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Benefits at a Glance

LCISD is committed to recruiting and maintaining the best employees and believes that quality employee health benefits are an important part of reaching that goal. LCISD strives to maintain competitive and cost-effective benefits with insurance options to best meet your individual and family needs.

The Employee Benefits Department is here to assist you with any questions you may have regarding the various benefit programs available. We also strive to make available cost effective options so that the District can maintain an excellent and competitive benefit package.

If you have questions on insurance benefit options, we are just a phone call away. Or if you prefer, you can visit us in person at our office located at 3911 Ave I, Rosenberg, Texas 77471.

Office of Employee Benefits

3911 Avenue I
Rosenberg, TX 77471
Fax: 832.223.0312

Employee Benefits Specialist
Erica Montalvo
832.223.0315

Employee Benefits Specialist
Cheryl Koteras
832.223.0313

Employee Benefits Specialist
Yosa Hernandez
832.223.0375

Employee Relations Specialist
Dawn Rice
832.223.0311


Director of Employee Services and Benefits

Trudy Harris
832.223.0307

For additional information regarding United Healthcare, Memorial Hermann, Kelsey Seybold please click on Benefit Tools.

2024-25 Benefits Plan

EPO (Choice) Memorial Hermann (NexusACO OA) Kelsey‐Seybold (Charter/Charter Balanced)
Plan A Plan B Plan HDHP Plan A Plan B Plan A Plan B
Office Copay
Preventative Care $0 $0 $0 $0 $0 $0 $0
Primary Care Physician - Tier 1 $30 $30 D&C $20 $20 $20 $20
Primary Care Physician - Tier 2 $50 $50 D&C $30 $30 N/A N/A
Specialist - Tier 1 $50 $50 D&C $40 $40 $40 $40
Specialist - Tier 2 $100 $100 D&C $80 $80 $0 $0
Virtual Vists $0 $0 D&C $0 $0 $0 $0
Other Copays
Hospital In Patient $750 $750 D&C N/A / $750 N/A / $750 N/A N/A
Emergency Room $500 $500 D&C $500 $500 $500 $500
Urgent Care $25 $25 D&C $25 $25 $25 $25
Deductible
Per Person $4,000 $2,000 $4,500 $3,150 $1,150 $2,150 $1,150
Max Family Deductible $12,000 $6,000 $9,000 $9,450 $3,450 $6,450 $3,450
Maximum Out of Pocket*
Co-Insurance 10% 40% 0% 0% 30% 0% 30%
Per Person $8,000 $8,000 $4,500 $6,000 $6,000 $6,000 $6,000
Family Maximum $16,000 $16,000 $9,000 $12,000 $12,000 $12,000 $12,000
Pharmacy
Deductible per person $150 $150 D&C $100 $100 $100 $100
Family Deductible (up to 3 persons) $450 $450 D&C $300 $300 $300 $300
Tier 1 $15 $15 D&C $10 $15 $10 $15
Tier 2 $60 $60 D&C $30 $35 $30 $35
Tier 2- Specialty 30% 30% D&C 20% 20% 20% 20%
Tier 3 $90 $90 D&C $60 $70 $60 $70
Tier 3- Specialty 40% 40% D&C 25% 25% 25% 25%
Rates Per Pay Period (24)
Employee Only $73.62 $103.67 $12.50 $51.86 $73.03 $51.86 $73.03
Employee + Spouse $406.02 $543.62
 $221.94 $286.04 $382.98 $286.04 $382.98
Employee + Children $337.02 $436.83 $181.19 $237.42 $307.75 $237.42 $307.75
Employee + Family $487.86 $706.74 $274.35 $343.69 $458.37 $343.69 $458.37

* Out of Pocket Maximums include all Deductible, Co-Insurance, Medical Copays and Pharmacy Copays

Plan HDHP ~ District Contribution to individual Health Savings Accounts of up to $500 within the plan year to help cover Deductible and Coinsurance (D&C)

2023-24 Benefits Plan

EPO (Choice) Memorial Hermann (NexusACO OA) Kelsey‐Seybold (Charter/Charter Balanced)
Plan A Plan B Plan HDHP Plan A Plan B Plan A Plan B
Office Copay
Preventative Care $0 $0 $0 $0 $0 $0 $0
Primary Care Physician - Tier 1 $30 $30 D&C $20 $20 $20 $20
Primary Care Physician - Tier 2 $50 $50 D&C $30 $30 N/A N/A
Specialist - Tier 1 $50 $50 D&C $40 $40 $40 $40
Specialist - Tier 2 $100 $100 D&C $80 $80 $0 $0
Virtual Vists $0 $0 D&C $0 $0 $0 $0
Other Copays
Hospital In Patient $750 $750 D&C N/A / $750 N/A / $750 N/A N/A
Emergency Room $500 $500 D&C $500 $500 $500 $500
Urgent Care $25 $25 D&C $25 $25 $25 $25
Deductible
Per Person $4,000 $2,000 $4,500 $3,150 $1,150 $3,150 $1,150
Max Family Deductible $12,000 $6,000 $9,000 $9,450 $3,450 $9,450 $3,450
Maximum Out of Pocket*
Co-Insurance 10% 40% 0% 0% 30% 0% 30%
Per Person $8,000 $8,000 $4,500 $6,000 $6,000 $6,000 $6,000
Family Maximum $16,000 $16,000 $9,000 $12,000 $12,000 $12,000 $12,000
Pharmacy
Deductible per person $150 $150 D&C $100 $100 $100 $100
Family Deductible (up to 3 persons) $450 $450 D&C $300 $300 $300 $300
Tier 1 $15 $15 D&C $10 $15 $10 $15
Tier 2 $60 $60 D&C $30 $35 $30 $35
Tier 2- Specialty 30% 30% D&C 20% 20% 20% 20%
Tier 3 $90 $90 D&C $60 $70 $60 $70
Tier 3- Specialty 40% 40% D&C 25% 25% 25% 25%
Rates Per Pay Period (24)
Employee Only $73.62 $103.67 $12.50 $51.86 $73.03 $51.86 $73.03
Employee + Spouse $406.02 $543.62
 $221.94 $286.04 $382.98 $286.04 $382.98
Employee + Children $337.02 $436.83 $181.19 $237.42 $307.75 $237.42 $307.75
Employee + Family $487.86 $706.74 $274.35 $343.69 $458.37 $343.69 $458.37

* Out of Pocket Maximums include all Deductible, Co-Insurance, Medical Copays and Pharmacy Copays

Plan HDHP ~ District Contribution to individual Health Savings Accounts of up to $500 within the plan year to help cover Deductible and Coinsurance (D&C)

To comply with the Transparency in Coverage Rule, as a self-funded customer, you must post UnitedHealthcare’s transparency-in-coverage.uhc.com link on your own publicly available website. We are providing this live link now so you can make preparations to have the link posted by July 1, 2022. Please remember that the machine-readable files themselves will not be available until July 1.

No coverage for specialty prescriptions dispensed through Optum by mail. Must be obtained through specialty retail program.

  • Dental Insurance
  • Disability Insurance
  • Vision Insurance
  • Term Life Insurance
  • Whole Life Insurance
  • Long Term Care
  • Cancer Insurance
  • Heart & Stroke Insurance
  • Critical Illness
  • Hospital Gap Plan
  • Sick Leave Bank
  • Cafeteria Plan (includes medical reimbursement and dependent care)
  • 403(B) and 457 retirement plans
  • Medical Flex Spending Accounts
Information on Elective Benefits

Wellness Benefit Claim Forms

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