Hughston 2024 Benefits Guide

EMPLOYEE BENEFITS GUIDE | 2024

THC | THF | HSC | JHMH | HMG | HOT | HOSE

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Hughston Benefits Guide

CONTENTS

05

09

FIND THE LOWEST COST PRESCRIPTION

FLEXIBLE SPENDING ACCOUNTS (FSAs)

03

06 DENTAL , VISION & TELEMEDICINE

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WELCOME TO HUGHSTON &

CHOOSE YOUR MEDICAL PLAN

HOW TO ENROLL ON ADP

04

08 LIFE, DISABILITY,

11

ELIGIBILITY AND ENROLLMENT

HEALTH SAVINGS ACCOUNT (HSA)

WORKSITE BENEFITS & EMPLOYEE ASSISTANCE PROGRAM (EAP)

Hughston Benefits Guide

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WELCOME TO HUGHSTON’S 2024 BENEFITS GUIDE!

Hughston’s most important asset is our people. That’s why we offer you an exceptional benefits program with many options, designed to meet your needs and the needs of your family. In this booklet you will find summaries of Hughston’s medical, dental, vision, life, disability, HSA, FSA, telehealth, EAP and worksite benefits. HOW TO ENROLL ON ADP Go to https://workforcenow.adp.com/workforcenow/login.html .

Step 5: Continue your enrollment by repeating the above steps for all employee paid plans such as Dental, Vision, Flexible Spending, Health Savings Account (only if High Deductible Health Plan is elected) and Voluntary Life Insurance. Please note that if you want Voluntary Life insurance for spouse or children, you are required to elect coverage for yourself.

Step 1: Log into ADP using your username and password. The Enrollment screen will pop up immediately upon login. Click on Start This Enrollment. Step 2: On the Enrollment screen first review your dependents/ beneficiaries; if you need to add or remove any dependents/ beneficiaries it must be completed prior to electing any benefits. **Please note that your legal spouse and any child(ren) under 26 years of age are eligible for the company paid basic life insurance plan. Step 3: Once the dependents/beneficiaries are updated, scroll down and click on walk me through my benefits options, then click continue. Step 4: In order to elect the plans, start by clicking on Medical (even if you are waiving, you need to click through the screens). Select the plan that best suits you and your

Special Notes:

1. Plans such as Basic Life, EAP and Long-Term Disability are set for automatic enrollment (employees only).

2. For Basic Life Insurance or Voluntary Life Insurance, confirm ALL dependents are enrolled and confirm ALL beneficiaries are designated.

Final Step: Click Review and Complete. Check your email for a Confirmation of Benefits Statement.

family (ex: Premium, Basic, HDHP). Click on enroll in this plan, then choose the level that corresponds with who needs to be included in your benefits. Click Enroll. ***Make sure that all dependents who should be enrolled in the coverage have a checkmark next to their name. ***

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Hughston Benefits Guide

ELIGIBILITY & ENROLLMENT

If enrolling as a new hire, you must complete the enrollment process within 30 days of your hire date.

NEW EMPLOYEES New employee benefits are effective on the first of the month following 30 days for all full-time employees.

Open enrollment refers to your opportunity to: • Change plans

• Enroll in benefits • Cancel benefits

• Add or remove dependents to your benefits. Eligible dependents are your legal spouse and dependent children.

MID-YEAR BENEFITS CHANGES Outside of your annual Open Enrollment period, you may be eligible to make certain benefits changes during the middle of the year. Please refer to your Summary Plan Description (SPD) for specifics, but examples of when you might be able to make mid-year changes are: • Marriage or Divorce

ELIGIBILITY All full-time employees are offered benefits. Spouses and dependent children of the employee are also eligible to participate in our benefits plans. Dependent children include your natural children, legally adopted children and children for whom you have been appointed guardian up to the age of 26.

• Birth, Death, or Adoption • Change in Eligibility Status

MEET YOUR CLIENT ADVOCATES

Contact your Client Advocates to help you get the most from your group insurance plans. Always ensuring confidentiality, your Client Advocates are ready to answer any of your benefits related questions including:

• Need help solving a benefit related problem • Have a question about a benefit • Have questions regarding a bill

• Need further clarification on an insurance matter • Believe that your claim has not been paid properly

Charlie McDaniel Yates LLC Broker cmcdaniel@yatesins.com 706.527.2090

Billy Eissler Yates LLC Broker beissler@yatesins.com 770.778.1978

Resa Carter Yates LLC Account Manager rcarter@yatesins.com 706.323.1600

Cheryl Janis Yates LLC Account Manager cjanis@yatesins.com 404.486.2273

Paige Duckworth Yates LLC Marketing Manager pduckworth@yatesins.com 404.982.2413

Leigh Drawdy Yates LLC Account Manager ldrawdy@yatesins.com 706.323.1600

Hughston Benefits Guide

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FIND THE LOWEST COST PRESCRIPTIONS Did you know that drug prices can drastically vary among different pharmacies? Did you know that purchasing a drug through your company medical plan is not always the lowest cost option? A free, independent third-party solution, GoodRx, is here to help!

• Navigate to www.GoodRx.com or download the free mobile app (search “GoodRx” in your app store).

• Download a free coupon for that pharmacy, or order online when available.

• Type in your prescription name, and then adjust your location, dosage, and quantity.

• Please be aware that any prescriptions purchased outside of your Medical Insurance do not accumulate to your plan deductible and/or out-of-pocket maximum.

• Review the real-time cost of your prescription at various pharmacies around your zip code.

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Hughston Benefits Guide

MEDICAL | ALLIED BENEFIT

Your medical coverage is offered through Allied Benefit for the 2024 plan year. Please review your plan summaries or Summary of Benefits and Coverage (SBC) for coverage information and full plan details. As an Allied member, www.alliedbenefit.com allows you to track your health care benefits and access timely information and tools to help you make better health care decisions. You can view your Personal Health Record, view detailed claims information and reports, find providers and access your ID card.

Remember to tell your providers that your plan utilizes the Aetna Signature Network.

Medical - Allied Benefit (TPA) Aetna Signature Administrators PPO Network Coinsurance (Member pays) Calendar Year Deductible - Individual ( Hughston | In-network) - Family ( Hughston | In-network)

Copay Plan

HSA 1600

In-Network

Out-of-Network

In-Network

Out-of-Network

20%

40%

20%

40%

Embedded $500 | $1,000 $1,000 | $2,000

Embedded $2,000 $4,000

Non-Embedded $1,600 $3,200

Non-Embedded $3,200 $9,600

Out-of-Pocket Maximum (Deductible included) - Individual -Family

$4,000 $8,000

$10,000 $20,000

$4,000 $8,000

$15,000 $30,000

Office Visit -Primary - Specialist - Preventive

$25 Copay $50 Copay 100% Covered

40% after Deductible 40% after Deductible 40% after Deductible

20% after Deductible 20% after Deductible 100% Covered

40% after Deductible 40% after Deductible 40% after Deductible

Emergency Room Services (Copay waived if admitted)

$150 Copay

$150 Copay

20% after Deductible

20% after Deductible

Urgent Care

$60 Copay

40% after Deductible 40% after Deductible 40% after Deductible

40% after Deductible 40% after Deductible 40% after Deductible

20% after Deductible 20% after Deductible 20% after Deductible

Inpatient Services Outpatient Services

20% after Deductible 20% after Deductible

Prescripctions (30 Day Supply) Deductible Tier 1 Tier 2 Tier 3 Tier 4 (Specialty Drugs) Mail Order (90 Day Supply) Tier 1 Tier 2 Tier 3 Medical Rates (Bi-Weekly) ** | *** Employee Employee + Spouse Employee + Child(ren) Family

The Prescription Benefit Coverage is Administered by ProAct

$200 Individual / $400 Family $10 Copay $30 Copay after Rx Deductible $60 Copay after Rx Deductible $120 Copay after Rx Deductible

Subject to Medical Deductible $10 Copay after Deductible $30 Copay after Deductible $60 Copay after Deductible $120 Copay after Deductible

$20 Copay $60 Copay after Rx Deductible $120 Copay after Rx Deductible

$20 Copay after Deductible $60 Copay after Deductible $120 Copay after Deductible

$72.07 $299.13 $268.31 $435.09

$52.17 $216.56 $194.25 $315.00

Hughston Urgent Ortho visits are subject to the primary care physician fee.

Hughston Benefits Guide

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SPOTLIGHT ON URGENT CARE

Is your medical issue a true emergency? While you may encounter urgent issues, they are not always life threatening. In these cases, you can save yourself both time and money by visiting an Urgent Care Center or using the Telemedicine benefit instead of the Emergency Room. Search the Aetna Signature Administrators PPO network for convenient Urgent Care Centers around your home or office, and register with Teladoc today!

Medical - Allied Benefit (TPA) Aetna Signature Administrators PPO Network Coinsurance (Member pays)

HSA 3000

In-Network

Out-of-Network

0%

40%

Calendar Year Deductible - Individual - Family Out-of-Pocket Maximum (Deductible included) - Individual -Family

Non-Embedded $3,000 $6,000

Non-Embedded $10,000 $20,000

SURCHARGES

$4,000 $8,000*

$15,000 $30,000

Office Visit -Primary - Specialist - Preventive

Bi-Weekly

Surcharge

Deductible Deductible 100% Covered

40% after Deductible 40% after Deductible 40% after Deductible

Employee Tobacco User** Spouse Eligible for Other Coverage***

$50

Emergency Room Services (Copay waived if admitted)

$75

Deductible

Deductible

Urgent Care

Deductible Deductible Deductible

40% after Deductible 40% after Deductible 40% after Deductible

** Your health plan is committed to helping you achieve your best health. Rewards for participating in a wellness program are available to all employees. If you think you might be unable to meet a standard for a reward under this wellness program, you might qualify for an opportunity to earn the same reward by different means. Contact us at 706.494.3447 and we will work with you (and if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status. *** If your spouse has access to medical coverage under his/her employer’s health plan, and you elect to cover them under the Hughston medical plan, you will pay a bi-weekly surcharge.

Inpatient Services Outpatient Services

Prescripctions (30 Day Supply) Deductible Tier 1 Tier 2 Tier 3 Tier 4 (Specialty Drugs) Mail Order (90 Day Supply) Tier 1 Tier 2 Tier 3 Medical Rates (Bi-Weekly) ** | *** Employee Employee + Spouse Employee + Child(ren) Family *$7,000 per individual in a family plan

The Prescription Benefit Coverage is Administered by ProAct

Subject to Medical Deductible $10 Copay after Deductible $30 Copay after Deductible $60 Copay after Deductible $120 Copay after Deductible

$20 Copay after Deductible $60 Copay after Deductible $120 Copay after Deductible

$30.19 $133.22 $121.08 $211.97

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Hughston Benefits Guide

HEALTH SAVINGS ACCOUNT | MEDCOM

Who contributes to an HSA? • You

• You will also receive a contribution from Hughston to help grow your balance faster. If you have employee only coverage, Hughston will contribute $250 annually, distributed in a bi- weekly contribution of $9.62. If you have employee plus dependent coverage, Hughston will contribute $750 annually, distributed in a bi-weekly contribution of $28.85 as long as you are benefit eligible. How much can I contribute to an HSA? • Employee only coverage: $4,150 per calendar year. • Employee plus dependent coverage: $8,300 per calendar year. • If you are 55 or older, you can make an additional annual catch-up contribution of $1,000. > Please be aware that the contribution maximums listed above include any employer contribution. You must subtract out the Hughston HSA contribution to determine the maximum amount that you as the employee can contribute. Who cannot contribute to an HSA? • If you are age 65 or older and enrolled in Medicare. • If you have health coverage under another medical plan that is not a high deductible plan. • If you or your spouse has a Full Purpose FSA, you can still enroll in the High Deductible Health Plan, but neither you nor Hughston can contribute money into the HSA.

What is a Health Savings Account?

A Health Saving Account (HSA) is a way for you to save pre-tax dollars that can be used to pay for qualified health care expenses like deductibles, copays, coinsurance, prescriptions, vision and dental expenses. The funds can be taken out via payroll deductions and are deposited into the account for future use. In order to contribute to an HSA, you must be enrolled in Hughston’s High Deductible Health Plan.

SPOTLIGHT ON HSA

Did you know your HSA provides triple tax benefits? All HSA contributions are made pre-tax, qualified healthcare expenses are not taxable, and any interest you may accumulate on the account is also tax-free!

Hughston Benefits Guide

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FLEXIBLE SPENDING ACCOUNTS (FSAs) | MEDCOM

FSAs offer opportunities to pay for eligible out-of-pocket health care expenses and dependent care expenses with pre-tax dollars. You have the option to participate in the following FSAs:

MEDICAL FSA

Who can participate? Benefit eligible employees not enrolled in a medical plan, or employees enrolled in the Copay plan.

What happens at the end of the year? Any leftover funds will be lost.

Grace period There is a 2.5 month grace period after the end of the plan year where you are still able to use funds for reimbursement.

Contribution Limits : Employees can contribute up to $3,200. You can use the funds for any qualified healthcare expense.

DEPENDENT CARE FSA

Who can participate? Benefit eligible employees

What happens at the end of the year? Any leftover funds will be lost.

Contribution Limits : Employees can contribute up to $5,000 per plan year. You can use the funds for any qualified dependent care expenses.

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Hughston Benefits Guide

DENTAL | METLIFE

Premium Plan

Basic Plan

Dental Plan - MetLife

Annual Deductible Individual | Family Preventive Services

$50 | $150 $50 | $150

100%

100%

Your dental coverage is offered through MetLife for the 2024 plan year. Please review your plan summaries or policy for coverage information and full plan details.

Basic Services Major Services

80% 50% 50%

80% N/A N/A

Orthodontia (Child up to age 26) Annual Benefit Maximum Orthodontia Lifetime Maximum Out-of-Network Reimbursement

$3,000 $1,500

$1,500

N/A

90th UCR Premium Plan

90th UCR

Dental Rates (Bi-Weekly)

Basic Plan

Employee Employee + Spouse Employee + Child(ren) Family

$11.29 $18.90 $20.48 $27.30

$6.82 $11.34 $12.34 $16.27

Out-of-Network Reimbursement

Vision Plan - MetLife

In-Network

Eye Exam Lenses Single Bifocals Trifocals

$10 Copay

Up to $45

$20 Copay $20 Copay $20 Copay

Up to $30 Up to $50 Up to $65

$130 Allowance after $20 Copay*

Frames

Up to $70

VISION | METLIFE

Contacts Electve Medically Necessary

$130 Allowance $20 Copay

Up to $105 Up to $210

Frequency Exam/Lenses or Contacts/Frames 12/12/24 Months Vision Rates (Bi-Weekly) Employee $3.41 Employee + Spouse $5.57 Employee + Child(ren) $5.46 Family $8.98

Your vision coverage is offered through MetLife for the 2024 plan year. Please review your plan summaries or policy for coverage information and full plan details.

* Costco, Walmart and Sam’s Club: $70 allowance after $20 eyewear copay.

TELEMEDICINE | TELADOC Telemedicine is an affordable plan that gives you and your family 24/7/365 access to U.S. Board Certified Physicians who can consult, diagnose, and if needed prescribe medication over the phone or via video technology for many common and acute illnesses.

Hughston Benefits Guide

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LIFE, DISABILITY, WORKSITE BENEFITS & EAP

LIFE INSURANCE | METLIFE

LONG TERM DISABILITY | METLIFE

Basic Life and Voluntary Life insurance provides for financial support in the untimely passing of a covered participant. Basic Life and AD&D* • Benefit amount: 1x your Basic Annual Earnings, rounded to the next higher $1,000 - up to $150,000. The spouse benefit amount is $5,000 and $100 for your child from 15 days to 6 months or $2,500 for child 6 months to age 26. • Please be advised that should you reach age 65, your coverage will reduce by 35%. Should you reach age 80, your coverage will reduce by 60%. • Employer Paid Voluntary Life and AD&D* • Employees can elect Voluntary Life and AD&D for the employee, spouse, and dependent children. • The cost is based on the amount you purchase and your age at the time of purchase, and you can calculate your cost while enrolling in the Hughston’s ADP employee portal. • Employee Paid

Long Term Disability insurance provides partial income replacement in the event of a covered illness or accident. • Benefit begins once you have been out of the office due to your disability for 90 days. • Monthly benefit checks will be 60% of your monthly earnings to a maximum of $10,000 a month. • You can receive these monthly benefit checks up to your normal retirement age if you meet the definition of disability. • Employer Paid

WORKSITE BENEFITS | AFLAC*

Accident The group accident policy provides a cash benefit for out-of- pocket expenses associated with an accidental injury and can help protect hard-earned savings should an on or off-the-job accident occur. Cancer With an Aflac Cancer Care insurance policy, you can have financial peace of mind if a diagnosis of cancer ever occurs. Short Term Disability Short Term Disability insurance provides partial income replacement in the event of a covered illness or accident that occurs outside of work. Hospital Confinement Hospital Confinement insurance complements your present major medical coverage by providing cash benefits that can be used to help pay out-of-pocket expenses associated with a hospital confinement.

Employee Coverage

Spouse Coverage

Child Coverage

Increments of $10,000 up to a maximum of $500,000, not to exceed 5x your earnings Guarantee Issue $150,000

Increments of $5,000 up to $250,000

Flat amount: $2,500 $5,000 $7,500 $10,000 Guarantee Issue $10,000

Guarantee Issue $50,000

*If your spouse is also a benefits-eligible employee at Hughston, then you may not be eligible to elect spousal coverage for Life insurance, Accident Insurance, Cancer Insurance, and Hospital Confinement. In addition, only one employee can elect life coverage for the child. Please refer to the plan document for details.

EMPLOYEE ASSISTANCE PROGRAM | BHS & METLIFE Hughston provides a confidential Employee Assistance Program (EAP) to you and members of your household. Examples of services provided by the EAP include financial counseling, professional help with drug/alcohol dependence and grief counseling. Services provided are completely confidential and available 24 hours a day, 7 days a week.

CONTACTS

Medical | Allied Benefit (TPA) Tel.: 1.800.288.2078 www.alliedbenefit.com

Employee Assistance Program (EAP) BHS Tel.: 1.800.327.2251

Voluntary Benefits | Aflac Tel.: 1.800.992.3522 www.aflac.com Yates LLC Client Advocates Tel.: 1.404.633.4321

portal.BHSonline.com Company ID: Hughston MetLife Tel.: 1.888.319.7819 metlifeeap.lifeworks.com User Name: metlifeeap Password: eap HSA & FSA | Medcom Tel.: 1.800.523.7542 www.medcombenefits.com

Prescription | ProAct Tel.: 1.877.635.9545 www.Proactrx.com Telemedicine | Teladoc

Tel.: 1.800.835.2362 www.teladoc.com Dental, Vision, Life & LTD | MetLife Dental: 1.800.275.4638 Vision: 1.855.638.3931

Life: 1.800.638.5000 LTD: 1.800.858.6506 www.metlife.com

6262 Veterans Parkway Columbus, GA 31908 Phone: 706.324.6661

This booklet is intended as a convenient summary of all major points of your benefits plan. This booklet does not cover all provisions, limitations, and exclusions. The official plan documents, policies, and certificates of insurance govern in all cases and are available for your inspection at any time.

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