We are pleased to offer a full benefits package to you and your eligible dependents. Read this guide to know what benefits are available to you. You may only enroll for or make changes to your benefits during Open Enrollment or when you have a Qualifying Life Event.
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 (SBC), available from Human Resources.
YOUR NEW BENEFITS BEGIN March 1, 2026
Give your loved ones a financial safety net after your death and/or an accident that causes loss of life, limb, or function
Get partial income protection if you are unable to work due to a covered accident or illness
Protect your finances and have the money to cover unexpected hospital or medical bills
Review your legal rights and get details on various benefit situations
ELIGIBILITY
New Hire
Who is Eligible
• A regular, full-time employee working an average of 30 hours per week
When to Enroll
• Enroll by the deadline given by Human Resources
When Coverage Starts
• First of the month after completing 60 days of full-time employment
Employee
Who is Eligible
• A regular, full-time employee working an average of 30 hours per week
When to Enroll
• Enroll during OE or when you have a QLE
When Coverage Starts
• OE: Start of the plan year
• QLE: Ask Human Resources
Dependent(s)
Who is Eligible
• 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
When to Enroll
• 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
When Coverage Starts
• Ask Human Resources, if needed
Qualifying Life Events
You
Change in employment status affecting benefits
Significant change in cost of spouse’s coverage
HRP Pro 3.0
HRP Pro 3.0 is our updated Employee Self-Service (ESS) portal, giving you access to your pay history, benefits information, and more. Follow the steps below to log in or create an account.
If You Already Have an HRPWeb/HRP Pro Login:
1 Visit https://pro3.hrp.net
2 Log in using your existing HRPWeb/HRP Pro credentials
3 If you forgot your password, click Forgot Password to reset it
If You Do Not Have an HRPWeb/HRP Pro Login: 1 Visit https://pro3.hrp.net
2 Click Employee Signup and complete the required information
3 Check your email for login credentials and follow the instructions to access your account
Navigating
HRP Pro 3.0
• Home will direct you to your front page which will display an overview of your payroll and time off notices, as well as HR&P and employer news.
• Documents allows you access to forms, policies, and other documents made available to you.
• eBenefits will allow you to electronically declare your benefits during open enrollment and submit life changes as needed (if available).
• My Payroll Information will give you access to your profile, direct deposit information, deductions, dependents, and other pertinent information.
• Check History will provide you with each of your pay stubs. Here you can view prior years, download the pay stub, or print it out for your records.
• W2/1099s will provide you with past W2s available for download or reprint.
• Year to Date will provide you with a snapshot overview of your current earnings for the year.
For further assistance with the ESS portal, please contact our offices at 281-880-6525
MEDICAL
The medical plan options through Blue Cross Blue Shield of Texas (BCBSTX) using the Blue Choice network protect you and your family from major financial hardship in the event of illness or injury. You have a choice of three plans:
Base Plan (ATBCB205)
This PPO plan has a $2,500 Individual and a $7,500 Family in-network deductible.
Buy-Up Plan (ATBCP202)
This PPO plan has a $1,000 Individual and a $3,000 Family in-network deductible.
HDHP/HSA Plan (ATBCP292)
This HDHP plan has a $5,000 Individual and a $10,000 Family in-network deductible.
Preferred Provider Organization Plan
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 network services are covered at the deductible and coinsurance level.
High Deductible Health Plan with HSA
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 (HSA – see page 12).
– Retail
•
•
•
•
Prescription Drugs – Mail Order
• Preferred generic
• Non-preferred generic
• Preferred brand name
• Non-preferred
Drugs – Specialty
¹ What you will pay after your deductible is met.
²
³
TELEMEDICINE
FOR CONVENIENT, 24/7 CARE
Your medical coverage offers telemedicine services through MDLIVE . Connect anytime day or night with a boardcertified doctor via your mobile device or computer 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
When to Use Telemedicine
Use telemedicine 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.
Registration is Easy Register with MDLIVE so you are ready to use this valuable service when and where you need it.
Visit www.mdlive.com/bcbstx
Call 888-680-8646
Text BCBSTX to 635-483
Download the MDLIVE app
HEALTH CARE OPTIONS
AND EMERGENCY CARE
Becoming familiar with your options for medical care can save you time and money.
Non-emergency Care
Telemedicine
Access to care via phone, online video, or mobile app whether you are home, work, or traveling; medications can be prescribed.
24 hours a day, 7 days a week Allergies
Doctor’s Office
Generally, the best place for routine preventive care; established relationship; able to treat based on medical history.
Office hours vary
Retail Clinic
Usually lower out-of-pocket cost than urgent care; when you can’t see your doctor; located in stores and pharmacies.
Infections
Sore and strep throat
Vaccinations
Minor injuries/sprains/strains
Hours vary based on store hours Common infections
Urgent Care
When you need immediate attention; walk-in basis is usually accepted.
Generally includes evening, weekend, and holiday hours
Emergency Care
Hospital ER
Life-threatening or critical conditions; trauma treatment ; multiple bills for doctor and facility.
24 hours a day, 7 days a week
Freestanding ER
Services do not include trauma care; can look similar to an urgent care center, but medical bills may be 10 times higher
24 hours a day, 7 days a week
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
FOR CURRENT OR FUTURE EXPENSES
A Health Savings Account (HSA) is a tax-exempt tool to supplement your retirement savings and to cover 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.
YOU DECIDE HOW TO USE YOUR HSA FUNDS
Use it Now
Make annual HSA contributions. Pay for eligible medical costs. Keep HSA funds in cash.
Let it Grow
Make annual HSA contributions. Pay for medical costs with other funds. Invest HSA funds.
TAX BENEFITS
HSA contributions are tax-deductible and grow tax-deferred
Withdrawals for qualifying medical expenses are tax-free.
HSA Eligibility
You are eligible to open and contribute to an HSA if you are:
• Enrolled in an HSA-eligible HDHP (ATPCP292)
• 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
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, 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 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 a 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.
• 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.
LIST OF QUALIFIED HSA EXPENSES
The products and services listed below are examples of medical expenses eligible for payment using your Health Savings Account. 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
Vaccines
Vitamins (if prescribed)
Wheelchair
X-rays
BCBSTX RESOURCES
FOR GETTING THE MOST OUT OF YOUR MEDICAL COVERAGE
BCBSTX Member Portal
Blue Access for Members (BAM) is the secure BCBSTX member website where you can:
• Check claim status or history
• Confirm dependent eligibility
• Sign up for electronic Explanation of Benefits statements
• Locate in-network providers
• Print or request an ID card
• Review your benefits
• Get tips to live and eat healthier Register for an account at www.bcbstx.com
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 to:
• Track account balances and deductibles
• Access ID card information
• Find doctors, dentists, and pharmacies
Cash Rewards Program
Member Rewards offers you cash rewards when you use the Provider Finder tool to choose the lower-cost, quality option for your health care.
• Visit www.bcbstx.com , register or log in to Blue Access for Members, and select Find Care
• Shop and compare costs and quality for screenings, scans, surgeries, and more.
• Get the procedure or service at a reward-eligible location.
• Receive a cash reward by check, mailed directly to your home, after the claim is paid and the location is verified as reward-eligible.
Blue365 Discounts
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. Visit www.blue365deals.com/bcbstx to sign up and receive weekly Featured Deals by email. Discount categories include:
• Apparel and footwear
• Fitness
• Hearing and vision
Women’s and Family Health
• Home and family
• Nutrition
• Personal care
Welcome to Maven, the new women’s and family health partner to BCBSTX. This digital maternity program provides personalized virtual support and guidance for pregnancy, postpartum, and newborn. Meet with providers anytime, day or night, 24/7/365, so you get the care you need when you need it along your pregnancy and postpartum journey.
CHRONIC MEDICAL CARE
FOR LONG-TERM TREATMENT
Back and Joint Pain
If you suffer from constant back and joint pain, Hinge Health can help without drugs or surgery. Get personal therapy, unlimited support, a computer tablet, and wearable sensors — all for free! Average results show 60% pain reduction and two out of three surgeries avoided. Visit www.hingehealth.com/bcbstx to learn more and apply.
Weight Loss
If you would like to lose weight and change how your body stores and uses energy, Wondr may be right for you. Wondr is a 100% digital weight loss program that teaches you how to eat your favorite foods and still lose weight, have energy, stress less, and sleep better. Visit https://wondrhealth.com/bcbstx to learn more and enroll.
Diabetes and High Blood Pressure
At Risk Prevention
If you are at risk of diabetes and/or high blood pressure, Omada helps you change the habits that put you most at risk for developing a chronic condition. A virtual care team will work with you to create a program to reduce your risk and build healthy habits. If you have any health claims that show you may be at risk for diabetes or high blood pressure, Omada will reach out to you directly. Visit www.omadahealth.com/bcbstx for details.
Diabetes and Metabolic Health Management
Diabetes and metabolic syndrome can be related, and now you can better manage these conditions with a diabetes reversal program from Twin Health The program creates a digital representation of your unique metabolism and provides ways to treat the underlying causes of metabolic syndrome to help reverse type 2 diabetes. Learn how to improve your blood sugar level and safely reduce or eliminate certain medications.
Muscle and Joint Health
The Flex program, from Airrosti, is a digital self-guided movement and exercise program that helps you reduce pain and enhance mobility from the comfort of your own home, in the office, at the gym, or even on vacation. Get your own personalized exercise plan, and connect directly with a health coach for additional support. In just 10 minutes a day, get moving and feel better! To learn more, visit https://flexbyairrosti.com
Cancer Services and Support
To help you in your cancer care journey, the Cancer Services and Support Hub is your one-stop shop for navigating your care and treatment. The Hub includes all your benefits information, cancer program details, and additional resources.
WELL-BEING MANAGEMENT
FOR PHYSICAL AND MENTAL HEALTH
The following integrated medical and behavioral health management programs are available to you and your eligible dependents at no additional cost.
Well onTarget
Get access to a wide variety of wellness tools and resources that help you make healthy choices while rewarding you for your hard work through Well onTarget . Resources include health assessments, self-directed programs, wellness challenges, and fitness tracking.
Fitness Program
With the Fitness Program , you can make fitness easy and fun! Get unlimited access to a nationwide network of fitness locations close to home or while you are traveling. Other program perks include no long-term contracts (with flexible plan and pricing options available), multiple ways to earn rewards, convenient payment options, and various online resources. You also have access to the Choices Program from WholeHealth Living . This program provides discounts on complementary and alternative medicine through a nationwide network of 40,000 health and wellbeing providers such as acupuncturists, massage therapists, and personal trainers.
Employee Assistance Program
In partnership with ComPsych GudianceResources , the Employee Assistance Program helps you and family members cope with a variety of personal and work-related issues. This program provides confidential counseling and support services at little or no cost to you to help with:
• Relationships
• Work-life balance
• Stress and anxiety
• Will preparation and estate resolution
• Grief and loss
• Childcare and eldercare issues
• Substance abuse
• Financial and legal matters
• And more
Behavioral Health Enhancements
In addition to your current mental health resources, programs, and access to case managers, the following new enhancements are also available to you.
Mental Health Hub: This digital one-stop-shop for mental health resources includes an optional selfassessment to help you navigate recommended solutions. It also gives you access to behavioral health providers who treat substance abuse disorders, pediatric mental illness, eating disorders, obsessivecompulsive disorders, and more.
Risk Identification and Outreach: This predictive analytics tool helps to identify members who may be at-risk, and it provides clinician outreach with the goal of preventing suicide and self-harm events.
Mental Health Response Course: This online selfpaced training helps you develop the skills you need to respond effectively to the signs and symptoms of mental illness and substance abuse.
Workplace Crisis Intervention: Clinical support is available to anyone who may need support should a tragedy affecting an employee occur in the workplace.
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 Mutual of Omaha.
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-ofnetwork provider.
Oral exams, cleanings, X-rays, fluoride application, space maintainers
1Out-of-Network Providers: When you use out-of-network providers, your bene fi ts will be paid based on a 90th Percentile of Submitted Charges. Charges are based upon an independent third party organization that is the industry standard. Percentile data is based upon the third party organization’s aggregated industry-wide claims data. Members may experience additional member responsibility in excess of coinsurance—the difference between the member’s dentist’s charge and the dental plan reimbursement level. 2Calendar year is January 1 – December 31. Your calendar year deductible and benefit maximum will reset to $0 every January 1.
VISION
FOR YOUR PEEPERS
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 in-network providers. Coverage is provided through Mutual of Omaha.
LIFE AND AD&D INSURANCE
Life and Accidental Death and Dismemberment (AD&D) insurance through Mutual of Omaha 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 to 65% at age 70, and 45% at age 75.
Basic Life and AD&D
Basic Life and AD&D insurance are provided at no cost to you. You are automatically covered at $20,000 for each benefit.
Voluntary Life and AD&D
If you need more coverage than Basic Life and AD&D, you may buy Voluntary Life and AD&D for yourself and your dependent(s). 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 covering your spouse and/or child(ren).
Employee
• Increments of $10,000 up to $300,000
• Guaranteed issue: $100,000
• Annual Increase Option: Employees currently enrolled in VTL may increase their election by up to $10,000 (subject to the plan’s GI amount) without showing proof of good health
Spouse
• Increments of $5,000 up to $150,000, not to exceed 100% of employee’s benefit
• Guaranteed issue: $30,000
Child(ren)
• Increments of $10,000 up to $10,000
• Guaranteed
1 Spouse rate is based on employee’s age.
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%).
DISABILITY INSURANCE
Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. We provide Short Term Disability (STD) and Long Term Disability (LTD) for you to purchase through Mutual of Omaha.
Voluntary Short Term Disability
STD coverage pays a percentage of your weekly salary if you are temporarily disabled and unable to work due to an illness, pregnancy, or non-work-related injury. STD benefits are not payable if the disability is due to a job-related injury or illness. If a medical condition is job-related, it is considered Workers’ Compensation, not STD.
Voluntary Short Term Disability Benefits
Voluntary 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 Social Security Normal Retirement Age (SSNRA). If you previously declined LTD, you will need to show proof of good health.
Voluntary Long Term
1
SUPPLEMENTAL BENEFITS
You and your eligible family members have the opportunity to enroll in additional coverage that complements our traditional health care programs through Mutual of Omaha. Health insurance covers medical bills, but if you have an emergency, you may face unexpected out-of-pocket costs such as deductibles, coinsurance, travel expenses, and non-medical expenses.
Accident Insurance
Accident insurance provides affordable protection against a sudden, unforeseen accident. The Accident plan helps offset the direct and indirect expenses resulting from an accident such as copayments, deductible, ambulance, physical therapy, childcare, rent, and other costs not covered by traditional health plans. See the plan document for full details.
Hospital Indemnity Insurance
The Hospital Indemnity plan 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. See the plan document for full details.
Hospital Indemnity Insurance
•
per day – up to 30 days
per day – up to 30 days
Screening Benefit
Specific Sum Injuries Burns, dislocations, ruptured discs, eye injuries, fractures, lacerations, concussions, etc.
Accidental Death & Dismemberment 1
•
1 Percentage
dismemberment is
on type of loss.
Critical Illness Insurance
Critical Illness insurance helps pay the cost of non-medical expenses related to a covered critical illness or cancer. The plan provides a lump sum benefit payment to you upon first and second diagnosis of any covered critical illness or cancer. The benefit can help cover expenses such as lost income, out-of-town treatments, special diets, daily living, and household upkeep costs. See the plan document for full details.
Critical Illness Insurance
Employee
$10,000-$20,000; Guaranteed Issue Amount: $20,000
Spouse Up to 100% of employee amount, up to $20,000; Guaranteed Issue Amount: $20,000
Children
Full Coverage
Heart Attack, Sudden Cardiac Arrest, Benign Brain Tumor or Spinal Cord (Intradural) Tumor, Bone Marrow Transplant, Invasive Cancer, Alzheimer’s Disease, ALS or Lou Gehrig’s Disease, Multiple Sclerosis, Dementia, Parkinson’s Disease, Bone Flap/Skull Defect, Stroke, Major Organ Failure, End Stage Renal Failure
Partial Coverage
Transient Ischemic Attack (TIA) or Reversible Ischemic Neurologic Deficit (RIND), Coronary Artery Disease (Minor or Major), Acute Respiratory Distress Syndrome (ARDS), Carcinoma in Situ (Non-Invasive Cancer)
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:
Gulf Coast Crane Services Human Resources 5961 Highway 44 Corpus Christi, TX 78406 361-299-2443
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 Gulf Coast Crane Services 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. Gulf Coast Crane Services has determined that the prescription drug coverage offered by the Gulf Coast Crane Services medical plan is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage pays and is considered Creditable Coverage. The HSA plan is not considered Creditable Coverage.
Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to enroll in a Medicare prescription drug plan, as long as you later enroll within specific time periods.
You can enroll in a Medicare prescription drug plan when you first become eligible for Medicare. If you decide to wait to enroll in a Medicare prescription drug plan, you may enroll later, during Medicare Part D’s annual enrollment period, which runs each year from October 15 through December 7 but as a general rule, if you delay your enrollment in Medicare Part D after first becoming eligible to enroll, you may have to pay a higher premium (a penalty).
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 Gulf Coast Crane Services 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 Gulf Coast Crane Services 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 361-299-2443.
NOTE: You will receive this notice annually and at other times in the future, such as before the next period you can enroll in Medicare prescription drug coverage and if this coverage changes. You may also request a copy.
For more information about your options under Medicare prescription drug coverage:
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You will get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. For more information about Medicare prescription drug coverage:
• Visit www.medicare.gov
• Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help.
• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 877-486-2048
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. Information about this extra help is available from the Social Security Administration (SSA) online at www.socialsecurity.gov, or you can call them at 800-772-1213. TTY users should call 800-3250778
Remember: Keep this Creditable Coverage notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty).
March 1, 2026
Gulf Coast Crane Services Human Resources 5961 Highway 44 Corpus Christi, TX 78406 361-299-2443
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www. healthcare.gov
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www. insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272)
If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of 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/
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 Gulf Coast Crane Services group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Gulf Coast Crane Services 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
Gulf Coast Crane Services Human Resources 5961 Highway 44 Corpus Christi, TX 78406 361-299-2443
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-ofnetwork provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that have not signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in- network facility but are unexpectedly treated by an out-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-ofnetwork provider or facility, the most the provider or facility may bill you is your plan’s in- network cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
• Certain services at an in-network hospital or ambulatory surgical center – When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-ofnetwork providers cannot balance bill you, unless you give written consent and give up your protections.
You are never required to give up your protections from balance billing. You also are not required to get care out-of-network. You can choose a provider or facility in your plan’s network.
When balance billing is not allowed, you also have the following protections:
• You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
• Your health plan generally must:
» Cover emergency services without requiring you to get approval for services in advance (prior authorization).
» Cover emergency services by out-of-network providers.
» Base what you owe the provider or facility (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-of-network services toward your deductible and outof-pocket limit.
If you believe you have been wrongly billed, you may contact your insurance provider. Visit www.cms.gov/nosurprises for more information about your rights under federal law.
New Health Insurance Marketplace Coverage Options and Your Health Coverage
PART A: General Information
Even if you are offered health coverage through your employment, you may have other coverage options through the Health Insurance Marketplace (“Marketplace”). To assist you as you evaluate options for you and your family, this notice provides some basic information about the Health Insurance Marketplace.
What is the Health Insurance Marketplace?
The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers “one-stop shopping” to find and compare private health insurance options in your geographic area.
Can I Save Money on my Health Insurance Premiums in the Marketplace?
You may qualify to save money and lower your monthly premium and other out-of-pocket costs, but only if your employer does not offer coverage, or offers coverage that is not considered affordable for you and doesn’t meet certain minimum value standards (discussed below). The savings on your premium that you’re eligible for depends on your household income. You may also be eligible for a tax credit that lowers your costs.
Does Employment-Based Health Coverage Affect Eligibility for Premium Savings through the Marketplace?
Yes. If you have an offer of health coverage from your employer that is considered affordable for you and meets certain minimum value standards, you will not be eligible for a tax credit, or advance payment of the tax credit, for your Marketplace coverage and may wish to enroll in your employment-based health plan. However, you may be eligible for a tax credit, and advance payments of the credit that lowers your monthly premium, or a reduction in certain cost-sharing, if your employer does not offer coverage to you at all or does not offer coverage that is considered affordable for you or meet minimum value standards. If your share of the premium cost of all plans offered to you through your employment is more than 9.12%1 of your annual household income, or if the coverage through your employment does not meet the “minimum value” standard set by the Affordable Care Act, you may be eligible for a tax credit, and advance payment of the credit, if you do not enroll in the employment-based health coverage. For family members of the employee, coverage is considered affordable if the employee’s cost of premiums for the lowest-cost plan that would cover all family members does not exceed 9.12% of the employee’s household income.1, 2
Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered through your employment, then you may lose access to whatever the employer contributes to the employment-based coverage. Also, this employer contribution -as well as your employee contribution to employment-based coverage- is generally excluded from income for federal and state income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis. In addition, note that if the health coverage offered through your employment does not meet the affordability or minimum value standards, but you accept that coverage anyway, you will not be eligible for a tax credit. You should consider all of these factors in determining whether to purchase a health plan through the Marketplace.
When Can I Enroll in Health Insurance Coverage through the Marketplace?
You can enroll in a Marketplace health insurance plan during the annual Marketplace Open Enrollment Period. Open Enrollment varies by state but generally starts November 1 and continues through at least December 15.
Outside the annual Open Enrollment Period, you can sign up for health insurance if you qualify for a Special Enrollment Period. In general, you qualify for a Special Enrollment Period if you’ve had certain qualifying life events, such as getting married, having a baby, adopting a child, or losing eligibility for other health coverage. Depending on your Special Enrollment Period type, you may have 60 days before or 60 days following the qualifying life event to enroll in a Marketplace plan.
There is also a Marketplace Special Enrollment Period for individuals and their families who lose eligibility for Medicaid or Children’s Health Insurance Program (CHIP) coverage on or after March 31, 2023, through July 31, 2024. Since the onset of the nationwide COVID-19 public health emergency, state Medicaid and CHIP agencies generally have not terminated the enrollment of any Medicaid or CHIP beneficiary who was enrolled on or after March 18, 2020, through March 31, 2023. As state Medicaid and CHIP agencies resume regular eligibility and enrollment practices, many individuals may no longer be eligible for Medicaid or CHIP coverage starting as early as March 31, 2023. The U.S. Department of Health and Human Services is offering a temporary Marketplace Special Enrollment period to allow these individuals to enroll in Marketplace coverage.
Marketplace-eligible individuals who live in states served by HealthCare.gov and either- submit a new application or update an existing application on HealthCare.gov between March 31, 2023 and July 31, 2024, and attest to a termination date of Medicaid or CHIP coverage within the same time period, are eligible for a 60-day Special Enrollment Period. That means that if you lose Medicaid or CHIP coverage between March 31, 2023, and July 31, 2024, you may be able to enroll in Marketplace coverage within 60 days of when you lost Medicaid or CHIP coverage. In addition, if you or your family members are enrolled in Medicaid or CHIP coverage, it is important to make sure that your contact information is up to date to make sure you get any information about changes to your eligibility. To learn more, visit www.HealthCare.gov or call the Marketplace Call Center at 1-800-318-2596. TTY users can call 1-855-889-4325
What about Alternatives to Marketplace Health Insurance Coverage?
If you or your family are eligible for coverage in an employmentbased health plan (such as an employer-sponsored health plan), you or your family may also be eligible for a Special Enrollment Period to enroll in that health plan in certain circumstances, including if you or your dependents were enrolled in Medicaid or CHIP coverage and lost that coverage. Generally, you have 60 days after the loss of Medicaid or CHIP coverage to enroll in an employment-based health plan, but if you and your family lost eligibility for Medicaid or CHIP coverage between March 31, 2023 and July 10, 2023, you can request this special enrollment in the employment-based health plan through September 8, 2023. Confirm the deadline with your employer or your employment-based health plan.
Alternatively, you can enroll in Medicaid or CHIP coverage at any time by filling out an application through the Marketplace or applying directly through your state Medicaid agency. Visit https://www.healthcare.gov/medicaid-chip/getting-medicaidchip/ for more details.
How Can I Get More Information?
The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit www.HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area.
PART B: Information About Health Coverage Offered by Your Employer
This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application.
3. Employer Name: Gulf Coast Crane Services, LLC
5. Employer Address: 5961 Highway 44
7. City: Corpus Christi
4. Employer Identification Number (EIN): 20-5976141
6. Employer Phone Number: 361-299-2443
8. State: TX 9. ZIP Code: 78406
10. Who can we contact at this job?: Memory Pinson
11. Phone Number (if different from above):
12. E-Mail Address: mpinson@gccrane.com
You are not eligible for health insurance coverage through this employer. You and your family may be able to obtain health coverage through the Marketplace, with a new kind of tax credit that lowers your monthly premiums and with assistance for outof-pocket costs.
1 Indexed annually; see https://www.irs.gov/pub/irs-drop/rp-22-34.pdf for 2023.
2 An employer-sponsored or other employment-based health plan meets the “minimum value standard” if the plan’s share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs. For purposes of eligibility for the premium tax credit, to meet the “minimum value standard,” the health plan must also provide substantial coverage of both inpatient hospital services and physician services.
This brochure highlights the main features of the Gulf Coast Crane Services 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. Gulf Coast Crane Services reserves the right to change or discontinue its employee benefits plans at anytime.
