2023 Benefits Enrollment Guide_PMI_FINAL Flipbook PDF

2023 Benefits Enrollment Guide_PMI_FINAL

47 downloads 103 Views

Recommend Stories


Your Summary of Benefits Planes Hospital BeneFits
Your Summary of Benefits Planes Hospital BeneFits Plan Hospital BeneFits para grupos pequeños Vigente desde 10/2011 Nota: Este plan rige únicamente pa

Employee Enrollment Form
(DO NOT STAPLE)/(NO ENGRAPAR) Formulario de Inscripción del Empleado/ Employee Enrollment Form Para agilizar el proceso de inscripción, sea cuidadoso

Global Employee Benefits Network
Global Employee Benefits Network Albania Tirana Argentina Buenos Aires Armenia Yerevan Australia Sydney, Brisbane, Melbourne Austria Vienna

Unemployment Insurance Benefits Information
--TEXAS WORKFORCE SOLUTIONS Unemployment Insurance Benefits Information It is your responsibility to read and follow this booklet and all instruction

Story Transcript

2023 Benefits Enrollment Guide

Table Of Contents 03 Open Enrollment Overview

34 Long Term Disability Benefits

04 Who is Eligible?

35 Accident Benefits

05 How to Enroll/Upload Documents/ Make Mid-Year Changes

36 Hospital Confinement Benefits

11 Frequently Asked Questions 12 Terms You Need to Know 13 Medical Benefits 17 Prescription Drug Benefits 20 Where to go for Care 21 Virtual Doctor Visits with MDLive 23 BCBSTX Member Resources 26 Dental Benefits 27 Vision Benefits 28 Health Savings Account (HSA) 30 Flexible Spending Accounts (FSA) 32 Life and Accidental Death Benefits 33 Short Term Disability Benefits

37 Critical Illness Benefits 38 Health Screening Benefit 39 Universal Life Benefits 41 Employee Assistance Program (EAP) 43 Guidance Resources 44 Beneficiary Advocate 45 Travel Assistance 46 Discounted Home and Auto Insurance 47 Watch and Learn Video Library 48 Benefit Premiums 51 Notices 53 Benefit Vendor Directory

Welcome to Your 2023 Benefits Open Enrollment

The Annual Open Enrollment period for 2023 begins Wednesday, November 30. All Open Enrollment elections for 2023 MEDICAL must be completed no later than 5:00 pm CST on Wednesday, December 14, 2022. This year’s open enrollment will continue to offer afrom comprehensive medical period is active which means you are required to make a planWe selection. Your elections 2022 will not plan administered by BlueCross BlueShield of Texas. automatically roll over into 2023. Learn more on Benefit plan If no action taken If you do not make a plan selection, you will be defaulted to waive Medical, Dental, Vision, FSA/HSA, Accident, coverage. Your next opportunity to enroll in these plans will be January Critical Illness, Hospital Indemnity of 2024. If you do not make a plan election for 2023 you will be defaulted to DENTAL waive coverage. Your next opportunity to enroll in these plans will be To encourage proper preventive and diagnostic Voluntary Life/AD&D, Universal Life January of 2024. If you choose to enroll for the 2024 plan year, you may care, we will continue to offer two dental plans to be required to submit evidence of insurability for any elected amount give you more choice and savings. Learn more on and your election could be denied. Basic Life/AD&D, Short Term Disability, These benefits are provided to you at no cost by Quantic Electronics. Long Term Disability, Employee Assistance You will automatically be defaulted into these benefits for 2023. Program (EAP) You have two options to complete your enrollment:  Schedule a telephonic enrollment with our benefitVISION counselors at AGM who will guide you through the enrollment process (see page 5). Eye care is a vital component of a healthy lifestyle.  Access the self-service benefits portal, bswift® at quantic.bswift.com (seehaving page 6). With vision insurance, regular exams and purchasing contacts or glasses is simple and Additional information regarding the benefits offered in this guide can be found online in the bswift® benefits portal. affordable. Here, you can access important content, including benefits and planmore information, a documents library, and more. Learn on The decisions you make during the Annual Open Enrollment period will affect your healthcare, financial security and take-home pay. You are encouraged to take time to read about your options in this guide, so that you can make informed choices when choosing your benefits. Then, make the most of your benefits to improve your health, your financial wellbeing and your peace of mind. NEW FOR 2023: • Four (4) medical plan options are being introduced and will be insured by BlueCross BlueShield of Texas. • Two (2) dental plans are being introduced and will be administered by Delta Dental of Texas. • A new vision plan insured by VSP is being introduced. • The Company is providing Term Life and AD&D benefits, Short Term Disability Benefits and Long Term Disability DISABILITY BENEFITS benefits at no cost to employees and will be insured by Prudential. Health insurance may cover most medical bills, • Accident benefits, Critical Illness benefits and Hospital Confinement be as offered onmortgage, a voluntary daily livingbenefits expenseswill such rent or carbasis and are designed to supplement the medical plan offerings. These benefits will be insured by Prudential. payments, and utilities continue. Short-term • A confidential Employee Assistance Program (EAP) is beingdisability providedinsurance to all employees no cost. providesatpartial income • Employees will have the opportunity to purchase homeowners insurance and auto insurance at replacement if you are unable to workpreferred due to a group pricing through a partnership with Liberty Mutual. qualifying illness or injury. Learn more on

3

Who is Eligible? Employees • Fulltime, actively working a minimum of 30 hours per week • Newly hired employees are eligible to enroll in benefits on the first day of day of the month following date of hire

This guide is not a contract. It is intended to help you compare the various Company benefit plans and is not intended to be a complete disclosure of the plan qualifications and limitations. The contract must be consulted to determine the exact terms and conditions of coverage. Information provided in this guide may be updated periodically to provide the clearest and most accurate information. If updates occur, the updated version will be available in the self- service portal. Click here to access bswift®.

Spouse • Legally married spouse • Common law marriages will be recognized upon receipt of a completed Common Law Certification. • The attestation form for Common Law Marriage can be found on the homepage, or in bswift® under the Library tab. Domestic Partner • Your domestic partner is the person with whom you are in a committed relationship that is substantially similar to a marriage. Domestic partnerships will be recognized upon receipt of a declaration/certificate of domestic partnership. • The attestation form for Common Law Marriage can be found on the homepage, or in bswift® under the Library tab.  IMPORTANT: Your contributions to cover a domestic partner are the same as those to cover a legal spouse. However, because of Internal Revenue Code (IRC) restrictions, the fair market value of your DP and/or DP’s children’s (if they are not federal tax dependents) healthcare coverage will be taxable to you as imputed income. Imputed income is determined by the amount that the Company pays in premium for DP coverage and is subject to federal, state, and Social Security taxes. This amount raises your taxable gross income. Also, the payroll deductions to cover a DP must be taken on an after-tax basis. (Imputed income is the value of any benefits or services provided to an employee.) Dependent Child(ren) • Your natural child, stepchild, adopted child or your domestic partner’s natural child or adopted child under 26 years of age, regardless of presence or absence of a child's financial dependency, residency, student status, employment status, marital status, eligibility for other coverage, or any combination of those factors. • A child not listed above who is legally and financially dependent upon you or your spouse is also considered a dependent child, provided proof of dependency is provided with the child’s application. • A dependent child who is medically certified as disabled and dependent upon you or your spouse is also considered a dependent child. Dependent Disability Certification may be required.

4

How to Enroll

AGM Benefit Solutions | bswift®

2023 OPEN ENROLLMENT | 2023 INSCRIPCION ABIERTA NOVEMBER ( NOVIEMBRE) 30 - DECEMBER ( DICIEMBRE) 14 , 2022

2023 OPEN ENROLLMENT | 2023 INSCRIPCION ABIERTA

• Open Enrollment will take place Wednesday, November 30 - Wednesday, December 14, 2022. • You will have the opportunity to enroll or make changes to your benefits by phone with a benefits counselor. • Any changes or elections will go into effect January 1, 2023. • La inscripción abierta se llevara a cabo desde el miercoles 30 de noviembre hasta el miercoles 14 de diciembre de 2022. • Tendra la oportunidad de inscribirse o realizar cambios en su beneficios por telefono con un asesor de benefios. • Cualquier cambio o eleccion entrara en vigencia el 1 de enero 2023.

HOW TO ENROLL | COMO INSCRIBIRSE

• This year, you will have the opportunity to complete your enrollment by phone with a benefits counselor. You can book your appointment at https://a.flexbooker.com/reserve/Quantic • Este ano tendrá la oportunidad de completar su inscripción por teléfono con un consejero de beneficios. Puedes reservar tu cita en https://a.flexbooker.com/reserve/Quantic

SCAN HERE TO SCHEDULE YOUR APPOINTMENT! ESCANEA AQUI PARA AGENDAR TU CITA! Questions? PREGUNTAS? (844) 880-6774 M - F (LUNES A VIERNES) 8:30 AM - 5 PM CST

5

How to Enroll Powered by bswift®

1) Login to bswift® by visiting http://www.quantic.bswift.com • First Time Users: click on “Register Now”. You will need to verify employment by entering your SSN, First and Last Name, and date of birth. Then you will be able to create a username and password.

2) Review your employee information for accuracy (name, SSN, address, etc.) a) If you need to update any information, please visit Paylocity by clicking here. The changes will then be updated in bswift®. Note, changes are not immediately reflected in bswift®. b) You can return to bswift® to complete your enrollment c) Click “I agree” at the bottom to continue 3) Review your family information for accuracy (name, date of birth, SSN, etc.). This is your opportunity to add new dependents or remove dependents. Click “I agree” at the bottom to continue. 4) When walking through your benefits, you can either select “I don’t want this benefit (waive)” to waive the plan, or “View Plan Options” to view more information about the plans being offered to you. Benefits that are 100% paid by your employer will be already selected for you without the option to waive.

If you select “I don’t want this benefit (waive)”, simply move onto the next benefit to elect or waive. If you select “View Plan Options”, you will be prompted to choose any dependent(s) that you will be covering for the specified benefit by selecting the checkbox next to their name. Once you have selected your dependent(s), click “Continue”. The available plan(s) that are offered to you will appear. If there are multiple plans available to choose from, you will have the option to select “View All Plans Side-by-Side”. To enroll in a plan, click “Select”. 6

How to Enroll Powered by bswift®

5) After selecting a plan, you will return to the main enrollment screen. Your total cost per pay period will be visible on the right side of the screen. 6) Once you have completed your benefit selection for all available plan types, click “Continue” at the bottom right of the page. You can click “Save and Finish Later” at any time if you are not ready to complete your benefits enrollment. You can return and make changes to your benefit selection at any time through the open enrollment period. 7) Next, you will be prompted to choose your Beneficiaries for applicable plan types. Your dependents will automatically appear on this page, however, you can also add a beneficiary that is not a dependent by clicking “Add New Beneficiary”. Once you have designated your beneficiaries, click “Continue” at the bottom right of the page. 8) From the Confirmation Page, review your benefit selections and click the “I Agree” button at the bottom of the page. You will then click “Complete Enrollment” at the right of the page. 9) Once you’ve completed your enrollment, you will have the option to View, Email, or Print a copy of your Confirmation Statement. You can also view your Confirmation Statement at any time by logging into the bswift® system and navigating to My Benefits > Current Benefits.

7

How to Upload Documents Powered by bswift®

REMINDER - you can now complete all changes needed for Life Events (i.e. birth/adoption of a baby, marriage, divorce, changes to your HSA contributions, etc.) in bswift®, our online benefits portal. You have 30 days from the date of the Life Event to request a change to your coverage. Benefit changes made as a result of a family status change must be consistent with the event. Failure to upload the required documentation as proof of the life event will result in the denial of your dependent’s benefit enrollment. Acceptable forms of documentation include: Spouse - Marriage certificate or prior year's tax return showing married status and both names Children - Child’s birth certificate showing names of parents Domestic Partner/Common Law Spouse - The attestation forms for Domestic Partnership and Common Law Marriage can be found on the homepage, or in the Library tab. How To Get Started 1. On the bswift® home page, you will see a panel titled “Life Events”. Click on the Life Event you are experiencing (from the common ones listed) or click on “All other Life Events”. 2. On the next page, select the Life Event if needed, enter the effective date, and add a new dependent (if applicable). 3. Follow the steps to make your Life Event Enrollment changes, including coverage, dependents, and beneficiaries.

4. To upload documents, click on “Employee File” under the My Profile menu and then select “View and Upload Documents” next to the appropriate dependent.

8

How to Upload Documents Powered by bswift®

5. Enter a title and description of the document being uploaded, and then select “Choose File” to browse for the document to be uploaded. 6. When finished, select “Save”. Human Resources will then review the submitted documents. The status of the document upload will then be visible and pended until approved or declined.

9

Mid-Year Election Changes | Life Events Powered by bswift®

Mid-Year Changes to Your Coverage: You have 30 days from the date of a qualifying life event to request a change to your coverage. Benefit changes made as a result of a family status change must be consistent with the event. Proof of family status change is required under the benefit plan. Family status changes include: • marriage or divorce • gain/loss of a dependent for reasons such as birth, adoption, court order, disability, or death • a dependent ceases to satisfy the eligibility age limitation of age 26 • changes in your dependent’s employment or benefits coverage that affect benefit eligibility • change in cost of dependent care or provider (Dependent Care Flexible Spending Accounts only) If you do not make the change within 30 days, you and/or your dependents must wait until the next Annual Enrollment Period to make a change to your benefitelections. Do not wait for documentation to begin this process.

The following items are needed before your request can be approved and processed: • BIRTH – copy of birth certificate • DIVORCE – copy of divorce decree • MARRIAGE – copy of marriage certificate • EMPLOYMENT STATUS – proof of gain/loss of coverage indicating effective date, specific coverage gained/lost (i.e., medical, dental, vision) and person(s) gaining/losing coverage

bswift® Self-Service: Employees may use the bswift® system to update information throughout the plan year due to qualified life events. These steps must be completed within 30 days of the event. 1. LOG IN to bswift ®

Follow these instructions to upload documentation to bswift® : • SCAN and save document to your computer • LOG IN to bswift® • SELECT My Profile • SELECT Employee File • SELECT Add Employee File Document • TITLE the document (i.e. Marriage Certificate, “Child’s Name” Birth Certificate, etc.) • SELECT Document Type • SELECT Browse to locate and select your scanned document • CLICK Save A confirmation email will be sent when Human Resources has completed the process.

2. SELECT Life Events 3. SELECT your specific Life Event 4. INDICATE the effective date 5. ENTER information as requested 6. CONFIRM and Save Enrollment

10

Frequently Asked Questions When do benefits go into effect? Elections made during Open Enrollment will be effective January 1, 2023. Will I get a new ID card? All employees who enroll in the new medical plans will receive new ID cards and have access to an online temporary ID card by January 1, 2023. Delta Dental and VSP do not require an ID card for members to receive dental and vision services. Members simply provide the employee’s Social Security Number to schedule an appointment. When are my elections due and how do I enroll? Open Enrollment for the 2023 plan year begins November 30, 2022 and all elections must be completed by 5:00 CST December 14, 2022. To enroll, you can schedule a telephonic enrollment with our benefit counselors at AGM who will guide you through the enrollment process, or you can access the self-service benefits portal, bswift® at quantic.bswift.com. Does BlueCross BlueShield of Texas offer online access or a mobile app? Yes – get information about your benefits, anytime, anywhere. Use your computer, phone or tablet to access the secure member website, mybam.bcbstx.com/. Download the BlueCross BlueShield mobile app for free on the App Store® and Google Play®. Can I make changes to my elections during the middle of the plan year? Employees cannot make changes to their elections during the plan year (such as dropping coverage or adding a dependent) unless they experience a qualifying event. Are pre-existing conditions covered under the medical plan? Under the Affordable Care Act, benefits are no longer subject to pre-existing condition exclusions.

11

Terms You Need to Know Annual Deductible Each year you have a deductible, which is the amount you pay before the Plan starts paying benefits for non-co-pay-based visits and other services. Your deductible counts towards your maximum out of pocket amount. Coinsurance Once your annual deductible has been met, you and the plan share in the cost of your medical care. This is called coinsurance. Example: BlueCross BlueShield pays 80% and you pay 20%. Copays Some of our plans offer copays for certain services like doctor’s visits. A copay is a flat dollar amount you pay at the time of service. After you pay the copay, the plan typically pays the remaining expenses for that service at a specified level. Even after you meet your deductible, you will be required to pay your copay for each medical visit.

Preventive Care Preventive care helps detect or prevent conditions before they can become serious. Annual check-ups, immunizations and certain screenings are a few examples. Preventive care is covered at 100% with no deductible when services are performed by a PPO physician. Out-of-Pocket Maximum The out-of-pocket maximum is the most you could pay out of your own pocket for covered medical expenses in one year. Once you reach this amount, the plan pays 100% of any additional covered expenses for the rest of the year. Deductibles, coinsurance, office visits, and prescription copays count toward the out-of-pocket maximum.

Prior Authorization / Step Therapy Your prescription benefit program has a prior authorization and step therapy process for certain medications. It’s a good idea to contact Prime Therapeutics or visit MyPrime.com to confirm how a certain prescription is covered.

PPO vs Non-PPO Provider Participating/In-Network Providers (your less expensive option): providers who are contracted to accept the BlueCross BlueShield of Texas allowable charge as payment in full for their service. You only have to pay your cost share when you visit the doctor, and the provider will collect the remaining amount directly from BlueCross BlueShield of Texas.

• Prior Authorization is a requirement that your physician obtain approval from your health plan to prescribe a specific medication for you.

Non-Participating/Out-of-Network Providers (your most expensive option): nonparticipating providers will not accept the BlueCross BlueShield of Texas allowable charge as payment in full, and they won't normally file claims on your behalf. You will probably be required to pay the full amount to the provider and file a claim directly with BlueCross BlueShield of Texas for reimbursement. Any charges above the allowable amounts are your responsibility and will not be reimbursed.

• Step Therapy is when your prescription benefit requires you to try another medication prior to starting the medication your physician prescribed.

12

Medical Benefits – HSA $6,350 Administered by BlueCross BlueShield of Texas

In-Network Member Pays

Out-of-Network Member Pays

Deductible Individual Family

$6,350 $12,700

$12,700 $38,100

Out-of-Pocket Maximum (incl. deductible) Individual Family

$6,350 $12,700

$25,400 $50,800

0% after deductible 0% after deductible 0% after deductible

50% after deductible 50% after deductible no benefit

0%, no deductible

50% after deductible

0% after deductible 0% after deductible 0% after deductible

50% after deductible 0% after deductible 0% after deductible

Hospital Expenses Outpatient Inpatient

0% after deductible 0% after deductible

50% after deductible 50% after deductible

Medical/Surgical Expenses

0% after deductible

50% after deductible

Outpatient Therapy Services

0% after deductible

50% after deductible

Complex Imagery

0% after deductible

50% after deductible

Mental Health/Substance Abuse Outpatient Inpatient

0% after deductible 0% after deductible

50% after deductible 50% after deductible

Extended Home Care Home Health Care (60 visits/year) Hospice Care

0% after deductible 0% after deductible

50% after deductible 50% after deductible

Prescription Drugs (retail: 30 days) Generic Preferred Brand Non-Preferred Brand

0% after deductible 0% after deductible 0% after deductible

50% after deductible + 50% penalty 50% after deductible + 50% penalty 50% after deductible + 50% penalty

2 ½ x retail after deductible

no benefit

Physician Office Visit

(includes simple labs and x-rays)

Primary Care Physician (PCP) Specialist MDLive Virtual Visit

Preventive Care Emergency Room Services Urgent Care Emergency Room Ambulance

(limited to 35 visits per year) (MRI, CT Scan, PET)

Prescription Drugs (mail order: 90 days)

Some services require prior authorization. Failure to pre-authorize may result in a reduction in benefits payable and may include penalties. For more information about these limitations, call the number shown on the back of your BCBSTX ID card or visit www.bcbstx.com. This is only a brief summary of the plan and is not intended to be a complete disclosure of the plan qualifications and limitations. The contract must be consulted to determine the exact terms and conditions of coverage. You may request a copy of the complete certificate of coverage from the Human Resources Department.

13

Medical Benefits – HSA $3,000 Administered by BlueCross BlueShield of Texas

In-Network Member Pays

Out-of-Network Member Pays

Deductible Individual Family

$3,000 $6,000

$9,000 $27,000

Out-of-Pocket Maximum (incl. deductible) Individual Family

$5,000 $10,000

$18,000 $36,000

20% after deductible 20% after deductible 20% after deductible

50% after deductible 50% after deductible no benefit

0%, no deductible

50% after deductible

20% after deductible 20% after deductible 20% after deductible

50% after deductible 20% after deductible 20% after deductible

Hospital Expenses Outpatient Inpatient

20% after deductible 20% after deductible

50% after deductible 50% after deductible

Medical/Surgical Expenses

20% after deductible

50% after deductible

Outpatient Therapy Services

20% after deductible

50% after deductible

Complex Imagery

20% after deductible

50% after deductible

Mental Health/Substance Abuse Outpatient Inpatient

20% after deductible 20% after deductible

50% after deductible 50% after deductible

Extended Home Care Home Health Care (60 visits/year) Hospice Care

20% after deductible 20% after deductible

50% after deductible 50% after deductible

Prescription Drugs (retail: 30 days) Generic Preferred Brand Non-Preferred Brand

$5 copay after deductible $10 copay after deductible $15 copay after deductible

same as in-network plus 50%

2.5 x retail copay after deductible

no benefit

Physician Office Visit

(includes simple labs and x-rays)

Primary Care Physician (PCP) Specialist MDLive Virtual Visit

Preventive Care Emergency Room Services Urgent Care Emergency Room Ambulance

(limited to 35 visits per year) (MRI, CT Scan, PET)

Prescription Drugs (mail order: 90 days)

Some services require prior authorization. Failure to pre-authorize may result in a reduction in benefits payable and may include penalties. For more information about these limitations, call the number shown on the back of your BCBSTX ID card or visit www.bcbstx.com. This is only a brief summary of the plan and is not intended to be a complete disclosure of the plan qualifications and limitations. The contract must be consulted to determine the exact terms and conditions of coverage. You may request a copy of the complete certificate of coverage from the Human Resources Department.

14

Medical Benefits – PPO $3,000 Administered by BlueCross BlueShield of Texas

In-Network Member Pays

Out-of-Network Member Pays

Deductible Individual Family

$3,000 $6,000

$9,000 $27,000

Out-of-Pocket Maximum (incl. deductible) Individual Family

$6,000 $12,000

$18,000 $36,000

$15 copay $50 copay $15 copay

50% after deductible 50% after deductible no benefit

0%, no deductible

50% after deductible

$75 copay 20% after $300 copay 20% after deductible

50% after deductible 20% after $300 copay 20% after deductible

Hospital Expenses Outpatient Inpatient

20% after deductible 20% after deductible

50% after deductible 50% after deductible

Medical/Surgical Expenses

20% after deductible

50% after deductible

Outpatient Therapy Services

20% after deductible

50% after deductible

Complex Imagery

20% after deductible

50% after deductible

Mental Health/Substance Abuse Outpatient Inpatient

20% after deductible 20% after deductible

50% after deductible 50% after deductible

Extended Home Care Home Health Care (60 visits/year) Hospice Care

20% after deductible 20% after deductible

50% after deductible 50% after deductible

Prescription Drugs (retail: 30 days) Generic Preferred Brand Non-Preferred Brand

$15 copay $40 copay $70 copay

$15 copay + 50% penalty $40 copay + 50% penalty $70 copay + 50% penalty

2 ½ x retail copay

no benefit

Physician Office Visit

(includes simple labs and x-rays)

Primary Care Physician (PCP) Specialist MDLive Virtual Visit

Preventive Care Emergency Room Services Urgent Care Emergency Room Ambulance

(limited to 35 visits per year) (MRI, CT Scan, PET)

Prescription Drugs (mail order: 90 days)

Some services require prior authorization. Failure to pre-authorize may result in a reduction in benefits payable and may include penalties. For more information about these limitations, call the number shown on the back of your BCBSTX ID card or visit www.bcbstx.com. This is only a brief summary of the plan and is not intended to be a complete disclosure of the plan qualifications and limitations. The contract must be consulted to determine the exact terms and conditions of coverage. You may request a copy of the complete certificate of coverage from the Human Resources Department.

15

Medical Benefits – PPO $1,000 Administered by BlueCross BlueShield of Texas

In-Network Member Pays

Out-of-Network Member Pays

Deductible Individual Family

$1,000 $2,000

$3,000 $9,000

Out-of-Pocket Maximum (incl. deductible) Individual Family

$5,000 $10,000

$9,000 $18,000

$10 copay $40 copay $10 copay

50% after deductible 50% after deductible no benefit

0%, no deductible

50% after deductible

$50 copay 20% after $250 copay 20% after deductible

50% after deductible 20% after $250 copay 20% after deductible

Hospital Expenses Outpatient Inpatient

20% after deductible 20% after deductible

50% after deductible 50% after deductible

Medical/Surgical Expenses

20% after deductible

50% after deductible

Outpatient Therapy Services

20% after deductible

50% after deductible

Complex Imagery

20% after deductible

50% after deductible

Mental Health/Substance Abuse Outpatient Inpatient

20% after deductible 20% after deductible

50% after deductible 50% after deductible

Extended Home Care Home Health Care (60 visits/year) Hospice Care

20% after deductible 20% after deductible

50% after deductible 50% after deductible

Prescription Drugs (retail: 30 days) Generic Preferred Brand Non-Preferred Brand

$5 copay $20 copay $40 copay

$5 copay + 50% penalty $20 copay + 50% penalty $40 copay + 50% penalty

2 ½ x retail copay

no benefit

Physician Office Visit

(includes simple labs and x-rays)

Primary Care Physician (PCP) Specialist MDLive Virtual Visit

Preventive Care Emergency Room Services Urgent Care Emergency Room Ambulance

(limited to 35 visits per year) (MRI, CT Scan, PET)

Prescription Drugs (mail order: 90 days)

Some services require prior authorization. Failure to pre-authorize may result in a reduction in benefits payable and may include penalties. For more information about these limitations, call the number shown on the back of your BCBSTX ID card or visit www.bcbstx.com. This is only a brief summary of the plan and is not intended to be a complete disclosure of the plan qualifications and limitations. The contract must be consulted to determine the exact terms and conditions of coverage. You may request a copy of the complete certificate of coverage from the Human Resources Department.

16

Prescription Drug Benefits

Administered by Prime Therapeutics, a BlueCross BlueShield Company

Generic Drugs May Save You Money They are safe, effective and approved by the FDA. Talk to your doctor to see if using generic drugs is an option for you. What is a generic drug? A generic drug is a version of a brand-name drug and is also approved by the FDA. When compared to the brand-name drug a generic drug is safe and works just as well in the body for most people. But the generic drug often costs less.

You may pay less for generic drugs. Some benefit plans offered by Blue Cross and Blue Shield of Texas (BCBSTX) use a prescription drug list, which is a list of drugs covered by your plan. If your plan is based on a drug list, how much you pay out-ofpocket for prescription drugs depends on whether the drug is on the list. Your drug list may also have different levels of coverage, called “tiers”. When you choose drugs in lower tiers, you may pay less. Generics are often in the lower tiers.

There are two types of generics: • A generic equivalent is made with the same active ingredient(s) at the same dose as the brandname drug. • A generic alternative is often used to treat the same condition, but the active ingredient(s) differ from the brand-name drug. Note: If you use a brand medication that has a generic equivalent, you will pay the cost difference between the brand-name drug and the generic drug in addition to your copay or coinsurance. Your pharmacist can often fill a prescription with a generic equivalent without a new prescription from your doctor.

Members whose plan does not include a drug list often pay less out-of-pocket for generic drugs as well.

Be informed. Talk to your doctor. Start saving now. 17

Prescription Drug Benefits

Administered by Prime Therapeutics, a BlueCross BlueShield Company

A home delivery (mail order) pharmacy service you can trust. Express Scripts® Pharmacy delivers your long-term (or maintenance) medicines right where you want them. No driving to the pharmacy. No waiting in line for your prescriptions to be filled. Savings and Convenience • Express Scripts® Pharmacy delivers up to a 90day supply of long-term medicines.1 • Prescriptions are delivered to the address of your choice, within the U.S., with free standard shipping. • You can order from the comfort of your home — through your mobile device, online or over the phone. Your doctor can fax, call or send your prescription electronically to Express Scripts® Pharmacy. • Tamper-evident, unmarked packaging protects your privacy.

Support and Service • You can receive notices by phone, email or text — your choice — when your orders are placed and shipped. You will be contacted, if needed, to complete your order. To select your notice preference, register online at express-scripts.com/rx or call 833-715-0942. • 24/7 access to a team of knowledgeable pharmacists and support staff. • Choose to receive refill reminder notices by phone or email. • Multiple pharmacy locations are located across the U.S., for fast processing and dispensing.

Medicines may take up to 5 business days to deliver after Express Scripts® Pharmacy receives and verifies your order. 18

Prescription Drug Benefits

Administered by Prime Therapeutics, a BlueCross BlueShield Company

Getting Started with Express Scripts® Pharmacy Mail Order Online and Mobile You have more than one option to fill or refill a prescription online or from a mobile device: • Visit express-scripts.com/rx. Follow the instructions to register and create a profile. See your active prescriptions and/or send your refill order. • Log in to myprime.com and follow the links to Express Scripts® Pharmacy.

Talk to Your Doctor Ask your doctor for a prescription for up to a 90-day supply of each of your long-term medicines.1 You can ask your doctor to send your prescription electronically to Express Scripts® Pharmacy, call 888327-9791 for faxing instructions or call the pharmacy at 833-715-0942. If you need to start your medicine right away, request a prescription for up to a one-month supply you can fill at a local retail pharmacy.

Over the Phone Call 833-715-0942, 24/7, to refill, transfer a current prescription or get started with mail order. Please have your member ID card, prescription information and your doctor’s contact information ready.

Refills Are Easy Refill dates are shown on each prescription label. You can choose to have Express Scripts® Pharmacy remind you by phone or email when a refill is due. Choose the reminder option that best suits you.

Through the Mail To send a prescription order through the mail, visit bcbstx.com and log in to Blue Access for MembersSM (BAMSM). Complete the mail order form. Mail your prescription, completed order form and payment to Express Scripts® Pharmacy.

Questions? Visit bcbstx.com. Or call the phone number listed on your member ID card.

Use the mobile app to manage your prescriptions • Refill prescriptions • Track your order • Make payments • Set reminders to take medicines and more

1. Prescriptions of up to a 90-day supply, or the most amount allowed by the benefit plan. Express Scripts® Pharmacy is a pharmacy that is contracted to provide mail pharmacy services to members of Texas. The relationship between Express Scripts® Pharmacy and Blue Cross and Blue Shield of Texas is that of independent contractors. Express Scripts® Pharmacy is a trademark of Express Scripts Strategic Development, Inc. Prime Therapeutics LLC is a pharmacy benefit management company, contracted by BCBSTX to provide pharmacy benefit management and related other services. BCBSTX, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics LLC. MyPrime.com is an online resource offered by Prime Therapeutics, LLC. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association 54445.0521

19

Where To Go For Care Using SmartER℠ Care Options If you aren’t having an emergency, knowing where to go for medical care may save you on cost and time. You have choices for where you get non-emergency care — what we call SmartER Care options. Try these places instead of the emergency room (ER). Plus, when you visit in-network providers, you may pay less for care. Visit the “Control Costs with SmartER Care” web page at bcbstx.com for more details. Need Advice? The 24/7 Bilingual NurseLine can help you identify some options. Nurses are available at 800-581-0393, 24 hours a day, seven days a week, to answer your health questions. The 24/7 Bilingual NurseLine may not be available with all plans. Check your benefits booklet for details.

Symptoms* Virtual Visits •Allergies • Cold/Flu • Depression

• Fever, colds and flu • Sore throat • Stomach ache

• Infections • Minor injuries or pain • Sore and strep throat • Cuts that need stitches • Migraines or headaches • Back pain • Sprains or strains •Animal bites or rashes •Tolerable pain •Heart problems, heart attack •Chest pain, stroke •Breathing problems •Heavy bleeding •Broken bones •Sudden or severe pain

You may be able to have a live doctor visit by phone, online video or mobile app for nonemergency medical and behavioral health care.1-2 24 hours a day, 7 days a week

Doctor’s Office

Talk to the person who knows you and your medical history. Office hours may vary

Retail Clinic Use for non-emergency care when you can’t see your doctor. Hours based on retail store hours

Urgent Care

Visit when it’s not an emergency, but needs immediate attention. Generally includes evening, weekend and holiday hours

Emergency Room Use for life-threatening symptoms. Open 24 hours, 7 days a week

*Note: These examples are not inclusive of all symptoms and health issues. 20

Average Cost Average Wait

$

20

Minutes

Average Cost Average Wait

$

18

Minutes

Average Cost Average Wait

$

15

Minutes

Average Cost Average Wait

$$

16-24 Minutes

Average Cost Average Wait

$$$

4 Hours 7Minutes

Virtual Visits for BCBSTX Members Powered by MDLive

Powered by

Care When and Where You Need It Just Got Easier

Virtual Visits

Convenient health care at your fingertips

Getting sick is never convenient, and finding time to get to the doctor can be hard. Blue Cross and Blue Shield of Texas (BCBSTX) provides you and your covered dependents access to care for non- emergency medical issues and behavioral health needs through MDLIVE. Whether you’re at home or traveling, access to an independently contracted board-certified doctor is available 24 hours a day, seven days a week. You can speak to a doctor immediately or schedule an appointment based on your availability. Virtual visits can also be a better alternative than going to the emergency room or urgent care center. MDLIVE doctors or therapists can help treat the following conditions and more: General Health • Allergies • Asthma • Nausea • Sinus infections

Pediatric Care • Cold • Flu • Ear problems • Pinkeye

Behavioral Health • Anxiety/depression • Child behavior/learning issues • Marriage problems

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association 731392.1117

21

Virtual Visits for BCBSTX Members Powered by MDLive

Connect

Computer, smartphone, tablet or telephone

Website: Visit the website MDLIVE.com/BCBSTX • Choose a doctor • Video chat with the doctor • You can also access through Blue Access for Members

Interact

Real-time consultation with a board-certified doctor or therapist

Mobile app: • Download the MDLIVE app from the Apple App Store or Google Play Store • Open the app and choose an MDLIVE doctor • Chat with the doctor from your mobile device

Diagnose

Prescriptions sent electronically to a pharmacy of your choice (when appropriate)

Telephone: Call MDLIVE (888-680-8646) • Speak with a health service specialist • Speak with a doctor

Get connected today! To register, you’ll need to provide your first and last name, date of birth and BCBSTX member ID number. Internet/Wi-Fi connection is needed for computer access. Data charges may apply. Check your cellular data or internet service provider’s plan for details. Non-emergency medical service in Idaho, Montana and New Mexico is limited to interactive audio/video (video only), along with the ability to prescribe. Non-emergency medical service in Arkansas is limited to interactive audio/video (video only) for initial consultation, along with the ability to prescribe. Behavioral health service is limited to interactive audio/video (video only), along with the ability to prescribe in all states. Service availability depends on location at the time of consultation. Virtual visits, powered by MDLIVE, may not be available on all plans. Virtual visits are subject to the terms and conditions of your benefit plan, including benefits, limitations, and exclusions. MDLIVE operates subject to state regulations and may not be available in certain states. MDLIVE is not an insurance product or a prescription fulfillment warehouse. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services. MDLIVE, an independent company, operates and administers the virtual visit program and is solely responsible for its operations and that of its contracted providers. MDLIVE® and the MDLIVE logo are registered trademarks of MDLIVE, Inc., and may not be used without written permission. Blue Cross®, Blue Shield® and the Cross and Shield symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. App Store is a service mark of Apple Inc. Google Play Store is a trademark of Google Inc. (“Google”). Windows is a registered mark of MicrosoftTM

22

BlueCross BlueShield of Texas Member Resources Member Portal and Mobile App

Go Mobile With Blue Stay connected with Blue Cross and Blue Shield of Texas (BCBSTX) and access important health benefit information wherever you are. Available in Spanish • Find an in-network doctor, hospital or urgent care facility • Access your claims, coverage and deductible information • View and email your member ID card • Login securely with your fingerprint • Download and share your Explanation of Benefits (EOB)* • Get push notifications and access to Message Center* • Text** BCBSTXAPP to 33633 to get the app • •

* Currently only available on iPhone®. iPhone is a registered trademark of Apple Inc. ** Message and data rates may apply. Terms and conditions and privacy policy at bcbstx.com/mobile/text-messaging.

bcbstx.com/mobile Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

23

BlueCross BlueShield of Texas Member Resources Find a Blue Choice PPO Provider

Your Doctor Is In… Provider Finder®

It’s now easier to find a provider and manage health care expenses. Provider Finder from Blue Cross and Blue Shield of Texas (BCBSTX) is a fast, easy-to-use tool that improves members’ experience when they’re looking for in-network health care providers. Plus, it can help them manage their out-ofpocket costs.

The updated Provider Finder platform has undergone intensive testing. The result is a better experience that will help members be smarter consumers of health care. By going to bcbstx.com, members can login or create an account on Blue Access for MembersSM (BAMSM) and use Provider Finder to: • • • • • •

Find in-network providers, clinics, hospitals and pharmacies. Search by specialty, ZIP code, language spoken, gender and more. See clinical certifications and recognitions. Compare quality awards for doctors, hospitals and more. Read or add reviews for providers. Estimate the out-of-pocket costs for more than 1,700 health care procedures, treatments and tests.* • Find cost savings opportunities using the Medication Finder tool.

Go Mobile with BCBSTX Even on the go members can manage their ID cards and stay on top claims activity, coverage information and prescription refill reminders. It’s easy: Log into or create a BAM account at bcbstx.com or text BCBSTX to 33633** to download our mobile app. * Not all plans provide this information. ** Message and data rates may apply. Terms and conditions and privacy policy are available at bcbstx.com/mobile/text-messaging.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

24

750975.0422

BlueCross BlueShield of Texas Member Resources 24-Hour NurseLine

24/7 NurseLine

For the right care at the right place

When you have a health concern, it can be difficult and time-consuming to find the information you need to get the right care. With telephone and online access to experienced registered nurses, you’ll get the help you need to make more informed health care decisions.

Your health advocate.

One toll-free number connects you with a registered nurse who will take the time to understand what is going on with your health and provide you with personalized information. As part of your health plan benefits, nurses are available 24 hours a day, seven days a week, at no additional cost to you.

Your one-stop source.

Whether it’s midnight and your baby has a 102degree temperature, you need help managing your diabetes or you’re not sure if you need a doctor, urgent care clinic or simply advice, NurseLine can help guide you to the care and services you need.

Here for you 24/7.

To talk with a NurseLine nurse, call 888-657-6061

When should you call? The toll-free NurseLine can help you or a covered family member get answers to health problem questions, such as: • Asthma, back pain or chronic health issues • Dizziness or severe headaches • High fever • A baby’s nonstop crying • Cuts or burns • Sore throat The 24/7 NurseLine can help you figure out if you should call your doctor, go to the ER or treat the problem yourself.

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your doctor's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. 25

Dental Benefits: Basic Plan and High Plan Administered by Delta Dental of Texas

The Dental Plan offers in-network and out-of-network coverage. When using in-network providers, participants cannot be billed for costs above the negotiated rates.

Deductibles and Maximums Individual Deductible Family Deductible Maximum Benefit Payable Preventive & Diagnostic Routine exam, routine cleaning, bitewing x-rays, full mouth x-rays, fluoride , sealants Basic Restorative Services Fillings, space maintainers, simple extractions and denture repair/reline/rebase Endodontia, Periodontia, Oral Surgery Root canals, gum therapy Major Services Crowns, inlays, onlays and cast restorations Prosthodontics Bridges and dentures

Basic Plan In Network: Member Pays

High Plan In Network: Member Pays

$50 $150 $1,500

$50 $150 $2,500

0%, no deductible

0%, no deductible

20% after deductible

0% after deductible

20% after deductible

0% after deductible

50% after deductible

40% after deductible

50% after deductible

40% after deductible

Implants Implant services

no benefit

40% after deductible

Orthodontic Services Adults and dependent children

no benefit

50%, no deductible

Orthodontic Lifetime Maximum n/a $2,000 Pre-Treatment Estimate: Obtaining a Pre-Treatment Estimate of Benefits is recommended whenever a Dentist's estimated charge is $500 or more. This feature is not mandatory; however, dental care can be expensive. A Covered Person may want to have an idea of how much this Plan will pay before agreeing to have the treatment performed. Find a network dentist: You have 2 options to help you in your search: 1) Visit deltadentalins.com/find-a-dentist and search “Delta Dental PPO” or “Delta Dental Premier” to search by name, facility or location to see a list of network dentists in your network. 2) Call 844.847.9516 for assistance in locating a network dentist Phillips Sonicare Discount: BrushSmart is an oral wellness program in partnership with Phillips Sonicare to help you improve your dental care routine by providing a 20% discount on Phillips Sonicare products. Go to brushsmart.org to learn more and receive your coupon code. 26

Vision Benefits Insured by VSP

In-Network Member Pays

Out-of-Network VSP Pays Benefit Frequency

Exam Lenses or Contact Lenses Frames

once per 12 months once per 12 months once per 24 months

Eye Exam $10 copay

up to $45

$25 copay $25 copay $25 copay $25 copay $0 copay

up to $30 up to $50 up to $65 up to $100 no benefit

copays/discounts varies

no benefit

VSP allows up to $130 + 20% discount on overage

up to $70

VSP allows up to $130 after $25 copay covered in full after $25 copay

up to $105 up to $210

Lenses Single Bifocal Trifocal Lenticular Progressive Lens, Standard Lens Enhancements UV treatment Tinting Scratch coating Photochromatic Anti-reflective coating Frames

Contact Lenses (in lieu of spectacles) Elective contact lenses Medically necessary contact lenses Value-Added Benefits LASIK vision discount

VSP has partnered with the Lasik Vision Institute, Lasik Plus and NVISION Eye Centers to provide members with discounted laser vision correction. Members pay an average of 15% off the regular price and 5% off the promotional price. Log in to your vsp.com account to learn more.

Exclusive value-added features

We put our members first by providing exclusive offers totaling over $3,000 in savings from VSP and other popular brands for your eye care and overall wellness needs. Save on your favorite frame brands and contact lenses, get discounts on wellness products and services, travel, entertainment, and everyday home and financial services that make your life easier.

A nationwide network of eye doctors

VSP network doctors, including Premier Program private practice doctors and VisionWorks retail locations, are here to help you use your vision benefits. Search for a VSP Choice Network provider by visiting vsp.com/eye-doctor. 27

Health Savings Account (HSA) Administered by Wex

What is an HSA? A Health Savings Account (HSA) is an individually-owned, tax-free, interest-bearing savings account that is used to pay for qualified medical expenses either now or in the future. To be eligible for an HSA, you must participate in one of the high deductible health plans (HDHP) administered by BlueCross BlueShield Texas. HSA contributions can also be used to pay for qualified medical expenses for you, your spouse, or your dependent(s)—even if your dependents are not covered by the HDHP. Qualified medical expenses include out-ofpocket medical expenses like deductibles, copays and coinsurance, as well as other expenses including dental, vision and long-term care premiums. What are the advantages of an HSA? Tax savings • The contributions you make to the HSA are pre-tax. • HSA investment earnings and interest are not taxed. • Unspent HSA funds can be invested tax-free. • Withdrawals made from your HSA to pay for qualified medical expenses are not taxed. No use-it-or-lose-it rule Unused HSA funds roll over year to year. You own your HSA Your HSA is yours even if you change jobs, change medical coverage, move, become unemployed or retire. HSA funds can be used for the entire family Use it for your spouse and tax dependents even if they are not covered by your insurance. Long-term, tax-free savings Funds left in your HSA grow tax-free. Once you reach age 65, you can use HSA funds for anything without paying a penalty. Using your HSA You will receive a debit card for instant access to your HSA funds. Just swipe your card to pay for eligible medical expenses and funds will be automatically deducted from your HSA. Remember, you must have enough funds in your HSA to cover the purchase. You also have the option of paying for medical expenses out of your own pocket and letting your HSA funds earn interest for future qualified expenses. NOTE: If you currently have funds in an HSA account, you have the option of transferring those funds to your new Wex HSA account. To exercise this option you will need to download and complete the HSA Transfer Request Form found in the bswift® library. 28

Eligibility • You must be enrolled in a qualified high deductible health plan (HDHP) and not be covered by other health insurance that is not a qualified HDHP. • You may not have any other coverage, such as: o A plan with a deductible lower than $1,500 for individual coverage ($3,000 family) and out-of-pocket maximum higher than $7,500 for individual ($15,000 family) o A spouse’s medical plan that covers you that is not an HDHP o Medicare or Tricare coverage o Health Flexible Spending Account (FSA) o Health Reimbursement Arrangement (HRA) o You cannot be claimed as a dependent on someone else’s tax return. Qualified HSA Expenses • Copays, deductibles and coinsurance • Diagnostic services not covered by your health plan • Dental procedures such as fillings, braces or extractions • Hearing aids and batteries • Eye exams, eyeglasses, and contact lenses • Chiropractic care and Acupuncture • Qualified long-term care insurance • COBRA premiums • Medicare premiums • Health plan coverage while receiving federal or state unemployment benefits • And more

Health Savings Account (HSA) Administered by Wex

Frequently Asked Questions • How much can I contribute to my HSA? o The maximum amount you can contribute each year to your HSA is $3,850 if you have individual medical coverage and $7,750 if you have family medical coverage. There is no minimum contribution amount. o If you are 55 or older, you can contribute up to an additional $1,000 per year. What are my investment options? You have the flexibility to choose how to use your HSA funds, both now and in the future. When you open an HSA, your contributions are deposited to an individual FDIC-insured HSA Deposit Account. Once your Base Account balance exceeds $1,000, you can invest your HSA funds in an interest-bearing account or our standard mutual fund lineup powered by Charles Schwab, giving you access to more than 8,500 mutual funds, stocks and bonds. What resources are available to help me manage my HSA? Benefits debit card The benefits debit card is the fastest and most convenient way to pay for eligible expenses. Just one debit card is all you need for your benefits regardless of how many plans you have with us. Benefits eligible expenses There are thousands of eligible procedures, items and expenses based on your plan. View our interactive list of eligible expenses a www.wexinc.com/insights/benefits-toolkit/eligible-expenses/ Knowledgebase Once you’re enrolled, check out the knowledgebase to quickly search for answers to your questions. The knowledgebase boasts millions of views of our videos, articles and step- by-step how-tos empowering you to get the most out of your benefits. Have a question? Visit any time of day or night by logging in to your online account on www.wexinc.com. Benefits mobile app & participant portal Access your benefits 24/7 with the WEX mobile app. Our app is free, convenient and offers real- time access to all your benefits accounts. With our benefits mobile app you can: • Get instant updates on the status of your claims. • File a claim and upload documentation in seconds using your phone’s camera. • Scan an item’s bar code to determine if it’s an IRS Code Section 213(d) eligible expenses

• Report a card as lost or stolen, which cancels the card and ships you a new one. • Log in through face recognition or fingerprint (depending on your phone). • Check your balance and view account activity. • Reset login credentials.

Don’t have a smartphone? Go to www.wexinc.com, hover over Solutions and select Participants/ Employees. This page provides login buttons for accessing your online account, along with helpful resources like a benefits knowledge base, a link to current eligible expenses, and chat. Have questions? Contact our Participant Services Department Monday - Friday 6:00 a.m. to 9:00 p.m. CT

Questions when enrolled: 1-866-451-3399 Questions before you enroll: 1-844-561-1337 Live chat: go to www.wexinc.com, hover over Solutions and select Participants/Employees. 29

Healthcare Flexible Spending Accounts (FSA) Administered by Wex

Healthcare Flexible SpendingAccount You may participate in the Healthcare FSA which allows you to set aside a portion of your salary before taxes, to pay for qualified healthcare expenses. You may use these funds to pay for eligible medical, dental, and vision expenses for you, your spouse, and your eligible dependents as long as they are claimed as dependents on your federal tax return. The maximum amount you can elect for 2023 is $3,050. IMPORTANT: You cannot participate in a traditional Healthcare FSA if you are currently making contributions to a Health Savings Account (HSA). However, you may participate in a Limited Purpose FSA as discussed below. Limited Purpose Flexible Spending Account (LPFSA) The limited purpose FSA is a flexible spending account that only reimburses for eligible dental and vision expenses. The LPFSA is available to employees who are enrolled in the HSA plan. The maximum amount you can elect for 2023 is $3,050. Use It Or Lose It Be conservative in your estimate. The IRS has a “Use or Lose” rule in place for FSAs. Funds not spent by the end of a plan year (December 31) are at risk of being forfeited. Note: The Quantic Electronics FSA plan includes a “grace period” allowing you to incur expenses through March 15th of the following year while using the unspent funds from the prior year to pay for them. Verifying Your Wex Benefits Debit Card Expenses For medical care purchases made with your Wex Benefits Debit Card, the IRS requires the expense be verified. Some of those purchases can be verified electronically at the point of purchase, so there’s no need for additional substantiation. They include: • Copays in doctors’ offices • Copays in pharmacies • Some vision copays Certain debit card transactions may need to be substantiated. Substantiating means validating a transaction to ensure the debit card was used for IRS-approved items/services within the allowed time frame. To find out which specific expenses are eligible, view the searchable eligibility list here. Reimbursement Documentation Requirements Approved documentation for medical expenses, required by the IRS, is a receipt or statement containing all of the following: name of provider, date(s) of service within the plan year, an eligible type of service, or product and dollar amount. An Explanation of Benefits (EOB) from your insurance provider is ideal for substantiating claims. Submitting Documentation: There are several ways to submit documentation: • Online, you can easily upload your receipts and other documents • Mobile app, available free, download in your device's app store Access Your Benefits Anytime, Anywhere • Get instant notifications on the status of your claims • File a claim and upload documentation in seconds using your phone’s camera • Scan an item’s bar code with your phone’s camera to determine if it’s an IRS eligible expense • Check your balance and view account activity 30

Dependent Care Flexible Spending Account (DCFSA) Administered by Wex

A Dependent Care Flexible Spending Account (DCA) is a benefit that lets employees set aside pre-tax dollars to help pay for dependent care. Contributing to this type of account reduces taxable income and spreads the benefits of pre-tax dollars throughout the year, helping you save 30 percent or more on your dependent care costs. Dependent Care Flexible Spending Account Eligibility Funds can be used to pay for childcare for children under age 13 when they’re claimed as qualifying dependents. To be eligible for the Dependent Care FSA, you and your spouse (if applicable) must be employed, or your spouse must be a full-time student or looking for work. Big Savings Potential Let’s say you enroll and contribute the $5,000 per year into a Dependent Care FSA (which is the maximum allowed by the IRS) and pay the average American tax rate of 29.8 percent. By putting that money aside before paying taxes on it rather than allowing the funds to be taxed, you’d save nearly $1,500 for the year! Note: The limit is $2,500 per person per year for married couples who file taxes separately. Weighing The Tax Credit The IRS offers a tax credit to those who have childcare or dependent care expenses. You can’t enroll in pre-tax benefits and apply for the tax credit with the same funds. However, the tax credit is $6,000 per year for two or more children, which is $1,000 more than a Dependent Care Flexible Spending Account's annual limit. It’s possible to apply the tax credit to the difference of what you put into dependent care and the tax credit (for example, if you’re putting $5,000 into the account, that would leave $1,000 that you can apply the tax credit to before you’ve reached the $6,000 ceiling for the credit).

Ineligible Expenses Services provided one of your dependents

$3,644 Average annual enrollment for DCFSA participants

Night-time babysitting (unless you work nights when the expenses are incurred.

$1,093 Average annual tax savings for DCFSA participants

Expenses paid for school (kindergarten and above) Nursing homes, respite care or other residential care centers

Common Eligible Expenses Pre-school and after school care Day care providers Summer day camps

Activity fees/field trips Meals, foodAPP or snacks DOWNLOAD THE FOR FREE ON APPLE AND ANDROID SMARTPHONES AND TABLETS

31

Life and Accidental Death Benefits Insured by Prudential

Employer Paid Group Life and AD&D Insurance: Life insurance is an important part of your financial well-being, especially if others depend on you for support. Therefore, Quantic Electronics provides Basic Term Life and Accidental Death & Dismemberment insurance in the amount of 2 times your base annual earnings to a maximum of $300,000. This benefit is provided at no cost to you. Voluntary Life and AD&D Insurance: You may also purchase Voluntary Life and AD&D Insurance for yourself, your spouse and your dependent children. However, you may only elect coverage for your dependents if you enroll for yourself for coverage. You pay for the cost of Voluntary Life and AD&D Insurance on an after-tax basis through payroll deductions VOLUNTARY TERM LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT • Purchase coverage in increments of $10,000 to a maximum of $500,000. • Guarantee Issue: o For January 1, 2023 or new hires only: employees are eligible to elect up to $150,000 without evidence of insurability (EOI) even if you waived coverage previously. If you forfeit this opportunity, you will be required to provide evidence of insurability if at any time in the future Employee you decide to elect coverage and your application could be denied.  If you elect coverage now, during future annual enrollment periods you may increase your current coverage by $50,000 without providing evidence of insurability (EOI) up to the guarantee issue amount of $150,000. o Benefit Reduction Schedule: reduces to 65% @ age 70 and to 50% @ age 75 • Purchase coverage for your spouse in $5,000 increments to a maximum of $250,000. • Guarantee Issue: o For January 1, 2023 or new hires only: employees are eligible to elect up to $50,000 of coverage for their spouse without proof of good health. If you forfeit this opportunity, your spouse will be required to provide evidence of insurability (EOI) if at any time in the future you decide to elect Spouse coverage. o Benefit Reduction Schedule: reduces to 65% @ age 70 and to 50% @ age 75 NOTE: If your spouse is also a full-time employee of Quantic Electronics, neither you nor your spouse may elect Voluntary Term Life/AD&D as a dependent of the other person. • Purchase $10,000 in coverage for your dependent children. Dependent • Coverage begins at birth and continues to age 26 if unmarried. Child(ren) • Guarantee Issue: o All amounts are guaranteed

You must provide your beneficiary designation for this coverage during enrollment. Designating a dependent child under age 18 is not recommended since minor children cannot directly receive the proceeds of a life insurance policy. Minor beneficiaries pose special problems because a legal guardian of their estate must be appointed by a court – even if one of their parents is still living. Often, the money must be held until the child reaches 18. 32

Short-Term Disability Benefits Insured by Prudential

What is Group Short-Term Disability Coverage? Group Short-Term Disability Coverage provides you with benefits to replace part of your paycheck when you can’t work because of a sickness or injury. Short-Term Disability coverage is intended to provide financial protection for a disability lasting just a few weeks. Below are a few examples of how your Short-Term Disability benefits could be used, depending on how much coverage you have: • Everyday expenses, such as groceries, utilities, house payments and car payments • Medical bills and recovery expenses • Support services during your recovery What are some of the most common causes of a short term disability? • Pregnancies (22.3%) • Musculoskeletal disorders affecting the back and spine, knees, hips, shoulders, and other parts of the body (18.5%) • Injuries such as fractures, sprains, and strains of muscles and ligaments (11.4%) • Digestive disorders, such as hernias and gastritis (7.4%) • Mental health issues including depression and anxiety (7.3%) ELIGIBILITY & COVERAGE Who is eligible? All active full-time employees working a minimum of 30 hours per week What amount of coverage am I 66.6% of your weekly earnings to a maximum benefit amount of $3,000 per week eligible for? What is the waiting period?

• For disabilities caused by a non-occupational accident or injury = 0 days • For disabilities caused by an illness, including pregnancy = 7 days

What is the maximum benefit 12 weeks period? Are there pre-existing limitations? There are no limitations related to pre-existing conditions. How much will it cost me to have This benefit is provided for you at no cost by Quantic Electronics. this coverage?

Day 1 through 7

Week 12

Day 8 Waiting period

PTO/ sick time (if available)

Short Term Disability benefits paid

Example based on a disability due to illness

33

Return to work or transition to Long- Term Disability

Long-Term Disability Benefits Insured by Prudential

What is Group Long-Term Disability Coverage? Long-term disability insurance protects your financial security if you become unable to work due to a lengthy illness or injury for more than three months. Benefits are payable until you recover from the disability or until you reach Social Security Normal Retirement Age, whichever comes first. How can Disability benefits be used? When your claim is approved, you will receive monthly benefits to replace part of your income based on your coverage level. You may use this money however you would like. Below are a few examples of how your Long-Term Disability benefits could be used, depending on how much coverage you have: What are some of the most common causes of a long term disability? • Musculoskeletal disorders (27.6%) • Cancer (15.0%) • Injuries such as fractures, sprains, and strains of muscles and ligaments (12.0%) • Mental health issues (9.3%) • Circulatory (heart attack, stroke) (8.2%) ELIGIBILITY & COVERAGE Who is eligible?

All active full-time employees working a minimum of 30 hours per week

What amount of coverage am I eligible for?

60% of your monthly earnings to a maximum benefit amount of $10,000

What is the waiting period? What is the maximum benefit period Are there pre-existing limitations?

90 days (equal to the short-term disability waiting period + maximum benefit period) If you become disabled prior to age 60, the maximum period of payment will be until the Social Security Normal Retirement Age (SSNRA). At age 60 (and older), the benefit period will be based on a reduced duration schedule.) Pre-existing conditions include any physical or mental condition, whether diagnosed or undiagnosed, resulting from an injury or sickness for which you received physician’s advice or treatment within 3 months prior to your effective date of coverage. Benefits for a pre-existing condition are not payable for your first 12 months of coverage.

How much will it cost me to have This benefit is provided for you at no cost by Quantic Electronics. this coverage?

12%

30% Average worker has a 30%chance of getting disabled.

12% of the population get disability benefits.

34

1 out of every 8 workers will be disabled within at least 5 years during their working years.

Accident Benefits Insured by Prudential

Now there’s help if you suffer an accident. Accident insurance pays benefits you can use for medical bills and other out-of-pocket expenses – or for any other purpose, including paying your mortgage or other bills. Your medical insurance may not take care of all of the added expenses you’ll have after an accident. This policy helps provide protection for you and your family and pays benefits for: • Accident only emergency benefit, including X-rays and physician care received within 96 hours of an accident • Accident only follow-up visits and physical therapy benefit, which could be important for recovery • Initial accident only hospitalization benefit, including ambulance and intensive care BENEFITS SNAPSHOT

AMOUNT PAYABLE

INITIAL ACCIDENT TREATMENT Emergency Room Doctor Office Urgent Care

$150 $50 $50

AMBULANCE

$300

LACERATIONS

Up to $400*

FRACTURES

Up to $6,000*

DISLOCATIONS

Up to $6,000*

BURNS

Up to $10,000

DENTAL

Up to $300*

HOSPITALIZATION BENEFITS Admission Daily confinement (max 365 days) ICU daily confinement (max 30 days)

Up to $2,000* $200 per day $400 per day

PROSTHETIC DEVICES

Up to $1,500*

ACCIDENTAL DEATH Employee/Spouse/Child

Up to $50,000/ $25,000 /$12,500

DISMEMBERMENT/PARALYSIS/ FUNCTIONAL LOSS

Up to $50,000*

COMA

Up to $10,000* HEALTH SCREENING BENEFIT

$75 annual benefit for completing an eligible health screening test such as blood test for triglycerides; bone density screening; mammogram; pap smear; colonoscopy; EKG; fasting blood glucose test; hemoccult stool analysis; PSA, serum cholesterol test *Benefit amount based on severity of injury; refer to the policy for full benefit details.

35

These benefits are paid directly to you, not to your doctor or hospital. Help offset your major medical deductible with benefits paid directly to you Spouse and children coverage available

Convenient payroll deduction

You can keep this insurance if you change jobs

Hospital Confinement Benefits Insured by Prudential

Out-of-pocket costs from a stay in a hospital or other medical facility can be overwhelming. When you're in the hospital or undergoing outpatient surgery, the last thing you need to worry about is how much it will cost to get better. Even when you have health insurance, premiums don't cover everything. The average expense for a hospital stay ranges from $9,100 for a medical stay to $22,700 for a surgical stay. Hospital Confinement Benefits pay a fixed daily benefit if you have a covered stay in a hospital, intensive care unit or other covered facility. Benefit amounts are listed below and depend on the type of facility and number of days of confinement. Any combination of facility confinement and admission benefits payable includes a limit, please see your certificate for further confirmation. When Your Stay Begins

HIGH Plan Benefit

LOW Plan Benefit

Hospital admission

$1,000

$750

Intensive Care Unit Admission (ICU)

$1,500

$1,000

As Your Stay Continues (beginning on day two)

Benefit payments can be used for any purpose such as:

Lost time from work HIGH Plan Benefit

LOW Plan Benefit

$200

$100

Mortgage, rent, utilities

$400

$200

Copays, deductibles and co-insurance

HIGH Plan Benefit

LOW Plan Benefit

Hospital Observation Benefit

$500

$500

Mental Illness Facility

$100

$100

Pandemic Benefit

25%

25%

Premature Infant

25%

25%

Quarantine Benefit

25%

25%

Substance Abuse Benefit

$100

$100

Hospital

(max 30 days per confinement, max 5 confinements per year)

Critical Care Unit (CCU)

(max 30 days per confinement, max 5 confinements per year)

Additional Benefits

Enroll in Hospital Confinement benefits

You are admitted to a hospital due to an illness or injury

While in the hospital, charges start to add up 36

Everyday expenses like groceries and childcare

Prudential pays you a lump sum for every day you are in the hospital up to the maximum.

Critical Illness Benefits Insured by Prudential

Major medical deductibles and out of pocket expenses continue to increase each year. While employees can’t predict a heart attack or stroke, they can help prepare for the financial impact it could have on his or her family by purchasing critical illness insurance. Critical illness insurance can help with the financial stress of a critical illness diagnosis through lump-sum cash benefits that can be used however the employee sees fit. Critical Illness benefits are designed to pay the costs associated with the initial occurrence of a heart attack, stroke, cancer or other serious illness as defined in the policy. You choose your benefit amount. Benefits are also available for your spouse and eligible children. BENEFIT AMOUNT Employee Spouse Child

Payments can be used to help pay for related expenses, medical or otherwise, including:

$20,000 or $40,000 50% of the employee amount 50% of the employee amount GUARANTEE ISSUE AMOUNT

Employee Spouse Child

Hospital bills and other medical expenses

$40,000 all amounts all amounts COVERED ILLNESS

BENEFIT

Invasive Cancer, Heart Attack, Major Organ Failure, Stroke, Renal Failure, Alzheimer’s Disease, Severe Coronary Artery Disease, Coma, Paralysis of Limbs, Third Degree Burns, Benign Brain Tumor

100%

Cancer in situ and infectious diseases such as Tuberculosis, Rabies, Osteomyelitis, Necrotizing Fasciitis, Malaria, Legionnaires Disease, Encephalitis, Diphtheria, Bacterial Meningitis, Tetanus, Anthrax, Cholera, Lyme Disease, Methicillin-Resistant Staphylococcus Aureus (MRSA), Pertussis (Whooping Cough), Rocky Mountain Spotted Fever, Typhoid Fever, COVID-19

Credit card payments and other household bills

25%

Childhood diseases such as , Sickle Cell Anemia, Cystic Fibrosis, Cerebral Palsy, Muscular Dystrophy, Down Syndrome, Spina Bifida, Cleft Lip / Palate ADDITIONAL FEATURES Recurrence benefit

Benefits for the diagnosis of a subsequent or different covered condition is payable after a 6 month separation period from diagnosis of 1st covered illness

Transportation and Lodging Benefits

Benefits for transportation expenses and lodging expenses related to a critical illness are included. Some limitations apply. Please refer to the certificate of coverage for details.

Health screening benefit

$75 annual benefit for completing an eligible health screening test such as blood test for triglycerides; bone density screening; mammogram; pap smear; colonoscopy; EKG; fasting blood glucose test; hemoccult, PSA, serum cholesterol test, and more. 37

Childcare or house-sitting for the family pet

Travel to out-of-town hospital or treatment facility Deductibles, co-pays and non-medical expenses such as missed work and housekeeping NOTE: If your spouse is also a full-time employee of Quantic Electronics, neither you nor your spouse may elect Critical Illness benefits as a dependent of the other person.

Health Screening Benefit

Included with the Accident Plan and Critical Illness Plans Insured by Prudential

GET CASH JUST FOR GETTING A HEALTH SCREENING Health screenings are important. That’s why Quantic Electronics included the Wellness Benefit Rider on your insurance policy from Prudential. It pays you a cash benefit once per calendar year when you receive a qualified screening like cardiac exams and blood tests. It’s a reward for taking care of your health — and helps pay you back for some of your premiums, too. MEET MARIA Maria knows cancer runs in her family, so she diligently goes for her screening every year. Her Critical Illness Plan includes a health screening benefit, so she got paid $75 cash.

COVERED SCREENINGS* • • • •

Blood test for triglycerides Bone marrow testing Breast ultrasound CA 125 (blood test for ovarian cancer) • CA 15-3 (blood test for breast cancer) • CEA (blood test for colon cancer)

• • • • • • •

Chest X-ray Colonoscopy Flexible sigmoidoscopy Hemoccult stool analysis Mammography Pap test PSA (blood test for prostate cancer)

• Serum cholesterol test to determine HDL/LDL level • Serum protein electrophoresis (blood test for myeloma) • Stress test on a bicycle or treadmill • Thermography

FILING A CLAIM IS EASY WAYS TO FILE:

INFORMATION YOU NEED TO FILE • Date of service • Doctor/facility name and contact info • Procedure performed

• ONLINE: step-by-step online submission here • PHONE: get assistance by calling 844.455.1002

38

Universal Life Insurance Insured by Trustmark

Trustmark Universal Life Insurance with long-term care Two important coverages in one to help protect you for life. Financial security even after a loss Protecting your loved ones is one of life’s greatest responsibilities. When a family loses someone, in addition to grief, survivors may suddenly be faced with costly expenses and debts, and even a loss of income. Universal Life can help. Whether you are married, a parent or single and starting out, Universal Life helps take care of the people important to you if tragedy happens. You can choose a benefit amount that provides the right protection for you.

Solving the long-term care issue At any point in your life, you may need long-term care services, which could cost hundreds of dollars per day. Universal Life includes a benefit for long-term care that can help pay for these services at any age.

Universal Life insurance can mean those left behind can still pursue their own dreams, and help ensure that the ending of one story won’t stop the beginning of another.

Here’s how it works: You can collect 4% of your Universal Life benefit per month for up to 25 months to help pay for long-term care services.

Universal Life sample rates Sample ranges of weekly rates for employee-only, non-smoker coverage. Your exact rate may depend on additional features selected by you and/or by your employer. Age at purchase

$25,000 policy

30

From $5.06 - $6.03

40

From $7.42 - $8.80

50

From $11.92 – 14.18

The benefit for long-term care is an acceleration of the death benefit and is not Long-Term Care Insurance. It begins to pay after 90 days of confinement or services, and to qualify you must meet conditions of eligibility for benefits. Your policy will contain complete details.

Sample rates are shown for illustrative purposes only. Rates may vary by age, smoking status, employer and features selected by you and/or by your employer. An application for insurance must be completed to obtain coverage. Universal Life is flexible permanent life insurance designed to last a lifetime.

The younger you are when you enroll, the more benefit you receive for the same premium. 39

No medical exams or blood work – just answer a few simple questions.

Universal Life Insurance Insured by Trustmark

What would happen if you weren’t around? 1 in 3 households would have immediate trouble paying for living expenses if they lost their primary earner.1

What can Universal Life benefits help pay for? Funeral and burial costs Rent or mortgage payments Tuition and loans Credit card bills Medical expenses Retirement savings

Benefit for terminal illness • Use part of your death benefit if you’re diagnosed with a terminal illness to help manage costs.

40%

40% of Americans live paycheck to paycheck. Could your family afford to stay in your home?2

56% of Americans have less than $10,000 saved for retirement – 1 in 3 have $0 saved. Wouldn’t it be nice to have some protection?3

Additional advantages • Keep your coverage at the same price and benefits if you change jobs or retire. • Apply for coverage for family members: spouse, children and grandchildren. • Convenient payroll deduction; pay via direct bill, bank draft or credit card if you leave your employer.

Individualized rates are available in bswift®, or you can visit with an AGM benefit counselor about the cost of this benefit.

This is a brief description of benefits under IUL.205 NY or GUL.205/IUL.205 and applicable riders. This policy guarantees against lapsing for 10 years as long as planned premiums are paid. If you make changes during this period, or pay only the minimum amount, your cash value may not accumulate, or your death benefit may reduce. If there is negative cash value at the end of your no-lapse period, you must make up the premium to establish positive cash value. You may need to pay more premium to maintain your policy than the rate you paid to keep the no-lapse guarantee, or coverage may end before age 100. An illustration will be delivered with your policy. For costs and coverage detail, including exclusions, reductions, limitations and terms, see your agent or write the company. Underwriting conditions may vary, and determine eligibility for the offer of insurance. In NY, this form is not complete without the insert “Limitations for Convalescent Care Benefit Rider – New York Residents.” In NY, the long-term care benefit is a Convalescent Care Benefit. 12016 Insurance Barometer Study LIMRA/Life Happens, lifehappens.org/industryresources/agent/barometer2016. 2nielsen.com/us/en/insights/news/2015/ saving-spending-and-living-paycheck-topaycheck-in-america.html. 3gobankingrates.com/retirement/1-3-americans-0-saved-retirement. 5An A.M. Best rating is an independent opinion of an insurer’s financial strength and ability to meet its ongoing insurance policy and contract obligations. Trustmark is rated A- (4th out of 16 possible ratings ranging from A++ to Suspended). In NY, plan form IUL.205 NY and applicable riders underwritten by Trustmark Life Insurance Company of New York. In other states, plan form GUL.205/IUL.205 and applicable riders underwritten by Trustmark Insurance Company, Lake Forest, Illinois. Rated A- (EXCELLENT) A.M. Best5 trustmarksolutions.com

40

Employee Assistance Program (EAP) Powered by Empathia and LifeMatters®

A Guide to LifeMatters® Services When you or your family need useful ideas, helpful resources, or reliable professional care, LifeMatters is just a phone call away. Free, confidential LifeMatters® services include: Unlimited telephonic support and three (3) Scheduled counseling visits for:  Stress, depression, and personal problems  Balancing work and personal needs  Family and relationship concerns  Alcohol or drug dependency  Workplace conflicts  Any other issue of concern in your life

Telephone counseling

Face-to-face counseling

Debt counseling

WorkLife Services:  Financial consultation and resources to set up a budget, obtain and review credit report information, or assist with debt management and consolidation.

Legal counseling

Financial counseling

Go to mylifematters.com on the Internet or your mobile device and enter the password to access resources, educational information, and self-service options.

 Legal consultation with an attorney either over the phone or face-to-face for consumer law, traffic citations and fender benders, family law, or estate planning.

Services provided directly by LifeMatters® are free. If you are referred to outside resources, you will be advised about your costs, if any.

Online and assisted searches for:  Child and elder care resources and guidance  Adoption assistance  Educational resources  Personal security  Online calculators for a variety of analytical questions and needs  Home improvement  Veterinarians, pet sitting, and obedience training

For more information, call LifeMatters® at 1-800-6346433 or visit mylifematters.com — password QE1. Call LifeMatters® toll-free anytime. 800-634-6433 Assistance with Life, Work, Family, and Wellbeing • 24/7/365 TDD and language translation services are available Call collect to 262-574-2509 if outside of North America Visit LifeMatters® online at mylifematters.com or

The program’s user-friendly, confidential services are available to you and your eligible dependents 24 hours a day, every day of the year by calling:

facebook.com/lifematterseap

800-634-6433 41

Employee Assistance Program (EAP) Powered by Empathia and LifeMatters®

Ten Reasons to Use LifeMatters® 1) Legal consultation. Your neighbor tripped over a crack in your sidewalk and is now suing you. LifeMatters® can connect you with an attorney for a free 30-minute consultation.

7) Credit report review. You and your spouse want to buy a house, but you aren’t sure whether your credit is good enough to secure a loan. LifeMatters® can help you review your credit report and discuss options.

2) Debt management. Your credit cards are maxed out and you don’t know how you are going to pay your next electric bill. LifeMatters ® can connect you with a financial advisor.

8) Stress management techniques. You are feeling overwhelmed and having difficulty sleeping. You feel like there is no one you can count on and no one who will listen to you. LifeMatters® offers support and encouragement 24/7/365. Someone is always here, even in the middle of the night when you can’t sleep.

3) Elder care resources. You and your spouse are unable to provide your elderly father with the assistance he needs. LifeMatters® can help you find resources.

9) Information and self-assessments. You want to learn more about drug and alcohol abuse and whether or not you have a problem, but you aren’t ready to talk to someone about it yet. The LifeMatters® website provides educational articles on these and other topics, as well as self-assessments to help you determine if you need to seek help for substance abuse.

4) Tobacco cessation assistance. You’ve been a smoker for as long as you can remember and have tried to quit more times than you can count. LifeMatters® provides a tobacco cessation program that includes telephonic counseling to help you succeed where other methods have failed. 5) Facing your fears. You are terrified of flying and need to go on a business trip. You don’t want your boss to know about your fear, but the idea of stepping on a plane makes you panic. LifeMatters® can give you the tools you need to face your fears.

10) Parenting tips. You have a teenage son who stays out all night, doesn’t do his homework, and becomes confrontational when you try to discipline him. You’re at the end of your rope. LifeMatters® can help by listening to your concerns and provide assistance with establishing appropriate boundaries.

6) Information on colleges and universities. Your daughter is beginning her search for her dream university and is overwhelmed by all the options. LifeMatters® offers services that can help you find the school that best meets her needs.

No matter what your concern, LifeMatters® is available to help. It is free and confidential, and you can even remain anonymous. To access LifeMatters® services, call 1-800- 634-6433 or visit mylifematters.com

For more information, call LifeMatters® at 800-634-6433 or visit mylifematters.com — password QE1. 42

Guidance Resources Powered by ComPsych

An Overview of Your GuidanceResources® Program No matter what’s going on in your life, ® GuidanceResources is here to help Personal problems, planning for life events or simply managing daily life can affect your work, health and family. GuidanceResources® is a company-sponsored service that is available to you and your dependents, at no cost. This flyer explains how GuidanceResources® can help you. Confidential Counseling on Personal Issues Your Guidance Resources Program is a confidential program to help address the personal issues you and your dependents are facing. This service, staffed by experienced clinicians, is available by phone 24 hours a day, seven days a week. A GuidanceConsultant℠ is available to listen to your concerns and refer you to a local provider for inperson counseling or to resources in your community. Call any time with personal concerns, including: • Stress and anxiety • Depression • Marital/family conflicts • Alcohol and drug abuse • Grief and loss • Job pressures Financial Information, Resources and Tools Financial issues can arise at any time. Our financial professionals are here to discuss your concerns and provide you with the tools and information you need to address your finances, including: • Saving for college • Tax questions • Getting out of debt • Estate planning • Retirement planning

Legal Information, Resources and Consultation When a legal issue arises, our attorneys are available to provide confidential support with practical, understandable information and assistance. If you require representation, you can also be referred to a qualified attorney in your area for a free 30-minute consultation with a 25% reduction in customary legal fees thereafter. Call any time with legal issues including: • Divorce and family law • Debt obligations • Landlord/tenant issues • Real estate transactions

• Bankruptcy • Criminal actions • Civil lawsuits • Contracts

Online Information, Tools and Services GuidanceResources® Online is your one stop for expert information to assist you with the issues that matter to you, from personal or family concerns to legal and financial concerns. Create your own account by going to www.guidanceresources.com. Each time you return to the site, you will find personalized, relevant information based on your individual life needs. WE ARE AVAILABLE 24 HOURS A DAY, 7 DAYS A WEEK. Call: 800.311.4327 TTY: 800.697.0353 Online: guidanceresources.com Your company WebID: GEN311 43

Prudential Beneficiary Advocate Powered by ComPsych

Prudential Beneficiary Advocate℠ Prudential understands that for those coping with the loss of a loved one, grief counseling can prove invaluable. Grieving loved ones, however, may require many other forms of assistance, including legal and financial services and funeral and estate planning. This is why we offer Beneficiary Advocate by Prudential, a comprehensive program of beneficiary services to help, no matter what the issue. Prudential has a thorough understanding of the unique responsibilities and difficulties in these situations. Whether coping with other family members' grief, struggling with estate-related issues, or coordinating urgent childcare or elder care needs, beneficiaries can benefit from the comprehensive, best-in-class services offered by Prudential in partnership with the worldwide leader in behavioral health solutions, ComPsych® Corporation. Comprehensive Beneficiary Support Beneficiaries can contact ComPsych 24 hours a day, seven days a week regarding behavioral and emotional health issues, along with family, legal and financial matters. All services are accessible via a dedicated tollfree line and connect you directly to a GuidanceExpert℠, who will conduct an assessment of your issues and put you in touch with the appropriate services. Our support includes:

Online Will Preparation Services EstateGuidance can help you secure your future by overcoming the legal, financial and emotional barriers to estate planning. This online service allows you to create a legally binding Last Will and Testament, Living Will and Final Arrangements document, without the hassle or expense of hiring a lawyer. EstateGuidance walks you through the documentation process and breaks down each step into easy-to understand terms.

Emotional Support for Grief and Loss • Unlimited, 24/7 toll-free phone access to masterslevel clinicians for in-the-moment support • Assessment and action planning to help you develop an individualized course of action • Up to three face-to-face or telephonic counseling sessions with a local provider. Talk to us about: o Grief and Loss o Anxiety, stress, depression o Guidance on returning to work, and more

Identity Theft Restoration Services Sadly, recent beneficiaries are often the targets of fraud and identify theft. IDResources® includes unlimited telephonic assistance from our staff of attorneys, financial professionals and counselors. Services are designed to address legal, financial and work/life issues associated with identity loss, assist with restoration of identity, and assist with damage to credit history. Financial Planning Services FinancialPoint® provides objective financial planning guidance to beneficiaries. This simple-to-follow online process makes it easy for individuals to create a financial plan to carry them forward in the wake of a loved one's passing. Users are given step-by step instructions to complete the data-gathering and personal investment viewpoint questionnaires online. A FinancialPoint expert reviews the individual's responses; corresponds directly with them for additional information or questions, and provides a detailed, customized personal financial plan.

Funeral Planning Services Planning a funeral can feel overwhelming. It is a stressful time and many decisions need to be made in a short timeframe. Many feel overwhelmed with the process and can be vulnerable to being taken advantage of financially. Final Arrangements services can prevent that. Our Funeral Planning Experts are specially trained to gather information and provide options so you can make the right decisions. Services include: • Thorough assessment of your needs • Options, pricing and availability for funeral homes, caskets, urns, cemeteries and more • Comprehensive referral packet with three detailed referrals for each needed resource

WE ARE AVAILABLE 24 HOURS A DAY, 7 DAYS A WEEK. Call: 833.962.0064 TTY: 800.697.0353 Online: guidanceresources.com Your company Web ID: ADVOCATE 44

Travel Assistance

Powered by IMG Travel Assistance Services

IN T ERN A T IO N A L

ME D I C A L

GRO UP ®

TRAVEL ASSISTANCE SERVICES

UNDERSTANDING YOUR NEEDS. EXCEEDING YOUR EXPECTATIONS Congratulations, you now have access to IMG’s Travel Assistance Services, an indispensable offering available to you and your dependents. IMG has extensive experience handling complex and remote medical transport situations, as well as providing support for travel concerns when they arise. Our team of international, multilingual specialists are accustomed to working across time zones and with different languages and currencies. Utilizing IMG’s extensive global network of medical care providers, our onsite 24/7/365 U.S.-based call center is available day or night to provide high-quality care you can depend on. EMERGENCY MEDICAL TRANSPORTATION SERVICES • Dispatch of a physician • Emergency medical evacuation • $25,000 emergency hospitalization guarantee payment* • Medical repatriation

• • • • •

Return of dependent children Repatriation of remains Return of travel companion Vehicle return services Visit of a family member or friend

*Only available when traveling outside your home country and the U.S., and can only be used in conjunction with an eligible medical evacuation

MEDICAL ASSISTANCE SERVICES • Convalescence arrangements/emergency travel arrangements • Outpatient and inpatient care • Interpretation services • Medical monitoring TRAVEL ASSISTANCE SERVICES • Emergency cash transfer • Consulate and embassy location • ID theft assistance • Legal referrals SECURITY ASSISTANCE SERVICES • Emergency political evacuation/repatriation • Location intelligence app

• • • •

Medical and dental referrals Prescription drug transfer and shipping Telemedicine Replacement of medical devices

• • • •

Lost luggage and/or document assistance Pet housing and return Pre-trip informational services Urgent message relay

• Natural disaster evacuation

Toll-free from within the U.S.: +1 (855)847-2194 / From anywhere in the world: +1 (317)927-6881 [email protected] 45

Discounted Home and Auto Insurance Liberty Mutual Insurance

We customize. You could save $947.



Switch to customized insurance and only pay for what you need. As an employee of Quantic Electronics, you could save $947 by bundling your auto and home insurance.†

More benefits you’ll love: Violation-Free Discount Customers can earn a discount for three years of violation-free driving. Get an even larger discount when you reach five years.

Multi-Policy Discount When you insure both your car and your home with Liberty Mutual, you qualify for comprehensive protection and additional savings.

Better Car Replacement™|| If your car is totaled, we’ll give you the money for a model that’s one year newer.

Loss Forgiveness# Your price won’t increase because of the first qualified loss in your home. Convenient Payment Options§ We are committed to making billing easy and hassle-free. Have your payments deducted automatically from your checking or savings account.

24-Hour Roadside Assistance If your car breaks down, we won’t leave you stranded. From a jump-start to a tow, our optional 24-Hour Roadside Assistance will get you moving again.

For a free quote, call 1-855-804-8626 or visit www.libertymutual.com/quantic Client #137255 AUTO

|

HOME

|

RENTERS

|

UMBRELLA

|

MOTORCYCLE

|

CONDO

|

WATERCRAFT

Savings validated by new customers who switched to Liberty Mutual between 1/2020-10/2020 and participated in a countrywide survey. Savings may vary. Comparison does not apply in MA. Discounts and savings are available where state laws and regulations allow and may vary by state. Certain discounts apply to specific coverages only. To the extent permitted by law, applicants are individually underwritten; not all applicants may qualify. Optional coverage in some states; availability varies by state. Eligibility rules apply. Coverage is provided on the optional Towing & Labor Coverage endorsement. May vary by state. Applies to mechanical breakdowns and disablements only and may be subject to limits. Subject to eligibility requirements. Benefits and eligibility requirements may vary by state. Coverage provided and underwritten by Liberty Mutual Insurance Company or its subsidiaries or affiliates, 175 Berkeley Street, Boston, MA 02116. In Texas, coverage provided and underwritten by one or more of the following companies: Liberty Insurance Corporation, Liberty Lloyds of Texas Insurance Company, Liberty Mutual Fire Insurance Company, Liberty Mutual Personal Insurance Company, Peerless Indemnity Insurance Company, and Liberty County Mutual Insurance Company. Learn more about our privacy policy at libertymutual.com/privacy. ©2021 Liberty Mutual Insurance 14991546

46

20PER909210-02B CW 2021/03

Watch and Learn Video Library CLICK on the video camera icon next to each topic to continue exploring your benefits. Medical benefits insured by BlueCross BlueShield Texas Make the most of your health coverage by exploring Blue Access for Members (BAM), the gateway to help manage your personal health information. Dental benefits administered by Delta Dental of Texas Learn how you can check your plan details, view claims history, view or print your ID card, estimate the cost of your next procedure and more. Vision benefits insured by VSP See what VSP can do for you and your vision health. VSP benefits are affordable and offer great savings. Members save an average of $329. Health Savings Account (HSA) administered by Wex Is an HSA right for you? Learn more about the value flexibility, convenience and “triple tax savings” advantages of a health savings account and how an HSA can help you control your healthcare costs now and into the future. Health Reimbursement Arrangement (HRA) administered by Wex Learn how an HRA can help you stretch the value of your health care dollars for eligible health care expenses and over-the-counter items.

What is an FSA?

Flexible Spending Accounts (FSA) administered by Wex FSAs are a benefit that allows you to choose how much of your paycheck you’d like to set aside, before taxes are taken out, for healthcare or dependent care expenses. This saves you money by reducing your taxable income.

Dependent Care FSA

Accident, Critical Illness and Hospital Confinement benefits insured by Prudential Learn how Accident, Critical Illness and Hospital Confinement benefits can help with money when you need it most. Universal Life benefits insured by Trustmark Choosing to buy insurance can be a tough decision. Learn more about why Universal Life benefits could help protect your family’s financial future. 47

Benefit Premiums (26 bi-weekly pay periods)

MEDICAL BENEFITS $6,350 HSA Plan

$3,000 HSA Plan

$3,000 PPO Plan

$1,000 PPO Plan

Employee Only

$51.20

$59.02

$61.87

$68.46

Employee + Spouse

$98.96

$114.09

$119.59

$132.34

Employee + Child(ren)

$94.97

$109.49

$114.76

$127.00

Employee + Family

$146.93

$169.40

$177.55

$196.49

DENTAL BENEFITS BASIC Plan

HIGH Plan

Employee Only

$2.22

$4.49

Employee + Spouse

$4.91

$8.69

Employee + Child(ren)

$6.64

$10.38

Employee + Family

$10.21

$15.76

VISION BENEFITS Employee Only

$0.64

Employee + Spouse

$1.29

Employee + Child(ren)

$1.46

Employee + Family

$2.29 ACCIDENT BENEFITS

Employee Only

$7.27

Employee + Spouse

$9.63

Employee + Child(ren)

$10.09

Employee + Family

$13.90 48

Benefit Premiums (26 bi-weekly pay periods)

VOLUNTARY LIFE & ACCIDENTAL DEATH EMPLOYEE PREMIUM AND SPOUSE PREMIUM BENEFIT AMOUNT

AGE

Get in touch

Social

© Copyright 2013 - 2024 MYDOKUMENT.COM - All rights reserved.