2026/27
Your Benefits
A guide to understanding your employee benefits program
Contents Welcome .....................................................3 Eligibility .....................................................4 Enrollment ..................................................5 Medical Coverage........................................6 UHC Resources...........................................8 Dental Coverage........................................ 10 Vision Coverage........................................ 11 Life and AD&D Insurance .......................... 12 Disability Insurance .................................. 13 Voluntary Accident and Critical Illness Insurance .......................... 14 Additional Benefits ................................... 15 Principal Value-Adds ................................ 16 Important Notices .................................... 17
Important Contacts MEDICAL UnitedHealthcare www.myuhc.com 866-801-4409
DENTAL Principal www.principal.com/dentist 800-247-4695
VISION Principal www.vsp.com 800-877-7195
BASIC AND VOLUNTARY LIFE AND AD&D Principal www.principal.com 800-245-1522
LONG TERM DISABILITY Principal www.principal.com 800-245-1522
VOLUNTARY ACCIDENT Principal www.principal.com 800-331-2213
VOLUNTARY CRITICAL ILLNESS
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 about your prescription drug coverage. Please see Important Notices for more details.
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Principal www.principal.com 800-245-1522
EMPLOYEE ASSISTANCE PROGRAM Principal/ComPsych www.guidancenow.com 844-869-2365
HUMAN RESOURCES Lori Benson lbenson@ffcbank.com 903-737-5452
Welcome We are pleased to offer 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 May 1, 2026.
AVAILABILITY OF SUMMARY HEALTH INFORMATION To help you understand your medical coverage, a Summary of Benefits and Coverage (SBC) is available at www.myuhc.com or by contacting Human Resources.
Each year during Open Enrollment (OE), you may change your benefit plans. Your benefit choices this year will remain in effect through April 30, 2027. Take time to review these benefit options and select the plans that best meet your needs. After OE, you may only change your benefit elections if you have a Qualifying Life Event (QLE).
EMPLOYEE BENEFITS
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Eligibility You are eligible for benefits if you are a regular, full-time employee working an average of 30 hours per week. Your coverage is effective on the first of the month following 60 days of employment. 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
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 leave, COBRA event, judgment, or decree Participating in 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.
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Enrollment HOW TO ENROLL To begin the enrollment process, go to www.benefitsinhand.com. First-time 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. 2. Registration link. Once you register, you will use your username and password to log in. 3. Enter your personal information and company identifier of FFCB and click Next. 4. Create a username (work email address recommended) and password, then check the I agree to terms and conditions box before you click Finish. 5. 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. 6. Click the Start Enrollment button to begin the enrollment process.
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Confirm or update your personal information and click Save & Continue.
8. Edit or add dependents who need to be covered on your benefits, then click Save & Continue. 9. 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. 10. 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.
EMPLOYEE BENEFITS
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Medical Coverage The medical plan offered through UnitedHealthcare (UHC) protects you and your family from major financial hardship in the event of illness or injury.
PPO HIGH DEDUCTIBLE HEALTH PLAN A High Deductible Health Plan (HDHP) allows you the freedom to see any provider when you need care; however, you will pay less if you use in-network providers. In exchange for a lower per-paycheck cost, you must satisfy a higher deductible that applies to almost all health care expenses, including those for prescription drugs. Preventive care is covered at 100% with the deductible waived if you see an in-network provider. The plan pays 100% for health care and prescription drug expenses once you meet your in-network deductible.
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FIND AN IN-NETWORK PROVIDER Visit www.myuhc.com or call 866-801-4409.
MEDICAL SUMMARY
UHC EPO HDHP In-Network
Calendar Year Deductible • Individual • Family
$5,000 $10,000
Calendar Year Out-of-Pocket Maximum • Individual • Family
$5,000 $10,000
Coinsurance
100%
You Pay Preventive Care
$0
Telemedicine
$0 after deductible
Primary Care Physician
$0 after deductible
Specialist
$0 after deductible
Urgent Care
$0 after deductible
Diagnostic X-ray and Lab
$0 copay
Complex Imaging (CT/PET scan, MRI)
$0 after deductible
Emergency Room
$0 after deductible
Inpatient Hospital Services
$0 after deductible
Outpatient Facility Services
$0 after deductible
Pharmacy Retail Pharmacy (Up to a 30-day supply) • Preferred Generic • Generic • Preferred Brand Name • Non-Preferred Brand Name • Preferred Specialty Drug • Non-Preferred Specialty Drug
$0 after deductible $0 after deductible $0 after deductible $0 after deductible $0 after deductible $0 after deductible
Mail Order Pharmacy (Up to a 90-day supply) • Preferred Generic • Generic • Preferred Brand Name • Non-Preferred Brand Name
$0 after deductible $0 after deductible $0 after deductible $0 after deductible
EMPLOYEE BENEFITS
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UHC Resources Your prescription drug coverage is provided through UHC.
PRESCRIPTION DRUG LIST UHC controls prescription drug costs by negotiating discounts on medications. Drugs included in the UHC Prescription Drug List (PDL) are classified in tiers – the different cost levels you pay for a medication. Tier 1 medications are the lowest-cost options. If your medication falls within tiers 2 or 3, discuss with your doctor if there is a tier 1 alternative.
SPECIALTY MEDICATIONS Use Optum Specialty Pharmacy for specialty drugs to treat complex or chronic conditions. Call 855-427-4682 to speak to a pharmacist or patient care coordinator, who can help with new or transfer orders and specialty medication support, including virtual visits. Specialty medications can only be filled through Optum. Certain exclusions and limitations apply.
Tier 1 – Lowest-cost medications
To access information on drugs included under the UHC PDL, log in at www.myuhc.com or use the UnitedHealthcare app. The following information and tools are available:
Tier 2 – Midrange-cost medications
Pharmacy benefit and coverage information
Tier 3 – Highest-cost medications
Suggestions for lower-cost medication alternatives
If your medication is not listed here, call the phone number on your member ID card.
Medications list based on specific medical conditions
RETAIL AND HOME DELIVERY Use a retail pharmacy or home delivery for non-specialty medications. Home delivery is a convenient, low-cost option for long-term medications to treat chronic conditions like diabetes and heart disease.
Medication interactions and side effects Locate a participating retail pharmacy Manage mail order prescriptions View your prescription history Refill prescriptions Check the status of an order Set up email reminders for refills Manage your account Certain drugs require prior authorization, step therapy, or may have dispensing limits or other coverage requirements.
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UHC MEMBER WEBSITE AND APP
TELEMEDICINE
Researching health information and keeping track of your family’s health care benefits can be time-consuming. With the UHC Member Portal you can easily find the answers you are looking for, anytime day or night. You can also download the UnitedHealthcare app to have access to your member account.
UHC offers two options for telemedicine.
Find information on in-network doctors and other health care providers.
24/7 Virtual Visits – Get non-emergency care for everything from flu and pink eye to anxiety and migraines, including prescription refills for the same or lower price than from your regular doctor.
Organize your medical claims online. View processed claims, remaining balances for deductibles, and outof-pocket expenses.
Virtual Primary Care – Get an annual wellness visit, regular follow-ups for ongoing conditions, preventive screenings, and prescriptions for the same price as your regular doctor.
Get started at www.myuhc.com/virtualcare or on the UnitedHealthcare app.
Check your current eligibility, deductibles, and out-ofpocket costs. Confirm what is covered and what is not covered. Learn about health conditions and treatment options. Request a medical ID card or print a temporary ID card. Update other coverage information for you and your eligible family members. To create an account, log in at www.myuhc.com, click Register Now, and complete the required fields.
EMPLOYEE BENEFITS
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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 Principal.
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 SUMMARY Calendar Year Deductible • Individual • Family
DPPO Plan In-Network
Out-of-Network
$50 $150
$50 $150
Calendar Year Benefit Maximum Per Individual
$5,000
You Pay Preventive and Diagnostic Care Exams, cleanings, X-rays, fluoride treatments, sealants
$0
$0
Basic Procedures Fillings, sealants, space maintainers, simple extractions, endodontics, periodontics, oral surgery, general anesthesia, emergency exams
20% after deductible
20% after deductible
Major Restorative Care Crowns, inlays/onlays, bridges, dentures
50% after deductible
50% after deductible
50% $1,500
50% $1,500
Orthodontia Lifetime Maximum per member
Non-Contracting Dentist Reimbursement - the “Plan Pays” percentage above will be applied to the lesser of the dentist’s submitted charge or the 99th percentile of select charge data purchased by the company supplemented by internal claim data for the Covered Service.
FIND AN IN-NETWORK DENTIST Visit www.principal.com/dentist or call 800-247-4695.
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Vision Coverage Our vision plan offers quality care to help preserve your health and eyesight. Regular exams can detect specific medical issues such as diabetes, high cholesterol, and vision and eye problems.
FIND AN IN-NETWORK VISION PROVIDER Visit www.vsp.com or call 800-877-7195.
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 Principal using the VSP Choice Network.
VISION SUMMARY
Vision Plan In-Network You Pay
Out-of-Network Reimbursement
$10 copay
Up to $45
Lenses Once every 12 months • Single Vision • Bifocals • Trifocals • Lenticular
$25 copay $25 copay $25 copay $25 copay
Up to $30 Up to $50 Up to $65 Up to $100
Frames Once every 12 months
Covered up to $150, and 20% discount off the balance
Up to $70
$60 $150 $25
N/A Up to $105 Up to $210
Exam Once every 12 months
Contacts Once every 12 months In lieu of lenses and frames • Fitting and evaluation • Elective conventional and disposable contact lenses • Medically necessary
EMPLOYEE BENEFITS
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Life and AD&D Insurance Life and Accidental Death and Dismemberment (AD&D) insurance through Principal are important to 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 35% at age 70, and 55% at age 75.
VOLUNTARY LIFE AND AD&D You may buy additional Life and AD&D insurance for you and your eligible dependents. If you do not elect Voluntary Life and AD&D insurance when first eligible, or if you want to increase your benefit amount at a later date, you may need to show proof of good health. 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 Coverage Employee
• Increments of $10,000 up to $500,000 • Guaranteed Issue $150,000
Spouse
• Increments of $5,000 up to 50% of employee amount not to exceed $150,000 • Guaranteed Issue $30,000
Children
• Birth to under 14 days - $1,000 • 14 days to age 26 - $5,000, $10,000 or $20,000 up to 50% of employee amount
BASIC LIFE AND AD&D First Federal Community Bank provides Basic Life and AD&D at no cost to you. We determine your coverage by classification defined by your earnings.
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%).
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Voluntary Life and AD&D rates are found in BenefitsinHand.
Disability Insurance Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. We offer Long Term Disability (LTD) insurance for you through Principal at no cost to you.
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 90 days. Benefits begin at the end of an elimination period and continue while you are disabled up to Social Security Normal Retirement Age (SSNRA). Long Term Disability Benefits Begin
91st day
Percentage of Earnings You Receive
66.67%
Maximum Monthly Benefit
$13,000
Maximum Benefit Period
SSNRA
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.
EMPLOYEE BENEFITS
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Voluntary Accident and Critical Illness Insurance First Federal Community Bank allows you and your eligible family members to enroll in additional coverage that complements our traditional health care programs. Health insurance covers medical bills, but if you have an emergency, you may face unexpected out-of-pocket costs such as deductibles, coinsurance, travel expenses, and non-medical-related expenses. These plans are offered through Principal and are portable. If you leave First Federal Community Bank employment, you can take these policies with you.
VOLUNTARY ACCIDENT INSURANCE Accident insurance provides affordable protection against a sudden, unforeseen accident. The Accident plan helps offset the direct and indirect expenses resulting from an accident such as copayments, deductible, ambulance, physical therapy, and other costs not covered by traditional health plans. Voluntary Accident Insurance Service Burns
$500 – $5,000
Coma
$15,000
Dislocation
$1,500 – $7,500
Fracture
$500 – $10,000
Specific Injuries Internal injury, knee cartilage injury, ruptured disc, and additional injuries not listed
$100 – $1,500
Wellness
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Benefit
$50
VOLUNTARY CRITICAL ILLNESS Critical Illness insurance from Principal helps pay the cost of non-medical expenses related to a covered critical illness or cancer. The plan provides a lump-sum benefit payment to you upon first and second diagnosis of any covered critical illness or cancer. The benefit can help cover expenses such as lost income, out-of-town treatments, special diets, daily living, and household upkeep costs.
Voluntary Critical Illness Benefit Amounts Available You Guaranteed Issue
$5,000 up to $50,000 $15,000
Your Spouse
50% of your benefit up to $25,000 $7,500
Guaranteed Issue
Automatically covered up to 25% of your benefit amount
Your Child
Service
Benefit
Alzheimer’s disease, full benefit cancer; heart attack; stroke; heart, kidney or organ failure; heart transplant; coronary artery bypass
100% of benefit amount
Partial cancer benefit, COVID-19, diphtheria, Lyme disease, malaria, and meningitis
25% of benefit amount
Health Screening Benefit One per covered person per calendar year
$50
Additional Benefits Principal offers the following program at no extra cost to you.
EMPLOYEE ASSISTANCE PROGRAM Carrier: ComPsych GuidanceResources The Employee Assistance Program (EAP) helps you and family members cope with a variety of personal and work-related issues. This program provides confidential counseling and support services at little or no cost to you to help with: Relationships Work-life balance Stress and anxiety
Will preparation and estate resolution
Substance abuse Financial and legal matters
Grief and loss
And more
Childcare and eldercare issues
SUPPORT AT ANY HOUR OF THE DAY OR NIGHT Visit www.guidanceresources.com then enter PrincipalCore as the program name. Call 844-869-2365. Download the GuidanceNow app.
EMPLOYEE BENEFITS
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Principal Value-Adds The following discounts and services are available through your group benefits. These discounts are not insurance. Some services may not be available based on your location.
LASER VISION CORRECTION Save $800 with featured providers, or receive 15% off standard pricing or 5% off promotional pricing on LASIK. Call 888-647-3937 or visit www.principallasik.com for details. Administered by LCA Vision.
HEARING AID PROGRAM Get discounts up to 48% off hearing aids, including rechargeable and Bluetooth options, with a 60-day trial to ensure full satisfaction. Get a free hearing consultation at any of the 3,000+ locations nationwide. Administered by Start Hearing. Learn more at www.starthearing.com/ partners/principallife or call 877-890-4694.
EMOTIONAL HEALTH SUPPORT LINE Call this free, confidential support line at 844-869-2365 to reach licensed behavioral health clinicians. Get emotional support, tips for coping, and referrals to local resources anytime, day or night. Available with your dental and vision insurance.
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PRINCIPAL ORAL HEALTH CENTER Get the information you need to make better decisions about oral health care. Submit a dental care question online and get a response from a dentist in one business day. A dental cost estimator shows approximate costs in a ZIP code. For details, go to https://c3.go2dental.com/ scontent.
TEETH WHITENING Save 20% on a dentist-invented teeth whitening technology from GLO Science. Available for home use. Access www.gloscience.com/principal and use discount code PRINCIPAL.
WILL AND LEGAL DOCUMENT CENTER Use online resources and tools provided by ARAG to prepare, print, and store essential legal documents such as a will, living will, health care power of attorney, durable power of attorney, and medical treatment authorization for minors. Access estate planning tools and resources, and a personal information organizer at https://principal.araggroup.com.
IDENTITY THEFT KIT If your identity is stolen, get valuable tips on how to restore it at https://principal.araggroup.com.
VISION CARE
BENEFICIARY SUPPORT
Get discounts on LASIK surgery from a network of VSP providers. You will also receive discounts on eye exams, prescription glasses and lenses, and contact lens evaluations and fittings. Visit www.principal.com/vsp and select the VSP Choice Network or call 800-877-7195.
After a loved one dies, beneficiaries receive help coping with the emotions and financial decisions that must be made. Individuals can receive support from licensed professionals with FamilySource, FinancialConnect, and LegalConnect services through ComPscyh GuidanceResources.
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:
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
• All stages of reconstruction of the breast on which the mastectomy was performed;
To request special enrollment or obtain more information, contact:
• Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
First Federal Community Bank Lori Benson 630 Clarksville St. Paris, TX. 75460 903-737-5452
• 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
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 First Federal Community Bank 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.
EMPLOYEE BENEFITS
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Important Notices 2.
First Federal Community Bank has determined that the prescription drug coverage offered by the First Federal Community Bank 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 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 First Federal Community Bank 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 First Federal Community Bank 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
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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 903-737-5452. 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 800-3250778. 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).
Important Notices May 1, 2026 First Federal Community Bank Lori Benson 630 Clarksville St. Paris, TX. 75460 903-737-5452
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 First Federal Community Bank, 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.
First Federal Community Bank Lori Benson 630 Clarksville St. Paris, TX. 75460 903-737-5452 Conclusion PHI use and disclosure by the Plan is regulated by a federal law known as HIPAA (the Health Insurance Portability and Accountability Act). You may find these rules at 45 Code of Federal Regulations Parts 160 and 164. The Plan intends to comply with these regulations. This Notice attempts to summarize the regulations. The regulations will supersede any discrepancy between the information in this Notice and the regulations.
PREMIUM ASSISTANCE UNDER MEDICAID AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employersponsored plan.
EMPLOYEE BENEFITS
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Important Notices 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).
Plan Contact Information
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 January 31, 2026. Contact your State for more information on eligibility.
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.
TEXAS – MEDICAID
What is “balance billing” (sometimes called “surprise billing”)?
Website: https://www.hhs.texas.gov/services/financial/health-insurancepremium-payment-hipp-program Phone: 1-800-440-0493
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.
To see if any other States have added a premium assistance program since January 31, 2026, 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 First Federal Community Bank group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the First Federal Community Bank 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.
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First Federal Community Bank Lori Benson 630 Clarksville St. Paris, TX. 75460 903-737-5452
YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS
“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 innetwork facility but are unexpectedly treated by an out-ofnetwork provider. You are protected from balance billing for: • Emergency services – If you have an emergency medical condition and get emergency services from an out-of- network provider or facility, the most the provider or facility may bill you is your plan’s in- network cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Important Notices • Certain services at an in-network hospital or ambulatory surgical center – When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot balance bill you and may not ask you to give up your protections not to be balance billed. If you get other services at these in-network facilities, outof-network providers cannot balance bill you, unless you give written consent and give up your protections.
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?
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.
The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers “one-stop shopping” to find and compare private health insurance options in your geographic area.
When balance billing is not allowed, you also have the following protections:
Can I Save Money on my Health Insurance Premiums in the Marketplace?
• 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.
You may qualify to save money and lower your monthly premium and other out-of-pocket 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.
• Your health plan generally must: •
Cover emergency services without requiring you to get approval for services in advance (prior authorization).
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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.
Does Employment-Based Health Coverage Affect Eligibility for Premium Savings through the Marketplace? 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”
EMPLOYEE BENEFITS
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Important Notices 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 employment-based 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
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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 either- submit 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 employmentbased 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 employmentbased 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/gettingmedicaid-chip/ for more details.
Important Notices 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: First Federal Community Bank
4. Employer Identification Number (EIN): 75-0482185
5. Employer Address: 630 Clarksville St Paris TX, 75461
6. Employer Phone Number: 903-737-5452
7. City: Pairs
8. State: TX
9. ZIP Code: 75461
10. Who can we contact at this job?: Lori Benson 11. Phone Number (if different from above):
12. E-Mail Address: lbenson@ffcbank.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/irs-drop/rp-22-34.pdf for 2023.
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. 2
EMPLOYEE BENEFITS
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This brochure highlights the main features of the First Federal Community Bank 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. First Federal Community Bank reserves the right to change or discontinue its employee benefits plans anytime.