Benefits Guides

Be sure to read this section in entirety to understand changes and action items for this upcoming plan year. Open enrollment is your annual opportunity to review your benefits and decide whether you need to update any of your elections. Any changes made at open enrollment are effective for the entire 2025 benefits plan year. Open Enrollment will be held November 15 th – November 30th . New enrollment or changes to existing enrollment will be effective January 1, 2025. In most cases, once you have made your benefit elections for the plan year, you cannot change them until the next annual open enrollment period, unless you experience a permitted election change event. You must notify your employer within 30 days of the event (60 days in the case of birth or adoption). For more information about making mid-year changes to your benefit elections, please contact Human Resources or refer to the “Important Information” section in your enrollment guide.

All employees must complete their enrollment selections through Paycom. Benefit selections are required whether you are maintaining, adding, or dropping benefits for yourself and/or your dependents. To begin the enrollment process, please visit the benefits section of your Paycom portal. All enrollments must be completed by Saturday, November 30th .

This is your once-a-year opportunity to review your benefits and decide whether to update your elections. Any changes made are effective January 1, 2025 and will remain in place for the entire 2025 benefits plan year. Open Enrollment materials containing information on the benefits available to you and required actions will be distributed soon.

Here are some tips and reminders to help you prepare:

Know the dates.
The open enrollment period is for a specific time frame. Please pay close attention to the dates noted within the Open Enrollment materials.

Consider all cost factors.
You should consider out-of-pocket expenses as you compare plans - deductibles, co-pays, coinsurance, formulary tiers and out-of-pocket maximums.

Know the network.
Evaluate the networks available:

❖ Regence Group Administrators: BlueCard Network
https://wa.accessrga.com/find-a-provider

If you have moved, or plan to move soon, prepare to review your providers for in-network access.

Review coverage details carefully. Keeping the same plan doesn’t mean you shouldn’t review plan details. A new plan year can mean new restrictions, new deductibles, copays and coinsurance or new formulary tiers.

Understand insurer processes. Medical necessity, prior authorization, benefit verification and step therapy are some of the insurer rules that affect what health services are covered and how much you pay.

Gather your dependents demographic information.
If you plan to add a dependent to your plan, be sure to have their full name, date of birth and Social Security Number available.

Medical and Vision employee contributions will remain the same Dental contributions will change slightly for the base plan for those enrolled with children and will increase if electing the new Buy-Up plan.

As a reminder, employee contributions are paid on a pre-tax basis, which reduces taxable income (except for domestic-partner premiums which are taken post-tax).

We offer you and your families a choice to enroll between 5 different medical plans:
$500 Deductible PPO (Plan 1)
$1,000 Deductible PPO (Plan 2)
$1,500 Deductible PPO (Plan 3)
$4,000 Deductible PPO (Plan 4)
$5,000 HDHP plan (Plan 5).

Both plans will renew as-is without any plan design modifications.
Dual Choice Option:
- Base Plan: $130 allowance
- Buy-Up Plan: $200 allowance with LightCare

Dual Choice Option:

Base Plan: current Delta Dental plan without child ortho

Buy-UP Plan: enhanced plan with higher maximum and ortho
- Increased annual benefit maximum to $2,000 per individual
- Ortho for adults and children with a lifetime maximum of $2,000 per individual

Please refer to the Benefit Guide and carrier collateral for details on network, the various programs and support that Delta Dental offers.

Healthcare FSA: Annual maximum election increased to $3,300

Commuter: Monthly maximum contribution increased to $325

Maximum contribution limit increase:

Employee Only coverage increased to $4,300

Employee + Dependent coverage increased to $8,550

As a general rule, once you have made your benefit elections for the plan year, they must remain in place and cannot be changed or revoked until the next annual open enrollment period, unless you experience a permitted election change event. These events include, but are not limited to:

• Change in legal marital status (marriage, divorce, annulment)

• Gain or loss of eligibility by one of your dependents

• Birth, adoption, or placement for adoption

• Loss of other health coverage by employee, spouse, or dependent(s)

• Gain or loss of eligibility for the Children’s Health Insurance Program (CHIP)

• Enrollment in or loss of eligibility for Medicare and Medicaid

• Employee or dependent change in employment affecting eligibility

• Enrollment in Marketplace Exchange coverage

• Enrollment required by judgment, decree or court order

• Change in coverage under another employer health plan

Any change must be on account of and consistent with the change in election event. If you experience an event that allows you to make changes to your benefit elections, you must notify Human Resources within 30 days (60 days for events related to Medicaid or CHIP). You may need to provide proof of the change, such as a marriage or birth certificate. For more information regarding permitted mid-year election changes, please contact Human Resources.

Access your EAP
Visit: rsli.acieap.com
Call: 1-855-775-4357
Email: rsli@acieap.com
Company Code: RSLI859

We offer you and your eligible family members an Employee Assistance Program (EAP) through Reliance Standard. The EAP provides confidential, immediate, professional assistance with any issues that create stress or anxiety in your life. Counselors are available by phone 24 hours a day, 7 days a week. In addition, the EAP pro- vides up to 3 face-to-face counseling sessions per concern. There is no cost to you for this benefit.

The EAP provides short-term counseling and referrals to help you deal with a variety of issues that can affect you at home or at work, such as:

» Daily living

» Managing stress and anxiety

» Depression

» Parenting

» Alcohol or substance use disorders

» Coping with grief and loss

» Legal assistance

» Debt management and budgeting

» Elder care options

With this Employee Assistance Program (EAP), you have access 24/7 online or

over the phone counselors trained to guide you through a variety of life’s everyday challenges. You also have access to up to three face-to-face sessions with a counselor, per household, per calendar year.

Benefit Advocates in the AssuredPartners Employee Service Center can assist with benefit questions and claim issues for you and your covered family members. They are specially trained individuals who can help answer your insurance questions.

This is a service provided at no cost to you. All personal health information is confidential.

mcm.esc@assuredpartners.com

Contacts

1-888-343-3330 | TTY/TDD: 1-855-877-4726

Access your digital ID cards for yourself and any dependents through the carrier’s mobile apps. You can download the card images to save, share, print or email directly to your dependents and/or providers.

The Reliance Matrix Travel Assistance Program is available to you and your family when you are traveling for business or pleasure, in a foreign country, or 100 miles or more away from home. The service provides assistance to you in the event of a medical emergency, including: emergency medical evacuation, prescription replacement assistance, multilingual crisis management professionals, and care and transport of unattended minor children.

Travel Assistance can help you with unexpected bumps in the road anywhere in the world. It is available to you, your spouse and dependent children on any single trip more than 100 miles from home. This benefit can assist you with translation and interpreter services, lost baggage, document replacement, and much more. Inside the US call 1.800.456.3893 or outside the US call 603.328.1966.

Deductible
The amount you owe for health care services, before insurance begins to pay coinsurance. For example, if your deductible is $1,000, your plan won’t pay for certain services until you’ve met your $1,000 deductible. The deductible does not apply to all services. See your plan summary for more details.

Coinsurance
Your share of the costs of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service. You pay coinsurance after you meet the deductible for your plan. For example, if the health plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your coinsurance payment of 20% would be $20. The health plan pays the rest of the allowed amount.

Out-of-Pocket
Maximum The most you pay during a calendar year for in-network covered services. Once you’ve met your calendar year out-of-pocket maximum, your health plan begins to pay 100% of the allowed amount for in-network covered services for the remainder of that calendar year. Office visit copays, prescription drug copays, deductibles, and coinsurance all accrue towards your out-of-pocket maximum.

Allowed Amount
Maximum amount on which payment is based for covered health care services. This may be called “eligible allowance” or “negotiated rate.” If your out-of-network provider charges more than the allowed amount, you may have to pay the difference. The following examples are for illustrative purposes only.* Deductible The amount you owe for health care services, before insurance begins to pay coinsurance. For example, if your deductible is $1,000, your plan won’t pay for certain services until you’ve met your $1,000 deductible. The deductible does not apply to all services. See your plan summary for more details. Coinsurance Your share of the costs of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service. You pay coinsurance after you meet the deductible for your plan. For example, if the health plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your coinsurance payment of 20% would be $20. The health plan pays the rest of the allowed amount. Out-of-Pocket Maximum The most you pay during a calendar year for in-network covered services. Once you’ve met your calendar year out-of-pocket maximum, your health plan begins to pay 100% of the allowed amount for in-network covered services for the remainder of that calendar year. Office visit copays, prescription drug copays, deductibles, and coinsurance all accrue towards your out-of-pocket maximum.

Balance Billing
When an out-of-network provider bills you for the difference between the provider’s charge and the allowed amount. For example, if the provider’s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30. An in-network provider may not balance bill you for covered services.

Copay
A fixed amount (for example, $25) you pay for a covered health care service, usually at the time of care. The amount can vary by the type of covered health care service.

In-Network
The facilities, providers, and suppliers with whom your health plan has contracted.