PowerPoint Presentation

BENEFITS GUIDE An overview of the wide array of benefits provided by Callen Lorde, to help you enjoy increased well-being and financial security

TABLE OF CONTENTS

 Introduction

4 6 8

 Overview of Benefits Programs

 Medical Benefits  Telemedicine  Dental Benefits  Vision Benefits

17 19 21 23 24 27 28 29 30 34 35 36 37 38 39 47 67 68

 Employee Contributions

 Life + AD&D

 Voluntary Life Insurance

 Gender Affirmation

 Pet Benefit & Commonbond

 Disability Coverage

 Flexible Spending Account (FSA)

 Commuter Benefit

 Employee Assistance Program

 Value of Pre-Tax Benefits

 403(b)

 Enrollment Information

 Legal Notices  Contact Page  Notes Page

TABLE OF CONTENTS I

Callen Lorde BENEFITS GUIDE

WE’VE GOT YOU COVERED

Callen Lorde is proud to offer a comprehensive benefits package for you and your family. This program is designed to take great care of you when you need it. Make sure to explore your options to help you make the selections that best meet your needs.

INTRO & OVERVIEW

INTRODUCTION

For the 2025 plan year, Callen Lorde has worked hard to offer a competitive total rewards package that includes valuable and competitive benefits plans. These programs reflect our commitment to keeping our staff healthy and secure. We understand that your situation is unique, and Callen Lorde is offering an overall benefits package that can be shaped and molded by you to fit your needs. As an employee of Callen Lorde , enjoying your work and making valuable contributions to business are equally vital. The health, satisfaction and security of you and your family are important, not only to your well-being, but ultimately, in terms of achieving the goals of our organization. This benefits booklet is a summary description of your Callen Lorde benefit plans. If there is a discrepancy between these summaries and the written legal plan documents, the plan documents shall prevail. This booklet and plan summaries do not constitute a contract of employment.

We hope this benefits booklet, along with our additional communication and decision-making tools, will help you make the best health care choices for you and your family.

INTRODUCTION I

Callen Lorde BENEFITS GUIDE

OVERVIEW OF BENEFITS

CHANGES AND QUALIFYING EVENTS

WHEN COVERAGE BEGINS AND ENDS Your coverage under the benefits plans will end if you no longer meet the eligibility requirements, your contributions are discontinued or the Group Insurance Policy is terminated.

QUALIFYING EVENTS • Eligible employees may enroll or make changes to their benefits elections during the annual open enrollment period. As with most benefits, once you elect an option you are bound to that choice for the entire plan year unless you experience a “Qualifying Event”. These may include, but are not limited to: • Changes in employment status • Changes in legal marital status • Changes in number of dependents • Taking an unpaid leave of absence • Dependent satisfies or ceases to satisfy eligibility requirement • Family Medical Leave Act (FMLA) leave. • A COBRA-qualifying event • Entitlement to Medicare or Medicaid • A change in the place of residence of the employee, resulting in the current carrier not being available

OVERVIEW I

Callen Lorde BENEFITS GUIDE

OVERVIEW OF BENEFITS Callen Lorde provides an array of benefits that can help you enjoy increased well-being, deal with an unexpected illness or accident, build and protect your financial security, balance your personal and professional life and meet every day needs. These benefits are affordable, comprehensive and competitive.

The table below summarizes the benefits available to eligible staff and their dependents. These benefits are described in greater detail in this booklet.

BENEFITS AT-A-GLANCE

Coverage

Carrier

Medical Dental Vision Life & Disability Prescription FSA & Gender Affirmation Acct Commuter EAP Telemedicine 403B Pet Vet Discount Pet RX Discount

OVERVIEW I

Callen Lorde BENEFITS GUIDE

MEDICAL

Aetna EPO Zero Copay Plan – Open Access Select

SUMMARY OF COVERAGE

Plan Features

Base EPO Plan

IN NETWORK

OUT OF NETWORK

Deductibles (Indiv / Family)

None

Out-of-Pocket Max (Indiv/ Family) Plan Cost Sharing

Individuals: $5,000 Families: $10,000

Covered 100%

Primary Care Visit

Covered 100%

Preventive Care

Covered 100%

N/A

Labs/Diagnostic & Imaging Services

Covered 100%

Outpatient Procedure

Covered 100%

Emergency Room

Covered 100%*

Urgent Care

Covered 100%*

Inpatient Visit

Covered 100%

*Non Urgent Use of Urgent Care Provider & Non Emergency Care in an Emergency Room/Ambulance are not covered

Your medical plan includes certain services that are not routinely covered. Please speak to HR for more info.

MEDICAL PLAN I

Callen Lorde BENEFITS GUIDE

PRESCRIPTION BENEFIT

EPO Zero Copay Plan

Plan Features

IN NETWORK

Generic Drugs

Covered 100%

Preferred Brand Drugs

Covered 100%

Non-Preferred Brand Drugs

Covered 100%

Specialty Drugs

Covered 100%

Covers 30 day supply (retail), 31-90 day supply (mail order). Includes contraceptive drugs & devices obtainable from a pharmacy, oral & injectable fertility drugs. No charge for preferred generic FDA-approved women's contraceptives in-network. Review your formulary for prescriptions requiring precertification or step therapy for coverage. If you have any questions please contact customer services for Capital Rx at 855-227-7928

MEDICAL PLAN I

PRESCRIPTION BENEFIT

EPO Zero Copay Plan

Using your Prescription Drug Card at Retail Pharmacies • Please present your new prescription card along with your prescription to any of our 60,000+ retail pharmacies every time you fill your prescription. Getting a 90-Day Supply of Your Prescriptions • If you are prescribed a 90-day prescription for maintenance medications (e.g. long- term conditions like arthritis, asthma, diabetes, high blood pressure or high cholesterol), you can fill your prescription at retail pharmacies or through mail service. Getting started with Walmart mail service: • Prior to your first fill by mail, please call 1-800-236-7563 or mail a completed order form to 1025 W. Trinity Mills, Carrollton TX, 75006 . This form can be downloaded at www.walmart.com/homedelivery . Choose one of the following options to submit your prescription: • E-prescribe: Have you doctor e-prescribe to Walmart Pharmacy Mail Order 2625 • Fax: Have your doctor fax your prescription to 1-800-406-8976 . Faxed prescriptions may only be sent by a doctor’s office and must include patient information and diagnosis for timely processing. • Mail: Mail Capital Rx your prescription and completed order form to 1025 W. Trinity Mills, Carrollton TX, 75006. Capital Rx Member Help Desk is available 24 hours a day, 7 days a week at 1-855-227-7928. You may also download their new digital app! Search “Capital Rx” on the app store to download.

MEDICAL PLAN I

Aetna POS Plan – Choice POS II

SUMMARY OF COVERAGE

Plan Features

Buy Up POS Plan

IN NETWORK

OUT OF NETWORK Individuals: $500 Families: $1,000 Individuals: $1,250 Families: $2,500 20% coinsurance

Deductibles (Indiv / Family)

None

Out-of-Pocket Max (Indiv/ Family) Plan Cost Sharing

Individuals: $1,250 Families: $2,500

Covered 100%

Primary Care Visit

$25 copay per Primary Care visit

20% coinsurance

Specialist Care Visit

$40 copay per Specialist visit

20% coinsurance

Preventive Care Labs/Diagnostic & Imaging Services Outpatient Procedure

Covered 100%

20% coinsurance

Covered 100%

20% coinsurance

Covered 100%

20% coinsurance

$100 copay per visit; Copay waived if admitted

Emergency Room

Urgent Care

$40 copay per visit;

20% coinsurance

Inpatient Visit

Covered 100%

20% coinsurance

MEDICAL PLAN I

Callen Lorde BENEFITS GUIDE

PRESCRIPTION BENEFIT

POS Plan

Plan Features

IN NETWORK

Copay/Prescription deductible doesn’t apply $15 retail, $30 mail order

Generic Drugs

Copay/Prescription deductible doesn’t apply $25 retail, $50 mail order

Preferred Brand Drugs

Copay/Prescription deductible doesn’t apply $40 retail, $80 mail order

Non-Preferred Brand Drugs

Applicable cost as noted above for generic or brand drugs

Specialty Drugs

Covers 30 day supply (retail), 31-90 day supply (mail order). Includes contraceptive drugs & devices obtainable from a pharmacy, oral & injectable fertility drugs. No charge for preferred generic FDA-approved women's contraceptives in-network. Review your formulary for prescriptions requiring precertification or step therapy for coverage. OOPM will be separate from medical OOPM. If you have any questions please contact customer services for Capital Rx at 855-227-7928

MEDICAL PLAN I

PRESCRIPTION BENEFIT

POS Plan

MEDICAL PLAN I

PRESCRIPTION BENEFIT Manufacturer Coupon Copay Program

Utilizing this Program • If you are filling a specialty drug or selected brand name medications that require manufacturer copay assistance, you will see an inflated copay starting 1/1/2025 • Capital Rx will be reaching out to assist you in enrolling in a manufacturer coupon that will bring that copay back down to $0.. • Capital RX communication will cease as of 1/1/2025 for new specialty prescriptions • To check if your prescription will require enrollment into this program (or if you are a new hire that is impacted): • Please reach out to Capital Rx at 855-227-7928 • Log into Paycom -> Benefits -> Benefits Forms and Links • Please visit the CommUnity HR page Applying for Manufacturer Copay Assistance is Quick and Easy Brand: 1. Capital Rx Care representative contacts member prior to their next fill to assist in enrolling for manufacturer coupon 2. Member fills out application form online and receives digital copay card in minutes 3. Member goes to pharmacy and sees an inflated copay for Brands (i.e. $600) – pharmacy provides message to member to enroll in copay card 4. Member uses their digital copay card to bring copay back down to $0. Specialty: 1. Optum Specialty representative will assist member in enrolling for manufacturer copay coupon (via phone) 2. Member fills out application form online and receives digital copay card in minutes 3. Optum Specialty representative uses digital copay card to bring copay to $0 4. Member will receive Specialty medication delivered to their home

MEDICAL PLAN I

MEDICAL PLAN

KEY TERMS TO REMEMBER

ANNUAL DEDUCTIBLE

OUT-OF POCKET MAXIMUM

The amount you have to pay each year before the plan starts paying a portion of medical expenses. All family members’ expenses that count toward a health plan deductible accumulate together in the aggregate; however, each person also has a limit on their own individual accumulated expenses (the amount varies by plan).

This is the total amount you can pay out of pocket each calendar year before the plan pays 100 percent of covered expenses for the rest of the calendar year. Most expenses that meet provider network requirements count toward the annual out- of-pocket maximum, including expenses paid to the annual deductible*, copays and coinsurance *Except for Grandfathered medical plans

COPAYS AND COINSURANCE

PLAN TYPES

• EPO/PPO – A network of doctors, hospitals, and other health care providers • HMO – A network that requires you to select a Primary Care Physician (PCP) who coordinates your health care • POS – Combines aspects of a PPO and HMO • HDHP – A plan that has higher annual deductibles in exchange for lower premiums.

These expenses are your share of cost paid for covered health care services. Copays are a fixed dollar amount, and are usually due at the time you receive care. Coinsurance is your share of the allowed amount charged for a service, and is generally billed to you after the health insurance company reconciles the bill with the providers.

MEDICAL PLAN I

Callen Lorde BENEFITS GUIDE

TELEMEDICINE

Callen Lorde employees have access to around the clock access to a doctor, no matter where they are, Teladoc through Aetna. This Telemedicine benefit will connect you to a board-certified doctor by phone or video chat.

Virtual consult cost is your primary care copay of your plan.

TELEMEDICINE I

Callen Lorde BENEFITS GUIDE

MEDICAL PLAN

Understanding the full value of covered benefits allows you to take responsibility for maintaining good health and incorporating healthy habits into your lifestyle. Some examples include getting regular physical examinations, mammograms and immunizations. Through the plans offered by Callen Lorde , all covered individuals and family members are eligible to receive routine wellness services like these, at no cost; all copays, coinsurance, and deductibles are waived.

WHICH PREVENTIVE CARE SERVICES ARE COVERED?

Below is a list of common services that are included in the plans offered this year:

“AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE”

• Routine Colorectal Cancer Screening • Routine Prostate Test

• Routine Physical Exam • Well Baby and Child Care • Well Woman Visits • Immunizations • Routine Bone Density Test • Routine Breast Exam • Routine Gynecological Exam • Screening for Gestational Diabetes • Routine Digital Rectal Exam

• Routine Lab Procedures • Routine Mammograms • Routine Pap Smear • Smoking Cessation Programs

• Testing for HPV and HIV • Routine Colonoscopy

MEDICAL PLAN I

Callen Lorde BENEFITS GUIDE

DENTAL

DENTAL PLANS

SUMMARY OF COVERAGE

Plan Features

DPPO Plan

DMO Plan

IN NETWORK Annual Deductible (Individual / Family) Preventive Care Basic Procedures (Fillings, etc.) Major Procedures (Crowns, etc.) Child Orthodontia

$50 / $150

NA / NA

100%

100% No charge

100%

100% No charge

60%

60% coinsurance

Not Covered

Calendar Year Maximum Benefit

$2,000

N/A

OUT OF NETWORK Annual Deductible (Individual / Family) Preventive Care Basic Procedures (Fillings, etc.) Major Procedures (Crowns, etc.) Child Orthodontia

$50 / $150

100%

80%

N/A

50%

Not Covered

Calendar Year Maximum Benefit

$2,000

Aetna’s Freedom of Choice Dental plan allows employees to switch from DMO to PPO or PPO to DMO as long as it is within certain time frames each month.

DENTAL PLAN I

Callen Lorde BENEFITS GUIDE

VISION

VISION PLAN

SUMMARY OF COVERAGE

Guardian Vision Features

Plan Features IN NETWORK

Vision Exam

$10

Lenses Single

$10 $10 $10

Bifocal Trifocal

Frames

80% of amount over $120

Elective Contact Lenses Medically Necessary Contact Lenses Frequency (Months) Exam

$120 max benefit

100%

Every 12 Months Every 12 Months Every 12 Months Every 12 Months

Lenses Frames Contacts

OUT OF NETWORK

Vision Exam

$46 max benefit

Lenses Single

$47 max benefit $66 max benefit $85 max benefit $47 max benefit $120 max benefit $210 max benefit

Bifocal Trifocal

Frames

Elective Contact Lenses Medically Necessary Contact Lenses

VISION PLAN I

Callen Lorde BENEFITS GUIDE

Employee Contributions

2025 BI-WEEKLY CONTRIBUTION RATES

IN-NETWORK ONLY – EPO ZERO DEDUCTIBLE PLAN

Managed Choice (Out-o-Network)

Elect Choice (In-Network)

Coverage Tier

Dental

Vision

Employee Only

$90.00

$23.08

$0.00

Employee + Spouse / Domestic Partner** Employee + Child(ren)

$55.38 $294.12**

$462.56

$22.88

$2.85

$392.61

$41.54

$23.62

$2.99

Family

$683.68

$78.46

$46.49

$7.16

**If your spouse or domestic partner is employed and has medical coverage available through their employer, a spousal surcharge of $294.12/bi-weekly will be added if you elect to cover your spouse or domestic partner under your medical plan **Imputed Income & after tax deductions may apply to those enrolling domestic partners **Spouse/D/P must provide proof they are NOT offered coverage

CONTRIBUTIONS I

Callen Lorde BENEFITS GUIDE

LIFE

LIFE + AD&D

SUMMARY OF COVERAGE

•

This benefit is paid for 100% by Callen Lorde. There is no cost to you, the employee.

•

All benefit eligible employees with Callen Lorde are provided with employer-paid Basic Life and Basic Accidental Death & Dismemberment (AD&D) coverage. All eligible employees are automatically enrolled in Basic Life and Basic AD&D.

Employee Basic Life Insurance • Benefit amount is dependent on your earnings, up to a maximum of $50,000

Basic Accidental Death and Dismemberment (AD&D) • 100% of the Basic Life benefit, up to $50,000 in increments of $1,000 • Provides specified benefits for a covered accidental bodily injury that directly causes dismemberment • In the event of death that occurs from a covered accident, both Life and AD&D benefit would be payable each in the amount of the basic life insurance

Benefits After Age 70 Your life benefits will reduce after age 70, and the reduction schedule is as follows:

• Reduce by 35% at age 70 • Reduce by 50% at age 75 • Benefits will terminate at retirement

LIFE INSURANCE I

Callen Lorde BENEFITS GUIDE

LIFE + AD&D

SUMMARY OF COVERAGE

•

Plan Features

Voluntary AD&D

Plan Features

AD&D

Employee Benefit Amount Maximum Benefit Amount

•

100%

$50,000

AD&D Benefit 100% of annual earnings up to $50000. Increments of $1000 The following shows how much benefits are reduced at certain ages: Age Band Benefit Reduction 70 35% 75 50%

AD&D Benefit 100% of annual earnings up to $50,000. Increments of $1000 The following shows how much benefits are reduced at certain ages: Age Band Benefit Reduction 70 35% 75 50%

Plan Features

Voluntary Life

Employees can choose different amounts of coverage between the minimum and maximum benefit amount. See plan documentation for more details. 100% of annual earnings up to $50000. Increments of $1000

Employee Benefit Amount

Maximum Benefit Amount

*For voluntary benefits please be aware you may be required to complete an evidence of insurability (EOI) form, and to list a beneficiary

LIFE INSURANCE I

Callen Lorde BENEFITS GUIDE

VOLUNTARY LIFE + AD&D

SUMMARY OF COVERAGE

•

Supplemental Child(ren) Life You may purchase additional coverage for your child(ren) in the following amounts: • 14 days to 6 months old: $250 • 6 months to 26: $5,000 or $10,000 * Should you choose to elect amounts over the guarantee issue amount, you and / or your spouse will need to complete the Evidence of Insurability (EOI) form for medical underwriting purposes – or if you enroll after your newly eligible event, EOI is required.

• This benefit is paid for 100% by the employee. As an added benefit, Callen Lorde offers Voluntary Life and Accidental Death & Dismemberment (AD&D) insurance for employees, their spouses, and/or children (children not eligible for AD&D). This benefit is voluntary and paid for 100% by eligible employees through payroll deductions. Employee must be enrolled to enroll dependents. Supplemental Employee Life/AD&D Employees may purchase additional life coverage in $1,000 increments. Guaranteed Issue amount is the lesser of 3 times your annual salary, or $140,000. Supplemental AD&D coverage can be purchased by you for additional premium. Benefit amount is equal to the life amount elected by you. Supplemental Spouse Life/AD&D You may purchase additional coverage for your spouse in $5,000 increments to the maximum of $250,000, limited to 50% of employee enrolled amount. • Guaranteed Issue amount* of $25,000 Supplemental AD&D coverage can be purchased by you for additional premium. Benefit amount is equal to the life amount elected.

Deductions will start when UNUM approves your coverage. Age reduction schedule applies.

LIFE INSURANCE I

Callen Lorde BENEFITS GUIDE

GENDER AFFIRMATION

Callen Lorde provides all of their employees with a $5,000 benefit through Total Administrative Services Corporation (TASC) to cover gender affirming services not covered by the medical plan for employees that are transitioning. All services must be paid for Out of Pocket, and then submitted for reimbursement to TASC for eligible expenses. Per IRS regulations, this benefits is considered a taxable benefit to employees. Any benefit used must be added to the taxable benefit amount of the employee’s W-2. Covered benefits include electrolysis and other Section 213D IRS qualified expenses.

All employees who wish to receive this benefit must actively re-enroll each year. Enrollment for this benefit will be available through Paycom.

Callen Lorde BENEFITS GUIDE

FSA I

PET INSURANCE & COMMONBOND

We are excited to announce the offering of Discount Pet Insurance and Prescription Plan through Pet Benefits Solutions. Pet Assure provides a 25% discount when using participating veterinarians in their network with no pre-existing condition exclusion. The PetPlus Prescription Discount Plan offers up to a 50% discount on certain prescriptions. Employees can purchase coverage separately or as a package.

Cost for one dog or cat is less than $12/month for both benefits

You will be able to enroll in this new benefit through our Paycom Portal

Callen Lorde BENEFITS GUIDE

FSA I

DISABILITY

This benefit is paid for 100% by Callen Lorde. There is no cost to you, the employee. SUMMARY OF COVERAGE

Callen Lorde provides employees with group short-term and long term disability coverage for those unexpected situations that may keep you from performing the daily responsibilities of your job. Your disability plan is available to help supplement your income when you are not able to continue employment for a certain period of time. Short-term and/or long-term disability benefits may be reduced by benefits received from state disability or temporary worker’s compensation programs. Total benefits received from the policy, state disability, temporary worker’s compensation programs and employers sick pay may not exceed 100% of your income prior to your disability. Short-Term Disability You will need to satisfy a 7-day elimination period. Benefits for short-term disability would begin on the 8 th day. This elimination period can be satisfied with days of partial disability, total disability or a combination of both. If you are totally disabled beyond the elimination period due to a covered injury or sickness, you will be eligible to receive a monthly benefit equal to 60% of your basic monthly income, up to $750 per week. This benefit has a duration of 13 weeks.

Long-Term Disability You will need to satisfy a 90-day elimination period before long-term disability benefits would begin. This elimination period can be satisfied with days of partial disability, total disability or a combination of both. If you are totally disabled beyond the elimination period due to a covered injury or sickness, you will be eligible to receive a monthly benefit equal to 60% of your basic monthly income, up to $6,000 per month. This benefit has a duration of until age 65 if you are disabled before age 60.

DISABILITY – SHORT TERM I

Callen Lorde BENEFITS GUIDE

PAID FAMILY LEAVE & NEW YORK STATE DBL

SUMMARY OF COVERAGE

New York State Paid Family Leave The New York Paid Family Leave allows employees to collect up to a maximum of ten weeks of benefits within a 52-consecutive week period. Employees are eligible to earn 67% of their average weekly salary, up to a cap set at 67% of the state average weekly wage. Currently, the NYPFL benefits has been calculated based on $1,757.19 per week. Thus, the maximum benefit amount in 2025 is $1,177.32 per week. Employees should expect a deduction amount of 0.388% from their salary with an annual cap of $354.53.

Key New York PFL Notes for 2025

$1,757.19

Statewide Average Weekly Wage

Up to 12 weeks or 50 days

Benefit Duration

67% of employee’s average weekly wage to a cap of 67% of the SAWW

Benefit Percentage

$1,177.32

Maximum Weekly Benefit Amount

0.388% covered payroll up to annual cap of $354.53

Payroll Deduction Rate

Callen Lorde BENEFITS GUIDE

DISABILITY – LONG TERM I

PAID FAMILY LEAVE & NEW YORK STATE DBL

SUMMARY OF COVERAGE

New York State Short-Term Disability Benefits In order to be eligible for short-term disability benefits, you must have become injured or ill while not at work but must be employed, or recently employed, at the time of illness or injury. (Those who are injured on the job are covered under a different set of rules.) Additionally, pregnancy is covered under short-term disability. The Employees Who Are Covered by Disability Include: An individual who is working or has recently worked (and is collecting unemployment) at least four consecutive weeks at a job that is considered to be owned by a “covered employer.”

Individuals who change from one covered employer to another covered employer. As long as your employment was continuous, coverage for short-term disability starts on your first day of work.

Domestic workers who work 40 hours or more for one employer. An example of this would be a nanny or personal assistant.

Individuals who are not employed by a covered employer but elect for voluntary coverage.

What Can I Expect to Receive in Benefits? Disability benefits will pay 50% of your average wages (calculated over the prior eight weeks) up to a maximum of $170 per week. Benefits will begin on your eight consecutive day out of work; the first seven days is an unpaid waiting period. You can receive benefits for a maximum of 26 weeks in a 52-week period. You will receive payment every two weeks. For pregnancy, women are covered for six weeks after a normal pregnancy and eight weeks after a Caesarian section (those these lengths may be extended if there are complications). Women filing for post-childbirth benefits receive the same payment as those filing for other disabilities.

Medical costs are not covered by disability insurance.

Callen Lorde BENEFITS GUIDE

DISABILITY – LONG TERM I

FLEXIBLE SPENDING ACCOUNT (FSA)

Callen Lorde is offering a Flexible Spending Account (FSA) for 2025. This is how an FSA works: • You set aside money for your FSA from your paycheck before taxes are taken out up to a $3,300 maximum. • Then use your pre-tax FSA funds throughout the plan year to pay for eligible health care or dependent care expenses. • You save money on expenses you’re already paying for.

DEPENDENT CARE FSA ELIGIBLE EXPENSES

HEALTH FSA ELIGIBLE EXPENSES

• Medical expenses: co-pays, co-insurance, and deductibles • Dental expenses: exams, cleanings, X-rays, and braces • Vision expenses: exams, contact lenses and supplies, eyeglasses, and laser eye surgery • Professional services: physical therapy,

• Care for your child who is under age 13 • Before and after-school care • Baby sitting and nanny expenses • Day care, nursery school, and preschool • Summer day camp • Care for a relative who is physically or mentally incapable of self-care and lives in your home

chiropractor, and acupuncture • Prescription drugs and insulin

• Over-the-counter health care items: bandages, pregnancy test kits, blood pressure monitors, etc.

FSA I

Callen Lorde BENEFITS GUIDE

COMMUTER BENEFIT

• There are two options for the transportation benefit, a monthly unlimited MetroCard OR a HealthEquity credit card with separate funds for parking or transit • You set aside money for your transportation costs from your paycheck before taxes up to $325 for transit and $325 for parking expenses • The monthly unlimited MetroCard refills itself from month to month so no more having to purchase unlimited MetroCards every month • The HealthEquity credit card allows unused funds to be rolled over to the next month • The HealthEquity credit card can be used for Lyft Pool and Uber Pool

• You save money on expenses you’re already paying for • Enrollment can be done on the HealthEquity website

COMMUTER BENEFIT I

Callen Lorde BENEFITS GUIDE

800.873.7138 | www.MINESandAssociates.com

Live well, live balanced, live life

Counseling Free and confidential counseling services for everyday life situations including stress, anxiety, depression, family situ- ations, drug and alcohol abuse, relationships, death and grief, and work-related topics. Legal & Financial Practical legal and financial assistance that includes: • Free 30-minute consult per legal/financial matter. • 25% discount on select services after the initial consult. • Useyour EAP sessions for financial/Medicare coaching. Work/Life Unlimited work/life services to help find the right service for your needs such as childcare, eldercare, and convenience services including everything from nutrition classes to find- ing the perfect dog walker. Wellness No matter your wellness goals, MINES can help. You have: • 4 professional wellness sessions with a personal coach. • 4 sessions of parental coaching & lactation consults. • 6week Virtual smoking cessation or stress reduction program.

i Your info

As an employee of Callen-Lorde ,

you and each member of your household have up to 6 counseling sessions per life situation*, per contract year . Digital message-based, telephonic, video, and face- to-face counseling available. To Access services: Call MINES at 1-800-873-7138 Or visit: minesandassociates.com Company Code: callenlorde Your company code isused to register for online profiles as well as complete online requests for service. Log on today to access your services and free mindfulness app. Contract Year: 1/1-12/31 Free & Confidential Support 24/7

Online Signon to PersonalAdvantage toaccess:

• Online Resource Library full of articles, assessments, training, and financial tools designed to beat stress and improve work/life balance. • eM Life mindfulness service for live sessions, community support, and expert instructors that can help you live a healthier, more balanced life.

*Per Life Situation: A distinct, separate and new life event. A MINES case manager will review requests for additional sets of sessions. Continuation of counseling is not aseparate,distinct andnewlife event.This guide is for informational purposes only. Call MINES for details.

MINES and Associates | 800.873.7138 | www.MINESandAssociates.com

VALUE OF PRE-TAX BENEFITS

Section 125 Plan Callen Lorde operates a Premium Only Section 125 Plan, which allows you to reduce your total taxable income by your portion of group insurance premiums. In effect, this is just like getting a raise - your withholding taxes are reduced, and your take-home pay increases!

Example: Employee earning $30,000 annually, paying $200/month for benefits Without Pre-Tax Benefits With Pre-Tax Benefits Gross Pay $30,000 $30,000 Insurance Deductions/Payments $0 $2,400 Taxable Income $30,000 $27,600 Taxes at 25% $7,500 $6,900 After-Tax Income $22,500 $20,700 After-Tax Payment for Benefits $2,400 $0 Take-home Pay $20,100 $20,700 INCREASE IN TAKE-HOME PAY +$600

PRE-TAX BENEFITS I

Callen Lorde BENEFITS GUIDE

403(b)

403(b) Plan Benefits

• Callen-Lorde offers a 403(b) Plan for both our Union and Non-Union Members

• The plan allows for you to defer up to $23,500 in 2025 o Deferring your own money into the plan lowers your taxable income each year and allows your savings to grow tax-deferred o The plan also allows you to defer a portion or all your salary deferrals on an after-tax basis. This is known as a Roth Contribution o For employees age 50 and over, they can save an additional $7,500 • Our 403(b) partner is T. Rowe Price. You can create and maintain your account at https://www.troweprice.com/

• Callen-Lorde offers a 4% Match to the 403(b) Plan for all Union Employees as well as a Discretionary Match for all Non-Union Employees.

The match is immediately vested

•

• You are eligible to participate in the plan immediately and you qualify for the match once you have completed 1,000 hours and one year of service.

• You may stop making contributions at any time during the year

If you have any questions pertaining to the 403(b) plan, you may also contact our Benefit Advisors at Brio at retirement@briobenefits.com

PRE-TAX BENEFITS I

Callen Lorde BENEFITS GUIDE

ENROLLMENT

ONLINE ENROLLMENT OVERVIEW

ONLINE ENROLLMENT I

Callen Lorde BENEFITS GUIDE

ONLINE ENROLLMENT OVERVIEW

2025

ONLINE ENROLLMENT I

Callen Lorde BENEFITS GUIDE

ONLINE ENROLLMENT OVERVIEW

ONLINE ENROLLMENT I

Callen Lorde BENEFITS GUIDE

ONLINE ENROLLMENT OVERVIEW

ONLINE ENROLLMENT I

Callen Lorde BENEFITS GUIDE

ONLINE ENROLLMENT OVERVIEW

2025

ONLINE ENROLLMENT I

Callen Lorde BENEFITS GUIDE

ONLINE ENROLLMENT OVERVIEW

Current 2025 Benefits

ONLINE ENROLLMENT I

Callen Lorde BENEFITS GUIDE

ONLINE ENROLLMENT OVERVIEW

ONLINE ENROLLMENT I

Callen Lorde BENEFITS GUIDE

LEGAL NOTICES

Health Insurance Portability and Accountability Act of 1996 (HIPAA) The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that addresses the privacy and security of certain individually identifiable health information, called protected health information (or PHI). You have certain rights with respect to your PHI, including a right to see or get a copy of your health and claims records and other health information maintained by a health plan or carrier. For a copy of the Notice of Privacy Practices, describing how your PHI may be used and disclosed and how you get access to the information, contact Human Resources. Women’s Health and Cancer Rights Act Enrollment Notice If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Woman’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for: 1. All stages of reconstruction of the breast on which mastectomy was performed. 2. Surgery and reconstruction of the other breast to produce a symmetrical appearance; prostheses. 3. Treatment of physical complications of the mastectomy, including lymphedema.

These will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under this benefits plan.

Newborns’ and Mothers’ Health Protection Act Disclosure 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). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). Patient Protection Notice Your carrier generally may require the designation of a primary care provider. You have the right to designate any primary care provider who participates in your network and who is available to accept you or your family members. Until you make this designation, your carrier may designate one for you. For children, you may designate a pediatrician as the primary care provider. You do not need prior authorization from your carrier or from any other person (including a primary care provider) in order to obtain access to obstetrical or gynecological care from a health care professional in your network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals.

Callen Lorde BENEFITS GUIDE

LEGAL NOTICES I

LEGAL NOTICES

HIPAA Special Enrollment Notice If you are declining enrollment 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). In addition, if you have a new dependent as a result of 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, adoption, or placement for adoption. 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. 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).

If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31, 2022. Contact your State for more information on eligibility –

ALABAMA – Medicaid

ARKANSAS – Medicaid

Website: http://myarhipp.com/ Phone: 1-855-MyARHIPP (855-692-7447)

Website: http://myalhipp.com/ Phone: 1-855-692-5447

COLORADO – Health First Colorado (Colorado’s Medicaid Program) & Child Health Plan Plus (CHP+)

ALASKA – Medicaid

Health First Colorado Website: https://www.healthfirstcolorado.com/ Health First Colorado Member Contact Center: 1-800-221-3943/ State Relay 711 CHP+: https://www.colorado.gov/pacific/hcpf/child-health-plan-plus CHP+ Customer Service: 1-800-359-1991/ State Relay 711

The AK Health Insurance Premium Payment Program Website: http://myakhipp.com/ Phone: 1-866-251-4861 Email: CustomerService@MyAKHIPP.com Medicaid Eligibility: http://dhss.alaska.gov/dpa/Pages/medicaid/default.aspx

Callen Lorde BENEFITS GUIDE

LEGAL NOTICES I

LEGAL NOTICES

FLORIDA – Medicaid

MASSACHUSETTS – Medicaid and CHIP

Website: http://flmedicaidtplrecovery.com/hipp/ Phone: 1-877-357-3268

Website: http://www.mass.gov/eohhs/gov/departments/masshealth/ Phone: 1-800-862-4840

GEORGIA – Medicaid

MINNESOTA – Medicaid

Website: https://medicaid.georgia.gov/health-insurance-premium- payment-program-hipp Phone: 678-564-1162 ext 2131

Website: https://mn.gov/dhs/people-we-serve/seniors/health-care/health-care- programs/programs-and-services/other-insurance.jsp Phone: 1-800-657-3739

INDIANA – Medicaid

MISSOURI – Medicaid

Healthy Indiana Plan for low-income adults 19-64 Website: http://www.in.gov/fssa/hip/ Phone: 1-877-438-4479 All other Medicaid Website: http://www.indianamedicaid.com Phone: 1-800-403-0864

Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Phone: 573-751-2005

IOWA – Medicaid

MONTANA – Medicaid

Website: http://dhs.iowa.gov/Hawki Phone: 1-800-257-8563

Website: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP Phone: 1-800-694-3084

KANSAS – Medicaid

NEBRASKA – Medicaid

Website: http://www.ACCESSNebraska.ne.gov Phone: (855) 632-7633 Lincoln: (402) 473-7000 Omaha: (402) 595-1178

Website: http://www.kdheks.gov/hcf/ Phone: 1-785-296-3512

KENTUCKY – Medicaid

NEVADA – Medicaid

Medicaid Website: http://dhcfp.nv.gov/ Medicaid Phone: 1-800-992-0900

Website: https://chfs.ky.gov Phone: 1-800-635-2570

LOUISIANA – Medicaid

NEW HAMPSHIRE – Medicaid

Website: https://www.dhhs.nh.gov/oii/hipp.htm Phone: 603-271-5218 Toll free number for the HIPP program: 1-800-852-3345, ext 5218

Website: http://dhh.louisiana.gov/index.cfm/subhome/1/n/331 Phone: 1-888-695-2447

MAINE – Medicaid

NEW JERSEY – Medicaid and CHIP

Website: http://www.maine.gov/dhhs/ofi/public-assistance/index.html Phone: 1-800-442-6003 TTY: Maine relay 711

Medicaid Website: http://www.state.nj.us/humanservices/dmahs/clients/medicaid/ Medicaid Phone: 609-631-2392 CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710

LEGAL NOTICES I

Callen Lorde BENEFITS GUIDE

LEGAL NOTICES

NEW YORK – Medicaid

TEXAS – Medicaid

Website: http://gethipptexas.com/ Phone: 1-800-440-0493

Website: https://www.health.ny.gov/health_care/medicaid/ Phone: 1-800-541-2831

NORTH CAROLINA – Medicaid

UTAH – Medicaid and CHIP

Medicaid Website: https://medicaid.utah.gov/ CHIP Website: http://health.utah.gov/chip Phone: 1-877-543-7669

Website: https://medicaid.ncdhhs.gov/ Phone: 919-855-4100

NORTH DAKOTA – Medicaid

VERMONT – Medicaid

Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/ Phone: 1-844-854-4825

Website: http://www.greenmountaincare.org/ Phone: 1-800-250-8427

OKLAHOMA – Medicaid and CHIP

VIRGINIA – Medicaid and CHIP

Website: http://www.insureoklahoma.org Phone: 1-888-365-3742

Medicaid Website: http://www.coverva.org/programs_premium_assistance.cfm Medicaid Phone: 1-800-432-5924 CHIP Website: http://www.coverva.org/programs_premium_assistance.cfm CHIP Phone: 1-855-242-8282

OREGON – Medicaid

WASHINGTON – Medicaid

Website: https://www.hca.wa.gov/ Phone: 1-800-562-3022 ext. 15473

Website: http://healthcare.oregon.gov/Pages/index.aspx http://www.oregonhealthcare.gov/index-es.html Phone: 1-800-699-9075

PENNSYLVANIA – Medicaid

WEST VIRGINIA – Medicaid

Website: http://www.dhs.pa.gov/provider/medicalassistance/healthinsurancepr emiumpaymenthippprogram/index.htm Phone: 1-800-692-7462

Website: http://mywvhipp.com/ Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447)

RHODE ISLAND – Medicaid

WISCONSIN – Medicaid and CHIP

Website: https://www.dhs.wisconsin.gov/publications/p1/p10095.pdf Phone: 1-800-362-3002

Website: http://www.eohhs.ri.gov/ Phone: 855-697-4347, or 401-462-0311 (Direct Rite Share Line)

WYOMING - Medicaid Website: https://wyequalitycare.acs-inc.com Phone: 307-777-7531

SOUTH CAROLINA – Medicaid

Website: http://www.scdhhs.gov Phone: 1-888-549-0820

SOUTH DAKOTA - Medicaid

Website: http://dss.sd.gov Phone: 1-888-828-0059

LEGAL NOTICES I

Callen Lorde BENEFITS GUIDE

LEGAL NOTICES

SOUTH DAKOTA – Medicaid

WASHINGTON – Medicaid

WASHINGTON – Medicaid Website: http://www.hca.wa.gov/free-or-low-cost- health-care/program-administration/premium-payment-program

SOUTH DAKOTA - Medicaid

Website: http://dss.sd.gov Phone: 1-888-828-0059

Phone: 1-800-562-3022 ext. 15473

TEXAS – Medicaid

WEST VIRGINIA – Medicaid

Website: http://mywvhipp.com/ Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447)

Website: http://gethipptexas.com/ Phone: 1-800-440-0493

UTAH – Medicaid and CHIP

WISCONSIN – Medicaid and CHIP

Website: https://www.dhs.wisconsin.gov/publications/p1/p10095.pdf

Medicaid Website:https://medicaid.utah.gov/ CHIP Website:http://health.utah.gov/chip Phone: 1-877-543-7669

Phone: 1-800-362-3002

VERMONT– Medicaid

WYOMING – Medicaid

Website: https://wyequalitycare.acs-inc.com/ Phone: 307-777-7531

Website: http://www.greenmountaincare.org/ Phone: 1-800-250-8427

Medicaid Website: http://www.coverva.org/programs_premium_assistance.cfm Medicaid Phone: 1-800-432-5924 CHIP Website: http://www.coverva.org/programs_premium_assistance.cfm CHIP Phone: 1-855-242-8282 VIRGINIA – Medicaid and CHIP

To see if any other states have added a premium assistance program since July 31, 2018, or for more information on special enrollment rights, contact either:

U.S. Department of Health and Human Services Employee Benefits Security Administration Centers for Medicare & Medicaid Services www.dol.gov/agencies/ebsa www.cms.hhs.gov 1-866-444-EBSA (3272) 1-877-267-2323, Menu Option 4, Ext. 61565

U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272)

Paperwork Reduction Act Statement According to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no persons are required to respond to a collection of information unless such collection displays a valid Office of Management and Budget (OMB) control number. The Department notes that a Federal agency cannot conduct or sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is not required to respond to a collection of information unless it displays a currently valid OMB control number. See 44 U.S.C. 3507. Also, notwithstanding any other provisions of law, no person shall be subject to penalty for failing to comply with a collection of information if the collection of information does not display a currently valid OMB control number. See 44 U.S.C. 3512.

Callen Lorde BENEFITS GUIDE

LEGAL NOTICES I

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