PIH 2023 Benefit Guide

2023 BENEFITS OVERVIEW

Medical Benefits �� 3 Medical Benefits Comparison�� 4 Health Savings Account�� 4 Dental Benefits��5 Vision Benefits��5 Telemedicine ��6 Phillips Wellness and Healthy Pregnancies, Healthy Babies��7 Flexible Spending Accounts ��8 Disability Benefits ��9 Paid Maternity Leave ��9 Basic and Supplemental Life Insurance�� 10 Supplemental Health Insurance�� 11 Employee Assistance Program�� 12 Student Loan Benefit Program�� 13 401(k) Retirement Plan �� 14 Annual Notices ��15-17 Table of Contents

Questions? If you have any questions about your PIH benefits, please contact Kelsey Shrader in Human Resources at (865) 364-8346 or benefits@phillipsih.com. When you have a qualifying event, you must immediately notify Human Resources and submit the appropriate form(s) within 30 days after the qualifying event. In the event that you experience a change in Medicaid/Children’s Health Insurance Program (CHIP) eligibility, appropriate form(s) must be submitted to Human Resources within 60 days after the eligibility change. When can you make changes to your enrollment? Changes to your benefits may be made during open enrollment each year which typically occurs in the fourth quarter. Changes may be made outside of open enrollment for qualifying events including, but not limited to: marriage/divorce, birth/adoption, or change in job status. Other qualifying events may apply.

Medical Benefits

Cigna - Open Access Plus Network 1-800-244-6224 | www.mycigna.com | Group Number: 3332287

PIH offers access to medical benefits through Cigna . You may choose between two different medical plans: Health Savings Account (HSA) Plan and Preferred Provider Organization (PPO) Plan.

Option 1: HSA Plan The HSA Plan offers lower premiums and generally covers 100% of medical expenses after the annual deductible has been met. Due to the higher out-of-pocket costs associated with the HSA Plan, PIH offers employees a Health Savings Account (HSA), which we will explain in more detail on page 4.

Option 2: PPO Plan The PPO Plan offers higher premiums, but a lower deductible and out-of-pocket maximum. After reaching your annual deductible, medical expenses will be covered at 80%. By choosing the PPO Plan, you are eligible to set aside money in a Flexible Spending Account (FSA).

Who is Eligible?

All full-time, non-union employees working at least 30 hours per week are eligible to participate in benefit plans on the first day of the month following 60 days of continuous active employment.

Eligible dependents include:

Your legal spouse • The term “spouse” means an eligible employee's legal spouse, whether same-sex or opposite-sex, in a marriage entered under the laws of a U.S. or foreign jurisdiction having the authority to sanction marriages. Child(ren) • Your dependent child(ren) up to age 26, regardless of student or marital status • Legal guardianship of minor(s) up to age 26, regardless of student or marital status • Disabled child(ren) may be eligible past age 26. Contact the Benefits department for more information. If you choose to add dependent(s) to your benefit coverage(s), please know that your benefits department obtain the right to request you provide documentation to support the relationship(s) at any time. If you are unable to provide the required documentation to validate the relationship(s), your dependent(s) coverage may be retroactively terminated from the plan(s). How do I enroll? Download the Employee Self Service app here: bit.ly/HRIS-App. To enroll over the phone, call 800-955- 0876 and ask for the benefits department. Please know that if you choose to call and enroll over the phone, that there could be long wait times or delayed returned calls due to a high volume of callers. Please note it is especially important to not wait until the last few days before OE closes to enroll.

HSA Plan Weekly Premiums

Non- Wellness

PPO Plan Weekly Premiums

Wellness

Employee Only

$62.81

$49.37

Employee Only

$77.34 $64.84

EMP + Spouse

$119.59 $106.16

EMP + Spouse

$151.91

$139.41

EMP + Child(ren)

$104.78

$91.34

EMP + Child(ren)

$132.46 $119.96

EMP + Family

$161.56

$148.12

EMP + Family

$207.02 $194.52

To receive the maximum benefit from your chosen plan, make sure your medical provider is a member of the network. • In-network providers will file your claims for you. • By using an out-of-network physician or facility, you will be subject to a higher deductible and responsible for a larger percentage of the charges. You may also have to pay for charges over the usual and customary rate. To find an in-network provider, download the MyCigna app or go to the online directory at www.cigna.com and click on the “Find a Doctor” button to begin your search. Please be sure to carefully review the online directory or call Cigna to confirm that your provider participates in the network.

Medical Benefits Comparison

Dental Benefits

Medical Benefits 1

Option 1: HSA Plan

Option 2: PPO Plan

Cigna | 1-800-244-6224 | www.mycigna.com | Group Number: 3332287

Deductible: Individual / Family

$3,000 / $6,000 (Shared) 2

$2,000 / $4,000 (Embedded) 3

Your PIH dental benefits are administered by Cigna.

Out-of-Pocket Maximum : Individual / Family

$3,000 / $6,000

Dental Weekly Premiums Employee Only

Base Plan

Buy-Up Plan

Services Received at a Practicioner's Office

Dental Plan Benefits

Base Plan Buy-Up Plan

$2.43 $3.71

Individual / Family Deductible Calendar Year Maximum (per enrolled person) Preventive Services (Deductible does not apply)

$50 / $150 $25 / $75

Preventive Care

100%

EMP + Spouse $5.35 $8.16 EMP + Child(ren) $4.87 $7.43 EMP + Family $6.81 $10.39

Office Visit For sick visits, please consider Teladoc first

$1,500

$2,500

100% after deductible

80% after deductible

Services Received at a Facility Emergency Room

100%

100% after deductible

80% after deductible

You can visit any dentist that you choose. However, if your provider is not in- network, they may charge more than the usual and customary rate, and you may be responsible for the additional charges. To find an in-network provider, go to the online directory at www.cigna.com. Please be sure to carefully review the online directory or call Cigna to confirm that your provider participates in the network.

80% after deductible 60% after deductible

80% after deductible 70% after deductible

Basic Services

Most Other Services

100% after deductible

80% after deductible

Pharmacy

Major Restorative Services

Retail Preventive Generics Generics / Preferred Brand/Non-Preferred Brands Mail Order 4 Preventive Generics Generics/Preferred Brand/Non-Preferred Brands

Orthodontic Services (Deductible does not apply) Orthodontic Lifetime Maximum (Covers children up to age 19, lifetime max per child)

Plan pays 100% 100% after deductible

$10 / $35 / $60

50%

$1,500

$2,500

Plan pays 100% 100% after deductible

3x Retail copay

Specialty Drugs

100% after deductible

N/A / $35 / $60

All benefits shown In-Network

Vision Benefits

1. See your Evidence of Coverage for Out-of-Network Benefits, prior authorization, visit limits and more. 2. Shared Family Deductible - entire family deductible must be met before the plan will pay. 3. Embedded Deductible - each individual is only responsible for the individual deductible amount before the plan will pay (maximum two deductibles).

Cigna | 1-800-244-6224 | www.mycigna.com | Group Number: 3332287

Health Savings Account

Your PIH vision benefits are administered by Cigna . When using in-network providers, this PPO plan covers most exams, eyeglasses, and medically necessary contacts in full. Discounts are available for upgrades on covered frames and lenses. Should you choose to see an out-of-network provider, Cigna will reimburse you up to a specified amount. The out-of-network reimbursement schedule is summarized in the Vision Plan Benefits table below.

Vision Weekly Premiums

Employee Only EMP + Spouse EMP + Child(ren)

$1.59 $3.20 $3.18 $5.05

HSA Bank | 1-855-731-5225

If you are enrolled in the HSA Plan, you are eligible to participate in a Health Savings Account (HSA) through HSA Bank . The HSA is established to pay for future qualified medical, dental and vision expenses that are incurred by you or your dependents enrolled in the plan. PIH contributes to the HSA quarterly on your be - half, so it is to your advantage to make the most of your HSA. You must contribute a minimum of $5 per week in order to receive the PIH contri- bution. You may make tax-free payroll contributions to the account to pay for subsequent future quali-

EMP + Family

Annual Maximum Contributions to your HSA

Total Amount You May Contribute

IRS Annual Maximum Contribution

Vision Benefits

In-Network Out-of-Network

PIH's Contribution

To find an in-network provider or surgery center, review out-of- network benefits, and other plan details, go to the online directory at cigna.vsp.com and click on the “Find a Cigna Vision Network Eye Care Professional” button to begin your search. Please be sure to care - fully review the online directory or call Cigna to confirm that your pro - vider participates in the network.

Vision Exam

$10 Copay

$45 Allowance

Up to $80 Allowance depending on type

$225 Quarterly, $900 Annually $400 Quarterly. $1,600 Annually $400 Quarterly. $1,600 Annually $500 Quarterly, $2,000 Annually

Lenses (once per year) Single / Bifocal / Trifocal / Lenticular

$2,950

Employee Only

$3,850

$10 Copay / covered in full

$6,150

Emp + Spouse

$7,750

Frames (once every 2 years)

$140 Allowance

$77 Allowance

$6,150

Emp + Child(ren)

$7,750

Contacts in lieu of eyeglasses (once per year) Medically Necessary Elective

$10 Copay

$5,750

Emp + Family

$7,750

Covered in full Up to $150

$210 Allowance $120 Allowance

fied medical expenses. Your contributions to the HSA will be payroll deducted and the funds deposited into your HSA. You may change the amount you contribute to your HSA at any time during the plan year. When a qualified expense is incurred, you simply use your HSA debit card or request reimbursement for the expense from the custodial account. Unused account dollars are yours to keep, even if you retire or leave the company. Also, if you are 55 years of age or older you may contribute an additional $1,000 catch-up contribu - tion to your HSA.

Telemedicine

Phillips Wellness

Teladoc | 1-800-835-2362 | www.teladoc.com

Cigna | 1-800-244-6224 | www.mycigna.com, Log in and click on "Wellness"

No cost for you or your household to call! PIH is proud to offer Teladoc to all employees and dependents enrolled in the medical plan. Teladoc is 24/7/365 access to a doctor by phone when your pri - mary care physician is not available, and you have a condition when you would consider using urgent care. All Teladoc doctors are practicing primary care physicians, pediatricians, and family medicine physicians who average 15 years experience and are U.S. board-certified and licensed in your state.

The Phillips Wellness Program, administered by Cigna , offers employees best-in-class wellness services and a discount on weekly medical benefit premiums. You can save $50 per month! Through the Phillips Wellness Program, all your health and wellness benefits will be integrated into one place and provide you with easy access to your plans, programs, and wellness resources. Most wellness activities will automatically be tracked for you. When you elect to participate in the program, the weekly medical benefit premium discount is automatically applied to your paycheck. To stay in the program, you must earn at least 100 points by participating in wellness activities each year.

Teladoc is most frequently used to treat conditions like: • Cold and flu symptoms • Allergies • Bronchitis

Here’s how you earn points:

Wellness Activity

Points

Annual Physical

100 100 100 100

Well Woman Exam

• Urinary tract infections • Respiratory infections • Sinus problems • And more!

Cancer Screening (various)

Mammogram

Complete the Cigna on-line Health assessment

50 25

Receive a flu shot

Complete an online coaching program • Nutrition • Exercise • Positive Mood • Weight • Stress • Tobacco one and six month programs

25 (maximum of 50)

Participate in Apps & Activities

25 (maximum of 50)

Self-reported goals: • I made smart and delicious food choices • I took part in physical activity • I’m managing my weight

25 (maximum of 50)

DID YOU KNOW? The preferred way to get the 100 points is to complete an annual physical. Healthy Pregnancies, Healthy Babies®

Cigna | 1-800-615-2906 | www.mycigna.com, Log in and click on "Wellness"

If you're pregnant or become pregnant, be sure to sign up for the Cigna Healthy Pregnancies, Healthy Babies® program, designed to help you and your baby stay healthy during your pregnancy and in the days and weeks after your baby’s birth. When you enroll in Cigna Healthy Pregnancies, Healthy Babies and complete the program, including your postpartum check-in, you’ll be eligible to receive up to $225 in gift cards.

Flexible Spending Account

Disability Benefits

Medcom | 1-800-523-7542 | www.medcombenefits.com

Guardian | 1-800-268-2525 (STD) | 1-800-538-4583 (LTD) www.guardiananytime.com | Group Number: 00534925

PIH offers employees the option to defer money on a pre-tax basis for use on approved medical and dependent care expenses. This is NOT insurance. This is simply a way for you to save on your healthcare or daycare expenses by setting money aside from your gross income, pre-tax for expenses that you anticipate for the plan year. Healthcare FSA This is for for those enrolled in the PIH/P&J PPO plan or another PPO plan. With the healthcare FSA, the total dollar amount set aside for the plan year is eligible for withdrawal from the account on day one of your first payroll deduction towards the account. The maximum healthcare FSA annual contribution amount is $3,050 . If you are a new hire and enroll in the plan midyear, your contributions will be prorated for the annual amount you select. Limited FSA This is for for those enrolled in the HSA plan or another qualified HDHP. If you enroll in the HSA Plan, you are only eligible for the Limited FSA. This account may be used on qualified dental and vision expense only, not medical expenses (you will use your HSA for medical expenses). The maximum annual contribution is $3,050 . By setting aside money pre-tax into either a FSA or DCA, you save on taxes and take home more spendable income! Please contact Medcom for a list of eligible medical and dependent care expenses. Dependent Care Account (DCA) You may elect to set money aside to use for your approved childcare services, provided at a daycare facility, in your home, or in someone else’s residence through a DCA. Certain requirements must be satisfied for the services to be approved for reimbursement. The maximum DCA annual contribution amount is $5,000 per family (if you are single or married and file a joint tax return) or $2,500 (if you are married and file a separate tax return).

Disability insurance can help support you and your family should you become disabled for a short period of time or for an extended period of time. Short-Term Disability (STD) STD provides you financial support in the event that you become temporarily disabled. STD coverage provides 60% of your weekly earnings up to a maximum of $1,000 per week. Benefit payments begin after an eight day waiting period if the disability is illness-related, or the first day if the disability is injury-related, and ends after 26 weeks of continuous disability. Long-Term Disability (LTD) LTD insurance protects your income in the event of a long-term illness or injury. LTD coverage provides 60% of your monthly earnings up to a maximum of $5,000 per month for hourly employees and a maximum of $10,000 per month for salaried employees. Benefit payments begin after you have been deemed to be disabled for 180 days, and ends when you are no longer disabled or reach Social Security Normal Retirement Age.

Paid Maternity Leave

Kelsey Shrader - Human Resources | 865-364-8346 | Email: benefits@phillipsih.com

PIH is proud to offer up to 8 weeks of paid maternity leave to its employees following the birth of a child.

This benefit is eligible to employees that meet the following criteria:

• Be a full-time, regular employee • Have been employed with the company for at least 12 months or • Have worked at least 1,250 hours during the 12 consecutive months immediately preceding the date the leave would begin.

Basic Life Insurance

Supplemental Health Insurance

Guardian | 1-800-600-1600 | www.guardiananytime.com | Group Number: 00534925

Cigna | 1-800-244-6224 | www.mycigna.com | Group Number: 3332287

PIH provides you with Basic Life and Accidental Death & Dismemberment (AD&D) insurance at no cost through Guardian . All full-time hourly and salaried employees receive: • $50,000 of coverage for yourself, • $10,000 of coverage for your spouse, and • $2,000 of coverage for child(ren) ages 6 months to 26 years, or $1,000 of coverage for child(ren) live birth to 6 months. You will need a beneficiary for this policy. You can update your beneficiaries at any time during the year by visiting the HR self-service app>benefits>my benefits. Download the App here: bit.ly/HRIS-App. Salaried Employees Buy-Up Option Salaried employees may increase their Basic Life and AD&D coverage up to 3x annual salary (up to an additional $250,000). Additional coverage premiums are based on your annual salary and only costs between $2.00 and $5.15 per week! PIH pays 65% of the cost, and you only pay 35% of the additional coverage amount.

PIH offers 3 different Cigna supplemental health insurance policies through payroll deductions at a Group Payroll Rate! When you experience a major health event, supplemental insurance policies help pay for many expenses that aren’t covered by your primary health insurance. Cigna Accidental Injury Insurance

Accidental Injury Weekly Premiums

An accident can happen to anyone at any time. Even with medical coverage, out-of-pocket expenses can quickly add up. That's why having Cigna Accidental Injury insurance is important. There is one plan to choose from for this benefit. Examples of coverages offered include:

Employee Only EMP + Spouse EMP + Child(ren)

$2.70 $5.00 $6.35 $8.65

• Dislocations: up to $6,000 • Burns: up to up to $10,000 • Emergency Dental: up to $150 • Plus a lot more benefits!

EMP + Family

• Emergency Care: $100 • Hospital Admission: $1,000 • General Anesthesia: $100 • Fractures: up to $8,000

The plan also offers Accidental Death and Dismemberment (AD&D) coverages. Please see your plan document for more details. Cigna Hospital Care Insurance

Supplemental Life Insurance

Guardian | 1-800-600-1600 | www.guardiananytime.com | Group Number: 00534925

Hospital Care Weekly Premiums

A hospital stay can happen at any time, and it can be costly. Cigna Hospital Care can help you and your loved ones have additional financial protection. We can help cover these unexpected events - so you can focus on getting better. Cigna's Hospital Indemnity policy covers costs associated with a hospital stay, such as: • Wellness Treatment, Health Screening Test and Preventive Care Benefit: $50 per person enrolled, per year • Hospital Admission: $1,000 per person enrolled, per year • Hospital Stay: $200 per day up to 30 days • Hospital Intensive Care Unit Stay: $400 per day up to 30 days • Newborn Nursery Care Stay: $200 per day up to 30 days Cigna Critical Illness Insurance Being diagnosed with a critical illness can happen to anyone at any time. Even with the medical coverage, out-of-pocket expenses can quickly add up. That's why having Cigna Critical Illness insurance is important. Covered Critical Illnesses include: Cancer, Heart Attack, Stroke, Renal Failure (End Stage), Carcinoma in Situ, Coronary Artery Disease and more. Employees can elect coverage in the amounts of $5,000,

Employee Only EMP + Spouse EMP + Child(ren)

$3.98 $12.90 $8.53 $17.45

In addition to the Basic Life insurance provided by PIH, you have the option to purchase Supplemental Life/AD&D insurance through Guardian . You may purchase: • Employee coverage in increments of $20,000 up to a maximum of $500,000. Newly hired employees may purchase the first $200,000 without Evidence of Insurability. • Spousal coverage may be purchased in increments of $1,000 up to $100,000, but must not exceed 50% of the employee purchase amount. Newly hired employees may purchase the first $50,000 without Evidence of Insurability. • Child(ren) coverage: • $500 of coverage on child(ren) age birth to 6 months. • $10,000 of coverage on child(ren) age 6 months to 26 years (if a full-time student). • The full amount is available without Evidence of Insurability.

Employee and Spouse Rates - Monthly Cost per $1,000 of Coverage Age Rate <30 $0.08 30-34 $0.09 35-39 $0.13 40-44 $0.21 45-49 $0.35 50-54 $0.62 55-59 $1.02 60-64 $1.36 65-69 $2.12 70+ See Plan Details Dependent Children $0.08 per $1,000

EMP + Family

Critical Illness Weekly Premiums Employee Only

Click here to access CI Cost Calculator

EMP + Spouse EMP + Child(ren) EMP + Family

Example of Voluntary Term Life Premium Calculations

Monthly Rate Per $1,000

Benefit in $1,000’s

Monthly Premium

Age

$10,000, $20,000 or $30,000. Spouse coverage is also available for 50% of the issued employee benefit amount. Each dependent child (birth to age 26 or age 26+ if disabled) can be covered at 50% of the employees insured amount. There are no age based reductions for this benefit.

Yours

$0.13

X 100 =

$13.00

Spouse

$0.09 $0.08

$4.50 $0.80 $18.30

Child(ren)

X 10 =

Total

Employee Assistance Program

Student Loan Benefit Program

Cigna Employee Assistance Program | 877-622-4327 | www.mycigna.com | Employer ID: Phillips

Fidelity Student Loan Benefit Center | 1-866-711-0350 | www.netbenefits.com

Cigna's employee assistance program services include counseling for marital/family, depression, addiction, stress/anger, life transitions or any issue for short-term counseling for you or an immediate household family member. • In-person help with short-term issues; up to 3 confidential unlimited telephonic support - Legal service, financial service, work/life service • Discount on in-person consultations with network lawyers • Financial consultations and referrals • Work/life services for assistance with child care, finding movers, kennels and pet care, vacation planning, and more.

It may seem too good to be true, but the Student Loan Benefit Program is really going to help you pay down your student debt! You worked hard to get through school and pay your loans. Now it’s time for a little help. How the Student Loan Benefit Program Works For employees who are eligible for the Student Loan Benefit Program (the “Program”) and sign up to participate, Phillips Infrastructure Holdings will make payments directly to the employee’s selected eligible loan service provider. For all program-eligible employees, a monthly payment of $150.00 will be paid by PIH to the loan service provider, up to a lifetime maximum of $10,000.00, OR until the loan(s) is considered repaid. Only one loan at a time may be selected by the employee for a payment under this Program. This payment is an additional payment designed to help employees pay their loans off faster and save on interest; employees are expected to continue making the minimum monthly payments to their loan service provider even if their monthly payments are less than Program monthly payment. Based on the monthly timing of the payment to the loan, employees should reach out to their Loan Service Provider to better determine how the payment will be applied (e.g., principal versus interest).

• Toll-free phone and web access 24/7 • All contact is completely confidential

Cigna can offer support with:

Face-toFace Counseling

Telephonic Work/Life Resources • Adoption • Education • Prenatal Care • Child care • Summer care • Senior care • Parenting • Speical Needs • At-risk adolescents • Pet care • Caregiver needs • Legal (30-minute free consulation with a network attorney

Lifestyle & Fitness Management • Access and referral • Provider directory and search • Self-assessment • Frequently asked questions • Web seminars • Review benefit information • Forms • Article library • Live chat • Interactive tools

It’s easy to get started.

• Mental, emotional,

psychological concerns

• Stress • Marital or relationship problems • Family issues • Anxiety • Depression • Substance use • Eating disorders

Employee Eligibility

Employees eligible to participate in the Program:

• Salaried employees working at least 30 hours per week. Employees become eligible on the first of the month following 60 days after hire. • Rehired employees are eligible; prior payments will count toward the lifetime maximum. • Employees making less than $125,000 per year.

Employees NOT eligible to participate in the Program: • Hourly employees are not eligible.

• Part-time employees working less than 30 hours per week are not eligible. • Employees on any type of leave are not eligible to receive loan payments. • Employees making more than $125,000 per year.

Annual Notices

401(k) Retirement Plan

Fidelity Investments | 1-800-294-4015 | www.netbenefits.com Michael Berger, Client Specialist, Retirement Plan Services | The Trust Company 865-673-3562 | Email: mberger@thetrust.com

SUMMARY OF BENEFIT COVERAGE The Patient Protection and Affordable Care Act (Affordable Care Act or ACA) requires health plans and health insurance issuers to provide a Summary of Benefits and Coverage (SBC) to applicants and enrollees. The SBC is provided by your Medical carrier. Its purpose is to help health plan consumers better understand the coverage they have and to help them make easy comparisons of different options when shopping for new coverage. This information is available when you apply for coverage, by the first day of coverage (if there are any changes), when your dependents are enrolled off your annual open enrollment period, upon plan renewal and upon request at no charge to you. PREMIUM ASSISTANCE UNDER MEDICAID AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer- sponsored plan. If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272). To see if any other states have added a premium assistance program since July 31, 2021 , or for more information on special enrollment rights, contact either: U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272) U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323, Menu Option 4, Ext. 61565 Alabama ...................................................................................................................... 855-692-5447 Alaska .......................................................................................................................... 866-251-4861 Arkansas ...................................................................................................................... 855-692-7447 Colorado . ..................................................................................................................... 800-221-3943 Florida.......................................................................................................................... 877-357-3268 Georgia........................................................................................................................ 404-656-4507 Indiana......................................................................................................................... 877-438-4479 Iowa. ............................................................................................................................ 888-346-9562 Kansas ......................................................................................................................... 785-296-3512 Kentucky ...................................................................................................................... 800-635-2570 Louisiana....................................................................................................................... 888-6952447 Maine........................................................................................................................... 800-442-6003 Massachusetts............................................................................................................. 800-462-1120 Minnesota. ................................................................................................................... 800-657-3739 Missouri........................................................................................................................ 573-751-2005 Montana....................................................................................................................... 800-694-3084 Nebraska...................................................................................................................... 855-632-7633 Nevada......................................................................................................................... 800-992-0900 New Hampshire...........................................................................................................603-271-5218 New Jersey..................................................................................................................800-701-0710 New York......................................................................................................................800-541-2831 North Carolina..............................................................................................................919-855-4100 North Dakota................................................................................................................844-854-4825 Oklahoma..................................................................................................................... 888-365-3742 Oregon......................................................................................................................... 800-699-9075 Pennsylvania ................................................................................................................ 800-692-7462 Rhode Island................................................................................................................401-462-5300 South Carolina ............................................................................................................. 888-549-0820 South Dakota...............................................................................................................888-828-0059 Texas............................................................................................................................ 800-440-0493 Utah . ............................................................................................................................ 877-543-7669 Vermont ........................................................................................................................ 800-250-8427 Virginia......................................................................................................................... 800-432-5924 Washington.................................................................................................................. 800-562-3022 West Virginia................................................................................................................877-598-5820 Wisconsin ..................................................................................................................... 800-362-3002 Wyoming...................................................................................................................... 307-777-7531 For a listing of State websites, visit: https://www.dol.gov/sites/dolgov/files/ebsa/laws-and- regulations/laws/chipra/model-notice.pdf For states not listed: 877-543-7669 www.insurekidsnow.gov OMB Control Number 1210-0137 Expires 1/31/2023 AFFORDABLE CARE ACT (ACA) HEALTHCARE REFORM EXCHANGE NOTICE Under ACA, large employers are responsible to provide eligible employees with coverage that meets the affordability and actuarial value rules set by our government. The plans offered by your employer meet these standards. You will receive a separate notice with specific information. As a result, you and/or your dependents may not be eligible for a federal or state subsidy when applying for

coverage in the Healthcare Marketplace. HIPAA– PRIVACY ACT LEGISLATION The Health Plan and your health care carrier(s) are obligated to protect confidential health information that identifies you or could be used to identify you as it relates to a physical or mental health condition or payment of your health care expenses. If you elect new coverage, you and your beneficiaries will be notified of the policies and practices to protect the confidentiality of your health information. WOMEN’S HEALTH AND CANCER RIGHTS ACT The Women’s Health and Cancer Rights Act (WHCRA) includes protections for individuals who elect breast reconstruction in connection with a mastectomy. WHCRA provides that group health plans provide coverage for medical and surgical benefits with respect to mastectomies. It must also cover certain post-mastectomy benefits, including reconstructive surgery and the treatment of complications (such as lymphedema). Coverage for mastectomy-related services or benefits required under the WHCRA are subject to the same deductible and coinsurance or copayment provisions that apply to other medical or surgical benefits your group contract providers. GENETIC INFORMATION NONDISCRIMINATION ACT (GINA) OF 2008 Title II of the Genetic Information Nondiscrimination Act of 2008 protects applicants and employees from discrimination based on genetic information in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment. GINA also restricts employers’ acquisition of genetic information and strictly limits disclosure of genetic information. Genetic information includes information about genetic tests of applicants, employees, or their family members; the manifestation of diseases or disorders in family members (family medical history); and requests for or receipt of genetic services by applicants, employees, or their family members. SECTION 111 OF JANUARY 1, 2009 Group Health Plans (GHP) are required to comply with the Federal Medicare Secondary Payer Mandatory Reporting provisions in Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007. It requires employers to report specified information regarding their GHP coverage (including Social Security numbers) in order for CMS to determine primary versus secondary payment responsibility. In essence, it helps determine if the Employer plan or Medicare/Medicaid/SCHIP is primary for those employees covered under a government plan and an employer sponsored plan. THE NEWBORNS’ AND MOTHERS’ HEALTH PROTECTION ACT OF 1996 The Newborns’ and Mothers’ Health Protection Act of 1996 provides that group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). An attending provider is defined as an individual who is licensed under applicable state law to provide maternal or pediatric care and who is directly responsible for providing such care to a mother or newborn child. The definition of attending provider does not include a plan, hospital, managed care organization or other issuer. In any case, plans may not, under federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). Please contact us if you would like any additional information on The Newborns’ and Mothers’ Health Protection Act or WHCRA. MICHELLE’S LAW An amendment to the Employee Retirement Income Security Act (ERISA), the Public Health Service Act (PHSA), and the Internal Revenue Code (IRC), this law ensures that dependent students who take a medically necessary leave of absence do not lose health insurance coverage. Michelle’s Law allows seriously ill college students, who are covered dependents under health plans, to continue coverage for up to one year while on medically necessary leaves of absence. The leave must be medically necessary as certified by a physician, and the change in enrollment must commence while the dependent is suffering from a serious illness or injury and must cause the dependent to lose student status. Under the law, a dependent child is entitled to the same level of benefits during a medically necessary leave of absence as the child had before taking the leave. If any changes are made to the health plan during the leave, the child remains eligible for the changed coverage in the same manner as would have applied if the changed coverage had been the previous coverage, so long as the changed coverage remains available to other dependent children under the plan. UNIFORMED SERVICES EMPLOYMENT AND REEMPLOYMENT RIGHTS ACT OF 1994 (USERRA) The Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA) was signed into law on October 13, 1994. USERRA clarifies and strengthens the Veterans’ Reemployment Rights (VRR) Statute. The Act itself can be found in the United States Code at Chapter 43, Part III, Title 38. The Department of Labor has issued regulations that clarify its position on the rights of returning service members to family and medical leave under the USERRA. See 20 CFR Part 1002.210. USERRA is intended to minimize the disadvantages to an individual that occur when that person needs to be absent from his or her civilian employment to serve in this country’s uniformed services. USERRA makes major improvements in protecting service member rights and benefits by clarifying the law and improving enforcement mechanisms. It also provides employees with Department of Labor assistance in processing claims. USERRA covers virtually every individual in the country who serves in or has served in the uniformed services and applies to all employers in the public and private sectors, including Federal employers. The law seeks to ensure that those who serve their country can retain their civilian employment and benefits, and can seek employment free from discrimination because of their service. USERRA provides protection for disabled veterans, requiring employers to make reasonable efforts to accommodate the disability. USERRA is administered by the United States Department of Labor, through the Veterans’ Employment and Training Service (VETS). VETS provides assistance to those persons experiencing service connected problems with their civilian employment and provides information about the Act to employers. VETS also assists veterans who have questions regarding Veterans’ Preference. HIPAA SPECIAL ENROLLMENT SPECIAL ENROLLMENT NOTICE This notice is being provided to make certain that you understand your right to apply for group health insurance coverage. You should read this notice even if you plan to waive health insurance coverage at this time. Loss of Other Coverage If you are declining coverage for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage).

The PIH 401(k) Retirement Plan is administered by Fidelity Investments and enables you to save money for retirement to cover living expenses such as mortgage, utilities, auto, etc.

AUTOMATIC ENROLLMENT All eligible new hires are automatically enrolled in the 401(k) Plan at 6% of your weekly earnings on the first of the month following 60 days of employment. If you do not select an investment mix of your own, PIH has directed Fidelity to place your contributions into a Fidelity Investments target date fund that most closely aligns with your projected retirement date based upon your birth year. The 2023 maximum annual combined contribution for the Traditional and Roth 401(k) plans is $22,500. Participants age 50 and older may contribute an additional “catch-up” contribution of $7,500 per year. PIH established an Annual Increase Program (AIP) that auto increases your contribution by 1% annually until you reach the AIP cap of 10% or plan limit.

PIH's Contribution PIH matches $0.50 of every dollar you contribute up to 6%. You will get a full 3% match by contributing 6%. You may change the percentage you contribute to your retirement plan at any time during the plan year. You are always 100% vested in your own contributions. The company’s contribution is on a 5 year vesting schedule. Being vested means that you have the right to receive the money in your account when you retire or leave the company.

Years of Service for Vesting

Percentage

Less than 1

40 60

100

The above Wellness Program notice is only applicable if your plan administrator or medical plan provides a wellness program. HIPAA PRIVACY NOTICE The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) requires that we maintain the privacy of protected health information, give notice of our legal duties and privacy practices regarding health information about you and follow the terms of our notice currently in effect. You may request a copy of the current Privacy Practices from the Plan Administrator explaining how medical information about you may be used and disclosed, and how you can get access to this information. As Required by Law. We will disclose Health Information when required to do so by international, federal, state or local law. You have the right to inspect and copy, the right to an electronic copy of electronic medical records, right to get notice of a breach, right to amend, right to an accounting of disclosures, right to request restrictions, right to request confidential communications, right to a paper copy of this notice and the right to file a complaint if you believe your privacy rights have been violated. Individual Rights You may obtain a copy of your health claims records and other health information from us typically within a 30 day period from your request. We may charge a reasonable, cost-based fee. You may ask us to correct your health/claims records if you think they are incorrect. We reserve the right to say “no” to your request, but will give you an explanation in writing within a 60 day period. Requesting a specific way to contact you for confidential reasons is permitted (home or office phone for example), specifically if you would be in danger from a certain form of communication. If you would like us not to use or share certain health information for treatment, payment or our operations, you are permitted to do so. However, we are not required to agree to your request if it would affect your care. At your request, we will provide you with a list of the times we have shared your health information up to six years prior to your request date, who we shared it with, and why. This list will include all disclosures excluding treatment, payment, and health care operations, as well as other certain disclosures (such as any you ask us to make). We provide one list a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months. You can ask for a paper copy of this notice at any time, which we will promptly provide, even if you have agreed to receive the notice electronically. If you have given someone medical power of attorney or if you have a legal guardian, that person can exercise your rights and make choices about your health information. We will make sure they have this authority and can act in your interests before we take any action. If you feel that we have violated your rights, you may contact us using the information on the back page, or file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We can assure no retaliation from us against you for filing a complaint. For certain health information, you can tell us your choices about what we share. You have the right and choice to tell us to share information with your family, close friends, or others involved in payment for your care, and in a disaster relief situation. If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest and when needed to lessen a serious and imminent threat to health or safety. We never share your information for marketing purposes of sale of your information without your expressed written consent. Our Uses and Disclosures We typically use or share your information in several different ways. We help manage the healthcare treatment you receive by sharing information with professionals who are treating you. We can use and disclose your information to run our organization and contact you when necessary. We are not allowed to use genetic information to decide whether we will give you coverage and the price of that coverage (this does not apply to long term care plans). Our organization can use and disclose your health information as we pay for your health services, as well as disclose your health information to your health plan sponsor for plan administration. Other Uses and Disclosures Typically in the matter of public health and safety issues, we can use and share your information. For instance, preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect or domestic violence, as well as preventing or reducing a serious threat to anyone’s health or safety, and health research. We may need to share your information if state or federal law requires it, including the Department of Health and Human Services if it wishes to see that we’re complying with federal privacy law. Other organizations and professionals we may share your information with are organ procurement organizations, coroners, medical examiners, and funeral directors. We can share your information in special instances such as for worker’s compensation claims, law enforcement purposes, health oversight agencies for activities authorized by law, and for special government functions such as military, national security, and presidential protective services. We can share information about you in response to a court or administrative order, or in response to a subpoena. Our Responsibilities We are required by law to maintain the privacy and security of your protected health information. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. We must follow the duties and privacy practices described in this notice and give you a copy of it. We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. PRESCRIPTION DRUG COVERAGE AND MEDICARE This notice has information about your current prescription drug coverage with Our Company and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage: 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2. Our Company has determined that the prescription drug coverage offered by the medical plans are, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan. What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan? If you decide to join a Medicare drug plan, your current employee coverage will not be affected. You can keep this coverage if you elect part D and the Medical Carrier plan will coordinate with Part D coverage. If you do decide to join a Medicare drug plan and drop your current Our Company’s coverage, be aware that you and your dependents may not be able to get this coverage back. When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? You should also know that if you drop or lose your current coverage with Our Company and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. More Information About Your Options Under Medicare Prescription Drug Coverage… More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage: • Visit www.medicare.gov • Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help • Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

Example: You waived coverage under this plan because you were covered under a plan offered by your spouse’s employer. Your spouse terminates employment. If you notify your employer within 30 days of the date coverage ends, you and your eligible dependents may apply for coverage under this health plan. Marriage, Birth, or Adoption If you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, or placement for adoption. Example: When you were hired, you were single and chose not to elect health insurance benefits. One year later, you marry. You and your eligible dependents are entitled to enroll in this group health plan. However, you must apply within 30 days from the date of your marriage. Medicaid or CHIP If you or your dependents lose eligibility for coverage under Medicaid or the Children’s Health Insurance Program (CHIP) or become eligible for a premium assistance subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents. You must request enrollment within 60 days of the loss of Medicaid or CHIP coverage or the determination of eligibility for a premium assistance subsidy. Example: When you were hired, your children received health coverage under CHIP and you did not enroll them in this health plan. Because of changes in your income, your children are no longer eligible for CHIP coverage. You may enroll them in this group health plan if you apply within 60 days of the date of their loss of CHIP coverage. For More Information or Assistance To request special enrollment or obtain more information, please contact: Human Resources 10142 Parkside Drive, Suite 500 Knoxville, TN 37922 Note: If you or your dependents enroll during a special enrollment period, as described above, you will not be considered a late enrollee. Therefore, your group health plan may not impose a preexisting condition exclusion period of more than 12 months. Any preexisting condition exclusion period will be reduced by the amount of your prior creditable health coverage. Effective for plan years beginning on or after Jan. 1, 2014, health plans may not impose pre-existing condition exclusions on any enrollees. HITECH (FROM WWW.CDC.GOV) The American Reinvestment & Recovery Act (ARRA) was enacted on February 17, 2009. ARRA includes many measures to modernize our nation’s infrastructure, one of which is the “Health Information Technology for Economic and Clinical Health (HITECH) Act.” The HITECH Act supports the concept of meaningful use (MU) of electronic health records (EHR), an effort led by the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC). HITECH proposes the meaningful use of interoperable electronic health records throughout the United States health care delivery system as a critical national goal. Meaningful Use is defined by the use of certified EHR technology in a meaningful manner (for example electronic prescribing); ensuring that the certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of care; and that in using certified EHR technology the provider must submit to the Secretary of Health & Human Services (HHS) information on quality of care and other measures. RESCISSIONS The Affordable Care Act prohibits the rescission of health plan coverage except for fraud or intentional misrepresentation of a material fact. A rescission of a person’s health plan coverage means that we would treat that person as never having had the coverage. The prohibition on rescissions applies to group health plans, including grandfathered plans, effective for plan years beginning on or after September 23, 2010. Regulations provide that a rescission includes any retroactive terminations or retroactive cancellations of coverage except to the extent that the termination or cancellation is due to the failure to timely pay premiums. Rescissions are prohibited except in the case of fraud or intentional misrepresentation of a material fact. For example, if an employee is enrolled in the plan and makes the required contributions, then the employee’s coverage may not be rescinded if it is later discovered that the employee was mistakenly enrolled and was not eligible to participate. If a mistake was made, and there was no fraud or intentional misrepresentation of a material fact, then the employee’s coverage may be cancelled prospectively but not retroactively. Should a member’s coverage be rescinded, then the member must be provided 30 days advance written notice of the rescission. The notice must also include the member’s appeal rights as required by law and as provided in the member’s plan benefit documents. MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT (MHPAEA) MHPAEA generally applies to group health plans and health insurance issuers that provide coverage for both mental health or substance use disorder benefits and medical/surgical benefits. MHPAEA provides with respect to parity in coverage of mental health and substance use disorder benefits and medical/ surgical benefits provided by employment-based group health plans. MHPA ‘96 required parity with respect to aggregate lifetime and annual dollar limits for mental health benefits. MHPAEA expands those provisions to include substance use disorder benefits. Thus, under MHPAEA group health plans and issuers may not impose a lifetime or annual dollar limit on mental health or substance use disorder benefits that is lower than the lifetime or annual dollar limit imposed on medical/ surgical benefits. MHPAEA also requires group health plans and health insurance issuers to ensure that financial requirements (such as co-pays and deductibles), and quantitative treatment limitations (such as visit limits), applicable to mental health or substance use disorder benefits are generally no more restrictive than the requirements or limitations applied to medical/surgical benefits. The MHPAEA regulations also require plans and issuers to ensure parity with respect to no quantitative treatment limitations (such as medical management standards). PREVENTIVE CARE Health plans will provide in-network, first-dollar coverage, without cost- sharing, for preventative services and immunizations as determined under health care reform regulations. These include, but are not limited to, cancer screenings, well-baby visits and influenza vaccines. For a complete list of covered services, please visit: https://www.healthcare.gov/ coverage/preventive-care-benefits/ WELLNESS PROGRAM Our company’s Wellness Program is a voluntary wellness program available to all employees. The program is administered according to federal rules permitting employer-sponsored wellness programs that seek to improve employee health or prevent disease, including the Americans with Disabilities Act of 1990, the Genetic Information Nondiscrimination Act of 2008, and the Health Insurance Portability and Accountability Act, as applicable, among others. If you choose to participate in the wellness program you will be asked to complete a voluntary health risk assessment or “HRA” that asks a series of questions about your health-related activities and behaviors and whether you have or had certain medical conditions (e.g., cancer, diabetes, or heart disease). You may also be asked to complete a biometric screening, which may include a blood test. You are not required to complete the HRA or to participate in the blood test or other medical examinations.

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