Abundant Life Benefit Guide : simplebooklet.com

Contents02 Important Contacts03 Eligibility04 How to Enroll Online06 Dental Coverage07 Vision Coverage08 EMI Health Resources09 Life and AD&D Insurance10 Accident Plan12 Critical Care Plan13 Cancer Plan16 Legal Notices17 NotesWe are pleasedto offer a full benefits package to you and your eligible dependents. Read this guide to know what benefits are available to you. Y O U R N E W B E N E F I T S B E G I NJuly 1 , 2025AND CONTINUE THROUGHJune 30, 20261

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Important ContactsProgram Provider Group No. Phone Website/EmailDentalEMI Health 8685 800-662-5851 emihealth.comVisionEMI Health 8685 800-862-5851 emihealth.comBasic Life and AD&DColonial E5806328 800-325-4368 www.coloniallife.comVoluntary Life and AD&DColonial E5806328 800-325-4368 www.coloniallife.comAccidentColonial E5806328 800-325-4368 www.coloniallife.comCritical IllnessColonial E5806328 800-325-4368 www.coloniallife.comCancerColonial E5806328 800-325-4368 www.coloniallife.comHospital IndemnityColonial E5806328 800-325-4368 www.coloniallife.comHuman Resources – Abundant Life HCSKaren JonesPhone 214-330-2222kjones@hcsintexas.comToni MeltonProducerPhone: 903-434-4783tmelton@higginbotham.netAlejandra LieraAccount ManagerPhone: 903-434-4774aliera@higginbotham.net2

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EligibilityYou have 30 days from the event to notify HR and complete your changes.You may need to provide documents to verify the change.Qualifying Life Events (QLE)CHANGING COVERAGE OUTSIDE OF OPEN ENROLLMENTYou may only change coverage during the plan year if you have a Qualifying Life Event, such as:new hirewho is eligible• A regular, full-time employee working an average of 30 hours per weekwhen to enroll• Enroll by the deadline given by Human Resourceswhen coverage starts• First of the month after completing 60 days of full-time employmentemployeewho is eligible• A regular, full-time employee working an average of 30 hours per weekwhen to enroll• Enroll during Open Enrollmentor when you have a QLEwhen coverage starts• Open Enrollment: Start of theplan year July 1• QLE: Ask Human Resourcesdependent(s)who is eligible• Your legal spouse• Child(ren) under age 26, regardless of student, dependency or marital status• Child(ren) over age 26 who are fullydependent on you for support due to amental or physical disability and who areindicated as such on your federal tax returnwhen to enroll• You must enroll the dependent(s) at OE orfor a QLE• When covering dependents, you must enroll for and be on the same planswhen coverage starts• Based on 2025 effective datesMarriageDivorceLegal separationAnnulmentDeathBirthAdoption/placement for adoptionChange in benefits eligibilityGain or loss of benefits coverageChange in employment status affecting benefitsSignificant change in cost of spouse’s coverageFMLA, COBRA event, court judgement or decreeBecoming eligible for Medicare, Medicaid, or TRICAREReceiving a Qualified Medical Child Support Order3

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How to Enroll Online4Step 1: Log InGo to www.employeenavigator.com and click Login• Returning users: Log in with the username and password you selected.If you have forgotten your password Click Reset a forgotten password.• First time users: Click on your Registration Link in the email sent to you by your admin or Register as a new user. Create an account, and create your own username and password.Step 2: Welcome!After you login click Let’s Begin to complete your required tasks.Step 4: Start EnrollmentsAfter clicking Start Enrollment, you’ll need to complete some personal & dependent information before moving to your benefit elections.T I PHave dependent details handy. To enroll a dependent in coverage you will need their date of birth and Social Security number.Step 3: Onboarding (For first time users, if applicable) Complete any assigned onboarding tasks before enrolling in your benefits. Once you’ve completed your tasks click Start Enrollment to begin your enrollments.T I Pif you hit “Dismiss, complete later” you’ll be taken to your Home Page. You’ll still be able to start enrollments again by clicking “Start Enrollments”Company Identifier: Abundant Life HCS Company

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Step 8: HR Tasks (if applicable)To complete any required HR tasks, click Start Tasks. If your HR department has not assigned any tasks, you’re finished!You can login to review your benefits 24/7Step 7: Review & Confirm ElectionsReview the benefits you selected on the enrollment summary pageto make sure they are correct then click Sign & Agree to complete your enrollment. You can either print a summary of your elections for your records or login at any point during the year to view your summary online.T I PIf you miss a step you’ll see Enrollment Not Complete in the progress bar with the incomplete steps highlighted. Click on any incomplete steps to complete them.Step 5: Benefit ElectionsTo enroll dependents in a benefit, click the checkbox next to the dependent’sname under Who am I enrolling?Below your dependents you can view your available plans and the cost per pay. To elect a benefit, click Select Plan underneath the plan cost.Click Save & Continue at the bottom of each screen to save your elections.If you do not want a benefit, click Don’t want this benefit? at the bottom of the screen and select a reason from the drop-down menu.Step 6: FormsIf you have elected benefits that require a beneficiary designation, Primary Care Physician, or completion of an Evidence of Insurability form, you will be prompted to add in those details.5

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Dental PlanIn-Network1Calendar YearDeductible• Individual• Family$50$150Calendar Year Benefit MaximumPer Individual$1,500You PayPreventive Care $0Basic Restorative Care 20% after deductibleMajor Restorative 40% after deductibleOrthodontia Discount OnlyOrthodontia Lifetime MaximumN/AEmployee Per Paycheck ContributionsEmployee$18.14Employee + Spouse$37.85Employee + Child(ren)$39.14Employee + Family$60.281 See your plan for details about out-of-network coverage.Our dental plan helps you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work. Coverage is provided through EMI Health using the Summit Plus Indemnity provider network.DPPO PlanTwo levels of benefits are available with the DPPO plan: in-network and out-of-network. You may see any dental provider for care, but you will pay less and get the highest level of benefits with in-network providers. You could pay more if you use an out-of-network provider.Dental CoverageFind a Provider• Call 800-662-5851• Visit emihealth.com • Download the mobile app6

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Our vision plan offers quality care to help preserve your health and eyesight. Regular exams can detect certain medical issues such as diabetes and high cholesterol, in addition to vision and eye problems. You may seek care from any vision provider, but the plan will pay the highest level of benefits when you see in-network providers. Coverage is provided through EMI Health using the VSP provider network.Vision CoverageVision SummaryIn-NetworkYou PayOut-of-Network ReimbursementExam $10 Up to $65Lenses• Single Vision• Bifocals• Trifocals• Lenticular$10 copay$10 copay$10 copay$10 copayUp to $30 Up to $50 Up to $65 Up to $100Frames $130 allowance at any VSP doctorUp to $70 at Costco, Sam’s Club or WalmartUp to $115Contacts: In lieu of frames and lenses• Elective• Medically NecessaryUp to $xx$xxUp to $xxUp to $xxBenefit FrequencyExamOnce every 12 monthsLensesOnce every 12 monthsFramesOnce every 12 monthsContactsOnce every 12 monthsEmployee Per Paycheck ContributionsEmployee$3.74Employee + Spouse$8.08Employee + Child(ren)$8.68Employee + Family$12.46Find a Provider• Call 800-662-5851• Visit emihealth.com • Download the mobile app7

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EMI Health ResourcesSetup your My EMI Health AccountIf you haven’t set up your My EMI Health account yet, here are the instructions: Go to emihealth.com. Click Login and select My EMI Health. Select Register and choose Member as the type of account . Enter the data to identify yourself and click Continue. The EMI Health AppDownload the app and log in using you My EMI Health username and password:• Find nearby in-network care• See your claim details• View and share your health plan ID card withyour providers office*You will need your Member ID found on your EMI Health ID card. Also, for your security, your password must be at least six characters and include a special character, e.g., !, @, #, $, etc.**Please note that you will only make an EMI Health account for your family through the plan subscriber. Dependents and spouses will not have their own account.8

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Life and AD&D InsuranceLife and Accidental Death and Dismemberment (AD&D) insurance through Colonial Life are important to your financial security, especially if others depend on you for support or vice versa. With Life insurance, you or your beneficiary(ies) can use the coverage to pay off debts, such as credit cards, loans, and bills. AD&D coverage provides specific benefits if an accident causes bodily harm or loss (e.g., the loss of a hand, foot, or eye). If death occurs from an accident, 100% of the AD&D benefit would be paid to you or your beneficiary(ies). Life coverage amounts reduce by 65% at age 70 and 50% at age 75.Basic Life Basic Life insurance is provided at no cost to you. You are automatically covered at $10,000 for each benefit.Voluntary LifeYou may buy more Life insurance for you and your eligible dependents. If you do not elect Voluntary Life insurance when first eligible or if you want to increase your benefit amount at a later date, you may need to show proof of good health. You must elect Voluntary Life coverage for yourself before you may elect coverage for your spouse or children. If you leave the company, you may be able to take the insurance with you. Designating a BeneficiaryA beneficiary is the person or entity you elect to receive the death benefits of your Life and AD&D insurance policies. You can name more than one beneficiary, and you can change beneficiaries at any time. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%). Voluntary Life and AD&DEmployee• Increments of $1,000 up to $10,000• Guaranteed Issue $75,000Spouse• Increments of $1,000 up to 100% of employee amount• Guaranteed Issue $25,000Child(ren)• Increments of $1,000 up to $10,000 or 100% of employee amount• Guaranteed Issue $10,0001 Spouse rates are based on their own age.Monthly Life and AD&D Rates per $1,000Employee Spouse1Age Uni-tobacco Uni-tobacco<24 $0.058 $0.29025-29 $0.057 $0.03930-34 $0.072 $0.05835-39 $0.098 $0.08940-44 $0.146 $0.13645-49 $0.231 $0.20850-54 $0.344 $0.30855-59 $0.517 $0.44260-64 $0.731 $0.59565-69 $1.028 $0.86370-74 $1.946 $1.63275+ $6.015 $5.045Child(ren)To age 26$0.3039

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Accident PlanColonial Life pays these benefits once per covered person for each covered accident unless otherwise noted.Accident BenefitsPreferredPremierAccident Emergency Treatment(Doctor’s office, urgent care facility or emergency room)One visit per person per accident; Four visits per person per calendaryear$150/visit$200/visitAccident Follow-Up Doctor Visit(Doctor’s office, urgent care facility or emergency room)$50/visit4 visits per covered accident;16 visits per calendar year$50/visit6 visits per covered accident;24 visits per calendar yearAccidental Death$50,000 employee;$50,000 spouse;$10,000 child$50,000 employee;$50,000 spouse;$10,000 childAccidental Death: Common Carrier$200,000 employee;$200,000 spouse;$40,000 child$200,000 employee;$200,000 spouse;$40,000 childAccidental Dismemberment:Loss or Loss of use of Hand/Foot/Sight (1)Hand/Foot/Sight (2+)Finger/Toe (1) Loss of Finger/Toe (2+)$9,000$18,000$1,050$2,100$15,000$30,000$1,500$3,000Ambulance - Air$1,500$2,000Ambulance - Ground$300$400Appliances(such as wheelchair, crutches)$100$200Blood/Plasma/Platelets$400$500Burns(based on size- in square inches or percent of body- and degree)2nd Degree 36% of body3rd Degree 9sq”–18sq”:3rd Degree: >18sq”–35sq”: 3rd Degree: Over 35 sq”:$1,000$2,000$7,000$15,000$1,500$3,000$10,000$21,000Burns - Skin Graft50% of burn benefit50% of burn benefitCatastrophic Accident (Accidental total and irrecoverable loss or loss of use of any combination of hand(s), arm(s), foot (feet), leg(s), sight of eye(s); or loss of hearing of both ears; or loss of the ability to speak. Payable once per covered person.)$50,000 employee;$50,000 spouse;$25,000 child$100,000 employee;$100,000 spouse;$50,000 childComa (duration of at least 14 consecutive days)$10,000$20,000Concussion $375$500Dislocation(Based on joint and if repaired by open or closed reduction)$200 - $6,000$280 - $8,0001 We will not pay the hospital admission benefit, and the hospital ICU admission benefit simultaneously.2We will not pay the hospital confinement benefit, and the hospital ICU confinement benefit simultaneously.3We will not pay the hospital confinement benefit, and the rehabilitation unit confinement benefit simultaneously.10

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Accident PlanAccident BenefitsPreferred PremierEmergency Dental Work Crown, Implant or Denture Extraction$300$100$600$200Eye Injury with surgical repair$300 $400Fracture(Based on bone and if repaired by open or closed reduction)$200 - $7,500 $200 - $10,000Hospital Admission1$1,000 $1,500Hospital Confinement2(up to 365 days)$250/day $350/dayHospital ICU Admission1$1,750 $2,500Hospital ICU Confinement2(up to 15 days)$400/day $600/dayKnee Cartilage - Torn$750 $1,250LacerationNo Stitches:With stitches less than 2”: With stitches 2”-6”:With stitches greater than 6”:$50$150$300$600$75$150$600$1,200Lodging (Companion)(per day up to 30 days)$200 $250Medical Imaging Study (Limit one per covered person per calendar year)$200 $400Pain Management(Epidural Anesthesia)$150 $150Prosthetic Device/Artificial Limb$1,250 (1);$2,500 (2+)$1,750 (1);$3,500 (2+)Rehabilitation UnitConfinement3(up to 15 days per covered accident, and up to 30 days per calendar year)$150/day $200/dayRuptured Disc with Surgical Repair$900 $1,200Surgery - Cranial, Open Abdominal, Thoracic$1,500 $2,000Surgery - Hernia$300 $400Surgery - Exploratory and Arthroscopic$225 $275Tendon/Ligament/Rotator Cuff$900(1);$1,800(2+)$1,200(1);$2,400(2+)Therapy - Occupational and Physical Therapy(up to 10 days)$45/day $55/dayTransportation(up to 3 trips per accident)$600/trip $700/tripX-Ray Benefit$60$60Accident Plan - Bi-weekly Rates11

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Critical Care PlanIncludes lump sum for covered critical illnesses and Benefit Payable Upon Subsequent Diagnosis of a Critical IllnessHeart Attack, Stroke, End Stage Renal (Kidney Failure), Major Organ Failure, Coma, Blindness, Occupational Infectious HIV or Occupational Infectious Hepatitis B, C, D, Permanent paralysis due to a covered accident, Coronary Artery Bypass Surgery/Disease$5,000 - $100,000 face amount in $1,000 incrementsUp to $30,000 during initial enrollment and ongoing for new hiresNamed Insured (Employee), Named insured and Spouse, One Parent Family, Two-Parent FamilyIncluded$50CoverageFace AmountGuarantee IssueCoverage Types availableSubsequent Diagnosis BenefitHealth Screening Benefit (Optional - Employer Choice)Critical Care - Bi-weekly Rates12

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Cancer PlanBenefits are payable for each covered person under the policy. Benefits are payable only when charges are incurred.Benefits Level 2Level 3Air Ambulance, per tripMaximum trips per confinement$2,000 2$2,000 2Ambulance, per tripMaximum trips per confinement$250 2$250 2Anesthesia, General25% of Surgical Procedures BenefitAnesthesia, Local, per procedure$30 $40Anti-Nausea Medication, per dayMaximum per month$40$160$50$200Blood/Plasma/Platelets/Immunoglobulins, per dayMaximum per calendar year$150$10,000$175$10,000Bone Marrow or Peripheral Stem Cell Donation, per donation, maximum one per lifetime$500 $750Bone Marrow Stem Cell Transplant, per transplantPeripheral Stem Cell Transplant, per transplant Maximum transplants per lifetime$4,000$4,000 2$7,000$7,000 2Companion Transportation, per mileMaximum per round trip$0.50$1,000$0.50$1,200Egg (s) Extraction or Harvesting or Sperm Collection,one per lifetime$700 $1,000Egg (s) or Sperm Storage, one per lifetime$200 $350Experimental Treatment, per dayMaximum per lifetime$250$12,500$300$15,000Family Care, per dayMaximum per calendar year$40$2,000$50$2,500Hair/External Breast/Voice Box Prosthesis, per calendar year$200$350Home Health Care Services, per day Maximum per calendar yearExamples include physical therapy, occupationaltherapy, speech therapy, and audiology, prosthesis and orthopedic appliances and rental or purchase of medical equipment.$75 $10030 days or twice the days confinedHospice, InitialHospice, DailyMaximum combined Initial and Daily per lifetime$1,000$50$15,000$1,000$50$15,000Hospital Confinement, 30 days or less, per day$150 $250Hospital Confinement, 31 days or more, per day$300 $50013

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Cancer PlanLodging, per day$50$75Maximum days per calendar year7070Medical Imaging Studies, per study$125$175Maximum per calendar year$250$350Outpatient Surgical Center, per day$200$300Maximum per calendar year$600$900Private Full-time Nursing Services, per day$75$125Prosthetic Device/Artificial Limb, per device or limb$1,500$2,000Maximum per lifetime$3,000$4,000Radiation/ChemotherapyInjected chemotherapy by medical personnel, one per week$500$750Radiation delivered by medical personnel, one per week$500$750Self-Injected Chemotherapy, one per month$200$300Pump Chemotherapy, one per month$200$300Topical Chemotherapy, one per month$200$300Oral Hormonal Chemotherapy (1-24 months), one per month$200$300Oral Hormonal Chemotherapy (25+ months), one per month$100$150Oral Non-Hormonal Chemotherapy, one per month$200$300Reconstructive Surgery, per surgical unit$40$60Maximum per procedure, including 25% for general anesthesia$2,500$3,000Second Medical Opinion, one per lifetime$200$300Skilled Nursing Care Facility, Per day up to the number of days for hospital confinement$100$100Skin Cancer Initial Diagnosis one per lifetime$300$400Supportive/Protective Care Drugs/Colony Stimulating Factors, per day$100$150Maximum per calendar year$800$1,200Surgical Procedures, per unit$50$60Maximum per procedure$3,000$5,000Transportation, per mile$0.50$0.50Maximum per round trip$1,000$1,200Additional BenefitsLevel 2Level 3Bone Marrow Donor ScreeningMaximum of one per lifetime$50$50Cancer Vaccine BenefitMaximum of one per lifetime$50$50Waiver of PremiumYesYesApplicable to AK, AL, AR, AZ, HI, IA, IN, KY, LA, MS, ND, NE, NM, NV, OH, OR, RI, TN, TX, UT Cancer Assist PS01834Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. This information is only intended for proposal use with employers.14

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Cancer PlanWellness Benefit – Employer OptionPart 1: Cancer Wellness/Health ScreeningAs the employer you will choose whether to include the Cancer Wellness/Health Screening Benefit. If selected, you will also choose one of four benefit amounts: $25, $50, $75 or $100. We will pay a benefit if any covered person incurs a charge and has one of the following tests listed below performed after the waiting period and while the policy is in force. This benefit is payable once per covered person per calendar year. The covered tests include:Cancer Wellness tests:• Bone marrow testing • Mammography• Breast ultrasound • Pap smear• CA 15-3 (blood test for breast cancer) • PSA (blood test for prostate cancer)• CA 125 (blood test for ovarian cancer) • Serum protein electrophoresis• CEA (blood test for colon cancer) (blood test for myeloma)• Chest x-ray • Skin biopsy• Colonoscopy • Thermography• Flexible sigmoidoscopy • ThinPrep pap test• Hemoccult stool analysis • Virtual colonoscopyHealth Screening tests:• Blood test for triglycerides• Carotid Doppler• Echocardiogram (ECHO)• Electrocardiogram (EKG, ECG)• Fasting blood glucose test• Serum cholesterol test to determine level of HDL and LDL• Stress test on a bicycle or treadmillPart 2: Cancer Wellness - Additional Invasive Diagnostic Test or Surgical ProcedureWe will pay an additional benefit if any covered person incurs a charge for an additional invasive diagnostic test or surgical procedure performed by a physician after the waiting period. This benefit matches the Part 1 benefit amount.We will pay this benefit only after an abnormal result from one of the covered Cancer Wellness tests in Part 1 has determined that an additional invasive diagnostic test or surgical procedure is necessary. We will pay a Part 2 benefit regardless of the results of the test(s). This benefit is payable once per covered person per calendar year.Cancer Plan - Bi-weekly Rates15

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This brochure highlights the main features of the Abundant Life HCS employ ee benefits program. It does not include all plan rules, details, limitations, and exclusions. The terms of your benefit plans are governed by legal documents, including insurance contracts. Should there be an inconsistency between this brochure and the legal plan documents, the plan documents are the final authority. Abundant Life HSCreserves the right to change or discontinue its employee benefits plans at any time.

Abundant Life Benefit Guide

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