BENEFITS - Dallas Fort Worth International Airport Vision Plan: Davis Vision will be the new vision...

YOUR WORLD of Health & Wellness BENEFITS

2018 Benefits Guide

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

1

PAGE 2 . . . . . . . . . . . . . . . . . . . . . . . . . INTRODUCTION

PAGE 3 . . . . . . . . .ENROLLMENT/CHANGES FOR 2018

PAGE 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ELIGIBILITY

PAGE 5 . . . . . . . . . . . . . . . . . QUALIFYING LIFE EVENT

PAGE 6 . . . . . . . . . . . . MEDICAL RATE SURCHARGES

PAGE 7 . . . . . . . . . . . . . INFORMATION & RESOURCES

PAGE 8 . . . . . HEALTH CARE ADVOCACY/NURSELINE

PAGE 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HCA

PAGE 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . EPO

PAGE 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PPO

PAGE 12 . . . . . . . . PRESCRIPTION DRUG COVERAGE

PAGE 13 . . . . . . . . . . . . . . . . . . . . . VISION COVERAGE

TABLE OF CONTENTS

PAGE 14 . . . . . . . . . . . FLEXIBLE SPENDING ACCOUNT

PAGE 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . CIGNA DHMO

PAGE 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . CIGNA DPPO

PAGE 17-18 . . . . . . LIFE INSURANCE/AD&D COVERAGE

PAGE 19 . . . . . . . . . . . . . . . . . . . DISABILITY COVERAGE

PAGE 20-21 . . . . . . . . . VOLUNTARY BENEFITS (AFLAC)

PAGE 21 . . . . . VOLUNTARY BENEFITS (LEGALSHIELD)

PAGE 22 . . . . . . . . . . . . . . . . . . . VOLUNTARY BENEFITS (TEXAS LIFE INSURANCE)

PAGE 23-24 . . . . . . . . . . . . . . . . . . LIVEWELL PROGRAM

PAGE 25 . . . . . . . . . . . . . . EMPLOYEE CONTRIBUTIONS

PAGE 26 . . . . . . . . . . . . . . . . . . CONTACT INFORMATION

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

WELCOME TO THE 2018 ANNUAL BENEFITS GUIDE

Employees are central to everything we do at DFW, ensuring that we continue to transform travel through employee engagement, customer experience, operational excellence, business performance, community engagement and our efforts to be safe and secure.

Because we value the hard work of our employees, the Airport continually evaluates the Total Rewards program to ensure we’re attracting and retaining the best people.

2017 enhancements include:

• Parking Privileges• LiveWell Upgrades

- Fitness trainers - Fitness tracker credits - New exercise equipment

• Retirement Savings Plan improvements• Healthy food options in The Hangar• Starbucks coffee

Plus, DFW became a Blue Zones certified workplace in 2017, in part because of how we invested in the benefits and privileges that make DFW a competitive employer and a healthier place to work.

2018 ENRICHED TOTAL REWARDS PROGRAM

As you consider your options for the upcoming year, we think you’ll like some of the changes to the benefits being offered to you and your family members.

We’re rolling out an enhanced vision plan. Everyone enrolled in a health care plan through DFW will also receive vision coverage without an added premium.

For dental plans, DFW will make a 10% contribution to the premiums, reducing the cost to employees.

We’re also offering supplemental short term disability coverage available through Aflac. If you’re ever out of work due to health reasons, this coverage can help you and your family supplement your income to pay for day-to-day expenses.

TOTAL REWARDS – IT’S ALL ABOUT YOU

Thank you for your contributions to DFW Airport. We’re proud to be one of the best and busiest Airports in the world, and we’re pleased to offer you these benefits through our Total Rewards Program.

2

WELCOME TO TOTAL REWARDS

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

New Vision Plan: Davis Vision will be the new vision provider for the Airport. In-network benefits will be the same or better than under the 2017 plan, and in-network costs will be the same or lower. Those who elect coverage will continue to receive a free in-network annual eye exam and dependents under age 19 will receive a free in-network pair of eyeglasses annually. Davis Vision ID cards will be mailed to each employee enrolled in a DFW medical plan. (See page 13.)

Dental: DFW will make a 10% contribution toward the dental premium, which means employee premiums per pay-period will go down by 10%. The plan remains the same with the same level of coverage. (See page 25.)

Prior Authorization and Step Therapy Program: To ensure employees and their dependents utilize the most appropriate and cost effective prescription drugs, DFW has adopted two processes to focus on using generic and lower cost drugs before moving to more expensive brand name or alternative drugs. Employees should discuss with their physician whether name-brand prescriptions are necessary. (See page 12.)

Health Care Flexible Spending Account: The annual maximum limit for employee contributions will increase to $2,600 annually.

• Any unused balance of $500 or less will automatically carry over year-to-year. (See page 14.)

Supplemental Short-Term Disability: To help you supplement income during an unexpected period when you cannot work, DFW will now offer additional optional Short-Term Disability Coverage through Aflac. (See pages 19 & 21.)

All employees must enroll for benefits every year. 2017 elections for medical and dental benefits and flexible spending accounts (FSAs) will not roll over to 2018. Employees who choose to waive coverage must submit that election in Employee Self Service (ESS). The last day to make benefit elections or waive coverage is October 30, 2017.

The benefit choices made during the annual enrollment period will go into effect January 1, 2018 (for new hires after January 1, 2018, on the hire date), and will stay in effect through December 31, 2018, unless there is a Qualifying Life Event.

During new employee orientation, employees will be given the opportunity to make benefit elections and designate beneficiaries through DFW Airport’s ESS (Employee Self Service) available on Connected Online, the Airport’s intranet site. In the packet of new hire material, there will be a Benefits Enrollment Worksheet that must be completed prior to the first day of work. By reviewing this Guide and completing the worksheet ahead of time, employees will be able to make online elections quickly.

3

ANNUAL BENEFITS ENROLLMENT

NEW HIRE BENEFITS ENROLLMENT

CHANGES FOR 2018

ENROLLMENT/CHANGES FOR 2018

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

Go to Forms and Approvals on Connected Online to complete the Certification of Domestic Partnership. For questions, contact Human Resources at 972-973-1124.

4

Marriage License ORIf common law: Declaration of Informal Marriage. This is available through the County Clerk’s Office in the county where you live. OR If domestic partner: Certification of Domestic Partnership and required documentation listed on form. This is available through Connected or Human Resources.

Natural Child: Birth Certificate listing employee as the parent.Stepchild: Birth Certificate showing your spouse is the natural parent AND Marriage Certificate or Declaration of Informal Marriage showing the natural parent is your spouse.Child of Domestic Partner: Birth Certificate showing your domestic partner is the natural parent. Domestic partner must be covered for the same benefit in order to cover the child. Other Dependent Children: Birth Certificate AND one of the following:

• Adoption Agreement • Court Order showing Legal Guardianship• Adoption Placement Documents • Qualified Medical Support Order

Disabled Dependent Child over age 26: Birth Certificate AND Approved Statement of Disability. This form is available through Connected or Human Resources.

Full-time employees and qualifying dependents are eligible on the first day of employment to participate in the DFW Airport benefit programs. Eligible dependents and the documentation required for enrollment are defined below.

• Former spouse/former domestic partner • Grandparents• Parents • Grandchildren (without legal guardianship)

In addition, DFW Airport’s plans specify:• If a spouse/domestic partner or child/domestic partner’s child is a full-time employee of DFW Airport, each must carry

their own medical, dental, and/or life insurance coverage.• Employees are not allowed to elect spouse/domestic partner life insurance for another DFW Airport employee.• Two employees are not allowed to cover the same dependents for medical, dental, and/or life insurance coverage.

When you log into Employee Self Service (ESS) to make your annual benefit elections for 2018, you must certify that your covered dependents meet the eligibility requirements as defined in this Benefits Guide.

DFW Airport has the right to conduct periodic random reviews of dependent eligibility and you may be requested to provide documentation validating your dependents’ eligibility.

Providing false or misleading information with respect to benefits enrollment or dependent eligibility may result in corrective action and/or termination of employment.

Eligible Dependent Documentation Required for Enrollment

DEPENDENT CHILD(REN)

Child(ren) must be under the age of 26, or any age if mentally or physically incapacitated.

SPOUSE

ELIGIBILITY

WHO IS NOT AN ELIGIBLE DEPENDENT?

PERIODIC DEPENDENT ELIGIBILITY REVIEWS

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

Qualifying Life Events are situations that may arise during the calendar year that will allow you to make changes to your benefit elections. Qualifying Life Events are based on IRS guidelines and regulations, which are outlined below.

If a Qualifying Life Event Occurs: • Submit a Qualifying Life Event Form

(located on Connected Online) and proof of the event that is consistent with your requested change.

• Documents must be turned in no later than 31 days from the actual event date.

• If you miss the 31 day deadline: - You are required to drop coverage on any ineligible dependent.

- If your event resulted in adding a dependent to your plan you must wait until the next annual enrollment to make a change.

• Deductions/refunds due are effective as of the event date. If you miss the 31 day deadline you will not receive a retroactive refund.

QUALIFYING LIFE EVENT

5

Qualifying Life Event Required DocumentationCHANGE IN LEGAL MARITAL STATUS:

Marriage, informal marriage, or domestic partnership

Marriage Certificate, Declaration of Informal Marriage, or Certification of Domestic Partnership

Divorce or dissolution of domestic partnership

Signed and dated Divorce Decree or Dissolution of Domestic Partnership

CHANGE IN NUMBER OF DEPENDENTS:

Birth Birth Certificate and/or Verification of Birth Facts that shows date of birth

Adoption Signed and dated Adoption Certificate

Death Death Certificate

Legal Guardianship or other court proceeding Court Order

CHANGE IN DEPENDENT STATUS:

Child turns age 26Child automatically removed from coverage effective the last day of the month of his/her 26th birthday (documentation not required)

Child enlists in the Armed Forces Letter from the Armed Forces or enlistment document showing date enrolled

Parent no longer required to provide health care

Letter from Attorney General stating the parent is no longer required to provide health care

CHANGE IN COVERAGE/EMPLOYMENT STATUS:

Loss of coverage by dependentLetter on company letterhead from dependents showing date the coverage ended

Gain of coverage bydependentLetter on company letterhead from dependents showing date the coverage began

CHANGE OF RESIDENCY:

Change of residency to the U.S.Immigrant Visa or Permanent Resident card (must be turned in within 31 days of the admittance date)

ENTITLEMENT TO MEDICARE:

Employee or dependent becomes eligible for Medicare

Copy of Medicare documentation showing the date the coverage began

CHANGE IN MEDICAID/CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) ELIGIBILTY: 60 -Day Special Enrol lment Per iod

Employee or dependent’s Medicaid or CHIP coverage terminates due to loss of eligibility or becomes eligible for Medicaid or CHIP

Copy of Medicaid/CHIP documentation showing the date the coverage ended or began

MAKING CHANGES DURING THE YEAR

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

56

SPOUSAL/DOMESTIC PARTNER SURCHARGE

TOBACCO USE SURCHARGEFor 2018 medical enrollment, a surcharge of $100 per month ($46.15 per pay period) will apply for tobacco users who enroll in medical coverage. Tobacco products include but are not limited to the following: cigarettes, cigars, pipes, chew, dip, snuff, and e-cigarettes. To avoid the surcharge, employees must be tobacco-free for at least 60 days prior to enrollment.

Notify Human Resources if your tobacco use changes or you complete a LiveWell or community-sponsored tobacco cessation program during the year by submitting the Tobacco Use Surcharge Affidavit on Connected Online. See sidebar for more information.

TOBACCO USECurrent employees who use tobacco:If an employee completes a LiveWell or a community-sponsored tobacco cessation program during the first six months of the calendar year, the surcharge will be refunded back to January 1 and waived for the remainder of the calendar year. If an employee completes the LiveWell or a community-sponsored tobacco cessation program during the last six months of the 2017 calendar year, the surcharge will be waived at the time the class is completed through the remainder of the calendar year; no refund will be issued.

New hires who use tobacco:The surcharge will be applied as of the hire date and the employee will be given six months to complete a LiveWell or a community-sponsored tobacco cessation program. Once completed, the surcharge will be refunded back to the hire date and waived through the end of the calendar year. If the class is not taken during the first six months of employment, the surcharge will be waived at the time the class is completed through the remainder of the calendar year; no refund will be issued.

LIVEWELL SURCHARGEFor 2018 medical enrollment, a surcharge of $75 per month ($34.62 per pay period) will apply to employees who did not earn at least one LiveWell Incentive component (Apple) and/or did not submit verification for an annual physical received in fiscal year 2017. The surcharge will not apply to employees who are hired or joined the plan after March 20, 2017.

For 2018 medical enrollment, employees electing to enroll a working spouse or domestic partner who has medical coverage available through his/her own employer will pay a surcharge of $200 per month ($92.31 per pay period).

You do not have to pay the monthly surcharge if:• Your spouse or domestic partner is not enrolled in DFW Airport’s medical plan.• Your spouse or domestic partner is enrolled in DFW Airport’s medical plan and is unemployed, self-employed, or retired.• Your spouse or domestic partner is enrolled in DFW Airport’s medical plan and is employed but does not have medical

benefits available through his/her employer.

Notify Human Resources if your spouse/domestic partner’s medical coverage and/or employment status changes by submitting the Spousal/Domestic Partner Surcharge Affidavit on Connected Online.

MEDICAL RATE SURCHARGES

Qualifying Life Event Required DocumentationCHANGE IN LEGAL MARITAL STATUS:

Marriage, informal marriage, or domestic partnership

Marriage Certificate, Declaration of Informal Marriage, or Certification of Domestic Partnership

Divorce or dissolution of domestic partnership

Signed and dated Divorce Decree or Dissolution of Domestic Partnership

CHANGE IN NUMBER OF DEPENDENTS:

Birth Birth Certificate and/or Verification of Birth Facts that shows date of birth

Adoption Signed and dated Adoption Certificate

Death Death Certificate

Legal Guardianship or other court proceeding Court Order

CHANGE IN DEPENDENT STATUS:

Child turns age 26Child automatically removed from coverage effective the last day of the month of his/her 26th birthday (documentation not required)

Child enlists in the Armed Forces Letter from the Armed Forces or enlistment document showing date enrolled

Parent no longer required to provide health care

Letter from Attorney General stating the parent is no longer required to provide health care

CHANGE IN COVERAGE/EMPLOYMENT STATUS:

Loss of coverage by dependentLetter on company letterhead from dependents showing date the coverage ended

Gain of coverage bydependentLetter on company letterhead from dependents showing date the coverage began

CHANGE OF RESIDENCY:

Change of residency to the U.S.Immigrant Visa or Permanent Resident card (must be turned in within 31 days of the admittance date)

ENTITLEMENT TO MEDICARE:

Employee or dependent becomes eligible for Medicare

Copy of Medicare documentation showing the date the coverage began

CHANGE IN MEDICAID/CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) ELIGIBILTY: 60 -Day Special Enrol lment Per iod

Employee or dependent’s Medicaid or CHIP coverage terminates due to loss of eligibility or becomes eligible for Medicaid or CHIP

Copy of Medicaid/CHIP documentation showing the date the coverage ended or began

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

BLUE ACCESS FOR MEMBERS (BAM)Blue Access for Members (BAM) is your secure member portal from BCBSTX which allows you to have immediate online access to personalized health and wellness information. Once you become a member, visit bcbstx.com to create your login.

You will have access to do the following:• Locate a network doctor, hospital, or other health

care provider, and get driving directions• View, print, or request additional member ID cards• Check the status of a claim and your claims history• View and print an Explanation of Benefits (EOB)

statement for a claim• Set your preferences to receive text or email

notifications for claims status and wellness updates

BLUE DISTINCTION CENTER (BDC)BDCs are health care facilities that have a record of providing proven, effective care. They have met national criteria for quality, efficiency and patient experience.

BDCs are available for the following specialty health care services:

• Knee and hip replacement • Spine surgery• Cardiac Care • Transplants• Certain cancers

HOW TO PRINT AN ID CARDLog on to Blue Access for Members (BAM), the secure member portal at bcbstx.com to print a temporary ID card or submit a request for additional permanent cards to be mailed to you.

HOW TO FIND A DOCTOR IN THE BCBSTX NETWORKUse the BCBSTX online provider tool to determine whether your doctor is part of the BlueChoice PPO network of preferred providers. Remember that all three plans offered by DFW Airport are part of the BlueChoice PPO network.

Go to bcbstx.com and click on the link for the Provider Finder® tool. Enter your search criteria to locate doctors, hospitals, and other health care providers in your area. You may also call BCBSTX Member Services at 800-521-2227 or Advocacy Services at 866-279-0495.

INFORMATION & RESOURCES

7

RESOURCES & TIPSDEFINITIONS - BCBSTX

We understand Benefits Enrollment can be a lot to take in. Take advantage of the following definitions and tips as you decide on medical coverage.

COPAYMENTThe amount you pay at the time you receive a service from a BCBSTX provider.

DEDUCTIBLEThe portion of covered expenses that you must pay each year before the plan will pay benefits.

OUT-OF-POCKET LIMITThe maximum amount of covered medical and prescription costs you’ll have to pay in one year including the annual deductible, coinsurance payments, and prescription copayments.

COINSURANCEThe portion of covered medical bills you are responsible to pay once your annual deductible has been met.

HCA FUND ADMINISTRATION*The fund will be used to pay for your out-of-pocket medical and prescription expenses, including your deductible and coinsurance. Once the deductible is met, the underlying medical plan provides coverage. Services covered at 100% with no deductible will be paid by the plan and not by the fund.

* Applies to HCA medical plan only.

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

8

DFW Airport’s employee advocacy program is provided by Alight Solutions. The Advocacy Service provides peace of mind, education, and issue resolution for employees and their families struggling with complicated benefits questions.

Contact Advocacy Services when you need help to:• Understand how to use your DFW Airport benefits• Understand the differences in the medical and dental

plans• Resolve billing and insurance claim disputes • Locate in-network medical, vision or dental provider facility• Navigate Medicare questions• Get help finding a Blue Distinction Center (BDC)

Advocacy Services are no cost to you and are also available to your immediate family members even if they not enrolled in the DFW health care plans.

Health happens — good and bad, 24 hours a day, seven days a week. Fortunately, registered nurses are on call to answer your health questions, wherever you may be, 24 hours a day seven days a week.

Our nurses can answer your health questions and give your general health tips. They can also try to help your decide whether you should go to the emergency room, urgent care or make an appointment with your doctor. You can also call the 24/7 Nurseline whenever you or your covered family members need answers to health questions about:

• Asthma• Back pain• Diabetes• Dizziness or severe headaches• High fever

• A baby’s nonstop crying• Cuts or burns• Sore throat • And Much More

Plus, when you call, you can access the AudioHealth Library which has more than 1,000 health topics — from allergies to surgeries — with more than 600 topics available in Spanish.

The AudioHealth Library is available to help you and your family educate yourselves about many common and chronic illnesses and diseases. Pre-recorded messages on topics provide the information you need to help:

• Prevent Illness• Identify warning signs• Administer self-care

Note: For medical emergencies, call 911. This program is not a substitute for a doctor’s care. Talk to your doctor about any health questions or concerns.

HEALTH CARE ADVOCACY & THE 24/7 NURSELINE

Contact the Nurseline at 800-581-0393

Contact Advocacy Services at 866-279-0495 or go to alight.com/advocacy.

ADVOCACY SERVICES

24/7 NURSELINERegardless of the plan you choose, all Airport Board employees can take advantage of additional health care resources.

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

HCA BCBSTX

9

The BlueCross and BlueShield of Texas (BCBSTX) Health Care Account (HCA) is a lower premium cost option for your health care coverage. This plan combines a BCBSTX high-deductible health plan with a health care account, known as a “fund,” to help pay your costs. In fact, the fund pays first before you begin paying your deductible. The plan provides you with security, convenience, tax benefits, and more!The HCA has three parts — the fund, the deductible, and the health plan.At the start of each plan year, DFW Airport provides you with a fund to help you pay for eligible out-of-pocket health care costs. Fund payments may help you meet your deductible. When you meet your deductible, the health plan pays for most of your eligible expenses. You pay a smaller share of these costs from your own pocket.

BENEFITS OF AN HCAThe plan is convenient and easy to use. DFW Airport automatically sets up the fund for you, and no claim forms are required if you visit doctors and other health care providers in the BlueChoice PPO network. Your eligible health care expenses, including prescription drug copayments, are automatically paid from the fund first.

• The HCA has staying power. If you do not use the entire fund during the year, the remaining balance rolls over to the following year’s fund, as long as you stay in the plan. Therefore, you may have a larger fund to help pay for future costs. If you have been in the plan for more than a year and your fund keeps growing, it may eventually build up enough to pay your entire deductible. However, if you leave the plan, any remaining balance in the fund will be forfeited.

• The plan offers tax-free benefits as the fund does not count as taxable income for you. That means you cover some health care costs with tax-free dollars.

• The HCA protects you by covering preventive care at 100% when services are performed by an in-network provider, so you do not need to use your fund!

P L A N F E A T U R E

BCBSTX PREFERRED (NETWORK)Y O U P AY

NON-PREFERRED (NON-NETWORK)

Y O U P AY

Annual Deductible (excludes prescription copayments)

• Per individual• Per family

$1,500$3,000

$3,000$6,000

Annual Out-of-Pocket Limit (includes deductible, coinsurance, and prescription copayments)• Per individual• Per family

$4,000$8,000

$8,000$10,000

Coinsurance (after annual deductible) 20% 40%

Preventive Care (1 exam per calendar year)Includes routine adult and routine child physical exams, lab tests, immunizations, and routine cancer screenings

100% covered;deductible waived

40% afterdeductible

Outpatient Surgery (after annual deductible) 20% 40%

Hospitalization and Inpatient Surgery (after annual deductible)

20% 40%

Mental Health (after annual deductible)

• Inpatient• Outpatient

20%20%

40%40%

Urgent Care Facility (after annual deductible) 20% 40%

Emergency Room and Ambulance (after annual deductible) 20% 20%

Precertification is required for all hospital admissions, treatment facility admissions, convalescent facility admissions, home health care, hospice care, and private duty nursing. $500 per occurrence penalty applies for failure to obtain precertification for non-preferred facilities and failure to obtain precertification for certain preferred and non-preferred care treatments and/or procedures. The covered employee and/or dependent is responsible for precertification for non-preferred care; the provider is responsible for precertification for preferred care.

HCA AMOUNT: The fund amount is provided by DFW Airport on a per calendar year basis. The fund received will be prorated based on your effective date of coverage.

$500 for employee only

$1000 for employee + dependents

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

10

When you choose the Exclusive Provider Organization (EPO) plan from BlueCross and BlueShield of Texas (BCBSTX), you are choosing to use participating in-network doctors, hospitals, and other health care providers in the BlueChoice PPO network.

Most office visits and services require a copayment, and the remainder is covered by BCBSTX, without deductibles. It’s an easy way to budget your health care expenses.

As long as you use in-network providers, you can visit any provider or any facility you want and see any specialist without a referral. You are not required to use a primary care physician (PCP) and you do not have to file any claims.

Since you are not required to go to a primary care doctor first, you may choose to go to a network specialist; however, you will pay the higher specialist copayment.

If you use a doctor, hospital, or other health care provider outside the network, your care will not be covered and you will have to pay the full amount for the services, except in the case of an emergency.

An emergency is defined as a sickness or injury so severe that failure to get immediate medical attention could cause serious bodily harm or put a person’s life in danger. Some examples are heart attack, excessive bleeding, loss of consciousness, and significant injuries.

P L A N F E A T U R E Y O U P AY

Office Visits $30 copayment

Specialist Office Visits $60 copayment

Annual Deductible $0

Annual Out-of-Pocket Limit (includes medical and prescription copayments)


$2,200$5,500

Preventive Care (1 exam per calendar year)

• Routine adult physical exams/ immunizations

• Routine well-child exams/immunizations• Routine gynecological care exams

Covered 100%

Covered 100%Covered 100%

Outpatient Surgery

Office visit copayment if performed in physician’s office; $200 copayment if performed in hospital or outpatient facility, then covered 100%

Hospitalization and Inpatient Surgery $500 copayment per admission, then covered 100%

Mental Health

$500 copayment per admission, then covered 100%

$60 copayment per visit

Mental Health

$500 copayment per admission, then covered 100%

$60 copayment per visit

Emergency Room$150 copayment; waived if admitted to a hospital or outpatient facility

Urgent Care $75 copayment

Ambulance $150 copayment

• Inpatient

• Outpatient

EPO BCBSTX




Y O U P AY



$1,500$3,000

$3,000$6,000


$4,000$8,000

$8,000$10,000




40% afterdeductible



20% 40%

Mental Health (after annual deductible)

• Inpatient• Outpatient

20%20%

40%40%



• Keep in mind that benefits are payable only for services performed by an in-network provider or facility.

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••




Y O U P AY



$300$750

$800$1,750


$2,300$5,750

$4,500$11,250




40% afterdeductible



20% 40%

Mental Health (after annual deductible)• Inpatient• Outpatient

20%20%

40%40%



When you choose the Preferred Provider Organization (PPO) plan from BlueCross and BlueShield of Texas (BCBSTX), you and your covered dependents can receive care from any doctor, hospital, or other health care provider. If you use an in-network provider, typically you’ll pay less out-of-pocket and get the highest level of benefits. If you use a provider outside the network, you’ll still be covered, but your out-of-pocket costs will be higher.

Under the BCBSTX PPO, you must first pay a deductible for you and your covered dependents, then pay the applicable coinsurance for covered medical bills.

There are no claim forms when you receive care from an in-network provider. But if you go outside the BlueChoice PPO network, claim forms may be required, and you may also have to provide payment in full at the time you receive services. In addition, you may be required to request your own precertification prior to certain procedures and you could be billed for the balance not payable by the plan.

Precertification is required for all hospital admissions, treatment facility admissions, convalescent facility admissions, home health care, hospice care, and private duty nursing. $500 per occurrence penalty applies for failure to obtain precertification for non-preferred facilities and failure to obtain precertification for certain preferred and non-preferred care treatments and/or procedures. The covered employee and/or dependent is responsible for precertification for non-preferred care; the provider is responsible for precertification for preferred care.

11

PPO BCBSTX

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

Retail (Up to 30-day supply)

Mail Order (31 to 90-day supply)

Retail (Up to 30-day supply)

Mail Order (31 to 90-day supply)

Y O U P AY Y O U P AY Y O U P AY Y O U P AY

Tier One Generic drugs $5 copayment $10 copayment $10 copayment $20 copayment

Tier Two Brand-name drugs (on the Preferred Drug List) $30 copayment $60 copayment $40 copayment $80 copayment

Tier Three Brand-name drugs (not on the Preferred Drug List) $60 copayment $120 copayment $80 copayment $160 copayment

Tier Four Specialty mail order drugs (injection, infused, or oral) N/A $100 copayment

(30 day supply) N/A $100 copayment(30 day supply)

12

PRESCRIPTION DRUG COVERAGE

Prescription drug coverage is included with all three DFW Airport health plans. This benefit is administered by BlueCross and BlueShield of Texas (BCBSTX), and their pharmacy vendor is Prime Therapeutics.

If you choose a brand-name drug when a generic is available, you will pay the difference in cost between the generic and brand-name drug plus the applicable brand copayment.

Retail Pharmacy Benefits: Use this benefit to purchase short-term or 30-day prescriptions at a BCBSTX preferred pharmacy.

Mail-Order Benefits: Use this benefit for maintenance medications that will continue for at least three months at a time. Medications are delivered to your home in three-month quantities; so it may save time and money at the pharmacy. Mail-Order Benefits are though PrimeMail by Walgreens Mail Service.

• Maintenance Medications: Prescribed for chronic, long-term conditions and are taken on a regular, recurring basis.

Prime Specialty Pharmacy: Specialty medications are required for some complex conditions. These drugs may be injected, infused or taken orally and typically require storage under special conditions or refrigeration. These types of prescriptions must be filled through Prime Specialty Pharmacy mail order service.

Preventive and Preferred Drug List can be found at bcbstx.com and on Connected Online.

Generic Medications: FDA-approved equivalent drugs that are effectively the same as a brand-name drug. *DFW’s plan is a mandatory generic plan.

Prior Authorization Program: This program will require your doctor to submit a prior authorization request for coverage of certain medications. To find out if your drug requires prior authorization, check the Preferred Drug List or you can call the number on the back of your ID card.

Step Therapy Program: This program will require you to try a proven, cost-effective medication before “ stepping-up” to a more costly treatment. Many drugs have less-expensive generic or brand alternatives that may be an option for you. To find out if your drug requires step therapy, check the Preferred Drug List or you can call the number on the back of your ID card.

Preventive Drug Benefit Program: Provides a discount to any member taking a generic and/or preferred brand drug in a designated class. Medications covered in this program are used to treat chronic health conditions such as Asthma, Diabetes, High Blood Pressure, and High Cholesterol.

• Tier 1 - Generic copayment - $0• Tier 2 - Preferred brand-name copayment –

Discounted 50%.

Preferred Drug List (Formulary): This list will help you determine the tier and the corresponding copayment for any medications you take.

WHERE SHOULD I FILL MY PRESCRIPTION?

STEPS TO SAVE MONEY

BCBSTX EPO & BCBSTX PPOBCBSTX HCAPrescription Drugs – Mandatory Generic*

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

VISION In-Network Out-of-Network

Eye Exam & Services

Routine Eye Examaniation (one per calendar year)Contacts Evalution (Conventional and specialty lenses)

$0 copay e$10 copay (Conventional and sp

Usual and customary retail charge (National average varies by zip code)Not Covered ar

Vision Eye Wear

Standard Plastic LensesSingleBifocalTrifocalStandard ProgressivePediatric Eye Wear (under age 19)

$10 copay$10 copay$10 copay$50 copay$0 copay

Reimbursement up to $30Reimbursement up to $45Reimbursement up to $55Reimbursement up to $45Same as above

TintScratch Resistant Coating

$0 copay$0 copay

Not CoveredNot Covered

Frames

Exclusive Collection (Fashion/Designer/Premier) Non-Collection - VisionWorks Non-CNon-Collection - Other locations Non-CPediatric Eye Wear (under age 19)

$0 copay xxx $200 Allowance + 20% discount OFF any overage$150 Allowance + 20% discount OFF any overage$0 copay, Allowances listed above apply

$70 Allowance (F) Non NonNon NonsPe

Contacts

Elective $t OF0Visually RequiredFit and Followup Cs 1ion

$0 copay $150 Allowance + 15% discount OFF balance over $150Covered in full with prior approvalCopay for adults 19+ Covered in full for Collection Contacts 15% discount for Non-Collection

$70 Allowance $150 OFF$200 AllowanceNot Covered Con Con

VISION COVERAGE

13

Vision care benefits are provided by Davis Vision. You must be enrolled in a DFW Airport health plan to have vision coverage.

What is the Exclusive Collection?The Exclusive Collection is a unique offering to Davis Vision members only available at independent private practice offices, and consists of 222 frames that have been identified as best sellers in the Visionworks stores. These frames are up to a $195 value and are no cost to you.

Some of the brands include Nike, Guess, Calvin Klein, Harley Davidson, Kate Spade, Bebe, and more.

How to find a Network provider:Log in using client code 8227 at davisvision.com in the “Member Sign In” section to locate a provider near you.

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

14

FLEXIBLE SPENDING ACCOUNTS

Flexible spending accounts (FSAs) are administered by BlueCross BlueShield of Texas (BCBSTX) through ConnectYourCare. FSAs allow you to use pre-tax dollars for eligible health care and work-related dependent care expenses. You decide how much money you want to put into the health care or dependent day care accounts, up to the limit. This amount is deducted from your paycheck through regular payroll deductions before any taxes are withheld, lowering you taxable income.

DOMESTIC PARTNER BENEFITSClaims for domestic partner benefits and their children cannot be reimbursed through pre-tax health care or dependent day care accounts per Internal Revenue Code regulations.

• The amounts you elect through open enrollment will remain in effect throughout the plan year (January 1 – December 31) and cannot be transferred between the two accounts.

• Health Care Spending Account - If you want to add a cardholder, replace a damage card, or report a lost or stolen card, go to connectyourcare.com and click My Payment Card.

- You can submit eligible expenses for your family members that are not covered under the DFW Airport’s medical or dental plans.

• Keep your receipts and invoices. You may be required to submit documentation for your expenditures.

• You can contribute up to $500 and not forfeit any unused balance. The unused balance of $500 or less will automatically carry over year-to-year.

FSA TIPSHOW TO REALIZE TAX SAVINGS

HEALTH CARE SPENDING ACCOUNT

This account is used for eligible out-of-pocket health care expenses which are not covered by your medical, dental, or vision care plans you may have. This includes copayments, coinsurance, and deductibles.

• Minimum Contribution $130 — Maximum Contribution $2,600 annually.

• The entire annual amount you elect may be used at any time during the plan year and is available January 1.

• You must incur costs between January 1 (or the date you enroll) – December 31. Claims must be submitted by March 31, 2019.

• You can rollover up to $500 of unused funds to the next calendar year. Unused funds over $500 will be forfeited (this is an IRS rule).

• You will receive a payment card that is designed to work with your medical, vision, pharmacy, and dental benefits. You may also choose to pay out of pocket and submit a claim for reimbursement. The choice is up to you.

DEPENDENT DAY CARE SPENDING ACCOUNT

This account is used to pay eligible day care expenses (not health care) for your dependent children under age 13 (or over age 13 if physically or mentally incapable of caring for themselves), elderly parent living with you, or a disabled spouse.

• Minimum Contribution $130 — Maximum Contribution $5,000 annually.

• Unlike Health Care FSAs, Dependent Day Care FSAs will only reimburse expenses up to the amount you have contributed at any time during the plan year.

• You must incur cost between January 1, 2018 – March 15, 2019. Claims must be submitted by April 30, 2019.

• To submit claims log into your account at connectyourcare.com

• In some cases, the IRS child tax credit may be better for you than the dependent day care spending account. You should consult a tax specialist to determine which option is better for you.

Health Care Expenses: irs.gov/publications/p502

Dependent Care Expenses: irs.gov/publications/p503

Examples include: Deductibles, copayments/coinsurance, prescription drug copayments, eye glasses and contact lenses, LASIK surgery, hearing exams, hearing aids, dental work/orthodontia, and chiropractic treatment.

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

Refer to the Cigna DHMO Schedule of Benefits on Connected Online for more details, exclusions, and/or limitations.

F O R T H I S S E R V I C E Y O U P AY

Annual Deductible None

Preventive Services (Type I)

• Office visit• Initial exam• X-rays (bitewing)• Routine cleanings• Fluoride• Sealants (per tooth)

$5 copayment$0$0$0$0$12 copayment

Basic Services (Type II)

• One surface silver filling• Two surface white filling (anterior)• Single tooth extraction• Surgical removal of erupted tooth• Perio scaling and root planing (1-3 teeth/quad)

$0$0$6 copayment$40 copayment$40 copayment

Major Services (Type III)

• Porcelain/ceramic substrate crown• Pontic-porcelain bridge fused to high noble metal• Two surface metallic inlay• Molar root canal• Complete upper or lower denture

$285 copayment$250 copayment$260 copayment$305 copayment$225 copayment

Orthodontics (Type IV)

• Evaluation and treatment planning• Orthodontic treatment – children (under 19 years)• Orthodontic treatment – adults (19 years and above)

$125 copayment$1,608 copayment$2,592 copayment

A N N U A L M A X I M U M B E N E F I T N O N E

A dental health maintenance organization (DHMO) provides benefits through a network of providers. You pay the in-network dentist a copayment according to the service provided, although some services have zero dollar copayments.

Specialists are included in the network, such as orthodontists, oral surgeons, endodontists, periodontists, and pedodontists. You must visit an in-network provider who is part of the DHMO network in order to receive benefits. If you need to see a specialty dentist (members may visit orthodontists without a referral), you must be referred by your primary care dentist. While there are certain exclusions and limitations, there are no pre-existing condition exclusions for services.

Pharmaceuticals, drugs, and medications are not covered under the dental plan. If your dentist or medical doctor writes a prescription, it can be covered under your BCBSTX medical plan.

As a new enrollee, you must decide on a primary care dentist (PCD) and identify the DHMO office number during the enrollment process for both you and your dependents. You may choose a different PCD for each dependent if you wish. Any change to your PCD after initial enrollment must be made before the 15th of the month to be effective by the first of the following month.

The Cigna DHMO plan is available to members residing in Texas. If you live outside the state of Texas or cannot find a DHMO dentist within 25 miles of your home or place of employment, call Cigna at 800-244-6224.

Cigna DHMO

15

CIGNA DHMO CIGNA DENTAL CARE

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

Refer to the Cigna DPPO Dental Schedule of Benefits on Connected Online for more details.

16

Like a medical PPO plan, this option pays benefits for covered services from any dentist you choose, but you may receive additional discounts if you choose a dentist who is an in-network provider.

The type of care you receive (preventive, basic, or major) determines the amount of your coinsurance and any out-of-pocket expenses.

Pharmaceuticals, drugs, and medications are not covered under the dental plan. If your dentist or medical doctor writes a prescription, it may be covered under your BCBSTX medical plan.

F O R T H I S S E R V I C E Y O U P AY

Annual Deductible (applies to Basic and Major Care services only)


$50$150

Preventive Care (annual deductible waived)

Includes checkups, cleanings, X-rays, etc. $0

Basic Care

Includes fillings, oral surgery, periodontal treatment, root canals, crown repairs, etc.

20% after deductible

Major Care

Includes installation of crowns, fixed bridgework, dentures, implants, etc.

50% after deductible

Orthodontia

Includes braces (adults and children)

50% after deductible until the plan pays lifetime maximum of $1,500, then 100% of any remaining costs

Orthodontia Lifetime Deductible (separate from deductible for basic and major services)

• Per individual

$50

M A X I M U M B E N E F I T P L A N P AY S

Maximum Benefit

Plan pays per calendar year per individual $2,000

Orthodontia Lifetime Maximum

Plan pays per individual $1,500

Cigna DPPO

CIGNA DPPO CIGNA DENTAL CARE

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

Basic term life insurance and AD&D coverage is automatically provided to employees through ReliaStar Life Insurance Company (ReliaStar), a subsidiary of Voya Financial, and is fully paid for by the Airport as a benefit of your employment. The life insurance benefit is equal to two times your annual salary to a maximum of $1,000,000. If you die in an accident, the AD&D feature of the plan also pays a benefit equal to the life insurance portion, for a total benefit of four times your annual salary up to a maximum of $2,000,000. A lump-sum benefit is payable to your beneficiary upon your death. If you suffer certain injuries in an accident, the plan’s AD&D feature may pay you partial benefits.

Should your employment with the Airport end, you may elect to continue your coverage, though you may pay a higher rate.

BE SURE TO CHECK:• Make sure your life insurance

beneficiaries are up to date.

• Go to Employee Self Service (ESS) to update your beneficiaries. Under Self Service, click on Benefits – Dependents and Beneficiaries – Life Insurance Beneficiaries.

Once you reach age 65, the amount of life and AD&D insurance for yourself (but not for your spouse/domestic partner) will be reduced to a percentage of the selected benefit amount.

Employee Age New Amount

65 through 69 65% of coverage amount

70 or older 50% of coverage amount

BASIC TERM LIFE INSURANCE/AD&D COVERAGE - Airport Paid

SUPPLEMENTAL TERM LIFE INSURANCE/AD&D COVERAGE - Employee Paid

LIFE AND AD&D INSURANCE REDUCTION

17

LIFE INSURANCE AND AD&D COVERAGERELIASTAR LIFE INSURANCE COMPANY

In addition to the Airport-paid basic life/AD&D, you can purchase supplemental employee term life insurance/AD&D coverage on yourself. You pay the full cost of this supplemental coverage at group rates on an after-tax basis. The premium for this coverage is based on your age and amount of coverage selected at the time of purchase. Your cost will change within the plan year as your age bracket and/or your salary changes. Highlights of this coverage are:

• You can purchase employee term life insurance coverage on yourself equal to one, two, or three times your annual salary, up to a maximum of $750,000. The total combined basic and supplemental life/AD&D coverage maximum is $1,750,000.

• If you decline this supplemental employee term life insurance/AD&D coverage as a new hire and then elect to enroll in it at a subsequent enrollment period, or if you currently have this supplemental coverage and wish to increase your coverage amount more than one times your annual salary, you will need to complete an Evidence of Insurability (EOI) form that must be approved by ReliaStar before the coverage goes into effect. The required form will be mailed to your home after you apply for the coverage.

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

18

If you have elected supplemental employee term life insurance/AD&D coverage for yourself, you can also purchase dependent term life insurance coverage for your spouse/domestic partner and/or children. You pay the full cost of this coverage at group rates on an after-tax basis. Highlights of this coverage are:

Spouse/Domestic Partner Coverage

• Spouse/domestic partner coverage is based on the age of the employee and amount of coverage selected at the time of purchase. Your cost will change within the plan year as your age bracket and/or your salary changes.

• You can purchase dependent term life insurance coverage for your spouse/domestic partner equal to one times your annual salary, up to a maximum of $75,000.

• If you decline dependent term life insurance for your spouse/domestic partner as a new hire and then elect to enroll at a subsequent open enrollment period, you will need to complete an EOI form that must be approved by ReliaStar before the coverage goes into effect. The required form will be mailed to your home after you apply for the coverage.

Dependent Children Coverage

• You can purchase dependent term life insurance coverage of $10,000 per child (from live birth to age 26) at a single premium amount.

• An EOI form is not required to add a child during either the annual open enrollment period or at the time of a qualifying Life Event.

DEPENDENT LIFE INSURANCE

LIFE INSURANCE AND AD&D COVERAGE(continued)

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

Two additional benefits the Airport provides to you are short-term and long-term disability, which are a component of DFW Airport’s Absence Management Program. The coverage is provided to regular, full-time employees who have completed six months of employment at the time of initial injury or onset of illness. This benefit is fully paid by the Airport. Short and long-term disability plans are administered by Matrix Absence Management and provide salary continuation to you if you are unable to work.

Short-term disability coverage provides salary continuation when an illness or non-work related injury prevents you from working. The plan pays you a portion of your salary for up to 180 days. The amount you receive depends on your years of service with DFW Airport.

Length of Service Amount of BenefitLess than 6 months Not eligible6 months through 3 years 40% of base pay4 years through 9 years 50% of base pay10 years through 14 years 75% of base pay15 years and above 90% of base pay

All applications for short-term disability are reviewed by Matrix Absence Management. Consult the Short-Term Disability Pay policy on Connected Online for benefit details.

The Airport now offers additional optional Short-Term Disability Coverage through Aflac. See page 21 for details.

If you are unable to work for more than 180 calendar days due to an approved short-term disability or workers’ compensation injury or illness you may be eligible for long-term disability benefits if you are totally disabled. If you are approved for long-term disability benefits, you will receive 60% of your base pay on a monthly basis up to a maximum of $10,000 per month. Your long-term disability coverage continues as long as you remain totally disabled or until age 65, at which time your disability benefits will end. If you are age 62 or older when your long-term disability benefit begins, your benefit will extend past age 65.

19

DISABILITY COVERAGESHORT-TERM AND LONG-TERM

SHORT-TERM DISABILITY

LONG-TERM DISABILITY

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

20

VOLUNTARY BENEFITS

The Airport provides the following voluntary benefits: Aflac supplemental benefits, legal services and permanent life insurance coverage. You own the policies and can take them with you if you ever decide to terminate your employment at the Airport. These benefits are over and above your other coverage and are not a part of the core benefits provided to you. You can enroll in voluntary benefits anytime throughout the year. You may also make changes to or cancel your coverage at any time during the year (unlike other health and welfare benefits offered by the Airport).

Age 18-65

EE Only $14.28

EE+ Spouse/DP $19.02

EE + EE Children $22.14

EE + Spouse/DP + EE/DP Children $27.90

Age 18-75

EE Only $24.30

EE+ Spouse/DP $43.68

EE + EE Children $24.30

EE + Spouse/DP + EE/DP Children $43.68

Aflac pays cash benefits that can be used to help with everyday living expenses such as mortgage payments, rent, utilities, groceries, deductibles, copayments, etc. The benefits are paid directly to you, unless otherwise assigned. All of the Aflac plans described below are portable, you can take them with you, and there are no deductibles, copayments, or network restrictions. There is also no coordination of benefits — Aflac pays regardless of any other insurance.

ACCIDENT ADVANTAGE• 24-hour accident only insurance

designed to provide you with cash benefits in the event of a covered accident, on or off the job.

• Daily hospitalization benefitspayable for hospital stays, and additional daily benefits paid for stays in a hospital intensive care unit.

Accident AdvantageEE = Employee DP = Domestic Partner

Cancer CareEE = Employee DP = Domestic Partner

CANCER CARE• The plan pays a cash benefit

upon initial diagnosis of a covered cancer, with a variety of other benefits payable throughout cancer treatment. You can use these cash benefits to help pay out-of-pocket medical expenses, the rent or mortgage, groceries, or utility bills - the choice is yours.

• Rates are the same for those18 to 75 years of age.

AFLAC SUPPLEMENTAL INSURANCE

AFLAC PLUS RIDERMust be enrolled in Accident Advantage Plan. Provides extra protection on specific health events. BENEFIT: $5,000 upon a covered person’s onset date. Rates vary with age.Events include: heart attack, stroke, coma, paralysis, type 1 diabetes, traumatic brain injury, Alzheimer’s disease, Parkinson’s disease, Lou Gehrig’s disease, loss of independence, multiple sclerosis, permanent loss of sight/hearing/speech, sudden cardiac arrest, encephalitis, meningitis, Lyme disease, sickle cell anemia, cerebral palsy, osteomyelitis, systemic lupus, cystic fibrosis.

• Benefits payable for initial treatment, X-rays, major diagnostic exams,and follow-up treatment.

• Rates are the same for those 18 to 65 years of age.

CRITICAL CARE PROTECTION• Pays $7,500 upon diagnosis of a specified health event,

which increases to $10,000 for dependent children.• Pays benefits for hospital confinement, continuing care,

transportation and lodging.• Is guaranteed-renewable for your lifetime.• Has no deductions, co-payments or network restrictions.Events include: heart attack, stroke, coronary artery bypass surgery, major organ transplant, and more. Refer to the policy brochures for benefit details, definitions, limitations and exclusions.

Age 18-35 36-45 46-55 56-70

EE Only $ 5.94 $10.02 $13.86 $18.24

EE+ Spouse/DP $ 6.54 $10.38 $14.22 $18.72

EE + EE Children $ 9.42 $16.50 $23.88 $33.54

EE + Spouse/DP + $10.50 $17.88 $25.56 $35.52EE/DP Children

Critical Care and ProtectionEE = Employee DP = Domestic Partner

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

21

VOLUNTARY BENEFITS(continued)

Have You Ever?• Needed your will prepared or updated• Been overcharged for a repair or paid an unfair bill • Had trouble with a warranty or defective product• Signed a contract • Received a moving traffic violation • Had concerns regarding child support

• Limited Benefit Disability Income Protection Insurance• It’s sold on an individual Basis. You choose the plan that’s

best for you based on your financial needs and income.• Aflac offers the option of guarantee issue short-term

disability• Aflac pays you a cash benefit for each day you are disabled• Aflac does not coordinate benefits, regardless of any other

insurance you might have

AFLAC SHORT-TERM DISABILITY INSURANCE

LEGALSHIELD A&J ASSOCIATES

• Monthly benefit is subject to income• Benefit period 3 or 6 months• Elimination period: 0/7, 0/14, 7/7The Elimination Period is the period of time between the onset of disability and the time you are eligible for the benefits to be paid. Example: 0/7 – payment for injury starts the first date of injury/payment for sickness has a 7 day waiting period.

WHAT IS LEGALSHIELD?Founded in 1972, LegalShield has over 1.5 million memberships protecting and empowering over 4 million lives and serving over 139,000 businesses throughout the United States and Canada. Our members can talk to a lawyer on any personal legal matter, no matter how trivial or traumatic, all without worrying about high hourly costs.

ADVICE ON ANY LEGAL ISSUEWith a LegalShield Legal Plan you will have access to attorneys who can provide advice or assistance on a variety of personal legal issues.

ELECTION OPTIONS Individual Coverage is 26 payments of $7.82per pay period Family Coverage is 26 payments of $8.75 THE LEGALSHIELD MEMBERSHIP INCLUDES:• Personal legal advice on unlimited issues• Letters/phone calls made on your behalf• Contracts and documents reviewed (up to 10 pages)• Residential loan documents assistance• Lawyers prepare your will, your living will and Health Care

Power of Attorney• Moving traffic violations (available 15 days after enrollment)• IRS audit assistance• Trial defense of named defendant/respondent in a covered

civil action suite

• Worried about being a victim of identity theft• Been concerned about your child’s identity• Lost your wallet• Worried about entering personal information on-line• Feared the security of your medical information • Been pursued by a collection agency

• Uncontested divorce, separation, adoption, representation and/or name change (available 90 days after enrollment)

• 25% Preferred Member Discount (bankruptcy, criminal charges, DUI, other matters, etc)

• 24/7 Emergency access for covered situations• The LegalShield benefit is “portable”. You can retain the

membership at the group discounted rate if no longer with your employer.

LegalShield legal plans cover the member; member’s spouse, never married dependent children under 26 living at home, dependent children under age 18 for whom the member is legal guardian, never married dependent children up to age 26 if full-time student, and physically or mentally disabled dependent children. An individual rate is available for those enrollees who are not married, do not have a domestic partner and do not have minor children or dependents. No family benefits are available to individual plan members.

Aflac insurance policies are underwritten by American Family Life Assurance Company of Columbus. Accident Policies: A36100TX-A36400TX. Cancer: Policies A78100TX - A78400TX. Critical Care: Policies A74100-A7300TX. Short-Term Disability Policy: A57600LBTX. Form Z171157

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

22

VOLUNTARY BENEFITS(continued)

A voluntary permanent life insurance policy available to you, your spouse/domestic partner, your children and grandchildren. An ideal complement to the term life insurance offered at the Airport, with the convenience of payroll deduction.

Keep the policy even when you retire or change jobs as long as you pay the premiums to keep the policy in force.

Premiums are based on the amount of coverage you select and your age as of the policy’s issue date. If a higher premium is required to keep the policy in force, you can either pay the higher premium or surrender the policy for a refund of ten years’ premium (certian conditions apply).

DEPENDENT PERMANENT LIFE INSURANCE• Apply for an individual permanent policy onyour spouse/domestic partner

(age 17 to 60), your children/domestic partner’s children (ages 15 days to 26 years), and your grandchildren (ages 15 days to 18 years) even if you do not purchase coverage for yourself. Dependent children ages 19 to 26 must be single, full-time students.

• Same features as employee permanent life insurance described above.

TEXAS LIFE INSURANCE COMPANY

BEYOND YOUR LEGALSHIELD MEMBERSHIP Save With These Incredible MEMBERPERKSYour LegalShield Benefit is simply amazing. And, in addition to the privileges that are already yours, we have added these MEMBERPERKS with hundreds of merchants and thousands of discounts. Members can access savings at both national and local companies on everyday purchases such as tickets, electronics, apparel, travel and more. Members have the opportunity to save, on average, over $2,000 per year. MEMBERPERKS comes with your Benefit. They can save you enough to pay for your membership for years to come!

OPTIONAL CHILD TERM RIDER• If you prefer not to purchase individual policies for your children and are age 59 or younger, for an additional cost, you can

apply for a child term life insurance rider for $10,000.• This rider insures all children (including children of your domestic partner), stepchildren, and adopted children ages

15 days to 18 years for one premium.• The premium does not increase as children age. Coverage terminates on each child either when the child reaches

age 25 or when you reach age 65, whichever occurs first.• Children born or adopted after the policy is issued are automatically covered at age 15 days. Coverage is one-half the face

amount from age 15 days to one year.• Child term riders are guaranteed issue.

EXPRESS ISSUE UNDERWRITING• You may qualify by answering three medical questions — no medical exams.

LEGALSHIELD APP - Worry less and live more on the GO This is a FREE App that comes with your membership. Now you can enjoy all the benefits of LegalShield on your phone. • Tap the App to call your Law Provider Firm• Tap the App to get Membership ID• Tap the App for 24/7 Access to Law Firm• Tap the App to call Member ServicesPlus many more benefit features and access to plan information and FAQsDownload from App Store (Apple)Get it on Google Play (Android)

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

1 day of pay

1 day of pay

1 day of pay

Our LiveWell Center provides the use of its facility and equipment to all employees, spouses/domestic partners, and dependents over age 18, at no cost. Recent upgrades enhance the experience with new equipment, towels, paint and improved ventilation. Onsite fitness specialists provide a range of assistance to employees who use the LiveWell Center, including one-on-one fitness guidance and counseling, correct weightlifting form and nutrition advice. Group fitness classes range from CrossFit to yoga.

To join the LiveWell Center, prospective members may stop by the LiveWell Center to receive an orientation and complete an application for membership.

The LiveWell Health Clinic provides an opportunity to complete the continuum of health care for employees. The clinic is convenient and allows for the benefit of onsite private and quality health care. All services are provided at no cost to all DFW Airport employees. Services offered mirror those of a general health care provider including preventive health screens, general examinations, urgent care, immunizations and seasonal flu shots and lab draws. Coaching and disease management services are available to address health conditions such as hypertension, diabetes and obesity.

Appointments may be scheduled with the clinic via phone reservation or by visiting the LiveWell page on Connected Online.

23

DFW LIVEWELL PROGRAM

DFW cares about the health and wellness of all employees and their families. That’s why DFW continues to invest in our award-winning health and wellness program, LiveWell. The program is your gateway to a host of resources and activities to help you, and your family, embrace a healthy lifestyle and make informed decisions about your total well-being.

LIVEWELL CENTER LIVEWELL CENTER

LIVEWELL HEALTH CLINIC

2018 WELLNESS INCENTIVE PROGRAM

ASSESSMENTS

EDUCATION AND AWARENESS

LIFESTYLE AND BEHAVIORAL

• Take the Health Risk Assessment (HRA).• Get a physical exam and a dental or vision exam.

• Complete 6 educational training credits via Lunch and Learns, the Learning Hub or attend a Blue Zones Purpose Workshop.

- The Purpose Workshop is worth 6 educational traning credits.

• Take the annual Blue Zones Personal Pledge.

• Complete 48 LiveWell Center Visits.- Visits must last at least 30 minutes. Visits can be substituted for fitness tracker data submissions.

• Complete one Challenge or complete 12 additional LiveWell Visits.

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

24

LIVEWELL PROGRAM INTEGRATION REWARDS HEALTHY LIFESTYLE

Embracing a healthy lifestyle has never been more important. DFW Airport supports this concept with the continual integration of the LiveWell program in our health and benefits plans. For 2018 medical enrollment, a surcharge of $75 per month ($34.62 per pay period) will apply to employees who did not earn at least one LiveWell apple.

DFW LIVEWELL PROGRAM(continued)

BLUE ZONES PROJECT

EMPLOYEE ASSISTANCE PROGRAM

We all need help every now and then. Problems are just a part of everyday life. In addition to the other benefits provided by DFW Airport that are explained in this Guide, you and your household members also have access to the Deer Oaks Employee Assistance Program (EAP) to help with the everyday challenges of life that may affect your health, family life and desire to excel at work.

At no cost to you, our EAP provides you and the members of your household with up to 5 consultations with a licensed clinician per incident, per individual, per calendar year. You also receive one 30-minute consultation with an attorney in the Deer Oaks network and a discounted rate for additional legal services.

All providers are licensed in their respective fields. You get to choose from Deer Oaks’ extensive network of providers. Your EAP can offer assistance with services such as counseling for:• Marriage, relationship and family problems• Problems at work• Changes in mood• Stress and anxiety• Alcohol and drug dependency • Identity theft• Health and wellness concerns

In addition, employees can take advantage of:• Legal and financial services• Free and simple will preparation and revisions• Credit monitoring• Savings Center which offers discounts on brand

name items• Reimbursed Cab, Uber or Lyft fare (one per year).

LiveWell uses an integrated approach to wellness through health assessments, education and awareness, lifestyle and behavioral changes and the Blue Zones Project philosophy. This philosophy holds that the world’s longest-lived people live in surroundings that make healthy choices easier. In 2017, DFW became the first airport to achieve Blue Zones Project Approved Worksite status. In order to achieve this designation, the Airport worked to integrate Blue Zones Project practices into the LiveWell program and further create a culture of wellness.

Employees are invited to take the Blue Zones Personal Pledge to learn the wisdom of the people who live the longest. Residents of the Blue Zones have nine commonalities – the Power 9 - that lead to longer, healthier, happier lives.

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

25

EMPLOYEE CONTRIBUTIONS - CORE PLANS

EE = EmployeeDP = Domestic Partner

DFW PAYS PER MONTH

EMPLOYEE PAYS PER MONTH

YOUR PER PAY PERIOD DEDUCTION

M E D I C A L P L A N S

BCBSTX HCA

EE Only $ 586.23 $ 69.33 $ 32.00

EE + EE Children $1,244.53 $ 132.17 $ 61.00

EE + Spouse/DP $1,467.70 $ 164.67 $ 76.00

EE + Spouse/DP + EE/DP Children $2,136.87 $223.17 $103.00

BCBSTX EPO

EE Only $ 648.33 $164.67 $ 76.00

EE + EE Children $1,371.46 $335.83 $155.00

EE + Spouse/DP $1,633.28 $407.33 $188.00


BCBSTX PPO

EE Only $ 925.12 $242.67 $112.00

EE + EE Children $1,886.12 $496.17 $229.00

EE + Spouse/DP $2,272.60 $600.17 $277.00


D E N TA L P L A N S

Cigna DHMO

EE Only $ 1.15 $ 10.42 $ 4.81

EE + EE Children $ 2.19 $ 19.70 $ 9.09

EE + Spouse/DP $ 2.04 $ 18.44 $ 8.51

EE + Spouse/DP + EE/DP Children $ 2.84 $ 25.59 $ 11.81

Cigna DPPO

EE Only $ 5.35 $ 48.10 $ 22.20

EE + EE Children $ 9.84 $ 88.60 $ 40.89

EE + Spouse/DP $ 9.60 $ 86.43 $ 39.89

EE + Spouse/DP + EE/DP Children $ 13.24 $119.10 $ 54.97

EMPLOYEE AGE AS OF 1/1/2018

MONTHLY RATE PER $1,000 COVERAGE

SUPPLEMENTAL EMPLOYEE TERM LIFE INSURANCE/AD&D*

29 and under $0.075

30-34 $0.085

35-39 $0.095

40-44 $0.115

45-49 $0.175

50-54 $0.265

55-59 $0.465

60-64 $0.555

65-69 $0.695

70-74 $1.275

75+ $1.835

DEPENDENT TERM LIFE INSURANCE - SPOUSE/DOMESTIC PARTNER*29 and under $0.040

30-34 $0.050

35-39 $0.060

40-44 $0.080

45-49 $0.140

50-54 $0.230

55-59 $0.430

60-64 $0.520

65-69 $0.660

70-74 $1.240

75+ $1.800

* Your monthly cost can be calculated by dividing your annual base salary by 1,000 and multiplying by rate based on age: your age is determined as of 1/1/18. Your cost will change within the plan year as your age bracket and/or your salary changes.

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

26

MEDICAL/PHARMACY

BCBSTX Group Nos. : bcbstx.com HCA – 167205BCBSTX Mobile App EPO – 168005Medical/Pharmacy PPO – 167191800-521-2227

HEALTH CARE ADVOCACY

Alight Solutionsalight.com/advocacy866-279-0495

NURSELINE

Nurseline800-581-0393

DENTAL COVERAGECigna Group No. : 3339042 cigna.comDental800-244-6224

VISION

Davis Visiondavisvision.com877-923-2847

FLEXIBLE SPENDING ACCOUNT

ConnectYourCareconnectyourcare.com866-808-1444

LIFE INSURANCE/AD&D COVERAGE

ReliaStar Life Insurance Company(subsidiary of Voya Financial)800-955-7736Policy No. : 689696

DISABILITY COVERAGE

Matrix Absence Managementmatrixabsence.comMatrix eServices Mobile App877-202-0055

EMPLOYEE ASSISTANCE PROGRAM

Deer Oaksdeeroakseap.comLogin: DFWPassword: DFW888-993-7650

SUPPLEMENTAL BENEFITS

Aflacaflac.com/[email protected] (Rosemary Herrera)972-733-3578 (Fax)800-992-3522 (Customer Service)

LEGAL SERVICES

LegalShield - A&J Associateslegalshield.com/info/[email protected] (Jerome Coleman)800-654-7757 (Customer Care)

PERMANENT LIFE INSURANCE

Texas Life Insurance Companytexlife.com/[email protected] (Susan Bulla)

DFW LIVEWELL PROGRAM

LiveWell Center [email protected]

LiveWell Health Clinic [email protected]

CONTACT INFORMATION

EMPLOYEE AGE AS OF 1/1/2018

MONTHLY RATE PER $1,000 COVERAGE

SUPPLEMENTAL EMPLOYEE TERM LIFE INSURANCE/AD&D*

29 and under $0.075

30-34 $0.085

35-39 $0.095

40-44 $0.115

45-49 $0.175

50-54 $0.265

55-59 $0.465

60-64 $0.555

65-69 $0.695

70-74 $1.275

75+ $1.835

DEPENDENT TERM LIFE INSURANCE - SPOUSE/DOMESTIC PARTNER*29 and under $0.040

30-34 $0.050

35-39 $0.060

40-44 $0.080

45-49 $0.140

50-54 $0.230

55-59 $0.430

60-64 $0.520

65-69 $0.660

70-74 $1.240

75+ $1.800

2018 BENEFITS GUIDE

This guide is intended to provide an overview only of certain benefits offered to eligible employees by DFW Airport. Complete details about how the plans work are included in the policies, summaries of benefit coverage, summary plan descriptions, and plan documents, which are available on Connected Online. If there is any discrepancy or conflict between the plan documents and the information presented in this booklet, the plan documents will govern. DFW Airport reserves the right to change or discontinue the plans at any time. Participation in the plans does not constitute an offer of employment, reemployment or an employment contract.

BENEFITS - Dallas Fort Worth International Airport Vision Plan: Davis Vision will be the new vision...

Documents

Transcript of BENEFITS - Dallas Fort Worth International Airport Vision Plan: Davis Vision will be the new vision...