Important Contacts
Employee Response Center
Employee benefits can be complicated. The Higginbotham Employee Response Center can assist you with the following:
z Benefits information
z Claims and billing questions
z Eligibility issues
Call or text a bilingual representative at 866-419-3518
Monday through Friday from 7:00 a.m. to 6:00 p.m. CT.
If you leave a message after 3:00 p.m. CT, your call or text will be returned the next business day. Email questions or requests to helpline@higginbotham.net
Of Summary Health Information
Eligibility
Who is Eligible for Benefits
Who is Eligible
When to Enroll
When Coverage Starts
• A regular, full-time employee working an average of 30 hours or more per week
OE: Open Enrollment
QLE: Qualifying Life Event
Dependent(s)
• By the deadline given by Human Resources
• First of the month after completing 30 days of full-time employment
• A regular, full-time employee working an average of 32 hours or more per week
• During OE or for a QLE
• OE: Start of the plan year
• QLE: Ask Human Resources
• Your legal spouse
• Children under age 26 regardless of student, dependency, or marital status
• Children age 26 or older 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
• During OE or for a QLE
• When covering dependents, you must enroll for and be on the same plans
• Ask Human Resources
Qualifying Life Events
You may only enroll for or make changes to coverage during the plan year if you are a new hire or if you have a QLE, such as:
z Marriage
z Divorce
z Legal separation
z Annulment
z Death of spouse
z Birth
z Adoption/placement for adoption
z Change in benefits eligibility
z Death of child
z FMLA, COBRA event, judgment, or decree
z Becoming eligible for Medicare, Medicaid, or TRICARE
z Receiving a Qualified Medical Child Support Order
z Gain or loss of benefits coverage
z Change in employment status affecting benefits
z Significant change in cost of spouse’s coverage
You have 30 days from the event to notify Human Resources and complete your changes. You may need to provide documents to verify the change.
How to Enroll Online
Enrolling in benefits is simple through UKG.
1. Log in to UKG Ready and navigate to My Benefits > Enrollment. There you will find an enrollment tile that allows you to review plan options and make your 2026-2027 benefit elections. Click https:// secure7.saashr.com/ta/6202483.login to enroll.
2. You will be asked to verify your personal information, your dependents’ information, and your beneficiary information.
3. Select Add/Change to update information.
4. Once you’ve completed updating this information, select Next
5. When you’ve completed verifying and updating this information, select Save
6. Select a session.
7. Select, change, or decline coverage in each plan.
8. Choose your benefit option.
9. Select your dependents you would like to cover.
10. Once you’ve completed this section, you are ready to review and submit your elections.
11. Return to the applicable page to complete changes, as needed.
12. Choose Draft to continue the election later; or select Submit to complete your elections now.
13. If you have completed and reviewed your elections. select OK, and the Confirmation page appears.
14. Print a summary of your elections.
15. Select Close
Benefit Questions
Call or text a bilingual representative at 866-419-3518 Monday through Friday from 7:00 a.m. to 6:00 p.m. CT. If you leave a message after 3:00 p.m. CT, your call or text will be returned the next business day. Email questions or requests to helpline@higginbotham.net
Medical Coverage
Protects you and your family from major financial hardship in the event of illness or injury.
Carrier: Blue Cross Blue Shield of Texas | Network: Blue Choice
You have a choice of six medical plans with various deductibles and out-of-pocket maximums.
z Plan 1: MTBCP507 (Traditional Copay Plan)
z Plan 2: MTBCP516 (Traditional Copay Plan)
z Plan 3: MTBCP524 (Traditional Copay Plan)
z Plan 4: MTBCP532 (Traditional Copay Plan)
z Plan 5: MTBCP317H (HDHP with HSA Option)
z Plan 6: MTBCP016H (HDHP with HSA Option)
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, you will pay less and get the highest level of benefits. You will pay more for care if you use outof-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 services are covered at the deductible and coinsurance level.
High Deductible Health Plan
A High Deductible Health Plan (HDHP) allows you to see any provider when you need care, and you will pay less 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.
You will pay more for care if you go to out-of-network providers.
Find an In-Network Provider
z Visit www.bcbstx.com .
z Call 800-521-2227
z Download the BCBSTX app
Medical Benefits Summary
Prescription Drugs – Mail Order
• Tier 1
• Tier 2
• Tier 3
Prescription Drugs –Specialty
•
•
1The amount you pay after the deductible is met.
²Certain services may require preauthorization for out-of-network; failure to preauthorize may result in 50% reduction in benefits not to exceed $500.
³Preauthorization required.
⁴The amount you pay at a preferred in-network pharmacy versus a non-preferred in-network pharmacy.
Embedded Deductible
All individual deductible amounts will count towards the family deductible, but one person will not have to pay more than the individual deductible amount.
Aggregate Deductible
If you and any family members have medical coverage, the individual deductible does not apply. One or all of you must meet the family deductible.
Prescription Drugs
Your medical coverage includes prescription benefits for retail, mail order (home delivery), and specialty drugs.
Carrier: Blue Cross Blue Shield of Texas
Prescription Drug List
Your medical carrier controls prescription drug costs by negotiating discounts on medications. Covered drugs are listed in the Prescription Drug List. If you take maintenance medications, review the list with your doctor to see which ones are covered and available. If your medication is not listed, call the phone number on your member ID card.
Retail
Use any participating retail pharmacy to fill short-term, non-specialty medications. Retail pharmacies often fill or refill 30- to 90-day supplies.
Home Delivery
If you take medication on a daily basis, consider using home delivery. It is a convenient, low-cost option that delivers up to a 90-day supply right to your home. You will need to set up an online pharmacy account and/or download the app to easily manage your prescriptions.
Specialty
If you need a specialty drug to treat a complex or chronic condition, you will be asked to enroll in a specialty drug program. It offers support to ensure the medication works well for you and costs as little as possible. If you do not enroll in the program, the specialty drug may not be covered. Certain exclusions and limitations apply.
SAVE MONEY. BUY GENERIC DRUGS!
Generic drugs are a safe and effective option to brand-name drugs – and they cost much less! They have the same active ingredients, strength, and dosage as brand-name drugs, and they also meet the same rigorous quality and safety standards set by the Food and Drug Administration.
Prescription Savings
z Automatic Discounts – If there is a discount at an in-network pharmacy, you pay the lower cost.
z $0 Emergency Medications – Critical medications like Epinephrine, Glucagon, Naloxone, and Nitroglycerin are covered at $0 at in-network pharmacies.
Preventive Care
Your medical plan offers $0 preventive care for everyone.
Preventive care is the care you receive to help prevent chronic illness or disease. It includes exams, lab work, screenings, immunizations, and counseling to prevent health problems, such as diabetes or heart disease.
Preventive Care Coverage Includes
Adults Teens
Cholesterol screening
Blood pressure screening
Colorectal cancer screening
Lung cancer screening
Hepatitis B screening
Well visits
Bone density screening
Obesity screening
Diabetes type 2 screening
Depression screening
Mammograms
Cervical cancer screening
Immunizations
Dental cleanings and exams
Vision screening
FREQUENTLY ASKED QUESTIONS
Physical exam
Blood tests for iron and cholesterol
Anxiety screening
Growth screening
Hearing screening
Hepatitis B screening
Depression screening
Alcohol, tobacco, and drug use assessments
Tuberculosis screening Immunizations
Dental cleanings and exams
Vision screening
Children
Autism screening
Blood screening
Depression screening
Developmental screening
Hearing screening
Obesity screening and counseling
Hypothyroidism screening
Behavioral assessments
Well visits
Immunizations
Dental cleanings and exams
Oral health risk assessment
Vision screening
Why should I get preventive care?
Preventive care is the fastest and best way to uncover potential risks and avoid chronic health conditions.
Are all screenings, tests, and procedures covered under preventive care?
No. Your doctor will be able to advise you as to the preventive care you need or should obtain, based on your medical and family history.
Why did I get a bill for preventive care?
Diagnosis codes on the doctor’s bill must meet certain insurance company conditions for them to be processed as preventive and covered at 100%. If you have a medical complaint, or your doctor finds a specific medical issue during your preventive care doctor’s visit, a diagnosis code for that issue or complaint will be on your bill. As a result, the insurance company may process the bill for a specific medical condition, not preventive care. In this case, you must pay the copay or portion of your deductible.
Telemedicine
Your medical coverage offers telemedicine services
so you can connect anytime day or night with a boardcertified doctor via your mobile device or computer.
Carrier: MDLIVE
While telemedicine does not replace your primary care physician, it is a convenient and cost-effective option when you need care and:
z Have a non-emergency issue and are considering an after-hours health care clinic, urgent care clinic, or emergency room for treatment
z Are on a business trip, vacation, or away from home
z Are unable to see your primary care physician
When to Use Telemedicine
Use telemedicine for minor conditions such as:
z Sore throat
z Headache
z Stomachache
z Cold/flu
z Virtual Behavioral Care
z Allergies
z Dermatology
z Primary care
z Fever
z Urinary tract infections
Virtual Behavioral Care
Licensed behavioral health therapists are available by appointment for:
z Depression
z Eating disorders
z ADHD
z Substance use disorders
z Trauma and PTSD
z Autism spectrum disorder
Do not use telemedicine for serious or life-threatening emergencies.
Get More Information or Register
Skip the trip to your doctor! Register for an account so you can get on-demand medical care.
z Visit www.mdlive.com/bcbstx
z Call 888-680-8646.
z Download the MDLIVE app
Health Care Options
Becoming familiar with your options for medical care can save you time and money.
Non-Emergency Care
Telemedicine
Access to care via phone, online video, or mobile app whether you are home, work, or traveling; medications can be prescribed.
24 hours a day, 7 days a week
Doctor’s Office
Generally, the best place for routine preventive care; established relationship; able to treat based on medical history.
Office hours vary
Retail Clinic
Usually lower out-of-pocket cost than urgent care; when you can’t see your doctor; located in stores and pharmacies.
Hours vary based on store hours
Urgent Care
When you need immediate attention; walk-in basis is usually accepted.
Generally includes evening, weekend, and holiday hours
Emergency Care
Hospital ER
Life-threatening or critical conditions; trauma treatment ; multiple bills for doctor and facility.
24 hours a day, 7 days a week
Freestanding ER
Services do not include trauma care; can look similar to an urgent care center, but medical bills may be 10 times higher
24 hours a day, 7 days a week
Infections
Sore and strep throat Vaccinations Minor injuries/sprains/strains
Common infections
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.
BCBSTX Resources
BCBSTX Member Portal and App
Blue Access for Members (BAM) is the secure BCBSTX member website where you can:
z Check claim status or history
z Confirm dependent eligibility
z Sign up for electronic Explanation of Benefits statements
z Locate in-network providers
z Print or request an ID card
z Review your benefits
z Get tips to live and eat healthier
Get the BCBSTX app for easy access to your information. Log in from your mobile device to access your BAM account.
Nurseline
Call 800-581-0368 for access to registered nurses who can answer general health questions, make appointments with your doctor, and help determine where to go for emergency health care services. You can also access an audio library of more than 1,000 health-related topics in both English and Spanish.
Cash Rewards Program
Member Rewards offers you cash rewards when you use the Provider Finder tool to choose the lower-cost, quality option for your health care.
z Visit www.bcbstx.com, register for or log in to BAM, and select Find Care.
z Shop and compare costs for screenings, scans, surgeries, and more.
z Get the procedure or service at a reward-eligible location.
z Receive a cash reward by check, mailed directly to your home, after the claim is paid and the location is verified as reward-eligible.
Blue365 Discounts
Blue365 can save you money on health and wellness products and services not covered by insurance. There are no claims to file, and you do not need a referral or preauthorization. Visit www.blue365deals. com/bcbstx to sign up and receive weekly featured deals by email. Discount categories include:
z Apparel and footwear
z Fitness
z Hearing and vision
z Home and family
z Nutrition
z Personal care
Well onTarget Wellness Program
When you are healthy, you spend less on doctors and hospitals, you feel better, and you tend to live longer. If you are enrolled in a BCBSTX medical plan, the Well onTarget program offers many ways to help you set and reach your health goals.
Wellness Portal
The Wellness Portal connects you with the entire Well onTarget program.
1. Go to www.bcbstx.com to sign up or log in.
2. Click the Wellness tab.
3. After you sign up, go directly to www.wellontarget.com
Mobile App
Download the AlwaysOn app to access the Wellness Portal on your phone.
Blue Points Program
The Blue Points program lets you rack up points and reward yourself – with electronics, sporting goods, clothes, and charity donations – for your healthy habits.
Blue Points Program
10 points per day
(up to 70 points per week)
55 points per day
250 points per month
300 points per week
1,000 points per quarter
2,500 points every six months
2,500 points
2,675 points
Track your progress toward your goals in the Wellness Portal.
Track your progress using a synced fitness device or app.
Complete any self-management program progress check-in.
Add weekly fitness program gym visits to your routine.
Complete a self-management program.
Complete your health assessment.
Enroll in the Fitness Program.
Connect a compatible fitness device to the portal.
Health Assessment
Answer questions about diet, physical activity, tobacco use, and emotional health and get a personalized health report and plan.
Fitness Program
Get a discounted monthly gym membership – for you and your family (ages 16 and older) – from a nationwide network of fitness locations. Or, opt for digital home fitness, boutiquestyle classes, or specialty gyms. Complementary and alternative medicine discounts are available for a variety of products and services, including massage therapists.
$19 Initiation Fee (No initiation fee for Digital Only Option)
Digital Self-management Programs
Get easy-to-learn tips and resources. Choose between educational content and six-week interactive programs that focus on health conditions and how to improve them.
Wellness Coaching
Get one-on-one coaching from health experts – including dietitians, nurses, and personal trainers – to help you set and achieve your goals. Coaches can:
z Help you quit tobacco or stay tobacco-free.
z Help you improve your physical fitness, nutrition, blood pressure, or cholesterol.
z Design a health and wellness plan that’s right for you.
Tools and Trackers
Get integrated trackers to help you monitor your health and well-being. You can sync them to popular health-tracking apps and wearable devices. Trackers can help with:
z Weight
z Blood pressure
z Tobacco use
z Water intake z Physical activity z Sleep
BCBSTX Wellness Resources
If you are enrolled in a BCBSTX medical plan, you have access to the following wellness resources.
Weight Loss
Wondr is a free digital weight loss program that teaches you how to eat your favorite foods and still lose weight, have energy, stress less, and sleep better. Wondr is not a diet plan. There are no points, plans, or calories to count. It teaches you skills to know how and when you eat and improve your long-term health. Enroll at https://wondrhealth.com/BCBSTX or get the Wondr app.
Diabetes and High Blood Pressure Management
Omada helps with type 2 diabetes and high blood pressure. Apply online at https://omadahealth.com/bcbstx and get:
z A smart scale to monitor progress on managing your weight
z Professional coaches
z Engaging weekly lessons
z Supportive peer group
Reversing Type 2 Diabetes
Twin Health offers a revolutionary program that helps reverse type 2 diabetes by treating the root cause: metabolic dysfunction. Members wear simple health trackers like a continuous glucose monitor and activity sensor to receive real-time, personalized guidance on sleep, nutrition, activity, and more. This approach –tailored to your individual lifestyle with a support team – improves mood, energy, and long-term health. Many have reversed type 2 diabetes in six months, with major reductions in A1C and medication use.
z Visit www.twinhealth.com.
z Email support@twinhealth.com
VirtualCheckup
Catapult Health offers an in-home VirtualCheckup program for your preventive care. It is fast, free, and easy to do! Simply order your kit for home delivery, follow the directions, and complete your VirtualCheckup with a Catapult nurse practitioner. Everything you need to collect vital information is included in the kit and is yours to keep (including a blood pressure monitor). Visit www.virtualcheckup.com/BCBSTX for details.
BCBSTX Wellness Resources
Back and Joint Pain Relief
Hinge Health offers remote care for your back and joint pain – without drugs or surgery. Get free personal therapy, unlimited support, a computer tablet, and wearable sensors. Average results show 60% pain reduction and two out of three surgeries avoided. You will begin with a 12-week intensive phase, followed by an ongoing program that builds on what you have learned. Learn more and apply at www.hingehealth.com/bcbstx
Muscle and Joint Pain Care
Flex by Airrosti provides personalized care for muscle and joint pain (back or neck issues, carpal tunnel, plantar fasciitis, tension headaches, and more). Convenient inclinic and virtual care options are available to serve you. Airrosti provides:
z Evaluation – A 10-15 minute complimentary evaluation with an Airrosti provider
z Assessment – An expert assessment of your injury or any pain-related issues
z Review – A review of findings and discussion of your treatment options
z Personalized plan – Targeted exercises, recovery tools, and provider-guided treatment
Visit www.airrosti.com/flex or call 800-404-6050 to schedule a free virtual evaluation.
Cancer Services and Support
If you or a covered family member are diagnosed with cancer, Cancer Services and Support provides personalized guidance and expert support at no additional cost. This support includes:
z Cancer Services and Support Hub – with benefits, resources, and care navigation tools.
z Expert Review – by cancer specialists who collaborate with your doctor.
z Dedicated Nurse Support – from your diagnosis through post-treatment.
z Care Coordination –as well as education throughout your treatment.
Log in to www.bcbstx.com and select Cancer Support – or call the number on the back of your member ID card and ask for a cancer care nurse.
BCBSTX Mental Health Resources
If you are enrolled in a BCBSTX medical plan, you have behavioral health resources to help support your mental and emotional well-being.
Digital Mental Health
BCBSTX’s Mental Health Hub is a free digital, one-stop, 24/7 resource to help you manage and overcome stress, anxiety, depression, insomnia, substance abuse, and more.
z Mental wellness check-In assessment – get a personalized report and a tailored list of resources, including apps, articles, and tools.
z Learn to Live – access interactive lessons, mindfulness exercises, and optional expert coaching, based on Cognitive Behavioral Therapy (CBT).
Log in at www.bcbstx.com or the BCBSTX app, select Behavioral Health, and choose Mental Health Hub or Digital Mental Health.
Counseling and Psychiatric Therapy
BCBSTX medical plans also provide coverage for mental health. Talk about your mental health with your doctor. He/ she can work with you to get the help you need and to find a specialist in your area.
z Mental health counseling
z Substance use/abuse counseling
z Psychiatric therapy
To get started, visit www.bcbstx.com, call 800-521-2227, or download the BCBSTX app.
Employee Assistance Program
The BCBSTX Employee Assistance Program offers free in-person sessions and 24/7 consultations by phone for short-term support and advice on issues like:
z Stress, anxiety, and depression
z Various personal challenges
z Work/life balance
z Legal and financial support
Visit www.guidanceresources.com, call 844-213-8968 , or download the GuidanceNow app. Use Web ID: BCBSTXEAP
Virtual Care
Schedule a video or phone visit with a board-certified therapist or psychiatrist with MDLIVE — for free or for the same cost as your regular doctor.
1. Register at www.mdlive.com/bcbstx .
2. Schedule a virtual visit on the website – call 888-680-8646 or download the MDLIVE app
Dental Coverage
Our dental plan helps you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work.
Carrier: Blue Cross Blue Shield of Texas Network: BlueCare
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.
BLUECARE DENTAL ENHANCED BENEFIT
The Enhanced Benefit provides additional dental benefits, such as an extra cleaning for members with specific health issues. Refer to the Dental Benefit Book for details.
Dental Benefits Summary
Year Deductible
Preventive Services
Cleanings, complete series X-rays, exams, fluoride
Basic Services
Endodontics, extractions, fillings, oral surgery, periodontics, sealants, space maintainers
Major Services
Bridges, crowns, dentures, root canals, surgical extractions, inlays, onlays
Find an In-Network Provider
z Visit www.bcbstx.com
z Call 800-521-2227.
Orthodontia
Children up to age 19
$1,500 lifetime maximum
1 All benefits are based upon the Allowable Amount, which is the amount determined by BCBSTX as the maximum amount eligible for payment of benefits. A Contracting Dentist cannot balance bill for charges in excess of the Allowable Amount. Benefits for covered services provided by a Non-Contracting Dentist will be based upon the same Allowable Amount, and it is likely that the Non-Contracting Dentist will balance bill for amounts above this, resulting in higher outof-pocket expenses.
2 The amount you pay after the deductible is met.
Vision Coverage
Helps detect certain medical issues, prolong your eyesight, and correct vision or eye problems.
Carrier: Blue Cross Blue Shield of Texas Network: EyeMed
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.
Vision Benefits Summary
Lenses
• Single vision
• Lined bifocals
• Lined trifocals
• Lenticular $25 copay $25 copay $25 copay $25 copay
to $55
to $55 Frames $25 copay, 20% off balance over $130 allowance Up to $65
Contacts
In lieu of frames and lenses
• Elective
• Medically necessary
• Laser Correction Surgery
Benefit Frequency
• Exam
• Lenses
• Frames
$25 copay, $130 allowance $25 copay / Covered in full Up to $15 off usual and customary charge
$210 Not covered
• Contacts Once every 12 months Once every 12 months Once every 24 months Once every 12 months
Find an In-Network Provider
z Visit www.eyemedvisioncare.com/bcbstxvis
z Call 855-875-6948 .
Health Savings Account
Administrator: Optum Bank
HSA Eligibility
You are eligible to open and contribute to an HSA if you are:
z Enrolled in an HSA-eligible HDHP
z Not covered by another plan that is not a qualified HDHP (e.g., spouse’s health plan)
z Not enrolled in a Health Care Flexible Spending Account
z Not eligible to be claimed as a dependent on someone else’s tax return
z Not enrolled in Medicare, Medicaid, or TRICARE
z Not receiving Veterans Administration benefits
Note: You may have an HSA at the financial institution of your choice, but only accounts opened through Optum Bank are eligible for automatic payroll deductions.
Two Ways to Use Your HSA
Use the Money Now
Pay for qualified out-of-pocket medical, dental, and vision expenses as they are incurred.
Invest Over Time
Invest and grow your HSA dollars tax-free. You can use the funds to pay for qualified expenses later.
Contributions
You may contribute up to the
If you are age 55 or older, you can contribute an extra
HOW TO PAY OR GET REIMBURSED
z Use your HSA debit card to pay for qualified expenses.
OR
z Pay out-of-pocket and submit your receipts for reimbursement online or through the app.
z Visit www.optumbank.com
z Call 800-791-9361 .
z Download the Optum Bank mobile app for secure account access on the go.
Flexible Spending Accounts
Set aside pretax dollars from each paycheck to pay for certain IRS-approved health and dependent care expenses. We offer the following Flexible Spending Accounts (FSAs).
Administrator: WageWorks
Health Care FSA
The Health Care FSA covers qualified medical, dental, and vision expenses for you and your eligible dependents. Eligible expenses include:
z Deductibles, copays, and coinsurance
z Prescription drugs
z Braces, glasses, and contacts
z Hearing aids and batteries
If you enrolled in an HDHP and contribute to an HSA, you may not contribute to a Health Care FSA.
Limited Purpose Health Care FSA
If you enroll in the HDHP medical plan and contribute to an HSA, you can use a Limited Purpose Health Care FSA to pay for eligible out-of-pocket dental and vision expenses only, such as:
z Dental and orthodontia care (fillings, X-rays, braces)
z Vision care (eyeglasses, contact lenses, LASIK)
Dependent Care FSA
The Dependent Care FSA helps pay expenses associated with caring for children under age 13 and elder dependents so you or your spouse can work or attend school full-time.
Dependent Care FSA Guidelines
z 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.
z You can use funds for daycare or babysitter expenses for your children under age 13, but only for the part of the year when the child is under 13.
z Only day camps – not overnight camps – can be considered for reimbursement.
z You can use funds 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 selfcare.
z The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.
Flexible Spending Accounts
HOW TO PAY OR GET REIMBURSED
z Use your FSA debit card (excludes the Dependent Care FSA).
OR
z Pay out-of-pocket, and submit your receipts for reimbursement.
Health Care FSAs and Limited Purpose Health Care FSAs allow you an additional grace period to submit claims after the plan year closes (up until March 31, 2027).
Get More Information or Submit Receipts
z Visit www.wageworks.com .
z Call 888-557-3156
z Download the EZ Receipts Mobile app for secure account access on the go.
Qualified HSA and FSA Expenses
Shows some medical expenses that are eligible for payment under your Health Care FSA, Limited Purpose Health Care FSA, or HSA.*
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.
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
* Excludes Dependent Care FSA.
Diagnostic fees
Diathermy
Drug addiction therapy
Drugs (prescription)
Elastic hosiery (prescription)
Eyeglasses
Fees paid to health institute prescribed by a doctor
FICA and FUTA tax paid for medical care service
Fluoridation unit
Guide dog
Gum treatment
Gynecologist
Healing services
Hearing aids and batteries
Hospital bills
Hydrotherapy
Insulin treatment
Lab tests
Lead paint removal
Legal fees
Lodging (away from home for outpatient care)
Metabolism tests
Neurologist
Nursing (including board and meals)
Obstetrician
Operating room costs
Ophthalmologist
Optician
Optometrist
Oral surgery
Organ transplant (including donor’s expenses)
Orthopedic shoes
Orthopedist
Osteopath
Oxygen and oxygen equipment
Pediatrician
Physician
Physiotherapist
Podiatrist
Postnatal treatments
Practical nurse for medical services
Prenatal care
Prescription medicines
Psychiatrist
Psychoanalyst
Psychologist
Psychotherapy
Radium therapy
Registered nurse
Special school costs for the handicapped
Spinal fluid test
Splints
Surgeon
Telephone or TV equipment to assist the hard-of-hearing
Therapy equipment
Transportation expenses (relative to health care)
Ultraviolet ray treatment
Vaccines
Vitamins (if prescribed)
Wheelchair X-rays
HSA/FSA Comparison Chart
Who is eligible?
Contribution limits
Must be enrolled in a High Deductible Health Plan (HDHP), have no other non-HDHP health plan, including coverage under Medicare, a spouse’s health plan, or FSA.
Individual: $4,400
Family: $8,750
Employees not eligible or participating in an HSA
$3,400
Who owns the account? Employee Employer
Contributions subject to income tax? No No
Does interest accrue? Yes No
Contributions
Disbursement of funds
Catch-up contribution for older workers
Portability and forfeiture
Money is deducted pretax from the employee’s salary every pay period. Additional individual contributions ARE allowed.
Only funds paid in by the employee and/or company are available for health care expenses.
Money is deducted pretax from the employee’s salary every pay period. Additional individual contributions are NOT allowed.
The entire annual contribution amount is available from the beginning of the year, even if the account is not yet fully funded.
Yes. Employees aged 55 and older may contribute up to $1,000 more to their account per year. No
Yes. HSA balance is not forfeited when the employee changes employers or health plans.
Expiration Never expires or lost
Balance carry-over (or rollover)
Yes. Unused funds are carried over to the following year.
Changes to contributions On a pay period basis
Eligible health care expenses
Non-health care expenses
Proof of expenses required?
Qualified medical expenses defined under IRC 213(d). HSAs can be used to pay premiums for Temporary Continuation of Coverage, Long Term Care, and health insurance for retirees.
HSA funds can be used for non-health care distributions but are included in gross income and subject to a 10% penalty if under age 65.
No. However, the employee should be prepared to substantiate to the IRS that the expense has been incurred, the amount of the expense and its eligibility.
Not portable. Unspent money in an FSA is lost when employment is terminated.
All money in an FSA expires and is lost at the end of the grace period.
Subject to IRS limits.
Only for Qualified Life Events, such as a marriage, divorce, birth, or during Open Enrollment.
Qualified medical expenses are those specified in the plan that would generally qualify for the medical and dental expenses deduction (e.g., copays, coinsurance, deductible, prescription drugs, braces, dental, and eye care expenses).
FSA funds cannot be used for non-medical expenses.
Yes
Life and AD&D Insurance
Life and Accidental Death and Dismemberment (AD&D) insurance are important to your financial security, especially if others depend on you for support or vice versa.
Carrier: BCBSTX /Symetra
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, 40% at age 70, and 25% at age 75.
Basic Life and AD&D
Basic Life and AD&D insurance are provided at no cost to you. You are automatically covered at $50,000 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).
• Increments of $10,000 up to $500,000 or 5 times salary, whichever is less
• Guaranteed Issue: $100,000 Spouse
Child(ren)
• Increments of $5,000 up to $100,000 or 50% of employee amount, whichever is less
• Guaranteed Issue: $25,000
• Increments of $1,000 up to $10,000
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
Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. We offer Short Term Disability (STD) and Long Term Disability (LTD) for you to purchase
Carrier: BCBSTX /Symetra
Voluntary Short Term Disability
STD coverage pays a percentage of your weekly salary if you are temporarily disabled and unable to work due to an illness, pregnancy, or non-work-related injury. STD benefits are not payable if the disability is due to a job-related injury or illness. If a medical condition is job-related, it is considered workers’ compensation, not STD.
Voluntary Long Term Disability
LTD insurance pays a percentage of your monthly salary for a covered disability or injury that prevents you from working for a specific period of time. Benefits begin at the end of an elimination period and continue while you are disabled up to the maximum benefit period.
1
Supplemental Benefits
Accident Insurance
Accident insurance provides affordable protection against a sudden, unforeseen accident.
Carrier: BCBSTX/Symetra
Accident insurance helps offset the direct and indirect expenses such as copayments, deductibles, ambulance, physical therapy, childcare, rent, and other costs not covered by traditional health plans. You will be paid a specific sum of money directly based on the care and services provided for your covered accident. Use the money any way you see fit. See the plan document for full details.
Critical Illness Insurance
Critical Illness insurance helps pay the cost of nonmedical expenses related to a covered critical illness or cancer.
Carrier: BCBSTX/Symetra
The plan provides a lump-sum benefit payment to you upon first and second diagnosis of any covered critical illness or cancer. The benefit can help cover expenses such as lost income, out-of-town treatments, special diets, daily living, and household upkeep costs. See the plan document for full details.
Critical Illness Insurance
•
Increments of $5,000 up to $30,000.
Guaranteed Issue: $20,000 Spouse
Increments of $2,500 up to $15,000 not to exceed the employee amount.
Guaranteed Issue: $10,000 Child
Increments of $2,500 up to $15,000 not to exceed the employee amount.
Guaranteed Issue: $10,000
For conditions such as advanced Alzheimer’s disease; coma; heart attack; heart, kidney, or organ failure; invasive cancer; paralysis; stroke; and more
For conditions such as noninvasive cancer and more
For childhood conditions such as cleft lip or palate, cystic fibrosis, Down syndrome, spina bifida, and more
Rates
Refer to the
Employee Assistance Program
The Employee Assistance Program helps you and family members cope with a variety of personal and work-related issues.
Administrator: ComPsych
This program provides confidential counseling and support services at little or no cost to you to help with:
z Relationships
z Work-life balance
z Stress and anxiety
z Will preparation and estate resolution
z Grief and loss
z Childcare and eldercare issues
z Substance abuse
z Financial and legal matters
z And more
z Visit www.guidanceresources.com
z Call 866-899-1363
z Download the ComPsych app.
Support at Any Hour of the Day or Night
Retirement Program
A 401(k) plan can be a powerful tool to help you be financially secure in retirement. Our 401(k) plan can help you reach your investment goals.
Administrator: Reliance Trust Company
How the Retirement Plan Works
You are eligible to participate in the plan if you are age 21 or older and have 30 days of service with the company. Part-time employees will become eligible after meeting the service requirement. You may contribute up to the IRS annual limits.
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.
ENROLLMENT
You must enroll through our 401(k) administrator at https://secure7.saashr.com
Company Matching Contributions
Amerapex will match up to 5% of your contribution per pay period up to a maximum of $1,500 annually. This matching contribution is at the company’s discretion and is subject to change.
VESTING
You are always 100% vested in your own contributions. You are 100% vested in matching company contributions after two years of service. You are not vested until two years.
Get More Information
z Visit www.mykplan.com .
z Call 866-MYKPLAN (866-695-7526)
Contribution (Age 50+):
Special Catch-Up (Age 60-63): $11,250 (Total: $35,750)
Total Limit (Employer + Employee): $72,000
*If your prior-year wages from this employer were $150,000+, catch-up contributions must be made as Roth (after-tax) contributions.
Employee Weekly Contributions
Important Notices
Women’s Health and Cancer Rights Act of 1998
In October 1998, Congress enacted the Women’s Health and Cancer Rights Act of 1998. This notice explains some important provisions of the Act. Please review this information carefully.
As specified in the Women’s Health and Cancer Rights Act, a plan participant or beneficiary who elects breast reconstruction in connection with a mastectomy is also entitled to the following benefits:
z All stages of reconstruction of the breast on which the mastectomy was performed;
z Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
z 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:
Amerapex Corporation Human Resources
2950 N Loop West, Suite 1100 Houston TX 77092
713-263-0900
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 Amerapex Corporation 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. Prescription coverage is creditable.
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. Amerapex Corporation has determined that the prescription drug coverage offered by the Amerapex Corporation 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 Amerapex Corporation 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 Amerapex Corporation 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 713-263-0900
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:
z Visit www.medicare.gov
z 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.
z Call 1-800-MEDICARE (1-800-6334227). TTY users should call 877-4862048
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. Information about this extra help is available from the Social Security Administration (SSA) online at www. socialsecurity.gov, or you can call them at 800-772-1213. TTY users should call 800-325-0778
Remember: Keep this Creditable Coverage notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty).
March 1, 2026
Amerapex Corporation Human Resources 2950 N Loop West, Suite 1100 Houston TX 77092 713-263-0900
Notice of HIPAA Privacy Practices
THIS NOTICE OF PRIVACY PRACTICES DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This Notice of Privacy Practices (the “Notice”) describes the legal obligations of Amerapex Corporation’s Group Health Plan (the “Plan”) and your legal rights regarding your protected health information held by the Plan under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH
Act). Among other things, this Notice describes how your protected health information may be used or disclosed to carry out treatment, payment, or health care operations, or for any other purposes that are permitted or required by law.
We are required to provide this Notice of Privacy Practices to you pursuant to HIPAA.
The HIPAA Privacy Rule protects only certain medical information known as “protected health information.” Generally, protected health information (PHI) is health information, including demographic information, collected from you or created or received by a health care provider, a health care clearinghouse, a health plan, or your employer on behalf of a group health plan, from which it is possible to individually identify you and that relates to:
1. Your past, present, or future physical or mental health or condition;
2. The provision of health care to you; or
3. The past, present, or future payment for the provision of health care to you.
I. Contact Information
If you have any questions about this Notice or about our privacy practices, and for any correspondence or requests related to the contents of this Notice, please contact:
Amerapex Corporation Human Resources 2950 N Loop West, Suite 1100 Houston TX 77092
713-263-0900
II. Effective Date
This Notice is effective February 15, 2026.
III. Our Responsibilities
We are required by law to:
1. maintain the privacy of your PHI;
2. provide you with certain rights with respect to your PHI;
3. provide you with a copy of this Notice of our legal duties and privacy practices with respect to your PHI; and
4. follow the terms of the Notice that is currently in effect.
We reserve the right to change the terms of this Notice and to make new provisions regarding your PHI that we maintain, as allowed or required by law. If we make any material change to this Notice, we will provide you with a copy of our revised Notice of Privacy Practices.
IV. How We May Use and Disclose Your PHI
Under the law, we may use or disclose your PHI under certain circumstances without your permission. The following categories describe the different ways that we may use and disclose your PHI. For each category of uses or disclosures we will explain what we mean and present some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories. Note that we will use and disclose PHI as described below unless otherwise prohibited or restricted by applicable state or other law, and that information can lose its protected status as PHI once re-disclosed by a recipient.
For Treatment. When and as appropriate, we may use or disclose medical information about you to facilitate medical treatment or services by health care providers. We may disclose medical information about you to providers, including doctors, nurses, technicians, medical students, or other hospital personnel who are involved in taking care of you. For example, we might disclose information about you with physicians who are treating you.
For Payment. We may use or disclose your protected health information to determine your eligibility for Plan benefits, to facilitate payment for the treatment and services you receive from health care providers, to determine benefit responsibility under the Plan, or to coordinate Plan coverage. For example, we may tell your health care provider about your medical history to determine whether a particular treatment is experimental, investigational, or medically necessary, or to determine whether the Plan will cover the treatment. We may also share your protected health information with a utilization review or pre-
certification service provider. Likewise, we may share your protected health information with another entity to assist with the adjudication or subrogation of health claims or to another health plan to coordinate benefit payments.
For Health Care Operations. We may use and disclose your protected health information for other Plan operations. These uses and disclosures are necessary to run the Plan. For example, we may use medical information in connection with conducting quality assessment and improvement activities; underwriting, premium rating, and other activities relating to Plan coverage; submitting claims for stop-loss (or excess-loss) coverage; conducting or arranging for medical review, legal services, audit services, and fraud and abuse detection programs; business planning and development such as cost management; and business management and general Plan administrative activities. However, we will not use your genetic information for underwriting purposes.
Substance Use Disorder (SUD) Treatment
Information. Some of your health information may be part of a SUD patient record and subject to additional protections under federal law (42 CFR Part 2) governing confidentiality of SUD patient records.
If we receive or maintain any information about you from a SUD treatment program that is covered by 42 CFR Part 2 (a “Part 2 Program”) through a general consent you provide to the Part 2 Program to use and disclose the SUD patient record for purposes of treatment, payment or health care operations, we may use and disclose your SUD patient record for treatment, payment and health care operations purposes as described in this Notice. If we receive or maintain your SUD patient record through specific consent you provide to us or another third party, we will use and disclose your SUD patient record only as expressly permitted by you in your consent as provided to us. In no event will we use or disclose your SUD patient record, or testimony that describes the information contained in your SUD patient record, in any civil, criminal, administrative, or legislative proceedings by any Federal, State, or local authority, against you,
unless authorized by your consent or the order of a court after it provides you notice of the court order.
To Business Associates. We may contract with individuals or entities known as Business Associates to perform various functions on our behalf or to provide certain types of services. In order to perform these functions or to provide these services, Business Associates will receive, create, maintain, transmit, use, and/or disclose your PHI, but only after they agree in writing with us to implement appropriate safeguards regarding your PHI. For example, we may disclose your PHI to a Business Associate to process your claims for Plan benefits or to provide support services, such as utilization management, pharmacy benefit management, or subrogation, but only after the Business Associate enters into a Business Associate contract with us.
Treatment Alternatives or HealthRelated Benefits and Services. We may use and disclose your protected health information to send you information about treatment alternatives or other healthrelated benefits and services that might be of interest to you.
As Required by Law. We will disclose your PHI when required to do so by federal, state, or local law. For example, we may disclose your PHI when required by national security laws or public health disclosure laws.
To Avert a Serious Threat to Health or Safety. We may use and disclose your PHI when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat. For example, we may disclose your PHI in a proceeding regarding the licensure of a physician.
To Plan Sponsors. For the purpose of administering the plan, we may disclose PHI to certain employees of the Employer. However, those employees will only use or disclose that information as necessary to perform plan administration functions or as otherwise required by HIPAA, unless you have authorized further disclosures. Your PHI cannot be used for employment purposes without your specific authorization.
V. Special Situations
In addition to the above, the following categories describe other possible ways that we may use and disclose your PHI without your specific authorization. For each category of uses or disclosures, we will explain what we mean and present some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
Organ and Tissue Donation. If you are an organ donor, we may release your PHI after your death to organizations that handle organ procurement or organ, eye, or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
Military. If you are a member of the armed forces, we may release your PHI as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority.
Workers’ Compensation. We may release your PHI for workers’ compensation or similar programs, but only as authorized by, and to the extent necessary to comply with, laws relating to workers’ compensation and similar programs that provide benefits for work-related injuries or illness.
Public Health Risks. We may disclose your PHI for public health activities. These activities generally include the following:
1. to prevent or control disease, injury, or disability;
2. to report births and deaths;
3. to report child abuse or neglect;
4. to report reactions to medications or problems with products;
5. to notify people of recalls of products they may be using;
6. to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
7. to notify the appropriate government authority if we believe that a patient has been the victim of abuse, neglect, or domestic violence. We will only
make this disclosure if you agree, or when required or authorized by law. Health Oversight Activities. We may disclose your PHI to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. We may also disclose your PHI in response to a subpoena, discovery request, or other lawful process by someone involved in a legal dispute, but only if efforts have been made to tell you about the request or to obtain a court or administrative order protecting the information requested.
Law Enforcement. We may disclose your PHI if asked to do so by a lawenforcement official.
1. in response to a court order, subpoena, warrant, summons, or similar process;
2. to identify or locate a suspect, fugitive, material witness, or missing person;
3. about the victim of a crime if, under certain limited circumstances, we are unable to obtain the victim’s agreement;
4. about a death that we believe may be the result of criminal conduct; and
5. about criminal conduct.
Coroners, Medical Examiners, and Funeral Directors. We may release PHI to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients to funeral directors, as necessary to carry out their duties.
National Security and Intelligence Activities. We may release your PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Inmates. If you are an inmate of a correctional institution or are in the custody of a law-enforcement official, we may disclose your PHI to the correctional institution or law-enforcement official if necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
Research. We may disclose your PHI to researchers when:
1. The individual identifiers have been removed; or
2. When an institutional review board or privacy board has reviewed the research proposal and established protocols to ensure the privacy of the requested information and approves the research.
VI. Required Disclosures
The following is a description of disclosures of your PHI we are required to make.
Government Audits. We are required to disclose your PHI to the Secretary of the United States Department of Health and Human Services when the Secretary is investigating or determining our compliance with the HIPAA privacy rule.
Disclosures to You. When you request, we are required to disclose to you the portion of your PHI that contains medical records, billing records, and any other records used to make decisions regarding your health care benefits. We are also required, when requested, to provide you with an accounting of most disclosures of your PHI if the disclosure was for reasons other than for payment, treatment, or health care operations, and if the PHI was not disclosed pursuant to your individual authorization.
VII. Other Disclosures
Personal Representatives. We will disclose your PHI to individuals authorized by you, or to an individual designated as your personal representative, attorneyin-fact, etc., so long as you provide us with a written notice/authorization and any supporting documents (i.e., power of attorney). Note: Under the HIPAA privacy rule, we do not have to disclose information to a personal representative if we have a reasonable belief that:
1. You have been, or may be, subject to domestic violence, abuse, or neglect by such person; or
2. Treating such person as your personal representative could endanger you; and
3. In the exercise of professional judgment, it is not in your best interest to treat the person as your personal representative.
Spouses and Other Family Members. With only limited exceptions, we will send all mail to the employee. This includes mail relating to the employee’s spouse and other family members who are covered under the Plan and includes mail with information on the use of Plan benefits by the employee’s spouse and other family members and information on the denial of any Plan benefits to the employee’s spouse and other family members. If a person covered under the Plan has requested Restrictions or Confidential Communications (see below under “Your Rights”), and if we have agreed to the request, we will send mail as provided by the request for Restrictions or Confidential Communications.
Authorizations. Other uses or disclosures of your PHI not described above will only be made with your written authorization. For example, in general and subject to specific conditions, we will not use or disclose your psychiatric notes; we will not use or disclose your PHI for marketing; and we will not sell your PHI, unless you give us a written authorization. You may revoke written authorizations at any time, so long as the revocation is in writing. Once we receive your written revocation, it will only be effective for future uses and disclosures. It will not be effective for any information that may have been used or disclosed in reliance upon the written authorization and prior to receiving your written revocation.
VIII. Your Rights
You have the following rights with respect to your PHI:
Right to Inspect and Copy. You have the right to inspect and copy certain PHI that may be used to make decisions about your Plan benefits. If the information you request is maintained electronically, and
you request an electronic copy, we will provide a copy in the electronic form and format you request, if the information can be readily produced in that form and format; if the information cannot be readily produced in that form and format, we will work with you to come to an agreement on form and format. If we cannot agree on an electronic form and format, we will provide you with a paper copy.
To inspect and copy your PHI, you must submit your request in writing. If you request a copy of the information, we may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request.
We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to your medical information, you may request that the denial be reviewed by submitting a written request.
Right to Amend. If you feel that the PHI we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the Plan.
To request an amendment, your request must be made in writing. In addition, you must provide a reason that supports your request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
1. is not part of the medical information kept by or for the Plan;
2. was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
3. is not part of the information that you would be permitted to inspect and copy; or
4. is already accurate and complete.
If we deny your request, you have the right to file a statement of disagreement with us and any future disclosures of the disputed information will include your statement.
Right to an Accounting of Disclosures. You have the right to request an “accounting” of certain disclosures of your PHI. The accounting will not include (1) disclosures for purposes of treatment, payment, or health care operations; (2) disclosures made to you; (3) disclosures made pursuant to your authorization; (4) disclosures made to friends or family in your presence or because of an emergency; (5) disclosures for national security purposes; and (6) disclosures incidental to otherwise permissible disclosures.
To request this list or accounting of disclosures, you must submit your request in writing. Your request must state the time period you want the accounting to cover, which may not be longer than six years before the date of the request. Your request should indicate in what form you want the list (for example, paper or electronic). The first list you request within a 12-month period will be provided free of charge. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Restrictions. You have the right to request a restriction or limitation on your PHI that we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on your PHI that we disclose to someone who is involved in your care or the payment for your care, such as a family member or friend. For example, you could ask that we not use or disclose information about a surgery that you had.
Except as provided in the next paragraph, we are not required to agree to your request. However, if we do agree to the request, we will honor the restriction until you revoke it or we notify you.
We will comply with any restriction request if (1) except as otherwise required by law, the disclosure is to a health plan for purposes of carrying out payment or health care operations (and is not for purposes of carrying out treatment); and (2) the PHI pertains solely to a health care item or service for which the health care provider involved has been paid in full by you or another person.
To request restrictions, you must make your request in writing. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both; and (3) to whom you want the limits to apply-for example, disclosures to your spouse.
Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you must make your request in writing. We will not ask you the reason for your request. Your request must specify how or where you wish to be contacted. We will accommodate all reasonable requests.
Right to Be Notified of a Breach. You have the right to be notified in the event that we (or a Business Associate) discover a breach of unsecured PHI.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
IX. Complaints
If you believe that your privacy rights have been violated, you may file a complaint with the Plan or with the Office for Civil Rights of the United States Department of Health and Human Services. To file a complaint with the Plan, contact the person listed in the Contact Information section of this Notice. All complaints must be submitted in writing.
You will not be penalized, or in any other way retaliated against, for filing a complaint with the Office for Civil Rights or with us.
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage,
using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-
KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www. askebsa.dol.gov or call 1-866-444-EBSA (3272)
If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of January 31, 2026. Contact your State for more information on eligibility.
Alabama – Medicaid
Website: http://www.myalhipp.com/ Phone: 1-855-692-5447
Alaska – Medicaid
The AK Health Insurance Premium Payment Program Website: http://myakhipp.com/ Phone: 1-866-251-4861
Email: CustomerService@MyAKHIPP.com
Medicaid Eligibility: https://health.alaska. gov/dpa/Pages/default.aspx
Arkansas – Medicaid
Website: http://myarhipp.com/ Phone: 1-855-MyARHIPP (855-692-7447)
California– Medicaid
Health Insurance Premium Payment (HIPP) Program Website: http://dhcs.ca.gov/hipp
Phone: 916-445-8322
Fax: 916-440-5676
Email: hipp@dhcs.ca.gov
Colorado – Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus (CHP+)
Health First Colorado website: https://www. healthfirstcolorado.com/ Health First Colorado Member Contact Center: 1-800-221-3943/State Relay 711
CHP+: https://hcpf.colorado.gov/childhealth-plan-plus
CHP+ Customer Service: 1-800-359-1991/ State Relay 711
Health Insurance Buy-In Program (HIBI): https://www.mycohibi.com/
HIBI Customer Service: 1-855-692-6442
Florida – Medicaid
Website: https://www.flmedicaidtplrecovery. com/flmedicaidtplrecovery.com/hipp/index. html
Phone: 1-877-357-3268
Georgia – Medicaid
GA HIPP Website: https://medicaid.georgia. gov/health-insurance-premium-paymentprogram-hipp
Phone: 678-564-1162, Press 1
GA CHIPRA Website: https://medicaid. georgia.gov/programs/third-party-liability/ childrens-health-insurance-programreauthorization-act-2009-chipra Phone: 678-564-1162, Press 2
Indiana – Medicaid
Health Insurance Premium Payment Program
All other Medicaid
Website: https://www.in.gov/medicaid/ http://www.in.gov/fssa/dfr/ Family and Social Services Administration Phone: 1-800-403-0864
Member Services Phone: 1-800-457-4584
Iowa – Medicaid and CHIP (Hawki)
Medicaid Website: https://hhs.iowa.gov/ programs/welcome-iowa-medicaid
Medicaid Phone: 1-800-338-8366
Hawki Website: https://hhs.iowa.gov/ programs/welcome-iowa-medicaid/iowahealth-link/hawki
Hawki Phone: 1-800-257-8563
HIPP Website: https://hhs.iowa.gov/ programs/welcome-iowa-medicaid/feeservice/hipp
HIPP Phone: 1-888-346-9562
Kansas – Medicaid
Website: https://www.kancare.ks.gov/ Phone: 1-800-792-4884
HIPP Phone: 1-800-967-4660
Kentucky – Medicaid
Kentucky Integrated Health Insurance Premium Payment Program (KI-HIPP)
Website: https://chfs.ky.gov/agencies/dms/ member/Pages/kihipp.aspx
Phone: 1-855-459-6328
Email: KIHIPP.PROGRAM@ky.gov
KCHIP Website: https://kynect.ky.gov Phone: 1-877-524-4718
Kentucky Medicaid Website: https://chfs. ky.gov/agencies/dms
Louisiana – Medicaid
Louisiana Medicaid Website: https://www. ldh.la.gov/healthy-louisiana
Medicaid Customer Service Line: 1-888342-6207
Louisiana Medicaid email: healthy@la.gov
Louisiana Health Insurance Premium Program (LaHIPP) Website: https://www.ldh. la.gov/lahipp
LaHIPP phone: 1-877-697-6703
LaHIPP email: La.HIPP@la.gov
LaHIPP fax: 1-888-716-9787
LaHIPP mailing address: 100 Crescent Centre Parkway, Suite 1000 Tucker, GA 30084
Maine – Medicaid
Enrollment Website: https://www. mymaineconnection.gov/benefits/ s/?language=en_US
Phone: 1-800-442-6003
TTY: Maine relay 711
Private Health Insurance Premium
Webpage: https://www.maine.gov/dhhs/ofi/ applications-forms
Phone: 1-800-977-6740
TTY: Maine Relay 711
Massachusetts – Medicaid and CHIP
Website: https://www.mass.gov/masshealth/ pa
Phone: 1-800-862-4840
TTY: 711
Email: masspremassistance@accenture.com
Minnesota – Medicaid
Website: https://mn.gov/dhs/health-carecoverage/
Phone: 1-800-657-3672
Missouri – Medicaid
Website: http://www.dss.mo.gov/mhd/ participants/pages/hipp.htm
Phone: 573-751-2005
Montana – Medicaid
Website: https://dphhs.mt.gov/ MontanaHealthcarePrograms/HIPP
Phone: 1-800-694-3084
Email: HHSHIPPProgram@mt.gov
Nebraska – Medicaid
Website: http://www.ACCESSNebraska. ne.gov
Phone: 1-855-632-7633
Lincoln: 402-473-7000
Omaha: 402-595-1178
Nevada – Medicaid
Medicaid Website: http://dhcfp.nv.gov
Medicaid Phone: 1-800-992-0900
New Hampshire – Medicaid
Website: https://www.dhhs.nh.gov/ programs-services/medicaid/healthinsurance-premium-program
Phone: 603-271-5218
Toll free number for the HIPP program: 1-800-852-3345, ext. 15218
Email: DHHS.ThirdPartyLiabi@dhhs.nh.gov
New Jersey – Medicaid and CHIP
Medicaid Website: http://www.state.nj.us/ humanservices/dmahs/clients/medicaid/ Phone: 1-800-356-1561
CHIP Premium Assistance Phone: 609-6312392
CHIP Website: http://www.njfamilycare.org/ index.html
CHIP Phone: 1-800-701-0710 (TTY: 711)
New York – Medicaid
Website: https://www.health.ny.gov/health_ care/medicaid/ Phone: 1-800-541-2831
North Carolina – Medicaid
Website: https://medicaid.ncdhhs.gov Phone: 919-855-4100
North Dakota – Medicaid
Website: https://www.hhs.nd.gov/ healthcare Phone: 1-844-854-4825
Oklahoma – Medicaid and CHIP
Website: http://www.insureoklahoma.org Phone: 1-888-365-3742
Oregon – Medicaid
Website: https://healthcare.oregon.gov/ Pages/index.aspx
Phone: 1-800-699-9075
Pennsylvania – Medicaid and CHIP
Website: https://www.pa.gov/en/services/ dhs/apply-for-medicaid-health-insurancepremium-payment-program-hipp.html
Phone: 1-800-692-7462
CHIP Website: https://www.dhs.pa.gov/chip/ pages/chip.aspx
CHIP Phone: 1-800-986-KIDS (5437)
Rhode Island – Medicaid and CHIP
Website: http://www.eohhs.ri.gov/
Phone: 1-855-697-4347 or 401-462-0311
(Direct RIte Share Line)
South Carolina – Medicaid
Website: https://www.scdhhs.gov
Phone: 1-888-549-0820
South Dakota - Medicaid
Website: https://dss.sd.gov
Phone: 1-888-828-0059
Texas – Medicaid
Website: https://www.hhs.texas.gov/ services/financial/health-insurancepremium-payment-hipp-program
Phone: 1-800-440-0493
Utah – Medicaid and CHIP
Utah’s Premium Partnership for Health Insurance (UPP) Website: https://medicaid. utah.gov/upp/ Email: upp@utah.gov
Phone: 1-888-222-2542
Adult Expansion Website: https://medicaid. utah.gov/expansion/ Utah Medicaid Buyout Program Website: https://medicaid.utah.gov/buyout-program/ CHIP Website: https://chip.utah.gov/
Vermont– Medicaid
Website: https://dvha.vermont.gov/ members/medicaid/hipp-program Phone: 1-800-250-8427
Virginia – Medicaid and CHIP
Website: https://coverva.dmas.virginia.gov/ learn/premium-assistance/famis-select https://coverva.dmas.virginia.gov/learn/ premium-assistance/health-insurancepremium-payment-hipp-programs Medicaid/CHIP Phone: 1-800-432-5924
Washington – Medicaid
Website: https://www.hca.wa.gov/ Phone: 1-800-562-3022
West Virginia – Medicaid and CHIP
Website: https://dhhr.wv.gov/bms/ http://mywvhipp.com/
Medicaid Phone: 304-558-1700
CHIP Toll-free phone: 1-855-MyWVHIPP (1-855-699- 8447)
Wisconsin – Medicaid and CHIP
Website: https://www.dhs.wisconsin.gov/ badgercareplus/p-10095.htm
Phone: 1-800-362-3002
Wyoming – Medicaid
Website: https://health.wyo.gov/ healthcarefin/medicaid/programs-andeligibility/
Phone: 1-800-251-1269
To see if any other States have added a premium assistance program since January 31, 2026, or for more information on special enrollment rights, can contact either:
U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272)
U.S. Department of Health and Human Services
Centers for Medicare & Medicaid Services www.cms.hhs.gov
1-877-267-2323, Menu Option 4, Ext. 61565
Continuation of Coverage Rights Under COBRA
Under the Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), if you are covered under the Amerapex Corporation group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Amerapex Corporation 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
Amerapex Corporation Human Resources 2950 N Loop West, Suite 1100 Houston TX 77092 713-263-0900
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-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-ofpocket 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-of-network provider.
You are protected from balance billing for:
z Emergency services – If you have an emergency medical condition and get emergency services from an out-ofnetwork provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
z 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 innetwork facilities, out-of-network providers cannot balance bill you, unless you give written consent and give up your protections.
You are never required to give up your protections from balance billing. You also are not required to get care out-ofnetwork. You can choose a provider or facility in your plan’s network.
When balance billing is not allowed, you also have the following protections:
z You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was innetwork). Your health plan will pay out-of-network providers and facilities directly.
z Your health plan generally must:
» Cover emergency services without requiring you to get approval for services in advance (prior authorization).
» Cover emergency services by outof-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-ofpocket costs, but only if your employer does not offer coverage, or offers coverage that is not considered affordable for you and doesn’t meet certain minimum value standards (discussed below). The savings on your premium that you’re eligible for depends on your household income. You may also be eligible for a tax credit that lowers your costs.
Does Employment-Based Health Coverage Affect Eligibility for Premium Savings through the Marketplace?
Yes. If you have an offer of health coverage from your employer that is considered affordable for you and meets certain minimum value standards, you will not be eligible for a tax credit, or advance payment of the tax credit, for your Marketplace coverage and may wish to enroll in your employment-based health plan. However, you may be eligible for a tax credit, and advance payments of the credit that lowers your monthly premium,
or a reduction in certain cost-sharing, if your employer does not offer coverage to you at all or does not offer coverage that is considered affordable for you or meet minimum value standards. If your share of the premium cost of all plans offered to you through your employment is more than 9.12%1 of your annual household income, or if the coverage through your employment does not meet the “minimum value” standard set by the Affordable Care Act, you may be eligible for a tax credit, and advance payment of the credit, if you do not enroll in the employment-based health coverage. For family members of the employee, coverage is considered affordable if the employee’s cost of premiums for the lowest-cost plan that would cover all family members does not exceed 9.12% of the employee’s household income.1, 2
Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered through your employment, then you may lose access to whatever the employer contributes to the employment-based coverage. Also, this employer contribution -as well as your employee contribution to employment-based coverage- is generally excluded from income for federal and state income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis. In addition, note that if the health coverage offered through your employment does not meet the affordability or minimum value standards, but you accept that coverage anyway, you will not be eligible for a tax credit. You should consider all of these factors in determining whether to purchase a health plan through the Marketplace.
When Can I Enroll in Health Insurance Coverage through the Marketplace?
You can enroll in a Marketplace health insurance plan during the annual Marketplace Open Enrollment Period. Open Enrollment varies by state but generally starts November 1 and continues through at least December 15.
Outside the annual Open Enrollment Period, you can sign up for health insurance if you qualify for a Special Enrollment Period. In general, you qualify
for a Special Enrollment Period if you’ve had certain qualifying life events, such as getting married, having a baby, adopting a child, or losing eligibility for other health coverage. Depending on your Special Enrollment Period type, you may have 60 days before or 60 days following the qualifying life event to enroll in a Marketplace plan.
There is also a Marketplace Special Enrollment Period for individuals and their families who lose eligibility for Medicaid or Children’s Health Insurance Program (CHIP) coverage on or after March 31, 2023, through July 31, 2024. Since the onset of the nationwide COVID-19 public health emergency, state Medicaid and CHIP agencies generally have not terminated the enrollment of any Medicaid or CHIP beneficiary who was enrolled on or after March 18, 2020, through March 31, 2023. As state Medicaid and CHIP agencies resume regular eligibility and enrollment practices, many individuals may no longer be eligible for Medicaid or CHIP coverage starting as early as March 31, 2023. The U.S. Department of Health and Human Services is offering a temporary Marketplace Special Enrollment period to allow these individuals to enroll in Marketplace coverage.
Marketplace-eligible individuals who live in states served by HealthCare.gov and either- submit a new application or update an existing application on HealthCare. gov between March 31, 2023 and July 31, 2024, and attest to a termination date of Medicaid or CHIP coverage within the same time period, are eligible for a 60-day Special Enrollment Period. That means that if you lose Medicaid or CHIP coverage between March 31, 2023, and July 31, 2024, you may be able to enroll in Marketplace coverage within 60 days of when you lost Medicaid or CHIP coverage. In addition, if you or your family members are enrolled in Medicaid or CHIP coverage, it is important to make sure that your contact information is up to date to make sure you get any information about changes to your eligibility. To learn more, visit www.HealthCare.gov or call the Marketplace Call Center at 1-800-3182596. 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, but if you and your family lost eligibility for Medicaid or CHIP coverage between March 31, 2023 and July 10, 2023, you can request this special enrollment in the employment-based health plan through September 8, 2023. Confirm the deadline with your employer or your employmentbased 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/gettingmedicaid-chip/ for more details.
How Can I Get More Information?
The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit www.HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area.
PART B: Information About Health Coverage Offered by Your Employer
This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application.
3. Employer Name: Amerapex Corporation
4. Employer Identification Number (EIN): 47-0873598
5. Employer Address: 2950 N Loop West, Suite 1100 Houston TX 77092
6. Employer Phone Number: 713-263-0900
7. City: Houston
8. State: TX 9. ZIP Code: 77092
10. Who can we contact at this job?: Lauren Gutfranski lgutfranski@amerapex.com
11. Phone Number (if different from above): N/A
12. E-Mail Address: HR@amerapex.com
You are not eligible for health insurance coverage through this employer. You and your family may be able to obtain health coverage through the Marketplace, with a new kind of tax credit that lowers your monthly premiums and with assistance for out-of-pocket costs.
1 Indexed annually; see https://www.irs.gov/pub/irsdrop/rp-22-34.pdf for 2023.
2 An employer-sponsored or other employmentbased 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 Amerapex Corporation 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. Amerapex Corporation reserves the right to change or discontinue its employee benefits plans anytime.