Jay School Corporation Benefits Plan Overview

Plan Year: Your Benefits Plan Jay School Corporation

Irene Taylor Your 2025 Benefits The health and financial security of you and your family is important to us. Our benefit program provides a variety of plans that can enhance the lives of you and your family both now and in the future. As an eligible employee, you will be asked to make decisions about the employee benefits described in this booklet. This guide provides information to enable you to effectively enroll in your benefits. Take time to read it carefully and use the available resources to ensure you make the decisions that are right for you and your family. Insurance Coordinator

Employees All employees working 30 hours per week, or more are eligible for the benefits program. You may insure yourself and eligible family members under the program. Spouse & Legal Dependents Your children are eligible for medical, dental, and vision to age 26. Your children of any age are also eligible if you support them, and they are incapable of self-support due to disability. As required by our insurance contracts, you may be required to provide proof of eligibility for your dependents. If your dependent becomes ineligible for coverage during the year, you must contact your plan administrator within 30 days. Qualifying Events You may make a change to your benefits if you have a qualified status change such as marriage divorce, birth/adoption, death, changes in spouses benefits, and more. Eligibility

Employee Cost: Medical Plan 2 SEE THIS PLAN Plan 1 SEE THIS PLAN Plan 3 SEE THIS PLAN 26 pays 20 Pays Single $237.12 $308.25 Family $583.11 $758.04 26 pays 20 Pays Single $114.25 $148.52 Family $302.54 $393.30 26 pays 20 Pays Single $79.61 $103.50 Family $223.42 $290.44

Employee Cost: Dental and Vision DENTAL SEE THIS PLAN VISION Delta Dental Coverage Employee Premiums SEE THIS PLAN EyeMed Coverage Employee Premiums 20 Pays Single $8.56 Family $27.97 20 Pays Single $2.92 Family $7.20

Medical BENEFITS Medical Benefits are offered through PHP View Your PHP Member Portal

Plan 1 Plan 2 Plan 3 Embedded Deductible (each family member is limited to the single deductible) Yes Yes Yes Deductible (Single/Family) $2,000 / $4,000 $3,500 / $7,000 $6,000 / $12,000 Out-of-Pocket Max (Single/Family) $5,000 / $8,000 $3,500 / $7,000 $8,050 / $16,100 Physician/Specialist Visits 20% after deductible Deductible + coinsurance 20% after deductible Coinsurance 20% 0% 20% Preventive Care 100% Coverage 100% Coverage 100% Coverage Hospital/Out-Patient 20% after deductible Deductible + coinsurance 20% after deductible Emergency Room 20% after deductible Deductible + coinsurance 20% after deductible Urgent Care Centers 20% after deductible Deductible + coinsurance 20% after deductible

Store & Easily Access Virtual ID Cards 1 2 3 Manage Claims for You & Your Dependents Track Your Deductible & Out-of-Pocket Max Totals 4 Find In-Network Providers PHP Mobile App & Desktop Portal View Your PHP Portal Download the PHP App

4 Ways to SAVE ON HEALTHCARE $ AVOID THE ER FOR TRUE EMERGENCIES DONT HESITATE TO CALL 911 OR GO TO THE EMERGENCY ROOM. WHEN POSSIBLE, UTILIZING A WALK-IN CLINIC OR URGENT CARE WILL SAVE YOU TIME AND MONEY FOR THE SAME SERVICES. $$ CUT Rx COST COMPARE DRUG PRICES & TALK TO YOUR DOCTOR ABOUT LOWER COST OPTIONS. UTILIZE COUPONS & SERVICES LIKE GOODRx, Rx HELP CENTERS, OR THE COSTPLUS DRUG COMPANY. $$$ SHOP AROUND UTILIZE THE SYDNEY APP TO FIND THE BEST CARE AT THE BEST PRICE. CHECK DISCOUNTS IN THE SYDNEY APP FOR MEDICAL TREATMENTS, DENTAL, VISION, HEARING, FITNESS, FAMILY, PETS, & MORE. LAB WORK & IMAGING SERVICES LIKE ULTRASOUNDS, X-RAYS, CT SCANS, BLOOD DRAWS, ETC. ARE COSTLY. RESEARCH PROVIDERS BEFORE YOU MAKE AN APPT. $$$$ STAY HEALTHY LIVE A HEALTHY LIFESTYLE THROUGH REGULAR MOVEMENT & HEALTHY EATING HABITS. REGULARLY VISIT YOUR PRIMARY CARE PHYSICIAN. SCHEDULE YOUR ANNUAL PHYSICAL & PREVENTIVE CARE APPOINTMENTS.

Prescription DRUGS Prescription drug coverage is offered through the PHP health plan via CVS.

Plan 1 Plan 2 Plan 3 Preventive Prescriptions $0 $0 $0 Retail Prescriptions: Tier 1 $15 Copay Deductible + coinsurance Deductible + coinsurance Retail Prescriptions: Tier 2 $15 Copay Deductible + coinsurance Deductible + coinsurance Retail Prescriptions: Tier 3 $30 Copay Deductible + coinsurance Deductible + coinsurance Retail Prescriptions: Tier 4 $60 Copay Deductible + coinsurance Deductible + coinsurance Specialty Prescription Drugs: (Self Administered) 20% after deductible (up to $350 Maximum) Deductible + coinsurance Deductible + coinsurance Mail Order Prescriptions: (Tier 1/ Tier 2/ Tier 3/ Tier 4) $45/$45/$90/$180 Deductible + coinsurance Deductible + coinsurance

Pharmacy Cost TOOLS GoodRx GoodRx has both a website and a mobile app that can be used to compare prices. Go to the website and type in your drug name. GoodRx will display the cost available at multiple pharmacies. Print the coupon and present to your pharmacist. Learn More Rx Help Centers RX Help Centers provides assistance in finding resources for high-cost brand name medications by advocating directly with drug manufacturers. Learn More CostPlus Drug Company The goal of the Mark Cuban Cost Plus Drug Company is to dramatically reduce the cost of drugs and introduce transparency to the pricing of drugs, so patients know they are getting a fair price. Learn More Watch Pharmacy Coupon Video

Health Savings ACCOUNT A Health Savings Account (HSA) is available to those enrolled in a High Deductible Health Plan. HSA funds can be used for a wide variety of qualified medical expenses all tax-free. Any unused earnings rollover from year-to-year. Watch This HSA Video to Learn More

Doctor Visit Visit your healthcare provider and the office will submit the claim to your health plan. Amount Owed The health plan will share the amount you owe with your doctor. EOB The health plan will send you the Explanation of Benefits (EOB). Bill Received Your doctor will then send you a bill. HDHP and HSA Consumer Experience Pay with HSA You can use your HSA funds to pay the bill from your doctor.

HEALTHCARE FSA LIMITED PURPOSE FSA Flexible Spending Accounts Flexible Spending Accounts (FSA) are set up to pay for many out-of-pocket medical expenses with tax-free dollars. The FSA account holder sets aside a pre-tax dollar amount for the year used to pay for medical expenses. Unused FSA funds can expire at the end of the year. 1 Healthcare FSA An FSA is an alternative to an HSA. FSAs are typically paired with a PPO plan while an HSA is paired with an HDHP. HSA funds can be used on various medical, dental, and vision related expenses. The IRS contribution maximum is $3,050. 2 Limited Purpose FSA A limited purpose FSA is only for dental and vision expenses. If you elect to participate in the High Deductible Health Plan and contribute to a Health Savings Account (HSA), you qualify for this FSA, not the full healthcare FSA. The IRS contribution maximum is $3,050. Watch This FSA Video to Learn More 1 2 View Eligible Expenses DEPENDENT CARE FSA 3 3 Dependent Care Account (DCA) FSA A DCA is a tax-free spending account for dependent care expenses such as daycare, preschool, or day camps for any dependent under the age of 13 or who is physically or mentally incapable of self-care. The IRS contribution maximum is $5,000 for families and $2,500 for individuals. Learn More About Your DCA

DENTAL Delta Dental offer three levels of benefits coverage; PPO Dentist, Premier Dentist, and Non-Participating Dentist. Find providers, view your ID card, and more online or using the mobile app. Dental Coverage with Delta Dental DELTA DENTAL OF INDIANA 225 S East St Indianapolis, IN 46202 317-842-4022 KRISTEN JONES Group Delta Dental PPO Online Portal Download the App

Deductible none Annual Plan Maximum $500 / person Preventive Services Exams, Cleanings, Fluoride, X-Rays You Pay 0% Basic Services Fillings, Extractions, Endodontics, Crown Repairs You Pay 20% Major Services Crowns, Dentures, In/Outlays, Periodontics You Pay 50% Orthodontia Services You Pay 50% Orthodontia Lifetime Maximum $1,000

VISION Jay School Corporation offers vision benefits through EyeMed Online Portal

Check benefit summary for additional lens options and costs Exam $0 copay Standard Glasses Lenses (Single / Bifocal/ Trifocal / Lenticular) $0 copay Glasses Frames $150 retail frame allowance OR $200 allowance at a PLUS Provider + 20% off remaining balance Contact Lenses (Medically Necessary / Elective) $0 copay / $25 copay with $200 retail allowance Vision Plan

EyeMeds New Mobile App New look. Fresh features. Same great benefits. Whenever you need them. See benefits/eligibility at a glance Track your claims Grab special offers to help you save more Find an in-network eye doctor with the Provider Locator View your ID Card Set upcoming exams Contact lens replacement reminders Access interactive vision guides Download the App (Apple) Download the App (Android) Watch EyeMed App Video

Additional BENEFITS Jay Schools provides full-time certified employees basic life insurance and disability income protection at a minimum cost through Madison National Life. Jay Schools offers full-time support employees basic life insurance for a minimum cost through Madison National Life. Other voluntary benefits offered through American Fidelity.

Basic Life Insurance The JSC employer-paid basic life insurance policy is available to all full-time employees. Benefit Amount depends on Employee Class. Coverage decreases to 35% at age 65 and 50% at age 70. Basic Accidental Death & Dismemberment Insurance The JSC employer-paid basic AD&D insurance policy is available to all full-time employees. The rider covers the unintentional death or dismemberment of the insured. Benefit Amount depends on Employee Class. Coverage decreases to 35% at age 65 and 50% at age 70. Employer-Paid Benefits Long-Term Disability Employer-paid long-term disability protects your income for a period of time due to illness, maternity leave, or an accident not related to your job. Benefits begin 180 days after the date of the incident and will cover 66.67% of your earnings (up to $8,889/month).

Voluntary Life Insurance Employees have the option to purchase additional life insurance. Employee Benefit: $10,000 Guarantee issue of $10,000. Employees have the option to purchase additional life insurance. Employee Benefit: $10,000 Guarantee issue of $10,000. Voluntary AD&D Insurance Employee-Paid Benefits Employees have the option to purchase additional voluntary coverages through Madison National.

Voluntary Benefits Accident Critical illness Term 100 Life Employees have the option to purchase additional voluntary coverages through American Fidelity. Short-Term Disability Employees have the option to purchase accident insurance to cover a variety of occurrences, such as dismemberment; dislocation or fracture; ambulance services; physical therapy; and more. Critical illness insurance protects you and your family if diagnosed with a critical illness. Short-term disability is 100% employee paid and protects your income during a short period of time due to illness or an accident not related to your job. Employees have the option to purchase term life insurance to age 100.

Cancer Plan Term Life Insurance Hospital Indemnity Whole Life Insurance Employees have the option to purchase cancer insurance. It can be used for treatments like chemotherapy, radiation, and immunotherapy, etc. The plan also includes annual screening benefits. Employees have the option to purchase additional life insurance in term periods of 10, 20 or 30 years up to $300,000 in coverage. Whole Life Insurance provides protection for your entire life. You can take it to a new job and into retirement up to age 121. The premium and amount of protection stay the same as long as the policy is active, provided premiums are paid as required. Employees have the option to purchase hospital indemnity insurance. It can be used for out-of-pocket expenses such as deductibles, copays, or everyday living costs. It is designed to supplement existing health insurance and ease financial strain during hospital stays.

Teacher Retirement Fund 401(a) Retirement Account Employer contributes 1.5% of salary RETIREMENT Benefits Certified Teaching Staff Corporation contributes 10.1% of salary Medical costs after retirement Employer contributes 1.5% of salary VEBA 403(b) Tax Deferred Annuity Employer math up to 1.5% of salary optional Must be 100% vested to receive the 401A and VEBA contributions At least age 55 and 6 years of teaching with Jay School Corporation (Retirement) upon death or disability

Teacher Retirement Fund 401(a) Retirement Account Employer contributes 2.25% of salary RETIREMENT Benefits Certified Administrative Staff Corporation contributes 10.1% of salary Medical costs after retirement Employer contributes 2.25% of salary VEBA 403(b) Tax Deferred Annuity Employer math up to 1.25% of salary optional Must be 100% vested to receive the 401A and VEBA contributions At least age 55 and 5 years of teaching with Jay School Corporation (Retirement) upon death or disability

Public Employee Retirement Fund 403(b) Tax Deferred Annuity Employer match up to 1.25% Full-time employees only Optional RETIREMENT Benefits Support Staff Corporation contributes 14.2% of salary