2022-23 ESC Region 10 Benefit Guide

ESC REGION 10 BENEFIT GUIDE EFFECTIVE: 09/01/2022 8/31/2023 www.mybenefitshub.com/escregion10 2022 - 2023 PlanYear 1

Table of Contents FLIP TO... How to Enroll 4-5 Annual Benefit Enrollment 6-11 1. Benefit Updates 6 2. Section 125 Cafeteria Plan Guidelines 7 3. Annual Enrollment 8 4. Eligibility Requirements 9 5. Helpful Definitions 10 6. Health Savings Account (HSA) vs. Flexible Spending Account (FSA) 11 Medical 12-18 Hospital Indemnity 19-20 Health Savings Account (HSA) 21 Dental 22-23 Vision 24-25 Telehealth 26 Disability 27-28 Cancer 29 Accident 30 Critical Illness 31-32 Life and AD&D 33-34 Individual Life 35-36 Identity Theft 37 Legal Services 38 Emergency Medical Transportation 39 Flexible Spending Account (FSA) 40 41 HOW TO ENROLLPG. 4 SUMMARYPAGESPG. 6 BENEFITSYOURPG. 12 2

ESC REGION 10 BENEFITS TRS ACTIVECARE MEDICAL TRS HMO MEDICAL Financial Benefit Services (800) 583 www.mybenefitshub.com/escregion106908 (866)BCBSTX355 www.bcbstx.com/trsactivecare5999 Scott & White HMO (844) 633 www.trs.swhp.org5325 HOSPITAL INDEMNITY HEALTH SAVINGS ACCOUNT (HSA) DENTAL The www.thehartford.com(866)GroupHartford#VHI8854845474205 (817)EECU 882 www.eecu.org0800 Lincoln Financial Group Group #00001D040849 (800) 423 www.lfg.com2765 VISION TELEHEALTH DISABILITY www.eyemedvisioncare.com(866)GroupEyeMed#10069688040982 (888)MDLIVE365 www.mdlive.com/fbsbh1663 The www.thehartford.com(866)GroupHartford#8854845479124 CANCER ACCIDENT CRITICAL ILLNESS American Public Life Group #22094 (800) 256 www.ampublic.com8606 Lincoln Financial Group Group #REGIONTN (800) 423 www.lfg.com2765 GroupUNUM#473108 001 (800) 635 www.unum.com5597 LIFE AND AD&D INDIVIDUAL LIFE IDENTITY THEFT The www.thehartford.com(800)Hartford5232233 (866)5Star 863 www.5starlifeinsurance.com9753 (855)iLOCK360287 www.ilock360.com8888 LEGAL SERVICES EMERGENCY TRANSPORTATIONMEDICAL FLEXIBLE SPENDING ACCOUNT (FSA) (888)LegalEase416 4313 www.legaleaseplan.com (800)MASA423 3226 www.masamts.com (866)Higginbotham4193519 www.higginbotham.com EMPLOYEE ASSISTANCE PROGRAM (EAP) The www.thehartford.com/employeebenefits(800)Hartford9643577 Benefit Contact Information 3

Employee benefits made easy through the FBS Benefits App! AllYour BenefitsOne App OR SCAN Text “FBS ESC10” to (800) 583-6908 App Group #: FBSESC10 Text “FBS ESC10” to (800) 583-6908 and get access to everything you need to complete your benefits enrollment: • Benefit Resources • Online Enrollment • Interactive Tools • And more! 4

1 www.mybenefitshub.com/escregion10 How to Log In 2 CLICK LOGIN 3 ENTER USERNAME & PASSWORD Your Username Is: Your email in THEbenefitsHUB. (Typically your work email) Your Password Is: Four (4) digits of your birth year followed by the last four (4) digits of your Social Security Number If you have previously logged in, you will use the password that you created, NOT the password format listed above. 5

LIFE INSURANCE

from your home,

kids playing sports, are you a weekend warrior, or

AC HD You must meet the deductible before the plan will pay for non preventive services. Includes nationwide network and out of network coverage. $42 Teladoc Virtual Health (was $30) and $0 RediMD Virtual Health visits. The out of pocket in network amount increased by $50 for individual and $100 for family.

directly to you. FSA PLAN ADMINISTRATION NOW WITH HIGGINBOTHAM Higginbotham will manage the Section 125 Flexible Spending Plan, effective 9 1 2022. This means that NBS will no longer manage the FSA Medical and Dependent Care reimbursements. If you enroll in the HealthCare FSA plan, you will receive a new debit card from Higginbotham. Please be looking for those to arrive in the mail, within the first three weeks in September. To enroll in the online portal, go to: www.flexservices.higginbotham.net • Addiction • Bipolar Disorder • Child/Adolescent Issues • Depression • Eating Disorders • Grief and Loss • Life Changes • Panic Disorders • Parenting Issues • Postpartum Depression • Relationship Issues • Stress • PTSD • And more 6

ACTIVECARE KEY

AC Primary This plan has the lowest premiums, $30 copays for primary care visits; $70 for specialist. There is no out of network coverage. $12 Teladoc (change from $0) and $0 RediMD Virtual Health visits. New Specialty Drug program through PrudentRx.

Benefit Updates What’s New: Don’t Forget! • Enrollment assistance is available by calling Financial Benefit Services at 866 914 5202 to speak to an enrollment representative Monday Friday, 8 AM 6 PM. Bilingual assistance is available. • Update your profile information: home address, phone numbers, email. • IMPORTANT!! Due to the Affordable Care Act (ACA) reporting requirements, please add your dependent’s social security numbers in the online enrollment system. If you have questions, please contact your Benefits Administrator. SUMMARY PAGESAnnual Benefit Enrollment

for medical

are

the go. Behavioral Health can help address: ACCIDENT Do you

NEW UNLIMITED BEHAVIORAL HEALTH! With MDLIVE, you can visit with a counselor or psychiatrist

AC 2 Remains closed to new enrollees. Central and North Texas Scott & White Care Plan Premiums have decreased. Individual and family deductible has increased to $1,900/$4,750. Out of Pocket maximums have increased for individual and family to $8,000/$15,000. Copay for Primary Care visits have decreased to $15 and Urgent Care copays have decreased to $45.

AC Primary+ This plan has lower deductibles and copays for many services and drugs. There is no out of network coverage. $12 Teladoc (change from $0) and $0 RediMD Virtual Health visits. New Specialty Drug program through PrudentRx.

Accident plans are

accidents and

Group term life is the most inexpensive way to purchase life insurance. You have the freedom to select an amount of life insurance coverage you need to help protect the well being of your Guaranteefamily.Issue for Group Term Life True Guarantee Issue amount for employees up to $200,000 with no health questions. You may also elect to cover your Spouses and Dependents up to their corresponding Guaranty Issue with no health questions. Beneficiaries are required to avoid funds being assigned to your Estate. 24/7 office or on have maybe accident prone? designed to help pay costs associated with benefits paid

TRS PLAN CHANGES

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Gain or loss of Medicare/Medicaid coverage may trigger a permitted election change.

(CIS):STATUS QUALIFYING

Change in Number of Tax Dependents

Gain/Loss

Changes in benefit elections can occur only if you experience a qualifying event. You must present proof of a qualifying event to your Benefit Office within 31 days of your qualifying event and meet with your Benefit/HR Office to complete and sign the necessary paperwork in order to make a benefit election change. Benefit changes must be consistent with the qualifying event. IN EVENTS

Enrollment is automatic unless you decline this benefit. Elections made during annual enrollment will become effective on the plan effective date and will remain in effect during the entire plan year.

An event that causes an employee's dependent to satisfy or cease to satisfy coverage requirements under an employer's plan may include change in age, student, marital, employment or tax dependent status.

Marital Status

Section 125 Cafeteria Plan Guidelines SUMMARY PAGESAnnual Benefit Enrollment CHANGES

A change in marital status includes marriage, death of a spouse, divorce or annulment (legal separation is not recognized in all states).

Change in Status of Employment Affecting Coverage Eligibility

If a judgment, decree, or order from a divorce, annulment or change in legal custody requires that you provide accident or health coverage for your dependent child (including a foster child who is your dependent), you may change your election to provide coverage for the dependent child. If the order requires that another individual (including your spouse and former spouse) covers the dependent child and provides coverage under that individual's plan, you may change your election to revoke coverage only for that dependent child and only if the other individual actually provides the coverage.

Change in employment status of the employee, or a spouse or dependent of the employee, that affects the individual's eligibility under an employer's plan includes commencement or termination of employment.

A Cafeteria plan enables you to save money by using pre tax dollars to pay for eligible group insurance premiums sponsored and offered by your employer.

Eligibility for Government Programs

Judgment/Decree/Order

A change in number of dependents includes the following: birth, adoption and placement for adoption. You can add existing dependents not previously enrolled whenever a dependent gains eligibility as a result of a valid change in status event.

EligibilityDependents'ofStatus

All new hire enrollment elections must be completed in the online enrollment system within the first 31 days of benefit eligible employment. Failure to complete elections during this timeframe will result in the forfeiture of coverage.

SUMMARY PAGESAnnual Benefit Enrollment 8

Annual Enrollment

During your annual enrollment period, you have the opportunity to review, change or continue benefit elections each year. Changes are not permitted during the plan year (outside of annual enrollment) unless a Section 125 qualifying event occurs.

Q&A Who do I contact with Questions? For supplemental benefit questions, you can contact your Benefits/HR department or you can call Financial Benefit Services at 866 914 5202 for assistance.

• Employees must review their personal information and verify that dependents they wish to provide coverage for are included in the dependent profile. Additionally, you must notify your employer of any discrepancy in personal and/or benefit information.

Howsection.can I find a Network Provider?

• Employees must confirm on each benefit screen (medical, dental, vision, etc.) that each dependent to be covered is selected in order to be included in the coverage for that particular benefit.

• Changes, additions or drops may be made only during the annual enrollment period without a qualifying event.

Where can I find forms?

For benefit summaries and claim forms, go to your benefit website: www.mybenefitshub.com/ escregion10. Click the benefit plan you need information on (i.e., Dental) and you can find the forms you need under the Benefits and Forms

New Hire Enrollment

For benefit summaries and claim forms, go to the ESC Region 10 benefit www.mybenefitshub.com/escregion10website:. Click on the benefit plan you need information on (i.e., Dental) and you can find provider search links under the Quick Links section. When will I receive ID cards? If the insurance carrier provides ID cards, you can expect to receive those 3 4 weeks after your effective date. For most dental and vision plans, you can login to the carrier website and print a temporary ID card or simply give your provider the insurance company’s phone number and they can call and verify your coverage if you do not have an ID card at that time. If you do not receive your ID card, you can call the carrier’s customer service number to request another card. If the insurance carrier provides ID cards, but there are no changes to the plan, you typically will not receive a new ID card each year.

Benefit Enrollment 9

Dependent Eligibility: You can cover eligible dependent children under a benefit that offers dependent coverage, provided you participate in the same benefit, through the maximum age listed below. Dependents cannot be double covered by married spouses within the district as both employees and dependents.

SUMMARY PAGES

Annual

Employee RequirementsEligibility

Dependent RequirementsEligibility

You acknowledge that you have read the limitations and exclusions that may apply to obtaining spouse and dependent coverage, including limitations and exclusions that may apply to enrollment in Flexible Spending Accounts and Health Savings Accounts as a married couple. You, the enrollee, shall hold harmless, defend, and indemnify Financial Benefit Services, LLC from any and all claims, actions, suits, charges, and judgments whatsoever that arise out of the enrollee's enrollment in spouse and/or dependent coverage, including enrollment in Flexible Spending Accounts and Health Savings Accounts.

If your dependent is disabled, coverage may be able to continue past the maximum age under certain plans. If you have a disabled dependent who is reaching an ineligible age, you must provide a physician’s statement confirming your dependent’s disability. Contact your HR/Benefit Administrator to request a continuation of coverage. PLAN MAXIMUM AGE Medical To age 26 Telehealth To age 26 (PPODental&MAC) To age 26 Vision To age 26 IndemnityHospital To age 26 Cancer To age 26 Life & AD&D To age 26 ID ProtectionTheft To age 26 Critical Illness To age 26 Accident To age 26 Individual Life To age 24 Legal Services To age 26 Emergency TransportationMedical To age 26 Please note, limits and exclusions may apply when obtaining coverage as a married couple or when obtaining coverage for dependents. Potential Spouse Coverage Limitations: When enrolling in coverage, please keep in mind that some benefits may not allow you to cover your spouse as a dependent if your spouse is enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Financial Benefit Services, or contact the insurance carrier for additional information on spouse FSA/HSAeligibility.Limitations:

Coverage Limitations: When enrolling for dependent coverage, please keep in mind that some benefits may not allow you to cover your eligible dependents if they are enrolled for coverage as an employee under the same employer. Review the applicable plan documents, contact Financial Benefit Services, or contact the insurance carrier for additional information on dependent Disclaimer:eligibility.

Supplemental Benefits: Eligible employees must work 18 or more regularly scheduled hours each work week. Eligible employees must be actively at work on the plan effective date for new benefits to be effective, meaning you are physically capable of performing the functions of your job on the first day of work concurrent with the plan effective date. For example, if your 2022 benefits become effective on September 1, 2022, you must be actively at work on September 1, 2022 to be eligible for your new benefits.

Please note, in general, per IRS regulations, married couples may not enroll in both a Flexible Spending Account (FSA) and a Health Savings Account (HSA). If your spouse is covered under an FSA that reimburses for medical expenses then you and your spouse are not HSA eligible, even if you would not use your spouse's FSA to reimburse your expenses. However, there are some exceptions to the general limitation regarding specific types of FSAs. To obtain more information on whether you can enroll in a specific type of FSA or HSA as a married couple, please reach out to the FSA and/or HSA provider prior to enrolling or reach out to your tax advisor for further Potentialguidance.Dependent

In Network Doctors, hospitals, optometrists, dentists and other providers who have contracted with the plan as a network provider. Out of Pocket Maximum

You are performing your regular occupation for the employer on a full time basis, either at one of the employer’s usual places of business or at some location to which the employer’s business requires you to travel If you will not be actively at work beginning 9/1/2022 please notify your benefits administrator. Enrollment

Calendar Year

Annual

After

January 1st through December 31st Co-insurance any applicable deductible, your share of the cost of a covered health care service, calculated as a percentage (for example, 20%) of the allowed amount for the service. Coverage

The most an eligible or insured person can pay in co insurance for covered expenses.

September

Actively at Work

Guaranteed

The amount of coverage you can elect without answering any medical questions or taking a health exam. Guaranteed coverage is only available during initial eligibility period. Actively at work and/or pre existing condition exclusion provisions do apply, as applicable by carrier.

Plan Year 1st through August 31st Pre Existing Conditions Applies to any illness, injury or condition for which the participant has been under the care of a health care provider, taken prescription drugs or is under a health care provider’s orders to take drugs, or received medical care or services (including diagnostic and/or consultation services).

SUMMARY PAGESHelpful Definitions 10

The period during which existing employees are given the opportunity to enroll in or change their current elections. Annual Deductible The amount you pay each plan year before the plan begins to pay covered expenses.

Health Savings Account (HSA) (IRC Sec. 223) Flexible Spending Account (FSA) (IRC Sec. 125) Description Approved by Congress in 2003, HSAs are actual bank accounts in employee’s names that allow employees to save and pay for unreimbursed qualified medical expenses tax free. Allows employees to pay out of pocket expenses for copays, deductibles and certain services not covered by medical plan, tax free. This also allows employees to pay for qualifying dependent care tax free. Employer Eligibility A qualified high deductible health plan. All employers Contribution Source Employee and/or employer Employee and/or employer Account Owner Individual Employer Underlying RequirementInsurance High deductible health plan None Minimum Deductible $1,400 single (2022) $2,800 family (2022) N/A Maximum Contribution $3,650 single (2022) $7,300 family (2022) $2,850 (2022) Permissible Use Of Funds Employees may use funds any way they wish. If used for non qualified medical expenses, subject to current tax rate plus 20% penalty. Reimbursement for qualified medical expenses (as defined in Sec. 213(d) of IRC). Cash Outs of Unused Amounts (if no medical expenses) Permitted, but subject to current tax rate plus 20% penalty (penalty waived after age 65). Not permitted Year-to-year rollover of account balance? Yes, will roll over to use for subsequent year’s health coverage. No. Access to some funds may be extended if your employer’s plan contains a 2 1/2 month grace period or $500 rollover provision. Does the account earn interest? Yes No Portable? Yes, portable year to year and between jobs. No SUMMARY PAGESHSA vs. FSA FLIP TO FOR HSA INFORMATION PG. 21 FLIP TO FOR FSA INFORMATION PG. 40 11

ABOUT MEDICAL Major medical insurance is a type of health care coverage that provides benefits for a broad range of medical expenses that may be incurred either on an inpatient or outpatient basis. For full plan details, please visit your benefit website: www.mybenefitshub.com/escregion10 Medical Insurance TRS EMPLOYEE BENEFITS Monthly Premium District Contribution Employee Cost TRS ActiveCare HD Employee Only $422.00 $422.00 $0.00 Employee & Spouse $1,187.00 $498.20 $688.80 Employee & Child(ren) $757.00 $498.20 $258.80 Employee & Family $1,419.00 $498.20 $920.80 TRS ActiveCare 2 Employee Only $1,013.00 $498.20 $514.80 Employee & Spouse $2,402.00 $498.20 $1,903.80 Employee & Child(ren) $1,507.00 $498.20 $1,008.80 Employee & Family $2,841.00 $498.20 $2,342.80 TRS ActiveCare Primary Employee Only $410.00 $410.00 $0.00 Employee & Spouse $1,157.00 $498.20 $658.80 Employee & Child(ren) $738.00 $498.20 $239.80 Employee & Family $1,384.00 $498.20 $885.80 TRS ActiveCare Primary+ Employee Only $515.00 $498.20 $16.80 Employee & Spouse $1,259.00 $498.20 $760.80 Employee & Child(ren) $829.00 $498.20 $330.80 Employee & Family $1,584.00 $498.20 $1,085.80 Scott and White HMO Employee Only $543.35 $498.20 $45.15 Employee & Spouse $1,364.92 $498.20 $866.72 Employee & Child(ren) $873.57 $498.20 $375.37 Employee & Family $1,570.98 $498.20 $1,072.78 12

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ABOUT HOSPITAL INDEMNITY This is an affordable supplemental plan that pays you should you be in patient hospital confined. This plan complements your health insurance by helping you pay for costs left unpaid by your health insurance. For full plan details, please visit your benefit website: www.mybenefitshub.com/escregion10 Hospital Indemnity The Hartford EMPLOYEE BENEFITS GROUP VOLUNTARY HOSPITAL INDEMNITY INSURANCE BENEFIT HIGHLIGHTS Hospital indemnity (HI) insurance pays a cash benefit if you or an insured dependent (spouse or child) are confined in a hospital for a covered illness or injury. Even with the best primary health insurance plan, out of pocket costs from a hospital stay can add up. The benefits are paid in lump sum amounts to you, and can help offset expenses that primary health insurance doesn’t cover (like deductibles, co insurance amounts or co pays), or benefits can be used for any non medical expenses (like housing costs, groceries, car expenses, etc.). To learn more about Hospital Indemnity insurance, visit thehartford.com/employeebenefits Coverage Information You have a choice of two hospital indemnity plans, which allows you the flexibility to enroll for the coverage that best meets your needs. Benefit amounts are based on the plan in effect for you or an insured dependent at the time the covered event occurs. Unless otherwise noted, the benefit amounts payable under each plan are the same for you and your PLANdependent(s).INFORMATION PLAN 1 PLAN 3 Coverage Type On and off job (24 hour) On and off job (24 hour) Covered Events Illness and injury Illness and injury HSA Compatible Yes Yes BENEFITS PLAN 1 PLAN 3 HOSPITAL CARE First Day Hospital Confinement Up to 1 day per year $1,000 $2,000 Daily Hospital Confinement (Day 2+) Up to 90 days per year $100 $200 Daily ICU Confinement (Day 1+) Up to 30 days per year $150 $250 VALUE ADDED SERVICES PLAN 1 PLAN 3 Ability Assist® EAP4 24/7/365 access to help for financial, legal or emotional issues Included Included HealthChampionSM5 Administrative & clinical support following serious illness or injury Included Included 19

AM I GUARANTEED COVERAGE?

WHEN DOES THIS INSURANCE END?

WHEN CAN I ENROLL?

This insurance is guaranteed issue coverage it is available without having to provide information about your or your family’s health. All you have to do is elect the coverage to become insured.

Premiums will be automatically paid through payroll deduction, as authorized by you during the enrollment process. This ensures you don’t have to worry about writing a check or missing a payment.

Hospital Indemnity The Hartford EMPLOYEE BENEFITS ASKED & ANSWERED IS THIS COVERAGE HSA COMPATIBLE?

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HOW MUCH DOES IT COST AND HOW DO I PAY FOR THIS INSURANCE? are provided above. You have a choice of plan options. You may elect insurance for you only, or for you and your dependent(s), by choosing the applicable coverage tier.

Premiums

You may enroll during any scheduled enrollment period, within 31 days of the date you have a change in family status, or within 31 days of the completion of any eligibility waiting period established by your employer.

WHO IS ELIGIBLE? are eligible for this insurance if you are an active full time employee who works at least 20 hours per week on a regularly scheduled basis. Your spouse and child(ren) are also eligible for coverage. Any child(ren) must be under age 26.

This plan design was designed to be compatible with Health Savings Accounts (HSAs). However, if you have or plan to open an HSA, please consult your tax and legal advisors to determine which supplemental benefits may be purchased by employees with an HSA.

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Yes, you can take this coverage with you. Coverage may be continued for you and your dependent(s) under a group portability policy. Your spouse may also continue insurance in certain circumstances. The specific terms and qualifying events for portability are described in the certificate.

You must be actively at work with your employer on the day your coverage takes effect. Your spouse and child(ren) must be performing normal activities and not be confined (at home or in a hospital/care facility).

CAN I KEEP THIS INSURANCE IF I LEAVE MY EMPLOYER OR AM NO LONGER A MEMBER OF THIS GROUP?

If you (or any dependent(s)) currently participate in a Health Saving Account (HSA) or if you plan to do so in the future, you should be aware that the IRS limits the types of supplemental insurance you may have in addition to a HSA, while still maintaining the tax exempt status of the HSA.

You

WHEN DOES THIS INSURANCE BEGIN?

The initial effective date of this coverage is September 1, 2018. Subject to any eligibility waiting period established by your employer, if you enroll for coverage prior to this date, insurance will become effective on this date. If you enroll for coverage after this date, insurance will become effective in accordance with the terms of the certificate (usually the first day of the month following the date you elect coverage).

This insurance will end when you or your dependents no longer satisfy the applicable eligibility conditions, premium is unpaid, you are no longer actively working, you leave your employer, or the coverage is no longer offered.

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• Online/Mobile: Sign in for 24/7 account access to check your balance, pay bills and more.

A Health Savings Account (HSA) is more than a way to help you and your family cover health care costs it is also a tax exempt tool to supplement your retirement savings and cover health expenses during retirement. An HSA can provide the funds to help pay current health care expenses as well as future health care costs.

Important HSA Information

ABOUT HSA

Contributions to a Health Savings Account can only be used if you are also enrolled in a High Deductible Health Care Plan (HDHP). full plan details, please visit your benefit website:

• You may open an HSA at the financial institution of your choice, but only accounts opened through EECU are eligible for automatic payroll deduction and company contributions.

Opening an HSA If you meet the eligibility requirements, you may open an HSA administered by EECU. You will receive a debit card to manage your HSA account reimbursements. Keep in mind, available funds are limited to the balance in your HSA.

HSA Eligibility

You can use the money in your HSA to pay for qualified medical expenses now or in the future. You can also use HSA funds to pay health care expenses for your dependents, even if they are not covered under your HDHP. Contributions

Your HSA contributions may not exceed the annual maximum amount established by the Internal Revenue Service. The annual contribution maximum for 2022 is based on the coverage option elect: Individual $3,650 Family (filing jointly) $7,300

• You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.

• Stop by: a local EECU financial center for in person assistance; find EECU locations & service hours a www.eecu.org/locations

• Always ask your health care provider to file claims with your medical provider so network discounts can be applied. You can pay the provider with your HSA debit card based on the balance due after discount.

A Health Savings Account (HSA) is a personal savings account where the money can only be used for eligible medical expenses. Unlike a flexible spending account (FSA), the money rolls over year to year however only those funds that have been deposited in your account can be used.

• Call/Text: (817) 882 0800. EECU’s dedicated member service representatives are available to assist you with any questions. Their hours of operation are Monday through Friday from 8:00 a.m. to 7:00 p.m. CT, Saturday 9:00 a.m. 1:00 p.m. CT and closed on Sunday.

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For

EECU EMPLOYEE BENEFITS

•

There is no “use it or lose it” rule you do not lose your money if you do not spend it in the calendar year and there are no vesting requirements or forfeiture provisions. The account automatically rolls over year after year.

You decide whether to use the money in your account to pay for qualified expenses or let it grow for future use. If you are 55 or older, you may make a yearly catch up contribution of up to $1,000 to your HSA. If you turn 55 at any time during the plan year, you are eligible to make the catch up contribution for the entire plan year.

Maximum

www.mybenefitshub.com/escregion10

A type of personal savings account, an HSA is always yours even if you change health plans or jobs. The money in your HSA (including interest and investment earnings) grows tax free and spends tax free if used to pay for qualified medical expenses.

• Not eligible to be claimed as a dependent on someone else’s tax return

• Not enrolled in Medicare or TRICARE

• Not receiving Veterans Administration benefits

•

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How to Use your HSA

Health Savings Account (HSA)

you

• Lost/Stolen Debit Card: Call the 24/7 debit card hotline at (800) 333 9934

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You are eligible to open and contribute to an HSA if you are: Enrolled in an HSA eligible HDHP Not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan Not enrolled in a Health Care Flexible Spending Account, nor should your spouse be contributing towards a Health Care Flexible Spending Account

ABOUT DENTAL Dental insurance is a coverage that helps defray the costs of dental care. It insures against the expense of routine care, dental treatment and Fordisease.fullplan details, please visit your benefit website: www.mybenefitshub.com/escregion10 Dental Insurance Lincoln Financial Group EMPLOYEE BENEFITS Dental DHMO PPO Low MAC Plan PPO High Plan Employee Only $11.57 $32.33 $46.13 Employee and Spouse $22.56 $64.91 $93.64 Employee and Child(ren) $24.41 $58.29 $88.84 Employee and Family $35.28 $83.49 $126.41 The Lincoln Dental Connect® Low MAC Plan Contracting Dentists Non Contracting Dentists Calendar (Annual) Deductible Individual: $50 Family: $150 Waived for: Preventive Individual: $50 Family: $150 Waived for: Preventive Deductibles are combined for basic and major Contracting Dentists’ services. Deductibles are combined for basic and major Non Contracting Dentists’ services. Annual Maximum $1,000 $1,000 Waiting Period There are no benefit waiting periods for any service types Preventive Services Contracting Dentists Non Contracting Dentists Routine oral exams Bitewing X rays Full mouth or panoramic X rays Other dental X rays including periapical films Routine cleanings Fluoride treatments Space maintainers for children Palliative treatment including emergency relief of dental pain Sealants 100% No Deductible 100% No Deductible Basic Services Contracting Dentists Non Contracting Dentists Problem focused exams Injections of antibiotics and other therapeutic medications SimpleFillings Generalextractionsanesthesia and I.V. sedation 70% After Deductible 70% After Deductible Major Services Contracting Dentists Non Contracting Dentists PrefabricatedConsultations stainless steel and resin crowns Surgical extractions Oral Biopsysurgeryandexamination of oral tissue including brush biopsy Prosthetic repair and recommendation services Endodontics including root canal treatment 50% After Deductible 50% After Deductible 22

The Lincoln Dental Connect® PPO High Plan Contracting Dentists Non Contracting Dentists Calendar (Annual) Deductible Individual: $50 Family: $150 Waived for: Preventive Individual: $50 Family: $150 Waived for: Preventive Deductibles are combined for basic and major Contracting Dentists’ services. Deductibles are combined for basic and major Non Contracting Dentists’ services. Annual Maximum $2,000 $2,000 Lifetime Orthodontic Max $1,000 $1,000 Orthodontic Coverage is available for dependent children. Waiting Period There are no benefit waiting periods for any service types Preventive Services Contracting Dentists Non Contracting Dentists Routine oral exams Bitewing X rays Full mouth or panoramic X rays Other dental X rays including periapical films Routine cleanings Fluoride treatments Space maintainers for children Palliative treatment including emergency relief of dental pain Sealants 100% No Deductible 100% No Deductible Basic Services Contracting Dentists Non Contracting Dentists Problem focused exams Injections of antibiotics and other therapeutic medications Fillings Simple extractions General anesthesia and I.V. sedation 80% After Deductible 80% After Deductible Major Services Contracting Dentists Non Contracting Dentists PrefabricatedConsultations stainless steel and resin crowns Surgical extractions Oral Biopsysurgeryandexamination of oral tissue including brush biopsy Prosthetic repair and recementation services Endodontics including root canal treatment 50% After Deductible 50% After Deductible Orthodontics Contracting Dentists Non Contracting Dentists Orthodontic exams X rays AppliancesStudyExtractionsmodels 50% 50% Dental Insurance Lincoln Financial Group EMPLOYEE BENEFITS Contracting Dentists/Non Contracting Dentists: Visit www.LincolnFinancial.com/FindADentist to find a contracting dentist near you. This plan lets you choose any dentist you wish. However, your out of pocket costs are likely to be lower when you choose a contracting dentist. DHMO Plan • You choose your primary care dentist when you enroll. To find a participating dentist, visit http://ldc.lfg.com and select Find a Dentist. (You can also print your dental ID card from this site once your coverage begins.) • This dental plan offers a detailed list of covered procedures, each with a dollar copayment (see the Summary of Benefits for details). You pay for services provided during your visit. • Emergency care away from home is covered up to a set dollar limit. • You can change your primary care dentist at any time by calling the customer service number listed on your dental ID card. A complete Summary of Benefits can be found at www.mybenefitshub.com/escregion10 23

ABOUT VISION Vision insurance provides coverage for routine eye examinations and can help with covering some of the costs for eyeglass frames, lenses or contact lenses. For full plan details, please visit your benefit website: www.mybenefitshub.com/escregion10 Vision Insurance EyeMed EMPLOYEE BENEFITS SUMMARY OF BENEFITS VisionServicesCare In MemberNetworkCost Out of ReimbursementNetwork Exam With Dilation as Necessary $10 Co pay Up to $40 Retinal Imaging Up to $39 N/A Frames $0 Co pay, $130 Allowance, 20% off balance over $130 Up to $91 Standard Plastic Lenses Single Vision $25 Co pay Up to $30 Bifocal $25 Co pay Up to $50 Trifocal $25 Co pay Up to $70 Standard Progressive Lens $90 Co pay Up to $50 Premium Progressive LensΔ $110 Co pay $135 Co pay Tier 1 Tier 2 Tier 3 Tier 4 $110 Co pay $120 Co pay $135 Co pay $90 Co pay, 80% of charge less $120 Allowance Up to $50 Up to $50 Up to $50 Up to $50 Lens Options UV Treatment $15 N/A Tint (Solid and Gradient) $15 N/A Standard Plastic Scratch Coating $15 N/A Standard Polycarbonate Adults $40 N/A Standard Polycarbonate Kids under 19 $40 N/A Standard Anti Reflective Coating $45 N/A Premium Anti Reflective CoatingΔ $57 $68 N/A Tier 1 Tier 2 Tier 3 $57 N/A $68 N/A 80% of charge N/A Photochromic/Transitions Adults $75 N/A Polarized 20% off retail N/A Other Add Ons and Services 20% off retail N/A Vision Employee Only $6.23 Employee and Spouse $15.89 Employee and Child(ren) $15.89 Employee and Family $15.89 24

VisionServicesCare In MemberNetworkCost Out of ReimbursementNetwork Contact Lens Fit and Follow Up (Contact lens fit and follow up visits are available once a comprehensive eye exam has been Standardcompleted)Contact Lens Fit & Follow Up Up to $55 N/A Premium Contact Lens Fit & Follow Up 10% off retail price N/A Contact Lenses (Contact lens allowance includes materials only.) Conventional $0 Co pay, $130 Allowance, 15% off balance over $130 Up to $130 Disposable $0 Co pay, $130 Allowance; plus balance over $130 Up to $130 Medically Necessary $0 Co pay, paid in full Up to $210 Laser Vision Correction LASIK or PRK from U.S. Laser Network 15% off the retail price or 5% off the promotional price N/A ExaminationFrequency Once every 12 months Lenses or Contact Lenses Once every 12 months Frame Once every 24 months Vision Insurance EyeMed EMPLOYEE BENEFITS Additional discounts These discounts are not insured benefits and are for in network providers only Take a sneak peek before enrolling • You’re on the INSIGHT Network • For a complete list of in network providers near you, use our Enhanced Provider Locator on eyemed. com or call 1.866.804.0982 • For LASIK providers, call 1.877.5LASER6. 40% OFF Complete pair of prescription eyeglasses 20% OFF Nonsunglassesprescription 20% OFF Remaining balance beyond plan coverage 25

ABOUT TELEHEALTH Telehealth provides 24/7/365 access to board certified doctors via telephone or video consultations that can diagnose, recommend treatment and prescribe medication. Telehealth makes care more convenient and accessible for non emergency care when your primary care physician is not available. For full plan details, please visit your benefit website: www.mybenefitshub.com/escregion10 Telehealth MDLIVE EMPLOYEE BENEFITS Alongside your medical coverage is access to quality telehealth services through MDLIVE. Connect anytime day or night with a board certified doctor via your mobile device or computer. While MDLIVE does not replace your primary care physician, it is a convenient and cost effective option when you need care and: • Have a non emergency issue and are considering a convenience care clinic, urgent care clinic or emergency room for treatment • Are on a business trip, vacation or away from home • Are unable to see your primary care physician When to Use MDLIVE: At a cost that is the same or less than a visit to your physician, use telehealth services for minor conditions such as: Do not use telemedicine for serious or life threatening emergencies. MDLIVE Behavioral Health: Managing stress or life changes can be overwhelming but it’s easier than ever to get help right in the comfort of your own home. Visit a counselor or psychiatrist by phone, secure video, or MDLIVE App. • Talk to a licensed counselor or psychiatrist from your home, office, or on the go! • Affordable, confidential online therapy for a variety of counseling needs. • The MDLIVE app helps you stay connected with appointment reminders, important notifications and secure messaging. Registration is Easy Register with MDLIVE so you are ready to use this valuable service when and where you need it. Online www.mdlive.com/fbs Phone 888 365 1663 Mobile download the MDLIVE mobile app to your smartphone or mobile device Select “MDLIVE as a benefit” and “FBS” as your Employer/Organization when registering your account. Telehealth Employee and Family Employer Paid • Sore throat • Headache • Stomachache • Cold • Flu • Allergies • Fever • Urinary tract infections 26

For those employees electing an elimination period of 30 days or less, if your are confined to a hospital for 24 hours or more due to a disability, the elimination period will be waived, and benefits will be payable from the first day of hospitalization.

What is Educator Disability Insurance?

Actively at Work: You must be at work with your Employer on your regularly scheduled workday. On that day, you must be performing for wage or profit all of your regular duties in the usual way and for your usual number of hours. If school is not in session due to normal vacation or school break(s), Actively at Work shall mean you are able to report for work with your Employer, performing all of the regular duties of Your Occupation in the usual way for your usual number of hours as if school was in session.

$2.40 $2.67 60/60 $1.55 $1.73 90/90 $1.33 $1.50 180/180 $1.01 $1.12 27

Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. The plan gives you flexibility to be able to choose an amount of coverage and waiting period that suits your needs.

Definition of Disability: Disability is defined as The Hartford’s contract with your employer. Typically, disability means that you cannot perform one or more of the essential duties of your occupation due to injury, sickness, pregnancy or other medical conditions covered by the insurance, and as a result, your current monthly earnings are 80% or less of your pre disability earnings.

EMPLOYEE BENEFITS

ABOUT DISABILITY

Disability Insurance

Disability insurance protects one of your most valuable assets, your paycheck. This insurance will replace a portion of your income in the event that you become physically unable to work due to sickness or injury for an extended period of time.

The Hartford

Educator Disability insurance is a hybrid that combines features of short term and long term disability into one plan.

Elimination Period Select Premium 0/7 $3.20 $3.51 30/30

14/14 $2.77 $3.15

Elimination Period: You must be disabled for at least the number of days indicated by the elimination period that you select before you can receive a Disability benefit payment. The elimination period that you select consists of two numbers. The first number shows the number of days you must be disabled by an accident before your benefits can begin. The second number indicates the number of days you must be disabled by a sickness before your benefits can begin.

Benefit Amount: You may purchase coverage that will pay you a monthly flat dollar benefit in $100 increments between $200 and $8,000 that cannot exceed 66 2/3% of your current monthly earnings. Earnings are defined in The Hartford’s contract with your employer.

Disability per $100 in benefit

For full plan details, please visit your benefit website: www.mybenefitshub.com/escregion10

One you have been disabled for 24 months, you must be prevented from performing one or more essential duties of any occupation, and as a result, your monthly earnings are 66 2/3% or less of your pre disability earnings.

Maximum Benefit Duration: Benefit Duration is the maximum time for which we pay benefits for disability resulting from sickness or injury. Depending on the age at which disability occurs, the maximum duration may vary. Please see the applicable schedules below based on the Premium benefit option.

• Social

The BENEFITS

Premium Option: For the Premium benefit option the table below applies to disabilities resulting from sickness or injury. Select Option: For the Select benefit option the table below applies to disabilities resulting from sickness or injury.

Hartford EMPLOYEE

Pre Existing Condition Limitation: Your policy limits the benefits you can receive for a disability caused by a pre existing condition. In general, if you were diagnosed or received care for a disabling condition within the 3 consecutive months just prior to the effective date of this policy, your benefit payment will be limited, unless: You have not received treatment for the disabling condition within 3 months, while insured under this policy, before the disability begins, or You have been insured under this policy for 12 months before your disability begins. If your disability is a result of a pre existing condition, we will pay benefits for a maximum of 4 weeks.

Benefit Integration: Your benefit may be reduced by other income you receive or are eligible to receive due to your disability, such as: Security you may have your employer fully or partially pays for (such as a pension plan) includes a minimum benefit of 25% of your elected benefit.

Age Disabled Maximum Benefit Duration Prior to 63 To Normal Retirement Age or 48 months if greater Age 63 To Normal Retirement Age or 42 months if greater Age 64 36 months Age 65 30 months Age 66 27 months Age 67 24 months Age 68 21 months Age 69 and older 18 months Age Disabled Maximum Benefit Duration Prior to 65 2 years Age 65 68 To Age 70, but not less than one year Age 69 and over 1 Year 28

Disability Insurance • State Teacher Retirement Disability Plans • Workers’ Compensation • Other employer based disability insurance coverage

Your plan

Disability Insurance

Effective Date: Coverage goes into effect subject to the terms and conditions of the policy. You must satisfy the definition of Actively at Work with your employer on the day your coverage takes effect.

Eligibility: You are eligible if you are an active employee who works at least 18 hours per week on a regularly scheduled basis.

• Unemployment benefits • Retirement benefits that

Enrollment: You can enroll in coverage within 31 days of your date of hire or during your annual enrollment period.

ABOUT CANCER Cancer insurance offers you and your family supplemental insurance protection in the event you or a covered family member is diagnosed with cancer. It pays a benefit directly to you to help with expenses associated with cancer treatment. For full plan details, please visit your benefit website: www.mybenefitshub.com/escregion10 Cancer Insurance American Public Life EMPLOYEE BENEFITS Treatment for cancer is often lengthy and expensive. While your health insurance helps pay the medical expenses for cancer treatment, it does not cover the cost of non medical expenses, such as out of town treatments, special diets, daily living, and household upkeep. In addition to these non medical expenses, you are responsible for paying your health plan deductibles and/or coinsurance. Cancer insurance through American Public Life helps pay for these direct and indirect treatment costs so you can focus on your Shouldhealth. you need to file a claim contact APL at 800 256 8606 or online at www.ampublic.com. You can find additional claim forms and materials at www.mybenefitshub.com/escregion10 *Carcinoma in situ is not considered internal cancer Pre Existing Condition Exclusion: Review the Benefit Summary page that can be found at www.mybenefitshub.com/escregion10 for full details CancerLow Plan High Plan Employee Only $23.40 $26.04 Employee and Spouse $49.38 $54.92 Employee and Child(ren) $29.70 $33.00 Employee and Family $55.68 $61.86 Plan 1 Plan 2 Internal Cancer First Occurrence* $5,000 $5,000 Cancer Screening Rider Benefits Diagnostic Testing 1 test per calendar year $100 per test $100 per test Follow Up Diagnostic Testing 1 test per calendar year $100 per test $100 per test Medical Imaging per calendar year $500 per test/ 2 per calendar year $500 per test/ 2 per calendar year Cancer Treatment Policy benefits Radiation and Chemotherapy, Immunotherapy Maximum Per 12 month period $15,000 $15,000 Hormone Therapy Maximum of 12 treatments per calendar year $50 per treatment $50 per treatment Surgical Rider Benefits Surgical $30 unit dollar amount Max $3,000 per operation $45 unit dollar amount Max $4,500 per operation Anesthesia 25% of amount paid for covered surgery Bone Marrow Transplant Maximum per lifetime $6,000 $9,000 Stem Cell Transplant Maximum per lifetime $600 $900 Heart Attack/Stroke First Occurrence Rider Benefits Lump Sum Benefit Maximum per 1 covered person per lifetime $5,000 $5,000 Hospital Intensive Care Unit Rider Benefits Intensive Care Unit $600 per day $600 per day 29

ABOUT ACCIDENT Do you have kids playing sports, are you a weekend warrior, or maybe accident prone? Accident plans are designed to help pay for medical costs associated with accidents and benefits are paid directly to you. For full plan details, please visit your benefit website: www.mybenefitshub.com/escregion10 Accident Insurance Lincoln Financial Group EMPLOYEE BENEFITS PLAN INFORMATION HIGH PLAN LOW PLAN Emergency Treatment Your Cash Benefit Your Cash Benefit Ambulance $225 $225 Air ambulance $1,125 $1,125 Emergency care/treatment $150 $150 X ray $30 $30 Initial care visit $75 $75 Major diagnostic exam $150 $150 Fractures * Your Cash Benefit Your Cash Benefit Fingers, toes $100 $50 Ankle, arm (elbow to wrist), elbow, foot (except toes), hand (except fingers), kneecap, rib, shoulder blade, vertebral process, wrist $450 $250 Coccyx, collarbone, lower jaw, sternum $525 $300 Arm (shoulder to elbow), bones of the face, nose, upper jaw $875 $500 Leg (knee to ankle), pelvis, skull non depressed, vertebral body $1,750 $1,000 Hip, leg (hip to knee) $2,625 $1,500 Skull depressed $3,500 $2,000 Surgical treatment Surgery 2x nonsurgical benefit 2x nonsurgical benefit Chip fracture 25% of fracture benefit 25% of fracture benefit Dislocations * Your Cash Benefit Your Cash Benefit Fingers, toes $100 $50 Collarbone (acromio and separation), elbow, hand (except fingers), lower jaw, shoulder, wrist $450 $250 Ankle, collarbone (sternoclavicular), foot (except toes) $875 $500 Knee (except kneecap) $1,750 $1,000 Hip $2,625 $1,500 Surgical treatment 2x nonsurgical benefit 2x nonsurgical benefit Partial dislocation 25% of dislocation benefit 25% of dislocation benefit Questions? Call 800 423 2765 and mention ID: REGIONTN 30

ABOUT CRITICAL ILLNESS Critical illness insurance can be used towards medical or other expenses. It provides a lump sum benefit payable directly to the insured upon diagnosis of a covered condition or event, like a heart attack or stroke. The money can also be used for non medical costs related to the illness, including transportation, child care, etc. For full plan details, please visit your benefit website: www.mybenefitshub.com/escregion10 Critical Illness Insurance UNUM EMPLOYEE BENEFITS Critical Illness Employee $10,000.00 $20,000.00 Spouse $10,000.00 $20,000.00 >25 $3.73 $5.93 >25 $3.73 $5.93 25 29 $4.73 $7.93 25 29 $4.73 $7.93 30 34 $5.93 $10.33 30 34 $5.93 $10.33 35 39 $7.93 $14.33 35 39 $7.93 $14.33 40 44 $10.33 $19.13 40 44 $10.33 $19.13 45 49 $13.53 $25.53 45 49 $13.53 $25.53 50 54 $16.83 $32.13 50 54 $16.83 $32.13 55 59 $22.53 $43.53 55 59 $22.53 $43.53 60 64 $31.13 $60.73 60 64 $31.13 $60.73 65 69 $44.83 $88.13 65 69 $44.83 $88.13 70 74 $69.93 $138.33 70 74 $69.93 $138.33 75 79 $103.63 $205.73 75 79 $103.63 $205.73 80 84 $151.73 $301.93 80 84 $151.73 $301.93 85 or over $244.93 $488.33 85 or over $244.93 $488.33 Who is eligible for this coverage? All employees in active employment in the United States working at least 20 hours per week and their eligible spouses and children (up to age 26 regardless of student or marital status). What are the Critical Illness coverage amounts? The following coverage amounts are available. For you: Select one of the following Choice $10,000 or $20,000 For your Spouse: 100% of employee coverage amount For your Children:100% of employee coverage amount Can I be denied coverage? Coverage is guarantee issue. When is coverage effective? Please see your Plan Administrator for your effective date of coverage. Insurance coverage will be delayed if you are not in active employment because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective. Critical Illness insurance provides financial protection by paying a lump sum benefit if you are diagnosed with a covered critical illness. To file a claim call UNUM at 800 858 6843 or find claim form at www.mybenefitshub.com/escregion10 31

The

Critical Illness Insurance UNUM EMPLOYEE BENEFITS Covered Conditions* Percentage of Coverage Amount Critical Illnesses Coronary Artery Disease (major) Coronary Artery Disease (minor) End Stage Renal (Kidney) Failure Heart Attack (Myocardial Infarction) Major Organ Failure Requiring Transplant Stroke 100%100%100%100%10%50% CancerInvasive Cancer (including all Breast Cancer) 100% Non Invasive Cancer 25% Skin Cancer 100%25%$500 Supplemental Critical Illnesses Benign Brain Tumor LossComaof Hearing Loss of Sight Loss of OccupationalInfectiousSpeechDiseaseHuman Immunodeficiency Virus (HIV) or Hepatitis Permanent Paralysis 100%100%100%100%100%100%100%25% ProgressiveAmyotrophicDiseasesLateral Sclerosis (ALS) Dementia (including Alzheimer’s Disease) Functional Loss Multiple Sclerosis (MS) Parkinson’s Disease 100% 100%100% 100%100% Cerebral Palsy Cleft Lip or Palate Cystic Fibrosis Down Syndrome Spina Bifida 100%100%100%100%100% 32

An insured has a pre existing condition if, within the 3 months just prior to their coverage effective date, they have an injury or sickness, whether diagnosed or not, for which: medical treatment, consultation, care or services, or diagnostic measures were received or recommended to be received during that period; drugs or medications were taken, or prescribed to be taken during that period; or symptoms existed. pre existing condition provision applies to any Insured’s initial coverage and any increases in coverage. Coverage effective date refers to the date any initial coverage or increases in coverage become effective.

What critical illness conditions are covered? Are wellness Screenings covered? Each insured is eligible to receive one Be Well Benefit per calendar year. Be Well Benefit For you, your spouse and your children: $50 Be Well Screenings include tests for the following: cholesterol and diabetes, cancer and cardiovascular function. They also include imaging studies, immunizations and annual examinations by a Physician. See certificate for details. Additional Critical Illnesses for your Children *Please refer to the policy for complete definitions of covered conditions. Pre existing Conditions We will not pay benefits for a claim when the covered loss occurs in the first 12 months following an insured’s coverage effective date and the covered loss is caused by, contributed to by, or occurs as a result of any of the following: • a pre existing condition; or • complications arising from treatment or surgery for, or medications taken for, a pre existing condition.

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•

•

Life and AD&D The Hartford ABOUT LIFE AND AD&D Group term life is the most inexpensive way to purchase life insurance. You have the freedom to select an amount of life insurance coverage you need to help protect the well being of your family. Accidental Death & Dismemberment is life insurance coverage that pays a death benefit to the beneficiary, should death occur due to a covered accident. Dismemberment benefits are paid to you, according to the benefit level you select, if accidentally dismembered. For full plan details, please visit your benefit website: www.mybenefitshub.com/escregion10 EMPLOYEE BENEFITS Voluntary Group Life per $1,000 in coverage (Emp) per $5,000 in coverage (Sp) Age Employee Spouse 18 29 $0.05 $0.05 30 34 $0.08 $0.08 35 39 $0.11 $0.11 40 44 $0.16 $0.16 45 49 $0.26 $0.26 50 54 $0.40 $0.40 55 59 $0.62 $0.62 60 64 $0.91 $0.91 65 69 $1.72 $1.72 70+ $2.20 $2.20 Spouse rates based on Employee's age. Voluntary Group Life Child(ren) Per $1,000 in coverage 0 26 $0.20 Voluntary AD&D Per $1,000 in coverage 18 64 $0.28 70 or over Reduce to 50% AD&D BENEFITS PERCENT OF COVERAGE AMOUNT PER ACCIDENT Covered accidents or death can occur up to 365 days after the accident. The total benefit for all losses due to the same accident will not exceed 100% of your coverage amount. LOSS FROM ACCIDENT COVERAGE Life 100% Both hand or both feet or sight of both eyes 100% One hand or one foot 100% Speech and Hearing in Both Ears 100% Either hand or foot and sight of one eye 100% Movement of Both Upper and Lower Limbs (Quadriplegia) 100% Movement of Both Lower Limbs (Paraplegia) 75% Movement of Three Limbs (Triplegia) 75% Movement of the Upper and Lower Limbs of One Side of the Body (Hemiplegia) 50% Either hand or foot 50% Sight of One Eye 50% Speech or Hearing in Both Ears 50% Movement of One Limb (Uniplegia) 25% Thumb and index finger of either hand 25% Coverage Information EmployeeAPPLICANT LIFE BenefitCOVERAGE 2 : $30,000 AD&D AD&D:COVERAGEIncluded 33

This insurance is guaranteed issue coverage it is available without having to provide information about your child(ren)’s

HOWhealth.MUCH DOES IT COST AND HOW DO I PAY FOR THIS INSURANCE? Premiums are provided on the Life Premium Worksheet. You have a choice of coverage amounts. You may elect insurance for you only, or for you and your dependent(s). 34

If you enroll during your annual enrollment period or are newly eligible and elect an amount that exceeds the guaranteed issue amount of $200,000, you will need to provide evidence of insurability that is satisfactory to The Hartford before the excess can become effective. If you enroll after your annual or initial enrollment period, evidence of insurability will be required for all coverage amounts.

Life and AD&D The Hartford EMPLOYEE BENEFITS APPLICANT LIFE COVERAGE Employee Benefit2: Increments of $10,000 Maximum: the lesser of 5x earnings or $500,000 Spouse Benefit2: Increments of $5,000. Maximum: the lesser of 100% of your supplemental coverage or $350,000 Child(ren) Benefit: Live Birth to 6 months ­ $1,000 6 months to 26 ­ $5,000 ASKED & ANSWERED WHO IS ELIGIBLE? You are eligible if you are an active full time employee who works at least 18 hours per week on a regularly scheduled Yourbasis.spouse and child(ren) are also eligible for coverage. Any child(ren) must be under age 26. AM I GUARANTEED COVERAGE?

If you enroll during your annual enrollment period or are newly eligible and elect an amount that exceeds the guaranteed issue amount of $50,000, your spouse will need to provide evidence of insurability that is satisfactory to The Hartford before the excess can become effective. If you enroll after your annual or initial enrollment period, evidence of insurability will be required for all coverage amounts.

CoveragePORTABLEcontinues with

* Financially

QUALITY

www.mybenefitshub.com/escregion10 Should

TERMINAL ILLNESS ACCELERATION OF BENEFITS

Coverage that pays 30% (25% in CT and MI) of the coverage amount in a lump sum upon the occurrence of a terminal condition that will result in a limited life span of less than 12 months (24 months in IL). no loss of benefits or increase in cost if employment terminates after the first premium is paid. simply bill the employee directly. CONVENIENCE Easy payments through payroll deduction. for spouses and financially dependent children, even if the employee doesn’t elect coverage on themselves. dependent children 14 days to 23 years old. TO COUNT ON one business day of notification, payment of 50% of coverage or $10,000 whichever is less is mailed to the unless the death is within the two year contestability period and/or under investigation. This coverage has no war or terrorism exclusions. OF LIFE benefit that accelerates a portion of the death benefit on a monthly basis, up to 75% of your benefit, and is payable directly to you on a tax favored basis for the following: Permanent inability to perform at least two of the six Activities of Daily Living (ADLs) without substantial assistance; Permanent severe cognitive impairment, such as dementia, Alzheimer’s disease and other forms of senility, requiring substantial supervision. full details rates at you need to file a claim, contact 5Star directly at (866) 863 9753.

and

or •

FAMILY CoveragePROTECTIONisavailable

Optional

ABOUT INDIVIDUAL LIFE Individual insurance is a policy that covers a single person and is intended to meet the financial needs of the beneficiary, in the event of the insured’s death. This coverage is portable and can continue after you leave employment or retire. For full plan details, please visit your benefit website: www.mybenefitshub.com/escregion10 Individual Life Insurance 5Star EMPLOYEE BENEFITS Individual Life and Accidental Death and Dismemberment Enhanced coverage options for employees. Easy and flexible enrollment for employers. The 5Star Life Insurance Company’s Family Protection Plan offers both Individual and Group products with Terminal Illness coverage to age 121, making it easy to provide the right benefit for you and your employees. WithCUSTOMIZABLEseveraloptions to choose from, employees select the coverage that best meets the needs of their families.

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beneficiary,

PROTECTION

Employee Coverage Issue Age $10,000 $20,000 $30,000 $40,000 $50,000 $75,000 $100,000 $125,000 $150,000 18 25 $9.90 $13.28 $16.68 $20.07 $23.46 $31.94 $40.42 $48.89 $57.38 26 $9.91 $13.34 $16.75 $20.16 $23.59 $32.13 $40.66 $49.21 $57.75 27 $9.98 $13.46 $16.96 $20.44 $23.92 $32.62 $41.34 $50.04 $58.76 28 $10.08 $13.66 $17.26 $20.84 $24.42 $33.37 $42.34 $51.29 $60.26 29 $10.23 $13.95 $17.68 $21.40 $25.13 $34.44 $43.75 $53.07 $62.38 30 $10.43 $14.35 $18.28 $22.20 $26.12 $35.94 $45.75 $55.56 $65.38 31 $10.64 $14.76 $18.90 $23.04 $27.16 $37.50 $47.84 $58.16 $68.50 32 $10.87 $15.23 $19.61 $23.97 $28.34 $39.25 $50.17 $61.09 $72.01 33 $11.11 $15.72 $20.33 $24.93 $29.55 $41.06 $52.58 $64.11 $75.63 34 $11.40 $16.30 $21.20 $26.10 $31.00 $43.26 $55.50 $67.75 $80.00 35 $11.72 $16.93 $22.16 $27.37 $32.59 $45.63 $58.67 $71.71 $84.76 36 $12.08 $17.65 $23.23 $28.80 $34.37 $48.31 $62.25 $76.18 $90.13 37 $12.46 $18.44 $24.40 $30.36 $36.34 $51.25 $66.16 $81.09 $96.00 38 $12.88 $19.25 $25.63 $32.00 $38.38 $54.32 $70.25 $86.19 $102.13 39 $13.33 $20.17 $27.00 $33.83 $40.67 $57.76 $74.83 $91.92 $109.00 40 $13.83 $21.15 $28.48 $35.80 $43.13 $61.44 $79.75 $98.06 $116.38 41 $14.38 $22.25 $30.13 $38.00 $45.87 $65.57 $85.25 $104.94 $124.63 42 $14.98 $23.46 $31.96 $40.44 $48.92 $70.12 $91.34 $112.54 $133.76 43 $15.60 $24.70 $33.81 $42.90 $52.00 $74.75 $97.50 $120.25 $143.01 44 $16.26 $26.02 $35.78 $45.53 $55.30 $79.69 $104.08 $128.48 $152.88 45 $16.93 $27.37 $37.80 $48.23 $58.67 $84.75 $110.83 $136.92 $163.00 46 $17.67 $28.83 $40.00 $51.17 $62.33 $90.26 $118.17 $146.09 $174.00 47 $18.43 $30.35 $42.28 $54.20 $66.13 $95.94 $125.75 $155.56 $185.38 48 $19.19 $31.88 $44.58 $57.27 $69.96 $101.69 $133.42 $165.15 $196.88 49 $20.02 $33.55 $47.08 $60.60 $74.13 $107.94 $141.75 $175.57 $209.38 50 $20.93 $35.36 $49.81 $64.24 $78.67 $114.75 $150.84 $186.92 $223.01 51 $21.94 $37.39 $52.83 $68.26 $83.71 $122.32 $160.91 $199.52 $238.13 52 $23.11 $39.74 $56.35 $72.96 $89.59 $131.13 $172.66 $214.21 $255.75 53 $24.42 $42.33 $60.26 $78.17 $96.09 $140.87 $185.67 $230.46 $275.26 54 $25.88 $45.27 $64.65 $84.03 $103.42 $151.88 $200.33 $248.80 $297.25 55 $27.44 $48.37 $69.31 $90.23 $111.17 $163.50 $215.83 $268.17 $320.51 56 $29.19 $51.87 $74.56 $97.23 $119.92 $176.63 $233.33 $290.04 $346.76 57 $30.99 $55.49 $79.98 $104.46 $128.96 $190.19 $251.41 $312.64 $373.88 58 $32.84 $59.19 $85.53 $111.86 $138.21 $204.06 $269.91 $335.77 $401.63 59 $34.74 $62.97 $91.21 $119.43 $147.67 $218.25 $288.83 $359.42 $430.01 60 $36.71 $66.94 $97.15 $127.36 $157.59 $233.13 $308.66 $384.21 $459.75 61 $38.77 $71.05 $103.33 $135.60 $167.88 $248.57 $329.25 $409.94 $490.63 62 $40.93 $75.37 $109.80 $144.23 $178.67 $264.75 $350.83 $436.92 $523.00 63 $43.22 $79.95 $116.68 $153.40 $190.13 $281.94 $373.75 $465.56 $557.38 64 $45.72 $84.93 $124.16 $163.37 $202.59 $300.62 $398.67 $496.71 $594.76 65 $48.50 $90.50 $132.51 $174.50 $216.50 $321.50 $426.50 $531.50 $636.51 66* $49.13 $91.75 $134.38 $177.00 $219.63 $326.19 $432.75 $539.31 $645.88 67* $52.62 $98.73 $144.85 $190.97 $237.08 $352.38 $467.67 $582.96 $698.25 68* $56.58 $106.67 $156.75 $206.83 $256.92 $382.13 $507.33 $632.54 $757.75 69* $61.09 $115.68 $170.28 $224.87 $279.46 $415.94 $552.42 $688.90 $825.38 70* $66.18 $125.85 $185.53 $245.20 $304.88 $454.06 $603.25 $752.44 $901.63 Individual Life Insurance 5Star EMPLOYEE BENEFITS *Quality of Life not available ages 66 70. Quality of Life benefits not available for children. Child life coverage available only on children and grandchildren of employee (age on application date: 14 days through 23 years). $7.15 monthly for $10,000 coverage per child.36

ABOUT IDENTITY THEFT PROTECTION Identity theft protection monitors and alerts you to identity threats. Resolution services are included should your identity ever be compromised while you are covered. For full plan details, please visit your benefit website: www.mybenefitshub.com/escregion10 Identity Theft iLOCK360 EMPLOYEE BENEFITS HAVE YOU EVER? Been a victim of a data breach? Data breaches increased by 133% in 2018 1 in 3 notified breach victims experience fraud. Known someone that has been a victim of identity theft? ID theft is the fastest growing crime, occurring once every 2 seconds Been concerned about your childrens’ and loved ones' identities being stolen? Child identity theft is projected to affect 25% of kids before turning 18. Had your credit impacted by financial fraud? If a criminal gains access to your personal information, they can open new accounts in your name that you may not learn of until the damage is done. HOW iLOCK360 HELPS FULL SERVICE IDENTITY RESTORATION. Rest assured that iLOCK360 will work on your behalf to restore your identity. Our experts can complete all restoration activities for you, and we can even help you with pre existing conditions. PEACE OF MIND. 56% of victims have to take time off work to resolve an identity theft case on their own. With iLOCK360, you have experienced professionals in your corner to restore your identity, so you can spend your time doing what you do best. DEFEND Your personal information is monitored 24/7/365 PROTECT Alerts inform you of potential threats for immediate action iLOCK360RESTOREdoesthe work to restore your identity Identity Theft Elite Essential Employee $6.95 $11.95 Employee and Family $13.95 $22.95 37

ABOUT LEGAL SERVICES Legal plans provide benefits that cover the most common legal needs you may encounter like creating a standard will, living will, healthcare power of attorney or buying a home. For full plan details, please visit your benefit website: www.mybenefitshub.com/escregion10 Legal Services LegalEase EMPLOYEE BENEFITS Protect your family’s future with LegalEASE. LegalEASE offers valuable benefits to shield your family and savings from unexpected personal legal issues. What you get with a LegalEASE plan An attorney with expertise specific to your personal legal matter Access to a national network of attorneys with exceptional experience that are matched to meet your needs, In and out of network coverage, Concierge help navigating common individual or family legal issues. Being a member saves costly legal fees and provides coverage for: Home & Residential: Purchase, Sale, Refinancing of Primary Residence/Vacation or Investment Home, Tenant Dispute, Tenant Security Deposit Dispute, Landlord Despite with Tenant, Security Deposit Dispute with Tenant, Construction Defect Despite, Neighbor Dispute, Noise Reduction Dispute, Disclosure Auto & Traffic: Traffic Ticket, Serious Traffic Matters (Resulting in Suspension or Revocation of License), License Suspension (Administrative Proceeding), First time Vehicle Buyer, Vehicle Repair & Lemon Law Litigation Estate Planning & Wills: Will or Codicil, Living Will and/or Health Care Power of Attorney, Probate of Small Estate, Living Trust FinancialDocument&Consumer: Debt Collection Defense, Bankruptcy, Tax Audit, Student Loan Refinancing/Collection Defense, Document Preparation, Consumer Dispute, Small Claims Court, Mail Order/Internet Purchase Dispute, Warranty Dispute, Healthcare Coverage Dispute, Financial Advisor, Identity Theft Defense Family: Separation, Divorce, Prenuptial Agreement, Name Change, Guardianship/Conservatorship, Adoptions, Juvenile Court Proceedings, Elder Law General: Civil Litigation Defense, Incompetency Defense, Initial Law Office Consultation, Review of Simple Documents, Mediation, Misdemeanor Defense, Identity Theft Assistance. Limitations apply please visit https:www.leagleaseplan.com/region10 for specific plan benefits. To learn more, call 1 (800) 248 9000, reference “Region 10” Member Services: 1(888) 416 4313 Legal Services Legal Plan Employee Only $24.16 38

Non Emergency Inter Facility Transportation In the event that a member is in stable condition in a medical facility but requires a heightened level of care that is not available at their current medical facility, Members have access to non emergency air or ground transportation between medical facilities.

assistance with a claim contact MASA at 800 643 9023. You can find full benefit details at www.mybenefitshub.com/region10.EmergencyTransportationEmergent $14.00

Medical Transport covers emergency transportation to and from appropriate medical facilities by covering the out of pocket costs that are not covered by insurance. It can include emergency transportation via ground ambulance, air ambulance and helicopter, depending on the plan. full plan details, please visit your benefit website: www.mybenefitshub.com/escregion10

MASA EMPLOYEE BENEFITS

Emergent Air Transportation In the event of a serious medical emergency, Members have access to emergency air transportation into a medical facility or between medical facilities.

A MASA MTS Membership provides the ultimate peace of mind at an affordable rate for emergency ground and air transportation service within the United States and Canada, regardless of whether the provider is in or out of a given group healthcare benefits network. If a member has a high deductible health plan that is compatible with a health savings account, benefits will become available under the MASA membership for expenses incurred for medical care (as defined under Internal Revenue Code (“IRC”) section 213 (d)) once a member satisfies the applicable statutory minimum deductible under IRC section 223(c) for high deductible health plan coverage that is compatible with a health savings account.

For

Emergent Ground Transportation In the event of a serious medical emergency, Members have access to emergency ground transportation into a medical facility or between medical facilities.

Suppose you or a family member is hospitalized more than 100 miles from your home. In that case, you have benefit coverage for air or ground medical transportation into a medical facility closer to your home for Shouldrecuperation.youneed

Repatriation/Recuperation

ABOUT MEDICAL TRANSPORT

Emergency Medical Transport

Plus Employee

Employee and Family $14.00 39

• You may request reimbursement for care of a spouse or dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self care.

•

A Spending Account allows you to pay for eligible healthcare expenses with a pre loaded debit card. You choose the amount to set aside from your paycheck every plan year, based on your employer’s annual plan limit. This money is use it or lose it within the plan year (unless your plan contains a $500 rollover or grace period provision). full plan details, please visit your benefit website: www.mybenefitshub.com/escregion10

Flexible Spending Account

Things to Consider Regarding the Dependent Care FSA

• Medical

batteries ABOUT FSA

The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.

Higginbotham Benefits Debit Card

The Dependent Care FSA helps pay for expenses associated with caring for elder or child dependents so you or your spouse can work or attend school full time. You can use the account to pay for day care or babysitter expenses for your children under age 13 and qualifying older dependents, such as dependent parents. Reimbursement from your Dependent Care FSA is limited to the total amount deposited in your account at that time. To be eligible, you must be a single parent, or you and your spouse must be employed outside the home, disabled or a full time student.

• Overnight camps are not eligible for reimbursement (only day camps can be considered).

The Health Care FSA covers qualified medical, dental and vision expenses for you or your eligible dependents. You may contribute up to $2,850 annually to a Health Care FSA and you are entitled to the full election from day one of your plan year. Eligible expenses include: You may not contribute to a Health Care FSA if you enrolled in a High Deductible Health Plan (HDHP) and contribute to a Health Savings Account (HSA).

Health Care FSA

•

The Higginbotham Benefits Debit Card gives you immediate access to funds in your Health Care FSA when you make a purchase without needing to file a claim for reimbursement. If you use the debit card to pay anything other than a copay amount, you will need to submit an itemized receipt or an Explanation of Benefits (EOB). If you do not submit your receipts, you will receive a request for substantiation. You will have 60 days to submit your receipts after receiving the request for substantiation before your debit card is suspended. Check the expiration date on your card to see when you should order a replacement card(s).

• If your child turns 13 midyear, you may only request reimbursement for the part of the year when the child is under age 13.

Dental and vision expenses deductibles aids and

Flexible

For

Dependent Care FSA

and coinsurance • Prescription copays • Hearing

(FSA) Higginbotham EMPLOYEE BENEFITS 40

Important FSA Rules • The maximum per plan year you can contribute to a Health Care FSA is $2,850. The maximum per plan year you can contribute to a Dependent Care FSA is $5,000 when filing jointly or head of household and $2,500 when married filing separately. • You cannot change your election during the year unless you experience a Qualifying Life Event. • You can continue to file claims incurred during the plan year for another 75 days after September 1st. • Your Health Care FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care expenses. Over the Counter Item Rule Reminder Health care reform legislation requires that certain over the counter (OTC) items require a prescription to qualify as an eligible Health Care FSA expense. You will only need to obtain a one time prescription for the current plan year. You can continue to purchase your regular prescription medications with your FSA debit card. However, the FSA debit card may not be used as payment for an OTC item, even when accompanied by a prescription. Higginbotham Portal The Higginbotham Portal provides information and resources to help you manage your FSAs. • Access plan documents, letters and notices, forms, account balances, contributions, and other plan information • Update your personal information • Utilize Section 125 tax calculators • Look up qualified expenses • Submit claims • Request a new or replacement Benefits Debit Card Register on the Higginbotham Portal Visit https://flexservices.higginbotham.net and click Register. Follow the instructions and scroll down to enter your information. • Enter your Employee ID, which is your Social Security number with no dashes or spaces. • Follow the prompts to navigate the site. • If you have any questions or concerns, contact Higginbotham: • Phone 866 419 3519 • Email flexclaims@higginbotham.net • Fax 866 419 3516 Flexible Spending Account (FSA) Higginbotham EMPLOYEE BENEFITS 41

Notes 42

Notes 43

44

2022 - 2023 PlanYear www.mybenefitshub.com/escregion10

Rate Sheet General Disclaimer: The rate information provided in this guide is subject to change at any time by your employer and/or the plan provider. The rate information included herein, does not guarantee coverage or change or otherwise interpret the terms of the specific plan documentation, available at the ESC Region 10 Benefits Website, which may include additional exclusions and limitations and may require an application for coverage to determine eligibility for the health benefit plan. To the extent the information provided in this summary is inconsistent with the specific plan documentation, the provisions of the specific plan documentation will govern in all cases.

Enrollment Guide General Disclaimer: This summary of benefits for employees is meant only as a brief description of some of the programs for which employees may be eligible. This summary does not include specific plan details. You must refer to the specific plan documentation for specific plan details such as coverage expenses, limitations, exclusions, and other plan terms, which can be found at the ESC Region 10 Benefits Website. This summary does not replace or amend the underlying plan documentation. In the event of a discrepancy between this summary and the plan documentation the plan documentation governs. All plans and benefits described in this summary may be discontinued, increased, decreased, or altered at any time with or without notice.