Helpful Resources
Important Contacts
Medical/Dental/Vision
Blue Cross Blue Shield of Texas
www.bcbstx.com
800-521-2227
Telemedicine
MDLIVE
www.mdlive.com/bcbstx
888-680-8646
Health Savings Account
HSA Bank www.hsabank.com
800-357-6246
Life/AD&D/Disability/Supplemental
Blue Cross Blue Shield of Texas www.bcbstx.com
800-721-7987
Human Resources
Nikki Simmons & Gracie Loyd hr@greenlightdistribution.com 469-647-5128
Benefit Questions and Support
Higginbotham Employee Response Center helpline@higginbotham.net
866-419-3518
Welcome
We are pleased to offer a full benefits package to help protect your wellbeing and financial health. Read this guide to learn about the benefits available to you and your eligible dependents starting May 1, 2026
Each year during Open Enrollment (OE), you may make changes to your benefit plans. The benefit choices you make this year will remain in effect through April 30, 2027. Take time to review these benefit options and select the plans that best meet your needs. After OE, you may only make changes to your benefit elections if you have a Qualifying Life Event (QLE).
Eligibility
You are eligible for benefits if you are a regular, full-time employee working an average of 30 or more hours per week. New hire coverage is effective on the first of the month following 60 days of full-time 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
Availability of Summary Health Information
Your benefits program offers three medical plan coverage options. To help you make an informed choice and compare your options, a Summary of Benefits and Coverage for each plan is available by contacting Human Resources.
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 child
{ FMLA leave, COBRA event, judgment, or decree
{ Becoming eligible for Medicare, Medicaid, or TRICARE
{ Receiving a Qualified Medical Child Support Order
If you have a QLE and want to change your elections, you must notify Human Resources and complete your changes within 30 days of the event. You will be asked to provide documentation to support the change. Contact Human Resources for specific details.
How to Enroll
Managing your benefits online is easy through ADP. Enroll for or update your benefits, and view benefit details, costs, and additional resources in one easily accessible place.
ADP Website
1. Go to https://workforcenow.adp.com
2. From the home page, select Myself, Benefits, then Enrollments
3. Select Start this Enrollment next to the appropriate qualifying event (e.g., New Hire Enrollment, Open Enrollment).
4. This opens the Enrollment Wizard, which will guide you through each step, such as adding dependents and beneficiaries, selecting plan options, and selecting coverages.
5. Once you have made all your selections, be certain to review the Benefits Summary on the final before clicking Submit to Administrator
ADP Mobile App
1. When you log in to the ADP app, you will see Recommended tiles. Click on Benefits
2. To start, select Start Enrollment
3. Continue through each plan type available during your enrollment period. Once you are ready to submit, click Submit enrollment
4. Make sure you receive the confirmation note indicating your selections have been submitted.
Note: At anytime in your enrollment process, you can select Finish later to save your enrollment information.
Employee Response Center
Employee benefits can be complicated. The Higginbotham Employee Response Center can assist you with the following:
CLAIMS OR BILLING QUESTIONS
Call or text 866-419-3518 to speak with a bilingual representative Monday through Friday from 7:00 a.m. to 6:00 p.m. CT. If you leave a message after 3:00 p.m. CT, your call or text will be returned the next business day. You can also email questions or requests to helpline@higginbotham.net
Medical Coverage
The medical plan options through Blue Cross and Blue Shield of Texas (BCBSTX) protect you and your family from major financial hardship in the event of illness or injury. You have a choice of three plans.
Preferred Provider Organization
Base PPO Plan
MTBCB049
$7,000
This plan is a PPO with a $7,000 individual and a $15,800 family in-network deductible.
Buy-up PPO Plan
MTBCB532
$3,750
This plan is a PPO with a $3,750 individual and a $11,250 family in-network deductible.
A Preferred Provider Organization (PPO) plan allows you to see any provider when you need care. When you see in-network providers for care, you will pay less and get the highest level of benefits. You will pay more for care if you use out-of-network providers. When you see in-network providers, your office visits, urgent care visits, and prescription drugs are covered with a copay and most other in-network services are covered at the deductible and coinsurance level.
High Deductible Health Plan
A High Deductible Health Plan (HDHP) allows you to see any provider when you need care, and you will pay less for care when you go to in-network providers. In exchange for a lower per-paycheck cost for medical benefits, you must satisfy a higher plan deductible that applies to almost all health care expenses, including prescription drugs. If you enroll in the HDHP, you may be eligible to open a Health Savings Account (see page 10).
HDHP/HSA Plan
MTBCP007H
$5,000
This plan is an HDHP HSA with a $5,000 individual and a $10,000 family innetwork deductible.
Medical Plan Summary
1 The amount you pay after the deductible is met.
Note: See plan summary for out-of-network benefits.
Telemedicine
Your medical coverage offers telemedicine services through MDLIVE . Connect anytime day or night with a board-certified doctor via your mobile device or computer for free or for the same or less cost than a visit to your regular physician.
While telemedicine does not replace your primary care physician, it is a convenient and cost-effective option when you need care and:
{ Have a non-emergency issue and are considering an after-hours health care clinic, urgent care clinic, or emergency room for treatment
{ Are on a business trip, vacation, or away from home
{ Are unable to see your primary care physician
Registration is Easy
Register with MDLIVE so you are ready to use this valuable service when and where you need it.
{ Online – www.mdlive.com/bcbstx
{ Phone – 888-680-8646
{ Mobile – download the mobile app
When to Use MDLIVE
Use MDLIVE for minor conditions such as:
{ Sore throat
{ Headache
{ Stomachache
{ Cold
{ Flu
{ Mental health issues
{ Allergies
{ Fever
{ Urinary tract infections
Do not use telemedicine for serious or life-threatening emergencies.
BCBSTX Nurseline
Call 800-581-0368 for immediate access to registered nurses who can answer general health questions, make appointments with your doctor, and help determine where to go for immediate or emergency health care services. You can also access an audio library of more than 1,000 health-related topics in both English and Spanish.
Health Care Options
Becoming familiar with your options for medical care can save you time and money.
Non-Emergency Care
Access to care via phone, online video, or mobile app whether you are home, at work, or traveling; medications can be prescribed
24 hours a day, 7 days a week
VIRTUAL VISITS
DOCTOR’S OFFICE
RETAIL CLINIC
Generally, the best place for routine preventive care; established relationship; able to treat based on medical history
Office hours vary
Usually lower out-of-pocket cost than urgent care; when you can’t see your doctor; located in stores and pharmacies
Hours vary based on store hours
When you need immediate attention; walk-in basis is usually accepted
Generally includes evening, weekend, and holiday hours
URGENT CARE
Emergency Care
Life-threatening or critical conditions; trauma treatment; multiple bills for doctor and facility
24 hours a day, 7 days a week
HOSPITAL ER
Services do not include trauma care; can look similar to an urgent care center, but medical bills may be 10 times higher
y Allergies
y Cough/cold/flu
y Rash
y Stomachache
y Infections
y Sore and strep throat
y Vaccinations
y Minor injuries/sprains/strains
y Common infections
y Minor injuries
y Pregnancy tests
y Vaccinations
y Sprains and strains
y Minor broken bones
y Small cuts that may require stitches
y Minor burns and infections
y Chest pain
y Difficulty breathing
y Severe bleeding
y Blurred or sudden loss of vision
y Major broken bones
y Most major injuries except trauma
y Severe pain
FREESTANDING ER
24 hours a day, 7 days a week
Minimal
Note: Examples of symptoms are not inclusive of all health issues. Wait times described are only estimates. This information is not intended as medical advice. If you have questions, please call the phone number on the back of your medical ID card.
Health Savings Account
A Health Savings Account (HSA) is a tax-exempt tool that supplements your retirement savings and covers current and future health costs.
An HSA is a type of personal savings account that is always yours even if you change health plans or jobs. The money in your HSA (including interest and investment earnings) grows tax-free and spends tax-free if used to pay for current or future qualified medical expenses. There is no “use it or lose it” rule – you do not lose your money if you do not spend it in the calendar year – and there are no vesting requirements or forfeiture provisions. The account automatically rolls over year after year.
HSA Eligibility
You are eligible to open and contribute to an HSA if you are:
{ Enrolled in an HSA-eligible HDHP (MTBCP007H HSA)
{ 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
{ Not eligible to be claimed as a dependent on someone else’s tax return
{ Not enrolled in Medicare, Medicaid, or TRICARE
{ Not receiving Veterans Administration benefits
You can also use HSA funds to pay health care expenses for your dependents, even if they are not covered by the High Deductible Health Plan (HDHP).
Maximum Contributions
Your HSA contributions may not exceed the annual maximum amounts established by the Internal Revenue Service (IRS). The 2026 annual contribution maximums are based on the coverage option you elect:
Maximum 2026 HSA Contributions
$4,400 Individual
$8,750 Family
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 age 55 or older, you may make an additional yearly catch-up contribution of up to $1,000 to your HSA. If you turn 55 anytime during the plan year, you are eligible to make the catch-up contribution for the entire plan year.
Opening an HSA
If you meet the eligibility requirements, BCBSTX will open an HSA on your behalf through HSA Bank . You will receive a debit card to manage your HSA account reimbursements. Keep in mind, available funds are limited to the balance in your HSA. To manage your account, go to www.hsabank.com
Important HSA Information
{ Always ask your network doctor to file claims with your medical, dental, or vision carrier so you will get the highest level of benefits. You can pay the doctor with your HSA debit card for any balance due.
{ 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.
Note: To contribute to your HSA, you must choose a contribution amount in ADP.
List of Qualified HSA Expenses
The products and services listed below are examples of medical expenses eligible for payment under HSA. This list is not all-inclusive; additional expenses may qualify, and the items listed are subject to change in accordance with IRS regulations. Please refer to IRS Publication 502 Medical and Dental Expenses at www.irs.gov for a complete description of eligible medical and dental expenses.
Abdominal supports
Acupuncture
Air conditioner (when necessary for relief from difficulty in breathing)
Alcoholism treatment
Ambulance
Anesthetist
Arch supports
Artificial limbs
Autoette (when used for relief of sickness/disability)
Blood tests
Blood transfusions
Braces
Cardiographs
Chiropractor
Contact lenses
Convalescent home (for medical treatment only)
Crutches
Dental treatment
Dental X-rays
Dentures
Dermatologist
Diagnostic fees
Diathermy
Drug addiction therapy
Drugs (prescription)
Elastic hosiery (prescription)
Eyeglasses
Fees paid to health institute prescribed by a doctor
FICA and FUTA tax paid for medical care service
Fluoridation unit
Guide dog
Gum treatment
Gynecologist
Healing services
Hearing aids and batteries
Hospital bills
Hydrotherapy
Insulin treatment
Lab tests
Lead paint removal
Legal fees
Lodging (away from home for outpatient care)
Metabolism tests
Neurologist
Nursing (including board and meals)
Obstetrician
Operating room costs
Ophthalmologist
Optician
Optometrist
Oral surgery
Organ transplant (including donor’s expenses)
Orthopedic shoes
Orthopedist
Osteopath
Oxygen and oxygen equipment
Pediatrician
Physician
Physiotherapist
Podiatrist
Postnatal treatments
Practical nurse for medical services
Prenatal care
Prescription medicines
Psychiatrist
Psychoanalyst
Psychologist
Psychotherapy
Radium therapy
Registered nurse
Special school costs for the handicapped
Spinal fluid test
Splints
Surgeon
Telephone or TV equipment to assist the hard-of-hearing
Therapy equipment
Transportation expenses (relative to health care)
Ultraviolet ray treatment
Vitamins (if prescribed)
Wheelchair X-rays
Therapy equipment
Transportation expenses (relative to health care)
Ultraviolet ray treatment
Vaccines
Vitamins (if prescribed)
Wheelchair X-rays
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 BCBSTX
DPPO Plan
Two levels of benefits are available with the DPPO plan: in-network and outof-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.
Blue Care Dental PPO
Low Plan (MAC) High Plan (UCR)
Out-of-Network Reimbursement Maximum Allowable Charge (MAC) for services.
percentile of Usual and Reasonable (U&R) charges.
1 You will be reimbursed up to the Maximum Allowable Charge (MAC) for services received from an out-of-network dentist. You are responsible for charges in excess of the MAC.
²Payment for covered services received from an out-of-network dentist is based on the 90th percentile of Usual, Customary, and Reasonable (UCR) charges.
³The amount you pay after the deductible is met.
Find an In-Network Dentist
{ Visit www.bcbstx.com
{ Call 800-521-2227
Vision Coverage
Our vision plan offers quality care to help preserve your health and eyesight. Regular exams can detect certain medical issues such as diabetes and high cholesterol, in addition to vision and eye problems. You may seek care from any vision provider, but the plan will pay the highest level of benefits when you see an in-network provider. Coverage is provided through BCBSTX using the EyeMed network of providers.
Life and AD&D Insurance
Life and Accidental Death and Dismemberment (AD&D) insurance through BCBSTX are important to your financial security, especially if others depend on you for support or vice versa. With Life insurance, you or your beneficiary(ies) can use the coverage to pay off debts such as credit cards, loans, and bills. AD&D coverage provides specific benefits if an accident causes bodily harm or loss (e.g., the loss of a hand, foot, or eye). If death occurs from an accident, 100% of the AD&D benefit would be paid to you or your beneficiary(ies). Life and AD&D coverage amounts reduce by 35% at age 65, and 50% at age 70.
Basic Life and AD&D
Basic Life and AD&D insurance are provided at no cost to you. You are automatically covered at one times annual earnings up to $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. 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
Annual Increase Option
Current enrollees may increase their coverage by $10,000, up to the Guaranteed Issue amount of $150,000. Applies to only employee coverage. Any amount above the Guaranteed Issue amount requires evidence of insurability. For those without current coverage, evidence of insurability is required.
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 any time. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%).
Short Term Disability Insurance
Short Term Disability (STD) insurance provides partial income protection if you are unable to work due to a covered accident or illness. We offer Voluntary STD insurance for you to purchase through BCBSTX
Voluntary STD coverage pays a percentage of your weekly salary if you are temporarily disabled and unable to work due to an illness, pregnancy, or non-work-related injury. STD benefits are not payable if the disability is due to a job-related injury or illness. If a medical condition is job-related, it is considered workers’ compensation, not STD.
Supplemental Coverage
You and your eligible family members can enroll in additional coverage through BCBSTX 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 nonmedical expenses.
Accident Insurance
Accident insurance provides affordable protection against sudden, unforeseen accidents. The Accident plan with BCBSTX helps offset the direct and indirect expenses resulting from an accident such as copayments, deductibles, ambulance, physical therapy, childcare, rent, and other costs not covered by traditional health plans. The chart below shows only some of the benefits available. See the plan document for full details.
Accident Insurance
Hospital Confinement
Intensive Care Unit
Specific Sum Injuries
Dislocations, ruptured discs, eye injuries, fractures, lacerations, concussions, etc.
Accidental Death & Dismemberment1
$250 per day, up to 365 days per accident
$500 per day, 15 days per accident
$100-$12,500
1 Percentage of benefit paid for dismemberment is dependent on type of loss.
Supplemental Coverage
Critical Illness Insurance
Critical Illness insurance helps pay the cost of non-medical expenses related to a covered critical illness or cancer. The BCBSTX 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. The chart below shows only some of the benefits available. See the plan document for full details.
Hospital Indemnity Insurance
Hospital Indemnity insurance through BCBSTX helps you with the high cost of medical care by paying you a cash benefit when you have an inpatient hospital stay. Unlike traditional insurance, which pays a benefit to the hospital or doctor, this plan pays you directly. It is up to you how you want to use the cash benefit. These costs may include meals, travel, childcare or eldercare, deductibles, coinsurance, medication, or time away from work. The chart below shows only some of the benefits available. See the plan document for full details.
Full
Benign brain tumor; coma; endstage renal failure; heart attack; major organ transplant; invasive cancer; loss of sight, speech, or hearing; major burns; paralysis; stroke; severe COVID-19 infection
Additional Benefits
As a BCBSTX Life and/or Disability member, you and your eligible dependents get the following programs and services at no cost.
Beneficiary Resource Services
Beneficiary Resource Services provide family wellness and security at the most difficult times through LifeWorks (formerly Morneau Shepell).
Services for You and Your Family
{ Online Will Preparation – Create a personalized will and keep your information safe and secure. Log on to www.beneficiaryresource.com to access this benefit.
{ Online Funeral Planning – Download a funeral planning guide and access helpful information such as funeral cost comparisons, funeral requirements, and various religious customs.
Services for Your Beneficiaries
{ Unlimited phone contact for up to one year with a grief counselor, legal advisor, or financial planner.
{ Up to five face-to-face working sessions that can be split between different counselors. Counselors will initiate follow-up calls, when necessary, for up to one full year from the date of initial contact.
{ Referrals and Support Services. Call 800-769-9187 for details.
Disability Resource Services
Disability Resource Services offered through ComPsych Corporation offer help to address a variety of emotional, legal, and financial issues. Whether it is depression, alcohol and drug abuse, grief, loss, legal, financial, or other work or life issue, help is available to you and your family 24/7 for free.
Services include:
{ In-Person Sessions – Get three face-to-face sessions per issue per year
{ Unlimited Phone Contact – Get 24/7 support from master’s degree-level clinicians
{ Web-based Services – Access extensive online resources to help with personal, relational, legal, health, financial concerns, and more
Get More Information
{ In the U.S. and Canada 866-899-1363
{ TDD 800-697-0353
{ www.guidanceresources.com (Company ID: DISRES)
BCBSTX Resources
Blue Access for Members
Blue Access for Members (BAM) is the secure BCBSTX member website where you can:
{ Check claim status or history
{ Confirm dependent eligibility
{ Print Explanation of Benefits (EOB) forms
{ Locate in-network providers
{ Print or request an ID card
To get started, log on to www.bcbstx.com and use the information on your BCBSTX ID card to complete the registration process.
Mobile App
The BCBSTX mobile app can help you stay organized and in control of your health anytime, anywhere. Log in from your mobile device to access your BAM account, including:
{ Track account balances and deductibles
{ Access ID card information
{ Find doctors, dentists, and pharmacies
Text BCBSTXAPP to 33633 or search your mobile device’s app store to download.
Blue365
Blue365 can help you save money on health and wellness products and services not covered by insurance. There are no claims to file and you do not need a referral or preauthorization. Sign up for Blue365 at www.blue365deals.com/bcbstx to receive weekly featured deals by email. Discount categories include:
{ Apparel and footwear
{ Fitness
{ Hearing and vision
{ Home and family
{ Nutrition
{ Personal care
Member Rewards
Sometimes it is hard to maintain a healthy lifestyle, and you may need a little motivation. The Blue Points program serves as motivation to help you get on track — and stay on track — to reach your wellness goals. Access www.wellontarget.com to find all the interactive tools and resources you need to start racking up Blue Points. Keep yourself motivated to earn more points by viewing the online shopping mall and checking out all the rewards you can earn for adopting — and continuing — healthy habits.
Employee Contributions
Legal Notices
Women’s Health and Cancer Rights Act of 1998
In October 1998, Congress enacted the Women’s Health and Cancer Rights Act of 1998. This notice explains some important provisions of the Act. Please review this information carefully.
As specified in the Women’s Health and Cancer Rights Act, a plan participant or beneficiary who elects breast reconstruction in connection with a mastectomy is also entitled to the following benefits:
{ All stages of reconstruction of the breast on which the mastectomy was performed;
{ Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
{ Prostheses and treatment of physical complications of the mastectomy, including lymphedema.
Health plans must determine the manner of coverage in consultation with the attending physician and the patient. Coverage for breast reconstruction and related services may be subject to deductibles and coinsurance amounts that are consistent with those that apply to other benefits under the plan.
Special Enrollment Rights
This notice is being provided to ensure that you understand your right to apply for group health insurance coverage. You should read this notice even if you plan to waive coverage at this time.
Loss of Other Coverage or Becoming
Eligible for Medicaid or a state Children’s Health Insurance Program (CHIP)
If you are declining coverage for yourself or your dependents because of other health insurance or group health plan coverage, you may be able to later enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must enroll within 31 days after your or your dependents’ other coverage ends (or after the employer that sponsors that coverage stops contributing toward the other coverage).
If you or your dependents lose eligibility under a Medicaid plan or CHIP, or if you or your dependents become eligible for a subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents in this plan. You must provide notification within 60 days after you or your dependent is terminated from, or determined to be eligible for, such assistance.
Marriage, Birth or Adoption
If you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must enroll within 31 days after the marriage, birth, or placement for adoption.
For More Information or Assistance
To request special enrollment or obtain more information, contact: Green Light Distribution Human Resources 555 Airline Drive, Suite 100 Coppell, TX 75019 469-918-4995
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 Green Light Distribution 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
Legal Notices
a copy of this notice in the event you or a dependent should qualify for coverage under Medicare in the future. Please note, however, that later notices might supersede this notice.
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage through a Medicare Prescription Drug Plan or a Medicare Advantage Plan that offers prescription drug coverage. All Medicare prescription drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
2. Green Light Distribution has determined that the prescription drug coverage offered by the Green Light Distribution medical plan is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage pays and is considered Creditable Coverage.
Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to enroll in a Medicare prescription drug plan, as long as you later enroll within specific time periods.
You can enroll in a Medicare prescription drug plan when you first become eligible for Medicare. If you decide to wait to enroll in a Medicare prescription drug plan, you may enroll later, during Medicare Part D’s annual enrollment period, which runs each year from October 15 through December 7 but as a general rule, if you delay your enrollment in Medicare Part D after first becoming eligible to enroll, you may have to pay a higher premium (a penalty).
You should compare your current coverage, including which drugs are covered at what cost, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. See the Plan’s summary plan description for a summary of the Plan’s prescription drug coverage. If you don’t have a copy, you can get one by contacting Green Light Distribution 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 Green Light Distribution 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 469-918-4995
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
Legal Notices
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 (1-800-6334227). TTY users should call 877486-2048
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).
May 1, 2026
Green Light Distribution Human Resources 555 Airline Drive, Suite 100 Coppell, TX 75019 469-918-4995
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 Green Light Distribution, 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.
Green Light Distribution Human Resources 555 Airline Drive, Suite 100 Coppell, TX 75019
469-918-4995
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.
Legal 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 employersponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www. askebsa.dol.gov or call 1-866-444EBSA (3272)
If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of July 31, 2024. Contact your State for more information on eligibility.
Florida – Medicaid
Website: https://www. flmedicaidtplrecovery.com/ flmedicaidtplrecovery.com/hipp/index. html
Phone: 1-877-357-3268
Texas – Medicaid
Website: https://www.hhs.texas.gov/ services/financial/health-insurancepremium-payment-hipp-program Phone: 1-800-440-0493
To see if any other States have added a premium assistance program since July 31, 2024, 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 Green Light Distribution group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Green Light Distribution 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
Green Light Distribution Human Resources
555 Airline Drive, Suite 100 Coppell, TX 75019 469-918-4995
Legal Notices
Your Rights and Protections Against Surprise
Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that have not signed a contract with your health plan. Out-ofnetwork 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-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 innetwork 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 in-network hospital or ambulatory surgical center, certain providers there may be out-ofnetwork. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-of-network providers cannot balance bill you, unless you give written consent and give up your protections.
You are never required to give up your protections from balance billing. You also are not required to get care out-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 innetwork). Your health plan will pay out-of-network providers and facilities directly.
{ Your health plan generally must:
y Cover emergency services without requiring you to get approval for services in advance (prior authorization).
y Cover emergency services by outof-network providers.
y Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
y Count any amount you pay for emergency services or out-ofnetwork 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.
This brochure highlights the main features of the Green Light Distribution 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. Green Light Distribution reserves the right to change or discontinue its employee benefits plans at anytime.
