Return to flip book view

2025 Medical Plan Comparison and

Page 1

1 BCT Employees Medical Plans Comparison and Health Savings Account Information Medical Plan Options –High Performance Plan (HPP) and HDHP Considerations When Making Your Medical Plan Election The following chart provides you with a snapshot of things to consider when reviewing your medical plan options; High Deductible Health Plan (HDHP) or High Performance Plan (HPP). It does not contain everything that should be considered. You will also want to review the Medical Plan Coverage Overview charts, the Summary of Benefits and Coverage and the Claim Comparisons for additional information to help you in your evaluation on which plan may be best for you and your family. Plan Feature HDHP HPP Plan Considerations Monthly Premiums Lower than the HPP Plan Higher than the HDHP The HDHP has lower monthly premiums than the HPP Plan. This is one consideration when deciding which plan might be best for you and your family. If you choose the HDHP, it is recommended that contribute the difference in premiums to a Health Savings Account (HSA) for future out-of-pocket expenses or saved for health care expenses in retirement. Health Savings Account (HSA) Make pre-tax contributions to the HSA through payroll deductions. Not Available When you are enrolled in a qualified HDHP you have the option to contribute to an HSA. An HSA allows for a triple tax savings: Contributions are pre-tax, earnings grow tax free, and the funds used for eligible expenses are tax free. HSA funds can be used when you need them for eligible expenses or saved as part of your retirement health care strategy. Deductible/ Out-of-Pocket Maximum (OOPM) Deductible is higher than the HPP Plan. Deductible is lower than the HDHP Does the lower deductible in the HPP Plan outweigh the savings in lower premiums or your ability to make contributions to an HSA if enrolling in the HDHP. Based on your anticipated claims, or in the event you have unexpected claims, are you comfortable with the potential additional out-of-pocket costs. Family Caps on Deductible and Out-of-Pocket Maximum Individual cap only applies to the out-of-pocket maximum Individual caps apply to the deductible and out-of-pocket maximum Plan Coverage Both plans cover the same health care services (office visits, prescriptions, hospitalizations, etc.), just at different benefit payment levels (deductibles, coinsurance, etc.). Read through the information in this document, review the Medical Plan Coverage Overviews, and the Summary of Benefits and Coverage to understand the differences in how benefits may be paid.

Page 2

2 Medical Plan Coverage Overview – Guided Care High Deductible Health Plan (HDHP) Chart represents employee responsibility unless otherwise indicated. Pre-certification recommended for certain services. PCP referrals required for most services (guided care). In-network care without required referral is considered unguided care. Coverage for in-network unguided care will be at the out-of-network benefit levels (except for the deductible) and will apply to the out-of-network out-of-pocket maximum, however, the total combined out-of-pocket maximum between in-network guided care and in-network unguided care will not exceed the ACA out-of-pocket maximum limits for essential health benefits. Benefit In-Network Guided Care Out-of-Network Annual Deductible* (Family coverage is any coverage level other than Employee Only). No Individual cap applies Individual: $1,650 Family: $3,300 Individual: $3,300 Family: $6,600 Annual Out-of-Pocket Maximum* (Family coverage is any coverage other than Employee Only). Individual cap applies Individual: $4,050 Family: $8,100 Individual: $8,100 Family: $16,200 Coinsurance 25% 45% Preventive Care (per ACA guidelines) Covered at 100%; deductible does not apply Deductible; then 45% coinsurance PCP Office Visit (includes mental health office visits and virtual or telephonic visits) Deductible; then 25% coinsurance Deductible; then 45% coinsurance Centivo Virtual Primary Care Visits $0; deductible does not apply N/A Specialist Office Visit Deductible; then 25% coinsurance Deductible; then 45% coinsurance Lab and X-rays Deductible; then 25% coinsurance Deductible; then 45% coinsurance Outpatient Surgery Deductible; then 25% coinsurance Deductible; then 45% coinsurance Inpatient Hospitalization (including Mental Health & Chemical Dependency) Deductible; then 25% coinsurance Deductible; then 45% coinsurance Urgent Care Deductible; then 25% coinsurance Deductible; then 45% coinsurance In-network benefits apply if out of area. Emergency Room (copay waived if admitted) Deductible; then 25% coinsurance + $150 copay In-network deductible; then 25% coinsurance + $150 copay Ambulance Deductible; then 25% coinsurance In-network Deductible; then 25% coinsurance Chiropractor (limited to 18 visits per calendar year) Deductible; then 25% coinsurance Deductible; then 45% coinsurance Durable Medical Equipment Deductible; then 25% coinsurance Deductible; then 45% coinsurance Home Health Care (maximum 40 visits per calendar year) Deductible; then 25% coinsurance Deductible; then 45% coinsurance Mental Health and Chemical Dependency: Outpatient Deductible; then 25% coinsurance Deductible; then 45% coinsurance Therapy (occupational, physical, speech, respiration) Deductible; then 25% coinsurance Deductible; then 45% coinsurance Therapy (chemotherapy and radiation) Deductible; then 25% coinsurance Deductible; then 45% coinsurance Vision Exam Deductible; then 25% coinsurance Deductible; then 25% coinsurance Prescription Drugs (In-Network medical deductible and out-of-pocket maximum applies) Retail Pharmacy (Up to a 30-day supply)** Mail Order (31 to 90-day supply) Generic Deductible; then $10 copay Deductible; then $10 copay Single-Source Brand 25% after deductible 25% after deductible Multi-Source Brand 30% after deductible 30% after deductible Preventive Prescription Drugs covered under the Affordable Care Act (ACA) are covered at 100%. Covered prescription drugs that are listed on the Express Scripts CDH Preventive Medications—Standard Plus list are covered without deductible. Only the applicable copayment or coinsurance will apply. * In-Network and Out-of-Network deductible and Out-of-Pocket maximums accumulate separately. ** Retail pharmacy 90-day supply available at 3x the 30-day supply cost. All covered benefits are subject to medical necessity as determined by the claims administrator. The SaveOnSP program is not available.

Page 3

3 Medical Plan Coverage Overview – Guided Care High Performance Plan (HPP) Chart represents employee responsibility unless otherwise indicated. Pre-certification recommended for certain services. PCP referrals required for most services (guided care). In-network care without required referral is considered unguided care. Coverage for in-network unguided care will be at the out-of-network benefit levels (except for the deductible) and will apply to the out-of-network out-of-pocket maximum, however, the total combined out-of-pocket maximum between in-network guided care and in-network unguided care will not exceed the ACA out-of-pocket maximum limits for essential health benefits. Preventive Prescription Drugs covered under the Affordable Care Act (ACA) are covered at 100%. SaveOnSP Specialty Pharmacy Copay Assistance Program. Applies to specialty drugs on the SaveOnSP list. 30% coinsurance does not apply towards satisfying deductible Enrolled in SaveOnSP $0 SaveOnSP monitors for no cost Not enrolled in SaveOnSP 30% coinsurance (does not count towards satisfying your deductible or OOPM) * In-Network and Out-of-Network deductibles and Out-of-Pocket maximums accumulate separately ** Retail pharmacy, 90-day supply available at 3x the 30-day supply cost. All covered benefits are subject to medical necessity as determined by the claims administrator. Benefit In-Network Guided Care Out-of-Network Annual Deductible* (Family coverage is any coverage level other than Employee Only) Individual cap applies Individual: $725 Family: $1,450 Individual: $1,450 Family: $2,900 Annual Out-of-Pocket Maximum* (Family coverage is any coverage other than Employee Only) Individual cap applies Individual: $3,425 Family: $6,850 Individual: $6,850 Family: $13,700 Coinsurance 25% 45% Preventive Care (per ACA guidelines) Covered at 100% Deductible; then 45% coinsurance PCP Office Visit (includes mental health office visits and virtual or telephonic visits) $5 copay per visit Deductible; then 45% coinsurance Centivo Virtual Primary Care Visits $0; deductible does not apply N/A Specialist Office Visit Deductible; then 25% coinsurance Deductible; then 45% coinsurance Lab and X-rays Deductible; then 25% coinsurance Deductible; then 45% coinsurance Outpatient Surgery Deductible; then 25% coinsurance Deductible; then 45% coinsurance Inpatient Hospitalization (including Mental Health & Chemical Dependency) Deductible; then 25% coinsurance Deductible; then 45% coinsurance Urgent Care Deductible; then 25% coinsurance Deductible; then 45% coinsurance In-network benefits apply if out of area Emergency Room (copay waived if admitted) Deductible; then 25% coinsurance + $150 copay In-network deductible; then 25% coinsurance + $150 copay Ambulance Deductible; then 25% coinsurance Deductible; then 45% coinsurance Chiropractor (limited to 18 visits per calendar year) Deductible; then 25% coinsurance Deductible; then 45% coinsurance Durable Medical Equipment Deductible; then 25% coinsurance Deductible; then 45% coinsurance Home Health Care (maximum 40 visits per calendar year) Deductible; then 25% coinsurance Deductible; then 45% coinsurance Mental Health and Chemical Dependency: Outpatient Deductible; then 25% coinsurance Deductible; then 45% coinsurance Therapy (occupational, physical, speech, respiration) Deductible; then 25% coinsurance Deductible; then 45% coinsurance Therapy (chemotherapy and radiation) Deductible; then 25% coinsurance Deductible; then 45% coinsurance Vision Exam Deductible; then 25% coinsurance Deductible; then 25% coinsurance Prescription Drugs (In-Network medical deductible and out-of-pocket maximum applies); excludes SaveOnSP drugs Retail Pharmacy (Up to a 30-day supply**) Mail Order (31 to 90-day supply) Generic $10 copay (no deductible) $10 copay (no deductible) Single-Source Brand 25% after deductible 25% after deductible Multi-Source Brand 30% after deductible 30% after deductible

Page 4

4 How the High Deductible Health Plan (HDHP) Works To help you understand how the plan works so you can make an informed decision regarding your medical plan election, please read through all of the following information regarding the HDHP and the Health Savings Account option. In order to be considered a qualified plan for purposes of contributing to a Health Savings Account, the plan is required to meet certain criteria. This includes the deductible, out-of-pocket maximum and how the plan pays for benefits it covers. You should also review the two Medical Plan Coverage Overview charts and the Summary of Benefits and Coverage documents. If you are interested in contributing to a Health Savings Account (HSA) you may also want to consult your tax advisor. Annual Deductible* The HDHP requires that all covered services be applied to the deductible before any benefits are paid by the plan. You will pay for covered services up to the full annual deductible (employee only or family coverage) before the plan begins to pay. This includes prescription drugs and services provided at the Health and Wellness Center (HWC) and near-site clinic if available in your area. There are some exceptions to this rule which are identified under Exceptions. Once the annual deductible is met, the plan will pay for covered services at the applicable coinsurance or copay level until you reach the out-of-pocket maximum. Preventive services are covered at 100%. If you have family coverage (any coverage level other than employee only), you are required to meet the full family annual deductible before the plan begins to pay. There is no individual cap. For example, if only one person within the family incurs claims, the full family annual deductible must be met before the plan will begin to pay. If more than one person in the family incurs claims, all the claims are accumulated together until the family annual deductible is met. This is different from the HPP plan which allows for each member in a family plan to have an individual deductible cap. Annual Out-of-Pocket Maximum* The HDHP annual out-of-pocket maximum works similar to the HPP plan. All covered eligible services under the plan that you pay for out-of-pocket will apply to the annual out-of-pocket maximum. This includes your deductible, coinsurance, and copayments for both medical and prescription drugs. Once the annual out-of-pocket maximum is met, the plan will pay for covered services at 100% for the remainder of the plan year. The annual out-of-pocket maximum allows for an individual cap on family coverage; same as the HPP. If you have family coverage (any coverage level other than employee only) each family member will be capped at the employee only out-of-pocket maximum. Once a covered family member meets the employee only out-of-pocket maximum, the plan will pay for covered services at 100% for that family member. The claims for each individual in the family will accumulate together until the full family out-of-pocket maximum is met. Once the full family out-of-pocket maximum is met, the plan will pay for covered services at 100% for the remainder of the plan year for all covered family members. *In-network and out-of-network deductibles and out-of-pocket maximums accumulate separately and do not cross apply.

Page 5

5 Prescription Drug Coverage All covered services must be applied to the deductible before the plan will begin to pay. This is true for prescription drugs including generic prescriptions. It’s important that you are aware of the cost of any prescriptions that you take as you will pay 100% of the cost until the annual deductible has been met. Once the deductible has been met, the plan will pay for prescriptions based upon the coverage tier they are in (i.e. generic, single source brand, multi-source brand). There are some exceptions to this rule which are identified under Exceptions. Prescriptions covered under the Affordable Care Act (ACA) are covered at 100%. In addition, covered preventive prescription drugs listed on the Express Scripts CDH Preventive Medications – Standard Plus list are covered without deductible. Only the applicable copayment or coinsurance will apply. Lists are available on the Bemis intranet or by contacting Human Resources – Corporate Benefits. Near-site Clinic (Marathon Heath) and On-site Health and Wellness Center (HWC)- Prevea (Based on availability in your area) The services at the near-site clinic (Marathon Health) and services for physical therapy and dietitian counseling provided by Prevea at the On-site Health and Wellness Center are also subject to the deductible. However, preventive services are covered at 100% and are not subject to the deductible. Once you have met the annual deductible, services at the near-site clinic and HWC will be covered at 100%. The cost of services is listed below. High Deductible Health Plan Near-site Clinic (Marathon) and Health and Wellness Center (Prevea) – office visit costs Marathon Health Near-site Clinic When you receive services from a Marathon Health provider, you will be asked for your medical ID card. Your ID card will identify you as an HDHP participant. The staff at the clinic will be able to verify with Centivo if your deductible has been met at the time of your visit. If applicable, Marathon will send you a bill for your visit and submit a claim to Centivo so that your payment can be applied to your deductible. Once you have met your deductible, any future Marathon Health services will be covered at 100%. Provider Cost per visit until deductible is met Marathon Health $30.00 (preventive services covered at 100%) Prevea – Physical Therapy $40.00 Prevea – Dietitian $25.00

Page 6

6 On-site Health & Wellness Center (HWC) Prevea Physical Therapy or Dietitian Services (Based on availability in your area) When you receive services from Prevea, you will be asked for your medical ID card. Your ID card will identify you as a HDHP participant. You will be required to pay for your physical therapy or dietitian services at the time of your appointment. You can use your HSA debit card, a credit card, or a personal check. If you have already met your deductible, it will be necessary to provide a copy of your Explanation of Benefits showing the deductible has been satisfied. Once you have met your deductible, any future HWC services will be covered at 100%. Prevea will submit a claim to Centivo so that your payment can be applied to your deductible. Once you have met your deductible, any future services will be covered at 100%. Exceptions In general, you must satisfy your deductible before the plan will begin to pay for covered services. The following exceptions to this rule apply: • Preventive care is covered at 100%. • Preventive prescription drugs covered under the Affordable Care Act (ACA) are covered at 100%. • Centivo Virtual Primary Care is covered at 100%. • Walmart Urgent Care and Talk Therapy is covered at 100%. • Covered prescription drugs that are listed on the Express Scripts CDH Preventive Medications – Standard Plus list are covered at their applicable copayment or coinsurance level. They are not subject to the deductible. Refer to the Express Scripts Consumer Directed Healthcare (CDH) Preventive Medications – Standard Plus list. Lists are available on the Bemis intranet or by contacting Human Resources – Corporate Benefits. Covered services not listed above are subject to the deductible before the plan begins to pay. Coordination of Benefits under the HDHP Under the HDHP, the plan will coordinate benefits with other plans on a non-duplicating basis. In addition, internal coordination of benefits is not available. You are eligible to enroll as an employee or a dependent, but not both.

Page 7

7 How the High Performance Health Plan (HPP) Works The Guided Care HPP allows for services to be covered differently than the HDHP. Some of the coverage levels under the HPP do not apply to the deductible. For example, the office visit copayment and generic prescription drugs. You can compare the coverage level differences between the HDHP and the HPP plan by reviewing both of the Medical Plan Coverage Overview charts and the Summary of Benefits and Coverage documents. The HPP is not considered a qualified plan for purposes of contributing to a Health Savings Account, however, you can contribute to a Health Care Flexible Spending Account (FSA) to take advantage of paying for out-of- pocket medical expenses with pre-tax dollars. Annual Deductible* The HPP plan provides an individual cap on deductibles for family coverage (all coverage levels other than employee only). This means that the plan caps each family member at the employee only deductible amount. Once the employee only deductible has been met, the plan pays at the applicable coinsurance level for that family member. All family members contribute towards satisfying the full family deductible. Once the full family deductible has been satisfied, the plan pays at the applicable coinsurance level for all covered family members. Annual Out-of-Pocket Maximum* The annual out-pocket maximum also has an individual cap for family coverage levels (all coverage levels other than employee only). This means that the plan caps each family member at the employee only out-of-pocket amount. All family members contribute towards satisfying the full family out-of-pocket maximum. Once the full family amount has been satisfied, the plan pays 100% for covered services for all covered family members. Prescription Drug Coverage The HPP provides for prescription drug coverage through Express-Scripts. Your cost sharing for prescriptions will be based on the prescription you fill; generic, single-source brand, multi-source brand, or specialty. Refer to the Medical Plan Coverage Overview chart and the Summary of Benefits and Coverage document for how the plan covers prescription drugs. The plan offers certain specialty drugs through the SaveOnSP Specialty Pharmacy Copay Assistance Program. If you are taking a prescription that is on the SaveOnSP list and enroll in SaveOnSP, your prescription will be covered for no cost. If you choose not to enroll in SaveOnSP, you will be required to pay a 30% coinsurance and the amount you pay will not count toward satisfying any out-of-pocket costs. Near-site Clinic (Marathon Heath) and On-site HWC- Prevea (Based on availability in your area) The services at the near-site clinic (Marathon Health) and services for physical therapy and dietitian services provided by Prevea at the On-site Health and Wellness Center have no out-of-pocket costs if you are enrolled in the Guided Care HPP or not covered under a Bemis medical plan. *In-network and out-of-network deductibles and out-of-pocket maximums accumulate separately and do not cross apply.

Page 8

8 Health Savings Account (HSA) A Health Savings Account is an individual account for your health care costs. It has a triple tax savings. Contributions to the HSA are tax free, earnings are tax free, and if you use the funds for qualified health care expenses you can pay for them tax free. You are the owner of the account, and you are the only one who can authorize a disbursement. You also control any investments, and because the account is yours, you take the HSA with you when you retire or leave Bemis. An HSA, in conjunction with a qualified High Deductible Health Plan (HDHP), may be an attractive option for your health care. It can also be a part of your retirement health care planning because you can save the funds to use in retirement. The Bemis High Deductible Health Plan (administered by Centivo) is a qualified HDHP for HSA purposes. HSA Eligibility In order to be eligible to contribute to an HSA you must meet the following criteria: • You must be covered by a qualified HDHP. The Bemis HDHP meets this requirement. • You can’t be covered under any other non-HDHP plan. Some examples of other non-HDHP coverage include: • General purpose Flexible Spending Accounts (FSA) – including your spouse’s employer. • General purpose Health Reimbursement Arrangement (HRA) – including your spouse’s employer. • You are eligible to contribute to an HSA if the FSA and HRA are considered Limited Purpose; meaning they are limited to reimbursing for only vision and dental expenses. • You are not enrolled in Medicare including Part A, Part B or Part D. It’s important to understand your Medicare effective date and eligibility options if you are or will be turning age 65. If you are thinking of retiring, you should know your Medicare effective date. In some cases, your effective date may be backdated which may impact contributions to your HSA. It is recommended that you discuss the ability to contribute to your HSA with your tax advisor. • You are not claimed as a dependent on someone else’s tax return (spouses aren’t considered dependents). Eligibility for contributing to an HSA is measured on the first of every month. An account can be opened on the first day of the month on or after the HDHP coverage takes effect. Your ability to contribute thereafter is based on your eligibility on the first day of every month. It’s your responsibility to make sure that you understand how an HSA works and that you are eligible to contribute to an HSA. There are tax consequences for contributing to an HSA if you are not eligible. It is recommended that you consult with your tax advisor.

Page 9

9 Opening a Health Savings Account Bemis has partnered with WEX Health to provide employees the opportunity to contribute to an HSA on a tax-free basis through payroll deduction. If you are newly enrolling in the High Deductible Health Plan, an HSA account will automatically be opened for you if you elect to make pre-tax deductions. You are free to choose any financial institution you would like to open up an HSA, however, if you want to make contribution through payroll pretax deduction, it will be necessary to have the account opened through Bemis with WEX Health. Contributions An HSA provides you with an option to make contributions on a tax-free basis. This can be done through pre-tax payroll deduction; you can also make after tax contributions and take a deduction on your tax return (consult with your tax advisor to see if this is an option for you). When you use the funds for qualified medical expenses, you can realize a triple tax savings. There are limits on how much you can contribute to your HSA. The limits are set each year by the federal government. In addition, the amount you can contribute depends upon the type of HDHP coverage you have (employee only or family), your age, and the date you become eligible or ineligible. When determining how much you can contribute, you will need to take into consideration the level of coverage that you have (employee only or family). If you will be age 55 or older by the end of the calendar year in which you are contributing, you have the option to contribute an additional catch-up contribution. You also have to take into consideration the months in which you are eligible to contribute. You can make a contribution for any month in which you are considered eligible. The chart below indicates the 2025 HSA annual contribution limits. 2025 HSA Annual Contribution Limit Employee Only Coverage $4,300 Family Coverage $8,550 Catch-up Contribution* $1,000 The annual limits are divided by each month in which you are eligible to contribute. If you first become eligible to contribute in March, you would be eligible to contribute 10/12ths of the annual limit**. The account owner is responsible for making sure that contributions do not exceed the annual limits or if contributions were made while you were not eligible. Excess contributions must be removed before the last day for filing your tax return (generally April 15 of the next year). You will pay a 6% excise tax for each year that goes by, and you are liable for taxes owed on the amount that is considered excess contributions. This would also apply to any earnings associated with the excess contributions. If you determine after year end that you did not meet your annual limit, you can still make an additional contribution. You will have until you file your tax return for that year to make an additional contribution. You would just need to make sure that WEX Health is aware of your intent so that they can properly document the funds for the correct year. * Each eligible individual is required to contribute to their own HSA account if they would like to make a catch-up contribution. **An exception to this rule is the last-month rule. If you want to take advantage of this, you will be required to make contributions outside of payroll deduction.

Page 10

10 Who can contribute to the HSA Contributions to an account owner’s HSA can be made by the account owner, an employer, a family member, or any other person. All contributions, regardless of who contributes to the account, must be added together for purposes of the annual contribution limit. Making your own contributions You have the opportunity to make an election during open enrollment on your open enrollment form through pre-tax payroll deduction. Deductions are taken out of each paycheck. It’s a good idea to consider contributing at least the difference in the monthly premium that you are saving between the HPP Plan and the HDHP. Remember that all contributions to your account, regardless of who contributes (you or anyone else), must not exceed your annual limit. Changing your contribution amount If you make an HSA payroll deduction election during open enrollment and decide later that you would like to change the amount you are contributing, that is not an issue. You are eligible to change your HSA election at any time during the year up to once per month. Managing your Account When you open an HSA, you have control and responsibility for managing the account including any investments. You choose how and when to spend the funds in your account. You don’t have to spend the money in your account each year. The funds roll-over year after year and you can let the money grow tax free. There are no requirements to take the funds out. If you have eligible expenses, you can take a distribution at the time of the expense, or you can take a distribution at any time in the future. Just make sure that you save your receipts! This is true for taking a distribution from your account at any time. It’s your responsibility to save receipts as you do not have to provide proof to WEX Health of eligible expenses. The HSA is your account to manage. Receipts should be saved in the event you need to prove your distributions are eligible in an IRS audit. You are the owner of your account including if you are eligible to contribute and using your funds. Your HSA account will earn interest and once you meet a specific dollar amount, you can begin to invest your funds in the portfolio of funds available from the HSA administrator, WEX Health. You are not required to invest your funds; the decision is up to you. You are responsible for making sure you don’t exceed the annual contribution limit. Anyone is eligible to make a contribution to your account on your behalf. For this reason, you will need to make sure that you do not go over the contribution annual limit. The annual limit is based on your coverage level, age, and eligibility date. Refer to Contributions for additional information on the limits. If you do go over, you would need to remove any excess funds in the account before the last day for filing your tax return. If you fail to remove the excess contribution, you pay a 6% excise tax for each year that goes by and are liable for taxes on the amount that should have been part of your gross income. You also need to make sure to take out any earnings. Reminder: one criteria for contributing to an HSA is that you cannot be enrolled in Medicare. This includes Part A, B or D. If you are or will be turning age 65, make sure you understand your Medicare eligibility options. If you are thinking of retiring, it’s important to know your Medicare effective date. In some cases, your effective date may be backdated which may impact contributions to your HSA. It is recommended that you discuss this with your tax advisor.

Page 11

11 Distributions The funds in your HSA account can be used to pay for eligible health care expenses for you and your dependents. Using the funds in this manner allows you to pay for the expenses with pre-tax dollars and reduces your out-of-pocket expenses. HSA accounts provide you with a triple tax savings; funds are deposited tax free, they earn interest tax free, and you pay for eligible expenses with tax free money. Your dependents do not have to be covered under your medical plan for you to pay for their expenses with your HSA funds. In fact, they can be covered under a non-HDHP plan. You are the only one who has to be eligible for the HAS to make contributions. You can use the funds in your account for anything you choose, but if you use the funds in your HSA account for non-qualified expenses before you turn age 65, you will be required to pay income tax plus a 20% penalty on the amount you withdraw. Once you turn age 65, you can use the funds in your HSA for any reason without a penalty. When you use them for eligible expenses, you pay for them with pre-tax dollars. If you take a distribution of your funds for a non-qualified purchase, there is no penalty, but you would be required to pay income tax. At age 65 you can also use the funds in your account to pay Medicare premiums or retiree health premiums from your employer. Medicare supplemental and Medigap policies are not eligible expenses. The Health Savings Account is a great account for helping you manage your out-of-pocket expenses. When you have an eligible expense, you can use the funds in your account, but before you do, it’s a good idea to determine if you have alternatives for paying those expenses. It’s not always possible and that is what your HSA is for, but by using an alternative payment method you can take advantage of your funds continuing to earn interest and grow tax-free. Eligible expenses that you can pay for tax-free are similar to the FSA and HRA (defined by the IRS under Section 213(d)). These include medical, dental, vision and prescription drug deductibles, copayments, and coinsurance. The HSA also allows you to pay for some health care premiums like COBRA or post-65 medical insurance premiums (excluding Medicare supplement and Medigap plans) and long-term care insurance, or premiums for health care if you are receiving federal or state unemployment benefits. If you are no longer eligible to make contributions to your HSA or you are no longer covered under a HDHP, you can continue to use the funds in your HSA account. Even though you may not be eligible to contribute, you can still use your funds for eligible expenses tax free. WEX Health Bemis has partnered with WEX Health to be the administrator of the HSA accounts. WEX Health is the custodian for the accounts and funds are held at Bell Bank. You also have the option to open an HSA at another financial institution of your choice. If you decide to go with this option, you will not have the option of making your contributions pre-tax basis through payroll deduction.

Page 12

12 Getting started with WEX Health and your Health Savings Account (HSA) If you choose to enroll in the Bemis High Deductible Health Plan administered by Centivo, you may also be eligible for an HSA through WEX Health. If newly enrolling in the HDHP, your account will be opened effective January 1st following open enrollment or the first of the month following the date your HDHP coverage is effective. Contributions to your account will typically occur with your first paycheck following eligibility if all requirements of opening the account are met. You will receive an email from WEX Health which will provide you with information to log into your account online. You will be required to accept the terms and conditions of opening the account. HSA funds will not be available until the agreements are agreed to and submitted. It’s important that you provide an email address on your enrollment form to receive important information about your account. If you do not provide an email address, you will be required to contact WEX Health directly to have an online login and password created for you. Any changes to your email address after the initial opening of your account will need to be managed directly with WEX Health. WEX Health must also adhere to the USA Patriot Act. This requires them to go through a verification process before opening your account. If additional information is required, WEX Health will reach out to you. Once your account is open, you can manage your account online at wexinc.com. Contact Information: WEX Health 1-866-451-3399 Monday - Friday: 6AM – 9PM CT customerservice@wexhealth.com wexinc.com | WEX, Inc. App

Page 13

13 Investment Options The funds that are in your HSA account earn interest. Your contributions are deposited in your cash account (default account). Once you meet the minimum threshold of $1,000 you have the option to move money into an interest-bearing account or mutual funds in $100 increments. Your cash account must maintain a minimum of $1,000. If your balance falls below this amount, mutual funds may be automatically sold to maintain the $1,000 limit in your cash account. WEX Health currently offers 30 different funds to choose from. Mutual funds are not FDIC insured and are subject to all applicable fees. They also offer a brokerage account that allows you to purchase and trade investment assets through Charles Schwab. There are no monthly fees as an active employee for opening your HSA account, however if you choose to invest in mutual funds or use the brokerage account, you would be responsible for the fees associated with your investments. Things to consider when reviewing the HPP Plan versus the HDHP When you are determining if the High Deductible Health Plan would be a good option for you and your family, there are a number of things that need to be taken into consideration. The list below are some examples of what you may want to consider. • The premiums savings between the HPP versus the HDHP. It’s recommended that at least the difference in premiums is contributed to your HSA to help grow your balance in that account. • The eligibility to open an HSA to help save for your out-of-pocket expenses now and for retirement. • Using the HSA to receive triple tax savings. • How much you expect your out-of-pocket expenses to be. • Your ability or comfort level to pay for out-of-pocket expenses in a different manner than the HPP Plan. • The differences in coverage levels between the two plans. When you choose to enroll in the HDHP you may find that your out-of-pocket costs are lower or that you are paying less when you consider the cost of claim(s) versus your savings in premium. There are times, however, when the claims that you incur may result in your out-of-pocket costs exceeding the amount you save in premiums. Your personal situation should be taken into consideration when evaluating the plans.

Page 14

14 Claim Comparisons The tables that follow provide examples of the total cost difference between the two plans for individuals with different health care needs. They do not consider costs for prescription drugs, office visit copayments, services at the on-site clinic/HWC, and services in the HPP Plan that have coverage levels other than deductible and coinsurance. The examples are based on care that is subject to the deductible and coinsurance. The examples also show the difference in costs between the HPP and HDHP plans when the premium savings are taken into consideration. Claim Comparisons – Employee Only Coverage Claim Example 1 (Employee Only Coverage) Assumptions: Employee with Employee Only coverage and incurs claims totaling $1,000. Out-of-Pocket Claims Cost HPP HDHP Claim Amount $1,000.00 $1,000.00 Plan Pays $206.25 $0.00 Employee Responsibility Deductible $725.00 $1,000.00 25% Coinsurance + $68.75 + $0.00 Net Employee Claims Responsibility $793.75 $1,000.00 HDHP higher claims out-of-pocket: $206.25 Annual HDHP Employee Only Coverage Premium Savings added to above claim exampleTotal Cost Comparison: HPP HDHP HDHP lower annual premium cost N/A $840.00 HDHP higher claims out-of-pocket N/A $206.25 Lower total cost of HDHP Plan: $633.75

Page 15

15 Claim Example 2 (Employee Only Coverage) Assumptions: Employee with Employee Only coverage and incurs claims totaling $3,500. Out-of-Pocket Claims Cost HPP HDHP Claim Amount $3,500.00 $3,500.00 Plan Pays $2,081.25 $1,387.50 Employee Responsibility Deductible $725.00 $1,650.00 25% Coinsurance + $693.75 + $462.50 Net Employee Claims Responsibility $1,418.75 $2,112.50 HDHP higher claims out-of-pocket: $693.75 Annual HDHP Employee Only Coverage Premium Savings added to above claim exampleTotal Cost Comparison: HPP HDHP HDHP lower annual premium cost N/A $840.00 HDHP higher claims out-of-pocket N/A $693.75 Lower total cost of HDHP Plan: $146.25

Page 16

16 Claim Example 3 (Employee Only Coverage) Assumptions: Employee with Employee Only coverage and incurs claims totaling $15,000. Out-of-Pocket Claims Cost HPP HDHP Claim Amount $15,000.00 $15,000.00 Plan Pays $11,575.00 $10,950.00 Employee Responsibility Deductible $725.00 $1,650.00 25% Coinsurance + $2,700.00 + $2,400.00 Net Employee Claims Responsibility $3,425.00 $4,050.00 HDHP higher claims out-of-pocket: $625.00 Annual HDHP Employee Only Coverage Premium Savings added to above claim exampleTotal Cost Comparison: HPP HDHP HDHP lower annual premium cost N/A $840.00 HDHP higher claims out-of-pocket N/A $625.00 Lower total cost of HDHP Plan: $215.00

Page 17

17 Claim Comparisons – Family Coverage The following examples show the same claim examples as before, except that the individual is covered under a family plan. As referenced under How the High Deductible Health Plan (HDHP) Works, the annual deductible works differently when you have family coverage (any coverage level other than employee only). With family coverage, you are required to meet the full family annual deductible before the plan begins to pay. There is no individual cap. For example, when only one individual in a family has claims that are subject to the deductible, the $3,300 family deductible will apply. You’ll see that the deductible applied is the same as the Employee Only coverage in example 4, but it is higher in examples 5 and 6. This is because claims 5 & 6 are larger claims and must meet the family coverage level deductible before the plan begins to pay at the co-insurance level. In all the family examples, you’ll also see that the premium difference between the plans is greater than the Employee Only coverage examples. The premium difference amount will vary between family coverage levels (Employee + Spouse, Employee+ Children, Family). You should factor this in when making your own comparisons.

Page 18

18 Claim Example 4 (Family Coverage) Assumptions: Employee with family coverage and one person incurs claims totaling $1,000. Out-of-Pocket Claims Cost HPP HDHP Claim Amount $1,000.00 $1,000.00 Plan Pays $206.25 $0.00 Employee Responsibility Deductible $725.00 $1,000.00 25% Coinsurance + $68.75 + $0.00 Net Employee Claims Responsibility $793.75 $1,000.00 HDHP higher claims out-of-pocket: $206.25 Annual HDHP Family Coverage Premium Savings added to above claim example Total Cost Comparison: HPP HDHP HDHP lower annual premium cost N/A $2,520.00 HDHP higher claims out-of-pocket N/A $206.25 Lower total cost of HDHP Plan: $2,313.25

Page 19

19 Claim Example 5 (Family Coverage) Assumptions: Employee with family coverage and one person incurs claims totaling $3,500. Out-of-Pocket Claims Cost HPP HDHP Claim Amount $3,500.00 $3,500.00 Plan Pays $2,081.25 $150.00 Employee Responsibility Deductible $725.00 $3,300.00 25% Coinsurance + $693.75 + $50.00 Net Employee Claims Responsibility $1,418.75 $3,350.00 HDHP higher claims out-of-pocket: $1,931.25 Annual HDHP Family Coverage Premium Savings added to above claim example Total Cost Comparison: HPP HDHP HDHP lower annual premium cost N/A $2,520.00 HDHP higher claims out-of-pocket N/A $1,931.25 Lower total cost of HDHP Plan: $588.75

Page 20

20 Claim Example 6 (Family Coverage) Assumptions: Employee with family coverage and one person incurs claims totaling $15,000. Out-of-Pocket Claims Cost HPP HDHP Claim Amount $15,000.00 $15,000.00 Plan Pays $11,575.00 $10,950.00 Employee Responsibility Deductible $725.00 $3,300.00 25% Coinsurance + $2,700.00 + $850.00 Net Employee Claims Responsibility $3,425.00 $4,050.00 HDHP higher claims out-of-pocket: $625.00 Annual HDHP Family Coverage Premium Savings added to above claim example Total Cost Comparison: HPP HDHP HDHP lower annual premium cost N/A $2,520.00 HDHP higher claims out-of-pocket N/A $625.00 Lower total cost of HDHP Plan: $1,895.00 The information in this document is not intended to describe all the details about the medical plans. If there are any differences between the information and this document and the Plan document, the Plan document governs. The Health Savings Account (HSA) is not considered an employer-sponsored plan and is an individually owned account. Information contained in this document is informational only. It is your responsibility to make sure you are eligible to open and make contributions into an HSA and understand how the account works according to IRS guidance. You should consult with your tax and/or financial advisor regarding your HSA.