Welcome
We are pleased to offer you a comprehensive benefits package intended to protect your well-being and financial health. This guide is your opportunity to learn more about the benefits that are available to you and your eligible dependents beginning August 1, 2025.
To get the best value from your health care plan, please take the time to evaluate your coverage options and determine which plans best meet the health care and financial needs of you and your family. By being a wise consumer, you can support your health and maximize your health care dollars.
Each year during Open Enrollment, you have the opportunity to make changes to your benefit plans. The enrollment decisions you make this year will remain in effect through July 31, 2026.
After Open Enrollment, you may make changes to your benefit elections only when you have a Qualifying Life Event. You will have 30 days to make your benefit elections and submit supporting documentation to Human Resources. Changes will be effective on the day of the event and must be consistent with your Qualifying Life Event. If you do not make your changes during the 30day period, your changes cannot be made until the next Open Enrollment period.
Availability of Summary Health Information
Your plan offers four options. To help you make an informed choice and compare your options, your plan makes available a Summary of Benefits and Coverage (SBC), which summarizes important information about your health coverage options in a standard format. A printed copy of the SBC is available by contacting Human Resources at 214-919-2520 ext. 110. You can also view and download a copy by visiting www.BenefitsInHand.com
Eligibility
You are eligible for benefits if you are a regular, full-time employee working an average of 30 hours per week. Your coverage is effective the first of the month after you have completed 60 days of full-time employment. You may also enroll eligible dependents for benefits coverage. The cost to you for dependent coverage will vary depending on the number of dependents you enroll in the plan and the particular plans you choose. When covering dependents, you must select and be on the same plans.
Eligible Dependents Include
Your legal spouse
Children under the age of 26, regardless of student, dependency, or marital status
Children over the age of 26 who are fully dependent on you for support due to a mental or physical disability and who are indicated as such on your federal tax return
Qualifying Life Events
Once you elect your benefit options, they remain in effect for the entire plan year until the following Open Enrollment. You may only change coverage during the plan year if you have a Qualifying Life Event, and you must do so within 30 days of the event.
Qualifying Life Events Include
Marriage, divorce, legal separation, or annulment
Birth, adoption, or placement for adoption of an eligible child
Death of a spouse or child
Change in your spouse’s employment that affects benefits eligibility
Change in your child’s eligibility for benefits (i.e., reaching the age limit)
Change in residence that affects your eligibility for coverage
Significant change in coverage or cost in your spouse’s or child’s benefit plans
FMLA leave, COBRA event, court judgment, or decree
Becoming eligible for Medicare, Medicaid, or TRICARE
Receiving a Qualified Medical Child Support Order
If you have a Qualifying Life Event and want to request a midyear change, you must notify Human Resources and complete your election changes within 30 days following the event. Be prepared to provide documentation to support the Qualifying Life Event.
If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, a federal law gives you more choices about your prescription drug coverage. Please see page 16 for more details.
Do you have questions about your benefits or need help enrolling? Call the Employee Response Center at 866-419-3518 Benefits experts are available to take your call Monday through Friday, 7:00 a.m. – 6:00 p.m. CT.
Enrollment
Online Enrollment Instructions
Go to www.benefitsinhand.com. First-time users follow steps 1-4. Returning users should log in and start at step 5.
1. If this is your first time to log in, click on the New User Registration link. Once you register, you will just use your username and password to log in.
2. Enter your personal information and Company Identifier of ASPCARES and click Next.
3. Create a username (work email address recommended) and password. Then check the I agree to terms and conditions box before you click Finish
4. If you used an email address as your username, you will receive a validation email to that address. You may now log in to the system.
5. Click the Start Enrollment button to begin the enrollment process.
6. Confirm or update your personal information and click Save & Continue
7. Add or edit dependents who need to be covered on your benefits. Once all dependents are listed, click Save & Continue.
8. Follow the steps on the screen for each benefit to make your selection. Please notice there is an option to Decline Coverage. If you wish to decline, click the Don’t want this benefit? button and select the reason for declining.
9. Once you have elected or declined all benefits, you will see a summary of your selections. Click the Click to Sign button. Your enrollment will not be complete until you click the Click to Sign button.
Medical
Medical Coverage
The medical plan options through UnitedHealthcare (UHC) protect you and your family from major financial hardship in the event of illness or injury. You have a choice of four plans:
Base HMO - EIW3 – $7,000/$14,000 in-network individual/ family deductible
Base EPO - EI4E – $6,000/$12,000 in-network individual/ family deductible
Mid EPO - EI4G – $3,000/$6,000 in-network individual/ family deductible
Buy-up PPO - EIXH – $2,500/$5,000 in-network individual/ family deductible
Health Maintenance Organization (HMO)
The EIW3 Base HMO Plan uses the UHC Navigate Network and is only available to Texas residents. The HMO limits care to providers in the UHC Navigate Network. The selection of a primary care physician is required and you do need a referral to see a specialist. It is best to confirm that your doctor and all specialists are innetwork before seeking care.
Exclusive Provider Organization (EPO)
You have a choice of two EPO plans: Both the EI4E and EI4G plans use the Nexus ACO Network, which is available for members nationwide. This is an in-network only plan. With the exception of a true emergency, benefits are only payable if an in-network physician or facility provides services. Choosing a primary care provider to coordinate your care is an option and you do not need a referral to see a specialist. When you see in-network designated (Tier 1) providers, your office visits, urgent care, and prescription drugs are covered at a lower cost. If you choose to see an in-network nondesignated (Tier 2) provider, you will pay a higher copay and have higher out-of-pocket costs.
Preferred Provider Organization (PPO)
The EIXH Buy-up PPO Plan uses the UHC Choice Plus Network and allows you the freedom to see any provider when you need care. When you use in-network providers, you receive benefits at a discounted network cost. You may pay more for services if you use out-of-network providers.
Find a Provider
To find a list of preferred providers, visit www.myuhc.com or call 866-633-2446.
Employee Response Center
Contact the Employee Response Center (ERC) when you need help with enrollment or have specific questions about your benefits. The ERC is available Monday through Friday, 7:00 a.m. – 6:00 p.m. CT. If you leave a message after 3:00 p.m., your call will be returned the next business day. Bilingual representatives are available.
For assistance email helpline@higginbotham.net or call 866-419-3518
Medical Benefits Summary
Wellness and Virtual Visits
Wellness Program
Save $50 Per Month on Your Medical Premium!
Participate in the wellness program, and you can save $50 a month on your medical cost.*
1. You must select to be a Wellness Participant as you go through enrollment in BenefitsInHand
2. To maintain your discount, you must complete an annual physical with your primary care doctor, as well as complete one other health screening.
3. You must submit your verification form to helpline@ higginbotham.net no later than June 30, 2026.
Scan the QR code for more info and access to the required forms.
Get In On UHC Rewards
Good news! With UHC Rewards, you and your enrolled spouse can each earn up to $1,000 for taking steps toward a healthier you. A variety of actions lead to rewards – some of which you may already be doing on a daily or weekly basis. Personalize your experience by selecting activities that are right for you, such as:
Connect a fitness tracker – $65
Take a health survey – $25
Get an annual checkup – $50
Get a biometric screening – $75
GET STARTED
Participation is easy online or through the app. Simply sign in or register, select UHC Rewards, activate UHC Rewards, and choose activities that appeal to you.
Visit www.myuhc.com
Download the UnitedHealthcare app. Questions? Call customer service at 866-230-2505
Virtual Visits
When you need care — anytime, day or night — Virtual Visits can be a convenient option. From treating flu and fevers to caring for migraines and allergies, you can chat with a doctor 24/7, and pay $0 for care.
Virtual Visits let you video chat with a doctor without setting up additional accounts or apps. But if you would rather just speak with a doctor, you can visit with a doctor by phone.
To get started, sign in at www.myuhc.com/virtualvisits. Register online so you will be ready to use this telehealth service when and where you need it.
Learn more about Virtual Visits by downloading the UnitedHealthcare app.
Use a Virtual Visit for Common Conditions
Allergies
Bronchitis
Eye infections
Flu
Headaches/migraines
Rashes
Sore throat
Stomachache
And more
* If you have a health factor that makes it unreasonably difficult or medically inadvisable for you to achieve the requirements of this program to qualify for the incentive, please contact hr@aspcares.com and we will work with you &/or your physician to develop an alternative. The purpose of this program is to promote health and prevent disease by alerting Assist Point & Affiliates employees to potential health risks. This program is confidential and HIPAA compliant. Protected Health Information will only be collected in aggregate form in order to design programs for the purpose of addressing the company’s overall risks. Any information shared will not be disclosed except in accordance with HIPAA laws.
Dental
Our dental plan helps you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work. Premium contributions for dental will be deducted from your paycheck on a pretax basis. Coverage is provided through EMI, using the Summit Plus network.
DPPO Plan
Two levels of benefits are available with the DPPO plan depending on whether your dentist is in-network or out-of-network. You have the flexibility to select the provider of your choice, but your level of coverage may vary based on the provider you see for services. Staying in-network and going to a contracted DPPO provider will provide you with the highest level of benefits and the best discounts your plan offers.
How to Find a Dentist
Visit emihealth.com.
Use the Find a Dentist tool
Search by name, facility, or location
You can also call 800-662-5851 to speak with member services or download the EMI Health app to your mobile device and search on the go.
*Out-of-Network Providers: When you use out-of-network providers, your benefits will be paid based on Reasonable and Customary (R&C) coverage (a set amount for each type of service that is determined by EMI). If your dentist’s fee is lower than R&C, the plan will pay benefits based on the R&C. If the fee is higher, the plan will pay benefits based only on the R&C and you are responsible for the difference. Pretreatment review is highly recommended when dental treatment proposed is over $200. Out-of-network providers have not agreed to EMI pricing and you may be balanced billed.
**Calendar year is January 1 – December 31. Your calendar year deductible and out-of-pocket maximums will reset to $0 every January 1.
Your vision plan is provided by EMI using the VSP Choice Plus Network and is designed to provide your basic eyewear needs and to preserve your health and eyesight. In addition to identifying vision and eye problems, regular exams can detect certain medical issues such as diabetes or high cholesterol. You may seek care from any licensed optometrist, ophthalmologist, or optician, but plan benefits are better if you use an in-network provider.
EMI VISION
*Frame allowance is limited to $90 at wholesale retail, such as Sam’s, Costco, and Walmart.
Life and AD&D Insurance
Life insurance is an important part of your financial security, especially if others depend on you for support. Even if you are single, your beneficiary can use your Life insurance to pay off your debts, such as credit cards, mortgages, and other final expenses.
Accidental Death and Dismemberment (AD&D) coverage helps protect you and your family from the unforeseen financial hardship of a serious accident that causes death or dismemberment. AD&D insurance provides you specified benefits for a covered accidental bodily injury that directly causes dismemberment (i.e., the loss of a hand, foot, or eye). In the event that death occurs from an accident, 100% of the AD&D benefit would be payable to your beneficiary(ies).
Basic Life insurance and AD&D coverage are provided by the company at no cost to you through OneAmerica . You are automatically covered up to $50,000. Benefits reduce to 65% at age 65 with an additional 50% reduction at age 70.
Voluntary Life and AD&D Coverage
You may purchase additional Life and AD&D insurance for you and your eligible dependents. If you decline Voluntary Life and AD&D insurance when first eligible, or if you elect coverage and wish to increase your benefit amount at a later date, Evidence of Insurability (EOI) — proof of good health — may be required before coverage is approved.
You must elect Voluntary coverage for yourself in order to elect coverage for your spouse or children. Coverage is provided through OneAmerica . If you leave the company, you may be able to take the insurance with you.
VOLUNTARY LIFE AND AD&D
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Designating a Beneficiary
A beneficiary is the person or entity you designate to receive the death benefits of your Life insurance policy. You can name more than one beneficiary and you can change beneficiaries at any time. If you name more than one beneficiary, you must identify the share for each.
Voluntary Short Term Disability Insurance
Disability insurance provides you with partial income protection if you are unable to work due to a covered accident or illness while insured.
Voluntary Short Term Disability Insurance
The company offers employees the opportunity to purchase Short Term Disability (STD) coverage through OneAmerica . STD pays 60% of your pre-disability earnings up to $2,400. Benefits are paid for up to 12 weeks if you are temporarily disabled and unable to work due to an illness, non-work-related injury, or pregnancy. STD benefits are NOT payable if the disability is due to a job-related injury or illness.
VOLUNTARY SHORT TERM DISABILITY
*Benefits may not be paid for conditions for which you have been treated within the three months prior to your effective date until you have been covered under this plan for 12 months.
Claim Instructions
OneAmerica Value Adds
As a OneAmerica member, you have the following value-add programs available to you and your eligible dependents at no cost to you.
Employee Assistance Program (EAP)
The ComPysch® Guidance Resources® EAP is a confidential program to help you find solutions for personal or workplace issues. Benefits for you and your eligible dependents include unlimited telephone access to an EAP professional and up to three face-toface sessions (per issue, per calendar year) with a counselor. Faceto-face sessions can be used toward legal consultations. There are professionals available 24/7 to help with:
Stress and depression
Financial concerns
Family and relationship issues
Substance abuse
Grief
Parenting and elder care
Other personal concerns
Contact Guidance Resources
Contact the EAP or access legal support and resources by calling 855-387-9727 or visiting www.guidanceresources.com (use company ID ONEAMERICA3).
Will Preparation and Legal Resources
You and your spouse have access to free online legal support and resources from Guidance Resources. Prepare, print, and store essential legal documents, including:
Will
Living will
Health care power of attorney
Durable power of attorney
Medical treatment authorization for minors
You can also access a personal information organizer, estate planning education and tools, and an identity theft prevention kit.
Travel Assistance
Generali Global Assistance ® provides travel assistance for you and your dependents when you are traveling more than 100 miles from home on a trip lasting 90 days or less. This coverage extends to your dependents even when they are traveling without you. Representatives can help with trip planning and assist in an emergency while traveling. They can find translation, interpreter, and legal services, and help with lost baggage, emergency funds, document replacement, and more.
Access this service by emailing ops@europassistance-usa.com or calling 866-294-2469.
Additional Voluntary Benefits
As a complement to our core benefits programs, the company offers you the opportunity to enroll in additional coverage in case of serious accidents or illnesses. Accident and Critical Illness insurance programs are provided by Allstate.
Accident
Accident insurance helps offset direct and indirect expenses resulting from an accident, such as: copayments, deductibles, physical therapy, and other costs not covered by traditional health plans.
ACCIDENT INSURANCE
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Accidental Death
• Employee
Care
Specific Sum Injuries
Dislocations, ruptured discs, eye injuries, fractures, lacerations, concussions, etc.
Claim Forms
$50-$4,000
Claim Forms
Scan this code for the forms you need to file a claim.
Critical Illness
Scan this code for the forms you need to file a claim.
Critical Illness insurance helps pay the cost of nonmedical expenses, such as loss of income, out-of-town treatments, special diets, daily living and household upkeep costs, in addition to deductibles and other cost-sharing arrangements. This plan provides you the ability to receive a lump sum benefit payment upon first and second diagnosis of any covered qualified critical illness. Benefits on this plan range between $3,750 and $15,000 depending on your diagnosis. There is also a $50 wellness benefit included in the plan.
CRITICAL ILLNESS
Invasive Cancer, Heart Attack, Stroke, End Stage Renal Failure, Major Organ Transplant, Invasive Cancer, Benign Brain Tumor, Coma, Complete Blindness or Loss of Hearing, Paralysis
Partial Benefit
Carcinoma in Situ, Coronary Artery
Bypass, Advanced Alzheimer’s Disease, Advanced Parkinson’s Disease
Retirement Plan
A 401(k) plan can be a powerful tool to help you be financially secure in retirement. Our 401(k) plan through American Funds RKDirect can help you reach your investment goals.
How the Retirement Plan Works
You are eligible to participate in the Plan if you are 21 years of age and employed for 12 months with 1,000 hours of service. You may contribute up to the 2025 IRS limit of $23,500. If you are over age 50, you may make an additional catch up contribution of $7,500. If you are age 60-63, you may make an additional ‘super catch up’ contribution of $11,250.
You decide how much you want to contribute and can change your contribution amount anytime. All changes are effective as soon as administratively feasible and remain in effect until you update or stop your contributions. You also decide how to invest the assets in your account and may change your investment choices anytime. For more details, refer to your 401(k) Enrollment Guide or contact American Funds RKDirect at 800-421-4120.
Enrollment
You must enroll through American FundsRKDirect. Scan the QR code to the right for helpful information and a link to enroll, or call 800-421-4120.
Vesting
You are always 100% vested in your own contributions. You are 100% vested in matching company contributions after six years of service.
401(K) VESTING SCHEDULE
Investment Options
You may direct your contributions to any of the investments offered within the company 401(k) plan. Changes to your investments can be made by calling 800-421-4120
Employee Contributions
Important Notices
WOMEN’S HEALTH AND CANCER RIGHTS ACT OF 1998
In October 1998, Congress enacted the Women’s Health and Cancer Rights Act of 1998. This notice explains some important provisions of the Act. Please review this information carefully.
As specified in the Women’s Health and Cancer Rights Act, a plan participant or beneficiary who elects breast reconstruction in connection with a mastectomy is also entitled to the following benefits:
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; and
Prostheses and treatment of physical complications of the mastectomy, including lymphedema.
Health plans must determine the manner of coverage in consultation with the attending physician and the patient. Coverage for breast reconstruction and related services may be subject to deductibles and coinsurance amounts that are consistent with those that apply to other benefits under the plan.
SPECIAL ENROLLMENT RIGHTS
This notice is being provided to ensure that you understand your right to apply for group health insurance coverage. You should read this notice even if you plan to waive coverage at this time.
Loss of Other Coverage or Becoming Eligible for Medicaid or a state Children’s Health Insurance Program (CHIP)
If you are declining coverage for yourself or your dependents because of other health insurance or group health plan coverage, you may be able to later 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 enroll within 31 days after your or your dependents’ other coverage ends (or after the employer that sponsors that coverage stops contributing toward the other coverage).
If you or your dependents lose eligibility under a Medicaid plan or CHIP, or if you or your dependents become eligible for a subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents in this plan. You must provide notification within 60 days after you or your dependent is terminated from, or determined to be eligible for, such assistance.
Marriage, Birth or Adoption
If you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must enroll within 31 days after the marriage, birth, or placement for adoption.
For More Information or Assistance
To request special enrollment or obtain more information, contact: Assist Point & Affiliates Human Resources
13988 Diplomat Drive Suite 100A-1 Farmers Branch, TX 75234 214-919-2520 ext. 110
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 Assist Point & Affiliates and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to enroll in a Medicare drug plan. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
If neither you nor any of your covered dependents are eligible for or have Medicare, this notice does not apply to you or the dependents, as the case may be. However, you should still keep a copy of this notice in the event you or a dependent should qualify for coverage under Medicare in the future. Please note, however, that later notices might supersede this notice.
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage through a Medicare Prescription Drug Plan or a Medicare Advantage Plan that offers prescription drug coverage. All Medicare prescription 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. Assist Point & Affiliates has determined that the prescription drug coverage offered by the Assist Point & Affiliates medical plan is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage pays and is considered Creditable Coverage.
Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to enroll in a Medicare prescription drug plan, as long as you later enroll within specific time periods.
You can enroll in a Medicare prescription drug plan when you first become eligible for Medicare. If you decide to wait to enroll in a Medicare prescription drug plan, you may enroll later, during Medicare Part D’s annual enrollment period, which runs each year from October 15 through December 7 but as a general rule, if you delay your enrollment in Medicare Part D after first becoming eligible to enroll, you may have to pay a higher premium (a penalty).
You should compare your current coverage, including which drugs are covered at what cost, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. See the Plan’s summary plan description for a summary of the Plan’s prescription drug coverage. If you don’t have a copy, you can get one by contacting Assist Point & Affiliates at the phone number or address listed at the end of this section.
If you choose to enroll in a Medicare prescription drug plan and cancel your current Assist Point & Affiliates prescription drug coverage, be aware that you and your dependents may not be able to get this coverage back. To regain coverage, you would have to reenroll in the Plan, pursuant to the Plan’s eligibility and enrollment rules. You should review the Plan’s summary plan description to determine if and when you are allowed to add coverage.
If you cancel or lose your current coverage and do not have prescription drug coverage for 63 days or longer prior to enrolling in the Medicare prescription drug coverage, your monthly premium will be at least 1% per month greater for every month that you did not have coverage for as long as you have Medicare prescription drug coverage. For example, if nineteen months lapse without coverage, your premium will always be at least 19% higher than it would have been without the lapse in coverage.
For more information about this notice or your current prescription drug coverage:
Contact the Human Resources Department at 214-919-2520 ext. 110.
NOTE: You will receive this notice annually and at other times in the future, such as before the next period you can enroll in Medicare prescription drug coverage and if this coverage changes. You may also request a copy.
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 will get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription 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 877-486-2048
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. Information about this extra help is available from the Social Security Administration (SSA) online at www.socialsecurity.gov, or you can call them at 800772-1213. TTY users should call 800-325-0778
Important Notices
Remember: Keep this Creditable Coverage notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty).
August 1, 2025
Assist Point & Affiliates
Human Resources
13988 Diplomat Drive Suite 100A-1
Farmers Branch, TX 75234
214-919-2520 ext. 110
NOTICE OF HIPAA PRIVACY PRACTICES
This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) imposes numerous requirements on employer health plans concerning the use and disclosure of individual health information. This information known as protected health information (PHI), includes virtually all individually identifiable health information held by a health plan – whether received in writing, in an electronic medium or as oral communication. This notice describes the privacy practices of the Employee Benefits Plan (referred to in this notice as the Plan), sponsored by Company, hereinafter referred to as the plan sponsor.
The Plan is required by law to maintain the privacy of your health information and to provide you with this notice of the Plan’s legal duties and privacy practices with respect to your health information. It is important to note that these rules apply to the Plan, not the plan sponsor as an employer.
You have the right to inspect and copy protected health information which is maintained by and for the Plan for enrollment, payment, claims and case management. If you feel that protected health information about you is incorrect or incomplete, you may ask the Human Resources Department to amend the information. For a full copy of the Notice of Privacy Practices describing how protected health information about you may be used and disclosed and how you can get access to the information, contact the Human Resources Department.
Complaints: If you believe your privacy rights have been violated, you may complain to the Plan and to the Secretary of Health and Human Services. You will not be retaliated against for filing a complaint. To file a complaint, please contact the Privacy Officer.
Assist Point & Affiliates
Human Resources
13988 Diplomat Drive Suite 100A-1 Farmers Branch, TX 75234 214-919-2520 ext. 110
Conclusion
PHI use and disclosure by the Plan is regulated by a federal law known as HIPAA (the Health Insurance Portability and Accountability Act). You may find these rules at 45 Code of Federal Regulations Parts 160 and 164. The Plan intends to comply with these regulations. This Notice attempts to summarize the regulations. The regulations will supersede any discrepancy between the information in this Notice and the regulations.
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 employersponsored 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 1-866-444EBSA (3272)
If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of March 17, 2025. Contact your State for more information on eligibility.
ALABAMA – MEDICAID
Website: http://www.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
Health Insurance Premium Payment (HIPP) Program Website: http://dhcs. ca.gov/hipp
Phone: 916-445-8322
Fax: 916-440-5676
Email: hipp@dhcs.ca.gov
COLORADO – HEALTH FIRST COLORADO (COLORADO’S MEDICAID PROGRAM) AND 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://hcpf.colorado.gov/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/flmedicaidtplrecovery.com/ hipp/index.html
Phone: 1-877-357-3268
GEORGIA – MEDICAID
GA HIPP Website: https://medicaid.georgia.gov/ health-insurance-premium-payment-program-hipp Phone: 678-564-1162, Press 1 GA CHIPRA Website: https://medicaid. georgia.gov/programs/third-party-liability/ childrens-health-insurance-program-reauthorization-act-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: https://hhs.iowa.gov/programs/welcome-iowa-medicaid Medicaid Phone: 1-800-338-8366
Hawki Website: https://hhs.iowa.gov/programs/welcome-iowa-medicaid/ iowa-health-link/hawki
Hawki Phone: 1-800-257-8563
HIPP Website: https://hhs.iowa.gov/programs/welcome-iowa-medicaid/ fee-service/hipp
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/kihipp.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)
Important Notices
MAINE – MEDICAID
Enrollment Website: https://www.mymaineconnection.gov/ benefits/s/?language=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
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: https://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/programs-services/medicaid/ health-insurance-premium-program
Phone: 603-271-5218
Toll free number for the HIPP program: 1-800-852-3345, ext. 15218
Email: DHHS.ThirdPartyLiabi@dhhs.nh.gov
NEW JERSEY – MEDICAID AND CHIP
Medicaid Website: http://www.state.nj.us/humanservices/dmahs/clients/ medicaid/ 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: https://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: https://healthcare.oregon.gov/Pages/index.aspx
Phone: 1-800-699-9075
PENNSYLVANIA – MEDICAID AND CHIP
Website: https://www.pa.gov/en/services/dhs/apply-for-medicaid-healthinsurance-premium-payment-program-hipp.html
Phone: 1-800-692-7462
CHIP Website: https://www.dhs.pa.gov/CHIP/Pages/CHIP.aspx
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: https://dss.sd.gov Phone: 1-888-828-0059
TEXAS – MEDICAID
Website: https://www.hhs.texas.gov/services/financial/ health-insurance-premium-payment-hipp-program 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: https://dvha.vermont.gov/members/medicaid/hipp-program Phone: 1-800-250-8427
VIRGINIA – MEDICAID AND CHIP
Website: https://coverva.dmas.virginia.gov/learn/premium-assistance/ famis-select https://coverva.dmas.virginia.gov/learn/premium-assistance/ health-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/ programs-and-eligibility/ Phone: 1-800-251-1269
To see if any other States have added a premium assistance program since March 17, 2025, or for more information on special enrollment rights, you can 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
CONTINUATION OF COVERAGE RIGHTS UNDER COBRA
Under the Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), if you are covered under the Company group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Company plan after you have left employment with the company. If you wish to elect COBRA coverage, contact your Human Resources Department for the applicable deadlines to elect coverage and pay the initial premium.
Plan Contact Information
Assist Point & Affiliates Human Resources 13988 Diplomat Drive Suite 100A-1 Farmers Branch, TX 75234 214-919-2520 ext. 110
Important Notices
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 have not 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 innetwork 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 cannot be balance billed for these emergency services. This includes services you may get after you are 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 cannot 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-ofnetwork providers cannot balance bill you, unless you give written consent and give up your protections.
You are never required to give up your protections from balance billing. You also are not required to get care out-of-network. You can choose a provider or facility in your plan’s network.
When balance billing is not 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 outof-network services toward your deductible and out-ofpocket limit.
If you believe you have been wrongly billed, you may contact your insurance provider. Visit www.cms.gov/nosurprises for more information about your rights under federal law.
Important Contacts
This brochure highlights the main features of the Assist Point & Affiliates Benefits Program. It does not include all plan rules, details, limitations, and exclusions. The terms of your benefit plans are governed by legal documents, including insurance contracts. Should there be an inconsistency between this brochure and the legal plan documents, the plan documents are the final authority. The Assist Point & Affiliates reserves the right to change or discontinue its employee benefits plans at any time.