If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, federal law gives you more choices for your prescription drug coverage. Please see page 16 for more details.
WELCOME
Preiss is pleased to offer a full benefits package to help protect your well-being and financial health. Read this Benefits Digest to learn about the benefits available to you and your eligible dependents starting July 1, 2025.
The benefit choices you make during Open Enrollment will remain in effect through June 30, 2026. After Open Enrollment, you may only make benefit changes if you have a Qualifying Life Event.
ELIGIBILITY
You are eligible for benefits starting on your date of hire if you are a regular, full-time employee. 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.
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
QUALIFYING LIFE EVENTS
Your benefit elections 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 such as marriage, divorce, birth or adoption, loss of other coverage, etc. You must notify Human Resources in a timely manner if any of these events occur. Contact Human Resources for a full list of Qualifying Events and the notification timeframes required for requested changes.
HOW TO ENROLL
You will make, change, or decline your benefit elections through UKG. Contact the Preiss Benefits Center by Higginbotham if you have benefit questions. Contact HR at hr@tpco.com if you need help with your enrollment.
Summary of Health Information
Your plan offers three health coverage options. To help you make an informed choice and compare your options, a Summary of Benefits and Coverage (SBC) is available by contacting Human Resources.
MEDICAL COVERAGE
You have a choice of three plans through Blue Cross Blue Shield North Carolina (BCBSNC).
All plans allow you to see any provider for care but you will pay less and get the highest level of benefits when you go to in-network providers and facilities.
PREISS CHOICE PLAN
An HDHP offering an optional Health Savings Account
Satisfy a higher plan deductible and pay the contracted rate at the time of service; meet your plan deductible for the plan to pay 80%; meet the out-of-pocket maximum for the plan to pay 100%.
Consider opening a Health Savings Account (see page 7) if eligible for tax benefits. Consider this plan if you want the advantage of a Health Savings Account (HSA) and lowest cost per paycheck.
PREISS SELECT PLAN
A PPO with fixed copayments
See network providers so office visits, urgent care, and prescriptions are covered with a copay, and most other services are covered at the coinsurance level. Consider this plan if you are willing to pay a higher premium for copays.
PREISS SELECT-PLUS PLAN
A PPO with fixed copayments and offers an HRA
See network providers so office visits, urgent care, and prescriptions are covered with a copay, and most other services are covered at the coinsurance level. Consider this plan if you are willing to pay a higher premium for copays and lower out-of-pocket expense.
HEALTH REIMBURSEMENT ARRANGEMENT (HRA)
Preiss provides an HRA administered by Flores to help offset your out-of-pocket costs.
How the HRA works:
You must have Preiss Select-Plus coverage.
An HRA reimburses a portion of your network deductible.
Use the HRA to help cover out-of-pocket costs that apply to your deductible.
Use your HRA to pay for qualified medical expenses if not reimbursed from other sources.
Review your plan documents for full details.
Examples
You Alone – After you reach the first $1,000 of the plan’s deductible, the HRA will reimburse up to the next $1,500 of the in-network deductible.
You Plus Family – After you reach the first $2,000 of the plan’s deductible, the HRA will reimburse up to the next $3,000 of the in-network deductible.
Find an In-Network Provider
Online – www.bluecrossnc.com
Phone – 877-275-9787
Mobile – get the mobile app
Submitting a Claim
You may submit for reimbursement throughout the plan year. All claims must be submitted within 180 days from the end of the plan year. You are responsible for submitting claims. Important! Save your Explanation of Benefits (EOBs) and all receipts for tax purposes.
Call Flores at 800-532-3327 or visit www.flores247.com if you have questions.
MEDICAL COVERAGE
MEDICAL BENEFITS SUMMARY
1 For in-network coverage, the family deductible and/or out-of-pocket maximum can be met by any combination of family members, with no member exceeding $3,300 deductible and $6,600 out-of-pocket.
2 This amount reflects the HRA, where Preiss reimburses a significant portion of your deductible liability and is based on a $2,500/$5,000 overall deductible. See HRA plan details on page 5.
3 For out-of-pocket coverage, the family deductible and/or out-of-pocket maximum can be met by any combination of family members, with no member exceeding $6,400 deductible and $12,800 out-of-pocket.
4 Preventive Care is covered at 100% in-network with a preventive primary diagnosis code. If anything is discussed or performed outside of the healthcare reform approved screenings, your visit may not be covered at 100%. See www.bcbsnc.com/preventive for details.
5 Primary Care Provider (PCP) copay is waived for the first three visits if PCP is selected in Blue Connect. This applies to PCPs in North Carolina only.
6 There is a $50 per drug minimum and a $100 per drug maximum for each 30-day supply of Tier 4 drugs.
TELEMEDICINE
Your medical coverage offers telemedicine services through the BCBS Primary360 program, using Teladoc Health. 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. The dedicated care team will create a personalized care plan to help you meet your long-term health goals, coordinate care across a range of services and provide ongoing support.
When to Use Telemedicine
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
Virtual Primary Care –
Annual checkups, overall health management and care plans provided by a U.S. board-certified doctor and a dedicated care team.
Urgent Care – Treatment available 24/7 for non-emergency and common conditions through sameday appointments with clinicians.
Mental Health Counseling –
Phone or video visits with licensed therapists or psychiatrists available by appointment every day of the week.
Dermatology – Online review, diagnosis, and treatment plan provided by a dermatologist within 24 hours.
Nutrition Counseling –
Personalized support and tips for healthy eating and overall well-being offered by registered dietitians.
How to sign up
Choice Plan – Cost applied to deductible ($0 after deductible)
Select Plan – $0
Select-Plus Plan – $0
Telemedicine providers can treat an assortment of conditions, including:
care
Download the Teladoc mobile app
Go to www.teladochealth.com and click Sign in/Register
Call 1-855-549-2214
Do not use telemedicine for serious or life-threatening emergencies.
HEALTH SAVINGS ACCOUNT
If you enroll in the Preiss Choice plan, you are eligible to open or maintain an HSA, which is like a personal savings account for health care expenses. You may make pre-tax contributions to your HSA that can be used to pay for eligible medical, dental, or vision expenses.
HSA Eligibility
You are eligible to open and contribute to an HSA if you are:
Enrolled in an HSA-eligible HDHP (Preiss Choice plan)
Not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan
Not enrolled in a Health Care Flexible Spending Account, except for Limited Purpose accounts
Not eligible to be claimed as a dependent on someone else’s tax return
Not enrolled in Medicare or TRICARE
Not receiving Veterans Administration benefits
Maximum 2025 HSA Contributions
Preiss will contribute $500 for employee only coverage and $1,000 for all other coverage levels to your account for the plan year!
You decide whether to use the money in your account to pay for qualified expenses or let it grow for future use. If you are 55 or older, you may make up to $1,000 yearly catch-up contributions.
Opening an HSA
HSA Bank administers the HSA and will start an account for you.
Important HSA Information
Always ask your health care provider to file claims with your medical provider so network discounts can be applied. You can pay the provider with your HSA debit card based on the balance due after discount.
You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.
You may open an HSA at the financial institution of your choice, but only accounts opened through HSA Bank are eligible for automatic payroll deduction and company contributions.
Important! Name Your Beneficiaries
If you open an HSA, it is very important to designate one or more beneficiaries! A beneficiary is a person or entity that you designate to receive the proceeds from your HSA in the event of your death.
Most beneficiary designations can be made or changed online at www.hsabank.com. However, if you are married, domiciled in a community property state, or designate a non-spouse primary beneficiary, you must submit a Beneficiary Form with the notarized consent of your spouse.
How to Contact HSA Bank
Online – www.hsabank.com
Phone – 800-357-6246
Mobile – get the mobile app
Use myHealth Portfolio to easily manage your account
HSA
FLEXIBLE SPENDING ACCOUNTS
An FSA allows you to set aside pretax dollars from each paycheck to pay for certain IRS-approved health and dependent care expenses.
We offer a health care FSA, limited purpose FSA, and a dependent care FSA. Flores administers our FSAs. You have 90 days following the end of the plan year to file for reimbursement for expenses incurred during the plan year (July 1-June 30).
Flexible Spending Accounts
Most medical, dental, and vision care expenses that are not covered by your health plan (e.g., copayments, coinsurance, deductibles, eyeglasses, and doctor-prescribed over-the-counter medications)
$3,300 per year
Saves on eligible expenses not covered by insurance, reduces your taxable income
Can not contribute to a Health Care FSA if enrolled in an HDHP (Choice Plan) and contribute to an HSA
Can only be used for health care expenses
Can carry over up to $660 to the next plan year Limited Purpose FSA
Dental and vision care expenses that are not covered by your health plan (such as eyeglasses, contacts, LASIK eye surgery, fillings, X-rays, and braces)
$3,300 per year
Saves on eligible expenses not covered by insurance, reduces your taxable income
Available if you enrolled in the HDHP (Choice Plan) medical plan and contribute to an HSA
Can only use for eligible out-of-pocket dental and vision expenses Dependent Care
Dependent care expenses (such as day care, after-school programs or elder care programs) so you and your spouse can work or attend school full time
Care of a spouse or dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self-care
$5,000 per year
($2,500 if married and filing separate tax returns)
Reduces your taxable income
Not for overnight camps
Reimbursements are only for children under age 13
Dependent care provider cannot be your child under age 19 or a dependent on your income taxes
Questions?
Contact Flores by calling 800-532-3327 or by visiting www.flores247.com
DENTAL AND VISION
DENTAL COVERAGE
The DentalGuard Preferred Network Access Plan (NAP) from Guardian helps you maintain good oral health. See network providers for highest benefits.
Guardian Rollover Program
If you elect dental coverage, you will be enrolled in Guardian’s Maximum Rollover Program. This program rewards you for regular dental checkups. If your yearly dental claims are below $700, Guardian will roll over a portion of your unused annual maximum into your personal Maximum Rollover Account (MRA). Ask Guardian for details.
DENTAL NAP Plan
VISION COVERAGE
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 a network provider. Coverage is provided through Superior Vision by MetLife
1 Frequency limit for routine exam is two per 12 months. The plan covers one additional periodontal cleaning under Preventive Care.
How to Find Dentists and View Rollover Statement
Visit www.guardiananytime.com or call Member Services at 800-541-7846 to find an in-network dentist and check your MRA account details.
up to $50; Lenses: varies from $26-$76 Contact Lenses in Lieu of Lenses and Frames Once every 12 months Anything above $120 allowance Up to $100
1 Copays apply to out-of-network providers for exams, lenses, and frames.
2 Frames are covered up to $125 allowance plus discount on balance over allowance after copay. Find an In-Network
call 800-507-3800
LIFE AND AD&D DISABILITY
Life and Accidental Death and Dismemberment (AD&D) insurance through The Hartford are important to financial security, especially if others depend on you for support.
Use Life insurance 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. Be sure to name beneficiaries!
BASIC LIFE AND AD&D
Basic Life and AD&D insurance are provided at no cost to you. You are automatically covered at $25,000 for each benefit.
VOLUNTARY LIFE AND AD&D
You may buy more Life and AD&D insurance for you and your eligible dependents.
Evidence of Insurability (EOI) is required if you enroll after your initial eligibility, if you are increasing your current election, or if you are requesting amounts above the guaranteed issue limit. Life and
AD&D Available Coverage
Increments of $50,000 up to 5x salary or $500,000
Increments of $25,000 up to $125,000
Birth to 14 days - $500
14 days to age 26 - $10,000
Note: See rates for Voluntary Life and AD&D in UKG.
We offer Short Term Disability (STD) and Long Term Disability (LTD) insurance for you to purchase through The Hartford.
SHORT TERM DISABILITY
STD coverage pays a percentage of your weekly income for up to 12 weeks if you are temporarily disabled and unable to work due to an illness, non-work related injury or pregnancy.
Short Term Disability
* Benefits may not be paid for any condition treated within three months prior to your effective date until you have been covered under this plan for 12 months.
LONG TERM DISABILITY
LTD insurance pays a percentage of your monthly income for a covered disability or injury that prevents you from working for more than 90 days. Evidence of Insurability is required if enrolling after you are first eligible.
Long Term Disability
Pre-existing Condition Exclusion 3/12*
* Benefits may not be paid for any condition treated within three months prior to your effective date until you have been covered under this plan for 12 months.
Note: Contact HR at hr@tpco.com for rates.
SUPPLEMENTAL INSURANCE
You and your eligible family members have the opportunity to enroll in additional coverage that complements our traditional health care programs.
The Accident and Critical Illness plans are offered through The Hartford
ACCIDENT INSURANCE
This plan helps offset the direct and indirect expenses resulting from an accident (e.g., copays, deductibles, ambulance, etc.). See chart for some examples.
CRITICAL ILLNESS
You get a lump-sum benefit payment upon first or second diagnosis of a covered illness or cancer.
Benefit Invasive Cancer, Brain Tumor, Heart Attack, Heart Failure/Transplant, Stroke, Oran Failure, Paralysis, Coma, Loss of Hearing/ Speech/Vision, MS, and more.
Partial Benefit
Non-invasive Cancer, Stent, Bone Marrow Transplant, and more.
Intensive Care Unit
Specific Sum Injuries Dislocations, ruptured discs, eye injuries, fractures, lacerations, concussions, etc.
Death & Dismemberment*
$400 per day – up to 30 days per accident
- $10,000
* Percentage of benefit paid for dismemberment is dependent on type of loss.
* If you were treated for a condition three months prior to your effective date, benefits may not be paid until you have been covered under this plan for 12 months.
Note: Rates are based on your age and can be viewed in UKG.
ADDITIONAL BENEFITS
EMPLOYEE ASSISTANCE PROGRAM (EAP)
You and your family have 24/7 access to the The Hartford Employee Assistance Program (EAP) through Ability Assist . The EAP offers confidential counseling and support services to help you cope with a variety of personal or work-related issues, connect with a mental health professional, or direct you to helpful resources. This free program includes:
Three face-to-face counseling sessions
Legal assistance
Financial counseling
Contact the EAP
Child and elder care resources
Identity theft
Employee discounts
Call 800-96-HELPS (800-964-3577) or visit www.guidanceresources.com (Company/Organization ID: HLF902 and Company Name: ABILI).
WILLPREP SERVICES
WillPrep Services can help you with estate planning and creating a will. Get legal advice for more complicated details.
WELLNESS PROGRAM
The 2025 Get a Move On Health and Wellness program by Preiss offers a variety of challenges to help you achieve your goals. Get a Move On allows you to track your Wellness activity progress and rack up points that can be redeemed for up to $600! Participate in regular company challenges, annual challenges, preventive care appointments, and more. To activate your account after July 1, look for an activation email from noreply@wellright.com
Note: The Healthy Lifestyle Reimbursement Program is part of the Preiss Get a Move On Health and Wellness program, and makes up $360 of the overall $600 in redeemable points.
Tracking your healthy habits is fun and easy:
Sync a Device: Sync your Fitbit, Apple Health, Garmin, or other device to automatically track progress to your portal
Contact support@healthsource-solutions.com for assistance with features
LEARNING STIPEND BENEFIT
If you are a full-time employee, you may receive up to $1,500 to cover certain approved learning and development opportunities. Ask Human Resources for details.
Contact WillPrep Services
Call 800-523-2233 or visit www.estateguidance.com (Code: WILLHLF).
WORK/LIFE BALANCE RESOURCES
NEW BENEFITS
We are pleased to offer a benefit package through New Benefits. The combined services below are available at no cost to you. Use the New Benefits mobile app and web portal to make it fast and easy to access or get information about all of these programs.
Available Programs
Worklife Services helps you find resources you need for everyday living and major life changes. Counselors are available 24/7 to provide an array of support resources, such as child care; summer camps; referrals for lawn or pet care; home cleaning and repairs; adoption, pregnancy and family resources; and more.
LawAssure helps you create high-quality legal documents with expert guidance. Get help with wills, powers of attorney, health care directives, living trusts, divorce paperwork, premarital agreements, elder and child care agreements, leases, bills of sale, and more.
RETIREMENT PLAN
Our 401(k) qualified retirement plan through John Hancock can help you reach your investment goals.
You are eligible to participate in the Plan if you are 19 years of age and have 12 months of service with the company and at least 500 hours worked during a 12-month period. Contact Human Resources if you have questions about your eligibility.
All changes are effective as soon as administratively feasible and remain in effect until you update or stop your contributions.
Enrollment
https://myplan.johnhancock.com
Phone – 800-800-7616
Mobile – Get the My Benefits Work mobile app
These services are available for FREE for all full-time employees.
401(k) Benefits
Preiss will match funds up to 4%
Offers a tax advantage with a pre-tax account
Automatic payroll deductions
You decide how much you want to contribute (up to IRS plan limits)
You decide how to invest your account assets
You can change your contribution and investment choices anytime
YOUR CONTRIBUTIONS
IMPORTANT CONTACTS
www.guidanceresources.com (Company ID: HLF90; Company Name: ABILI)
Travel Assistance and ID Theft Protection The Hartford US: 1-800-243-6108 Other: 202-828-5885 (ID: GLD-09012) www.thehartford.com/employeebenefits
401(k)
www.jhpensions.com
Human Resources Preiss 919-870-5080 hr@tpco.com
Preiss Benefits Center Higginbotham 833-473-TPCO (8726) helpline@higginbotham.net
Preiss Benefits Center
Employee benefits can be complicated. The Preiss Benefits Center by Higginbotham can assist you with the following:
Enrollment Questions
Benefit Information
Claims or Billing Questions Eligibility Issues
Call 833-473-TPCO (8726) to speak with a representative Monday through Friday, 8:00 a.m. to 5:00 p.m. CT. If you leave a voicemail after 3:00 p.m. CT, your call will be returned the next business day. You can also email your questions or requests to helpline@higginbotham.net. Bilingual representatives are also available. For help with your enrollment, contact HR at hr@tpco.com
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:
Preiss
Human Resources
1700 Hillsborough St Raleigh, NC 27605 919-870-5080
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 Preiss 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.
Preiss has determined that the prescription drug coverage offered by Preiss 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. The HSA plan is not 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).
IMPORTANT NOTICES
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 Preiss 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 Preiss 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 919-870-5080.
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 800-772-1213. 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).
July 1, 2025
Preiss Human Resources 1700 Hillsborough St Raleigh, NC 27605 919-870-5080
Notice of HIPAA Privacy Practices
THIS NOTICE OF PRIVACY PRACTICES DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This Notice of Privacy Practices (the “Notice”) describes the legal obligations of Preiss Group Health Plan (the “Plan”) and your legal rights regarding your protected health information held by the Plan under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH Act). Among other things, this Notice describes how your protected health information may be used or disclosed to carry out treatment, payment, or health care operations, or for any other purposes that are permitted or required by law.
We are required to provide this Notice of Privacy Practices to you pursuant to HIPAA.
The HIPAA Privacy Rule protects only certain medical information known as “protected health information.” Generally, protected health information (PHI) is health information, including demographic information, collected from you or created or received by a health care provider, a health care clearinghouse, a health plan, or your employer on behalf of a group health plan, from which it is possible to individually identify you and that relates to:
1. Your past, present, or future physical or mental health or condition;
2. The provision of health care to you; or
3. The past, present, or future payment for the provision of health care to you.
I. Contact Information
If you have any questions about this Notice or about our privacy practices, and for any correspondence or requests related to the contents of this Notice, please contact:
Preiss Human Resources
1700 Hillsborough St Raleigh, NC 27605
919-870-5080
IMPORTANT NOTICES
II. Effective Date
This Notice is effective February 15, 2026.
III. Our Responsibilities
We are required by law to:
1. maintain the privacy of your PHI;
2. provide you with certain rights with respect to your PHI;
3. provide you with a copy of this Notice of our legal duties and privacy practices with respect to your PHI; and
4. follow the terms of the Notice that is currently in effect.
We reserve the right to change the terms of this Notice and to make new provisions regarding your PHI that we maintain, as allowed or required by law. If we make any material change to this Notice, we will provide you with a copy of our revised Notice of Privacy Practices.
IV. How We May Use and Disclose Your PHI
Under the law, we may use or disclose your PHI under certain circumstances without your permission. The following categories describe the different ways that we may use and disclose your PHI. For each category of uses or disclosures we will explain what we mean and present some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories. Note that we will use and disclose PHI as described below unless otherwise prohibited or restricted by applicable state or other law, and that information can lose its protected status as PHI once re-disclosed by a recipient.
For Treatment. When and as appropriate, we may use or disclose medical information about you to facilitate medical treatment or services by health care providers. We may disclose medical information about you to providers, including doctors, nurses, technicians, medical students, or other hospital personnel who are involved in taking care of you. For example, we might disclose information about you with physicians who are treating you.
For Payment. We may use or disclose your protected health information to determine your eligibility for Plan benefits, to facilitate payment for the treatment and services you receive from health care providers, to determine benefit responsibility under the Plan, or to coordinate Plan coverage. For example, we may tell your health care provider about your medical history to determine whether a particular treatment is experimental, investigational, or medically necessary, or to determine whether the Plan will cover the treatment. We may also share your protected health information with a utilization review or pre-certification service provider. Likewise, we may share your protected health information with another entity to assist with the adjudication or subrogation of health claims or to another health plan to coordinate benefit payments.
For Health Care Operations. We may use and disclose your protected health information for other Plan operations. These uses and disclosures are necessary to run the Plan. For example, we may use medical information in connection with conducting quality assessment and improvement activities; underwriting, premium rating, and other activities relating to Plan coverage; submitting claims for stop-loss (or excessloss) coverage; conducting or arranging for medical review, legal services, audit services, and fraud and abuse detection programs; business planning and development such as cost management; and business management and general Plan administrative activities. However, we will not use your genetic information for underwriting purposes.
Substance Use Disorder (SUD) Treatment Information. Some of your health information may be part of a SUD patient record and subject to additional protections under federal law (42 CFR Part 2) governing confidentiality of SUD patient records.
If we receive or maintain any information about you from a SUD treatment program that is covered by 42 CFR Part 2 (a “Part 2 Program”) through a general consent you provide to the Part 2 Program to use and disclose the SUD patient record for purposes of treatment, payment or health care operations, we may use and disclose your SUD patient record for treatment, payment and health care operations purposes as described in this Notice. If we receive or maintain your SUD patient record through specific consent you provide to us or another third party, we will use and disclose your SUD patient record only as expressly permitted by you in your consent as provided to us. In no event will we use or disclose your SUD patient record, or testimony that describes the information contained in your SUD patient record, in any civil, criminal, administrative, or legislative proceedings by any Federal, State, or local authority, against you, unless authorized by your consent or the order of a court after it provides you notice of the court order.
To Business Associates. We may contract with individuals or entities known as Business Associates to perform various functions on our behalf or to provide certain types of services. In order to perform these functions or to provide these services, Business Associates will receive, create, maintain, transmit, use, and/or disclose your PHI, but only after they agree in writing with us to implement appropriate safeguards regarding your PHI. For example, we may disclose your PHI to a Business Associate to process your claims for Plan benefits or to provide support services, such as utilization management, pharmacy benefit management, or subrogation, but only after the Business Associate enters into a Business Associate contract with us.
Treatment Alternatives or Health-Related Benefits and Services. We may use and disclose your protected health information to send you information about treatment alternatives or other health-related benefits and services that might be of interest to you.
IMPORTANT NOTICES
As Required by Law. We will disclose your PHI when required to do so by federal, state, or local law. For example, we may disclose your PHI when required by national security laws or public health disclosure laws.
To Avert a Serious Threat to Health or Safety. We may use and disclose your PHI when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat. For example, we may disclose your PHI in a proceeding regarding the licensure of a physician.
To Plan Sponsors. For the purpose of administering the plan, we may disclose PHI to certain employees of the Employer. However, those employees will only use or disclose that information as necessary to perform plan administration functions or as otherwise required by HIPAA, unless you have authorized further disclosures. Your PHI cannot be used for employment purposes without your specific authorization.
V. Special Situations
In addition to the above, the following categories describe other possible ways that we may use and disclose your PHI without your specific authorization. For each category of uses or disclosures, we will explain what we mean and present some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
Organ and Tissue Donation. If you are an organ donor, we may release your PHI after your death to organizations that handle organ procurement or organ, eye, or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
Military. If you are a member of the armed forces, we may release your PHI as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority.
Workers’ Compensation. We may release your PHI for workers’ compensation or similar programs, but only as authorized by, and to the extent necessary to comply with, laws relating to workers’ compensation and similar programs that provide benefits for work-related injuries or illness.
Public Health Risks. We may disclose your PHI for public health activities. These activities generally include the following:
1. to prevent or control disease, injury, or disability;
2. to report births and deaths;
3. to report child abuse or neglect;
4. to report reactions to medications or problems with products;
5. to notify people of recalls of products they may be using;
6. to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
7. to notify the appropriate government authority if we believe that a patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree, or when required or authorized by law.
Health Oversight Activities. We may disclose your PHI to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. We may also disclose your PHI in response to a subpoena, discovery request, or other lawful process by someone involved in a legal dispute, but only if efforts have been made to tell you about the request or to obtain a court or administrative order protecting the information requested.
Law Enforcement. We may disclose your PHI if asked to do so by a law-enforcement official.
1. in response to a court order, subpoena, warrant, summons, or similar process;
2. to identify or locate a suspect, fugitive, material witness, or missing person;
3. about the victim of a crime if, under certain limited circumstances, we are unable to obtain the victim’s agreement;
4. about a death that we believe may be the result of criminal conduct; and
5. about criminal conduct.
Coroners, Medical Examiners, and Funeral Directors. We may release PHI to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients to funeral directors, as necessary to carry out their duties.
National Security and Intelligence Activities. We may release your PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Inmates. If you are an inmate of a correctional institution or are in the custody of a law-enforcement official, we may disclose your PHI to the correctional institution or lawenforcement official if necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
IMPORTANT NOTICES
Research. We may disclose your PHI to researchers when:
1. The individual identifiers have been removed; or 2. When an institutional review board or privacy board has reviewed the research proposal and established protocols to ensure the privacy of the requested information and approves the research.
VI. Required Disclosures
The following is a description of disclosures of your PHI we are required to make.
Government Audits. We are required to disclose your PHI to the Secretary of the United States Department of Health and Human Services when the Secretary is investigating or determining our compliance with the HIPAA privacy rule. Disclosures to You. When you request, we are required to disclose to you the portion of your PHI that contains medical records, billing records, and any other records used to make decisions regarding your health care benefits. We are also required, when requested, to provide you with an accounting of most disclosures of your PHI if the disclosure was for reasons other than for payment, treatment, or health care operations, and if the PHI was not disclosed pursuant to your individual authorization.
VII. Other Disclosures
Personal Representatives. We will disclose your PHI to individuals authorized by you, or to an individual designated as your personal representative, attorney-in-fact, etc., so long as you provide us with a written notice/authorization and any supporting documents (i.e., power of attorney). Note: Under the HIPAA privacy rule, we do not have to disclose information to a personal representative if we have a reasonable belief that:
1. You have been, or may be, subject to domestic violence, abuse, or neglect by such person; or
2. Treating such person as your personal representative could endanger you; and
3. In the exercise of professional judgment, it is not in your best interest to treat the person as your personal representative.
Spouses and Other Family Members. With only limited exceptions, we will send all mail to the employee. This includes mail relating to the employee’s spouse and other family members who are covered under the Plan and includes mail with information on the use of Plan benefits by the employee’s spouse and other family members and information on the denial of any Plan benefits to the employee’s spouse and other family members. If a person covered under the Plan has requested Restrictions or Confidential Communications (see below under “Your Rights”), and if we have agreed to the request, we will send mail as provided by the request for Restrictions or Confidential Communications.
Authorizations. Other uses or disclosures of your PHI not described above will only be made with your written authorization. For example, in general and subject to specific conditions, we will not use or disclose your psychiatric notes; we will not use or disclose your PHI for marketing; and we will not sell your PHI, unless you give us a written authorization. You may revoke written authorizations at any time, so long as the revocation is in writing. Once we receive your written revocation, it will only be effective for future uses and disclosures. It will not be effective for any information that may have been used or disclosed in reliance upon the written authorization and prior to receiving your written revocation.
VIII. Your Rights
You have the following rights with respect to your PHI:
Right to Inspect and Copy. You have the right to inspect and copy certain PHI that may be used to make decisions about your Plan benefits. If the information you request is maintained electronically, and you request an electronic copy, we will provide a copy in the electronic form and format you request, if the information can be readily produced in that form and format; if the information cannot be readily produced in that form and format, we will work with you to come to an agreement on form and format. If we cannot agree on an electronic form and format, we will provide you with a paper copy.
To inspect and copy your PHI, you must submit your request in writing. If you request a copy of the information, we may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request.
We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to your medical information, you may request that the denial be reviewed by submitting a written request.
Right to Amend. If you feel that the PHI we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the Plan.
To request an amendment, your request must be made in writing. In addition, you must provide a reason that supports your request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
1. is not part of the medical information kept by or for the Plan;
2. was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
3. is not part of the information that you would be permitted to inspect and copy; or
4. is already accurate and complete.
IMPORTANT NOTICES
If we deny your request, you have the right to file a statement of disagreement with us and any future disclosures of the disputed information will include your statement.
Right to an Accounting of Disclosures. You have the right to request an “accounting” of certain disclosures of your PHI. The accounting will not include (1) disclosures for purposes of treatment, payment, or health care operations; (2) disclosures made to you; (3) disclosures made pursuant to your authorization; (4) disclosures made to friends or family in your presence or because of an emergency; (5) disclosures for national security purposes; and (6) disclosures incidental to otherwise permissible disclosures.
To request this list or accounting of disclosures, you must submit your request in writing. Your request must state the time period you want the accounting to cover, which may not be longer than six years before the date of the request. Your request should indicate in what form you want the list (for example, paper or electronic). The first list you request within a 12-month period will be provided free of charge. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Restrictions. You have the right to request a restriction or limitation on your PHI that we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on your PHI that we disclose to someone who is involved in your care or the payment for your care, such as a family member or friend. For example, you could ask that we not use or disclose information about a surgery that you had.
Except as provided in the next paragraph, we are not required to agree to your request. However, if we do agree to the request, we will honor the restriction until you revoke it or we notify you.
We will comply with any restriction request if (1) except as otherwise required by law, the disclosure is to a health plan for purposes of carrying out payment or health care operations (and is not for purposes of carrying out treatment); and (2) the PHI pertains solely to a health care item or service for which the health care provider involved has been paid in full by you or another person.
To request restrictions, you must make your request in writing. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both; and (3) to whom you want the limits to apply-for example, disclosures to your spouse.
Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you must make your request in writing. We will not ask you the reason for your request. Your request must specify how or where you wish to be contacted. We will accommodate all reasonable requests.
Right to Be Notified of a Breach. You have the right to be notified in the event that we (or a Business Associate) discover a breach of unsecured PHI.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
IX. Complaints
If you believe that your privacy rights have been violated, you may file a complaint with the Plan or with the Office for Civil Rights of the United States Department of Health and Human Services. To file a complaint with the Plan, contact the person listed in the Contact Information section of this Notice. All complaints must be submitted in writing.
You will not be penalized, or in any other way retaliated against, for filing a complaint with the Office for Civil Rights or with us.
IMPORTANT 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)
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.
To see if any other States have added a premium assistance program since July 1, 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
IMPORTANT NOTICES
Continuation of Coverage Rights Under COBRA
Under the Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), if you are covered under the Preiss group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Preiss 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
Preiss Human Resources 1700 Hillsborough St Raleigh, NC 27605 919-870-5080
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-ofnetwork 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-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 outof- 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 poststabilization services.
• Certain services at an in-network hospital or ambulatory surgical center – When you get services from an innetwork 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 innetwork 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-ofnetwork. 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 (costsharing) 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 have been wrongly billed, you may contact your insurance provider. Visit www.cms.gov/nosurprises for more information about your rights under federal law.
a comprehensive guide to understanding your 2025 - 2026 Preiss employee benefits program
This brochure highlights the main features of Preiss 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. Preiss reserves the right to change or discontinue its benefits plans at anytime.
