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Arlington Public SchoolsBenefits OrientationNew EmployeesandNewly-Eligible EmployeesBenefits Packetrev. 12-31-19

View the 2020 Benefits Guide online.Go to www.apsva.us/benefits

Benefits at a GlancePlan Year 2020Medical CoveragePlans OfferedCigna Open Access HighCigna Open Access LowKaiser Permanente HMODental CoverageDelta Dental of VirginiaVision CoverageVision Service Plan (VSP)Group Term Life Insurance and Accidental Death& Dismemberment (AD&D) InsuranceEmployees who are members of the VirginiaRetirement System are covered by the VRS groupterm life insurance program. The life insurancebenefit is 2 x times your annual base salary.Optional Life Insurance and AD&D InsuranceVRS member employees may also purchaseadditional coverage for themselves, their spouse,and their dependent children.Disability InsuranceDisability insurance provides income replacement inthe event of a non‐work related illness or injury.VRS Hybrid Plan members are eligible for disabilitybenefits after 12‐months of continuous APS service.Long Term Care InsuranceLong Term Care coverage, provided by GenworthLife Insurance Co., is available for employees.Family members are also eligible, including spouse,adult children, siblings, parents, parents‐in‐law,grandparents, and grandparents‐in‐law.Flexible Spending Accounts (FSAs)Health Care FSADependent Care FSAParking FSA and Transit FSAVirginia Retirement System (VRS)VRS Hybrid Plan MembersThe VRS Hybrid Plan combines the features of aDefined Benefit plan and a Defined Contributionplan. Benefits‐eligible employees with no previousVRS service credit, whose VRS membership date ison or after January 1, 2014, are automaticallyenrolled as Hybrid Plan members. A mandatoryemployee contribution applies equal to 5% of yourannual salary; 4% funds your Defined Benefit planand 1% funds your Defined Contribution plan.VRS Hybrid Plan members can save additionalmoney (up to 4% of your annual base salary)deposited into a Defined Contribution plan. You willreceive an employer match on voluntary employeecontributions. Go to www.varetire.org/hybrid tolearn more.VRS Plan 1 and VRS Plan 2 MembersVRS Plan 1 and VRS Plan 2 are Defined Benefitplans. A mandatory employee contribution applies,equal to 5% of your annual salary. If you werepreviously a member of VRS and you have notreceived a refund of your member contributions,you will be placed back into your previous VRS Plan.If you are uncertain if you remained in VRS, pleasecontact VRS directly at 1‐888‐827‐3847.Optional Supplemental Retirement PlanAPS offers several voluntary retirement plans tohelp you achieve your retirement goals. 403(b),ROTH 403(b), 457, and ROTH 457 plans are offeredthrough Lincoln Financial Group and AXAAdvisors/PlanMember Services.School Board Match ProgramThe Supplemental Retirement Plan includes aSchool Board Match Program. For Benefits‐EligibleEmployees, the School Board matches up to 0.4% ofyour base salary, or up to 240 per year, whicheveris greater.This information is intended as a brief summary. For full plan and coverage details, read the information on the Benefits Home Page andin the Benefits Guide available at www.apsva.us/benefits, or the APS School Board Policies and Policy Implementation Procedures.page 1 of 4, rev. 12 02 19

Employee Assistance Program (EAP)The Arlington EAP provides services to employeesof Arlington County Government and ArlingtonPublic Schools and their family members. The EAPworks with employees and family members whohave problems which may affect job performance;these can be problems at home or on the job. TheEAP adheres to strict laws of confidentiality. Thereis no charge for EAP services.APS WellnessAPS Wellness promotes health, productivity, andhappiness through employee wellness initiativessuch as Active for Life, The Biggest Loser, HealthyHabits, and volleyball, kickball, and bowlingtournaments.Paid LeaveAnnual leave12‐Month employees earn annual leave of 14 to28 days each fiscal year, depending on years ofservice with APS.Personal leave3 days are advanced to all 10 and 11‐Monthemployees at the beginning of the school year.A maximum balance of 3 days may be carriedover with the remainder transferred to sickleave balance.Sick leaveEmployees who earn annual/personal leave alsoearn sick leave for each month worked. Sickleave may be used for personal illness or theillness or death of a family member. There is nolimit to the amount of sick leave you mayaccrue.ScholarshipsThe School Board funds scholarships to eligibleemployees pursuing courses of study that arerelated to their job responsibilities. Payments arebased on the University of Virginia undergraduatetuition rate. Funds are budgeted annually and maybe limited.Retiree Medical and Dental BenefitsEmployees who are enrolled in an APS sponsoredmedical and/or dental insurance plan may beeligible to retain their coverage upon retirement.The Children’s SchoolSchool system employees are eligible to enroll theirchildren in The Children’s School, an employee‐owned cooperative day care facility that providesday care for infants through five‐year‐olds duringthe school year.HolidaysAPS provides employees with 13 paid holidays eachyear.Other Leave (may be paid or unpaid)Family and Medical Leave (FML)Military LeaveProfessional LeaveLeave of AbsenceReligious Observation LeaveCivil LeaveStudy LeaveThis information is intended as a brief summary. For full plan and coverage details, read the information on the Benefits Home Page andpage 2 of 4, rev. 12 02 19in the Benefits Guide available at www.apsva.us/benefits, or the APS School Board Policies and Policy Implementation Procedures.

Medical Coverage at a Glance(2020 Plan Year)Cigna Open AccessLow OptionYou PayCigna Open AccessHigh OptionYou PayProviders located in KaiserPermanente Medical CentersNational Provider NetworkNational Provider NetworkYesNoNoYesNoNoKaiser Permanente HMOIn‐Network BenefitsProvider NetworkPrimary Care Physician (PCP)referral required to see Specialist?PCP Required?You PayPCP Office Visit 15 copay 30 copay 20 copaySpecialist Office Visit 20 copay 60 copay 40 copayMental Health Provider Office Visit 15 copay 30 copay 20 copayAnnual DeductibleNone 400 Individual / 800 Family 300 Individual / 600 FamilyAnnual Out‐of‐Pocket Maximum 2,250 Individual / 4,500 FamilyInpatient Hospitalization, FacilityCovered 100% 3,000 Individual / 6,000 FamilyAfter deductible, 250 copay and20% coinsuranceAfter deductible, 100 copay and20% coinsurance 3,000 Individual / 6,000 FamilyAfter deductible, 250 copay and10% coinsuranceAfter deductible, 100 copay and10% coinsurance 50 copay 250 copay 200 copay 20 copay 50 copay 50 copay 4 copay 4 copayOutpatient Hospitalization, FacilityEmergency Room, Facility(waived if admitted)Urgent Care Visit 20 copayat KaiserMedical Centerat ParticipatingRetail PharmacyGeneric 20 copay 30 copayPreferred Brand 30 copay 50 copay35% (Minimum 35; Maximum 50) 25 copayNon‐Preferred Brand 45 copay 65 copay50% (Minimum 50; Maximum 100) 45 copayRetail Pharmacy(up to a 30‐day supply)Out‐of‐Network BenefitsYou PayYou PayYou PayAnnual DeductibleNo Benefits Available 800 Individual / 1,600 Family 750 Individual / 1,500 FamilyAnnual Out‐of‐Pocket MaximumCoinsuranceNo Benefits Available 5,000 Individual / 10,000 Family 3,750 Individual / 7,500 FamilyNo Benefits Available40%*30%*(% of allowed amount you payfor most services)Your Cost of CoverageThe semi‐monthly payroll deductions listed below apply to Medical coverage in effect from January 1, 2020 through December 31, 2020. The deductions listed below arebased on 24 pay checks per year. If you are a 10‐month employee and elected to receive 20 pay checks per year, Reserve Deduction amounts will also apply.Individual Coverage30 – 40 hours (full‐time)15 – 29 hours (part‐time)Individual Spouse Coverage30 – 40 hours (full‐time)15 – 29 hours (part‐time)Individual Child(ren) Coverage30 – 40 hours (full‐time)15 – 29 hours (part‐time)Family Coverage30 – 40 hours (full‐time)15 – 29 hours (part‐time) 65.76 182.33 75.70 183.43 136.53 281.59 159.31 386.03 201.77 406.59 322.54 609.24 143.77 348.37 182.55 367.87 291.83 551.23 277.98 587.34 331.91 602.68 550.37 915.15* You may also be responsible for 100% of any amounts charged that exceed Cigna’s allowed amounts.This information is intended as a brief summary. For full plan and coverage details, read the information on the Benefits Home Page andpage 3 of 4, rev. 12 02 19in the Benefits Guide available at www.apsva.us/benefits, or the APS School Board Policies and Policy Implementation Procedures.

Dental Coverage at a GlanceDelta Dental of VirginiaService / FeatureProvider NetworkCalendar Year Deductible(2020 Plan Year)In‐NetworkOut‐of‐Network*You PayYou PayPPO or Premier Networkn/a 50 Individual / 100 Familywaived for diagnostic and preventive careDiagnostic and Preventive Servicese.g., cleanings, oral examsBasic Servicese.g., fillings, root canalsMajor Servicese.g., crowns, denturesOrthodontic ServicesCovered in fullCovered in fullYou pay 20% after deductibleYou pay 20% after deductibleYou pay 35% after deductibleYou pay 35% after deductibleYou pay 50%You pay 50%Calendar Year Annual Maximum Benefit 1,500 per family memberOrthodontic Lifetime Maximum 1,500 per family memberYour Cost of CoverageThe semi‐monthly payroll deductions listed below apply to Dental coverage in effect from January 1, 2020 through December 31, 2020. The deductions listed beloware based on 24 pay checks per year. If you are a 10‐month employee and elected to receive 20 pay checks per year, Reserve Deduction amounts will also apply.Individual Coverage30 – 40 hours (full‐time)15 – 29 hours (part‐time)Individual Spouse Coverage30 – 40 hours (full‐time)15 – 29 hours (part‐time)Individual Child(ren) Coverage30 – 40 hours (full‐time)15 – 29 hours (part‐time)Family Coverage30 – 40 hours (full‐time)15 – 29 hours (part‐time) 14.84 18.81 29.02 36.80 29.83 37.83 43.20 54.78* You may also be responsible for the full amount an out‐of‐network dentist charges in excess of the fee schedule.Vision Coverage at a GlanceVision Service Plan (VSP)Service / FeatureProvider NetworkWellVision Exam (every calendar year)Lenses (every calendar year)e.g., single vision, lined bifocal, lined trifocalFrame (every calendar year)(2020 Plan Year)In‐NetworkOut‐of‐NetworkYou PayYou ReceiveVSP Signature Network 10 copayn/aReimbursement up to 52 20 copayReimbursement from 55 to 100 150 allowanceReimbursement up to 70Contacts (instead of glasses, every calendar year) 150 allowanceReimbursement up to 105VSP EasyOptions: Members can choose one of the following enhanced options: additional 100 frame allowance, additional 50 contact lensallowance, fully covered progressive lenses, or fully covered anti‐reflective coating.Your Cost of CoverageThe semi‐monthly payroll deductions listed below apply to Vision coverage in effect from January 1, 2020 through December 31, 2020. The deductions listed beloware based on 24 pay checks per year. If you are a 10‐month employee and elected to receive 20 pay checks per year, Reserve Deduction amounts will also apply.Individual Coverage30 – 40 hours (full‐time)15 – 29 hours (part‐time)Individual Spouse Coverage30 – 40 hours (full‐time)15 – 29 hours (part‐time)Individual Child(ren) Coverage30 – 40 hours (full‐time)15 – 29 hours (part‐time)Family Coverage30 – 40 hours (full‐time)15 – 29 hours (part‐time) 4.54 4.54 7.27 7.27 11.70 11.70 11.70 11.70This information is intended as a brief summary. For full plan and coverage details, read the information on the Benefits Home Page andpage 4 of 4, rev. 12 02 19in the Benefits Guide available at www.apsva.us/benefits, or the APS School Board Policies and Policy Implementation Procedures.