Employee 2025Benefits GuideEffective July 2025 – June 2026Artegan – Facilities Message
2TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSThese buttons are interactive!Click to jump to more information. Welcome3Eligibility 4Your Coverage5Enrollment 6How A Health Plan Works7Medical Overview8Medical 9Prescription Drugs / Preventive Care10Supplemental Health Benefits11Dental PPO12Voluntary Vision13Life and AD&D14Disability15Voluntary Life and AD&D16Supplemental Health Benefits17Cost of Coverage 18Resources and Contact Information 19Table of Contents
3TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSTo our Valued Employees of Artegan WelcomeWe are pleased to present this overview of your employee benefits! Artegan offers a variety of benefits to help you protect your health, your family, and your way of life. As a valued employee, we want you to have the best benefits possible which is why we’ve carefully reviewed our benefits to ensure affordability, quality, and ease of use for 2025.Some of the benefits we offer are paid for in full by Artegan. For others, it is a shared contribution between you and the Company. Other benefits are also available to you at reasonable group rates. Your benefits are an important part of your total compensation at Artegan. Please take the time to review and evaluate all the options available to you and your family.Kind regards, Warren PageCEO
4TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSWho is Eligible?Eligibility• An active full-time employee working 30 or more hours per weekQualifying Life Event Change in Marital Status Change in Dependents Change in Employment • Marriage • Divorce• Death of your spouse• Birth, adoption or placement for adoption of aneligible child (Retroactive to the date of the event)• Death of your covered dependent• Gain or loss of Medicare or Medicaid during the year • Change in you or your spouse’s work status that affects benefits eligibility• Your spouse’s Open Enrollment differs from yours• Relocation if the move impacts eligibility for the plan Your dependents are eligible if they are: • Your legal spouse • Your child(ren) † up to age 26 and your disabled children up to any age (pursuant to plan documents and state law, please see Payroll/Benefits for more information)† Includes natural, step, legally adopted/or a child placed for adoption, or a child under your legal guardianshipMaking Benefit Changes During the Plan YearThe benefit elections you make during your initial enrollment period will be in effect through the end of the plan year. If you have a “qualifying life event,” you may make changes to certain benefits if you apply for the change and provide supporting documentation to Payroll/Benefits and Human Resources within 30 days of the event. Proof of life events are subject to approval. Please reach out to your employer for specific documentation to be submitted for a qualified life event during the benefit year. Changes are effective prospectively unless the event is for birth, adoption, or placement for adoption.
5TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSYour CoverageWhen Does Coverage Begin?Benefits for new hires, unless explained otherwise, will become effective on the first of the month following 60 days of employment.If you do not enroll during your eligibility period, you may enroll at the next open enrollment period.Termination of CoverageIf you or a covered dependent no longer meet the eligibility requirements or if your employment ceases, your benefits will end on the last day of the month in which you become ineligible.You are responsible for informing Payroll/Benefits and Human Resources within 30 days if any of your dependents become ineligible for benefits.Benefits can be canceled due to:• Open Enrollment• Termination (voluntary or involuntary)• Retirement• Qualified Life EventA Note About Health Care Reform If you choose to purchase individual coverage through the Marketplace, you should know that because Artegan’s medical insurance meets specific ACA requirements, you may not be eligible to receive a federal subsidy. Additional information is available at www.healthcare.gov.
6TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSEnrollmentWhen Can I Enroll in Benefits?You can enroll in benefits:• Within 30 days of first becoming eligible for benefits• During the annual Open Enrollment period• During the plan year, if you experience a Qualifying Life EventHow Do I Enroll? You must actively enroll in all benefits that require employee contributions. You will be automatically enrolled in all Company paid benefits.You can enroll (or make changes) to your benefits through Employee Navigator. The benefit enrollment process will be completed with a benefit counselor to assist you in making your elections and answering any questions you might have about the benefits offered. Please see your local Business Office Manager for more information on how to complete your benefit enrollment through Employee Navigator.Annual Open EnrollmentThis is a once-a-year opportunity to review your benefit plan elections and make adjustments that meet the needs of you and your family. Changes will go into effect July 1st.
7TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSCoinsurance Your share of the costs of a covered health care service, calculated as a percentage (for example, 20%) of the allowed amount for the service. You generally pay coinsurance plus any deductibles you owe. (For example, if the health insurance or plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your coinsurance payment of 20% would be $20. The health insurance or plan pays the rest of the allowed amount.) CopaymentA fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service (sometimes called “copay”). The amount can vary by the type of covered health care service. DeductibleAn amount you could owe during a coverage period (usually one year) for covered health care services before your plan begins to pay. An overall deductible applies to all or almost all covered items and services. A plan with an overall deductible may also have separate deductibles that apply to specific services or groups of services. A plan may also have only separate deductibles. (For example, if your deductible is $1000, your plan won’t pay anything until you’ve met your $1000 deductible for covered health care services subject to the deductible.)Evidence of Insurability (EOI) EOI is an application process through which you provide information on the condition of your health or your dependent's health in order to be considered for certain types of insurance coverage. EOI may be required for life and/or disability insurance elections.Maximum Out-of-pocket LimitYearly amount the federal government sets as the most each individual or family can be required to pay in cost sharing during the plan year for covered, in-network services. Applies to most types of health plans and insurance. This amount may be higher than the out-of-pocket limits stated for your plan. How a Health Plan WorksA qr code with a white backgroundDescription automatically generatedScan to view Glossary of Health Coverage and Medical Terms
8TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSDownload the Mobile App Today!Members: To search for in-network medical providers:Log onto https://www.loomislive.com/view/login/Access care from your home through Telehealth Services.Log onto http://www.teladoc.com/ Medical Provider Finder Download the Mobile App Today!Medical Provider Finder Medical OverviewWe offer 2 medical plans through Apex/Loomis with the following features:• No deductibles and out-of-pocket maximums and benefits are limited• Includes limited prescription drug coverage• Please refer to the Summary Plan Description (SPD) and Summary of Benefits and Coverage (SBC) as well as the carrier contracts for information regarding specific benefit levels, exclusions and limitations for all policies
9TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSMEC Base MEC EnhancedYou Pay In-NetworkIn-Network(Individual / Family) In-Network(Individual / Family) Preventative Care with PHCS PPONetwork ProviderCovered at 100% Covered at 100%Teladoc 24/7 Telemedicine Free & UnlimitedFree & UnlimitedClever Health Behavioral HealthServicesFree & UnlimitedFree & UnlimitedCoinsurance/CopaysPrimary Care Office Visit $20 copay-up to 3 visits PPY $20 copay-up to 3 visits PPYSpecialty Care Office visit Not Included Network Discount AvailableUrgent Care $50 copay-up to 3 visits PPY $50 copay-up to 3 visits PPYHospital Confinement Not included $600/day-up to 10 days PPYHospital Intensive Care Unit Not included $1,000/day up to 10 days PPYHospital Admission Not included $1,000/day-up to 1 day PPYInpatient Surgery Not included $500/day-up to 1 day PPYOutpatient Major Surgery Not included $300/day-up to 1 day PPYOutpatient Minor Surgery Not included $100/day-up to 1 day PPYAnesthesia Not included $300/day-up to 1 day PPYEmergency Room for Sickness Not included $50/day-up to 2 days PPYEmergency Room for Injury Not included $200/day-up to 2 days PPYOutpatient Diagnostic Lab Not included $50/day-up to 3 days PPYOutpatient Diagnostic X-ray Not included $100/day-up to 1 day PPYOutpatient Major Diagnostic Testing Not included $300/day-up to 1 day PPYPharmacy Retail RX (only 30-day supply shown)Tier 1: Low Cost$1 copay $1 copayTier 2: Generic10% Coinsurance 10% CoinsuranceTier 3: Preferred20% Coinsurance 20% CoinsuranceMedicalOnly In-Network benefits are shown as a summary of your medical plan benefits offered to you. For details and limitations, please refer to your summary of benefits for specific requirements regarding pre-authorizations, coverage limits, and out-of-network costs.
10TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSGet the most from your prescription coverage.Prescription DrugsWhen you enroll in a medical plan, you receive comprehensive prescription drug coverage through Apex. For a list of approved drugs, log onto http://www.citizensrx.com/. • If you take a maintenance medication, you can save money by enrolling in mail order RX • Not all medications can be filled via mail order• Specialty medications must be filled at the approved Apex• Ask your doctor if it is appropriate to use a generic drug rather than a brand name• Compare pharmacies for the best price• Prescription Management may apply; such as prior authorization, step therapy, and quantity limitsPreventive CarePreventive services help you stay healthy, detect health problems early, determine the most effective treatments, and prevent certain diseases. • Preventive services include exams, shots, lab tests, and screenings• Routine visits will only be covered under preventive care when using an in-network provider• Full list: healthcare.gov/what-are-my-preventive-care-benefits
11TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSSupplemental Health Benefits Artegan offers additional voluntary benefit plans through Colonial Life. These plans are not medical insurance and do not replace your medical coverage but instead pays cash directly to you in addition to any benefits you receive from your health plan. Accident insurance Pays a cash benefit when you or your covered family members suffer injuries sustained in an accident. • Accidental Death Benefit• Hospital Admission, Emergency Care and Ambulance• Fractures, tears, concussion• Burns• $50 Cash Benefit for completing health screenings.What Can I Do with the Money I Receive?• Cover cost of copays, deductibles, and coinsurance• Reimburse yourself for transportation and lodging costs • Help with childcare and other domestic expenses• Assist with home health care cost • Make up for lost wages• Pay everyday expenses, such as rent, utilities, and groceriesWhat Can I Do with the Money I Receive?• Cover cost of copays, deductibles, and coinsurance• Reimburse yourself for transportation and lodging costs • Help with childcare and other domestic expenses• Assist with home health care cost • Make up for lost wages• Pay everyday expenses, such as rent, utilities, and groceriesCritical IllnessHelps protect you from financial loss by providing a lump-sum benefit upon diagnosis of a covered condition, such as Heart Attack, Stroke, Cancer, and Major Organ Failure, etc. Hospital IndemnityHelps with medical costs associated with a hospital stay that your health insurance may not cover. These benefits are available for you, your spouse, and eligible children.
12TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSDental (PPO)Dental insurance is offered through Mutual of Omaha. Your choice of dentists can determine the cost savings you receive. You will pay less for in-network services. For out-of-network providers, Mutual of Omaha will pay claims based on reasonable and customary (R&C) charges. You are responsible for paying the balance of the bill.Please refer to plan summary for out-of-network benefits, subject to balance billing, and limitations.In-Network Out-of-NetworkBenefit Maximum Per Person2025 Year Annual Max$1,500 $1,500Orthodontia Lifetime Max Not Covered50% up to a $1,000 lifetime maximumDeductible (applies only to Basic & Major Services)Individual$100 $75Family $300 $225Benefit You Pay You PayPreventive Services20% 0%Basic Services 20% 20%Major Services 50% 50%Orthodontia (to age 19)Not Covered 50%
13TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSVoluntary VisionRoutine eye exams are important for maintaining good vision and can also provide early warning of other health conditions. The EyeMed vision plan provides coverage for exams, glasses and contact lenses, as shown below.In-network coverage is provided when you use EyeMed providers. Refer to plan summary for out-of-network benefits and limitations.EyeMed Voluntary Vision Voluntary VisionBased on Last Date of ServiceIn-Network Out-of-NetworkEye ExamOnce every 12 months$10 Copay Up to $35Lenses Single, Lined Bifocal, Lined Trifocal, LenticularOnce every 12 months$10 CopayUp to $25Up to $40Up to $60Frame Once every 12 months$120 allowance Up to $48ContactsElective, instead of glasses, once every 12 monthsAllowance up to $135Up to $95Up to $95Up to $200Here is what you’ll pay in-network: In addition to discounts on contacts, and frames, additional discounts through participating providers may include: • 40% off complete pair of prescription eyeglasses• 20% off non-prescription sunglasses• 20% off remaining balance beyond plan coverage
14TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSLife and AD&D InsuranceBasic Life/AD&DA $10,000 Basic Life insurance policy is provided to you at no cost through Mutual of Omaha. You are automatically enrolled in this benefit. This coverage includes an Accidental Death and Dismemberment (AD&D) provision, at the same coverage amount, in the event of accidental death and other conditions. Please refer to the benefit summary for details.Reminder! Update your Beneficiaries!Plan for your expected and unexpected life changes by ensuring you and your family are protected. Update your beneficiaries now and keep them current each year. What is Life Insurance?• A lump sum payment distributed to beneficiaries upon death of the insured or insureds• Reassurance that your loved ones would be financially secure if you passed away unexpectedly• Ability to assist with funeral costs – the average funeral cost is $10,000
15TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSShort-Term Disability Mutal of Omaha administers our Disability insurance benefit plans for any full-time employee that chooses to enroll. You will pay the full cost of this benefit with post-tax payroll deductions, therefore your benefit while out on Disability will not be taxed. Short-Term DisabilityShort-Term Disability (STD) benefits are payable when you are unable to work due to an injury or illness unrelated to work.When do the benefits start?8th day of accident or illness(Benefit duration is reduced by the initial disability waiting period (before benefits begin)How much would the benefit pay?60% of your weekly earnings up to $1,200 per weekAre there any pre-existing exclusions? 3 prior / 6 exclusionHow long will the benefit pay? Up to 13 weeksA pre-existing condition is any accident or illness for which you have received advice or treatment in the months prior to your coverage effective date and will be excluded from this benefit for the month exclusion period listed.STD benefits integrate with state mandated disability plans. Maternity claims fall under this policy.
16TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSVoluntary Life InsuranceVoluntary Life and AD&DYou can purchase Voluntary Life insurance through Mutual of Omaha for you, your legal spouse and dependent children. Please refer to the benefit summary for details.Voluntary Life and AD&DEmployee$10,000 increments up to the lesser of 5 times your annual earnings or $500,000Guaranteed issue†: $150,00Spouse $5,000 increments to a maximum of $250,000Guaranteed issue†: $25,000 Child (up to age 26)$2,000 increments to a maximum of $10,000Guaranteed issue†: $10,000Medical review (often referred to as evidence of insurability or EOI) is completed via the enrollment site. † Guaranteed issue is the amount of coverage you or your dependents can elect up to without medical questions. Guaranteed issue is only available to newly benefit eligible employees. Reminder! Update your Beneficiaries!Plan for your expected and unexpected life changes by ensuring you and your family are protected. Update your beneficiaries now and keep them current each year.
17TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSSupplemental Health Benefits Artegan offers additional voluntary benefit plans through Colonial Life. These plans are not medical insurance and do not replace your medical coverage but instead pays cash directly to you in addition to any benefits you receive from your health plan. Accident insurance Pays a cash benefit when you or your covered family members suffer injuries sustained in an accident. • Accidental Death Benefit• Hospital Admission, Emergency Care and Ambulance• Fractures, tears, concussion• Burns• $50 Cash Benefit for completing health screenings.What Can I Do with the Money I Receive?• Cover cost of copays, deductibles, and coinsurance• Reimburse yourself for transportation and lodging costs • Help with childcare and other domestic expenses• Assist with home health care cost • Make up for lost wages• Pay everyday expenses, such as rent, utilities, and groceriesWhat Can I Do with the Money I Receive?• Cover cost of copays, deductibles, and coinsurance• Reimburse yourself for transportation and lodging costs • Help with childcare and other domestic expenses• Assist with home health care cost • Make up for lost wages• Pay everyday expenses, such as rent, utilities, and groceriesCritical IllnessHelps protect you from financial loss by providing a lump-sum benefit upon diagnosis of a covered condition, such as Heart Attack, Stroke, Cancer, and Major Organ Failure, etc. Voluntary Life InsuranceVoluntary life insurance is a financial protection plan that provides a cash benefit to a beneficiary at the death of the insured. This optional insurance provides additional financial protection for your family.
18TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSCost of CoverageContributions are made semi-monthly from each paycheck toward the benefits below. These are automatically deducted from your gross pay before Federal Income and Social Security taxes are calculated. Since contributions are deducted before your pay is taxed, your taxes will be based on a lower gross pay, and you end up paying lower taxes on the same salary. The premium amounts listed below are monthly amounts.Medical Contributions MEC Base MEC EnhancedEmployee Only $0.00 $56.34Employee + Spouse $85.00 $201.07Employee + Child(ren) $85.00 $185.47Employee + Family $190.00 $356.99Dental Contributions Low Plan High PlanEmployee Only $23.98 $36.13 Employee + Spouse $50.57 $76.27 Employee + Child(ren) $44.52 $67.36 Employee + Family $67.51 $101.83 Voluntary Vision Contributions EyeMed VisionEmployee Only $9.89 Employee + 1 $18.75 Employee + Family $27.52
19TABLE OF CONTENTSTABLE OF CONTENTSENROLL NOWENROLL NOWCARRIER CONTACTSCARRIER CONTACTSContact InformationBenefitPartner Website / PhoneMedical & Prescription Apexapex@regionalcare.com(833) 602-0054Prescription Drug Benefit CitizensRXhttp://www.citizensrx.com/(877) 532-7912Telemedicine Teladoc Healthhttp://www.teladoc.com/(800) 835-2362Dental Mutual of Omahahttp://www.mutualofomaha.com/employer-based-plans/dental-insurance/employee(800) 927-9197Vision EyeMedhttp://www.eyemed.com/(866) 299-1358Life and Disability Mutual of Omahahttp://www.mutualofomaha.com/(800) 775-6000Critical Illness, Accident and Hospital Indemnity Colonial Lifehttp://www.coloniallife.com/(800) 325-4368Payroll/Benefits Payroll payroll@artegan.com