We are pleased to offer a full benefits package to help protect your well-being and financial health. Read this guide to learn about the benefits available to you and your eligible dependents starting May 1, 2026
Each year during Open Enrollment (OE), you may make changes to your benefit plans. The benefit choices you make this year will remain in effect through April 30, 2027. Take time to review these benefit options, and select the plans that best meet your needs. After OE, you may only make changes to your benefit elections if you have a Qualifying Life Event (QLE) (see page 4).
Availability of Summary Health Information
Your benefits program offers three medical coverage options. To help you make an informed choice, review each plan’s Summary of Benefits and Coverage document, all of which are available from Human Resources.
Introduction Important Contacts
Eligibility
Who is Eligible for Benefits
Eligibility
Enrollment
Coverage Begins
Regular, full-time employee
Working an average of 20 hours per week
Enroll by the deadline given by Human Resources
Date of hire
Qualifying Life Events
Regular, full-time employee
Working an average of 20 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: You
Undergoing FMLA, COBRA event, court judgment or decree
Becoming eligible for Medicare, Medicaid, or TRICARE
Receiving a Qualified Medical Child Support Order
Gain or loss of benefits coverage
Change in employment status affecting benefits
Significant change in cost of spouse’s coverage
How to Enroll
Managing your benefits online is easy through ADP Enroll, update, and find benefit details, costs and additional resources in one easily accessible place. Register
1. Step 1: Go to workforcenow.adp.com
2. Step 2: Select Start this Enrollment . Next, click Enroll Now in the Open Enrollment box. Once you read the Welcome Note and Introduction, click Continue
3. Step 3: Add your dependent or beneficiary information before starting your benefit selections.
Make Your Elections
The left side of the screen shows available plan types. When you are viewing the selected plan type, all enrollment options will be displayed on screen.
1. Step 1: Choose your plan
Click Select Plan for the plan you want or select Waive This Benefit . If you chose to waive a benefit, you will be required to select a reason for waiving.
You may review your costs on a per-pay-period, monthly, or annual basis by selecting the desired view in the calculator drop-down.
2. Step 2: Choose whom to enroll
Indicate which dependents should be enrolled (Employee Only, Employee + Spouse, Employee + Children, Employee + Family). Click Continue to preview.
Review your enrollment, costs, and covered dependents carefully. Then click Save and Continue to Next Benefit to continue making your desired selections until the Continue to Summary button is activated.
Enrollment Assistance
For enrollment assistance, contact MyLife Advisors at 855-547-8508, 8:00 a.m. – 11:30 p.m. EST.
Review Your Selections and Submit
Click Submit Enrollment . Please note that your benefit elections will not be processed until you click Submit Enrollment . If you select Save for Later, these enrollments will not be submitted to your HR team until you fully submit the enrollment. Please ensure you receive the confirmation note indicating your elections have been submitted.
Make Changes During the OE Period
You may log in and navigate to Myself > Benefits > Enrollments and click the Enroll Now option again in the Open Enrollment box to make any desired election changes.
Medical Coverage
Protects you and your family from financial hardship in the event of illness or injury.
Medical Provider:
Network:
Open Access Plus (OAP)
About This Coverage
You have a choice of three medical plans:
Cigna OAP 500 – This OAP plan has a $500 individual and $1,000 family deductible.
Cigna OAP 2000 – This OAP plan has a $2,000 individual and $4,000 family deductible.
Cigna OAP HDHP – This OAP plan is an HDHP that has a $3,500 individual and $7,000 family deductible.
Open Access Plus
An Open Access Plus (OAP) plan, named after the Open Access Plus network of providers, makes it easy to get quality, innetwork care through a large, national network of providers. Choosing a primary care physician to coordinate your care is an option, but you do not need a referral to see a specialist. OAP plans can steer you through different tiers of in-network providers for the best specialized care. Prior authorization may be required for hospitalizations and some types of outpatient services.
High Deductible Health Plan
A High Deductible Health Plan (HDHP) allows you to see any provider when you need care, and you will pay less for care when you go to in-network providers. In exchange for a lower per-paycheck cost for medical benefits, you must satisfy a higher plan deductible that applies to almost all health care expenses, including prescription drugs. If you enroll in the HDHP, you may be eligible to open a Health Savings Account (HSA) (see page 14).
Medical Benefits Summary
Cigna Resources
Cigna One Guide
The personalized Cigna One Guide experience via www.mycigna.com offers the convenience of an app with the personal touch of live service to help you engage in your health and get the most out of your health plan. The program allows you to connect with specially trained personal guides who help you:
Choose the right benefit plans and programs
Learn about incentives and rewards
Save money
Connect with a nurse
Use the Cigna One Guide service by app, chat, or phone:
Visit www.mycigna.com
Call 866-494-2111
Download the myCigna app
The myCigna app allows you to:
View messages from Cigna
View your ID card
Get claim status and history
Find doctors
Refill prescriptions
And more
Cigna Pharmacy Benefits
Pharmacy Network
You have the choice of two different pharmacy networks – CVS Pharmacy or Walgreens Pharmacy. There is no option that includes both pharmacy networks. You are automatically enrolled in CVS Pharmacy, but you can choose to switch to Walgreens Pharmacy at anytime at www.mycigna.com, on the myCigna app, or by calling the toll-free number on your Cigna Healthcare ID card.
Prescription Drug List
Your plan uses the Cigna Healthcare Advantage 3-Tier prescription drug list. Log in to www.mycigna.com or the myCigna app and use the Price a Medication tool to see how your medication is covered and how much it costs.
Some medications on your drug list have extra requirements before your plan will cover them.
Prior Authorization – Certain medications need approval from Cigna before your plan will cover them.
Quantity Limits – For some medications, your plan only covers up to a certain amount over a certain length of time. For example, 30 mg a day for 30 days.
Step Therapy – Certain high-cost medications are part of this program. Your plan doesn’t cover step therapy medications until you try one or more generic and/or preferred-brand alternative first (unless you receive approval from Cigna).
Prescription Services
If you take medication on a regular basis for a chronic condition, Cigna 90 Now will make buying your maintenance medications easier. The program allows you to choose how, where, and in what quantity you fill your medication. You can:
Choose a 30-day or 90-day supply
Choose a pharmacy for retail or home delivery
Order, manage, track, and pay for medications by phone or online
Go to www.cigna.com/rx90network or download the myCigna app to learn more.
Home Delivery Service
Cigna’s Express Scripts Home Delivery service is a convenient, cost-effective way to receive up to a 90day supply of prescription drugs. Your medication is delivered by mail directly to your home or work address. Orders can be managed online and through the myCigna app. To learn more about the home delivery service, call 800-835-3184
Specialty Pharmacy Services
Cigna offers a specialized support team to help manage complex chronic health conditions. Cigna helps you understand, manage, and treat complex conditions that require specialty medication. The Cigna team provides:
24/7 specialized support
Free home delivery
Financial assistance
Online delivery tracking
For more information, go to www.cigna.com/specialty call 800-351-3606
GoodRx
Cigna partners with GoodRx to give you the best price on your generic prescriptions when filled at an in-network retail pharmacy. When you present your Cigna ID card at the pharmacy, the system will automatically scan your pharmacy benefits as well as any GoodRx discounts so you pay the lowest price available.
Cigna Wellness Resources
Well-being Solution
This solution, offered in partnership with Virgin Pulse, helps you reach your health goals in a variety of ways. Access the platform through www.mycigna.com to set up your profile, complete your health assessment, view customized resources, track healthy habits, complete online coaching modules, sync-up wearable fitness devices, and more.
Program Marketplace offers discounts on a vast diversity of products, including apparel, electronics, food, home supplies, strength-building products, and skin products. To access the Program Marketplace:
1. Log in to www.mycigna.com
2. Hover over Wellness
3. Click Program Marketplace
4. Click See All Programs
Cigna Pathwell Bone and Joint
This program helps assess bone and joint pain and manage it with non-surgical options or surgery. The program combines designated providers, clinical expertise, coordinated support, and intuitive digital tools to provide the right care for you at no additional cost. Visit connectedcare.cigna.com/login/landing or call 877-505-5875
Cigna Pathwell Specialty
If you need specialty medication to treat a complex medical condition, Cigna Pathwell Specialty offers the medication, providers, and support you need. The Cigna Pathwell Specialty program offers many specialty medications that are covered under the Cigna medical benefit. Some restrictions apply. For infused or injected medication needs, go to cigna.com/pathwellspecialty to find Specialty Network providers. In-home infusions are available. Call 877-505-3681 to speak with a Cigna specialty care manager.
Virtual Physical Therapy
Cigna’s RecoveryOne program offers virtual physical therapy. The program includes:
A private video consult with a virtual physical therapist
Customized plans to meet your needs
A multimedia app that guides you through your personalized exercises
Video, voice, and chat conversations with your support team
Motion-tracking technology
Visit recoveryone.com/cigna to learn more.
Health Assistant Coach
Cigna’s online Health Assistant Coach helps you reach big health and wellness goals in small, easy-to-do steps. Choose a program that aligns with your health goals and get personalized activities and a weekly plan that are fun and motivating. The program offers an array of programs, such as losing weight, coping with the blues, managing chronic illness, and more. Enroll at www.myCigna.com
Omada – Diabetes
If you meet eligibility criteria, Cigna offers a personalized diabetes prevention program to you at no additional cost through Omada. The 16-week program includes a digital platform and scale, access to professional coaches, online peer support groups, and interactive, online training sessions focused on healthy eating, physical activity, sleep, and stress.
Learn more at go.omadahealth.com/omadaforcigna
Cigna Mental Health Resources
Cigna offers free digital tools to improve your emotional well-being and help manage life events.
Online Counselling
Online visits with our behavioral health network providers cost the same as in-office visits.
1. Go to www.mycigna.com > Find Care & Cost
2. Search for Behavioral Health Counselor under Doctor by Type
3. Call to make an appointment with your selected provider
Happify App
The Happify app helps you take control of your feelings and thoughts anytime, anywhere on your laptop or phone. Discover engaging activities, games, and other effective tools developed by leading scientists and experts in positive psychology, mindfulness, and cognitive behavioral therapy.
Go to www.mycigna.com and click on the Happify link –or download the Happify app to start.
iPrevail
Get online mental health support 24/7 with on-demand coaching, lessons, and more with this one-of-a-kind mental health support network.
One-on-one peer support
Interactive mental health activities
Community support groups
Go to www.mycigna.com and click on the iPrevail link to learn more. These programs are included with your Cigna medical coverage at no cost !
Cigna Telemedicine
Allows 24/7/365 access to boardcertified doctors from your mobile phone or computer.
Your medical coverage offers telemedicine services through MDLIVE . Connect anytime day or night with a board-certified doctor via your mobile device or computer for the same or lower 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
Telemedicine providers can treat an assortment of conditions, including:
PRIMARY CARE
Preventive care
Wellness screenings
Chronic condition management
BEHAVIORAL/MENTAL HEALTH
Addictions
Bipolar disorders
Depression
Eating disorders
DERMATOLOGY
Acne
Eczema
URGENT CARE
Sore throat
Headache
Earache
Fever
Grief/Loss
Panic disorders
Parenting issues
Psoriasis
Rosacea
Cold/Flu
Bronchitis
Allergies
Stomachache
Do not use telemedicine for serious or life-threatening emergencies.
Lab work
Diagnostic tests
Postpartum depression
Stress
Trauma/PTSD
Suspicious spots
And more
Urinary tract infection
Pink eye
Rashes
Register with MDLIVE so you are ready to use this valuable service when and where you need it.
Visit www.mycigna.com
Call MDLIVE 24/7 at 888-726-3171
Download the MyCigna app to schedule an appointment with an MDLIVE provider.
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 MDLIVE 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
Mace will contribute to the HSA
$68 per month for individuals and $136 per month for families enrolled in the HDHP.
HSA Eligibility
You are eligible to open and contribute to an HSA if you are:
Enrolled in an HSA-eligible HDHP (Cigna OAP HDHP)
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 (FSA)
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
Important HSA Information
Always ask your network doctor to file claims with your medical, dental, or vision carrier so you will get the highest level of benefits. You can pay the doctor with your HSA debit card for any balance due.
You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.
You may open an HSA at the financial institution of your choice, but only accounts opened through HealthEquity are eligible for automatic payroll deduction.
Open an HSA
You must open an HSA and complete the account verification process before accessing your funds with HealthEquity Register at www.healthequity.com to get an account and get an HSA debit card. Once you are a member, you can contact HealthEquity 24/7/365 at 866-346-5800
Qualified HSA and FSA Expenses
Shows some medical expenses that are eligible for payment under your HSA or FSAs.
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)
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.
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
Dental Coverage
Helps maintain fresh breath, healthy gums and teeth, and other dental work.
Two levels of benefits are available with the DPPO plans: 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 innetwork providers. You could pay more if you use an out-of-network provider.
Vision Coverage
Helps detect certain medical issues, prolong your eyesight, and correct vision or eye problems.
About This Plan
See any vision provider for care.
Pay less and get the highest level of benefits by seeing participating VSP Choice in-network providers. Pay more for care if you go to out-of-network providers.
Vision
Benefits Summary
Exam – Once every 12 months
Routine Exam
Retinal Screening
Lenses – Once every 12 months
Single Vision
Lined Bifocal
Lined Trifocal
Lenticular
Frames – Once every 12
Contacts – Once every 12 months In lieu of eyeglasses
Fitting and Evaluation
Elective
Medically Necessary
Flexible Spending Accounts
Allows you to set aside pretax dollars from each paycheck to pay for certain IRS-approved health and dependent care expenses. We offer three FSAs, administered by Clarity Benefit Solutions.
Health Care FSA
The Health Care FSA covers qualified medical, dental, and vision expenses for you or your eligible dependents. You may contribute up to $3,400 annually to a Health Care FSA, and you are entitled to the full election from day one of your plan year. Eligible expenses include:
Dental and vision expenses
Medical deductibles and coinsurance
Prescription copays
Hearing aids and batteries
You may not contribute to a Health Care FSA if you enrolled in an HDHP and contribute to an HSA.
Limited Purpose Health Care FSA
A Limited Purpose Health Care FSA is available if you enrolled in the HDHP medical plan and contribute to an HSA. You can use a Limited Purpose Health Care FSA to pay for eligible outof-pocket dental and vision expenses only, such as:
Dental and orthodontia care
(e.g., fillings, X-rays, and braces)
Vision care
(e.g., eyeglasses, contact lenses, and LASIK surgery)
How the Health Care and Limited Purpose Health Care FSAs Work
You can access the funds in your FSAs two different ways:
Use your FSA debit card to pay for qualified expenses, doctor visits, and prescription copays.
Pay out-of-pocket and submit your receipts for reimbursement online at www.claritybenefitsolutions.com or through the Clarity Benefits app
Important FSA Rules
The maximum per plan year you can contribute to a Health Care or Limited Purpose Health Care FSA is $3,400. The maximum per plan year you can contribute to a Dependent Care FSA is $7,500 when filing jointly or head of household and $3,750 when married filing separately.
You cannot change your election during the year unless you experience a QLE.
Your Health Care or Limited Purpose Health Care FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care expenses.
See page 15 for a list of qualified FSA expenses. Register Now: Log in to www.claritybenefitsolutions.com and sign up for BenefitConnect (under Additional Resources on the home page).
The IRS has amended the “use it or lose it” rule to allow you to carry over up to $680 in your Health Care FSA into the next plan year. The carryover rule does not apply to your Dependent Care FSA.
Dependent Care FSA
The Dependent Care FSA helps pay for expenses associated with caring for elder or child dependents so you or your spouse can work or attend school full-time. You can use the account to pay for daycare or babysitter expenses for your children under age 13 and qualifying older dependents, such as dependent parents. Reimbursement from your Dependent Care FSA is limited to the total amount deposited in your account at that time. To be eligible, you (and your spouse, if married) must be gainfully employed, looking for work, a full-time student, or incapable of self-care.
DEPENDENT CARE FSA CONSIDERATIONS
Overnight camps are not eligible for reimbursement (only day camps can be considered).
If your child turns age 13 midyear, you may only be reimbursed for the time the child was under age 13.
You may request reimbursement for care of a spouse or dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self-care.
The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.
DEPENDENT CARE FSA REIMBURSEMENT
Submit your receipts for reimbursement online at www.claritybenefitsolutions.com or through the Clarity Benefits app
Care
Most medical, dental and vision care expenses that are not covered by your health plan, such as:
Copayments
Coinsurance
Deductibles
Glasses
Doctor-prescribed over-the-counter medications
Purpose FSA Dependent Care FSA
Expenses
Most dental and vision care expenses that are not covered by your health plan, such as:
Eyeglasses
Contacts
LASIK eye surgery
Fillings
X-rays
Braces
$3,400
Saves on eligible expenses not
Reduces your
Saves on
Reduces
Dependent care expenses so you and your spouse can work or attend school full-time, such as:
Daycare
After-school programs
Eldercare programs
Reduces
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 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 65, and to 50% at age 70.
If you decline Voluntary Life and AD&D insurance when first eligible, or if you elect coverage and wish to increase your benefit amount at a later date, Evidence of Insurability (EOI) – proof of good health – may be required before coverage is approved.
Basic Life and AD&D
If you are working 20 or more hours per week, Basic Life and AD&D insurance are provided at no cost to you. You are automatically covered at twice your annual base earnings to a maximum of $750,000 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%).
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).
Spouse
Child(ren)
Increments of $10,000 up to $500,000 not to exceed five times annual earnings.
Guaranteed Issue: $100,000
Increments of $5,000 up to $250,000 not to exceed 100% of your election.
Guaranteed Issue: $30,000
Increments of $1,000 up to $10,000.
Guaranteed Issue: $10,000
1Spouse rate is based on employee’s age. Spouse’s coverage ends at age 70.
Conversion – Portability – Waiver of Premium
Upon termination of employment, you have the option to continue your company-paid Life and AD&D insurance and pay premiums directly to Mutual of Omaha . Your company-paid Life and AD&D insurance may be converted to individual policies. Portability is available for Life coverage if you are enrolled in additional Life coverage. Portability is not available for AD&D. If you are disabled at the time your employment is terminated, you may be eligible for a Waiver of Premium while you are disabled. Contact Human Resources for a Conversion, Portability, or Waiver of Premium application.
Disability Insurance
Provides partial income protection through Mutual of Omaha if you are unable to work due to a covered accident or illness.
We provide Short Term Disability (STD) and Long Term Disability (LTD) at no cost to you . Additional Voluntary Buy-Up STD is available for purchase.
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 jobrelated, it is considered workers’ compensation, not STD.
Short Term Disability Benefits
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 maximum benefit period.
Long Term Disability Benefits
1Benefits
If you were temporarily unable to work, would you be able to cover your bills?
Voluntary Buy-up Short Term Disability
Voluntary STD coverage pays a percentage of your weekly salary if you are temporarily disabled and unable to work due to an illness, pregnancy, or non-work-related injury. STD benefits are not payable if the disability is due to a job-related injury or illness. If a medical condition is jobrelated, it is considered workers’ compensation, not STD.
Voluntary Buy-up Short Term Disability
Employee Assistance Program
Helps you and family members cope with a variety of personal or workrelated issues.
The Employee Assistance Program (EAP) from LifeCare 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 resources
Substance abuse
Get support at any hour of the day or night. Visit
Additional Benefit
Included with your LifeCare coverage are three face-to-face sessions with a certified therapist. These sessions can be used for you or any of your eligible dependents. Additional sessions can be purchased at a discounted rate. Visit https://workforcenow.adp.com for more details.
Commuter Benefit Program
The Commuter Benefit Program, administered by Clarity Benefit Solutions, offers you the opportunity to pay for out-of-pocket commuting expenses through pretax payroll deductions. You can use this program for both parking and public transit. You can set aside up to $340 per month in pretax dollars for work-related commuter transit expenses.
Parking Benefit
Eligible parking expenses include:
Parking at or near work
Parking at or near transportation service site
Park and ride expenses
Transit Benefit
The transit benefit applies to monthly passes, tokens, fare cards, vouchers, or similar ticket options for:
Bus
Subway
Train
Ferry
Commercial Vanpool (vanpool registration varies by state)
PLEASE NOTE: If you currently participate in the Commuter Benefit Program, your current election will continue as of May 1, 2027, unless you elect otherwise via the ADP Benefits Portal. You can adjust both your pre- and post-tax elections monthly via the ADP portal.
Set aside
$340 per month in pretax dollars.
401(k) Retirement Program
A 401(k) plan can be a powerful tool to help you be financially secure in retirement. Our 401(k) plan through Transamerica can help you reach your investment goals.
How the Retirement Plan Works
You are eligible to participate in the plan on the first of the month following 90 days of employment with the company. You may contribute up to the IRS limit, and you have a choice of a traditional (before-tax) or ROTH (after-tax) plan.
You decide how much you want to contribute and you can change your contribution amount anytime. All changes are effective as soon as administratively feasible and remain in effect until you update or stop your contributions. You also decide how to invest the assets in your account and may change your investment choices anytime. For more details, refer to your 401(k) Enrollment Guide or:
Visit www.transamerica.com/portal
Call 800-401-8726
Vesting
You are always 100% vested in your own and company matching contributions.
Enrollment
You must enroll through Transamerica at www.transamerica.com/portal or by calling 800-401-8726
Safe Harbor Contributions
Mace will make a safe harbor matching contribution equal to 100% of the first 5% of eligible pay you contribute to the plan.
Investment Options
You may direct your contributions to any of the investments offered within the company 401(k) plan.
Go to www.transamerica.com/portal and use the OnTrack tool to create a personalized retirement income goal and decide how much to invest. You can also make changes to your investments by calling 800-401-8726
Scan the QR code to watch a video and learn more about your retirement plan options.
Additional Benefits
Worldwide Travel Assistance
AXA Assistance USA provides travel assistance for you and your dependents if you are traveling on any single trip more than 100 miles from home. Contact a representative to get pre-trip planning; translation, interpreter, or legal services; lost baggage assistance; emergency funds; document replacement; medical emergency help; and more. Services are available for business and personal travel.
For inquiries within the U.S.: 800-856-9947
Outside the U.S.: 312-935-3658
Identity Theft Protection
IdentityForce offers identity monitoring, restoration, and response services to help protect you from identity theft. IdentityForce is available at no additional cost as part of your Cigna medical plan for you and any child(ren) living in your home up to age 18. Family coverage for adults in your home is available for purchase. To enroll, call 833-580-2523 or go to cigna.identityforce.com/starthere
Will Preparation
Creating a will is an important investment in your future. In just minutes, you can create a personalized will that keeps your information safe and secure. These services through Epoq offer a secure account space to prepare wills and other legal documents. Log on to www.willprepservices.com and use the code MUTUALWILLS to register.
Hearing Discount
As a disability member, Mutual of Omaha offers a hearing discount program at no additional cost to you through Amplifon . This program gives you access to a free hearing testing, low-price guarantee, 60-day risk-free trial period, and two years of batteries with purchase. To activate your benefit, call 844-267-5436. To learn more, go to www.amplifonusa.com/mutualofomaha
These programs are included with your Mutual of Omaha Life and AD&D coverage and Cigna medical coverage at no cost!
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: Mace North America, Ltd. Human Resources 1350 Broadway, Suite 408 New York, NY 10018 917-436-4600
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 Mace North America, Ltd. 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
Important Notices
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. Mace North America, Ltd. has determined that the prescription drug coverage offered by the Mace North America, Ltd. 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 Mace North America, Ltd. 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 Mace North America, Ltd. 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 917-436-4600.
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 (1-800633-4227). TTY users should call 877-486-2048
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. Information about this extra help is available from the Social Security Administration (SSA) online at www.socialsecurity.gov, or you can call them at 800-772-1213. TTY users should call 800-325-0778
Important Notices
Remember: Keep this Creditable Coverage notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty).
May 1, 2026
Mace North America, Ltd. Human Resources
1350 Broadway, Suite 408 New York, NY 10018
917-436-4600
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 Mace North America, Ltd., 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.
Mace North America, Ltd.
Human Resources 1350 Broadway, Suite 408 New York, NY 10018 917-436-4600
Conclusion
PHI use and disclosure by the Plan is regulated by a federal law known as HIPAA (the Health Insurance Portability and Accountability Act). You may find these rules at 45 Code of Federal Regulations Parts 160 and 164. The Plan intends to comply with these regulations. This
Notice attempts to summarize the regulations. The regulations will supersede any discrepancy between the information in this Notice and the regulations.
Premium
Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www. healthcare.gov
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www. insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.
Important Notices
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www. askebsa.dol.gov or call 1-866-444EBSA (3272).
If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of January 31, 2026. Contact your State for more information on eligibility. Alabama – Medicaid
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
Important Notices
Continuation of Coverage Rights Under COBRA
Under the Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), if you are covered under the Mace North America, Ltd. group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Mace North America, Ltd. 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
Mace North America, Ltd. Human Resources 1350 Broadway, Suite 408 New York, NY 10018 917-436-4600
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that have not signed
a contract with your health plan. Out-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-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these poststabilization services.
Certain services at an in-network hospital or ambulatory surgical center – When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-ofnetwork. In these cases, the most those providers may bill you is your plan’s in-network costsharing 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-of-network. You can choose a provider or facility in your plan’s network.
Important Notices
When balance billing is not allowed, you also have the following protections:
You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
Your health plan generally must:
• Cover emergency services without requiring you to get approval for services in advance (prior authorization).
• Cover emergency services by out-of-network providers.
• Base what you owe the provider or facility (costsharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
• Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit. If you believe you have been wrongly billed, you may contact your insurance provider. Visit www. cms.gov/nosurprises for more information about your rights under federal law.
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 employmentbased 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
Important Notices
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 employment-based health plan (such as an employersponsored 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
Important Notices
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-medicaid-chip/ for more details.
How Can I Get More Information?
For more information about your coverage offered through your employment, please check your health plan’s summary plan description or contact Human Resources.
The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit www.HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area.
PART B: Information About Health Coverage Offered by Your Employer
This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application.
3. Employer Name: Mace North America, Ltd.
4. Employer Identification Number (EIN): 45-2795670
5. Employer Address: 1350 Broadway, Suite 408
6. Employer Phone Number: 917-436-4600
7. City: New York
8. State: NY 9. ZIP Code: 10018
10. Who can we contact at this job?: Khushali Yi
11. Phone Number (if different from above):
12. E-Mail Address: Khushali.Yi@macegroup.com
As your employer, we offer a health plan to all eligible employees (see the Eligibility section of this guide). This coverage meets the minimum value standard, and the cost of this coverage to you is intended to be affordable, based on employee wages.
1 Indexed annually; see https://www.irs.gov/pub/irsdrop/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.
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 Mace North America, Ltd. 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 and Customary Allowance (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.
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.
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.
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 Mace North America, Ltd. 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. Mace North America, Ltd. reserves the right to change or discontinue its employee benefits plans anytime.
