| Location | St. Clair, MO |
| Salary | $4–$7 Per Hour |
St. Clair R-XIII Benefit Enrollment Guide
2026
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Table of Contents
A Message from HR at St. Clair R-XIII School District 3 Eligibility 4 2026 Online Employee Login Instructions 7 Medical Insurance 11 Medical Insurance (continued) 13 Health Savings Account (HSA) 15 Flexible Spending Accounts (FSA) 16 Additional Information 17 Dental Insurance 18 Vision Insurance 19 Life and Accidental Death & Dismemberment (AD&D) Insurance 20 Voluntary Life Insurance 21 Disability Insurance (Short-Term and Long-Term) 22 Employee Assistance Plan (EAP) 23 Worksite Products 25 Benefit Resources 26
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A Message from HR at St. Clair R-XIII School District At St. Clair R-XIII School District we recognize our ultimate success depends on our talented and dedicated workforce. We understand the contribution each employee makes to our accomplishments and so our goal is to provide a comprehensive program of competitive benefits to attract and retain the best employees available. Through our benefits programs we strive to support the needs of our employees and their dependents by providing a benefit package that is easy to understand, easy to access and affordable for all our employees. This brochure will help you choose the type of plan and level of coverage that is right for you.
Sincerely,
Raechel Garmer (STC)
Lindsay Heady (COOP)
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Eligibility
Eligible Employees: You may enroll in the St. Clair R-XIII School District Employee Benefits Program if you are a Full-Time employee working at 20 or more hours per week. Newly hired employees and dependents will be effective in St. Clair R -XIII School District's benefits programs first of the month following date of hire .
Eligible Dependents: If you are eligible for our benefits, then your dependents are too. In general, eligible dependents include your lawful spouse and children up to age 26. Children may include natural, adopted, stepchildren , and children obtained through court - appointed legal guardianship.
Note: Dependent children will be automatically terminated at the end of the month in which they turn 26. This may affect you r monthly premium deduction.
When Coverage Begins: The effective date for your benefits is July 1, 2026, through June 30, 2027. All elections are in effect for the entire plan year and can only be changed during Open Enrollment unless you experience a family status event.
Open Enrollment: With few exceptions, Open Enrollment is the only time of year when you can make changes to your benefits plan. All elections and changes take effect on the first day of the plan year (July 1, 2026). During Open Enrollment, you can: Add, change, or delete coverage Add, or drop dependents from coverage Enroll, or re-enroll in dependent or health care flexible spending accounts. To continue your FSA benefits, you must re-enroll each plan year. In order to secure or continue coverage, you must complete the online enrollment process between April 27, 2026, and May 11, 2026. Once the system is closed, you will not be able to make any changes unless you experience a qualifying event. If you do not make your 2026-27 benefit elections, you will automatically be defaulted to your prior year elections, except for the HSA and FSA contribution elections , which will default to zero ($0) elections.
Family Status Change: A change in family status is a change in your personal life that may impact your eligibility or dependent's eligibility for benefits. Examples of some family status changes include:
Change of legal marital status (i.e., marriage, divorce, death of spouse, legal separation) Change in number of dependents (i.e., birth, adoption, death of dependent, ineligibility due to age) Change in employment or job status (spouse loses job, etc.)
If such a change occurs, you must make the changes to your benefits within 30 days of the event date. Documentation may be required to verify your change of status. Failure to request a change of status within 30 days of the event may result in your having to wait until the next open enrollment period to make your change. Please contact HR to make these changes.
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At the Doctor's Office It's recommended that you choose an in-network primary care physician (PCP) for your medical coverage, even though it is not required. A PCP can be your Family Practitioner, Internist, General Medicine, Pediatrician, or an OB/GYN (Obstetrician and Gynecologist). Each member of your family may have a different PCP.
If you are newly enrolling in medical benefits, make an appointment with your PCP- even if you're NOT sick, once the plan year has begun. This relationship will set the foundation for staying healthy -today and well into the future.
Network Provider/Facility Search Make sure that your provider or facility is in-network. To locate a network provider, follow the steps below or call 1-844-333-2598. Visit www.myuhc.com , select Find a Provider. Then select what type of provider you are looking for and then click on Employer and Individual Plans. Choose UHC Member if you are already enrolled. To continue as a guest, select Shopping Around then choose Choice Plus to view providers in your plan's network.
Preventive Care You and your family have access to a wide range of preventive services under the Affordable Care Act. These services are 100% covered by your medical plan when using in -network providers. For more details about the covered services , please visi t: www.healthcare.gov/coverage/preventive-care-benefits.
Common preventive services include:
Routine physicals (age 18+) or Pediatric exams (birth to age 17)
Age & Gender Appropriate Screenings
Blood pressure screening for adults and children Immunizations for adults and children
Member Service Portal Your medical carrier's member portal is your access to secure, personalized services with interactive health tools built around you, your benefits, and your health. Access the UnitedHealthcare portal at www.myuhc.com.
Once you are registered by creating your HealthSafe ID, your personal health information will be available to you 24/7, including: Finding care Managing prescriptions Managing claims Staying healthy Getting coverage and cost details Request or View (Digital) Member ID card
For assistance with password resets, change requests, and technical issues, call 1 -877-844-4999.
Need your health data on the run? Download your free carrier app from the App Store or Google Play. Use your mobile device to search for doctors, hospitals and more! Just search for UnitedHealthcare. The UnitedHealthcare app is available for download for iPhone or Android
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What Are My Options For Care? You have many options for how and where you can receive care through your UnitedHealthcare medical plan. But which one is best for your situation? Use the chart below to help you decide and see the benefit grid on the next page for service costs.
Care Center What is it? What can they treat? NurseLine
Staffed by registered nurses Resource for guidance during natural catastrophes or health outbreaks Available 24/7/365 days a year at NO COST
Answer general questions like "how long should I ice my sprained ankle?" Give advice/referrals of where to go for treatment e.g. ER or primary care doctor Telemedicine / Virtual Visits
Convenient, low cost option for treating common, non-urgent health concerns A doctor will diagnose the issue over the phone and write a prescription, if necessary. Available 24/7/365 days a year, by web, phone or mobi le app Minor illnesses Minor infections Cold and flu symptoms Bronchitis Allergies Mental health Headaches/migraines And more… Doctor's Office
Routine care or treatment for a current health issue Your primary doctor knows you and your health history To manage your medications To refer you to a specialist Normally available Monday-Friday. Check with your provider for actual office hours. Routine checkups and preventive services Immunizations Minor injuries, such as sprains Illnesses Manage your general health and chronic conditions Urgent Care Clinic
Treatment of non-life-threatening inj uries or illness es Staffed by qualified physicians Generally open night and weekends; some open 24/7 Cold and flu symptoms Minor accidents or falls Minor sprains or fractures Minor cuts and burns Vomiting, diarrhea Emergency Room
Immediate treatment for serious, life-threating conditions. Ready to treat any critical situation Can be hospital-based or freestanding Available 24/7/365 days a year Chest pain Difficulty breathing Severe abdominal pain Broken bones Head injuries Uncontrolled bleeding Seizures Coughing or vomiting blood
NurseLine Virtual Visits Find A Doctor / Facility 1-866-444-3011 UnitedHealthcare: www.myuhc.com/virtualvisits Or access on the UnitedHealthcare app www.myuhc.com
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2026 Online Employee Login Instructions
2026 Online Employee Login Instructions for Benefit Express, a WEX Company How to Login My Benefit Express Enrollment Portal and Complete Your Enrollment
Please follow the instructions below to login to the benefits administration portal and create a new password.
Go to: www.mySCECbenefits.com and enter your username and password. For security purposes, you will be asked to change your password after your initial login.
Step 1: Your username is SCEC + last 4 digits of your SSN + Your Date of Birth in MMDDYYY format Please note the username is not case sensitive. Example: If your last 4 digits of your Social Security number are 4456, and your date of birth is September 5, 1996, then your username would be SCEC445609051996.
Step 2: Your initial password is the last 4 digits of your SSN + your full Date of Birth in MMDDYYYY format, followed by your Zip Code.
For security purposes, you will be asked to change your password after your initial login. Example: If your SSN is 111-22-2243, your Date of Birth is May 16, 1975, and your zip code is 02469, then your password would be 22430516197502469.
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You will be required to accept the terms and conditions.
Next, create a new password and complete security questions. Once you create a custom password and complete security questions, you will use your new password to access the website. Please save your new password in a safe place for future use.
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Provide the email address that you would prefer to use for multi -factor authentication, and select communication preference.
Electronic Communication Information
Transmission of information electronically and/or digitally allows BE to communicate in a more efficient and timely manner with employees .
By electing to communicate electronically, you are authorizing BE to provide access to forms and documents via email and website access. You are agreeing that you do not require receipt of these materials in paper format. You are also certifying that ema il notifications sent to the address provided below are sufficient to meet the government requirements.
Personal Email Address (Verified)
Company Email Address chastings@mybenefitexpress.com
Mailing Address 4567 Some Street
Apt 1
Any Town
MO
Automated Phone Info: As an added convenience, you have the ability to retrieve your FSA balance or reset your password via a text message at any time. To set this up, simply type in your cell phone number below (without dashes or parentheses), click SEND and within a few minutes your phone will receive a text message containing a four -digit verification code to be entered.
Text/SMS Number
____
Communication Preference This authorization will remain in effect until terminated by you by submitting a written request to the Benefits Department, or by changing your election on this website. If you select Text/SMS, you can stop receiving messages by replying STOP to any message.
Personal Email
mnorthey@mybenefitexpress.com Send 63048 Send
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If you are providing an email for the first time, the system will ask you to 'verify' this. A verification code will be sent to the email address provided, and you will need to enter that verification code to proceed to the homepage.
Updating Your Election Choices & Updating Your Beneficiaries
Make Y our Election Choices: From the Choices section of the enrollment, you will make your benefit elections. Each page will display your plan choices and will prompt you for additional information where needed. All deductions are shown on a per pay basis. Y ou may navigate through this section by using the Previous and Save and Continue buttons. Y ou can also jump between plans by clicking anywhere in the Choices step/button and selecting your desired plan from the drop -down.
Add/Review Beneficiaries: Y ou will also be able to add new beneficiaries, update beneficiary information , and assign beneficiary percentages . Any plans requiring a beneficiary designation will be listed on this page.
Enrollment Confirmation Confirm Y our Choices: The last page/section in the enrollment is your confirmation statement, which you can print or email. The site will automatically save a copy for your future reference. If you need to change any of the plan selections you have made, you can go back into th e enrollment and make any additional changes through the end of your enrollment period.
For login assistance or site navigation questions, please contact Benefit Express at 877-837-5017. For all other inquiries, please contact your HR Representative.
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Medical Insurance Medical Benefits St. Clair R -XIII School District will continue to offer five medical plan options through UnitedHealthcare, all with an unlimited lifetime maximum. The charts on the following pages are a brief outline of what is offered. Please refer to the summary plan description for complete plan details.
Coverage - PPO Plans
Plan 1
Plan 2
Plan 6
In-Network Benefi ts Ou t-of-Network Benefi ts In-Network Benefi ts Ou t-of-Network Benefi ts In-Network Benefi ts Ou t-of-Network Benefi ts Annual Deductible Individual $1,500 $6,000 $1,500 $6,000 $2,500 $6,000 Family $3,000 $12,000 $3,000 $12,000 $5,000 $12,000 Coinsurance 80% after deductible 70% after deductible 70% after deductible 60% after deductible 70% after deductible 60% after deductible Maximum Out-of-Pocket (Includes Deductibles) Individual $4,000 $9,000 $5,000 $10,000 $6,000 $10,000 Family $8,000 $18,000 $10,000 $20,000 $12,000 $20,000 Physician Office Visit Primary Care $30 copay 70% after deductible $30 copay 60% after deductible $30 copay 60% after deductible Specialty Care $60 copay 70% after deductible $60 copay 60% after deductible $60 copay 60% after deductible Preventive Care Adult Periodic Exams 100% 70% after deductible 100% 60% after deductible 100% 60% after deductible Well-Child Care 100% 70% after deductible 100% 60% after deductible 100% 60% after deductible Diagnostic Services X-ray and Lab Tests 100% 70% after deducitble 100% 60% after deducitble 100% 60% after deductible Complex Radiology 80% after deductible 70% after deductible 70% after deductible 60% after deductible 70% after deductible 60% after deductible Urgent Care Facility $50 copay 70% after deductible $50 copay 60% after deductible $50 copay 60% after deductible Emergency Room Facility Charges $250 copay; waived if admitted $250 copay $250 copay; waived if admitted $250 copay $250 copay; waived if admitted $250 copay Inpatient Facility Charges 80% after deductible 70% after deductible 70% after deductible 60% after deductible 70% after deductible 60% after deductible Outpatient Facility and Surgical Charges 80% after deductible 70% after deducitble 70% after deductible 60% after deducitble 70% after deductible 60% after deductible
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Coverage - PPO Plans
Plan 1
Plan 2
Plan 6
In-Network Benefi ts Ou t-of-Network Benefi ts In-Network Benefi ts Ou t-of-Network Benefi ts In-Network Benefi ts Ou t-of-Network Benefi ts Mental Health Inpatient 80% after deductible 70% after deductible 70% after deductible 60% after deductible 70% after deductible 60% after deductible Outpatient $30 copay 70% after deductible $30 copay 60% after deductible $30 copay 60% after deductible Substance Abuse Inpatient 80% after deductible 70% after deductible 70% after deductible 60% after deductible 70% after deductible 60% after deductible Outpatient $30 copay 70% after deductible $30 copay 60% after deductible $30 copay 60% after deductible Other Services Chiropractic 50% 50% 50% 50% 50% 50% Retail Pharmacy (30 Day Supply) Tier 1 (Lowest Cost Option) $15 copay $15 copay $15 copay $15 copay $15 copay $15 copay Tier 2 (Mid-Range Option) $40 copay $40 copay $40 copay $40 copay $40 copay $40 copay Tier 3 (Mid Range Option) $75 copay $75 copay $75 copay $75 copay $75 copay $75 copay Tier 4 (Highest Cost Option) 20% up to a $150 maximum 20% up to a $150 maximum 20% up to a $150 maximum 20% up to a $150 maximum 20% up to a $150 maximum 20% up to a $150 maximum Mail Order Pharmacy (90 Day Supply) Tier 1 (Lowest Cost Option) $37.50 copay Not covered $37.50 copay Not covered $37.50 copay Not covered Tier 2 (Mid-Range Option) $100 copay Not covered $100 copay Not covered $100 copay Not covered Tier 3 (Mid Range Option) $187.50 copay Not covered $187.50 copay Not covered $187.50 copay Not covered Tier 4 (Highest Cost Option) 20% up to a $375 maximum Not covered 20% up to a $375 maximum Not covered 20% up to a $375 maximum Not covered IF YOU AND/OR YOUR SPOUSE WILL HAVE COVERAGE UNDER ONE OF THE MEDICAL PLAN OPTIONS BEING OFFERED THIS YEAR, BUT DID NOT PARTICIPATE IN THE WELLNESS PROGRAM, YOU WILL NEED TO ADD THE $50 SURCHARGE ($50 EMPLOYEE AND/OR $50 FOR SPOUSE) TO BELOW PREMIUM RATES. Total Monthly Cost
Plan 1
Plan 2
Plan 6
Employee Only: Employee + Spouse: Employee + Child(ren): Family:
$ 188.00 $1,219.00 $ 926.00 $1,882.00
$ 78.00 $ 989.00 $ 732.00 $1,575.00
$ 0.00 $ 826.00 $ 591.00 $1,357.00
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Medical Insurance (continued) The charts below are a brief outline of the HSA plan options that are offered. Please note, per IRS guidelines, the in- network deductibles will be increasing this plan year for HSA Plan 4. The in-network deductible will increase to $3,400 for an individual and to $6,800 for family. The requirement only affects HSA Plan 4. The max out of pocket has decreased for HSA Plan 4 from $4,500 to $4,000 per individual and from $9,000 to $8,000 for family. Please refer to the summary plan description for complete plan details.
Coverage - HSA Plans
In-Network Benefi ts Ou t-of-Network Benefi ts In-Network Benefi ts Ou t-of-Network Benefi ts Annual Deductible Individual $3,400 $6,000 $4,000 $8,000 Family $6,800 $12,000 $8,000 $16,000 Coinsurance 70% 60% 100% 80% Maximum Out-of-Pocket (Includes Deductibles) Individual $4,000 $10,000 $5,500 $11,000 Family $8,000 $20,000 $11,000 $22,000 Physician Office Visit Primary Care 70% after deductible 60% after deductible 100% after deductible 80% after deductible Specialty Care 70% after deductible 60% after deductible 100% after deductible 80% after deductible Preventive Care Adult Periodic Exams 100% 60% after deductible 100% 80% after deductible Well-Child Care 100% 60% after deductible 100% 80% after deductible Diagnostic Services X-ray and Lab Tests 70% after deducitble 60% after deducitble 100% after deductible 80% after deductible Complex Radiology 70% after deductible 60% after deductible 100% after deductible 80% after deductible Urgent Care Facility 70% after deductible 60% after deductible 100% after deductible 80% after deductible Emergency Room Facility 70% after deductible Same as Network 100% after deductible Same as Network Inpatient Facility Charges 70% after deductible 60% after deductible 100% after deductible 80% after deductible Outpatient Facility and Surgical Charges 70% after deductible 60% after deducitble 100% after deductible 80% after deductible Mental Health Inpatient 70% after deductible 60% after deductible 100% after deductible 80% after deductible Outpatient 70% after deductible 60% after deductible 100% after deductible 80% after deductible
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Coverage - HSA Plans
In-Network Benefi ts Ou t-of-Network Benefi ts In-Network Benefi ts Ou t-of-Network Benefi ts Substance Abuse Inpatient 70% after deductible 60% after deductible 100% after deductible 80% after deductible Outpatient 70% after deductible 60% after deductible 100% after deductible 80% after deductible Other Services Chiropractic 70% after deductible 60% after deductible 100% after deductible 80% after deductible Retail Pharmacy (30 Day Supply) Generic (Tier 1) $15 copay after deductible $15 copay after deductible $15 copay after deductible $15 copay after deductible Preferred (Tier 2) $40 copay after deductible $40 copay after deductible $40 copay after deductible $40 copay after deductible Non-Preferred (Tier 3) $75 copay after deductible $75 copay after deductible $75 copay after deductible $75 copay after deductible Preferred Specialty (Tier 4) 20% after deductible up to a $150 maximum 20% after deductible up to a $150 maximum 20% after deductible up to $150 max 20% after deductible up to $150 max Mail Order Pharmacy (90 Day Supply) Generic (Tier 1) $37.50 copay after deductible Not covered $37.50 copay after deductible Not covered Preferred (Tier 2) $100 copay after deductible Not covered $100 copay after deductible Not covered Non-Preferred (Tier 3) $187.50 copay after deductible Not covered $187.50 copay after deductible Not covered Preferred Specialty (Tier 4) 20% after deductible up to a $375 maximum Not covered 20% after deductible up to $375 max Not covered
Total Monthly Cost Plan 4 (HSA) Plan 7 (HSA)
Employee Only: Employee + Spouse: Employee + Child(ren): Family:
$ 0.00 $ 625.00 $ 447.00 $1,027.00 $ 0.00 $ 601.00 $ 431.00 $ 987.00
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Health Savings Account (HSA) When you are enrolled in a Qualified High Deductible Health Plan (QHDHP) and meet the eligibility requirements, the IRS allows you to open and contribute to an HSA Account. Plan s 4 and 7 (HSA Options) do qualify as a HDHP.
When selecting Plan 4, the school district will contribute $185.00 a month to the HSA or $2,220 annually.
When selecting Plan 7, the school district will contribute $206.00 a month to the HSA or $2, 472 annually.
What is a Health Savings Account (HSA)? An HSA is a tax -sheltered bank account that you own to pay for eligible health care expenses for you and/or your eligible dependents for current or future healthcare expenses. The Health Savings Account (HSA) is yours to keep, even if you change jobs or medical plans. There is no "use it or lose it" rule; your balance carries over year to year. Plus, you get extra tax advantages with an HSA because: Money you deposit into an HSA is exempt from federal income taxes Interest in your account grows tax free; and You don't pay income taxes on withdrawals used to pay for eligible health expenses. (If you withdraw funds for non-eligible expenses, taxes and penalties apply). You also have a choice of investment options which earn competitive interest rates, so your unused funds grow over time.
Are you eligible to open a Health Savings Account (HSA)? Although everyone is able to enroll in the Qualified High Deductible Health Plan, not everyone is eligible to open and contribute to an HSA. If you do not meet these requirements, you cannot open an HSA. You must be enrolled in a Qualified High Deductible Health Plan (QHDHP) You must not be covered by another non -QHDHP health plan, such as a spouse's PPO plan. You are not enrolled in Medicare. You are not in the TRICARE or TRICARE for Life military benefits program. You have not received Veterans Administration (VA) benefits within the past three months.
Are you eligible to open a Health Savings Account (HSA)? (continued) You are not claimed as a dependent on another person's tax return. You are not covered by a traditional health care flexible spending account (FSA). This includes your spouse's FSA. (Enrollment in a limited purpose health care FSA is allowed).
2026 HSA Contributions You are able to contribute to your Health Savings Account on a pre-tax basis through payroll deductions up to the IRS statutory maximums. The IRS has established the following maximum HSA contribution limits between employer and employee : FOR THE 2026 TAX YEAR: $4,400 Individual $8,750 Family If you are age 55 and over, you may contribute an extra $1,000 catch up contribution (per participant).
Scan the below QR Code to learn more about how to optimize your HSA .
QR Code
Important Note Regarding Additional HSA Contributions
If you want to make additional contributions to your health savings account via payroll deduction, you will need to re-enroll and elect your new contribution amount for the 2026-2027 plan year.
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Flexible Spending Accounts (FSA) The Flexible Spending Account (FSA) plan allows you to set aside pre -tax dollars to cover qualified expenses you would normally pay out of your pocket with post -tax dollars. The plan is comprised of a health care spending account and a dependent care accou nt. You pay no federal or state income taxes on the money you place in an FSA.
Employees who enroll in the PPO (Plans 1, 2, and 6) are also eligible to enroll in a flexible spending account.
Employees who enroll in the HSA (Plans 4 and 7) are not eligible for the medical portion of the FSA but could still elect to have a Dependent Care Reimbursement Account (DCRA).
This account is managed by Benefit Express, a WEX company, for the school district.
How an FSA works: Choose a specific amount of money to contribute each pay period, pre-tax, to one or both accounts during the year. The amount is automatically deducted from your pay at the same level each pay period. As you incur eligible expenses, you may use your flexible spending debit card to pay at the point of service OR submit the appropriate paperwork to be reimbursed by the plan. Important rules to keep in mind: The IRS has a strict "use it or lose it" rule. If you do not use the full amount in your FSA, you will lose any remaining funds. Once you enroll in the FSA, you cannot change your contribution amount during the year unless you experience a qualifying life event. You cannot transfer funds from one FSA to another.
Please plan your FSA contributions carefully, as any funds not used by the end of the year will be forfeited. Re-enrollment is required each year.
Scan the below QR Code to learn more about how to optimize your FSA. QR Code
Maximum Annual Election Health Care FSA $3,400 Dependent Care FSA $7,500
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Additional Information
Medical Insurance The District contributes $ 758.00 towards the "employee only" premium for employees electing either Plan 1, Plan 2 or Plan 6. You must work 30+ hours per week to be eligible for the employer contribution. The District will pay the full "employee only" premium on Plans 4 and 7 and apply the difference to your HSA bank account. If an employee chooses either Plan 4 or Plan 7 and is not eligible for a HSA bank account, the District will put $37.17 a month into a FSA and pay the $4.50 administration fee. The employer contribution will not exceed $446.04. Employees have the option to purchase health insurance for eligible dependents.
403b/457 The St. Clair R -XIII School District offers voluntary 403b/457 contributions through Corebridge (Valic). If you are interested in setting up an account, please contact:
Robert Palmer Financial Advisor 636.222.8600 314.439.4850 robert.palmer@corebridgefinancial.com 12312 Olive Blvd, Ste 265 St Louis, MO 63141
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Dental Insurance Dental Benefits Regular dental checkups can help find early warning signs of certain health problems, which means you can get the care you need to get healthy. St. Clair R-XIII School District will continue to offer a dental program through Guardian. The chart below is a brief outline of the plan. Please refer to the summary plan description for complete plan details.
Guardian Low Plan
Guardian High Plan In-Network Benefi ts Negoti ated Fee Sch edu l e Ou t-of-Network Benefi ts (U CR 90th Percenti l e) In-Network Benefi ts Negoti ated Fee Sch edu l e Ou t-of-Network Benefi ts (U CR 90th Percenti l e) Annual Deductible Individual $50 $50 $50 $50 Family $150 $150 $150 $150 Waived for Preventive Care? Yes Yes Yes Yes Annual Maximum Per Person / Family $2,000 $2,000 $2,000 $2,000 Preventive 100% 100% 100% 100% Basic 80% 80% 90% 80% Major 50% 50% 60% 50% Orthodontia Benefit Percentage 50% 50% 50% 50% Adults Not covered Not covered Not covered Not covered Dependent Child(ren) Covered Up to age 26 Covered Up to age 26 Covered up to age 26 Covered Up to age 26 Lifetime Maximum $2,000 $2,000 $2,000 $2,000 Benefit Waiting Periods 12 months Late Entrant Limitation 12 months Late Entrant Limitation
Total Monthly Cost
Guardian Low Plan
Guardian High Plan Employee Only: Employee + Spouse: Employee + Child(ren): Family: $ 33.26 $69.83 $ 98.52 $135.08 $ 46.57 $ 97.75 $122.53 $179.62
Waiting Period Penalty for Late Entrants:
Visit www.GuardianAnytime.com to locate Dental providers in the DentalGuard Preferred network and view more detailed benefit information.
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Vision Insurance Eye doctors detect problems in vision, overall eye health, and detect signs of other health conditions like diabetic eye disease, high blood pressure and high cholesterol.
If you do not elect Vision during the annual open enrollment period or when you first become eligible, you will have to wait until the next annual open enrollment period to enroll, which is every July 1 st (unless you have a qualifying event). Visit www.GuardianAnytime.com to locate Vision providers and view more detailed benefit information. Dependent Age Limit is to Age 26
Guardian VSP Vision Plan (VSP Choice Network) Guardian Davis Vision Plan (Davis Vision Network) In-Network Out-of-Network (Before Copay) In-Network Out-of-Network (Before Copay) Annual Eye Exam $10 Copay $39 Max $10 Copay $50 Max Lenses (Single, Bifocal, Trifocal, Lenticular)
Contact Lenses (Elective)
$0 Copay $130 Allowance $0 Copay $120 Allowance $0 Copay $130 Allowance +15% off balance $0 Copay $108 Allowance Contact Lenses (Medically Necessary)
Total Monthly Cost Guardian VSP Vision Plan Guardian Davis Vision Plan Employee Only: Employee + Spouse: Employee + Child(ren): Family: $ 9.71 $17.88 $18.74 $28.06 $ 8.29 $15.28 $16.02 $23.98
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Life and Accidental Death & Dismemberment (AD&D) Insurance Basic Life and AD&D Insurance St. Clair R-XIII School District provides employer-paid Basic Life and AD&D benefits to eligible employees. You must work 30+ hours per week to be eligible for this employer -paid benefit. The Life insurance benefit will be paid to your designated beneficiary in the event of death while covered under the plan. The AD&D benefit will be paid in the event of a loss of life or limb by accident while covered under the plan.
Guardian Basic Life and AD&D You Benefit Maximum $40,000 Guaranteed Issue $40,000 Your Spouse Benefit Maximum Not covered Guaranteed Issue Not covered Your Child Benefit Maximum Not covered Guaranteed Issue Not covered
The above benefits will begin to decrease at age 65. Benefits terminate at retirement.
Important Reminder! Be sure to assign a beneficiary or living trust to ensure your assets are distributed according to your wishes.
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Voluntary Life Insurance In addition to the employer-paid Basic Life and AD&D coverage, you have the option to purchase additional voluntary life insurance to cover any gaps in your existing coverage that may be a result of age reduction schedules, cost of living, existing financial obligations, etc. Your election, however, could be subject to medical questions and evidence of insurability.
Voluntary Life Insurance You may purchase additional Life insurance with Guardian if you want more coverage. Your contributions will depend on your age and the amount of coverage you elect. Coverage is paid for by you through payroll deduction. Accidental Death and Dismemberment (AD&D) is included in this coverage.
NOTE: Employees may elect up to the Guarantee Issue (GI) amount on yourself, a spouse, or child with no proof of evidence of insurability. However, if you apply for coverage over the GI amount, you will be subject to providing EOI by answering a few questions and could be denied coverage. If EOI is approved, your effective date will be the first of the mon th following approval.
Plan Highlights Carrier: Guardian Coverage Premiums (Note: The enrollment portal will calculate your premiums at the time of enrollment and will be based on age. Premium for spouse is based on age of employee. Premiums increase every five years).
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Disability Insurance (Short-Term and Long-Term) One of the most important assets to you as an employee is the ability to earn an income. Disability insurance provides income protection in the event you become unable to work due to a non-work-related illness or injury. Please note that disability plans are subject to reduction if you receive disability payments from other sources, such as state or federal programs.
Short-Term Disability Insurance St. Clair R-XIII School District offers a short-term disability option through Guardian . Premiums are employee paid and rates vary by age and salary level. This benefit covers 50% of your weekly base salary up to $1,250/week. The benefit begins on the 15th day of injury or illness and lasts up to 11 weeks. There is a pre-existing condition limitation, which means there is a 3-month look back period (anything that has been treated or diagnosed 3 months prior to effective date) and would not be covered for the first 12 months of the plan.
Maternity is covered as any other illness. If a new enrollee that does not currently have short term disability coverage in place and already pregnant, the benefit would be limited to two weeks. If you are a new enrollee and NOT pregnant on July 1st, you would be limited by the definition of disability, not to exceed the benefit duration of 11 weeks.
Please see the summary plan description on the online enrollment system for complete plan details and rates .
Long-Term Disability Insurance You may purchase voluntary long-term income protection through Guardian in the event you become unable to work due to a non-work-related illness or injury. Premiums are employee paid and rates vary by age and salary level. This benefit covers 60% of your monthly base salary up to $6,000. Benefit payments begin after 90 days of disability. Please see the summary plan description on the online enrollment system for complete plan details and rates.
This benefit is a very inexpensive way to "insure" your paycheck in the event of extended sick time away from your job.
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Employee Assistance Plan (EAP) Life does not always go smoothly. All of us experience times when a personal problem or crisis affects the way we function at work or home. Your Employee Assistance Program (EAP) is a problem -solving resource available to you and your household members. A professional counselor will assist you in assessing your situation, finding options, making choices or locating further help.
It's free...Your employer covers the cost of initial assessment, additional problem-solving sessions and referral services. If there is a need for further counseling or treatment, your counselor will help you explore various options.
It's confidential...Your EAP has been set up with Guardian, and administered by Uprise Health, an outside counseling resource to assure confidentiality. No one at work will know you have chosen to seek help unless you choose to tell them. Nothing concerning your use of EAP will appear in your personnel file.
These services include:
ealth today!
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St. Clair R-XIII School District's Wellness Initiatives
Whether your goal is to have more energy, lose weight, manage stress, or improve your diet, St. Clair R-XIII School District Wellness program can help you. We consider Wellness to be a vital part of our overall benefits program.
As healthcare costs continue to rise, we strive to offer competitive health benefits to take care of you and your family. A successful wellness program is a win -win - it means our employees are improving their lives, and we are one step closer to managing rising health insurance costs.
Participate in your Wellness Program this year to avoid a $50.00 monthly surcharge per person. The program is applicable to all eligible retirees, employees, and spouses covered under the UHC medical plan with an effective date prior to January 1,
A detailed packet of information for the 2026-27 wellness program year will be distributed by the district, so be on the lookout for that. This informational packet will include:
Step 1 Step 2 Step 3
Complete Proof of Annual Physical Exam Form with your physician. Complete the Registration and Consent Form using Company ID 11821. Submit your completed packet by the deadline.
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Worksite Products Your voluntary worksite benefit offerings effective July 1, 2026, for the 2026-2027 school years are being offered once again through Guardian.
Accident & Injury - There is no pre-existing limitation (guaranteed acceptance). Helps with out-of-pocket costs that arise when you have a covered accident, including: Hospital Admission, Hospital Confinement, Physical Therapy, Lacerations, Major Injuries (Fractures and Dislocations). Most major medical insurance plans only pay a portion of the bills. Our policy can help pick up where other insurance leaves off and provide cash to cover the expenses. Our accident coverage helps offer peace of mind when an accidental injury occurs. Includes $50 wellness benefit per year. Accident & Injury - Monthly Rates (Employee Paid): Employee $20.63 EE + Spouse $30.92 EE + Child(ren) $36.16 Family $46.45
Critical Illness - The signs pointing to a critical illness are not always clear and may not be preventable, but our coverage can help offer financial protection in the event you are diagnosed. Guardian group voluntary critical illness coverage provides a lump-sum cash benefit to help you cover the out-of-pocket expenses associated with a critical illness. Employee may choose lump sum benefit of $10,000 , $20,000, or $30,000. All amounts are Guarantee Issue with annual open enrollment each year. Spouse's benefit would be up to 50% of employee's benefit and dependent child benefit amount of 50% of employee's benefit. The plan includes a $100 per year benefit for completing certain wellness screenings for the covered employee, spouse, and child. NOTE: No coverage/benefit if illness was diagnosed prior to the plan's issue date. Critical Illness - Monthly Rates (Employee Paid): Simplified Rate Structure Effective 7/1/2 6 - Varies by issue age
Cancer - There are two options to choose from. All options are Guarantee Issue with annual open enrollment. All have a pre-existing condition limitation, which means there is a 3-month look back period (anything that has been treated or diagnosed 3 months prior to effective date) and would not be covered for the first 12 months of the plan. Benefits include: Cancer screening ($50; $50 for follow-up screening), Radiation Therapy, Chemotherapy, Blood/Plasma/Platelets, Second Surgical Opinion, Hospital Confinement, ICU Confinement, and Hospice. Value Plan Premier Plan Employee $15.88 $42.74 EE + Spouse $33.46 $94.70 EE + Child(ren) $19.18 $49.00 Family $36.77 $100.97
Hospital Indemnity - Group Hospital Indemnity Insurance from Guardian helps with the out-of-pocket costs associated with a covered hospital stay, including benefits for hospital admission, confinement, and intensive care. Guaranteed acceptance, however, there is a 12/12 pre-existing limitation, which means there would be a 12 -month look back period (anything that has been treated or diagnosed 12 months prior to effective date) and would not be covered for the first 12 months of the plan. Plan 1: $1,500 per insured per calendar year (max of 2 payments per family per year) Plan 2: $2,500 per insured per calendar year (max of 2 payments per family per year) Both plans will pay $200 per day for hospital confinement and $400 per day for ICU (combined max imum of 30 days per year, per insured). Hospital Indemnity - Monthly Rates (Employee Paid): Plan 1 Plan 2 Employee $25.57 $33.65 EE + Spouse $50.24 $66.10 EE + Child(ren) $36.44 $47.99 Family $61.11 $80.43
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Benefit Resources USI Benefit Resource Center Have Questions? Need Help? St. Clair R-XIII School District is excited to offer access to the USI Benefit Resource Center (BRC), which is designed to provide you with a responsive, consistent, hands -on approach to benefit inquiries. Benefit Specialists are available to research and solve elevated claims, unresolved eligibility problems, and any other benefit issues with which you might need assistance. The Benefit Specialists are experienced professionals, and their primary responsibility is to assist you.
Carrier Contacts Please contact Human Resources to complete any changes to your benefits that are not related to your initial or annual enrollment.
CARRIER PHONE NUMBER WEBSITE Medical UnitedHealthcare (Policy #911283) 844-333-2598 www.myuhc.com Dental PPO Guardian (Policy #526484) 800-541-7846 www.guardiananytime.com Vision Life and AD&D Voluntary Life Short Term Disability (STD) Long Term Disability (LTD) Voluntary Critical Illness Voluntary Cancer Accident Employee Assistance Program Guardian - Administerd by Upsrise Health (Access code: worklife) 855-239-0743 www.guidanceresources.com Health Savings Account Benefit Express, a WEX Co. (Policy: SCEC St. Clair R-XIII) 877-837-5017 www.help@mybenefitexpress.com Section 125 Benefit Express, a WEX Co. (Policy: SCEC St. Clair R-XIII) 877-837-5017 www.myfsaexpress.com Wellness Program Wellworks For You 800-425-4657 www.wellworksforyoulogin.com This brochure summarizes the benefit plans that are available to St. Clair R-XIII School District eligible employees and their dependents. Official plan documents, policies and certificates of insurance contain the details, conditions, maximum benefit levels and restrictions on benefits. These documents govern your benefits program. If there is any conflict, the official documents prevail. These documents are availa ble upon request through the Human Resources Department. The information provided in this bro chure is not a guarantee of benefits. Why won't they pay my claim? Do I have mail-order prescription benefits? I called my insurance carrier, but now I'm just more confused. How can my claim still be "in process"? It's been two months! Services denied?! Toll Free: 855-874-0742 Monday - Friday 8:00am to 5:00pm CST
BRCCentral@usi.com