Employee Benefits Guide 2025-2026

Employee Benefits Guide 2025 – 2026

Open Enrollment: June 2, 2025 – June 30, 2025 For changes effective July 1, 2025

ENROLLING IN YOUR BENEFITS

TABLE OF CONTENTS

Enrolling In Your Benefits

Dental Resources

Medical Benefits

Vision Benefits

Medical Resources

Benefit Cards

Shopping for Care

Ambulatory Surgery / Imaging

Employee Assistance Program

Opt-Out Benefit / Beneficiaries

Life / Accidental Death & Dismemberment

Disability Benefits

Accident Coverage

19-22

Know Your Healthcare Options / Proactive MD

8-9

Cancer Coverage

23-24

Hospital Confinement Coverage

Colonial Resources

Prescription Benefits and Specialty Medications

Retirement Plans – PEBA Employees

Retirement Plans – General Employees

Wellness Incentive (HRA) / Medical and Dependent Care FSA

Supplemental Retirement Options – All Employees

HRA / FSA Resources

Employee Cost

Dental Benefits

Contact Information

An eligible employee is defined as a full-time employee working 40 hours or more per week. This excludes temporary, seasonal or contract positions. Your benefits become effective on the first of the month following date of hire. You may also elect coverage for your dependents including: your legal spouse and/or your dependent children up to the age of 26 for dependent eligible benefits. Who is Eligible? How & When Do I Enroll? Open Enrollment: Open enrollment is the period each year when changes to your benefit elections are permitted. You may change plans as well as add or drop coverage for you or your eligible dependents. Any changes made during open enrollment must remain until the following open enrollment period, unless you experience a qualifying life event. New employees complete benefit elections during their New Employee Orientation . To make changes to your benefit elections, please schedule an appointment with Christine Scalise , HR Coordinator. Changes can only be made during your open enrollment period unless you have a qualified life event (see list below).

Qualifying Status Changes:  Change in employee’s legal marital status  Birth, adoption or change in custody of an eligible dependent  Change in your or your spouse's employment status (i.e., full-time to part-time)

 Gain or Loss of a dependent’s eligibility due to change in age or student status  Loss of other coverage (i.e., spouse’s health plan coverage ends, or Medicare or Medicaid eligibility ends)  Death of a covered dependent

The change to your benefit elections must be consistent with the life event. You have 30 days from the date of the life event to submit an enrollment change form and documentation of the event to Human Resources. In most cases, your election will become effective the first day of the month following the life event once the paperwork is received. Birth of a child or adoption is an exception and would begin on the day of birth or adoption. Otherwise, you must wait until the next annual enrollment period to make a change to your elections. This guide provides an overview of your benefit plans that take effect July 1, 2025 . The complete provisions of the plans are set forth in the plan documents and insurance contracts. If any information in this guide conflicts with the plan documents and insurance policies, those documents/policies will govern. This guide is not intended as a contract of employment or a guarantee of current or future employment. City of North Myrtle Beach reserves the right to amend, modify or terminate these plans at any time. This guide, together with your other enrollment communications, serves as a Summary of Material Modification (SMM) to the City of North Myrtle Beach Health & Welfare Benefit Plan SPD. It is meant to supplement and/or replace certain information in the SPD, so retain it for future reference, along with your SPD. Please contact Human Resources with questions or to request a copy of the applicable plan documents .

CONMB Employee Benefit Guide 2025

MEDICAL BENEFITS

In-Network

Out-of-Network*

July 1 – June 30

Plan Year Deductible

Individual $1,000 Individual $2,250

Family $3,000 Family $4,500

Individual $1,000 Individual $2,500

Family $3,000 Family $5,000

Coinsurance Shown as a percentage

Maximum Out-of-Pocket Includes Deductible, Copays & Coinsurance

Individual $3,250

Family $7,500

Individual $3,500

Family $8,000

Primary Care Office Visit (General, Family, Pediatrician, Internist, OB/GYN)

$35 Copay

Deductible, 35%

Specialist Office Visit

$45 Copay

Deductible, 35%

Other Physician Services** Anesthesia Services, Radiology, Pathology, Obstetrical Delivery, Initial Newborn Pediatric Exam, Office Surgery, Dialysis Treatment Blue CareOnDemand (Telehealth) Powered by MD Live Preventive / Wellness Benefits In accordance with Health Care Reform Sustained Health Services (Services not covered at 100% under Preventive Care) $500 Annual Maximum Urgent Care (Not associated with a hospital) Freestanding Ambulatory Surgical Rotator Cuff Surgery, Total Knee Replacement, Total Hip Replacement, Spinal Fusion, Hernia Surgery

Deductible, 25%

Deductible, 35%

Urgent Care: $0 Copay Behavioral Health/Dermatology: $25 Copay

Not Covered

Covered in Full

Not Covered

$35 Copay

Not Covered

$35 Copay

Deductible, 35%

$500 Copay

Deductible, 35%

Freestanding Imaging Center MRI and CAT

$500 Copay

Deductible, 35%

Ambulance Air Ambulance

Deductible, 25% 75% of billed charges

Deductible, 25%

Emergency Room Facility Charges**

$150 Copay, Deductible, 25%

Emergency Room Professional Charges**

Deductible, 25%

Inpatient Hospital Services

Deductible, 25%

Deductible, 35%

Outpatient Hospital Services**

Deductible, 25%

Deductible, 35%

Other Services Physical/Occupational Therapy (40 Visits) Home HealthCare (60 Days) Hospice Chiropractic ($2,000 Annual Maximum)

Deductible, 25%

Deductible 35%

* Providers may balance bill for non-covered charges. ** Non-Participating Provider at a Participating Facility (generally includes Ambulance Services, Emergency Services and Non-Emergency Services) are subject to In-Network Deductible, Coinsurance, and Out-of-Pocket Level.

See page 30 for employee premiums

CONMB Employee Benefit Guide 2025

MEDICAL RESOURCES

My Health Toolkit Your insurance benefits are wherever you go, whenever you need them with the My Health Toolkit app. Here’s what you’ll see at-a-glance inside your account:

 View your insurance card  Who is covered by your health plan  Your deductible and out-of-pocket spending  Recent claims activity  Quick links to the most popular resources

 Ways to contact customer service  Authorization status  Prescription drug lists and costs  Find an in-network provider  Medical cost estimator

Registration is easy: Step 1: Go to www.SouthCarolinaBlues.com or download the app and select “Register Now.” Step 2: Enter the Member ID located on the front of your insurance card and your date of birth. If you do not have an ID card, you can enter your social security number. Step 3: Choose a username and password. You will also select a security question and answer. If you ever forget your username or password, you will be asked to answer the security question instead. Step 4: To complete registration, tell us how you’d like to receive your explanation of benefits (EOB).

My Health Toolkit is available on the App Store and Google Play. Download today!

Blue CareOnDemand / Telehealth Skip the emergency room for non-emergency conditions! By using Blue CareOnDemand , you save valuable time and money while getting the quality care you need. Blue CareOnDemand is available to employees that are covered by BlueCross BlueShield of SC. Why wait for the care you need now? You can see trusted, board-certified doctors when and where you want through video consults using the web or mobile app. Use your smartphone, tablet or personal computer to access faster and easier care.

It’s truly care on demand – no matter the time of day or night, or even where you happen to be! It’s free to enroll, and the cost of a consultation is the same as your primary care copay. Examples Of Treatment: Colds, Flu, Fever, Rash, Pinkeye, Ear Infection, Abdominal Pain, Sinusitis, Migraines, Dermatology Access Blue CareOnDemand by accessing your My Health Toolkit QR code above.

City’s telehealth options: Urgent Care $0 Copay, Behavioral Health $25 Copay, Dermatology $25 Copay

CONMB Employee Benefit Guide 2025

SHOPPING FOR CARE

Find the best health care options just like you check out your choices in cars, hotels or restaurants. “Know before you go.” It’s a smart idea before you make any important decision, including finding a new doctor or choosing a location for surgery. Your health plan makes these decisions easier with Shopping for Care. Find it at www.SouthCarolinaBlues.com .  Find health care providers and services within our vast provider network.  Check out cost information to make sure you’re getting the care you need at the best possible price.*  See reviews from other patients who have rated a provider you’re considering.  Identify the highest-quality providers in your area, with Total Care and Blue Distinction ® Specialty Care designations.  View a detailed map to help you get where you need to go. After you’ve registered with My Health Toolkit: Access Shopping for Care from your computer:  Visit www.SouthCarolinaBlues.com .  Log in to your account, select Providers & Services, then Find Care .  We’ll walk you through each step! Or take it with you:  Log in to the My Health Toolkit app from your mobile device.  Select Find Care . *Cost details might not be included with all plans.

“How much will it cost?” Estimates help you avoid surprises when the bills come.

Costs for a medical procedure — like an ultrasound, a checkup, x-rays or joint replacement — can vary by hundreds of dollars. Our Shopping for Care feature includes cost estimates to help you find the right care at the right price. (Cost information might not be included for all plans.) Estimate your out-of-pocket expenses for medical procedures and compare pricing details that show you the most cost- efficient providers.  At www.SouthCarolinaBlues.com , you’ll log in to your My Health Toolkit account.  Select Providers & Services , then Find Care . As you explore the Find Care categories further, you’ll see a Cost Estimates tab that’s loaded with price information about hundreds of procedures, from mammograms and MRIs to allergy testing, sleep studies, physical therapy and various types of surgery.

TIP: When you get your member ID card, use your ID number to create your My Health Toolkit account. Then you’ll see cost information about copays and other details specific to your health plan.

CONMB Employee Benefit Guide 2025

AMBULATORY SURGERY & IMAGING

Your benefit plan offers an unprecedented savings opportunity. Your plan covers seven procedures at 1 00%, with a zero out of pocket cost to you, after your $500.00 copay when any of the procedures outlined below are performed in a free-standing Ambulatory Surgical Center (ASC) or Imaging Facility. These are BlueCross BlueShield in-network facility not associated with a hospital.

See an example of the potential savings below:

SAMPLE COMPARISION Total Knee Replacement

Place of Service

Free Standing ASC or Imaging Facility

Outpatient Hospital

Expenses

$500 Copay

$1,000 Deductible $2,250 Coinsurance

Total Member Responsibility $3,250 *Savings are based on the cost of the procedure, applicable deductible and coinsurance at the time the service is rendered. $500

Procedures covered at 100% after copay include: Rotator Cuff Surgery

Total Knee Replacement

Total Hip Replacement

MRI

Spinal Fusion

Hernia Surgery

CT Scan

Frequently Asked Questions (FAQ) How do I know if my facility is an in-network free standing facility? Check with the facility prior to any procedure to ensure they are still in-network and are contracted as a free-standing facility. How do I know how much I will be charged for my MRI/CT Scan? It is recommended that you contact the provider prior to your appointment to confirm how it will be billed. Imaging services can be billed in the following ways. If you need additional assistance verifying how a facility bills a specific service, please contact the BlueCross BlueShield .

If the provider files as an office visit (some may and some may not); then the $45 copay will apply.

If the provider files as outpatient hospital, then deductible and coinsurance will apply.

If the provider files as outpatient at a free standing facility; a $500 copay will apply.

Is there anything additional I need to do to take advantage of this benefit? No. Insurance will automatically process any qualifying services as a $500 copay. How do know if my doctor can perform my surgery at an Ambulatory Surgery Center? It is important to discuss with your doctor where you intend to have your surgery. Your doctor will be able to tell you if he/she can perform the surgery or possibly refer you to someone who can.

CONMB Employee Benefit Guide 2025

OPT-OUT BENEFIT / BENEFICIARES

Opt-Out of Medical Benefits

Effective January 1, 2024, the city added an Opt-Out Provision for Health Insurance.

Employees are eligible for a $75 Benefit Credit per month added to employee's paycheck if the employee meets the requirements below:

 Must show evidence that employee and members of employee's tax family have minimal essential coverage .

 Employee will sign the Opt-Out Provision agreeing to the terms.

Note : Employees that opt-out will not have access to the Wellness Incentive Plan or Health Center (other than WC injuries or Occupational Health requirements). If eligible and interested, please contact Christine Scalise at cnscalise@nmb.us or 843-281-3752 to schedule a time to meet. Christine will review the provision and requirements at this time.

Beneficiaries

Open enrollment is a good time to review your beneficiary information. OneAmerica Life Insurance and Colonial Accident policy beneficiaries can be updated with Christine Scalise. Mission Square and PEBA beneficiaries can be updated on-line. If you name a minor as a beneficiary, they will have to settle the matter in probate court. Appointing an adult guardian who you trust to manage the proceeds for your life insurance or accident policy and who will use the money to benefit your children.

How can I update my beneficiaries?

Benefit

Process to update beneficiary

OneAmerica Life Insurance

Complete a change of beneficiary form provided by HR

Colonial Accident Insurance

Complete a Colonial change of beneficiary form provided by HR

Misson Square Retirement

Complete an on-line beneficiary change at www.missionsq.org

PEBA Complete an on-line beneficiary change at www.peba.sc.gov through Member Access Beneficiaries can be updated at ANY time. If you have any questions, please contact Human Resources Benefits to schedule an appointment to discuss questions related to beneficiaries.

CONMB Employee Benefit Guide 2025

KNOW YOUR HEALTHCARE OPTIONS

EMPLOYEE HEALTH CENTER (EHC) – FREE TO FULL-TIME EMPLOYEES

The Employee Health Center (EHC) offers on-site, in-person healthcare. This option reduces the need to use sick time for doctor appointments. Treatment, preventative and occupational health services for all employees to promote wellness, prevent illness, and manage health conditions within the work force to maintain a healthy, productive working environment.  The EHC offers primary medical care to include care to manage chronic conditions, provide preventive care, and serve as a long-term partner in managing your health.  Health maintenance, annual check-ups, physicals, vaccinations, health screenings, EKG, bloodwork, allergy shots, and wellness check.

1120-B 2 nd Ave South North Myrtle Beach, SC 29582 854.504.1440 Hours of Operation Monday – Friday 8 am – 5 PM Lunch from 12 PM – 1 PM Daily Subject to Change

 Prescription consultation and refills

 Build personal relationship over time, which can lead to better, more tailored care.

 Offer resources and education to promote a healthy lifestyle and prevent illness.

 Referrals to specialist when needed.

 Also offer Occupational Heath Services that address workplace-related illnesses or injuries

 Treat minor illnesses and injuries:

Common cold, flu, fever or rash

Earaches or infections and sore throats

Sprains and minor broken bones

Back strains or pain

Minor cuts, burns or eye injuries

Migraines, allergies and allergy shots

Pinkeye, rashes and other skin irritations

Primary Care Physicians can also provide these services for a copay; see medical benefit summary.

THE PROACTIVE MD DIFFERENCE AT CITY OF NORTH MYRTLE BEACH

What is Advanced Primary Care?

We’re different from traditional primary care. Every Proactive MD patient is guaranteed:  Convenient care  No cost for on-site care  Robust provider-patient relationship  Patient Advocacy  Care coordination  Constant communication  On-site medication dispensing

It’s the type of care you deserve.

 High quality  Broad-scope  Patient-centered

Our model is designed to support every patient’s individual needs and fight for their greatest good no matter what. If you want to schedule an appointment with your provider today, call the City’s Employee Health Center at 854.504.1440.

On-site Medications available at no cost to enrolled employees and covered dependents.

Our patients are our number one priority, and they will always come first.

Call to schedule a prescription review today.

CONMB Employee Benefit Guide 2025

KNOW YOUR HEALTHCARE OPTIONS

TELEHEALTH / URGENT CARE – FREE TO FULL-TIME EMPLOYEES 2 Telehealth is convenient 24/7/365, non-emergency, medical care requiring no travel or waiting in line. Established for care when the clinic is not open. Just download the My Health Toolkit mobile app on your PC or cell phone, sign in or create an account. You will need your subscriber ID# to register. You can consult with a healthcare provider via video or phone calls.  Use the urgent care option when the clinic is closed to treat minor illnesses or injuries mentioned above to include: cold and flu symptoms, fever, coughing, sore throat and mild nausea, bronchitis and other respiratory infections, seasonal allergies, pinkeye, migraines, rashes, insect bites, sunburn and other skin irritations.

 Behavioral Health and Dermatology - $25 Copay

Walk in clinic for non-life threating medical issues that require attention after hours or before you can get in to see the clinic or your primary care provider.  Non-emergency issues requiring immediate attention  Treatment for minor injuries and illnesses  Offer extended hours including evenings and weekends  No appointment necessary  X-rays  Lab tests IN-PERSON URGENT CARE - $35 COPAY 3 4 Serious and life-threatening situations warrant a visit to the ER which provides 24/7 care in critical situations with specialized personnel on staff. Call 911 or get to the nearest ER if you believe you are in a potentially life threating condition. If you are experiencing any of the following symptoms, seek emergency care:  Chest pain or pressure  Numbness in face, arm, or leg  Loss of speech or vision  Severe pain anywhere on the body  Coughing or vomiting blood  Severe allergic reactions  Loss of consciousness or sudden dizziness  Major injuries such as head trauma, heavy bleeding or deep cuts, any broken bones breaking through the skin  High fever with a stiff neck, severe burns, and any other condition you believe is life-threating EMERGENCY ROOM - $150 COPAY

CONMB Employee Benefit Guide 2025

PRESCRIPTION BENEFITS Included in the City’s medical coverage / premium

Prescription Drug Benefits Mandatory Generic – you will pay more for non-generic drugs

Retail Up to 31-Day

Mail Order 90-Day

Generic Preferred Non-Preferred Brand Drugs

$10 $35 $45

$20 $70 $90

Specialty Drugs

$70

N/A

One retail copay per 31- day supply when purchased at a retail pharmacy up to 90-day supply. Some drugs require prior authorization, step therapy and/or quantity management. Specialty medications are not available through mail order and must be filled by Sav-Rx Specialty Pharmacy. Specialty medications are typically very high cost and require special handling, patient care and training, frequent dosing adjustments or other special clinical review.. Benefit Year January 1 st through December 31 st

 To sign up, use your Sav-Rx card information or any active Rx number (for Sav-Rx Mail Order utilizers).  Once you are logged in, you can use the dashboard to access a range of enhanced features.

How to make a quick refill:  Go to www.savrx.com  Click on Mail Order Quick Refill and fill out the form  Click Refill Prescription

Use the dashboard to access:

My Account:  Edit all account information  View Sav-Rx ID card  Download or print a soft card  Add a payment method for mail order Claim History:  Search claims by date range  Download claim history as a .pdf file

Sav-Rx Mail Order:  See prescriptions in progress  Find tracking information  Request refills

Drug Price Lookup:  Compare prices at area retail pharmacies  Information based on your benefits  Sort by lowest out-of-pocket cost

The City of North Myrtle Beach’s Employee Health Center (EHC) carries on-site medications at no cost to enrolled employees and dependents. How to save on Specialty Medications  Contact Sav-Rx Anytime: 24/7/365 Availability You, your prescriber, or pharmacy can contact Sav-Rx at 800-228-3108, and we’ll do the rest!  Sav-Rx helps you enroll in a Patient Assistance Program (PAP) Sav-Rx can help you receive your medication for free if you qualify for an available program. If approved, your medication will come directly from the manufacturer.  Sav-Rx helps you receive significant savings Even if there is no patient assistance program available. Sav-Rx will apply all applicable coupons and discounts so that you and the Plan still receive significant savings!  Your medication is shipped directly to you Your medication is delivered directly to you or your prescriber!  Easily track medications You can track your medications on our website, through our mobile app, or by calling customer service! Specialty medications are typically very high cost and require special handling, patient care and training, frequent dosing adjustments, or other special clinical review.

CONMB Employee Benefit Guide 2025

WELLNESS INCENTIVE PLAN (WIP) HEALTH REIMBURSEMENT ACCOUNT (HRA)

The City of North Myrtle Beach maintains a Wellness Incentive Plan to help reduce health risk among employees and promote a healthy workplace. As a member on the City of North Myrtle Beach’s plan, participating in the Wellness Incentive Plan provides you the benefit of:  Saving money on insurance premiums Saves You Money

 Affordable Health Insurance  Discounts on Health Insurance  Wellness Incentive Plan with Incentive Payouts into an HRA

 Earning up to $505 in HRA funds  Learning more about your health  Helping to keep City health insurance premiums low

In order to receive the premium discount and HRA funds for participating in the Wellness Program, you and your spouse (if he/she is on the city’s insurance) need to complete ALL three (3) of the Wellness Incentive Plan steps.  Step 1 : Complete the Health Risk Questionnaire  Step 2 : Complete the Biometric Screening

Support Your Needs

 Step 3 : Attend a Wellness Consultation appointment  Optional Step 4 : Reasonable Alternative Standards (RAS) HRA monies roll-over each year. Employees will receive a separate Beach Healthy Wellness Incentive Plan brochure upon date of hire and annually at the start of each WIP program year, October 1 st .

 On-Site Health Care  Yearly Wellness Screenings  Aquatic & Fitness Center Discount  Wellness Program  Employee Assistance Program  Paid Time Off

HEALTH CARE FSA  A Healthcare FSA is a benefit program that allows you to use pre-tax dollars to pay for eligible health care expenses, such as: FLEXIBLE SPENDING ACCOUNT (FSA) – Open enrollment held in November

 Prescription copayments and deductibles  Out-of-pocket, non-cosmetic dental fees  Doctor and emergency room copayments  Laser eye surgery, eyeglasses and contacts

 Medical supplies and prescribed OTC medications  Orthodontics  Hearing expenses  Prescribed over-the-counter items

 Estimate your extra medical expenses for the upcoming year so that the right amount is deducted from your paycheck. An FSA is a use-it-or-lose-it account. You will only be able to roll-over $660 of your unused dollars from 2025 into 2026.  You may only change your payroll election amount if you experience a major life change, such as marriage, divorce, birth, adoption, change in spouse’s employment status, etc. DEPENDENT CARE FSA (DCFSA) Per IRS regulations, the following, while not intended to be complete, illustrates examples of eligible dependent care expenses. Expenses must be incurred during the Plan Year from which you are requesting reimbursement. Expenses are considered incurred when service is rendered, not when service is billed, or payment is made. Expenses cannot be reimbursed in advance of the date service is rendered. **Children under age 13 and your spouse or adult dependent (may include parent or relative) who is physically or mentally incapable of self-care and lived with you for more than half the year. NOTE: Regardless of the amount of your claim, you will only be reimbursed up to the amount in your account at the time the claim was submitted. Therefore, you may need to continue to pay your provider prior to submitting a claim for reimbursement. Examples of Eligible Benefits: Adult Day Care, After School Programs, Preschool, Summer Day Camps (Not Overnight)

2025 FSA Maximum Contributions

Medical: $3,300 Dependent Care: $5,000

SCAN HERE

CONMB Employee Benefit Guide 2025

HRA / FSA RESOURCES

The Flores Benefits Card is designed to work at merchants with a healthcare merchant category code, such as doctor’s offices and hospitals. Your Flores card will also work at retail pharmacies for items such as prescriptions and FSA-eligible over-the-counter items. Access funds when you need them to pay providers for eligible services with the Flores Benefits Card. How do I obtain my account details? Website Visit www.flores247.com and log-in using your Participant ID or Username and password. Or Scan the mobile app QR code PID & Password Assistance – Dial 800.840.7684 Mobile App

SCAN HERE

Ways to Submit Claims

Upload Claims

Smartphone App

www.flores247.com You may scan your claim and upload it to our secure website.

Use your phone’s camera to take a picture of your documentation and upload.

Mail Claims

Fax Claims

Claims Processing PO Box 31397 Charlotte, NC 28231 Please keep in mind, certified mail will need to be sent to our physical address. Flores & Associates 2013 W Morehead St Suite B Charlotte, NC 28208

704.335.0818 Or 800.726.9982

How to upload a claim on www.flores247.com

To get started, click Upload Data on the home page. Step One : Select Claim Type in the Select Document Type dropdown menu. Click Next .

Step Two : If you have already completed a hard copy claim form and scanned it as a PDF or TIF into your computer for this submission, click Already Completed . If you have not already completed and scanned a hard copy claim form, then complete the table with your claim detail and click Next . Step Three : Click Choose File , select the file from your computer that you wish to upload and repeat until all documents are attached. Click Submit to finalize your claim.

CONMB Employee Benefit Guide 2025

DENTAL BENEFITS

Benefit Summary

In-Network

Calendar Year Deductible Waived for Preventive

$50 Individual $150 Per Family

Annual Maximum

$1,750

Preventive Care  Bitewing X-Rays - as required  Emergency Palliative Treatment  Full-Mouth X-Rays - once in any 24-months  Oral Examinations & Cleanings - twice in any benefit period  Sealants - under age 19, once in 5 years  Space Maintainers - under age 19  Topical Fluoride - under age 19, twice in any benefit period

100%

Basic Care  Fillings  Endodontics / Periodontics  General Anesthesia  Simple / Surgical Extractions  Stainless Steel Crowns

80%

Major Care  Bridges – once every 7 years  Crowns, Inlays, Onlays – once every 7 years

50%

 Dentures – once every 5 years  Implants – once every 5 years Orthodontia – All Participants Lifetime Maximum

50% $1,750

24/7 online access to benefits and service - Register today! Visit www.DeltaDentalSC.com/Members/Register to receive electronic delivery of your benefit information. Once registered, log in to your account online or with the Delta Dental Mobile App.  Order or print an ID card  View your Explanation of Benefits (EOB)  Get answers to frequently asked questions  Review and print your dental plan’s coverage levels, deductibles, maximums, age limits and limitations  Verify your eligibility  Request or download a claim form

Delta Dental Mobile App Use the mobile app to access:  Your Mobile ID card  Coverage and claims information  Find a dentist  Dental Care cost estimator

Scan To Download Delta Dental Mobile

See page 30 for employee premiums

CONMB Employee Benefit Guide 2025

DENTAL RESOURCES

About Delta Dental Networks: Delta Dental has two networks that subscribers may utilize.

 Delta Dental Premier Network: This is the largest network which provides great discounts and savings  Delta Dental PPO Network: This network has a higher rate of savings than the Premier network. Note: Subscribers will not be balance billed if they go to either of these networks. We encourage employees to look for a PPO network dentist first, and then a Premier dentist since the PPO is the most cost efficient. Members still receive great discounts and savings in the Premier Network if they are unable to find a PPO network dentist they prefer. Out-of-Network Providers: are not contracted with Delta Dental and therefore may balance bill the difference between Delta Dental's out-of-network payment and billed .

Log In To View Your Benefits: Visit www.DeltaDentalSC.com, and click on one of the Member or Sign In links. To register, follow the steps under Member Sign In .

Find A Delta Dental Participating Dentist: Visit www.DeltaDentalSC.com, and click on Find a Provider

Call Or Email Customer Service: We are here to help every Mon – Fri - 7 am to 5 pm CT 800-335-8266 Service@DeltaDentalSC.com

Example Savings for a Common Procedure

Maximum Allowed Fees

Percentage Paid By Your Plan

Amount Your Plan Pays

Amount Dentist Can Balance Bill

Total Amount You Pay

Your Total Cost Savings

Estimated Charge

Delta Dental PPO

$1,200

$750

50%

$375

$450

Delta Dental Premier

$1,200

$975

50%

$487.50

$225

Out-of-Network

$1,200

$750

50%

$375

$450

$825

CONMB Employee Benefit Guide 2025

VISION BENEFITS Included in the City’s medical coverage / premium

Benefit Summary

In-Network

Frequency

Once per calendar year

Exam Copay

$10

Retinal Screening Copay

$39

Materials Copay

$25

Eyewear

$225 allowance plus 20% discount on glasses / 10% discount on contacts for amount over allowance

Contact Lense Fitting Fee Copay

$10

Don’t Need Prescription Glasses? Non-prescription eyewear, including blue-light blocking glasses, sunglasses , safety glasses, and readers are covered by your CEC vision plan. This is a great way to use your annual eyewear allowance. How to Use Your Vision Benefits  Register and log in to the Member Portal at www.cecvision.com/members/login . You will need your Member ID number to register. If your ID number is not readily available and you need assistance, please contact us at 888-254-4290.  Review your vision benefit information.  Find an in-network provider near you and schedule your appointment.

Find an in-network provider by visiting www.cecvision.com/search . You will find eye doctors and retail chains that you can contact directly for an appointment. Bring your member ID card and any current eyewear prescriptions. If you have any questions, please contact Customer Service at 888-254-4290 . Our operating hours are Monday - Friday, 8:00 am - 6:00 pm ET and Saturday, 10:00 am - 3:00 pm ET.

Locating a Provider

What to Bring

Questions?

ADDITIONAL SAVINGS

Members receive a 20% savings on additional pairs of prescription and non-prescription glasses from most CEC in- network providers within 12 months of their last eye exam. Members are eligible for discounts from participating providers. including QualSight LASIK, TLC Laser Eye Center, LasikPlus, and the LASIK Vision Institute. A variety of special offers are available to CEC members. Visit www.cecvision.com/members/specialoffers for additional information.

Additional Pairs of Glasses

LASIK Discounts

Special Offers

Access the Patient Portal by scanning the QR Code

CONMB Employee Benefit Guide 2025

BENEFIT CARDS

Below is a summary of your benefit cards and when each one is to be used. If you are missing any of the benefit cards shown below, contact Human Resources to order a replacement or log on to the benefit portal for easy access.

What is this card used for?

BlueCross BlueShield Card  Doctor’s office visits  Hospital visits  Medical procedures and tests  Durable medical equipment (some diabetic supplies)

Sav-Rx Prescription Drug Card  Mail order prescriptions  Prescriptions picked up at a pharmacy

Delta Dental Card  Dental Services

Community Eye Care Card  Routine eye exams  Glasses and contact lenses

Flores Card  Used to access HRA funds earned in the Wellness Program and any available medical FSA funds  Can be used to pay for any approved medical expenses for example, office visit copay, prescriptions, glasses or contacts, over the counter medications, etc.

CONMB Employee Benefit Guide 2025

EMPLOYEE ASSISTANCE PROGRAM

Your Assistance Program can help you reduce stress, improve mental health, and make life easier by connecting you to the right information, resources, and referrals. All services are free, confidential, and available to you and your family members. This includes access to short-term counseling and the wide range of services listed below:  Mental Health Sessions Manage stress, anxiety, and depression, resolve conflict, improve relationships and address any personal issues. Choose from in-person sessions, video counseling, or telephonic counseling.  Life Coaching Reach personal and professional goals, manage life transitions, overcome obstacles, strengthen relationships, and achieve greater balance.  Financial Consultation Build financial wellness related to budgeting, buying a home, paying off debt, resolving general tax questions, preventing identity theft and saving for retirement or tuition.  Legal Referrals Receive referrals for personal legal matters including estate planning, wills, real estate, bankruptcy, divorce, custody, and more.  Work-Life Resources and Referrals Obtain information and referrals when seeking childcare, adoption, special needs support, eldercare, housing, transportation, education, and pet care.  Personal Assistant Save time with referrals for travel and entertainment, seeking professional services, cleaning services, home food delivery, and managing everyday tasks.  Medical Advocacy Get help navigating insurance, obtaining doctor referrals, securing medical equipment, and planning for transitional care and discharge.  Member Portal Access your benefits 24/7/365 through your member portal with online requests and chat options. Explore thousands of self-help tools and resources including articles, assessments, podcasts, and resource locators.

Specific offerings may vary depending on your organization's assistance program plan design.

Your Assistance Program offers a wide range of benefits to help improve mental health, reduce stress and make life easier— all easily accessible through your member portal.

Getting Started Is Easy 1. Visit www.allonehealtheap.com and click on Sign Up below the login form 2. Enter your email address and the company code LS0367 provided by your organization to create an account and sign in 3. For login assistance, select Email Support * You can always call to access services, without needing to create an account or log in to the portal. Call 800.822.4847.  Request a Mental Health Session Request counseling by submitting an online form or live chat. Choose from in-person or virtual counseling options to meet your needs.  Request Referrals & Resources Submit a request for family care and lifestyle support including childcare and eldercare referrals, legal referrals and financial consultation, personal assistant referrals and medical advocacy consultation.  Explore Thousands of Self-Care Articles & Resources Health and lifestyle assessments, interactive checklists, soft skills courses, podcasts, resource locators, exclusive discounts, and expansive articles on whole health and well-being.  Visit Your Online Financial Center Featuring worksheets, calculators, and a wide range of financial resources and tools to help reach personal goals and build financial wellness.

CONMB Employee Benefit Guide 2025

LIFE / DISABILITY

Basic Life / AD&D – 100% Employer Paid

All full-time eligible employees receive a $10,000 basic life and accidental death and dismemberment (AD&D) policy.

Benefit reduces to 50% at age 70 .

Mandatory Voluntary Term Life / AD&D – General Employees Only

Employee

Spouse

Child

Increments of $10,000 to a maximum of $175,000 not to exceed one (1) times your annual base salary

$10,000

$5,000

AD&D is for employees only. Benefit reduces to 50% at age 70. Spouse benefit terminates at age 95.

  

 Coverage amounts and rates calculated at start of employment and adjusted as salary increases.

VOLUNTARY LIFE – Optional for General and PEBA Employees

Employee

Spouse

Child

Benefit

$10,000 increments to a maximum of $200,000 not to exceed five (5) times annual base salary

$20,000 | $25,000 | $30,000 $40,000 | $50,000

$10,000

Guaranteed Issue Amount* $10,000 * Guaranteed issue amounts for new employees without completing a medical questionnaire. If you select a benefit amount over the guaranteed issue amount listed above or if you enroll in voluntary life insurance after your new hire eligibility window has closed, you must complete a medical questionnaire. Your enrollment will pend underwriting approval.  Benefit reduces to 50% at age 70, 25% at age 75.  Spouse premium is based on employee’s age.  Spouse benefit terminates at age 70. $200,000 $50,000 See page 30 for employee premiums

Long –Term Disability – 100% Employer Paid – General Employees Only

Benefit

66.67% of your monthly pre-disability earnings

Maximum Monthly Benefit

$7,500

Benefits Begin

91 st Day

Benefit Duration

Greater of Social Security Normal Retirement Age or see chart below *

Pre-Existing Limitations

3-month look back / 12-month exclusion Mental Illness: Two (2) Years Drug/Alcohol Abuse: Two (2) Years

• • • • • • • • • • •

Less than age 60

To age 65 5 Years 4 Years 3.5 Years 3 Years 2.5 Years 2 Years 21 months 18 months 15 months 12 months

60 61 62 63 64 65 66 67 68

69+

 Public Safety employees have life insurance and long-term disability insurance through their membership in the S.C. Retirement System.

CONMB Employee Benefit Guide 2025

SUPPLEMENTAL BENEFITS

Group Accident Insurance

Nobody expects an accident to happen. But if it does, your main focus should be on recovery, not how you’re going to pay your bills. Colonial Life accident insurance provides benefits directly to you to use however you like – from medical costs to everyday expenses. Whether it's a fall or a car accident, your benefits offer support when you need it.  Wellness Benefit: Pays $50 for you and your covered dependents for a wellness screening. These include but no limited to blood test for triglycerides, bone marrow testing, breast ultrasound, CA 15-3 (blood test for breast cancer), CA 125 (blood test for ovarian cancer), carotid doppler, CEA (blood test for colon cancer), chest x-ray, colonoscopy, ECHO, EKG, ECG, fasting blood glucose test, flexible sigmoidoscopy, hemoccult stool analysis, mammography, pap smear, PSA (blood test for prostate cancer), serum cholesterol test for HDL and LDL levels, serum protein electrophoresis (blood test for myeloma), skin cancer biopsy, stress test on bicycle or treadmill, thermography, thin prep pap test, virtual colonoscopy. Below is a list of examples of covered illnesses and conditions. For a complete listing, please see your Colonial benefits summary for details.

Benefit

Amount

Accident emergency treatment - One visit per covered person per covered accident and up to four (4) visits per covered person per calendar year Accident follow-up doctor visit - Up to four (4) visits per covered person per covered accident and up to sixteen (16) visits per covered person per calendar year  Accidental dismemberment  One hand, arm, foot, leg or sight of an eye  Both hands, arms, feet, legs or sight of both eyes  One finger or one toe  Two or more fingers, two or more toes Air Ambulance - Transportation to or from a hospital or medical facility Ground Ambulance - Transportation to or from a hospital or medical facility Appliance aid in personal locomotion of mobility - Walking boot, neck brace, back brace, leg brace, cane, crutches, walker and wheelchair Blood / Plasma / Platelets - Required during treatment of a covered accident Burn  2 nd Degree burns - covering at least 36% of the body’s surface  3 rd Degree burns (based on size)

$150

$50

 $9,000  $18,000  $1,050  $2,100

$1,500

$300

$100

$400

 $1,000

 $2,000 - $15,000

Burn Skin Graft - As a result of 2 nd or 3 rd degree burns

50% of applicable burn benefits

Coma - L asting for 14 or more consecutive days

$10,000

Concussion

$375

Emergency dental work  Dental crown or denture  Dental extraction

 $300  $100

CONMB Employee Benefit Guide 2025

SUPPLEMENTAL BENEFITS

Group Accident Insurance - Continued

Eye injury - With surgical repair or removal of a foreign object

$300

Hospital admission - Per covered person per covered accident

$1,000

Hospital confinement - Up to 365 days per covered person per covered accident

$250 per day

Hospital Intensive care unit admission - Per covered person per accident

$1,750

Hospital Intensive care unit confinement - Up to 15 days per covered person per covered accident

$400 per day

Knee cartilage – Torn

$750

Laceration - No repair, without stitches

$50

Laceration - Repaired by stitches  Less than 2 inches  2 – 5 inches  6 inches or longer

 $150  $300  $600

Lodging - Up to 30 days per covered person per accident

$200 per day

Medical Imaging (CT, CAT, EEG, MRI, MR) - One benefit per covered person per covered accident per calendar year

$200

Occupational or physical therapy - Up to 10 days per covered person per covered accident

$45 per day

Pain management for epidural anesthesia

$150

Prosthetic device / artificial limb - One benefit per covered person per accident  One  Two or more Rehabilitation unit confinement - Immediately after a period of hospital confinement due to a covered accident; up to 15 days per covered person per accident, not to exceed 30 days per covered person per calendar year

 $1,250  $2,500

$150 per day

Ruptured disc with surgical repair

$900

Surgery  Cranial, open abdominal and thoracic  Hernia with surgical repair

 $1,500  $300

Surgery - Exploratory and arthroscopic

$225

Tendon/ligament/rotator cuff One with surgical repair Two or more with surgical repair

 $900  $1,800

Transportation for hospital confinement - Up to 3 round trips from more than 50 miles from home per covered person per covered accident

$600 per round trip

X-ray

$60

Accidental Death

Employee Spouse Child(ren)

Per Covered Person

$50,000

$50,000 $10,000

Catastrophic Accident

Employee Spouse Child(ren)

Total and irrecoverable loss or loss of use of both hands, arms, feet, legs or the sight of both eyes, loss of hearing in both ears or loss of ability to speak  Subject to a 365-day elimination period; payable once per lifetime per covered person

$50,000

$50,000 $25,000

CONMB Employee Benefit Guide 2025

SUPPLEMENTAL BENEFITS

Group Accident Insurance - Continued

Dislocation

Non-Surgical

Surgical

Hip

$3,000

$6,000

Knee (except patella)

$1,500

$3,000

Ankle, bone or bones of the foot (other than toes)

$1,200

$2,400

Collarbone (sternoclavicular)

$800

$1,600

Collarbone (acromioclavicular or separation)

$200

$400

Lower jaw

$720

$1,440

Shoulder (glenohumeral)

$1,200

$2,400

Elbow

$450

$900

Wrist

$600

$1,200

Bone(s) of the hand (other than fingers)

$810

$1,620

Finger, toe

$200

$400

Incomplete dislocation or dislocation reductions without anesthesia

25% of the applicable non-surgical amount

Fracture

Non-Surgical

Surgical

Skull, depressed fracture (except face/nose)

$3,750

$7,500

Skull, simple non-depressed facture (except face/nose)

$1,800

$3,600

Hip, thigh (femur)

$3,150

$6,300

Body of vertebrae (excluding vertebral processes)

$2,700

$5,400

Pelvis

$2,400

$4,800

Leg (tibia and/or fibula)

$1,800

$3,600

Bones of the face or nose (except mandible or maxilla)

$910

$1,820

Upper jaw, maxilla, upper arm between elbow and shoulder

$1,050

$2,100

Lower jaw, mandible

$1,200

$2,400

Kneecap, ankle, foot

$1,200

$2,400

Shoulder blade, collarbone

$1,200

$2,400

Vertebral processes

$630

$1,260

Forearm, hand, wrist

$1,200

$2,400

Rib

$375

$750

Coccyx

$320

$640

Finger, toe

$200

$400

Chip fracture

25% of the applicable non-surgical amount

CONMB Employee Benefit Guide 2025

SUPPLEMENTAL BENEFITS

Group Accident Insurance - Continued

Example Alex was cleaning out the gutters when he fell.

Emergency Room Visit

Alex was taken by ambulance to the nearest emergency room and received immediate care.

Diagnostic Procedure

The doctor ordered an x-ray and discovered Alex had fractured his leg.

Hospital Confinement

Alex was admitted to the hospital for surgery on his leg. He was confined for three (3) days.

Appliance For Mobility

Alex used crutches.

Physical Therapy

Alex had eight (8) sessions of physical therapy to help him regain the strength in his leg.

Doctor’s Office Visit

Over the next several weeks, he had three (3) follow-up appointments with this doctor.

Alex’s Benefits

Ambulance

$300

Emergency Room

$150

X-ray

$60

Hospital Admission

$1,000

Hospital Confinement

$750

Leg Fracture (surgical)

$3,600

Physical Therapy

$360

Appliance (crutches)

$100

Doctor’s Follow-Up Visit

$150

Total

$6,470

Alex’s Out-of-Pocket Expenses

When Alex totaled up his bills, he had to pay his annual deductible, as well as co-payments for the ambulance, emergency room, hospital, surgery, physical therapy and follow-up visits. Luckily, Alex had accident coverage to help with these expenses.

See page 30 for employee premiums

CONMB Employee Benefit Guide 2025

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