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Ella SA Contracting 24-25 Employee Benefits Guide

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2024 –2025Employee Benefits Guide

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The benefits plan year runsfrom October 1st, 2024, through September 30th,2025. Unless you have a qualified change-in-status event that impacts your eligibility and the change is allowed underthe terms of the insurance contract or plan document, you cannot make changes to your benefits until the next Open Enrollment period.Changes must be submitted to Human Resources within 30 days of the event;documentation supportingthe change will be required.Change-in-Status EventsUnless you have a qualified change-in-status event that impacts your eligibility and the 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 Enrollment period. 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 EnrollmentElla S.A. Contracting takes pride in providing a comprehensive employee benefits program, and we recognize the important role employee benefits play as a critical component of your overall compensation. We strive to maintain a benefits program that is rewarding and competitive.WHAT’S INSIDE2Employee ResourcesMedical Plan OptionsDental Plan Vision PlanLife/AD&DVoluntary Life and AD&DVoluntary WorksiteWho 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 1st of the month following 60 days 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• Domestic Partner: a person in which you are in a committed relationship, living together• 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 26Follow this QR code to a recorded benefits presentation

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EMPLOYEE RESOURCESMany of our providers have mobile apps that provide personalized access to your benefits when and where you need it! There are also a variety of FREE health and fitness related apps available. Browse and download apps to your smartphone or tablet from the App Store or Google Play.THERE’S AN APP FOR THAT!EMPLOYEE CONTRIBUTIONSBased on 52 pays periods3Carrier/Vendor Group # Website Phone NumberMedical1458568www.uhc.com/find-a-doctor(800) 782-3158Network: Navigate HMO or Charter PlusUnitedHealthcareHealth Savings Accountwww.proficientbenefits.com(210) 659-8100ProficientDental1100527 www.principal.com/dentist (800) 247-4695PrincipalVision1100527www.vsp.com/eye-doctor (800) 877-7195Principal - VSPLife and AD&D1100527 www.principal.com (800) 986-3343PrincipalVoluntary Life and AD&D1100527 www.principal.com (800) 986-3343PrincipalVoluntary Worksitewww.coloniallife.com (800) 325-4368Colonial LifeVoluntary Whole Life*Salaried Employees Only*www.massmutual.com(800) 272-2216Mass MutualMedicalEmployee Only Employee + Spouse Employee + Child(ren) Employee + FamilyDQ29 $6,750 Ded HDHP HMOEmployee$24.51 $49.01 $49.01 $73.52Employer$73.52 $147.04 $147.04 $220.56 DQ2B $4,000 Ded HMOEmployee$52.55 $105.09 $105.09 $157.64Employer$73.52 $147.04 $147.04 $220.56 DQ3W $3,000 Ded PPOEmployee$85.55 $171.10 $171.10 $256.65Employer$73.52 $147.04 $147.04 $220.56 DentalLow DPPOEmployee$3.33 $6.58 $6.93 $10.74Employer$0.00 $0.00 $0.00 $0.00 High DPPOEmployee$8.58 $18.20 $20.49 $32.32Employer$0.00 $0.00 $0.00 $0.00 VisionEmployee$1.28 $2.61 $2.21 $3.64Employer$0.00 $0.00 $0.00 $0.00

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myUHC.com (best to register)UHC’s personalized website, www.myuhc.com, provides access to your plan information, as well as many online tools with information to help you make more informed health decisions. Want to find out how to improve your fitness or eat better? UHC’s online tools can help you stay active and take care of your health.UHC Mobile appThe UHC mobile app for members gives you an easy way to organize and accessyour important health information —anytime, anywhere. Download the freeapp and gain instant access to multiple services.Preventive Care Covered at 100%Prevention is the best medicine, andyour UHC medical plans cover a widerange of preventive services to help you and your family lead healthy, productive lives. These services include annual routine examinations, well-childcarevisits, immunizations, routine OB/GYN visits, mammograms, PAP tests, prostatescreenings, and other services asrequired by the Affordable Care Act.These preventive services are covered at100% when seeking care with in-networkproviders.Get the most out of your medical plan with value-added resources from UHC.UNITEDHEALTHCARE MEMBER BENEFITSNeed to locate a participating, in-network provider?Go www.uhc.com/find-a-doctor and login, register, or select “Find a Doctor, Dentist*, or Facility” and enter a few keywords regarding who or what you are looking for. Click the search button to find participating providers near you.Note: UHC’s “Find a Provider” search is for medical and prescription providers only. To locate a participating dentist, please refer to your Principal resources.NOTE: The information provided herein regarding various care options is meant to be helpful when you are seeking care and is not intended as medical advice. Only a medical provider can offer medical advice. The choice of provider or place to seek medical treatment belongs entirely to you.Choosing the right type of careYour Doctor Knows Best• Your personal physician best understands your health.• Having a personal physician can result in overall better care.But what if you get sick or injured when your doctor’s office is closed?UHC Virtual CareYour health plan through UHC includes access to medical and behavioral/mental health virtual care.With UHC Virtual Care, you can get the care you need—including most prescriptions—for a widerange of minor conditions. You can connect with a board-certified doctor when, where, and how it works best for you—via video or phone— without having to leave home or work. Members will seetheir appropriate cost share when they access virtual visits through UHC. Whether it’s late at nightand your doctor or therapist isn’t available, or you just don’t have the time or energy to leave thehouse, you can:• Get medical virtual care 24/7/365—even on weekends and holidays• Schedule a behavioral/mental health virtual care appointment online in minutes• Have a prescription sent directly to your local pharmacy, if appropriateUrgent Care Centers• Urgent care centers are usually open after normal business hours, including evenings and weekends.• Many urgent care centers offer on-site diagnostic tests and x-rays.• In most situations, you’ll find that you save time and money by going to urgent care instead of theEmergency Room.• To locate the urgent care center nearest you, visit www.uhc.com/find-a-doctor or check the UHC mobile app.Emergency Room (ER)• This is the best place for treating severe and life-threatening conditions.• ERs provide the most expensive type of care.4

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UHC MEMBER RESOURCESUHC Virtual VisitsYour health plan through UHC includes access to medical and behavioral/mental health virtual care. With virtual visits,you can get the care you need—including most prescriptions—for a wide range of minor conditions 24/7. You canconnect with aboard-certified doctor when, where, and how it works best for you—via video or phone— without having to leave homeor work. Members will see their appropriate cost share when they access through myUHC. Whether it’s late at night and your doctor or therapist isn’t available, or you just don’t have the time or energy to leave thehouse, you can:• Get medical virtual care 24/7/365—even on weekends and holidays• Schedule a behavioral/mental health virtual care appointment online in minutes• Have a prescription sent directly to your local pharmacy, if appropriateConditions commonly treated through a virtual visit:HEALTH SAVINGS ACCOUNT (HSA)The HDHP allows employees to set aside money on a pre-tax basis into a Health Savings Account (HSA). The HSA is anaccount established exclusively for the purpose of paying for qualified medical expenses for you and your eligibledependents on a tax-free basis.Contributions to the HSA are funded with pre-tax deductions withheld from your paycheck. The funds are deposited intoan interest-bearing account in your name. The money in the HSA can be used to reimburse eligible expenses not coveredby your insurance plan, including the deductible, coinsurance, and copays. Any money not used for medicalreimbursement remains in the account. In the event you leave the company, you own the account and the money therein.For a complete list of “qualified medical expenses,” please refer to Publication 502 at www.irs.gov.5IRS Annual Limits2024 MaximumContribution(Employer + Employee)2025 Maximum(Employer + Employee)Ella EmployerMonthly ContributionSingle Only $4,150 $4,300  $50 Employee + Spouse $8,300 $8,550  $75 Employee +Child(ren)$8,300 $8,550  $75Employee + Family $8,300 $8,550  $100 Catch-Up ContributionEmployees Age 55+ may contribute an additional $1,000• Bladder infection/UTI• Bronchitis• Cold/flu• Diarrhea• Fever• Migraine/Headaches• Pink Eye• Rash• Sinus Problems• Sore Throat• Stomachache

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MEDICAL AND PRESCRIPTION PLAN HIGHLIGHTSYou have three medical plan choices administered by UHC. All three options include prescription drug coverage. To locate a participating, in-network provider, visitwww.uhc.com/find-a-doctor.This chart is intended for comparison purposes only. If there are any discrepancies, the official plan documents will govern. Pre-certification is required for certainservices. *Out-of-network providers and facilities may balance bill you for any charges in excess of the amount paid by the plan.6IN-NETWORK$6,750 HDHP HMODQ29$4,000 HMODQ2B$3,000 PPODQ3WProvider Network Navigate HMO Navigate HMO Choice Plus PPOHSA Compatible? YES NO NODeductible (Individual / Family)Amount you must pay beforethe plan will begin to pay for certain services$6,750 / $13,500  $4,000 / $8,000 $3,000 / $6,000Coinsurance(Member Responsibility)0% after deductible 0% after deductible 0% after deductibleOut-of-Pocket Maximum (Individual / Family)Maximum amount youpay per year for covered expenses$6,750 / $13,500(Includes Deductible& Coinsurance)$7,000 / $14,000(Includes Deductible,Coinsurance, & Copays)$4,500 / $9,000(Includes Deductible,Coinsurance, & Copays)Preventive CareWell-child visits and immunizations, routine GYN visit, annual adult physical, and other age/genderappropriate screeningsNo Charge No Charge No ChargePrimary Care Visit 0% after deductible $10 copay$30 copay($0 copay for children <19)Telehealth*Designated virtual network provider0% after deductible *$0 copay *$0 copaySpecialist Visit*Designated network provider0% after deductible $60 copay *$30 / $60 copayDiagnostic Lab & X-Ray 0% after deductible $40 copay No ChargeComplex Imaging  0% after deductible $500 copay 0% after deductibleUrgent Care 0% after deductible $25 copay $50 copayEmergency Room 0% after deductible$500 copay per visit +deductible$500 copay per visit,deductible does not applyRetail Pharmacy(30-Day Supply)Generic/Preferred/Non-Preferred/Specialty0% after deductible$10 / $35 / $85Specialty Rx:$10 / $150 / $500$10 / $35 / $85Specialty Rx: $10 / $150 $500Mail Order Pharmacy(90-Day Supply)Generic/Preferred/Non-PreferredExcludes specialty Rx0% after deductible $25 / $87.50 / $212.50 $25 / $87.50 / $212.50 / N/AOUT-OF-NETWORK$6,750 HDHP HMODQ29$4,000 HMODQ2B$3,0.00 PPODQ3WDeductible(Individual / Family)Not Covered Not Covered $5,000 / $10,000Out-of-Pocket Maximum(Individual / Family)Not Covered Not Covered $10,000 / $20,000Emergency Room(must be true emergency)0% after deductible$500 copay per visit+ deductible$500 copay per visit,deductible does not apply

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Ella SA Contracting offers dental coverage through Principal. You can visit any licensed dentist, but your costs are 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.The features of your dental plan are highlighted in the table below. Pleaserefer to your plan description for full details.Limitations or waiting periods may apply for some benefits; some services may be excluded from your plan. This chart is intended for comparison purposes only. If there are any discrepancies, the plan document will govern. *Reimbursement is based on the maximum contract allowances and not necessarily each dentist’s submitted fees.Need to locate a participating, in-network provider?To locate a participating provider, visit www.Principal.com, select “search for a dentist”, then enter your search credentials. DENTAL PLAN HIGHLIGHTS7Carrier: PrincipalPlan Name: Low Plan High PlanNetwork Principal PPO NetworkAnnual Maximum (per person) $1,000 $2,000 Deductibleamount you must pay per calendar year before the plan begins to pay benefits, waived for preventive services)Individual $50 $50 Family $150 $150 Out-of-Network Processing MAC 90th UCRPreventive Services No charge No chargeBasic Services 80% 100%Major Services 50% 60%OrthodontiaOrtho Services (Children to age 19) Not Covered 50%Lifetime Orthodontia Maximum N/A $1,000Preventionfirst!Make sure you take advantage of your preventive dental visits. Preventive care services are not subject to the deductible andthe plan covers 100% of the costif you visit an in-network provider!Maximum RolloverSome of your unused annual benefit maximum can be carried over to the next year. To qualify, you must have had a dental service performed within the calendar year and used less than the maximum threshold. The threshold is equal to the lesser of 50% of the out-of-network maximum benefit or $1,000. If the qualification is met, 50% of the threshold is carried over to next year’s maximum benefit. You can accumulate no more than four times the carryover amount. The entire accumulation amount will be forfeited if no dental service is submitted within a calendar year.To check your rollover amount, login to Principal.com.

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Your vision coverage provides a full range of vision care services provided through Principal & VSP. You may receive care from any provider you choose, but your benefits are greater when you see a participating provider in the VSP CHOICE 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 to VSP for reimbursement.This chart is intended for comparison purposes only. If there are any discrepancies, the plan document will  govern. Limitations and exclusions may apply.VISION PLAN HIGHLIGHTSDid you know your eyes can tell an eye care provider a lot about you?Vision insurance can make routine eye care more affordable, especially if you are among the majority of people who wear prescription eyeglasses or contact lenses.In addition to getting a vision screening, a routine eye exam can help detect signs of serious health conditions like diabetes and high cholesterol. This is important, since you won’t always notice the symptoms yourself and since some of these diseases cause early and irreversible damage.Need to locate a participating, in-network provider?To locate a participating provider, visit www.vsp.com/eye-doctor, click “Find a Provider,” and choose the CHOICE network, or call (800) 877-7195.8Plan FeaturesIn-NetworkOut-of-Network ReimbursementVision ExamOnce every 12 months$10 copay Up to $45Eyeglass FramesOnce every 24 months$150 plan allowance+ 20% off balanceUp to $70Eyeglass LensesOnce every 12 monthsSingle visionLined bifocal Lined trifocal$20 copay$20 copayUp to $30-$100Contact LensesOnce every 12months in lieu of eyeglassesFitting/ExamStandard: Up to $60 copayElective contact lensesConventional: $150allowanceUp to $105Necessary contact lensesConventional: $150allowanceUp to $210

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Life insurance helps protect your family from financial risk and sudden loss of income in the event of your death. Accidental death and dismemberment (AD&D) insurance provides an additional benefit if you lose your life, sight, hearing, speech, or limbs in an accident. Coverage is provided at no cost to you through Principal.Basic Life and AD&D InsuranceElla SA Contracting provides you with basic life insurance in the amount of$15,000. If you die because of an accident, your beneficiary will receive an additional benefit equal to the basic life insurance. For other coveredlosses, the amount of the benefit is a percentage of the AD&D insurancecoverage amount. Evidence of good health is not required. Benefits reduceto 65% at age 65 and 50% at age 70. Coverage terminates at retirement.Voluntary Life and AD&D InsuranceAll full-time employees are eligible to enroll in Voluntary Life and AD&D insurance through Principal. Coverage is voluntary and premiums are 100% paid by the employee.BASIC AND VOLUNTARY LIFE AND AD&D INSURANCEDuring your benefits enrollment, don’t forget to designate a beneficiary!Additional Plan Features:Accelerated Death Benefit – If you become terminally ill, you may be able to receive a portion of your life benefit.Conversion – If you retire, reduce your hours or leave Ella SA Contracting, you may be eligible to take your coverage with you. You will be required to apply to Principal within 31 days of your termination if you wish to continue your coverage. Contact Principal or the summary plan description for details.Waiver of Premium – If it is determined that you are totally disabled, your life insurance benefit may continue without payment of premium, subject to certain conditions. 9Coverage Provided ForVoluntary Term Life and AD&D(Employee Paid)Guaranteed Issue*(new hires underage 70 only)Minimum Maximum IncrementsEmployee $10,000 $300,000 $10,000If you're under 70: $100,000 If you're 70 or older: $10,000Spouse (terminates at age 70)$5,000 $100,000 $5,000If your spouse is under 70: $25,000 If your spouse is age 70 or older: $10,000Child(ren) (14 days to 26 years)$5,000 $10,000 $5,000 or $10,000All amountsIncluded BenefitsAnnual Benefit Increase Option, Accelerated Death Benefit, Conversion, Portability, Waiver of PremiumThe following benefit reduction schedule shows how much benefits are reduced at certain ages:Age Benefit Reduces by:65 35%70 15%

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VOLUNTARY WORKSITEPlease review the worksite benefitsummaries for more details. Be sure tospeak with a benefit enroller for moreinformation.10COLONIAL LIFEIndividual Short-Term Disability How will you pay your bills if you were sick or injured? Even a short illness or injury could seriously impact your paycheck. What happens when your sick time runs out? Disability replaces part of your income if you are unable to work due to an accident, illness, or if you are expecting a new addition to your family. Maternity Leave is one of the most common uses for disability insurance. Fortunately, all full-time employees who work a minimum of 30 hours per week are eligible to elect an individual short-term disability and take advantage of the group rate through Colonial Life.Accident InsuranceNobody can predict when an accident might happen. That’s why accident insurance is an important add-on policy forpeople who want to supplement the health and disability insurance coverage they already have through Ella SAContracting . Accident Insurance pays you lump sum of benefits after you suffer an accident. This could be more than40 different circumstances, including: emergency treatment, ambulance, burns, dislocations, fractures, hospitalconfinement, and surgery. Please review the benefit summary for more information.Hospital Indemnity - Medical Bridge InsuranceBeing hospitalized for illness or injury can happen to anyone, at any time. While medical insurance may cover hospital bills,it may not cover all the costs associated with a hospital stay. That’s where hospital indemnity coverage can help. Hospitalindemnity insurance is for people who need help covering the costs associated with a hospital stay if they suddenlybecome sick or injured. Please review the benefit summary for more information.Critical Illness InsuranceCritical illness insurance may help you cover expenses not covered by your health insurance. It’s a cash payment you receive ifyou ever experience a serious illness like cancer, a heart attack, or a stroke, giving you the financial support to focus on recovery.Critical illness insurance is a supplemental policy for people who already have health insurance. It provides you with anadditional payment to cover expenses like deductibles, treatments, and living costs. Critical illnesses include strokes, heartattacks, Parkinson’s disease and cancer. Our policies can cover over 30 major illnesses, helping you stay financially stable bypaying you a lump sum if you’re diagnosed with one of them. Please review the benefit summary for more information.Mass MutualGroup Whole Life Insurance *Salaried Employees Only*Group Whole Life Insurance provides coverage at a set premium, builds cash value over time that your Employees can borrow from and pays a death benefit. Group Whole Life Insurance may be easier and more affordable than you think. Speak to a benefits enroller for pricing and benefit information.

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