2026 TEAM MEMBER BENEFITS GUIDE A comprehensive guide to your Farm Bureau Bank team member benefits program
2
HELPFUL INFORMATION IMPORTANT CONTACTS COVERAGE
PROVIDER
PHONE
WEBSITE/EMAIL
Medical
Blue Cross Blue Shield of Texas
800-810-2583
www.bcbstx.com
Dental
Blue Cross Blue Shield of Texas
800-521-2227
www.bcbstx.com
Vision
Principal/VSP
800-877-7195
www.vsp.com
Flexible Spending Accounts
Higginbotham
866-419-3519
https://flexservices.higginbotham.net flexclaims@higginbotham.net
Life and AD&D
Principal
800-843-1371
www.principal.com
Disability
Principal
800-843-1371
www.principal.com
Critical Illness/Accident/ Hospital Indemnity
Principal
800-843-1371
www.principal.com
Higginbotham
817-797-0556
fbbenefits@higginbotham.net
Benefits Advisor
TABLE OF CONTENTS Welcome and Eligibility..............................................................3 Medical Coverage........................................................................4 Health Care Options...................................................................6 Dental Coverage..........................................................................7 Vision Coverage...........................................................................8 Flexible Spending Accounts.......................................................9 Life and AD&D Insurance........................................................ 10 Disability Insurance..................................................................11 Supplemental Insurance..........................................................12 Principal Value Adds ................................................................13 Important Notices.....................................................................14
If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, federal law gives you more choices about your prescription drug coverage. Please see page 14 for more details. Farm Bureau Bank
3
WELCOME AND ELIGIBILITY We are pleased to offer you a comprehensive
Qualifying Life Events
benefits package intended to protect your
Your benefits elections remain in effect for the entire
well-being and financial health. This guide
only change coverage during the plan year if you have a
plan year until the following Open Enrollment. You may
is your opportunity to learn more about the
Qualifying Life Event, and you must do so within 30-31
benefits available to you and your eligible
days of the event.
dependents beginning January 1, 2026. Each year during Open Enrollment, you have the opportunity to make changes to your benefits plans. The enrollment
Marriage, divorce, legal separation, or annulment
Birth, adoption, or placement for adoption of an eligible child
decisions you make this year will remain in effect through
Death of a spouse or child
December 31, 2026. To get the best value from your health
Change in your spouse’s employment that affects
care plan, please take time to evaluate your coverage options and determine which plans best meet the health care and financial needs of you and your family. After Open Enrollment, you may make changes to your benefits elections only when you have a Qualifying Life Event.
ELIGIBILITY
benefits eligibility
reaching the age limit)
Change in residence that affects your eligibility for coverage
You are eligible for benefits if you are a regular, full-time employee working an average of 30 hours per week. Your
Change in your child’s eligibility for benefits (e.g.,
Significant change in coverage or cost in your, your spouse’s, or your child’s benefits plans
FMLA Leave, COBRA event, court judgment, or decree
days of full-time employment. You may also enroll eligible
Becoming eligible for Medicare, Medicaid, or TRICARE
dependents for benefits coverage. The cost for dependent
Receiving a Qualified Medical Child Support Order
coverage depends on the number of dependents you
If you have a Qualifying Life Event and want to request a
coverage is effective the first of the month following 30
enroll and the particular plans you choose. When covering dependents, you must select the same plans for your dependent(s) as you select for yourself.
Eligible Dependents Include:
Your legal spouse
Children under the age of 26 regardless of student,
midyear change, you must notify Human Resources and complete your election changes within 30-31 days of the event. Be prepared to provide documentation to support the Qualifying Life Event.
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 options. A Summary of Benefits and Coverage (SBC) is available for each plan by contacting Human Resources.
2026 Team Members Benefits Guide
4
MEDICAL COVERAGE The medical plan options through Blue Cross Blue Shield of Texas (BCBSTX) protect you and your family from major financial hardship in the event of illness or injury.
PREFERRED PROVIDER ORGANIZATION The Preferred Provider Organization (PPO) plans allow you the freedom to see any provider when you need care. When you use in-network providers, you receive benefits at a discounted network cost. You may pay more for services if you use out-of-network providers.
PRESCRIPTION DRUG COVERAGE Your BCBSTX medical benefits include coverage for prescription drugs. Using in-network participating pharmacies means you pay less for your medications and do not require claim forms. Show your BCBSTX ID card to your pharmacist and pay the amount shown in the medical benefits summary chart. You may also use the BCBSTX mail order service, Alliance Rx Walgreens + Prime, to fill a 90-day supply of your prescription
BLUE ACCESS FOR MEMBERS Log on to Blue Access for Members (BAM) to manage your health care. Go to www.bcbstx.com to:
Download a claim form
Stop receiving paper statements
HOW TO FIND AN IN-NETWORK PROVIDER
Print a temporary ID card
Find a doctor or hospital
Visit www.bcbstx.com or call 800-810-2583.
Take a health assessment
Access the 24/7 Nurseline
View your medical claims
Join the fitness program
Access the Blue365 discount program
Begin a program to stop smoking or lose weight
and have it delivered directly to your home or office.
BCBSTX MOBILE APP Access important health insurance information wherever you are with the BCBSTX app:
Find a doctor, hospital, or urgent care facility
Get coverage and claims information
Access deductible information
View or order a new ID card
To download the BCBSTX app, text BCBSTXAPP to 33633 (messages and data rates may apply) or visit your mobile device’s app store.
Farm Bureau Bank
5
MEDICAL COVERAGE MEDICAL BENEFITS SUMMARY MTBCB514 PPO PLAN In-Network Calendar Year Deductible Individual Family
$1,500 $4,500
Calendar Year Out-of-Pocket Maximum Includes deductible Individual Family
$6,000 $18,000 You Pay
Preventive Care
$0
Virtual Visits
$0
Primary Care Physician
$40
Specialist
$80
Diagnostic Tests X-ray and Lab
20%1
Diagnostic Imaging CT, PET, MRI
20%1
Urgent Care
$75
Emergency Room
$500 + 20%1
Inpatient Hospital Care
20%1
Outpatient Services Office Visits Other Services
$40 20%1
Retail Prescriptions Up to 30-day supply Preferred generic Non-preferred generic Preferred brand name Non-preferred brand name Preferred specialty Non-preferred specialty
Participating Pharmacy $0 $10 $50 $100 $150 $250
Mail Order Prescriptions Up to 90-day supply Preferred generic Non-preferred generic Preferred brand name Non-preferred brand name
Non-Participating Pharmacy $10 $20 $70 $120 $150 $250
$0 $30 $150 $300
Per-Paycheck Rates
Employee Cost
Employer Contribution
Team Member Only
$60.95
$375.00
Team Member + Spouse
$324.16
$625.00
Team Member + Child(ren)
$199.49
$500.00
Team Member + Family
$485.63
$800.00
1
After deductible.
2026 Team Members Benefits Guide
6
HEALTH CARE OPTIONS Becoming familiar with your options for medical care can save you time and money.
HEALTH CARE PROVIDER
SYMPTOMS
AVERAGE COST
AVERAGE WAIT
Allergies Cough/cold/flu Rash Stomachache
$
2-5 minutes
Infections Sore and strep throat Vaccinations Minor injuries, sprains and strains
$
15-20 minutes
Common infections Minor injuries Pregnancy tests Vaccinations
$
15 minutes
Sprains and strains Minor broken bones Small cuts that may require stitches Minor burns and infections
$$
15-30 minutes
Chest pain Difficulty breathing Severe bleeding Blurred or sudden loss of vision Major broken bones
$$$$
4+ hours
Most major injuries except trauma Severe pain
$$$$$$
Minimal
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
Office hours vary
Usually lower out-of-pocket cost than urgent care; when you can’t see your doctor; located in stores and pharmacies RETAIL CLINIC
Hours vary based on store hours
When you need immediate attention; walk-in basis is usually accepted URGENT CARE
Generally includes evening, weekend and holiday hours
Emergency Care
Life-threatening or critical conditions; trauma treatment; multiple bills for doctor and facility HOSPITAL ER
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 FREESTANDING ER
24 hours a day, 7 days a week
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.
Farm Bureau Bank
7
DENTAL COVERAGE Our dental plan helps you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work. Premium contributions are deducted from your paycheck on a pretax basis. Coverage is provided through BCBSTX.
DPPO PLAN Two levels of benefits are available with the DPPO plan: in-network and out-of-network. You may select the dental provider of your choice, but your level of coverage may vary based on the provider you see for services. You could pay more if you use an out-of-network provider.
DENTAL BENEFITS SUMMARY BCBSTX DENTAL In-Network Calendar Year Deductible Individual Family
$25 $75
Calendar Year Benefit Maximum Per Individual
$3,000 You Pay
HOW TO FIND AN IN-NETWORK DENTIST
Preventive and Diagnostic Care Exams, cleanings, X-rays, fluoride treatments, sealants, space maintainers
$0
Basic Restorative Care Fillings, simple extractions, oral surgery, endodontics, periodontics
20%*
Major Restorative Care Crowns, dentures, bridges, implants, inlays, onlays
50%*
Orthodontia Adults and children to age 19
50% $2,000 lifetime maximum
Per-Paycheck Rates
Employee Cost
Employer Contribution
Team Member Only
$16.19
$4.05
Team Member + Spouse
$36.44
$0.00
Team Member + Child(ren)
$49.62
$0.00
Team Member + Family
$77.14
$0.00
Visit www.bcbstx.com or call 800-521-2227.
* After deductible.
2026 Team Members Benefits Guide
8
VISION COVERAGE Our vision plan provides quality care to help preserve your health and eyesight. In addition to identifying vision and eye problems, regular exams can detect certain medical issues from any licensed optometrist, ophthalmologist, or optician,
HOW TO FIND AN IN-NETWORK VISION PROVIDER
but plan benefits are better if you use an in-network
Visit www.vsp.com or call 800-877-7195.
such as diabetes and high cholesterol. You may seek care
provider. Premium contributions are deducted from your paycheck on a pretax basis. Coverage is provided through Principal using the VSP network of providers.
VISION BENEFITS SUMMARY VSP VISION In-Network You Pay
Out-of-Network Reimbursement
$10 copay Up to $60 standard, 10% off retail for premium
Up to $45
$25 copay $25 copay $25 copay $25 copay
Up to $30 Up to $50 Up to $65 Up to $100
Frames
Balance over $150
Up to $70
Contacts In lieu of frames and lenses Conventional Medically necessary
Balance over $150 $25 copay
Up to $105 Up to $210
Exam With dilation as necessary Contact lens fit and follow-up Lenses Single Vision Bifocals Trifocals Lenticular
Benefit Frequency Exam
Once every 12 months
Lenses or Contacts
Once every 12 months
Frames
Once every 12 months
Per-Paycheck Rates
Employee Cost
Employer Contribution
Team Member Only
$3.92
$0.00
Team Member + Spouse
$7.45
$0.00
Team Member + Child(ren)
$7.85
$0.00
Team Member + Family
$11.53
$0.00
Farm Bureau Bank
9
FLEXIBLE SPENDING ACCOUNTS A Flexible Spending Account (FSA) allows you to set aside pretax dollars from each paycheck to pay for certain IRS-approved health and dependent care expenses. We offer two different FSAs: one for health care expenses and one for dependent care expenses. Our FSAs are administered by Higginbotham.
HEALTH CARE FSA
DEPENDENT CARE FSA
The Health Care FSA covers qualified medical, dental, and
The Dependent Care FSA helps pay expenses associated with
vision expenses for you or your eligible dependents. You may
caring for elder or child dependents so you or your spouse
contribute up to $3,400 annually to a Health Care FSA and
can work or attend school full time. You can use the account
you are entitled to the full election from day one of your plan
to pay for daycare or babysitter expenses for your children
year. Eligible expenses include:
under age 13 and qualifying older dependents, such as
Dental and vision
Prescription copays
expenses
Hearing aids and
Medical deductibles and
batteries
coinsurance
How the Health Care FSA Works Access the funds in your Health Care FSA two different ways:
Care FSA is limited to the total amount deposited in your account at that time. To be eligible, you must be a single parent or you and your spouse must be employed outside the home, disabled, or a full-time student.
Important Information about Dependent Care FSA
Use your Higginbotham FSA debit card to pay for qualified expenses, doctor visits, and prescription copays.
dependent parents. Reimbursement from your Dependent
Overnight camps are not eligible for reimbursement (only day camps can be considered).
If your child turns 13 midyear, you may only request
Pay out-of-pocket and submit your receipts for
reimbursement for the part of the year when the child is
reimbursement via:
under age 13.
Fax – 866-419-3516
Email – flexclaims@higginbotham.net
Online – https://flexservices.higginbotham.net
dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self-care.
IMPORTANT FSA RULES
The maximum per plan year you can contribute to
You may request reimbursement for care of a spouse or
The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.
a Health Care FSA is $3,400. The maximum per plan year you can contribute to a Dependent Care FSA is $7,500 when filing jointly or head of household and $3,750 when married filing separately.
You cannot change your election during the year
REGISTER ON THE HIGGINBOTHAM PORTAL
click Get Started. Follow the instructions and scroll
unless you experience a Qualifying Life Event.
You can continue to file claims incurred during the January 1 – December 31, 2026, plan year for
down to enter your information.
Your Health Care FSA debit card can be used for health care expenses only.
The IRS has amended the “use it or lose it” rule to allow you to carry over up to $680 in your Health Care FSA into the next plan year. The carryover
Enter your Employee ID, which is your Social Security number with no dashes or spaces.
another 60 days (until February 28, 2027).
Visit https://flexservices.higginbotham.net and
Follow the prompts to navigate the site.
If you have any questions or concerns, contact: Phone – 866-419-3519 Email – flexclaims@higginbotham.net Fax – 866-419-3516
rule does not apply to your Dependent Care FSA. 2026 Team Members Benefits Guide
10
LIFE AND AD&D INSURANCE Life and Accidental Death and Dismemberment (AD&D) insurance are important parts of your financial security, especially if others depend on you for support. With Life insurance, your beneficiary(ies) can use the coverage to pay off your debts, such as credit cards, mortgages, and other final expenses. AD&D coverage provides specified benefits for a covered accidental bodily injury that causes dismemberment (e.g., the loss of a hand, foot, or eye). In the event that death occurs from an accident, 100% of the AD&D benefit would be payable to your beneficiary(ies). Coverage is provided through Principal.
BASIC LIFE AND AD&D
VOLUNTARY LIFE AND AD&D
Basic Life and AD&D insurance are provided by the
You may buy more Life and AD&D insurance for you and your
company at no cost to you. You are automatically covered
eligible dependents. If you do not elect Voluntary Life and
at two times your salary to a maximum of $500,000 for each
AD&D insurance when first eligible or if you want to increase
benefit. If you leave the company, you may be able to take
your benefit amount at a later date, you may need to show
the insurance with you. Benefits reduce by 35% at age 70,
proof of good health. You must elect Voluntary Life and
and 55% at age 75.
AD&D coverage for yourself before you may elect coverage
BASIC LIFE AND AD&D Benefit
Increments of $10,000 up to two times salary to a maximum of $500,000
Guaranteed Issue
$400,000
Accelerated Death Benefit
Up to 75% if life expectancy is 12 months or less
for your spouse or children. If you leave the company, you may be able to take the insurance with you. Benefits reduce by 35% at age 70, and 50% at age 75.
VOLUNTARY LIFE AND AD&D Employee
Increments of $10,000 up to $500,000 Guaranteed Issue $150,000
Spouse
Increments of $5,000 up to 100% of employee amount to a maximum of $200,000 Guaranteed Issue $30,000
Child(ren)
Birth to 14 days - $1,000 15 days to age 26 - $10,000 or $20,000
MONTHLY VOLUNTARY LIFE AND AD&D RATES PER $1,000 Life Rates Employee and Spouse
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 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%).
Farm Bureau Bank
Age
Rate
Age
Rate
<30
$0.067
50-54
$0.468
30-34
$0.078
55-59
$0.743
35-39
$0.124
60-64
$1.130
40-44
$0.188
65-69
$1.904
45-49
$0.287
70+
$3.383
Child(ren) To age 26
$0.200 AD&D Rate $0.020
11
DISABILITY INSURANCE Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. Long Term Disability (LTD) insurance is provided by the company at no cost to you through Principal. LTD insurance pays a percentage of your monthly salary for a covered disability or injury that prevents you from working for more than 90 days. Benefits begin at the end of an elimination period and continue while you are disabled up to Social Security Normal Retirement Age (SSNRA).
LONG TERM DISABILITY Benefits Begin
91st day
Percentage of Earnings You Receive
66.67%
Maximum Monthly Benefit
$10,000
Maximum Benefit Period
SSNRA
Pre-existing Condition Exclusion
3/12*
*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.
DEFINITION OF DISABILITY
Total Disability – Inability to perform all of the material and substantial duties of your regular occupation due to an injury or illness.
Partial Disability – Ability to perform some, but not all, of the material and substantial duties of your regular occupation due to an injury or illness.
2026 Team Members Benefits Guide
12
SUPPLEMENTAL INSURANCE 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. These plans are offered through Principal 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, deductibles, ambulatory fees, physical therapy, and other costs not covered by traditional health plans.
ACCIDENT INSURANCE*
CRITICAL ILLNESS INSURANCE Critical Illness insurance helps pay the cost of non-medical
Service
Benefit
Burns
$500-$5,000
plan provides a lump-sum benefit payment to you upon
Coma
$15,000
first and second diagnosis of any covered critical illness or
Concussion
$500
Dislocation
$1,500-$7,500
Fractures
$500-$10,000
expenses related to a covered critical illness or cancer. The
cancer. This benefit can help cover expenses, such as lost income, out-of-town treatments, special diets, daily living, and household upkeep costs.
CRITICAL ILLNESS INSURANCE Benefit Amounts Available Employee Spouse Child
Increments of $5,000 up to $100,000 maximum Guaranteed Issue $30,000 Increments of $3,500 up to 50% of your benefit Guaranteed Issue $15,000 Automatically covered at 25% of your benefit
Condition
First Occurrence Benefit
Full Coverage Alzheimer’s Disease, ALS, Benign Brain Tumor, Coma, Heart Attack, Invasive Cancer, Loss of Hearing, Sight, or Speech, Major Organ Failure, Multiple Sclerosis, Occupational Infectious Disease, Paralysis, Parkinson’s Disease, Stroke
100%
Partial Coverage Cancer in situ, coronary artery disease, infectious diseases
25%
Health Screening Benefit One per covered person per calendar year
$50
Pre-existing Condition Limitation
6/12*
Accidental Death & Dismemberment* Employee Spouse Child
$25,000 $12,500 $6,250
Wellness Benefit
$50 per calendar year
*See Benefit Summary for complete list of covered accident benefits.
HOSPITAL INDEMNITY INSURANCE 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, which 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.
* If you were treated for a condition six months prior to your effective date, benefits may not be paid until you have been covered under this plan for 12 months.
HOSPITAL INDEMNITY INSURANCE* Service Hospital Admission
$1,000 (one day per year)
ICU Admission
$2,000 (one day per year)
Hospital Confinement
$100 (30 days per year)
ICU Confinement
$200 (30 days per year)
Newborn Nursery
$100 (one day per year)
* See Benefit Summary for more details.
Farm Bureau Bank
Benefit
13
PRINCIPAL VALUE ADDS The following discounts and services are available through
Employee assistance program (EAP) – Access free,
your group benefits with Principal. These discounts are not
confidential resources to help handle life’s challenges. Talk
insurance. Some services may not be available based on
with a licensed EAP professional by using in-person or virtual
your location.
counseling. Legal, financial, and identify theft services are
Laser vision correction – Save $800 with featured
also available. Go to www.guidanceresources.com (program
providers and receive 15% off standard pricing or 5% off
name, PrincipalCore), or call 844-869-2365. You can also
promotional pricing on LASIK. Call 888-647-3937 or visit
download the GuidanceNow app.
www.principallasik.com for details. Administered by
Will & Legal Document Center – Use online resources and
LCA Vision.
tools provided by ARAG to prepare, print, and store essential
Hearing aid program – Get discounts up to 48% off hearing
legal documents, including your will, living will, health care
aids, including rechargeable and Bluetooth options, with a 60-day trial to ensure full satisfaction. Get a free hearing consultation at any of the 3,000+ locations nationwide.
power of attorney, durable power of attorney, and medical treatment authorization for minors. Access estate planning tools and resources as well as a personal information
Administered by Start Hearing. Call 877-890-4694 or visit
organizer at www.principal.araggroup.com.
www.starthearing.com/partners/principallife to learn
Identity theft kit – If your identity is stolen, get valuable tips
more.
on how to restore it at www.principalaraggroup.com.
Emotional health support line – Call the free, confidential
Beneficiary support – After a loved one dies, beneficiaries
support line at 800-424-4612 to reach licensed behavioral
may receive help coping with their emotions and with
health clinicians. Get emotional support, tips for coping, and
making financial decisions. Services include grief support
referrals to local resources anytime, day or night. Available
from Magellan Healthcare and financial review from
with your dental and vision insurance.
Principal. Spouses and dependents receive three months of
Vision care – Get discounts on LASIK surgery from a
free online will preparation services provided by ARAG.
network of VSP providers. You will also receive discounts on eye exams, prescription glasses and lenses, and contact lens evaluations and fittings. Visit www.principal.com/vsp and select the VSP Choice Network or call 800-877-7195.
2026 Team Members Benefits Guide
14
IMPORTANT NOTICES WOMEN’S HEALTH AND CANCER RIGHTS ACT OF 1998
If you or your dependents lose eligibility under a Medicaid
In October 1998, Congress enacted the Women’s Health
to enroll yourself and your dependents in this plan. You
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
plan or CHIP, or if you or your dependents become eligible for a subsidy under Medicaid or CHIP, you may be able 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: Farm Bureau Bank Human Resources 17300 Henderson Pass San Antonio, TX 78232 210-637-4855
YOUR PRESCRIPTION DRUG COVERAGE AND MEDICARE Please read this notice carefully and keep it where you
This notice is being provided to ensure that you understand
can find it. This notice has information about your current
your right to apply for group health insurance coverage. You
prescription drug coverage with Farm Bureau Bank and
should read this notice even if you plan to waive coverage at
about your options under Medicare’s prescription drug
this time.
coverage. This information can help you decide whether or
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).
Farm Bureau Bank
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.
15
IMPORTANT NOTICES 1.
2.
Medicare prescription drug coverage became available
If you cancel or lose your current coverage and do not have
in 2006 to everyone with Medicare. You can get this
prescription drug coverage for 63 days or longer prior to
coverage through a Medicare Prescription Drug Plan or
enrolling in the Medicare prescription drug coverage, your
a Medicare Advantage Plan that offers prescription drug
monthly premium will be at least 1% per month greater for
coverage. All Medicare prescription drug plans provide
every month that you did not have coverage for as long as
at least a standard level of coverage set by Medicare.
you have Medicare prescription drug coverage. For example,
Some plans may also offer more coverage for a higher
if nineteen months lapse without coverage, your premium
monthly premium.
will always be at least 19% higher than it would have been
Farm Bureau Bank has determined that the prescription
without the lapse in coverage.
drug coverage offered by the Farm Bureau Bank medical
For more information about this notice or your current
plan is, on average for all plan participants, expected to
prescription drug coverage:
pay out as much as the standard Medicare prescription
Contact the Human Resources Department at 210-637-4855.
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
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:
prescription drug plan, as long as you later enroll within
More detailed information about Medicare plans that
specific time periods.
offer prescription drug coverage is in the “Medicare & You”
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,
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:
which runs each year from October 15 through December
Visit www.medicare.gov.
7 but as a general rule, if you delay your enrollment in
Call your State Health Insurance Assistance Program
Medicare Part D after first becoming eligible to enroll, you
(see the inside back cover of your copy of the “Medicare
may have to pay a higher premium (a penalty).
& You” handbook for their telephone number) for personalized help.
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 Farm Bureau Bank 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 Farm Bureau Bank prescription drug
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 800-325-0778.
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. 2026 Team Members Benefits Guide
16
IMPORTANT NOTICES Remember: Keep this Creditable Coverage notice. If you
Complaints: If you believe your privacy rights have been
enroll in one of the new plans approved by Medicare which
violated, you may complain to the Plan and to the Secretary
offer prescription drug coverage, you may be required to
of Health and Human Services. You will not be retaliated
provide a copy of this notice when you join to show whether
against for filing a complaint. To file a complaint, please
or not you have maintained creditable coverage and whether
contact the Privacy Officer.
or not you are required to pay a higher premium (a penalty).
Farm Bureau Bank
January 1, 2026
Human Resources
Farm Bureau Bank
17300 Henderson Pass
Human Resources
San Antonio, TX 78232
17300 Henderson Pass
210-637-4855
San Antonio, TX 78232 210-637-4855
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.
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
The Health Insurance Portability and Accountability Act
any discrepancy between the information in this Notice and
of 1996 (HIPAA) imposes numerous requirements on
the regulations.
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 Farm Bureau Bank , hereinafter referred to as the plan sponsor.
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
The Plan is required by law to maintain the privacy of your
or CHIP, you won’t be eligible for these premium assistance
health information and to provide you with this notice of the
programs but you may be able to buy individual insurance
Plan’s legal duties and privacy practices with respect to your
coverage through the Health Insurance Marketplace. For
health information. It is important to note that these rules
more information, visit www.healthcare.gov.
apply to the Plan, not the plan sponsor as an employer.
If you or your dependents are already enrolled in Medicaid
You have the right to inspect and copy protected health
or CHIP and you live in a State listed below, contact your
information which is maintained by and for the Plan for
State Medicaid or CHIP office to find out if premium
enrollment, payment, claims and case management. If
assistance is available.
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.
Farm Bureau Bank
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.
17
IMPORTANT NOTICES If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-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.
NORTH CAROLINA – MEDICAID Website: https://medicaid.ncdhhs.gov Phone: 919-855-4100 TEXAS – MEDICAID Website: https://www.hhs.texas.gov/services/financial/ health-insurance-premium-payment-hipp-program Phone: 1-800-440-0493 VIRGINIA – MEDICAID AND CHIP Website: https://coverva.dmas.virginia.gov/learn/ premium-assistance/famis-select https://coverva.dmas.virginia.gov/learn/premiumassistance/health-insurance-premium-payment-hippprograms Medicaid/CHIP Phone: 1-800-432-5924 To see if any other States have added a premium assistance
ALABAMA – MEDICAID Website: http://www.myalhipp.com/ Phone: 1-855-692-5447 ARKANSAS – MEDICAID Website: http://myarhipp.com/ Phone: 1-855-MyARHIPP (855-692-7447) 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 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 Website: www.medicaid.la.gov or www.ldh.la.gov/lahipp Phone: 1-888-342-6207 (Medicaid hotline) or 1-855-6185488 (LaHIPP) NEVADA – MEDICAID Medicaid Website: http://dhcfp.nv.gov Medicaid Phone: 1-800-992-0900
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 Farm Bureau Bank group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Farm Bureau Bank 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 January 1, 2026 Farm Bureau Bank Human Resources 17300 Henderson Pass San Antonio, TX 78232 210-637-4855
2026 Team Members Benefits Guide
18
IMPORTANT NOTICES YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS
surgical center – When you get services from an innetwork hospital or ambulatory surgical center, certain
When you get emergency care or get treated by an out-of-
providers there may be out-of-network. In these cases,
network provider at an in-network hospital or ambulatory
the most those providers may bill you is your plan’s in-
surgical center, you are protected from surprise billing or
network cost-sharing amount. This applies to emergency
balance billing.
medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist
What is “balance billing” (sometimes called “surprise
services. These providers cannot balance bill you and
billing”)?
may not ask you to give up your protections not to be
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
Certain services at an in-network hospital or ambulatory
balance billed. If you get other services at these in-network facilities, out-ofnetwork providers cannot balance bill you, unless you give
health care facility that isn’t in your health plan’s network.
written consent and give up your protections.
“Out-of-network” describes providers and facilities that have
You are never required to give up your protections from
not signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference
balance billing. You also are not required to get care out-ofnetwork. You can choose a provider or facility in your plan’s
between what your plan agreed to pay and the full amount
network.
charged for a service. This is called “balance billing.” This
When balance billing is not allowed, you also have the
amount is likely more than in-network costs for the same service and might not count toward your annual out-ofpocket limit.
following protections:
cost (like the copayments, coinsurance, and deductibles
“Surprise billing” is an unexpected balance bill. This
that you would pay if the provider or facility was in-
can happen when you can’t control who is involved in
network). Your health plan will pay out-of-network
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:
You are only responsible for paying your share of the
providers and facilities directly.
Your health plan generally must:
to get approval for services in advance (prior
Emergency services – If you have an emergency medical condition and get emergency services from an outof- network provider or facility, the most the provider
authorization).
provider or facility and show that amount in your
services. This includes services you may get after you
explanation of benefits.
are in stable condition, unless you give written consent for these post-stabilization services.
Base what you owe the provider or facility (costsharing) on what it would pay an in-network
You cannot be balance billed for these emergency
and give up your protections not to be balanced billed
Cover emergency services by out-of-network providers.
or facility may bill you is your plan’s in- network costsharing amount (such as copayments and coinsurance).
Cover emergency services without requiring you
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.
Farm Bureau Bank
19
NOTES
2026 Team Members Benefits Guide
This brochure highlights the main features of the Farm Bureau Bank team member benefits program. It does not include all plan rules, details, limitations, and exclusions. The terms of your benefits 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. Farm Bureau Bank reserves the right to change or discontinue its team member benefits plans at anytime.