8-05.N267524AN - Exhibit 1.pdf
PDF 2 MB Posted
- Attached to
- Benefits Consulting and Actuarial Services
- Solicitation number
- N267524AN
- Issued by
- Lee County, Florida
About this file
This document is an employee benefits at-a-glance summary provided by the School District of Lee County, Florida, outlining the comprehensive benefits package offered to eligible employees for the 2026-2027 plan year. The School District of Lee County offers a tiered benefits structure with eligibility based on scheduled work hours: full-time employees working at least 30 hours per week receive access to all benefits including medical, dental, vision, life insurance, disability coverage, and voluntary supplemental plans, while employees scheduled for 20-29 hours per week are limited to voluntary benefits only. The benefits program includes company-provided benefits such as basic life and accidental death and dismemberment insurance, an employee assistance program, a wellness program called ActiveLee, Florida Retirement System participation, medical coverage, and health savings accounts administered by Voya. Employee-elected benefits encompass dental coverage through Humana, vision coverage through Aetna Vision, flexible spending accounts, supplemental medical benefits including critical illness and accident insurance, supplemental life and AD&D insurance, voluntary legal insurance through MetLife, and short-term and long-term disability insurance through MetLife. The document provides detailed benefit structures across three Aetna medical plan options (plans 9520, 7419, and HDHP), three dental plans (High 2000, Medium 1500, and Low 1000), and vision coverage, with specific deductibles, out-of-pocket maximums, copayments, and coinsurance percentages outlined for each service category.
The document details comprehensive medical coverage including preventive care at no charge, physician services ranging from $45-$65 copays for office visits, emergency care with a $750 copay, hospital services with varying coinsurance rates, and prescription drug coverage with retail copays for generic ($8-$30), preferred brand ($48-$72), and non-preferred brand ($80-$104) medications at 30-day supplies. Dental coverage includes preventive services at 100% coverage, basic services at 80%, and major services at 50% for in-network providers, with annual maximums ranging from $1,000 to $2,000 depending on plan selection. Vision benefits cover routine eye exams in full, eyeglasses with a $150 allowance for frames every 24 months, and contact lenses with a $200 allowance. Additional voluntary benefits include flexible spending accounts for healthcare and dependent care expenses, short-term disability providing 60% of base earnings up to $1,750 per week, long-term disability providing 60% of monthly earnings up to $10,000, accident insurance, critical illness insurance, cancer and specified disease insurance, and legal services through a network of attorneys. The document provides contact information and website resources for all benefits administrators, including Aetna for medical services, Humana for dental, The Standard for voluntary accident and critical illness coverage, and ESI for employee assistance programs.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
At The School District of Lee County, we understand that our employees are our most valuable asset, and we are dedicated to investing in your well-being. That is why we offer a range of benefits that can help you stay healthy, feel secure, and achieve your goals. From medical coverage to supplemental health plans and voluntary benefits, our comprehensive benefits package is designed to meet your unique needs and help you thrive both inside and outside of work.
EMPLOYEE-ELECTED BENEFITS
• Dental Coverage
• Vision Coverage
• Flexible Spending Accounts (FSAs)
• Supplemental Medical Benefits Such as Critical Illness, Cancer, and Accident Insurance
• Supplemental Life and Accidental Death and Dismemberment (AD&D) Insurance
• Voluntary Legal Insurance
• Short-Term Disability (STD) and Long-Term Disability (LTD)
COMPANY-PROVIDED BENEFITS
• Basic Life and Accidental Death and Dismemberment
(AD&D) Insurance
• Employee Assistance Program (EAP)
• Wellness Program (ActiveLee)
• Florida Retirement System (FRS)
• Medical Coverage
• Health Savings Account (HSA)
ELIGIBILITY
Full-time employees who are regularly scheduled to work at least 30 hours per week are eligible for all benefits, including medical and life insurance. If you are scheduled to work 20-29 hours per week, you are only eligible for voluntary benefits. To enroll in our benefits program, you will need to meet this requirement and complete the enrollment process within the designated time frame. We will provide you with all of the information and resources you need to enroll in our benefits, including details about coverage options available and the enrollment process.
BE WELL. SAVE WELL. LIVE WELL.
2026 - 2027
THE SCHOOL DISTRICT
OF LEE COUNTY
BENEFITS AT-A-GLANCE
MEDICAL AND PRESCRIPTION DRUG BENEFITS
Medical and prescription benefits are an essential part of your overall health and wellness. With our comprehensive medical plan, you will have access to a network of doctors and specialists to help you manage your health. You will also have coverage for prescription drugs, including both generic and brand name medications.
BENEFIT
AETNA: 9520 AETNA: 7419 AETNA: HDHP
IN-NETWORK OUT-OF-NETWORK IN-NETWORK OUT-OF-NETWORK IN-NETWORK OUT-OF-NETWORK
Annual/Calendar Year Deductible (Individual/Family)
$2,000/$6,000 N/A $3,000/$9,000 $6,000/$18,000 $4,000/$8,000 $8,000/$16,000
Out-of-Pocket Maximum (Individual/Family)
$8,000/$16,000 N/A $8,500/$25,500 $17,000/$34,000 $8,500/$17,000 $17,000/$34,000
Lifetime Maximum Unlimited N/A Unlimited Unlimited Physician Services
Doctor’s Office Visit $45 Copay Not Covered $65 Copay 60% Coinsurance 30% Coinsurance 60% Coinsurance Specialist Office Visit $65 Copay Not Covered 25% Coinsurance 60% Coinsurance 30% Coinsurance 60% Coinsurance Preventive Care No Charge Not Covered No Charge 60% Coinsurance No Charge 60% Coinsurance
Lab
25% Coinsurance for hospital. $0
Independent Lab/ Quest and/or
LabCorp
Not Covered 25% Coinsurance;
$0 for Quest and/or LabCorp
60% Coinsurance* 30% Coinsurance* 60% Coinsurance*
X-Ray Services $50 Copay for X-Ray at Free
Standing Facility Not Covered 25% Coinsurance for X-Ray* 60% Coinsurance* 30% Coinsurance* 60% Coinsurance*
Urgent Care $50 Copay Not Covered 25% Coinsurance 60% Coinsurance 30% Coinsurance 60% Coinsurance Hospital Services
Inpatient 25% Coinsurance after $1,200 Copay/Stay
Not Covered 25% Coinsurance 60% Coinsurance 30% Coinsurance 60% Coinsurance
Outpatient 25% Coinsurance Not Covered 25% Coinsurance 60% Coinsurance 30% Coinsurance 60% Coinsurance Emergency Care $750 Copay $750 Copay 25% Coinsurance 30% Coinsurance* Pregnancy & Maternity Care (Prenatal)
Office Visits No Charge
Not Covered
No Charge
60% Coinsurance
No Charge
60% Coinsurance* Childbirth/ Delivery Professional
25% Coinsurance + 100 Copay 25% Coinsurance* 30% Coinsurance*
Childbirth/ Delivery Facility
25% Coinsurance + $1,200 Copay 25% Coinsurance* 30% Coinsurance*
PRESCRIPTION DRUGS
Retail (30-Day Supply)
Generic $8 Copay Not Covered $24 Copay 60% Coinsurance* 30% Coinsurance* 60% Coinsurance* Preferred Brand $48 Copay Not Covered $72 Copay 60% Coinsurance* 30% Coinsurance* 60% Coinsurance* Non-preferred Brand $80 Copay Not Covered $104 Copay 60% Coinsurance* 30% Coinsurance* 60% Coinsurance* Specialty (Prudent Rx) 30% ($0 PrudentRx) Not Covered 30% ($0 PrudentRx) N/A 30% Coinsurance* Not Covered
90-Day Supply Generic $16 Copay Not Covered $48 Copay Not Covered 30% Coinsurance* Not Covered Preferred Brand $96 Copay Not Covered $144 Copay Not Covered 30% Coinsurance* Not Covered Non-preferred Brand $160 Copay Not Covered $208 Copay Not Covered 30% Coinsurance* Not Covered Specialty (Prudent Rx) N/A N/A N/A N/A N/A N/A
PER PAY DEDUCTIONS
Employee Only $25.50 $12.50 $0.00 Employee + Spouse $413.00 $375.83 $215.70 Employee + Child(ren) $127.01 $106.48 $20.60 Family $639.24 $592.11 $385.45
NOTE: The information above is a summary of coverage.
*Coinsurance/percentage applies after Plan Year Deductible (PYD) is met.
TELEMEDICINE
Telemedicine and virtual care are a convenient way to access medical care from the comfort of your own home. With our telemedicine benefit, you will have access to virtual consultations with health care providers for a range of non-emergency medical issues (i.e. cold/flu). This can save you time and money, and help you get the care you need when you need it.
HEALTH SAVINGS ACCOUNT (HSA)
NOW OFFERED BY VOYA
To enroll in our HSA, you must be enrolled in our High Deductible Health Plan (HDHP). Our HSA is a tax-advantaged savings account that can help you save money on your eligible medical expenses. This account allows you to set aside pre-tax dollars to pay for eligible medical expenses, including deductibles, copays, and coinsurance. You can contribute to your HSA on a pre-tax basis through payroll deductions, and any unused funds will roll over from year to year.
VOLUNTARY BENEFITS
DENTAL
Our dental benefits provide comprehensive coverage for preventive, basic, and major dental services.
BENEFIT DPPO: HIGH 2000 DPPO: MEDIUM 1500
DPPO: LOW 1000
IN-NETWORK OUT-OF-NETWORK
Annual/Calendar Year Maximum $2,000 $1,500 $1,000 $250 Annual/Calendar Year Deductible (Individual/Family) $25/$75 $50/$150 $100/$300 $250/$750
Preventive Services 100% 100% 100% 50% Basic Services 80%* 80%* 80%* 30%* Major Services 50%* 50%* 50%* Not Covered
Orthodontia Lifetime Maximum $2,000 (adult/children)
$1,500 (children only)
N/A. 20% discount available at participating providers discretion.
N/A
PER PAY DEDUCTIONS
Employee Only $21.05 $15.90 $12.25 Employee + Spouse $42.90 $32.60 $24.95 Employee + Child(ren) $43.00 $32.75 $25.15 Family $68.05 $52.05 $40.00
NOTE: The information above is a summary of coverage.
*Coinsurance applies after Plan Year Deductible (PYD) is met.
VISION
Our vision benefits provide comprehensive coverage for routine eye exams, eyeglasses, and contact lenses. It is highly encouraged to see an in-network provider to make the most of your benefits. To find an in-network provider, visit AetnaVision.com and select “Find a Provider”.
BENEFIT AETNA VISION: IN-NETWORK AETNA VISION: OUT-OF-NETWORK
Exam Covered in Full Up to $35
Lenses (Every 12 Months)
Single Covered in Full Up to $25
Bifocal Covered in Full Up to $40
Trifocal Covered in Full Up to $50
Frames (Every 24 Months) $0 Copay; $150 Allowance, 20% off balance over allowance
Up to $66
Contact Lenses Instead of Glasses
Conventional/Disposable Conventional: $0 Copay; $200 allowance, 15% off balance over allowance
Disposable: $0 Copay; $200 allowance Up to $200
Medically Necessary Covered in Full Up to $210
PER PAY DEDUCTIONS
Employee Only $3.94
Employee + Spouse $8.34
Employee + Child(ren) $8.49
Family $14.22
NOTE: The information above is a summary of coverage.
http://AetnaVision.com
4 Updated: May 2026
ADDITIONAL BENEFITS
School District of Lee County offers a range of additional benefits designed to help you protect your health, your income, and your financial security.
BENEFIT KEY FEATURES
WHO
CONTRIBUTES?
Flexible Spending Accounts (FSA)
• Health Care FSA: You may use pre-tax dollars to pay for eligible health care expenses such as copays, deductibles, orthodontia, over-the-counter medications, etc.
• Dependent Care FSA: You may use pre-tax dollars to pay for eligible care for your dependents under the age of 13, including day care, nursery school, elder care expenses, etc.
Employee
Disability Insurance
• Short-Term Disability: After you are out of work for your plan's elimination period (14-days or 60-days), and declared disabled, you will receive 60% of your base earnings for up to a maximum of $1,750/week.
• Long-Term Disability: The benefit is equal to 60% of your base monthly earnings to a maximum of $10,000 per month. Benefits begin after 90 or 180 days, depending on which option you choose.
Employee
Life and Accidental Death & Dismemberment Insurance (AD&D)
• Basic Term Life: The benefit is $20,000.
• AD&D: If you are seriously injured or lose your life in an accident, you and/or your beneficiary(ies) will be eligible for $20,000.
• Supplemental Life and AD&D: You may also choose to purchase additional coverage for your spouse and/or your dependents in addition to the company-paid benefit.
Employee
Critical Illness Insurance Pays a full lump sum benefit directly to you if you are diagnosed with a covered illness that meets the plan criteria. The benefit is paid in addition to any other insurance coverage you may have. Employee
Accident Insurance Pays direct benefits for a range of injuries and accident-related expenses such as fractures, concussions, and hospital admissions. Employee
Cancer & Specified Diseases Pays flat dollar amount for certain services/treatment for cancer and/or specified diseases. Employee
Legal Plan
Legal insurance offers you and your eligible dependents access to a network of experienced attorneys who can help you navigate a variety of legal issues at a fraction of the cost. This can provide you with the support and guidance you need to handle complex legal situations, protect your rights, and achieve the best possible outcome for you and your family. Employees may not use this for any matter pertaining to their employment.
Employee
Employee Assistance Program (EAP)
Our EAP provides confidential counseling and support services to help you and your family members deal with a range of personal and work-related issues. From stress and anxiety to financial problems and relationship issues, our EAP can connect you with licensed professionals who can provide guidance, resources, and support when you need it most. Best of all, our EAP is available to you at no cost, so you can take advantage of these valuable services whenever you need them.
Employer
Wellness Program (ActiveLee)
Our wellness program (ActiveLee) is designed to help you achieve your health and wellness goals, with a range of resources and tools to support your physical, mental, and emotional well-being. Whether you are looking to improve your fitness, manage stress, or make healthier lifestyle choices, our program can provide the guidance and support you need to succeed. With access to fitness center reimbursements, the Walkingspree app, nutrition classes, mental health resources, and more, our wellness program can help you live your best life.
Employer
GET MORE INFORMATION
BENEFIT WHO TO CALL WEBSITE PHONE NUMBER
Medical & Prescription Drug Aetna MyAetnaWebsite.com 1-800-872-7576 Dental Humana www.MyHumana.com 1-800-233-4013 Vision Aetna AetnaVision.com 1-877-973-3238 Basic Life & Accidental Death & Dismemberment Claims Securian www.Securian.com 1-866-293-6047
Supplemental Life Claims Securian www.Securian.com 1-866-293-6047 Legal MetLife https://members.legalplans.com 1-800-821-6400 Short- & Long-Term Disability Claims MetLife https://mybenefits.metlife.com 1-800-300-4296 Voluntary Accident, Critical Illness, and Cancer & Specified Diseases
The Standard (formally Allstate) standard.com/ahl/mybenefits 1-800-521-3535
Flexible Spending Accounts VOYA myhealthaccountsolutions.voya.com/ 1-833-232-4673 Health Savings Account VOYA myhealthaccountsolutions.voya.com/ 1-833-232-4673 Employee Assistance Program ESI www.EducatorsEAP.com 1-800-252-4555
ActiveLee ActiveLee Employee Wellness School Board of Lee County www.wellness.leeschools.net 1-239-337-8318
Florida Retirement System (FRS) - Pension Plan Members FRS www.myfrs.com 1-844-377-1888
Florida Retirement System (FRS) - Investment Plan Members FRS www.myfrs.com 1-866-446-9377
Insurance & Benefits School Board of Lee County www.leeschools.net 1-239-337-8321 http://MyAetnaWebsite.com http://www.MyHumana.com http://AetnaVision.com http://www.Securian.com http://www.Securian.com https://members.legalplans.com https://mybenefits.metlife.com http://standard.com/ahl/mybenefits http://myhealthaccountsolutions.voya.com/ http://myhealthaccountsolutions.voya.com/ http://www.EducatorsEAP.com http://www.wellness.leeschools.net http://www.myfrs.com http://www.myfrs.com http://www.leeschools.net
File details come from the government source that posted it. Updated .