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HISD Benefits Office

Bringing Benefits To Life

2019 Plan and Legal Documents

Aflac Group Insurance Plans Overview

HISD Aflac Insurance Plan

HISD Bklt FINAL 3-4-19.pdf 690.48 KB (Last Modified on July 17, 2019)

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HISD Aflac Insurance Plan Spanish

HISD Bklt ESP FINAL 3-4-19.pdf 239.8 KB (Last Modified on July 17, 2019)

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Accident

2019 AFLAC Accident Certificate High

HISD_2019_Acc_Cert_High_101216.pdf 196.21 KB (Last Modified on January 18, 2019)

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2019 AFLAC Accident Certificate Low

HISD_2019_Acc_Cert_Low_101216.pdf 196.12 KB (Last Modified on January 18, 2019)

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2019 AFLAC Accident Low Plan Dependent Rider

HISD_2019_AFLAC_Accident_Low_Plan_Dependent_Rider.pdf 265.88 KB (Last Modified on January 18, 2019)

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2019 HISD AFLAC Accident High Plan Dependent Rider

HISD_2019_AFLAC_Accident_High_Plan_Dependent_Rider.pdf 138.15 KB (Last Modified on January 18, 2019)

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Cancer & Specified Diseases

2019 AFLAC Cancer Certificate Low

HISD_2019_CA_Cert_Low_101216.pdf 885.35 KB (Last Modified on January 18, 2019)

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AFLAC Cancer Certificate High

HISD_2019_CA_Cert_High_101216.pdf 884.32 KB (Last Modified on January 18, 2019)

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Critical Illness

2019 AFLAC Critical Illness Certificate

HISD_2019_CI_Cert_101216.pdf 922.44 KB (Last Modified on January 18, 2019)

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General

2019 New Hire Guide

New_Hire_Guide7-22-19.pdf 11.83 MB (Last Modified on July 22, 2019)

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Hospital Indemnity

2019 AFLAC Hospital Indemnity Certificate High

HISD_2019_SHI_Cert_High_101216.pdf 865 KB (Last Modified on January 18, 2019)

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2019 AFLAC Hospital Indemnity Certificate Low

HISD_2019_SHI_Cert_Low_101216.pdf 865.8 KB (Last Modified on January 18, 2019)

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Legal Documents

2019 Legal Notices

2019 Legal Notices - Revisedv2.pdf 1,004.33 KB (Last Modified on June 24, 2019)

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Dept. of Labor National Healthcare Exchange

department of labor national heath care exchange.pdf 163.18 KB (Last Modified on October 26, 2018)

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Notice for Employers Offering Health Plans

model-notice-for-employers-who-offer-a-health-plan-to-some-or-all-employees FULL.pdf 162.55 KB (Last Modified on October 26, 2018)

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Medical Plan Summary

2019 Select SPD

SELECT Final 06-10-2019.pdf 1.53 MB (Last Modified on August 26, 2019)

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2019 Plus Limited SPD

PLUS Limited Final 06-10-2019.pdf 1.56 MB (Last Modified on August 26, 2019)

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2019 Plus Choice SPD

Plus Choice Final 06-10-2019.pdf 1.64 MB (Last Modified on August 26, 2019)

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2019 Open Access SPD

Open Access Final 06-10-2019.pdf 1.6 MB (Last Modified on August 26, 2019)

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2019 Basic Limited SPD

Basic Limited Final 06-10-2019.pdf 1.56 MB (Last Modified on August 26, 2019)

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2019 Basic Choice SPD

Basic Choice Final 06-10-2019.pdf 1.63 MB (Last Modified on August 26, 2019)

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2019 Select Plan Guide

2019-selectplan_guide-english.pdf 480.4 KB (Last Modified on September 18, 2018)

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SBC HISD Basic Choice 2019

SBC Houston ISD_Basic Choice 01.01.2019.pdf 488.03 KB (Last Modified on October 4, 2018)

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SBC HISD Basic Limited 2019

SBC Houston ISD_Basic Limited 01.01.2019.pdf 487.41 KB (Last Modified on October 4, 2018)

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SBC HISD Open Access 2019

SBC Houston ISD_Open Access 01.01.2019.pdf 483.53 KB (Last Modified on October 4, 2018)

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Personal Legal

2019 Hyatt Legal Fee Reimbursement Schedule

HISD_2019_FeeReimbursementSchedule.pdf 161.66 KB (Last Modified on January 18, 2019)

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2019 Hyatt legal Plan

HISD_2019_Hyatt_Legal_Plans.pdf 116.62 KB (Last Modified on January 18, 2019)

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2019 Hyatt Legal Summary Plan

HISD_2019_Hyatt_legal_Summary_Plan_Description.pdf 176.71 KB (Last Modified on January 18, 2019)

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Prescription Drugs

2019 National Preferred Formulary Alpha with Exclusion list

National Preferred Alpha with Exclusion List.190701.pdf 108.76 KB (Last Modified on August 26, 2019)

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2019 ESI High Performance Formulary Alpha

ESI High Performance Alpha PRMT1703A-19.190701.pdf 54.22 KB (Last Modified on August 26, 2019)

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2019 Comprehensive National Preferred Formulary Alpha with Exclusions

Comprehensive National Preferred Alpha with Exclusion List.190701.pdf 180.6 KB (Last Modified on August 26, 2019)

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2019 Comprehensive High Performance Formulary Alpha

Comprehensive High Performance Alpha COMP1703A-19.190701.pdf 121.54 KB (Last Modified on August 26, 2019)

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Sumario de Plan Médico

Cobertura HISD Basic Limited 2019

SBC Houston ISD_Basic Limited 01.01.2019_SP.pdf 1.16 MB (Last Modified on October 26, 2018)

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Cobertura HISD Choice Plan 2019

SBC Houston ISD_Basic Choice 01.01.2019_SP.pdf 1.19 MB (Last Modified on October 26, 2018)

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Cobertura HISD Open Access 2019

SBC Houston ISD_Open Access 01.01.2019_SP.pdf 1.15 MB (Last Modified on October 26, 2018)

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Cobertura HISD Plus Choice 2019

SBC Houston ISD_Plus Choice 01.01.2019_SP.pdf 1.16 MB (Last Modified on October 26, 2018)

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Cobertura HISD Plus Limited 2019

SBC Houston ISD_Plus Limited 01.01.2019_SP.pdf 1.16 MB (Last Modified on October 26, 2018)

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Cobertura HISD Select Plan 2019

SBC Houston ISD_Select 01.01.2019_SP.pdf 1.13 MB (Last Modified on October 26, 2018)

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Vision

2019 EyeMed Members App Infographic

HISD-2019_EyeMed_Members_App_Infographic.pdf 928.37 KB (Last Modified on January 18, 2019)

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2019 Vision Plan Certificate High

HISD_2019_High_Plan_Vision_Certificate_101216.pdf 612.08 KB (Last Modified on January 18, 2019)

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2019 Vision Plan Certificate Low

HISD_2019_Low_Plan_Vision_Certificate_101216.pdf 612.15 KB (Last Modified on January 18, 2019)

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2019 Vision Plan Summary High

HISD_2019_High_Plan_Vision_Summary_101216.pdf 293.23 KB (Last Modified on January 18, 2019)

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2019 Vision Plan Summary Low

HISD_2019_Low_Plan_Vision_Summary_101216.pdf 293.15 KB (Last Modified on January 18, 2019)

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Health Insurance Marketplace Coverage Options

New Health Insurance Marketplace Coverage Options

model-notice-for-employers-who-offer-a-health-plan-to-some-or-all-employees.pdf 162.55 KB (Last Modified on July 22, 2019)

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Nuevas opciones de cobertura en el mercado de seguros medicos

model-notice-for-employers-who-offer-a-health-plan-to-some-or-all-employees-spanish.pdf 161.09 KB (Last Modified on July 22, 2019)

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Dental

2019 Annual Compliance Rider

2019 Annual Compliance Rider.pdf 609.49 KB (Last Modified on June 17, 2019)

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2019 Annual Compliance Rider 2

Annual Compliance Rider 2.pdf 626.13 KB (Last Modified on June 17, 2019)

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2019 Annual Compliance Rider 3

2019 Annual Compliance Rider 3.pdf 626.13 KB (Last Modified on June 17, 2019)

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2019 Annual Compliance Rider 4

2019 Annual Compliance Rider 4 ETALLD19A-002.pdf 632.03 KB (Last Modified on June 17, 2019)

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2019 Annual Compliance Rider XXACLAD19

2019 Annual Compliance Rider xxACLAD19-003.pdf 609.49 KB (Last Modified on June 17, 2019)

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2019 Annual Compliance Rider XXACTXD19

2019 Annual Compliance Rider xxACTXD19-003.pdf 626.13 KB (Last Modified on June 17, 2019)

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2019 PPO SPD

2019 PPO SPD.pdf 970 KB (Last Modified on June 17, 2019)

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2019 Xtra Territorial Legislation ETALLD19B

2019 Xtra Territorial Legislation ETALLD19B.pdf 414.29 KB (Last Modified on June 17, 2019)

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2019 Xtra Territorial Legislation ETALLD19B-002

2019 Xtra Territorial Legislation ETALLD19B-002.pdf 414.29 KB (Last Modified on June 17, 2019)

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