EMPath FY26 Benefit Guide

FY26 BENEFIT GUIDE

This guide is a brief summary of benefits offered to your group and does not constitute a policy. Economic Mobility Pathways reserves to itself, pursuant to its sole and exclusive discretion, the right to change, amend or terminate the benefits program at any time. The insurance companies plan descriptions will contain the actual detailed provisions of your benefits. If there are any discrepancies between the information in the guide and the insurance company’s plan descriptions, the language in the insurance companies plan descriptions will always prevail. As an Economic Mobility Pathways employee, you are eligible for benefits if you work at least 30 hours per week. You become benefits eligible on your date of hire. You may enroll your eligible dependents for coverage once you are eligible. Your eligible dependents include: • Your legal spouse • Your children up to the age of 26 (Children will be covered until the last day of the month in which they turn 26) Once your benefit elections become effective, they remain in effect until June 30, 2026. Should you leave your employment with EMPath, your benefits will end on your final day of employment per plan rules. You may only change your benefits within 30 days of a qualified life event. BENEFITS RUN JULY 1, 2025 – JUNE 30, 2026 ELIGIBILITY 2 // FY26 Benefit Guide

Employee Only Bi-Weekly Cost Employee + Family Bi-Weekly Cost Medical – BCBSMA HMO $127.92 $335.52 Medical – BCBSMA PPO $127.27 $333.84 Dental – BCBSMA $15.94 $46.35 Vision – EyeMed Employee Only: $3.28 Employee + Spouse: $6.23 Employee + Child(ren): $6.55 Employee + Family: $9.63 Health Reimbursement Arrangement (HRA) – HealthEquity Economic Mobility Pathways funds this account Flexible Spending Accounts (FSAs) – Cafeteria Plan Advisors, Inc. Employee contributions vary Basic Life/AD&D & Long-Term Disability – Equitable Economic Mobility Pathways funds 100% of premium Voluntary Short-Term Disability – Equitable Employee’s electing Voluntary Short-Term Disability coverage will pay 100% of premium Employee Assistance Program (EAP) – ComPsych Available to employees at no additional cost Travel Assistance – AXA Assistance USA Available to employees at no additional cost 403(b) Retirement Plan – Fidelity Employee contributions vary BENEFIT COSTS AMOUNTS DEDUCTED FROM EMPLOYEES’ CHECK PER PAY PERIOD 3 // FY26 Benefit Guide

EMPLOYER FUNDED BENEFITS

HMO BLUE NE DEDUCTIBLE II PREFERRED BLUE PPO DEDUCTIBLE II In-Network Only In-Network Out-of-Network Deductible $4,000 member / $8,000 family $4,000 member / $8,000 family Out-of-Pocket Max $7,000 member / $14,000 family $7,000 member / $14,000 family Preventive Visit $0 $0 20% coinsurance after deductible PCP Office Visit $25 $25 20% coinsurance after deductible Specialist Visit $40 $40 20% coinsurance after deductible Diagnostic Testing X-rays $75 / Labs $25 after deductible X-rays $75 / Labs $25 after deductible 20% coinsurance after deductible High-tech Imaging $100 after deductible $100 after deductible 20% coinsurance after deductible Emergency Room $250 $250 Inpatient Care $250 after deductible $250 after deductible 20% coinsurance after deductible Outpatient Care $250 after deductible $250 after deductible 20% coinsurance after deductible Prescriptions (Retail / Mail Order) Generic Brand Non-Formulary $15 / $30 $30 / $60 $50 / $150 $15 / $30 $30 / $60 $50 / $150 $30 / all charges $60 / all charges $100 / all charges MEDICAL PLAN OPTIONS PPO HMO 5 // FY26 Benefit Guide

HMO PPO Member Deductible Responsibility Individual: $1,000 Family: $2,000 Individual: $2,000 Family: $4,000 HRA Pays Toward Deductible (Funded By EMPath) Individual: $3,000 Family: $6,000 Individual: $2,000 Family: $4,000 BCBSMA Plan Deductible Individual: $4,000 Family: $8,000 Individual: $4,000 Family: $8,000 The HRA is an account that EMPath funds to help employees enrolled in the HRA medical plan pay for expenses that apply towards their deductible. Employees will pay the first portion of their deductible, and EMPath will pay the remainder. These amounts are outlined below. Copays and coinsurance are not deductible expenses, so you will still have to pay those when applicable. When you do incur a deductible expense that is HRA eligible, you can submit your receipts to HealthEquity online or through their mobile app. Watch:HRA The Easy Way HEALTH REIMBURSEMENT ARRANGEMENT (HRA) ALL MEDICAL PLAN PARTICIPANTS ARE AUTOMATICALLY ENROLLED IN HRA 6 // FY26 Benefit Guide

- Using a doctor, facility, or other provider from the BCBS of MA network will mean a lower bill for you. The Find a Doctor tool lets you search for doctors or check to see if yours is in-network. - Get discount prescription drugs by using GoodRx to search for drugs you or your family members are prescribed to. - Make sure you’re choosing the most cost-effective option for finding care. Check out this easy guide for where to go when you’re sick or injured so you aren’t paying too much out-of-pocket. How to Save on Costs BCBS MyBlue Member App - Track claims & benefits - Check deductible balances - Find a doctor - View your member ID card - Contact member services scan QR learn more member login telehealth phone support glossary find a doctor MEDICAL PLAN EDUCATION 7 // FY26 Benefit Guide

Telehealth Receive treatment and prescriptions (when necessary) from home for a variety of common ailments through the Well-Connection telehealth platform Learn to Live Help coping with stress/anxiety/worry, depression, social anxiety, insomnia and substance use through self-paced, online programs. Unlimited coaching is available Fitness Reimbursement Get up to $150 annually towards gym fees, home fitness equipment, fitness classes, or online workout programs Weight Loss Reimbursement Get up to $150 annually towards in-person or online weight loss programs like Weight Watchers, or hospital-based programs Blue365 Discounts Access exclusive discounts on things like gym memberships, fitness gear, healthy eating options, and more – only for BCBS members BCBS MEMBER PERKS 8 // FY26 Benefit Guide

Pillar Rx Pillar Rx is BCBS’s cost share assistance program for specialty medications based on manufacturer’s coupon programs. Learn more here. Reproductive Health Travel Benefit BCBS will reimburse you and one companion if necessary for certain expenses related to travel for reproductive health services. Learn more here. Virtual Provider Networks Carbon Health & Firefly Health are the two in- network virtual provider. PCP, urgent care, and mental health services are provided virtually for a $0 office visit copay. CVS Caremark BCBS’s Pharmacy Benefit Manager is CVS Caremark. To pay the least for care, make sure your prescriptions are filled at a pharmacy within their network. Learn more here. ADDITIONAL BCBS RESOURCES 9 // FY26 Benefit Guide

Mental & Behavioral Health Resource Center Nothing should stand between you and your mental wellness, whether that means emotional, psychological, or social well-being. Your mental health is essential to your overall well-being. BCBSMA’s Mental Health Resource Center is the place to explore your care options, insightful information, and helpful wellness choices. Members can review difference resources available as well as check out difference articles and videos but visiting the BCBSMA Mental Health Resource Center. If you do not find what you need there, Team Blue can help by calling 1-888-389-7764. Learn to Live Get support for your mental health. If you’re ready to get support for your mental health, Learn To Live, an independent company, may be able to help. Use it to identify and work through your thoughts and behaviors by accessing self-guided, personalized programs that can help with: o Social anxiety, depression, insomnia o Stress, anxiety, and worry o Substance use, panic, resilience It’s confidential and available online 24/7, at no additional cost to BCBSMA members. The get started, complete a self-assessment to find out which programs might work best for you. It only takes about fives minutes and can be accessed by signing into MyBlue or creating a MyBlue account, then click Online Mental Health Tool under My Plan & Claims. BCBS MENTAL WELLNESS RESOURCES 10 // FY26 Benefit Guide

DENTAL BLUE FREEDOM In-Network Deductible $50 member / $150 family Calendar Year Max $1,000 / year per person Preventive Care 100% Covered; deductible does not apply to preventive services Basic Care 85% Covered* Major Care 55% Covered* Accumulated Maximum Rollover If your claims do not exceed $500 during the plan year, BCBS will rollover $350 towards your calendar year maximum to use next year and beyond. The rollover balance is capped at $1,000 Members Under The Age Of 13 Members under the age of 13 will be 100% covered up to the annual maximum for covered dental services Enhanced Dental Benefits Enhanced Dental Benefits for certain dental care services are available for members who have been diagnosed with qualifying conditions (such as diabetes, stroke, coronary disease, etc.). To learn more about specific conditions included in this benefit, please review your plan description *after deductible DENTAL PLAN DENT 11 // FY26 Benefit Guide

- Your plan allows you two free dental cleanings a year, and one routine x- ray every 12 months. - All services you receive at the dentist fall under preventive, basic, or major. Preventive services are fully covered even before the deductible has been met. Your Dental Benefits BCBS MyBlue Member App - Track claims & benefits - Check deductible balances - Find a doctor - View your member ID card - Contact member services scan QR - When you see a BCBS of MA network dentist, benefits are covered at the in-network level – you will enjoy the greatest savings. Click here to find an in-network dental provider. learn more member login learn more phone support DENTAL PLAN EDUCATION 12 // FY26 Benefit Guide

BASIC LIFE AND AD&D LONG-TERM DISABILITY Plan Employer Paid Basic Life and AD&D Employer Paid Long-Term Disability Benefit Pays 1x Annual Salary Up to $200,000 60% of your monthly pre-disability earnings up to $9,500/month Additional Information Guaranteed Issue is: $200,000 Elimination Period is: 90 days Benefit Length Benefit Reduces to 65% at age 65, to 50% at age 70, and to 35% at age 75 Pays up to (SSNRA) Social Security Normal Retirement Age Cost Responsibility EMPath pays 100% of the cost of this benefit EMPath pays 100% of the cost of this benefit LTD LIFE BASIC LIFE/AD&D AND LONG-TERM DISABILITY 13 // FY26 Benefit Guide

Get Support Now Online guidanceresources.com Web ID: EQUITABLE3 Toll-free 24/7 access 833-256-5115 (multi-lingual) App GuidanceNow EMPath employees and their family members may access the Employee Assistance Program (EAP) 24/7, 365 days a year. Support includes: Assessment & Referral Services • Unlimited telephonic assessment and referral • Up to 3 face-to-face diagnostic and short-term problem resolution sessions • Global network of 52,000+ licensed providers Legal & Financial Services • Financial consultation for an unlimited number of issues per year • Legal consultation for an unlimited number of issues per year • Online legal and financial resource center including document preparation Work-Life Benefits & Resources • Child, elder, and pet care • Education, personal services, and health and wellness • Veteran resources and support • Online resources & tools for 100+ work-life topics EAP EMPLOYEE ASSISTANCE PROGRAM (EAP) 14 // FY26 Benefit Guide

Get Support Now Register Online AXA Travel Web Portal Within the U.S. 855-327-1476 EMPath employees and their dependents have access to the Emergency Travel Assistance Program provided by AXA Assistance USA, Inc. As a member, you can access a broad range of worldwide travel, emergency medical transportation and concierge services 24 hours a day, 365 days a year. Call AXA Assistance if you require: • Medical & dental referrals • Emergency medical evacuation & repatriation, or hospital admission & critical care monitoring • Lost document & luggage assistance or ID theft assistance • General travel information Medical Assistance Services • Coordination of hospital admission • Critical care monitoring or dispatch of physician • Dispatch of prescription medication Concierge Services • Make your life simpler and easier – concierge services are designed to fulfill various travel and entertainment requests, including restaurant and entertainment recommendations, locating available business services, airfare and care rental and much more! TRAV TRAVEL ASSISTANCE PROGRAM Outside the U.S. 312-356-5980 15 // FY26 Benefit Guide

VOLUNTARY BENEFITS

EYEMED - INSIGHT NETWORK In-Network Out-of-Network Reimbursement Eye Exam Once every plan year $10 copay $0 at PLUS Providers Up to $57 Prescription Glasses - $25 materials copay Frames Once every other plan year $0 copay; 20% off balance over $130 allowance At Plus Prover: $0 copay; 20% off balance over $180 allowance Up to $104 Lenses Once every plan year Single Vision, Lined Bifocal, and Lined Trifocal allowance copay included in the $25 prescription glasses materials copay Single Vision: up to $47 Lined Bifocal: up to $79 Lined Trifocal: up to $113 Standard Progressive Lenses $80 copay Up to $73 Premium Progressive Lenses $110 - $240 copay Up to $95 Contact Lenses (instead of glasses) Once every plan year Contact Lenses Conventional - $0 copay; 15% off balance over $130 allowance Disposable - $0 copay; 100% of balance over $130 allowance Medically Necessary - $0 copay; paid-in-full Conventional – Up to $104 Disposable – Up to $104 Medically Necessary – Up to $300 Contact Lens Exam (fitting & evaluation) Up to $40; contact lens fit and two follow-up visits Not covered VISION PLAN VIS 17 // FY26 Benefit Guide

- Your plan allows you one eye exam per year. This eye exam can diagnose medical issues as well as determine a prescription for glasses or contacts. - You are provided an annual allowance to spend at an in- network provider for either frames or contact lenses. Your Vision Perks EyeMed Mobile App - Track claims & benefits - Check deductible balances - Find a doctor - View your member ID card - Contact member services scan QR Watch: See What’s Covered - When you see an EyeMed network eye doctor, benefits are covered at the in-network level – you will enjoy the greatest savings. - Your plan is part of the Insight Network. Click here to find an in-network vision provider. member login learn more phone support apple android VISION PLAN EDUCATION 18 // FY26 Benefit Guide

VOLUNTARY SHORT-TERM DISABILITY STATUTORY BENEFIT: MA PAID FAMILY & MEDICAL LEAVE Plan Voluntary Short-Term Disability Statutory Massachusetts Paid Family & Medical Leave (MAPFML) Benefit 70% of your weekly pre-disability earnings up to $1,000/week Weekly maximum benefit is: $1,170.64 Additional Information Elimination Period is: 15th day for Accident 15th day for Sickness Total combined benefit length (includes PFL & PML) is 26 weeks Benefit Length Pays up to 13 weeks Employee’s own serious health condition: 20 weeks Baby bonding, care for family member: 12 weeks Care for Service Member: 26 weeks Cost Responsibility If you choose to enroll in this benefit, you are 100% responsible for paying the benefit premiums EMPath & Employee’s both pay for monthly premiums per MA State Law MAPFML STD VOLUNTARY SHORT-TERM DISABILITY & MAPFML 19 // FY26 Benefit Guide

Enrollment & Account Access You can enroll in the plan, access your account, or get more information any time by: • Fidelity Online Enrollment Instructions • You will select Enroll and when prompted, enter the Plan ID: 50913 • Calling 800-343-0860 Monday through Friday from 8:30am – 8:30pm ET • View additional details on managing your account with Fidelity How much do you need to save for retirement? That depends on your expenses. Use this calculator from Fidelity to determine how much you should be saving now to be comfortable in your retirement. Read: What’s a 403(b)? Contributions Employees are eligible to contribute to this plan upon hire. Employees can opt to defer pre-tax or post-tax contributions. 403(B) RETIREMENT PLAN WITH FIDELITY FAQ Contributions You can contribute up to $23,500 into your 403(b) in 2025. If you’re age 50 or older, you can defer an additional $7,500 catch- up contribution through your bi-weekly payroll Eligibility You are eligible to contribute to the Plan upon hire. You may enter the plan at any time Plan Administrator Fidelity 20 // FY26 Benefit Guide

Contributions Calculated annually at the end of the fiscal year (June 30th) Eligibility All employees who have completed two (2) years of service Plan Administrator TIAA Enrollment & Account Access EMPath will automatically enroll you in TIAA after 2 years of employment. Once you have been enrolled you can create an account and invest your balances: • TIAA Online Enrollment • Calling 800-842-2252 Monday through Friday from 8:00am – 10:00pm ET • View additional details on managing your account with TIAA How much do you need to save for retirement? That depends on your expenses. Use these retirement calculators & financial tools from TIAA to determine how much you should be saving now to be comfortable in your retirement. Employer Match All employees who have completed two (2) years of service as of June 30th and have worked at least 1,000 hours in the previous 12 months are eligible. EMPath contributes 3% of Gross Salary up to $50,000. Employees can opt to defer pre-tax or post-tax contributions. 403(B) RETIREMENT PLAN WITH TIAA FAQ Read: 6 Ways to Maximize Retirement Savings 21 // FY26 Benefit Guide

FAQ PERQ MBTA PROGRAM Eligible expenses include: subway trolley train bus ferry PLAN DETAILS What is Perq? Perq is the MBTA program that helps employees get passes with pre-tax dollars, avoid the hassle of renewing passes each month, and avoid administrative fees. What passes can you get? You can choose from any of the passes at MBTA.com/Perq-Products. Visit MBTA.com/Fares to explore all of the T’s fare options. If you’re a bus or subway rider You will receive a reusable monthly pass and keep the same card from month to month. If your pass gets lost or stolen, EMPath will replace it. Participants will tap the pass when you enter the bus or subway. If you ride the commuter rail or ferry You will receive a new plastic card each month from EMPath. Your pass will include transfer to bus and subway. Show the pass to the conductor, or tap it to board a bus or the subway. Participants cannot receive the pass on the mTicket App. If your pass is lost or stolen, it cannot be replaced. Treat your monthly pass as you would cash. PERQ 22 // FY26 Benefit Guide Do you use the MBTA every day?

VERIZ VERIZON FRONTLINE PROGRAM We recognize the critical role you play on the front lines in emergencies and crises. Whether you are a part-time, full-time or volunteer first responder, the ability to use your personal device to communicate is paramount to the success and outcome of any mission. Contact Verizon: For more information, call 877-224-0348 PLAN DETAILS What is the Verizon Frontline program? Verizon Frontline is the advanced network for first responders on the front lines. This program offers first responders discounts and priority services on personal wireless devices, at no additional cost. With the First Responder Benefits Program, you get: *Wireless Priority Service and Mobile Broadband Priority *Access to discount programs to unlock exclusive offers Verizon account enrollment To be eligible, you must be the owner of the account to receive first responder discounts. Please view the Verizon Frontline Program Summary for instructions to get started. Agency point of contact (POC) for DHS enrollment Your agency POC must certify your status with DHS, part of the Cybersecurity and Infrastructure Security Agency (CISA). Enrollment for GETS or WPS is required for applicants regardless of your wireless carrier. This process can take up to two weeks. Voice eligibility CISA: Call 866-627-2255 E-mail [email protected] Or visit www.cisa.gov/pts Mobile Broadband Priority: Eligibility is dependent on data enrollment requirements. 23 // FY26 Benefit Guide

DECEMBER OPEN ENROLLMENT – FLEX SPENDING

Enrolling in the FSA Watch: Everything You Need to Know About FSAs - You are required to re-enroll in the Healthcare Flexible Spending Account annually to contribute to the account, per IRS regulations - Once you enroll, you will need to elect the amount you would like to contribute for the entire year - You may not contribute to an FSA if you also contribute to an HSA - On the first day of the plan, your entire annual election is available to use - Newly hired employees and employees with a Qualifying Life Event (QLE) may use this New Hire/Change in Status Form for Flexible Spending Pre-Tax Payroll Reduction Authorizations Maximum Annual Contribution $3,300 Please note: the Maximum Annual Contribution amount will change for 2026 calendar year. Open Enrollment for FSA will take place in December. Eligible Expenses Medical, Dental, and Vision. Search eligible expenses How to Use Funds Use your CPA debit card at the point of sale, or submit receipts for reimbursement through the member portal Funds Rollover You may rollover up to $660 of unused Healthcare FSA funds into the next plan year Plan Administrator Cafeteria Plan Advisors, Inc. HEALTH CARE FLEXIBLE SPENDING ACCOUNT (FSA) AVAILABLE FOR EMPLOYEES TO ENROLL IN 25 // FY26 Benefit Guide

Enrolling in the DCA Watch: Everything You Should Know About FSAs - You are required to re-enroll in the Dependent Care Flexible Spending Account annually to contribute to the account, per IRS regulations - Once you enroll, you will need to elect the amount you would like to contribute for the entire year - Your funds are only available as they are distributed to your account from your paycheck - View the benefits of a Dependent Care account here Maximum Annual Contribution $5,000 ($2,500 if married filing separately) Eligible Expenses Childcare and eldercare Plan Administrator Cafeteria Plan Advisors, Inc. How to Use Funds Submit receipts for reimbursement through the member portal Funds Rollover Unused funds are forfeited at the end of the plan year DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT (DCA) AVAILABLE TO EMPLOYEES WITH ELIGIBLE DEPENDENTS 26 // FY26 Benefit Guide

EMPLOYEE RESOURCES

EMPATH CARRIER CONTACT LIST Benefit Carrier Login Phone Medical & Dental Blue Cross Blue Shield of MA BCBS of MA Member Portal 1-800-262-2583 Health Reimbursement Arrangement (HRA) HealthEquity HealthEquity Member Portal 877-924-3967 Flexible Spending Accounts (FSAs) Cafeteria Plan Advisors, Inc. CPA Member Portal 781-848-9848 Voluntary Vision EyeMed EyeMed Member Portal 1-866-939-3633 Life/AD&D and Disability Equitable Equitable Member Portal 866-274-9887 Employee Assistance Program (EAP) ComPsych ComPsych Member Portal 833-256-5115 Emergency Travel Assistance Program AXA Assistance USA AXA Travel Registration Portal Within US: 855-327-1476 Outside of US: 312-356-5980 Perq MBTA Program Perq Perq Products Portal 617-222-3200 Verizon Frontline Program Verizon Verizon First Responder Benefits Program 877-224-0348 403(b) Retirement Plan with Fidelity Fidelity Fidelity Member Portal 800-343-0860 403(b) Retirement Plan with TIAA TIAA TIAA Member Portal 800-842-2252 CARRIER CONTACTS ACCESS YOUR BENEFIT INFORMATION THROUGH THE MEMBER PORTAL 28 // FY26 Benefit Guide

PLAN DOCUMENTS CLICK ON EACH BENEFITS ICON TO VIEW THE PLANS DOCUMENT Medical – HMO BCBSMA Medical – PPO BCBSMA Dental Blue Freedom BCBSMA Life/AD&D and LTD Equitable EAP & Travel Assistance ComPsych & AXA Vision EyeMed Voluntary STD & MA PFML Equitable & MA 403(b) Retirement Plan Fidelity & TIAA MBTA Program Perq Frontline Benefits Program Verizon SBC SOB SBC SOB SOB LIFE LTD EAP TRAV SOB STD PFML FAQ FAQ PERQ FAQ SUM CERT CERT CERT 29 // FY26 Benefit Guide

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 turn 26 regardless 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 lifetime 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 permitted 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 before 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 purchase a health plan through the Marketplace, you will lose any employer contribution toward the cost of your health coverage. Employer contributions to employer-provided coverage may be excludable for federal income tax purposes. The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit www.Healthcare.gov for more information and contact information for a Health Insurance Marketplace in your area. The Genetic Information Nondiscrimination Act (GINA) - GINA prohibits the Plan from discriminating against individuals on the basis of genetic information in providing any benefits under the Plan. Genetic information includes the results of genetic tests to determine whether someone is at increased risk of acquiring a condition in the future, 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 rewards 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 standard for 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 work with you (and, if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status. 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 health plan’s network. “Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers 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 billing.” 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. HEALTH PLAN NOTICES

Special Enrollment Rights - If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group 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’ other 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. Grandfathered Status - The Plan believes that none of the group health plans available under the Plan are “grandfathered health plans” as described under the Patient Protection and Affordable Care Act (the “Affordable Care Act”). 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 length 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 section. However, Federal law generally does not prohibit the attending provider or physician, after consulting with the mother, from discharging the mother or her newborn earlier 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 Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for: all stages of reconstruction of the breast on which the mastectomy was performed; surgery and reconstruction of the other breast 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 Economic Mobility Pathways 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, items and services covered within certain categories including emergency services, hospitalization, prescription drugs, rehabilitative and habilitative services and 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 (for 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 participating 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 provider, in order to obtain access to obstetrical or gynecological care from a health care professional; however, you may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals. For a list of participating health care professionals who specialize in obstetrics or gynecology, contact the health plan. Michelle’s Law - Michelle’s Law provides continued health and dental insurance benefits under the Plan for dependent children who are covered under 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 school. 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 covered under the Plan for up to one year from the beginning of the leave of absence. HEALTH PLAN NOTICES

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 billed for these post-stabilization services. 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 up your 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 written consent and give up your protections. You’re never required to give up your protections 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 that 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

11. 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 prescription 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 prescription 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 eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan. 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 decide to join a Medicare drug plan, your current medical coverage will not be affected; you can keep this coverage if you elect part D and 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 that 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 that you and your dependents will not be able to get this coverage back. HEALTH PLAN NOTICES

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 information 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). 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 days 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 least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you 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

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 state 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 Medicaid 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 Marketplace. 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 Medicaid 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 be eligible 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 plan, 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). HEALTH PLAN NOTICES

Alabama Website: http://myalhipp.com/ Phone: 1-855-692-5447 Alaska The AK Health Insurance Premium Payment Program Website: http://myakhipp.com/ Phone: 1-866-251-4861 Email: [email protected] Medicaid Eligibility: http://dhss.alaska.gov/dpa/Pages/medicaid/default.aspx Arkansas Website: http://myarhipp.com/ Phone: 1-855-MyARHIPP (855-692-7447) California Website: Health Insurance Premium Payment (HIPP) Program http://dhcs.ca.gov/hipp Phone: 916-445-8322 Email: [email protected] Colorado 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.colorado.gov/pacific/hcpf/health-insurance- buyprogram HIBI Customer Service: 1-855-692-6442 Florida Website: https://www.flmedicaidtplrecovery.com/flmedicaidtplrec overy.com/hipp/index.html Phone: 1-877-357-3268 Georgia Website: https://medicaid.georgia.gov/health- insurance-premium-payment-program-hipp Phone: 678-564-1162 ext 2131 Massachusetts Website: https://www.mass.gov/info- details/masshealthpremium-assistance-pa Phone: 1-800-862-4840 Minnesota https://mn.gov/dhs/people-we-serve/children-and- families/health-care/health-care-programs/programs-and- services/other-insurance.jsp Phone: 1-800-657-3739 Missouri Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Phone: 573-751-2005 Montana Website: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP Phone: 1-800-694-3084 Nebraska Website: http://www.ACCESSNebraska.ne.gov Phone: 1-855-632-7633 Lincoln: 402-473-7000 Omaha: 402-595-1178 Nevada Medicaid Website: http://dhcfp.nv.gov Medicaid Phone: 1-800-992-0900 HEALTH PLAN NOTICES

New Hampshire Website: https://www.dhhs.nh.gov/oii/hipp.htm Phone: 603-271-5218 Toll free number for the HIPP program: 1-800-852-3345, ext 5218 New Jersey Medicaid Website: http://www.state.nj.us/humanservices/dmahs/clients/medic aid/ Medicaid Phone: 609-631-2392 CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710 New York Website: https://www.health.ny.gov/health_care/medicaid/ Phone: 1-800-541-2831 North Carolina Website: https://medicaid.ncdhhs.gov/ Phone: 919-855-4100 North Dakota Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/ Phone: 1-844-854-4825 Oklahoma Website: http://www.insureoklahoma.org Phone: 1-888-365-3742 Vermont Website: http://www.greenmountaincare.org/ Phone: 1-800-250-8427 Virginia Website: https://www.coverva.org/en/famis-select https://www.coverva.org/en/hipp Medicaid Phone: 1-800-432-5924 CHIP Phone: 1-800-432-5924 Washington Website: https://www.hca.wa.gov/ Phone: 1-800-562-3022 West Virginia Website: http://mywvhipp.com/ Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447) Wisconsin Website: https://www.dhs.wisconsin.gov/badgercareplus/p- 10095.htm Phone: 1-800-362-3002 Wyoming Website: https://health.wyo.gov/healthcarefin/medicaid/progra ms-and-eligibility/ Phone: 1-800-251-1269 Oregon Website: http://healthcare.oregon.gov/Pages/index.aspx http://www.oregonhealthcare.gov/index-es.html Phone: 1-800-699-9075 Pennsylvania Website: https://www.dhs.pa.gov/providers/Providers/Pages/Medical/HI PP-Program.aspx Phone: 1-800-692-7462 Rhode Island Website: http://www.eohhs.ri.gov/ Phone: 1-855-697-4347, or 401-462-0311 (Direct RIte Share Line) South Carolina Website: https://www.scdhhs.gov Phone: 1-888-549-0820 South Dakota Website: http://dss.sd.gov Phone: 1-888-828-0059 Texas Website: http://gethipptexas.com/ Phone: 1-800-440-0493 Utah Medicaid Website: https://medicaid.utah.gov/ CHIP Website: http://health.utah.gov/chip Phone: 1-877-543-7669 HEALTH PLAN NOTICES

To see if any other states have added a premium assistance program, or for more information on special 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 Paperwork Reduction Act Statement According to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no persons are required to respond to a collection of information unless such collection displays a valid Office of Management and Budget (OMB) control number. The Department notes that a Federal agency cannot conduct or sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is not required to respond to a collection of information unless it displays a currently valid OMB control number. See 44 U.S.C. 3507. Also, notwithstanding any other provisions of law, no person shall be subject to penalty for failing to comply with a collection of information if the collection of information does not display a currently valid OMB control number. See 44 U.S.C. 3512. The public reporting burden for this collection of information is estimated to average approximately four minutes per respondent. Interested parties are encouraged to send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Office of Policy and Research, Attention: PRA Clearance Officer, 200 Constitution Avenue, N.W ., Room N-5718, Washington, DC 20210 or email [email protected] and reference the OMB Control Number 1210- 0137. HEALTH PLAN NOTICES