cigna Dental Health of Pennsylvania, Inc.,

Cigna Dental Health of Texas, Inc., and Cigna Dental Health of Virginia, Inc. In other states, Cigna Dental Care plans are underwritten by CGLIC, CHLIC, or Cigna

HealthCare of Connecticut, Inc. and administered by Cigna Dental Health, Inc.

BSD45193 2014 Cigna

Page 18

Superior Vision Services, Inc. P.O. Box 967 Rancho Cordova, CA 95741 800-507-3800 www.superiorvision.com The Superior Vision Plan is underwritten by National Guardian Life Insurance Company. National Guardian Life Insurance Company is not

affiliated with The Guardian Life Insurance Company of America, AKA The Guardian or Guardian Life NVIGRP 5-07 1211-BSv1/TX

Vision Plan Benefits for Pecos-Barstow-Toyah Independent School District

Co-Pays Monthly Premiums Services/Frequency Exam $10 Emp. only $7.64 Exam 12 months Materials1 $25 Emp. + 1 dependent $14.84 Frame 12 months Contact Lens Fitting $25 Emp. + family $21.80 Contact Lens Fitting 12 months (standard & specialty) Lenses 12 months Contact Lenses 12 months (Based on date of service)

Benefits In-Network Out-of-Network Exam (Ophthalmologist) Covered in full Up to $42 retail Exam (Optometrist) Covered in full Up to $37 retail Frames $100 retail allowance Up to $48 retail Contact Lens Fitting (standard2) Covered in full Not covered Contact Lens Fitting (specialty2) $50 retail allowance Not covered Lenses (standard) per pair Single Vision Covered in full Up to $32 retail Bifocal Covered in full Up to $46 retail Trifocal Covered in full Up to $61 retail Progressive Covered at lined trifocal level Up to $61 retail Contact Lenses3 $100 retail allowance Up to $100 retail

Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements. 1 Materials co-pay applies to lenses and frames only, not contact lenses. 2 Visit FAQs on www.superiorvision.com for definitions of standard and specialty CLF. 3 Contact lenses are in lieu of eyeglass lenses and frames benefit

Discount Features

Look for providers in the Provider Directory who accept discounts; please verify their discounts prior to service. Discounts on Covered Materials Frames: 20% off amount over allowance Lens options: 20% off retail Progressives: 20% off amount over retail lined trifocal lens, including lens options The following options have out-of-pocket maximums4 on standard (not premium, brand, or progressive) plastic lenses. Maximum Member Out-of-Pocket Single Vision Bifocal & Trifocal Scratch coat $13 $13 Ultraviolet coat $15 $15 Tints, solid or gradients $25 $25 Anti-reflective coat $50 $50 Polycarbonate $40 20% off retail High index 1.6 $55 20% off retail Photochromics $80 20% off retail

Discounts on Non-Covered Exam and Materials Exams, frames, and prescription lenses: 30% off retail Lens options, contacts, other prescription materials: 20% off retail Disposable contact lenses: 10% off retail

Refractive Surgery

Superior Vision has a nationwide network of refractive surgeons and leading LASIK networks who offer members a discount. These discounts range from 5%-50%, and are the best possible discounts available to Superior Vision.

4 Discounts and maximums may vary by lens type. Please check with your provider.

www.superiorvision.comCustomer Service

800-507-3800

www.superiorvision.comCustomer Service

800-507-3800

All allowances are retail; member is responsible for any amount over the allowance, minus available discounts.

Discounts are subject to change without notice.

Disclaimer: All final determinations of benefits, administrative duties, and definitions are governed by the Certificate of Insurance for your vision plan. Please check with your Human Resources department if you have any questions.

Page 19

Educator Select Income Protection

Plan Insurance Highlights

EB-975

Pecos-Barstow-Toyah Independent School District Policy # 217516

Please read carefully the following description of your Unum Educator Select Income Protection Plan

insurance.

Your Plan

Eligibility You are eligible for disability coverage if you are an active employee in the United States working a minimum of 20 hours per week. The date you are

eligible for coverage is the later of: the plan effective date; or the day after

you complete the waiting period.

Guarantee Issue Current Employees: Coverage is available to you without answering any medical questions or providing evidence of insurability. You may enroll

on or before the enrollment deadline. After the initial enrollment period,

you can apply only during an annual enrollment period.

New Hires: Coverage is available to you without answering any medical

questions or providing evidence of insurability. You may apply for

coverage within 60 days after your eligibility date. If you do not apply

within 60 days after your eligibility date, you can apply only during an

annual enrollment period.

Benefits are subject to the pre-existing condition exclusion

referenced later in this document.

Please see your Plan Administrator for your eligibility date.

Benefit Amount

You may purchase a monthly benefit in $100 units, starting at a minimum

of $200, up to 66 2/3% of your monthly earnings rounded to the nearest

$100, but not to exceed a monthly maximum benefit of $8,000. Please see

your Plan Administrator for the definition of monthly earnings.

The total benefit payable to you on a monthly basis (including all benefits

provided under this plan) will not exceed 100% of your monthly earnings

unless the excess amount is payable as a Cost of Living Adjustment.

However, if you are participating in Unums Rehabilitation and Return to Work Assistance program, the total benefit payable to you on a monthly

basis (including all benefits provided under this plan) will not exceed 110%

of your monthly earnings (unless the excess amount is payable as a Cost of

Living Adjustment).

Elimination Period The Elimination Period is the length of time of continuous disability, due to sickness or injury, which must be satisfied before you are eligible to receive

Page 20

benefits.

You may choose an Elimination Period (injury/sickness) of 14/14, 30/30,

60/60, 90/90 or 180/180 days.

If, because of your disability, you are hospital confined as an inpatient,

benefits begin on the first day of inpatient confinement. Inpatient means

that you are confined to a hospital room due to your sickness or injury

for 23 or more consecutive hours. (Applies to Elimination Periods of 30

days or less.)

Benefit Duration Your duration of benefits is based on your age when the disability occurs.

Plan: ADEA II: Your duration of benefits is based on the following table:

Age at Disability Maximum Duration of Benefits

Less than age 60 To age 65, but not less than 5 years

Age 60 through 64 5 years

Age 65 through 69 To age 70, but not less than 1 year

Age 70 and over 1 year

Federal Income Taxation The taxability of benefits depends on how premium was taxed during the plan year in which you become disabled. If you paid 100% of the premium

for the plan year with post-tax dollars, your benefits will not be taxed. If

premium for the plan year is paid with pre-tax dollars, your benefits will be

taxed. If premium for the plan year is paid partially with post-tax dollars

and partially with pre-tax dollars, or if you and your Employer share in the

cost, then a portion of your benefits will be taxed.

Additional Benefits

Work/Life Balance Employee Assistance

Program1

Work-life balance is a comprehensive resource providing access to

professional assistance for a wide range of personal and work-related

issues. The service is available to you and your family members twenty-

four hours a day, 365 days a year, and provides resources to help employees

find solutions to everyday issues such as financing a car or selecting child

care, as well as more serious problems such as alcohol or drug addiction,

divorce, or relationship problems.

Services include: toll-free phone access to masters-level consultants, up to three face-to-face sessions to help with more serious issues; and online

resources. There is no additional charge for utilizing the program.

Participation is confidential and strictly voluntary, and employees do not

have to have filed a disability claim or be receiving benefits to use the

program.

However, if you become disabled and are receiving benefits, Unum's On

Claim Support can provide additional resources including: coaching on how

to communicate effectively with medical personnel, conducting consumer

research for medical equipment and supplies, assessing emotional needs

and locating counseling resources.

Return to Work/ Unum supports efforts that enable a disabled employee to remain on the job or return to work as soon as possible. If you are disabled but working part

Page 21

Work Incentive Benefit time with monthly disability earnings of 20% or more of your indexed monthly earnings, during the first 12 months, the monthly benefit will not be

reduced by any earnings until the gross disability payment plus your

disability earnings, exceeds 100% of your indexed monthly earnings. The

monthly benefit will then be reduced by that amount.

Rehabilitation and Return to Work Assistance

Unum has a vocational Rehabilitation and Return to Work Assistance

program available to assist you in returning to work. We will make the

final determination of your eligibility for participation in the program, and

will provide you with a written Rehabilitation and Return to Work

Assistance plan developed specifically for you. This program may include,

but is not limited to the following benefits:

coordination with your Employer to assist your return to work;

adaptive equipment or job accommodations to allow you to work;

vocational evaluation to determine how your disability may impact

your employment options;

job placement services;

resume preparation;

job seeking skills training; or

education and retraining expenses for a new occupation.

If you are participating in a Rehabilitation and Return to Work Assistance

program, we will also pay an additional disability benefit of 10% of your

gross disability payment to a maximum of $1,000 per month. In addition,

we will make monthly payments to you for 3 months following the date

your disability ends, if we determine you are no longer disabled while:

you are participating in a Rehabilitation and Return to Work Assistance

program; and

you are not able to find employment.

(This benefit is not allowed in New Jersey.)

Worksite Modification If a worksite modification will enable you to remain at work or return to work, a designated Unum professional will assist in identifying whats needed. A written agreement must be signed by you, your employer and

Unum, and we will reimburse your employer for the greater of $1,000 or

the equivalent of two months of your disability benefit.

Medical Treatment Benefit

A Medical Treatment Benefit will be paid when you receive treatment by a

doctor as a result of a sickness or injury, provided no other benefits are

payable under the plan as a result of the condition for which the treatment

was rendered.

The Medical Treatment Benefit will be the doctor's actual charge for

services rendered, up to a maximum benefit of $50 for sickness or $100 for

injury. In addition, the charges must be for medically necessary care and

treatment and in keeping with the extent of the sickness or injury.

No benefit will be paid unless you are personally seen and treated by a

doctor and the treatment is not for routine medical examinations or dental

Page 22

work.

Note: No more than one Medical Treatment Benefit will be paid for the same or related condition(s) unless the treatment dates are separated by at least 14 consecutive days. In addition, no more than one benefit will be paid for treatment during any 24 hour period and the benefit will not be paid more than 4 times per calendar year.

Waiver of Premium After you have received disability payments under the plan for 90 consecutive days, from that point forward you will not be required to pay

premiums as long as you are receiving disability benefits.

Survivor Benefit

Unum will pay your eligible survivor a lump sum benefit equal to 3 months

of your gross disability payment.

This benefit will be paid if, on the date of your death, your disability

had continued for 180 or more consecutive days, and you were

receiving or were entitled to receive payments under the plan. If you

have no eligible survivors, payment will be made to your estate, unless

there is none. In that case, no payment will be made. However, we will

first apply the survivor benefit to any overpayment which may exist on

your claim.

You may receive your survivor benefit prior to your death if you are

receiving monthly payments and your physician certifies in writing that you

have been diagnosed as terminally ill and your life expectancy has been

reduced to less than 12 months. This benefit is only payable once and if

you elect to receive this benefit, no survivor benefit will be payable to your

eligible survivor upon your death. (Note this Accelerated Survivor Benefit is not available in Connecticut.)

Dependent Care Expense Benefit

If you are disabled and participating in Unums Rehabilitation and Return to Work Assistance program, Unum will pay a Dependent Care Expense

Benefit when you are disabled and you provide satisfactory proof that you:

are incurring expenses to provide care for a child under the age of 15; and/or start incurring expenses to provide care for a child age 15 or

older or a family member who needs personal care assistance.

The payment will be $350 per month per dependent, to a maximum of

$1,000 per month for all dependent care expenses combined.

Worldwide Emergency Travel

Assistance Services2

Whether your travel is for business or pleasure, our worldwide

emergency travel assistance program is there to help you when an

unexpected emergency occurs. With one phone call anytime of the

day or night, you, your spouse and dependent children can get

immediate assistance anywhere in the world3. Emergency travel

assistance is available to you when you travel to any foreign

country, including neighboring Canada or Mexico. It is also

available anywhere in the United States for those traveling more

Page 23

than 100 miles from home. Your spouse and dependent children do

not have to be traveling with you to be eligible. However, spouses

traveling on business for their employer are not covered by this

program.

Other Important Provisions

Pre-existing Condition Exclusion

Benefits will not be paid for disabilities caused by, contributed to by, or

resulting from a pre-existing condition. You have a pre-existing condition if:

you received medical treatment, consultation, care or services including diagnostic measures, or took prescribed drugs or

medicines in the 3 months just prior to your effective date of

coverage; and the disability begins in the first 12 months after your

effective date of coverage.

Continuity of Coverage

If you are actively at work at the time you convert to Unums plan and become disabled due to a pre-existing condition, benefits may be

payable if you were:

in active employment and insured under the plan on its effective date; and

insured by the prior plan at the time of change.

To receive a payment, you must satisfy the pre-existing condition under

the Unum policy or the prior carriers policy. If you satisfy Unums pre-existing condition provision, payments will be determined by the

Unum policy.

If you only satisfy the pre-existing condition provision for the prior carriers policy, the claim will be administered according to the Unum policy.

However,

the payments will be the lesser of the benefit payable under the terms of the prior plan or the benefit under the Unum plan;

the elimination period will be the shorter of the elimination period under the prior plan or the elimination period under the Unum plan;

and

benefits will end on the earlier of the end of the maximum period of payment under the Unum plan or the date benefits would have

ended under the prior plan.

Definition of Disability

You are disabled when Unum determines that:

you are limited from performing the material and substantial duties of your regular occupation due to your sickness or injury;

you have a 20% or more loss in indexed monthly earnings due to the same sickness or injury; and

during the elimination period you are unable to perform any of the material and substantial duties of your regular occupation.

After benefits have been paid for 24 months, you are disabled when Unum

determines that due to the same sickness or injury, you are unable to

perform the duties of any gainful occupation for which you are reasonably

fitted by education, training or experience.

Page 24

You must be under the regular care of a physician in order to be considered

disabled.

Gainful Occupation

Gainful occupation means an occupation that is or can be expected to

provide you with an income within 12 months of your return to work, that

exceeds 80% of your indexed monthly earnings if you are working or 60%

of your indexed monthly earnings if you are not working.

Benefit Integration Your disability benefit will be reduced by deductible sources of income and any earnings you have while disabled. Your gross disability payment

will be reduced immediately by such items as disability income or other

amounts you receive or are entitled to receive from workers compensation

or similar occupational benefit laws, sabbatical or assault leave plans and

the amount of earnings you receive from an extended sick leave plan as

described in Louisiana Revised Statutes or any other act or law with similar

intent.

After you have received monthly disability payments for 6 months, your

gross disability payment will be reduced by such items as additional

deductible sources of income you receive or are entitled to receive under:

state compulsory benefit laws; automobile liability insurance; legal

judgments and settlements; certain retirement plans; salary continuation or

sick leave plans; other group or association disability programs or

insurance; and amounts you or your family receive or are entitled to receive

from Social Security or similar governmental programs.

Regardless of deductible sources of income, an employee who qualifies for

disability benefits is guaranteed to receive a minimum benefit amount of the

greater of $100 or 10% of the gross disability payment.

Mental Illness/Self-Reported Symptoms

The lifetime cumulative maximum benefit period for all disabilities due to

mental illness and disabilities based primarily on self-reported symptoms is

24 months. Only 24 months of benefits will be paid for any combination of

such disabilities even if the disabilities are not continuous and/or are not

related. Payments would continue beyond 24 months only if you are

confined to a hospital or institution as a result of the disability.

Instances When Benefits Would Not Be Paid

Benefits will not be paid for disabilities caused by, contributed to by, or

resulting from:

intentionally self-inflicted injuries;

active participation in a riot;

commission of a crime for which you have been convicted;

loss of professional license, occupational license or certification;

pre-existing conditions (see definition).

Unum will not cover a disability due to war, declared or undeclared, or any

act of war.

Unum will not pay a benefit for any period of disability during which you

are incarcerated.

Termination of Coverage Your coverage under the policy ends on the earliest of the following:

The date the policy or plan is cancelled;

Page 25

The date you no longer are in an eligible group;

The date your eligible group is no longer covered;

The last day of the period for which you made any required contributions;

The later of the last day you are in active employment except as

provided under the covered layoff or leave of absence provision; or

if applicable, the last day of your contract with your Employer but

not beyond the end of your Employers current school contract year.

Unum will provide coverage for a payable claim which occurs while you are

covered under the policy or plan.

Next Steps

How to Apply/ Effective Date of Coverage

Current employees: To apply for coverage, complete your enrollment

form by the enrollment deadline. Your effective date of coverage is 02/01.

New Hires: To apply for coverage, complete your enrollment form within

60 days of your eligibility date. Please see your Plan Administrator for your

effective date.

If you do not enroll during the initial enrollment period, you may apply

only during an annual enrollment.

Delayed Effective Date of Coverage

If you are absent from work due to injury, sickness, temporary layoff or

leave of absence, your coverage will not take effect until you return to

active employment. Please contact your Plan Administrator after you return

to active employment for when your coverage will begin.

Questions If you should have any questions about your coverage or how to enroll, please contact your Plan Administrator.

This plan highlight is a summary provided to help you understand your insurance coverage from Unum.

Some provisions may vary or not be available in all states. Please refer to your certificate booklet for

your complete plan description. If the terms of this plan highlight summary or your certificate differ from

your policy, the policy will govern. For complete details of coverage, please refer to policy form number

C.FP-1, et al.

1,2 Work-life balance employee assistance program and On-Claim Support services are provided by Ceridian

Corporation. Worldwide emergency travel assistance services are provided by Assist America, Inc. Services are

available with selected Unum insurance offerings. Exclusions, limitations and prior notice requirements may apply,

and service features, terms and eligibility criteria are subject to change. The services are not valid after termination

of coverage and may be withdrawn at any time. Please contact your Unum representative for full details. 3 All Worldwide emergency travel assistance must be arranged by Assist America, which pays for all services it

provides. Medical expenses such as prescriptions or physician, lab or medical facility fees are paid by the employee

or the employees health insurance. Underwritten by: Unum Life Insurance Company of America 2211 Congress Street, Portland, Maine 04122, www.unum.com

2007 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group

and its insuring subsidiaries.

Page 26

PECOS-BARSTOW-TOYAH INDEPENDENT SCHOOL

DISTRICT Costs below are based on a Monthly payroll deduction

(Employer billing mode is based on 12 Payments per year)

Product: Plan A

Educator Select Income

Protection Plan

ADEA II Duration of Benefits

Elimination Period (Days)

Injury (Days) 14* 30* 60 90 180

Sickness (Days) 14* 30* 60 90 180 Annual

Earnings Monthly

Earnings Maximum

Monthly Benefit

3600 300 200 5.78 4.98 4.00 2.26 1.58 5400 450 300 8.67 7.47 6.00 3.39 2.37

7200 600 400 11.56 9.96 8.00 4.52 3.16 9000 750 500 14.45 12.45 10.00 5.65 3.95

10800 900 600 17.34 14.94 12.00 6.78 4.74 12600 1050 700 20.23 17.43 14.00 7.91 5.53

14400 1200 800 23.12 19.92 16.00 9.04 6.32 16200 1350 900 26.01 22.41 18.00 10.17 7.11

18000 1500 1000 28.90 24.90 20.00 11.30 7.90 19800 1650 1100 31.79 27.39 22.00 12.43 8.69 21600 1800 1200 34.68 29.88 24.00 13.56 9.48 23400 1950 1300 37.57 32.37 26.00 14.69 10.27 25200 2100 1400 40.46 34.86 28.00 15.82 11.06

27000 2250 1500 43.35 37.35 30.00 16.95 11.85 28800 2400 1600 46.24 39.84 32.00 18.08 12.64

30600 2550 1700 49.13 42.33 34.00 19.21 13.43 32400 2700 1800 52.02 44.82 36.00 20.34 14.22

34200 2850 1900 54.91 47.31 38.00 21.47 15.01 36000 3000 2000 57.80 49.80 40.00 22.60 15.80 37800 3150 2100 60.69 52.29 42.00 23.73 16.59 39600 3300 2200 63.58 54.78 44.00 24.86 17.38 41400 3450 2300 66.47 57.27 46.00 25.99 18.17

43200 3600 2400 69.36 59.76 48.00 27.12 18.96 45000 3750 2500 72.25 62.25 50.00 28.25 19.75

46800 3900 2600 75.14 64.74 52.00 29.38 20.54 48600 4050 2700 78.03 67.23 54.00 30.51 21.33

50400 4200 2800 80.92 69.72 56.00 31.64 22.12 52200 4350 2900 83.81 72.21 58.00 32.77 22.91 54000 4500 3000 86.70 74.70 60.00 33.90 23.70

55800 4650 3100 89.59 77.19 62.00 35.03 24.49 57600 4800 3200 92.48 79.68 64.00 36.16 25.28

59400 4950 3300 95.37 82.17 66.00 37.29 26.07 61200 5100 3400 98.26 84.66 68.00 38.42 26.86

63000 5250 3500 101.15 87.15 70.00 39.55 27.65 64800 5400 3600 104.04 89.64 72.00 40.68 28.44

66600 5550 3700 106.93 92.13 74.00 41.81 29.23 68400 5700 3800 109.82 94.62 76.00 42.94 30.02 70200 5850 3900 112.71 97.11 78.00 44.07 30.81

72000 6000 4000 115.60 99.60 80.00 45.20 31.60 73800 6150 4100 118.49 102.09 82.00 46.33 32.39

75600 6300 4200 121.38 104.58 84.00 47.46 33.18 77400 6450 4300 124.27 107.07 86.00 48.59 33.97

79200 6600 4400 127.16 109.56 88.00 49.72 34.76 81000 6750 4500 130.05 112.05 90.00 50.85 35.55

82800 6900 4600 132.94 114.54 92.00 51.98 36.34 84600 7050 4700 135.83 117.03 94.00 53.11 37.13

86400 7200 4800 138.72 119.52 96.00 54.24 37.92 88200 7350 4900 141.61 122.01 98.00 55.37 38.71 90000 7500 5000 144.50 124.50 100.00 56.50 39.50

91800 7650 5100 147.39 126.99 102.00 57.63 40.29 93600 7800 5200 150.28 129.48 104.00 58.76 41.08

REF #: 2938462

* If, because of your disability, you are hospital confined as an inpatient, benefits begin on the first day of inpatient

confinement.

Find your Annual/Monthly Earnings above to determine your Maximum Monthly Benefit. If your Annual/Monthly Earnings are

not shown, use the next lower Annual/Monthly Earnings and corresponding Maximum Monthly Benefit. Or, you may refer to the

Plan Highlights to calculate your Maximum Monthly Benefit based on your earnings.

Page 27

PECOS-BARSTOW-TOYAH INDEPENDENT SCHOOL

DISTRICT Costs below are based on a Monthly payroll deduction

(Employer billing mode is based on 12 Payments per year)

Product: Plan A

Educator Select Income

Protection Plan

ADEA II Duration of Benefits

Elimination Period (Days)

Injury (Days) 14* 30* 60 90 180

Sickness (Days) 14* 30* 60 90 180 Annual

Earnings Monthly

Earnings Maximum

Monthly Benefit

95400 7950 5300 153.17 131.97 106.00 59.89 41.87 97200 8100 5400 156.06 134.46 108.00 61.02 42.66

99000 8250 5500 158.95 136.95 110.00 62.15 43.45 100800 8400 5600 161.84 139.44 112.00 63.28 44.24

102600 8550 5700 164.73 141.93 114.00 64.41 45.03 104400 8700 5800 167.62 144.42 116.00 65.54 45.82

106200 8850 5900 170.51 146.91 118.00 66.67 46.61 108000 9000 6000 173.40 149.40 120.00 67.80 47.40

109800 9150 6100 176.29 151.89 122.00 68.93 48.19 111600 9300 6200 179.18 154.38 124.00 70.06 48.98 113400 9450 6300 182.07 156.87 126.00 71.19 49.77 115200 9600 6400 184.96 159.36 128.00 72.32 50.56 117000 9750 6500 187.85 161.85 130.00 73.45 51.35

118800 9900 6600 190.74 164.34 132.00 74.58 52.14 120600 10050 6700 193.63 166.83 134.00 75.71 52.93

122400 10200 6800 196.52 169.32 136.00 76.84 53.72 124200 10350 6900 199.41 171.81 138.00 77.97 54.51

126000 10500 7000 202.30 174.30 140.00 79.10 55.30 127800 10650 7100 205.19 176.79 142.00 80.23 56.09 129600 10800 7200 208.08 179.28 144.00 81.36 56.88 131400 10950 7300 210.97 181.77 146.00 82.49 57.67 133200 11100 7400 213.86 184.26 148.00 83.62 58.46

135000 11250 7500 216.75 186.75 150.00 84.75 59.25 136800 11400 7600 219.64 189.24 152.00 85.88 60.04

138600 11550 7700 222.53 191.73 154.00 87.01 60.83 140400 11700 7800 225.42 194.22 156.00 88.14 61.62

142200 11850 7900 228.31 196.71 158.00 89.27 62.41 144000 12000 8000 231.20 199.20 160.00 90.40 63.20

REF #: 2938462

* If, because of your disability, you are hospital confined as an inpatient, benefits begin on the first day of inpatient

confinement.

Find your Annual/Monthly Earnings above to determine your Maximum Monthly Benefit. If your Annual/Monthly Earnings are

not shown, use the next lower Annual/Monthly Earnings and corresponding Maximum Monthly Benefit. Or, you may refer to the

Plan Highlights to calculate your Maximum Monthly Benefit based on your earnings.

Page 28

The following is not an exhaustive list of terms and conditions but only serves as a depiction of benefits and exclusions. Interested parties should consult the contract for a complete listing of terms and conditions.

FOR GROUP PRESENTATION PURPOSES ONLY

LG-6040

Administrative Office: P.O. Box 1604 Duncan, OK 73534-1604

Toll Free: 1-800-366-8354

A Promise In an era where many financial services companies are concerned with bottom- line results at the expense of customer service and loyalty, we come from the old school. We take great pride in providing the finest services to our employer groups, policyholders, business associates, agents - to everyone with whom we come in contact.

A New Dimension in

Supplemental Cancer Insurance

National Marketing Office - Worksite: P.O. Box 10190 Kansas City, MO 64171

Toll Free: 1-877-523-0176

Page 29

BASE POLICY BENEFITS

BENEFIT PROVISIONS. We will pay the benefits described in the Certificate for the treatment of an Insured Persons Cancer, provided he or she is covered under an issued Certificate which remains in force. Payment will be made in accordance with all applicable policy provisions. Benefits are

payable for a positive diagnosis that begins after the Effective Date. The positive diagnosis must be for Cancer as defined in the policy.

1. POSITIVE DIAGNOSIS BENEFIT. We will pay the Actual Charge but not to exceed $300 per Calendar Year for one test that confirms the Positive Diagnosis of Cancer in an Insured Person. This benefit is not payable for multiple diagnoses of the same Cancer or for

Cancer that metastasizes or for recurrence of the same Cancer.

2. NATIONAL CANCER INSTITUTE DESIGNATED COMPREHENSIVE CANCER TREATMENT CENTER EVALUATION/CONSULTATION BENEFIT We will pay the Actual Charge, but not to exceed a lifetime maximum of $750, if an Insured Person is diagnosed with Internal Cancer and seeks evaluation or consultation from a National Cancer Institute designated

Comprehensive Cancer Treatment Center. If the Comprehensive Cancer Treatment Center is located more than 30 miles from the Insured

Persons place of residence, We will also pay the transportation and lodging expenses incurred but not to exceed a lifetime maximum of $350. This benefit is not payable on the same day a Second or Third Surgical Opinion Benefit is payable and is in lieu of the Non-Local Transportation

and Lodging Expense Benefits of the Policy. This benefit is payable one time during the lifetime of the Insured Person.

3. SECOND AND THIRD SURGICAL OPINION EXPENSE BENEFIT We will pay the Actual Charge for a written second surgical opinion concerning the recommendation of Cancer surgery and if the second surgical opinion is in conflict with that of the

Physician originally recommending the surgery and the Insured Person desires a third opinion, We will the Actual Charge for a written third

surgical opinion. The Physician providing the second or third surgical opinion cannot be associated with the Physician who originally

recommended the surgery. This benefit is not payable the same day the National Cancer Institute Evaluation/Consulting Benefit is payable.