Helpful Resources
Welcome
We are pleased to offer a full benefits package to help protect your wellbeing and financial health. Read this guide to learn about the benefits available to you and your eligible dependents starting January 1, 2026. Each year during Open Enrollment, you may make changes to your benefit plans. The benefit choices you make this year will remain in effect 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.
AVAILABILITY OF SUMMARY HEALTH INFORMATION
Your benefits program offers one medical plan coverage option. To help you make an informed choice, a Summary of Benefits and Coverage (SBC) is available at www.mycigna.com or by contacting Human Resources.
ELIGIBILITY
You are eligible for benefits if you are a regular, full-time employee as defined by the Cypress Bank employee handbook. Your coverage is effective the first of the month following 60 days of full time employment. 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
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
Qualifying Life Events
Your benefit elections remain in effect for the entire plan year until the following Open Enrollment. You may only change coverage during the plan year if you have a Qualifying Life Event such as marriage, divorce, birth or adoption, loss of other coverage, etc. You must notify Human Resources in a timely manner if any of these events occur. Contact Human Resources for a full list of Qualifying Events and the notification time frames required for requested changes.
Medical Coverage
The medical plan option through Cigna protects you and your family from major financial hardship in the event of illness or injury. Your plan option is a PPO plan.
PREFERRED PROVIDER ORGANIZATION
A Preferred Provider Organization (PPO) plan allows you to see any provider when you need care. When you see in-network providers for care, you will pay less and get the highest level of benefits. You will pay more for care if you use out-of-network providers. When you see in-network providers, your office visits, urgent care, and prescription drugs are covered with a copay, and most other network services are covered at the coinsurance level.
Cigna Resources
MEMBER WEBSITE
myCigna.com serves as your one-stop shop for all Cigna health plan and benefits information. Key features include managing and tracking claims, accessing digital ID cards, finding in-network providers, accessing cost comparison tools, reviewing coverage details, and more. Visit www.mycigna.com to register.
One Guide – Get help from a personal guide to navigate your Cigna benefits and resources. Call the number on the back of your Cigna ID card, use the click-to-chat function on www.mycigna.com, or call 866-494-2111.
Health Information Line – Speak to a nurse anytime to get answers and recommendations based on your specific health situation. Call the number on the back of your Cigna ID card for 24/7 access.
Live, 24/7 Customer Service – Contact a representative via phone, chat, or app.
MOBILE APP
Download the myCigna app to access your Cigna health plan and benefits information while on the go. This app helps you organize and access important plan information on your smartphone or tablet.
CIGNA EDUCATION SITE
Choosing the right health plan is one of the most important decisions you will make all year. Cigna created a benefits education website to make your pre-enrollment experience easier. Compare your plan options, get answers to benefits questions, and choose a plan that best fits your needs. Representatives are also available to speak with you.
Visit www.benefitseducationcigna.com
Call 888-806-5094
CIGNA DIGITAL ID CARD
You have one ID card for both your pharmacy and medical needs. Cigna no longer issues and mails physical ID cards.
How to Access Your Digital ID Card
1. Log in at www.mycigna.com or the myCigna app
2. Click or tap ID Cards
3. View your card and any dependent cards as well as request physical cards be mailed to the address on file.
4. Email cards directly to doctors.
5. Save your digital ID cards in your Apple Wallet.
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 Cigna.
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.
Basic Restorative Fillings, extractions, periodontics, root canals, endodontics, oral surgery
(deductible waived)
1Payment for covered services received from an out-of-network dentist is based on the 90th percentile of Usual, Customary, and Reasonable (UCR) charges.
2Benefits for covered services received from a Non-Contracting Dentist will be based upon an Allowable Amount determined by Cigna, where the noncontracting Allowable Amount will be not less than the amount Cigna would have paid, for the same covered service, supply, or procedure if performed or provided by a Contracting Dentist, and it is possible that such Dentist will balance bill for amounts above this.
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 through Guardian through the VSP Choice Network
VOLUNTARY VISION PLAN
Lined Bifocal
Lined Trifocal
Lenticular
Fitting and Follow-Up
Life and AD&D Insurance
LIFE AND AD&D INSURANCE
Life and Accidental Death and Dismemberment (AD&D) insurance through Guardian 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).
BASIC LIFE AND AD&D
Basic Life and AD&D insurance are provided at no cost to you. You are automatically covered for an amount based on a multiple of your annual earnings.
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-related expenses. The plans are offered through Guardian and are portable.
ACCIDENT INSURANCE
Accident insurance provides affordable protection against a sudden, unforeseen accident. The Accident plan helps offset the direct and indirect expenses resulting from an accident, such as copayments, deductible, ambulance, physical therapy, and other costs not covered by traditional health plans.
CRITICAL ILLNESS
Critical Illness insurance helps pay the cost of nonmedical 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.
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. Life and AD&D coverage amounts reduce by 35% at age 65, 50% at age 70, and 65% at age 75 (percent of the original amount).
Increments of $10,000 up to $150,000 not to exceed 100% of employee amount
Guaranteed Issue $25,000 Child(ren)
Birth to 14 days: $0
15 days to six months: $1,000
Six months to age 26: $10,000
HOSPITAL INDEMNITY
The Hospital Indemnity plan helps you with the high cost of medical care by paying you a set amount when you have an inpatient hospital stay. Unlike traditional insurance that pays a benefit to the hospital or doctor, this plan pays you directly based on the care or treatment that you receive. These costs may include meals and transportation, childcare, or time away from work due to a medical issue that requires hospitalization.
To get your specific benefit rates, go to the Insperity portal.
DESIGNATING A BENEFICIARY
A beneficiary is the person or entity you elect to receive the death benefits of your Life and AD&D insurance policies. You can name more than one beneficiary, and you can change beneficiaries at any time. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%).
Disability Insurance
Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. We provide Long Term Disability (LTD) insurance at no cost to you through Guardian
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 30 days. 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 twelve months.
Flexible Spending Account
A Flexible Spending Account (FSA) allows you to set aside pretax dollars from each paycheck to pay for certain IRSapproved health and dependent care expenses. We offer two different types of FSAs: one for health care expenses and one for dependent care expenses. isolved Benefit Services 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 a High Deductible Health Plan (HDHP) and contribute to a Health Savings Account (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:
Fax – 866-350-3040
Email – fsa@isolvedhcm.com
Online – www.isolvedbenefitservices.com
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 Qualifying Life Event.
You can continue to file claims incurred during the plan year for another 45 days after the plan year ends.
Your Health Care FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care expenses.
The IRS has amended the “use it or lose it” rule to allow you to carry over up to $680 in your Health Care FSA into the next plan year.
Employee Costs
Important Notices
WOMEN’S HEALTH AND CANCER RIGHTS ACT OF 1998
In October 1998, Congress enacted the Women’s Health and Cancer Rights Act of 1998. This notice explains some important provisions of the Act. Please review this information carefully. As specified in the Women’s Health and Cancer Rights Act, a plan participant or beneficiary who elects breast reconstruction in connection with a mastectomy is also entitled to the following benefits:
• All stages of reconstruction of the breast on which the mastectomy was performed;
• Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
• Prostheses and treatment of physical complications of the mastectomy, including lymphedema.
Health plans must determine the manner of coverage in consultation with the attending physician and the patient. Coverage for breast reconstruction and related services may be subject to deductibles and coinsurance amounts that are consistent with those that apply to other benefits under the plan.
SPECIAL ENROLLMENT RIGHTS
This notice is being provided to ensure that you understand your right to apply for group health insurance coverage. You should read this notice even if you plan to waive coverage at this time.
Loss of Other Coverage or Becoming Eligible for Medicaid or a state Children’s Health Insurance Program (CHIP)
If you are declining coverage for yourself or your dependents because of other health insurance or group health plan coverage, you may be able to later enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must enroll within 31 days after your or your dependents’ other coverage ends (or after the employer that sponsors that coverage stops contributing toward the other coverage).
If you or your dependents lose eligibility under a Medicaid plan or CHIP, or if you or your dependents become eligible for a subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents in this plan. You must provide notification within 60 days after you or your dependent is terminated from, or determined to be eligible for, such assistance.
Marriage, Birth or Adoption
If you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must enroll within 31 days after the marriage, birth, or placement for adoption.
For More Information or Assistance
To request special enrollment or obtain more information, contact:
Cypress Bank, SSB
Human Resources
801 N. Jefferson Ave Mt. Pleasant, TX 75455 903-572-7585
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 Cypress Bank, SSB 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. Cypress Bank, SSB has determined that the prescription drug coverage offered by the Cypress Bank, SSB medical plan is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage pays and is considered Creditable Coverage.
Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to enroll in a Medicare prescription drug plan, as long as you later enroll within specific time periods.
You can enroll in a Medicare prescription drug plan when you first become eligible for Medicare. If you decide to wait to enroll in a Medicare prescription drug plan, you may enroll later, during Medicare Part D’s annual enrollment period, which runs each year from October 15 through December 7 but as a general rule, if you delay your enrollment in Medicare Part D after first becoming eligible to enroll, you may have to pay a higher premium (a penalty).
You should compare your current coverage, including which drugs are covered at what cost, with the coverage and cost of the plans offering Medicare 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 Cypress Bank, SSB 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 Cypress Bank, SSB 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 903-572-7585.
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
Cypress Bank, SSB Human Resources 801 N. Jefferson Ave Mt. Pleasant, TX 75455 903-572-7585
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 Cypress Bank, SSB, 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.
Cypress Bank, SSB Human Resources
801 N. Jefferson Ave
Mt. Pleasant, TX 75455
903-572-7585
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.
TEXAS – MEDICAID
Website: https://www.hhs.texas.gov/services/financial/healthinsurance-premium-payment-hipp-program
Phone: 1-800-440-0493
To see if any other States have added a premium assistance program since July 31, 2025, or for more information on special enrollment rights, you 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 Cypress Bank, SSB group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Cypress Bank, SSB 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
Cypress Bank, SSB Human Resources 801 N. Jefferson Ave
Mt. Pleasant, TX 75455 903-572-7585
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 outof-network provider.
You are protected from balance billing for:
• Emergency services – If you have an emergency medical condition and get emergency services from an out-ofnetwork provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing
amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these poststabilization services.
• Certain services at an in-network hospital or ambulatory surgical center – When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-ofnetwork providers cannot balance bill you, unless you give written consent and give up your protections.
You are never required to give up your protections from balance billing. You also are not required to get care out-of-network. You can choose a provider or facility in your plan’s network.
When balance billing is not allowed, you also have the following protections:
• You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
• Your health plan generally must:
• Cover emergency services without requiring you to get approval for services in advance (prior authorization).
• Cover emergency services by out-of-network providers.
• Base what you owe the provider or facility (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.
This brochure highlights the main features of the Cypress Bank 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. Cypress Bank reserves the right to change or discontinue its benefits plans at anytime.
