Getting Started
Important Contacts
Welcome Table of Contents
Eligibility
Enrollment
Important Contacts
Healthy HIGG Wellness
Program
Asset Health
855-444-1255
support@assethealth.com
Katie Callender: 817-349-2205
kcallender@higginbotham.com
Telemedicine and Benefits
Savings
Teladoc via HealthJoy
877-500-3212
www.healthjoy.com
Employee Assistance
Programs
Lyra Health
For all benefit-eligible employees
877-842-0006
https://higginbotham.lyrahealth.com/
The Standard
888-293-6948
https://healthadvocate.com/standard3
Health Care Advocacy
Collective Health
Care Navigation Team
833-834-1170
https://bcbstx.collectivehealth.com
Medical
Collective Health
Member Advocate Team
855-495-5996
https://bcbstx.collectivehealth.com
Policy Number: 654266
Pharmacy
Collective Health / Prime Therapeutics
855-495-5996
https://bcbstx.collectivehealth.com
Policy Number: 654266
Dental
Sun Life
800-442-7742
www.sunlife.com/findadentist
Group Number: 962825
Vision EyeMed
866-804-0982
www.eyemed.com
Low Plan Group Number: 1062567
High Plan Group Number: 1062566
Health Savings Account
HSA Bank
800-357-6246 www.hsabank.com askus@hsabank.com
Medical Emergency Transportation
MASA MTS
800-423-3226
www.masamts.com
FSA
Higginbotham
866-419-3519
https://flexservices.higginbotham.net
Life and AD&D / Disability
The Standard
800-368-1135
888-325-0091 (Voluntary LTD)
www.standard.com
Group Number: 760744
Accident / Critical Illness / Hospital Indemnity
Allstate
800-521-3535
www.allstatebenefits.com
Group Number: OC0000554998
Legal and Identity Theft
Legal Shield/ID Shield
888-807-0407
24/7 emergency line: 877-825-3797
https://benefits.legalshield.com/ higginbotham membersupport@legalshieldcorp.com
Travel Assistance
Assist America, Inc.
800-872-1414 (US/Canada, Puerto Rico, US Virgin Islands and Bermuda) +1-609-986-1234 (other locations)
Text: +1-609-334-0807
medservices@assistamerica.com
Reference number 01-AA-STD-5201
Pet Insurance
Nationwide 877-738-7874
www.petinsurance.com/ higginbothamemployees
Student Loan Refinancing
SoFi
855-456-7634
www.sofi.com/higg
Personal Home & Auto
Travelers Benefits Plus 972-569-3112
myinsurance@higginbotham.com
401(k) Savings Plan
Fidelity
800-835-5095
www.netbenefits.com
Group Number: 83967
FMLA
The Standard
800-610-6544
General information: 866-756-8116 www.standard.com/absence
Welcome
Higginbotham is proud to offer you a comprehensive benefits program designed to meet individual and family needs. Our program provides:
Certainty – Offering health and well-being benefits that you will value and can consider through the various stages of life.
Freedom – Offering benefit plans that provide choice and the opportunity for you to select what works best for you and your budget.
Simplicity – Offering an enrollment platform that is easy to access, no matter the location, time or day.
Benefit Highlights
Plan changes include the following:
New Healia Plan Selection Tool and spousal HRA
New Choose to Lose personalized weight management program with Tria
New Regenexx musculoskeletal treatment program
Dual-option vision plans with EyeMed
Changing to Balanced Biosimilar drug list with Advocate+ Pharmacy Match for specialty medications (replacing Accredo)
Eligibility
If you are an active employee working at least 30 hours per week, you are eligible to enroll in our benefits program on the first of the month following your date of hire. You may also enroll eligible dependents for benefits coverage. The cost to you for dependent coverage depends on the tier you enroll in and the particular plans you choose. When covering dependents, you must select and be on the same plan.
Eligible Dependents
Your legally-married spouse.
Dependent children up to age 26 (includes birth children, stepchildren, legally adopted children, children placed for adoption, and children for whom legal guardianship has been awarded to you or your spouse).
Dependent children, regardless of age, provided he or she is incapable of self-support due to a mental or physical disability and is fully dependent on you for support as indicated on your federal tax return.
Verification of dependent eligibility may be required.
Qualifying Events
Once you elect your benefit options, they 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:
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 or cost for you, your spouse or child
FMLA leave, COBRA event, court judgment or decree
Becoming eligible for Medicare, Medicaid or TRICARE
Receiving a Qualified Medical Child Support Order (QMCSO)
If you have a Qualifying Life Event and want to change your elections, you must notify Human Resources and complete a Life Event Enrollment form within 30 days.* You may be asked to provide documentation to support the change.
*See the green box on page 3 for where to find benefit forms and information.
Health Coverage Options
Our employee benefits program offers health coverage options. To see a Summary of Benefits and Coverage (SBC), go to the Human Resources and Payroll tile on My Apps (SSO) or email benefits@higginbotham.com for a copy.
*See the green box on page 3 for where to find benefit forms and information.
Enrollment
Open Enrollment
Open Enrollment is your opportunity to choose your benefits for the upcoming plan year (January 1 – December 31, 2026). After Open Enrollment, you may make changes to your elections only when you experience a Qualifying Life Event.
New Employees
You must enroll within 31 days of your eligibility date. If you do not enroll during your eligibility period, you will have to wait until the next Open Enrollment to enroll, unless you have a Qualifying Life Event.
Default Benefits
If you do not enroll for benefits by the deadline given to you, you will receive the following default benefits:
Wellness Program
Telemedicine
Basic Life and AD&D
Long Term Disability
Employee Assistance Program
Benefits Assistance
For enrollment and benefits-related questions, email benefits@higginbotham.com.
Your Health and Well-being
HealthJoy
Wellness Programs
Wellness Resources
Employee Assistance Program
Collective Health Resources
Medical Coverage
Prescription Drug Coverage
Prescription Drug Resources
International Prescription Programs
Medical and Prescription Benefits
Summary
Medical Plan Monthly Premiums
Healia Health
Health Savings Account
Flexible Spending Accounts
Telemedicine
Dental Coverage
Vision Coverage
HealthJoy
Your digital front door to benefits and savings
HealthJoy is available for free to all eligible employees and their dependents! Higginbotham partners with HealthJoy to make it easy for you to be healthy and well. HealthJoy is the virtual access point for all your health care navigation and employee benefits needs. When you use HealthJoy’s concierge services, you will save time, money, and frustration and get the most out of your benefits. Check out all the free services available to you via the HealthJoy app:
24/7 Healthcare Concierge Services
Provider and facility recommendations
Appointment booking
Health cost estimation
Prescription savings review
HealthJoy App
Inbox
Provider search
Chat with Joy, the chatbot
Personalized benefits wallet
Claims issue resolution
Dental and vision assistance
General benefits-related answers
Dedicated member support team
Surgical Guidance and Savings
If you a planning for a surgery, contact HealthJoy first. SurgeryPlus covers more than 1,500 procedures, so you may access to a wide range of best-in-class surgical care for little to no cost through the SurgeryPlus network. A SurgeryPlus advocate will support you before and after your surgery, and ensure you get convenient, high-quality care close to home. Log in to the HealthJoy app or call 855-200-2099 for details.
Virtual Health Care
Virtual health care is available 24/7 through Teladoc Health within the HealthJoy app. Access board-certified physicians and licensed mental health care professionals by phone or video consultations. See page 30 for more details.
Deductible accumulator
Profile information
Personalized health plan and care recommendations
Get Started Today!
You must activate your HealthJoy account to use these services.
Visit www.healthjoy.com/download to get the HealthJoy app.
Call 877-500-3212 for assistance.
HealthJoy is available for free to all eligible employees and their dependents!
Wellness Programs
Healthy HIGG Wellness Program
The Healthy HIGG Wellness Program supports your health and well-being. As a program participant, you can complete activities, earn points and get a $70 monthly medical premium discount. You can also participate in challenges and campaigns to be entered into raffles for other prizes!
Earn points by completing these activities:
Health Assessment
Biometric screening
Preventive care exams
Challenges
Nicotine-free agreement or cessation program
Healthy or improved biometric measurements, including: BMI, waist, cholesterol, blood pressure, glucose, or A1C
Online education
If you are hired on or after June 1, 2026, your point requirements will be prorated.
Healthy HIGG Enhancements for 2026
New challenges
New assessments
Courses for physical, emotional, social, and financial health
Spouse Incentive
Spouses covered by a Higginbotham medical plan can earn a $150 gift card by getting a Biometric Screening and completing an online Health Assessment by November 30, 2026. You do not need to participate in Healthy HIGG for your spouse to earn the incentive (the incentive is not available to adult children).
Wellness Programs
Asset Health Portal
Asset Health helps you build and sustain healthy habits and lifestyles in a streamlined program experience. Using personalized data, Asset Health encourages and rewards you to make and maintain your healthy goals. With your Asset Health portal, you have access to a variety of resources and online tools that will help you take an active role in the management of your most important asset — your health!
Visit www.assethealth.com/HealthyHIGG.
Call 855-444-1255.
Email support@assethealth.com.
Download the Asset Health Mobile app.
Registration is Easy
To register with Asset Health for the first time, employees and spouses covered by a Higginbotham medical plan may use the default credentials below:
Username – first initial + last name + last 4 digits of SSN
Password – date of birth (MMDDYYYY)
After registering, you will be asked to set your own unique account credentials and contact information for accessing the site in the future.
Higginbotham partners with Asset Health to host the Healthy HIGG program and its services. All programs are confidential and HIPAAcompliant. Any information shared with the Asset Health team will not be disclosed, except in accordance with HIPAA laws. Your Protected Health Information (PHI) will not be shared with Higginbotham. Information is only shared in aggregate form for planning purposes to address Higginbotham’s overall risks.
Note: If you have a health factor that makes it unreasonably difficult or medically inadvisable for you to achieve the requirements of the wellness program to qualify for the incentive(s), please contact Human Resources and we will work with you and/or your physician to develop an alternative. The purpose of this program is to promote health and prevent disease by alerting you to potential health risks. This program is confidential and HIPAA-compliant. Protected Health Information will only be collected in aggregate form to design programs for the purpose of addressing Higginbotham’s overall risk(s). Any information shared will not be disclosed except in accordance with HIPAA laws.
Wellness Resources
The following benefits are available to all benefit-eligible employees:
Lyra Health
Lyra provides a range of care options for your emotional and mental health at no cost to you, including:
Work-life services (financial, legal, identity theft support, child/elder/pet care resources, etc.)
Self-guided care activities (meditation, sleep, stress-relief, etc.)
Mental health coaching
Therapy sessions*
The Lyra Care Navigator Team will answer questions about your care and help you find a provider. Learn more at https://higginbotham.lyrahealth.com/ or call 877-842-0006 to connect to confidential mental health support.
*Benefit-eligible employees and your benefit-eligible dependents have unlimited access to work-life services, self-guided care activities, and up to eight free coaching or therapy sessions per person, per plan year. If you are enrolled in a Higginbotham health plan, you get additional therapy sessions beyond the eight free sessions and medication management support from a Lyra network provider. This care is subject to in-network outpatient mental health cost-sharing, as defined under your health plan.
HUSK Wellness
Meet a HUSK Registered Dietitian at no cost for customized support in mindful eating, developing healthful habits, disease management, and more. If you are enrolled in a Higginbotham medical plan, you and your covered dependents may meet with a Registered Dietitian up to 12 times per year. If you are enrolled in another health plan, schedule an intake consultation with a HUSK team member to verify that your insurance provides coverage for preventive nutrition counseling. Dependent children must be at least 12 years of age to be eligible for this program. Visit https://register. nutrition.huskwellness.com/register?code=HIGG and use registration code HIGG to get started.
Tobacco Cessation Program
You can receive a $50 medical premium discount each month ($600 per year) if you are a nontobacco user or if you complete the S.T.O.P. tobacco cessation program through Tria Health. Submit a program completion form to Human Resources within 30 days of finishing the program.
Higginbotham will also reimburse you up to $250 per year for tobacco cessation therapies, such as counseling, Nicotine Replacement Therapy, acupuncture, etc.
Note: Wellness Resources are not part of the Asset Health Points Program. Participation in Wellness Resources will not count toward the annual point goal associated with Healthy HIGG.
Wellness Resources
Weight Management Programs
Higginbotham will reimburse you up to $20 of the monthly fee for approved weight management programs, including WW, Nutrisystem, Noom, and MyFitnessPal. On a quarterly basis, complete an expense report through www.concursolutions.com and include proof of payment. Contact vendorpayables@higginbotham.com if you need assistance accessing the system.
New! Choose to Lose
Tria Health’s Choose to Lose program is a benefit through our health plan. A health coach will speak to you by phone to give you expert advice and assistance to help manage your health and achieve your weight loss goals. It's free!
Highlights
Welcome Kit – You will get a welcome kit with a digital scale, measuring tape, portion plate, and water bottle.
Personalized – Care plans are designed to fit your lifestyle and help you reach your weight loss goals.
Expert Advice – Health coaches have experience in nutrition and exercise coaching and are certified by the National Board of Health and Wellness Coaches.
Ongoing Support – Stay motivated and focused with ongoing support, regular check-ins, and resources.
Get Started Today!
Visit www.triahealth.com/ctl-higginbotham
Call 913-322-8456
Scan the QR code
Note: Wellness Resources are not part of the Asset Health Points Program.
Participation in Wellness Resources will not count toward the annual point goal associated with Healthy HIGG.
Wellness Resources
Reduce Pain and Improve Joint Function Without Surgery
Regenexx: Avoid Surgery with this Low-cost Benefit
Higginbotham now offers Regenexx as part of your medical plan. If you suffer from a medical condition or injury that causes pain, Regenexx uses your body’s natural healing agents to help you recover. Your stem cells and blood platelets are injected precisely into the area of your injury to promote healing. If you suffer from issues in the spine, hands, shoulders, knees, hips, ankles, or feet, Regenexx may be able to help you get back to your everyday life.
Conditions Treated
Bulging, collapsed, herniated, ruptured, or torn disc
Degenerative disc disease
Disc extrusion
Disc protrusion
Back or neck nerve pain
Arthritis
Rotator cuff tears
Labral tear
Rotator cuff tendinosis
Joint replacement alternative
Arthritis
Meniscus tear
Sprain or tear of ACL/ PCL
Sprain or tear of the MCL/LCL
Tendinopathy
Joint replacement alternative
Arthritis
Tennis elbow
Ulnar nerve entrapment
CMC joint arthritis (thumb)
Carpal tunnel syndrome
Trigger finger
Arthritis
Osteonecrosis
Bursitis
Labral/labrum tear
Tendinopathy
Joint replacement alternative
Arthritis
Instability
Bunions
Ligament sprain or tear
Plantar fasciitis
Achilles tendinopathy
Following your Regenexx procedure, you’ll be asked to refrain from heavy activity for at least six weeks while the new tissue grows and begins to mature. Most patients see continued improvement for six months or more.
Call
Spine Shoulders
Knees Hands/Wrists/Elbows Hips
Ankles/Feet
Employee Assistance Program
The Standard provides FREE Employee Assistance Program (EAP) support for all benefit-eligible employees and their benefit-eligible dependents. The services are personal, confidential and available 24/7. Online resources are available at www.healthadvocate.com/standard3.
EAP services can help with:
Depression, grief, loss and emotional well-being
Family, marital and other relationship issues
Life improvement and goal-setting
Addictions such as alcohol and drug abuse
Stress or anxiety with work or family
Financial and legal concerns
Identity theft and fraud resolution
Online will preparation and other legal documents
The EAP includes up to three counseling sessions per issue. Sessions can be done in person, on the phone, by video or text. WorkLife Services are included with the EAP for help with referrals for education, adoption, daily living and care for your pet, child or elderly loved one.
Contact the EAP
Visit www.healthadvocate.com/standard3
Call 888-293-6948
Life Services Toolkit
HealthAdvocate’s Life Services Toolkit can help you make plans that will make a difference for your family now and in the future.
Services to Help You Now
These resources help you with estate planning, financial planning, funeral planning and more. Visit the Life Services Toolkit website at www. standard.com/mytoolkit and enter user name assurance for details.
Services for Beneficiaries
The time after a loved one dies is difficult for a beneficiary. The Standard partnered with HealthAdvocate to offer services to Group Life insurance beneficiaries* for 12 months after receiving a Life claim letter from The Standard. Services include grief support, legal services, financial assistance, etc. Call the Life Services Toolkit phone assistance line at 800-378-5742 or go online at www.standard.com/mytoolkit (login: support).
*The Life Services Toolkit is also available to recipients of an Accelerated Death Benefit or Accelerated Benefit for 12 months after the date of payment. It is not available to Life insurance beneficiaries who are minors or to nonindividual entities such as trusts, estates or charities.
Collective Health Resources
Collective Health will provide customer service, claim processing and support for our members. They contract with Blue Cross Blue Shield (BCBS) allowing our members to see any physician or use any facility in the BCBS National PPO Network of providers. Please contact Collective Health for all medical and prescription drug questions, not BCBS. This includes claims questions, health care guidance, provider issues, precertification, prior authorization and/or for any assistance regarding your medical and prescription drug coverage. If in doubt, call Collective Health! Note: Your doctor must also file claims with Collective Health, not BCBS.
My Collective Website
My Collective is the online portal you will use to register for and access your account information. View your digital ID cards, review your health plan coverage, find providers, check deductibles, and more — all in one place! Explore the Help Center on the Home Page for timely answers and information about your benefits. Go to https://bcbstx.collectivehealth.com and click Register Now to get started.
Collective Health App
Get the Collective Health app for on the go access to your benefit plan. See page 46 for a link to download or scan the QR code below with your phone.
Scan or click for more information.
Member Advocates
Contact a Member Advocate whenever you need help in managing your care, finding a doctor, answering benefit-related or prescription drug questions, helping you with claims and billing issues, and more. When you contact a Member Advocate, you will get free conciergelevel support by phone, online chat or secure message. Member Advocates help solve complex problems and give helpful direction about your benefits. You must be registered to sign in to the app or website. Call 855-4955996 or access https://bcbstx.collectivehealth.com
Scan or click to access the Collective Health online portal.
Care Navigation
Care Navigation plays a crucial role in helping you get the right support, at the right time, across a wide range of healthcare needs. The Care Navigation program is offered at no cost to you to help you understand your unique needs and provide you with a care management experience that truly makes a difference.
Pregnancy, newborn, or birth-related complications
Genetic and rare conditions
Developmental conditions such as autism
Support talking to doctors or understanding treatments or medications
Manage infusions, injectables, or multiple medications
Surgeries and transplants
Traumatic injury
Contact the Care Navigation Team
Call the Care Navigation team or send a secure message from your Collective Health account. You must register for an account first to sign in to the app or website.
Call 833-834-1170
Chat https://bcbstx.collectivehealth.com
Download the Collective Health mobile app.
Cancer
Stroke
Asthma
Diabetes
Disabilities
Neurologic, cardiac, or gastrointestinal conditions
Unsafe environment
Find community resources
Need a Medical Precertification?
Contact Collective Health to manage any precertifications you may need by calling 833-834-1170
New employees who do not have Medical coverage can access plan info and search in-network providers at https://join.collectivehealth.com/higginbotham.
Medical Coverage
Collective Health offers three medical plans which use the BCBS National PPO provider network:
Base EPO Plan – An Exclusive Provider Organization (EPO) plan with in-network benefits only
Buy Up PPO Plan – A Preferred Provider Organization (PPO) plan with in-network and out-of-network benefits
HDHP – A High Deductible Health Plan (HDHP) with in-network and out-of-network benefits and a tax-free Health Savings Account (HSA – see page 26)
All plans cover preventive care at 100% from in-network providers only.
See any provider in the BCBS National PPO network for care.
Get no benefits for out-of-network care, except in true emergencies.
Pay a copay for in-network office visits, urgent care and generic drugs.
Meet your deductible then pay a copay or coinsurance for other in-network services and non-generic drugs:
$3,500 individual deductible
$7,000 family deductible
Pay copay and coinsurance for emergency care (ER). Non-emergency care in an ER is not covered.
Have plan pay 70% after in-network deductible is met and 100% after in-network out-of-pocket max is reached:
$5,650 individual
$11,300 family
Enjoy lowest per-paycheck cost.
Total Care Option (TCO)
Contact Collective Health at 855-495-5996 or access https://bcbstx.collectivehealth.com and open the Get Care tab.
See any provider in the BCBS National PPO network for care.
Get significantly reduced benefits for out-of-network care. See page 23.
Pay a copay for in-network office visits, urgent care and prescription medications.
Meet your deductible for other in-network services to be covered by coinsurance:
$2,000 individual deductible
$4,000 family deductible
Pay copay and coinsurance for ER care.
Have plan pay 80% after in-network deductible is met and 100% after in-network out-of-pocket max is reached:
$5,600 individual
$11,200 family
See any provider in the BCBS National PPO network for care.
Get significantly reduced benefits for out-of-network care. See page 23.
Satisfy a higher deductible that applies to almost all health care expenses.
Know plan is a qualified HDHP:
$3,500 individual deductible
$7,000 family deductible
Have plan pay 80% after in-network deductible is met and 100% after in-network out-of-pocket max is reached:
$4,500 individual
$9,000 family
Enjoy lower per-paycheck cost than Buy Up Plan.
If you are currently enrolled in one of Higginbotham's medical plans through Collective health, and you decide to enroll in your spouse's employers medical plan, Higginbotham will reimburse up to $6,000 of your family’s out-of-pocket costs if you enroll in your spouse’s health insurance plan with their employer. That could mean $0 for prescriptions, doctors visits, and any medical care you and your family needs. There is no cost to join TCO. Have a question? Email our Healia Health partner at support@healiahealth.com. See page 25 for more information.
Medical Coverage
The following programs and services are only available if you enroll in one of our medical plans.
Hinge Health
Reduce back and joint pain without drugs, surgery or office visits with Hinge Health. If you or a covered dependent (age 18+) have musculoskeletal pain in your back, knees, hips, neck, shoulders or other joints, join Hinge Health at no cost to you. On average, participants reduce their pain by 68%! Programs include:
Personalized exercise therapy
Unlimited one-on-one health coaching
Motion tracking technology for instant feedback on your form
Pelvic floor programming for pregnancy and postpartum, bladder control, muscle relaxation, and more
Menopause care for managing symptoms like joint pain, bone density changes, hot flashes, and more
Learn more at https://hinge.health/higginbotham or call 855-902-2777.
Well onTarget
Get the support you need to make healthy choices and be rewarded for your hard work with Well onTarget. Find a suite of inviting programs and tools that are personalized for you, including:
An online Health Assessment
Self-management programs
Tools and trackers
Download the AlwaysOn Wellness mobile app in the Apple or Google store. Click on Create an Account and follow the prompts to verify information from your member ID card.
Fitness Program
Fitness can be easy, fun and affordable. The Fitness Program powered by Tivity gives you unlimited access to a nationwide network of more than 10,000 fitness locations. Visit locations while you are on vacation or traveling for work. Other program perks include:
No long-term contract – Enjoy a month-to-month membership, with flexible plans (from $10 to $239 a month) and studio classes.
Convenient payment – Have monthly fees paid by automatic credit card or bank account withdrawals.
Complementary and alternative medicine – Get discounts through the Whole Health Living Choices Program for acupuncturists, massage therapists, trainers and more.
To Register
Visit the Well onTarget Fitness Program benefit tile on your MyCollective Health portal or app.
Visit https://bcbsilforyourhealth.com
Call a member advocate at 855-495-5996
Note: Wellness Resources are not part of the Asset Health Points Program. Participation in Wellness Resources will not count toward the annual point goal associated with Healthy HIGG.
Medical Coverage
The following programs and services are only available if you enroll in one of our medical plans.
Wondr
If you would like to lose weight and change how your body stores and uses energy, Wondr may be right for you. Wondr is a 100% digital weight loss program that teaches you how to eat your favorite foods and still lose weight, have energy, stress less and sleep better. It is not a diet plan. There are no points, plans or calories to count. It teaches you skills to know how and when you eat and improve your long-term health. To learn more, visit the Wondr benefit tile on your MyCollective Health portal or app or call a member advocate at 855-495-5996.
Ovia Health
Ovia Health offers support for reproductive health, starting a family, having a healthy pregnancy, balancing life as a parent, and managing menopause. Ovia Health apps are included in your health plan benefits. All Ovia Health members have access to these features:
Health and menstrual cycle tracker
Pregnancy calendar and daily baby updates
Child’s development checklist
Data and symptom feedback
Tools to help manage menopause symptoms
To learn more, visit the Ovia benefit tile on your MyCollective Health portal or app or call a member advocate at 855-495-5996.
Blue365
Blue365 saves you money on health and wellness products and services from top retailers that are not covered by insurance. There are no claims, referrals or preauthorization. Once you sign up, you will receive weekly Blue365 Featured Deals to alert you to special savings. To learn more, visit the Blue365 benefit tile on your MyCollective Health portal or app.
Note: Wellness Resources are not part of the Asset Health Points Program. Participation in Wellness Resources will not count toward the annual point goal associated with Healthy HIGG.
Prescription Drug Coverage
Prime Therapeutics
Prime Therapeutics provides pharmacy benefit management and other related services through the Traditional Select Network. Use www.myprime.com to save money on medicines for you and your family. It is easy to compare costs and find the nearest in-network pharmacy.
Note: Collective Health Member Advocates are available to help with your prescription drug questions by calling 855-495-5996
myprime.com
Use the www.myprime.com website to access specific information.
See cost and coverage information for your medicines. Consider generic drugs to save up to 30-80%.
30-Day Prescriptions
Search pharmacies in your network. Review your prescription history and cost information
Fill 30-day prescriptions at any pharmacy in the Traditional Select Network. Major chains include Walgreens, CVS, Walmart, etc.
90-Day Prescriptions
Fill maintenance medication for chronic conditions in one of two ways:
Home delivery via Express Scripts (drugs delivered anywhere in the U.S.)
Extended Supply Network via certain retail pharmacies (over 65,000 participating pharmacies)
Specialty Medications
Specialty medicines must be filled through Advocate+ Pharmacy Match or other in-network specialty pharmacy to avoid paying higher out-of-pocket costs. These are noted on the Drug List as Specialty Drugs and if they need prior authorization.
Manage on the Go
Anytime, anywhere from your mobile device with the Prime Therapeutics mobile app.
MedsYourWay Retail
Good news! This drug discount card savings program automatically searches for and finds lower costs for eligible medicines. You only need to show your medical ID card to the pharmacy to pay the lowest price for your medication.
Quick Reference
Pharmacy Website www.myprime.com
Drug List
Balanced Biosimilar Drug List
Pharmacy Network Traditional Select
Home Delivery www.express-scripts.com 833-715-0942
Specialty Drugs advocateplus@primetherapeutics.com 833-950-3858
General Help and Prescription-Related Questions Collective Health Member Advocates 855-495-5996
Prescription Drug Resources
Tria Health
Tria Health is a free and confidential benefit available through your health plan. If you or a covered dependent have a chronic condition or take multiple medications, a Tria Health pharmacist can help you better manage your health and medication.
Who Should Participate?
Tria Health is recommended if you have the following conditions and/or take multiple medications:
Asthma/COPD
Diabetes
Heart disease
High blood pressure
Why Participate?
A Tria Health pharmacist can help:
Ensure your medications are working as intended
Save you money ($250 a year on average)
Answer health questions
Control your diabetes
High cholesterol
Mental health issues
Migraines
Osteoporosis
All Tria Health pharmacists are Certified Diabetes Care and Education Specialists
Eligible members receive a free blood glucose meter and testing supplies
Control your high blood pressure
Eligible members receive a free blood pressure monitoring system
Get tips to lower your blood pressure; tips are not limited to medications and can include lifestyle and diet adjustments
Coordinate care with your doctor(s) – over 95% of recommendations made by Tria Health were accepted by an individual’s physician.
Develop a personalized quit plan through the S.T.O.P program if you want to quit tobacco
Ready to Get Started?
To schedule your first appointment, visit http://www.triahealth.com/schedule or call 888-799-8742 to speak with a Tria Health member advocate.
This benefit is only available if you enroll in one of our medical plans.
NEW! $0 International Prescription Programs
Beginning January 1, you can save money and simplify your prescription routine with the international prescription programs offered through CANARx and ElectRx. Use CANARx for common, brand-name maintenance medications, and use ElectRx for specialty and diatetes medications. Eligible employees and dependents can receive select brand-name medications at no cost, shipped safely and directly to your home. To be eligible, you must already be taking the drug for at least 30 days without complications.
How It Works
1. Check Your Medication
Review the drug formulary list of eligible medications or call CANARx or ElectRx to confirm if your prescription qualifies (the list is subject to change).
2. Get Enrolled
CANARx – Complete an enrollment form from the CANARx website and submit it along with your prescription and photo ID.
ElectRx – Have your doctor fax or mail your prescription directly to the program.
3. Receive Your Medication
Your prescription will be filled through licensed pharmacies in Canada, the United Kingdom, Australia, or New Zealand, and delivered to your home in the manufacturer’s sealed packaging – all at no cost to you.
Highlights
$0 copay and $0 shipping
Safe, simple, and convenient — delivered right to your door
Government-licensed Tier 1 pharmacies with U.S.-equivalent safety standards
Numerous brand-name medications available
Easy refills with reminder notices and refill tracking information
Program participation is voluntary – you can continue to use your current pharmacy for other medications
Important Notes
Generic medications, controlled substances, and antibiotics are not available through this program.
A local trial is required for any new medication before enrolling in a program.
Allow about 4 weeks for delivery once your order is processed.
To Learn More or Enroll
CANARx
Visit www.canarx.com.
Call 866-893-6337. ElectRx
Call 855-353-2879.
Email info@electrx.com.
Fax for physicians 833-353-2879.
Mail A&M Pharmacy NCPDP: 2338514 8282 Woodward Ave. Detroit, MI 48202
Medical and Prescription Benefits Summary
2
Why Choose the HDHP over the Buy Up PPO Medical Plan?
If you are in the HDHP:
The HDHP out-of-pocket maximums are $4,500/ Individual or $9,000/Family
It offers triple tax advantages if you enroll in the Health Savings Account (HSA)
The HSA is yours to keep; use the money now to pay for qualified expenses or let it grow for future use
If you are in the Buy Up PPO:
You pay 100% of premiums to Collective Health, whether you use the plan or not
You pay copays, a deductible and coinsurance (up to $5,600/Individual or $11,200/Family) It has no tax-advantaged HSA
Medical Plan Monthly Premiums
Healia Health
Available at no cost to you, the Healia Health plan selection tool can help you determine which medical plan is best for you! If you have a working spouse, you can upload her/his benefits information and rates into the tool, and all of your medical plan options will be analyzed, including your spouse’s plan. All employees can use this tool to help you determine which plan is best for you and your family.
Plan Selection Tool
With the plan selection tool, your medical plans are already loaded. All you need to do is enter your expected medical expenses for the year, and the tool will provide you with the approximate cost for enrolling in each medical plan.
Total Care Option (TCO)
If you had coverage through a Higginbotham medical plan in 2025 and your working spouse has medical insurance, you can upload her/his benefits information into the TCO portal. Healia Health will assess your options and provide a personalized summary of your cost for coverage in our medical plans and your spouse’s plans, making the choice decision easier.
To compare our plan options with those of your spouse, upload any of these items from your spouse’s medical plan options:
Benefits booklet or benefits summary
Summary Plan Description (SPD)
Summary of Benefits and Coverage (SBC)
If you currently have coverage in a Higginbotham 2025 medical plan and elect to enroll in your spouse’s medical plan for 2026, Higginbotham will provide you with a fully-funded Health Reimbursement Arrangement (HRA), administered by Healia Health.
How to Enroll in the TCO
To be eligible for the TCO, you must be a new hire enrolling in benefits for the first time, or you must currently be enrolled in a Higginbotham 2025 medical plan and choose to enroll in your spouse’s medical plan for 2026 through her/his employer. Medicare, Medicaid, TRICARE coverage, or a plan on the ACA marketplace are not eligible.
Choose the Total Care Option during your enrollment at https://app.healiahealth.com/join/higginbotham.
How to Receive Reimbursement for Expenses
Present your insurance card from your spouse’s medical plan to the provider or pharmacy.
Once you receive the Explanation of Benefits (EOB), doctor’s bill, or pharmacy receipt, upload it to Healia’s online portal or mobile app.
Healia will review the claim and reimburse you for eligible expenses up to $6,000.
This could mean you will pay $0 for prescriptions, doctor’s visits, and any medical care you and your family need. Scan or click to get started
with Healia Health.
Health Savings Account
A Health Savings Account (HSA) is more than a way to help you cover health care costs — it is also a tax-exempt tool to supplement your retirement savings and cover health expenses during retirement. An HSA provides funds to help pay current and future health care expenses and is yours to keep, even if you change HDHP health plans or jobs. HSA funds (including interest and investment earnings) grow and spend tax-free if used for qualified expenses. There is no “use it or lose it” rule 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
Not covered by a plan that is not a qualified HDHP, such as your spouse’s health plan
Not enrolled in a Health Care FSA (nor can a covered spouse participate in one)
Not eligible to be claimed as a dependent on someone else’s tax return
Not enrolled in Medicare or TRICARE
Not receiving Veterans Administration benefits
Use the money in your HSA to pay for qualified expenses now or in the future. You can also use HSA funds to pay health care expenses for your dependents, even if they are not covered by the HDHP.
Covering Your Children
Children can be covered under your medical plan up to age 26, but you can only use your HSA to cover their expenses to age 19 (age 24 if a full-time student). Once your child(ren) reach age 19 (or 24), they can open their own HSA at the family maximum limit of $8,750.
Important HSA Information
Always ask your health care provider to file claims with your medical provider so network discounts can be applied. You can pay the provider with your HSA debit card based on the balance due after discount.
You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.
If you are enrolled in the HDHP and meet the eligibility requirements for an HSA, you may not participate in the general Health Care FSA. However, you can participate in the Limited Health Care FSA (for dental and vision expenses only). You may participate in the Dependent Care FSA for child care expenses.
Opening an HSA
If you meet the eligibility requirements, you may open an HSA administered by HSA Bank. You will receive a debit card to manage your reimbursements. Available funds are limited to the balance in your HSA. An eligibility file will be sent to HSA Bank when you enroll in the HDHP, which will automatically open your account. You may be contacted by HSA Bank to verify your identity as part of their security protocols. Please respond to them timely to prevent any delay in your account being opened. Funds are deposited to accounts after each payroll run.
Maximum Contributions
Your HSA contributions may not exceed the annual maximum amount established by the Internal Revenue Service. The annual contribution maximum for 2026 is based on the coverage option you elect. 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 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.
HSA Fees
Monthly administrative fees are waived:
Printed statement fee – $1.50
Account closure fee – $25.00
Flexible Spending Accounts
One way to plan ahead and save money over the course of a year is to participate in our Flexible Spending Account (FSA) programs. FSAs allow you to pay for certain health, dental, vision and dependent care expenses with pretax dollars that reduce your taxable income and save you money. Our FSAs are administered by Higginbotham There are three kinds of accounts: two for health care expenses and one for dependent care expenses. When you enroll, you must decide how much money to set aside from your paycheck for each account. Be sure to estimate your expenses conservatively as the IRS requires that you use the money in your account during the plan year and applicable grace period (the “use it or lose it” rule).
You may participate in the FSA programs even if you waive Higginbotham medical benefits.
Health Care FSA
Set aside pretax dollars from each paycheck
Contribute up to $3,400 annually
Pay for eligible health care expenses such as office visit copays, deductible, prescription drugs, braces, dental and eye care expenses
Is available only if you do not have a Health Savings Account
Is compatible with the Base and Buy Up medical plans
Limited Purpose Health Care FSA Dependent Care FSA
Set aside pretax dollars from each paycheck
Contribute up to $3,400 annually
Pay for eligible vision and dental expenses
Is available only if you have a Health Savings Account
Is compatible with the HDHP medical plan
You can carry over up to the IRS limit from your Health Care or Limited Purpose Health Care FSA:
Up to $680 from 2026 to the 2027 plan year
If you enroll in the HDHP and contribute to an HSA, you can only participate in the Limited Purpose Health Care FSA.
Remember
Flex dollars are use it or lose it, outside of the below IRS carryover limits. Should you terminate employment, your Flex dollars can only be used through your termination date. You will have 90 days after termination to file a claim that was incurred prior to your termination date. If you have a positive balance at termination, you have the right to elect COBRA.
Set aside pretax dollars from each paycheck
Contribute up to $7,500 annually (single parent filing head of household; or married filing jointly) or $3,750 annually (married filing separately)
Use for child or dependent elder care expenses
Allows you and your spouse to work or attend school full time
Cannot be used to pay for dependent health care expenses
Flexible Spending Accounts
How the Health Care FSA Works
When you incur a medical, dental, vision or hearing expense, you will be reimbursed the full amount of the expense at that time (up to your annual election amount). You are entitled to the full election amount from day one of your plan year. When you incur a qualified health care expense, you can choose one of two reimbursement methods:
Use your FSA debit card (see information below) to pay doctor visit and prescription copays. Your FSA will be charged for the amount and you will not need to submit a request for reimbursement.
Pay out-of-pocket and then submit your receipts for reimbursement:
App – download the Higginbotham Flex mobile app
Fax – 866-419-3516
Email – flexclaims@higginbotham.com
Online – https://flexservices.higginbotham.net
You can only enroll in the Health Care FSA if you elect the Base or Buy Up medical plans or you are enrolled in the HDHP and are not eligible to open an HSA (i.e., you are enrolled in Medicare).
Limited Purpose Health Care FSA
A Limited Purpose Health Care FSA is available if you are enrolled in the HDHP medical plan and have an HSA. You can use a Limited Purpose Health Care FSA to pay for eligible out-of-pocket dental and vision expenses only, such as:
Dental and orthodontia care (e.g., fillings, X-rays and braces)
Vision care (e.g., eyeglasses, contact lenses and LASIK surgery)
Higginbotham Benefits Debit Card
The Higginbotham Benefits Debit Card is a quick and easy way to pay for qualified expenses from your Health Care and Limited Purpose Health Care FSA. The debit card links directly to your FSA and gives you immediate access to funds when you are making a qualified purchase. You do not need to file a claim for reimbursement. New cards will automatically be sent for all NEW enrollees; otherwise, your current card is still good for the 2026 plan year.
Note: If you use the debit card to pay anything other than copay amounts, prescriptions or vision expenses, you will need to submit an itemized receipt or an Explanation of Benefits (EOB). If you do not submit your receipts, you will receive a request for substantiation. You will have 60 days to submit your receipts after receiving the request for substantiation before your debit card is suspended.
About the Dependent Care FSA
Dependent Care FSA reimbursement is limited to your account balance. To be reimbursed, you must provide the tax identification or Social Security number of the party providing care (provider cannot be your dependent).
Things to Consider Regarding the Dependent Care FSA
Overnight camps are not eligible for reimbursement (only day camps).
A dependent child must be under age 13 and claimed as a dependent on your federal income tax return, or a disabled dependent of any age incapable of caring for themselves and who spends at least eight hours a day in your home.
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.
To qualify for elder care, care for a tax dependent elder must be so you can work, go to school or find work.
If the expense is directly related to extend in-home medical care (e.g., full-time nursing), the expenses are NOT eligible.
Advanced care is eligible (i.e., personal care assistant to help with daily living, medical appointments, errands, etc.).
Flexible Spending Accounts
Higginbotham Portal
The Higginbotham Portal has everything you need to manage your FSAs:
24/7 access to plan documents, letters and notices, forms, account balances, contributions and other plan information
Update your personal information
Look up qualified expenses
Submit claims
Important FSA Rules
The maximum per plan year you can contribute to a Health Care or Limited Purpose FSA is $3,400. The maximum per plan year you can contribute to a Dependent Care FSA is $7,500 (single parent filing head of household; or married filing jointly) or $3,750 (married filing separately).
You can only change your election during the year if you have a Qualifying Life Event.
You can continue to file claims incurred during the plan year for another 31 days (up until January 31, 2027).
Your Health Care FSA debit card can be used for health care expenses only.
Register on the Higginbotham Portal
Go to https://flexservices.higginbotham.net and click Register. Follow the instructions and scroll down to enter your information.
Enter your Employee ID, which is your Social Security number with no dashes or spaces.
Follow the prompts to navigate the site.
If you have any questions or concerns, contact Higginbotham:
Phone – 866-419-3519
Email – flexclaims@higginbotham.com
Fax – 866-419-3516
Higginbotham Flex Mobile App
Easily access your Health Care FSA on your smartphone or tablet with the Higginbotham mobile app. Search for Higginbotham in your mobile device’s app store and download as you would any other app.
View Accounts – Includes detailed account and balance information
Card Activity – View debit card activity
SnapClaim – File a claim and upload receipt photos directly from your smartphone
Manage Subscriptions – Set up email notifications to keep up-to-date on all account and Health Care FSA debit card activity
Log in using the same username and password you use to log in to the Higginbotham Portal. Note: You must register on the Higginbotham Portal to use the mobile app.
Telemedicine
HealthJoy partners with Teladoc to provide no cost telemedicine services to all benefit eligible employees and their enrolled eligible dependents, regardless of medical plan enrollment. Connect anytime day or night with a board-certified doctor via your mobile device or computer. While telemedicine does not replace your primary care physician, it is a convenient and cost-effective option when you need care and:
Have a non-emergency issue and are considering an after-hours health care clinic, urgent care clinic or emergency room for treatment
Are on a business trip, vacation or away from home
Are unable to see your primary care physician
Medical Practice Areas
Primary care
Preventive care
Urgent care
Dermatology
Nutrition
1 If you are enrolled in a medical plan, use HUSK for $0 nutrition services. See page 12 for details.
Registration is Easy
Visit www.healthjoy.com
Call 877-500-3212
Download the HealthJoy app
When to Use Teladoc
Use telehealth services for minor conditions such as:
Sore throat
Headache
Stomachache
Cold
Flu
Allergies
Fever
Allergies
Poison ivy Urinary tract infections
Dermatology
Do not use telemedicine for serious or life-threatening emergencies. HealthJoy offers so much more than telemedicine! Save time, money, and frustration by using their concierge-style services and support. See page 9 for details.
Dental Coverage
Our dental plans help 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 Sun Life using the Sun Life Dental network. Download the Sun Life app to show your dental ID card. Low
DPPO (Preventive/Basic Services Only)
This plan is for preventive and basic services only.
Choose in-network or out-of-network providers.
Orthodontic care is not provided.
In-network providers are reimbursed on a negotiated fee schedule.
You must cover major services and out-of-network care costs.
Out-of-network payments are based on the Maximum Allowable Charge (MAC).
Dental Benefits Summary
DPPO
This plan covers preventive, basic and major services as well as orthodontic services for adults and children.
Choose in-network or out-of-network providers.
Use in-network providers for the highest level of benefits.
In-network providers are reimbursed on a negotiated fee schedule.
Out-of-network payments are based on the Maximum Allowable Charge (MAC).
This plan covers preventive, basic and major services as well as orthodontic services for adults and children.
Choose in-network or out-of-network providers.
Use in-network providers for the highest level of benefits.
In-network providers are reimbursed on a negotiated fee schedule.
Out-of-network payments are based on a percentage of the Usual and Customary charge.
Vision Coverage
EyeMed vision care is for more than just the eyes. Eye exams can detect early signs of diabetes, high blood pressure and heart disease. Early treatment leads to better outcomes and lower costs. When looking for a provider, select Insight Network.
Choose ANY in-network provider
Choose ANY frame, lens or contacts
Benefits can be applied online at glasses.com, lenscrafters.com, contactsdirect.com, targetoptical. com, oakley.com, nuanceaudio.com and rayban.com
Additional discounts and services are available (see plan for details)
Vision Benefits Summary
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Eyes to See and Ears to Hear
More than 36 million U.S. adults have some degree of hearing loss, but vision and hearing loss often go hand in hand. If you enroll for vision coverage, Amplifon offers discounts on hearing aids. Visit www.eyemed.com for details.
Life and AD&D Insurance
Life and Accidental Death and Dismemberment (AD&D) insurance through The Standard 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).
Basic and Voluntary coverage are portable. As you grow older, your Life and AD&D coverage amount reduces by 35% at age 65 and 50% at age 70.
Basic Life and AD&D
Basic Life and AD&D insurance are provided by Higginbotham at no cost to you. You are automatically covered at two times your basic annual earnings (based on your benefit salary as of January 1) up to a maximum of $300,000. There is an accelerated benefit of 75% of life benefit to a maximum of $300,000.
Voluntary Life and AD&D
If you need more coverage than Basic Life and AD&D, you may purchase Voluntary Life and AD&D for yourself and your dependents. You must elect coverage for yourself before buying dependent coverage. The amount of coverage you elect for yourself must be equal to or higher than the highest dependent coverage amount elected.
Increments of $10,000 not to exceed five times annual salary up to $1,000,000
Initial Enrollment Guaranteed Issue: $500,000
Increase coverage by two increments during Open Enrollment (not to exceed Guaranteed Issue)
Increments of $5,000 up to $500,000 not to exceed 100% of your coverage
Initial Enrollment Guaranteed Issue: $100,000
Designating A Beneficiary
A beneficiary is the person or entity you designate to receive the death benefits of your Life insurance policy. You can name more than one beneficiary and you can change beneficiaries at anytime. If you name more than one beneficiary, you must identify the share for each.
Disability Insurance
Disability insurance through The Standard provides partial income protection if you are unable to work due to a covered accident or illness. We provide Long Term Disability (LTD) at no cost to you and additional protection by offering Voluntary LTD and Short Term Disability (STD) insurance for you to purchase.
Long Term Disability
LTD insurance pays a percentage of your monthly salary for a covered disability or injury that prevents you from working for more than 90 days. Higginbotham provides Basic LTD coverage at no cost to you. You pay the tax on these premiums and receive the disability benefit taxfree. This is a significant benefit increase if you have a qualifying LTD claim.
Benefits begin on the 91st day of injury or illness
Receive 60% of your predisability earnings
Maximum monthly benefit:
Class 1 (annual salary at or above $100,000) – $25,000
Class 2 (annual salary less than $100,000) –$6,000
SSNRA maximum benefit period
3/121 pre-existing condition exclusion
Basic LTD is provided at no cost to you
An additional amount of 10% disability coverage is offered as a Voluntary benefit to Class 1 employees. Rates are based on age, position and coverage amount. Email HR at benefits@ higginbotham.com to request an illustration and application kit.
Benefits begin on the 15th day of injury or illness
First-day hospital benefit waives your waiting period and pays benefits if you are confined in a hospital for at least four hours
Receive 60% of your predisability earnings
$2,000 maximum weekly benefit
90-day maximum benefit period
No pre-existing condition exclusion
Voluntary STD cost is $0.29 per $10 of weekly benefit
Calculate your monthly rate:
Weekly Earnings (up to $3,334 maximum) ×
0.60 × $0.29 ÷ $10
1 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.
If you are a Class 1 employee, you can purchase additional Voluntary LTD when you become benefitseligible, which pays an additional 10% of your annual earnings equal to a total of 70% coverage. Employee rates include a 25% discount. Coverage is individuallyowned and portable.
Short Term Disability
STD coverage pays a percentage of your weekly salary for up to 90 days if you are temporarily disabled and unable to work due to an illness, non-work related injury or pregnancy. STD benefits are not payable if the disability is due to a job-related injury or illness. You may purchase STD for yourself. When collecting STD benefits, your other benefits continue as long as you keep paying the cost of those plans.
Employee Assistance Program (EAP) Visits
If you are enrolled in the employer-provided LTD plan, you are eligible for The Standard’s HealthAdvocate EAP service, which includes three face-to-face visits. Call 888293-6948 or visit www.healthadvocate. com/standard3
Medical Emergency Transportation
Did you know the average cost for air ambulance transportation is $40,000 and can go as high as $70,000?
MASA Medical Transport Solutions (MASA MTS) helps you prepare for the unexpected by providing access to affordable medical emergency air and ground transportation.
Participation in this plan is voluntary. If you or your family members are in need of emergency medical transport, your insurance coverage and Medicare may not cover all of the costs. Following your medical crisis, MASA MTS will negotiate with your medical plan provider and cover your remaining balance on your medical transportation bills.
MASA MTS provides coverage with no limitations. You have two plans to choose from: Emergent Plus and Platinum. The Emergent Plus plan provides coverage for airplane, helicopter or ground ambulance expenses anywhere in the U.S. or Canada. The Platinum Plan provides emergency transportation in the U.S. or Canada and non-emergency transportation worldwide.
MASA MTS
Supplemental Insurance
Your health insurance covers medical bills, but if you have an emergency situation, you may encounter unexpected out-of-pocket costs such as deductibles, coinsurance, loss of income and non-medical related expenses. The following coverages are provided by Allstate.
Accident Insurance
Accident insurance pays a fixed benefit direct to you in the event of an accident, regardless of any other coverage you may have. Benefits are paid according to a fixed schedule for accident-related expenses including hospitalizations, fractures, dislocations, emergency room visits, major diagnostic exams and physical therapy.
Special Features
Benefits are paid as a lump sum
Coverage is guaranteed – you will not be required to answer health questions
Coverage is portable
This is a brief description of the benefits available to you. See brochure for details.
Specific Sum Injuries
Dislocations, ruptured disks, eye injuries, fractures, lacerations, coma, concussions, etc.
Supplemental Insurance
Critical Illness Insurance
A critical illness can expose you to an unexpected gap in protection. While health plans may help cover many of the direct costs associated with a critical illness, related expenses such as lost income, child care, travel to and from treatment, high deductibles and copays may quickly diminish savings. Critical Illness insurance pays a fixed benefit if you are diagnosed after your coverage effective date. All amounts are Guaranteed Issue.
Invasive Cancer; Advanced Alzheimer's Disease; Advanced Parkinson's Disease; Heart Attack; Stroke; Heart, Kidney or Organ Failure; Heart Transplant; Bone Marrow or Stem Cell Transplant; Coma; Neonatal Intensive Care Unit; Childhood Benefits
Coverage1
Carcinoma in Situ, Coronary Artery Bypass Graft, Coronary Artery Disease
Choose a Plan
Select
Supplemental Insurance
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. You decide how to use the benefit funds for medical and non-medical expenses. No medical questions or exams are required for coverage.
Hospital Indemnity
Legal and ID Theft Services
If you need guidance and assistance with legal consultation, family matters or small claims court assistance, work with local plan attorneys through LegalShield. Protect your identity with IDShield
Legal Protection
Put a law firm in the palm of your hand with LegalShield. Benefits include:
Family matters (e.g., adoption, elder care, juvenile court, prenuptial agreements)
Financial (e.g., affidavits, consumer protection, tax audit and collection service, bankruptcy)
Home (e.g., boundary or title disputes, deeds, foreclosure, mortgages)
Estate planning (e.g., probate, trusts, wills and codicils, living wills)
Auto (e.g., driver’s license restoration, moving traffic violations, motor vehicle property damage)
General (e.g., 24/7 emergency access, document review, demand letters and phone calls on your behalf, consultations)
Identity Theft Protection
Millions of people have their identity stolen each year. IDShield provides identity theft protection and identity restoration services for you, your spouse and up to 10 dependents. Benefits include:
Monitored information (e.g., email, phone, account numbers, names)
Privacy and security monitoring (e.g., internet and dark web, social media)
Comprehensive source monitoring (e.g., global black market, online chat rooms, social feeds)
Unlimited consultation (e.g., child identity theft, credit reports, data breaches)
Complete identify restoration ($1 million protection policy, unlimited service guarantee)
General (e.g., 24/7 emergency access, alerts, access to licensed private investigators)
Financial account monitoring and a $1 million identity fraud protection plan for unauthorized electronic fund transfers and identity theft related expenses
Legal Consultation and Advice
Court Representation
Legal Document Prep and Review
Letters and Phone Calls on Your Behalf
Speeding Traffic Violations
Will Preparation, Estate Planning
Home Buy/Sell Assistance
Bankruptcy, Foreclosure
24/7 Emergency Legal Access
Identity Consultation and Advice
Licensed Private Investigators
Identity and Credit Monitoring
Social Media Monitoring
Child Monitoring (Family Plan Only)
Comprehensive Identity Restoration
Identity and Credit Threat Alerts
24/7 Emergency ID Protection Access
Mobile App
Travel Assistance
Higginbotham’s 24-hour emergency travel services are available when you travel 100 or more miles away from home or internationally for up to 180 days for business or pleasure. Coverage is provided by Assist America, Inc. for FREE This plan is not travel insurance but provides assistance when needed while traveling.
Emergency travel assistance is available at no cost to you. Services include:
Personal Support – trip information, lost or stolen item assistance, legal referral and bail, interpretation and translation services, crime information
Medical Emergency* Support – medical monitoring, provider search and referrals, replacement of medication, medical devices and glasses or corrective lenses, hospital admission
Emergency Support – travel arrangement, cash advance, message relay, evacuation, trauma counseling
Emergency Transport* for Travelers – medical evacuation, repatriation of mortal remains, medical repatriation
Emergency Transport* for Others – care of minor children; return of traveling companion, pet or service animal; vehicle return; evacuation transport for family members
Return of Travel Companion – due to travel disruptions from emergency transportation services or care of minor children if left unattended due to prolonged hospitalization
Connection – medical providers, interpreter services, local attorneys and bail bond coordination
* Must be arranged by Assist America.
Contact Assist America
For a complete list of services, contact Assist America:
800-872-1414 (U.S./Canada, Puerto Rico, U.S. Virgin Islands and Bermuda)
+1-609-986-1234 (other locations)
Text +1-609-334-0807
Email medservices@assistamerica.com
Get the Assist America mobile app
Reference number 01-AA-STD-5201
Pet Insurance
You have the opportunity to purchase medical insurance for your pets through Nationwide. Coverage is available for cats, dogs, birds and certain exotic animals. Each pet has an individual policy and discounts are available for two or more pets.
Visit any veterinarian clinic and receive up to 50% or 70% reimbursement on your vet bills after a $250 deductible ($7,500 maximum annual benefit).
To obtain our preferred rates, enroll for coverage through our designated website at www. petinsurance.com/higginbothamemployees. Nationwide will bill you direct.
My Pet Protection Wellness500
My Pet Protection Wellness500 covers preventive care, including eligible exams, vaccinations, flea prevention, spay or neuter, teeth cleaning and more. New members can select the MPP Wellness500 coverage option effective immediately. Existing members can add Wellness500 during their respective renewal period only. All changes are subject to underwriting approval.
Additional Features
Cost is based on your pet's breed, age and ZIP code (enroll before age 10)
Boarding/kennel fees if hospitalized due to injury or illness
Advertising/reward fees for pets that may go missing
Pet replacement costs if a missing pet is not found within 60 days
Mortality coverage for euthanization due to illness/injury and cremation/burial fees
Subscription to The Companion newsletter
Access to VetHelpLine, Nationwide PetRx and the Pet Health Zone portal
Important
During the policy implementation process, you will receive multiple emails from Nationwide. Even though you will need to answer questions about your pet, coverage is guaranteed. Pre-existing conditions limitations will apply.
Use any vet/Access to 24/7 Vet Helpline
Accidents, including poisonings and allergic reactions
Injuries, including cuts, sprains and broken bones
Common illnesses, including ear infections, vomiting and diarrhea
Serious illnesses, including cancer and diabetes
Hereditary and congenital conditions
Surgeries and hospitalization, including X-rays, MRIs, CT scans
Prescription medications and therapeutic diets
Preventive care, including wellness exams, vaccinations, spay/neuter, flea and tick prevention, heartworm testing and prevention, and routine blood tests
My Pet Protection with Wellness500 My Pet Protection
Personal Home and Auto Insurance
Travelers offers you a complete line of personal insurance to meet your individual needs, including auto, homeowners, condominium, renters, boat and yacht, identity theft protection, personal liability umbrella and valuable items.
Homeowner Coverage
Your Dwelling – your physical home
Other Structures – such as a garage or shed on the residence premises
Personal Property – anywhere in the world
Loss of Use – for incurred living expenses when your home is uninhabitable due to a covered loss
Personal Liability – protects you against a claim for bodily injury or property damage for which you are legally responsible
Medical Payments – covers necessary medical expenses due to an accident which causes bodily injury to others
Additional Options
Replacement cost on contents for personal belongings
Travelers identity theft protection program
Excess personal liability often referred to as an umbrella policy, with limits ranging from $1,000,000 to $5,000,000
Auto Coverage
Collision Coverage – pays for damage to your car if you hit another car or object
Comprehensive Coverage – if your car is stolen or damaged by causes other than collision, such as fire, theft or vandalism
Liability Insurance – to protect you from costs related to bodily injury or property damage if you are responsible for an accident
Medical Payments – covers payments for medical services for you, your family or your passengers if you are injured in a car accident (or as a pedestrian)
Uninsured or Underinsured Motorists – pays for damages caused by a driver with inadequate or no insurance
Additional Options
Extended Transportation Expenses – rental car or other transportation payment while your car is being repaired
Towing and Labor – covers towing and labor charges
Auto Loan and Lease Protection – to pay the outstanding balance of your car loan or lease if your car is totally destroyed
Deductible Options – a higher deductible may lower your premium
Convenient Billing Options
Electronic Funds Transfer (EFT)
Recurring Credit Card (RCC)
Direct Bill (if your homeowner’s insurance is held in escrow, Travelers can automatically bill your lender)
For more information, call 972-569-3112 or email myinsurance@higginbotham.com.
Student Loan Refinancing
Higginbotham partners with SoFi, a finance company that offers solutions for student loan refinancing. Managing multiple loans with varying interest rates, due dates and maturity dates can be a daunting task. Consolidate your loans into one new loan with a lower interest rate to save you money and payoff time with SoFi. Refinancing solutions are available to you and your family if you have federal or private student loans. Fixed and variable rates and flexible terms are offered. Benefits include:
No application fees, origination fees or prepayment penalties
Loan payments can be paused if you become unemployed
Access to wealth advisors
If eligible, you may be able to use SoFi to refinance a Parent PLUS loan.
For More Information
Visit www.sofi.com/higg to check your rates online. SoFi will conduct a soft credit pull that will not affect your credit score. Call 855-456-7634 or email ask@sofi.com for details.
Apps to Download
Download these helpful apps to access your benefits anytime, anywhere.
HealthJoy – Access to telemedicine. Online medical consultations, recommendations and prescription savings.
Collective Health – Access and manage health benefits. See claims details, find in-network providers and access ID cards.
Tria Health – Manage your health, medications and health care budget.
Lyra Health – Improve your mental well-being anytime, anywhere. Access skill-building videos, activities and resources on-the-go.
Asset Health – Access the Healthy Higg wellness program. Track activity, program rewards, and progress.
HUSK Nutrition – Access virtual health and nutrition services.
Hinge Health – Get an exercise therapy program available 24/7 for back, knee, hip, neck, or shoulder pain.
HSA Bank
View your HSA balance and manage your reimbursements.
Sun Life – Learn more about your Sun Life benefits, manage your claims and upload documents.
EyeMed – Check your vision benefits, find an eye care provider and view claims.
Higginbotham FSA – Check your account summary, available balances, claims requiring receipts, statements and notifications.
Allstate – Learn more about your Allstate benefits, manage your claims and upload documents.
Fidelity Investments – Track your retirement plan, review and change investments, check your account balance, and view recent transactions.
Shareworks – View, manage and forecast your Higg Grants and Shares portfolio and see transaction history.
LegalShield – Get legal support and answers to legal questions, help with estate planning and will preparation.
IDShield – Get ID theft protection and credit monitoring, credit score tracker, fraudulent activity alerts, and ID restoration support.
UKG Pro – Access personal HR and pay information, request time off and view the company directory.
https://apps.apple.com/us/app/healthjoy/ id1104881108
https://apps.apple.com/us/app/collective-health/ id1032100065
https://apps.apple.com/us/app/tria-health/ id1541412621
https://apps.apple.com/us/app/lyra-health/ id1534654470
https://apps.apple.com/us/app/asset-health-mobile/ id1325821489
https://apps.apple.com/us/app/husk-nutrition/ id1562801782?l=ar
https://apps.apple.com/us/app/hinge-health/ id1429270372
https://apps.apple.com/us/app/hsa-bank/ id6443886451
https://apps.apple.com/us/app/sun-life-dental-u-s/ id6476400437
https://apps.apple.com/us/app/eyemed/ id1531198681
https://apps.apple.com/us/app/higginbotham-fsa/ id1558901680
https://apps.apple.com/us/app/allstate-mobile/ id364376344
https://apps.apple.com/us/app/fidelity-investments/ id348177453
https://apps.apple.com/us/app/shareworks/ id1098307422
https://apps.apple.com/us/app/legalshield-lawfirms-on-call/id924247236
https://apps.apple.com/us/app/%CE%B9dshieldprotect-what-matters/id1444809858
https://apps.apple.com/us/app/ukg-pro/ id6445849909
https://play.google.com/store/apps/details?id=com. healthjoy.groups&hl=en_US
https://play.google.com/store/apps/details?id=com. collectivehealth.member&hl=en_US&gl=US
https://play.google.com/store/apps/details?id=com. tria.health&hl=en_US&gl=US
https://play.google.com/store/apps/details?id=com. lyra.lyrawebmobile&hl=en_US&gl=US
https://play.google.com/store/apps/details?id=com. assethealth.assethealthmobile&hl=en_US
https://play.google.com/store/apps/ details?id=nutritiion.charge&hl=en_US&gl=US
https://play.google.com/store/apps/details?id=com. hingehealth.phoenix&hl=en_US&gl=US
https://play.google.com/store/ search?q=hsabank&c=apps
https://play.google.com/store/apps/details?id=com. sunlifeus&hl=en_US
https://play.google.com/store/apps/details?id=com. eyemed.app.members&hl=en_US&gl=US
https://play.google.com/store/ search?q=higginbotham&c=apps
https://play.google.com/store/apps/details?id=com. allstate.view&hl=en_US
https://play.google.com/store/apps/details?id=com. fidelity.android&hl=en_US
https://play.google.com/store/apps/details?id=com. solium.shareworks&hl=en_US&gl=US
https://play.google.com/store/ search?q=legalshield&c=apps
https://play.google.com/store/ search?q=idshield&c=apps
https://play.google.com/store/apps/details?id=com. ultimatesoftware.ultipromobile&hl=en_US&gl=US
Investing in Yourself
401(k) Savings Plan
Incentive Grants and Referrals
Employee Development
Community Involvement
Time Off
401(k) Savings Plan
Higginbotham offers a 401(k) Savings Plan to help plan for retirement. The plan is administered by Fidelity
You are eligible to enter and begin contributing to the plan on your first day of service with the company if you are at least 21 years of age.
Save 1% to 75% of your eligible compensation on a pretax or post-tax (Roth) basis. Your total salary deferral in 2026 may not be more than $24,500 (projected), if you are under the age of 50. If you are age 50 or older, you may make additional catch-up contributions up to 8,000 (not to exceed $32,500 total). Your maximum deferral percentage and/or dollar amount may also be limited by IRS regulations.
If you are age 60-63, you may be able to use a SECURE 2.0 Act of 2022 optional age-based catch-up contribution. The projected contribution for 2026 is $11,500.
Making Changes
You may change your salary deferral amount at anytime by logging into your Fidelity NetBenefits account at www.netbenefits.com. Your changes are automatically uploaded into our payroll system and will be reflected on the first administratively feasible payroll check after the update is made in the Fidelity NetBenefits portal. You can stop making salary deferral contributions at anytime.
Choose from pre-selected investment plan options or customize your own.
Receive detailed statements.
Withdrawal options are available for financial hardships, including college tuition, purchase of a primary residence, prevention of eviction or foreclosure, burial and unreimbursed medical expenses.
Loan options allow you to borrow up to 50% of your vested account balance or $50,000, whichever is less (special rules apply).
Access Your Account
Visit www.netbenefits.com anytime or call 800-835-5095 Monday through Friday from 7:30 a.m. – 7:00 p.m. CT.
Incentive Grants and Referrals
The Higginbotham Incentive Grant Plan enables you to participate in the company’s growth by earning grants that appreciate with the value of the company’s common equity units. Once you have worked at Higginbotham (or one of its partner agencies) as a full-time employee for a year as of May 1, you are eligible to participate in the plan.
Once you receive a Higg grant, the value of each grant upon vesting is the excess of the fair market value per share of common stock over the value (the Exercise Value) per share of common stock at the time the grant is awarded. Higg grants generally vest in four equal increments on each of the first four anniversaries of their date of grant, as long as you remain employed by Higginbotham. To the extent vested, Higg grants become exercisable upon your death, disability, retirement after the age of 60 or the seventh anniversary of their date of grant.
Shareworks
Shareworks is a secure, cloud-based management platform which allows you to view, manage and forecast your Higg Grants and Shares portfolio and see transaction history. You will receive account set-up information when you are eligible to participate in the Higg Grant Plan.
Accessing Your Shareworks Account
Download the mobile app to accept certificates and monitor your account 24/7.
Contact the Armanino CPA firm with general questions by emailing higgquestions@armaninollp.com
Contact Shareworks with technical questions by calling 877-380-7793 Monday through Friday, 7:00 a.m. –7:00 p.m. CT.
Employee Referral Program
If you know someone who would be a good addition to our company, you could receive up to $2,250 if that person is hired. All Higginbotham employees are eligible to refer candidates and receive a bonus. Ask candidates to apply on our website Careers page. If your candidate is hired, send the following information to hiring@higginbotham.com within 60 days of their date of hire:
Referral date
Candidate's name
Candidate's job title
You will be awarded 20% of the bonus after 30 days from the date of hire. The balance will be paid to you when the individual has been employed with the company for 90 days. Operations, Day Two, and Non-Retail hires may fall into any of the three Client Services categories noted in orange below. Bonus amounts are based on the skill level required of the position:
Support Role – $750
Account Management or Consultant Roles – $1,500
Managers with Supervisory and Above Roles – $2,250
Newbie, Rookie, or Recruit Producer Roles – $1,750
5-Star Recruits (book of $500K+ revenue) – Contact Ben Walsh
Full plan details can be found on the Human Resources and Payroll tile on My Apps (SSO).*
*See the green box on page 3 for where to find benefit forms and information.
Employee Development
Professional Development
Continuous learning and professional development are key factors to propel Higginbotham forward on all levels. In addition to our internally-sponsored training and development courses, Higginbotham will pay the cost of attending business-related seminars and conferences. Your manager must approve the course in advance and any time away from work.
Email licensing@higginbotham.com for questions or more information.
Licensing / Continuing Education
Higginbotham believes when you continue your education and development, you and the company both benefit. If you are involved in handling insurance placement or if you have contact with customers, you must obtain a proper insurance license.
Higginbotham will pay for the insurance license fee and any training expenses. To maintain your license, you must accumulate continuing education credits. Your manager must approve the course in advance and any time away from work. If approved, Higginbotham will pay the cost of applicable fees and materials.
Email licensing@higginbotham.com for questions or more information.
Community Involvement
Community Fund
The Higginbotham Community Fund, administered by the North Texas Community Foundation, donates money to 501(c)3 organizations throughout Texas. Grants of the donor-advised fund are distributed to charitable organizations recommended by employees and selected by an advisory committee comprised of Higginbotham’s leadership.
The fund is financed by employee donations with a corporate matching component. Payroll deductions make donating to the Community Fund fast and easy. You may elect to donate or change your donation amounts at anytime during the year. Updates will be made according to the next available payroll cycle.
Higginbotham Helps
An offshoot of the Higginbotham Community Fund, Higginbotham Helps mobilizes to offer volunteer and monetary support within our local communities that are impacted by a natural disaster, health scare or other well-being or life-threatening public event. Opportunities to help will be announced as needed. If interested, please get management approval before taking any time off from work.
Community Involvement
Higginbotham values and encourages community service and volunteer commitment. With your manager’s approval, you may participate in any of our charitable endeavors. Community involvement can also be selfreported for points in the Healthy HIGG program.
How to Donate to the Fund
You may enroll for or change your donations to the fund by following these steps in UKG Pro:
Select Myself on the UKG Pro Home Page.
Select the Giving option.
Click on the Community Fund tile to open the Giving page.
Choose the amount you would like to donate.
Pick the date you want your donation to begin.
Indicate if you want the donation to be recurring.
Click Submit.
To request a one-time contribution, please complete the Community Fund form found on the Human Resources and Payroll tile on My Apps (SSO).*
*See the green box on page 3 for where to find benefit forms and information.
Time Off
Holidays
If you are a full-time employee, you are eligible to receive holiday pay. You are not eligible for holiday pay if you are on unpaid status (e.g., military leave, leave of absence, etc.).
Holiday Date
New Year’s Day January 1
Martin Luther King, Jr. Day January 19
President's Day February 16
Good Friday April 3
Memorial Day May 25
Juneteenth June 19
Independence Day July 3
Labor Day September 7
Thanksgiving Day November 26
Day After Thanksgiving November 27
Christmas Eve December 24
Christmas Day December 25
Paid Time Off (PTO)
If you are a full-time or a part-time employee who is regularly scheduled to work 30 or more hours per week, you will accrue PTO for vacation, personal business, religious observance, military leave or illness. Other time off for which you may receive compensation is separate from PTO.
Part-time, benefit-eligible employees will be prorated based on the number of hours they are regularly scheduled to work per week.
Time Off
Paid Parental Leave
You may take up to six weeks of paid parental leave following the birth of a child or placement of a child in your home for adoption or foster care. This time is available once within a rolling 12-month period. The policy will run concurrently with Family and Medical Leave Act (FMLA) leave, as applicable, and is in addition to PTO.
Non-Production Salaried/Hourly Employees – Each occurrence of paid parental leave is compensated at 67% of the employee’s regular, straight-time hourly pay. Part-time, benefit-eligible employees would be compensated based on standard weekly hours worked. Paid parental leave will be paid on regularly scheduled pay dates.
Production Employees Not On Straight Commission – Each occurrence of paid parental leave is compensated at 67% of the current Schedule B salary. Paid parental leave will be paid on regularly schedule pay dates. The Schedule B end date will be extended by the number of weeks the employee is on leave.
Approved paid parental leave may be taken at anytime during the three-month period immediately following the birth, adoption or placement of a child with the employee. Paid parental leave and/or PTO may not be used or extended beyond this three-month time frame.
For birth-giving employees, the six weeks of paid parental leave will commence at the conclusion of:
a. any Short Term Disability leave/benefit provided to the employee for the employee’s own medical recovery following childbirth and/or,
b. any PTO the employee elects to take.
In no case will the total amount of leave — whether paid or unpaid — granted to the employee under the FMLA exceed 12 weeks during the 12-month FMLA period.
See full policy details on the Human Resources and Payroll tile on My Apps (SSO).*
*See the green box on page 3 for where to find benefit forms and information.
Time Off
Family & Medical Leave Administration (FMLA)
If eligible, you may be entitled for up to 12 weeks of FMLA. To request a leave of absence, notify our administrator, The Standard, at 800-610-6544 or visit www.standard.com/absence no more than 30 days in advance of the requested leave. Standard will determine your eligibility. You may also request intermittent leave. See the Employee Handbook for more details.
An FAQ and job aid for requesting FMLA are located on the Human Resources and Payroll tile on My Apps (SSO).*
*See the green box on page 3 for where to find benefit forms and information.
Your Rights
Women’s Health and Cancer Rights Act of 1998
Special Enrollment Rights
Your Prescription Drug Coverage and Medicare
Notice of HIPAA Privacy Practices
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
Continuation of Coverage Rights Under COBRA
Your Rights and Protections against Surprise Medical Bills
Notice Regarding Wellness Program
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:
Higginbotham Human Resources
500 West 13th Street Fort Worth TX 76102
benefits@higginbotham.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 Higginbotham 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. Higginbotham has determined that the prescription drug coverage offered by the Higginbotham medical plans are, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage pays and are 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.
Important Notices
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 Higginbotham 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 Higginbotham 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 benefits@ higginbotham.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 800772-1213. TTY users should call 800-325-0778.
Remember: Keep this Creditable Coverage notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty).
January 1, 2026
Higginbotham Human Resources
500 West 13th Street Fort Worth TX 76102 benefits@higginbotham.com
Notice of HIPAA Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Effective Date of Notice: September 23, 2013
Higginbotham’s Plan is required by law to take reasonable steps to ensure the privacy of your personally identifiable health information and to inform you about:
1. the Plan’s uses and disclosures of Protected Health Information (PHI);
2. your privacy rights with respect to your PHI;
3. the Plan’s duties with respect to your PHI;
4. your right to file a complaint with the Plan and to the Secretary of the U.S. Department of Health and Human Services; and
5. the person or office to contact for further information about the Plan’s privacy practices.
The term “Protected Health Information” (PHI) includes all individually identifiable health information transmitted or maintained by the Plan, regardless of form (oral, written, electronic).
Section 1 – Notice of PHI Uses and Disclosures
Required PHI Uses and Disclosures
Upon your request, the Plan is required to give you access to your PHI in order to inspect and copy it.
Use and disclosure of your PHI may be required by the Secretary of the Department of Health and Human Services to investigate or determine the Plan’s compliance with the privacy regulations.
Important Notices
Uses and disclosures to carry out treatment, payment and health care operations.
The Plan and its business associates will use PHI without your authorization to carry out treatment, payment and health care operations. The Plan and its business associates (and any health insurers providing benefits to Plan participants) may also disclose the following to the Plan’s Board of Trustees: (1) PHI for purposes related to Plan administration (payment and health care operations); (2) summary health information for purposes of health or stop loss insurance underwriting or for purposes of modifying the Plan; and (3) enrollment information (whether an individual is eligible for benefits under the Plan). The Trustees have amended the Plan to protect your PHI as required by federal law.
Treatment is the provision, coordination or management of health care and related services. It also includes but is not limited to consultations and referrals between one or more of your providers.
For example, the Plan may disclose to a treating physician the name of your treating radiologist so that the physician may ask for your X-rays from the treating radiologist.
Payment includes but is not limited to actions to make coverage determinations and payment (including billing, claims processing, subrogation, reviews for medical necessity and appropriateness of care, utilization review and preauthorizations).
For example, the Plan may tell a treating doctor whether you are eligible for coverage or what percentage of the bill will be paid by the Plan.
Health care operations include but are not limited to quality assessment and improvement, reviewing competence or qualifications of health care professionals, underwriting, premium rating and other insurance activities relating to creating or renewing insurance contracts. It also includes case management, conducting or arranging for medical review, legal services and auditing functions including fraud and abuse compliance programs, business planning and development, business management and general administrative activities. However, no genetic information can be used or disclosed for underwriting purposes.
For example, the Plan may use information to project future benefit costs or audit the accuracy of its claims processing functions.
Uses and disclosures that require that you be given an opportunity to agree or disagree prior to the use or release.
Unless you object, the Plan may provide relevant portions of your protected health information to a family member, friend or other person you indicate is involved in your health care or in helping you receive payment for your health care. Also, if you are not capable of agreeing or objecting to these disclosures because of, for instance, an emergency situation, the Plan will disclose protected health information (as the Plan determines) in your best interest. After the emergency, the Plan will give you the opportunity to object to future disclosures to family and friends.
Uses and disclosures for which your consent, authorization or opportunity to object is not required.
The Plan is allowed to use and disclose your PHI without your authorization under the following circumstances:
1. For treatment, payment and health care operations.
2. Enrollment information can be provided to the Trustees.
3. Summary health information can be provided to the Trustees for the purposes designated above.
4. When required by law.
5. When permitted for purposes of public health activities, including when necessary to report product defects and to permit product recalls. PHI may also be disclosed if you have been exposed to a communicable disease or are at risk of spreading a disease or condition, if required by law.
6. When required by law to report information about abuse, neglect or domestic violence to public authorities if there exists a reasonable belief that you may be a victim of abuse, neglect or domestic violence. In which case, the Plan will promptly inform you that such a disclosure has been or will be made unless that notice would cause a risk of serious harm. For the purpose of reporting child abuse or neglect, it is not necessary to inform the minor that such a disclosure has been or will be made. Disclosure may generally be made to the minor’s parents or other representatives although there may be circumstances under federal or state law when the parents or other representatives may not be given access to the minor’s PHI.
Important Notices
7. The Plan may disclose your PHI to a public health oversight agency for oversight activities required by law. This includes uses or disclosures in civil, administrative or criminal investigations; inspections; licensure or disciplinary actions (for example, to investigate complaints against providers); and other activities necessary for appropriate oversight of government benefit programs (for example, to investigate Medicare or Medicaid fraud).
8. The Plan may disclose your PHI when required for judicial or administrative proceedings. For example, your PHI may be disclosed in response to a subpoena or discovery request.
9. When required for law enforcement purposes, including for the purpose of identifying or locating a suspect, fugitive, material witness or missing person. Also, when disclosing information about an individual who is or is suspected to be a victim of a crime but only if the individual agrees to the disclosure or the Plan is unable to obtain the individual’s agreement because of emergency circumstances. Furthermore, the law enforcement official must represent that the information is not intended to be used against the individual, the immediate law enforcement activity would be materially and adversely affected by waiting to obtain the individual’s agreement and disclosure is in the best interest of the individual as determined by the exercise of the Plan’s best judgment.
10. When required to be given to a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death or other duties as authorized by law. Also, disclosure is permitted to funeral directors, consistent with applicable law, as necessary to carry out their duties with respect to the decedent.
11. When consistent with applicable law and standards of ethical conduct if the Plan, in good faith, believes the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public and the disclosure is to a person reasonably able to prevent or lessen the threat, including the target of the threat.
12. When authorized by and to the extent necessary to comply with workers’ compensation or other similar programs established by law.
Except as otherwise indicated in this notice, uses and disclosures will be made only with your written authorization subject to your right to revoke such authorization.
Uses and disclosures that require your written authorization.
Other uses or disclosures of your protected health information not described above will only be made with your written authorization. For example, in general and subject to specific conditions, the Plan will not use or disclose your psychiatric notes; the Plan will not use or disclose your protected health information for marketing; and the Plan will not sell your protected health information, unless you provide a written authorization to do so. You may revoke written authorizations at any time, so long as the revocation is in writing. Once the Plan receives your written revocation, it will only be effective for future uses and disclosures. It will not be effective for any information that may have been used or disclosed in reliance upon the written authorization and prior to receiving your written revocation.
Section 2 – Rights of Individuals
Right to Request Restrictions on Uses and Disclosures of PHI
You may request the Plan to restrict the uses and disclosures of your PHI. However, the Plan is not required to agree to your request (except that the Plan must comply with your request to restrict a disclosure of your confidential information for payment or health care operations if you paid for the services to which the information relates in full, out of pocket).
You or your personal representative will be required to submit a written request to exercise this right. Such requests should be made to the Plan’s Privacy Official.
Right to Request Confidential Communications
The Plan will accommodate reasonable requests to receive communications of PHI by alternative means or at alternative locations if necessary to prevent a disclosure that could endanger you.
You or your personal representative will be required to submit a written request to exercise this right.
Such requests should be made to the Plan’s Privacy Official.
Right to Inspect and Copy PHI
You have a right to inspect and obtain a copy of your PHI contained in a “designated record set,” for as long as the Plan maintains the PHI. If the information you request is in an electronic designated record set, you may request that these records be transmitted electronically to yourself or a designated individual.
Important Notices
Protected Health Information (PHI)
Includes all individually identifiable health information transmitted or maintained by the Plan, regardless of form.
Designated Record Set
Includes the medical records and billing records about individuals maintained by or for a covered health care provider; enrollment, payment, billing, claims adjudication and case or medical management record systems maintained by or for the Plan; or other information used in whole or in part by or for the Plan to make decisions about individuals. Information used for quality control or peer review analyses and not used to make decisions about individuals is not in the designated record set.
The requested information will be provided within 30 days if the information is maintained on site or within 60 days if the information is maintained off site. A single 30-day extension is allowed if the Plan is unable to comply with the deadline.
You or your personal representative will be required to submit a written request to request access to the PHI in your designated record set. Such requests should be made to the Plan’s Privacy Official.
If access is denied, you or your personal representative will be provided with a written denial, setting forth the basis for the denial, a description of how you may appeal the Plan’s decision and a description of how you may complain to the Secretary of the U.S. Department of Health and Human Services.
The Plan may charge a reasonable, cost-based fee for copying records at your request.
Right to Amend PHI
You have the right to request the Plan to amend your PHI or a record about you in your designated record set for as long as the PHI is maintained in the designated record set.
The Plan has 60 days after the request is made to act on the request. A single 30-day extension is allowed if the Plan is unable to comply with the deadline. If the request is denied in whole or part, the Plan must provide you with a written denial that explains the basis for the denial. You or your personal representative may then submit a written statement disagreeing with the denial and have that statement included with any future disclosures of your PHI.
Such requests should be made to the Plan’s Privacy Official.
You or your personal representative will be required to submit a written request to request amendment of the PHI in your designated record set.
Right to Receive an Accounting of PHI Disclosures
At your request, the Plan will also provide you an accounting of disclosures by the Plan of your PHI during the six years prior to the date of your request. However, such accounting will not include PHI disclosures made: (1) to carry out treatment, payment or health care operations; (2) to individuals about their own PHI; (3) pursuant to your authorization; (4) prior to April 14, 2003; and (5) where otherwise permissible under the law and the Plan’s privacy practices. In addition, the Plan need not account for certain incidental disclosures.
If the accounting cannot be provided within 60 days, an additional 30 days is allowed if the individual is given a written statement of the reasons for the delay and the date by which the accounting will be provided.
If you request more than one accounting within a 12-month period, the Plan will charge a reasonable, costbased fee for each subsequent accounting.
Such requests should be made to the Plan’s Privacy Official.
Right to Receive a Paper Copy of This Notice Upon Request
You have the right to obtain a paper copy of this Notice. Such requests should be made to the Plan’s Privacy Official.
A Note About Personal Representatives
You may exercise your rights through a personal representative. Your personal representative will be required to produce evidence of his/her authority to act on your behalf before that person will be given access to your PHI or allowed to take any action for you. Proof of such authority may take one of the following forms:
1. a power of attorney for health care purposes;
2. a court order of appointment of the person as the conservator or guardian of the individual; or
3. an individual who is the parent of an unemancipated minor child may generally act as the child’s personal representative (subject to state law).
The Plan retains discretion to deny access to your PHI by a personal representative to provide protection to those vulnerable people who depend on others to exercise their rights under these rules and who may be subject to abuse or neglect.
Section 3 – The Plan’s Duties
The Plan is required by law to maintain the privacy of PHI and to provide individuals (participants and beneficiaries) with notice of the Plan’s legal duties and privacy practices.
This Notice is effective September 23, 2013, and the Plan is required to comply with the terms of this Notice. However, the Plan reserves the right to change its privacy practices and to apply the changes to any PHI received or maintained by the Plan prior to that date. If a privacy practice is changed, a revised version of this Notice will be provided to all participants for whom the Plan still maintains PHI. The revised Notice will be distributed in the same manner as the initial Notice was provided or in any other permissible manner.
Important Notices
If the revised version of this Notice is posted, you will also receive a copy of the Notice or information about any material change and how to receive a copy of the Notice in the Plan’s next annual mailing. Otherwise, the revised version of this Notice will be distributed within 60 days of the effective date of any material change to the Plan’s policies regarding the uses or disclosures of PHI, the individual’s privacy rights, the duties of the Plan or other privacy practices stated in this Notice.
Minimum Necessary Standard
When using or disclosing PHI or when requesting PHI from another covered entity, the Plan will make reasonable efforts not to use, disclose or request more than the minimum amount of PHI necessary to accomplish the intended purpose of the use, disclosure or request, taking into consideration practical and technological limitations. When required by law, the Plan will restrict disclosures to the limited data set, or otherwise as necessary, to the minimum necessary information to accomplish the intended purpose. However, the minimum necessary standard will not apply in the following situations:
1. disclosures to or requests by a health care provider for treatment;
2. uses or disclosures made to the individual;
3. disclosures made to the Secretary of the U.S. Department of Health and Human Services;
4. uses or disclosures that are required by law; and
5. uses or disclosures that are required for the Plan’s compliance with legal regulations.
De-Identified Information
This notice does not apply to information that has been de-identified. De-identified information is information that does not identify an individual and with respect to which there is no reasonable basis to believe that the information can be used to identify an individual.
Summary Health Information
The Plan may disclose “summary health information” to the Trustees for obtaining insurance premium bids or modifying, amending or terminating the Plan. “Summary health information” summarizes the claims history, claims expenses or type of claims experienced by participants and excludes identifying information in accordance with HIPAA.
Notification of Breach
The Plan is required by law to maintain the privacy of participants’ PHI and to provide individuals with notice of its legal duties and privacy practices. In the event of a breach of unsecured PHI, the Plan will notify affected individuals of the breach.
Section 4 – Your Right to File a Complaint With the Plan or the HHS Secretary
If you believe that your privacy rights have been violated, you may complain to the Plan. Such complaints should be made to the Plan’s Privacy Official.
You may file a complaint with the Secretary of the U.S. Department of Health and Human Services, Hubert H. Humphrey Building, 200 Independence Avenue SW, Washington, D.C. 20201. The Plan will not retaliate against you for filing a complaint.
Section 5 – Whom to Contact at the Plan for More Information
If you have any questions regarding this notice or the subjects addressed in it, you may contact the Plan’s Privacy Official. Such questions should be directed to the Plan’s Privacy Official at:
Higginbotham Human Resources
500 West 13th Street
Fort Worth TX 76102
benefits@higginbotham.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.
Important Notices
Premium Assistance Under
Medicaid and the Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employersponsored 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
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-insurance-programreauthorization-act-2009-chipra
Phone: 678-564-1162, Press 2
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/welcomeiowa-medicaid
Medicaid Phone: 1-800-338-8366
Hawki Website: https://hhs.iowa.gov/programs/welcome-iowamedicaid/iowa-health-link/hawki
Hawki Phone: 1-800-257-8563
HIPP Website: https://hhs.iowa.gov/programs/welcome-iowamedicaid/fee-service/hipp
HIPP Phone: 1-888-346-9562
Website: https://www.kancare.ks.gov/ Phone: 1-800-792-4884
HIPP Phone: 1-800-967-4660
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
GEORGIA – MEDICAID
INDIANA – MEDICAID
KANSAS – MEDICAID
KENTUCKY – MEDICAID
Important Notices
Website: www.medicaid.la.gov or www.ldh.la.gov/lahipp
Phone: 1-888-342-6207 (Medicaid hotline) or 1-855-618-5488 (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 NEW HAMPSHIRE – MEDICAID
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
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: https://www.health.ny.gov/health_care/medicaid/ Phone: 1-800-541-2831
NORTH CAROLINA – MEDICAID
Website: https://medicaid.ncdhhs.gov Phone: 919-855-4100
NORTH DAKOTA – MEDICAID
Website: https://www.hhs.nd.gov/healthcare Phone: 1-844-854-4825
OKLAHOMA – MEDICAID AND CHIP
Website: http://www.insureoklahoma.org Phone: 1-888-365-3742
OREGON – MEDICAID
Website: https://healthcare.oregon.gov/Pages/index.aspx Phone: 1-800-699-9075
PENNSYLVANIA – MEDICAID AND CHIP
Website: https://www.pa.gov/en/services/dhs/apply-formedicaid-health-insurance-premium-payment-program-hipp. html
Phone: 1-800-692-7462
CHIP Website: https://www.dhs.pa.gov/chip/pages/chip.aspx CHIP Phone: 1-800-986-KIDS (5437)
RHODE ISLAND – MEDICAID AND CHIP
Website: http://www.eohhs.ri.gov/ Phone: 1-855-697-4347 or 401-462-0311 (Direct RIte Share Line)
Website: https://www.scdhhs.gov
Phone: 1-888-549-0820
Website: https://dss.sd.gov
Phone: 1-888-828-0059 TEXAS –
Website: https://www.hhs.texas.gov/services/financial/healthinsurance-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/hippprogram
Phone: 1-800-250-8427
MINNESOTA
NEVADA
NEW
SOUTH CAROLINA – MEDICAID
SOUTH DAKOTA - MEDICAID
VIRGINIA – MEDICAID AND CHIP
Website: https://coverva.dmas.virginia.gov/learn/premiumassistance/famis-select
https://coverva.dmas.virginia.gov/learn/premium-assistance/ health-insurance-premium-payment-hipp-programs
Medicaid/CHIP Phone: 1-800-432-5924
WASHINGTON – MEDICAID
Website: https://www.hca.wa.gov/ Phone: 1-800-562-3022
WEST VIRGINIA – MEDICAID AND CHIP
Website: https://dhhr.wv.gov/bms/ http://mywvhipp.com/ Medicaid Phone: 304-558-1700
CHIP Toll-free phone: 1-855-MyWVHIPP (1-855-699- 8447)
WISCONSIN – MEDICAID AND CHIP
Website: https://www.dhs.wisconsin.gov/ badgercareplus/p-10095.htm Phone: 1-800-362-3002
WYOMING – MEDICAID
Website: https://health.wyo.gov/healthcarefin/medicaid/ programs-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 Higginbotham group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Higginbotham 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
Higginbotham Human Resources
500 West 13th Street
Fort Worth TX 76102
benefits@higginbotham.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. Outof-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.
Important Notices
You are protected from balance billing for:
Emergency services – If you have an emergency medical condition and get emergency services from an out-of- network provider or facility, the most the provider or facility may bill you is your plan’s innetwork cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
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-ofnetwork. 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, 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 outof-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 outof-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.
Notice Regarding Wellness Program
The employee wellness program is a voluntary program administered according to federal rules permitting employer-sponsored wellness programs that seek to improve employee health or prevent disease, including the Americans with Disabilities Act of 1990, the Genetic Information Nondiscrimination Act of 2008, and the Health Insurance Portability and Accountability Act, as applicable, among others. If you choose to participate in the wellness program you may be asked to complete a voluntary health risk assessment or “HRA” that asks a series of questions about your health-related activities and behaviors and whether you have or had certain medical conditions (e.g., cancer, diabetes, or heart disease). You may also be asked to complete a biometric screening, which could include a blood test for certain medical conditions such as diabetes, heart disease, etc. You are not required to complete the HRA or to participate in the blood test or other medical examinations.
However, employees who choose to participate in the wellness program may qualify for an incentive. Although you are not required to complete a HRA or biometric screening, the wellness program may specify that only employees who do so will qualify for the incentive. Additional incentives may be available for employees who participate in certain health-related activities or achieve certain health outcomes.
Important Notices
If you are unable to participate in any of the healthrelated activities or achieve any of the health outcomes required to earn an incentive, you may be entitled to a reasonable accommodation or an alternative standard. You may request a reasonable accommodation or an alternative standard by contacting Human Resources.
If you choose to participate in a HRA and/or biometric screening, information from your HRA and results from your biometric screening will be used to provide you with information to help you understand your current health and potential risks and may also be used to offer you services through the wellness program. You also are encouraged to share your results or concerns with your own doctor.
Protections from Disclosure of Medical Information
We are required by law to maintain the privacy and security of your personally identifiable health information. Although the wellness program may use aggregate information it collects to design a program based on identified health risks in the workplace, the wellness program will never disclose any of your personal information either publicly or to the employer, except as necessary to respond to a request from you for a reasonable accommodation needed to participate in the wellness program, or as expressly permitted by law. Medical information that personally identifies you that is provided in connection with the wellness program will not be provided to your supervisors or managers and may never be used to make decisions regarding your employment.
Your health information will not be sold, exchanged, transferred, or otherwise disclosed except to the extent permitted by law to carry out specific activities related to the wellness program, and you will not be asked or required to waive the confidentiality of your health information as a condition of participating in the wellness program or receiving an incentive. Anyone who receives your information for purposes of providing you services as part of the wellness program will abide by the same confidentiality requirements.
In addition, all medical information obtained through the wellness program will be maintained separate from your personnel records, information stored electronically will be encrypted, and no information you provide as part of the wellness program will be used in making any employment decision. Appropriate precautions will be taken to avoid any data breach, and in the event a data breach occurs involving information you provide in connection with the wellness program, we will notify you immediately.
You may not be discriminated against in employment because of the medical information you provide as part of participating in the wellness program, nor may you be subjected to retaliation if you choose not to participate.
If you have questions or concerns regarding this notice, or about protections against discrimination and retaliation, please contact Human Resources.
This brochure highlights the main features of the Higginbotham 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. Higginbotham reserves the right to change or discontinue its employee benefits plans at anytime.