Important Contacts
BENEFIT HELPLINE/EMPLOYEE RESPONSE CENTER
Employee benefits can be complicated. The Higginbotham Employee Response Center can assist you with the following:
z Enrollment
z Benefits information
z Claims or billing questions
z Eligibility issues
Call 866-365-2193 to speak with a representative Monday through Friday from 8:00 a.m. to 7:00 p.m. ET. If you leave a voicemail message after 3:00 p.m. ET, your call will be returned the next business day. You can also email questions or requests to hrcpbenefits@eb.higginbotham.net
Bilingual representatives are also available.
We are pleased to offer a full benefits package to help protect your wellbeing and financial health. Read this guide to learn about the benefits available to you and your eligible dependents effective July 1, 2026.
Each year during Open Enrollment (OE), you may make changes to your benefit plans. The benefit choices you make this year will remain in effect through June 30, 2027. Take time to review these benefit options and select the plans that best meet your needs. After OE, you may only make changes to your benefit elections if you have a Qualifying Life Event (QLE).
AVAILABILITY OF SUMMARY HEALTH INFORMATION
Your plan offers two health coverage options. To help you make an informed choice and compare your options, a Summary of Benefits and Coverage is available online at www.benefitsinhand.com or by contacting Human Resources.
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 30 days of full-time employment. You may also enroll eligible dependents for benefits coverage. The cost to you for dependent coverage depends on the number of dependents you enroll and the particular plans you choose. When covering dependents, you must select the same plans for your dependents as you select for yourself.
ELIGIBLE DEPENDENTS INCLUDE
z Your legal spouse
z Children under the age of 26 regardless of student, dependency, or marital status
z Children over the age of 26 who are fully dependent on you for support due to a mental or physical disability and who are indicated as such on your federal tax return
QUALIFYING LIFE EVENTS
Your benefit elections remain in effect for the entire plan year until the following OE. You may only change coverage during the plan year if you have a QLE, and you must do so within 30 days of the event.
z Marriage, divorce, legal separation, or annulment
z Birth, adoption, or placement for adoption of an eligible child
z Death of a spouse or child
z Change in your spouse’s employment that affects benefits eligibility
z Change in your child’s eligibility for benefits (e.g., reaching the age limit)
z Change in residence that affects your eligibility for coverage
z Significant change in coverage or cost in your, your spouse’s, or your child’s benefit plans
z FMLA leave, COBRA event, judgment, or decree
z Becoming eligible for Medicare, Medicaid, or TRICARE
z Receiving a Qualified Medical Child Support Order
If you have a QLE and want to request a midyear change, you must notify Human Resources and complete your election changes within 30 days following the event. Be prepared to provide documentation to support the QLE.
How to Enroll
To begin the enrollment process, go to www.benefitsinhand.com. First-time users, follow steps 1-4. Returning users, log in and start at step 5.
1. If this is your first time to log in, click on the New User Registration link. Once you register, you will use your username and password to log in.
2. Enter your personal information and company identifier of HRCP and click Next
3. Create a username (work email address recommended) and password, then check the I agree to terms and conditions box before you click Finish
4. If you used an email address as your username, you will receive a validation email to that address. You may now log in to the system.
5. Click the Start Enrollment button to begin the enrollment process.
6. Confirm or update your personal information and click Save & Continue.
7. Edit dependents or add dependents that need to be covered on your benefits. Once all dependents are listed, click Save & Continue
8. Follow the steps on the screen for each benefit to make your selection. Please notice there is an option to decline coverage. If you wish to decline, click the Don’t want this benefit? button and select the reason for declining.
9. Once you have elected or declined all benefits, you will see a summary of your selections. Click the Click to Sign button. Your enrollment will not be complete until you click the Click to Sign button. If you would like to continue in Spanish, click the arrow next to your name. You must be registered to choose this option.
BENEFIT HELPLINE/ EMPLOYEE RESPONSE CENTER
Have questions about your benefits or need help enrolling? Call the Benefits Helpline at 866-365-2193 Benefits experts are available to take your call Monday through Friday, 8:00 a.m. – 7:00 p.m. ET.
Medical Coverage
The medical plan options through Anthem Blue Cross Blue Shield (BCBS) protect you and your family from major financial hardship in the event of illness or injury. You have a choice of two PPO plans:
z Base Plan – $5,000 individual/$10,000 family innetwork deductible
z Buy-Up Plan – $1,500 individual/$3,000 family innetwork deductible
Note: Virginia employees are enrolled in plans that use the HealthKeepers network. Employees residing outside of Virginia are enrolled in plans that use the KeyCare network.
PREFERRED PROVIDER ORGANIZATION (PPO)
A PPO plan allows you the freedom to see any provider when you need care, without having a primary care provider or a referral. When you use providers from either the HealthKeepers or KeyCare networks, you receive benefits at a discounted network cost. If you use non-PPO providers, you will pay more for services.
The Anthem plans cover preventive care at no cost to you. In-network office visits, urgent care, and prescription drugs are covered with a copay. Most other in-network services are covered at the coinsurance level after you have met your deductible.
Note: Virginia employees are enrolled in plans that use the HealthKeepers network. Employees with a permanent address outside of Virginia are enrolled in plans that use the KeyCare network.
FIND AN IN-NETWORK PROVIDER
Visit www.anthem.com or call 833-592-9956
ANTHEM MOBILE APP
Sydney, the Anthem mobile app can help you stay organized and in control of your health anytime, anywhere. Log in from your mobile device to:
z Access personalized health and wellness information
z Locate community resources and find free or reduced-cost programs for food, transportation, and childcare
z Track your account balances and deductibles
z View, fax, or email ID card information
z Find doctors, dentists, or pharmacies
z Refill your Anthem home delivery prescriptions and view order history
z View medication costs based on your plan and search for lower, cost-saving alternatives
z Access and print your ID cards
Search for the Sydney Health app in your mobile device’s app store.
MEDICAL BENEFITS SUMMARY
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•
•
• Tier
• Tier
Anthem Resources
TELEMEDICINE
Your medical coverage offers telemedicine services through LiveHealth Online. Connect anytime day or night with a board-certified doctor via your mobile device or computer for free, or for the same or less cost than a visit to your regular physician.
WHEN TO USE LIVEHEALTH ONLINE
While telemedicine does not replace your primary care physician, it is a convenient and cost-effective option when you need care and:
z Have a non-emergency issue and are considering an after hours health care clinic, urgent care clinic, or emergency room for treatment
z Are on a business trip, vacation, or away from home
z Are unable to see your primary care physician
Use telemedicine services for minor conditions such as:
z Sore throat
z Headache
z Stomachache
z Cold
z Flu
z Allergies
z Fever
z Urinary tract infections
Do not use telemedicine for serious or life-threatening emergencies.
REGISTRATION IS EASY
Register with www.livehealthonline.com so you are ready to use this valuable service when and where you need it.
z Visit www.livehealthonline.com
z Call 888-548-3432
z Download the LiveHealth Online Mobile app
EMPLOYEE ASSISTANCE PROGRAM
This confidential Employee Assistance Program (EAP) helps you find balance between work and home life. Resource Advisor provides guidance for personal issues you might be facing and information about other concerns that affect your life, including:
z Stress and depression
z Financial issues
z Family/relationships
z Substance abuse
z Grief
z Parenting
z Elder care
z Identity theft
z Other personal concerns
Your benefits include unlimited free telephone consultation with an EAP counselor 24/7/365. Three face-to-face sessions with local counselors are also available to you and your eligible dependents.
Call 800-209-7840 and ask for Resource Advisor or visit www.resourceadvisor.anthem.com. Log in using program name AnthemResourceAdvisor
ANTHEM DISCOUNTS
Included with your Anthem coverage are discounts on products and services that help promote better health and well-being. These discounts are available through SpecialOffers to help save money while taking care of your health. Discounts include:
z Vision, hearing, and dental care
z Health and fitness
z Family and home
z Medicine and treatments
To find available discounts, log in to www.anthem.com and click on Care and select Discounts
Where to Go for care
Becoming familiar with your options for medical care can save you time and money. HEALTH
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 VISIT
24 hours a day, 7 days a week
Generally, the best place for routine preventive care; established relationship; able to treat based on medical history
DOCTOR’S OFFICE
Office hours vary
RETAIL CLINIC
URGENT CARE
Emergency Care
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
When you need immediate attention; walk-in basis is usually accepted
Generally includes evening, weekend, and holiday hours
z Allergies
z Cough/cold/flu z Rash z Stomachache
z Infections
z Sore and strep throat z Vaccinations
z Minor injuries, sprains and strains
z Common infections
z Minor injuries z Pregnancy tests z Vaccinations
z Sprains and strains
z Minor broken bones
z Small cuts that may require stitches
z 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
z Chest pain
z Difficulty breathing
z Severe bleeding
z Blurred or sudden loss of vision
z Major broken bones
z Most major injuries except trauma
z Severe pain
15-20 minutes
15 minutes
15-30 minutes
4+ hours
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 Mutual of Omaha helps you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work. Premium contributions for dental will be deducted from your paycheck on a pretax basis.
DPPO PLAN
Mutual of Omaha allows you to see any provider you choose. To get the most from your benefits and reduce out-of-pocket costs, choose an in-network provider by utilizing Mutual of Omaha’s large national network. These providers have agreed to file your claims and uphold the highest quality standards. You could pay more by using an out-of-network provider. The maximum allowance for out-of-network services is based on the 90th percentile of Usual, Customary, and Reasonable (UCR) fees determined by Mutual of Omaha.
DENTAL BENEFITS SUMMARY
FIND AN IN-NETWORK DENTIST
Visit www.mutualofomaha.com/dental or call 800-927-9197
Vision Coverage
Our vision plan provides quality care to help preserve your health and eyesight. In addition to identifying vision and eye problems, regular exams can detect certain medical issues such as diabetes and high cholesterol. You may seek care from any licensed optometrist, ophthalmologist, or optician, but plan benefits are better if you use an in-network provider. Premium contributions are deducted from your paycheck on a pretax basis. Coverage is provided through Mutual of Omaha using the EyeMed Insight Network
FIND AN IN-NETWORK VISION PROVIDER
Visit www.mutualofomaha.com/vision or call 833-279-4358
VISION BENEFITS SUMMARY
Lenses
• Single vision
• Lined bifocals
• Lined trifocals
• Lenticular
Contacts
In lieu of frames and lenses
• Conventional
• Disposable
• Medically necessary
Benefit Frequency
Exam Once every 12 months
Lenses Once every 12 months
Frames Once every 12 months
Contacts Once every 12 months
ADDITIONAL DISCOUNTS
Additional Pair of Glasses or Contacts: 40% discount off a complete pair of eyeglasses, and 15% off conventional contact lenses once the funded benefit has been used.
LASIK: With your EyeMed membership, you get discounts on laser vision correction through nationwide providers who are part of the U.S. Laser Vision network. Learn more at www.eyemed.com
Browse and Buy Online: The EyeMed life is even easier when you use your benefits online to shop and buy the latest brands at major retail sites at www.eyemed.com
The Hearing Discount Program provides you and your family discounted hearing products, including hearing aids and batteries. Call 888-534-1747 or visit www.amplifonusa.com/mutualofomaha to learn more.
Life and AD&D Insurance
Life and Accidental Death and Dismemberment (AD&D) insurance through Mutual of Omaha are important parts of your financial security, especially if others depend on you for support. With Life insurance, your beneficiary(ies) can use the coverage to pay off your debts, such as credit cards, mortgages, and other final expenses. AD&D coverage provides specified benefits for a covered accidental bodily injury that causes dismemberment (e.g., the loss of a hand, foot, or eye). In the event that death occurs from an accident, 100% of the AD&D benefit would be payable to your beneficiary(ies). As you grow older, your Life and AD&D coverage amount reduces by 35% at age 65, and 50% at age 70.
BASIC LIFE AND AD&D
Basic Life and AD&D insurance are provided at no cost to you. You are automatically covered at $25,000 for each benefit.
VOLUNTARY LIFE AND AD&D
You may purchase additional Life and AD&D insurance for you and your eligible dependents. If you decline Voluntary Life and AD&D insurance when first eligible, or if you elect coverage and wish to increase your benefit amount at a later date, Evidence of Insurability — proof of good health — may be required before coverage is approved. You must elect Voluntary Life and AD&D coverage for yourself in order to elect coverage for your spouse or children. If you leave the company, you may be able to take the insurance with you.
Employee
Spouse
Child(ren)
• Increments of $10,000, up to five times your annual earnings, not to exceed $500,000 • Guaranteed Issue $150,000
• Increments of $5,000, up to 100% of employee amount, not to exceed $500,000
• Guaranteed Issue $25,000
• Live birth to 14 days - no coverage
• 15 days to 26 – increments of $2,000, up to 100% of employee amount, not to exceed $10,000
*Spouse rate is based on employee’s age. Spouse coverage terminates at age 70.
For costs and contributions, visit BenefitsInHand at www.benefitsinhand.com
DESIGNATING A BENEFICIARY
A beneficiary is the person or entity you designate to receive the death benefits of your Life and AD&D insurance policies. You can name more than one beneficiary, and you can change beneficiaries at anytime. If you name more than one beneficiary, you must identify the share for each. Your primary beneficiary should be someone over the age of 18.
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 Mutual of Omaha
VOLUNTARY 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, non-work-related injury, or pregnancy. 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 workers’ compensation, not STD.
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. Benefits begin at the end of an elimination period and continue while you are disabled up to Social Security Normal Retirement Age (SSNRA).
1 Benefits may not
For costs and contributions, visit BenefitsInHand at www.benefitsinhand.com
1 Benefits may not be paid for any condition treated within three months prior to your effective date until you have been covered under this plan for 12 months.
For costs and contributions, visit BenefitsInHand at www.benefitsinhand.com
Supplemental benefits
You and your eligible family members can enroll in additional coverage that complements our traditional health care programs. Health insurance covers medical bills, but if you have an emergency, you may face unexpected out-of-pocket costs such as deductibles, coinsurance, travel expenses, and non-medical related expenses. These voluntary plans are offered through Mutual of Omaha and are portable.
ACCIDENT INSURANCE
Accident insurance provides affordable protection against a sudden, unforeseen accident. The Accident plan helps offset the direct and indirect expenses resulting from an accident such as copayments, deductibles, ambulance, physical therapy, and other costs not covered by traditional health plans.
ACCIDENT INSURANCE
HOSPITAL INDEMNITY INSURANCE
Hospital Indemnity insurance helps you with the high cost of medical care by paying you a set amount when you have an inpatient hospital stay. Unlike traditional insurance, which pays a benefit to the hospital or doctor, this plan pays you directly based on the care or treatment that you receive. These costs may include meals and transportation, childcare, or time away from work due to a medical issue that requires hospitalization.
CRITICAL ILLNESS INSURANCE
Critical Illness insurance helps pay the cost of non-medical expenses related to a covered critical illness or cancer. The plan provides a lump-sum benefit payment to you upon first and second diagnosis of any covered critical illness or cancer. The benefit can help cover expenses such as lost income, out-of-town treatments, special diets, daily living, and household upkeep costs.
CRITICAL ILLNESS INSURANCE
Benign brain tumor or benign spinal cord tumor; bone flap/skull defect; bone marrow/stem cell recipient; end stage renal failure; heart attack; major organ failure; stroke; sudden cardiac arrest; invasive cancer; Alzheimer’s disease; ALS; Multiple Sclerosis; Parkinson’s disease
Childhood Conditions
Congenital heart diseases or defects; sickle cell disease
Partial Coverage
respiratory distress syndrome; carcinoma in
coronary artery disease (major and minor); inflammatory bowel disease; transient ischemic attack
ADVOCACY SERVICES
Advocacy services give an employee who has been diagnosed with a medical condition access to skilled clinicians and nurses for personalized, problem-solving assistance in a one-on-one setting. Call 866-372-5577 Monday through Friday 7:00 a.m. to 7:00 p.m. CT or email customerserve@personifyhealth.com for assistance.
Additional Benefits
Mutual of Omaha provides the following programs and services at no cost to you.
EMPLOYEE ASSISTANCE PROGRAM
The EAP is a confidential program to help you find solutions for personal and workplace issues. Benefits for you and your eligible dependents include unlimited telephone access to EAP professionals and up to three face-to-face sessions with a counselor. Professionals are available 24/7 to help with the following:
z Stress and depression
z Financial issues
z Family and relationship issues
z Addiction
z Grief issues
z Parenting and eldercare
z Legal services
z Financial services
z Other personal concerns
For assistance, call 800-316-2796 or visit www.mutualofomaha.com/eap. Additional resources are available on the website.
WORLDWIDE TRAVEL ASSISTANCE
AXA Assistance USA provides travel assistance for you and your dependents if you are traveling on any single trip more than 100 miles from home. Contact a representative to get trip planning assistance; translation, interpreter, or legal services; lost baggage assistance; emergency funds; document replacement; medical emergency help; and more. Services are available for business and personal travel.
For inquiries within the U.S., call 800-856-9947
From outside the U.S., call 312-935-3658
IDENTITY THEFT SERVICES
The Identity Theft Assistance program, provided by AXA Assistance, helps you understand the risks of identity theft and how to prevent it. If your information is compromised, a representative will connect you with the resources needed. Call AXA Assistance at 800-856-9947 to learn more.
WILL PREPARATION
Creating a will is an important investment in your future. In just minutes, you can create a personalized will that keeps your information safe and secure. The services provided by Epoq offer a secure account space to prepare wills and other legal documents. Log in at www.willprepservices.com and use the code MUTUALWILLS to register.
HEARING DISCOUNT
As part of your Disability insurance coverage, you have access to a hearing discount program at no additional cost through Amplifon. This program provides free hearing testing, a low-price guarantee, a 60-day risk-free trial period, and two years of batteries with purchase. To activate your benefit, call 888-534-1747. Learn more at www.amplifonusa.com/ mutualofomaha
Employee Benefit Costs
Legal 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:
z All stages of reconstruction of the breast on which the mastectomy was performed;
z Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
z 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:
Hampton Roads Connector Partners HRCP JV Human Resources 1611 Bayville Street Norfolk, VA 23503 757-578-9284 ext 362 hr@hrcpjv.com
YOUR PRESCRIPTION DRUG COVERAGE AND MEDICARE
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Hampton Roads Connector Partners HRCP JV 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. Hampton Roads Connector Partners HRCP JV has determined that the prescription drug coverage offered by the Hampton Roads Connector Partners HRCP JV 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 Hampton Roads Connector Partners HRCP JV at the phone number or address listed at the end of this section.
Legal Notices
If you choose to enroll in a Medicare prescription drug plan and cancel your current Hampton Roads Connector Partners HRCP JV 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 Phone
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:
z Visit www.medicare.gov
z 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.
z Call 1-800-MEDICARE (1-800-633-4227) TTY users should call 877-486-2048
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. Information about this extra help is available from the Social Security Administration (SSA) online at www. socialsecurity.gov, or you can call them at 800-772-1213. TTY users should call 800-3250778
Remember: Keep this Creditable Coverage notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty).
July 1, 2026
Hampton Roads Connector Partners HRCP JV Human Resources 1611 Bayville Street Norfolk, VA 23503
757-578-9284 ext 362 hr@hrcpjv.com
NOTICE OF HIPAA PRIVACY PRACTICES
This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) imposes numerous requirements on employer health plans concerning the use and disclosure of individual health information. This information known as protected health information (PHI), includes virtually all individually identifiable health information held by a health plan –whether received in writing, in an electronic medium or as oral communication. This notice describes the privacy practices of the Employee Benefits Plan (referred to in this notice as the Plan), sponsored by Company, hereinafter referred to as the plan sponsor.
The Plan is required by law to maintain the privacy of your health information and to provide you with this notice of the Plan’s legal duties and privacy practices with respect to your health information. It is important to note that these rules apply to the Plan, not the plan sponsor as an employer.
You have the right to inspect and copy protected health information which is maintained by and for the Plan for enrollment, payment, claims and case management. If you feel that protected health information about you is incorrect or incomplete, you may ask the Human Resources Department to amend the information. For a full copy of the Notice of Privacy Practices describing how protected health information about you may be used and disclosed and how you can get access to the information, contact the Human Resources Department.
Complaints: If you believe your privacy rights have been violated, you may complain to the Plan and to the Secretary of Health and Human Services. You will not be retaliated against for filing a complaint. To file a complaint, please contact the Privacy Officer.
Hampton Roads Connector Partners HRCP JV Human Resources 1611 Bayville Street Norfolk, VA 23503 757-578-9284 ext 362 hr@hrcpjv.com
Conclusion
PHI use and disclosure by the Plan is regulated by a federal law known as HIPAA (the Health Insurance Portability and Accountability Act). You may find these rules at 45 Code of Federal Regulations Parts 160 and 164. The Plan intends to comply with these regulations. This Notice attempts to summarize the regulations. The regulations will supersede any discrepancy between the information in this Notice and the regulations.
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
Legal Notices
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.
Website: http://www.myalhipp.com/ Phone: 1-855-692-5447
The AK Health Insurance Premium Payment Program Website: http://myakhipp.com/
Phone: 1-866-251-4861
Email: CustomerService@MyAKHIPP.com
Medicaid Eligibility: https://health.alaska.gov/ dpa/Pages/default.aspx
ARKANSAS – MEDICAID
Website: http://myarhipp.com/ Phone: 1-855-MyARHIPP (855-692-7447)
CALIFORNIA– MEDICAID
Health Insurance Premium Payment (HIPP) Program Website: http://dhcs.ca.gov/hipp Phone: 916-445-8322
Fax: 916-440-5676
Email: hipp@dhcs.ca.gov
COLORADO – HEALTH FIRST COLORADO (COLORADO’S MEDICAID PROGRAM) AND CHILD HEALTH PLAN PLUS (CHP+)
Health First Colorado website: https://www. healthfirstcolorado.com/
Health First Colorado Member Contact Center: 1-800-221-3943/State Relay 711
CHP+: https://hcpf.colorado.gov/childhealth-plan-plus
CHP+ Customer Service: 1-800-359-1991/ State Relay 711
Health Insurance Buy-In Program (HIBI): https://www.mycohibi.com/
HIBI Customer Service: 1-855-692-6442
FLORIDA – MEDICAID
Website: https://www.flmedicaidtplrecovery. com/flmedicaidtplrecovery.com/hipp/index. html
Phone: 1-877-357-3268
GEORGIA – MEDICAID
GA HIPP Website: https://medicaid.georgia. gov/health-insurance-premium-paymentprogram-hipp
Phone: 678-564-1162, Press 1
GA CHIPRA Website: https://medicaid. georgia.gov/programs/third-party-liability/ childrens-health-insurance-programreauthorization-act-2009-chipra Phone: 678-564-1162, Press 2
INDIANA – MEDICAID
Health Insurance Premium Payment Program
All other Medicaid
Website: https://www.in.gov/medicaid/ http://www.in.gov/fssa/dfr/
Family and Social Services Administration Phone: 1-800-403-0864
Member Services Phone: 1-800-457-4584
IOWA – MEDICAID AND CHIP (HAWKI)
Medicaid Website: https://hhs.iowa.gov/ programs/welcome-iowa-medicaid
Medicaid Phone: 1-800-338-8366
Hawki Website: https://hhs.iowa.gov/ programs/welcome-iowa-medicaid/iowahealth-link/hawki
Hawki Phone: 1-800-257-8563
HIPP Website: https://hhs.iowa.gov/ programs/welcome-iowa-medicaid/feeservice/hipp
HIPP Phone: 1-888-346-9562
KANSAS
– MEDICAID
Website: https://www.kancare.ks.gov/ Phone: 1-800-792-4884
HIPP Phone: 1-800-967-4660
KENTUCKY – MEDICAID
Kentucky Integrated Health Insurance Premium Payment Program (KI-HIPP) Website: https://chfs.ky.gov/agencies/dms/ member/Pages/kihipp.aspx Phone: 1-855-459-6328
Email: KIHIPP.PROGRAM@ky.gov
KCHIP Website: https://kynect.ky.gov Phone: 1-877-524-4718
Kentucky Medicaid Website: https://chfs. ky.gov/agencies/dms
LOUISIANA – MEDICAID
Louisiana Medicaid Website: https://www. ldh.la.gov/healthy-louisiana
Medicaid Customer Service Line: 1-888-3426207
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
MAINE – MEDICAID
Enrollment Website: https://www. mymaineconnection.gov/benefits/ s/?language=en_US
Phone: 1-800-442-6003
TTY: Maine relay 711
Private Health Insurance Premium
Webpage: https://www.maine.gov/dhhs/ofi/ applications-forms
Phone: 1-800-977-6740
TTY: Maine Relay 711
MASSACHUSETTS – MEDICAID AND CHIP
Website: https://www.mass.gov/masshealth/ pa
Phone: 1-800-862-4840
TTY: 711
Email: masspremassistance@accenture.com
MINNESOTA – MEDICAID
Website: https://mn.gov/dhs/health-carecoverage/
Phone: 1-800-657-3672
MISSOURI – MEDICAID
Website: http://www.dss.mo.gov/mhd/ participants/pages/hipp.htm
Phone: 573-751-2005
Legal Notices
MONTANA – MEDICAID
Website: https://dphhs.mt.gov/ MontanaHealthcarePrograms/HIPP
Phone: 1-800-694-3084
Email: HHSHIPPProgram@mt.gov
NEBRASKA – MEDICAID
Website: http://www.ACCESSNebraska. ne.gov
Phone: 1-855-632-7633
Lincoln: 402-473-7000
Omaha: 402-595-1178
NEVADA – MEDICAID
Medicaid Website: http://dhcfp.nv.gov Medicaid Phone: 1-800-992-0900
NEW HAMPSHIRE – MEDICAID
Website: https://www.dhhs.nh.gov/ programs-services/medicaid/healthinsurance-premium-program
Phone: 603-271-5218
Toll free number for the HIPP program: 1-800-852-3345, ext. 15218
Email: DHHS.ThirdPartyLiabi@dhhs.nh.gov
NEW JERSEY – MEDICAID AND CHIP
Medicaid Website: http://www.state.nj.us/ humanservices/dmahs/clients/medicaid/ Phone: 1-800-356-1561
CHIP Premium Assistance Phone: 609-6312392
CHIP Website: http://www.njfamilycare.org/ index.html
CHIP Phone: 1-800-701-0710 (TTY: 711)
NEW YORK – MEDICAID
Website: https://www.health.ny.gov/health_ care/medicaid/ Phone: 1-800-541-2831
NORTH CAROLINA – MEDICAID
Website: https://medicaid.ncdhhs.gov Phone: 919-855-4100
NORTH DAKOTA – MEDICAID
Website: https://www.hhs.nd.gov/healthcare Phone: 1-844-854-4825
OKLAHOMA – MEDICAID AND CHIP
Website: http://www.insureoklahoma.org
Phone: 1-888-365-3742
OREGON – MEDICAID
Website: https://healthcare.oregon.gov/ Pages/index.aspx
Phone: 1-800-699-9075
PENNSYLVANIA – MEDICAID AND CHIP
Website: https://www.pa.gov/en/services/ dhs/apply-for-medicaid-health-insurancepremium-payment-program-hipp.html
Phone: 1-800-692-7462
CHIP Website: https://www.dhs.pa.gov/chip/ pages/chip.aspx
CHIP Phone: 1-800-986-KIDS (5437)
RHODE ISLAND – MEDICAID AND CHIP
Website: http://www.eohhs.ri.gov/ Phone: 1-855-697-4347 or 401-462-0311
(Direct RIte Share Line)
SOUTH CAROLINA – MEDICAID
Website: https://www.scdhhs.gov
Phone: 1-888-549-0820
SOUTH DAKOTA - MEDICAID
Website: https://dss.sd.gov
Phone: 1-888-828-0059
TEXAS – MEDICAID
Website: https://www.hhs.texas.gov/ services/financial/health-insurance-premiumpayment-hipp-program
Phone: 1-800-440-0493
UTAH – MEDICAID AND CHIP
Utah’s Premium Partnership for Health Insurance (UPP) Website: https://medicaid. utah.gov/upp/
Email: upp@utah.gov
Phone: 1-888-222-2542
Adult Expansion Website: https://medicaid. utah.gov/expansion/
Utah Medicaid Buyout Program Website: https://medicaid.utah.gov/buyout-program/ CHIP Website: https://chip.utah.gov/
VERMONT– MEDICAID
Website: https://dvha.vermont.gov/members/ medicaid/hipp-program
Phone: 1-800-250-8427
VIRGINIA – MEDICAID AND CHIP
Website: https://coverva.dmas.virginia.gov/ learn/premium-assistance/famis-select https://coverva.dmas.virginia.gov/learn/ premium-assistance/health-insurancepremium-payment-hipp-programs Medicaid/CHIP Phone: 1-800-432-5924
WASHINGTON – MEDICAID
Website: https://www.hca.wa.gov/ Phone: 1-800-562-3022
WEST VIRGINIA – MEDICAID AND CHIP
Website: https://dhhr.wv.gov/bms/ http://mywvhipp.com/ Medicaid Phone: 304-558-1700
CHIP Toll-free phone: 1-855-MyWVHIPP (1-855-699- 8447)
WISCONSIN – MEDICAID AND CHIP
Website: https://www.dhs.wisconsin.gov/ badgercareplus/p-10095.htm Phone: 1-800-362-3002
WYOMING – MEDICAID
Website: https://health.wyo.gov/ healthcarefin/medicaid/programs-andeligibility/ Phone: 1-800-251-1269
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 Hampton Roads Connector Partners HRCP JV group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Hampton Roads Connector Partners HRCP JV 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
Hampton Roads Connector Partners HRCP JV Human Resources 1611 Bayville Street Norfolk, VA 23503 757-578-9284 ext 362 hr@hrcpjv.com
Legal Notices
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:
z 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.
z 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 costsharing 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:
z You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay outof-network providers and facilities directly.
z Your health plan generally must:
y Cover emergency services without requiring you to get approval for services in advance (prior authorization).
y Cover emergency services by out-ofnetwork providers.
y 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.
y Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
If you believe you have been wrongly billed, you may contact your insurance provider. Visit www.cms.gov/nosurprises for more information about your rights under federal law.
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
Legal Notices
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 lowestcost 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 1-800-318-2596. 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. 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/ getting-medicaid-chip/ for more details.
How Can I Get More Information?
For more information about your coverage offered through your employment, please check your health plan’s summary plan description or contact Human Resources.
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: Hampton Roads Connector Partners JV
4. Employer Identification Number (EIN): 30-1036637
5. Employer Address: 1611 Bayville Street
6. Employer Phone Number: 757-578-9284 ext 362
7. City: Norfolk
8. State: VA 9. ZIP Code: 23503
10. Who can we contact at this job?: Human Resources
11. Phone Number (if different from above):
12. E-Mail Address: he@hrcpjv.com
As your employer, we offer a health plan to all eligible employees (see the Eligibility section of this guide). This coverage meets the minimum value standard, and the cost of this coverage to you is intended to be affordable, based on employee wages.
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 Hampton Roads Connector Partners 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. Hampton Roads Connector Partners reserves the right to change or discontinue its employee benefits plans anytime.
