2026 Richard Benefits Book - FT

Employee Benefits Guide

Enrollment Instructions

You have two ways to enroll for benefits: online or by phone.

Online Enrollment

1. Log in to https://benefits.plansource.com

Username: The first letter of your first name + up to the first six letters of your last name + the last four digits of your Social Security number (SSN).

For example: If your name is John Anderson and the last four digits of your SSN are 1234, your username would be janders1234.

Password: Use your current password. If you need assistance, contact the Benefits Department. Passwords are being reset to YYYYMMDD.

Example: January 1, 1971 is 19710101.

Launch Enrollment: Click on Get Started to begin.

2. Enroll: Follow through each step of the enrollment process from updating your profile to electing your benefits. When making your benefit elections, you will need to select or decline each plan. If enrolling dependents, email dependent verification to benefits@richardepc.com

3. Confirm Enrollment Selections: The shopping cart displays a running total of your benefits costs. To finalize your elections, click Review and check out.

Phone Enrollment

To schedule an appointment, call 833-944-4576 or go to the website https://richardbenefitsoe.com

z Schedule your Open Enrollment (OE) session between 7:00 a.m. and 7:00 p.m. CT beginning Friday, March 20, 2026.

z OE runs from April 2 through April 10

Need Help Enrolling?

Contact the Benefits team at benefits@richardepc.com for assistance.

Important Contacts

We are pleased to offer you a comprehensive benefits package intended to protect your well-being and financial health. This guide is your opportunity to learn more about the benefits available to you and your eligible dependents.

To get the best value from your health care plans, please take the time to evaluate your coverage options and determine which plans best meet the health care and financial needs of you and your family. By being a wise consumer, you can support your health and maximize your health care dollars.

If there is a discrepancy between the description of the benefit plans in this guide and the official plan documents, the language in the official plan documents is the final authority. Richard reserves the right to modify or discontinue the employee benefits program anytime.

Enrollment and Eligibility

Enrollment

OE is your opportunity to choose benefits for the upcoming plan year (May 1, 2026 through April 30, 2027). You may make changes to your benefit elections during the plan year only if you experience a Qualifying Life Event (QLE).

Eligibility

If you are an active employee working at least 30 hours per week and are at least 18 years of age, you are eligible to enroll in our benefits program. Your coverage is effective on the first of the month following your date of hire. Your Disability insurance has a six-month waiting period.

Eligible dependents include:

z Your legally married or common law spouse

z Dependent children up to age 26 (including birth children, children placed for adoption, and children for whom legal guardianship has been awarded to you or your spouse)

z Dependent children, regardless of age, provided they are incapable of selfsupport due to a mental or physical disability and who are fully dependent on you for support as indicated on your federal tax return

Email dependent verification to benefits@richardepc.com

Qualifying Life Events

Your benefit elections remain in effect for the entire plan year until the following OE. You may only change coverage during the plan year if you have a QLE such as marriage, divorce, birth or adoption, loss of other coverage, etc. You must notify the Benefits Department within 30 days if any of these events occur (60 days for a newborn). Contact the Benefits Department at benefits@richardepc.com and place “QLE” in the subject line of the email.

Making Changes

Richard utilizes PlanSource for enrollment and making benefit election changes due to a QLE. You can view your benefit elections anytime throughout the year, as well as access plan information and forms in the PlanSource Document Library. Refer to the Enrollment Instructions on page 2 for details.

Medical Plans

Richard offers two medical plans provided by Blue Cross Blue Shield of Texas (BCBSTX). Both are Preferred Provider Organization (PPO) plans, which allow access to both in-network and out-of-network providers. When you use innetwork providers, you receive benefits at a discounted network cost. You may pay more for services if you use out-of-network providers. All out-of-network services are subject to Reasonable and Customary (R&C) limitations, and you are responsible for all charges over this allowance. Each medical plan offers:

z Comprehensive health care benefits

z In-network preventive care covered at 100%

z Coverage for eligible children up to age 26

z Prescription drug coverage

Choose the Plan Right for You

The key differences between the plans are the amount of money you contribute each pay period and how much you pay when you need care. The plans also differ with their:

z Calendar year deductibles (January-December) – This is the amount you pay each year for eligible in-network and out-of-network charges before the plan begins to pay.

z Calendar year out-of-pocket maximums (January-December) – This is the most you pay each year for eligible services, including prescriptions.

z Copays and coinsurance – These are the amounts you pay toward the cost of covered services.

HSA Plan (HDHP)

The HSA Plan (HDHP) has a lower payroll deduction, but you must meet a higher deductible amount prior to the plan beginning to pay. This is a High Deductible Health Plan (HDHP), and is considered a qualified plan that is combined with a tax-advantaged personal savings account called a Health Savings Account (HSA). With an HSA, you can pay for current health expenses and save for future qualified expenses on a pretax basis. You must contribute a minimum of $20 each month to your HSA. More details are on page 12

If you elect employee plus dependent coverage, once a family member meets the individual deductible amount, the plan will begin paying benefits for that family member. The entire family deductible does not need to be met first before this family member will begin receiving benefits.

PPO Base Plan

The traditional PPO Base plan has a lower deductible and higher payroll deduction . Providers typically charge a copay before the plan begins to pay.

Health Coverage Options

You have two medical plan coverage options. To see the benefits summaries, go to the Document Library at https://benefits.plansource.com or call the Benefits Department at 409-832-7827

Medical Plans

BCBSTX Resources

Blue Access for Members

Blue Access for Members (BAM) is the secure BCBSTX member website where you can:

z Search for providers in your area

z Order mail order prescriptions

z Order additional ID cards

z Verify your benefits, deductible, and out-of-pocket accumulations

z Monitor your claims

To get started, log in at www.bcbstx.com and use the information on your BCBSTX ID card to complete the registration process.

Blue365

Blue365 helps you save money on health care products and services not generally covered by your medical plan. Discounts are available for TruHearing, EyeMed, Lifetime Fitness, Jenny Craig, and Procter & Gamble products. Sign up for Blue365 at www.blue365deals.com/bcbstx

Well onTarget

Wellness resources are available by logging in to www.wellontarget.com or by calling 888-762-BLUE (2583). Well onTarget features include:

z Self-directed health and wellness courses

z Health assessments

z Tools and trackers

z Fitness program that locates gyms with BCBSTX membership discounts

Maternity and Family Benefits

If you are pregnant or are planning to get pregnant, your medical plan offers tools from Maven and Well onTarget to help you prepare for parenthood. Call 888-421-7781 for more information.

z Maven – Its suite of maternity and family apps supports you by tracking your cycle, pregnancy, and your baby’s growth.

X Fertility

X Pregnancy

X Parenting

X Peri-menopause

X Menopause

z Well onTarget – Well onTarget offers self-guided courses about pregnancy that you can take online. Topics include healthy foods, body changes, and labor.

Mobile App

The BCBSTX mobile app can help you stay organized and in control of your health — anytime, anywhere. Text BCBSTXAPP to 33633 or visit your device’s app store to download.

Medical Plans

Medical Plan Summary and Payroll Deductions

1 What you will pay after your deductible is met.

2

3 Specialty

Choosing a Medical Plan

If you have an idea of which medical plan option is best for you and your family, use these examples to confirm your choice of coverage.

Example 1

I am a healthy, single person with minimal expenses.

* Assumes 12%

Example 2

I cover my family, and one member incurs more than $5,000 in expenses.

* Assumes 22% federal income marginal tax rate + 7.65% FICA.

Example 3

I cover my family. Two members have serious health conditions, and they both incur more than $50,000 in expenses each, meeting their individual out-of-pocket maximums for the year.

* Assumes 22% federal income marginal tax rate + 7.65% FICA.

Prescription Coverage

Retail Prescriptions

Retail prescriptions will be managed and processed by CVS Caremark . Visit www.caremark.com to sign in or register, or download the CVS Caremark app

International Mail Order Prescription Program

If you enroll in the PPO Base plan, CANARX provides you and your eligible dependents access to an affordable international mail order program for select brand name prescriptions. This program is voluntary and offered in addition to the prescription benefits available with the BCBSTX PPO Base Plan medical coverage.

CANARX Highlights

z $0 copay

z Three-month supply with three refills

z Free shipping directly to your home or location that you designate

z No out-of-pocket expenses

Visit www.canarx.com for a complete list of covered medications.

How CANARX Works

If your prescription is available through the CANARX formulary of more than 400 brand name drugs, and you have taken the medication for at least 30 days without complications, you can send your prescription to CANARX for filling. Your physician can fax the prescription, or you can download an enrollment form online and mail the completed form with your original prescription. Allow up to four weeks for delivery when ordering new medications. CANARX will call you prior to each refill to ensure you have a continuous supply of medication.

ElectRx International

If you enroll in the PPO Base plan, the ElectRx International mail order program offers savings on certain specialty prescription drugs. If you are enrolled in the PPO Base plan, you pay $0 on all specialty drugs on the ElectRx formulary. Here is how you can begin using the program:

z Call 855-353-2879 to enroll. A Customer Service representative will complete the enrollment process and order for you. You will be asked several questions related to your medical condition, including any known allergies and a list of the prescription drugs you are currently taking. You should have those prescription drugs with you when you make the call.

z Have your physician prepare a prescription with three refills and fax it to 833-353-2879. You will receive an automated reminder notification when you need a refill. Shipping takes five to 15 business days from the date of completed requirements.

For more information or to find out if your prescription is on the ElectRx formulary, call 855-353-2879 or email info@electrx.com .

1

Imaging Services

Zero-cost X-ray and Imaging Services

Green Imaging provides diagnostic imaging services to you for FREE. If your physician prescribes a diagnostic imaging service (e.g., X-ray, CT scan, MRI, etc.), contact Green Imaging to schedule the procedure. This service is $0 if you enroll in the PPO Base plan. If you enroll in the HSA Plan (HDHP), you can use Green Imaging and pay the cash price, but the fee will not apply towards your deductible.

Provided Services

z MRI

z CT scan

z PET

z Ultrasound

z Nuclear medicine

Earn a Gift Certificate1

z $500 gift card for any MRI or CT scan

z $300 gift card for all other imaging services

z Mammography

z DXA

z X-ray

z Arthrogram

z Echocardiogram

Find a Green Imaging Location

Visit www.greenimaging.net to locate a Green Imaging facility near you.

How Green Imaging Works

Ask your doctor to fax your diagnostic imaging service prescription order to 866-653-0882 . Then:

z Contact Green Imaging to schedule an appointment and request a voucher:

X Text – 713-524-9190

X Chat –www.greenimaging.net

X Call – 844-968-4647

You will need your name, ZIP code, physician order (a photo of it if texting) and your Group Name.

z Green Imaging will schedule your appointment and send you a voucher.

z Show your voucher at your appointment.

z Your exam report will be sent to your Green Imaging account and your doctor.

Health Savings Account

If you enroll in the HSA Plan (HDHP), HSA Bank will automatically open an HSA in your name and mail you a debit card. Amounts you contribute each paycheck will not be taxed. You can use your HSA money to pay for qualified health care expenses, including medical, pharmacy, dental, and vision expenses.

You own your HSA account and the money grows tax-free. As long as the funds are used to pay for qualified medical expenses, they are spent tax-free. If you have unused dollars in your account at the end of the year, the balance will roll over to the following year. If you change health plans or jobs, the account is yours to keep.

If you contribute to an HSA, you may not contribute to a Health Care Flexible Spending Account (FSA). However, you can contribute to a Limited Purpose Health Care FSA, which covers only dental and vision expenses (see page 17 for more details).

HSA Eligibility

You can contribute to an HSA if you meet the following criteria:

z You are enrolled in an HSA-eligible High Deductible Health Plan

z You are not covered by other non-High Deductible Health Plans, such as your spouse’s health plan or a Health Care FSA

z You are not eligible to be claimed as a dependent on someone else’s tax return

z You are not enrolled in Medicaid, Medicare, or TRICARE

z You have not received Veterans Administration benefits

Be sure to keep your receipts in the event of an IRS audit!

Maximum Contributions

The annual contribution maximum is based on the coverage option you elect (individual or family coverage). Employees age 55 or older are allowed to make an additional annual catch-up contribution of up to $1,000. 2026 HSA Contribution

Minimum Contributions

You must contribute a minimum of $20 each month to your HSA.

Designating a Beneficiary

A beneficiary is a person or entity you elect to receive the death benefits of your HSA with HSA Bank. You can name more than one beneficiary and change beneficiaries anytime. Visit www.hsabank.com and go to Settings, select Profile, then Edit and designate your beneficiaries. You can also email your beneficiary information to benefits@richardepc.com and place “Beneficiary Information” in the subject line.

Health Savings Account

HSA FAQ

An HSA paired with an eligible HDHP helps you and your family plan, save, and pay for health care. An HSA is a tax-advantaged savings account that allows you to pay for IRS-qualified health care expenses for you and your dependents. Richard will withhold your HSA contribution through payroll deductions and will deposit the pretax money into your HSA Bank account.

Who is eligible to open an HSA and make contributions?

z You must be enrolled in the HSA Plan (HDHP) medical plan.

z You must not be covered by another medical plan unless it is an IRSqualified HDHP.

z You must not be enrolled in Medicare, Medicaid, or TRICARE.

z You cannot be claimed as a dependent on someone else’s tax return.

z You, family, and friends can contribute to your HSA up to the IRS maximums.

Can I participate in both the Health Care FSA and the HSA?

Generally, no. However, if you enroll in the HSA Plan (HDHP), you may enroll in a Limited Purpose Health Care FSA for dental and vision expenses only. Once your Limited Purpose Health Care FSA balance is exhausted, you can begin using funds in your HSA to pay for any additional dental and vision expenses. You may not use your Limited Purpose Health Care FSA for medical expenses.

How do I open an HSA account?

If you enroll in the HSA Plan (HDHP), BCBSTX will automatically open an HSA for you through HSA Bank.

How much can I contribute to the HSA?

The 2026 calendar year maximum HSA contribution amounts are $4,400 for those with individual coverage and $8,750 for family coverage. If you are age 55 or older, you may make an additional annual catch-up contribution up to $1,000.

If I do not spend all of the money in my HSA, do I lose it?

No. You own the HSA. Any unused funds are yours and roll over each year. Are there fees associated with the HSA?

Yes. Please refer to the HSA Bank website at www.hsabank.com

What expenses may I pay for from my HSA?

Refer to IRS Publication 502 Medical and Dental Expenses at www.irs.gov for a complete description of eligible medical and dental expenses, or see page 18 for an abbreviated list. You may also use the money for long term care and COBRA premiums in the event you lose your coverage.

NOTE: The IRS requires you to remain enrolled in an HSA-eligible plan for 12 months following the last month of the year in which you became eligible to open an HSA; otherwise, a prorated contribution amount will be included as income and subject to a 10% additional tax.

Covering Your Children

You can use the funds in your HSA to pay for eligible dependent expenses even if they are not covered by the HSA Plan (HDHP). However, you can only do so until they reach age 19 (age 24 if a fulltime student). Once your children reach age 19 (or 24), they can open their own HSA.

Is there a penalty for paying for nonqualified medical expenses from my HSA?

Yes, you will be subject to your regular income tax rate and a 20% penalty, until/unless you reach age 65. If you are 65 or older, there is no penalty for withdrawal, but it is subject to your regular income tax rate.

Do I have to prove my HSA reimbursements are qualified health care expenses?

You are responsible for keeping receipts in the event of an IRS audit.

Does my HSA earn interest? Are there investment options? If so, is the interest taxable?

Yes, your HSA earns interest. The interest earned is tax-free. Once your HSA balance is $1,000, you may transfer funds into mutual funds. Please refer to your HSA Bank account at www.hsabank.com

If I leave Richard, do I lose the money in my HSA?

No. You own your HSA and the money is yours.

Telemedicine

Telemedicine provided by BCBSTX and powered by MDLIVE makes it easy for you to get the treatment you need, when you need it. MDLIVE is a convenient alternative if it is difficult to leave home or work for an in-person office visit or if care is needed after regular office hours. Board-certified doctors are available 24/7 for non-emergency care by phone, online video, or mobile app.

MDLIVE doctors can treat a variety of conditions and can write prescriptions, if needed. Common health conditions include:

z Allergies

z Cold/flu

z Fever

z Headaches

z Nausea

z Sinus infections

If your situation is not life-threatening, you can avoid crowded waiting rooms, expensive urgent care or ER bills, or waiting weeks to see your doctor. With MDLIVE, you can talk to or see a doctor in minutes.

Know Your Options

Your regular provider may offer telemedicine services, so ask now and know your options before you need care. Your doctor may offer telemedicine consultations by phone or video during or after normal office hours. Ask what the cost would be versus an MDLIVE virtual visit.

Note: Always go to the emergency room in life-threatening situations.

Virtual Behavioral Health Care

Telemedicine visits with licensed behavioral health therapists are also available by appointment for help with:

z Anxiety

z Depression

z Stress management

z And more

Visit www.mdlive.com/bcbstx

Call 888-680-8646

Text BCBSTX to 635-483. Download the MDLIVE app

Health Care Options

Becoming familiar with your options for medical care can save you time and money.

Non-Emergency Care

Access to care via phone, online video, or mobile app whether you are home, work or traveling; medications can be prescribed

Virtual Visits/ Telemedicine

Doctor’s Office

24 hours a day, 7 days a week

Generally, the best place for routine preventive care; established relationship; able to treat based on medical history

Office hours vary

Usually lower out-of-pocket cost than urgent care; when you can’t see your doctor; located in stores and pharmacies

Retail Clinic

Urgent Care

Emergency Care

Hours vary based on store hours

When you need immediate attention; walk-in basis is usually accepted

Generally includes evening, weekend, and holiday hours

ƒ Allergies

ƒ Cough/cold/flu

ƒ Rash ƒ Stomachache

ƒ Infections

ƒ Sore and strep throat

ƒ Vaccinations

ƒ Minor injuries, sprains and strains

ƒ Common infections

ƒ Minor injuries

ƒ Pregnancy tests

ƒ Vaccinations

ƒ Sprains and strains

ƒ Minor broken bones

ƒ Small cuts that may require stitches

ƒ Minor burns and infections

Hospital ER

Freestanding ER

Life-threatening or critical conditions; trauma treatment; multiple bills for doctor and facility

24 hours a day, 7 days a week

Services do not include trauma care; can look similar to an urgent care center, but medical bills may be 10 times higher

24 hours a day, 7 days a week

ƒ Chest pain

ƒ Difficulty breathing

ƒ Severe bleeding

ƒ Blurred or sudden loss of vision

ƒ Major broken bones

ƒ Most major injuries except trauma

ƒ Severe pain

Minimal

Note: Examples of symptoms are not inclusive of all health issues. Wait times described are only estimates. This information is not intended as medical advice. If you have questions, please call the phone number on the back of your medical ID card.

Urgent Care Locations

The list of urgent care locations is just a sample. Always verify the provider is still in-network at the time of service as network status is subject to change without notice as are the methods in which the provider contracts with BCBSTX.

Texas

Beaumont Nederland Lumberton

Immediate Medical Care Center

Next Level Urgent Care

Concentra Urgent Care

Premier Urgent Care

Affinity Immediate Care

Dowlen Urgent Care

AFC Urgent Care

Peoples Urgent Care

Beaumont Urgent Care

Eastex Urgent Care

Hamshire-Fannett Urgent Care

Promptu Immediate Care

Texas Medclinic

Bestmed Urgent Care

Louisiana Sulfur

Next Level Urgent Care

Mid County Urgent Care

Tower Medical Center of Nederland

Lifeline Urgent Care

Wellfast Health Urgent Care

Peoples Urgent Care

Hardin County Urgent Care

Texas Medclinic

Bestmed Urgent Care

First Response Urgent Care

Your Medical Home

Total Care Port Arthur

Lifeline Urgent Care

Tower Medical Center of Nederland

First Urgent Care

Bestmed Urgent Care

Urgent Care Aceso Urgent Care

Flexible Spending Accounts

FSAs allow you to set aside pretax dollars to cover eligible expenses. By spending pretax FSA dollars, you end up with more take-home pay. The FSAs are administered by HSA Bank

When you enroll, you must decide how much money to set aside for each account. Estimate conservatively because the IRS requires that you use the pretax money placed in your account during the plan year (May 1, 2026 through April 30, 2027). Unspent dollars up to $680 will roll over to the next plan year as long as you re-enroll for the next plan year. If you do not re-enroll, you will forfeit all balances in your account.

Health Care FSA

You may contribute up to $3,400 to your Health Care FSA if you are enrolled in the PPO Base plan. Your election amount will be deducted from your paycheck throughout the year, but your entire annual contribution is immediately available to pay for eligible health care expenses not covered by insurance. A debit card will be sent to you from HSA Bank. Be sure to keep all receipts of your purchases and payments for your records.

Common eligible expenses include:

z Office visit copays

z Prescription drug copays

z Coinsurance and deductibles

z Dental and vision expenses

For a complete list of eligible expenses, view IRS Publication 502 online at www.irs.gov

Limited Purpose Health Care FSA

If you enroll in the HSA Plan (HDHP), you can participate in a Limited Purpose Health Care FSA which allows you to receive reimbursement for dental and vision expenses only, such as:

z Dental and orthodontia care (e.g., fillings, X-rays, and braces)

z Vision care (e.g., eyeglasses, contact lenses, and LASIK surgery)

FSA Claims Reimbursements

z Claims must occur May 1, 2026 through April 30, 2027 in order to be reimbursable. You have until July 31, 2027 to submit your claims.

z The IRS has amended the “use it or lose it” rule to allow you to carry over up to $680 in your Health Care or Limited Purpose Health Care FSA into the next plan year.

Download the HSA Bank app

HSA/FSA Expenses

The products and services listed below are examples of expenses eligible for payment using your HSA, Health Care FSA, or Limited Purpose Health Care FSA. This list is not all inclusive and additional expenses may qualify. Refer to IRS Publication 502, Medical and Dental Expenses at www.irs.gov for a complete description of eligible medical and dental expenses.

z Abdominal supports

z Acupuncture

z Alcoholism treatment

z Ambulance

z Anesthetist

z Arch supports

z Artificial limbs

z Autoette (when used for relief of sickness/disability)

z Birth control pills (by prescription)

z Blood tests

z Blood transfusions

z Braces

z Cardiographs

z Chiropractor

z Christian Science Practitioner

z Contact lenses

z Contraceptive devices (by prescription)

z Convalescent home (for medical treatment only)

z Crutches

z Dental treatment

z Dental X-rays

z Dentures

z Dermatologist

z Diagnostic fees

z Diathermy

z Drug addiction therapy

z Drugs (prescription)

z Elastic hosiery (prescription)

z Eyeglasses

z Fees paid to health institute prescribed by a doctor

z Fluoridation unit

z Guide dog

z Gum treatment

z Gynecologist

z Healing services

z Hearing aids and batteries

z Hospital bills

z Hydrotherapy

z Insulin treatment

z Lab tests

z Lead paint removal

z Legal fees

z Lodging (away from home for outpatient care)

z Metabolism tests

z Neurologist

z Nursing (including board and meals)

z Obstetrician

z Operating room costs

z Ophthalmologist

z Optician

z Optometrist

z Oral surgery

z Organ transplant (including donor’s expenses)

z Orthopedic shoes

z Orthopedist

z Osteopath

z Oxygen and oxygen equipment

z Pediatrician

z Physician

z Physiotherapist

z Podiatrist

z Postnatal treatments

z Practical nurse for medical services

z Prenatal care

z Prescription medicines

z Psychiatrist

z Psychologist

z Psychotherapy

z Radium therapy

z Registered nurse

z Special school costs for the handicapped

z Spinal fluid test

z Splints

z Sterilization

z Surgeon

z Telephone or TV equipment to assist the hard-of-hearing

z Therapy equipment

z Transportation expenses (relative to health care)

z Ultraviolet ray treatment

z Vaccines

z Vasectomy

z Vitamins (if prescribed)

z Wheelchair

z X-rays

Dental Plans

There are two dental plans to choose from offered through BCBSTX . Both PPO plans offer the freedom to see any provider you choose. When you use providers in the BCBSTX BlueCare Dental network, you receive benefits at the discounted network cost after you meet a calendar year deductible (except for preventive services), then the plan pays a percentage of covered costs.

Dental Plans Summary and Payroll Deductions

cleanings, fluoride

Basic Restorative Care

Amalgams and composites, simple extractions, anesthesia, stainless steel crowns, root canals, endodontics, sealants, space maintainers

Major Restorative Care

Periodontics, scaling and root planing, gingivectomy, osseous surgery, soft tissue grafts, surgical tooth extractions, crowns and inlays, onlays, bridges, dentures, implants

Vision Plan

Our vision plan is provided by BCBSTX using the EyeMed vision network. You may seek care from any provider; however, EyeMed in-network benefits are higher if you use an in-network provider.

Vision Plan Summary and Payroll Deductions

Exam – Once Every Plan Year

Routine Examination

Lenses (Standard) – Once Every Plan Year

ƒ Single Vision

ƒ Bifocal

ƒ Progressive

ƒ Trifocal

ƒ Lenticular

Contact Lenses – Once Every Plan Year

ƒ Fitting and Evaluation (in lieu of glasses)

ƒ Materials Allowance

Frames – Once Every Plan Year Frame Allowance (retail)

Vision Discount Program

BCBSTX provides a vision discount program through EyeMed if you enroll in one of our medical plans.

Vision Discount Program Plan Summary

Vision Care Services

ƒ Routine Examination

ƒ Contact Lens Fit and Follow-Up

at provider location

Standard Plastic Lenses*

ƒ Single Vision

ƒ Bifocal

ƒ Trifocal

ƒ Lenticular

ƒ Standard Progressive

ƒ Premium Progressive

Lens Options*

ƒ UV Coating

ƒ Tint (Solid and Gradient)

ƒ Standard Scratch-resistant

ƒ Standard Polycarbonate

ƒ Standard Anti-reflective

ƒ Other Add-ons and Services

Lenses

Complete Pair of Glasses Purchase

Life and AD&D Insurance

Basic Life and AD&D

Richard provides Basic Life insurance at one times your annual earnings to a maximum of $150,000. All full-time employees are also provided Basic Accidental Death & Dismemberment (AD&D) insurance in the same amount. Both of these benefits are provided at no cost through Sun Life. Benefits for Basic Life and AD&D insurance reduce to 65% at age 70, and to 50% at age 75.

Voluntary Life and AD&D

If you need more life insurance coverage, you may purchase Voluntary Life insurance for yourself. Coverage is available in $1,000 increments up to $500,000 (minimum of $10,000). For employees not currently enrolled, Evidence of Insurability (EOI) is required. Currently enrolled employees may increase as much as $10,000 up to Guaranteed Issue (GI) limit of $300,000. If requesting coverage over the GI limit, then EOI is required. For employees already over GI but not requesting more than $10,000, no EOI is required; but for those requesting more than $10,000, an EOI is required. Voluntary Life and Voluntary AD&D coverage amounts are the same. If an EOI is required due to the amount of coverage you elect over the GI amount, you must submit your EOI through the PlanSource portal within 30 days or your benefit will be declined.

Spouse Life and AD&D

If you have elected Voluntary Life insurance for yourself, you may purchase Voluntary Life insurance for your spouse. Coverage is available in $1,000 increments up to the lesser of 100% of the employee’s benefit or $500,000. If you are a newly eligible employee, your spouse is guaranteed coverage up to $100,000. Spouses can increase by $5,000, up to the GI limit with no EOI during OE, and is capped at the employee’s GI amount. If the spouse is not currently enrolled, then EOI is required.

Dependent Child(ren) Life and AD&D (up to age 26)

If you have elected Voluntary Life insurance for yourself, you may purchase Voluntary Dependent Child(ren) Life insurance for your dependent child(ren). New hires can enroll children without providing EOI. Coverage is available for a flat $10,000. Voluntary Dependent Child(ren) AD&D coverage and Voluntary Dependent Child(ren) Life coverage amounts are the same. Child coverage is dependent on the employee being approved for coverage.

Designating a Beneficiary

A beneficiary is a person or entity you elect to receive the death benefits of your Life and AD&D insurance policies. You can name more than one beneficiary and change beneficiaries anytime. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%). Enter your beneficiary(ies) in PlanSource.

How to Calculate Your Payroll Deduction

Decide the amount of coverage you want to purchase. Divide that number by $10,000, then multiply by your ageappropriate rate listed in the table.

Example: You are 40 years old and wish to purchase $100,000 of coverage.

$100,000 ÷ $10,000 = 10 × $1.49 = $14.90 (monthly rate) × 12 = $178.80 annual cost ÷ 27 (biweekly) or 53 (weekly) pay periods = $6.62 (biweekly) or $3.37 (weekly)

Conversion – Portability –Waiver of Premium

Want to keep your life insurance when your job ends? You can call Sun Life at 800-247-6875 to set up direct payment. If you are disabled, you might be able to have your premiums waived.

Disability Insurance

Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. We offer Short Term Disability (STD) and Long Term Disability (LTD) insurance for you to purchase through Sun Life

Voluntary Short Term Disability

You may purchase Voluntary STD coverage for yourself. Voluntary STD can pay a percentage of your gross weekly salary if you are not able to work due to a covered injury or illness. During the time you are collecting STD benefits, your other benefits will continue as long as you continue to make the appropriate contributions toward the cost of these plans.

Voluntary Long Term Disability

You may purchase Voluntary LTD coverage for yourself. Voluntary LTD can pay a percentage of your gross monthly salary if you are not able to work past 26 weeks due to a covered injury or illness. If you have been paying for coverage with Richard for two years, your coverage will become company-paid.

Short Term Disability Long Term Disability

Condition Limitations2

1 Earnings are based on 2025 W-2.

2

How to Calculate Your Payroll Deduction

Example: You are 40 years old with an annual salary of $55,000.

STD Calculation

$55,000 ÷ 53 weeks × 60% x $0.339 ÷ $10 = $21.10 monthly

LTD Calculation

$55,000 ÷ 12 months × $.342 ÷ $100 = $15.67 monthly

Biweekly or Weekly Payroll Deduction

To calculate your biweekly or weekly payroll deduction, multiply the monthly rate by 12 and then divide by 27 (biweekly) or 53 (weekly).

Accident Insurance

Accident insurance, offered through Sun Life, pays a fixed benefit directly 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 hospitalizations, fractures, dislocations, emergency room visits, major diagnostic exams, physical therapy, and more. Portability allows you to take coverage with you even if employment has ended.

You will receive a $100 annual health screening benefit for completing routine wellness screenings.

2 Percentage of benefit paid is dependent on type of loss.

Critical Illness Insurance

Sun Life’s Critical Illness insurance provides a lump-sum benefit payment upon first and second diagnosis of any qualified critical illnesses listed under covered conditions. Benefits are available for diagnoses which occur after the effective date of the plan and are paid directly to you. Expenditures for claim proceeds are not limited to medical expenses. Funds can be used at your discretion for things such as childcare, transportation, and to fill in gaps in your medical plan, like copays and deductibles. Portability allows you to take coverage with you even if employment has ended. Your coverage ends the last day worked.

You will receive a $100 annual health screening benefit for completing routine wellness screenings.

Critical Illness Plan

Invasive cancer, heart attack, stroke, major organ failure, end-stage kidney disease, occupational HIV/Hepatitis B, C or D, complete blindness, loss of speech, complete loss of hearing, benign brain tumor, paralysis, coma, severe burns, ALS

$2,500 increments to Guaranteed

amount of $30,000

$1,250 increments to Guaranteed Issue amount of $15,000,

*If you were treated for a condition three months prior to your effective date, benefits may not be paid until you have been covered under this plan for 12 months.

How to Calculate Your Payroll Deduction

Decide the amount of coverage you want to purchase. Divide that number by $1,000, then multiply by your ageappropriate rate listed in the table.

Example: You are 40 years old and wish to purchase $10,000 of tobaccofree coverage.

$10,000 ÷ $1,000 = 10 × $2.00 = $20.00 (monthly rate) × 12 = $240 annual cost ÷ 27 (biweekly) or 53 (weekly) pay periods = $8.89 (biweekly) or $4.53 (weekly)

Hospital Indemnity Insurance

Hospital Indemnity insurance through Sun Life provides financial assistance to enhance your current health plan coverage. It helps you avoid utilizing savings or borrowing money to cover out-of-pocket costs that health insurance does not cover. Hospital Indemnity insurance can help with expenses such as transportation, meals for family members, or childcare. Portability allows you to take coverage with you even if employment has ended.

Employee Assistance Program

ComPsych GuidanceResources is your confidential Employee Assistance Program (EAP). The program offers three face-to-face sessions and other support programs at no cost to help you and your family deal with personal concerns, work-related problems, and life’s toughest issues. Whether you are dealing with job pressures, substance abuse, or depression, ComPsych GuidanceResources can help you 24 hours a day, seven days a week.

ComPsych GuidanceResources is available to all employees. You do not need to be enrolled in a Sun Life plan to access the EAP online (you must be enrolled in a Sun Life plan for face-to-face sessions).

Visit www.guidanceresources.com

Web ID: EAPBusiness

Call 877-595-5281

Download the GuidanceNow app

Guidance and support are offered for issues including:

z Work-life balance

z Stress and anxiety

z Grief and loss

z Child/eldercare resources

z Relationships

z Legal

z Financial

The EAP is confidential and available at no cost to you.

Legal and Identity Theft Benefits

Richard provides access to affordable legal and identity theft services through U.S. Legal Services

Family Defender – Legal Services

U.S. Legal Services is affordable for personal legal needs and allows you to talk to an attorney about any personal legal concerns. Whether the issue is big, small, or somewhere in-between, your U.S. Legal Services provider law firm can offer advice or assistance on a variety of personal legal issues, including:

z Civil litigation

z Family law

z Immigration matters

z Traffic violations

z Criminal law

z Document preparation and review

z Real estate transactions

z Estate planning

z IRS audit protection

z Elder law matters

z Sale of secondary residence

Identity Defender – Identity Protection

Identity theft affects millions of Americans each year. U.S. Legal Services offers a high-quality identity theft plan to help protect and restore your identity. If you enroll for family coverage, your spouse and dependent children under 26 will also be covered.

z Monitoring – Compromised credentials, account takeover, bank account numbers, credit and debit card accounts, passport numbers, Social Security numbers, and phone numbers

z Fraud – Identity threat alerts, fraud alerts, medical identity fraud protection, and court records monitoring

z Credit – Credit inquiry alerts, credit report monitoring, and monthly credit score tracking

z Recovery – Identity restoration, credit freeze, ransomware resolution, and identity theft insurance

z Support – 24/7 customer support and online resources

Visit www.uslegalservices.net

Call 800-356-LAWS (5297)

Download the U.S. Legal Services app

Richard offers a 401(k) Retirement Plan to help you save for retirement. The plan is administered by John Hancock . Richard will match dollar for dollar up to 3% of your weekly or biweekly contribution.

Enrollment representatives can help you enroll over the phone, answer questions you may have about joining your employer’s plan, moving other retirement plans into your new plan, and much more.

Visit www.jhgoenroll.com

Contract Number: 65941

Enrollment Access Number: 237960

Call 855-JHENROL (543-6765).

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:

X All stages of reconstruction of the breast on which the mastectomy was performed;

X Surgery and reconstruction of the other breast to produce a symmetrical appearance; and

X 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:

Richard

Benefits Department

750 Pearl Street

Beaumont, TX 77701

409-832-7827

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 Richard 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. Richard has determined that the prescription drug coverage offered by the Richard medical plan is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage pays and is considered Creditable Coverage.

Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to enroll in a Medicare prescription drug plan, as long as you later enroll within specific time periods.

You can enroll in a Medicare prescription drug plan when you first become eligible for Medicare. If you decide to wait to enroll in a Medicare prescription drug plan, you may enroll later, during Medicare Part D’s annual enrollment period, which runs each year from October 15 through December 7 but as a general rule, if you delay your enrollment in Medicare Part D after first becoming eligible to enroll, you may have to pay a higher premium (a penalty).

You should compare your current coverage, including which drugs are covered at what cost, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. See the Plan’s summary plan description for a summary of the Plan’s prescription drug coverage. If you don’t have a copy, you can get one by contacting Richard 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 Richard 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 409-832-7827

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:

X Visit www.medicare.gov

X 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.

X Call 1-800-MEDICARE (1-800-6334227). TTY users should call 877-4862048

If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. Information about this extra help is available from the Social Security Administration (SSA) online at www. socialsecurity.gov, or you can call them at 800-772-1213. TTY users should call 800-325-0778

Remember: Keep this Creditable Coverage notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty).

May 1, 2026

Richard Benefits Department 750 Pearl Street Beaumont, TX 77701 409-832-7827

Notice of HIPAA Privacy Practices

THIS NOTICE OF PRIVACY PRACTICES DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This Notice of Privacy Practices (the “Notice”) describes the legal obligations of Richard’s Group Health Plan (the “Plan”) and your legal rights regarding your protected health information held by the Plan under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH Act). Among other things, this Notice describes how your protected health information may be used or disclosed to carry out treatment, payment, or health care operations, or for any other purposes that are permitted or required by law.

We are required to provide this Notice of Privacy Practices to you pursuant to HIPAA.

The HIPAA Privacy Rule protects only certain medical information known as “protected health information.” Generally, protected health information (PHI) is health information, including demographic information, collected from you or created or received by a health care provider, a health care clearinghouse, a health plan, or your employer on behalf of a group health plan, from which it is possible to individually identify you and that relates to:

1. Your past, present, or future physical or mental health or condition;

2. The provision of health care to you; or

3. The past, present, or future payment for the provision of health care to you.

I. Contact Information

If you have any questions about this Notice or about our privacy practices, and for any correspondence or requests related to the contents of this Notice, please contact: Richard Benefits Department

750 Pearl Street Beaumont, TX 77701 409-832-7827

II. Effective Date

This Notice is effective February 15, 2026.

III. Our Responsibilities

We are required by law to:

1. maintain the privacy of your PHI;

2. provide you with certain rights with respect to your PHI;

3. provide you with a copy of this Notice of our legal duties and privacy practices with respect to your PHI; and

4. follow the terms of the Notice that is currently in effect.

We reserve the right to change the terms of this Notice and to make new provisions regarding your PHI that we maintain, as

allowed or required by law. If we make any material change to this Notice, we will provide you with a copy of our revised Notice of Privacy Practices.

IV. How We May Use and Disclose Your PHI

Under the law, we may use or disclose your PHI under certain circumstances without your permission. The following categories describe the different ways that we may use and disclose your PHI. For each category of uses or disclosures we will explain what we mean and present some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories. Note that we will use and disclose PHI as described below unless otherwise prohibited or restricted by applicable state or other law, and that information can lose its protected status as PHI once re-disclosed by a recipient.

For Treatment. When and as appropriate, we may use or disclose medical information about you to facilitate medical treatment or services by health care providers. We may disclose medical information about you to providers, including doctors, nurses, technicians, medical students, or other hospital personnel who are involved in taking care of you. For example, we might disclose information about you with physicians who are treating you.

For Payment. We may use or disclose your protected health information to determine your eligibility for Plan benefits, to facilitate payment for the treatment and services you receive from health care providers, to determine benefit responsibility under the Plan, or to coordinate Plan coverage. For example, we may tell your health care provider about your medical history to determine whether a particular treatment is experimental, investigational, or medically necessary, or to determine whether the

Plan will cover the treatment. We may also share your protected health information with a utilization review or precertification service provider. Likewise, we may share your protected health information with another entity to assist with the adjudication or subrogation of health claims or to another health plan to coordinate benefit payments.

For Health Care Operations. We may use and disclose your protected health information for other Plan operations. These uses and disclosures are necessary to run the Plan. For example, we may use medical information in connection with conducting quality assessment and improvement activities; underwriting, premium rating, and other activities relating to Plan coverage; submitting claims for stop-loss (or excess-loss) coverage; conducting or arranging for medical review, legal services, audit services, and fraud and abuse detection programs; business planning and development such as cost management; and business management and general Plan administrative activities. However, we will not use your genetic information for underwriting purposes.

Substance Use Disorder (SUD)

Treatment Information. Some of your health information may be part of a SUD patient record and subject to additional protections under federal law (42 CFR Part 2) governing confidentiality of SUD patient records.

If we receive or maintain any information about you from a SUD treatment program that is covered by 42 CFR Part 2 (a “Part 2 Program”) through a general consent you provide to the Part 2 Program to use and disclose the SUD patient record for purposes of treatment, payment or health care operations, we may use and disclose your SUD patient record for treatment, payment and health care operations purposes as described in this Notice. If we receive or maintain your SUD patient record through specific consent you provide to us or another third party, we will use and disclose your SUD patient record only as expressly permitted by you in your consent as provided to us.

In no event will we use or disclose your SUD patient record, or testimony that describes the information contained in your SUD patient record, in any civil, criminal, administrative, or legislative proceedings by any Federal, State, or local authority, against you, unless authorized by your consent or the order of a court after it provides you notice of the court order.

To Business Associates. We may contract with individuals or entities known as Business Associates to perform various functions on our behalf or to provide certain types of services. In order to perform these functions or to provide these services, Business Associates will receive, create, maintain, transmit, use, and/or disclose your PHI, but only after they agree in writing with us to implement appropriate safeguards regarding your PHI. For example, we may disclose your PHI to a Business Associate to process your claims for Plan benefits or to provide support services, such as utilization management, pharmacy benefit management, or subrogation, but only after the Business Associate enters into a Business Associate contract with us.

Treatment Alternatives or HealthRelated Benefits and Services. We may use and disclose your protected health information to send you information about

treatment alternatives or other healthrelated benefits and services that might be of interest to you.

As Required by Law. We will disclose your PHI when required to do so by federal, state, or local law. For example, we may disclose your PHI when required by national security laws or public health disclosure laws.

To Avert a Serious Threat to Health or Safety. We may use and disclose your PHI when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat. For example, we may disclose your PHI in a proceeding regarding the licensure of a physician.

To Plan Sponsors. For the purpose of administering the plan, we may disclose PHI to certain employees of the Employer. However, those employees will only use or disclose that information as necessary to perform plan administration functions or as otherwise required by HIPAA, unless you have authorized further disclosures. Your PHI cannot be used for employment purposes without your specific authorization.

V. Special Situations

In addition to the above, the following categories describe other possible ways that we may use and disclose your PHI without your specific authorization. For each category of uses or disclosures, we will explain what we mean and present some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

Organ and Tissue Donation. If you are an organ donor, we may release your PHI after your death to organizations that handle organ procurement or organ, eye, or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and

transplantation.

Military. If you are a member of the armed forces, we may release your PHI as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority.

Workers’ Compensation. We may release your PHI for workers’ compensation or similar programs, but only as authorized by, and to the extent necessary to comply with, laws relating to workers’ compensation and similar programs that provide benefits for work-related injuries or illness.

Public Health Risks. We may disclose your PHI for public health activities. These activities generally include the following:

1. to prevent or control disease, injury, or disability;

2. to report births and deaths;

3. to report child abuse or neglect;

4. to report reactions to medications or problems with products;

5. to notify people of recalls of products they may be using;

6. to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;

7. to notify the appropriate government authority if we believe that a patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree, or when required or authorized by law.

Health Oversight Activities. We may disclose your PHI to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. We may also disclose your PHI in response to a subpoena, discovery request, or other lawful process by someone involved in a legal dispute, but only if efforts have been made to tell you about the request or to obtain a court or administrative order protecting the information requested.

Law Enforcement. We may disclose your PHI if asked to do so by a lawenforcement official.

1. in response to a court order, subpoena, warrant, summons, or similar process;

2. to identify or locate a suspect, fugitive, material witness, or missing person;

3. about the victim of a crime if, under certain limited circumstances, we are unable to obtain the victim’s agreement;

4. about a death that we believe may be the result of criminal conduct; and

5. about criminal conduct.

Coroners, Medical Examiners, and Funeral Directors. We may release PHI to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients to funeral directors, as necessary to carry out their duties.

National Security and Intelligence Activities. We may release your PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Inmates. If you are an inmate of a correctional institution or are in the custody of a law-enforcement official, we may disclose your PHI to the correctional institution or law-enforcement official if necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.

Research. We may disclose your PHI to researchers when:

1. The individual identifiers have been removed; or

2. When an institutional review board or privacy board has reviewed the research proposal and established protocols to ensure the privacy of the requested information and approves the research.

VI. Required Disclosures

The following is a description of disclosures of your PHI we are required to make.

Government Audits. We are required to disclose your PHI to the Secretary of the United States Department of Health and Human Services when the Secretary is investigating or determining our compliance with the HIPAA privacy rule.

Disclosures to You. When you request, we are required to disclose to you the portion of your PHI that contains medical records, billing records, and any other records used to make decisions regarding your health care benefits. We are also required, when requested, to provide you with an accounting of most disclosures of your PHI if the disclosure was for reasons other than for payment, treatment, or health care operations, and if the PHI was not disclosed pursuant to your individual authorization.

VII. Other Disclosures

Personal Representatives. We will disclose your PHI to individuals authorized by you, or to an individual designated as your personal representative, attorneyin-fact, etc., so long as you provide us with a written notice/authorization and any supporting documents (i.e., power of attorney). Note: Under the HIPAA privacy rule, we do not have to disclose information to a personal representative if we have a reasonable belief that:

1. You have been, or may be, subject to domestic violence, abuse, or neglect by such person; or

2. Treating such person as your personal representative could endanger you; and

3. In the exercise of professional judgment, it is not in your best interest to treat the person as your personal representative.

Spouses and Other Family Members. With only limited exceptions, we will send all mail to the employee. This includes mail relating to the employee’s spouse and other family members who are covered under the Plan and includes mail with information on the use of Plan benefits by the employee’s spouse and other family members and information on the denial of any Plan benefits to the employee’s spouse and other family members. If a person covered under the Plan has requested Restrictions or Confidential Communications (see below under “Your Rights”), and if we have agreed to the request, we will send mail as provided by the request for Restrictions or Confidential Communications.

Authorizations. Other uses or disclosures of your PHI not described above will only be made with your written authorization. For example, in general and subject to specific conditions, we will not use or disclose your psychiatric notes; we will not use or disclose your PHI for marketing; and we will not sell your PHI, unless you give us a written authorization. You may revoke written authorizations at any time, so long as the revocation is in writing. Once we receive your written revocation, it will only be effective for future uses and disclosures. It will not be effective for any information that may have been used or disclosed in reliance upon the written authorization and prior to receiving your written revocation.

VIII. Your Rights

You have the following rights with respect to your PHI:

Right to Inspect and Copy. You have the right to inspect and copy certain PHI that may be used to make decisions about your Plan benefits. If the information you request is maintained electronically, and you request an electronic copy, we will provide a copy in the electronic form and format you request, if the information can be readily produced in that form and format; if the information cannot be readily produced in that form and format, we will work with you to come to an agreement on form and format. If we cannot agree on an electronic form and format, we will provide you with a paper copy.

To inspect and copy your PHI, you must submit your request in writing. If you request a copy of the information, we may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request.

We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to your medical information, you may request that the denial be reviewed by submitting a written request.

Right to Amend. If you feel that the PHI we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the Plan. To request an amendment, your request must be made in writing. In addition, you must provide a reason that supports your request.

We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny

your request if you ask us to amend information that:

1. is not part of the medical information kept by or for the Plan;

2. was not created by us, unless the person or entity that created the information is no longer available to make the amendment;

3. is not part of the information that you would be permitted to inspect and copy; or

4. is already accurate and complete.

If we deny your request, you have the right to file a statement of disagreement with us and any future disclosures of the disputed information will include your statement.

Right to an Accounting of Disclosures.

You have the right to request an “accounting” of certain disclosures of your PHI. The accounting will not include (1) disclosures for purposes of treatment, payment, or health care operations; (2) disclosures made to you; (3) disclosures made pursuant to your authorization; (4) disclosures made to friends or family in your presence or because of an emergency; (5) disclosures for national security purposes; and (6) disclosures incidental to otherwise permissible disclosures.

To request this list or accounting of disclosures, you must submit your request in writing. Your request must state the time period you want the accounting to cover, which may not be longer than six years before the date of the request. Your request should indicate in what form you want the list (for example, paper or electronic). The first list you request within a 12-month period will be provided free of charge. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Right to Request Restrictions. You have the right to request a restriction or limitation on your PHI that we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on your PHI that we disclose to someone who is involved in your care or the payment for your care, such as a family member or friend. For example, you could ask that we not use or disclose information about a surgery that you had.

Except as provided in the next paragraph, we are not required to agree to your request. However, if we do agree to the request, we will honor the restriction until you revoke it or we notify you.

We will comply with any restriction request if (1) except as otherwise required by law, the disclosure is to a health plan for purposes of carrying out payment or health care operations (and is not for purposes of carrying out treatment); and (2) the PHI pertains solely to a health care item or service for which the health care provider involved has been paid in full by you or another person.

To request restrictions, you must make your request in writing. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both; and (3) to whom you want the limits to apply-for example, disclosures to your spouse.

Right to Request Confidential Communications.

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.

To request confidential communications, you must make your request in writing. We will not ask you the reason for your request. Your request must specify how or where you wish to be contacted. We will accommodate all reasonable requests.

Right to Be Notified of a Breach. You have the right to be notified in the event that we (or a Business Associate) discover a breach of unsecured PHI.

Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.

IX. Complaints

If you believe that your privacy rights have been violated, you may file a complaint with the Plan or with the Office for Civil Rights of the United States Department of Health and Human Services. To file a complaint with the Plan, contact the person listed in the Contact Information section of this Notice. All complaints must be submitted in writing. You will not be penalized, or in any other way retaliated against, for filing a complaint with the Office for Civil Rights or with us.

Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)

If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.

If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www. askebsa.dol.gov or call 1-866-444-EBSA (3272)

If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of January 31, 2026. Contact your State for more information on eligibility.

Louisiana

– Medicaid

Louisiana Medicaid Website: https://www. ldh.la.gov/healthy-louisiana

Medicaid Customer Service Line: 1-888342-6207

Louisiana Medicaid email: healthy@la.gov

Louisiana Health Insurance Premium Program (LaHIPP) Website: https://www. ldh.la.gov/lahipp

LaHIPP phone: 1-877-697-6703

LaHIPP email: La.HIPP@la.gov

LaHIPP fax: 1-888-716-9787

LaHIPP mailing address: 100 Crescent Centre Parkway, Suite 1000 Tucker, GA 30084

Texas – Medicaid Website: https://www.hhs.texas.gov/ services/financial/health-insurancepremium-payment-hipp-program Phone: 1-800-440-0493

To see if any other States have added a premium assistance program since January 31, 2026, or for more information on special enrollment rights, can contact either:

U.S. Department of Labor Employee Benefits Security Administration

www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272)

U.S. Department of Health and Human Services

Centers for Medicare & Medicaid Services www.cms.hhs.gov

1-877-267-2323, Menu Option 4, Ext. 61565

Continuation of Coverage Rights Under COBRA

Under the Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), if you are covered under the Richard group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Richard 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

Richard Benefits Department 750 Pearl Street Beaumont, TX 77701 409-832-7827

Your Rights and Protections Against

Surprise Medical Bills

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain outof-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that have not signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

X Emergency services – If you have an emergency medical condition and get emergency services from an out-ofnetwork provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

X Certain services at an in-network hospital or ambulatory surgical center – When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these innetwork facilities, out-of-network providers cannot balance bill you, unless you give written consent and give up your protections.

You are never required to give up your protections from balance billing. You also are not required to get care out-ofnetwork. You can choose a provider or facility in your plan’s network.

When balance billing is not allowed, you also have the following protections:

X You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was innetwork). Your health plan will pay out-of-network providers and facilities directly.

X Your health plan generally must:

ƒ Cover emergency services without requiring you to get approval for services in advance (prior authorization).

ƒ Cover emergency services by outof-network providers.

ƒ Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.

ƒ Count any amount you pay for emergency services or out-ofnetwork services toward your deductible and out-of-pocket limit.

If you believe you have been wrongly billed, you may contact your insurance provider. Visit www.cms.gov/nosurprises for more information about your rights under federal law.

New Health Insurance Marketplace Coverage Options and Your Health Coverage

PART A: General Information

Even if you are offered health coverage through your employment, you may have other coverage options through the Health Insurance Marketplace (“Marketplace”). To assist you as you evaluate options for you and your family, this notice provides some basic information about the Health Insurance Marketplace.

What is the Health Insurance Marketplace?

The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers “one-stop shopping” to find and compare private health insurance options in your geographic area. Can I Save Money on my Health Insurance Premiums in the Marketplace?

You may qualify to save money and lower your monthly premium and other out-of-pocket costs, but only if your employer does not offer coverage, or offers coverage that is not considered affordable for you and doesn’t meet certain minimum value standards (discussed below). The savings on your premium that you’re eligible for depends on your household income. You may also be eligible for a tax credit that lowers your costs.

Does Employment-Based Health Coverage Affect Eligibility for Premium Savings through the Marketplace?

Yes. If you have an offer of health coverage from your employer that is considered affordable for you and meets certain minimum value standards, you will not be eligible for a tax credit, or advance payment of the tax credit, for your Marketplace coverage and may wish to enroll in your employment-based health plan. However, you may be eligible for a tax credit, and advance payments of the credit that lowers your monthly premium, or a reduction in certain cost-sharing, if your employer does not offer coverage to you at all or does not offer coverage that is considered affordable for you or meet minimum value standards. If your share of the premium cost of all plans offered to you through your employment is more than 9.12%1 of your annual household income, or if the coverage through your employment does not meet the “minimum value” standard set by the Affordable Care

Act, you may be eligible for a tax credit, and advance payment of the credit, if you do not enroll in the employment-based health coverage. For family members of the employee, coverage is considered affordable if the employee’s cost of premiums for the lowest-cost plan that would cover all family members does not exceed 9.12% of the employee’s household income.1, 2

Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered through your employment, then you may lose access to whatever the employer contributes to the employment-based coverage. Also, this employer contribution -as well as your employee contribution to employment-based coverage- is generally excluded from income for federal and state income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis. In addition, note that if the health coverage offered through your employment does not meet the affordability or minimum value standards, but you accept that coverage anyway, you will not be eligible for a tax credit. You should consider all of these factors in determining whether to purchase a health plan through the Marketplace.

When Can I Enroll in Health Insurance Coverage through the Marketplace?

You can enroll in a Marketplace health insurance plan during the annual Marketplace Open Enrollment Period. Open Enrollment varies by state but generally starts November 1 and continues through at least December 15.

Outside the annual Open Enrollment Period, you can sign up for health insurance if you qualify for a Special Enrollment Period. In general, you qualify for a Special Enrollment Period if you’ve had certain qualifying life events, such as getting married, having a baby, adopting a child, or losing eligibility for other health

coverage. Depending on your Special Enrollment Period type, you may have 60 days before or 60 days following the qualifying life event to enroll in a Marketplace plan.

There is also a Marketplace Special Enrollment Period for individuals and their families who lose eligibility for Medicaid or Children’s Health Insurance Program (CHIP) coverage on or after March 31, 2023, through July 31, 2024. Since the onset of the nationwide COVID-19 public health emergency, state Medicaid and CHIP agencies generally have not terminated the enrollment of any Medicaid or CHIP beneficiary who was enrolled on or after March 18, 2020, through March 31, 2023. As state Medicaid and CHIP agencies resume regular eligibility and enrollment practices, many individuals may no longer be eligible for Medicaid or CHIP coverage starting as early as March 31, 2023. The U.S. Department of Health and Human Services is offering a temporary Marketplace Special Enrollment period to allow these individuals to enroll in Marketplace coverage.

Marketplace-eligible individuals who live in states served by HealthCare.gov and either- submit a new application or update an existing application on HealthCare. gov between March 31, 2023 and July 31, 2024, and attest to a termination date of Medicaid or CHIP coverage within the same time period, are eligible for a 60-day Special Enrollment Period. That means that if you lose Medicaid or CHIP coverage between March 31, 2023, and July 31, 2024, you may be able to enroll in Marketplace coverage within 60 days of when you lost Medicaid or CHIP coverage. In addition, if you or your family members are enrolled in Medicaid or CHIP coverage, it is important to make sure that your contact information is up to date to make sure you get any information about changes to your eligibility. To learn more, visit www.HealthCare.gov or call the Marketplace Call Center at 1-800-3182596. TTY users can call 1-855-889-4325

What about Alternatives to Marketplace Health Insurance Coverage?

If you or your family are eligible for coverage in an employment-based health plan (such as an employer-sponsored health plan), you or your family may also be eligible for a Special Enrollment Period to enroll in that health plan in certain circumstances, including if you or your dependents were enrolled in Medicaid or CHIP coverage and lost that coverage. Generally, you have 60 days after the loss of Medicaid or CHIP coverage to enroll in an employment-based health plan, but if you and your family lost eligibility for Medicaid or CHIP coverage between March 31, 2023 and July 10, 2023, you can request this special enrollment in the employment-based health plan through September 8, 2023. Confirm the deadline with your employer or your employmentbased health plan.

Alternatively, you can enroll in Medicaid or CHIP coverage at any time by filling out an application through the Marketplace or applying directly through your state Medicaid agency. Visit https://www. healthcare.gov/medicaid-chip/gettingmedicaid-chip/ for more details.

How Can I Get More Information?

The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit www.HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area.

PART B: Information About Health Coverage Offered by Your Employer

This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application.

3. Employer Name: Richard Design Services, Inc.

4. Employer Identification Number (EIN): 20-2036476 RDS 20-4181369 RCI

5. Employer Address: 750 Pearl Street

6. Employer Phone Number: 409-832-7827

7. City: Beaumont

8. State: TX 9. ZIP Code: 77701

10. Who can we contact at this job?: Benefits Department

11. Phone Number (if different from above): N/A

12. E-Mail Address: benefits@richardepc.com

You are not eligible for health insurance coverage through this employer. You and your family may be able to obtain health coverage through the Marketplace, with a new kind of tax credit that lowers your monthly premiums and with assistance for out-of-pocket costs.

1 Indexed annually; see https://www.irs.gov/pub/irsdrop/rp-22-34.pdf for 2023.

2 An employer-sponsored or other employment-based health plan meets the “minimum value standard” if the plan’s share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs. For purposes of eligibility for the premium tax credit, to meet the “minimum value standard,” the health plan must also provide substantial coverage of both inpatient hospital services and physician services.

This brochure highlights the main features of the Richard 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. Richard reserves the right to change or discontinue its employee benefits plans anytime.