Jefferson Center - 2025 Open Enrollment Benefit Guide

2025 EMPLOYEE BENEFITS GUIDE

MAKE THE MOST OF BENEFITS TO SUPPORT YOUR TOTAL WELL-BEING

Jefferson Center for Mental Health Benefits At Jefferson Center for Mental Health (Jefferson Center), we know our dedicated employees — YOU — are key to our overall success as an organization. We recognize that offering a quality, comprehensive benefit program is an important way to show you how valuable you are to the organization. We understand that navigating the world of employee benefits is challenging and no two employees are alike, which is why we offer this benefits guide to explain the multiple benefit options to improve your physical, financial and mental well-being. YOUR BENEFITS Benefit Eligibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Benefit Enrollment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Changing Your Benefits During the Year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 YOUR HEALTH PLANS Medical Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Kaiser DHMO PLUS Plan Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Medical Decision Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Telemedicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Wellness Benefits & Health Insurance Reimbursement . . . . . . . . . . . . . . . . 9 Flexible Spending Account . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Dental Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Vision Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Medical Premiums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Vision and Dental Premiums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Voluntary Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Life and Accident Death and Dismemberment Insurance . . . . . . . . . . . . . . . 16 Voluntary Life and Accidental Death and Dismemberment Premiums . . . . 17 Disability Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 ADDITIONAL BENEFITS Employee Assistance Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Retirement/ Tuition Reimbursement / Paid Leave . . . . . . . . . . . . . . . . . . . . . . . 20 ADDITIONAL INFORMATION Resources and Contact Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 State Specific Social Determinants of Health . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Benefit Notices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

Your Benefits Eligibility Benefit eligible employees are scheduled to work 20 or more hours per week. Please contact Human Resources for more information on rates, eligibility, benefit start dates, and for any summary plan descriptions for these benefit plans. Insurance coverage may be elected or changed ONLY at time of hire, due to a qualifying life event or during open enrollment.

Part-time benefit eligible employees: Are eligible to enroll in the Jefferson Center benefits if their scheduled work hours are 20-29 hours per week. Benefits are effective on the 1 st day of the month following their date of hire. Coverage ends: Upon separation of employment with Jefferson Center (voluntarily or otherwise), benefits will end on the last day of the month in which you terminate employment, except when indicated otherwise.

Full-time benefit eligible employees:. Are eligible to enroll in the Jefferson Center benefits if their scheduled work hours are 30-40 hours per week. Benefits are effective on the 1 st day of the month following their date of hire.

Coverage begins: The first day of the month following date of hire. If enrolled during open enrollment, coverage is effective January 1 of the following year.

Adding a family member Prior to electing benefits, employees should verify that Human Resources has proof of dependent status for any dependent who are being added. This is not required if your dependents have previously been covered through the Jefferson Center insurance plan. The following can be used as proof: • Marriage license for spouse • Birth certificate, adoption, or placement documents for children • Signed domestic partner affidavit Covering your family members Many of the plans offer coverage for your eligible family members, including: • Your spouse, including your legally married same- or opposite-sex spouse, common law spouse, civil union partner, or same- or opposite-sex domestic partner • Your dependent children, including your stepchildren, legally-adopted children, and children placed with you for adoption • Dependent children are eligible for medical, dental, and vision insurance up to the end of the month in which they turn age 26 (regardless of student or marital status) • Dependent children of any age may remain eligible if they are physically or mentally incapable of self-support.

Benefits Enrollment

How to Enroll

New employees As a new employee, you must enroll in benefits within 30 days of your date of hire. If you do not enroll within 30 days, you will need to wait until the next open enrollment period to enroll. Current employees Open enrollment is the only time during the year that you can change your benefits unless you experience a qualifying life event. During the open enrollment period, you have the opportunity to newly enroll in coverage and/or make changes to your current coverage. If you wish to contribute pre-tax dollars to a flexible spending account in 2025, you must make a new election during open enrollment. FSA elections do not carry over from year to year.

Log into UKG Navigate to Myself > Open Enrollment > select 2025 Open Enrollment.

In order to complete your enrollment, you may need:

• Dates of birth and social security numbers for dependents and beneficiaries as well as any family members you are enrolling. • Proof of eligibility for your spouse and dependent children (e.g., marriage license, birth certificate, common law affidavit).

Any changes you make during open enrollment become effective January 1 st .

Changing Your Benefits During the Year As stated above, you cannot change your benefits during the year unless you experience a qualifying life event. The most common qualifying life events are: • Marriage, legal separation or divorce • Birth, adoption or change in legal custody of eligible child(ren) • Death of your spouse or covered child • Loss of other coverage (e.g., child turns 26 and loses coverage through parent’s plan) There are other, less common, life events that allow you to change your benefits. Please contact Human Resources at humanresources@JCMH.org or visit The Hub . Human Resources Team > Benefits for a complete list of qualifying life events. If you experience a qualifying life event and wish to change your benefits, you must log into the UKG> Myself > Life Events > Family Status Change within 30 days of the life event. You may be required to provide proof of your life event, such as a birth certificate or marriage license. You can only change benefits that were impacted by the life event (e.g., if you get married, you can add your new spouse to the medical plan, but you cannot change medical plans).

Medical Insurance

Jefferson Center offers four (4) medical insurance plan options. Employees may choose between two (2) Kaiser Permanente plans or two (2) Cigna Healthcare plans. Please take the time to understand the features and differences of each plan so that you choose the coverage that is best for you and your family. Each Cigna medical plan includes in-network benefits only, which means you must obtain medical / prescription drug care from contracted in-network ( Local Plus ) providers for coverage under the health plan. Locate a Cigna Local Plus network provider at www.cigna.com . The Kaiser medical plans include in-network benefits only, with exception of the $1,500 Deductible plan option which allows for up to ten (10) out-of-network provider visits per calendar year , which means you can choose any provider that you would like. However, you will pay less out of your pocket when you choose a Kaiser HMO network provider. Locate a Kaiser HMO network provider at www.kp.org. The table below summarizes the key features of the medical plans. The coinsurance amounts listed reflect the amount you pay for services. Please refer to the official pan documents for additional information on coverage and exclusions.

KAISER DHMO PLUS 1500

KAISER DHMO 500

Deductible (individual/family) - Embedded Out-of-pocket maximum (individual/family) - Embedded

$500 / $1,000

$1,500 / $3,000

$2,000 / $4,000

$4,500 / $9,000

Coinsurance

90% / 10%

Covered at 100% in- network

Preventive care

Office visits (primary care/ specialist)

$25 / $35

Deductible / Coinsurance Deductible / Coinsurance Deductible / Coinsurance

Emergency Room

$250 copay $100 copay

Urgent Care

Diagnostic Lab: Plan pays 100% X-ray: Deductible/ Coinsurance

Diagnostic Lab/x-ray

Deductible / Coinsurance

Inpatient hospital

Deductible / Coinsurance Surgical Center: $500 OP Hospital: Deductible / Coinsurance Deductible / Coinsurance

Deductible / Coinsurance Surgical Center: $500 OP Hospital: Deductible / Coinsurance Deductible / Coinsurance Deductible / Coinsurance $15 / $25 / $40 / 20% up to $250

Outpatient hospital

Inpatient Mental Health Outpatient Mental Health

$25 copay

$15 / $25 / $40 / 20% up to $250

Rx (generic/preferred/brand/specialty)

CIGNA HMO 500

CIGNA HMO 1500

Deductible (individual/family) – Embedded

$500 / $1,000

$1,500 / $3,000

Out-of-pocket maximum (individual/family) - Embedded

$2,000 / $4,500

$4,500 / $9,000

Coinsurance

90% / 10%

Preventive care

Covered at 100% in-network

Office visits (primary care/ specialist)

$25 / $35

Deductible / Coinsurance

Emergency Room

$250 copay

Deductible / Coinsurance

Urgent Care

$100 copay

Deductible / Coinsurance

Diagnostic Lab/x-ray

Plan pays 100%

Deductible / Coinsurance

Inpatient & Outpatient Hospital

Deductible / Coinsurance

Inpatient Mental Health

Deductible / Coinsurance

Outpatient Mental Health

$35 copay

Deductible / Coinsurance

Rx (generic/preferred/brand/specialty)

$15 / $25 / $40 / 20% up to $100 $15 / $25 / $40 / 20% up to $100

Kaiser DHMO PLUS 1500 Plan Features

In- and out-of-network benefits available under the Kaiser DHMO Plus 1500 plan only (up to 10 out-of-network provider visits allowed per calendar year)

Members are allotted 10 visits with an out-of-network provider. If they exceed 10 visits, any additional services will be an out-of- pocket expense as long as it isn’t emergency or urgent care.

There is a $40.00 copay per visit for the following: • Family Practice • Outpatient Mental Health & Outpatient Chemical Dependency • Outpatient Therapy Office Visits (PT, OT, ST) • Allergy Injection • Each allergy injection will count as a visit used

There is a $60.00 copay per visit for the following: • Specialist Office Visits • Allergy Office Visits • Gynecology Office Visits

There is a 30% coinsurance for the following: • Lab (any lab tests done by the provider on the same day will count as a visit) • Radiology (multiple views of the same body part will count as one visit) • Select Durable Medical Equipment • Items must be supplied from the office visit

Services excluded from the PLUS benefit include, but are not limited to: • Inpatient or outpatient hospital services and any out of area facility fees • Any services provided while in a hospital, skilled nursing facility or ambulatory surgical center • Acupuncture, chiropractic, and massage therapy • Applied behavior analysis (ABA) therapy • Routine prenatal and maternity

• Dialysis • Oxygen

• Bariatric surgery • Genetic testing • Infertility • Home health care and hospice care • Dental services • Office administered drugs • Breast cancer screenings and/or imaging • Therapeutic x-rays • PET, CT, MRI, and Nuclear Medicine • Screening colonoscopies • Exams for the fitting and dispensing of contact lenses • Any and all services not covered under the members in network plan

Which Medical Plan is Right For Me?

Kaiser DHMO PLUS 1500 Plan • In- and out-of-network benefits available under the Kaiser DHMO Plus 1500 plan only (up to 10 out-of-network provider visits allowed per calendar year) • You pay deductible and coinsurance for most covered health services • You pay copays for covered prescription drugs • You can fund a health care flexible spending account (FSA) Kaiser DHMO 500 Plan • In-network benefits only • You pay copays for office visits and covered prescription drugs • You pay deductible and coinsurance for all other covered health services (i.e. hospitalization) • You can fund a health care flexible spending account (FSA) Cigna HMO 1500 Local Plus Plan • In-network benefits only • You pay deductible and coinsurance for most covered health services • You pay copays for covered prescription drugs • You can fund a health care flexible spending account (FSA) Cigna HMO 500 Local Plus Plan • In-network benefits only • You pay copays for office visits and covered prescription drugs • You pay deductible and coinsurance for all other covered health services (i.e. hospitalization) • You can fund a health care flexible spending account (FSA)

Things to consider before you enroll:

1. What planned health care services are you expecting to need next year?

2. Do you take any prescription drugs on a regular basis?

3. Are you currently seeing any doctors that are outside of the Kaiser HMO or Cigna Local Plus networks?

4. Would you rather pay less out of your paycheck but more when you need care? Or, would you prefer to pay more out of your paycheck but less when you need care?

5. Are you able to budget for your health care expenses by funding a flexible spending account?

Telemedicine

Virtual Healthcare Jefferson Center is committed to your physical and mental well-being, offering several program options with you in mind. Virtual doctor’s visits allow you to see and speak to a doctor or licensed therapist online, anytime. The Kaiser and Cigna medical plans offer virtual healthcare benefits to their plan members.

Behavioral Health Virtual Healthcare

Stressed or anxious? Getting help is now easier than ever with the help of virtual therapy. Virtual therapy offers confidential counseling and includes: • Private video sessions: get 1-on-1 support in your home and at a time that’s convenient for you • Help with coping (for children, teens and adults): your licensed therapist may provide a diagnosis, treatment and medication if needed • Similar standard of care as in-person visits: you can see the same therapist with each appointment and establish an ongoing relationship Virtual therapy is designed to help treat conditions like: • ADD/ADHD • Addiction • Anxiety • Depression • Mental health disorders

When Virtual Healthcare is Appropriate Virtual healthcare is good for routine issues such as: • Cold and flu symptoms • Allergies • Pink eye • Urinary tract infections • Rash • Sinus problems • Quick assessment for severity

When Virtual Healthcare is Not Appropriate

•

Virtual healthcare is not good for diagnoses that require a hands-on exam and lab test, emergencies or for injuries such as sprains and broken bones

•

Stomach aches

EXAMPLE Over the weekend, Linda’s daughter begins itching her eye excessively. Knowing her primary care physician is not in the office, Linda utilizes virtual healthcare. She simply speaks with a doctor virtually, sends in photos of her child’s eye, and the doctor is able to prescribe an antibiotic for pink eye.

Rather than waiting in an urgent care, Linda is able to stay home and care for her daughter!

Virtual care is easy to use! ❖ Cigna Plan Members: • Book an MDLive appointment from anywhere, anytime at www.myCigna.com ❖ Kaiser Plan Members: Book a virtual care appointment from anywhere, anytime at www.kp.org/getcare • Video chat with a board-certified doctor from your phone, tablet, or computer • A prescription can be sent to the pharmacy nearest you All four of the Jefferson Center medical plans include telemedicine benefits. Register today so that you are ready to use this benefit when you need it. You will need your medical insurance information to complete your registration so be sure to have your medical insurance ID card handy.

Wellness Benefits

ALIVE! Wellness Program This program is designed to assist you in feeling and performing at your best at work and at home. The ALIVE! Program offers a variety of activities and incentives (including a discount on your health insurance premiums) to help you get and stay on the road to wellness. ALIVE! Wellness Program Wellness Hour Jefferson Center allows one hour each week to spend time on your personal well-being. You can go to the gym, take a walk, practice yoga or any other activity you choose. The Wellness Hour is based on FTE and is prorated accordingly (must be coordinated with your supervisor). Wellness Hour

Health Insurance Reimbursement

Benefit eligible employees who choose to be covered under a non-Jefferson Center health insurance plan, The Center will reimburse up to $125 per month (this benefit is prorated based on scheduled hours worked). Complete form and upload in the Documents tab in UKG

Flexible Spending Account

Jefferson Center offers two flexible spending account (FSA) options through ThrivePass . The money that you put into an FSA is collected from your paycheck before taxes are withheld, which means you don’t pay taxes on those dollars. Basically, it is like using a 25% off coupon for your health care and dependent care expenses! Please read this page carefully before you make your FSA elections. Important Information Regarding Your FSA Accounts • FSA dollars must be used by the end of the year. Any unused dollars in excess of the rollover limit will be lost • At the end of the 2025 plan year, you can roll over up to $660 from your health care FSA to use in future years • All requests for reimbursement for the prior plan year must be submitted to ThrivePass by March 31 st . • FSA elections must be made every year during open enrollment. Your current year election WILL NOT carry over to next year • A full list of eligible expenses is available at www.fsastore.com Health Care FSA (not allowed if you fund an HSA) • Health care FSA dollars can be used to pay for eligible out-of-pocket expenses such as deductibles, copays, and other health-related expenses that are not reimbursed by the medical, dental, or vision plans • Use dollars to pay for over-the-counter (OTC) medications • You may contribute up to the IRS maximum, projected to be $ 3,300 to your health care FSA for the 2025 calendar year. The entire amount you elect is available to you on January 1 or your benefits effective date • At the end of the 2025 plan year, you can roll over up to $660 from your health care FSA to use in future years Dependent Care FSA • Dependent care FSA dollars can be used to pay for eligible dependent care expenses that allow you and your spouse to work or attend school full time • Eligible expenses include day care, preschool, summer camp, before- and after-school care, and elder care • Funds can be used to care for your: • Children under 13 years of age; • Child over 13, spouse, and/or elderly parent who lives with you and is unable to care for themselves. • You may contribute up to $5,000 to the dependent care FSA for the 2025 calendar year if you are married and file a joint return or if you file a single or head of household return. If you are married and file separate returns, you can each elect $2,500 • Dependent care contributions are deposited each pay period. You can only be reimbursed for amounts up to what is currently in your account • Dependent care dollars do not carry over to the next year. Any dollars remaining in your account on December 31 will be lost

Dental Insurance

Jefferson Center offers PPO dental insurance through Delta Dental of Colorado . This dental plan includes in- and out-of- network benefits, which means you can choose any dentist that you would like. However, you will pay less out of your pocket when you choose a Delta Dental of Colorado PPO network dentist. Locate a Delta Dental of

Do I need to see a dentist?

Colorado network dentist at www.deltadentalco.com.

A visit to the dentist is about more than just a teeth cleaning. By looking in your mouth, your dentist can tell a lot about your overall health. In fact, he or she may be able to identify early signs of disease, such as diabetes, heart disease, kidney disease, and even some forms of cancer, before you even notice symptoms.

The table below summarizes the key features of the dental plans. Please refer to the official plan documents for additional information on coverage and exclusions.

PPO*

Premier**

Non-Network***

$50 / $150

Deductible (individual/family)

$1,500 per enrolled member

Annual Benefit Maximum

Plan pays 100%; deductible waived

Member pays 20%; deductible waived

Member pays 20% + any balance billed charges not covered; deductible waived Member pays 50% + any balance billed charges not covered; after deductible Member pays 75% + any balance billed charges not covered; after deductible

Diagnostic / Preventive Services

Member pays 20% after deductible

Member pays 50% after deductible

Basic Services

Member pays 50% after deductible

Member pays 75% after deductible

Major Services

Plan pays 50% up to lifetime maximum benefit of $1,000 per enrolled eligible dependent

Orthodontia / Braces (up to age 19)

PREVENTION FIRST INCLUDED – Diagnostic and preventive care services do not apply toward the calendar year maximum.

*PPO contracted providers extend the deepest discount for services resulting in the strongest benefit at the least out-of-pocket costs to DDCO plan members. The PPO percentage of benefits is based on the PPO Schedule of Allowance.

**Premier providers percentage of benefits is limited to the Premier Maximum Plan Allowance and will have higher out-of-pocket costs for plan members accessing care from a Premier provider.

***Non-participating (out-of-network) providers are not bound by contracted fees for services; therefore, plan members are responsible for the difference between the non-participating maximum plan allowance and the full fee charged by the dentist.

Vision Insurance

Jefferson Center offers a vision insurance plan through EyeMed . This plan allows you to choose any eye care provider. However, you will maximize the plan benefits when you choose an ACCESS network provider. Locate an EyeMed network provider at www.eyemed.com and choose ACCESS network or call 866.723.0596. The table below summarizes the key features of the vision plan. Please refer to the official plan documents for additional information on coverage and exclusions.

In-Network Benefits (ACCESS Network)

Frequency of Glasses/Lenses/Frames

12 / 12 / 24

Exams

$10 copay

Lenses

$25 copay

Frames

$130 allowance

Medically Necessary: Plan pays 100% (no copay) Elective: $130 Allowance Discounts available 15% off retail price or 5% off promotional price

Contacts

Laser Correction

Do I need an annual eye exam if I have perfect vision? Your eyes are your windows to the world. They are also your eye doctor’s windows into your body. Just by looking in your eyes, a doctor can find warning signs of serious diseases and conditions like high blood pressure, high cholesterol, thyroid diseases, and certain types of cancer. In fact, eye doctors are frequently the first to detect signs of abnormal health conditions.

Medical Premium Rates

Monthly Kaiser DHMO 500 Medical Cost

Full-Time Employee

Part-Time Employee

Monthly Cost w/Wellness Discount

Employee Monthly Cost

Employee Only

$164.24

$139.60

$369.53

$314.10

Employee + Spouse

$656.50

$558.03

$1,077.34

$915.74

Employee + Child(ren)

$640.49

$544.42

$1,051.06

$893.40

Employee + Family

$925.52

$786.69

$1,518.80

$1,290.98

Monthly Kaiser DHMO PLUS 1500 Medical Cost

Full-Time Employee

Part-Time Employee

Monthly Cost w/Wellness Discount

Employee Monthly Cost

Employee Only

$95.37

$81.06

$297.54

$252.91

Employee + Spouse

$422.26

$358.92

$860.16

$731.13

Employee + Child(ren)

$411.96

$350.16

$839.17

$713.30

Employee + Family

$595.29

$506.00

$1,212.63

$1,030.73

Monthly Cigna HMO 500 Medical Cost

Full-Time Employee

Part-Time Employee

Monthly Cost w/Wellness Discount

Employee Monthly Cost

Employee Only

$198.38

$168.62

$446.36

$379.41

Employee + Spouse

$731.99

$622.19

$1,301.32

$1,106.12

Employee + Child(ren)

$714.14

$607.02

$1,269.58

$1,079.14

Employee + Family

$1,031.95

$877.16

$1,834.57

$1,559.39

Monthly Cigna HMO 1500 Medical Cost

Full-Time Employee

Part-Time Employee

Monthly Cost w/Wellness Discount

Employee Monthly Cost

Employee Only

$107.48

$91.36

$335.35

$285.04

Employee + Spouse

$475.91

$404.52

$969.44

$824.02

Employee + Child(ren)

$464.30

$394.66

$945.80

$803.93

Employee + Family

$670.93

$570.29

$1,366.70

$1,161.70

Dental and Vision Premium Rates

Monthly Dental Cost

Full-Time Employee

Part-Time Employee

Employee

Employee Only

$7.57

$17.99

Employee + Spouse

$32.40

$52.21

Employee + Child(ren)

$41.19

$66.37

Employee + Family

$57.17

$92.10

Monthly Vision Cost

Full-Time Employee

Part-Time Employee

Employee

Employee Only

$8.04

Employee + Spouse

$15.18

Employee + Child(ren)

$15.97

Employee + Family

$23.44

Full-Time Employee: 30-40 scheduled hours per week Part-Time Employee: 20-29 scheduled hours per week

Voluntary Benefits Jefferson Center provides you the option to purchase pet insurance through Nationwide . We also provide you the opportunity to purchase ID theft protection coverage through Norton LifeLock . The amount you pay for these plans are deducted from your paycheck on a post-tax basis. Pet Insurance

Coverage includes: • Accidents • Illnesses • Hereditary and congenital conditions • Cancer • Behavioral treatments • Rx therapeutic diets and supplements • Wellness and more Key features of the pet insurance plan:

Nationwide pet insurance helps you cover veterinary expenses so you can provide your pets with the best care possible without worrying about the cost. My Pet Protection is available in two reimbursement options (50% and 70%) with an optional $500 wellness benefit so you can find coverage that fits your budget.¹ Base plans have a $250 annual deductible and $7,500 annual benefit.

ID Theft Protection In today’s world of online shopping, using public Wi -Fi and giving out Social Security numbers as a form of ID, our personal information can be exposed. Unfortunately, free credit monitoring simply alerts you to credit issues. LifeLock not only has proprietary technology to detect a range of identity threats, if you do have an identity theft problem, our U.S.-Based team of Identity Restoration Specialists can help fix it. It pays to have the comprehensive protection of LifeLock.

Helps protect 401(k) and other investment accounts from fraudulent withdrawals and balance transfers. This plan also includes one- bureau annual credit score and reports, monthly credit score tracking, and three-bureau annual credit monitoring. LifeLock Benefit Elite:

Protection is aimed at what matters to you, helping protect your identity and your nest egg. LifeLock Benefit Elite Plus protection helps detect potential fraud and notifies you through email, text, phone or mobile app alerts. LifeLock Benefit Elite Plus: Membership is available only as an added membership to an adult LifeLock Plan. This benefit offers protection to help safeguard your child’s Social Security number and name with proactive identity theft protection designed specifically for children. Learn more by visiting www.LifeLock.com/products/lifelock-junior. LifeLock Junior:

How To Enroll Enroll online at: http://jeffersoncenter.excelsiorenroll.com

15 [1] Starting on 9/1/23 new members can select the My Pet Protection® Wellness500 coverage option, with the earliest effective date of 10/1/23 and forward. Existing members can add My Pet Protection® Wellness500 during their respective renewal period only. [2] These are examples of general coverage; please review plan document for specific coverages. Some exclusions may apply. Certain coverages may be excluded due to pre-existing conditions. See policy documents for a complete list of exclusions. [3] Guaranteed issuance does not mean guaranteed coverage since certain exclusions could apply. [4] State of the Industry Report 2022, North American Pet Health Insurance Association. Products underwritten by Veterinary Pet Insurance Company (CA), Columbus, OH; National Casualty Company (all other states), Columbus, OH. Agency of Record: DVM Insurance Agency. All are subsidiaries of Nationwide Mutual Insurance Company. Nationwide, the Nationwide N and Eagle, Nationwide is on your side, vethelpline® and Nationwide PetRxExpress ℠ are service marks of Nationwide Mutual Insurance Company. ©2023 Nationwide. 23GRP9316D 23GRPPLNSUMRY

Life and Accidental Death and Dismemberment Insurance

Life and accidental death and dismemberment (AD&D) insurance provides financial protection for those who depend on you for financial support. Upon your death, your designated beneficiary will receive the life benefit. If you die as the result of an accident, your beneficiary will receive both the life and AD&D benefits.

Basic Life and AD&D Insurance

Voluntary Life and AD&D Insurance

If you purchase life and AD&D insurance for yourself or your spouse and/or children when you are first eligible to enroll, you may purchase up to the guarantee issue amounts without completing a statement of health (evidence of insurability). If you do not enroll when first eligible and choose to enroll during a future open enrollment period, you will be required to submit evidence of insurability for any amount of coverage. Coverage will not take effect until approved by UNUM . Depending on your personal situation, basic life and AD&D insurance might not be enough coverage for your needs. Jefferson Center provides you the option to purchase voluntary life and AD&D insurance at group rates through UNUM. You may also purchase voluntary coverage for your spouse and eligible children. Coverage options: • Employee : $10,000 increments up to $500,000 or 5x annual salary, whichever is less; guarantee issue: $150,000. • Spouse : $5,000 increments up to 100% of the employee coverage amount; guarantee issue: $25,000. • Dependent children : Birth to 6 months: $1,000; 6 months to age 19 (or 26 if a full- time student): $2,000 increments up to $10,000; guarantee issue: $10,000.

Jefferson Center provides you with basic life and AD&D insurance at no cost to you . • Employee life insurance benefit: 2x annual earnings up to a maximum of $300,000 • Employee AD&D insurance benefit: 2x annual earnings up to a maximum of $300,000 If you are eligible for $50,000 or more in basic, Jefferson Center -paid life insurance, you are required to pay income tax on the value of the coverage in excess of $50,000. Designate a Beneficiary In the event of your death, UNUM would pay your Life and/or AD&D policy to your beneficiaries. Designate your beneficiary for your Basic Life and AD&D insurance, as well as any Voluntary Life insurance in UKG > navigate to Myself > Life Events > select Update/Change Beneficiaries. Enter information and save changes. You may change this designation at any time. You are automatically the beneficiary on your Spouse and/or Child Life policy.

UNUM Evidence of Insurability Link : https://securehealth.unum.com/eoiaccess Access codes: Jefferson Center for Mental Health Employees : ICIH5ER Front Range Health Partners Employees : 3QGPLSV

Voluntary Life and AD&D Premium Rates

Monthly Voluntary Life and AD&D Cost

Employee Rates per $1,000

Spouse Rate Per $1,000

<24

$0.050

25 – 29

$0.060

30 – 34

$0.080

35 – 39

$0.090

40 – 44

$0.100

45 – 49

$0.150

50 – 54

$0.230

55 – 59

$0.430

60 – 64

$0.660

65 – 69

$1.270

70 - 74

$2.060

75+

$4.120

AD&D (Employee | Spouse)

$0.020

$0.030

Child Life

$0.350

Child AD&D

$0.030

Disability Insurance Jefferson Center offers you income protection insurance with short- and long-term disability coverage through UNUM . These benefits are in place to support you through situations that may prevent you from working due to an injury or illness, and are provided at no cost to you, as an eligible employee.

Short-Term Disability Insurance

Long-Term Disability Insurance If you are not able to return to work after the short-term disability benefit period ends, you may be eligible for long-term disability, which provides additional salary continuation. • Elimination period: 90 days (benefits begin on day 91) • Benefit continues up to social security normal retirement age • Benefit amount: 60% of salary up to a maximum of $6,000 per month

Short-term disability (STD) insurance allows you to continue earning a portion of your salary if you are unable to work due to an illness or injury.

• Elimination period: 7 days (benefits begin on day 8)

• Benefit continues for up to: 12 weeks not including the elimination period • Benefit amount: 60% of salary up to a maximum of $1,000 per week • Your state may provide disability or PFML benefits that could offset any GOLFTEC sponsored coverage.

Employee Assistance Program Mines and Associates

Jefferson Center provides you and your household family members with an Employee Assistance Program (EAP) through Mines and Associates at no cost to you. The EAP is a valuable resource that can help you identify and resolve many workplace, family, social, economic, and mental health issues.

Talk to a counselor about: • Improving relationships • Managing life changes • Improving esteem and confidence •

Connect to local resources for: • Childcare needs • Caring for an elder • School success • Legal resources

Get tips for staying healthy: • Sleep practices • Eating well • Finding a gym

Achieving work-life harmony

EAP Benefits

Call or go online to help with:

• Completely confidential. Jefferson Center does not receive any information about who contacts the EAP • Available 24/7/365 • Includes six (6) in-person therapy sessions per issue, per year • Online resources • Unlimited phone consultations

• Depression • Conflict resolution • Drug or alcohol abuse • Marital or family difficulties • Legal concerns • Help finding child and elder care • Wills and estate planning • Financial counseling

EXAMPLE:

Jim has recently been struggling to balance his responsibilities at work with his responsibilities at home. At times, he struggles to find childcare and finds that this impacts his performance on the job. Jim contacted the EAP to talk through these struggles, and they were also able to provide trusted childcare resources that he now uses regularly!

Call: 800-873-7138 Website:

www.MINESandAssociates.com EAP resources are available for free to you and your household family members.

Additional Benefits

Retirement 401(k) : Upon hire, employees are eligible and automatically enrolled in their retirement and savings plan with a three (3) percent contribution. After one year of employment, Jefferson Center will automatically contribute one (1) percent on your behalf and match your contributions up to three (3) percent. Link to Benefits on The HUB Tuition Reimbursement To encourage employees to enhance their development and increase their skills and knowledge through continuing education, Jefferson Center provides financial assistance towards courses that are either job-related or allow career progression within Jefferson Center. Personal Annual Leave (PAL) PAL is a program of accrued paid leave which includes both sick and vacation, providing maximum flexibility for employees. Each pay period, employees accrue based on their number of regularly scheduled hours. The following schedule outlines the accrual rates for a full-time employee (scheduled 40 hour per week), this benefit is also prorated based on scheduled hours worked.

Discounted Programs

Tickets at Work : A variety of discounted services and tickets are offered to Jefferson Center employees.

Holidays

Paid Holidays : Designated every calendar year, these are paid holidays in which The Center will be closed. This benefit is prorated based on scheduled hours worked.

Working Holidays : Designated every calendar year, “working holidays” are holidays in which The Center is open and employees are given the opportunity to observe a day as a “working holiday” or may choose to work the designated holiday. If the employee works, the time is added to their PAL account.

Additional Information

Resources and Contact Information

Do you have a question about your benefits?

This link will take you directly to the Benefits section on The Hub. This page includes detailed information on each benefit plan.

Enrollment portal: Link to UKG Navigate to Myself > Open Enrollment

If you have a general benefits question, contact the Human Resources • Email: humanresources@jcmh.org • Phone: 303-432-5040

Plan

Phone

Website

Medical – Kaiser Permanente Group # 00296 Medical – Cigna Healthcare Group # 3344601 Dental – Delta Dental of Colorado Group # 8018

855-249-5005

www.kp.org

www.cigna.com (public website) www.mycigna.com (plan members)

800-244-6224

800-610-0201

www.deltadentalco.com

Vision – EyeMed Group # 9685645

www.eyemed.com (ACCESS Network)

866-939-3633

Life and AD&D – UNUM Group #715009 011

Email: customerservices@unum.com www.unum.com (public website)

800-421-0344

Disability (STD, LTD) – UNUM Group #715009 012 Employee Assistance Program – Mines and Associates Group #

Email: customerservices@unum.com www.unum.com (public website)

800-421-0344

800-873-7138

www.MINESandAssociates.com

www.PetsNationwide.com (for pet insurance quote)

Pet Insurance – Nationwide

877-738-7874

Enroll online at: http://jeffersoncenter.excelsiorenroll.co m

ID Theft Protection – Norton LifeLock

800-607-9174

Flexible Spending Accounts – ThrivePass

866-855-2844

Email: tpa@thrivepass.com

Annual Notices Each year, employers that offer health care benefit plans are required to provide specific state and federal notices to employees regardless of their participation in the benefit plans offered. Electronic versions of these notices may be found on Benefits Link on the Hub. If you have any questions, please contact the humanresources@jcmh.org .

Definitions

Benefits can be confusing, but you don’t need to be a benefits specialist to understand what is available to you. We’ve made these definitions available so you can make the most educated and best decision for yourself and your family.

Premium:

The amount you pay out of your paycheck to be covered by the plan.

Deductible:

Most general: The amount you must pay each calendar year before the plan begins paying toward covered services. For most PPOs and some HMOs: The amount you must pay each calendar year before the plan begins paying toward certain covered services such as emergency room visits and hospitalizations.

Out-of-pocket maximum:

• The most you will be required to pay out of your pocket for covered health care services in any one calendar year. The out-of-pocket maximum does not include premium payments taken from your paycheck. • Embedded out-of-pocket maximum: If your spouse and/or children are covered by the plan, the individual out-of-pocket maximum applies to each covered family member (capped at family amount). Are you covering your spouse and/or children? • PPO and HMO plan members: If your spouse and/or children are covered by the plan, the individual deductible and out-of-pocket maximum apply to each covered member of the family (capped at family amount).

Plan deductibles and out-of-pocket maximums reset on January 1 each year.

Definitions Continued

Copayment or Copay A set dollar amount you pay for certain health care services such as an office visit. Copays are usually paid at the time of the office visit. (e.g., A set dollar amount that PPO and HMO plan members pay for an office visit).

Coinsurance A set percentage of the total cost for a covered health care service that you pay after you have paid your deductible. For example, after your deductible is paid, plan members pay 10% of covered services and the plan pays the remaining 90%.

In-Network Providers In-network providers have contracted with Cigna Local Plus or Kaiser HMO and have agreed to provide a discount to Cigna or Kaiser plan members. You will pay less out of your pocket when you choose a Cigna Local Plus network provider if you’re on the Cigna health plan, or a Kaiser HMO network provider if you’re on the Kaiser health plan. Out-of-Network Providers Out of-network providers, facilities, and pharmacies can charge you the full price for services, which is typically much higher than the in-network discounted rate. You will pay more out of your pocket when you choose an out-of-network provider. Preventive Care Health care services that help keep you healthy by preventing diseases and other health conditions. The Cigna Local Plus and Kaiser HMO medical plans pay 100% of the cost of preventive care when it is provided by a Cigna Local Plus or Kaiser HMO provider. Some preventive care services that may be covered include: exams, screenings, and vaccinations. Please be aware that you may be billed for non- preventive care services that you receive at a preventive care exam. Learn more about preventive care at www.cigna.com or www.kp.org.

Embedded vs. Non-Embedded Deductible

Non-Embedded

Embedded

When a plan has an embedded deductible, an individual cannot contribute more than that individual deductible amount towards the family deductible. Example: The DHMO Plan has an individual deductible of $500 and a family deductible of $1,000. Once an individual meets the $500 individual deductible, the plan will start paying 90% of the total charges (coinsurance) as that member works towards meeting the individual out-of-pocket maximum of $2,000. The other covered family members would each need to meet their $500 individual deductibles or combined, no more than the $1,000 family deductible, before the plan would start to pay the 90% of their healthcare expenses (coinsurance). Once the $1,000 family deductible has been met, the plan will pay 90% of the charges for all covered members, regardless of who helped meet the family deductible, as they work towards the family out-of-pocket maximum of $4,000.

When a plan has a non-embedded deductible and family coverage is in place (covering one or more dependents), the individual deductible amount does not apply – there is only one family deductible, and any of the covered members can contribute to meeting it.

All four (4) of the medical plan offerings between Kaiser and Cigna offer embedded deductibles and out-of-pocket maximums.

STATE SPECIFIC INFORMATION: SOCIAL DETERMINANTS OF HEALTH Many employees are looking for free state resources and may be hesitant to reach out to their employer for help due to the negative stigma attached. Consider including these resources to help bridge that gap for employees.

Need Additional Resources?

Check out these free state resources available to all employees!

COLORADO

Education & Employment Colorado Department of Education: Offers resources related to education and workforce development. They provide information on schools, colleges, and universities in Colorado, as well as resources for continuing education, adult education, and vocational training. (https://www.cde.state.co.us/) Colorado Division of Vocational Rehabilitation (DVR): Assists individuals with disabilities in obtaining and maintaining employment. They offer vocational counseling, training, and job placement services. DVR can provide assistance with accommodations, accessibility, and job retention support. (https://dvr.colorado.gov/) Colorado Department of Human Services: Oversees several programs that can help with socioeconomic factors. For example, the Office of Early Childhood offers resources for childcare and early education. The Division of Employment and Benefits provides information on public assistance programs like food assistance, Medicaid, and cash assistance. (https://cdhs.colorado.gov/) Health & Well-Being Colorado Department of Public Health and Environment (CDPHE): Responsible for promoting and protecting the health and well-being of Colorado residents. They provide information on healthy eating, physical activity, tobacco cessation, and substance abuse prevention. (https://cdphe.colorado.gov/) Colorado Physical Activity and Nutrition Program (C-PAN): An initiative by the CDPHE that focuses on promoting physical activity and healthy eating. They offer resources, educational materials, and programs to encourage individuals and communities to engage in regular exercise and adopt healthy eating habits. (https://cdphe.colorado.gov/health/prevention-and-wellness/healthy-eating-and-active-living) Colorado QuitLine: Free, confidential service that helps individuals quit tobacco and nicotine use. They offer coaching, support, and resources to develop a personalized quitting plan. They provide telephone counseling, online support, and information on nicotine replacement therapies. (https://www.coquitline.org/en-US/) Colorado Substance Abuse Trend and Response Task Force : They provide resources, information, and support related to substance abuse prevention, treatment, and recovery. Their website offers resources for individuals seeking help with substance abuse issues. (https://coag.gov/task-force/) Colorado 2-1-1: A free and confidential service that connects individuals to a wide range of health and human services. They can provide information on local resources for diet and exercise programs, substance abuse treatment centers, mental health services, and more. You can contact them by dialing 2-1-1 or visiting their website. (https://www.211colorado.org/)

COLORADO

Healthcare Resources Colorado PEAK (Program Eligibility and Application Kit): An online portal that allows individuals to determine their eligibility and apply for various state assistance programs, including Medicaid and the Children's Health Insurance Program (CHIP). Through PEAK, you can access information on healthcare coverage options and apply for enrollment. (https://peak--coloradopeak.force.com/peak/s/peak-landing-page?language=en_US) Connect for Health Colorado: State health insurance marketplace providing a platform for individuals and families to compare and purchase health insurance plans, including private plans and coverage options through Medicaid and CHIP. The marketplace also offers assistance in finding financial aid or subsidies to help make insurance more affordable. (https://connectforhealthco.com/) Colorado Medicaid: Provides healthcare coverage for low-income individuals and families. Employees who meet the income and eligibility criteria can apply for Medicaid to access comprehensive healthcare services, including doctor visits, hospital care, prescriptions, and preventive care. (https://www.healthfirstcolorado.com/) Colorado Indigent Care Program (CICP): A discounted healthcare program that provides reduced-cost medical services to low-income individuals and families who do not qualify for Medicaid. It helps eligible individuals access medical care from participating providers at a reduced fee. (https://hcpf.colorado.gov/colorado-indigent-care-program) Housing & Mobility Colorado Housing Connects: A resource that helps individuals find affordable housing options in the state. They provide information and assistance on rental housing, homeownership programs, and resources for individuals facing housing challenges. They can connect you with affordable housing resources and programs in your area. (https://coloradohousingconnects.org/) Colorado Division of Housing: Administers various housing programs and initiatives in the state. They offer resources and support for affordable housing development, rental assistance programs, and homelessness prevention efforts. The DOH website provides information on housing programs and resources available in different communities across Colorado. (https://cdola.colorado.gov/housing) Colorado Housing and Finance Authority (CHFA): Provides financing options and resources for affordable homeownership and rental housing in Colorado. They offer programs such as down payment assistance, low-interest mortgages, and rental assistance for low-income individuals and families. (https://www.chfainfo.com/) Aging and Disability Resources for Colorado (ADRC): Offers information and resources for older adults, individuals with disabilities, and their caregivers. They can provide assistance in finding accessible housing options, home modifications, transportation services, and other resources to support independent living and mobility. (https://cdhs.colorado.gov/our- services/older-adult-services/state-unit-on-aging/aging-and-disability-resources-for-Colorado)

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