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Naperville Community Unit School District 203 Benefits

Naperville Community Unit School District 203 offers a comprehensive suite of benefits to help support the physical and financial health of you and your family. These benefits help you pay for health care and provide financial protection for you and your family. Effective January 1, 2026, medical benefits will renew with BCBS. and all ancillary lines will remain with Guardian. Effective immediately, our near-site clinic, Priority Care, is available for all members enrolled in medical to utilize for preventive, acute, mental health and more. See more details in the guide.

This guide provides highlights of your benefits programs. Keep this guide with your other important papers so you can refer to it as needed. For a complete description of your benefits please refer to your benefit plan certificates, located on your employee benefits account.

New Employee Enrollment As a newly hired employee of Naperville Community Unit School District 203, you are eligible to make an election of benefits within 31 days of your effective date.

Existing Employee Enrollment Annual Benefits Enrollment starts mid-October to make elections for benefits effective January 1 to December 31. If you wish to change benefits outside of the Annual Benefits Enrollment period, you may only do so within 31 days of an IRS qualifying life event, such as:

• Change in legal marital status (marriage, divorce, death of spouse)
• Change in employment status for you, your spouse, or a dependent that affects eligibility
• Birth, adoption, or placement for adoption of a child
• Death of a spouse or dependent
• Change in a dependent's eligibility

Benefit changes due to a qualifying life event must satisfy a consistency rule. That is, any change must be consistent with the qualifying event. Example: If you get a divorce, you can remove your spouse but cannot add existing dependents who were not on your plan.

Voluntarily terminating existing benefits does not qualify as an IRS qualifying life event. You have the right to terminate your benefits with Naperville CUSD 203 during the Annual Benefits Enrollment period. The last effective date of coverage will be December 31; you may not rejoin the plan until the next Annual Benefits Enrollment period unless you experience an IRS qualifying life event.

It is your responsibility to notify your Employee Benefits Specialist and take action within 31 days of an IRS qualifying life event date. Any misrepresentations, inaccurate information, or failure to provide information could result in the loss of coverage. If you cover an individual who is not eligible for benefits, you will be required to reimburse the plan for any expenses incurred as a result and further disciplinary actions may be taken.

Enrollment in Naperville CUSD 203's family health care plan requires proof of dependent eligibility.

Eligible dependents are spouses, civil union partners, and children (biological, adopted and those for whom you have legal guardianship and accompanying documentation) under age 26. You will be required to provide the following documents (as applicable) to the Employee Benefits Specialist:

• A copy of your Marriage or Civil Union Certificate OR a copy of your most recent joint Federal Tax Return
• A copy of the Birth Certificate for each dependent to be covered under the plan, excluding your spouse, OR Adoption Certificate or Court Order
• Spousal/Civil Union Partner Affidavit

Divorced or legally separated spouses are ineligible for coverage as of the day of the divorce or legal separation. Dependent children are eligible for coverage through the month they turn age 26. It is essential to notify your Benefits Specialist of a change in eligibility within a timely manner to ensure your dependent's right to COBRA Continuation.

Medical insurance is one of your most important benefits. When you enroll in one of the BCBS of Illinois medical plans offered by Naperville Community Unit School District 203, you have peace of mind knowing that you have coverage for medical services if you need them for you or your family. Prime Therapeutics (BlueCross BlueShield's prescription partner) administers the prescription drug plan, providing you a single ID card for medical and prescription drug coverage. Please note that CVS/Target is not covered as an in-network pharmacy benefit.

District 203 offers four choices for medical/prescription plans through BlueCross BlueShield of Illinois. Each of the plans uses a specific BCBS network. To take full advantage of each plan, it is important to confirm in-network status with BCBSIL prior to services being rendered. Visit BCBSIL.com or call View phone number on click.appcast.io to check for in-network providers for your chosen medical plan Blue Choice Options (BCO) Plan: This 3-tier PPO plan features a low deductible, co-insurance, and copays for office visits and prescriptions. This plan has two in-network tiers. Tier 1 utilizes the Blue Choice Options (BCO) network and offers the highest level of benefits. Tier 2 utilizes the larger Participating Provider Organization (PPO) but has a slightly higher deductible and out-of-pocket costs. Tier 1 and Tier 2 cross-feed deductible and out-of-pocket costs. If you use Tier 2 benefits after meeting the deductible and/or out-of-pocket costs on Tier 1, Tier 1 costs will count towards your Tier 2 total.

Blue Choice Select (BCS) Plan: This plan features a low deductible and co-insurance with copays for office visits and prescriptions along with the claims savings that come from using a narrower network. This plan utilizes the Blue Choice Select (BCS) network which is a smaller network of providers but features greater average discounts and lower negotiated in-network fees.

Blue Choice Options (BCO) HDHP: This 3-tier HDHP features a higher deductible, no copays for office visits and prescriptions, and is a health savings account (HSA) eligible plan. This plan has two in-network tiers. Tier 1 utilizes the Blue Choice Options (BCO) network and offers the highest level of benefits. Tier 2 utilizes the larger Participating Provider Organization (PPO) network but has a slightly higher deductible and out-of-pocket costs.

Tier 1 and Tier 2 cross-feed deductible and out-of-pocket costs. If you use Tier 2 benefits after meeting the deductible and/or out-of-pocket costs on Tier 1, costs will count towards your Tier 2 total. The annual District contribution to an employee's active Lively HSA is $1,500 for individual coverage and $3,000 for family coverage.

Blue Choice Select (BCS) HDHP: This plan features a higher deductible, no copays for office visits and prescriptions and health savings account (HSA) eligibility along with the claims savings that come from using a narrower network. This plan utilizes the Blue Choice Select (BCS) network which is a smaller network of providers but features greater average discounts and lower negotiated in-network fees. The annual District contribution to an employee's active Lively HSA is $1,500 for individual coverage and $3,000 for family coverage.

BlueCross BlueShield of Illinois' Benefits Value Advisor: When you enroll in any one of the District 203 Health Plans, you gain access to BCBSIL's Benefits Value Advisor (BVA), a customer service program to help you improve your quality of care and achieve cost savings.

• Find and compare In-Network providers based on quality, patient reviews and cost
• Compare treatment cost estimates among facilities to access savings
• Obtain preauthorization, schedule appointments and connect to clinical programs
• Review benefits, claims and coverage guidelines

BlueCross BlueShield of Illinois' Utilization Management Programs

Utilization Review Program: Utilization Review assists you in determining the course of treatment that will maximize your benefits. The program requires a review of inpatient hospital, skilled nursing facility, coordinated home care program, and private duty nursing services before they are rendered. Members are required to contact the Utilization Review department at the toll-free telephone number identified on your ID card one business day prior to elective admission or within two business days after an emergency or maternity admission. Failure to receive Preauthorization will result in a $200 reduction of benefits.

Mental Health Unit: The Mental Health Unit assists in the administration of Mental Illness and Substance Abuse Rehabilitation Treatment benefits. The Mental Health Unit requires a review of inpatient hospital, emergency mental illness or substance abuse admission, partial hospitalization and outpatient services before they are rendered. Members are required to contact the Mental Health Unit at View phone number on click.appcast.io at least one business day prior to non-emergency inpatient hospital admission and outpatient services or within two business days after an emergency admission or partial hospitalization treatment. Failure to receive preauthorization will result