know you work hard every day to achieve your personal and professional goals. Since your health and wellness are key to meeting these goals, we are pleased to offer a comprehensive benefits package that supports your health, mind, and body. May you always be Working Towards Healthy Goals.
this guide to learn more about these and other benefits. You may only enroll for or make changes to your benefits during Open Enrollment (OE) or when you have a Qualifying Life Event (QLE) (see page 5).
Availability of Summary Health Information
Your benefits program offers three medical plan coverage options. To help you make an informed choice, review each plan’s Summary of Benefits and Coverage documents available from Human Resources. If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, federal law gives you more choices for your prescription drug coverage. Please see page 24 for more details.
Eligibility
Who is Eligible for Benefits
Eligibility
Enrollment
Coverage Begins
Regular, full-time employee
Working an average of 30 hours per week
Enroll by the deadline given by Human Resources
First of the month following your date of hire
Qualifying Life Events
Regular, full-time employee
Working an average of 30 hours per week
Enroll during OE or when you have a QLE
OE: Start of the plan year
QLE: Ask Human Resources
Your legal spouse
Child(ren) under age 26 regardless of student, dependency, or marital status
Child(ren) over age 26 who are fully dependent on you for support due to a mental or physical disability and who are indicated as such on your federal tax return
You must enroll the dependent(s) at OE or for a QLE
When covering dependents, you must enroll for and be on the same plans
Based on OE or QLE effective dates
You may only change coverage during the plan year if you have a QLE such as:
Significant
If you have a QLE and want to request a midyear change, you must notify Human Resources and complete your election changes within 31 days following the event . Be prepared to provide documentation supporting the QLE.
Medical Coverage
Protects you and your family from major financial hardship in the event of illness or injury.
Medical Provider:
UnitedHealthcare (UHC)
Networks:
Nexus OAP (Base and Buy-Up Plans)
UHC Choice Plus (Surest PPO Plan)
About This Coverage
You have a choice of three medical plans:
Base HDHP Plan with HSA – This plan uses Nexus Open Access Network. It has a $3,500 individual and a $7,000 family in-network deductible.
Buy-Up Plan – This plan uses UHC’s Nexus Open Access Network. It has a $2,000 individual and $4,000 family innetwork deductible.
Surest PPO Plan – This plan uses the UHC Choice Plus Network. This plan is a fee-per-service model and does not have a deductible.
High Deductible Health Plan
The 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 perpaycheck 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).
Preferred Provider Organization
A Preferred Provider Organization (PPO) plan allows you to see any provider when you need care. When you see in-network providers for care, you will pay less and get the highest level of benefits. You will pay more for care if you use out-of-network providers. When you see in-network providers, your office visits, urgent care visits, and prescription drugs are covered with a copay, and most other network services are covered at the deductible and coinsurance level.
About the Nexus OAP Network
The Nexus OAP is a tiered network model, meaning providers are grouped into tiers based on cost and efficiency. Members receive the highest level of benefits and lowest out-of-pocket costs when using Tier 1 providers, while higher tiers may result in higher member costs. This design helps members save money while maintaining flexibility in provider choice.
Mail Service Member Select, through Optum Rx , is a home delivery program that makes it easy for you to get maintenance medications by mail. Get free standard shipping to your mailbox.
You must choose to fill your maintenance medication through either Optum Rx or a retail pharmacy. If you choose a retail pharmacy, you must opt out of the Mail Service Member Select program.
You are allowed two fills of your maintenance medication at your retail pharmacy before you must choose whether to continue to fill the medication at your retail pharmacy or switch to the home delivery program. If you do not take action after the second refill, you may pay more for your medication until you make a decision.
Register for home delivery using any of the follow options:
Online – Go to www.myuhc.com
By Phone – Call the number on the back of your ID card.
By Mail – Ask your doctor for a new prescription for up to a three-month supply, plus refills for up to one year. Go to www.myuhc.com and download the new prescription order form. Mail it to the address on the bottom of the form.
By Fax – Ask your doctor to call 800-791-7658 for instructions on how to fax your prescription directly to Optum Rx.
Convenient Mobile Access
Access and manage your pharmacy benefits and mail service prescriptions from your smartphone or other mobile device by logging in at www.optumrx.com
Surest Resources
The following programs are available with your Surest medical plan at no additional cost.
Smoking Cessation Program
Quit smoking with support from Pivot, a personalized tobacco cessation program designed to help you successfully quit for good – whether you vape, chew, or smoke cigars. The program includes the Pivot app, SmartSensor, a free supply of nicotine replacement therapy (NRT), unlimited one-on-one coaching, and access to an online support community – all designed to help replace unhealthy habits with positive behaviors. Pivot is available to you and eligible family members age 18 or older for a $0 copay.
Visit www.pivot.co/surest (use code surest).
Weight Loss Program
Real Appeal offers a free online weight loss program that provides personal coaching to help you and eligible family members lose weight and keep it off. On average, participants lose 10 pounds after attending just four online sessions.
Learn more and start today at https://enroll.realappeal.com
Gym Discount
One Pass Select offers a flexible, low-cost nationwide gym membership – including digital fitness. Enjoy access to gyms, studios, on-demand workouts, and grocery/home essentials delivery with a single monthly membership.
Go to www.onepassselect.com to find a gym near you.
*An enrollment fee may apply. Use your UHC Rewards Dollars towards your One Pass Select subscription.
Gym partners include Anytime Fitness, Crunch, LA Fitness, Life Time, Orangetheory, CrossFit, and others, depending on your
Need Help Finding Care?
https://benefits.surest.com 866-683-6440
Download the Surest app
Unlock Your Surest Plan With the App
Member Services is available online via chat and email or by calling the number on the back of your Surest member ID card.
Set up your free account and use the app to:
✓ Check prices
✓ Compare care options
✓ Choose what works best for you
Scan the QR code to download the app, or visit https://benefits.surest.com
Virtual Mental Health
Valera Health – Provides virtual mental health care designed to support emotional well-being and long-term success. Members receive personalized treatment that may include therapy, psychiatry services, medication management, and ongoing care coordination – all delivered through convenient telehealth visits. Visit www.valerahealth.com/consult-today
Talkspace – Provides convenient online mental health support through secure messaging and live virtual sessions. Members can connect with licensed therapists and psychiatric providers for therapy, medication management, and ongoing mental health care – all from the comfort and privacy of home. Download the Talkspace app (organization code: Surest).
Nexus/UHC Resources
If you are enrolled in one of our UHC medical plans, you have access to the following resources.
Remember to look for the Tier 1 symbol when choosing care. Tier 1 providers offer the greatest value under your plan, helping lower your out-of-pocket costs and maximizing your plan benefits. Your plan includes access to high-quality providers and facilities for preventive care, chronic condition management, and coordinated specialty care when needed.
UHC Member Website and App
The UHC member website at www.myuhc.com and the UnitedHealthcare app give you access to resources, answers, and customer support.
Search for in-network doctors
Refill prescriptions
Access your plan ID cards
Check your benefits and coverage
View your claims
Get virtual care
Preventive care
Prior authorization
UHC TELEMEDICINE
UnitedHealthcare offers two options for telemedicine.
Virtual Primary Care – Get an annual wellness visit, regular follow-ups for ongoing conditions, preventive screenings, and prescriptions for the same price as your regular doctor.
24/7 Virtual Visits – Get non-emergency care for everything from flu and pink eye to anxiety and migraines, including prescription refills for the same or lower price than from your regular doctor.
Get started at www.myuhc.com/virtualvisits or on the UnitedHealthcare app
EMOTIONAL SUPPORT
Your behavioral health benefit provides access to a network of local providers offering both in-person care and 24/7 virtual visits. Support is available for a wide range of needs, including stress, anxiety, depression, substance use recovery, grief and loss, relationship challenges, compulsive behaviors, and medication management.
UHC WELLNESS RESOURCES
The following programs and services are available to you at no additional charge as a UHC member.
HEALTH REWARDS PROGRAM
The health rewards program by Rally helps you stay motivated as you get healthier. Take a health survey to see how you are doing in key areas like nutrition, fitness, and stress. Get personalized recommendations that fit your lifestyle, track your progress, and earn Rally Coins that can be redeemed for rewards. Get started at www.myuhc.com
HEALTHY HABITS APP
The Rally website and mobile app help you learn simple ways to build healthier habits, from being more active to eating better. Get a customized program designed to help you live healthier.
See Your Rally Age – Take a health survey to see your Rally age, a measure of your overall health.
Accept Your Missions – Receive a list of easy, fun missions based on your Rally age, all designed to help you eat better, lift your fitness level, and improve your mood.
Take on a Challenge – Use the Rally app to track your activity and compete with other Rally members to earn extra rewards.
Connect With a Coach – Talk with a coach and work together to create a personalized healthy-living plan that works with your lifestyle.
Visit www.myuhc.com to sign up.
Telemedicine
Allows 24/7/365 access to boardcertified doctors from your mobile phone or computer.
Your medical coverage offers virtual visits through UHC 24/7 Virtual Visits. Connect anytime day or night with a board-certified doctor via your mobile device or computer for free.
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 UnitedHealthcare so you are ready to use this valuable service when and where you need it.
Visit www.myuhc.com/virtualcare. Download the UnitedHealthcare app
Did You Know?
Your regular provider may offer telemedicine services, so it is best to ask now and know what your options are before you need care.
Healia Health
Available at no cost to you, the Healia Health plan selection tool can help you determine which medical plan is best for you! If you have a working spouse, you can upload her/his benefits information and rates into the tool, and all of your medical plan options will be analyzed, including your spouse’s plan. You can also use this tool if you enroll in Employee Only or Employee + Child(ren) coverage.
Plan Selection Tool
With the plan selection tool, your Dallas Stars medical plans are already loaded. All you need to do is enter your expected medical expenses for the year, and the tool will provide you with the approximate cost for enrolling in each medical plan.
Total Care Option
If you had coverage through a Dallas Stars medical plan in 2025, and your working spouse has medical insurance, you can upload her/his benefits information into the Total Care Option (TCO) portal. Healia Health will assess your options and provide a personalized summary of your cost for coverage in our medical plans and your spouse’s plans, making the decision easier.
To compare our plan options with those of your spouse, upload any of these items from your spouse’s medical plan options:
Benefits booklet or benefits summary
Summary Plan Description (SPD)
Summary of Benefits and Coverage (SBC)
If you currently have coverage in a Dallas Stars 2025 medical plan and elect to enroll in your spouse’s medical plan for 2026, Dallas Stars will provide you with a fullyfunded Health Reimbursement Arrangement (HRA), administered by Healia Health
How to Enroll in the TCO
To be eligible for the TCO, you must be a new hire enrolling in benefits for the first time, or you must currently be enrolled in a Dallas Stars 2025 medical plan and choose to enroll in your spouse’s medical plan for 2026 through her/his employer. Medicare, Medicaid, TRICARE coverage, or a plan on the ACA Marketplace are not eligible.
Choose the “Total Care Option” during your enrollment at https://app.healiahealth.com/join/ dallas-sports--entertainment-dba-dallas-stars .
How to Receive Reimbursement for Expenses
Present your insurance card from your spouse’s medical plan to the provider or pharmacy.
Once you receive the Explanation of Benefits (EOB), doctor’s bill, or pharmacy receipt, upload it to Healia’s online portal or mobile app.
Healia will review the claim and reimburse you for eligible expenses:
Employee Only: Up to $8,000
Spouse Only: Up to $8,000
Employee + Child(ren): Up to $10,000
Employee + Spouse + Child(ren): Up to $10,000
Child(ren) Only: Up to $10,000
This could mean you will pay $0 for prescriptions, doctor’s visits, and any medical care you and your family need.
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
2026 Maximum Contributions
Individual – $4,400
Family – $8,750
Catch-Up Contribution (if age 55+) – $1,000
Annual Employer Contribution:
Individual – $500
Family – $1,000
HSA Eligibility
You are eligible to open and contribute to an HSA if you are:
Enrolled in an HSA-eligible HDHP (Base 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
Ask your network doctor to file claims with your medical, dental, or vision carrier so you will get the highest level of benefits. 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 Optum Bank are eligible for automatic payroll deduction and company contributions.
Open an HSA
If you meet the eligibility requirements, you may open an HSA administered by Optum 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.optumbank.com
Contributions
If you enroll in the HDHP medical plan, Dallas Stars will contribute $41.66 to your employee only HSA each month (or $83.33 per month for employee plus one or more dependents). Proration rules apply if you enroll after January 1. See plan documents for details.
If you are age 55 or older, you may make an additional yearly catch-up contribution of up to $1,000 to your HSA. If you turn 55 anytime during the plan year, you are eligible to make the catch-up contribution for the entire plan year.
Qualified HSA Expenses
Shows some medical expenses that are eligible for payment under your HSA.
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
Dental Benefits Summary
DPPO Plan
Two levels of benefits are available with the DPPO plan: in-network and out-of-network. You may see any dental provider for care, but you will pay less and get the highest level of benefits with in-network providers. You could pay more if you use an out-of-network provider.
Vision Coverage
Our vision plan offers quality care to help preserve your health and eyesight. Regular exams can detect certain medical issues such as diabetes and high cholesterol, in addition to vision and eye problems. You may seek care from any vision provider, but the plan will pay the highest level of benefits when you see in-network providers. Coverage is provided through VSP and uses the VSP Choice Network . No ID card is necessary to obtain care. There are no claims to file with VSP providers.
Vision Benefits Summary
Lenses
Frames
Contacts
Once every 12 months Once every 12 months
Once every 24 months Once every 12 months
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 Unum are important to your financial security, especially if others depend on you for support or vice versa. With Life insurance, you or your beneficiary(ies) can use the coverage to pay off debts such as credit cards, loans, and bills. AD&D coverage provides specific benefits if an accident causes bodily harm or loss (e.g., the loss of a hand, foot, or eye). If death occurs from an accident, 100% of the AD&D benefit would be paid to you or your beneficiary(ies). Life and AD&D coverage amounts reduce by 35% at age 65, and 50% at age 70.
Basic Life and AD&D
Basic Life and AD&D insurance are provided at no cost to you. You are automatically covered at two times your covered annual earnings (not to exceed $300,000) 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). To view rates, contact Human Resources or visit www.paylocity.com.
Employee
Spouse
Child(ren)
Voluntary Life and AD&D
Increments of $10,000 up to five times annual earnings, not to exceed $500,000
New hire Guaranteed Issue $300,000
Increments of $5,000 up to $250,000, not to exceed 100% of employee benefit amount
New hire Guaranteed Issue $30,000
Birth to six months – $1,000
Six months to age 26 – $1,000 increments up to $10,000 (minimum of $2,000)
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 anytime. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%).
Disability Insurance
Provides partial income protection if you are unable to work due to a covered accident or illness.
We provide Short Term Disability (STD) and Long Term Disability (LTD) at no cost to you through Unum
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.
Class I: Executives, Management, Coaches
insurance is there for you in a pinch!
Long Term Disability
LTD insurance pays a percentage of your monthly salary for a covered disability or injury that prevents you from working for more than 90 days. Benefits begin at the end of an elimination period and continue while you are disabled up to the maximum benefit period.
Contract limitations may apply, and benefits may be reduced based on Social Security Normal Retirement Age (SSNRA) or other sources of income. Refer to the summary plan description and Dallas Stars’ LTD policy for details.
Class II:
Other Eligible
1
1
Employee Assistance Program
Helps you and family members cope with a variety of personal or workrelated issues.
The Employee Assistance Program (EAP) from CuraLinc provides confidential short-term counseling and support services at no cost to you to help with:
Relationships
Work-life balance
Stress and anxiety
Will preparation and estate resolution
Grief and loss
Coaching
Childcare and eldercare resources
Substance abuse
Legal issues
Financial services
Behavioral health issues
Get support at any hour of the day or night.
To access all the program has to offer, you will need to create an account.
Visit www.supportlinc.com and click Create Account . Use Group Code: dallasstars.
Once you create your username and password, follow the account creation prompts.
For further assistance, call 888-881-5462
Coverage includes five face-to-face sessions with a certified therapist. These sessions can be used for you or any of your eligible dependents. Access the EAP
Worldwide Travel Assistance
You are automatically enrolled in the Worldwide Emergency Travel Assistance Program provided by Unum . Get travel assistance if you are traveling for business or pleasure in another country or if you are 100 or more miles away from home. Representatives can help with trip planning and will assist in medical emergencies or urgent situations. Other services include:
Medical evacuation/return home
Replacement of medication and eyeglasses
Locating lost or stolen items
Legal assistance/bail
Interpretation/translation
Return of mortal remains
And more
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 Dallas Stars 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.
Health Savings Account (HSA) – A personal savings account that allows you to pay for qualified medical expenses with pretax dollars.
High Deductible Health Plan (HDHP) – A medical plan with a higher deductible in exchange for a lower monthly premium. You must meet the annual deductible before any benefits are paid by the plan.
In-Network – Doctors, hospitals, and other providers that contract with your insurance company to provide health care services at discounted rates.
Out-of-Network – Doctors, hospitals, and other providers that are not contracted with your insurance company. If you choose an out-of-network provider, you may be responsible for costs over the amount allowed by your insurance carrier.
Out-of-Pocket Maximum – Also known as an out-of-pocket limit. The most you pay during a policy period (usually a 12-month period) before your health insurance or plan begins to pay 100% of the allowed amount. The limit does not include your premium, charges beyond the Reasonable & Customary (R&C) or health care your plan does not cover. Check with your health insurance carrier to confirm what payments apply to the out-of-pocket maximum.
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.
Over-the-Counter (OTC) Medications – Medications typically made available without a prescription.
Preventive Care – The care you receive to prevent illness or disease. It also includes counseling to prevent health problems.
SSNRA – Social Security Normal Retirement Age.
Usual, Reasonable, and Customary Allowance (URC)
– 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. Learn some common
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:
Dallas Sports and Entertainment Human Resources
2601 Avenue of the Stars Frisco, Texas 75034 Dallas Stars: 214-387-5500
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 Dallas Sports and Entertainment 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. Dallas Sports and Entertainment has determined that the prescription drug coverage offered by the Dallas Sports and Entertainment medical plan is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage pays and is considered Creditable Coverage
Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to enroll in a Medicare prescription drug plan, as long as you later enroll within specific time periods.
You can enroll in a Medicare prescription drug plan when you first become eligible for Medicare. If you decide to wait to enroll in a Medicare prescription drug plan, you may enroll later, during Medicare Part D’s annual enrollment period, which runs each year from October 15 through December 7 but as a general rule, if you delay your enrollment in Medicare Part D after first becoming eligible to enroll, you may have to pay a higher premium (a penalty).
You should compare your current coverage, including which drugs are covered at what cost, with the coverage and cost of the plans offering Medicare
Important Notices
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 Dallas Sports and Entertainment 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 Dallas Sports and Entertainment prescription drug coverage, be aware that you and your dependents may not be able to get this coverage back. To regain coverage, you would have to re-enroll in the Plan, pursuant to the Plan’s eligibility and enrollment rules. You should review the Plan’s summary plan description to determine if and when you are allowed to add coverage.
If you cancel or lose your current coverage and do not have prescription drug coverage for 63 days or longer prior to enrolling in the Medicare prescription drug coverage, your monthly premium will be at least 1% per month greater for every month that you did not have coverage for as long as you have Medicare prescription drug coverage. For example, if nineteen months lapse without coverage, your premium will always be at least 19% higher than it would have been without the lapse in coverage.
For more information about this notice or your current prescription drug coverage:
Contact the Human Resources Department at 214-387-5500
NOTE: You will receive this notice annually and at other times in the future, such as before the next period you can enroll in Medicare prescription drug coverage and if this coverage changes. You may also request a copy.
For more information about your options under Medicare prescription drug coverage:
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You will get a copy of the
handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. For more information about Medicare prescription drug coverage:
Visit www.medicare.gov
Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help.
Call 1-800-MEDICARE (1-800-6334227). TTY users should call 877486-2048
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. Information about this extra help is available from the Social Security Administration (SSA) online at www. socialsecurity.gov, or you can call them at 800-772-1213. TTY users should call 800-325-0778
Remember: Keep this Creditable Coverage notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty).
July 1, 2026
Dallas Sports and Entertainment Human Resources 2601 Avenue of the Stars Frisco, Texas 75034
Dallas Stars: 214-387-5500
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 Dallas Sports and Entertainment, 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.
Dallas Sports and Entertainment Human Resources
2601 Avenue of the Stars Frisco, Texas 75034
Dallas Stars: 214-387-5500
Important Notices
Conclusion
PHI use and disclosure by the Plan is regulated by a federal law known as HIPAA (the Health Insurance Portability and Accountability Act). You may find these rules at 45 Code of Federal Regulations Parts 160 and 164. The Plan intends to comply with these regulations. This Notice attempts to summarize the regulations. The regulations will supersede any discrepancy between the information in this Notice and the regulations.
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare. gov
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and
you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272)
If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of January 31, 2026. Contact your State for more information on eligibility.
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 Dallas Sports and Entertainment group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Dallas Sports and Entertainment 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
Dallas Sports and Entertainment Human Resources
2601 Avenue of the Stars Frisco, Texas 75034
Dallas Stars: 214-387-5500
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain outof-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that have not signed a contract with your health plan. Out-ofnetwork providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an innetwork facility but are unexpectedly treated by an out-of-network provider.
You are protected from balance billing for:
Emergency services – If you have an emergency medical condition and get emergency services from an out-ofnetwork provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these poststabilization services.
Certain services at an in-network hospital or ambulatory surgical center – When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-of-network providers cannot balance bill you, unless you give written consent and give up your protections.
You are never required to give up your protections from balance billing. You also are not required to get care out-ofnetwork. You can choose a provider or facility in your plan’s network.
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-ofnetwork providers and facilities directly.
Your health plan generally must:
• Cover emergency services without requiring you to get approval for services in advance (prior authorization).
• Cover emergency services by out-of-network providers.
• Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
• Count any amount you pay for emergency services or out-ofnetwork services toward your deductible and out-of-pocket limit.
If you believe you have been wrongly billed, you may contact your insurance provider. Visit www.cms.gov/ nosurprises for more information about your rights under federal law.
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 employmentbased 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.
Important Notices
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 1-800-3182596. TTY users can call 1-855-8894325
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 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. 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: Dallas Sports & Entertainment
4. Employer Identification Number (EIN): 453194126
5. Employer Address: 2601 Avenue of the Stars Frisco, Texas 75034
6. Employer Phone Number: 214-387-5500
7. City: Frisco
8. State: TX 9. ZIP Code: 75034
10. Who can we contact at this job?: MEGAN LIPPE
11. Phone Number (if different from above): 214-387-5566
12. E-Mail Address: mlippe@dallasstars.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.
This brochure highlights the main features of the Dallas Stars 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. Dallas Stars reserves the right to change or discontinue its employee benefits plans anytime.
