Welcome
We are pleased to offer a full benefits package to help protect your well-being and financial health. Read this guide to learn about the benefits available to you and your eligible dependents.
Each year during Open Enrollment (OE), you may make changes to your benefit plans. The benefit choices you make this year will remain in effect from January 1 through December 31, 2026. Take time to review these benefit options and select the plans that best meet your needs.
After Open Enrollment, you may only make changes to your benefit elections if you have a Qualifying Life Event (QLE).
Eligibility
You are eligible for benefits if you are an active, full-time employee working an average of 30 or more hours per week. If you are a new hire, your coverage is effective on your date of hire.
You may also enroll eligible dependents for benefits coverage. The cost for coverage depends on the number of dependents you enroll and the benefits you choose. When covering dependents, you must select and be on the same plans.
Eligible Dependents
• Your legal spouse or domestic partner
• Children under the age of 26 regardless of student, dependency, or marital status
• Children over the age of 26 who are fully dependent on you for support due to a mental or physical disability, and who are indicated as such on your federal tax return
Availability of Summary Health Information
Your benefits program offers two medical plan coverage options. To help you make an informed choice and compare your options, Summary of Benefits and Coverage (SBC) documents are available in UKG via the member portal at https://baylorgenetics.ultipro.com or by contacting Human Resources.
Qualifying Life Events
Once you elect your benefit options, they remain in effect for the entire plan year until the following OE. You may only change coverage during the plan year if you have a QLE, some of which include:
• Marriage, divorce, legal separation, or annulment
• Birth, adoption, or placement for adoption of an eligible child
• Death of your spouse or child
• Change in your spouse’s employment status that affects benefits eligibility
• Change in your child’s eligibility for benefits
• Significant change in benefit plan coverage for you, your spouse, or your child
• FMLA event, COBRA event, judgment, or decree
• Becoming eligible for Medicare, Medicaid, or TRICARE
• Receiving a Qualified Medical Child Support Order
If you have a QLE and want to change your elections, you must notify Human Resources and complete your changes within 30 days of the event . You may be asked to provide documentation to support the change. Contact Human Resources for specific details.
Helpful Resources
Employee Care Advocate
Employee benefits can be complicated. The Higginbotham Employee Care Advocate can assist you with the following:
• Enrollment
• Benefits information
• Claims or billing questions
• Eligibility issues
Call or text
866-949-2645 to speak with a representative 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. You can also email questions or requests to baylorgenetics@eb.higginbotham.net Bilingual representatives are available.
Medical Coverage
The medical plan options through UnitedHealthcare (UHC) protect you and your family from major financial hardship in the event of illness or injury. You have a choice of two plans:
• Choice EPO Copay Plan
• Choice Plus HDHP/HSA Plan
Exclusive Provider Organization
With an Exclusive Provider Organization (EPO) plan, you must only see in-network providers for your care. With the exception of a true emergency, benefits are only payable if you go to UHC Choice Network providers or facilities for care. If you go to an out-of-network provider or facility, you will be responsible for all costs. You do not have to select a primary care physician or get a referral to see a specialist. Always confirm that your doctors and specialists are in-network before seeking care.
High Deductible Health Plan
A High Deductible Health Plan (HDHP) allows you to see any provider when you need care, but you will pay less for care when you go to UHC Choice Plus Network providers. In exchange for a lower per-paycheck cost for medical benefits, you must satisfy a higher plan deductible that applies to almost all health care expenses, including prescription drugs. If you enroll in the HDHP, you may be eligible to open a Health Savings Account (HSA) (see page 10).
If you are Medicare eligible, please reach out to Boomer Benefits at 817-249-8600 or visit their website at https://boomerbenefits.com/higginbotham. Boomer Benefits has dedicated client service representatives for all your Medicare needs. They can assist with quotes for Medicare Supplements, Medicare Advantage plans, and Part D drug analysis and quotes. They can also help guide you through the Medicare enrollment process, as well as any analysis needed, when comparing your group benefits to Medicare.
myUHC.com
myUHC.com is the secure UHC member website where you can:
• Find and estimate the cost for care
• Check claim status or history
• Review plan balances
• Print Explanation of Benefits (EOB) forms
• Locate in-network providers and pharmacies
• Order prescriptions To get started, log on to www.myuhc.com and use the information on your ID card to complete the registration process. You can also download the mobile app for onthe-go access from anywhere.
Find an In-Network Provider
• Visit www.myuhc.com
• Choice EPO Copay Plan – Choice Network
• Choice Plus HDHP/HSA Plan – Choice Plus Network
• Call 866-633-2446
Medical Plans
Your Per-Pay-Period Costs (24 pay periods)
1Embedded: All
2
3The
Copay
2026,
Virtual Visits
Your medical coverage offers telemedicine services through UHC 24/7 Virtual Visits. Connect anytime day or night with a board-certified doctor via your mobile device or computer.
While 24/7 Virtual Visits does not replace your primary care physician, it provides a convenient and cost-effective option when you need care and:
• Have a non-emergency issue and are considering an afterhours health care clinic, urgent care clinic, or emergency room for treatment
• Are on a business trip, vacation, or away from home
• Are unable to see your primary care physician
When to Use Virtual Visits
Use Virtual Visits for minor conditions such as:
• Sore throat
• Headache
• Stomachache
• Cold
• Flu
• Allergies
• Fever
• Urinary tract infections
Do not use Virtual Visits for serious or life-threatening emergencies.
Visit with a Doctor 24/7 Anytime, Anywhere.
• Visit – www.myuhc.com/virtualvisits
• Call – 855-615-8335
• Download – UnitedHealthcare app
Health Care Options
Becoming familiar with your options for medical care can save you time and money.
NON-EMERGENCY CARE
Access to care via phone, online video, or mobile app whether you are home, work, or traveling; medications can be prescribed
VIRTUAL VISITS
24 hours a day, 7 days a week
Generally, the best place for routine preventive care; established relationship; able to treat based on medical history
DOCTOR’S OFFICE
RETAIL CLINIC
Office hours vary
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
• Allergies
• Cough/cold/flu
• Rash
• Stomachache
URGENT CARE
EMERGENCY CARE
When you need immediate attention; walk-in basis is usually accepted
Generally includes evening, weekend, and holiday hours
• Infections
• Sore and strep throat
• Vaccinations
• Minor injuries/sprains/ strains
HOSPITAL ER
Life-threatening or critical conditions; trauma treatment; multiple bills for doctor and facility
24 hours a day, 7 days a week
Services do not include trauma care; can look similar to an urgent care center, but medical bills may be 10 times higher
• Common infections
• Minor injuries
• Pregnancy tests
• Vaccinations
• Sprains and strains
• Minor broken bones
• Small cuts that may require stitches
• Minor burns and infections
• Chest pain
• Difficulty breathing
• Severe bleeding
• Blurred or sudden loss of vision
• Major broken bones
• Most major injuries except trauma
• Severe pain
FREESTANDING ER
24 hours a day, 7 days a week
2-5 minutes
15-20 minutes
15 minutes
15-30 minutes
Minimal
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.
UHC Wellness Programs
The following UHC wellness programs are included with your medical coverage and are available to you and your eligible dependents at no additional cost.
One Pass Select
One Pass Select offers a low-cost nationwide gym membership — including digital fitness. Get access to gyms, studios, online workouts, and even grocery delivery with one monthly membership.
• There are no long-term contracts or annual gym registration fees
• You can change your subscription or add family members (ages 18+) anytime
Use your UHC Rewards dollars toward your One Pass Select subscription.
Calm Health App
The Calm Health app is designed to support your mental health and well-being at your own pace. The app starts with a short mental health screening so it can suggest a tailored program of content and tools created by psychologists to help you meditate, improve focus, move mindfully, and feel calm. You can set your own pace and track your progress along the way.
Download the Calm Health app to get started. You first need to sign into your account on www.myuhc.com or the UnitedHealthcare app
Real Appeal
Real Appeal is a free digital program that provides up to a full year of support for lasting weight loss, including:
• A personal transformation coach to offer step-by-step guidance and customization for a program that fits your needs, preferences, and goals
• 24/7 convenience through online access to food, activity and goal trackers, group classes, and expert health tips
Find a Gym Near You
Go to www.onepassselect.com to find a gym near you.
Gym partners include Anytime Fitness, Crunch, LA Fitness, Life Time, Orangetheory, and CrossFit.
UHC Telemedicine
UHC offers two options for telemedicine.
• Virtual primary care – Get an annual wellness visit, regular follow-ups for ongoing conditions, preventive screenings, and prescriptions for the same price as your regular doctor.
• 24/7 Virtual Visits – Get nonemergency care for everything from flu and pinkeye to anxiety and migraines, including prescription refills, as needed, for the same price or less than your regular doctor.
Get started at www.myuhc.com/virtualcare or via the UnitedHealthcare app
• A Success Kit to help kickstart your weight loss journey and keep you on the road to results
To get started, join today at www.realappeal.com, or scan this code.
Wellness Discounts
UHC makes it easier to get healthier with a new shop that provides discounts on health and wellness items from brands you may know. Visit the UHC Store to find offerings for all of this and more:
• Fitness
• Nutrition
• Women’s health
• Sleep
Visit www.myuhc.com.
• Weight loss
• Coaching
Wellos Wellness Program
Wellos is a no-cost digital wellness app from UnitedHealthcare designed to help you build healthier habits at your own pace. With Wellos, eligible members get daily tracking, personalized content, 5,000+ recipes, mini challenges, and optional coaching. Whether your goal is better nutrition, emotional well-being, or weight management, Wellos adapts to your progress and gives you tools, insights, and encouragement to stay motivated.
Visit www.wellos.com/member
Download the Wellos: Health Transformation app
Quit for Life
The Quit for Life program is available to help meet your goal of becoming tobacco free. This program provides the support you need to quit the way you want.
• Online Support – Get access to a website with an action plan and quit guide to help you beat urges, manage withdrawal, and switch your habits to avoid tobacco.
• Quit for Life Mobile App – 24/7 urge management support plus on-the-go access to your program. Download the app through your mobile device’s app store.
• Quit Smoking Medication – You may be eligible for medications to help you quit.
• Live Tobacco-Free Course – Participate in an online quit tobacco course at your own pace and gain knowledge and skills to help you quit and stay on track.
Visit www.myuhc.com to enroll.
Biometric Screening
Learn your numbers for blood pressure, glucose, cholesterol, weight, and more to help your health and receive $50 with UHC Rewards. You can get an at-home screening, complete the screening at one of many lab locations, or go to your doctor or clinic and then send in the screening form.
HOW TO GET STARTED
1. Sign in on the UnitedHealthcare app.
2. Go to the Menu tab and select UHC Rewards.
3. Scroll to Available activities and select See all.
4. Select Biometric screening and then Get started.
UHC Rewards Program
UHC Rewards is replacing the SimplyEngaged program. Under this new rewards program, you can earn up to $300 for taking steps toward a healthier you. A variety of actions lead to rewards – some of which you may already be doing on a daily or weekly basis. Here are just a few ways you can earn through UHC Rewards:
• Take a health survey – $15
• Connect a tracker – $25
• Get an annual checkup – $25
• Get a biometric screening – $50
Personalize your experience by selecting activities that are right for you. Get the UnitedHealthcare app or go to www.myuhc.com to register and select UHC Rewards.
Employee Assistance Program
Available only to UHC medical plan participants. For the company-wide program open to all employees, see page 21.
The Employee Assistance Program (EAP) from UHC helps you and family members cope with a variety of personal or workrelated issues. This program provides confidential counseling and support services at little or no cost to you to help with:
• Relationships
• Work-life balance
• Stress and anxiety
• Grief and loss
• Legal and financial concerns
Call 888-887-4114 for support at any hour of the day or night.
Vital Medication Program
This new program can help to reduce or eliminate your costs on certain medications. Prescription drugs that may qualify for discounts include but are not limited to: Insulin, Epinephrine, Glucagon, Naloxone, and Albuterol.
To see if you’re eligible for reduced or no out-of-pocket costs on preferred insulins and certain other prescription drugs, sign in to www.myuhc.com/rx .
Health Savings Account
An HSA is more than a way to help you and your family cover current medical costs — it is also a tax-exempt tool to supplement your retirement savings and to cover future health costs. HealthEquity is our HSA plan administrator.
An HSA is a type of personal savings account that is always yours even if you change health plans or jobs. The money in your HSA (including interest and investment earnings) grows tax-free and spends tax-free if used to pay for current or future qualified medical expenses. There is no “use it or lose it” rule — you do not lose your money if you do not spend it in the calendar year — and there are no vesting requirements or forfeiture provisions. The account automatically rolls over year after year.
HSA Eligibility
You are eligible to open and contribute to an HSA if you are:
• Enrolled in an HSA-eligible HDHP (Choice Plus HDHP/ HSA plan)
• Not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan
• Not enrolled in a Health Care Flexible Spending Account (FSA)
• Not eligible to be claimed as a dependent on someone else’s tax return
• Not enrolled in Medicare, Medicaid, or TRICARE
• Not receiving Veterans Administration benefits
You can also use HSA funds to pay health care expenses for your dependents even if they are not covered by the HDHP.
Maximum Contributions
Your HSA contributions may not exceed the annual maximum amount established by the IRS. The 2026 annual contribution maximum is based on the coverage option you elect:
• Individual – $4,400
• Family (filing jointly) – $8,750
You decide whether to use the money in your account to pay for qualified expenses or let it grow for future use. If you are age 55 or older, you may make a yearly catch-up contribution of up to $1,000 to your HSA. If you turn 55 at anytime during the plan year, you are eligible to make the catch-up contribution for the entire plan year.
Opening an HSA
If you meet the eligibility requirements, you may open an HSA administered by HealthEquity. You will receive a debit card to manage your HSA account reimbursements. Keep in mind, available funds are limited to the balance in your HSA. To open an account, go to www.healthequity.com
Important HSA Information
• Always ask your in-network doctor to file claims with your medical, dental, or vision carrier so you will get the highest level of benefits. You can pay the doctor with your HSA debit card for any balance due.
• You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.
• You may open an HSA at the financial institution of your choice, but only accounts opened through HealthEquity are eligible for automatic payroll deduction.
Health Reimbursement Arrangement
Baylor Genetics provides a Health Reimbursement Arrangement (HRA) to support employees on their familybuilding journey by helping offset out-of-pocket fertility health care costs. An HRA is an employer-funded account provided for you if you enroll in one of our UHC medical plans. Higginbotham is our HRA plan administrator.
How the HRA Works
• Your HRA is funded entirely through Baylor Genetics contributions.
• You must be enrolled in a company-sponsored UHC medical plan to receive the funds.
• You can use your HRA to pay for a qualified fertility expense if it is not reimbursed from another source (e.g., another group health insurance plan, or if you take a tax deduction for those expenses). Fertility expenses that may be covered include:
• In vitro fertilization (IVF)
• Egg or sperm freezing
• Egg or sperm donor expenses
• Intrauterine insemination (IUI)
• Pre-implantation genetic testing (PGT)
• Embryo transfer
• Hysterosalpingogram
• Hysteroscopy
• There is a $15,000 lifetime maximum for HRA reimbursement.
Review your plan documents for full details.
Submitting a Claim
Submit your Explanation of Benefits (EOB) along with the Higginbotham Claim (available online at https://flexservices.higginbotham.net).
• Email – flexclaims@higginbotham.net
• Online – https://flexservices.higginbotham.net
• Fax – 866-419-3516
Call 866-419-3519 if you have questions or need more information.
Dental Coverage
Our dental plan helps you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work. Coverage is provided through UHC .
DPPO Plan
Two levels of benefits are available with the DPPO plan: innetwork 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.
Find an In-Network Dentist
• Call 866-633-2446
• Visit www.myuhc.com, search the dental directory by your ZIP code, and select the National Options PPO 30 provider network.
Dental Plan Summary
1Payment for covered services received from an out-of-network dentist is based on the 90th percentile of Usual, Customary and Reasonable (UCR) charges.
2The amount you pay after deductible. Refer to the UnitedHealthcare Patient Charge schedule for details.
In 2026, benefit deductions will be taken from the first two paychecks of each month only. If a month includes a third paycheck, no deduction will occur on that check. Rates reflect this 24-pay-period schedule, though the overall pay schedule remains the same.
Additional Wellness Services
Our dental plan includes additional oral wellness benefits, including:
• Enhanced prenatal care
• Oral cancer screenings
• Teledentistry clinical consultations 24/7 up to two times a year
• Access to the Discount and Rewards marketplace at www.uhc.com/benefithub Visit www.myuhc.com for full details and information.
Vision Coverage
Our vision plan offers quality care to help preserve your health and eyesight. Regular exams can detect certain medical issues such as diabetes and high cholesterol, in addition to vision and eye problems. You may seek care from any vision provider, but the plan will pay the highest level of benefits when you see an in-network provider. Coverage is provided by UHC using the UHC Vision network.
Find an In-Network Vision Provider
Visit www.myuhcvision.com or call 800-638-3120
Vision Benefits Summary
Your Per-Pay-Period Cost (24 pay periods)
Flexible Spending Account
An FSA allows you to set aside pretax dollars from each paycheck to pay for certain IRS-approved health care expenses. You must use the funds in your FSA during the plan year; they do not carry over (this is the “use it or lose it” rule). HealthEquity administers our FSAs.
Health Care FSA
The Health Care FSA covers qualified medical, dental, and vision expenses for you or your eligible dependents. You may contribute up to $3,400 annually to a Health Care FSA and you are entitled to the full election from day one of your plan year. Eligible expenses include:
• Dental and vision expenses
• Medical deductibles and coinsurance
• Prescription copays
• Hearing aids and batteries
You may not contribute to a Health Care FSA if you enrolled in an HDHP and contribute to an HSA.
How the Health Care FSA Works
You can access the funds in your Health Care FSA two different ways:
• Use your FSA debit card to pay for qualified expenses, doctor visits, and prescription copays.
• Pay out-of-pocket and submit your receipts for reimbursement online at www.healthequity.com or from the app.
Important FSA Rules
• The maximum per plan year you can contribute to a Health Care FSA is $3,400.
• You cannot change your election during the year unless you experience a QLE.
Dependent Care FSA
The Dependent Care FSA helps pay for expenses associated with caring for elder or child dependents so you or your spouse can work or attend school full-time. You can use the account to pay for daycare or babysitter expenses for your children under age 13 and qualifying older dependents, such as dependent parents. Reimbursement from your Dependent Care FSA is limited to the total amount deposited in your account at that time. To be eligible, you (and your spouse, if married) must be gainfully employed, looking for work, a full-time student, or incapable of self-care. For 2026, the maximum contribution to a Dependent Care FSA (DCFSA) is $7,500 per household for those filing as single or married filing jointly, and $3,750 for those married and filing separately.
Dependent Care FSA Guidelines
• Overnight camps are not eligible for reimbursement (only day camps can be considered).
• If your child turns 13 midyear, you may only request reimbursement for the part of the year when the child is under age 13.
• You may request reimbursement for care of a spouse or dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self-care.
• The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.
FSA Store
Use your FSA dollars easily at FSAstore.com, where every product is FSA-eligible - no guessing, no receipts. Shop over 2,500 qualified items including everyday health care needs and wellness essentials, and enjoy 24/7 expert support. Plus, get $5 off your first order with code HealthEquity24 at checkout.
Flexible Spending Account (with grace period)
• The grace period is 2 1/2 months which means members have until March 15, 2027 to incur expenses.
• Your Health Care FSA debit card can be used for health care expenses only.
A healthcare FSA lets you use tax-free money to pay for eligible medical, dental, and vision expenses.1 So you spend less on the healthcare you need. FSA paycheck deductions are tax-free too, which helps reduce your taxable income. The more you contribute, the more you save.
Access annual contribution amount on day one.
Pay for your spouse and dependents too.
Enjoy an extra grace period at the end of the plan year to spend your benefit.2
Scan to download the HealthEquity mobile app.
Enrolling in the FSA is Easy
Visit www.healthequity.com
Call 866-346-5800
Download the HealthEquity app
Already enrolled? Set up your account directly in the app. No need to go online.
Spend tax-free on
Abbreviated List of Qualified HSA/FSA Expenses
The products and services listed below are examples of medical expenses eligible for payment under your Health Care FSA or HSA. This list is not all-inclusive; additional expenses may qualify and the items listed are subject to change in accordance with IRS regulations. Please refer to IRS Publication 502 Medical and Dental Expenses at www.irs.gov for a complete description of eligible medical and dental expenses.
• Abdominal supports
• Acupuncture
• Air conditioner (when necessary for relief from difficulty in breathing)
• Alcoholism treatment
• Ambulance
• Anesthetist
• Arch supports
• Artificial limbs
• Autoette (when used for relief of sickness/disability)
• Blood tests
• Blood transfusions
• Braces
• Cardiographs
• Chiropractor
• Contact lenses
• Convalescent home (for medical treatment only)
• Crutches
• Dental treatment
• Dental X-rays
• Dentures
• Dermatologist
• Diagnostic fees
• Diathermy
• Drug addiction therapy
• Drugs (prescription)
• Elastic hosiery (prescription)
• Eyeglasses
• Fees paid to health institute
prescribed by a doctor
• FICA and FUTA tax paid for medical care service
• Fluoridation unit
• Guide dog
• Gum treatment
• Gynecologist
• Healing services
• Hearing aids and batteries
• Hospital bills
• Hydrotherapy
• Insulin treatment
• Lab tests
• Lead paint removal
• Legal fees
• Lodging (away from home for outpatient care)
• Metabolism tests
• Neurologist
• Nursing (including board and meals)
• Obstetrician
• Operating room costs
• Ophthalmologist
• Optician
• Optometrist
• Oral surgery
• Organ transplant (including donor’s expenses)
• Orthopedic shoes
• Orthopedist
• Osteopath
• Oxygen and oxygen equipment
• Pediatrician
• Physician
• Physiotherapist
• Podiatrist
• Postnatal treatments
• Practical nurse for medical services
• Prenatal care
• Prescription medicines
• Psychiatrist
• Psychoanalyst
• Psychologist
• Psychotherapy
• Radium therapy
• Registered nurse
• Special school costs for the handicapped
• Spinal fluid test
• Splints
• Surgeon
• Telephone or TV equipment to assist the hard-of-hearing
• Therapy equipment
• Transportation expenses (relative to health care)
• Ultraviolet ray treatment
• Vaccines
• Vitamins (if prescribed)
• Wheelchair
• X-rays
Life and AD&D Insurance
Life and Accidental Death and Dismemberment (AD&D) insurance through UHC are important to your financial security, especially if others depend on you for support or vice versa. With Life insurance, you or your beneficiary(ies) can use the coverage to pay off debts such as credit cards, loans, and bills. AD&D coverage provides specific benefits if an accident causes bodily harm or loss (e.g., the loss of a hand, foot, or eye). If death occurs from an accident, 100% of the AD&D benefit would be paid to you or your beneficiary(ies). Life and AD&D coverage amounts reduce to 65% at age 65, and to 50% at age 70.
Basic Life and AD&D
Basic Life and AD&D insurance are provided at no cost to you. You are automatically covered at two times your annual earnings (up to $500,000) for each benefit.
Basic Life and AD&D Available Coverage
• Two times your basic annual earnings to a maximum of $500,000
Voluntary Life and AD&D
You may buy more Life and AD&D insurance for you and your eligible dependents. 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 you may elect coverage for your spouse or children. If you leave the company, you may be able to take the insurance with you.
Voluntary Life and AD&D Available Coverage
Employee
Spouse
Child(ren)
• Increments of one time your annual earnings, up to four times your annual earnings not to exceed $500,000
• New Hire Guaranteed issue $100,000
• Increments of $5,000 up to $100,000 not to exceed 50% of your election
• New Hire Guaranteed issue $20,000
• Increments of $2,000 up to $10,000
• Birth to 14 days - $0
• 14 days to age 26 - $10,000 not to exceed 50% of your election
• New Hire Guaranteed issue $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 at anytime. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%).
Disability Insurance
Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. Baylor Genetics provides Short Term Disability (STD) and Long Term Disability (LTD) insurance at no cost to you through UHC
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.
Short Term Disability
Long Term Disability
LTD insurance pays a percentage of your monthly salary for a covered disability or injury that prevents you from working for more than six months. Benefits begin at the end of an elimination period and continue while you are disabled up to Social Security Normal Retirement Age (SSNRA)
Long Term Disability
*Benefits may not be paid for any condition treated within three months prior to your effective date until you have been covered under this plan for 12 months.
Supplemental Benefits
You and your eligible family members have the opportunity to enroll in additional coverage that complements our traditional health care programs. Health insurance covers medical bills, but if you have an emergency, you may face unexpected out-of-pocket costs such as deductibles, coinsurance, travel expenses, and non-medical expenses.
Accident Insurance
Accident insurance provides affordable protection against a sudden, unforeseen accident. The Accident plan helps offset the direct and indirect expenses resulting from an accident such as copayments, deductibles, ambulance, physical therapy, childcare, rent, and other costs not covered by traditional health plans. The chart below shows only some of the benefits available. See the plan document for full details.
Accident Insurance
Supplemental Benefits
Critical Illness Insurance
Critical Illness insurance helps pay the cost of non-medical expenses related to a covered critical illness or cancer. The plan provides a lump-sum benefit payment to you upon first and second diagnosis of any covered critical illness or cancer. The benefit can help cover expenses such as lost income, out-of-town treatments, special diets, daily living, and household upkeep costs. The chart below shows only some of the benefits available. See the plan document for full details.
Critical Illness Insurance
Alzheimer’s Disease; Full Benefit Cancer; Heart Attack; Stroke; Heart, Kidney or Organ Failure; Heart Transplant; Coronary Artery Bypass
Partial Coverage
Non-invasive cancer, coronary artery disease, Addison’s disease, myasthenia gravis, systemic lupus, systemic sclerosis, Alzheimer’s disease, ALS, Huntington’s disease, multiple sclerosis, Parkinson’s disease
Employee Per-paycheck Contributions
Log in to UKG for the
and
Hospital Indemnity Insurance
Hospital Indemnity insurance through UHC helps you with the high cost of medical care by paying you a cash benefit when you have an inpatient hospital stay. Unlike traditional insurance, which pays a benefit to the hospital or doctor, this plan pays you directly. It is up to you how you want to use the cash benefit. These costs may include meals, travel, childcare or eldercare, deductibles, coinsurance, medication, or time away from work. The chart below shows only some of the benefits available. See the plan document for full details.
Hospital Indemnity Insurance
Employee Assistance Program
The Employee Assistance Program (EAP) offers 24/7 access to confidential support, resources, and no-cost referrals to help you and your family with a range of personal or workplace issues. Get up to three counseling sessions per issue, per year, and pay $0 for the care. You also have unlimited phone support at no additional cost. Master’s-level professionals are available to help with the following:
• Stress/depression
• Financial issues
• Family/relationship issues
• Drug/alcohol abuse
• Grief issues
• Parenting/eldercare
• Legal/financial services
• Other personal concerns
Call or visit online for assistance or to register.
Phone: 800-343-3822 (teen line: 800-334-8336)
Web: www.awpnow.com (Registration code: AWP-BG-6093)
No-Cost Call
The call costs nothing for all Baylor Genetic Employees, regardless of health care coverage.
Confidential
Your personal information is kept completely private in accordance with the law.
Personal Service
Whatever your specific situation, our coordinators can connect you to the right services and specialists.
Available to all full-time Baylor Genetics employees — even those not enrolled in a UHC medical plan!
Pet Insurance
You may buy PetPartners medical insurance for your pet(s) with after-tax payroll deductions.
The My Pet Protection (MPP) plan covers cats and dogs only. The MPP plan offers a choice of reimbursement options (80%) so you can find coverage that best fits your budget. All plans have a $300 deductible and $5,000 maximum annual benefit.
See any veterinary professional for care and get discounts for multiple pets. Coverage includes:
• Accidents
• Illnesses
• Surgeries and hospitalization
• Hereditary and congenital conditions
• Cancer
• Dental diseases
• Behavioral treatments
• Therapeutic diets
• And more
Every policy includes 24/7 access to veterinary experts by phone, chat, and email, and unlimited help for general to urgent care needs via VetHelpline. PetRXExpress is also included to save money on your pet’s prescriptions. Preexisting conditions are not covered.
How To Enroll
You may enroll for pet coverage anytime during the year.
• Visit https://portal.independenceamerican.com/ login?groupNumber=GPPI-00661 (if this is your first time logging in, enter your email then follow the prompts).
• Call 800–956-2495 or email mypolicy@petpartners.com to contact customer care.
Once registered and logged in, you can access deductible, limits, and more within the portal.
Accidents, including poisonings and allergic reactions
Injuries, including cuts, sprains, and broken bones
Common illnesses, including ear infections, vomiting, and diarrhea
Serious/chronic illnesses, including cancer and diabetes
Hereditary and congenital conditions
Surgeries and hospitalization
X-rays, MRIs, and CT scans
Prescription medications and therapeutic diets
Wellness exams
Your Per-Pay-Period Costs (24 deductions)
See page 18
See page 19
See page 20 Pet Insurance
See page 22
In 2026, benefit deductions will be taken from the first two paychecks of each month only. If a month includes a third paycheck, no deduction will occur on that check. Rates reflect this 24-pay-period schedule, though the overall pay schedule remains the same.
Legal Notices
Women’s Health and Cancer Rights Act of 1998
In October 1998, Congress enacted the Women’s Health and Cancer Rights Act of 1998. This notice explains some important provisions of the Act. Please review this information carefully.
As specified in the Women’s Health and Cancer Rights Act, a plan participant or beneficiary who elects breast reconstruction in connection with a mastectomy is also entitled to the following benefits:
• All stages of reconstruction of the breast on which the mastectomy was performed;
• Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
• Prostheses and treatment of physical complications of the mastectomy, including lymphedema.
Health plans must determine the manner of coverage in consultation with the attending physician and the patient. Coverage for breast reconstruction and related services may be subject to deductibles and coinsurance amounts that are consistent with those that apply to other benefits under the plan.
Special Enrollment Rights
This notice is being provided to ensure that you understand your right to apply for group health insurance coverage. You should read this notice even if you plan to waive coverage at this time.
Loss of Other Coverage or Becoming Eligible for Medicaid or a state Children’s Health Insurance Program (CHIP)
If you are declining coverage for yourself or your dependents because of other health insurance or group health plan coverage, you may be able to later enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must enroll within 31 days after your or your dependents’ other coverage ends (or after the employer that sponsors that coverage stops contributing toward the other coverage).
If you or your dependents lose eligibility under a Medicaid plan or CHIP, or if you or your dependents become eligible for a subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents in this plan. You must provide notification within 60 days after you or your dependent is terminated from, or determined to be eligible for, such assistance.
Marriage, Birth or Adoption
If you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must enroll within 31 days after the marriage, birth, or placement for adoption.
For More Information or Assistance
To request special enrollment or obtain more information, contact:
Baylor Genetics hr-support@baylorgenetics.com
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 Baylor Genetics and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to enroll in a Medicare drug plan. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
If neither you nor any of your covered dependents are eligible for or have Medicare, this notice does not apply to you or the dependents, as the case may be. However, you should still keep a copy of this notice in the event you or a dependent should qualify for coverage under Medicare in the future. Please note, however, that later notices might supersede this notice.
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage through a Medicare Prescription Drug Plan or a Medicare Advantage Plan that offers prescription drug coverage. All Medicare prescription drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
2. Baylor Genetics has determined that the prescription drug coverage offered by the Baylor Genetics 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 Baylor Genetics 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 Baylor Genetics 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 hr-support@ baylorgenetics.com.
NOTE: You will receive this notice annually and at other times in the future, such as before the next period you can enroll in Medicare prescription drug coverage and if this coverage changes. You may also request a copy.
For more information about your options under Medicare prescription drug coverage:
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You will get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. For more information about Medicare prescription drug coverage:
• Visit www.medicare.gov.
• Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help.
• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 877-486-2048.
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. Information about this extra help is available from the Social Security Administration (SSA) online at www.socialsecurity.gov, or you can call them at 800-772-1213. TTY users should call 800-3250778.
Remember: Keep this Creditable Coverage notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty).
January 1, 2026
Baylor Genetics hr-support@baylorgenetics.com
Notice of HIPAA Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) imposes numerous requirements on employer health plans concerning the use and disclosure of individual health information. This information known as protected health information (PHI), includes virtually all individually identifiable health information held by a health plan – whether received in writing, in an electronic medium or as oral communication. This notice describes the privacy practices of the Employee Benefits Plan (referred to in this notice as the Plan), sponsored by Baylor Genetics, hereinafter referred to as the plan sponsor.
The Plan is required by law to maintain the privacy of your health information and to provide you with this notice of the Plan’s legal duties and privacy practices with respect to your health information. It is important to note that these rules apply to the Plan, not the plan sponsor as an employer. You have the right to inspect and copy protected health information which is maintained by and for the Plan for enrollment, payment, claims and case management. If you feel that protected health information about you is incorrect or incomplete, you may ask the Human Resources Department to amend the information. For a full copy of the Notice of Privacy Practices describing how protected health information about you may be used and disclosed and how you can get access to the information, contact the Human Resources Department.
Complaints: If you believe your privacy rights have been violated, you may complain to the Plan and to the Secretary of Health and Human Services. You will not be retaliated against for filing a complaint. To file a complaint, please contact the Privacy Officer.
Baylor Genetics hr-support@baylorgenetics.com
Conclusion
PHI use and disclosure by the Plan is regulated by a federal law known as HIPAA (the Health Insurance Portability and Accountability Act). You may find these rules at 45 Code of Federal Regulations Parts 160 and 164. The Plan intends to comply with these regulations. This Notice attempts to summarize the regulations. The regulations will supersede any discrepancy between the information in this Notice and the regulations.
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.
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 July 31, 2025. 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: 1-800-2213943/State Relay 711
CHP+: https://hcpf.colorado.gov/child-health-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/healthinsurance-premium-payment-program-hipp Phone: 678-564-1162, Press 1
GA CHIPRA Website: https://medicaid.georgia.gov/ programs/third-party-liability/childrens-health-insuranceprogram-reauthorization-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/welcomeiowa-medicaid/iowa-health-link/hawki
Hawki Phone: 1-800-257-8563
HIPP Website: https://hhs.iowa.gov/programs/welcomeiowa-medicaid/fee-service/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
New Hampshire – Medicaid
Website: www.medicaid.la.gov or www.ldh.la.gov/lahipp
Phone: 1-888-342-6207 (Medicaid hotline) or 1-855-6185488 (LaHIPP) 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
Website: https://mn.gov/dhs/health-care-coverage/
Phone: 1-800-657-3672
Website: http://www.dss.mo.gov/mhd/participants/pages/ hipp.htm
Phone: 573-751-2005
Website: https://dphhs.mt.gov/ MontanaHealthcarePrograms/HIPP
Phone: 1-800-694-3084
Email: HHSHIPPProgram@mt.gov
Website: http://www.ACCESSNebraska.ne.gov
Phone: 1-855-632-7633
Lincoln: 402-473-7000
Omaha: 402-595-1178
Medicaid Website: http://dhcfp.nv.gov
Medicaid Phone: 1-800-992-0900
Website: https://www.dhhs.nh.gov/programs-services/ medicaid/health-insurance-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: 609-631-2392
CHIP Website: http://www.njfamilycare.org/index.html
CHIP Phone: 1-800-701-0710 (TTY: 711)
New York – Medicaid
Website: http://www.eohhs.ri.gov/ Phone: 1-855-697-4347 or 401-462-0311 (Direct RIte Share Line) Louisiana – 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
Website: https://healthcare.oregon.gov/Pages/index.aspx
Phone: 1-800-699-9075
Website: https://www.pa.gov/en/services/dhs/apply-formedicaid-health-insurance-premium-payment-programhipp.html
Phone: 1-800-692-7462
CHIP Website: https://www.dhs.pa.gov/chip/pages/chip. aspx
CHIP Phone: 1-800-986-KIDS (5437)
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-insurance-premium-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/premiumassistance/famis-select
https://coverva.dmas.virginia.gov/learn/premiumassistance/health-insurance-premium-payment-hippprograms
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-and-eligibility/ Phone: 1-800-251-1269
To see if any other States have added a premium assistance program since July 31, 2025, 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 Baylor Genetics group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Baylor Genetics 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
Baylor Genetics hr-support@baylorgenetics.com
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-ofnetwork provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that have not signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care— like when you have an emergency or when you schedule a visit at an in- network facility but are unexpectedly treated by an out-of-network provider.
You are protected from balance billing for:
• Emergency services – If you have an emergency medical condition and get emergency services from an out-ofnetwork provider or facility, the most the provider or facility may bill you is your plan’s in- network cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these poststabilization services.
• Certain services at an in-network hospital or ambulatory surgical center – When you get services from an innetwork 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 innetwork cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, outof-network providers cannot balance bill you, unless you give written consent and give up your protections.
You are never required to give up your protections from balance billing. You also are not required to get care out-ofnetwork. You can choose a provider or facility in your plan’s network.
When balance billing is not allowed, you also have the following protections:
• You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
• Your health plan generally must:
• Cover emergency services without requiring you to get approval for services in advance (prior authorization).
• Cover emergency services by out-of-network providers.
• Base what you owe the provider or facility (costsharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
• Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
If you believe you have been wrongly billed, you may contact your insurance provider. Visit www.cms.gov/nosurprises for more information about your rights under federal law.
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This brochure highlights the main features of the Baylor Genetics 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. Baylor Genetics reserves the right to change or discontinue its employee benefits plans at anytime.