2026 Urban Genesis Benefits Book

2026 2027 my benefits

Welcome

We are pleased to offer a full benefits package to help protect your well-being and financial health. Read this guide to learn about the benefits available to you and your eligible dependents starting April 1, 2026, including:

» Medical

» Dental

» Vision

» Life and AD&D

» Disability

» Health Savings Account (HSA)

Each year during Open Enrollment, you may make changes to your benefit plans. The benefit choices you make this year will remain in effect through March 31, 2027. Take time to review these benefit options and select the plans that best meet your needs. After Open Enrollment (OE), you may only make changes to your benefit elections if you have a Qualifying Life Event (QLE).

Availability of Summary Health Information

Your benefits program offers three medical plan coverage options. To help you make an informed choice and compare your options, Summary of Benefits and Coverage documents for each plan are available at UG Employee Information or by emailing Elizabeth Kamp in Human Resources at ekamp@urban-genesis.com

Your new benefits begin April 1, 2026.

If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, federal law gives you more choices for your prescription drug coverage. Please see page 25 for more details.

» Flexible Spending Accounts (FSAs)

Eligibility

You are eligible for benefits if you are a regular, full-time employee working an average of 30 hours per week. Your coverage is effective the first of the month following your date of hire. You may also enroll eligible dependents for benefits coverage. The cost for coverage depends on the number of dependents you enroll and the benefits you choose. When covering dependents, you must select and be on the same plans.

Benefit Eligibility STATUS

New Hire

Employee

Dependent(s)

• Regular, full-time employee

• Working an average of 30 hours per week

• Regular, full-time employee

• Working an average of 30 hours per week

• Your legal spouse

• Child(ren) under age 26 regardless of student, dependency, or marital status

• Child(ren) over age 26 who are fully dependent on you for support due to a mental or physical disability and who are indicated as such on your federal tax return

ENROLLMENT

30 DAYS

Notify Human Resources and complete your changes within 30 days of the event. You may need to provide documents to verify the change.

• Enroll by the deadline given by Human Resources

• Enroll during OE or when you have a QLE

• You must enroll the dependent(s) during OE or when you have a QLE

• When covering dependents, you must enroll for and be on the same plans

COVERAGE BEGINS

• First of the month following date of hire.

• OE: Start of the plan year

• QLE: Ask Human Resources

• Based on OE or QLE effective dates

Enrollment

Qualifying Life Events

Once you elect your benefit options, they remain in effect for the entire plan year until the following OE. You may only change coverage during the plan year if you have a QLE, some of which include:

» Marriage, divorce, legal separation, or annulment

» Birth, adoption, or placement for adoption of an eligible child

» Death of your spouse or your child

» Change in your spouse’s employment status that affects benefits eligibility

» Change in your child’s eligibility for benefits

» Significant change in benefit plan coverage for you, your spouse, or your child

» FMLA event, COBRA event, court judgment, or decree

» Becoming eligible for Medicare, Medicaid, or TRICARE

» Receiving a Qualified Medical Child Support Order

Medical Coverage

The medical plan options through Angle Health using the Cigna PPO network protect you and your family from major financial hardship in the event of illness or injury. You have a choice of three plans:

» Buy-up PPO Plan (Trad 2000) – This is a PPO plan with $2,000 individual and $4,000 family in-network deductibles.

» Base PPO Plan (Trad 4000) – This is a PPO plan with $4,000 individual and $8,000 family in-network deductibles.

» HDHP (HSA) Plan (HDHP 5000) –This is an HDHP/HSA plan with $5,000 individual and $10,000 family innetwork deductibles.

No matter which plan you choose, Urban Genesis contributes $650 a month to help lower your premiums.

Preferred Provider Organization

A Preferred Provider Organization (PPO) plan allows you to see any provider when you need care. When you see Cigna PPO network providers for care, you will pay less and get the highest level of benefits. You will pay more for care if you use out-of-network providers. When you see in-network providers, your office visits, urgent care visits, and prescription drugs are covered with a copay, and most other in-network services are covered at the deductible and coinsurance level.

High Deductible Health Plan

A High Deductible Health Plan (HDHP) allows you to see any provider when you need care, and you will pay less for care when you go to Cigna PPO network providers. In exchange for a lower per-paycheck cost for medical benefits, you must satisfy a higher plan deductible that applies to almost all health care expenses, including prescription drugs. If you enroll in the HDHP, you may be eligible to open an HSA (see page 16)

Note: Angle Health “borrows” the Cigna PPO network but handles all your claims and billing. You should show your Angle Health ID card to your doctor and point out that Cigna PPO is the network. However, if you have questions about a bill or claim, contact Angle Health. Do not contact Cigna for any reason.

Medical Plans Comparison

Physician Office Visit

Retail Pharmacy

30-day supply

• Generic

• Preferred Brand Name

• Non-Preferred Brand Name

• Specialty

Mail Order Pharmacy

90-day supply

• Generic

• Preferred Brand Name

• Non-Preferred Brand Name

• Specialty

* The amount you pay after the deductible is met.

Preventive Care Screening Benefits

You take your car in for maintenance, so why not do the same for yourself? Annual preventive checkups can help you and your doctor identify your baseline level of health and detect issues before they become serious.

What is Preventive Care?

Health insurers are required by law to cover a set of preventive services at no cost to you, even if you haven’t met your annual deductible. The preventive care services you’ll need to stay healthy vary by age, sex, and medical history.

Typical Screening for Adults

» Blood pressure

» Cholesterol

» Diabetes

» Colorectal cancer

» Depression

» Prostate cancer

» Testicular exam

» Mammograms

» OB/GYN screening

Preventive care is covered in full only when obtained from an IN-NETWORK Cigna PPO provider.

Exams performed by specialists are generally not considered preventive and may not be covered at 100%.

Additionally, certain screenings may be considered diagnostic, not preventive, based on your current medical condition. You may be responsible for paying all or a share of the cost for those screening services. If you have a question about whether a service will be covered as preventive care, contact your medical plan.

Angle Health Resources

Angle Health Member Portal

Visit www.anglehealth.com to access your member portal and:

» Review your health plan

» View eligibility criteria

» View claims and billing

» Access your digital ID card

» Find health educational information tailored to your needs

» Access virtual care through Doctor on Demand

» Connect to a dedicated care advocate

Angle Health App

You can also download the Angle Health app, which makes it even easier and more convenient to access your member portal and:

» Chat one-on-one with an Angle team member

» Show your digital ID to a provider

» Use Doctor on Demand for a virtual visit

Scan to download the Angle Health app

Access+

Access+ is a free optional program through Angle Health that helps you improve your health and reduce your out-of-pocket healthcare costs. Once you enroll, you will automatically be directed to programs specific to your care needs.

» A growing library of relevant and impactful programs – at no cost to you

» Assistance from the Access+ team

» Additional programs – may be unlocked upon completion of the health profile

You may qualify for coverage tailored to your needs and assistance solutions that help with high-cost medications and conditions. If so, you will receive a call from the Angle team to complete a health survey and personalize your benefits experience.

Note: You will be enrolled in Access+ only if you opt in. Once you enroll, you can opt out if you have a QLE.

» To learn more, call 866-257-5824

Angle Health Pharmacy Resources

AngleRx is the Pharmacy Benefit Administrator of your prescription benefit. They offer a broad PPO pharmacy network that includes all national chains and most local pharmacies. Your pharmacy coverage is through Promote Care

You can keep your prescription drug costs down if you:

» Fill your prescriptions at an in-network pharmacy

» Ask your doctor if a generic drug is an option

» Get up to a 90-day supply of covered drugs used regularly through mail delivery

» Use the specialty pharmacy service for specialty drugs

Mail Delivery Pharmacy Service

If you have your long-term or maintenance medications, you can save time by getting them delivered through the mail – to your home, doctor’s office, or anywhere you choose. With mail delivery by PillPack you get:

» Pre-sorted medications – If you take daily medication, PillPack can presort them by date and time.

Home delivery – Get the medications you need delivered to your door every month.

No additional costs – Service and shipping are always free. You simply pay your copays.

When your medications are in the mail, you can receive updates with email and text message alerts and a tracking number for every shipment.

Specialty Medication Pharmacy Service

If your treatment plan calls for specialty medications that require special handling, you have access to the AngleRx specialty pharmacy service. 945-224-0872 to get help with your specialty medications for chronic and complex conditions such as multiple sclerosis, rheumatoid arthritis, cancer, hepatitis, and others.

Get Started

» Visit www.cerpassrx.com/pillpack

» Email hello@pillpack.com

» Call 855-966-0966, available 24/7*

*After normal business hours, a voicemail service is available for customers. Leave a message and a pharmacist will return urgent calls within 30 minutes.

Member Web Portal

Visit https://rx.anglehealth.com to:

» Find participating pharmacy locations

» Compare pharmacy copays to determine the most costeffective options

» Track your medication history

» Access ID cards

How to Register

On the homepage, click on the Member Portal button. Then click Register Your Account. From there, enter your member ID located on your AngleRx ID card.

Mobile App

Download the AngleRx app to do what you can on the website, but also:

» Chat with a care team member (8 a.m. to 6 p.m. CT, Monday through Friday)

» Search a map for facilities

» Access your digital ID card

Access+ Rx Assistance

Access+ Rx offers more ways to save money on your prescription drugs through the following programs

Coupons and Copay Cards

These programs are known as copay savings programs, copay coupons, or copay assistance cards. These manufacturer copay cards from drug companies help patients afford expensive medications by reducing the out-of-pocket costs.

Prescription Assistance

Members can get free or discounted medications with prescription assistance programs from pharmaceutical companies.

International Sourcing

An international pharmacy will get a prescription from the member’s doctor and mail the medication to the member at $0 cost. This saves the plan a lot of money with no expense for the member.

Questions?

Call member services at 945-224-0872

Member Services

The Member Services Support Center is available to our members 24 hours a day, 7 days a week, 365 days a year. Please call 945-224-0872 for any questions regarding anything relating to your pharmacy benefits or drug coverage.

Virtual Care

Get 24/7/365 access to board-certified doctors from your mobile device or computer.

Your medical coverage includes telemedicine services through Doctor on Demand. Connect anytime day or night with a board-certified doctor via your mobile device or computer for free or for the same or lower cost than a visit to your regular physician.

When to Use Doctor on Demand

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

Use telemedicine services for minor conditions such as:

» Sore throat

» Headache

» Stomachache

» Cold/Flu

» Mental health issues

» Allergies

» Fever

» Urinary tract infections

Do not use telemedicine for serious or life-threatening emergencies.

Registration is Easy

Register with Doctor on Demand so you are ready to use this valuable service when and where you need it.

» Visit – www.anglehealth.com and select Virtual Care

» Mobile – Download the Doctor on Demand app You will need your Angle credentials to be able to sign up. Note: You can also access Doctor on Demand from the Angle Health app

Health Care Options

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

NON-EMERGENCY CARE

Telemedicine

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

24 hours a day, 7 days a week

Doctor’s Office

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

Office hours vary

Retail Clinic

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

Hours vary based on store hours

Urgent Care

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

Generally includes evening, weekend, and holiday hours

EMERGENCY CARE

Hospital ER

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

24 hours a day, 7 days a week

Freestanding ER

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

Allergies

Cough/cold/flu

Rash

Stomachache

Infections

Sore and strep throat

Vaccinations

Minor injuries/sprains/strains

Common infections

Minor injuries

Pregnancy tests

Vaccinations

Sprains and strains

Minor broken bones

Small cuts that may require stitches

Minor burns and infections

Chest pain

Difficulty breathing

Severe bleeding

Blurred or sudden loss of vision

Major broken bones

Most major injuries except trauma

Severe pain

15 minutes

Varies

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.

Dental Coverage

Our dental plan through Guardian helps you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work.

DentalGuard Preferred Network DPPO Plan

Two levels of benefits are available with the DentalGuard Preferred Network DPPO plan: in-network and out-of-network. You may see any dental provider for care, but you will pay less and get the highest level of benefits with in-network providers. You could pay more if you use an out-of-network provider.

Find an In-network

Dental Provider

» Visit www.guardianlife.com

» Call 888-600-1600

Calendar Year Deductible •

Preventive Care

Exams, cleanings, fluoride treatments, sealants, complete series X-rays

Basic Restorative Care

Fillings, repair of crowns, bridges, dentures

Major Restorative Care

Anesthesia, periodontics, root canals, endodontics, oral surgery, crowns, bridges, dentures, extractions

Orthodontia

Individuals

1Payment for covered services received from an out-of-network dentist is based on the 90th percentile of Usual, Customary, and Reasonable charges (UCR).

2You will be reimbursed up to a Maximum Allowable Charge (MAC) for services received from an out-of-network dentist. You are responsible for charges in excess of the MAC.

Maximum Rollover Program

If you enroll in our dental plan, you will automatically be enrolled in the Guardian Maximum Rollover Program. This program rewards you for going to the dentist regularly to prevent or detect the early signs of cases. If you submit a claim (without exceeding the paid claims threshold of a benefit year), Guardian will roll over part of your unused annual maximum into a Maximum Rollover Account (MRA). This can be used in future years if your plan’s annual maximum is reached. View your MRA statement at www.guardianlife.com or call 888-600-1600

Vision Coverage

Our vision plan offers quality care to help preserve your health and eyesight. Regular exams can detect certain medical issues such as diabetes and high cholesterol, in addition to vision and eye problems. You may seek care from any vision provider, but the plan will pay the highest level of benefits when you see in-network providers. Coverage is provided through Guardian

GUARDIAN VISION

• Single Vision

• Bifocals

• Trifocals

• Lenticular

Contacts

In lieu of frames/lenses

• Elective

• Medically Necessary

Health Savings Accounts

An HSA is a tax-exempt tool to supplement your retirement savings and cover current and future health costs. An HSA is a type of personal savings account that is always yours even if you change health plans or jobs. The money in your HSA (including interest and investment earnings) grows taxfree and spends tax-free if used to pay for current or future qualified medical expenses. There is no “use it or lose it” rule – you do not lose your money if you do not spend it in the calendar year – and there are no vesting requirements or forfeiture provisions. The account automatically rolls over year after year.

HSA Eligibility

You are eligible to open and contribute to an HSA if you are:

» Enrolled in the HDHP (HSA) Plan

» Not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan

» Not enrolled in a Health Care FSA

» Not eligible to be claimed as a dependent on someone else’s tax return

» Not enrolled in Medicare, Medicaid, or TRICARE

» Not receiving Veterans Administration benefits

You can also use HSA funds to pay health care expenses for your dependents, even if they are not covered by the HDHP.

MAXIMUM HSA CONTRIBUTIONS

Your HSA contributions may not exceed the annual maximum amounts established by the IRS. The 2026 annual contribution maximums are 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 age 55 or older, you may make a yearly catchup contribution of up to $1,000 to your HSA. If you turn 55 anytime during the plan year, you are eligible to make the catch-up contribution for the entire plan year.

Open an HSA

If you meet the eligibility requirements, you may open an HSA administered by Rippling (UMB Bank). You will receive a debit card to manage your HSA account reimbursements. Keep in mind, available funds are limited to the balance in your HSA. Go to www.rippling.com to open your account.

Important HSA Information

» Always ask your network doctor to file claims with your medical, dental, or vision carrier so you will get the highest level of benefits. You can pay the doctor with your HSA debit card for any balance due.

» You, not your employer, are responsible for maintaining ALL records and receipts for HSA reimbursements in the event of an IRS audit.

» You may open an HSA at the financial institution of your choice, but only accounts opened through Rippling (UMB Bank) are eligible for automatic payroll deduction and company contributions.

•

•

•

• Make annual HSA contributions

• Pay for medical costs with other funds

• Invest HSA funds

Flexible Spending Accounts

An FSA allows you to set aside pretax dollars from each paycheck to pay for certain IRS-approved health and dependent care expenses. We offer three different FSAs: two for health care expenses and one for dependent care expenses. Rippling administers our FSAs.

Health Care FSA

The Health Care FSA covers qualified medical, dental, and vision expenses for you or your eligible dependents. You may contribute up to $3,400 annually to a Health Care FSA, and you are entitled to the full election from day one of your plan year. Eligible expenses include:

» Dental and vision expenses

» Medical deductibles and coinsurance

» Prescription copays

» Hearing aids and batteries

You may not contribute to a Health Care FSA if you enrolled in an HDHP and contribute to an HSA.

Limited Purpose Health Care FSA

A Limited Purpose Health Care FSA is available if you enrolled in the HDHP medical plan and contribute to 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)

How the Health Care and Limited Purpose FSAs Work

You can access the funds in your Health Care or Limited Purpose Health Care FSA two different ways:

» Use your Rippling FSA debit card to pay for qualified expenses, doctor visits, and prescription copays.

» Pay out-of-pocket and submit your receipts for reimbursement:

1. Go to www.rippling.com or download and use the Rippling app

2. Open the Rippling My Benefits app > Overview tab > under Current benefits

3. Click Go to dashboard to the right of your FSA.

4. Under the Claims tab, click Submit New Claim, then follow the steps to complete the claim.

Flexible Spending Accounts

Dependent Care FSA

The Dependent Care FSA helps pay for expenses associated with caring for elder or child dependents so you or your spouse can work or attend school fulltime. You can use the account to pay for daycare or babysitter expenses for your children under age 13 and qualifying older dependents, such as dependent parents. Reimbursement from your Dependent Care FSA is limited to the total amount deposited in your account at that time. To be eligible, you (and your spouse, if married) must be gainfully employed, looking for work, a full-time student, or incapable of self-care.

Dependent Care FSA Guidelines

» Overnight camps are not eligible for reimbursement (only day camps can be considered).

» If your child turns 13 midyear, you may only request reimbursement for the part of the year when the child is under age 13.

» You may request reimbursement for care of a spouse or dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self-care.

» The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.

Important FSA Rules

» The maximum per plan year you can contribute to a Health Care or Limited Purpose Health Care FSA is $3,400. The maximum per plan year you can contribute to a Dependent Care FSA is $7,500 when filing jointly or head of household and $3,750 when married filing separately.

» You cannot change your election during the year unless you experience a Qualifying Life Event.

» You can continue to file claims incurred during the plan year for another 90 days (up until June 29, 2027 ).

» Your Health Care or Limited Purpose Health Care FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care expenses.

» The IRS has amended the “use it or lose it” rule to allow you to carry over up to $680 in your Health Care or Limited Purpose Health Care FSA into the next plan year. The carryover rule does not apply to your Dependent Care FSA.

Health Care FSA

Limited Purpose Health Care FSA

Most medical, dental, and vision care expenses that are not covered by your health plan (such as copayments, coinsurance, deductibles, eyeglasses, and doctor-prescribed over-thecounter medications)

$3,400

Dependent Care FSA

Dental and vision care expenses that are not covered by your health plan (such as eyeglasses, contacts, LASIK eye surgery, fillings, X-rays, and braces) $3,400

Dependent care expenses (such as daycare, after-school programs, or eldercare programs) so you and your spouse can work or attend school full-time

Saves on eligible expenses not covered by insurance; reduces your taxable income

Saves on eligible expenses not covered by insurance; reduces your taxable income

$7,500 (filing jointly or head of houshehold); $3,750 (married and filing separately) Reduces your taxable income

Getting Reimbursed for Dependent Care Costs

You must pay out of pocket and submit your receipts for reimbursement. Go to www.rippling.com or download and use the Rippling app.

List of Qualified HSA/FSA Expenses

The products and services listed below are examples of medical expenses eligible for payment under your HSA and FSAs. This list is not all-inclusive; additional expenses may qualify, and the items listed are subject to change in accordance with IRS regulations. Please refer to IRS Publication 502 Medical and Dental Expenses at www.irs.gov for a complete description of eligible medical and dental expenses.

Abdominal supports

Acupuncture

Air conditioner (when necessary for relief from difficulty in breathing)

Alcoholism treatment

Ambulance

Anesthetist

Arch supports

Artificial limbs

Autoette (when used for relief of sickness/disability)

Blood tests

Blood transfusions

Braces

Cardiographs

Chiropractor

Contact lenses

Convalescent home (for medical treatment only)

Crutches

Dental treatment

Dental X-rays

Dentures

Dermatologist

Diagnostic fees

Diathermy

Drug addiction therapy

Drugs (prescription)

Elastic hosiery (prescription)

Eyeglasses

Fees paid to health institute prescribed by a doctor

FICA and FUTA tax paid for medical care service

Fluoridation unit

Guide dog

Gum treatment

Gynecologist

Healing services

Hearing aids and batteries

Hospital bills

Hydrotherapy

Insulin treatment

Lab tests

Lead paint removal

Legal fees

Lodging (away from home for outpatient care)

Metabolism tests

Neurologist

Nursing (including board and meals)

Obstetrician

Operating room costs

Ophthalmologist

Optician

Optometrist

Oral surgery

Organ transplant (including donor’s expenses)

Orthopedic shoes

Orthopedist

Osteopath

Oxygen and oxygen equipment

Pediatrician

Physician

Physiotherapist

Podiatrist

Postnatal treatments

Practical nurse for medical services

Prenatal care

Prescription medicines

Psychiatrist

Psychoanalyst

Psychologist

Psychotherapy

Radium therapy

Registered nurse

Special school costs for the handicapped

Spinal fluid test

Splints

Surgeon

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

Therapy equipment

Transportation expenses (relative to health care)

Ultraviolet ray treatment

Vaccines

Vitamins (if prescribed)

Wheelchair X-rays

Life And AD&D Insurance

Life and Accidental Death and Dismemberment (AD&D) insurance through Guardian are important to your financial security, especially if others depend on you for support or vice versa.

With Life insurance, you or your beneficiary(ies) can use the coverage to pay off debts such as credit cards, loans, and bills.

AD&D coverage provides specific benefits if an accident causes bodily harm or loss (e.g., the loss of a hand, foot, or eye). If death occurs from an accident, 100% of the AD&D benefit would be paid to you or your beneficiary(ies).

Life and AD&D coverage amounts reduce by 35% at age 65, and 15% at age 70.Basic Life and AD&D

Basic Life and AD&D

Voluntary Life and AD&D

You may buy more Life and AD&D insurance for you and your eligible dependents. If you do not elect Voluntary Life and AD&D insurance when first eligible or if you want to increase your benefit amount at a later date, you may need to show proof of good health. You must elect Voluntary Life and AD&D coverage for yourself before you may elect coverage for your spouse or children. If you leave the company, you may be able to take the insurance with you.

Designating a Beneficiary

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

Increments of $10,000 up to $300,000

Guaranteed Issue

$150,000

• Increments of $5,000 up to $250,0000 not to exceed 100% of your election

• Guaranteed Issue

$25,000 • Increments of $5,000 up to $10,000

Guaranteed Issue $10,000

Conversion – Portability – Waiver of Premium

Upon termination of employment, you have the option to continue your company-paid Life and AD&D insurance and pay premiums directly to Guardian. Your company-paid Life and AD&D insurance may be converted to individual policies. Portability is available for Life coverage if you are enrolled in additional Life coverage. Portability is not available for AD&D. If you are disabled at the time your employment is terminated, you may be eligible for a Waiver of Premium while you are disabled. Contact Human Resources for a Conversion, Portability, or Waiver of Premium application.

Disability Insurance

Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. We provide Short Term Disability (STD) at no cost to you and offer Voluntary Long Term Disability to purchase through Guardian.

Short Term Disability

STD coverage pays a percentage of your weekly salary if you are temporarily disabled and unable to work due to an illness, pregnancy, or non-work-related injury. STD benefits are not payable if the disability is due to a job-related injury or illness. If a medical condition is job-related, it is considered under workers’ compensation, not STD.

SHORT TERM DISABILITY BENEFITS

Voluntary 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.

LONG TERM DISABILITY BENEFITS

Benefits Begin 91st day Percentage of Earnings You Receive

Pre-existing Condition Exclusion 3/12*

*Benefits may not be paid for any condition treated within three months prior to your effective date until you have been covered under this plan for 12 months.

** Social Security Normal Retirement Age

*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.

Additional Benefits

Employee Assistance Program

The Employee Assistance Program (EAP) offered through Guardian helps address a variety of emotional, legal, and financial issues. Whether it is depression, alcohol and drug abuse, grief, loss, identify theft, legal, financial, or other work or life issues, help is available to you and your family 24/7 for free.

Services include:

» Unlimited phone contact – Get 24/7 support from licensed professional counselors

» Web-based services – Access extensive online resources to help with personal, relationships, legal, health, and financial concerns, and more

» Referrals for additional care

» Medical bill saver assistance – helps you save on medical bills

Get More Information

» Call 855-239-0743 (multilingual).

» Visit www.guidanceresources.com

» Download the GuidanceNow app

Estate Guidance

Secure your wishes with a legally binding will. EstateGuidance makes drafting a will easy with online tools that walk you through the process in minutes. Draft a living will to ensure you get the end-of-life care you desire and a final arrangements document that states your wishes for your funeral services. There is a nominal fee for drafting and printing the legal documents. To learn more, call 855-239-0743, visit www.estateguidance.com, or get the GuidanceNow app (promo code: Guardian).

Cancer Support

Get personal, empathetic support to help you navigate a cancer diagnosis. Guardian partners with Osara Health to bring cancer support services that can help you focus on your holistic well-being throughout your treatment. Because you have Guardian LTD insurance as a benefit through your employer, you have access to this unique six- to 12-week program at no additional cost to you. The program offers a dedicated health coach, digital resource modules, and tailored well-being information. Guardian will proactively provide details about this service as part of the disability claims process.

Glossary of Terms

Beneficiary – Who will receive a benefit in the event of the insured’s death. A policy may have more than one beneficiary.

Coinsurance – Your share of the cost of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service, typically after you meet your deductible.

Copay – The fixed amount you pay for health care services received.

Deductible – The amount you owe for health care services before your health insurance begins to pay its portion. For example, if your deductible is $1,000, your plan does not pay anything until you meet your $1,000 deductible for covered health care services. The deductible may not apply to all services, including preventive care.

Employee Contribution – The amount you pay for your insurance coverage.

Employer Contribution – The amount Urban Genesis contributes to the cost of your benefits.

Explanation of Benefits (EOB) – A statement sent by your insurance carrier that explains which procedures and services were provided, how much they cost, what portion of the claim was paid by the plan, what portion of the claim is your responsibility, and information on how you can appeal the insurer’s decision. These statements are also posted on the carrier’s website for your review.

Flexible Spending Account (FSA) – An option that allows participants to set aside pretax dollars to pay for certain qualified expenses during a specific time period (usually a 12-month period).

Health Savings Account (HSA) – A personal savings account that allows you to pay for qualified medical expenses with pretax dollars.

High Deductible Health Plan (HDHP) –

A medical plan with a higher deductible in exchange for a lower monthly premium. You must meet the annual deductible before any benefits are paid by the plan.

In-Network – Doctors, hospitals, and other providers that contract with your insurance company to provide health care services at discounted rates.

Out-of-Network – Doctors, hospitals, and other providers that are not contracted with your insurance company. If you choose an out-of-network provider, you may be responsible for costs over the amount allowed by your insurance carrier.

Out-of-Pocket Maximum – Also known as an out-of-pocket limit. The most you pay during a policy period (usually a 12-month period) before your health insurance or plan begins to pay 100% of the allowed amount. The limit does not include your premium, charges beyond the Reasonable and Customary allowance, or health care your plan does not cover. Check with your health insurance carrier to confirm what payments apply to the out-of-pocket maximum.

Over-the-Counter (OTC) Medications – Medications typically made available without a prescription.

Prescription Medications – Medications prescribed by a doctor. Cost of these medications is determined by their assigned tier.

» Brand Name Drugs (Formulary) –Brand name drugs on your provider’s list of approved drugs. You can check online with your provider to see this list.

» Brand Name Drugs (Non-Formulary) – Brand name drugs not on your provider’s list of approved drugs. These drugs are typically newer and have higher copayments.

» Generic Drugs – Drugs approved by the U.S. Food and Drug Administration (FDA) to be chemically identical to corresponding brand name versions. The color or flavor of a generic medicine may be different, but the active ingredient is the same. Generic drugs are usually the most costeffective version of any medication.

Preventive Care – The care you receive to prevent illness or disease. It also includes counseling to prevent health problems.

Reasonable and Customary (R&C) Allowance – Also known as an eligible expense or the Usual and Customary (U&C). The amount your insurance company will pay for a medical service in a geographic region based on what providers in the area usually charge for the same or similar medical service.

SSNRA – Social Security Normal Retirement Age.

Employee Contributions

Required 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:

Urban Genesis, LLC Human Resources

2215 Lawrence St., Suite A Houston, TX. 77008 832-819-0863

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 Urban Genesis 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. Urban Genesis has determined that the prescription drug coverage offered by the Urban Genesis medical plan is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage pays and is considered Creditable Coverage. The HSA plan is not considered Creditable Coverage.

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

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

You should compare your current coverage, including which drugs are covered at what cost, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. See the Plan’s summary plan description for a summary of the Plan’s prescription drug coverage. If you don’t have a copy, you can get one by contacting Urban Genesis 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 Urban Genesis 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 832-819-0863.

NOTE: You will receive this notice annually and at other times in the future, such as before the next period you can enroll in Medicare prescription drug coverage and if this coverage changes. You may also request a copy.

For more information about your options under Medicare prescription drug coverage: More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You will get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. For more information about Medicare prescription drug coverage:

• Visit www.medicare.gov

• Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help.

• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 877-486-2048.

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

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).

April 1, 2026

Urban Genesis, LLC

Human Resources

2215 Lawrence St., Suite A Houston, TX. 77008 832-819-0863

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 Urban Genesis’ 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:

Urban Genesis, LLC Human Resources

2215 Lawrence St., Suite A Houston, TX. 77008 832-819-0863

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 pre-certification 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 excessloss) 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 Health-Related Benefits and Services. We may use and disclose your protected health information to send you information about treatment alternatives or other health-related 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 law-enforcement 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, attorney-in-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 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 1-866-444EBSA (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.

Texas – Medicaid

Website: https://www.hhs.texas.gov/services/ financial/health-insurance-premium-paymenthipp-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, you can contact either:

U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272)

U.S. Department of Health and Human Services

Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323, Menu Option 4, Ext. 61565

Continuation of Coverage Rights Under COBRA

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

Urban Genesis

Human Resources

2215 Lawrence St., Suite A Houston, TX. 77008

832-819-0863

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

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

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

You are protected from balance billing for:

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

• Certain services at an in-network hospital or ambulatory surgical center – When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be outof-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount.

This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-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-of-network. You can choose a provider or facility in your plan’s network.

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

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

• 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.

• 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-ofpocket 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 employmentbased 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 1-800-318-2596 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 employmentbased health plan through September 8, 2023. Confirm the deadline with your employer or your employment-based 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: Urban Genesis

4. Employer Identification Number (EIN): 47-3010857

5. Employer Address: 2215 Lawrence St. Suite A

6. Employer Phone Number: 832-819-0863

7. City: Houston

8. State: TX 9. ZIP Code: 77008

10. Who can we contact at this job?: Elizabeth Kamp

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

12. E-Mail Address: ekamp@urban-genesis.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 Urban Genesis 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. Urban Genesis reserves the right to change or discontinue its employee benefits plans anytime.