2026-2027 Benefits Guide
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Table of Contents ENROLLMENT ELIGIBILITY .................................................................................................. 4 BENEFIT CARRIER CONTACT INFORMATION ...................................................................... 8 MEDICAL PLANS ............................................................................................................... 10 MEDICAL PLAN SUMMARY COMPARISON CHART............................................................ 11 VISION PLAN .................................................................................................................... 18 DENTAL PLAN................................................................................................................... 21 HEALTH REIMBURSEMENT ACCOUNT (HRA) .................................................................... 23 FLEX SPENDING ACCOUNTS (FSA) .................................................................................... 24 GROUP TERM LIFE INSURANCE ........................................................................................ 26 ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) COVERAGE ................................... 26 LIFE INSURANCE FEATURES.............................................................................................. 26 LONG-TERM DISABILITY (LTD) .......................................................................................... 27 OPTIONAL TERM LIFE INSURANCE ................................................................................... 28 WELLNESS ........................................................................................................................ 34 OPTIONAL BENEFITS ........................................................................................................ 37 LEAVE............................................................................................................................... 42 RETIREMENT .................................................................................................................... 43 TRAINING......................................................................................................................... 46 REQUIRED NOTICES ......................................................................................................... 47
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ENROLLMENT ELIGIBILITY Employee Eligibility All active full-time employees are eligible for full benefits. Full-time is defined as employees who work more than 30 hours per week. Dependent Eligibility Dependents who meet the descriptions listed below are eligible for coverage. Full-time employees may elect medical, dental, and dependent life coverage for their dependents within 30 days of being hired. Current full-time employees may elect health care coverage for their dependents during the Open Enrollment period or within 30 days of experiencing a Qualifying Life Event. • Your spouse – the person to whom you are legally married. • Your child – your biological child, child with a qualified medical support order, legally adopted child, or child placed in the home for the purpose of applicable state and federal laws through the end of the month in which the child turns age 26. • Your stepchild – the child of your spouse for as long as you remain legally married to the child’s parent through the end of the month in which the child turns age 26. • Legal guardianship – a child for whom you have legal guardianship in accordance with an Order of Guardianship pursuant to applicable state or federal laws or a child for whom you are grant court-ordered temporary or other custody through the end of the month in which the child turns age 26. • Your adopted child – a child through adoption through the end of the month in which the child turns age 26. • Other Medical Support Order – a child in accordance with a Court Order pursuant to applicable state or federal laws. • Children over the age of 26 with permanent intellectual or physical disabilities if: o They were enrolled before they turned 26 and remain covered or they were over the age of 26 at the time of the enrollee’s initial enrollment; and o They are incapable of self-sustaining employment because of the intellectual or physical disability; and o They are dependent on the enrollee for care and financial support. How to Enroll in Benefits New hires will complete their benefit enrollment forms through the NEOGOV Onboarding portal and will also create an ADP account as first-time users to make benefit elections. Instructions will be emailed to new hires on how to register for ADP and make benefit elections. Current EAA employees will elect benefits via ADP during the annual Open Enrollment period. Instructions to make benefit elections will be emailed to employees prior to each annual Open Enrollment period. Employees are automatically enrolled in the following EAA plans and the required payroll deductions for TCDRS: • Basic Life & AD&D Insurance – no cost to the employee • Long Term Disability – no cost to the employee • Texas County District Retirement System (TCDRS) – 7% mandatory contribution Benefit elections become effective on the first of the month following date of hire. TCDRS becomes effective on date of hire.
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Coverage Effective Dates The following effective dates apply provided the appropriate enrollment transaction (electronic or paper form) has been completed within the applicable enrollment period. Your coverage is effective for you and your dependent as follows: New Hire If you enroll within 30 days from date of hire, coverage for you and any dependents you enroll will be effective on the first of the month following date of hire. Annual Open Enrollment If you enroll during annual Open Enrollment, coverage for you and any dependents you enroll will be effective on the beginning of the plan year, October 1st. If you do not submit the appropriate enrollment forms during the required eligibility period of 30 days, you will have to wait until the next open enrollment period or experience a qualifying life event to make enrollment changes to your medical health plans. Coverage End Dates Coverage for you and your dependents will end on the earliest of the following: • The date the plan in question is terminated. • The last day of the month, in which you voluntarily terminate you or your dependents’ coverage. • The last day of the month in which you or your dependents no longer meet eligibility requirements. • The last day of the month your dependents no longer meet eligibility due to age. Waiving Coverage If you have medical coverage under another plan, you may choose to decline (waive) the EAA’s medical plans. When an employee makes this choice, a “Declination of Coverage” form must be completed and returned to Human Resources. If you decide later that you would like coverage, you will not be able to enroll until the next Open Enrollment period or within 30 days of a qualifying life event. Some examples of other coverage could be: • Your spouse’s or parents’ plan • A government insurance program • An individual policy or other group coverage Qualifying Life Events A qualifying event is a life event that may allow an employee to add or drop coverage after being hired and outside of the Open Enrollment period. The change must be consistent with the event and documentation (i.e., marriage license, birth certificate, divorce decree, etc., ) must be provided to the HR Administrator within 30 days of the event. Please call or email the HR Administrator to schedule an appointment. You can add, drop or change coverage for yourself and your dependents when you experience a Qualifying Life Event such as: • Marriage • Divorce • Birth or adoption of a child
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• Death • Child reaching age 26
• Child’s loss of eligibility on another plan • Spouse’s gain or loss of other coverage A child is terminated from medical and dental on the last day of the month he/she attains age 26. When a child gains or loses Children’s Health Insurance Program also known as CHIP, employees have 60 days to provide documentation of the gain or loss of coverage to make a corresponding change to their coverage (adding or dropping). If notification isn’t made to the HR Administrator within 30 days of the event, then employees must wait until the next Open Enrollment period. However, you must notify the HR Administrator to drop coverage for dependents who no longer meet eligibility requirements. Coverage effective dates for Qualifying Life Events Qualifying Event – Other than Birth/Adoption of Child If you enroll within 30 days of the qualifying life event, coverage for you and any dependents you enroll will be effective on the first day of the month following the date you submit the enrollment form. Qualifying Event – Birth/Placement/Adoption of Child If you enroll within 30 days of the date of birth, coverage will be effective on the date of birth; even if you have family coverage, you must complete an enrollment form. Premium is due for any period of dependent coverage if the dependent is subsequently enrolled, unless, specifically not allowed by applicable law. Additional premium may not be required when dependent coverage is already in force. If you enroll within 30 days of the court-ordered adoption, placement for adoption, guardianship or conservatorship of a child, coverage will be effective on the date of the adoption, placement for adoption, guardianship or conservatorship; even if you have family coverage, you must complete a Benefits Enrollment Form. Enrollment Tips • Have Social Security numbers, birth dates and required documentation to enroll your eligible dependents. • Choose your options carefully. Once you make an election as a new hire, during open enrollment or within the 30-day qualifying event window, you cannot cancel or change to another plan (i.e., switch your health insurance plan). Group insurance plan premiums are deducted from your paycheck before calculating payroll taxes. Because of these pretax tax savings, the IRS determines when you may make changes—either annually during open enrollment or during the plan year if you experience a qualifying life event. • Enroll online in ADP during open enrollment or within 30 days from your date of hire if you are a new employee. If you miss either of these enrollment deadlines, then you must wait until the next open enrollment period unless you experience another qualifying event during the year that allows you to make a change. • If you are hired during open enrollment and your benefits become effective prior to the new plan year, you will have to make new hire elections for the current year first, and then make open enrollment elections/changes for the next plan year.
• Medical benefit plans run from October 1st through September 30th. • Medical deductibles run from January 1st through December 31st.
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Enrollment Form Errors It is your responsibility to ensure that information on your Benefits Enrollment Form is correct. If an error occurs, notify the Human Resources Administrator immediately. Premium Deduction Errors It is your responsibility to verify that the premium deductions taken from your paycheck are correct. Any deduction errors must be reported immediately to the HR Administrator. If an underpayment occurs, the EAA has the right
to collect any additional premiums owed. Human Resources Contact Information
Human Resources Contact Information
Hilda Campos, Sr. HR Administrator (210) 477-8508
hcampos@edwardsaquifer.org
Raquel Garza, Sr. Director/CHRO
(210) 477-5137
rgarza@edwardsaquifer.org
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BENEFIT CARRIER CONTACT INFORMATION Contact the HR Administrator for questions regarding insurance plans, premiums, eligibility or enrollment. For claims information, please contact the carriers below for assistance. Provider/Plan Contact Information Website MEDICAL Cigna (800) 244-6224 Claims Mailing Address: PO Box 182223 Chattanooga, TN 37422-7223 www.cigna.com DENTAL Ameritas (800) 659-2223 www.ameritas.com
VISION Ameritas
(800) 659-2223
www.ameritas.com
LIFE INSURANCE - Life, AD&D, Vol Life Securian Financial LONG TERM DISABILITY Madison National Life Insurance Co.
(833) 810-8260
www.securian.com
(800) 356-9601
www.madisonlife.com
(210) 659-8100 (888) 659-8151 ask@proficientbenefits.com
HRA/FSA Proficient Benefit Solutions
www.proficientbenefits.com
RETIREMENT TCDRS Group# 448
Member Services (800) 823-7782
www.TCDRS.org
MissionSquare 457 Group #304645 IRA Group #701784 IRA Group #705239 RHS Group #801871
(800) 669-7400 Mailing Address: PO Box 96220 Washington, DC 20090
www.missionsq.org
401a Group #100069(MP) 401a Group #1000105 (PS)
Voluntary Benefits
AFLAC
(800) 992-3522 admin@canalichiogroup.com
www.aflac.com
Gold’s Gym
(210) 489-6239 or call any Gold’s Gym location directly (800) 654-7757 memberservices@legalshield.com support@getpeanutbutter.com (319) 355-8511 admin@canalichiogroup.com 800-891-2565 customercare@petbenefits.com
www.goldsgym.com
Legal Shield
www.legalshield.com
Peanut Butter Student Loan Program
www.getpeanutbutter.com/
TransAmerica
www.transamerica.com
Pet Benefit Solutions
www.petbenefits.com/land/edwardsaq uifer www.texastuitionpromisefund.com
Texas Tuition Promise Fund
1-800-445-4723
YMCA
(210)-246-9600 or call any YMCA location directly
www.ymcasatx.org
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MEDICAL PLANS Medical coverage for full-time employees is provided through Cigna and there are two medical plan options to choose from, the Open Access Plan (OAP) or the High Deductible Health Plan (HDHP). Each plan provides comprehensive major medical and prescription drug coverage as well as preventative care benefits and wellness programs. The premium rates for the medical plans being offered by the EAA are effective for the current plan year and run from October 1, 2026 through September 30, 2027. The EAA will pay 100% of the premium for the employee only cost on both plans. Employees may elect to add dependent coverage to their plan, however the cost associated with adding dependent coverage is to be paid for by the employee. The OAP plan is an Open Access Plan that provides in and out of network coverage and has pre-set copays and deductibles. Once you meet your calendar year deductible, the plan will pay 70% coinsurance for in-network covered services while you pay 30%. A referral is not required to see a specialist. For additional information regarding the various services, deductibles and copays, please refer to the Summary of Benefits located at the end of this booklet. The HDHP is a high deductible health plan that provides in and out of network coverage. Services under this plan are paid 100% by the employee until the calendar year deductible has been met. Once the calendar year deductible has been met, the plan covers benefits at 100%. A referral is not required to see a specialist. For additional information regarding the various services, deductibles and copays, please refer to the Summary of Benefits located at the end of this booklet. To compare the premium between the two plans and determine what your biweekly cost will be, see Tables I and II. These tables reflect what the biweekly and monthly costs are. Premiums for benefits are based on 24 pay periods annually. Employees who enroll in a medical plan will be automatically enrolled in a Health Reimbursement Arrangement (HRA) account. An HRA account is an employer-funded plan that reimburses employees for qualified medical expenses at no cost to employees. Depending on the plan that is selected, the EAA will contribute a set dollar Open Access Plus (OAP) Table I Biweekly Employee Cost Monthly Employee Cost Employee Only $0.00 $0.00 Employee + Spouse $583.40 $1,166.80 Employee + Child(ren) $450.20 $901.04 Employee + Family $1,033.92 $2,067.84 HDHP Plan – OAP HDHPQ Table II Biweekly Employee Cost Monthly Employee Cost Employee Only $0.00 $0.00 Employee + Spouse $463.29 $926.58 Employee + Child(ren) $357.77 $715.53 Employee + Family $821.05 $1,642.11
amount towards the employee’s Health Reimbursement Arrangement (HRA) account. For new hires, this contribution amount is prorated. The prorated amount is determined by the number of full months from an employee’s hire date to the remainder of the plan year. For example, if you are hired on July 5th and elect the PPO plan, then the HRA amount will be 5/12th of the annual contribution ($1000/12 X 5 = 416.67).
HRA ANNUAL CONTRIBUTION
OAP Medical
$0.00
OAP Dental/Vision
$1,000.00 $3,499.99 $1,000.00 $500.00
HDHP Medical
HDHP Dental/Vision
HDHP FSA
Employees enrolled in the PPO Plan will be enrolled in an HRA that can be applied to medical, dental and vision expenses. Employees enrolled in the HDHP plan will be enrolled in two separate HRA accounts. One account is exclusive to medical expenses and the other is only for dental and vision expenses. If enrolled in the HDHP plan, you will also receive an employer FSA contribution. For more info on FSA accounts, refer to page 17.
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For a brief overview of the two plans, please see the following comparison chart.
MEDICAL PLAN SUMMARY COMPARISON CHART
Cigna OAP
Cigna HDHP
OUT-OF- NETWORK
Services you may need
IN-NETWORK
IN-NETWORK
OUT-OF-NETWORK
Calendar Year Deductible Individual
$5,250 $15,750
$5,250 $15,750
$6,000 $12,000
$6,000 $12,000
Family
Coinsurance Out-of-Pocket Max per cal. Year Individual $5,850
$5,850 $17,550
$6,000 $12,000
$6,000 $12,000
Family
$17,550
Office Visits
Primary care visit to treat an injury or illness
$50 copay/visit Deductible does not apply $100 copay/visit Deductible does not apply
30% coinsurance Deductible does not apply for immunizations
50% coinsurance Deductible does not apply
100% after cal yr deductible
Specialist
Preventative care
Preventive Care/Screening/ Immunization
No charge; Deductible does not apply
50% coinsurance Deductible does not apply
No charge; Deductible does not apply
30% coinsurance Deductible does not apply
Diagnostic Testing
No charge; Deductible does not apply
100% after cal yr deductible
X-Ray / Blood work
50% coinsurance
30% coinsurance
Other Diagnostic Procedures Imaging (CT/PET scans, MRIs)
100% after cal yr deductible 100% after cal yr deductible 100% after cal yr deductible 100% after cal yr deductible
30% coinsurance
50% coinsurance
30% coinsurance
Durable Medical Equipment
30% coinsurance
50% coinsurance
30% coinsurance
Physician/Surgeon Fees
30% coinsurance
50% coinsurance
30% coinsurance
$75 copay Deductible does not apply $500 copay/visit plus 30% coinsurance. Deductible does not apply
$75 copay Deductible does not apply $500 copay/visit plus 30% coinsurance Deductible does not apply
100% after cal yr deductible
Urgent Care
Emergency Room Care (copay waived if admitted)
100% after cal yr deductible
100% after cal yr deductible
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Emergency Medical Transportation Outpatient Surgery Facility fee
100% after cal yr deductible
100% after cal yr deductible
30% coinsurance
30% coinsurance
(ambulatory surgery center) Physician/Surgeon Fees Facility fee (hospital room) Physician/Surgeon Fees Extended Care Services Home Health Care Hospital Stays
100% after cal yr deductible
30% coinsurance
50% coinsurance
30% coinsurance
100% after cal yr deductible 100% after cal yr deductible 100% after cal yr deductible 100% after cal yr deductible 100% after cal yr deductible 100% after cal yr deductible 100% after cal yr deductible 100% after cal yr deductible 100% after cal yr deductible 100% after cal yr deductible 100% after cal yr deductible 100% after cal yr deductible 100% after cal yr deductible
30% coinsurance
50% coinsurance
30% coinsurance
30% coinsurance
50% coinsurance
30% coinsurance
30% coinsurance
50% coinsurance
30% coinsurance
Skilled Nursing Facility
Hospice Care 30% coinsurance Mental Health/Behavior Health/ Substance Abuse Services (Certain services must be preauthorized) Inpatient Services 30% coinsurance 50% coinsurance 30% coinsurance 30% coinsurance 50% coinsurance
$100 copay/visit Deductible does not apply
Outpatient Services (Office Visits) All other outpatient services Rehabilitation Services
50% coinsurance
30% coinsurance
30% coinsurance
50% coinsurance
30% coinsurance
$100 copay/visit Deductible does not apply $100 copay/visit Deductible does not apply $100 copay/visit Deductible does not apply
Physical Therapy
50% coinsurance
30% coinsurance
Speech, Hearing & Occupational Therapy
50% coinsurance
30% coinsurance
Chiropractic Care
50% coinsurance
30% coinsurance
If you are pregnant Office Visits
30% coinsurance
50% coinsurance
30% coinsurance
Childbirth/delivery professional services
30% coinsurance
50% coinsurance
30% coinsurance
Inpatient services
30% coinsurance
50% coinsurance
30% coinsurance
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PRESCRIPTION DRUG COVERAGE
Cigna OAP
Cigna HDHP
OUT-OF- NETWORK
IN-NETWORK
IN-NETWORK
OUT-OF-NETWORK
Retail Prescription (retail, 30 day supplies) Deductible does not apply Generic drugs (Tier 1) $20 copay 50% coinsurance
100% after cal yr deductible
Preferred brand drugs (Tier 2)
$50 copay
50% coinsurance
100% after cal yr deductible
Non-preferred brand drugs (Tier 3)
In-network Federally required preventive drugs will be provided at no charge.
$100 copay
50% coinsurance
Specialty drugs (Tier 4)
$150 copay
50% coinsurance
Mail Service Prescription (copays per 90-day supply) Deductible does not apply
$60 copay
Generic drugs (Tier 1) Preferred brand drugs (Tier 2)
$150 copay
100% after cal yr deductible
100% after cal yr deductible
50% coinsurance
Non-preferred brand drugs (Tier 3) Specialty drugs (Tier 4)
$300 copay
N/A More information about prescription drug coverage is available at https://www.cigna.com/individuals families/member-guide/offered-by-employers-drug-list
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MEDICAL PLAN FEATURES Finding a Cigna Network Provider
To get the most from your medical benefits, it is important to confirm that your doctor, hospital, or other healthcare provider participates in your Cigna Healthcare network. Cigna’s online provider directory allows you to search for participating providers by name, specialty, location, and other criteria. To search for a provider, visit Cigna.com and select “Find a Doctor.” Under “How are you Covered?” select “Employer or School.” Enter the city, state, or ZIP code where you would like to search, then search by provider name, specialty, or another search term. Answer any additional questions and verify where you live to identify the networks available in your area. You may then select the Cigna plan offered by EAA to view providers participating in that plan’s network. Search results can be further refined by distance, years in practice, specialty, languages spoken, and more. Because provider participation can change, you are encouraged to verify that their providers participate in the applicable Cigna network before receiving services. Accessing Your Cigna ID Card After logging in, select “ID Cards” to view your card as well as ID cards for your covered dependents. You can also email a copy of the ID card directly to your healthcare provider or save your digital ID card to your Apple Wallet for easy access. If you have not registered for myCigna, visit myCigna.com or download the myCigna App to create your account. Cigna One Guide® Cigna One Guide® provides personalized support to help you understand your medical plan and make informed healthcare decisions. During your enrollment period, a One Guide representative can help you understand your plan options, compare available coverage, check whether your doctors are in-network, and answer questions about provider networks and benefits. To speak with a representative during your enrollment period, call 888 806-5094. After enrollment, One Guide continues to provide personalized assistance to help you resolve healthcare issues, find in-network providers and facilities, obtain cost estimates, understand your medical bills, and get the most from your benefits while helping you save time and money. Once enrolled, you can access One Guide through myCigna.com, the myCigna App, live chat, or by phone. Health Information Line Not sure where to go for care? The Cigna Healthcare® Health Information Line can help you decide whether your needs may be best addressed by your primary care provider, urgent care, emergency room, or another care option. At no additional cost, trained nurses are available to answer your health questions and help you make an informed choice based on your needs. To connect with a health advocate, log in to the myCigna App or myCigna.com. With myCigna®, you can conveniently access your medical ID card anytime from your computer or mobile device. Your digital ID card is available through myCigna.com or the myCigna App, so you don’t have to worry about keeping track of a physical card.
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Virtual Care with MDLIVE Through Cigna Healthcare, you and your covered family members have access to MDLIVE, providing convenient virtual healthcare by phone or video, with appointments available in English or Spanish. MDLIVE gives you access to a variety of care options from the convenience of home. Primary Care: Schedule virtual appointments for preventive care, referrals, prescriptions, lab work, and diagnostic tests. You can also establish an ongoing relationship with the same primary care provider to help manage chronic conditions and routine care.
Urgent Care: Access convenient care for many minor illnesses and injuries, including infections, cold and flu symptoms, and sinus problems. Pediatric care is also available, providing an alternative to visiting an urgent care center or emergency room for non-emergency needs. Dermatology: Receive care for common skin, hair, and nail conditions such as acne, eczema, psoriasis, and rosacea. Upload photos and describe your symptoms for review by a board-certified dermatologist. A diagnosis and customized treatment plan are typically provided within 24 hours, with no appointment required. Behavioral Care: Connect privately with licensed therapists and board-certified psychiatrists for support with anxiety, stress, life changes, grief, depression, and other behavioral health needs. Appointments can be scheduled at a convenient time, with the option for recurring sessions with the same provider. How to Access MDLIVE
Log in to myCigna.com or the myCigna App and select “Talk to a Doctor.” Choose the type of virtual care you need, medical or counseling, review the estimated cost, and schedule an appointment or begin an available visit. You may also contact MDLIVE at 888-726-3171. Costs and covered services may vary based on your Cigna medical plan. Cigna Healthcare Wellness Experience℠
The Cigna Healthcare Wellness Experience℠ is available at no additional cost and provides tools and resources to help you reach your health and wellness goals. You can personalize your experience by connecting an activity tracker and selecting topics that interest you, complete a health assessment to better understand your health and potential risks, and track healthy habits over time. You can also participate in wellness challenges with coworkers and invite up to 10 friends or family members to help keep you motivated. Once your Cigna plan is active, you can access the Wellness Experience through the Wellness tab on myCigna.com
or the myCigna® App. Cigna Healthy Babies
Cigna Healthy Babies provides support and resources throughout your pregnancy. The program includes educational guidance on topics such as prenatal care, exercise, stress, depression, and caring for your baby, as well as access to a maternity specialist who can answer questions about pregnancy, from morning sickness and prenatal concerns to your maternity benefits.
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Emotional Support at Cigna Healthcare In the event of a behavioral health crisis, 24/7 support is available by calling the number on your Cigna ID card. Licensed and experienced behavioral health professionals are available to provide real-time crisis support, help coordinate care after regular business hours, and connect you with valuable community resources. Behavioral Health Support Cigna provides access to a large network of behavioral health specialists, with both in-person and virtual care options available. To find a provider, log in to myCigna.com or use the myCigna App. You can search by provider type and select a behavioral health professional who participates in your network. Virtual appointments may be available in as little as two days. Through the Employee Assistance Program (EAP), you also have access to three in-person or virtual visits with a licensed mental health provider at no additional cost. Contact Cigna or use the chat feature through myCigna to obtain authorization before visiting your provider. Cost of Care: For behavioral health services outside of the three EAP visits, virtual appointments are subject to the same cost-sharing as an outpatient office visit with an in-network provider, based on your medical plan. For in person office visits, applicable copays, coinsurance, and deductibles apply. Virtual Behavioral Health Resources Cigna provides access to several virtual behavioral health resources designed to support employees and their families with mental health and emotional well-being. Any of these can be accessed through your myCigna account. Copays/cost-share applies. Headspace Care: Connect virtually with a certified coach through texting and app-based programs for support with anxiety, depression, and everyday stressors. When additional support is needed, a licensed therapist or psychiatrist may be added to the care team. MDLIVE: Access licensed therapists and board-certified psychiatrists virtually for support when you are feeling overwhelmed, stuck, or simply not like yourself. Services include talk therapy, coping strategies, psychiatric care, and assistance with medication management. Bend Health: Provides mental health, behavioral health, and substance use support specifically for children and teens. Its family-focused approach helps parents and caregivers stay involved in their child’s care. Talkspace: Connect virtually with licensed therapists through live video appointments and private messaging. Psychiatric services and additional behavioral health resources are also available. Therapeutic Apps Cigna provides access to therapeutic apps designed to support your emotional health and well-being at no additional cost. iPrevail: Designed by experienced clinicians to help you manage everyday stress and navigate difficult life transitions. Resources include interactive video lessons, one-on-one peer coaching, support communities, and wellness activities. Happify: Offers science-based activities and games designed to help manage negative thoughts, stress, and life’s challenges. The program can help you build resilience, improve coping skills and focus, reduce stress, and manage symptoms associated with anxiety and depression.
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Identity Theft Protection Cigna provides IdentityForce® identity theft protection at no additional cost. This service offers proactive identity and credit monitoring, fraud alerts, and assistance resolving identity compromises. Employees can also access legal guidance for identity theft concerns. Call 1-833-580-2523 or visit cigna.identityforce.com/starthere to enroll. Legal & Financial Consultations Employees have access to 30-minute legal and financial consultations at no additional cost. Legal guidance includes consultations with an attorney for matters such as civil suits, personal or family concerns, and issues involving the Internal Revenue Service (IRS). Financial guidance provides access to a financial specialist for assistance with debt counseling, budgeting, and other financial concerns. Contact Cigna Healthcare to schedule a consultation.
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VISION PLAN The EAA offers voluntary vision insurance through Ameritas. Our vision benefit plan gives you the freedom to choose any in-network provider with the option to pick out any frames, any lenses, and any contacts. Browse and buy eyewear online with network benefits. Please see the table below for a list of pricing for this voluntary pre-tax benefit. Dependent coverage is available to age 26.
Vision Plan Biweekly Employee Cost
Monthly Employee Cost
For a complete list of in-network providers near you, visit: www.ameritas.com
Employee Only
$3.52 $6.66
$7.04 $13.32 $14.04 $20.60
Employee + Spouse
Employee + Child(ren) $7.02
Employee + Family
$10.30
ViewPointe Plan H Summary EyeMed Insight Network
Benefit
Out of Network
Deductibles
$10 for Exam $25 for Eye Glass Lenses
No deductible
Annual Eye Exam Lenses (per pair) Single Vision
Covered in full
Up to $35
Covered in full Covered in full Covered in full 20% discount See lens options
Up to $25 Up to $40 Up to $55 No benefit
Bifocal Trifocal
Lenticular Progressive
N/A
Contacts Fit & Follow Up Exams Standard Premium (Allowance)
Standard: Member cost up to $40
No benefit No benefit Up to $120 Up to $200 Up to $75
Premium: 10% off of retail
Elective
Up to $150
Medically Necessary
Covered in full
Frame Allowance
$150
Frequencies (months) Exam/Lens/Frame
12/12/24 Based on date of service
12/12/24 Based on date of service
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Lens Options (Member Cost)
EyeMed Insight Network
Out of Network
Progressive Lenses Standard
$65 + lens deductible
No benefit
Premium Tier 1
$85 + lens deductible $95 + lens deductible $110 + lens deductible
No benefit No benefit No benefit No benefit
Tier 2 Tier 3 Tier 4
$65 plus 80% of charge less $120 allowance Covered in full for dependent children Adults: $40
Std. Polycarbonate
No benefit
Tint (solid and gradient) Scratch Resistant Coating Anti-Reflective Coating Standard
$15
No benefit No benefit
Covered in full
$45
No benefit
Premium Tier 1
$57 $68
No benefit No benefit No benefit No benefit No benefit No benefit
Tier 2 Tier 3
80% of the charge
Ultraviolet Coating
$15 $75
Plastic Photochromatic/Transition
Lasik or PRK
Average discount of 15% off retail price or 5% off promotional price at US Laser Network participating providers.
For additional information regarding the various services and how often you may receive services, please refer to the Summary of Benefits located at the end of this booklet. ADDITIONAL PLAN FEATURES EyeMed In-Network Discounts When you visit an EyeMed network provider, you can receive additional savings beyond your plan allowances. Receive a 15% discount on the remaining balance above the conventional contact lens allowance and a 20% discount on the remaining balance above the frame allowance. You may also receive a 20% discount on eligible items not covered by the plan when purchased from a network provider. Discounts cannot be combined with other discounts or promotional offers. The discount on non-covered items does not apply to professional services or contact lenses. EyeMed In-Network Secondary Purchase Plan After your funded vision benefit has been used, you can continue to receive savings at EyeMed network providers. Members receive a 40% discount on an additional complete pair of glasses and a 15% discount on the retail price of conventional contact lenses. Discounts apply to materials only.
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Eye Care Plan Member Service ViewPointe eye care from Ameritas Group features the money-saving eye care network of EyeMed Vision Care. Customer service is available to plan members through EyeMed's well-trained and helpful service representatives. Call or go online to locate the nearest EyeMed network provider, view plan benefit information and more. EyeMed Customer Care Center: 1-866-289-0614 • Service representative hours: 8 a.m. to 11 p.m. ET Monday through Saturday, 11 a.m. to 8 p.m. ET Sunday • Interactive Voice Response available 24/7 Locate an EyeMed provider at: ameritas.com View plan benefit information at: eyemedvisioncare.com Access your account and ID card Register for or log in to your member account at EyeMed.com and locate the My Benefits page to verify your coverage and eligibility. Access your ID card directly from your account. Manage your vision benefits anytime by downloading the EyeMed Members app. Find a provider Verify your network and search for a network provider in your member account by selecting Find an Eye Doctor. EyeMed’s network includes some of the most recognized names, including: Lenscrafters, PearleVision, Target Optical. Important: Walmart and Sam’s Club are not in the EyeMed network. When you visit these retail locations, your out-of-network benefits apply. Browse and buy eyewear online with network benefits. Vision benefits are applied directly to online orders at lenscrafters.com, targetoptical.com, rayban.com, oakley.com, glasses.com and contactsdirect.com. Rx Savings Employees enrolled in Ameritas dental, vision, or both and their covered dependents have access to prescription medication discounts at more than 60,000 participating pharmacies nationwide, including CVS, Walgreens, Rite Aid, and Walmart. This discount program is available at no additional cost and is not insurance. To access the savings, log in to your secure Ameritas member account to access and print your Rx discount savings ID card.
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DENTAL PLAN The EAA offers two dental plan options through Ameritas, both designed to help you maintain good oral health through preventive, basic, and major dental services. You may receive care from any licensed dentist; however, you'll generally save the most when visiting an in-network provider. The primary difference between the two plans is how benefits are calculated for covered services and out-of-network reimbursement. Dental Plan Comparison Chart Benefit MAC 100/60 Plan UCR 80/50 Plan PLAN BENEFIT Type 1 100% 100% Type 2 100% 80% Type 3 60% 50% Deductible $50 Lifetime (Type 2 & 3) Waived Type 1 No Family Maximum $50 Lifetime (Type 2 & 3) Waived Type 1 No Family Maximum Maximum (per person) $1,500 per calendar year $1,500 per calendar year Allowance Discounted Fee 90th U&C Waiting Period None None ORTHODONTIA SUMMARY Adult and Child Coverage Adult and Child Coverage Allowance U&C U&C Plan Benefit 50% 50% Lifetime Maximum (per person) $1,500 $1,500 Waiting Period None None
Sample Procedure Listing Type 1 • Routine Exam (2 per benefit period) • Bitewing X-rays (1 per benefit period) • Full Mouth/Panoramic X-rays (1 in 5 years)
Type 2
Type 3
• Fillings for Cavities
• Onlays
• Restorative Composites (anterior and posterior teeth) • Endodontics (nonsurgical)
• Crowns (1 in 8 years per tooth)
• Crown Repair
• Periapical X-rays
• Endodontics (surgical) • Periodontics (nonsurgical)
• Denture Repair
• Cleaning (2 per benefit period)
• Prosthodontics (fixed bridge; removable complete/partial dentures) (1 in 8 years)
• Fluoride for Children 15 and under (2 per benefit period)
• Periodontics (surgical)
• Sealants (age 13 and under)
• Simple Extractions • Complex Extractions • Anesthesia
• Space Maintainers
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Premiums are the same for both plans. Employee only dental coverage is provided at no cost to employees. However, if you choose to add dependents, you will be responsible for the additional premium costs. Please refer to the table on the left to view the monthly and bi-weekly costs. For additional information regarding the various services and how often you may receive services,
Employee Bi-Weekly Cost
Employee Monthly Cost
Dental Rates
Employee Only
$0.00
$0.00
Employee + Spouse Employee + Child(ren) Employee + Family
$29.84 $52.32 $93.92
$14.92 $26.16 $46.96
please refer to the Summary of Benefits located at the end of this booklet. Choosing the Right Dental Plan To determine whether your dentist participates in the Ameritas network, visit the Ameritas website and search by dentist name, practice name, or location. If your dentist is in the Ameritas network, the Texas Freedom (MAC) Plan offers higher coinsurance for Type 2 and Type 3 services, providing greater coverage when using participating providers. If your dentist is not in the Ameritas network and you prefer not to change providers, the Texas Freedom (UCR) Plan reimburses covered services based on the 90th percentile of Usual, Customary, and Reasonable (UCR) charges. The Texas Freedom (MAC) Plan reimburses covered services based on the Maximum Allowable Charge (MAC) schedule. Depending on your provider's fees, the UCR Plan may provide higher reimbursement and lower out-of-pocket costs for out-of-network services. Dental Cost Estimator Members can use the dental cost estimator at any time to find average procedure charges in their area. The estimates do not include network discounts or plan benefits. Find the dental cost estimator at ameritas.com/applications/group/estimator. After coverage begins, members can view average in-network charges in their secure member account. Members also may ask their dentist’s office to submit a pretreatment estimate so they can see exactly how a proposed service would be covered and avoid any surprises. Eyewear Savings Plan members may receive up to 10% off eyewear frames and lenses purchased at any Walmart Vision Center nationwide. Members may also bring in their current vision prescription from any vision care provider and purchase eyewear at Walmart. This savings arrangement is not insurance: it is available to members at no additional cost to their plan premium. To receive the eyewear savings identification card, Ameritas plan members can visit ameritas.com and sign-in (or create) a secure member account. Members must present the Ameritas Eyewear Savings Card at time of purchase to receive the discount. Rx Savings Plan members and their covered dependents can save on prescription medications at over 60,000 pharmacies across the nation including CVS, Walgreens, Rite Aid and Walmart. This Rx discount is offered at no additional cost, and it is not insurance. To receive this Rx discount, Ameritas plan members just need to visit us at ameritas.com and sign into (or create) a secure member account where they can access and print an online-only Rx discount savings ID card.
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HEALTH REIMBURSEMENT ACCOUNT (HRA) The Health Reimbursement Arrangement (HRA) is administered through Proficient Benefits Solutions. An HRA is an employer sponsored benefit contributed 100% by the EAA and is designed to help offset medical expenses incurred by you. The HRA functions the same as an FSA plan. Even if you do not elect medical and dental coverage for your dependents, you can still utilize your HRA funds to cover their eligible expenses. The HRA contribution provided by the EAA is tied to the medical plan elected. Employees who elect the HDHP plan, are eligible to enroll in the medical HRA and a dental/vision HRA. Employees who elect the OAP plan, are only eligible to enroll in the Dental/Vision HRA. Please refer to the table on the right for the annual maximum contribution. As mentioned, for new hires, this
HRA ANNUAL CONTRIBUTION January 1
contribution amount is prorated. The prorated amount is determined by the number of full months from an employee’s hire date. For example, if you are hired on July 5th and elect the OAP plan, then the dental/vision HRA amount will be 5/12th of the annual contribution ($1000/12 X 5 = $416.67). Amounts are prorated for both the medical HRA and the dental/vision HRA.
OAP Medical
$0.00
OAP Dental/Vision
$1,000.00 $3,499.99 $1,000.00 $500.00
HDHP Medical
HDHP Dental/Vision
HDHP FSA
You can receive reimbursement from your HRA for eligible medical, dental and vision expenses incurred by you or an eligible dependent during the current plan year, January 1 – December 31. HRA funds must be reimbursed during the plan year in which the expense was incurred. For example, expenses incurred in plan year 2026, must be reimbursed from funds during the same year (2026). Claims are processed by Proficient Benefit Solutions. You CANNOT cash the HRA annual contribution out and the funds must be spent on eligible expenses. Any money that is not used during the plan year will be rolled over for use in future years for medical expenses up to a maximum of $2,500. At the end of the plan year and allotted run-off period, any funds over $2,500 are rolled over to a Retirement Health Savings Account (RHS) in April of each year. For more information regarding an RHS, please see the RHS section of this booklet. For those enrolled in the OAP Plan, $2500.00 will be rolled into the dental/vision HRA account for the following year. For those enrolled in the HDHP Plan, $1500.00 of the $2500.00 will be rolled into their Medical HRA account for the following year. The remaining $1000.00 will be rolled over into their Dental and Vision HRA account.
01/01/2027 Employer Contribution
Maximum Rollover from previous year*
Maximum Funds Available the Following Year**
Plan
OAP Dental/Vision HRA
$1,000.00
$2,500.00
$3,500.00
HDHP Medical HRA
$3,499.99 $1,000.00
$1,500.00 $1,000.00
$4,999.99 $2,000.00
HDHP Dental/Vision HRA
*Following run off period **Assumes no HRA funds are used during the calendar year. HRA Run Off Period
December 31st is the last day to incur claims for the 2026 plan year, and you must submit all claims by the end of the runoff period which runs January 1, 2027 to March 31, 2027. During this time, you can submit receipts and other documentation for eligible expenses incurred during the previous year (2026). Eligible Expenses HRA eligible expenses are the same as FSA eligible expenses. A list of HRA eligible expenses can be found here.
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FLEX SPENDING ACCOUNTS (FSA) A Flexible Spending Account (FSA) is a tax advantaged benefit plan administered by Proficient Benefit Solutions that allows employees to set aside portions of their salary to pay for their family’s health and/or daycare expenses. The amount set aside is not subject to payroll taxes. Flexible spending accounts contributions are based on the plan year (October 1, 2026 to September 30, 2027) election. IMPORTANT : You are not eligible to contribute towards a Medical FSA or be enrolled in the employer FSA, if you or your spouse have a Health Savings Account (HSA). Medical FSA You can receive reimbursement from your Health Care FSA for eligible medical and dental expenses incurred by you or an eligible dependent using your pre-tax dollars. Claims will be processed through Proficient Benefits Solution. The maximum amount you may contribute to your Health Care FSA for plan year 2026-2027 is $3,300.00. Employees who enroll in the HDHP medical plan will receive FSA funds from the EAA and the amount The entire annual amount is prefunded at the beginning of the plan year for immediate use on eligible expenses for current employees. You must enroll as a new hire for the FSA or enroll for the FSA every year during open enrollment or after a qualifying life event. The IRS publishes information on FSAs and eligible expenses on their website. If you have questions about an expense, please contact Proficient at (210) 659-8100. You may also view a list of eligible expenses on the Proficient Benefits Solution website. Dependent Care FSA A Dependent Care FSA offers an opportunity to save money on daycare expenses for eligible dependents. The maximum amount you may contribute to your Dependent Care FSA is $5,000 for individuals or married couples filing jointly or $2,500 for a married person filing separately. Also, the person whose daycare expenses you are claiming must satisfy the definition of a Tax Dependent, per IRS regulations. If you're a new hire enrolling mid-year, consider selecting a lower annual contribution amount initially, with the option to increase it during the next open enrollment period. For example, if you are hired in June and choose a $4,000 annual contribution amount, that amount will be divided by the number of payrolls remaining in the plan year (e.g., October to September). The resulting amount will be deducted from each paycheck. For instance, if you elect $4,000 and there are 7 pay periods left in the plan year, approximately $571.43 will be deducted from each paycheck. You can receive reimbursement from your Dependent Care FSA for expenses that have already been incurred and only up to the dollar amount that has already been deposited into your account. If you have funds remaining at the end of the plan year these funds will be forfeited. FSA Run Off Period September 30th is the last day to incur claims for the 2026-2027 plan year, and you must submit all claims by December 31, 2027. EAA FSA CONTRIBUTION PPO HDHP October 1 N/A $500.00 is pro-rated if you are a new hire. Please refer to the table on the right for the plan year amount. If you have funds remaining at the end of the plan year, a maximum of $640 will carry over to the next plan year while any funds in excess of $640 will be forfeited.
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