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The benefits plan year runsJanuary 1stthroughDecember 31st. Unless you have a qualified change-in-status event that impacts your eligibility and thechange is allowed underthe terms of the insurancecontract or plan document, you cannot make changes to your benefits until the nextOpen Enrollment period.Benefit changes must be consistent with yourqualified change-in-statusevent.Changes must besubmitted to HumanResources within 30 daysof the event;documentationsupporting the changewill be required.Who is eligible for benefits?All full-time employees who work a minimum of 30 hours per week are eligible for benefits. For new hires, benefits are effective on the first of the month following 60 days of your date of employment.In addition to enrolling yourself, you may also enroll any eligible dependents.Eligible dependents are defined below:• Spouse: a person to whom you are legally married by ceremony• Child(ren): Your biological, adopted, or legal dependents up to age 26 regardlessof student, financial, and marital status; coverage for a dependent child will terminate at the end of the month in which the child turns age 26Change-in-Status EventsUnless you have a qualified change-in-status event that impacts your eligibility andthe change is allowed under the terms of the insurance contract or plan document,you cannot make changes to the benefits you elect until the next Open Enrollmentperiod. Some examples of qualified change-in-status events are highlighted below:Marriage or divorceBirth, adoption, or deathChange in employment, or employment status for you, your spouse, or your dependent childChange in coverage under another employer plan, such as a change made during your spouse’s Open EnrollmentDelgado Collective takes pride in providing acomprehensive employee benefits program,and we recognize the important roleemployee benefits play as a criticalcomponent of your overall compensation.We strive to maintain a benefits programthat is rewarding and competitive.WHAT’S INSIDEEmployee ResourcesEmployee ContributionsMedicalDental Vision2

EMPLOYEE RESOURCESPlanPolicy Number Phone Number and WebsiteMedicalUnited HealthcareTBD(866) 414-1959www.myuhc.comDentalAmeritasTBD(800) 659-2223 www.ameritas.comVisionAmeritasTBD(800) 659-2223 www.ameritas.comHR & Payroll QuestionsVeronica Samples(956)994-8331Many of our providers have mobile apps that providepersonalized access to your benefits when and where youneed it! There are also a variety of FREE health and fitnessrelated apps available. Browse and download apps to yoursmartphone or tablet from the App Store or Google Play.THERE’S AN APP FOR THAT!EMPLOYEE CONTRIBUTIONS PER PAY PERIODBased on 24 pay periods per year3Plan Features Employee Employee + Spouse Employee + Child(ren) FamilyMEDICAL—United HealthcareP3000i80LX21B Choice Plus HDHP PPO$103.15 $348.83 $281.00 $528.52DENTAL—AmeritasDental Plan$11.54 $22.36 $25.94 $36.76VISION—AmeritasVision Plan$3.67 $7.16 $6.46 $9.95

This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations, and exclusions set forth in each insurance carrier or provider’s contract.KEY TERMS TO REMEMBER & PLAN DETAILSANNUAL DEDUCTIBLEThe amount you must pay each year beforethe plan starts paying a portion of medicalexpenses. All family members’ expenses thatcount toward a health plan deductibleaccumulate together in the aggregate;however, each person also has a limit on theirown individual accumulated expenses (theamount varies by plan).OUT-OF-POCKET MAXIMUMThis is the total amount you can pay out ofpocket each calendar year before the planpays 100 percent of covered expenses forthe rest of the calendar year. Most expensesthat meet provider network requirementscount toward the annual out-of-pocketmaximum, including expenses paid to theannual deductible*, copays and coinsurance.*Except for Grandfathered medical plansCOPAYS AND COINSURANCEThese expenses are your share of cost paidfor covered health care services. Copays area fixed dollar amount and are usually due atthe time you receive care. Coinsurance isyour share of the allowed amount chargedfor a service and is generally billed to youafter the health insurance companyreconciles the bill with the provider.4PLAN TYPESPPO – A network of doctors, hospitals, andother healthcare providers. You havecoverage in and out of network.4MEDICAL TERMS

Frequently Asked Questions5BENEFIT TERMINATION DATEWhen do benefits end if I were no longereligible for benefits or when Ileave the company?The date coverage ends will depend on the benefitplan. Some may end on your last day of employment, while others may continue through the last day of the month in which you worked. Refer to your benefitsummary, contact your HR Department, or call theinsurance carrier directly to confirm the date benefits end for each of your benefit plans.BENEFIT CONTINUATIONMay I continue my benefits if I lose coverage due tothe above-mentioned reasons?Yes, you may be eligible to continue your medical,dental, or vision plans via COBRA Continuation Coverage if covered under these plans. Please refer tothe COBRA section of this guide located in the “LegalRequired Notices” section.Other policies may have Conversion/Portability options as well. Please refer to the respective benefit plansummaries for additional information.ACTIVELY-AT-WORK CLAUSEDo any of the benefit plans summarized in this guideinclude what is referred to an “Actively-at-Work” clause?Yes. Some plans will require that you be actively at work on the day benefits are scheduled to take effect. If you are not actively at work on mentioned date, coverage will be delayed and benefits will not take effect until the date you are actively at work; this stipulation may also apply to your covered dependents.BENEFIT PREMIUM PAYMENTSHow do I find out how much my share of thebenefit premium cost is for the benefits Ielect toenroll in?Please refer to the specific benefit pages of this guide to find the employee benefit cost per pay periodinformation.How will I pay for the voluntary benefits I elect toenroll in?Once your benefits take effect, premiums associated with each voluntary benefit plan option you enroll in will be deducted from your paychecks.COMPREHENSIVE PLAN DETAILSDoes this benefit guide include all plan coverage details, exclusions, restrictions, limitations, and/or other stipulations that apply to the benefits described in this guide?No. This guide is intended to provide benefit coverage information in a summarized fashion and so does not Include all plan coverage information.For detailed coverage information, please refer to therespective benefit plan’s Summary Plan Description.NETWORKS & YOUR OUT-OF-POCKET COSTSHow do I make sure I get the best coverage?Many of your benefit plan options have provider net-works. When you use doctors, other health careproviders, hospitals and facilities that are in yourinsurance plan’s network you will receive the best coverage your benefit plans have to offer. Making surethat you use in- network providers will ensure you getthe best coverage as out-of-network coverage does notprovide discounts, does not protect you from balancebilling, and may im- pose higher deductibles,coinsurance, and out - of - pocket maximums.If you receive services from out-of-network providers your out-of-pocket costs are usually considerably higher. This is partly the case because you lose valuable network dis-counts and, in addition to you not receiving a discount, you may also be balance billed*.*Balance billing occurs when an out-of-network provider bills a patient for the difference between what theybilled for services rendered and what the insurancecompany has established as the maximum allowablecharge for the service(s) rendered by out-of-networkproviders; depending on the type of service(s) renderedyou may be balanced billed hundreds or thousands ofdollars more than what you would have been billed hadyou used an in-network provider. Why pay more? Selectfrom in-network providers and enjoy the best coverageyour plans have to offer.How do I locate in-network providers?Call the specific insurance carrier’s customer servicenumber or visit their website to locate in-networkproviders. Refer to the “Important Contact Information”section of this guide for instructions on how to locateIn-network providers for each of the benefit plans you are enrolled in.

6This chart is intended for summary purposes only. If there are any discrepancies, the official plan documents will always govern. Pre-certification may be required for certain services.MEDICAL & PRESCRIPTION PLAN HIGHLIGHTS Plan Features Plan: P3000i80LX21B Choice Plus HDHP PPOProvider NetworkIn-Network (you pay)Out-of-Network(you pay)Deductibles(Individual / Family)$3,000 / $6,000 $6,000 / $12,000Coinsurance(Member Responsibility)20% after deductible 50% after deductible Out-of-Pocket Max(Individual / Family)$8,150 / $16,300 $16,300 / $32,600Preventive Care No Charge Not coveredTelehealth / Virtual Visit No Charge n/aPrimary Care VisitUnder age 19 $0 copay; $25 copay50% after deductibleSpecialist Visit $75 copay 50% after deductibleDiagnostic Test (x-ray, blood work)20% after deductible 50% after deductibleComplex Imaging (CT/MRI, PET scan)20% after deductible 50% after deductible Outpatient Procedure 20% after deductible 50% after deductible Inpatient Visit 20% after deductible 50% after deductible Urgent Care $50 copay 50% after deductible Emergency Room 20% after deductibleRetail Pharmacy(31 day supply)Retail Rx Tier 1 / 2 / 3 / 4 $10 / $35 / $75 / $250 copay$10 / $35 / $75 / $250 copaySpecialty Rx Tier(tier 1,2,3,4)$10,$150,$350,$500 $10,$150,$350,$500Mail Order Pharmacy / RX(90 Day Supply)2.5x retail copay n/a

We are pleased to offer you comprehensive dental plans. You can visit any licensed dentist, but your costsare usually lowest with an in-network dentist. In-network dentists accept reduced fees for covered services;out-of-network dentists may balance bill you the difference between their usual fee and what the plan pays.DENTAL PLAN HIGHLIGHTS7In &Out-of-NetworkAnnual DeductibleType 1: Waived / Type 2 & 3: $50 Lifetime (Carrier pays)Type 1: Preventive Care• RoutineExam (once every 6months)• Routinecleanings (once every 6months)• X-rays(fullmouth & panoramic frequency limitsapply)• Fluoride treatment (age & frequency restrictionsapply)• Sealants (age & frequency restrictionsapply)100%Type 2: Basic Services• Fillings• Endodontics (root canal)• Extractions• Periodontics80 – 90 - 100%Type 3: Major Services• Crowns• Onlays• Bridges& Dentures50%Orthodontia(Children under 19/Adults)Not CoveredCalendarYear Max$1,500In-Network Benefits are based on the negotiated rate withyour provider and Ameritas.Out-of-network services are based on the Maximum Allowable Charge (MAC). TheMAC is the amountthatcan be charged back to patients. An out of network provider will be paid the maximum allowablechargebased upon the agreement between Principaland yourdentist. Thiscould result in a balance billtothemember.

Need to locate a participating, in-network provider?To locate a participating provider, visit www.vsp.com. Select “Find a Doctor” and then enter search criteria using the “Choice” network.8Your vision coverage provides a full range of vision care services. You may receive care from any provider you choose, but yourbenefits are greater when you see a participating provider in the network. If you choose to receive services from an out-of-network provider, you will be required to pay that provider at the time of service and submit a claim form for reimbursement.Limitations or waiting periods may apply for some benefits; some services may be excluded from yourplan. These charts are intended for summary purposes only. If there are any discrepancies, the plandocument will always govern.Please refer to your plan documents for additional information.VISION PLAN HIGHLIGHTSVision Coverage In-Network Frequency Out-of-NetworkExam $0 Copay12 MonthsUp to $30Prescription Lenses*• Single Vision• Lined Bifocal• Lined Trifocal• Lenticular$0 copay 12 MonthsUp to $25Up to $40Up to $60Up to $100Frames$130 Allowance;20% off over allowance24 Months $665 allowanceElective Contact Lenses* $130 Allowance12 Months $65 allowanceMedically NecessaryContacts$0 copay 12 Months $200 allowanceAdditionalSavings for Members:• 20% off any itemnot covered by the plan, including non-prescription sunglasses.• Lasikor PRK:15% off retailprice or 5% off promotional price.