Annual Notices Packet 2026

1 ©2024 United Benefit Advisors, LLC. All rights reserved. Annual Notices Packet  Contents Medicare Creditable Coverage Letter Medicare Non-Creditable Coverage Letter Women’s Health and Cancer Rights Act Notice Newborns’ and Mothers’ Health Protection Act Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) HIPAA Notice of Privacy Practices Notice to Enrollees Regarding Opt-Out Notice of Special Enrollment Rights Continuation Coverage Rights Under COBRA Health Insurance Marketplace Coverage Options and Your Health Coverage ° For Employers that Offer a Health Plan to Some or All Employees Your Rights and Protections Against Surprise Medical Bills General FMLA Notice Mental Health Parity and Addiction Equity Act (MHPAEA) Disclosure Genetic Information Nondiscrimination Act of 2008 USERRA Notice Snellings Walters

1 Important Notices from Snellings Walters Insurance Agency regarding the Medical Plans The following notices provide important information about the group health plan provided by Snellings Walters. Please read the attached notices carefully and keep a copy for your records. If you have any questions regarding any of these notices, please contact: General Contact Name ° The Benefits Team: Alexandra Gebara or Brannon Johnston Phone ° (770) 396-9600 Email ° Benefitsquestions@snellingswalters.com Plan Administrator Name ° Snellings Walters Phone ° (770) 396-9600 Email ° Benefitsquestions@snellingswalters.com Privacy Officer Name ° Brannon Johnston Phone ° (770) 396-9600 Email ° Benefitsquestions@snellingswalters.com Distribution Date: October  , 2025 Please note this is not a legal document and should not be construed as legal advice 7KHVHQRWLFHVDUHDYDLODEOHRQOLQHDWZZZSD\ORFLW\FRPRUYLDSDSHUIUHHRIFKDUJH XSRQUHTXHVWWRWKH3ODQ$GPLQLVWUDWRU .

2 Medicare Creditable Coverage Letter These notices are for all participants and dependents who are or may become eligible for Medicare Part D in the next 12 months. Important Notice from Snellings Walters About Your Prescription Drug Coverage and Medicare Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Snellings Walters and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage: 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2. Snellings Walters has determined that the prescription drug coverage offered by the $3500 HDHP Plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan. When Can You Join a Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15 to December 7. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two-month Special Enrollment Period (SEP) to join a Medicare drug plan. What Happens to Your Current Coverage If You Decide to Join a Medicare Drug Plan? If you decide to join a Medicare drug plan, your current Snellings Walters coverage may be

3 affected. You may keep this coverage if you elect part D and this plan will coordinate with Part D coverage. If you do decide to join a Medicare drug plan and drop your current Snellings Walters coverage, be aware that you and your dependents will not be able to re-enroll in this coverage outside of Open Enrollment or a Qualifying Life Event. https://www.cms.gov/medicare/prescription-drug-coverage/creditablecoverage) When Will You Pay a Higher Premium (Penalty) To Join a Medicare Drug Plan? You should also know that if you drop or lose your current coverage with Snellings Walters  and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. For More Information About This Notice or Your Current Prescription Drug Coverage Contact the person listed below for further information.  NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Snellings Walters  changes. You also may request a copy of this notice at any time. For More Information About Your Options Under Medicare Prescription Drug Coverage More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage: x Visit www.medicare.gov x Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help x Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at ssa.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).

4 Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty). Notice Date ° October  , 2025 Name of Entity/Sender ° Snellings Walters Contact ° Alexandra Gebara – Account Manager Phone Number ° (470) 514 - 4868

5 Medicare Non-Creditable Coverage Letter Important Notice from Snellings Walters About Your Prescription Drug Coverage and Medicare Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Snellings Walters and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are three important things you need to know about your current coverage and Medicare’s prescription drug coverage: 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2. Snellings Walters has determined that the prescription drug coverage offered by the $5000 HDHP Plan is, on average for all plan participants, NOT expected to pay out as much as standard Medicare prescription drug coverage pays. Therefore, your coverage is considered Non-Creditable Coverage. This is important because, most likely, you will get more help with your drug costs if you join a Medicare drug plan, than if you only have prescription drug coverage from the $5000 HDHP Plan. This also is important because it may mean that you may pay a higher premium (a penalty) if you do not join a Medicare drug plan when you first become eligible. 3. You can keep your current coverage from the $5000 HDHP Plan. However, because your coverage is non-creditable, you have decisions to make about Medicare prescription drug coverage that may affect how much you pay for that coverage, depending on if and when you join a drug plan. When you make your decision, you should compare your current coverage, including what drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. Read this notice carefully - it explains your options. When Can You Join a Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15 to December 7. If you decide to drop your current coverage with Snellings Walters, since it is employer- sponsored group coverage, you will be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan; however, you also may pay a higher premium (a penalty) if you went 63 or more days without creditable coverage.

6 When Will You Pay a Higher Premium (Penalty) To Join a Medicare Drug Plan? Since the coverage under $5000 HDHP Plan , is not creditable, depending on how long you go without creditable prescription drug coverage you may pay a penalty to join a Medicare drug plan. Starting with the end of the last month that you were first eligible to join a Medicare drug plan but didn’t join, if you go 63 continuous days or longer without prescription drug coverage that’s creditable, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. What Happens to Your Current Coverage If You Decide to Join a Medicare Drug Plan? If you decide to join a Medicare drug plan, your current Snellings Walters coverage may be affected. You may keep this coverage if you elect part D and this plan will coordinate with Part D coverage. https://www.cms.gov/medicare/prescription-drug-coverage/creditablecoverage) If you do decide to join a Medicare drug plan and drop your current Snellings Walters coverage, be aware that you and your dependents will not be able to re-enroll in this coverage outside of Open Enrollment or a Qualifying Life Event. For More Information About This Notice or Your Current Prescription Drug Coverage Contact the person at the beginning of this notice. Note: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan and if this coverage through Snellings Walters changes. You also may request a copy of this notice at any time. For More Information About Your Options Under Medicare Prescription Drug Coverage For more information about Medicare prescription drug coverage: x Visit www.medicare.gov x Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help x Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at ssa.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778). Remember: Keep this non-Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).

9 ©2024 United Benefit Advisors, LLC. All rights reserved. Women’s Health and Cancer Rights Act Notice Do you know that your plan, as required by the Women’s Health and Cancer Rights Act of 1998 (WHCRA), provides benefits for mastectomy-related services including all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy, including lymphedema? Call your plan administrator at 770-508-3005 for more information. If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the WHCRA. For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for: x All stages of reconstruction of the breast on which the mastectomy was performed x Surgery and reconstruction of the other breast to produce a symmetrical appearance x Prostheses x Treatment of physical complications of the mastectomy, including lymphedema These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under this plan. Therefore, the following deductibles and coinsurance apply: See your current coverage on the SBC document (Medical Summary of Benefits Coverage). If you would like more information on WHCRA benefits, call your plan administrator, 770-508-3005.

10 ©2025 United Benefit Advisors, LLC. All rights reserved. Newborns’ and Mothers’ Health Protection Act (ȖȅȣȒǦǓƺǹȠǦȒǹƺǿșƺǿǏǦǓƺǹȠǦǩǿșȣȖƺǿljǓǩșșȣǓȖșǠǓǿǓȖƺǹǹΡǾƺΡǿȅȠॹȣǿǏǓȖ'ǓǏǓȖƺǹǹƺΛॹȖǓșȠȖǩljȠLjǓǿǓǟǩȠșǟȅȖƺǿΡ ǦȅșȒǩȠƺǹǹǓǿǠȠǦȅǟșȠƺΡǩǿljȅǿǿǓljȠǩȅǿΛǩȠǦljǦǩǹǏLjǩȖȠǦǟȅȖȠǦǓǾȅȠǦǓȖȅȖǿǓΛLjȅȖǿljǦǩǹǏȠȅǹǓșșȠǦƺǿࢵࢹǦȅȣȖș ǟȅǹǹȅΛǩǿǠƺΚƺǠǩǿƺǹǏǓǹǩΚǓȖΡॹȅȖǹǓșșȠǦƺǿࢺࢷǦȅȣȖșǟȅǹǹȅΛǩǿǠƺljǓșƺȖǓƺǿșǓljȠǩȅǿঀ/ȅΛǓΚǓȖॹ'ǓǏǓȖƺǹǹƺΛǠǓǿǓȖƺǹǹΡ ǏȅǓșǿȅȠȒȖȅǦǩLjǩȠȠǦǓǾȅȠǦǓȖঢ়șȅȖǿǓΛLjȅȖǿঢ়șƺȠȠǓǿǏǩǿǠȒȖȅΚǩǏǓȖॹƺǟȠǓȖljȅǿșȣǹȠǩǿǠΛǩȠǦȠǦǓǾȅȠǦǓȖॹǟȖȅǾ ǏǩșljǦƺȖǠǩǿǠȠǦǓǾȅȠǦǓȖȅȖǦǓȖǿǓΛLjȅȖǿǓƺȖǹǩǓȖȠǦƺǿࢵࢹǦȅȣȖșশȅȖࢺࢷǦȅȣȖșƺșƺȒȒǹǩljƺLjǹǓষঀ2ǿƺǿΡljƺșǓॹȒǹƺǿșƺǿǏ ǩșșȣǓȖșǾƺΡǿȅȠॹȣǿǏǓȖ'ǓǏǓȖƺǹǹƺΛॹȖǓȕȣǩȖǓȠǦƺȠƺȒȖȅΚǩǏǓȖȅLjȠƺǩǿƺȣȠǦȅȖǩΦƺȠǩȅǿǟȖȅǾȠǦǓȒǹƺǿȅȖȠǦǓǩǿșȣȖƺǿljǓ ǩșșȣǓȖǟȅȖȒȖǓșljȖǩLjǩǿǠƺǹǓǿǠȠǦȅǟșȠƺΡǿȅȠǩǿǓΠljǓșșȅǟࢵࢹǦȅȣȖșশȅȖࢺࢷǦȅȣȖșষঀ

11 ©2025 United Benefit Advisors, LLC. All rights reserved. Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) 2ǟΡȅȣȅȖΡȅȣȖljǦǩǹǏȖǓǿƺȖǓǓǹǩǠǩLjǹǓǟȅȖEǓǏǩljƺǩǏȅȖ/2XƺǿǏΡȅȣঢ়ȖǓǓǹǩǠǩLjǹǓǟȅȖǦǓƺǹȠǦljȅΚǓȖƺǠǓǟȖȅǾΡȅȣȖ ǓǾȒǹȅΡǓȖॹΡȅȣȖșȠƺȠǓǾƺΡǦƺΚǓƺȒȖǓǾǩȣǾƺșșǩșȠƺǿljǓȒȖȅǠȖƺǾȠǦƺȠljƺǿǦǓǹȒȒƺΡǟȅȖljȅΚǓȖƺǠǓॹȣșǩǿǠǟȣǿǏșǟȖȅǾ ȠǦǓǩȖEǓǏǩljƺǩǏȅȖ/2XȒȖȅǠȖƺǾșঀ2ǟΡȅȣȅȖΡȅȣȖljǦǩǹǏȖǓǿƺȖǓǿঢ়ȠǓǹǩǠǩLjǹǓǟȅȖEǓǏǩljƺǩǏȅȖ/2XॹΡȅȣΛȅǿঢ়ȠLjǓ ǓǹǩǠǩLjǹǓǟȅȖȠǦǓșǓȒȖǓǾǩȣǾƺșșǩșȠƺǿljǓȒȖȅǠȖƺǾșॹLjȣȠΡȅȣǾƺΡLjǓƺLjǹǓȠȅLjȣΡǩǿǏǩΚǩǏȣƺǹǩǿșȣȖƺǿljǓljȅΚǓȖƺǠǓ ȠǦȖȅȣǠǦȠǦǓ/ǓƺǹȠǦ2ǿșȣȖƺǿljǓEƺȖǷǓȠȒǹƺljǓঀ'ȅȖǾȅȖǓǩǿǟȅȖǾƺȠǩȅǿॹΚǩșǩȠΛΛΛঀǦǓƺǹȠǦljƺȖǓঀǠȅΚঀ 2ǟΡȅȣȅȖΡȅȣȖǏǓȒǓǿǏǓǿȠșƺȖǓƺǹȖǓƺǏΡǓǿȖȅǹǹǓǏǩǿEǓǏǩljƺǩǏȅȖ/2XƺǿǏΡȅȣǹǩΚǓǩǿƺșȠƺȠǓǹǩșȠǓǏLjǓǹȅΛॹljȅǿȠƺljȠ ΡȅȣȖ^ȠƺȠǓEǓǏǩljƺǩǏȅȖ/2XȅǟǟǩljǓȠȅǟǩǿǏȅȣȠǩǟȒȖǓǾǩȣǾƺșșǩșȠƺǿljǓǩșƺΚƺǩǹƺLjǹǓঀ 2ǟΡȅȣȅȖΡȅȣȖǏǓȒǓǿǏǓǿȠșƺȖǓFKeljȣȖȖǓǿȠǹΡǓǿȖȅǹǹǓǏǩǿEǓǏǩljƺǩǏȅȖ/2XॹƺǿǏΡȅȣȠǦǩǿǷΡȅȣȅȖƺǿΡȅǟΡȅȣȖ ǏǓȒǓǿǏǓǿȠșǾǩǠǦȠLjǓǓǹǩǠǩLjǹǓǟȅȖǓǩȠǦǓȖȅǟȠǦǓșǓȒȖȅǠȖƺǾșॹljȅǿȠƺljȠΡȅȣȖ^ȠƺȠǓEǓǏǩljƺǩǏȅȖ/2XȅǟǟǩljǓȅȖǏǩƺǹ ࢲেࢹࢸࢸে?2^FKvȅȖΛΛΛঀǩǿșȣȖǓǷǩǏșǿȅΛঀǠȅΚȠȅǟǩǿǏȅȣȠǦȅΛȠȅƺȒȒǹΡঀ2ǟΡȅȣȕȣƺǹǩǟΡॹƺșǷΡȅȣȖșȠƺȠǓǩǟǩȠǦƺșƺ ȒȖȅǠȖƺǾȠǦƺȠǾǩǠǦȠǦǓǹȒΡȅȣȒƺΡȠǦǓȒȖǓǾǩȣǾșǟȅȖƺǿǓǾȒǹȅΡǓȖেșȒȅǿșȅȖǓǏȒǹƺǿঀ 2ǟΡȅȣȅȖΡȅȣȖǏǓȒǓǿǏǓǿȠșƺȖǓǓǹǩǠǩLjǹǓǟȅȖȒȖǓǾǩȣǾƺșșǩșȠƺǿljǓȣǿǏǓȖEǓǏǩljƺǩǏȅȖ/2XॹƺșΛǓǹǹƺșǓǹǩǠǩLjǹǓ ȣǿǏǓȖΡȅȣȖǓǾȒǹȅΡǓȖȒǹƺǿॹΡȅȣȖǓǾȒǹȅΡǓȖǾȣșȠƺǹǹȅΛΡȅȣȠȅǓǿȖȅǹǹǩǿΡȅȣȖǓǾȒǹȅΡǓȖȒǹƺǿǩǟΡȅȣƺȖǓǿঢ়ȠƺǹȖǓƺǏΡ ǓǿȖȅǹǹǓǏঀeǦǩșǩșljƺǹǹǓǏƺ৚șȒǓljǩƺǹǓǿȖȅǹǹǾǓǿȠ৛ȅȒȒȅȖȠȣǿǩȠΡॹƺǿǏ ΡȅȣǾȣșȠȖǓȕȣǓșȠljȅΚǓȖƺǠǓΛǩȠǦǩǿࢷࢱǏƺΡș ȅǟLjǓǩǿǠǏǓȠǓȖǾǩǿǓǏǓǹǩǠǩLjǹǓǟȅȖȒȖǓǾǩȣǾƺșșǩșȠƺǿljǓ ঀ2ǟΡȅȣǦƺΚǓȕȣǓșȠǩȅǿșƺLjȅȣȠǓǿȖȅǹǹǩǿǠǩǿΡȅȣȖ ǓǾȒǹȅΡǓȖȒǹƺǿॹljȅǿȠƺljȠȠǦǓǓȒƺȖȠǾǓǿȠȅǟ@ƺLjȅȖƺȠΛΛΛঀƺșǷǓLjșƺঀǏȅǹঀǠȅΚȅȖljƺǹǹࢲেࢹࢷࢷেࢵࢵࢵে^শࢴࢳࢸࢳষঀ 2ǟΡȅȣǹǩΚǓǩǿȅǿǓȅǟȠǦǓǟȅǹǹȅΛǩǿǠșȠƺȠǓșॹΡȅȣǾƺΡLjǓǓǹǩǠǩLjǹǓǟȅȖƺșșǩșȠƺǿljǓȒƺΡǩǿǠΡȅȣȖǓǾȒǹȅΡǓȖǦǓƺǹȠǦȒǹƺǿ ȒȖǓǾǩȣǾșঀeǦǓǟȅǹǹȅΛǩǿǠǹǩșȠȅǟșȠƺȠǓșǩșljȣȖȖǓǿȠƺșȅǟ=ȣǹΡࢴࢲॹࢳࢱࢳࢶঀȅǿȠƺljȠΡȅȣȖșȠƺȠǓǟȅȖǾȅȖǓǩǿǟȅȖǾƺȠǩȅǿ ȅǿǓǹǩǠǩLjǩǹǩȠΡঀ

12 ©2025 United Benefit Advisors, LLC. All rights reserved. ALABAMA – Medicaid vǓLjșǩȠǓॸǦȠȠȒॸইইǾΡƺǹǦǩȒȒঀljȅǾ XǦȅǿǓॸࢹࢶࢶেࢷࢺࢳেࢶࢵࢵࢸ ALASKA – Medicaid eǦǓǹƺșǷƺ/ǓƺǹȠǦ2ǿșȣȖƺǿljǓXȖǓǾǩȣǾ XƺΡǾǓǿȠXȖȅǠȖƺǾ vǓLjșǩȠǓॸǦȠȠȒॸইইǾΡƺǷǦǩȒȒঀljȅǾ XǦȅǿǓॸࢹࢷࢷেࢳࢶࢲেࢵࢹࢷࢲ ǾƺǩǹॸȣșȠȅǾǓȖ^ǓȖΚǩljǓ૬EΡ?/2XXঀljȅǾ EǓǏǩljƺǩǏǹǩǠǩLjǩǹǩȠΡॸ ǦȠȠȒșॸইইǦǓƺǹȠǦঀƺǹƺșǷƺঀǠȅΚইǓǿইǏǩΚǩșǩȅǿেȅǟেȒȣLjǹǩljে ƺșșǩșȠƺǿljǓ ARKANSAS – Medicaid vǓLjșǩȠǓॸǦȠȠȒșॸইইǾΡƺȖǦǩȒȒঀljȅǾ XǦȅǿǓॸࢹࢶࢶেEΡ[/2XXশࢹࢶࢶেࢷࢺࢳেࢸࢵࢵࢸষ CALIFORNIA – Medicaid /ǓƺǹȠǦ2ǿșȣȖƺǿljǓXȖǓǾǩȣǾXƺΡǾǓǿȠশ/2XXষ XȖȅǠȖƺǾΛǓLjșǩȠǓॸǦȠȠȒșॸইইǏǦljșঀljƺঀǠȅΚইǦǩȒȒ XǦȅǿǓॸࢺࢲࢷেࢵࢵࢶেࢹࢴࢳࢳ 'ƺΠॸࢺࢲࢷেࢵࢵࢱেࢶࢷࢸࢷ ǾƺǩǹॸǦǩȒȒ૬ǏǦljșঀljƺঀǠȅΚ COLORADO – Health First Colorado (Colorado’s Medicaid Program) & Child Health Plan Plus (CHP+) /ǓƺǹȠǦ'ǩȖșȠȅǹȅȖƺǏȅvǓLjșǩȠǓॸ ǦȠȠȒșॸইইΛΛΛঀǦǓƺǹȠǦǟǩȖșȠljȅǹȅȖƺǏȅঀljȅǾ /ǓƺǹȠǦ'ǩȖșȠȅǹȅȖƺǏȅEǓǾLjǓȖȅǿȠƺljȠǓǿȠǓȖॸ ࢹࢱࢱেࢳࢳࢲেࢴࢺࢵࢴই^ȠƺȠǓ[ǓǹƺΡࢸࢲࢲ /X੼ॸǦȠȠȒșॸইইǦljȒǟঀljȅǹȅȖƺǏȅঀǠȅΚইljǦȒ /X੼ȣșȠȅǾǓȖ^ǓȖΚǩljǓॸࢹࢱࢱেࢴࢶࢺেࢲࢺࢺࢲই^ȠƺȠǓ [ǓǹƺΡࢸࢲࢲ /ǓƺǹȠǦ2ǿșȣȖƺǿljǓȣΡে2ǿXȖȅǠȖƺǾশ/22ষॸ ǦȠȠȒșॸইইΛΛΛঀǾΡljȅǦǩLjǩঀljȅǾই /22ȣșȠȅǾǓȖ^ǓȖΚǩljǓॸࢹࢶࢶেࢷࢺࢳেࢷࢵࢵࢳ FLORIDA – Medicaid vǓLjșǩȠǓॸ ǦȠȠȒșॸইইΛΛΛঀǟǹǾǓǏǩljƺǩǏȠȒǹȖǓljȅΚǓȖΡঀljȅǾইǟǹǾǓǏǩljƺǩ ǏȠȒǹȖǓljȅΚǓȖΡঀljȅǾইǦǩȒȒইǩǿǏǓΠঀǦȠǾǹ XǦȅǿǓॸࢹࢸࢸেࢴࢶࢸেࢴࢳࢷࢹ GEORGIA – Medicaid (/2XXvǓLjșǩȠǓॸ ǦȠȠȒșॸইইǾǓǏǩljƺǩǏঀǠǓȅȖǠǩƺঀǠȅΚইȒȖȅǠȖƺǾșইȠǦǩȖǏে ȒƺȖȠΡেǹǩƺLjǩǹǩȠΡইǦǓƺǹȠǦেǩǿșȣȖƺǿljǓেȒȖǓǾǩȣǾে ȒƺΡǾǓǿȠেȒȖȅǠȖƺǾেǦǩȒȒ XǦȅǿǓॸࢷࢸࢹেࢶࢷࢵেࢲࢲࢷࢳॹXȖǓșșࢲ (/2X[vǓLjșǩȠǓॸ ǦȠȠȒșॸইইǾǓǏǩljƺǩǏঀǠǓȅȖǠǩƺঀǠȅΚইȒȖȅǠȖƺǾșইȠǦǩȖǏে ȒƺȖȠΡেǹǩƺLjǩǹǩȠΡইljǦǩǹǏȖǓǿșেǦǓƺǹȠǦেǩǿșȣȖƺǿljǓেȒȖȅǠȖƺǾে ȖǓƺȣȠǦȅȖǩΦƺȠǩȅǿেƺljȠেࢳࢱࢱࢺেljǦǩȒȖƺ XǦȅǿǓॸࢷࢸࢹেࢶࢷࢵেࢲࢲࢷࢳॹXȖǓșșࢳ INDIANA – Medicaid /ǓƺǹȠǦ2ǿșȣȖƺǿljǓXȖǓǾǩȣǾXƺΡǾǓǿȠXȖȅǠȖƺǾ ǹǹȅȠǦǓȖEǓǏǩljƺǩǏ vǓLjșǩȠǓॸǦȠȠȒșॸইইΛΛΛঀǩǿঀǠȅΚইǾǓǏǩljƺǩǏ ǦȠȠȒॸইইΛΛΛঀǩǿঀǠȅΚইǟșșƺইǏǟȖই 'ƺǾǩǹΡƺǿǏ^ȅljǩƺǹ^ǓȖΚǩljǓșǏǾǩǿǩșȠȖƺȠǩȅǿ XǦȅǿǓॸࢹࢱࢱেࢵࢱࢴেࢱࢹࢷࢵ EǓǾLjǓȖ^ǓȖΚǩljǓșXǦȅǿǓॸࢹࢱࢱেࢵࢶࢸেࢵࢶࢹࢵ IOWA – Medicaid and CHIP (Hawki) EǓǏǩljƺǩǏvǓLjșǩȠǓॸǦȠȠȒșॸইইǦǦșঀǩȅΛƺঀǠȅΚইǾǓǏǩljƺǩǏ EǓǏǩljƺǩǏXǦȅǿǓॸࢹࢱࢱেࢴࢴࢹেࢹࢴࢷࢷ /ƺΛǷǩvǓLjșǩȠǓॸ ǦȠȠȒșॸইইǦǦșঀǩȅΛƺঀǠȅΚইǾǓǏǩljƺǩǏইȒǹƺǿșে ȒȖȅǠȖƺǾșইǦƺΛǷǩ /ƺΛǷǩXǦȅǿǓॸࢹࢱࢱেࢳࢶࢸেࢹࢶࢷࢴ /2XXvǓLjșǩȠǓॸ ǦȠȠȒșॸইইǦǦșঀǩȅΛƺঀǠȅΚইǾǓǏǩljƺǩǏইȒǹƺǿșে ȒȖȅǠȖƺǾșইǟǓǓেșǓȖΚǩljǓইǦǓƺǹȠǦেǩǿșȣȖƺǿljǓেȒȖǓǾǩȣǾে ȒƺΡǾǓǿȠেȒȖȅǠȖƺǾ /2XXXǦȅǿǓॸࢹࢹࢹেࢴࢵࢷেࢺࢶࢷࢳ KANSAS – Medicaid vǓLjșǩȠǓॸǦȠȠȒșॸইইΛΛΛঀǷƺǿljƺȖǓঀǷșঀǠȅΚ XǦȅǿǓॸࢹࢱࢱেࢸࢺࢳেࢵࢹࢹࢵ /2XXXǦȅǿǓॸࢹࢱࢱেࢺࢷࢸেࢵࢷࢷࢱ

13 ©2025 United Benefit Advisors, LLC. All rights reserved. KENTUCKY – Medicaid ?ǓǿȠȣljǷΡ2ǿȠǓǠȖƺȠǓǏ/ǓƺǹȠǦ2ǿșȣȖƺǿljǓXȖǓǾǩȣǾ XƺΡǾǓǿȠXȖȅǠȖƺǾশ?2ে/2XXষvǓLjșǩȠǓॸ ǦȠȠȒșॸইইljǦǟșঀǷΡঀǠȅΚইƺǠǓǿljǩǓșইǏǾșইǾǓǾLjǓȖইXƺǠǓșই ǷǩǦǩȒȒঀƺșȒΠ XǦȅǿǓॸࢹࢶࢶেࢵࢶࢺেࢷࢴࢳࢹ Ǿƺǩǹॸ?2/2XXঀX[K([E૬ǷΡঀǠȅΚ ?/2XvǓLjșǩȠǓॸǦȠȠȒॸইইǷΡǿǓljȠঀǷΡঀǠȅΚ XǦȅǿǓॸࢹࢸࢸেࢶࢳࢵেࢵࢸࢲࢹ ?ǓǿȠȣljǷΡEǓǏǩljƺǩǏvǓLjșǩȠǓॸ ǦȠȠȒșॸইইΛΛΛঀljǦǟșঀǷΡঀǠȅΚইƺǠǓǿljǩǓșইǏǾș LOUISIANA – Medicaid vǓLjșǩȠǓॸǦȠȠȒșॸইইǹǏǦঀǹƺঀǠȅΚইǾǩljȖȅșǩȠǓইࢲȅȖ ǦȠȠȒșॸইইǹǏǦঀǹƺঀǠȅΚইǹƺǦǩȒȒ XǦȅǿǓॸࢹࢹࢹেࢴࢵࢳেࢷࢳࢱࢸশEǓǏǩljƺǩǏǦȅȠǹǩǿǓষȅȖ ࢹࢶࢶেࢷࢲࢹেࢶࢵࢹࢹশ@ƺ/2XXষ MAINE – Medicaid ǿȖȅǹǹǾǓǿȠvǓLjșǩȠǓॸ ǦȠȠȒșॸইইΛΛΛঀǾΡǾƺǩǿǓljȅǿǿǓljȠǩȅǿঀǠȅΚইLjǓǿǓǟǩȠșইșই ঁ ǹƺǿǠȣƺǠǓ઀Ǔǿউh^  XǦȅǿǓॸࢹࢱࢱেࢵࢵࢳেࢷࢱࢱࢴ ee|ॸEƺǩǿǓȖǓǹƺΡࢸࢲࢲ XȖǩΚƺȠǓ/ǓƺǹȠǦ2ǿșȣȖƺǿljǓXȖǓǾǩȣǾvǓLjȒƺǠǓॸ ǦȠȠȒșॸইইΛΛΛঀǾƺǩǿǓঀǠȅΚইǏǦǦșইȅǟǩইƺȒȒǹǩljƺȠǩȅǿșে ǟȅȖǾș XǦȅǿǓॸࢹࢱࢱেࢺࢸࢸেࢷࢸࢵࢱ ee|ॸEƺǩǿǓȖǓǹƺΡࢸࢲࢲ MASSACHUSETTS – Medicaid and CHIP vǓLjșǩȠǓॸǦȠȠȒșॸইইΛΛΛঀǾƺșșঀǠȅΚইǩǿǟȅে ǏǓȠƺǩǹșইǾƺșșǦǓƺǹȠǦেȒȖǓǾǩȣǾেƺșșǩșȠƺǿljǓেȒƺ XǦȅǿǓॸࢹࢱࢱেࢹࢷࢳেࢵࢹࢵࢱ ee|ॸࢸࢸࢲ ǾƺǩǹॸǾƺșșȒȖǓǾƺșșǩșȠƺǿljǓ૬ƺljljǓǿȠȣȖǓঀljȅǾ MINNESOTA – Medicaid vǓLjșǩȠǓॸ ǦȠȠȒșॸইইǾǿঀǠȅΚইǏǦșইǦǓƺǹȠǦেljƺȖǓেljȅΚǓȖƺǠǓ XǦȅǿǓॸࢹࢱࢱেࢷࢶࢸেࢴࢷࢸࢳ  MISSOURI – Medicaid vǓLjșǩȠǓॸǦȠȠȒșॸইইǾΡǏșșঀǾȅঀǠȅΚইǾǦǏইǦǓƺǹȠǦljƺȖǓ XǦȅǿǓॸࢶࢸࢴেࢸࢶࢲেࢳࢱࢱࢶ MONTANA – Medicaid vǓLjșǩȠǓॸ ǦȠȠȒॸইইǏȒǦǦșঀǾȠঀǠȅΚইEȅǿȠƺǿƺ/ǓƺǹȠǦljƺȖǓXȖȅǠȖƺǾ șই/2XX XǦȅǿǓॸࢹࢱࢱেࢷࢺࢵেࢴࢱࢹࢵ Ǿƺǩǹॸ//^/2XXXȖȅǠȖƺǾ૬ǾȠঀǠȅΚ NEBRASKA – Medicaid vǓLjșǩȠǓॸ ǦȠȠȒșॸইইǏǦǦșঀǿǓঀǠȅΚইȒƺǠǓșইƺljljǓșșǿǓLjȖƺșǷƺঀƺșȒΠ XǦȅǿǓॸࢹࢶࢶেࢷࢴࢳেࢸࢷࢴࢴ @ǩǿljȅǹǿॸࢵࢱࢳেࢵࢸࢴেࢸࢱࢱࢱ KǾƺǦƺॸࢵࢱࢳেࢶࢺࢶেࢲࢲࢸࢹ NEVADA – Medicaid EǓǏǩljƺǩǏvǓLjșǩȠǓॸǦȠȠȒșॸইইΛΛΛঀǾǓǏǩljƺǩǏঀǿΚঀǠȅΚ EǓǏǩljƺǩǏXǦȅǿǓॸࢹࢱࢱেࢺࢺࢳেࢱࢺࢱࢱ NEW HAMPSHIRE – Medicaid vǓLjșǩȠǓॸǦȠȠȒșॸইইΛΛΛঀǏǦǦșঀǿǦঀǠȅΚইȒȖȅǠȖƺǾșে șǓȖΚǩljǓșইǾǓǏǩljƺǩǏইǦǓƺǹȠǦেǩǿșȣȖƺǿljǓেȒȖǓǾǩȣǾে ȒȖȅǠȖƺǾ XǦȅǿǓॸࢷࢱࢴেࢳࢸࢲেࢶࢳࢲࢹ eȅǹǹǟȖǓǓǿȣǾLjǓȖǟȅȖȠǦǓ/2XXȒȖȅǠȖƺǾॸ ࢹࢱࢱেࢹࢶࢳেࢴࢴࢵࢶॹǓΠȠঀࢲࢶࢳࢲࢹ Ǿƺǩǹॸ//^ঀeǦǩȖǏXƺȖȠΡ@ǩƺLjǩ૬ǏǦǦșঀǿǦঀǠȅΚ NEW JERSEY – Medicaid and CHIP EǓǏǩljƺǩǏvǓLjșǩȠǓॸ ǦȠȠȒॸইইΛΛΛঀșȠƺȠǓঀǿǴঀȣșইǦȣǾƺǿșǓȖΚǩljǓșইǏǾƺǦșইljǹǩǓ ǿȠșইǾǓǏǩljƺǩǏ XǦȅǿǓॸࢹࢱࢱেࢴࢶࢷেࢲࢶࢷࢲ /2XXȖǓǾǩȣǾșșǩșȠƺǿljǓXǦȅǿǓॸࢷࢱࢺেࢷࢴࢲেࢳࢴࢺࢳ /2XvǓLjșǩȠǓॸǦȠȠȒॸইইΛΛΛঀǿǴǟƺǾǩǹΡljƺȖǓঀȅȖǠ /2XXǦȅǿǓॸࢹࢱࢱেࢸࢱࢲেࢱࢸࢲࢱশee|ॸࢸࢲࢲষ NEW YORK – Medicaid vǓLjșǩȠǓॸ https://www.health.ny.gov/health_care/medicaid/  XǦȅǿǓॸࢹࢱࢱেࢶࢵࢲেࢳࢹࢴࢲ

14 ©2025 United Benefit Advisors, LLC. All rights reserved. NORTH CAROLINA – Medicaid vǓLjșǩȠǓॸǦȠȠȒșॸইইǾǓǏǩljƺǩǏঀǿljǏǦǦșঀǠȅΚ XǦȅǿǓॸࢺࢲࢺেࢹࢶࢶেࢵࢲࢱࢱ NORTH DAKOTA – Medicaid vǓLjșǩȠǓॸǦȠȠȒșॸইইΛΛΛঀǦǦșঀǿǏঀǠȅΚইǦǓƺǹȠǦljƺȖǓ XǦȅǿǓॸࢹࢵࢵেࢹࢶࢵেࢵࢹࢳࢶ OKLAHOMA – Medicaid and CHIP vǓLjșǩȠǓॸ ǦȠȠȒșॸইইȅǷǹƺǦȅǾƺঀǠȅΚইȅǦljƺইǩǿșȣȖǓȅǷǹƺǦȅǾƺঀǦȠǾǹ XǦȅǿǓॸࢹࢹࢹেࢴࢷࢶেࢴࢸࢵࢳ OREGON – Medicaid vǓLjșǩȠǓॸǦȠȠȒॸইইǦǓƺǹȠǦljƺȖǓঀȅȖǓǠȅǿঀǠȅΚ XǦȅǿǓॸࢹࢱࢱেࢷࢺࢺেࢺࢱࢸࢶ PENNSYLVANIA – Medicaid and CHIP vǓLjșǩȠǓॸ ǦȠȠȒșॸইইΛΛΛঀȒƺঀǠȅΚইǓǿইșǓȖΚǩljǓșইǏǦșইƺȒȒǹΡেǟȅȖে ǾǓǏǩljƺǩǏেǦǓƺǹȠǦেǩǿșȣȖƺǿljǓেȒȖǓǾǩȣǾেȒƺΡǾǓǿȠে ȒȖȅǠȖƺǾেǦǩȒȒঀǦȠǾǹ XǦȅǿǓॸࢹࢱࢱেࢷࢺࢳেࢸࢵࢷࢳ /2XvǓLjșǩȠǓॸ ǦȠȠȒșॸইইΛΛΛঀȒƺঀǠȅΚইƺǠǓǿljǩǓșইǏǦșইȖǓșȅȣȖljǓșইljǦǩȒ /2XXǦȅǿǓॸࢹࢱࢱেࢺࢹࢷে?2^শࢶࢵࢴࢸষ RHODE ISLAND – Medicaid and CHIP vǓLjșǩȠǓॸǦȠȠȒșॸইইǓȅǦǦșঀȖǩঀǠȅΚই XǦȅǿǓॸࢹࢶࢶেࢷࢺࢸেࢵࢴࢵࢸॹȅȖࢵࢱࢲেࢵࢷࢳেࢱࢴࢲࢲ শǩȖǓljȠ[2ȠǓ^ǦƺȖǓ@ǩǿǓষ SOUTH CAROLINA – Medicaid vǓLjșǩȠǓॸǦȠȠȒșॸইইΛΛΛঀșljǏǦǦșঀǠȅΚ XǦȅǿǓॸࢹࢹࢹেࢶࢵࢺেࢱࢹࢳࢱ SOUTH DAKOTA – Medicaid vǓLjșǩȠǓॸǦȠȠȒșॸইইǏșșঀșǏঀǠȅΚ XǦȅǿǓॸࢹࢹࢹেࢹࢳࢹেࢱࢱࢶࢺ TEXAS – Medicaid vǓLjșǩȠǓॸ ǦȠȠȒșॸইইΛΛΛঀǦǦșঀȠǓΠƺșঀǠȅΚইșǓȖΚǩljǓșইǟǩǿƺǿljǩƺǹইǦǓƺǹȠ ǦেǩǿșȣȖƺǿljǓেȒȖǓǾǩȣǾেȒƺΡǾǓǿȠেǦǩȒȒেȒȖȅǠȖƺǾ XǦȅǿǓॸࢹࢱࢱেࢵࢵࢱেࢱࢵࢺࢴ UTAH – Medicaid and CHIP hȠƺǦঢ়șXȖǓǾǩȣǾXƺȖȠǿǓȖșǦǩȒǟȅȖ/ǓƺǹȠǦ2ǿșȣȖƺǿljǓ শhXXষvǓLjșǩȠǓॸǦȠȠȒșॸইইǾǓǏǩljƺǩǏঀȣȠƺǦঀǠȅΚইȣȒȒই ǾƺǩǹॸȣȒȒ૬ȣȠƺǦঀǠȅΚ XǦȅǿǓॸࢹࢹࢹেࢳࢳࢳেࢳࢶࢵࢳ ǏȣǹȠΠȒƺǿșǩȅǿvǓLjșǩȠǓॸ ǦȠȠȒșॸইইǾǓǏǩljƺǩǏঀȣȠƺǦঀǠȅΚইǓΠȒƺǿșǩȅǿই hȠƺǦEǓǏǩljƺǩǏȣΡȅȣȠXȖȅǠȖƺǾvǓLjșǩȠǓॸ ǦȠȠȒșॸইইǾǓǏǩljƺǩǏঀȣȠƺǦঀǠȅΚইLjȣΡȅȣȠেȒȖȅǠȖƺǾই /2XvǓLjșǩȠǓॸǦȠȠȒșॸইইljǦǩȒঀȣȠƺǦঀǠȅΚই VERMONT– Medicaid /ǓƺǹȠǦ2ǿșȣȖƺǿljǓXȖǓǾǩȣǾXƺΡǾǓǿȠশ/2XXষ XȖȅǠȖƺǾ ~ ǓȒƺȖȠǾǓǿȠȅǟtǓȖǾȅǿȠ/ǓƺǹȠǦljljǓșș vǓLjșǩȠǓॸ ǦȠȠȒșॸইইǏΚǦƺঀΚǓȖǾȅǿȠঀǠȅΚইǾǓǾLjǓȖșইǾǓǏǩljƺǩǏইǦǩȒ ȒেȒȖȅǠȖƺǾ XǦȅǿǓॸࢹࢱࢱেࢳࢶࢱেࢹࢵࢳࢸ VIRGINIA – Medicaid and CHIP vǓLjșǩȠǓॸ ǦȠȠȒșॸইইljȅΚǓȖΚƺঀǏǾƺșঀΚǩȖǠǩǿǩƺঀǠȅΚইǹǓƺȖǿইȒȖǓǾǩȣǾে ƺșșǩșȠƺǿljǓইǟƺǾǩșেșǓǹǓljȠ ǦȠȠȒșॸইইljȅΚǓȖΚƺঀǏǾƺșঀΚǩȖǠǩǿǩƺঀǠȅΚইǹǓƺȖǿইȒȖǓǾǩȣǾে ƺșșǩșȠƺǿljǓইǦǓƺǹȠǦেǩǿșȣȖƺǿljǓেȒȖǓǾǩȣǾেȒƺΡǾǓǿȠে ǦǩȒȒেȒȖȅǠȖƺǾș EǓǏǩljƺǩǏই/2XXǦȅǿǓॸࢹࢱࢱেࢵࢴࢳেࢶࢺࢳࢵ WASHINGTON – Medicaid vǓLjșǩȠǓॸǦȠȠȒșॸইইΛΛΛঀǦljƺঀΛƺঀǠȅΚ XǦȅǿǓॸࢹࢱࢱেࢶࢷࢳেࢴࢱࢳࢳ WEST VIRGINIA – Medicaid and CHIP vǓLjșǩȠǓॸǦȠȠȒșॸইইǏǦǦȖঀΛΚঀǠȅΚইLjǾș ǦȠȠȒॸইইǾΡΛΚǦǩȒȒঀljȅǾ EǓǏǩljƺǩǏXǦȅǿǓॸࢴࢱࢵেࢶࢶࢹেࢲࢸࢱࢱ /2XeȅǹǹেǟȖǓǓȒǦȅǿǓॸࢹࢶࢶেEΡvt/2XX শࢹࢶࢶেࢷࢺࢺেࢹࢵࢵࢸষ

15 ©2025 United Benefit Advisors, LLC. All rights reserved. WISCONSIN – Medicaid and CHIP vǓLjșǩȠǓॸ ǦȠȠȒșॸইইΛΛΛঀǏǦșঀΛǩșljȅǿșǩǿঀǠȅΚইǾǓǏǩljƺǩǏইǩǿǏǓΠঀǦ ȠǾ XǦȅǿǓॸࢹࢱࢱেࢴࢷࢳেࢴࢱࢱࢳ WYOMING – Medicaid vǓLjșǩȠǓॸ ǦȠȠȒșॸইইǦǓƺǹȠǦঀΛΡȅঀǠȅΚইǦǓƺǹȠǦljƺȖǓǟǩǿইǾǓǏǩljƺǩǏইȒȖ ȅǠȖƺǾșেƺǿǏেǓǹǩǠǩLjǩǹǩȠΡ XǦȅǿǓॸࢹࢱࢱেࢳࢶࢲেࢲࢳࢷࢺ  eȅșǓǓǩǟƺǿΡȅȠǦǓȖșȠƺȠǓșǦƺΚǓƺǏǏǓǏƺȒȖǓǾǩȣǾƺșșǩșȠƺǿljǓȒȖȅǠȖƺǾșǩǿljǓ=ȣǹΡࢴࢲॹࢳࢱࢳࢵॹȅȖǟȅȖǾȅȖǓǩǿǟȅȖǾƺȠǩȅǿ ȅǿșȒǓljǩƺǹǓǿȖȅǹǹǾǓǿȠȖǩǠǦȠșॹljȅǿȠƺljȠǓǩȠǦǓȖॸ hঀ^ঀǓȒƺȖȠǾǓǿȠȅǟ@ƺLjȅȖ ǾȒǹȅΡǓǓǓǿǓǟǩȠș^ǓljȣȖǩȠΡǏǾǩǿǩșȠȖƺȠǩȅǿ ΛΛΛঀǏȅǹঀǠȅΚইƺǠǓǿljǩǓșইǓLjșƺ ࢲেࢹࢷࢷেࢵࢵࢵে^শࢴࢳࢸࢳষ hঀ^ঀǓȒƺȖȠǾǓǿȠȅǟ/ǓƺǹȠǦƺǿǏ/ȣǾƺǿ^ǓȖΚǩljǓș ǓǿȠǓȖșǟȅȖEǓǏǩljƺȖǓ૭EǓǏǩljƺǩǏ^ǓȖΚǩljǓș ΛΛΛঀljǾșঀǦǦșঀǠȅΚ ࢲেࢹࢸࢸেࢳࢷࢸেࢳࢴࢳࢴॹEǓǿȣKȒȠǩȅǿࢵॹΠȠঀࢷࢲࢶࢷࢶ  XƺȒǓȖΛȅȖǷ[ǓǏȣljȠǩȅǿljȠ^ȠƺȠǓǾǓǿȠ ljljȅȖǏǩǿǠȠȅȠǦǓXƺȒǓȖΛȅȖǷ[ǓǏȣljȠǩȅǿljȠȅǟࢲࢺࢺࢶশXȣLjঀ@ঀࢲࢱࢵেࢲࢴষশX[ষॹǿȅȒǓȖșȅǿșƺȖǓȖǓȕȣǩȖǓǏȠȅȖǓșȒȅǿǏȠȅƺljȅǹǹǓljȠǩȅǿȅǟ ǩǿǟȅȖǾƺȠǩȅǿȣǿǹǓșșșȣljǦljȅǹǹǓljȠǩȅǿǏǩșȒǹƺΡșƺΚƺǹǩǏKǟǟǩljǓȅǟEƺǿƺǠǓǾǓǿȠƺǿǏȣǏǠǓȠশKEষljȅǿȠȖȅǹǿȣǾLjǓȖঀeǦǓǓȒƺȖȠǾǓǿȠǿȅȠǓș ȠǦƺȠƺǟǓǏǓȖƺǹƺǠǓǿljΡljƺǿǿȅȠljȅǿǏȣljȠȅȖșȒȅǿșȅȖƺljȅǹǹǓljȠǩȅǿȅǟǩǿǟȅȖǾƺȠǩȅǿȣǿǹǓșșǩȠǩșƺȒȒȖȅΚǓǏLjΡKEȣǿǏǓȖȠǦǓX[ॹƺǿǏǏǩșȒǹƺΡșƺ ljȣȖȖǓǿȠǹΡΚƺǹǩǏKEljȅǿȠȖȅǹǿȣǾLjǓȖॹƺǿǏȠǦǓȒȣLjǹǩljǩșǿȅȠȖǓȕȣǩȖǓǏȠȅȖǓșȒȅǿǏȠȅƺljȅǹǹǓljȠǩȅǿȅǟǩǿǟȅȖǾƺȠǩȅǿȣǿǹǓșșǩȠǏǩșȒǹƺΡșƺ ljȣȖȖǓǿȠǹΡΚƺǹǩǏKEljȅǿȠȖȅǹǿȣǾLjǓȖঀ^ǓǓࢵࢵhঀ^ঀঀࢴࢶࢱࢸঀǹșȅॹǿȅȠΛǩȠǦșȠƺǿǏǩǿǠƺǿΡȅȠǦǓȖȒȖȅΚǩșǩȅǿșȅǟǹƺΛॹǿȅȒǓȖșȅǿșǦƺǹǹLjǓșȣLjǴǓljȠ ȠȅȒǓǿƺǹȠΡǟȅȖǟƺǩǹǩǿǠȠȅljȅǾȒǹΡΛǩȠǦƺljȅǹǹǓljȠǩȅǿȅǟǩǿǟȅȖǾƺȠǩȅǿǩǟȠǦǓljȅǹǹǓljȠǩȅǿȅǟǩǿǟȅȖǾƺȠǩȅǿǏȅǓșǿȅȠǏǩșȒǹƺΡƺljȣȖȖǓǿȠǹΡΚƺǹǩǏKE ljȅǿȠȖȅǹǿȣǾLjǓȖঀ^ǓǓࢵࢵhঀ^ঀঀࢴࢶࢲࢳঀ eǦǓȒȣLjǹǩljȖǓȒȅȖȠǩǿǠLjȣȖǏǓǿǟȅȖȠǦǩșljȅǹǹǓljȠǩȅǿȅǟǩǿǟȅȖǾƺȠǩȅǿǩșǓșȠǩǾƺȠǓǏȠȅƺΚǓȖƺǠǓƺȒȒȖȅΠǩǾƺȠǓǹΡșǓΚǓǿǾǩǿȣȠǓșȒǓȖȖǓșȒȅǿǏǓǿȠঀ 2ǿȠǓȖǓșȠǓǏȒƺȖȠǩǓșƺȖǓǓǿljȅȣȖƺǠǓǏȠȅșǓǿǏljȅǾǾǓǿȠșȖǓǠƺȖǏǩǿǠȠǦǓLjȣȖǏǓǿǓșȠǩǾƺȠǓȅȖƺǿΡȅȠǦǓȖƺșȒǓljȠȅǟȠǦǩșljȅǹǹǓljȠǩȅǿȅǟǩǿǟȅȖǾƺȠǩȅǿॹ ǩǿljǹȣǏǩǿǠșȣǠǠǓșȠǩȅǿșǟȅȖȖǓǏȣljǩǿǠȠǦǩșLjȣȖǏǓǿॹȠȅȠǦǓhঀ^ঀǓȒƺȖȠǾǓǿȠȅǟ@ƺLjȅȖॹǾȒǹȅΡǓǓǓǿǓǟǩȠș^ǓljȣȖǩȠΡǏǾǩǿǩșȠȖƺȠǩȅǿॹKǟǟǩljǓȅǟ XȅǹǩljΡƺǿǏ[ǓșǓƺȖljǦॹȠȠǓǿȠǩȅǿॸX[ǹǓƺȖƺǿljǓKǟǟǩljǓȖॹࢳࢱࢱȅǿșȠǩȠȣȠǩȅǿΚǓǿȣǓॹFঀvঀॹ[ȅȅǾFেࢶࢸࢲࢹॹvƺșǦǩǿǠȠȅǿॹࢳࢱࢳࢲࢱȅȖ ǓǾƺǩǹǓLjșƺঀȅȒȖ૬ǏȅǹঀǠȅΚƺǿǏȖǓǟǓȖǓǿljǓȠǦǓKEȅǿȠȖȅǹFȣǾLjǓȖࢲࢳࢲࢱেࢱࢲࢴࢸঀ KEȅǿȠȖȅǹFȣǾLjǓȖࢲࢳࢲࢱেࢱࢲࢴࢸশǓΠȒǩȖǓșࢲইࢴࢲইࢳࢱࢳࢷষ  

16 ©2024 United Benefit Advisors, LLC. All rights reserved. HIPAA Notice of Privacy Practices The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires that we maintain the privacy of protected health information, give notice of our legal duties and privacy practices regarding health information about you and follow the terms of our notice currently in effect. If not attached to this document, you may request a copy of the current Privacy Practices, explaining how medical information about you may be used and disclosed and how you can get access to this information. As Required by Law . We will disclose Health Information when required to do so by international, federal, state, or local law. You have the right to: x Inspect and copy records x Receive an electronic copy of electronic medical records x Get notice of a breach x Amend records x Receive an accounting of disclosures x Request restrictions x Request confidential communications x Receive a paper copy of this notice x File a complaint if you believe your privacy rights have been violated Your Information. Your Rights. Our Responsibilities. This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. Your Rights When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. Get a copy of health and claims records x You can ask to see or get a copy of your health and claims records and other health information we have about you. Ask us how to do this. x We will provide a copy or a summary of your health and claims records, usually within 30 days of your request. We may charge a reasonable, cost-based fee. Ask us to correct health and claims records x You can ask us to correct your health and claims records if you think they are incorrect or incomplete. x We may say “no” to your request, but we’ll tell you why in writing within 60 days.

17 ©2024 United Benefit Advisors, LLC. All rights reserved. Request confidential communications x You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. x We will consider all reasonable requests, and must say “yes” if you tell us you would be in danger if we do not. Ask us to limit what we use or share x You can ask us not to use or share certain health information for treatment, payment, or our operations. x We are not required to agree to your request, and we may say “no” if it would affect your care. Get a list of those with whom we’ve shared information x You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. x We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months. Get a copy of this privacy notice You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly. Choose someone to act for you x If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. x We will make sure the person has this authority and can act for you before we take any action. File a complaint if you feel your rights are violated x You can complain if you feel we have violated your rights by contacting us using the information on page 1. x You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting https://www.hhs.gov/hipaa/filing-a-complaint/what-to- expect/index.html. x We will not retaliate against you for filing a complaint. Your Choices For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

18 ©2024 United Benefit Advisors, LLC. All rights reserved. In these cases, you have both the right and choice to tell us to: x Share information with your family, close friends, or others involved in payment for your car x Share information in a disaster relief situation If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. In these cases, we never share your information unless you give us written permission: x Marketing purposes x Sale of your information Our Uses and Disclosures How do we typically use or share your health information? We typically use or share your health information in the following ways. Help manage the health care treatment you receive We can use your health information and share it with professionals who are treating you. Example: A doctor sends us information about your diagnosis and treatment plan so we can arrange additional services. Run our organization We can use and disclose your information to run our organization and contact you when necessary. We are not allowed to use genetic information to decide whether we will give you coverage and the price of that coverage. This does not apply to long term care plans. Example: We use health information about you to develop better services for you. Pay for your health services We can use and disclose your health information as we pay for your health services. Example: We share information about you with your dental plan to coordinate payment for your dental work.

19 ©2024 United Benefit Advisors, LLC. All rights reserved. Administer your plan We may disclose your health information to your health plan sponsor for plan administration. Example: Your company contracts with us to provide a health plan, and we provide your company with certain statistics to explain the premiums we charge. How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html. Help with public health and safety issues We can share health information about you for certain situations such as: x Preventing disease x Helping with product recalls x Reporting adverse reactions to medications x Reporting suspected abuse, neglect, or domestic violence x Preventing or reducing a serious threat to anyone’s health or safety Do research We can use or share your information for health research. Comply with the law We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law. Respond to organ and tissue donation requests and work with a medical examiner or funeral director x We can share health information about you with organ procurement organizations. x We can share health information with a coroner, medical examiner, or funeral director when an individual dies. Address workers’ compensation, law enforcement, and other government requests We can use or share health information about you: x For workers’ compensation claims x For law enforcement purposes or with a law enforcement official x With health oversight agencies for activities authorized by law x For special government functions such as military, national security, and presidential protective services Respond to lawsuits and legal actions We can share health information about you in response to a court or administrative order, or a subpoena.

20 ©2024 United Benefit Advisors, LLC. All rights reserved. Our Responsibilities x We are required by law to maintain the privacy and security of your protected health information. x We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. x We must follow the duties and privacy practices described in this notice and give you a copy of it. x We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. For more information see: www.hhs.gov/hipaa/for-individuals/notice-privacy-practices/index.html. Changes to the Terms of this Notice We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, on our web site, and we will mail a copy to you.

21 ©2024 United Benefit Advisors, LLC. All rights reserved. Additional Notices for New Enrollees Notice of Special Enrollment Rights If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must request enrollment within “30 days” after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within “30 days” after the marriage, birth, adoption, or placement for adoption. To request special enrollment or obtain more information, contact: Name of Entity/Sender ° Contact ° ° Phone Number Snellings Walters Brannon Johnston 770-508-3005

22 ©2024 United Benefit Advisors, LLC. All rights reserved. Continuation Coverage Rights Under COBRA Introduction You’re getting this notice because you recently gained coverage under a group health plan (the Plan). This notice has important information about your right to COBRA continuation coverage, which is a temporary extension of coverage under the Plan. This notice explains COBRA continuation coverage, when it may become available to you and your family, and what you need to do to protect your right to get it. When you become eligible for COBRA, you may also become eligible for other coverage options that may cost less than COBRA continuation coverage. The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you and other members of your family when group health coverage would otherwise end. For more information about your rights and obligations under the Plan and under federal law, you should review the Plan’s Summary Plan Description or contact the Plan Administrator. You may have other options available to you when you lose group health coverage. For example, you may be eligible to buy an individual plan through the Health Insurance Marketplace. By enrolling in coverage through the Marketplace, you may qualify for lower costs on your monthly premiums and lower out-of-pocket costs. Additionally, you may qualify for a 30-day special enrollment period for another group health plan for which you are eligible (such as a spouse’s plan), even if that plan generally doesn’t accept late enrollees. What is COBRA continuation coverage? COBRA continuation coverage is a continuation of Plan coverage when it would otherwise end because of a life event. This is also called a “qualifying event.” Specific qualifying events are listed later in this notice. After a qualifying event, COBRA continuation coverage must be offered to each person who is a “qualified beneficiary.” You, your spouse, and your dependent children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event. Under the Plan, qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage. If you’re an employee, you’ll become a qualified beneficiary if you lose your coverage under the Plan because of the following qualifying events: x Your hours of employment are reduced, or x Your employment ends for any reason other than your gross misconduct.

23 ©2024 United Benefit Advisors, LLC. All rights reserved. If you’re the spouse of an employee, you’ll become a qualified beneficiary if you lose your coverage under the Plan because of the following qualifying events: x Your spouse dies x Your spouse’s hours of employment are reduced x Your spouse’s employment ends for any reason other than his or her gross misconduct x Your spouse becomes entitled to Medicare benefits (under Part A, Part B, or both) x You become divorced or legally separated from your spouse Your dependent children will become qualified beneficiaries if they lose coverage under the Plan because of the following qualifying events: x The parent-employee dies x The parent-employee’s hours of employment are reduced x The parent-employee’s employment ends for any reason other than his or her gross misconduct x The parent-employee becomes entitled to Medicare benefits (Part A, Part B, or both) x The parents become divorced or legally separated x The child stops being eligible for coverage under the Plan as a “dependent child” When is COBRA continuation coverage available? The Plan will offer COBRA continuation coverage to qualified beneficiaries only after the Plan Administrator has been notified that a qualifying event has occurred. The employer must notify the Plan Administrator of the following qualifying events: x The end of employment or reduction of hours of employment x Death of the employee x The employee’s becoming entitled to Medicare benefits (under Part A, Part B, or both) For all other qualifying events (divorce or legal separation of the employee and spouse or a dependent child’s losing eligibility for coverage as a dependent child), you must notify the Plan Administrator within 60 days the qualifying event occurs. You must provide this notice to: Snellings Walters General Contact – Brannon Johnston. How is COBRA continuation coverage provided? Once the Plan Administrator receives notice that a qualifying event has occurred, COBRA continuation coverage will be offered to each of the qualified beneficiaries. Each qualified beneficiary will have an independent right to elect COBRA continuation coverage. Covered employees may elect COBRA continuation coverage on behalf of their spouses, and parents may elect COBRA continuation coverage on behalf of their children. COBRA continuation coverage is a temporary continuation of coverage that generally lasts for 18 months due to employment termination or reduction of hours of work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit a beneficiary to receive a maximum of 36 months of coverage. There are also ways in which this 18-month period of COBRA continuation coverage can be extended.

24 ©2024 United Benefit Advisors, LLC. All rights reserved. Disability extension of 18-month period of COBRA continuation coverage If you or anyone in your family covered under the Plan is determined by Social Security to be disabled and you notify the Plan Administrator in a timely fashion, you and your entire family may be entitled to get up to an additional 11 months of COBRA continuation coverage, for a maximum of 29 months. The disability would have to have started at some time before the 60th day of COBRA continuation coverage and must last at least until the end of the 18-month period of COBRA continuation coverage. Second qualifying event extension of 18-month period of continuation coverage If your family experiences another qualifying event during the 18 months of COBRA continuation coverage, the spouse and dependent children in your family can get up to 18 additional months of COBRA continuation coverage, for a maximum of 36 months, if the Plan is properly notified about the second qualifying event. This extension may be available to the spouse and any dependent children getting COBRA continuation coverage if the employee or former employee dies; becomes entitled to Medicare benefits (under Part A, Part B, or both); gets divorced or legally separated; or if the dependent child stops being eligible under the Plan as a dependent child. This extension is only available if the second qualifying event would have caused the spouse or dependent child to lose coverage under the Plan had the first qualifying event not occurred. Are there other coverage options besides COBRA continuation coverage? Yes. Instead of enrolling in COBRA continuation coverage, there may be other coverage options for you and your family through the Health Insurance Marketplace, Medicaid, Children’s Health Insurance Program (CHIP), or other group health plan coverage options (such as a spouse’s plan) through what is called a “special enrollment period.” Some of these options may cost less than COBRA continuation coverage. You can learn more about many of these options at www.healthcare.gov. Can I enroll in Medicare instead of COBRA continuation coverage after my group health plan coverage ends? In general, if you don’t enroll in Medicare Part A or B when you are first eligible because you are still employed, after the Medicare initial enrollment period, you have an eight-month special enrollment period to sign up for Medicare Part A or B, beginning on the earlier of x The month after your employment ends; or x The month after group health plan coverage based on current employment ends. If you don’t enroll in Medicare and elect COBRA continuation coverage instead, you may have to pay a Part B late enrollment penalty and you may have a gap in coverage if you decide you want Part B later. If you elect COBRA continuation coverage and later enroll in Medicare Part A or B before the COBRA continuation coverage ends, the Plan may terminate your continuation coverage. However, if Medicare Part A or B is effective on or before the date of the COBRA election, COBRA coverage may not be discontinued on account of Medicare entitlement, even if you enroll in the other part of Medicare after the date of the election of COBRA coverage.

25 ©2024 United Benefit Advisors, LLC. All rights reserved. If you are enrolled in both COBRA continuation coverage and Medicare, Medicare will generally pay first (primary payer) and COBRA continuation coverage will pay second. Certain plans may pay as if secondary to Medicare, even if you are not enrolled in Medicare. For more information visit https://www.medicare.gov/medicare-and-you. If you have questions Questions concerning your Plan or your COBRA continuation coverage rights should be addressed to the contact or contacts identified below. For more information about your rights under the Employee Retirement Income Security Act (ERISA), including COBRA, the Patient Protection and Affordable Care Act, and other laws affecting group health plans, contact the nearest Regional or District Office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) in your area or visit www.dol.gov/agencies/ebsa. (Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA’s website.) For more information about the Marketplace, visit www.HealthCare.gov. Keep your Plan informed of address changes To protect your family’s rights, let the Plan Administrator know about any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator. Plan contact information Name of Entity/Sender ° Contact ° ° Phone Number Snellings Walters Brannon Johnston 770-508-3005

26 ©2024 United Benefit Advisors, LLC. All rights reserved. For the Department of Labor’s Employer Exchange/Marketplace Notices and Instructions, visit: http://www.datair.com/PDF/DOL Employer Exchange Notices.pdf Health Insurance Marketplace Coverage Options and Your Health Coverage ° For Employers that Offer a Health Plan to Some or All Employees PART A: General Information Even if you are offered health coverage through your employment, you may have other coverage options through the Health Insurance Marketplace (“Marketplace”). To assist you as you evaluate options for you and your family, this notice provides some basic information about the Marketplace and health coverage offered through your employment. What is the Health Insurance Marketplace? The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers "one-stop shopping" to find and compare private health insurance options in your geographic area. Can I save money on my health insurance premiums in the Marketplace? You may qualify to save money and lower your monthly premium and other out-of-pocket costs, but only if your employer does not offer coverage, or offers coverage that is not considered affordable for you and doesn’t meet certain minimum value standards (discussed below). The savings that you're eligible for depends on your household income. You may also be eligible for a tax credit that lowers your costs. Does employment-based health coverage affect eligibility for premium savings through the Marketplace? Yes. If you have an offer of health coverage from your employer that is considered affordable and meets certain minimum value standards, you will not be eligible for a tax credit or advance payment of the tax credit, for your Marketplace coverage and may wish to enroll in your employment-based health plan. However, you may be eligible for a tax credit and advance payments of the credit that lowers your monthly premium, or a reduction in certain cost-sharing, if your employer does not offer coverage to you at all or does not offer coverage that is considered affordable for you or meet minimum value standards. If your share of the premium cost of all plans offered to you through your employment is more than 9.02% of your annual household income, or if the coverage through your employment provides does not meet the "minimum value" standard set by the Affordable Care Act, you may be eligible for a tax credit and advance payment of the credit, if you do not enroll in the employment-based health coverage. For family members of the employee, coverage is considered affordable if the employee’s cost of premiums for the lowest-cost plan that would cover all family members does not exceed 9.02% of the employee’s household income. (An employer-sponsored or other employment-based health plan meets the "minimum value standard" if the plan's share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs. For purposes of eligibility for the premium tax credit, to meet

27 ©2024 United Benefit Advisors, LLC. All rights reserved. the “minimum value standard,” the health plan must also provide substantial coverage of both inpatient hospital services and physician services.) Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered through your employment, then you may lose access to whatever the employer contributes to the employment- based coverage. Also, this employer contribution – as well as your employee contribution to employment-based coverage – is generally excluded from income for federal and state income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis. In addition, note that if the health coverage offered through your employment does not meet the affordability or minimum value standards, but you accept that coverage anyway, you will not be eligible for a tax credit. You should consider all of these factors in determining whether to purchase a health plan through the Marketplace. When can I enroll in health insurance coverage through the Marketplace? You can enroll in a Marketplace health insurance plan during the annual Marketplace Open Enrollment Period. Open Enrollment varies by state but generally starts November 1 and continues through at least December 15. Outside the annual Open Enrollment Period, you can sign up for health insurance if you qualify for a Special Enrollment Period. In general, you qualify for a Special Enrollment Period if you’ve had certain qualifying life events, such as getting married, having a baby, adopting a child, or losing eligibility for other health coverage. Depending on your Special Enrollment Period type, you may have 60 days before or 60 days following the qualifying life event to enroll in a Marketplace plan. There is also a Marketplace Special Enrollment Period for individuals and their families who lose eligibility for Medicaid or Children’s Health Insurance Program (CHIP) coverage on or after March 31, 2023, through July 31, 2024. Since the onset of the nationwide COVID-19 public health emergency, state Medicaid and CHIP agencies generally have not terminated the enrollment of any Medicaid or CHIP beneficiary who was enrolled on or after March 18, 2020, through March 31, 2023. As state Medicaid and CHIP agencies resume regular eligibility and enrollment practices, many individuals may no longer be eligible for Medicaid or CHIP coverage starting as early as March 31, 2023. The U.S. Department of Health and Human Services is offering a temporary Marketplace Special Enrollment period to allow these individuals to enroll in Marketplace coverage . Marketplace-eligible individuals who live in states served by HealthCare.gov and either submit a new application or update an existing application on HealthCare.gov between March 31, 2023, and July 31, 2024, and attest to a termination date of Medicaid or CHIP coverage within the same time period, are eligible for a 60- day Special Enrollment Period. That means that if you lose Medicaid or CHIP coverage between March 31, 2023, and July 31, 2024, you may be able to enroll in Marketplace coverage within 60 days of when you lost Medicaid or CHIP coverage. In addition, if you or your family members are enrolled in Medicaid or CHIP coverage, it is important to make sure that your contact information is up to date to make sure you get any information about changes to your eligibility. To learn more, visit HealthCare.gov or call the Marketplace Call Center at 1-800-318-2596. TTY users can call 1-855-889-4325.

28 ©2024 United Benefit Advisors, LLC. All rights reserved. What about alternatives to Marketplace Health Insurance Coverage? If you or your family are eligible for coverage in an employment-based health plan (such as an employer- sponsored health plan), you or your family may also be eligible for a Special Enrollment Period to enroll in that health plan in certain circumstances, including if you or your dependents were enrolled in Medicaid or CHIP coverage and lost that coverage. Generally, you have 60 days after the loss of Medicaid or CHIP coverage to enroll in an employment-based health plan, but if you and your family lost eligibility for Medicaid or CHIP coverage between March 31, 2023, and July 10, 2023, you can request this special enrollment in the employment-based health plan through September 8, 2023. Confirm the deadline with your employer or your employment-based health plan. Alternatively, you can enroll in Medicaid or CHIP coverage at any time by filling out an application through the Marketplace or applying directly through your state Medicaid agency. Visit https://www.healthcare.gov/medicaid-chip/getting-medicaid-chip/ for more details. How can I get more information? For more information about your coverage offered by your employer, please check your summary plan description or contact Contact Brannon Johnston Phone Number 770-508-3005 The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area. OMB No. 1210-0149 (expires 12-31-2026)

29 ©2024 United Benefit Advisors, LLC. All rights reserved. PART B: Information About Health Coverage Offered by Your Employer This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application. ͤ ͟ ͶΞΡΝΠΪΖΣ͑ΟΒΞΖͫ͑ ́ΟΖΝΝΚΟΘΤ͑ΈΒΝΥΖΣΤ ͥ ͟ ͶΞΡΝΠΪΖΣ͑ ͅΕΖΟΥΚΗΚΔΒΥΚΠΟ ͿΦΞΓΖΣ͙͑Ͷ ͅͿ͚ ͦ ͟ ͶΞΡΝΠΪΖΣ͑ΒΕΕΣΖΤΤͫ͑ ͧ ͟ ͶΞΡΝΠΪΖΣ͑ΡΙΠΟΖ͑ΟΦΞΓΖΣ ͨ ͨ ͡ ͞ ͦ ͡ ͩ ͞ ͤ ͡ ͡ ͦ ͨ ͟ ʹΚΥΪͫ͑ͲΥΝΒΟΥΒ ͩ ͟ ́ΥΒΥΖͫ͑͸Ͳ ͪ ͟ ΋ ͅ΁͑ʹΠΕΖ ͤ ͡ ͤ 2 ͩ ͢ ͡ ͟ ΈΙΠ͑ΔΒΟ͑ΨΖ͑ΔΠΟΥΒΔΥ͑ΒΓΠΦΥ͑ΖΞΡΝΠ ΪΖΖ͑ΙΖΒΝΥΙ͑ΔΠΧΖΣΒΘΖ͑ΒΥ͑ΥΙΚΤ͑ΛΠ ΓͰ͑͑ͳΣΒΟΟΠΟ͑ͻΠΙΟΤΥΠΟ ͢ ͢ ͟ ΁ΙΠΟΖ͑ΟΦΞΓΖΣ͙͑ΚΗ͑ΕΚΗΗΖΣΖΟΥ͑ΗΣΠΞ͑ΒΓΠΧΖ͚ ͢ ͣ ͟ ͶΞΒΚΝ͑ΒΕΕΣΖΤΤͫ͑ΓΛΠΙΟΤΥΠΟͱΤΟΖΝΝΚΟΘΤΨΒΝΥΖΣΤ͟ΔΠΞ Here is some basic information about health coverage offered by this employer: As your employer, we offer a health plan to: † All employees. Eligible employees are: All Full Time Employees † Some employees. Eligible employees are: With respect to dependents: † We do offer coverage. Eligible dependents are:

30 ©2024 United Benefit Advisors, LLC. All rights reserved. † We do not offer coverage. † If checked, this coverage meets the minimum value standard, and the cost of this coverage to you is intended to be affordable, based on employee wages. Even if your employer intends your coverage to be affordable, you may still be eligible for a premium discount through the Marketplace. The Marketplace will use your household income, along with other factors, to determine whether you may be eligible for a premium discount. If, for example, your wages vary from week to week (perhaps you are an hourly employee or you work on a commission basis), if you are newly employed mid- year, or if you have other income losses, you may still qualify for a premium discount. If you decide to shop for coverage in the Marketplace, HealthCare.gov will guide you through the process. Here's the employer information you'll enter when you visit HealthCare.gov to find out if you can get a tax credit to lower your monthly premiums. The information below corresponds to the Marketplace Employer Coverage Tool. Completing this section is optional for employers but will help ensure employees understand their coverage choices. 13. Is the employee currently eligible for coverage offered by this employer, or will the employee be eligible in the next 3 months? † Yes (continue) 13a. If the employee is not eligible today, including as a result of a waiting or probationary period, when is the employee eligible for coverage? __________(mm/dd/yyyy) (Continue) † No (STOP and return this form to the employee) 14. Does the employer offer a health plan that meets the minimum value standard? An employer-sponsored health plan meets the “minimum value standard” if the plan's share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs (Section 36B(c)(2)(C)(ii) of the Internal Revenue Code of 1986). † Yes (go to question 15) † No (STOP and return this form to the employee) 15. For the lowest-cost plan that meets the minimum value standard offered only to the employee (don't include family plans): If the employer has wellness programs, provide the premium that the employee would pay if the employee received the maximum discount for any tobacco cessation programs, and didn't receive any other discounts based on wellness programs. a. How much would the employee have to pay in premiums for this plan? $________________ b. How often? † Weekly † Every 2 weeks † Twice a month † Monthly † Quarterly † Yearly

31 ©2024 United Benefit Advisors, LLC. All rights reserved. If the plan year will end soon and you know that the health plans offered will change, go to question 16. If you don't know, STOP and return the form to the employee.

32 ©2024 United Benefit Advisors, LLC. All rights reserved. 16. What change will the employer make for the new plan year? __________________________ † Employer won't offer health coverage † Employer will start offering health coverage to employees or change the premium for the lowest-cost plan available only to the employee that meets the minimum value standard. (Premium should reflect the discount for wellness programs. See question 15.) a. How much would the employee have to pay in premiums for this plan? $________________ b. How often? † Weekly † Every 2 weeks † Twice a month † Monthly † Quarterly † Yearly

33 ©2024 United Benefit Advisors, LLC. All rights reserved. To comply with the No Surprises Act, group health plans and health insurance issuers offering group or individual health insurance coverage must make publicly available, post on a public website of the plan or issuer, and include on each Explanation of Benefits, information in plain language on the restrictions on balance billing in certain circumstances, any applicable state law protections against balance billing, the requirements of the Act, and information on contacting appropriate state and federal agencies to report suspected violations of these balance billing restrictions. For more information and further instructions, see https://www.cms.gov/files/document/model-disclosure- notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf. Your Rights and Protections Against Surprise Medical Bills When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance, or deductible. What is “balance billing” (sometimes called “surprise billing”)? When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network. “Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit. “Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service. You’re protected from balance billing for: Emergency services If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services. Certain services at an in-network hospital or ambulatory surgical center When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology,

34 ©2024 United Benefit Advisors, LLC. All rights reserved. assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed. If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections. You’re never required to give up your protections from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in your plan’s network. When balance billing isn’t allowed, you also have the following protections: x You’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly. x Generally, your health plan must: o Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”). o Cover emergency services by out-of-network providers. o Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits. o Count any amount you pay for emergency services or out-of-network services toward your in- network deductible and out-of-pocket limit. If you believe you’ve been wrongly billed, contact The federal phone number for information and complaints is 1-800-985-3059. Visit www.cms.gov/nosurprises/consumers for more information about your rights under federal law. Visit https://oci.georgia.gov/ for more information about your rights under Georgia law

35 ©2024 United Benefit Advisors, LLC. All rights reserved. General FMLA Notice Your Employee Rights under the Family and Medical Leave Act What is FMLA leave? The Family and Medical Leave Act (FMLA) is a federal law that provides eligible employees with job-protected leave for qualifying family and medical reasons. The U.S. Department of Labor’s Wage and Hour Division (WHD) enforces the FMLA for most employees. Eligible employees can take up to 12 workweeks of FMLA leave in a 12-month period for: x The birth, adoption or foster placement of a child with you x Your serious mental or physical health condition that makes you unable to work x To care for your spouse, child or parent with a serious mental or physical health condition x Certain qualifying reasons related to the foreign deployment of your spouse, child or parent who is a military servicemember An eligible employee who is the spouse, child, parent or next of kin of a covered servicemember with a serious injury or illness may take up to 26 workweeks of FMLA leave in a single 12-month period to care for the servicemember. You have the right to use FMLA leave in one block of time. When it is medically necessary or otherwise permitted, you may take FMLA leave intermittently in separate blocks of time, or on a reduced schedule by working less hours each day or week. Read Fact Sheet #28M(c) for more information. FMLA leave is not paid leave, but you may choose, or be required by your employer, to use any employer- provided paid leave if your employer’s paid leave policy covers the reason for which you need FMLA leave. Am I eligible to take FMLA leave? You are an eligible employee if all of the following apply: x You work for a covered employer, x You have worked for your employer at least 12 months, x You have at least 1,250 hours of service for your employer during the 12 months before your leave, and x Your employer has at least 50 employees within 75 miles of your work location. Airline flight crew employees have different “hours of service” requirements.

36 ©2024 United Benefit Advisors, LLC. All rights reserved. You work for a covered employer if one of the following applies: x You work for a private employer that had at least 50 employees during at least 20 workweeks in the current or previous calendar year x You work for an elementary or public or private secondary school x You work for a public agency, such as a local, state or federal government agency. Most federal employees are covered by Title II of the FMLA, administered by the Office of Personnel Management. How do I request FMLA leave? Generally, to request FMLA leave you must: x Follow your employer’s normal policies for requesting leave x Give notice at least 30 days before your need for FMLA leave, or x If advance notice is not possible, give notice as soon as possible. You do not have to share a medical diagnosis but must provide enough information to your employer so they can determine whether the leave qualifies for FMLA protection. You must also inform your employer if FMLA leave was previously taken or approved for the same reason when requesting additional leave. Your employer may request certification from a health care provider to verify medical leave and may request certification of a qualifying exigency. The FMLA does not affect any federal or state law prohibiting discrimination or supersede any state or local law or collective bargaining agreement that provides greater family or medical leave rights. State employees may be subject to certain limitations in pursuit of direct lawsuits regarding leave for their own serious health conditions. Most federal and certain congressional employees are also covered by the law but are subject to the jurisdiction of the U.S. Office of Personnel Management or Congress. What does my employer need to do? If you are eligible for FMLA leave, your employer must: x Allow you to take job-protected time off work for a qualifying reason x Continue your group health plan coverage while you are on leave on the same basis as if you had not taken leave x Allow you to return to the same job, or a virtually identical job with the same pay, benefits and other working conditions, including shift and location, at the end of your leave. Your employer cannot interfere with your FMLA rights or threaten or punish you for exercising your rights under the law. For example, your employer cannot retaliate against you for requesting FMLA leave or cooperating with a WHD investigation.

37 ©2024 United Benefit Advisors, LLC. All rights reserved. After becoming aware that your need for leave is for a reason that may qualify under the FMLA, your employer must confirm whether you are eligible or not eligible for FMLA leave. If your employer determines that you are eligible, your employer must notify you in writing: x About your FMLA rights and responsibilities x How much of your requested leave, if any, will be FMLA-protected leave. Where can I find more information? Call 1-866-487-9243 or visit dol.gov/fmla to learn more. If you believe your rights under the FMLA have been violated, you may file a complaint with WHD or file a private lawsuit against your employer in court.

38 ©2024 United Benefit Advisors, LLC. All rights reserved. Mental Health Parity and Addiction Equity Act (MHPAEA) Disclosure The Mental Health Parity and Addiction Equity Act of 2008 generally requires group health plans and health insurance issuers to ensure that financial requirements (such as co-pays and deductibles) and treatment limitations (such as annual visit limits) applicable to mental health or substance use disorder benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical/surgical benefits. For information regarding the criteria for medical necessity determinations made under the 2024 Plan Year with respect to mental health or substance use disorder benefits, please contact Contact Brannon Johnston Phone Number 770-508-3005

39 ©2024 United Benefit Advisors, LLC. All rights reserved. GINA General Notice Genetic Information Nondiscrimination Act of 2008 The Genetic Information Nondiscrimination Act of 2008 (GINA) protects employees against discrimination based on their genetic information. Unless otherwise permitted, your employer may not request or require any genetic information from you or your family members. The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employers and other entities covered by GINA Title II from requesting or requiring genetic information of an individual or family member of the individual, except as specifically allowed by this law. To comply with this law, we are asking that you not provide any genetic information when responding to this request for medical information. “Genetic information,” as defined by GINA, includes an individual’s family medical history, the results of an individual’s or family member’s genetic tests, the fact that an individual or an individual’s family member sought or received genetic services, and genetic information of a fetus carried by an individual or an individual’s family member or an embryo lawfully held by an individual or family member receiving assistive reproductive services.

40 ©2024 United Benefit Advisors, LLC. All rights reserved. USERRA Notice Your Rights Under USERRA The Uniformed Services Employment and Reemployment Rights Act USERRA protects the job rights of individuals who voluntarily or involuntarily leave employment positions to undertake military service or certain types of service in the National Disaster Medical System. USERRA also prohibits employers from discriminating against past and present members of the uniformed services, and applicants to the uniformed services. Reemployment Rights You have the right to be reemployed in your civilian job if you leave that job to perform service in the uniformed service and: x You ensure that your employer receives advance written or verbal notice of your service; x You have five years or less of cumulative service in the uniformed services while with that particular employer; x You return to work or apply for reemployment in a timely manner after conclusion of service; and x You have not been separated from service with a disqualifying discharge or under other than honorable conditions. If you are eligible to be reemployed, you must be restored to the job and benefits you would have attained if you had not been absent due to military service or, in some cases, a comparable job. Right to Be Free from Discrimination and Retaliation If you: x Are a past or present member of the uniformed service x Have applied for membership in the uniformed service x Are obligated to serve in the uniformed service

41 ©2024 United Benefit Advisors, LLC. All rights reserved. Then an employer may not deny you: x Initial employment x Reemployment x Retention in employment x Promotion x Any benefit of employment because of this status In addition, an employer may not retaliate against anyone assisting in the enforcement of USERRA rights, including testifying or making a statement in connection with a proceeding under USERRA, even if that person has no service connection. Health Insurance Protection x If you leave your job to perform military service, you have the right to elect to continue your existing employer-based health plan coverage for you and your dependents for up to 24 months while in the military. x Even if you do not elect to continue coverage during your military service, you have the right to be reinstated in your employer's health plan when you are reemployed, generally without any waiting periods or exclusions (e.g., pre-existing condition exclusions) except for service-connected illnesses or injuries. Enforcement x The U.S. Department of Labor, Veterans' Employment and Training Service (VETS) is authorized to investigate and resolve complaints of USERRA violations. x For assistance in filing a complaint, or for any other information on USERRA, contact VETS at 1-866- 4-USA-DOL or visit its Web site at http://www.dol.gov/vets. An interactive online USERRA Advisor can be viewed at http://www.dol.gov/elaws/userra.htm. x If you file a complaint with VETS and VETS is unable to resolve it, you may request that your case be referred to the Department of Justice or the Office of Special Counsel, as applicable, for representation. x You may also bypass the VETS process and bring a civil action against an employer for violations of USERRA. The rights listed here may vary depending on the circumstances. The text of this notice was prepared by VETS, and may be viewed on the Internet at this address: http://www.dol.gov/vets/programs/userra/poster.htm . Federal law requires employers to notify employees of their rights under USERRA, and employers may meet this requirement by displaying the text of this notice where they customarily place notices for employees. U.S. Department of Labor, Veterans' Employment and Training Service, 1-866-487-2365.

ADDENDUM TO THE NOTICES DISTRIBUTED IN OCTOBER 2025 – UPDATES APPLICABLE TO THE HIPAA NOTICE EFFECTIVE 2/16/2026

Notice of Privacy Practices - Updated 2/16/2026 THIS NOTICE OF PRIVACY PRACTICES DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. This Notice of Privacy Practices (the "Notice") describes the legal obligations of Snellings Walters (the "Plan") and your legal rights regarding your protected health information held by the Plan under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH Act). Among other things, this Notice describes how your protected health information may be used or disclosed to carry out treatment, payment, or health care operations, or for any other purposes that are permitted or required by law. We are required to provide this Notice of Privacy Practices to you pursuant to HIPAA. The HIPAA Privacy Rule protects only certain medical information known as "protected health information." Generally, protected health information (PHI) is health information, including demographic information, collected from you or created or received by a health care provider, a health care clearinghouse, a health plan, or your employer on behalf of a group health plan, from which it is possible to individually identify you and that relates to: a. Your past, present, or future physical or mental health or condition; b. The provision of health care to you; or c. The past, present, or future payment for the provision of health care to you. I. Contact Information If you have any questions about this Notice or about our privacy practices, and for any correspondence or requests related to the contents of this Notice, please contact Alexandra Gebara at 470-514 4868 II. Effective Date This Notice is effective February 16, 2026 III. Our Responsibilities We are required by law to: a. maintain the privacy of your PHI; b. provide you with certain rights with respect to your PHI; c. provide you with a copy of this Notice of our legal duties and privacy practices with respect to your PHI; and d. follow the terms of the Notice that is currently in effect. 1

We reserve the right to change the terms of this Notice and to make new provisions regarding your PHI that we maintain, as allowed or required by law. If we make any material change to this Notice, we will provide you with a copy of our revised Notice of P rivacy Practices. IV. How We May Use and Disclose Your PHI Under the law, we may use or disclose your PHI under certain circumstances without your permission. The following categories describe the different ways that we may use and disclose your PHI. For each category of uses or disclosures we will explain what we mean and present some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories. Note that we will use and disclose PHI as described below unless otherwise prohibited or restricted by applicable state or other law , and that information can lose its protected status as PHI once re - disclos ed by a re cipient . For Treatment. When and as appropriate, we may use or disclose medical information about you to facilitate medical treatment or services by health care providers. We may disclose medical information about you to providers, including doctors, nurses, techni cians, medical students, or other hospital personnel who are involved in taking care of you. For example, we might disclose information about you with physicians who are treating you. For Payment . We may use or disclose your protected health information to determine your eligibility for Plan benefits, to facilitate payment for the treatment and services you receive from health care providers, to determine benefit responsibility under the Plan, or to coordinate Plan coverage. For example, we may tell your health care provider about your medical history to determine whether a particular treatment is experimental, investigational, or medically necessary, or to determine whether the Plan wil l cover the treatment. We may also share your protected health information with a utilization review or pre - certification service provider. Likewise, we may share your protected health information with another entity to assist with the adjudication or subrogation of health claims or to another health plan to coordinate benefit payments. For Health Care Operations . We may use and disclose your protected health information for other Plan operations. These uses and disclosures are necessary to run the Plan. For example, we may use medical information in connection with conducting quality assessment and improvement ac tivities; underwriting, premium rating, and other activities relating to Plan coverage; submitting claims for stop - loss (or excess - loss) coverage; conducting or arranging for medical review, legal services, audit services, and fra ud and abuse detection programs; business planning and development such as cost management; and business management and general Plan administrative activities. However, we will not use your genetic information for underwriting purposes. Substance Use Disorder (SUD) Treatment Information . Some of your health information may be part of a SUD patient record and subject to additional protections under federal law (42 CFR Part 2) governing confidentiality of SUD patient records. If we receive or maintain any information about you from a SUD treatment program that is covered by 42 CFR Part 2 (a “Part 2 Program”) through a general consent you provide to the Part 2 Program to use and disclose the SUD patient record for purposes of treatment, payment or health care operations, we may use and disclose your SUD patient record for treatment, payment and health care operations purposes as described in this Notice. If we receive or maintain your SUD patient record through specific 2

consent you provide to us or another third party, we will use and disclose your SUD patient record only as expressly permitted by you in your consent as provided to us. In no event will we use or disclose your SUD patient record, or testimony that describes the information contained in your SUD patient record, in any civil, criminal, administrative, or legislative proceedings by any Federal, State, or local authority, against you, unless authorized by your consent or the order of a court after it provides y ou notice of the court order. To Business Associates . We may contract with individuals or entities known as Business Associates to perform various functions on our behalf or to provide certain types of services. In order to perform these functions or to provide these services, Business Associates will recei ve, create, maintain, transmit, use, and/or disclose your PHI, but only after they agree in writing with us to implement appropriate safeguards regarding your PHI. For example, we may disclose your PHI to a Business Associate to proce ss your claims for Plan benefits or to provide support services, such as utilization management, pharmacy benefit management, or subrogation, but only after the Business Associate enters into a Business Associate contract with us. Treatment Alternatives or Health - Related Benefits and Services . We may use and disclose your protected health information to send you information about treatment alternatives or other health - related benefits and services that might be of interest to you. As Required by Law . We will disclose your PHI when required to do so by federal, state, or local law. For example, we may disclose your PHI when required by national security laws or public health disclosure laws. To Avert a Serious Threat to Health or Safety . We may use and disclose your PHI when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat. For exampl e, we may disclose your PHI in a proceeding regarding the licensure of a physician. To Plan Sponsors . For the purpose of administering the plan, we may disclose PHI to certain employees of the Employer. However, those employees will only use or disclose that information as necessary to perform plan administration functions or as otherwise required by HIP AA, unless you have authorized further disclosures. Your PHI cannot be used for employment purposes without your specific authorization. V. Special Situations In addition to the above, the following categories describe other possible ways that we may use and disclose your PHI without your specific authorization. For each category of uses or disclosures, we will explain what we mean and present some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories. Organ and Tissue Donation . If you are an organ donor, we may release your PHI after your death to organizations that handle organ procurement or organ, eye, or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantat ion. 3

Military . If you are a member of the armed forces, we may release your PHI as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority. Workers' Compensation . We may release your PHI for workers' compensation or similar programs, but only as authorized by, and to the extent necessary to comply with, laws relating to workers' compensation and similar programs that provide benefits for work - related injuries or i llness. Public Health Risks . We may disclose your PHI for public health activities. These activities generally include the following: a. to prevent or control disease, injury, or disability; b. to report births and deaths; c. to report child abuse or neglect; d. to report reactions to medications or problems with products; e. to notify people of recalls of products they may be using; f. to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; g. to notify the appropriate government authority if we believe that a patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree, or when required or authorized by law. Health Oversight Activities . We may disclose your PHI to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws. Lawsuits and Disputes . If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. We may also disclose your PHI in response to a subpoena, discovery request, or other lawful process by someone involved in a legal dis pute, but only if efforts have been made to tell you about the request or to obtain a court or administrative order protecting the information requested. Law Enforcement . We may disclose your PHI if asked to do so by a law - enforcement official. a. in response to a court order, subpoena, warrant, summons, or similar process; b. to identify or locate a suspect, fugitive, material witness, or missing person; c. about the victim of a crime if, under certain limited circumstances, we are unable to obtain the victim's agreement; d. about a death that we believe may be the result of criminal conduct; and e. about criminal conduct. 4

© 202 6 Lumelight. All Rights Reserved. Coroners, Medical Examiners, and Funeral Directors . We may release PHI to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients to funeral directors, as necessary to carry out their duties. National Security and Intelligence Activities . We may release your PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law. Inmates . If you are an inmate of a correctional institution or are in the custody of a law - enforcement official, we may disclose your PHI to the correctional institution or law - enforcement official if necessary (1) for the institution to provide you with health c are; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution. Research . We may disclose your PHI to researchers when: a. The individual identifiers have been removed; or b. When an institutional review board or privacy board has reviewed the research proposal and established protocols to ensure the privacy of the requested information and approves the research. VI. Required Disclosures The following is a description of disclosures of your PHI we are required to make. Government Audits . We are required to disclose your PHI to the Secretary of the United States Department of Health and Human Services when the Secretary is investigating or determining our compliance with the HIPAA privacy rule. Disclosures to You . When you request, we are required to disclose to you the portion of your PHI that contains medical records, billing records, and any other records used to make decisions regarding your health care benefits. We are also required, when requested, to provid e you with an accounting of most disclosures of your PHI if the disclosure was for reasons other than for payment, treatment, or health care operations, and if the PHI was not disclosed pursuant to your individual authorization. VII. Other Disclosures Personal Representatives . We will disclose your PHI to individuals authorized by you, or to an individual designated as your personal representative, attorney - in - fact, etc., so long as you provide us with a written notice/authorization and any supporting documents (i.e., power of attorney). Note: Under the HIPAA privacy rule, we do not have to disclose information to a personal representative if we have a reasonable belief that: a. You have been, or may be, subject to domestic violence, abuse, or neglect by such person; or b. Treating such person as your personal representative could endanger you; and c. In the exercise of professional judgment, it is not in your best interest to treat the person as your personal representative. 5

Spouses and Other Family Members . With only limited exceptions, we will send all mail to the employee. This includes mail relating to the employee's spouse and other family members who are covered under the Plan and includes mail with information on the use of Plan benefits by the employee's spouse and other family members and information on the denial of any Plan benefits to the employee's spouse and other family members. If a person covered under the Plan has reque sted Restrictions or Confidential Communications (see below under "Your Rights"), and if we have agreed to the request, we will send mail as provided by the request for Restrictions or Confidential Communications. Authorizations . Other uses or disclosures of your PHI not described above will only be made with your written authorization. For example, in general and subject to specific conditions, we will not use or disclose your psychiatric notes; we will not use or disclose your PHI for marketing; and we will not sell your PHI, unless you give us a written authorization. You may revoke written authorizations at any time, so long as the revocation is in writing. Once we receive your written revocation, it will only be effective for future uses and disclosures. It will not be effective for any information that may have been used or disclosed in reliance upon the written authorization and prior to receiving your written revocation. VIII. Your Rights You have the following rights with respect to your PHI: Right to Inspect and Copy . You have the right to inspect and copy certain PHI that may be used to make decisions about your Plan benefits. If the information you request is maintained electronically, and you request an electronic copy, we will provide a copy in the electronic form and format you request, if the information can be readily produced in that form and format; if the information cannot be readily produced in that form and format, we will work with you to come to an agreement on form and format. I f we cannot agree on an electronic form and format, we will provide you with a paper copy. To inspect and copy your PHI, you must submit your request in writing. If you request a copy of the information, we may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to your medical information, you may request that the denial be reviewed by submitting a written request. Right to Amend . If you feel that the PHI we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the Plan. To request an amendment, your request must be made in writing. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that: a. is not part of the medical information kept by or for the Plan; b. was not created by us, unless the person or entity that created the information is no longer available to make the amendment; 6

c. is not part of the information that you would be permitted to inspect and copy; or d. is already accurate and complete. If we deny your request, you have the right to file a statement of disagreement with us and any future disclosures of the disputed information will include your statement. Right to an Accounting of Disclosures . You have the right to request an "accounting" of certain disclosures of your PHI. The accounting will not include (1) disclosures for purposes of treatment, payment, or health care operations; (2) disclosures made to you; (3) disclosures made pursuant to your authorization; (4) disclosures made to friends or family in your presence or because of an emergency; (5) disclosures for national security purposes; and (6) disclosures incidental to otherwise permissible disclos ures. To request this list or accounting of disclosures, you must submit your request in writing. Your request must state the time period you want the accounting to cover, which may not be longer than six years before the date of the request. Your request should indicate in what form you want the list (for example, paper or electronic). The first list you request within a 12 - month period will be provided free of charge. For additional lists, we may charge you for the costs of providing the list. We will notify yo u of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred. Right to Request Restrictions . You have the right to request a restriction or limitation on your PHI that we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on your PHI that we disclose to someone who is involved in your ca re or the payment for your care, such as a family member or friend. For example, you could ask that we not use or disclose information about a surgery that you had. Except as provided in the next paragraph, we are not required to agree to your request. However, if we do agree to the request, we will honor the restriction until you revoke it or we notify you. We will comply with any restriction request if (1) except as otherwise required by law, the disclosure is to a health plan for purposes of carrying out payment or health care operations (and is not for purposes of carrying out treatment); and (2) the PHI p ertains solely to a health care item or service for which the health care provider involved has been paid in full by you or another person. To request restrictions, you must make your request in writing. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both; and (3) to whom you want the limits to apply - for example, disclosures to your spouse. Right to Request Confidential Communications . You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing. We will not ask you the reason for your request. Your request must specify how or where you wish to be contacted. We will accommodate all reasonable requests. Right to Be Notified of a Breach . You have the right to be notified in the event that we (or a Business Associate) discover a breach of unsecured PHI. 7

Right to a Paper Copy of This Notice . You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. IX. Complaints I f you believe that your privacy rights have been violated, you may file a complaint with the Plan or with the Office for Civil Rights of the United States Department of Health and Human Services. To file a complaint with the Plan, contact the person listed in the Contact Information section of this Notice . All complaints must be submitted in writing. You will not be penalized, or in any other way retaliated against, for filing a complaint with the Office for Civil Rights or with us. The language of this notice was provided by © 2026 Lumelight. All Rights Reserved. with the intent of complying with HIP A A update notices. Feb 2026 Lumelight is not a law firm and cannot dispense legal advice. Anything contained in this communication is not and should not be construed as legal advice. If you need legal advice, please contact your legal counsel. 8