Administered by Anthem Blue Cross Blue Shield

Please take the time to understand the features and differences of each plan so that you choose the coverage that is best for you and your family.

Choosing a Medical Plan

As you review your plan options, it may be helpful to consider the following questions:

• What is the cost to enroll in the plan? This is the amount you pay out of your paycheck.
• How much will you pay out of your pocket when you see your doctor or need other health care services?
• Do you prefer to pay more out of your paycheck each week, but less when you need health care? Or do you prefer to pay less out of your paycheck each week, but more when you need health care?
• Who are you covering, and what are their current medical needs, including prescription drugs taken regularly?

Understanding Health Insurance Terminology

What is a deductible?
It is a set dollar amount determined by your plan that you will pay out of your pocket if you have claims. The deductible accumulates on a calendar year basis and is reset at $0 each January 1.

What is coinsurance?
After your deductible is met, you then pay a share of your eligible medical expenses. This is called coinsurance. For the HSA plan, you pay 10% of the charges after the deductible for each covered person on your plan up to the maximum of $6,000 ($12,000 for family coverage). For the PPO plan, you pay 10% after the deductible for each covered family member up to the maximum of $2,000 ($4,000 for family coverage). This is your share of the coinsurance.

What is my out-of-pocket maximum

This is the maximum amount (deductible and coinsurance combined) you are responsible to pay per calendar year. For the HSA plan, it is $6,000 per person ($12,000 family). For the PPO plan, it is $2,000 per person ($4,000 per family).

Anthem Blue Cross Blue Shield provides a mobile app to help members make the most of their medical plan benefits. With the Sydney app, you can find everything you need to know about your medical benefits all in one place.
Register on anthem.com/ or the Sydney mobile app.* Have your member ID card handy to register.

Administered by MetLife

School City of Mishawaka offers dental insurance through MetLife. Locate a provider at www.metlife.com. The link below summarizes the key features of the dental plan. The coinsurance amounts listed reflect the amount you pay for services. Please refer to the official plan documents for additional information on coverage and exclusions.

Administered through MetLife

School City of Mishawaka offers vision insurance through MetLife utilizing the VSP Choice Network. This plan allows you to choose any eye care provider. However, you will maximize the plan benefits when you choose a network provider. Locate a provider at www.metlife.com/vision.

The link below summarizes the key features of the vision plan. Please refer to the official plan documents for additional information on coverage and exclusions.

Administered through MetLife

Basic Life and AD&D Insurance

Life and accidental death and dismemberment (AD&D) insurance thru MetLife provides financial protection for those who depend on you for financial support.

Employee Basic Life and AD&D Insurance

• All Active Certified & Non-Certified Employee life and AD&D benefit amount: $50,000
• All Active School Board Members, and Administrators life and AD&D benefit amount: $200,000
• All Eligible Retirees life only benefit amount: $3,000

Spouse and Dependent Basic Life Insurance

• Spouse Life benefit amount: $10,000
• Dependent children benefit amount:
  
  • $500 (Birth- 6 months)
  • $5,000 (6 months- 26 years)

Benefit Reduction:

• 65% at age 70
• 45% of the original amount at age 75
• 30% of the original amount at age 80

If you are eligible for $50,000 or more in basic, School City of Mishawaka-paid life insurance, you are required to pay income tax on the value of the coverage in excess of $50,000.

Administered through MetLife

Life and accidental death and dismemberment (AD&D) insurance provides financial protection for those who depend on you for financial support.

Supplemental Life and AD&D Insurance

Depending on your personal situation, basic life and AD&D insurance might not be enough coverage for your needs. School City of Mishawaka provides you the option to purchase additional life and AD&D insurance at group rates through MetLife. You may also purchase
coverage for your spouse and eligible children. You must purchase additional coverage for yourself in order to purchase coverage for your spouse and/or child(ren).

Use the calculator to determine how much coverage you need.

Coverage options:

• Employee: $10,000 increments up to $500,000 or 5x annual salary, whichever is less; guarantee issue: $100,000.
• Spouse: $5,000 increments up to 50% of the employee coverage amount; guarantee issue: $25,000.
• Dependent children: Birth to 6 months: $5,000; 6 months to age 19 (or 26 if a full-time student): $10,000; guarantee issue: $10,000.

Supplemental life rates are based on age. Benefits will reduce to 65% at age 65 and to 50% at age 70.

If you purchase life and AD&D insurance when you are first eligible to enroll, you may purchase up to the guarantee issue amounts without completing a statement of health evidence of insurability).

If you do not enroll when first eligible and choose to enroll during a future open enrollment period, you will be required to submit evidence of insurability

Administered by Anthem Blue Cross Blue Shield

If you enroll in the Anthem HSA (High Deductible Health Plan, HDHP) Plan, you may be eligible to open and fund a health savings account (HSA) through the bank of your choice.

2026 IRS HSA contribution limits

• Employee-only: $4,400.
• All other coverage levels: $8,750.

If you are age 55+ by December 31, 2026, you may contribute an additional $1,000.

• You are eligible to fund an HSA if you are enrolled in the HDHP and meet additional eligibility requirements.
• You may use the bank of your choice to set up your Health Savings Account

Maximize your savings!

• Money you put into your HSA is not taxed.
• Tax-free spending when HSA funds are used to pay for eligible health care expenses.
• HSA contributions grow tax free, which means you don’t pay taxes on the interest or investment earnings.
• HSA funds roll over from year to use (no use it or lose it policy).
• The money you put into your HSA is yours to keep—even if you change plans or jobs in the future.
• After you reach age 65, your HSA dollars can be spent without penalty on any expense.

An HSA is a savings account that you can use to pay out-of-pocket health care expenses with pre-tax dollars.

Administered through Flores

School City Of Mishawaka offers two flexible spending account (FSA) options through Flores. The money you put into an FSA is deducted from your paycheck before taxes are taken out, meaning you pay less in taxes because your taxable income is lower.

Plan carefully!
Any funds left in the account after the plan year grace period will be rolled over to the next plan year up to a maximum of $660. Thus, while an FSA can save you money on taxes and health care and dependent care costs, it's important to not contribute more than you think you'll spend on eligible expenses in a single year.

Health care flexible spending account (HCFSA)

• Pay for eligible out-of-pocket medical, dental, and vision expenses with pre-tax dollars.
• Over-the-counter (OTC) medications are not eligible for reimbursement without a prescription.
• Total amount for the year is available on January 1, 2026. 

Dependent care flexible spending account (DCFSA)

• Pay for eligible dependent day care expenses with pre-tax dollars.
• Eligible dependents are children under 13 years of age, or a child over 13, spouse, or elderly parent residing in your house who is physically or mentally unable to care for himself or herself.
• Funds are deposited into your account on a per-pay-period basis.

You may contribute up to $7,500 to the dependent care FSA for the 2026 plan year if you are married and file a joint return or if you file a single or head of household return. If you are marriedand file separate returns, you can each elect $3,750 for the 2026 plan year.

Log into your account at https://flores247.com/ to:

• View your account balance(s).
• Calculate tax savings.
• View eligible expenses.
• Submit claims.
• Download forms.
• View transaction history.
• And more!

Paying with an FSA is like using a 20%* off coupon for your health care and dependent care expenses.
*Actual savings varies based on tax bracket.

Administered through AllOne Health

School City of Mishawaka provides you and your household family members with an employee  assistance program (EAP) at no cost to you. The EAP is a valuable resource that can help you identify and resolve many workplace, family, social, economic, and mental health issues.

This is a confidential program available 24 hours a day, 7 days a week, to help you and your family members handle the stresses involved with everyday issues and/or crisis situations.

• Services are accessible through toll-free phone calls and online access.
• Each member can receive up to 5 free face-to-face counseling sessions, per family, per year.
• No personal information is ever shared with School City of Mishawaka.

The free EAP can support you. Call 24/7 at 800.731.6501 or visit allonehealth.com

Administered by MetLife

Disability insurance can help you meet your financial needs if you become unable to work due to an illness or injury.

Administered by MetLife

• Help ensure your family is financially protected in the event of a loss. You own the policy, so you can take it with you to a different job or into retirement.
• Whole Life Insurance is a guaranteed death benefit that will never decrease with premiums that will never increase.
• With a cash value accumulation, living benefits and other options, Whole Life through MetLife goes beyond typical term life insurance.
• As life insurance, this plan protects your family with money that can be used any way they choose. It is most often used to pay for mortgage or rent, education for children and grandchildren, retirement, family debt, and final expenses.
• ]This plan includes “living benefits” that allows you to accelerate a portion of the life insurance death benefit if diagnosed by a physician as terminally ill. These extra “living benefits” can be used to help pay expenses from an unexpected medical crisis and help alleviate the worry of future financial problems.

Administered through MetLife

• Pays you a set amount for a hospital admission.
• Even with health insurance, a stay in the hospital can become costly quickly as out-of-pocket charges begin to add up. Hospital Indemnity Insurance through MetLife can reduce the financial and emotional stress
• The policy does not coordinate with any other coverage, so you can still receive benefits on top of what your medical plan provides.

Administered by MetLife

• Accident Insurance through MetLife can help cover the out-of-pocket costs associated with a both on and off-the-job accidents by paying you a benefit depending on the injuries you suffer and the treatment you receive.
• You can use the money as you see fit, whether to pay for expenses associated with your accident, like an emergency room copay, or to pay for childcare so you can get to the doctor for a follow-up visit.
• Organized Sports Activity Injury Benefit - Receive an additional 25% on each benefit for injuries sustained in an organized sports activity.
• Health Screening Benefit - Every year that you complete a qualified health screening, you and your covered dependent(s) are eligible for a $75 Health Screening Benefit.

Administered through MetLife

• Pays you a cash benefit if you or a covered family member are diagnosed with a specific critical illnesses.
• Examples of a critical illness: heart attack, coronary artery disease, stroke, major organ failure, and cancer.
• The policy provides you with a lump sum cash benefit in the event you or an insured loved one is diagnosed with a covered condition such as cancer, heart attack, or stroke.
• The policy also a $50 annual health
• screening benefit when you complete a qualified screening.

Administered through Aura

Aura keeps your identity safe with extensive monitoring of your personal info, accounts, IDs, and more, and will let you know if any of your online accounts, passwords, or personal information have been compromised. Aura will also monitor your Social Security Number and personal information for bank fraud, including unauthorized wire transfers, new bank account openings, and more.

Administered through MetLife

• Legal coverage through MetLife Legal Plans means added peace of mind for employees and their dependents. Having to hire an attorney can be very stressful if you don’t know where to go or how much it will cost.
• MetLife Legal Plans makes it very simple to get the legal advice and the representation you need without draining your finances.

• Pet insurance through MetLife provides coverage for a wide range of veterinary services and helps cover the costs of unexpected veterinary bills.
• You can also purchase optional coverage to help pay for routine care expenses. Pet parents can select from a range of annual limits, deductibles, and coinsurance levels.