KISD Open Enrollment Guide 2020

Killeen ISD 2020 BENEFITS

Med i ca l Bene f i t s , con t ’ d…

*Plan 5 – BSW Preferred HMO Network $5,000 deductible(HSA qualified plan) $5,000 Individual Deductible** / 20% Coinsurance after Deductible $6,650 Individual Out Of Pocket Maximum***

** All claims, including prescriptions ( Not Including claims coded as Preventive Care ) are subject to the deductible. ***Once the Out of Pocket Maximum is met, covered benefits are received at 100% for the remainder of the calendar year.

Monthly Cost (Total)

KISD Monthly Contribution

State Monthly Contribution

Monthly Cost

TIER Election

Employee Only

$432.73

$325.00 $325.00 $325.00 $325.00

$75.00 $75.00 $75.00 $75.00

$32.73 $727.14 $397.68 $961.24

Employee & Spouse

$1,127.14

Employee & Child(ren)

$797.68

Employee & Family

$1,361.24

Plan 6 - PPO Choice Network (Tier 1 ICSW PPO/ Tier 2 Cigna PPO) $0 deductible in-network Tier 1 - $30 Primary Care Copay / $70 Specialist Copay/ Urgent Care $75 Copay/ ER $500/$6,500 Individual Out of Pocket Maximum/RX $10-$45-$90 Tier 2 - $35 Primary Care Copay / $80 Specialist Copay/ Urgent Care $75 Copay/ ER $500/$7,350 Individual Out of Pocket Maximum/RX $10-$45-$90

Monthly Cost (Total)

KISD Monthly Contribution

State Monthly Contribution

Monthly Cost

TIER Election

Employee Only*

$723.80

$325.00 $325.00 $325.00 $325.00

$75.00 $75.00 $75.00 $75.00

$323.80

Employee & Spouse**

$1,881.89 $1,331.80 $2,272.73

$1,481.89

Employee & Child(ren)**

$931.80

Employee & Family**

$1,872.73

For 2020, the maximum contribution as set by the IRS for an individual HSA account is $3,550 and the maximum contribution for family coverage is $7,100. People over the age of 55 can make an additional “catch-up” contribution of $1,000. These limits are the same regardless of the source of the contribution.

Employees that make / receive contributions to an HSA cannot also make contributions to the FSA

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