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EMPLOYEE BENEFITS GUIDE
What’s Inside Introduction
We know you work hard every day to achieve your personal and professional goals. Since your health and wellness are key to meeting these goals, we are pleased to offer a comprehensive benefits package that supports your health, mind, and body. May you always be Working Towards Wellness!
Read this guide to learn more about these and other benefits. You may only enroll for or make changes to your benefits during Open Enrollment (OE) or when you have a Qualifying Life Event (QLE) (see page 4)
Your New Benefits Begin: March 1, 2026
Availability of Summary Health Information
Your plan offers medical coverage options. To help you make an informed choice, review each plan’s Summary of Benefits and Coverage available from Human Resources.
If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, federal law gives you more choices for your prescription drug coverage. Please see page 22 for more details.
Response Center
Eligibility
Who is Eligible for Benefits
Eligibility
Enrollment
Coverage Begins
Regular, full-time employee
Working an average of 30 hours per week
Enroll by the deadline given by Human Resources
First of the month after completing 60 days of fulltime employment
Qualifying Life Events
Regular, full-time employee
Working an average of 30 hours per week
Enroll during OE or when you have a QLE
OE: Start of the plan year
QLE: Ask Human Resources
Dependent(s)
Your legal spouse
Child(ren) under age 26 regardless of student, dependency, or marital status
Child(ren) over age 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
You must enroll the dependent(s) at OE or for a QLE
When covering dependents, you must enroll for and be on the same plans
Based on OE or QLE effective dates
You may only change coverage during the plan year if you have a QLE, such as:
Significant
How to Enroll
First-time
Users
Go to www.benefitsinhand.com
1. If this is your first time to log in, click New User Registration Once you register, use your username and password to log in.
2. Enter your personal information and company identifier GreshamJames and click Next
3. Create a username (work email address recommended) and password, then check the I agree to terms and conditions box before you click Finish
4. If you used an email address as your username, you will get a validation email to that address to log in and begin the step-by-step enrollment process.
Returning Users
Go to www.benefitsinhand.com
1. Click Start Enrollment
2. Confirm or update your personal information and click Save & Continue
3. Edit or add dependents, if needed, then click Save & Continue
4. Follow the steps on the screen for each benefit to select or decline coverage. To decline coverage, click Don’t want this benefit? and select the reason for declining.
5. When you finish making your benefit elections, review the summary of your selections. If they are correct, click the Click to Sign button to complete and submit your enrollment choices. Your enrollment will not be complete until you click the Click to Sign button.
Medical Coverage
Protects you and your family from major financial hardship in the event of illness or injury.
About This Coverage
You have a choice of three medical plans:
z Base Plan - This HMO plan has a $4,000 individual and a $8,000 family in-network deductible. It uses the UHC Navigate network.
z Buy-Up Plan - This PPO plan has a $3,000 individual and $6,000 family in-network deductible. It uses the UHC Choice Plus network.
z Premium Plan - This PPO plan has a $2,000 individual and $4,000 family in-network deductible. It uses the UHC Choice Plus network.
Preferred Provider Organization
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.
Health Maintenance Organization
With a Health Maintenance Organization (HMO) plan, you must seek care from in-network providers in the UHC Navigate network. The selection of a primary care physician is required, and you need a referral to see a specialist. Always confirm that your doctors and specialists are in-network before seeking care.
Find an In-Network Provider
Call the number on the back of your ID card
Visit https://connect.werally.com/plans/uhc
Medical Provider: UnitedHealthcare (UHC)
Network: Navigate (HMO plan) and Choice Plus (PPO plans)
Medical Benefits Summary
Prescription Drugs
UHC Resources
If you are enrolled in one of our UHC medical plans, you have access to the following resources.
UHC Member Website and App
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.
z Find information on in-network doctors and other health care providers.
z Organize your medical claims online. View processed claims, remaining balances for deductibles, and outof-pockets expenses.
z Check your current eligibility, deductibles, and outof-pocket costs.
z Confirm what is covered and what is not covered.
z Learn about health conditions and treatment options.
z Request a medical ID card or print a temporary ID card.
z 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.
Health4Me Mobile App
For more personalized health care services, download the Health4Me app, the on-the-go version of www.myuhc.com . This app provides medical cost and service information based on your individual UHC medical plan:
z Locate health care providers close to you.
z Comparison shop for medical services.
z Use the app’s myHealthcare Cost Estimator.
z Review pricing for medical services.
z Receive real-time account balances.
z Learn what to expect throughout your course of medical treatment.
Download the Health4Me app from your mobile device’s app store.
Health Concierge Service
Care24 is a health and well-being concierge service that connects you with a single point of contact to guide you to clinical, wellness, financial, legal, or counseling services through NurseLine and the Employee Assistance Program
Get Answers to Your Health Care Questions
Navigating health care is easier with the UnitedHealthcare Customer Service team on your side. The team can help you:
z Improve your health, manage chronic conditions, and understand complex medical issues
z Understand how your health plan coverages and benefits work
z Get details on a recent claim or how much you can expect to pay
z Find an in-network provider, get a new ID card, or save on health care costs
Call Customer Service at 877-359-3714.
UHC May Call You
A UHC nurse or advocate may contact you to provide extra support. They can help you schedule appointments, enroll in programs, manage prescriptions, and answer questions.
You may be contacted if you are:
z Recovering from a hospital stay : to review after-care instructions and medications
z Managing a health condition: such as cancer, asthma, diabetes, heart failure, or kidney issues
z Expecting a baby : to provide guidance and support from a maternity nurse
UHC Wellness Resources
The following programs and services are available to you at no additional charge as a UHC member.
UHC Rewards
Earn up to $300 with UHC Rewards for a variety of activities, including tracking your steps or sleep.
z Get a biometric screening
z Get an annual checkup
z Connect a tracker
z Take a health survey
REGISTER FOR UHC REWARDS
$50
$25
$25
$15
1. Download the UnitedHealthcare app or sign up at www.myuhc.com
2. Select UHC Rewards.
3. Activate UHC Rewards.
4. Choose reward activities and start earning.
GET AN APPLE WATCH WITH UHC REWARDS
You can use your rewards – up to $300 – towards an Apple watch. You can also choose the “Earn It Off” payment option, which has a $0 up-front cost. The remaining costs can be paid off as you earn your rewards points over 12 months.
EARN $50 FOR BIOMETRIC SCREENING
Learn your blood pressure, glucose, cholesterol, weight, and more to support your health and receive $50 with UHC Rewards. Get an at-home screening, complete the screening at one of many lab locations, or go to your doctor or clinic. Then, submit the completed screening form.
HOW TO GET STARTED
1. Sign in on the UnitedHealthcare app.
2. Go to the Menu tab and select UHC Rewards.
3. Scroll to Available activities and select See all.
4. Select Biometric screening and then Get started.
CALM HEALTH APP
The Calm Health app is designed to support your mental health and well-being at your own pace. The app starts with a short mental health screening so it can suggest a tailored program of content and tools created by psychologists to help you meditate, improve focus, move mindfully, and feel calm. You can set your own pace and track your progress along the way.
Download the Calm Health app to get started. You first need to sign into your account at www.myuhc.com or on the UnitedHealthcare app.
Prescription Drugs
Your medical coverage includes prescription benefits for retail, mail order (home delivery), and specialty drugs.
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 tier 2 or 3, discuss with your doctor if there is a tier 1 alternative.
z Tier 1 – Lowest-cost medications
z Tier 2 – Midrange cost medications
z Tier 3 – Highest-cost medications
If your medication is not listed here, call the phone number on your member ID card.
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.
Pharmacy Discounts
Use Optum Perks to get discounts on prescription drugs so you do not overpay for medications. This service is free and does not require membership. Visit https://perks.optum.com or download the free Optum Perks app to get discounts.
z Search . Type in your drug name(s).
z Find the best price. See prices from pharmacies near you to get the best discount.
z Get your coupons. Print, email, or text the coupon.
z Show the coupon to your pharmacist.
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.
To access information on drugs included under the UHC PDL, log in at www.myuhc.com or use the UnitedHealthcare mobile app. The following information and tools are available:
z Pharmacy benefit and coverage information
z Suggestions for lower-cost medication alternatives
z Medications list based on specific medical conditions
z Medication interactions and side effects
z Locate a participating retail pharmacy
z Manage mail order prescriptions
z View your prescription history
z Refill prescriptions
z Check the status of an order
z Set up email reminders for refills
z Manage your account
Certain drugs require prior authorization, step therapy, or may have dispensing limits or other coverage requirements.
Preventive Care
Your medical plan offers $0 preventive care for everyone.
Preventive care is the care you receive to help prevent chronic illness or disease. It includes exams, lab work, screenings, immunizations, and counseling to prevent health problems, such as diabetes or heart disease.
Preventive Care Coverage Includes
Adults
Cholesterol screening
Blood pressure screening
Colorectal cancer screening
Lung cancer screening
Hepatitis B screening
Well visits
Bone density screening
Obesity screening
Diabetes type 2 screening
Depression screening
Mammograms
Cervical cancer screening
Immunizations
Dental cleanings and exams
Vision screening
Teens
Physical exam
Blood tests for iron and cholesterol
Anxiety screening
Growth screening
Hearing screening
Hepatitis B screening
Depression screening
Alcohol, tobacco, and drug use assessments
Tuberculosis screening
Immunizations
Dental cleanings and exams
Vision screening
Children
Autism screening
Blood screening
Depression screening
Developmental screening
Hearing screening
Obesity screening and counseling
Hypothyroidism screening
Behavioral assessments
Well visits
Immunizations
Dental cleanings and exams
Oral health risk assessment
Vision screening
Frequently Asked Questions
Why should I get preventive care?
Preventive care is the fastest and best way to uncover potential risks and avoid chronic health conditions.
Are all screenings, tests, and procedures covered under preventive care?
No. Your doctor will be able to advise you as to the preventive care you need or should obtain, based on your medical and family history.
Why did I get a bill for preventive care?
Diagnosis codes on the doctor’s bill must meet certain insurance company conditions for them to be processed as preventive and covered at 100%. If you have a medical complaint, or your doctor finds a specific medical issue during your preventive care doctor’s visit, a diagnosis code for that issue or complaint will be on your bill. As a result, the insurance company may process the bill for a specific medical condition, not preventive care. In this case, you must pay the copay or portion of your deductible.
Telemedicine
Allows 24/7/365 access to boardcertified doctors from your mobile phone or computer.
Your medical coverage offers telemedicine services through UHC 24/7 Virtual Visits. Connect anytime day or night with a board-certified doctor via your mobile device or computer for free or for the same or less cost than a visit to your regular physician.
While telemedicine does not replace your primary care physician, it is a convenient and cost-effective option when you need care and:
z Have a non-emergency issue and are considering an after hours health-care clinic, urgent care clinic, or emergency room for treatment
z Are on a business trip, vacation, or away from home
z Are unable to see your primary care physician
When to Use Telemedicine
Use telemedicine for minor conditions such as:
z Sore throat
z Headache
z Stomachache
z Cold/flu
z Mental health issues
z Allergies
z Dermatology
z Primary care
z Fever
z Urinary tract infections
Do not use telemedicine for serious or life-threatening emergencies.
Registration is Easy
Register with UHC 24/7 Virtual Visits so you are ready to use this valuable service when and where you need it.
UHC Virtual Care
Visit www.myuhc.com/virtualvisits Call 866-801-4409
Download the UnitedHealthcare app
CVS Virtual Care Visit www.cvs.com/virtual-care Call 877-993-4321
Download the CVS Virtual Care app
Did You Know?
Your regular provider may offer telemedicine services, so it is best to ask now and know what your options are before you need care. Costs may differ from UHC 24/7 Virtual Visits services.
Health Care Options
Becoming familiar with your options for medical care can save you time and money.
Health Care Provider
Non-Emergency Care
Access to care via phone, online video, or mobile app whether you are home, work, or traveling; medications can be prescribed
Telemedicine
24 hours a day, 7 days a week
Generally, the best place for routine preventive care; established relationship; able to treat based on medical history
Doctor’s Office
Office hours vary
Usually lower out-of-pocket cost than urgent care; when you can’t see your doctor; located in stores and pharmacies
Retail Clinic
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
Hospital ER
Freestanding ER
Life-threatening or critical conditions; trauma treatment; multiple bills for doctor and facility
24 hours a day, 7 days a week
Services do not include trauma care; can look similar to an urgent care center, but medical bills may be 10 times higher
24 hours a day, 7 days a week
Allergies
Cough/cold/flu
Rash
Stomachache
Infections
Sore and strep throat
Vaccinations
Minor injuries/sprains/strains
Common infections
Minor injuries
Pregnancy tests
Vaccinations
Sprains and strains
Minor broken bones
Small cuts that may require stitches
Minor burns and infections
Chest pain
Difficulty breathing
Severe bleeding
Blurred or sudden loss of vision
Major broken bones
Most major injuries except trauma
Severe pain
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
Offsets your medical costs, reduces your taxes, and offers a long-term taxadvantaged savings account.
An HSA is a tax-deductible savings plan that allows you to put aside pretax dollars to use for current or future health care expenses. It is also a tax-exempt tool to supplement your retirement savings. It is always yours to keep, even if you change health plans or jobs.
HSA Contributions
z
z
HSA Eligibility
You are eligible to open and contribute to an HSA if you are:
z Enrolled in an HSA-eligible HDHP
z Not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan
z Not enrolled in a Health Care Flexible Spending Account
z Not eligible to be claimed as a dependent on someone else’s tax return
z Not enrolled in Medicare, Medicaid, or TRICARE
z Not receiving Veterans Administration benefits
Important HSA Information
z 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.
z You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.
z 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.
Open an HSA
If you meet the eligibility requirements, you may open an HSA administered by 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 open an account, contact Rae Zeller in Human Resources.
Contributions
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 at anytime during the plan year, you are eligible to make the catch-up contribution for the entire plan year.
Qualified HSA Expenses
Shows some medical expenses that are eligible for payment under your HSA.
z Abdominal supports
z Acupuncture
z Air conditioner (when necessary for relief from difficulty in breathing)
z Alcoholism treatment
z Ambulance
z Anesthetist
z Arch supports
z Artificial limbs
z Autoette (when used for relief of sickness/disability)
z Blood tests
z Blood transfusions
z Braces
z Cardiographs
z Chiropractor
z Contact lenses
z Convalescent home (for medical treatment only)
z Crutches
z Dental treatment
z Dental X-rays
z Dentures
z Dermatologist
z Diagnostic fees
z Diathermy
z Drug addiction therapy
z Drugs (prescription)
z Elastic hosiery (prescription)
z Eyeglasses
z Fees paid to health institute prescribed by a doctor
z FICA and FUTA tax paid for medical care service
z Fluoridation unit
z Guide dog
z Gum treatment
z Gynecologist
z Healing services
z Hearing aids and batteries
z Hospital bills
z Hydrotherapy
z Insulin treatment
z Lab tests
z Lead paint removal
z Legal fees
z Lodging (away from home for outpatient care)
This list is not all-inclusive; additional expenses may qualify and the items listed may change in accordance with IRS regulations. Refer to IRS Publication 502 Medical and Dental Expenses at www.irs.gov for complete details.
z Metabolism tests
z Neurologist
z Nursing (including board and meals)
z Obstetrician
z Operating room costs
z Ophthalmologist
z Optician
z Optometrist
z Oral surgery
z Organ transplant (including donor’s expenses)
z Orthopedic shoes
z Orthopedist
z Osteopath
z Oxygen and oxygen equipment
z Pediatrician
z Physician
z Physiotherapist
z Podiatrist
z Postnatal treatments
z Practical nurse for medical services
z Prenatal care
z Prescription medicines
z Psychiatrist
z Psychoanalyst
z Psychologist
z Psychotherapy
z Radium therapy
z Registered nurse
z Special school costs for the handicapped
z Spinal fluid test
z Splints
z Surgeon
z Telephone or TV equipment to assist the hard-of-hearing
z Therapy equipment
z Transportation expenses (relative to health care)
z Ultraviolet ray treatment
z Vaccines
z Vitamins (if prescribed)
z Wheelchair
z X-rays
Dental Coverage
Helps maintain fresh breath, healthy gums and teeth, and other dental work.
Our dental plans help you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work. Coverage is provided through Humana
DHMO Plan
If you enroll in the DHMO plan, you must select a primary care dentist (PCD) from the DHMO network directory to manage your care. Eligible dependents may each choose their own PCD. Dental services are unlimited and have fixed copays. There are no deductibles or claim forms to file. There is no coverage for services provided without PCD referral or if you get care from out-of-network providers.
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 Benefits Summary
Find an In-Network Dentist
Call 800-542-1146 or follow the steps below.
STEP 1:
Scan the QR code or go to https://finder. humana.com and select the Dentist tab.
STEP 2:
Enter your search information based on plan
For the PPO plan:
z Enter your ZIP code
z In Select a lookup method, choose PPO coverage type
z Select the network: PPO/Traditional Preferred
z Click the Search button
For the DHMO plan:
z Enter your ZIP code
z In Select a lookup method choose DHMO coverage type
z Select the network: HS405 DHMO
z Click the Search button
Note: For the DHMO plan, you must choose a PCD.
Cleanings, complete series X-rays, exams, fluoride treatments, sealants, space maintainers
Basic Services
Amalgam fillings, crowns, emergency care for pain, endodontics, extractions, general anesthesia, oral surgery, periodontics
Major Services Bridges, crowns, dentures, implants, inlays, onlays
Orthodontia Children to age 18
Vision Coverage
Single
Lined bifocals
Lined trifocals
Lenticular
Lenses
Life and AD&D Insurance
Provides your loved ones with a financial safety net after your death and/or after an accident that causes loss of life, limb, or function.
Life and Accidental Death and Dismemberment (AD&D) insurance through Humana 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 by 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 $50,000 for each benefit.
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%).
Disability Insurance
Provides partial income protection if you are unable to work due to a covered accident or illness.
We provide Long Term Disability (LTD) at no cost to you through Humana Note: This benefit is ONLY available for salaried/management employees.
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 the maximum benefit period.
Long Term Disability Benefits
Employee Assistance Program
Helps you and family members cope with a variety of personal or workrelated issues.
The Employee Assistance Program (EAP) through UHC provides confidential counseling and support services at little or no cost to you to help with:
z Relationships
z Work-life balance
z Stress and anxiety
z Will preparation and estate resolution
z Grief and loss
z Child and eldercare resources
z Substance abuse
Employee Contributions
Important Notices
Women’s Health and Cancer Rights Act of 1998
In October 1998, Congress enacted the Women’s Health and Cancer Rights Act of 1998. This notice explains some important provisions of the Act. Please review this information carefully.
As specified in the Women’s Health and Cancer Rights Act, a plan participant or beneficiary who elects breast reconstruction in connection with a mastectomy is also entitled to the following benefits:
All stages of reconstruction of the breast on which the mastectomy was performed;
Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
Prostheses and treatment of physical complications of the mastectomy, including lymphedema.
Health plans must determine the manner of coverage in consultation with the attending physician and the patient. Coverage for breast reconstruction and related services may be subject to deductibles and coinsurance amounts that are consistent with those that apply to other benefits under the plan.
Special Enrollment Rights
This notice is being provided to ensure that you understand your right to apply for group health insurance coverage. You should read this notice even if you plan to waive coverage at this time.
Loss of Other Coverage or Becoming
Eligible for Medicaid or a state Children’s Health Insurance Program (CHIP)
If you are declining coverage for yourself or your dependents because of other health insurance or group health plan coverage, you may be able to later enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your
or your dependents’ other coverage). However, you must enroll within 31 days after your or your dependents’ other coverage ends (or after the employer that sponsors that coverage stops contributing toward the other coverage). If you or your dependents lose eligibility under a Medicaid plan or CHIP, or if you or your dependents become eligible for a subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents in this plan. You must provide notification within 60 days after you or your dependent is terminated from, or determined to be eligible for, such assistance.
Marriage, Birth or Adoption
If you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must enroll within 31 days after the marriage, birth, or placement for adoption.
For More Information or Assistance
To request special enrollment or obtain more information, contact:
Gresham James Hotels
Ms. Rae Zeller 417 Oakbend Drive, Suite 170 Lewisville, TX 75067 rae.zeller@greshamjames.com 214-488-5211
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 Gresham James Hotels and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to enroll in a Medicare drug plan. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
If neither you nor any of your covered dependents are eligible for or have
Medicare, this notice does not apply to you or the dependents, as the case may be. However, you should still keep a copy of this notice in the event you or a dependent should qualify for coverage under Medicare in the future. Please note, however, that later notices might supersede this notice.
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage through a Medicare Prescription Drug Plan or a Medicare Advantage Plan that offers prescription drug coverage. All Medicare prescription drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
2. Gresham James Hotels has determined that the prescription drug coverage offered by the Gresham James Hotels 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 Gresham James Hotels 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 Gresham James Hotels 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 214-488-5211
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 (1-800-6334227). 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).
March 1, 2026
Gresham James Hotels Ms. Rae Zeller
417 Oakbend Drive, Suite 170 Lewisville, TX 75067
rae.zeller@greshamjames.com 214-488-5211
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 Gresham James Hotels, 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.
Gresham James Hotels
Ms. Rae Zeller
417 Oakbend Drive, Suite 170
Lewisville, TX 75067
rae.zeller@greshamjames.com 214-488-5211
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 1-877KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called
a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272)
If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of January 31, 2026. Contact your State for more information on eligibility.
Alabama – Medicaid
Website: http://www.myalhipp.com/ Phone: 1-855-692-5447
Alaska – Medicaid
The AK Health Insurance Premium Payment Program Website: http://myakhipp.com/ Phone: 1-866-251-4861
Email: CustomerService@MyAKHIPP.com
Medicaid Eligibility: https://health.alaska. gov/dpa/Pages/default.aspx
Arkansas – Medicaid
Website: http://myarhipp.com/ Phone: 1-855-MyARHIPP (855-692-7447)
California– Medicaid
Health Insurance Premium Payment (HIPP) Program Website: http://dhcs.ca.gov/hipp Phone: 916-445-8322
Fax: 916-440-5676
Email: hipp@dhcs.ca.gov
Colorado – Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus (CHP+)
Health First Colorado website: https:// www.healthfirstcolorado.com/
Health First Colorado Member Contact Center: 1-800-221-3943/State Relay 711
CHP+: https://hcpf.colorado.gov/childhealth-plan-plus
CHP+ Customer Service: 1-800-359-1991/ State Relay 711
Health Insurance Buy-In Program (HIBI): https://www.mycohibi.com/ HIBI Customer Service: 1-855-692-6442
Florida – Medicaid
Website: https://www. flmedicaidtplrecovery.com/ flmedicaidtplrecovery.com/hipp/index.html
Phone: 1-877-357-3268
Georgia – Medicaid
GA HIPP Website: https://medicaid.georgia. gov/health-insurance-premium-paymentprogram-hipp
Phone: 678-564-1162, Press 1
GA CHIPRA Website: https://medicaid. georgia.gov/programs/third-party-liability/ childrens-health-insurance-programreauthorization-act-2009-chipra
Phone: 678-564-1162, Press 2
Indiana – Medicaid
Health Insurance Premium Payment Program
All other Medicaid
Website: https://www.in.gov/medicaid/ http://www.in.gov/fssa/dfr/
Family and Social Services Administration
Phone: 1-800-403-0864
Member Services Phone: 1-800-457-4584
Iowa – Medicaid and CHIP (Hawki)
Medicaid Website: https://hhs.iowa.gov/ programs/welcome-iowa-medicaid Medicaid Phone: 1-800-338-8366
Hawki Website: https://hhs.iowa.gov/ programs/welcome-iowa-medicaid/iowahealth-link/hawki
Hawki Phone: 1-800-257-8563
HIPP Website: https://hhs.iowa.gov/ programs/welcome-iowa-medicaid/feeservice/hipp
HIPP Phone: 1-888-346-9562
Kansas – Medicaid
Website: https://www.kancare.ks.gov/ Phone: 1-800-792-4884
HIPP Phone: 1-800-967-4660
Kentucky – Medicaid
Kentucky Integrated Health Insurance Premium Payment Program (KI-HIPP) Website: https://chfs.ky.gov/agencies/dms/ member/Pages/kihipp.aspx
Phone: 1-855-459-6328
Email: KIHIPP.PROGRAM@ky.gov
KCHIP Website: https://kynect.ky.gov Phone: 1-877-524-4718
Kentucky Medicaid Website: https://chfs. ky.gov/agencies/dms
Louisiana – Medicaid
Louisiana Medicaid Website: https://www. ldh.la.gov/healthy-louisiana
Medicaid Customer Service Line: 1-888342-6207
Louisiana Medicaid email: healthy@la.gov
Louisiana Health Insurance Premium Program (LaHIPP) Website: https://www. ldh.la.gov/lahipp
LaHIPP phone: 1-877-697-6703
LaHIPP email: La.HIPP@la.gov
LaHIPP fax: 1-888-716-9787
LaHIPP mailing address: 100 Crescent Centre Parkway, Suite 1000 Tucker, GA 30084
Maine – Medicaid
Enrollment Website: https://www. mymaineconnection.gov/benefits/ s/?language=en_US
Phone: 1-800-442-6003
TTY: Maine relay 711
Private Health Insurance Premium
Webpage: https://www.maine.gov/dhhs/ ofi/applications-forms
Phone: 1-800-977-6740
TTY: Maine Relay 711
Massachusetts – Medicaid and CHIP
Website: https://www.mass.gov/ masshealth/pa
Phone: 1-800-862-4840
TTY: 711
Email: masspremassistance@accenture. com
Minnesota – Medicaid
Website: https://mn.gov/dhs/health-carecoverage/
Phone: 1-800-657-3672
Missouri – Medicaid
Website: http://www.dss.mo.gov/mhd/ participants/pages/hipp.htm
Phone: 573-751-2005
Montana – Medicaid
Website: https://dphhs.mt.gov/ MontanaHealthcarePrograms/HIPP
Phone: 1-800-694-3084
Email: HHSHIPPProgram@mt.gov
Nebraska – Medicaid
Website: http://www.ACCESSNebraska. ne.gov
Phone: 1-855-632-7633
Lincoln: 402-473-7000
Omaha: 402-595-1178
Nevada – Medicaid
Medicaid Website: http://dhcfp.nv.gov
Medicaid Phone: 1-800-992-0900
New Hampshire – Medicaid
Website: https://www.dhhs.nh.gov/ programs-services/medicaid/healthinsurance-premium-program
Phone: 603-271-5218
Toll free number for the HIPP program: 1-800-852-3345, ext. 15218
Email: DHHS.ThirdPartyLiabi@dhhs.nh.gov
New Jersey – Medicaid and CHIP
Medicaid Website: http://www.state.nj.us/ humanservices/dmahs/clients/medicaid/ Phone: 1-800-356-1561
CHIP Premium Assistance Phone: 609-6312392
CHIP Website: http://www.njfamilycare. org/index.html
CHIP Phone: 1-800-701-0710 (TTY: 711)
New York – Medicaid
Website: https://www.health.ny.gov/ health_care/medicaid/ Phone: 1-800-541-2831
North Carolina – Medicaid
Website: https://medicaid.ncdhhs.gov Phone: 919-855-4100
North Dakota – Medicaid
Website: https://www.hhs.nd.gov/ healthcare Phone: 1-844-854-4825
Oklahoma – Medicaid and CHIP
Website: http://www.insureoklahoma.org Phone: 1-888-365-3742
Oregon – Medicaid
Website: https://healthcare.oregon.gov/ Pages/index.aspx Phone: 1-800-699-9075
Pennsylvania – Medicaid and CHIP
Website: https://www.pa.gov/en/services/ dhs/apply-for-medicaid-health-insurancepremium-payment-program-hipp.html Phone: 1-800-692-7462
CHIP Website: https://www.dhs.pa.gov/ chip/pages/chip.aspx
CHIP Phone: 1-800-986-KIDS (5437)
Rhode Island – Medicaid and CHIP
Website: http://www.eohhs.ri.gov/ Phone: 1-855-697-4347 or 401-462-0311 (Direct RIte Share Line)
South Carolina – Medicaid
Website: https://www.scdhhs.gov Phone: 1-888-549-0820
South Dakota - Medicaid
Website: https://dss.sd.gov Phone: 1-888-828-0059
Texas – Medicaid
Website: https://www.hhs.texas.gov/ services/financial/health-insurancepremium-payment-hipp-program Phone: 1-800-440-0493
Utah – Medicaid and CHIP
Utah’s Premium Partnership for Health Insurance (UPP) Website: https://medicaid. utah.gov/upp/ Email: upp@utah.gov Phone: 1-888-222-2542
Adult Expansion Website: https://medicaid. utah.gov/expansion/
Utah Medicaid Buyout Program Website: https://medicaid.utah.gov/buyoutprogram/ CHIP Website: https://chip.utah.gov/
Vermont– Medicaid
Website: https://dvha.vermont.gov/ members/medicaid/hipp-program Phone: 1-800-250-8427
Virginia – Medicaid and CHIP
Website: https://coverva.dmas.virginia.gov/ learn/premium-assistance/famis-select https://coverva.dmas.virginia.gov/learn/ premium-assistance/health-insurancepremium-payment-hipp-programs Medicaid/CHIP Phone: 1-800-432-5924
Washington – Medicaid
Website: https://www.hca.wa.gov/ Phone: 1-800-562-3022
West Virginia – Medicaid and CHIP
Website: https://dhhr.wv.gov/bms/ http://mywvhipp.com/ Medicaid Phone: 304-558-1700
CHIP Toll-free phone: 1-855-MyWVHIPP (1-855-699- 8447)
Wisconsin – Medicaid and CHIP
Website: https://www.dhs.wisconsin.gov/ badgercareplus/p-10095.htm Phone: 1-800-362-3002
Wyoming – Medicaid
Website: https://health.wyo.gov/ healthcarefin/medicaid/programs-andeligibility/ Phone: 1-800-251-1269
To see if any other States have added a premium assistance program since January 31, 2026, or for more information on special enrollment rights, 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 Gresham James Hotels group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Gresham James Hotels 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
Wex Ms. Rae Zeller
417 Oakbend Drive, Suite 170 Lewisville, TX 75067 rae.zeller@greshamjames.com 214-488-5211
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 outof-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 innetwork facility but are unexpectedly treated by an out-of-network provider. You are protected from balance billing for:
Emergency services – If you have an emergency medical condition and get emergency services from an out-ofnetwork provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these 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-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-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 in-network). Your health plan will pay out-ofnetwork providers and facilities directly.
Your health plan generally must:
• Cover emergency services without requiring you to get approval for services in advance (prior authorization).
• Cover emergency services by out-of-network providers.
• Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
• Count any amount you pay for emergency services or 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.
Glossary of Terms
Beneficiary – Who will receive a benefit in the event of the insured’s death. A policy may have more than one beneficiary.
Coinsurance – Your share of the cost of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service, typically after you meet your deductible.
Copay – The fixed amount you pay for health care services received.
Deductible – The amount you owe for health care services before your health insurance begins to pay its portion. For example, if your deductible is $1,000, your plan does not pay anything until you meet your $1,000 deductible for covered health care services. The deductible may not apply to all services, including preventive care.
Employee Contribution – The amount you pay for your insurance coverage.
Employer Contribution – The amount Gresham James Hotels contributes to the cost of your benefits.
Explanation of Benefits (EOB) – A statement sent by your insurance carrier that explains which procedures and services were provided, how much they cost, what portion of the claim was paid by the plan, what portion of the claim is your responsibility, and information on how you can appeal the insurer’s decision. These statements are also posted on the carrier’s website for your review.
Flexible Spending Account (FSA) – An option that allows participants to set aside pretax dollars to pay for certain qualified expenses during a specific time period (usually a 12-month period).
Health Savings Account (HSA) – A personal savings account that allows you to pay for qualified medical expenses with pretax dollars.
High Deductible Health Plan (HDHP) – A medical plan with a higher deductible in exchange for a lower monthly premium. You must meet the annual deductible before any benefits are paid by the plan.
In-Network – Doctors, hospitals, and other providers that contract with your insurance company to provide health care services at discounted rates.
Out-of-Network – Doctors, hospitals, and other providers that are not contracted with your insurance company. If you choose an out-of-network provider, you may be responsible for costs over the amount allowed by your insurance carrier.
Out-of-Pocket Maximum – Also known as an out-of-pocket limit. The most you pay during a policy period (usually a 12-month period) before your health insurance or plan begins to pay 100% of the allowed amount. The limit does not include your premium, charges beyond the Reasonable & Customary (R&C) or health care your plan does not cover. Check with your health insurance carrier to confirm what payments apply to the out-of-pocket maximum.
Over-the-Counter (OTC) Medications – Medications typically made available without a prescription.
Prescription Medications – Medications prescribed by a doctor. Cost of these medications is determined by their assigned tier.
z Brand Name Drugs (Formulary) – Brand name drugs on your provider’s list of approved drugs. You can check online with your provider to see this list.
z Brand Name Drugs (Non-Formulary) – Brand name drugs not on your provider’s list of approved drugs. These drugs are typically newer and have higher copayments.
z Generic Drugs – Drugs approved by the U.S. Food and Drug Administration (FDA) to be chemically identical to corresponding brand name versions. The color or flavor of a generic medicine may be different, but the active ingredient is the same. Generic drugs are usually the most cost-effective version of any medication.
Preventive Care – The care you receive to prevent illness or disease. It also includes counseling to prevent health problems.
Reasonable and Customary Allowance (R&C) – Also known as an eligible expense or the Usual and Customary (U&C). The amount your insurance company will pay for a medical service in a geographic region based on what providers in the area usually charge for the same or similar medical service.
SSNRA – Social Security Normal Retirement Age.
This brochure highlights the main features of the Gresham James Hotels 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. Gresham James Hotels reserves the right to change or discontinue its employee benefits plans anytime.