BB&N 2026-2027 Benefits Guide
This document provides detailed information about the benefits available to members of the Buckingham Browne & Nichols School community for the period from June 1, 2026, to May 31, 2027.
2026 - 2027 BENEFITS GUIDE BUCKINGHAM BROWNE & NICHOLS SCHOOL JUNE 1, 2026 – MAY 31, 2027
ELIGIBILITY You are eligible for participation in some BB&N benefits if you work at least 20 hours per week Benefits are effective on your first day of employment You may enroll your eligible dependents, including your legal spouse, domestic partner, and children up to the age of 26 Your benefit elections remain in effect until May 31, 2027 You may only change your benefits during open enrollment or within 30 days of a qualifying life event 2026 Benefits Guide | 1
BENEFIT COSTS The below amounts are for full-time staff and faculty. Costs are deducted from your paycheck on a bi-weekly basis. Rates below will go into effect September 11th pay date 2026 Benefits Guide | 2 Employee Only Bi - weekly cost Employee + One Bi - weekly cost Family Bi - weekly cost Medical – HMO (with HRA) $118.37 $306.15 $353.21 Medical – PPO HSA (with HRA) $129.73 $335.90 $387.09 Medical – PPO HSA Only $103.85 $260.77 $311.54 Dental $16.25 - $40.12 Vision $3.65 $6.21 $9.65
BENEFIT COSTS The below amounts are for part-time staff and faculty (80-99%). Costs are deducted from your paycheck on a bi-weekly basis. Rates below will go into effect September 11th pay date. 2026 Benefits Guide | 3 Employee Only Bi - weekly cost Employee + One Bi - weekly cost Family Bi - weekly cost Medical – HMO $208.16 $463.35 $621.12 Medical – PPO HSA (with HRA) $228.12 $508.37 $680.70 Medical – PPO HSA Only $182.62 $394.66 $547.83 Dental $16.25 - $40.12 Vision $3.65 $6.21 $9.65
BENEFIT COSTS • The below amounts are for part-time staff and faculty (50-79%). Costs are deducted from your paycheck on a bi-weekly basis. Rates below will go into effect September 11th pay date 2026 Benefits Guide | 4 Employee Only Bi - weekly cost Employee + One Bi - weekly cost Family Bi - weekly cost Medical – HMO (with HRA) $ 342.84 $ 699.13 $ 1,022.98 Medical – PPO HSA (with HRA) $ 375.71 $ 767.07 $ 1,121.11 Medical – PPO HSA Only $ 300.77 $ 595.50 $ 902.28 Dental $16.25 - $40.12 Vision $3.65 $6.21 $9.65
CORE BENEFITS
MEDICAL PLAN OPTIONS 2026 Benefits Guide | 6 Blue Cross Blue Shield of MA HMO (with HRA ) Blue Cross Blue Shield of MA PPO HSA (with HRA ) Blue Cross Blue Shield of MA PPO HSA Only In - Network Only In - Network / Out - of - Network* In - Network / Out - of - Network* Plan Deductible $6,000 member / $12,000 family $6,000 member / $12,000 family $6,000 member / $12,000 family BB&N Pays via HRA $5,000 member / $10,000 family $4,000 member / $8,000 family - Employee Deductible Responsibility $1,000 member / $2,000 family $2,000 member / $4,000 family** $6,000 member / $12,000 family BB&N HSA Contribution - $1,000 member / $2,000 family $2,000 member / $4,000 family Net Employee Deductible Responsibility $1,000 member / $2,000 family $1,000 member / $2,000 family** $4,000 member / $8,000 family Out - of - Pocket Maximum $8,000 member / $16,000 family $8,000 member / $16,000 family $8,000 member / $16,000 family Net Employee OOP Max $1,000 member / $2,000 family $1,000 member / $2,000 family $6,000 member / $12,000 family Preventive Visit $0 $0 $0 to employee after deductible $0 20% coinsurance after deductible PCP Office Visit $0 to employee after deductible $0 to employee after deductible $0 after deductible 20% coinsurance after deductible Specialist Office Visit $0 to employee after deductible $0 to employee after deductible $0 after deductible 20% coinsurance after deductible Emergency Room Visit $0 to employee after deductible $0 to employee after deductible $0 after deductible 20% coinsurance after deductible Diagnostic X - Ray & Lab $0 to employee after deductible $0 to employee after deductible $0 after deductible 20% coinsurance after deductible High Tech Imaging $0 to employee after deductible $0 to employee after deductible $0 after deductible 20% coinsurance after deductible Inpatient Care $0 to employee after deductible $0 to employee after deductible $0 after deductible 20% coinsurance after deductible Outpatient Care $0 to employee after deductible $0 to employee after deductible $0 after deductible 20% coinsurance after deductible *PPO Plan: For Out - of - Network claims that are submitted to BCBSMA/HealthEquity there may be b alance billing due for the difference between the provider’s charge and BCBSMA allowed charge. B alance billing amounts are completely outside of the medical plan and your responsibility. Please refer to the medical plan certific at e for more information. ** F amily Deductible: A ll members in a family plan will contribute towards the family deductible, with no per member cap before the full deductible res po nsibility is met.
RX DRUG BENEFITS PPO HSA Only Plan Member Responsibility (Out of Pocket Cost after deductible) Tier 1 Tier 2 Tier 3 30 Day (Retail) $15 50% 50% 90 Day (Mail Order) $30 50% 50% • HMO (with HRA ) & PPO HSA (with HRA ) plans ( Same benefit level) • Rx drug costs will go towards the combined medical/Rx drug member deductible then the HRA will cover any RX copay • PPO HSA Only plan • Rx drug costs will go towards the combined medical/Rx drug member deductible • Since this plan does not utilize the HRA, out of pocket Rx drug costs are still the member’s responsibility after the deductible • All major pharmacies are included • Pharmacy Benefit Manager is CVS Caremark
MEDICAL PLAN EDUCATION 2026 Benefits Guide | 8 HOW TO SAVE ON COSTS + Use a doctor, facility, or other provider from the Blue Cross Blue Shield of MA network means you’ll pay less out of pocket + Use the Find a Doctor tool to search for in - network providers + Get discount prescription drugs by using GoodRx to search for drugs you and your family members are prescribed + Make sure you’re choosing the most cost - effective option for getting care. Check out this easy guide to help decide where to go when you’re sick or injured + The SmartShopper tool offers you incentives for using a cost - effective in - network provider. + As of June 1, 2023, BB&N is discontinuing the BB&N Medical plan opt - out program for new employees and for current employees newly waiving the medical plan. + Any employees currently receiving the buy - out benefit may continue to receive the opt - out benefit until they decide to utilize BB&N's medical plan or lose their eligibility for BB&N’s medical plan. + Note that employees are only eligible for the opt - out benefit if they are not on BB&N’s medical plan as either the primary subscriber or as a participant or have not been on the plan for the full year. The amount for the medical plan opt - out is $1,500 and will be paid at the end of the academic year. Icon Description automatically generated WATCH: GET REWARDED WITH SMARTSHOPPER MEMBER LOGIN MEMBER LOGIN PHONE SUPPORT PHONE SUPPORT TELEHEALTH TELEHEALTH SMART SHOPPER SMART SHOPPER FIND A DOCTOR FIND A DOCTOR GLOSSARY GLOSSARY MOBILE APP MOBILE APP Blue Cross Blue Shield of MA Member Extras + Mail - order pharmacy + aHealthyMe wellness program + MyBlue member mobile app + Blue365 Discounts + Fitness, weight loss, and mind - body reimbursements + 24/7 nurse care hotline
Well Connection provides you and your family access to board certified physicians around the clock (24/7/365) via telephone or secure video. Well Connection physicians can give advice, diagnose or treat illness, and even prescribe medication right over the phone. Best of all, there is lower cost to you or your family for this service. How to access the Well Connection telehealth platform: + Login to your MyBlue account or call member services at 1 - 855 - 292 - 6355 to request a consultation anytime 24/7. + Receive diagnosis and treatment, giving you quality care and peace of mind wherever you are. + No referral needed! + Before starting your visit, or scheduling an appointment, BCBS will show you a list of available doctors, their experience and ratings. Choose the doctor that works best for you! Well Connection TELEHEALTH Common Conditions Treated + Allergies + Arthritic Pain + Bronchitis + Cold/flu + Conjunctivitis + Diarrhea + Gastroenteritis + Headaches + Insect bites + Strains/sprains + Sinus infections + UTI 2026 Benefits Guide | 9
SPENDING ACCOUNTS HMO (with HRA) Plan • Healthcare Flexible Spending Account (FSA) • Dependent Care FSA PPO HSA (with HRA) Plan • Dependent Care FSA • Limited Purpose FSA • Health Savings Account (HSA) PPO HSA Only Plan • Dependent Care FSA • Limited Purpose FSA • Health Savings Account (HSA)
HEALTH SAVINGS ACCOUNT (HSA) 11 HSA eligibility - You must be enrolled in one of the PPO plans to be eligible to contribute - You cannot be enrolled in another medical plan - You cannot be enrolled in Medicare or Medicaid - You cannot be claimed as a dependent on another person’s tax return - You cannot be enrolled in a general - purpose healthcare FSA plan (including through a spouse ) Watch: 5 Benefits of a Health Savings Account Maximum Annual Contribution Individuals: $4,400 Families: $8,750 $1,000 Additional contribution for ages 55+ Eligible Expenses Medical, Dental, and Vision View eligible expenses here Plan Administrator HealthEquity How to Use Funds - Options Use the HSA debit card at the point of sale. Pay Provider Directly - log into the HealthEquity Member Portal, view claims. Pay from a personal bank account and save your HSA funds. If you decide later that you want reimbursement, log into the portal and select reimburse me. Account Owner You own this account. The funds remain t here until you use or invest them .
HEALTH SAVINGS ACCOUNT ( HSA ) EDUCATION 2026 Benefits Guide | 12 BB&N will contribute: PPO HSA with HRA Plan: $1,000 per year for Employee - only coverage $2,000 per year for Family coverage PPO HSA Only Plan: $2,000 per year for Employee - only coverage $4,000 per year for Family coverage You pay the full cost of non - preventive care, including Rx until you meet your deductible. When you have an eligible expense, you can decide whether to use your HSA funds or pay out of pocket. Either way, these expenses count towards your deductible and out - of - pocket maximum. Any money left in your account is yours to pay for healthcare in the future or to invest. If you leave BB&N, you’ll take your HSA with you – you own this account. Money Goes In Money Comes Out Have Money Left? It Rolls Over! TAX ADVANTAGES OF AN HSA 100% deductible contributions up to a legally mandated maximum amount Money withdrawn for medical spending never falls under taxable income Tax deferred interest earnings Tax free interest earnings, if money is spent on health care costs
PPO HSA with HRA Plan Individual IRS 2026 max. contribution: $4,400 BB&N Contribution: $1,000 Max. Employee contribution: $3,400 Family IRS 2026 max. contribution: $8,750 BB&N Contribution: $2,000 Max. Employee contribution: $6,750 PPO HSA Only Plan Individual IRS 2026 max. contribution: $4,400 BB&N Contribution: $2,000 Max. Employee contribution: $2,400 Family IRS 2026 max. contribution: $8,750 BB&N Contribution: $4,000 Max. Employee contribution: $4,750 Below is a calculation of how much you can contribute to your HSA while remaining within IRS 2026 limits. HSA CONTRIBUTIONS 13
FLEXIBLE SPENDING ACCOUNTS Annual Contribution Max $3,400 Rollover Rollover up to $680 of unused funds into the next plan year. Unused funds beyond $680 are forfeited Eligible Expenses Use funds on FSA - eligible out - of - pocket medical, dental, and vision expenses How to use Funds Use your FSA debit card at point of sale or request reimbursement with receipt through your member portal Plan Administrator HealthEquity Enrolling Annually The IRS requires annual re - enrollment in Flexible Spending Accounts. The funds you elect for the year are available to use the day the plan begins Healthcare FSA Dependent Care FSA Annual Contribution Max $7,500 per household ($3,750 if married filing separately) Rollover Unused funds are forfeited at the end of the plan year Eligible Expenses Use funds on FSA - eligible childcare or eldercare expenses How to use Funds Request reimbursement with receipt through your member portal Plan Administrator HealthEquity Enrolling Annually The IRS requires annual re - enrollment in Flexible Spending Accounts. The funds you elect for the year are available to use the day the plan begins 2026 Benefits Guide | 14 Limited Purpose FSA (PPO HSA PLANS ONLY) Annual Contribution Max $3,400 Rollover Rollover up to $680 of unused funds into the next plan year. Unused funds beyond $680 are forfeited Eligible Expenses Use funds on FSA - eligible out - of - pocket dental and vision expenses only How to use Funds Use your FSA debit card at point of sale or request reimbursement with receipt through your member portal Plan Administrator HealthEquity Enrolling Annually The IRS requires annual re - enrollment in Flexible Spending Accounts. The funds you elect for the year are available to use the day the plan begins
BENEFITS OF AN FSA 15 Your gross annual pay $88,000 Estimated tax rate (30%) - $26,400 Your net annual pay $61,600 Your annual healthcare expenses - $2,000 Your final take - home pay $59,600 Your gross annual pay $88,000 Your annual healthcare expenses - $2,000 Your adjusted gross pay $86,000 Estimated tax rate (30%) - $25,800 Your final take home pay $60,200 With an FSA Without an FSA Why Enroll? You can save an average of 30% on healthcare services with a Flexible Spending Account. This account will reduce your overall tax burden, plus funds are conveniently withdrawn from your paycheck each pay period before taxes have been deducted. 2026 Benefits Guide | 15 FSA Benefits Enjoy significant tax savings with pre - tax deductible contributions and tax - free reimbursements for qualified plan expenses Quickly and easily access funds using the prepaid benefits card at point of sale, or request to have funds directly deposited to your bank account via online or mobile app Get one - click answers to benefits questions File claims easily online (when required) and let the system determine approval based on eligibility and availability of funds Stay up to date on balances and action required with automated email alerts and the convenient web portal and mobile app home page messages
DENTAL PLAN 2026 Benefits Guide | 16 Dental Summary of Benefits BLUE CROSS BLUE SHIELD OF MA DENTAL BLUE FREEDOM Benefits begin on June 1 st but dental benefits are provided on a calendar year basis In - Network Annual Deductible $50 member / $150 family maximum Annual Max imum Benefits $1, 5 00 / year per person Preventive Care (Cleanings and Exams) 100% Cover age ; deductible does not apply to preventive services Basic Care (Fillings, Extractions, etc.) 80% Cover age * Major Care (Crowns, Implants, Dentures) 50% Cover age * Orthodontia 10 0% Cover age; deductible does not apply to orthodontia services L ifetime max imum of $ 2 ,000 per family member Accumulated Maximum Rollover If your claims do not exceed $ 7 00 during the plan year, BCBS will rollover $ 50 0 towards your calendar year maximum to use next year and beyond. The rollover balance is capped at $1, 25 0 *after deductible Benefits are reduced by 20 percent when services are received from an out - of - network dentist
DENTAL PLAN EDUCATION When you see a BCBS of MA network dentist, benefits are covered at the in - network level which provides the greatest savings. Click here to find an in - network dental provider. PAY THE LEAST Download the app to: - track claims & benefits - check deductible balances - find an in - network doctor - view your member ID card - contact member services MYBLUE MEMBER APP Your plan allows you two free dental cleanings, and one routine x - ray every 12 months ROUTINE CARE 2026 Benefits Guide | 17 MEMBER LOGIN MEMBER LOGIN PHONE SUPPORT PHONE SUPPORT FIND A DOCTOR FIND A DOCTOR GLOSSARY GLOSSARY MOBILE APP MOBILE APP Icon Description automatically generated WATCH: SEEING THE DENTIST IS GOOD FOR YOUR HEALTH
BLUE CROSS BLUE SHIELD OF MA 20/20 VISION PLAN In - Network Out - of - Network Reimbursement Eye Exam – Benefit available every 12 months $ 1 0 copay Up to $50 Frames – Benefit available every 24 months Allowance $150 allowance, then additional 20% off the balance Up to $90 Lenses & Enhancements – Benefit available every 12 months Single Vision $25 copay Up to $42 Lined Bifocal $25 copay Up to $78 Lined Trifocal Lenses $25 copay Up to $130 Standard Progressive $90 copay Up to $130 Contact Lenses – Benefit available every 12 months Conventional $150 allowance, then additional 15% off the balance Up to $120 Disposable $150 allowance Up to $120 Medically Necessary Paid in full Up to $210 VISION PLAN 2026 Benefits Guide | 18 Vision Summary of Benefits
TOUCHCARE TouchCare is a health care concierge focused on saving you and your dependents time, money and frustration. TouchCare is available to all BB&N employees and family members enrolled in the medical plans. The TouchCare Health Assistants can help you with anything you may need relating to your benefits and ensure that you have all the tools you need to get to the bottom of any issue. TouchCare will work on your behalf to: 2026 Benefits Guide | 19 WATCH: TOUCHCARE IS YOUR HEALTHCARE CONCIERGE Icon Description automatically generated Solve billing and claims concerns Find and schedule quality doctors and specialists in your area Provide accurate cost estimates for facilities and treatments close by Answer any benefit related questions, simple or complex, including assisting with PFMLA paperwork Provide guidance on open enrollment decisions or mid - year benefit reviews Assist with finding lowest cost Rx options TouchCare is open from 8:00 am until 9:00 pm, EST, Monday through Friday. Here is how you can reach the TouchCare team: Phone: 866 - 486 - 8242 E - mail: assist@touchcare.com Website : www.touchcare.com YOUR HEALTHCARE CONCIERGE
LIFE AND AD&D INSURANCE + Employees receive 1x your salary up to $100,000 in life coverage and AD&D coverage + This benefit reduces to 67% at age 70 + BB&N covers 100% of the premium costs of Life and Accidental Death and Dismemberment Insurance through MetLife. + Employees are automatically enrolled in this coverage once they become benefits eligible. + Employees must choose a beneficiary upon eligibility. Additional employee Life insurance on an employee - paid basis is also available. This benefit is provided to all benefits - eligible employees and does not require enrollment. However, we do recommend reviewing your designated beneficiaries regularly to ensure we have the most updated information. 2026 Benefits Guide | 20
LONG - TERM DISABILITY Long - Term Disability (LTD) insurance provides income to workers whose earnings are interrupted by periods of disability longer than 90 consecutive days. Long - term disability refers to a condition where an individual is unable to work for an extended period due to a severe illness, injury, or medical condition. LTD insurance is designed to provide financial support to individuals who are unable to work due to such disabilities, offering a portion of their pre - disability income to help cover liv ing expenses and medical costs during their period of incapacity. This insurance can offer peace of mind by providing a safety ne t f or individuals and their families in the event of a long - lasting inability to work. This benefit pays 60% of your monthly salary tax - free up to $6,500 Coverage is paid for by your employer and enrollment is automatic This benefit begins paying after 90 days of disability 2026 Benefits Guide | 21
Employee Paid Supplemental Life Insurance Opportunity • Supplemental Life Insurance is additional Term Life insurance beyond what BB&N provides and it’s 100% employee paid (participation is voluntary) • Supplemental Life is purchased in increments of $10,000 above the BB&N provided Basic Life coverage amount (one times base salary) for faculty/staff • Employees can elect an amount up to the lesser of 5x salary or $300,000 • Most Supplemental Life coverage elected after initial eligibility requires medical questions before acceptance, i.e. Statement of Health (SOH) • If you already have Supplemental Life Insurance, you may elect an additional $10,000 up to a combined $120,000 of Supplemental Life without SOH • Coverage is portable if an employee leaves BB&N (Please note additional supplemental life insurance can only be elected during open enrollment) Employee Paid Supplemental Life Insurance Opportunity 2026 Benefits Guide | 22
23 As of July 1, 2026, BB&N and its employees will work directly with the Department of Family and Medical Leave (DFML) on PFML claims. NOTE: Claims initiated before July 1, 2026 will continue to be administered by MetLife through the entirety of the claim. • The notification/request process for PFML (through HR) will remain the same, although there will be some additional claim steps with DFML that HR can assist employees with. • BB&N employees receiving PFML will continue to be paid through BB&N. • BB&N's PFML supplement remains the same. PFML INFORMATION
NEW! VOLUNTARY BENEFITS 24 Accident Insurance While you can’t always prevent accidents from occurring, you can get financial support to make your recovery less stressful. Accident insurance offsets the costs associated with a covered accident based on a schedule of benefits. A lump - sum payment will be provided to you or you family, which you can use for your individual needs. Note: You must elect coverage for yourself to add your spouse/domestic partner and/or children. To maintain the right balance and security in your life, you may need support outside of the traditional care benefits. Our v olu ntary benefits, administered by MetLife, are employee - paid benefits that complement your medical coverage and offer financial support. Critical Illness Insurance Critical Illness Insurance pays a cash benefit if you are diagnosed with a covered disease or condition, such as cancer, a heart attack, or stroke. You can use this benefit however you like, including to help pay for treatments, prescriptions, travel, increased living expenses, and more. Note: You must elect coverage for yourself to add dependents. Spouse elections not to exceed 100% of employee election. Child(ren) election not to exceed 50% of employee election.
RETIREMENT PLAN Overview BB&N sponsors a 403(b) Retirement Plan through TIAA. Participants select investments based on their goals and risk tolerance. There are two classes of Participants. Full Participants are those employees in regularly scheduled positions with service requirements of at least 1,000 hours per year. Limited Participants are those with lesser schedules, such as those who are temporary, seasonal, or part - time. All Participants, regardless of Plan class, may save from their pay on a pre - tax basis up to IRS limits. Enrollment in this plan must be completed prior to making employee contributions or receiving employer matching contributions. The Plan document has more detailed provisions which will override any conflict with this brief description. IRS Limits + You may contribute up to $24,500 annually + Employees aged 50+ may contribute an additional $8,000 annually + Employees aged 60 - 63 may contribute an additional $11,250 annually + Click here to access the TIAA portal BB&N Contribution + BB&N contributes 8% of base pay plus a 2% match for those who save at least 2% + Full participants receive BB&N contributions without a waiting period Additional Details (applicable to anyone who began work on or after June 1, 2023) + Any BB&N contributions are forfeited if employment terminates before 15 months of service + Service age requirement of 21 is also added for employer contributions, but not for voluntary savings contributions 2026 Benefits Guide | 25
EXTRAS & PERKS
Protection Planning Personal Finance Retiring Well Investment Planning Retirement Planning Estate Planning RPAG FINANCIAL WELLNESS Helping Employees Develop Financial Confidence RPAG : www.rpagwellness.com Code: BBNS RP A G is a financial wellness solution that helps employees develop financial confidence and remove barriers that prohibit them from reaching their financial goals. The program provides: + Personal financial assessments and planning guidance + One - on - one consultations with an IMA Retirement advisor focused on establishing a personalized financial plan based upon the employee’s unique financial priorities + Coordinated advice that integrates an employer’s available benefits offerings + Tailored group education meetings to address a workforce’s specific areas of interest + Mobile app for employees to complete assessments, schedule one - on - one sessions, and review action plans + Employer reporting that provides insights into a workforce’s financial challenges and measures overall wellness RPAG Wellness TM program technology is not proprietary to IMA Retirement. This technology is offered through the RPAG platform. RPAG and IMA Retirement are separate, non - affiliated companies. IMA Retirement pays RPAG for use of their platform and resources. Questions? Please feel free to contact Ben Stein , Retirement Plan Manager. 2026 Benefits Guide | 27
BENEFIT HUB The BB&N BenefitHub employee perk program provides exclusive access to discounts and cash back offers on thousands of the brands you love. Take advantage of savings in a variety of categories, including: Register to save + Go to: bbns.benefithub.com + Use referral code 9SYQUQ + Complete the registration process + Bookmark the page for easy access + Call: 1 - 866 - 664 - 4621 + Email: customercare@benefithub.com Questions? + Travel & auto + Beauty & spa + Electronics + Apparel + Education + Entertainment + Restaurants + Health & wellness + Sports & outdoors 2026 Benefits Guide | 28
+ Call 1 - 888 - 319 - 7819 + Visit metlifeeap.lifeworks.com Lifeworks EAP BB&N faculty & staff and their families have access to free, confidential support to programs, tools, and services intended to help you live a balanced and happy life. Get 5 no - cost phone or online sessions per faculty/staff with EAP counselor (MetLife participants) Counselors provided through LifeWorks can support you with: Family: Going through a divorce, caring for an elderly family member, returning to work after having a baby Work: Job relocation, building relationships with co - workers and managers, navigating through reorganization Money: Budgeting, financial guidance, retirement planning, buying or selling a home, tax issues Legal Services : Issues relating to civil, personal and family law, financial matters, real estate and estate planning I dentity Theft Recovery: ID theft prevention tips and help from a financial counselor if you are victimized Health: Coping with anxiety or depression, getting the proper amount of sleep, how to kick a bad habit like smoking Everyday Life: Moving and adjusting to a new community, grieving over the loss of a loved one, military family matters, training a new pet EMPLOYEE ASSISTANCE PROGRAM CONTACT THE EAP 2026 Benefits Guide | 29 + Username: metlifeeap + Password: eap + View the flyer
• Commuter Benefits BB&N subsidizes the cost of MBTA or Commuter Rail passes if an employee does not drive and park at the school. If you have any questions regarding this benefit, please contact the Payroll Team. • Be Better & Now Wellness Program In an effort to health and well - being among BB&N employees and their families, BB&N has a wellness site which includes a number of health and related fitness programs HERE . • Bicycle Commuter Benefit The Bicycle Commuter Benefit offers reimbursement for employees who regularly use a bicycle to travel to work, and who do not receive any other transportation or parking benefits from BB&N. Bicycle commuters are eligible for reimbursement of up to $240/year for the costs associated with bicycle purchase, improvement, repair and storage. Reimbursement is paid through payroll and is a taxable benefit. • Fitness Reimbursement $150 per calendar year for health club with cardiovascular and strength - training equipment; or a fitness studio offering instructor - led group classes for certain cardiovascular and strength - training programs. You can learn more and submit a reimbursement here . • Weight Loss Reimbursement $150 per calendar year for hospital - based or non - hospital - based weight loss programs that focus on eating and physical activity habits and behavioral/lifestyle counseling with certified health professionals. • Other Support & Discounts 24 - hour Nurse Care Line: 1 - 800 - 247 - BLUE (25823) www.ahealthyme.com www.livinghealthbabies.com (Text BABY to 511411) www.blue365deals.com All BB&N faculty and staff have access to the below perks EMPLOYEE PERKS BCBS of MA medical plan subscribers have access to the below perks ALL FACULTY & STAFF PERKS BCBS OF MA MEMBER PERKS 2026 Benefits Guide | 30
CHILDCARE BENEFIT 31 BB&N offers a cash early childcare benefit of $200 per month per child for benefits eligible employees, adjusted for the employee's work schedule if less than 100%. Other requirements are: • The benefit is available for employees with dependent children • The benefit is available for each preschool aged dependent child not eligible for Kindergarten ( ie children aged 0 - 4, turning 5 after September 1, 2026) • The benefit is available for employees who have not accessed other BB&N benefits for their preschool aged dependent children, such as enrollment in BB&N’s Lower School or Summer Camp • The benefit is available for the months the employee works at BB&N • All families enrolled in TFC and Four Seasons may elect to have their monthly stipend directly credited to their TFC or Four Seasons tuition account. Further information about how to elect this benefit will be provided during open enrollment in May 2026.
AFTER SCHOOL PROGRAMS All benefits - eligible employees whose children attend the Lower School can receive After Care for their Lower School students at no added cost. Please note that ASAP classes, which provide more structured enrichment opportunities after school, are available for an additional fee. Any questions regarding after school programming can be directed to the Director of After School and Auxiliary Faculty . SUMMER CAMP Employees receive a 60% discount on Summer@BB&N Programs! Summer@BB&N provides a valuable and enjoyable summer camp experience for campers from 4 years old through rising 12th grade every summer. Between Classic Camps, Speciality Camps, and Sports Camps there is something for everyone! For more information, please visit our website bbnsummer.com or email summer@bbns.org . AFTERSCHOOL/CAMP 2026 Benefits Guide | 32
FREQUENTLY ASKED QUESTIONS (FAQ) 2025 Benefits Guide | 33 • How do I contact HealthEquity ? You can contact HealthEquity via phone at the numbers below. FSA and HRA Questions | 877 - 924 - 3967 HSA Questions | 866 - 346 - 5800 You can also log into the member portal here to view additional information. • What’s the difference between HealthEquity and Touchcare? HealthEquity is our plan administrator that works with BCBS to administer your medical expenses. HealthEquity also administers the FSA and HSA. Touchcare is a medical concierge service that is here to support you regarding navigating healthcare and disputing any issues around medical expenses. • How much do I have left on my FSA? HealthEquity is our FSA provider - you can contact them, and they will be able to tell you your exact balance. If you have any additional questions, please feel free to contact the Office of Human Resources. • I elected the PPO plan and now I have a statement for using an out of network provider. Why is that? We highly encourage staying within the BCBS network county - wide. However, we understand there are times you might have to go out of network and when that happens the out of network medical provider can choose to charge over the BCBS allowable amount. In those cases, you will receive a bill for the difference. This is called balance billing. Linked here is additional information.
FREQUENTLY ASKED QUESTIONS ( FAQ ) 2025 Benefits Guide | 34 • How do I change my TIAA contribution? Please make contribution changes in the TIAA Portal, the link to the portal can be found here . • How do I change my tax withholdings? Tax withholdings need to be submitted electronically in ADP. Please log into ADP , then go to the Myself tab>Pay>Tax Withholdings. In ADP you will see your Federal and State W4 forms where you can edit your withholdings. If you have any questions, please feel free to contact us. • Are there any additional steps to take if I want to increase my voluntary life insurance? If you are increasing your life insurance by $20,000 or more, you will need to fill out a medical certification form called a Statement of Health. You will also need to fill out a Statement of Health if you are electing an amount over $120,000. • Who can fill out the Public Service Loan Forgiveness (PSLF) form for me? Please have your form emailed directly to hr@bbns.org and the Office of Human Resources will be happy to assist you.
FREQUENTLY ASKED QUESTIONS ( FAQ ) 2025 Benefits Guide | 35 • How do I receive my bike reimbursement? BB&N Bicycle Commuter Benefit offers reimbursement for employees who regularly use a bicycle to travel to work, and who do not receive any other transportation or parking benefits from BB&N. To receive reimbursement please submit your receipt to Bobby Hahn, Payroll Coordinator, and he will be happy to assist you. Please note the maximum reimbursement amount is $240. • What BB&N Commuter Benefits am I entitled to? MBTA Passes : BB&N will provide employees with MBTA monthly passes at no cost. Commuter Rail Pass Reimbursement: BB&N will reimburse employees through payroll (tax free) upon approval up to $90 per month. This benefit is only available to employees who do not receive any other transportation or parking benefits from BB&N. Please contact Bobby Hahn, Payroll Coordinator, with any questions and he will be happy to assist you. • What is the difference between RPAG Wellness and TIAA? TIAA is our retirement administrator. We also have the added benefit of RPAG Wellness which supports with retirement planning but can also help with any form of financial planning.
QUESTIONS? PLEASE FEEL FREE TO CONTACT THE OFFICE OF HUMAN RESOURCES AT HR@BBNS.ORG
HEALTH PLAN NOTICES
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES HIPAA SPECIAL ENROLLMENT RIGHTS If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or gro up health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage ( or if the employer stops contributing toward your or your dependents’ other coverage). However, you must request enrollment within 30 days after your or your dependents’ oth er coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption. To request special enrollment or obtain more information, contact the Plan Administrator. HIPAA NOTICE OF PRIVACY PRACTICE Your Information. Your Rights. Our Responsibilities. This notice describes how medical information about you may be used and disclosed and how you can get access to this informat ion . It also describes how your protected health information may be used or disclosed to carry out treatment, payment or healthcare operation or for any purp ose s that are permitted or required by law. Your Rights You have the right to: ❖ Get a copy of your health and claims records ❖ Correct your health and claims records ❖ Request confidential communication ❖ Ask us to limit the information we share ❖ Get a list of those with whom we’ve shared your information ❖ Choose someone to act for you ❖ File a complaint if you believe your privacy rights have been violated
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES ??????????? Your Choices You have some choices in the way that we use and share information as we: ❖ Answer coverage questions from your family and friends ❖ Provide disaster relief ❖ Market our services and sell your information Our Uses and Disclosures We may use and share your information as we: ❖ Help manage the health care treatment you receive ❖ Run our organization ❖ Pay for your health services ❖ Help with public health and safety issues ❖ Do research ❖ Comply with the law ❖ Respond to organ and tissue donation requests and work with a medical examiner or funeral director ❖ Address workers’ compensation, law enforcement and other government requests ❖ Respond to lawsuits and legal action Your Rights When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES ??????????? Get a copy of health and claims records ❖ You can ask to see or get a copy of your health and claims records and other health information we have about you. Ask us how to do this. ❖ We will provide a copy or a summary of your health and claims records, usually within 30 days of your request. We may charge a reasonable, cost - based fee. Ask us to correct health and claims records ❖ You can ask us to correct your health and claims records if you think they are incorrect or incomplete. Ask us how to do thi s. ❖ We may say “no” to your request, but we’ll tell you why in writing within 60 days. Request confidential communications ❖ You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. ❖ We will consider all reasonable requests, and must say “yes” if you tell us you would be in danger if we do not. Ask us to limit what we use or share ❖ You can ask us not to use or share certain health information for treatment, payment or our operations. ❖ We are not required to agree to your request, and we may say “no” if it would affect your care. Get a list of those with whom we’ve shared information ❖ You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask , who we shared it with and why. ❖ We will include all the disclosures except for those about treatment, payment and health care operations and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, c ost - based fee if you ask for another one within 12 months. Get a copy of this privacy notice ❖ You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We wi ll provide you with a paper copy promptly.
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES ??????????? Choose someone to act for you ❖ If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your right s and make choices about your health information. ❖ We will make sure the person has this authority and can act for you before we take any action. File a complaint if you feel your rights are violated ❖ You can complain if you feel we have violated your rights - please contact HR who will direct you to our HIPAA Security Officer. ❖ You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling (877) 696 - 6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/ . ❖ We will not retaliate against you for filing a complaint. Your Choices For certain health information, you can tell us your choices about what to share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what yo u want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to: ❖ Share information with your family, close friends, or others involved in payment for your care ❖ Share information in a disaster relief situation If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your informatio n i f we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat t o h ealth or safety. In these cases, we never share your information unless you give us written permission: ❖ Marketing purposes ❖ Sale of your information
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES ??????????? Our Uses and Disclosures How do we typically use or share your health information. We typically use or share your health information in the following ways. Help manage the health care treatment you receive ❖ We can use your health information and share it with professionals who are treating you. Example: A doctor sends us information about your diagnosis and treatment plan so we can arrange additional services. Run our organization ❖ We can use and disclose your information to run our organization and contact you when necessary. ❖ We are not allowed to use genetic information to decide whether we will give you coverage and the price of that coverage. This does not apply to long term care plans. Example: We use health information about you to develop better services for you. Pay for your health services ❖ We can use and disclose your health information as we pay for your health services. Example: We share information about you with your dental plan to coordinate payment for your dental work. Administer your Plan ❖ We may disclose your health information to your health plan sponsor for plan administration. Example: Your company contracts with us to provide a health plan, and we provide your company with certain statistics to explain the premiums we charge. How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: Your Rights Under HIPAA | HHS.gov .
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES ??????????? Help with public health and safety issues We can share health information about you for certain situations such as: ❖ Preventing disease ❖ Helping with product recalls ❖ Reporting adverse reactions to medications ❖ Reporting suspected abuse, neglect or domestic partner violence ❖ Preventing or reducing a serious threat to anyone’s health or safety Do research ❖ We can use or share your information for health research. Comply with the law ❖ We will share information about you if State or Federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with Federal privacy law. Respond to organ and tissue donation requests and work with a medical examiner or funeral director ❖ We can share health information about you with organ procurement organizations. ❖ We can share health information with a coroner, medical examiner or funeral director when an individual dies. Address workers’ compensation, law enforcement and other government requests We can use or share health information about you: ❖ For workers’ compensation claims ❖ For law enforcement purposes or with a law enforcement official ❖ With health oversight agencies for activities authorized by law ❖ For special government functions such as military, national security and presidential protective services. Respond to lawsuits and legal actions ❖ We can share health information about you in response to a court or administrative order or in response to a subpoena.
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES FAMILY AND MEDICAL LEAVE ACT (FMLA) If the Company and employee (you) are covered under the federal Family and Medical Leave Act (FMLA), then you can take up to 12 weeks of unpaid leave during a 12 - month period for one or more of the following reasons: • for the birth and care of the newborn child of the employee; • for placement with the employee of a son or daughter for adoption or foster care; • to care for an immediate family member (spouse, child, or parent) with a serious health condition; or • to take medical leave when the employee is unable to work because of a serious health condition. If you are covered by FMLA, you will have certain rights to maintain health benefits during the FMLA leave. You will be notif ied of any requirement for you to make any premium payments to maintain health benefits and the arrangements for making such payments along with the possible conseq uen ces of failure to make such payments on a timely basis (i.e., the circumstances under which coverage may lapse) and your potential liability for payment of health insurance premiums paid by the employer during your unpaid FMLA leave if you fail to return to work after taking FMLA leave. For more information about FML A, contact the Plan administrator. GRANDFATHERED STATUS The Plan believes that none of the group health plans available under the Plan are “grandfathered health plans” as described und er the Patient Protection and Affordable Care Act (the “Affordable Care Act”). Our Responsibilities ❖ We are required by law to maintain the privacy and security of your protected health information. ❖ We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. ❖ We must follow the duties and privacy practices described in this notice and give you a copy of it. ❖ We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us w e c an, you may change your mind at any time. Let us know in writing if you change your mind. For more information see: Your Rights Under HIPAA | HHS.gov .
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES SPECIAL RULE FOR MATERNITY AND INFANT COVERAGE Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any hospital leng th of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean se cti on. However, Federal law generally does not prohibit the attending provider or physician, after consulting with the mother, from discharging the mother or her newbor n e arlier than 48 hours (or 96 hours, as applicable). SPECIAL RULE FOR WOMEN’S HEALTH COVERAGE (WHCRA) If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women's Health and Cance r R ights Act of 1998 (WHCRA). For individuals receiving mastectomy - related benefits, coverage will be provided in a manner determined in consultation with the att ending physician and the patient, for: all stages of reconstruction of the breast on which the mastectomy was performed; surgery and reconstruction of the othe r b reast to produce a symmetrical appearance; prostheses; and treatment of physical complications of the mastectomy, including lymphedema. These benefits will be provided subject to the same deductibles and co - insurance applicable to other medical and surgical benefits provided under the BB&N Health Plan. If you would like more information on WHCRA benefits, please call your Plan Administrator. NOTICE REGARDING LIFETIME AND ANNUAL DOLLAR LIMITS In accordance with applicable law, any lifetime dollar limits and annual dollar limits set forth in the Plan shall not apply to “essential health benefits,” as such term is defined under Section 1302(b) of the Affordable Care Act. The law defines “essential health benefits” to include, at minimum, it ems and services covered within certain categories including emergency services, hospitalization, prescription drugs, rehabilitative and habilitative service s a nd devices, and laboratory services. A determination as to whether a benefit constitutes an “essential health benefit” will be based on a good faith interpretation by the Plan Administrator of the guidance available as of the date on which the determination is made. PATIENT PROTECTION DISCLOSURE You have the right to designate any participating primary care provider who is available to accept you or your family members (f or children, you may designate a pediatrician as the primary care provider). For information on how to select a primary care provider and for a list of partic ipa ting primary care providers, contact the Plan Administrator. You do not need prior authorization from the Plan or from any other person, including your primary care p rov ider, in order to obtain access to obstetrical or gynecological care from a health care professional; however, you may be required to comply with certain proced ure s, including obtaining prior authorization for certain services, following a pre - approved treatment plan, or procedures for making referrals. For a list of p articipating health care professionals who specialize in obstetrics or gynecology, contact the health plan.
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES AFFORDABLE CARE ACT CONSUMER PROTECTIONS a.) Coverage for Children Up to Age of 26 The Affordable Care Act of 2010 requires that the Plan must make dependent coverage available to adult children until they tu rn 26 regardless of if they are married, a dependent, or a student. (b.) Prohibition of Lifetime Dollar Value of Benefits: the Affordable Care Act of 2010 prohibits the Plan from imposing a l ife time limit on the dollar value of benefits. (c.) Your Health Insurance Cannot be Rescinded The Affordable Care Act of 2010 prohibits the Plan, or any insurer, from rescinding your health insurance coverage except as per mitted under the Act. (d.) Prohibition of Pre - Existing Conditions No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had b efo re your coverage started. (e.) Prohibition of Restrictions on Annual Limits on Essential Benefits The Affordable Care Act of 2010 prohibits the Plan, or any insurer, effective January 1, 2014, from placing annual limits on the value of essential health benefits. (f) Notice of Marketplace/Exchange You have the option to purchase health insurance at the Health Insurance Marketplace. The Marketplace offers "one - stop shopping" to find and compare private health insurance options as well as a premium tax credit or a cost sharing reduction for certain qualified individuals. If you purch ase a health plan through the Marketplace, you will lose any employer contribution toward the cost of your health coverage. Employer contributions to employer - provided cov erage may be excludable for federal income tax purposes. The Marketplace can help you evaluate your coverage options, including your eligibility for coverage thr oug h the Marketplace and its cost. Please visit www.Healthcare.gov for more information and contact information for a Health Insurance Marketplace in your area. MICHELLE’S LAW Michelle’s Law provides continued health and dental insurance benefits under the Plan for dependent children who are covered und er the Plan as a student but lose their student status in a post - secondary school or college because they take a medically necessary leave of absence from sc hool. If your child is no longer a student because he or she is out of school because of a medically necessary leave of absence, your child may continue to be c ove red under the Plan for up to one year from the beginning of the leave of absence.
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES THE GENETIC INFORMATION NONDISCRIMINATION ACT (GINA) GINA prohibits the Plan from discriminating against individuals on the basis of genetic information in providing any benefits un der the Plan. Genetic information includes the results of genetic tests to determine whether someone is at increased risk of acquiring a condition in the futur e, as well as an individual’s family medical history. WELLNESS Your health plan is committed to helping you achieve your best health. If your Plan includes a Wellness program that provides re wards or surcharges based on your ability to complete an activity or satisfy an initial health standard, and if you think you might be unable to meet a standar d f or a reward under the wellness program, you might qualify for an opportunity to earn the same reward by different means. Contact the Plan Administrator and we will w ork with you (and, if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status. YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS When you get emergency care or get treated by an out - of - network provider at an in - network hospital or ambulatory surgical center , you are protected from surprise billing or balance billing. What is “balance billing” (sometimes called “surprise billing”)? When you see a doctor or other health care provider, you may owe certain out - of - pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your heal th plan’s network. “Out - of - network” describes providers and facilities that haven’t signed a contract with your health plan. Out - of - network provide rs may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billin g.” This amount is likely more than in - network costs for the same service and might not count toward your annual out - of - pocket limit. “Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care — like when you have an emergency or when you schedule a visit at an in - network facility but are unexpectedly treated by an out - of - network provider. You are protected from balance billing for: Emergency services If you have an emergency medical condition and get emergency services from an out - of - network provider or facility, the most the provider or facility may bill you is your plan’s in - network cost - sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced bi lled for these post - stabilization services.
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS (CONTINUED) Certain services at an in - network hospital or ambulatory surgical center When you get services from an in - network hospital or ambulatory surgical center, certain providers there may be out - of - network. In these cases, the most those providers may bill you is your plan’s in - network cost - sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give u p y our protections not to be balance billed. If you get other services at these in - network facilities, out - of - network providers can’t balance bill you, unless you give writt en consent and give up your protections. You’re never required to give up your protection from balance billing. You also aren’t required to get care out - of - network. You can choose a provider or facility in your plan’s network. When balance billing isn’t allowed, you also have the following protections: You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in - network). Your health plan will pay out - of - network providers and facilities directly. Your health plan generally must: • Cover emergency services without requiring you to get approval for services in advance (prior authorization). • Cover emergency services by out - of - network providers. • Base what you owe the provider or facility (cost - sharing) on what it would pay an in - network provider or facility and show th at amount in your explanation of benefits. • Count any amount you pay for emergency services or out - of - network services toward your deductible and out - of - pocket limit. If you believe you’ve been wrongly billed , you may contact the Centers for Medicare & Medicaid Services https://www.cms.gov/nosurprises . Visit https://www.cms.gov/nosurprises/Policies - and - Resources/Overview - of - rules - fact - sheets for more information about your rights under federal law.
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES PREMIUM ASSISTANCE UNDER MEDICAID AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your st ate may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Me dicaid or CHIP, you won’t be eligible for these premium assistance programs, but you may be able to buy individual insurance coverage through the Health Insurance Mark etp lace. For more information, visit www.healthcare.gov . If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State M edi caid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might b e e ligible for either of these programs, contact your State Medicaid or CHIP office or dial 1 - 877 - KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer - sponsored plan. If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer pl an, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance . If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1 - 866 - 444 - EBSA (3272) . If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The fo llowing list of states is current as of July 31 , 2025. Contact your State for more information on eligibility - ALABAMA - Medicaid Website: http://myalhipp.com/ Phone: 1 - 855 - 692 - 5447 ALASKA - Medicaid The AK Health Insurance Premium Payment Program Website: http://myakhipp.com/ Phone: 1 - 866 - 251 - 4861 Email: CustomerService@MyAKHIPP.com Medicaid Eligibility: https://health.alaska.gov/dpa/Pages/default.aspx ARKANSAS - Medicaid Website: http://myarhipp.com/ Phone: 1 - 855 - MyARHIPP (855 - 692 - 7447) CALIFORNIA - Medicaid Website: Health Insurance Premium Payment (HIPP) Program http://dhcs.ca.gov/hipp Phone: 916 - 445 - 8322 Fax: 916 - 440 - 5676 Email: hipp@dhcs.ca.gov
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES PREMIUM ASSISTANCE UNDER MEDICAID AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) (CONTINUED) COLORADO – Health First Colorado (Colorado’s Medicaid Program) & Child Health Plan Plus (CHP+) Health First Colorado Website: https://www.healthfirstcolorado.com/ Health First Colorado Member Contact Center: 1 - 800 - 221 - 3943/ State Relay 711 CHP+: https://www.colorado.gov/pacific/hcpf/child - health - plan - plus CHP+ Customer Service: 1 - 800 - 359 - 1991/State Relay 711 Health Insurance Buy - In Program (HIBI): https://www.mycohibi.com/ HIBI Customer Service: 1 - 855 - 692 - 6442 FLORIDA - Medicaid Website: https://www.flmedicaidtplrecovery.com/flmedicaidtplreco very.com/hipp/index.html Phone: 1 - 877 - 357 - 3268 GEORGIA - Medicaid GA HIPP Website: https://medicaid.georgia.gov/healthinsurance - premium - payment - program - hipp Phone: 678 - 564 - 1162, Press 1 GA CHIPRA Website: https://medicaid.georgia.gov/programs/third - partyliability/childrens - health - insurance - program - reauthorizationact - 2009 - chipra Phone: 678 - 564 - 1162, Press 2 INDIANA - Medicaid Health Insurance Premium Payment Program All other Medicaid Website: https://www.in.gov/Medicaid/ http://www.in.gov/fssa/dfr/ Family and Social Services Administration Phone: 1 - 800 - 403 - 0864 Member Services Phone: 1 - 800 - 457 - 4584 IOWA – Medicaid and CHIP ( Hawki ) Medicaid Website: Iowa Medicaid | Health & Human Services Medicaid Phone: 1 - 800 - 338 - 8366 Hawki Website: Hawki - Healthy and Well Kids in Iowa | Health & Human Services Hawki Phone: 1 - 800 - 257 - 8563 HIPP Website: Health Insurance Premium Payment (HIPP) | Health & Human Services (iowa.gov) HIPP Phone: 1 - 888 - 346 - 9562 KANSAS – Medicaid Website: https://www.kancare.ks.gov/ Phone: 1 - 800 - 792 - 4884 HIPP Phone: 1 - 800 - 967 - 4660 KENTUCKY – Medicaid Kentucky Integrated Health Insurance Premium Payment Program (KI - HIPP) Website: https://chfs.ky.gov/agencies/dms/member/Pages/kihip p.aspx Phone: 1 - 855 - 459 - 6328 Email: KIHIPP.PROGRAM@ky.gov KCHIP Website: https://kynect.ky.gov Phone: 1 - 877 - 524 - 4718 Kentucky Medicaid Website: https://chfs.ky.gov/agencies/dms LOUISIANA - Medicaid Website: www.medicaid.la.gov or www.ldh.la.gov/lahipp Phone: 1 - 888 - 342 - 6207 (Medicaid hotline) or 1 - 855 - 618 - 5488 (LaHIPP) MAINE – Medicaid Enrollment Website: https://www.mymaineconnection.gov/benefits/s/?lang uage=en _US Phone: 1 - 800 - 442 - 6003 TTY: Maine relay 711 Private Health Insurance Premium Webpage: https://www.maine.gov/dhhs/ofi/applications - forms Phone: 1 - 800 - 977 - 6740 TTY: Maine relay 711
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES PREMIUM ASSISTANCE UNDER MEDICAID AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) (CONTINUED) MASSACHUSETTS – Medicaid and CHIP Website: https://www.mass.gov/masshealth/pa Phone: 1 - 800 - 862 - 4840 TTY: 711 Email: masspremassistance@accenture.com MINNESOTA – Medicaid Website: https://mn.gov/dhs/health - care - coverage/ Phone: 1 - 800 - 657 - 3672 MISSOURI – Medicaid Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Phone: 573 - 751 - 2005 MONTANA – Medicaid Website: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP Phone: 1 - 800 - 694 - 3084 Email: HHSHIPPProgram@mt.gov NEBRASKA – Medicaid Website: http://www.ACCESSNebraska.ne.gov Phone: 1 - 855 - 632 - 7633 Lincoln: 402 - 473 - 7000 Omaha: 402 - 595 - 1178 NEVADA – Medicaid Medicaid Website: http://dhcfp.nv.gov Medicaid Phone: 1 - 800 - 992 - 0900 NEW HAMPSHIRE – Medicaid Website: https://www.dhhs.nh.gov/oii/hipp.htm https://www.dhhs.nh.gov/programs - services/medicaid/health - insurance - premiums - program Phone: 603 - 271 - 5218 Toll free number for the HIPP program: 1 - 800 - 852 - 3345, ext 5218 Email: DHHS.ThirdPartyLiabi@dhhs.nh.gov NEW JERSEY – Medicaid and CHIP Medicaid Website: http://www.state.nj.us/humanservices/dmahs/clients/medicai d/ Phone: 1 - 800 - 356 - 1561 CHIP Premium Assistance Phone: 609 - 631 - 2392 CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1 - 800 - 701 - 0710 (TTY: 711) NEW YORK – Medicaid Website: https://www.health.ny.gov/health_care/medicaid/ Phone: 1 - 800 - 541 - 2831 NORTH CAROLINA – Medicaid Website: https://medicaid.ncdhhs.gov/ Phone: 919 - 855 - 4100 NORTH DAKOTA – Medicaid Website: http://www.hhs.nd.gov/healthcare Phone: 1 - 844 - 854 - 4825 OKLAHOMA – Medicaid and CHIP Website: http://www.insureoklahoma.org Phone: 1 - 888 - 365 - 3742 OREGON – Medicaid Website: http://healthcare.oregon.gov/Pages/index.aspx Phone: 1 - 800 - 699 - 9075 PENNSYLVANIA – Medicaid and CHIP Website: https://www.pa.gov/en/services/dhs/apply - formedicaid - health - insurance - premium - payment - programhipp.html Phone: 1 - 800 - 692 - 7462 CHIP Website: Children's Health Insurance Program (CHIP) (pa.gov) CHIP Phone: 1 - 800 - 986 - KIDS (5437) RHODE ISLAND – Medicaid and CHIP Website: http://www.eohhs.ri.gov/ Phone: 1 - 855 - 697 - 4347, or 401 - 462 - 0311 (Direct RIte Share Line) SOUTH CAROLINA – Medicaid Website: https://www.scdhhs.gov Phone: 1 - 888 - 549 - 0820 SOUTH DAKOTA – Medicaid Website: http://dss.sd.gov Phone: 1 - 888 - 828 - 0059
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES PREMIUM ASSISTANCE UNDER MEDICAID AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) (CONTINUED) TEXAS – Medicaid Website: Health Insurance Premium Payment (HIPP) Program | Texas Health and Human Services Phone: 1 - 800 - 440 - 0493 UTAH – Medicaid and CHIP Utah’s Premium Partnership for Health Insurance (UPP) Website: https://medicaid.utah.gov/upp/ Email: upp@utah.gov Phone: 1 - 888 - 222 - 2542 Adult Expansion Website: https://medicaid.utah.gov/expansion/ Utah Medicaid Buyout Program Website: https://medicaid.utah.gov/buyout - program/ CHIP Website: https://chip.utah.gov/ VERMONT – Medicaid Website: Health Insurance Premium Payment (HIPP) Program | Department of Vermont Health Access Phone: 1 - 800 - 250 - 8427 VIRGINIA – Medicaid and CHIP Website: https://coverva.dmas.virginia.gov/learn/premiumassistance/fami s - select and https://coverva.dmas.virginia.gov/learn/premiumassistance/healt h - insurance - premium - payment - hipp - programs Medicaid/CHIP Phone: 1 - 800 - 432 - 5924 WASHINGTON – Medicaid Website: https://www.hca.wa.gov/ Phone: 1 - 800 - 562 - 3022 WEST VIRGINIA – Medicaid and CHIP Website: https://dhhr.wv.gov/bms/ http://mywvhipp.com/ Medicaid Phone: 304 - 558 - 1700 CHIP Toll - free phone: 1 - 855 - MyWVHIPP (1 - 855 - 699 - 8447) WISCONSIN – Medicaid and CHIP Website: https://www.dhs.wisconsin.gov/badgercareplus/p - 10095.htm Phone: 1 - 800 - 362 - 3002 WYOMING – Medicaid Website: https://health.wyo.gov/healthcarefin/medicaid/progra ms - and - eligibility/ Phone: 1 - 800 - 251 - 1269 To see if any other states have added a premium assistance program since July 31,2025, or for more information on S pecial Enrollment Rights , contact either: U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1 - 866 - 444 - EBSA (3272) U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1 - 877 - 267 - 2323, Menu Option 4, Ext. 61565 OMB Control Number 1210 - 0137 (Expires: 1/31/2026)
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES IMPORTANT NOTICE ABOUT YOUR PRESCRIPTION DRUG COVERAGE AND MEDICARE Please read this notice carefully and keep it where you can find it. This notice has information about your current prescript ion drug coverage with your employer and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescrip tio n drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage: 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2. Your employer has determined that the prescription drug coverage offered by the employer sponsored medical plans are, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and are therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan. When Can You Join a Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th . However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligi ble for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES IMPORTANT NOTICE ABOUT YOUR PRESCRIPTION DRUG COVERAGE AND MEDICARE (CONTINUED) What Happens to Your Current Coverage If You Decide to Join a Medicare Drug Plan? Your current coverage pays for other health expenses, in addition to prescription drugs. If you are actively employed and dec ide to join a Medicare drug plan, your current medical coverage will not be affected; you can keep this coverage if you elect part D an d this plan will coordinate with Part D coverage. If you are actively employed and you decide to join a Medicare drug plan and drop your current medical coverage, be aware tha t you and your dependents may be able to get this coverage back at the next open enrollment period or upon a qualifying status change if you remain otherwise eligible to enroll in the Plan. If you are no longer actively employed and you decide to join a Medicare drug plan and drop your current coverage, be aware t hat you and your dependents will not be able to get this coverage back. When Will You Pay a Higher Premium (Penalty) To Join a Medicare Drug Plan? You should also know that if you drop or lose your current coverage and don’t join a Medicare drug plan within 63 continuous day s after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at le ast 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if yo u go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. For More Information About This Notice or Your Current Prescription Drug Coverage... Contact the plan administrator for further information.
HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES IMPORTANT NOTICE ABOUT YOUR PRESCRIPTION DRUG COVERAGE AND MEDICARE (CONTINUED) For More Information About Your Options Under Medicare Prescription Drug Coverage... More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You ’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage: • Visit www.medicare.gov • Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help. • Call 1 - 800 - MEDICARE (1 - 800 - 633 - 4227). TTY users should call 1 - 877 - 486 - 2048. If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For informa tio n about this extra help, visit Social Security on the web at www.socialsecurity.gov , or call them at 1 - 800 - 772 - 1213 (TTY 1 - 800 - 325 - 0778). Last updated: July 2025
