Noblesville Schools Employee Benefits Guide

2026 ACTIVE Benefits Enrollment October 27th – November 7th Noblesville Schools Employee Benefits

Your 2026 Benefits Watch Video 2026 benefits enrollment is an active enrollment for health, dental, and vision coverage effective January 1, 2026. If you do not make changes, your current elections for these plans—along with your HSA, Voluntary Short-Term Disability, Accident, Critical Illness, Hospital Indemnity, and Voluntary Life Insurance—will automatically carry over into 2026. Please note that Flexible Spending Accounts (FSAs) require re-enrollment each year, so you must re-enroll to participate in 2026.

Employees Full-time employees of Noblesville Schools are eligible for medical, dental, and vision benefits. Noblesville Schools also provides you with Basic Life and AD&D and Long-Term Disability coverage, at no cost to you with the option to purchase Voluntary Life and AD&D, Short-Term Disability, Accident, Critical Illness, and Hospital Indemnity Coverages. Spouse & Legal Dependents Your spouse is eligible for medical, dental, and vision as well as legal dependents up to age 26. Eligible children are defined as natural children, legally adopted children, step- children, and children for whom you have legal guardianship. Your children of any age are also eligible if you support them, and they are incapable of self-support due to disability. Dependents turning 26 are eligible to stay on the plan until December 31st of the year they turn 26. 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 spouse’s benefits, and more. Eligibility

How Does Our Health Plan Work? Carrier Noblesville Schools Pays You Pay Medical UHC/Surest Dental Delta Dental Vision Anthem HSA Contribution Voya Basic Life and AD&D Voya Voluntary Life Voya Short-Term Disability Voya Long-Term Disability Voya Accident & Hospital Indemnity Voya

Employee Cost: Medical Core HDHP SEE THIS PLAN Surest SEE THIS PLAN Basic HDHP SEE THIS PLAN Monthly 24 Deductions 20 Deductions Employee Only $267.50 $133.75 $160.50 Employee + Spouse $653.55 $326.78 $392.13 Employee + Child(ren) $501.52 $250.76 $300.91 Family $716.19 $358.10 $429.72 Monthly 24 Deductions 20 Deductions Employee Only $146.18 $73.09 $87.71 Employee + Spouse $340.81 $170.41 $204.49 Employee + Child(ren) $264.16 $132.08 $158.50 Family $372.35 $186.18 $223.41 Monthly 24 Deductions 20 Deductions Employee Only $58.02 $29.01 $34.81 Employee + Spouse $143.44 $71.72 $86.06 Employee + Child(ren) $109.80 $54.90 $65.88 Family $157.33 $78.67 $94.40

Employee Cost: Dental & Vision Vision SEE THIS PLAN Dental SEE THIS PLAN Monthly 24 Deductions 20 Deductions Employee Only $7.12 $3.56 $4.27 Employee + Spouse $14.24 $7.12 $8.54 Employee + Child(ren) $18.98 $9.49 $11.39 Family $28.35 $14.18 $17.01 Monthly 24 Deductions 20 Deductions Employee Only $1.16 $0.58 $0.70 Employee + Spouse $2.31 $1.16 $1.39 Employee + Child(ren) $2.33 $1.17 $1.40 Family $3.72 $1.86 $2.23

Medical BENEFITS All three medical plans are administered through UHC/Surest. View Your UHC Portal View Your Surest Portal

Upfront Pricing No deductibles. No coinsurance. Copay-only plan with lower out-of-pocket costs. Find Care Quickly Find the care you need on the Surest app or website. Compare & Save Check costs and compare options before you make an appointment. Learn More About Surest Watch the Surest “How it Works” Video UnitedHealthcare’s Surest Health Plan Download App

View Your Claims Check the status of new and past claims. See the amount billed, what your plan paid and how much you owe. Find Care & Pricing Search for network providers near you, see ratings and reviews, and estimate out-of-pocket costs. Access Your ID Card Your digital ID card is always with you when you need it. UnitedHealthcare Mobile App Download the App

Deductible (Single/Family) $0 $0 $2,200/ $4,400 $4,400 / $8,800 $5,000 / $10,000 $10,000/ $20,000 Out-of-Pocket Max (Single/Family) $4,000 / $8,000 $8,000 / $16,000 $4,400 / $8,800 $8,800 / $17,600 $5,000 / $10,000 $10,000 / $20,000 Coinsurance N/A N/A 20% 40% 0% 30% Preventive Care No charge $100 copay No charge 40% after deductible No charge No charge Office Visit Primary/Specialist Visit $10 - $65 copay $195 20% after deductible 40% after deductible 0% after deductible 30% after deductible Scans (MRI, CT, etc.) $75 - $950 copay $1,350 - $2,850 copay 20% after deductible 40% after deductible 0% after deductible 30% after deductible Hospital Services $15 to $2,500 copay Up to $7,000 copay 20% after deductible 40% after deductible 0% after deductible 30% after deductible Emergency Room $375 copay 20% after deductible 40% after deductible 0% after deductible 30% after deductible Urgent Care Centers $35 copay $105 copay 20% after deductible 40% after deductible 0% after deductible 30% after deductible Surest Core HDHP IN NETWORK OUT-OF-NETWORK IN NETWORK OUT-OF-NETWORK Basic HDHP IN NETWORK OUT-OF-NETWORK

Prescription DRUGS Your prescription drug plan is through CVS Caremark. CVS Caremark is your pharmacy benefit manager. The Caremark network includes most retail chain pharmacies such as Walgreens, CVS, Walmart, Meijer, Kroger, and Costco. Mail order prescriptions can be ordered directly through Caremark. A preventive drug list can be found using the Caremark Portal link below. Caremark Portal

Retail Prescriptions: Generic $10 copay 50% after deductible, Minimum $30 20% after deductible 40% after deductible 0% after deductible 30% after deductible Retail Prescriptions: Preferred $30 copay 50% after deductible, Minimum $30 20% after deductible 40% after deductible 0% after deductible 30% after deductible Retail Prescriptions: Non-Preferred $75 copay 50% after deductible, Minimum $30 20% after deductible 40% after deductible 0% after deductible 30% after deductible Retail Prescriptions: Specialty $300 copay 50% after deductible, Minimum $30 20% after deductible 40% after deductible 0% after deductible 0% after deductible Mail Order: Generic $10 copay Not covered 20% after deductible Not covered 0% after deductible Not covered Mail Order: Preferred $65 copay Not covered 20% after deductible Not covered 0% after deductible Not covered Mail Order: Non-Preferred $145 copay Not covered 20% after deductible Not covered 0% after deductible Not covered Mail Order: Specialty $300 Copay Not covered 20% after deductible Not covered 0% after deductible Not covered Surest Core HDHP IN NETWORK OUT-OF-NETWORK IN NETWORK OUT-OF-NETWORK Basic HDHP IN NETWORK OUT-OF-NETWORK

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. The 2026 annual max contribution is $4,400 for an individual and $8,750 for families.

View Qualified Expenses 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 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.

DENTAL For the highest benefit levels, we encourage you to select a provider from Delta Dental’s extensive network. You may pay less out of your pocket. 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 No deductible $25 Annual Plan Maximum $1,250 (Maximum Per Person) Preventive Services Exams, Cleanings, Fluoride, X-Rays You Pay 0% Basic Services Fillings, Extractions, Endodontics, Crown Repairs You Pay 10% You Pay 15% Major Services Crowns, Dentures, In/Outlays, Periodontics You Pay 40% You Pay 45% Orthodontia Services (maximum age limit 18) You Pay 50% Orthodontia Lifetime Maximum $1,250 $1,000 IN NETWORK OUT-OF-NETWORK

VISION For the highest benefit levels, we encourage you to select a provider from Anthem’s extensive network. You may pay less out of your pocket. Vision Coverage with Anthem View Your Anthem Portal

Each material benefit is paid out once per calendar year. Exam $10 copay Up to $42 Glasses Lenses (Single / Bifocal/ Trifocal / Lenticular) $15 copay Up to $40 Up to $60 Up to $85 Glasses Frames $15 copay, then $130 allowance, 20% off remaining balance Up to $45 Contact Lenses (Medically Necessary & Elective) $15 copay, then $130 allowance, 20% off remaining balance Up to $210/$105 IN NETWORK OUT-OF-NETWORK

4 Ways to SAVE ON HEALTHCARE $ AVOID THE ER FOR TRUE EMERGENCIES DON’T 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 MYUHC APP TO FIND THE BEST CARE AT THE BEST PRICE. CHECK DISCOUNTS IN THE MYUHC 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 PRIMIARY CARE PHYSICIAN. SCHEDULE YOUR ANNUAL PHYSICAL & PREVENTIVE CARE APPOINTMENTS.

GENERAL PURPOSE FSA DEPENDENT CARE ACCOUNT Flexible Spending Accounts Flexible Spending Accounts (FSA) are set up to pay for many of 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 General Purpose FSA An FSA is an alternative to an HSA. FSAs are typically paired with a traditional copay-based plan which would include the new Surest PPO plan while an HSA is paired with an HDHP. FSA funds can be used on various medical, dental, and vision related expenses including but not limited to the copays that are your responsibility. 2 Dependent Care Account (DCA) 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. Watch This FSA Video to Learn More 1 2 View Eligible Expenses

Additional BENEFITS Noblesville Schools offers a suite of life and disability coverages available through Voya.

Basic Life Insurance The Noblesville Schools employer-paid basic life insurance policy is available to all full-time employees. Basic Accidental Death & Dismemberment Insurance The Noblesville Schools employer-paid basic AD&D insurance policy is available to all full-time employees in the event of death, loss of (or loss of use of) a body part or function, speech, eyesight, or hearing. Coverage decreases incrementally at age 65. Employer-Paid Benefits Long-Term Disability Employer-paid long-term disability protects your income for a period of time due illness or injury that last longer than your short-term disability benefit. Benefits begin 90 days after the date of the incident and will cover 60% of your earnings. For basic life, long-term disability, and AD&D insurance eligibility requirements, please log in to PlanSource.

Employee-Paid Benefits Short-Term Disability Accident Up to $3,400 cash benefits that correspond with hospital and intensive care confinement. Your plan may also include coverage for a variety of occurrences, such as dismemberment; dislocation or fracture; ambulance services; physical therapy and more. Critical Illness Employee & Spouse Benefit: $5,000 to $30,000 (Spouse cannot exceed employee coverage amount). Child(ren) Benefit: 50% of employee benefit. Employee Benefit: Increments of $1,000 up to $500,000. Guarantee issue of $300,000. Spouse Benefit: Increments of $5,000 up to $250,000. (Cannot exceed 50% of employee amount) Guarantee issue of $25,000. Child(ren) Benefit: Up to $2,500 up to $10,000. Guarantee issue is $10,000. (Children age 14 days to 23 years, 26 if full-time student) Voluntary Life & AD&D Hospital Indemnity Hospital indemnity coverage pays you cash benefits that correspond with hospital admission, confinement and intensive care confinement. Employee-paid short-term disability protects your income during a short period of time due to illness, maternity leave, or an accident not related to your job. Benefits begin on the 7th day after the date of the incident and will cover 66 2/3% of your weekly earnings up to $1,750.

Pay and Deduction Calendar JANUARY FEBRUARY MARCH APRIL 1 2 3 4 1 1 1 2 3 4 5 5 6 7 8 9 10 11 2 3 4 5 6 7 8 2 3 4 5 6 7 8 6 7 8 9 10 11 12 12 13 14 15 16 17 18 9 10 11 12 13 14 15 9 10 11 12 13 14 15 13 14 15 16 17 18 19 19 20 21 22 23 24 25 16 17 18 19 20 21 22 16 17 18 19 20 21 22 20 21 22 23 24 25 26 26 27 28 29 30 31 23 24 25 26 27 28 23/ 30 24/ 31 25 29 27 28 29 27 28 29 30 MAY JUNE JULY AUGUST 1 2 3 1 2 3 4 5 6 7 1 2 3 4 5 1 2 4 5 6 7 8 9 10 8 9 10 11 12 13 14 6 7 8 9 10 11 12 3 4 5 6 7 8 9 11 12 13 14 15 16 17 15 16 17 18 19 20 21 13 14 15 16 17 18 19 10 11 12 13 14 15 16 18 19 20 21 22 23 24 22 23 24 25 26 27 28 20 21 22 23 24 25 26 17 18 19 20 21 22 23 25 26 27 28 29 30 31 29 30 27 28 29 30 31 24/ 31 25 26 27 28 29 30 SEPTEMBER OCTOBER NOVEMBER DECEMBER 1 2 3 4 5 6 1 2 3 4 1 1 2 3 4 5 6 7 8 9 10 11 12 13 5 6 7 8 9 10 11 2 3 4 5 6 7 8 7 8 9 10 11 12 13 14 15 16 17 18 19 20 12 13 14 15 16 17 18 9 10 11 12 13 14 15 14 15 16 17 18 19 20 21 22 23 24 25 26 27 19 20 21 22 23 24 25 16 17 18 19 20 21 22 21 22 23 24 25 26 27 28 29 30 26 27 28 29 30 31 23/ 30 24 25 26 27 28 29 28 29 30 31 Pay Date 24 Deduction 20 Deduction Beginning Ending Pay Day 12/7/25 12/20/25 1/2/26 12/21/25 1/3/26 1/16/26 1/4/26 1/17/26 1/30/26 1/18/26 1/31/26 2/13/26 2/1/26 2/14/26 2/27/26 2/15/26 2/28/26 3/13/26 3/1/26 3/14/26 3/27/26 3/15/26 3/28/26 4/10/26 3/29/26 4/11/26 4/24/26 4/12/26 4/25/26 5/8/26 4/26/26 5/9/26 5/22/26 5/10/26 5/23/26 6/5/26 5/24/26 6/6/26 6/19/26 6/7/26 6/20/26 7/3/26 6/21/26 6/27/26 7/10/26 6/28/26 7/11/26 7/24/26 7/12/26 7/25/26 8/7/26 7/26/26 8/8/26 8/21/26 8/9/26 8/22/26 9/4/26 8/23/26 9/5/26 9/18/26 9/6/26 9/19/26 10/2/26 9/20/26 10/3/26 10/16/26 10/4/26 10/17/26 10/30/26 10/18/26 10/31/26 11/13/26 11/1/26 11/14/26 11/27/26 11/15/26 11/28/26 12/11/26

PlanSource User: Fname Initial + 1st 6 letters of Lname + last 4 digits of SSN Password: Birthday in format of YYYY/MM/DD Get Enrolled Today! Enroll Online