Message Open Enrollment Guide 2025 Prepared by: Hauser Employee Benefits 2025 Edition
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 2 WELCOME We would like to welcome you to the 2025 annual benefits summary package for Hauser, Inc. This packet contains summaries of the benefits offered to you by Hauser, Inc. We encourage you to take the time to educate yourself about your options and choose the best coverage for you and your family. This benefits guide provides an overview of benefit plans, including eligibility, election periods and costs. In addition, the guide offers descriptions and explanations of each coverage plan option. We urge you to carefully consider all aspects of these programs, including their premiums, accessibility to healthcare services, flexibility, and restrictions. TABLE OF CONTENTS WELCOME ................................................................................................................................................................................................................................................................................ 2 ELIGIBILITY & ENROLLMENT ......................................................................................................................................................................................................................................... 3 MEDICAL & PRESCRIPTION DRUG BENEFITS ...................................................................................................................................................................................................... 5 KISx Card ................................................................................................................................................................................................................................................................................... 6 PRESCRIPTION DRUG BENEFITS ................................................................................................................................................................................................................................. 8 DREXI MOBILE APP ............................................................................................................................................................................................................................................................. 9 SCRIPTSOURCING ............................................................................................................................................................................................................................................................ 10 WHERE TO SEEK CARE ................................................................................................................................................................................................................................................... 11 TELADOC ............................................................................................................................................................................................................................................................................... 12 DENTAL BENEFITS ............................................................................................................................................................................................................................................................ 13 VISION BENEFITS .............................................................................................................................................................................................................................................................. 14 EYEMED KNOW BEFORE YOU GO TOOL ..................................................................................................................................................................................... 15 COST OF COVERAGE (per 24 pay periods) .......................................................................................................................................................................................... 16 HEALTH SAVINGS ACCOUNTS (HSA) ............................................................................................................................................................................................. 17 FLEXIBLE SPENDING ACCOUNTS (FSA) ............................................................................................................................................................................................ 18 NAVIA MOBILE APP .............................................................................................................................................................................................................................. 19 NAVIA FSA TAX INFORMATION ...................................................................................................................................................................................................... 20 LIFE AND AD&D INSURANCE........................................................................................................................................................................................................................................................24 SHORT-TERM DISABILITY...............................................................................................................................................................................................................................................................25 LONG-TERM DISABILITY ................................................................................................................................................................................................................................................................. 26 MENTAL HEALTH WELLNESS .......................................................................................................................................................................................................................................................27 VOLUNTARY BENEFITS ....................................................................................................................................................................................................................................................................28 SMART IDENTITY .................................................................................................................................................................................................................................................................................. 30 HAUSER TRAVEL PERKS................................................................................................................................................................................................................................................................... 32 401(k) BENEFITS .....................................................................................................................................................................................................................................................................................33 IMPORTANT NOTICES ......................................................................................................................................................................................................................................................................34 IMPORTANT NOTICE FROM HAUSER, Inc........................................................................................................................................................................................................................... 41 PRESCRIPTION DRUG COVERAGE AND MEDICARE FOR PLANS ...................................................................................................................................................................... 42 CONTACTS ............................................................................................................................................................................................................................................................................................... 47
HAUSER 2025 ENROLLMENT GUIDE ELIGIBILITY & ENROLLMENT The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 3 Who Is Eligible? Employees who are scheduled to work an average of at least 30 hours per week are eligible to be enrolled in the benefits described in this guide. Benefits are effective on the first of the month following your date of employment. You may enroll your eligible dependents in the same plans you choose for yourself, including medical, dental, vision and voluntary life insurance coverage. Eligible dependents may include the following: Your legal spouse Your children up to age 26 Your unmarried dependent children over age 26 who are incapable of self-care because of a disability and who rely on you for support. Please note, if your spouse has medical coverage available to them via their employer, your spouse will not be eligible for the HAUSER medical plan. Enrolling in Coverage Your enrollment period is an important time to review your benefits and choose the best options for you and your family. Review the 2025 Benefits Guide to understand the coverage available and any changes to the Hauser, Inc. Benefit Program. You can enroll in coverage within 31 days of your hire date or during the annual open enrollment period. Newly hired eligible employees enrolling for the first time will make their benefit elections via Employee Navigator. You can make your benefit elections during the enrollment window. Coverage will begin on the first of the month following your hire date. Please visit Employee Navigator to access your account profile. Your personal benefit elections will be housed in Employee Navigator.
HAUSER 2025 ENROLLMENT GUIDE ELIGIBILITY & ENROLLMENT The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 4 Open Enrollment Open Enrollment is your annual opportunity to make changes to your benefits. You must complete the Open Enrollment module in Employee Navigator even if you elect to waive coverage. Changing Your Coverage During the Year Elected benefits will be effective January 1st. You are unable to make any changes during the year unless you experience a qualifying life event (as defined by the IRS) that allows a mid-year plan change. These changes include (but are not limited to): Birth or adoption of a baby or child Loss of other healthcare coverage Eligibility for new healthcare coverage Marriage Divorce Change in child’s dependent status If you experience a qualifying life event, or if you have questions, please contact Human Resources (HR). You have 31 days after a qualifying event to make changes to your benefit elections. Please notify HR to make this request. When Dependent Children Age Out Dependent children can remain on the medical, dental and/or vision coverage(s) until the end of the month in which they turn 26, at which time their coverage will be cancelled. Coverage under Voluntary Life and AD&D ends on their 26th birthday. This open enrollment is a PASSIVE ENROLLMENT meaning employees must log-on to Employee Navigator if you are making changes or need to add FSA or HSA. If you are enrolled in benefits today and you do nothing, your benefit elections will rollover, effective 01/01/2025.
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 5 MEDICAL & PRESCRIPTION DRUG BENEFITS Plan Year: January 1st through December 31st Hauser, Inc. offers a comprehensive benefits program to help you and your family protect your health and financial security. Your benefits are a valuable part of your compensation; we encourage you to learn how your plans work so you can get the most from them. These plans do not require you to select a primary care provider, nor is it necessary to obtain a referral to see a specialist. Please review the following pages which highlight the main features of the two Medical plans offered this year. The complete benefit summaries are available on the Employee Navigator Portal. The following chart provides a summary of the main features of the Medical benefit options. Medical Network: Pharmacy: HSA Plan Network: Cigna PPO PPO Plan Network: Cigna PPO Services In-Network You Pay In-Network You Pay Deductible - Individual - Family Embedded $3,500 $7,000 Embedded $1,500 $3,000 Coinsurance 0% 20% Max. Out-of-Pocket - Individual - Family (Includes deductible, coinsurance & copays) $3,500 $7,000 $4,500 $9,000 Physician Office Visit - Primary - Specialist 0% after deductible 0% after deductible $30 copay $60 copay Preventive Care (Adult/Well-Child) No Cost No Cost Urgent Care 0% after deductible $60 copay Emergency Room 0% coinsurance after annual deductible $300 copay Inpatient Service** 0% coinsurance after annual deductible 20% coinsurance after deductible Outpatient Services** 0% coinsurance after annual deductible 20% coinsurance after deductible *Out-of-Network benefits available on both plan options. Visit the HAUSER landing page for more information. **If using KISx, pre-certification is part of the process. Medical Key Reminders If services are provided by an out-of-network provider, the member is responsible for any amounts exceeding the “allowable charges,” in which case balance billing could occur.
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 6 KISx Card
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 7
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 8 PRESCRIPTION DRUG BENEFITS Plan Year: January 1st through December 31st We know prescription drug coverage is important to you and your family, so when you elect medical coverage, you are automatically covered under the prescription drug plan. You may fill your prescriptions at participating retail pharmacies. Under the prescription drug coverage, the mail order option allows you to buy qualified prescriptions in larger 90-day quantities for a slightly higher copay amount as a 30-day supply at the retail pharmacy. Mail order saves you time on trips to the pharmacy because prescriptions are delivered right to your door. There are several categories of drugs under the plans. The differences between these categories are described below: Tier 1 – Generic: Frequently prescribed generic drugs. Tier 2 – Formulary: Brand name drugs. Tier 3 – Non-formulary: Highest-cost drugs. Find individualized information on your benefit coverage, determine tier status, check the status of claims and search for network pharmacies by logging on to www.drexi.com. Ways to Save Start with generics, which are usually the lowest-cost options and have the same active ingredients as brand-name versions. And remember, if the generic price is lower than the co-pay, you receive the better price. Use the Price and Save tool on www.drexi.com to find drug costs in your area. If your medication is intended for short-term use, such as antibiotic therapies for an illness, go to one of more than 68,000 network pharmacies to get it filled. Find a network pharmacy at www.drexi.com. If you take a maintenance medication (a drug you take until further notice) you can get 90-day supplies by using home delivery service. Get up to 90-day supply delivered to your home and save. You also can sign up for automatic refills. Sign up for home delivery at www.drexi.com. *Mail order prescription benefits are available, go to www.drexi.com for more information. H.S.A Plan PPO Plan Prescription Drugs - Retail (Up to 30-day supply) Tier 1/ Tier 2/ Tier 3/Specialty - Mail Order (90-day supply) Tier 1/ Tier 2 0% after deductible 0% after deductible $10/$35/$35/ 20% with a maximum of $250 $20/$70
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 9 DREXI MOBILE APP
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 10 SCRIPTSOURCING
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 11 WHERE TO SEEK CARE You think you may be sick, but your primary care physician is booked through the end of the month. You have a question about the side effects of a new medication, but the pharmacy is closed. Instead of immediately choosing an expensive trip to the emergency room or relying on questionable information from the internet, look below at various care centers and resources and the types of care they provide. *This is sample of services and may not be all-inclusive. **Cost and time information represent average only and are not tied to a specific condition or treatment.
The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 13 TELADOC *A Teladoc doctor is always just a call or click away at NO cost to you! www.Teladoc.com 1-800-Teladoc Mobile App: Visit Teladoc.com/mobile to download the app. Log into your account and complete the “My Health Record” section. HAUSER 2025 ENROLLMENT GUIDE Access to a doctor anytime, anywhere Talk to a doctor any time for free! * *When enrolled in Hauser medical coverage (members & dependents).
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 14 DENTAL BENEFITS Plan Year: January 1st through December 31st Dental coverage is important to your overall health and wellness. You can enroll in dental benefits offered by Guardian for yourself and your family. The dental plan features a network of dentists and specialists who have agreed to provide services at a discounted price. If you choose to see a dentist out of the network, you may be balance billed for any charges over what is considered “reasonable and customary”. This helps minimize any balanced billing but remember that the best way to maximize the benefit is by visiting an in-network dentist. Please note ID cards are not required for you to receive services. Providers can confirm coverage with your Social Security Number. Any dependents on your plan can also use your Social Security Number to get care. The following chart shows the features of the Dental benefit option. A complete benefit summary is available on Employee Navigator. Services Dental Core Plan Dental Buy-Up In-Network You Pay Out-of-Network You Pay In-Network You Pay Out-of-Network You Pay Deductible (Applies to Basic & Major) $50 individual $150 family $50 individual $150 family $25 individual $75 family $25 individual $75 family Preventive Services (Deductible waived for Preventive) Covered 100% Covered 100% Covered 100% Covered 100% Basic Services 20% after deductible 20% after deductible 20% after deductible 20% after deductible Major Services 50% after deductible 50% after deductible 50% after deductible 50% after deductible Annual Maximum $1,000 $1,000 $2,000 $2,000 Orthodontia (Dependent Children to age 19) 50% 50% 50% 50% Orthodontia Lifetime Maximum $1,000 $1,000 $2,500 $2,500 Out-of- Network Reimbursement* Negotiated Fee Schedule 90th Percentile Negotiated Fee Schedule 90th Percentile * Out-of-Network benefits for a given dental procedure are calculated according to the reasonable and customary charge for a particular area. Visit www.GuardianAnytime.com to access secure information about your Guardian benefits and locate in-network providers.
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 15 VISION BENEFITS Plan Year: January 1st through December 31st Your vision health is an important part of complete wellness. EyeMed is pleased to present your vision benefits which are designed to give you and your covered family members the care, value, and service to help maintain good vision and overall health. Please note ID cards are not required for you to receive services. Providers can confirm coverage with your Social Security Number. Any dependents on your plan can also use your SSN to get care. The following chart shows the features of the Vision benefit option. A complete benefit summary is available on Employee Navigator. VISION NETWORK: Services In-Network You Pay Out-of-Network Reimbursement Eye Exam (Every 12 months) $10 copay Up to $30 Materials $10 copay Standard Frame (Every 24 months) $150 retail allowance Additional 20% off balance over allowance Up to $75 Standard Plastic Lenses (Every 12 months in lieu of contact lenses) Single Vision Bifocal Trifocal No cost after materials copay No cost after materials copay No cost after materials copay Up to $25 Up to $40 Up to $60 Contact Lenses (Every 12 months in lieu of frames and lenses) Exam $25 Copay Elective Medically Necessary $130 allowance Additional 15% off balance over allowance Up to $104 $130 allowance Up to $104
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 16 EYEMED KNOW BEFORE YOU GO TOOL
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 17 COST OF COVERAGE (per 24 pay periods) Hauser, Inc. pays a portion of your health care premiums; however, we do require employees to contribute toward their health care costs as well. Employees pay a dollar amount based on the level of coverage they select. The following Payroll Deductions will be effective for this plan year and will be reflected on your first paycheck after your effective date. MEDICAL CONTRIBUTIONS (PER 24 PAY PERIODS) HDHP Base PPO Buy-Up Employee $60.00 $70.00 Employee + Spouse $120.00 $140.00 Employee + Children $90.00 $105.00 Employee + Family $170.00 $195.00 DENTAL CONTRIBUTIONS (PER 24 PAY PERIODS) Dental Core Dental Buy-Up Employee $15.83 $17.78 Employee +1 $31.69 $35.59 Employee + Family $54.17 $63.16 VISION CONTRIBUTIONS (PER 24 PAY PERIODS) Employee $3.47 Employee + Spouse $6.59 Employee + Children $6.94 Employee + Family $10.20 The Medical, Dental and Vision benefits offered by Hauser, Inc. are covered under the IRS Section 125 plan. This plan allows your premium contributions to be taken out of your paycheck before taxes are applied. This results in greater take-home pay for you.
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 18 HEALTH SAVINGS ACCOUNTS (HSA) Plan Year – January 1st through December 31st Hauser, Inc. will offer an HSA to those who enroll in the HDHP plan. The HSA provides you with the ability to save and use pretax dollars to pay for eligible medical expenses (i.e., deductible). You can save approximately 25 percent of each dollar spent on medical expenses when you participate. Contributions to your HSA are withdrawn from your paycheck on a pre-tax basis. This means you don’t pay federal income tax, Social Security taxes, or local income taxes on the portion of your paycheck you contribute to the HSA. HAUSER partners with General Electric Credit Union to provide HSA services, but you can use any bank of your choice. What are the benefits of an HSA? Funds Rollover – No “use it or lose it” provision. Earns Interest – Monies accrue tax-free interest. Portable – Yours to keep. If you leave your employer, your HSA funds go with you. The IRS HSA Contribution Limits are as follows: 2025 Annual Contribution Limits $4,300 (single) $8,550 (family) NOTE: If you are age 55 or older, you may make an additional “catch-up” contribution of $1,000. You are eligible to enroll in an HSA if: You are enrolled in a qualified High Deductible Health Plan You have no other traditional medical coverage or prescription coverage. You or your spouse is not enrolled in a General-Purpose HealthCare FSA You are not claimed as a dependent on another person’s tax return. You are not enrolled in Medicare, Medicaid nor have received care within the last three months through the Veteran’s Administration for something that was not connected to a service disability.
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 19 FLEXIBLE SPENDING ACCOUNTS (FSA) Plan Year: January 1st through December 31st An FSA allows you to place money in a tax-sheltered, short-term account for use in paying for approved healthcare expenses. Enrollment occurs before the beginning of each plan year, or for new employees, during your initial enrollment period. You must enroll each year to participate in the Healthcare and Dependent Care Reimbursement Accounts. The amount you designate will be taken from your paycheck in equal amounts throughout the plan year. Keep your receipts and Explanation of Benefits (EOBs) in the event Navia or the IRS requests additional information on your transaction. General Purpose HealthCare FSA Contribution Limit: $3,200 (2025) You are eligible to contribute to an FSA and use the funds for medical, dental and vision expenses not covered by the plan. The Health Care FSA contribution will be deducted from your paycheck over the course of the year. Since you pay no taxes on the money placed in the FSA, you effectively adjust your annual taxable salary. Contributions available on the first day of the new plan year. Dependent Care FSA Contribution Limit (2025): $5,000 if you are a single or married filing jointly $2,500 if you are married and filing separately Money only available as contributed via your payroll deductions IMPORTANT: Elections cannot be changed during the plan year unless you have a qualified change in family status like birth, death, marriage, or divorce. Unused healthcare FSA amounts in excess of $660 will be forfeited, so plan carefully before making your elections. *If you are contributing to an HSA, you must use a limited purpose FSA. When you make your elections in Employee Navigator, the system only allows you to enter a general-purpose FSA. Please enroll in the general-purpose FSA and contact HR to have the account switched to the limited-purpose FSA. General Purpose Health Care FSA Rollover Provision Up to $660 of 2025 unused FSA dollars can be used to reimburse eligible FSA expenses incurred in the next plan year.. Claims incurred between January 1st , 2025, and December 31st , 2025 may be submitted for reimbursement between January 1st , 2026 and March 31st , 2026. Individual FSA accounts will be updated with Rollover amounts up to the $660 limit, after the run-out period ends on March 31st, 2026. Navia Benefits Tax Calculator
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 20 NAVIA MOBILE APP Access your benefits and submit claims anytime, anywhere! Whether you’re at the doctor’s office or on vacation, the MyNavia App allows you to manage and access your benefits right from your smartphone! Available for iPhone and Android devices, the MyNavia App is a free-to-download and free-to-use tool for any Navia participant with an FSA or HSA.
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 21 NAVIA FSA TAX INFORMATION
The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 22 HAUSER 2025 ENROLLMENT GUIDE
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 23
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 24
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 25 LIFE AND AD&D INSURANCE Plan Year: January 1st through December 31st Group Life and AD&D Coverage is available through MetLife. Life and Accidental Death & Dismemberment (AD&D) insurance is an important benefit as it provides your beneficiaries financial protection in the event of a tragic loss. Hauser, Inc. provides full-time employees with group life and accidental death and dismemberment (AD&D) insurance and pays for 100% of the coverage. Voluntary Life and AD&D If you need additional Life insurance to meet your financial needs, you can purchase Voluntary Life and AD&D insurance through after-tax payroll deductions for yourself, your spouse, and your child(ren). How much your family needs depends on your personal situation (other income, monthly expenses, short and long-term debt such as credit card or mortgage expenses, etc.). Should you leave the company, you can elect to continue this coverage directly with MetLife. Basic Life - Group Employee Benefit Amount: Life Employees making less than $150,000, the amount provided by HAUSER is one (1) time salary up to a maximum of $150,000. Employees making more than $150,000 the amount provided by HAUSER is two (2) time salary (Guaranteed Issue - $375,000), up to a maximum of $500,000. Employee Benefit Amount: AD&D Equal to your Basic Life benefit. Benefits Reduction: Age Band 35% at age 65 50% at age 70 Voluntary Life Employee Increments of $10,000 up to a maximum $500,000 or 5x annual salary, whichever is less Benefit Amount: Life/AD&D New Entrants: Guarantee Issue (GI) Amount $100,000 Spouse Increments of $5,000 to a maximum of $100,000. Not to exceed 100% of the e election. Benefit Amount: Life/AD&D New Entrants: GI Amount $25,000 Child(ren) $1,000, $2,000, $4,000, $5,000 or $10,000 Benefit Amount: Life/AD&D New Entrants: GI Amount $10,000 Evidence of Insurability (EOI): is required if you are requesting an amount of coverage that exceeds the maximum guaranteed issue amount on your plan.
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 26 SHORT-TERM DISABILITY Plan Year: January 1st through December 31st If you become disabled and cannot work, no benefit becomes more important to your financial security than Disability Income protection. Short- term disability coverage provides income protection on a short- term basis in the event you experience a non-occupational injury or illness that prevents you from working. Please note that for the purposes of short- term disability, pregnancy is a covered condition. Short-term disability is offered through MetLife, and you as the employees are 100% responsible for the cost. If you have previously not enrolled in the short-term disability benefit and wish to now enroll you will need to complete a Statement of Health to be evaluated by MetLife. Short-Term Disability Elimination Period 7 days illness / injury Income Replacement 60% of your basic earnings Maximum Benefit $1,500 weekly Maximum Benefit Period 12 weeks Pre-Existing Limitations 3/12 Employee Rates All Active Full-Time Employees $0.227 per $10 of Short-Term Disability Benefits. Terms Elimination Period: The period of time you have to wait before benefits begin, starting the day you become ill or injured. Maximum Benefit: This is the highest dollar amount a disabled employee can receive on a weekly basis under the plan. Pre-Existing Limitations: Anything that you have been diagnosed with or treated for within 3 months prior to the effective date will not be covered for the first 12 months.
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 27 LONG-TERM DISABILITY Plan Year: January 1st through December 31st Long-term disability coverage provides income protection on a long-term basis in the event you experience a non- occupational injury or illness that prevents you from working. Long- term disability is offered through MetLife. Long-Term Disability Long-term disability (LTD) coverage is a type of disability insurance that pays you a set percentage of your regular income after a specified waiting period. For example, if you’re covered under short-term disability (STD) insurance as well, the LTD insurance would kick in once the STD policy is exhausted. This benefit is 100% Employer paid. Since HAUSER pays the premium for the plan, the benefit, should you become disabled, is taxable to you. Under section 2004-55 of the tax-code, the IRS allows employees to obtain a tax-free disability benefit, so you may decide whether or not you want your LTD benefits to be taxed. If you choose to have non-taxable LTD benefits, YOU MUST PAY TAX ON THE PREMIUM HAUSER pays on your behalf. Choosing non-taxable benefits is an excellent way of improving your LTD benefits. In most cases, one month of increased LTD benefit will cover years of any income tax liability. If you choose to have non-taxable LTD benefits, HAUSER will add the cost of the insurance to your payroll on a semi- monthly basis. As your income increases so will the cost of your LTD benefits. The amount of premium paid is dependent upon your income. If you choose non-taxable benefits, the premium amount will be added to your W-2. A complete benefit summary is available on our Employee Navigator Portal. Elimination Period 90 days Income Replacement 60% of your basic earnings Maximum Benefit $12,000 per month Benefit Duration Social Security Normal Retirement Age Own Occupation Period 2 years Pre-Existing Limitations 3/12
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 28 MENTAL HEALTH WELLNESS Included at no additional cost with your company paid Basic Life Insurance
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 29 VOLUNTARY BENEFITS Plan Year: January 1st through December 31st CRITICAL ILLNESS Hauser, Inc provides all active full-time employees with the opportunity to purchase Critical Illness benefits through Guardian. You may have medical insurance, but that doesn’t mean you’re covered for all the expenses resulting from a serious illness that you probably haven’t budgeted for—things like copays, deductibles, loss of income, childcare and travel expenses. Critical illness insurance provides a cash benefit for a covered illness, creating a financial safety net for you and your family. Employees may choose a lump sum benefit of $5,000 to $20,000 in $5,000 increments. Employee cost includes child cost. Children are eligible for 25% of the elected employee coverage. You can also elect spousal/domestic partner coverage not to exceed 50% of the elected employee coverage. Employees and dependents are eligible for a $50/year wellness benefit. Tobacco and non-tobacco rates apply and are based on age and elected benefit level. ACCIDENT INSURANCE Nobody plans to have an accident, and most people do not budget for one! Hauser, Inc provides all active full-time employees with the opportunity to purchase Accident benefits through Guardian. Accident insurance helps you pay for out-of- pocket expenses medical insurance will not cover. It is an affordable way to make sure you can cover the gap between what your medical insurance covers and what you might owe out of pocket if you or a family member were to get injured. It’s protection that’s also convenient: Your premium payments are deducted directly from your paycheck. If you enroll in the Accident benefits, you will automatically have access to TravelAid which provides global around the clock service to ensure you get the assistance you need while traveling. Services include preventive tips and information before you travel, 24/7 security and response and medical referrals and medical transportation services. For more information call 800-527-0218. PET INSURANCE MetLife Pet insurance helps to reimburse pet parents for covering unexpected veterinary expenses for their furry family members if they become sick or have an accidental injury. You can select the coverage that best meets your needs from a range of annual limits, deductibles, and coinsurance levels, including optional wellness coverage (preventive care). Accident coverage begins at midnight on policy effective date and after 14 days for illness coverage. Your premiums are based on: o Species, breed, and age of pet o Employee zip code o Coverage amount elected If interested, enroll by calling: (855)270-7387
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 30 VOLUNTARY BENEFITS Plan Year: January 1st through December 31st IDENTITY THEFT & CREDIT MONITORING SmartIDentity provides you with Fully Managed Identity Recovery Services to protect you and your qualified family members from fraud and/or identity theft. If, for any reason, you or a qualifying family member becomes a victim or even suspects identity fraud, a professional and certified Recovery Advocate will manage the logistics of restoration and will take control to resolve the issues on your behalf, no matter how long it takes. This is not a “do-it-yourself” kit! You will have access to Identity Fraud Research, Remediation and Recovery services. Three Generation Fully Managed Identity Recovery protects not only you as an employee of Hauser from identity theft, but the services also extend to cover up to three generations (3G) of your family. See benefit summary for more details. NOTE: You will find rates and benefit summaries for all voluntary benefits as you enroll in Employee Navigator
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 31 SMART IDENTITY
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 32
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 33 HAUSER TRAVEL PERKS
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 34 401(k) BENEFITS With John Hancock, you’ll find simple suggestions to help you in your journey to retirement. Contact John Hancock to access your account 24 hours per day, seven days per week. With John Hancock, you’ll find simple suggestions to help you in your journey to retirement. Contact John Hancock to access your account 24 hours per day, seven days per week.
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 35 IMPORTANT NOTICES Notice of Patient Protections & Prior Authorization Procedures Your Hauser, Inc plans allow you to visit any doctor or hospital you choose. However, Prior Authorization is required for certain services. Make sure Your Provider obtains Prior Authorization before any planned hospital stays (except maternity admissions), skilled nursing and rehabilitative facility admissions, certain outpatient procedures, Advanced Radiological Imaging services, certain Specialty Drugs, and Durable Medical Equipment costing $500 or more. Contact BPA Customer Service using the number on the back of your medical ID card or online at www.bpaco.com to find out which services require Prior Authorization. You can also call the customer service department to find out if your admission or other service has received Prior Authorization. For more information, please refer to your Evidence of Coverage document located online at www.bpaco.com . Women’s Health and Cancer Rights Act of 1998 If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for: • 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 • Prostheses; and Treatment of physical complications of the mastectomy, including lymphedema. These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under this plan. Therefore, the following deductibles and coinsurance apply: • HDHP/HSA: $3,500 Individual Deductible / $7,000 Family Deductible / 0% Coinsurance • PPO Plan: $1,500 Deductible / $3,000 Family Deductible / 20% Coinsurance If you would like more information on WHCRA benefits, call your plan administrator 1-866-801-4409. Newborns’ and Mothers’ Health Protection Act Under federal law, group health plans and health insurance issuers offering group health insurance coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. In addition, a plan or issuer may not, under federal law, require that a physician or other health care provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). However, to use certain providers or facilities, or to reduce your Out-of- Pocket costs, you may be required to obtain precertification. For information on precertification, contact your plan administrator. Notice of Special Enrollment Rights If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to 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 request enrollment within 31 days after you or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 31 days after the marriage, birth, adoption, or placement for adoption. To request special enrollment or obtain more information, contact Human Resources. Notice of Privacy Practices BPA is required to maintain the privacy of all medical information as required by applicable laws and regulations; provide a notice of privacy practices to all Members; inform Members of the Plan’s legal obligations; and advise Members of additional rights concerning their medical information. For more information, please refer to your Evidence of Coverage document located online at www.bpaco.com All Members will be notified of any changes by receiving a new notice of the Plan’s privacy practices. You may request a copy of this notice of privacy practices at any time by contacting BPA.
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 36 Uniformed Services Employment and Reemployment Rights Act of 1994 A Subscriber may continue his or her Coverage and Coverage for his or her Dependents during military leave of absence in accordance with the Uniformed Services Employment and reemployment Rights Act of 1994. When the Subscriber returns to work from a military leave of absence, the Subscriber will be given credit for the time the Subscriber was covered under the Plan prior to the leave. PREMIUM ASSISTANCE UNDER MEDICAL AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs, but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877- KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer- sponsored plan. If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272). ALABAMA – Medicaid ALASKA – Medicaid Website: http://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 CALIFORNIA – Medicaid Website: http://myarhipp.com/ Phone: 1-855-MyARHIPP (855-692-7447) Website: Health Insurance Premium Payment (HIPP) Program 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) & Child Health Plan Plus (CHP+) FLORIDA – Medicaid
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 37 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/child-health-plan-plus CHP+ Customer Service: 1-800-359-1991/ State Relay 711 Health Insurance Buy-In Program (HIBI): https://www.mycohibi.com/ HIBI Customer Service: 1-855-692-6442 Website: https://www.flmedicaidtplrecovery.com/flmedicaidtplrecovery.com/hi pp/index.html Phone: 1-877-357-3268 GEORGIA – Medicaid INDIANA – Medicaid GA HIPP Website: https://medicaid.georgia.gov/health-insurance- premium-payment-program-hipp Phone: 678-564-1162, Press 1 GA CHIPRA Website: https://medicaid.georgia.gov/programs/third- party-liability/childrens-health-insurance-program-reauthorization-act- 2009-chipra Phone: (678) 564-1162, Press 2 Healthy Indiana Plan for low-income adults 19-64 Website: http://www.in.gov/fssa/hip/ Phone: 1-877-438-4479 All other Medicaid Website: https://www.in.gov/medicaid/ Phone 1-800-457-4584 IOWA – Medicaid and CHIP (Hawki) KANSAS – Medicaid Medicaid Website: https://dhs.iowa.gov/ime/members Medicaid Phone: 1-800-338-8366 Hawki Website: http://dhs.iowa.gov/Hawki Hawki Phone: 1-800-257-8563 HIPP Website: https://dhs.iowa.gov/ime/members/medicaid-a-to- z/hipp HIPP Phone: 1-888-346-9562 Website: https://www.kancare.ks.gov/ Phone: 1-800-792-4884 HIPP Phone: 1-800-766-9012 KENTUCKY – Medicaid LOUISIANA – 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://kidshealth.ky.gov/Pages/index.aspx Phone: 1-877-524-4718 Kentucky Medicaid Website: https://chfs.ky.gov Website: www.medicaid.la.gov or www.ldh.la.gov/lahipp Phone: 1-888-342-6207 (Medicaid hotline) or 1-855-618-5488 (LaHIPP) MAINE – Medicaid MASSACHUSETTS – Medicaid and CHIP
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 38 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 Website: https://www.mass.gov/masshealth/pa Phone: 1-800-862-4840 TTY: (617) 886-8102 MINNESOTA – Medicaid MISSOURI – Medicaid Website: https://mn.gov/dhs/people-we-serve/children-and-families/health- care/health-care-programs/programs-and-services/other-insurance.jsp Phone: 1-800-657-3739 Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Phone: 573-751-2005 MONTANA – Medicaid NEBRASKA – Medicaid Website: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP Phone: 1-800-694-3084 Email: HHSHIPPProgram@mt.gov Website: http://www.ACCESSNebraska.ne.gov Phone: 1-855-632-7633 Lincoln: 402-473-7000 Omaha: 402-595-1178 NEVADA – Medicaid NEW HAMPSHIRE – Medicaid Medicaid Website: http://dhcfp.nv.gov Medicaid Phone: 1-800-992-0900 Website: https://www.dhhs.nh.gov/programs- services/medicaid/health-insurance-premium-program Phone: 603-271-5218 Toll free number for the HIPP program: 1-800-852-3345, ext. 5218 NEW JERSEY – Medicaid and CHIP NEW YORK – Medicaid Medicaid Website: http://www.state.nj.us/humanservices/ dmahs/clients/medicaid/ Medicaid Phone: 609-631-2392 CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710 Website: https://www.health.ny.gov/health_care/medicaid/ Phone: 1-800-541-2831 NORTH CAROLINA – Medicaid NORTH DAKOTA – Medicaid Website: https://medicaid.ncdhhs.gov/ Phone: 919-855-4100 Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/ Phone: 1-844-854-4825 OKLAHOMA – Medicaid and CHIP OREGON – Medicaid Website: http://www.insureoklahoma.org Phone: 1-888-365-3742 Website: http://healthcare.oregon.gov/Pages/index.aspx http://www.oregonhealthcare.gov/index-es.html Phone: 1-800-699-9075
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 39 PENNSYLVANIA – Medicaid and CHIP RHODE ISLAND – Medicaid and CHIP Website: https://www.dhs.pa.gov/Services/Assistance/Pages/HIPP- Program.aspx Phone: 1-800-692-7462 CHIP Website: Children's Health Insurance Program (CHIP) (pa.gov) CHIP Phone: 1-800-986-KIDS (5437) Website: http://www.eohhs.ri.gov/ Phone: 1-855-697-4347, or 401-462-0311 (Direct RIte Share Line) SOUTH CAROLINA – Medicaid SOUTH DAKOTA - Medicaid Website: https://www.scdhhs.gov Phone: 1-888-549-0820 Website: http://dss.sd.gov Phone: 1-888-828-0059 TEXAS – Medicaid UTAH – Medicaid and CHIP Website: http://gethipptexas.com/ Phone: 1-800-440-0493 Medicaid Website: https://medicaid.utah.gov/ CHIP Website: http://health.utah.gov/chip Phone: 1-877-543-7669 VERMONT– Medicaid VIRGINIA – Medicaid and CHIP Website: Health Insurance Premium Payment (HIPP) Program | Department of Vermont Health Access Phone: 1-800-250-8427 Website: https://www.coverva.org/en/famis-select https://www.coverva.org/en/hipp Medicaid/CHIP Phone: 1-800-432-5924 WASHINGTON – Medicaid WEST VIRGINIA – Medicaid and CHIP Website: https://www.hca.wa.gov/ Phone: 1-800-562-3022 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 WYOMING – Medicaid Website: https://www.dhs.wisconsin.gov/badgercareplus/p-10095.htm Phone: 1-800-362-3002 Website: https://health.wyo.gov/healthcarefin/medicaid/programs- and-eligibility/ Phone: 1-800-251-1269
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 40 Notice of Privacy Practices BPA is required to maintain the privacy of all medical information as required by applicable laws and regulations; provide a notice of privacy practices to all Members; inform Members of the Plan’s legal obligations; and advise Members of additional rights concerning their medical information. For more information, please refer to your Evidence of Coverage document located online at www.bpaco.com. All Members will be notified of any changes by receiving a new notice of the Plan’s privacy practices. You may request a copy of this notice of privacy practices at any time by contacting BPA. Uniformed Services Employment and Reemployment Rights Act of 1994 A Subscriber may continue his or her Coverage and Coverage for his or her Dependents during military leave of absence in accordance with the Uniformed Services Employment and reemployment Rights Act of 1994. When the Subscriber returns to work from a military leave of absence, the Subscriber will be given credit for the time the Subscriber was covered under the Plan prior to the leave. To see if any other states have added a premium assistance program since January 31, 2023, or for more information on special enrollment rights, contact either: U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272) Paperwork Reduction Act Statement According to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no persons are required to respond to a collection of information unless such collection displays a valid Office of Management and Budget (OMB) control number. The Department notes that a Federal agency cannot conduct or sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is not required to respond to a collection of information unless it displays a currently valid OMB control number. See 44 U.S.C. 3507. Also, notwithstanding any other provisions of law, no person shall be subject to penalty for failing to comply with a collection of information if the collection of information does not display a currently valid OMB control number. See 44 U.S.C. 3512. The public reporting burden for this collection of information is estimated to average approximately seven minutes per respondent. Interested parties are encouraged to send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Employee Benefits Security Administration, Office of Policy and Research, Attention: PRA Clearance Officer, 200 Constitution Avenue, N.W., Room N-5718, Washington, DC 20210 or email ebsa.opr@dol.gov and reference the OMB Control Number 1210-0137. OMB Control Number 1210-0137 (expires 1/31/2026)
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 41 IMPORTANT NOTICE FROM HAUSER, Inc. PRESCRIPTION DRUG COVERAGE AND MEDICARE FOR PLANS: Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage under the HAUSER, Inc. plan and about your options under Medicare’s prescription drug coverage. This information can help you decide whether you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage: 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare 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. HAUSER, Inc. has determined that the prescription drug coverages offered by HAUSER, Inc. are, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan. 3. When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th. When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? Since the coverage under your BPA is creditable, depending on how long you go without creditable prescription drug coverage you may pay a penalty to join a Medicare drug plan. Starting with the end of the last month that you were first eligible to join a Medicare drug plan but didn’t join, if you go 63 continuous days or longer without prescription drug coverage that’s creditable, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. What Happens to Your Current Coverage If You Decide to Join A Medicare Drug Plan? If you decide to join a Medicare drug plan, your current UnitedHealthcare coverage will not be affected. You can keep this coverage if you elect part D and this plan will coordinate with Part D coverage. If you do decide to join a Medicare drug plan and drop your current HAUSER, Inc. coverage, be aware that you and your dependents will not be able to get this coverage back until the next Annual Open Enrollment or a mid-year qualifying event. 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’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare 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 1-877-486-2048. If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778). Date: 01/01/2025 Name of Entity/Sender: Hauser, Inc. Office Contact/Position: Colleen Sheehan Phone: 513.936.7362 Address: 5905 E. Galbraith Road, Suite 9000, Cincinnati, OH 45236 Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 42 CONTACTS Your Carriers Contact Name Contact Information Medical Benefit Plan Administrators Phone: 1.800.236.7789, Option #3 Email: customerservice@bpaco.com Phone: 1.877.438.5479 Email: info@getKISx.com KISx Card Pharmacy Drexi Phone: 1.844.724.3479 Website: www.drexi.com Pharmacy Advocate Script Sourcing Phone: 1.844.724.3479 Website: www.scriptsourcing.com Dental Guardian Phone: 1.800.541.7846 Website: www.guardiananytime.com Vision Eyemed Phone: 1.866.939.3633 Website: www.eyemed.com Health Savings Account GE Credit Union Phone: 1.800.542.7093 Website: www.gecreditunion.com Flexible Spending Account Navia Phone: 1.877.669.3539 Website: www.naviabenefits.com Life and AD&D and Disability MetLife Phone: 1.800.275.4638 Website: www.metlife.com Employee Assistance Program MetLife through LifeWorks Phone: 1.888.319.7819 Website: metlifeeap.lifeworks.com Username: metlifeeap/ Password: eap Accident & Critical Illness Guardian Phone: 1.888.600.1600 Website: www.guardiananytime.com Identity Theft & Credit Monitoring Smart Identity Phone: 1.800.487.9051 Website: www.thehausergroup.merchantsinfo.com 401 (k) John Hancock Phone: 1.877.525.7655 Website: www.johnhancock.com/myplan Human Resources Contact Name Email Colleen Sheehan Phone: 513.936.7362 Email: csheehan@thehausergroup.com
HAUSER 2025 ENROLLMENT GUIDE The information in this Enrollment Guide is presented for illustrative purposes and the text contained herein was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. 43 Prepared by Hauser Employee Benefits Cincinnati-HQ | Atlanta | Chicago | Kansas City | Los Angeles | New York | St. Louis 5905 E. Galbraith Road, Suite 9000, Cincinnati, Ohio 45236 1.800.866.0098