2025-2026 Guide to Employee Benefits
Helpful Resources
UnitedHealthcare
www.myuhc.com
866-633-2446 Telemedicine
UnitedHealthcare
www.myuhc.com
866-633-2446
Sun
www.sunlife.com
800-247-6875
Employee Assistance Program
GuidanceResources
www.guidanceresources.com
877-595-5281
401(k) Retirement Plan
Fidelity www.netbenefits.com
800-294-4015 Benefits
Employee
helpline@higginbotham.net
866-419-3518
Welcome
We are pleased to offer to Glenfarne Group and Glenfarne Sponsor team members a full benefits package to help protect your well-being and financial health. Read this guide to learn about the benefits available to you and your eligible dependents starting September 1, 2025.
Each year during Open Enrollment (OE), you may make changes to your benefit plans. The benefit choices you make this year will remain in effect through August 31, 2026. Take time to review these benefit options and select the plans that best meet your needs. After OE, you may only make changes to your benefit elections if you have a Qualifying Life Event (QLE).
Eligibility
All permanent, active employees who work at least 30 hours per week on average are eligible for coverage on the first day of the month or first of the month following your employment start date. You may also enroll eligible dependents for benefits coverage. The cost for coverage depends on the number of dependents you enroll and the benefits you choose. When covering dependents, you must select and be on the same plans.
Eligible Dependents
{ 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
{ Domestic partnerships if you meet your city or state’s requirements
Qualifying Life Events
Once you elect your benefit options, they remain in effect for the entire plan year until the following OE. You may only change coverage during the plan year if you have a QLE, some of which include:
{ Marriage, divorce, legal separation, or annulment
{ Birth, adoption, or placement for adoption of an eligible child
{ Death of your spouse or child
{ Change in your spouse’s employment status that affects benefits eligibility
{ Change in your child’s eligibility for benefits
{ Significant change in benefit plan coverage for you, your spouse, or your child
{ FMLA event, COBRA event, court judgment, or decree
{ Becoming eligible for Medicare, Medicaid, or TRICARE
{ Receiving a Qualified Medical Child Support Order
If you have a QLE and want to change your elections, you must notify Human Resources and complete your changes within 30 days of the event. You may be asked to provide documentation to support the change. Contact Human Resources for specific details.
Availability of Summary Health Information
Your benefits program offers medical plan coverage options. To help you make an informed choice and compare your options, a Summary of Benefits and Coverage for each plan is available at www.myuhc.com or by contacting Human Resources.
How to Enroll
Go to www.benefitsinhand.com to begin the enrollment process. Firsttime users, follow steps 1-4. Returning users, 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 use your username and password to log in.
2. Enter your personal information and company identifier of Glenfarne 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. Edit or add 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.
Have questions about your benefits or need help enrolling? Call the Employee Response Center (ERC) at 866-419-3518. Benefits experts are available to take your call Monday through Friday, 7:00 a.m. – 6:00 p.m. CT.
Employee Response Center
Employee benefits can be complicated. The Higginbotham ERC can assist you with the following:
ENROLLMENT CLAIMS OR BILLING QUESTIONS
Call or text
866-419-3518 to speak with a bilingual representative Monday through Friday from 7:00 a.m. to 6:00 p.m. CT. If you leave a message after 3:00 p.m. CT, your call or text will be returned the next business day. You can also email questions or requests to helpline@higginbotham.net
Medical Coverage
The medical PPO plan through UnitedHealthcare (UHC) protects you and your family from major financial hardship in the event of illness or injury.
Preferred Provider Organization
A Preferred Provider Organization (PPO) allows you to see any provider when you need care. When you see UHC in-network providers for care, you will pay less and get the highest level of benefits. You will pay more for care if you use out-ofnetwork providers. When you see in-network providers, your office visits, urgent care visits, and prescription drugs are covered with a copay, and most other innetwork services are covered at the deductible and coinsurance level.
Find an In-Network Provider
{ Visit www.myuhc.com
{ Call 866-633-2446
{ Download the myUHC mobile app
Preventive Services
Your medical plan covers screenings and services with no out-of-pocket costs when you visit a doctor in your plan’s provider network — even if you have not met your deductible. Some examples of preventive care services covered by your plan include general wellness exams each year, assessments, counseling, and screenings for things like diabetes or cancer. Preventive services are provided for women, men, and children of all ages.
Medical Plan Summary
1
Telemedicine
Your medical coverage offers telemedicine services through UHC Virtual Visits. Connect anytime day or night with a board-certified doctor via your mobile device or computer for free, or for the same or less cost than a visit to your regular physician.
While telemedicine does not replace your primary care physician, it is a convenient and cost-effective option when you need care and:
{ Have a non-emergency issue and are considering an after hours health care clinic, urgent care clinic, or emergency room for treatment
{ Are on a business trip, vacation, or away from home
{ Are unable to see your primary care physician
Contact Virtual Visits
Connect with Virtual Visits online, by phone, or through the myUHC mobile app.
{ Online – www.myuhc.com
{ Phone – 866-633-2446
{ App – Download the app to your mobile device
When to Use Virtual Visits
Use telemedicine for minor conditions such as:
{ Sore throat
{ Headache
{ Stomachache
{ Cold { Flu
{ Mental health issues
Do not use telemedicine for serious or life-threatening emergencies.
{ Allergies
{ Fever
{ Urinary tract infections
Health Care Options
Becoming familiar with your options for medical care can save you time and money. Health Care Provider
Nonemergency Care
Access to care via phone, online video, or mobile app whether you are home, at work, or traveling; medications can be prescribed
24 hours a day, 7 days a week
TELEMEDICINE
Generally, the best place for routine preventive care; established relationship; able to treat based on medical history
Office hours vary
DOCTOR’S OFFICE
Usually lower out-of-pocket cost than urgent care; when you can’t see your doctor; located in stores and pharmacies
Hours vary based on store hours
RETAIL CLINIC
URGENT CARE
Emergency Care
When you need immediate attention; walk-in basis is usually accepted
Generally includes evening, weekend, and holiday hours
y Allergies
y Cough/cold/flu
y Rash
y Stomachache
y Infections
y Sore and strep throat
y Vaccinations
y Minor injuries/sprains/strains
y Common infections
y Minor injuries
y Pregnancy tests
y Vaccinations
y Sprains and strains
y Minor broken bones
y Small cuts that may require stitches
y Minor burns and infections
y Chest pain
Life-threatening or critical conditions; trauma treatment; multiple bills for doctor and facility
24 hours a day, 7 days a week
HOSPITAL ER
FREESTANDING ER
Services do not include trauma care; can look similar to an urgent care center, but medical bills may be 10 times higher
24 hours a day, 7 days a week
y Difficulty breathing
y Severe bleeding
y Blurred or sudden loss of vision
y Major broken bones
y Most major injuries except trauma
y Severe pain
4+ hours
Minimal
Note: Examples of symptoms are not inclusive of all health issues. Wait times described are only estimates. This information is not intended as medical advice. If you have questions, please call the phone number on the back of your medical ID card.
Dental Coverage
Our dental plan helps you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work. Coverage is provided through Sun Life DPPO Plan
Two levels of benefits are available with the DPPO plan: in-network and out-of-network. You may see any dental provider for care, but you will pay less and get the highest level of benefits with in-network providers. You could pay more if you use an out-of-network provider.
Dental Plan Summary
extractions,
Vision Coverage
Our vision plan offers quality care to help preserve your health and eyesight. Regular exams can detect certain medical issues such as diabetes and high cholesterol, in addition to vision and eye problems. You may seek care from any vision provider, but the plan will pay the highest level of benefits when you see an in-network provider. Coverage is provided through Sun Life using the VSP Choice vision network.
Plan Summary
•
•
•
Life and AD&D Insurance
Life and Accidental Death and Dismemberment (AD&D) insurance through Sun Life are important to your financial security, especially if others depend on you for support or vice versa. With Life insurance, you or your beneficiary(ies) can use the coverage to pay off debts such as credit cards, loans, and bills. AD&D coverage provides specific benefits if an accident causes bodily harm or loss (e.g., the loss of a hand, foot, or eye). If death occurs from an accident, 100% of the AD&D benefit would be paid to you or your beneficiary(ies). Life and AD&D coverage amounts reduce by 65% at age 65, and 50% at age 70.
Basic Life and AD&D
Basic Life and AD&D insurance are provided at no cost to you. You are automatically covered at your base annual salary (up to $300,000) for each benefit.
Voluntary Life and AD&D
You may buy more Life and AD&D insurance for you and your eligible dependents. If you are electing coverage for the first time during OE, you can elect up to the Guaranteed Issue amount without having to provide Evidence of Insurability (EOI) — proof of good health. If you have $50,000 or more in existing coverage through Principal, you will retain that coverage amount with Sun Life. Any additional amount will require EOI. You may increase your existing voluntary coverage by one increment without providing EOI. You must elect Voluntary Life and AD&D coverage for yourself before you may elect coverage for your spouse or children. If you leave the company, you may be able to take the insurance with you.
Voluntary Life and AD&D
• Increments of $10,000 up to $500,000 (not to exceed five times basic annual salary)
Employee
Spouse
Child(ren)
• Guaranteed Issue: five times annual salary up to $110,000
• Increments of $5,000 up to $500,000, up to 100% of employee’s benefit
• Guaranteed Issue: $20,000
• Increments of $2,000 up to $10,000 for children from six months to 26 years
• $500 for children from 14 days to age six months
Designating a Beneficiary
A beneficiary is the person or entity you elect to receive the death benefits of your Life and AD&D insurance policies. You can name more than one beneficiary, and you can change beneficiaries at anytime. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%). You can update your beneficiaries through BenefitsInHand.
Disability Insurance
Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. We provide Long Term Disability (LTD) and Short Term Disability (STD) at no cost to you through Sun Life. Because the employee is responsible for taxes on premiums, we “gross-up” the income of the employees by the amount the employees must pay in taxes for the domestic partner’s coverage.
Short Term Disability
STD coverage pays a percentage of your weekly salary if you are temporarily disabled and unable to work due to an illness, pregnancy, or non-work-related injury. STD benefits are not payable if the disability is due to a job-related injury or illness. If a medical condition is job-related, it is considered workers’ compensation, not STD.
Short Term Disability
90 days. Benefits begin at the end of an elimination period and continue while you are disabled up to the maximum benefit period as long as you remain disabled, or the Social Security Normal Retirement Age (SSNRA).
Long Term Disability
1 Benefits may not be paid for any condition treated within three months prior to your effective date until you have been
Long Term Disability
LTD insurance pays a percentage of your monthly salary for a covered disability or injury that prevents you from working for more than
Employee Assistance Program
The ComPsych GuidanceResources Employee Assistance Program (EAP) provides a variety of services to help you plan life events or manage daily life and work. Included with your Sun Life benefits, GuidanceResources is confidential, professional, and free to you and your dependents. Services include:
Confidential Counseling
Highly trained masters- and doctoral-level clinicians can listen to your concerns and quickly refer you to in-person counseling (up to three sessions per issue per year). They can also provide resources to help with:
{ Stress, anxiety, and depression
{ Relationship/marital conflicts
{ Problems with children
Financial Information
{ Work-life balance
{ Grief and loss
{ Substance abuse
Speak by phone with a certified public accountant or financial planner on a wide range of issues, including:
{ Debt management
{ Credit card or loan problems
{ Tax questions
Legal Support
{ Retirement and estate planning
{ Saving for college
Talk to an attorney by phone about a variety of legal issues, including:
{ Divorce and family law
{ Debt and bankruptcy
{ Landlord/tenant issues
{ Real estate transactions
{ Civil and criminal actions
{ Contracts
You can also request a referral to a local attorney for a free 30-minute in-person consultation and 25% fee reduction if additional legal assistance is retained.
Work-Life Solutions
Request assistance or referrals for help with a multitude of issues, including:
{ Child and eldercare
{ Moving and relocation
{ Major purchases
{ College planning
{ Pet care
{ Home repair
HELP WHEN YOU NEED IT
{ Call 877-595-5281
{ Visit www.guidanceresources.com (use web ID EAPBusiness when prompted)
Will Preparation
Quickly and easily create a will online at www.guidanceresources.com. Click the EstateGuidance link and follow the prompts to create and download documents. Online support and instructions for executing your will are included.
GuidanceResources Online
Visit www.guidanceresources.com for expert information on what matters most to you. Find articles, tutorials, videos, self-assessments, and more. GuidanceResources Online is always available when you need it.
ParentGuidance
Whether you are a biological or adoptive parent, find support as you balance the demands of work and parenthood. Specialists can provide information and assistance for new and expectant parents on topics such as:
{ Preparing for baby
{ Emotional concerns
{ Finding child care
{ Wills and estate planning
{ Financial issues
{ Returning to work
401(k) Retirement Plan
A 401(k) plan can be a powerful tool to help you be financially secure in retirement. Our 401(k) plan through Fidelity can help you reach your investment goals.
How the Retirement Plan Works
You are eligible to participate in the plan on the first day of the month following your date of hire and you are at least 18 years of age. You may contribute up to the IRS limit.
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 Fidelity at 800-294-4015.
Enrollment
You must enroll through Fidelity at www.netbenefits.com or by calling 800-294-4015.
Legal 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:
Glenfarne Group, LLC Human Resources 9950 Woodloch Forest Drive #1500 The Woodlands, TX 77380 713-491-2779
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 Glenfarne Group, LLC 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. Glenfarne Group, LLC has determined that the prescription drug coverage offered by the Glenfarne Group, LLC 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 Glenfarne Group, LLC 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 Glenfarne Group, LLC 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 re-enroll 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 713-491-2779
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.
Legal 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 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
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).
September 1, 2025 Glenfarne Group, LLC Human Resources 9950 Woodloch Forest Drive #1500 The Woodlands, TX 77380 713-491-2779
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 Glenfarne Group, LLC, 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.
Glenfarne Group, LLC
Human Resources 9950 Woodloch Forest Drive #1500 The Woodlands, TX 77380 713-491-2779
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 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)
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 July 31, 2025. Contact your State for more information on eligibility.
Legal Notices
New York – Medicaid
Website: https://www.health.ny.gov/health_care/ medicaid/
Phone: 1-800-541-2831
Texas – Medicaid
Website: https://www.hhs.texas.gov/services/ financial/health-insurance-premium-paymenthipp-program
Phone: 1-800-440-0493
To see if any other States have added a premium assistance program since July 31, 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 Glenfarne Group, LLC group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Glenfarne Group, LLC 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 Glenfarne Group, LLC Human Resources 9950 Woodloch Forest Drive #1500 The Woodlands, TX 77380 713-491-2779
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 in-network costs for the same service and might not count toward your annual out-ofpocket 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-ofnetwork 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 costsharing 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-of-network 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 outof-network providers and facilities directly.
{ Your health plan generally must:
y Cover emergency services without requiring you to get approval for services in advance (prior authorization).
y Cover emergency services by out-ofnetwork providers.
y 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.
y Count any amount you pay for emergency services or out-of-network services toward your deductible and outof-pocket 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.
New Health Insurance Marketplace Coverage Options and Your Health Coverage
PART A: General Information
Even if you are offered health coverage through your employment, you may have other coverage options through the Health Insurance Marketplace (“Marketplace”). To assist you as you evaluate options for you and your family, this notice provides some basic information about the Health Insurance Marketplace.
What is the Health Insurance Marketplace?
The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers “onestop shopping” to find and compare private health insurance options in your geographic area.
Can I Save Money on my Health Insurance Premiums in
the Marketplace?
You may qualify to save money and lower your monthly premium and other out-ofpocket costs, but only if your employer does not offer coverage, or offers coverage that is not considered affordable for you and doesn’t meet certain minimum value standards (discussed below). The savings on your premium that you’re eligible for depends on your household income. You may also be eligible for a tax credit that lowers your costs. Does Employment-Based Health Coverage Affect Eligibility for Premium Savings through the Marketplace?
Legal Notices
Yes. If you have an offer of health coverage from your employer that is considered affordable for you and meets certain minimum value standards, you will not be eligible for a tax credit, or advance payment of the tax credit, for your Marketplace coverage and may wish to enroll in your employment-based health plan. However, you may be eligible for a tax credit, and advance payments of the credit that lowers your monthly premium, or a reduction in certain cost-sharing, if your employer does not offer coverage to you at all or does not offer coverage that is considered affordable for you or meet minimum value standards. If your share of the premium cost of all plans offered to you through your employment is more than 9.12%1 of your annual household income, or if the coverage through your employment does not meet the “minimum value” standard set by the Affordable Care Act, you may be eligible for a tax credit, and advance payment of the credit, if you do not enroll in the employment-based health coverage. For family members of the employee, coverage is considered affordable if the employee’s cost of premiums for the lowest-cost plan that would cover all family members does not exceed 9.12% of the employee’s household income.1, 2
Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered through your employment, then you may lose access to whatever the employer contributes to the employmentbased coverage. Also, this employer contribution -as well as your employee contribution to employment-based coverage- is generally excluded from income for federal and state income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis. In addition, note that if the health coverage offered through your employment does not meet the affordability or minimum value standards, but you accept that coverage anyway, you will not be eligible for a tax credit. You should consider all of these factors in determining whether to purchase a health plan through the Marketplace.
When Can I Enroll in Health Insurance Coverage through the Marketplace?
You can enroll in a Marketplace health insurance plan during the annual Marketplace Open Enrollment Period. Open Enrollment varies by state but generally starts November 1 and continues through at least December 15.
Outside the annual Open Enrollment Period, you can sign up for health insurance if you qualify for a Special Enrollment Period. In general, you qualify for a Special Enrollment Period if you’ve had certain qualifying life events, such as getting married, having a baby, adopting a child, or losing eligibility for other health coverage. Depending on your Special Enrollment Period type, you may have 60 days before or 60 days following the qualifying life event to enroll in a Marketplace plan.
There is also a Marketplace Special Enrollment Period for individuals and their families who lose eligibility for Medicaid or Children’s Health Insurance Program (CHIP) coverage on or after March 31, 2023, through July 31, 2024. Since the onset of the nationwide COVID-19 public health emergency, state Medicaid and CHIP agencies generally have not terminated the enrollment of any Medicaid or CHIP beneficiary who was enrolled on or after March 18, 2020, through March 31, 2023. As state Medicaid and CHIP agencies resume regular eligibility and enrollment practices, many individuals may no longer be eligible for Medicaid or CHIP coverage starting as early as March 31, 2023.
The U.S. Department of Health and Human Services is offering a temporary Marketplace Special Enrollment period to allow these individuals to enroll in Marketplace coverage.
Marketplace-eligible individuals who live in states served by HealthCare.gov and eithersubmit a new application or update an existing application on HealthCare.gov between March 31, 2023 and July 31, 2024, and attest to a termination date of Medicaid or CHIP coverage within the same time period, are eligible for a 60-day Special Enrollment Period. That means that if you lose Medicaid or CHIP coverage between March 31, 2023, and July 31, 2024, you may be able to enroll in Marketplace coverage within 60 days of when you lost Medicaid or CHIP coverage. In addition, if you or your family members are enrolled in Medicaid or CHIP coverage, it is important to make sure that your contact information is up to date to make sure you get any information about changes to your eligibility. To learn more, visit www.HealthCare.gov or call the Marketplace Call Center at 1-800-318-2596 TTY users can call 1-855-889-4325
What about Alternatives to Marketplace Health Insurance Coverage?
If you or your family are eligible for coverage in an employment-based health plan (such as an employer-sponsored health plan), you or your family may also be eligible for a Special Enrollment Period to enroll in that health plan in certain circumstances, including if you or your dependents were enrolled in Medicaid or CHIP coverage and lost that coverage. Generally, you have 60 days after the loss of Medicaid or CHIP coverage to enroll in an employment-based health plan, but if you and your family lost eligibility for Medicaid or CHIP coverage between March 31, 2023 and July 10, 2023, you can request this special enrollment in the employment-based health plan through September 8, 2023. Confirm the deadline with your employer or your employment-based health plan.
Alternatively, you can enroll in Medicaid or CHIP coverage at any time by filling out an application through the Marketplace or applying directly through your state Medicaid agency. Visit https://www.healthcare.gov/ medicaid-chip/getting-medicaid-chip/ for more details.
How Can I Get More Information?
For more information about your coverage offered through your employment, please check your health plan’s summary plan description or contact Human Resources.
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, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area.
PART B: Information About Health Coverage Offered by Your Employer
This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application.
3. Employer Name: Glenfarne Group LLC
4. Employer Identification Number (EIN): 45-1142895
5. Employer Address: 292 Madison Ave Floor 19
6. Employer Phone Number: 540-346-6884
7. City: New York
8. State: NY 9. ZIP Code: 10017
10. Who can we contact at this job?: Sarah Irvin
11. Phone Number (if different from above): 540-346-6884
12. E-Mail Address: sarah.irvin@glenfarnecopmanies.com
As your employer, we offer a health plan to all eligible employees (see the Eligibility section of this guide). This coverage meets the minimum value standard, and the cost of this coverage to you is intended to be affordable, based on employee wages.
1 Indexed annually; see https://www.irs.gov/pub/irsdrop/rp-22-34.pdf for 2023.
2 An employer-sponsored or other employment-based health plan meets the “minimum value standard” if the plan’s share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs. For purposes of eligibility for the premium tax credit, to meet the “minimum value standard,” the health plan must also provide substantial coverage of both inpatient hospital services and physician services.
This brochure highlights the main features of the Glenfarne Group, LLC employee 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. Glenfarne Group, LLC reserves the right to change or discontinue its employee benefits plans at anytime.
